bluuebunny/crossref_metadata_2025 huggingface dataset:
The reliability of DSM‐III prodromal symptoms in first‐episode psychotic patients
Authors: Jackson H. J. , McGorry P. D. , McKenzie D.
Published: August 2007

Thirty‐one first‐episode psychotic patients were assessed via a semistructured interview to determine the presence or absence of the 8 DSM‐III prodromal symptoms. Interrater reliability data were calculated for the same symptoms according to the patient, an informant and the raters blending the previous 2 sources of information. Levels of reliability, reported as kappa and percentage agreements, were generally acceptable.
Perceptual defense and vulnerability to postpartum depression
Authors: Borgeat F. , David H. , Saucier J. F. , Dumont M.
Published: August 2007

The objective was to assess the relationship between vulnerability to postpartum depression and perceptual defense evoked by tachistoscopic stimuli alluding to perinatal themes in pregnant women. Tachistoscopic stimuli have been shown to produce different thresholds of conscious identification according to their emotional content: a phenomenon termed perceptual defense. A total of 412 women in their 3rd of 4th month of pregnancy were asked to identify 14 pictures and 18 verbal stimuli shown for initially very brief but increasing durations. Presentation times required for a correct identification were measured. Depression was assessed, at 2 and 6 months postdelivery, by the Hamilton Depression Rating Scale: 53 women were defined as depressed by a score ≥ 15. Discriminant analysis showed that the women who would become depressed 7 to 11 months later were slower than the nondepressed to identify 5 stimuli alluding to pregnancy, sexuality or a father image. Particular attitudes towards the themes of being pregnant, of sexuality and of the father could be components of a psychological predisposition to the development of depressed mood in the postpartum.
Antisocial Personality Disorders
Authors: Swanson M.C.J. , Bland R.C. , Newman S.C.
Published: August 2007

3258 randomly selected adult household residents of Edmonton, Canada, were interviewed by trained lay interviewers using the Diagnostic Interview Schedule (DIS). 104 subjects fulfilled DSM‐III antisocial personality disorder (ASP) criteria. Lifetime prevalence rates were found to be significantly higher in males and in the younger adult age groups. The age of onset (i.e. age at which conduct disorder symptoms first appeared) was found to be under 10 years in the majority of cases, with females lagging just slightly behind males. Symptom patterns and frequencies were examined and the relative risks for these symptoms were calculated. Comorbidity, calculated using full DSM‐III severity criteria, but without exclusion criteria, revealed an increased prevalence of nearly every other psychiatric disorder in those with antisocial personality disorder, with 90.4% having at least one other lifetime psychiatric diagnosis.
Biological aspects of depression
Authors: Syvälahti E. K. G.
Published: August 2007

In most cases, depression involves the interaction of biological and psychosocial factors. The impact of biological factors seems to be more prominent in major depressive syndrome, where typical symptoms and signs such as decrease in weight, changes in libido, dysmenorrhea, and sleeping disorders cannot be explained on psychodynamic grounds alone. Some of the symptoms and signs typical of patients suffering from depression reflect a primary disorder of biochemical and neuro‐physiological functions and are not commonly found in other forms of psychic disturbances. Studies related to monoamine (noradrenaline, serotonin or 5‐HT, dopamine) metabolism have assumed a major role in biochemical research into depression; this research now also includes studies on other central neurotransmitters such as GABA and glutamic acid, and neuropeptides like somatostatin and corticotropin‐releasing factor (CRF). Several theories have been suggested for the biochemical background of depression, and these hypotheses can now be tested using new and sophisticated research methods. Recent progress in understanding receptor structure and function and the regulation of neuroendocrine functions will substantially increase our knowledge of the biological deviations in depression and eventually lead to better drugs and treatment strategies. In the following, current perspectives on the biology of depressive disorders are introduced. It seems clear that susceptibility to depression is linked with deviations in presynaptic and postsynaptic neurotransmitter turnover and function. These, in turn, may lead to alterations in other regulatory mechanisms, such as the neuroendocrine and immune systems.
Life events, Social support and depression
Authors: Paykel E. S.
Published: August 2007

This paper reviews current findings regarding Social stress and support in clinical depression. Comparisons of recent life events at depressive onset and in general population controls show consistently raised event rates. The events span a range of threatening and undesirable experiences, with limited selectivity to exit events and interpersonal losses. Effects are similar in endogenous and non‐endogenous symptom pictures, and there are suggestive findings in bipolar disorder, but these require further study. Events are also related to outcome and to relapse. Effects are moderate in degree, but relatively short‐term of over six months to a year. For Social support there are greater problems in the extent to which Social support may be determined by the individual's own behaviour. Absence of Social support appears to be associated with onset and relapse of depression, both acting independently and modifying effects of life events. Social stress findings have implications for prevention. The occurrence of major life events signals a period of increased risk when supportive interventions may prevent evolution of distress to disorder.
Recent life events, Social support and suicide
Authors: Heikkinen M. , Aro H. , Lönnqvist J.
Published: August 2007

The occurrence of recent life events during the last 3 months, and Social support received were studied in a nationwide suicide population (N = 1,067) in Finland. Recent life events were reported in 80 % of the suicides. Job problems (28 %), family discord (23 %), somatic illness (22 %), financial trouble (18 %), unemployment (16 %), separation (14 %), death (13 %) and illness in family (12 %) were the most common life events. Sex differences were found in recent life events: any life event, separation, financial trouble, job problems and unemployment were more common among males. The mean number of life events was also higher among males.

