bluuebunny/crossref_metadata_2025 huggingface dataset:
Clinical Judgements of Self-Dramatisation
Authors: Slavney P. R. , Chase G. A.
Published: August 2008

It has been claimed that the diagnosis of histrionic personality disorder is inherently sexist. To estimate the extent to which psychiatrists are influenced by sexist prejudice in their judgements about self-dramatisation (the central trait in the histrionic cluster), we conducted a study in which male and female subjects rated the degree of self-dramatisation portrayed in videotaped vignettes. The results did not support the sexist hypothesis that dramatic behaviour would more often be attributed to a woman than to a man, especially by male raters.
Law, Psychiatry and Women's Imprisonment
Authors: Carlen Pat
Published: August 2008

This paper analyses the legal and other social conditions under which the concept of ‘psychopathic personality disorder’ continues to play a strategic part in both the repeated imprisonment of female petty offenders and in the justifications put forward for the rigidity of the disciplinary regimes in women's prisons.
Toward a Biochemical Classification of Depressive Disorders IX
Authors: Schatzberg Alan F. , Rothschild Anthony J. , Gerson Benjamin , Lerbinger Jan E. , Schildkraut Joseph J.
Published: August 2008

Post-dexamethasone cortisol and platelet monoamine oxidase (MAO) activity levels were examined in 50 depressed patients. The incidence of non-suppression was significantly greater in patients with high platelet MAO activity than in those with low activity. Similar results were obtained when males and females were analysed separately. The mean 4 p.m. post-dexamethasone cortisol level was significantly higher in those patients who had high MAO activity than in their low MAO counterparts. Moreover, a statistically significant positive correlation was observed between platelet MAO activity and 4 p.m. post-dexamethasone cortisol levels.
The Relationship between Scores on Ryle's Marital Patterns Test and Independent Ratings of Marital Quality
Authors: Birtchnell John
Published: August 2008

This study concerns 250 marriages of 40–49 year-old women from a psychiatric patient and general population series. Psychiatric patients' marriages involved less exchange of affection, were husband-dominated, and were of poor quality. In general population marriages, poor quality was related to wife domination. Affection given (AG) and affection received (AR) scores were significantly associated, being high in good marriages and low in bad ones. Zero or near-zero domination was associated with high AG and AR scores and with good quality marriages. Husband domination was linked with wives having high (MMPI) dependency scores. Terminated marriages, compared with bad but non-terminated marriages, had significantly lower AR scores.
Anorexia and Bulimia in Anorexia Nervosa
Authors: Yellowlees A. J.
Published: August 2008

Seventeen fasting patients with anorexia nervosa and 15 who also binged were compared in terms of their psychosocial functioning and associated psychiatric symptomatology, using the Delusions Symptoms and States Inventory (Foulds & Bedford, 1975). Both groups scored very highly on the state of anxiety, depression, and elation sets of the DSSI, but less highly on the compulsive and ruminative symptoms sets and on the phobic dissociative and conversion symptom sets. The bingeing anorexic group was significantly older and heavier than the fasting group and experienced more feelings of self-harm and guilt. The bingeing group reported sexual interference during childhood, and currently experienced a desire to vomit during sexual activity to a significantly greater degree than the fasting group.
Anorexia Nervosa in Patients of Afro-Caribbean Extraction
Authors: Thomas Joseph P. , Szmukler George I.
Published: August 2008

Recently there has been an increase in the number of reports of anorexia nervosa in non-Caucasian subjects. This paper describes three patients of Afro-Caribbean extraction with anorexia nervosa and/or bulimia nervosa seen at a specialist eating disorders clinic at the Maudsley Hospital between 1981 and 1983. No cases had been seen prior to this. The key clinical features were found to be, in the main, typical.
The Outcome of Anorexia Nervosa in Younger Subjects
Authors: Hawley Richard M.
Published: August 2008

Twenty-one children who conformed to DSM-III criteria for anorexia nervosa, and who were aged 13 or younger at onset, were followed up after several years (mean = eight) using a range of outcome parameters. Comparison of these results with previous studies of later onset cases suggests that the age of onset of anorexia nervosa carries no prognostic significance.
Changes in the Incidence of Alcohol-Related Problems in North-East Scotland, 1974–1982
Authors: Eagles John M. , Besson John A. O.
Published: August 2008

The age-standardised rates of first-ever alcohol-related diagnoses amongst both general hospital in-patients and psychiatric referrals were examined in the Grampian region from 1974 to 1982. Male general hospital admissions in this category rose steeply from 1974 to 1978, but then declined steeply thereafter; it is concluded that this may reflect a beneficial effect on male drinking habits as a result of the liberalisation of Scottish licensing laws. The remaining data supported the belief that the gap is narrowing between male and female rates of alcohol-related illness.
Ageing in Down's Syndrome
Authors: Hewitt K. E. , Carter G. , Jancar J.
Published: August 2008

