bluuebunny/crossref_metadata_2025 huggingface dataset:
The Berkeley Group: Ten Years' Experience of a Group for Non-violent Sex Offenders
Authors: Cook David A. G. , Fox Charles A. , Weaver Christine M. , Rooth F. Graham
Published: October 2008

During the first ten years of a group started in February 1977 by the Avon Probation Service for the treatment of non-violent sex offenders, many of the offenders have shown a high degree of commitment to the group, and attendance levels have run consistently at over 70%. Of 63 men who came to the group during the ten-year study period, 33 completed their stay at the group, 11 left the group prematurely, and 11 never engaged satisfactorily. The remaining eight were still attending the group at the end of the study period. Of the 55 men whose contact with the group had ended, 36 (65%) had not been convicted of further sex offences by the end of the study period.
Intoxicated by Water
Authors: Bremner Alexander J. , Regan Adrienne
Published: October 2008

A cross-sectional survey of the drinking habits of 877 mentally handicapped in-patients revealed 31 patients (prevalence 3.5%) who, in the opinion of nurses, drank five litres or more daily. Low urine specific gravity was a less useful indicator of polydipsia. Polydipsia appeared to be significantly associated with a borderline level of handicap and with a diagnosis of schizophrenia, autism or severe personality/behaviour disorder. Of five cases of water intoxication associated with polydipsia, one was fatal. In two cases excess drinking improved with increased neuroleptic medication. Lithium and demeclocycline were used in two cases to prevent hyponatraemic episodes.
Hypersexuality, Fetishism and Multiple Sclerosis
Authors: Huws R. , Shubsachs A. P. W. , Taylor P. J.
Published: October 2008

Hypersexuality and fetishism appeared in a patient with multiple sclerosis whose MRI scan showed frontal and temporal lesions. The hypersexuality may have been the presenting symptom of the multiple sclerosis.
Motor, Volitional and Behavioural Disorders in Schizophrenia
Authors: McKenna P. J. , Lund C. E. , Mortimer A. M. , Biggins C. A.
Published: October 2008

An alternative to the conventional separation of extrapyramidal and catatonic symptoms exists in the ‘conflict of paradigms' hypothesis, which proposes that there is a relative rather than absolute distinction between the two. The hypothesis predicts that a clinical association should exist between extrapyramidal and catatonic symptoms in schizophrenia. After rating 75 schizophrenic patients, a highly significant correlation between scores on the two classes of disorder was indeed found. This was composed of separate correlations between tardive dyskinesia and ‘positive’ catatonic phenomena, and Parkinsonism and ‘negative’ catatonic phenomena. The associations were not easily attributable to confounding factors and they were supported by factor analysis.
Suicide and Other Unexpected Deaths among Psychiatric In-patients
Authors: Morgan H. G. , Priest Pamela
Published: October 2008

By matching information collected from coroner inquest records with hospital admission and discharge registers, 27 suicides and 5 other unexpected deaths were identified over 30 months among persons who either were psychiatric in-patients at the time or had been up to eight weeks previously. The relevant consultant completed a questionnaire concerning assessment and management in each case. It is suggested that such an approach might usefully be adopted widely as an audit of unexpected deaths. In 20 of the suicides the seriousness of the risk was not fully recognised; 13 absented themselves from the hospital ward without leave. Misleading clinical improvement in the absence of corresponding alleviation of situational problems, and patient alienation appeared important hazards. The findings have implications for service development, particularly when major reduction of bed numbers is planned.
Prescription-Event Monitoring of 10 895 Patients Treated with Alprazolam
Authors: Edwards J. Guy , Inman William H. W. , Pearce Gillian L. , Rawson Nigel S. B.
Published: October 2008

‘Prescription-event monitoring’ (PEM) is one of two national systems of post-marketing surveillance in operation in Britain. It identified 22 065 patients who had received NHS prescriptions for alprazolam, and data available on 10 895 of these were analysed. The main reasons for treatment with alprazolam were anxiety and depression. The patients provided 3360 patient-years of treatment and 7540 patient-years of follow-up. No serious events clearly associated with treatment were recorded. The main events reported during treatment, albeit infrequently, were drowsiness and depression, although depression is more likely to be due to the disorder being treated than to the drug. Some of the other alleged unwanted effects of alprazolam in published reports were not encountered. Since PEM is unable to determine the dependence potential of alprazolam, further evaluation of this problem is called for.
Prophylactic Lithium in Puerperal Psychosis
Authors: Stewart D. E. , Klompenhouwer J. L. , Kendell R. E. , Van Hulst A. M.
Published: October 2008

At three centres, 21 women at high risk for puerperal psychosis were given prophylactic lithium carbonate late in the third trimester of pregnancy or immediately after delivery. Only two of the women had a recurrence of their psychotic illness while on prophylactic lithium. One woman given lithium during third trimester had an unexplained stillbirth. Although a larger sample in a carefully controlled study is still required, there now seems to be grounds for the use of prophylactic lithium immediately after delivery in women not breastfeeding who have previously suffered from either puerperal psychosis or bipolar disorder.
The Scottish Survey of Old Long-Stay In-patients
Authors: McCreadie R. G. , Stewart Mary , Robertson Lesley , Dingwall J. M.
Published: October 2008

