bluuebunny/crossref_metadata_2025 huggingface dataset:
Symptom Changes in Chronic Schizophrenic Patients on a Token Economy: a Controlled Experiment
Authors: Baker R. , Hall John , Hutchinson K. , Bridge G.
Published: August 2008

An 18-month controlled experiment was conducted into the effects of a token economy programme on the ward behaviour and symptoms of chronic schizophrenic patients. An experimental group received tokens dependent upon appropriate behaviour, while a matched control group on the same ward received every aspect of the ward programme similarly except that tokens were not dependent upon their behaviour. Regular assessment showed that both groups improved substantially in social withdrawal. Over twelve months of treatment the experimental group improved no more than the control group. There were no symptomatic changes. The conclusions were that token economy is a treatment affecting withdrawal and social behaviour rather than symptomatology, and that factors other than reinforcement by tokens were responsible for the main changes.
The Repetitiveness of Self-poisoning and Self-injury
Authors: Bancroft John , Marsack Pamela
Published: August 2008

A year's cohort of 690 suicide ‘attempters' was followed for two years in order to monitor further attempts leading to referral to the general hospital. Eighteen per cent were involved in one or more repeat episodes, 16 per cent within the first year. More repeats occurred within the first three months than in the rest of the 21 months, and a large majority of repeats occurred within the first year.

Study of a smaller cohort of 141 persons gave information about the frequency and timing of previous attempts. Forty-five per cent had made previous recognized attempts and 10 per cent previous unrecognized attempts. Sixty persons reported 166 previous attempts. Of previous attempters 32 per cent made two or more attempts within a three-month period.

Three types of repeaters are suggested: (a) the chronic, habitual repeater; (b) the individual who repeats several times within a short period, and (c) the ‘one-off’ very occasional repeater.
The Immediate and Enduring Effects of the Inquest on Relatives of Suicides
Authors: Barraclough B. M. , Shepherd D. M.
Published: August 2008

A survey of relatives' experience of coroners' inquests on suicides is reported. The survey was conducted shortly after the inquest and gave results similar to those of a survey which took place some years after the relevant inquests. Both surveys show that the inquest aggravates the distress resulting from bereavement by suicide. Implementing the Brodrick Report and preventing the publication of inquest reports in the press would relieve some of this additional distress.
Behaviour Problems in Pre-School Children: Family and Social Factors
Authors: Richman Naomi
Published: August 2008

In a group of 99 three-year-old children with behaviour problems identified in an epidemiological survey, family and social factors were compared with those in a group of controls. Behaviour problems were significantly associated with a strained marital relationship between parents, with social stresses and with type of housing. There was a high rate of maternal depression in both problem and control groups. The interaction between a behaviour problem in a young child, maternal mental health and social factors is discussed.
A Study of Predictive Factors in Depressive Disorders of Poor Outcome
Authors: Toone B. K. , Ron M.
Published: August 2008

A retrospective comparison was made between two groups, each consisting of 30 depressed patients, one in which the outcome following discharge had been good, the other where it had been poor. A previous psychiatric history, earlier admission for psychiatric illness, particularly for affective disorders and a poorer performance on routine intelligence tests were found in the poor prognosis group. In this group the duration of the index admission was longer and the condition of the patient was less improved at the time of discharge. Several symptom variables also discriminated between the groups. These findings are discussed.
Monozygotic Twins Concordant for Infantile Autism: Follow-up
Authors: Campbell Magda , Dominijanni Cristina , Schneider Barry
Published: August 2008

This paper presents a well-documented case of monozygotic male twins concordant for infantile autism, with a twelve-year follow-up. Assessments include birth records, laboratory studies, physical measurements, psychometrics and quantifiable behavioural ratings by independent raters using multiple scales. Possible aetiological factors of infantile autism, as well as outcome are discussed.
Gamma-Aminobutyric Acid (GABA) in the CSF of Schizophrenic Patients Before and After Neuroleptic Treatment
Authors: Lichtshtein D. , Dobkin J. , Ebstein R. P. , Biederman J. , Rimon R. , Belmaker R. H.
Published: August 2008

Gamma-aminobutyric acid (GABA) levels in the CSF were measured in 9 normal individuals, 17 drug-free schizophrenic patients and 10 of these same schizophrenic patients after neuroleptic treatment. There was no significant difference between CSF level of GABA in the control group compared to those in schizophrenic patients; however, 6 of the 7 lowest GABA levels were from schizophrenic patients. There was a significant decline of 12 per cent in mean GABA levels in the CSF after a mean of two months of neuroleptic treatment.
Problems Associated with the Analysis and Interpretation of Saliva Lithium
Authors: Sims Andrew , White A. C. , Garvey K.
Published: August 2008

The correlation between serum and saliva lithium levels in patients undergoing lithium prophylaxis therapy is discussed. Although a high correlation can be obtained, there is an unacceptably high individual variation of paired results. Two strategies were used in an attempt to improve the reliability of saliva as a predictor of serum levels. A naturally occurring marker in saliva and serum was used. This showed high correlation but still did not prevent large sporadic differences. Serially paired results in individual patients also showed occasional excessive variation. Although saliva lithium has been used for monitoring when serum assessment is impracticable, it is considered that it is, as yet, an unreliable technique.
Nineteen Cases of Morbid Grief
Authors: Lieberman Stuart
Published: August 2008

