bluuebunny/crossref_metadata_2025 huggingface dataset:
Training Opportunities for Overseas Psychiatrists
Authors: Brook Peter
Published: August 2008

The literature relating to the training opportunities offered to overseas graduates in this country and the United States is reviewed. Although overseas trainees in psychiatry do not see themselves at a great disadvantage, the fact that the great majority are working in non-teaching hospitals means by implication that overall their training is not as good as that of home graduates.
Psychiatric Morbidity in Parents and Sibs of Schizophrenics and Non-Schizophrenics
Authors: Stephens D. A. , Atkinson M. W. , Kay D. W. K. , Roth M. , Garside R. F.
Published: August 2008

The aims of this study were to compare the psychiatric morbidity occurring in the close relatives (N = 332) of patients showing nuclear forms of schizophrenia with that of a control group (N = 201), and to consider the findings in relation to the concept of the schizophrenic ‘spectrum’ and to some genetic theories of schizophrenia. About one third of each group were interviewed by a psychiatrist using defined diagnostic criteria, and information of varying degrees of completeness was obtained about the remainder. After considering possible biases, it was concluded that the ‘spectrum disorders' most likely to be biologically related to schizophrenia were personality disorders of non-neurotic type, either alone or in combination with another diagnosis. The results, however, did not fit well with the model of dominant inheritance of schizophrenia and schizoid disease proposed by Heston (1970).
Psycho-social Transitions: Comparison between Reactions to Loss of a Limb and Loss of a Spouse
Authors: Parkes Colin Murray
Published: August 2008

In 21 widows and 46 amputees a psychological reaction to loss designated as ‘grief’ was commonly reported. This included an initial period of numbness, soon followed by restless pining with preoccupation with thoughts of the loss, a clear visual memory of the lost object and a sense of its presence. Defensive processes, reflected in difficulty in believing in the loss and avoidance of reminders, were also evident.

Widows differed from amputees in showing more evidence of overt distress in the early post-loss phase, but whereas these features diminished in prevalence in the course of the next year the equivalent features reported by the amputee group remained virtually unchanged.
The Treatment of Psychotic Depression by Sleep Deprivation: A Replication Study
Authors: Bhanji S. , Roy G. A.
Published: August 2008

A replication study of the effects of single-night sleep deprivation therapy was carried out as a preliminary to a controlled comparison with orthodox antidepressant measures. The results show that sleep deprivation therapy was acceptable to a majority of the patients studied, and was followed by an improvement in over half those who completed treatment. Adverse effects were minimal. The authors feel that further clinical and physiological study is warranted.
Fertility of the Sibs of Schizophrenic Patients
Authors: Buck Carol , Hobbs G. Edgar , Simpson Helen , Wanklin James M.
Published: August 2008

This investigation has provided evidence against the hypothesis that heterozygous carriers of a schizophrenic gene have a reproductive advantage through enhanced fertility. An advantage arising from lower mortality between birth and the end of the reproductive period was not investigated, but should be examined before we search for other explanations of the apparently stable polymorphism of schizophrenia.
Looseness of Associations in Acute Schizophrenia
Authors: Reilly Frank , Harrow Martin , Tucker Gary , Quinlan Donald , Siegel Andrew
Published: August 2008

To study looseness of associations and other theoretically relevant variables of speech pathology, 51 acute psychiatric patients, including 26 schizophrenics, were studied at the acute phase of their disorder by means of a free verbalization interview. The results on these 51 patients during the acute period were.

1.

There were clear differences between the schizophrenic patient group and the control patient group, the overall index of deviant verbalizations being significant at the .001 el.

2.

Many types of looseness were found in non-schizophrenic patients as well as in schizophrenics. Except at the very mildest levels, however, the variants of overt looseness were strikingly more frequent in occurrence and severe in degree in the schizophrenic group (p < .01).

3.

Gaps in communication, vagueness of ideas and blocking, though present to some degree in our control group, were much more common in the schizophrenic sample (p < .001).

4.

In the control group of patients, private meanings (including neologisms), repetition and perseveration were extremely rare, and current delusional thinking virtually non-existent. Private meanings and current delusional thinking were conspicuously present in the schizophrenic sample; repetition and perseveration were present to a mild degree in this acute schizophrenic sample.

5.

Schizophrenic patients tend to show more looseness of associations when faced with a request to talk about topicsnotrelated to their illness.
Class Change in the Personal Illness Hierarchy
Authors: Foulds G. A. , Bedford A. , Csapo K. G.
Published: August 2008

Sixty-eight psychiatric in-patients who had completed the Delusions-Symptoms-States Inventory (D.S.S.I.) on admission were retested after one month. On first testing 92.6 per cent conformed to the hierarchy of classes of personal illness model, and on the second occasion 91.2 per cent. Of those who could improve, 72 per cent did so, most commonly by moving down one hierarchy class, e.g. from the Neurotic Symptoms class to the Dysthymic States class. (On the other hand only 30 per cent of the 61 patients who originally reported symptoms did not do so after one month.) Thus although it is clear that the patients as a group changed markedly, they have not departed from the hierarchy. These results indicate that either the symptoms further up the hierarchy remit before those lower in the hierarchy or they remit together. Certainly those lower in the hierarchy do not go first. It is suggested that the results would be difficult to accommodate within strict disease-entity models, and that they have different implications for both treatment and the assessment of change in current state.
A Study of 65 Impotent Males
Authors: Ansari J. M. A.
Published: August 2008

