bluuebunny/crossref_metadata_2025 huggingface dataset:
Biology of Sexuality Inborn Determinants of Human Sexual Response
Authors: Goodman Raymond E.
Published: August 2008

Opinions vary on the relative importance of biological and learning processes in the aetiology of sexual expression and deviance. The structure of personality, consistency of fantasy patterns, and the familial nature of homosexuality hint at a biological an/age. Research with the HY-antigen complex and X chromosome, and the elucidation of the interactions of intrauterine testosterone and its products with the foetal brain and neurotransmitters, have given us new models to understand the programming of sexuality. However, gonadotrophin feedback is not relevant as an indicator of brain feminization in primates and man. Finally, the interaction of masculinization and defeminization provides us with a model for understanding homosexual behaviour.
Identical Triplets with Infantile Autism and the Fragile-X Syndrome
Authors: Gillberg Christopher
Published: August 2008

In a continuing twin study of autism in Scandinavia and Finland, moderately mentally retarded triplets fulfilling Rutter's criteria for infantile autism were reported. Judging by physical appearance the triplets were identical. Behaviourally they were extremely similar though one was intellectually slightly better than the other two. All three showed the physical stigmata characteristic of the fragile–X syndrome, in spite of their overall appearance being non-conspicuous. The triplets had between 8 and 12 per cent of fragile–X positive cells and showed a distinct pattern of urinary excretion of substances yielding absorbency at 280 nM. Their mother and sister also had a high count of fragile–X positive cells.
Severe Depression: A Patient's Thoughts
Authors: Gray E. George
Published: August 2008

A research neuroscientist in his fifties, who has recovered from endogenous depression after several years, describes the experience and makes some comments on treatment and management. He found electroconvulsive therapy, mianserin, lithium carbonate and diazepam acceptable. He considers that occupational therapy and conventional psychotherapy were counter-therapeutic. He stresses how physically ill he felt when depressed, and compares this with prolonged influenza. He hypothesises that the underlying psychological disorder in endogenous depression is the learned extinction of optimistic thoughts, and suggests that any psychotherapy used should be aimed at restoring these.
‘Wind Illness' or Somatic Depression?
Authors: Eisenbruch Maurice
Published: August 2008

A 46-year-old mother with a history of chronic headaches and other symptoms, and a clinical diagnosis (in Western terms) of depression, ascribed her condition to non-observance of Chinese postpartum ritual. The characteristic features of ‘wind illness' are described. Western medicine proved useless but acupuncture was beneficial. The case underlines the importance of understanding the patient's own view of his/her illness and its causes in arriving at a correct diagnosis and intervening effectively: this is particularly true when the gap between the doctor's and the patient's cultures is wide. The value of the distinction between thedisease(the pathological process, which may be universal) and an episode ofillness(the personal and cultural construction of disease) is emphasized.
A Comparison of Subliminal, Supraliminal and Faded Phobic Cine-Films in the Treatment of Agoraphobia
Authors: Lee Ian , Tyrer Peter , Horn Sandra
Published: August 2008

Thirty-two agoraphobic patients were randomly allocated to four groups and treated by repeated exposure to cine-films at twice weekly intervals for three weeks. Three of the groups saw the same cine-film, comprising a range of agoraphobic scenes, and a control group saw a potter working on his wheel. The three groups seeing the phobic cine-film included one who viewed it at an illumination level below the visual threshold (subliminal group), one seeing it under normal conditions (supraliminal group) and one which underwent graduated exposure from subliminal to supraliminal viewing levels as the study proceeded (faded group). The faded group showed significantly greater improvement than the control and supraliminal groups and this improvement was maintained over twelve weeks.
A Survey of the Criminal Careers of Hospital Order Patients
Authors: Gibbens T. C. N. , Robertson G.
Published: August 2008

All men receiving hospital orders (Section 60) in the UK in the year 1963–64 (excluding those receiving restriction orders (Section 60/65)) were followed up over 15 years with regard to (1) subsequent offences and convictions, (2) hospital admissions, and (3) death. Nine per cent of the patients involved could not be traced. Sixteen per cent had died by 1978, a quarter of them by suicide.

Of the mentally ill only 4 per cent subsequently committed serious offences (manslaughter, wounding, GBH, robbery, rape or arson), although a further 4 per cent committed assaults repeatedly. Sex crimes were uncommon. Among the mentally subnormal, 7 per cent committed serious sex crimes subsequent to committal. A further 9 per cent were considered to be persistent sex offenders and another 9 per cent were judged to be persistently violent. In general the mentally subnormal were much younger and were detained for much longer than the mentally ill. Since 1964 the use of hospital orders for the detention of such people has become much less frequent.

The best predictor of subsequent offences was found by multiple regression analysis to be the number of previous offences: this was especially true for acquisitive offences committed by the young. The mentally ill were less often reconvicted than the mentally subnormal.
A Psychotherapist Looks at Depression
Authors: Storr Anthony
Published: August 2008

1. Depression is not an illness, but a psychobiological reaction which can be provoked in anyone.

2. It is much more easily provoked in some people than in others.

3. Vulnerability to depression is partly dependent upon social factors, as George Brown has demon strated. It is also determined by internal factors in the personality.