A total of 2605 old long-stay patients, defined as those admitted to hospital before the age of 65 years and in hospital more than six years, were identified in psychiatric hospitals serving 83% of the Scottish population. The bed occupancy was 59 per 100 000 of the general population, with a range among hospitals of 19–123 per 100 000. Of all patients, 64% were schizophrenic and 15% had organic brain disease; most patients were male, single and over 60 years of age; 41 % had been in hospital more than 30 years; 61 % had either florid psychotic symptoms or symptoms of a deficit state in marked or severe degree, and the rehabilitation potential for 70% was low. An increasing prevalence of deficit symptoms in schizophrenics was associated with increasing length of stay in hospital; the difference was most marked between those admitted before and after 1953.
Systemic Lupus Erythematosus in a Woman with Mental Handicap
Authors: Wilson David N.
Published: October 2008

A woman with a mental handicap developed SLE. This magnified the level of her handicap, and because of her difficulties in giving a history, mildly abnormal results of tests in any one system were dismissed over long periods of time. This resulted in very late diagnosis of a potentially treatable disease.
A Genetic Model Compatible with a Dimensional View of Schizophrenia
Authors: Roberts David , Claridge Gordon
Published: October 2008

Throughout the history of schizophrenia as a psychiatric concept, opinions have differed sharply over its essential nature and its causes, giving rise to a wide range of explanations that have drawn upon ideas from almost all of the social and biological sciences. Only one fact has truly survived the vicissitudes of argument about the condition: that genetic factors contribute to its aetiology. Even that conclusion, first reached in the very early days of schizophrenia research, sank temporarily out of sight during the radical psychiatry challenges of the 1960s. However, the continuing collection of family, twin, adoption and other data over that period put the genetic hypothesis beyond reasonable doubt (McGuffin, 1988).
Psychotic Depression: Psychoanalytic Psychopathology in Relation to Treatment and Management
Authors: Lund Charles
Published: October 2008

Jacobson's theory of affects and psychotic depression can be of benefit to the management of patients, even when recourse to physical therapies is required. Awareness of such psychodynamic issues would improve staff training, morale, and practice; rotation schemes for junior staff may have serious effects through the abandonment of patients and established therapeutic relationships.
Prevalence of Delusional Jealousy in Different Psychiatric Disorders
Authors: Soyka M. , Naber G. , Völcker A.
Published: October 2008

The prevalence of delusional jealousy in 8134 psychiatric in-patients was 1.1%. Delusions of jealousy were most frequent in organic psychoses (7.0%), paranoid disorders (6.7%), alcohol psychosis (5.6%) and schizophrenia (2.5%), while in affective disorder delusions of jealousy could be found in only 0.1%. Because schizophrenia and affective disorder were the most common diagnoses, most patients with delusions of jealousy were schizophrenics. In schizophrenia, women were more likely to suffer from delusional jealousy, while in alcohol psychosis, men were more likely than women to suffer from delusional jealousy.
Psychiatric Screening of Admissions to an Accident and Emergency Ward
Authors: Bell Gary , Reinstein Dan Z. , Rajiyah Gitendra , Rosser Rachel
Published: October 2008

One hundred medical and surgical patients admitted to an accident and emergency ward were screened for psychiatric disorder. A psychiatric diagnosis was made in 37 patients, 32 of whom were correctly identified by the GHQ. Psychiatric morbidity was associated with being single, lower social class, unemployment, homelessness and living in Bloomsbury Health District or north-east London. It was also associated with not being registered with a GP. The 14 overdose patients were no more likely to receive a psychiatric diagnosis than other patients, yet constituted most of the psychiatric referrals. Few patients were asked by medical staff about emotional worries or problems. A desire to be asked such questions and a past psychiatric history were associated with a psychiatric diagnosis. Routine screening of psychiatric morbidity in both medical and surgical patients and appropriate psychiatric referral of identified patients is recommended. A system of facilitating GP registration is necessary, as much of the morbidity identified could be contained within primary care.
Jealousy: The Pathology of Passion
Authors: Mullen Paul E.
Published: October 2008

Emotions may be rooted in biology but the process of cultural construction gives those emotions form and a language for their expression. The changing construction of jealousy in Western societies has transformed a socially sanctioned response to infidelity into a form of personal pathology which is the mere outward expression of immaturity, possessiveness and insecurity. This is a history of the stripping away of social, ethical and finally interpersonal meanings from an experience, to leave it as a piece of individual psychopathology. Fidelity and jealousy are constructed as they are because of the nature of the social and economic realities which drive our culture. The erosion of the area of human experience which could be identified with normal jealousy leaves the boundary between the pathological jealousy of psychiatry and normal experience increasingly problematic.
Collaborative Strategies in the Molecular Genetics of the Major Psychoses
Authors: Leboyer Marion , McGuffin Peter
Published: October 2008

