bluuebunny/crossref_metadata_2025 huggingface dataset:
Outcome of Anorexia Nervosa in Males
Authors: Burns Tom , Crisp A. H.
Published: August 2008

Twenty-seven consecutive male patients suffering from anorexia nervosa were fol lowed-up 2–20 years after presentation; 20 had been treated with an in-patient refeeding/psychotherapy regime. The outcome of the series compared very closely with a similar group of female anorectics: 12 (44%) had a good outcome, stable weight restoration and normal sexual functioning; seven (26%) had an intermediate outcome, and eight (30%) poor (weight more than 15% below normal, and poor or no sexual activity). No patient had died. Good outcome in terms of weight was associated with good psychological and social functioning, while poor outcome was clearly associated with a longer duration of illness, previous treatment, and greater weight-loss during illness, although not with any specific dietary behaviour. Poor relationship with parents during childhood and the absence of normal adolescent sexual behaviour premorbidly were also strongly predictive of poor outcome.
Dexamethasone Suppression Test and REM Sleep in Patients with Major Depressive Disorder
Authors: Mendlewicz Julien , Kerkhofs Myriam , Hoffmann Guy , Linkowski Paul
Published: August 2008

Dexamethasone suppression Test (DST) and sleep electroencephalogram (EEG) recordings were carried out during three consecutive nights in 39 depressed patients who met Research Diagnostic Criteria (RDC) for major depressive disorder and in nine normal controls. Cortisol response to DST was abnormal in 26 patients and normal in all controls. REM latency and REM density were compared in patients with abnormal DST (n = 26) to values obtained in patients with normal DST (n = 13) and in normal controls (n = 9). Rapid Eye Movement (REM) latencies were significantly lower in depressed patients showing cortisol non-suppression after dexamethasone than in patients with a normal DST or in controls. REM densities were significantly higher in depressed patients than in normal controls (P <0.025), but there was no significant difference between DST suppressors and non–suppressors. The DST provided high specificity (100%) and a sensitivity of 67%, while REM latency showed a lower specificity (78%), but a higher sensitivity (85%).
Clinical use of the DST in a Psychogeriatric Population
Authors: McKeith Ian G.
Published: August 2008

The dexamethasone suppression test (DST) was administered to 95 patients referred to a psychogeriatric assessment service. Non-suppression of plasma cortisol was found in 28 out of 48 patients (58%) with senile dementia and all patients with arteriosclerotic dementia or acute confusional states. Non-suppression could not be explained by associated depressive symptoms. The DST was confirmed as a valid diagnostic test for endogenous depression in the elderly, but its value in distinguishing true dementing illnesses from depressive pseudodementia was not supported. The clinical implications of these findings for interpreting DST results in the elderly are discussed.
Perceptual Learning with Right Unilateral versus Bilateral Electroconvulsive Therapy
Authors: Daniel Walter F. , Crovitz Herbert F. , Weiner Richard D.
Published: August 2008

Perceptual learning was examined with respect to variations in ECT electrode placement (bilateral versus right unilateral) and ECT stimulus waveform (sinusoidal versus brief-pulse). While patients receiving right unilateral ECT demonstrated more perceptual learning than did those receiving bilateral ECT, no difference in perceptual learning resulted from the variation in electrical stimulus waveform. Furthermore, the amount of perceptual learning was unaffected by EEG seizure duration and by the total amount of electrical stimulus energy delivered. The theoretical issue of whether an electrical or a seizure difference between bilateral and right unilateral ECT is responsible for inter-group learning or memory differences is discussed, as well as practical issues related to the choice of electrode placement.
Anorexia Nervosa: A Study of 34 Twin Pairs and One Set of Triplets
Authors: Holland A. J. , Hall A. , Murray R. , Russell G. F. M. , Crisp A. H.
Published: August 2008

In a collaborative study between St George's and the Maudsley Hospitals, 34 pairs of twins and one set of triplets were identified in which the proband had anorexia nervosa. The diagnosis was based on standard criteria and zygosity was established by blood group analysis or by use of the physical resemblance questionnaire. In the 30 female twin pairs, 9/16 of the monozygotic (MZ) and 1/14 of the dizygotic (DZ) pairs were concordant for anorexia nervosa. Three of the non-anorexia co-twins had other psychiatric illnesses, and two had minor eating disorders. None of the male co-twins had anorexia nervosa.
Psychosis in Anorexia Nervosa and Bulimia
Authors: Hudson James I. , Pope Harrison G. , Jonas Jeffrey M.
Published: August 2008

In a sample of 130 consecutive patients with a lifetime diagnosis of anorexia nervosa and/or bulimia, 17 displayed psychotic symptoms. In 16 patients, these symptoms appeared attributable to major affective disorder or schizo–affective disorder, while in one, they appeared to represent factitious psychosis. No cases of schizophrenia or organic psychosis were identified.
Smoking and Malignancy in Schizophrenia
Authors: Masterson E. , O'Shea B.
Published: August 2008

