bluuebunny/crossref_metadata_2025 huggingface dataset:
Mental illness, physical abuse and burden of care on relatives: a study of acute psychiatric admission patients
Authors: Vaddadi K. S. , Soosai E. , Gilleard C. J. , Adlard S.
Published: November 2007

As mental health care policies increasingly emphasize treatment and care in community settings, there has been concern over the burden that families of mentally ill people might suffer as a result. We conducted a study of the prevalence of abuse faced by relatives of patients admitted during a 6‐month period to the acute psychiatric unit of a busy general hospital, who had previously been living with a relative. Patients and their relatives were assessed using semi‐structured interview schedules. The experience of burden and the specific experiences of abuse since the onset of their relative's illness were recorded. In total, 32 (32%) of the 101 relatives had been struck on at least one or two occasions. Verbal abuse, threats and temper outbursts were reported by over 50% of the relatives. Principal correlates of abuse were diagnosis, concurrent drug misuse and a poor pre‐morbid relationship between carer and patient.
A two‐phase, double‐blind randomized study of three haloperidol plasma levels for acute psychosis with reassignment of initial non‐responders
Authors: Janicak P. G. , Javaid J. I. , Sharma R. P. , Leach A. , Dowd S. , Davis J. M.
Published: November 2007

To clarify the plasma level/therapeutic response relationship of haloperidol (HPDL) we used a prospective double‐blind design in 95 acutely psychotic patients. After drug washout, patients were randomly assigned to a low, middle or high plasma level range for 2 weeks (phase A), and then 50% of the initial non‐responders were randomly reassigned into the putative therapeutic range for an additional 2 weeks (phase B). There were no significant differences in clinical outcome between the three plasma level ranges in phase A. However, in phase B initial non‐responders displayed greater improvement in the middle range than in the low or the high ranges. No further benefit was observed when plasma levels were raised to or maintained in the high range.
Parapartum mental illness: an interview follow‐up study
Authors: Bågedahl‐Strindlund M.
Published: November 2007

A total of 54 parapartum mentally ill mothers and 89 controls were followed up approximately 6 years after childbirth. In total, 80% of the patients avoided further pregnancies during the follow‐up period, compared to 58% of the controls (non‐significant difference). One‐third of the patients did not live together with their child, compared to only 3% of the controls. Index mothers tended to report more problematic relationships with their children. Poor childhood relationships during the mother's own childhood seem to be of special significance for the development of these problems. This study suggests a rather gloomy prognosis for parapartum mental illness. The suicide rate was 4.5%. In total, 22% of the patients, compared to none of the controls, had been on sick leave during the last 3 years, or had received a disability pension owing to mental illness at the time of the follow‐up. The readmission rate for psychiatric in‐patient care was 46% in the patient group.
Temperament and personality features in panic disorder with or without comorbid mood disorders
Authors: Ampollini P. , Marchesi C. , Signifredi R. , Maggini C.
Published: November 2007

Personality and temperament features, assessed with the Structured Interview for DSM‐III‐R Personality Disorders — Revised (SIDP‐R) and the Tridimensional Personality Questionnaire (TPQ), respectively, were evaluated in 62 patients affected by panic disorder with (PD+MD) (n= 22) or without comorbid mood disorder (PD) (n=40). A significant difference in the prevalence of personality disorders (PD+MD, 86% vs. PD, 62%; P <0.05), particularly dependent (PD+DM, 50% vs. PD, 17%; P < 0.01) and borderline (PD+DM, 9% vs. PD, 0%; P=0.05) personality disorders, was observed between the groups. Moreover, patients in the PD+MD group had higher scores for harm avoidance (PD+MD, 22.2±5.6 vs. PD, 26.9±5.1; P < 0.05) than patients in the PD group. The harm avoidance score in PD patients was significantly related to personality disorder and not to MD, suggesting that harm avoidance is not associated with greater severity of the illness. Our data confirm the hypothesis that subjects with higher harm avoidance scores have a greater probability of being affected by cluster C personality disorders and comorbid mood and anxiety disorders.
Seizures and myoclonus associated with antidepressant treatment: assessment of potential risk factors, including CYP2D6 and CYP2C19 polymorphisms, and treatment with CYP2D6 inhibitors
Authors: Spigset O. , Hedenmalm K. , Dahl M.‐L. , Wiholm B.‐E. , Dahlqvist R.
Published: November 2007

All adverse drug reaction reports labelled seizures or myoclonus during treatment with antidepressants and stored in the Swedish national database for spontaneous reporting of adverse drug reactions were reviewed in order to evaluate possible risk factors. The reporting physicians were contacted and asked for complementary information, and blood samples for determination of the CYP2D6 and CYP2C19 genotypes were obtained from patients available. In total, 25 cases of seizures and 7 cases of myoclonus were studied. The drugs included were maprotiline (n=8), mianserin (n=7), fluvoxamine (n=6), amitriptyline (n=3), clomipramine (n=3), citalopram (n=2), paroxetine (n=2) and lofepramine (n= 1). Previously suggested predisposing factors were identified in all but four cases (87%). None of the 11 patients genotyped were found to be poor metabolizers with respect to the enzymes CYP2D6 or CYP2C19. Thus, neither the CYP2D6 nor the CYP2C19 genotype were found to be associated with the occurrence of seizures/myoclonus during treatment with antidepressants. However, 15 patients (47%) were concomitantly treated with drugs with potential inhibitory effects on CYP2D6, such as neuroleptics and dextropropoxyphene, and the patients might thus have been converted from the extensive metabolizer to the poor metabolizer phenotype during this treatment. Concomitant treatment with drugs decreasing the seizure threshold and/or inhibiting the metabolism of antidepressants appeared to be an important risk factor for the occurrence of seizures/myoclonus.
Cortisol in light treatment of seasonal and non‐seasonal depression: relationship between melatonin and Cortisol
Authors: Thalén B.‐E. , Mørkrid L , Kjellman B. F. , Wetterberg L.
Published: November 2007