Three different patterns of morbid grief are noted. The effect of forced mourning procedures on morbidly grieving patients is discussed with some indication of beneficial and harmful effects of psychotherapeutic intervention.
Suicide Attempts 1970—75: Updating a United States Study and Comparisons with International Trends
Authors: Wexler Lawrence , Weissman Myrna M. , Kasl Stanislav V.
Published: August 2008

This paper brings up to date a 1970 study of suicide attempters coming to a major emergency room in an United States urban community and reviews international trends in suicide attempts. Results of the study and the review of the international literature indicate that the high rates of suicide attempts that were observed in 1970 are continuing into 1975. The incidence of suicide attempts continues to be a public health problem primarily among young women. Pill ingestion, usually barbiturates and psychotropic drugs, continues to be the most common method used.
Dichotic Listening in Psychotic Patients
Authors: Lishman W. A. , Toone B. K. , Colbourn C. J. , McMeekan E. R. L. , Mance R. M.
Published: August 2008

Patients recently recovered from schizophrenic or manic-depressive psychoses showed larger ear difference scores than normal controls on a dichotic listening test, i.e. when asked to identify dissimilar words fed synchronously to the two ears. The possible significance of the finding is discussed, in relation both to hemispheric organization and to other aspects of cognitive activity which may underlie performance on the task.
Immunoglobulins and Viral Antibodies in Psychiatric Patients
Authors: Torrey E. Fuller , Peterson Michael R. , Brannon William L. , Carpenter William T. , Post Robert M. , Van Kammen Daniel P.
Published: August 2008

The serum and CSF of 66 patients with functional psychoses were tested for immunoglobulins and antibodies to measles, HSV-1, CMV, and rubella viruses. Ten surgical and 80 neurological patients were controls. There were no significant findings in the serum, consistent with most previous studies. In the CSF 6 of 17 multiple admission schizophrenic patients had definite elevations of IgG or measles antibody and differed significantly from the surgical controls. Immunologically this group resembled the seriously ill neurological patients. No previous study has been made of immunoglobulins or viral antibodies in the CSF of psychiatric patients. It is concluded that further work is warranted in a search for biological subgroups of schizophrenia.
Incidence of Depressive Symptoms in Users of the Oral Contraceptive
Authors: Fleming O. , Seager C. P.
Published: August 2008

Evidence is presented that the incidence of depression among users of oral contraceptives is no higher than that among matched controls not taking such medication. There is an association between high depression scores and high neuroticism scores, more marked in controls than takers. Intensity of depression is related more to age, personality and occupation than to the use of oral contraceptives. A higher proportion of users than of controls experience sexual satisfaction. Past takers include a large number of individuals with a high neuroticism score. The incidence of depressive symptoms in women increases with age. A higher proportion of housewives than of women going out to full-time work show depressive symptoms.
Residential Needs in Hospital and the Community for Mentally Handicapped People
Authors: Craft Michael , Wilkins Rodney
Published: August 2008

Using successive analyses of hospitalized mentally handicapped people from a geographically defined Welsh catchment area, this article attempts to evaluate changes in cohorts of such patients. It suggests the likelihood that the level of hospital accommodation predicted in the White Paper ‘Better Services for the Mentally Handicapped’ will be sufficient.
Some Psychological Correlates of Long-term Heavy Cannabis Users
Authors: Mendhiratta Sarabjit Singh , Wig N. N. , Verma S. K.
Published: August 2008

Fifty persons who had all been heavy cannabis users for a long time were given psychological tests measuring psychomotor, perceptual and other variables. Half of these persons were ‘Charas' smokers, half ‘Bhang’ drinkers. The duration of cannabis use was 4–10 years, with an average daily dose of 150 mg tetrahydrocannabinol. A matched control group of twenty-five persons were given the same tests. Compared with this group, the cannabis users were found to react more slowly, to be poorer in concentration and time estimation, to have higher neuroticism and greater perceptuo-motor disturbance. The Charas smokers were the poorest performers and also showed poor memory, lowered psychomotor activity, and poor size estimation.
The Relationship Between Duration of Treatment in a Therapeutic Community for Drug Abusers and Subsequent Criminality
Authors: Wilson Stephen , Mandelbrote Bertram
Published: August 2008

The conviction rates for the first 61 admissions to a therapeutic community for drug dependence were obtained for a period two years prior to admission and two years after discharge, by searching in the Criminal Records Office at Scotland Yard.

A long-stay group (n = 20) which had remained in residence more than six months was compared with a medium-stay group (n = 20) which had remained from one to six months and a short stay group (n = 21) which had remained less than one month.

