bluuebunny/crossref_metadata_2025 huggingface dataset:
Impact of Lithium Therapy on Core Psychotic Symptoms of Schizophrenia
Authors: Zemlan Frank P. , Hirschowitz Jack , Sautter Frederic J. , Garver David L.
Published: August 2008

The authors have previously reported that a sub-group of schizophrenic-like patients respond favorably to lithium therapy: furthermore, psychotic patients who respond to lithium demonstrate appreciable improvement during the first seven days of treatment. The present study investigated which symptoms of schizophrenia improved quickly during lithium treatment. We found that patients who do respond to lithium show significant improvement in the core symptoms of psychosis—hallucinations, delusions and formal thought disorder—during the first seven days of treatment, thus allowing early identification of 88 per cent of schizophrenic patients who ultimately respond to lithium and 91 per cent of those who do not.
Schizophrenic Patients and their Families a Survey in a Psychiatric service based on a DGH Unit
Authors: Gibbons J. S. , Horn S. H. , Powell J. M. , Gibbons J. L.
Published: August 2008

We identified the population of schizophrenic patients under 65 in a geographically defined area. The number using psychiatric services based on a new District General Hospital unit in the course of one year was 364, a prevalence of 2.2 per 1000 adult population. Half the patients lived in supportive private households, most often with spouses or mothers. More women than men married and retained supporters. Patients and their primary supporters were interviewed separately. The PSE Catego programme classed 47 per cent of patients as psychotic. Supporters reported disturbed behaviour in 65 per cent of patients, and restricted social performance in 78 per cent. There was evidence of hardship (emotional and physical ill-health, problems with children) in 90 per cent of households. Supporters' subjective distress was directly related to the presence of psychosis and disturbed behaviour and inversely related to the duration of the illness. Drop-out and failure to take medication appeared to be causes of the relatively high prevalence of psychosis.
Classification of Anxiety
Authors: Tyrer Peter
Published: August 2008

Current psychiatric classifications of anxiety are examined critically. In the European literature a specific cluster of symptoms is diagnostic of anxiety neurosis and their subsidiary classification is based on precipitating factors and duration of symptoms. In the American literature, exemplified by DSM-III, greater emphasis is placed on symptomatic classification and panic is given separate diagnostic status, both alone and in conjunction with agoraphobia. In both classifications generalized anxiety is at the bottom of a diagnostic hierarchy so that all other symptoms take precedence. It is argued that neither classification properly identifies a discrete syndrome of pathological anxiety that is recognizable in clinical practice.
Trends in Suicide Rate for England and Wales 1975–80
Authors: McClure G. M. G.
Published: August 2008

The suicide rate in England and Wales has increased annually in the period 1975 to 1980. The increase has occurred in both sexes, but has been greater for males. There has been a decrease in suicide by poisoning with solid or liquid substances (including overdoses) and a marked increase in poisoning by vehicle exhaust gas. The rate of hanging, strangulation and suffocation has also increased substantially: taken together (ICD E953) these now form the most common method of suicide in males. Statistics for ‘undetermined’ and ‘accidental’ death have been examined, and indicate that the increase in the official suicide rate represents a real increase in suicides during this period.
How Effective is the Standard Dose of Disulfiram? A Review of the Alcohol-Disulfiram Reaction in Practice
Authors: Brewer Colin
Published: August 2008

The current maximum recommended dose of disulfiram, 200 mg daily, is often inadequate. Of 63 patients taking disulfiram under supervision who either risked drinking alcohol or who had a medically supervised challenge with alcohol, only half produced a significant response on a dose of 200–300 mg daily. Some patients need as much as 1.5 g daily but even at high dosage significant side effects are uncommon, reversible and rarely serious.

A modification to the recommended technique for a medically supervised alcohol challenge is described, which minimises distress.
Evaluating the Teaching of a Method of Psychotherapy
Authors: Maguire G. P. , Goldberg D. P. , Hobson R. F. , Margison F. , Moss S. , O'Dowd T.
Published: August 2008

A teaching package was produced to help trainees in psychiatry learn the techniques specific to a ‘conversational model’ of psychotherapy, prior to group supervision. This consisted of a booklet and three videotapes. The third tape used a micro-counselling approach to illustrate each key skill and was viewed together with a teacher. After this, trainees met in groups of three with a psychotherapist for eight weekly sessions. To evaluate this teaching, 12 trainees were asked to interview simulated patients before and after they used the package and after supervision. These interviews were recorded on videotape and rated. There were significant improvements on most of the key skills as a result of this training, and nine of the 12 trainees improved considerably. There was a strong negative correlation between improvement scores and a biological orientation to psychiatry. It is concluded that the teaching package is an economic but effective way of helping trainees learn the basics of a method of psychotherapy before they are given supervision.
Psychiatric Diagnostic Discriminations with Combinations of Quantitative EEG Variables
Authors: Shagass Charles , Roemer Richard A. , Straumanis John J. , Josiassen Richard C.
Published: August 2008

