bluuebunny/crossref_metadata_2025 huggingface dataset:
Adolescents who Take Overdoses: Their Characteristics, Problems and Contacts with Helping Agencies
Authors: Hawton Keith , O'Grady John , Osborn Madeline , Cole Deborah
Published: August 2008

In a consecutive sample of 50 adolescents aged 13–18 admitted to hospital after taking overdoses, 90 per cent were girls. There were other clear differences between this sample and adolescents in general. Twenty-four per cent had visited their general practitioners in the previous week, and 50 per cent during the previous month. The most common difficulties preceding the overdoses were problems with parents, boy or girlfriends, and with school or work, including unemployment. A substantial proportion of the subjects had recent or current physical ill health. In the majority of cases the problems appeared to be transient so that one month later two-thirds of the adolescents had shown considerable general improvement. However, 14 per cent were referred to hospital for further self-poisoning or self-injury in the following year. The recent increase in the incidence of self-poisoning among adolescents suggests that more attention must be paid to this group in terms of both primary and secondary prevention.
Subsequent Deliberate Self-Harm in Patients Referred to a Psychiatrist: A Prospective Study
Authors: Myers E. D.
Published: August 2008

One thousand and five patients referred to a psychiatrist were questioned, during a routine clinical interview, about current and previous suicidal ideas and previous suicide behaviour; they were also specifically asked what made life worth living for them at that time. In a four-year case-record follow-up 102 patients (10.1 per cent) were found subsequently to have attempted deliberately to harm themselves. Such deliberate self-harm (DSH) was significantly associated with female sex, with age below 35, and with evidence of suicidal ideation and/or behaviour at the time of and/or before the initial referral. To the question, “What makes life worth living for you at the present time?” a significant number of subsequent self-harmers had answered ‘Nothing’ or ‘Not much’ while a significant number of subsequent non-self-harmers had answered “Spouse and children” or “Family”.

The results suggest that the answers to questions about current and previous suicidal ideas and behaviour and perceptions of what makes life worth living may be useful in the prediction of deliberate self-harm.
Delirium and Dementia: Diagnostic Criteria and Fatality Rates
Authors: Rabins Peter V.
Published: August 2008

Medically ill patients diagnosed at index admission as delirious, i.e., suffering cognitive decline and an altered state of consciousness, had higher fatality rates than demented, cognitively intact or depressed patients. At a one-year follow-up the death rate of those who had been delirious was still higher than that of demented patients. Delirious patients were more likely to have a diffusely slow EEG, tachycardia and hyperthermia and lower mean systolic and diastolic blood pressure. These results validate the distinction between delirium and dementia and the importance of alteration of consciousness as a defining characteristic of delirium.
Community Screening for Mental Illness: A Validity Study of the General Health Questionnaire
Authors: Benjamin Sidney , Decalmer Peter , Haran Dave
Published: August 2008

The 60-item GHQ was validated in a community population by comparison with the CIS. The GHQ failed to identify nearly half of the psychiatric ‘cases' in this population. Those missed were similar to those detected except for greater chronicity of illness and more frequent social and interpersonal problems. The GHQ appears to be unsuitable as a screening instrument for mental illness in the community and the possible reasons are discussed. Principal components analysis resulted in a 15-item GHQ factor which, when used with Likert scoring, resulted in considerable improvement and failed to identify only 4 per cent of ‘cases'. It is suggested that this may provide a more satisfactory screening instrument.
Psychoses of Epilepsy: A Radiological Evaluation
Authors: Toone B. K. , Dawson J. , Driver M. V.
Published: August 2008

Computerized axial tomography (CAT) scanning was carried out on 57 patients who had received a hospital diagnosis of psychoses associated with epilepsy, and 78 epileptic patients with psychiatric illness other than epilepsy. Abnormal scans were reported in approximately half of the cases in both groups. An excess of left hemisphere abnormality was noted in the psychotic group, but this was not significant. These findings failed to provide firm support for the hypothesis that lateralized structural damage to the cerebral hemispheres plays a major part in determining the specific pattern of associated psychotic illness.
Plasma Prolactin and Growth Hormone Levels in Manic Patients Treated with Pimozide
Authors: Cookson J. C. , Silverstone T. , Rees Lesley
Published: August 2008

During two weeks' treatment of 11 manic patients with pimozide there was close correspondence between the timecourse of improvement in clinical ratings and the rise in plasma prolactin between the second and fourteenth day. There were no significant differences in growth hormone levels during the manic episodes compared to recovery. These findings are discussed in relation to the role of dopamine in the release of prolactin and growth hormone, and in the pathogenesis of mania.
Is there a Syndrome of Pure Hyperactivity?
Authors: August Gerald J. , Stewart Mark A.
Published: August 2008

A comparison of hyperactive boys with and without associated conduct disorder was made to determine the validity of a narrowly defined concept of pure hyperactivity. Although clinical differences between the two sub-groups supported the diagnostic distinction, few differences appeared with respect to various possibly causal background factors. A small group of boys with pure hyperactivity was separated, however, on the basis of subnormal IQ scores. In contrast to the hyperactive boys with normal IQ, these boys showed a more serious history of developmental disturbances which appeared to be linked to organicity. It was concluded that pure hyperactivity is an elusive concept and probably defines a heterogeneous group of children whose primary problems are cognitive in nature.
Anxiety Management Training for Anxiety States: Positive Compared with Negative Self-Statements
Authors: Ramm Elizabeth , Marks Isaac , Stern Richard , Yuksel Sahika
Published: August 2008

