bluuebunny/crossref_metadata_2025 huggingface dataset:
Mood Change following Bilateral Hemisphere Brain Injury
Authors: Lipsey John R. , Robinson Robert G. , Pearlson Godfrey D. , Rao Krishan , Price Thomas R.
Published: August 2008

Fifteen patients with bilateral hemisphere brain injury secondary to thromboembolic stroke or trauma were evaluated for depression, cognitive impairment, and functional physical impairment. Analysis of CT scans and standardized mood scales revealed that patients with left anterior brain injury were significantly more depressed than patients without such injury. Depression severity was directly and significantly correlated with left lesion proximity to the frontal pole. Left lesion age, lesion temporal sequence, right lesion location, cognitive impairment, and functional physical impairment did not significantly correlate with depression. Depressive symptomatology previously shown to be associated with single left frontal lobe lesions appeared to dominate post-brain injury psychopathology regardless of location or temporal sequence of other brain lesions.
Alcohol and Old People
Authors: Wattis J. P.
Published: August 2008

Over the last 30 years the proportion of those over 65 in our population has increased by nearly 50 per cent. Over the same period alcohol consumption in general has risen by nearly 100 per cent, probably with an even greater increase in those suffering from alcohol-related problems. Nevertheless, many doctors still do not expect to find alcohol abuse in elderly people.
Long-Term Prophylactic Effects of Carbamazepine in Affective Disorder
Authors: Kishimoto Akira , Ogura Chikara , Hazama Hidebumi , Inoue Kinuo
Published: August 2008

The prophylactic effects of carbamazepine (CBZP) were studied in 32 patients with affective disorder who were receiving long-term therapy with CBZP. Complete inhibition of both manic and depressive episodes was observed in four cases, reduced incidence of episodes or decreased intensity of symptoms in twenty, and no change in eight. CBZP was significantly more effective in cases with an onset before the age of 20, and subjects showing a continuous pattern of alternating episodes responded better than those with a more intermittent history of mania and depression. Where CBZP had an effect it was generally apparent soon after therapy started. These results suggest that in some cases CBZP is an agent suitable for long-term continuous prophylactic therapy in manic-depressive disorder.
The Sexual Adjustment of Chronic Schizophrenics: A Preliminary Study
Authors: Lyketsos G. C. , Sakka P. , Maïlis A.
Published: August 2008

A comparison of a group of chronic schizophrenics with controls showed that: the patients had significantly less interest in sex, frequency of intercourse, and satisfaction from sex; the percentage of individuals with sexual dreams and sexual fantasies did not differ between the two groups; the severity of psychopathology influenced frequency of intercourse and satisfaction from sex, and the length of institutionalization influenced interest in sex; the schizophrenics had a variety of sexual disorders, but there was a significant difference between the sexes in disturbances of thought and perception; and, significantly more male schizophrenics, in comparison with females, had sexual dysfunction associated with pharmacotherapy, but feminization in the males was far from predominant.

The patients' sexual disorders are not disturbing to the social life of the open mental hospital or the community surrounding it.
Thyrotrophin Response to Thyreostimulin in Affectively Ill Women Relationship to Suicidal Behaviour
Authors: Linkowski P. , Van Wettere J. P. , Kerkhofs M. , Brauman H. , Mendlewicz J.
Published: August 2008

Past history of suicidal behaviour was investigated in 51 depressed women (27 unipolar and 24 bipolar) in whom the TSH response to TRH was studied. Patients with a history of violent suicidal attempts were shown to have a reduced TSH response to TRH, compared to depressed patients with a history of non-violent suicidal attempts and depressed patients with no history of suicidal behaviour. A five-year follow-up study on these patients revealed that four patients who died from suicide had an absence of TSH response to TRH.
Addison's Disease, Psychosis, and the Syndrome of Inappropriate Secretion of Antidiuretic Hormone
Authors: Lever E. G. , Stansfeld S. A.
Published: August 2008

A case of tuberculous Addison's disease presenting with psychosis, profound hyponatraemia, and detectable plasma antidiuretic hormone is reported. Clinical and biochemical improvement after corticosteroid replacement was followed by relapse with further psychosis and inappropriate antidiuretic hormone secretion: both were promptly reversed by demethylchlortetracycline. The association of psychological symptoms with Addison's disease, the role of anti-diuretic hormone secretion in Addison's disease, and the inter-relationship between Addison's disease, psychosis and anti-diuretic hormone secretion are discussed.
The use of ECT for Mania in Childhood Bipolar Disorder
Authors: Carr Vaughan , Dorrington Carol , Schrader Geoffrey , Wale Jocelyn
Published: August 2008

A case of childhood bipolar disorder, manic type, is presented in which electroconvulsive therapy was used for the acute manic episode. The pharmacological complications which led to this choice of treatment and the computerized tomography finding of ventricular enlargement, are discussed.
Contraindications and Dangers of Psychotherapy
Authors: Crown Sidney
Published: August 2008