The effect of bright light on Cortisol and the relationship between melatonin and Cortisol were studied in 63 depressed patients (42 patients with a seasonal pattern and 21 patients with a non‐seasonal pattern). The patients were matched for age, time of treatment and severity of depression. Before and after light treatment the severity of the depression was rated with the Comprehensive Psychopathological Rating Scale (23 items) and the Hamilton Depression Rating scale (18 items), and serum Cortisol and melatonin were drawn at nine time‐points between 20.00 and 08.00 hours. Two hours of light treatment (350 cd m−2) was given daily for 10 days either in the morning (06.00–08.00 hours) or in the evening (18.00–20.00 hours). As reported earlier, patients with a seasonal pattern improved significantly more than patients with a non‐seasonal pattern of depression, and no significant differences were found between the treatment efficacy of morning compared to evening light. A cosinor analysis showed that the Cortisol batyphase was significantly advanced by morning light, but was not delayed by evening light. A delay in batyphase Cortisol showed a weak significant correlation with a decrease in the absolute and relative sum of scores. The batyphase of Cortisol occurred approximately 3 h earlier than the acrophase of melatonin. Of the changes in the melatonin acrophase 43% were reflected in a change of Cortisol batyphase, indicating a hierarchical relationship with melatonin as the co‐ordinating hormone transducing part of the information of the external light to the phase position of Cortisol. No significant differences between patients with a seasonal or a non‐seasonal pattern were seen in mesor, amplitude or batyphase of Cortisol before treatment, and no significant changes in mesor or amplitude were seen as a result of light treatment.
Communication disturbances in the natural speech of schizophrenic patients and non‐schizophrenic parents of Patients
Authors: Docherty N. M. , Miller T. N. , Lewis M. A.
Published: November 2007

Subclinical communication disturbances in the relatives of schizophrenic patients appear to be heterogeneous in both form and origin. The Communication Disturbances Index (CDI) was applied to the natural speech of stable schizophrenic out‐patients, non‐schizophrenic parents of patients, and control subjects. The parents of schizophrenic patients displayed more frequent overall instances of communication failure in their speech than the controls. The specific types of disturbance that were more frequent were structural lack of clarity, vague and ambiguous word meanings. The parents did not differ significantly from the patients with regard to total CDI ratings. However, patients made more frequent missing‐information reference than parents, and parents made more frequent vague reference than patients. High CDI scores in parents were associated with more severe lifetime core positive symptoms in their patient offspring.
Relatives’ emotional warmth towards patients with schizophrenia or related psychoses: demographic and clinical predictors
Authors: Bentsen H. , Munkvold O. G. , Notland T. H. , Boye B. , Oskarsson K. H. , Uren G. , Lersbryggen A. B. , Bjørge H. , Berg‐Larsen R. , Lingjaerde O. , Malt U. F.
Published: November 2007

Despite the importance of relatives’ emotional warmth for outcome in schizophrenia, no studies to date have addressed demographic and clinical predictors of warmth. We examined a Norwegian sample of 47 recently hospitalized patients (with schizophrenia or schizophreniform disorder) and 72 key relatives. Relatives’ emotional warmth was assessed by means of the Camberwell Family Interview. Regression analyses showed that no substance abuse (especially amphetamines), better premorbid adjustment (12–15 years), a chronic social security status, and the relative not being a parent were the strongest predictors of emotional warmth. Emotional warmth was not related to patients’ symptoms.
Mitral valve prolapse and autonomic function in panic disorder
Authors: Hamada T. , Koshino Y. , Misawa T. , Isaki K. , Gejyo F.
Published: November 2007

We investigated the significance of mitral valve prolapse (MVP) and autonomic function in 121 patients diagnosed with panic disorder (PD). The incidence of MVP was higher in these patients (32.2%) than in the healthy controls (16.7%), but the difference was not significant. In the group with PD accompanied by depression, the MVP rate was 58.1%, significantly higher than the value of 25.7% observed in the PD patients without depression. The severity of MVP was mild; nearly all of the cases were silent, without cardiac murmur, and there was no problem with the left ventricular function. The coefficient of variation for R‐R intervals on electrocardiograms (CV R‐R) was smaller in patients with PD than in healthy controls. The CV R‐R of PD patients was significantly lower in the group with MVP than in the group without MVP, suggesting a strong association with the parasympathetic nervous system. Since the CV R‐R tended to decrease in the presence of depression, involvement of the parasympathetic nervous system was inferred.
A cross‐sectional audit of benzodiazepine use among general practice patients
Authors: Barbui C. , Gregis M. , Zappa M.
Published: November 2007

