bluuebunny/crossref_metadata_2025 huggingface dataset:
Dimensions of functional social support and psychological symptoms
Authors: Schonfeld Irvin Sam
Published: July 2009

SYNOPSIS

In the summer following graduation a sample of 125 female college graduates (mean age = 28) completed Cohen & Wills' ISEL (1985) which includes scales measuring four social support functions: belonging (social companionship), appraisal (availability of confidants), tangible (instrumental), and self-esteem support. In the summer and fall subject status on two outcome scales was ascertained: the Psychophysiologic Symptom Scale and the Center for Epidemiologic Studies Depression Scale (CES-D). Reliability of the difference scores suggested that the ISEL scales do not measure entirely different constructs and the ISEL Self-esteem Scale is operationally redundant with the Rosenberg Self-esteem scale and the CES-D. Cross-sectional analyses indicated that the ISEL scales were related to symptoms. By contrast, standard longitudinal and prospective MLR analyses indicated that only the Belonging Scale was significantly related to future symptoms. The issues of confounding support with symptoms and the dimensionality of the subscales were discussed. The study suggests that specific functions of support take on greater importance during major life transitions and that any one supportive behaviour often serves multiple functions.
Lasègue's editorial riposte to Gull's contributions on anorexia nervosa
Authors: Silverman Joseph A.
Published: July 2009

SYNOPSIS

One week after Sir William Gull read his seminal report on anorexia nervosa to the Clinical Society of London, a brief account was published (Anonymous, 1873). In Paris, Charles Lasègue, editor of Archives Générales de Médecine read the report and printed an immediate editorial riposte, parts of which will be quoted in this communication.
Noradrenaline uptake inhibition increases melatonin secretion, a measure of noradrenergic neurotransmission, in depressed patients
Authors: Palazidou E. , Papadopoulos A. , Ratcliff H. , Dawling S. , Checkley S. A.
Published: July 2009

SYNOPSIS

Eight patients with endogenous depression who had received no antidepressant treatment for the previous year were treated with the noradrenaline (NA) uptake inhibitor, desipramine (DMI). Pre-treatment plasma melatonin concentrations were normal. After one day of DMI treatment plasma melatonin concentrations were increased but the response was impaired compared to normal subjects. The acute effect of DMI on plasma melatonin persisted after six weeks of treatment. These findings question the hypothesis that beta adrenoceptors are supersensitive in depression and that antidepressant drugs act by down-regulating these receptors.
Comorbidity of substance abuse and schizophrenia: the role of pre-morbid adjustment
Authors: Arndt Stephan , Tyrrell Gary , Flaum Michael , Andreasen Nancy C.
Published: July 2009

SYNOPSIS

Co-morbid substance use and abuse is common in schizophrenic patients, and the role of substance abuse in initiating and maintaining psychosis has important definitional and aetiological implications. We investigated the issue in a cohort of 131 schizophrenic patients. We found non-users (N= 67) were similar to pathological users (N= 64) in current symptomatology and clinical history. The pathological users did, however, have better pre-morbid adjustment levels. Only alcohol use and to some extent cannabis use contributed to this effect; use of stimulants or hallucinogens did not. These results indicate the importance of evaluating the various types of substance used when attempting to explore the significance of co-morbidity. The results also suggest that co-morbidity of substance abuse and schizophrenia may be explained by a common factor antecedent to both: better pre-morbid adjustment. A two-stage model is proposed to explain these findings: increased sociability increases exposure to opportunities of substance use in a subset of patients; subsequent onset of psychotic illness accelerates the use to a pathological level as the individual attempts to cope with the stress of the developing mental illness.
Autobiographical memory and problem-solving strategies of parasuicide patients
Authors: Evans J. , Williams J. M. G. , O'Loughlin S. , Howells K.
Published: July 2009

SYNOPSIS

Recent research has noted the tendency of parasuicide patients to retrieve over-general autobiographical memories. Separate studies suggest problem-solving deficits within this group.

The present study was concerned first with replicating these findings and, secondly, with developing a model of the relationship between over-general memory recall and poor problem-solving abilities in parasuicide patients. Anger and hopelessness were measured as markers for mood.

In line with the hypotheses, the parasuicide group (N = 12) produced significantly over-general memories in contrast to a matched control group (N = 12). This occurred significantly in relation to positive cues, and latency to first responses was significantly delayed in the parasuicide group. The parasuicide group also provided fewer and less-effective problem-solving strategies than the control group, and a significant association was found between low effectiveness of problem-solving strategies and over-general memory recall in the parasuicide group. Anger and hopelessness levels were significantly higher within the parasuicide group in line with previous findings.