Most authorities now agree that a genetic contribution is the best established aetiological factor in manic-depressive illness (McGuffin & Katz, 1989) and schizophrenia (Gottesman & Shields, 1982). In both cases the size of the genetic contribution is substantial, as reflected in estimates of broad heritability (the proportion of total phenotypic variance accounted for by genes) of 60–80%. However, the evidence in favour of a genetic contribution from family, twin and adoption studies tells us that we are dealing with complex conditions which do not have simple Mendelian modes of transmission and in which environmental influences almost certainly play a part. The main debate about mode of transmission has centred upon whether it is entirely polygenic (i.e. dependent upon the action of many different genes, each of small effect) or whether for each of the major psychoses there is a gene of major effect.
A Comparison of the Withdrawal Responses of Heroin and Methadone Addicts during Detoxification
Authors: Gossop Michael , Strang John
Published: October 2008

This study compares the withdrawal responses of methadone and heroin addicts during a ten-day in-patient detoxification programme with methadone. Contrary to suggestions in the literature, the methadone group reported more severe withdrawal symptoms during both the acute withdrawal phase and the recovery phase. There were no differences between the two groups in onset or duration of symptoms. Whereas there may be reasons to favour methadone as a maintenance drug, its use may lead to difficulties during withdrawal.
Interictal Psychopathology in Epilepsy Prevalence and Pattern in a Nigerian Clinic
Authors: Gureje Oye
Published: October 2008

An unselected sample of 204 epileptic patients attending a neurological out-patient clinic in Abeokuta, Nigeria, was evaluated for psychiatric morbidity using the CIS. Thirty-seven per cent emerged as psychiatric cases, almost a third of these being cases of psychosis. Patients with partial seizure of temporal lobe origin were the most psychiatrically impaired, while those with partial seizure of non-temporal lobe origin the least. These findings are broadly similar to those reported for epileptic populations in other studies. However, in spite of the relatively high prevalence of major psychiatric disorders among these patients, their impairments were more likely to remain ‘hidden’ and untreated than those in similar patients in developed countries.
Child Psychiatry in Developing Countries
Authors: Nikapota Anula D.
Published: October 2008

Child psychiatry in developing countries has recently attained the status of an established specialty. This review looks at available epidemiological data, and factors contributing to similarities and differences in rates of disorder. The relevance of child psychiatry to child health in these countries has service, training and research implications.
The Clinical Correlates of Neurological Soft Signs in Chronic Schizophrenia
Authors: King D. J. , Wilson A. , Cooper S. J. , Waddington J. L.
Published: October 2008

Among 16 chronic schizophrenic in-patients, all had at least one neurological soft sign (NSS), and 6 (40%) had definite neurodysfunction. NSS and TD scores were highly intercorrelated, and NSS were significantly correlated with neuroleptic drug exposure. NSS correlated positively with both positive and negative symptoms and cognitive impairment but not with cerebral ventricular size on CT. Patients with neurodysfunction had more positive and negative psychopathology, cognitive impairment and TD than those without. Cerebral ventricular sizes and family histories of schizophrenia were similar in both NSS groups. The presence of NSS may be a simple but important way of identifying a subgroup of schizophrenics with neurodevelopmental predisposing abnormalities, and vulnerability to TD.
Sex Differences in Suicidal Behaviour of Referred Adolescents
Authors: Rey Joseph M. , Bird Kevin D.
Published: October 2008

Reports of suicidal behaviour from four countries using the same measures were higher for girls than for boys, and higher in self-reports than in parent reports for both referred and normal adolescents. In a sample of 480 referred adolescents, patterns of ‘low’ and ‘high’ suicidal scores were different when age, sex and diagnosis were considered. The probability of high scores for girls showed only a marginal increase with age, while there was a striking rise for boys. An affective diagnosis doubled the probability of high scores for both boys and girls, while it had no effect on low scores. Psychosocial stressors also increased the probability of high suicidal scores, particularly in adolescents with an affective disorder. Sex differences in suicidal behaviour were marked in the low-scoring groups.
Compulsory Psychiatric Treatment in the Community
Authors: Sensky Tom , Hughes Timothy , Hirsch Steven
Published: October 2008

Several English consultant psychiatrists were asked to identify which patients currently under their care they would recommend for treatment with a community treatment order, if such a provision existed. The psychiatrists were asked to match each such ‘nominated’ patient for age, sex and diagnosis with one or two control patients, not considered to require compulsory treatment in the community. From specific data collected, it was found that: the two groups did not differ in their ‘lifetime’ histories of psychiatric admissions, substance misuse, criminal charges or dangerousness; 65–72% of the total sample had a history of serious dangerousness; but in the 12 months before nomination, the ‘nominated’ patients were significantly less likely than the controls to have complied with psychiatric treatment, and more likely to have defaulted from follow-up. The results indicate that a psychiatrist's decision to recommend a patient for treatment with a community treatment order will depend predominantly on specific criteria related to the patient's recent past.
The Nature and Severity of Disabilities in Long-Stay Psychiatric In-patients in South Glamorgan
Authors: Pryce I. G. , Griffiths R. D. , Gentry R. M. , Hughes I. C. T. , Montague L. R. , Watkins S. E. , Champney-Smith J. , Mclackland B. M.
Published: October 2008

Long-stay psychiatric in-patients in South Glamorgan were reviewed using the MRC Needs for Care assessment. The majority were middle aged or elderly and were severely disabled, with problems encompassing symptoms/behavioural difficulties, social skills, and physical health. In most, long-standing psychiatric illness was compounded by physical illness and cognitive deficits as age advanced, producing care needs that were greater than existing community services could meet.
Personality as a Vulnerability Factor to Depression
Authors: Boyce Philip , Parker Gordon , Barnett Bryanne , Cooney Margaret , Smith Fiona
Published: October 2008