4. There is increasing evidence to show that the child's attachment to his mother is an important determinant of future mental health.

5. It will be argued that children who make ‘anxious attachments’ to the mother, as described by Bowlby, are less likely to incorporate her as a ‘good object’ within the psyche, and that this renders them more vulnerable to later depression than children who form ‘secuartetachments.’

6. Many features of depression in adults resemble or are related to ‘anxiouatstachments.’

7. The way in which psychotherapy can alleviate vulnerability to depression is described in terms of this hypothesis.

8. Reference is also made to the fact that effective action can be a source of self-esteem as well as love. Many of the great creators were partially effective in dealing with vulnerability to depression by work.

9. Freud affirmed that mental health depended upon the capacity to love and the capacity to work. It will be argued that the former capacity has been over-emphasized at the expense of the latter.
Standardized Assessment of Depressive Disorders (Sadd) in Ghana
Authors: Majodina M. Z. , Johnson F. Y. Attah
Published: August 2008

A study on the Standardized Assessment of Depressive Disorders (SADD) in collaboration with WHO Headquarters, Geneva, is reported in this paper. The instruments used for the study were screening forms and the SADD schedule, both of which were supplied by WHO. Fifty depressed patients were selected from the outpatients and inpatients of the Accra psychiatric hospital by experienced specialist psychiatrists using the screening forms. The two investigators then carried out a clinical assessment on each selected patient using the SADD schedule. The data collected were subjected to computer analysis. Findings were similar to those from previous WHO/SADD studies in different cultures. Specifically, the investigators found a “core” of depressive symptomatology among African patients in Ghana. An interesting finding was the change in the presentation of depression in African patients over the past 30 years. Broad diagnostic groupings like endogenous depression and psychogenic depression could easily be applied to the study patients. There is a great need for more SADD studies in Africa.
A Psychiatric Emergency Clinic: A Study of Attendances Over Six Months
Authors: Lim Meng Hooi
Published: August 2008

Two thousand three hundred and ninety consecutive visits to a walk-in psychiatric emergency service were studied to examine issues relevant to service provision. Only a third of patients were from the catchment area. Psychotic patients and those admitted or kept overnight (guests) were more frequent after hours and among non-medical referrals, especially family and police referrals; but suicidal patients often came from other hospitals. At index visit a third of patients were offered follow-up, but attendance was poor. Factors influencing attendance were examined. Keeping overnight avoided unnecessary admissions. There was little evidence that patients abused the service.

The findings suggest that a psychiatric emergency service should be available to all referrals 24 hours a day.
Prevalence of Self-Reported Depressive Symptoms and Associated Social Factors in Mothers in Dunedin
Authors: McGee Rob , Williams Sheila , Kashani Javad H. , Silva Phil A.
Published: August 2008

A large sample of women (n = 899) from Dunedin, New Zealand, completed a self-report questionnaire on depressive symptoms. On this basis, about 8 per cent of the sample were identified as having major depressive disorder. These women tended to have a history of previously reported psychological symptoms and formal treatment for depression. A significantly high proportion of the depressed group had been young at first pregnancy and had since been separated from their partners. The depressed women also reported more behaviour problems in their children, but these reports were not confirmed by teachers' reports or by the children's self-reports, suggesting a response bias in depressed women towards reporting problems.
Activity/Disengagement Revisited: Personality Types in the Aged
Authors: Gaber Lee Bennett
Published: August 2008

Different patterns of personality in old age were examined in an aged community sample of 82 subjects (mean age 79.6 years). Four personality patterns in old age were identified using multivariate techniques. They were the normal, the introverted, the perturbed and the matured integrated. The clinical implications of personality types in old age are discussed; the perturbed group are most likely to develop psychiatric disorder.
A Survey of Training in Child and Adolescent Psychiatry
Authors: Garralda M. E. , Wieselberg M. , Mrazek D. A.
Published: August 2008

In a survey of training in child psychiatry in Great Britain, all senior registrars were sent questionnaires; the response rate was 69 per cent. We describe background factors of the trainees, details of the clinical and academic experience available to them, and their attitudes towards their training.

Most trainees had had extensive previous experience in adult psychiatry and the predominant orientation was psychoanalytic. In general, they approved of the guidelines for training issued by the Joint Committee for Higher Psychiatric Training. Family therapy was the most popular treatment method. We comment on their training experience where the interest expressed was not matched by adequate availability of the training facilities.
Psychiatric Illness in Medical Students
Authors: Salmons Paula H.
Published: August 2008

Over a 25 year period, 2.4 per cent of Birmingham medical students developed psychiatric disorder which was severe enough to cause loss of time from the course; 1 per cent of the total required hospital admission. One-third of the psychiatrically ill students did not graduate, but those who did were as likely as graduates who had not been ill to remain on the Medical Register.
The Experimental Treatment of Two Cases of Auditory Hallucinations
Authors: James David A. E.
Published: August 2008

