bluuebunny/crossref_metadata_2025 huggingface dataset:
Koro-Like Symptoms in a Man Infected with the Human Immunodeficiency Virus
Authors: Heyman Isobel , Fahy Thomas A.
Published: October 2008

A 32-year-old man presented with koro-like symptoms in association with a depressive illness and HIV infection.
Risk Factors in Schizophrenia
Authors: Pulver Ann E. , Liang Kung-Yee , Brown C. Hendricks , Wolyniec Paula , McGrath John , Adler Lawrence , Tam Doreen , Carpenter William T. , Childs Barton
Published: October 2008

The risk for schizophrenia among first-degree relatives of schizophrenic probands obtained from an epidemiological sample using family history methods was examined to determine whether month of birth of the proband was associated with familial risk. The results of this study of the first-degree relatives of 106 female schizophrenics and 275 male schizophrenics suggested that the relatives of probands born in the months February to May had the highest risk, although the association between month of birth and familial risk among the male probands was present only for those relatives who had onset of schizophrenia before the age of 30.
A Critical Appraisal of X-Linked Bipolar Illness
Authors: Hebebrand Johannes
Published: October 2008

The major assumption underlying all X-linkage studies of bipolar disorder has been that a subgroup of manic–depressive illness follows an X-linked dominant mode of inheritance. An evaluation of the segregation patterns in the pedigrees that have been analysed for X-linkage over the past 20 years does not support this assumption, because the formal genetic criteria for an X-linked dominant mode of inheritance are virtually absent. Not a single pedigree has been ascertained in which the segregation pattern is suggestive of the assumed mode of inheritance. This is mainly because segregation ratios characteristic for X-linked dominant inheritance cannot be observed among the offspring of affected males.
Emotional Distress in the Hebrew Bible
Authors: Mumford David B.
Published: October 2008

A systematic search was made in the Hebrew Bible for expressions of emotional distress. A wide range of somatic and psychological vocabulary was found, especially in the Psalms and other poetic literature. Somatic expressions most frequently involved the heart, bowels, belly, bones, and eyes. Head symptoms were rare. Metaphors referring to the heart were common; other somatic expressions appeared to be descriptions of actual physical sensations. Usually somatic and psychological expressions were paired together, utilising the ‘parallelism’ of Hebrew verse form. Biblical Hebrew thus incorporated a powerful and sophisticated language of emotional expression.
Panic Attacks
Authors: Nutt David , Lawson Christopher
Published: October 2008

The delineation of panic disorder as a distinct diagnostic entity has provided renewed impetus for research into panic. This review describes and examines the range of neurobiological theories of panic attacks. It illustrates the diversity of mechanisms that have been invoked to explain the production of panic attacks, and which have influenced much of the current thinking about the neurochemistry of anxiety.
Patterns of Cerebral Blood Flow in Schizophrenia
Authors: Liddle P. F. , Friston K. J. , Frith C. D. , Hirsch S. R. , Jones T. , Frackowiak R. S. J.
Published: October 2008

Positron emission tomography was used to study the relationship between rCBF and symptom profiles in 30 schizophrenic patients. Factor analysis confirmed that the symptoms segregated into three syndromes – psychomotor poverty, disorganisation, and reality distortion – described previously. Analysis of the correlations between syndrome scores and rCBF revealed that each syndrome was associated with a specific pattern of perfusion in paralimbic and association cortex, and in related subcortical nuclei. The study confirmed predictions that psychomotor poverty and disorganisation are associated with altered perfusion at different loci in the pre-frontal cortex, and reality distortion with altered perfusion in the medial temporal lobe. The perfusion patterns suggest that the abnormalities of brain function underlying each of the three syndromes are not confined to single loci, but involve distributed neuronal networks.
Post-mortem Proton Magnetic Resonance Spectrometric Measures of Brain Regions in Patients with a Pathological Diagnosis of Alzheimer's Disease and Multi-infarct Dementia
Authors: Besson John A. O. , Best Philip V. , Skinner E. Roy
Published: October 2008

In-vitro spectrometric measures were made of spin-lattice (T1) and spin-spin (T2) relaxation times of samples of grey and white matter from the brains of 15 patients with a pathological diagnosis of Alzheimer's disease, 5 with multi-infarct dementia, and 11 non-demented subjects. Relaxation times were significantly greater in the parietal white matter and temporal white matter of patients with Alzheimer's disease compared with that of the other subjects. This was associated with an increase in tissue water content. These findings confirm measures obtained in some imaging studies.
The Hamilton Scales and the Hopkins Symptom Checklist (SCL–90)
Authors: Bech P. , Allerup P. , Maier W. , Albus M. , Lavori P. , Ayuso J. L.
Published: October 2008

The HRSD, HRSA, SCL–90 scales were psychometrically investigated in a cross-national sample of patients with varieties of non-psychotic symptoms of anxiety and depression. Across the cultural backgrounds the scores obtained from the original versions of these scales are not sufficient statistics. However, latent structure analysis has identified homogeneous subscales for depression (the HRSD) and for discomfort (an SCL subscale). High concurrent validity was found between the subscales of depression, anxiety and discomfort. In international research, inhomogeneity among scale items can be confounded with group differences which are usually ascribed to drug differences.
Screening for Depression in the Medically Ill
Authors: Meakin C. J.
Published: October 2008