One hundred and forty non-depressed primiparous women in a stable relationship completed two personality measures (the EPI and the IPSM) antenatally, and were then assessed for depression at several times post-natally. The risk of depression at six months was increased up to tenfold by high interpersonal sensitivity and threefold by high neurotic ism. When previously depressed women were excluded from analyses, high interpersonal sensitivity and, to a lesser extent, high neuroticism were still associated with an increased risk of being depressed. Interpersonal sensitivity, as measured, is suggested as a refined personality risk factor to both the onset and recurrence of depression.
Early Sexual Abuse and Clinical Depression in Adult Life
Authors: Bifulco A. , Brown G. W. , Adler Z.
Published: October 2008

Sexual abuse in childhood and adolescence was studied in 286 working-class mothers living in Islington, who were contacted on three occasions over a two-year period. The sample was collected primarily to study current vulnerability factors in the onset of depression, but childhood measures were also included to look at longer-term risk factors. Twenty-five women – 9% of the sample – reported sexual abuse involving physical contact before age 17 and, of these, 64% had case depression in a three-year period (which included the year before first interview). While such abuse was related to other earlier stressful experiences such as parental indifference, violence to the child and institutional stay, it was associated with an increased risk of depression over and above these factors. Sexual abuse before age 17 also related to having been divorced/separated or never having married/cohabited.
Symptoms of Post-traumatic Stress Disorder in Falklands Veterans Five Years After the Conflict
Authors: O'Brien L. S. , Hughes S. J.
Published: October 2008

A group of 64 Falklands war veterans who were still serving in the British Army were studied and compared with a group of matched controls. Half the veterans reported some symptoms of post-traumatic stress disorder, and 22% were rated as having the complete PTSD syndrome. Presence of the symptoms was associated with intensity of combat experience and the retrospective report of emotional difficulties in the initial period on return from the war.
Case Management
Authors: Holloway Frank , McLean Elizabeth K. , Robertson J. A.
Published: October 2008

“This paper discusses the advantages and disadvantages of case management systems for the co-ordination of care of people with long-term mental illness living in the community. Many of the principles are equally applicable to other client groups with long-term needs, e.g. elderly people or people with learning difficulties. Some of the historical background to the emergence of case management concepts is discussed, culminating in the recent White Paper on Community Care. The underlying concept of case management is examined, together with a number of fundamental questions concerning who should act as case managers, what kinds of training they will require, problems of inter- and intra-agency co-operation, and the empirical evidence regarding its effectiveness. It is concluded that case management could be an important element in a comprehensive range of mental health services, but it is not a substitute for basic community provisions.”
The Human Brain and Political Behaviour
Authors: Freeman Hugh
Published: October 2008

“I think you ought to leave your head to the College of Surgeons to ascertain what wonderful impressionable substance it contains instead of brains” (G. B. Shaw to a correspondent, 1926).
The Holocaust and German Psychiatry
Authors: Meyer-Lindenberg Johannes
Published: October 2008

The Holocaust under the Nazi regime is probably the most traumatic catastrophe of our century and even of history in the civilised world. Its deepest abyss consumed the lives of one-third of the world's Jewish population, who were selected and murdered in a cold-blooded industrialised machinery of death in this their ‘Shoa’. The Jewish people represent the victims of the Holocaust more than any other group of human beings who suffered this iniquity. The Holocaust has left in its wake few survivors, and many invalids in body and in mind, who remain compelled to live with a trauma that surpasses any other deliberately caused by fellow humans: and it has left in its wake an entire nation in shame and bewilderment, stigmatised and traumatised by the horrifying crimes that were committed in its name, faced with the task of analysing what happened, so that it may never be repeated, forbidden by the enormity of the horrors from repressing the past, and obliged to integrate deeds that cannot be undone.
Drinking, Thirst and Water Intoxication
Authors: Crammer John L.
Published: October 2008

Drinking is an activity determined partly by oropharyngeal stimulation and gastrointestinal sensations as well as biochemical changes, and thirst need not be involved. It is sometimes disturbed in mania or depression. Overdrinking (polydipsia) is common in long-stay in-patients, but only gives rise to water intoxication when there is a variable functional renal abnormality such as SIADH causing water retention. In contrast, in affective disorders, disturbance of sodium retention may be seen, possibly representing failure of nervous vascular control as part of the mental illness.
D1and D2and D3
Authors: Healy D.
Published: October 2008

Good scientific hypotheses rarely succumb to a lack of confirmatory evidence; they may sometimes even be resistant to apparent outright refutation (Kuhn, 1970; Lakatos, 1970). Considering this, Kuhn (1970) suggested that the dominant hypotheses in a field are often replaced not on grounds of greater theoretical coherence but rather on grounds of strategic necessity.
The World Health Organization's Cross-cultural Study on Neuropsychiatric Aspects of Infection with the Human Immunodeficiency Virus 1 (HIV-1) Preparation and Pilot Phase
Authors: Maj Mario , Janssen Robert , Satz Paul , Zaudig Michael , Starace Fabrizio , Boor Darwin , Sughondhabirom Bhirom , Bing Eric G. , Luabeya Mesu’ A Kabwa , Ndetei David , Riedel Rolf , Schulte George , Sartorius Norman
Published: October 2008