In a group of 23 hospital patients aged over 50 with Down's syndrome, psychological testing indicated that significant intellectual deterioration, which was un-related to chronological age, sex, length of hospitalisation, or earlier mental age, had occurred in nine. Clinically, there was no evidence in any patient of active physical illness, focal neurological signs, or dementia, but significant associations were found between intellectual deterioration and decreased visual acuity, hearing loss, and macrocytosis.
Depression in General Practice:
Authors: Sireling L I. , Paykel E. S. , Freeling P. , Rao B. M. , Patel S. P.
Published: August 2008

Using multiple diagnostic and epidemiological criteria, three samples of general practice (GP) depressives were studied: those prescribed a new course of antidepressants, those given other treatment, and those missed by the GP. The majority of patients qualified as psychiatric cases on the PSE Index of Definition, the Bedford College Criteria, and the Research Diagnostic Criteria. Most satisfied diagnostic criteria for depression, or (fewer) anxiety. The disorders were relatively mild and often borderline on all three systems. Depressives given other treatment most often failed to meet diagnostic criteria. About half the antidepressant treated patients received RDC diagnoses of major depression. Among the other treatment sample, only one-fifth met these criteria, and half had non-depressive diagnoses. Most cases of depression treated by GPs satisfy criteria for psychiatric disorder, but tend to be relatively mild and borderline in quality.
Depression in General Practice:
Authors: Sireling L. I. , Freeling P. , Paykel E. S. , Rao B. M. , Patel S. P.
Published: August 2008

General practice (GP) depressives prescribed an antidepressant were compared with those given other treatment, and with antidepressant-treated psychiatric out-patient depressives. GP depressives were considerably less severely ill than out-patients, with fewer depressive symptoms and shorter illness, as well as less primary and less endogenous depression. The two groups of GP depressives differed less, but those receiving other treatment tended to have less severe depression than those receiving antidepressants and were less likely to satisfy diagnostic criteria for depression. Depressives in GP differ considerably in clinical characteristics from psychiatric out-patient depressives, and clinical features influence the GP's decision to treat with antidepressants.
A Survey of Serum Antibodies to Eight Common Viruses in Psychiatric Patients
Authors: King D. J. , Cooper S. J. , Earle J. A. P. , Martin S. J. , McFerran N. V. , Rima B. K. , Wisdom G. B.
Published: August 2008

Serum antibody titres to eight neurotropic viruses were measured by enzyme immunoassay in 450 psychiatric in-patients and 143 controls. A seasonal variation in schizophrenic births was observed, with a peak incidence between March and April. Both herpes simplex virus and cytomegalovirus antibody titres correlated with age and, when this was controlled for, no significant differences emerged between any patient group and the controls. Mumps antibody titres were significantly lower in patients with mental subnormal and neurosis or personality disorder; measles and rubella antibody titres were lower in male but not female mentally handicapped patients; males had lower antibody titres to mumps, cytomegalovirus and Epstein-Barr virus than females in all groups. A decrease in mumps antibody titres was also found in schizophrenics if the medication factor was excluded. These low antibody titres may indicate an impaired immune response. Thus perinatal or childhood subclinical viral infections of the central nervous system, particularly of mumps, might lead to a range of possible psychiatric outcomes in later life.
Serum and CSF Antibody Titres to Seven Common Viruses in Schizophrenic Patients
Authors: King D. J. , Cooper S. J. , Earle J. A. P. , Martin S. J. , McFerran N. V. , Wisdom G. B.
Published: August 2008

CSF and matched serum antibody titres to seven common viruses were measured in 20 chronic schizophrenic patients, and 17 of these were age and sex-matched with orthopaedic controls. CT scans were carried out in patients and age and sex-matched radiological controls. There was a trend for CSF viral antibody titres (except CMV, HSV and VZV) to be decreased in the patients compared to controls, statistically significant for mumps and IgG. The CSF/serum ratios showed a reduction in the patients, compared to controls, statistically significant for measles and rubella as well as mumps and IgG. Cerebral ventricular size was significantly increased in the patients compared to controls, but did not correlate with any of the antibody data. These findings suggest that there is a reduced immune response to certain common viruses in the CNS of schizophrenic patients, but possible effects of institutionalisation or current medication could only be adequately excluded by further prospective studies.
The Pattern and Prevalence of Symptoms During the Menstrual Cycle
Authors: van den Akker Olga , Steptoe Andrew
Published: August 2008

One hundred volunteers completed a modified version of the Moos Menstrual Distress Questionnaire daily for 35 days. The purpose of the study was disguised. None of the participants was taking oral contraceptives. Significantly more symptoms were reported in the premenstrual and menstrual phases and fewer during the follicular phase of the cycle, but the pattern of response varied considerably between subjects. Symptom reporting was higher, in all phases of the cycle, in women with high trait anxiety or psychiatric morbidity (indexed by the General Health Questionnaire) but these measures did not relate to fluctuations of symptoms around the menstrual cycle. The need for prospective longitudinal studies of menstrual cycle symptomatology is emphasised.
Home Care for Chronic Mental Illness in Bangalore: An Experiment in the Prevention of Repeated Hospitalisation
Authors: Pai Shaila , Channabasavanna S. M. , Nagarajaiah  , Raghuram R.
Published: August 2008

