bluuebunny/crossref_metadata_2025 huggingface dataset:
The symptom structure of panic disorder: a trial using factor and cluster analysis
Authors: Shioiri T. , Someya T. , Murashita J. , Takahashi S.
Published: August 2007

Using cluster analysis of 207 patients with panic disorder (PD), we investigated the relationships between several panic symptoms at the time of panic attacks, which included anticipatory anxiety, agoraphobia, and 13 clinical symptoms based on the Diagnostic and Statistics Manual‐III‐Revised. Cluster analysis revealed three panic symptom clusters: cluster A (dyspnea, choking, sweating, nausea, flushes/chills); cluster B (dizziness, palpitations, trembling or shaking, depersonalization, agoraphobia, and anticipatory anxiety); and cluster C (fear of dying, fear of going crazy, paresthesias, and chest pain or discomfort). Generally, cluster A was comprised exclusively of physiological symptoms, among which respiratory symptoms were prominent, cluster B included both panic and non‐panic symptoms such as agoraphobia and anticipatory anxiety, and cluster C was comprised chiefly of fear symptoms.
A factor analytic study of symptoms in acute schizophrenia
Authors: Mellers J. D. C. , Sham P. , Jones P. B. , Toone B. K. , Murray R. M.
Published: August 2007

The three‐syndrome model of schizophrenic phenomenology has been well established in chronic illness. We report an attempt to replicate this concept in a sample of acutely unwell schizophrenic patients. Factor analysis was performed using PSE data collected within a week of admission from 114 patients who met DSMIII(R) diagnostic criteria for schizophrenia. Four main factors accounted for 58% of the variance. The first two factors closely resembled Liddle's disorganisation and psychomotor poverty syndromes. Hallucinations and delusions loaded separately under the third and fourth factors. To examine the validity of these four syndromes, the relationships between factor scores and other clinical data were examined. The disorganisation syndrome was associated with a history of multiple past admissions and a longer lifetime duration of in‐patient treatment.
Towards an understanding of defense style in terms of temperament and character
Authors: Mulder R. T. , Joyce P. R. , Sellman J. D. , Sullivan P. F. , Cloninger C. R.
Published: August 2007

The aim was to investigate the relationships between a model of personality based on the concept of defense mechanisms, as articulated by Vaillant, with the psychobiological model of personality, as developed by Cloninger. A total of 128 adults from 11 family pedigrees with at least two alcohol‐dependent members completed the self‐report Defense Style Questionnaire and the Temperament and Character Inventory. Immature defenses were largely explained by low character scores, while neurotic defenses were part temperament and part character. Cluster A, B and C defenses were related to low reward dependence, high novelty‐seeking and high harm avoidance respectively. In a regression analysis, cluster B and C defenses were more related to low character scores than to temperament but, for cluster A defenses, temperament and character both contributed. The results suggest that it is possible to integrate an ego defense model of personality with a psychobiological model of personality, thereby enriching both approaches.
Catatonia. I. Rating scale and standardized examination
Authors: Bush G. , Fink M. , Petrides G. , Dowling F. , Francis A.
Published: August 2007

To facilitate the systematic description of catatonic signs, we developed a catatonia rating examination, rating scale and screening instrument. We constructed a 23‐item rating scale and a truncated 14‐item screening instrument using operationalized definitions of signs ascribed to catatonia in published sources. Inter‐rater reliability was tested in 44 simultaneous ratings of 28 cases defined by the presence of ≥2 signs on the 14‐item screen. Inter‐rater reliability for total score on the rating scale was 0.93, and mean agreement of items was 88.2% (SD 9.9). Inter‐rater reliability for total score on the screening instrument was 0.95, and mean agreement of items was 92.7% (SD 4.9). Diagnostic agreement was high based on criteria for catatonia put forth by other authors. Seven per cent (15/215) of consecutively admitted patients to an academic psychiatric in‐patient facility met criteria for catatonia. It is concluded that catatonia is a distinct, moderately prevalent neuropsychiatric syndrome. The rating scale and screening instrument are reliable and valid. Their use facilitates diagnosis, treatment protocols, and cross‐study comparisons.
Suicide attempters in a general hospital unit in India: their socio‐demographic and clinical profile — emphasis on cross‐cultural aspects
Authors: Latha K. S. , Bhat S. M. , D'Souza P.
Published: August 2007

The number of suicide attempts in developing countries has been increasing progressively, as in the West. It is important to note that much of the data on suicidal behaviour is based on information obtained from developed Western societies. All such data need to be evaluated within their specific cultural context as well as cross‐culturally. The present study explored the various socio‐demographic, clinical characteristics of suicide attempters in a general hospital unit in India. There were certain findings that contrasted markedly with those observed in the West. Male suicides tended to predominate here, as in many Indian studies. None of them were living alone, separated or deserted by their partner. Some suicide attempters continued to live with their extended family. There was virtually no alcohol consumption by female suicide attempters. The commonest agents used were organophosphates and other household poisons. Several cross‐cultural variations in the suicidal act emerged compared to the West. The 'suicide potential’ in the Indian culture is discussed.
Contextual aspects of mental disorders: a proposal for axis III of the ICD‐10 multiaxial system
Authors: Janca A. , Kastrup M. , Katschnig H. , López‐Ibor J. J. , Mezzich J. E. , Sartorius N.
Published: August 2007

