bluuebunny/crossref_metadata_2025 huggingface dataset:
A study concerning the time‐related and other burdens when severely handicapped children are reared at home
Authors: Dupont A.
Published: August 2007

In order to examine the impact of a handicapped person on the family a representative sample of families with severely mentally retarded children (IQ < 50) living at home was studied.

The material was based on an epidemiological survey of severe mental retardation among children in the county of Aarhus, Denmark, performed by Dr. Bemsen. Of the 171 families involved in Dr. Bernsen's survey 39 had a child between six and 14 years and these children were all living at home and attended day‐institutions or schools (with one exception).

Results: on an average, the families devoted 7 hours and 11 minutes seven days per week to the care, supervision, occupation, and training of these children. In 80 % of the cases the parents’ sleep was disturbed by the child. Only one fourth of the children could be left alone, and only for about half an hour. All the others needed constant care and supervision. Eighty‐seven percent of the families had limited cultural activities, 77% had limited contact with friends, 49% had limited contact with relatives and 59% had stopped going on vacation. Sixty‐seven percent of the families stated that the circumstances had been altered, and stressed the special conditions under which the other siblings lived. In one third of the families the siblings took part in the care, in two thirds of the families the siblings supervised the handicapped child.

If the family shall not suffer too much, it is necessary that they receive advisory service from skilled social workers and home advisers, technical aid equipment, financial support, as the work they carry out is a full‐time job, and most important: a possibility of regular leisure‐time and holiday arrangements.
Cost study of mental health services
Authors: Vlnni K. , Slllanpää A. , Anttinen E.
Published: August 2007

This survey deals with the structure and formation bases of the direct costs of different forms of psychiatric care in North‐Häme mental health district in Finland. By combining patient data and cost data it has been possible to calculate the care period costs of the different patient groups and to compare the costs of inpatient care and some alternative forms of outpatient care.
The selective factors leading to psychiatric referral
Authors: Hurry J. , Tennant C. , Bebbington P.
Published: August 2007

Community surveys identify a much higher proportion of people suffering from “mental disorder” than are found in psychiatric clinics. We wanted to examine the role that social class played in selection into treatment and to what extent this influence if any, was due to an interaction effect with severity of illness.

A community psychiatric survey was carried out in a working class area of London, sampling 800 adults. The Present State Examination was used to identify those subjects with psychological impairment, while a structured interview was used to elicit demographic data. In addition 74 “new” outpatient referrals were selected at random from a psychiatric case register existing in the area and interviewed using the same instruments.

Is it concluded that while own social class has no significant effect on service use, father's social class and education are directly related to service use, though weakly, and that this relationship is unaltered when severity of illness is taken into account.
Parent‐Child separations during childhood: their relation to adult psychiatric morbidity and to psychiatric referral: preliminary findings
Authors: Tennant C. , Hurry J. , Bebbington P.
Published: August 2007

A large body of literature suggests that parental loss in childhood bears a causal relation to adult psychiatric morbidity. As previous studies have used identified psychiatric patients, from psychiatric hospitals, it is unclear whether childhood parental loss causes psychiatric impairment (severity of symptomatology) in adult life or is in fact merely associated with psychiatric referral (illness behaviour). The present study of psychiatric outpatients, and “cases” and non‐cases from a community survey, allows these two factors, impairment (severity of symptomatology) and illness behaviour (psychiatric referral) to be clearly distinguished. Parent‐child separations bear no significant relation to psychiatric symptomatology in adult life, but are associated with referral to psychiatric services.
Discontinuing antiparkinson medication in chronic schizophrenics
Authors: MANOS N. , GKIOUZEPAS J.
Published: August 2007

In a double‐blind study of 100 chronic schizophrenic patients, withdrawal of antiparkinson (AP) medication showed that 44 % of the 75 patients who constituted the placebo group (versus none of the patients on active AP medication), complained strongly of debilitating extrapyramidal symptoms (EPS) and another 22.6 % (versus 8.7 % of the patients on active AP medication), displayed disturbing psychotic symptomatology related to EPS. The authors discuss their findings in relation to the widely held view that AP medication may be safely withdrawn from chronic schizophrenics.
Cross‐cultural approaches to transsexualism
Authors: Ross M. W. , Wålinder J. , Lundströ B. , Thuwe I.
Published: August 2007

Several hypotheses with regard to the influence of societal factors including the rigidity of the society with regard to sex roles, sexual equality and homosexual behaviour were tested comparing prevalence, incidence and sex ratio of transsexualism between Sweden and Australia, two societies which differ with respect to these factors while otherwise remaining comparable as Western democratic societies of about the same size and level of technological development. Significant differences were found between the two countries in both frequency and sex ratio of transsexualism. These findings are discussed and it is concluded that societal influences seem to have an influence on the number of transsexuals presenting as patients. Further research is needed to assess whether these factors also influence aetiology and development of transsexualism.
MAO inhibition and control of anxiety following amitriptyline therapy
Authors: Davidson J. , Linnoila M. , Raft D. , Turnbull C. D.
Published: August 2007