Twelve patients complaining of chronic free-floating anxiety, usually also with panic attacks, were assigned at random to treatment by six hour-long sessions of anxiety-management training, either with positive or with negative self-statements, given over six weeks. Patients in both treatment conditions improved, with a small trend favouring positive over negative self-instruction, especially at follow-up. It is unclear how much self-instruction, rather than therapeutic attention or mere passage of time, accounted for the bulk of the modest improvement obtained.
Separation of Subtypes of Depression using Discriminant Analysis
Authors: Feinberg Michael , Carroll Bernard J.
Published: August 2008

We derived a discriminant function based on clinical features to classify patients with endogenous depression (‘melancholia’) and non-endogenous (‘neurotic’) depression. The difference between the groups was not one of overall severity of illness alone. Bipolar melancholic patients were classified less well than were unipolars, supporting previous findings of clinical differences between these groups.

The discriminant function (DF) was reduced to a discriminant index (DI) which classified a separate group of unipolar melancholic and non-endogenous patients with comparable accuracy. Approximately 80 per cent of all cases received a definite classification by the DI. The agreement between the 105 definite DI classifications and the clinical diagnoses was 90 per cent when results from the derivation and validation groups were combined.

The DI classification was then validated against an objective biological marker, the dexamethasone suppression test (DST). The diagnostic discriminant index predicted the DST result with the same accuracy as the clinical diagnoses. The discriminant index can serve as an operational definition of the patients diagnosed as endogenous or nonendogenous unipolar depression in future studies by ourselves and other groups of investigators.
Season of Birth in High and Low Genetic Risk Schizophrenics
Authors: Shur Eric
Published: August 2008

Hypotheses which have been proposed to account for the unusual seasonal birth pattern observed in schizophrenic populations are discussed. These competing hypotheses were tested by retrospectively studying season of birth in 975 schizophrenics divided according to family history of psychiatric illness. Information was obtained from case notes, item sheets, and questionnaires sent to general practitioners. The results were inconclusive, but there was a trend for high genetic risk cases to be born less often in the first quarter of the year. Although no clear support could be provided for one or other season of birth hypothesis, it is tentatively suggested that a seasonal constitutional damage factor may be responsible for the excess of births described in schizophrenic populations in the early months of the year.
Some Psychological Problems of Acquired Deafness
Authors: Stevens John M.
Published: August 2008

This pilot study seeks to identify the psychological problems in middle aged and elderly subjects with impaired hearing, and to determine whether hearing aids improve these.

The results indicate three main areas of psychological handicap and suggest that these are reduced by the provision of a hearing aid.
Reality Orientation: A Critical Appraisal
Authors: Powell-Proctor Linda , Miller Edgar
Published: August 2008

Reality orientation is now extensively used with psychogeriatric patients. The evidence for its effectiveness is reviewed and the underlying philosophy and assumptions are critically examined. Whilst reality orientation does appear to have some effect the benefits are small and restricted in range. It can be argued that it is not directed at the most appropriate therapeutic goals. Reality orientation should be seen as the starting point for the development of more effective intervention techniques for use with this client population and not as an end in itself.
Fluctuations of Free Choline Levels in Plasma of Alzheimer Patients Receiving Lecithin: Preliminary Observations
Authors: Chuaqui Paz , Levy Raymond
Published: August 2008

Plasmas of 12 patients currently taking part in a double-blind trial of lecithin in senile or presenile dementia of Alzheimer type were analysed for plasma choline levels at fixed intervals during lecithin treatment. The values were not maintained at a constant level and showed a decline after one or two months of treatment, often followed by a subsequent rise. Possible explanations for this observation are given, and its significance to the treatment of dementia discussed.
Trihexyphenidyl (Artane) Abuse: Euphoriant and Anxiolytic
Authors: Kaminer Yifrah , Munitz Hanan , Wijsenbeek Henricus
Published: August 2008

Trihexyphenidyl (benzhexol, Artane) is an anticholinergic drug widely used among the psychiatric population in order to control extrapyramidal symptoms from the use of anti-psychotic drugs. In addition to the many well-known somatic and psychiatric side effects caused by the drug (Shader and Greenblatt, 1971), including toxic psychosis, trihexyphenidyl has been reported as causing a euphoriant effect (Bolin, 1960; Jellinek, 1977; Parker, 1978; Rubinstein, 1978; Shader and Greenblatt, 1971; Goggin and Solomon, 1979). Benztropine and biperiden are known to have caused similar phenomena (Jellinek, 1977; Stephens, 1967). Trihexyphenidyl is known as an hallucinogenic agent amongst thrill-seeking adolescents (Rouchell and Dixon, 1977) and among prisoners in the US who abuse the drug either orally or by smoking it as a powder mixed with tobacco (Woody and O'Brien, 1974).
Phenelzine and Amitriptyline: Effects on Symptoms of Neurotic Depression
Authors: Rowan P. R. , Paykel E. S. , Parker R. R.
Published: August 2008

