bluuebunny/crossref_metadata_2025 huggingface dataset:
Lifetime prevalence of specific mental disorders among people born in Iceland in 1931
Authors: Stefánsson J. G. , Líndal E. , Björnsson J. K. , Guðomundsdóttir Á.
Published: August 2007

The lifetime prevalence rates are presented for mental disorders in a random sample of people born in Iceland in 1931, interviewed at the age of 55–57 years. The diagnoses are made according to DSM‐III, on the basis of the National Institute of Mental Health's diagnostic Interview Schedule (NIMH‐DIS) used by trained lay interviewers. The most common diagnoses were alcohol abuse and dependence, generalized anxiety disorder, phobic disorders, dysthymic disorder and major depressive episode. Disorders more common in men were antisocial personality, alcohol abuse and alcohol dependence. Disorders more common among women were major depressive episode and generalized anxiety disorder. Alcohol abuse was more prevalent among those living in rural areas, but dependence was more prevalent in the urban area, where panic disorder is also more frequent. Widowed, separated and divorced people had most of the highest prevalences: tobacco‐use disorder, alcohol abuse and dependence, dysthymia and generalized anxiety disorder. Except for a very high rate of alcohol abuse and dependence and a low rate of substance abuse disorders, the prevalence rates are similar to those obtained in North American studies using the NIMH‐DIS as a survey instrument. The DSM‐III criteria for alcohol abuse or dependence may be less applicable to Iceland than to North America, because of differences in what is culturally regarded as acceptable use of alcohol.
Depression in an elderly population in Turkey
Authors: Bekaroğlu M. , Uluutku N. , Tanriöver S. , Kirpinar I.
Published: August 2007

The prevalence of depression was investigated in 2 groups of elderly‐people in Turkey living in a public old people's home and in their own home. Depression was assessed according to the Hamilton Rating Scale for Depression, not clinical diagnosis. The prevalence of depression was 35% (33% for men, 37% for women) for the total population, 41% (40% for men, 42% for women) for those living in an institution and 29% (24% for men, 33% for women) for those living at home. Not being able to work actively, poor religious interest, widowhood, alcohol consumption, older age and physical disability were significantly correlated with the prevalence of depression. Institutional care was also associated with depression. The prevalence of depression was not related to sex, education, occupation or economic status.
Tourette syndrome and neuropsychological performance
Authors: Bornstein R. A. , Baker G. B. , Bazylewich T. , Douglass A. B.
Published: August 2007

This study examined performance on a battery of neuropsychological tests in a sample of 28 patients with Tourette's syndrome (TS). Test scores were converted to age‐corrected T‐scores to control for the effect of age on test performance. The frequency of abnormal test performances was variable, but more frequent on motor and sensory tasks. Symptom severity as measured by the Tourette Syndrome Global Scale was inversely related to neuropsychological performance. In general, neuropsychological performance was mildly below average. The pattern of performance was similar to previous studies of TS patients.
Suicide in Estonia
Authors: Värnik A.
Published: August 2007

Data on the suicide rate from 1922 to 1935 and from 1965 to 1988 are obtained from annual journals and original documents compiled by the Estonian State Committee for Statistics. During the period of Estonian independence (1922–1935 under consideration), the suicide rate was 16.7 per 100,000 inhabitants at the beginning of the period. During the Great Depression, this figure temporarily rose to 30 and declined to 20.6 in the year 1935. From 1965 to 1985 the suicide rate remained constantly high: on average 33 per 100000 inhabitants. A decline in the male suicide rate from 55.2 to 36.8 has occurred since 1986. The effects of sociopolitical changes and of limitations on the sale of alcohol on suicide rates are discussed.
Delusional disorder: the predictive validity of the concept
Authors: Opjordsmoen S. , Retterstöl N.
Published: August 2007

A sample of 72 first‐admitted patients with delusional disorder was personally re‐examined after a mean of 10 years, and 42 of them after an average of 27 years. The mean observation period for all patients from admission to last follow‐up was 20 years (3–39). There was a trend that patients with delusions of jealousy did better on course variables, but similar outcomes were revealed in groups with delusions of jealousy, persecution and a mixed group with different main delusions. Duration of symptoms prior to admission was a significant predictor of outcome, indicating dividing lines of 1 and 6 months at 10‐year follow‐up and 3 and 6 months at long‐term follow‐up. Based on the data, a minimal duration of 6 months is proposed for persistent delusional disorder.
Psychometric evaluation of a standardized and expanded Brief Psychiatric Rating Scale
Authors: Hafkenscheid A.
Published: August 2007

The interrater reliability, factorial and discriminant validity of a standardized and expanded Brief Psychiatric Rating Scale (BPRS‐E) were investigated in a heterogeneous short‐stay group of psychiatric inpatients in the Netherlands (n= 162). Repeated separate interviews by single clinicians (psychiatrists, residents or clinical psychologists), best reflecting the way the BPRS is usually employed in clinical practice and psychopharmacological research, were used to determine interrater reliability (n= 79). Although the 5 subscales of the original 18‐item BPRS (BPRS‐18) were successfully cross‐validated in this Dutch sample, 4 of these subscales (except for thought disturbance) were found to lack interrater reliability. The 10‐item schizophrenia scale derived from the BPRS‐18 by a Scandinavian group met the standard of acceptable interrater reliability; BPRS‐18 and BPRS‐E global scales approximated this standard. For the thought disturbance subscale, the schizophrenia scale and for BPRS‐18 and BPRS‐E global scales, findings supported discriminatory power.
Low serum iron in patients with neuroleptic‐induced akathisia and dystonia under antipsychotic drug treatment
Authors: Horiguchi J.
Published: August 2007

