bluuebunny/crossref_metadata_2025 huggingface dataset:
The comparative antidepressant value of lofepramine and amitriptyline
Authors: McClelland H. A. , Kerr T. A. , Stephens D. A. , Howell R. W.
Published: August 2007

A double‐blind controlled trial comparing the antidepressant activity of amitriptyline with lofepramine is reported. Forty‐six patients entered the 4‐week trial. Analysis of the Hamilton Depression Rating Scale scores at the beginning and end of the trial showed no significant difference between the therapeutic efficacy of lofepramine and amitriptyline. However, patients with endogenous depression responded, significantly more rapidly lofepramine as measured by Visual analogue Scales and showed a significantly greater degree of clinical improvement after 4 weeks' treatment, as measured by Golbal Assessment. Adverse effects were similar in the two treatment groups. The use of rating scales in trials of depression was found to be a simple, useful and valid measure.
Termination of the drug career: AN INTERVIEW STUDY OF 58 EX‐ADDICTS
Authors: Frykholm B.
Published: August 2007

Fifty‐eight ex‐addicts, representing 87 % of a group found to be drug‐free at an earlier 3‐year follow‐up, have been the target group of an interview study, which aimed at elucidating various phases of the drug career. It was found that drug abusers tend to break their drug‐taking habits either early (before 2 years of abuse) or late (after 6 years or more). Those who abandoned the drug career early regarded giving up drugs as easy and had often been supported by relatives and drug‐free friends. Their dominating reason for giving up drugs was adverse drug reactions, or infectious complications. Those who abandoned the career late reported that it had been a difficult process and that they had received little or no support from friends and relatives. To a large extent they had resorted to the aid of outpatient clinics. This group of ex‐addicts gave as their most common reason for giving up drugs: they had grown tired of the life of a street addict. The considerable number of critics of psychiatric inpatient treatment (74 % rated inpatient clinics as moderately important or unimportant) casts doubt on present treatment approaches.

A simplified clinical description of the drug career is given, where attention is focussed on three stages within the process of de‐addiction.
Disease pattern among 942 mentally retarded persons in a Danish county
Authors: Dyggve H. , Kodahl T.
Published: August 2007

An analytical description is presented of 942 mentally retarded persons from the county of West Zealand. The prevalence of mental retardation (i.e. persons who were registered with an IQ below 75) was 0.36 %. Almost half of the patients were living in institutions. Of the patients 43 % were women and 57 % men.

Important aetiological factors are listed. In almost one third of the patients, similar cases were present among the closcst relatives; 30 % of the patients were born as the fourth or subsequent child in the family; one sixth of the mothers were more than 35 years old at the birth of the handicapped child. Twenty‐two percent of the patients with IQs below 50 had Down's syndrome. Seventeen percent of the patients had epilepsy and 11 % cerebral palsy. In the central institution all patients had psychiatric or somatic complications.
Tryptophan‐nicotinamide, imipramine and their combination in depression
Authors: Chouinard G. , Young S. N. , Annable L. , Sourkes T. L.
Published: August 2007

In a double‐blind controlled study lasting 4 weeks 25 newly admitted severely depressed patients were randomly assigned to tryptophan‐nicotinamide or imipramine or tryptophan‐nicotinamideimipramine combination. Nicotinamide was given to reduce peripheral breakdown of tryptophan. Although there were no substantial differences between the three treatments, the efficacy of tryptophannicotinamide tended to diminish after 2 weeks when the dose of tryptophan was increased from 4 g/day to 6 g/day and that of nicotinamide from 1.0 g/day to 1.5 g/day. The therapeutic response of patients treated with tryptophan‐nicotinamide was significantly correlated with the rise in plasma tryptophan. For the tryptophannicotinamide‐imipramine group, however, therapeutic response and rise in plasma tryptophan were negatively correlated, implying that tryptophan levels were too high in some patients. The data suggest that tryptophan‐nicotinamide may be as effective as imipramine in unipolar patients providing the dose is kept within the therapeutic window, and that at low doses it could also potentiate the action of tricyclic antidepressants. Bipolar patients seem to require higher doses of tryptophan than unipolar patients.
Attitudes towards criminal and other patients
Authors: Viukari M. , Rimón R. , Söderholm S.
Published: August 2007

Staff attitudes towards mentally abnormal offenders were investigated on a forensic psychiatric assessment ward as reflected in a drug trial. The attitude towards drug trials was negative in 79 % of the personnel, in contrast to 71 % positive in three Swedish mental hospitals. Of the respondents 75 % considered that drug treatment did not benefit the patients. Then the attitudes of 21 general physicians towards assessment and drug treatment of mentally abnormal offenders as well as towards 10 illnesses were measured by self‐rating scales employing a 10‐cm line technique. Both the assessment and drug treatment of mentally abnormal offenders were the least favoured as compared with somatic illnesses. Other neuropsychiatric disorders ranked with them were also very significantly (P < 0.001) less favoured than pneumonia. They considered that these attitudes were shared in general by medical and nursing staff.
Simulated discharge system of prescription and long‐term drug treatment in a psychiatric hospital
Authors: Ballinger B. R.
Published: August 2007

