bluuebunny/crossref_metadata_2025 huggingface dataset:
Decreased Imipramine Binding in the Brains of Patients with Depressive Illness
Authors: Perry E. K. , Marshall E. F. , Blessed G. , Tomlinson B. E. , Perry R. H.
Published: August 2008

The binding of tritiated imipramine was significantly reduced in the hippocampus and occipital cortex from a series of patients with depressive illness compared with age-matched patients with no psychiatric disorder. In contrast there was no change in imipramine binding in established cases of senile dementia of Alzheimer-type. Scatchard analysis indicated normal binding affinity but a reduction in the number of imipramine binding sites in depression. These observations parallel previous findings of decreased binding sites in platelets from depressed patients and suggest there may be an abnormality in the uptake mechanism for serotonin in depression.
A Psychiatric Service to the Remote Areas of Botswana
Authors: Ben-Tovim David I.
Published: August 2008

A psychiatric service was provided to the remote areas of Botswana by means of regular visits from psychiatrists and psychiatric nurses to the primary care facilities in those areas. The service was well used by the local health workers and general populations and encountered a substantial psychiatric morbidity. Studies in one region indicated that by using the primary care staff as case finders a substantial proportion of a total likely population of schizophrenic and epileptic patients could be bought into treatment. The specific conditions that enabled this service to become established are discussed.
Dreaming: The Functional State-Shift Hypothesis
Authors: Koukkou M. , Lehmann D.
Published: August 2008

The different brain functional states during sleep and wakefulness are associated with differences in processing strategies, memory stores, and EEG patterns. Shifts of functional state occur spontaneously or as orienting reactions to processed information, and cause the formal characteristics of dreams. Forgetting of dreams is a function of the magnitude of the difference between states during storage and recall. Based on EEG similarities between sleep stages and developmental stages, brain states during sleep in adults are proposed to correspond functionally with waking states during childhood. Repeated functional regressions occur during sleep, with access to earlier memory material and cognitive strategies unavailable during waking life, so that earlier experiences can be used for current problems. This dream work constitutes the biological significance of sleep.
Psychiatric Disorder in Women from an Edinburgh Community: Associations with Demographic Factors
Authors: Surtees P. G. , Dean C. , Ingham J. G. , Kreitman N. B. , Miller P. McC. , Sashidharan S. P.
Published: August 2008

The prevalence of psychiatric disorder was determined according to alternative diagnostic criteria in a random sample of 576 women from an Edinburgh community. Whichever diagnostic system was applied, significantly higher rates of disorder were found among the working class, the unemployed and women who were divorced, widowed, separated or cohabiting; in the subgroup of women who met all these conditions, up to half were found to satisfy the diagnostic criteria. The observed prevalence estimates can be explained as the effects of each demographic factor acting independently, no interaction effects being needed. Our results are discussed in relation to the findings of others, and in terms of the statistical issues involved.
First Rank Symptoms as Predictors of ECT Response in Schizophrenia
Authors: Koehler Karl , Sauer Heinrich
Published: August 2008

First rank symptoms (FRS) in association with affective features predict improvement on ECT. When affectivity was disregarded in 142 schizophrenic probands given ECT and the relationship between FRS alone and ECT response examined, those without FRS had a significantly better ECT outcome score than those with FRS. In various schizophrenic sub-samples, defined in terms of hypothesized predictive abilities of different sets of FRS, no differences came to light.
Low CSF Concentrations of Cyclic GMP in Schizophrenia
Authors: Gattaz W. F. , Cramer H. , Beckmann H.
Published: August 2008

Increasing evidence suggests that the concentrations of cyclic guanosine 3′5′-monophosphate (cGMP) in the cerebrospinal fluid (CSF) may reflect central cholinergic activity. When the concentrations of this nucleotide in the CSF from 28 schizophrenic patients (13 without and 15 with neuroleptic treatment) and 16 psychiatrically healthy controls was determined the schizophrenics showed significantly lower CSF levels of cGMP as compared to controls.

As dopamine and homovanillic acid concentrations were not altered in these CSF samples, this finding of reduced cGMP suggests a cholinergic-dopaminergic imbalance in schizophrenia, with a reduction of the former and consequently a relative dominance of the latter.
Eating Attitudes and Neurotic Symptoms in University Students
Authors: Clarke M. G. , Palmer R. L.
Published: August 2008

A postal survey of male and female university students is reported, using the Eating Attitude Test (EAT) and the Crown Crisp Experiential Index (CCEI). Eleven per cent of the 156 female respondents but none of 120 males scored above 30 on the EAT, thereby declaring eating attitudes comparable to anorexic subjects. Of those interviewed, none fulfilled diagnostic criteria for anorexia nervosa, but half showed eating disorder of clinical severity. There was a clear association between high EAT scores and higher scores on all the subscales of the CCEI except the phobic scale. The results are discussed in relation to ideas about the possible origins of clinical eating disorders.
USA: Michigan State University
Authors: Werner Arnold
Published: August 2008