The possible psychiatric diagnostic utility of certain quantitative EEG measures was evaluated by further analysis of previously reported data from 242 unmedicated patients and 94 non-patients. Time series of amplitude, frequency and wave symmetry measures for 12-lead EEGs (eyes closed and open) were factor analyzed across leads. Factor scores meeting specified criteria in multivariate analyses were entered into discriminant analyses comparing pairs of the following groups: non-patients, neurotics, personality disorders, overt schizophrenics, latent schizophrenics, major depressives and manics. The following discriminations were obtained with at least 50 per cent sensitivity, and diagnostic confidence rates from 69 to 92 per cent: (a) non-psychotic patients (neuroses, personality disorders) from overt schizophrenics, latent schizophrenics or manics; (b) major depressives from latent schizophrenics or manics; (c) non-patients from schizophrenics (overt and latent), depressives or manics. Most discriminations were replicable in split-half analyses. Possible utility of EEG measures in differential diagnosis is supported.
Positive and Negative Symptoms and the Thematic Organisation of Schizophrenic Speech
Authors: Allen Heidelinde A.
Published: August 2008

This study questions the prevailing view that schizophrenic delusions, hallucinations and incoherence of speech (positive symptoms) reflect loss of cognitive control and that flattening of affect and poverty of speech (negative symptoms) reflect restriction of cognitive processing.

The prevailing view was examined by analysing the thematic organisation of speech produced by 18 patients describing pictures. Results showed that (a) positive and negative symptom schizophrenics did not differ in the control and restriction of thematic speech organisation; (b) speech disordered schizophrenics, positive as well as negative, showed cognitive restriction, by producing fewer inferential ideas than non-speech disordered schizophrenics.

The wider implications of these results are discussed, particularly the implications of (b) for the notion of concreteness in schizophrenia.
No Correlation between Neuroleptic-induced Increase of β-Endorphin Serum Level and Therapeutic Efficacy in Schizophrenia
Authors: Naber D. , Nedopil N. , Eben E.
Published: August 2008

In 23 acute, unmedicated, schizophrenic patients, psychotic behaviour and β-endorphin serum level were measured before and during four weeks of neuroleptic therapy. Prior to drug treatment, β-endorphin level of all patients was within the normal range. Neuroleptic therapy induced marked elevations of β-endorphin in eight subjects; statistical analysis revealed a slight but significant increase for the whole group. This endocrine effect was not correlated with therapeutic efficacy of neuroleptic treatment.
A Note on Two Important Aspects of Kleinian Theory ‘Projective Identification’ and ‘Idealisation’
Authors: Ployé Philippe M.
Published: August 2008

The concept of ‘projective identification’, introduced by Melanie Klein and extensively used by her followers, is still held by many to be highly controversial and difficult to understand. Great importance is also attached by Kleinian workers to what they describe as the infant's early use of ‘idealisation’ as a defence against anxiety. A hypothesis is presented according to which both mechanisms could be seen as the continuation or persistence, in mental form and in early post-natal life, of some of the ways in which the unborn child could be said to relate to the mother physically during the last few months of intrauterine life.
Drugs and Suicide Attempts in Benin City, Nigeria
Authors: Eferakeya Adego E.
Published: August 2008

A review of reported cases of attempted suicide in Benin City indicates that the incidence has not increased over the four-year period 1978 to 1981, during which the average crude suicide attempt rate was 7 per 100, 000. Eighty seven per cent of the attempters were under the age of 30, but the commonest age-group was 15–19 years (39.4 per cent). The female/male ratio was 1:1.2. The majority of the attempters (64 per cent) were students, housewives, and the unemployed. Ingestion of drugs (68 per cent) or of chemicals (20 per cent) was the predominant method. The major predisposing factors were mental illness (32 per cent) and conflicts with parents (24 per cent).
Nutritional Aspects of Down's Syndrome with Special Reference to the Nervous System
Authors: Sylvester Peter E.
Published: August 2008

Multiple deficiencies of vitamins and trace metals have been demonstrated in Down's syndrome. The picture is complex, especially since not all individuals are affected equally. Deficiencies are not age-related, but appear to be lifelong. The brain in Downs's syndrome does not develop adequately; one area, the hippocampus, which is concerned with memory, is poorly developed and is also involved in the pathological changes of Alzheimer's disease. The role of nutrients is discussed in relation to damage to the mature brain, and to the ageing process.
Happy Families?
Authors: Heron Judith , Leheup Rachel
Published: August 2008

Sixteen consecutive patients with anorexia nervosa were studied and compared with a control group of other patients coming to an adolescent service, matched for sex and admission status. The anorexic group were not significantly different from the controls in social class and I.Q., and had a male-to-female ratio of one to four. However, they were significantly more likely to have perfectionistic personality traits and to profess to be happy with their families; these families had few external stresses, were very close, and had a high degree of exclusivity.
The use of the C. A.T. Head Scanner in Clinical Psychiatry
Authors: Roberts J. K. A. , Lishman W. A.
Published: August 2008