The drug sheets of patients resident in a psychiatric hospital for more than 1 year were reviewed. The simulated discharge system involving the re‐writing of drug sheets every 12 weeks was in operation, but there was only a slight increase in prescription changes at the time of renewal; 35.4 % of prescriptions had been unchanged for 1 year and 4.3 % for 5 years. A high proportion of long‐term prescriptions were for purgatives, hypnotics and neuroleptics.
Effect of naloxone or levallorphan on serum prolactin concentrations and apomorphine‐induced growth hormone secretion
Authors: Lal S. , Nair N. P. V. , Cervantes P. , Pulman J. , Guyda H.
Published: August 2007

Naloxone HCL (0.8 mg intravenously; n= 9) or levallorphan tartrate (0.25 mg subcutaneously; n= 5) had no effect on basal prolactin or grwoth hormone secretion in normal men. Neither narcotic antagonist inhibited the grwoth hormone secretory response to apomorphine HCL (0.75 mg subcutaneously). These findings suggest that narcotic antagonists do not block dopamine receptors in the hypothalamic‐pituitary axis in man and that if these agents have antischizophrenic properties then these are not mediated by dopamine receptor blockade.
Psychiatric assessment of healthy children with various EEG patterns
Authors: Bosaeus E. , Selldén U.
Published: August 2007

A sample of 222 healthy children, 112 girls and 110 boys, aged 5–16 years, with different types of EEG pattern, were investigated by current child‐psychiatric methods. The children were recruited from a large material of children selected in accordance with strict criteria of normality from the paediatric and neurological points of view (Petersén & Eeg‐Olofsson (1970/71)).

The aim of the child‐psychiatric assessment was to find out whether any clinical correlation with the EEG patterns could be shown. First of all, 96 children with some form of EEG deviation were included. Besides these, 126 children with normal EEG were recruited at random from the material. In this selected material significant relations emerged between clinical variables and EEG patterns. Normal EEG showed negative correlations with childpsychiatric variables, while deviating EEG patterns were positively correlated. Many of the correlations disappeared in the oldest age group.
Personality and mental health characteristic of Nigerian university students
Authors: Jegde R. O.
Published: August 2007

In this paper are reported some of the results of a 1976 study of 145 female and 725 male freshmen University of Ibadan students who were assessed with the Health Opinion Survery, Eysenck Personality Questionnaire and a 65‐item gerneral questionnaire. A major aim of the study was to obtian data on th social, personality and mental health characteistics of the studient.

Over 6% of subjects assessed their current mental health to be “fair” or “poor” as opposed to “good” or “excellent”. There was no significant association betwween self‐assessed mental health significant relationship with Neuroticism, self‐assessed current physicl health and having problems to discuss with a doctor. These findings, along with the results of factor analysis of the general questionnaire, are discussed and their clinical, methodological and other implications commented upon.
Borderline: A concept analysis
Authors: Modestin J.
Published: August 2007

An examination of the literature concerning the borderline revelas that different authors, using different concepts of the borderline state, are describing different patient groups. Related to the background of the generally accepted psychiatric nosological classification, three borderline concepts are clearly discernible: (1) borderline equated with a forme fruste of schizophrenia, (2) borderline equated with a general category of personality disorder (psychopathy) and (3) borderline equated with a special form of personality disorder.
Community reactions to mental disorders – A KEY INFORMANT STUDY IN THREE DEVELOPING COUNTRIES
Authors: Wig N. N. , Suleiman M. A. , Routledge R. , Srinivasa Murthy R. , Ladrido‐Ignacio L. , Ibrahim H. H. A. , Harding T. W.
Published: August 2007

Attitudes towards mental disorders have been studied in rural areas of Sudan and Northern India and an urban area of the Philippines using standardized interviews with key informants. On average each informant knew by name 3.6 individuals who corresponded to descriptions provided of common mental disorders. The conditions most frequently identified were mental retardation (in all three areas), alcohol and drug related problems (in the Sudanese and Philippines areas) and acute psychosis (in the Indian area). In the Philippines area, the majority of informants indicated traditional healers as the primary source of help for psychological symptoms; in all areas people were judged to be more likely to seek help for psychological than for physical symptoms from traditional healers.

Perceptions of mental illness and their consequences have been presented in graphic form through “attitude profiles”. These reveal differences in responses to the seven mental disorders presented to the key informants through vignettes. More negative and pessimistic attitudes were found in the Indian area than in the other two areas.

