bluuebunny/crossref_metadata_2025 huggingface dataset:
A reappraisal of alcoholic psychoses
Authors: Cutting John
Published: July 2009

SYNOPSIS

A retrospective study of alcoholic psychoses is reported. The phenomena of the illnesses corresponded poorly with classical descriptions of alcoholic hallucinosis, delirium tremens and alcoholic paranoia. Alternative diagnostic approaches were tried (Catego, restrictive definition of alcoholic hallucinosis). The problems of distinguishing psychoses with associated organic factors from ‘idiopathic’ forms are discussed.
Experimental and clinical evidence of the antidepressant effect of a beta-adrenergic stimulant
Authors: Simon P. , Lecrubier Y. , Jouvent R. , Puech A. J. , Allilaire J. F. , Widlöcher D.
Published: July 2009

SYNOPSIS

A group of 49 patients with depressive illness were treated in an uncontrolled study by the intravenous administration of the beta-adrenergic stimulant, salbutamol. The results suggested a rapid antidepressant action in the majority of cases without significant adverse effects.
Historical terminology of eating disorders
Authors: Parry-Jones Brenda
Published: July 2009

SYNOPSIS

Using a wide range of rare, early printed sources, including literary material, some of the first English language dictionaries, medical lexicons and medical texts, the historical origins, development and application of five terms relating to eating abnormalities are investigated. It is demonstrated that four of these, which are in current psychiatric usage, exhibited notable consistency of meaning and application over many centuries.
Dementia in idiopathic Parkinson's disease: prevalence and relationship with symptoms and signs of Parkinsonism
Authors: Ebmeier K. P. , Calder S. A. , Crawford J. R. , Stewart L. , Cochrane R. H. B. , Besson J. A. O.
Published: July 2009

SYNOPSIS

A whole population cohort of 157 patients with idiopathic Parkinsonism, most of whom had previously been clinically examined by Mutch (1986 a), were assessed to determine prevalence figures for dementia and examine the relationship between dementia, cognitive impairment and Parkinsonian signs. Dementia according to DSM-III-R criteria was diagnosed in 23·3% of all patients (95% confidence interval: 17·1 to 32·4%). Dementia and cognitive impairment were associated with overall measures of Parkinsonian impairment and rigidity, but not tremor, even after controlling for age, sex and education.
The role of unemployment in parasuicide
Authors: Jones S. C. , Forster D. P. , Hassanyeh F.
Published: July 2009

SYNOPSIS

Sixty-four in-patient cases of deliberate non-fatal self-poisoning were compared for psychosocial problems in a case-control study with a similar number of individually matched community controls. A strongly significant association was found between unemployment and self-poisoning. Further analysis revealed no firm evidence to support the hypotheses that unemployment was causally related to self-poisoning in an indirect manner or that it increased the vulnerability of individuals who self-poison to other stressful life events and difficulties. It is concluded that a possible explanation is that some third factor independently increases the risk of both unemployment and self-poisoning, giving rise to a non-causal relationship between these last two variables.
The need for social support among out-patients suffering from functional psychosis
Authors: Salokangas Raimo K. R. , Palo-Oja Timo , Ojanen Markku
Published: July 2009

SYNOPSIS

From an original sample of 177 patients in community care and suffering from functional psychosis, the psychiatric teams involved in the treatment of these patients interviewed 136 patients and 103 relatives. The interviews aimed at determining the patient's problems in socialrole behaviour, as evaluated both by the patients themselves and by their relatives, and to measure the stress caused to the relatives.

According to the patients themselves, over 60% had considerable difficulties in at least one area of social-role behaviour; the same conclusion was reached by over 50% of the relatives. The patients had a more positive view of their abilities to cope with housework, self-care, and managing money than their relatives. One-third of the relatives said they were dissatisfied with the situation, and more than 40% displayed a resigned attitude to the amount of support required by the patient.

Problems in social-role behaviour were commonest in patients who were dissatisfied with their treatment, in male patients, and in patients who lived together with their spouse, and among the relatives dissatisfaction with the situation as a whole was also highest in these cases. On the basis of these findings it is stressed that the treatment of psychotic patients should be based on a broad approach involving not only the patients themselves but also their relatives.
The NH & MRC Social Psychiatry Research Unit, at the Australian National University, Canberra, 1975–90
Authors: Henderson A. S.
Published: July 2009

In 1974, the National Health and Medical Research Council (NH & MRC) in Australia reviewed what initiatives might be undertaken to promote medical research relevant to the needs of the population. It noted that Australia had contributed with distinction in some areas, such as the neurosciences and immunology, whereas fields such as epidemiology and psychiatry were much less developed scientifically. As the principal source of funding for medical research, the NH & MRC had hitherto supported projects, individuals and a small number of institutions (e.g. the Walter and Eliza Hall, the Florey and the Baker Institutes). The initiative adopted in 1974, as an additional commitment, was to establish some research units in areas of major relevance for public health. These were intended to become centres of excellence in fields where more expertise was needed at a national level.
Gastric emptying, glucose tolerance and associated hormonal changes in heroin addiction
Authors: Ghodse A. Hamid , Reed J. L.
Published: July 2009

