bluuebunny/crossref_metadata_2025 huggingface dataset:
Which Depressed Patients will Respond to Electroconvulsive Therapy?
Authors: Scott Allan I. F.
Published: August 2008

A small yet significant minority of contemporary patients with endogenous depressive illness who are treated with electroconvulsive therapy (ECT) gain little or no benefit. It is argued that the use of clinical features alone may not improve the ability to predict outcome after ECT. Many biological measures have been used to attempt to identify depressed patients for whom ECT would be an effective treatment, but none has yet been shown to be superior to clinical predictors. Depressed patients show a wide range of physiological responses to the first treatment of a course of ECT. Of these physiological responses, estimations of seizure threshold and of the release of posterior pituitary peptides merit further investigation as putative predictors of recovery.
Hospital Suicides: Are There Preventable Factors?
Authors: Goh Seng Eng , Salmons Paula H. , Whittington R. M.
Published: August 2008

The coroner's and hospital records of 57 consecutive in-patient or day-patient suicides were examined. There was a preponderance of males, but no difference between the sexes in violent deaths. The patients were generally chronically ill, and risk of suicide continued indefinitely after diagnosis. Risk was recorded in the medical notes for 16 patients and in the nursing notes for 12, but only six were under special observation. Half the patients were thought to be improving at the time of death. Psychiatrists and coroners should pay attention to aspects such as nursing and environmental factors in suicides in order to identify those at risk.
AIDS as a Current Psychopathological Theme
Authors: Todd John
Published: August 2008

Five patients are described, whose common fear of contracting, or a belief of having contracted, AIDS is the presenting feature. There is a need for liaison with psychiatrists in the provision of counselling services for AIDS patients.
Treatment of Severe Psychiatric Illness in a Day Hospital
Authors: Creed Francis , Anthony Philip , Godbert Ken , Huxley Peter
Published: August 2008

Severity of psychiatric illness was assessed using standardised clinical and social measures in 69 in-patients and 41 day patients admitted consecutively from the community. Day and in-patients differed little in terms of psychiatric symptoms and social disability, especially if compulsory admissions were excluded. Protection of self or others was a common reason for in-patient admission given by clinicians, who were otherwise prepared to treat seriously ill patients in the day hospital. Very few of the day patients had to be transferred to the in-patient facility, and at three months and one year the two groups showed similar improvements. It is concluded that day treatment is feasible for some seriously ill psychiatric patients, but a random-allocation study is required to assess more completely the efficacy of day treatment, and define the characteristics of those who require in-patient admission.
PROQSY: a Computerised Technique for Psychiatric Case Identification in General Practice
Authors: Wilkinson Greg , Markus A. C.
Published: August 2008

Two-stage screening for minor psychiatric morbidity was carried out with a consecutive sample of 256 patients aged 15–69 consulting an experienced GP in a semirural setting over a seven-week period. Patients completed a short GHQ, and the GP made a standardised assessment of the reason for consultation and the degree of psychological disorder. A 40% random subsample were evaluated using PROQSY, a newly developed computerised psychiatric assessment based on the CIS. PROQSY is acceptable to patients in general practice, and yields an estimate of the prevalence of minor psychiatric morbidity (33%), and validity indices for the 12-item, 28-item, and 30-item GHQs, comparable with those found in similar studies, when the CIS has been administered by an interviewer. PROQSY may be recommended as a research tool, providing a criterion measure of minor psychiatric morbidity in general practice, where it may reduce time and manpower, and eliminate interviewer bias.
Perceptivity and Paraceptivity During Measurement of Gastric Emptying in Anorexia and Bulimia Nervosa
Authors: Robinson P. H.
Published: August 2008

Gastric emptying of a mixed meal was measured in 22 patients with anorexia nervosa, ten with bulimia nervosa and ten controls. Ratings on a visual analogue scale (VAS) were made during the test. Patients with anorexia nervosa felt fuller and less hungry than controls, although satiety was not related to gastric emptying rate. Controls showed a correlation of about 0.6 between gastric contents and reported hunger and satiety. Patients with anorexia nervosa had significantly lower correlations between gastric contents and hunger, but normal correlations with fullness. Significant correlations were often observed between gastric contents and symptoms of eating disorder in both anorexic and bulimic groups, but not in controls.
Psychotherapy and General Practice
Authors: Gask Linda , McGrath Graeme
Published: August 2008

The authors review the development of liaison psychotherapy in general practice, and argue that a 'skill-sharing’ approach, where the general practitioner retains the treatment role, is a more efficient model than a ‘consultation’ approach. Skill-sharing models are reviewed, and the need for psychiatrists and psychotherapists to be more directly involved in teaching basic psychotherapeutic skills to general practitioners is emphasised.
Factors Associated with the Course and Outcome of Schizophrenia in India Results of a Two-Year Multicentre Follow-Up Study
Authors: Verghese A. , John J. K. , Rajkumar S. , Richard J. , Sethi B. B. , Trivedi J. K.
Published: August 2008