It has been suggested that schizophrenic patients have a lower risk of cancer than the general population. We therefore investigated the smoking patterns of 100 current chronic schizophrenic in-patients, and the causes of death in 122 recently deceased schizophrenics. We found that schizophrenics are heavy smokers, and that schizophrenics do die from carcinoma of the bronchus. Proportional mortality rates for all malignancies were not significantly lower in schizophrenics than in the general population but there was a significant absence of cancer of the gastro-intestinal tract. Proportional mortality rates for female mammary carcinoma, pneumonia, and suicide were raised, and that for cerebrovascular disease was low. These differences between schizophrenics and the general population warrant further investigation.
Doctors and Nurses Use of the Word Confused
Authors: Simpson C. J.
Published: August 2008

A questionnaire was sent to 274 doctors and nurses. The first section was to see if certain symptoms and signs elicited the description of patients as ‘confused’, and the second to discover the respondents' definitions. The results showed a marked discordance in health workers' understanding of this word ‘confused’ in reference to patients, and it is suggested that it should only be used if it is clearly defined.
Schizophrenia and Spectral Analysis of the Visual Evoked Potential
Authors: Jutai J. W. , Gruzelier J. H. , Connolly J. F. , Manchanda R. , Hirsch S. R.
Published: August 2008

Power spectral analysis was performed on the visual evoked potentials (VEPs) recorded in response to flashes of different intensity in both unmedicated schizophrenic and normal subjects. At occipital locations (01, 02), schizophrenics showed less power than normals in the 10–14 Hz frequency range. In the 18–22 Hz range, schizophrenics showed under-activation in the left hemisphere and over-activation in the right. At temporal locations (T3, T4), schizophrenics showed abnormal (left greater than right) hemisphere patterns of activation in 10–14 Hz and 18–22 Hz ranges. There were no group differences in relationships between power and intensity changes at vertex (Cz). The results suggest abnormal cortical-subcortical interactions during analysis of visual information in schizophrenia.
Mood Changes in Bulimia Nervosa
Authors: Johnson-Sabine Eric C. , Wood Kathryn H. , Wakeling Anthony
Published: August 2008

Daily measurement of mood, and the occurrence of specific eating behaviours, were assessed concurrently over an eight-week period in a sample of 50 patients meeting diagnostic criteria for bulimia nervosa. Results of observer-rated scales of mood showed a significant reduction of scores, whereas self-assessment of mood showed no change over the study period. Negative mood states, although not severe, were more marked when the specific behavioural symptoms of binge-eating, vomiting, or purging occurred, and they increased as abnormal eating behaviours accumulated. It is suggested that the accompanying dysphoric mood states of bulimia nervosa are likely to be a secondary manifestation related to the presence of abnormal eating symptoms, and that they do no constitute a primary depressive illness.
The Measurement of Psychiatric Rehabilitation Status
Authors: Affleck James W. , McGuire Ralph J.
Published: August 2008

The recognition of rehabilitation as a special interest in psychiatry, and its practice by professional teams, raises the need for some uniformity in examining patient outcome. The features required in a scale designed for this purpose are considered and the Morningside Rehabilitation Status Scales, which have been prepared specifically for psychiatric rehabilitation, have their development and use described. They measure the dimensions of dependency, inactivity in occupation and leisure, social integration/isolation, and current symptoms and deviant behaviour. The measures can be expressed as a profile of the dimensions, with the total a measure of overall level of functioning; reliability has been established, and validity assessed. The soales are not difficult to apply when the patients are known to the staff using them. They should be useful to rehabilitation teams for defining the current status of patients, measuring changes produced by rehabilitation programmes, deciding areas where treatment or service deficits may exist which the team should be attempting to remedy, as well as for teaching purposes.
Schizophrenic Patients Discharged from Hospital—A Follow-up Study
Authors: Johnstone Eve C. , Owens David G. C. , Gold Aviva , Crow Timothy J. , Macmillan J. Fiona
Published: August 2008

A cohort of 120 patients, comprising all those who met the St Louis criteria for a diagnosis of schizophrenia, discharged from a mental hospital over a five-year period, were followed-up in the community after an interval of five to nine years; 105 were traced and 94 were alive. Of those, 66 were living in UK, out of hospital, and willing to be seen. Their mental states, and social functioning and circumstances were assessed by interview with the patients and those with whom they lived; 18% had recovered to the extent that they had no significant symptoms and appeared to function satisfactorily. More than 50% had definite psychotic features. No patients and few relatives sought a return to hospital care, but severe emotional, social, and financial difficulties were commonplace; 27% of the sample had no contact with medical or social services, a further 14% saw only community nurses, and 24% only their general practitioners. The findings emphasise the limitations of community services in dealing with the chronicity and severity of the impairments resulting from schizophrenic illness.
AIDS in New York City with Particular Reference to the Psycho-Social Aspects
Authors: Deuchar Neil
Published: August 2008

The condition known as AIDS (Aquired Immune Deficiency Syndrome) was first described by the Centre of Disease Control (CDC), Atlanta in June 1981. A subsequent nationwide survey soon revealed that similar cases had been occurring since 1979. At the time of writing, 3064 cases have been reported to the CDC of which 1,292 (42.2%) have died; 1,275 (41%) have occurred in New York City.
The Impact of Political Violence on Mild Psychiatric Morbidity in Northern Ireland
Authors: Cairns Ed , Wilson Ronnie
Published: August 2008

