bluuebunny/crossref_metadata_2025 huggingface dataset:
As the Years Go Rolling By
Authors: Edwards Griffith
Published: August 2008

Research which tries to understand human experience within the time dimension is entering difficult and uncomfortable territory. Long before the first prospecting research worker arrived on this scene with his questionnaires and statistical methods, creative writers had been exploring the same terrain. Take poetry, for instance. When poets write about the passage of time the visions which they conjure seem nearly always to carry menace. An image offered by Yeats exactly captures the sense of helplessness and haplessness which we may all sometimes experience under the pressure of passing time:

The years like great black oxen tread the world.

And God the herdsman goads them on behind.

And I am broken by their passing feet.
The Aetiology of Post-traumatic Morbidity: Predisposing, Precipitating and Perpetuating Factors
Authors: McFarlane Alexander C.
Published: August 2008

A group of 469 firefighters were studied 4, 11 and 29 months after having an extreme exposure to a bushfire disaster. The relative importance of the impact of the disaster, personality and ways of coping were investigated as determinants of post-traumatic morbidity. Neuroticism and a past history of treatment for a psychological disorder were better predictors of post-traumatic morbidity than the degree of exposure to the disaster or the losses sustained. These results raise doubts about the postulated central aetiological role a traumatic event plays in the onset of morbidity.
Is Electroencephalographic Monitoring of Electroconvulsive Therapy Clinically Useful?
Authors: McCreadie R. G. , Phillips K. , Robinson A. D. T. , Gilhooly G. , Crombie W.
Published: August 2008

Electroencephalographic (EEG) monitoring was carried out in 169 bilateral and 114 unilateral applications of electroconvulsive therapy (ECT), given to 51 patients in an everyday setting within the National Health Service by junior medical staff. In 2.5% of bilateral and 8% of unilateral applications there was disagreement between clinical and EEG assessment as to whether a fit had occurred. When an EEG fit was said to have occurred only if it lasted longer than 25 seconds, then disagreement rose to 7% in bilateral and 28% in unilateral applications; disagreement was higher with unilateral applications, as they produced more short fits than bilateral applications. If future work shows duration of seizure is clearly associated with clinical efficacy, it is suggested the case for routine EEG monitoring is greatly strengthened.
Psychosocial Status of 192 Out-Patients with HIV Infection and AIDS
Authors: King Michael B.
Published: August 2008

One hundred and ninety-two out-patients with HIV infection were interviewed in a standardised manner at two London hospitals. Almost all had revealed their diagnosis to others, one-quarter receiving negative reactions from confidants. Thirty-one per cent had significant psychiatric problems, almost half of whom reported emotional problems before HIV infection. Twenty-two per cent complained of difficulties with memory or concentration, of whom 12.5% had objective cognitive impairment on brief assessment. Excessive health ruminations were an important indicator of more extensive psychological problems. This degree of psychological distress is in keeping with reports for patients with other medical conditions, and overall, patients appeared to have adapted well, despite the obvious stigma and poor prognosis of their condition.
Suicide Among Chinese Schizophrenics in Hong Kong
Authors: Cheng K. K. , Leung C. M. , Lo W. H. , Lam T. H.
Published: August 2008

A descriptive study of suicides in 74 Chinese schizophrenic out-patients (43 male) is presented. The mean age at death was 31.3 years. The mean duration of illness was 8.5 years and 50 of the 74 died within ten years of onset of illness. Only five lived alone; 35 were openly employed and 20 were married at the time of death. Twenty had a history of depression, and 27 had attempted suicide previously. More females had been depressed or had attempted suicide than males. Over half were last admitted for reasons other than schizophrenic symptoms alone and ten died within one month of discharge. Eight of 71 patients followed up expressed suicidal ideas at the last psychiatric contact, but only 15 were symptomatic. Jumping was the commonest method used. Analytical studies are needed to identify risk factors in Chinese schizophrenics.
Genetics, Alzheimer's Disease and Senile Dementia
Authors: Kay D. W. K.
Published: August 2008

Genetic factors in the aetiology of Alzheimer's disease (AD), are now being intensively investigated. The homogeneity of AD is under investigation. There are a few large kindreds with early onset of AD in whom transmission appears to be typically autosomal dominant, and 65% or more of the remaining cases at any age may have genetic aetiology. Both multifactorial and autosomal dominant inheritance with age-dependent expression have been proposed, but the late onset and death of unaffected relatives from competing causes make it difficult to choose between them. Lifetime risk gives the best estimate of incidence in family studies, but clinical and pathological criteria are not clear enough for confident diagnosis of AD in late old age. A role for external factors is indicated by twin studies, and the role of aluminium is currently under investigation. Molecular genetics promises to resolve many questions. The clinicians' role will be to provide well documented families for interdisciplinary research and to help in clarifying diagnosis in late old age.
Lapse, Relapse and Survival among Opiate Addicts after Treatment
Authors: Gossop Michael , Green Lynette , Phillips Grania , Bradley Brendan
Published: August 2008