The paper describes the two-year follow-up results from 323 out of 386 patients fulfilling a modified version of Feighner's criteria for diagnosis of schizophrenia, in Lucknow, Vellore, and Madras. There was remission in 66% of cases. Short duration of illness, consistent compliance with medication, positive attitudes of relatives and neighbours, absence of economic difficulties, increase in religious activities on the part of patients, a rural background, and a non-schizoid pre-morbid personality were associated with good outcome. Features of depression, dangerous behaviour, and absence of agitation were associated with poor outcome.
Epilepsy and Arson
Authors: Carpenter Peter K. , King Alan L.
Published: August 2008

A man temporarily developed an organic personality change, psychosis and epilepsy after a frontal lobe operation for a subarachnoid haemorrhage. While affected, he set fire to his house. The arson is thought to have been a direct result of a seizure. The case and its legal management are discussed.
Psychotic Illness Following Termination of Pregnancy
Authors: Davidson Kim , Clare Anthony W.
Published: August 2008

A case of a psychotic illness following an induced termination of pregnancy is described; this is discussed in relation to the literature on the subject, and possible aetiological factors in the case are reviewed.
The Relationship Between Depression and Hopelessness
Authors: Greene Sheila M.
Published: August 2008

In both Beck's cognitive theory of depression and Brown & Harris's sociopsychological model, hopelessness is given unwarranted universality and centrality. Empirical evidence contradicting this element of the two theories has been ignored, and two new investigations are presented which suggest the existence of ‘non-hopeless' depression. A more complete account of the heterogeneous nature of depression is now required.
Quality of Parenting in Alcoholics and Narcotic Addicts
Authors: Bernardi Elsa , Jones Michael , Tennant Chris
Published: August 2008

Alcoholics and heroin addicts were compared with a normal control group to determine whether there were differences in quality of parenting during childhood, assessed using the Parental Bonding Instrument. Maternal and paternal overprotection were reported more commonly by narcotic addicts. Maternal overprotection alone was implicated in alcoholics. Narcotic addicts seem to have more disturbed parenting than alcoholics, especially paternal parenting.
Anorexia Nervosa in Hong Kong
Authors: Lee Sing , Chiu Helen F. K. , Chen Char-Nie
Published: August 2008

Anorexia nervosa is a geographically distinct psychiatric disorder; it is rapidly increasing in incidence in Western countries, while being virtually unreported in China, or in the Chinese community of Hong Kong. This is surprising when the Chinese preoccupation with food and their reported readiness to somatise dysphoria are considered. Three Chinese anorectics born and living in Hong Kong and exhibiting mostly typical clinical features are reported. The rarity of the disorder in the East could be related to protective biological and sociocultural factors specific to the Chinese, and while it may become more common, anorexia nervosa is unlikely to reach Western proportions.
Two Cases of Agranulocytosis on Addition of a Butyrophenone to a Long-Standing Course of Phenothiazine Treatment
Authors: Young Allan , Kehoe Robert
Published: August 2008

Two cases of agranulocytosis occurring after addition of a butyrophenone to a course of phenothiazine treatment are reported and possible mechanisms for this interaction are discussed. Agranulocytosis is a well-documented adverse effect of phenothiazine administration (Vincent, 1986). Important factors are the total amount of drug given and the duration of administration. Agranulocytosis usually occurs within the first three months of therapy (Pisciotta, 1971; Marcus & Mulvihill, 1978) and the relationship with the cumulative dose has been emphasised (Ananth et al, 1973). Agranulocytosis following prolonged administration has been rarely reported (Denber, 1970, Pisciotta, 1978). We report two cases where agranulocytosis developed in patients with a long previous exposure to phenothiazines, treated for the first time with a combination of phenothiazines and a butyrophenone.
The Womb Lay Still in Ancient Egypt
Authors: Merskey Harold , Potter Paul
Published: August 2008

Any reader of the handbooks of medical history will know that among the ancient Greeks, the womb was on occasion held to cause various complaints by moving about the body. A particularly graphic account is to be found in the Timaeus (91b–c), where, in likening sexual desire to an actual animal, Plato first mentions “… in men the organ of generation becoming rebellious and masterful like an animal disobedient to reason”, and then alludes to:
Eating Habits in Dementia
Authors: Morris Charles H. , Hope R. A. , Fairburn Christopher G.
Published: August 2008

The eating habits of 33 patients with dementia were studied. They were assessed by semistructured interview with a relative who was able to act as an informant for the whole period of the dementia. Changes in eating were found to be common and included both increased and decreased food intake, altered food choice, the consumption of inedible substances and disturbances in the process of eating. The clinical significance of these changes and some likely underlying mechanisms are discussed.
The Validity of the Eating Disorder Examination and its Subscales
Authors: Cooper Zafra , Cooper Peter J. , Fairburn Christopher G.
Published: August 2008

The EDE is a semistructured interview which has been developed as a measure of the specific psychopathology of anorexia nervosa and bulimia nervosa. To establish its discriminant validity it was administered to 100 patients with anorexia nervosa or bulimia nervosa and to 42 controls. The two groups differed significantly on all items. Five subscales were derived on rational grounds and evaluated on the two populations. The α coefficients for each subscale indicated a satisfactory degree of internal consistency. The EDE provides clinicians and research workers with a detailed and comprehensive profile of the psychopathological features of patients with eating disorders.
The Effects of Childhood Parental Death and Divorce on Six-Month History of Anxiety Disorders
Authors: Tweed J. Lindsey , Schoenbach Victor J. , George Linda K. , Blazer Dan G.
Published: August 2008