Sixty-five patients primarily referred for erectile impotence were investigated. Information was obtained from patients and their partners. The demographic data are compared with those from a non-impotent psychiatric out-patient group, matched for age. Results indicate that impotent cases do not form a homogeneous population and can be classified into three fairly distinct groups. These groups differ in age, marital status, sex drive, pre-marital and post-marital relationships, duration of illness, etc. Group 1 develop impotence because of anxiety in sexual situations, Group 2 react to the sexual response and personality of their partners, while Group 3 decline, perhaps from inherent constitutional causes. Factors such as religious restrictions, sexual taboos, alcoholism and homosexuality do not appear to be of any aetiological importance.
A Phenomenological Analysis of Symptoms in Obsessive-Compulsive Neurosis
Authors: Akhtar Salman , Wig N. N. , Varma V. K. , Pcrshad Dwarka , Verma S. K.
Published: August 2008

Eighty-two obsessional neurotics were studied from a phenomenological point of view in order to delineate the various forms and contents of obsessions and compulsions. An attempt was made to ascertain the frequency with which the different forms and content occur and their effect on the final outcome of the disorder. Five types of obsessions were identified: doubts, obsessive thinking, fears, impulses, and images, in order of frequency of their occurrence. Compulsive acts could be classified in two types, depending on whether they yielded to or diverted the underlying obsession. One-fourth of the patients displayed no compulsions. The content of obsession could be classified in five broad categories as relating to: dirt and contamination, aggression, inanimate-impersonal themes, religion, and sexual matters, in order of the frequency of their occurrence. The paper, while offering an interpretation of these findings, emphasizes the part played by socio-cultural factors in the character of an obsession's thought content.

The absence of compulsions was found to be associated with good prognosis. A downward gradient was noted in the final outcome of patients without compulsions, those with controlling compulsions alone, those with both varieties of compulsions, and those displaying yielding compulsions alone, in that order. Based on this observation the paper suggests a prognosis-related hierarchical continuum of the severity of obsessional disorder.
Chromosome Examination of Male Patients in a Psychiatric Hospital
Authors: Nielsen Johannes
Published: August 2008

The present study has been made with the purpose of studying the frequency of chromosome aberrations in a male psychiatric hospital population, especially in order to look for possible associations between minor chromosome aberrations such as variations in short arms or satellites in D or G chromosomes as well as in Y length on the one hand and mental illness and criminality on the other.
Impact of Psychosocial Factors on the Conduct of Combined Drug and Psychotherapy Research
Authors: Stone W. N. , Green B. L. , Gleser G. C. , Whitman R. M. , Foster B. B.
Published: August 2008

The effect of attitudes of therapists, patients and researchers on the conduct and outcome of combined drug and psychotherapy research was examined in a brief crisis-oriented psychotherapy clinic. Seventy-seven consecutive patients were given one of two anti-anxiety drugs or a placebo in conjunction with the typical psychoanalytically-oriented treatment used in the clinic. The therapists' attitudes favouring psychotherapy over drug therapy (and psychotherapy research) were clearly conveyed to the patients. Indicative of this are the following: (a) 82 per cent of the patients dropped out of drug taking, although a similar percentage remained in treatment; (b) only a third of the patients perceived it as being important to their therapists that they should take medication; (c) 87 per cent of the patients were rated as improved; and 75 per cent of patients completing forms considered that most or all of their improvement was attributable to talking.

The research team, made up of members of the same department who therefore had similar values as the therapists, diligently collected outcome data, but ignored its responsibility to enforce drug-related portions of the protocol. Overall, patients remained in therapy, improved and participated in completing forms, so that only the research goals of combined therapy were thwarted, while traditional clinic service and training goals proceeded as usual.
A Comparison of EMG Feedback and Progressive Muscle Relaxation Training in Anxiety Neurosis
Authors: Canter Arthur , Kondo Charles Y. , Knott John R.
Published: August 2008

Two similar groups of adult psychiatric patients carrying the diagnosis of anxiety neurosis were compared in their response to different methods of training in deep muscle relaxation. One group received EMG feedback and the other a modification of the Jacobson Progressive Relaxation method. The frontalis muscle was chosen as the target for feedback training and for the measurement of tension reduction in both groups, for the reason that this muscle has been shown to reflect the general muscle tension level in anxious patients. Training was carried out under controlled laboratory conditions, and objective muscle tension levels were obtained. Overall changes in the status of the anxiety symptoms, as determined by global ratings from patients and from primary therapists, were also compared in the two groups at the end of training. The results of the study indicated that both EMG feedback and the progressive muscle relaxation training produced significant reductions in frontalis tension levels. However, EMG feedback was found to be generally superior in producing larger reductions in muscle activity, with a concomitant relief in anxiety symptoms, for a greater number of the patients.
A Brief Psychogeriatric Assessment Schedule
Authors: Pattie Anne H. , Gilleard Christopher J.
Published: August 2008

