bluuebunny/crossref_metadata_2025 huggingface dataset:
A survey of sudden death associated with the use of antipsychotic or antidepressant drugs: 49 cases in Finland
Authors: Mehtonen O.‐P. , Aranko K. , Mälkonen L. , Vapaatalo H.
Published: August 2007

Phenothiazines have repeatedly been found to be associated with cases of sudden death, but the issue of causality has remained controversial. A survey of medicolegal autopsies performed in Finland over a 3‐year period revealed that sudden unexpected deaths of 31 women (mean age 44 years, range 25–69) and 18 men (mean age 40 years, range 26–62) were associated with either the use of antipsychotic or antidepressant drugs. Therapeutic use of phenothiazines was documented in all but 3 of these 49 cases and thioridazine was involved in over half of them. Thus, whereas thioridazine was the only antipsychotic drug associated with 15 cases, only 5 cases were associated with any of the other antipsychotic or antidepressant drugs. The differences between the subgroups of psychotropic drugs remained clear after adjustment according to the respective data on drug use in the population. Although there are several uncontrolled confounding factors, the overrepresentation of phenothiazines, especially thioridazine, among psychiatric patients who died suddenly is striking and, taken together with their well‐established arrhythmogenic effects, warrants further attention.
Disposition of the neuroleptic zuclopenthixol cosegregates with the polymorphic hydroxylation of debrisoquine in humans
Authors: Dahl M.‐L. , Ekqvist B. , Widén J. , Bertilsson L.
Published: August 2007

The pharmacokinetics of a single oral dose of the neuroleptic drug zuclopenthixol (10 or 6 mg) was studied in 6 extensive and 6 poor metabolizers of debrisoquine. The peak plasma concentrations of zuclopenthixol did not differ between the phenotypes, whereas the plasma elimination half‐life was significantly longer in poor than in extensive metabolizers (29.9 ± 6.6 vs 17.6 ± 6.9 h). Accordingly, the total oral plasma clearance was lower in poor than in extensive metabolizers (0.78 ± 0.27 vs 2.12 ± 0.65 1/h/kg). Ten of the volunteers had previously participated in a similar study in which the kinetics of perphenazine, another neuroleptic drug, were studied in poor and in extensive metabolizers of debrisoquine. There was a significant correlation between the oral clearance of perphenazine and that of zuclopenthixol among these 10 subjects. The study indicates that the disposition of zuclopenthixol, as well as that of perphenazine, is related to the genetically determined capacity to hydroxylate debrisoquine. The significance of this polymorphism for the clinical use of neuroleptics is discussed.
Validation criteria for panic disorder as a nosological entity
Authors: Rosenberg R. , Ottosson J.‐O. , Bech P. , Mellergard M. , Rosenberg N. K.
Published: August 2007

Panic disorder (DSM‐III, DSM‐1I1‐R) has been thoroughly studied in recent years. The main evidence for panic disorder as a nosological entity is reviewed, to delineate some important questions for future research. Validation criteria include epidemiological, phenomenological, genetic, neu‐robiological, pharmacological and behavioral findings. Biological, behavioral and psychodynamic considerations on etiology, pathogenesis and treatment are presented.
Characteristics of panic disorder patients responding to placebo
Authors: Rosenberg N. K. , Mellergard M. , Rosenberg R. , Beck P. , Ottosson J.‐O.
Published: August 2007

Forty‐one panic disorder patients receiving placebo were investigated in a double‐blind comparison of alprazolam, imipramine and placebo in panic disorder. A significantly higher drop‐out rate was found in the placebo group than in the active treatment groups, but placebo response was found in 34% of the patients, defined as reduction of panic attacks to zero, and in 23%, defined as a score of > 8 on the Physician Global Improvement Scale (0 10 points). Several predictors of response to placebo were found. The responders had fewer panic attacks than the nonrcsponders at baseline. They also reported less psychopathology and were less help‐seeking than the nonresponders. The implications for psychopathology and possible response to psychotherapy among responders and nonresponders are discussed. It is hypothesized that the responders show more signs of realistic processing of internal and external stimuli and fewer signs of subjective distress than the nonresponders. Responders will therefore probably be more responsive to psychotherapy than nonresponders.
Cholinergic neurons of the central nervous system: morphofunctional aspects
Authors: Bigl V. , Arendt T.
Published: August 2007

Impairment of central cholinergic function is an early and constant finding in a number of mental disorders associated with amnesia or dementia. Although knowledge of the detailed functional implications of cholinergic mechanisms in cognition is still very incomplete, some recent results and concepts about the morphofunctional organization of the cholinergic basalo‐cortical projection system are reviewed. This cholinergic system is quite different from other so‐called unspecific subcortical projection systems and might have some bearing on understanding the role of cholinergic mechanisms in cognitive function and its disorders.
Depressive disorders and dementia: the clinical view
Authors: Lauter H. , Dame S. , Lauter Hans
Published: August 2007

