bluuebunny/crossref_metadata_2025 huggingface dataset:
Traditional Arabian marriages and mental health in a group of outpatient Saudis
Authors: Chaleby K.
Published: August 2007

ABSTRACT— This is a prospective study of 150 consecutive outpatients who were either married or divorced. Marriage custom in Saudi Arabia is unique to the culture of that country and several different kinds of marriage are identified: arranged marriage of cousins; marriage of a couple who have not met before consummation; marriage of a couple who have met once before consummation; forced marriage; and, rarely, marriage preceded by a period of courtship. Marital discord defined by the patients as fully or partially responsible for their presenting symptoms, was correlated with the different kinds of marriage. Discord was found to be more likely when the couple had never met or when there had been a period of courtship; more likely associated with anxiety and dysthymic disorders; and to affect females more than males. Polygamy was a definite stress. The consanguinous marriage had a higher rate of marital discord than the non‐consanguinous, but this was found to be not statistically significant. In 40% of discordant, consanguinous marriages the discord was directly related to the degree of consanguinity.
Treatment of sex offenders with imaginal desensitization and/or medroxyprogesterone
Authors: McConaghy N. , Blaszczynski A. , Kidson W.
Published: August 2007

ABSTRACT— Thirty sex offenders were randomly allocated: 10 to receive medroxyprogesterone therapy (M), 10, imaginal desensitization (ID) and 10 both (ID + M). Twenty‐four responded for one year though 3 subsequently relapsed. There were no significant differences in response to the 3 treatments. Four patients who did not respond to the initial treatment and the 3 who relapsed responded to further treatment. Most treated with M maintained heterosexual intercourse at pretreatment frequency. Self‐reported reduction in anomolous sexual urges in patients receiving M correlated with reduced testosterone levels one month following treatment, demonstrating that the response was specific and validating the assessment by patients’ self‐reports. Where cost‐effectiveness or time constraints are factors influencing treatment of sex offenders, one of these therapies warrants consideration.
Parasuicidal snow‐wandering in Arctic Northern Norway
Authors: Nissen T. , Haggag A.
Published: August 2007

ABSTRACT— Psychiatric morbidity in the Arctic has not been extensively studied. Seasonal variations in climate, light and darkness are unique for these areas and impose special kinds of strains on the population. Three case‐histories focusing on snow‐wandering as a parasuicidal act are presented. One of them bears some resemblance to the Arctic hysteria described among Eskimoes. Reasons for choosing snow‐wandering as an alternative to other kinds of suicide are discussed and a hypothesis is suggested. The psychological and physiological factors as explanations for post snow‐wandering amnesia are discussed.
Predicting repetition of deliberate self‐harm: A review of the literature in the light of a current study
Authors: Myers E. D.
Published: August 2007

ABSTRACT— Three hundred and sixty‐five patients exhibiting deliberate self‐harm (DSH) were rated for DSH repetition on the six‐item predictive scale of Buglass & Horton and on a five‐point predictive scale developed from a previous study by the author. The Buglass & Horton scale was more sensitive and more specific overall and for female patients, but the five‐point scale predicted better for males, especially those aged under 35. The results are discussed in relation to previous work on the prediction of DSH repetition.
Total and free testosterone in depressed men
Authors: Levitt A. J. , Joffe R. T.
Published: August 2007

ABSTRACT— Total and free testosterone, estradiol and cortisol were measured in 12 depressed males and 12 age‐matched normal volunteers. There was no significant difference in any of the hormone levels between the patient and control group. Total testosterone was negatively correlated with age in the depressed group, but not with severity of depression.
Psychopathological and social outcome in schizophrenia versus affective/schizoaffective psychoses and prediction of poor outcome in schizophrenia Results from a 5‐8 year follow‐up
Authors: Möller H. J. , Schmid‐Bode W. , Cording‐Tömmel C. , Wittchen H.‐U. , Zaudig M. , von Zerssen D.
Published: August 2007

ABSTRACT— Forty‐six patients with the ICD diagnosis of schizophrenic or similar paranoid psychosis, 35 patients with the ICD diagnosis of affective psychosis, 22 patients with the ICD diagnosis of schizoaffective psychosis, and a large sample of control probands from the general population were followed up using standardized assessment procedures 5‐8 years after index hospital treatment. A comparison of respective psychopathological or social outcome measures among the diagnostic groups and between patients and matched non‐patients from the general population survey confirms the hypothesis that patients with the diagnosis of schizophrenia have, as a group, the poorest degree of psychopathological disturbances and social maladjustment. However, there is a large subgroup with a favourable outcome. Some predictors for poor outcome, described in the literature and in a former follow‐up study of ours, could be confirmed. Under the aspect of invariance under different sample conditions, the predictive power of some prognostic scales, such as the Stephens Scale, the Vaillant Scale, and the Strauss‐Carpenter Scale, was substantiated.
Attempted suicide by jumping: Clinical and social features
Authors: Kontaxakis V. , Markidis M. , Vaslamatzis G. , Loannidis H. , Stefanis C.
Published: August 2007