This paper represents part of an investigation designed to establish the validity of the Clifton Assessment Scale (a brief psychogeriatric assessment procedure) and the Stockton Geriatric Rating Schedule. One hundred consecutive admissions over the age of 60 were assessed soon after admission to the acute wards of a psychiatric hospital. The results indicated a close relationship between the scores and psychiatric diagnoses. Outcome was differentiated in terms of discharge home or of transfer to psychogeriatric and to other non-psychogeriatric wards, and significant differences were obtained between groups. The assessment procedure had predictive validity comparable with other reported procedures, with the advantages of brevity and test acceptability for an elderly population.
Methods of Assessment of Drug Administration in a Psychiatric Hospital
Authors: Ballinger Brian R. , Ramsay Anna C. , Stewart Michael J.
Published: August 2008

Previous studies have shown varying rates of discrepancy in drug administration in psychiatric hospitals, and the present survey attempted to elucidate this problem further, using two methods of investigation simultaneously.

Two wards in a psychiatric hospital and one ward in a mental subnormality hospital were studied. Urine specimens were tested for psychotropic drugs, and ward drug rounds were observed to detect discrepancies in administration.

Of the 266 instances of drug administration tested for in urine specimens, prescribed drugs were not detected in 7·9 per cent of cases and non-prescribed drugs were found in another 29 instances. Observation was made of 3,689 instances of drug administration, and in 1·7 per cent of these the drug was not given or taken as prescribed, whereas no instances of ingestion of non-prescribed drugs were observed. The reasons for the discrepancies and the different results obtained by the two methods are discussed.
Interpersonal Relationships and Child-Rearing Practices in 214 Parents of Battered Children
Authors: Smith Selwyn M. , Hanson Ruth
Published: August 2008

The self-reported child-rearing practices of 214 parents of battered babies were characterized in a few but not all respects by demanding behaviour which exceeded that to be expected in relation to their social class and age. Inconsistency in child management was noted in the comparison between lack of demonstrativeness and emotional over-involvement, and between physical punishment and a tendency to be lax in the supervision of the child, and was reminiscent of parents of delinquents. Unhappiness and hostility in relationships with members of their families of origin, with unsupporting partners and with people in general were other important features. Generally, identified perpetrators were characterized by features significant for the sample as a whole.
The Frequency of Visual Hallucinations in Schizophrenic Patients in Saudi Arabia
Authors: Zarroug El-Tayeb A.
Published: August 2008

Sixty-nine schizophrenic patients (52 men and 17 women) who were consecutive admissions to Shehar Psychiatric Hospital, Taif, Saudi Arabia, were investigated for the phenomenology and frequency of visual hallucinations. Of these patients 43 (62 per cent) were visually hallucinated. It is concluded that visual hallucinations in schizophrenia are of common occurrence in this country. The need for further investigation as to the part played by cultural and other factors is emphasized.
A Factor-Analytical Study of Depression Across Cultures (African and European)
Authors: Binitie Ayo
Published: August 2008

In a factor-analytical study of depression across two cultures, African and European, certain similarities and important differences were found. Depression in African cultures presented principally as depressed mood, somatic symptoms and motor retardation. In European cultures depression presented with depressed mood, guilt, suicidal ideas, motor retardation or anxiety. Both groups lost interest in work and the environment.

Guilt and suicidal ideas and acts are uncommon in African sample, and appear to be culturally determined.
Deliberate Self-Harm: Clinical and Socio-Economic Characteristics of 368 Patients
Authors: Morgan H. Gethin , Burns-Cox Christopher J. , Pocock Helen , Pottle Susan
Published: August 2008

In this study 368 patients were interviewed after they had attended the Bristol Royal Infirmary Accident and Emergency Department following a non-fatal act of deliberate self-harm. There were twice as many women (247) as men (121), and two thirds of the patients were in the 15–35 age group. Ninety-five per cent had taken a drug overdose, most commonly one or more of the tranquillizers, antidepressants, hypnotics or analgesics. Seventy-eight per cent had taken drugs prescribed by a doctor. Half the patients mentioned interpersonal conflict as a major precipitating factor in the episode. A psychiatric diagnosis was completed for all admitted patients, of whom 52 per cent were considered to be suffering from neurotic depression, 29 per cent from personality disorder, 12 per cent from functional psychosis and 10 per cent from alcohol addiction. Almost half had deliberately harmed themselves on a previous occasion. The series showed a greater than average incidence of unemployment, overcrowded living conditions, divorce and antisocial behaviour. The implications of these findings for the clinical management and prevention of non-fatal deliberate self-harm are discussed.
Effect of ADP on PGE1Formation in Blood Platelets from Patients with Depression, Mania and Schizophrenia
Authors: Abdulla Y. H. , Hamadah K.
Published: August 2008