After several years of development and testing, the World Health Organization (WHO) has recently completed work on the multiaxial presentation of ICD‐10 for use in adult psychiatry. Axis III of the ICD‐10 multiaxial system is intended for clinicians’ reporting of contextual factors which may influence the diagnosis, treatment or prognosis of mental disorders that are recorded on Axis I. It was tested in two WHO‐coordinated international field trials and found to be user‐friendly, reasonably reliable and useful in routine clinical work, in the training of mental health professionals and in research on mental disorders.
Do endogenous features in depression predict the risk of psychiatric illness in relatives?
Authors: Fanous A. H. , Walsh D. , Kendler K. S.
Published: August 2007

We sought to evaluate the hypothesis that endogenous symptoms define a form of depression that is relatively distinct from a familial perspective. Cox models examined the relationship between endogenous symptoms in 88 epidemiologically ascertained cases of treated major depression and the risk for a range of psychiatric disorders in relatives. Endogenicity did not predict risk of major depression, bipolar disorder, anxiety disorders, schizophrenia, or schizophrenia spectrum illnesses in relatives. Risk in relatives of illness as an external validator of endogenous depression is not supported by our family study data.
Are suicide rates in Sweden associated with changes in the prescribing of medicines?
Authors: Carlsten A. , Allebeck P. , Brandt L.
Published: August 2007

A key issue in the debate on suicide prevention is the extent to which suicide rates are affected by the availability of means of committing suicide. The aim of this study was to analyse the changes in rates of suicides committed by poisoning in Sweden between 1969 and 1992, and to determine to what extent these were associated with changes in the prescribing of medicines. We compared suicide rates from 1969 to 1992 with trends in the sales of antidepressants, barbiturates, neuroleptics and analgesics during the same period. The incidence of suicide by poisoning decreased during the 1970s, especially in younger and middle‐aged men. This was mainly due to a decrease in suicides by barbiturate poisoning, which closely followed a decrease in sales of barbiturates. Sales of analgesics and antidepressants increased during the study period, and so did the rates of suicide using these drugs. We conclude that the availability of medicines is an important factor influencing suicide rates, and that changes in the prescribing of medicines may influence suicide rates.
Decreased efficacy of combined benzodiazepines and unilateral ECT in treatment of depression
Authors: Jha A. , Stein G.
Published: August 2007

In a retrospective study, 124 patients with depression who were concomitantly receiving ECT and benzodiazepines were compared with patients (matched for age, sex, diagnosis, and laterality of ECT) receiving ECT without benzodiazepines in order to investigate the efficacy of ECT in terms of therapeutic response and length of stay in hospital. Most of the subjects (84% of cases and 89% of controls) improved on ECT, but the benzodiazepine group of patients receiving unilateral ECT showed a significantly poorer response and a longer stay in hospital. No such difference was detected with the bilateral ECT. It is therefore concluded that prescription of benzodiazepines with ECT does compromise the therapeutic effect of unilateral ECT for depression.
Alcohol consumption and regular benzodiazepine use in 55‐year‐old female Malmö residents: results of a health screening
Authors: Österling A. , Berglund M.
Published: August 2007

The main objective of the present study was to examine the relationship between regular benzodiazepine (BZD) use and drinking patterns in 55‐year‐old female residents of Malmö, Sweden. All women born in 1935 (a total of 1223 subjects) were invited to a health screening at the Preventive Medicine Section, Malmö General Hospital; 69% agreed to participate. The screening included an extensive health questionnaire, and the responses to 33 items assessing social background, including immigrant status, use of BZD and analgesics, alcohol consumption (the revised Malmö‐MAST), smoking and morbidity were analysed. A psychiatric symptoms scale including five of these items was constructed, yielding a Cronbach's alpha of 0.57. Present use of BZD hypnotics and/or tranquillizers was acknowledged by 6% of the women. BZD use at any time in the past or present was endorsed by 23%. Endorsement of ≥3 revised Malmö‐MAST items, indicating problem drinking, occurred in 3% of the participants; 16% were teetotallers and about 25% were regular weekend drinkers. BZD use was significantly more likely to occur in women with the following characteristics: early retirement, pain symptoms, longstanding use of analgesics, multiple psychiatric symptoms. Drinking patterns in relation to BZD use indicated that regular weekend drinkers were significantly less likely to be current and/or previous BZD users than problem drinkers and teetotallers. Logistic regression analyses indicated that use of BZDs was mainly predicted by endorsement of multiple psychiatric symptoms.
Psychopathy and Axis I and Axis II psychiatric disorders in a forensic psychiatric population in Sweden
Authors: Stålenheim E. G. , Von Knorring L.
Published: August 2007

The relationship between psychopathy and mental disorders was investigated in 61 male subjects during a forensic psychiatric examination. The Psychopathy Checklist Revised (PCL‐R) and the Structured Clinical Interview for DSM‐III‐R (SCID) were used for the assessments. Although psychotic subjects were excluded, the overall psychiatric morbidity in the study population was high. Comorbidity was common, irrespective of the degree of psychopathy. Psychopathy was strongly positively correlated with substance abuse/dependence but negatively correlated with depression. Almost all of the subjects with high PCL‐R scores had DSM‐III‐R antisocial and/or borderline personality disorders. However, some subjects with antisocial personality disorders had medium or low PCL‐R scores. When the subjects were reassessed with diagnoses of DSM‐IV and ICD‐10 personality disorders, the difference between psychopathy and antisocial personality disorder was reduced.
A new questionnaire assessing coping strategies in relatives of patients with schizophrenia: development and factor analysis
Authors: Magliano L , Guarneri M. , Marasco C. , Tosini P. , Morosini P. L. , Maj M.
Published: August 2007