The clinical implications of these findings are discussed.
Longitudinal analysis of a two-component model of the memory deficit in Alzheimer's disease
Authors: Becker James T. , Bajulaiye Olurotimi , Smith Christine
Published: July 2009

SYNOPSIS

The memory deficit in Alzheimer's disease (AD) has been characterized as consisting of multiple components. The purpose of this study was to confirm the utility of a two-process model, and to examine changes in the nature and extent of the neuropsychological deficits after a one-year interval. The results replicate the initial observation that the memory loss in AD can be described as consisting of a focal amnesic syndrome and a dysexecutive syndrome characterized by failure of rapid information processing and search of both episodic and semantic memory. One year after the initial observation, all dysexecutive patients and the majority of the amnesic patients had become non-focal. No patient developed a dysexecutive syndrome, but 18 patients developed amnesic syndromes. These results suggest that, like other aspects of the cognitive deficits of AD, the memory loss is multifactorial. These results have implications for understanding the pathophysiology of AD, and for designing pharmacotherapeutic intervention.
Research directions in psychiatric epidemiology
Authors: Leighton Alexander H.
Published: July 2009

Synopsis

A sufficient number of studies of geographically defined populations have now been done so as to make it clear that when all the various kinds of mental illnesses are lumped together, the total prevalence rates commonly amount to 20% or more. These findings imply major challenges to theory, policy, administration, and practice in the health field, and point to a need for vastly more information and understanding. This article sketches some of the directions such investigations might take.
Amenorrhoea, body weight and serum hormone concentrations, with particular reference to prolactin and thyroid hormones in anorexia nervosa
Authors: Wakeling A. , de Souza V. F. A. , Gore M. B. R. , Sabur M. , Kingstone D. , Boss A. M. B.
Published: July 2009

Synopsis

Twenty women with anorexia nervosa were investigated at varying stages during weight gain. Basal prolactin and TSH and prolactin responses to TRH were normal and unrelated to body weight. LH, FSH and 17β oestradiol were low in emaciated patients and rose with weight gain. There was no correlation between serum gonadotrophin and prolactin concentrations. T3 and T4 concentrations were low but T3 rose with weight gain during refeeding over 4–6 weeks, whereas T4 remained low. A positive correlation was found between the TSH response to TRH and body weight.

The abnormalities in the hypothalamic–pituitary–thyroid axis were similar to those seen in a variety of chronic illnesses and appear to be unrelated to the amenorrhoea. The failure of restoration of normal function at least after short-term refeeding requires further investigation.

It was concluded that the amenorrhoea in anorexia nervosa is not associated with changes in prolactin but is determined primarily by changes in the hypothalamic–pituitary–gonadal axis. These changes are induced largely by nutritional factors but psychological factors may also be involved.
Follow-up of 11 XYY males with impulsive and/or sex-offending behaviour
Authors: Wiedeking Claus , Money John , Walker Paul
Published: July 2009

Synopsis

Eleven behaviourally abnormal XYY males who had been treated in a structured combined programme of antiandrogen medication and counselling were followed up 1 year after cessation of the programme. Behavioural ratings were made in each of 5 categories: assault against people, destructiveness against things, threatening behaviour, stealing, and self-harming. On examining the follow-up findings, therapeutic success appeared questionable.
Hysterical traits and variability of mood in normal men
Authors: Rabins Peter V. , Slavney Phillip R.
Published: July 2009

Synopsis

In a study of 40 normal men it was found that self-ratings on variability of mood were positively correlated with self-ratings on hysterical traits. These results are similar to those found in normal women and lend support both to the validity of the concept of hysterical personality and to the idea that men and women experience fluctuations of mood in a similar way.
Classification of depression and response to amitriptyline therapy
Authors: Rao V. A. Rama , Coppen Alec
Published: July 2009

Synopsis

Fifty-four patients suffering from primary depressive illness were rated on the Newcastle diagnostic scale while taking part in a pharmacokinetic study of amitriptyline therapy, and their clinical response was assessed by the Hamilton Rating Scale for depression. Patients with a Newcastle score of 4−8 showed the best response to amitriptyline. Patients with low Newcastle scores, representing the non-endogenous or neurotic group, responded poorly. Patients with high scores on the Newcastle scale, representing those with marked endogenous features, also responded poorly.
Tranylcypromine (‘Parnate’) overdose: measurement of tranylcypromine concentrations and MAO inhibitory activity and identification of amphetamines in plasma
Authors: Youdim M. B. H. , Aronson J. K. , Blau K. , Green A. R. , Grahame-Smith D. G.
Published: July 2009

Synopsis

A case of tranylcypromine overdose is reported. Tranylcypromine, amphetamine, methamphetamine and phenylethylamine were detected in the plasma by gas chromatography and their identity confirmed by mass spectrometry. The data suggested that the amphetamines were metabolic products of tranylcypromine. Platelet monoamine oxidase activity was more than 95% inhibited during the 72 h after the overdose despite complete clinical recovery by that time. The possible role of amphetamines and phenylethylamine in causing the clinical manifestations of tranylcypromine overdose is discussed.
Psychiatric aspects of railway fatalities
Authors: Symonds R. L.
Published: July 2009