Problems in psychiatric and psychosocial education arise from the absence of agreement on curricular content, failure to emphasize observable skill development, and the ambivalent views on psychosocial material found in modern medicine. The curriculum for medical students presented here emphasizes an integrated approach to teaching psychiatry and psychosocial material. Great emphasis is placed on interviewing and history-taking as well as on problem-solving. Specific courses in development, psychiatry and ageing are prescribed. Preclinical education in psychiatry emphasizes a bio-psycho-social view of mental disorder.
Undergraduate Medical Students in Denmark
Authors: Nystrup Jørgen , Rafaelsen Ole J.
Published: August 2008

The increasing role of psychiatry in the medical curriculum in Denmark is described. The general schedule of psychiatric teaching to medical students is outlined, emphasizing some of the special features of the Danish tradition. Roughly speaking, six per cent of all curriculum time is devoted to psychiatry. Clinical psychiatry, medical psychology and human sexuality are described separately. Interesting new possibilities for psychiatry in connection with a current curriculum reform, allotting more time to clerkships, elective periods and liaison teaching are pointed out.
The Frequency of Psychiatric Disorders among Patients Attending Semi-Urban and Rural General Out-Patient Clinics in Kenya
Authors: Dhadphale M. , Ellison R. H. , Griffin L.
Published: August 2008

The prevalence of psychiatric morbidity (PM) was studied among general hospital out-patients in a rural and in a semi-urban area of Kenya. There were no significant differences in the demographic features of psychiatric patients from the two areas, so the results were pooled: this gave a PM prevalence rate of 29 per cent among 388 patients. Anxiety and depression were the most frequent diagnostic categories. Alcoholism was more common in the rural than in the semi-urban area. There was no sex difference in the prevalence of PM and possible reasons for this, which is in contrast to western findings, are discussed.

Psychiatric symptoms could be readily elicited when present. Patients showing them had been ill longer than non-PM patients.

The study suggests that clinic staff not psychiatrically trained should be able to identify and treat psychiatric morbidity, even when it is presented as somatic illness.
Relationship between Neurosis and Personality Disorder
Authors: Tyrer Peter , Casey Patricia , Gall Joanna
Published: August 2008

316 psychiatric patients—predominantly out-patients—with a clinical diagnosis of neurosis (International Classification of Disease), were given an interview schedule for assessing personality disorders. Nearly two fifths were rated as having personality disorder, the anankastic type being the most common and sociopathic personality disorder the least. Patients with anxiety, phobic and obsessional neurosis were all significantly more likely to show personality disorder than those with depressive neurosis. Broadly, passive-dependent personalities were linked to anxiety neurosis, anankastic personality disorder to obsessional neurosis, and both anankastic and passive-dependent personalities to phobic neurosis. In a clinical trial of the efficacy of two dosage regimes of phenelzine in 60 patients the presence of personality disorder significantly impaired clinical outcome. The results suggest strongly that the assessment of personality in neurotic disorders is necessary to make an adequate diagnosis and predict the outcome of treatment.
The Treatment of Obsessive-Compulsive Disorder in Adolescence
Authors: Bolton Derek , Collins Suzanne , Steinberg Derek
Published: August 2008

The treatment of 15 adolescents with obsessive-compulsive disorder is described. Treatment was in most cases primarily behavioural (response-prevention), with the family involved in the therapy. Other components of treatment which were used in some cases are also described: medication, psychotherapy, and ‘milieu’ therapy. Outcome after treatment was generally good, with symptoms in most cases being relieved entirely or reduced to a mildly incapacitating level. Treatment gains in most cases were maintained at follow-up. Obstacles to treatment are noted, and recommendations are made as to the management of the disorder in adolescence.
Dexamethasone Suppression Test in Depression and other Psychiatric Illness
Authors: Coppen A. , Abou-Saleh M. , Milln P. , Metcalfe M. , Harwood J. , Bailey J.
Published: August 2008

The prevalence of an abnormal response to the dexamethasone suppression test (DST) was examined in 119 in-patients suffering from a major depressive disorder and in 79 normal controls. Only 11 per cent of controls showed an abnormal DST as against 70 per cent of depressed patients. The specificity of the DST was examined by testing patients with other psychiatric disorders. Abnormal responses were found in one-fifth of a sample of schizophrenics, over one-quarter of abstinent alcoholics, two-fifths of neurotics (including neurotic depressives) and almost half of senile dements. Abnormal DST was also found in 33 per cent of patients receiving prophylactic lithium for recurrent affective disorders.
The Effect of Beta Adrenergic Blocking Drugs on Speakers' Performance and Memory
Authors: Hartley L R. , Ungapen S. , Davie I. , Spencer D. J.
Published: August 2008

Propranolol 40 mg was compared with a matched placebo tablet in its effect on the performance of anxious and non-anxious human volunteers. Subjects were required to give a brief speech, which was video-taped and later rated by trained observers for signs of anxiety; propranolol clearly reduced rated anxiety in the non-verbal behaviour of anxious subjects, as well as the anxiety observed in the speech of the anxious compared to the non-anxious. It also affected self-reported anxiety in the anxious, and reduced the pulse rate of anxious and non-anxious alike. Subjects were also prompted, by being given the first letter, to recall both difficult and easy words, drawn from selected verbal categories; propranolol impaired recall of difficult items in the memory of anxious subjects. Results were interpreted as showing a central as well as peripheral role for propranolol in blocking adrenergic receptors' activity in anxiety.
A Cross-Cultural Investigation of Foulds' Hierarchy Model of Psychiatric Illness
Authors: Gilleard Esen
Published: August 2008

In order to investigate the validity of Foulds' hierarchical model of psychiatric illness a cross-cultural study was carried out. The DSSI, a self-report symptom inventory, was administered to 100 English psychiatric patients and a translated version was administered to 100 Turkish psychiatric patients. The report of symptoms in both nationality groups conformed to Foulds' hierarchy principles in 93 per cent and 87 per cent of cases respectively.