Adenosine diphosphate (ADP) stimulates the synthesis of prostaglandin E1(PGE1) in lysed platelets from normal subjects, patients with affective illness but not in platelets from cases of schizophrenia. The stimulation is concentration-dependent and follows a curve which is mildly sigmoid in the normal, markedly sigmoid in depression and hyperbolic in mania.
The Relationship of Plasma to Erythrocyte Lithium Levels in Patients Taking Lithium Carbonate
Authors: Lee C. R. , Hill S. E. , Dimitrakoudi M. , Jenner F. A. , Pollitt R. J.
Published: August 2008

Plasma and erythrocyte lithium levels have been determined repeatedly in twelve patients taking lithium carbonate for affective disorders. In any individual the plot of the plasma lithium level against erythrocyte/plasma ratio is linear, but the ratio can either increase or decrease with increasing plasma lithium concentration. Erythrocyte/plasma ratio is an unsound basis for comparing individual responses to lithium.
Intravenous Tranquillization with ECT
Authors: Gomez Joan , Dally Peter
Published: August 2008

Forty depressed in-patients for whom electro-convulsive therapy had been prescribed were rated before treatment on depression and anxiety scales. Side effects, post-operative agitation and retrograde memory impairment were assessed in each patient after each of several treatments. Results were compared when no tranquillizer was given and when either diazepam or haloperidol was administered intravenously immediately before the anaesthetic. It was found than when ECT was given without tranquillization, the incidence and severity of post-operative agitation and of side effects were significantly greater in those patients with a high level of anxiety before treatment. Both diazepam and haloperidol were found to be effective in subduing agitation and side effects in anxious, depressed patients, but with diazepam recovery time was longer.
Attitude to Psychiatric Treatment Before Suicide in Schizophrenia and Paranoid Psychoses
Authors: Virkkunen Matti
Published: August 2008

The purpose of the study was to clarify the attitude of patients with schizophrenia and paranoid psychoses towards hospital personnel and treatment procedures during the two pre-suicidal months. The study was carried out on subjects from south Finland who had committed suicide during a three-year period and had been treated under these diagnoses. The controls included suicides who had received psychiatric treatment for other reasons. A questionnaire was issued to ascertain the opinions of the doctor last in charge of the patient and other personnel. Both groups answered independently, and the opinions given were almost the same. Both groups stated that during the last pre-suicidal months the patients with schizophrenia and paranoid psychoses had shown a more negative or indifferent attitude towards personnel than the controls, and their attitude towards medication had been clearly more negative. Among them there were considerably more patients who had ceased to request support or attention. Thus these patients had developed a degree of despair which manifested itself in a negative attitude towards personnel and treatment.
Thyrotoxicosis and Lithium
Authors: Rosser Rachel
Published: August 2008

Two cases are presented in which treatment with lithium was complicated by thyrotoxicosis. The underlying physiological mechanisms are discussed.

Lithium suppresses thyroid function, so the early stages of thyrotoxicosis may be clinically undetectable. The symptoms and signs of thyrotoxicosis may be confused with the side effects of lithium, and if lithium is withdrawn severe rebound thyrotoxicity may occur. Furthermore, some of the side effects of lithium may be aggravated by thyrotoxicity.

These cases provide further evidence of the importance of routine screening of thyroid function before starting treatment with lithium.
Psychosocial Consequences of Therapeutic Abortion King's Termination Study III
Authors: Greer H. Steven , Lal Shirley , Lewis Stella C. , Belsey Elizabeth M. , Beard Richard W.
Published: August 2008

A follow-up study is reported of a consecutive series of 360 women who underwent termination of first trimester pregnancies by vacuum aspiration. Each patient received brief counselling before termination. Follow-up examinations were carried out by means of detailed, structured interviews at three months and between 15 months and two years (mean: 18 months) after termination. Outcome was assessed in terms of psychiatric symptoms, guilt feelings, and adjustment in marital and other interpersonal relationships, sexual responsiveness and work record. Compared with ratings of psychosocial adjustment before termination, significant improvement had occurred at follow-up in respect of psychiatric symptoms, guilt feelings and interpersonal and sexual adjustment; there was no significant change in marital adjustment. Adverse psychiatric and social sequelae were rare.
Homicide in the West of Scotland
Authors: Gillies Hunter
Published: August 2008

Between 1953 and 1974 the author made psychiatric examinations for the prosecution of 400 persons, 367 males and 33 females, accused of the murders of 307 victims, 194 males and 113 females. The 367 males were accused of 273 murders, 172 male and 101 female victims, and the 33 females were accused of 34 murders, 22 male and 12 female victims. The salient features amongst the accused were maleness, youthfulness, the causal importance of alcohol, the rarity of suicide after murder and the high percentage of psychiatrically normal persons: in these last two respects the picture differed from that reported in England and Wales. The normality of these Scottish accused was further shown by the finding that in the decade 1965 to 1974 no material psychiatric abnormality was seen in 90 per cent of the males examined.
Cognitive Reduction in Presenile Dementia Related to Regional Abnormalities of the Cerebral Blood Flow
Authors: Hagberg Bo , Ingvar David H.
Published: August 2008