Psychotherapy, like any other effective treatment in medicine, may lead to negative effects either in the patient or those around him. The source of these unwanted effects may be in the patient's or the therapist's personality, in the patient-therapist interaction, in faulty therapy technique or in the patient's unresolvable social situation. The possibility of negative effects should be anticipated during the descriptive and psychodynamic assessment of the patient and before establishing the therapeutic contract. The technique of a trial of psychotherapy should be more frequently used than it is in cases where the therapist is in doubt. If negative effects do develop, these should be minimized by decreasing the frequency of psychotherapy sessions and depth of exploration. This may be done by allowing greater therapist “transparency”, by making fewer psychodynamic interpretations and by altering the focus of therapy from problems of early development to problems of current living.
Social Relationships During the Onset and Remission of Neurotic Symptoms
Authors: Henderson A. S. , Moran P. A. P.
Published: August 2008

In a prospective study of a community sample, we examined changes in social relationships accompanying the onset and remission of neurotic symptoms. For those who developed symptoms in the course of 12 months, no decrease was found in the availability or reported adequacy of either close or diffuse ties, compared to those who remained symptom-free. For those having a remission, an increase in the adequacy of social relationships and a decrease in rows was observed only in those who improved later on, at the 12-month interview. But with either the onset or remission of symptoms, the availability of relationships remained unchanged. These observations cannot establish the direction of causality, but suggest that neurotic symptoms are more associated with the perception of social relationships than with the structure of personal networks.
Coefficients of Agreement
Authors: Dewey M. E.
Published: August 2008

Several coefficients have been suggested for the measurement of agreement between raters. Recently Maxwell (1977) has proposed, and Janes (1979) has extended, a new coefficient, which they have termed therandom errorcoefficient (RE).This paper criticizes their proposal and suggests that Cohen's (1960) coefficientkappa(K) is still the measure of choice.
Short-Course Diphenoxylate Hydrochloride for Treatment of Methadone Withdrawal Symptoms
Authors: Ives T. J. , Stults C. C.
Published: August 2008

The authors conducted a preliminary trial of a 5-day course of diphenoxylate in the treatment of out-patients with methadone withdrawal symptoms. Diphenoxylate provided substantial relief from detoxification symptoms with no drug-associated adverse effects.
Delusional Depressive In-Patients, 1892 to 1982
Authors: Eagles John M.
Published: August 2008

Three groups of 114 depressed patients admitted to hospital in Edinburgh, one in the year 1892, one in 1942–3 and one in 1981–2, were studied. The occurrence and content of depressive delusions were recorded. A significantly higher proportion of depressives had delusions in 1892 than in 1942–3, but there was no significant decline between 1942–3 and 1981–2. It is concluded that this decline in the proportion of depressives having delusions since 1892 probably does not reflect a genuine decline in the prevalence of depressive illness with delusions. The content of delusions differs between the years and between the sexes, and these differences are discussed.
Changes in Cognition with Pharmacotherapy and Cognitive Therapy
Authors: Blackburn I. M. , Bishop S.
Published: August 2008

A treatment trial comparing cognitive therapy and pharmacotherapy, alone and in combination, in depressed out-patients, indicated that outcome on cognitive variables was similar to outcome on mood and severity measures, pharmacotherapy being less effective than cognitive therapy or the combined treatment in a hospital and a general practice sample. While combined treatment was superior to cognitive therapy in the hospital outpatients, the two treatments were equivalent in the general practice. Significant effects were obtained on measures of views of self, the world and the future, whose validity was demonstrated. The pattern of change through treatment showed the same order of progress for responders, while non-responders to cognitive therapy tended to do worst. The specificity of treatment effect is discussed.
Hyperkinetic Syndrome of Childhood: Clinical Characteristics
Authors: Thorley Geoffrey
Published: August 2008

The diagnosis of hyperkinetic syndrome is rarely used in the UK, in marked contrast to its counterpart in the USA. Most of the work on hyperkinesis is concerned with the North American concept and relatively little attention has been paid to the British approach. The present paper reviews the development of the UK concept and diagnosis, describes the characteristics of 73 hyperkinetic syndrome children seen at the Bethlem and Maudsley Hospitals over 13 years and compares them to matched psychiatric controls diagnosed as conduct disordered. Results indicate that the two groups are differentiated by a number of symptomatic and clinical features, with the conduct disorder group showing a greater frequency of aggressive, antisocial, emotional and psychosocial disturbance which contrasts with higher frequencies of motor disturbance, inattentive and articulatory disturbance in the hyperkinetic group. No differences were found between the groups in brain pathology or sensory handicap. The findings provide support, at least in terms of symptoms and clinical features, for the concept and diagnosis of hyperkinetic syndrome (ICD 9).
Alcohol Dependence and Phobic Anxiety States I. a Prevalence Study
Authors: Smail Penelope , Stockwell Tim , Canter Sandra , Hodgson Ray
Published: August 2008

Sixty alcoholics (40 males) were assessed for agoraphobia and social phobia, and over half the sample were rated as having either or both these disorders when last drinking. Twenty one subjects had mild phobias and eleven had severe phobias. The more severely phobic males were also found to be the most alcohol dependent and those with no phobias were least alcohol dependent but this effect was not found among the females. All phobic alcoholics reported that alcohol had helped them to cope in feared situations, and almost all had deliberately used it for this purpose.

