bluuebunny/crossref_metadata_2025 huggingface dataset:
Bulimia nervosa: a four- to six-year follow-up study
Authors: Hsu L. K. George , Sobkiewicz Theresa A.
Published: July 2009

SYNOPSIS

A consecutive series of 45 female bulimic patients treated by one of us was followed four to six years after termination of treatment. Thirty-five (78 %) were successfully followed, six refused to participate in the study and four were untraced. At least seven (16%) had diagnosable bulimia nervosa at follow-up, and at least another seven had a subclinical form of the disorder during the six months prior to follow-up. Relapse into anorexia nervosa was uncommon, and the severity of the bulimic features had improved even among those still diagnosable as having the disorder. Affective disturbances were common among those who were bulimic. The findings were discussed in terms of the intermediate term outcome of the disorder and its identity as a clinical entity.
Hormones and sexual behaviour
Authors: Bancroft John
Published: July 2009

Psychiatrists react to the complexity of human nature in two principal ways; they either take it as justification for their ascientific humanism, or, with unwavering optimism, they accept the challenge and seek scientific explanations. ‘Hormones and behaviour’ has been a favourite hunting ground for such hopefuls, and it is perhaps the sexual part of our natures that we are most ready to attribute to chemistry.
The inner side of wisdom: suicide in early modern England
Authors: MacDonald Michael
Published: July 2009

Synopsis

This essay traces the shifting perception of the nature and prevalence of suicide in early modern England. Suicide is presented as one form of deviance contemporaries recognized and is used to illuminate the history of mental disorder in its social and intellectual context.

Daft Meg [an idiot and suicide] was a sort of household familiar among us, and there was much like the inner side of wisdom in the pattern of her sayings, many of which are still preserved as proverbs.

John Galt, Annals of the Parish, p. 126.
Cyclic AMP in cerebrospinal fluid of manic and depressive patients
Authors: Post Robert M. , Cramer Hinrich , Goodwin Frederick K.
Published: July 2009

Synopsis

Cyclic 3′5′-adenosine monophosphate (c-AMP) was measured in cerebrospinal fluid (CSF) of manic and depressive patients with and without probenecid administration both before and during treatment with various psychotropic drugs. Oral probenecid (100 mg/kg) produced substantial c-AMP accumulations in CSF suggesting a probenecid-sensitive transport mechanism for c-AMP. Baseline and probenecid-induced accumulations of c-AMP were not significantly different in manic and depressed patients, while baseline levels in depressed patients were higher than those in neurological controls. Imipramine, amitriptyline, lithium, tryptophan, and electroconvulsant therapies did not significantly alter levels or accumulations of c-AMP in CSF of depressed patients.
Schizophrenia succeeded by affective illness: catamnestic study and statistical enquiry
Authors: Sheldrick C. , Jablensky A. , Sartorius N. , Shepherd Michael
Published: July 2009

Synopsis

On the basis of data derived from a long-term follow-up of 12 cases and a 2-year follow-up of the International Pilot Study of Schizophrenia it is suggested that some patients with remitting schizophrenic illnesses can subsequently present clear-cut affective disorders. The implications of these findings are discussed.
The late effects of necrotizing encephalitis of the temporal lobes and limbic areas: a clinico-pathological study of 10 cases
Authors: Hierons R. , Janota I. , Corsellis J. A. N.
Published: July 2009

Synopsis

The clinical and neuropathological features are reported of 10 patients who had suffered, usually for several years, from the after effects of an acute or sub-acute necrotizing encephalitis of the limbic grey matter and of the adjacent temporal lobes. Emphasis is laid on the memory disturbance and on the behavioural and emotional aberrations that tended to occur and that are in some ways reminiscent of the Klüver–Bucy syndrome.
Dichotic listening and allusive thinking
Authors: Armstrong M. S. , Blaszczynski A. P. , McConaghy N.
Published: July 2009

Synopsis

Previous work suggests that allusive thinkers have a broader attentional process associated with weak central inhibition. The method of dichotic stimulation was used to investigate this concept. Sixty-three university students completed a battery of tests including 2 dichotic listening tasks. The Object Sorting Test was used as a measure of allusive thinking.

Allusive thinkers showed a trend towards impaired shadowing performance. Mislabelling of shadow as distractor words andvice versa, on recall and recognition tasks, showed the strongest correlation with allusive thinking. Such mislabelling was considered to reflect impaired discrimination learning, and provides further support for a hypothesis relating allusive thinking to weak Pavlovian central inhibition.
Responses of Australian patients with gynaecological disorders to the General Health Questionnaire: a factor analytic study
Authors: Worsley A. , Walters W. A. W. , Wood E. C.
Published: July 2009

Synopsis

One hundred and twenty-seven out-patients attending a gynaecology clinic completed the General Health Questionnaire (GHQ, 60-item version) and a role problems checklist (RPCL). Principal factors analysis of the GHQ yielded 8 factors which were named: poor performance (which accounted for 63·3 % of total variance), depression-anxiety, sleep-disturbance, anhedonia-anergia, loss of confidence, general illness, social dysfunction and headache. These results were compared with previous principal components analyses of the GHQ (Goldberg, 1972; Goldberget al.1976).

