bluuebunny/crossref_metadata_2025 huggingface dataset:
Reversible and selective inhibitors of monoamine oxidase A in the treatment of depressed elderly patients
Authors: Nair N. P. V. , Ahmed S. K. , Ying Kin N. M. K. Ng , West T. E. G.
Published: August 2007

The treatment of depression in the elderly population needs a thorough and careful work‐up and an aggressive therapeutic approach. Any treatment initiative in this population often becomes difficult because of accompanying physical illness, concomitant medication, possible degenerative changes in central nervous system and age‐related altered metabolic status. Despite unevenness in research findings, pharmacological treatment remains the mainstay of management of depression among elderly people. Currently available antidepressants, although effective, are problematic because of the increased vulnerability of the elderly to side effects. Recent research efforts to improve the efficacy and safety of drug treatment of depression resulted in development of reversible and selective monoamine oxidase inhibitors of the isoenzyme A (RIMA), with antidepressant efficacy comparable to tricyclic antidepressants and newer generation antidepressants. RIMAs include moclobemide, brofaromine, toloxatone and cimoxatone. Moclobemide is the most investigated available RIMA for therapeutic use at present. Its absorption and disposition in elderly individuals do not differ significantly from those in young healthy volunteers and depressed patients. The results of present clinical studies show that, in elderly depressed patients, moclobemide is at least as effective as other antidepressants. Its particular advantage is, however, that it is as well tolerated in elderly people as in younger people. There are only few significant adverse events, and they are generally less frequent and less severe than those with TCAs. An additional attribute of moclobemide seems also to be its beneficial effect on cognitive functions.
Studies of reversible and selective inhibitors of monoamine oxidase A in dysthymia
Authors: Pétursson H.
Published: August 2007

Dysthymia is a relatively common disorder and is frequently associated with other mental conditions such as major depression and anxiety. A number of controlled and uncontrolled studies have indicated that conventional as well as more recent antidepressants such as moclobemide, a selective, reversible inhibitor of monoamine oxidase (MAOI), may be effective in dysthymia and dysthymia‐like disorders. However, assessment of the results of previous studies is confounded by the relative lack of standards in diagnostic criteria, outcome measures, dosage and duration of treatment. Applying DSM‐III‐R criteria, the efficacy of moclobemide in dysthymia has been confirmed in a significant study from South America, and other comparable studies are under way. The potential role of selective, reversible MAOIs such as moclobemide can be more firmly established when results of additional investigations have become available.
Long‐term treatment of mood disorders in schizophrenia
Authors: Azorin J‐M.
Published: August 2007

Mood disorders in schizophrenia are common and are associated with a poor outcome, an increased risk of relapse and a high rate of suicide. Consequently, treatment strategies need to take mood disorders into account.

In depressed and actively psychotic schizophrenic and schizoaffective patients, treatment with neuroleptic plus antidepressant may be less effective than neuroleptic alone. However, patients with post‐psychotic depression on maintenance neuroleptics respond well to tricyclic antidepressants. Mood disorders can be caused by neuroleptics and if so will often improve if the dose is reduced or if the drug is changed. Anticholinergics may also help. In schizoaffective disorder, lithium is usually beneficial, especially for patients with classical affective disorder. Carbamazepine may be more effective in patients with schizoaffective and schizophreniform disorders. At doses comparable with those effective in schizophrenia, clozapine may be as good or better than conventional neuroleptics in schizophrenic patients with psychotic mood disorder or schizoaffective disorder. In patients with high BPRS anxiety/depression scores, risperidone (8 mg/day) was more effective than haloperidol (10 mg/day). Risperidone at a mean dose of 8.6 mg/day was also more effective than haloperidol (mean dose 9.2 mg/day) or levomepromazine (methotrimeprazine — mean dose 125 mg/day) on the Psychotic Anxiety Scale.

Mood‐related symptoms are therefore amenable to treatment. Risperidone and clozapine appear to be good candidates for the long‐term treatment of mood disorders in schizophrenia, although long‐term, double‐blind, controlled studies are needed to confirm this.
Incidence of eating disorders in psychiatric hospitals and wards in Denmark, 1970–1993
Authors: Munk‐Jørgensen P. , Møller‐Madsen S. , Nielsen S. , Nystrup J.
Published: August 2007

Two previous studies in Denmark found diverging results in analyzing trends in new cases of eating disorders in the psychiatric in‐ and day‐patient services, although the same data source, the nationwide Danish Psychiatric Case Register, was used. The present study – also using information from the nationwide Danish Psychiatric Case Register, but correcting for several register biases – confirms a highly significant increase in new cases of eating disorders in psychiatric hospitals and wards. The increase is seen exclusively in younger females. The diverging results in the previously mentioned studies in Denmark may be ascribed to methodological issues.
Cost‐effectiveness of clozapine treatment in therapy‐refractory schizophrenia
Authors: Jonsson D. , Wålinder J.
Published: August 2007