A small sample of out-patients referred for phobias alone were also asked about their use of alcohol. The majority had found it helpful in coping with fears, although more men than women had deliberately used it for this purpose.
Morbidity following Sudden and Unexpected Bereavement
Authors: Lundin Tom
Published: August 2008

With the help of data on the registered days of sickness per year, a study was made of a group of relatives (n = 32) who had suffered sudden and unexpected bereavement to determine whether this resulted in an increase in morbidity in the two-year period following the loss, compared with the previous two years. A comparison was made with a control group of relatives who had also suffered bereavement but where the deaths were not unexpected. Increased morbidity, especially psychiatric morbidity, was found following sudden and unexpected bereavement but not in the control group. It is concluded that persons exposed to sudden and unexpected loss of a close relative are subject to increased psychiatric morbidity and should be regarded as a high-risk group.
Cerebral Ventricular Enlargement in Non-Genetic Schizophrenia: a Controlled Twin Study
Authors: Reveley Adrianne M. , Reveley Michael A. , Murray Robin M.
Published: August 2008

In a group of schizophrenics of twin birth, no evidence of ventricular enlargement was found where there was a family history of major psychiatric disorder. Among those schizophrenics without such a family history, cerebral ventricular size was significantly increased (P <0.01), and there was also evidence of birth complications. Among normal control twins, those who reported complicated births had significantly larger ventricles.
Change in the Pattern of Care for the Demented
Authors: Christie A. B. , Train Jean D.
Published: August 2008

The experience of 82 demented female patients, admitted to Crichton Royal in the period 1957–59, is compared with 107 similar female patients from 1974–76. All finally died in the hospital, or at the closure of the study in November 1981 were long-stay patients there. Results show that on average, each patient in the more recent group spent 24 per cent longer in hospital; the results, however, were only statistically significant in the very elderly—over 85. Further study of the 1970s failed to demonstrate that day care and intermittent holiday admissions had any effect on the length of time the patient spent in hospital on final admission. Using the study data, models of future needs are worked out on the basis of bed requirements for patients admitted without prospect of discharge.
The French Approach to Psychiatric Classification
Authors: Pichot P. J.
Published: August 2008

It is common knowledge that the French school of psychiatry began with Pinel (1745–1826) at the end of the 18th century. Pinel is credited with having delivered the insane from their chains in the two hospitals of Paris where they were detained, Bicêtre and la Salpêtrière: his near contemporaries in the humanization of the treatment of the insane were Tuke in England, Chiarugi in Tuscany and Daquin in Savoy. Pinel's essential achievement was the creation of the 19th-century French tradition in psychiatry, encompassing the medical, clinical, descriptive and nosological fields. Pinel's breadth of outlook was shared by his pupil Esquirol (1772–1840), who dominated the so-called ‘classical’ school of the ‘Alienists of the Salpêtrière’ via his numerous disciples and his treatise, published in 1838, Des Maladies Mentales Considérées sous le Rapports Médical, Hygiénique et Médicol-légal.
The Reliability of Dangerousness Assessments. A Decision Making Exercise
Authors: Montandon Cléopâtre , Harding Timothy
Published: August 2008

One hundred and ninety three raters drawn from six countries and representing different professional groups considered 16 case histories. Raters were asked to indicate what degree of ‘dangerousness' they attributed to each individual and what they considered to be the optimal management.

The level of agreement between raters concerning the assessment of dangerousness was generally low, the level of 60 per cent being reached for only 4 cases out of 16. Psychiatrists did not reach a higher level of agreement on the ratings of dangerousness than non-psychiatrists. Psychiatrists had a tendency to rate individuals as more dangerous than did non-psychiatrists.

The results of this exercise do not support the use of ‘dangerousness' as a scientifically or operationally valid concept.
Body Shape Perception and its Disturbance in Anorexia Nervosa
Authors: Touyz S. W. , Beumont P. J. V. , Collins J. K. , McCabe M. , Jupp J.
Published: August 2008

The perception of body shape was studied in 15 female patients with anorexia nervosa and 15 age matched controls. A lens was used which could be manipulated to cause a horizontal distortion of an image projected onto a video monitor. The patients showed a greater tendency to over- and under-estimate their present body shape than did the controls. Further, the patients' desired body shape was significantly thinner than that of controls, as was their estimation of what constitutes a normal body shape. These findings are discussed in relation to the literature and it is suggested that they may have important implications for treatment.
Elevated Cerebrospinal Fluid Noradrenaline in Tardive Dyskinesia
Authors: Jeste Dilip V. , Doongaji Dinshaw R. , Linnoila Markku
Published: August 2008

