bluuebunny/crossref_metadata_2025 huggingface dataset:
The Supplementation of Alcoholic Beverages with Thiamine—A Necessary Preventive Measure in Queensland?
Authors: Price John , Theodoros M. T.
Published: October 2008

The large and increasing number of cases of Korsakoff's psychosis in a Queensland mental hospital prompts an examination of the theoretical and practical issues concerning the supplementation of alcoholic beverages with thiamine. It is concluded that supplementation of alcoholic beverages in Queensland with thiamine (and in particular with one of the allithiamines) warrants urgent and unprejudiced consideration.
Chlormethiazole Dependency—A Case Report
Authors: De Groot M. H. L.
Published: October 2008

Although dependency is reported to be one of the side effects of chlormethiazole, very few cases of such dependency have been reported. A detailed report of a female patient with a previous history of other dependencies, and who subsequently became dependent on chlormethiazole, is offered.
Peer Review—The West Australian Experience
Authors:   The West Australian Peer Review Sub-Committee
Published: October 2008

In view of the Department of Health's recommendations that Peer Review be accepted as an integral part of the medical system, local members of the college volunteered to take part in a pilot study. Those involved were divided into three groups and were left to devise their own system. Following subsequent discussion and assessment, a workable scheme evolved as described. This system employs a ‘rolling’ or an on going technique in which a group of four psychiatrists form the peer review group. Following each assessment a new member joins the team and the longest serving person is assessed before leaving. The problems and difficulties of peer review are discussed and the importance of the link between peer review and continuing education is stressed.
Suicide in Brisbane—A Retrospective Psychosocial Study
Authors: Chynoweth R. , Tonge J. I. , Armstrong J.
Published: October 2008

A consecutive series of 135 suicides is described, this being the total which occurred during one year in Brisbane from 1 March 1973 to 28 February 1974, resulting in a rate of 16 per 100,000. The clinical and social characteristics of the suicides are described. Important contributing factors were depressive illness (55%), physical illness (52%), and drug dependency (34%). About half of the suicides were taking prescribed medication and about a third had been in contact with a doctor shortly before death. Social isolation or loss appeared to contribute to the suicide risk. The study confirms the importance of the recognition and treatment of depressive illness in attempting to prevent suicide and draws attention to the significant contribution of physical illness, especially when affecting the nervous system or gastrointestinal tract, and the importance of the role of alcohol and/or barbiturate dependency.
Psychological Aspects of Carcinoma of the Breast in the Male—Two Case Reports
Authors: Singh Bruce S.
Published: October 2008

Whilst there have been a number of reports about the psychological features of women who develop carcinoma of the breast, there have been no such studies of men. This paper details two reports of men with this unusual condition. In both cases, this illness in the male followed a similar condition which occurred in the breast on the same side in a woman with whom each had an intense relationship. That this could be considered a more than coincidental event is explored. The role of identification with a significant other in determining site and type of illness is discussed, as is a hypothetical mechanism whereby such identification could facilitate the development of the cancers in these cases.
The Effect of Thioridazine on Prolactin Levels in Actutely Schizophrenic Patients: Challenge-Dose and Steady-State Levels
Authors: Johnson G. F. S. , Hunt G. E.
Published: October 2008

Prolactin (PRL) levels in unmedicated male patients with acute schizophrenia were within normal range at baseline, increased five fold after a challenge dose of thioridazine, did not significantly increase further after therapeutic dosages, and remained elevated for the duration of treatment. The rise in PRL levels was significantly correlated with the steady-state plasma levels of thioridazine and/or mesoridazine. Baseline and challenge-dose PRL levels did not correlate with severity of symptoms as measured by the Brief Psychiatric Rating Scale, or predict response to thioridazine. Overall, there was a trend for the drug and PRL levels to increase very quickly and remain elevated while the clinical response was gradual over the four-week period. Clinically, it may be useful monitoring PRL levels, since the therapeutic dosage should usually be above the dosage required to produce maximal PRL levels.
The Case of William Chidley: A Study in Psychiatry, Morality and Lunacy Law
Authors: Edwards G. A. , Hall Wayne
Published: October 2008

William Chidley was a unique Australian. He lectured frequently on his beliefs that the answer to society's problems was a three-fold program of correct dress, proper diet and a new method of sexual intercourse. His compulsory admissions to psychiatric hospitals were on the grounds that he was insane and a danger to public morals. The case raised basic questions in psychiatry, morality and lunacy law. These questions, which are discussed, are still of contemporary significance.
The Medical Model-Why Psychiatry is a Branch of Medicine
Authors: Joyce Peter R.
Published: October 2008

With a perspective from evolutionary biology and a view of the philosophy of science as described by Popper, various models of psychiatry are discussed. It is concluded that any satisfactory model must be a synthesis of the biological, psychological and social. It is argued that the concept of diagnosis is the core of the medical model, and that psychiatry is a branch of medicine, and not a social science, because the biological aspect is very important.
Attempted Suicide in Christchurch: A Controlled Study
Authors: Adam K. S. , Bouckoms A. , Scarr G.
Published: October 2008