Living alone was more common among female victims. Females had children more often than males. In terms of friendships, more females had a close friend, whereas more males had friends sharing common interests. Females had complained of loneliness more often than males. Those females who had lived alone had encountered a recent death more often than other females. The male victims who had lived alone had experienced separation, financial trouble and unemployment during the last 3 months more frequently than other males, suggesting a concurrent stressor effect of these recent life events with living alone in male suicides.
Depression and cardiovascular diseases
Authors: Aromaa A. , Raitasalo R. , Reunanen A. , Impivaara O. , Heliovaara M. , Knekt P. , Lehtinet V. , Joukamaa M. , Maatela J.
Published: August 2007

We first review the asSociations between depression and cardiovascular diseases (CVDs). Then we examine them in the nationally representative Mini‐Finland Health Survey, which covers 8,000 persons. Chronic somatic diseases and mental disorders were diagnosed using standardized methods. Cross‐sectionally, CVDs and neurotic depression were asSociated both before and after adjustment for covariates. The strongest asSociations were observed in the case of severe CVDs. During a 6.6 year follow‐up, the risk of CVD death and coronary death was elevated in depressed persons both with and without CVDs at entry. Much of the cross‐sectional asSociation is probably due to depression caused by CVDs. The outcome of CVD may be poorer in depressed persons. The hypothesis that depression is a cause of CVDs requires further study.
What are the borders of borderline personality disorder?
Authors: Tyrer P.
Published: August 2007

It is argued that the usefulness of borderline personality disorder in clinical and research practice is largely because the borders of the diagnosis are so flexible. The diagnosis overlaps with other personality disorders, disturbances of mood and intermittent abnormal behavior. As almost all behavior likely to lead to consultation with mental health professionals is included among the elements of personality disorder, it is not surprising that it is almost the most common condition seen by specialists in the field. An attempt is made to define the borders of the condition in this review. It is concluded that these are so far‐reaching that they negate the notion that borderline conditions are personality disorders. It is argued that the borderline state is a coaxial diagnosis of personality and mental state disorder and to continue to describe the concept as a personality disorder is wrong and misleading.
Instrumental assessment of psychomotor functions and the effects of psychotropic drugs
Authors: Hindmarch I.
Published: August 2007

The basic assumption underlying psychopharmacology is that the effects of psychoactive drugs can be assessed by measuring the changes produced on aspects of human behaviour and cognitive function. This review concentrates on 3 established psychometric tests that have been shown over a long period of time to be not only valid and reliable measures of aspects of behaviour relevant to the daily activities of patients taking such drugs but also appropriate indicators of any countertherapeutic effects or side effects of medication. Choice reaction time (CRT) is a reliable index of sedation directly related to accident risk situations at home, on the road or at work. Critical flicker fusion threshold (CFFT), a direct measure of the capacity for processing cognitive information, is an accurate measure of various aspects of mental illness and drug effects, and the continuous daytime EEG (c‐EEG) is a truly objective measure of CNS activity on a continuous 24‐h basis. The judicious use of CRT, CFFT, CFFT and c‐EEG not only demonstrates the inherent potential of certain molecules to adversely affect the performance of certain daily activities but also helps identify the drugs with profiles of activity or side effects that are likely to be countertherapeutic.
The role of dosage and plasma levels in neuroleptic relapse prevention
Authors: Marder SR
Published: August 2007

Recent research has focused on strategies for optimizing the long‐term treatment of schizophrenia by decreasing relapse rates at the same time that antipsychotic drug side effects are minimized. Studies have suggested that substantially lowering the dose by as much as 80% can result in fewer side effects, less anxiety and depression, and improved compliance. However, dosage reduction can also lead to increases in the vulnerability to mild exacerbation of psychosis. A recent study from our laboratory indicates that supplementing low dose depot antipsychotic medications with oral supplementation at the time of prodromal symptoms may improve the safety of low doses. For patients who are treated with fluphenazine decanoate, monitoring plasma fluphenazine levels may also help to minimize relapse rates.
Intermittent medication ‐ an alternative?
Authors: Gaebel W.
Published: August 2007