Synopsis

The gastric emptying rate of 8 heroin-dependent males was measured by means of a radioactive isotope method. A simultaneous oral glucose tolerance test was carried out. The glucose response showed a low, flat curve with a delayed peak, and increased secretion of insulin and growth hormone occurred. As the gastric emptying rate proved to be normal the observed metabolic abnormalities are not due to the effect of heroin on the gastro-intestinal tract, but must be attributed to some other effect of chronic heroin administration.
Life stress and symptom pattern in out-patient depression
Authors: Paykel E. S. , Rao B. M. , Taylor C. N.
Published: July 2009

Synopsis

The relationship was examined between symptoms rated in a sample of out-patient depressives, and measures of life stress derived from a separate interview. There was an association between symptoms reflecting the endogenous–neurotic distinction and life stress. However, the association was relatively weak, and was mainly with total social problems at the time of presentation, rather than with life events at onset. These findings are consistent with other studies which indicate that the absence of prior life events and the presence of the endogenous symptom pattern are only weakly related.
Psychological distress among Canadian adolescents
Authors: D'Arcy Carl , Siddique C. M.
Published: July 2009

Synopsis

This paper examines a comprehensive set of data on the prevalence and correlates of psychological distress in a sample of 1038 adolescent students in a major urban area of a Canadian prairie province. About 27% of the students reported 6 or more symptoms of psychological distress on the GHQ-30. The frequency of symptoms varied with age, grade level and average marks, with sex being the most significant variation. ‘Anxiety’ and ‘social dysfunction’ were the most frequent symptom dimensions reported. More detailed analysis of possible predictors of mental health showed that the nature and quality of family life strongly affected adolescent mental health. Adolescents' positive evaluation of their school atmosphere and peer group life and their locus of control orientation also positively influenced their psychological well-being.
Foulds’ hierarchical model of psychiatric illness in a Dutch cohort: a re-evaluation
Authors: De Jong A. , Giel R. , Lindeboom E. G. , Slooff C. J. , Wiersma D.
Published: July 2009

Synopsis

In order to evaluate Foulds' hierarchical model of psychiatric illness, a study was carried out using data from a 3-year follow-up of patients suffering from functional non-affective psychoses. Of the 177 Present State Examinations carried out 86% yielded symptom patterns compatible with the model. It was shown that failures to fit the hierarchy can be explained either by measurement error or by the masking of major symptoms by the simultaneous presence of minor ones. A one-dimensional scale to measure the severity of psychiatric illness was constructed. Patients' scores were compared with ratings on the Index of Definition and the diagnosis of current mental state. The results of these comparisons were considered to be supportive validatory evidence. Some of the implications of the model and the data are discussed.
The case of Arise Evans: a historico-psychiatric study
Authors: Hill Christopher , Shepherd Michael
Published: July 2009

synopsis

The life and the ideas of a mentally aberrant figure in mid-seventeenth century England are presented in relation to the sociocultural background of the time and the available clinical information. The material illustrates the need to draw on both sources when applying psychiatric concepts to particular historical epochs.
Clinical significance of plasma chlorpromazine levels I. Plasma levels of the drug, some of its metabolites and prolactin during acute treatment
Authors: Wiles D. H. , Kolakowska T. , McNeilly A. S. , Mandelbrote B. M. , Gelder M. G.
Published: July 2009

Synopsis

Seventeen acute psychotic patients were studied in the course of chlorpromazine (CPZ) treatment. Blood samples were taken weekly both before and two hours after the morning CPZ dose. Plasma levels of CPZ, CPZ sulphoxide (CPZSO) monodesmethylated CPZ (NOR1CPZ) and 7-hydroxy CPZ (7OH CPZ) were estimated by gas chromatography. Plasma prolactin, luteinizing hormone, testosterone and oestrogens were measured by radioimmunoassay. Six of the seven patients who showed no clinical improvement had plasma CPZ levels equal to or higher than those of patients who improved. ‘Non-responders’ had a greater proportion of CPZ SO in pre-dosage samples. The occurrence of parkinsonian side effects was associated with a mean plasma CPZ of > 50 ng/ml and a mean plasma prolactin of > 30 ng/ml two hours after dosage. The elevation of prolactin preceded the onset of parkinsonian symptoms by 1–2 weeks. There was a significant positive correlation between mean plasma prolactin and mean plasma CPZ levels. The prolactin response may prove a useful index of the central antidopaminergic effect of neuroleptic drugs.
Completed suicide: a taxonomic analysis of clinical and social data
Authors: Bagley Christopher , Jacobson Solomon , Rehin Ann
Published: July 2009

Synopsis

A post mortem enquiry has been made into the social family and clinical circumstances of 50 individuals who, according to a coroner's verdict, killed themselves in Brighton. A dimensional analysis of the 123 variables thus collected suggested the possibility of three distinct types of suicide: ‘depressive suicide’, ‘sociopathic suicide’ and ‘physical illness suicide’. The reliability of this typology has been checked by the analysis of 55 selected variables for a total of 193 cases considered by the same coroner. A cluster analysis has confirmed that the data contain at least three independent types of suicide. Some implications for the prevention of suicide are discussed.
Institute of Psychiatry Department of Child and Adolescent Psychiatry
Authors: Rutter Michael
Published: July 2009