A multiple regression analysis indicated that age and 7 of the 8 factors were significantly related to the number of role problems reported by the patients. However, it appears that psychiatric distress (as measured by the GHQ) and role problems were only related to a small degree (multipleR2=12·69% only).
Preliminary Communication Thyro-endocrine pathology, obstetric morbidity and schizophrenia: survey of a hundred families with a schizophrenic proband
Authors: MacSweeney David , Timms Pauline , Johnson Anthony
Published: July 2009

Synopsis

This preliminary communication reports that the mothers of 104 schizophrenic patients had: (1) a significantly higher incidence of thyroid disease than a carefully matched control group; (2) significantly more abortions, still-births and greater infant mortality. The findings and possible relevance of thyroid disease to schizophrenia are discussed. Three prospective studies currently in progress are outlined.
Preliminary Communication Absence of cardiac deceleration in a signalled escape paradigm: a psychophysiological deficit in chronic schizophrenia
Authors: Waddington John L. , Macculloch Malcolm J. , Schalken Marie L. , Sambrooks Jean E.
Published: July 2009

Synopsis

Fourteen chronic male schizophrenic patients and six male control subjects were com pared in an escape paradigm involving temporal warning of the presentation of an aversive tone stimulus to which an escape response was to be made. The characteristic heart rate deceleration shown immediately prior to the aversive stimulus by control subjects was absent in the schizophrenic group. Further features of this novel test paradigm distinguished the control and schizophrenic groups. This psychophysiological test procedure may be fruitful for schizophrenia research.
The diagnosis of ‘hysteria’
Authors: Reed John L.
Published: July 2009

Synopsis

A study of 120 inpatients diagnosed as suffering from hysteria is presented and the validity of the diagnosis questioned. Clinical study showed that 13% showed only hysterical symptoms, 33% showed hysterical symptoms occurring with affective symptoms, 28% showed affective symptomatology only, and the remainder were either of other or uncertain diagnostic grouping. It is concluded that the 13% are suffering from a condition that can only be diagnosed as hysteria.
Hysteria and parental psychiatric illness
Authors: Cloninger C. Robert , Guze Samuel B.
Published: July 2009

Synopsis

A two-generation study of 46 families of convicted women felons showed that the daughters of sociopathic fathers had a significantly higher prevalence of hysteria than did the daughters of other fathers. The differences were significant both for daughters with hysteria plus sociopathy and for daughters with hysteria without sociopathy. The association was independent of assortative mating between sociopathic men and women with hysteria or sociopathy.
Severity of symptoms of psychiatric outpatients: use of the General Health Questionnaire in hospital and general practice patients
Authors: Sims A. C. P. , Salmons P. H.
Published: July 2009

Synopsis

A sample of 91 new referrals to a community based psychiatric outpatient service was compared with a cross-matched control sample of 107 patients attending the general practitioner's surgery. The subjects in both groups completed the General Health Questionnaire and there was a very marked difference between the scores of the two groups. Seventy-five of the psychiatric group had a high score on the questionnaire, and a large number of these were extremely high, while 74 of the general practice group had a low score. The ‘false’ positives and negatives are discussed. It is considered that the validity of this questionnaire as a screening device for demonstrating psychiatric morbidity and severity in general practice is further established in this study by showing that in matched samples the expected psychiatric morbidity in general practice can be compared with the much greater morbidity in psychiatric outpatient referrals. For the psychiatric sample more patients showed high scores and these tended to be much higher.
Influence of psychiatric training, medical qualification, and paramedical training on the rating of abnormal behaviour
Authors: Copeland J. R. M. , Kelleher M. J. , Gourlay A. J. , Smith A. M. R.
Published: July 2009

Synopsis

The psychiatric ratings, using the In-Patient Multi-dimensional Psychiatric Scale, of (1) a group of over 200 psychiatrists from the British Isles, (2) third year psychology students, (3) trainee sister tutors, (4) general practitioners attending a postgraduate course in psychiatry, and (5) a group of new registrars at the Maudsley Hospital, were compared. The first hypothesis, that, whereas the non-psychiatrists would rate similar levels of symptoms, the psychiatrists would tend to rate lower than other professional groups, was upheld. The second, that the pattern or profile of symptoms as shown by the IMPS syndromes would differ little between the groups, was also upheld. The third hypothesis, that because of their special training in the recognition of symptoms, psychiatrists would tend to show greater intra-group agreement on the levels of symptoms than the other groups, was not upheld. Some possible reasons for the findings are discussed. The importance for a screening schedule, designed to be used by non-psychiatrists for the detection of psychiatric illness, of the finding that non-psychiatrists rate higher levels of symptoms than psychiatrists, is also discussed.
Psychiatric symptoms duringL-dopa therapy for Parkinson's disease and their relationship to physical disability
Authors: Mindham R. H. S. , Marsden C. D. , Parkes J. D.
Published: July 2009