The results of a comparison of a sample of consecutive admissions for attempted suicide to matched patients from a general practice are presented. Significant differences were found in the degree of social and psychiatric disturbance, the quality of current interpersonal relationships, and the family backgrounds of the two groups. The implications of these findings for the clinical management of attempted suicide patients are discussed.
Family Therapy—An attempt to integrate models and modes into a structure of developing phases of therapy
Authors: Kippax Donna E.
Published: October 2008

There is a need experienced by most practitioners of family therapy to impose order and structure upon the considerable range of concepts currently used in the family process approach. This paper suggests a possible structure utilizing five phases which characteristically unfold during the treatment process. The structure provides a rationale so that seemingly divergent techniques of therapy may be seen to be appropriate to particular phases of therapy, rather than mutually contradictory or exclusive. The article further attempts to demonstrate that certain conceptual models and the techniques that arise from them, are called into play depending upon the nature of the family in treatment.
Psychiatry and Family Law in Western Australia
Authors: Quadrio Carolyn
Published: October 2008

The use of psychiatric evidence in Family Law Courts considering custody disputes is questioned. It is postulated that such evidence is often prejudiced, not always related to parental competence, and is morally and politically questionable.
The Reliability of Reports of Early Separations
Authors: Finlay-Jones Robert , Scott Ruth , Duncan-Jones Paul , Byrne Don , Henderson Scott
Published: October 2008

A random sample of adult community residents (n 244) was asked about separations in their childhood. Eight months later, the group was asked the same questions again. Only the death of a parent and the break-up of the parental marriage were reported with high reliability. These events made up one third of all reported separations.
Double Blind Controlled Trial of Deanol in Tardive Dyskinesia
Authors: George Jacob , Pridmore Saxby , Aldous Diane
Published: October 2008

Thirty three chronic psychiatric hospital subjects with oral tardive dyskinesia were divided into three groups. The subjects were matched for severity of symptoms then randomly assigned to treatment with a placebo, 1g deanol or 2g deanol per day.

Statistical analysis showed that after 30 days treatment, there was a significant reduction in the mean rating of the movements of the group of 11 subjects on 2g deanol per day. Six of these subjects showed substantial reduction in movement. Further studies using this dosage of deanol are warranted.
Recent Advances in the Genetics of Affective Illness
Authors: James Norman McI.
Published: October 2008

Variability in the classification of depressive illness greatly handicapped the work of geneticists prior to the application of the polarity concept. The past decade has however, seen a burgeoning of interest in this area, with researchers concentrating on bipolar illness, this being the most clearly defined entity. Findings of a lifetime morbidity risk for affective illness of 15–20% in the first degree relatives of bipolar patients has been usual. This compares with 10–15% for patients with unipolar illness. Transmission patterns indicative of known forms of Mendelian inheritance have not been consistently demonstrated. Genetic markers including colour blindness and HLA antigens have been pursued avidly but have yielded inconclusive results. Further progress seems unlikely unless more sub-groups are defined using biochemical and physiological markers.
Agoraphobia in Men
Authors: Hafner R. Julian
Published: October 2008

Twenty male and 20 female agoraphobics, matched for age and marital status, were systematically compared using self-report questionnaire measures of symptoms and hostility, and clinical observations. The males differed significantly from the females as follows: the males were less phobic of social situations but more preoccupied with somatic symptoms and related fears. The females were more phobic of mental illness, more extrapunitive, and reported fewer obsessional symptoms. Two distinct but overlapping clinical sub-groups of males were defined. The sub-group in which separation anxiety, extreme dependence on spouse, denial of hostility and hypochondriasis were prominent, responded poorly to behavioural treatment; the sub-group in which a fear of loss of control of aggressive impulses and generalised anxiety were prominent, responded comparatively well to behaviour therapy.
The Expression and Possible Origins of Depression in Male Adolescent Delinquents
Authors: Howard John
Published: October 2008

The literature on adolescent delinquent behaviour and psychopathy contains the view that much of the delinquent behaviour is masking a depressive underlay, and that psychopaths may be in a chronic state of helplessness which they defend against through their anti-social behaviour. The current study examined the levels of trait depression in two groups of adolescent male offenders in a state training school. The group classified as anti-social personalities showed higher levels of trait depression than a group of first committals. The role of a perceived lack of paternal care, and, to a lesser extent, maternal over-protection emerged as the main variables explaining the variance in the trait depression scores. The quality of parental care appeared more important than continuity, with perceived affectionless control being significantly related to high trait depression scores. The importance of the mother in the development of persistent anti-social behaviour was highlighted as was the role of the father in relation to trait depression and overall delinquent development.
A Controlled Study of Psychiatric Hospital versus Community Treatment — the Effect on Relatives
Authors: Hoult John , Reynolds Ingrid , Charbonneau-Powis Marie , Coles Penelope , Briggs Jennifer
Published: October 2008