Synopsis

National statistics for railway fatalities in England and Wales show a reduction of train crashes and a fluctuating level of deaths, of which an increasing proportion is from suicide. A closer examination of a two-year sample from the South of England revealed a large proportion of probable suicides and a small proportion of pure accidents. The remainder appeared to have medical, mainly psychiatric, contributions to their death, of which alcohol was an important factor in single young men. Rail suicides appear to be younger, the men less often married, the women more often married, and both sexes less often widowed than other suicides. They included more cases of major psychosis and neurosis, but fewer and less severe alcoholics. Characteristic patterns of this method of suicide are described with examples. Hypotheses to explain the choice of method suggest that it is not related to either volume of traffic, or residence in a rail-dense area or in an area with a high suicide rate, or the proximity of a psychiatric hospital.
The construction, development and testing of a self-report questionnaire to identify social problems
Authors: Corney Roslyn H. , Clare Anthony W.
Published: July 2009

Synopsis

The construction and testing of a short self-report questionnaire identifying social problems, difficulties and dissatisfactions is described. The questionnaire covers housing, occupation, finance, social and leisure activities, child/parent and martial relationships, relationships with relatives, friends, neighbours and workmates, and legal problems. The results of the administration of the questionnaire in a number of settings are provided and discussed, and a final version is included in the Appendix.
The relevance of the multiple criterion screen to an adolescent population
Authors: Place Maurice , Kolvin Israel , Macmillan Angus , Nicol Rory
Published: July 2009

Synopsis

The 4th- and 5th-year pupils of four large comprehensive schools, which were broadly typical of the schools serving an urban population, were screened using a multiple criterion approach. The screen results were compared with those found in a younger population drawn from the same area, and a similar rate of efficiency was found. However, in the adolescent age group the screen was more accurate at detecting true negative cases (specificity) but less able to identify true positive cases (sensitivity). Overall, the multiple criterion screen proved more efficient than a variety of single screen criteria, and the findings also suggest that certain screen measures used in adolescence may be more effective at identifying disturbed girls while others are more effective at identifying disturbed boys. This confirms the principle that the choice of screening instruments must be made with reference to their proposed use.
Medical students' attitudes towards psychiatry: a conceptual shift
Authors: Augoustinos Martha , Schrader Geoffrey , Chynoweth Ray , Reid Mark
Published: July 2009

Synopsis

Based on the Nevid & Morrison Libertarian Mental Health Ideology Scale, the present study shows a conceptual/ideological shift in medical students' attitudes towards psychiatry after a 6-week psychiatry course. The resultant attitudes were more in line with those of teaching staff than those of the clinical team. Overall, the students developed a more positive view of psychiatry.
Parental pressure for tonsillectomy: attitudes and knowledge of parents accompanying their children to an ear, nose and throat clinic
Authors: Long Clive G. , Smith Derek H.
Published: July 2009

Synopsis

The parents of 120 children referred for possible tonsillectomy to an ear, nose and throat (ENT) surgeon were studied. There was no evidence that a desire for the operation fulfilled ‘psychological needs’ for parents or was a means of coping with a ‘deviant’ child. Parents favouring tonsillectomy were less well informed, and the educational role of the general practitioner in reducing the small number of those who inappropriately pressurize medical services is highlighted.
Plasma cortisol levels in depression and other psychiatric disorders: a study of newly admitted psychiatric patients
Authors: Swigar M. E. , Kolakowska T. , Quinlan D. M.
Published: July 2009

Synopsis

Morning and evening plasma cortisol levels were checked in 123 consecutively newly admitted psychiatric patients with a variety of diagnoses. Questions asked were whether there were differences among groups with more severe illness, type of depression, alcohol abuse, or particular symptoms. Morning cortisol elevation was found in 33% of patients and was not associated with any particular diagnostic category. Evening cortisol elevation occurred in 85% of the subjects. It was significantly higher in those with unipolar depression and organic brain syndrome, also in those patients who abused alcohol regardless of diagnosis. Evening cortisol elevation was twice as common in patients with diagnoses of more severe psychiatric illness than in those with minor disorders. Further study is suggested to see if these patterns of cortisol elevation are sustained beyond the stress-of-admission period.
Tryptophan disposition in psychiatric patients before and after stress
Authors: Curzon G. , Kantamaneni B. D. , Lader M. H. , Greenwood M. H.
Published: July 2009

Synopsis

Non-esterified fatty acid and total and free tryptophan were determined in the plasma of psychiatric patients unselected with respect to psychiatric diagnosis and in the plasma of normal subjects before and after physiological and psychiatric tests. Retarded patients had significantly low total and free tryptophan values which correlated negatively with agitation. Total tryptophan fell significantly after testing in the non-retarded subjects. The only biochemical abnormality significantly associated with a diagnosis of primary depression was the rise of plasma non-esterified fatty acid after testing. Thus, tryptophan abnormalities were associated more with psychiatric rating scores than with diagnoses.
Parasuicide in young Edinburgh women, 1968–75
Authors: Kreitman Norman , Schreiber M.
Published: July 2009