The long-stay group had a pre-admission conviction rate of 60 per cent, which was significantly reduced to 10 per cent during the follow-up period. The conviction rate of the medium-stay group was reduced from 70 per cent before treatment to 45 per cent after treatment; that of the short stay group remained constant at 57 per cent before and after treatment. It is suggested that periods of more than six months treatment in the community are effective in reducing subsequent criminality.
School Phobia: Classification and Treatment
Authors: Baker Hazel , Wills Ursula
Published: August 2008

Ninety-nine cases of school phobia seen at a child guidance clinic over a period of twelve years were divided into acute and chronic groups and investigated in several ways. The results indicate that the children of both groups are more likely to be the eldest or youngest in the family. Acute school phobia is more likely to occur in youngest children with two or fewer siblings, and mothers tend to be older. It is most common in adolescence and seems often to be precipitated by stress. Chronic school phobia is likely to occur in a child from a larger family and with a younger mother. It is more common in social class V and in children of mentally ill parents. Implications for treatment are discussed.
The Treatment of Frigidity: A Comparative Study of Group and Individual Desensitization
Authors: O'Gorman Ethna C.
Published: August 2008

Forty patients took part in this study. Twenty patients treated by group desensitization were compared with twenty treated by individual desensitization. Group desensitization appeared the more effective treatment if outcome was measured on the patients' self-rating scale, but the less effective if outcome was measured by the sexual interest questionnaire. Of the two, the group method took longer to administer, but more patients treated in this way completed the course of treatment.
Kindling as a Model for Alcohol Withdrawal Syndromes
Authors: Ballenger James C. , Post Robert M.
Published: August 2008

Periodic brain stimulation, particularly in the limbic system, at stimulus intensities initially too low to produce any behavioural or EEG effects, progressively produces EEG changes, motor automatisms, and eventually convulsions, an effect called kindling. Data are presented and reviewed that suggest that the severity of alcohol withdrawal symptoms progressively increases over years of alcohol abuse in a stepwise fashion similar to the kindling process. The model is presented that the limbic system hyperirritability which accompanies each alcohol withdrawal serves over time to kindle increasingly widespread subcortical structures. These long-term changes in neuronal excitability might relate to the progression of alcohol withdrawal symptoms from tremor to seizures and delirium tremens, as well as the alcoholic personality changes between episodes of withdrawal.
The Münchausen Syndrome as a Psychiatric Condition
Authors: Cheng L. , Hummel L.
Published: August 2008

In this presentation of two cases it is suggested that many Münchausen syndrome patients present with psychiatric symptoms. This syndrome, however, should be differentiated from other clinical psychiatric conditions.
Physical Disorder Among Day Hospital Patients
Authors: Burke Aggrey W.
Published: August 2008

During a six-month period, physical disorder was found among 50 per cent of the 133 patients at a day hospital. Few of these cases (5) had organic brain syndromes. Among the remainder (62) physical disorder was not associated with sex, formal psychiatric diagnosis or time of referral to the hospital; of those 33 patients with a neurological disorder, one-third had previously been diagnosed to be hysterical. For this ‘hysterical’ group, however, associations with folate deficiency, organic brain disease, and depression were noted. The need is demonstrated for routine investigations among day hospital patients with particular attention for those with atypical features.
Pseudohypoparathyroidism and Capgras Syndrome
Authors: Preskorn Sheldon H. , Reveley Adrianne
Published: August 2008

The patient described in this report is the second case in which the Capgras syndrome has occurred in association with pseudohypoparathyroidism (Hay et al, 1974). Her admission was for evaluation and treatment of psychosis, but after detailed metabolic and psychometric testing it was established that pseudohypoparathyroidism and cerebral dysfunction were antecedent conditions. In view of recent reports in the literature, the significance of these conditions in the pathogenesis of the Capgras syndrome will be discussed.
Multivariate Statistical Methods and Problems of Classification in Psychiatry
Authors: Garside Roger F. , Roth Martin
Published: August 2008

This paper is concerned with the use of multivariate statistical methods in relation to classification in psychiatry. There are two aspects of classification: the classification of symptoms to form syndromes and of patients into diagnostic groups. Critical papers are reviewed, and proposed severe limitations on the methods answered. The use of multivariate methods has increased objectivity and agreement between investigators, but differences remain, largely on issues in statistical logic, which must be resolved.
Sodium Valproate and Tardive Dyskinesia
Authors: Gibson Alan C.
Published: August 2008

Twenty-five schizophrenic patients with tardive dyskinesia were given 600 mgs sodium valproate daily with their neuroleptic medication. After one month there was no change in their signs, as judged by a panel of nine viewing films of them taken before and at the end of this treatment.
Specific Psychological Deficits in Alcoholism
Authors: Cutting John
Published: August 2008

Forty alcoholics and 40 controls were compared on tests of frontal lobe functions, abstracting ability, and verbal and picture memory. Alcoholics were inferior to controls, and heavy drinkers poorer than moderate ones (life-time alcohol consumption) on picture memory and a verbal fluency test of frontal lobe functions. Verbal memory and abstracting ability were not significantly impaired. Although this pattern may indicate that frontal and right temporal areas of the brain are particularly vulnerable to the effects of chronic alcoholism, the possibility that it may merely reflect general sensitivity of the tests to brain damage cannot be ruled out.
Age Disorientation in Chronic Schizophrenia: The Nature of the Cognitive Deficit
Authors: Crow T. J. , Stevens M.
Published: August 2008

In an interview survey of temporal orientation in chronic schizophrenia, patients with age disorientation (n = 77) were much less likely than patients without age disorientation (n = 222) to be able to give correct answers to simple questions about dates and the passage of time (e.g. their date of birth, the present year and the duration of their hospital stay). The age disorientated systematically underestimate the present year and their duration of hospital stay; in individual patients the errors they make are consistent with their concept of their own age. ‘Time stands still’ for these patients.