A double-blind controlled trial of phenelzine, amitriptyline and placebo was carried out in out-patients suffering from depression or mixed anxiety and depression. After six weeks treatment both active drugs were clearly superior to placebo and of similar efficacy; therapeutic effects started to appear at two weeks. Comparisons on symptom ratings showed that both drugs acted as true antidepressants, producing their greatest effects on ratings of depressive mood and thought content. There were additional weak differences, phenelzine producing more improvement on anxiety ratings, while amitriptyline gave greater effects on depressive impairment of work and interests and anergia. Analyses showed little evidence of clinical subgroups responding preferentially to either drug. The findings indicate that MAO inhibitors and tricyclic antidepressants have more closely similar clinical effects than has been thought and that either may be a useful treatment for these patients who are often considered to respond poorly to antidepressant drug treatment.
Evaluation of Different Forms of Community Meeting in a Psychiatric Unit in Hong Kong
Authors: Ng M. L. , Tam Y. K. , Luk S. L.
Published: August 2008

In an in-patient psychiatric unit attached to a teaching general hospital in Hong Kong, community meetings went through doctor-directed and nurse-directed forms to develop into a non-directive one. The therapeutic value of these different forms was tested by retrospective and prospective studies. In the retrospective study the rates of ward incidents and discharge rates of inpatients before and during the three stages were compared. In the prospective study an ABA design was used with ten-week blocks of regular non-directive meetings, cessation of meetings and then resumption; ward incidents, discharge rates and ward atmosphere during these blocks were compared. Both the non-directive and nurse-directed forms were equally associated with a reduction in ward incidents, aggressive incidents showing the greatest tendency to change; ward atmosphere and patient discharge rates did not change with community meetings.
Motor Lateralization in Manic Males
Authors: Nasrallah Henry A. , McCalley-Whitters Mona
Published: August 2008

A handedness test, administered to 88 manic male patients and 86 male control subjects, showed no difference between the two groups. The results suggest that unlike schizophrenia, mania is not associated with increased left and/or mixed-handedness.
A New Clinical Scale for the Staging of Dementia
Authors: Hughes Charles P. , Berg Leonard , Danziger Warren , Coben Lawrence A. , Martin Ronald L.
Published: August 2008

Accurate clinical staging of dementia in older subjects has not previously been achieved despite the use of such methods as psychometric testing, behavioural rating, and various combinations of simpler psychometric and behavioural evaluations. The Clinical Dementia Rating (CRD), a global rating device, was developed for a prospective study of mild senile dementia—Alzheimer type (SDAT). Reliability, validity, and correlational data are discussed. The CDR was found to distinguish unambiguously among older subjects with a wide range of cognitive function, from healthy to severely impaired.
Plasma Lithium Levels and Therapeutic Outcome in the Prophylaxis of Affective Disorders: A Retrospective Study
Authors: Sashidharan S. P. , McGuire R. J. , Glen A. I. M.
Published: August 2008

Patients receiving prophylactic lithium therapy for primary affective disorder during a four year period were studied for recurrence of affective illness. Patients who had affective episodes during this period did not differ from those who remained well in age, sex or diagnosis. Those with a favourable outcome had spent significantly less time at serum lithium levels above 0.9 mmol/litre than those who had a recurrence of affective episodes.
Seasonal Variation in Depressive Disorders and Suicidal Deaths in New South Wales
Authors: Parker Gordon , Walter Stephen D.
Published: August 2008

Month of admission data to psychiatric facilities in New South Wales, 1971–76, were examined for some 23, 000 patients with a depressive disorder to determine if seasonal variations in admissions, described in the northern hemisphere, exist there. In addition, data were examined on month of occurrence of some 3, 000 deaths due to suicide and self-inflicted injury, over the same period. Seasonality was demonstrated for three ‘psychotic’ depressive disorders, but not found for neurotic depression, further supporting the binary view of depression. A peak incidence in spring was found for MDP-mania and reactive depressive psychosis, while the peak incidence for MDP-depression was was in late winter. It is suggested that the increase in certain affective disorders around spring may follow a rapid increase in luminance, and in stimulation of the pineal gland. Suicidal deaths of males did not show significant seasonality, while those of females showed two incidence peaks, the significant one occurring in spring.
Phantom Limb: A Phenomenological Study
Authors: Shukla G. D. , Sahu S. C. , Tripathi R. P. , Gupta D. K.
Published: August 2008

Phantom limb phenomena during the post-operative period were studied in 72 amputees. All were right handed. Phantom limb was present in 86.1 per cent of the cases, significantly more commonly following amputation of the right arm. Nearly half of the phantoms developed within the first 24 hours and another quarter in the next 24 hours, appearing earlier in lower limb amputees. Movements in the phantom were felt by three-quarters of the cases, an incidence unaffected by site or side of amputation. Telescopy was present in nearly two-thirds and phantom limb pain in over two-thirds, significantly more commonly in the upper limb amputees but uninfluenced by the side of amputation. Thirty-one of the patients dreamed that their limbs were intact.
Mania Secondary to Procyclidine (‘Kemadrin’) Abuse
Authors: Coid Jeremy , Strang John
Published: August 2008