ABSTRACT—A group of 46 persons who had attempted suicide by jumping was compared on clinical and social‐demographic parameters with another group of 214 persons who had attempted suicide by drug overdose. The differential characteristics of persons attempting suicide by jumping are the following: more often men, of a more advanced age, married or widowed, more often suffering from major psychopathology (that is affective psychosis‐depressive type or schizophrenia), and quite frequently having a serious somatic illness.
Psychiatric disturbances associated with myasthenia gravis
Authors: Magni G. , Micaglio G.F. , Lalli R. , Bejato L. , Candeago M.R. , Merskey H. , Angelini C.
Published: August 2007

ABSTRACT— Seventy‐four myasthenic patients (54 F, 20 M; mean age 49.6 years) were evaluated using the diagnostic criteria of the DSM‐III in order to investigate the prevalence of psychiatric disturbances in this disorder. Fifty‐one had had thymectomies, of whom 28 females had hyperplasia, two females and five males had involution of the thymus, and 10 females and six males had thymomata. Psychiatric disturbances were observed in 38 subjects (51%), in particular adjustment disorders with depressed mood and mixed emotional features (22%), affective disorders (14%) and personality disorders (18%).
The proband method in psychiatric epidemiology: A bias associated with differences in family size
Authors: Kendler K.S. , Eaton W.W.
Published: August 2007

ABSTRACT— Psychiatric epidemiology has traditionally employed both census and proband‐based methods to determine the population prevalence of psychiatric disorders. In this article we outline a potential bias in the proband method. With this method, the probability of ascertainment for an individual depends on the number of available relatives. If the average size of families containing one or more affected individuals (RA) differs from the average size of families with no affected individuals (Ru). then the ratio of the prevalence estimated by the proband method to the true prevalence is approximately [(RA ‐1)/(Ru ‐1)]. For certain psychiatric disorders associated with decreased family size (e.g. schizophrenia), the underestimation of prevalence by the proband method may be non‐trivial.
Anorexia nervosa and motherhood: Reproduction pattern and mothering behavior of 50 women
Authors: Brinch M. , Isager T. , Tolstrup K.
Published: August 2007

ABSTRACT— A follow‐up carried out on an average 12.5 years after hospital contact of 151 patients with a former diagnosis of anorexia nervosa (AN), aimed at reproduction outcome. None of the 11 males had children. Fifty of the 140 women had given birth to a total of 86 children, which is approximately one third of the expected fertility. Involuntary childlessness was of the same size as found in the background population. The rate of prematurity among the offspring was twice the expected and perinatal lethality six times the expected. Mentally the mothers did well, both during pregnancy and the post partum period. They breast‐fed their children for the same mean time as did other women, and the development of the children did not differ from that found in a background population. More women in the group of mothers than in the group of non‐mothers had better scores of allround functioning at follow‐up.
Psychopathology and temporal lobe epilepsy in adolescents
Authors: Kaminer Y. , Apter A. , Aviv A. , Lerman P. , Tyano S.
Published: August 2007

ABSTRACT— Although high rates of psychopathology in children and adolescents suffering from temporal lobe epilepsy (TLE) have been reported in the literature, the subject remains controversial. In this investigation we made a psychiatric study of 26 adolescents with TLE using a detailed structure interview and rigorous diagnostic criteria. These were compared to 26 matched controls suffering from chronic bronchial asthma (BA). In neither group was there a high rate of specific psychiatric illness, although many adolescents in both samples showed moderate to severe depression. We conclude that TLE may not be a specific cause of psychopathology in adolescence, and that the depression might result from the suffering involved in chronic illness.
Psychiatric case identification in two Athenian communities: estimation of the probable prevalence
Authors: Madianos M. G. , Tomaras V. , Kapsali A. , Vaidakis N. , Vlachonicolis J. , Stefanis C. N.
Published: August 2007

A two stage cross sectional survey on the prevalence of psychiatric disorders was conducted in a sample of 1,574 adults, residents of two boroughs in the greater Athens area. In this paper we examine the value of the first stage self report symptom screening scales (CES‐D and Langner) for case finding, by comparing it to five psychiatric case identification criteria, proven to be highly reliable, after the completion of an inter‐rater reliability study. A higher proportion of mentally impaired respondents was found with the criterion of screening scale cut off scores than the cases found by the application of the five case identification criteria. The practical significance of establishing case finding reliable criteria is apparent for the purpose of epidemiologic research e.g. the problem of false positive and negative cases, the completion of the second stage of diagnostic interviews and for the planning of outreach programs, identifying and helping high risk individuals.
Offspring of women with nonorganic psychosis: antecedents of anxious attachment to the mother at one year of age
Authors: Persson‐Blennow I. , Binett B. , McNeil T. F.
Published: August 2007

Mother‐infant interaction characteristics at six ages during the first year of life were studied in relationship to the development of the infant's anxious vs. secure attachment to the mother at 1 year of age. The same antecedent maternal characteristics, notably less harmony during feeding and less consideration for the child's needs in play, were associated with anxious attachment in both index and control groups. In contrast, control infants’ behaviors were totally unrelated to the development of anxious attachment, while index infants developing anxious attachment evidenced reduced social contact toward the mother and increased crying prior to 1 year, suggesting either vulnerability to negative maternal influence or initial deviations in these index offspring.
Carbamazepine in the treatment of aggression: a case report and a review of the literature
Authors: Yatham L. N. , McHale P. A.
Published: August 2007

