bluuebunny/crossref_metadata_2025 huggingface dataset:
Transvaginal sonographic measurements of postmenopausal ovarian volume as a possible detection of ovarian neoplasia
Authors: Zalel Yaron , Tepper Ron , Altaras Marco , Beyth Yoram
Published: November 2007

Background. The purpose of our study was to determine whether ovarian volume, as measured by transvaginal ultrasound and plotted on the nomogram of normal postmenopausal ovarian volume, could assist in the diagnosis of ovarian neoplasia.

Methods. A retrospective study was undertaken, in which the ovaries of 85 postmenopausal women were examined by transvaginal ultrasonography prior to laparotomy. Three dimensions of each ovary were measured and ovarian volume was calculated. The results were plotted on the nomogram of normal postmenopausal ovarian volume.

Results. Eighty‐five ovarian tumors were diagnosed. The range of the mean ovarian volume varied between 98.15 cm3 to 161.81 cm3 from perimenopausal age to >15 postmenopausal years, as compared to 2.21.4 − 8.6±2.8 cm in the normal postmenopausal women. The deviation from the normal volume was more striking in the malignant tumors group (100%) than in the benign group (86%). When plotted on the nomogram, these values showed significant deviation (above 2 s.d.) from the norm for each group of neoplasms in every menopausal age.

Conclusions. Sonographic detection of abnormal postmenopausal ovarian volume and the demonstration of the deviation from the ovarian volume nomogram, could assist the physician in early diagnosis of ovarian neoplasia. Ovarian volume measurements can serve as the primary method leading to diagnosis of ovarian cancer.
Diagnostic accuracy of 2 mm microlaparoscopy
Authors: Haeusler Guenther , Lehner Rainer , Hanzal Engelbert , Kainz Christian
Published: November 2007

Objective. To assess the diagnostic accuracy of a 2 mm microlaparoscope compared to the conventional 10 mm laparoscope.

Design. A prospective study.

Patients and methods. Fifty‐two patients underwent 2 mm and 10 mm laparoscopy in the same session. All procedures were videotaped and the quality of visualization for both methods was assessed by an independent investigator using a 3‐step grading scale.

Results. Diagnostic information was found to be similar for both methods.

Conclusion. In most cases undergoing laparoscopy for diagnostic purposes 2 mm microlaparoscopy yields sufficient information to abandon the conventional 10 mm technique.

Fifty‐two patients were laparoscoped with the 2 mm and the 10 mm system in the same session. Diagnostic information was found to be similar for both methods. The present study demonstrated that in most cases 2 mm microlaparoscopy yields sufficient information to abandon the conventional 10 mm technique.
Expression of interleukin‐8 receptors in the gestational tissues before and after initiation of labor: Immunohistochemical study
Authors: Maradny Emad El , Kanayama Naohiro , Maehara Kayoko , Kobayashi Takao , Terao Toshihiko
Published: November 2007

Background. Interleukin‐8 (IL‐8) has an essential role in the mechanism of parturition. IL‐8 induces its effect through specific cell binding receptors. The main purpose of this research was to elucidate the presence of IL‐8 receptors in the gestational tissues and their relation to parturition.

Materials and methods. Fetal membranes, placenta, umbilical cord and myometrial samples were collected before the initiation of labor during elective Cesarean sections (n=15). Similar biopsies (except myometrial samples) were also gathered after normal vaginal delivery (n= 15). Immunohistochemical staining for IL‐8 receptors type I and II was carried out for the fresh frozen sections of all samples. Immunoreactive score (IRS) was calculated for the stained sections.

Results. IL‐8 Receptors type I and II were recognized in the fetal membranes, placenta, umbilical cord and myometrial samples collected from patients before the initiation of labor. The staining of amnion and placentas were found to be more intensified in the samples collected after vaginal delivery compared to those from elective cesarean sections and before initiation of labor.

Conclusions. Increased expression of IL‐8 receptors after initiation of labor may indicate that IL‐8 receptors might have a role during parturition.
Infertile women with and without endometriosis: A case control study of luteal phase and other infertility conditions
Authors: Matorras Roberto , Rodríguez Fernando , Pérez Carlos , Pijoan Jose Ignacio , Neyro Jose Luis , Rodríguez‐escudero Francisco Javier
Published: November 2007

Objective. To assess the relationship in infertile women between endometriosis and luteal phase defects and other infertility conditions.

Setting. University Medical School.

Design. Case‐control study.

Patients. One hundred and seventy‐four infertile women with endometriosis and 174 infertile women without endometriosis, all of them studied by laparoscopy. The inclusion criteria were failure of six cycles of ovulation stimulation or abnormal preliminary study (abnormal pelvic physical, hysterosalpingographic or ultrasound findings).

Results. The frequency of out‐of‐phase biopsies (16.1%vs 16.7%) as well as other endometrial abnormalities were similar in endometriosis associated infertility (EAI) and in non‐endometriosis infertility (NEI). Mean progesterone and prolactin levels, as well as the proportion of abnormal progesterone levels (37.4%vs 44.3%) and of hyperprolactinemia (12.9%vs 13.2%) were similar in EAI and NEI. The frequency of uterine myomas was similar in both groups. Sperm characteristics were not better in EAI than in NEI. Higher endometriosis stages were not associated with a higher frequency of the aforementioned conditions.

