bluuebunny/crossref_metadata_2025 huggingface dataset:
Comparison of negative symptoms in schizophrenic and poor outcome bipolar patients
Authors: Reddy Ravinder , Mukherjee Sukdeb , Schnur David B.
Published: July 2009

SYNOPSIS

Using the Scale for the Assessment of Negative Symptoms (SANS), affective blunting, alogia, and attentional impairment were assessed in 30 manic patients with chronic impairment of inter-episode instrumental functioning and 85 chronic schizophrenic patients. The schizophrenic patients had markedly higher ratings on all three negative symptom dimensions. When negative symptoms were examined categorically, no manic patient was rated to show prominent affective flattening or alogia. This relative specificity may not apply to attentional impairment which was rated as prominent in 17% of the manic patients and in 55% of the schizophrenic patients.
Diagnostic concordance in functional psychosis revisited: a study of inter-relationships between alternative concepts of psychotic disorder
Authors: McGorry Patrick D. , Singh Bruce S. , Connell Sheryl , McKenzie Dean , Van Riel Raphael J. , Copolov David L.
Published: July 2009

SYNOPSIS

More than a decade ago, a series of retrospective studies examined the concordance between proliferating definitions of severe psychiatric disorder. The European response has been a polydiagnostic one, which has attempted to maintain interest in a broad range of psychiatric phenomena in the psychoses. In North America a more convergent approach has emerged, resulting in a series of operational definitions evolving from one another, and a correspondingly limited capacity to allow alternative perspectives to co-exist. The present study uses a prospective design as well as recent improvements in the clinical validity of psychopathology assessment to re-evaluate the relationships between competing concepts of psychotic illness in a broad sample (N= 176) of recent-onset psychotic patients. In the schizophrenic group, concordance was predictably highest among recent North American ‘cousins’, and lowest among various historical concepts. There was a moderately high concordance between selected schizoaffective and atypical psychosis definitions, indicating that this component is an important area for further studies of descriptive validity. These interrelationships may be used as a starting point to explore latent classes underlying the phenomena of functional psychosis.
Railway suicide: the psychological effects on drivers
Authors: Farmer Richard , Tranah Troy , O'Donnell Ian , Catalan Jose
Published: July 2009

SYNOPSIS

People have jumped (or fallen) in front of trains on the London Underground system in increasing numbers throughout the twentieth century. During the past decade there have been about 100 such incidents each year, of which around 90 would involve the train driver witnessing his train strike the person on the track. Most are suicides or attempts at suicide. They represent major unexpected and violent events in the lives of the train drivers and it might be expected that some of them would respond by developing a post-traumatic stress reaction of the type identified by Horowitz (1976) or other adverse psychological reactions or both. The research reported in this paper was designed to characterize the range of responses of drivers to the experiences of killing or injuring members of the public during the course of their daily work. It was found that 16·3% of the drivers involved in incidents did develop post-traumatic stress disorder and that other diagnoses, e.g. depression and phobic states, were present in 39·5% of drivers when interviewed one month after the incident.
Coping strategies and breast disorders/cancer
Authors: Cooper Cary L. , Faragher E. Brian
Published: July 2009

SYNOPSIS

This prospective study of 2163 women attending a breast-screening clinic, or for a routine medical check-up, indicates that there is a statistically small but potentially important clinical link between the methods used to cope with stressful situations and breast disease.
Measuring psychiatric disorder in the recent past: the use of the Psychiatric Assessment Schedule retrospectively
Authors: Kisely Stephen R. , Faragher Brian , Gask Linda , Goldberg David P.
Published: July 2009

SYNOPSIS

Ninety-four patients were asked about the presence of psychiatric symptoms on admission to hospital using the revised Psychiatric Assessment Schedule. Three months later they were asked to recall their symptoms at admission using the same instrument retrospectively. The results of the initial and retrospective interviews showed good rates of agreement in terms of PAS score, ID level, psychiatric ‘caseness’ and both CATEGO and DSM-III-R diagnoses. The study demonstrates that it is possible to make reliable measurements of the mental status of three months previously, simultaneously with assessments of current mental status. The uses of such a measuring instrument are discussed.
Why people with probable minor psychiatric morbidity consult a doctor
Authors: Vázquez-Barquero J. L. , Diez-Manrique J. F. , Gaite L. , García C. Iglesias , Artal J. , Roberts Stephen E. , Wilkinson Greg
Published: July 2009

SYNOPSIS

This epidemiological investigation examines factors determining medical consultation in people with probable minor psychiatric morbidity. About 54% of people with probable minor psychiatric morbidity and about 23% of the (numerically much greater) remainder with lower probability of psychiatric morbidity consulted a doctor, usually a primary care physician, in the two weeks prior to a research interview. Medical consultation rates were higher in females than in males.