In order to assess how many general practice patients take benzodiazepines for long periods, a cross‐sectional audit of clinical practice was conducted. During a 3‐day census period, 26 general practitioners in the area of Bergamo, Italy, entered into the study every patient who was taking benzodiazepines. The prevalence of use of this class of drugs was 14.0% (CI 12.5–15.7), while the prevalence of daily use for 12 months or more was 4.7% (CI 3.8–5.8). Finally, the prevalence of very long‐term use of benzodiazepines, i.e. those taking these drugs for more than 10 years, was 0.65% (CI 0.34–1.14). Compared to non‐long‐term users, long‐term users were older (OR 2.38, CI 1.39–4.08) and had a lower level of education (OR 2.40, CI 1.04–5.54). In addition, insomnia was associated with long‐term use of this class of drugs (OR 1.82, CI 1.02–3.24). These findings provide evidence that the long‐term use of benzodiazepines is an important issue in everyday general practice and that this calls for precise management tactics.
Case report: akathisia abolished by passive movement
Authors: Smith M.
Published: November 2007

Akathisia is a common and poorly understood complication of treatment with psychotropic medication. A patient is described whose severe akathisia was abolished by passive motion when travelling as a car passenger. The case reported here highlights the importance of sensory input in akathisia.
Trauma exposure, postmigration stressors, and symptoms of anxiety, depression and post‐traumatic stress in Tamil asylum‐seekers: comparison with refugees and immigrants
Authors: Silove D. , Steel Z. , McGorry P. , Mohan P.
Published: November 2007

Compared to research on displaced persons whose refugee status has been endorsed prior to arriving in Western countries, there is little systematic information available about levels of past trauma, postmigration living difficulties and psychiatric symptoms amongst asylum‐seekers who claim refugee status only after arrival. Asylum‐seekers, authorized refugees and immigrants of Tamil background were recruited by personal contact and mail‐out in Sydney, Australia. A total of 62 subjects, constituting approximately 60% of the estimated pool of Tamil asylum‐seekers, agreed to participate in the study. They returned statistically significantly higher scores than immigrants (n=104) on measures of past trauma, symptoms of anxiety, depression and post‐traumatic stress, and on all dimensions of postmigration difficulties. Asylum‐seekers did not differ from refugees (n=30) on measures of past trauma or psychiatric symptoms, but they scored higher on selective components of postmigration stress relating to difficulties associated with their insecure residency status. Although limited by sampling and diagnostic constraints, the present study suggests that asylum‐seekers may be a high‐risk group in relation to ongoing stress in the postmigration period.
Clinical characteristics of a total cohort of female and male applicants for sex reassignment: a descriptive study
Authors: Landén M. , Wålinder J. , Lundström B.
Published: November 2007

The objective of this study was to compare the features of female‐to‐male transsexuals (F‐M) with those of male‐to‐female transsexuals (M‐F) in the cohort of all applicants for sex reassignment over a 20–year period. In an observational, cross‐sectional design the cohort was retrospectively identified, consisting of all 233 subjects who applied for sex reassignment in Sweden during the period 1972–1992. The cohort was subdivided into the groups M‐F (n=134) and F‐M (n=99), and the two groups were compared. M‐F were older when applying for sex reassignment surgery than F‐M, and more often had a history of marriage and children than their F‐M counterparts. M‐F also had more heterosexual experience. F‐M, on the other hand, more frequently exhibited cross‐gender behaviour in childhood than did M‐F transsexuals. The present and previous studies strongly support the view that transsexualism manifests itself differently in males and females. Various models for understanding these differences are discussed.
Fatigue mood as an indicator discriminating between anorexia nervosa and bulimia nervosa
Authors: Nakao M. , Kumano H. , Nomura S. , Kuboki T. , Yokoyama K. , Murata K.
Published: November 2007

In order to clarify the differences in mood states between anorexia and bulimia nervosa, the Profile of Mood States (POMS) with tension‐anxiety, depression, anger‐hostility, vigour, fatigue and confusion scales was administered to 32 female patients with anorexia nervosa (age range 14 to 32 years, mean age 20 years), 49 female patients with bulimia nervosa (age range 15 to 33 years, mean age 23 years) and 410‘normal’ female subjects (age range 14 to 35 years, mean age 23 years). The scores on the depression, fatigue and confusion scales for both anorexia and bulimia nervosa and those on the tension‐anxiety and anger‐hostility scales for bulimia nervosa were significantly higher than those for the control subjects. The score on the fatigue scale for bulimia nervosa was significantly higher than that for anorexia nervosa. Moreover, the result of the multiple logistic regression analysis including all of the POMS scales indicated that the fatigue scale significantly discriminated between the two disorders. Fatigue mood appears to be a principal indicator for differentiating between the two disorders.
A prevalence study of folate deficiency in a psychiatric in‐patient population
Authors: Skerritt U. M.
Published: November 2007