Cerebrospinal fluid was collected from 28 psychiatric (mostly schizophrenic) inpatients from Bombay, India. These included eight patients with tardive dyskinesia, five with spontaneous dyskinesia and 15 without dyskinesia. The samples were flown to the National Institute of Mental Health, Washington, D.C., where they were analyzed “blind” for concentrations of noradrenaline and several monoamine metabolites. Patients with tardive dyskinesia had significantly higher noradrenaline concentrations in the CSF as compared with the other two groups. Spontaneous dyskinesia group had significantly lower concentrations of homovanillic acid in the CSF. Our results support the hypothesis of noradrenergic hyperactivity, rather than postsynaptic dopamine receptor supersensitivity, in tardive dyskinesia.
Life Events and Personality Traits in Obsessive-Compulsive Neurosis
Authors: Mckeon Joseph , Roa Bridget , Mann Anthony
Published: August 2008

Twenty-five patients with obsessive-compulsive neurosis and matched controls had their life event scores (Paykel's Life Event Schedule) rated for the year prior to the onset of illness and the date of interview, respectively. The Standard Assessment of Personality Schedule, whose high inter-temporal and inter-informant reliability was confirmed, was used to rate the patients' premorbid personality.

The obsessive-compulsive patients' mean life event score was significantly higher than the control subjects; and this excess spanned the six months prior to the onset of illness. Patients with abnormal personality traits (obsessional, anxious and self-conscious) experienced significantly fewer life events than those without such traits.
Obsessive-Compulsive Neurosis Following Head Injury
Authors: McKeon Joseph , McGuffin Peter , Robinson Paul H.
Published: August 2008

Four cases of obsessive-compulsive neurosis following head injury are described, three of which are from a consecutive series and the fourth from a discordant monozygotic twin pair. The aetiological significance of head injury in this disorder is discussed in the context of the clinical findings and of previous series of brain injured patients.
Age Disorientation in Chronic Schizophrenia is Associated with Global Intellectual Impairment
Authors: Liddle P. F. , Crow T. J.
Published: August 2008

From a population of long-stay patients with a diagnosis of schizophrenia according to the St Louis criteria, a group of 21 patients with ‘age disorientation’ was selected, and compared on a series of tests of intellect and learning capacity with a matched control group of 21 schizophrenic patients without this feature. The age-disorientated patients demonstrated substantial impairments on tests of orientation and general knowledge, associational learning, the ‘famous personality’ test, tests of vocabulary and aphasia, Raven's matrices, the digit–symbol substitution test and the mental test score. We conclude that profound ‘organic-type’ psychological deficits (global impairment of intellectual function associated with temporal disorientation) undoubtedly occur in chronic schizophrenia. The findings on the ‘famous personality’ test and the Peabody vocabulary test did not exclude the possibility that such impairment arises early in life, at a time preceding the onset of the illness which leads to hospital admission.
Hormonal Effects of Apomorphine in Schizophrenia
Authors: Ferrier I. N. , Johnstone E. C. , Crow T. J.
Published: August 2008

The hormonal effects of apomorphine, a direct-acting dopamine receptor agonist, in schizophrenic patients are of interest in view of the therapeutic efficacy of dopamine receptor antagonists. In this study, apomorphine (0.75 mg s.c.) and placebo were administered to unmedicated acute and chronic schizophrenics and controls. Apomorphine-induced prolactin suppression did not discriminate between the groups. However, an inverse relationship between basal prolactin levels and the severity of positive symptoms was detected in the patients with acute schizophrenia, consistent with a role for dopamine in the genesis of these symptoms. Growth hormone increments after apomorphine administration were blunted in the chronic schizophrenic patients, particularly those with ‘negative’ symptoms. It is argued that this blunting is not due to previous neuroleptic therapy and may represent evidence of structural change in the hypothalamus in this group of patients.
Depression, Recognition-Memory and Hedonic Tone a Signal Detection Analysis
Authors: Dunbar G. C. , Lishman W. A.
Published: August 2008

A signal detection analysis was used in a recognition memory task involving material of varying hedonic tone. Major differences were found between the control and depressed states. Although overall recognition rates were the same, pleasant material was recognised less and unpleasant material more easily by depressives. Neutral material was recognised equally well by both groups. In the depressed state, response biases were altered such that unpleasant material was handled in a preferential way to neutral or pleasant material.
Assessing Family Relationships: A Multi-method, Multi-situational Approach
Authors: Walker L. G. , Thomson N. , Lindsay W. R.
Published: August 2008

Ratings of behaviour and family relationships were made on the basis of (a) a non-schedule standardised interview, (b) direct observation of family interaction during a meal time and (c) direct observation of mother-child interaction during free play. A number of scales met a battery of reliability and other criteria, and possible generalisation of these ratings across methods (interview versus direct observation) and settings (meal time versus free play) was assessed. For the vast majority of scales this was low. Reasons for this, together with some clinical implications, are discussed.
Cognitive Therapy for Major Depressive Disorder in Primary Care
Authors: Teasdale John D. , Fennell Melanie J. V. , Hibbert George A. , Amies Peter L
Published: August 2008