Two cases are described where auditory hallucinations persisted, in spite of medication, in two schizophrenic patients, one with acute onset and one with a severe chronic illness. The hallucinations were treated successfully by methods derived from Green's theory that auditory hallucinations are represented in the non-dominant hemisphere.
Cancer and the Mind
Authors: Greer Steven
Published: August 2008

1848, as every student of history knows, was a revolutionary year in Europe. During that year, a minor, long forgotten revolution occurred in London medical circles when a physician, John Elliotson, published a paper entitled ‘Cure of a true cancer of the female breast with mesmerism’ (Elliotson, 1848). It is, as far as I can ascertain, the first recorded case of its kind. The author hypnotized his patient, a 42-year-old single woman, for “5 years and upwards … and for the greater part of the period three times a day”; during that time, Elliotson observed a ‘cancerous tumour’ in her right breast shrink away completely. No less than seven physicians and surgeons independently attested to the diagnosis of breast cancer, but no pathological examination was carried out. Elliotson was roundly abused, not for using hypnosis to treat cancer, but for using hypnosis at all—a practice condemned by certain physicians of fervid imagination as “indecent, disgraceful … liable to excite lascivious passions … an infernal system … the workings of Satan” (Elliotson, 1848).
Relationship of Headaches to Depression
Authors: Garvey Michael J. , Schaffer Charles B. , Tuason V. B.
Published: August 2008

One hundred and sixteen patients with major depressive disorder were asked for details of headaches during a depressive episode and during a nondepressed period. They experienced a headache rate similar to controls during the nondepressed period, but had an increased headache rate during depression (P <.02). Patients with an increase in depressive headaches were younger, had more somatic complaints, and experienced more hypersomnia than other depressives.
Bipolar Illness: Correlates of Dangerous Inpatient Behaviour
Authors: Yesavage Jerome A.
Published: August 2008

Forty male patients with bipolar affective illness were examined for factors correlating with dangerous inpatient behaviour. It was found that 63 per cent of the variance for inpatient assaults could be accounted for by a combination of a history of severe childhood discipline, a manic state, the degree of psychosis and a record of violence prior to admission. Such information may be of use in the clinical prediction of violent acts by bipolar patients, as well as suggesting ways of preventing them.
A Search for ‘Schizophrenia Spectrum Disorders’: An Application of a Multiple Threshold Model to Blind Family Study Data
Authors: Tsuang Ming T. , Bucher Kathleen D. , Fleming Jerome A.
Published: August 2008

Family data from schizophrenic and control probands were analyzed using a descriptive analysis and multiple threshold models to determine whether a given group of diagnoses made in accordance with ICD–9 was aetiologically related to schizophrenia. The proportion of relatives receiving any psychiatric diagnosis, other than schizophrenia and affective disorder, was essentially the same between the two study groups. Furthermore, the data did not fit the multiple threshold model tested. Thus, the hypothesis that schizophrenia and a spectrum of disorders defined according to ICD–9 have a common familial aetiology was not accepted.
Evaluation of a Planned Change on a Long-Stay Rehabilitation Ward
Authors: Guirguis Waguih R. , Rayner Rosemary , Hurley Michael
Published: August 2008

This is an attempt to evaluate the results of planned changes on a long-stay rehabilitation ward in a traditional mental hospital in England. The ward was housing a mixture of groups of patients of differing types and needs. The results of our study suggest that it is possible to improve patient care and staff morale on similar wards without extra staff, money or structural changes. Good planning, collaborative teamwork and dedication were the main tools.
Classification of Depression and Response to Antidepressive Therapies
Authors: Abou-Saleh M. T. , Coppen A.
Published: August 2008

Two hundred inpatients suffering from primary depressive illness were studied. Seventy eight of the patients were treated by electroconvulsive therapy (ECT) and 122 patients received antidepressant medication. Response to ECT and antidepressant medication at 4 weeks showed a curvilinear relationship to Newcastle scores. Patients with Newcastle scores in the middle range (4–8) showed significantly higher percentage improvement than those with low (0–3) and high (9–12) scores. Ninety five patients with unipolar depression who received lithium therapy for one year were also studied. Response to lithium showed a linear relationship to Newcastle scores in these patients. It is suggested that these differences in response to antidepressant therapies reflect the heterogeneity of depressive illness.
Psychiatric Morbidity in a Gynaecology Clinic
Authors: Byrne Patrick
Published: August 2008

Two hundred and eleven women between the ages of 18 and 65 years referred to a gynaecological out-patient clinic were screened for psychiatric disorder using the General Health Questionnaire (GHQ) and a Demographic Questionnaire. A random sub-sample of 35 women were interviewed using the Present State Examination (PSE) and the Brown and Harris Life Events and Difficulties Schedule (LEDS), and compared to a general population sample (N = 140) matched for life stage (LS) and social class. Forty six per cent of women in the clinic scored as cases on the GHQ. High scores were associated with being divorced, separated, or widowed, and with complaints of pelvic pain. PSE case rates were higher in the clinic sample than in the general population group (29 per cent and 17 per cent). Younger women (LS 1) and middle class women in the clinic sample had higher rates than in the general population. Only the middle class women in the clinic sample showed significantly higher rates for severely threatening life events and/or difficulties before onset of psychiatric disorder. The study supports the view that rates of psychiatric disorder are high among women referred to a gynaecology clinic and indicates the importance of associations with demographic factors and recent experience of life stress, especially marital difficulties.
Alcohol Dependence and Phobic Anxiety States II. a Retrospective Study
Authors: Stockwell Tim , Smail Penelope , Hodgson Ray , Canter Sandra
Published: August 2008