Evidence concerning the impact of the violence in Northern Ireland on psychiatric morbidity is limited to studies examining admission rates and psychotropic drug prescribing rates; their results varied from suggesting no effect to indicating that greater levels of violence are actually equated with higher levels of mental health. The present study is the first to use a community sample, in which respondents (797) from two towns, which have experienced contrasting levels of violence over the last ten years, completed the 30-item version of the General Health Questionnaire (GHQ), and also indicated their perception of the level of violence in their area and how safe they felt this was to live in. Those who lived in the more violent town scored higher on the GHQ, as did women compared to men and those who perceived that their area had experienced more violence. There was also a two-way interaction, such that the small number of people, who perceived much violence in their area and who also lived in the more violent town, scored more highly on the GHQ. It is possible that the majority of people in Northern Ireland deal effectively with stress generated by the political violence, but do so by denying the existence of this violence around them.
Marital Intimacy and Depression
Authors: Waring Edward M. , Patton David
Published: August 2008

Recent research has suggested that the absence of an intimate, confiding relationship may be a vulnerability factor in the development of depression in women living under adverse circumstances. This study demonstrates a significant association between severity of depression and deficiencies of marital intimacy; depressed patients with the lowest levels of marital intimacy failed to improve at one month follow-up, while 36% of the spouses of the depressed patients had symptoms of non-psychotic emotional illness. The depressed patients and their spouses' perception of their marital intimacy differ, but these differences appear not to be solely related to the spouse's depression.
Is there Hypothalamic - Pituitary - Gonadal Dysfunction in Paedophilia?
Authors: Gaffney Gary R. , Berlin Fred S.
Published: August 2008

The hypothalamic - pituitary - gonadal axis was evaluated in men with paedophilia and non-paedophilic paraphilia, and in normal male controls, by infusion of 100 meg. of synthetic luteinising hormone-releasing hormone (LHRH). There were no significant differences among groups in age, height, weight, testosterone, baseline luteinising hormone (LH) and follicle stimulating hormone (FSH), and FSH response to LHRH. However, there was a significant difference between the paedophilic group and the other two groups in the LH response to LHRH. The paedophiles responded with a marked elevation of LH, when compared with the non-paedophilic paraphiliacs and controls. These data indicate a hypothalamic - pituitary - gonadal dysfunction in paedophiles.
Serum Immunoglobulin Concentrations in Patients Admitted to an Acute Psychiatric In-patient Service
Authors: DeLisi Lynn E. , King Catherine , Targum Steven
Published: August 2008

Serum immunoglobulins were quantified in 85 consecutively admitted patients from an acute-care psychiatric in-patient unit. The patients were diagnosed as: major depressive disorder, 53; chronic schizophrenia, 12; schizophreniform psychosis, 4; substance abuse disorder, 12; and miscellaneous other diagnoses, 4. A small sub-group of these patients, which included six with major depression, one with chronic schizophrenia, and one with a personality disorder, were found to have low IgM concentrations. Immunoglobulin levels were not associated with use of medication or length of illness prior to this hospital admission. This study provides further evidence for suppression of humoral immunity in some psychiatric patients (approximately 10%).
An Investigation of the Aetiology of Chronic Headache. The Role of Headache Models
Authors: Turkat Ira Daniel , Kuczmierczyk Andrzej R. , Adams Henry E.
Published: August 2008

Headache sufferers (n = 30) reported significantly more immediate family members with headache, compared to controls (n = 22). Sensitivity, specificity, and efficiency analyses revealed that knowledge of family headache history has predictive value. The results are consistent with findings with other pain disorders.
Alternatives to Psychiatric Hospitalisation
Authors: Tantam Digby
Published: August 2008

Battles have always been a feature of psychiatry, and the traditional hegemony of the hospital has been contested particularly often. Mosher (1983) has made one of the most recent major incursions into enemy territory on behalf of the community care guerillas, in a paper in the New England Journal of Medicine.
A Follow-up Study of Accident Neurosis
Authors: Tarsh Michael J. , Royston Claire
Published: August 2008

Thirty five claimants with accident neurosis, in which there were gross perplexing somatic symptoms without demonstrable organic pathology were traced and followed-up in their homes, from one to seven years after compensation was received. Few claimants recovered and such recovery as did take place was unrelated to the time of compensation. Family processes leading to over-protection by relatives were examined and appeared to be vitally important in the prolongation of symptoms. The legal process and the delays involved caused great distress.
Nuclear Magnetic Resonance (NMR) II. Imaging in Dementia
Authors: Besson J. A. O. , Corrigan F. M. , Foreman E. Iljon , Eastwood L. M. , Smith F. W. , Ashcroft G. W.
Published: August 2008

Proton NMR imaging of the brain is rapidly becoming established as a useful investigative tool in medicine. This paper examines the usefulness of the NMR parameters—spin-lattice relaxation time (T1) and proton density (PD)—in differentiating groups of patients with senile dementia of Alzheimer type (SDAT) and multi-infarct dementia (MID) from each other, and from elderly controls. T1 values increase with severity of dementia. NMR parameters may also be of use in localising regions of brain damage.
A Cognitive Behavioural Group Treatment of Bulimia
Authors: Schneider John A. , Agras W. Stewart
Published: August 2008

