bluuebunny/crossref_metadata_2025 huggingface dataset:
Immigration, moving house and psychiatric admissions
Authors: Johansson L. M. , Sundquist J. , Johansson S.‐E. , Bergman B.
Published: November 2007

This study was designed to elucidate psychiatric admission rates for native Swedes and foreign‐born individuals during the period 1991–1994, when Sweden had a great influx of refugees. During the same period, and even earlier, psychiatric in‐patient care had been reduced. Tests of differences between Swedes and foreign‐born individuals in first psychiatric admission rates were performed using Poisson regressions, and the risk of a readmission was assessed using a proportional hazard model. Foreign‐born individuals and native Swedes, both males and females, showed a similar admission pattern with regard to the number of admissions. Foreign‐born males under 55 years of age and foreign‐born females under 35 years of age had significantly higher admission rates than native Swedes. In total, native Swedes, both males and females, were hospitalized for a significantly longer period than the foreign‐born subjects. About 43% of the patients were readmitted. The risk of a readmission was significantly increased among those with a high rate of internal migration. The high admission rates for young foreign‐born individuals might be explained by a high incidence of mental illness owing to the trauma of being violently forced to migrate, acculturation difficulties, or unsatisfactory social circumstances such as high unemployment. The shorter hospitalization time could be due to undertreatment or less serious mental illness.
Full‐syndrome, partial‐syndrome and subclinical eating disorders: an epidemiological study of female students in Southern Italy
Authors: Cotrufo P. , Barretta V. , Monteleone P. , Maj M.
Published: November 2007

We screened a sample of 919 female students, aged 13–19 years, by means of the EDI 2 and GHQ‐28 questionnaires. Those students identified as being at risk for an eating disorder (281 subjects) underwent a psychiatric interview. We found 2 cases of full‐syndrome anorexia nervosa (0.2%), 21 cases of full‐syndrome bulimia nervosa (2.3%) and 2 cases of full‐syndrome binge‐eating disorder (0.2%). Moreover, 35 girls (3.8%) met the criteria for partial‐syndrome and 98 girls (10.7%) fulfilled the criteria for subclinical eating disorders. Subjects with partial‐syndrome and subclinical eating disorders had higher scores than those with no diagnosis, but lower scores than students with full‐syndrome eating disorders, on both the EDI 2 and GHQ‐28 questionnaires. A follow‐up of subjects with partial‐syndrome and subclinical eating disorders is now in progress.
Subjective quality of life in out‐patients with schizophrenia: clinical and utilization correlates
Authors: Dickerson F. B. , Ringel N. B. , Parente F.
Published: November 2007

The relationship between subjective quality of life (QOL), clinical measures, and service utilization was measured in out‐patients with schizophrenia. A total of 72 subjects completed the Quality of Life Interview and were also assessed by means of the Positive and Negative Syndrome Scale, a battery of neuropsychological tests, and two measures of social functioning. Use of psychiatric services over a 2‐year period was ascertained from comprehensive records. Global subjective QOL was lower than patients' satisfaction with specific life domains. There were few significant correlations between satisfaction with, and objective measures of, specific life areas. In a multiple regression, patients' global subjective QOL was inversely related to their scores on the PANSS depression factor, and to the number of psychiatrist out‐patient visits.
The treatment of social phobia: a critical assessment
Authors: Stravynski A. , Greenberg D.
Published: November 2007

This article critically reviews the effects of psychological treatment (exposure, cognitive restructuring, social skills training) and pharmacological treatment (MAOIs, reversible MAOIs, anxiolytics and SSRIs) of social phobia. Only controlled studies have been included, and their outcomes were assessed for improvement in anxiety and avoidance, social functioning and clinical status. Both psychological and pharmacological treatments resulted in a significant and meaningful reduction in anxiety and, in most cases, a weakening of the tendency to avoid. Although useful, the effects were not of such a magnitude as to result in remission. Reduction in anxiety was long‐lasting in patients treated by psychological methods. The lessening of anxiety did not necessarily lead to meaningfully improved social functioning. The combination of psychological and pharmacological treatments was disappointing, and did not exceed the effects of psychological treatments alone. However, the most promising medications were not tested. Subtype of social phobia and additional diagnoses did not determine the response to treatment.
A 16‐year follow‐up study of schizophrenia and related disorders in Sofia, Bulgaria
Authors: Ganev K. , Onchev G. , Ivanov P.
Published: November 2007

A total of 60 patients with functional non‐affective psychoses were assessed 16 years after their inclusion in the WHO co‐ordinated study on reduction and assessment of psychiatric disability. All patients at inclusion had a recent onset of a psychotic disorder. About one‐third of the patients had a good outcome. The rest showed moderate to severe psychiatric symptoms and social disability. Comparison with other similar studies suggested that our results show a low mortality rate, high levels of clinical symptoms, high levels of social disability and a low percentage of institutionalized patients. These findings are discussed in the context of the high level of family involvement in patients' care, which could reflect a cultural factor.
Repetition of parasuicide —ICD‐10 personality disorders and adversity
Authors: Dirks B. L.
Published: November 2007