One hundred and twenty patients presenting at Macquarie Hospital for admission were randomly allocated into two groups. The control group patients received standard hospital care and follow-up. The project group patients were not admitted if this could be avoided; instead they were taken back to the community by the project team who provided them and their relatives with comprehensive, assertive and prolonged follow-up treatment backed by a 24-hour crisis service. The majority (63%) of the project group had no admission during the 10 month study period. Initially, the burden on the relatives of the project group was higher, but by one month it was somewhat lower and by four months it was significantly lower than the burden on the control group relatives. Relatives of the project group patients were significantly more satisfied with the treatment than control group relatives. It is clearly feasible to treat most psychiatric patients in the community without increasing the burden on their relatives.
The Need for Mental Health Services for Adolescents in the Hunter Region
Authors: Wells Peter
Published: October 2008

A survey was carried out to determine the need for mental health services for adolescents in the Hunter Region. Based on health surveys elsewhere, it was estimated that 21,400 of the population of 13 to 18 year-olds in the Hunter Psychiatric Catchment Area would be mildly to seriously disturbed. A sample of disturbed youngsters making demands on agencies in the City of Newcastle and on community health teams and school guidance in the rest of the Region suggests that during November 1980 only about one in 20 of those in need were receiving help from these agencies. Eighty-five per cent involved major family issues. Of those receiving help, at least 40% would have been referred to an adolescent mental health service, had there been one. Of the alternatives that had to be used, about 75% were estimated to have been less than adequate.
Bulimia: The Emergence of a Syndrome
Authors: Huon G. F. , Brown L. B.
Published: October 2008

The literature on bulimia, which has regarded it as a psychiatric entity or as a form of disordered eating, suggests that this behaviour is now widespread among the obese, among those with anorexia nervosa and those of normal weight. While physiological, psychological and sociocultural explanations and forms of treatment have been proposed, a holistic perspective on the context in which it occurs can distinguish bulimia nervosa and bulimarexia from ‘simple’ bulimia.
The Recognition of Psychiatric Illness by Non-Psychiatrists
Authors: Goldberg David
Published: October 2008

Psychiatric illness occurs commonly during the course of medical and surgical illnesses, and commonly presents to non-psychiatric physicians inextricably mixed with physical symptoms. Non-psychiatrists vary widely between themselves in their ability to detect such disorders, so that such disorders are often missed. Reasons for failure to detect such disorders include the diagnostic practices taught in medical schools, the inadequacy of psychiatric taxonomy of neurosis, and the fact that most doctors have not been taught how to interview their patients.
Freedom of Information: Can we Afford to be Anything but Clinical?
Authors: Lipton G. L. , White W.
Published: October 2008

Following the introduction of the Freedom of Information Code and Act in Victoria there have been numerous requests seeking the opportunity for patients and ex-patients to view their own records. This paper explores the clinical context within which patients traditionally have had, or not had, access to their own records, and the ways in which this is now altered by freedom of information legislation. The view is put forward that such disclosure in the past has always been within a clinical context whereas now there is potential for legislative intrusion into the psychiatrist/patient relationship of which the patient record is a part. A number of case examples is provided to exemplify the issues involved and the approach that the Victorian Health Commission has taken to resolve some of the difficulties.
Multidisciplinary or Nondisciplinary: Evaluation of Staff Functioning in a Community Mental Health Centre
Authors: Krupnski Jerzy , Lippmann Lenora
Published: October 2008

This paper describes the staffing aspects of an experimental community mental health centre (Melville Clinic). The different components of staff roles of members of a team consisting of different health professionals, crystallised during the three-year period with a shift from a ‘nondisciplinary’ to a ‘multidisciplinary’ approach, with preservation of ‘generalised’ and ‘specialised’, ‘clinical’ and ‘community’ roles of all staff members. The decision-making in the centre oscillated between group decisions by all staff members, and the acceptance of the leading role of the psychiatrist with the active Involvement of the test of the staff. This paper provides a model for multidisciplinary teamwork in community mental health centres.
Depression in Pre-Pubertal, Children
Authors: Waters Brent G. H. , Storm Victor
Published: October 2008

Pre-pubertal depression has attracted a great deal of interest recently. The literature is reviewed with a particular focus on the better designed studies. While isolated symptoms of depression are relatively common, definite depressive disorder is much less prevalent. The majority of studies have focused on the most severely depressed subgroup of children. While effective treatment regimes are being developed for this small group of children, there is no evidence that such regimes should be applied to every depressed child. Major gaps exist in our knowledge of the range of depressive symptomatology in pre-pubertal children, the relationship of developmental factors to depressive symptoms, the reliability and validity of existing diagnostic tools, and the effectiveness of traditional child psychiatric treatment modalities for depression.
Do Vietnam Veterans Suffer from Toxic Neurasthenia?
Authors: Hall Wayne , Macphee Donald
Published: October 2008

This paper evaluates the claim that Vietnam veterans with psychiatric disorders are suffering from toxic neurasthenia — a neurasthenic syndrome caused by exposure to pesticides while serving in Vietnam.
Psychotherapy: The Treatment of Choice for Neurotic/Reactive Depression?
Authors: Parker Gordon
Published: October 2008