A case of procyclidine abuse is described in which the clinical presentation was indistinguishable from mania. The patient was a long-standing poly-drug abuser and was obtaining the drugs from medical sources. Controlled exposure on the ward to drugs of abuse, including a double-blind comparison with placebo, confirmed that procyclidine caused a manic response in this patient.
Animal Studies of Alcohol Intake
Authors: Meisch Richard A.
Published: August 2008

Animal studies of alcohol intake can be divided into two groups based on the methodology. General findings of each group will be reviewed especially as they relate to current areas of research interest. Some implications of research findings for theories of alcoholism and drug addiction will be mentioned.
A Controlled Trial of Social Intervention in the Families of Schizophrenic Patients
Authors: Leff Julian , Kuipers Liz , Berkowitz Ruth , Eberlein-Vries Rosemarie , Sturgeon David
Published: August 2008

A study is reported of a controlled trial of social intervention in the families of schizophrenic patients at high risk of relapse. The patients were selected for being in high contact with high Expressed Emotion relatives. All patients were maintained on neuroleptic drugs. One half of the 24 families were randomly assigned to routine out-patient care, while the other half received a package of social interventions. This comprised a programme of education about schizophrenia, a group for the relatives, and family sessions for relatives and patients.

The relapse rate in the control group was 50 per cent compared with nine per cent in the experimental group (P = 0.04). The stated aims of the therapeutic interventions were achieved in 73 per cent of experimental families. In these families, no patient relapsed. The results provide evidence for the causal role of relatives' expressed emotion (EE) in schizophrenic relapse, as well as for the therapeutic effectiveness of social intervention combined with drug treatment.
The Season of Birth of Schizophrenic, Neurotic and Psychiatrically Normal Twins
Authors: Kendler Kenneth S.
Published: August 2008

The quarter of birth of 536 schizophrenic, 1,991 neurotic and 12,085 psychiatrically normal twin pairs from the National Academy of Sciences-National Research Council Twin Registry was compared. When either all twin pairs, or only monozygotic or dizygotic twin pairs, were considered, no significant differences were found in the quarter of birth between the 3 groups. No difference in quarter of birth was found for twin pairs concordant versus discordant for schizophrenia. Despite the increased risk for intrauterine and perinatal complications in twin births, schizophrenic twins appear (at least) to be no more vulnerable than schizophrenic singletons to the seasonal gestation and birth-related insults which probably underlie the seasonality in schizophrenic births. Controlling for season of birth probably has little effect on the results of twin studies of schizophrenia.
Tourette-like Syndrome after Long-term Neuroleptic Drug Treatment
Authors: Mueller Jonathan , Aminoff Michael J.
Published: August 2008

Tourette syndrome is a disorder of chronic multiple motor and vocal tics with an age of onset between 2 and 15 years. Clicks, grunts, barks, coughs and yelps are common vocal manifestations, while coprolalia eventually occurs in 60 per cent of cases (Shapiro et al, 1978). Nine years or more (Bruun and Shapiro, 1972) may pass between the onset of the disorder and its diagnosis. Although mental and mood changes are not an intrinsic part of the syndrome, suicide may occur secondary to the profound social disruption produced by the disorder.
Parental Representations of Hypochondriacal Patients from a Psychiatric Hospital
Authors: Baker Brian , Merskey Harold
Published: August 2008

This study investigated parental bonding patterns of hypochondriacal patients using the Parental Bonding Instrument. Hypochondriacal patients and a matched control group were drawn from in and out-patients of a psychiatric hospital. Maternal over-protection was found much more frequently (P <.005) in the hypochondriacal group than in the control group. This offers support for previous clinical observations on hypochondriacal patients. The implications of this and other findings of the study are discussed.
Temper Tantrums, Epilepsy and Episodic Dyscontrol
Authors: Leicester Jon
Published: August 2008

Seventeen patients were seen by a neurologist for diagnosis of temper tantrums. The referring psychiatrist had thought that they might have been caused by organic disease, either epilepsy or the episodic dyscontrol syndrome. The final diagnosis in every case was temper tantrums due to psychological causes. The patients had a wide range of psychiatric disorders. Theories that might explain the tantrums are discussed.
Impairment of the Blood-Brain Barrier as an Aetiological Factor in Paranoid Psychosis
Authors: Axelsson Rolf , Martensson Erik , Alling Christer
Published: August 2008

Possible psychiatric implications of impairment of the blood-brain barrier were studied in 25 patients with paranoid psychosis. Determination of the ratio between the albumin concentrations in cerebrospinal fluid and serum showed increases, indicating impairment of the blood-brain barrier, in seven patients and normal values in 18. The two groups were compared for clinical, pharmacokinetic, neurophysiological and anamnestic variables. The highly significant finding that onset of psychosis had occurred, on average, 20 years earlier in the patients with impairment of the blood-brain barrier than in those without suggests that such impairment might influence the development of psychosis in predisposed individuals.
Motivational Aspects of Deliberate Self-Poisoning in Adolescents
Authors: Hawton Keith , Cole Deborah , O'Grady John , Osborn Madeline
Published: August 2008

A systematic study of 50 adolescent self-poisoners aged from 13 to 18 demonstrated considerable discrepancies between the reasons chosen by the subjects to explain the overdoses and those chosen by clinical assessors. Most adolescents indicated that they had been feeling lonely or unwanted, or angry with someone, and had taken the overdose to alleviate or demonstrate this distress. A third said they had wanted to die. In contrast, clinical assessors tended to attribute the overdose to punitive or manipulative reasons and suggested that only seven out of the 50 had wished to die.

