bluuebunny/crossref_metadata_2025 huggingface dataset:
Onset of acute psychotic states in India: a study of sociodemographic, seasonal and biological factors
Authors: Malhotra S. , Varma V. K. , Misra A. K. , Das S. , Wig N. N. , Santosh P. J.
Published: November 2007

This is a comparative study of patients with acute‐onset, non‐affective, non‐organic, remitting psychoses and with non‐remitting or schizophrenic psychoses in India. Two groups of patients with acute remitting and non‐remitting or schizophrenic psychoses were compared with regard to the following variables: month of onset of psychosis; presence of stress, particularly fever, within 4 weeks preceding the onset of psychosis; childbirth within 12 weeks preceding the onset of psychosis; gender differences. It was found that the acute remitting psychoses showed an overrepresentation of females, a higher frequency of associated stress preceding the onset of psychosis, more often had onset during the summer months, i.e. between May and September, and had fever and childbirth preceding the onset of psychosis in a significantly higher proportion of patients, compared to acute non‐remitting psychoses or schizophrenia. The implications of the findings which point towards biological factors in the aetiology of acute remitting psychoses are discussed.
Interaction of affective and cognitive impairments in the suicidal state: a brief elaboration
Authors: Mendonca J. D. , Holden R. R.
Published: November 2007

This report examines the comorbidity among three key symptoms associated with suicidal intent, namely hopelessness, depression and unusual thinking. A total of 97 out‐patients with suicidal thoughts were assessed using the Beck Hopelessness Scale, the anxious depression and unusual thinking factor scales of the Derogatis Symptom Checkhst‐90, and the Beck Scale for Suicide Ideation. It was found that, in considering the interaction between key presenting symptoms, the combination of hopelessness and unusual thinking (which consisted of symptoms such as ‘trouble concentrating’ and ‘mind going blank’) was the strongest predictor of the seriousness of current suicidal inclinations.
Time to initial medical presentation in a first‐admission group with depression
Authors: Gormley N. , O'Leary D.
Published: November 2007

This paper examines the interval between the onset of depressive illness and subsequent medical presentation in a group of patients undergoing their first psychiatric admission with moderate to severe depression. The average preconsultation interval was 76 days, compared with an average time from consultation to the commencement of adequate treatment of 40 days. The time to initial consultation was found to correlate significantly with neuroticism, but not with sociodemographic factors. This study suggests that neuroticism may act as a predictor of poor outcome in depressive illness through its impact on help‐seeking behaviour.
The association between attitudes toward suicide and suicidal ideation in adolescents
Authors: Stein D. , Brom D. , Elizur A. , Witztum E.
Published: November 2007

The aims of this study were to determine whether adolescent attitudes to suicide could be grouped into distinct factors, and then to examine the relationship between these factors and the psychosocial parameters known to be associated with suicide, and between attitudes towards suicide and suicidal ideation. A questionnaire designed to assess attitudes to suicide was distributed to a total of 525 Israeli adolescents. Statistical analysis indicated that the attitude items could be grouped into four distinct factors: the right of society to prevent suicide; suicide as a symptom of mental illness; the right of the individual to talk about suicide; and taking suicidal behaviour seriously. Each factor was differentially associated with the various psychosocial parameters examined. The association between the attitude factors and subjects' suicidal ideation was significant and at least as strong as that of the psychosocial parameters normally associated with adolescent suicide, namely gender and exposure to suicide. A generally approving attitude towards suicide was correlated with a high level of suicidal ideation.
Factors affecting the development of spontaneous recurrence of methamphetamine psychosis
Authors: Yui K. , Ishiguro T. , Goto K. , Ikemoto S.
Published: November 2007

The process triggering spontaneous recurrences of methamphetamine (MAP) psychosis (i.e. flashbacks) was studied in 41 flashbackers, along with 84 non‐flashbackers with a history of MAP psychosis. Plasma monoamine metabolite levels were assayed in 25 of the 41 flashbackers, 16 of the 84 non‐flashbackers, 9 subjects with persistent MAP psychosis and 28 control subjects. All flashbackers had experienced threatening events or frightening paranoid‐hallucinatory states during previous MAP use. The dominant factor triggering flashbacks was a mild fear of other people. Plasma norepinephrine levels were elevated during flashbacks. The results suggest that a mild fear of other people may have elicited memories of MAP psychosis associated with threatening experiences through increased sensitivity to psychosocial stressors. As a result the flashbacks occurred, including an increase in peripheral noradrenergic activity.
Naturalistic experience with the use of divalproex sodium on an in‐patient unit for adolescent psychiatric patients
Authors: Deltito J. A. , Levitan J. , Damore J. , Hajal F. , Zambenedetti M.
Published: November 2007