A recently published paper by Prioleau and colleagues has questioned whether the benefits of psychotherapy exceed those of placebo in real patients. A critique of that paper is presented drawing attention to key methodological weaknesses, to the subjective interpretation of the meta-analysis data, and to the selective and tendentious presentation of the authors' conclusions. Arguing that psychotherapy is best evaluated in relation to a limited group of conditions, and to disorders in which high efficacy is claimed, controlled studies of psychotherapy for neurotic and reactive depressive disorders are reviewed. The view that psychotherapy may have a key effect in influencing the natural history of these depressive disorders is explored.
Family Admission Policy in a Child Psychiatric Unit
Authors: Bornstein Don , Belcher Noelle M. , Baumgartner Shirley
Published: October 2008

The literature on residential admissions of whole families to psychiatric facilities is reviewed. Over the past decade, several child and family psychiatric centres have become the focus of innovative family admission programs. When a child or family presents with serious psychiatric problems, the availability of such programs dramatically increases the effective assessment and treatment options available. The benefits of a whole family admission policy are outlined and illustrated by a case example. In some cases, a brief family admission circumvents the need for a lengthy admission of the child alone. Disadvantages and contraindications are described. The adoption of a set of criteria and a specific policy for family admissions in a child psychiatric residential unit has challenged its organisational structure. The conceptual framework applied to requests for admission has broadened and been complemented by creative program development within the centre for children and families.
The Psychosexual Histories of Young Women with Bulimia
Authors: Abraham Suzanne F. , Bendit Nicholas , Mason Catherine , Mitchell Helen , O'Connor Nicholas , Ward Jeanette , Young Simon , Llewellyn-Jones Derek
Published: October 2008

While it is known that anorexia nervosa patients show a wide range of sexual knowledge, attitudes and practices, the psychosexual histories of bulimia patients have not been studied. in this paper the psychosexual histories of 20 bulimic patients and 20 matched control subjects are presented. Bulimic patients were more likely to experience orgasm with masturbation, were more likely to have experimented with anal intercourse, and were more ilkely to describe their libido as ‘above average’. Control subjects were more likely to experience orgasm during sexual intercourse. Bulimic patients associated high body weights with unattractiveness, and tended to withdraw from social and sexual activity at high weights. In other aspects of their sexual behaviour, and in their attitudes to sexual matters, the two groups were similar.
Psychoactive Substances of the South Seas: Betel, Kava and Pituri
Authors: Cawte John
Published: October 2008

Before white man brought his alcohol to the South Pacific, the indigenes were using many wild plants possessing psychoactive properties. The most prominent were betel in much of Melanesia, kava in much of Polynesia, and pituri in much of Australia. The use of each of these three drugs was widespread, institutionalised as a ritual and the occasion for extensive trade. Each was valued for its effect in reducing tension or in producing altered states of consciousness. Each was also capable of inducing intoxication. Since few physicians nowadays have had my opportunity to observe the use of all three of these substances, their main features are recalled here. Attention is paid to their traditional use and probable future use, to their pharmacological and clinical properties, and to their place in the zeitgeist of people and period. There is no indication that these substances will be espoused by the drug enthusiasts of the West as avidly as other ethno-psychopharmacological agents such as Peruvian coca leaf, the Indian hemp, the Asian poppy, or the American tobacco. The possibility, however, of some use in the West cannot be discounted.
Therapy Managing in Botswana
Authors: Ben-Tovim David I.
Published: October 2008

Varied and apparently ideologically incompatible systems of health care are available in many developing countries. Patients move freely between them, receiving care serially or simultaneously from different types of healers. Therapy managing is an anthropological term used to describe how choice of health care is made by an informal group that forms around the patient. The author's experiences while running a community-based psychiatric treatment program in Botswana are discussed in terms of his interaction with patients' managing groups.
Psychiatric Sequelae of Manganese Exposure in the Adult, Foetal and Neonatal Nervous Systems
Authors: Cawte John
Published: October 2008

It is important for psychiatrists to recognise that vulnerability to the trace element manganese is different in the adult, foetal and neonatal nervous systems, and that different syndromes may result from exposure.
Psychological Aspects of Irritable Bowel Syndrome
Authors: Langeluddecke Pauline M.
Published: October 2008

The literature on psychological aspects of Irritable Bowel Syndrome (IBS) is reviewed. Psychiatric and/or psychometric assessment of IBS samples has consistently revealed a high prevalence of psychological symptoms by comparison with non-psychiatric patient and healthy control groups. Various psychological factors have been implicated in the aetiology of IBS and in the decision to seek medical help, including psychoneurotic personality traits, abnormal illness behaviour and life event stress. Controlled studies of psychological intervention for IBS, while scarce, suggest that supportive psychotherapy and hypnotherapy may be helpful. The long-term efficacy of such treatments remains to be demonstrated.
Burmese Culture, Personality and Mental Health
Authors: Way Raymond Tint
Published: October 2008