This paper describes the development and validation of a questionnaire assessing the coping strategies adopted by relatives of patients with schizophrenia. The final version of the questionnaire includes 27 items, grouped into seven subscales (information, positive communication, social interests, coercion, avoidance, resignation and patient's social involvement), the intra‐rater reliability of which ranges from 0.46 to 0.76. Cronbach's alpha coefficient, which tests the content validity of the subscales, ranges from 0.68 to 0.83. Factor analysis identifies three factors (problem‐oriented coping strategies, emotionally focused strategies, and maintenance of social interests in association with patient's avoidance), accounting for 70.9% of the total variance. This questionnaire may be particularly useful for targeting and monitoring psychoeducational interventions in the families of patients with schizophrenia.
Suicide as a crime in the UK: legal history, international comparisons and present implications
Authors: Neeleman J.
Published: August 2007

Suicide was a crime in England and Wales until 1961. This paper compares the English legal treatment of suicide with that in other Western countries. The delayed English decriminalization of suicide is a likely result of the nature of English common law, rather than a reflection of actual public opinion and medico‐legal practice. This subject remains of interest. Coronership, the cornerstone of English suicide certification, developed out of anti‐suicide legislation, and important biases result from this. The Church of England may still deny ordinary burial rites to certain suicide victims. Assisted suicide, to be distinguished from euthanasia and suicide pacts, became a separate offence in 1961. Legislative reform regarding these issues, similarly to that regarding suicide, is likely to lag behind the development of public opinion and medical practice.
Dementia of depression or depression of dementia in stroke?
Authors: Andersen G. , Vestergaard K. , Riis J. Ø. , Ingeman‐Nielsen M.
Published: August 2007

This study describes the correlation between changes in mood symptoms assessed by the Hamilton Depression Rating Scale (HDRS) and intellectual impairment assessed by the Brief Cognitive Rating Scale (BCRS) and Mattis Dementia Rating Scale (MDRS) in 166 unselected 1‐year survivors after stroke, in whom post‐stroke depression (PSD) has previously been described and validated. The course of intellectual impairment associated with PSD was compared with the course of intellectual impairment in non‐PSD patients. In general, improvement in mood symptoms was correlated with an improvement in intellectual function. However, in 53 PSD patients improvement in intellectual performance was absent, despite the fact that the patients reported being significantly less distressed by dementia symptoms. Antidepressive medication did not lead to any improvement in MDRS score. No evidence was found to support the hypothesis of ‘dementia of depression’. To the contrary, the findings indicate ‘depression of dementia’.
Symptoms at index admission as predictor for 1‐5 year outcome in schizophrenia
Authors: Wieselgren I. M. , Lindström E. , Lindström L. H.
Published: August 2007

A total of 107 drug‐free schizophrenic patients (76 males and 31 females) were consecutively admitted to an emergency ward and rated for psychotic symptoms by means of 32 items from the Comprehensive Psychopathological Rating Scale (CPRS). They were followed prospectively with ratings of social functioning by use of Strauss‐Carpenter's outcome scale at 1, 3 and 5 years after index admission with the aim of determining possible early symptoms that are predictors of social outcome. In total, 59 of the patients were first admissions and had never been treated. At index admission, no difference was found in total CPRS scores between first‐admission patients and chronic readmitted patients, or between male and female subjects. When subscales for positive symptoms (flights of ideas, feeling controlled, disrupted thoughts, auditory hallucinations, ideas of persecution) and negative symptoms (indecision, withdrawal, reduced speech, lack of appropriate emotions, slowness of movements) from the CPRS were applied, no relationship between the two subscales and outcome scores was found. However, in patients with a duration of the disorder of less than 24 months before index admission, high scores on both negative and positive subscales were significantly correlated with a poor 5‐year outcome. No correlation was found in the group with a duration of illness of more than 24 months before index admission. It is concluded that symptoms at index admission have a predictive value for outcome in schizophrenic patients. Negative symptoms measured by use of a subscale of the CPRS have a predictive value for outcome up to 5 years after index admission, but high scores on both positive and negative symptoms are more strongly associated with a poor outcome. The duration of the symptoms before admission, as well as the kind of neuroleptic treatment given (clozapine vs. classical neuroleptics), seem to be important factors for prediction of outcome. Our data support the view that early negative symptoms in particular have a predictive value for the prognosis in schizophrenia for up to 5 years.
The Marke‐Nyman Temperament (MNT) Scale in suicide attempters
Authors: Engström G. , Nyman G. E. , Träskman‐Bendz L.
Published: August 2007