The costs and effects of clozapine treatment of refractory schizophrenic patients have been discussed recently. This study shows that 18 months of clozapine treatment results in an improvement of symptoms and social functioning in approximately 70% of treatment‐refractory schizophrenic patients, compared with treatment with conventional neuroleptics during a similar period of time. Treatment with clozapine reduces the cost of inpatient care but places increased demands on active rehabilitation resources in outpatient care. This leads to increased total costs in a short‐term perspective, but clozapine treatment is cost‐saving for annual maintenance therapy. These costs must be weighed against the positive effects on psychotic symptoms and social functioning.
Effect of paroxetine on seizure length during electroconvulsive therapy
Authors: Curran S.
Published: August 2007

This study reports the effect of paroxetine, a selective serotonin reuptake inhibitor, on seizure length during electroconvulsive therapy. Seven inpatients taking paroxetine were compared with 7 controls taking tricyclic antidepressants. The mean seizure length of the paroxetine group was approximately twice that of the control group.
The prevalence of prodromal features of schizophrenia in adolescence: a preliminary survey
Authors: McGorry P. D. , McFarlane C. , Patton G. C. , Bell R. , Hibbert M. E. , Jackson H. J. , Bowes G.
Published: August 2007

In most cases of schizophrenia the onset of frank psychosis is preceded by a period of prodromal features. This period has been relatively neglected by researchers and is potentially important in promoting early intervention. The prevalence of DSM‐III‐R schizophrenia prodrome symptoms was assessed as part (n= 657) of a large (n= 2525) questionnaire‐based survey of high school students. Individual symptoms were highly prevalent and the prevalence of DSM‐III‐R prodromes ranged from 10–15% to 50%. Despite methodological weaknesses, the data suggest that DSM‐III‐R prodromal features are extremely prevalent among older adolescents and unlikely to be specific for subsequent schizophrenia. Clinically these features cannot be regarded as sufficient evidence of early schizophrenia and more accurate predictors of incipient schizophrenia need to be defined.
Children with mental disorders in primary care: functional status and risk factors
Authors: Gureje O. , Omigbodun O. O.
Published: August 2007

Using data derived from a large epidemiological survey of children attending a pediatric primary care clinic, this article reports the relationship between the presence of mental disorders and functional status and the risk factors for depressive, anxiety‐related and conduct disorders in these children. The results suggest that children with mental disorders in primary care are more functionally impaired than those without such disorders, with depressive and conduct disorders more often associated with such impairment. Analysis using logistic regression analysis to determine risk factors showed that broadly different familial and antecedent features predicted the presence of these groups of disorders. The findings confirmed the salience of factors relating to family and socioeconomic status and of maternal psychological health in a culture characterized by the extended family structure and widespread economic deprivation.
Attempted suicide predicts suicide risk in mood disorders
Authors: Nordström P. , Åsberg M. , Åberg‐Wistedt A. , Nordin C.
Published: August 2007

Suicide risk was studied in a sample of 346 mood disorder inpatients, 92 of whom were admitted after a current suicide attempt. The overall suicide mortality after a mean observation period of 6 years was 8%. The potential of attempted suicide to predict suicide risk in hospitalized patients with mood disorders was studied by survival analysis after subgrouping on the basis of whether a current suicide attempt had occurred or not. The suicide risk the first year after attempting suicide was 12% (11/92), compared with 2% (4/254) in the mood disorder subgroup with no current suicide attempt. The long‐range suicide risk after a current suicide attempt in depression was 15% (14/92) as compared with 5% (13/254) among those without a current suicide attempt. It is concluded that a current suicide attempt in mood disorder inpatients predicts suicide risk particularly within the first year and should be taken very seriously.
Experiences with a checklist for DSM‐III‐R in the Russian Federation and Belarus. A study about the interrater reliability and the concurrent validity of the Munich Diagnostic Checklist for DSM‐III‐R
Authors: Havenaar J. M. , Rumyantzeva G. M. , Filipenko V. V. , van den Brink W. , Poelijoe N. W. , van den Bout J. , Romasenko L.
Published: August 2007

The interrater reliability of the Munich Diagnostic Checklist (MDCL) was assessed in a small clinical sample and two population samples in the Russian Federation and Belarus. A team of Russian and Belarussian psychiatrists made DSM‐III‐R diagnoses, using the MDCL as the basis for a standardized interview. The interrater reliability was found to be satisfactory (kappa = 0.86 for case vs non‐case distinction). In the population samples, the interviewing psychiatrist, in addition to making a DSM‐III‐R diagnosis, classified each respondent on a checklist of 11 clinical syndromes familiar to Russian psychiatry and made a severity rating. The overall concurrent validity indices based on the comparison of these diagnostic ratings were fairly high (kappa 0.48–0.82), suggesting considerable agreement between the DSM‐III‐R and traditional Russian diagnostic I concepts
An association study of a neurotrophic3 (NT‐3) gene polymorphism with schizophrenia
Authors: Dawson E. , Powell J. F. , Sham P. C. , Nöthen M. , Crocq M.‐A. , Propping P. , Körner J. , Rietschel M. , van Os J. , Wright P. , Murray R. M. , Gill M.
Published: August 2007