The article describes the outcome of a comparative study of home care, by a trained nurse, versus hospital out-patient supervision in the management of chronic psychiatric patients in Bangalore, India. Twenty-five patients, with a mean duration of illness of nine years, were started on the home care programme while a matched control group of 25 similar patients continued the regular out-patient contact offered by the hospital. Comparative assessments were carried out on the groups at the time of intake and again after two years. The results indicate that hospital admission was less often needed among the home care group.
Ageing and Affective Disorders: The Age at First Onset of Affective Disorders in Scotland, 1969–1978
Authors: Eagles John M. , Whalley Lawrence J.
Published: August 2008

First admission rates from 1969–78 for Scottish psychiatric units were calculated for discharge diagnoses of affective psychosis for each five-year age-group from 15 years to over 74 years. There were clear-cut linear increases in rates of depressive psychoses, mania, and all affective psychoses, consistent with a relatively steady increase in the rate of first-onset affective psychoses with increasing age. These findings are discussed in terms of social, psychological, and biological hypotheses of the causes of affective disorder. It is argued that no single factor could produce the observed linear increases with age and that the data appear more consistent with an integrative aetiological model of affective disorder.
Anorexia Nervosa, Parental ‘Expressed Emotion’ and Dropping Out of Treatment
Authors: Szmukler G. I. , Eisler I. , Russell G. F. M. , Dare C.
Published: August 2008

The number of dropouts from a long-term treatment study of patients with anorexia nervosa (AN) and bulimia nervosa (BN) was substantial. A variety of social, clinical, parental, and treatment factors were examined for their association with early termination of treatment by the patient or the family. Parents ‘expressed emotion’ (EE) (particularly critical comments), BN, and the type of therapy offered (family or individual) were found to interact in some manner to result in dropping out. Some other aspects of parents' EE were also examined, including a comparison of scores in parental pairs; EE was found to be influenced by social class, and there were significant associations with the patient's symptomatology and social adjustment. There was a strong relationship between mothers' and fathers' scores in parental pairs.
Social Support and Long-Term Lithium Outcome
Authors: O'Connell Ralph A. , Mayo Julia A. , Eng Leonard K. , Jones J. Sidney , Gabel Richard H.
Published: August 2008

The failure rate in long-term lithium treatment of bipolar affective disorder is in the range of 20 to 30%, even with rigorous diagnostic criteria and adequate serum lithium levels. This may be due to a variety of biologic and psychosocial factors. Psychosocial factors affecting treatment outcome were studied in 60 RDC diagnosed bipolar patients treated with lithium for one year. Outcome was measured using an affective episode score, a social adjustment scale and a global assessment scale. Social support was the factor most strongly correlated with a good outcome on all three measures.
The Scottish Survey of Psychiatric Rehabilitation and Support Services
Authors: McCreadie Robin G. , Affleck James W. , Robinson Andrew D. T.
Published: August 2008

Rehabilitation and support services in psychiatric hospitals and general hospital psychiatric units serving two-thirds of the population of Scotland were reviewed. Although there are wide between-hospital differences, especially between rural and urban areas, the National Health Service in Scotland is making considerable efforts to provide staffing, accommodation, occupational activities, and support services for the long term mentally ill. Services provided by local authorities, with the exception of group homes, are seriously deficient. The total number of services provided by an individual hospital correlated highly with an assessment of its adequacy in providing such services in relation to other hospitals. A simple count of services may therefore be used to assess adequacy. There was also a correlation between the range of a hospital's services and numbers of misplaced new chronic in-patients.
Cryptotrauma and “Accident Neurosis”
Authors: Pilowsky I.
Published: August 2008

Accidents may often have been far more traumatic psychologically and emotionally than appears to be the case at first sight. Attention is drawn to such “Cryptotrauma” and illustrated with three clinical vignettes. Emphasis is placed on the need for painstaking analysis of the accident in all its details. Without such careful investigation “Post traumatic stress disorders” can easily be overlooked, since patients tend not to offer the information spontaneously.
Treatment of Seasonal Affective Disorder with Light in the Evening
Authors: James Steven P. , Wehr Thomas A. , Sack David A. , Parry Barbara L. , Rosenthal Norman E.
Published: August 2008

A cross-over comparison study of exposure, in the evenings only, to bright versus dim light was carried out on nine female patients with seasonal affective disorder. A significant antidepressant effect of the bright lights was shown. No consistent observable effects were produced by the dim lights. These results support earlier studies demonstrating the efficacy of bright light given morning and evening. The antidepressant effect of light is not mediated by sleep deprivation, and the early morning hours are not crucial for a response.
Recurrent Unipolar Manic Disorder in the Yoruba Nigerian: Further Evidence
Authors: Makanjuola Roger O. A.
Published: August 2008

One hundred and four Yoruba Nigerian patients are described who presented with manic disorder over a five-year period; 55 could be classified as suffering from recurrent unipolar manic disorder, while 36 had suffered only one attack of mania. Only 13 patients suffered from bipolar disorder, in contrast to studies from Western societies, in which bipolar disorder is much more common than unipolar. The unipolar manic and bipolar patients could not be differentiated on the basis of clinical and social data, apart from a possible preponderance of the female sex in the bipolar group. The clinical presentation of mania was similar to that described from Western Countries. Long-term prophylaxis with depot neuroleptics may be advisable in such cases.
Electroconvulsive Therapy in the Republic of Ireland 1982: A Summary of Findings
Authors: Latey R. H. , Fahy T. J.
Published: August 2008