The study has been carried out within a programme to introduce community based mental health care as part of primary health care in developing countries. The results have already been used in selecting priorities and designing interventions to promote community involvement. Their eventual use in evaluating the effectiveness of new forms of mental health care is also described.
Cognitive and affective functions in patients with affective disorders treated with lithium AN ASSESSMENT BY QUESTIONNAIRE
Authors: Kjellman B. F. , Karlberg B. E. , Thorell L.‐H.
Published: August 2007

A questionnaire of 19 items was devised to assess subtle changes in affective and cognitive function in patients with affective disorders under long‐term lithium therapy. Of 147 patients, 138 (93.9%) answered the questionnaire. The function of the hypothalamic‐pituitary‐thyroid axis was also analysed by biochemical investigations, and the interrelations between the function of this axis and affective and cognitive functions were studied. The patients under lithium maintenance therapy showed no clearcut changes in affective and cognitive functions. Some statistically significant correlations were found between rising thyrotropin levels and improved affective function. Patients who admitted periods of depression under lithium therapy showed highly significantly greater variance both in free thyroxine index and in thyrotropin levels than patients denying such periods. We may conclude that successful prophylactic lithium therapy against depression is linked to a stabilizing effect on the hypothalamic‐pituitary‐thyroid axis.
The 24‐hour pattern of serum TSH in patients with endogenous depression
Authors: Weeke A. , Weeke J.
Published: August 2007

The 24‐h pattern of serum thyrotropin (TSH) has been studied using hourly blood‐sampling in four patients with severe endogenous depression. All patients showed a pattern similar to that of normal subjects, with lowest levels of serum TSH between 0900 and 2000 h and highest levels between 2100 and 0800 h.

A phaseshift of the TSH rhythm can therefore not account for our previous finding of a significant negative correlation between severity of endogenous depression and night increase in serum TSH measured as the difference between the values at 2400 and 1400 h.
Clinically significant side effects of lithium treatment A SURVEY OF 237 PATIENTS IN LONG‐TERM TREATMENT
Authors: Vestergaard P. , Amdisen A. , Schou M.
Published: August 2007

A group of 237 patients in long‐term lithium treatment were questioned specifically about five side effects commonly associated with lithium treatment and unspecifically about “other” complaints. About one tenth of the patients did not complain of side effects, two thirds had one or two complaints, and one fourth had three or more.

About one half of the patients complained of hand tremor, two thirds of increased thirst, one fifth of weight gain exceeding 10 kg, one fifth of diarrhea, and one tenth of edema of legs or face. A few patients had other complaints.

For each side effect we analysed whether its presence was significantly associated with such patient and treatment variables as sex, age, duration of the lithium treatment, 12‐h serum lithium concentration, type of lithium preparation, and additional medication. Men complained of tremor significantly more often than women. Diarrhea was significantly less frequent in patients given additional treatment with antidepressants. Weight gain was associated with increased thirst and fluid output and with significantly increased blood pressure. None of the other variables distinguished between patients with and without the various complaints. We nevertheless hypothesize that a moderate reduction of the serum lithium level may lead to a lowering of the frequency of some side effects.
Stepwise regression analysis of an intensive 1‐year study of delirium tremens
Authors: Stendig‐lindberg G. , Rudy N.
Published: August 2007

An intensive 1‐year study was carried out on 41 male patients, mean age 49, mean hospitalization time 49 days, admitted to a special ward of the Beckomberga Hospital with the diagnosis of delirium tremens and 50 concomitant somatic and psychiatric diagnoses (1–9 per capita), and given a standardized treatment. The mean duration of delirium tremens after admission was 2 days; 76 % recovered within 48 h. The duration after admission was positively correlated to age, number of previous delirium tremens, negatively correlated to B‐haemoglobin and B‐haematocrit for laboratory data obtained within the first 24 h and was positively correlated to blood sugar and S‐creatinine on data taken within 40 h (Pearson correlation matrix).

Stepwise multiple regression (SWR) based on 46 quantitative and dummy variables (the latter used to represent the presence of various concomitant diseases) was employed to identify the factors predicting the duration of delirium tremens. On final SWR analysis, which limited the number of observations to cases with complete observation vectors, the following regression equation was obtained: Duration after admission = 3.47–0.93 (S‐magnesium)‐0.29 (B‐eosinophils) + 0.62 (liver disease), P > 0.05, n= 14. Although the regression coefficients were not statistically significant, S‐magnesium, negatively associated with the duration after admission, offered 20 % out of the total 38 % of explanation given, whereas B‐eosinophils, negatively associated, offered 12 %, and liver disease, positively associated, 6 %.

The choice by the SWR program of S‐magnesium as the most important factor in predicting the duration of delirium tremens is consistent with clinical evidence that alcohol ingestion causes magnesium diuresis and that magnesium deficiency is present in chronic alcoholism. In view of this knowledge, it is reasonable to assume that the lack of statistical significance is due to the small sample size rather than to the alternative that no explanation is offered by S‐magnesium. Furthermore, B‐haemoglobin, S‐potassium, S‐ASAT, and S‐ALAT, known to be characteristically altered in delirium tremens, were found on forcing (a variant of SWR) to be of secondary importance to S‐magnesium as explaining factors, whereas blood sugar and S‐creatinine derived part of their explaining power from S‐magnesium.