Paper and pencil screening tests for depression have never become widely used in the medically ill, despite consensus that a sizeable pool of depression exists in this population. The performance of several self-rating scales in these patients is reviewed, demonstrating that satisfactory screening of depression as defined by standard case criteria can be achieved. It is proposed that it is primarily the absence of clear guidelines for treatment to be used in conjunction with these scales which will make clinicians sceptical of their value. Treatment validation of case criteria is required to demonstrate that screening for depression in medical patients is worthwhile.
Enhanced Serotonergic Responsivity Following Electroconvulsive Therapy in Patients with Major Depression
Authors: Shapira Baruch , Lerer Bernard , Kindler Seth , Lichtenberg Pesach , Gropp Cornelius , Cooper Thomas , Calev Avraham
Published: October 2008

Prolactin release in response to fenfluramine hydrochloride (60 mg orally) and placebo was evaluated in 18 medication-free patients with RDC major depressive disorder, endogenous subtype, before and after a series of bilateral treatments with ECT. Before ECT, fenfluramine induced a twofold increase in plasma prolactin levels. This response was significantly enhanced after the ECT series, while baseline prolactin levels and response to the placebo challenge were not altered. There was no significant difference in plasma fenfluramine and norfenfluramine levels during the pre- and post-ECT challenges. These findings suggest that ECT enhances central serotonergic responsivity and extend to depressed patients pre-clinical observations regarding the effect of electroconvulsive shock on serotonergic function.
Abnormalities of Response Processing in a Chronic Psychiatric Group
Authors: Wykes T. , Katz R. , Sturt E. , Hemsley D.
Published: October 2008

This study attempted to identify, in a mixed group of chronic patients, a specific measure of cognitive processing that may be of use in predicting dependence on psychiatric care. The measures investigated are derived from reaction-time tasks. Difficulties of response processing seem to account for the largest amount of variance in current service use. When compared with other variables shown to have some predictive power (e.g. social behaviour, symptoms and chronicity), the reaction time measures fare well. Functions derived from discriminant analyses using all the variables correctly classified 90% of those requiring day care and 95% of those requiring night care. Stepwise methods produced lower classification rates but always included reaction-time measures in the predictor set. Patients with continuing cognitive difficulties are likely to remain in more supportive psychiatric settings despite rigorous rehabilitation procedures.
Drug Therapy of Post-traumatic Stress Disorder
Authors: Davidson Jonathan
Published: October 2008

Post-traumatic stress disorder (PTSD) is a recently introduced diagnosis. The disorder is quite common, yet often unrecognised, and leads to significant morbidity or mortality. Effective treatment often entails use of psychotropic medication. Only recently has this become apparent, and awareness of the role of drug therapy in PTSD remains limited. A number of studies have indicated efficacy for antidepressant, mood-stabilising, anticonvulsant and antianxiety medications. This review describes the role of pharmacotherapy, by examining issues of diagnosis and recognition of PTSD, the theoretical basis for drug use, goals of drug treatment, dose ranges, and clinical application of psychotropic drugs.
Pica: Symptom or Eating Disorder? A Historical Assessment
Authors: Parry-Jones B. , Parry-Jones W. Ll.
Published: October 2008

In DSM–III–R, pica, with anorexia nervosa, bulimia nervosa and rumination disorder of infancy, is accorded the status of a separate eating disorder. However, in the Draft of ICD–10, only anorexia nervosa and bulimia nervosa are listed under eating disorders. Pica in children, and feeding disorder in infancy and childhood, are incorporated with enuresis, encopresis, and feeding, movement and speech disorders in a separate “heterogeneous group of disorders”. Extensive research on the history and terminology of eating disorders from the 16th to the 20th century suggests that, historically, pica was regarded as a symptom of other disorders rather than a separate entity. This paper aimed to locate and assess chronologically significant definitions and accounts of pica, to provide a fuller clinical description of a condition which, despite its current relevance, has received little detailed historical examination, and to give some consideration to the multiple aetiological theories which have been put forward. The historical findings are related to the descriptive criteria for pica in DSM–III–R and Draft ICD–10.
Is Old-Fashioned Electroconvulsive Therapy More Efficacious?
Authors: Scott Allan I.F. , Rodger Colin R. , Stocks Ruth H. , Shering Anne P.
Published: October 2008

In-patients suffering from major depressive disorder (endogenous subtype) were randomly allocated to treatment by either traditional ECT with constant-voltage modified sine-wave stimuli (n = 17) or modern, constant-current brief-pulse ECT (n = 14). All treatments were bilateral and monitored by simultaneous recording by EEG. The severity of depressive illness was assessed the day before treatment, after three treatments, and seven days after the last treatment. The improvement and final depression rating scores, the likelihood of recovery, and the average number of treatments received were virtually identical in the two groups. We concluded that the policy of bilateral suprathreshold modern ECT monitored by EEG is as efficacious as traditional ECT.
Decreased 5-HT-Mediated Prolactin Release in Major Depression
Authors: Anderson I. M. , Ware C. J. , da Roza Davis J. M. , Cowen P. J.
Published: October 2008

