bluuebunny/crossref_metadata_2025 huggingface dataset:
The Special Characteristics of Suicide in Hospital In-Patients
Authors: Crammer J. L.
Published: August 2008

A category of suicide which only accounts for about 5% of the annual suicidal deaths in the country may at first seem unimportant. Suicide is seen around the world in different races and cultures, so it is a fact of human nature. However, the suicide of an in-patient is uncommon, and produces great guilt in doctors and nurses when it happens. The result is often a defensive fatalism. However, if we do not allow feeling to block thought and observation, it is possible to learn from each of these deaths something about human beings which we can use in the practice of psychiatry.
Assessment of Suicide Risk in Psychiatric In-Patients
Authors: Morgan H. G. , Priest Pamela
Published: August 2008

Assessment of suicide risk is an important and complex issue. We know that a considerable proportion of those who kill themselves seek help before they do so (Robins et al, 1959; Barraclough et al, 1974), and it is therefore essential both to recognise indices of suicide risk and to react appropriately to them. This means being sensitive to many personal, social and environmental factors, rendered more problematic by the fact that each individual is uniquely responsive to life events. The traditional approach, based on clinical epidemiological considerations, has long identified such factors as depression, alcoholism, increasing age, social isolation, physical illness and significant loss as important correlates of suicide, but there is now increasing evidence of other important factors which are frequently associated with suicide. Patients who commit suicide exhibit a wide range of behavioural problems which may hamper recognition of underlying suicide risk (Seager & Flood, 1965); and young adults with a history of chronic social turmoil are highly represented amongst suicides (Ovenstone & Kreitman 1974).
Suicide in High Buildings
Authors: Salmons Paula H.
Published: August 2008

When a psychiatric in-patient commits suicide by jumping out of the hospital building, the death is liable to attract Press attention and become public knowledge. In 1981, the psychiatric unit situated on the fifth floor of the Queen Elizabeth Hospital in Birmingham (UK) was closed by the Chairman of the District Health Authority on the advice of the coroner. This was a direct result of several in-patients committing suicide by jumping.
A Survey of Unexpected Deaths among Psychiatric In-Patients and Ex-Patients
Authors: Shaw Susan , Sims Andrew
Published: August 2008

The foundation of charitable institutions for the care of the mentally ill began towards the end of the eighteenth century as a result of concern amongst the articulate for the disadvantaged in society. It was not long before this same concern was again aroused; this time at the high death rate within many of these asylums. In the case of the York Asylum, which was the subject of a Parliamentary Select Committee in 1815, this was found to be due to poor conditions (Digby, 1983). Recently the Royal College of Psychiatrists has focussed attention on the continuing problem of patients who kill themselves while receiving treatment in hospital (Crammer, 1983). Particular attention was drawn to the reluctance of psychiatrists and those around them to examine the events leading to death; this compares unfavourably with the attitudes of anaesthetists and obstetricians, who have an established procedure for confidential inquiries into unexpected deaths.
Schizophrenia in Old Age (Late Paraphrenia)
Authors: Grahame Peter S.
Published: August 2008

Late paraphrenia is the form of expression of schizophrenia in old age. Twenty five patients diagnosed as suffering from the condition were studied, and their symptoms compared with the diagnostic criteria for schizophrenia of Spitzeret al(1975), the Catego system (Winget al, 1974), Carpenteret al(1973a) and Langfeldt (1960). The study confirms late paraphrenia as one of the schizophrenias, and discusses differences with previous studies.
A Survey of Prescribing of Psychotropic Drugs in a Birmingham Psychiatric Hospital
Authors: Edwards Stephen , Kumar Vinod
Published: August 2008

Of 603 patients receiving in-patient or day-patient psychiatric care, one-sixth were taking no psychotropic drugs, but nearly 50% of those receiving medication had a combination of two or more such drugs. Hypnotics and minor tranquillisers were frequently prescribed together with neuroleptics and antidepressants. One-third of all patients receiving neuroleptics received a combination of oral and depot preparations, while half of all patients on neuroleptics were prescribed anti-parkinsonian drugs. One-fifth of patients treated with neuroleptics had a diagnosis other than schizophrenia, and one-third of patients treated with antidepressants had a diagnosis other than affective disorder. A comparison of our findings with those from Oxford show some significant differences, particularly in the use of depot, oral, of combined neuroleptic drugs. An analysis of prescribing could be a useful part of self-audit for hospitals.
The Dexamethasone Suppression Test in Psychotic versus Non-psychotic Endogenous Depression
Authors: Rihmer Zoltán , Arató Mihály , Szádoczky Erika , Révai Katalin , Demeter Erzsébet , György Sandor , Udvarhelyi Pal
Published: August 2008

The authors investigated the dexamethasone suppression test (DST) in 93 female patients with primary (endogenous) major depression; in 20 female paranoid schizophrenics, and in 17 healthy females. Depressed patients had a significantly higher rate of abnormal DST response and significantly higher post-dexamethasone serum cortisol levels than schizophrenics and normal controls. The unipolar and bipolar depressives showed a similar profile of DST abnormalities. Depressed patients with psychotic features had a significantly higher rate of positive DST results than non-psychotic patients.
The Hyperventilation Syndrome
Authors: Kraft A. R. , Hoogduin C. A. L.
Published: August 2008