However, there are patients in whom an incorrect appreciation of their own age co-exists with correct awareness of the present year. Between these patients and those for whom subjective time stands still, there appears to be a continuum of increasing temporal disorientation. This dimension may be a clinical correlate of intellectual impairment.
The Influence of Videotape Feedback on the Self-Assessments of Psychiatric Patients
Authors: Griffiths R. D. P. , Gillingham P.
Published: August 2008

The effects of videotape feedback on patients' self-perception were assessed in a study which was a partial replication of an investigation reported by Griffiths and Hinkson (1973). Subjects were randomly allocated to one of three groups. After a semi-structured interview, they were either (1) shown a videotape of the interview, or (2) shown a videotape of another person being interviewed, or (3) engaged in other activities not involving videotape. Patients' self-ratings indicated that videotape feedback has immediate effects on self-assessments of social ease and physical attractiveness. Feedback produced changes in ratings of social ease, but individuals differed in the direction of the change (i.e. whether social ease was ‘better’ or ‘worse’). The direction of the change was predicted by a questionnaire measure of response style. Feedback also tended to make patients rate themselves as less attractive in the eyes of other people. All changes were, however, temporary and had disappeared at a two-week follow-up.

The results are generally consistent with those reported by Griffiths and Hinkson in that they indicate temporary and specific changes in response to videotape feedback. The implications of the results are discussed.
The Qualities of a Good Psychiatrist
Authors: Hill Denis
Published: August 2008

There are in the eyes of the world different sorts of ‘good’ psychiatrists. It depends who is making the judgement; it depends what is asked of the psychiatrist, what role he is expected to take and how successfully he has measured up to it. One would expect that the qualities of a doctor would be judged to a very large degree by his capacity to treat patients. This is what his long period of undergraduate and postgraduate training and education is about. Recently this concept of the doctor, and particularly that of consultant psychiatrist, has been challenged. The expectation that in the future he will continue to treat patients personally seems to be doubted. I wish to make my own attitude clear at the outset. The psychiatrist in my view is a physician in psychological medicine—a clinician—which means that his business and his professionalism are the personal care of patients. He is now called upon to do much more than this, and the reasons are several and complex. But the old view of a psychiatrist as physician may be lost if he accepts only the role of administrator, PR man, member of a multiprofessional team with far-ranging, ubiquitous responsibilities.
The Imprisonment of Mentally Disordered Offenders
Authors: Orr J. H.
Published: August 2008

I am glad to have this opportunity to talk about an unfortunate consequence of developments in the Health Service over recent years. My theme will be what is now happening to mentally disordered people who have committed criminal offences. At present, many of them are going to prison. The prison system—already severely overcrowded—contains some hundreds of mentally disordered offenders who in the opinion of prison medical officers need and are capable of gaining benefit from care, management and treatment in psychiatric hospitals. When using the term ‘mental disorder’ I shall, of course, be referring to those states of mind which have been classified and defined in Section 4 of the Mental Health Act 1959: members of the College who work in the National Health Service will be relieved to know that I do not share the view of the citizens of Samuel Butler's Erewhon that crime itself is an illness, whose sufferers should all be placed in the hands of the omniscient psychopathologists. Indeed, when one has the practical responsibility for the provision of health care for prisoners, it is quite irrelevant whether or not they committed their offences as a result of a mental disorder or whether their mental disorder developed before or after the offence or trial. The only thing that matters is their present condition. If a prisoner is suffering from mental disorder of a nature or degree that warrants his detention in hospital for treatment, then the prison medical officer will want to bring about his admission to hospital under the appropriate section of the 1959 Act. This is wholly in accordance with the philosophy of the Act, which does not limit hospital admission to cases in which the criminal offence was causally related to a mental disorder. In this talk I shall want to consider why in so many cases hospital places cannot be found.
Mianserin and Lithium in the Prophylaxis of Depression
Authors: Coppen Alec , Ghose Karabi , Rao Rama , Bailey John , Peet Malcolm
Published: August 2008

Forty-one out-patients with a history of at least three attacks of depressive illness were randomly allocated to treatment on a double-blind basis for one year with either mianserin 20 mg three times daily plus placebo lithium tablets, or to lithium tablets once daily plus placebo mianserin tablets. After one year, the dosage of mianserin was increased to 30 mg t.d.s. for a further six months. All but three of the patients had previously been stabilized on prophylactic lithium therapy. Lithium was found to be significantly superior to mianserin in avoiding admission to hospital or ECT. The overall affective morbidity index, calculated from global rating, showed no significant difference between drugs, but the index of the mianserin group was higher in the second six months than in the first. The lithium group showed no such change. Lithium remains the choice for the prophylaxis of unipolar recurrent depressive illness.
A Study of Thyroid Function in Psychiatric In-patients
Authors: McLarty D. G. , Ratcliffe W. A. , Ratcliffe J. G. , Shimmins J. G. , Goldberg A.
Published: August 2008