The dominant finding was that in people with probable minor psychiatric morbidity physical illness was strongly associated with medical consultation. Almost 89% of males and 97% of females with probable minor psychiatric morbidity and physical illness consulted a doctor in the two weeks prior to interview. Logistic regression modelling was used to investigate the joint effects on medical consultation of physical illness and six socio-demographic variables, and physical illness emerged as the major single determinant of medical consultation in women and, in men, it exerted its effect through an interaction with lower educational level.
Genetic and physical studies of male children with psychological gender disturbances
Authors: Rekers George A. , Crandall Barbara F. , Rosen Alexander C. , Bentler Peter M.
Published: July 2009

Synopsis

Twelve male children were diagnosed with psychological gender disturbances by 3 independent clinical psychologists using independent data sources focusing on behavioural deviance from normal comparison groups, on conventional psychological testing, and on parent report instruments which had been validated on normal comparison samples. These children received a paediatric evaluation consisting of a medical history, complete physical examination, chromosome analysis including 2 cells karyotyped and 15 counted, and sex chromatin studies. All gender disturbed boys were found to be normal genetically and physically with the exception of one subject with one undescended testicle.
Abnormal illness behaviour in young women in a primary care setting: is Briquet's Syndrome a useful category?
Authors: Deighton C. M. , Nicol A. R.
Published: July 2009

Synopsis

In a study of abnormal behaviour in women aged 16–25 in one large group practice a screening instrument and an interview were used to identify Briquet's Syndrome. The prevalence, 2·04 per 1000, was lower than that found in previous studies. The fact that many other patients showed both the high consultation rates and the other correlates of Briquet's Syndrome brings the usefulness of a discrete syndrome into doubt.
Subtypes of Alzheimer's Dementia: a conceptual analysis and critical review
Authors: Jorm A. F.
Published: July 2009

Synopsis

Criteria necessary for establishing the existence of qualitatively-different subtypes of a disorder are proposed. A review is made of the existing literature on Alzheimer's Dementia which proposes subtypes on the basis of either psychological or neuropathological data. It is concluded that, as yet, this research has not met the criteria for establishing qualitatively-different subtypes. However, Alzheimer's Dementia does seem to show quantitative variability in a number of respects and this appears to be related to factors of aetiological significance. The possibility that this quantitative variability could provide the basis for subtyping is discussed.
Severe hypoglycaemia and sudden death in anorexia nervosa
Authors: Ratcliffe P. J. , Bevan J. S.
Published: July 2009

Synopsis

Two patients with severe anorexia nervosa developed hypoglycaemic coma which was fatal in one case. Physical exertion may have contributed to this complication.
Moral treatment reconsidered: some sociological comments on an episode in the history of British psychiatry
Authors: Scull Andrew T.
Published: July 2009

Synopsis

A reappraisal is offered of the precise sense in which the introduction of moral treats ment at the end of the eighteenth century marked a decisive shift in our characteristic ways of responding to and coping with the mentally disturbed. Some connections are explored between this new approach to the ‘mad’ and larger social movements and processes.
An international comparison of two systems of community mental health care
Authors: Tantam Digby , Burns Barbara J.
Published: July 2009

Synopsis

A neighbourhood health centre in the US is compared with the mental health services in an area of the UK.

Patients with severe, but long-standing psychiatric illnesses, or patients with transient emotional problems are likely to be treated by a general practitioner in London and by non-medical mental health specialists in Boston. These patients receive more overall care, more specialist, non-medical care but make as many visits to a medical provider, other than a psychiatrist, in Boston as they do in London. Psychiatrists see more acutely ill patients for a shorter time than non-medical specialists in both places, and in both Boston and London there is a highly selective referral process which results in psychiatrists from both areas seeing approximately the same proportion of the population of their catchment areas.

The integration of these findings with community attitudes in planning services is discussed.
Organization and interaction in psychiatric day centres
Authors: Shepherd Geoff , Richardson Anne
Published: July 2009

Synopsis

One of the major problems in the care of chronic patients is the design of suitable long-term environments. Following from the work of Tizard and his colleagues, a study is described which investigated the aspects of the organization, management practices and social interactions in 4 local authority day centres for the care of chronic patients in the community. It was found that these centres differed markedly in terms of their organization and management practices and that these differences were correlated with the nature and quality of staff-client (although not staff–staff) interactions. Client-oriented management attitudes were correlated with a more personal approach to clients' problems and a warmer quality of interaction. These differences did not seem attributable to different kinds of clients being involved in each centre. The results are discussed in terms of the possible causal mechanisms involved and their implications for designing systems of long-term care.
Pyridostigmine-induced growth hormone responses in healthy and depressed subjects: evidence for cholinergic supersensitivity in depression
Authors: O'Keane V. , O'Flynn K. , Lucey J. , Dinan T. G.
Published: July 2009