The aim of the study was to discover the relative effectiveness of four methods of treating patients suffering from hyperventilation attacks. The methods used were: breathing and relaxation therapy, hyperventilation provocation training, treatment based on influencing the factors which lead to the development of the syndrome, and drug treatment. The first three methods were demonstrated to be effective, whilst the fourth showed no signs of effectiveness. The condition of patients in the control group remained the same or deteriorated.
Approaches to the Evaluation and Treatment of Rapid-Cycling Affective Illness
Authors: Roy-Byrne Peter P. , Joffe Russell T. , Uhde Thomas W. , Post Robert M.
Published: August 2008

The definition and clinical aspects of rapid cycling affective illness are reviewed and various factors associated with the onset and maintenance of rapid cycling enumerated. On the basis of this information and of reports of the response of rapid cycling patients to various treatment interventions, an approach is suggested to the evaluation and treatment of rapid cycling affective illness.
Psychiatry in Jeopardy
Authors: Rawnsley Kenneth
Published: August 2008

Society's attitude to psychiatry has always been ambivalent. When, as a young doctor, I announced my intention to take up this discipline to my then chief, who was a distinguished clinical pathologist, his face turned a deeper shade of purple, and he muttered something about “mumbo-jumbo and guesswork” before stalking off into his den. Much more recently, I broke a lifelong tradition by actually entering into conversation with a stranger on a British railway train. Somehow or another, he extracted from me the information that I was a Professor of Psychological Medicine. “Well, well, he murmured, “and I always thought that was the stuff they put into those huge bottles of red and blue liquid you sometimes see in the windows of the older chemist shops”. That gentle twitting is small beer by comparison with the grave reservations expressed by many individuals and groups.
Day-to-Day Mood Changes after Childbirth: Further Data
Authors: Kendell R. E. , Mackenzie W. E. , West C. , McGuire R. J. , Cox J. L.
Published: August 2008

The depression and lability of mood which have been previously reported on the fifth day after childbirth are largely restricted to women with high neuroticism scores. The pattern of day-to-day mood changes is the same after Caesarian section as after vaginal delivery, but there is no ‘day five’ phenomenon after hysterectomy. Post-partum mood disturbance is less prominent in women who return home 48 hours after delivery.
The Scottish Survey of Chronic Day-Patients
Authors: McCreadie Robin G. , Robinson Andrew D. , Wilson A. Oliver A.
Published: August 2008

All chronic day-patients (n= 422), defined as patients aged 18–64 years attending a day facility of a psychiatric hospital or general hospital psychiatric unit continuously for more than a year, were identified in hospitals and units serving 56% of the Scottish population. The number of day patients was 14.8 per 100,000 of the general population, but the range between hospitals was very great—0 to 37.7 per 100,000—indicating the patchy development of such care. A typical day patient was a rather chronic middle-aged male schizophrenic, who lived on his own or with ageing parents. Most patients' accommodation was satisfactory, but the occupational activity of more than a third was inappropriate; 18% could have attended a local authority sheltered workshop if one had been available.
Is there really a Schizophrenia? The Long-term Course of Psychotic Phenomena∗
Authors: Ciompi Luc
Published: August 2008

The author fundamentally questions the traditional concept of the disease-entity (or several disease entities) of ‘schizophrenia’ and discusses an alternative concept, based on vulnerability and information-processing. According to this, schizophrenia-like psychotic phenomena develop in three phases. In the first, premorbid phase, combined biological (genetic and possibly other organic) and psycho-social influences lead to a premorbid ‘vulnerability’, characterised by a low tolerance of cognitive and emotional stress, corresponding to an insufficient capacity for the adequate processing of complex information. In the second phase, stressful life-events can lead to unique or repeated acute productive psychotic episodes. The third phase, that of long-term evolution, depends more on psycho-social influences than on biological factors. Under unfavourable conditions, it may lead to predominantly unproductive residual states of various degrees, which can largely be understood as regulatory mechanisms to restrict stressful over-stimulation. There is no clearly delimitable disease entity of schizophrenia with constant causes, psychopathological picture, or course, but rather a multi-conditioned life-process, occuring in people with a particular vulnerability, interacting with complex life-events and circumstances. This new concept has important consequences for therapy and prevention.
TRH Response Pattern in Adolescent Schizophrenic Males
Authors: DeMilio Lawrence
Published: August 2008

A marked elevation in human growth hormone (GH) following intravenous infusion of thyrotropin releasing hormone (TRH) was seen in three of seven adolescent male schizophrenic patients receiving neuroleptic drugs, and in one of five controls matched for age, sex, and developmental stage, receiving the same drugs. A positive family history for schizophrenia was noted in all three schizophrenic ‘responders' but in only one of the remaining patients. The response patterns of thyroid stimulating hormone (TSH), triiodothyronine (T3), and thyroxine (T4 following TRH infusion were not significantly different in the two groups. No significant correlations were found between T3, T4, TSH, or GH response patterns and age of patient, duration of illness, medication dose or duration, weight change, or hours of sleep preceding testing.
Nuclear Magnetic Resonance (NMR): I. Imaging Biochemical Change
Authors: Eastwood L. M. , Hutchison J. M. S. , Besson J. A. O.
Published: August 2008