This paper focuses on the importance of data collected not only from controlled clinical trials, but also from naturalistic treatment experience. In particular we examine the use of divalproex sodium either as monotherapy or as part of combined therapy on an in‐patient ward for adolescents aged 13–18 years. All admissions in which divalproex sodium use was attempted (n=36) were analysed over a 1‐year period. The most common use was in patients with a mixed‐presentation bipolar disorder (n=16), followed by patients with major depression (n=7), mania (n=4) or psychoses not otherwise specified (n=4). Divalproex sodium use was evaluated in the control of mania, psychosis, agitation, mood swings, aggression and/or anxiety. Overall, the use of divalproex sodium was associated with a marked improvement along all psychopathological variables in the vast majority of patients. Few side‐effects or medical complications were noted. We believe that divalproex sodium is a potentially useful drug in adolescent patients with varying forms of psychopathology.
Psychological morbidity and HIV in Kenya
Authors: Carson A. J. , Sandler R. , Owino F. N. , Matete F. O. G. , Johnstone E. C.
Published: November 2007

This paper describes a cross‐sectional study with subjects and raters blind to HIV status to assess psychiatric morbidity associated with HIV in a sample of working adults in Western Kenya. Subjects were recruited from an occupational health clinic for statutory annual health checks of workers in the food industry. Psychiatric interviews and neuropsychological tests were conducted. Of 230 subjects, 34% were HIV positive. Women had a higher rate than men, and those who worked as bargirls or were divorced, widowed or separated were particularly at risk. There were no substantial differences in psychiatric morbidity or neuropsychological functioning between the HIV‐positive and HIV‐negative subjects.
Expatriate mental health
Authors: Foyle M. F. , Beer M. D. , Watson J. P.
Published: November 2007

This paper reviews the historical aspects of expatriate mental health, and comments on the paucity of literature in the medical and psychiatric journals. Data obtained from 397 expatriate probands examined during overseas service are described. It was noted that there was a high incidence of affective and adjustment disorders. The results showed six areas significantly related to those with affective disorders at interview, namely a history of consultation for psychological problems in out‐patient departments or with the patient's own doctor, a history of depressed mood, and a family history of suicide, psychosis or personality disorder. Subjects with adjustment disorders at interview showed a significant positive correlation with four stressors (occupational anxiety, home country anxieties, acculturation and physical ill‐health), but showed a negative association with a past personal history of consultation for psychological problems at out‐patient departments or with their own doctors. These findings are discussed and practical applications suggested for improving expatriate mental health.
Factors predictive of regret in sex reassignment
Authors: Landén M. , Wålinder J. , Hambert G. , Lundström B.
Published: November 2007

The objective of this study was to evaluate the features and calculate the frequency of sex‐reassigned subjects who had applied for reversal to their biological sex, and to compare these with non‐regretful subjects. An inception cohort was retrospectively identified consisting of all subjects with gender identity disorder who were approved for sex reassignment in Sweden during the period 1972‐1992. The period of time that elapsed between the application and this evaluation ranged from 4 to 24 years. The total cohort consisted of 218 subjects. The results showed that 3.8% of the patients who were sex reassigned during 1972‐1992 regretted the measures taken. The cohort was subdivided according to the presence or absence of regret of sex reassignment, and the two groups were compared. The results of logistic regression analysis indicated that two factors predicted regret of sex reassignment, namely lack of support from the patient's family, and the patient belonging to the non‐core group of transsexuals. In conclusion, the results show that the outcome of sex reassignment has improved over the years. However, the identified risk factors indicate the need for substantial efforts to support the families and close friends of candidates for sex reassignment.
Neurocognitive function and insight in schizophrenia: support for an association with impairments in executive function but not with impairments in global function
Authors: Lysaker P. H. , Bell M. D. , Bryson G. , Kaplan E.
Published: November 2007

It remains unclear how impaired insight and neurocognitive impairment are related to one another in schizophrenia. In order to examine this relationship, subjects with schizophrenia or schizoaffective disorder were classified as having‘impaired’(n=38) or‘unimpaired’(n=43) insight based on their insight rating on the Positive and Negative Syndrome Scale (PANSS). Their performance on neuropsychological tests of global function, executive function, memory and vigilance was then compared. Multivariate analyses followed by Scheffe tests indicated that subjects with impaired insight performed less well on the Wisconsin Card Sorting Test, demonstrating poorer abstract flexibility and heightened perseveration. No differences were found between the groups with regard to global cognitive function, memory or vigilance. This suggests that insight is closely linked to deficits in executive function, and that it may be associated with the compromise of frontal lobe function.
Serum levels of excitatory amino acids, serine, glycine, histidine, threonine, taurine, alanine and arginine in treatment‐resistant depression: modulation by treatment with antidepressants and prediction of clinical responsivity
Authors: Maes M. , Verkerk R. , Vandoolaeghe E. , Lin A. , Scharpé S.
Published: November 2007