Duke Epidemiologic Catchment Area (ECA) data were used to examine the relationships between: (a) early childhood maternal death, paternal death, and parental separation/divorce, and (b) six-month DIS/DSM-III diagnoses of agoraphobia with and without panic attacks, simple phobia, social phobia, panic disorder, generalised anxiety disorder, and obsessive-compulsive disorder. Associations were found between: (a) maternal death and agoraphobia with panic attacks, and (b) parental separation/divorce and agoraphobia with panic attacks and panic disorder. The associations could not be explained by the effects of potentially confounding socio-demographic factors.
Would Monitoring by Electroencephalogram Improve the Practice of Electroconvulsive Therapy?
Authors: Scott Allan I. F. , Shering P. Anne , Dykes Sheena
Published: August 2008

Estimates of seizure length made by the treating psychiatrist were compared with estimates made by six-channel EEG in 100 electroconvulsive treatments in 22 depressed patients. In 70 treatments the doctor observed a fit which was shorter than 25 seconds. No doctor restimulated a patient in such a case and on only three occasions was the electrical stimulus increased at the next treatment. EEG monitoring revealed that only 30 of the treatments resulted in a seizure of less than 25 seconds, and this was detected in almost all cases by the treating doctor. The potential value of EEG monitoring was to identify patients whose visible seizure was short but where cerebral seizure length was satisfactory. Trainee psychiatrists often mismanage patients who have short seizures.
The Functional Discrimination of Attachment and Affiliation
Authors: Sheldon Adrienne E. R. , West Malcolm
Published: August 2008

Volunteer college students completed a categorisation task designed to test the hypothesis that adults organise their expectations of relationships in a manner that reflects a functional distinction between attachment and affiliation. Terms associated with the provision of security and with characteristics theoretically identified as definitive of attachment relationships were significantly more likely to be associated with the relationship identified as ‘lover’. There was substantial overlap between attachment and affiliation relationships in functions relating to intimacy and disclosure. These results highlight the need to differentiate close relationships by functional rather than structural characteristics.
The Role of Electroconvulsive Therapy in the Treatment of Depressive Illness in Old Age
Authors: Benbow Susan M.
Published: August 2008

Electroconvulsive therapy is an important treatment in the depressive states of late life, and there is general agreement about the indications for its use in old age psychiatry. Indeed, old age may be associated with a better response to ECT than that in younger age groups. The additional risk involved through physical problems in the elderly is not great when compared with that of continuing depression and of the side-effects of alternative treatments. Temporary memory disorders and confusion may occur, but are minimised if unilateral electrode placement is used. Some patients treated with unilateral ECT do not respond, but will respond to bilateral treatment. Anxiety over unwanted treatment effects, which can lead to ineffective treatment of depressive illness, must be outweighed by knowledge of the dangers of leaving depression untreated in old age.
‘Puerperal Psychosis' Following Male-to-Female Sex Reassignment?
Authors: Mallett P. , Marshall E. J. , Blacker C. V. R.
Published: August 2008

Psychosis is reported following abrupt withdrawal of oestrogen and surgery for male-to-female sex reassignment. The resemblance of the patient's mental state to puerperal psychosis suggested a hormonal aetiology.
Deinstitutionalisation — from Hospital Closure to Service Development
Authors: Thornicroft Graham , Bebbington Paul
Published: August 2008

The necessary components of a comprehensive service of local non-institutional forms of care for the seriously mentally ill have been researched separately in pilot trials, but not within integrated programmes for defined populations. Reported outcomes are at least as favourable as for traditional long-term hospital care, but alternative provisions are no less costly. A case manager system may allow co-ordinated formal and informal services to meet the individual needs of chronically ill patients. Poorly integrated programmes will expose discharged patients to disadvantages.
A Profile of Long-Stay Psychogeriatric Patients
Authors: Hilton Z. , Ong Y. L. , Richardson A. , Bender M. P. , Cooper A. F.
Published: August 2008

An assessment of 106 long-stay psychogeriatric in-patients in an East London borough was made using the CAPE and supplementary items in order to obtain a comprehensive picture of their needs; 51 long-stay residents in the care of local authority social services provided a comparison. Patients in hospital were found to be more disturbed, more disabled and more dependent than residents in local authority care.
Impaired Lymphocyte Stimulation by Mitogens in Severely Depressed Patients
Authors: Maes Michaël , Bosmans Eugéne , Suy Eduard , Minner Bob , Raus Jef
Published: August 2008

To investigate the relationships between the immune apparatus, major depression, and HPA-axis and noradrenergic activity, the authors measured the lymphocyte stimulation responses to the mitogens phytohaemagglutinin (PHA), pokeweed mitogen (PWM) and concanavalin A (CON A), post-dexamethasone Cortisol (DST) values and 3-methoxy-4-hydroxyphenylglycol (MHPG) excretion in 24-hour urine samples from 48 patients. We found that lymphocyte responses to PHA and PWM in melancholic and psychotic depressives were significantly lower than in minor depressives. The lymphocyte responses to PHA, PWM and CON A showed significantly negative correlations with age, DST results and HRSD score. Responses to PHA were significantly negatively correlated with MHPG excretion. Up to ±33% of the variance in the three mitogenic lymphocyte responses could be explained by canonical correlation with age, DST results and MHPG values.
HIV Infection: Psychiatric Findings in the Netherlands
Authors: Sno Herman N. , Storosum Jitschak G. , Swinkels Jan A.
Published: August 2008