There has been a child psychiatry research group within the Institute of Psychiatry since 1952. At first it constituted a section of the Department of Psychiatry and for a while it formed part of the MRC Social Psychiatry Research Unit. However, in 1973 London University established a Chair of Child Psychiatry and since that time there has been a separate Department of Child and Adolescent Psychiatry. The research in this field undertaken up to 1967 has been described previously (Rutter, 1968a) and the present report brings the account up to date with a summary of work carried out during the last eight years.
The seasonal incidence of mania and its relationship to climatic variables
Authors: Myers D. H. , Davies P.
Published: July 2009

Synopsis

Monthly hospital admission rates (HA) for mania were classified by sex, type of admission (first, or re-admission) and by country (England and Wales or Scotland). Of the 8 classes thus created, all but one showed a statistically significant annual cycle with a peak in Summer and trough in Winter. There was no significant difference in phase or amplitude between male and female cycles. A linear increase in yearly re-admission rates was found during the 8 years of the English and the 11 years of the Scottish data.

Current month's mean daily temperature (lag0) and last month's (lag1) mean day-length and mean daily hours of sunshine correlated better with admission rate than did the values for other months. In a multiple regression analysis temperature made the other 2 climatic variables redundant in accounting for variation in HA.
Contrasting demographic patterns of minor psychiatric morbidity in general practice and the community
Authors: Finlay-Jones Robert A. , Burvill Peter W.
Published: July 2009

Synopsis

The 60-item General Health Questionnaire was completed by 90% of 4798 patients aged 15–69 years who consulted, on one day, the general practitioners of 97% of practices in the Perth Statistical Division. A point prevalence rate of minor psychiatric morbidity in various demographic groups was calculated in terms of the population at risk. The demographic pattern of morbidity was compared with that found in a probability sample of 2324 community residents drawn from the same population at risk, and surveyed at the same time using the same screening instrument.

Widowed persons, British-born men who had recently migrated to Australia, and lower-social-class men with minor psychiatric morbidity were under-represented in general practice. Elderly men and women in upper-class occupations with minor psychiatric morbidity were over-represented in general practice. These differences, unlike others that were found, could not be explained by differing consulting habits or by differing completion rates of the screening instrument.
A further test of Foulds' personality and personal illness differentiae in a psychiatric group
Authors: Bedford A. , McIver D. , Pearson P. R.
Published: July 2009

Synopsis

Test and retest scores on the Symptom Rating Test (SRT), Manifest Anxiety Scale (MAS) and Maudsley Personality Inventory (MPI) were obtained from 45 non-psychotic psychiatric in-patients. The change in scores and the score distributions were examined to assess the extent to which these tests meet Foulds' criteria for measures belonging respectively to the universes of personality and personal illness. MPI Extraversion emerged as a stable, normally distributed, personality trait in contrast to the SRT which showed the characteristics of a symptom-state measure. MPI Neuroticism and MAS scores could not be allocated definitively to either universe and seemed to be hybrids. It is suggested that more attention must be paid to the ‘ purity’ of scales if meaningful interpretation is to be made in treatment assessment.
The effect of fluphenazine on basal prolactin concentrations
Authors: Chalmers R. J. , Bennie E. H.
Published: July 2009

Synopsis

The effect of fluphenazine on basal human prolactin (hPRL) concentrations was studied in 10 male schizophrenics who had received fluphenazine treatment for at least 6 months, in 10 male alcoholics before and during the first week of fluphenazine treatment and in 8 alcoholics at daily intervals before and after treatment. The results were compared with basal hPRL concentrations in 17 healthy male controls. Investigations involved giving fluphenazine (Modecate) by intramuscular injection and taking blood samples at appropriate intervals by venepuncture. Basal hPRL concentrations were significantly increased in the schizophrenics. The alcoholics showed a significant rise in hPRL concentrations after fluphenazine but there was considerable variation in hPRL levels between individual patients. Most patients showed marked elevation of daily hPRL levels with peak concentrations occurring 5–6 days after the injection. The results demonstrate that fluphenazine elevates basal hPRL levels and the variation between levels of individual patients merits further investigation.
Multicompartmental analysis of amino acids: II. Tryptophan in affective disorder
Authors: Shaw David M. , Tidmarsh Simon F. , Johnson Anthony L. , Michalakeas Alexandros C. , Riley Graham J. , Blazek Richard , Francis Antony F.
Published: July 2009

Synopsis

Two of the tryptophan pools in the body and their associated fluxes, as defined by multicompartmental analysis, were studied in patients with unipolar affective disorder, bipolar patients (manic) and control subjects. The 2 pools were tentatively associated with extra- and intracellular compartments. The investigations were performed fasting and may have been mildly stressful. Under these conditions the concentration of tryptophan in plasma and perhaps amounts in the extracellular space were reduced in unipolar depression, with intermediate values after recovery. Some model parameters were lower in females than males. The results in unipolar affective disorder were interpreted in terms of a previously presented hypothesis that this illness may result in an idiosyncratic response to stress in which patients are unable to maintain normal amounts of tryptophan in the body. In manic patients extracellular levels of tryptophan were unchanged but intracellular and total quantities of ‘freely available’ tryptophan may have been reduced.
Psychiatric consequences of temporal lobectomy for intractable seizures: a 20–30-year follow-up of 14 cases
Authors: Stevens Janice R.
Published: July 2009