In a pilot study, 32 patients with mixed states of anxiety, depression, somatization and panic received amitriptyline for 4 weeks, the dose ranging from 50 to 300 mg/day. Steady‐state plasma levels of the drug and activity of platelet monoamine oxidase were measured after 4 weeks. Clinical change was rated, using the SCL‐90. Amitriptyline produced a small but significant inhibition of platelet monoamine oxidase activity (range 1.4–82%). A significant positive correlation was noted between MAO inhibition and improvement on somatization, and psychological and panic‐phobic components of anxiety, but not for depression. No significant correlations were observed between improvement and combined or separate ami‐ + nortriptyline plasma levels.
Plasma tryptophan binding to albumin in unipolar depressives
Authors: Riley G. J. , Shaw D. M.
Published: August 2007

The equilibrium binding constants of the interaction of tryptophan with albumin have been determined in plasma samples from both controls and patients suffering from affective disorders. The data corresponded with literature values for both the albumin concentration in plasma and the equilibrium constant for tryptophan binding to albumin. No differences in the equilibrium constants were detected between patients and controls but a small increase in the albumin concentration was noted in the depressives. It was agreed that this rise would be inadequate to lead to a significant effect on free tryptophan levels. Non‐esterified fatty acid analysis indicated no differences between patient groups.
Catecholamines and monoamine oxidase activity in anxiety
Authors: Mathew R. J. , Ho B. T. , Kralik P. , Taylor D. L. , Claghorn J. L.
Published: August 2007

Levels of platelet monoamine oxidase activity, state anxiety and trait anxiety were quantified twice in 20 drug‐free subjects with generalized anxiety and an equal number of healthy drug‐free controls at 4‐week intervals. Fiften subjects in each group also had plasma epinephrine and norepinephrine measured. The index group received relaxation training during the interval between the two evaluation sessions. Post‐relaxation training values for monoamine oxidase, epinephrine, norepinephrine and the anxiety levels were found to be significantly lower than the pre‐treatment values for the index group. No significant changes were seen in the control group values. For the index group, catecholamine levels and monoamine oxidase activity were seen to correlate significantly before and after relaxation training.
Prevalence of suicidal feelings in a sample of non‐consulting medical students
Authors: Okasha A. , Lotaif F. , Sadek A.
Published: August 2007

Five hundred and sixteen final‐year non‐consulting medical students were studied as to the occurrence of different degrees of suicidal feelings. A total of 12.6 % reported some degree of suicidal feelings during the past year. Responses ranged along a continuum such that subjects reporting the more intense feelings also reported the less intense feelings.

In 5.6 % of the subjects the maximum intensity was only a feeling that life was not worthwhile, 4 % had thought of taking their life, 0.9 % had seriously considered suicide or made plans, and 0.4 % had made an actual suicide attempt.

Subjects experiencing suicidal feelings in the past year had had more minor psychiatric symptoms, particularly of depression, and had experienced more stressful events and somatic illness. In these respects they resembled the description of completed suicide.
Maintenance of therapeutic effects of total sleep deprivation by limitation of subsequent sleep A PILOT STUDY
Authors: Bemmel A. L. Van , Hoofdakker R. H. Van Den
Published: August 2007

In a previous study it was shown that in endogenous depression repeated sleep deprivation (SD) during clomipramine treatment resulted in rapid improvement after each SD. However, except after the first night, relapses were observed after all sleep nights following SD (the “recovery nights”). The present pilot study had a therapeutic aim, namely to prevent these relapses. We were interested in whether limitation of sleep during the recovery nights might prevent these relapses and whether different amounts of sleep would have different effects on the course of mood after recovery sleep. Ten endogenously depressed patients were treated with clomipramine and with three SD's. Five patients slept for approximately 2 h, and the other five for about 5 h during the second and third recovery nights. On average, no relapse was shown by these patients and, in fact, there was some additional improvement after these nights, in contrast to the findings in the previous study, where patients were allowed unlimited sleep.
A follow‐up study of operated transsexual males
Authors: Sørensen T.
Published: August 2007

The opportuneness of operating on transsexuals has often been discussed but it has obviously been the only form of treatment they wish themselves. Most transsexuals in Denmark have been assessed at the Rigshospital prior to surgery. Since 1951, when the first operation on a transsexual took place, we have had a thorough pre‐operative knowledge of a total of 29 transsexual males who have all obtained official status as females and who have subsequently been followed up.

A phenomenologically based clinical theory of the dynamic coherence of the symptomatology of transsexuals has been advanced. A special core group of transsexual males has been described as characterized by a stable defence in the form of a pseudofeminine narcissism, a stable ego strength, an intact reality testing and a poor genital interest. These patients are expected to have a relatively stable life postoperatively.

Of the 29 operated transsexual males six were not interviewed, three had committed suicide and two refused to take part in the follow‐up. These last five did not belong to the core group, whereas one patient, who emigrated to Canada after sex‐reassignment, belonged to the core group. The remaining 23 have all been interviewed, of these 14 belonged to the core group. The average for the follow‐up period is 6 years.