A psychiatric consultation was requested in 51 in-patient cases of HIV infection. Reasons for referral included counselling, the evaluation of depressive symptoms, and the treatment of delirium. The most common DSM–III diagnoses included: delirium (n = 13), major depressive disorders (n = 12), dementia (n = 5), and adjustment disorders with depressive or anxious mood (n = 5). The psychiatric treatment of patients with HIV infection does not differ fundamentally from that of other medically ill patients with similar psychiatric symptoms. However, the psychiatric treatment of patients with HIV infection can be hampered by the fear of contagion, negative attitudes towards homosexuals and drug users, and overidentification or avoidance reactions.
Aggressiveness, Anxiety and Drugs
Authors: Kirov Kiril
Published: August 2008

Aggression and anxiety are among the most common phenomena needing medical control, especially in acute mental disorders. Today we can choose from a confusingly large array of drugs which can quickly control these two kinds of emotional and behavioural disorders. Everyday practice shows that these two groups of symptoms, seemingly so different from one another, can be treated with the same drugs. If we probe more deeply into the matter, we find that the similarities in these effects include not only inhibition of aggressiveness and anxiety but also their enhancement, activation, and provocation. These effects seem to form a regular pattern: those that increase aggressiveness (sympathicomimetics, catecholamines, ‘activating’ antidepressants, psychostimulants, and anti-Parkinsonics (cholinolytics)) also tend to increase anxiety, while those that decrease aggressiveness (beta-blockers, neuroleptics (major tranquillisers), ‘sedative’ antidepressants, minor tranquilisers, hypnotics, analgesics, and anticonvulsants) also tend to decrease anxiety.
Paedophilia and Hyperprolactinaemia
Authors: Harrison Paul , Strangeway Philip , McCann Jacinta , Catalan Jose
Published: August 2008

The case of a man presenting with paedophilia who has found to be hyperprolactinaemic is described. There is possibly a link between paedophilia and endocrine disorders.
Depressive Illness in Multiple Sclerosis
Authors: Berrios G. E. , Quemada J. I.
Published: August 2008

The present state of knowledge of the possible relationship between depressive illness and multiple sclerosis is described. Problems of the research methodology are identified and suggestions made for useful areas of inquiry.
Anxiety and Depression in Mothers of Children with Psychotic Disorders and Mental Retardation
Authors: Ryde-Brandt Brita
Published: August 2008

Using the HAD scale, anxiety and depression were assessed in 18 mothers of mentally retarded psychotic children and a comparative group of 18 mothers of children with motor handicaps. Anxiety and depression scores were significantly higher among the mothers of the psychotic children, although no definite signs of depression were recorded.
Screening for Adjustment Disorders and Major Depressive Disorders in Cancer In-Patients
Authors: Razavi Darius , Delvaux Nicole , Farvacques Christine , Robaye Edmond
Published: August 2008

The Hospital Anxiety and Depression Scale (HADS), a four-point, 14-item questionnaire, was tested as a screening method for adjustment disorders and major depressive disorders in a sample of 210 cancer in-patients. A receiver operating characteristic (ROC) analysis was performed, giving the relationship between the true positive rate (sensitivity) and the false positive rate (1 – specificity). This makes it possible to choose an optimal cut-off point that takes into account the costs and benefits of treatment of psychological distress. For screening for major depressive disorders only, a cut-off score of 19 gave 70% sensitivity and 75% specificity. For screening for adjustment disorders and major depressive disorders taken together, a cut-off score of 13 gave 75% sensitivity and 75% specificity. HADS appears in this study to be a simple, sensitive and specific tool for screening for psychiatric disorders in an oncology in-patient population.
Psychological Aspects of HIV Infection and AIDS
Authors: King Michael B.
Published: August 2008

Publications on the acquired immunodeficiency syndrome (AIDS) have reached such a pitch that leading medical journals have received letters of protest (Kubin, 1989), and some have been forced to defend themselves for the space they devote to the subject (Lock, 1989). While some consider that their problems have been ignored and that AIDS is attracting too much money and publicity (Adler, 1987), others believe AIDS research and clinical services are grossly underfunded (Rogers, 1989). Perhaps because modern medicine has rarely encountered such a completely ‘new’ disorder the fascination is great, no less in psychiatry than in other fields. An editorial in theLancet(1989), just before the annual International Conference on AIDS, reminded us bluntly of the crucial questions: how many cases of HIV infection had been prevented in the year since the previous conference, and how many would be prevented before the next?
First-Rank Symptoms of Schneider
Authors: Trimble Michael R.
Published: August 2008

Based on evidence from patients with epilepsy who develop a schizophrenia-like illness, it is argued that the first-rank symptoms of Schneider are closely related to temporal lobe pathology, particularly in the dominant hemisphere. It is suggested that the first-rank symptoms should be seen as signifiers of temporal lobe pathology, as opposed to being pathognomonic for schizophrenic illness.
Cognitive Processing and its Relationship to Symptoms and Social Functioning in Schizophrenia
Authors: Allen Heidi
Published: August 2008