The adolescents rarely indicated that they had taken the overdose to get help; this may explain the resistance that may be shown to psychiatric intervention, and casts doubt on the possible effectiveness of preventive agencies. Modification of attitudes to both self-poisoning and early help-seeking may be a more effective means of prevention.
Conjugal Bereavement amongst the Huli People of Papua New Guinea
Authors: Frankel Stephen , Smith David
Published: August 2008

The Huli people of the Southern Highlands Province of Papua New Guinea mourn in culturally patterned ways that differ for men and women. One difference is that women are expected to express their emotions, while men are discouraged from doing so. In this study the mortality of bereaved spouses was determined by following 100 widowers and 208 widows for four years following their bereavements. Widowers showed an excess mortality in the first year following bereavement while widows showed no such tendency. The possible relationship between these findings and Huli mourning practices is discussed.
A Double-Blind Controlled Comparison of the Therapeutic Effects of Low and High Energy Electroconvulsive Therapies
Authors: Robin Ashley , De Tissera Sanath
Published: August 2008

Patients were randomly allocated to treatment with either low energy pulses, high energy pulses, or high energy sinusoidal wave ECT and, despite the induction of convulsions of similar duration, were found to respond at different rates and to a different degree, depending on whether low or high energy currents were used. It is suggested that the quantity of current, as well as the induction of a convulsion, is relevant to therapeutic outcome with ECT. A reexamination of previous work shows that this is not necessarily inconsistent with these findings, which also explain the contradictory results in recent controlled trials of ECT.
The Effect of Desipramine upon Central Adrenergic Function in Depressed Patients
Authors: Glass Ilana B. , Checkley Stuart A. , Shur Eric , Dawling Sheila
Published: August 2008

Eleven drug free patients meeting Research Diagnostic Criteria for Major Depressive Disorder have been treated with desipramine and given a clonidine infusion after 0, 1 and 3 weeks of treatment. The sedative and hypotensive effects of clonidine were significantly inhibited after three weeks of treatment with desipramine: a similar interaction was seen after one week of treatment although this just failed to reach statistical significance. The growth hormone (GH) response to clonidine was initially impaired, but increased significantly after one week of treatment. A significant reduction in the GH response occurred during the second and third weeks of treatment with desipramine. This last finding is interpreted as evidence of adaptive change of α2 adrenoceptors: the other changes can be explained by the known ability of desipramine to block the re-uptake of noradrenaline.
Lithium Treatment in Schizophrenia and Schizo-Affective Disorders
Authors: Delva N. J. , Letemendia F. J. J.
Published: August 2008

Between one third and one half of schizophrenic patients appear to benefit from treatment with lithium carbonate. An even higher proportion of schizo-affective patients benefit some showing complete recovery. Current unfavourable views on the use of lithium in schizophrenia are contested. Lithium as well as neuroleptics have a place in the treatment of schizophrenia.
Lithium Withdrawal Triggers Psychosis
Authors: Margo A. , McMahon P.
Published: August 2008

Four healthy people on lithium for manic depressive liability relapsed within 14 days of the drug being secretly replaced by placebo. Their new manic attacks were at least as severe as any of their previous episodes.
Psychiatrists Also Need Interview Training
Authors: Maguire Peter
Published: August 2008

Much of the psychiatric morbidity which presents to general practitioners remains hidden, especially when the patient offers somatic symptoms or is already suffering from an established illness (Goldberg and Blackwell, 1970). This failure to recognize patients who need psychiatric help stems largely from inadequacies in the practitioner's interviewing skills (Goldberg and Huxley, 1980). Deficiencies in the content of their consultations which correlate with low recognition include the failure to screen for the possibility of psychiatric symptoms and the absence of any questions about the patient's family. Interviewing skills associated with a high detection rate include the establishing and maintenance of good eye contact, clarification of the patients' presenting complaints, picking up verbal and non-verbal cues, using open questions, and the ability to control the course of the interview.
The Dexamethasone Suppression Test in Affective Disorder
Authors: Mendlewicz J. , Charles G. , Franckson J. M.
Published: August 2008