SYNOPSIS

Theorists have extrapolated the cholinergic supersensitivity theory of affective disorder from a convincing and broad spectrum of clinical observation and research. This hypothesis is tested using a neuroendocrine probe approach with the challenge drug pyridostigmine, an indirect cholinergic agent thought to release growth hormone (GH) by decreasing inhibitory somatostatin tone. The consequent increments in plasma GH were considered to reflect central acetylcholine responsivity. Fifty-four volunteers were tested: 27 DSM-III-R major depressives (18 women and 9 men) and 27 age- and sex-matched healthy controls. Subjects were cannulated at 9.00 h following an overnight fast and two baseline samples were taken at 15 min intervals. Pyridostigmine 120 mg was administered orally and thereafter samples were taken at the time points +60, +90, +120 and +180 min. GH responses were significantly greater in depressives than controls and this effect was more marked for men than women. These results support the proposal that muscarinic upregulation and/or supersensitivity is associated with depression.
Orofacial dyskinesia and the alcohol dependence syndrome
Authors: Lucey James V. , Dinan Timothy G.
Published: July 2009

SYNOPSIS

A total of 52 patients with a DSM-III-R diagnosis of alcohol dependence syndrome underwent successful detoxification. Two to three weeks later they were examined for the presence of abnormal involuntary movements and rated with the abnormal involuntary movements scale (AIMS). They were also assessed with subtests from the Wechsler Adult Intelligence Scale (WAISR), namely, visual reproduction from memory, digit symbols substitution and the vocabulary test. Twenty-nine had evidence of orofacial dyskinesia and the presence of such movements was strongly associated with visuospatial deficits.
The use of hospitalizations by persistent somatizing patients
Authors: Fink Per
Published: July 2009

SYNOPSIS

Medical records were selected from the Danish National Patient Register in order to study individuals between the ages of 17 and 49 years in the general population who, during an 8-year period, were admitted at least 10 times to a general hospital (N = 282). Fifty-six subjects (19%) were found to be persistent somatizers, i.e. they were admitted repeatedly to general hospitals for physical symptoms without an organic basis. This corresponded to a frequency of persistent somatization in the population 0·6 per 1000 men and 3·2 per 1000 women.
Patterns of denial in sex offenders
Authors: Kennedy H. G. , Grubin D. H.
Published: July 2009

SYNOPSIS

Men convicted of sex offences (N = 102) were interviewed in two prisons. Cluster analysis was used to generate three groups according to pattern of denial; a fourth group was composed of men who denied their offence altogether. The groups differed in their ethnic make-up, offence type and past history of sexual offending.
A community study of mental disorders among four aboriginal groups in Taiwan
Authors: Cheng Tai Ann , Hsu Mutsu
Published: July 2009

SYNOPSIS

In this paper background, objectives, methodology and a few preliminary findings of a comparative epidemiological study of mental disorders among four aboriginal groups in Taiwan are presented. The study includes both a cross-sectional sample survey (N= 993) and prospective cohort studies involving psychoses, minor psychiatric morbidity, alcoholism, suicide, and accidental death. The total response rate to the sample survey was 98·3%; respondents were found to be representative. A preliminary analysis found very high rates of death from suicide, accidents and chronic liver and lung disease with a previous history of alcoholism in many of these deaths. Implications of these findings and studies of risk factors of all these health problems and their relationships are discussed.
The Department of Neuroscience at the Institute of Psychiatry
Authors: Anderton Brian , Kerwin Robert
Published: July 2009

During the 1988/89 academic year the Department of Neuroscience was formed at the Institute of Psychiatry from the former Departments of Biochemistry and Pharmacology. The University agreed to the establishment of a new Chair of Neuroscience to accompany this academic initiative and to which Professor Brian Anderton was appointed in 1989. In 1989, a new Lecturer in Molecular Biology, Dr John Powell, was appointed as well as a Clinical Senior Lecturer jointly with the Department of Psychiatry, Dr Robert Kerwin; this latter post was a new post under the UFC New Clinical Appointments Scheme. These changes have led to a strengthening of the molecular and cellular neurobiological interests of this new department and will influence the future academic aims of the Department of Neuroscience and Institute of Psychiatry as a whole.
‘Under the influence’ in British India: James Esdaile's Mesmeric Hospital in Calcutta, and its critics
Authors: Ernst Waltraud
Published: July 2009

Synopsis

Mesmerism was for a period very popular in Victorian Britain. The special clinical approach developed by Dr J. Esdaile while on duty in British India is elaborated in detail. The controversy surrounding Esdaile's treatment of surgical, medical and psychiatric cases at the ‘mesmeric hospital’ at Calcutta is discussed, and the main arguments are set within their contemporary socio-cultural context. Some of the arguments advanced for and against mesmerism contain concerns similar to those that have been raised during later decades in regard to hypnotism and hypnotherapy.
Residual symptoms after partial remission: an important outcome in depression
Authors: Paykel E. S. , Ramana R. , Cooper Z. , Hayhurst H. , Kerr J. , Barocka A.
Published: July 2009