Since abnormalities of brain development play a role in the aetiology of schizophrenia, growth factors, known to play a role in neurodevelopment, such as neurotrophin‐3 (NT‐3), are therefore candidate genes for this disorder. The A3/147 bp allele of a dinucleotide repeat polymorphism in the promoter region of the NT‐3 gene has been reported as occurring more frequently in a sample of Japanese schizophrenics compared to controls. We have determined the frequency of alleles of this polymorphism in 175 Caucasian schizophrenic patients and 147 control subjects. The patient and control samples showed no significant deviation from Hardy‐Weinberg equilibrium and, in a test of all alleles, the patients and controls did not differ significantly in allele frequencies. However, the male schizophrenics were more likely than male controls to have the A3/147 bp allele (P= 0.029).
Cross‐national comparison of prevalence of symptoms of neurotic disorders in older people in two community samples
Authors: Saz P. , Copeland J. R. M. , de la Camara C. , Lobo A. , Dewey M. E.
Published: August 2007

The objective of this research was to compare the prevalence of symptoms characteristic of neurotic disorders in two different cultural settings. The design was two random community samples in Liverpool (United Kingdom) and Zaragoza (Spain), of 1070 and 1080 people aged 65 and over. The main outcome measures were the rating of symptoms on the Geriatric Mental State and syndrome levels using the Automated Geriatric Examination for Computer Assisted Taxonomy. The results showed substantial differences between the two cities in the symptomatic pattern of phobias, but both the symptomatic and syndrome presentation of obsessional, hypochrondriacal and anxiety disorders were much more similar.
Suicide attempts in which alcohol is involved: a special group in general hospital emergency rooms
Authors: Suokas J. , Lönnqvist J.
Published: August 2007

Sixty‐two percent of 1018 parasuicide patients treated in the emergency room of Helsinki University Central Hospital in 1983 for 1207 suicide attempts had recently consumed alcohol in addition to medical drugs: 46% were women and 54% men. High body alcohol levels were associated with young age and male gender. Alcohol consumption shortly before, or at the time of, parasuicidal acts was more common among young or lonely men with previous suicide attempts. Their suicide risk was assessed as less severe and they were less often referred to a psychiatrist compared with those who had not consumed alcohol. They were also more often left without arranged after‐care. By the end of a 5.5‐year follow‐up period, 3.3% of these alcohol consumers had committed suicide, an annual suicide mortality of 598/100,000. In the year following the initial attempt, suicide mortality was 1809/100,000, a 51‐fold risk compared to that of the total population in Helsinki. Sixty‐seven percent of alcohol consumers during the initial suicide attempt also took it before actually committing suicide, and 30% of these revealed clear evidence of chronic alcohol consumption. Those who initially consumed alcohol were identifiable as a risk group for suicide, and thus improvement in their recognition and treatment in the emergency rooms of general hospitals is recommended.
Self‐injurious behaviour Psychopathological and nosological characteristics in subtypes of self‐injurers
Authors: Herpertz S.
Published: August 2007

This study explored the symptoms of self‐injurious behaviour (SIB) in a consecutive sample of 54 mostly female psychiatric inpatients. The phenomenological analysis presented SIB as quite a uniform syndrome the starts latest in early adulthood, is often committed impulsively, is used in the function of releasing tension and occurs in patients with eating sand psychoactive substance use but also schizophrenic disorders. The quality of mood preceding SIB was best characterized as dysphoria and was qualitively not different from patients' longstanding affective traits. Two subgroups were differentiated, those with borderline personality disorder and those without; there was some evidence that patients with borderline personality disorder present a quite homogeneous core group of SIB, whereas others show a higher variety of psychopathological features. The hypothesis is proposed that poor affect regulation is the underlying psycopathological dimension.
Schizophrenics with small P300: a subgroup with a neurodevelopmental disturbance and a high risk for tardive dyskinesia?
Authors: Hegerl U. , Juckel G. , Müller‐Schubert A. , Pietzcker A. , Gaebel W.
Published: August 2007

Schizophrenics with a neurodevelopmental disturbance resulting in micro‐and macroanatomical cortical abnormalities are supposed to form a subgroup clinically characterized by low premorbid adjustment, early onset, incomplete remission, poor outcome, male predominance and high risk for tardive dyskinesia. A small amplitude of the event‐related P3 (P300) potential could be a marker of this subgroup, because the cortical neurons and their orderly laminar arrangement are crucial for the electrogenesis of P3. In a 2‐year follow‐up study, auditory evoked P3 was recorded in 89 stabilized schizophrenic outpatients. Patients who developed tardive dyskinesia during the follow‐up had smaller P3 than matched controls. Furthermore, a small P3 was associated with low premorbid adjustment, pronounced residual symptoms, low relapse rate, and male predominance. These findings indicate that schizophrenic patients with a reduced P3 have a higher risk of developing tardive dyskinesia and correspond clinically to a schizophrenic subgroup with a supposedly neurodevelopmental disturbance.
Season of birth: comparison of patients with schizophrenia, affective disorders and alcoholism
Authors: Modestin J. , Ammann R. , Würmle O.
Published: August 2007