Aggressive behaviour is an inescapable clinical problem confronting practitioners of medicine, neurology and psychiatry. Several drugs have been used to treat it, with limited success. Successful use of carbamazepine in the treatment of aggressive behaviour in a patient with limbic dysfunction is reported, and varieties of aggressive behaviour that respond to carbamazepine are examined. The authors suggest that carbamazepine may have a specific anti‐aggressive effect perhaps due to an anti‐kindling effect, but caution that double‐blind studies are needed before firm conclusions are drawn.
CSF biochemical correlates of mixed affective states
Authors: Tandon R. , Channabasavanna S. M. , Greden J. F.
Published: August 2007

To evaluate the question of whether “mixed” bipolar disorder is a distinct entity, we compared selected cerebrospinal fluid (CSF) biochemical parameters from patients with bipolar disorder, mixed, to those with mania and major depression. Fourteen patients in each category (DSM‐III) were studied with regard to CSF HVA, 5HIAA, sodium, potassium, calcium, and magnesium levels under carefully controlled conditions. CSF HVA, 5HIAA, and sodium were found to be significantly higher in manics than in major depressives. Discriminant analysis of the biochemical variables of the mixed affective group identified two biochemically distinct and clinically different subgroups of seven patients each, one resembling the manic group and the other the major depressive group. These findings suggest that mixed affective states do not exist as a separate entity, but are compsed of two subgroups obtained from the manic and major depressive categories.
Prevalence and incidence of eating disorders in a suburban area
Authors: Cullberg J. , Engström‐Lindberg M.
Published: August 2007

There has been no previous epidemiological study on anorexia nervosa (AN) and bulimia (BU) where non‐medical care givers have also been included in the case‐finding procedure. In this study, psychiatric, somatic, child psychiatric, social and primary care personnel were systematically asked for information on patients. Fifty‐one cases of eating disorder (17 AN, 34 BU) according to slightly modified DSM‐III criteria were traced in a suburban catchment area of 78,000 inhabitants during a two‐year period. This means a two‐year prevalence of 66/100,000 (22 AN and 44 BU). For females between 16–24 years the prevalence of AN was 258/100,000; BU: 473/100,000; total 730/100,000 (1/137). There were also 10 “possible cases” where the diagnosis could not be established with certainty, mainly because of insufficient information. If these patients were added, the number of cases would be 61 (or a prevalence of 79/100,000 inhabitants). The one‐year incidence for AN was 2.6/100,000 and for BU 3.9. The incidence for AN was 43/100,000 for females 16–24 years old (1/2326). For BU it was 65/100,000 (1/1538). There seems to be no clear social class grouping. Twenty (56%) of the adult patients had been hospitalized for eating disorder during the last six‐year period.
Correlates of alcohol‐related casualty in Kuwait
Authors: Bilal A. M. , Angelo‐Khattar M.
Published: August 2007

This paper reports the extent to which alcohol consumption is associated with casualties in a country in which alcohol is prohibited religiously and culturally. Selective screening of particular casualty groups by blood test established qualitative evidence of alcohol use in 107 out of 1058 patients (10%) examined at a general hospital and a traumatology hospital in Kuwait. The rate of alcohol‐associated casualty was significantly higher in traumatology hospital patients (15%) than in general hospital (7%), stressing the association between alcohol and tauma. Absence of differences by place of casualty disproves lay beliefs that motor vehicle casualty is the major alcohol‐associated risk in Kuwait. Other casualties, particularly work and domestic injuries, should be regarded as being affected by alcohol consumption. Statistically significant high alcohol‐associated casualty rates characterized Kuwaitis (14%), the unemployed/retired (20%) and coma cases (22%) suggesting that these categories may suffer from serious alcohol problems.
Prospective studies on a lithium cohort
Authors: Vestergaard P. , Schou M.
Published: August 2007

Since 1979, patients started on long‐term lithium treatment at the Psychiatric Hospital in Risskov have been followed systematically with recording of clinical and laboratory variables before the start of treatment, after 6 and 12 months of treatment, and thereafter at yearly intervals. By June 1987, 480 examinations had been carried out before the start of lithium treatment, 236 after treatment for 6 months, and decreasing numbers up to 7 years of lithium treatment. The total lithium exposure time was 548 years. The mean lithium dose was 23.2 mmol/d and the mean serum lithium concentration 0.68 mmol/1. These values are about 30% lower than the corresponding values in patients given lithium treatment prior to 1979. About one half of the patients who had gone through the pre‐lithium examinations did not reach the 6‐month examination. This was because they did not start lithium, or because they stopped it again before 6 months of treatment or before they had reached that point. Thereafter there was a drop‐out rate of about 25% per year during the first 2 years of lithium treatment and about 10% per year after 4–5 years of treatment. More men than women left the cohort.
Prospective studies on a lithium cohort
Authors: Schou M. , Vestergaard P.
Published: August 2007