Twenty-four hospitalised problem drinkers who were currently suffering from a phobic anxiety state served as subjects for this study. Each was given a detailed retrospective interview concerned with the development over time of both their alcohol dependence and phobic problems. The test-retest and inter-rater reliabilities of the data collected were found to be high. In accordance with previous experimental work, periods of heavy drinking and dependence upon alcohol were associated with an exacerbation of agoraphobia and social phobias. Subsequent periods of abstinence were associated with substantial improvements in these phobic anxiety states. It is suggested that both learning and psychobiological processes underly these observed relationships and that the implications of this finding for treatment of both disorders should be explored.
Hopelessness, Depression and Suicidal Intent in Parasuicide
Authors: Dyer J. A. T. , Kreitman N.
Published: August 2008

Previous work on the inter-relationships among depression, hopelessness and suicidal intent in parasuicide is reviewed. Our own study of 120 hospital-referred parasuicides confirms previous findings that, while both depression and hopelessness correlate with the degree of suicidal intent as measured on a Suicide Intent Scale, the relationship between depression and suicidal intent is dependent on that between hopelessness and suicidal intent. Some practical and theoretical implications are discussed.
Stress Factors in Affective Diseases
Authors: Bidzińska Elisabeth J.
Published: August 2008

An investigation carried out on 97 patients with affective disorders and on 100 healthy control subjects, revealed that acute and chronic stress factors occurred more in the group of patients with affective disorders than among healthy control over a similar time period. The frequency of stressful life situations was the same before the first affective episode in patients with unipolar and bipolar illness. The possible participation of such factors in triggering the first phase of illness is discussed. Similar factors appeared in both types of affective disorders. Significantly more frequent among patients than in the control group were: marital and family conflicts, health problems, emotional and ambitional failures, lack of success and work overload.
Dexamethasone Suppression Test in Depressive Illness: Its Relation to Anxiety Symptoms
Authors: Saleem P. T.
Published: August 2008

Fifty-nine depressed inpatients who satisfied Feighner's criteria for depression were separated into two groups by the response of their plasma Cortisol (1600 hours) to a dose of 1 mg of dexamethasone given at 2100 hours. No statistically significant differences were found between suppressors and non-suppressors as regards severity of anxiety or depressive symptoms in the Leeds and the MADRS rating scales. No single item either in the Leeds or the MADRS scale was associated with a positive DST. The reason for this negative finding is discussed.
The Clinical Effectiveness of Electrostimulation vs Oral Methadone in Managing Opiate Withdrawal
Authors: Gossop Michael , Bradley Brendan , Connell Philip , Strang John
Published: August 2008

Summary A group of 24 opiate addicts admitted to an in-patient drug dependence unit received either electrostimulation or graduated oral methadone withdrawal. Addicts treated with electrostimulation showed high levels of withdrawal symptoms during the first week of treatment: these reached a peak on Day 3. In this respect electrostimulation was markedly inferior to methadone withdrawal treatment. However, although progressive methadone withdrawal quickly reduced symptoms to a moderate or low level, there was no reduction in symptomatology as late as one month after admission (i.e. after ten days without methadone). The implications of these findings are discussed.
Clinical Effects of Apomorphine in Schizophrenia
Authors: Ferrer I. N. , Johnstone E. C. , Crow T. J.
Published: August 2008

There have been reports that low doses of the dopamine-agonist apomorphine, which may inhibit dopamine neurotransmission, are of therapeutic benefit in schizophrenia. We conducted a placebo-controlled study of acute and chronic schizophrenics in which videotaped interviews were blindly rated. No specific therapeutic effect was demonstrated for apomorphine other than a reduction in anxiety in acute schizophrenics. Furthermore, there was no difference in the frequency of side-effects of apomorphine between schizophrenic patients and controls, and no specific effect of apomorphine on blink-rates. These findings emphasize the importance of placebo-controlled studies in schizophrenia research.
‘Borderline Personality’: Diagnostic Attitudes at the Maudsley Hospital
Authors: Tarnopolsky Alex , Berelowitz Mark
Published: August 2008

About a quarter of the psychiatrists at the Maudsley Hospital use the diagnosis of ‘borderline’ personality. The description of the borderline patient obtained in this study does not overlap with any existing ICD personality disorder but has characteristics of the schizoid, paranoid, hysteric, explosive, anankastic and antisocial personalitities. The item that discriminated best between borderlines and controls was ‘brief, unsystematized, psychotic episodes', which is not included in the DSM-III definitions of borderline diagnoses. Items of the DSM-III ‘schizotypal’ set—e.g. ‘suspiciousness' and ‘ideas of reference'—discriminated better between borderline cases and controls, whereas items of the DSM-III ‘borderline personality’ set—e.g. ‘impulsivity’ or ‘unpredictability'— scored more frequently in both groups. These are similar to American findings.
Memory Test Performance Under Three Different Waveforms of ECT for Depression
Authors: Warren Eric W. , Groome David H.
Published: August 2008