The distribution of patients suffering from schizophrenia, affective disorders and alcoholism by months of their birth was studied, all patients having been reliably diagnosed using Research Diagnostic Criteria. Significant differences were found between the three groups. The winter‐spring birth rate excess in schizophrenia was confirmed, a spring‐summer birth rate excess in alcoholics was demonstrated. Different distributions are due to different reasons: for schizophrenic patients the harmful effects hypothesis and for alcoholics the procreational hypothesis seem to be appropriate explanations.
Psychosocial functioning of transsexuals in Belgium
Authors: De Cuypere G. , Jannes C. , Rubens R.
Published: August 2007

Male‐to‐female (M‐F) transsexuals differ consistently from female‐to‐male (F‐M) transsexuals in their sociodemographic characteristics, cross‐gender and sexual history and the degree to which personality disorder is concomitant to their transsexuality. As a group, female‐to‐male transsexuals are more homogeneous. Both groups are impaired in their mental functioning, but the male‐to‐female population is more mentally disordered. In a comparison between Dutch transsexuals and their Belgian counterparts, the latter were shown to have more mental problems.
Religious psychotherapy as management of bereavement
Authors: Azhar M. Z. , Varma S. L.
Published: August 2007

This study was aimed at determining the effect of psychotherapy in patients in bereavement. Fifteen patients in a control group were given brief psychotherapy and 15 study group patients received psychotherapy with a religious perspective. The patients in the study group showed consistently significant improvements as compared with the control group at the end of 6 months. The results indicate that highly religious patients with grief and bereavement tend to improve faster when a religious psychotherapy is added to a cognitive‐behaviour approach.
Light treatment in seasonal and nonseasonal depression
Authors: Thalén B.‐E. , Kjellman B.F. , Mørkrid L. , Wibom R. , Wetterberg L.
Published: August 2007

Ninety patients with major depressive disorder were classified according to seasonal (n= 68, 50 women) or nonseasonal (n= 22, 17 women) pattern according to DSM‐III‐R. They were also clinically evaluated and rated before and after morning (0600–0800. or evening (1800–2000. light treatment for 10 days in a room with a luminance of 350 cd/m2 (∼ 1500 lx) at eye level. Mood ratings were performed using both the Comprehensive Psychopathological Rating Scale and the Hamilton Depression Rating Scale. Depressed patients with seasonal pattern improved significantly more than those with a nonseasonal pattern suggesting a specific nonplacebo effect of light treatment in depressed patients with seasonal pattern. There were no significant differences in outcome when light treatment was given in the morning or in the evening, and not between patients with and without atypical symptoms such as carbohydrate craving or increased appetite.
Affective and neurotic disorders in community‐based services: a comparative study in south Verona and south Manchester
Authors: Amaddeo F. , Gater R. , Goldberg D. , Tansella M.
Published: August 2007

The service utilization by patients with affective and neurotic disorders in two defined populations of south Verona in Italy and south Manchester in England was compared. The composition and function of the two community‐based psychiatric services, and the sociodemographic characteristics of the two centers are described and related to epidemiologically based data on service use in the community, outpatient clinic, day hospital and inpatient care. The results suggest that close liaison with primary care in south Manchester results in more referrals, and therefore higher treated incidence and prevalence rates. The close integration between hospital and community staff in south Verona is associated with greater permeability of the filter between inpatient and community care, indicated by higher admission rates for patients known to the service, and shorter length of inpatient stay (only for affective disorders) in south Verona compared with south Manchester.
The Chernobyl accident and mental wellbeing — a population study
Authors: Viinamäki H. , Kumpusalo E. , Myllykangas M. , Salomaa S. , Kumpusalo L. , Kolmakov S. , Ilchenko I. , Zhukowsky G. , Nissinen A.
Published: August 2007

We studied the long‐term effects of the 1986 Chernobyl nuclear power plant accident on mental wellbeing 7 years after the event. Mental wellbeing was assessed using a 12‐item General Health Questionnaire (GHQ). The study group comprised 325 persons (aged 15–54 years) who had continued to live in the high‐fallout area in Bryansk, Russian Federation, classified as a strict control zone with respect to the level of fallout and subsequent radiation protection countermeasures. The control group comprised 278 persons living in a noncontaminated area. The mental wellbeing of women in the study group was poorer than in controls (age‐adjusted means). Based on the GHQ score, a minor mental disorder was detected in 48% of the women in the study group and 34% of the female controls. The corresponding figures for men were 26% and 28%, respectively. Those living with a partner coped better mentally than the others. The level of education was not associated with the GHQ score. Poor financial situation and self‐rated poor health were associated with a high GHQ score. Fifty‐nine per cent of the study group and 14% of the control group wanted to move away from the area of residence, but it was not associated with GHQ score. In a logistic regression analysis, independent factors explaining the GHQ score in the study group were uncertainty about the future in the men and, in addition, poor financial situation and insufficient social support in the women. According to the results, the Chernobyl nuclear power plant accident impaired the long‐term mental wellbeing of women living in the contaminated area.
The role of cognition in the risk‐benefit and safety analysis of antipsychotic medication
Authors: Borison R.L.
Published: August 2007