In 1981, Pippard & Ellam published the findings of their survey of electroconvulsive treatment (ECT) in Great Britain. This was the first such survey to use a ‘medical audit’ approach, and included field visits to ECT clinics and a three-month uncontrolled outcome study of patients. They reported that ECT was used selectively, but that equipment, administration of the treatment, and clinic premises left much to be desired.
Successive Generations of Child Maltreatment: Social and Medical Disorders in the Parents
Authors: Oliver J. E.
Published: August 2008

Sustained attempts were made to identify all families in which there was a pattern of two or more generations of child maltreatment and multi-agency involvement in North-East Wiltshire (population 200,000) and where there were also two or more children maltreated in the current generation (born between 1960 and 1980). One hundred and forty-seven families were discovered. Disorders of behaviour of the parents of the 1960–1980 children are described. Collating information laboriously from at least 34 different agencies revealed very high levels of disturbance. Such detail was generally inaccessible, and its full significance for each family could only be assessed by using family medical record linkage methods. In the parents and antecedents, mental and personality disorders, suicidal attempts, mental handicap, dependence on drugs (mothers) or on alcohol (fathers), epilepsy and criminality were conspicuous features.
Psychiatric Illness in First-Degree Relatives of Patients with Paranoid Psychosis, Schizophrenia and Medical Illness
Authors: Kendler Kenneth S. , Masterson Catherine C. , Davis Kenneth L.
Published: August 2008

This study examines the respective morbid risk for psychiatric illness determined by the family history method in the first-degree relatives of medical controls and patients with delusional disorder (paranoid psychosis) and schizophrenia. The morbid risk for schizophrenia and schizoid-schizotypal personality disorder was significantly greater in the relatives of the schizophrenic patients than in those of the delusional disorder or medical control patients, but no difference in the risk for affective illness or alcoholism was found in the three groups of relatives. Paranoid personality disorder was significantly more common in the relatives of the delusional disorder patients than in those of the medical controls. These results support the familial independence of delusional disorder and schizophrenia.
Self-Referrals to a Community Mental Health Centre: A Three Year Study
Authors: Hutton Francoise M.
Published: August 2008

The records of all 53 clients who referred themselves to a community mental health centre in the first three years of its existence were studied retrospectively. These showed increasing and generally appropriate use of direct access for the relief of serious, often long-standing emotional distress. Self-referrals were much more often men than women, and some clients would probably not have been reached in any other way. The service seemed to reduce the local GPs' burden, at least subjectively. However, no-one presented with acute psychiatric disturbance or immediately impending breakdown. Any prevention achieved seems likely to be long-term rather than short-term.
The Importance of Dosage in Prescribing Antidepressants
Authors: Quitkin Frederick M.
Published: August 2008

The treatment of depressive disorders was significantly altered by the introduction of the tricyclic antidepressants and the monoamine oxidase inhibitors. One salient factor in determining efficacy is the dose prescribed. The few good dose response studies which are available indicate that patients should receive 300 mg of imipramine or equivalent, and a separate trial of 90 mg of phenelzine or equivalent, before concluding they are treatment refractory. Data are reviewed which suggest many patients receive inadequate doses.
Social Disability and Outcome in Schizophrenic Patients
Authors: de Jong A. , Giel R. , Slooff C. J. , Wiersma D.
Published: August 2008

To gain more insight into the social (as opposed to clinical) outcome of schizophrenia, a unidimensional, hierarchical scale was constructed. Items were selected from the Disability Assessment Schedule (DAS)–a new instrument, used in the WHO Collaborative Study on the Assessment and Reduction of Psychiatric Disability. Data were derived from the Dutch cohort participating in this study, which consisted of patients with a first life-time episode of a non-affective, functional psychosis. Patients were followed-up during the first three years of their illness, and analyses of the stability and reliability of the scale proved to be satisfactory. It was subsequently used to characterise the course of social disability.
The Scottish Survey of New Chronic In-patients: Two Year Follow Up
Authors: McCreadie Robin G. , Robinson Andrew D. T. , Wilson A. Oliver A.
Published: August 2008

‘New chronic inpatients' (patients aged 18–64 years in hospital more than one but less than six years) were followed-up two years after identification in the catchment areas of 14 psychiatric hospitals, serving 56% of the Scottish population. Nine per cent had died, 71% remained in-patients, and 20% had been discharged; 40% of those discharged had no contact with after-care services, and 37% of those remaining in hospital did not need in-patient care. Discharged patients were younger, had been in hospital a shorter time, and less often had organic brain disease. Only 13% of patients who, when first identified, had been rated at a low functioning level had been discharged; 64% of those remaining in-patients at follow up had such a rating.
Life Stress, Medical Lethality, and Suicidal Intent
Authors: Power K. G. , Cooke D. J. , Brooks D. N.
Published: August 2008