Patients with a history of previous parasuicide were compared to those who had made their first attempt. A scale for suicidal ideation derived from the Scaled Version of the General Health Questionnaire was completed by patients. ICD‐10 personality disorder diagnoses were derived from the Standardized Assessment of Personality which was administered to knowledgeable informants. Logistic regression showed that unemployment, increasing severity of suicidal ideation, previous psychiatric treatment and borderline personality disorder increased the risk of reports of previous parasuicide. Anankastic personality disorder decreased the risk of reports of previous parasuicide. Unemployment and specific personality disorders have independent risks for repetition of parasuicide. Specific ICD‐10 personality disorders may increase or decrease the risk for repetition of parasuicide.
TCI temperamental scores in bulimia nervosa patients and normal women with and without diet experiences
Authors: Mizushima H. , Ono Y. , Asai M.
Published: November 2007

In order to distinguish the trigger and the factors maintaining bulimia nervosa (BN), TCI temperamental scores were compared among BN patients, normal controls without diet experiences (N‐N), and normal controls with diet experiences (N‐D). On the novelty‐seeking (NS) scale, the BN patients scored significantly higher than the N‐N subjects, but there was no significant difference between the BN patients and the N‐D subjects, and the N‐D subjects scored higher than the N‐N subjects. These findings suggest that high NS scores are related to diet experiences rather than chronic bulimic symptoms.
Repeated use of psychiatric emergency out‐patient services among new patients: a 3‐year follow‐up study
Authors: Saarento O. , Hakko H. , Joukamaa M.
Published: November 2007

The aim of this study was to examine repeated use of psychiatric emergency out‐patient services during the second and third years after the first contact. A 1‐year treated incidence cohort of 537 new patients was studied in the Department of Psychiatry in Oulu, Finland. Repeat users were defined as patients belonging to the upper 10th percentile of the emergency out‐patient contacts. The median of emergency out‐patient contacts among repeaters was 4. The repeaters constituted 8% of the cohort and they used 65% of the cohort's emergency contacts. They were more likely to be male and living alone, and they tended to have more serious diagnoses than non‐repeaters. Having hospital admissions, planned out‐patient contacts and repeated emergency out‐patient contacts also during the first year of follow‐up was associated with an increased probability of repeatedly using emergency services during the second and third years. Living alone and having hospital admissions during the follow‐up period were associated with being a continuous repeat visitor during the whole follow‐up period. It is concluded that the extended repeated use of emergency services is associated with inadequate social support and serious psychiatric problems.
Childhood experiences and personality traits in patients with motor conversion symptoms
Authors: Binzer M. , Eisemann M.
Published: November 2007

A total of 30 patients with newly diagnosed motor conversion disorder were consecutively investigated by means of a Swedish self‐rating inventory designed to assess perceived parental rearing practices (EMBU), and the Karolinska Scale of Personality (KSP). DSM Axis I and II psychopathology was assessed using a Structured Clinical Interview (SCID), and comparisons were made with 30 age‐ and sex‐matched in‐patients with motor symptoms due to a neurological disorder. Depression, the presence of a personality disorder and also poor schooling proved to be significantly associated with motor conversion disorder. The index patients perceived a high degree of parental rejection as well as low levels of affection and emotional warmth during childhood, but contrary to most previous studies, childhood physical and/or sexual abuse was not found to be associated with motor conversion disorder.
Setback phenomenon in autism and longterm prognosis
Authors: Kobayashi R. , Murata T.
Published: November 2007

From among the subjects of a follow‐up study on cases of autism conducted by the authors in 1990, 179 cases for which precise records were available on the infancy period were selected for evaluation of the relationship between the occurrence of setback phenomenon in infancy and long‐term prognosis. The following results were obtained: (i) a significantly higher rate of epilepsy among the setback group compared to the non‐setback group; and (ii) a significantly lower level of language development among the setback group upon entering elementary school compared to the non‐setback group, although the difference between the present levels of adaptation of the two groups was not significant. Factors determining the long‐term prognosis of the setback group are discussed.
The relationship between coping style and burden in the carers of reatives with schizophrenia
Authors: Budd R. J. , Oles G. , Hughes I. C. T.
Published: November 2007

The development of a questionnaire to measure the coping style of people caring for a relative with schizophrenia is described. Data on the psychometric properties of this questionnaire are reported for a sample of 91 carers. It is shown that coping style is associated with carer burden and psychological distress. In particular, the coping styles ‘collusion’, ‘criticism/coercion’,‘overprotectiveness',‘emotional over‐involvement’ and‘resignation’ were found to be associated with higher levels of carer burden, and the coping style‘warmth’ was found to be associated with lower levels of carer burden.
Outcome of lithium prophylaxis: a prospective follow‐up of affective disorder patients assigned to high and low serum lithium levels
Authors: Vestergaard P. , Licht R. Wentzer , Brodersen A. , Rasmussen N.‐A. , Christensen H. , Arngrim T. , Grønvall B. , Kristensen E. , Poulstrup I.
Published: November 2007