The WHO launched a multicentre study to explore the nature and prevalence of HIV-1-associated neurological, psychiatric, and neuropsychological abnormalities in persons living in different geographical and sociocultural contexts. The study is being conducted in Brazil, Germany, Kenya, Thailand, the United States of America, and Zaire. A comprehensive instrument for the collection of neuropsychiatric data (including a battery of neuropsychological tests suitable for cross-cultural use) has been developed, and the feasibility of the recruitment and assessment procedure designed for the main phase has now been demonstrated.
The Structure of Phobias in Panic Disorder
Authors: Argyle Nick , Solyom Carol , Solyom Leslie
Published: October 2008

Fear and avoidance of individual phobic situations were measured in 1168 patients with panic disorder suffering current attacks. Correlation and principal-components analyses give components of agoraphobia, illness phobia, and social phobia in panic disorder. Agoraphobia does not stand out so clearly as illness phobia and social phobia as a separate factor; ‘fear of open spaces' shows some separation from other agoraphobic situations. Frequency of panic attacks and changes associated with their remission have no special relationship to agoraphobia. Closer attention to social and illness phobia may be fruitful in discerning the evolution of panic disorder.
A Comparison of Paroxetine, Imipramine and Placebo in Depressed Out-patients
Authors: Dunbar G. C. , Cohn J. B. , Fabre L. F. , Feighner J. P. , Fieve R. R. , Mendels J. , Shrivastava R. K.
Published: October 2008

To compare the safety and antidepressant efficacy of paroxetine, imipramine, and placebo, data from six centres using the same protocol were pooled. A double-blind parallel-group design was used, with therapy lasting six weeks. From week 2 onwards, both the 240 paroxetine-treated and the 237 imipramine-treated patients were significantly different from the 240 placebo-treated patients, but no different from each other. Side-effects with paroxetine were less likely to lead to drop-out than with imipramine. Paroxetine had a possible earlier antidepressant effect than imipramine, and a possible earlier beneficial effect on anxiety symptoms associated with depression.
Classification of Dissociative States in DSM–III–R and ICD–10 (1989 Draft) a Study of Indian Out-patients
Authors: Das Partha Sarathi , Saxena Shekhar
Published: October 2008

When 42 cases of primary dissociative states from India were classified according to DSM–III–R and ICD–10 criteria, DSM–III–R was found to be unsatisfactory, with 40 (95.2%) cases receiving a diagnosis of dissociative disorder not otherwise specified. The majority fit well into simple dissociative and possession disorders. ICD–10 was found to be more satisfactory, with 36 (85.5%) patients fitting into specific subcategories, which, however, need to be defined and described more explicitly.
Post-traumatic Stress Disorder and Severe Head Injury
Authors: McMillan T. M.
Published: October 2008

Post-traumatic stress disorder (PTSD) is described following a road traffic accident in which the patient suffered a severe head injury. The stress reaction was associated with intrusive thoughts and avoidance of cognitive and physical events associated with consequences of the accident. The condition was successfuly treated by behavioural intervention. It seems clear that PTSD can occur even where there is loss of consciousness and organic amnesia for the event and its immediate sequelae.
Serotonin Reuptake Inhibitors, Epilepsy and Myoclonus
Authors: Deahl Martin , Trimble Michael
Published: October 2008

Specific inhibitors of 5-HT reuptake are reported to have lower preconvulsive activity than other antidepressants. A patient with post-traumatic epilepsy who had remained fit-free for many years until she was given the 5-HT reuptake inhibitor fluvoxamine is reported. Changes in serotonergic function may play a more widespread role in the pathophysiology of seizure disorders than hitherto thought.
Some Aspects of Family Interventions in Schizophrenia. II: Financial Considerations
Authors: Tarrier Nicholas , Lowson Karen , Barrowclough Christine
Published: October 2008

The direct costs to the mental health services for patients who participated in a trial of a behavioural family intervention to reduce schizophrenic relapse were estimated. Comparisons were made between two patient groups from households of high expressed emotion (HEE): one group received a nine-month family intervention (HEE Intervention) and the other group routine treatment (HEE Control). A third group consisted of patients from low-EE households (LEE Control). The significant decrease in relapse rates in the HEE Intervention group compared with the HEE Control group has previously been reported; the analysis of costs indicates that any increase in costs due to the family intervention is outweighed by a decrease in usage of the established mental health services. The intervention resulted in a decrease of 27% in mean cost per patient.
Douglas House Seven Years' Experience of a Community Hostel Ward
Authors: Creighton F. J. , Hyde C. E. , Farragher B.
Published: October 2008

Of 24 residents of a ten-bed, community-based hostel ward suffering chronic psychiatric illness, nine have been resettled in the community, with four more expected to follow them. Five residents have made Douglas House their home but another six have manifested behavioural disturbance necessitating return to hospital wards. We found community discharge to be associated with illnesses having good prognostic features, while organic illness militated against such placement. Indicators of a prior history of behavioural disturbance seem to predict difficulties in managing a patient in this environment.
Sleep Electroencephalography in Depressive Illness a Collaborative Study by the World Health Organization
Authors: Mendlewicz Julien , Kerkhofs Myriam
Published: October 2008