A cohort of manic‐depressive patients given prophylactic lithium treatment were examined before treatment started and at intervals during treatment for up to 7 years. The mean lithium dosage was 23.2 mmol/d and the mean serum lithium concentration 0.68 mmol/1. The treatment did not affect glomerulus function. Urine volume rose by 10–20% and renal concentrating ability fell by 7–10% during the treatment. These changes were markedly smaller than those found in patients treated previously with higher lithium doses and serum lithium concentrations. High urine volumes and low renal concentrating abilities were not more frequent during than before lithium treatment. Complaints of increased thirst, frequent urination, and nycturia were presented more often during than before lithium treatment. Serum concentrations, urinary excretions and renal clearances of sodium and potassium were not altered by the treatment.
Khat‐induced hypnagogic hallucinations
Authors: Granek M. , Shalev A. , Weingarten A. M.
Published: August 2007

Khat is a plant whose leaves are chewed for their stimulating effect. This effect is attributed to cathinone, an alkaloid identical to dextroamphetamine. Khat chewing is widespread among eastern African and Yemenite populations and is believed to be innocuous. Our experience shows, however, that a substantial number of chronic khat chewers experience persistent hypnagogic hallucinations ‐ a symptom that has not yet been described. Three vignettes illustrates this phenomena, which often interferes with psychiatric diagnosis. Different explanatory models are discussed, among them chronic suppression of REM sleep.
The valence theory of Bion and the significance of (DSM‐III) diagnoses for inpatient group behavior
Authors: Karterud S.
Published: August 2007

The aim of this study was to investigate the validity of Bion's hypothesis of valence and the significance of (DSM‐III) diagnoses for inpatient group behavior. All verbal statements (approximately 17,000) from 91 patients in 75 small group therapy sessions were assessed according to Group Emotionality Rating System, which contains the (Bion) categories of dependency, fight, flight and pairing. The results confirmed the valence theory, since diagnoses explained 7–20% of the variance in emotional group behavior, while sex and age only explained 1–2% of the variance. The personality disorders of the schizoid/paranoid spectrum had the strongest valence for fight(/flight). The major depressions and the dependent personality disorders had the strongest valence for dependency. Neuroses and personality disorders had a significantly higher (P < 0.05) valence for pairing than psychoses. Tables demonstrating the valence strength for 9 diagnostic categories are presented. The group culture seemed to modify behavior differently according to the diagnoses.
A prospective study of postpartum psychoses in a high‐risk group
Authors: McNeil T. F.
Published: August 2007

Within a sample of 88 pregnant index women with a history of nonorganic psychosis, the psychosocial aspects of labor and delivery, assessed through personal observation, were studied in relation to the development of 22 postpartum psychotic episodes (PPPs) occurring during the first 6 months postpartum. As compared with index cases not developing PPPs, cases with PPP onset after 3 weeks postpartum had been significantly more anxious, had received significantly less help from the midwife, and their husbands tended to have attended the birth less often. Cases with PPP onset within 3 weeks of delivery had not been more anxious, but their husbands had been significantly more anxious and the midwives tended to have helped less. Early Onset (but not Later Onset) mothers had had slightly more frequent negative reactions towards the newborn, while the husbands in both groups tended to have been more positive towards the newborn than were other husbands.
Immunoreactive somatomedin B is increased in serum in patients with major depressive disorder
Authors: Tham A. , Undén F. , Sara V. R. , Ljunggren J.‐G. , Wetterberg L.
Published: August 2007

Serum levels of immunoreactive somatomedin B (RIA‐B) were investigated in patients with major depressive disorder both in the acute state and during remission at 8 h and 22 h and at 22 h after the dexamethasone suppression test. Elevated levels of RIA‐B at 8 h and at 22 h after the dexamethasone suppression test were found consistently in the patient group compared with the healthy controls. No indication was obtained that the patients’ clinical condition or depressive symptomatology as revealed by their CPRS score, psychotropic medication or TSH, prolactin, melatonin or cortisol levels was significantly related to the RIA‐B levels.
HIV infection presenting as psychosis: a critique
Authors: Vogel‐Scibilia S. E. , Mulsant B. H. , Keshavan M. S.
Published: August 2007

A review of the literature on HIV and psychiatry thus far has revealed 13 cases of HIV infection presenting as psychosis. We argue that these cases could in fact represent either coincidental schizophrenia or bipolar disorder and HIV infection or HIV‐related organic hallucinosis, delusional or affective syndromes with or without associated dementia (AIDS‐dementia complex). The use of the term psychosis in describing AIDS‐related behavioral syndromes is misleading, and should be replaced when possible by specific DSM‐III‐R categories.
Treatment strategy in depression
Authors: Nolen W. A. , Putte J. J. van de , Dijken W. A. , Kamp J. S. , Blansjaar B. A. , Kramer H. J. , Haffmans J.
Published: August 2007