Previous research has revealed that major depression is accompanied by disorders in excitatory amino acids, e.g. glutamate and aspartate, and alterations in serum levels of other amino acids, e.g. serine, glycine and taurine. The aim of the present study was to examine serum levels of aspartate, asparagine, glutamate, glutamine, serine, glycine, threonine, histidine, alanine, taurine and arginine in major depression patients with treatment‐resistant depression (TRD). No significant differences in the serum concentrations of any of the above amino acids could be found between patients with and without TRD and normal controls. Non‐responders to treatment with antidepressants during a period of 5 weeks were characterized by significantly lower serum levels of aspartate, asparagine, serine, threonine and taurine. A 5‐week period of treatment with antidepressants significantly reduced the serum levels of aspartate, glutamate and taurine, and significantly increased the serum concentrations of glutamine. The results suggest that alterations in serum levels of aspartate, asparagine, serine, threonine and taurine may predict the subsequent response to treatment with antidepressants, and that the latter may modulate serum levels of excitatory amino acids and taurine.
The Nordic Comparative Study on Sectorized Psychiatry: contact rates and use of services for patients with a functional psychosis
Authors: Hansson L. , Muus S. , Vinding H. R. , Göstas G. , Saarento O. , Sandlund M. , Lönnerberg O. , Öiesvold T.
Published: November 2007

As part of a Nordic comparative study on contact rates of new patients and use of services in seven catchment areas, contact rates and use of services for patients with a functional psychosis during a 1‐year follow‐up period were investigated. The highest contact rates were found in two large city catchment areas in Stockholm and Copenhagen. Compared to other patients in the cohorts, patients with a functional psychosis were more often found to be unemployed and living alone. They also showed more extensive service use in terms of both voluntary and compulsory admissions, and in the use of day‐care facilities. In addition, they were more often multiple users of inpatient care (≥=3 admissions during the follow‐up period). Large differences in service use among patients with a functional psychosis were discovered between the catchment areas, with the most extensive use of voluntary inpatient care and day‐care facilities in Frederiksberg. Patients most frequently had compulsory admissions in Bodö and least frequently had them in Frederiksberg. Out‐patient services were most frequently used in Stockholm. Correlations between levels of resources and use of services for patients with a functional psychosis were in general low, except for the rates of short‐term beds, which showed a strong and significant correlation wit the number of days in voluntary in‐patient care (r=0.89).
Cognitive deficits in schizophrenia and affective disorders: evidence for a final common pathway disorder
Authors: Zihl J. , Grön G. , Brunnauer A.
Published: November 2007

This study was designed to determine whether patients with schizophrenia and those with affective disorders display a common pattern of cognitive deficits. Cognitive performance was assessed with a neuropsychological test battery in consecutively admitted in‐patients with schizophrenia (n= 100) and affective disorders (n= 100). The two groups of patients showed a similar pattern of cognitive deficits, especially in tests focusing on attentional capacities. The groups only differed significantly in their performance on the Wisconsin Card Sorting Test (WCST), with the schizophrenic patients performing less well. These results suggest that, with the exception of the deficit as measured by the WCST, similar cognitive impairments exist in schizophrenia and affective disorders, even at very early stages of the illness. Therefore, patients with schizophrenia and those with affective disorders cannot be qualitatively distinguished with sufficient reliability. We postulate that the cognitive deficit pattern represents a final common pathway disorder in the two groups of patients.
Impact of a history of physical and sexual abuse in eating disordered and asymptomatic subjects
Authors: Favaro A. , Grave R. Dalle , Santonastaso P.
Published: November 2007

The present study aimed to explore the impact of sexual and/or physical abuse among eating disordered patients (ED) and asymptomatic subjects. A total of 86 patients with anorexia nervosa, 69 patients with bulimia nervosa and 81 asymptomatic subjects were assessed. Among ED, we did not find a significant association between abuse experiences and the severity of the eating disorder, or between abuse and dissociative symptoms. Among ED, self‐destructive behaviour appears to be the most important predictor of a history of sexual and/or physical abuse. In contrast, in the asymptomatic group, the score on the Dissociation Questionnaire is the only significant predictor of reported abuse experiences.
Drug treatment of mania: a critical review
Authors: Licht R. W.
Published: November 2007

While lithium is generally considered to be a first‐line treatment for mania, the position of the anticonvulsants and the antipsychotics in the treatment of this disorder is currently under debate. For that reason, this paper reviews the original literature, in particular addressing the randomized controlled trials (RCTS) on lithium, anticonvulsants and antipsychotics, and the methodological limitations therein. As the treatment of mania needs to anticipate the future course of the illness, the data on prophylaxis will also be reviewed, albeit briefly. It is concluded that antipsychotics are powerful antimanics, which are particularly beneficial for some clinical presentations of severe mania. However, in general their use should not be prolonged into the maintenance phase. Lithium is still to be considered the mood‐stabilizing drug par excellence, although it may be insufficient in mixed states and severe mania. The evidence for antimanic efficacy of valproate, in particular for mixed states, seems more convincing than that for carbamazepine, while the evidence for a prophylactic action of carbamazepine still exceeds that for valproate. Adjunctive treatment with benzodiazepines is often useful. Small sample sizes, highly selected study populations and high drop‐out rates seem to be the most important limitations of the RCTS on mania. Quasi‐experimental, naturalistic studies on unselected populations are needed to investigate how the various treatments work in clinical practice. Based on the available evidence, summary guidelines for treatment are proposed.
Major depression as a predictor of premature deaths in lderly people in Finland: a community study
Authors: Pulska T. , Pahkala K. , Laippalla P. , Kivelä S.‐L.
Published: November 2007