Conventional neuroleptics can further reduce cognitive function, which is already impaired in most patients with schizophrenia. Although some areas of cognition may remain relatively well preserved in schizophrenia, it has been suggested that the origins of a neurocognitive decline in schizophrenia may be related to a reduction in dopamine activity in the prefrontal cortex. If this is the case, dopamine D2 blockade would be expected to impair some aspects of neurocognitive function further. The level of neurocognitive function in schizophrenia is related to vocational and social ability, and the course of cognitive decline appears to be consistent with a static encephalopathy, rather than progressive dementia. Intensive cognitive retraining in patients with schizophrenia may improve, but not normalize, some aspects of cognitive performance. Most cognitive deficits remain stable, even when improvements in symptoms are obtained with antipsychotic treatment. Drugs such as risperidone, one of the newer serotonin‐dopamine antagonists (SDAs), have a better effect on cognitive function than conventional antidopaminergic neuroleptics, and are therefore more likely to enable the patient to benefit from cognitive and other forms of training. Anticholinergic drugs used to treat EPS, or drugs with anticholinergic activity, also impair cognitive function. Consequently, because the need to use anticholinergic drugs is less with the SDA antipsychotics, the cognitive function of patients treated with drugs such as risperidone is likely to be better than it would be if they took a conventional neuroleptic.
Spontaneous and drug‐induced movement disorders in schizophrenia
Authors: Kopala L. C.
Published: August 2007

The extrapyramidal side‐effects (EPS) of conventional neuroleptics are widely recognized. However, a substantial number of drug‐naïve patients exhibit movement disorders which could be mistaken for EPS if drug therapy were started without a careful baseline assessment. Patients' experience of EPS during their first exposure to antipsychotic medication can have lasting effects on their attitudes to medication and compliance. Unmedicated, approximately 60% of patients will relapse in the first year after resolution of an acute psychotic episode, whereas prophylactic medication can reduce the relapse rate to less than 20%. The conventional neuroleptics produce antipsychotic effects at doses which differ little from those that induce EPS, and although anticholinergic medication helps to reduce the severity of EPS, it also causes side‐effects, e.g. constipation, blurred vision, retention of urine, dry mouth and disturbances of sexual function. More importantly, anticholinergic drugs may worsen the psychosis and impair memory. Low or intermittent dose strategies with conventional neuroleptics may give patients relief from EPS, but they increase the relapse risk, and may also increase the risk of tardive dyskinesia. The serotonin‐dopamine antagonist (SDA) antipsychotics, such as risperidone, produce both significant antipsychotic effects at doses which are lower than those that cause EPS, and also a lower level of EPS compared with conventional drugs. Clinical trials have shown that risperidone is effective in first‐episode schizophrenia. In these trials the same doses were used as in chronic patients. However, clinical experience in Canada since the drug became generally available in 1993 suggests that first‐episode patients require lower doses of risperidone than chronically ill patients who have had several acute psychotic episodes. More than 3 years of use has made it clear that risperidone should be seriously considered in first‐episode patients, as it offers an opportunity to treat psychosis with minimal EPS. This in turn should lead to better compliance and a lower long‐term relapse rate.
Psychosocial impact of bereavement after suicide and fatal traffic accident: a comparative two‐country study
Authors: Cleiren M. P. H. D. , Grad O. , Zavasnik A. , Diekstra R. F. W.
Published: August 2007

This study examines the psychosocial problems of spouses bereaved as a consequence of unnatural causes of death (suicide and traffic fatality) in two countries, Slovenia (n= 53) and The Netherlands (n= 32). Structured interviews consisted of standardized measures for depression, substance use, social reactions, and acceptance and attribution of the loss. Although marked differences in sociodemographic background exist, bereaved subjects from both countries show more similarities than differences. Depressed symptomatology is slightly higher in the Slovene bereaved, but symptom patterns are almost identical. Core indicators of clinical depression, as well as reported substance use, are equally low in both countries, and gender and mode of death do not differ significantly. Social acceptance is more problematic in suicide bereaved, particularly in Slovenia. Methodological considerations of cross‐cultural bereavement studies are discussed.
The risk for psychiatric illness in siblings of schizophrenics: the impact of psychotic and non‐psychotic affective illness and alcoholism in parents
Authors: Kendler K. S. , Karkowski‐Shuman L. , Walsh D.
Published: August 2007

Clarification of the nature of the liability to schizophrenia transmitted within families is a major goal of family studies. In the Roscommon Family Study, the risk in relatives of schizophrenic vs. control probands was significantly increased for psychotic affective illness (PAI), but not for non‐psychotic affective illness (NPAI) or alcoholism (ALC). We attempt to confirm these findings independently by examining, within families of schizophrenia spectrum probands, the relationship between PAI, NPAI and ALC in parents and the risk for schizophrenia spectrum disorders in siblings. A parental diagnosis of PA1 predicted a significantly increased risk for schizophrenia, affective illness and anxiety disorders in siblings. In particular, schizophrenia in siblings was predicted by a parental diagnosis of mood‐incongruent PAI. By contrast, neither a parental diagnosis of NPAI nor a parental diagnosis of ALC was associated with an increased risk for schizophrenia spectrum disorders in siblings. Consistent with our earlier findings, these results suggest that (a) the familial liability to schizophrenia is neither extremely nonspecific nor extremely specific and (b) PAI, and particularly mood‐incongruent PAI, may occur particularly in parents of schizophrenics because, although it reflects a significant familial liability to schizophrenia, it does not markedly impair the ability to marry and reproduce.
General practitioners’ views of an open referral system to a community menial health service
Authors: Puri B. K. , Hall A. D. , Reefat R. , Mayer R. , Tyrer P.
Published: August 2007