The prolactin response to intravenous clomipramine, a 5-HT uptake inhibitor, was significantly attenuated in 12 patients with major depression. In contrast, in a further 12 depressed patients, the PRL responses to thyrotropin-releasing hormone, which acts directly on the pituitary to release PRL, were not reduced. These findings suggest that the reduction in 5-HT-mediated PRL release seen in depressed patients is due to an impairment of brain 5-HT function rather than a pituitary abnormality.
Preschizophrenics: Adding to the Evidence, Sharpening the Focus
Authors: Ambelas Aris
Published: October 2008

The notion of a subclinical preschizophrenic condition already present in childhood is given further support by the findings of this follow-back study, which also brings into sharper focus the childhood profile of the likely adult schizophrenic.
Eating Disorders in Men with HIV Infection
Authors: Ramsay Noreen , Catalan Jose , Gazzard Brian
Published: October 2008

Four men with HIV infection who were referred to liaison psychiatry for assessment of eating disorders are described. In all four cases the eating disorder had implications for the clinical management of their HIV infection. Investigations of weight loss, dietary intervention, and compliance may all be affected by the presence of an eating disorder. The development of HIV disease may exacerbate the symptoms of an eating disorder.
Homosexuals who are Twins
Authors: King Michael , McDonald Elizabeth
Published: October 2008

Forty-six homosexual men and women who were twins took part in a study of their sexuality and that of their co-twin. Discordance for sexual orientation in the monozygotic pairs confirmed that genetic factors are insufficient explanation of the development of sexual orientation. There was a high level of shared knowledge of sexual orientation between members of twin pairs, and a relatively high likelihood of sexual relations occurring with same sex co-twins at some time, particularly in monozygotic pairs. The implications of these results for the study of the origins of sexual orientation and for twin research are discussed.
Parental Hostage Takers
Authors: Kennedy H. G. , Dyer D. E.
Published: October 2008

Three men presented to a single regional secure psychiatric unit over a twelve-month period, after taking their youngest child hostage in their own homes because of a threatened separation from the family. In each case the episode had escalated because of hostility to police involvement in what for them was a typical domestic upheaval. All cases ended without injury. In each man, substance abuse, a family history of domestic violence and fears of rejection were prominent, and the recent birth of a child may have been an added precipitant. There may be a common family structure which predisposes to such situations. Psychiatric intervention was deemed appropriate, with some evidence of benefit for the two men who engaged in treatment.
Acute Transient Stress-Induced Hallucinations in Soldiers
Authors: Spivak Baruch , Trottern Susan F. , Mark Mordechai , Bleich Avraham , Weizman Abraham
Published: October 2008

Three cases of stress-induced hallucinations in young soldiers are described. The hallucinatory experience was not accompanied by gross psychopathology. The phenomenology and psychopathological implications of hallucinations following exposure to environmental stress are discussed.
Delusional Misidentification of Persons in Dementia
Authors: Mendez Mario F.
Published: October 2008

The misidentification of a familiar person or of oneself may occur as a complication of dementia. Seven patients experienced alterations of the sense of familiarity for a familiar object or place, for the misidentified person in a novel role, for personal characteristics, or for unfamiliar events as familiar. Five of these had persecutory delusions. These cases suggest that person misidentification in dementia begins with an altered sense of familiarity for a familiar person from a mismatch of new perceptions with past memories. They are sustained by paranoid elaboration or confabulatory rationalisation of a double.
The Safety of Antidepressants
Authors: Henry John A.
Published: October 2008

It is no exaggeration to say that, in the 30 years since antidepressants were introduced, they have revolutionised the management of depression, thus fulfilling, at least for depressive illness, Paracelsus' prophetic wish. We now have a group of drugs which can induce remission in a disease which is disabling and not infrequently fatal. Despite intensive research, however, our understanding of the mechanism of action of these drugs is still largely hypothetical. Even our methods of evaluation are sufficient only to enable one to decide whether an antidepressant drug is effective or ineffective; there is no experimental method which can rank them in an overall order of potency, and perhaps this should not be the aim, since there must be subgroups of depressed patients who will respond differently to any one agent.
Is the Concept of Frontal–Subcortical Dementia Relevant to Schizophrenia?
Authors: Pantelis Christos , Barnes Thomas R. E. , Nelson Hazel E.
Published: October 2008

A syndrome of subcortical dementia has been described in conditions predominantly affecting the basal ganglia or thalamus, structures that have also been implicated in the pathogenesis of schizophrenia. There are similarities between subcortical dementia and the type II syndrome of schizophrenia, in terms of clinical features, pattern of neuropsychological deficits, pathology, biochemistry and data from brain-imaging studies. These similarities raise the possibility that certain schizophrenic symptoms, particularly negative symptoms and disturbance of movement, may reflect subcortical pathology. Neuropsychological deficits of presumed frontal lobe origin have been reported in some schizophrenic subjects. The occurrence of such deficits in a condition in which frontal lobe pathology has not been clearly demonstrated may be explicable in terms of a subcortical deafferentation of the pre-frontal cortex.
The Ability of Schizophrenics to Perceive and Cope with Negative Affect
Authors: Bellack Alan S. , Mueser Kim T. , Wade Julie , Sayers Steven , Morrison Randall L.
Published: October 2008