Controlled clinical trials in the UK have shown folate deficiency in psychiatric patients, and it has been suggested that such deficiency is most likely to occur among patients with affective disorders. Studies have led to the use of folate as an adjunct to therapy in such patients. The present paper describes a preliminary investigation into the red cell folate status of psychiatric patients in a general hospital unit compared with age‐ and sex‐matched healthy controls, using up‐to‐date assays and strict entry criteria and overall improved methods on previous studies. The study showed that, although there is a trend for psychiatric patients to have lower serum folate levels than controls, there is no statistically significant difference in folate levels as measured by red cell folate, a more reliable measure of folate status, between healthy controls and psychiatric patients, and all but one of the patients had normal haematological indices.
Economic comparisons of the pharmacotherapy of depression: an overview
Authors: Crott R. , Gilis P.
Published: November 2007

As many countries find that their health care expenditure is taking up an increasing proportion of their financial resources, economic aspects of care processes have become more important in the choice of optimal strategies. This review of the economic studies of the comparative treatment of depression shows that nearly every aspect of treatment has important economic consequences. Cost‐of‐illness studies have documented the high burden on society of this disorder, and the associated loss of productivity and work. Comparative cost‐effectiveness/utility studies, the majority of which are based on modelling techniques, have consistently shown a better cost‐effectiveness ratio of the newer antidepressants over more traditional tricyclic antidepressants (TCAs), when all therapy‐related costs are taken into account.
Association of maternal, antenatal and perinatal complications with suicide in adolescence and young adulthood
Authors: Neugebauer R. , Reuss M. L.
Published: November 2007

The aim of the present study was to investigate whether maternal, antenatal and perinatal complications are associated with adolescent or young adulthood suicide in offspring. Cases consisted of individuals, aged 15–22 years, born in New York City and committing suicide in New York City between 1985 and 1991 (n= 189). Two controls were selected for each case, constituting the hospital birth immediately preceding and following that of the case, matched with the case with regard to sex and ethnicity. Cases were compared with controls using an index that summed a range of maternal, antenatal and perinatal complications and also with regard to the frequency of individual complications. In the total sample, cases and controls did not differ either in the mean number of all complications combined or in the proportions with specific complications. This lack of association between complications and outcome also obtained in separate analyses by sex, ethnicity, socio‐economic status and age at suicide. These results fail to replicate the findings of two previous reports implicating maternal, antenatal and perinatal complications in risk of youth suicide. At present, epidemiological evidence that adverse reproductive events increase the risk for suicide in offspring remains inconclusive.
The efficacy of psychotherapy in non‐bipolar depression: a review
Authors: Jørgensen M. Balslev , Dam H. , Bolwig T. G.
Published: November 2007

A review of efficacy studies on psychotherapy of depression is made. Based on the available literature, there is evidence of effectiveness of cognitive and interpersonal therapy in the treatment of mild to moderate depression. To a lesser degree, the effect of psychoanalytically oriented and behavioural therapy has been documented. The effectiveness of psychotherapy among inpatients and patients with severe depression has not been documented. No studies have documented a preventive effect of psychotherapy on future recurrent depressive episodes. In recurrently depressive patients who respond to a combination of imipramine and interpersonal psychotherapy, maintenance treatment with interpersonal psychotherapy may prevent new episodes, but not as effectively as maintenance therapy with imipramine.
Suicidal ideation among the long‐term unemployed: a 5‐year follow‐up
Authors: Claussen B.
Published: November 2007

Suicidal ideation was monitored in a 5‐year follow‐up of a representative sample of long‐term unemployed Norwegians. Four items from the General Health Questionnaire‐28 were used as a Suicidal Ideation Index, which showed a prevalence of 17% in the present sample of unemployed subjects, higher than the value of 11% in a sample of Australian students used to construct the Index. Five years later, suicidal ideation was found in 6% of those who had been re‐employed and 22% of those still unemployed, indicating that the high prevalence of suicidal ideation may be due to unemployment. Routine clinical examination was also tried for preventive purposes. In total, 8% of the unemployed subjects showed clinically significant suicidal ideation. They were referred to a psychologist or their GP, and were given the standard advice about suicide prevention. A Resource Centre, which many employees at the Labour Office have missed, has now been set up in the area under the National Plan for Suicide Prevention.
Female suicides and alcohol consumption duringperestroikain the former USSR
Authors: Wasserman D. , Värnik A. , Eklund G.
Published: November 2007

During 1984–1990, a decline in suicide rates of 32% for males and 19% for females took place in the former Soviet Union. The observed annual decrease in mortality from suicide was most marked for men in 1984–1986 and for women in 1984–1988. This article illuminates the hypothesis that the restrictive anti‐alcohol campaign initiated by Gorbachev on 1 June 1985, in which prices of alcoholic beverages were raised substantially, had an impact on female mortality from suicide in the former Soviet Union. Data regarding alcohol consumption, female violent death (n=451537), suicide (n=94149), death due to accidental alcohol poisoning (n=28 078), and undetermined death, whether accidental or self‐inflicted (n=23 982) were analysed for three Slavic (Russia, Belarus and the Ukraine), three Baltic (Lithuania, Latvia and Estonia) and two Central Asian republics (Kazakhstan and Kirgizia). Regression analyses with alcohol consumption as the independent variable and female suicide rates and female violent‐death rates as dependent variables showed that suicide and alcohol consumption, as well as violent death and alcohol consumption, were positively correlated. However, alcohol seems to have a lower explanatory value for female suicides and female violent deaths compared with male suicides and male violent deaths. The attributable fraction of alcohol for female suicides in the whole USSR (27%) is estimated at approximately half of that for male suicides (50%).
MMPI variables predictive of schizophrenia in the Copenhagen High‐Risk Project: a 25‐year follow‐up
Authors: Carter J. W. , Parnas J. , Cannon T. D. , Schulsinger F. , Mednick S. A.
Published: November 2007