Eighty parasuicide patients were studied. The importance of life stress, age, and General Health Questionnaire score as predictors of the suicidal intent and medical lethality which they exhibited was examined. Medical lethality and suicidal intent were closely related: those whose parasuicide resulted in high lethality differed from those showing low lethality in their degree of suicidal intent, but did not differ in life stress, age, or GHQ score. Although both life stress and GHQ score were significantly correlated with suicidal intent, the GHQ score accounted for a greater proportion of the variance. These results suggest a more complex relationship between life stress, GHQ score, and suicidal intent than is often assumed.
Psychiatric Disorder in the Middle-Aged and Elderly Mentally Handicapped
Authors: Day Kenneth
Published: August 2008

In a study of 357 long-stay hospital residents aged 40 years and over, 30% had significant psychiatric disorder, while a retrospective survey of 215 new admissions over a seven-year period to a psychiatric unit for the mentally handicapped revealed that 20% of patients were aged 40 years and over. Both similarities and differences were found in the overall pattern of disorders between the two groups and a non-handicapped population in a comparable age-range.
Family and Individual Therapy: Comparisons and Contrasts
Authors: Holmes Jeremy
Published: August 2008

Psychoanalytical and family therapies are contrasted: psychotherapeutic change involves a change of frame. The new frame in family therapy is the system; for analytical therapy it is the unconscious, but there are striking formal similarities between them. To achieve this change, there are two basic modes of therapy, reflective and directive, each containing elements of both. An essential ingredient in therapy is an uncoupling of action from effect, which occurs in play; psychotherapy can be seen as a special type of play. In family therapy, the therapist may useful playful paradox: ‘therapeutic double binds'. Transference, the vehicle of psychoanalytical therapy, is a metaphorical relationship that is also essentially playful—serious but not real. Some guidelines for considering the relative indications and contraindications of family and individual psychotherapy are offered.
Psychiatric Aspects of Wilson's disease
Authors: Dening T. R.
Published: August 2008

A variety of psychiatric symptoms have been described in relation to Wilson's disease, an inherited disorder of copper metabolism. At least four symptom clusters can be identitifed: affective, behavioural/personality, schizophrenia-like, and cognitive; the first two groups appear to be the commonest. Four cases (three newly reported) are described, and current approaches to the psychiatric management of Wilson's disease discussed.
On Serious Violence during Sleep-Walking
Authors: Oswald Ian , Evans John
Published: August 2008

It is not sufficiently realised that sleep-walking is not an hysterical condition, nor in any way related to epilepsy, nor that it can be accompanied by violent injury to the self or others. Three case reports here include that of a 14-year-old boy who rose from his bed at 2 a.m. and severely stabbed his five-year-old girl cousin. The sleeping mind is not in touch with reality and amnesia for events during sleep is usual.
Imipramine and Amitriptyline Plasma Concentrations and Clinical Response in Major Depression
Authors: Kocsis James H. , Hanin Israel , Bowden Charles , Brunswick David
Published: August 2008

Plasma drug concentrations and clinical response were measured in two groups of hospitalised depressed patients, who received amitriptyline or Imipramine double-blind, in a dosage of 250 mg for four weeks. Virtually no significant linear or curvilinear relationships were found between any plasma measure and any measure of clinical response. Modest but significant direct relationships were found between age and concentration of parent drugs but not demethylated metabolites. Blood drug level measurement therefore appears to be of little value in monitoring drug treatment of depressed in-patients.
Computed Tomography in the Elderly
Authors: Bird Jonathan M. , Levy Raymond , Jacoby Robin J.
Published: August 2008

The clinical, psychometric, and computed tomographic (CT) status of previously fit elderly volunteers is described at follow-up for up to four years. A number of relationships were found between psychometric and CT scores, but a dementing group could not be determined on the basis of a single scan. However, a subtle reduction in cognition over time was significantly related to CT changes, and occurred in 10%. Larger ventricles were also found in a small sub-group, who developed late-onset depressive disorders; recent bereavement was related to ventricular size. Thus a single CT scan may not be a useful discriminatory test in early dementia, but a repeat demonstrating ventricular enlargement, is likely to be significant. In the elderly, cognitive and CT scan deterioration should not be expected unless a disease process is occurring; this may be indicated by subtle cognitive impairment or by late-onset depressive disorder.
Pseudodementia: Facts and Figures
Authors: Bulbena A. , Berrios G. E.
Published: August 2008

The historical and conceptual aspects of the pseudodementia state are briefly touched upon. A “collective sample”, composed of 61 cases culled from the literature, is analysed and compared with the “Fulbourn sample” consisting of 22 cases reported for the first time. Two sub-types of pseudodementia emerge, one associated with depressive illness and the other with delirium. A follow-up of the Fulbourn sample (1–4 years after discharge) showed 14 patients to be alive and 8 to show no signs of dementia. No variable except the diagnosis “non-specific psychosis” correlated with death during the follow-up period.
Affective Disorder amongst Women in the General Population: A Longitudinal Study
Authors: Surtees P. G. , Sashidharan S. P. , Dean C.
Published: August 2008