In conclusion, extensive use of SWR analysis based on 46 potential explaining variables points to serum magnesium concentration as the most important factor in predicting the duration of delirium tremens.
Influence of maternal distress during pregnancy on fetal development and mortality
Authors: Blomberg S.
Published: August 2007

The children of 1,263 women whose applications for legal abortion in 1960 had been refused, were compared with the next children born in the same delivery wards. Thus paired, matched controls were obtained and the children were compared with regard to height and weight in relation to gestational age, prematurity, perinatal mortality and mortality up to 12 years of age.

There was a significantly lower number of stillbirths in the proband series, which is probably due to an increased number of abortions of less viable fetus. There were no differences in weight and height development, prematurity or neonatal and subsequent mortality.
Long‐term treatment of depression with isocarboxazide
Authors: Larsen J. K. , Rafaelsen O. J.
Published: August 2007

Isocarboxazide has been used as long‐term treatment for a selected group of 20 depressive patients, of whom some 90% (17/19) were non‐responders to treatment with tricyclic antidepressants. At the follow‐up the median duration of illness was 162 months, and the median duration of treatment was 42 months. Side‐effects and interactions were moderate thus legitimating a treatment procedure on which all the patients of the material responded better than on any other antidepressive treatment.

Treatment with monoamine‐oxidase‐inhibitors, like isocarboxazide, should not be left untried in the case of therapy‐resistant depression.
Personality dimensions in a 70‐year‐old urban population NORMS FOR THE MNT SCALES AND SEX AND AGE RELATIONS
Authors: Persson G.
Published: August 2007

The three personality dimensions validity, solidity and stability according to Sjöbring were measured by means of the MNT scales in representative samples of 70‐year‐old men and women taking part in a health control survey in Gothenburg, Sweden. Means, standard deviations, stanine scores and a comparison with results from other Swedish studies pertaining to representative samples of middle‐aged men and women and 16‐year‐old boys and girls are presented. Seventy‐year‐old men scored higher than 70‐year‐old women on validity, as did men in all other age‐groups. The difference could, to some extent, be related to the lower prevalence of neurosis and personality deviations in men. There was no difference between the sexes in the 70‐year‐olds nor in the middle‐aged people with regard to solidity and stability. Sixteen‐year‐old boys scored higher on stability than 16‐year‐old girls. Seventy‐year‐olds of both sexes scored lower on validity than 45‐year‐olds of both sexes, and 70‐year‐old men scored higher on stability than 45‐year‐old men. The size of the differences of personality dimensions between the sexes was similar in 70‐year‐olds and 45‐year‐olds, and the standard deviations of the personality dimensions were also similar between the 70‐year‐olds and the 45‐year‐olds.
Effect of repeated sleep deprivation on clinical symptoms and the TRH test in endogenous depression
Authors: Kvist J. , Kirkegaard C.
Published: August 2007

Twenty‐eight patients with endogenous depression were treated with repeated total sleep deprivation (TSD) as the only treatment. In eight patients complete remission was obtained, but an early relapse occurred in five, and after 6 months only three patients (11 %) remained in remission. The remaining group of 20 patients with no or only a partial response to TSD also had a significant reduction of the score on the Hamilton Rating Scale (median 23 versus 17, P < 0.01).

A thyrotropin‐releasing hormone (TRH) stimulating test was performed before and after TSD. According to previous studies an increase of the maximal response in serum thyrotropin (TSH) to TRH (ΔΔ max TSH > 2.0 μU/ml), after TSD was taken as a predictor of a favourable long‐term outcome. Under blind conditions a correct prognosis was made in all patients (n= 8) from the group of responders. By comparison, only two of the 20 patients from the nonresponding group had a ΔΔ max TSH > 2.0 μU/ml after TSD.
Psychophysiological studies in schizophrenic patients selected on the basis of a “genetic marker”
Authors: Maricq H. R. , Weinrich M. C.
Published: August 2007

Psychophysiological studies in schizophrenics have generally resulted in contradictory and inconclusive reports. The purpose of the present study was to determine whether a better psychophysiological separation of schizophrenic and control subjects could be accomplished by selecting them on the basis of a biological marker: the high plexus visualization score (PVS).

Finger blood flow, skin temperature and electrodermal recovery rates were studied in 64 male schizophrenics (33 high PVS and 31 low PVS) and 24 male controls (10 high PVS and 14 low PVS) matched for age. All control subjects and 30 of the schizophrenics (16 high PVS and 14 low PVS) had been drug‐free for at least 1 month. They were studied in a sound attenuated, temperature controlled room under 12 experimental conditions. The results demonstrate that, as predicted, schizophrenics with high PVS have the lowest finger blood flow rates, the lowest skin temperatures and the slowest GSR recovery rates of all groups studied. The largest difference in all three variables was found between high PVS schizophrenics and high PVS controls.