Neuroleptic maintenance medication is clearly effective for relapse prevention in schizophrenia. However, besides benefits for the majority of patients, there are also failures and/or serious risks for some patients (e.g., tardive dyskinesia). Since the risk‐benefit ratio is often difficult to predict in the individual case, this has stimulated the search for modifications and alternatives to maintenance treatment. In particular. neuroleptic low‐dose treatment strategies obviously compare quite favourably with standard‐dose treatment concerning relapse prevention and side effects. Alternatively, on the basis of reports on prodromal symptoms preceding a relapse, early intervention, intermittent neuroleptic treatment strategies have been developed. However, all recently completed controlled 2‐year studies have not confirmed this strategy to be as effective as maintenance treatment in preventing relapse, although total drug exposure is significantly reduced and social adjustment seems to be unaffected. Therefore, for the majority of patients, intermittent treatment cannot be recommended.
Schizophrenia epigenesis: past, present, and future
Authors: Gottesman Irving I.
Published: August 2007

Sociopolitical and ideological attacks on the various genetically oriented programs of research into the causes of schizophrenia, even when well‐motivated to prevent genetic discrimination in all its forms, endangers the enterprise. Although there have been no replicated successes in finding genes linked or associated to markers for schizophrenia yet, the solid foundation for the fact that genetic factors are importantly involved in the etiology of schizophrenia derives from replicated studies using the strategies of genetic epidemiology ‐ families, twins, adoptees. The models to emulate in schizophrenia research should follow the paths of researchers on coronary artery disease, diabetes, and Alzheimer's disease. All are complex diseases with multifactorial and multigenic components. Even when the necessary genotype is present, it may not be expressed as clinical disease at the phenotypic level.
Biologic factors in schizotypal personal disorders
Authors: Siever Larry J.
Published: August 2007

New studies of the boundaries of schizophrenia suggest that schizotypal personality disorder is biologically and genetically related to schizophrenia with alterations in brain structure/function related to deficit‐like symptoms and increased dopaminergic function to psychotic‐like symptoms.
Positive and negative symptoms of schizophrenia: past, present, and future
Authors: Andreasen Nancy C. , Nopoulos Peg , Schultz Susan , Miller Del , Gupta Sanjay , Swayze Victor , Flaum Michael
Published: August 2007

The “group of schizophrenias,” normally referred to with a single nominative, is phenomenologically heterogeneous. Its symptoms represent multiple psychological domains, including perception, inferential thinking, language, attention, social interaction, emotion expression, and volition. Studies of psychopathology have simplified this complex array in several ways; one has been a subdivision into positive and negative symptoms. Reports by our group and others suggest that the symptoms of schizophrenia fall into three natural dimensions: positive symptoms subdivided into psychotic and disorganized dimensions, while a third negative dimension also emerges. Since these dimensions have impressive consistency across studies, future work must examine their relationship to clinically relevant concepts such as prognosis or etiology and examine four different aspects: longitudinal course, neural mechanisms, relationship to treatment, and interrelationships in other pathological conditions.
Family interaction: parental representation in schizophrenic patients
Authors: Onstad Sidsel , Skre Ingunn , Torgersen Svenn , Kringlen Einar
Published: August 2007

12 monozygotic (MZ) and 19 same‐sexed dizygotic (DZ) twin pairs discordant for DSM‐III‐R schizophrenia completed the Parental Bonding Instrument (PBI). The schizophrenic twins described their parents as less caring and being more overprotective compared to their non‐schizophrenic co‐twins. These results were independent of age, sex and zygosity. Difference in paternal overprotection was the most important variable discriminating between the schizophrenic probands and their co‐twins. Three different hypotheses regarding these findings are discussed.
Information‐processing abnormalities as neuropsychological vulnerability indicators for schizophrenia
Authors: Nuechterlein Keith H. , Dawson Michael E. , Green Michael F.
Published: August 2007

Studies of schizophrenic patients in psychotic and clinically remitted states and of biological relatives indicate that subtle anomalies in information processing may be critical components of neuropsychological vulnerability to schizophrenia. We describe a conception of possible abnormalities and several recent strategies to differentiate these possibilities. Within Continuous Performance Test conditions, varying the perceptual load vs. the active, working memory load yields a distinction between a stable vulnerability factor across clinical states and a potential mediating vulnerability factor. Specialized backward masking paradigms offer ways to separate two initial sensory‐perceptual processes from attentional shifting processes. Top‐down attentional influences on sensorimotor gating allow examination of the role of central executive processes in modulating early sensory processes. Initial results are discussed.
Assessment of sociocultural influences on the aesthetic body shape model in anorexia nervosa
Authors: Toro J. , Salamero M. , Martinez E.
Published: August 2007

The prevailing aesthetic body shape model in our culture – that of slenderness – plays a leading role in eating disorders. A questionnaire (CIMEC) was prepared in an attempt to measure the influence of the agents and situations that transmit this model. The CIMEC questionnaire was applied to 59 anorectics and 59 normal girls matched by age and social class. Highly significant differences were found between the scores obtained from both groups, showing the patients to have a much greater involvement with the sociocultural agents encouraging weight loss. Factorial analysis of the discriminating items gave rise to 5 factors, each of which also significantly differentiated between anorectics and the normal group. The questionnaire, in two versions, showed satisfactory internal consistency and appropriate sensitivity and specificity and would serve as a sound instrument for screening. It calls into question the causal relationship between anorexia nervosa and sociocultural influences.
Antisocial behaviour in adolescent suicide
Authors: Marttunen M.J. , Aro H.M. , Henriksson M.M. , Lönnqvist J.K.
Published: August 2007