Synopsis

Between 1968 and 1975 there was a marked, non-artefactual rise in the numbers of young female parasuicides admitted to the Regional Poisoning Treatment Centre in Edinburgh. The greatest increase in rates occurred among girls aged 15–19 (for events, persons and ‘first-ever’ episodes). Among teenagers the most marked increase occurred for those who were married: this group also reported a greater increase than did the non-married in the frequency of physical violence and Serious debt. ‘Marginal’ social-sexual roles have also become progressively more common in this age group. The 20- to 24-year group showed a more modest increase in rates, similar for the married and the non-married. In this age group there was no consistent pattern of change for reported violence or debt over the study period, nor were changes in these variables related to marital status. An increase in consumption of alcohol before parasuicide was noted for both age groups.
Patterns of health care in non-fatal deliberate self-harm
Authors: Turner Richard J. , Morgan H. Gethin
Published: July 2009

Synopsis

A series of 80 patients who had deliberately but not fatally harmed themselves and had been admitted to hospital was examined with special reference to their use of available services during the period of distress prior to the episode. They were followed up for 4 months and the ways in which they subsequently made use of helping agencies were also monitored.

Three broad groups of patient attitudes to help and its utilization are described. ‘General practitioner help-seekers’ (29) defaulted least often and appeared to have more positive attitudes towards seeking help for their problem. The ‘psychiatric help-seekers’ (17) appeared to be a chronically disorganized group who, though previously often in treatment, seemed unable to cooperate: they defaulted frequently and apparently gained little. ‘Non-help-seekers’ (34) had been reluctant to ask for help concerning psychological problems and subsequently defaulted just as frequently as did the ‘psychiatric help seekers’.

The need to take into account variation in patient attitude to help and its utilization in designing services for the primary prevention of non-fatal deliberate self-harm is emphasized.
Psychiatric diagnosis in self-poisoning patients
Authors: Urwin P. , Gibbons J. L.
Published: July 2009

Synopsis

The Present State Examination was administered to 539 patients who attended a casualty department after an act of self-poisoning during the course of a year. Computer analysis by means of the Catego program showed that 30% of the patients had insufficient symptoms to be considered as psychiatric ‘cases’. Fewer than 4% had symptoms of functional psychosis. About 60% of the patients were classed as depressed: on several indices this group was less severely ill than a group of depressives receiving psychiatric treatment. It is suggested that psychiatric treatment is essential for only a small proportion of self-poisoning patients. The effectiveness of psychiatric treatment for the large group of patients with depressive disorders of minor severity and probably short duration has still to be evaluated.
The prevalence of psychiatric illness among patients on home haemodialysis
Authors: Farmer C. J. , Snowden S. A. , Parsons V.
Published: July 2009

Synopsis

An entire population of 32 patients on regular dialysis treatment (RDT) in their own homes were ranked according to their present mental state as assessed by a standardized semi-structured interview. The point-prevalence of psychiatric morbidity was 31 % which compares closely with that of patients attending a general practitioner's surgery who were assessed by the same method. The 10 patients who were psychiatrically ill had more organic symptoms and their spouses were less able to tolerate RDT in the home.
Accumulating long-stay in-patients in Salford: monitoring further progress
Authors: Fryers T.
Published: July 2009

Synopsis

Data derived from a psychiatric case-register are presented on the accumulation of new long-stay cases in Salford from 1967 to 1976. The analysis supports the general decline reported in an earlier shorter-term study except for the over 65s, where the trend was reversed. The implications of the findings are discussed.
Distribution of CCK binding sites in the human hippocampal formation and their alteration in schizophrenia: a post-mortem autoradiographic study
Authors: Kerwin R. , Robinson P. , Stephenson J.
Published: July 2009

SYNOPSIS

The distribution of cholecystokinin binding sites has been visualized and quantified by quantitative autoradiography in the human hippocampus from post-mortem brains of 11 controls and 11 schizophrenics. CCK receptors were localized to subiculum and parahippocampal gyrus. In the cortical areas there was a particularly dense lamination of receptors.

In the schizophrenic material a similar overall pattern was seen, but there were significant losses of receptors in CA1 subiculum and cortex. These findings confirm the distribution of CCK receptors in the retrohippocampal areas in man and also provide further support for earlier homogenate studies which have also shown a loss of CCK binding sites in schizophrenia. This effect was localized primarily to parahippocampal gyrus suggesting that CCK plays some role in the genesis of developmental abnormalities in this region.
The acute and chronic effects of (+) and (−) oxaprotiline upon melatonin secretion in normal subjects
Authors: Palazidou E. , Skene D. , Arendt J. , Everitt B. , Checkley S. A.
Published: July 2009