Antidepressants are ineffective in about 30% of patients with major depression. Some authors then advise treatment of non‐responders with (non‐tricyclic) more selective reuptake inhibitors. In a double‐blind, partial crossover study, 71 patients were selected for treatment during 4 weeks with oxaprotiline and/or fluvoxamine, two non‐tricyclic antidepressants that are selective reuptake inhibitors of noradrenaline and serotonin respectively. All patients had failed to respond to earlier treatment with cyclic antidepressants during the current episode. Only 13% of the patients responded, with 27% of them responding to oxaprotiline and none to fluvoxamine. Moreover, a low response of 27% was also obtained in the crossover phase, which included all non‐responders to the first treatment, oxaprotiline being effective in 39% and fluvoxamine in 10% of the patients. The results indicate that selective reuptake inhibitors are not an effective alternative for non‐responders to other cyclic antidepressants and that non‐responders to “nor‐adrenergic” antidepressants do not appear to have much chance of responding to “serotonergic” antidepressants and vice versa.
Treatment strategy in depression
Authors: Nolen W. A. , Putte J. J. van de , Dijken W. A. , Kamp J. S. , Blansjaar B. A. , Kramer H. J. , Haffmans J.
Published: August 2007

Antidepressants are ineffective in about 30% of the patients with major depression. Besides electroconvulsive therapy (ECT) and lithium, MAO inhibitors have been suggested as an alternative in such patients. In 2 controlled, partial crossover studies involving 47 patients with major depression who had already been treated unsuccessfully with at least 2 cyclic antidepressants, the effect of the MAO inhibitor tranylcypromine was studied. The first study was an open comparison with L‐5‐hydroxytryptophan (L‐5HTP), the second study a double‐blind comparison with nomifensine. Neither the patients treated with L‐5HTP nor the patients treated with nomifensine, except one, improved. In contrast, tranylcypromine was effective in 50% of the patients. The depressions of the responders to tranylcypromine appeared to be more endogenous (according Newcastle Scale II) and of shorter duration than those of the non‐responders. It is concluded that MAO inhibitors such as tranylcypromine are an effective alternative to ECT and lithium in patients with major depression who have failed to respond to cyclic antidepressants.
Electrodermal activity in relation to cortisol dysregulation in depressive patients
Authors: Thorell L.‐H. , Kjellman B. F. , D'Elia G. , Kågedal B.
Published: August 2007

Electrodermal activity (EDA), basal morning plasma cortisol, outcome of the dexamethasone suppression test (DST), and nocturnal urinary cortisol excretion were studied in a somewhat confined number of originally 59 depressive patients and 59 matched healthy subjects. The patients showed nocturnal hypercortisolism. According to the DST, EDA and cortisol dysregulation were unrelated. In the total patient group, the correlations between EDA and cortisol in plasma and in urine were small and insignificant. However, in suicide attempters, in nonsuicidal patients, and in the healthy subjects, complex patterns of correlations were found between tonic electrodermal activity, electrodermal responsivity, basal morning plasma cortisol, and nocturnal urinary cortisol. Some inconsistencies in the patterns may be explained by differences in the sampling of data. Future research should try to delineate possible relationships between EDA and hormones on all levels of the hypothalamic‐pituitary‐adrenocortical axis.
Ichthyosis and delusions of lizard invasion
Authors: Browning S. M. , Jones S.
Published: August 2007

We report the case of a young man who developed a delusion that his body was being invaded by a lizard during an acute psychotic episode. This occurred in the context of ichthyosis presenting as scaling on his arms and legs, which he believed to be the growth of the lizard's skin.
Environmetal and Behavioral Influences on Affective Illness
Authors: Wehr T. A. , Rosenthal N. E. , Sack D. A.
Published: August 2007

A behavioral factor, sleep, and a physical environmental factor, light, can trigger or terminate episodes of affective illness. The authors review the experimental evidence for these effects and discuss recent research on their biological mechanisms. In light of these findings the authors speculate that affective illness could partly be a disorder of systems that mediate the organism's adaptations to changes in the physical environment.
Implications of altered limbic‐hypothalamicpituitary‐adrenocortical (LHPA)‐function for neurobiology of depression
Authors: Holsboer Florian
Published: August 2007

The current article suggests that the neuroendocrine system constitutes a bidirectional link between the brain and humoral homeostasis in the periphery. Any change of neuronal activity in the brain ‐ regardless whether induced by external stimuli or endogenous errors of metabolism ‐ may result in altered composition of gene products. Among these are peptides which directly or indirectly alter endocrine activity and may concomitantly induce a variety of behavioral effects. This has been experimentally demonstrated by neuropeptidergic manipulation of sleep‐electroencephalographic (EEG) measures and behavioral studies in animals. An integral part of the neuroendocrine communication are effects of peripheral hormones upon brain structures and their interactions with the immune system.

Within this framework all hormones of the limbic‐hypothalamic‐ pituitary‐adrenocortical (LHPA)‐axis play a dominant role, because: (1) corticotropin‐releasing hormone (CRH) was shown to integrate centrally behavioral and metabolic responses to stress; and (2) corticosteroids exert a host of neurochemical changes within the CNS which by far exceed their primary endocrine feedback action. As a corollary, hyperexposure to corticosteroids induces widespread changes of neuronal cell biology which are of clinical significance for depression research (e.g. neuronal cell loss in the hippocampus, down‐regulation of glucocorticoid receptors within monoaminergic neurons).