Synopsis

This paper draws attention to an important adverse outcome in depression, the occurrence of residual symptoms after partial remission. Among patients with definite major depression followed every 3 months to remission and thereafter, residual symptoms reaching 8 or more on the Hamilton Depression Scale 17-item total were present in 32% (19) of the 60 who remitted below major depression by 15 months. The pattern was of mild but typical depressive symptoms. Residual symptoms were more common in subjects with more severe initial illness, but were not related to any other predictors, including longer prior illness, dysthymia, or lower dose of drug treatment during the illness episode. There were weak associations with personality that might have been consequences of symptom presence. Residual symptoms were very strong predictors of subsequent early relapse, which occurred in 76% (13/17) of those with residual symptoms and 25% (10/40) of those without.
Psychiatric diagnoses, sexual and physical victimization, and disability in patients with irritable bowel syndrome or inflammatory bowel disease
Authors: Walker E. A. , Gelfand A. N. , Gelfand M. D. , Katon W. J.
Published: July 2009

Synopsis

We compared 71 patients with irritable bowel syndrome (IBS) and 40 patients with inflammatory bowel disease (IBD) using structured interviews for psychiatric, gastrointestinal and sexual/physical victimization histories, as well as self-reported measures of personality, functional disability and dissociation. IBS patients had significantly higher lifetime prevalence rates of major depression, current panic disorder, and childhood sexual abuse. Despite the absence of organic pathology, IBS patients had significantly higher numbers of medically unexplained physical symptoms and disability ratings equal to, or greater than, those of patients with severe organic gastrointestinal disease.
Neuropsychiatric and neuropsychological correlates of delusions in Alzheimer's disease
Authors: Migliorelli R. , Petracca G. , Tesón A. , Sabe L. , Leiguarda R. , Starkstein S. E.
Published: July 2009

SYNOPSIS

We examined the prevalence, phenomenology, and clinical correlates of delusions in a consecutive series of 103 patients with probable Alzheimer's disease (AD). Patients were examined with the Present State Exam and the Dementia–Psychosis Scale. Twenty-one patients (20%) met DSM-III-R criteria for a delusional disorder. The most frequent delusion type was paranoid (71%), followed by hypochondriacal (67%), the Capgras syndrome (29%), house misidentification (29%), and grandiose delusions (29%). Out of the 21 AD patients with delusions, 76% had three or more different types of delusions simultaneously. The frequency of delusions was not significantly associated with age, education, or age at dementia onset, and the type and severity of cognitive impairments was similar for AD patients with and without delusions. However, AD patients with delusions had significantly higher mania and anosognosia scores.
Life events, social support and marital relationships in the outcome of severe depression
Authors: Paykel E. S. , Cooper Z. , Ramana R. , Hayhurst H.
Published: July 2009

Synopsis

The effects of life events, social support and marital relationships on outcome were examined in a predominantly recurrent in-patient sample of depressives studied longitudinally every 3 months to remission and up to 15 months thereafter. Outcomes examined were length of time to remission, presence of residual symptoms at remission, and subsequent relapse. There were few associations between these outcomes and the social variables. These findings add to other recent evidence that psychosocial factors are relatively unimportant in the subsequent course of severe and recurrent depressions, in contrast to their contribution to onset of such depressions and subsequent outcome of milder depressions.
Post-natal depression in an urban area of Portugal: comparison of childbearing women and matched controls
Authors: Augusto A. , Kumar R. , Calheiros J. M. , Matos E. , Figueiredo E.
Published: July 2009

Synopsis

The point prevalence of depression measured on one occasion between 2 and 5 months after childbirth was estimated to be 13·1% in 352 mothers living in urban Portugal; the criterion was a score of 13 or more on a translated version of the Edinburgh Post-natal Depression Scale (EPDS). More detailed comparisons were made between a subgroup of 118 mothers and 118 matched controls who had not borne a child in the previous 2 years. Post-natal women were twice as likely as non-childbearing controls to meet the EPDS criterion for depression. In comparison with controls, they were also more severely depressed as judged by their total scores on another questionnaire, the Zung Scale. Comparisons of individual symptom scores (Zung Scale) showed that childbearing women, as a whole, reported more somatic symptoms than controls, but when only those women judged to be depressed or dysphoric by the EPDS were compared, this difference disappeared. Stepwise logistic analyses of symptoms contributing to the categorization of a ‘case’ of post-natal versus non-post-natal depression did not reveal any very clear divergences in selfreported psychopathology. In childbearing women, two factors were found significantly to contribute to higher depression scores; women with more children and those from lower socioeconomic groups were most at risk.
Season of birth and Alzheimer's disease: a population-based study in Saguenay-Lac-St-Jean/Québec (IMAGE Project)
Authors: Vézina H. , Houde L. , Charbonneau H. , Beaudry M. , Cholette A. , Daoud N. , Mathieu J. , Robitaille Y. , Veilleux F. , Gauvreau D.
Published: July 2009

Synopsis

The birth distribution of 399 cases of Alzheimer's disease (AD) identified in the region of Saguenay-Lac-St-Jean (Québec) was compared with that of: (a) the population currently living in the area; and (b) the population born during the same period in the area. AD cases have been recruited since 1986 by the IMAGE Project. Cases and controls were grouped according to the month of birth and according to the day of birth using density estimation. Analyses showed a significant deficit of births in the month of May. We believe these preliminary results deserve further attention and we suggest two possible explanations that could lead to a deficit of AD births at specific periods during the year.
Psychopathological syndromes in the functional psychoses: associations with course and outcome
Authors: Van Os J. , Fahy T. A. , Jones P. , Harvey I. , Sham P. , Lewis S. , Bebbington P. , Toone B. , Williams M. , Murray R.
Published: July 2009