Nuclear magnetic resonance (NMR) imaging of hydrogen in body water and fat is proving valuable in clinical investigation of the brain. An introduction to the technique and to the biological significance of the images is presented here. The ‘multi-parameter’ nature of these images is stressed, and the individual parameters described. NMR imaging may well be of value in investigating the pathology of organic and functional psychoses.
The Needs of Young Intellectually Retarded Adults
Authors: Brimblecombe F. S. W.
Published: August 2008

It is now generally agreed that the words ‘handicapped individual’ need to be considered as having a social rather than a medical or educational meaning. To arrive at such a conclusion, however, it is necessary briefly to consider the words ‘impairment’, ‘disability’ and ‘handicap’ (Figure 1).
The Psychiatric Intensive Care Unit
Authors: Goldney Robert , Bowes Julia , Spence Neil , Czechowicz Andrew , Hurley Rod
Published: August 2008

The first three and a half years' operation of a psychiatric intensive care unit, based on the general hospital model, is described. This eight-bedded ward focusses on the treatment of the most acutely psychiatrically ill patients, and not on the forensic or custodial aspects of such units previously described. It has gained general acceptance within the setting of a state psychiatric hospital, and has received 1132 admissions since its inception. Demographic, clinical, and treatment data are presented and the advantages and disadvantages of the unit are discussed.
Chronicity and the General Health Questionnaire
Authors: Goodchild M. E. , Duncan-Jones Paul
Published: August 2008

We propose a new scoring for Goldberg's (1972) General Health Questionnaire. We argue that the response ‘no more than usual’, to an item describing pathology, should be treated as an indicator of chronic illness rather than of good health, and we score these responses accordingly. We give evidence that this set of responses is associated with other measures of neurotic illness, and that the revised scoring provides a better prediction of caseness than the conventional scoring. The revised scoring is more strongly associated with trait neuroticism, and is more stable in repeated measurement. It is recommended in preference to the conventional scoring for most research and epidemiological purposes.
The Impact of Lithium in South-West Scotland II. A Longitudinal Study
Authors: Morrison D. P. , Mccreadie R. G.
Published: August 2008

In a longitudinal study in South-west Scotland of patients suffering mainly from affective illness, the introduction of lithium as prophylactic therapy was associated with a significant reduction in the number and length of hospital in-patient admissions, as well as in the number of courses and total number of electro-convulsive treatments. However, there was no significant reduction in the length of time patients received either antidepressants or major tranquillisers. A rating of individual patients suggested that a bare majority (52%) had improved considerably following the introduction of lithium.
Academic Difficulty among Male Egyptian University Students
Authors: Okasha A. , Kamel M. , Khalil A. H. , Sadek A. , Ashour A.
Published: August 2008

A survey was made of academic difficulties among undergraduate students at Ain Shams University, Cairo, during the academic year 1979–1980. Almost 6% of students dropped out before graduating and a further 8% required substantial extra time to complete their course of study: these figures were almost identical for both sexes. Psychiatric disorders were diagnosed in 42% of male students with academic problems (compared with 9% among the academically successful), with neuroses accounting for nearly half of the cases and schizophrenia for a quarter. Serious psychiatric illness was nearly four times as frequent among 3rd-year students as among 1st-year students.
Suppression of Eating by Fenfluramine in Patients with Bulimia Nervosa
Authors: Robinson P. H. , Checkley S. A. , Russell G. F. M.
Published: August 2008

Fifteen patients with bulimia nervosa received fenfluramine (60 mg po) or placebo under double-blind, randomly ordered conditions. Two hours later food was presented. Significantly less food was eaten after fenfluramine and the quantity eaten was inversely correlated with serum fenfluramine levels. Significantly fewer patients reported bulimic symptoms during the test after fenfluramine, but no significant effect was demonstrated after leaving the ward. Fenfluramine caused drowsiness but did not reduce hunger ratings. Similarly, eating failed to reduce hunger ratings normally in the patients. These findings suggest that in patients with bulimia nervosa, hunger is reported abnormally and eating is suppressed by fenfluramine. Bulimic symptoms were probably reduced by fenfluramine, which may prove to be a useful treatment for bulimia nervosa.
Why Teetotallers Abstain
Authors: Hughes Jennifer , Stewart Murray , Barraclough Brian
Published: August 2008

Drinking practices and attitudes to alcohol among the members of a Southampton church were investigated by questionnaire (602 subjects) and by interviews (126 subjects). Teetotallers were older than drinkers, and included a higher proportion of women. They perceived their childhood upbringing and the teaching of the Bible as the main factors influencing them to abstain. Both teetotallism and alcoholism were more common among relatives of teetotallers than among relatives of social drinkers.
Attempted Infanticide
Authors: Wilkins A. J.
Published: August 2008