A total of 89 suicide attempters were diagnosed according to the DSM‐III‐R, and categorized according to suicide method as ‘violent’ and ‘non‐violent’ attempters, and also as those who had made previous suicide attempts (‘repeaters’) and those who had not (‘non‐repeaters’). All of the subjects completed the MNT questionnaire. Our hypothesis was that the temperament patterns would reflect specific clinical characteristics, such as psychiatric diagnoses and type of suicidal behaviour. The ‘validity’ (ranging from fatiguableness to a high level of psychic energy) showed a bimodal distribution, suggesting the existence of two subgroups. The subjects with adjustment disorders displayed a significantly higher mean validity than the other patients. The lowest validity scores were found in subjects with bipolar depression. Men showed significantly higher 'stability’ (reflecting emotional distance from others) than women. Subjects with major depression and those who were ‘violent’ suicide attempters showed somewhat higher 'solidity’ (unchangeability, non‐impulsiveness) compared with the other groups. Female ‘non‐repeaters’ displayed significantly lower solidity than males or other females. In general, no clear temperament patterns were detected in patients categorized according to type of suicidal behaviour. In contrast to the findings of studies of normal populations, the intercorrelations between the dimensions were considerable, especially among the men. This prompted us to perform a cluster analysis procedure in which the subjects were allocated to five clusters according to the MNT dimensions. No distinct clinical characteristics appeared in these clusters, except in the cluster with the highest validity and the lowest stability, as 54% (P= 0.014) of the patients in this cluster had an adjustment disorder diagnosis. These temperament results reflect the clinical heterogeneity of patients who attempt suicide.
A double‐blind randomized placebo‐controlled study of the efficacy and safety of pirlindole, a reversible monoamine oxidase A inhibitor, in the treatment of depression
Authors: De Wilde J. E. , Geerts S. , Van Dorpe J. , Bruhwyler J. , Géczy J.
Published: August 2007

The efficacy and safety of pirlindole (300 mg/day), a new reversible inhibitor of monoamine oxidase A, have been evaluated in a multicentre placebo‐controlled double‐blind randomized trial in 103 in‐patients suffering from unipolar major depression (DSM‐III‐R 296.2, 296.3) over a 42‐day period after a run‐in placebo period of 6 days. Pirlindole produced a significantly greater decrease than placebo in the Hamilton depression score (from day 28), the Hamilton anxiety score (from day 28) and the Montgomery‐Asberg depression score (on day 42). On day 42, the Hamilton depression score was ≤ 7, ≥8 and ≤15, or ≥16 in 21 %, 45% and 34%, respectively, in the placebo group compared to 72%, 24% and 3.4%, respectively, in the pirlindole group (P < 0.001). The differences between the two groups in terms of tolerance and safety were not statistically significant.
Screening of somatization disorder: validation of the Spanish version of the Othmer and DeSouza Test
Authors: Garc ‘ia‐Campayo J. J. , Sanz‐Carrillo C. , Perez‐Echeverria M. J. , Campos R. , Lobo A.
Published: August 2007

The objective of this study was to validate the Spanish version of the Othmer and DeSouza Screening Test for Somatization Disorder. We have designed a validity study using the Standardized Polyvalent Psychiatric Interview, an instrument specifically designed to diagnose psychiatric morbidity in medical settings as the ‘golden rule’. The control group displayed ‘functional’ and ‘presenting’ somatization. The Othmer and DeSouza Screening Test, with a threshold of three symptoms, shows 88% sensitivity, 78% specificity and a misclassification rate of 17%. It is concluded that Othmer and DeSouza's screening test, with a threshold of three symptoms, is a useful tool for the diagnosis of somatization disorder in medical and primary care settings in Spain. Discrepancies with US findings are discussed on a cross‐cultural basis.
Married patients with eating disorders in Japan
Authors: Kiriike N. , Nagata T. , Matsunaga H. , Tobitani W. , Nishiura T.
Published: August 2007

A total of 40 married and 22 unmarried female patients with eating disorders were studied in order to investigate the relationship between eating disorders and marriage. Eating disorders developed in 14 patients before marriage (premarital onset) and in 26 patients at the time of or after marriage (postmarital onset). The postmarital‐onset group was characterized by a significantly higher age at onset, but was similar in age and duration of illness to the group of 22 unmarried patients. However, the various clinical features of the three groups did not differ. Four premarital‐onset patients showed exaggerated clinical features after marriage, but the other patients showed no change in clinical features after marriage. In the postmarital‐onset group, eating disorders were triggered in 18 patients (69%) by marital problems, separation or divorce. In contrast, eating disorders were triggered by dieting in order to lose weight in 8 patients (57%) in the premarital‐onset group and 12 patients (55%) in the unmarried group. These results suggest that marital conflict plays an important role in the development and continuation of eating disorders in married women.
Heritability of personality disorder traits: a twin study
Authors: Jang K. L. , Livesley W. J. , Vernon P. A. , Jackson D. N.
Published: August 2007

Genetic and non‐genetic influences on the hierarchy of traits that delineate personality disorder as measured by the Dimensional Assessment of Personality Problems (DAPP‐DQ) scale were examined using data from a sample of 483 volunteer twin pairs (236 monozygotic pairs and 247 dizygotic pairs). The DAPP‐DQ assesses four higher‐order factors, 18 basic dimensions and 69 facet traits of personality disorder. The correlation coefficients for monozygotic and dizygotic twin pairs ranged from 0.26 to 0.56 and from 0.03 to 0.41, respectively. Broad heritability estimates ranged from 0 to 58% (median value, 45%). Additive genetic effects and unique environmental effects emerged as the primary influences on these scales, with unique environmental influences accounting for the largest proportion of the variance for most traits at all levels of the hierarchy.
Mortality in anorexia nervosa in Denmark during the period 1970‐1987
Authors: Møller‐Madsen S. , Nystrup J. , Nielsen S.
Published: August 2007