In order to analyse the survival of elderly Finnish people with major depression, a total of 29 elderly (≥65 years) subjects suffering from major depression (DSM‐III criteria) and 853 non‐depressed elderly subjects were followed up for 6 years. The Kaplan‐Meier survival curves showed the survival of patients suffering from major depression to be poorer than that of non‐depressed subjects. When age, sex, marital status, level of education, smoking habits, physical health, functional abilities and major depression were introduced into the Cox model, advanced age, male sex, smoking, poor physical health, reduced functional abilities and the occurrence of major depression were found to be related to higher levels of mortality. The results suggest that major depression in the elderly predicts higher mortality which is not explained by their poor baseline level of physical health alone.
The evaluation of an Urdu version of the GHQ‐28
Authors: Riaz H. , Reza H.
Published: November 2007

The Urdu and English versions of the GHQ‐28 were administered in Pakistan to bilingual students using a crossover design, in order to evaluate the equivalence and reliability of the translation in relation to the original, and to determine convergent validity using the Hospital Anxiety and Depression Scale (HADS) as a comparison measure. Satisfactory findings at each of level of analysis indicated that the Urdu GHQ‐28 was comparable to the original English version.
Blunted adrenocorticotropin and Cortisol responses to corticotropin‐releasing hormone stimulation in chronic fatigue syndrome
Authors: Scott L. V. , Medbak S. , Dinan T. G.
Published: November 2007

Hyperfunctioning of the pituitary‐adrenal axis has been suggested as the pathophysiological basis for chronic fatigue syndrome (CFS). Blunted adrenocorticotropin (ACTH) responses but normal Cortisol responses to exogenous corticotropin‐releasing hormone (CRH), the main regulator of this axis, have been previously demonstrated in CFS patients, some of whom had a comorbid psychiatric disorder. We wished to re‐examine CRH activation of this axis in CFS patients free from concurrent psychiatric illness. A sample of 14 patients with CDC‐diagnosed CFS were compared with 14 healthy volunteers. ACTH and Cortisol responses were measured following the administration of 100 μg ovine CRH. Basal ACTH and Cortisol values did not differ between the two groups. The release of ACTH was significantly attenuated in the CFS group (P<0.005), as was the release of Cortisol (P<0.05). The blunted response of ACTH to exogenous CRH stimulation may be due to an abnormality in CRH levels with a resultant alteration in pituitary CRH receptor sensitivity, or it may reflect a dysregulation of vasopressin or other factors involved in HPA regulation. A diminished output of neurotrophic ACTH, causing a reduced adrenocortical secretory reserve, inadequately compensated for by adrenoceptor upregulation, may explain the reduced Cortisol production demonstrated in this study.
A polydiagnostic approach to the differences in the symptoms of schizophrenia in different cultural and ethnic populations
Authors: Maslowski J. , van Rensburg D. Jansen , Mthoko N.
Published: November 2007

This study evaluates the pathoplastic influences of ethnicity and culture on the symptoms of schizophrenia. A sample of 113 schizophrenics was evaluated using the Present State Examination (PSE) and Landmark's Manual for the Assessment of Schizophrenia. The subjects were 57 coloured and 56 black individuals. Six different tribes of Bantu, Negroid and Khoisan origin and with different language and cultural backgrounds were represented among the black subjects. Core symptoms remained basically the same in two groups, but the content of positive symptoms was found to be influenced by culture. However, no statistically significant differences in the presentation of negative symptoms were found in terms of quantity, but there were qualitative differences between the ethnic groups.
Uniform abnormalities in the hippocampus of five chronic schizophrenic men compared with age‐matched controls
Authors: Luts A. , Jönsson S. A. T. , Guldberg‐Kjaer N. , Brun A.
Published: November 2007

In a post‐mortem study five chronic schizophrenic men were matched with respect to age and sex to five control subjects without a known history of psychiatric illness, and were compared in pairs with regard to neurone number and pyramidal cell orientation in the left hippocampus. All five schizophrenics had significantly more disoriented pyramidal cells in the Cornu Ammonis subregions CA1‐CA3 than their matched controls. They also had significantly fewer pyramidal cells in the observed areas of CA1 and CA3, but not in CA2 and CA4. There was no difference in the number of granular cells of the dentate gyrus. In pairwise comparisons the pattern was never reversed with respect to these two parameters, except in a single case where one schizophrenic proband had more cells in subregion CA2. In the absence of gliosis the findings were interpreted as sequelae of an early, presumably prenatal, injury.
Dawn simulation vs. lightbox treatment in winter depression: a comparative study
Authors: Lingjærde O. , Føreland A. R. , Dankertsen J.
Published: November 2007