The relationship between depression and dementia is complex. Transient emotional disturbances and long‐lasting depressive disorders may occur as psychological reactions to the loss of mental abilities or as behavioural manifestations of brain injury. On the other hand, major depressive disorder of late onset or of a recurrent type may be superimposed on dementing illness. Depression, particularly in elderly individuals, can manifest itself as a reversible syndrome of dementia that responds favourably to antidepressant treatment. It is not known whether the dementia syndrome of depression represents a quantitative intensification of minor cognitive impairments that can be observed in a large proportion of depressed patients. It also remains doubtful whether dementia in depressed patients has to be considered as an epiphenomenon of pervasive melancholic illness. An alternative explanation would look at such conditions as manifestations of a specific brain dysfunction. Major depression associated with cognitive impairment in stroke patients might be regarded as an example of a reversible dementia dysfunction.
Need for community care among psychotic outpatients
Authors: Salokangas R. K. R. , Palo‐oja T. , Ojanen M. , Jalo K.
Published: August 2007

Psychiatric teams examined a representative sample of 177 psychotic patients in community care. The patients’ need for care was assessed using a standardized method. The need for alternative, noninstitutional forms of care (i.e. day and residential services) was greater than the actual use of these services. The same was true of the need for support in social activities, for occupational therapy, training in domestic skills, counselling for relatives and psychotherapy. Unmet needs for care were commonest among patients who were young, who drank heavily, and who suffered from many psychotic symptoms and drug side effects. Outpatient care based primarily on visits to the community mental health centres did not provide adequate services for the most disabled patients. It is concluded that decrease of hospital care has brought a growing need for psychiatric day and residential services among outpatients suffering from psychotic disorders.
Aggression, hyperactivity and platelet imipramine binding
Authors: Marazziti D. , Conti L.
Published: August 2007

We measured platelet 3H‐imipramine binding parameters in 16 subjects affected by different types of mental deficiency, all characterized by‐hyperactive and/or aggressive behaviour, and in 16 healthy controls. The patients had a lower maximum binding capacity than the controls, with no difference in Kd, irrespectively of the type of mental disorder. These findings suggest a link between 5‐HT disturbances, reflected by reduced imipramine binding sites, and behavioural dyscontrol, expressed as hyperactivity and aggression.
Serum melatonin levels in schizophrenic and schizoaffective hospitalized patients
Authors: Robinson S. , Rosca P. , Durst R. , Shai U. , Ghinea C. , Schmidt U. , Nir I.
Published: August 2007

Conflicting results on changes of the diurnal melatonin rhythms of patients with affective disorders have been reported in the literature. The heterogeneous data may derive from the great discrepancy in the diagnostic criteria of different authors. A study of 12 schizoaffective and chronic schizophrenic psychotic patients found a constant pattern of an obliterated nocturnal melatonin rise only in the latter group. The presence or absence of the nocturnal melatonin rise was determined in drug‐free hospitalized patients and remained unchanged despite 2 months of drug treatment including large doses of neuroleptics. This finding, when confirmed in a larger number of patients, could possibly serve as a marker for the type of mental disorder, drug to be applied and response expected.
Reliability of the draft diagnostic criteria for research of ICD‐10 in comparison with ICD‐10 and DSM‐III‐R
Authors: Mellsop G. W. , Thomas C. S. , Ellis P. M. , Purdie G. , Crawshaw J. , Mendis N.
Published: August 2007

The reliability and ease of use of DSM‐III‐R and the clinical and research versions of ICD‐10 were assessed by 5 psychiatrists working in pairs. They diagnosed 60 patients. All 3 systems showed similar and high interrater and intersystem agreement for major diagnostic categories but not for subcategories. A number of implications of these results are discussed.
Involuntary commitment in Greenland, the Faroe Islands and Denmark
Authors: Engberg M.
Published: August 2007

Greenland, the Faroe Islands and Denmark have common legislation and registration for involuntary commitment. Commitment rates were calculated based on information from the Danish psychiatric register for 1984–1988. Direct standardization with the Danish male and female population as a standard population (1984–1988) was carried out to evaluate differences in rates. An increased risk of commitment was found in Greenland, where the crude commitment rate was 43.5 commitments per 100.000 inhabitants. The commitment rate on the Faroe Islands was 19.2 per 100,000 and 24.2 per 100,000 in Denmark. The relative risk of commitment in Greenland vs Denmark was 2.0 (1.6–2.4) and increased to the same extent for both sexes. Young men constituted a high‐risk group for commitment in Greenland. Males between 15 and 34 years accounted for 55% of the total number of commitments in Greenland. The high relative commitment risk in Greenland is related to higher homicide rates, lower psychiatric bed availability, reduced access to psychiatric treatment, small settlements and increased alcohol consumption and violence than in Denmark.
A modern therapeutic approach for chronically mentally ill patients — results of a four‐year prospective study
Authors: Eikelmann B. , Reker T.
Published: August 2007