When the reporting of symptoms within classes was investigated, nationality effects were observed to influence the self-reporting of ‘hysterical’ neurotic symptoms, irrespective of diagnostic class. Nationality was also observed to influence the reporting of ‘delusional’ symptoms, but in non-psychotic patients.

These results suggest that Foulds' model is a useful one in cross-cultural psychiatry, because it indicates both the universal features of hierarchical ordering of symptoms and the cultural influence on those symptoms which do not define the diagnostic class of the patient.
Marital Coital Rates and Dominance
Authors: James William H.
Published: August 2008

Are heterosexual pairings in which the male is dominant more satisfactory? Coital rates of couples in which husbands were younger than their wives were contrasted with those in which husbands were older, but there was no significant difference. However, the data were not controlled for duration of marriage, and for a constant spouse-age-sum, couples with the husband the younger marry later on average than do the others. So whether younger-husband couples have lower coital rates is undecided.
Recurrent Post-Partum Psychosis
Authors: Kumar R. , Isaacs S. , Meltzer E.
Published: August 2008

Two women who both experienced a psychotic illness after each of three consecutive pregnancies are described. Subjects who are at high risk for post-partum psychotic breakdown offer an almost unique opportunity for prospective tests of hypotheses about the aetiology of severe mental illness.
The Causality of Depression in Schizophrenia
Authors: Galdi Joe , Hirsch Steven R.
Published: August 2008

The phenomenon of post-treatment depression in schizophrenia has become the subject of considerable controversy regarding its causality (Ananth and Chadirian, 1980; McGlashan and Carpenter, 1976a). But as the recent commentary by Hirsch (1982) emphasizes, the most controversial issue is focused on whether this depression is neuroleptic-induced. Hirsch himself refutes neuroleptic-induction on the basis of various uncontrolled data which seem ostensibly incompatible with this causality. Results indicating that pretreatment depressions appear in a high proportion of recently hospitalized schizophrenics, occur in drug-free patients, and frequently remit or decrease following neuroleptic therapy are cited as evidence contradicting neuroleptic-induction. Hirsch therefore proposes an alternative view: that this post-treatment depression is an integral, “revealed” aspect of the schizophrenia syndrome which arises from the same pathophysiological process (cf. McGlashan and Carpenter, 1976b).
“… and a small dose of an antidepressant might help”
Authors: Bridges P. K.
Published: August 2008

My association with the psychosurgical unit now carrying out over 80 per cent of these operations in Britain affords an unusual opportunity to assess the management of treatment-resistant affective disorders by a large number of psychiatrists from various parts of the country. The psychiatrists likely to refer patients for psychosurgery would be expected to be those more inclined to use psychotropic medication and physical treatments in general. Nonetheless, our experience is unequivocally of a widespread under-use of antidepressants. Most referral letters state that ‘… just about every antidepressant has been tried …’, but it is rare for the maximum dose of each drug used to be quoted. The letters suggest that with resistant illnesses the prescription of a series of drugs one after another at the usual doses is the therapeutic strategy, rather than giving one drug only in progressively increasing amounts to the limit of tolerance. Of course, the doses recommended by drug companies are understandably cautious and sometimes excessively so. For example, MIMS (November 1982) gives for “Anafranil” (Geigy); “More severe cases, 75 mg daily or more if necessary” and for “Surmontil” (M & B) “50–75 mg as single dose”.
Withdrawal Symptoms from Lithium
Authors: King J. R. , Hullin R. P.
Published: August 2008

Evidence from four case reports of heightened anxiety, irritability and emotional lability following withdrawal of lithium was confirmed by a questionnaire survey of 110 defaulters from a lithium clinic: 19 per cent of respondents retrospectively reported these temporary symptoms following withdrawal. The possible mechanisms of such a withdrawal effect are discussed, and a phased withdrawal is advocated in situations where continued clinical benefit from lithium is being evaluated. The questionnaire results also confirm anecdotal evidence that lithium reduces emotional responsiveness. The significance of these findings in terms of the current models of lithium's action is discussed.
Acute Lithium-Induced Tremor
Authors: Pullinger S. , Tyrer P.
Published: August 2008

