bluuebunny/crossref_metadata_2025 huggingface dataset:
THE MILLENIUM (REV 20.4–6) AS
HEAVEN
Authors: GIBLIN CHARLES
HOMER
Published: July 2002

Taking the ‘first
resurrection’ (Rev 20.4–6) as ‘heaven’ accords
with early Christian, non-chiliast views of martyrs and other blessed.
Exegetical development of this interpretation requires plotting (in line
with the literary structure of Rev 4–22) the convergence
of complementary eschatologies: first, the millennium brings to a climax
a series of images expressing ‘vertical’ eschatology (the
life of God's witnesses after death); second, the whole narrative
focuses fulfilment of the Creator's scroll (‘what must
take place
[γενε´σθαι]
hereafter’) on the very end of the end-time (i.e.
‘horizontally’, on the moment marked by the enthroned's
voice in 16.17, γη´γoνην, and 21.6,
γη´oναν: ‘It/They has/have
taken place’), and on God's victory over those gathered
by powers of deception for ‘the war’ at Armageddon
(16.12–16; 19.19–21; 20.7–10). Christ's kingdom
in heaven is followed by the advent of God's sacred kingdom on
earth.
Albendazole: a review of anthelmintic efficacy and safety in humans
Authors: HORTON J.
Published: July 2002

This comprehensive review briefly describes the history and pharmacology of albendazole as an anthelminthic drug and presents detailed summaries of the efficacy and safety of albendazole's use as an anthelminthic in humans. Cure rates and % egg reduction rates are presented from studies published through March 1998 both for the recommended single dose of 400mg for hookworm (separately for Necator americanus and Ancylostoma duodenale when possible), Ascaris lumbricoides, Trichuris trichiura, and Enterobius vermicularis and, in separate tables, for doses other than a single dose of 400mg. Overall cure rates are also presented separately for studies involving only children 2–15 years. Similar tables are also provided for the recommended dose of 400mg per day for 3 days in Strongyloides stercoralis, Taenia spp. and Hymenolepis nana infections and separately for other dose regimens. The remarkable safety record involving more than several hundred million patient exposures over a 20 year period is also documented, both with data on adverse experiences occurring in clinical trials and with those in the published literature and/or spontaneously reported to the company. The incidence of side effects reported in the published literature is very low, with only gastrointestinal side effects occurring with an overall frequency of just >1%. Albendazole's unique broad-spectrum activity is exemplified in the overall cure rates calculated from studies employing the recommended doses for hookworm (78% in 68 studies: 92% for A. duodenale in 23 studies and 75% for N. americanus in 30 studies), A. lumbricoides (95% in 64 studies), T. trichiura (48% in 57 studies), E. vermicularis (98% in 27 studies), S. stercoralis (62% in 19 studies), H. nana (68% in 11 studies), and Taenia spp. (85% in 7 studies). The facts that albendazole is safe and easy to administer, both in treatment of individuals and in treatment of whole communities where it has been given by paramedical and nonmedical personnel, have enabled its use to improve general community health, including the improved nutrition and development of children.
A microsatellite polymorphism in the gamma interferon gene is associated with resistance to gastrointestinal nematodes in a naturally-parasitized population of Soay sheep
Authors: COLTMAN D. W. , WILSON K. , PILKINGTON J. G. , STEAR M. J. , PEMBERTON J. M.
Published: July 2002

Free-living Soay sheep (Ovis aries) on the island of Hirta, St Kilda, Scotland, are naturally parasitized by gastrointestinal nematodes, predominantlyTeladorsagia circumcincta. In this paper we show that reduced faecal egg counts (FEC) are associated with an allele at a microsatellite locus located in the first intron of the interferon gamma gene (o(IFN)-γ) in Soay sheep lambs and yearlings, measured at approximately 4 and 16 months of age, respectively. The same allele was also associated with increasedT. circumcincta-specific antibody (IgA) in lambs, but not associated significantly in yearlings. Flanking control markers failed to show a significant association with either FEC or IgA. These results suggest that a polymorphic gene conferring increased resistance to gastrointestinal nematode parasites is located at or near the interferon gamma gene, and support previous reports which have mapped a quantitative trait locus (QTL) for resistance to this region in domestic sheep. Our data are consistent with the idea that a functional polymorphism leading to reduced expression or efficacy of (IFN)-γ could enhance the immune response to gastrointestinal nematodes by favouring the activity of the Th2cell subset and antibody associated immune mechanisms.
Meloidogyne javanica surface proteins: characterization
and lability
Authors: SPIEGEL Y. , KAHANE I. , COHEN L. , SHARON E.
Published: July 2002