The concentration of iron was determined in the serum of 35 patients; 10 with akathisia, 8 with dystonia and 17 without akathisia or dystonia. The patients exhibiting akathisia or dystonia had significantly lower serum concentration of iron than the patients without akathisia or dystonia. Neuroleptic‐induced akathisia or dystonia may be facilitated by the low serum iron.
Greek version of the General Health Questionnaire: accuracy of translation and validity
Authors: Garyfallos G. , Karastergiou A. , Adamopoulou A. , Moutzoukis C. , Alagiozidou E. , Mala D. , Garyfallos A.
Published: August 2007

The purpose of this study was to examine the accuracy of translation and to test the validity of the Greek version of the General Health Questionnaire (GHQ). In the translation study, the English and the Greek versions of the GHQ were administered to a sample of 50 bilingual respondents. The internal consistency, item‐by‐item and the subject‐by‐subject analysis have shown that the 2 versions are equivalent and therefore the Greek translation is highly accurate. In the validity study, 100 consecutive patients attending an internal medicine outpatient clinic completed the Greek version of the GHQ‐60 and were interviewed independently using the Present State Examination (PSE). The validity of the shorter forms of the questionnaire (GHQ‐30 and GHQ‐28) was tested by disembedding the relevant items from the larger set. The correlations obtained between the scores of the questionnaire and the PSE ratings, as well as all the validity indices (sensitivity, specificity, positive predictive value, negative predictive value and overall misclassification rate) were quite satisfactory for all the GHQ forms, thus confirming the validity of the questionnaire in its Greek version. The best cut‐off points as found by receiver‐operating characteristics analysis were 11/12 for the GHQ‐60, 5/6 for the GHQ‐30 and 4/5 for the GHQ‐28. The revised (CGHQ) scoring system for the GHQ‐30 has not been proved superior to the conventional scoring method. The above results are discussed in relation to the pertinent literature and especially the studies carried out in similar settings and in countries with similar cultural backgrounds.
Some themes from the philosophy of psychiatry: a short review
Authors: Rosenberg R.
Published: August 2007

Some major themes in the philosophy of science are briefly reviewed, considering epistemological, ontological and ethical problems in modern psychiatry. A conception of realism at the ontological, empiricism at the methodological level and humanistic ethics is proposed. Metapsychiatry is suggested as a theoretical discipline integrating clinical research methodology and philosophy of science.
Interaction between genetic vulnerability and family environment: the Finnish adoptive family study of schizophrenia
Authors: Tienari P.
Published: August 2007

A nationwide Finnish sample of schizophrenics' offspring given up for adoption was compared blindly with matched controls, that is, adopted‐away offspring of nonschizophrenic biologic parents. The adoptive families were investigated thoroughly by joint and individual interviews and psychologic tests. Biologic parents were also interviewed and tested. Among the 144 index and 178 control offspring, the percentage of both psychoses and other severe diagnoses (borderline syndrome and severe personality disorder) was significantly higher in the index adoptees than in the matched control adoptees. Of the 15 psychotic adoptees in the total sample to date, 13 are offspring of schizophrenics and 2 are control offspring. Both global clinical ratings and test data for the adoptive, rearing parents also correlate with the symptomatic status of the adoptees. A prospective, longitudinal study of adoptees at risk is being undertaken to explore the direction of effects between adoptees and adoptive parents.
De novo mania among elderly people
Authors: Charron M. , Fortin L. , Paquette I.
Published: August 2007

De novo mania is defined as the occurrence of a first manic episode in a patient with no history of mood disorder, after exclusion of organic etiologies. Although it is believed to be rare in elderly populations, the authors nonetheless report 6 cases encountered over a 2‐year period. The literature regarding mania among elderly people is reviewed, and the authors formulate their recommendations in view of more frequent recognition and better management of these patients.
Peripheral‐type benzodiazepine receptors in anxiety disorders
Authors: Rocca P. , Ferrero P. , Gualerzi A. , Zanalda E. , Maina G. , Bergamasco B. , Ravizza L.
Published: August 2007