Clinical neuroendocrine research over the past years focussed upon evaluation of pathophysiology underlying dexamethasone resistant cortisol levels or hypercortisolism linked to depression and utilized advanced methods for multihormonal analysis and newly synthesized neuropeptides (e.g. CRH) for challenge studies in combination with neurophysiological assessments. The major conclusions from this research were: (1) neuroendocrine changes of the LHPA‐axis such as enhanced secretory activity of pituitary corticotrophic cells or altered feedback regulation during depression are driven by central (suprapituitary) mechanisms; (2) behavioral response to CRH in humans and animals, particularly the sleep‐EEG modulation are compatible with the hypothesis that central CRH hypersecretion contributes to the clinical phenotype of depression; (3) the brain is a major target for adrenocortical hormones resulting in changes of neurotransmitter/receptor dynamics of systems being important for neuropharmacology of depression (e.g. catecholamine and serotonin biosynthesis or GABA receptor activity); and (4) there exists considerable cross talk not only between different neuroendocrine systems and the LHPA‐hormones but also between neuroendocrine circuits and immunofunction.
Psychiatric phenomenology across countries: constitutional, cultural, or environmental?
Authors: Ndetei David M.
Published: August 2007

ABSTRACT Some literature on the significance of culture on psychiatric phenomenology and also literature on psychiatric phenomenology in immigrants, particularly in Great Britain, are reviewed. It is pointed out that paranoid and religious phenomenology is particularly common in some immigrant groups and that this can be understood to some extent as a reflection of cultural factors. In order to elucidate more the role of culture in psychiatric phenomenology in immigrants to Great Britain the socio‐cultural backgrounds of the immigrants and in particular the Africans, the West Indians and the Asians are discussed in some details. The phenomenology of psychiatric illness as recorded in a hospital based population of diverse cultural backgrounds in a London hospital was studied to see if any variations across the various cultural groups could be understood in terms of cultural factors. It was found that paranoid and religious phenomenology was more associated with African and West Indian groups for cultural reasons rather than their socio‐environmental and racial status in Britain. Paranoia was directed to fellow immigrants rather than to the host population. It is concluded that paranoia and religious phenomenology do not necessarily have the same clinical significance in various cultural groups. It is also pointed out that hallucinations, and in particular auditory hallucinations and First Rank Symptoms of schizophrenia, which have assumed diagnostic significance in some cultures, may not necessarily have the same significance in other cultures.
Distribution of Major Mental Disorders in an US Metropolis
Authors: Escobar Javier I. , Karno Marvin , Burnam Audrey , Hough Richard L. , Golding Jacqueline
Published: August 2007

ABSTRACT This paper reviews the evolution of psychiatric nosologies in North America and the major epidemiological surveys of Mental Disorders culminating with the recently completed National Institute of Mental Health Epidemiologic Catchment Area project (NIMH‐ECA). The NIMH‐ECA examined the prevalence of diagnosable (DSM III) Mental disorders in 5 U.S. communities utilizing a highly structured diagnostic interview, the Diagnostic Interview Schedule (DIS). Data from the Los Angeles ECA, one of five study sites are presented with particular emphasis on cross‐cultural comparison (Mexican Americans versus Non Hispanic Whites). Overall, there were only a few cross‐cultural differences in prevalence of specific diagnoses. Mexico‐born Mexican Americans showed a lower prevalence for most disorders examined than their U.S. born counterparts, and a subgroup of Mexican‐American women (those over the age of 40) showed higher rates of phobic and dysthymic disorders as well as a greater number of functional somatic symptoms than other groups.
On the picture of depression and suicide in traditional societies
Authors: Jacobsson Lars
Published: August 2007

SUMMARY The paper deals with three problem areas regarding depression and suicide in traditional society; 1) What is the relation between the depression and suicide? 2) Is there any illness like depression all over the world? 3) What do we know about suicide in traditional societies? The author agrees with Durkheim's classical conclusion that the incidence of suicide in a society has no clear correlation with the prevalence of mental disorders and no clear correlation with different forms of mental disorders. There are a number of studies showing that depressive syndromes exist in traditional societies. However, there is a clear difference in symtomatology between different cultures which might be the result of differences in the conception of illness. The suicide rate is generally very low in traditional societies.

The ultimate solution to an unbearable life situation is apparently known to all human cultures and the suicide rate is an important indication in every society of the existential conditions of life.
Experience from the mental health programme of the World Health Organization
Authors: Sartorius Norman
Published: August 2007

ABSTRCT‐

The managerial structure of collaborative studies is usually not described in reports presenting results from such investigations. The same is true about the experience obtained in the day to day conduct of such studies. Ethical rules which should govern collaboration between individuals and centres are rarely spelled out. The paper presents an outline of WHO's mental health programme and proposes, on the basis of experience obtained in the course of several WHO multicentric international studies, a set of guidelines concerning ethical aspects of scientific collaboration involving several centres or teams.
Psychosomatic aspects of coronary artery bypass graft surgery
Authors: Eriksson Johan
Published: August 2007

101 consecutive male patients were examined by means of clinical interviews and depression, anxiety, personality, psychometric and life stress tests. The examinations took place preoperatively. on the 9th postoperative day (average) and 7.5 months after surgery. The mean age of the patients was 52.2 years and the mean duration of CHD was 6.7 years. Prior to surgery 77% had experienced myocardial infarction and 85% belonged to NYHA class III or IV. 74% had a 3‐vessel disease. When the NYHA classification was used as criterion for rehabilitation the result was excellent. Postoperatively 80% belonged to NYHA class I or II. Hospital mortality rate was 4% and one patient died from myocardial infarction prior to the final follow‐up.