Three hundred and twenty-three patients were referred by psychiatrists for scanning with a 160 x 160 matrix CT 1010 Head Scanner at the Maudsley Hospital during the first year this machine was in use (1977/1978). Two hundred and one referrals were for clinical and 122 for research reasons, 50% of the former and 57% of the latter showed some abnormality on their scans. Review of the patients' notes identified data that were significantly predictive of abnormal scan results; and the referring psychiatrists were significantly more able to predict the scan results correctly during the second six months of the study. Diagnosis, management, and/or prognosis were influenced in 11.7% of those patients scanned for clinical reasons.
Community Care in Camberwell
Authors: Sturt Elizabeth
Published: August 2008

A census was taken of all patients in psychiatric hostels and homes, psychiatric day care, and short-term in-patient care who also had at least one year's history of contact with services. During the following two years, 61% of the patients stayed continuously in day or residential care, while 17% were discharged from care within the first year and made no further use of day or residential services. Two main patterns of contact were evident–repeated short-term in-patient care or longer-term care in services outside hospital. Their most important determinant was whether a viable marriage still existed for the patient.
Anorexia Nervosa in Down's Syndrome—A Case Report
Authors: Cottrell D. J. , Crisp A. H.
Published: August 2008

A case is described of anorexia nervosa arising in a mentally-handicapped 35-year old person with Down's syndrome. The late onset is accounted for on the grounds that adolescent challenges had only recently arisen in this instance. Removal of the patient from the provocative situation, coupled with some effective psychotherapeutic ‘grief work’ with the family, was associated with restoration of normal body weight and menstrual function, following the patient's acceptance of the usual re-feeding treatment programme.
Cognitive-Behaviour Therapy for Depression: Problems and Perspectives
Authors: Williams J. Mark G.
Published: August 2008

A number of reviews of the effectiveness of cognitive behaviour therapy for depression, though optimistic, have pointed to some difficulties in interpretation of the outcome literature. These difficulties, and the extent to which more recent research has dealt with them, are reviewed. It is suggested that while some of the genuine difficulties have been resolved, and other commonly expressed criticisms may prove to be unfounded, there remain a number of important areas of ignorance which demand further investigation.
Anorexia Nervosa in a Black Zimbabwean
Authors: Buchan T. , Gregory L. D.
Published: August 2008

In spite of the comparative rarity of anorexia nervosa in African patients, the case of a young black Zimbabwean woman which fulfils Feighner's diagnostic criteria is presented. Special reference is made to several unusual features which include the social and psychological conflicts engendered by changes of culture, the clinical symptoms, and the role of a traditional healer in her recovery. A speculative hypothesis concerning aetiology is suggested.
Koro-like symptom in a Non-Chinese Subject
Authors: Berrios G. E. , Morley S. J.
Published: August 2008

‘KORO’ (head of turtle) or ‘suk-yeong’ (shrinking penis) names a symptom characterized by the belief that: 1. the penis is shrinking; 2. it will disappear into the abdomen; 3. it will cause death. It is usually accompanied by intense fear and by preventive manoeuvres such as tying or clamping or grasping the penis. It tends to be short-lived and may affect single individuals or groups.
Koro and Psychosis
Authors: Ang P. C. , Weller M. P. I.
Published: August 2008

‘Koro’ has been described as a culture-bound syndrome with localised depersonalisation confined to the penis, occurring in the context of a panic state with fear of impending disaster (Yap 1965,1969). Because ghosts are not thought to possess genitals, penile shrinkage is believed to be potentially fatal, with the risk that the victim will himself turn into a ghost. Until recently the syndrome was thought to be restricted to Southern Chinese emigres in Hong Kong and South East Asia. We wish to report two such cases, one in a West Indian and the other in a Greek Cypriot, admitted to Friern Hospital.
The Limited Utility of the Dexamethasone Suppression Test for the Diagnostic Process in Psychiatry
Authors: Berger Mathias , Pirke Karl-Martin , Doerr Peter , Krieg Jürgen-Christian , von Zerssen Detlev
Published: August 2008

In 231 psychiatric in-patients, the 1 mg or 1.5 mg DST with blood samples at 0900 h, 1600 h and 2300 h and a post-dexamethasone plasma cortisol threshold of ⩾ 5 μg/dl were tested for their differential diagnostic utility in clinical psychiatry. Neither test significantly separated endogenous depressed. patients from patients with other depressive or non-depressive psychiatric disorders. Studies of the 1 mg or 1.5 mg DST in 75 healthy subjects revealed about 12% of cortisol non-suppressors, when a post–dexamethasone cortisol threshold of ⩾ 5 μg/dl was used. This seemed to be an unacceptably low specificity of the test in normal subjects. A threshold criterion of ⩾ 8 μg/dl, however, yielded only 2.7% of non-suppressed normal subjects. Analyses of the DST data of the psychiatric patients, using a cortisol threshold of ⩾ 8 μg/dl, also failed to reveal a significantly higher specificity of the DST for endogenous depression. However, it was demonstrated that intervening variables such as stress due to hospital admission, drug withdrawal, suicidal turmoil, weight loss, as well as a low dexamethasone plasma level, enhance the rate of abnormal DST results in psychiatric in-patients, regardless of their diagnostic classification.
Psychosocial Outcome after Coronary Artery By-pass Surgery
Authors: Bass Christopher
Published: August 2008