The offence of attempted infanticide has hitherto been unknown in English Law. A case is here described in which a woman was convicted of infanticide, and attempted infanticide, having been charged with murder and attempted murder. The relevance of this is discussed, together with an aspect of infanticide previously unreported in the English literature, i.e. repetition of the offence.
Schizophrenia with Good and Poor Outcome. I: Early Clinical Features, Response to Neuroleptics and Signs of Organic Dysfunction
Authors: Kolakowska T. , Williams A. O. , Ardern M. , Reveley M. A. , Jambor K. , Gelder M. G. , Mandelbrote B. M.
Published: August 2008

Seventy-seven patients with diagnosis of schizophrenia (62) or schizoaffective disorder (15) were studied 2–20 years since onset of illness, when in a stable condition. The investigation included clinical assessment, measurement of plasma concentrations of neuroleptics and prolactin, computed tomography brain scan, neuropsychological and neurological examination. Outcome of illness was classified according to the presence of chronic psychiatric symptoms and social impairment, and response to neuroleptics according to the effect of treatment in the most recent psychotic episode. Neither outcome nor response to neuroleptics was related to duration of illness. The groups with good and poor outcome differed in premorbid adjustment, age at onset and symptoms of the initial episode, but not in drug bio-availability or prolactin response. Large cerebral ventricles and cognitive impairment, but not neurological ‘soft’ signs, were associated with unfavourable outcome. The three measures of organicity were not inter-related. No clinical differences were found between chronic patients with and without signs of organic dysfunction. The findings suggest that schizophrenia with good and unfavourable outcome may be separate sub-types. However, the role of organic factors in the latter group remains unclear.
The Denial of the Institution
Authors: Papeschi Raffaello
Published: August 2008

The writings of Franco Basaglia are critically reviewed, both from a technical psychiatric point of view and from a general political and social one. Basaglia maintained that the causes of psychiatric disorder are essentially social in nature, and that the only valid treatments are political struggle and the revival of the patient's aggressiveness. Therefore, no institution can be therapeutic for the patient, since its aim must be his custody and violent destruction. These statements are considered in the light of the need for institutions which are a therapeutic alternative to the mental hospital. Basaglia's ‘liberal’ defence of the individual against society is analysed, in relation to the negative consequences that the Italian Law 180 of 1978 is having on the care of long-term psychiatric patients. This law ‘forgot’ such patients, as well as adversely affecting the treatment of acute patients, for whom an insufficient number of psychiatric beds was permitted in general hospitals. A revision is proposed of Law 180 that would make possible the setting up of alternative institutions to outdated mental hospitals, but at the same time allow a transformation of their old structures.
Eating Disorders in Schizophrenia
Authors: Lyketsos G. C. , Paterakis P. , Beis A. , Lyketsos C. G.
Published: August 2008

An investigation of eating disorders in a population of chronic schizophrenic patients confirmed that there is a distinction between eating disorders of psychotics and eating disorders of the young. All the DSM-III criteria of eating disorders, except one, were observed among the psychotics although no patient fulfilled the necessary criteria for an eating disorder diagnosis except for one anorexic woman. All varieties of schizophrenic eating disorder were reported: in two-fifths of the patients eating disorders were associated with delusions and in one sixth with hallucinations; more than half of the patients had deviant eating behaviour which was not associated with any thought or perceptual disorders. Schizophrenic eating disorders were common, yet not disturbing to the social life of the open mental hospital or to that of the community surrounding it.
Does the Dexamethasone Suppression Test Predict Antidepressant Treatment Success?
Authors: Coppen Alec , Milln Philip , Harwood Janet , Wood Keith
Published: August 2008

The 1 mg dexamethasone suppression test (DST) was carried out in patients with a major depressive illness in order to establish whether the results of this test, given before antidepressant or ECT treatment, could predict eventual therapeutic outcome. No significant difference could be detected in overall therapeutic improvement between those patients with a normal or abnormal DST response respectively, based on the 50 ng/ml cortisol cut-off point. However, using 100 ng/ml as a cut-off point it was found that patients with an abnormal DST response (i.e. a post-DST plasma cortisol concentration ⩾ 100 ng/ml) responded significantly better than those who had a normal DST response. These observations were statistically significant for those patients receiving antidepressants and in the combined treatment groups of those patients receiving either antidepressants or ECT.
The Aftercare of the Patient with the Neuroleptic Malignant Syndrome
Authors: Aizenberg Dov , Shalev Arieh , Munitz Hanan
Published: August 2008

The neuroleptic malignant syndrome (NMS) is an idiosyncratic reaction to neuroleptic drugs, made up of hyperthermia, muscular rigidity, disturbance of level of consciousness and autonomic dysfunction. It is potentially lethal and should be kept in mind whilst using anti-psychotic drugs; as most patients treated by them require further anti-psychotic treatment, the clinician faces the problem of treating those patients after a NMS episode, yet reports in the literature have generally neglected the problem of late management. A patient suffering from a psychosis and NMS is presented, and a rationale for management offered.
A Mechanism to Inhibit Input Activation and its Dysfunction in Schizophrenia
Authors: Johnson J. David
Published: August 2008