Conclusion. Luteal phase defects, sperm abnormalities and myomas are no more common in EAI than in NEI or in advanced stages of endometriosis.
Infertility and subfertility in Norwegian women aged 40‐42 Prevalence and risk factors
Authors: Sundby Johanne , Schei Berit
Published: November 2007

Background. There are few population estimates of the prevalence of infertility that also include some information about medical conditions and social classification of study objects. This is a study of 4034 out of a total of 5139 (78% of all invited) women in one county of Norway.

Methods. All female inhabitants born 1950 to 1952 living in the county were invited to participate in a health screening. The screening comprised a clinical screening and two questionnaires; one about reproductive history and infertility.

Results. This survey found permanent primary infertility in 2.6% of the women. Subfertility, as at least one year's delay of pregnancy, was reported by 7.7%. A history of different reproductive problems was associated with impaired fertility. Thirty‐two percent of primary infertile women had a history of PID, 13% had experienced amenorrhea and almost 40% reported premenstrual tension, compared with lower frequencies in women with normal fertility (11.0%, 3.3% and 29.4% respectively).

Conclusions. Up to 10% of the female population may experience infertility at one stage in their reproductive career. Clinicians should pay special attention to women presenting any genital or reproductive disorder regarding risks for future fertility impairment.
Effects of thyroxine therapy on bone metabolism in postmenopausal women with hypothyroidism
Authors: Affinito Pietro , Sorrentino Claudia , Farace Maria Jussie , di Carlo Costantino , Moccia Gianfranco , Canciello Pasqualina , Palomba Stefano , Nappi Carmine
Published: November 2007

Objective. To evaluate whether thyroid stimulating hormone‐suppressive thyroxine replacement therapy increases bone loss in postmenopausal women.

Materials and method. The study had a cross‐sectional design. Fifty‐four postmenopausal women on long‐term treatment with thyroxine for primary hypothyroidism, who showed suppressed thyroid stimulating hormone levels were enrolled in our study. In these patients and in a control group of 54 healthy postmenopausal women we evaluated bone mineral density at distal radius and the main biochemical parameters of bone turnover. Student's t test, Wilcoxon signed rank‐test, Chi‐square test and the univariate linear regression in the statistical analysis of the data were employed.

Results. Bone mineral density values, expressed as z‐scores, in the treated group were significantly decreased in comparison with the control group (p<0.01). We did not detect a significant relationship between different L‐thyroxine doses administered and bone mineral density z‐scores. On the contrary, an inverse correlation was detected between length of treatment and bone mineral density z‐scores. Treated patients showed a significantly higher concentration of serum alkaline phosphatase, osteocalcin, urinary calcium/creatinine and hydroxyproline/creatinine in comparison with the controls.

Conclusions. Our study suggests that thyroxine replacement therapy in patients with suppressed thyroid stimulating hormone levels increases postmenopausal bone loss.
Prediction of genital prolapse after Burch colposuspension
Authors: Kjølhede Preben , Rydén Gunnar , Norén Bengt
Published: November 2007

Objective. The aim of this prospective observational study was to investigate the gynecological and defecographic features in women with stress urinary incontinence operated with Burch colposuspension in order to analyze if the findings could predict subsequent development of genital prolapse.

Subject. Twenty‐one women with urodynamically proven genuine stress urinary incontinence were consecutively operated with the Burch colposuspension during 1991‐1992. No concomitant prolapse repair surgery was performed.

Methods. All were carefully examined in the lithotomy position at rest and with the Valsalva maneuver. The pelvic floor laxity was graded semiquantitatively. The defecography and the clinical examination were done preoperatively and repeated one year postoperatively.

Results. The clinical examination revealed a significant progression of rectoceles (p=0.003) after the colposuspension. The colposuspension cured a significant number of cystoceles (p=0.035). Six women (29%) had subsequent corrective prolapse surgery median 2 years after the colposuspension.

The defecographic measurements showed a significant increase of the recto‐vaginal distance (RVD) following the operation (p=0.020). At the postoperative measurement the group with subsequent prolapse surgery had a significantly larger RVD as compared to the group without further surgery (p=0.004). The kappa reliability test showed poor agreement between the defecographic and clinical assessment of the rectoceles.

Conclusion. We failed to find any clinical or defecographic characteristic which could predict the development of surgery‐demanding genital prolapse following colposuspension. The colposuspension seemed to accelerate the deterioration of the pelvic floor. However, only a minority of the patients developed symptomatic genital prolapse demanding corrective surgery. We suggest that only women with symptomatic prolapse should be considered for concomitant corrective surgery at the time of the colposuspension.
DNA ploidy of ectopic pregnancy and first trimester spontaneous abortion investigated by flow cytometry
Authors: Erel Cemal Tamer , Kaleli Semih , Oral Engin , Engür AyE , Eren Tuncer , Calay Zerrin , Aydinli Kili
Published: November 2007

Background. To compare the success rate of DNA flow cytometry in determining the DNA ploidy status in ectopic pregnancy and first trimester spontaneous abortion.

