bluuebunny/crossref_metadata_2025 huggingface dataset:
A Prospective Study of Panic and Anxiety in Agoraphobia with Panic Disorder
Authors: Başoǧlu Metin , Marks Isaac M. , Şengün Seda
Published: October 2008

The features of panic and anxiety in the natural environment were studied by prospective self-monitoring in 39 patients with chronic agoraphobia and panic disorder. Panics overlapped greatly with anxiety episodes but were more intense. Panics occurred more often in public places than did anxiety episodes, but had otherwise similar symptom profile, time of occurrence, and antecedents. Most panics surged out of a pre-existing plateau of tonic anxiety which lasted most of the day. Spontaneous panics were less frequent than situational panics and occurred more often at home but were otherwise similar. These findings do not support the sharp distinction between panic and anxiety in DSM–III–R, not its emphasis on spontaneous panic in classifying anxiety disorders. Thoughts of dying and ‘going crazy’/losing control accompanied only a minority of panic/anxiety episodes and seemed to be a product of intense panic rather than a cause.
Season of Birth of Siblings of Schizophrenic Patients
Authors: Pulver Ann E. , Liang Kung-Yee , Wolyniec Paula S. , Mcgrath John , Melton Beth A. , Adler Lawrence , Childs Barton
Published: October 2008

The hypothesis that mothers of winter–spring-born schizophrenics have an unusual pattern of conception which results in an excess of winter–spring births was tested by studying the distribution of birth-dates of 401 siblings of 120 winter–spring-born schizophrenics and 157 siblings of 59 winter–spring-born controls. All analyses were gender-specific. The results suggest there is no association between the probability of a winter–spring date of birth and being a sibling of a winter–spring–born schizophrenic or control.
Marital Support and Recovery from Depression
Authors: Goering P. N. , Lancee W. J. , Freeman S. J. J.
Published: October 2008

A prospective study of 47 married women who met RDC for major depressive disorder investigated the relationship between the social support provided by the husbands and the post-hospital symptom course of the women. Separate taped semistructured interviews were held with the patient and husband at the time of admission. Six months later, symptom course was rated using the LIFE psychiatric status schedule. Only 51 % of the sample recovered in the six months. Few demographic or clinical factors were related to symptom course. Recovery was predicted by the depressed woman's ratings of the current marital relationship and by the husband's rating of the pre-morbid relationship but not by the husband's level of expressed criticism or his ratings of the current relationship.
Out-patient Compliance with Antidepressant Medication
Authors: Myers E. D. , Branthwaite Alan
Published: October 2008

A total of 89 depressed out-patients were randomly allocated to one of three groups: group A received one dose of antidepressant medication at night; group B received three doses of medication during the day; group C were allowed to choose either A or B above. Compliance with medication was assessed at three, six, nine and 12 weeks by interrogation and pill count; at the same time, depression and side-effects were rated. No overall significant difference was found between doctor-prescribed and patient-chosen regime, or between once-a-day and three-times-a-day dosage. However, compliance was significantly better in those patients who were allowed to choose, when they selected the three-times-a-day regime. There was a significant decline in compliance for all regimes over the 12 weeks. There was no evidence that better compliance produced a better therapeutic result, and possible reasons are given for this finding.
Is Hysteria on the Wane?
Authors: Nandi D. N. , Banerjee Gauranga , Nandi Sabyasachi , Nandi Parthasarathi
Published: October 2008

A field survey was conducted in two villages – Gambhirgachi and Paharpur – in 1972. The survey was repeated after 10 years in the former village and after 15 years in the latter one. The second survey showed very little change in the rate of total mental morbidity. The rate of prevalence of hysteria declined significantly in both villages. In Gambhirgachi the rate of hysteria dropped from 16.9 to 4.6 per 1000 in 10 years, and in Paharpur it dropped from 32.3 to 2.05 per 1000 in 15 years.
Childhood Sexual Experiences with Adults Reported by Female Psychiatric Patients
Authors: Palmer R. L. , Chaloner D. A. , Oppenheimer R.
Published: October 2008

A group of 115 female psychiatric in-patients and out-patients were studied, using a self-report questionnaire followed by interview, for evidence of childhood sexual activity with adults. About half of the sample reported some childhood sexual experience, ranging from full sexual intercourse to sexual suggestions. Future research should study the possible role of such experience in the genesis of subsequent psychiatric disorder.
Psychosocial Family Intervention in Schizophrenia: A Review of Empirical Studies
Authors: Kuipers L. , Birchwood M. , McCreadie R. G.
Published: October 2008

“This paper reviews the recent empirical studies on psychosocial family intervention in schizophrenia. Six family educational intervention studies and five more intensive family work studies with 2-year follow-up have been included. A series of questions is asked relating to the effects of such interventions, the efficacy of the different educational models, the active ingredients of these multi-component treatment packages, and the contribution of this new generation of studies to our understanding of the mechanisms through which these interventions work. Suggestions for further research are made. Finally, from the published manuals, the common components of these diverse, multi-component treatment packages of different family-intervention studies are identified.”
Research on Symptoms Versus Research on Syndromes
Authors: Costello Charles G.
Published: October 2008