SYNOPSIS

Ten healthy male subjects were treated for three weeks with (+)oxaprotiline, a selective inhibitor of noradrenaline (NA) uptake and with (−)oxaprotiline which does not inhibit NA uptake. Plasma melatonin concentrations were measured throughout the night at 0, 1, 7 and 21 days and were higher during treatment with (+)oxaprotiline than with (−)oxaprotiline for the entire three weeks of treatment. Since NA stimulates the production and secretion of melatonin, these results are consistent with a sustained increase in noradrenergic activity within the pineal, during 21 days of treatment with an effective NA uptake inhibitor.
Memory impairment in schizophrenia: its extent, affiliations and neuropsychological character
Authors: Tamlyn D. , McKenna P. J. , Mortimer A. M. , Lund C. E. , Hammond S. , Baddeley A. D.
Published: July 2009

SYNOPSIS

In a sample of 60 schizophrenic patients encompassing all grades of severity and chronicity memory impairment was found to be prevalent, often substantial, and disproportionate to the overall level of intellectual impairment. The deficits were not easily attributable to poor cooperation, attention or motivation; nor were they related to neuroleptic or anticholinergic medication. Memory impairment was significantly associated with severity and chronicity of illness and also with negative symptoms and formal thought disorder. There was evidence from the sample as a whole, and from a more detailed examination of five patients with relatively isolated deficits, that schizophrenic memory impairment conformed to the pattern seen in the classical amnesic syndrome. Additionally, there was preliminary evidence for a marked deficit in semantic memory.
Memory and hedonic tone: ‘personality’ or ‘mood’ congruence?
Authors: Desrosiers Gabriel , Robinson David
Published: July 2009

SYNOPSIS

Four groups of healthy women matched for age and IQ were reliably classified on the Eysenck Personality Questionnaire as being either high or low in extraversion or neuroticism. As part of a larger research project, each participant was administered a range of psychometric measures together with three paired-associate learning lists varying in hedonic tone and difficulty levels together with the Beck Depression Inventory. Performance on the hedonic lists covaried with personality categories but, unlike what typically obtains in clinical patients, less association emerged between performance and mood states. Performance was particularly polarized in women scoring high in neuroticism but low in extraversion. Speculations about the apparent correlates of so-called mood congruence in healthy subjects are put forward and parallels are drawn with studies reporting the phenomenon in clinically depressed patients.
Diagnostic disclosure: a tale in two cultures
Authors: McDonald-Scott Patricia , Machizawa Shizuo , Satoh Hiroyuki
Published: July 2009

SYNOPSIS

Diagnostic communication between doctors and patients is thought to differ radically between Japan and Western countries. To understand diagnostic disclosure to psychiatric patients, a questionnaire with six case vignettes was sent to practising psychiatrists in Japan (N= 166) and North America (N= 112). While over 90% of both groups would inform patients with affective and anxiety disorders of their diagnoses, only 70% of North Americans and less than 30% of Japanese would similarly inform patients with schizophrenia or schizophreniform disorders. The Japanese preferred alternative was to give a vague alternative diagnosis such as neurasthenia. North Americans would discuss differential diagnoses with the patient instead. Nearly all in both groups would inform the family, but North Americans would do so only with patient consent. For disorders for which there are effective treatments, diagnostic disclosure is common to both cultures; when prognosis is uncertain or the diagnosis is feared, as in schizophrenia, culturally constructed views of patienthood govern disclosure practice.
Self-reported psychotropic drug use and associated factors in a French community sample
Authors: Pariente P. , Lépine J. P. , Lellouch J.
Published: July 2009

SYNOPSIS

Drug use was examined in a French general population adult sample from a household survey conducted in 1987–8 in a newly built town near Paris. Psychotropic drug use was measured by the percentage of subjects reporting their use during the past week. It was prominently represented by benzodiazepines (90% of psychotropic users), differed strongly between genders (4·6% in men, 10·2% in women) and age groups (higher after 40 years). A lifetime history of major depressive episode (MDE) or of anxiety disorders was associated with a higher proportion of psychotropic drug use. Psychotropic drug use also went with a current well-being questionnaire score. Using a logistic analysis, the following set of variables held for women: well-being score, history of both MDE and anxiety disorder, age, and marital status. Making allowance for the cross-sectional nature of this retrospective survey, these finding confirmed the relatively high level of benzodiazepine drug use in an urban French community sample and emphasized its association with mental health status.
The order effect: reflections on the validity of multiple test presentations
Authors: Lucas Christopher P.
Published: July 2009

SYNOPSIS

The effect of order has been previously addressed in test–retest studies but its effect on the presentation of more than one test, in the same time, is often underestimated. This study has shown that when two rating scales were given sequentially, each scored lower if received second in the pair, and that this particular form of order effect (occasion effect) was enough to affect markedly agreement on caseness when utilizing standard cut-off scores. It is therefore important that research workers not only adopt design strategies such as counterbalanced presentation, but also analyse their data for the effects of test order and position within such designs.
A psychometric analysis of the Mental Adjustment to Cancer Scale
Authors: Schwartz Carolyn E. , Daltroy Lawren H. , Brandt Ursula , Friedman Richard , Stolbach Leo
Published: July 2009

SYNOPSIS

This paper describes a psychometric replication study of a British coping scale, the Mental Adjustment to Cancer scale, on 239 USA cancer patients. The internal consistency and construct validity were similar to the original validation study. However, the factor structure was different. Cultural differences between the British and USA patient populations are discussed.
The Present Behavioural Examination (PBE): the development of an interview to measure current behavioural abnormalities
Authors: Hope Tony , Fairburn Christopher G.
Published: July 2009

SYNOPSIS

Behavioural problems are an important feature of dementia and other neuropsychiatric conditions. This paper describes the development and performance of an investigator-based interview (the PBE) for the detailed assessment of the behaviour of subjects over the preceding four weeks. The interview is designed to be administered to carers.