Dawn simulation, with gradually increasing bedside light in the morning, has shown promising results as an alternative to bright light treatment for winter depression. To compare these treatments, 61 out‐patients with winter depression (20–70 years of age, 80% women) were randomized to receive either lightbox treatment with 1500–2500 lux white light for 2 h in the morning for 6 days on an out‐patient basis (n=34), or dawn simulation treatment in their homes, with 60 or 90 min of light augmentation time to 100–300 lux, for 2 weeks (n=27). Patients’ ratings of improvement on a visual analogue scale (correlating strongly with percentage reduction in an extended Montgomery‐Åsberg Depression Rating Scale (MADRS) score) at the end of treatment showed a mean of 40.0% (SD 27.7%) in the dawn simulation group and 57.4% (SD 29.9%) in the lightbox group (p=0.02). The majority of the patients in both groups maintained their improvement during a 9‐week follow‐up. Age, sex, current major depression or current use of antidepressants did not predict outcome in either group. No serious side‐effects were observed.
Mental health expectancy — the European perspective: a synopsis of results presented at the Conference of the European Network for the Calculation of Health Expectancies (Euro‐REVES)
Authors: Jagger C. , Ritchie K. , Brønnum‐Hansen H. , Deeg D. , Gispert R. , Evans J. Grimley , Hibbett M. , Lawlor B. ,   the Medical Research Council Cognitive Function and Ageing Study Group, Perenboom R. , Polge C. , Van Oyen H.
Published: November 2007

The increase in life expectancy observed over the last decade has particular relevance for mental health conditions of old age, such as dementia. Although mental disorders have been estimated to be responsible for 60% of all disabilities, until recently population health indicators such as health expectancies have concentrated on calculating disability‐free life expectancy based on physical functioning. In 1994, a European Network for the Calculation of Health Expectancies (Euro‐REVES) was established, one of its aims being the development and promotion of mental health expectancies. Such indicators may have an important role in monitoring future changes in the mental health of populations and predicting service needs. This article summarizes the proceedings and recommendations of the first European Conference on Mental Health Expectancy.
Prevalence, patterns and role of personality disorders in panic disorder patients with and without comorbid (lifetime) major depression
Authors: Langs G. , Quehenberger F. , Fabisch K. , Klug G. , Fabisch H. , Zapotoczky H. G.
Published: November 2007

A total of 84 consecutive out‐patients from the Anxiety Disorders Clinic of the Psychiatric University Hospital in Graz with a current panic disorder were diagnosed for Axis I and II disorders using the Structured Clinical Interviews for DSM‐III‐R. The subjects were divided into two groups: (i) 49 patients who met the criteria for panic disorder with or without agoraphobia and had no history of an affective disorder and (ii) 35 patients who had a (lifetime) comorbidity of a major depressive disorder. There was a statistically significant difference in the prevalence of personality disorders between the two groups, which was due to the higher frequency of narcissistic personality disorder in the comorbid sample. Logistic regression analysis revealed that agoraphobia and/or major depression were associated with personality disorders, thus indicating that the relationship between panic disorder, agoraphobia and major depression is not straightforward, but is strongly influenced by the presence of Axis II disorders. Furthermore, the results of this study provide support for the ‘unitary position’ concerning the relationship between panic disorder and depression.
Personality disorders in patients with obsessive‐compulsive disorder in Japan
Authors: Matsunaga H. , Kiriike N. , Miyata A. , Iwasaki Y. , Matsui T. , Nagata T. , Takei Y. , Yamagami S.
Published: November 2007

A total of 75 patients with obsessive‐compulsive disorder (OCD) were studied in order to investigate the characteristics of OCD symptoms and the comorbidity of personality disorders (PD). Contamination obsessions and checking compulsions were most commonly found in patients, of whom 53% met the criteria for at least one PD. Among comorbid PD, the anxious‐fearful (cluster C) PDs, such as avoidant, obsessive‐compulsive and dependent PD, were most prevalent, followed by the odd‐eccentric (cluster A) PDs, such as paranoid and schizotypal PD. The patients with PD had more severe social maladaptation and concurrent depressive and anxious symptoms than the patients without any PD, despite the similar severity of OCD symptoms. These results are consistent with those reported in the Western world, and are considered to be relatively stable cross‐culturally.
Relationship of neuropsychological and MRI measures to age of onset of schizophreniaa
Authors: Jeste D. V. , McAdams L. A. , Palmer B. W. , Braff D. , Jernigan T. L. , Paulsen J. S. , Stout J. C. , Symonds L. L. , Bailey A. , Heaton R. K.
Published: November 2007

Age of onset of schizophrenia (AOS) may be largely determined by neurobiological factors. We examined in a diverse sample of schizophrenia out‐patients the relationships of AOS with neuropsychological abilities and structural brain abnormalities as measured on cerebral magnetic resonance imaging (MRI). A total of 82 out‐patients meeting DSM‐III‐R criteria for schizophrenia were evaluated with a comprehensive neuropsychological battery and semi‐automated quantitatively analysed cerebral MRI. Earlier AOS correlated with poorer performance in learning and abstraction/ cognitive flexibility, and with larger volumes of caudate and lenticular nuclei, and smaller volume of thalamus on MRI. A model for predicting AOS consisting of abstraction and thalamic and caudate volumes remained significant after controlling for duration of illness, current age and daily neuroleptic dose. In conclusion, AOS may be related to specific rather than general measures of cognitive performance and structural brain abnormalities.
Regional differences in the use of psychiatric hospital beds in Finland: a national case‐register study
Authors: Korkeila J. A. , Lehtinen V. , Tuori T. , Helenius H.
Published: November 2007