The operations turned out not to be resocializing, rather the contrary. The majority had no occupation at follow‐up and the number of persons with disablement pension had increased considerably. About 66% lived alone and the majority of those with sexual relationships had had problems. Both before and after operation the majority felt socially isolated. About 66% were satisfied with the surgical outcome, nevertheless 50% wished for supplementary plastic surgery. None of the patients showed signs of more severe psychic sufferings or psychoses postoperatively. Psychically, 83% felt better after than before sex‐reassignment. The majority have had complications and subjective trouble in connection with plastic surgery leading to reoperations of the vagina in most of them. Almost 75% have had sexual relationships postoperatively but not without difficulties.

Characteristic of the persons in the core group is a better economy, a better adjustment to the environment and less problems with neighbours, they are more satisfied with the surgical outcome and have had fewer surgical corrections and also have a better psychic condition than the rest.

It is the general impression at follow‐up that the advantages of sex‐reassignment outweigh the disadvantages where the core group is concerned. But among the persons who do not belong to the core group subjective and objective problems seem so pronounced that operation must be advised against in spite of the often extremely, subjectively unsatisfactory condition of these patients preoperatively.
Zimelidine to geriatric patients: A pharmacokinetic and clinical study
Authors: Dehlin O. , Björnsson G. , Lundström J.
Published: August 2007

To evaluate the clinical efficacy, tolerance and pharmacokinetic properties of zimelidine in elderly people, twelve hospitalized depressed patients with a mean age of 80 years were included in a clinical trial. Zimelidine was administered twice daily at a dose of 50 mg during the first week, 75 mg during the second week and 100 mg during the third to sixth week. The patients also received a single oral test dose of 75 mg of zimelidine during an initial placebo week. All patients that completed the study improved according to the rating scales used. The drug was well tolerated, and adverse reactions were few and of mild or moderate severity. No influence of clinical importance was noted on hematology, liver and kidney functions, ECG, blood pressure or pulse rate. The mean elimination half‐lives of zimelidine and norzimelidine were found to be 15 h and 35 h, respectively, which were longer than the half‐lives earlier obtained in younger patients. The blood levels (AUC) in the geriatric patients were about twice those obtained earlier in healthy volunteers. The AUC values for both zimelidine and norzimelidine increased in close proportion to the increase in dose and, thus, the pharmacokinetics of zimelidine was apparently not dose‐dependent in the dose interval used. The results obtained may indicate a reduction in the rate of metabolism for zimelidine in the elderly, possibly combined with increased total bioavailability of the drug. A reduction of the regular zimelidine dose may be recommended in the treatment of elderly patients.
Fluvoxamine and clomipramine in depressed patients A DOUBLE‐BLIND CLINICAL STUDY
Authors: Klok C. J. , Brouwer G. J. , Van Praag H. M. , Doogan D.
Published: August 2007

In a double‐blind study we compared fluvoxamine, a new selective serotonin re‐uptake inhibitor, with clomipramine. In 36 female in‐patients with vital depression, the antidepressant properties of fluvoxamine and clomipramine were studied. Eight patients did not complete the study.

During a 4‐week treatment period the Hamilton‐, Zung‐, Clinical Global Impression‐ and Leyden ratings showed, apart from the last scale in the fluvoxamine group, significant improvement in both groups. In the latter scale, a statistically significant difference was found in favour of clomipramine. Additional anxiolytic‐sedative medication was required equally in both groups. CSF data in 10 patients are discussed. Non‐specific electrocardio‐graphic (ECG) repolarization disturbances were observed in both groups. Anticholinergic side effects were more prominent with clomipramine than with fluvoxamine; gastrointestinal symptoms and agitation were more prominent with fluvoxamine than with clomipramine. Fluvoxamine did not show particular advantages or disadvantages over clomipramine.
Bromocriptine treatment of depressive disorders
Authors: Nordin C. , Siwers B. , Bertilsson L.
Published: August 2007

Fifteen depressed patients were treated with increasing doses of bromocriptine in an open study. Twelve were treated for 5 weeks (final dose 20–60 mg daily) and nine of these recovered almost completely. As expected from a dopamine agonist, bromocriptine decreased the level of homovanillic acid (HVA) in cerebrospinal fluid (CSF) by 15 % (P < 0.05) and 23% (P < 0.01) after 2 and 5 weeks of treatment, respectively. After 2 but not after 5 weeks of treatment there was also a small but significant decrease (13%; P < 0.001) of the noradrenaline metabolite HMPG in CSF. Although there was no mean effect on 5‐HIAA in CSF, there was a significant relationship between the HVA and 5‐HIAA levels (as % of pretreatment level) both after 2 and 5 weeks of treatment (r = 0.96 and r = 0.62, respectively). This may indicate that the drug has an effect on the serotonin system secondary to the dopamine receptor stimulation. The amelioration of depression was not related to HVA, but did correlate to HMPG in CSF (r = 0.65; P < 0.05) both metabolites measured before treatment These results indicate that bromocriptine may have antidepressant effects possibly mediated through the noradrenergic system rather than the dopaminergic system.
A depot neuroleptic withdrawal study
Authors: Wistedt B.
Published: August 2007

A double‐blind withdrawal trial in 41 chronic schizophrenic outpatients on neuroleptics was carried out during 6 months. Long‐acting neuroleptics (fluphenazine decanoate or flupenthixol decanoate) were used in comparison with placebo to determine the value in maintenance therapy. Most patients had a rather low maintenance dose, about 12.5‐25 mg fluphenazine decanoate or 20–40 mg flupenthixol decanoate every third week.