In this nation‐wide register linkage study of the mortality among psychiatric in‐patients with anorexia nervosa who were admitted between 1970 and 1986 (n= 853), 50 deaths were recorded during a mean follow‐up period of 7.8 years (6680 person‐years of observation). Among male subjects, five of 63 probands died, and the mean age at death was 24.5 years (range 14.2‐48.1 years). Among female subjects, 45 of 790 probands died, and the mean age at death was 36 years (range 18.1‐64.7 years). The standardized mortality ratio (SMR) was 9.1 in both sexes. A significantly increased SMR was demonstrated in males up to 5 years after index admission, and for females up to 15 years. There was no mortality among childhood‐onset female subjects, but among males one death was recorded in this age group. In male subjects the highest SMR was found among those with index admission in the second decade of life, and in females among those with index admission in the third decade of life. The SMR was maximal during the first year after index admission. Suicide was the dominant cause of death among subjects who died from unnatural causes (18 of 22 cases). Among those who died from natural causes (24 subjects), 13 individuals died from anorexia nervosa and 11 individuals died from other illnesses.
Familial‐genetic and reproductive epidemiology of schizophrenia in rural Ireland: age at onset, familial morbid risk and parental fertility
Authors: Waddington J. L. , Youssef H. A.
Published: August 2007

Waddington JL and Youssef HA. Familial‐genetic and reproductive epidemiology of schizophrenia in rural Ireland: age at onset, familial morbid risk and parental fertility Acta Psychiatr Scand 1996: 93: 62–68. © Munksgaard 1996.

Among all ascertainable cases of DSM IIIR schizophrenia within an unusually homogeneous region of rural Ireland, family history information was sought from multiple sources. Morbid risk for schizophrenia among probands' first degree relatives was 6.1% and did not differ between male (6.5%) and female (5.5%) probands; risk among probands' siblings (8.3%) exceeded that among their parents (1.4%), with only 2% of male and 31% of female probands being themselves married. Both age at onset <25 and having >7 siblings were associated with elevated morbid risk, particularly among relatives of male probands (11.9% vs. 2.2% and 11.8% vs. 3.7%, respectively). Increased fertility particularly among parents of male patients with high familial‐genetic loading may contribute to perpetuation of the disorder in the face of those patients' own extremely low fecundity.
An analysis of age and gender influences on the relative risk for suicide and psychotropic drug self‐poisoning
Authors: Buckley N. A. , Dawson A. H. , Whyte I. M. , Hazell P. , Meza A. , Brie H.
Published: August 2007

Buckley NA, Dawson AH, Whyte IM, Hazell P, Meza A, Britt H. An analysis of age and gender influences on the relative risk for suicide and psychotropic drug self‐poisoning. Acta Psychiatr Scand 1996: 93: 168–171. © Munksgaard 1996.

Psychiatric illness is a significant risk factor for both attempted and completed suicide and psychotropic medications account for 80% of all drug overdoses involving prescription medications. One challenge facing clinicians is to balance the benefit of treatment against the risk of drug overdose. The aim of the present study was to compare the age and gender distribution of patients prescribed psychotropic drugs with patients attempting and completing suicide with these drugs. Data were obtained from the Australian census and studies of general practitioner prescribing, patients who committed suicide or presented with self‐poisoning within a defined geographic area. The characteristics of these populations were compared to calculate odds ratios for attempting or completing suicide with psychotropic drugs, before and after correction for rates of prescription, in different age and gender groups. The odds ratios (ORs) for self‐poisoning were higher for those aged less than 45 years and yet this group was least likely to be prescribed psychotropic drugs. Men had a much higher rate of completed suicide using more lethal methods. The ORs for self‐poisoning and suicide with psychotropic drugs, after correction for prescription rates, for those aged 15 to 24 years were 11.1 and 1.7, respectively. Those aged 25 to 44 years had ORs of 4.9 and 4.3, and, by contrast, those over 75 years had ORs of 0.03 and 0. Women were slightly more likely to poison themselves with psychotropic drugs (OR 1.2). However, the situation reversed after correction for prescription rates (OR 0.69). It is concluded that greater caution should be exercised in prescribing for those under 45 years of age, given their relatively higher risk of drug overdose, and that the least toxic compounds should be used. The risk (of self‐poisoning) among the elderly may have been overstated, so that some patients may have been denied the benefit of adequate treatment.
Long‐term effects of transference interpretations: comparing results from a quasi‐experimental and a naturalistic long‐term follow‐up study of brief dynamic psychotherapy
Authors: Høglend P.
Published: August 2007

Herglend P. Long‐term effects of transference interpretations: comparing results from a quasi‐experimental and a naturalistic long‐term follow‐up study of brief dynamic psychotherapy. Acta Psychiatr Scand 1996: 93: 205–211. © Munksgaard 1996.

A follow‐up study, using a quasi‐experimental non‐equivalent groups comparison design, the so‐called regression discontinuity design, reported a negative long‐term effect of a high frequency of transference interpretations given to patients in brief dynamic psychotherapy who had been deemed highly suitable for such treatment. The major threat to internal validity of the findings was the possibility that the patients who were evaluated as highly suitable for dynamic psychotherapy might be the ones with the naturally worst outcomes, independent of therapy technique (selection maturation). Data from a similar naturalistic study with no quasi‐experimental manipulation of the treatment technique revealed, however, that highly suitable and relatively less suitable patients had similar outcomes. This makes selection maturation a less plausible confound of the (negative) treatment effect estimated in the quasi experimental study. A high frequency of transference interpretations in brief dynamic psychotherapy seems to be causally related to less favourable long‐term dynamic change.
Alcohol‐related problems in primary care patients in Nigeiia
Authors: Abiodun O. A.
Published: August 2007

Abiodun OA. Alcohol‐related problems in primary care patients in Nigeria.