A 4‐year prospective study was carried out on 53 chronically mentally ill patients living in a differentiated complementary residential complex. Our main question was how the lives of these patients develop, as reflected in their psychological wellbeing, working capacity, therapeutic requirements and any necessary periods of rehospitalization. At the end of a 4‐year rehabilitation period, 50% of the patients were living in sheltered communities and about 25% on their own. Only 10% had returned to the psychiatric hospital as long‐term patients. The psychological findings were characterized by apathetic, depressive and psycho‐organic syndromes (AMDP system) and were subject overall to minimum variation. Very few patients succeeded in obtaining work on the general labour market, but the work available on the sheltered labour market was suitable for a large proportion (40%) of them. All patients were undergoing medical care after 4 years. Patients suffering from chronic mental disorders can be cared for in the community even after long‐term hospitalization. Special success has been achieved with rehabilitation in the residential sphere. Adequate care implies numerous services to ensure that patients are integrated into the labour market, to help establish contacts and to enable chronically ill patients to take part in social and cultural life. Most patients retain a considerable degree of psychological disturbance and are permanently dependent on psychiatric therapy or psychosocial care. On the other hand, they benefit from the fact that their living circumstances are largely normal and that they have higher degree of personal autonomy.
Depression‐related disturbances in mitogen‐induced lymphocyte responses and interleukin‐1β and soluble interleukin‐2 receptor production
Authors: Maes M. , Bosmans E. , Suy E. , Vandervorst C. , DeJonckheere C. , Raus J.
Published: August 2007

In an attempt to delineate the pathophysiology underpinning the previously reported blunted lymphocyte responses to mitogenic stimulation in depressed patients, we measured the following immune variables in 28 depressives and 10 healthy controls: pre‐ and postdexamethasone (1 mg orally) lymphocyte responses to various mitogens, such as phytohaemagglutinin (PHA), and the PHA‐induced accumulation of interleukin‐1β (Il‐1β) and soluble interleukin‐2‐receptors (sIl‐2Rs) in culture supernatants. In the predexamethasone state, we found significantly more mitogen‐stimulated blastogenesis in minor depressives vs healthy controls and major depressives. In depressed subjects there was a significant inverse relationship between the severity of illness and the mitogen‐induced lymphocyte responses. Melancholics exhibited significantly more Il‐1β accumulation in PHA culture supernatant than healthy controls. In healthy controls – but not in depressed patients – the sIl‐2R accumulation perfectly reflects the magnitude of the PHA‐induced lymphocyte stimulation. Dexamethasone administration significantly suppressed the lectin‐induced blastogenesis and the Il‐1β production rate in normal volunteers, whereas depressives exhibited dexamethasone nonsuppression in those factors. Healthy controls exhibited significantly less postdexamethasone blast transformation, Il‐1β and sIl‐2Rs accumulation in culture supernatant than the depressed patients.
An interactionistic integrating view of depressive disorders and their treatment
Authors: Perris C.
Published: August 2007

The development of a depressive disorder is often considered from the perspective of biological causation, mental processes, or with a focus on possible social determinants, even though the possible concomitance of factors belonging to the different domains is generally acknowledged. In this article, a further development of an interactional model previously described is presented. The model is focused on the concept of individual vulnerability, which is assumed to result from a continuous interplay of the individuals with their environment, and from the effect of factors belonging to different domains that interact. A closer definition of individual vulnerability suggests that it consists of the interaction of biological characteristics of the person and a basically dysfunctional self‐schema. Empirical studies in support of some of the hypotheses which can be derived from the model are briefly reviewed, and the implications of the model for the treatment of depression is underscored.
What is an adequate treatment in convulsive therapy?
Authors: Fink M.
Published: August 2007

The parameters of the induction of an effective electroconvulsive therapy (ECT) treatment are poorly defined. We find variations in outcome, with changes in electrode placement and energy levels, despite measures of motor seizure duration greater than 25 s. To maximize the outcome of ECT, attention is again focused on the electrophysiologic and biochemical features of seizures, much as Ottosson studied them in 1960.
Ethical aspects of psychological autopsy
Authors: Beskow J. , Runeson B. , Åsgård U.
Published: August 2007

Survivors of suicide victims are usually vulnerable to new traumatic experiences. Researchers who have used the method of psychological autopsy, including interviews with survivors, have paid little attention to ethical questions. The purpose of this article is to discuss such issues based on empirical data. Data and experiences from 3 studies of suicide among men (n= 271), women (n= 104) and youth (n= 58) are presented; the last 2 also include telephone follow‐up by an independent researcher who measured the reactions of the interviewees to the main interviews. The ethical problems for 3 groups of agents (informants and other relatives, including the deceased; the researcher; and the research) are discussed according to 3 basic ethical principles (nonmaleficence, beneficence and respect for autonomy). Many of the interviewees still had signs of crisis reactions and thus constituted a vulnerable group. Nevertheless, drop‐out was infrequent. Nor did we find any interviewee who was hurt by the interview, even if the possibility cannot be excluded in a few cases (less than 4%). Many of the interviewees seem to benefit from the interview. The interviews ought to be done by researchers prepared to meet people in crisis situations. The informants had different opinions on whether letter or telephone was the best method for first contact. Tape‐recording was generally accepted. It seems to be possible and advisable to further change the design to better meet the needs of the interviewees, without violating the requirements of the researcher and the research.
Comparison of the Chinese Depression Inventory and the Chinese version of the Beck Depression Inventory
Authors: Zheng Y.P. , Lin K.‐M.
Published: August 2007