Research on symptoms may often be more fruitful than research on syndromes because: (a) the validities of psychiatric diagnoses remain questionable; (b) interview assessments of a large number of symptoms are inadequate; (c) the diagnostic approach results in problems of misclassification and confounding; (d) the dimensional/categorical issue may be more readily resolved with research using a symptom approach; (e) useful animal models of symptoms are more likely to be developed than useful animal models of syndromes; and (f) symptoms may be better phenotypes than syndromes in genetic research.
New Treatments for Erectile Impotence
Authors: Gregoire Alain
Published: October 2008

The range of interventions available for the treatment of erectile failure has increased in the past ten years. A significant development is intracavernosal injection of vasoactive drugs, but this treatment is far from ideal. Other, less invasive, pharmacological interventions are being investigated; as yet, none of these appear effective enough to have any significant clinical impact. External vacuum devices are a viable option for some patients, and penile prostheses have become increasingly sophisticated, although research examining their benefits has not. The range of available treatment methods and the growing complexity of the assessment for erectile problems demands an eclecticism of approach which can best be provided by multidisciplinary clinics specialising in sexual dysfunctions.
Charles Bonnet's Description of Cotard's Delusion and Reduplicative Paramnesia in an Elderly Patient (1788)
Authors: Förstl Hans , Beats Barbara
Published: October 2008

An elderly woman developed the delusion that she was dead (‘Cotard's delusion’) and that she was in another place (‘reduplicative paramnesia’). Charles Bonnet reported this unique combination of symptoms a century before Cotard's influential description of the nihilistic delusions and of Pick's description of ‘reduplicative paramnesia’.
Binge Eating and Weight Concerns among Young Adults
Authors: Vollrath Margarete , Koch Regula , Angst Jules
Published: October 2008

In the longitudinal cohort study of young adults from the Canton of Zurich in Switzerland, two groups of eating problems were defined: binge eating and weight concerns. Subjects with these conditions were interviewed at the ages of 27–28 and 29–30 years. The binge eaters, mostly women, differed both from subjects with weight concerns and from controls. They had more severe eating problems and more anxiety and depression. Follow-up as well as retrospective data suggest that eating problems are persistent for the binge eaters, and, to a lesser extent, also for subjects with weight concerns. Even so, professional treatment is rarely sought by subjects with eating problems. These findings encourage long-term studies on eating problems in community samples.
Art Imitates Life: Déjà vu Experiences in Prose and Poetry
Authors: Sno Herman N. , Linszen Don H. , De Jonghe Frans
Published: October 2008

The déjà vu experience is a subjective phenomenon that has been described in many novels and poems. Here we review over 20 literary descriptions. These accounts are consistent with the data obtained from psychiatric literature, including various phenomenological, aetiological and psychopathogenetic aspects of the déjà vu experience. The explanations, explicitly formulated by creative authors, include reincarnation, dreams, organic factors and unconscious memories. Not infrequently, an association with defence or organic factors is demonstrable on the basis of psychoanalytic or clinical psychiatric interpretation. The authors recommend that psychiatrists be encouraged to overstep the limits of psychiatric literature and read prose and poetry as well.
A Misleading Case of Central Pontine Myelinolysis
Authors: McColl Peter , Kelly Christopher
Published: October 2008

Central pontine myelinolysis (CPM) is an uncommon disorder initially described in alcoholic or malnourished patients. Recent reports suggest an aetiological association with abnormalities of serum sodium. A physically unwell non-alcoholic chronic schizophrenic patient, whose symptoms led to psychiatric referral, died of CPM. A review of the literature reveals that psychiatric patients may indeed be at risk for CPM.

British Journal of Psychiatry(1992),160, 550–552
The Role of Right Hemisphere Dysfunction in Psychiatric Disorders
Authors: Cutting John
Published: October 2008

In 1861 Broca, a Parisian surgeon, reported a postmortem he had carried out on a man who had lost his ability to speak 20 years previously and who in the intervening period had only regained the use of one phrase: “Tan-tan”. Broca found that this man had an old infarct in his left hemisphere, affecting the posterior portions of the second and third frontal gyri.
The Effect of Neuroleptics on Cognitive and Psychomotor Function
Authors: King David J. , Henry Geraldine
Published: October 2008

The effects of haloperidol (1 mg), benzhexol (5 mg), diazepam (10 mg) and caffeine (400 mg) on subjective and objective measures of cognitive and psychomotor function were compared with placebo in 20 healthy volunteers. While both diazepam and benzhexol were associated with highly significant impairments in subjective alertness, critical flicker fusion threshold and choice reaction time (CRT), haloperidol could not be distinguished from placebo in most tests but was actually associated with an apparent improvement in CRT (in males) and simple visual reaction time. The perceptual maze test detected impairment by benzhexol on processing speed but was not sensitive to any other drug effects. Multiple-dose studies are required to establish if there is a true activating effect of haloperidol using a test of sustained attention. No effect of Eysenck personality subtype or life events on baseline or drug response data was detected.
Trace Elements and the Electroencephalogram During Long-term Lithium Treatment
Authors: Harvey Norman S. , Jarratt John , Ward Neil I.
Published: October 2008