Synopsis

Between 1958 and 1968, 14 patients from the epilepsy clinic at the University of Oregon Hospitals and Clinics with a diagnosis of temporal lobe epilepsy (TLE) had a temporal lobectomy for medically intractable seizures. Nine of the 14 patients operated on remained seizure-free over the 20–30-year period of follow-up. Between 6 months and one year following temporal lobectomy, two women, previously healthy from a psychiatric standpoint, developed psychoses, and the previous psychiatric problems of four other patients worsened. Two patients, one with incapacitating paranoid personality disorder and the other with explosive rage attacks preoperatively, had marked improvement in their psychiatric status following temporal lobectomy. The remaining six patients, all psychiatrically healthy prior to surgery, have had no change in psychiatric status following surgery. Development of psychosis or deterioration in psychiatric status after surgery was more common in patients with later age of onset, unreality or déjà vu rather than epigastric aura, pre-operative evidence of bilateral brain damage, and persistence of EEG or clinical seizure activity. Development of a chronic psychosis in psychiatrically healthy individuals many months after temporal lobectomy, even when seizures are arrested or ameliorated, suggests that anomalous synaptic regeneration may follow the surgery in these cases. Careful analysis of histories and outcomes may contribute to better understanding of the pathophysiology and anatomical substrates of psychoses.
Estimating psychiatric morbidity by logistic regression: application to post-natal depression in a community sample
Authors: Carothers Andrew D. , Murray Lynne
Published: July 2009

Synopsis

The use of logistic regression to estimate the prevalence of psychiatric morbidity in community samples is illustrated here with data from a study of post-natal depression in 702 primiparous Cambridge mothers. The method is also used to validate the primary screening instrument (in this case the Edinburgh Postnatal Depression Scale – EPDS), and to estimate the effects of cofactors, such as maternal age, previous psychiatric history and social class.
Psychiatric morbidity among Punjabi medical patients in England measured by General Health Questionnaire
Authors: Krause I-B. , Rosser R. M. , Khiani M. L. , Lotay N. S.
Published: July 2009

Synopsis

The 28-item GHQ was administered to 282 Punjabi and white British patients visiting two Health Centres in Bedford. We discovered that ethnicity is not significantly correlated with GHQ ‘caseness’, but that differences exist in somatic and depressive symptomatology. The discussion relates these findings to debates about the psychiatric morbidity of Asian immigrants and somatization.
Madness at the crossroads: John Home's letters from the Royal Edinburgh Asylum, 1886–87
Authors: Barfoot M. , Beveridge A. W.
Published: July 2009

Synopsis

A detailed and critical discussion of John Home, a certified inmate of the Royal Edinburgh Asylum during 1886–87, is presented from a historical perspective which is sensitive to the respective positions of the practitioner and the patient. Particular attention is paid to the letters Home wrote during his confinement and their significance for understanding asylum life during this period. Some interpretative difficulties surrounding the use of medical records, patient letters and other related evidence are also examined.
Emotional factors in forgetting
Authors: Bradley B. P. , Baddeley A. D.
Published: July 2009

Synopsis

Levinger & Clarke (1961) found that subjects tended to forget more word associations to emotional rather than neutral words. Kline (1981) regarded this study as providing “irrefutable evidence for the Freudian concept of repression”. On the other hand, results from Kleinsmith & Kaplan (1964) suggested that this effect may reverse after a delay. The present study attempted to replicate Levinger & Clark's result using stimulus words balanced for concreteness and frequency. In addition, recall was tested immediately and after a delay. Associations to emotional material were more poorly recalled immediately than associations to material which was low in emotional valence, but tended to be better recalled a month later. There were no differences in recall of pleasant versus unpleasant material. Results do not support the repression hypothesis, in that emotional material becomes more memorable over time. Moreover, repression should differentially apply to unpleasant rather than pleasant material but no such differences were found.
An epidemiological study of histrionic personality disorder
Authors: Nestadt G. , Romanoski A. J. , Chahal R. , Merchant A. , Folstein M. F. , Gruenberg E. M. , McHugh P. R.
Published: July 2009

Synopsis

In conjunction with the Epidemiological Catchment Area (ECA) survey conducted in Baltimore, MD, a two-stage probability sample of community subjects was developed with a full psychiatric examination employing DSM-III criteria. This report details the observations on those subjects diagnosed with the DSM-III diagnosis Histrionic Personality Disorder. The results indicate that this condition can be diagnosed reliably and that it is a valid construct. It has a prevalence of 2·1 % in a general population. Males and females are equally affected, suggesting that prior reports of an increased prevalence in females was an expression of ascertainment bias found in hospital-based studies. The diagnosis is associated with clear evidence of disturbance in the emotional, behavioural, and social realms. Individuals with this disorder tend to use health care facilities more frequently than others.
The aetiology of childhood autism: a criticism of the Tinbergens' ethological theory
Authors: Wing Lorna , Ricks Derek M.
Published: July 2009