Thirty-eight patients suffering from severe depression were given a course of ECT (Electroconvulsive therapy) in one of three waveforms. These were high-energy sine wave (HS), high-energy pulse (HP), and low-energy pulse (LP). Patients were assigned to one of these treatments on a double-blind basis. The patients were given a battery of memory tests before ECT commenced, after three treatments, at the termination of treatment, and two weeks after the last treatment. The marked improvement in both verbal and nonverbal memory scores was attributed to the lifting of depression. No significant differences were found between the memory scores of the three treatment groups at any point during the treatment period.
Cued Recall and the Nature of the Memory Disorder in Dementia
Authors: Davis Paul E. , Mumford Susan J.
Published: August 2008

The study investigated the retrieval deficit hypothesis of forgetting in senile dementia, using a cued recall technique. Memory for lists of words was tested with either no cues given at the time of recall, or alternatively by cueing the patient either with the word's first letter or its semantic category. Results do not support a retrieval deficit explanation of forgetting in dementia, but instead suggest the possibility of a processing deficit at the acquisition stage.
Long-Term Phenothiazine Treatment does not Cause Pituitary Tumours
Authors: Lilford Victoria A. , Lilford R. J. , Dacie Janet E. , Rees Lesley A. , Chard T.
Published: August 2008

In order to explore the possibility that prolactinomas may be caused by prolonged under-inhibition of prolactin-secreting cells we examined the pituitary fossa in 69 patients on long-term phenothiazine treatment. The average duration of treatment was 12.5 years and 55 (80 per cent) of the patients had persistently raised serum prolactin levels. The incidence of radiologically detectable pituitary fossa abnormalities was not significantly different to that in control populations. In 62 per cent of patients the skull x-rays from an earlier admission were available. Comparison of these with earlier films did not show a higher incidence of pituitary fossa abnormalities after prolonged exposure to phenothiazines.
Response to Tranylcypromine and Thought Stopping in Obsessional Disorder
Authors: Swinson Richard P.
Published: August 2008

A case of obsessional disorder is described in which a combination of tranylcypromine and thought stopping was effective in markedly reducing obsessional ruminations. Thought stopping appears to have had a major role in preventing relapse on withdrawal of the tranylcypromine. Isberg (1981) and Jenike (1981) have reviewed the literature regarding the response of obsessive compulsive disorders to monoamine oxidase inhibitors, the results of such treatment may be quite dramatic but there is a tendency to report positive results and not to report treatment failures.
Amelioration of Psychosis with Carbidopa: A Case Report
Authors: Linnoila Markku , Karoum Farouk , Potkin Steven G. , Wyatt Richard Jed , Potter William Z.
Published: August 2008

We have recently demonstrated that some patients with atypical bipolar affective disorders, characterized by psychotic manias and depressions, have fluctuating and episodic high urinary phenylethlamine (PEA) excretion. We treated a 30 year old woman, who has this disorder, with 200 mg/24 hours of carbidopa. Her psychosis was ameliorated and the urinary PEA output stabilized to a low normal level. Upon withdrawal of carbidopa her psychosis worsened and improved again when carbidopa treatment was reinstated. Carbidopa did not affect the duration or severity of the patient's mood cycles.
Psychiatric Disorder in Pregnancy and the First Postnatal Year
Authors: Watson J. P. , Elliott S. A. , Rugg A. J. , Brough D. I.
Published: August 2008

We interviewed 128 women regularly during pregnancy and the first postnatal year. Psychiatric interviews identified eight ‘cases' of psychiatric disorder (6 per cent) in early pregnancy and twenty ‘cases' (16 per cent) at six weeks after birth. Postnatal affective disorder, which accounted for 15 of these cases, was significantly associated with dissatisfaction with the marital relationship and also with previous psychiatric history. The implications of the term ‘postnatal depression’ are considered in terms of the course of the disorder in the 29 women (23 per cent) who had episodes of affective disorder at some time during pregnancy and the postnatal year. We found that the majority of episodes of affective disorder could be understood in terms of previous psychiatric history and/or reaction to life-events, including the stress of childbirth itself.
The Contingent Negative Variation, Personality and Antisocial Behaviour
Authors: Howard Richard C. , Fenton George W. , Fenwick Peter B. C.
Published: August 2008