Characterization of surface coat (SC) proteins including
carbohydrate-binding proteins and glycoproteins of the plant-parasitic
nematode Meloidogyne javanica 2nd-stage juvenile (J2) is reported.
Extraction of surface proteins with sodium
dodecyl sulfate (SDS) and separation by denaturing polyacrylamide gel
electrophoresis (SDS–PAGE) results with bands
at 6, 9, 14, 22, 26, 31, 46, 49, 58, 66, 80, 205 and 250 kDa. On Western
blots, the neoglycoprotein, fucosylated-,
mannosylated- and glucosylated-bovine serum albumin, reacted with the
14, 22, 26, 58 and 66 kDa bands. The lectins,
Concanavalin A and wheat-germ agglutinin (WGA) labelled surface protein
bands
of 6, 9, 14, 31, 58 and 66 kDa; WGA
also labelled the 22 and 26 kDa bands. Biotin reagents were used to specifically
trace surface proteins on live J2.
SDS–PAGE of biotinylated J2 extracts revealed only 2 specific biotin-protein
bands at 46 and 49 kDa. The labile and
transitory nature of Meloidogyne javanica SC was demonstrated
by the
dynamics of human red blood cells (HRBC)
adherence to J2 of different ages. HRBC adherence was also used to demonstrate
the SC recovery of detergent-treated
J2, which was further exhibited in the SDS–PAGE profiles.
The processes influencing the distribution of parasitic
nematodes among naturally infected lambs
Authors: STEAR M. J. , BAIRDEN K. , BISHOP S. C. , GETTINBY G. , McKELLAR Q. A. , PARK M. , STRAIN S. , WALLACE D. S.
Published: July 2002

The impact of mixed, nematode infection upon a group of animals

will depend upon the number of nematodes present,
how they are distributed among hosts and whether individuals that
are heavily parasitized with one species are more likely
to be heavily parasitized with other species. A survey of over 500
six-month-old, Scottish Blackface lambs from a single
farm in Southwest Strathclyde identified 7 different categories of
nematodes in the abomasum and small intestine. There
were considerable differences among years and among nematodes in
the prevalence and mean intensity of infection. Ostertagia circumcincta was present in nearly all lambs and judged
by prevalence and intensity is one of the most successful
of all parasitic nematodes. Each category of nematodes had a
skewed distribution; most animals had relatively few worms
but a small proportion had many worms. The variances of the number
of nematodes in each category were approximately
equal to the square of the mean. The counts of adult O. circumcincta

followed a negative binomial distribution, but the
negative binomial distribution did not provide a good description of
the observed values for the other species. These other
species had a lower prevalence and possibly some sheep were not exposed

to infection. There was no significant genetic
variation among lambs in the number of nematodes present and therefore

the differences among these lambs were unlikely
to be a consequence of genetic differences in host susceptibility.
Lambs with increased numbers of one species were more
likely to have increased numbers of the other species, but the
correlations were weak and may reflect covariation in
exposure to different parasites.
An analysis of the temperature effects of fever on the
intra-host population dynamics of Plasmodium falciparum
Authors: GRAVENOR M. B. , KWIATKOWSKI D.
Published: July 2002

Observations that growth of Plasmodium falciparum in vitro

is inhibited by high temperatures have led to hypotheses that
malaria fever may influence the parasite population dynamics,
regulating parasite density and synchronizing parasite
growth. In order to investigate the fever hypotheses, we have
developed an age-structured coupled Markov chain model
that describes the parasite erythrocyte cycle and its interaction
with the host fever response. We estimated the model
parameters using data collected from laboratory parasite cultures that

were exposed to febrile or normal temperature.
Using the experimental parameter values, quantitative predictions
were made of the effect of fever in determining the
parasite population dynamics. It was concluded from the model
behaviour that, during the primary infection of a non-immune host,
a typical episode of fever can effect density-dependent
regulation of the parasite population, maintaining
cycles of parasitaemia and promoting synchronous parasite growth.
Trypanosoma brucei spp. development in the tsetse fly:
characterization of the post-mesocyclic stages in the
foregut and proboscis
Authors: VAN DEN ABBEELE J. , CLAES Y. , VAN BOCKSTAELE D. , LE RAY D. , COOSEMANS M.
Published: July 2002

Post-mesocyclic development of Trypanosoma brucei in the tsetse fly in its migration from midgut to salivary glands, was
revisited by sequential microdissection, morphometry and DNA-cytofluorometry. This development started by day 6
after the infective feed, with passage of mesocyclic midgut trypomastigotes through proventriculus and upward migration
along foregut and proboscis to the salivary gland ducts. Kinetics of salivary gland infection showed that colonization of
the salivary glands by epimastigotes occurred only during the time-limited presence of this developmental phase in the
foregut and proboscis. Post-mesocyclic trypanosomes in the foregut and proboscis were pleomorphic, with 4 morphological
stages in various constant proportions and present all through from proventriculus up to the salivary gland ducts:
67% long trypomastigotes, 27% long epimastigotes, 4% long epimastigotes undergoing asymmetric cell division and
2% short epimastigotes. Measurements of DNA content demonstrated a predominant tetraploidy for 67% of these
trypanosomes, the remainder consisting of the homogeneous diploid short epimastigotes and some long epimastigotes.
According to the experimental data, the following sequence of trypanosome differentiation in the foregut and proboscis
is proposed as the most obvious hypothesis. Incoming mesocyclic trypomastigotes (2N) from the ectoperitrophic anterior
midgut start to replicate DNA to a 4N level, are arrested at this point, and differentiate into the long epimastigote (4N)
which give rise, by an asymmetric cell division, to 2 unequal, diploid daughter cells: a long, probably dead-end long
epimastigote and a short epimastigote. The latter is responsible for the epimastigote colonization of the salivary glands
if launched at the vicinity of the gland epithelium by the asymmetric dividing epimastigote.
The surface coat of infective larvae of Trichinella spiralis
Authors: MODHA J. , ROBERTS M. C. , ROBERTSON W. M. , SWEETMAN G. , POWELL K. A. , KENNEDY M. W. , KUSEL J. R.
Published: July 2002