A test–retest reliability study was carried out on the penultimate edition of this interview; and the inter-rater reliability of the final edition was measured. These studies show that the reliability of the PBE is comparable with that of other investigator-based interviews.
Immunological variability associated with experimentally-induced positive and negative affective states
Authors: Futterman Ann D. , Kemeny Margaret E. , Shapiro David , Polonsky William , Fahey John L.
Published: July 2009

SYNOPSIS

Functional and phenotypic immunological parameters were examined immediately before, after, and 30 minutes after experimentally-induced short-term positive (happiness) and negative (anxiety, depression) affective states and a neutral state, in five healthy subjects. Results indicated that all affective states induced more immune fluctuations (regardless of the direction) than the neutral state. Furthermore, among the affective states, anxiety induced the most immunological variability and depression the least.
Filters on the pathway to mental health care I. Incident mental disorders
Authors: Marino S. , Gallo J. J. , Ford D. , Anthony J. C.
Published: July 2009

Synopsis

This study investigates health and mental health services use by adults with and without newly incident mental disorders and uses prospectively gathered data from the Epidemiologic Catchment Area Program, a multi-site interview survey of adult household residents in the United States. Study subjects were 13400 participants who completed interviews in the initial survey and also in a follow-up 1 year later, and who reported no contact with mental health services in either the specialized mental health sector or in the general medical sector in the 6 months prior to the initial survey. Case ascertainment was by means of a standardized interview method, the Diagnostic Interview Schedule. Separately, and before the mental health assessments were made, respondents were asked about their use of health and mental health services. ‘Hierarchical’ and ‘filter’ models of mental health services provide frameworks useful in understanding the possible effects of specific categories of psychiatric disturbances on use of health services. Only a minority of individuals with newly incident psychiatric disorder report discussion of mental health issues in a health care setting. Persons who developed a mental disorder during the follow-up interval were just as likely to consult a non-psychiatrist physician for their mental health problems as to consult a specialist in mental health, even accounting for other factors known to be associated with differential use of health care services. This large community study of incident psychiatric disorders strengthens prior evidence on the importance of the general medical sector in the care of individuals with psychiatric disturbances.
Alzheimer's disease in the NAS–NRC Registry of ageing twin veterans, IV. Performance characteristics of a two-stage telephone screening procedure for Alzheimer's dementia
Authors: Gallos Joseph J. , Breitner John C. S.
Published: July 2009

Synopsis

In the course of a large twin study of Alzheimer's disease we used a two-stage telephone screening procedure. The modified Telephone Interview for Cognitive Status (TICS-m) served as an initial screen for dementia in 12709 individuals. The telephone Dementia Questionnaire (DQ) was then asked of collateral informants for subjects with TICS-m scores below 28, as well as for samples of persons with higher TICS-m scores. Based upon DQ responses, individuals with cognitive impairment not attributable to focal causes underwent assessment for the clinical diagnosis of Alzheimer's disease (‘Alzheimer's dementia’), as did their twins. Well-defined Alzheimer's dementia was apparent in 39 subjects. Employing a cut-off of 27 or lower as indicative of cognitive impairment, the sensitivity of the TICS-m in the detection of Alzheimer's dementia was estimated at >99% and specificity at 86%. Inclusion of the DQ increased the specificity at the 27/28 cut-point to 99%. The TICS-m score was associated with an area under the receiver operating characteristic (ROC) curve of 0·88 (95% confidence interval 0·81 to 0·94). The maximum number of cases of Alzheimer's dementia remaining undetected in the sample was estimated to be 34.
Decline in working memory associated with HIV infection
Authors: Stout J. C. , Salmon D. P. , Butters N. , Taylor M. , Peavy G. , Heindel W. C. , Delis D. C. , Ryan L. , Atkinson J. H. , Chandler J. L. , Grant I. ,   the HNRC Group
Published: July 2009