The satisfaction of general practitioners with a community mental health service operating an open referral system was compared to that with two services both operating a closed referral system covering the same inner‐city district. The open referral system allows any agency (including patients) to contact the service by letter or by telephone, and priority is given to patients with serious mental illness. General practitioners’ satisfaction with all aspects of the open referral system was greater than that with either of the closed referral systems. In particular, speed of assessment of referrals was preferred in the open referral system.
Belief in supernatural causes of mental illness among Malay patients: impact on treatment
Authors: Razali S. M. , Khan U. A. , Hasanah C. I.
Published: August 2007

The concept of aetiology of mental illness in 134 Malay patients was investigated by means of a 20‐item checklist. About 53% of the patients attributed their illnesses to supernatural agents. Witchcraft and possession by evil spirits were regarded as common causes of illness. The number of patients who believed in supernatural causes of their mental illness was significantly higher among those who had consulted bomohs (Malay traditional healers) than among those who had not consulted them. The belief that mental illness is caused by supernatural agents is firmly held by bomohs, who reinforce this notion in those who seek their advice. Belief in supernatural causes of mental illness was not significantly associated with age, gender, level of education or occupation of the patients. Patients who believed in supernatural causes of mental illness were also found to show poor drug compliance, and the number of such patients at 6 months follow‐up was significantly lower than the corresponding figure for those who did not believe in supernatural causes. The importance of understanding the patients’ cultural background when treating psychiatric patients is highlighted.
Relapse prevention by means of paroxetine in ECT‐treated patients with major depression: a comparison with imipramine and placebo in medium‐term continuation therapy
Authors: Lauritzen L. , Odgaard K. , Clemmesen L. , Lunde M. , Öhrström J. , Black C. , Bech P.
Published: August 2007

In‐patients with severe major depression were treated in the acute phase with electroconvulsive therapy (ECT) in combination with antidepressants. The drug treatment consisted of two randomized trials which were both extended into the post‐ECT continuation phase. Patients with electrocardiological impairment were randomized to either 30 mg paroxetine daily or placebo under blind conditions. Patients without electrocardiological impairment were randomized to either 30 mg paroxetine daily or 150 mg imipramine daily. There was a high level of agreement between the Hamilton Depression Scale and the Melancholia Scale, demonstrating that the patients treated with ECT plus imipramine in the acute phase showed greater symptom reduction than those treated with ECT plus paroxetine. However, in the post‐ECT phase paroxetine was superior to both imipramine and placebo in preventing relapse. Thus in the post‐ECT phase 65% of the placebo‐treated patients relapsed, compared to 30% of the imipramine‐treated patients and 10% of the paroxetine‐treated patients. The psychometric analysis of the Melancholia Scale in the continuation or post‐ECT phase showed that relapsing patients displayed a pattern with lack of interests, impaired concentration, depressed mood and anxiety among the less severe symptoms (first‐compartment symptoms). In other words, these symptoms represent the gate to full‐blown depression (second‐compartment symptoms). Serotonin‐selective antidepressants such as paroxetine appear I to be more effective in controlling the first‐compartment symptoms.
Antecedent life events, social supports and response to antidepressants in depressed patients
Authors: Tomaszewska W. , Peselow E. D. , Barouche F. , Fieve R. R.
Published: August 2007

We evaluated 355 subjects who entered one of six double‐blind placebo‐controlled antidepressant drug trials with respect to the occurrence of antecedent adverse life events and their meaning to the patient. Patients were also assessed with regard to the degree of social support they received for the negative life event. The groups differed as to whether they did or did not meet the criteria for melancholic depression; 43 one‐week placebo responders were statistically significantly more likely to believe that adverse life events predisposed them to depressive illness and that such life events precipitated their current depression, compared to 312 one‐week placebo non‐responders. Of the 312 patients who went on to the double‐blind phase in which they were treated with either drug (n= 204) or placebo (n= 108), it was noted that, for both melancholic and non‐melancholic patients, responders to drug treatment (but not placebo) had a more favourable ratio of social support received/social support desired than non‐responders. Non. melancholic responders to both drug and placebo were statistically significantly more likely to report fewer adverse life events and have a less strong belief that adverse life events predispose one to depressive illness than non‐responders. Melancholic patients did not show this trend.
Correlates of life satisfaction among psychiatric patients
Authors: Koivumaa‐Honkanen H‐T. , Viinamäki H. , Honkanen R. , Tanskanen A. , Antikainen R. , Niskanen L. , Jääskeläinen J. , Lehtonen J.
Published: August 2007