This paper presents data from the first British prospective study to investigate relapse among opiate addicts after treatment. Eighty subjects were followed up over the six-month period immediately after discharge from treatment and were interviewed on several occasions. Large numbers of subjects used opiates within a very short time after discharge; 71% used them within the first six weeks. However, this first lapse to opiate use did not herald a full-blown relapse to dependent use. There was a gradual increase in the number of abstinent subjects, with 45% abstinent and living in the community at the six-month point. The practical and theoretical implications may be regarded as broadly encouraging.
Characteristics of Psychiatric Hospital Absconders
Authors: Tomison Arden Randall
Published: August 2008

Absence of patients without leave is common in psychiatric hospitals, and causes anxiety to staff, relatives, and the lay public. Such incidents are difficult to predict. This study attempted to identify the characteristics of patients absconding from a UK hospital over one year. Numbers were small, as those patients discharged against advice and failing to return from leave were excluded. Absconders were predominantly male, young, compulsorily admitted, and discharged with a diagnosis of schizophrenia. They tended to be single, had many previous admissions, and a longer total length of stay, and the police were more often involved in their admission. Reasons for absconding and the implications for management of newly admitted psychiatric patients are discussed.
Social Support and the Outcome of Major Depression
Authors: George Linda K. , Blazer Dan G. , Hughes Dana C. , Fowler Nancy
Published: August 2008

One hundred and fifty middle-aged and elderly adults with a diagnosis of major depression were assessed initially as inpatients, and were reinterviewed 6–32 months later. Both size of social network and subjective social support were significant predictors of depressive symptoms at follow-up, with baseline depression scores and other predictors of outcome status statistically controlled. Subjective social support was most strongly associated with major depression; this effect was significantly stronger for middle-aged than older adults, and for men than women. Differences in the effects of marital status, size of social network, and subjective social support also suggest the importance of distinguishing between involvement in and quality of interpersonal relationships.
The Nature and Prevalence of Depression in Chronic Schizophrenic In-patients
Authors: Barnes Thomas R. E. , Curson David A. , Liddle Peter F. , Patel Meena
Published: August 2008

Out of 194 chronic schizophrenic inpatients, depressed mood (item 23 of the PSE) was present in 25 (13%). When compared with 25 matched controls, the patients with depressed mood had significantly higher scores on the MADRS and the Beck Depression Inventory. Serious suicidal ideas and auditory hallucinations were significantly more common in the depressed group. However, there were no significant differences between the matched groups in terms of negative symptoms, Parkinsonism, tardive dyskinesia, anticholinergic medication, or current dose of antipsychotic drug, which suggests that the depression identified was not related to drug treatment, nor was it a direct manifestation or misinterpretation of negative symptoms. Over three-month follow-up, the MADRS and Beck scores covaried closely with the presence or absence of depressed mood. This depressive syndrome persisted over the three months in the majority of patients originally depressed.
The Psychiatrist in the Obstetric Unit
Authors: Appleby Louis , Fox Helena , Shaw Mike , Kumar R.
Published: August 2008

The establishment and first 18 months of a psychiatric liaison service to a general hospital obstetric unit are described. The service was initially intended to predict antenatally those at risk of postnatal depression and to offer follow-up throughout pregnancy and in the postnatal period. However, a large proportion of referrals were of women currently unwell. Furthermore, postnatal follow-up in the community proved difficult. Referrals, diagnoses and disposal are analysed, leading to conclusions about the effectiveness and problem of such a service. The components of a comprehensive obstetric liaison provision are proposed, emphasising the need for strong community links built around a CPN service, allowing adequate postnatal psychiatric care.
Psychological Aspects of Hysterectomy
Authors: Ryan Margaret M. , Dennerstein Lorraine , Pepperell Roger
Published: August 2008

Sixty women aged between 30 and 55 years, having hysterectomy for benign conditions, were prospectively studied to investigate psychological adjustment to operation, and to explore social, psychological and physical factors associated with psychological outcome. A further 30 women were included for prospective research on psychological outcome. Investigations took place within two weeks of operation and after four months and 14 months. The findings indicated a high prevalence of pre-operative psychological morbidity (55%), which reduced to 31.7% afterwards. There was no evidence that hysterectomy led to a greater psychological distress. The principal risk factors of poor psychological outcome were the previous scores on the mental health measures and personality inventory. Involvement in the research process did not appear to affect psychological outcome.
The Course of Tardive Dyskinesia in Patients on Long-Term Neuroleptics
Authors: Bergen J. A. , Eyland E. A. , Campbell J. A. , Jenkings P. , Kellehear K. , Richards A. , Beumont P. J. V.
Published: August 2008

Results are presented of five consecutive annual examinations using the Abnormal Involuntary Movement Scale for 101 community-based chronic psychiatric patients. These 101 patients had a history of longer and more consistent neuroleptic treatment than the 231 patients who initially entered the study, so no conclusions about prevalence of TD can be drawn. At each examination two-thirds of this group showed signs of TD; however, only 45% were TD positive at most examinations and 24% were best described as having fluctuating TD status. Of those patients who were consistently TD positive, 82% showed no overall significant change in summed AIMS scores, 11% improved and 7% became worse.
Significance of Extreme Temperament in Infancy for Clinical Status in Preschool Years
Authors: Maziade Michel , Côté Robert , Bernier Hugues , Boutin Pierrette , Thivierge Jacques
Published: August 2008