Synopsis

Fifty patients attending a neurological outpatient clinic for Parkinson's disease were assessed by standardized methods for both physical and psychiatric symptoms. The patients then received treatment withL-dopa,L-dopa with carbidopa or anticholinergic drugs and/or amantadine. During the following six-month period the subjects were assessed at intervals, both physically and psychiatrically. Forty patients were followed up for the full six-month period. The severity of physical signs and affective symptoms was shown to be significantly related at several stages of the investigation. Initially, the patients showed a high psychiatric morbidity. During treatment, 22 patients developed a depressive disorder, 12 of which had a history of previous depressive episodes. By contrast, of the 11 patients who showed very few affective symptoms during follow-up, none had a history of depression. Of the 22 patients with a depressive disorder, only two were in the anticholinergic/amantadine group, compared with nine and 11 in the other groups.L-dopa was not an effective antidepressant agent. The probable relevance of the findings of the study to the management of patients with Parkinson's disease is outlined.
A survey of social inadequacy among psychiatric outpatients
Authors: Bryant Bridget , Trower Peter , Yardley Krysia , Urbieta H. , Letemendia F. J. J.
Published: July 2009

Synopsis

An investigation into the extent and nature of social inadequacy among outpatients diagnosed as neuroses and personality disorders was undertaken on patients aged 18–49 attending one clinic over a six-month period. A feature of this survey was that each patient took part in a standard social interaction test, and their performance was assessed by two psychologists. A relatively high proportion of patients, one in six on the most conservative estimate, and probably over one in four, were judged by psychologists and psychiatrists to be socially inadequate, and the results showed a clear pattern of behavioural, social and personality factors associated with these judgements. Implications for assessment and treatment are discussed.
Age and parasuicide (‘attempted suicide’)
Authors: Kreitman Norman
Published: July 2009

Synopsis

A one-year cohort of parasuicide patients (n= 822) was divided into three age groups, subdivided by sex where indicated. Systematic comparisons of the groups were made, and significant discrepancies validated using a second cohort of patients. A number of social, demographic and clinical differences were found, as well as some unexpected similarities. The rates for subsequent (completed) suicide were conspicuously different in the six age-sex subgroups.
The relationship between different evaluations of drinking behaviour
Authors: Bowden Paul
Published: July 2009

Synopsis

Prisoners' attitudes to their drinking behaviour, although largely accurate, minimize problems in terms of other assessments made at interview. Semantic differences are apparent in the use of the terms ‘heavy’ and ‘problem’ as descriptions of drinking behaviour; thus men who admit heavy but deny problem drinking are often reported to be problem drinkers by their family and myself. There is close agreement between the family's reported attitude to a man's drinking and the assessment made in a structured psychiatric interview.
Treatment or punishment? A nineteenth-century scandal
Authors: Patch Ian Lodge
Published: July 2009

Synopsis

In psychiatry the relationship between treatment and punishment is variable and ambiguous. It has always been possible to employ physical methods of treatment for punitive ends, against which the introduction of liberal policies is no complete safeguard. Indulging one's personal animosities towards a difficult or violent patient has always been condemned, but the motives of a psychiatrist may be particularly easily misconstrued. These inherent risks in a psychiatrist's situation are illustrated by a case from the 19th century.
Schizophrenia before 1800? The case of the Revd George Trosse
Authors: Hare Edward
Published: July 2009

Synopsis

Trosse's account of his life has been described as one of the strangest pieces of realism in the English language. It gives a detailed description of the author's personal experience of three episodes of psychotic disorder during the years 1656–7. The disorder has been considered an early instance of schizophrenia, but evidence is presented here to suggest that a more plausible diagnosis was alcoholic psychosis and affective disorder.
Biochemical hypotheses on antidepressant drugs: a guide for clinicians or a toy for pharmacologists?
Authors: Garattini Silvio , Samanin Rosario
Published: July 2009

Synopsis

The development of knowledge about the mechanism of action of tricyclic and the so-called ‘atypical’ antidepressants (AD) is reviewed. The discovery of clinically active antidepressants with little or no effect on noradrenaline or serotonin uptake has disproved the widely accepted concept that inhibition of monoamine uptake is a prerequisite for antidepressant activity. Another serious objection to this hypothesis is that blockade of monoamine uptake occurs in a matter of minutes after administration while 2–3 weeks of repeated treatment are necessary for the clinical AD effect. Nevertheless, the effect of repeated treatment with AD is compatible with the hypothesis that changes in central monoamine transmission are involved in the clinical activity of these drugs. Major changes in monoamine function after repeated treatment with AD include: desensitization and reduced density of noradrenaline receptors coupled to the adenylcyclase system, opposite changes in the sensitivity of α1(increased) and α2-adrenoreceptors (decreased), down regulation of serotonin2receptors and complex changes in the behavioural and electrophysiological responsiveness to serotonin agonists, subsensitivity of presynaptic dopamine receptors and enhanced activity of the mesolimbic dopamine system, decreased and increased density of GABA-A and GABA-B receptors respectively and down regulation of [3H]benzodiazepine binding.