Endogenous bromine has been found to be raised during lithium treatment, and it has been suggested that it may augment the therapeutic effect of lithium. Our findings in a study of 12 patients and 12 controls support this contention. Electroencephalographic effects of bromine, vanadium and aluminium were studied – higher bromine and vanadium levels were associated with irregular cortical activity. Electroencephalographic abnormalities were associated with more side-effects of lithium.
Feelings of Guilt in Major Depression
Authors: Berrios G. E. , Bulbena A. , Bakshi N. , Dening T. R. , Jenaway A. , Markar H. , Martin-Santos R. , Mitchell S. L.
Published: October 2008

A new scale for the evaluation of feelings of guilt is described. Two types of guilt feeling were of potential interest: ‘delusional’ guilt or shame (experienced in relation to one's actions), and ‘affective’ guilt (a more general feeling of unworthiness). Reliability and validity analyses for the first (15–item) version of the scale were performed in three separate and contrasting clinical samples. The second and final (seven-item) version was tested in another sample of major depressives and in normal controls. The HRSD was used as a measure of severity throughout. The BDI and Widlöcher psychomotor retardation scale were also used as external criteria for the seven-item scale. Exploratory factor analysis of this sample yielded two factors – ‘cognitive/attitudinal’ and ‘mood/feeling’ – of which only the first correlated with scores for psychomotor retardation. It is suggested that these two factors represent two forms of guilt, but that only the former is related to a putative dopaminergic disorder. Guilt scores and measures of severity were not correlated. It is suggested that feelings of guilt should be considered as a behavioural marker for a subtype of depression.
Rapid Tranquillisation
Authors: Pilowsky L. S. , Ring H. , Shine P. J. , Battersby M. , Lader M.
Published: October 2008

Rapid tranquillisation – giving a psychotropic to control behavioural disturbances – is common in medical practice, yet few surveys describe its use in psychiatric populations. Over five months, 102 incidents, involving 60 patients, were retrospectively surveyed. Patients most often involved were young white men. The commonest diagnosis was affective disorder (manic phase) (39%) followed by schizophrenia (33%). Fifteen patients were involved in 57% of the incidents. The majority of incidents involved injury to people or damage to property. The most frequently used drugs were diazepam and haloperidol, alone or in combination. Droperidol, chlorpromazine, sodium amytal and paraldehyde were rarely used. Diazepam alone or in combination with haloperidol delivered intravenously was most rapidly effective and was associated with greatest staff satisfaction. Serious side-effects were rare.
Training Community Psychiatric Nurses for Psychosocial Intervention
Authors: Brooker Charles , Tarrier Nicholas , Barrowclough Christine , Butterworth Anthony , Goldberg David
Published: October 2008

Community psychiatric nurses were trained to deliver psychosocial intervention to clients with a diagnosis of schizophrenia living at home with relatives. The training package consisted of family assessment, health education, and family stress management strategies. In a ‘quasi-experimental’ design, a sample of families (n = 54) were recruited to either a control or experimental condition and followed up for 12 months. A number of favourable outcomes were observed in the experimental group, including improvements in the client's target symptoms, personal functioning, and social adjustment. Relatives' satisfaction with services increased and reports of their own minor psychiatric morbidity improved.
Minaprine in Depression
Authors: Wheatley David
Published: October 2008

Minaprine (200 mg daily, either once or divided b.d.) was compared with amitriptyline (25–50 mg t.d.s.) over six weeks in 144 patients with major depression. Significant reductions in HRSD scores at the end of six weeks' treatment were recorded with both dose regimes of minaprine and with amitriptyline, with no significant differences between them. There was a significantly greater incidence of drowsiness and dry mouth with amitriptyline than with minaprine.
Evidence for a Pseudoautosomal Locus for Schizophrenia
Authors: Gorwood Ph. , Leboyer M. , D'Amato T. , Jay M. , Campion D. , Hillaire D. , Mallet J. , Feingold J.
Published: October 2008

A locus for schizophrenia within the pseudoautosomal region of chromosomes X and Y has been suggested by Crow on the basis of epidemiological data. The present report replicates this finding in a sample of 38 French multiply affected families with schizophrenia. Sibship and pairwise analysis, with or without weighted-pair correction, with three different systems of family classifications, showed there to be an excess of same-sex pairs in paternally derived sibships, as predicted by the pseudoautosomal hypothesis.
Anna O. Had a Severe Depressive Illness
Authors: Merskey Harold
Published: October 2008

The information available on the illness of Anna 0. is reviewed together with follow-up data from the literature. It is concluded that the diagnosis of a severe depressive illness with depressive delusions is well justified. Hysterical symptoms which appeared can be understood as part of the depressive state modified by the expectations of the period and by the intervention of physicians. The illness was a very protracted one, with fluctuations or exacerbations lasting from 1880 to 1887, and was complicated by dependence upon morphine and chloral hydrate. However, by 1888, the patient appears to have made a considerable recovery, and she went on to lead an effective and fruitful life, demonstrating high intelligence and the resilience of the cyclothymic temperament.
Women Whose Mental Illnesses Recur after Childbirth and Partners' Levels of Expressed Emotion During Late Pregnancy
Authors: Marks M. N. , Wieck A. , Seymour A. , Checkley S. A. , Kumar R.
Published: October 2008