The relationship between extreme temperament in infancy and clinical status at 4.7 years of age was studied in temperamentally different groups of infants matched for sex and SES, and subselected from a large birth cohort representative of the general population. The effects of certain dimensions of family functioning and of other risk factors were examined. By itself, extremely difficult temperament in infancy had no strong direct association with clinical outcome at four years of age, whereas temperament assessed at four, family attitudes to discipline, and stressful events did. However, extreme temperament in infancy might indirectly affect outcome through its association with temperament at four. The interplay between adverse temperament and parental attitudes of discipline previously observed in middle childhood might have antecedents in preschool years.
A Family Study of Two Subgroups of Schizoaffective Patients
Authors: Maj Mario
Published: August 2008

A family study was carried out in two groups of patients fulfilling RDC for schizoaffective disorder: in one, a full affective and a full schizophrenic syndrome were simultaneously present; in the other, affective and schizophrenic features appeared within a polymorphic and rapidly changing clinical picture, with depersonalisation/derealisation and/or confusion. In the first-degree relatives of patients of the former group, the risk of major psychiatric disorders was not significantly different from that of relatives of schizophrenics, whereas in the first-degree relatives of patients of the latter group a low risk for both schizophrenia and major affective disorders, and a relatively high risk for schizoaffective disorders, were observed.
De Clérambault's Syndrome (Erotomania) in Organic Delusional Syndrome
Authors: Gaddal Y. Y. El
Published: August 2008

A patient with de Clérambault's syndrome (erotomania) following brain damage and epilepsy is described. The delusion appeared after brain surgery for subarachnoid haemorrhage, and remained chronic. Erotomania in this patient may be judged to be aetiologically related to organic brain damage.
Health Education and the AIDS Epidemic
Authors: Eisenberg Leon
Published: August 2008

What is known about the biology of AIDS is reviewed, and the social factors which influence disease transmission and public attitudes are considered. After an evaluation of the methods available to control the epidemic, the reasons for the limited success of public health measures thus far undertaken are considered. The ethical debate on public health policy is analysed, and the need for a nationwide educational programme on AIDS is emphasised – one which is responsive to the rights and obligations of citizens in a democratic society.
The Natural History of Mental Disorder in Old Age
Authors: Robinson John R.
Published: August 2008

In a prospective study, 153 consecutive new referrals to a psychogeriatrician in Oxfordshire in 1973 were followed up for 15 years. The percentage of the over-65 population at risk was 0.27 and, of those aged over 80, 0.6. Alzheimer's dementia and depressive illness comprised over two-thirds of referrals. A quarter became permanent admissions, half of them with Alzheimer's dementia, 19% of whom were alive five years later. Depressive illness, at ten years, had a mortality 1.2–1.6 times that of the population at risk. The distinction between Alzheimer's dementia and depressive illness, based on their natural history and causes of death, was reinforced.
Maternal Depression and the Emotional Development of the Child
Authors: Caplan H. L. , Cogill S. R. , Alexandra Heather , Robson Kay Mordecai , Katz R. , Kumar R.
Published: August 2008

Ninety-two women and their first-born children took part in a longitudinal survey of maternal mental health. When the children were four years old, their mothers were interviewed by means of the Behavioural Screening Questionnaire, and the children's problems were rated by a psychiatrist, who was unaware of the mothers' psychiatric histories or of assessments of their current health. As expected, mothers who were concurrently depressed reported significantly more behavioural difficulties in their children. Marital disharmony during pregnancy and a history of paternal psychiatric problems were also associated with later childhood behavioural difficulties. Children who scored below average on the McCarthy scales of cognitive abilities were also reported by their mothers to have more behavioural problems, but the children's behavioural difficulties at four showed no clear links with postnatal depression.
Prevalence of Benzodiazepine Abuse and Dependence In-Psychiatric In-Patients with Different Nosology
Authors: Schmidt L. G. , Grohmann R. , Müller-Oerlinghausen B. , Otto M. , Rüther E. , Wolf B.
Published: August 2008

Frequencies of abuse and dependence assessed continuously within a drug surveillance system were analysed as a contribution to risk-benefit evaluations of benzodiazepines (BZDs). In 4.7% of 15 296 patients admitted to psychiatric hospitals between 1980 and 1985, BZDs had been involved in some kind of abuse or dependence. Primary BZD dependence, defined as physical dependence on BZDs in patients who had not been dependent before, was observed in about 1% of admitted patients. Linking these data with psychiatric diagnoses revealed a high risk of primary BZD dependence for inpatients (11.8%) with anxiety neurosis (ICD-9, 300.0), and a lower risk for neurotic (300.4) and for endogenous depressives (296.1) (risk 3.7% and 2.7% respectively). Older age was also related to primary BZD dependence. For depressive inpatients, the risk was twice as high in females as in males. Anecdotal observations advocate more systematic investigation of the emotional effects of long-term therapy with BZDs.
Tricyclic Wash-out and Growth Hormone Response to Clonidine
Authors: Schittecatte M. , Charles G. , Machowski R. , Wilmotte J.
Published: August 2008