The aim of this study was to examine the sociodemographic and clinical variables associated with life satisfaction in psychiatric patients. The study population consisted of out‐patients and in‐patients (n= 1204) treated at the Department of Psychiatry of Kuopio University Hospital in North Savo, Finland, during May 1993. Sociodemographic, psychosocial and clinical correlates of life satisfaction were examined by means of two different questionnaires, one directed at patients and the other directed at the staff. Life satisfaction was assessed by means of a separate scale based on four questions. Patients with schizophrenia were less dissatisfied than patients with other disorders. The strongest correlates of dissatisfaction were depression and poor social support. Other factors relating to dissatisfaction in multiple regression analysis were self‐rated health and poor financial circumstances. A psychosomatic reaction tendency or degree of psychosocial functioning at the time of the study was not independently related to life satisfaction. Psychiatric patients who are dissatisfied should be evaluated both for depression and for effectiveness of their social network.
The content and characteristics of auditory hallucinations in Saudi Arabia and the UK: a cross‐cultural comparison
Authors: Kent G. , Wahass S.
Published: August 2007

This study investigated the content and characteristics of auditory hallucinations reported by 75 patients in Saudi Arabia (SA) and the UK. Each patient was asked to report on the content and characteristics of their hallucinations with regard to several dimensions, including loudness, frequency, clarity and perceived validity. In general, the characteristics of the voices did not vary between the SA and UK patients, but the content differed between cultures. Much of the content of the hallucinations of SA patients was religious and superstitious in nature, whereas instructional themes and running commentary were common in the UK patients. The results suggest that cultural differences need to be taken into account when applying psychological methods to this group of patients.
Elevated tryptophan levels in post‐withdrawal alcoholics
Authors: Farren C. K. , Dinan T. G.
Published: August 2007

Changes in serotonin function and disturbances in tryptophan availability have been implicated in many psychiatric disorders, including alcoholism. In the present study we took serum free tryptophan samples from 31 healthy volunteer controls and from 42 DSM‐III‐R alcohol‐dependent subjects who had abstained from alcohol for at least 2.5 weeks (range 2.5‐104 weeks). We also measured the basal serum Cortisol level at 09.00 hours for the same subjects and controls. There was a significant increase in the serum tryptophan level of the alcoholic subjects, by 43.7 μmol l‐1 (range 29‐63 μmol l‐1), regardless of age of onset of alcoholism, family history of alcoholism or sociopathic traits, compared to the controls (33.0 μmol l‐1, range 19‐60 μmol l‐1). There was also an increase in the basal serum Cortisol level in the alcoholic subjects compared to the controls, but this was not related to the increase in tryptophan levels. These findings indicate a disturbance in serotonin precursor availability in post‐withdrawal alcoholics, and contribute to the evidence for involvement of the serotonin system in alcoholism.
Anhedonia, depression and the deficit syndrome of schizophrenia
Authors: Loas G. , Noisette C. , Legrand A. , Boyer P.
Published: August 2007

A total of 29 deficit schizophrenics were compared with 121 non‐deficit schizophrenics using the Physical Anhedonia Scale (PAS) and the abridged form of the Beck Depression Inventory (BDI). The results show that the deficit schizophrenics had a higher score on the PAS and a lower score on the BDI than the non‐deficit schizophrenics.
Oestradiol treatment helped a depressed postmenopausal woman to stop her psychotropic medication: a case report
Authors: Korhonen S. , Saarijärvi S.
Published: August 2007

We report the case of a postmenopausal woman who had severe depression with psychotic features. She was treated over a period of 10 years with heavy psychotropic medication. Hormone replacement therapy alone replaced the medication and had an even better effect on her affective symptoms. Increasing serum oestradiol levels were correlated with improvement in mood.
Successful treatment of citalopram‐induced anorgasmia by cyproheptadine
Authors: Lauerma H.
Published: August 2007

Lauerma H. Successful treatment of citalopram‐induced anorgasmia by cyproheptadine. Acta Psychiatr Scand 1996: 93: 69–70. © Munksgaard 1996.

This is the first report of the use of cyproheptadine to treat anorgasmia induced by citalopram, a highly selective serotonine reuptake inhibitor (SSRI). Total anorgasmia of a 47 year‐old man who suffered from severe unipolar major depression was successfully treated without adverse effects. This case strengthens the impression that anorgasmia associated with SSRIs is related primarily to the serotonine reuptake inhibition and not to various receptor bindings of different compounds.
Alexithymia in suicide attempters
Authors: Taiminen T. J. , Saarijärvi S. , Helenius H. , Keskinen A. , Korpilahti T.
Published: August 2007

Taiminen TJ, Saarijärvi S, Helenius H, Keskinen A, Korpilahti T. Alexithymia in suicide attempters. Acta Psychiatr Scand 1996: 93: 195–198. © Munksgaard 1996.