Relapse was often characterized by a return of the same symptoms as the patient had during his first schizophrenic attack. Drugs were significantly more effective than placebo in preventing relapse and readmission to hospital. 62 % relapsed in the placebo groups as compared with 27 % in the drug group.

All patients on active substance and without relapse during the controlled study had their treatment discontinued for 24 months in an open follow‐up investigation. This resulted in relapse of all patients but one, i.e. a final relapse frequency of 97 %.

A significant weight decrease was observed in the placebo group. The risk of withdrawal is discussed.
Assessment of a secure/intensive care/forensic ward
Authors: Basson J. V. , Woodside M.
Published: August 2007

Recent trends in psychiatric hospitals have re‐established the need for semi‐secure, well‐staffed acute wards. Such a ward is described and 400 consecutive admissions over a 34‐month period reviewed. Using 13 beds all the acute patients requiring security and intensive treatment are managed from a total catchment area of 600,000. A wide range of referral agencies and diagnostic categories are encountered. Staff in the general psychiatric hospital where the ward is situated are satisfied with the service. A small group of chronically‐disturbed patients require separate facilities.
Low platelet MAO activity and schizophrenia: sex differences
Authors: Gattaz W. F. , Kasper S. , Propping P. , Friedl W. , Beckmann H.
Published: August 2007

The authors compared platelet monoamine oxidase activity in schizophrenic patients and normal controls. A significant reductkm in the enzyme activity was found in the male schizophrenic patients but not in the females. No differences were detected among the subgroups of schizophrenia. Sources of bias and the possible mechanism for the findings are discussed.
Electroconvulsive therapy: A comparison of seizure duration as monitored with electroencephalograph and electromyograph
Authors: Sørensen P. Soelberg , Bolwig T. G. , Lauritsen B. , Bengtson O.
Published: August 2007

EEG and EMG were monitored simultaneously at 72 ECT sessions in 18 patients. When EMG was recorded from the leg the duration of EMG curve convulsions varied between 43 and 89 % of the EEG recorded seizure duration of the same fit. The EMG/EEG seizure ratio varied widely among different patients as well as within the single patient during a series of ECT sessions. EMG recording from the masseter muscles showed EMG seizure duration to be more in accordance with the EEG seizure duration than EMG recordings from the leg. The EMG/EEG seizure ratio (masseter) varied from 65 to 100 %, which was significantly higher than the EMG/EEG seizure ratio obtained with EMG recorded from the calf muscles.

The use of EEG monitoring of ECT is advocated in order to obtain the most precise evaluation of the cerebral seizure activity. If EEG monitoring is not available EMG recorded from the masseter muscles provides a reasonably accurate and easily applicable method of monitoring the presence and duration of the ECT‐induced seizure.
Flupenthixol decanoate in recurrent manic‐depressive illness
Authors: Ahlfors U. G. , Baastrup P. C. , Dencker S. J. , Elgen K. , Lingjærde O. , Pedersen V. , Schou M. , Aaskoven O.
Published: August 2007

The hypothesis that flupenthixol decanoate may serve as an alter‐native to prophylactically administered lithium in recurrent manicdepressive illness, bipolar and unipolar type, was tested in two groups of patients. In Group I the patients were allocated randomly to maintenance treatment with either lithium or flupenthixol decanoate. The patients in Group II had previously been given lithium and were switched to flupenthixol decanoate because of unsatisfactory prophylactic effect of lithium, doubtful tablet compliance, troublesome side effects, or fear of later harmful effects. The flupenthixol decanoate dosage was 20 mg every 2–3 weeks. The study was not blind.

In Group I neither lithium treatment (14 patients) nor treatment with flupenthixol decanoate (19 patients) led to a significant fall of mean episode frequency or mean per cent time ill. The reasons for this lack of response are not clear, but prognostically negative selection of the patients presumably took place before and possibly also during the hospitalization. Since absent effects cannot be compared, this part of the trial remains inconclusive.

In Group II (93 patients) treatment with flupenthixol decanoate was associated with significant falls of the frequency of manic episodes and per cent time ill in mania and with significant rises of the frequency of depressive episodes and per cent time ill in depression. Increase of depressive morbidity was seen only in patients who had been given lithium during the pre‐trial period and was presumably a result of the discontinuation of lithium.