Thirty-six patients with obstructive coronary artery disease were interviewed before by-pass graft surgery, and again a mean period of 12.3 months (n = 34) after the operation. The operation was successful in providing relief from chest pain in 31 patients. Psychiatric outcome was related to preoperative mental state, social maladjustment, neuroticism, Bortner Type A score, and previous psychiatric history. One quarter of those employed preoperatively failed to return to work after operation, even though they were improved in terms of symptoms and functional capacity. No association was found between measures of either psychiatric morbidity, or employment status at follow-up, and pre-operative physical variables.
Autonomic Monitor for Electroconvulsive Therapy
Authors: Watkins-Pitchford J. M. , Reynolds Felicity
Published: August 2008

A successful preliminary trial of an inexpensive non-invasive method for detecting successfully administered electroconvulsive therapy is described.
Changes occurring in Appetite and Weight during Short-Term Antidepressant Treatment
Authors: Harris Brian , Young John , Hughes Bill
Published: August 2008

Changes in appetite and weight were recorded in mild to moderately depressed out-patients during the course of clinical trials of various antidepressant drugs. After six weeks, differences due to treatment regimes were minimal. Patients who on becoming depressed experienced severe changes in appetite and weight in either direction, tended to return to normal. The significant associations of appetite and weight change during treatment were with weight, appetite, and carbohydrate preference at presentation, and also with the ‘appetite history’ and ‘weight history’. The associations with the degree of depression were relatively minor.
On the value of P300 Event-Related Potentials in the Differential Diagnosis of Dementia
Authors: Slaets J. P. J. , Fortgens C.
Published: August 2008

The possible value of event-related potentials (ERPs) in the differential diagnosis of dementia was investigated in a group of 42 demented elderly patients, 29 non-demented elderly patients, and 10 healthy young controls. The auditory evoked potentials were elicited by using target and non-target auditory stimuli. There was no significant difference in N100 and P200 latency between these groups. Our results indicate an age-related increase of P300 latency of 0.3 msec/year in the non-demented subjects. There was no significant difference in P300 latency between demented and non-demented patients, and the latencies vary widely within the groups of elderly patients.
The X-ray Department and Psychiatry
Authors: Larkin E. P.
Published: August 2008

All X-rays requested by psychiatrists in-training during 1982 and performed by the Department of Radiology of a large mental hospital were analysed. Forty-five per cent of all requests were marked routine, and the majority of these were for chest X-rays; only 4% of these revealed significant abnormality and no patient under the age of 55 had a significant abnormality on routine chest X-ray. All routine skull X-rays were normal. One-third of the long-stay hospital population accounted for one-quarter of the overall workload of the department. It is recommended that: requests for routine skull X-rays be abandoned, and that routine chest X-rays for patients below the age of 55 be restricted to high-risk groups such as immigrants, those on steroids, etc. The financial implications of such a policy are discussed.
Fusarial Mycotoxins and Behaviour: Possible Implications for Psychiatric Disorder
Authors: Schoental R.
Published: August 2008

Man and animals are sporadically exposed to mycotoxins (the secondary metabolites of moulds), which include those produced in damp and cool environment by the almost ubiquitous soil-microfungi, theFusaria.Perinatal exposure to the mycotoxins may cause damage to many organs, including the CNS and those which are targets for oestrogenic agents. Depending on the levels of the mycotoxins and the time of their action, the effects may manifest themselves as neonatal abnormalities, or as neurological and behavioural anomalies and chronic disorders later in life. The relationship between the anatomical and behavioural development of individuals and their perinatal exposure to fusarial mycotoxins requires further investigation.
A Study of 250 Patients Referred to a Department of Psychiatry for the Deaf
Authors: Denmark John C.
Published: August 2008

250 patients referred to a department of psychiatry for the deaf were selected by random sampling and studied. The results underline the need for specialised services for deaf patients of all types, not only those who communicate solely by manual methods. Patients are referred to this department suffering from mental illness and communication disorders, as well as from problems related to their deafness. Some of the difficulties of managing a supra-regional service are discussed.
Zopiclone: A Non-Benzodiazepine Hypnotic
Authors: Wheatley David
Published: August 2008

Zopiclone, a non-benzodiazepine hypnotic, was compared with temazepam in the treatment of 36 patients suffering from insomnia; the trial period was two weeks, with cross-over of medications at one week and a randomised order of administration. There were highly significant improvements with both drugs, as compared to the control period in respect of: sleep latency, number of times waking during the night, and quality and duration of sleep. The incidence of side-effects was very low. No significant between-drug differences were found in respect of any of the assessment measures or of the incidence of side-effects.
Is Mania Incompatible with Down's Syndrome?
Authors: Sovner Robert , Hurley Anne Desnoyers , Labrie Richard
Published: August 2008

In reviewing the medical literature on the association between affective illness and mental retardation (Sovner & Hurley, 1983), we were intrigued to find that, although there were many cases of major depression and depressive neurosis among people with Down's syndrome, there were no reports of mania in such individuals. This finding provoked us to pursue the hypothesis that Down's syndrome may preclude the development of mania.
Understanding the Italian Experience
Authors: Jones Kathleen , Poletti Alison
Published: August 2008