Using a sample of 329 currently depressed patients from 24 hospitals across China, the Chinese Depression Inventory (CDI) was developed based on its own culture and verbal expression styles. The reliability and validity of CDI were much better for these patients than the Chinese version of the Beck Depression Inventory (CBDI). This study demonstrated that the CDI is both a culturally sensitive and cross‐culturally useful self‐report scale for measuring the severity of depression in Chinese. The authors suggest that such a rating scale would eliminate serious cultural biases, control for the severity of illness among different ethnic groups and thereby make cross‐cultural studies more valid.
Moclobemide in depression: a randomized, multicentre trial against isocarboxazide and clomipramine emphasizing atypical depression
Authors: Larsen J. K. , Gjerris A. , Holm P. , Andersen J. , Bille A. , Christensen E. M. , Høyer E. , Jensen H. , Mejlhede A. , Langagergaard A. , Laursen A. L. , Nilakantan B. , Olafsson K. , Severin B. , Rafaelsen O. J.
Published: August 2007

Moclobemide was compared with isocarboxazide and clomipramine in patients with depression. A total of 167 outpatients were allocated to daily treatment with 300 mg moclobemide, 30 mg isocarboxazide or 150 mg clomipramine for 6 weeks. Moclobemide was slightly inferior to clomipramine, whereas isocarboxazide had an intermediate position. There was no interaction between treatment and atypical or nonatypical depression. Anticholinergic symptoms and orthostatic hypotension were most pronounced in the clomipramine group.
Childhood experiences and repeated suicidal behavior
Authors: Krarup G. , Nielsen B. , Rask P. , Petersen P.
Published: August 2007

The aim of this study was to elucidate the influence of various events in childhood on suicidal behavior in adult age. For this purpose, 99 patients admitted to the Department of Psychiatry of Odense University Hospital after making a suicide attempt were followed for 5 years, to register repeated suicidal behavior. The results showed that three fourths of the patients attempted suicide more than once (62% nonfatal and 14% fatal outcome). The sex distribution was about the same among the first‐evers as among the repeaters. Most repeaters were younger people in their twenties and thirties, and the first‐evers on average were past the age of 40. Somewhat unexpectedly, significantly more repeaters than first‐evers had grown up with both their parents. However, the results also showed that significantly more repeaters than first‐evers had had an unhappy childhood. This indicates that the psychological climate of the home may be more important than the rupture of early home life. It is noteworthy that the group of repeaters, as against the first‐evers, could be characterized by personality disorders and abuse, especially of alcohol: disorders known to be precipitated by a discordant childhood. It is commonly agreed that the experience in childhood of suicidal behavior among family members or other persons in the close environment is of importance in future suicidal risk. The results of this study indicate that the predictive value of this factor mainly applies to attempts with no fatal outcome: the suicidal act is perceived ‐ and learned ‐ as way to solve problems.
Psychometric evaluation of the Nurses Observation Scale for Inpatient Evaluation in the Netherlands
Authors: Hafkenscheid A.
Published: August 2007

The interrater reliability, temporal stability and factorial, convergent, discriminant and predictive validity of the Nurses Observation Scale for Inpatient Evaluation (NOSIE‐30) were investigated in a heterogeneous group of psychiatric inpatients in the Netherlands (n= 179). Data in support of the scale's dimensional structure (recoverability of Anglo‐American subscale structure in this Dutch sample and distinctiveness of subscales), discriminatory power and convergent validity are presented. Interrater reliability was satisfactory at global scale level. However, 3 subscales (irritability, psychosis and depression) were found to lack interrater reliability. Although temporal stability coefficients were high, large score changes are presupposed to show that pre‐ versus posttherapy differences are attributable to real change rather than error. NOSIE‐30 had limited predictive value.
The Karolinska Psychodynamic Profile. II. Interdisciplinary and cross‐cultural reliability
Authors: Weinryb R. M. , Rössel R. J. , Åsberg M.
Published: August 2007

The Karolinska Psychodynamic Profile (KAPP) is a rating instrument based on psychoanalytical theory, that is intended to assess relatively stable modes of mental functioning, as they appear in self‐perception and in interpersonal relations. The 18 subscales of the KAPP and their scale steps are described in detail and kept close to clinically observable phenomena. The information needed for assessment is obtained through a structural interview procedure. The interrater reliability was tested with different Swedish raters with varying psychodynamic training and experience. It was also tested with a non‐Swedish rater with psychoanalytic training. The interrater correlations were generally high, suggesting that the KAPP has interdisciplinary and cross‐cultural reliability.
Reactions of survivors of suicide victims to interviews
Authors: Runeson B. , Beskow J.
Published: August 2007

Fifty‐eight consecutive suicides committed between 1984 and 1987 by adolescents and young adults (age 15‐29 years) in an urban community were the subject of retrospective investigations by means of interviews with survivors. The outcome of the survivors’ crisis reactions and the interviewees’ capacity to participate in the interviews were evaluated. Two weeks after a main interview, a follow‐up interview dealing with the interviewee's reactions to the investigation was performed. The cautious interview procedure seemed very acceptable to the survivors. An initial contact about 2 months after the suicide is recommended. Tape‐recording was generally tolerated. There was a relationship between a satisfactory outcome of the crisis and good quality of the information given by the interviewee, but survivors in severe crisis may also cooperate well and give information with good trustworthiness and precision. An unsatisfactory crisis outcome was significantly more common in interview subjects with post‐traumatic stress disorder according to DSM‐III‐R. Many interviewees benefit from the single interview.
A retrospective study of separation in the development of adult avoidant personality disorder
Authors: Arbel N. , Stravynski A.
Published: August 2007