Antisocial behaviour among adolescent suicide victims (44 males, 9 females) was investigated in a nationwide psychological autopsy study of suicides in Finland. The data were collected through interviews of the victims' relatives and attending health care personnel, and from official records. Antisocial behaviour was reported among 43% of the victims. Separation from parents, parental alcohol abuse and parental violence were common among male victims with antisocial behaviour. Their psychosocial adjustment was poor, and they had experienced severe stressors. Depressive disorders were common among all suicides, but male victims with antisocial behaviour had more often alcohol abuse and comorbid mental disorders compared with victims without antisocial behaviour. The results indicate a strong relatedness between adolescent suicide and antisocial behaviour. Recognition and treatment of manifest mental symptoms and evaluation of suicide risk among adolescents with antisocial behaviour and substance abuse is emphasized. Antisocial symptoms with relatively short duration and not severe enough to meet the criteria for actual antisocial disorders also need to be taken into account.
Life satisfaction as a mediator between distressing events and neurotic impairment in a general population
Authors: Baruffol E. , Gisle L. , Corten P.
Published: August 2007

Quality of life and life satisfaction have often been investigated as concomitant variables of anxious and depressive symptoms as well as an outcome measure in psychotherapy research. In the present prospective survey, life satisfaction and stressful events function as independent variables predicting the development of neurotic disturbances in a general population. A random sample of 184 adults completed two quality of life surveys (1990 and 1992). Results showed that satisfaction in relevant life domains was related to the mental status assessed 2 years later, and more specifically, that domain satisfactions were mediators of the event‐impairment relationship. It is argued that life satisfaction might be considered as a vulnerability or resistance factor with regard to stress‐related disorders.
Classification of psychotic symptoms in dementia sufferers
Authors: Ballard C. G. , Bannister C. L. , Patel A. , Graham C. , Oyebode F. , Wilcock G. , Chung M. C.
Published: August 2007

Little attention has been payed to the classification of psychotic symptoms in dementia sufferers. This article compares the etiology of delusions, visual hallucinations and delusional misidentification and examines the value of factors generated from principal components analysis as a possible classificatory system in a group of 125 patients with DSM‐III‐R dementia in contact with clinical services who were prospectively evaluated using standardized instruments to describe in detail individual psychotic symptoms. The assessment also included the Geriatric Mental State Schedule, the History and Aetiology Schedule and the CAMCOG. Delusions and visual hallucinations had a distinct cognitive profile as did delusions and delusional misidentification, although there was an overlap between visual hallucinations and delusional misidentification. Four factors were generated from principal components analysis. Three of these closely mirrored the 3 symptom groups delusions, visual hallucinations and delusional misidentification, although the phantom‐boarder delusion was correlated with the visual hallucination factor and not delusional misidentification. The fourth factor included visual hallucinations of relatives and delusions that relatives were in the house. This factor was strongly inversely associated with emotional distress and could perhaps best be seen as a comfort phenomena. The pattern of cognitive deficits and etiological associations of each of the factors were independent of one another, supporting the notion that it is useful to consider them as separate entities.
Spiritual distress: an indigenous model of nonpsychotic mental illness in primary care in Harare, Zimbabwe
Authors: Patel V.
Published: August 2007

Spiritual models of illness causation are common in Africa. This article reports an investigation of some clinical correlates of patients who believe that their problem has a spiritual cause. A cross‐sectional survey of random attenders at primary health care clinics and traditional medical practitioners (TMP) in Harare (n= 302) was performed. Interviews included eliciting of explanatory models, indigenous and etic psychiatric measures. Spiritual models of illness were held by half the subjects. Patients who hold this model had higher levels of mental disorder and were more likely to have a mental illness as judged by the patient, care provider and psychiatric measures. The symptoms of such patients resemble the construct of anxiety. Such patients are more likely to consult TMP and to have a chronic illness. Spiritual models of illness may represent an indigenous model to explain the distressing symptoms of nonpsychotic mental illness. Including them in training of primary health care providers may improve the recognition of mental illness.
No association between prenatal exposure to influenza and autism
Authors: Dassa D. , Takei N. , Sham P. C. , Murray R. M.
Published: August 2007

We examined the relationship between the number of autistic patients, obtained from the register of the National Autism Society (NAS), born each month between January 1953 and December 1988 in England, and the occurrence of influenza epidemics one to nine months before birth. The relative risk of developing autism, for exposure to influenza during gestation, was assessed by a Poisson regression model. Our results indicate that exposure to influenza epidemics during gestation is not associated with autism.
The impact of somatic morbidity on the Hamilton Depression Rating Scale in the very old
Authors: Linden M. , Borchelt M. , Barnow S. , Geiselmann B.
Published: August 2007