The purpose of the study was to examine the outcome of long‐term lithium treatment in consecutively admitted affective disorder patients assigned to high and low serum lithium levels. A total of 91 patients were diagnosed according to DSM‐III criteria and randomly allocated to two open treatment groups in which prophylactic lithium was administered in high (serum lithium 0.8‐1.0 mmol L‐1) and low (serum lithium 0.5‐0.8 mmol L‐1) doses, respectively. The patients were followed for 2 years or until discontinuation of lithium treatment or readmission to hospital for recurrence of affective illness. The main outcome of the treatment groups was compared with Kaplan‐Meier survival curves and by Cox regression analysis. A total of 31 patients (34%) completed 24 months of prophylactic lithium treatment without recurrence and readmission to hospital. In total, 18 patients (20%) suffered a recurrence on lithium, and 42 patients (46%) discontinued lithium or were lost to follow‐up. No effect of treatment group was seen, either for the total patient group or for the large subgroup of bipolar patients when analysed separately. A number of patients did not maintain their original assignment to the high serum lithium levels group. The results were analysed both according to assignment and according to actual serum lithium levels. Abuse of alcohol or medication was associated with a poor outcome. Only one third of the patients completed 2 years of lithium prophylaxis successfully. No difference in the protection against recurrences was observed between patients maintained on high and low serum lithium levels.
Reduced fertility in schizophrenia: here to stay?
Authors: Nimgaonkar V. L.
Published: November 2007

Studies of reproduction among individuals with schizophrenia published in this century are reviewed. Past studies suggesting normalization of reproductive deficits are disputed in view of recent reports of a persistent impairment. The handicap appears to be more significant among men with schizophrenia. The implications of these findings for genetic research in schizophrenia are discussed.
The TAPS Project 42: the last to leave hospital — a profile of residual long‐stay populations and plans for their resettlement
Authors: Trieman N. , Hughes J. , Leff J.
Published: November 2007

This study aims to assess the service needs of residual hospital populations and the adequacy of the alternative facilities provided for them following the closure of psychiatric hospitals. The remaining 368 long‐stay patients in four representative English hospitals scheduled for closure within 1 year were assessed by means of a standardized schedule devised to rate problem behaviours. The residual populations consisted predominantly of elderly, male and very long‐stay patients. The most frequent problem behaviours were hostility, physical aggression and incontinence. The one hospital which allowed new admissions to continue indefinitely had the highest proportion of problematic patients. Alternative care facilities were provided by a diverse range of agencies. Large residential homes were the predominant type of provision for most patients, and private nursing homes often accommodated mixed groups of elderly people. NHS trusts catered for most of the ‘difficult to place’ patients within specialized facilities, based in the community. There were some indications that compromises led to insufficient and understaffed specialist facilities. In view of the increasing demand for long‐term intensively staffed facilities, this policy might put an extra burden on the local health services.
A factor analysis of the Mini‐Mental State Examination in schizophrenic disorders
Authors: de Leon J. , Baca‐Garcia E. , Simpson G. M.
Published: November 2007

The Mini‐Mental State Examination (MMSE) is frequently used in schizophrenia studies. Therefore, it is surprising that no factor analysis of MMSE has been carried out in schizophrenic patients. The MMSE ratings of 80 long‐term in‐patients with DSM–111‐R schizophrenia or schizoaffective disorder were introduced into a principal‐component analysis with varimax rotation which generated three MMSE factors or subscales (frontal, memory and spatial). The limitations of this pilot study are the small sample size and the inclusion of only hospitalized patients.
Factorial structure of the Positive and Negative Syndrome Scale (PANSS): a forced five‐dimensional factor analysis
Authors: Lancon C. , Aghababian V. , Llorca P. M. , Auquier P.
Published: November 2007

We conducted a study on 205 schizophrenic patients in order to explore the factorial structure of the Positive and Negative Syndrome Scale (PANSS). We first documented the validity and reliability of the five‐dimensional structure of the PANSS, initially derived from the work of Kay and Sevy and completed by Lindenmayer et al. Some items (stereotyped thinking, mannerisms and posturing, poor attention, lack of judgement, disturbance of volition, and preoccupation) appeared to contribute little to the constitution of the dimensions initially described by Kay and Sevy. Those items were not taken into account in the forced five‐dimensional factor analysis. We therefore investigated further the psychometric properties of the PANSS using only the retained items. The validity and reliability of this new five‐dimensional structure are discussed.
Suicide notes: what do they tell us?
Authors: Ho T. P. , Yip P. S. F. , Chiu C.W. F. , Halliday P.
Published: November 2007