It has recently been found that tremor in patients on long-term lithium therapy has a lower frequency than that of normal physiological tremor and is likely to have an extrapyramidal component (Tyrer et al, 1981). Other extrapyramidal signs and symptoms have been found with chronic lithium therapy (Shopsin and Gershon, 1975; Baastrup et al, 1976; Branchey et al, 1976; Asnis et al, 1979). These extrapyramidal effects differ from the pseudoparkinsonism produced by antipsychotic drugs in that they do not respond to antiparkinsonian drug treatment (Schou, 1970; Tyrer et al, 1980).
Use and Misuse of the PSE
Authors: Wing J. K.
Published: August 2008

The principles underlying the development of the Present State Examination and the instruments and computer programmes associated with it are discussed in the light of comments made in three recent papers by psychiatrists trained in the German tradition of clinical phenomenology. Many of their comments are cogent and highly relevant to the future development of the system. Some common misunderstandings are also considered; in particular, those that lead to results being interpreted outside the limits of the specifications laid down. The potential for improvement in the system is emphasized and the next stage of development briefly described.
Quantitative Computed Tomography in Elderly Depressed Patients
Authors: Jacoby Robin J. , Dolan Raymond J. , Levy Raymond , Baldy Robert
Published: August 2008

An index of brain tissue density was obtained from the CT scans of 37 elderly depressed patients by measuring Hounsfield Units (HU) in 12 predefined brain areas. Comparisons were made with 23 patients suffering from senile dementia and 36 healthy controls. As a group the depressed patients resembled the dements more than the controls, although analysis of variance indicated differences between all three groups, controls showing the highest HU values and dements the lowest. In the depressed patients ventricular dilatation, which had already been shown to predict increased mortality, was also associated with lower HU levels. The significance of these and other findings is discussed.
A Comparison of Alcoholics with and without Coexisting Affective Disorder
Authors: O'Sullivan K. , Whillans P. , Daly M. , Carroll B. , Clare A. , Cooney J.
Published: August 2008

Three hundred male Irish alcoholics were selected from 508 consecutive alcoholic admissions to hospital. Using well defined diagnostic criteria, they were divided into three subgroups (1) primary alcoholics, (2) alcoholics with secondary affective disorder and (3) those with primary affective disorder and secondary alcoholism. Although the three groups reported differences in past history and family history of affective disorder and in time spent in hospital for both alcoholism and affective disorder, there was little to distinguish them in behaviour associated with alcoholism or in family history of alcoholism. The implications of these findings and their significance for the relationship of affective disorder and alcoholism are discussed.
Dermatitis Artefacta in Mother and Baby as Child Abuse
Authors: Jones David P. H.
Published: August 2008

There has been attention drawn recently to those parents who deliberately harm their children in relatively unusual ways such as poisoning (Rogerset al, 1976; Lorberet al, 1980; Kempe and Heifer, 1980). Prognosis has been poor, with a high mortality rate for the children unless removed, and parental denial precluding any form of family rehabilitation.
Homosexuality and Lesbianism
Authors: West D. J.
Published: August 2008

Definitions

Homosexual behaviour often occurs among persons who do not have a settled homosexual orientation. Sometimes, as among prisoners, it can be the direct result of lack of contact with the opposite sex. Around puberty, especially among males, it may represent the easiest way of testing sexual performance. In Kinsey's great survey of American white males, 37 per cent had had at least some overt homosexual experience to the point of orgasm since adolescence, 10 per cent had been more or less exclusively homosexual for at least three years between ages 16 and 55, but only 4 per cent remained so all their lives. Kinsey regarded sexual preference as potentially changeable and a matter of degree, not the clear, permanent dichotomy that had been popularly supposed.
Paraphilias
Authors: Brown J. R. W. Christie
Published: August 2008

Particular instances of sexual deviation can not be discussed sensibly without first considering certain general issues.

The first of these is the question of definition. The notion of what constitutes abnormal sexual behaviour has changed in the course of history and indeed its boundaries have expanded and contracted at different times. What emerges from the history of the concept is that it has been defined by the social and moral climate of the time and indeed sexual deviance can be seen, for the most part, as a social rather than a medical concept (Bancroft, 1974).
Exhibitionism: A Clinical Conundrum
Authors: Snaith Philip
Published: August 2008

Genital exhibitionism is a disorder without a satisfactory explanation; many views have been put forward as to its nature but although fragments of some of these theories appear to be relevant to the problems of some individuals, for others they are incongruent with the clinical data. At the present time we must conclude that the behavioural act does not signify a homogeneous population and that in every parameter so far studied, be it personality structure, attitude to women, erotic gratification from the act, other deviant behaviour or whatever, there is no single unifying characteristic which is always to be found. The intention in this paper is not to make a broad survey of the disorder for that has been undertaken within the last fifteen years by, inter alia, Evans (1970) and Rooth (1971, 1980); the purpose is to draw attention to some of the more recent studies in order to dispel stereotyped views and thereby to avoid the pitfalls in deriving the formulation of each individual case.
Sex Crimes
Authors: Chiswick Derek
Published: August 2008