Methods. Thirteen women with ectopic pregnancy (Group I) and 17 women with first trimester spontaneous abortion (Group II) were included into this study. DNA flow cytometric analysis was performed on all specimens. Aneuploidy was classified according to DNA index. The first trimester spontaneous abortions were also karyotyped after long‐term culture of chorionic villi. Student‐t test and Fisher's exact test were used in statistical comparisons.

Results. DNA aneuploidy was found in five women with ectopic pregnancy (38.5%) versus in 12 women with first trimester spontaneous abortion (70.6%), and it was comparable. A triploidy and a tetraploidy were detected in group I. Six tubal ectopic pregnancies were unruptured at laparatomy and four of them had aneuploid DNA content.

Conclusions. We believed that DNA flow cytometry was successful in determining the ploidy status of ectopic pregnancy and first trimester spontaneous abortion. In addition, it was interesting that ectopic pregnancies with aneuploid DNA content tended to be unruptured. However, this suggestion needs to be confirmed by further studies with larger numbers of cases.
Maternal renal artery blood flow velocimetry in normal and hypertensive pregnancies
Authors: Kublickas Marius , Lunell Nils‐Olov , Nisell Henry , Westgren Magnus
Published: November 2007

Objective. To investigate the effect of normal pregnancy and hypertensive disorders of pregnancy on the maternal renal artery Doppler blood flow velocity indices.

Methods. The patient material consisted of 30 normal pregnant women, 29 women with pregnancy induced hypertension, 43 women with preeclampsia and 22 pregnant women with chronic hypertension. Blood flow velocities in the segmental renal arteries from the right kidney were analysed by pulsed and color Doppler. The systolic/diastolic (s.d.) ratio, resistance index (RI) and pulsatility index (PI) were used for Doppler waveform analysis.

Results. In all of the groups of hypertensive pregnant women renal artery Doppler indices were significantly lower compared to the normal pregnant women group. There was a significant negative relationship between renal artery PI and mean arterial pressure in the preeclampsia group and in the chronic hypertension group.

Conclusion. The present results demonstrate that the mechanism of renal autoregulation in preeclampsia might be altered, leaving glomerulus unprotected from increased blood pressure. It seems that the concept of renal vasoconstriction in preeclampsia might be disputed and needs further investigation.
Nasal spray bromocriptine: Effects on serum prolactin in puerperal women
Authors: Cicinelli Ettore , Petruzzi Donatina , Ragno Gaetano , Schönauer Luca Maria , Ruccia Carmela , Matteo Giuseppina
Published: November 2007

Background. The objective of this study was to investigate the effectiveness of a single nasal spray administration of 0.8 mg bromocriptine in reducing PRL serum levels.

Methods. Eighteen physiologically hyperprolactemic women in the early days of puerperium were randomized to receive nasal bromocriptine or placebo; PRL serum levels were measured by RIA at 45, 30 and 15 minutes before the administration and after the following times: 15, 30, 45, 60, 120, 180, 240, 300, and 480 minutes.

Results. After the administration of bromocriptine serum levels of PRL decreased rapidly; the reduction was statistically significant after 45 minutes. Four hours after the administration mean serum levels of PRL resulted in the normal range (<20 μg/1); at the eighth hour the PRL levels were still normal. No one patient complained of any local or systemic side‐effects.

Conclusion. Nasal route seems to be an effective and probably safe administration route for bromocriptine.
Effect of post‐coital contraceptive methods on the endometrium and the menstrual cycle
Authors: Swahn Marja‐Liisa , Westlund Pär , Johannisson Elisabeth , Bygdeman Marc
Published: November 2007

Study objective. To evaluate the effect of treatment with ethinylesteradiol‐levonorgestrel or danazol on ovarian function, gonadotrophin release and endometrial development during the time when a pregnancy may occur following unprotected intercourse.

Methods. Women with regular menstrual cycles were followed during one control, one treatment and one follow‐up month. The women obtained either a combination of 0.5 mg levonorgestrel and 0.1 mg ethinylestradiol (Yuzpe regimen; n=16) or 600 mg danazol orally and repeated after 12 hours (n=16). The treatment was administered on either cycle day (cd) 12 or day LH+2. An endometrial biopsy was obtained once on cd LH+6 to +8 in the subjects treated on cd LH+2 both in control and treatment cycles, and morphometric analysis was performed. The concentrations of LH, pregnandiol (P2G), and estrone (E1G) glucuronide were followed daily in morning urine during control and treatment cycles.

Results. Following treatment with the Yuzpe regimen on cd 12 the LH surge was either undetectable (three subjects), postponed to cd 16 to 22 (three subjects) or cd 38 to 39 (two subjects) with lower P2G and LH levels than in the control cycle. Following preovulatory treatment with danazol, no LH peak could be detected in four subjects and in the remaining four subjects the LH peak varied between cd 13 and cd 24. The mean area under the curve for LH was significantly lower, the levels of E1G were slightly higher and the P2G levels were unaffected in comparison with the control cycle. Neither of the two treatments administered on cd LH+2 affected the hormonal pattern and only a discreet effect on the development of the endometrium was seen after the EE/LNG treatment.