The blood flow rates and the skin temperature were higher and the electrodermal responses were fewer in patients taking medications than in those receiving placebos. A suggestion of a bimodal distribution into “responders” and “non‐responders” was apparent only in patients receiving medications.
Incidence and prevalence of treated mental disorders: HEALTH CARE PLANNING IN A SMALL‐TOWN‐RURAL REGION OF UPPER BAVARIA
Authors: Diling H. , Weyerer S.
Published: August 2007

An analysis of those to be cared for and those destined to provide the care is necessary, in order to develop an effective system of mental health care. Such an analysis is given here for a rural‐small‐town region of Upper Bavaria with 424,000 residents. The treated incidence and prevalence are presented according to sex, age and diagnosis. The morbidity rates for patients from communities of various sizes and distances from the institution of treatment are discussed as an example of ecological analysis. The future planning for the research area should be based on varied community‐centred possibilities for psychiatric care.
Studies on the prolactin response induced by electroconvulsive therapy in schizophrenics
Authors: Arató M. , Erdós A. , Kurcz M. , Vermes I. , Fekete M.
Published: August 2007

Electroconvulsive therapy (ECT) and simulated ECT (SECT)‐induced prolactin response has been studied in 14 schizophrenic males. Cortisol, growth hormone, and thyroid stimulating hormone (TSH) changes have been measured simultaneously. The prolactin rise was significantly higher after ECT than after SECT. Cortisol increase after ECT did not exceed significantly the elevation after SECT. Changes in growth hormone and TSH concentrations were inconsistent and non‐significant. On the basis of the results it may be assumed that ECT‐induced prolactin response is a consequence of specific transmitter changes in the CNS and not a result of stress reaction or generalized neuronal discharge. ECT‐induced prolactin response was negligible in two cases. Both patients were chronically hospitalized schizophrenics resistant to therapy. Whether the prolactin response or its absence is of predictive value with respect to prognosis or effect of ECT remains to be seen.
Long‐term fluphenazine decanoate maintenance dosage requirements of chronic schizophrenic patients
Authors: Capstick N.
Published: August 2007

Forty‐seven schizophrenic out‐patients, who were satisfactorily maintained on a depot injection of fluphenazine decanoate, and who received the injection every 28 days, were progressively withdrawn from medication by increasing the time interval between injections while maintaining the amount of drug per injection. The rate of reduction varied with each patient depending on various factors such as environmental stress considerations, and the patient's wishes. Finally three injections at 8‐weekly intervals were given before complete withdrawal. The follow‐up period was 23.7 months with a standard deviation of 1.9. A relapse rate of 80% was found, 25 patients relapsing during the withdrawal phase and 22 patients after the drug had been completely withdrawn.
Who takes care? How and where? And why?
Authors: Strömgren E.
Published: August 2007

Facilities and man‐power available for treatment and prevention of mental disorders are grossly insufficient and will probably always remain so. It is therefore a crucial objective to find out to whom and in which ways available forces should be applied so as to make best possible use of them. Instances of existing obstacles to rational application of these forces are mentioned, and suggestions for minimizing such obstacles are put forward. The importance for the solution of these problems of studies like those conveyed at the present symposium is stressed.
Teaching psychiatric interview techniques to family doctors
Authors: Goldberg D. P. , Steele J. J. , Smith C.
Published: August 2007

Recent studies indicate that family doctors fail to detect a substantial proportion of minor psychiatric disorders, and there is considerable variation between doctors in their ability to make accurate assessments. Previous research had indicated that such ability was correlated with certain interviewing techniques and variables relating to the doctors’ personality. The present research measured the interview techniques of 12 trainee family doctors who made inaccurate assessments of their patients’ degree of psychiatric disorder, and then offered them 4 sessions each of teaching based on acquisition of a simple model and videotaped feedback in an attempt to modify their interview techniques. The interview techniques were then measured again 1–4 months later. The reliability of the ratings of interview techniques is given, together with details about those medical behaviours which were capable of modification, and those which persisted unchanged.
Biosocial implications growing from high‐risk research
Authors: Schulsinger F. , Mednick S. A. , Walker E. F. , Cudeck R. , Moffitt T.
Published: August 2007

A brief report of Mednick & Schulsinger's high‐risk study of schizophrenia is given. Path analyses of social and biological variables in the study demonstrate sex differences with implications for the etiology of schizophrenia. Sex is discussed as a possible non‐descriptive, biological addition to the traditional descriptive way of conceptualizing schizophrenia. Evidence for other social or psychological extensions of the definition of schizophrenia is mentioned.
The Children's Handicaps, Behaviour and Skills (HBS) Schedule
Authors: Bernsen A. H.
Published: August 2007

The Children's Handicaps, Behaviour and Skills Schedule (HBS Schedule) was used in a semistructured interview with parents and professionals concerned with 148 severely retarded children in the county of Aarhus. Results as to agreement between informants are presented including an analysis of the effect of increasing time interval between the interviews. Comparisons are made with a similar study from Camberwell, England. It is concluded that the HBS Schedule constitutes a valuable supplement in assessing retarded children, and it is suitable for subgroup‐ ing such children which is important in planning as well as in research.
The use of rating scales in an epidemiological field study on diseases of the ICD‐numbers 300–307
Authors: Glettler G. , Schepank H.
Published: August 2007