Moldin et al. (1) have identified a cluster of Minnesota Multiphasic Personality Inventory (MMPI) scales that discriminate adolescents at risk for schizophrenia from those not at risk. The present study examines how well Moldin's scales predict schizophrenic decompensation in a sample of 207 Danish adolescents at high genetic risk for schizophrenia. Subjects were assessed using a modified, 304‐item MMPI in 1962 (mean age=15.1 years) and diagnosed in 10‐year and 25‐year follow‐ups. Premorbidly. schizophrenic subjects (n = 31) scorcd higher than subjects with no mental illness on the frequency (F) and psychoticism (PSY) scales. When paranoid and non‐paranoid preschizophrenics were separated, three scales (F, Pz (paranoid schizophrenia) and PSY) significantly discriminated paranoid preschizophrenics. Discriminant function analyses confirmed these results. It is concluded that the MMPI may be useful for identifying schizophrenia premorbidly.
Developmental neuropathology and the precursors of schizophrenia
Authors: Walker E. F. , Diforio D. , Baum K.
Published: November 2007

Changes in the manifestation of vulnerability to schizophrenia across the life‐span may hold important clues about aetiology. They may also illustrate some general principles about the nature of neurodevelopmental processes. Within the framework of a neural diathesis‐stress model, we review findings on the precursors of schizophrenia and schizotypal personality disorder. The findings suggest that there are critical developmental periods for the manifestation of dysfunction and that, within certain domains of behaviour, there is a temporal disjunction between the onset of the neuropathology and its expression. It also appears that the diathesis for schizophrenia involves polymorphic behavioural expression, such that it can be manifested in multiple domains — motoric, cognitive and socio‐emotional. Taken together, the data on the longitudinal course of schizophrenia indicate that the expression of the diathesis is moderated by central nervous system maturational processes. One putative moderating system, the hypothalamic‐pituitary‐adrenal (HPA) axis, is discussed, and implications for preventive intervention are explored.
From predisposition to psychosis: progression of symptoms in schizophrenia
Authors: Parnas J.
Published: November 2007

Schizophrenia is increasingly viewed as a neurodevelopmental process caused by an interaction between genetic factors and environmental stressors. Prospective studies and retrospective research using objective data indicate that behavioural deviations can be dated to early infancy and cut across multiple behavioural domains. In adolescence, preschizophrenics exhibit subtle changes in cognition and affect as well as a variety of anomalous subjective experiences (so‐called ‘basic symptoms’), suggesting ‘trait’ status of these features. Prodromal symptoms occur in a substantial proportion of preschizophrenics. followed by a short prepsychotic phase with the crystallization of a psychotic syndrome. Clinical, phenomenological and conceptual aspects of these early phases are reviewed, and their neurobiological implications are briefly addressed. It is concluded that there is an urgent need for detailed and multidisciplinary prospective studies, but that the evidence accumulated to date is sufficient to justify research‐based secondary prevention programmes.
A long‐term follow‐up study of adolescent psychiatric in‐patients. Part I. Predictors of early death
Authors: Kjelsberg E. , Sandvik L. , Dahl A. A.
Published: November 2007

A total of 1095 adolescent psychiatric in‐patients were followed up 15–33 years after hospitalization by record linkage to the National Registry of Causes of Death. On the basis of hospital records all patients were rediagnosed according to DSM‐IV and scored on data postulated to be predictors of early death. The factors were investigated by Kaplan‐Meyer survival analysis and Cox regression. Cox regression showed that male sex (relative risk (RR)=2.7, 95% confidence interval (CI) = 1.9–3.9), psychoactive substance use disorder (RR = 2.9, CI = 2.0–4.0), short hospital stay (RR = 3.1. CI = 1.9–5.5) and poor impulse control (RR=1.6, CI = 1.1–2.2) remained strong and independent predictors of death. Patients with psychoactive substance use disorder had different predictors of death (male sex, short hospital stay, poor impulse control, poor parental relationship, and low socio‐economic status) than did patients without this disorder (male sex, somatic disorder at hospitalization, more than one hospitalization). In our patient population it seemed possible to identify a subgroup of adolescent psychiatric in‐patients with an extremely high mortality (about 40%), namely males with psychoactive substance use disorder and poor impulse control.
Serum testosterone levels, mental disorders and criminal behaviour
Authors: Räsänen P. , Hakko H. , Visuri S. , Paanila J. , Kapanen P. , Suomela T. , Tiihonen J.
Published: November 2007

Objective: Although previous studies have revealed an association between androgens and aggression, there is a lack of knowledge of this issue in different mental disorders.

Method: The associations between serum testosterone levels and criminal behaviour in different mental disorders were examined using data collected from forensic psychiatric male patiens (20 schizophrenics and 42 subjects with personality disorders).