Conclusion. The findings indicate that the contraceptive effect of postcoital treatment with EE/LNG and danazol is mainly due to an inhibition or delay of ovulation and insufficient corpus luteum function. The direct effect on the endometrium is limited, if any.
Changing Patterns of Suicide in Australia
Authors: Hassan Riaz , Carr Joan
Published: November 2007

This paper examines the suicide trends in Australia from a sociological perspective using a selected number of sociological variables. Our aim is not to minimize the importance of psychogenic factors in suicide but to highlight its sociological aspects. The analysis of suicide trends shows that the overall suicide rate in Australia has remained fairly stable over the past one hundred years. This outward stability, however, camouflages some important internal changes in the suicide trends in Australian society. The paper examines some of these trends and provides a profile of some of the possible sociological factors which appear to have influenced the suicide rates of men and women in Australian society between 1880 and 1985.
The Use of Seclusion: A Comparison of Two Psychiatric Intensive Care Units
Authors: Hafner R. J. , Lammersma J. , Ferris R. , Cameron M.
Published: November 2007

The use of seclusion within a psychiatric intensive care unit in a South Australian metropolitan mental hospital was documented over a ten week period. The seclusion rate within the unit was 32% of all admissions and 34% of new admissions. The overall seclusion rate for the hospital was 5.4% of all admissions and 6.3% of new admissions, somewhat higher than in the United Kingdom but considerably lower than in the Eastern United States. A comparison was then made between consecutive new admissions (30 secluded and 30 non-secluded) to this unit and to a similar unit without a seclusion room in the other mental hospital in the State. Although seclusion offered no clear advantages in terms of duration of admission, levels of medication or relapse rates, it appeared to reduce the level of dangerousness in the unit, thereby enhancing staff morale. The overall mean daily total of neuroleptic medication was about 1,200 mg chlorpromazine equivalent, somewhat less than in comparable units in the United States and Europe.
Modifiability of Trait Anxiety and Neuroticism: A Meta-Analysis of the Literature
Authors: Jorm A. F.
Published: November 2007

It is argued that personality scales of neuroticism and anxiety are tapping the same personality trait and that this is a risk factor for neurotic disorders. To see whether this trait is modifiable, a meta-analysis was carried out of therapy outcome studies which included a measure of trait anxiety or neuroticism as a dependent measure. This meta-analysis showed that all psychological therapies are to some extent effective. However, rational-emotive and related therapies produced particularly large reductions in trait anxiety/neuroticism (around 1.25 standard deviations). The possibility that rational-emotive education programmes could be used to lower trait anxiety/neuroticism as a preventive measure is discussed.
Depression and Attempted Suicide: A Comparative Study
Authors: Davis Anthony
Published: November 2007

The Levine-Pilowsky depression questionnaire was used to compare the qualitative and quantitative characteristics of depression in 176 patients admitted to a general hospital following a suicide attempt and 65 psychiatric in-patients with a diagnosis of major affective disorder. the study showed that despite significant age and sex differences there was a striking similarity between the groups on all measures of depression. Diagnostic and therapeutic implications of these findings are discussed, and further research directions are suggested.
Group Process and Social Climate of Grow, a Community Mental Health Organisation
Authors: Young Jim , Williams Christopher L.
Published: November 2007

GROW, a community based mutual-help organisation, aims to provide the means for those who have been mentally ill to rehabilitate themselves and grow personally. We measured psychiatric symptoms, group processes, social environment and perceived social support in a sample of GROW group members. We found that GROW does provide the opportunity for and encourages some personal changes and does provide social support. We could not draw any conclusions about GROW'S efficacy as a rehabilitative agent.
Ganser Syndrome in a 10 Year Old Boy — An 8 Year Follow up
Authors: Adler Robert , Touyz Stephen
Published: November 2007

A case of pseudodementia in a 10 year old boy was first reported in 1981. When reviewed 8 years after initial presentation, his symptoms were largely unchanged. the case continues to be complicated by claims for compensation and a successful appeal against the initial compensation judgment.
Origins and Establishment of the Schizophrenia Research Programme at Royal Park Psychiatric Hospital
Authors: Copolov David L. , McGony Patrick D. , Keks Nicholas , Minas Iraklis H. , Heman Helen E. , Singh Bruce S.
Published: November 2007

This paper documents the initial phase of a new research direction which began in 1984 at Royal Park Hospital. Attention is focussed on the place of the university and the research institute in the psychiatric hospital and on the perceived need for concerted research on the major psychoses in Australia. The focal point of the Royal Park research programme, the Aubrey Lewis Clinical Research Unit, has been open since October 1984. The development of the unit's research activities during the initial few years of its existence required an awareness of specific scientific, administrative and political issues. These are discussed in detail in order to convey something of the process, as well as the content of such development, and in an attempt to provide some assistance to others undertaking similar developments.
Use of Private Psychiatric Services in Australia: An Analysis of Medicare Data
Authors: Jorm A. F. , Henderson A. S.
Published: November 2007