This retrospective study investigated experiences of separation and perceptions of early relations with parents and peers by patients diagnosed as having avoidant personality disorder. The main hypothesis of our study was that patients diagnosed as having avoidant personality disorder would report more actual separations and more pathogenic parenting than normal control subjects. This hypothesis was not supported. The main features differentiating patients from normals were: perceptions of a unencouraging home climate, and less demonstrations of love and pride in the child on the part of the parents.
Patterns of care among people with long‐term functional psychosis in three different areas of Stockholm County
Authors: Borgå P. , Widerlöv B. , Cullberg J. , Stefansson C.‐G.
Published: August 2007

This study of long‐term functionally psychotic people in Stockholm County describes the psychiatric and somatic care provided as well as social welfare support and medication in a total cohort. This group included all non‐organic cases of psychosis aged 18‐64 years. The group was found still to be very dependent on institutional care, with an average of 75 d of psychiatric inpatient care. Males spent twice as long as females as inpatients, and people from the urban area spent a longer time than those from the other areas. Antipsychotic medication increased from the rural to the urban area. The diagnosis of schizophrenia and early age at onset were each per se associated with higher likelihood of inpatient treatment and depot medication. Contrary to expectations, medication with antipsychotic drugs was shown to increase with illness duration.
Symptoms of major depression: acute effect of withdrawing antidepressants
Authors: Halle M. H. , Medico V. J. Del , Dilsaver S. C.
Published: August 2007

The literature is devoid of reports indicating that a reduction in the dosage or discontinuation of antidepressants of any chemical class produces symptoms of major depression within 2‐4 d. Four cases suggesting that a reduction in the daily dose or withdrawal of an antidepressant may produce symptoms of major depression within hours to days are presented.
Risk factors of alcoholism among Taiwan aborigines: implications for etiological models and the nosology of alcoholism
Authors: Hwu H.‐G. , Yeh Y.‐L. , Wang J.‐D.
Published: August 2007

The objective of this study was to explore possible risk factors of alcohol abuse (AA) and dependence (AD), as defined by DSM‐III criteria, in Taiwan aborigines. The risk factors in a sample of 1555 Taiwan aborigines were analyzed by using the chi‐square test and multivariate logistic regression statistics. The logistic regression showed that the risk factors of AD are being male, having relatively little education, being involved in a problem marriage, being a laborer, being part of a couple with a drinking problem, and having a positive family history of alcoholism. AA has the risk factors of ethnic subgroups dwelling in the main Taiwan Island, male, poor education, working people, and a drinking problem for the couple. Etiological models are proposed as social origins for AA, with interactional model for AD, in this aboriginal sample. Data on Chinese alcoholism is discussed, and a generalized hypothesis constructed that, for the same phenotypical subtype of alcoholism in different ethnic groups, the etiological models are different.
Serum mianserin concentrations in psychiatric inpatients of different ages
Authors: Leinonen E.
Published: August 2007

One hundred and sixty‐nine depressive psychiatric inpatients were treated with routine therapeutic doses of mianserin. Altogether 256 serum mianserin samples were measured gas‐chromatographically in 3 age groups: 17 samples in patients under 35 years, 116 samples in patients between 35 and 65 years, and 123 samples in patients over 65 years. No differences in dose‐corrected (calculated as mg/kg dose basis) mean serum mianserin concentrations were found between the age classes. Neither the interindividual variation nor the number of high serum mianserin concentrations was larger among elderly subjects than in the other age groups. Concurrent neuroleptic treatment significantly increased serum mianserin levels in the oldest patient group but not in the 2 others. The results suggest that mianserin dose should not be generally reduced with advancing age.
Dementia associated with human immunodeficiency virus: subcortical or cortical?
Authors: Poutiainen E. , Haltia M. , Elovaara I. , Lähdevirta J. , Livanainen M.
Published: August 2007

Two different types of dementia and corresponding neuropathological findings of patients with human immunodeficiency virus (HIV) infection are presented. In one case, “subcortical” dementia with slow movements and mental processes as well as problems in active recall but without focal defects corresponded to diffuse leukoencephalopathy. In another case, “cortical” dementia with impaired abstraction and memory as well as several focal defects corresponded to microglial nodules in cortical and in deep grey matter, with only a mild diffuse leukoencephalopathy. Thus, in contrast to earlier interpretations, subcortical dementia does not appear to be the only form of dementia in HIV‐infected patients, and cortical dysfunction may also occur.
Predicting long‐term outcome in schizophrenia
Authors: Jonsson H. , Nyman A. K.
Published: August 2007