As Australia, shaped by new policies of immigration and multiculturalism, grows more cosmopolitan, the challenge for psychiatry is to gain greater familiarity with the new ethnic minority groups, including their cultural personalities and backgrounds. The problem faced by the Burmese group in Australia is distinctive and poignant. Some 20,000 Burmese immigrated following World War II, chiefly to Western Australia in the first place, uniting and consolidating their families. Following the military coup and the Revolutionary Council Government of the early 60s, further emigration from Burma was cut off. This meant that the Burmese in Australia, already under stress arising from cultural differences, were prevented from developing the extensive internal social support systems that characterise other major ethnic groups. The author, a Burmese doctor working in a psychiatric setting in Sydney, draws attention to aspects of his country and its people which should be helpful for psychiatric and related professions.
The Traditional Healer and Psychiatry
Authors: Wessels W. H.
Published: October 2008

Successful psychiatric treatment for rural Africans should incorporate their traditional belief that illness should be viewed in terms of magical, social, physical and religious parameters. Traditional healers divide illness into those of natural causation and those of traditional cultural aetiology which are peculiar to African people. Natural illness includes epilepsy, familial/genetic disorders, mental retardation and schizophrenia. Traditional, cultural disorders often cause difficulties for Western-trained psychiatrists because sorcery, spirit possession and ancestral worship are central to their aetiology and treatment as practised by traditional healers. They, in a state of altered consciousness, use a process of divination to determine why and from whom the misfortune originated. With this in mind, reputable traditional healers were consulted in therapy-resistant cases of culture-bound syndromes in Africans. Their high rate of success in treating these cases was notable. More recognition should be given to the reputable traditional healers.
The Premorbid Adjustment Scale (PAS): Its Use in an Australian Study
Authors: Morice Rodney , Urbanc Susan , McNicol Don
Published: October 2008

The Premorbid Adjustment Scale (PAS) is a new premorbid scale for use in schizophrenia, developed by the National Institute of Mental Health. Its use in a recent Australian study is described. While total scores clearly discriminated schizophrenic from manic patients, and good test-retest reliability was demonstrated for the schizophrenic patients, the scores did not predict duration of hospitalisation for the schizophrenic group, as reported in the North American study. It is concluded that more research on the PAS is necessary before it can be accepted as a useful instrument in schizophrenia research and clinical practice.
Cognitive Deficit in the Depressed Elderly: A Review of Some Basic Unresolved Issues
Authors: Jorm A. F.
Published: October 2008

Research relating to three interrelated issues concerning cognitive deficit in the depressed elderly is reviewed. The issues are: the role of ageing in cognitive deficit associated with depression; whether the cognitive deficit is intrinsic to depression in the elderly or a secondary motivational effect; and the possibility of qualitative differences between the cognitive deficits seen in the depressed elderly and in senile dementia. Despite their fundamental importance, only the most tentative conclusions can be drawn with respect to any of these issues because researchers have either failed to recognise them or failed to appreciate the methodological problems involved in researching them.
Squibb Academic Lecture: Shakespeare and DSM-III
Authors: Colman E. A. M.
Published: October 2008

Modern literary criticism generally rejects the idea of off-stage lives for Shakespeare's characters. All we have is behaviour — the visible behaviour of ‘Shakespeare's talking animals’. But a review of that behaviour in the light of DSM-III suggests a high degree of clinical accuracy in some of it. The depictions of Ophelia, Lear and Caius Martius Coriolanus supply examples.
Simultaneous Multiple Comparison Procedures in Psychiatric Research
Authors: Hall Wayne , Bird Kevin D.
Published: October 2008

Methods are presented for using linear contrasts to make inferences about differences between the means of several populations on continuous dependent variables. These methods control the experimentwise error rate (the probability of committing one or more type 1 errors in the set of decisions made within the experiment) for linear contrasts which compare some sub-sets of populations with others. Appropriate methods are outlined for testing contrasts which have been planned (i.e., specified independently of the data on which they are tested) and defined post hoc (i.e., after an inspection of the data). We show how these methods can be adapted to the analysis of data from factorial analysis of variance research designs.
D. H. Lawrence and Self-Psychology
Authors: Bragan Kenneth
Published: October 2008

The work and life of D. H. Lawrence is examined as an example of Kohut's notion of the anticipatory function of art and as providing a rich source of material for examination of the respective importance in personality development of Oedipal conflict and the pre-Oedipal establishment of a sense of self. The importance of self-psychology as an expansion of psychoanalysis is noted and some of the ways Lawrence anticipated this development are described. It is also suggested that Lawrence provides convincing confirmation of a self-psychology view of creative drive, and a thesis is briefly expounded that in his major novels he was pursuing his own self-healing.
The Adjustment of Hospitalised Vietnam Veterans
Authors: Streimer Jeffrey , Temperly Helen , Tennant Christopher
Published: October 2008

The psychosocial adjustment of 126 Vietnam veterans admitted to the psychiatric unit of a Veterans' Affairs hospital was compared with age and diagnosis matched non-veteran controls. Violent behaviour and heavy alcohol use were common in Vietnam veterans. In other domains of personal and social adjustment the veterans and controls did not differ.
Pathological Gambling
Authors: Allcock C. C.
Published: October 2008