Police investigation records of all suicide cases in 1992 (n= 769) and the suicide notes that had been left (224 notes for 154 subjects) were examined. Note‐leavers were characterized as young females, of non‐widowed marital status, with no history of previous suicide attempts, no previous psychiatric illness, and with religious beliefs. Suicide notes written by young people were longer, rich in emotions, and often begging for forgiveness. Suicide notes written by the elderly were shorter, contained specific instructions, and were less emotional. A significant proportion of note‐leavers did mention their difficulties. Suicide notes may serve some explanatory purpose and may have a therapeutic role in helping the surviving relatives to understand the suicide. A knowledge of the messages contained within suicide notes could be useful for suicide prevention programmes. The significance of suicide notes is best understood within the context of the occurrence of suicides.
Suicide‐preventive effects of perestroika in the former USSR: the role of alcohol restriction
Authors: Wasserman D. , Värnik A.
Published: November 2007

A background to this supplement is presented, together with a short summary of results.
Marked decrease in suicide among men and women in the former USSR during perestroika
Authors: Värnik A. , Wasserman D. , Dankowicz M. , Eklund G.
Published: November 2007

At the same time as substantial and rapid socio‐political and socio‐economic changes took place during the period of perestroika, suicide rates in the former USSR decreased by approximately 32% for men and 19% for women. The decreases in the suicide rates of men in the former USSR were unlike the suicide rate decreases taking place in 22 other European countries, where rates decreased by approximately 8% for men and 17% for women during this time period. Declines in suicide rates from 1984 to 1986–1988 occurred in all republics, with the largest decreases in Russia and Belarus, at 42% for men and 20% for women. The decrease in suicide rates of men in the former USSR was most pronounced until 1986–1988, after which time an increasing trend was observed. Suicide rates for men in the former USSR decreased 3.8‐fold more than they did for men in other parts of Europe, while decreases in the suicide rates for women in the former USSR were on the same level as in Europe.
Age‐specific suicide rates in the Slavic and Baltic regions of the former USSR during perestroika, in comparison with 22 European countries
Authors: Värnik A. , Wasserman D. , Dankowicz M. , Eklund G.
Published: November 2007

Age‐specific differences in suicide rates in the Baltic and Slavic regions of the former USSR were studied for the period 1984–1990, and were compared to those of 22 European countries. It was observed that suicide rates per 100000 inhabitants in the Slavic and Baltic regions increased directly with age for women, and showed a bimodal distribution with peaks for the 45–54 and ≥75 age groups for men. In most of the 22 European countries, the suicide rates of both men and women increased directly with age. In 1990 the suicide rates in the Slavic and Baltic regions ranged from 25.1 for the 15–24 age group to 86.9 for men aged 75 or older, and from 6.0 to 29.8 for women, while the suicide rates in Europe ranged from 13.0 to 64.8 for men and from 3.6 to 18.7 for women. Decreases in the suicide rates in the Slavic and Baltic regions during perestroika were largest for the 25–54 age group, averaging a drop of 45% for men and 33% for women between 1984 and 1986–1988. The pattern of age‐specific suicide rates for women in the Slavic and Baltic regions remained similar to that in Europe throughout the period studied. This was in contrast to a distinct pattern of male suicide rates in the Slavic and Baltic regions in 1984, which converged with those found in other parts of Europe during 1986–1988. It appears that perestroika contributed to a unique pattern of male suicide mortality in the Slavic and Baltic regions, especially in the 25–54 age group.
Comparison of patient satisfaction with community‐based vs. hospital psychiatric services
Authors: Henderson C. , Phelan M. , Loftus L. , Dall'Agnola R. , Ruggeri M.
Published: November 2007

Objective: Previous work suggests that psychiatric patients are more satisfied with community‐based than with hospital‐based services, but it is not clear how far these findings can be generalized to routine services. The aim of this study was to compare the satisfaction of patients with psychosis between a hospital‐based service in London, UK and a community‐based service in Verona, Italy.

Method: The Verona Service Satisfaction Scale (VSSS) was used to measure satisfaction among patients with psychosis in Nunhead (London) and South Verona.

Results: Satisfaction across all dimensions was higher in South Verona than in Nunhead. Sociodemographic and service use differences between the two groups were insufficient to explain this difference.

Conclusion: This study suggests that experimental findings that patients prefer community‐based to hospital psychiatric services can be generalized to routine services.
Attempted suicide and major public holidays in Europe: findings from the WHO/EURO Multicentre Study on Parasuicide
Authors: Jessen G. , Jensen B. F. , Arensman E. , Bib‐Brahe U. , Crepet P. , Leo D. De , Hawton K. , Haring C. , Hjelmeland H. , Michel K. , Ostamo A. , Salander‐Renberg E. , Schmidtke A. , Temesvary B. , Wasserman D.
Published: November 2007

Objective: The aim of the study was to examine the relationship between suicide attempts and major public holidays in Europe.

Method The analysis was based on data on 24388 suicide attempts by persons aged 15 years or older in the period 1989–1996. Data from 13 centres (representing 11 countries) participating in the WHO/EURO Multicentre Study on Parasuicide were analysed. The analysis of the fluctuation of suicide attempts around public holidays was based on the daily number of suicide attempts for each centre. For each day in the period under examination a mean number of suicide attempts (μ) was calculated. The analysis was based on the assumption that the data followed a Poisson distribution. The observed number of daily suicide attempts was compared with the expected number of attempts. A multiplicative model for the expected number in each centre was developed.