This paper reports upon a longitudinal general population survey of psychiatric disorder among a sample of women in Edinburgh. The course and outcome of the identified disorders, defined according to the RDC, are described. In addition the report documents the consequence, for the description of episodes, of adopting a diagnostic scheme which embodies hierarchical and inter-episode interval rules. Estimates of disease rates per year revealed a period prevalence of RDC disorder of 25.2% (17.6% depressive and 7.6% anxiety disorder) and an RDC new episode inception rate of 12.6%. In spite of the evident nontrivial nature of these conditions, and of the extent to which they were found to endure, contact with the psychiatric services was found to be minimal.
Volatile Substance Abuse: A Review of Possible Long-Term Neurological, Intellectual and Psychiatric Sequelae
Authors: Ron Maria A.
Published: August 2008

The possibility that chronic abuse of volatile substances can cause permanent neurological, psychiatric, and intellectual sequelae is critically reviewed. Toluene, present in the commonly used adhesives, is most often implicated in ‘glue sniffing’; this review focuses on its potential long-term effects. Many criticisms—particularly poor matching of control samples and inability to distinguish between acute and chronic effects—can be levelled at the available studies, while no adequate follow-up studies have been performed. In the light of present knowledge, the possibility that permanent structural brain damage, with accompanying psychiatric manifestations, results from solvent abuse remains inconclusive.
Political Hazards in the Diagnosis of ‘Sluggish Schizophrenia’
Authors: Merskey Harold , Shafran Bronislava
Published: August 2008

The concept of ‘sluggish schizophrenia’ is virtually limited to the USSR and some other East European countries, and may contribute to the mis-diagnosis of democrats as psychiatric patients. Recently, a number of articles have appeared in the Soviet literature relating the diagnosis of ‘sluggish schizophrenia’ or ‘slowly progressive schizophrenia’ to affective disorders, especially hypomania. Soviet publications on this theme from 1980 to 1984 are discussed, together with their relationship to questions on the abuse of psychiatry.
The Endogenous Sub-type of Depression: A Study of its Internal Construct Validity
Authors: Young Michael A. , Scheftner William A. , Klerman Gerald L. , Andreasen Nancy C. , Hirschfeld Robert M. A.
Published: August 2008

The internal construct validity of the endogenous sub-type of major depression was investigated by statistically modelling the RDC endogenous and DSM-III melancholia diagnostic criteria. Data consisted of symptom ratings on 788 patients with major depression from NIMH Collaborative Depression Study. Results indicated that the symptoms in the criteria do not specify a dichotomous classification, melancholic-non-melancholic or endogenous-nonendogenous. Results did support the existence of two sub-typings, one related to anhedonia, and one related to vegetative symptoms. The vegetative sub-type rarely occurred in non-anhedonic patients. Previous studies may have found support for a simple endogenous sub-type because of this hierarchical relationship and as a result of methodological differences.
The Depressive Symptoms of Bulimia Nervosa
Authors: Cooper Peter J. , Fairburn Christopher G.
Published: August 2008

Standardised measures of mental state were used to compare patients with bulimia nervosa with those with major depressive disorder. The two groups were found to be similar in terms of severity of psychiatric disturbance, as measured by the Montgomery & Åsberg Scale and the Present State Examination. Noteworthy symptomatic differences were a greater frequency of obsessional ruminations and anxiety amongst the first group, and a greater frequency of depressed mood, apparent sadness, and suicidal ideation amongst the second. Discriminant function analyses revealed that the two patient groups had a different pattern of symptoms. Examination of the character of the psychiatric symptoms of patients with bulimia nervosa suggests that the anxiety and depressive symptoms are likely to be secondary to the eating disorder itself, rather than of primary significance.
The Influence of Seizure Type and Medication on Psychiatric Symptoms in Epileptic Patients
Authors: Brown S. W. , McGowan M. E. L. , Reynolds E. H.
Published: August 2008

The influence of type of seizure and medication on psychological disability was assessed using the Standard Psychiatric Interview in matched epileptic patients. In comparison to patients with idiopathic tonic-clonic seizures, those with temporal lobe epilepsy complained of more irritability and impaired concentration, and were rated as more depressed and slowed up. Compared to patients on phenytoin, those on carbamazepine complained of more sleep disturbance and were more likely to be taking an hypnotic.
A Model of Brain Function: Its Implications for Psychiatric Research
Authors: Wexler Bruce E.
Published: August 2008

Much current research in psychiatry proceeds in the absence of an integrated model of brain function. It is based instead on the effort to relate clinical syndromes to single, localised abnormalities in the brain. Such an approach is inconsistent with existing data, inadequate for linking research findings with clinical practice, and, probably, fundamentally misdirected. A model of brain function is presented that is based on Luria's notion of cerebral functional systems and on the proposition that the neural substrates of emotion are those processes that integrate different brain regions. Some of the implications of this model for research are discussed.
Ventricular Size and CSF Transmitter Metabolite Concentrations in Severe Endogenous Depression
Authors: Standish-Barry H. M. A. S. , Bouras N. , Hale A. S. , Bridges P. K. , Bartlett J. R.
Published: August 2008