This study analyses the relationship between contextual processing ability and symptom and social status in schizophrenia. The results showed that current symptom status is related to occupational status, and contextual processing is related to current symptom status and employment history. Current symptom severity in chronic schizophrenics may indicate an increased frequency and/or duration of symptom episodes in the past, and therefore an increase in the periods in which contextual processing was disturbed, which would therefore account for the observed decrease in work achievements.
General Hospital Admission in the Management of Parasuicide
Authors: Waterhouse John , Platt Stephen
Published: August 2008

Suitably trained junior doctors selected parasuicides with no immediate medical or psychiatric treatment needs on initial assessment in a casualty department. This group was then randomly allocated to hospital admission (38 cases) or discharge home (39 cases). One week later there were no significant differences between groups on diverse outcome measures, including repetition rate, psychological symptoms, and social functioning. A second follow-up using the same measures at 16 weeks also failed to demonstrate any differences between groups, both of which showed considerable overall improvement. A parasuicide management policy consisting of assessment in a casualty department and selective discharge was appropriate for 15% of a hospital-referred population. This lends support to recent government recommendations, but caution should be exercised before such a result is generalised.
Attachment and Morality: Developmental Themes with Different Values
Authors: Wolff Sula
Published: August 2008

The stage theories of personality development, such as those of Piaget, Freud, and Erikson, are not currently popular, in part because of misunderstandings about the supposed restrictions of timing and of confines of developmental stages. But the stage theorists did draw attention to newly appearing, qualitatively different cognitive, emotional, and behavioural systems of interaction, which come into being sequentially as children grow up.
From Categories to Contexts: A Decade of the ‘New Cross-Cultural Psychiatry’
Authors: Littlewood Roland
Published: August 2008

Over the last ten years a new approach to psychiatric knowledge has developed under the influence of social anthropology. Its origins, assumptions, methods, achievements, and limitations are reviewed.
Relatives' Expressed Emotion and the Course of Schizophrenia in Chandigarh
Authors: Leff J. , Wig N. N. , Bedi H. , Menon D. K. , Kuipers L. , Korten A. , Ernberg G. , Day R. , Sartorius N. , Jablensky A.
Published: August 2008

A two-year follow-up was conducted of a subsample of the Chandigarh cohort of first-contact schizophrenic patients from the WHO Determinants of Outcome project. The patients were those living with family members who had been interviewed initially to determine their levels of expressed emotion (EE). The interview was repeated for 74% of the relatives at one-year follow-up. A dramatic reduction had occurred in each of the EE components and in the global index. No rural relative was rated as high EE at follow-up. Of the patients included in the one-year follow-up, 86% were followed for two years. In contrast to the one-year findings, the global EE index at initial interview did not predict relapse of schizophrenia over the subsequent two years. However, there was a significant association between initial hostility and subsequent relapse. The better outcome of this cohort of schizophrenic patients compared with samples from the West is partly attributable to tolerance and acceptance by family members.
The Incidence of Schizophrenia in Croatia
Authors: Folnegović Z. , Folnegović-šmalc V. , Kulčnar Ž.
Published: August 2008

Hospital-based annual incidence rates for schizophrenia in Croatia over 1965–84 did not change significantly. Rates ranged from 0.21 to 0.22 per 1000 population (0.26–0.29 per 1000 population aged over 15). Factors that could influence these rates were analysed, but it appeared that the rates were a true reflection of the incidence rate of schizophrenia in the Croatian population.
Symptoms and Social Adjustment in Jewish Depressives
Authors: Ball R. A. , Clare A. W.
Published: August 2008

In 25 Jewish and 26 non-Jewish depressives resident in Hackney, the PSE revealed that ‘hypochondriasis' and ‘tension’ were more common in the Jewish group, and special features of depression, containing symptoms connected with guilt, was less common. These differences could not be explained by variation in severity of illness as both groups had similar scores on the HRSD. The ‘social maladjustment’ scores were similar, very probably reflecting an elderly, deprived, inner-city population.
Problem Resolution and Repetition of Parasuicide
Authors: Sakinofsky Isaac , Roberts Robin S. , Brown Yvonne , Cumming Carmen , James Patricia
Published: August 2008

Resolution of presenting problems at three-month follow-up was studied in 228 parasuicides. ‘Non-resolvers' presented with less severe problems, but prodromes were longer, prior episodes more frequent, and they experienced more powerlessness and internally directed hostility than the resolvers. At follow-up resolvers had improved more on measures of depression, externally and internally directed hostility, locus of control, powerlessness, self-esteem, sensitivity to criticism, and social adjustment. Baseline problem severity, powerlessness (negatively), and ‘normlessness' ‘predicted’ degree of problem resolution, while baseline problem severity, the number of previous parasuicide episodes, and baseline internal hostility (the latter two variables negatively) were associated with problem resolution as a dichotomous variable. Resolvers improved more in social functioning during the follow-up than non-resolvers, but a similar proportion (16%) in each group reported repeat episodes of parasuicide at follow-up.
The Prevalence and Diagnostic Significance of Schneiderian First-Rank Symptoms in a Random Sample of Acute Psychiatric In-patients
Authors: O'Grady John C.
Published: August 2008