Fifty-five patients with presenile dementia were examined. There were 28 women and 27 men, and the mean age was 59 and 56 years respectively at the time of the study. A large series of psychometric tests was used, and with the aid of age-matched non-demented controls five significantly different cognitive reduction groups could be identified. In the demented patients the regional cerebral blood flow (rCBF) was determined with an eight-detector or 32-detector equipment. There was a rough proportionality between the cognitive reduction and a decrease of the cerebral blood flow (especially the flow in the grey matter). In addition, certain regional flow abnormalities correlated with specific cognitive functions in a manner resembling the cognitive defects found in focal brain lesions in the same region. Thus, patients who showed only memory disturbances demonstrated a focal flow reduction in the temporal region. More severely affected patients, with reduction of verbal abilities and signs of agnosia, showed very low flows in occipitotemporo-parietal parts of the hemisphere. The results offer a principal confirmation of the dynamic field theory concerning the functional organization of the cerebral cortex (Luria, 1966).
Stereotactic Limbic Leucotomy—A Follow-up at 16 Months
Authors: Mitchell-Heggs Nita , Kelly Desmond , Richardson Alan
Published: August 2008

Sixty-six patients were assessed clinically, psychologically and physiologically before operation, at six weeks and at a mean of 16 months following stereotactic limbic leucotomy. Seventy-three per cent were clinically improved at six weeks and 76 per cent at 16 months. In obsessional neurosis, 89 per cent of patients showed definite clinical improvement at 16 months; in chronic anxiety, 66 per cent were improved; in depression, 78 per cent; and in the small number of schizophrenics treated the improvement rate was over 80 per cent. Self-assessment and observer-assessment questionnaires and scales measuring Depression, Anxiety, Neuroticism, Hysterical symptoms and Obsessional symptoms and traits all showed highly significant reductions of mean scores at 16 months. There was no fall-off in intelligence, and adverse effects were minimal. Limbic leucotomy, with its enhanced accuracy and safety, compares very favourably with similarly assessed, more extensive ‘free-hand’ procedures, and in obsessional neurosis and chronic anxiety the results are superior.
A Genetic Model of Narcolepsy
Authors: Leckman James F. , Gershon Elliot S.
Published: August 2008

An analysis of recently published family history data on rapid eye movement (REM) narcolepsy was undertaken to determine the goodness-of-fit of a multifactorial (MF) model of inheritance. The analysis revealed that a two-threshold MF model can successfully account for the prevalence of REM narcolepsy and other disorders of excessive sleep (DES) observed in the first-degree relatives of the REM narcoleptic probands studied.
Career Intentions of Senior Registrars in General Psychiatry
Authors: Brook Peter
Published: August 2008

A postal inquiry of all senior registrars in general psychiatry in the United Kingdom gave a nearly 90 per cent response rate. Between a quarter and a fifth of the respondents will not be pursuing general psychiatry at consultant level in this country, most of these opting for a psychiatric specialty. Nearly all the overseas graduates will probably remain in this country. Slightly fewer women than men are aiming for a consultancy in general psychiatry, the rest of the women proposing to switch to one of the specialties. Some of the implications of these findings are discussed, including a proposal for a yearly follow-up of the respondents.
Hormonal Changes and Mood in the Puerperium
Authors: Nott P. N. , Franklin M. , Armitage C. , Gelder M. G.
Published: August 2008

This investigation is an attempt to test the common supposition that postpartum emotional disturbance is related to hormone changes. A group of 27 normal pregnant women were assessed three times before delivery and sixteen times in the six weeks following delivery. During the first two interviews baseline data on personality and other personal variables were obtained. On each occasion blood was taken and three measures of clinical status and mood were completed. Plasma LH, FSH, total oestrogen and progesterone results are presented in detail and the results of prolactin assays mentioned more briefly. An attempt to correlate hormone findings and clinical findings is described. This failed to produce any strong evidence that hormones are related to mood at this time, although hormone changes were correlated weakly with a few specific symptoms. Some of the unexpected clinical findings and technical difficulties of the study are discussed, with special reference to possible further research in this area.
Plasma Concentrations of Protriptyline and Clinical Effects in Depressed Women
Authors: Whyte S. F. , Macdonald A. J. , Naylor G. J. , Moody J. P.
Published: August 2008

We studied the relationship between side effects, clinical outcome and the drug plasma levels in 28 female depressed patients treated with protriptyline. After 3½ weeks treatment, patients with plasma levels within a median range (630 to 900 nmol/1) showed better responses to the drug than patients with plasma levels outside this range.