We investigated the possible differences in the utilization of psychiatric hospital beds among five social security areas in Finland, and the association between the variables related to the psychiatric services and the use of hospital beds. The use of hospital beds varied quite distinctly among these areas, as did the total rate of in‐patients, readmissions, and rates of in‐patients with psychotic and affective disorders. The treatment practices appeared to vary as the length of stay (LOS) and the rate of committal differed regionally in a significant manner. There was a significant positive correlation between the total rate of in‐patients and the rate of readmitted patients (r=0.92, P<0.001), and a significant negative correlation between the number of visits per worker in out‐patient care and the rate of readmissions (r=‐0.94, P <0.001).
Suicides hidden among undetermined deaths
Authors: Ohberg A. , Lonnqvist J.
Published: November 2007

The research phase of the National Suicide Prevention Project in Finland (from 1 April 1987 to 31 March 1988) included medico‐legal investigation and psychological autopsy of all deaths suspected of being suicides, including 1397 official suicides and 61 undetermined deaths. In later analyses on suicide, undetermined cases were excluded. This paper presents an analysis of all officially classified undetermined deaths (n= 139) over the study period, consisting of all the initially suspected suicides (n=61) and the remaining undetermined deaths (n=78) where suicide could not be excluded. Poisoning by solids or liquids and drowning were the most common causes of all undetermined deaths. Suicidal intent was observed in 87% of undetermined deaths initially suspected of being suicides. In addition, 31 % of these subjects had previously attempted suicide, and 34% had made suicidal threats. Depression was diagnosed in 23% of cases and alcohol dependence or abuse in 31 % of cases. Undetermined deaths resembled suicides arid appeared to reduce the suicide rate by 10%.
Development and preliminary application of a new scale for assessing dysfunctional working models of self and others (DWM‐S) in severely disturbed patientsa
Authors: Perris C. , Fowler D. , Skagerlind I. , Olsson M. , Thorsson C.
Published: November 2007

Although several suggestions have been made concerning the content and characteristics of cognitive/emotive schemata held by people with different disorders, there is still a scarcity of suitable instruments for verifying or measuring such constructs. This is particularly true of schemata postulated to be present in patients with personality disorders or a schizophrenic disorder. This article deals with the development of a new scale for assessing dysfunctional internal working models of self and others (DWM‐S) in psychiatric patients. Preliminary results obtained in a sample of patients (n= 110) and healthy subjects (n=40) suggest that the scale has a highly satisfactory internal consistency (Cronbach's alpha=0.97), and satisfactory test‐retest reliability (rho coefficient=0.90 in healthy subjects and 0.86 in patients). Moreover, the DWM‐S is able to discriminate between patients and healthy subjects and between patients suffering from various disorders. Further studies are in progress to assess the cross‐national generalizability of the findings obtained so far.
Behaviour/emotional problems in male juvenile delinquents and controls in Russia: the role of personality traits
Authors: Ruchkin V. V. , Eisemann M. , Cloninger C. R.
Published: November 2007

Recent studies based on the psychobiological theory of personality by Cloninger postulate a relationship between certain personality traits and various psychopathological manifestations. To test this theory, we administered the Temperament and Character Inventory and the Youth Self‐Report to 188 male delinquents from a juvenile correction centre in Northern Russia, and to 111 age‐matched male controls recruited from among schoolchildren. As assumed by previous studies, psychological symptoms were primarily positively correlated with harm avoidance and negatively correlated with self‐directedness. At the same time, the higher levels of aggressive and delinquent behaviour were positively correlated with novelty‐seeking and negatively correlated with co‐operativeness. The possible mechanisms underlying these findings are discussed.
Severity of psychiatric disorder in day hospital and in‐patient admissions
Authors: Weinberg A. , Greaves J. , Creed F. , Tomenson B.
Published: November 2007

This study assessed whether severity of psychiatric disorder varies across day hospital and in‐patient units according to local need, and whether severity of disorder predicts length of stay and therefore costs. Data were collected for a consecutive series of 2230 in‐patients and 712 day patients using the Social Behaviour Scale (data completed by nurses) and diagnosis and Clinical Global Impression (CGI) (completed by doctors). Severity of illness of subjects admitted to in‐patient units, but not to day hospitals, was associated with under‐privileged area score (UPA). Length of in‐patient stay is most accurately predicted by Clinical Global Impression and six other variables relating to diagnosis, demographic status and individual hospital. Improved resource allocation for mental health services could be achieved if severity of disorder was routinely collected.
Marijuana precipitation of panic disorder with agoraphobia
Authors: Ströhle A. , Müller M. , Rupprecht R.
Published: November 2007

We report the case of a 16‐year‐old adolescent with the onset of a panic disorder with agoraphobia after a first panic attack during marijuana intoxication. There was a good response to standard cognitive behavioural therapy for panic disorder.
Prevalence of child and adolescent psychiatric disorders: the Zürich Epidemiological Study
Authors: Steinhausen H.‐C. , Metzke C. Winkler , Meier M. , Kannenberg R.
Published: November 2007