Thirty-four schizophrenic patients in an acute in-patient hospital were compared with 24 in-patients with major affective disorder and 19 non-patient controls on a role-play test of social skills and a test of affect perception. The role-play test consisted of 12 simulated conversations in which the subject was confronted by parents and friends expressing high-EE criticism or non-critical dissatisfaction. Schizophrenic patients lacked assertiveness and social skills in all conditions, but they did not show any differential impairment when presented with high EE. They consistently lied and denied errors rather than responding assertively or apologising, whether confronted with high-EE or benign criticisms. On the affect perception test, schizophrenic patients consistently underestimated the intensity or negativeness of negative emotions, but they were not deficient in perception of positive emotional displays. The data do not support the hypothesis that schizophrenic patients are poor at dealing with high-EE behaviours, but do indicate that their ability to cope with even mild negative affect is impaired. Possible explanations for this impairment include limited attentional capacity, a neurologically based perceptual deficit, and a self-protective mechanism to reduce or avoid stress.
Can Autoimmune Mechanisms Account for the Genetic Predisposition to Schizophrenia?
Authors: Knight John , Knight Allison , Ungvari Gabor
Published: October 2008

Applications of molecular genetic techniques to schizophrenia have shown great initial promise but have then proved disappointing. In order to maximise chances of elucidating the genetic mechanism underlying schizophrenia, diverse strategies and diverse perspectives must be adopted. Most studies begin with the premise that, although schizophrenia may be a heterogeneous collection of diseases, some subtypes will be primarily single-gene disorders. We are concerned that this single-gene hypothesis may be incorrect. Schizophrenia research may benefit from application of knowledge from other disciplines and from other diseases which, in terms of epidemiology and apparent genetic mechanisms, bear some resemblance to schizophrenia.
Innovations in Mental Health Care Delivery
Authors: Marks Isaac
Published: October 2008

In serious mental illness (SMI) even good community care does not usually make a major impact on clinical or social function, but patients and relatives prefer community to hospital care, and it tends to be cheaper. Any gains are lost if the required community services are not resourced, coordinated, and maintained indefinitely. A few SMI patients continue to need asylum under one roof. CPNs see more anxiety/depression than SMI. Their patients come increasingly from GPs, and they tend to work in practices with less need. Their cost-effectiveness is uncertain, although nurse behaviour therapists are cost-effective in anxiety disorders in primary care. Such research is also needed into the work of other mental health professionals. Despite their effectiveness, there is a dearth of behaviour therapists among nurses and psychiatrists. Problem-orientated training is lacking for most professionals with most patients. Behavioural self-treatments have improved phobic disorders and non-severe depression in controlled studies. Gains were as great when self-treatment was guided by a computer or by a manual as by a clinician. Self-help can extend care delivery, with therapists acting as consultants. Computers can also aid clinical audit.
Recent Developments in Expressed Emotion and Schizophrenia
Authors: Kavanagh David J.
Published: October 2008

Expressed emotion (EE) has substantial scientific support as a predictor of relapse of positive symptoms. The median relapse rate in a high-EE environment is 48%, compared with 21% in a low-EE environment. This effect does not seem to be due to confounding with other variables, but it is subject to limitations in its scope of application. EE probably determines relapse through its effect on emotions and symptom control. A stress-vulnerability model of relapse is advanced that incorporates biological factors as well as cycles of mutual influence between symptomatic behaviour, life events, and EE. Aversive types of behaviour in patients and their relatives are seen as understandable reactions to stress that are moderated by social perceptions and coping skills. Families have made positive achievements, including the provision of non-invasive support.
Effect of Psychotropic Drugs on Excitatory Amino Acids in Patients Undergoing Psychosurgery for Depression
Authors: Pangalos M. N. , Malizia A. L. , Francis P. T. , Lowe S. L. , Bertolucci P. H. F. , Procter A. W. , Bridges P. K. , Bartlett J. R. , Bowen D. M.
Published: October 2008

Samples of ventricular CSF were taken from 52 consecutive patients admitted for psychosurgery for intractable depression. Concentrations of asparagine, aspartate, glutamine, glutamic acid, and serine were determined. Glutamate and aspartate concentrations, implicated in excitotoxic brain damage, were not affected by various types of psychotropic drug treatment. Serine, a modulator of glutamate responses, was significantly elevated in samples from subjects receiving antidepressants. These subjects responded poorly to the operation. Psychotropic drugs are unlikely to be neurotoxic. Nevertheless, antidepressants may influence excitatory neurotransmission.
Psychophysiological Investigations of Patients with Unilateral Symptoms in the Hyperventilation Syndrome
Authors: O'Sullivan G. , Harvey I. , Bass C. , Sheehy M. , Toone B. , Turner S.
Published: October 2008