In a field study, three age groups (1935, 1945 and 1955) in a German city will be tested by questionnaires and a half standardized interview. The hypotheses relate in a descriptive way to the rates of prevalence and incidence of the psychogenic diseases of the ICD numbers 300–307. In the follow‐up study after three years, the prognosis will be compared with the actual state of health of the proband. Various rating scales will be used for the measurement of complex variables (e.g. social integration). A general characterization of the ratings will be given. Then the intuitive rating will be compared with the rating on the basis of a concept.
WHO collaborative study on impairments and disabilities associated with schizophrenic disorders
Authors: Jablensky A. , Schwarz R. , Tomov T.
Published: August 2007

According to WHO estimates up to two‐fifths of all disability is associated with mental disorders. Because of the severe burden of psychiatric disability on individuals, families and communities, programmes aiming at its prevention, containment or reduction are likely in the future to receive a high priority in public health planning. However, the rational selection of effective approaches to disability prevention and reduction is hampered by the absence of: (i) agreed concepts and criteria of psychiatric impairments and disabilities; (ii) standardized methods for assessment; and (iü) knowledge about the predictors and precursors of specific impairments and disabilities in patients suffering from mental disorders.

A recently undertaken WHO collaborative study in seven countries draws on findings from earlier research, and aims to contribute to the resolution of these problems. In the first phase of the project, instruments for the assessment of psychological impairments and specific disabilities in patients suffering from schizophrenic psychoses have been drafted. In the second phase, the instruments have been applied to assess series of 70 patients each selected in seven catchment areas on the basis of specified screening criteria. In the third phase, follow‐up examinations are being carried out at one‐ and two‐year points after the initial evaluation. It is expected that detailed information will be collected in the course of the study on the nature and extent of impairments and disabilities in the early stages of schizophrenia, and on their prognosis.
Application of WHO scales for the assessment of depressive states in different cultures
Authors: Sartorius N. , Jablensky A. , Gulbinat W. , Ernberg G.
Published: August 2007

In order to develop crossculturally applicable instruments for a standardized assessment of depressive states, and to evaluate the clinical and social characteristics of depressive patients seeking treatment in different cultures, WHO has coordinated a collaborative study with the participation of five research centres in Canada, Iran, Japan and Switzerland. A screen form and a schedule for Standardized Assessment of Depressive Disorders (SADD) were designed and proved to be reliable and easily applicable. The 573 patients with endogenous and psychogenic depression assessed in the five centres had many characteristics in common across the different cultural settings but analysis of variance demonstrated statistically significant differences in symptom profiles between endogenous and psychogenic depressive disorders. Although no inferences about the validity of such diagnostic distinctions can be drawn from cross‐sectional data only, this result shows that psychiatrists in different cultures can be consistent in assessing depressive symptomatology and applying specified diagnostic criteria. The study is a component of a multi‐faceted WHO research programme on depression.
Mental health, neighborhood and related social variables in Oslo
Authors: Dalgard O. S.
Published: August 2007

The present study aims at screening the psychiatric morbidity in different areas of Oslo, relating the findings to qualitative aspects of neighborhood. The general hypothesis is that the risk of mental disorders increases by decreasing quality of neighborhood, possibly through negative impact on psycho‐social variables like social network.

The sample which consists of 1,003 randomly picked adults from five main types of neighborhood is interviewed by means of a structured questionnaire, and a statistical procedure is applied to estimate, on the basis of symptom scores, the risk of being “a psychiatric case”.

In short, the hypothesis is by and large confirmed by the study, indicating that the lower the quality of neighborhood, in terms of possibilities for recreation and social interaction, as well as private and public services, the higher the prevalence of mental disorder, treated as well as untreated. Unsatisfactory social network is related to low quality of neighborhood and seems to interact with negative neighborhood characteristics, increasing sharply the risk of mental disorder in low quality areas.

Variables like sex, age, marital status, education or place of birth can not explain the differences in psychiatric morbidity between the qualitatively different neighborhoods, nor can variables indicating mental health problems before moving into the present neighborhood.
The rising pandemic of mental disorders and associated chronic diseases and disabilities
Authors: Kramer M.
Published: August 2007

Prevalence rates of mental disorders, hypertensive disease, cerebrovascular disease and other chronic conditions are increasing throughout the world. Two mechanisms are responsible for this situation: the large relative increases that are occurring in the number of persons in age groups at high risk for developing these conditions; and the increase in average duration of chronic diseases resulting from the successful application of techniques for arresting their fatal complications and prolonging the lives of affected individuals. In the absence of effective techniques for reducing incidence, the prevalence of such diseases will continue to increase.

The chronic mental disorders and conditions related to them are used to illustrate the manner in which these mechanisms are operating. Data are presented to demonstrate the increases likely to occur between 1975 and 2000 in the number of persons with these conditions in the more and less developed regions of the world and in selected countries.