It is not known whether flupenthixol decanoate is of value in the prophylactic treatment of recurrent manic‐depressive illness, but the drug may be worth trying in patients whose disease is dominated more by manic than by depressive recurrences and who do not respond to lithium or do not tolerate it or do not take it.
A double‐blind comparison of carbamazepine and clomethiazole in the treatment of alcohol withdrawal syndrome
Authors: Ritola E. , Malinen L.
Published: August 2007

The efficacy and tolerability of carbamazepine and clomethiazole in the treatment of alcohol withdrawal symptoms were compared in a double‐blind study with 68 hospitalized patients. Target withdrawal symptoms, the patient's subjective feeling and unwanted effects were recorded daily during the 1 week‐treatment period. No significant differences between the two treatments could be demonstrated in the parameters studied. It appears that carbamazepine, which is widely used as an antiepileptic drug, well tolerated and not likely to produce any addiction as such, might offer a valuable alternative treatment for the symptoms of alcohol withdrawal.
Psychiatric disorders in a rural practice in the Bendel State of Nigeria
Authors: Binitie A.
Published: August 2007

Patients attending a clinic were ascertained for psychiatric morbidity by a general practitioner and reascertained by a psychiatrist. The agreement ranged from 84% for neurosis and 60% for psychosis. The differences were mainly due to a lack of the depression category in the general practitioner's classification. One year incidence of psychiatric morbidity was 35.7 per 1,000 with anxiety state and depression as the two most common disorders. Depression mainly manifested as masked depression with somatic complaints.
Intellectual efficiency in manic‐depressive patients treated with lithium
Authors: Loo H. , Bonnel J. , Etevenon P. , Benyacoub J. , Slowen P.
Published: August 2007

A longitudinal study of 21 non‐hospitalized manic‐depressive subjects treated with lithium was carried out over a 3‐year period: year 1 (Y1), year 2 (Y2), year 3 (Y3). A control group C of 21 subjects matched for age, sex and educational level was compared to Y1, Y2 and Y3 using the Cattell Intelligence Scale, the immediate memory recall test of numbers, the Code Test (WAIS), the 15‐Word Test and the Benton Visual Retention Test. The vocabulary test of Binois and Pichot was first applied to C and Y1 to test the homogeneity of intellectual level between these two groups.

A strategy of variance analysis followed by non‐parametric Mann‐Whitney and Wilcoxon tests was applied for statistical analysis of the results. Generally, except for the Cattell test, the patients presented lower scores than the control group. This decrease was not accentuated as time elapsed; the non‐verbal were not affected more than the verbal tests.

A clinical analysis was carried out relating the importance of the criteria “deterioration” to four other criteria: “age”, “gravity and duration of illness”, “history of E.C.T.” and “insufficient mood stabilization”. The factor “gravity of the illness” was slightly more frequently associated with factor deterioration.
Genetic heterogeneity in affective disorders
Authors: Baron M.
Published: August 2007

The extent of genetic heterogeneity in major affective illness was estimated via three paradigms of single‐major‐locus inheritance. In the first paradigm bipolar and unipolar disorders were represented at different liability thresholds on a genetic‐environmental continuum. The second paradigm incorporated sex‐related thresholds into the model, thereby testing the hypothesis that affective illness is a transmitted trait whose phenotypic expression is a function of the individual's sex. The third paradigm included both clinical polarity and sex effect as threshold phenomena. All three paradigms predicted considerable genetic heterogeneity in affective disorders. Bipolar homozygotes were far more common than unipolar homozygotes, although the majority of ill individuals in the first two paradigms were heterozygotes. According to the third paradigm bipolar males had the highest proportion of homozygotes amongst the affected population. Significant increases in nomo‐zygosity occurred using the dual mating sampling method. Depending on the model paradigm and parameters these increases were 140–25,000% over the random sample method. The implications for biologic and genetic research in affective disorders were discussed.
Chronic psychosis in epilepsy
Authors: Parnas J. , Korsgaard S. , Krautwald O. , Jensen P. Stigaard
Published: August 2007

A clinical study comprising psychiatric, psychological and neurological examination of 29 patients suffering from long‐term psychosis and severe epilepsy was performed. Only five patients fulfilled the diagnostic criteria of schizophrenia. They differed from the rest of the patients by being less organic and having infrequent laterality to the left of their epileptogenic focus. They were regarded as genuine schizophrenics, while the pathogenesis of the remaining sample was considered multifactorial, including both organic and psycho‐social causes.
Aspects of tempo and perception of music in mania
Authors: Nielzén S. , Cesarec Z.
Published: August 2007

Ten patients with manic psychosis were compared with 20 normal subjects with respect to their ratings of emotional meaning in music. As stimulus two pieces of music for a small symphony orchestra were used. These were structurally identical but performed at two different tempos: slow and fast. The change in tempo was found to lead to dissimilar consequences in emotional experience in the two groups studied. In normal subjects an increased tempo led to the experience of more tension, while in manic psychotics this was associated with an experience of more gaiety. The pattern of ratings constitutes further evidence that temporal relations are of importance hi the psychopathology of mania.
Mercy killing without consent. Historical comments on a controversial issue
Authors: Lauter H. , Meyer J.‐E.
Published: August 2007