The surface coat of the infective larvae of the parasitic nematode Trichinella spiralis was characterized with respect to its
biophysical properties, morphology and composition. Labelling of larvae with the fluorescent surface probe PKH26 was
lost after activation (by incubation in mammalian medium containing trypsin and bile), or following pronase treatment.
Electron microscopical examination revealed that pronase treatment resulted in the loss of an amorphous surface layer
only, further demonstrating the specificity of PKH26 for the larval surface coat. Surface coat shedding was inhibited by
sodium azide and carbonyl cyanide, or by incubation of larvae at 4°C, suggesting the shedding process required metabolic
energy. Pre-labelled, unactivated larvae demonstrated continuous slow surface coat shedding and could be re-labelled
with PKH26, indicating that the shed coat is replaced in these parasites. However, pre-labelled larvae which were activated
failed to re-label with the probe, suggesting that activation provides an irreversible trigger for surface changes. PKH26,
therefore, is a useful marker for larval activation. Examination of the shed coat material by scanning electron microscopy
revealed 2 types of morphologies; one comprising thin multilaminate sheets and the other of amorphous material with
ridges producing a fingerprint-like motif. Western- and lectin-blotting of the shed coat material demonstrated 2 prominent
entities; a 90 kDa glycoprotein, which bound Datura stramonium agglutinin and was resistant to N- and O-glycanase
treatment and a 47–60 kDa set of protein(s). Analysis of the surface lipids by electrospray mass spectometry revealed the
presence of lysophosphatidic acid (lysoPA, C14[ratio ]2) and an unidentifiable component of 339·4 Da. These two lipids
constituted 36·9% and 36% by mass of surface coat lipids respectively. The presence of lysoPA was confirmed by thin
layer chromatography, which also detected phosphatidic acid (PA). The polar lipids detected in solvent rinses of intact
parasites by electrospray mass spectrometry were PI (C48[ratio ]4), PE (C40[ratio ]4 and C38[ratio ]4), PS (C40[ratio ]4), lysoPC (C20[ratio ]2 and
C18[ratio ]2) and lysoPA (C14[ratio ]2). These observations are discussed with respect to the role of the surface coat and its shedding
in the T. spiralis host–parasite relationship.
Geographical distances and the similarity among parasite
communities of conspecific host populations
Authors: POULIN R. , MORAND S.
Published: July 2002

The geographical distance between conspecific host populations is no doubt a key determinant of the likelihood that
exchanges of parasite species occur between these populations. This variable must therefore be taken into account in
studies that compare parasite species richness or similarity among host populations. This paper presents a multivariate
approach, based on the permutation of matrices, that allows all pairwise geographical distances between host populations
to be included as independent variables. The method is illustrated with 3 separate data sets on parasite communities of
conspecific fish from different lakes. In 2 of 3 cases, geographical distances among lakes had a significant influence on the
similarity of their parasite communities. The effect of geographical distance on species richness of parasite communities
also proved important in 2 of the 3 case studies. These examples demonstrate the pervasive influence of distances among
host populations on their parasite communities, and the need to properly control for them in statistical analyses.
Discrimination between two Perkinsus spp. isolated from
the softshell clam, Mya arenaria, by sequence analysis of
two internal transcribed spacer regions and the 5·8S
ribosomal RNA gene
Authors: KOTOB S. I. , McLAUGHLIN S. M. , Van BERKUM P. , FAISAL M.
Published: July 2002

The internal transcribed spacer (ITS-1 and ITS-2) regions and the 5·8S ribosomal RNA gene of 2 Perkinsus spp. (G117
and H49) originating from the softshell clam, Mya arenaria, of the Chesapeake Bay were cloned and sequenced to obtain
evidence for their genetic divergence. A high level of heterogeneity in both regions, probably resulting from deletions,
insertions, and base substitutions, was evident from alignments of the sequences of the 2 isolates with published sequences
of other Perkinsus spp. The isolate G117 and other Perkinsus spp. were highly divergent (13–26% and 19–20% sequence
divergence in ITS-1 and ITS-2, respectively). These regions in the isolate H49 and Perkinsus marinus were similar
(99·07% and 99% for ITS-1 and ITS-2, respectively). Evidence obtained from a phylogenetic analysis using the aligned
sequences suggests that G117 and H49 belong to 2 distinct species of Perkinsus. The isolate G117 possibly belongs to an
as yet undescribed species of Perkinsus, and H49 belongs to the species P. marinus. The conclusions drawn from the
genetic analysis of H49 and G117 are supported by previously reported morphological characteristics (McLaughlin &
Faisal, 1998b). Isolates H49 and G117 originated from the same molluscan species demonstrating that at least 2 different
species of Perkinsus can co-exist in 1 host.
The spatial pattern of trypanosomosis prevalence predicted
with the aid of satellite imagery
Authors: HENDRICKX G. , NAPALA A. , SLINGENBERGH J. H. W. , DE DEKEN R. , VERCRUYSSE J. , ROGERS D. J.
Published: July 2002