There were no statistically significant correlations between plasma levels and side effect scores or ‘corrected’ side effect scores (scores after subtracting pre-treatment values) for the group at any time after starting the treatment. But we found positive correlations between plasma levels and ‘corrected’ side effect scores for the neurotic subgroup after 14 and 21 days of treatment. Other correlations between plasma levels and side effect scores were non-significant.
‘Filtering’ and the Cognitive Deficit in Schizophrenia
Authors: Hemsley D. R. , Zawada S. L.
Published: August 2008

This study attempted to clarify the nature of dysfunction in the selective attention of schizophrenics. Within the framework of Broadbent's (1971) theory of information processing it was argued that ‘filtering’ inefficiency should be reflected in a reduction in the discrepancy in performance on a short-term memory task between the condition of pre-instruction as to the relevant material and that of post-instruction. Three groups of subjects, 10 schizophrenics, 10 depressives, and 10 normals, matched for age and intelligence were tested on such a task. While the overall performance of normal subjects was superior to that of both psychiatric groups, depressives and schizophrenics did not differ. The normal group also showed a significantly greater improvement with pre-instruction than the psychiatric groups; again, the schizophrenics and depressives did not differ significantly, though there was a tendency for schizophrenics to benefit less than depressives from pre-instruction. It appears that ‘filtering’ difficulties as here defined may not be specific to schizophrenia. Alternative conceptualizations of the cognitive abnormalities shown by schizophrenics, such as slowness of information processing and difficulties in response selection, may be more useful.
Monosymptomatic Hypochondriasis, Abnormal Illness Behaviour and Suicide
Authors: Bebbington Paul E.
Published: August 2008

Two cases of chronic monosymptomatic psychogenic eye pain with abnormal illness behaviour are presented. Both failed to respond to a wide variety of treatments, and despite the accepted low suicidal risk in hypochondriasis both killed themselves. The origin, prognosis and therapy of such behaviour are discussed in this context.
Psychiatric Aspects of Narcolepsy
Authors: Roy Alec
Published: August 2008

Among twenty patients with narcolepsy intelligence was normal and no characteristic personality or psychopathology was found. A family history of psychiatric disorder was present in five and a past personal history in ten. Eight had a current psychiatric disorder and twelve either a current or past psychiatric disorder. Chronic sexual disorder was present in eleven. Arousal appeared to be the mechanism by which emotions precipitated symptoms. Ten patients were found to have had difficulties at work, in marriage or in social life.
The Efficacy of Alcoholics Anonymous: The Elusiveness of Hard Data
Authors: Bebbington Paul E.
Published: August 2008

The paper is concerned with methodological problems relating to the scientific study of the effectiveness of Alcoholics Anonymous (AA). Studies of the effectiveness of AA fall into two categories—longitudinal and cross-sectional, and may be criticized on the basis of over-simple criteria of success.

The particular problems of the requirement for control groups in studies of effectiveness are pointed out. The problems arising out of the whole process of affiliation and disaffiliation and their implications for scientific study are discussed. The requirement for sound statistical analysis is stressed, and inadequacies in the techniques of follow-up are indicated.

The studies which have some bearing on AA as a treatment facility are reviewed. These include multivariate studies involving AA attendance as one factor, studies in which AA was the main variable in a hospital programme, and longitudinal studies of AA from within the organization. Particular difficulties in using cross-sectional surveys for the purpose of estimating efficacy are pointed out.

The conclusion reached is that because of the methodological difficulties the totality of these studies does not add significantly to the knowledge concerning AA which we possess from clinical experience. Moreover, without a change in the unusual characteristics of AA when considered as a treatment facility it seems unlikely to be possible to assess its effectiveness in a scientific manner.
An Intensive Case-Study of a Therapeutic Group
Authors: Ryle Anthony , Lipshitz Susan
Published: August 2008

A therapeutic group with eight members was studied, using psychometric tests, improvement ratings based on pre-treatment statements of patients' hopes, and of therapists' aims rated for achievement on the basis of post-treatment interviews, and two forms of repertory grid testing. The In-Group Grid yielded a number of measures relating to outcome and to aspects of the group process. Most patients improved by some criteria, and most measures of improvement intercorrelated positively but not, in most cases, highly. Few clear relations between process and outcome measures were demonstrated.
Women Senior Registrars in Psychiatry: Background and Career Intentions
Authors: Brook Peter
Published: August 2008

An inquiry was made of all women senior registrars in general psychiatry who were known to be planning to remain in psychiatry in this country. Most were hoping to work full or maximum part-time, and all except one were aiming for a consultant appointment in general psychiatry or one of the specialties. Many anticipated difficulties in realizing their ambitions because of being tied to one particular area on account of their husbands' employment. A number of solutions to this problem are suggested.
Subacute Sclerosing Panencephalitis Presenting as Leonhard's Speech-prompt Catatonia
Authors: Koehler Karl , Jakumeit Ulrike
Published: August 2008

A woman aged 20, first presenting with what appeared to be hysterical blindness as part of the syndrome of hysterical pseudo-dementia, soon showed the picture of speech-prompt catatonia, one of the subtypes of chronic schizophrenia described by Karl Leonhard. However, within a short time the neurological, EEG and laboratory findings indicated that the condition was one of subacute sclerosing panencephalitis.
Problems in the Interpretation of Cognitive Abnormalities in Schizophrenia
Authors: Hemsley D. R.
Published: August 2008

This study compared matched groups of patients with acute schizophrenia and with depression on three tests used in the assessment of schizophrenic thinking disorder. Most measures derived from these tests significantly differentiated the groups; however, within the schizophrenic group there were no significant correlations between scores on the three tests. Further data were available from a choice reaction-time card-sorting task, from which estimates of distractability, stimulus decision time, response decision time, and movement time, were obtained. Only one significant relation was found between these measures and scores on the clinical tests. The possible confounding effects of intelligence and responsiveness are discussed. It is argued that more direct measures of the latter are preferable to interpreting tests of thinking disorder in terms of information processing deficits.
The Nature of Bodily Symptoms
Authors: Mayou Richard
Published: August 2008