Peripheral benzodiazepine receptors (pBDZr) were analyzed in lymphocyte membranes from patients with anxiety disorders (generalized anxiety disorder (GAD), n= 15; panic disorder (PD), n= 10; obsessive‐compulsive disorder (OCD), n= 18), other mental disorders (n= 40) and 50 healthy controls, by the specific binding of 3H‐PK11195. The number of binding sites (Bmax) was significantly decreased in groups with both GAD and OCD as compared with age‐matched controls, by 45% and 25% respectively, whereas the binding affinity (Kd) was the same in all disorder and control groups. Conversely, no changes in binding capacity was observed in the other disorder groups and particularly in the one with PD. The abnormality in pBDZr observed in patients with GAD was restored to a normal value after long‐term treatment with 2′‐chloro‐N‐desmethyldiazepam, which also coincided with their recovery from anxiety. Our data suggest that the clinical heterogeneity in anxiety disorders might be related to different biological mechanisms and that lymphocyte pBDZr might be useful in demonstrating these differences.
Relationship of dose to antidepressant prophylactic efficacy
Authors: Peselow E. D. , Difiglia C. , Fieve R. R.
Published: August 2007

We studied 75 patients on prophylactic antidepressants (imipramine or amitriptyline) to examine the effect of antidepressant dose on long‐term prophylaxis of depression and to see whether lowering the dose during the prophylactic period affected subsequent relapse. There was no statistically significant difference in maintenance and prophylactic doses between the group that completed the 2 years free of a depressive episode, the group that had a depressive relapse and the group that dropped out of treatment before the end of the prophylactic period. However, the group that completed the 2 years free of a depressive episode had significantly less of a difference between the maintenance and prophylactic doses than the other 2 groups. Overall, 11/31 who remained on the same dose during the prophylactic period vs the maintenance period relapsed vs 17/25 who had their dose lowered during the prophylactic period vs the maintenance period. This difference was statistically significant.
Hyperthyroxinemia in major affective disorders
Authors: Styra R. , Joffe R. , Singer W.
Published: August 2007

Ninety‐nine patients fulfilling DSM‐III criteria for primary major affective disorder, either bipolar or unipolar, were studied. A 12% prevalence of elevated thyroxine levels was found. Three of the 12 hyperthyroxinemia patients also had elevated free thyroxine index. No statistically significant difference in response to antidepressant treatment was observed between the hyperthyroxinemia group and the normal serum thyroxine group.
Selection of patients who attempted suicide for psychiatric consultation
Authors: Suokas J. , Lönnqvist J.
Published: August 2007

A total of 1018 self‐poisoned patients were treated during one year (1983) at the emergency room of Helsinki University Central Hospital for 1207 suicide attempts: 46% were left without psychiatric consultation. Women were consulted more frequently than men. Patients with previous psychiatric treatment were referred more often for psychiatric consultation. The use of alcohol was more frequently present in suicide attempts that did not lead to psychiatric consultation. Somatic seriousness was also less severe in this group. It was assumed that those left without consultation were not in mortal danger. There were no differences in the suicide mortality of these 2 groups during a 5‐year follow‐up.
5‐HT2 receptor antagonism in dysthymic disorder: a double‐blind placebo‐controlled study with ritanserin
Authors: Bersani G. , Pozzi F. , Marini S. , Grispini A. , Pasini A. , Ciani N.
Published: August 2007

Thirty patients suffering from dysthymic disorder participated in a 6‐week double‐blind trial comparing ritanserin 10 mg and placebo. After a single blind placebo wash‐out period of one week, the test medication was administered during 5 weeks on a double‐blind basis. Twenty‐three patients completed the study. At the end of the trial, ritanserin was significantly superior to placebo in its effect as manifested on the 19‐item Hamilton Rating Scale for Depression, the Hamilton Rating Scale for Anxiety and the State Trait Anxiety Inventory X‐1 and X‐2. At the end of the study, the therapeutic effect was rated marked or moderate in 75% of the ritanserin‐treated patients, but only in 18% of the controls. These data are consistent with the hypothesis of serotonin abnormalities in dysthymic disorder and suggest a therapeutic role of 5‐HT2 antagonists. Ritanserin treatment was very well tolerated; no serious adverse experiences were reported.
The dilemma of civil rights versus the right to treatment: questionable involuntary admissions to a mental hospital
Authors: Isohanni M. , Nieminen P. , Moring J. , Pylkkänen K. , Spalding M.
Published: August 2007

Admission to a closed ward was analyzed at the Department of Psychiatry, University of Oulu using 888 patients and their 1861 assessment and treatment episodes. Of all referrals for involuntary assessment (n= 237, 12.7% of all episodes) a total of 44 (2.4%) used “questionable” juridical criteria: the final diagnosis was not psychosis. In the follow‐up, the admission of the questionable patients was mainly considered a clinical necessity, and at least one third of them were diagnosed as being psychotic and 2 committed suicide. An elevated probability of belonging to the questionable group was seen among patients in their first treatment episode, with minimal professional education, female sex, short treatment time, or residence in a rural area. The result suggests that some inequality existed between women and men, less and more educated and residents of urban and rural areas. The results also reflect conflict between the ethics and clinical practice of involuntary commitment, and the phrasing of the law, especially its diagnostic limitation to psychotic states only.
Dementia and depression in old age: psychophysiological aspects
Authors: Have G. , Kolbeinsson H. , Pétursson H.
Published: August 2007