Synopsis

HIV infection has been associated with decline in a number of cognitive functions that are components of ‘working memory’. Thus, tests of working memory that require the interaction of these components may be particularly sensitive to cognitive dysfunction that arises from HIV infection. To assess this possibility, working memory was examined in 147 HIV-seropositive (HIV+) and 38 HIV-seronegative (HIV−) males using the Reading Span Test and the Digit Span subtest from the Wechsler Memory Scale-Revised (WMS-R). Speed of information processing, a component of some working memory tasks, was assessed with a version of the Sternberg Memory Scanning task. Results indicated that symptomatic HIV+ subjects were impaired relative to HIV− control subjects on the Reading Span and Digit Span tests. Asymptomatic and mildly symptomatic HIV+ groups exhibited a trend toward impairment on these tests, and on the whole, a greater proportion of HIV+ subjects than HIV− subjects were impaired. The groups did not differ significantly in information processing speed. These results indicate that deficits in working memory are apparent in at least a subset of HIV-infected individuals. These deficits are most apparent in symptomatic HIV+ individuals, but the decline may begin during the asymptomatic phase of infection.
Neuropsychological deficits in tests of executive function in asymptomatic and symptomatic HIV-1 seropositive men
Authors: Sahakian B. J. , Elliott R. , Low N. , Mehta M. , Clark R. T. , Pozniak A. L.
Published: July 2009

Synopsis

There has been much debate about the exact nature and time of onset of the cognitive impairments associated with infection by the human immunodeficiency virus type 1 (HIV-1). Studies to date have not reached consistent conclusions. The present study comprised 22 asymptomatic and 18 symptomatic HIV-1 seropositive men, whose only risk factor for contraction of the virus was sexual intercourse, and 18 seronegative controls matched for age and IQ. Subjects were given computerized neuropsychological tests from the CANTAB battery, which assessed visuospatial memory, attention and executive function. Both the asymptomatic and the symptomatic HIV-1 seropositive subjects showed a selective pattern of deficits relative to the controls. In addition, the seropositive subjects were subtly but significantly impaired on tests of executive function but unimpaired on certain tests of visual memory. This finding supports an hypothesis that frontostriatal dysfunction occurs in HIV-1 infected individuals prior even to the expression of clinical symptoms.
The effect of prior stressful experience on coping with war trauma and captivity
Authors: Solomon Zahava
Published: July 2009

Synopsis

The study assessed the implications of childhood life events, Holocaust background, combat experiences, war captivity and negative post-captivity life events in the mental status of ex-POWs (164) and comparable controls (184), 18 years after the war. Findings confirm the association between stressful life events in the course of the life span and five outcomes: PTSD, intrusion and avoidance tendencies, psychiatric symptomatology, and impaired social functioning. Different life events have different effects. War captivity made the strongest contribution to all dependent variables.
Saccadic abnormalities in psychotic patients. II. The role of neuroleptic treatment
Authors: Crawford T. J. , Haeger B. , Kennard C. , Reveley M. A. , Henderson L.
Published: July 2009

SYNOPSIS

The effects of dopamine-antagonistic neuroleptic (NL) medication on saccadic eye movements were compared in matched groups of 40 NL-treated and 18 NL-free schizophrenic patients and in 18 NL-treated and 14 NL-free bipolar affective patients. Manipulation of the saccadic paradigm yielded data on four types of saccade: those reflexively elicited by novel stimuli (REFLEX saccades), those directed towards the remembered location of a target now extinguished (REM) or towards the location where a predictably alternating target is expected to appear (PRED), or ANTI saccades, directed away from the stimulus to the mirror image location. Extensive psychiatric, neurological and neuropsychological assessments were also carried out on all subjects. The saccades of NL-treated patients, regardless of diagnosis, were less spatially accurate than those of NL-free patients, with a greater tendency to fall short of the target when generated towards the locus of a mentally represented target. This effect was greatest with a predictably alternating target, especially during periods when target visibility was withdrawn, only a temporal cue remaining. This pattern of impairment which is also found in early stages of Parkinson's disease is likely to be due to deficiency of striatal dopamine. Its best clinical predictors were disease duration, and Webster–Parkinsonism scores. Failure to suppress reflexive saccades to the stimulus in the REM and ANTI paradigms were more closely associated with schizophrenia than with NL treatment and were best predicted by negative symptoms and Wisconsin perseverative errors, both of which are widely regarded as indicators of frontal lobe dysfunction.
Concepts of mental illness and medical pluralism in Harare
Authors: Patel V. , Musara T. , Butau T. , Maramba P. , Fuyane S.
Published: July 2009

SYNOPSIS

The Focus Group Discussions (FGD) described in this paper are the first step of a study aiming to develop an ‘emic’ case-finding instrument. In keeping with the realities of primary care in Zimbabwe, nine FGD were held with 76 care providers including 30 village community workers, 22 traditional and faith healers (collectively referred to as traditional healers in this paper), 15 relatives of patients and 9 community psychiatric nurses. In addition to the general facets of concepts of mental illness, three ‘etic’ case vignettes were also presented.

A change in behaviour or ability to care for oneself emerged as the central definition of mental illness. Both the head and the heart were regarded as playing an important role in the mediation of emotions. The types of mental illness described were intimately related to beliefs about spiritual causation. Angered ancestral spirits, evil spirits and witchcraft were seen as potent causes of mental illness. Families not only bore the burden of caring for the patient and all financial expenses involved, but were also ostracized and isolated. Both biomedical and traditional healers could help mentally ill persons by resolving different issues relating to the same illness episode. All case vignettes were recognized by the care providers in their communities though many felt that the descriptions did not reflect ‘illnesses’ but social problems and that accordingly, the treatment for these was social, rather than medical.