The Hamilton Depression Rating Scale (HDRS) is world‐wide the most important observer rating scale for depression. Many items of this scale refer to somatic symptoms of depression which cast doubt on the validity of HDRS scores in the presence of somatic comorbidity as, for example, in elderly patients. The present study, therefore, was planned to investigate the validity of the HDRS in cases in which the patient is suffering from a depressive illness together with somatic illnesses. The study population (n= 516) is a representative sample of citizens aged 70 years and older in West Berlin. They were assessed independently by internists and psychiatrists. Each positive item of the HDRS scale was then rated by the internists as to what degree it reflects somatic morbidity. Results show that multimorbidity interferes with the validity of the HDRS. There were 8 items for which more than half of all positive scores as rated by psychiatrists were seen by the internists as being possibly related to somatic disorders. Patients with corrections in the HDRS score showed a somewhat increased rate of medicines and cardiovascular diagnoses. There was less ambiguity for items with greater severity.
Temperamental vulnerability in attempted suicide
Authors: Nordström P. , Schalling D. , Asberg M.
Published: August 2007

The aim of this study was to explore and describe features of suicidal temperament and to describe the psychological domains of vulnerability in attempted suicide. Thirty‐two suicide attempters were compared with 32 sex‐ and age‐matched convalescent surgical controls on self‐report personality inventories; the Eysenck Personality Questionnaire, the Chapman Scales, the Beck Hopelessnes Scale and the Karolinska Scales of Personality. Suicide attempters showed higher scale scores on neuroticism, psychoticism, interpersonal aversiveness, perceptual aberration, nonconformity, hopelessness, somatic anxiety, muscular tension, indirect aggression, suspicion and lower socialization. The features of suicidal temperament include hopelessness and anhedonia, anxiety, hostility and undirected anger expression, psychosis proneness, antisocial traits and interpersonal difficulties. These temperamental features might render the suicidal individual particularly vulnerable to suicidal behavior.
Factorial structure of the 17‐item Hamilton Depression Rating Scale
Authors: Fleck M. P. A. , Poirier‐Littre M. F. , Guelfi J.‐D. , Bourdel M. C. , Loo H.
Published: August 2007

The Hamilton Depression Rating Scale was applied to 60 depressed inpatients diagnosed using the Composite International Diagnostic Interview. The information to rate the scale was obtained with a semistructured interview to standardize the scale administration method. Items were factorized using principal components analysis with Varimax rotation. Three factors were obtained with the simulation method, accounting for 47% of variance. The first includes the core symptoms of depression. The symptoms of patients having an isolated mood disorder were compared with those having comorbidity with other diagnoses. The comorbidity did not affect the first factor but modified the second factor (anxiety) and the third factor (insomnia).
Timing of completed suicides among residents of Olmsted County, Minnesota, 1951–1985
Authors: Panser L. A. , McAlpine D. E. , Wallrichs S. L. , Swanson D. W. , O'Fallon W. M. , Melton L. J.
Published: August 2007

Previous studies of suicide timing may have been biased by incomplete ascertainment of suicides and by delays between the suicidal act and subsequent death. Those potential biases were assessed and minimized in this population‐based study by using the unique resources of the Rochester Epidemiology Project in Olmsted County, Minnesota. Using these more accurate data, we confirmed previous reports of no excess suicides on birthdays (± 3 days), or during 3 United States national holidays. While most prior reports found excess post‐holiday suicides and suicide peaks on Mondays, those findings were not observed in Olmsted County. Because 93% of deaths occurred on the date of the suicidal act, using date of death instead of the actual date of suicide is sufficient for most research purposes.
Lithium addition to neuroleptic treatment in chronic schizophrenia: a randomized, double‐blind, placebo‐controlled, cross‐over study
Authors: Terao T. , Oga T. , Nozaki S. , Ohta A. , Ohtsubo Y. , Yamamoto S. , Zamami M. , Okada M.
Published: August 2007

We studied the effect of lithium addition to neuroleptic treatment in chronic schizophrenia, for which contradictory results have been produced in previous studies. Twenty‐one chronic schizophrenic inpatients received lithium in a study with randomized, double‐blind, placebo‐controlled, cross‐over design consisting of 8 weeks each of treatment with lithium capsules and identical placebo capsules. The total Brief Psychiatric Rating Scale (BPRS) scores at week 8 of the lithium treatment were improved significantly compared with those at week 8 of the placebo treatment. Of the BPRS subscales, however, only anxiety‐depression improved, whereas none of the subscales for anergia, thought disturbance, activation and hostile‐suspiciousness improved. There was no significant difference between the total Scale for the Assessment of Negative Symptoms (SANS) scores at any time during lithium and placebo treatment. These results suggest that the addition of lithium to neuroleptic treatment improves anxiety‐depression in chronic schizophrenia.
Coercive measures in psychiatric care. Reports and reactions of patients and other people involved
Authors: Eriksson K. I. , Westrin C.‐G.
Published: August 2007