This study describes the psychophysiological results of a larger investigation of the clinical, morphological, psychometric and psychophysiological aspects of dementia of the Alzheimer type and depression in elderly patients. Healthy volunteers provided a further measure of control. It was found that widely used clinical rating scales delineated the 3 groups of subjects to a significant degree. The average frequency of the electroencephalogram (EEG), the P2‐N2 peak‐to‐peak amplitude and P3 latency of the auditory evoked potential and a characteristic downward shift of the EEG power spectrum differed significantly between demented patients, depressive patients and normal controls. The higher total power in the EEG of the dementia group did not prove statistically significant, probably because of the small numbers. Other psychophysiological measures such as skin conductance level (SCL) and skin temperature (ST) did not reveal statistically significant differences between the groups. Thus, certain psychophysiological measurements may become valuable in the differential diagnosis of these disorders.
The concept of cycloid psychosis: sensitivity and specificity of syndromes derived by multivariate clustering techniques
Authors: Jönsson S. A. T. , Jonsson H. , Nyman A. K. , Nyman G. E.
Published: August 2007

A total of 154 patients admitted for the first time to hospital for a psychotic or affective disorder in 1925 were rediagnosed in accordance with DSM‐III and Leonhard's diagnostic system. Symptoms were rated in accordance with a rating protocol containing 33 items based on Leonhard's descriptions of cycloid psychoses. The patients were followed up through parish registers and hospital records. Of 42 cases considered to be cycloid psychosis at index admission, 34 were prognostically verified. The symptom ratings of the 154 patients were analysed by K‐means cluster analysis to test whether the patients with cycloid psychoses would separate from the rest of the material. With a 2‐cluster solution, 30 of 34 cases (88%) were contained in the same cluster. The sensitivity of the ratings was therefore judged to be acceptable. Specificity was low, however, since 19 cases in the cluster were differently diagnosed. A subcohort of 64 patients, satisfying at least 5 items of the rating protocol, was then analysed by Q‐factor analysis to test whether nuclear cases of cycloid psychosis differ from symptomatically related syndromes. No such differences could be statistically verified; no symptom profile specifically indicating cycloid psychosis could be found. Prominent confusion symptoms appear, however, to be prognostically favourable, whereas motility symptoms without confusion seem to indicate an unfavourable course.
ardive dyskinesia and positive symptoms of schizophrenia
Authors: White T. , Brown K. W. , Woods J. P.
Published: August 2007

Positive symptoms and movement disorders were rated in 44 schizophrenic inpatients. A significant negative correlation was demonstrated between tardive dyskinesia and positive symptoms. Possible explanatory mechanisms are discussed.
Twin concordance for DSM‐III‐R schizophrenia
Authors: Onstad S. , Skre I. , Torgersen S. , Kringlen E.
Published: August 2007

The monozygotic (MZ)/dizygotic (DZ) concordance rates for schizophrenia and the relationship between schizophrenia and schizophrenic spectrum disorders were studied in a sample of 31 MZ and 28 DZ schizophrenic probands and their co‐twins. All subjects were personally interviewed with structured diagnostic instruments and classified according to DSM‐III‐R criteria. The concordance rates of 48% for MZ twins and 4% for DZ twins indicate a genetic transmission of DSM‐III‐R schizophrenia. In addition to the schizophrenic co‐twins, 3 MZ co‐twins had a nonaffective psychotic disorder, thus supporting the hypothesis that genes are involved in the development of Axis I schizophrenic spectrum disorders. Schizotypal and paranoid personality disorders were observed in both MZ and DZ co‐twins. These disorders may be familially related to schizophrenia, but a genetic relationship was not confirmed for the Axis II spectrum disorders. A substantial number of MZ co‐twins of schizophrenic probands had no mental disorder.
Suicide and other causes of death in a five‐year follow‐up of patients treated for self‐poisoning in Oslo
Authors: Ekeberg Ø. , Ellingsen Ø. , Jacobsen D.
Published: August 2007

This 5‐year follow‐up study includes all patients (n= 934; 50% females) treated for self‐poisoning in Oslo during 1 year. Seventeen percent were considered suicide attempts upon admission, 25% among the nonabusers and 8% among the abusers. At follow‐up, 122 patients were dead (61% males). The mortality rate was highest among the abusers. The mortality rate was similar (13%) among those who were considered to be suicidal on admittance and those who were not. The causes of death were suicide (28%), opiate abuse (16%), heart disease (14%), accidents or wounds (11%), alcoholism (9%) and others (22%). The standard mortality rate was highly increased in all groups (8 times on average), highest among the female opiate abusers, whose rate was 63 times higher than expected. The increased suicide rates (87 times for females, 27 times for males), however, may be a more relevant measure of mental morbidity than the standard mortality rate. Logistic regression analysis demonstrated that male sex, age above 50 years and the lowest social group were factors on admission associated with death in the follow‐up period. Age above 50 years and suicidal attempt on admission were associated with subsequent suicide. The study strongly supports the idea of self‐destructiveness and slow suicide in substance abuse.
Latencies of the P300 component of the auditory event‐related potential in depression are related to the Bech‐Rafaelsen Melancholia Scale but not to the Hamilton Rating Scale for Depression
Authors: Schlegel S. , Nieber D. , Herrmann C. , Bakauski E.
Published: August 2007