Psychiatric descriptions of bodily symptoms have usually been derived from narrowly restricted clinical experience. It is argued that it is more useful to review evidence from all medical settings and occurrence, nature, disability and presentation are here discussed. Syndromes of hypochondriacal reactions appear to be extreme and uncommon manifestations of a universal potential.
The Clifton Assessment Schedule—Further Validation of a Psychogeriatric Assessment Schedule
Authors: Pattie Anne H. , Gilleard Christopher J.
Published: August 2008

This paper is concerned with the further evaluation of the Clifton Assessment Schedule (CAS), a brief psychogeriatric assessment procedure, providing a cross-validation study on a second sample of acute elderly psychiatric admissions. Additionally, further work is reported on its use with a psychogeriatric population resident within the hospital. The results suggest the usefulness of the CAS across a broad range of psychogeriatric patients, providing significant differentiation between groups receiving varying degrees of care and with differing outcome expectations.
A Dialogue with Mandeville
Authors: Shoenberg P. J.
Published: August 2008

In A Treatise of the Hypochondriack and Hysterick Passions published in 1711, Bernard Mandeville, writing by way of ‘Information to Patients’ describes three dialogues between an imaginary physician, Philoperio, and his patient, a confirmed hypochondriac, Misomedion. The book is original in its conception inasmuch as it represents an early recorded conversation between a physician and his patient. As such it represents a development in the writing on therapeutic technique of the eighteenth century. Though Mandeville's originality has been emphasized by contemporary medical historians, this book seems to have had little influence on the therapeutic style of the physicians of his day.
Rationing Out-Patients: A Defence of the Waiting List
Authors: Robin Ashley
Published: August 2008

New psychiatric out-patients were offered immediate or delayed appointments (average delay 12 weeks) in random order. The two groups thus formed, comprising 234 patients, were shown to be comparable in some important respects. Immediate appointments were taken up significantly more frequently than delayed appointments, and 12 per cent of immediate and 22 per cent of delayed patients did not receive any psychiatric service. No evidence was found that delay increased other medical services supplied. Non-attenders were presumed to suffer from ‘neurosis’ and ‘personality problem’. Initial attenders used more services than those who failed to keep their first appointment but came later. A waiting list is proposed as a screening device to limit out-patient referrals.
Hand Preference Patterns in Psychiatric Patients
Authors: Lishman W. A. , McMeekan E. R. L.
Published: August 2008

A brief survey, using a standardized questionnaire, has been made of hand preference patterns in a series of patients admitted to hospital with functional psychiatric disorders. A small but significant shift towards left hand preference has been observed, more marked in the young patients and virtually confined to the males. Psychotic patients show such a shift more clearly than neurotic or personality disordered patients. Simple genetic factors do not appear to be responsible for these sinistral tendencies. The findings are discussed in relation to possible acquired abnormalities of functional brain organization.
Urinary Adenosine 3’,5′-Cyclic Monophosphate: Effects of Electroconvulsive Therapy
Authors: Moyes Richard B. , Moyes Isabel C. A.
Published: August 2008

Serial studies of urinary cyclic AMP in in-patients undergoing electroconvulsive therapy (ECT) have been carried out. No consistent pattern of change following ECT could be demonstrated. The results do not support earlier reports of large rises in urinary cAMP directly after administration of ECT.
The Origins and Practice of Psychodrama
Authors: Davies Martin Hugh
Published: August 2008

Psychodrama, a method of human relations training and psychotherapy, is traced from its creation by Moreno fifty years ago to its present resurgence with the growth of ‘humanistic’ psychology. The basic techniques are described, together with Moreno's concepts of social interaction, e.g. encounter, spontaneity, the moment, catharsis and role playing. Its uses and limitations are discussed briefly.
Platelet Monoamine Oxidase in Schizophrenia and Manic-Depressive Illness
Authors: Belmaker Robert H. , Ebbesen Kirsten , Ebstein Richard , Rimon Ranan
Published: August 2008

Monoamine oxidase (MAO) is an important enzyme in the catabolism of brain biogenic amines. Platelet MAO has been reported to be moderately reduced in manic-depressive patients and markedly reduced in schizophrenic patients. This enzyme's activity has been shown to be under a large degree of genetic control and has been proposed as a ‘genetic marker’ in schizophrenia. A transcultural replication of the finding of low platelet MAO in schizophrenia and manic-depressive illness was carried out at the Jerusalem Mental Health Centre. Manic-depressive patients were found to have higher platelet MAO activity than schizophrenic patients, as reported previously, but control individuals were as low as the schizophrenic patients. It is unlikely that platelet MAO activity is a transculturally-valid marker for schizophrenia.
Disulfiram Implantation: Placebo, Psychological Deterrent, and Pharmacological Deterrent Effects
Authors: Wilson Allan , Davidson William J. , White John
Published: August 2008