It remains to be clarified whether some of these changes have larger roles than others or whether they all contribute to the AD activity. An important role of dopamine in the activity of AD drugs is suggested by findings in the forced swimming test, whereas both catecholamines seem to be involved in the attenuation of escape deficit provoked by inescapable shock (learned helplessness). No clear evidence for a role of serotonin (with the possible exception of serotonin1Areceptors) or GABA has been obtained in these experimental models of depression. The general validity of these findings obviously rests on the assumption that these models represent significant aspects of human depression.
Obstetric complications and schizophrenia: a computed tomographic study
Authors: Owen Michael J. , Lewis Shôn W. , Murray Robin M.
Published: July 2009

Synopsis

All patients aged 16–50 years who had been discharged from the Maudsley Hospital over a 4-year period with a diagnosis of schizophrenia were ascertained retrospectively. Case records were rated blindly for a history of obstetric complications (OCs). Sixty-one patients who satisfied the RDC for schizophrenia had undergone CT scanning. Those with a definite history of OCs presented at an earlier age. In this group widening of cortical sulci and fissures was more strongly correlated with VBR than in subjects without OCs. Moreover, large VBRs when accompanied by widened cortical sulci and fissures occurred more commonly in subjects with OCs than in those without. These results support the hypothesis that OCs, or a factor associated with them, lead to brain damage of aetiological significance in some cases of schizophrenia.
Structural brain changes in patients with anorexia nervosa
Authors: Dolan R. J. , Mitchell J. , Wakeling A.
Published: July 2009

Synopsis

Twenty-five patients with anorexia nervosa were compared with 17 normal healthy control subjects in terms of their cerebral computed tomographic (CT) scan appearances. The patients displayed significantly greater ventricular and sulcal enlargement when compared to control subjects. There were no relationships between the CT scan appearance and clinical indices of illness severity or weight loss in the patient group. In 14 patients who had repeat scans after attaining normal body weight, no significant change was observed in the ventricular appearance, but there was a significant lessening in the degree of sulcal widening.
The relationship between breast feeding persistence, sexuality and mood in postpartum women
Authors: Alder Elizabeth , Bancroft John
Published: July 2009

Synopsis

91 women were assessed early in pregnancy and again 3 and 6 months postpartum. Women who persisted in breastfeeding were less neurotic on the EPI but did not differ from artificial feeders in psychiatric history or sexuality before pregnancy. Breast feeders showed greater impairment of sexuality and slightly more depression at 3 months postpartum. These differences had largely disappeared at 6 months. Possible reasons for these negative effects of breast feeding are discussed and are likely to be multifactorial.
The transition to parenthood in dual-earner couples
Authors: Lewis Suzan N. C. , Cooper Cary L.
Published: July 2009

Synopsis

The impact of the transition to parenthood for dual-earner couples was examined in a longitudinal study. Data were collected by questionnaire from couples expecting their first child, during pregnancy and after maternity leave, and from childless couples at two separate time points. The impact of the transition was minimal overall, although women experienced more pressure than men and there were some cases of extreme stress. New single-earner parents reported a greater decline in life satisfaction than dual-earners.
Henry Maudsley – psychiatrist, philosopher and entrepreneur
Authors: Turner Trevor
Published: July 2009

Synopsis

Despite his acknowledged pre-eminence among British psychiatrists of the 19th century, Henry Maudsley (1835–1918) remains a ‘shadowy figure’, a name known through the Hospital and annual lecture funded by his beneficence. Apart from the homage paid by Sir Aubrey Lewis in 1951, there has been no recent attempt at any biography nor any critical reappraisal of Maudsley's life and work. On the basis of reviewing his role in the Medico-Psychological Association (MPA), his rather pessimistic and degenerationist philosophy, his undoubted wealth and his ‘hypercritical nature’, it is possible to define an alternative view of his significance and influence.

‘…comical, almost pitiable at times, is the ludicrous display of vanity by men of great eminence…they leave behind them carefully preserved letters and elaborate memoirs of what they thought and felt’. (Maudsley, 1918)
Response to drugs in schizophrenia: the influence of family history, obstetric complications and ventricular enlargement
Authors: Nimgaonkar V. L. , Wessely S. , Tune L. E. , Murray R. M.
Published: July 2009

Synopsis

A prospective study of antipsychotic drug treatment showed no difference in response between schizophrenic in-patients with or without a familial predisposition to the illness (N = 53). All patients received at least 600 mg chlorpromazine equivalents antipsychotic medication for 6 weeks. Ventricle brain ratios, ratings of cortical sulcal widening and a history of obstetric complications also failed to account for the variability, but early age of onset was associated with unsatisfactory response.
A prospective study of severe mental disorder in Afro-Caribbean patients
Authors: Harrison Glynn , Owens David , Holton Anthony , Neilson David , Boot Daphne
Published: July 2009