We have observed a significantly higher growth hormone (GH) response to clonidine administration (150 μg i.v.) in 14 patients with a major depressive disorder who had never received antidepressant therapy than in 14 matched depressive patients who had not received tricyclic drugs for at least 15 days. Compared with a control group of eight subjects, untreated depressed patients, as a group, had a normal response, while matched patients had markedly blunted response. Results for the group of untreated depressed patients showed that some patients had a blunted response while others had a response in the normal range. The results suggest that studies on the GH response to clonidine in psychiatric patients need to take into account the confounding and long-lasting effects of tricyclics.
2. Szasz on Psychiatric Justice
Authors: West D. J.
Published: August 2008

It would be absurd to suggest that mental health legislation is never abused, that individuals are never detained unnecessarily on inappropriate psychiatric grounds, or that political expediency does not sometimes exert an influence on decision making in this regard. Dr Szasz, however, takes an extreme view in rejecting the moral or legal right of psychiatrists to participate in the compulsory hospital admission of offenders. He rightly points out that if psychiatric involvement is wrong in principle, then “periodic outbursts of indignation against ‘abuses'” are “both naive and foolish”. Nevertheless, he sees fit to support his arguments with examples of what he deems abuses.
Self-Neglect and Frontal Lobe Dysfunction
Authors: Orrell Martin W. , Sahakian Barbara J. , Bergmann Klaus
Published: August 2008

An elderly lady, of superior verbal intelligence and with no severe psychiatric condition, severely neglected herself, and required prolonged day patient care. Brain scans showed selective frontal atrophy, and both traditional and new computerised neuropsychological testing demonstrated severe frontal dysfunction.
DSM–III Major Depressive Disorder in the Community
Authors: Eaton William W. , Dryman Amy , Sorenson Ann , McCutcheon Allan
Published: August 2008

The fit of the structure of DSM–III major depressive disorder to data from two large epidemiological surveys is assessed by latent class analysis. The surveys were conducted at the Baltimore and Raleigh–Durham sites of the National Institute of Mental Health (NIMH) Epidemiologic Catchment Area Program. Three classes are required to fit the data, and the third class bears a strong resemblance to major depressive disorder, although it requires slightly more symptoms to be present than DSM–III. The derived structure replicates successfully for Baltimore and Raleigh-Durham, with a prevalence of the major depression category of 0.9% for both sites.
The Delineation of Schizophrenia from other Psychiatric Illnesses
Authors: Kazanetz Etely Ph.
Published: August 2008

Evidence is provided in support of the nosological concept which distinguishes schizophrenia from borderline states. Differentiation of these disorders by a computer pattern-recognition program was based on the initial descriptive characteristics of patients. As a result, we observed good correlation between computer diagnosis from data on 215 patients and follow-up data analysed according to the criteria of Kraepelin's model of schizophrenia and its course. According to the findings on outcome, the states designated as 'sluggish schizophrenia’ (or 'slowly developing variant of schizophrenia’) comprise a group of dissimilar psychiatric disorders, including borderline states and cases of process schizophrenia, with the specific initial symptoms of the latter disease.
The Factor Structure of the General Health Questionnaire (GHQ-30)
Authors: Huppert Felicia A. , Walters D. E. , Day N. , Elliott B. Jane
Published: August 2008

An individual's responses to Goldberg's 30-item General Health Questionnaire are usually represented as a single score which provides a measure of the number of psychiatric symptoms reported. No account is taken of the nature of the symptoms. Factor analyses of the GHQ-30 were undertaken in ten randomly selected samples of 600 adults each, and also on 12 age-sex groupings covering the age range 18–98. The results indicate an impressive degree of consistency of the factor structure, and the identification of five distinct factors corresponding to anxiety, feelings of incompetence, depression, difficulty in coping, and social dysfunction.
Differential Classification in School Refusal
Authors: Atkinson Leslie , Quarrington Bruce , Cyr James J. , Atkinson Frederick V.
Published: August 2008

It has been argued that school refusal may not be a unitary syndrome, but a common presenting symptom founded on differing underlying dynamics. The paper explores this hypothesis empirically. The clinical files of 100 refusers were scored for several variables which could potentially differentiate between school refusal subtypes, and for several commonly accepted beliefs about school refusal. The data were subjected to a variety of analyses, culminating in cluster analysis. Cluster (C) 1 consisted of children who feared separation from dependent, overprotective mothers. C2 youngsters were perfectionistic and depressed. They dominated mothers who had been deprived in childhood. C3 consisted of extensively disturbed children from multiproblem families, who had suffered early separation or loss, and who were fearful and depressed.
Signal and Noise in Psychotherapy
Authors: Omer Haim
Published: August 2008

Four major categories of nonspecific or common factors are systematically analysed: relationship, expectancy, reorganising, and impact factors. The placebo control method should be discarded in psychotherapy research for two reasons: (a) sham treatment controls are unworkable because common factors in treatment are manifest only when real treatment is administered; and (b) the very events which were once thought of as ‘nonspecific’ noise are now recognised as active therapeutic factors common to many schools.
A Chinese Classic Phenylketonuria Manifested as Autism
Authors: Chen C. H. , Hsiao K. J.
Published: August 2008