Prediction of 14‐ to 17‐year outcome from symptoms present at admission and psychosocial and personality data was attempted among the 92 survivors of a group of 110 first‐admitted schizophrenic patients. Three different outcome criteria were used and the correlations between these varied from low to high. Using a discriminant analytical approach where all 107 predictor variables were used to predict a combination of outcome criteria, 23% of outcome variance could be explained, which should be compared with 49% in a previous 5‐ to 9‐year outcome study on the same material. At least one outcome variable ‐ economic self‐support ‐ could not at all be predicted. “Atypical” symptoms were associated with favourable outcome and longitudinal variables indicative of “high‐risk personality”, or duration and severity of illness, were related to bad prognosis. Overt psychotic symptoms had no significant correlation with outcome.
Short‐term stability of depressive symptoms and suicide attempts in Swedish adolescents
Authors: Larsson B. , Melin L. , Breitholtz E. , Andersson G.
Published: August 2007

The prevalence of depressive symptoms, suicidal ideation and their relationship to perceived health problems and social relations were examined in a sample of 605 Swedish adolescents aged 13‐18 years. Short‐term stability of depressive symptoms and the turnover rate from a nondepressed to a depressed state were examined for subsamples of 36 depressed and 71 nondepressed subjects, respectively, who were retested after 4 to 6 weeks. Using Beck's criteria for clinical depression, 9% of the adolescents experienced moderate to severe depressive symptom levels. However, a more conservative estimate, 4%, was obtained when DSM‐III criteria for major depressive disorder were applied. Approximately 3% of the adolescents had pronounced suicidal ideation and had made at least one previous suicide attempt. There was a tendency for boys to show more stable depressive symptoms and suicidal ideation than girls. Furthermore, a set of 5 psychosocial variables concerning the students’ satisfaction with their school and leisure time, conflictual level at home and number of close friends predicted 31% of the variance of the subjects’ total depressive symptom scores. Although a 32% decrease of depressive symptoms was noted for the depressed subsample of adolescents, 44% of these subjects continued to experience moderate to severe depression at follow‐up.
Cerebrospinal fluid acetylcholinesterase in patients with dementia associated with schizophrenia or chronic alcoholism
Authors: Koponen H. , Riekkinen P. J.
Published: August 2007

Cerebrospinal fluid (CSF) acetylcholinesterase (AChE) was determined for 11 chronic schizophrenic patients with dementia, 9 patients with dementia associated with alcoholism and 8 age‐equivalent control subjects. The AChE levels in both patient groups were unrelated to the degree of cognitive decline and they were in the same range as in the control group. In schizophrenic patients no relationship was found between CSF AChE and the severity of psychotic symptoms. Our results suggest that dementia may occur in these patient groups without CSF AChE involvement.
Suicidal ideation: its enduring nature and associated morbidity
Authors: Goldney R. D. , Smith S. , Winefield A. H. , Tiggeman M. , Winefield H. R.
Published: August 2007

A longitudinal study between 1980 and 1988 of school leavers entering adulthood examined suicidal ideation 4 and 8 years after an initial battery of psychological tests. The report of suicidal ideation during their lives was significantly associated with measures of depression, self‐esteem and locus of control 8 years previously. It was also associated with those measures as well as anomie, hopelessness and scores on the General Health Questionnaire 4 years previously. These associations were not as strong for subjects whose suicidal ideation had been present in the most recent 6 months, or for those who acknowledged having attempted suicide. No fewer than 40% of subjects who acknowledged suicidal ideation when examined in 1984 denied ever having had suicidal ideation during their lives when re‐examined in 1988. This raises doubts about the validity of such studies. Although these findings provide data that confirm the enduring nature of suicidal ideation and its continuing morbidity, they do not give confidence that any screening of schoolchildren could actually predict those who will attempt suicide. Such studies cannot replace full clinical assessment of individual suicidal subjects.
Effects of clomipramine treatment on cerebrospinal fluid monoamine metabolites and platelet 3 H‐imipramine binding and serotonin uptake and concentration in major depressive disorder
Authors: Mårtensson B. , Wägner A. , Beck O. , Brodin K. , Montero D. , Åsberg M.
Published: August 2007

In an open study of 12 inpatients who met the DSM‐III criteria for a major depressive episode, the effects of clomipramine (CI) on the monoamine metabolites 5‐hydroxyindoleacetic acid (5‐HIAA), homovanillic acid (HVA), 4‐hydroxy‐3‐methoxyphenyl glycol (HMPG) in cerebrospinal fluid (CSF) were measured simultaneously with the effects on 3H‐imipramine binding, serotonin (5‐HT) uptake and 5‐HT concentration in platelets after 3 and 6 weeks of treatment. Drug (CI and desmethylclomipramine) plasma concentrations were determined. The concentrations of 5‐HIAA and HMPG decreased substantially, and the concentration of HVA remained unchanged. There was also a large and significant reduction of the number of imipramine binding sites (Bmax and of the platelet 5‐HT concentration. The 5‐HT uptake was not measurable after 3 weeks of treatment. None of the parameters changed significantly between weeks 3 and 6. There were no significant correlations between antidepressant effect (measured by the Montgomery‐Åsberg Depression Rating Scale) and plasma drug concentrations, although a tendency to a significant correlation between antidepressant effect and CI was observed at 3 weeks. There were no significant intercorrelations between the different 5‐HT parameters and no other significant correlations between the biochemical measures and clinical outcome.
A retrospective study of symptom patterns of cannabis‐induced psychosis
Authors: Imade G. T. , Ebie J. C.
Published: August 2007