Results: Male criminals with personality disorders had significantly higher serum levels of total and free testosterone than criminal schizophrenics. Among schizophrenics, total (P= 0.01) and free testosterone (P = 0.01) declined significantly more with age compared to healthy controls and patients with personality disorders, and also correlated with duration of neuroleptic drug use (r=‐0.60, P= 0.000 for total and r=‐0.46, P = 0.0001 for free testosterone). The recidivists with personality disorder had higher total (P=0.04) and free testosterone (P=0.05) levels than non‐recidivists with personality disorder.

Conclusion: Personality disordered criminals with multiple offences had high serum testosterone levels. The low testosterone concentrations among schizophrenics may be due either to long‐term use of neuroleptic agents or to the mental illness itself and its possible inhibition of the pituitary‐gonadal axis.
The epidemiology of alcohol dependence and problem drinking in Addis Ababa, Ethiopia
Authors: Kebede D. , Alem A.
Published: November 2007

We describe here a prevalence study of alcohol dependence and problem drinking in a representative sample of 10203 adults in Addis Ababa. At the first stage the study employed a 4‐scale screening instrument (CAGE) and at the second stage the Composite International Diagnostic Interview (CIDI) was used to identify cases of alcohol dependence. Of the total population, 2.7% responded positively to at least 2 of the 4 CAGE items, fulfilling the definition of problem drinking. By use of the CIDI, the weighted lifetime and one‐month prevalence of alcohol dependence was 1.0% and 0.8%, respectively. It occurred almost exclusively among men. The prevalence of problem drinking increased with increasing age. The trend was statistically significant (Pfor trend = 0.03). On the other hand, there was a statistically significant negative trend in the association with educational level, use decreasing with increasing educational attainment (Pfor trend=0.0006). There was also a statistically significant 39% increased risk of alcohol use with employment. The association with ethnicity was not statistically significant. Only sex was significantly associated with alcohol dependence. Women had a 84%) less risk of becoming dependent compared to men.
Validity and reliability of the French‐language version of the Positive and Negative Syndrome Scale (PANSS)
Authors: Lançon C. , Reine G. , Llorca P. M. , Auquier P.
Published: November 2007

Lançon C, Reine G, Llorca PM, Auquier P. Validity and reliability of the French‐language version of the Positive and Negative Syndrome Scale (PANSS). Acta Psychiatr Scand 1999: 100: 237–243. © Munksgaard 1999.

Objective: The main objective of this study was to evaluate the psychometric properties of the French‐language version of the Positive and Negative Syndrome Scale (PANSS).

Method: The validity and reliability of the PANSS were studied in a population of 342 patients diagnosed as schizophrenic according to DSM‐III‐R criteria.

Results: The study of the internal consistency and principal‐component analysis of the initial structure with three subscales (positive, negative and general psychopathology) led us to investigate other factorial structures. We isolated a 5‐factor structure (negative, positive, hostility, disorganization and anxietyidepression) explaining 57.5% of the total variance. The internal consistency of the 5 factors isolated was good (0.87 for the negative factor, 0.82 for the positive factor, 0.78 for the hostility factor, 0.71 for the disorganization factor and 0.68 for the anxiety/depression factor, respectively). The validity study on the external criteria confirmed the relationship between the negative and anxiety/depression factors and the extrapyramidal symptoms.

Conclusion: The stability of the PANSS factorial warrants discussion.
Depressive disorders in Chinese patients with Alzheimer's disease
Authors: Liu C. Y. , Fuh J. L. , Teng E. L. , Wang S. J. , Wang P. N. , Yang Y. Y. , Liu H. C.
Published: November 2007

Objective

The present study was to investigate the prevalence and potential risk factors of depressive disorders in Chinese patients with Alzheimer's disease (AD).

Method

A series of consecutive AD patients from the Memory Disorders Clinic of the Veterans General Hospital, Taipei were studied. Psychiatric diagnosis was made according to DSM‐III‐R criteria with the use of the Structured Clinical Interview for DSM‐III‐R (SCID). The Chinese version of the Cognitive Abilities Screening Instrument (CASI) and the Hamilton Depression Rating Scale (HDRS) were also applied. Primary caregivers were interviewed for the Clinical Dementia Rating (CDR) scale, the Barthel Index and the Alzheimer's Deficit Scale (ADS).

Results

Among 141 AD patients, seven (5.0%)were diagnosed with major depression, 11 (7.8%) with dysthymia and five (3.5%) with depressive disorder not otherwise specified. Women were at elevated risk for depressive disorders and had more severe symptoms of depressio.

Conclusions

The prevalence of depressive disorders among Chinese AD patients is in the middle of the range of western findings. The risk factor for depression is female gender.
Psychometric properties of the General Health Questionnaire (GHQ‐12) in a German primary care sample
Authors: Schrnitz N. , Kruse J. , Tress W.
Published: November 2007

Objective

The aim of this investigation was to examine the psychometric properties of the German 12‐item General Health Questionnaire (GHQ‐12) in a primary care sample.

Method

A sample (n= 421) of adult out‐patients was screened using the GHQ‐I2. A standardized clinical interview (SCID) was conducted with all screened patients. Reliability, validity and factor analysis of the GHQ‐12 were evaluated. Item characteristics were examined using item characteristics curves. Item bias analysis was performed using contingency tables.