Cognitive therapy for depression is a psychological treatment designed to train patients to identify and correct the negative depressive thinking which, it has been hypothesised, contributes to the maintenance of depression. General practice patients meeting Research Diagnostic Criteria for primary major depressive disorder were randomly allocated either to continue with the treatment they would normally receive (which in the majority of cases included antidepressant medication) or to receive, in addition, sessions of cognitive therapy. At completion of treatment, patients receiving cognitive therapy were significantly less depressed than the comparison group, both on blind ratings of symptom severity made by psychiatric assessors and on a self-report measure of severity of depression. At three-month follow-up cognitive therapy patients no longer differed from patients receiving treatment-as-usual, but this was mainly as a result of continuing improvement in the comparison group.
Was Insanity Increasing? a Response to Edward Hare
Authors: Scull Andrew
Published: August 2008

One of the central paradoxes of the Victorian reforms in the treatment of the mentally ill was the curious fact that the “scientific” discovery of mental illness and the adoption of a more rational approach based on this discovery—an approach which aimed at treating and curing the lunatic, rather than neglecting him or incarcerating him in a gaol or workhouse—were associated with an explosive growth in the number of insane people. Edward Hare's recent Maudsley Lecture raises again the interesting question of whether or not this reflects a true increase in the incidence of mental illness in nineteenth century England. As he correctly notes, the aggregate data collected at the time do not allow a “decisive answer”, but I am pleased that his reassessment of the probabilities led him to endorse my prior conclusion that its incidence was indeed increasing. (Scull, 1979).
Interactional Correlates of Expressed Emotion in the Families of Schizophrenics
Authors: Miklowitz David J. , Goldstein Michael J. , Falloon Ian R. H. , Doane Jeri A.
Published: August 2008

Measures of intrafamilial expressed emotion (EE) predict relapse in schizophrenic patients, but previous research has not investigated whether EE scores are representative of ongoing family transactions. Parents of 42 hospitalized schizophrenic patients were rated for level and type of EE. Following the patient's discharge, families participated in two 10-minute direct interaction tasks. Transcripts from these interactions were coded on dimensions of affective communication.

High-EE parents exhibited more negatively charged emotional verbal behaviour in direct transaction with their schizophrenic offspring than did low-EE parents. Some parents rated high-EE were distinguished by their frequent usage of critical comments during the interactions, whereas high-EE overinvolved parents used more intrusive, invasive statements. These findings support the construct validity of expressed emotion.
Cognitive Vulnerability to Auditory Hallucination Impaired Perception of Meaning
Authors: Heilbrun Alfred B. , Blum Nancy A.
Published: August 2008

Forty-four psychiatric patients were separated into four groups on the basis of presence/absence of hallucinations and reactive/process status. Reactive hallucinators were found to be singularly impaired in two aspects of cognitive processing: (1) tolerance of ambiguity; and (2) availability of alternative meanings. The perceptual errors produced by premature judgment and limited consideration of alternative meanings for misperceptions are discussed as factors predisposing to auditory hallucination.
Dysmorphophobia: a Question of Definition
Authors: Thomas Christopher S.
Published: August 2008

Dysmorphophobia is an uncommon psychiatric syndrome characterized by a subjective feeling of ugliness or physical defect. Although appearance is within normal limits, the patient feels that this is noticeable to others. Views on the nature of this condition are illustrated by two case histories. It is proposed that dysmorphophobia is a discrete psychiatric illness. The symptoms arise in individuals with schizoid, narcissistic, or obsessional personality traits and should be distinguished from those phenomena which are secondary to morbid psychological processes.
Personality and Regional Cerebral Blood Flow
Authors: Mathew Roy J. , Weinman Maxine L. , Barr Deborah L.
Published: August 2008

The extraversion–introversion dimension of personality is believed to have an inverse relationship with cortical arousal. Brain capillary perfusion is a well established index of brain function and arousal. Regional cerebral blood flow was measured in 51 right-handed females whose personality structure was examined with the Eysenck Personality Inventory (EPI). Significant inverse correlations were found between the brain blood flow and the extraversion–introversion score of EPI.
The Nithsdale Schizophrenia Survey: IV. Social Adjustment by Self-Report
Authors: McCreadie R. G. , Barron E. T.
Published: August 2008

The Social Adjustment Scale Self-report (SAS-SR) was completed by chronic schizophrenics (N = 82) living in Nithsdale, in Dumfries and Galloway region. Relatives also assessed patients' adjustment. The questionnaire response indicated that scrutiny of the form by a professional immediately after completion is necessary. Patients' and relatives' assessment of the patients' overall adjustment correlated very closely, thus suggesting a schizophrenic can satisfactorily describe his own adjustment. The patients were less well adjusted than a normal community population in all areas except the parental role. The SAS-SR highlights for each individual where many of his problems lie, and therefore may act as a guide to specific rehabilitative measures.
The Clarification and Assessment of a Method of Psychotherapy
Authors: Goldberg D. P. , Hobson R. F. , Maguire G. P. , Margison F. , O'Dowd T. , Osborn M. , Moss S.
Published: August 2008