Eight WHO research centres from Europe, North America and Asia took part in a WHO study aimed at assessing the reliability and consistency of sleep-EEG abnormalities in major depression. Each centre was asked to include in the study ten depressed patients aged 20–65 years meeting the Research Diagnostic Criteria for a major depressive disorder, and to match them by age and gender with ten controls. There were 67 patients and 66 controls included in the study. Compared with controls, depressed patients showed sleep-continuity disturbances such as increase in sleep-onset latency, and decrease in total sleep time and in sleep efficiency. Stages 2 and 3, as percentages of total sleep time, were reduced in depressed patients, REM latency was shortened and REM density increased. These findings confirm the presence of specific sleep-EEG abnormalities in major depression.
Psychiatric Manifestation of Systemic Lupus Erythematosus in Singapore a Cross-cultural Comparison
Authors: Lim Lionel Chee-Chong , Lee Tock-Eng , Boey Mee-Ling
Published: October 2008

In a case-control, cross-cultural study of the psychiatric morbidity of systemic lupus erythematosus in an Oriental population, 30 patients suffering from SLE and 29 controls with rheumatoid arthritis were interviewed. The SLE patients in Singapore exhibited greater psychiatric morbidity than their Western counterparts. Significant correlation was observed between psychiatric morbidity and the clinical disease activity. The patient's perception of the severity of arthritis, myalgia and dermatological lesions was an important aetiological factor. Culturally determined, disease-related psychological stresses also contributed to the psychopathology.
Phobic Disorders in the Elderly
Authors: Lindesay James
Published: October 2008

Sixty confirmed cases of phobic disorder identified in an urban elderly community sample were compared with 60 controls matched pairwise for age and sex. Cases reported higher rates of specific and non-specific neurotic symptoms, and all were assigned to a diagnostic catego class, compared with seven of the controls. A past history of chronic psychiatric disorder other than phobia was commoner in the cases. Most cases had more than one fear; agoraphobic main fears were predominantly of late onset and associated with moderate to severe social impairment, whereas specific main fears were associated with early onset and minimal social impairment. The onset of agoraphobic fears in old age was attributed by most cases to an episode of physical illness or other traumatic event. Increased rates of palpitations, dyspnoea, giddiness and tinnitus not attributable to anxiety were identified in the cases. Cases did not differ from the controls in socio-economic status, or in the number or quality of current intimate confiding relationships, but they reported higher rates than controls of parental loss before the age of 18 years. Cases reported higher rates of contact with general practitioners, but only one was in contact with psychiatric services at the time of interview. Cases also reported receiving more help in personal care from family members.
Causal Attributions and Psychiatric Symptoms in Survivors of the Herald of Free Enterprise Disaster
Authors: Joseph Steve A. , Brewin Chris R. , Yule William , Williams Ruth
Published: October 2008

The aim of the present study was to explore the relationship between causal attributions and psychiatric symptoms in those who survived the capsizing of the Herald of Free Enterprise ferry, two years following the disaster. Internal and controllable attributions for disaster-related experience are strongly related to poorer psychological outcome.
The 1978 Italian Mental Health Law – A Personal Evaluation: A Review
Authors: Jones Kathleen , Wilkinson Greg , Craig T. K. J.
Published: October 2008

“The author discusses the sociopsychiatric consequences of the 1978 Italian mental health law. He also reviews the international scientific ideas that led up to it. The sociopolitical psychiatric views of the late Franco Basaglia, pioneer of the change in the mental health system of the Italian Republic, are described. Statistical reports and critical analyses are reported. Objective data, based on the author's personal experience as a practising psychiatrist in Rome, Italy, from 1969 to 1987, are given.”
Recurrence of Puerperal Psychosis During Late Pregnancy
Authors: Glaze Robin , Chapman Gail , Murray Declan
Published: October 2008

Two cases of pre-partum psychosis are described. Both patients had previous episodes of puerperal psychosis but no non-puerperal illnesses. The possible relationship of pre-partum and post-partum psychosis is discussed.
Neuroleptic Malignant Syndrome Secondary to Loxapine
Authors: Chong L. S. , Abbott P. M.
Published: October 2008

Loxapine was introduced to the British market two years ago although it has been used in North America for eight years. We report the first probable case of neuroleptic malignant syndrome (NMS) secondary to loxapine in Britain. Two previous cases have been reported in North America (manufacturer's data).
Sleep-Loss as a Possible Mediator of Diverse Causes of Mania
Authors: Wehr Thomas A.
Published: October 2008

When sleep duration and mood were monitored longitudinally in a 59–year-old woman with bipolar illness, sleep loss appeared to mediate the triggering of mania by psychosocial and pharmacological precipitating factors. This interpretation was supported by observations that mania could repeatedly be induced experimentally by depriving her of sleep for one night. The patient's data illustrate how sleep-loss might be a preventable cause of mania in a variety of situations.
Sex Therapy
Authors: Guirguis Waguih R.
Published: October 2008