An analysis of Medicare data for the 1985–86 financial year showed that the distribution of private psychiatric services varied greatly by age and sex. Females were greater users than males, except in childhood where the opposite was true. Service use was lowest for children and for the elderly and highest for the 35–44 year old group. Amongst patients receiving psychiatric services, elderly people were more likely to receive short consultations and ECT. These findings carry considerable implications for health service policy and for medical education.
CNS Stimulant Controversies
Authors: Levy Florence
Published: November 2007

Controversies in the use of central nervous system stimulant medications in children with attention deficit hyperactivity disorder are discussed. Diagnostic issues, age of optimal use, side effects, effects on learning and ethical considerations are current issues. An animal model for the effects of chronic long-term high dose regimes is proposed.
The Limitations of Multivariate Statistical Methods in the Mensuration of Human Misery
Authors: Hall Wayne
Published: November 2007

Multivariate statistical methods have been widely used in the analysis of the multiple symptom data which are routinely collected in psychiatric research on the classification of depressive illnesses. The most commonly used methods, those of factor analysis and discriminant function analysis, were introduced into research on the classification of depressive illness with unreasonably high expectations about what they could achieve. The failure to realize these expectations has produced scepticism in some quarters about the usefulness of multivariate methods in psychiatric research. When evaluated more circumspectly, multivariate statistical methods have made a contribution to our understanding of depressive illnesses, and they will continue to do so, if they are used with more reasonable expectations.
Post-Traumatic Stress Disorder: Some Diagnostic and Clinical Issues
Authors: Creamer Mark
Published: November 2007

The development of post-traumatic stress disorder (PTSD) in a group of 42 individuals exposed to a multiple homicide was examined. A comparison of DSM-III and DSM-III-R indicated that 74% qualified for a diagnosis of PTSD using DSM-Ill, but only 33% met the criteria outlined in DSM-III-R. The most commonly reported symptoms were found to be intrusive recollections of the event and exaggerated startle response. In general, those symptoms that are new additions in the revised version were the least frequently reported, whilst guilt, which has been excluded from DSM-III-R, was experienced by 38% of the sample. It is suggested that the new criteria may not cluster with the core syndrome of PTSD.
Ethical Issues and Acquired Immunodeficiency Syndrome (AIDS)
Authors: Judd F. K. , Biggs B. A. , Burrows G. D.
Published: November 2007

Acquired Immunodeficiency Syndrome (AIDS) has received much publicity and medical attention. Interest has focused on education, epidemiology, treatment and prevention of the syndrome. This paper raises other issues for consideration, including problems associated with HIV testing, confidentiality, informed consent and the dilemmas facing those involved in the treatment of patients suffering from HIV infection.
Psychological Sequelae of Induced Abortion
Authors: Romans-Clarkson Sarah E.
Published: November 2007

This article reviews the scientific literature on the psychological sequelae of induced abortion. The methodology and results of studies carried out over the last twenty-two years are examined critically. The unanimous consensus is that abortion does not cause deleterious psychological effects. Women most likely to show subsequent problems are those who were pressured into the operation against their own wishes, either by relatives or because their pregnancy had medical or foetal contraindications. Legislation which restricts abortion causes problems for women with unwanted pregnancies and their doctors. It is also unjust, as it adversely most affects lower socio-economic class women.
Psychosis in Sleep Apnoea
Authors: Lee Sing , Chiu Helen F.K. , Chen Char-Nie
Published: November 2007

A 30-year-old man presenting with intellectual impairment and recurrent psychotic episodes was subsequently found to have suffered from a chronically untreated obstructive sleep apnoea syndrome. Polysomnography revealed sleep fragmentation, slow wave sleep deprivation and abnormal arterial oxygen desaturation. Tonsillectomy led to complete resolution of sleep apnoea and remission of psychosis at 2 years' follow-up, but his apparent intellectual impairment persisted. The limited literature on psychosis associated with sleep apnoea is briefly reviewed.
Christchurch Psychiatric Epidemiology Study, Part II: Six Month and other Period Prevalences of Specific Psychiatric Disorders
Authors: Oakley-Browne Mark A. , Joyce Peter R. , Wells J. Elisabeth , Bushnell John A. , Hornblow Andrew R.
Published: November 2007

The Christchurch Psychiatric Epidemiology Study determined the occurrence (over 2 weeks, 1 month, 6 months, 12 months and life-time) of a number of specific DWDSM-III psychiatric diagnoses in the Christchurch urban area. Data were collected on 1498 randomly selected adults, aged between 18 and 64 years. The Diagnostic interview Schedule (DIS) was used to collect information to make a DSM-III diagnosis. The six month prevalence rates of disorder are presented and compared with available results from the NlMH Epidemiological Catchment Area Program, Puerto Rico and Edmonton. Other period prevalences for the total sample are also presented. Christchurch is shown to have higher six month prevalence rates for major depression and alcohol abuse/dependence than other sites which have utilised the DIS in community surveys.
Endogenous Depression as a Construct: A Quantitative Analysis of the Literature and a Study of Clinician Judgements
Authors: Parker Gordon , Hadzi-Pavlovic Dusan , Boyce Philip
Published: November 2007