In recent discussions on euthanasia the question about mercy killing without consent of mentally ill persons has turned up, particularly in cases of hopeless suffering among senile or chronically insane patients. Possible analogies to the actions under the German Naziregimen and relations to the concept of Social Darwinism with suggestions about active eugenic control as propagated in the early part of this century are outlined in a historical review. The implications and obvious dangers of misuse of any such kind of active euthanasia in psychiatry are discussed on this background.
Double‐blind comparison of doxepin and desipramine in patients with primary affective disorder
Authors: Amsterdam J. D. , Caroff S. , Potter L. , Brunswick D. , Conn J. W. , Rickels K.
Published: August 2007

A double‐blind comparison of doxepin versus desipramine was performed in carefully defined patients with research diagnoses of Primary Affective Disorder. While both drugs showed equal efficacy after 4 weeks, doxepin demonstrated a more rapid onset of action and surprisingly few side effects. Desipramine did not prove to be “activating” and did not worsen agitated depression. Although doxepin showed few autonomic side effects, it was nevertheless sedating, indicating that tricyclics with more anticholinergic effects are not necessarily more sedating drugs.
Tolerance and serum levels of haloperidol during parenteral and oral haloperidol treatment in geriatric patients
Authors: Viukari M. , Salo H. , Lamminsivu U. , Gordin A.
Published: August 2007

Eleven geriatric chronic psychotic hospital patients were treated with monthly intramuscular haloperidol decanoate injections for 5 months. The first and second haloperidol decanoate dose was 20 times and thereafter 15 times the “optimal” oral haloperidol dose. The serum haloperidol concentrations were fairly stable during the whole month following parenteral administration. After the second and third injection the concentration was about twice as high as during oral treatment. No clinically significant changes were established in routine haematological or biochemical laboratory tests studied during the trial. No significant changes in serum prolactin levels were observed after parenteral haloperidol compared to the levels during oral treatment. No local or systemic side effects were observed during the trial. The psychiatric status of the patients was fairly constant during the whole study. Haloperidol decanoate was thus shown to be therapeutically effective and it can be administered safely to geriatric patients.
Computed tomography of the brain in patients with acute psychosis and in healthy volunteers
Authors: Nybäck H. , Wiesel F.‐A. , Berggren B.‐M. , Hindmarsh T.
Published: August 2007

Evidence has been obtained by computed tomography (CT) that some chronic schizophrenic patients have enlarged cerebral ventricles and other brain abnormalities when compared to other patient groups and to healthy controls (Johnstone et al. (1976), Weinberger et al. (1979)). In order to investigate whether structural brain abnormalities can be demonstrated also in younger patients with acute psychosis we have undertaken a CT study in 46 patients and 46 healthy volunteers. Twenty‐eight of the patients fulfilled the Research Diagnostic Criteria for schizophrenia. Nineteen had not been hospitalized for psychiatric reasons before.

The lateral and third ventricles were significantly wider in the patients than in the volunteers. In the volunteers there was a significant positive correlation between age and size of the lateral ventricles, whereas in the patients, particularly those fulfilling the criteria for schizophrenia, no such correlation was obtained. These results indicate that schizophrenia may be associated with pathophysiological processes which interfere with the normal age‐related enlargement of the ventricles. Signs of cortical atrophy, CSF circulation disturbances and reversed asymmetry of the occipital lobes were more frequent in the patient group than among the controls. These results are in accordance with previously published findings and indicate that structural brain abnormalities can be found in relatively young patients with acute psychosis.
Time passes slowly for patients with depressive state
Authors: Kitamura T. , Kumar R.
Published: August 2007

Twenty‐three depressive inpatients and the same number of matched non‐psychiatric controls were examined on three occasions ‐ following admission, 14 days after, and 28 days after the admission ‐ by administering a self‐rating questionnaire of time awareness and Hamilton's Rating Scale for Depression (HRS). The patients were found to feel time passing slowly. This was correlated with the severity of depression expressed as the total HRS score. No significant differences emerged between diagnostic groups, namely endogenous depression, neurotic depression, and schizophrenia or paranoid state with depressive symptoms. Correlations of the time awareness with symptoms listed in the HRS also denied a specific relationship of time awareness to specific diagnoses. The subjective feeling of slow time flow reflects, therefore, the depth of depressive state in general, which is nevertheless not specific to any diagnostic subcategory.
An epidemiological approach to the improvement of mental health services in developing countries
Authors: Giel R.
Published: August 2007

Developing proper criteria for case‐finding in the community and conducting surveys are already such major undertakings that we hardly ever achieve the ultimate goals of:

(a) determining accurately the psychiatric needs of a population;

(b) establishing the types and numbers of personnel required to satisfy these needs; and

(c) defining their tasks, and developing training programmes for the workers who will carry out these tasks.
Methodology of data collection in field surveys
Authors: Wig N. N.
Published: August 2007

In recent years field surveys have come to occupy a very prominent place as a method of data collection for psychiatric epidemiology. They offer a number of advantages over the older methods of data collection from the records of mental hospitals and related health services. However, as experience is gained, it is becoming obvious that there are many limitations to this approach also. Some excellent reviews of field surveys have already appeared in the WHO Public Health Papers series by Reid (1960) and Lin & Standley (1962). The present paper first discusses some of the existing survey methods as they are applicable to mental health problems of developing countries and then reviews some of the studies on the prevalence of mental illness done in India and other parts of South‐east Asia.
A double–blind study of zimelidine, a serotonin uptake inhibitor, and desipramine, a noradrenaline uptake inhibitor, in endogenous depression
Authors: ÅBerg‐Wistedt A.
Published: August 2007