Crimes relating to sexual behaviour account for only 1 per cent of all indictable crimes but for half a century sex offenders have been the subject of a disproportionate amount of psychiatric interest and enquiry. The belief, that there is a link between specific mental malfunction and sex offending, as distinct from other forms of offending appears to have wide acceptance. In 1972 the Royal College of Psychiatrists appeared sufficiently confident of this view to ask candidates aspiring to membership of the College to “Give an account of the psychopathology of rape”. Like incest and buggery, rape is an act, a deed, an item of behaviour. To speak of the aetiology, treatment and prognosis of such acts is to misapply terminology and to confuse criminal behaviour with mental disorder. The problem is not simply one of semantic niceties for the sloppy use of medical language in this controversial area can lead jurists and policy-makers to carry expectations that lack any firm psychiatric basis. This contribution will attempt to review some legal and psychiatric aspects of the more serious crimes.
Identical Triplets with Asperger's Syndrome
Authors: Burgoine Eyrena , Wing Lorna
Published: August 2008

The case histories are presented of three 17 year old identical male triplets with Asperger's syndrome. They show the impairments affecting social interaction, non-verbal communication and imagination, the motor clumsiness, and the circumscribed interests characteristic of that condition. They also have some features in their history and present behaviour more typical of childhood autism. Despite marked overall similarities, the three differ in the severity with which their problems are manifested. A relationship can be found between the amount of peri- and post-natal trauma, degree of intellectual impairment and number of autistic features. The findings support the hypothesis that autism and Asperger's syndrome are on the same continuum of pathology.
Hypertension, Multi-Infarct Dementia and Alzheimer's Disease
Authors: Clair D. St. , Whalley L. J.
Published: August 2008

Retrospective review of 89 patients with pre-senile dementia followed by necropsy indicated significant differences between sub types of dementia. Patients with multi-infarct dementia (MID, 27 subjects) more often had cardiovascular abnormalities than patients with Alzheimer's disease (46 subjects). No patients with MID alone had a systolic blood pressure below 140 mm Hg, whereas 23 of 46 Alzheimer subjects and three of 16 patients with mixed features had such a systolic pressure.
Dexamethasone Suppression Test and Serum Prolactin in Dementia Disorders
Authors: Balldin Jan , Gottfries C-G. , Karlsson I. , Lindstedt G. , Långström G. , Wålinder J.
Published: August 2008

The dexamethasone suppression test (DST) was performed on 21 patients with dementia of the Alzheimer type (DAT), 11 patients with multiinfarct dementia (Ml) and 14 healthy controls. Twelve of the DAT patients and eight of the Ml patients showed abnormal lack of suppression, compared with just one member of the control group. Abnormal DST was related to dementia as such and not to age or depression, or to levels of CSF monoamine metabolites. Basal serum prolactin concentrations were not increased.
Management and Outcome in Anorexia Nervosa
Authors: Morgan H. G. , Purgold Joan , Welbourne Jill
Published: August 2008

The outcome of 78 patients with anorexia nervosa treated in a special clinic is described, using a standardized follow-up technique. The findings are compared with two previous studies which utilized an identical evaluation procedure. Certain predictors of poor outcome already identified by previous studies (long duration of illness before referral, previous personality problems, difficulties in relationship between family and patient) are confirmed. The findings suggest that early intervention may be an important component of effective treatment. The possible advantages of long term continuity of outpatient care are also discussed and the need for careful scrutiny of criteria for hospital admission emphasized.

It is concluded that chronic morbidity due to anorexia nervosa represents an important topic for further research. There is need for further identification of factors associated with chronicity, some of which may be secondary repercussions of the illness itself, and prospective evaluation of treatment programmes which focus on predictors of poor outcome.
Cognitive Vulnerability to Auditory Hallucination
Authors: Heilbrun Alfred B. , Blum Nancy , Haas Marilyn
Published: August 2008

Goldstone and Sarbin proposed that auditory hallucinations occur because imagery in a non-preferred sensory mode is more easily misinterpreted as having an external origin. This led to the hypothesis that auditory hallucinators would show less preference for auditory than for visual imagery. Our results suggest that this is true. We also compared the vividness of internally-generated auditory imagery with that of visual imagery, independently of preference, to see whether vividness was impaired in the non-preferred mode in hallucinators. The evidence suggested that this was not the case, but we did find a significantly deficient capacity for creating vivid images of either kind in process patients (i.e. those with poor premorbid status) compared with reactive (good premorbid) patients, regardless of any history of hallucinations. The withdrawal of external attention which characterizes process patients might also be expected to impair their ability to confirm or disconfirm the external origin of an auditory stimulus. We predicted therefore that process hallucinators would be particularly incompetent in spatial location of sounds: our experimental results confirmed this to be the case.
Pemoline induced Chorea and Gilles de la Tourette's Syndrome
Authors: Bonthala Chandra Mohan , West Albert , Bonthala Chandra Mohan , West Albert
Published: August 2008

Pemoline is a central nervous system stimulant, with pharmacological effects resembling amphetamine and methylphenidate in increasing central dopamine transmission (Fuxeet al, 1970; Sheel-Kurge, 1971).
The Two-Way Trade—Psychiatry and Neuroscience
Authors: McHugh Paul R. , Robinson Robert G.
Published: August 2008