Information on the spatial pattern of African animal trypanosomosis forms a prerequisite for rational disease management,
but few data exist for any country in the continent. The present study describes a raster or grid-based Geographic
Information System for Togo, a country representative of subhumid West Africa, with data layers on tsetse, trypanosomosis,
animal production, agriculture and land use. The paper shows how trypanosomosis prevalence and packed cell
volume (PCV) map displays may be predicted from correlations between representative field data and environmental and
satellite data acquired from the National Oceanographic and Atmospheric Administration (NOAA) and Meteosat platforms.
Discriminant analytical methods were used to assess the relationship between the amount of field data used and
the accuracy of the predictions obtained. The accuracy of satellite derived predictions decreases from tsetse abundance
to trypanosomosis prevalence to PCV value. The predictions improve when eco-climatic and epidemiological predictors
are combined. In Togo, and probably elsewhere, the patterns of trypanosomosis prevalence and PCV are much influenced
by animal husbandry and other anthropogenic factors. Additional predictor variables, incorporating these influences might
therefore further improve the models.
Decision-making cognition in mania and depression
Authors: MURPHY F. C. , RUBINSZTEIN J. S. , MICHAEL A. , ROGERS R. D. , ROBBINS T. W. , PAYKEL E. S. , SAHAKIAN B. J.
Published: July 2002

Background. Despite markedly different clinical presentations, few studies have reported differences in neuropsychological functioning between mania and depression. Recent work has suggested that differences may emerge on cognitive tasks requiring affective processing, such as decision-making. The present study sought to compare decision-making cognition in mania and depression in order to clarify the current profiles of impairment for these disorders and to contribute to our more general understanding of the relationship between mood and cognition.

Methods. Medicated manic patients, depressed patients, and normal healthy controls completed a computerized decision-making task. All subjects were asked to win as many points as possible by choosing outcomes based on variably-weighted probabilities and by placing ‘bets’ on each decision.

Results. Both patient groups were impaired on this task, as evidenced by slower deliberation times, a failure to accumulate as many points as controls and suboptimal betting strategies. Manic, but not depressed, patients made suboptimal decisions – an impairment that correlated with the severity of their illness.

Conclusions. These findings are consistent with a growing consensus that manic and depressed patients are characterized by significant impairments in cognitive and particularly executive, functioning. Furthermore, the distinct patterns of observed impairment in manic and depressed patients suggests that the nature and extent of cognitive impairment differ between these two groups. Viewed in the context of other recent studies, these findings are consistent with a role for the ventromedial prefrontal cortex in mediating mood–cognition relationships.
Panic syndromes in a population-based sample of male and female twins
Authors: KENDLER K. S. , GARDNER C. O. , PRESCOTT C. A.
Published: July 2002

Background. The risk for panic disorder (PD) is substantially increased in relatives of probands with PD. Prior literature provides only limited information about the degree to which this increase is due to genetic factors or family environment.

Methods. In personal interviews with both members of 3194 twin pairs, we assessed the lifetime history of lifetime panic attacks and PD. Twin resemblance was assessed by tetrachoric correlation and single and multiple threshold biometrical model fitting.

Results. As fully syndromal PD, by DSM-III-R criteria, was too rare to analyse usefully we examined four other dichotomous definitions of increasing stringency: panic probe and very broad, broad and intermediate PD. For all four definitions and for the multiple threshold analyses, the best-fit model indicated that twin resemblance was due solely to genetic factors with a moderate heritability (33–43%). For the broad and intermediate dichotomous definitions of PD, however, a model with twin resemblance due to familial–environmental factors fit nearly as well. No gender effects were seen on the genetic risk factors for these PD-like syndromes.

Conclusion. Even with large epidemiological samples of twins, studying disorders as uncommon as PD is problematical. Despite these difficulties, our results suggest that: (i) narrowly and broadly defined PD are probably on the same continuum of liability; (ii) twin resemblance for these PD-like syndromes is likely due largely to genetic factors with a moderate level of heritability although a contribution of familial–environmental factors cannot be excluded; and, (iii) the same familial risk factors impact, to a similar degree, on the liability to PD in males and females.
Depression and anxiety among women in an urban
setting in Zimbabwe
Authors: ABAS MELANIE A. , BROADHEAD JEREMY C.
Published: July 2002

One hundred and seventy-two women randomly selected from a Zimbabwean
township were interviewed with a Shona screen for mental disorders and a semi-structured interview
to assess symptoms suggestive of emotional distress, followed by the Present State Examination.
Using criteria slightly stricter than threshold level 5 of the PSE-CATEGO-ID system, 30·8% of
women had a depressive or anxiety disorder during the previous year. Nearly all disorders met
Bedford College criteria for depression; 65% of these also had anxiety features. Only 0·6% of
women had a ‘pure’ anxiety disorder not preceded by or associated with depression in the study
year. Compared with London, the higher annual prevalence of disorders in Harare could mostly be
accounted for by an excess of onset cases in the study year, 70% of which made a full or partial
recovery within 12 months. The women's own words for these episodes included ‘thinking too
much’, ‘deep sadness’ and a variety of terms describing heart discomfort, interpretation showing
many of the latter to be expressions for grief, fear, or the possession of an insoluble problem, and
73% explained their symptoms as caused by a specific social stressor.
Impairment, disability and handicap as risk factors for
depression in old age. The Gospel Oak Project V
Authors: PRINCE M. J. , HARWOOD R. H. , BLIZARD R. A. , THOMAS A. , MANN A. H.
Published: July 2002

Background. An association between disablement and
late-life depression is often reported in cross-sectional studies.
However, many lack effect sizes, and do not control for confounding.
Therefore, it is difficult both to quantify the overall impact of poor
health on depression and to understand which aspects are most
salient.