Expressed emotion (EE) in the partners of 25 pregnant women with a history of psychosis or severe depression and in 13 pregnant control subjects without any previous psychiatric disorder was assessed in the ninth month of pregnancy. At this time, no patient presented as a case according to RDC. Eleven subjects with a history of psychiatric disorder experienced a further episode of illness in the six months following delivery. Partners of women who became ill had made fewer critical and positive comments about their wives during the pregnancy than the partners of women who remained well. Poor self-rated social adjustment in the partners was also predictive of recurrence of illness after delivery.
Life-Threatening Allergic Reaction to Clozapine
Authors: Stoppe Gabriela , Müller Peter , Fuchs Thomas , Rüther Eckart
Published: October 2008

Clozapine, an ‘atypical’ antipsychotic drug, rarely induces allergic complications, which usually present as cutaneous reactions. We report the case of a 69-year-old woman, suffering from chronic schizophrenia, who developed an allergic asthmatic reaction following clozapine therapy. Intensive-care treatment was necessary. The reaction could be repeated by further exposure to the drug. Skin tests for hypersensitivity were negative.
Visual Hallucinations as the Presenting Symptom of Senile Dementia
Authors: Haddad Peter M. , Benbow Susan M.
Published: October 2008

A case of senile dementia that initially presented with complex visual hallucinations in the absence of clinical cognitive impairment or other psychopathology is described. Dementia must be added to the differential diagnosis of isolated visual hallucinations in the elderly.
Plasma Melatonin Levels in Anorexia Nervosa
Authors: Arendt Josephine , Bhanji S. , Franey Christine , Mattingly D.
Published: October 2008

Plasma melatonin levels were measured at three-hourly intervals over 24 hours in 11 women with untreated anorexia nervosa, and in nine healthy women of normal weight. The circadian rhythm was unaltered but the nocturnal secretion of melatonin was significantly greater in anorectics. It is possible that this was related to nocturnal hypoglycaemia.
Suicide and Self-burning Among Indians and West Indians in England and Wales
Authors: Raleigh V. Soni , Balarajan R.
Published: October 2008

Suicide levels in England and Wales during 1979–83 were low among males from the Indian subcontinent (SMR 73) and significantly high in young Indian women (age-specific ratios 273 and 160 at ages 15–24 and 25–34 respectively). Suicide levels were low in Caribbeans (SMRs 81 and 62 in men and women respectively) and high in East Africans (SMRs 128 and 148 in men and women respectively). The excess in East Africans (most of whom are of Indian origin) was largely confined to younger ages. Immigrant groups had significantly higher rates of suicide by burning, with a ninefold excess among women of Indian origin. The pressures leading to higher suicide levels among young women of Indian origin highlight the need for making appropriate forms of support and counselling available to this community.
Failure of a Binaural Comprehension Deficit to Select Responders to Earplug use in Schizophrenia
Authors: Luchins Daniel J. , Dyson Vida , Hanrahan Patricia , Marks Robert , Blake Lesley
Published: October 2008

Previous studies have suggested that on the Auditory Comprehension Test, a significant proportion of schizophrenics demonstrate a binaural comprehension deficit. To test whether wearing an earplug in their more poorly performing ear would be beneficial, we studied 34 in-patient schizophrenics and noted a binaural deficit in 12 (35%). Of these, eight patients subsequently wore an earplug in each ear for at least one week. We found no effect of the earplug on psychopathology.
Supersensitivity Psychosis with Concurrent Episodic Vomiting
Authors: Malcolm Katy
Published: October 2008

A patient with a 15-year history of psychiatric illness treated with neuroleptics presented with vomiting, thought alienation, auditory hallucinations and self-neglect. Dopaminergic supersensitivity was diagnosed and increased doses of neuroleptics caused cessation of vomiting. The patient is currently attempting discontinuation of neuroleptics.
Sex and Schizophrenia: Vive la Différence
Authors: Lewis Shón
Published: October 2008

Epidemiological research in schizophrenia is back in fashion and has taken an iconoclastic turn. Received truths about schizophrenia had a reassuring stability about them, rather like Euclidean geometry. In contrast to, and perhaps in reaction to, the frustrating nebulousness of the disorder itself, its distribution had the attributes of a universal constant: incidence and symptoms unchanging over time and across space–and between the sexes. Dissenting voices were few, but now are growing in number and volume. One sex difference, that of age at onset of schizophrenia, has been accepted since Kraepelin's time, although is still unexplained. But sex differences in incidence, course, and symptoms are now being mooted which hint at sex-dependent differences in aetiology. Much of the re-examination of this issue has sprung from the work of Jill Goldstein and colleagues at Harvard, Robin Murray, David Castle, and colleagues at the Institute of Psychiatry, as well as others, such as Mathias Angermeyer in Mannheim.
Incidence and Other Aspects of the Epidemiology of Schizophrenia in Denmark, 1971–87
Authors: Munk-J⊘rgensen Povl , Mortensen Preben Bo
Published: October 2008

All Danish psychiatric patients admitted to hospital for the first time in the period 1969–88 with a diagnosis of schizophrenia given at least once during the period were included in the study. More than 8500 patients were examined in the Danish nationwide psychiatric register. First-admission rates decreased by approximately 50% irrespective of mode of calculation and increase in SMR. The use of in-patient care was unchanged despite a reduction in available beds of more than 40% in the study period.
The Edinburgh Cohort of HIV-Positive Drug Users: Pattern of Cognitive Impairment in Relation to Progression of Disease
Authors: Egan Vincent , Brettle Ray P. , Goodwin Guy M.
Published: October 2008