We review the concept of endogenous depression historically and undertake quantitative analyses of representative factor analytic studies. We also report an empirical study, isolating symptoms and signs associated with a clinical diagnosis of psychotic/endogenous depression, made by a large number of clinical raters assessing 300 depressives. The quantitative analyses and the study of practising psychiatrists agreed in delineating depressive type and together suggest a more restricted construct of endogenous and psychotic depression than has been held historically. Key clinical features isolated were severity, retardation, delusions and paranoid features, non-reactivity and non-variability in mood, while vegetative features appeared to lack relevance.
Behaviour Completion Mechanisms, Anxiety and Agoraphobia
Authors: McConaghy Nathaniel , Silove Derrick , Hall Wayne
Published: November 2007

Little attention has been paid to the situations which provoke the initial attack of anxiety in agoraphobia. According to the behaviour completion hypothesis many normal subjects experience increased tension in such situations when there is a delay in the completion of a behaviour. One hundred and eight medical students completed a questionnaire designed to investigate this hypothesis. They reported experiencing increased tension or anxiety significantly more frequently in situations provoking agoraphobia when the situations contained a component of delay, as compared to such situations without this component, or to situations not commonly provoking agoraphobia. It is proposed that tension, anxiety and panic form a continuum of increasing levels of arousal, but are associated with different cognitions. It is further proposed that the arousal level of agoraphobics is sensitized, so that delay which provokes mild increases of arousal in the healthy, provokes high arousal in agoraphobics. This finding supports the hypothesis that delay in behaviour completion is a mechanism in the generation of tension and anxiety.
Victims of Crime as Victims of Disaster
Authors: Taylor A. J. W.
Published: November 2007

The gross disparity between the routine attention paid to criminals and that paid to their victims led to the proposition that victims of major crime be treated as victims of disaster. The fresh appraisal might provide the impetus for appropriate services for them as a matter of social policy.
Psychiatric Aspects of Renal Transplantation
Authors: Fricchione Gregory L.
Published: November 2007

Despite the growth of heart, liver and bone marrow transplantation, the kidney continues to be the organ most frequently transplanted. Over the years psychiatrists have been active in attempting to understand the adaptational tasks of organ donors and recipients and in evaluating and treating transplant patients. A body of knowledge with regard to renal transplantation has developed. What follows is an update of psychiatric aspects of renal transplantation.
Kleine-Levin Syndrome 15 Years Later
Authors: Chiu Helen F. K. , Li Siu Wah , Lee Sing
Published: November 2007

A Chinese man with Kleine-Levin syndrome showed evidence of hypothalamic disturbance and damage to the limbic system. He has been free from symptoms of hypersomnia and hyperphagia for 15 years, but now suffers from ejaculatory impotence which is discussed in the light of aetiological theories of this puzzling disorder.
Personality Disorder Assessment for Psychiatric Inpatients
Authors: Nazikian H. , Rudd R. P. , Edwards Jane , Jackson H. J.
Published: November 2007

The standardised criteria for DSM-III personality disorders encouraged the development of numerous multidimensional instruments to make the diagnosis of such disorders more objective and reliable compared with clinical judgement. Yet, there is no published research on the concordance between these instruments when used with psychiatric inpatients. Two such measures, the Millon Clinical Multiaxial Inventory (MCMI) and the Structured Interview for DSM-III Personality (SIDP), were chosen for this study. The MCMI identified a significantly greater number of personality disorders than the SIDP for each subject. Despite overall high interrater reliability with the SIDP, low agreement was found between the two instruments for most of the 11 DSM-III Axis II (personality disorders) categories. Different normative populations on which the instruments were developed, method variance, and theoretical differences between Millon and DSM-Ill, were all likely to contribute to the low concordance. Systematic research of possible confounding factors is suggested.
Adolescent Marijuana Use: Risk Factors and Implications
Authors: Rob Marilyn , Reynolds Ingrid , Finlayson Paul F.
Published: November 2007

A sample of 1,270 students in Years 7, 10 and 11 attending seven State high schools in a middle class area of Sydney answered a self-report questionnaire designed to measure many aspects of their family situation, school performance, spare time activities, drinking and drug taking behaviour and sexual activity. Data on the reported prevalence of marijuana use and the variables significantly associated with marijuana use are presented and discussed. Marijuana use was reported by 4.2% of 12 year olds (Year 7), 26.5% of 15 year olds (Year 10) and 26.7% of 16 year olds (Year 11). More than half of those who had ever used marijuana had used it during the week prior to the survey and there were no significant differences in the characteristics between these recent and the remaining users. Marijuana users reported significantly poorer family relationships than non-users and were about twice as likely as non-users to come from a broken home and/or to have a mother who works full-time, which is often a consequence of marital break-up. Marijuana users also displayed poorer school performance, spent less time on homework and had more school absenteeism than non-users. Marijuana users were more than three times as likely as non-users to have had heterosexual intercourse, drunk alcohol 3 or more times in the past week and to smoke cigarettes. Also, the reported use of stimulants, hallucinogens, narcotics (heroin) and sedatives was almost entirely restricted to those who reported marijuana use. Improvements in the quality of family life may prevent the use of marijuana and other probably more harmful drugs, as well as the indulgence in other acting-out behaviours.
Effects on Care-Givers of Special Day Care Programmes for Dementia Sufferers
Authors: Wells Y. D. , Jorm A. F. , Jordan F. , Lefroy R.
Published: November 2007