According to DSM-III criteria, pathological gambling is now recognised as a mental illness. Epidemiological data suggest that the incidence of this disorder in the general population varies from 0.5% to 1%. However, until recently, psychiatrists and clinical psychologists have tended to neglect the problem because of a lack of understanding of its aetiology and management. This paper describes pathological gambling and presents an overview of current psychiatric treatments. It concludes that behavioural interventions are the most effective treatments for compulsive gamblers.
A Cross-Cultural Study of the Possession-Trance in Singapore
Authors: Kua Ee Heok , Sim Li Ping , Chee Kuan Tsee
Published: October 2008

Possession-trance is a common culture-bound syndrome in Singapore. The characteristic features as seen in 36 young men of the three different ethnic communities are described. At follow-up four to five years later, none of the 26 who could be contacted showed any evidence of mental illness. The psychopathology of the possession-trance is discussed.
The Safe Use of High Dose Neuroleptics in a Psychiatric Intensive Care Unit
Authors: Goldney Robert D. , Spence Neil D. , Bowes Julia A.
Published: October 2008

A review of the use of high dose neuroleptics in the management of acute psychoses in a psychiatric intensive care unit confirms the previously reported safety of such regimes. The risk of extreme unwanted effects, such as cardiac arrest and sudden death, was considerably less than the risk of suicide as an inpatient. Although high doses of neuroleptics appear to be relatively safe, there is no advantage, in terms of the length of admission required in the intensive care unit, in using a dose of neuroleptic above the equivalent of 60-80 mg of haloperidol in any one 24-hour period.
On Not Being a Psychiatrist
Authors: Cramond W. A.
Published: October 2008

Although psychiatrists, particularly those who work in the public service, are required to be familiar with administrative practices, it is comparatively rare for a psychiatrist to become a full-time administrator in a situation where clinical skills are not required. This paper gives an account of such a position where, nevertheless, a knowledge of psychiatry was of some help.
Diagnostic Reasoning and Treatment Planning: I. Diagnosis
Authors: Nurcombe Barry , Fitzhenry-Coor Ina
Published: October 2008

Information-processing research into the natural process of clinical reasoning is reviewed and the University of Vermont diagnostic reasoning research project is described. Experienced psychiatric diagnosticians use a hypothetico-deductive logic. The development of a profile of diagnostic competencies is outlined and a course in diagnostic reasoning for medical students, which specifically objectified the tactics and strategy of reasoning and resulted in a significant improvement in the profile of competencies, is described. Finally, the organisation of a diagnostic formulation is discussed.
Evaluation of a Special Nursing Home Unit for Dementia Sufferers: A Randomised Controlled Comparison with Community Care
Authors: Wells Yvonne , Jorm A. F.
Published: October 2008

Applicants for a newly opened special unit for dementia sufferers were randomly allocated to full-time care in the unit or placed on a waiting list and offered periodic respite care in the meantime. All applicants were living in the community at the time of random assignment. Both groups were followed up for three months to assess the effects on the dementia sufferers and on their family care-givers. Care-givers initially had a high level of psychological symptoms, which was greatly reduced after admission of the dementia sufferer to full-time care. By contrast, the care-givers of the community care group of sufferers continued to have a high level of symptoms. Dementia sufferers continued to deteriorate with both forms of care, with little difference between the two groups. Admission of dementia sufferers to full-time care in a special unit appears to be of great benefit to the psychological health of their care-givers and has no adverse effects on the dementia sufferers themselves.
The Zelig Phenomenon: A Specific form of Identity Disturbance
Authors: McGorry Patrick D. , Campbell Rosemary , Copolov David L.
Published: October 2008

A variety of identity disturbances has been described in psychiatric patients. Although such disturbances possess some common features linked to shared or core psychological structures, qualitative differences that allow them to be distinguished from one another also exist. The cases reported are intended to draw attention to a severe and striking type of identity disturbance observed in psychotic patients, for which we have proposed the eponym, ‘the Zelig phenomenon’. The discussion focuses upon the issue of the coexistence in psychopathology of continuity and discontinuity. This apparent paradox can be regarded as an example of parallax, in which two quite different, yet equally valid, perspectives are possible and may be brought alternately into play. It is, however, argued that in the delineation of psychopathological entities it is necessary to adopt the perspective that considers discontinuities and matters of form, even though they may be at times overshadowed by continuities that derive from the alternate perspective.
The Post-Accident Syndrome: Variations in the Clinical Picture
Authors: Jones Ivor H. , Riley William T.
Published: October 2008