Plasma Cortisol suppression after dexamethasone administration in 113 consecutively hospitalized patients (54 patients with primary depression, 41 with secondary depression and 18 non-depressed controls) showed early morning hypersecretion of Cortisol and Cortisol non-suppression after dexamethasone mainly in patients with primary depression. The sensitivity of the dexamethasone suppression test was 79 per cent in unipolar and bipolar primary depressed patients, specificity 79 per cent and diagnostic confidence of a positive test 82 per cent. Non-suppression to dexamethasone was observed in 81 per cent of patients with psychotic depression but only 37 per cent of those with non-psychotic depression. Age, sex and severity of depression, menopausal status, or benzodiazepines did not influence results. There was no association between Cortisol non-suppresssion and any genetic subgroup of affective disorder.
Plasma and CSF Gaba in Affective Illness
Authors: Berrettini Wade H. , Nurnberger John I. , Hare Theodore , Gershon Elliott S. , Post Robert M.
Published: August 2008

CSF and plasma GABA was measured in patients with bipolar affective illness and matched controls. There was no correlation between CSF and plasma GABA in 10 pairs of simultaneously obtained samples. Plasma GABA was significantly lower in a group of 10 euthymic medication-free bipolar patients compared to 41 normal volunteers (P <.02). This finding was replicated in a second study involving 6 patients and 10 normal volunteers. Twin studies showed a high correlation between members of 11 monozygotic twin pairs (P <.008). Diurnal variation was minimal, but bimonthly sampling over one year revealed somewhat higher values in the late summer compared to late winter.
The Syndrome of Schizophrenia: Relations Between Electrodermal Response, Lateral Asymmetries and Clinical Ratings
Authors: Gruzelier J. H. , Manchanda R.
Published: August 2008

Forty-eight undrugged hospital admissions with a present state examination (PSE) diagnosis of schizophrenia were subdivided by the direction of lateral differences in electrodermal response amplitudes to tones. The 29 with larger right-hand responses and the 19 with larger left-hand responses were compared on CATEGO syndromes and brief psychiatric rating scale (BPRS). The larger group had symptoms like those of classical Bleulerian schizophrenia—blunted affect emotional withdrawal, impaired social functioning, disorganized thought and retarded motility. The other group manifested florid symptoms including hypomanic affect pressure of speech, ideas of reference, depressive hallucinations and delusions, hypochondriasis, grandiosity and situational anxiety. The psychophysiological measures may provide an objective aid to diagnosis and implications for altered cerebral organization in psychotic patients.
The Clinical Anxiety Scale: An Instrument Derived from the Hamilton Anxiety Scale
Authors: Snaith R. P. , Baugh S. J. , Clayden A. D. , Husain A. , Sipple M. A.
Published: August 2008

The Hamilton Anxiety Scale (HAS) was administered to 51 patients with anxiety neurosis along with an independent criterion of severity. Each item from the HAS was significantly correlated with severity, and those items with the highest correlations were combined to form new anxiety scales. These scales were then used on a new group of 27 patients suffering from anxiety neurosis. All the new scales had better correlations with severity than the full HAS. The six-item scale was selected as being the most suitable to be a new Clinical Anxiety Scale.
The Pharmacological Management of Epilepsy Associated with Psychological Disorders
Authors: Reynolds E. H.
Published: August 2008

The anticonvulsant treatment of epilepsy associated with psychological disorders is reviewed in the light of modern knowledge of the clinical pharmacology and adverse mental effects of the drugs. Careful monitoring of individual drug therapy from the onset of treatment improves compliance and seizure control and avoids unnecessary and harmful polypharmacy, and some of the neurological and psychosocial problems of chronic epilepsy. In chronic patients on polypharmacy cautious rationalization may improve mental function but can be hazardous due to withdrawal seizures. A clearer perception of the limits of anticonvulsant therapy will allow more attention to appropriate psychosocial measures.
The Clinical Picture of Bipolar Affective Disorder in its Depressed Phase
Authors: Brockington Ian F. , Altman Edward , Hillier Valerie , Meltzer Herbert Y. , Nand Surinder
Published: August 2008

Using structured psychiatric interviews, we searched for differences between depressed patients with bipolar affective disorder, and with other types of depression. The patients were taken from 2 large series, collected in London and Chicago. Some differences were found, but few more than would be expected by chance, in view of the large number of variables examined. The possible reasons for this failure are discussed. They include contamination of the groups, and the insensitivity of structured mental state inventories.
Identical Twins Concordant for the Progression of Affective Illness to Schizophrenia
Authors: Kendler Kenneth S. , Tsuang Ming T.
Published: August 2008

A pair of identical twins for whom long-term follow-up information was available progressed concordantly from typical ‘affective illness' to process schizophrenia. We discuss a possible genetic basis for a certain form of schizophrenia which may present typical affective features in the initial phase of process schizophrenia.
Abnormal Growth Hormone Response to TRH in Chronic Adolescent Schizophrenic Patients
Authors: Weizman Ronit , Weizman Abraham , Tyano Sam , Gil-Ad Irit , Laron Zvi
Published: August 2008

There was a significant rise in the human growth hormone response to intravenous thyrotropin releasing hormone in 5 of 10 chronic schizophrenic adolescents maintained on antipsychotic agents, but in none of 10 age and sex matched control subjects. In 4 of the 5 patients with growth hormone rise there was a positive family history of schizophrenia, but such a family history was obtained in only one of the non-responding schizophrenics.
A Comparison of In-Patient Costs of Treatment and Care in a Scottish Psychiatric Hospital
Authors: McKechnie A. A. , Rae D. , May J.
Published: August 2008