Scand 1996: 93: 235–239. © Munksgaard 1996.

A total of 440 (50.1%) drinking patients were found in a study of 878 primary care patients in Nigeria, of whom 126 (28.6%) of drinking patients were observed to have alcohol‐related problems. Those with alcohol‐related problems were significantly more likely to be males, middle‐aged and to belong to higher occupational groups. In addition, they were also more likely to be separated, divorced or widowed, made more frequent visits to health care facilities and were more likely to have associated mental morbidity. The primary health care (PHC) workers did not recognize these problem drinkers in their care. The need to improve the ability of PHC workers to detect and manage primary care patients with alcohol‐related problems in developing countries through the use of reliable and valid short alcohol screening instruments (e.g. CAGE, AUDIT) and brief intervention techniques is emphasized. It is also suggested that, on a long‐term basis, the training curricula for medical and paramedical primary care personnel in third world countries should include more hours on alcohol education.
Hypochondriacal fears and beliefs in obsessive‐compulsive disorder
Authors: Savron G. , Fava G. A. , Grandi S. , Rafanelli C. , Raffi A. R. , Belluardo P.
Published: August 2007

Savron G, Fava GA, Grandi S, Rafanelli C, Raffi AR, Belluardo P. Hypochondriacal fears and beliefs in obsessive‐compulsive disorder.

Acta Psychiatr Scand 1996: 93: 345–348. © Munksgaard 1996.

The relationship of obsessions and compulsions with hypochondriasis is receiving increasing attention, but has not been substantiated by adequate research. The Illness Attitude Scales (IAS), which identify hypochondriacal patients, were administered to 30 patients with DSM‐IV obsessive‐compulsive disorder and 30 healthy control subjects matched for sociodemographic variables. All IAS scales were significantly higher in patients with obsessions and compulsions. However, there were no significant differences between patients and controls in the number of subjects whose symptom intensity exceeded a clinical threshold for hypochondriasis and disease phobia. Furthermore, hypochondriacal fears and beliefs were poorly correlated with obsessions and compulsions. The results suggest the presence of mild abnormal illness behaviour in patients with obsessive‐compulsive disorder. unlike the situation in patients with panic disorder and depression.
Course of illness and pattern of recurrences in patients with affective disorders during long‐term lithium prophylaxis: a retrospective analysis over 15 years
Authors: Berghöfer A. , Kossmann B. , Müller‐Oerlinghausen B.
Published: August 2007

Berghöfer A, Kossmann B, Müller‐Oerlinghausen B. Course of illness and pattern of recurrences in patients with affective disorders during long‐term lithium prophylaxis: a retrospective analysis over 15 years.

Acta Psychiatr Scand 1996: 93: 349–354. © Munksgaard 1996.

We analysed the recurrences of 86 patients with monopolar and bipolar mood and schizoaffective disorders treated with lithium over a period of 8.2 years on average in a specialized out‐patient clinic. Lithium medication was discontinued by 24% of patients. Diagnosis, age and gender had no influence on the mean morbidity index. Bipolar and schizoaffective patients suffered from more severe recurrences, resulting in hospital admissions, than monopolar patients. A significant decrease in intensity of manic episodes and a significant shortening of depressive episodes was observed over a 10‐year treatment period. However, the percentage of manic episodes among all episodes remained constant. There was no indication of a loss of the prophylactic effect in a subgroup of 30 patients who had been treated for a minimum of 10 years. The morbidity index also remained constant over 10 years in the whole sample. Furthermore, the mean lithium blood levels as well as the additional medication in this subgroup could be lowered in the second half of the treatment decade as compared to the initial 5 years.
Suicide in the People's Republic of China categorized by age and gender: evidence of the influence of culture on suicide
Authors: Pritchard C.
Published: August 2007

Pritchard C. Suicide in the People's Republic of China categorized by age and gender: evidence of the influence of culture on suicide.

Acta Psychiatr Scand 1996: 93: 362–367. © Munksgaard 1996.

Throughout the developed world suicide is predominantly associated with psychiatric disorders and substance misuse. The main social factors are age, as suicide increases with each decade, and gender, as suicide is more frequent among men than women, and proportionately more young men die than their female peers. An analysis of suicide in the People's Republic of China found that the profile was the opposite to that reported in the rest of the world, as more female subjects kill themselves than males, particularly younger women. Also, unlike the situation in other countries, suicide occurred more often in rural than in urban areas. It is argued that the Chinese data provide evidence of a greater cultural influence upon suicide rates than had previously been realized.
Schizophrenic patients' experiences of neuroleptic medication: a Q‐methodological investigation
Authors: Day J. C. , Bentall R. P. , Warnel S.
Published: August 2007

Day JC, Bentall RP, Warner S. Schizophrenic patients' experiences of neuroleptic medication: a Q‐methodological investigation.

Acta Psychiatr Scand 1996: 93: 397–402. © Munksgaard 1996.