Ninety-nine acute in-patients were interviewed within four days of admission to hospital. The interview included items concerning all 11 first-rank symptoms. Two definitions (wide and narrow) of each first-rank symptom were employed. Three definitions of schizophrenia and a research diagnosis of major affective disorder were used to determine their relationship with first-rank symptoms. Of subjects with schizophrenia, 73% had first-rank symptoms, as had five (14%) of 34 subjects with affective disorder. The results do not support the hypothesis that first-rank symptoms are specific to schizophrenia, although the specificity of first-rank symptoms for schizophrenia increased if a narrow rather than a wide definition of symptoms was employed.
Acute Psychotic Reactions and Stress Response Syndromes Following Intramuscular Aqueous Procaine Penicillin
Authors: Ilechukwu S. T. C.
Published: August 2008

Acute non-anaphylactic reactions to procaine penicillin include fear of death, sensations of disintegration, perceived changes of body shape, and visual and auditory hallucinations. Fragments of the original reaction experience, or elaborations of it, feature prominently in a chronic syndrome which persists if the initial reaction is not supported emotionally or professionally. The cultural acceptance of the reality of ‘mysterious' forces played a role in the syndrome. Compatible diagnostic labels were panic disorder, post-traumatic disorder, mixed phobic disorder, and depressive illness. The observed period prevalence rate is 5.9 per 1000.
Anorexia Nervosa in Adolescents of Asian Extraction
Authors: Bhadrinath B. R.
Published: August 2008

Case reports of anorexia nervosa in subjects of Asian (Indian subcontinental) extraction have been rare. Three Asian adolescents with anorexia nervosa are described, one of whom is male. The impact of the Muslim festival of Ramadan is described in the two Muslim cases. There is a need for better understanding of attitudes towards body shape and food within the subculture.
Left Temporal Lobe Damage in Asperger's Syndrome
Authors: Jones P. B. , Kerwin R. W.
Published: August 2008

In the search for neurobiological factors in the aetiology of autism, interest has focused on the temporal lobes. We present a case of Asperger's syndrome in an otherwise healthy adult with direct evidence of left temporal lobe damage on computerised tomography.
The Stress Profile
Authors: Wheatley David
Published: August 2008

The Stress Profile consists of a number of questionnaires which have been developed to assess the severity of stress in nine areas of life: social habits, social relationships, life events, sexual problems, sleep, psychiatric symptoms, old age, menstrual stresses, and ‘stress and the heart’. The questionnaires have been validated for inter-rater reliability and against the Hamilton anxiety and depression rating scales. Using the Profile, the inter-relationships between different stress areas can be assessed, appropriate treatments advised, and the response to treatment in relation to different components evaluated.
Asperger's Syndrome: To be or Not to Be?
Authors: Kerbeshian Jacob , Burd Larry , Fisher Wayne
Published: August 2008

It has been questioned whether Asperger's syndrome (AS) is in fact a specific (high-functioning) subgroup of autism, rather than a distinct entity. Thirteen AS patients were compared with 13 autistic patients and 13 developmentally disordered controls. While there was symptom overlap between AS and autism, patients could be separated into one or other group. However, current criteria are based on symptoms, and it is argued that studies of genetics and treatment response are needed to elucidate the relationship between these developmental disorders.
The Continuum of Psychosis and Its Genetic Origins
Authors: Crow T. J.
Published: August 2008

Attempts to draw a line of genetic demarcation between schizophrenic and affective illnesses have failed. It must be assumed that these diseases are genetically related. A post-mortem study has demonstrated that enlargement of the temporal horn of the lateral ventricle in schizophrenia but not in Alzheimer-type dementia is selective to the left side of the brain. This suggests that the gene for psychosis is the ‘cerebral dominance gene‘, the factor that determines the asymmetrical development of the human brain. That the psychosis gene is located in the pseudoautosomal region of the sex chromosomes is consistent with observations that sibling pairs with schizophrenia are more often than would be expected of the same sex and share alleles of a polymorphic marker at the short-arm telomeres of the X and Y chromosomes above chance expectation. That the cerebral dominance gene also is pseudoautosomal is suggested by the pattern of verbal and performance deficits associated with sex-chromosome aneuploidies. The psychoses may thus represent aberrations of a late evolutionary development underlying the recent and rapid increase in brain weight in the transition from Australopithecus through Homo habilis and Homo erectus to Homo sapiens.
Insight and Psychosis
Authors: David Anthony S.
Published: August 2008

The concept of insight into psychosis has received scant attention in the psychiatric literature. Drawing on sources such as phenomenology, clinical research and experimental psychology, it is proposed that insight is not an ‘all-or-none’ phenomenon but is composed of three distinct, overlapping dimensions, namely, the recognition that one has a mental illness, compliance with treatment, and the ability to relabel unusual mental events (delusions and hallucinations) as pathological. A scheme is proposed to standardise the assessment of insight to assist further research.
Sex Differences in the Familial Transmission of Schizophrenia
Authors: Goldstein Jill M. , Faraone Stephen V. , Chen Wei J. , Tolomiczencko George S. , Tsuang Ming T.
Published: August 2008