Schizophrenics appear to be unable to regulate adequately the effects of external stimulation, but the cause of this deficit is unclear. Recent evidence suggests that input activation can normally be inhibited by an appropriate leading or conditioning stimulus; such inhibition has been found to be diminished in schizophrenics. Based on this evidence, a feed-forward regulating mechanism that serves to stabilise reactivity to environmental events is described; it is hypothesised that failure of the mechanism to inhibit adequately surges of activity is an underlying cause of schizophrenic symptoms. Some ways to test the validity of the mechanism are proposed, and an outline presented of steps to link the mechanism's dysfunction to schizophrenia.
British Opiate Addicts: An 11-Year Follow-up
Authors: Cottrell David , Childs-Clarke Adrian , Ghodse A. Hamid
Published: August 2008

A cohort of 83 British addicts from one clinic was followed-up after 11 years; Home Office records and medical notes were personally searched to trace current status. Twenty-nine were still using drugs, 37 were not known to be using drugs, and 17 had died. The group still using drugs had become markedly more stable on parameters of drug use, criminality, and social stability over the follow-up period.
I. Course of Illness, Stability of Diagnosis, and the Role of a Special Maintenance Clinic
Authors: Curson D. A. , Barnes T. R. E. , Bamber R. W. , Piatt S. D. , Hirsch S. R. , Duffy J. C.
Published: August 2008

A follow-up study of all patients entering the MRC double-blind trial of fluphenazine decanoate in chronic schizophrenic out-patients achieved a trace rate of 94%. In general, these patients were severely disabled, continued under the care of the maintenance clinic, and their diagnoses remained remarkably consistent; more than one-fifth were found to be in acute schizophrenic relapse and in over a half of these cases, the relapse was not known to the treatment agency. The maintenance clinic attenders were little different from those who no longer used such a facility.
The Risk of Child Abuse among Mothers who Attempt Suicide
Authors: Hawton Keith , Roberts Jacqueline , Goodwin Guy
Published: August 2008

The association between parental attempted suicide and child abuse was investigated in 114 mothers with children aged five years and under, referred to a general hospital following suicide attempts. The risk was greatly increased in the attempted suicide mothers, compared with both similar mothers at risk for depression and general population control mothers; well-documented risk of child abuse was identified in 29.8% of those who attempted suicide. No major differences were found between the attempted suicide mothers whose children were at risk and those whose children were not at risk. During the general hospital assessment of mothers with young children who attempt suicide, careful enquiry concerning the relationship with the children is essential
Plasma Cortisol Levels in Mania: Associated Clinical Ratings and Changes during Treatment with Haloperidol
Authors: Cookson J. C. , Silverstone T. , William S. , Besser G. M.
Published: August 2008

Plasma Cortisol levels were elevated in a large proportion of samples from manic patients. Although a correlation was found between clinical ratings of the severity of mania and the degree of elevation of daytime Cortisol levels, some patients with low clinical ratings had elevated Cortisol levels. During treatment with haloperidol, Cortisol levels returned to normal earlier that the clinical state. The underlying mechanisms are discussed.
An Evaluation of Alprazolam in the Treatment of Reactive or Neurotic (Secondary) Depression
Authors: Imlah Norman William
Published: August 2008

To investigate the effectiveness of a new benzodiazepine, alprazolam, and to compare this with amitriptyline (AMT) and with placebo, a trial was undertaken in 65 patients in whom depression was considered to be the dominating feature but not considered to be the primary cause of their condition; it was designed to exclude endogenous depressions. A consistent pattern was found favouring alprazolam over AMT both in rate of response and in total response, as well as significant differences in favour of both alprazolam and AMT over placebo. A comparison of side effects showed a definite trend in favour of alprazolam and placebo over AMT.
Motor and Sighting Dominance in Schizophrenia and Affective Disorder
Authors: Merrin Edward L.
Published: August 2008

Unusually frequent sinistral motor and sighting dominance have sometimes been reported in schizophrenics, although the majority of patients are still dextral. In this study, assessment of lateral dominance also included a measure of grip strength—a potentially more sensitive index of dominance or lateralised impairment; schizophrenics, non-schizophrenic patients (affective disorder), and normal controls were studied. There were no differences in handedness or sighting dominance. Affective patients, particularly bipolar psychotics, had greater right-handed grip superiority than normals or non-paranoid schizophrenics. Paranoid schizophrenics were similar, being significantly greater in right-sided dominance than non-paranoids, who tended toward a smaller value than normals. Hand grip asymmetry was highly correlated with handedness in normals, but not in patients. The possibility is discussed that these results may reflect asymmetrical patterns of cerebral impairment or attentional bias.
Postnatal Depression and Child Development
Authors: Wrate R. M. , Rooney A. C. , Thomas P. F. , Cox J. L.
Published: August 2008

This study investigates whether three-year-old children whose mothers had been depressed after their birth showed more behaviour disturbance than children of mothers who were not depressed at that time. Ninety-one of 103 mothers who took part in an earlier prospective study of postnatal depression were reinterviewed three years later to determine their present mental state, and to assess their child's behaviour, using Richman's Behavioural Screening Questionnaire.