This study describes a group treatment of bulimia using an adaptation of Fairburn's (1981) cognitive behavioural approach. Thirteen bulimic women with a self-reported average of 24 self-induced vomiting episodes per week were treated in two groups; each group met once a week for 16 weeks. The primary outcome measure was the number of self-reported vomiting episodes; pre- and post-treatment measures of eating attitudes, depression, assertiveness, and global level of psychological distress were also evaluated. Vomiting frequency decreased to an average 2.2 times per week (a 91% improvement) with seven patients abstinent by the end of treatment. Significant pre- to post-treatment changes were also demonstrated on measures of depression, eating attitudes, and assertiveness. Six-month follow-up data on 11 patients indicate a mean vomiting frequency of 3.8 per week; six patients maintained their progress. Although Fairburn had greater success using an individual cognitive behavioural approach, the results of the present study are promising for the development of a cost-effective treatment.
The Impact of Lithium in South-West Scotland I. Demographic and Clinical Findings
Authors: McCreadie R. G. , Morrison D. P.
Published: August 2008

A point-prevalence study in South-west Scotland found that 0.77 per 1,000 of the total population were receiving lithium. Almost one quarter had done so for more than ten years. At the time of lithium commencement, only 68% had always been diagnosed as having an affective illness; 59% of the patients were also receiving antidepressants, major tranquillisers, or both. Though this might be due in part to unnecessary administration of supplementary drugs, 19% of non-inpatients had moderate depressive symptoms, significant depressive illness, or manic symptoms. Lithium side-effects were prominent: 30% of the sample complained of weight gain, thirst or excessive micturition; 42% had noticed hair changes; and 7% had diminished thyroid activity, but most patients believed they had benefited considerably from lithium therapy.
Transient Sensory, Cognitive and Affective Phenomena in Affective Illness
Authors: Silberman Edward K. , Post Robert M. , Nurnberger John , Theodore William , Boulenger Jean-Philippe
Published: August 2008

Behavioural changes have often been noted in patients with epilepsy. This study investigated the converse phenomenon—the occurrence of transient sensory, cognitive and affective changes resembling those described by epileptics, in affectively ill patients. Forty-four patients with affective illness, 37 with complex partial seizures, and 30 hypertensive controls were interviewed to determine the lifetime occurrence of these phenomena. Such symptoms occurred frequently in association with episodes of affective illness and epilepsy, but were rare in controls. Visual, auditory, olfactory and epigastric symptoms, illusions, jumbled thoughts and amnesia were common to both epilepsy and affective illness. Greater numbers of symptoms were associated with better response to lithium and tricyclic antidepressants. Transient sensory, cognitive, and affective phenomena may be more common in affective illness and other psychiatric conditions than is generally recognised, and may be clues to the underlying pathophysiology of these conditions.
What Price Psychotherapy? a Rejoinder
Authors: Bloch Sidney , Lambert Michael J.
Published: August 2008

In 1952 Eysenck threw down the gauntlet, when he claimed that psychoanalytical forms of psychotherapy were no more effective than spontaneous remission. As we trudge through the fourth decade of this debate, its quality remains as divisive and acrimonious as ever. Professor Michael Shepherd (1979, 1980) has latterly taken on Eysenck's mantle, averring that psychotherapy is not only ineffective but may actually harm patients. In an editorial in the British Medical Journal (1984), he launched yet a further attack, arguing on this occasion that the psychotherapist is little more than a ‘placebologist’ exerting his effects through nonspecific means. Why bother with highly trained therapists when an inert pill will produce the same result?
“The Other Half of Medicine” and St. Bartholomew's Hospital
Authors: Clare Anthony W.
Published: August 2008

There cannot be many hospitals and medical schools owing their origins to the visual hallucinations and grim forebodings of a depressed monk. Yet that is precisely the story of how the venerable institution of St. Bartholomew's Hospital was founded. The monk Rahere, on a journey to Rome to obtain forgiveness for his sins, “fell ill and thought his last hour was drawing nigh. He burst into tears and vowed a vow that if he should be allowed to return to his own country he would there build a hospital for the recovering of the poor” (Moore, 1918). On his way home, he had a vision of St. Bartholomew who instructed him, among other things, to build a church in Smithfield. Was it, asks Moore, a fantastic illusion, such as men have in their sleep, or was it a heavenly oracle? Was the illness, he might have added, a depressive illness given the melancholic mood, tearfulness, feelings of impending doom, and gradual recovery? And why a vision of St. Bartholomew? The saint is associated with medicine, or more accurately with surgery. The fact that he was flayed alive and thereafter has tended to be protrayed pictorially with his skin draped in folds about his bones has suggested to some a distinctly ‘barber-surgeon’ flavour, and he is indeed the patron saint of butchers. Less well-known is the fact that he exorcised a devil from King Polimius's daughter—a therapeutic action which entitles him to be regarded as the patron saint of nervous diseases, (Dawson, 1957).
Water Intoxication in Psychiatric Patients
Authors: Singh Satnam , Padi Madhu H. , Bullard Henrietta , Freeman Hugh
Published: August 2008