Synopsis

Several previous studies have reported increased rates of schizophrenia among Afro-Caribbean immigrants, although doubt has been cast upon the value of case-note diagnoses and retrospective case-finding. A prospective study was therefore undertaken, including all patients of Afro-Caribbean ethnic origin with a first onset psychosis presenting to the psychiatric services from a defined catchment area. Utilizing several diagnostic classifications, rates for schizophrenia were found to be substantially increased in the Afro-Caribbean community, and especially in the ‘second generation’ British born. Mode of onset and symptom profiles of psychoses suggest that atypical syndromes, and by implication ‘misdiagnoses’, do not account for reported higher rates of schizophrenic illness in these patients.
Autobiographical memory in depression
Authors: Williams J. M. G. , Scott J.
Published: July 2009

Synopsis

Recent research has shown that suicidal patients are not only biased in the speed with which they can remember positive and negative events from their past, but that they also find it more difficult to be specific in their memories. That is, they tend to recall sequences of events, or time periods, rather than single episodes. This tendency has been found to be more evident with positive than with negative events. This paper examines whether the same phenomenon can be observed in patients with a diagnosis of primary Major Depressive Disorder. Twenty depressed patients and twenty matched controls were presented with positive and negative cue words and asked to retrieve specific personal memories. Results showed that depressives (unlike controls) took longer to respond to positive than to negative cues. In addition, the depressed patients were less specific in their memories, especially in response to positive cues. These results are explained within a ‘descriptions’ theory of autobiographical memory, and the remedial implications are discussed.
The development of a computerized assessment for minor psychiatric disorder
Authors: Lewis Glyn , Pelosi Anthony J. , Glover Eric , Wilkinson Greg , Stansfeld Stephen A. , Williams Paul , Shepherd Michael
Published: July 2009

Synopsis

This paper describes the development, validation and use of a computerized assessment for minor psychiatric disorder based on the Clinical Interview Schedule (CIS; Goldberg et al. 1970). There was good agreement between the computerized assessment and the CIS administered by psychiatrists, both in assessing overall severity and in defining ‘cases’ of psychiatric disorder. Individual symptoms elicited by the computer and the CIS were compared, and the levels of agreement found were similar to those from inter-observer studies of standardized interviews. Subjects from a variety of non-psychiatric settings regarded the assessment as acceptable, accurate and easy to use. It is concluded that this computerized assessment of neurotic symptoms is valid and reliable. It eliminates observer bias, it is an efficient use of research resources and it may have clinical applications in primary care.
Factors related to successful outcome in the treatment of sexually unresponsive women
Authors: Whitehead Antonia , Mathews Andrew
Published: July 2009

Synopsis

Couples in whom the main complaint was of a lack of female sexual response were treated using a practical counselling approach. A number of pre-treatment measures were studied to determine which factors were predictive of treatment outcome. While age and chronicity were not predictive, the quality of the general relationship and measures of sexual attitude did give useful indications of likely outcome.
The early development of Kraepelin's ideas on classification: a conceptual history
Authors: Berrios G. E. , Hauser R.
Published: July 2009

Synopsis

Psychiatry still lives in a Kraepelinian world and scholarship on the work of Kraepelin has consequently been unhistorical. Selective exegesis of the various editions of his textbook has led to a rigid view of his contribution. However, Kraepelin lived and wrote during an important period of European intellectual history and his work can only be understood against this background. This paper analyses the development of his views in terms of the ‘Research Programme’ he planned early in his life and whose objective was the creation of a stable description and classification of the psychoses. This Kraepelin eventually achieved by longitudinally studying patient cohorts in terms of methodological criteria such as illness course and incurability. In the event, this methodology allowed him to identify by correlation ‘clinical pictures’ that both represented the ‘essence’ of the disease and provided a taxonomic criterion. Although avowedly atheoretical, Kraepelin thus managed to construct (influenced by Kahlbaum and Wundt) an empirical support for his Kantian categorization of the psychoses. A discussion of the cultural variables that moulded these ideas is included.
Expressed emotion research in schizophrenia: theoretical and clinical implications
Authors: Kuipers Liz , Bebbington Paul
Published: July 2009

Synopsis

The expressed emotion (EE) measure is a robust predictor of relapse in schizophrenia. At least twelve studies from a range of cultures have now shown this, although the authors of one maintain their findings are the result of confounding factors. A thirteenth study which failed to demonstrate a predictive effect was seriously weakened by methodological defects. There is now also evidence for the construct validity of EE, which has been shown to reflect ongoing family interactions. High EE relatives display less effective coping responses, and may adversely affect the patient by creating an unpredictable environment. EE may change with time, and probably reflects the interaction of external stresses, the real problems with the patient, and inappropriate coping responses. The association of high EE with arousal in the patient, as indicated by skin conductance abnormalities, has now been replicated. Although the EE phenomenon can be subsumed under a vulnerability-stress model, the way in which it might mediate relapse has not as yet been specified. Interventions have been successful in reducing relapse, and do so by increasing the tolerance and coping skills of the relatives, and by establishing more realistic expectations. As most have also involved the patient in the process of treatment, they have not fully resolved the question of causal direction.