The prevalence of abnormal serum total thyroxine (T4) and triiodothyronine (T3) concentrations were determined in 1,206 in-patients in two associated psychiatric hospitals. The biochemical pattern of primary hypothyroidism occurred in five females and one male (prevalence 0.5 per cent), but in only one patient was the diagnosis clinically obvious. Eight patients (all female) were clinically hyperthyroid (prevalence 0.7 per cent), of whom six were previously undiagnosed. There was no evidence that phenothiazines or benzodiazepine therapy had any significant effect on thyroid hormone levels. The small differences in thyroid hormone levels between psychiatric diagnostic groups could be explained by differences in age distribution.
Accidents in a Psychiatric Hospital
Authors: Hawton Keith , Leopoldt Helmut
Published: August 2008

In a six-month study of psychiatric hospital in-patients, it was found that accidents more often occurred among females and among patients on psychogeriatric wards. Falls were the most common form of accident. Accidents resulting from the aggressive behaviour of other patients usually occurred on long-stay and rehabilitation wards, with middle-aged patients the victims.
Molecular Mechanisms Mediating the Action of Diazepam on GABA Receptors
Authors: Costa E. , Guidotti A. , Toffano G.
Published: August 2008

Two types of crude synaptic membranes have been prepared which differ in their kinetic properties to bind3H-GABA in a Na+-free medium. One type (B) has one type of receptor (affinity or KDabout 0.2 μM), the other type (A) has two populations of receptors which have a high (0.16 μM) and a low (.02 μM) KDfor GABA binding. This difference is due to the presence of a selective endogenous inhibitor of the high affinity receptor for GABA, a thermostable protein of about 15,000 molecular weight. Inhibitor action is counteracted by diazepam (7 x 10-7M), competitively. Clonazepam is more active but chlordiazepoxide is less active than diazepam. Two enantiomers of a benzodiazepine were studied. One of them is endowed with anxiolytic activity and nullifies the action of the endogenous inhibitor on high affinity GABA binding, the other is devoid of anxiolytic activity and is inactive against the inhibitor. The endogenous protein inhibitor also competitively blocks the high affinity binding of3H-diazepam to Type A membranes. It is concluded that the endogenous inhibitor and diazepam act on the same receptor; and suggested that the endogenous inhibitor may be the natural ligand for the brain receptors that bind benzodiazepines with high affinity.
The Pattern of Mortality in Severe Neuroses
Authors: Sims Andrew , Prior Patricia
Published: August 2008

Is there an increased relative risk of death in severe neurosis? 1,482 patients from three psychiatric units in different hospitals in Birmingham were followed-up after a mean of 10.9 years. 91 per cent of the sample were traced and 139 patients were found to have died; a highly significant increased mortality for both sexes for all causes of death. Although suicide and accidents contributed disproportionately, particularly in early follow-up, there was still a markedly increased mortality from the combined categories of nervous respiratory and cardiovascular disease, more evenly distributed in time.
Childhood Behaviour in Schizophrenia, Personality Disorder, Depression, and Neurosis
Authors: Lewine Richard R. J. , Watt Norman F. , Prentky Robert A. , Fryer John H.
Published: August 2008

Teachers' comments in the childhood school records (grades K-12) of 143 psychiatric patients and their matched controls were coded along 23 bipolar dimensions. Two methods of grouping these scales were compared: rational clusters and factor analysis. Factor analysis yielded more numerous and narrowly defined behavioural groupings. Schizophrenics, personality disorder patients, neurotics, and depressives were compared to their matched controls on each of the cluster and factor scores. Both schizophrenics and personality disordered patients were significantly less agreeable in childhood than their respective controls. Pre-schizophrenics also were significantly more unstable. Depressives were more independent than their controls, while neurotics did not differ significantly in any respect from normals in childhood. The data suggest that schizophrenia may have specific developmental patterns of possible aetiological or early diagnostic significance.
Depot Injections and Tardive Dyskinesia
Authors: Gibson Alan C.
Published: August 2008

A prospective study was undertaken on 374 out-patients receiving depot fluphenazine or depot flupenthixol to determine the incidence of tardive dyskinesia. In three years the percentage showing the bucco-linguo-masticatory syndrome rose from 8 per cent to 22 per cent, though patients had received various neuroleptics for a mean of 13 years previously. Fluphenazine and flupenthixol were equally involved though 75 per cent of affected patients had the condition in mild degree. Six additional cases of generalized chorea were all receiving flupenthixol. Reduction of dose or the substitution of pimozide produced marked improvement, but results suggest that it is unlikely that this will be permanent. Substitution of depot fluspirilene also produced favourable results. Careful monitoring, minimal neuroleptic dosage, and periods of neuroleptic abstinence are recommended.
Assessment of Familial Risks in the Functional Psychoses and their Application in Genetic Counselling
Authors: Kay D. W. K.
Published: August 2008