A 12-year-old Chinese boy had a diagnosis of infantile autism at infancy that was finally confirmed as classic phenylketonuria at adolescence. This treatable inborn metabolic disease should be investigated in cases of apparent autism, especially where mass neonatal screening of inborn metabolic diseases has not been established.
Treatment of Depression
Authors: Paykel E. S.
Published: August 2008

My aim in this lecture is to review a wide range of published studies on the treatment of depression. I want to look at these with one major clinical question in mind: given the range of treatments available, which treatment should be chosen for which patient? In July 1985 a report, published as a special supplement to the American Journal of Psychiatry, called for more research on this topic:

“As the number and diversity of the effective drugs and psychosocial interventions expand, clinicians will increasingly want objective, reliable criteria with which to match the patient to the optimal treatment modality and to monitor the response.” (Institute of Medicine, 1985)
The History of General Hospital Psychiatry
Authors: Mayou Richard
Published: August 2008

General hospital psychiatry in Britain began in 1728, and thereafter several new voluntary hospitals provided separate wards for lunatics, but none survived beyond the middle of the 19th century. Less severe nervous organic disorder has always been common in the general wards of voluntary hospitals, and was accepted as the responsibility of neurologists and other physicians; all forms of disorder were admitted to the infirmaries of workhouses. During the present century psychiatrists began to take an interest in non-certifiable mental illnesses and in working in general hospitals. Out-patient clinics became more common following the Mental Treatment Act 1930. The growth of general hospital psychiatric units in the last 30 years began amidst controversy, but has received little recent critical attention.
Patterns of Benzodiazepine use in Great Britain as Measured by a General Population Survey
Authors: Dunbar G. C. , Perera M. H. , Jenner F. A.
Published: August 2008

In a general population survey by Gallup in Great Britain of 4148 subjects, 7.7% had taken benzodiazepines within the last year (male:female ratio 106:212). Younger subjects tended to take anxiolytics for shorter periods compared with older subjects, who often took hypnotics chronically. This pattern was most marked among females. Dosage escalation, tolerance, high daily dose usage, and hoarding were not common. A substantial proportion of current users had experienced difficulty in stopping their medication. Withdrawal problems were associated with being older than 45 years and consuming benzodiazepines for over 12 months. This lends support to the idea of benzodiazepine dependency. However, the appropriateness of long-term therapy for chronic symptoms cannot be ruled out.
Chronic Psychosis in Turner's Syndrome
Authors: Bamrah J. S. , Mackay M. E.
Published: August 2008

A 59-year-old woman with Turner's syndrome developed epilepsy, diabetes mellitus, chronic psychosis, and subsequently pre-senile dementia. This would endorse the view that psychosis in Turner's syndrome arises through brain damage.
The Effects of Loss of Taste and Smell in a Case of Anorexia Nervosa and Bulimia Nervosa
Authors: Fahy Thomas A. , DeSilva Padmal , Silverstone Peter , Russell Gerald F. M.
Published: August 2008

A woman with a mixed eating disorder is reported. Her disorder did not remit after a head injury which caused her to lose her sense of taste and smell.
A Transition Period in Psychiatric Care in Italy Ten Years after the Reform
Authors: Crepet Paolo
Published: August 2008

Ten years after the passing of the Italian psychiatric reform bill, the author assesses the state of the national mental health services. Albeit slowly, the decrease in the number of in-patients in mental hospitals is accompanied by a numerical increase in district and out-patient services. However, the quality of care provided and the regional distribution of services are not acceptable. The reorganisation has benefited hospital and out-patient services, but community care facilities remain inadequate. The mental health of the general population seems to be unaffected by the ongoing transition in psychiatric care.
Prison Suicide in England and Wales, 1972–87
Authors: Dooley Enda
Published: August 2008

The case notes of 295 suicides (98.3% of the total) in prisons in England and Wales between 1972 and 1987 were studied. This period has witnessed an increase in the suicide rate far in excess of the rate of rise in the prison population. The most common method of suicide was by hanging, usually at night. There was a frequent past history of psychiatric treatment and self-injury. People charged or convicted of violent or sexual offences were over-represented, as were those serving life sentences. There was an association between suicide and both guilt for the offence and being charged or convicted of a homicide offence. Some suicides occurred many years after reception into prison. Routine enquiry about previous suicide attempts must be implemented, along with better, ongoing, active communication between staff and inmates.
Psychoanalytical Aspects of Morbid Jealousy in Women
Authors: Freeman Thomas
Published: August 2008

During the course of the psychoanalytical treatment of patients whose morbid jealousy is of the non-psychotic type it is possible to identify the unconscious causes of the pathological mental state. This material can provide an insight into the unconscious determinants of the contents of delusions of jealousy.
Glucose Metabolic Rate in Normals and Schizophrenics During the Continuous Performance Test Assessed by Positron Emission Tomography
Authors: Buchsbaum Monte S. , Nuechterlein Keith H. , Haier Richard J. , Wu Joseph , Sicotte Nancy , Hazlett Erin , Asarnow Robert , Potkin Stephen , Guich Steven
Published: August 2008