Future studies will clarify these issues, but will not detract from the value that EE has already had in energizing research. It has also provided a framework within which clinicians have begun to recognize and deal with the disabling problems that beset schizophrenic patients and their families.
A community study of minor psychiatric morbidity in Taiwan
Authors: Cheng Tai Ann
Published: July 2009

Synopsis

A community study of minor psychiatric morbidity (MPM) was carried out on three population samples aged 15 and above randomly selected from rural (Yenpu), suburban (Chishan), and urban (Kaohsiung) communities (N= 350 for each) in Taiwan. A two-stage case finding strategy was applied with a newly developed and validated screening questionnaire (CHQ), and a modified Chinese version of the Clinical Interview Schedule (CIS-CV). The total response rate was 99·4% and there was no time lag between the CHQ screening and the second stage clinical interview conducted by a psychiatrist. The weighted validity of the CHQ was found to be acceptable (sensitivity 69·6%, specificity 94·8%, misclassification rate 11·4%). The overall weighted prevalence rate was 18·0% for men and 33·3% for women. Both the CIS and the CHQ data are used as the morbidity indices to investigate the sociodemographic risk factors of MPM. A higher risk of MPM, which occupied 92% of the total morbidity, was found to be associated with women aged 35 and above, the unemployed men, and the lower socioeconomic status after linear modelling.
Marriage, motherhood and psychiatric morbidity in New Zealand
Authors: Romans-Clarkson S. E. , Walton V. A. , Herbison G. P. , Mullen P. E.
Published: July 2009

Synopsis

The prevalence of psychiatric disorder, as assessed by both the GHQ-28 and the short PSE, is described for a random community sample of New Zealand women. In contrast to previous studies, married and widowed women and mothers showed lower rates than the never married and childless women. A plausible explanation is provided by available analysis of New Zealand gender roles. Such an explanation would reconfirm the importance of socio-cultural factors in community psychiatric disorder.
Cannabis affects the severity of schizophrenic symptoms: results of a clinical survey
Authors: Negrete Juan C. , Knapp Werner P. , Douglas Donald E. , Smith W. Bruce
Published: July 2009

Synopsis

Data on the history of cannabis use and a spot urine test for cannabinoids were obtained for 137 schizophrenics in treatment. Subjects who were using cannabis during the 6-month observation period presented with a significantly higher degree of delusional and hallucinatory activity than those who did not. Moreover, the group using cannabis made a higher average number of visits to the hospital during the same period. The status of cannabis use appeared to contribute to such variance more than did other relevant factors (age, stage of the illness, amount of medication prescribed, occasional use of other psychoactive substances).
The contributions of sex and drinking history to the CT brain scan changes in alcoholics
Authors: Jacobson Robin
Published: July 2009

Synopsis

Consecutive series of male and female alcoholics, Alcoholic Anonymous (AA) members and controls were examined by interview and with a CT brain scan. Male controls were shown to have larger CT brain parameters than healthy females of the same age. Female alcoholics revealed equivalent CT scan abnormalities, apart from less sulcal widening, after a markedly shorter drinking history and at a lower estimated peak alcohol consumption than male alcoholics. The CT scan findings persisted after accounting for body weight and after matching for age and length of drinking history. The CT scan parameters of female AA members approached control values more completely and after briefer abstinence than did those of male AA members. Methodological problems and sex differences in selection and other processes are discussed. The findings are consistent with sex differences in the vulnerability of the brain to alcohol toxicity, and in its recovery with abstinence.
Measuring psychiatric disorder among Southeast Asian refugees
Authors: Beiser Morton , Fleming Jonathan A. E.
Published: July 2009

Synopsis

Four measures of mental health – Panic, Depression, Somatization and Well-Being – have been developed for use in a population of Southeast Asian refugees. The scales, a product of work with 1348 refugees, demonstrate conceptual significance, good reliability, concurrent validity and stability of structure across samples. They are culturally sensitive, enabling intra-cultural study as well as screening for clinical purposes. The measures also permit comparisons, for research purposes, with non-Asians.
Loss of parent in childhood and adult psychiatric disorder: the role of lack of adequate parental care
Authors: Harris Tirril , Brown George W. , Bifulco Antonia
Published: July 2009

Synopsis

The inconclusiveness of the literature on the role of loss of parent in influencing psychiatric disorder in adulthood is well known. A number of reasons involving sampling, location and other methodological features, are given to account for these contradictory findings. A study specially designed to cope with these features is then described and basic results are reported. These indicate that, in a sample of women aged 18–65, loss of mother before the age of 17, either by death or by separation of one year or more, was associated with clinical depression in the year of interview. Loss of father by death was in no way associated with current depression, but separation from father showed a trend which, however, did not reach statistical significance. Control for other possible confounding factors did not change this patterning of results; these were further supported when psychiatric episodes earlier in adulthood were examined. Examination of the caregiving arrangements in childhood suggests that it is ‘lack of care’, defined in terms of neglect rather than simply hostile parental behaviour, which accounts for the raised rate of depression. Such ‘lack of care’ is more frequent after loss of mother than after loss of father.
Luteinizing hormone responses to luteinizing hormone releasing hormone (LHRH) in acute mania and the effects of lithium on LHRH and thyrotrophin releasing hormone tests in volunteers
Authors: Hunter R. , Christie J. E. , Whalley L. J. , Bennie J. , Carroll S. , Dick H. , Goodwin G. M. , Wilson H. , Fink G.
Published: July 2009