Synopsis

The aim of this study was to identify underlying dimensions of psychopathology in a cohort of patients with functional psychosis of recent onset, and to examine their prognostic value. Factor analysis of the psychopathological features of 166 consecutively admitted patients with functional psychosis of recent onset revealed seven psychopathological dimensions, which explained 63% of the variance. Five of these seven syndromes bore differential associations with subsequent treatment and illness course, independent of: (i) associations with DSM-III-R diagnosis; (ii) associations with other prognostic factors; and (iii) associations with the baseline values of outcome variables. The most striking associations were shown for an early and insidious onset syndrome with affective flattening, which predicted a more disabled course of illness on three of four outcome dimensions, and which was more common in males and unmarried individuals. A second syndrome, characterized by bizarre behaviour, inappropriate affect, catatonia, and poor rapport showed similar, slightly less striking, associations with illness course, as well as with poor pre-morbid social functioning. A third syndrome, characterized by positive psychotic symptoms was to a lesser degree associated with poorer outcome, whereas a fourth syndrome distinguished by manic symptomatology predicted a more benign illness course. A fifth syndrome identified by lack of insight predicted more time in hospital and admission under a section of the Mental Health Act during the follow-up period.

A further finding was that dimensional representations of psychopathological features were considerably more useful than categorical representations (DSM-III-R and ICD-10) as predictors of illness course and treatment decisions.
Depression and cancer: a follow-up study
Authors: Whitlock F. A. , Siskind M.
Published: July 2009

SYNOPSIS

Thirty-nine male and 90 female patients aged 40 and over, who had been given a primary diagnosis of depression, were followed up for 2⅓;13–4 years. During this period 9 male and 9 female patients died. Five male patients and 1 female died from cancer that had not been diagnosed at the time of their psychiatric admissions. The male cancer deaths are significantly higher than expected. The possible relationships of malignant neoplasm to affective disorder are discussed.
Personality variables and dysthymic symptoms: a comparison between a Greek and a British sample
Authors: Lyketsos G. C. , Blackburn Ivy M. , Mouzaki D.
Published: July 2009

SYNOPSIS

Foulds' short psychiatric screening questionnaire and personality measures were administered to a representative Greek sample. The results were significantly different from British norms, highlighting the importance of the interaction between states and traits in population morbidity and the need for local norms.
Comparative reliability of categorical and analogue rating scales in the assessment of psychiatric symptomatology
Authors: Remington Marina , Tyrer P. J. , Newson-Smith J. , Cicchetti D. V.
Published: July 2009

SYNOPSIS

The reliability of 26 items from the ninth edition of the Present State Examination (PSE) was assessed using both the conventional categorical scales and separately constructed analogue scales. Reliability was also calculated when the analogue responses were rescaled down to 2, 3 and 4 categories. The levels of inter-rater agreement obtained were comparable to those achieved in previous studies of PSE reliability, although as expected the levels of agreement on audiotapes were greater than those for independent interviews performed on the same day. These levels were not significantly affected by any of the changes in scale format, but there were apparent differences in reliability depending on the statistics used. In selecting or constructing a psychiatric rating scale, the question of reliability should not influence the choice of a categorical or continuous scale, or the number of scored points in the scale.
Acetylator status and inhibition of platelet monoamine oxidase following treatment with pheneizine
Authors: Yates Celia M. , Loudon J. B.
Published: July 2009

SYNOPSIS

The activity of platelet monoamine oxidase(MAO)was measured in 22 severely depressed patients before and after treatment with 45 mg and 60 mg phenelzine. The per cent inhibition of platelet MAO after both doses was not related to acetylator status.

Phenelzine, since it is a hydrazine derivative, is probably metabolized by polymorphic acetylation. Patients who were phenotypically slow acetylators have been reported to show a better clinical response (Johnstone & Marsh, 1973) and more side-effects (Evanset al.1965) to a given dose of phenelzine than patients who were fast acetylators.
Obstetric complications in children born to parents with schizophrenia: a meta-analysis of case–control studies
Authors: Sacker A. , Done D. J. , Crow T. J.
Published: July 2009

Synopsis

On the basis of previous findings, we used meta-analyses to consider whether births to parents with schizophrenia have an increased risk of obstetric complications. Meta-analyses were based on published studies satisfying the following selection criteria. The schizophrenic diagnosis could apply to either parent: parents with non-schizophrenic psychoses were not included: only normal controls were accepted. In all, 14 studies provided effect sizes or data from which these could be derived. Studies were identified by data searches through MEDLINE, PSYCLIT and through references of papers relating to the subject. Births to individuals with schizophrenia incur an increased risk of pregnancy and birth complications, low birthweight and poor neonatal condition. However, in each case the effect size is small (mean r = 0·155; 95% CI = 0·057). The risk is greater for mothers with schizophrenia and is not confined to mothers with onset pre-delivery or to the births of the children who become schizophrenic themselves.
Reversibility of brain tissue loss in anorexia nervosa assessed with a computerized Talairach 3-D proportional grid
Authors: Swayze V. W. , Andersen A. , Arndt S. , Rajarethinam R. , Fleming F. , Sato Y. , Andreasen N. C.
Published: July 2009