As scientific technologies become more sophisticated, clinicians may come to think that they must devolve into passive recipients rather than contributors to the advances in basic knowledge. This perception and accompanying modesty towards the neurosciences, however, is an error. The intellectual trade between clinician and bench scientist has always been bi-directional and nowhere is this more clearly evident than in recent interactions between psychiatry and neuroscience.
Are there Anticompulsive or Antiphobic Drugs? Review of the Evidence
Authors: Marks Isaac
Published: August 2008

Review of 19 uncontrolled studies of antidepressants in phobic and in obsessive-compulsive disorders suggests that such drugs do not act reliably in the absence of symptoms of anxiety-depression (dysphoria). In dysphoric patients the drugs have a broad-spectrum effect not only reducing phobias and rituals but also anxiety-depression, panic, anger, and hostility, all of which are highly intercorrelated, but none yet demonstrated to be the core disturbance. Phobics, but not obsessive-compulsives, have an unusually high dropout rate from treatment when drugs or placebo are given. When antidepressants are stopped, even after 6–8 months, relapse is likely. The drugs do not reduce the liability of many phobics and obsessive-compulsives to have dysphoric episodes over the years. Exposure treatments are more lastingly effective for phobias and for rituals, but do not reduce the liability to later dysphoric episodes.
Pharmacological Treatment of Agoraphobia
Authors: Mavissakalian Matig , Michelson Larry , Dealy Robert S.
Published: August 2008

Eighteen agoraphobic patients were randomly assigned to 12 week treatment with imipramine (I) or imipramine and programmed in-vivo exposure practice (l+BT) to investigate the contribution of behavioural instructions to the clinical effects of pharmacotherapy. Significantly greater improvement on phobic measures was found in the l+BT group compared to the I group. Differences were less marked on measures of panic and anxiety. The results suggest that imipramine possesses an antiphobic effect which can be substantially enhanced with programmed practice. Controlled large-scale investigations of the pharmacological and instructional effects of the pharmacotherapy of agoraphobia are needed for a definitive evaluation of the specific antiphobic effect of antidepressant drugs.
A Survey of the Criminal Careers of Restriction Order Patients
Authors: Gibbens T. C. N. , Robertson G.
Published: August 2008

The offenders committed to local hospitals in 1962 and 1964 under a hospital order with restriction of discharge were followed up for 15 years with regard to subsequent court appearances, hospital admissions, and death. One hundred and forty-six were traced. Of these, 49 per cent had been diagnosed as mentally ill: most of this group were committed for violent offences. Thirty-five per cent were mentally subnormal: they were frequently committed for sexual offences, arson and property offences. Twelve per cent were diagnosed psychopathic: this group had a wide variety of committal offences.

Fourteen per cent of the mentally ill and 17 per cent of the mentally subnormal were still in hospital after 15 years, but 51 per cent of the mentally ill and 36 per cent of the mentally subnormal were released within three years. Sixty-one per cent of the psychopaths were released within two years. Few of the subsequent offences were serious in any of the diagnostic groups.

Since 1973 there has been a dramatic fall in restriction orders, especially for mentally subnormal patients.
The Interaction of Seasonality, Place of Birth, Genetic Risk and Subsequent Schizophrenia in a High Risk Sample
Authors: Machón Ricardo A. , Mednick Sarnoff A. , Schulsinger Fini
Published: August 2008

Births occurring in winter months, which are high viral infection months, have been repeatedly shown to produce a slight excess of later-diagnosed schizophrenics. As a result, some researchers have speculated on the possible aetiological effect of viral infections on some forms of schizophrenia. The implications of the viral hypothesis were indirectly tested in the context of an ongoing prospective study of Danish children at high-risk (HR) for schizophrenia. A third-order analysis of variance interaction was hypothesized. Genetically vulnerable individuals, born in winter, in an urban environment (which increases the likelihood of the presence and transmission of viruses) would be more likely, as foetuses or neonates, to have suffered some CNS damage due to the infection; thus they would show higher rates of schizophrenia diagnoses. This hypothesis was supported. The rate of schizophrenia in the HR-urban-winter birth condition reached 23.3 per cent, considerably above population base rates (1 per cent) or rates for the HR subjects (8.9 per cent). Alternative explanations for the results were explored.
Risk Factors in Schizophrenia: Season of Birth in Maryland, USA
Authors: Pulver Ann E. , Stewart Walter , Carpenter William T. , Childs Barton
Published: August 2008

The association between the risk for schizophrenia and season of birth was studied using a standard actuarial life table method. This method of analysis eliminates the possibility of the previously described statistical artifacts from the data. An increased risk for schizophrenia for winter born individuals was demonstrated. The analyses also supported the hypothesis that season of birth is associated with an increased risk for a subtype of schizophrenia.
The Aetiological Importance of Stressful Life Events
Authors: Cooke D. J. , Hole D. J.
Published: August 2008

Despite a large research effort, there is still some doubt whether life events can increase the rate of psychiatric morbidity. It is argued that this doubt arises from a confusion between measures of goodness of fit and measures of causal importance. The distinction between these types of measures is discussed.