Synopsis

Kanner's descriptions of the children showing the abnormal behaviour pattern he observed and named 'early infantile autism’ are summarized. E. A. and N. Tinbergens' ethological theory of the aetiology of this syndrome is outlined and criticized. The major problem in evaluating this theory, apart from the absence of any evidence in its favour, is the lack of precision with which the Tinbergens use the terms ‘autism’ and ‘Kanner's syndrome’.
Observer variation and depressive phenomenology
Authors: Verghese Abraham , Burrows Graham , Foenander George , Stevenson James , Davies Brian
Published: July 2009

Synopsis

An investigation into observer variation and depressive phenomenology is described. A group of 6 clinicians independently completed a 43-item sheet for 20 depressed patients at the same clinical interview. The coefficient of agreements on the items are given. Patient variables and observer variables did not have any influence on the degree of agreement. There was also an agreement in the subtyping of depression.
Chronic mania in childhood: case report of a possible association with a radiological picture of cerebellar disease
Authors: Cutting J. C.
Published: July 2009

Synopsis

The case-history of a woman with psychiatric symptoms since childhood is reported, the best label for which was that of ‘chronic mania’. Cerebellar atrophy was suspected on radiological grounds. The literature on chronic mania in childhood and on cerebellar damage and mental changes is reviewed and the view is put forward that cerebellar dysfunction may play a part in the production of some psychiatric symptoms.
The learning of motor movements: a neurostatistical approach
Authors: Maxwell A. E.
Published: July 2009

Synopsis

From a factor analysis of data from a learning experiment evidence is presented which appears to support the Blomfield–Marr thesis that in the learning of motor actions the cerebellum operates by the turning off of incorrect movements rather than by the turning on of correct ones. The factor model employed is that due to Godfrey Thomson which gives a neurostatistical explanation of the origin of mental factors.
A technique for studying psychiatric morbidity in in-patient and out-patient series and in general population samples
Authors: Wing J. K.
Published: July 2009

Synopsis

Many surveys of general populations have suggested a high untreated psychiatric morbidity, variously referred to as mental illness, pre-clinical neurosis, minor neurosis, untreated depression, etc.

An Index of Definition of psychiatric disorders is described which incorporates cut-off points on the basis of symptoms rated in the Present State Examination. Eight degrees of definition are specified. At the ‘borderline disorder’ level and above, disorders are sufficiently well defined to apply the CATEGO program of clinical classification. This procedure enables in-patients, out-patients and samples of the general population to be compared.

Data from surveys in south-east London are presented in order to illustrate the technique. The main conclusion at this stage is that it is possible to identify, by strictly defined and repeatable procedures, a substantial proportion of people in the general population who have ‘borderline disorders’ that can be tentatively classified in terms of the ICD. Whether it is clinically useful to do so requires further investigation.

It is also suggested that techniques of this kind can be scientifically useful in comparing the level of morbidity in various populations, both referred and non-referred, and in testing theories concerned with the causes and treatment of various types of psychiatric disorders.
Culture and reality
Authors: Leach Edmund
Published: July 2009

I only met Sir Aubrey Lewis on one occasion and that was in passing. Most of what little I know of his career is derived from the admirable biographical account which Professor Michael Shepherd provided in his Adolf Meyer Lecture delivered to the American Psychiatric Association in 1976 (Shepherd, 1977). But that little is reassuring. Aubrey Lewis clearly took a catholic view of the scope of the field of psychiatry, for at the age of 25 he was combining the study of psychological medicine with anthropological research among the Australian Aborigines! I cannot myself claim this kind of many-sided expertise and, knowing little or nothing about the language or theory or practice of psychiatry, I foresee a problem of communication which calls for the establishment of a frame of discourse.
Conjoint marital therapy: a controlled outcome study
Authors: Crowe Michael J.
Published: July 2009

Synopsis

Forty-two couples with marital problems were randomly allocated to conjoint therapy of (i) a directive, (ii) an interpretative or (iii) a supportive (control) type. Self and independent assessment at the end of treatment showed the directive significantly superior to the control procedure on several measures. This superiority was maintained to 18 months' follow-up, when the interpretative procedure also showed some superiority over the control.
Cycloid psychosis: an investigation of the diagnostic concept
Authors: Cutting J. C. , Clare A. W. , Mann A. H.
Published: July 2009

Synopsis

Seventy-three patients with the features of ‘cycloid psychosis’, adopted from Perris and Leonhard, were identified from case records. Information concerning background, presenting illness and follow-up was compared with that from the case-records of patients with schizophrenic, affective and schizoaffective psychoses. The characteristic features of ‘cycloid psychosis’ were a female predominance and a remittent course. The ‘cycloid’ group resembled the conventional groups in some respects, but differences from schizophrenic, affective and, to a lesser extent, schizoaffective groups were also striking. The factors which might account for the apparent independence of the ‘cycloid’ group from other diagnostic categories are discussed.
Endocrine changes and clinical profiles in depression: II. The thyrotropin-releasing hormone test
Authors: Calloway S. P. , Dolan R. J. , Fonagy P. , De Souza V. F. A. , Wakeling A.
Published: July 2009

Synopsis

Thirty-one (43%) of 68 patients with primary depression were found to have a blunted thyroid-stimulating hormone (TSH) response to thyrotropin-releasing hormone (TRH). Increased thyroid activity, as measured by the free thyroxine index (FTI), was present in 16 (24%) of the patients. Patients with blunted responses had a higher mean FTI level than those with normal responses. Patients with blunted responses were significantly more likely to exhibit the symptoms of depersonalization, derealization and agitation. There was no clear association between blunting and any particular diagnostic category of depression.