Using a classical click/flash paradigm the contingent negative variation (CNV) was recorded from 60 consecutive male admissions to Broadmoor Hospital. Clinical and psychometric Minnesota Multiphasic Personality Inventory (MMPI) assessments were made independently of the electroencephalography (EEG) data. A trend for higher amplitude CNV's to be recorded from patients with a clinical diagnosis of antisocial (psychopathic) personality was observed. Patients with a Mental Health Act diagnosis of psychopathic disorder had significantly higher voltage CNV's than those in the mental illness category. These CNV differences were only found in the primary (non-anxious, sociable) psychopaths. Secondary (neurotic, unsociable) psychopaths did not differ from staff controls. A positive association between CNV voltage and the personality factor of sociability(sociable-shy dimension) was observed. A weak, negative correlation between CNV amplitude and impulsivity (impulsive-controlled dimension) was also apparent. All subjects showed an habituation effect across trials. No difference in response variability between successive series of trials was apparent in any of the patient groups.
Criteria for Diagnosing Reversible Dementia Caused by Depression: Validation by 2-year Follow-up
Authors: Rabins Peter V. , Merchant Altaf , Nestadt Gerald
Published: August 2008

Eighteen patients fulfilling DSM-III criteria for both major depression and dementia were matched by age and sex to patients with a diagnosis of irreversible dementia and patients with a diagnosis of major depression. A past history of depression, self reports of depressed mood, self blaming, hopeless and somatic delusions, an appetite disturbance and subacute onset identified the patients suffering from dementia caused by depression. Two year follow-up confirmed the initial diagnosis and demonstrated that coexisting cognitive impairment and major depression are not usually precursory to a progressive dementing illness.
Tardive Dyskinesia: Fluctuating Patient or Fluctuating Rater
Authors: Bergen J. A. , Griffiths D. A. , Rey J. E. , Beumont P. J. V.
Published: August 2008

Tardive dyskinesia (TD) is usually described as fluctuating in its clinical manifestations. We attempted to quantify fluctuations in TD using the Abnormal Involuntary Movement Scale (AIMS). Three psychiatrists rated multiple video-recorded examinations of four outpatients with mild TD. The unexpected finding was that within-rater variability dominated within-patient variability.
Organic Mental Disorders—An American Perspective
Authors: Lipowski Z. J.
Published: August 2008

The new American psychiatric classification (DSM–III) features a radically new approach to organic mental disorders. The concept of organicity has been liberalised to allow inclusion of psychiatric correlates of cerebral disorders which not only fail to involve cognitive impairment but in some cases also resemble affective, paranoid, and schizophrenic disorders. The highlights, and implications of the new approach are discussed.
The Effects of Non-Prescribing of Anxiolytics in General Practice: I. Controlled Evaluation of Psychiatric and Social Outcome
Authors: Catalan Jose , Gath Dennis , Edmonds Gillian , Ennis John
Published: August 2008

Ninety one patients with new episodes of minor affective disorder were selected by their general practitioners as suitable for anxiolytic medication. Half the patients were allocated randomly to a drug-group (anxiolytic medication), and half to a non-drug group (brief counselling without anxiolytics). Psychiatric and social assessments were made (i) at initial consultation when treatment was started; (ii) one month later; (iii) seven months later. Before treatment the two groups were similar on all main variables. On the General Health Questionnaire, 85 per cent of patients were psychiatric cases before treatment, 40 per cent at one month and 30 per cent at seven months. Similar improvements were found with other measures of psychiatric state (Profile of Mood States; Present State Examination) and social functioning (SAS-M). Improvements were similar and parallel in the two groups. Neither group of patients increased their consumption of alcohol, tobacco or non-prescribed drugs. The non-drug group did not make increased demands on the doctors' time.
Within-Individual Variation in Steady State Plasma Levels of Different Neuroleptics and Prolactin
Authors: McCreadie R. G. , Mackie Margaret , Wiles David H. , Jorgensen Aksel , Hansen Villy , Menzies Colin
Published: August 2008

Eleven male chronic schizophrenics were given, serially, oral pimozide, fluphenazine, and flupenthixol; the two latter were also given intramuscularly as decanoates in oil. Oral haloperidol was given before and after each drug. Analysis of variance of steady state plasma levels of the different neuroleptics showed considerable within-individual variation in such levels, probably due to differences in absorption and metabolism and between routes of administration. The findings suggest that if a patient fails to respond to one neuroleptic, there may be good pharmacokinetic reasons for switching him to another belonging to a different group, or for giving the same neuroleptic by a different route of administration. The study also showed that previous administration of one neurololeptic may influence the steady state level of another. The various neuroleptics produced different effects on plasma prolactin levels.
Evidence of Disturbed CSF Circulation and Brain Atrophy in Cases of Schizophrenic Psychosis
Authors: Bergstrand G. , Bjerkenstedt L. , Oxenstierna G. , Sedvall G. , Wik G.
Published: August 2008

The cerebrospinal fluid (CSF) circulation was studied with isotope cisternography in 30 patients with a schizophrenic type of psychosis. All had previously received neuroleptic treatment. Disturbed CSF circulation was found in 10 cases. In four of these, persistent intraventricular radioactivity was observed as well as partly obstructed CSF spaces. In the other six cases a slow CSF circulation was noted as well as evidence of partly obstructed CSF spaces especially of the upper posterior frontal region. Signs of atrophy of the cortex and vermis were found on CT scan in 10 cases. In four of these subjects a local atrophy was noticed in the upper posterior frontal cortex and around the frontal part of the interhemispheric fissure. Seventeen of the patients (57 per cent) had pathological findings at isotope cisternography and/or at CT. Disturbed circulation did not correlate with CT-findings, age, duration of psychosis, alcohol abuse, drug consumption or family history for psychosis. CT evidence of brain atrophy was significantly related to nonfamilial type of psychosis.
Hypnosis
Authors: Snaith Philip
Published: August 2008