A comparison has been made of costs within in-patient units in a large Scottish psychiatric hospital. Cost differences were found between short-stay, rehabilitation and long-stay psychosis units and beds for the elderly with mental disorder. These differences reflected staffing levels, particularly of nurses. The costs were greater than average for psychiatric hospitals and approximated to geriatric units—a finding in keeping with the high occupancy of beds by the elderly. Existing long-stay elderly patients require to be considered separately in distinguishing elderly in-patient costs without total psychogeriatric care offered by society.
Enema Abuse
Authors: Barton John L. , Terry J. Michael , Barton Elizabeth Spindler
Published: August 2008

Enema abuse is a pernicious disorder, not extensively reported in the psychiatric literature. It may occur as an isolated paraphilia, klismaphilia (Denko, 1973, 1976), or as a symptom reflecting more pervasive illness or abnormality of attitude (Engel, 1975; Greenberg-Englander and Levine, 1981). Our patient had been using enemata excessively for sixteen years and presented in a state of cachexia; she had both obsessive-compulsive and affective symptoms, both frequently found in association with anorexia nervosa (Snaith, 1981).
Anwesenheit: Psychopathology and Clinical Associations
Authors: Thompson C.
Published: August 2008

A feeling of ‘presence’ is a common but relatively neglected phenomenon. The psychopathology, definition and six clinical associations are discussed. Two case histories are presented to demonstrate the induction of anwesenheit by serotonergic and dopaminergic drugs.
Cushing's Syndrome and Depression—A Prospective Study of 26 Patients
Authors: Kelly William F. , Checkley Stuart A. , Bender David A. , Mashiter Keith
Published: August 2008

Of 26 patients with active Cushing's syndrome assessed before and at three and 12 months after treatment, 21 had pituitary-dependent disease. Median urinary free Cortisol values (per 24 hours) were 680, 180 and 200 nmol at zero, three and 12 months (normal <270 nmol), with significant improvement (P <0.001) at three and 12 months. Depression on the Hamilton rating scale was significantly less at three months (P <0.01) and at 12 months (P <0.001). We have already demonstrated that some patients with Cushing's syndrome have PSE diagnoses of depression and are more depressed than patients with other pituitary tumours. This is the firmest evidence to date that when Cushing's syndrome occurs it commonly causes depressive illness.
Autonomic Arousal in Eating Disorders: Further Evidence for the Clinical Subdivision of Anorexia Nervosa
Authors: Calloway Paul , Fonagy Peter , Wakeling Anthony
Published: August 2008

Autonomic arousal, measured by skin conductance level and response, was examined in 36 female patients with eating disorders (anorexia nervosa and bulimia nervosa) and 32 control subjects. No differences were found between the control group and anorexics who lost weight solely through dieting (restricting anorexics). Patients with a diagnosis of bulimia nervosa and anorexics with bulimic features, however, showed fewer spontaneous skin conductance responses and were faster to habituate to 85 dB tones than either controls or restricting anorexic patients. The pattern of findings supports recent views concerning the clinical subdivision of anorexia nervosa.
Characteristics of Child Battering in Hong Kong: A Controlled Study
Authors: Lieh-Mak F. , Chung S. Y. , Liu Y. W.
Published: August 2008

The characteristics in Hong Kong of 37 cases of child battering and their families compared to a control group matched for age of child and social class of family revealed that the families of battered children had significantly more problems, with a higher prevalence of psychiatric disorder among the parents. The victims were usually the product of unwanted pregnancy and had been separated from their parents in the first year of life. In Hong Kong older children rather than infants were at risk of being battered. The cultural factors in operation are discussed.
The use of Ward Support by Psychiatric Patients in the Community
Authors: Mitchell S. F. , Birley J. L. T.
Published: August 2008

A system of ward support for chronic psychiatric patients in an urban community is described, which makes available ward and staff facilities throughout the 24 hours and at weekends. Details are given of a group of 41 patients using this facility over a period of six months. Two types of use of the ward were identified, based on the amount of social interaction with other staff and patients. The ‘unengaged’, with a high rate of visits, were mainly schizophrenic patients with an early first onset of illness and currently a scanty social network (small primary group and often no confidant). The ‘engaged’, with a lower rate of visits, were people with a later onset and a larger social network.
The Prognosis of Depression in Old Age
Authors: Murphy Elaine
Published: August 2008

The paper describes a one year prospective study of 124 elderly depressed patients. Only one third of the group had a good outcome. Poor outcome was associated with severity of initial illness, those with depressive delusions having a particularly poor outcome. Outcome was also influenced by physical health problems and severe life events in the follow-up year. Social class differences in outcome were thought to be due to class differences in the experience of severe life events. There was no evidence that an intimate relationship protected against relapse in the face of continuing life stress.
Distress or Illness? a Study of Psychological Symptoms after Myocardial Infarction
Authors: Lloyd G. G. , Cawley R. H.
Published: August 2008