The aim of this study was to find out whether there are any similarities between cannabis psychosis on the one hand and schizophrenia and mania on the other, and to delineate any consistency in the pattern of clinical symptoms of cannabis psychosis. Relevant data were collected from patient's case‐notes depicting biographical information and the frequencies of mental symptoms. Age and duration in hospital agreed between the 3 groups. Although several significant differences were recorded in the distribution of mental symptoms, it was not possible to demonstrate a consistent pattern of symptoms typical of cannabis psychosis.
The epidemiology of eating disorders in Fyn County, Denmark, 1977–1986
Authors: Joergensen J.
Published: August 2007

The occurrence of anorexia nervosa and bulimia in Fyn County, Denmark is described. Incidence was estimated from national and local registers. The DSM‐III‐R criteria of one or both eating disorders were met by 104 patients. The incidence of anorexia nervosa for females 10 to 24 years of age was 11.0 per 100,000 per year. In the same population, the incidence of bulimia was 5.5 per 100,000 per year. Prevalence was estimated from questionnaires to and interviews with general practitioners. There were 193 cases; the prevalence of anorexia nervosa was estimated at 1:780 (patient years/total population years), and the prevalence of bulimia at 1:1480, in the high‐risk population: females 15–19 years of age. Sixty percent of the anorexia nervosa patients, but only 30% of the bulimia patients, were admitted to hospital; this is an important difference in regard to estimation of occurrence from registers.
Diagnostic and demographic correlates of substance abuse in schizophrenia and major affective disorder
Authors: Mueser K. T. , Yarnold P. R. , Bellack A. S.
Published: August 2007

The relationship between history of specific types of substance abuse (alcohol, stimulants, cannabis, hallucinogens, narcotics) and demographic and diagnostic variables was evaluated in a large (n= 263) sample of schizophrenic, schizoaffective, major depression and bipolar disorder patients. Prevalence rates were also compared with rates observed in a previous study (1983–1986) conducted using the same methods. Demographic characteristics (gender, age, race, educational level) were strong predictors of type of substance abuse. Patients with a history of cocaine abuse had fewer prior hospitalizations, suggesting that less impaired psychiatric patients may be more prone to illicit substance abuse. Diagnoses were not related to most types of substance abuse, although there was a trend for bipolar patients to have a history of alcohol abuse. The results demonstrate the importance of matching groups on demographic characteristics when exploring diagnostic differences in preference to abuse specific types of substances.
Simple schizophrenia: an investigation of Bleuler's criteria based on the major twin studies of schizophrenia
Authors: Dworkin R. H.
Published: August 2007

Schizophrenics fulfilling Bleuler's criteria for simple schizophrenia ‐ no evidence of hallucinations, delusions, and catatonic behavior ‐ were similar to schizophrenics with more typical forms of the disorder with respect to negative symptoms, premorbid social adjustment, and age at onset. These results support the validity of the simple schizophrenia subtype by providing evidence that schizophrenics without conspicuous positive symptoms are similar to those with such symptoms on these core features of the disorder.
The Canberra Interview for the Elderly: a new field instrument for the diagnosis of dementia and depression by ICD‐10 and DSM‐III‐R
Authors:   Social Psychiatry Research Unit, National Health and Medical Research, Council, Australian National University
Published: August 2007

The Canberra Interview for the Elderly (CIE) has been developed as a field instrument for identifying cases of dementia and depression, doing so strictly according to the diagnostic criteria in both the draft ICD‐10 and DSM‐III‐R. It has been designed to be administered by lay interviewers. Information is gathered from the subject and an informant, and is then processed by computer algorithm to generate diagnoses. In a sample of 76 elderly patients attending a hospital clinic, test‐retest reliability was found to be high at the level of individual items. For the diagnoses made on two occasions, agreement was comparable with other standardized psychiatric interviews designed for lay administration in the community. Validity, other than content validity, remains to be assessed. The CIE and its diagnostic algorithms are an efficient tool for clinical and epidemiological research on dementia and depression among elderly people, where close adherence to international criteria is required.
Carbamazepine versus lithium in the prophylaxis of bipolar affective disorder
Authors: Coxhead N. , Silverstone T. , Cookson J.
Published: August 2007

A 12‐month double‐blind trial of carbamazepine vs lithium, given as sole treatment for the prophylaxis of bipolar affective disorder, was carried out in 31 patients. All were previously stable on lithium; 15 were switched over to carbamazepine and 16 remained on lithium. Although the overall relapse rate was similar in the 2 groups (6 on carbamazepine, 8 on lithium), nearly all the relapses in carbamazepine occurred in the first month, probably precipitated by lithium withdrawal. Two patients on carbamazepine developed a rash and were withdrawn. More side effects were noted during the early stages on carbamazepine. Patients on lithium tended to gain weight (+ 4 kg) compared with carbamazepine (‐ 3.1 kg). It is concluded that carbamazepine is as effective as lithium in the prophylaxis of bipolar affective disorder; changeover from lithium to carbamazepine should be done slowly.
Antecedents of anxiety syndromes in a cohort of 50,465 young men in Sweden. A prospective analysis of self‐reported and professionally assessed psychosocial characteristics
Authors: Allgulander C. , Allebeck P. , Brandt L.
Published: August 2007