Synopsis

We describe the results of our follow-up magnetic resonance imaging (MRI) study of underweight patients with anorexia nervosa, using rigorous methodology to control for head position across time. All subjects first underwent an initial scan and rescan to verify that our computerized three-dimensional co-planar grid method for volume measurement was reliable and accurate, regardless of head positioning. After a period of several months, subjects had a follow-up scan to assess for changes that may have occurred following significant weight gain.

Ventricular and total brain volume measurements from the initial scans were compared with the scans from an age- and sex-matched normal control group to determine whether we could replicate previous findings of ventricular enlargement compared with controls and whether brain volume is reduced compared with controls. Anorexic subjects had significantly larger ventricles when compared with normal controls but did not differ significantly in total brain volume. Using a repeated measures analysis of variance,a prioricontrasts compared the initial/rescan pair volumes with each other and the initial/rescan pair volumes with the follow-up volume. These analyses showed that ventricular and total brain volumes derived from the initial/rescan pair were nearly identical, but that at follow-up ventricular volume decreased significantly and total brain volume increased significantly after weight gain.
The Gospel Oak Study stage IV: the clinical relevance of subjective memory impairment in older people
Authors: Tobiansky R. , Blizard R. , Livingston G. , Mann A.
Published: July 2009

SYNOPSIS

The prevalence rate of subjective memory impairment (SMI) and its value as a predictor of future depression or dementia was studied in a community sample of elderly residents in one electoral ward using the short-CARE. SMI was found to be common, occurring in 25% of subjects. Subjects with SMI were more likely to be suffering from either dementia or depression than those without the complaint, although 60% of subjects with SMI did not have evidence of either disorder. When followed up over a 2-year period, subjects with SMI were found to be at four-fold greater risk of developing future dementia and two-fold greater risk of developing a depression compared with those without SMI. The SMI scale was not found to be useful as a population screen for dementia or depression, although two of the nine items might have value as screening questions in clinical circumstances to determine those with memory complaints at risk for dementia.
Sub-typing depression, II. Clinical distinction of psychotic depression and non-psychotic melancholia
Authors: Parker G. , Hadzi-Pavlovic D. , Brodaty H. , Austin M.-P. , Mitchell P. , Wilhelm K. , Hickie I.
Published: July 2009

SYNOPSIS

We have attempted to clarify clinical differentiating features of psychotic depression. Forty-six depressed subjects meeting DSM-III-R criteria for major depression with psychotic features were compared with (i) DSM-defined melancholic, (ii) Newcastle-defined endogenous, and (iii) a residual DSM-defined major depressive episode group. Additionally, a ‘bottom up’ latent class analysis (LCA) suggested a larger sample of 82 ‘psychotic depressive’ subjects, and multivariate analyses contrasted these subjects with both LCA-identified melancholic and all residual depressed subjects. Analyses suggested that, in addition to two features with absolute specificity (delusions and hallucinations), both the DSM-defined and LCA-defined ‘psychotic depressive’ subjects were significantly more likely to demonstrate marked psychomotor disturbance, to report two morbid cognitions (feeling sinful and guilty; feeling deserving of punishment), as well as be more likely to report constipation, terminal insomnia, appetite/weight loss and (variable across the defined ‘psychotic depressive’ groups) loss of interest and pleasure. The study identifies a wider set of potentially discriminating clinical variables than previous studies, as well as both indicating the existence and assisting identification of ‘true’ psychotic depression in the absence of formal psychotic features being acknowledged or elicited.
Sub-typing depression, III. Development of a clinical algorithm for melancholia and comparison with other diagnostic measures
Authors: Parker G. , Hadzi-Pavlovic D. , Hickie I. , Brodaty H. , Boyce P. , Mitchell P. , Wilhelm K.
Published: July 2009

SYNOPSIS

We describe the development of a clinical algorithm to differentiate melancholic from non-melancholic depression, using refined sets of ‘endogeneity’ symptoms together with clinician-rated CORE scores assessing psychomotor disturbance. Assignment by the empirically developed algorithm is contrasted with assignment by DSM-III-R and with several other melancholia subtyping indices. Both the numbers of ‘melancholies’ assigned by the several systems and their capacity to distinguish ‘melancholics’ on clinical, demographic and a biological index test (the DST) varied across the systems with the algorithm being as ‘successful’ as several systems that include inter-episode and treatment response variables. Analyses provide information on the criteria set developed for DSM-IV definition of ‘melancholia’.
Homesickness: a review of the literature
Authors: Van Tilburg M. A. L. , Vingerhoets A. J. J. M. , Van Heck G. L.
Published: July 2009