Three groups of patients were identified during a study of men who had recently suffered an acute myocardial infarction: those with psychiatric morbidity antedating the infarction, those with psychiatric morbidity immediately following the infarction and those with no significant psychopathology. Compared to the other two groups, patients with psychiatric morbidity before the infarction were more likely to be unmarried, unemployed and to have received previous psychiatric treatment. They also obtained higher scores for neuroticism and psychoticism on personality assessment. Patients whose symptoms have been precipitated by the infarction resembled the psychologically healthy group with regard to their demographic characteristics and personality. Their symptoms tended to be transient, improving without special psychiatric treatment.
Genetics of Neurosis
Authors: Torgersen Svenn
Published: August 2008

In a study of 229 neurotic same-sex adult twins admitted to all psychiatric in- and out-patient clinics and mental hospitals in Norway, a statistically significant, moderately higher concordance was found for MZ than for DZ twins. When the sample was subdivided, this higher concordance for MZ pairs was true only for male twins and for twins admitted to mental hospitals. The results are compared to those from earlier studies; different findings on the importance of genetic factors in the development of neuroses may be due to differences in sample selection.
Family History Study of Anorexia Nervosa and Bulimia
Authors: Hudson James I. , Pope Harrison G. , Jonas Jeffrey M. , Yurgelun-Todd Deborah
Published: August 2008

The 420 first-degree relatives of 14 patients with anorexia nervosa, 55 patients with bulimia, and 20 patients with both disorders were evaluated for the presence of psychiatric illness, using DSM-III criteria, by the family history method. The morbid risk for affective disorder in the families of the eating disorder probands was similar to that found in the families of patients with bipolar disorder; but was significantly greater than that found in the families of patients with schizophrenia or borderline personality disorder. These results add to the growing evidence that anorexia nervosa and bulimia are closely related to affective disorder.
Prognostic Implications of the Sex of Schizophrenic Patients
Authors: Salokangas Raimo
Published: August 2008

In two follow-up studies of a total of 175 patients, carried out approximately eight years after first hospitalization, men were under hospital care more often and for more prolonged periods than women, but used outpatient services less. At the end there were only small differences in clinical condition between the sexes, but social condition, as depicted by social adjustment, psychosexual situation and work adjustment, was clearly poorer in men than in women. This was perhaps a reflection of the men's poorer premorbid psychosocial development and social role. The differences between the sexes in the prognosis for schizophrenia are considered.
Visual Evoked Potentials in Schizophrenia
Authors: Connolly J. F. , Gruzelier J. H. , Manchanda R. , Hirsch S. R.
Published: August 2008

Visual evoked potentials (VEP) to different flash intensities were recorded at a central site (Cz) plus at homologous temporal and occipital locations in normal and unmedicated schizophrenic subjects. Schizophrenic patients showed an hemisphere asymmetry of the P100–N120 peak-trough amplitude with smaller left but larger right hemisphere amplitudes than normal. Further, two subgroups of patients were found with abnormalities lateralized to the left hemisphere. One group was found to have abnormal P100 amplitude-intensity patterns at the left temporal site while the other group showed deviant N120 amplitude-intensity patterns at the left occipital location. The clinical significance of these results can be seen in the higher nuclear schizophrenia (PSE-CATEGO) scores in the left temporal subgroup and the higher hypomania and situational anxiety scores in the left occipital group. Patients also showed slower than normal P100 and N120 peak latencies.
The Abrupt Withdrawal of Antiparkinsonian Drugs in Mentally Handicapped Patients
Authors: Carter Graham
Published: August 2008

Long-term antiparkinsonian medication given to 20 mentally handicapped patients also on neuroleptics was abruptly withdrawn. Transient extrapyramidal signs developed in most patients during the following four weeks but in 60 per cent had disappeared by 12 weeks. Reintroduction of medication was necessary in only three patients, who developed acute dystonic reactions within one week of withdrawal.
Social Phobia: A Comparative Clinical Study
Authors: Amies P. L. , Gelder M. G. , Shaw P. M.
Published: August 2008

Eighty-seven people with the symptom of social phobia were compared with 57 people with the symptom of agoraphobia to determine whether these symptoms were part of distinct syndromes. Comparisons were made on demographic, clinical and questionnaire data. Significant differences were found on important variables. The social phobics were younger and more often male, unmarried, and from social classes I and II. The pattern of phobic situations was different in the two groups and so was the pattern of autonomic symptoms experienced in these situations. Symptoms visible to others were more frequent among social phobics. Fainting was more frequent among the agoraphobics.
Growth Hormone Response to Clonidine in Obsessive-Compulsive Patients
Authors: Siever Larry J. , Insel Thomas R. , Jimerson David C. , Lake C. Raymond , Uhde Thomas W. , Aloi Joseph , Murphy Dennis L.
Published: August 2008

We have observed a lesser growth hormone response to intravenous clonidine administration in nine obsessive-compulsive disorder patients meeting research diagnostic criteria than in nine matched controls. The obsessive-compulsive disorder patients had higher plasma free 3-methoxy-4-hydroxyphenylglycol and plasma norepinephrine levels before clonidine than the controls. As blunted growth hormone responses to clonidine are also characteristic of affective disorder patients, these results support other observations of a psychobiologic affinity between these two groups and are also compatible with an association between increased presynaptic noradrenergic activity and decreased post-synaptic receptor responsiveness.