Compulsive water drinking is associated with a broad spectrum of psychopathology, from mild neurosis to psychosis. Since the normal kidney is capable of excreting large volumes of fluid rapidly, water intoxication requires both a pathological basis and a psychiatric explanation of why so much water is being taken. Excessive water consumption can be dangerous, so that the fluid intake of patients with a history of polyuria together with a low urinary specific gravity should be closely observed. Four cases of water intoxication resulting from psychogenic polydipsia are described, three of them in chronic schizophrenics, where inappropriate ADH secretion might represent part of the psychosis.
Decline in the Diagnosis of Schizophrenia among First Admissions to Scottish Mental Hospitals from 1969–78
Authors: Eagles John M. , Whalley Lawrence J.
Published: August 2008

Annual age-standardised first admission rates from 1969–78 for Scottish mental hospitals were calculated for schizophrenia, paranoid states, reactive psychoses, all affective psychoses, mania, and depressive neuroses. Significant decreases were found in the diagnosis of schizophrenia (P <0.001) and, to a lesser extent, affective psychoses (P <0.01) and depressive neuroses (P <0.02). The incidence of paranoid states, reactive psychoses, and mania did not change significantly.

Several factors possibly contributing to the decline in diagnoses of schizophrenia are discussed, but it is concluded that the figures probably reflect a genuine fall in incidence. The decline in the categories of affective disorder is likely to reflect trends towards increasing provision of community-based care.
Leicester ECT Trial: Results in Schizophrenia
Authors: Brandon S. , Cowley P. , Mcdonald C. , Neville P. , Palmer R. , Wellstood-Eason S.
Published: August 2008

As part of the Leicester electroconvulsive therapy (ECT) study, the role of ECT in schizophrenia was investigated in a double-blind trial. The Present State Examination criteria for schizophrenia were fulfilled by 22 patients, of whom 19 gave consent and entered the trial. Neuroleptic medication was restricted during the trial period. Patients were randomly allocated to eight real ECT or eight simulated ECT. At the end of the four-week trial period, patients receiving real ECT showed a significantly greater improvement when measured on the Montgomery-Asberg Schizophrenia Scale (MASS), the visual analogue global psychopathology scale, and the depression scale. The differences on the MASS and visual analogue global psychopathology scale were not due to improvement in depressive symptoms. The superiority of real ECT was not demonstrated at the 12- and 28- week follow-up, when treatment was not controlled.
The Familial Occurrence of Agoraphobia
Authors: Moran Carmen , Andrews Gavin
Published: August 2008

Agoraphobia is believed to run in families, but this belief is not well supported by the literature. Data were gathered on the risk of agoraphobia in parents and siblings of 60 agoraphobic probands; 12½% of the relatives were reported to have or have had agoraphobia. This risk is significantly greater than estimates of the population incidence, and requires explanation. The details of the pedigrees do not directly support simple genetic models while investigations into environmental factors in agoraphobia by other workers have been inconclusive. As a putative case has been established for the familial occurrence of agoraphobia, further work is required to shed light on whether genetic or cultural factors are paramount
Familial Transmission of Major Affective Disorders
Authors: Tsuang Ming T. , Faraone Stephen V. , Fleming Jerome A.
Published: August 2008

The two-threshold multifactorial polygenic (MFP) model was applied to blind family study data, collected in a long-term follow-up and family study of major affective disorders. This model tested whether bipolar and unipolar disorders are manifestations of the same underlying factors or if they are independently caused disorders. The hypothesis that bipolar and unipolar disorders are, respectively, severe and mild forms of the same disorder was supported. There was little evidence for different familial aetiologies for bipolar and unipolar disorders in our sample.
Biological Antagonism and Epileptic Psychosis
Authors: Wolf P. , Trimble M. R.
Published: August 2008

The controversial literature about the biological antagonism between schizophrenia and epilepsy involves at least two areas of clinical interest. Firstly, it is frequently stated that convulsive treatment was introduced into psychiatry for the management of psychosis because of this antagonism, and secondly, it has a bearing on the topics of ‘alternative psychosis' and ‘forced normalisation’, as reported in the epilepsy literature. In addition to these, the subject is of theoretical interest in its relationship to other biological antagonisms that may be found in nature, but closer examination of the literature suggests that some of the discussions and controversies surrounding this problem are based on assumptions that may be incorrect. One possible reason for this may be the fact that much of the original work was written in German, and we propose therefore to give a brief account of the origins of the theories, as derived from their original sources.
Professional and Non-Professional Intervention for Highly Anxious Primiparous Mothers
Authors: Barnett Bryanne , Parker Gordon
Published: August 2008

Primiparous women (n= 627) were screened on state and trait anxiety measures in the post-partum period; sub-groups of highly anxious (n= 89), moderately anxious (n= 29), and minimally anxious (n= 29) mothers were derived and subsequently interviewed. The high-anxiety mothers were randomly assigned to a professional intervention, to a non-professional intervention, and to a control group, and their progress was reviewed over the following 12 months. Compliance, both in responding to progressive assessments and in accepting therapeutic intervention, was extremely high. Changes in anxiety levels for mothers not receiving an intervention were minimal over the study. In the high-anxiety sub-groups, there was a 19% reduction in state anxiety levels for those receiving a professional intervention, a 12% reduction for those receiving a nonprofessional intervention, and a 3% reduction in the controls. A planned contrast analysis determined that only professional intervention had a significant effect, intervention successfully lowering state anxiety levels to a value comparable with the moderately anxious mothers.
Depressive Illness and Morbid Distress
Authors: Copeland J. R. M.
Published: August 2008