Synopsis

Homesickness has not received due attention from psychological researchers, in spite of the fact that it is of considerable interest to counsellors and care-givers of those who have migrated or moved temporarily or permanently (e.g. immigrants, refugees, students, soldiers). First, this review addresses the definition of homesickness, the possible different kinds of homesickness, its prevalence rate, and symptomatology, Secondly, an overview is given of the theories that account for psychological distress following leaving home. These theories link homesickness with separation-anxiety and loss, the interruption of lifestyle, reduced control, role change, and internal conflict. In addition, the review focuses on: (i) studies that show that subjects reporting homesickness differ from non-homesick persons in terms of personality; (ii) the analyses of environmental characteristics that may play a crucial role in the onset and course of homesickness. Thirdly, Fisher's (1989) composite model of homesickness, which summarizes key findings of the major studies on homesickness is discussed. Fourthly, methodological issues are addressed. Finally, suggestions for future research are presented and possibilities for interventions are proposed.
Neuropsychological impairments in unipolar depression: the influence of perceived failure on subsequent performance
Authors: Elliott R. , Sahakian B. J. , McKay A. P. , Herrod J. J. , Robbins T. W. , Paykel E. S.
Published: July 2009

Synopsis

The CANTAB battery of neuropsychological tests was used to compare the performance of 28 patients with unipolar depression with that of 22 age and IQ matched controls. The patients were impaired on almost all tests studied with deficits in pattern and spatial recognition memory, matching to sample, spatial span, spatial working memory and planning. Most of the patients showed at least some impairment and deficits were seen across cognitive domains. An important finding was the detrimental effect of failure on subsequent performance; having solved one problem incorrectly, patients were far more likely than controls to fail the subsequent problem. Superimposed on the general deficits, there were also specific deficits in executive tasks characteristic of frontostriatal dysfunction and deficits in mnemonic tasks characteristic of temporal lobe dysfunction. This combination of a specific form of motivational deficit, resulting in oversensitivity to negative feedback, and superimposed specific neuropsychological deficits were correlated with severity of depression. The most significant correlations were seen between mnemonic deficits and clinical rating scores. Comparisons of the deficits seen in the depressed patients in this study with other patient groups assessed with the CANTAB neuropsychological battery, showed that one of the hypotheses of the neuropsychological deficits in depression, that of ‘frontosubcortical’ or ‘frontostriatal’ dysfunction, was not supported. These findings are discussed in relation to the likely neural substrates of depression.
Depressive thinking: changes in schematic mental models of self and world
Authors: Sheppard Leyland C. , Teasdale John D.
Published: July 2009

Synopsis

Alternative explanations for the changes in thinking associated with depression were examined. Depressive thinking could reflect a generalized increase in accessibility of negative constructs and memories, previously associated with depression. Alternatively, depressive thinking could reflect changes at a more generic level of cognitive representation, related to schematic mental models. To investigate contrasting predictions from these two explanations, depressed patients and non-depressed controls completed sentence stems involving social approval or personal achievement e.g. ‘If I could always be right then others would____me’. Construct accessibility views predict that depression will be associated with more negative completions (e.g. ‘dislike’). By contrast, the schematic model view predicts patients may give more positive completions (e.g. ‘like’). This is because schematic models reflect inter-relationships between constructs, and, it is suggested, depression is associated with use of schematic mental models that imply closer dependence of personal worth/acceptance on success/approval than the models used in the non-depressed state. Predictions from the schematic model view were supported, confirming previous findings. Results suggest that depressive thinking reflects changes in the high level mental models used to interpret experience.
Prevention of winter seasonal affective disorder by bright-light treatment
Authors: Partonen Timo , Lönnqvist Jouko
Published: July 2009

Synopsis

In patients with winter seasonal affective disorder (SAD) the onset of a depressive episode is probably associated with the decreasing amount of light during the autumn. A highly predictable onset of a recurrent depressive episode with seasonal pattern provides a rationale for testing the efficacy of bright-light treatment as a preventive measure. Twelve out-patients with winter SAD were assigned to start bright light treatment either when they were well, or not to start it until the first symptoms of depression had already emerged. The severity of depressive symptoms was prospectively rated for a parallel randomized comparison. Bright light given well in advance of the emerging symptoms prevented a depressive episode. Clinical remission was significantly more frequent in the former subgroup of the patients in January and in March. To sum up, bright light can be successfully administered as prophylactic treatment for the prevention of winter SAD.
Factors affecting the success of community placement: the TAPS project 26
Authors: Gooch Christopher , Leff Julian
Published: July 2009