Now that the evidence for genetic factors in the major psychoses is very strong but still essentially circumstantial (what is transmitted is unknown), there is a danger that myths about the nonexistence of mental illness may be replaced by equally misleading myths about its inheritance. The need for genetic counselling is therefore likely to increase (counselling is advice given as a result of consultation). Admittedly, the literature on counselling in mental illness is scanty, the author's own experience slight, and the public demand small. Reed (1972) stated that less than 1 per cent of the 3,000 cases seen at the Dight Institute over 20 years were concerned with schizophrenia. Nevertheless, it is probable that much unrequested and ill-informed advice is being given.
Written Treatment Contracts: Their use in Planning Treatment Programmes for In-patients
Authors: Rosen B.
Published: August 2008

The formation of a therapeutic relationship involves the negotiation of a treatment contract which conforms to the general principles of any contractual agreement. Attempts have been made to formalize the therapeutic alliance, and this paper reports the development of a written contract for psychiatric in-patients.
Eysenck's Theory of Criminality Applied to Women Awaiting Trial
Authors: Barack Leonard I. , Widom Cathy Spatz
Published: August 2008

American women awaiting trial were administered the Eysenck Personality Questionnaire. Compared to a heterogeneous control group, these women scored significantly higher on the neuroticism and psychoticism scales and on Burgess's ‘hedonism’ variable, though they did not differ with respect to extraversion or lie scale scores. Women awaiting trial were more likely to fall in the neurotic-extravert quadrant (a trend more marked for non-white women). In general, the results support Eysenck's theory of criminality and the usefulness of Burgess's ‘hedonism’ variable.
The Prevalence of Problem Drinking and Alcoholism in the West of Scotland
Authors: Saunders W. M. , Kershaw P. W.
Published: August 2008

A 10 per cent probability sample of the population of Clydebank was interviewed, using an indirect questionnaire, to assess the extent of alcohol-related disabilities. Eighty-two per cent of 4,397 persons gave information and weighted symptom-scoring analysis showed 5.0 per cent of adult males and 1.1 per cent of adult females could be classified as problem drinkers and 5.2 per cent and 0.5 per cent respectively could be labelled alcoholics. These figures are compared to existing Scottish and English alcoholism prevalence statistics.
Recovery from ECT in Elderly Patients
Authors: Fraser R. M. , Glass I. B.
Published: August 2008

Nine elderly depressed patients were given ECT in courses which alternated unilateral and bilateral electrode placement; recovery times were measured. When compared with similar times for younger patients, recovery took on average five times as long from unilateral treatment and nine times as long from bilateral. Within the group, bilateral treatment took significantly longer for recovery than unilateral treatment and was significantly more sensitive to cumulative effect and interval effect.
Undetermined Deaths—Suicide or Accident?
Authors: Holding T. A. , Barraclough B. M.
Published: August 2008

A consecutive series of 110 undetermined deaths (U.D.) was compared with matched samples of suicides and accidents recorded in the same metropolitan Coroner's District. The hypothesis tested was that U.D. are mostly concealed suicides and will resemble known suicides more closely than accidents. The samples were compared on social and demographic variables, psychiatric and physical illness, evidence of suicide intent, information available to the Coroner and the circumstances of death. The results did not confirm the hypothesis. The study widens the investigation of the mortality of mental disorder from unnatural causes beyond the category of suicide.
The Outcome of Severe Acute Schizophrenic Illnesses After One Year
Authors: Johnstone Eve C. , Frith C. D. , Gold Aviva , Stevens Marilyn
Published: August 2008

Forty-five patients with acute schizophrenic illnesses (defined by PSE criteria) were assessed in clinical, cognitive and social terms before being entered in a four week study of the isomers of flupenthixol and placebo. At the end of one year they were re-assessed in the same terms. The clinical and psychological features of the acute illness and the drug treatment given did not predict outcome. Poor outcome in social terms was significantly related to severe social isolation in the initial assessment and to the presence of nuclear symptoms and negative schizophrenic features at follow-up.
The Focus in Brief Interpretive Psychotherapy: Dilemmas, Traps and Snags as Target Problems
Authors: Ryle Anthony
Published: August 2008

The need for a focus for brief interpretive psychotherapy is considered and a new approach is suggested. In this method, the ways in which the patient's construction of himself and his relationships are related to his problems are identified and expressed in the form of dilemmas, traps and snags. It is suggested that these formulations represent an appropriate level of abstraction, allowing patient and therapist to share provisional hypotheses about the goals of therapy and offering the basis for a method of measuring how far these goals are achieved.
Behaviour Therapy in Anorexia Nervosa
Authors: Eckert Elke D. , Goldberg Solomon C. , Halmi Katherine A. , Casper Regina C. , Davis John M.
Published: August 2008

In three collaborating hospitals, 81 anorexia nervosa patients were randomly assigned to behaviour modification or its absence and followed over 35 days. There was no overall significant difference in weight gain in the two groups except in a subset of patients: those with no prior out-patient treatments.
Cyproheptadine in Anorexia Nervosa
Authors: Goldberg Solomon C. , Halmi Katherine A. , Eckert Elke D. , Casper Regina C. , Davis John M.
Published: August 2008