Anxiety states sometimes lead to hyperventilation (HV) which may, in turn, give rise to a variety of physical symptoms. One way in which HV may present is with unilateral somatosensory symptoms, often left-sided. We report nine such cases. The mechanism of lateralisation was examined using EEG and bilateral somatosensory evoked potentials which were carried out before and after HV. No difference in conduction velocity was found between affected and unaffected arms, but non-specific abnormalities were frequently noted in the EEGs. The results support the role of a central rather than a peripheral mechanism in the production of unilateral symptoms in HV.
Psychological Precursors of Panic Attacks
Authors: Kenardy Justin , Fried Leslie , Kraemer Helena C. , Taylor C. Barr
Published: October 2008

The ongoing experience of panic disorder was assessed in 20 female subjects, to determine psychological precursors to panic attacks. Measures of anxiety, threat, control, prediction of panic, and symptoms were assessed at hourly intervals during waking hours for one week. Measures were taken using a portable computerised diary which prompted for and stored responses. Patients' ratings of the prediction of panic attacks were the only significant precursors to panic attacks. This supports recent research that expectancy is important in panic onset. The data also suggested that anxiety levels follow a circadian pattern.
Is There a Link Between Suicide in Young Men and Unemployment?
Authors: Pritchard Colin
Published: October 2008

Within the context of marked increases in suicide rates in the UK among men between 1974 and 1988, the rate among those aged 15–24 years rose more than that of any other age band. The UK suicide rate among young men also worsened compared with those of most other countries in the EC. Rises in the general male suicide rate were statistically associated with rises in unemployment in most of the EC.
Psychiatric Morbidity in Homeless Women
Authors: Marshall E. Jane , Reed John L.
Published: October 2008

The psychiatric status of 70 homeless women from two direct-access hostels in inner-London was assessed. Detailed sociodemographic, psychiatric and physical illness data were also collected, and where possible, verified from psychiatric and general hospital sources. Forty-five women met DSM–III–R criteria for schizophrenia, but few were in contact with the psychiatric services or in receipt of any treatment.
A Survey of Practice at a Regional Forensic Service: What Do Forensic Psychiatrists Do?
Authors: Mendelson Eric F.
Published: October 2008

Nearly half of those seen in a forensic service were offered some form of help, but it did not reliably match that requested. In 63% of court reports there was no specific treatment recommendation, but where there was, it was likely to be accepted. Only one-third of all outpatients completed the treatment offered – 40% of the lapses were due to imprisonment. One-third of out-patient treatments were conducted under conditions of probation orders, and this form of compulsion was associated with a significantly higher number of completed treatment plans. Personality disorder was also associated with more treatment completions. These and other findings are discussed to assist in an understanding of the service.
The Nithsdale Schizophrenia Surveys X: Obstetric Complications, Family History and Abnormal Movements
Authors: McCreadie Robin G. , Hall David J. , Berry Ian J. , Robertson Lesley J. , Ewing James I. , Geals Michael F.
Published: October 2008

Obstetric histories of 54 schizophrenic patients and 114 siblings were obtained from their mothers and scored using the Obstetric Complications Scale. There was no statistically significant difference in the proportion of schizophrenic patients (35%) and siblings (29%) who had at least one definite obstetric complication. There was no evidence that schizophrenic patients with a history of obstetric complications were less likely to have a first-degree relative with a history of psychiatric illness leading to in-patient care. Schizophrenic patients with a history of obstetric complications were more likely to have drug-induced Parkinsonism. There was a trend for tardive dyskinesia to be more common in those schizophrenic patients with no obstetric complications but a family history of schizophrenia.
Specific and Non-specific Effects of Educational Intervention for Families Living with Schizophrenia
Authors: Birchwood Max , Smith Jo , Cochrane Ray
Published: October 2008

Three methods of delivering an educational intervention to families living with a schizophrenic relative were compared in terms of their efficacy in improving understanding and promoting family and patient well-being. Relatives receiving education in a group acquired more information than relatives receiving information by post or on video, but these differences were not maintained at six-month follow-up. The inclusion of homework assignments did not significantly affect gains in knowledge or any of the non-specific effects observed. The intervention overall led to considerable gains in knowledge, increased optimism concerning the family's role in treatment, and reductions in relatives' stress, which were maintained at follow-up. Fear was reduced in the short-term. Significant improvements in social function were observed at follow-up. The results suggest that the delivery of information, rather than the mode of delivery, is the crucial element in the intervention; however, the additional contextual factors operating in a group may be important if the full potential of education is to be realised.
Clinical Observation of Assessment Using the Composite International Diagnostic Interview (CIDI)
Authors: Janča Aleksandar , Robins Lee N. , Cottler Linda B. , Early Terrence S.
Published: October 2008