Local cerebral uptake of glucose labelled with fluorine-18 was measured by positron emission tomography in 13 patients with schizophrenia and 37 right-handed volunteers. Patients received no medication for a minimum of 31 days and a mean of 30 weeks. The subjects were administered the labelled deoxyglucose just after the beginning of a 32-minute sequence of blurred numbers as visual stimuli for the Continuous Performance Test. In normal controls, task performance was associated with increases in glucose metabolic rate in the right frontal and right temporoparietal regions; occipital rates were unchanged. Patients with schizophrenia showed both absolutely and relatively reduced metabolic rates in the frontal cortex and in the temporoparietal regions compared with normal controls.
A Study of Epileptic Psychosis Using Magnetic Resonance Imaging
Authors: Conlon P. , Trimble M. R. , Rogers D.
Published: August 2008

Magnetic resonance imaging (MRI) was used in patients with epilepsy and psychosis. From 50 patients with epilepsy, a subgroup of 12 patients were categorised by the Present State Examination (PSE) as having nuclear schizophrenia (NS) and then compared with an epileptic control group with no psychiatric history. Further, patients with hallucinations were compared with patients without hallucinations. No differences in T1 relaxation times in any regions of interest were noted in the NS group compared with the other group. However, patients with hallucinations had a significantly higher T1 value in the left temporal lobe. These findings support the concept that specific abnormalities in limbic system structures relate to the phenomenology of the psychoses of epilepsy, especially left temporal lobe epilepsy.
A Prospective Study of First-Incidence Depression
Authors: Rorsman Birgitta , Gräsbeck Anne , Hagnell Olle , Lanke Jan , ÖHman Rolf , Öjesjö Leif , Otterbeck Lena
Published: August 2008

The present study is based on the so-called 1957 Lundby cohort, a geographically defined normal Swedish population of 2612 individuals who were evaluated for mental disorders in 1957 and 1972. The annual age-standardised first incidence of depression, with or without other psychiatric symptoms, all degrees of impairment included, was found to be 4.3 per 1000 person years in men and 7.6 per 1000 person years in women. Up until 70 years of age, the cumulative probability of suffering a first episode of depression was 27% in men and 45% in women.
Age of Disease Onset in Croatia's Hospitalised Schizophrenics
Authors: Folnegović-Šmalc V. , Folnegović Z. , Kulčr Z.
Published: August 2008

Age at onset was determined in a sample of 360 patients representative of the 8069 schizophrenics hospitalised in SR Croatia. The 95% confidence interval for mean age at onset was 22.9–26.7 years. The difference between males and females was not significant, unlike the age difference between the sexes reported for age at first admission for schizophrenia. Results may be influenced by attrition of the original population of patients.
Patterns of Attendance of Child Psychiatry Out-patients with Special Reference to Asian Families
Authors: Stern Gillian , Cottrell David , Holmes Julian
Published: August 2008

Asian and non-Asian referrals to the department of child psychiatry at the London Hospital in 1987 were analysed. Asian referrals were under-represented with respect to the local population but, contrary to our expectations, there were no significant differences between the groups with regard to demographic data, the nature of the presenting problem, and attrition rates.
Why Parasuicides Repeat Despite Problem Resolution
Authors: Sakinofsky Isaac , Roberts Robin S. , James Patricia
Published: August 2008

To discover why parasuicides who resolved their difficulties repeated self-harm within three-month follow-up at the same rate as those who had not resolved problems, a group of 30 repeaters was compared with 156 non-repeaters. The repeaters had a history of more frequent episodes, beginning younger. Their problems were more severe, the acts of self-harm potentially less lethal. They experienced greater feelings of externally directed hostility, powerlessness, and ‘normlessness'. A constellation of nine variables correctly predicted 81.5% of the repeaters and 77.5% of the non-repeaters. At follow-up the non-repeaters had improved on several parameters but the repeaters were essentially unchanged. The resolvers among the subgroup of repeaters were more like repeaters in the overall sample than the resolvers, which may explain why some parasuicides repeat in spite of resolving their problems.
The Psychiatric Status of Patients with the Chronic Fatigue Syndrome
Authors: Hickie Ian , Lloyd Andrew , Wakefield Denis , Parker Gordon
Published: August 2008

The prevalence of psychiatric disorder in 48 patients with chronic fatigue syndrome (CFS) was determined. Twenty-two had had a major depressive (non-endogenous) episode during the course of their illness, while seven had a current major (non-endogenous) depression. The pre-morbid prevalence of major depression (12.5%) and of total psychiatric disorder (24.5%) was no higher than general community estimates. The pattern of psychiatric symptoms in the CFS patients was significantly different to that of 48 patients with non-endogenous depression, but was comparable with that observed in other medical disorders. Patients with CFS were not excessively hypochrondriacal. We conclude that psychological disturbance is likely to be a consequence of, rather than an antecedent risk factor to the syndrome.
Resistant Bipolar Disorder
Authors: Thomas I. G. , Oswald A. G. , Eagles J. M.
Published: August 2008

A 66-year-old farmer's wife had been admitted 31 times over eight years, suffering from manic depression. A variety of treatments for depressive episodes led to hypomania, and a case conference was held to discuss treatment.
Organic Affective Psychosis Associated with the Routine Use of Non-prescription Cold Preparations
Authors: Brown Terry M. , Golden Robert N. , Evans Dwight L.
Published: August 2008