These findings set new priorities for future epidemiologic research. Emphasis must be placed on discovering the preventable causes of the conditions which are increasing in prevalence.
Nigerian psychiatry in perspective
Authors: Jegede R. O.
Published: August 2007

The history of Nigerian psychiatry is reviewed, and the main features and leading figures identified. The author then proceeds to discuss future directions to be taken by Nigerian psychiatry, if it is to effectively meet the challenges involved, the most prominent being to provide service for a large but growing population living in rapidly changing times.
Mental health and the use of alcohol, tobacco, analgesics and vitamins in a secondary school population
Authors: Henderson S. , Lewis I. C. , Howell R. H. , Rayner K. J.
Published: August 2007

A survey of mental health in relation to patterns of alcohol, tobacco, pharmaceutical drug use and reducing diets was carried out in six Hobart high schools and matriculation colleges. A response rate of 89% was achieved, yielding a sample of 2,419 teenagers. Psychiatric disorder was assessed by the 60‐item General Health Questionnaire. A statistically significant association was found between the probability of psychiatric disturbance and the use of alcohol, cigarettes, analgesics, vitamin supplements and weight‐reducing diets.
Some clinical aspects of criminology: A study of criminal psychiatrie patients at the Lantoro Psychiatrie Institution
Authors: Odejide A. O.
Published: August 2007

Mentally ill criminals at Lantoro Institution (an annex of Aro Neuropsychiatric long‐stay Hospital, Abeokuta, Nigeria) were studied. Thirty‐six (67.9 %) of the 53 patients had committed homicide while 11 (20.7 %) had been involved in other offences against the person. Forty (75.5 %) of the 53 patients were diagnosed as schizophrenic patients with the paranoid subtypes predominating. All the 10 epileptics had committed homicide whereas the few cases of organic psychosis had committed less grievous offences such as disorderly behaviour and stealing.

In comparison with the civil (voluntary) admissions to the institution, a greater percentage of the involuntary patients (mentally ill criminals) were found to have lost social contacts especially with their key relatives. Some of the factors thought to be responsible for this phenomenon were the long duration of hospitalization and the social implications of the offences committed. Measures for rehabilitating the mentally ill criminals in Nigeria were suggested.
Age distribution of patients with delirium tremens in Denmark 1836–1978
Authors: Kramp P. , Hemmingsen R.
Published: August 2007

The age of Danish delirium tremens (DT) patients in five different time periods – 1836, 1897, 1954–60, 1961 and 1978 – was compared. The age distribution of DT patients was very similar in the 1836‐, 1897‐ and 1978‐studies, about half of the patients were below the age of 40. The studies from the middle of this century differ remarkably from this, only 10–15% of the patients were below the age of 40 in these two studies. Similar changes in the age of DT patients seemingly have occurred in other countries. The similarity in the age distribution of DT patients in the last century and today may suggest that independently of many other factors young persons excessively drinking alcohol have a greater risk of developing a DT than have older alcohol‐abusing persons. The alcohol consumption of the general population and the incidence of DT have been found to correlate. The high mean age of DT patients in the 1950's could be explained by the low alcohol consumption – and thereby the low incidence of DT – in this period, which in turn gives a decreasing number of DT patients; the largest decrease would occur in the most sensitive group – the young alcoholics – causing an increasing age maximum of the patients.

The age distribution of DT patients in the various materials has been corrected according to changes in the age distribution of the general population during the 150 years investigated. These corrections did not change the main conclusion: independently of a series of social, health and environmental factors young alcohol‐abusing persons are especially prone to develop a DT. Finally, some possible explanations of this phenomenon are suggested.
Sulpiride and the role of dopaminergic receptor blockade in the antipsychotic activity of neuroleptics
Authors: Memo M. , Battaini F. , Pano P. F. , Trabucchi M.
Published: August 2007

It is now generally recognized that dopamine receptors exist in the CNS as different subtypes: D1 receptors, associated with adenylyl cyclase activity, and D2 receptor, uncoupled to a cyclic AMP generating system. In order to understand the role of D1 and D2 receptors in the antipsychotic action of neuroleptics, we have performed subchronic treatment with haloperidol, a drug which acts on D2 receptors, and sulpiride, a selective antagonist to D2 receptors.

Long‐term treatment with haloperidol does not induce significant supersensitivity of the D2 receptors. In fact under these conditions 3H‐(‐)‐sulpiride binding, which is a marker of D2 receptor function, does not increase in rat striatum, while the long‐term administration of sulpiride itself produces supersensitivity of D2 receptors. Moreover, sulpiride does not induce supersensitivity of the D1 receptors, characterized by 3H‐spiroperidol binding.

These data suggest that both types of dopamine receptors may be involved in the clinical antipsychotic effects of neuroleptics.