Three hundred and twenty-seven subjects involved in civil accident litigation and referred by solicitors for either plaintiff or defendant were examined. A precise psychiatric diagnosis was applicable in only a minority of subjects, although psychiatric symptoms, including pain, anxiety and depression, were prominent. Overall the clinical picture was an amorphous one. Cluster analysis was performed to examine a variety of clinical, demographic and historical variables. This showed four stable groups, which are here described as: stoic, depressive, phobic motor accident and prior claimants. It is suggested that the phenomenological approach taken here, paying particular attention to clinical sub-groups, may be a more useful route towards the understanding and treatment of post-accident psychiatric disturbance than is the existing but confused approach, in which motivation has been a prime focus of interest. The particular sub-groups demonstrated here, if replicated, could form the basis for such an approach.
The Place of Family Therapy in the Treatment of Anorexia Nervosa
Authors: Hall Anne
Published: October 2008

There has been widespread, uncritical support for family therapy as the treatment of choice for all anorexia nervosa patients since Minuchin's report in 1976, but recent research has not been able to validate Minuchin's theories about the functioning of anorexia nervosa families. In the only controlled trial to date, the efficacy of family therapy was found to be superior to that of individual therapy, but only in younger patients. Selection factors for family therapy in the treatment of anorexia norvosa are illustrated by a report on 23 consecutive referrals to an eating disorder clinic. Although knowledge of the patient's family was an essential part of the assessment for all patients, and nuclear family sessions were considered to be highly desirable for all patients, in only six instances was nuclear family therapy a major component of treatment. These patients were mainly younger, had a recent onset of illness and lived in an intact nuclear family with co-operative parents.
Psoriatic Arthritis during Lithium Therapy
Authors: Skerritt Paul W.
Published: October 2008

A case is presented of psoriasis occurring de novo during lithium therapy and progressing to psoriatic arthritis. Exacerbation of pre-existing psoriasis during lithium treatment has often been described, as has the disease occurring de novo. This would seem to be the first description of psoriatic arthritis apparently related to lithium.
An Interaction between Haloperidol and Carbamazepine in a Patient with Cerebral Palsy
Authors: Brayley John , Yellowlees Peter
Published: October 2008

A 37-year-old woman with cerebral palsy and a rapid cycling bipolar affective disorder developed drowsiness and slurred speech when being treated with a combination of haloperidol and a low dose of carbamazepine. This effect occurred twice but did not appear when the patient was given carbamazepine alone at much higher doses. This suggests that some patients who appear intolerant of carbamazepine may still benefit from this drug if concomitant haloperidol therapy is ceased.
Euthyroid Hyperthyroxinaemia in Acute Psychiatric Admissions
Authors: Lambert T. J. R. , Davidson R. , McLellan G. H.
Published: October 2008

Of 98 patients studied prospectively during admission to the psychiatric ward of a general hospital, 13% showed an initial transient elevation of the serum thyroxine (T4) level (range 142–174 nmol/l) with the incidence increasing to 15% on serial testing at days five and fourteen. There was no clinical evidence of a thyrometabolic disorder and, as the mild hyperthyroxinaemia normalised rapidly, recourse to other thyroid function tests was not required. The possible causes of the transient hyperthyroxinaemia are discussed, but examination of the hyperthyroxinaemic patients' diagnoses did not reveal anything in common. These data indicate that the results of routine thyroid function tests in acute psychiatric admissions should be interpreted with care, and that historical and physical examination remains the primary avenue of diagnosis of thyroid disorders.
Learning and Memory Impairment with Benzhexol
Authors: Galletly Cherrie A. , Field Colin D.
Published: October 2008

A double-blind trial to determine the effects of a single dose of 2 mg benzhexol on cognitive functioning was undertaken using normal volunteers. Ninety minutes after the drug or placebo was taken, subjects completed a battery of psychological tests designed to measure learning, memory and motor skills. Benzhexol ingestion was associated with significant impairment of short-term memory and slowing of the rate of new learning.
Persistent Psychotic Symptoms at Discharge in Patients with Schizophrenia
Authors: Minas I. H. , Joshua S. D. , Jackson H. J. , Burgess P. M.
Published: October 2008

A sample of patients with DSM-III schizophrenia was examined and rated using Andreasen's Schedule for the Assessment of Positive Symptoms (SAPS) and the Schedule for the Assessment of Negative Symptoms (SANS), soon after admission and in the week prior to discharge. A high proportion of the sample had persistent positive and negative symptoms at discharge. This finding is discussed in relation to the service demands placed on the hospital, changing government policies concerning hospital and community care, and the possible consequences of early discharge policies in the absence of adequate community services.
Two Cases of Papillary Carcinoma of the Thyroid Associated with Psychosis and Violence
Authors: Stedman Terry J. , Price John
Published: October 2008

Two cases are described in which serious violent acts occurred during the course of a psychotic illness and in which papillary carcinoma of the thyroid was later diagnosed. Several possible explanations are examined, including a suggestion that neuroendocrine changes reportedly associated with violence may have allowed existing thyroid cancers to grow so as to become clinically apparent.
Spina bifida occulta and monozygotic twins
Authors: Spacca Barbara , Buxton Neil
Published: October 2008