The “Italian Experience” in closing down mental hospitals has been highly praised by some British observers, who have seen lessons for Britain in the development of community care. However, it has been the subject of heated debate in Italy—and the policy is now to be reversed by law. Two questions arise: why have the claims been exaggerated? And why have they found such ready and uncritical acceptance in Britain?
Language in Schizophrenia
Authors: Rutter D. R.
Published: August 2008

Experimental research into language in schizophrenia has been guided traditionally by two main assumptions: that language disturbance is widespread among schizophrenic patients and easy to detect and measure, and that schizophrenia is fundamentally a cognitive disorder in which language disturbance is part of an inability or failure to regulate one's thoughts. However, recent findings have challenged both assumptions. Two experiments are reported here, the first based on monologues, the second on conversations, which were subjected to reconstruction and discourse analyses. Schizophrenic material is found to be harder to follow than normal, and is characterised by poor reference networks and inappropriate use of questions. While some of the results are specific to the schizophrenic group, others are found also in affective patients, but none is the product of formal thought disorder. The central problem lies less in cognition than in the social process of taking the role of the other.
Psychological Profile of the Spouse of the Female Agoraphobic Patient
Authors: Arrindell Willem A. , Emmelkamp Paul M. G.
Published: August 2008

It has been contended that psychological characteristics of the partner of the agoraphobic patient are important factors in the development and maintenance of the patient's symptoms. To examine this hypothesis, male partners of female agoraphobics were compared with those of non-phobic psychiatric patients and of normal controls on a total of 48 measures referring to several symptom complexes and traits, including defensiveness. The partners of agoraphobics as a group were not found to be more defensive or psychologically more disturbed than their control counterparts. Additional within-couple analyses across groups showed spouses in the control couples to be more comparable to each other than were agoraphobics and their partners—a finding which was attributed to the highly elevated scores of the agoraphobic patients.
Maggot in the Salt, the Snake Factor and the Treatment of Atypical Psychosis in West African Women
Authors: Farmer Anne E. , Falkowski Wojciech F.
Published: August 2008

We describe psychotic illness in a Nigerian and a Togoese woman respectively. Although the clinical presentation was familiar to the clinical team, neither responded to conventional methods of treatment. Detailed ethnic enquiry revealed cultural beliefs which had a profound impact on each illness. Swift recovery occurred after repatriation. Eisenbruch (1983) has reported a case of ‘wind illness' in a paper described as a 'study of psychiatric anthropology’, which stresses the importance of understanding the patient's own view of his illness and it causes, in arriving at the correct diagnosis and intervening effectively. We describe here two cases of atypical psychosis in West African women, which lead us to endorse this view; as in his case, Western medicine proved useless, although complete recovery occurred once both had been repatriated.
Mates of Schizophrenic Mothers
Authors: Parnas Josef
Published: August 2008

Both mates of schizophrenic mothers and a control group consisting of mates of non-schizophrenic mothers were diagnostically examined. The former were more frequently psychiatrically deviant than their controls, both with respect to a life-time syndrome diagnosis and a personality diagnosis. Mating between a schizophrenic mother and a father who suffered from schizophrenia spectrum disorder significantly increased the offspring's risk of developing a schizophrenia spectrum disorder himself. Assortative mating was negatively correlated with age of onset of maternal schizophrenia. It is proposed that defective emotional rapport or sub-psychotic features constitute the phenotypic traits by which assortative mating operates in schizophrenia.
Tritiated Etorphine and Naloxone Binding to Opioid Receptors in Caudate Nucleus in Schizophrenia
Authors: Owen F. , Bourne R. C. , Poulter M. , Crow T. J. , Paterson S. J. , Kosterlitz H. W.
Published: August 2008

Opioid receptor binding sites were assessed in membrane preparations of caudate nucleus from post-mortem brains of controls and of patients with schizophrenia. There was no difference between the two groups in the total specific binding of3H-etorphine or in its ‘μ’ and (‘δ+χ’) components. Similarly, the binding of3H-naloxone did not differ between patients and controls. It is concluded that a previous report of reduced opioid receptors in caudate of schizophrenics is unlikely to prove a consistent finding and that the results of the present study offer no support to the claim that there is a general disturbance in opiate mechanisms in schizophrenia.
The Nottingham ECT Study
Authors: Gregory S. , Shawcross C. R. , Gill D.
Published: August 2008

Sixty nine patients took part in a double-blind study to investigate the efficacy of bilateral, unilateral, and simulated ECT in the treatment of depressive illness. The findings suggest that both bilateral and unilateral ECT are highly effective treatments for depression and are significantly superior to simulated ECT. There was also evidence that patients receiving bilateral ECT recovered more rapidly than those receiving unilateral ECT and required significantly fewer treatments. The relevance of these findings to clinical practice is discussed.
The Medical and Psychological Investigation of Psychogenic Polydipsia: A Case Study
Authors: Kulkarni J. , McLachlan R. , Copolov D.
Published: August 2008