Two groups of care-givers to dementia sufferers were interviewed to assess their psychological symptoms and the behaviour problems of the dementia sufferers. The first group were using special dementia day care while the second group were about to begin using it. The second group were re-interviewed three months later. Therefore two comparisons could be made; a with/without day care comparison and a before/after admission to day care comparison. Care-givers had a high level of psychological symptoms which were not significantly reduced by using day care. Full-time institutional care did reduce distress. Day centre clients continued to deteriorate as would be expected with a degenerative condition. While special dementia day care centres appear to play a useful role for many care-givers, they may provide too few hours relief per week to markedly reduce the care-givers' psychological symptoms. Family care-givers currently take the major role in caring for dementia sufferers in the community and the burden of care needs to be shared more equitably.
To What Extent Does Age Influence the Reporting of Life Events?
Authors: Oei Tjoe I. , Zwart Frans M.
Published: November 2007

A study of life events reporting was carried out among 64 depressed and 74 non-depressed patients. The results show that age as well as depression can affect the number and type of reported life events. The younger age group (<45 years) reported more events than the older group, and the depressed patients reported more events than their non-depressed counterparts. The younger group also listed more desirable events than their elders. There was no evidence of an interaction between diagnosis and age.
The First Australian Case Description of Anorexia Nervosa
Authors: Vandereycken W. , Beumont P.J.V.
Published: November 2007

To the best of our knowledge, H.E. Astles was the first Australian physician who, in a lecture in 1882, paid explicit attention to the illness of anorexia nervosa. We reproduce his paper because of its historical value, which we underline in our comments.
Firearms and Suicide in Australia
Authors: Cantor Christopher H. , Lewin Terry
Published: November 2007

Australia has a moderate overall suicide rate but an extremely high male firearm suicide rate. Using data covering the years 1961–1985, a series of multiple regression based analyses were performed. During this period, overall suicide rates fell but firearm suicides remained constant with a resulting increase in the proportion of suicides by firearms. There has been an increase in suicides in the young offset by a decline in the elderly. Young males showed the greatest proportional increase in the use of firearms. A limited regional analysis supported the hypothesis that lack of legislative restrictions on long guns in Queensland with a greater household prevalence of such weapons and different cultural attitudes were associated with higher overall and firearm suicide rates. Such findings are consistent with reports from North America, although trends in Australia are more modest. Reducing the availability and cultural acceptance of firearms is likely to decrease suicide rates, especially in males.
Individuality, Narcissism and the Bipolar Self
Authors: Bragan Ken
Published: November 2007

Oscar Wilde and George Bernard Shaw are introduced as great exponents of the cult of individuality and as providing examples of the two poles of the self as defined by Kohut. Wilde's need for mirroring, and his use of defensive strategies to support the self, is contrasted with Shaw's compensatory use of idealisation to create a strong and stable self. While acknowledging the way self psychology can explain some aspects of the personalities of these great men, it is also suggested that it does not explain all, and in particular does not explain the economic aspect. Questions about the latter are raised in conclusion.
The Impact of Television on Children and Clinical Practice
Authors: Tonge Bruce J.
Published: November 2007

The impact of television on children and child development and on the practice of child psychiatry is reviewed. Evidence from research is that children learn from watching television and the programs they see can change their behaviour. Programs with violent and aggressive themes tend to make children more aggressive and disobedient. Cultural sex-role and social stereotypes depicted on the television can also influence children's perceptions of society. Programs specifically designed for different age groups of children which depict pro-social behaviour are likely to lead children to become more friendly, co-operative and self-controlled. The use of television in child psychiatric clinical work supervision and research, and its potential to reduce the psychological trauma experienced by children in the legal proceedings of child abuse cases is discussed. More research is needed to determine the content and intervening variables that effect the acquisition of both positive and negative behaviour from television and enhance its promotion of mental health.
Persisting Hallucinations following Childhood Sexual Abuse
Authors: Heins Terry , Gray Allison , Tennant Maxine
Published: November 2007

Hallucinations can persist for many years after childhood sexual abuse. If we recognise this, we will not mis-diagnose psychosis and we may treat with psychotherapy (talk). The hallucinations are distinct from hallucinations in schizophrenia though patients have frequently been given that diagnosis. They would generally be classified as pseudo-hallucinations. They are generally self-referential. They can involve all sensory modalities. Three case reports illustrate this link. Methods for interviewing and providing ongoing help are discussed. Issues in phenomenology and diagnosis are considered. Posttraumatic stress disorder is the best diagnostic fit, though psychotic depression may explain some cases. Freud's case of Frau P (1896) was an early report of this link.
Genital Self-Amputation and the Klingsor Syndrome
Authors: Schweitzer Isaac
Published: November 2007