A cluster analysis was done on items concerned with the onset and development (including life events) of depressive illness derived from standardised interviews on 70 in-patients with that diagnosis. The resulting groups were compared for symptoms derived from the Present State Examination (PSE) and outcome, five years later. New Groupings were sought, based on onset and development data, to test their predictive power, and to observe how closely they replicated existing binary classifications and whether or not suggestions emerged for narrowing the concept of depressive illness. The groups were clinically recognisable, and measures of five-year outcome differed significantly between the groups. They have been designated as forms of ‘Somatic depression’, type I ‘Slow onset—depression of middle age’; type II ‘Rapid onset—depression of middle age’; type III ‘Slow onset — depression of younger age’; type IV ‘Rapid onset — depression of younger age, and morbid distress. It is suggested that no simple binary classification is likely to prove as satisfactory for depression as a multi-axial method; the concept of ‘morbid distress' is advanced as a way of narrowing the over-extended rubric of depressive illness.
Short-Term Cognitive Effects of Unilateral and Bilateral ECT
Authors: Taylor Michael Alan , Abrams Richard
Published: August 2008

We administered an extensive battery of primarily non-memory neuropsychological tasks to 37 patients with endogenous depression, randomly assigned to either bilateral (B/ECT) or unilateral (U/ECT) electroconvulsive therapy. Testing was done prior to therapy and again shortly after the sixth induced seizure. The two groups did not significantly differ in cognitive impairment, either before or after treatment, and within-group cognitive changes following treatment were small. We conclude that neither B/ECT nor U/ECT substantially worsen non-memory cognitive performance in depressed patients, yet both result in significant clinical improvement.
CT Scans in Schizophrenia
Authors: Reveley Michael A.
Published: August 2008

The term ‘dementia praecox’ was used by Kraepelin to emphasise the tendency towards deterioration to a state of impairment resembling a dementia. Early studies looked for structural brain lesions post mortem, and later using pneumoencephalography; there were positive findings (Haug, 1962), but they were not always replicated (Storey, 1966). The risks and limitations of pneumoencephalography gradually led to its being abandoned. However, studies showing minor neurological abnormalities (Rochford et al, 1970) and cognitive impairment (Malec, 1978) continued to suggest an organic component to schizophrenia.
Changes in the Diagnoses of the Functional Psychoses Associated with the Introduction of Lithium
Authors: Parker Gordon , O'Donnell Maryanne , Walter Stephen
Published: August 2008

Diagnostic patterns for schizophrenia and affective psychosis were examined for all admissions to psychiatric facilities in New South Wales over a ten-year (1967–1977) period, before, during, and after lithium carbonate had been established as an accepted treatment. While the proportion of functional psychoses to total admissions remained relatively constant over the study, there was a relative decrease in schizophrenia, and a relative increase in the affective psychosis group. Analyses of sub-groups suggested, after controlling for the effects of time, that the introduction of lithium has been associated with an increase in diagnoses of mania and a decrease in diagnoses of paranoid schizophrenia, both for first admissions and for readmissions.
Subcultural Delusions and Hallucinations Comments on the Present State Examination in a Multi-Cultural Context
Authors: Swartz L. , Ben-Arie O. , Teggin A. F.
Published: August 2008

The challenges presented by the Present State Examination (PSE) in a multi-cultural context are explored. The general approach to the use of this instrument, difficulties with rating items relevant to cultural or subcultural conditions, and particularly the assessment of psychosis are considered, as well as the possibility of additions to and modifications of the PSE-CATEGO system. Though disagreement exists as to whether the research model which the PSE represents is adequate to deal exhaustively with cultural factors, the instrument is useful in cross-cultural research and also in stimulating debate and crystallising issues.
Repetition of Self-Poisoning and Subsequent Death in Adolescents who take Overdoses
Authors: Goldacre Michael , Hawton Keith
Published: August 2008

Hospital Activity Analysis data and record linkage were used to investigate repetition of self-poisoning, and deaths, among 2,492 people, aged 12 to 20 years, who took overdoses between 1974 and 1978. Repetition occurred most frequently during the first few months after an initial admission; 9.5% of patients repeated within the study period (mean follow-up of 2.8 years). Ten of the 2,492 subjects died during the study period, and the average annual death rate in the cohort was approximately four times higher than the national average annual death rate in this age-group as a whole. Six of the deaths were probably suicides. Repetition and suicide rates were highest among males aged 16 to 20 years.
Pairs of Same-Sexed Siblings Discordant for Antisocial Behaviour
Authors: Reitsma-Street Marge , Offord David R. , Finch Terri
Published: August 2008

Seventy-one pairs of same-sexed biological adolescent siblings, discordant for antisocial behaviour and service contact, were compared using matched-pairs analyses along several dimensions which included developmental, family, psychiatric, educational, cognitive, pro- and antisocial behaviour. The antisocial youth had significantly more negative perceptions and experiences than their siblings, who experienced more protective influences. Earlier onset in the antisocial youth of activities such as smoking also significantly differentiated the pairs. The early temperament index alone correctly classified as proband and sibling 95% of the youth, using discriminant analysis procedures. The findings are relevant to the aetiology of antisocial behaviour and to possible treatment interventions.
A Comparative Validation of the Foulds and Bedford Hierarchy of Psychiatric Symptomatology
Authors: Morey Leslie C.
Published: August 2008