Two clinicians scored the ICD–10 Research Criteria Checklist either while observing or after administering CIDI interviews to a sample of 20 subjects. Overall diagnostic concordance between clinical and CIDI assessments was found to be good (overall kappa = 0.77). Assessment of the specific diagnoses could be done only for the three most commonly represented in the studied sample: anxiety/phobic disorders (kappa = 0.73), depressive disorders (kappa = 0.78), and psychoactive substance use disorders (kappa = 0.83). While the lack of independence of the two assessments and the small, non-randomly selected sample might have exaggerated the concordance, this study shows that the CIDI provides all the data needed to score diagnoses in the ICD–10 nomenclature, as indicated by the small number of questions clinicians needed to ask following completion of the CIDI.
The Explanatory Model Interview Catalogue (EMIC)
Authors: Weiss Mitchell G. , Doongaji D. R. , Siddhartha S. , Wypij David , Pathare S. , Bhatawdekar M. , Bhave A. , Sheth A. , Fernandes R.
Published: October 2008

The Explanatory Model Interview Catalogue (EMIC) has been developed to elicit illness-related perceptions, beliefs, and practices in a cultural study of leprosy and mental health in Bombay. Leprosy is an especially appropriate disorder for studying the inter-relationship of culture, mental health and medical illness because of deeply rooted cultural meanings, the emotional burden, and underuse of effective therapy. Fifty per cent of 56 recently diagnosed leprosy out-patients, 37% of 19 controls with another stigmatised dermatological condition (vitiligo), but only 8% of 12 controls with a comparable non-stigmatised condition (tinea versicolor) met DSM–III–R criteria for an axis I depressive, anxiety or somatoform disorder. Belief in a humoral (traditional) cause of illness predicted better attendance at clinic.
Autosomal Dominant Gene Transmission in a Large Kindred with Gilles de la Tourette Syndrome
Authors: Curtis David , Robertson Mary M. , Gurling Hugh M. D.
Published: October 2008

A multiplex kindred ascertained through a single proband with GTS has been systematically investigated with standardised diagnostic instruments for other cases of GTS and related disorders. Complex segregation analysis supported the hypothesis that a single major gene inherited in autosomal dominant fashion but with incomplete penetrance contributed most of the variance in the liability to develop GTS and related disorders. This result is consistent with previous segregation analyses which have employed different methods of ascertainment, and tends to confirm that a proportion of GTS is due to a dominant gene and is suitable for investigation with genetic markers for linkage analysis.
The Meaning of Insight in Clinical Psychiatry
Authors: Marková I. S. , Berrios G. E.
Published: October 2008

Insight can be defined not only in terms of people's understanding of their illness, but also in terms of understanding how the illness affects individuals' interactions with the world. The term ‘insight’ encompasses a complex concept which should not be considered as an isolated symptom which is present or absent. Instead, it may be more appropriate to think of insight as a continuum of thinking and feeling, affected by numerous internal and external variables. Different psychiatric disorders involve different mechanisms in the process of impairment of insight; this may influence the ways in which insight should be assessed in clinical practice.
Screening of Acute Psychiatric Admissions for Previously Undiagnosed Systemic Lupus Erythematosus
Authors: Hopkinson N. D. , Bendall P. , Powell R. J.
Published: October 2008

An auto-antibody screen for SLE, which included anti-nuclear antibodies, was performed on 296 patients admitted to acute psychiatric and psychogeriatric wards. Three cases (1% of those screened) of previously undiagnosed SLE were found, and one patient was found to have autoimmune chronic active hepatitis. An auto-antibody screen may be a useful investigation in psychiatric practice.
Depression and ‘Hassles' in Globus Pharyngis
Authors: Deary Ian J. , Smart Astrid , Wilson Janet A.
Published: October 2008

A group of 25 patients (16 women, 9 men) attending an ENT department with globus sensation and 25 matched ENT controls were assessed using the Beck Depression Inventory and scales for daily stressful events (‘hassles’). Globus patients of both sexes were significantly more depressed than controls and had Beck scores suggestive of significant depression. Thirteen patients, but only two controls, had an independent life event within two months of disease onset, and patients had higher hassles scores than controls.
Psychiatric Aspects of Liver Disease
Authors: Collis Ian , Lloyd Geoffrey
Published: October 2008

This paper reviews the literature on the effects of liver disease on mental health, a topic which has been relatively neglected in the recent psychiatric literature. It discusses both the encephalopathy which may be associated with liver disease of almost any type and the psychological consequences of specific liver disorders. Also considered are the effects of liver disease on sexual function; the relationship between alcohol and hepatic disorder in causing mental disturbance; the effects of childhood liver disease; psychiatric aspects of liver transplantation; and the use of psychotropic drugs in patients with hepatic dysfunction.
Capgras and Koro
Authors: Smyth Marcellino G. , Dean Christine
Published: October 2008

The concurrence of Capgras and koro syndromes in a man with affective disorder is reported.
Psychotherapy in Borderline and Narcissistic Personality Disorder
Authors: Higgitt Anna , Fonagy Peter
Published: October 2008

Psychodynamic concepts about borderline personality disorder are reviewed and the literature concerning psychotherapeutic treatment of this group is examined. The treatment contexts considered include: psychoanalysis and intensive (expressive) psychoanalytic psychotherapy, supportive psychotherapy, group psychotherapy, family therapy, in-patient treatment, the therapeutic community, cognitive–behavioural approaches, and combinations of drugs and psychotherapy. The practical implications of recent follow-up studies for intervention strategies are considered.
Anger and Irritability
Authors: Kennedy H. G.
Published: October 2008