Epidemiological studies of life events and psychiatric cases are reviewed. It is argued that, in general, 32 per cent of psychiatric cases can be attributed to stressful life events. Within female samples, approximately 41 per cent of psychiatric cases can be attributed to life events. It is suggested that the effect of specific types of events on specific psychiatric disorders may be of even greater importance.
On Informed Consent
Authors: Hamilton Max
Published: August 2008

The tradition of medical practice is based on the assumption that the patients come to the doctor for professional advice and service. Having done so, they have the right to reject the advice or refuse the service, and to go elsewhere. There are a few exceptions to this general rule. Children do not come to doctors, they are brought to them. In that case, the rights pertain to the parents. Persons who are so seriously injured or ill that they cannot exercise their judgement, will be brought for treatment, and it is then assumed that the doctors will use their professional judgement and do their best, considering the circumstances, for them. This applied also to those patients who were mentally disturbed in such a way that they could not make proper decisions.
The Scottish Survey of ‘New Chronic’ Inpatients
Authors: McCreadie Robin G. , Wilson A. Oliver A. , Burton Leslie L
Published: August 2008

All ‘new chronics' (N = 571), defined as patients aged 18–64 years in hospital more than one but less than six years, were identified in 14 psychiatric hospitals serving 56 per cent of the Scottish population. The bed occupancy was 20/100,000 of the general population (range between hospitals 12–29/100,000). First admissions (5.8 beds/100,000) were clearly distinguished from re-admissions. Although for the whole group schizophrenia was the most common diagnosis the majority of first admissions had organic brain disease. First admissions were more disabled and most were well placed in hospital. Thirty-eight per cent of all patients did not need inpatient care; 20 per cent could have been accommodated in staffed hostels. Widespread differences, especially in numbers, found between hospitals may have been due in part to different attitudes among staff towards the prospect of patients' discharge.
Predictability as an Index of Impaired Verbal Communication in Schizophrenic and Affective Disorders
Authors: Ragin Ann Barnett , Oltmanns Thomas F.
Published: August 2008

The cloze procedure was used to examine predictability in speech samples from schizophrenic, depressive, manic, schizoaffective and normal subjects. Each speech sample was also rated for particular indices of thought disorder using the Andreasen Scale for the Assessment of Thought, Language and Communication. Schizophrenics were found to be less predictable than other patient groups or normals. Depressives were found to be the most predictable. Correlational analyses of cloze scores and specific thought disorder ratings suggest that reduced predictability is associated with traditional indicators of thought disorder.
The Withdrawal of Benztropine Mesylate in Chronic Schizophrenic Patients
Authors: Baker Linda A. , Cheng L. Y. , Amara I. B.
Published: August 2008

In this double-blind, four-week study, 28 chronic schizophrenic patients receiving neuroleptic medication plus the antiparkinsonian drug, benztropine mesylate, were either switched to placebo or maintained on benztropine. Patients withdrawn from benztropine reliably increased their overall scores on the Wechsler Memory Scale in comparison with the drug group. Sub-test scores suggest that deficits in attention and concentration were induced by treatment with benztropine. Psychotio decompensation appeared to develop simultaneously with extrapyramidal symptoms (EPS) in some patients, but only 14.2 per cent of the placebo group experienced extrapyramidal symptoms severe enough to require resumption of benztropine therapy. It is suggested that antiparkinsonian agents should be prescribed only if and when EPS occur.
Caffeine and Cerebral Blood Flow
Authors: Mathew Roy J. , Barr Deborah L. , Weinman Maxine L.
Published: August 2008

Two groups of normal volunteers had regional cerebral blood flow (rCBF) measured, by the133Xenon inhalation technique, before and 30 minutes after 250 mg or 500 mg caffeine given orally. rCBF was measured in a third group of subjects, twice, at a similar interval under identical laboratory conditions. Subjects who received caffeine showed significant decreases in rCBF while the others showed no rCBF change from the first to the second measurement. However, the two caffeine groups did not differ in degrees of rCBF reduction. There were no regional variations in the post-caffeine decrease in cerebral blood flow. The three groups did not show significant changes in end-tidal carbon dioxide, pulse rate, blood pressure, forehead skin temperature and respiratory rate.
Effects of ECT on Pituitary Hormone Release: Relationship to Seizure, Clinical Variables and Outcome
Authors: Deakin J. F. W. , Ferrier I. N. , Crow T. J. , Johnstone E. C. , Lawler P.
Published: August 2008

Prolactin, Cortisol, growth hormone and TSH serum levels (before and 15 minutes after treatment) were measured in 62 patients with endogenous depression randomly allocated to real or pseudo-ECT. Prolactin increased significantly more in those receiving real ECT than in those receiving pseudo-ECT, but the size of this effect had diminished by the time of the last (8th) treatment in the trial. Cortisol secretion was also significantly increased following the first treatment by real ECT, but this increase was of significantly smaller size in patients with delusions. Tolerance to the effects of ECT on Cortisol secretion was not observed. No effects of ECT on growth hormone or TSH secretion were detected, and no clear evidence was obtained that endocrine responses can be used as a predictor of response to ECT.
A Prospective Study of Emotional Disorders in Childbearing Women
Authors: Kumar R. , Robson Kay Mordecai
Published: August 2008

A group of first-time mothers (119) were interviewed repeatedly at fixed intervals during their pregnancies and until their babies were a year old; they were then followed up at four years. A similar investigation was carried out on 38 other primiparae and 39 multiparae, but only postnatally.