Hypnosis has never reached a widespread acceptance as a therapeutic technique and psychiatrists, especially, appear to give it a wide berth. Since the time when John Elliotson (1791–1868) was forced to resign from the Chair of Medicine at University College Hospital because of his advocacy of mesmerism, the attitude of the medical profession has been one of frank hostility subsiding, in this century, into a lingering mistrust of medically qualified hypnotists. Hypnotherapy is regarded as a form of ‘alternative medicine’ and a recent survey (British Medical Journal, 1978) found that organized teaching of the subject occurred in two of the 33 medical schools and two of the 18 dental schools in Britain. Although I have no exact figures, in a conversation with Professor Gwynne Jones, we suspected that there was also widespread disregard of the subject in psychology courses at both undergraduate and postgraduate level. “Why” asked Sir William Trethowan (1976), in a somewhat sceptical vein, “if hypnotherapy is so effective as some authors of books claim it to be, is the subject not more widely taught on medical courses?”. He partly answered his own question by pointing to the lack of good quality research, but I would add a more fundamental inhibitor and that is the manner in which the subject is presented; if the interested trainee in psychiatry or clinical psychology picks up any of a number of recommended texts, disillusion will rapidly follow. Hypnotherapy is too frequently presented in terms which seem to be frankly anti-scientific and at variance to all other teaching. The expectation of the dramatic disappearance of symptoms, and even disease, at the authoritative command of the practitioner, is clearly allied to the practice of the fairground rather than accredited healing; psychiatrists, especially, shudder at such frequently repeated statements as that hypnosis enables the therapist to ‘directly converse with the unconscious mind of the patient’.
Clinical Medicine: Its Challenges and its Responsibilities
Authors: Walton John
Published: August 2008

I regard it as a singular honour and privilege to have been invited to deliver this lecture named in honour of Dr Henry Maudsley. His name is revered in medicine, not least because of his generosity in founding the Maudsley Hospital, famous throughout the world, but also because, as a former President of the Royal Medico-Psychological Association, he was active in that body out of which your distinguished college eventually evolved. The topic I have chosen is one which seems to me to be of great topical interest in an era both of increasing public scrutiny of medical practice and of the delivery of health care in a changing society. This scrutiny has brought advantages, but also substantial disadvantages to clinical medicine.
Genetics, Ageing and Dementia
Authors: Wright A. F. , Whalley L. J.
Published: August 2008

The contribution of genetic differences to variation in ageing and the relationship of ageing to certain types of dementia are discussed. Neuropathological changes commonly found in the ageing brain are present in more severe form in Alzheimer-type dementia, Down's syndrome, multi-infarct dementia, and a substantial number of patients with Parkinson's disease. An increased frequency of ageing-associated changes outside the brain have been reported in Alzheimer-type dementia, Down's syndrome, and multi-infarct dementia, although the evidence is generally meagre and in many cases requires further corroboration. Genetic studies of Alzheimer-type dementia support the existence of heterogeneity on the basis of family history and age of onset; early onset is associated with greater genetic risk and severity of abnormality. The increasing evidence of an association between DNA damage, premature ageing, and neuronal cell loss may provide insights into the aetiology of these and other forms of dementia.
Alcohol and Sedative Drug use in Neurotic Outpatients
Authors: Samarasinghe D. S. , Tilley S. , Marks I. M.
Published: August 2008

One hundred and six adult neurotic patients attending a behavioural psychotherapy unit were asked about their use of alcohol and other drugs and the perceived anxiolytic effect of these substances. Their drinking behaviour was not significantly different from that of the general population. Alcohol and other drugs were not perceived as reliable anxiolytics and not regularly used as such. Where alcohol or drug abuse coexist with anxiety-related problems, it is helpful to ask the patient to withdraw from these substances prior to starting behavioural therapy of the latter. We ask patients having behavioural therapy to refrain from alcohol or drug use prior to therapy or homework tasks.
How many Psychiatric Patients in Prison?
Authors: Coid Jeremy
Published: August 2008

The paper compares the prevalence of psychiatric morbidity amongst sentenced prisoners and in the general population. Major psychosis was no more common in the majority of studies of criminal populations. Although prisoners have a higher level of neurotic symptomatology, this was mainly found to be secondary to imprisonment itself. Long term imprisonment was not found to be a precipitant of severe psychiatric morbidity or intellectual deterioration, and prisoners adopt elaborate coping mechanisms which may themselves be protective. However, there is a higher prevalence of mentally handicapped and epileptic prisoners, and doctors in the Prison Medical Service have to cope with frequent, serious behavioural problems. Prisons appear to be a particularly important area for future psychiatric research.
Use of Memory Tests in Differentiating Organic Disorder from Depression
Authors: Coughlan Anthony K. , Hollows Susan E.
Published: August 2008