Alexithymia seems to share some common features with psychological constriction, a phenomenon described in suicidal individuals. Fifty suicide attempters were interviewed within 24 h after arrival at a hospital, and measures of lethality of the attempt, suicidal intent, depression and alexithymia were carried out with structured instruments. Almost all the attempters were depressive, and about half of them were also alexithymic. However, alexithymia was not more prevalent in this population than in non‐suicidal depressive patients. Depression and alexithymia correlated significantly with each other, but there was no correlation between alexithymia and lethality of the suicide attempt or suicidal intent. The authors conclude that alexithymia in suicide attempters seems to be associated with depression, but not with suicidality per se. Therefore, measurement of alexithymia may not yield extra information in suicide risk assessment.
Ketoacidosis as a side‐effect of clozapine: a case report
Authors: Kostakolu A. E. , Yazici K. M. , Erbas T. , Güvener N.
Published: August 2007

Kostakolu AE, Yazici KM, Erbas T, Güvener N. Ketoacidosis as a side‐effect of clozapine: a case report. Acta Psychiatr Scand 1996: 93: 217–218. © Munksgaard 1996.

We report the case of a patient fulfilling DSM‐IV criteria for schizophrenia and treated with clozapine who later developed hyperglycemia and ketoacidosis.
Circadian rhythm of parasuicide in relation to violence if method and concomitant mental disorder
Authors: Caracciolo S. , Manfredini R. , Gallerani M. , Tugnoli S.
Published: August 2007

Caracciolo S, Manfredini R, Gallerani M, Tugnoli S. Circadian rhythm of parasuicide in relation to violence of method and concomitant mental disorder.

Scand 1996: 93: 352–256. © Munksgaard 1996.

Circadian occurrence of parasuicide was evaluated in relation to sex, violence of parasuicide method and psychiatric diagnosis. In all, 457 consecutive episodes of parasuicide were recruited during a 5‐year period. Complete data for time of parasuicide, parasuicide method, parasuicide recurrency and psychiatric diagnosis (ICD‐9) were available for 304 subjects. Parasuicide methods were classified into two groups depending on the violence of the method. Parasuicide occurred significantly more often in the afternoon and evening hours for both men and women, for both violent and non‐violent methods, both in first‐event cases and repeaters, and in the following diagnostic groups: organic mental and psychoactive substance disorders, neurotic disorders and personality disorders. The data support the hypothesis of a circadian rhythmicity of parasuicide, showing an area of chronobiological risk in the afternoon and early evening hours.
Charles Bonnet syndrome in leprosy; prevalence and clinical characteristics
Authors: Adachi N.
Published: August 2007

Adachi N. Charles Bonnet syndrome in leprosy: prevalence and clinical characteristics.

Scand 1996: 93: 279–281. © Munksgaard 1996.

Charles Bonnet syndrome (CBS) is diagnosed when a visually impaired patient without any mental disorder develops visual hallucinations. A survey of patients in a National Leprosarium revealed that the point prevalence of CBS in leprosy was 0.4%. This prevalence appears to be high, as few cases with CBS have been reported. The semeiology of visual hallucinations was typical of CBS. However, the clinical features were different from previous reported cases because of the history of leprosy and associated multi‐sensory loss. Patients with leprosy appear to be at increased risk for CBS, due to frequent eye complications combined with sensory loss, ageing, and intact intellectual functions.
An epidemiological study of eating disorders in a northern area of Japan
Authors: Nadaoka T. , Oiji A. , Takahashi S. , Morioka Y. , Kashiwakura M. , Totsuka S.
Published: August 2007

Nadaoka T, Oiji A, Takahashi S, Morioka Y, Kashiwakura M, Totsuka S. An epidemiological study of eating disorders in a northern area of Japan.

Scand 1996: 93: 305–310. © Munksgaard 1996.

A total of 97 patients with eating disorders who visited the Department of Neuro‐Psychiatry, Yamagata University Hospital, between 1978 and 1992 were studied. According to the diagnostic criteria of DSM‐III‐R, there were 48 cases of anorexia nervosa (AN), 38 cases of bulimia nervosa (BN) and 11 cases with both AN and BN. Both the number of patients and the ratio to all out‐patients in each year increased four times during the period 1988–1992 compared to the previous period. With regard to their places of residence, the number of patients with AN and with BN from every district appeared to increase at almost the same rate, although the majority of the patients were from medium‐sized cities. These findings may indicate that eating disorders are influenced by urbanization.
Electrocardiographic changes in patients receiving neuroleptic medication
Authors: Warner J. P. , Barnes T. R. E. , Henry J. A.
Published: August 2007

Warner JP, Barnes TRE, Henry JA. Electrocardiographic changes in patients receiving neuroleptic medication.

Acta Psychiatr Scand 1996: 93: 311–313. © Munksgaard 1996.

The precise aetiology of sudden death in patients receiving neuroleptic medication is uncertain, but cardiac arrhythmias are a possible cause. We investigated the link between neuroleptic medication and electrocardiographic changes predictive of malignant cardiac arrhythmias. Electrocardiographs were performed on 111 patients receiving neuroleptic medication and on 42 unmedicated controls. Prolonged QTc intervals were more common in the patient sample, but QTc dispersion was not significantly increased. QTc interval prolongation was more likely in patients on doses above 2000 mg chlorpromazine equivalents daily (odds ratio 4.28, P<0.02). Neuroleptic medication, especially at high doses, is associated with ECG changes that may herald more serious cardiac problems.