Central nervous system maldevelopment can have different presentations in twins. We report on a case of different presentations of spina bifida occulta in monozygotic twins. The first twin presented at birth with a lipomyelomeningocele; a tethered cord was diagnosed in the second twin at 2 years of age. Neural tube defects (NTDs) are a group of common congenital malformations of the brain and spine generated during neurulation. The genetic basis of this process is still not well known. Whenever an NTD is diagnosed in one of a pair of twins, the other twin should also be evaluated for NTDs.
Expanded endoscopic endonasal resection of an olfactory schwannoma
Authors: Kanaan Hilal A. , Gardner Paul A. , Yeaney Gabrielle , Prevedello Daniel M. , Monaco Edward A. , Murdoch Geoffrey , Pollack Ian F. , Kassam Amin B.
Published: October 2008

Olfactory schwannomas are rare tumors of the anterior skull base that are possibly derived from ectopic Schwann cells, perivascular neural tissue, or sensory nerves of the meninges. The authors report the case of a 14-year-old boy with an olfactory schwannoma that extended inferiorly through the cranial base and superiorly into the frontal lobe. Because of the growth characteristics of the tumor and the significant overlying frontal lobe edema, the lesion was approached via an endonasal endoscopic route, as a strategy to minimize brain retraction. This tumor was characterized radiographically as contrast-enhancing with cystic areas and erosion into bone. The tumor showed immunoreactivity for S100 protein and leukocyte antigen 7 (CD57) but not epithelial membrane antigen, supporting the diagnosis of olfactory schwannoma. A gross-total resection was achieved. This approach represents a novel application of endoscopic endonasal surgery to the pediatric neurosurgical context, as well as a favorable outcome in an extremely unusual tumor type, that should be applicable to other appropriately selected pediatric brain tumors.
Third ventricular chordoid meningioma in a child
Authors: Song Kyung Sun , Park Sung-Hye , Cho Byung-Kyu , Wang Kyu-Chang , Phi Ji Hoon , Kim Seung-Ki
Published: October 2008

Meningiomas are rare in children. Chordoid meningioma is a very rare variant, as only 16 cases in children have been reported. The authors report the first case of a chordoid meningioma in the third ventricle.

A 12-year-old boy presented with headache, abnormal behaviors, and ataxia. Brain MR imaging revealed a 2-cm, well-enhanced mass in the third ventricle and hydrocephalus. Positron emission tomography with [18F]fluorodeoxyglucose showed that the mass was hypermetabolic. Gross-total removal of the mass was performed using a left frontal transcortical and transventricular approach. The mass originated from the left caudate head and was connected to the choroid plexus. A chordoid meningioma was diagnosed on the basis of the histological characteristics of the tumor, which was composed of cords and nests of eosinophilic vacuolated cells with an abundant myxoid matrix, similar to the features of a chordoma. A typical focal meningiomatous pattern was observed. The tumor cells were immunoreactive for vimentin and epithelial membrane antigen. The patient's headache and gait disturbance improved after the tumor was removed. The tumor showed no signs of recurrence during 12 months of follow-up.
Polypoid gall bladder lesions: Is it necessary for immediate surgery?
Authors: Ansari Selim M. , Banu Sabina , Awal M.A. , Siddique Abu Bakkar , Alam Md. Monjur
Published: October 2008

Ultrasonographic study of hepatobiliary system was done in 481 patients with acute right hypochondriac pain to find out any pathology in hepatobiliary system. A total of 57 patients with polypoid lesions in gall bladder were diagnosed and underwent extensive follow-up.Â  In 31 patients, who underwent surgery, the histological findings were cholesterol polyp/cholesterosis (n=14), cholesterosis with fibrous displasia of gall bladder (n=7), adenomyomatosis (n=3), hyperplastic cholecystosis (n=5) and adenocarcinoma (n=2). Remaining 26 patients were under follow-up up to 18 months from first diagnosis. Though most of the polyps diagnosed on ultrasound appeared to be benign without any risk of malignant transformation, it, however, may be recommended to go for surgery in a persistent symptomatic patient.Â  Keywords: Polypoid; Gall bladderDOI: 10.3329/bmrcb.v33i2.1203Bangladesh Med Res Counc Bull 2007; 33: 44-47
Effects of activity modification on the patients with osteoarthritis of the knee
Authors: Shakoor M. A. , Taslim Md. Abu , Hossain Md. Shahadat
Published: October 2008

A prospective randomized clinical trial was conducted on 162 patients of osteoarthritis of knee were included in the study. The patients were divided into two groups- Group A and Group B. The Group A was treated with shortwave diathermy, exercise, naproxen and activity modification and the Group B was treated with shortwave diathermy, exercise and naproxen. Improvement was found more in Group A than Group B after 4th week (95 % CI was -2.59 to 6.56). Then it was found that the improvement was gradually increased in Group A than Group B and finally, it was found that there was highly significant improvement in Group A than Group B after 6th week (95 % CI was -3.45 to -0.70). This study suggests that activity modification play an important role for the treatment of the patients with osteoarthritis of knee.Â Â Â Â  Keywords: Knee; Osteoarthritis DOI: 10.3329/bmrcb.v33i2.1205Bangladesh Med Res Counc Bull 2007; 33: 55-59