The case of a 17 year-old female with psychogenic polydipsia is reported; 13 out of 18 members of her maternal family were known to have had polydipsia and polyuria, but only two had undergone endocrine investigations—one had diabetes insipidus and one also had psychogenic polydipsia. There are probable contributions of non-genetic family factors including imitation and identification to the development of this patient's condition. Detailed family and developmental histories may be of particular assistance in the understanding of the psychogenesis of the disorder in some patients.
Huntington's Chorea without Dementia
Authors: Turner T. H.
Published: August 2008

An unusual case of Huntington's Chorea, without dementia, is described. The diagnostic issues are discussed with particular reference to the problems of psychiatric assessment and management of the disease.
Social Anthropology in Relation to Psychiatry
Authors: Littlewood Roland
Published: August 2008

The relationship between psychopathology and culture remains a vexed question. Whilst organic reactions (and by extension the ‘functional’ psychoses) can be conveniently coded in terms of an invariate biologically determinedformand a culturally variablecontent,the same is not true of those reactions which we might feel are characteristic of Western society: agoraphobia, anorexia nervosa, self-poisoning, Briquet's syndrome or the chronic pain syndromes. When cultural explanations are offered, however, they usually employ naive and implicit anthropological assumptions, and it is perhaps only the phenomenon of conversion hysteria in the nineteenth century which has been adequately related to its social context (Ellenberger, 1970).
Stable Abnormalities in the Lateralisation of early Cortical Somatosensory Evoked Potentials in Schizophrenic Patients
Authors: Cooper J. E. , Andrews H. , Barber C.
Published: August 2008

During the investigation of somatosensory evoked cortical potentials arising from a complex vibro-tactile stimulus to the forefingers, an abnormal lack of lateralisation of response was found in 10 out of 21 schizophrenic patients. Eight patients with severe affective illness all had the expected degree of lateralisation of cortical potentials, as did 12 out of 15 normals. Three normals and 3 schizophrenic patients had a loss of lateralisation of the evoked response on stimulation of one hand but a normal lateralisation on stimulation of the other. The considerable technical problems of this and related techniques are discussed, but it is suggested that further exploration of this technique is justified. At this stage, no conclusion can be drawn about the cause of the abnormalities.
Gilles de la Tourette Syndrome and Mania in an Adolescent
Authors: Bleich Avraham , Bernout Edna , Apter Alan , Tyano Sam
Published: August 2008

The case is presented of a twelve-year-old boy suffering simultaneously from Tourette Syndrome (TS) and a manic episode. The problems of this unique clinical association are discussed from the point of view of differential diagnosis, treatment, and possible biochemical basis. The case also illustrates the usefulness of the expanded concept of TS as a neuropsychiatric disorder with dys-regulation of perceptual, motor, and cognitive functioning.
Vampirism—A Clinical Condition
Authors: Prins Herschel
Published: August 2008

The phenomenon of the vampire is ancient, ubiquitous, and fascinating; moreover, it can only be understood adequately within the context of more general blood reliefs and rituals. (See Prins, 1984 for a review). References to vampires and associated phenomena may be found in the world's great literature long before Bram Stoker created his notorious and evil Count (Summers, 1960, 1980). Belief in the vampire's actual physical existence was probably encouraged by the prevalent practice of premature burial during times of plague, by the large numbers of itinerants and beggars that abound at such times, and by the fact that many of them took refuge in vaults and graveyards. In addition, the myth was probably given more tangible reality by such physical explanations asErythropoietic Protoporphyriaor its variants. This disorder is said to induce the body to produce an excess of porphyria, which results not only in excess redness of the eyes, skin and teeth, but also a receding of the upper lip and cracking of the skin, which bleeds when exposed to light. It has been suggested that physicians of the day could only treat sufferers by secluding them during the day and by persuading them to drink blood to replace that lost by bleeding (Illis, 1964; Milgrom, 1984; Prins, 1984). In more modern times, there have been accounts of people seeking to protect themselves from vampiric attentions (Farson & Hall, 1978).
Regional Density and Survival in Senile Dementia
Authors: Colgan John
Published: August 2008

Computed cranial tomography was performed on 48 patients with Senile Dementia of the Alzheimer Type (SDAT) who have since been followed up in a continuing prospective study. At six-months follow-up, ten patients had died; these did not differ significantly from the survivors either in mean age or duration of dementia, although the latter tended to have been shorter in the deceased. Despite having shorter histories, the deceased had performed worse on initial testing with several cognitive measures, and this was significant for the mental test score; this suggests some patients may have a more rapidly progressive form of SDAT. In a comparison between the CT scan of the deceased and survivors, the deceased were found to have significantly lower mean attenuation densities in the parietal, occipital, and left thalamic regions. The hypothesis that low attenuation density in the parietal regions of the CT scan in SDAT is associated with a more rapid demise is supported for the present period of follow-up.
How Likely is it that a District Health Authority can Close its Large Mental Hospitals?
Authors: Levene L. S. , Donaldson L. J. , Brandon S.
Published: August 2008