To examine the neuropsychiatric effects of infection with HIV, 220 drug users (27 HIV negative, 193 HIV positive) completed tests evaluating premorbid intelligence, memory, non-verbal performance, information processing speed, and mood. When these measures were compared cross-sectionally by the severity of HIV illness, symptomatic patients (in CDC stage IV) were impaired on Trails B, two-choice decision time, delayed recall of the Wechsler Logical Memory Test and most components of the Auditory Verbal Learning Test. These findings imply reduced capacity for concentration, speed of thought and memory. When 101 patients were retested a mean of 16 months after their initial assessment, performance on Trails A and B, Block Design and delayed recall of the Wechsler Logical Memory Test deteriorated more for patients at, or progressing within, CDC stage IV, than performance of patients at stage III. The results broadly correspond to the cross-sectional findings. However, there was a decline in all tests of memory function for the sample independent of clinical staging. This may be evidence of brain involvement before the appearance of other symptoms. Self-rated measures of mood did not change cross-sectionally, progressively, or interactively with time and stage of HIV illness, and cannot account for the changes in cognitive function observed. Change in drug use, similarly, does not account for the cognitive findings. Four (5%) of the retested subjects developed AIDS dementia complex, but most of the performance and memory impairments seen were subclinical despite the destructive neuropathology presumed to underlie intellectual decline in patients with HIV infection. An exploratory analysis of treatment with zidovudine in 65 patients with stage IV disease showed no demonstrable benefit for cognitive function.
Bulimia Nervosa in Hong Kong Chinese Patients
Authors: Lee Sing , Hsu L. K. George , Wing Y. K.
Published: October 2008

In contrast to the West, bulimic disorders are rarer than anorexia nervosa in Hong Kong. Four female normal-weight bulimic patients with mostly typical clinical features and conspicuous morbidity are reported. The case histories support the hypothesis that binge-eating is used to regulate unpleasant affect.
Chromosomal Aberrations in a Patient with Severe Psychopathology
Authors: Akner Gunnar , Gustavson Karl-Henrik , Håkansson Eva , Sääf Jan , Kiessling Hans , Yuwiler Arthur , Wetterberg Lennart
Published: October 2008

The case of a female patient showing aggressive, compulsive, destructive behaviour, ritualistic faecal smearing, and hyperactivity is presented. The behaviour is long standing, therapy-resistant, and its aetiology is unknown, although it is seemingly associated with chromosomal abnormalities secondary to abnormal plasma factors.
Lower Incidence and Increased Male: Female Ratio in Schizophrenia
Authors: Nicole Luc , Lesage Alain , Lalonde Pierre
Published: October 2008

Patients with an ICD–9 diagnosis of psychotic disorder were assessed for DSM–III–R schizophrenia. Rates of schizophrenia were found to be higher in males (39.8 per 100 000) than females (22.4 per 100 000). The DSM–III–R Incidence supports recent studies which suggest a decrease in rates of schizophrenia across time, and also suggests that men suffer from both more schizophrenia and a more severe form of the disease.
Catatonia and the Neuroleptic Malignant Syndrome – a Single Entity?
Authors: White D. A. C.
Published: October 2008

Separate episodes of both catatonia and the so-called ‘neuroleptic malignant syndrome’ (NMS) occurred within the same patient. The only evidence for NMS in this case was prior administration of a neuroleptic and the presence of generalised muscular rigidity. It is suggested that it is misleading to view these conditions as separate diagnostic entities and that NMS is probably more correctly incorporated into the catatonic disorders.
Combination Treatment with Noradrenalin and Serotonin Reuptake Inhibitors in Resistant Depression
Authors: Seth R. , Jennings A. L. , Bindman J. , Phillips J. , Bergmann K.
Published: October 2008

Eight cases of resistant recurrent depression were treated with a combination of nortriptyline and a new serotonin reuptake inhbitor, with or without concurrent lithium therapy. Significant improvement was seen in all patients where other drug regimes and ECT had been ineffective. No adverse reactions occurred in any of our patients, seven of whom were elderly. The combination treatment was more effective than individual therapies alone.
Déjà Vu Experiences and Reduplicative Paramnesia
Authors: Sno Herman N. , Linszen Don H. , De Jonghe Frans
Published: October 2008

A schizophrenic patient with different forms of experiences of inappropriate familiarity is described. The authors discuss traumatic experiences as aetiological factors in déjà vu experiences and reduplicative paramnesia. Finally, the differential diagnostic problem in psychotic and dissociative phenomena is stressed.
Life Events and Schizophrenic Relapse after Withdrawal of Medication
Authors: Ventura Joseph , Nuechterlein Keith H. , Hardesty Jean Pederson , Gitlin Michael
Published: October 2008