Q‐methodology was used to explore the experiences of 50 medicated schizophrenic patients. Four main factors were identified. Participants loading on the first factor agreed with statements suggesting an uncomplaining attitude towards their medication and also with statements indicating a dependent attitude towards the medical profession. Those loading on the second factor endorsed statements indicative of a sceptical attitude towards medication, together with a concern for personal autonomy. Participants loading on the third factor had apparently made a balanced appraisal of the advantages and disadvantages of their medication, whereas those who loaded positively on the final factor reported positive benefits of medication but a sceptical attitude towards medical advice. The study highlights the complexity of psychiatric patients' attitudes to treatment.
Recovery from depression: risk or reality?
Authors: Angst J. , Kupfer D. J. , Rosenbaum J. F.
Published: August 2007

Depression is a serious condition associated with a high rate of recurrence in all populations of depressed patients. Research studies in the past have focused more on the criteria for onset of depressive disorder than on consistent criteria for outcome. However, the issue of concern to the patient is whether their depression is a lifelong condition or a condition from which they can reasonably expect to make a complete recovery. The issues surrounding recovery from depression are reviewed in the following article. The lifetime prognosis of depression is examined with reference to the Zurich follow‐up study, and outcome criteria and the importance of assessing recovery in terms of quality of life as well as symptomatic improvement are considered. The relevance of clinical trial results to the clinical management of depression is also addressed.
Cardiovascular reactivity of mitral valve prolapse patients during experimental stress exposure: evidence for a functional nature of cardiovascular symptoms
Authors: Chiaie R. Delle , Baciarello G. , Villani M. , Iannucci G. , Regine F. , Didonna A. , Talamonti F. , Pancheri P.
Published: August 2007

We studied a group of 18 patients with mitral valve prolapse (MVP) and a group of 20 healthy controls. Subjects in both groups were subjected to a 1–h experimental stress exposure during which Holter‐ECG monitoring was performed and was then continued for the following 24 h. MVP patients complained of significant cardiac palpitation during the stress session, but ECG examination did not reveal significant inter‐group differences. However, the two groups did show statistically significant differences in some psychometric measurements (Toronto Alexithymia Scale, Anxiety Sensitivity Index, Fear Questionnaire, Beck Depression Inventory, and Harm Avoidance subscale of Tridimensional Personality Questionnaire) that underlie personality traits known to be important in the process fostering functional somatic symptoms, according to the somatosensory amplification model. As no objective signs of cardiac rhythm modification were found in MVP patients under stress, we postulate that the symptoms for which these patients were referred have a functional nature, and that there is no pathogenetic link with the underlying valvular defect.
Long;‐term observation of the hypgthalamic‐pituitary‐thyroid (HPT) axis in alcohol‐dependent patients
Authors: Heinz A. , Bauer M. , Kuhn S. , Krüger F. , Gräf K. J. , Rommelspacher H. , Schmidt L. G.
Published: August 2007

Thyroid hormone levels and thyrotrophin (TSH) were measured in 45 alcohol‐dependent patients before detoxification and 8 days, 3 months and 6 months after detoxification, and compared to levels in healthy controls. Before detoxification, levels of thyroxine (T4) and thyroxine‐binding globulin (TBG) were significantly reduced in patients compared with healthy controls, while triiodothyronine (T3), reverse T3, and TSH levels did not differ from those in healthy controls. During the entire observation period, free T4 (fT4) and free T, (fT3) levels were slightly elevated compared with those in healthy controls. T4 and TBG levels increased significantly during the first week of abstinence. Severity of withdrawal symptoms was negatively correlated with the total T4 levels after 8 days of abstinence. Three months after detoxification, relapsers displayed significantly lower T4 and TBG levels compared with abstinent patients. The increase in T3 levels was most pronounced between 8 days and 3 months of abstinence in both relapsing and abstinent patients. Six months after detoxification, only abstinent patients could be assessed, and they displayed increased TBG and T3 levels compared to healthy controls. Our findings suggest a different time‐course for T3 and T4 levels after detoxification in alcohol‐dependent patients, and indicate that T4 levels after detoxification interact with withdrawal symptoms.
Mechanical loading and Δ12prostaglandin J2 induce bone morphogenetic protein‐2, peroxisome proliferator‐activated receptor γ‐1, and bone nodule formation in an osteoblastic cell line
Authors: Siddhivarn C. , Banes A. , Champagne C. , Riché E. L. , Weerapradist W. , Offenbacher S.
Published: August 2007

Background and Objective:  We have previously reported that mechanical strain applied at a 1% level to an osteoblastic cell line induces the transcription of prostaglandin D2 synthase and increases the levels of prostaglandin D2 and its Δ12prostaglandin J2 metabolite. Mechanical strain also induces the expression of peroxisome proliferator‐activated receptor γ‐1 and bone nodule formation. We hypothesized that mechanical load induces bone formation via Δ12prostaglandin J2‐dependent synthesis of bone morphogenetic proteins. Our goal was to investigate the molecular events involved in osteogenesis induced by mechanical loading and Δ12prostaglandin J2, namely the induction of bone morphogenetic proteins and peroxisome proliferator‐activated receptor γ‐1, a nuclear receptor for Δ12prostaglandin J2.

Material and Methods:  Osteoblast monolayers were stretched for 1 h with a 1‐h resting period and stretched for another hour at 1 Hz with 1% elongation. Cells were collected 0, 1, 6 and 16 h after stretching. Cyclooxygenase inhibitors and Δ12prostaglandin J2 were added in some experiments. Relative quantitative reverse transcriptase‐polymerase chain reaction was used to examine whether the mRNA of bone morphogenetic protein‐2, ‐4, ‐6, ‐7 and peroxisome proliferator‐activated receptor γ‐1 was induced. Immunohistochemistry was used to evaluate bone morphogenetic protein expression in cells.