The relationship between severity of depression and the P300 latency of auditory event‐related potential was investigated in 36 patients with a major depressive episode according to DSM‐III. Positive correlations were found between of the P300 latency and the total score of the Bech‐Rafaelsen Melancholia Scale (BRMS), the 4 retardation items of the BRMS (motor, verbal, intellectual and emotional) and the item for lowered mood. In contrast, latencies were not associated with the scores of the Hamilton Rating Scale for Depression, which considers retardation to a lesser extent than the BRMS.
Reliable use of the Present State Examination by psychiatric nurses for clinical studies of psychotic and nonpsychotic patients
Authors: Lesage A. D. , Cyr M. , Toupin J.
Published: August 2007

Four psychiatric nurses were trained with the French version of the Present State Examination, 9th edition (PSE‐9). Reliability was tested on 18 cases of psychotic and nonpsychotic patients. The reliability indexes were comparable to those reported for the English version of PSE‐9. These preliminary results indicate that further training may improve reliability for the nurses. It also warrants other trials in which psychiatric nurses will be used as interviewer with instruments that require clinical judgement.
Folie à six: a case report on induced psychotic disorder
Authors: Dippel B. , Kemper J. , Berger M.
Published: August 2007

A case of folie à six is described in which the persecutory delusions of the central figure spread to her husband and their 2 sons, and even to her sister‐in‐law and a nephew. The main factor in the development of this shared paranoid disorder seems to have been the dominant personality of the inducer. In contrast to reports in the literature, there was no family history of such disorders and there were no adverse social or environmental circumstances.
Karolinska Psychodynamic Profile
Authors: Weinryb RM , Rössel RJ
Published: August 2007

Weinryb RM, ROssel RJ: Karolinska Psychodynamic Profile ‐ KAPP. Acta Psychiatr Scand 1991:83 (suppl 363):l‐23.

The Karolinska Psychodynamic Profile, KAPP, is a rating instrument founded upon psychoanalytic theory. Its validity is satisfactory, and high interrater reliability can be attained with modest training of the raters in using the instrument. It enables relatively stable and only slowly variable modes of mental functioning and character traits to be assessed psychodynamically. The profile is based upon eighteen subscales, by means of which these modes of mental functioning and character traits can be represented. The subscales have been chosen with a view to obtaining a comprehensive assessment of modes of mental functioning and character traits, as reflected in the patient's self‐image and relationships with others. The subscales and their scale steps have been provided with relatively detailed descriptions which are kept close to clinically observable phenomena. The information needed for making the assessments is obtained through a structural interview procedure. The manual, the subscales and their scale steps, and the assessment procedure is presented.
Attitude of the medical profession to psychiatry
Authors: Buchanan A. , Bhugra D.
Published: August 2007

The attitude of the medical profession to psychiatry carries important implications for the quality of personnel attracted into the specialty and for the treatment, in a general medical setting, of patients with mental disorders. This article examines the components of doctors’ attitudes and reviews the literature with regard to their attitudes to psychiatrists themselves, psychiatric patients and psychiatry as a vocation. The implications of these findings for psychiatrists are discussed.
Pancreatic B‐cell functioning after intravenous glucagon administration in anorexia nervosa
Authors: Kobayashi N. , Tamai H. , Takii M. , Matsubayashi S. , Nakagawa T.
Published: August 2007

Abnormal glucose tolerance is often found in patients with anorexia nervosa (AN). We attempted to evaluate pancreatic B‐cell functioning after intravenous glucagon administration. Fourteen patients with the restricting type of AN (percentage of ideal body weight 71.5 ± 1.6%, mean ± SE) and 6 patients with the bulimic type of AN (77.0 ± 3.0%) were studied. After an overnight fast, glucagon (0.02 mg/kg) was injected i.v. into all subjects and 6 normal controls. Blood samples were obtained at 0, 5, 30, 60, 90 and 120 min to measure blood glucose (BS), serum insulin (IRI) and C‐peptide (CPR). The same tests were repeated in 8 patients with restricting AN after therapy and restoration of body weight (85.9 ± 1.0% of ideal body weight). BS responses did not differ among the groups. Peak serum levels (5 min) of both IRI and CPR in restricting AN patients were significantly lower than those in bulimic AN patients and in normal controls. BS, IRI and CPR concentrations did not change significantly following restoration of body weight. Pancreatic B‐cell dysfunction after glucagon administration was observed in restricting AN patients and the abnormality persisted after short‐term weight restoration.
Miscounting suicides
Authors: Lester D.
Published: August 2007

Data from 15 countries indicate that the death rates from causes recorded as suicide, undetermined and certain types of accidents are not significantly associated. Thus, it did not appear that some countries have lower suicide rates because their suicides are hidden as undetermined or accidental deaths. Furthermore, adding the undetermined death rate and a portion of the accidental death rate to the suicide rate did not greatly change the relative rankings of the national suicide rates.
Personality as a cause of adverse life events
Authors: Poulton R. G. , Andrews G.
Published: August 2007