No relationship was found between a prolonged postnatal depression and behaviour disturbance in the child, but children whose mothers had brief postnatal depressive episodes showed more behaviour disturbance than those whose mothers had not been depressed since childbirth.
Alcoholics
Authors: O'Connor Art , Daly Joan
Published: August 2008

A 20 year follow-up on 133 alcoholics was carried out. Tracing methods are outlined and the difficulties reviewed. A questionnaire was completed by 40 subjects concerning drinking outcome, aids to recovery and morbidity. Mortality data are outlined and discussed for the 53 subjects who died during the follow-up period.
Adrenergic Receptors in Depression
Authors: Cooper Stephen J. , Kelly John G. , King David J.
Published: August 2008

Platelet α2-and lymphocyte ß2-adrenoceptor densities, plasma noradrenaline and serum Cortisol were measured before, during and one week after a course of EEG-monitored electroconvulsive therapy, in nine depressed patients. A 50% fall in Hamilton Depression Rating scores occurred after a fairly consistent total seizure time, regardless of the amount of ECT given. Platelet α2-adrenoceptor densities showed a statistically significant fall after three ECTs, but were unchanged after the full course of ECT and were independent of clinical change. Lymphocyte ß2-adrenoceptor densities were unaltered. Plasma noradrenaline concentrations were initially high, and fell with ECT in a manner paralleling clinical recovery. Plasma noradrenaline may be a more useful index of central changes during antidepressant treatment than peripheral blood cell receptor densities.
ECT, Blood Pressure Changes and Neuropsychological Deficit
Authors: Taylor John R. , Kuhlengel Barbara G. , Dean Raymond S.
Published: August 2008

Twenty psychiatric in-patients were studied before and after five bilateral electroconvulsive treatments for major depression. There were significant memory and neuropsychological changes after treatment, and significant reductions in depression rating scores, but they did not correlate with various measures of blood pressure elevation during treatment. The importance of ECT-related amnesia is discussed.
Sex Concordance for Schizophrenia in Proband-relative Pairs
Authors: Sturt Elizabeth , Shur Eric
Published: August 2008

Some hypotheses about the cause of schizophrenia are based on the puzzling tendency for mental illness to affect the same sex when two close relatives become psychiatrically ill. Sex-concordance rates were examined in 71 schizophrenic probands, who had at least one first-degree relative suffering from the same disorder, in order to test this tendency in a population of recently admitted patients. No unusual concordance rates were found when unaffected sibs were taken into account and relatives were stratified to take account of possible confounding factors. It would seem premature to construct hypotheses about the aetiology of schizophrenia based on evidence of this type.
A Twin study of Individuals with both Schizophrenia and Alcoholism
Authors: Kendler Kenneth S.
Published: August 2008

Substantial evidence suggests that genetic factors contribute to the aetiology of both schizophrenia and alcoholism, when they occur alone. To examine the role of genetic factors in schizophrenia and alcoholism when they occur together in the same individual, the frequency of both conditions was investigated in the co-twins of 34 monozygotic (MZ) and 47 dizygotic (DZ) index twins with a diagnosis of both schizophrenia and alcoholism. Both disorders alone were significantly more common in the MZ than in the DZ co-twins, suggesting that individuals suffering from schizophrenia and alcoholism have a genetic predisposition to both disorders, which is of the same nature as that which causes the two when they occur alone. In the co-twins of the MZ index twins, the diagnoses of schizophrenia and alcoholism were uncorrelated, indicating that the specific environmental factors of causal importance in the two disorders are not closely related.
Interpreting Data in Aetiological Studies of Affective Disorder: Some Pitfalls and Ambiguities
Authors: Harris Tirrill O. , Brown George W.
Published: August 2008

Although recent research in social psychiatry has produced an encouraging congruence of findings and conclusions, puzzling inconsistencies continue to be reported. One explanation which is often overlooked is that subtle differences in the way seemingly identical variables are grouped can produce sizeable, and sometimes dramatic, differences in the patterning of the same data. Re-examination of existing results can therefore often better clarify confusing inconsistencies than collection of new data. This is illustrated by examples from recent studies of affective disorder where the grouping of variables is discussed in three broad areas: parental loss in childhood, precipitating stress, and social support. Until the aetiology of affective disorder is more fully understood, it will often be clearer if data are analysed more than once, so that several combinations of variables are systematically examined.
Therapeutic Manipulation of Nightmares and the Management of Neuroses
Authors: Bishay N.
Published: August 2008

Seven cases of nightmare were treated by simple rehearsal of the nightmare and/or rehearsal with an altered ending, followed by earlier introduction of the ending. One-year follow-up of five patients showed complete relief from nightmares in the four patients who achieved early introduction of a ‘masterful’ ending, and marked improvement in the patient who could only imagine a neutral ending. All but one of the patients also presented with neurotic symptoms (anxiety, phobias, depression and compulsion/obsession). These were treated by rational discussion and the formulation of positive ‘threat-eliminating’ statements to be repeated as homework and in times of stress.
Presbyophrenia: Clinical Aspects
Authors: Berrios G. E.
Published: August 2008