Synopsis

Long-stay patients who were discharged from Friern and Claybury hospitals during the 6-year period between September 1985 and August 1991 were followed up for at least 1 year and the details of all readmissions were recorded. Of the 615 hospital leavers, some 178 (29%) were readmitted at some time during the follow-up period. A proportional hazards regression analysis revealed a number of independent baseline factors which affect the risk of readmission at any time during the follow-up period. Younger patients were more at risk of readmission than were older patients and ‘new’ long-stay patients had a greater risk than baseline patients. Risk was also greater in patients who had a larger number of pre-discharge admissions,a higher abnormal behaviour score (PSE BSO) or a diagnosis of manic psychosis. An ordinal logistic regression analysis revealed that these same five factors tended to increase the actual number of readmission episodes. The proportion of post-discharge time spent in hospital among the readmitted patients was found to be greater for males, new long-stay patients and for patients with a higher number of positive social behaviour symptoms (SBSPOS score).
Effects of positive and negative life events on time to depression onset: an analysis of additivity and timing
Authors: Frank E. , Tu X. M. , Anderson B. , Reynolds C. F. , Karp J. F. , Mayo A. , Ritenour A. , Kupfer D. J.
Published: July 2009

Synopsis

While the relationship of life events to depression onset has occupied researchers for almost a quarter of a century, few studies have attempted to account for either the temporal patterning of events relative to episode onset, or, the effect of multiple events in a study period. In this report, we attempt to address the issues of timing of events, multiple events (both positive and negative) and multiple aspects (both positivity and negativity) of single events on latency time to depression onset, while simultaneously accounting for possible decay in the effects of events over time. We use the proportional hazards approach to model the effects of life events and consider modelling the change in impact of events with the passage of time.

After interviewing 142 recurrent unipolar patients using the Life Events and Difficulties Schedule, we rated severity and positivity of life events reported during the 6-month period prior to onset. As we hypothesized, additional life events occurring after an initial provoking agent level event significantly alter the risk of illness onset. Additional severely threatening events decrease the time to onset, but positive events do not appear to delay onset. Interestingly, seemingly neutral events had a highly significant effect in shortening the time to onset. We note the many limitations imposed on the interpretation of these findings related to the selected group of subjects studied and encourage those who have more generalizable data to apply these methods of analysis.
Causal attributions about common somatic sensations among frequent general practice attenders
Authors: Sensky T. , MacLeod A. K. , Rigby M. F.
Published: July 2009

Synopsis

The causal attributions that people make about bodily symptoms or sensations are likely to influence their decisions whether or not to consult a doctor. Previous research has supported the model that people tend initially to look for external or environmental explanations for bodily sensations (normalizing attributions) and only if this process fails do they search for attributions internal to themselves (somatic or psychological attributions). This study tested two hypotheses about frequent general practice attenders: (1) compared with others, they are more likely to make somatic attributions and less likely to make normalizing ones; and (2) given a bodily symptom together with a somatic explanation, frequent attenders will have greater difficulty than others in finding reasons why the given (pathological) explanation is untrue. The frequent attenders' group had themselves initiated an average of 12 general practice visits in the 12 months before assessment, while a control group of infrequent attenders had not made appointments to see their general practitioner for an average of 24 months. The results provide partial support for the hypotheses. Frequent attenders generated significantly fewer normalizing explanations for a series of common bodily sensations than the comparison group, although the two groups did not differ in their somatic attributions. Given a common bodily sensation and an accompanying pathological explanation, the frequent attenders were less able than the control group to generate reasons why the given explanation might be untrue. Some associations were found between these measures and anxiety.
Changes in regional cerebral blood flow on recovery from depression
Authors: Bench C. J. , Frackowiak R. S. J. , Dolan R. J.
Published: July 2009

Synopsis

We have previously described focal abnormalities of regional cerebral blood flow (rCBF) in the left dorsolateral prefrontal cortex (DLPFC), anterior cingulate cortex and angular gyrus in 40 patients with major depression. We now report on the patterns of change in rCBF in a subgroup of 25 of the same patients who were rescanned following clinical remission of depression. Fifteen patients were scanned when optimally matched for drug treatment (4) or drug free on both occasions (11). The other 10 patients were fully recovered but could not be matched for drug status for clinical and ethical reasons. In a paired comparison of the same patients when ill and following recovery it was evident that remission was associated with a significant increase in rCBF in the left DLPFC and medial prefrontal cortex including anterior cingulate. Increases in rCBF in the angular gyrus were not seen when the comparison of depressed and recovered scans was matched for medication. The previously described relationship between clinical symptoms and brain perfusion in the depressed state was no longer present in the recovered state; this supports the hypothesis of state relatedness. Thus, recovery from depression is associated with increases in rCBF in the same areas in which focal decreases in rCBF are described in the depressed state in comparison with normal controls.
Relationship between family attitudes measured by the Semantic Differential and relapse in schizophrenia: a 2 year follow-up prospective study
Authors: Girón Manuel , Gomez-Beneyto Manuel
Published: July 2009

Synopsis

A prospective study was carried out to investigate the relationship between family attitudes and relapse in a cohort of 80 schizophrenic patients followed up for 2 years. A significant relationship was found between attitudes as measured by means of a semantic differential during hospitalization and later relapse. Lack of treatment compliance, negative symptoms, unemployment and poor pre-morbid adjustment were also associated with relapse. In a multivariate analysis some of these variables changed their predictive power but the association between attitudes and relapse was maintained.