Research with schizophrenic out-patients has shown that antipsychotic medication reduces relapse rates. This protective factor may operate partially by raising the threshold for relapse in the face of environmental stressors such as life events and high levels of familial expressed emotion. A prospective, longitudinal design was employed in the monthly collection of life-events data with 23 recent-onset schizophrenic out-patients. In a between-subjects ANOVA, a significantly higher frequency of independent life events was found in the month prior to a relapse for ten patients on medication, as compared with the analogous month for 13 drug-free patients. These findings suggest that neuroleptic medication may produce a prophylactic effect by raising a patient's threshold of vulnerability to relapse.
Salivary Testosterone Levels and Major Depressive Illness in Men
Authors: Davies R. Huw , Harris Brian , Thomas D. Roger , Cook Nigel , Read Graham , Riad-Fahmy Diana
Published: October 2008

Studies of testosterone levels in patients with major depressive illness have produced varying results, plasma levels usually being reported. Saliva levels reflect ‘free’ plasma testosterone, and a pilot study of 11 men with major depression with melancholia, who underwent a standard dexamethasone suppression test, is described. There were no significant differences in testosterone levels compared with an age-matched control group. In the patient group, pre-dexamethasone levels correlated significantly and negatively with depression ratings on the 21–item Hamilton and the Montgomery and åsberg depression scales, and also with state anxiety measured on the Spielberger scale.
The Use of Image Habituation Training with Post-traumatic Stress Disorders
Authors: Vaughan Kevin , Tarrier Nicholas
Published: October 2008

An exposure treatment for patients suffering from post-traumatic stress disorder (PTSD) is described. Image habituation training (IHT) involves the patient in generating verbal descriptions of the traumatic event and recording these onto an audiotape. After the initial training session with the therapist, homework sessions of self-directed exposure in which the patient visualised the described event in response to listening to the audiotape were carried out. Of ten consecutive patients who received this treatment, six improved considerably after ten homework sessions, two showed moderate improvements, and two showed minimal improvement on a range of outcome measures. There were significant decreases in anxiety between and within homework sessions, suggesting that habituation did occur and was responsible for improvement. Treatment gains were maintained at six-month follow-up.
Differential Rates of Psychiatric Disorders in Adults with Down's Syndrome Compared with Other Mentally Handicapped Adults
Authors: Collacott Richard A. , Cooper Sally-Ann , McGrother Catherine
Published: October 2008

The total number of adults with Down's syndrome living in Leicestershire, ascertained by widespread enquiry, was found to be 378. Of these, 371 were matched with adults with mental handicap due to other pathologies, on the basis of age, sex, and type of residence. Those with Down's syndrome were found to have a different spectrum of mental disorders from those without the syndrome. In particular, Down's syndrome patients were more likely to have been diagnosed as having depression and dementia; the controls were more likely to have been diagnosed as suffering from conduct disorder, personality disorder, or schizophrenia/paranoid state. The same proportion of each group had been given a diagnosis of autism.
The Effect of Age and Residential Placement on Adaptive Behaviour of Adults with Down's Syndrome
Authors: Collacott Richard A.
Published: October 2008

Through widespread enquiry, the population of adults with Down's syndrome (aged over 18 years) in Leicestershire was estimated at 376. For 315 of these (83.8%), the immediate carer was invited to complete the Adaptive Behavior Scale (ABS). Completed ABS assessments were obtained on 81.9% of the adult population with Down's syndrome in the county. Additional information concerning residential history was obtained. When the sample was divided into five cohorts on the basis of age when the ABS assessment took place, an exponential decline in ability was observed. Deterioration in most domains of the ABS achieved statistical significance in the cohort aged 50–59, and in all domains in those aged 60 and over. The deterioration in global skills in older cohorts was attributed to ageing (and thereby probably Alzheimer's disease). Institutional placement was associated with low scores in younger groups only.
Diagnoses are not Diseases
Authors: Mindham R. H. S. , Scadding J. G. , Cawley R. H.
Published: October 2008

The psychiatric community seems determined to ground its medical legitimacy on principles that confuse diagnoses with disease. If mental illnesses are diseases of the CNS, they are diseases of the brain, not the mind. If mental illnesses are the names of (mis)behaviour, they are forms of behaviour, not diseases. Psychiatric metaphors have the same role in medicine as religious metaphors have in theology. Religion is, among other things, the institutionalised denial of a finite life. Psychiatry is, among other things, the institutionalised denial of the tragic nature of life: individuals who want to reject the reality of free will and responsibility can medicalise life, and entrust its management to health professionals. Psychiatrists have succeeded in persuading the scientific community, the courts, the media, and the general public that the conditions they call mental disorders are diseases, that is, phenomena independent of motivation or will. The more firmly psychiatrically based ideas take hold of the collective American mind, the more foolishness and injustice they generate. Long ago, the law makers agreed to let psychiatrists literalise the metaphor of mental illnesses. Thus, the Americans With Disabilities Act (AWDA), scheduled to be fully implemented by July 1992, covers claustrophobia, personality problems, and mental retardation, though unlike DSM–III–R it excludes kleptomania, pyromania, compulsive gambling, and transvestism. The literal language of psychiatry allows motivated actions to be called ‘diseases'. Other examples of behaviour for which psychiatrists have disease names, and which AWDA implicitly accepts as genuine diseases, include dysmorphophobia, multiple personality disorder, frotteurism, hypoactive sexual desire disorder, and factitious disorder with physical symptoms. However, it remains an open question whether premenstrual syndrome will achieve similar recognition in DSM–IV. Diseases occur naturally, whereas diagnoses are artefacts; why do psychiatrists make diagnoses?
Puerperal Affective Psychosis: is There a Case for Lithium Prophylaxis?
Authors: Austin M-P. V.
Published: October 2008