In three hospitals 81 female patients satisfying rigorous diagnostic criteria for anorexia nervosa were randomly allocated to one of four treatment combinations of cyproheptadine and placebo with behaviour therapy and no behaviour therapy. Cyproheptadine was found to be effective in inducing weight gain in a subgroup of anorexia nervosa patients who (a) had a history of birth delivery complications, (b) had lost 41–52 per cent weight from norm and (c) had a history of prior outpatient treatment failure. This subgroup may represent a more severe form of anorexia nervosa.
Pretreatment Predictors of Outcome in Anorexia Nervosa
Authors: Halmi Katherine A. , Goldberg Solomon C. , Casper Regina C. , Eckert Elke D. , Davis John M.
Published: August 2008

The relationship of selected pretreatment characteristics to weight gain during treatment was examined in 81 anorexia nervosa patients. Good prognostic indicators correlating positively with weight gain were: no previous hospitalizations for anorexia nervosa, a great amount of overactivity before treatment, less denial of illness, less psychosexual immaturity and the admission to feeling hunger. A perinatal history of delivery complications was associated with the poor outcome predictor of prior hospitalizations.
Psychotic and Neurotic Depression: 1. Some Points of Method
Authors: Bhrolcháin Máire Ní
Published: August 2008

Testing hypotheses on classification could be made more precise by using only clinical symptoms and signs as its basis. Analyses based on a mixture of clinical, aetiological and background variables give ambiguous results since they incorporate the assumption that aetiological and symptomatological patterns are related in a one-to-one manner. A set of simplified models of possible relationships between aetiology and symptomatology is used to discuss these problems of interpretation. The clinical variables to be used for discriminant analyses may be chosen by testing for the existence of lower-order and higher-order differences between groups.
Parental Age and Birth Order in Homosexual Patients: A Replication of Slater's Study
Authors: Hare E. H. , Moran P. A. P.
Published: August 2008

Parental age (at patient's birth) and birth order were studied in 623 male and 89 female patients diagnosed as homosexual, who were born in England and Wales and first attended the Maudsley Hospital between the years 1961–1975. For male patients, mean parental ages were significantly higher than expectation, and mean birth order was significantly later. Regression analysis indicated that the raised fathers' age was probably of more aetiological importance than the raised mothers' age. The results confirm those of previous studies. The female patients did not show a raised parental age or late birth order.
A Shifting Seasonality of Schizophrenic Births
Authors: Torrey E. Fuller , Torrey Barbara Boyle
Published: August 2008

In view of recent findings in Japan, and in England and Wales, data on schizophrenic births in the United States were reexamined to see if seasonal shifts had occurred. In Missouri a progressive shift from February to April and May was noted between 1921 and 1930 and between 1941 and 1950. In five New England states there was no shift over the same period. Data were then obtained to compare the Missouri shift with two hypotheses previously put forward to explain schizophrenic birth seasonality: (1) that it is related to the seasonality of general births, and (2) that it is related to seasonal temperature variation. Neither hypothesis was supported by the data.
An Experimental Study of Pictures Produced by Acute Schizophrenic Subjects
Authors: Russell-Lacy Stephen , Robinson Victoria , Benson Janet , Cranage Janet
Published: August 2008

The purpose of this study was to examine the validity of assessing pictures produced by acute schizophrenic subjects as a technique in differential diagnosis. It was hypothesized that art productions by schizophrenics differ from those both by other acute psychiatric patients and by ‘normals'. Coloured slides were made from pictures produced in standardized conditions by three samples each of thirty subjects. It was found that repetition of abstract forms was the only factor studied to be associated specifically with schizophrenia; whereas the presence of pictorial imbalance, overelaboration, childlike features, uncovered space, detail and colour variety were found to be associated with psychiatric admission irregardless of diagnosis. Doubt is cast on the use of art as a technique in differential psychiatric diagnosis.
Psychological and Behavioural Disturbance in West Indians, Indians and Pakistanis in Britain: A Comparison of Rates Among Children and Adults
Authors: Cochrane Raymond
Published: August 2008

Data are presented from four studies which compare rates of psychological disturbance for three groups of immigrants to Britain and natives respectively. Children of West Indian and Asian parents are compared to native British children on the Rutter Teachers' Questionnaire and on rates of admission to psychiatric hospitals. Asian children have lower rates of behavioural deviance and mental hospital admissions than do British children. Children of West Indian immigrants show no more behavioural deviance in schools than do British children, but have considerably higher rates of admission to mental hospitals. The pattern for adults is remarkably similar to that shown by children, even though different definitions of psychological disturbance are used. The findings are discussed in the context of previous studies of immigrants to Britain and contemporary theories of immigrant adjustment.
First Rank Symptoms of Schizophrenia: Questions Concerning Clinical Boundaries
Authors: Koehler Karl
Published: August 2008