In ongoing studies of the quality of the mental health services in two Swedish counties, two thirds of the committed versus about one third of the voluntarily admitted patients reported coercive measures during the index period of care. Committed patients reported an equal degree of coercive treatment and restraint, whereas restraint dominated among the voluntarily admitted. The majority of the patients described the coercive measures as implemented by fait accompli; force was reported in 23 % of the examples given by the committed patients but never by the voluntarily admitted. The committed patients justified 19% and the voluntarily admitted 38% of the coercive measures reported; the committed patients justified coercive treatment and restraint to about the same extent; the voluntarily admitted patients justified 65% of the examples of restraint but only 20% of the examples of coercive treatment. There was a 70% concordance between the reports of the committed patients and psychiatric personnel as to the occurrence of coercion, but the head nurses tended to state that treatment had been implemented by persuasion in cases where the patients stated that implementation was by coercion.
Successful estradiol treatment of psychotic symptoms in the premenstrual phase: a case report
Authors: Korhonen S. , Saarijärvi S. , Aito M.
Published: August 2007

We report a patient fulfilling the DSM‐III‐R criteria for schizoaffective psychosis in which estradiol therapy alone cured all psychotic symptoms occurring in the premenstrual phase.
Antinuclear autoantibodies in chronic schizophrenia
Authors: Spivak B. , Radwan M. , Bartur P. , Mester R. , Weizman A.
Published: August 2007

We determined the presence of antinuclear autoantibodies (ANA), antinative DNA and histone‐reactive ANA in 3 groups of chronic schizophrenic patients (n= 85): haloperidol‐treated patients (for at least 3 months) (n= 35), drug‐free for at least 3 months (n= 35) and neuroleptic‐naive patients (n= 15). The autoantibody titers were compared with those of healthy controls (n= 37). A significantly higher frequency of positive ANA was found among chronic schizophrenic patients (∼20%) as compared with the controls (∼5 %), irrespective of drug treatment, sex and age. No antinative ANA autoantibodies or histone reactive ANA were detected in either schizophrenic patients or controls. Further studies are needed to isolate and characterize in ANA‐positive schizophrenic patients 1 a putative specific ANA profile.
The assessment of needs in psychiatric patients. Interrater reliability of the Swedish version of the Camberwell Assessment of Needs instrument and results from a cross‐sectional study
Authors: Hansson L. , Björkman T. , Svensson B.
Published: August 2007

The assessment of needs has been put forth as an important dimension in both the planning, development and evaluation of psychiatric services. A needs assessment tool for routine use should ideally be brief, not require additional staff, be valid and reliable with respect to setting, gender and culture, and also be sensitive to changes in needs and differences in needs between subgroups of patients. In this study, the interrater reliability of the Swedish version of the Camberwell Assessment of Needs instruments (CAN), measuring needs in 22 areas, was investigated in a cross‐sectional sample consisting of 119 psychiatric inpatients and outpatients. The prevalence and severity of needs, prevalence of unmet needs, as well as current help received was also investigated. The interrater reliability of the instrument was found to be good both measured as total percentages of agreement in ratings, where an agreement of 80 % or above was found in 90% of the comparisons, and as measured by Cohen's kappa. Predominant needs in the sample were in addition to clinical needs concerning psychological distress and psychotic symptoms, social needs such as the need for company, daytime activities and information concerning condition and treatment. The CAN seems to be a instrument with a high interrater reliability also when used under routine conditions as in this study. It also seems to have a high degree of feasibility with regard to different types of patients and settings and a sensitivity concerning differences in needs in subgroups of patients.
Subclinical thought disorder in first‐degree relatives of schizophrenic patients. Results from a matched‐pairs study with the Thought Disorder Index
Authors: Hain C. , Maier W. , Hoechst‐Janneck S. , Franke P.
Published: August 2007

To assess the frequency and quality of formal thought disorder in schizophrenic patients and their first‐degree relatives, a consecutive series of 36 unmedicated patients, 20 siblings of these patients and 37 normal control subjects were examined with Holzman's Thought Disorder Index (TDI). As a proof of the internal validity of this tool, the patients demonstrated significantly more thought disorder than the controls as measured by the TDI total score and various subscores, which proved the internal validity of this tool in a German‐speaking sample. In addition, in a pairwise comparison with controls who were individually matched by age and sex the patients’ siblings had a significantly higher total TDI score and nonsignificant elevations on several subscores (combinatory and flippant). As to the level of severity of the thought disorder, the siblings mostly took an intermediate position between patients and controls. In conjunction with previous reports from other authors, our findings lend further support to the notion of subclinical thought disorder as an indicator of familial vulnerability to schizophrenia.
Adolescent suicide, depression and family dysfunction
Authors: Martin G. , Rotaries P. , Pearce C. , Allison S.
Published: August 2007