The element of chance and the role of the individual in causing negative life events was explored by examining the relationship between measures of personality, symptoms, and a number of demographic variables in a nonclinical population (n= 892). The results indicated that Eysenck's neuroticism was the best predictor of negative interpersonal life events. Symptoms added a negligible amount to the variance explained in the occurrence of life events. The well‐established relationships between neuroticism and symptoms and life events and symptoms are discussed in the light of these findings.
Long‐term effects of an educational program for general practitioners given by the Swedish Committee for the Prevention and Treatment of Depression
Authors: Rutz W. , Knorring L. von , Wålinder J.
Published: August 2007

In 1983‐1984 the Swedish Committee for the Prevention and Treatment of Depression offered an educational program on diagnosis and treatment of depressive disorders to all general practitioners on the island of Gotland. The program has been carefully evaluated; 1982 was used as the baseline and the main evaluation was carried out in 1985. After the educational programs, the frequency of sick leave for depressive disorders decreased, the frequency of inpatient care for depressive disorders decreased to 30% of that at the baseline; the prescription of antidepressants increased, but prescription of major tranquilizers, sedatives and hypnotics decreased. The frequency of suicide on the island decreased significantly. This study describes the long‐term effects. In 1988, 3 years after the project ended, the inpatient care for depressive disorders increased, the suicidal rate returned almost to baseline values and the prescription of antidepressants stabilized. Thus, the effects were strictly related in time to the educational programs, indicating that the effects were real and not only a coincidence with local trends on Gotland. Furthermore, the results indicate that educational programs that can have pronounced effects on the health care system have to be repeated approximately every 2 years if long‐term effects are to be expected.
Light exposure patterns in schizophrenia
Authors: Gerbaldo H. , Demisch L. , Cardinali D. P.
Published: August 2007

Spontaneous light exposure patterns were studied in 10 chronic schizophrenic patients. Half of our schizophrenic patients exposed themselves to bright light exceeding ordinary indoor illumination. There was a significant positive correlation between the percentage of exposure to bright light and the Brief Psychiatric Rating Scale subscore anergia and a significant negative correlation with depression.
Validity and reliability of the Anorectic Behavior Observation Scale for parents
Authors: Vandereycken W.
Published: August 2007

The Anorectic Behavior Observation Scale (ABOS) is a new self‐reporting questionnaire developed to obtain information from parents about specific behaviors and attitudes in their children that might be symptomatic for anorexia or bulimia nervosa. Parents of 191 eating disorder patients and 174 female students completed the questionnaire. Using a cut‐off score of 19, the ABOS has a sensitivity of 90.0% and a specificity of 89.6%. A comparison with a clinician's evaluation of the patients’ behavior and, in the control group, with the subjects’ own judgement, revealed that parents generally give reliable information. The ABOS may be used as a valuable supplement to existing screening instruments for eating disorders.
The St. George's dementia bed investigation study: a comparison of clinical and pathological diagnosis
Authors: Gilleard C. J. , Kellett J. M. , Coles J. A. , Millard P. H. , Honavar M. , Lantos P. L.
Published: August 2007

Sixty‐four elderly patients who had been admitted to the St. George's Hospital Alzheimer's disease evaluation project during 1981–1989 were followed up to postmortem examination. Comparison between clinical diagnoses and neuropathological diagnoses indicated positive predictive values for the antemortem diagnoses of 50–67%. Existing clinical criteria may not be accurate enough to permit firm antemortem diagnosis of older people for either research or clinical purposes.
Drop‐out rate as a performance indicator in psychotherapy
Authors: Hunt C. , Andrews G.
Published: August 2007

Many large studies of psychotherapy show that the median patient drops out by the 5th session and most before the 10th session. Data from an effective behavior therapy clinic for the anxiety disorders showed that only 17% of patients failed to complete a median of 60 h of therapy. Patient characteristics were not associated with attrition. We examined 5 meta‐analytic treatment reviews and found the median drop‐out rate was 8% after 20 h of therapy. We suggest that low attrition is associated with effective, standardized treatment and as such, drop‐out rate may be a proxy variable that can indicate effective service delivery.
The structure of personality disorders in DSM‐III
Authors: Bell R. C. , Jackson H. J.
Published: August 2007

In DSM‐III it is proposed that there are 11 personality disorders (PDs) that fall into 3 superordinate clusters: cluster A, labelled the odd or eccentric; cluster B, labelled the emotional, dramatic or erratic; and cluster C, described as the anxious or fearful. To check this proposal, data were obtained from a sample of 112 state hospital psychiatric inpatients via the Structured Interview for DSM‐III Personality (SIDP). Various statistical techniques were applied to the data, ranging from the least constrained method of multidimensional scaling to the most constrained and statistically rigorous approach of confirmatory factor analysis. In the latter approach, the models suggested by the various statistical approaches were contrasted directly. A 3‐cluster solution was accepted as the best representation of the data, although PD membership of the 3 clusters varied in some ways from those suggested by DSM‐III. An exploratory correlational analysis showed that many of the items were more strongly correlated with PDs other than the ones specified by DSM‐III, but generally items clustered within the 3 superordinate clusters. This issue deserves further investigation.
Early signs of cognitive deficits among human immunodeficiency virus‐positive hemophiliacs
Authors: Riedel R.‐R. , Helmstaedter C. , Bülau P. , Durwen H. F. , Brackmann H. , Fimmers R. , Clarenbach P. , Miller E. N. , Böttcher M.
Published: August 2007