Results: Before Christmas there were fewer suicide attempts than expected, and after Christmas there were approximately 40% more attempts than expected. In addition, more attempts than expected were registered on New Year's Day. In countries where people have the day off work on Whit Monday there were significantly fewer attempts during the 3 days before, but where Whit Monday is a normal working day significantly fewer attempts occurred on the Monday to Wednesday after Whit Sunday.

Conclusion: There appears to be a transposition of a significant number of suicide attempts from before (and during) a major public holiday until after it. The division of holidays into non‐working and working days showed that a ‘holiday effect’ could only be found around major public holidays, particularly Christmas, Easter and Whitsun. These findings support the theory of the ‘broken‐promise effect’ for major public holidays.
Assessing varying degrees of lethality in depressed adolescent suicide attempters
Authors: Nasser E. H. , Overholser J. C.
Published: November 2007

Objective: Understanding the lethality of suicide attempts and its relation to other psychological variables may improve clinical judgement with regard to suicide risk.

Method: The lethality of suicidal behaviour was examined in 60 hospitalized adolescent in‐patients who had recently attempted suicide. Subjects were divided into non‐lethal, low‐lethal and high‐lethal groups based on the qualities of their suicidal acts.

Results: The groups did not differ in terms of hopelessness, depression, substance abuse or self‐esteem. Moreover, they did not differ significantly in diagnoses of major depression. adjustment disorder, substance abuse and bipolar disorder. The group of high‐lethal attempters was the only group with several individuals diagnosed with a major depressive episode and comorbid attention deficit disorder. The high‐lethal group also reported the strongest desire to end their lives.

Conclusion: Based on lethality of suicide attempts, adolescent suicide attempters can be differentiated in terms of the wish to die as well as some instances of diagnostic comorbidity. However, they may not be differentiated in terms of severity of depression or hopelessness, demographic variables and other aspects of suicidal behaviour.
The fertility and fecundity of patients with psychoses
Authors: McGrath J. J. , Hearle J. , Jenner L. , Plant K. , Drummond A. , Barkla J. M.
Published: November 2007

Objective: Previous research has suggested that patients with schizophrenia have fewer offspring compared to the general population. Reduced fertility in a disorder with a strong genetic component and an apparently stable incidence has implications for models of genetic transmission. There is also a need to obtain contemporary estimates of the prevalence of parenthood among subjects with psychotic disorders in order to inform service planning. The aim of this study was to determine the fertility and fecundity of a representative sample of individuals with psychoses who were in contact with mental health services, and to explore the interactions between age at first diagnosis and fertility.

Method All clients of two community mental health clinics and an extended‐care psychiatric hospital were surveyed. Data on diagnosis, age at first diagnosis, and the number and age of offspring were collected. Based on interviews with the proband and chart review, a genogram of the probands’ family was drawn that identified sex, age, affected status and the number of offspring for each patient and their siblings.

Results: In total, 36% of all patients were parents. Most women with psychoses (59%) were mothers. Patients with psychoses had fewer offspring compared to their unaffected same‐sex siblings. This was especially the case for men with non‐affective psychoses. Higher levels of fertility were associated with a later age at first diagnosis.

Conclusion: The consistent finding of reduced ‘reproductive fitness’ in those with non‐affective psychoses needs to be incorporated in the genetic epidemiology of these disorders. Despite this reduction in fertility and fecundity, many patients with psychoses are parents. Services need to remain mindful of the special needs of these patients.
Subjective and external assessments of quality of life in schizophrenia: relationship to insight
Authors: Doyle M. , Flanagan S. , Browne S. , Clarke M. , Lydon D. , Larkin C. , O'Callaghan E.
Published: November 2007

Objective: This study assessed the manner in which insight influenced schizophrenic patients’ evaluation of their objective life conditions and the concurrent validity between patients’ and clinicians’ assessments of patients’ global quality of life.

Method: Forty out‐patients who fulfilled DSM‐III‐R criteria for schizophrenia were independently interviewed using the Lancashire Quality of Life Profile and the Standard of Living Interview. Insight was assessed using a self‐report questionnaire, the Insight Scale.

Results: For insightful patients there was a significant but modest correlation between objective and subjective indicators of quality of life. Likewise, a significant correlation between subjective and external evaluations of global quality of life was limited to those individuals who had good insight. Conclusion: Diminished insight may limit the usefulness of the self‐report methodology for assessing quality of life for some individuals with schizophrenia.
Family burden and coping strategies in schizophrenia: are key relatives really different to other relatives?
Authors: Magliano L. , Fadden G. , Fiorillo A. , Malangone C. , Sorrentino D. , Robinson A. , Maj M.
Published: November 2007