This study investigated associations between adolescents' perceptions of their family dynamics (McMaster Family Assessment Device, FAD) and depression, suicide thoughts and attempts. High school students (mean age 15.2 years) completed self‐report questionnaires including the Beck Depression Inventory (BDI), the FAD, questions about suicidal thoughts, plans and attempts, deliberate self harm, and selected life experiences. Univariate analysis showed that family dysfunction measured on the FAD is associated with thinking and planning suicide, deliberate self harm, suicide attempts, as well as severe depression (BDI ≥ 222). Despite this, stepwise regression indicated that family dysfunction influences suicide behaviors indirectly through other variables such as depression. The FAD is recommended as a useful addition to questionnaires seeking to identify vulnerability to both depression and adolescent attempted suicide in early detection studies.
The prescription of psychotropic drugs in primary health care
Authors: Joukamaa M. , Sohlman B. , Lehtinen V.
Published: August 2007

We followed the prescription of psychotropic drugs by primary health care physicians over a 3‐year period. The material consisted of 1000 randomly selected adult primary health care patients. At least one psychotropic drug was prescribed to one third (n= 307) of the sample during the follow‐up period. The most commonly used drug category was that of benzodiazepines, which was prescribed to 24% of the sample. An antidepressive was prescribed to 8%, a neuroleptic to 2% and “other psychotropic drugs” to 10% of the sample. The most important predictor for prescribing psychotropic drugs was recognition of mental problems at the initial survey, but age and marital status also had an association with the prescription. No gender difference was found after controlling for mental problems. Psychotropic medication was also prescribed to 13% of the patients who had no sign of mental disorder.
Cognitive deficits and emotional disorders in HIV‐1 infected individuals
Authors: Poutiainen E.
Published: August 2007

The associations between cognitive functioning, depression questionnaire results, and diagnosed psychiatric disorders were examined among 85 HIV‐1 infected patients at different stages of systemic infection and 39 seronegative controls. An affective scale and a somatic scale of the Beck Depression Inventory (BDI) were used to measure depression. Psychiatric disorders before or after the diagnosis of seropositivity were evaluated. The patients with symptomatic HIV‐1 infection (AIDS related complex, AIDS) reported more somatic symptoms of depression than the subjects with asymptomatic infection or the controls, whereas psychological depression and psychiatric disorders were unrelated to the severity of HIV‐1 disease. Psychiatric disorders diagnosed during HIV‐1 disease were slightly associated with poor verbal memory only among symptomatic patients. Impaired visual memory showed an association with depressive mood and with psychiatric disorders preceding the diagnosis of seropositivity which suggests that factors other than HIV‐1 may explain these subjects' poor visual memory.
Recovery and insight in schizophrenia
Authors: Jørgensen P.
Published: August 2007

A study sample of 50 patients suffering from schizophrenia was examined at readmission and thereafter every second week until each patient had been interviewed five times i.e. eight weeks in total. Three types of recovery are identified, one with full and two with partial recovery of delusional beliefs. In patients with full recovery, the delusional dimensions (conviction, extension and pressure) decrease in a parallel manner. In patients with partial recovery, decreases in pressure precede decreases in other dimensions. Two‐thirds (64%) of the patients have high insight from the very start of admission, and for two‐thirds (68%) the degree of insight does not change during recovery. The average degree of insight increases during recovery, irrespective of the type of recovery. It is concluded that insight operates to some degree independently of positive psychotic symptoms and may be perceived as a distinct component of recovery.
Lack of association of schizophrenia with the neurotrophin‐3 gene locus
Authors: Nimgaonkar V. L. , Zhang X. R. , Brar J. S. , DeLeo M. , Ganguli R.
Published: August 2007

A case‐control association study was conducted among patients with schizophrenia (DSM‐III‐R, n= 141) and unaffected controls (n= 177) of Caucasain and African‐American ethnicity. No significant differences in the distribution of a dinucleotide repeat polymorphism in the neurotrophin‐3 (NT‐3) gene were noted between the two groups. This study does not support an association between schizophrenia and the NT‐3 gene locus in a United States cohort.
Life events and severe anorexia nervosa in adolescence
Authors: Horesh N. , Apter A. , Lepkifker E. , Ratzoni G. , Weizmann R. , Tyano S.
Published: August 2007

The purpose of the study was to study the influence of life events on adolescent patients suffering from anorexia nervosa. Twenty one hospitalized adolescent inpatients with severe anorexia nervosa were compared with 79 adolescent nonanorectic psychiatric inpatients and 40 healthy adolescents for stressful life events throughout their lives. The nonanorectic patients suffered from schizophrenia, affective disorders, anxiety disorders, borderline personality disorder or conduct disorder. The assessment of the contribution of life events to the development of anorexia and the control mental disorders was based on semistructured interviewing of the patients, their parents and the patients' therapists. The instrument used was that developed by Pfeffer. The anorectic patients showed significantly higher negative life event scores than healthy controls in all the areas of life events examined. In addition, they showed significantly more negative life events concerning parents than patients in the other psychiatric diagnostic categories. These findings have relevance for the growing literature on the association between eating disorders and certain forms of child abuse.
Dhat syndrome: is it a distinct clinical entity?
Authors: Chadda R. K.
Published: August 2007