Results

The German version of the GHQ‐12 is a reliable instrument and performed well in detecting cases of psychological disorders. Factor analysis replicated the findings of earlier studies. Item characteristics curves and item bias analysis indicated that the individual items should be assessed carefully. One item was biased in relation to age, while another item showed a low positive response rate.

Conclusion

The GHQ‐12 as a whole is a reliable questionnaire and can be a useful screening tool in primary care.
A follow‐up study of postpartum psychoses: prognosis and risk factors for readmission
Authors: M. Terp I. , Engholm G. , Meller H. , Mortensed P. B.
Published: November 2007

Terp IM, Engholm G, Møller H, Mortensen PB. A follow‐up study of postpartum psychoses: prognosis and risk factors for readmission. Acta Psychiatr Scand 1999: 100: 40–46. © Munksgaard 1999.

Objective: The aim of this study was to describe the prognosis and risk factors for the first readmission after postpartum psychosis.

Method Linking the Danish Medical Birth Register and the Danish Psychiatric Central Register from 1 January 1973 to 31 December 1993 revealed 1173 women diagnosed with a psychosis within 91 days of delivery. The relative risk (RR) of readmission was estimated using Cox proportional hazard regression models.

Results: An increased risk of readmission was found for women with a diagnosis of schizophrenia (RR = 2.4, 95% CI = 1.9–3.1) and for women with a history of previous psychiatric admission (RR = 1.8, 95% CI = 152.1) compared to first‐admitted women with other functional psychoses. Unmarried women also showed an increased risk of readmission, and only preterm delivery was associated with a reduced risk of readmission.

Conclusion: Preterm delivery predicts the best prognosis after postpartum psychosis. The majority of readmissions were related to the psychopathology of the patient and to lack of social support.
White Mothers, Brown Children: Ethnic Identification of Maori‐European Children in New Zealand
Authors: Kukutai Tahu H
Published: November 2007

Studies of multiethnic families often assume the ethnic identification of children with the minority group results from the minority parent. This study examines an alternate view that mainstream parents also play an important role in transmitting minority ethnicity. It explores this argument using data from New Zealand on the ethnic labels mothers assign to their Maori‐European children. It finds that European mothers are just as disposed as Maori mothers to designate their child as Maori, either exclusively or in combination. Two explanations, grounded in ethnic awareness and gendered inheritance, are proposed. Although neither satisfactorily predicts maternal designation decisions, the readiness of European mothers to identify their child as Maori underscores their role in diffusing Maori ethnicity.
When Children Have Two Mothers: Relationships With Nonresident Mothers, Stepmothers, and Fathers
Authors: King Valarie
Published: November 2007

Using data on 294 adolescents from the National Longitudinal Study of Adolescent Health who live with a biological father and have both a resident stepmother and a nonresident biological mother, this study examines the prevalence, antecedents, and consequences of adolescents’ closeness to each of their parents. Findings demonstrate that adolescents vary in their likelihood of having close relationships to resident fathers, resident stepmothers, and nonresident biological mothers, but when they can do so, they appear to benefit. Close relationships with both resident fathers and nonresident mothers are associated with fewer adolescent internalizing and externalizing problems. Closeness to resident stepmothers, however, is unrelated to these two outcomes. Results suggest that fathers play a particularly important role in these families.
Postdivorce Father‐Adolescent Closeness
Authors: Scott Mindy E. , Booth Alan , King Valarie , Johnson David R.
Published: November 2007

Research indicates that closeness of the father‐child bond following parental divorce is associated with better outcomes for children and adolescents. Unlike other investigations, this study takes a long‐term developmental approach to understanding stability and change in postdivorce father‐adolescent relationship closeness. Drawing on Add Health data (n= 483), we examine factors that explain (a) why some high‐quality father‐adolescent relationships remain the same after divorce whereas others decline, and (b) why some low‐quality relationships are stable following divorce whereas others improve. High mother‐offspring relationship quality and offspring feelings of well‐being prevented close father‐offspring relationships from deteriorating. Offspring’s childbearing and cohabitation following parental divorce increase closeness in father‐offspring relationships that were not close prior to divorce. Although a majority of offspring experienced a decline in closeness following divorce, results from this study show that some very close father‐offspring relationships are maintained and some poor relationships become closer.
Religious Identity and Family Ideologies in the Transition to Adulthood
Authors: Pearce Lisa D. , Thornton Arland
Published: November 2007

This article examines how religion shapes family ideologies in young adulthood. Using the 31‐year Intergenerational Panel Study of Parents and Children (N= 909), we find relationships between mother’s religious characteristics when her child was born and the child’s own family ideologies in young adulthood. Further, multiple dimensions of young adults’ religious identities are independently related to their family ideologies, suggesting unique influences of both religious service attendance and the importance of religion. Our results vary across time and family ideologies in interesting patterns, but relationships between religion and attitudes are remarkably consistent. From early in life, mothers’ and children’s religious characteristics shape family ideologies in ways likely to help explain relationships found between religion and family behaviors.
Cytapheresis: The First 25 Years
Authors: Isbister James P.
Published: November 2007