The incidence of depressive neurosis rose significantly in early pregnancy and in the first three months after delivery (10 per cent and 14 per cent of the main sample respectively). Subjects mainly suffered either from antenatal or postnatal depression, not both. Marital conflict and severe doubts about having the baby were associated with depression at either time. Bereavement and preterm birth were the only life events to relate with the onset of depression and bereavement had a greater impact during pregnancy.

Depressed mothers were more likely to express negative or mixed feelings about their three-month-old babies. Many who had become depressed for the first time in their lives continued to experience psychological problems for up to four years after childbirth.
Oxypertine in Tardive Dyskinesia: An 8-week Controlled Study
Authors: Soni S. D. , Freeman H. L. , Hussein E. M.
Published: August 2008

In a double-blind placebo controlled trial of oxypertine in the treatment of tardive dyskinesia, 33 patients with chronic schizophrenia received either oxypertine or placebo. At the end of eight weeks, the results showed that oxypertine was superior to placebo at a statistically significant level.
Recent Trends in Suicide Amongst the Young
Authors: McClure G. M. G.
Published: August 2008

Suicide is rare under 14 years but thereafter increases with increasing age, with males predominating. The suicide rate for 15–19 year olds in England and Wales has increased since the nineteen fifties for both males and females, with a recent substantial rise in males. There has also been an increase in the small number of female suicides aged 10–14 years between 1941–50 and 1971–80. In younger age groups there is a higher proportion of undetermined deaths compared with officially recorded suicides, and this category has recently increased disproportionately in the young. The number of deaths by poisoning with solids or liquids recorded as suicide, accidental poisoning or undetermined poisoning has increased markedly in young people, and the relationship between the three groups might repay investigation.
Estimating Suicide Risk Among Attempted Suicides
Authors: Pallis D. J. , Gibbons J. S. , Pierce D. W.
Published: August 2008

We predicted that the closer the resemblance of attempted suicide to completed suicide, the greater the risk of patients later killing themselves after an unsuccessful attempt. Using two risk scales, one of 6 and the other of 18 socio-demographic and clinical items, weighted according to their value in discriminating between suicides and attempted suicides, and a rating of intent to die during the index suicide attempt, we followed up 1263 attempted suicides for two years. Ten of the twelve suicidal deaths in the first year occurred in patients scoring in the top quartile on the 6-item scale; and among high-risk scorers there was an excess of those defined as ‘failed suicides' at the index attempt. The 18-item scale was superior to the shorter one, but both scales were improved by taking into account the rating of intent-to-die. The potential value of these findings is discussed in the light of some inherent problems of predicting suicide in the clinical setting.
Comparison of Delinquent Boys and Girls in Group Homes and Factors Associated with the Outcome
Authors: Kashani Javad H. , Daniel Anasseril E. , Reid John C. , Sirinek Alan J.
Published: August 2008

One hundred boys and girls who were placed in two group homes by court order were studied. The girls were admitted mostly for status offences while the boys were admitted for offences to property and persons. Over half of the sample had an immediate family member who had committed a serious crime. This group differed in several ways from the group with no family history of crime. When the outcome of the entire sample was investigated, it was found that there are some indicators that could be used as predictors for the outcome in a delinquent population. This could have a definite clinical application.
The Ventricular System in Chronic Schizophrenic Patients
Authors: Pandurangi Anand K. , Dewan Mantosh J. , Lee Seungho Howard , Ramachandran Tarakad , Levy Benjamin F. , Boucher Michael , Yozawitz Allan , Major Leslie , Pandurangi Anand K.
Published: August 2008

Twenty-three chronic schizophrenic patients and 23 controls, all males between 20 and 40 years of age, were evaluated by CT scan. The lateral, third and fourth ventricles, the Sylvian fissures, and the largest sulcus from each of the frontal, parietal, and occipital lobes, were measured in order to determine whether the previously reported ventriculomegaly in schizophrenics was perhaps due to a disturbance of CSF flow or to atrophy, two common causes of ventricular enlargement. We found that in the schizophrenic group the third and fourth ventricles and both Sylvian fissures were significantly enlarged, but not the lateral ventricles or cerebral sulci. Our data suggest that these ventricular changes are not due to a disturbance of CSF flow or to cerebral atrophy. Other possible explanations are discussed.
Comparison of Borderline Personality Subcategories to Schizophrenic and Affective Disorders
Authors: Andrulonis Paul A. , Vogel Naomi
Published: August 2008

This clinical research report identified 4 subcategories of the hospitalized borderline personality disorder: developmental, affective disorder, attentional deficit/learning disabled, and organic. Developmental and affective disorder subcategories are predominantly composed of females, while males are overly represented in the attentional deficit/learning disabilities subcategory. Comparison of the borderline patients with schizophrenic and affective disorder control groups supports the hypothesis that the borderline personality disorder is a diagnostic entity distinct from schizophrenia, but perhaps not from affective disorders.