Dhat syndrome is a culture‐bound neurotic disorder seen in the Indian subcontinent. The disorder has recently been included in ICD‐10. In the present study, illness behaviour of 50 dhat syndrome patients was studied using a Hindi version of Illness Behaviour Questionnaire (IBQ) and was compared with 50 controls. Sixty‐six percent of dhat syndrome patients received unspecified diagnoses on DSM‐III‐R. Patients with dhat syndrome showed a distinct illness behaviour profile consisting of higher scores on IBQ factors of general hypochondriasis and affective discomfort and lower scores on denial compared with controls, suggesting that the disorder may be a distinct entity.
Mortality among patients in psychiatric hospitals in Germany
Authors: Hewer W. , Rössler W. , Fätkenheuer B. , Löffler W.
Published: August 2007

Data from 7 psychiatric hospitals with defined catchment areas were analyzed; 14,195 episodes of treatment in acute psychiatry wards were recorded within 30 months. During their stay in hospital 196 patients died, 174 from natural causes and 22 by suicide, compared to the expected 32 deaths. Standardized mortality ratios (SMRs) were calculated for the different diagnostic and age groups, mortality risk being highest in organic mental disorder (SMR 7.59, followed by functional psychoses (SMR 4.55) and the “other disorders” (alcoholism, neurotic and related disorders, SMR 3.25). Roughly one half of the 196 deaths were due to cardiovascular disorders and pneumonia. In patients with nonorganic psychiatric syndromes, suicide was the most frequent cause of death (21 of 58 fatalities). With regard to the elevated mortality risk of patients with acute mental illness, a reduction of fatality rates from natural and unnatural causes should remain a major objective of hospital care in psychiatry.
Reproductive rates in families of schizophrenic patients in a case‐control study
Authors: Fañanás L. , Bertranpetit J.
Published: August 2007

Data about the fertility of 142 schizophrenic patients and their ancestors are reported and compared with healthy people in a case‐control study. The biological fitness of the patients is 76% of controls in individuals with at least one child, and 48% of controls in all patients, with clear low fertility rates in patients, especially in men. When looking at the previous generations, the existence of a significant increase in fertility in the relatives of schizophrenics was reinforced in the maternal lineage. These results confirm the previous findings about the decreasing fertility in schizophrenic patients and may be of interest in understanding the maintenance of the illness despite its genetic background.
Negative symptoms and vocational impairment in schizophrenia: repeated measurements of work performance over six months
Authors: Lysaker P. , Bell M.
Published: August 2007

Interest in negative symptoms as a dimension of schizophrenia has grown dramatically in the last decade. One hypothesized correlate of negative symptoms that has received less attention is deteriorated work function. To address this issue, this study compared biweekly measurements of work performance for 21 patients with prominent negative symptom and 29 patients without prominent negative symptoms enrolled in a 26‐week supported work program. Nonparametric analysis indicated that subjects with prominent negative symptoms demonstrated poorer performance than other subjects on task orientation, social skills and personal presentation. No evidence was found that the work performance of either group improved or worsened over time, although a trend suggested that social skills may have improved slightly for both groups across the 26 weeks. These results support hypotheses linking negative symptoms with deteriorated work function.
Educational level and hospital use in mental disorders A population‐based study
Authors: Aro S. , Aro H. , Salinto M. , Keskimäki I.
Published: August 2007

This population‐based study presents socioeconomic differences in psychiatric inpatient care by diagnosis. Inpatient care among the Finnish population aged 25–64. years was studied using data from the Finnish National Hospital Discharge Register. All major mental disorders in the ICD‐9 were included in the study. The socioeconomic status of individual patients was defined by years of education in the population census. Discharge rates, first–time admission rates and hospitalization risk were usually 2‐ to 4‐fold higher in the low educational group compared with the highly educated population. The socioeconomic gradient was steepest for schizophrenia. No gradient was observed for major affective disorders. However, bipolar disorder was most common in the highest educational category. For most conditions, the socioeconomic gradient among women was lower than among men. In Finland hospitalization was more common among low than high socioeconomic groups for most mental disorders and most indicators of inpatient care. Most of these differences are fairly consistent with previous data on socioeconomic gradients in the prevalence of mental disorders.
Children from unwanted pregnancies in Prague, Czech Republic revisited at age thirty
Authors: Kubička L. , Matějček Z. , David H.P. , Dytrych Z. , Miller W.B. , Roth Z.
Published: August 2007

The results of the fourth wave of the Prague Study of subjects born of unwanted pregnancies (UP) are reported. Of these young adults, 190 were examined at age 30 together with pair‐matched control subjects born of accepted pregnancies (AP). Siblings of both UP and AP subjects were also examined. As in the previous data waves the UP subjects manifest less favorable psychosocial development on average than their AP controls, although the differences have narrowed. In some respects the siblings of the UP subjects share the latter's less favorable characteristics. However, there is a gender specific nonshared late effect of unwanted pregnancy: the UP females are more frequently emotionally disturbed than their AP female controls, whereas no such difference occurs between the female siblings of the UP and AP subjects.