Psychiatric disorders were studied in an epidemiological and representative sample of 1964 pupils attending the first to ninth grade in various types of schools in the Canton of Zürich, Switzerland. Using a two‐stage procedure, parents were asked to respond to a standardized behaviour problem checklist in the screening phase. In the second stage, structured interviews were performed with 399 parents representing both screen positive and control children. DSM‐III‐R diagnoses were derived from the interviews. The total prevalence figure for any disorder amounted to 22.5%. Prevalence rates were influenced by the multi‐screen procedure. Among various correlates, sex, nationality, age and residence were to some extent significant. Comorbid disorders were present in 12.5% of the subjects.
A housing support programme for the mentally ill: need profile and satisfaction among users
Authors: Middelboe T. , Mackeprang T. , Thalsgaard A. , Christiansen P. B.
Published: November 2007

Housing support has become an integrated part of the community psychiatric service during the past years. In this study, the need profile, satisfaction rates and clinical characteristics of the users of a housing support programme in Copenhagen are described. Among the 45 residents interviewed, schizophrenia was by far the dominant diagnosis. The Camberwell Assessment of Needs procedure revealed a total of 8.3 needs, including 3.4 unmet needs per resident, within the 22 need areas investigated. The needs were most prevalent within the areas of psychological and social functioning. Agreement between residents and staff on the presence of needs was generally low. Satisfaction rates were moderate to high, and a substantial proportion of the residents reported their general quality of life to be improved during participation in the programme. The type of support provided seemed to fit important need areas, suggesting that the programme is appropriate.
Increased 24‐hour urinary cortisol excretion in patients with post‐traumatic stress disorder and patients with major depression, but not h patients with fibromyalgia
Authors: Maes M. , Lin A. , Bonacccorso S. , Van Hunsel F. , GASTEL A. Van , Delmeire L. , Biondi M. , Bosmans E. , Kenis G. , Scharpé S.
Published: November 2007

There is now firm evidence that major depression is accompanied by increased baseline activity of the hypothalamic‐pituitary‐adrenal (HPA) axis, as assessed by means of 24‐h urinary cortisol (UC) excretion. Recently, there were some reports that fibromyalgia and post‐traumatic stress disorder (PTSD), two disorders which show a significant amplitude of depressive symptoms, are associated with changes in the baseline activity of the HPA axis, such as low 24‐h UC excretion. The aim of the present study was to examine 24‐h UC excretion in fibromyalgia and PTSD patients compared to normal controls and patients with major depression. In the three patient groups, severity of depressive symptoms was measured by means of the Hamilton Depression Rating Scale (HDRS) score. Severity of fibromyalgia was measured using a dolorimetrically obtained myalgic score, and severity of PTSD was assessed by means of factor analytical scores computed on the items of the Composite International Diagnostic Interview (CIDI), PTSD Module. Patients with PTSD and major depression had significantly higher 24‐h UC excretion than normal controls and fibromyalgia patients. At a threshold value of ≥240 μg/24 h, 80% of PTSD patients and 80% of depressed patients had increased 24‐h UC excretion with a specificity of 100%. There were no significant differences in 24‐h UC excretion either between fibromyalgia patients and normal controls, or between patients with major depression and PTSD patients. In the three patient groups, no significant correlations were found between 24‐h UC excretion and The HDRS score. In fibromyalgia, no significant correlations were found between 24‐h UC excretion and the myalgic score. In PTSD, no significant correlations were found between 24‐h UC excretion and severity of either depression‐avoidance or anxiety‐arousal symptoms. In conclusion, this study found increased 24‐h UC excretion in patients with PTSD comparable to that in patients with major depression, whereas in fibromyalgia no significant changes in 24‐h UC were found.
The concept of mental disorder in Greek cinema
Authors: Fountoulakis K. , Kogiopoulos K. , Nimatoudis I. , Lacovides A. , Nikolaou T. , Lerodiakonou Ch.
Published: November 2007

Mental patients in Greek society have never been considered as ‘sacred’, but on the contrary as handicapped, and cinema largely reflects these concepts. A total of 30 films that appeared to deal with mental disorder in a direct or indirect way have been reviewed. The identification of each mental disorder was made according to DSM‐IV criteria. Five of these cases were presented as having a factitious disorder, seven were psychotic and two had dissociative (hysterical) disorders. The remaining eight cases related to personality disorder or character deviance. In two cases diagnosis was impossible. The image of mental disorder is consistent with psychiatric nosology, and disorders with‘dramatic’ or‘impressive’ manifestation of symptomatology are chosen. No real solutions, proposals or ideology on mental illness emerge.
Treatment of tardive dystonia with an antispastic agent
Authors: Nisijima K. , Shirnizu M. , Ishiguro T.
Published: November 2007

Tardive dystonia is a difficult condition to treat. We describe the case of a patient with tardive dystonia that was unresponsive to various pharmacological and electroconvulsive therapies. The patient showed dramatic improvement after the administration of eperisone, a centrally acting muscle relaxant. Eperisone and tolperisone are beta;‐aminopropiophenone derivatives which are used clinically as antispastic agents. To date there have been no reports describing the effect of such muscle relaxants on tardive dystonia. The results of our study suggest that these muscle relaxants may be promising therapeutic drugs for the treatment of tardive dystonia.
Hallucinatory modalities in prelingually deaf schizophrenic patients: a retrospective analysis of 67 cases
Authors: Schonauer K. , Achtergarde D. , Gotthardt U. , Folkerts H.W.
Published: November 2007