Synopsis

The endocrine responses to Luteinizing Hormone Releasing Hormone (LHRH) of eight drug-free males with mania were determined. Basal levels of Luteinizing Hormone (LH) and the plasma levels following injection of LHRH were elevated in patients compared with controls; Follicle Stimulating Hormone (FSH) and testosterone were not different. Elevated levels of LH have been described previously in recovered manic patients and have been suggested to be state-independent features of mania. In order to clarify the status of this finding, the effects of lithium administration upon hormone responses to LHRH in six male volunteers were also investigated, together with the effects upon Thyrotrophin Releasing Hormone (TRH) stimulation of Thyroid Stimulating Hormone (TSH) and prolactin release. Lithium increased the basal levels of LH and levels after injection of LHRH without effect upon FSH and testosterone. Lithium also increased basal and TRH stimulated release of TSH and basal prolactin levels. Lithium was without effect upon prolactin responses to TRH. The results are discussed in relation to current information on the mechanism of lithium's action. The implications for neuroendocrine work on recovered patients taking lithium are also explored.
The spectrum of structural brain changes in schizophrenia: age of onset as a predictor of cognitive and clinical impairments and their cerebral correlates
Authors: Johnstone E. C. , Owens D. G. C. , Bydder G. M. , Colter N. , Crow T. J. , Frith C. D.
Published: July 2009

Synopsis

A range of cerebral structures was assessed in a series of 172 CT scans of groups of psychiatric patients (including 101 in-patients with chronic schizophrenia) and related to assessments of clinical state and psychological function. Ventricular indices were increased in patients with schizophrenia by comparison with patients with other psychiatric disorders: brain area, which is modestly positively correlated with ventricular indices, was significantly (P < 0·01) reduced in patients with schizophrenia. Among in-patients with chronic schizophrenia, measures of increased ventricular size were significantly associated with impaired social behaviour and with movement disorder. Memory for famous names in the distant past (a test of remote memory) was the only psychological test which showed significant associations with indices of ventricular size; this suggests that ventricular enlargement and its psychological sequelae occur relatively early in the disease process. Dichotomization of the sample of schizophrenic patients around the mean age of onset revealed that a range of clinical and psychological functions are significantly more abnormal in those with an early age of onset than in those in whom the onset was later. Early onset cases also perform less well academically and occupationally before illness onset. Within the early onset group some significant correlations between cognitive function and brain area were seen.

The findings suggest that: (i) some at least of the structural changes in schizophrenia arise at a time when the brain is still developing; and (ii) age of onset is an important determinant of social and intellectual impairment and is relevant to the relationship between brain structure and cognitive deficits.
Social interaction and speed of information processing following very severe head-injury
Authors: Godfrey Hamish P. D. , Knight Robert G. , Marsh Nigel V. , Moroney Bernadette , Bishara Samir N.
Published: July 2009

Synopsis

Eighteen adults who had suffered a very severe closed head-injury more than 18 months previously and required long-term rehabilitative support were compared with a closely matched control group. Unlike previous studies, which have reported negative personality change involving an increase in aversive behaviour, our behavioural observation data suggest that a global reduction in behavioural productivity, or negative symptomatology, characterizes social interaction by this group. This resulted in their being judged less socially skilled, less likeable and less interesting, and thus less reinforcing to interact with. Speed of information processing was specifically impaired for the closed head-injury group, although this did not correlate with global behavioural ratings of social interaction behaviour. It is suggested that low behavioural productivity may be associated with family burden, and that the low quantity of social interaction experienced by severely head-injured adults may reflect the unreinforcing nature of their interactions.
Seasonal variation in suicide: is there a sex difference?
Authors: Micciolo Rocco , Zimmermann-Tansella Christa , Williams Paul , Tansella Michele
Published: July 2009

Synopsis

Seasonal variation in suicide in Italy for the years 1969–81 has been assessed in males and females by means of harmonic analysis. Cyclical fluctuations in the number of suicides, reasonably consistent over the 13 years of the study, have been observed in both sexes. Seasonal harmonics accounted for 65·3 and 48·4% of the variance in male and female suicides respectively. While in males the only important seasonal harmonic was the first (one cycle per year), in females there was an important first harmonic and a second harmonic (two cycles per year). In both sexes the peak of the first harmonic occurred in May, while in females the subsidiary peak occurred in October–November.
The effects of sexual assault on men: a survey of 22 victims
Authors: Mezey Gillian , King Michael
Published: July 2009