Abstract: In vivo blood cell separator technology was originally developed in response to a perceived need for granulocytes for septic neutropenic patients. This impetus led to the development of a variety of cell separators which, paradoxically, ultimately have found their main applications in pheresis procedures other than granulocyte collection. In vivo blood cell separators are ideal for the removal of large numbers of normal or abnormal hemopoietic cells. Their early use in chronic myeloid leukemia demonstrated that leukapheresis could be used as definitive therapy for the disease. However, most hematological diseases in which the circulating malignant cells can be pheresed off have definitive and cost effective standard of care therapies, and cytapheresis is limited to specific circumstances. This paper reviews therapeutic cytapheresis and summarizes the current status of its limited specific indications.
Therapeutic Apheresis in Malignancy
Authors: Nand Sucha
Published: November 2007

Abstract: Plasmapheresis (PP), staphylococcal protein A immunoadsorption (SPI), and extracorporeal photochemotherapy (EP) have been utilized in cancer treatment for about 20 years. PP removes immune complexes and induces a temporary increase in T4/T8 ratio, natural killer cell activity, and blastogenic responses. SPI removes immune complexes, enhances lymphocytic responses, and activates complement. EP increases lysis of circulating lymphoma cells by CD8+ cytotoxic T cells and increases tumor necrosis factor production by host monocytes. PP induces partial remission in about 28% of patients, but this remission is short lived. SPI gives similar results. Addition of PP to chemotherapy has been reported to prolong survival in patients with multiple myeloma. EP appears useful in treating cutaneous T cell lymphomas with 25% of patients achieving complete response and 50% of patients attaining partial remission. Thus, PP and SPI induce short‐lived immune responses, but have no proven clinical utility. EP may be useful in the treatment of cutaneous T cell lymphomas.
Conventional Care of Fulminant Hepatic Failure: Medical and Surgical Aspects
Authors: Hassanein Tarek I. , Wahlstrom H. Erik , Zamora Jose U. , Thiel David H. Van
Published: November 2007

Abstract: Fulminant hepatic failure (FHF) is a clinical syndrome with a poor outcome. Survival rates are between 10% and 40% depending on the etiology of hepatic necrosis. Multiple supportive modalities have been tried to improve patient outcome. However, orthotopic liver transplantation has been shown to be the most effective therapy at improving survival. Management of these patients requires invasive monitoring, mechanical ventilation, and infection prophylaxis, all of which are conducted most efficiently in specialized units. The goal is to allow the native liver to regenerate and to prevent the development of complications while maintaining the patient in a condition suitable for orthotopic liver transplantation. Therapeutic plasma exchange improves survival in patients with sufficient residual capacity for regeneration. It is effective in restoring hemostasis, improving neurological function, and prolonging biochemical stability of patients awaiting liver transplantation. Hepatoprotective and hepatotrophic substances are still in the experimental stage. Auxiliary liver grafting and artificial liver support devices have proved to be an adjunct or a bridge to transplantation; however, they are not yet widely available.
Cryofiltration Apheresis in the Treatment of Cryoprecipitate Induced Diseases
Authors: Siami Flora S. , Siami Ghodrat A.
Published: November 2007

Abstract: Cryoprecipitates include cryoglobulins, cryofibrinogen, cryoparaproteins, and some cold hemagglutinins. We used 3 different methods: plasma exchange (PE), plasma filter (PF), and cryofilter (CF) to remove cryoproteins. Twenty‐four patients received more than 800 CF, PF, and PE treatments. The PF and CF methods have average pore sizes of 0.03 μm and 4.3 μm and surface areas of 2.0 m2 and 0.135 m2, respectively. The plasma was separated by centrifugation, cooled to 4°C, and the cryopreipitate was removed by CF. Albumin solution 5% was used as a replacement fluid in PE, but no albumin was required when using PF or CF. Our results show that the CF and PF methods do not cause complement activation. Although PE is effective for removal of cryoproteins, it is nonspecific, nonselective, and requires human albumin or fresh frozen plasma. If intensive PE is required, it may cause depletion of immunoglobulins and coagulation factors and other vital plasma components. The PF removes macromolecules such as IgM and IgG effectively and it is semiselective. It removes any protein with a molecular weight ≥200,000, which makes it semispecific treatment. CF is very effective and selectively removes cryoproteins; therefore it is a specific therapy. In conclusion, cryofiltration apheresis is the best method to remove cryoproteins in the treatment of cryoprecipitate induced diseases.
Cytapheresis—The Next 25 Years: Stem Cell Therapy
Authors: Isbister James P.
Published: November 2007

Abstract: Hemopoietic stem cell transplantation therapy has firmly established a role in the management of a range of malignant and nonmalignant disorders. Allogeneic bone marrow transplantation has been used as an adjunct in the treatment of acute leukemia with impressive results that have translated into long‐term survival and cure. This experience has now extended to the management of other hematological malignancies and some solid tumors. With the ability to source hemopoietic stem cells from the peripheral blood by in vivo cytapheresis, there has been a rapid growth in the use of this form of therapy. The risks and benefits must be clearly appreciated and appropriate resources available with associated monitoring and quality assurance. There are few areas of medicine for which such close cooperation is necessary between medical, nursing, scientific, and allied health professionals to achieve successful outcomes. This paper addresses the logistical aspects of the provision of hemopoietic stem cell therapy in a routine clinical setting.