A total of 181 human immunodeficiency virus (HIV)‐seropositive hemophiliacs and 28 hemophilic controls were evaluated by psychometric tests and by electroencephalogram (EEG). Patients were classified from stages 1–6 according to the immunological criteria of the Walter Reed staging system. Statistical analysis of psychometric data showed an effect of the stage of the disease on test performances, indicating a decline in attention, accumulation of perceptual interferences, decline in visuoperceptual speed and visuomotor response speed and reduced verbal memory performance, especially in stage 6 patients. Comparison of performance levels with normative test data already revealed cognitive deficits in about 20–30% of the patients in stages 2–5. As regards verbal memory, especially learning and recognition of new verbal information were impaired. In contrast, there was no significant deficit for nonverbal memory processing. Compared with the controls, patients exhibited an increasing number of abnormal EEG findings in stages 2–6. As a conclusion, in the stages before acquired immunodeficiency syndrome (AIDS) develops, EEG findings as well as psychometric findings indicate central nervous system involvement of AIDS in about 20–30% of cases, whereas in full‐blown AIDS there is a marked increase to 80%. Besides a more general deficit of attention and psychomotor speed as is seen in subcortical dementia, there is evidence for a particular verbal learning disorder, suggesting additional selective impairment of the brain.
The psychological management of depression
Authors: Stravynski A. , Greenberg D.
Published: August 2007

This article reviews the effects of psychological treatments specifically developed for depression. Promising and durable results have been reported for cognitive and interpersonal psychotherapies but also for behavioral psychotherapy, which has generated less research interest so far. The therapeutic effects seem to be equivalent and at least comparable to pharmacotherapy in mild to moderate depression.
Projective identification and suicide contagion
Authors: Taiminen T. J.
Published: August 2007

The effect of suggestion on suicide is well established. However, the intrapsychic mechanisms of the contagion of suicides are poorly understood. In this article I first present the literature about suicide clustering and about projective identification. In the following clinical vignette I try to understand a patient's suicidal behaviour, referring to William Goldstein's clarifying model of projective identification. I aim to illustrate that his model has heuristic value in the treatment of suicidal patients when the effect of suggestion or identification is suspected.
Social conditions in a total population with long‐term functional psychosis in three different areas of Stockholm County
Authors: Borgå P. , Widerlöv B. , Stefansson C. G. , Cullberg J.
Published: August 2007

A number of social conditions regarding interpersonal relations, housing and employment were studied in a total population of individuals with long‐term functional psychosis (n= 341) drawn from the population aged 18–64 years inhabiting three different areas of Stockholm County, altogether about 57,000 inhabitants. Individuals were included irrespective of whether they had a psychiatric treatment contact or not. They were mostly unmarried (57%) and living alone (64%). Most were unemployed (69%) and over half received a disability pension. However, 76% had their own flat and a reasonable financial standard, not deteriorating with illness duration. The diagnosis of schizophrenia led to poorer social conditions, as did early age at onset, male sex and co‐morbidity of substance abuse. A larger number of individuals lived in an institution in the urban area while a greater number lived with relatives in the rural area.
Urinary excretion of albumin and retinol‐binding protein in lithium‐treated patients: a longitudinal study
Authors: Jensen H. V. , Hemmingsen L. , Holm J. , Christensen E. M. , Aggernæs H.
Published: August 2007

The urinary excretion of albumin and retinol‐binding protein was determined by means of sensitive immunochemical methods in a 2‐year longitudinal study of 22 lithium‐treated patients. During lithium treatment, there were no significant changes in the median albumin:creatinine ratios or retinol‐binding protein:creatinine ratios. However, the median albumin:creatinine ratios were significantly higher in lithium‐treated patients than in 22 normal subjects, which indicates that glomerular permeability is increased; no correlation with serum lithium level or duration of lithium treatment could be shown. In patients treated with slow‐release tablets, the urinary excretion of albumin was significantly higher after 2 years than in patients given lithium carbonate. The median retinol‐binding protein:creatinine ratios did not differ significantly between lithium‐treated patients and normal subjects, suggesting that lithium does not affect the catabolism of low‐molecular‐weight proteins in the proximal tubules. In conclusion, the study supports the hypothesis that lithium treatment produces a small but significant and nonprogressive elevation of the urinary excretion of albumin.
Should a biologic marker be sensitive and specific?
Authors: Nurnberger J. I.
Published: August 2007

Potential biologic markers in psychiatry are often subjected to tests of sensitivity and specificity. However, in many instances, clinically diagnosed diseases may not be truly singular in their pathophysiology, and these tests may be inappropriate. One may distinguish between diagnostic markers useful in clinical pathology, linkage markers specifying genetic location and pathophysiologic markers that are primarily valuable as research tools. The latter are probably most useful in present‐day psychiatry but they may not be sensitive or specific in their correspondence to clinical diagnosis.
Antidepressants may not assist recovery in practice: a naturalistic prospective survey
Authors: Brugha T. S. , Bebbington P. E. , MacCarthy B. , Sturt E. , Wykes T.
Published: August 2007