The data enabled us to develop screening criteria for mental illness to be used by traditional healers and primary care nurses in the next stage of the study in which patients selected by these care providers on the grounds of suspicion of suffering from mental illness will be interviewed to elicit their explanatory models of illness and phenomenology.
Magnetic resonance imaging volumetric measurements of the superior temporal gyrus, hippocampus, parahippocampal gyrus, frontal and temporal lobes in late paraphrenia
Authors: Howard R. , Mellers J. , Petty R. , Bonner D. , Menon R. , Almeida O. , Graves M. , Renshaw C. , Levy R.
Published: July 2009

SYNOPSIS

Quantified magnetic resonance measurements were made of superior temporal gyrus, parahippocampal gyrus, hippocampal, frontal and temporal lobe volumes and of the planar area of the thalamus and basal ganglia structures in 47 late paraphrenic patients and 33 healthy elderly controls. The late paraphrenics were divided into 31 schizophrenics and 16 patients with delusional disorder according to ICD-10 guidelines. Patients with delusional disorder tended to have smaller left temporal volumes compared with control subjects and patients with schizophrenia, but this difference failed to reach accepted levels of statistical significance after correction for the effects of multiple statistical comparisons, age and total brain size. Physiological right–left asymmetry, reported for temporal and frontal lobe volumes, was present in control, schizophrenic and delusional disorder subjects but delusional disorder patients had a significantly greater degree of temporal lobe asymmetry. The results add to the evidence for heterogeneity among late-onset psychoses and emphasize the subtle nature of any structural brain abnormalities in these patients.
Insight and psychosis: a social perspective
Authors: Johnson Sonia , Orrell Martin
Published: July 2009

SYNOPSIS

The last 5 years have seen a resurgence of interest in insight, with better definitions and operationalizations of the concept. However, recent work has paid little attention to the ways in which patients' understanding of their illnesses may be shaped by perceptions of mental illness and treatment prevailing in their cultures and social groups. We review work by social scientists on cultural and social variations in lay perceptions of mental illness and on the stigma attached to mental illness, and argue that these varying views are likely to be one of the influences on insight, requiring further exploration in research on this subject.
Psychosocial sequelae of the 1989 Newcastle earthquake: I. Community disaster experiences and psychological morbidity 6 months post-disaster
Authors: Carr V. J. , Lewin T. J. , Webster R. A. , Hazell P. L. , Kenardy J. A. , Carter G. L.
Published: July 2009

SYNOPSIS

A stratified random sample of 3007 Australian adults completed a screening questionnaire 6 months after the 1989 Newcastle earthquake. Information was obtained on initial earthquake experiences and reactions, use of specific services, social support, coping strategies and psychological morbidity. This questionnaire was the first phase of the Quake Impact Study, a longitudinal project investigating the psychosocial impact of the earthquake. Two weighted indices of exposure were developed: a threat index, which measured exposure to injury or the possibility of injury; and a disruption index, which measured experiences of property damage, displacement and other losses. Levels of exposure to threat and disruption events were significant predictors of morbidity on both the General Health Questionnaire and Impact of Event Scale, as were coping style and gender. Effects of exposure to threat and disruption were largely additive, with higher exposure being associated with greater use of support services, higher perceived stressfulness and more severe psychological morbidity. Use of avoidance as a coping strategy, female gender, lower social support and being older were also associated with higher post-disaster psychological distress. It was estimated that 14·8% of the population was exposed to high levels of threat or disruption, of whom approximately 25% experienced moderate to severe psychological distress as a direct result of the disaster. It was further estimated that 18·3% of those exposed to high levels of threat were at risk of developing post-traumatic stress disorder, representing approximately 2% of the city's adult population.
The Cardinal Needs Schedule – a modified version of the MRC Needs for Care Assessment Schedule
Authors: Marshall M. , Hogg L. I. , Gath D. H. , Lockwood A.
Published: July 2009

SYNOPSIS

This paper describes a modified version of the MRC Needs for Care Schedule (the Cardinal Needs Schedule), for measuring needs for psychiatric and social care amongst patients with severe psychiatric disorders. The modified schedule has three new features: (i) it is quick and easy to use; (ii) it takes systematic account of the views of patients and their carers; (iii) it defines and identifies need in a way that is concise and easy to interpret. The paper describes why the three new features were considered necessary, and then gives an overview of the structure of the Cardinal Needs Schedule, together with a description of how the three new features were developed. During a study of social services care management the practicality of the modified schedule was investigated and further data were obtained on the reliability and validity of the standardized approach to measuring need, in domains not previously investigated. Because of its speed and simplicity, the Cardinal Needs Schedule offers a new choice to researchers who wish to use a standardized and practical assessment of need in evaluative studies of community care. Examples of the usage of the modified schedule are given in an Appendix.