The ‘conversational model’ of psychotherapy was investigated with a view to discovering which behaviours distinguish psychotherapists trained in this method from others, of equal clinical experience. A rating scheme designed to capture the theoretical aspects of the model, and 30 predictions were made concerning behaviours which were expected to distinguish the psychotherapists. Five psychotherapists were matched to five psychiatrists who had not been trained in this method; each doctor took on four patients for therapy, and each patient was seen on five occasions. All interviews were recorded, and excerpts from the recordings rated. Only ten of the 30 predictions were upheld. In ten further predictions, the psychotherapists displayed the appropriate behaviours, but the behaviours were not peculiar to the model, since eclectic psychiatrists also displayed them. Six model behaviours were not practised frequently by the psychotherapists, and four ‘non-model’ behaviours were equally common in either group. The research formed the basis for the preparation of materials to teach psychotherapeutic skills in a more efficient way.
Ideational Components of Anxiety: Their Origin and Content
Authors: Hibbert G.A.
Published: August 2008

Twenty-five out-patients with generalised anxiety or panic disorders were interviewed. A characteristic ideational component was identified, centering on the theme of personal danger and, in particular, on physical harm. A range of features of the ideational content is described. In the 12 months preceding onset 88 per cent of the patients had experienced significant stresses. For 50 per cent the onset of panic attacks was precipitated by somatic symptoms other than those of anxiety. The relationship between ideational content, stress and somatic symptoms is discussed.
Diabetes Mellitus and Anorexia Nervosa: Another View
Authors: Brooks Simon A.
Published: August 2008

Two patients are described in whom diabetes mellitus and anorexia nervosa occurred together. The nature of the relationship between the two conditions is discussed. It is suggested that weight loss is not always the primary goal in such patients.
Prolactin Levels after Bilateral and Unilateral ECT
Authors: Swartz Conrad , Abrams Richard
Published: August 2008

Serial post-ictal serum prolactin levels were obtained over a period of one hour after bilateral or unilateral electroconvulsive therapy (ECT) in six patients. Bilateral ECT yielded significantly higher mean post-ictal prolactin levels than unilateral ECT at the 15,20,30 and 60 minute sampling times. These findings demonstrate a greater hypothalamic-stimulating effect of bilateral than unilateral ECT, and may explain the reported therapeutic advantage of bilateral over unilateral ECT in the treatment of patients with melancholia.
A Syndrome of Misinterpreting Role Changes as Changes of Person
Authors: MacCallum W. A. G.
Published: August 2008

A syndrome is described in three elderly women who all suffered from cerebral arteriosclerosis, and who in their dependent condition were looked after by their daughters. These women accepted their daughters as their daughters when carrying out directly caring tasks related to them, but spoke of them and addressed them as different women, with the same forenames as their daughters, when their daughters were engaged in other duties. This syndrome is compared with the syndromes of Capgras and similar conditions. It is likely to be detected with increasing frequency as psychiatrists become involved in the community aspects of the speciality.
Visual Hallucinations and Sensory Delusions in the Elderly
Authors: Berrios G. E. , Brook P.
Published: August 2008

One hundred and fifty successive referrals to a psychogeriatrician were assessed for visual hallucinations. Forty-four (29.33 per cent) patients reported visual perceptual disturbances. No differences between hallucinators and non-hallucinators were found in terms of sex, age, length of illness, underlying psychiatric diagnosis or cognitive score. There was a significant correlation between presence of hallucinations and eye pathology (<.001) and delusions (<.001). The phenomenological characteristics of the visual hallucinations are analyzed. The “picture” sign is described in 7 patients and the Charles Bonnet syndrome in two. The significance of these findings is discussed.
General Practice Psychiatric Clinics
Authors: Tyrer Peter , Seivewright Nicholas , Wollerton Stanley
Published: August 2008

The impact of devolving out-patient care to general practice (GP) psychiatric clinics over a two-year period is examined by comparing the frequency of contact with different psychiatric services in practices with and without psychiatric clinics. The clinics led to an increase in the number of outpatients seen, but to a fall in the number of new referrals. There was also a relative increase in the number of domiciliary visits and increase in acute day hospital referrals. The most important result was a 20 per cent fall in the number of admissions to the psychiatric hospital, which took place at a time when the national trend of falling admission rates was reversed. The findings suggest that psychiatric resources for in-patients can be deployed successfully in primary care without any increase in staffing.
Hypocholesterolaemia in Cancer and Other Causes of Death in the Mentally Handicapped
Authors: Jancar J. , Eastham R. D. , Carter G.
Published: August 2008

Serum cholesterol levels were estimated in 313 mentally handicapped patients who subsequently died from various causes. Although cholesterol levels in the mentally handicapped are lower than those in the general population, it was found that there was still an association between relatively low serum cholesterol values and mortality due to cancer of the colon. Similarly, patients who died from myocardial infarction had relatively high serum cholesterol levels. The mechanism of the relationship between hypocholesterolaemia and cancer of the colon is unclear, but the increasing longevity of the mentally handicapped is an important factor which has contributed to a rising incidence of cancers, particularly gastrointestinal forms, in this group.
Case Report: Psychomotor Status-like Episodes under Haloperidol Treatment
Authors: Kaminer Y. , Munitz H.
Published: August 2008