This study investigated the validity of the Fould & Bedford hierarchical model of psychiatric illness, as compared to hierarchical models based upon prevalence and severity of disorder. The DSSI was administered to 52 American psychiatric in-patients with severe disturbances. The reports of symptoms in this sample conformed to the Foulds hierarchy in 90% of cases, while 94% of cases conformed to a model based upon prevalence. When a cross-method validation was investigated, the Foulds & Bedford classification demonstrated good discriminative capacity, while models based upon prevalence and severity failed to achieve significance. These results suggest that the Foulds & Bedford model is a useful taxonomy of symptomatology in psychiatric illness.
Did Shakespeare know Schizophrenia?
Authors: Bark Nigel M.
Published: August 2008

There is doubt whether schizophrenia, the most common and most devastating serious mental illness, existed much more than 200 years ago. Many authors who have written recently on the history of schizophrenia suggest that it is a disease that first appeared towards the end of the eighteenth century and rapidly increased in prevalence throughout the nineteenth. Cooper & Sartorius (1977) ask “Why are good descriptions of what can now be recognized as chronic schizophrenia so scarce in European medieval and earlier literature?” and they associate schizophrenia with industrialisation. Torrey (1980) argues that although descriptions of madness, including hallucinations and delusions, date to ancient times, schizophrenia as we know it with an onset in early adulthood and progressive deterioration, is not described. He associates schizophrenia with civilisation, and proposes an infectious cause. Hare (1979, 1982) supports this hypothesis, providing detailed evidence for a real increase in hospitalised psychiatric patients who most probably had schizophrenia in the last century (Hare, 1983), and also states that there are no good earlier descriptions of schizophrenia.
Neuroleptic Serum Levels Measured by Radioreceptor Assay in Patients Receiving Intramuscular Depot Neuroleptics Some Preliminary Findings
Authors: Turbott John , Villiger John , Hunter Lynley
Published: August 2008

Twenty-six chronic schizophrenic patients on well established depot neuroleptic regimes with stable doses (16 on fluphenazine decanoate, ten on flupenthixol decanoate) had serum neuroleptic levels measured by a radioreceptor assay (RRA) method. The assay was sufficiently sensitive to measure serum levels in all cases, with acceptable levels of inter-assay variation. Blood level measurements were repeated on two occasions, at the same time interval from the last injection, in 18 patients (11 on fluphenazine decanoate, seven on flupenthixol decanoate) and remained reasonably stable in most cases, although others showed a wider variation. Despite a wide range of doses (× 32 fluphenazine decanoate, × 21 flupenthixol decanoate) the serum levels fell in a remarkably narrow range (× 4, × 6). There was a significant correlation between dose and blood level for flupenthixol decanoate, but not for fluphenazine decanoate.
Neurotic Patients who Terminate their own Treatment
Authors: Roberts Howard
Published: August 2008

40 new neurotic patients who lapsed from out-patient treatment were compared with 40 new neurotic patients who remained in treatment. The lapsed patients more often reported marital disharmony and 40% of them no longer felt ill at follow-up.
Suicide and Parasuicide in Childhood and Early Adolescence
Authors: Brooksbank Donald J.
Published: August 2008

Suicide is intentional self-killing, and parasuicide an act of deliberate self-harm—either by injury, ingestion or inhalation—not resulting in death (Blacket al,1982). Both are rare under the age of 12 and the rate of suicide in those under 16 remains consistently low. Referrals to psychiatric services reported by Shaffer (1974) indicated that 7–10% were for threatened or attempted suicide, while Hawton (1982) quoted studies giving the incidence as 10–33% for children aged six to 12; in England and Wales (1962–1968), suicide accounted for 0.6% of deaths in the 10–14 age-range. McClure (1984) found that between 1975 and 1980, only ten such deaths were recorded in the 13-and-under range, and 26 deaths in the 14 year-olds, after which the number of suicides rose sharply with each successive year. That study also showed that parasuicide was most common in the 15–24 age-group, but at younger ages there was a higher proportion of undetermined deaths, as against officially recorded suicides. The social taboos associated with suicide may lead to its systematic under-reporting, but even allowing for that, the phenomenon is still a rare one under the age of 16.
III. Relapse Postponement or Relapse Prevention? The Implications for Long-term Outcome
Authors: Curson D. A. , Barnes T. R. E. , Bamber R. W. , Platt S. D. , Hirsch S. R. , Duffy J. C.
Published: August 2008

The relapse and admission histories revealed a positive correlation between number of schizophrenic episodes and time on maintenance medication, probably reflecting severity of illness. Relapse rates after drug discontinuation rose to 45% within 13 months. There were no differences of predictive value between those relapsing on or off medication. The relationship between relapse rates, drug treatment, and social outcome is complex; antipsychotic drugs may postpone relapse, and frequent relapses might inhibit improvement in social performance long after florid symptoms have been controlled by medication.
Cytomegalovirus and Schizophrenia
Authors: Shrikhande Satish , Hirsch Steven R. , Coleman J. C. , Reveley Michael A. , Dayton R.
Published: August 2008