A comparative evaluation of zimelidine, a potent and selective serotonin (5‐HT) uptake inhibitor, and desipramine, a potent nor‐adrenaline (NA) uptake inhibitor, was carried out in a 4‐week randomized, double‐blind study in 65 hospitalized patients with endogenous depression. For evaluation of the clinical effect, Hamilton Rating Scale for depression (HRS) and a 14‐item scale chosen from the Comprehensive Psychopathological Rating Scale (CPRS) were used. The concentration of drug in plasma was determined on the same days as the clinical ratings. There was no significant difference in the overall therapeutic effect between the two drugs. However, zimelidine had significantly better effect on anxiety. Although both agents were well tolerated, the zimelidine‐treated patients reported significantly less severe anticholinergic side effects. Body weight did not change significantly in either treatment group. In the total material there were no significant correlations between plasma concentrations of zimelidine, norzimelidine and desipramine and the amelioration score of either HRS and CPRS.
Differences in lateral brain ventricular size among various types of chronic schizophrenics: EVIDENCE BASED ON A CT STUDY
Authors: Frangos E. , Athanassenas G.
Published: August 2007

Data from a previous study of ours, based on computerised tomography of the brain in 70 chronic schizophrenics, indicated that a severe degree of lateral brain enlargement was present in a great proportion. No correlation was found between lateral ventricular enlargement and age of patients, length of illness, duration of hospitalization o'r ECT treatment. In order to elucidate whether other factors (e.g. type of disease) are likely to correlate with the enlargement we divided these patients into three subgroups: hebephrenics, paranoids and undifferentiated. Comparison of the mean values of ventricular brain ratio (VBR) of the above groups showed that paranoids presented a statistically greater enlargement than hebephrenics. There was no statistically significant difference between undifferentiated and hebephrenics. The difference between undifferentiated and paranoids approached statistical significance. This study provides evidence that there exists a difference between the types of schizophrenia in CT images, a finding that may suggest different degrees of underlying disease process.
Lithium effects on calcium, magnesium and phosphate in man: effects on balance, bone mineral content, faecal and urinary excretion
Authors: Plenge P. , Rafaelsen O. J.
Published: August 2007

Calcium, magnesium and phosphate metabolism was studied in lithium‐treated patients, using a metabolic balance technique. Two groups of patients participated in the study: 1) Patients who were to start on a prophylactic lithium treatment, and 2) Long‐term lithium‐treated patients whose treatment was to be terminated.

Lithium treatment produced a positive balance in both calcium, phosphate and magnesium. By continuous lithium treatment the effect on magnesium wore off, whereas the effect on calcium and phosphate persisted. In urine, lithium induced a decrease in both calcium and phosphate excretion, whereas the excretion of magnesium was increased. Bone mineral content was measured by photon absorption, and lithium treatment resulted in a decrease in bone mineral content occurring within the first 6 months of lithium treatment. In the patients, bioavailability of the Li2CO3 preparation was found to be about 95 %, and the patients contained about one 24‐h dose of lithium just before the next dose of lithium was administered.
Pneumoencephalographic evidence of brain atrophy in acute and chronic schizophrenic patients
Authors: Haug J. O.
Published: August 2007

Pneumoencephalography (PEG) was carried out in 50 patients of both sexes consecutively discharged from a psychiatric department with a diagnosis of acute schizophrenia. At clinical follow‐up with a mean observation time of 8 years the diagnosis was verified in 38 patients, while 12 were considered to have had a reactive psychosis. The PEG findings and clinical findings in these two groups are compared, and compared to corresponding findings in 101 chronic schizophrenics previously studied with the same method.

Linear measurements were used in estimating the size of the ventricular system, which was safely within normal limits in all but three of the 50 patients. Mean ventricular size did not differ significantly in the two groups of acute psychoses. No case of cortical atrophy was found. More than half of the chronic schizophrenics had abnormal PEG's, the typical finding being a bilateral enlargement of the ventricular system. The mean size of all parts of the ventricular system was significantly higher than in the acute schizophrenics. A close correlation was found between mental deterioration and ventricular enlargement. The most reasonable explanation of these findings is that schizophrenia is an inborn error of metabolism, disturbing normal brain function and in the long run leading to degenerative changes of the nervous tissue.
Penile malformation and mental health
Authors: Berg R. , Berg G. , Svensson J.
Published: August 2007