It is well known that women with a history of manic-depressive or puerperal affective psychosis are at particularly high risk of relapse in the puerperium. This paper describes the use of lithium given during or after pregnancy to women with a history of bipolar illness or puerperal affective psychosis. The rate of puerperal relapse in these subjects was compared with that in a similar group of women not on lithium. The significantly better outcome of the treatment group highlights the need for a prospective controlled trial looking at the effectiveness of lithium in minimising puerperal bipolar relapse.
A Transsexual Male with 47, XYY Karyotype
Authors: Taneja Neelam , Ammini A. C. , Mohapatra Itu , Saxena Shekhar , Kucheria Kiran
Published: October 2008

Transsexuals are usually found to have a normal chromosome complement. The literature to data documents four transsexuals with 47,XYY pattern. This paper reports a ferule male with major cell line of 47, XYY and a gender identity disorder.
Delusional Parasitosis: Folie à Deux and Attempted Murder of a Family Doctor
Authors: Bourgeois Marc L. , Duhamel Pascale , Verdoux Helene
Published: October 2008

A 58-year-old woman suffering from delusional parasitosis tried to kill her general practitioner. Her husband shared in her beliefs but lost all delusional conviction after she was compulsorily admitted to a special hospital. The case illustrates the intractable nature and potential dangerousness of some of these cases, and their affinity to paranoia.
Suicide in Psychiatric Patients: Risk and Prevention
Authors: Appleby Louis
Published: October 2008

The prevention of suicide requires an understanding of protective as well as risk factors, and the recognition of high-risk groups. Factors which increase the risk in patient populations include previous parasuicide, recent relapse or discharge, features of mental state (depression, psychosis), social circumstances (isolation, unemployment), and demographic characteristics (male sex, young age). Protective factors are under-researched but are likely to lie in the nature of psychiatric care. Consequently, community care may affect suicide by altering the level of protection at critical periods in an episode of illness. The clinical prevention of suicide should therefore be a priority for community services, and the relationship between suicide and mental health care should be researched by a national process of monitoring.
The Burden of Schizophrenia on the Family
Authors: Martyns-Yellowe I. S.
Published: October 2008

The burden of schizophrenia on rural and urban Nigerian families was studied using a standardised questionnaire. Rural families experienced more burden; however, the difference was significant only in respect of financial burden. Rural families of schizophrenics were shown to be more prone to minor psychiatric morbidity than urban families. Policies should be instigated to reduce such burden.
Expressed Emotion in Staff Working with the Long-Term Adult Mentally Ill
Authors: Moore E. , Ball R. A. , Kuipers L.
Published: October 2008

Staff-patient relationships in long-term settings were examined in 35 staff and 61 patients. Measures were also taken of the staff's general health, their coping style in relation to work events, and job satisfaction. A range of ratings of EE was evident in staff descriptions of patients under their care. Strain and criticism in the relationship were not associated with identified stressors in the workplace, or the general health of the carer. When patients were grouped according to high-EE and low-EE interviews, there were no significant differences in their symptoms. Criticism was associated with other patient characteristics, including aggressive and attention-seeking behaviour, underactivity, and limited social interaction. The findings have implications for staff training and for the maintenance of optimal staff-patient relationships in services supporting severely disabled patients.
Methodological Issues in Using a Polydiagnostic Approach to Define Psychotic Illness
Authors: Farmer Anne E. , Wessely Simon , Castle David , McGuffin Peter
Published: October 2008

Although a polydiagnostic approach to the definition of psychotic disorder provides many advantages to the researcher, there are also disadvantages. A comparison between several different sets of operational criteria using the opcrit computer program on a consecutive series of 397 psychotic subjects is described. The results show that although current diagnostic procedures are generally reliable, such approaches can still only supplement skilled clinical judgement, and there remain many pitfalls for the unwary.
Compulsive Personality as Predictor of Response to Serotonergic Antidepressants
Authors: Pollitt John , Tyrer Peter
Published: October 2008

A short paper of this title reported a study by Ansseau et al (1991). The present authors were invited to comment upon the study.
Clozapine Rechallenge after an Episode of ‘Neuroleptic Malignant Syndrome’
Authors: Weller Michael , Kornhuber Johannes
Published: October 2008

Nine out of 4044 patients admitted to our institution between 1987 and 1990 suffered an episode of NMS. Neuroleptic rechallenge using clozapine for persisting psychiatric illness was tolerated by eight patients. Clozapine was discontinued in one older, high-risk patient because recurrence of NMS was anticipated. Clozapine should be considered a drug of choice for psychotic patients with a history of NMS.
Cocaine in the UK-1991
Authors: Strang John , Johns Andrew , Caan Woody
Published: October 2008