Preoperatively 17% of the study group were working. 87% of the patients experienced negative effects on work life, caused by CHD. Postoperatively 33% worked regularly. The postoperative work situation correlated with the duration of preoperative unemployment (p<0.0001), the patient's own opinion about work return (willingness/unwill.ingness to return to work) (p<0.01), as well as with the amount of negative life stress experienced preoperatively (p<0.01). Only 13% of the series experienced positive effects on work life. caused by CABG surgery. The majority of the patients had experienced negative effects on social and economic life (51%). as well as on sexual life (70%). caused by CHD. After surgery improvements were noted by 36% on social life and by 27% on sexual life. 15% experienced impairment of sexual life postoperatively. According to the Beck Depression Inventory 29% showed depression preoperatively. and 10% postoperatively. The difference is significant (p<0.0001). Clinically the figures tended to be higher. The same tendency holds for anxiety scores as measured by the Hamilton anxiety scale. The incidence of postoperative psychoses was 35%. Higher age (p<0.01) and/or absence of psychosomatic diseases (p<0.05) correlated with higher frequency of psychoses. Even though cardiological rehabilitation according to the NYHA classification was excellent, 22% of the series did not think their expectations were fulfilled. Psychic and social rehabilitation was in several aspects unsatisfactory, and the patients did not seem prepared for this. The importance to consider rehabilitation from a psychosomatic standpoint is clearly shown.

To predict the result of rehabilitation preoperatively is not possible.
Acute antidepressant effect of lithium is associated with fluctuation of calcium and magnesium in plasma
Authors: Under J. , Fyrö B. , Petlersson U. , Werner S.
Published: August 2007

In a double‐blind study on 22 patients with major depressive disorder the effects of lithium and clomipramine on signs and symptoms and on calcium and magnesium in plasma were compared. Ratings of antidepressant and side effects were performed by 2 psychiatrists at the end of a placebo period of 5–7 days and after treatment for 2 and 4 weeks. Psychopathology was rated by 15 reported and 4 observed items from the Comprehensive Psycho pat ho logical Rating Scale (CPRS). Eleven items present in 72–100% of the patients were used to evaluate the effect of the two drugs. After 2 weeks of treatment the rated scores dropped for more than half of the CPRS items. After 4 weeks the scores for all but one item were reduced in both groups. The sums of scores were significantly reduced after 2 weeks in both groups and after 4 weeks global scores were reduced as well. The drugs had notable and similar antidepressant effects. Lithium treatment was associated with fluctuations in calcium and magnesium levels in plasma not seen during clomipramine treatment. Serum prolactin increased during clomipramine treatment but was unaffected by lithium treatment. No correlations were found between the sum of rating scores and blood levels of drugs, prolactin, calcium or magnesium.
Personality factors and pathological gambling
Authors: Roy A. , Custer R. , Lorenz V. , Linnoila M.
Published: August 2007

Pathological gambling is a disorder in which personality factors are thought to be important. Therefore, we compared 19 male pathological gamblers with 18 male normal controls for their scores on 3 personality questionnaires. Pathological gamblers were found to have significantly higher psychoticism and neuroticism scores on the Eysenck Personality Questionnaire than controls. Gamblers also had significantly higher total hostility scores on the Hostility and Direction of Hostility Questionnaire. The possible implications of these findings are discussed.
Rapid cycling depression in adolescence
Authors: Spurkland I. , Vandvik I. H.
Published: August 2007

This report aims at alerting [he clinician to the existence of rapid cycling depression in adolescence. The importance of integrating psychodynamic, social and pharmacological modalities in evaluation and treatment is emphasized.
Serum and red blood cell folate in depression
Authors: Abou‐Saleh M. T. , Coppen A.
Published: August 2007

Serum folate concentrations were estimated in patients with major depressive disorders, lithium‐treated patients, detoxified alcoholic patients and normal controls. Red blood cell (RBC) folate concentrations were also estimated in subgroups of patients with major depressive disorder and normal controls. Results showed significantly lower serum and RBC folate concentrations in patients with major depressive disorder than in normal controls. Lower serum folate concentrations were associated with greater seventy of depression. There was no association between serum and RBC folate concentrations and endogenicity of depression or the presence of weight loss.
A comparison of electroconvulsive therapy with a combined lithium and tricyclic combination among depressed tricyclic nonresponders
Authors: Dinan T.G. , Barry S.
Published: August 2007

Thirty severely depressed patients who were resistant to tricyclic antidepressant therapy were randomly allocated to treatment either with electroconvulsive therapy (ECT) or addition of lithium (Li) to the tricyclic. Twenty‐one of the 30 patients significantly improved at the end of 3 weeks of treatment. There were no differences in improvement rates between the two groups. However, the patients treated with a Li/tricyclic combination improved more rapidly, showing significant alterations in mental state by day 7. It is suggested that in otherwise physically healthy patients who are tricyclic nonresponders, the addition of U may be a more rapid treatment than the use of ECT.
Exercise intensity and reduction in neurotic symptoms
Authors: Sexton H. , Mære Å. , Dahl N. H.
Published: August 2007