Subjective and objective burden, psychiatric symptoms and coping strategies in a sample of 90 key relatives and other relatives of patients with schizophrenia. living in two European countries, were explored by means of well‐validated questionnaires. The levels of burden on key relatives did not differ significantly from those on other relatives. Moreover, the risk of developing psychiatric symptoms was similar in the two subject groups at both centres. Significant correlations were found between key relatives and other relatives concerning the adoption of emotion‐focused coping strategies. These data contrast with the current belief that family burden in schizophrenia is mainly a burden of key relatives, and they emphasize the need to provide supportive interventions for as many relatives as possible.
Pubertal maturation and the development of behavioural and emotional problems in early adolescence
Authors: Laitinen‐Krispijn S. , Van der Ende J. , Hazebroek‐Kampschreur A. A. J. M. , Verhulst F. C.
Published: November 2007

Development of problem behaviour in early adolescence was predicted from change in pubertal stage and timing of pubertal development. Parent‐reported (Child Behavior Checklist) and self‐reported (Youth Self‐Report) problem behaviour, pubertal stage and life events were assessed twice from a community sample of nearly 1300 Dutch children, aged 10–12 years at T1 and 12–14 years at T2. Pubertal change was a significant predictor of development in most parent‐reported problems. Once initial differences in problems had been accounted for, the slower the progress in pubertal development, the higher the problem score at T2. Development of self‐reported problems was independent of pubertal change. Pubertal timing predicted development of two parent‐reported and three self‐reported problem scales. Of the parent‐reported problems, early maturation was associated with a decrease in boys' social problems and attention problems. Late maturing increased girls' social problems. Of the self‐reported problems, early maturation was associated with an increase in girls' withdrawn and delinquent behaviour. Late maturing increased boys' attention problems. We conclude that pubertal development has small but significant effects on the development of problem behaviour in early adolescence.
Long‐term outcome of pharmacological and psychological treatment for panic disorder with agoraphobia: a 2‐year naturalistic follow‐up
Authors: de Beurs E. , van Balkom A. J. L. M. , Dyck R.Van , Lange A.
Published: November 2007

Two years after completion of a controlled outcome study of treatments for panic disorder with agoraphobia, patients were revisited and interviewed about their complaints. In the initial study, four treatments had been compared: (i) fluvoxamine combined with exposure; (ii) placebo medication plus exposure; (iii) psychological panic management plus exposure: and (iv) exposure alone. Comparison of the results at post‐test had revealed superior efficacy of fluvoxamine combined with exposure over the other three treatments in reducing agoraphobic avoidance. The current naturalistic follow‐up study investigated the long‐term efficacy of the treatments with regard to abatement of complaints and reduced demand for further treatment. In addition, we examined whether patients were able to taper off the study medication without a recurrence of complaints. In total, 71 of the 76 patients of the original trial (93%) were interviewed. Comparison of the mean level of psychopathology at follow‐up revealed no difference between the original treatment groups. The effect in the fluvoxamine plus exposure group was maintained, but was no longer superior, due to further improvements in the other treatment groups. Most patients received additional treatment during the follow‐up period, usually because the 12 treatment sessions in the controlled study had yielded insufficient improvement. There was a trend for patients who received the fluvoxamine plus exposure treatment to require less aftercare than those who received the other treatments. Finally, almost 50% of the patients who had received medication in the original trial were able to taper off the use of fluvoxamine without a recurrence of complaints.
Cognition and neuropathology in schizophrenia
Authors: Arnold S. E.
Published: November 2007

Clinical, neuropsychological and neuropathological avenues of research have advanced in concert to increase our understanding of schizophrenia. Progress in four general areas of investigation will be reviewed: (i) fronto‐temporal‐limbic dysfunction; (ii) abnormal connectivity or ‘miswiring’; (iii) aberrant neurodevelopment; and (iv) neurodegeneration and neural injury. The challenge for post‐mortem research is to identify the molecular pathways in which abnormalities culminate in the highly diverse features of the disorder. Candidate pathways must be able to account for the developmental and deteriorative clinical profiles and the global and focal neuropsychological deficits, as well as the various patho‐anatomical abnormalities that indicate aberrant cytoarchitecture and connectivity in the absence of neurodegeneration or other obvious evidence of postmaturational neural injury.
Transmitter dysfunction during the process of schizophrenia
Authors: Glenthøj B. Y. , Hemmingsen R.
Published: November 2007

Transmitters that are primarily or secondarily involved in the pathogenesis of schizophrenia have been extensively studied for many years. This review will focus on the transmitter systems that are known to be directly or indirectly involved in the mode of action of the novel atypical antipsychotics and clozapine, i.e. the dopaminergic, serotonergic and glutamatergic systems. The consequences of transmitter dysfunction for perception and for the ability of the individual to adapt to a constantly changing environment are discussed, and a hypothesis that can explain how a primary cortical defect will progressively involve secondary transmitter dysfunction and spontaneous dopaminergic sensitization is proposed. According to the suggested hypothesis for the pathogenesis of development of schizophrenic symptoms, pharmacological treatment strategies should focus on flexible as opposed to rigid modulation of sensorimotor gating. The hypothetical effects of serotonergic and dopaminergic interactions on sensarimotor gating are illustrated, and the implications of the broader receptor profile of atypical antipsychotics for the reduced capacity to induce extrapyramidal side‐effects and the supposedly superior effect on cognitive dysfunction and negative symptoms are discussed.
Seasonal affective disorders among rural Finns and Lapps
Authors: Saarijärvi S. , Lauerma H. , Helenius H. , Saarilehto S.
Published: November 2007

Saarijärvi S, Lauerma H, Helenius H, Saarilehto S. Seasonal affective disorders among rural Finns and Lapps.