Patients with blunted responses and high FTI values were more likely to report significant long-term environmental difficulties than patients with blunted responses and normal FTI values. It is suggested that there may be more than one mechanism responsible for blunting of the TSH response in depressed patients. In some patients blunting may be due to negative feedback from increased output of thyroid hormones, possibly released as part of a stress response. In other patients blunting may be due to a different mechanism, possibly involving pituitary gland dysfunction. These mechanisms would not necessarily be mutually exclusive in any one patient.
Depression following withdrawal from long-term benzodiazepine use: a report of four cases
Authors: Olajide Dele , Lader Malcolm
Published: July 2009

Synopsis

Depression following withdrawal from long- or short-term use of benzodiazepines is not uncommon, yet it is under-reported in the benzodiazepine withdrawal literature. Four cases of depressive illness supervening during benzodiazepine withdrawal are reported. Depression may, it is suggested, be an integral part of the benzodiazepine withdrawal syndrome.
The psychobiology of minor head injury
Authors: Montgomery E. A. , Fenton G. W. , McClelland R. J. , MacFlynn G. , Rutherford W. H.
Published: July 2009

SYNOPSIS

Twenty-six consecutive admissions to an accident and emergency unit with minor head injury were examined. This was defined as a head injury warranting brief in-patient overnight stay but with a post-traumatic amnesia of less than 12 hours. Each patient had a neurological examination, a post-traumatic symptom check list completed, EEG power spectra analysis and auditory brain stem-evoked potential recordings, and a four-choice reaction-time measurement. These assessments were repeated six weeks later. Six months after the head injury a symptom check list was completed and four-choice reaction time measured again. Post-traumatic symptoms are persistent in half of all patients at six weeks and six months follow-up. The EEG power spectra showed a significant change in theta power between the first recording and the second one at six weeks, with relative reduction being noted. Approximately half of all the patients had significant delays in brain stem conduction time at day 0. There was a trend towards a decrease in brain stem conduction time at six weeks, though in almost half the brain stem conduction time still remained abnormal at six weeks. Head-injured patients had prolonged choice reaction times at day 0 with serial improvement between then and six months, though the values at six weeks were still significantly longer than healthy controls. It is suggested that these findings reflect both cortical and brain stem damage following minor head injury, the brain stem damage being more persistent. There appear to be three patterns of recovery, half recovering within six weeks, a minority persisting over six months with persisting brain stem dysfunction and less than a third showing an exacerbation of symptoms with no evidence of brain stem dysfunction, the exacerbation being possibly a consequence of psychological and social factors.
Determinants of somatization in primary care
Authors: Bridges K. , Goldberg D. , Evans B. , Sharpe T.
Published: July 2009

SYNOPSIS

This study explores possible determinants of somatization in primary care. Hypotheses were tested on samples of ‘somatizers’, ‘psychologizers’ and controls recruited by epidemiological procedures. Although ‘somatizers’ were found to be similar to ‘psychologizers’ in many respects, they were (i) less depressed; (ii) reported lower levels of social dissatisfaction, social stress and less dependence on their relatives; (iii) more likely to have an unsympathetic attitude towards mental illness and less likely to consult a doctor about psychological symptoms, and (iv) more likely to have received medical in-patient care as an adult before they had consulted their doctor with their current illness. These findings are discussed in the context of previous research.
A three-year follow-up of psychiatric morbidity in urban and rural primary care
Authors: Seivewright Helen , Tyrer Peter , Casey Patricia , Seivewright Nicholas
Published: July 2009

SYNOPSIS

Follow-up by examination of medical and psychiatric records was carried out on 357 patients with conspicuous psychiatric morbidity in two general practices three years after clinical and personality assessment using structured interview schedules. One practice was an inner-city urban one and the other was rural. Full follow-up data over the 3-year period was available for 301 patients (84 3%). After three years patients with personality disorder and those in the urban practice had greater morbidity, more contacts with all levels of the psychiatric service and more psychotropic drugs, particularly benzodiazepines. Despite this increased morbidity, the number of consultations with the general practitioner for psychiatric illness was no higher in the urban group and those for medical illness were significantly higher in the rural one. The implications of the findings are discussed with particular reference to developments in community psychiatric care.
Computer diagnosis of depression and anxiety: the Stirling County Study
Authors: Murphy Jane M. , Neff Raymond K. , Sobol Arthur M. , Rice Joseph X. , Olivier Donald C.
Published: July 2009