The phenomenological criteria of prominent Anglo-American researchers on certain so-called passivity experiences, sense deceptions and delusional phenomena, reflecting their interpretations of Kurt Schneider's first rank symptoms of schizophrenia, are examined. In this way the frequent discrepancies and difficulties in delimiting the clinical boundaries of these phenomena more clearly come to light.
Monoamine Mechanisms in Chronic Schizophrenia: Post-Mortem Neurochemical Findings
Authors: Crow T. J. , Baker H. F. , Cross A. J. , Joseph M. H. , Lofthouse R. , Longden A. , Owen F. , Riley G. J. , Glover V. , Killpack W. S.
Published: August 2008

Dopamine and its metabolites homovanillic acid and dihydroxyphenylacetic acid, noradrenaline, serotonin and its metabolite 5-hydroxyindoleacetic acid, and tryptophan and its metabolite kynurenine have been assayed in 9 schizophrenic and 10 control brains, together with the monoamine-related enzymes tyrosine hydroxylase monoamine oxidase, dopamine-β-hydroxylase, and catechol-o-methyltransferase. In schizophrenic brains dopamine, noradrenaline and serotonin were significantly increased in some areas of corpus striatum, but there were no significant changes in enzyme activity or monoamine metabolite concentrations in any of the brain areas examined. The findings are not consistent with theories that serotonin or noradrenaline stores are grossly depleted or noradrenaline neurones have degenerated, or that monoamine oxidase activity is abnormal, in schizophrenia, and provide no direct support for the hypothesis that dopamine neurones are overactive.
A Comparison of Social Workers and Psychiatrists in Evaluating Parasuicide
Authors: Newson-Smith J. G. B. , Hirsch S. R.
Published: August 2008

Sixty parasuicide patients admitted to medical wards were assessed by social workers prior to routine psychiatric assessment. Both disciplines completed a rating schedule. The social workers' and psychiatrists' rating schedule responses were compared, and their decisions were examined against further information obtained by a research psychiatrist, which included standardized mental state assessment. Overall the results show that social workers can safely and reliably assess these patients, but they are more cautious. A management approach involving social workers as assessors of parasuicide patients is discussed.
The Reconstruction of Schizophrenic Speech
Authors: Rutter D. R.
Published: August 2008

A suggestion that schizophrenic speech may be harder to understand than normal speech was tested by a technique of reconstruction. Ten schizophrenic and ten normal passages were typed onto cards, one sentence per card. Each passage was then presented with the sentences in random order, and students were asked to reconstruct what they believed was the original order. Fewer correct strings of three or more sentences were achieved for the schizophrenic material than the normal material. It is concluded that thereisa detectable abnormality in the structure of schizophrenic speech, but that it stems from the relationshipbetweensentences rather than the content of individual sentences.
A New Depression Scale Designed to be Sensitive to Change
Authors: Montgomery Stuart A. , Åsberg Marie
Published: August 2008

The construction of a depression rating scale designed to be particularly sensitive to treatment effects is described. Ratings of 54 English and 52 Swedish patients on a 65 item comprehensive psychopathology scale were used to identify the 17 most commonly occurring symptoms in primary depressive illness in the combined sample.

Ratings on these 17 items for 64 patients participating in studies of four different antidepressant drugs were used to create a depression scale consisting of the 10 items which showed the largest changes with treatment and the highest correlation to overall change.

The inter-rater reliability of the new depression scale was high. Scores on the scale correlated significantly with scores on a standard rating scale for depression, the Hamilton Rating Scale (HRS), indicating its validity as a general severity estimate. Its capacity to differentiate between responders and non-responders to antidepressant treatment was better than the HRS, indicating greater sensitivity to change. The practical and ethical implications in terms of smaller sample sizes in clinical trials are discussed.
Clinical Response and Tricyclic Plasma Levels During Treatment with Clomipramine
Authors: Corte L. Della , Broadhurst A. D. , Sgaragli G. P. , Filippini S. , Heeley A. F. , James H. D. , Faravelli C. , Pazzagli A.
Published: August 2008

Fifty depressed in-patients at two psychiatric units, one in Italy the other in England, were treated with clomipramine, either orally, or intravenously and orally. A comparison of clinical response with plasma levels of clomipramine and its metabolite, desmethylclomipramine, showed clear relationships especially in the case of desmethylclomipramine. In the intravenously-treated group this was linear, in the orally-treated group it was curvilinear. Plasma levels of desmethylclomipramine and administered clomipramine correlate highly.

These findings, together with the fact that significant clinical improvement was observed in only 55 per cent of the patients, suggest that titration of the administered dose to obtain more effective plasma levels of the metabolite might improve the clinical response to the drug in some patients.
Psychiatric Morbidity and Pregnancy: a Controlled Study of 263 Semi-Rural Ugandan Women
Authors: Cox John L.
Published: August 2008

Two hundred and sixty three pregnant Ugandan women and 89 non-pregnant, non-puerperal women were interviewed using a semi-structured psychiatric questionnaire. Comparison of psychiatric morbidity between the control group and matched pregnant women showed an increased frequency of psychiatric morbidity in pregnant women. Separated pregnant women were particularly at risk. No association was found between antenatal psychiatric morbidity and age, gravidity, number of co-wives or the duration of the pregnancy.