Methods. A catchment area survey of all over 65-year-old
residents of an electoral district in London, UK, using a population
register derived from a door-to-door census was undertaken. Depression
was measured using SHORT-CARE, and the consequences of disease
classified according to the WHO International Classification of
Impairments, Disabilities and Handicaps.

Results. Six hundred and fifty-four subjects were
interviewed out of an older population of 889. The prevalence of
SHORT-CARE pervasive depression was 17%. Impairment, disability and,
particularly, handicap were strongly associated with depression. The
adjusted odds ratio for depression in the most handicapped quartile
compared with the least was 24·2
(8·8–66·6). The population attributable fraction
(PAF) for depression attributable to handicap was 0·78. The
PAFs for recent life events and female gender were much lower.
Handicap explained most of the depression associated with individual
impairments and disabilities. Adjusting for handicap abolished or
weakened the associations between depression and social support,
income, older age, female gender and living alone.

Conclusions. Even given some uncertainty in distinguishing
handicap and depression as constructs, and the impossibility of
deciding direction of causality, it seems likely that handicap is of
central significance to late-life depression. Handicap may be more
amenable to intervention than either impairment or
disability.
Lateral preference in post-traumatic stress disorder
Authors: SPIVAK B. , SEGAL M. , MESTER R. , WEIZMAN A.
Published: July 2002

Background. We assessed lateral preference in 80 male

patients with combat-related post-traumatic

stress disorder (PTSD) and in 100 healthy age-matched male controls.

Methods. Hand, foot, eye and ear preferences were examined,

using the Edinburgh Handedness

Inventory-Modified and the Coren Inventory of Lateral Preference.

Results. Mixed lateral preference was noted in

significantly more PTSD patients than controls

(65 v. 43%, P<0·005).

Conclusions. These results indicate a possible hemispheric

imbalance (less lateralization) in PTSD

patients, with the right hemisphere playing a more active role in

perceptual and cognitive processing

and in the regulation of biological responses in these patients.

This imbalance may be relevant to the pathophysiology of PTSD.
The effect of personality on withdrawal severity and
taper outcome in benzodiazepine dependent patients
Authors: SCHWEIZER E. , RICKELS K. , De MARTINIS N. , CASE G. , GARCÍA-ESPAÑA F.
Published: July 2002

Background. Personality psychopathology exerts a significant

and independent effect on the course
of benzodiazepine (BZ) discontinuation, worsening the subjective
severity of withdrawal symptoms
and significantly increasing the occurrence of early taper failures.

Method. One hundred and seventy-one patients participating
in
a BZ discontinuation programme
were administered several personality measures prior to taper. Patients

were stabilized for 3 weeks
at their baseline BZ dosage and then tapered off 25% per week over 4 weeks,
with the option to
extend up to 6 weeks if necessary.

Results. High levels of passivity and dependency as
assessed by the MMPI Dependence subcluster,
and at a trend level high Eysenck Neuroticism and high TPQ Harm Avoidance
contributed
significantly to the prediction of benzodiazepine withdrawal severity.
Though there was a high
correlation between personality measures, psychopathology and adjusted
BZ dose, the effects of
personality on withdrawal severity was significant, particularly in
the initial phases of BZ taper,
when taper severity was still relatively mild.

Conclusions. These findings indicate that clinical decisions

on how to manage BZ tapering should
be guided by personality assessments, in addition to the usual
considerations of BZ dosage, residual
psychopathology, duration of treatment, etc. The potential for difficulty
with discontinuation
related to personality traits should be one of the factors weighed
in the risk–benefit assessment made
in the planning of benzodiazepine treatment for patients with anxious symptomatology.
Why GHQ threshold varies from one place to another
Authors: GOLDBERG D. P. , OLDEHINKEL T. , ORMEL J.
Published: July 2002

Background. No convincing explanation has been forthcoming

for the variation in best threshold
to adopt for the GHQ in different settings.

Methods. Data dealing with the GHQ and the CIDI in 15 cities
from
a recent WHO study was subjected to further analysis.

Results. The mean number of CIDI symptoms for those with single

diagnoses, or those with
multiple diagnoses, does not vary between cities. However, the best
threshold is found to be related
to the prevalence both of single and of multiple diagnoses in a
centre. Variations in the diagnoses
to be included in the ‘gold standard’ did not account
for the variation observed. There was a strong
relationship between area under the ROC curve (as a measure of the discriminatory
power of the
GHQ) and the best threshold, with higher thresholds being associated with
superior performance
of the GHQ. The items on the GHQ-12 that provided most discrimination between
cases and
non-cases varied from one centre to another.