Synopsis

A computer programme (DPAX) was constructed for a longitudinal study of psychiatric epidemiology in Stirling County (Canada). It identifies disorders involving the syndromes of depression and anxiety based on responses given in structured questionnaire interviews. The programme follows a diagnostic algorithm that uses criteria for: (1) essential features; (2) number, frequency, and pattern of associated symptoms; (3) impairment; and (4) duration. The programme reproduces case evaluations provided by psychiatrists, as conveyed by a sensitivity of 92% and a specificity of 98%.
Classification of severe school attendance problems
Authors: Berg Ian , Casswell Geraldine , Goodwin Alison , Hullin Roy , McGuire Ralph , Tagg Gill
Published: July 2009

Synopsis

Sixty-four children taken to court for failure to attend school were reliably classified into 4 groups, according to whether they exhibited the features of ‘school refusal’ and/or ‘truancy’. About a fifth of them were found to exhibit ‘school refusal’; a third showed ‘truancy’; less than a sixth exhibited both ‘school refusal’ and ‘truancy’ combined; and over a third had the characteristics of neither condition. Differences between these categories were found in manifestations of psychiatric disturbance and in responsiveness to a court adjournment procedure.
Systematic observation and clinical insight – are they compatible? An experiment in recognizing family interactions
Authors: Eisler I. , Szmukler G. I. , Dare C.
Published: July 2009

Synopsis

Clinical descriptions of families are often viewed as being too subjective for systematic scientific inquiry. This study examines the extent to which independent observers can recognize statements made about family interactions. These statements were of a type which clinicians dealing with families would make and comprised observations with varying levels of inference. A special method was devised to test a number of specific hypotheses concerning the processes of clinical observation. The results show that such descriptions are recognizable as being made about a particular family even when this involves discriminating between clinically similar families. Some of the implications of these results for observational research are discussed.
Psychophysiologic disorders: a critical appraisal of concept and theory illustrated with reference to the irritable bowel syndrome (IBS)
Authors: Latimer Paul
Published: July 2009

SYNOPSIS

The concept of psychophysiologic disorders and the major theories invented to account for such disorders are critically reviewed. The Irritable Bowel Syndrome (IBS) serves to illustrate the application of each theory and provides a vehicle for their appraisal. The tendency to think of ‘physical’ and ‘psychological’ as separate entities rather than separate languages has led to attempts to make a categorical distinction between disorders caused by ‘psychological’ factors and those caused by ‘physical’ factors. Some of the theories developed to account for psychophysiologic disorders are unscientific and none can adequately account for all the features of IBS. It is concluded that the concept of psychophysiologic or psychosomatic disorder is outmoded.
Dilemmas in psychiatry
Authors: Lewis Aubrey
Published: July 2009

Socrates said that it was the duty of teachers to be gad-flies, stirring people up, irritating them rather, but perhaps serving a useful purpose on the way. I propose therefore to present some of the unsettling and disturbing issues which psychiatrists encounter in their day-to-day work.
A comparative psychiatric assessment of patients with chronic fatigue syndrome and muscle disease
Authors: Wood G. C. , Bentall R. P. , Göpfert M. , Edwards R. H. T.
Published: July 2009

SYNOPSIS

The psychiatric status of patients with chronic fatigue syndrome (N = 34) and muscle disease (N = 24) attending a general medical clinic was studied. Among fatigue patients 14 (41·2%) were cases and a further 9 (26·5%) were subcases of psychiatric disorder as defined by CATEGO. A variety of diagnoses was found. Significantly fewer of the muscle patients had a psychiatric disorder with 3 (12·5%) being cases and 1 (4%) a subcase. The relative risk of psychiatric disorder in patients with chronic fatigue syndrome compared to patients with muscle disease was 3·3:1.
Psychiatric morbidity in young adults with insulin-dependent diabetes mellitus
Authors: Mayou Richard , Peveler Robert , Davies Beverley , Mann Jim , Fairburn Christopher
Published: July 2009

SYNOPSIS

Psychiatric disorder and sub-threshold psychological distress were more common in 113 young men and women with insulin-dependent diabetes living in a defined area than in comparable general population samples. Twelve per cent of men and 19% of women were classified by the PSE as psychiatric ‘cases’. Forty per cent of women and 47% of men reported at least one major social problem; effects of diabetes on everyday activities were common.