Synopsis

Twenty-two men, who had been forcibly sexually assaulted, participated in a study to determine the circumstances of the attacks and the effects on the victims. The immediate and long-term responses were very similar to those described in female victims of rape.
Validation of a computerized assessment (PROQSY) of minor psychological morbidity by Relative Operating Characteristic analysis using a single GP's assessments as criterion measures
Authors: Wilkinson Greg , Markus A. C.
Published: July 2009

Synopsis

This is a study of the criterion validity of a newly developed computerized assessment (PROQSY) of minor psychological morbidity based on the Clinical Interview Schedule, employing a single GP's assessments as criterion measures of such morbidity and Relative Operating Characteristic (ROC) analysis. Two-stage screening was carried out with a consecutive sample of 256 patients aged 15 69 consulting an experienced GP in a semi-rural setting over a six-week period. The GP made a standardized assessment of the reason for consultation and the degree of psychological disorder present. A 40% random sub-sample was then assessed using PROQSY. The area under the ROC curve using a GP criterion of minor psychological disorder (‘degree of psychological problem - mild or greater’) was 081 (s.D. = 006). However, the kappa coefficient obtained between this criterion assessment and the PROQSY assessment of minor psychological problem at the observed optimal cut-off score was only 0·28 (S.E. = 0–1; z = 2.83). It is concluded that PROQSY may be recommended for further development as a research tool providing a valid measure of minor psychological morbidity as assessed by GPs in primary care settings.
The adolescence of a thirteenth-century visionary nun
Authors: Kroll Jerome , Ganck Roger De
Published: July 2009

Synopsis

Among the most notable features of the religious revival in western Europe in the early thirteenth century was the development of mysticism among the nuns and religious women of the lowlands. As scholarly attention becomes increasingly focused on this group of remarkable women, the question arises whether a psychiatric viewpoint has something of value to offer to the understanding of such individuals and the culture in which they struggled. The methodological and intellectual problems inherent in examining the life of a thirteenth-century mystic with a twentieth-century empirical frame of reference are illustrated in this study of the adolescence of Beatrice of Nazareth. Beatrice's stormy asceticism, ecstatic states and mood swings lend themselves to potentially competing hypotheses regarding the spiritual and psychopathological significance of her adolescent development and eventual life-course. Common grounds for reconciling these alternative models are discussed.
Memory selectivity and unilateral cerebral dysfunction
Authors: Master D. R. , Thompson C. , Dunn G. , Lishman W. A.
Published: July 2009

Synopsis

The relative speed of recall of pleasant and unpleasant experiences was investigated in patients with unilateral temporal lobe epilepsy and after unilateral temporal lobectomy. Indications have been obtained that right, but not left, temporal lobe dysfunction may impair hedonic aspects of memory selectivity.
Clinical psychiatric illness in prisoners of war of the Japanese: forty years after release
Authors: Tennant Christopher , Goulston Kerry , Dent Owen
Published: July 2009

Synopsis

Clinical psychiatric and medical assessments were carried out on a randomly selected sample of Australian prisoners of war captured by the Japanese in 1942 and a sample of combatants from Pacific theatres of war who were not captured. Prisoners of war had significantly more anxiety and depressive ‘neuroses’ and more major affective illness, although the latter finding was not statistically significant. The two groups did not differ in the risk of alcohol abuse and dependence.
Experiments on clinical observation and judgement in the assessment of depression: profiled videotapes and Judgement Analysis
Authors: Bech P. , Haaber A. , Joyce C. R. B. ,   The Danish University Anti-Depressant Group (DUAG)
Published: July 2009

Synopsis

Variations within and between observer-judges reduce the accuracy of clinical research. Judgement Analysis allows strategies to be developed and applied which reduce variation in judgement. The prediction that the removal of important sources of error variance by this means would reduce the likelihood of committing a Type 2 Error was supported by the application of Judgement Analysis to assessments by 15 psychiatrists of 92 patients in a clinical trial of 2 antidepressive treatments. The statistical significance of differences between the effect of the treatments on the severity of depression was increased, and significant differences appeared earlier. Ten stimulated patient profiles were also converted into narrative case histories, enacted by experienced psychiatrists or psychologists and videotaped. The participants' judgements of the overall severity of the depression were in good agreement with those they had made on the original cases. Videotapes so prepared help training to reduce variation in observation, just as Judgement Analysis can lead to reductions in the variation of judgement.
Behaviour problems in severely mentally handicapped children
Authors: Quine Lyn
Published: July 2009

Synopsis

A population study was undertaken in two health districts of children with severe mental handicap. Prevalence figures for behaviour problems are presented. A stratified random sample of 200 families was drawn from the population. Detailed structured interviews were carried out with the children's parents. The children were divided into two groups comprising those with behaviour problems and those with no problems. There was a significant association between behaviour disorder and incontinence, lack of self-help skills, poor reading, writing and counting skills, and poor communication skills. Environmental correlates were few. There were no differences between groups in family size, birth order, age of parents, marital discord, social class or income. However, behaviour problems were more common in one-parent families. An association was found between maternal stress and problem behaviour. The possible mechanisms underlying this association are discussed