Although there have been many studies of violent behaviour, anger has been neglected as a subject of scientific and clinical investigation. Anger can be defined as an affective state experienced as the motivation to act in ways that warn, intimidate or attack those who are perceived as challenging or threatening. Anger is associated with sensitivity to the perception of challenges or heightened awareness of threats. Anger is likely to be closely associated with fear. Although anger is common in mental illnesses it is largely neglected, perhaps because of the social stigma attached to its expression.
Drug Treatment of the Personality Disorders
Authors: Stein George
Published: October 2008

Many people with well defined borderline and schizotypal personality disorders may benefit considerably from small doses of neuroleptics. Depression that occurs with personality disorders, which is frequent, responds poorly to tricyclics but may respond better to neuroleptics, while the response to ECT is usually short lived. Selected borderline subjects may respond to MAOIs, particularly where there is a history of childhood hyperactivity. Carbamazepine and lithium may help some individuals with episodic behavioural dyscontrol and aggression, even in the absence of epileptic, affective or organic features. Drug treatments can be combined with psychotherapy, but further placebo-controlled trials are needed to clarify which drugs are most useful, and whether there are any useful clinical predictors of drug responsiveness.
A Comparison of Academic and Lay Theories of Schizophrenia
Authors: Furnham A. , Bower P.
Published: October 2008

This study investigated lay subjects' theories of schizophrenia. A questionnaire examining the five identified main academic theories of schizophrenia (medical, moral–behavioural, social, psychoanalytic, and conspiratorial) along various dimensions (aetiology, behaviour, treatment, function of the hospital, and the rights and duties of both patients and society) was constructed for use in the study. The results from 106 lay respondents showed that no single model was favoured exclusively but seemed to point to a synthesis of several academic theories. The lay subjects stressed the importance of patient environment in the aetiology of schizophrenia rather than a physiological malfunction, but tended to stress the personal rights of the schizophrenic. The differences between lay and the currently dominant psychiatric models are discussed in terms of the function these models serve for each group.
Expressed Emotion and Schizophrenia in Italy
Authors: Bertrando P. , Beltz J. , Bressi C. , Clerici M. , Farma T. , Invernizzi G. , Cazzullo C. L.
Published: October 2008

Forty-two schizophrenic patients and their close relatives took part in an Italian replication study of expressed emotion (EE). The patients were selected from the psychiatric ward of a general hospital in Milan and were subsequently followed up for nine months. All patients attended a community service clinic as out-patients, and all but one were prescribed neuroleptics for the duration of the study. Relatives were assigned to the high-EE group if they scored 4 or 5 on the emotional overinvolvement (EOI) scale, or showed hostility, or made six or more critical comments. On this basis, 18 (42%) families were rated as low EE and 24 (57%) as high EE. At follow-up, the admission rate for the 9-month period was significantly higher for the high-EE group (P<0.05). Furthermore, significantly fewer patients were readmitted from families showing high warmth (P<0.05). The presence of high warmth appeared to be associated with a lower admission rate, even in high-EE families.
Neurosyphilis and Schizophrenia
Authors: Sivakumar Kandiah , Okocha Chike I.
Published: October 2008

Neurosyphilis continues to present in atypical forms, leading to erroneous diagnoses by physicians and psychiatrists. This patient, with a previous history of psychosis, presented in a catatonic state with rhabdomyolysis and renal failure. A subsequent breakdown was thought to be schizophrenic until unusual features led to a reassessment and discovery of neurosyphilis which was treated with penicillin and resulted in a remarkable clinical recovery.
The Origins of Delusion
Authors: Roberts Glenn
Published: October 2008

Although delusion remains one of the basic problems in psychopathology, attempts to understand its pathogenesis have been dominated by unsubstantiated speculation. Previous psychodynamic formulations have recently given way to increasing interest in measurement, and testing of models derived from cognitive psychology. However, the formation, elaboration, and persistence of delusional beliefs may be an expression of the convergence of numerous causal influences, each exerting an effect at a different stage in the evolution of the belief. This review takes a structured overview of the literature, placing the numerous part theories and scant experimental findings within a general model of delusional development. It argues for a return to systematic research on symptoms rather than complex diagnostic formulations to facilitate better understanding of the development of delusional disorders and stimulate further interest in therapeutic intervention.
Maintenance Treatment in Recurrent Depression: Current and Future Directions
Authors: Kupfer David J.
Published: October 2008

When William Sargant died in 1988 at the age of 81, he had made his mark on British psychiatry. He had exerted considerable influence on US psychiatry as well. This was especially obvious during a time when physical treatments were hardly the fashion in US psychiatry. As The Times (1988) stated at the time of his death, he had made psychiatry more respectable by keeping it close to the medical model. He did a great deal to make depression intelligible to general practitioners and, therefore, to make it a legitimate, respectable illness.
Pharmacotherapy of Social Phobia
Authors: Versiani M. , Nardi A. E. , Mundim F. D. , Alves A. B. , Liebowitz M. R. , Amrein R.
Published: October 2008