Results:  Mechanical strain significantly increased the mRNA expression of bone morphogenetic protein‐2, ‐6, ‐7 and of peroxisome proliferator‐activated receptor γ‐1, but not of bone morphogenetic protein‐4. In stretched cells, bone morphogenetic protein‐2 and peroxisome proliferator‐activated receptor γ‐1 expression was blocked by cyclooxygenase inhibitors, but restored by exogenous Δ12prostaglandin J2. Δ12Prostaglandin J2 significantly enhanced bone nodule formation and bone morphogenetic protein‐2 expression when added alone to resting osteoblasts.

Conclusion:  These results suggest that the osteoblastic biomechanical pathways that trigger bone formation involve cyclooxygenase and prostaglandin D2 synthase activation, induction of Δ12prostaglandin J2 and its nuclear receptor, peroxisome proliferator‐activated receptor γ‐1, and increased expression of bone morphogenetic protein‐2. These data suggest that the Δ12prostaglandin J2/peroxisome proliferator‐activated receptor γ‐1/bone morphogenetic protein‐2 pathway plays an important role in osteogenesis.
HEPATIC VOLUME ESTIMATION USING QUANTITATIVE COMPUTED TOMOGRAPHY IN DOGS WITH PORTOSYSTEMIC SHUNTS
Authors: STIEGER SUSANNE M. , ZWINGENBERGER ALLISON , POLLARD RACHEL E. , KYLES ANDREW E. , WISNER ERIK R.
Published: August 2007

The purpose of this study was to use quantitative computed tomography (CT) to estimate liver volume in dogs with a portosystemic shunt and to compare the liver volume in normal dogs to dogs with a shunt. Twenty‐one dogs with a portosystemic shunt underwent contrast‐enhanced abdominal CT for shunt characterization and preoperative planning. Six dogs without clinical signs relating to liver disease were used as a control group. In addition, liver volume was compared before and 2–4 months after surgical shunt attenuation in three dogs. All studies followed established clinical imaging protocols. Liver margins were defined on each image using an operator‐defined region of interest and hepatic volume renderings were produced from which the liver volume was quantitatively estimated. There was a statistically significant association between liver volume and body weight in control and shunt dogs (r=0.909 and 0.899, respectively, P<0.01). Liver volume normalized to body weight was 15.5±5.2 cm3/kg in affected dogs and 24.5±5.6 cm3/kg in control dogs. Based on postligation CT studies in three affected dogs, liver volume increased by 43%, 51%, and 62%. Hepatic volume estimation may be a clinically useful parameter in the initial and postsurgical evaluation of dogs with portosystemic shunts.
IMAGING DIAGNOSIS—DEGENERATIVE INTRASPINAL CYST ASSOCIATED WITH AN INTERVERTEBRAL DISC
Authors: PENNING VICTORIA A. , BENIGNI LIVIA , STEEVES ELIZABETH , CAPPELLO RODOLFO
Published: August 2007

A 6‐year‐old neutered male Rottweiler had chronic episodic signs of thoracolumbar pain and inability to stand that did not improve after rest and nonsteroidal antiinflammatory medication. In magnetic resonance images, an extradural mass was identified between the spinal cord and the T13/L1 intervertebral disc; the mass was compressing the cord in a dorsoventral direction. The lesion had a low signal intensity rim that enhanced slightly after gadolinium administration, and contents with similar signal intensity to cerebrospinal fluid. The lesion was removed surgically by severing its attachments to the annulus fibrosus. The histologic diagnosis was degenerative intraspinal cyst. The origin of such cysts, and their relationship to synovial and ganglion cysts is discussed.
CONTRAST HARMONIC IMAGING OF THE NORMAL CANINE SPLEEN
Authors: OHLERTH STEFANIE , RÜEFLI EVA , POIRIER VALERIE , ROOS MALGORZATA , KASER‐HOTZ BARBARA
Published: August 2007

The purpose of this study was to assess the perfusion pattern and perfusion dynamics in the normal canine spleen using contrast harmonic imaging. Twenty‐five dogs without clinical or ultrasonographic evidence of splenic disease were studied. Twenty‐three dogs were scanned with only manual restraint; two dogs were sedated with buprenorphin. All dogs received an intravenous bolus of a microbubble contrast medium (SonoVue). The perfusion pattern during the blood pool phase represented a skewed bell‐shaped curve. A tissue‐specific late phase, similar to humans, was not observed. Time/intensity curves were generated for a selected region. Mean average‐derived peak intensity (PI) was 6.6 dB, mean time to peak intensity calculated from the initial rise (TTP) was 25.6 s and mean area under the curve (AUC) was 523.6 dB s. If dogs were divided into two body weight groups (≤15 and >15 kg body weight), average derived peak intensity area, time to peak intensity, and area under the curve were lower for the smaller dogs than for the larger animals. However, differences were not statistically significant (P=0.2, 0.05, and 0.08, respectively). No significant association was found between hematocrit, hemoglobin concentration, red blood cell count, blood pressure, heart rate, age, gender, and the perfusion variables. In conclusion, these baseline data may prove useful in the evaluation of dogs with diffuse or focal splenic disease.