Fifteen cases meeting the diagnostic criteria for presbyophrenia are reported and compared with a control sample of patients suffering from dementia. The presbyophrenic patients exhibited more elevated mood, more hyperactivity, more disorientation, and had lower information scores than the controls. Traditional explanations of ‘presbyophrenic behaviour’ such as delirium, pathoplastic effect of personality, or superimposed cerebrovascular disease are not adequate. Instead, presbyophrenia may constitute a sub-type of dementia characterised by severe atrophy of the locus coeruleus, marked impairment of noradrenergic transmission, and uninhibited behaviour.
Genetic Counselling for Schizophrenia
Authors: Reveley Adrianne
Published: August 2008

It is possible that genes contributing to the development of schizophrenia may be identified within the next decade. Genetic methods are improving rapidly, and are surrounded by great public interest. Requests for genetic counselling are keeping pace with this increased attention, but the problems faced by psychiatric genetic counsellors are complex, and the experience of offering such counselling and the issues involved are rarely discussed. In this context the paper describes a year's work counselling for schizophrenia in the Maudsley Hospital Genetic Clinic.
The Motor Disorders of Severe Psychiatric Illness: A Conflict of Paradigms
Authors: Rogers Daniel
Published: August 2008

The motor disorder of 100 patients with severe psychiatric illness is described and the contribution of previous treatment, hospitalization and possible neurological disorder is considered. The conflict of paradigms between the concept that this motor disorder has two distinct aetiologies, psychiatric and neurological, and the concept that both motor and mental disorder are an expression of underlying cerebral disorder is discussed. An attempt is made to resolve this conflict by description of motor disorder without reference to neurological or psychiatric diagnosis.
Third Ventricle Size and Dementia in Schizophrenia
Authors: Bankier Robert G.
Published: August 2008

Using an ultrasound technique, the widths of the third ventricle in a group of normal subjects was compared with groups of chronic schizophrenics and acutely ill schizophrenics. While the chronic patients showed a significantly wider ventricle (p < 0.5) from the other two groups, only 14% of the chronic patients had a third ventricle greater than the accepted normal maximum of 8 mm. Neuropsychological tests confirmed organic brain impairment in both chronic and acutely ill patients but there was no significant difference between chronic patients with large ventricles and those with normal size ventricles. This suggests that third ventricle size is not part of the schizophrenic disease process and is not related to the dementia seen in the late stages of the illness.
Day Treatment: Suitability and Referral Procedure
Authors: Dick Peter , Cameron Lewis , Cohen David , Barlow Marion , Ince Anne
Published: August 2008

In a prospective screening of emergency admissions of patients suffering from neurosis, personality disorder or adjustment reaction, 100 were assessed as suitable for early transfer to day hospital treatment, 101 as unsuitable, and 39 as not requiring further intervention. Of the unsuitable patients, 39 were grossly disturbed; the remainder did not differ in severity from those thought suitable, but there was a specific reason against day treatment in all but 13 of the 62—most commonly alcohol abuse, physical problems, social problems or aggression. Patients' attitudes were also important. Recruitment of patients had to be active, with regular visits to the wards by day hospital staff.
Psychiatric Reform in Italy—How does it Work in Piedmont?
Authors: Becker Thomas
Published: August 2008

Psychiatric reform in Piedmont following new mental health legislation in Italy (1978) is described. The process of reform is characterised by a drastic reduction in psychiatric hospital populations and the setting-up of a new system of community-based services. The number of hospital admissions remains stable, but the character of inpatient care has changed. The reform involves problems of care for chronic patients.
Rehabilitation and Institutionalisation in Community Care in West Germany
Authors: Kunze Heinrich
Published: August 2008

This study examines the quality of residential care in non-psychiatric nursing homes and psychiatric group homes for a representative epidemiologically-based sample of patients discharged from a psychiatric hospital in West Germany. There were twice as many chronically ill patients in sheltered accommodation as in hospital, 85% of them in nursing homes, which scored badly on all measures of therapeutic environment. This poverty of social environment was correlated with severity of symptoms for schizophrenics, especially with flatness of affect and poverty of speech. Nursing homes were just as likely as hospitals to promote chronic illness and hinder rehabilitation.
Psychopathological Aspects of the Toxic Oil Syndrome Catastrophe
Authors: López-Ibor J. J. , Soria J. , Cañas F. , Rodriguez-Gamazo M.
Published: August 2008

In May 1981 a new disease caused by widespread food-poisoning (probably with adulterated rape-seed oil) appeared in Spain. More than 20000 people were affected, and about 350 patients have died. The clinical syndrome consisted of pulmonary, neuromuscular and systemic symptoms, which evolved to produce mild or severe physical disabilities. Although the disease is not primarily a psychiatric condition, more than 6000 TOS patients have been referred to a psychiatrist: these patients show a well-defined ‘reactive disaster syndrome’, vulnerability being associated with female sex, low income and class, and a personal history of ‘nervous' disorders. The enormous public repercussions of the disease and the specific administrative measures it provoked are discussed and evaluated. This unique experience of a specific disaster can contribute to our knowledge of the psychological and psychiatric aspects of disasters in general; and it suggests that teams of psychologists and psychiatrists should play a significant role in managing the effects of major catastrophes.
Teenage School Refusers Grow Up: A Follow-up Study of 168 Subjects, Ten Years on Average after In-Patient Treatment
Authors: Berg Ian , Jackson Ann
Published: August 2008