The relationship between neurotransmitter metabolite concentrations and measurements of ventricular size on CAT scans and pneumoencephalographs was investigated in 15 patients with severe affective disorder. An association was identified between reduced levels of plasma free tryptophan and ventricular enlargement and also between raised ventricular CSF levels of 5 HIAA and ventricular enlargement.
Psychiatric Disorder, Drinking and Alcoholism:
Authors: Bernadt Morris W. , Murray Robin M.
Published: August 2008

We studied 371 psychiatric admissions in an attempt to relate primary and secondary diagnosis, psychopathology, and stated reasons for drinking to alcohol consumption and alcoholism. No diagnostic group other than the alcoholics drank significantly more than the mean, and the schizophrenics drank less. One-third of those with bipolar and minor depression increased their drinking in the month before admission, but this was almost offset by those with similar diagnoses who drank less. Alcoholism, though not alcohol consumption, was related to a high prevalence of affective syndromes, but these did not amount to secondary diagnoses. Drinking for ‘escape reasons' was significantly associated with consumption levels, but the reasons patients gave did not correspond well with the objective presence or severity of the associated psychiatric symptoms.
Social Determinants of Self-Poisoning
Authors: Daly Maura , Conway Miranda , Kelleher Michael J.
Published: August 2008

The non-fatal deliberate taking of overdoses in Cork city during 1982 was investigated from records in the general hospitals. In one of the hospitals, those attending after an overdose were personally interviewed. For both sexes, the greatest incidence of overdoses was in the younger groups; for females, there was a seasonal variation. Those taking overdoses were grouped by electoral wards, and the social characteristics of these wards determined. The frequency varied greatly throughout the city; some wards, particularly in corporation northern estates and part of the city centre, showed a rate of up to three times the average; these areas were the most likely to show social deprivation.
Homosexuality in Monozygotic Twins Reared Apart
Authors: Eckert Elke D. , Bouchard Thomas J. , Bohlen Joseph , Heston Leonard L.
Published: August 2008

We describe six pairs of monozygotic twins, in which at least one member of five pairs were homosexual, and one of the remaining pair was bisexual, from a series of 55 pairs, reared apart from infancy; all the female pairs were discordant for homosexual behaviour. This and other evidence suggest that female homosexuality may be an acquired trait. One male pair was concordant for homosexuality, while the other was not clearly concordant or discordant; this suggests that male homosexuality may be associated with a complex interaction, in which genes play some part.
The Relationship between Alcoholism and Neurosis:
Authors: Mullan M. J. , Gurling H. M. D. , Oppenheim B. E. , Murray R. M.
Published: August 2008

The twin register of the Maudsley Hospital was used to select a series of monozygotic (MZ) and same-sexed dizygotic (DZ) twins who had been given an ICD8 diagnosis related to alcoholism. They and their co-twins were traced. Medical and drinking histories were compiled (from records and by interview) for 56 twin-pairs, to permit current and retrospective diagnosis of any neurotic disorders. RDC diagnoses of panic disorder generalised anxiety disorder, obsessive–compulsive disorder and phobias were more common in the alcoholic probands and the co-twins who were also alcoholics than in the normal-drinking co-twins. The Eysenck Personality Questionnaire (EPQ) and the Severity of Alcohol Dependence Questionnaire (SADQ) were completed by 54 individuals. Neuroticism scores were significantly higher for both male and female alcoholics than for their normal-drinking co-twins; and intra-pair differences in neuroticism were significantly correlated with intra-pair differences in severity of dependence. These results suggest that both clinically diagnosed neurotic illness and high neuroticism scores are more often a consequence than a cause of alcoholism.
Late-Onset Folie Simultanée in a Pair of Monozygotic Twins
Authors: Kendler Kenneth S. , Robinson Gillian , McGuire Mary , Spellman Mary P.
Published: August 2008

A case-report is presented of folie simultanée in a pair of female monozygotic twins with onset at the remarkable age of 81. The twins demonstrated no evidence of dementia or other psychopathology apart from delusions. Folie simultanée in monozygotic twins provides a model example of the potential role of genotype-environment correlation in the etiology of psychiatric illness.
The AMDP-System in Clinical Psychopharmacology
Authors: Bobon D. , Woggon B.
Published: August 2008

The AMDP-System has been developed in Europe by the Association for Methodology and Documentation in Psychiatry the standardised documentation of psychiatric files and for the measurement of change in drug trials. It is increasingly used in the French-speaking and German-speaking countries by clinical psychopharmacologists for teaching classical German psychopathological concepts to students and for the multicentre and multifactorial evaluation of drug changes. The AMDP-System consists of three anamnestic forms and of two comprehensive rating scales on present psychopathology (100 items+ write-in items) and somatic complaints (40 items+write-in items).
Deficits of Chronic Schizophrenia in Relation to Long-Term Hospitalisation
Authors: Mathai P. John , Gopinath P. S.
Published: August 2008