A patient experienced an organic affective psychosis on three separate occasions after taking recommended doses of non-prescription cold/sinus preparations. The possible underlying pharmacological mechanisms of this clinical reaction lend support to the cholinergic-adrenergic balance hypothesis of affective disorders. Recognition of this acute drug-induced state can lead to appropriate short-term pharmacotherapy and can prevent misdiagnosis of a major affective disorder or schizophrenia.
Use of Carbamazepine in Psychosis after Neuroleptic Malignant Syndrome
Authors: Peet Malcolm , Collier John
Published: August 2008

A case is described of NMS during treatment with sulpiride. The subsequent psychosis resolved during treatment with carbamazepine. It is proposed that this patient may have suffered from a supersensitivity psychosis, and that resolution of her post-NMS psychosis could have been spontaneous.
Incipient Neuroleptic Malignant Syndrome?
Authors: Velamoor V. R. , Fernando M. L. D. , Williamson P.
Published: August 2008

Recognising confusion as an antecedent to NMS may help abort the full-blown syndrome. Two such cases are reported, along with a third.
Childhood Sexual Experiences with Adults Reported by Women with Eating Disorders: An Extended Series
Authors: Palmer R. L. , Oppenheimer R. , Dignon A. , Chaloner D. A. , Howells K.
Published: August 2008

A total of 158 women presenting with clinical eating disorders have been investigated using a self-report questionnaire and subsequent interview concerning their recollections of sexual experiences with adults before the age of 16 and later adverse sexual experiences. About a third reported events in childhood and over half described some adverse experiences. It may be that these experiences are relevant to the subsequent illness in some cases, but greater certainty must await further research. In the meantime, inquiring about such matters would seem to be advisable in the assessment and therapy of eating-disordered patients.
Psychiatric Aspects of the Menopause
Authors: Ballinger C. B.
Published: August 2008

In the debates about the association between mental illness and the menopause, the psychiatric approach contradicts assertions by the gynaecological and psychoanalytic literature that the menopause has a negative effect on mental health. General population studies show that, if at all, psychiatric morbidity is more common in women in the five years before menopause. Sociocultural and family factors are more important in the aetiology of mental illness in menopausal women than physiological changes. Anxiety and depression in such women do not respond to oestrogen therapy, although some cases respond to antidepressants.
The Patients' View of Life in a Psychiatric Hospital
Authors: Myers D. H. , Leahy A. , Shoeb H. , Ryder J.
Published: August 2008

In any assessment of hospital life, the patients' view is indispensable, but there is no generally accepted way of seeking it. In this study, the views of 258 patients in four ‘traditional’ English psychiatric hospitals were obtained by a questionnaire of 45 items supplemented by freehand comments. Their experience of fellow patients, the staff and the material and institutional aspects of hospital care were explored. Some of the benefits and problems of questionnaire use in this realm are discussed.
A Structured Programme for Out-patient Alcohol Detoxification
Authors: Collins Mark N. , Burns Tom , Van Den Berk Peter A. H. , Tubman Gary F.
Published: August 2008

An out-patient alcohol detoxification service based in a psychiatric emergency clinic is described. Of 173 patients referred during the first year, 76 (44%) were accepted for the programme; 60 (79%) of these successfully completed detoxification with no medical complications. Compared with previous years, during the year of operation of the service there was a 50% fall in the number of in-patient admissions for detoxification to the local hospital. We conclude that a structured out-patient detoxification programme is safe and effective, and may obviate the need for many patients to be admitted, freeing psychiatric beds for other uses.
Seasonal Affective Disorder Following Brain Injury
Authors: Hunt Neil , Silverstone Trevor
Published: August 2008

Seasonal affective disorder has not previously been linked with neuroanatomical abnormalities despite its relationship to biological rhythms. A 45–year-old woman is described with an arteriovenous abnormality in the right frontotemporal region who developed recurrent winter depression and summer hypomania.
Anorexia Nervosa and Baby Gazing
Authors: Rutherford J. , Russell G. F. M.
Published: August 2008

The uncommon behaviour of baby gazing is described in a patient who had also suffered three episodes of anorexia nervosa. The baby gazing responded to joint therapeutic interviews leading to the patient and her husband resolving their different views about having a family and the patient becoming pregnant. Even then there was a minor recurrence of anorexic behaviour which yielded to treatment.
Interepisodic Morbidity in Kleine–Levin Syndrome
Authors: Sagar R. S. , Khandelwal S. K. , Gupta Surya
Published: August 2008

Three patients with Kleine–Levin syndrome had evidence of interepisodic organic brain dysfunction. This is counter to earlier views that the disorder is benign.
Koro: the Genital Retraction Symptom after Stroke
Authors: Anderson D. N.
Published: August 2008

The complete Koro complex in an elderly male Briton was associated with psychotic depression following a non-dominant temporoparietal stroke. As Koro lacks both cultural and diagnostic specificity, it would be more appropriately renamed the genital retraction symptom.
Cognitive Inflexibility and Pre-frontal Dysfunction in Schizophrenia and Mania
Authors: Morice Rodney
Published: August 2008