The first scientist to confront society with the central role of sex in human development was Freud. His method, the detailed and in depth analysis of the childhood experiences of a handful of upper class Viennese women, may be suspect by today's standard of scientific inquiry. It was, however, the first systematic attempt to study an area of human behaviour which was wrapped in mystery, prejudice and fear. His crucial and most controversial book,Three Essays on the Sexual Theory,was published in 1905 and branded at the time as an obscene book. A disclaimer from the publisher was attached to the English translation of this book which read: “The sale of this book is limited to Members of the Medical, Scholastic, Legal and Clerical professions”. If read together with Freud's earlier book,The Interpretation of Dreams(1899), these two books give the distinct impression that Freud did discover the problem of sexual abuse.
Coherence on Electroencephalography and Aberrant Functional Organisation of the Brain in Schizophrenic Patients During Activation Tasks
Authors: Morrison-Stewart Sandra L. , Williamson Peter C. , Corning William C. , Kutcher Stanley P. , Merskey Harold
Published: October 2008

Thirty schizophrenic patients (20 medicated, 10 off medication) were compared with 30 normal control subjects matched for age, sex, handedness, and intelligence. During the performance of left-hemisphere cognitive activation tasks, normal subjects had significantly increased EEG alpha coherence in areas related to left focal frontal sites, with decreases in temporal and posterior areas. Schizophrenic patients did not show the same degree of focal activation of left frontal areas. During the performance of right-hemisphere cognitive activation tasks, normal subjects and schizophrenic patients had similar patterns of right posterior increases in alpha coherence. Discriminant analyses were able to classify 81.4% of all subjects correctly. It is suggested that the findings indicate an aberrant functional organisation of the brain in schizophrenia, particularly affecting the left hemisphere.
Cross-cultural Feasibility, Reliability and Sources of Variance of the Composite International Diagnostic Interview (CIDI)
Authors: Wittchen H.-U. , Robins L. N. , Cottler L. B. , Sartorius N. , Burke J. D. , Regier D. ,   Participants In The Multicentre Who/Adamha Field Trials
Published: October 2008

The CIDI is a fully standardised diagnostic interview designed for assessing mental disorders based on the definitions and criteria of ICD–10 and DSM–III–R. Field trials with the CIDI have been conducted in 18 centres around the world, to test the feasibility and reliability of the CIDI in different cultures and settings, as well as to test the inter-rater agreement for the different types of questions used. Of 590 subjects interviewed across all sites and rated by an interviewer and observer, 575 were eligible for analysis. The CIDI was judged to be acceptable for most subjects and was appropriate for use in different kinds of settings. Many subjects fulfilled criteria for more than one diagnosis (lifetime and six-month). The most frequent lifetime disorders were generalised anxiety, major depression, tobacco use disorders, and agoraphobia. Percentage agreements for all diagnoses were above 90% and the kappa values were all highly significant. No significant numbers of diagnostic disconcordances were found with lifetime, six-month, and four-week time frames.
The CIDI-Core Substance Abuse and Dependence Questions: Cross-cultural and Nosological Issues
Authors: Cottler L. B. , Robins L. N. , Grant B. F. , Blaine J. , Towle L. H. , Wittchen H.-U. , Sartorius N. ,   Participants in the Who/Adamha Field Trial
Published: October 2008

The CIDI is a fully standardised, structured interview for the assessment of psychiatric disorders according to DSM–III–R and proposed ICD–10 criteria. The development of this interview has been the collaborative effort of researchers from 18 sites around the world. In a field trial to test the cross-cultural acceptability and reliability of the questions, there was found to be high acceptance and excellent reliability for the substance use questions, problems with the lengthy alcohol section, and difficulties translating relevant substance use concepts into different languages. There is therefore room for further improvement in the substance-related questions. There proved to be differences between ICD–10 and DSM–III–R regarding substance abuse and dependence disorders.
Against Pathology the New Psychiatry and its Critics
Authors: Littlewood Roland
Published: October 2008

The notion of ‘pathology’ presumes an experiential and socially embedded frame of reference which is at variance with some recent attempts to understand the procedures and subject matter of psychiatry. Psychiatric theories remain bound by individual and historical contingencies whose compelling urgency obfuscates the inter-relationship of phenomenon, social context, response, and explanatory model.
The Treatment of Neuroleptic Malignant Syndrome are Dantrolene and Bromocriptine Useful Adjuncts to Supportive Care?
Authors: Rosebush Patricia I. , Stewart Thomas , Mazurek Michael F.
Published: October 2008

In a prospective study of 20 patients with NMS, those who received dantrolene (2 patients) or bromocriptine (2 patients) or both (4 patients) tended to have a more prolonged course of illness and a greater incidence of sequelae than those treated with supportive care alone. These results do not indicate a useful role for dantrolene or bromocriptine in the treatment of NMS.
‘Ecstasy’ Psychosis and Flashbacks
Authors: Creighton F. J. , Black D. L. , Hyde C. E.
Published: October 2008

We report three cases of flashbacks and one case of recurrent psychosis experienced by three MDMA users. We draw the attention of clinicians to the combination of adverse effects observed with this drug of abuse and to the advisability of prolonged treatment should they occur.
Psychiatric Hospital Admission Rates in Jamaica, 1971 and 1988
Authors: Hickling Frederick W.
Published: October 2008