In order to examine the effect of congenital or early acquired deafness on hallucinatory modalities in schizophrenia, we interviewed 67 prelingually deaf schizophrenic patients (using sign language) about their hallucinatory experiences over the entire course of their illness. We also analysed the clinical records of our subjects' previous hospitalizations. In our deaf sample, visual and tactile hallucinations were plainly over‐represented as hallucinatory modalities in comparison with hearing schizophrenic samples. Although some patients reported visual hallucinatory perceptions of sign language messages, the hallucinatory reception of meaningful information in deaf patients seems also to remain affiliated to the ‘auditory’ modality. It was concluded that the different representation of hallucinatory modalities reflects in particular the influence of ‘the deaf way’ of sensory experience on imagery processes.
Essential components of schizophrenia care: a Delphi approach
Authors: Fiander M. , Burns T.
Published: November 2007

Other than medication and access to in‐patient care, there is little published consensus on the essential components of schizophrenia care. This paper reports a Delphi approach to the identification of these components. This approach identifies and measures the degree of consensus, using a structured iterative series of questionnaires by a group of experienced UK and Irish psychiatrists (n= 15) on the essential components. Pharmacotherapy, in‐patient care and community mental health team (CMHT) staffing were explicitly excluded from the study. In total, 106 components were identified and their importance was rated twice. There was consensus on 92% of the components and strong consensus on 64%. The Delphi results were refined by the participants to produce 10 essential components of care.
The presence of psychiatric consultations in relation to divorce
Authors: Svedin C. G. , Wadsby M.
Published: November 2007

In this study all couples who during a period of 1 year were divorced at a Swedish district court, and who had children living at home, were examined for psychiatric consultations before, during and after the divorce period. Psychiatric consultation was defined as having a psychiatric record at the only psychiatric clinic in the catchment area. The divorced couples were compared with a matched group of married people. The results showed that there was a 4.1‐fold higher risk for divorced men and a 2.5‐fold higher risk for divorced women of acquiring a psychiatric record. The increased rate of psychiatric consultations was evident before as well as after the divorce period, but was most striking during the divorce period. A greater proportion of men than women started and continued to experience their psychiatric problems before and during the divorce period, while women more often started and continued to experience their psychiatric problems during the divorce period and afterwards.
Are in‐patient depressives more often of the melancholic subtype?
Authors: Stage K. B. , Bech P. , Gram L. F. , Kragh‐Sørensen P. , Rosenberg C. , Øhrberg S.
Published: November 2007

In contrast to out‐patients, hospitalized depressed patients have been reported to respond better to tricyclic antidepressants (TCAs) than to selective serotonin reuptake inhibitors (SSRIs) and moclobemide. This may be due to differences in the type of patients included in the trials. The hypothesis that hospitalized depressed patients have a different symptom profile to out‐patients was tested by comparing 352 patients from three in‐patient studies with 581 patients from three out‐patient studies conducted in Denmark during the period 1980–1992. All patients had major depression and were evaluated using the Hamilton Depression Scale. The full version of the Newcastle Diagnostic Rating Scale (1965) was applied to 443 of the patients. In‐patients were characterized by higher scores on the items ‘depressed mood’, ‘suicidal impulses’,‘work and interest (reduced)’, ‘retardation’, ‘distinct quality of depression’, ‘weight loss’, ‘feeling of guilt’ and‘nihilistic delusions’, and by lower scores on the items ‘somatic complaints’, ‘hypochondriasis’, ‘psychological stressors’ and‘anxiety’. In total, 76% of the in‐patients and 40% of the out‐patients had melancholic/endogenous depression. These findings may explain why TCAs are superior to SSRIs and moclobemide in hospitalized patients, since other data indicate that TCAs seem to be the most effective treatment for the melancholic/endogenous subtype.
A prospective study of bipolar disorder in children and adolescents from India
Authors: Srinath S. , Reddy Y. C. Janardhan , Girimaji S. R. , Seshadri S. P. , Subbakrishna D. K.
Published: November 2007

Bipolar disorder in adults is known to run an episodic course. However, little information exists on the long‐term naturalistic course of bipolar disorder in juvenile populations. The present study was undertaken with the objectives of (i) documenting the rates of recovery and relapse, (ii) identifying the predictors of recovery and relapse and (iii) assessing the rates of comorbid conditions. A total of 30 subjects with onset of bipolar illness (according to DSM‐III‐R criteria) in childhood and adolescence were assessed systematically at baseline and 4 to 5 years later. All 30 subjects (100%) had recovered from their index episodes and none had exhibited chronicity. Twenty of the 30 subjects (67%) had relapsed, with most relapses occurring within 2 years of recovery from index episodes. No predictors of recovery and relapse could be identified. Conduct disorder was the only comorbid diagnosis in two subjects (7%). The main implication of our study, in view of the high rates of relapse in the crucial developmental phase of a young individual, is that long‐term maintenance medication should be considered in juvenile bipolar patients, even if it is a first episode.