In a double-blind, parallel group trial, 78 subjects with social phobia received moclobemide (a new reversible inhibitor of monoamine oxidase A) phenelzine, or placebo. After eight weeks, both active drugs – phenelzine somewhat more than moclobemide – were clinically and statistically significantly more effective than placebo, as assessed by rating scales. There was some further improvement between weeks 8 and 16, particularly in the moclobemide group; at week 16, 82% of the moclobemide and 91% of the phenelzine-treated patients were almost asymptomatic. Moclobemide was, however, much better tolerated than phenelzine. Patients withdrawn from active drugs had relapsed by week 24, providing additional support for the efficacy of the active drugs.
Hysterical Conversion
Authors: Mace C. J.
Published: October 2008

The career of the diagnosis of conversion hysteria is reviewed at a time when it is threatened with expulsion from classifications of psychiatric disorder. Criticism of its face validity has not led to adequate diagnostic alternatives, and has been insensitive to its unusual form as a category as well as the contribution it has made to the stability of the classificatory system around it.
Personality Disorder and Self-wounding
Authors: Tantam Digby , Whittaker Jane
Published: October 2008

At least 1 in 600 adults wound themselves sufficiently to need hospital treatment. More men than women do it, although more women receive psychological treatment. Many have a history of sexual or physical abuse. Self-wounding differs from other self-harm in being aimed neither at mutilation nor at death. Self-wounding coerces others and relieves personal distress. Repeated self-wounding is one criterion of borderline personality disorder but we prefer to consider it an ‘addictive’ behaviour rather than an expression of a wider disorder. Psychological management may need to be augmented by drug or social treatment. Carers, including professional carers, usually need help to contain the turbulence that self-wounding produces.
Child Psychiatric Disorders: Are They Classifiable?
Authors: Werry John S.
Published: October 2008

Classification of child (including adolescent) disorders is reviewed within six areas: requirements for a good taxonomy, current systems of classification for children, data-capture methods, reliability and validity, the link between child and adult disorders, and directions for future developments. While substantial progress has been made, there is a continuing need for comparisons of different systems, more systematic yet practicable data capture, proper psychometric analyses of criteria and categories, intensive studies of clinical validity, closer attention to the similarity of, and links between, child and adult categories, and better definition and targeting of those disorders with a serious outcome.
Presymptomatic Testing for Huntington's Disease in Wales 1987–90
Authors: Tyler Audrey , Morris Michael , Lazarou Lazarus , Meredith Linda , Myring Jennifer , Harper Peter
Published: October 2008

Between 1987 and 1990 a large series of at-risk individuals has been referred to our Huntington's disease (HD) presymptomatic testing programme. A detailed protocol for assessment and counselling has been followed. Out of 238 serious inquiries, 36% were potentially suitable for the testing programme, but 19% chose not to continue. Reasons for exclusion included the presence of clinical features of HD and being under the age of 18 years. Out of 40 final results given to 38 individuals, 23 indicated a lowered risk, 11 an increased risk, while five results were uninformative, two of these becoming informative on repeat testing. This series contained more women than men, and was disproportionately from the higher socio-economic groups. Motives for requesting a test principally related to child-bearing, informing existing children, and planning for the future. No significant psychiatric symptoms have been reported in the short term, but difficult counselling problems were presented by the high proportion of applicants who already showed clinical signs of HD. It is concluded that a detailed counselling protocol is essential in testing for HD, as many applicants are ill-prepared; this will assume even greater importance when the HD gene is identified and a test for specific mutations is available. The experience of presymptomatic testing for HD provides important general lessons which are likely to be applicable to other inherited neurological and psychiatric disorders.
Diurnal Rhythms and Symptom Severity in Panic Disorder
Authors: Geraci Marilla F. , Uhde Thomas W.
Published: October 2008

Diurnal changes in the frequency of panic attacks and symptoms of generalised anxiety, phobic anxiety and phobic avoidance in 34 panic-disorder patients and 40 normal controls were evaluated. The panic-disorder patients had significant diurnal changes in generalised and phobic anxiety, but not phobic avoidance. Increased severity of symptoms and prominent diurnal changes were most evident in the panic-disorder patients with a history of depression. Although panic attacks were distributed throughout the 24–hour period, patients with a current episode or history of depression tended to have more frequent panic attacks in the morning or early afternoon. These observations challenge the traditional belief that ‘anxious neurotic’ patients are relatively asymptomatic upon awakening in the morning and then develop more severe symptoms of anxiety later in the day.
The Role of the Amygdaloid Complex in Gilles de la Tourette's Syndrome
Authors: Jadresic Danitza
Published: October 2008

Gilles de la Tourette's syndrome (GTS) is a relatively rare neuropsychiatric disorder characterised by multiple motor tics accompanied by vocalisations. It usually starts in early childhood and is more common in males than females. Obsessional compulsive disorder (OCD) is an integral part of GTS (Robertson, 1989). GTS is also associated with coprolalia, copropraxia, and other echophenomena, as well as attention-deficit disorder, self-injury, and other behaviour problems (Robertson et al, 1988; Robertson, 1989). Family pedigree studies have demonstrated that most GTS cases in the community are mild and do not receive medical attention (Kurlan et al, 1987; Robertson & Gourdie, 1990).