The hypothesis that schizophrenic men have a lower familial risk for schizophrenia than schizophrenic women was tested using the DSM–III-diagnosed samples of the Iowa 500 and non-500 family studies. Survival analyses were used to test for differences in the risk for schizophrenia and spectrum disorders, for sex of proband and sex of relative, controlled for fertility effects and ascertainment bias. Male and female relatives of schizophrenic men had a significantly lower risk for schizophrenia, schizophreniform, and schizoaffective disorders than relatives of schizophrenic women. However, the effect was not significant for the full spectrum nor when analysed by sex of relative. Sex differences in the risk for other psychiatric disorders among relatives of schizophrenic probands were not significant.
Drug Prescribing for Schizophrenic Out-patients on Depot Injections
Authors: Johnson D. A. W. , Wright N. F.
Published: August 2008

Serial surveys of the prescribing practices of psychiatrists for schizophrenic out-patients over 1970–88 showed important changes. During the interval 1970–83, polypharmacy and the use of multiple neuroleptics were reduced. The total dose of neuroleptics prescribed fell and the proportion administered by depot injection increased. Since 1983, however, some of these favourable trends have been reversed. Prescribing practices may also vary between teaching and non-teaching hospitals.
An Increase in Violence on an Acute Psychiatric Ward
Authors: James David V. , Fineberg Naomi A. , Shah Ajit K. , Priest Robert G.
Published: August 2008

The increase in violent incidents on an acute psychiatric ward over a 15–month period was found to be strongly associated with the increase in use of temporary nursing staff (r = 0.63; P = 0.0005). The change in staffing patterns accounted for 39% of the variance in violence. An examination of the characteristics of all patients admitted to the ward revealed that the violent patients were significantly younger, more likely to have been admitted compulsorily and less likely to be depressed than non-violent ones.
Self-poisoning in Adolescents
Authors: Sellar C. , Hawton K. , Goldacre M. J.
Published: August 2008

Linked hospital and death records for 10–20–year-olds admitted with a diagnosis of poisoning were analysed. Between 1980 and 1985 there was a significant decline in admission rates, which was mainly attributable to a decline among 16–20–year-old females. There was no evidence of a decline in the admission rates among 12–15–year-olds. Ten per cent of the study population had at least one further hospital admission for poisoning during the mean follow-up period of 3.6 years. Female admission rates were substantially higher than those in males but readmission rates, given a first admission, were similar. The death rate in the study cohort was significantly higher than would be expected in the general population of this age and nearly all the deaths were from violent or unnatural causes.
A Variant of Capgras Syndrome with Substitution of Inanimate Objects
Authors: Rastogi S. C.
Published: August 2008

An unusual and rare variant of Capgras syndrome is reported in which a patient with depressive illness became preoccupied with doubles of inanimate objects. The patient responded to antidepressant therapy.
Manic–Depressive Psychosis in a Mentally Handicapped Person
Authors: Arumainayagam M. , Kumar A.
Published: August 2008

Diagnosis of mental illness in mentally-handicapped people is often difficult and complex, because of atypical presentation and lack of clear diagnostic criteria. A patient in whom seasonal variation in behaviour and mood gave a clue to the diagnosis of manic–depressive psychosis is reported.
Calcium-Channel Blockade and Depressive Illness
Authors: Eccleston Donald , Cole Andrew J.
Published: August 2008

A case of depressive disorder in which treatment resistance was associated with the calcium-channel blocker nifedipine is described.
Symptomatic Trans-sexualism
Authors: Commander Martin , Dean Christine
Published: August 2008

A 24-year-old male schizophrenic had a delusion that he was female and had lived his life as a woman for almost two years. Unlike the only other reported case, his ‘symptomatic transsexualism’ responded to the effective treatment of his schizophrenia.
Reduction in Antipsychotic Drug Dosage in Mentally Handicapped Patients
Authors: Wressell Susan E. , Tyrer Stephen P. , Berney Thomas P.
Published: August 2008

An investigation in a large mental handicap hospital revealed that 24% of the in-patients were receiving antipsychotic drugs. Chlorpromazine and thioridazine prescriptions accounted for 62% of the total while 10% of patients received depot preparations. Fifty-five per cent of the patients receiving these drugs had no established psychiatric diagnosis; most of these could be categorised as having a behaviour disorder. Patients aged 30–50 received higher doses, and female patients received a significantly higher mean dosage than male ones. In the patients receiving neuroleptic drugs who had also been taking them four years previously, there was a significant reduction in the dosage of the drugs received and the extent of polypharmacy of these agents. A mandatory requirement to review all prescriptions annually, implemented in 1984, may be a reason for this.
Philosophy and Medicine: the Oxford Connection
Authors: Fulford K. W. M.
Published: August 2008

Three aspects of the approach to philosophy advocated by the Oxford philosopher J. L. Austin are outlined: his conception of the nature of philosophical problems, essentially as a mixed bag; his method of linguistic analysis, namely, clarification of our concepts by active observation of the ways in which they are actually used rather than by passive reflection on their meanings; and his views on the organisation of philosophical research, that in some areas it should be pursued rather as a science is pursued, as a corporate rather than merely individual venture. It is suggested that Austin's approach provides the basis for a potentially fruitful two-way relationship between philosophical theory and medical practice.
Does Personality Predict Long-Term Outcome in Depression?
Authors: Duggan Conor F. , Lee Alan S. , Murray Robin M.
Published: August 2008