More than 100 years after Freud's original endorsement of the drug, the use of cocaine is a problem for both users and for society, which struggles to organise effective responses to the epidemic of the last decade. During the 1980s the rapid spread of smokeable cocaine (including ‘crack’) was seen in the Americas (particularly the US). The initial simple predictions of an identical European epidemic were mistaken. The available data on the extent of cocaine use and of cocaine problems in the UK are examined. New forms of cocaine have been developed by black-market entrepreneurs (‘freebase’ and ‘crack’), and new technologies have emerged for their use; with these new technologies have come new effects and new problems. The general psychiatrist now needs a knowledge of directly and indirectly related psychopathology which has an increasing relevance to the diagnosis and management of the younger patient.
The Psychological Adjustment of the Chinese Community in Britain
Authors: Furnham Adrian , Li Ying Har
Published: October 2008

The psychological health and adjustment to life in Britain of a sample of first- and second-generation Chinese immigrants were measured. It was predicted that problems with the English language, inadequate social support, value differences, and unfulfilled expectations would induce more symptoms of psychological distress and depression in first-generation than in second-generation Chinese immigrants. Overall psychological hearth, and hence adjustment, was good. There was evidence for language problems and unfulfilled expectations, but not social support and value differences, being linked to mental health in the second generation. Evidence linking mental health to other personal variables was found in both generations.
Psychiatric Problems Following Bereavement by Murder or Manslaughter
Authors: Parkes Colin Murray
Published: October 2008

Bereavement by murder or manslaughter is often associated with a high incidence of factors which increase the risk of lasting psychological problems after bereavement. In this study it appears that self-perpetuating vicious circles often accounted for the persistence of symptoms, which fitted the diagnostic categories of post-traumatic stress disorders, anxiety states, panic syndromes, obsessive revenge-seeking, and depression. Therapeutic approaches should be aimed at interrupting these vicious circles and fostering the work of grieving.
Psychiatric Morbidity in Survivors of Organised State Violence Including Torture
Authors: Ramsay Rosalind , Gorst-Unsworth Caroline , Turner Stuart
Published: October 2008

The case notes documenting the psychological well-being of 100 survivors of torture and other forms of organised state violence were analysed retrospectively. The most common diagnoses were post-traumatic stress disorder (PTSD), major depression, and somatoform disorders. Of these, PTSD showed the strongest association with experience of torture. It is possible that PTSD has a dimensional nature, and that reactions to different stressors are heterogeneous.
Stressful Life Events and Schizophrenia
Authors: Norman Ross M. G. , Malla Ashok K.
Published: October 2008

Empirical research concerning the relationship between life event stressors and schizophrenia is critically reviewed. In accordance with the view that patients suffering from schizophrenia are vulnerable to stress, there is evidence of a relationship between stressors and variation in severity of symptoms over time. There is less indication that schizophrenic patients have had higher levels of stressors than the general population or than patients suffering from other psychiatric disorders. These findings are consistent with vulnerability-stress models of the development of schizophrenia.
Is the Mechanism of Prefrontal Hypofunction in Depression the Same as in Schizophrenia?
Authors: Berman Karen Faith , Doran Allen R. , Pickar David , Weinberger Daniel R.
Published: October 2008

To test the hypothesis that depressed and schizophrenic patients have a common pathophysiological mechanism for hypofunction of the prefrontal cortex (‘hypofrontality’), we measured regional cortical blood flow (rCBF) in ten depressed patients, ten patients with schizophrenia, and 20 age- and sex-matched normal controls. Blood flow was measured during three different cognitive conditions: a resting state, a simple number-matching sensorimotor control task, and the Wisconsin Card Sorting test (WCS). The schizophrenic patients had lower prefrontal rCBF during the WCS. There were no differences in global or regional flow between the depressed patients and the normal subjects during any testing condition. Analysis of rCBF lateralisation showed that during the WCS normal subjects had relatively more left parietal blood flow than depressed patients, who had more right parietal blood flow. Since the testing condition that has most consistently revealed hypofrontality in schizophrenia (i.e. the WCS) was not associated with abnormal rCBF in the depressed patients, these data suggest that the pathophysiological mechanisms underlying prefrontal hypofunction in depression and schizophrenia are different.
Impulsivity and Eating Disorders
Authors: Fahy Thomas , Eisler Ivan
Published: October 2008

Sixty-seven patients with bulimia nervosa and 29 patients with anorexia nervosa completed the Impulsiveness Questionnaire and questionnaires detailing severity of eating disorder. Bulimic patients had higher impulsivity scores than anorexic patients. Bulimics with high impulsivity scores did not have more severe eating disorders than low scorers. When 39 bulimics and 25 anorexics were interviewed about other impulsive behaviour, 51 % of bulimics and 28% of anorexics reported at least one other impulsive behaviour. Patients with so-called ‘multiimpulsive’ bulimia reported more severe eating disturbance, but this was not reflected on more reliable measures of symptoms. Thirty-nine bulimics entered an eight-week treatment trial and their progress was assessed at eight weeks, 16 weeks and one year. ‘Non-impulsive’ bulimics had a more rapid response than ‘impulsives' during treatment, but there was no difference at follow-up. There was no evidence of an association between high impulsivity trait scores and poor treatment response. It is concluded that impulsivity may shape the expression of eating disorders, but that ‘multi-impulsives' do not constitute a categorically distinct subgroup of bulimics.
Blood-Letting in Bulimia Nervosa
Authors: Parkin J. Richard , Eagles John M.
Published: October 2008

Three cases of blood-letting in association with bulimia nervosa are reported. This association has not previously been described.