We investigated the prevalence of seasonal affective disorder (SAD) and subsyndromal SAD (S‐SAD) in rural populations in south‐western and northern Finland by using the Seasonal Pattern Assessment Questionnaire (SPAQ). A total of 1710 SPAQs were analysed. The prevalences of overall SAD and S‐SAD were 12.0% and 27.1%, respectively. Winter SAD (W‐SAD) was the most common type, with prevalences of 9.5%, for W‐SAD and 18.4% for W‐S‐SAD. The prevalences of overall and winter SAD did not differ between Finns living in northern and south‐western Finland. Among the Lapps, W‐SAD cases were less frequent than among the Finns in Lapland. Overall seasonality correlated significantly with female gender, high body mass index, high level of education and young age.
Prevalence and psychological correlates of eating disorders among females aged 18–30 years in the general population
Authors: Ghaderi A. , Scott B.
Published: November 2007

Objective: The prevalence of eating disorders (ED) according to DSM‐IV, and also correlates of ED, were examined.

Method: This study represented the first phase of a questionnaire‐based prospective study. The subjects consisted of 1157 women randomly selected from the general population of females aged 18–30 years in Sweden. Results: Lifetime and point prevalences of 7.8% and 2.6%, respectively, were reported for ED. Subjects with ED reported lower self‐esteem, less perceived social support from the family and higher concern about body shape than controls.

Conclusion: Establishing the prevalence and correlates of ED simultaneously and longitudinally among females in the general population may promote our understanding of the development, course and maintenance of ED.
Low body mass indices in adolescents with obsessive‐compulsive disorder
Authors: Hennighausen K. , Rischmüller B. , Heseker H. , Remschmidt H. , Hebebrand J.
Published: November 2007

The aim of this study was to evaluate the growth of adolescents with obsessive‐compulsive disorder (OCD). Body heights and body mass indices (BMIs; expressed in kg m‐2) of 51 adolescent patients with OCD were compared with the corresponding anthropometric variables in age‐ and sex‐matched psychiatric controls and in a general population sample. respectively. In accordance with a previous epidemiologically based investigation, body heights and weights were found to be reduced, especially in male patients with OCD. The body mass indices of the patients with OCD were significantly lower than those of age‐matched control patients and population controls. However, some of the parameters were also reduced in male psychiatric controls, indicating that the reductions are not entirely specific for adolescent OCD. The results suggest a neurocridocrine dysfunction in adolescent OCD. The low body mass index indicates that psychiatric disorders other than anorexia nervosa are associated with underweight during adolescence.
Health care costs of therapy‐refractory schizophrenic patients treated with clozapine: a study in a community psychiatric service in Italy
Authors: Percudani M. , Fattore G. , Galletta J. , Mita P. L. , Contini A. , Altamura A. C.
Published: November 2007

This study evaluates the utilization of clozapine in the treatment of therapy‐refractory schizophrenia in terms both of patterns of care and of health care costs in a community psychiatric service in Italy. Data covering the year prior to commencing clozapine and the year following the initiation of the therapy were collected. Clinical outcome was assessed by means of the Clinical Global Impression (CGI) and Global Assessment of Functioning (GAF) scales. Cost analysis followed a two‐step procedure: (i) to record all health care services provided to patients and (ii) to assign a monetary value to each service. Three of the 15 patients enrolled in the study dropped out before the end of the 12‐month period of therapy. Considering the 12 patients on clozapine treatment for at least 1 year, clinical improvements are associated with a substantial modification of the pattern of care. While patients in the pre‐clozapine period were mainly managed in hospital settings, patients on clozapine were prevalently placed in the community and participated in intensive rehabilitative programmes. The higher costs of drug therapy and community services in the post‐clozapine period were more than offset by the lower costs of acute hospital care.
Tardive dyskinesia in psychosis: probing abnormal metabolism with promethazine
Authors: Bates G. O. L. , Lopes O. , van Woerkom A. E. , Klovrza L. , Waring R.
Published: November 2007

Ten in‐patients with tardive dyskinesia (TD) (mean AIMS score 16.7) and 8 controls were recruited to the study, and 3 h after oral administration of promethazine a blood sample was taken for assay of levels of promethazine and its immediate metabolites by high‐performance liquid chromatography (HPLC). The TD group had a variety of indicators of impaired or slow metabolism compared to the controls. There was a significant difference in the ratio of promethazine to promethazine sulphoxide (P < 0.05) between patients with TD and the control group. The TD group but not the controls showed increasing metabolic impairment with age. This small study confirms the previous reports of impaired neuroleptic metabolism in TD, particularly 1 in the elderly.
Adolescent depression: prevalence in Swedish high‐school students
Authors: Olsson G. I. , von Knorring A.‐L.
Published: November 2007