There were associations between medical and social variables. The clinical implications are discussed.
William Mayer-Gross: an appreciation
Authors: Lewis Aubrey
Published: July 2009

William Mayer-Gross was born in the ancient Rhineland town of Bingen. He attended the Gymnasium in Worms and studied medicine in Heidelberg, Kiel and Munich. He took his final medical examinations in Heidelberg in 1912. He then became an assistant in the Heidelberg Psychiatric Clinic and in 1913 presented his doctoral thesis, which dealt with the phenomenology of abnormal feelings of felicity. On the outbreak of the First World War he was called up and served for a year on the Western front; he was then in 1915 assigned to duties in a base hospital where neurotic soldiers were being cared for.
An indigenous conceptualization of reactive depression in Trinidad
Authors: Littlewood Roland
Published: July 2009

Synopsis

While depressive reactions appear to be universal, until recently they have seldom been described outside Europe, probably because of their lack of exotic salience, but also because they are seldom identified locally as distinct entities. Where it occurs, such an identification reflects a local preference for the articulation of individual psychological notions, rather than universal moral imperatives. While the symptoms of reactive depression are recognized in rural Trinidad as a common experience, but not especially remarked, they are also identified by Afro-Caribbeans as a specific state, Tabanka, following the loss of a sexual partner to another. Tabanka is characterized by lassitude, anorexia, insomnia, feelings of worthlessness, anger, a loss of interest in work and other activities and, especially, by a preoccupation with the faithless one. It is said to be most common among married men and among the upwardly socially mobile, and to lead to heavy drinking and occasionally madness or suicide. The precipitation of Tabanka provokes hilarity rather than moral indignation, and its humour articulates an egalitarian and individualistic working-class attitude to marriage and social mobility. In contrast, Trinidadians of Asian or Venezuelan origin emphasize moral notions of honour and shame.
Some cognitive correlates of affective disorders
Authors: Robertson Graham , Taylor Pamela J.
Published: July 2009

Synopsis

Seventy-one men completed a battery of cognitive tests which were designed to reflect verbal analytic and non-verbal holistic functioning. Interest centred around pattern of response. Thirty men were suffering from an affective disorder and forty-one were well. All the men were in prison, the majority awaiting trial. The affective disorder group was subdivided into three categories: men who had a history of manic-depressive illness; a group of unipolar, psychotically depressed men; and men who were regarded as being depressed in reaction to circumstances. All three groups showed specific difficulty in dealing with spatial/holistic tasks, other factors being held constant. They were also found to differ in a number of other respects. The possible significance of these differences is discussed.
Description and measurement of concentration problems in depressed patients
Authors: Watts Fraser N. , Sharrock Robert
Published: July 2009

Synopsis

Depressed patients commonly complain of concentration problems, yet these have seldom been the focus of systematic investigation. A structured interview about concentration problems was administered to a group of relatively severely depressed patients. Problems in reading and watching television were the most common, and were highly correlated with each other. Direct report of the number of concentration lapses on a reading task was the most generally satisfactory task-performance correlate of complaints of reading/TV concentration problems. Evidence both from this task and from the interview suggests that depressive concentration problems may often be due to ‘mind-wandering’. The correlations with concentration problems with the severity and endogeneity of depression and with state anxiety were generally similar.
Carotid endarterectomy: does it improve cognitive or motor functioning?
Authors: Van Den Burg W. , Saan R. J. , Van Zomeren A. H. , Boontje A. H. , Haaxma R. , Wichmann T. E.
Published: July 2009

Synopsis

In a group of 20 patients who were to undergo endarterectomy for atherosclerotic occlusive disease of the internal carotid artery, the stenosis did not appear to have resulted in cognitive or motor deficits. Consistent with this finding, surgery could not be shown to have a beneficial effect on cognitive or motor functioning. Control data were supplied by 20 patients who underwent peripheral vascular surgery and 20 healthy subjects. The test-retest interval was 10 weeks.
Effects of the contraceptive pill on sedative responses to clonidine and apomorphine in normal women
Authors: Chalmers J. S. , Fulli-Lemaire I. , Cowen P. J.
Published: July 2009

Synopsis

In normal women sedation following intravenous administration of the α2-adrenoceptor agonist clonidine (1·3 μg/kg) was significantly greater following 3 weeks' continuous treatment with the combined contraceptive pill than at the end of the 7-day withdrawal period. In contrast, sedative responses to the dopamine agonist apomorphine (5 μg/kg subcutaneously) were decreased when subjects were taking the contraceptive pill. These findings are in agreement with animal experimental studies, indicating that oestrogen can alter α-adrenoceptor and dopamine autoreceptor sensitivity. Such interactions may be involved in the effects of female sex steroids on mood.
A study of variables associated with under-attendance at a psychiatric day centre
Authors: Bender M. P. , Pilling S.
Published: July 2009

Synopsis

This study examines the problems of client under-attendance at a psychiatric day centre. Demographic, psychiatric, psychometric and Semantic Differential measures were used. Several of these measures were significantly associated with under-attendance. Various methods are suggested for the identification of and reduction of the level of under-attendance.
Cerebrospinal fluid somatostatin in delirium
Authors: Koponen Hannu , Stenbäck Ulla , Mattila Esa , Reinikainen Kari , Soininen Hilkka , Riekkinen Paavo J.
Published: July 2009

Synopsis

Cerebrospinal fluid somatostatin-like immunoreactivity (CSF SLI) was determined for 67 elderly patients who met the DSM-III criteria for delirium and for 19 age-matched controls. As a group, and also when subdivided according to the type of delirium, severity of cognitive decline or the type of central nervous system disease, the delirious patients showed significant reductions of SLI compared with the controls, together with a declining trend associated with increasing cognitive dysfunction. These findings are in accordance with previous observations that reduced CSF SLI is associated with diseases in which cognitive function is disturbed and they extend this finding to delirium.