Unilateral lesion of the nigrostriatal dopaminergic pathway produces an increase of striatal dopaminergic receptors, measured either by 3H‐spiroperidol and 3H‐(‐)‐sulpiride binding. These findings suggest that D1 and D2 receptors are present in postsynaptic membranes while it is still not known whether they exist in the same cellular elements.
Characteristics of depressive patients contacting psychiatric services in four cultures
Authors: Jablensky A. , Sartorius N. , Gulbinat W. , Ernberg G.
Published: August 2007

The paper is a report on results obtained in the course of a multicentre international study on depressive disorders in four countries, which was sponsored and co‐ordinated by the World Health Organization. A screen form was developed and tested in order to select depressive patients among psychiatric in‐patient and outpatient populations. The patients selected in this way were assessed clinically by experienced investigators using the WHO schedule for Standardized Assessment of Depressive Disorders (SADD). A total of 573 patients were evaluated in the five research centres, and the data were utilized in uni‐ and multivariate statistical analyses aiming to establish whether similar cases of depression could be found in different cultures, to describe their characteristics and to ascertain the extent to which diagnostic concepts and classification categories could be applied in different settings. The results point to a considerable degree of similarity in depressive symptomatology across the cultures if particular selection criteria are applied, and suggest that broad diagnostic groupings such as ‘endogenous’ and ‘psychogenic’ depressions could be used consistently by clinicians working in different cultures.
Similarities and differences in the approach of R. M. Reitan and A. R. Luria
Authors: Diamant J. J.
Published: August 2007

The approaches of Reitan and Luria to the brain‐behaviour relationships are compared in ternis of the dichotomies between clinical neuropsychology and behavioural neurology, indirect inference and direct inference, standard approach and flexible approach.

The underlying neuropsychological models of Halstead and Reitan and of Luria are confronted. The outcomes of a pilot study comparing the results of the Halstead‐Reitan Neuropsychological Test Battery (HRNTB) and Luria's Neuropsychological Investigation (LNI) in Christensen's version are briefly mentioned.

The possibilities of an integration of these two approaches are discussed and a step approach to the neuropsychological assessment described.
Mental health of 58 Swedish men living together with their wives and preschool children
Authors: Nettelbladt P. , Uddenberg N. , Englesson I.
Published: August 2007

The mental health of the man was studied in a random sample of 58 Swedish unbroken families. Men with mental symptoms above an approximate median were compared to men with mental symptoms below the median. Thirteen of the men with mental symptoms were regarded as suffering from clinical psychopathology. Men reporting many mental symptoms more often than the others, had poor contact with their parents and poor mental health during childhood and adolescence, and also their parents’ marriage had been disharmonious. Men with mental symptoms above the median more often tended to have a less satisfying relationship to their wives and children. This same group of men usually had low incomes and tended to be dissatisfied with their job and present dwelling. There was no relationship between the man's current mental health and the child's report of its emotional contact with its father in a projective play session. Nor was the number of mental symptoms related to the emotional and intellectual development of the child.
Clinical features and classification of symptoms in depression
Authors: Guilmot P. H.
Published: August 2007

The typical depressed patient is described as well as the course of the depression. Recommendations for the physician, treating depressed patients, are given. There are two main groups of depressions ‐ endogenous depression and reactive depression ‐ which are explained. Depression is a syndrome with “seven principal dimensions”. The depressive syndrome is always a serious condition, reacting to suicidal behaviour, which is the greatest of psychiatric emergencies.
Pre‐ and postsynaptic effects of zimelidine and norzimelidine on the serotoninergic system: single cell studies in the rat
Authors: Montigny C. De , Blier P. , Caillé G. , Kouassi E.
Published: August 2007

The pre‐ and postsynaptic effects of zimelidine and norzimelidine were studied in adult male Sprague‐Dawley rats. The potency of the presynaptic effect was estimated from their ability to depress the rate of firing of serotonin (5‐HT)‐containing raphe neurons. Chronic administration of tricyclic antidepressant drugs has been shown to sensitize forebrain postsynaptic 5‐HT receptors. The effect of zimelidine on these receptors was compared to that of saline and chlorimipramine by assessing the responsiveness of hippocampal pyramidal cells to microiontophoretic applications of 5‐HT, norepinephrine (NE) and γ‐aminobutyric acid (GABA).

Consistent with their known 5‐HT reuptake blocking property, acute intravenous administration of zimelidine and norzimelidine depressed the firing rate of 5‐HT‐containing dorsal raphe neurons. ED50 of zimelidine and norzimelidine were respectively 1.1 mg/kg and 0.8 mg/kg.

Chronic administration of zimelidine (5 and 10 mg/kg, q.d. for 14 days) did not modify the responsiveness of hippocampal pyramidal cells to iontophoretic applications of 5‐HT, NE and GABA, whereas chlorimipramine (5 mg/kg, q.d. for 14 days) increased selectively their sensitivity to 5‐HT.

Since the antidepressant efficacy of zimelidine is well documented, it is concluded that sensitization of forebrain postsynaptic 5‐HT receptors is not a prerequisite for a drug to exert an antidepressant effect. It is suggested that an enhancement of the 5‐HT‐mediated synaptic transmission might be the final effect of the various types of antidepressant treatment whether their primary effect is pre‐ or postsynaptic.