The ability to shift cognitive set, which is probably subserved, at least in part, by the pre-frontal cortex, was determined for schizophrenic, bipolar (manic) and control subjects, using the Wisconsin Card Sorting Test (WCST). The schizophrenic and manic subjects both demonstrated poor performance on the WCST, suggesting that cognitive inflexibility and/or pre-frontal dysfunction, is not specific to schizophrenia (although laterality differences could exist). Moderate levels of poor performance in the non-psychiatric control group suggest the need for a review of the cut-off figures in the WCST currently used for predicting ‘brain damage’ and ‘focal frontal involvement‘, especially given the trend for the increasing use of cognitive assessment and rehabilitation in the major psychoses.
Evidence for a General Neurotic Syndrome
Authors: Andrews Gavin , Stewart Gavin , Morris-Yates Allen , Holt Phoebe , Henderson Scott
Published: August 2008

Neurotic syndromes are defined by characteristic patterns of symptoms, but the validity of the distinction between one syndrome and another depends on associations between the syndromes and clinical history, or treatment response factors that are independent of the defining phenomena. In both a group of twin volunteers and a group of patients with panic disorder/agoraphobia, the lifetime experience of more than one diagnosis of a neurotic syndrome was common but there was no evidence of patterns of co-occurrence of diagnoses being associated with particular syndromes. Receiving a diagnosis was associated with abnormal scores on measures of neuroticism and locus of control, the extent of the abnormality increasing with the number of different diagnoses satisfied. It is argued that the concept of a general neurotic syndrome depends in part on the presence of such predisposing personality factors, and that reduction in this predisposition to neurosis should be the focus of treatment.
Psychiatric Phenomena in Alzheimer's Disease. I: Disorders of Thought Content
Authors: Burns Alistair , Jacoby Robin , Levy Raymond
Published: August 2008

In a sample of 178 subjects with Alzheimer's disease, diagnosed by clinical criteria (NINCDS/ADRDA), delusions had occurred in 16% of the sample since the onset of the illness and been present within the last 12 months in 11%. Simple delusions of theft and suspicion were the most common types and a greater proportion of men suffered delusions of theft. Subjects with other types of delusion had relatively well preserved lateral ventricular size and basal ganglia calcification. Twenty per cent of the group had experienced persecutory ideation short of delusions since the onset of the illness. Cognitive function at entry to the study and cognitive deterioration over the succeeding 12 months was not influenced by the presence of disorders of thought content.
Psychiatric Phenomena in Alzheimer's Disease. IV: Disorders of Behaviour
Authors: Burns Alastair , Jacoby Robin , Levy Raymond
Published: August 2008

Out of a sample of 178 patients with AD, aggression was present in 20%, wandering in 19%, binge-eating in 10%, hyperorality in 6%, urinary incontinence in 48%, and sexual disinhibition in 7%. Behavioural abnormalities were greater in those with more severe dementia. Temporal-lobe atrophy correlated with aggression, and widening of the third ventricle with hyperorality. Features of the Kluver–Bucy syndrome were commonly seen, but the full syndrome occurred in only one subject. Patients with at least one feature of the Kluver–Bucy syndrome had greater temporal-lobe atropy than those without any of the features.
Educating the Psychiatrist of the 21st Century
Authors: Cawley R. H.
Published: August 2008

Psychiatry is under threat from developments within mental health care. In educating future psychiatrists, more emphasis should be placed upon: collaborative research; integrated teamwork, without interprofessional rivalry; work in primary care; the non-scientific components of psychiatry, centred upon relationships with patients; less dogmatic attitudes for or against psychoanalysis; psychiatry as a branch of medicine; and modern management and audit methods. Younger psychiatrists should be encouraged to take responsibility for shaping the future of the profession.
The Case-Control Study in Psychiatry
Authors: Lewis Glyn , Pelosi Anthony J.
Published: August 2008

Case-control studies involve ‘cases' being compared to ‘controls' with respect to ‘exposures', possible aetiological (or associated) factors. Associations between a disease and an exposure can be explained by chance, reverse causality, confounding and biases or, lastly, by causality. However, confounders as well as information and selection biases can be adjusted for at the design (or analysis) stage of the study. The strength of an association can be measured by means of relative risk, calculated indirectly using the odds ratio. Well conducted control studies should produce accurate estimates of relative risks in many psychiatric investigations.
Daughters of People with Dementia Expressed Emotion, Strain and Coping
Authors: Bledin K. D. , Maccarthy B. , Kuipers L. , Woods R. T.
Published: August 2008

Twenty-five women who were the primary carers for a parent with dementia were rated for expressed emotion (EE) and then divided into two groups: 11 with low-EE ratings and 14 with high-EE ratings. Although there were no differences between these groups in the levels of their parents' cognitive impairment, when such impairment was taken into account, high-EE subjects were found to report higher levels of strain and distress. More efficient coping strategies were reported by subjects who made fewer critical comments and more positive remarks. High-EE subjects more frequently had no living siblings, and were more likely to have had a respite break from caring. EE status was not associated with continuing care in the community at a nine-month follow-up.