A total population of high‐school students aged 16–17 years in a Swedish town was screened for depression and previous suicide attempts, and 2300 students (413.3%) participated. Those with high depression scores (12.3%) and previous suicide attempts (2.4%), as well as controls matched for gender and education, were interviewed for diagnosis (DICA‐R‐A), and 88.8% participated. The 1‐year prevalence of major depression was 5.8% and the lifetime prevalence was 11.4%, with four girls being represented for every boy. A depression lasting for at least 1 year was the most common type. Dysthymia was found in 2% (two girls for every boy). Short hypomanic episodes were present in 13.2% of those with a lifetime diagnosis of major depression.
Personality disorders in dysthymia and major depression
Authors: Garyfallos G. , Adarnopoulou A. , Karastergiou A. , Voikli M. , Sotiropoulou A. , Donias S. , Giouzepas J. , Paraschos A.
Published: November 2007

Objective: The purpose of the present study was to investigate the comorbidity of personality disorders in patients with primary dysthymia compared to those with episodic major depression.

Method: A total of 177 out‐patients with primary dysthymia and 187 outpatients with episodic major depression were administered a structured diagnostic interview for DSM‐III‐R Axis II disorders. In addition, all of these patients completed the BDI, and those with the appropriate level of education also completed the Minnesota Multiphasic Personality Inventory (MMPI).

Results: A significantly higher proportion of dysthymic patients than patients with major depression met the criteria for a personality disorder, for borderline, histrionic, avoidant, dependent, self‐defeating types and for personality disorders of clusters B and C. Further analysis revealed that the above differences were mainly due to the subgroup of patients with ‘early‐onset dysthymia’. Finally, patients with a personality disorder, both dysthymics and those with major depression, had significantly higher scores on the RDI and on the majority of the MMPI scales compared to those without a personality disorder.

Conclusion: The data indicated that (i) dysthymia—mainly that of early onset—is associated with significantly higher personality disorder comorbidity than episodic major depression, and (ii) the presence of a personality disorder is related to more severe overall psychopathology.
Suicide attempts and ideation among adults in Addis Ababa, Ethiopia
Authors: Kebede D. , Alem A.
Published: November 2007

Attempted suicide is one of the major risk factors for completed suicide, is associated with psychiatric disorders, and is also a potentially fatal event. We describe here a study of suicide attempts and ideation in a representative sample of 10203 adults in Addis Ababa. The study was conducted between January and March 1994. The prevalence of current suicidal ideation was 2.7%). Lifetime prevalence of suicidal attempt was 0.9%. Most of the attempts (66%)) occurred when subjects were under 25 years of age. Hanging was the preferred method for men and poisonings for women. There were no significant associations between suicide attempt and sex, ethnicity or religion. Current suicidal ideation was more common in men than women, odds ratio (95% confidence interval), OR (95% CI): 0.67 (0.48, 0.93). There was a statistically significant trend of decreasing risk of ideation with increasing age and educational attainment. There was a 68% decrease in the risk of ideation in the 60 years of age and above group compared to the 15–24 year group: OR (95% CI): 0.32 (0.16, 0.62). Marital status, ethnicity, and religion were not associated with suicidal ideation.
The prevalence and socio‐demographic correlates of khat chewing in Butajira, Ethiopia
Authors: Alem A. , Kebede D. , Kullgren G.
Published: November 2007

A house‐to‐house survey was carried out in a rural Ethiopian community to determine the prevalence and socio‐demographic correlates of khat use. A total of 10 468 adults were interviewed. Of these, 58% were female, and 740/0 were Muslim. More than half of the study population (55.7%) reported lifetime khat chewing experience and the prevalence of current use was 50%. Among current chewers, 17.40/0 reported taking khat on a daily basis; 16.1% of these were male and 3.4% were female. Various reasons were given for chewing khat; 80% of the chewers used it to gain a good level of concentration for prayer. Muslim religion, smoking and high educational level showed strong association with daily khat chewing.
The Child Behavior Checklist (CBCL) and related material: standardization and validation in Danish population based and clinically based samples
Authors: Bilenberg N.
Published: November 2007

The Child Behavior Checklist (CBCL) and related material, developed by Achenbach and Edelbrock in Vermont, was validated in a mailed survey. A population based sample of 779 children between the age of four and 17 years was compared to a sample of 146 children referred for child psychiatric service. Danish children scored very much like our Scandinavian and German neighbours, but low compared to most others. The CBCL mean ‘total behavior problem score’ in the population was 17.7. The checklists, especially the parent and teacher versions, provided good construct validity. Youths generally reported more emotional problem behavior than their parents and teachers did about them. In general, parents and youths agree more, reporting emotional problems, and parents and teachers agree more, when scattering externalizing behavior. Short screening constructs are introduced, and by the use of latent trait analysis, four clinically relevant sub‐scales were generated. Predictive value, sensitivity, specificity and clinical validity must be undertaken in a future two‐phase study.