Generalized and partial seizures induced by antipsychotic agents are well documented in the medical literature, but these patients generally do not present a management problem. The incidence of this phenomenon is less than 1% in both psychiatric and general medical population (Malcolm, 1972); we came upon only one report of a psychomotor status-like episode due to iatrogenic drug effect in the relevant literature (Kuschke, 1972). According to Gastaut's (1970) classification of epileptic seizures, the general term for psychomotor status is partial seizures with complex symptoms.
Children who Poison Themselves II. Prediction of Attendance for Treatment
Authors: Taylor E. A. , Stansfeld S. A.
Published: August 2008

The factors making for therapeutic engagement were examined in a series of 50 schoolchildren who had deliberately poisoned themselves. Of these 28 kept an appointment for psychiatric treatment: they were characterised by high levels of psychological symptoms, especially those of depression. The kind of treatment offered was not predictive, but parental attitudes and background contributed to the likelihood of returning for treatment. Psychiatric treatment, if effective, would be appropriate for many such children, and should be offered to them.
Testosterone Therapy for Low Sexual Interest and Erectile Dysfunction in Men: a Controlled Study
Authors: O'Carroll Ronan , Bancroft John
Published: August 2008

A double blind cross-over comparison of testosterone and placebo injection was carried out in two groups of men with normal circulating testosterone levels, 10 complaining principally of loss of sexual interest and 10 complaining principally of erectile failure. A significant increase in sexual interest was produced by testosterone in the first group. There was no effect on erectile function in either group. These results support previous findings from hypogonadal men that testosterone influences sexual interest but not erectile function, and indicate that increasing plasma testosterone can effect sexual interest even in men with pre-treatment testosterone levels within the normal range.
Modern or Traditional? A Study of Treatment Preference for Neuropsychiatric Disorders in Botswana
Authors: Dale Jeremy R. , Ben-Tovim David I.
Published: August 2008

Subjects in Botswana were asked to state their preference between modern (doctor or nurse) or indigenous (traditional or religious healer) care for three case vignettes of epilepsy, psychosis, and tuberculosis. Nurses, medical patients, and a general village population were studied. Many subjects preferred modern care for all disorders, whilst a small number favoured indigenous treatment only. A significant percentage discriminated between disorders, choosing indigenous care for some and modern for others. Indigenous care was most favoured for epilepsy, and least for tuberculosis. Psychosis took an intermediate position. The size of the discriminating group varied between populations, but the overall pattern of attitudes remained the same. Neither demographic factors nor aetiological beliefs consistently identified those who choose indigenous care.
Psychophysiological Assessment of Expressed Emotion in Schizophrenia: A Case Example
Authors: Tarrier Nicholas , Barrowclough Christine
Published: August 2008

Previous research has demonstrated a different psychophysiological response of schizophrenic patients depending on whether their key relative was rated high or low on Expressed Emotion (EE). A case assessment is described in which a young man suffering from schizophrenia, who lived with both a high EE and a low EE parent, was tested psychophysiologically in their presence using an ABAC design. The patient demonstrated a significantly higher amount of spontaneous activity in skin conductance level when the high EE parent was present. The high EE parent also demonstrated a greater perceived inability to cope, and a higher level of personal distress.
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Authors: Thompson Christopher
Published: August 2008

There is currently a great deal of interest in whether or not circadian rhythms are capable of explaining certain psychiatric phenomena. This short review will briefly explain the concept of endogenous circadian rhythms and then go on to describe some of the attempts to relate this to psychiatry. It is not possible to give a complete discussion in the space available and interested readers are referred to two recent texts on circadian rhythms (Wever 1979, Minors and Waterhouse, 1981). The psychiatric aspects have been reviewed by Sampson and Jenner (1975).
Psychosis in Bipolar and Unipolar Affective Illness with Special Reference to Schizo-affective Disorder
Authors: Winokur George
Published: August 2008

Bipolar and unipolar patients respectively were separated into psychotic and non-psychotic sub-types. The bipolar psychotic patients were more likely to have certain severe symptoms, such as hallucinations and motor abnormalities, than were the unipolar patients, but the family histories of the four sub-groups were identical. The psychotic sub-groups had a different course of illness, in that they were less likely to have had a history of multiple episodes on admission and were more likely to show chronicity for a period of time on discharge. The data are interpreted as being opposed to the concept of a continuum of vulnerability in the affective disorders, and as not favouring either psychotic unipolar or psychotic bipolar illnesses or schizo-affective disorder being considered autonomous. One possible interpretation of the findings is that a trait or propensity to psychosis is transmitted totally independently of the major affective illness, and that this propensity is silent or not observed when the patient is in remission.
A Re-Evaluation of the Viral Hypothesis: Is Psychosis the Result of Retroviral Integration at a Site Close to the Cerebral Dominance Gene?
Authors: Crow Timothy J.
Published: August 2008

The extent to which concordance rates for schizophrenia in monozygotic twins (between 36 and 58%) fall short of 100% is often taken as an index of the role of an environmental factor in schizophrenia, but such an agent remains elusive. That schizophrenic symptoms are observed in some viral illnesses suggests that schizophrenia might be due to a gene-virus interaction, but analysis of age of onset in pairs of siblings with the disease rules out horizontal transmission. An alternative hypothesis is proposed that onset of disease is due to the expression of a ‘provirus', which is integrated in the genome, having been acquired either by prenatal infection or in the germ-line from an affected parent; this could explain why the season of birth effect is accentuated in, and perhaps confined to the group of patients without a family history of the disease.