In an effort to examine the placebo, psychological deterrent, and pharmacological deterrent effects associated with implanted disulfiram, subjects were given either disulfiram implants or sham operations. Ethanol challenges elicited no disulfiram-ethanol reactions (DERs), indicating that at the time of the challenge neither a pharmacological deterrent nor a placebo effect was operating. Of the patients who resumed drinking, only those with disulfiram implants experienced DERs. Sham operation subjects continued to drink after their first post-challenge drink; four of five disulfiram implant recidivists remained abstinent following their experience of a DER. It is concluded that the pharmacological deterrent effect of the disulfiram implant may have been underestimated in previous reports.
Cardiac Effects of Different Tricyclic Antidepressant Drugs
Authors: Burrows G. D. , Vohra J. , Hunt D. , Sloman J. G. , Scoggins B. A. , Davies Brian
Published: August 2008

The effects of tricyclic antidepressants on the heart are reviewed. Statistically significant increases in heart rate and in atrioventricular conduction times were found following the administration of tricyclic drugs to 32 depressed patients. The method of His bundle electrocardiography was used to study atrioventricular conduction in ambulant patients and in patients admitted after an overdose of tricyclic antidepressant drugs. Distal conduction defects were frequently found in patients following tricyclic overdosage, but these were not seen with doxepin overdosage. Impaired distal conduction was also found in occasional patients on therapeutic doses of tricyclic drugs. Some animal experiments giving similar results to the above clinical findings are also described. The clinical implications of these findings are discussed.
Creativity and Schizophrenia: An Equality of Empirical Constructs
Authors: Hasenfus Nancy A. , Magaro Peter A.
Published: August 2008

The possibility that schizophrenia and creativity are two aspects of the same process is discussed, and parallels between different types of schizophrenia and different factors of creativity are sought. The discussion begins at a theoretical level, but its main thrust is an analysis of the research literature at an empirical level. Similarities are pointed out between tasks used for the purpose of operationally defining the schizophrenic ‘deficit’ and tasks used to define creativity. Some evidence is found for different subtypes of schizophrenics exhibiting different factors or types of creativity.
Imaginal Flooding and Exposure to Real Phobic Situations: Treatment Outcome with Agoraphobic Patients
Authors: Mathews A. M. , Johnston D. W. , Lancashire M. , Munby M. , Shaw P. M. , Gelder M. G.
Published: August 2008

Each of thirty-six female agoraphobic out-patients were treated by one of three methods: 8 sessions of imaginal flooding followed by 8 sessions of practice in the real situation; 16 sessions of combined flooding and practice; or 16 sessions of practice alone. Three therapists treated equal numbers of patients in each group, and there was some evidence that patients' response varied according to the therapist seen, irrespective of treatment group. There were no significant differences between treatment groups after 8 sessions, 16 sessions or on six-month follow-up. It is concluded that there are no long-term differences between the effects of treatments involving exposure to either imaginai or real phobic situations or to a combination of both, provided that patients are encouraged to practise between sessions.
Imaginal Flooding and Exposure to Real Phobic Situations: Changes During Treatment
Authors: Johnston D. W. , Lancashire M. , Mathews A. M. , Munby M. , Shaw P. M. , Gelder M. G.
Published: August 2008

This paper reports the results of measures taken during treatment in the study of imaginai flooding and exposure to real phobic situations previously described by Mathews, Johnston, Lancashire, Munby, Shaw and Gelder (1976). On weekly measures of change a similar reduction in phobic behaviour in all treatments was found, confirming the previous findings. Differences in therapist effectiveness were also confirmed. On measures of the immediate effects of treatment, exposure to the phobic situation had consistent positive effects, imaginai flooding had little or no detectable effect. It is proposed that the treatments studied differ in their immediate effects on phobic behaviour but also have the common effect of facilitating counterphobic behaviour outside the treatment situation, and that this is the main agent of therapeutic change.
Psychopathology Seen Against the Background of Normal Development
Authors: Freud Anna
Published: August 2008

When choosing a title for this Lecture, I hesitated between two possible ones, the one above which I selected finally and another, termed ‘Links between Adult Psychiatry and Child Psychiatry’ Although in wording they seem different enough from each other, I hope to show in what follows where the two subject-matters meet.
Psychiatric Service for the Elderly: How Many Beds?
Authors: Jolley D. J. , Arie Tom
Published: August 2008

Reported here is a cohort study of five years' bed usage in the Goodmayes Psychiatric Unit for Old People. Patients first admitted in 1970 continued to use beds, by readmission or by continuing stay, over the next four years; subsequent cohorts of admissions made correspondingly extended use of beds. Bed-usage by men appears now to have stabilized, whilst for women it is still rising.

Over the first six years the bed complement was reduced by 40%, despite an increase in referrals of over 40%; this is because the Unit's style of work prevented newly admitted patients from accumulating in beds made available by deaths. It looks as if in future not only will patients who die be replaced by new female admissions but more beds will be needed for these admissions. The present bed-usage is just within the Government's recommended guidelines, and the local issues are considered in the context of national policy.