In 1965/66, a consecutive series of 89 in-patients with depression were interviewed, given two personality tests (the EPI and LOI), and were accorded a score on a neurotic-psychotic continuum (Dl). Eighteen years later, the series was followed up and the predictive power of the original data was determined. High neuroticism scores on the EPI on recovery and particularly when ill but referring to the pre-morbid state were associated with poor overall outcome and chronicity. High obsessional interference scores on the LOI on recovery were also associated with poor long-term outcome, impaired social adjustment, more time spent in hospital, and with the subsequent development of schizophrenic or schizoaffective episodes. High psychotic scores on the Dl were also associated with poor long-term outcome, a greater length of time spent in hospital, and with bipolar affective disorder, and this effect was independent of the personality measures.
Cannabis and Psychosis
Authors: Thornicroft Graham
Published: August 2008

A review of the evidence shows that there is no convincing support for a separate clinical diagnosis of ‘cannabis psychosis'. Cannabis can, however, produce brief acute organic reactions and, in moderate to heavy doses, psychotic episodes in clear consciousness. Ingestion in naive users or increasingly heavy use in habitual users can precipitate a schizophreniform episode. Heavy users may have an increased risk of developing schizophrenia in the subsequent 15 years. Well controlled, longitudinal studies are required to explore these associations further and their possible aetiological significance.
The Effects of Chronic Lithium Treatment on Psychomotor Performance Related to Driving
Authors: Hatcher Simon , Sims Ruth , Thompson David
Published: August 2008

A group of 16 psychiatric out-patients in remission, who had been taking lithium carbonate as their sole medication for at least three months, were compared with a control group of 22 healthy volunteers. On a computerised driving simulator which produced measures of reaction time, tracking ability and mistakes made, the patient group had a significantly slower reaction time. Patients should be warned therefore that lithium may affect their ability to drive or operate machinery and that psychomotor impairment and sedation are not synonymous.
Do-Do Abuse
Authors: Loosmore S. , Armstrong D.
Published: August 2008

Three cases of prolonged abuse of Do-Do tablets, an over-the-counter remedy for “coughs, wheezing and breathlessness”, are reported. They have an amphetamine-like action and were used as easily obtained amphetamine substitutes, in one case to relieve social anxiety. Withdrawal symptoms similar to those following cessation of amphetamines occurred in two cases. Do-Do tablets are CNS stimulants and their abuse may be accounted for by the fact that they perhaps affect amine neurotransmitters.
Folie à Trois among Two Soviet-Jewish Immigrant Families to Israel
Authors: Maizel Shmuel , Knobler Haim Y. , Herbstein Ruth
Published: August 2008

In two cases of folie à trois, affecting two Soviet-Jewish families who emigrated to Israel, both elderly parents in both cases shared the paranoid delusional beliefs of an only child. Severe trauma in the past and social maladjustment in the present may be among the precipitating factors for the development of the shared paranoid disorder.
Morbid Jealousy: a Review and Cognitive-Behavioural Formulation
Authors: Tarrier Nicholas , Beckett Richard , Harwood Susan , Bishay Nagy
Published: August 2008

Jealousy is a common emotion which can be considered pathological in some circumstances. The term ‘morbid jealousy’ has been used to signify this abnormal or extreme condition. However, the literature on morbid jealousy is sparse and the empirical data fragmentary. The aims of this paper are to briefly review the concept, to define the dimensions of the disorder and to apply a cognitive-behavioural framework to it. Such a summary paper is timely, to draw together the different aspects of the problem and to provide a theoretical base from which to generate further research.
Schizophrenia and Crime
Authors: Lindqvist Per , Allebeck Peter
Published: August 2008

To compare the crime rate of schizophrenics with that of the general population, data from the Central Swedish Police Register on 790 schizophrenic patients discharged from hospitals in Stockholm in 1971 was analysed for the period 1972–86. Relative risk of criminal offence was assessed by comparing the observed number of offences committed with the expected number (estimated from official statistics). The crime rate among male schizophrenics was almost the same as that in the general male population, whereas among females it was twice that of the general female population. The rate of violent offences was, however, four times higher among the schizophrenics. The violence recorded was almost exclusively of minor severity.
The Value of the Claybury Selection Battery in Predicting Benefit from Group Psychotherapy
Authors: Pearson Mark J. , Girling Alan J.
Published: August 2008

Before receiving psychodynamic group psychotherapy at the Uffculme Clinic four groups of out-patients were assessed on the Claybury Selection Battery and the SCL 90, and therapists were asked to predict their progress. Outcome was assessed at about three months and one year by patients' self-reports of symptom change on the SCL 90 and therapists' ratings of progress. Only one of the three Claybury questionnaires, the TEQ, which measures attitudes to treatment, was significantly correlated with outcome, along with therapists' predictions. This result is different to that of a previous study which also found that outcome correlated with direction of interest (DIQ) and conservatism (C). The C and DIQ scales may provide useful predictive information only in a small proportion of cases.