Germ-line integration is known to occur following infection with agents of the retrovirus class.∗ Such agents can integrate at many sites in the host genome, but their interactions with proto-oncogenes (cellular genes which may act as growth factors) identify one type of integration site, and are. associated with some of their pathogenic effects. Some characteristics of schizophrenic illness, particularly their selectivity for the dominant hemisphere, can be understood on the assumption that the virus (perhaps a retrovirus) responsible for the disease interacts with a proto-oncogene, which induces the asymmetrical brain growth responsible, for laterality and cerebral dominance. The aetiologies of manic-depressive illness and schizophrenia may be related (the season of birth and onset effects are the same for the two conditions) and there is some evidence that the former transmutes into the latter in succeeding generations. The persistence of the functional psychoses may be due to the ability of the psychosis gene (or ‘provirus’) to induce change in the genetic mechanisms responsible for the development of laterality. (∗ See postscript pp 253).
Psychiatric Aspects of Diabetes Mellitus
Authors: Surridge D. H. C. , Erdahl D. L. Williams , Lawson J. S. , Donald M. W. , Monga T. N. , Bird C. E. , Letemendia F. J. J.
Published: August 2008

A descriptive study of the psychiatric findings in 50 insulin—dependent diabetics is presented. Among the symptoms found were a marked reduction in energy level, increased fatigue and irritability, depression, and delayed psychosexual maturation. Diabetes mellitus is commonly considered to be a disease that, if properly controlled, allows the patient to lead a relatively normal life. We found, however, that these symptoms often made the patients' lives uncomfortable, reduced their functional capacity, disrupted their family life, and disturbed the adolescence of those who were affected at an early age.
Mortality of a Lithium-Treated Population
Authors: Norton Beverley , Whalley Lawrence J.
Published: August 2008

In South-East Scotland, 791 subjects treated with lithium for more than two months during 1967–76 were traced, using public and health service records; 751 were traced alive, 33 had died, and seven remained untraced. The standardised mortality rate was 2.83, and excess mortality was attributable to suicide (increased 36-times) and cardiovascular disease (increased 2.15-times); deaths from nephropathy, cancer or leukaemia were not increased. Comparison of the 33 deaths and 33 matched patients, selected from the 751 survivors, showed that patients dying on lithium were similar in most respects to survivors, but when first starting lithium, they had more signs of physical disease.
Why are the Mentally Handicapped admitted to Hospital?
Authors: Carter G.
Published: August 2008

Admissions of mentally handicapped patients over a ten-year period to a hospital group with a catchment area population of 213, 000 are described and discussed. During this time, there was a progressive increase in temporary admissions for assessment, day care, and for both planned and emergency respite care. There were also 89 admissions for permanent care associated with conditions such as psychiatric disorder, multiple handicap, and changed family circumstances.
A Study of Benzhexol Abuse
Authors: Crawshaw John A. , Mullen Paul E.
Published: August 2008

The occasional abuse of anticholinergic drugs for their psychotropic and specifically hallucinogenic properties has been known for over a century, but benzhexol (trihexyphenidyl) abuse has only recently attracted attention in the literature, mainly in case reports. This paper reports on a study of 21 benzhexol abusers. They were a young, single, and disadvantaged group of poyldrug abusers with poor employment, educational, and social skills, who abused benzhexol mainly for its euphorogenic properties. The two major diagnostic categories were antisocial personality disorder and schizophrenia. An unexpected finding was cognitive impairment persisting after acute intoxication.
Family Therapy with the Elderly Mentally Ill
Authors: Ratna Lawrence , Davis Jill
Published: August 2008

Over a six month period, 142 consecutive referrals of patients over 65 to a community-orientated psycho-geriatric service in North London were studied. The psycho-social factors determining referral were quantified and their relationship to diagnosis analysed. Therapeutic strategies are described, devised to deal with the presenting psycho-social problems. It is suggested that a family-centred approach is of some value in the management of the elderly mentally ill.
Rejection of a Child by his Mother
Authors: Brockington I. F. , Brierley E.
Published: August 2008

It is known that the development of maternal feelings for a newborn baby is often delayed or may not occur at all (Robson & Moss, 1970); something is also known about the psychopathology of the mother-baby relationship (Margison, 1982) but little has been written about the natural history and treatment of child rejection. The case reported here demonstrates that long-lasting rejection can be successfully treated.