A total of 130 people attending psychiatric hospitals within 6 months of onset or relapse of an episode of depressive disorder were interviewed about their symptoms and treatment at the time of their initial contact. After a mean 4‐month interval, 119 were reassessed to test the hypothesis that patients treated with antidepressants would be significantly more likely to be clinically improved compared with those untreated. Severity and duration of the episode emerged as the only significant clinical predictors of clinical improvement. Patients on treatment with antidepressants at the start of the study showed a nonsignificant trend for a lesser degree of clinical improvement, even when clinical severity and compliance were taken into account. Those who were not commenced on treatment until later in the study also fared no better than those who were never prescribed antidepressants. The effect of low doses of antidepressants (almost always a tricyclic) appeared to be less beneficial than either higher doses or clinical management without antidepressant drugs. The need for further experimental and naturalistic studies conducted over various periods of time and the implications for clinical practice, medical audit and the appropriate use of health outcome indicators are discussed.
Trends in psychiatric hospitalization in Denmark: a 10‐year register‐based investigation
Authors: Munk‐Jørgensen P. , Lützhøft J. H. , Jensen J. , Strömgren E.
Published: August 2007

Information about all admissions to psychiatric hospitals and departments in Denmark in 1977, 1982 and 1987 and about all resident patients on census days in the same years were extracted from the central psychiatric register. The number of available beds decreased by 43% from 1977 to 1987. The admission rates decreased for all diagnostic groups but schizophrenia, which increased. The group of younger schizophrenic men declined in size, which is alarming if mentally ill homeless people are considered. The census study shows a decrease in all diagnostic groups, most pronounced in the elderly age groups. Patients with neuroses disappear from the available beds in the mental hospitals and departments. The changes in the psychiatric service system from mostly hospitalization to outpatient treatment and community psychiatric treatment require a comprehensive personal registration of treatment regardless of the administrative affiliations of these services.
Do perceived parental rearing patterns influence social behaviour dimensions and disease severity in schizophrenia?
Authors: Khalil N. , Stark F.‐M.
Published: August 2007

In an explorative study, a clinical sample of 53 schizophrenic patients was examined. The EMBU inventory was used for measuring perceived parental rearing practices, the AfS for rating the quality of relationship to key relatives and the U‐Scale for assessing social anxiety. The findings obtained were intercorrelated and compared with 3 selected parameters of disease severity: age at first hospitalization, number of treated episodes and length of hospital stay. The results suggest that the quality of contact with key relatives is determined to a larger extent by the schizophrenia than by parental rearing attitudes. Rearing behaviour more likely influences the age at first hospitalization and social anxiety, whereas considering the length of face‐to‐face contact, the quality of the relationships between patients and their key relatives can be assumed to be associated with the duration of hospital stays.
Middle cerebral artery velocity during upright posture after marijuana smoking
Authors: Mathew R. J. , Wilson W. H. , Humphreys D. , Lowe J. V. , Wiethe K. E.
Published: August 2007

Marijuana is known to cause symptoms suggestive of orthostatic hypotension such as dizziness and fainting during upright posture. We examined changes in cerebral blood velocity (CBV) and peripheral circulation during upright posture after smoking marijuana in 10 right‐handed male subjects with a previous history of exposure to marijuana. The participants were physically and mentally healthy and drug‐free for a minimum of 3 months before the experiment. Middle cerebral artery CBV, blood pressure and pulse rate were recorded during reclining position and standing, before and after smoking a high‐potency marijuana cigarette or a placebo cigarette administered during 2 separate visits to the laboratory. The participants were questioned about dizziness during the upright position. Six of 10 subjects reported moderate to severe dizziness during standing after marijuana but not placebo. Subjects who experienced severe dizziness during standing showed marked decreases in blood pressure and CBV. Those who reported moderate dizziness showed reduction in CBV but not blood pressure. Subjects who reported mild dizziness after marijuana and after placebo smoking showed minimal changes in blood pressure and CBV. Cerebral ischemia during upright position after marijuana smoking may be caused by hypotension and impaired cerebral autoregulation.
Stability over time of character assessment using a psychodynamic instrument and personality inventories
Authors: Weinryb R. M. , Gustavsson J. P. , Åsberg M. , Rössel R. J.
Published: August 2007

In a group of patients with a preoperative diagnosis of ulcerative colitis, the stability of character traits and modes of mental functioning were studied after a major life event, major abdominal surgery, using the Karolinska Psychodynamic Profile (KAPP), an interview‐based assessment instrument founded upon psychoanalytic theory. In addition, different personality and temperamental variables were assessed with 2 self‐report instruments. The patients were assessed before surgery, and follow‐up was made at least 1 year after their final scheduled surgery. Although the patients had undergone major abdominal surgery and convalescence between the assessments, the correlations between the scores before and after surgery were very high, and the levels of the scores were very similar. This was true for all the instruments, indicating that they assessed stable characteristics in the patients. The changes that did occur were mainly in the predicted direction. The results of this study suggest that the KAPP can assess modes of mental functioning and character traits that are relatively stable and only slowly variable.