A cross-sectional survey assessed all 1,087 patients who were in psychiatric beds provided by a large district health authority. The elderly predominated in all length of stay categories, and a high proportion of them had levels of social and physical incapacity which made it unlikely that they could be cared for other than in residential care. A substantial minority of younger patients with a length of stay between one and two years had levels of incapacity which suggested the need for major treatment, rehabilitation, or training efforts. The findings have major implications for Government policy to replace large mental hospitals.
Family Management in the Prevention of Morbidity of Schizophrenia: The Adjustment of the Family Unit
Authors: Falloon Ian R. H. , Pederson Jean
Published: August 2008

Changes in the functioning of family members were assessed during a randomly controlled study of community management of schizophrenia. Eighteen families who completed two years community management based upon behavioural family therapy were compared with 18 families who received patient oriented management with family support. Families receiving family management reported less disruption of activities, reductions in physical and mental health problems, and less subjective burden than those receiving the patient oriented approach. It is concluded that the benefits of family management extend beyond the reduction in clinical and social morbidity of the index patient to beneficial effects for the family as a whole.
The Role of Meals as a Reinforcing Event in a Token Economy Programme
Authors: Higson P. J. , Woods P. A. , Tannahill M. M. , Ellis N. C.
Published: August 2008

Items such as meals have frequently been used as back-up events in Token Economy Programmes (TEPs) because of their supposed reinforcing effectiveness. However, despite the dubious ethical questions that this raises, there is little research evidence to support the necessity for their use in TEP's with hospitalised chronic mentally ill patients. The effects of introducing meals as a ‘free’ item on patients' performance of a number of target behaviours were investigated in a TEP where they had previously been scheduled as a back-up event. While ‘free’ meals produced a slight increase in the actual number of meals eaten, there were no systematic effects on patients' performance of the target behaviours.
A Double-Blind Out-Patient Trial of Indalpine vs Mianserin
Authors: Naylor G. J. , Martin B.
Published: August 2008

Indalpine 150 mg per day and mianserin 60 mg per day were compared in a double-blind study of 65 depressed out-patients: 52 patients completed the 4-week trial. At the end of four weeks there was no significant difference in antidepressant effect between the two drugs; but in the first two weeks, improvement in the mianserin-treated group was significantly greater than that in the indalpine group. The mianserin-treated group reported more side-effects of sedation (eg. drowsiness, clumsiness, heaviness of limbs etc.) and one patient on indalpine developed a mild leucopenia.
Douglas House: a New Type of Hostel Ward for Chronic Psychotic Patients
Authors: Goldberg David , Bridges Keith , Sterling Chris , Hyde Clive , Cooper Winifred , Wyatt Rosemary
Published: August 2008

A new type of hostel ward is described in which domestic activities take the place of attendance at a day centre or industrial workshop. Residents no longer depend on the institution for meals, cleaning, or social activities. The programme is resident-orientated, and individual treatment plans are designed and effected using a points system. The emphasis of group activities is on communication and living skills. The hostel ward is able to care for our most disabled patients who are thought to need 24-hour nursing care.
The Validity of the SCL-90 in a Sample of British Men remanded to Prison for Psychiatric Reports
Authors: Wilson James H. , Taylor Pamela J. , Robertson Graham
Published: August 2008

The SCL-90 is a self-report inventory of psychopathology, which has not previously been validated in the UK. In the present study, the scale was found to correlate well with other measures of mental state, namely the Present State Examination (PSE) and the Comprehensive Psychopathological Rating Scale (CPRS). The scale was able to distinguish psychotic from non-psychotic patients on its paranoid ideation sub-scale, but not on its psychoticism one, nor any of its seven neurotic sub-scales. It is suggested that in research or population screening studies, this type of questionnaire should be supplemented with information relating to psychiatric history and motivation for treatment.
Nutritional State of Elderly Women on Admission to Mental Hospital
Authors: Hancock M. R. , Hullin R. P. , Aylard P. R. , King J. R. , Morgan D. B.
Published: August 2008

Since nutritional deficiencies might worsen the severity of symptoms and prolong the length of illness in non-nutritional disorders, particularly in the elderly, we examined the nutritional status of 216 elderly women newly admitted to a mental hospital. Compared to healthy elderly women, they had lower values for plasma prealbumin, vitamin C, and B vitamins. This was particularly common in senile dementia, and appeared to be the result of inadequate intake of protein or vitamins. Regular hospital diet for one month corrected the very low levels of prealbumin, but supplements were essential to remove deficiency of the water-soluble vitamins. Although vitamin supplements did not influence the length of stay in hospital, we did not exclude the possibility that nutritional deficiencies have a significant effect on the severity of mental illness.
The Dexamethasone Suppression Test and Suicidal Patients
Authors: Ennis Jon , Barnes Rosemary A. , Kennedy Sidney
Published: August 2008

The dexamethasone suppression test (DST) was used in an in-patient crisis unit to determine whether the test could identify suicidal patients who might benefit from tricyclic antidepressants. DST results, DSM-III diagnoses, and measures of symptom levels were obtained for 72 patients admitted for a 3–5 day period; 31 were non-suppressors. Abnormal DST results were not related to DSM-III diagnosis or to scores on measures of depression and symptom levels. Only three patients met DSM-III criteria for major depression with melancholia; 26 patients had a diagnosis of alcohol or substance abuse. The poor specificity of the DST in this patient population suggests that its routine use in such patients could be highly misleading.
Relatives as a Resource in the Management of Functional Illness
Authors: Kuipers Liz , Bebbington Paul
Published: August 2008