Although memory tests are commonly used to help differentiate organic conditions from depression, the extent to which depression might influence test performance is unclear. Comparison of the performances of normal, brain-damaged, and depressed subjects on a battery of verbal and visual memory tests revealed that the incidence of impairment amongst the depressed subjects was not significantly greater than amongst normal subjects on the majority of measures, and that within the depressed group, the degree of depression was not related to poor test performance. The brain-damaged group displayed a significant incidence of impairment on all measures, and a significantly greater incidence than the depressed group on the majority of measures. It is concluded that memory tests have a useful role to play in differential diagnosis.
Nominal Dysphasia and the Severity of Senile Dementia
Authors: Skelton-Robinson M. , Jones S. P.
Published: August 2008

Previous research has shown that nominal dysphasia occurs commonly as a language disorder in senile dementia (Alzheimers' type). This study provides evidence that the degree of nominal dysphasia shown by a patient may be a reliable index of the severity of dementia, as measured by both behavioural and cognitive rating scales.
Emotional Distress amongst the Supporters of the Elderly Mentally Infirm
Authors: Gilleard C. J. , Belford H. , Gilleard E. , Whittick J. E. , Gledhill K.
Published: August 2008

Three samples of supporters of elderly infirm dependents who were either attending or about to attend day hospitals were given the 30-item General Health Questionnaire (GHQ) to complete. Prevalence levels of disturbance varied from 57% to 73%; female supporters (the majority) reported higher levels of distress. High scores were related to a diagnosable psychiatric condition, and were significantly associated with a combination of poor self-health ratings in the supporters, more frequent behaviour problems in the dependents, and a more negative view of the premorbid relationship between supporter and dependent. Reported amount of contact time and levels of formal and informal outside support were not related to GHQ scores.
Mental Changes Resulting from Subdural Haematoma
Authors: Black Donald W.
Published: August 2008

A retrospective study was carried out of 79 patients with subacute or chronic subdural haematomata. Forty-six (58.2%) had mental changes at admission which were categorised using DSM-III criteria. Delirium was the most frequent mental change, followed by dementia and coma. Three cases of organic affective syndrome were found. In those with mental changes, delirium was significant in older patients (P <.05) and coma in young patients (P <.001). Dementia was more common in the elderly. These findings confirm the presence of common mental syndromes in patients with subdural and haematomata and substantiate time-honoured clinical stereotypes.
Zetidoline, A New Antipsychotic
Authors: Silverstone T. , Levine S. , Freeman H. L. , Dubini A.
Published: August 2008

Zetidoline (ZTD), a compound chemically unrelated to any available antipsychotic, with selective dopamine receptor-blocking properties, was compared with haloperidol (HLP) in a double-blind study on 56 in-patients who had either first episodes or acute relapses of schizophrenia. ZTD was found to be safe, as effective as HLP, and to produce significantly fewer extrapyramidal side-effects (EPS).
Classification and Diagnosis of Depression in School Phobia
Authors: Kolvin Israel , Berney Thomas P. , Bhate Surya R.
Published: August 2008

Fifty-one school phobic children, aged nine to fourteen years, were assessed for psychiatric diagnosis; this revealed the presence of two clinically meaningful sub-groups—depressed and residual school phobic. A wide range of symptoms were studied to identify those which might prove useful in diagnosing adult-type depression in childhood and early adolescence, both in terms of frequency of symptoms in the depressed group and the extent of the distinction between the two groups. Eleven such key symptoms were identified and based on these, a formula for diagnosing adult-type depression was evolved. The validity of several different ways of classifying the above cases were explored; these covered: kind of disorder; type of onset; adolescence versus pre-adolescence; and sex of the child. However, on only one dichotomy—depression versus absence of depression—were there many significant discriminants. Affective symptomatology of more recent onset was contrasted with pre-morbid personality traits, usually associated with school phobia. There was no evidence to support the concept of ‘masked depression’ in childhood.
Comparison of Pharmacological Treatment Response between Situational and Non-situational Depressions
Authors: Garvey Michael J. , Schaffer Charles B. , Tuason V. B.
Published: August 2008

Fifty-one patients with a primary major depressive disorder preceded by a stressful environmental event were compared for their response to pharmacological treatment with 75 depressives who experienced no stressful life event before illness episodes. There was no difference between the groups in treatment response rates after four and six weeks of treatment respectively.
An Evaluation of Cognitive-Behaviour Therapy for Depression in Patients with Multiple Sclerosis
Authors: Larcombe Nora A. , Wilson Peter H.
Published: August 2008

Twenty depressed multiple sclerotic patients were randomly allocated either to cognitive-behaviour therapy or to a waiting list control condition. Assessment of depressive symptoms was conducted at pre-treatment, post-treatment, and a four-week follow-up. In comparison to the waiting list control condition, cognitive-behaviour therapy was found to result in clinically and statistically significant improvement on most measures. Although the mechanism by which such treatment achieves its effects is unclear, these results clearly support the use of cognitive-behavioural treatments for depression in this population.