Conclusions. The GHQ threshold is partly determined by the

prevalence of multiple diagnoses, with
higher thresholds being associated by higher rates of both single
and multiple diagnosis. The mean
GHQ score for the whole population of respondents provides a rough
guide to the best threshold.
In those centres where the discriminatory power of the GHQ is
lowest, it is necessary to use a low
threshold as a way of ensuring that sensitivity is protected, but
the positive predictive value of the
GHQ is then lower. Some of the variation between centres is due
to variation in the discriminatory power of different items.
Are social supports in late midlife a cause or a result
of successful physical ageing?
Authors: VAILLANT G. E. , MEYER S. E. , MUKAMAL K. , SOLDZ S.
Published: July 2002

Background. Many studies have noted a strong association

between poor social support and
premature mortality. A limitation of such studies has been their failure

to control adequately for
confounders that damage both social supports and physical health.

Methods. A 50-year prospective multivariate study of 223 men

was used to examine the possible
causal relationships between social supports and health. Alcohol abuse,

prior physical health and
mental illness prior to age 50 were controlled. Relative social supports
were
quantified over the period from age 50 to 70.

Results. Adequacy of social supports from age 50 to 70 was

powerfully correlated with physical
health at age 70 (P<0·001). However, such social
supports were also powerfully predicted by
alcohol abuse (P<0·001), smoking (P<0·001)

and indicators of major
depressive disorder (P<0·01) assessed at age 50. When
prior smoking,
depression and alcohol abuse were controlled, then
the association of physical health with social supports was very
much attenuated. Some facets of
social support like religion and confidantes were unassociated with
health even at a univariate level.
Surprisingly, in this sample friends seemed more important for sustained
physical health than
closeness to spouse and to children.

Conclusions. While social supports undoubtedly play a significant

role in maintaining physical well-being in late life, much of the
association between poor social supports and mortality may be
mediated by alcoholism, smoking and pre-morbid psychopathology.
The impact of dementia on the detection of
depression in elderly subjects from the general
population
Authors: PAPASSOTIROPOULOS A. , HEUN R. , MAIER W.
Published: July 2002

Background. The performance of the CES-D in a sample of
elderly community residents was
assessed. The influence of dementia on test performance and the necessity
for the use of four factor
scores instead of a single summary score of the CES-D were studied.

Method. Two hundred and eighty-seven subjects out of the general
population aged 60–99 years
were personally interviewed with standardized diagnostic tools and completed
the CES-D. Best-estimate
diagnoses served as ‘gold standards’ for receiver operating
characteristics (ROC) analysis.

Results. The CES-D discriminated well between depressive and
non-depressive subjects. Exclusion
of demented subjects from the sample did not markedly increase test performance.
Current
depressive illness and dementia led to high scores on the CES-D. Unlike
the factors ‘depressive
affect’, ‘somatic/vegetative complaints’, and ‘interpersonal
relations’, the factor ‘positive affect’ of
the CES-D discriminated well between demented and non-demented participants.

Conclusions. The CES-D is a valid instrument for screening
for depression in a community sample
of elderly subjects. Its use can be recommended even if the presence of
dementia is likely. The use
of factor scores of the CES-D does not substantially contribute to an improvement
of overall test
performance, but, nevertheless, allows a more detailed insight and better
interpretation of test
results.
Increased automatic spreading activation in healthy
subjects with elevated scores in a scale assessing
schizophrenic language disturbances
Authors: MORITZ S. , ANDRESEN B. , DOMIN F. , MARTIN T. , PROBSTHEIN E. , KRETSCHMER G. , KRAUSZ M. , NABER D. , SPITZER M.
Published: July 2002

Background. Previous studies on semantic priming have
suggested that schizophrenic patients with
language disturbances demonstrate enhanced semantic and indirect semantic
priming effects relative
to controls. However, the interpretation of semantic priming studies in
schizophrenic patients is
obscured by methological problems and several artefacts (such as length
of illness). We, therefore,
used a psychometric high-risk approach to test whether healthy subjects
reporting language
disturbances resembling those of schizophrenics (as measured by the Frankfurt
Complaint
Questionnaire subscale ‘language’) display increased priming
effects. In addition, the Schizotypal
Personality Questionnaire was used to cover symptoms of schizotypal personality.
Enhanced
priming was expected to occur under conditions favouring automatic processes.

Methods. One hundred and sixty healthy subjects performed a
lexical decision semantic priming
task containing two different stimulus onset asynchronicities (200 ms and
700 ms) with two
experimental conditions (semantic priming and indirect semantic priming)
each.

Results. Analyses of variance revealed that the Frankfurt Complaint
Questionnaire-‘language’ high
scorers significantly differed from low scorers in three of the four priming
conditions indicating
increased automatic spreading activation. No significant results were obtained
for the Schizotypal
Personality Questionnaire total and subscales scores.

Conclusions. In line with Maher and Spitzer it is suggested
that increased automatic spreading
activation underlies schizophrenia-typical language disturbances which
in our study cannot be
attributed to confounding variables such as different reaction time baselines,
medication or length
of illness. Finally, results confirm that the psychometric high-risk approach
is an important tool for
investigating issues relevant to schizophrenia.
Marital status transitions and psychological distress:
longitudinal evidence from a national population sample
Authors: HOPE S. , RODGERS B. , POWER C.
Published: July 2002

Background. Evidence is conflicting as to whether the
association between marital status and
psychological distress is due to selection (i.e. distress influences marital
status) or causation (marital
status influences distress). We investigate: (i) whether differences
in psychological distress pre-date
marital transitions; (ii) whether levels of distress change following
transitions;
and (iii) potential mediating and moderating factors.