Two psychotic individuals, who performed acts of genital self-amputation, are presented. One of the patients had self-mutilated with the intention of suicide and had also in the past amputated his hand. Psychotic patients with delusions (often religious), sexual conflict associated with guilt, past suicide attempts or other self-destructive behaviour and depression, severe childhood deprivation, and major premorbid personality disorder, are the group at risk for genital self-amputation. It has been proposed that the eponym, the “Klingsor” syndrome, be applied only to acts of genital self-mutilation, involving religious delusions. The author suggests that this syndrome should be expanded to include all cases of genital self-mutilation resulting from a psychotic illness.
Assessment and Treatment of Sex Offenders: The Prince of Wales Programme
Authors: McConaghy Nathaniel
Published: November 2007

The treatment programme for sex offenders at the Prince of Wales Hospital, Sydney, is described. Penile circumference assessment is not used as there is no evidence it provides a valid measure of individuals' paedophile or rapist tendencies. Sex offenders' self-reports remain the major source of information in their assessment. The development of the two major techniques used -imaginal desensitization and short-term medroxyprogesterone — is outlined. About 80% of subjects can be expected to show a good response to one or other of these therapies. Of those who do not, most respond to the alternative or aversive therapy. Adolescent offenders appear to require more intensive treatment. Results appear comparable with those of more intensive programmes in use overseas.
The Epidemiology of Anorexia Nervosa in South Australia
Authors: Ben-Tovim David I. , Morton Jacqueline
Published: November 2007

A survey of 5,705 pupils in girls' schools in South Australia revealed that the one year prevalence of cases of anorexia nervosa, diagnosed according to DSM-Ill criteria, was 1.05 cases per thousand of the population studied. This study has a number of advantages in comparison to the majority of other school-based surveys, and confirms that descriptions of anorexia nervosa as a disorder of epidemic proportions may be premature.
Seasonality of Mania in New Zealand
Authors: Mulder R. T. , Cosgriff J. P. , Smith A. M. , Joyce P. R.
Published: November 2007

This paper examines the seasonal variation in manic admissions over a five year period in New Zealand. There is a significant monthly variation in admission rates with a spring/summer peak. Breakdown by sex, age and admission status suggested that there is no particular subgroup responsible, but that young first admissions and older female readmissions do not follow this trend. Examination of the monthly admission rates revealed that this peak is not constant from year to year. Possible mechanisms, which link fluctuating environmental variables with an irregular spring/summer peak for manic admissions, are discussed.
Using a Socio-Historical Frame to Analyse Aboriginal Self-Destructive Behaviour
Authors: Hunter Ernest
Published: November 2007

The last two decades have seen rapid changes in many facets of Aboriginal society, including morbidity and mortality. The same period has witnessed a dramatic increase in writing about and by Aborigines and this has necessitated a re-examination of the national “history” to include the indigenous people of Australia. Medical workers in Aboriginal Australia should be alert to the historical forces determining patterns of ill-health. Psychiatry in particular must develop this perspective if it is to participate with Aborigines in addressing emergent patterns of behavioural distress including suicide, parasuicide, ludic behaviour and self-mutilation. This paper demonstrates the importance of the socio-historical frame in the examination of these behaviours from one discrete region in isolated Aboriginal Australia: the Kimberley.
One Way Mirror on the Wall, who is Freudiest of us All?
Authors: Mellsop Graham W.
Published: November 2007

Their longer training and base in biological medicine results in psychiatrists having a different range of skills to psychologists. Each is better fitted to certain tasks. Using a marketing model, it is argued that in New Zealand both groups will survive and spread best by selecting, from the myriad of patient need options, those that most closely match their skills. The more they compete, the more they undermine their own professional credibility.
Hyperventilation and Panic Attacks
Authors: Kenardy Justin , Oei Tian P. S. , Evans Larry
Published: November 2007

The role of hyperventilation in the aetiology of panic attacks is still unclear. This paper briefly reviews the role of hyperventilation and abnormal respiration to panic attacks and examines the experimental evidence. Evidence has been found that physiological variables such as paCO2 and pH are involved in the aetiology of panic attacks and panic disorder but the extent and the nature of the involvement of cognitive variables is undetermined. Based on current evidence, there is a need to integrate cognitive variables with the physiological framework proposed by the hyperventilation theory. Until clear experimental evidence is produced about the relationships between cognitive and physiological factors, the applicability of hyperventilation in the aetiology and treatment of panic attacks remains in question.
Premenstrual Syndrome in Three Generations Responds to Antidepressants
Authors: Taghavi Ebrahim
Published: November 2007

The author identified the clinical picture of 11 patients with premenstrual complaint in a genealogical tree spanning three generations. Seven patients who satisfied criteria for premenstrual syndrome (PMS) were treated successfully with amitriptyline. The possible role of antidepressant treatment for PMS is discussed. The possibility is raised of genetic predisposition in some subtypes of PMS, particularly those in which depression is a feature.
Fole À Deuxand Dementia
Authors: Draper Brian , Cole Andrew
Published: November 2007

Folie à deux has been infrequently reported in dementia patients. A case is described in which both partners with folie à deux suffered from an Alzheimer type dementia. The development and management of fotie à deux in dementia is discussed.