The purpose of this study was to find psychiatric, behavioral and social characteristics that predict subsequent anxiety syndromes in men. Questionnaire data were collected in a cohort of all 50,465 men in Sweden who were conscripted for military training. By record linkage with the national psychiatric inpatient register, we identified 68 probands with pure anxiety neurosis occurring in the cohort during a 13‐year follow‐up period. Baseline characteristics were categorized into 8 variables that were entered into logistic regression models. We found that reported treatment with psychoactive drugs and perceived mental health problems at baseline increased the odds of being admitted for anxiety neurosis by 1.9 and 1.8. Other predictors were family problems (odds ratio = 2.0) and having a family member being treated with psychoactive drugs (odds ratio = 1.7). Univariate relative risks were higher, and a psychiatric diagnosis at conscription conferred a relative risk of anxiety neurosis of 2.2. A similar profile was obtained for subjects admitted for a depressive neurosis, in support of the continuum hypothesis between anxiety and depression. We conclude that the necessity of admission for anxiety neurosis in young men originates in genuine mental symptoms in the family setting.
The concept of alexithymia: an empirical study using psychodynamic ratings and self‐reports
Authors: Weinryb R. M. , Gustavsson J. P. , Åsberg M. , Rössel R. J.
Published: August 2007

In patients with ulcerative colitis, alexithymia and related traits were studied using the Karolinska Psychodynamic Profile (KAPP), a recently constructed psychodynamic assessment instrument, and other measures of alexithymia (the Schalling‐Sifneos Personality Scale (SSPS) and the Beth Israel Questionnaire (BIQ)), and other personality traits using the Karolinska Scales of Personality (KSP). The results of these measures were analyzed for correlation. The prevalence of mental disorder as defined by DSM‐III was not above normal, and the KSP T‐scores were within normal limits. As rated with the KAPP, alexithymia was uncorrelated with age or level of education, but was inversely correlated with proximity to a major life event (abdominal surgery), suggesting that alexithymia may have a defensive function. Cluster analysis, with Regression in the service of the ego (R), Alexithymia (A) and Normopathy (N) as clustering variables, yielded 3 groups: normal, multidisturbed (problems with R, A and N) and inhibited (problems with R and N). SSPS failed to distinguish between the multidisturbed and the inhibited groups, and BIQ between any groups. In the multidisturbed group, correlations were found with detachment and with disturbances in interpersonal relations. The results suggest that disturbances in object relations are of major importance in alexithymia.
Hypothalamic‐pituitary‐adrenocortical function in mixed and pure mania
Authors: Swann A. C. , Stokes P. E. , Casper R. , Secunda S. K. , Bowden C. L. , Berman N. , Katz M. M. , Robins E.
Published: August 2007

There is little information about hypothalamic‐pituitary‐adrenocortical (HPA) axis function in mania, particularly in mixed states. We therefore investigated HPA function and its relationship to clinical state in 19 hospitalized manic patients meeting Schedule for Affective Disorders and Schizophrenia ‐ Research Diagnostic Criteria for acute manic episodes, compared patients with and without a mixed presentation, and examined correlations between HPA activity and behavior. Data were available from 13–16 patients. Behavioral and biochemical analyses were conducted during a 15‐d placebo period. Patients with mania had elevated cerebrospinal fluid (CSF) and urinary free cortisol excretion compared with healthy subjects, and did not differ from depressed patients in any cortisol measures. Mixed manics had significantly higher morning plasma cortisol, postdexamethasone plasma cortisol and CSF cortisol than pure manics. Five of 7 mixed manics and 3 of 9 pure manics were dexamethasone suppression test (DST) nonsuppressors. Afternoon plasma cortisol and CSF cortisol correlated significantly with depressed mood; urinary free cortisol correlated with anxiety. None of the cortisol measures correlated with mania or agitation scores. These data suggest that increased cortisol secretion is a characteristic of the depressed state in mixed manics, although pure manics may also have increased DST nonsuppression.
Sex differences in problem drinking among 42‐year‐old residents of Malmö, Sweden
Authors: Österling A. , Nilsson L.‐H. , Berglund M. , Moberg A.‐L. , Kristenson H.
Published: August 2007

The main objective was to describe sex‐related differences in rates of nonidentified vs identified problem drinking in 42‐year‐old Malmö residents. All 1264 women and 1368 men born in 1941 were invited to a health screening at the Preventive Medicine Section, Malmö General Hospital. Individuals registered at the Department of Alcohol Diseases because of problem drinking prior to screening (identified problem drinkers) were excluded and analyzed separately. Intervention in the remaining subjects was made if any of 3 sets of inclusion criteria was met. The sex ratios (female:male) of identified and nonidentified problem drinking were 1:4.1 and 1:2.8 respectively. Thus, nonidentified problem drinking is by and large proportional to identified problem drinking in both sexes, arguing against hidden drinking being an exclusively female phenomenon.