Methods. Data on psychological distress (indicated by the Malaise
Inventory) and marital status at
ages 23 and 33 were analysed for 4514 men and 4842 women from the 1958
birth cohort.

Results. Higher levels of distress were found among the divorced
and lower levels among the single
and the married. Selection was seen in the lower initial mean symptoms
of those who married (1·69
for men; 2·84 for women) compared to those remaining single (2·41
for men; 3·26 for women).
Causation was indicated by the relative deterioration in distress of those
who divorced compared
to the continuously married (an increase of 0·31 and 0·03
respectively for men), especially in women
(a decrease of 0·18 versus 0·71). This was most
evident in women who were downwardly mobile and
those with children. Recently separated men and women showed especially
large increases in
distress.

Conclusions. The relationship between marital status and psychological
distress involves selection
and causation. Findings failed to support ideas of marriage being protective
(through social
support), or detrimental (through family roles). Divorce increased distress,
with both acute and
longer-term components moderated by secondary factors such as childcare
and declining socio-economic status.
Impaired distractor inhibition on a selective attention
task in unmedicated, depressed subjects
Authors: MacQUEEN G. M. , TIPPER S. P. , YOUNG L. T. , JOFFE R. T. , LEVITT A. J.
Published: July 2002

Background. Impaired distractor inhibition may contribute to the selective attention deficits
observed in depressed patients, but studies to date have not tested the distractor inhibition theory
against the possibility that processes such as transient memory review processes may account for the
observed deficits. A negative priming paradigm can dissociate inhibition from such a potentially
confounding process called object review. The negative priming task also isolates features of the
distractor such as colour and location for independent examination.

Method. A computerized negative priming task was used in which colour, identification and
location features of a stimulus and distractor were systematically manipulated across successive
prime and probe trials. Thirty-two unmedicated subjects with DSM-IV diagnoses of non-psychotic
unipolar depression were compared with 32 age, sex and IQ matched controls.

Results. Depressed subjects had reduced levels of negative priming for conditions where the colour
feature of the stimulus was repeated across prime and probe trials but not when identity or location
was the repeated feature. When both the colour and location feature were the repeated feature
across trials, facilitation in response was apparent.

Conclusions. The pattern of results supports studies that found reduced distractor inhibition in
depressed subjects, and suggests that object review is intact in these subjects. Greater impairment
in negative priming for colour versus location suggests that subjects may have greater impairment
in the visual stream associated with processing colour features.
Prevention research in eating disorders: theory and new directions
Authors: AUSTIN S. BRYN
Published: July 2002

Background. Over the past two decades, scores of articles and several books have been published
calling for more attention to the prevention of eating disorders, but less than two dozen prevention
intervention studies have been conducted to date.

Methods. This paper reports the results of a systematic review of 20 empirical intervention studies
on eating disorders prevention, discussing the data accumulated on what has and has not been
effective. Beyond a description of study design and findings, this paper devotes special attention to
the theoretical orientations of the studies and their implied assumptions about preventive strategies.

Results. Though there has been a compelling interest in social, political and economic factors
influencing the incidence of disordered eating, little of this interest has been carried over into the
prevention end of eating disorders research. Most studies reported thus far have been designed to
target and measure change principally on the individual level, to the exclusion of considering
leverage points for intervention in the larger social environment.

Conclusions. This paper concludes with a recommendation for new attention to a model of
proactive primary prevention targeted at environmental change and cross-disciplinary collaboration
to achieve a reduction in the incidence of eating disorders.
A differential neural response in obsessive–compulsive disorder patients with washing compared with checking symptoms to disgust
Authors: PHILLIPS M. L. , MARKS I. M. , SENIOR C. , LYTHGOE D. , O'DWYER A.-M. , MEEHAN O. , WILLIAMS S. C. R. , BRAMMER M. J. , BULLMORE E. T. , McGUIRE P. K.
Published: July 2002

Background. Patients with obsessive–compulsive disorder (OCD) have symptoms that pre-dominantly concern washing (washers) or checking (checkers), or both. Functional neuroimaging has been used to identify the neural correlates of the urge to ritualize but has not distinguished between washing and checking symptoms in OCD. We used functional magnetic resonance imaging to compare the neural response to emotive pictures in washers and checkers.

Methods. In one of two 5-minute experiments, washers (N = 7), checkers (N = 7) and age-matched normal controls (N = 14) were scanned while viewing alternating blocks of normally disgusting (rated as disgusting by all subjects) and neutral pictures. In the other experiment, all patients and a normal subgroup (N = 8) viewed alternating blocks of washer-relevant (rated as more disgusting by washers than normal controls or checkers) and neutral pictures.

Results. In all subjects, normally disgusting pictures activated visual regions implicated in perception of aversive stimuli and the insula, important in disgust perception. Only in washers were similar regions activated by washer-relevant pictures. In checkers, these pictures activated fronto-striatal regions associated with the urge to ritualize in OCD. Normal controls were more similar in neural response to checkers than washers to these pictures. Both normal controls and checkers had frontal regions activated significantly more by washer-relevant than normally disgusting pictures, and had these regions activated significantly more than washers by washer-relevant pictures.