Cerebrospinal fluid (CSF) from 20 chronically hospitalised male schizophrenics and from 12 patients admitted with acute schizophrenia were examined for antibodies against cytomegalovirus. A sensitive and specific enzyme-immunoassay was used to detect IgG or I g M classes of antibodies in the CSF of the schizophrenic patients and often orthopaedic patients, who served as controls. No significant amounts of I g M antibody were found in the CSF of either group. A significant titre of IgG was found in only one of the 32 schizophrenics, an acute patient, but in four of the orthopaedic patients. The results do not support an association of cytomegalovirus infection with schizophrenia; if such an association occurs, it must be unusual.
Neuroleptics, Lithium and Renal Function
Authors: Waller Derek G. , Edwards J. Guy , Polak A.
Published: August 2008

Renal function test results in 26 patients on neuroleptic treatment, who had never received lithium or antidepressants, were compared with those in a matched group, treated with lithium; also, their tubular response to DDAVP was compared with that of 25 control subjects. Measurements of serum creatinine, creatinine clearance, and urinary albumin excretion showed no abnormality attributable to either neuroleptics or lithium. The maximum urine concentrating ability after DDAVP was significantly lower in the neuroleptic group than in controls, but significantly higher than in the lithium-treated patients. There was a significant correlation between excretion of urinary ß2-microglobulin and duration of neuroleptic treatment, but mean excretion rates were the same in both treatment groups. The results suggest that neuroleptics as well as lithium impair urine concentrating ability.
Pipothiazine Palmitate in the Management of Aggressive Mentally Handicapped Patients
Authors: Lynch D. M. , Eliatamby C. L. S. , Anderson A. A.
Published: August 2008

The efficacy of intramuscular pipothiazine palmitate (PP) in the management of aggressive mentally handicapped patients was examined in a double-blind, placebo-controlled, cross-over study, in which 30 patients received each treatment for 13 weeks. A target symptom scale of aggressiveness (TSA) and a clinical global impression scale of efficacy were rated at monthly intervals, and an extra-pyramidal side-effects scale weekly. The patients showed marked improvement during treatment with PP, which was assessed as superior to placebo. Individual and total TSA scores were also reduced compared to placebo.
Hereditary Differentiation of Anxiety and Affective Neuroses
Authors: Torgersen Svenn
Published: August 2008

One hundred and fifty anxiety neurotic and neurotic depressive twin probands were differentiated into three groups by means of discriminant analysis, 50 in each group. The groups were named: pure anxiety neurosis, mixed anxiety-depression, and pure neurotic depression. Analysis of concordance rates indicated that only pure anxiety neurosis seemed to be influenced by hereditary factors.
Speech Pause Time as a Method for the Evaluation of Psychomotor Retardation in Depressive Illness
Authors: Hoffman G. M. A. , Gonze J. C. , Mendlewicz J.
Published: August 2008

Psychomotor retardation is important in some depressed patients. We found that speech pause time (SPT) during a counting test correlated with the reaction time of both depressed patients and controls. It also correlated with global psychomotor retardation measured on Widlocher's scale. We demonstrated increased SPT in unipolar depressives, and also in retarded depressives as a group when compared with controls and with non-retarded depressives. SPT varied diurnally in controls, but not in depressed subjects. It did not correlate with biological markers of depression (REM sleep latency and the dexamethasone suppression test). It did, however, shorten during clinical improvement with antidepressant chemotherapy.
The Hive System
Authors: Tyrer Peter
Published: August 2008

Psychiatry has an advantage over other medical disciplines in that its skills are ones that can be practised in almost any setting. Although this is a truism it is worth repeating as psychiatry is still strongly associated with hospital treatment in the public mind. This view is endorsed by the activities of most psychiatrists, who spend their working lives in psychiatric hospitals or in extensions of them such as out-patient clinics or day hospitals. The reasons for this are at least partly historical. The great mental hospital building programme of the 19th century was planned deliberately to set up hospitals in isolated areas away from the centre of the community they served (Scull, 1979). Many countries are still left with this legacy of mental quarantine and find it difficult to overcome its geographical handicaps. Although it is appreciated that more patients can be treated successfully outside hospital it is often easier to follow the maxim, “if in doubt don't keep them out” and admit patients who seem to need further assessment. This is understandable whilst most personnel are based within the hospital and is certainly easier than setting up alternative systems of care away from the hospital base.
The Emotional Consequences of Ejection, Rescue and Rehabilitation in Royal Air Force Aircrew
Authors: Fowlie D. G. , Aveline M. O.
Published: August 2008

Retrospective questionnaire information was sought from 175 Royal Air Force officers who had survived ejection from an aircraft and 88% replied. A profile of risk factors, both objective and subjective, was found in the 40% who subsequently experienced prolonged emotional disturbances. Confidential counselling of ejection survivors should therefore be routine. Consultation between involved medical staff and a Service psychiatrist can increase awareness that surviving aircrew may not be as composed and unaffected as they seem, while appropriate counselling can reduce prolonged emotional morbidity.