Efforts were made to follow up 168 young teenage school refusers ten years, on average, after they had been treated as inpatients in an adolescent psychiatric unit. Almost half were well or much improved throughout the follow-up period. Outcome was most satisfactory in intellectually bright children treated under the age of 14 and among those who were well or substantially better shortly after discharge. Thirty per cent of the group had received treatment for psychiatric illness, 14% had seen a psychiatrist and 5% had been admitted to hospital for psychiatric treatment during the follow-up period. Thirty per cent appeared to be disturbed at the time that they were reviewed. The ‘decennial-inception’ and ‘point-prevalence’ rates for psychiatric disorder appeared unduly high by comparison with local and national rates of disturbance.
Psychiatrists in Primary Health Care Settings
Authors: Mitchell Alexander R. K.
Published: August 2008

An increasing number of psychiatrists are now working partly in primary care settings. This paper describes how the movement began and how both psychiatrists and other members of the specialist psychiatric treatment team have explored ways of working with family doctors in the diagnosis and management of psychiatric disorders. Various styles of collaborative work, the declared advantages of such attachment schemes, the reservations being expressed about their further extension, and their research and educational potential are explored. If such enterprises, designed to help the family doctor identify psychiatric morbidity in the practice and to extend his skills in managing such patients and their relatives, are to be commended, they must be carefully monitored so that the cost-benefit balance can be established.
The Relationship between Parkinson's Disease and Dementia: A study using Proton NMR Imaging Parameters
Authors: Besson J. A. O. , Mutch W. J. , Smith F. W. , Corrigan F. M.
Published: August 2008

The value of the spin lattice relaxation time (T1) obtained during nuclear magnetic resonance imaging of the brain was studied in patients with idiopathic Parkinson's disease, with and without dementia. T1 increases significantly in the basal ganglia and cerebral white matter of the demented and non-demented groups. T1 of the cerebral white matter correlates with the severity of dementia.
Possible Improvements to the Diagnostic Criteria for Dementia in DSM-III
Authors: Jorm A. F. , Henderson A. S.
Published: August 2008

The DSM-III diagnostic criteria for dementia can be criticised because they treat dementia as a categorical rather than dimensional disorder, and thus ignore the problem of placing appropriate cutoffs. They are also too broad and may result in diagnostic unreliability because of varying interpretations of the criteria by different diagnosticians. Strategies for overcoming these problems are discussed and some improved criteria proposed.
Body Image Distortion in Bulimia Nervosa
Authors: Birtchnell Sandra A. , Lacey J. Hubert , Harte Anne
Published: August 2008

Body image perception was measured in 50 women with bulima nervosa and 19 age and weight matched female controls, using a visual size estimation apparatus. Both groups overestimated body widths, but not the width of a neutral object, and whilst there was a trend for bulimics to overestimate more than controls this did not reach significance. The part of the body most overestimated corresponded to the part most disliked in only a third of both groups. The bulimics without a previous history of anorexia nervosa overestimated body width more than those with such a history; this may be related to the fact that the former had a significantly greater weight index. Bulimics who were within 5% of mean-matched population weight overestimated body width less than the others, this difference reaching significance when compared with the heavier groups; a similar, but non-significant, trend was demonstrated in controls. This may be linked to a greater dissatisfaction with body size. Duration of illness, frequency of bingeing and self-induced vomiting were not shown significantly to alter body size estimation. The bulimics who completed a 10-session outpatient treatment programme subsequently demonstrated a significant decrease in overestimation of waist and hip width.
Concept of Ego Strength in Psychotherapy
Authors: Lake Brian
Published: August 2008

The concept is discussed of how ego strength and equivalent dimensions of the term have been developed by well known contributors to psychotherapeutic literature and theory. A case is made for the translation of these dimensions, which include motivation and psychological mindedness, into operational terms and into items which are descriptive of the notion of personal and social competence. This has been done to provide guidelines for the assessment of patients for an optimal psychotherapy. A rationale for the inclusion for each item is constructed from the observations of experienced psychotherapists and research workers.
Motives for Offending among Violent and Psychotic Men
Authors: Taylor Pamela J.
Published: August 2008

Two hundred and three male remanded prisoners were interviewed with respect to their current offence, mental state, and social and psychiatric histories. All but nine of the sub-group of 121 psychotic men showed active symptoms at the time of committing a criminal offence; 20% of the actively ill psychotics were directly driven to offend by their psychotic symptoms, and a further 26% probably so. If some of the indirect consequences of the psychosis were taken into account, 82% of their offences were probably attributable to the illness. Among the normal and neurotic men, none claimed psychotic motives for offending, but motives suggesting high emotional arousal such as panic or retaliation triggered the greatest violence. Within the psychotic group, those driven to offend by their delusions were most likely to have been seriously violent, and psychotic symptoms probably accounted directly for most of the very violent behaviour.