Though there is evidence that the burdens which people face when they live with someone suffering from a functional pyschiatric illness have a considerable effect on both relatives and patients, very little is done in routine clinical practice to help in dealing with them. However, intervention with relatives is both practicable and effective, and sufficient is now known to indicate tentative guidelines for involving relatives in the management of patients by the psychiatric services. Strategies are suggested for dealing with problems of this sort which are faced by relatives.
A Survey of the Regional Secure Unit Programme
Authors: Snowden Peter R.
Published: August 2008

Progress in building and opening permanent and interim secure units between October 1982 and March 1984 was surveyed. Reasons for the delays in implementing the secure unit policy recommended in the 1975 Butler Report are described, and comparisons made between the different Regional Secure Unit (RSU) designs, staffing policies, and Regional Forensic Service models. The development of this Health Service innovation has now reached the stage where the limiting factor to further progress is not building but finding suitable staff and paying their salaries. The secure unit programme will highlight another group of underprivileged patients who will require further Health Service innovation.
Definitions of Psychiatric Syndromes—Comparison in Hospital Patients and General Population
Authors: Sashidharan S. P.
Published: August 2008

Four sets of commonly used ‘operational definitions' of psychiatric disorders were applied to clinical information, obtained on the basis of semi-structured interviews with samples of hospital in-patients, out-patients, and general population. The agreement among them in defining ‘cases' and in assigning specific diagnostic categories was examined. There was considerable variation among the diagnostic systems in distinguishing between ‘cases' and ‘non-cases' and in identifying sub-groups of cases as having specific diagnoses. Comparison of operationally defined syndrome categories with diagnoses assigned by clinicians also showed much disagreement.
Electrophysiological and Hormonal Responses to Three Types of Electroconvulsive Therapy
Authors: Robin Ashley , Binnie Colin D. , Copas J. B.
Published: August 2008

Patients were treated with three different types of electroconvulsive therapy in random order in the first three sessions of their courses. Anaesthetic and muscle relaxants were administered in standard doses, and treatment applied a set time after bolus injection. Electroencephalographic recordings were undertaken before, during, and after treatment, and hormonal measures before and after. The responses to treatment differed between the three types of current in both EEG and prolactin measures. It is suggested that the quality of the convulsive response varies with different currents.
Life Events and Schizophrenia
Authors: Al Khani M. A. F. , Bebbington P. E. , Watson J. P. , House F.
Published: August 2008

Using an Arabic version of the PSE, supplemented by CATEGO, we selected 48 patients with acute schizophrenia from the population of the Najd region of Saudi Arabia. Their life-event histories for the six months before onset or relapse were compared with those of 62 control subjects. A postive association between events and onset was established only for married women, although there was a parallel trend for men and single women suffering their first schizophrenic episode. The observed impact of life events was limited to the three weeks before onset. These findings are discussed in the light of Saudi culture.
A Baseline Study on Mental Disorders in Guiné-Bissau
Authors: de Jong Joop T. V. M. , de Klein Guus A. J. , ten Horn Sineke G. H. M. M.
Published: August 2008

Adults attending general health facilities in Guiné-Bissau were screened for the presence of mental disorder; minimum estimate of definite mentally ill cases was found to be 12%. The proportion correctly identified by general health workers was low: only one of every three patients with a mental disorder was recognised and of every 100 non-cases 12 patients were wrongly diagnosed by the health worker as suffering from psychiatric illness. On the basis of these results health workers are now being taught how to detect mental illness.
Outcome of Patients Committed to Hospital under the Mental Health (Scotland) Act 1960
Authors: McKechnie A. A. , Corser Alison , McMillan Mrs V.
Published: August 2008

All patients formally detained in a Scottish psychiatric hospital between 1974 and 1979 were identified and their outcome determined 2½–8½ years later. A matched group, detained under Emergency Orders only, were also followed-up. Those formally detained had more previous psychiatric contact: functional psychoses were significantly more common in them. They remained in hospital longer, and required extensive community support when discharged. Those detained under Emergency Orders only, consisted of two sub-groups–one who left the area within two years of admission and could not be traced, and the remainder, who continued to require hospital treatment but for shorter times and with less continuous support. Amongst those detained, lack of insight was a predominant feature, which may create difficulty with regard to informed consent to treatment, given the present Amendments to the Mental Health Acts.
Should Plasma or Urinary MHPG be Measured in Psychiatric Research? A Critical Comment
Authors: Filser J. G. , Müller W. E. , Beckmann H.
Published: August 2008

Many experimental findings suggest that disturbances of noradrenergic neurons in the CNS are involved in the pathogenesis of depressive disorders. Moreover, evidence indicates that adaptive changes of central noradrenergic neurons contribute to the biochemical mechanism of action of most anti-depressive treatments (Goodwin, 1984; Johnstone, 1982). Accordingly, assessing the activity of central noradrenergic neurons in depressive patients has become important in psychiatric research.