Aspects of mental health were investigated by means of interviews and register data in 34 men operated on for hypospadias in childhood and in 36 matched control subjects. Most hypospadiacs adjust well both in childhood and adult age. However, they reported more neurotic disturbances in their childhood than the controls. Shyness and enuresis were common troubles among the probands, and they had been more timid, isolated and mobbed. Similar although less striking differences in mental health were reported also in adult age. Depression and anxiety were dominating symptoms. The interviewer assessed the hypospadiacs to show more anxiety and to use more immature defence mechanisms and consequently to have less stress tolerance. The probands were further judged to have less capacity for social relations and their over‐all capacity to utilize existent psychological resources was small as compared to the controls. The findings indicate that hypospadiacs are more prone to neurotic (but not psychotic) disturbances than other young men and have more disturbed social relations. The need for psychological guidance for the boys and their parents is stressed.
Neuroendocrine regulation in depressed postmenopausal women and healthy subjects
Authors: Amsterdam Jay D. , Winokur A. , Lucki I. , Snyder P.
Published: August 2007

ABSTRACT ‐ Results from prior studies utilizing gonadotropin‐releasing hormone (GnRH) in affective illness have been contradictory. There have been no systematic investigations of multiple pituitary hormonal responses to GnRH infusion in either depressed or healthy post‐menopausal women. Potential abnormalities in the hypothalamic‐pituitary‐gonadal (HPG) axis may be limited to postmenopausal women who lack the estradiol feedback influence at the pituitary level.

We therefore studied 18 depressed and nine healthy postmenopausal women with the GnRH infusion test and measured LH, FSH, prolactin, growth hormone, and thyrotropin responses. Our findings confirmed earlier reports of a lower basal LH concentration in postmenopausal depressed subjects. GnRH stimulated release of LH, FSH, and prolactin in both patients and controls; however, there were no differences in the mean peak hormone values between groups.
Schneider's first rank symptoms of schizophrenia in Kenyan patients
Authors: Ndetei D. M. , Singh A.
Published: August 2007

ABSTRACT ‐ Eighty‘psychotic’patients admitted to Mathare Psychiatric Hospital, Nairobi, were screened using the New Haven Schizophrenic Index (NHSI). Fifty‐one (64 %) of these were positive and the rest negative. Of those positive 73 % had First Rank Symptoms (FRS) of schizophrenia as opposed to only 24 % in the group negative for schizophrenia. This difference is highly significant (P < 0.001). The commonest individual FRS were thought echo, thought insertion, delusional mood and auditory hallucinations in third per‐son. The frequency distribution of FRS had no relation to sex or age. These results are compared and contrasted with the findings of similar studies in various cultures.
Toxic exposures and psychiatric disease — lessons from the epidemiology of cancer
Authors: Landrigan P. J.
Published: August 2007

Toxic chemicals such as lead, methyl mercury, organic solvents, manganese, kepone, and the organophosphates are recognized to cause psychiatric disease. Whether such associations are exceptional, or if in fact a high proprtion of all psychiatric illnesses are of toxic environmental etiology, and therefore potentially avoidable, is not known. Epidemiologic studies of cancer, particularly analyses of geographic variations in mortality, of variations in incidence in migrant populations, of trends over time, and of induction by environmental agents suggest that extragenetic environmental factors (tobacco, alcohol, drugs, diet, radiation, air pollution, and industrial chemicals) may account for the majority of all human cancers. Similar application of epidemiologic techniques to the study of psychiatric illnesses might yield etiologic clues in relation to toxic environmental exposures and may also suggest approaches to disease prevention.
Indirectly acting neurotoxins
Authors: Silbergeld E. K.
Published: August 2007

The role of toxic substances in causing central nervous system dysfunction is discussed with a focus on effects which are mediated indirectly through other organ systems which affect the brain. Neurochemical measurements of brain function, and the use of neuropharmacological probes of behavior are presented with the examples of lead poisoning, as a case of chemical porphyria, and estrogenization, as a case of hormonal dysfunction.
Lead at low dose and the behavior of children
Authors: Needleman H. L.
Published: August 2007

Over 3,000 children attending first and second grade in public school were classified as to past lead exposure according to the concentrations of lead in their teeth. Those in the highest and lowest deciles for lead were evaluated by a broad panel of neuropsychologic outcome measures. Controlled either by matching or analysis of coveriance were 39 other variables which could effect outcome. High lead children were significantly impaired on IQ, auditory processing and reaction time under varying intervals of delay. Teacher's rating scales showed a dose‐related increase in non‐adaptive classroom behavior with no evidence of a threshold. EEG scores and observations of children in class demonstrated differences in high and low lead subjects.
The role of occupational lead exposure in the genesis of psychiatric and behavioral disturbances
Authors: Baker E. L. , Feldman R. G. , White R. F. , Harley J. P.
Published: August 2007

In a prospective study of lead neurotoxicity, exposed foundry workers and referents were evaluated using a comprehensive set of neurobehavioral tests. Other performance indexes were used including a questionnaire, physical examination, and nerve conduction testing. Results show increased rates of depression, confusion, anger, fatigue and tension among workers with blood levels over 40 mcg/dl. Other aspects of neurobehavioral function, including verbal concept formation, memory, and visual/motor performance were also impaired. In view of the large number of individuals exposed to lead in their work, specific inquiries should be made of individuals with affectual complaints to clarify the nature of their work and workplace exposure to lead.