The overall psychiatric hospital admission rates in Jamaica were 136 per 100 000 in 1971 and 69 per 100 000 in 1988. The admission rate for schizophrenia was 69 per 100 000 in 1971 and 35 per 100 000 in 1988. The 49% reduction in admission rates over these 17 years is attributed to the introduction of an island-wide community mental health service with psychiatric admission to general parish hospitals in 1972. This admission rate for schizophrenia is five to six times lower than the rate reported for Afro-Caribbeans in the UK by a number of studies, and is more in keeping with the admission rate for schizophrenia reported for the general population in England.
Psychopathology of People with Mental Handicap and Epilepsy I: Maladaptive Behaviour
Authors: Deb S. , Hunter David
Published: October 2008

One hundred and fifty mentally handicapped people (100 from hospital and 50 from the community) with epilepsy were studied along with an individually matched control group of 150 (100 from hospital and 50 from the community) non-epileptic mentally handicapped people. Behaviour was studied using the Profile of Abilities and Adjustment Schedule. Of the total population, 55.3% showed some type of severe behaviour problem. Although the epileptics showed slightly more severe behaviour problems than the non-epileptic group, there was no statistically significant difference between the two groups. Some differences emerged between the groups when subgroups of epileptics were studied.
Psychopathology of People with Mental Handicap and Epilepsy II: Psychiatric Illness
Authors: Deb S. , Hunter David
Published: October 2008

The prevalence of psychiatric illness was studied in 150 epileptic mentally handicapped people (both hospital in-patients and living in the community) and a matched group of 150 non-epileptic controls. The Profile of Abilities and Adjustment (PAA) scale was used for the initial screening of psychiatric illness. Mildly to moderately handicapped individuals who had good communication skills and scored positively on the PAA schedule for psychiatric illness were interviewed using the PSE interview schedule. Severely mentally handicapped individuals who scored positively on the PAA's psychiatric illness subscale were observed and information was gathered from their medical notes and carers. A psychiatric diagnosis was made using DSM–III–R criteria. The non-epileptic group showed significantly more psychiatric illness than the epileptic group. Psychiatric illness was diagnosed in 25% of the cohort.
Psychopathology of People with Mental Handicap and Epilepsy III: Personality Disorder
Authors: Deb S. , Hunter David
Published: October 2008

A group of 75 mildly to moderately mentally handicapped people with epilepsy, resident in both a hospital and the community, were studied together with an individually matched control group of non-epileptic patients. Their carers were interviewed to gather information for two observer-rated personality questionnaires, the Standardised Assessment of Personality (SAP) and the T-L Personality Behaviour Inventory. The two groups were compared with respect to the prevalence rates of various personalities. An abnormal personality score according to the SAP schedule was reported in 26% (n = 39) of the cohort, of which 28 (18.6% of the cohort) were personality disorders. A diagnosis of SAP abnormal personality was made in 46% of the in-patients and 6.5% of the community-based population. Of the cohort, 15% had an abnormal personality score according to the T-L schedule. No statistically significant difference emerged between the epileptic and the non-epileptic groups in the prevalence of either the SAP or T-L personality.
Decreased Hippocampal Expression of a Glutamate Receptor Gene in Schizophrenia
Authors: Collinge John , Curtis David
Published: October 2008

‘A striking and specific loss of the messenger RNA that encodes a non-N-methyl D-aspartate (non-NMDA) glutamate receptor was found in hippocampal tissue obtained at necropsy from 6 patients with schizophrenia, when compared to specimens from 8 controls without neurological or psychiatric signs or symptoms. These findings support suggestions of aberrant glutamatergic function in schizophrenia. Evidence that gene expression may be abnormal in schizophrenia, with decreased production of an excitatory neurotransmitter receptor, may have therapeutic as well as pathogenetic implications.’
Continuation Electroconvulsive Therapy: Preliminary Guidelines and an Illustrative Case Report
Authors: Scott Allan I. F. , Weeks David J. , Mcdonald Claire F.
Published: October 2008

Despite renewed interest in ECT as a continuation treatment after an episode of depressive illness, few guidelines for its use are available. Meaningful research findings are few, although the potential benefits and risks of modern continuation ECT merit study. We suggest preliminary guidelines and provide an illustrative clinical example.
Psychological Approaches to the Management of Memory Impairments
Authors: Miller Edgar
Published: October 2008

Memory impairments are handicapping to those who suffer them, and a number of ways of trying to help those afflicted have been devised. Effective psychological approaches are likely to be based on methods designed either to make the most efficient use of remaining memory capacity, or to alter the environment so as to reduce the demands placed on memory. At present the success of such approaches is limited.
Tardive Dyskinesia
Authors: Macpherson Robertson , Collis Rachel
Published: October 2008

Of 113 patients in long-stay wards of a psychiatric hospital, 43 had TD. Twenty-six of the 39 patients who consented to take part in the study were unaware of abnormal involuntary movements. These patients scored significantly lower on a short test of cognitive function than patients who were aware of such movements. The diagnosis of schizophrenia, perticularly the ‘defect’ state with cognitive deficit and negative symptoms, was found to be associated with lack of awareness of TD.