Eighty chronic schizophrenic and 16 manic-depressive psychotic patients conforming to Research Diagnostic Criteria were examined in terms of their mental state, cognitive functioning, current behaviour, and neurological status. They comprised out-patients, day-care patients, and long-stay in-patients belonging to two mental hospitals with different social conditions. Assessed deficits were not significantly related to record variables such as age, duration of Illness, duration of hospitalisation, or treatment received. Analysis of the different groups of patients reveals that long-term hospital care has had little effect on the deficits of chronic schizophrenia, and suggests that these are integral features of the disease process.
Respiratory Control in the Treatment of Panic Attacks:
Authors: Salkovskis Paul M. , Jones David R. O. , Clark David M.
Published: August 2008

A case series is reported in which nine patients who experienced phobic and/or non-phobic panic attacks were given a cognitive-behavioural treatment based on the supposition that catastrophic interpretations of sensations produced by hyperventilation played an important role in their attacks. Large and rapid reductions in panic attack frequency and questionnaire report of fear were observed. Patients' resting pCO2 was significantly lower than controls and rose to normal levels during treatment.
At Risk Drinking among General Practice Attenders:
Authors: King Michael B.
Published: August 2008

In a sample of attenders screened at a London health centre, 13.6% of male and 1.3% of female respondents were drinking at levels considered unsafe by the Royal College of Psychiatrists, and yet revealed few indicators to alert the general practitioner in terms of classical alcohol-related disability. Males, the unemployed, and those of Scottish or Irish origin were over-represented in the ‘at risk’ group. A significant proportion viewed their general practitioner as a source of help.
Depression Influences Intellectual Impairment in Stroke Patients
Authors: Robinson Robert G. , Bolla-Wilson Karen , Kaplan Edith , Lipsey John R. , Price Thomas R.
Published: August 2008

Patients with ischaemic lesions of the left cerebral hemisphere were examined for depression and intellectual impairment: in non-depressed patients, the severity of impairment was related to both lesion volume and location, as assessed by CT scan analysis. Cognitive impairment in patients with major depression was greater than predicted by lesion volume alone, and when patients were matched for severity of impairment, depressed patients had smaller lesion volumes than the non-depressed. After six months, non-depressed patients had significantly less cognitive impairment than depressed patients who showed no improvement. Both depression and lesion volume were significantly and independently related to cognitive impairment. These findings suggest that post-stroke depression can produce a true dementia in Its own right, and that treatment of post-stroke depression might benefit cognitive function.
Development of Scales to Measure Treatment Attitudes in Psychiatry
Authors: Wilkinson Greg , Williams Paul
Published: August 2008

We used multiple regression analysis to modify and shorten two scales for measuring practitioners' attitudes to psychotherapy and drug therapy. The resulting scales have been combined in a 21-item questionnaire (Treatment Attitudes in Psychiatry Scales (TAPS)) which is brief and easy to use, and should have wide application in psychiatry. The results of a concurrent validation of the scales, using two large groups of consultant psychiatrists who were members of either the Biological Psychiatry or Psychotherapy Section of the Royal College of Psychiatrists, show the extent to which their attitudes to psychotherapy or drug therapy tend to overlap. Polarisation of attitudes was more evident in the results from the Biological Psychiatry Section. A method is described by which scores obtained with the TAPS can readily be compared with those obtained by the criterion groups.
Dominance Hierarchies in Psychotherapy Groups
Authors: Kennedy James L. , MacKenzie K. Roy
Published: August 2008

For a social group to develop, two opposing adaptive processes must be reconciled—mechanisms for developing cohesion and mechanisms for establishing a dominance hierarchy. The formation of stable groups provides significant evolutionary advantages: a source of protection, increased reproductive opportunities, and a larger store of survival strategies than any one individual could encompass. A recent theory of human evolution (Reynolds, 1981) stresses that social behaviour would seem to be the most likely single cause of the origin of human intelligence, if one origin must be isolated. Current interest in the biological basis of behaviour has been focused particularly on specific diagnostic categories and biochemical mechanisms. This paper reviews a different research tradition, based on ethological principles, and applies the findings to an understanding of human group behaviour.
Psycho-Social Predictors of Chronicity in Depressed Patients
Authors: Hirschfeld R. M. A. , Klerman G. L. , Andreasen N. C. , Clayton P. J. , Keller M. B.
Published: August 2008

Nineteen patients with an episode of major depressive disorder who did not recover within two years of prospective follow-up were compared with an equal number who recovered within a year of the initial evaluation and remained well through the two-year follow-up date. The groups were individually matched for age, sex, primary/secondary status, and prior duration of episode. The only psycho-social variable that predicted chronicity was increased neuroticism on self-report personality inventories administered during the index evaluation. Early loss, recent life events, and recent social supports were not predictive of outcome.
The Nottingham Experiential Day in Psychotherapy:
Authors: Aveline Mark , Price Jane
Published: August 2008

A prime objective in teaching psychotherapy to medical students is to convey a practical understanding of what happens and a sense of the pleasure and responsibility of working with another person to improve the quality of their relationships. In Nottingham an experiential day was developed during the psychiatry clerkship; the teaching is by doing rather than describing, while spontaneity and individual expression are encouraged; the experience is valued by most and forgotten by none; it would be improved by a second experiential day or by a weekly forum for discussion of the personal and patient-care issues raised.