The psychological benefits of walking and jogging were compared in 52 symptomatic neurotics over an 8‐week training period and subsequent 6‐month follow‐up. Both groups showed marked reduction of anxiety, depression and global symptoms. Joggers had greater aerobic gain, but no greater psychologic benefit. Significantly larger numbers of joggers dropped out of the study. There was no relationship between aerobic gain and reduction of symptoms at the end of the program. However, at 6 months’ follow‐up, those with greater aerobic fitness had much lower anxiety levels. Changes in exercise frequency and aerobic capacity were also maintained at follow‐up. Depression levels were not associated with aerobic fitness at follow‐up. High initial exercise intensity appears to inhibit the forming of new exercise habits.
A double‐blind study of adjunctive carbamazepine versus placebo on excited states of schizophrenic and schizoaffective disorders
Authors: Okuma T. , Yamashita I. , Takahashi R. , Itoh H. , Otsuki S. , Watanabe S. , Sarai K. , Hazama H. , Inanaga K.
Published: August 2007

A multi‐institutional double‐blind study comparing the therapeutic effect of adjunctive carbamazepine and placebo with standard neuroleptic treatment was performed on 162 patients with DSM‐UI diagnosis of schizophrenic (n = 127) or schizoaffective disorders (n = 35) who had excited states or aggressive /violent behavior that responded unsatisfactorily to neuroleptic treatment. The patients participated in a 4‐week trial of carbamazepine plus neuroleptics (n = 82) or placebo plus neurolep‐tics (n = 80). The sum of patients with marked and moderate improvement was modestly larger in the carbamazepine group (48 vs. 30%, P <0.05). There was no significant, difference between the carbamazepine and placebo groups in the changes of total BPRS scores, although the carbamazepine group showed more improvement on the items suspiciousness, uncooperativeness and excitement. The results suggest that carbamazepine, when used in combination with neuroleptics, is a useful drug for the treatment of excited states of patients with schizophrenic and schizoaffective disorders.
Change in culture and language environment in childhood and its effect on adult life
Authors: Räsänen E.
Published: August 2007

During the Second World War 70,000–75,000 Finnish children were sent to Sweden to protect them from the war‐ This article describes a group of children sent to Sweden from Kuopio County. The management of this group is discussed in light of their health, education and profession in adulthood. The change in culture and language environment did not affect mental and physical health; physical health is even better in the group sent to Sweden than in the control group. The change in language and culture environment affected education, and the professional level is lower than in the control group. Difficulties associated with language seem to be especially important when discussing scholastic skills, education and profession.
Psychopathology during long‐term lithium treatment of patients with major affective disorders
Authors: Nilsson A , Axelsson R.
Published: August 2007

ABSTRACT— Thirty‐seven patients with major affective disorders according to DSM‐HI and on continuous lithium treatment were followed during a 7‐year period. Outcome was assessed by use of the Comprehensive Psychopathological Rating Scale and by the need for additional psychotropic medication and for hospital and outpatient care. Anamnestic variables and patients’ attitudes to their lithium medication were also included in the analysis of outcome, as were laboratory data, including lithium parameters. An increase in psychopathology was demonstrated in a significant number of patients and was attributed mainly to an increase in the depressive symptoms, with a significant increase in the rated scores for fatiguability, pessimistic thoughts, reduced sleep, and inner tension. Suicidal thoughts were common, but no suicide attempts were made. A significant number of patients complained of failing memory, but no significant progression was demonstrated during the 7‐year study period. The increase in the depressive symptoms was closely correlated with the number of hospital admissions for depressive recurrence and with the number of days in hospital. The following factors showed a significant relationship with the increase in depressive symptoms: serum lithium levels, large increase in the elimination half‐life of lithium, low level of social functioning, low TSH values, and need of concomitant administration of antidepressants and benzodiazepines.
Subjective bias in reports of poor work adjustment in depressed patients
Authors: Morgado A. , Raoux N. , Smith M. , Allilaire J.‐F. , Widlöcher D.
Published: August 2007

ABSTRACT— Twenty‐five depressed inpatients were asked to report their adjustment at work during the 4‐month period preceding their hospitalization. Two separate reports were given: the first during the acute illness phase and the second one 10–28 days later, after symptomatic remission following standardized pharmacotherapy. Thirty‐two percent more patient ratings showed absence of adjustment problems on the second report compared with the first. Significant differences between the 2 reports were found in 7 of the 9 items on the Structured and Scaled Interview to Assess Maladjustment, which is designed to assess specific aspects of maladjustment at work. The changes in the scores of maladjustment correlated with the changes in the scores of depressive symptoms, and 40% of the variation in maladjustment scores was accounted for by the pessimism item of the Montgomery‐Asberg Depression Rating Scale. Much of the poor work adjustment reported by the acutely depressed patients thus seems to be caused by symptom‐related subjective bias.