Conclusions. We demonstrate a differential neural response to washer-relevant disgust in washers and checkers: only washers demonstrate a neural response to washer-relevant disgust associated with emotion perception rather than attention to non-emotive visual detail.
Personality traits among currently eating disordered, recovered and never ill first-degree female relatives of bulimic and control women
Authors: LILENFELD L. R. R. , STEIN D. , BULIK C. M. , STROBER M. , PLOTNICOV K. , POLLICE C. , RAO R. , MERIKANGAS K. R. , NAGY L. , KAYE W. H.
Published: July 2002

Background. A combined family study and recovered study design was utilized to examine several
hypothesized relationships between personality and bulimia nervosa (BN).

Methods. We studied 47 women with a lifetime history of DSM-III-R BN (31 currently ill and 16
recovered), 44 matched control women (CW) with no history of an eating disorder (ED), and their
first-degree female relatives (N = 89 and N = 100, respectively), some of whom had current or
previous EDs.

Results. BN probands' relatives with no ED history had significantly elevated levels of
perfectionism, ineffectiveness, and interpersonal distrust compared to CW probands' relatives with
no ED history. In contrast, diminished interoceptive awareness, heightened stress reactivity and
perfectionistic doubting of actions were found among the previously eating disordered relatives of
bulimic probands compared to their never ill relatives. Finally, a sense of alienation and emotional
responsivity to the environment were elevated among currently ill compared to recovered bulimic
probands.

Conclusions. The fact that perfectionism, ineffectiveness and interpersonal distrust are transmitted
independently of an ED in relatives suggests that they may be of potential aetiological relevance for
BN. In contrast, diminished interoceptive awareness, heightened stress reactivity and perfectionistic
doubting of actions are more likely consequent to, or exacerbated by, previously having experienced
the illness. Finally, a sense of alienation and emotional responsivity to the environment are more
likely to be associated with currently having BN.
Evaluating psychiatric morbidity in a general
hospital: a two-phase epidemiological survey
Authors: MARTUCCI M. , BALESTRIERI M. , BISOFFI G. , BONIZZATO P. , COVRE M. G. , CUNICO L. , DE FRANCESCO M. , MARINONI M. G. , MOSCIARO C. , PICCINELLI M. , VACCARI L. , TANSELLA M.
Published: July 2002

Background. This study aimed to assess psychiatric morbidity and to collect information on
disability, life events and family support in a representative sample of patients admitted to a general
hospital.

Methods. On the basis of information collected in a pilot study a systematic sample of patients
consecutively admitted to seven general medical and seven surgical wards of the Academic General
Hospital of Verona was selected and interviewed using a two-phase screening procedure and
standardized instruments (GHQ-12, HADS, BDQ and CIDI-PHC). All data were analysed using
appropriately weighted logistic regression procedures.

Results. A total of 1039 patients completed the GHQ-12 and 298 (28·7%) were high-scorers: 363
patients were interviewed with CIDI-PHC. The prevalence of ICD-10 cases was 26·1%. The most
common psychiatric diagnoses were current depression (12·8%) and generalized anxiety disorder
(10·8%), followed by alcohol related disorders (5%). A higher prevalence of ICD-10 cases was
found in medical wards, among females, patients older than 24 years, unemployed and
separated/divorced people. Life events were associated with psychopathology, and so was the
number of disability days. Although 49·8% of ICD-10 cases were identified by the hospital doctors
as having a psychological disorder, 23·1% of ICD-10 cases were referred to the liaison psychiatric
service.

Conclusion. The results of the present study stress the need to collect epidemiologically-based data
on psychological disorders and their recognition not only in general practice, but also in general
hospital settings, in order to have a more complete picture of the pathways to specialist care.
Neuroticism and self-esteem as indices of the
vulnerability to major depression in women
Authors: ROBERTS SETH B. , KENDLER KENNETH S.
Published: July 2002

Background. Neuroticism and self-esteem, two commonly used personality constructs, are thought
to reflect a person's underlying vulnerability to major depression. The relative strength of these
predictors is not known.

Method. Information was gathered on 2163 individual women from an epidemiological sample of
female–female twin pairs. Neuroticism was assessed by the Eysenck Personality Questionnaire and
global self-esteem by the Rosenberg Self-Esteem Scale. Major depression (DSM-III-R criteria) and
stressful life events were also assessed. The personality constructs were studied in relation to major
depression by logistic regression and structural equation modelling.

Results. Both cross-sectionally and prospectively, examined individually, neuroticism was a
stronger predictor of risk for major depression than was self-esteem. When examined together, the
predictive power of neuroticism remained substantial, while that of self-esteem largely disappeared.
The same pattern of findings was obtained when a subset of subjects who had recently experienced
stressful life events was analysed. By trivariate twin modelling, we found that the covariation of
self-esteem, neuroticism and major depression was due largely to genetic factors. When self-esteem
was the ‘upstream’ variable, a substantial genetic correlation remained between neuroticism
and major depression. By contrast, when neuroticism was the ‘upstream’ variable, the genetic
correlation between self-esteem and major depression disappeared.

Conclusions. The personality construct of neuroticism is a substantially better index of a woman's
underlying vulnerability to major depression than is self-esteem. These findings suggest that overall
emotionality or emotional reactivity to the environment reflects risk for depression better than
does global self-concept.