bluuebunny/crossref_metadata_2025 huggingface dataset:
Morphology according to cranial computed tomography of first‐episode cycloid psychosis and its long‐term‐course: differences compared to schizophrenia
Authors: Höffler J. , Bräunig P. , Krüger S. , Ludvik M.
Published: November 2007

Cranial computed tomography (CCT) findings for 37 patients with cycloid psychosis and 19 patients with DSM‐III‐R schizophrenia were compared with findings for age‐ and sex‐matched controls. Schizophrenic patients showed enlarged ventricles compared both to controls and to patients suffering from cycloid psychosis. In patients with cycloid psychosis, neither at the first episode nor after many years (mean 16.6 years) of disease were significant differences found compared to control subjects. Over the course of the illness, patients with cycloid psychosis showed ventricular enlargement which was correlated with age but not with the duration of illness. The morphological differences provide further evidence for the proposed nosological distinction between cycloid psychosis and schizophrenia.
Tardive dyskinesia in older out‐patients: a follow‐up study
Authors: Labbate L. A. , Lande R. G. , Jones F. , Oleshansky M. A.
Published: November 2007

Tardive dyskinesia (TD) is a long‐term potential adverse effect of neuroleptic treatment, and older age has been correlated with the development of TD. We conducted a chart review of current out‐patients and examined annual Abnormal Inventory Movement Scale (AIMS) evaluations for the period 1987‐1995 for 43 patients who started neuroleptic treatment after the age of 35 years. Patients (mean age 67 years) began neuroleptic treatment at a mean age of 46 years and were taking neuroleptics for 18 years on average. A total of 18 patients (42%) met the research criteria for TD, of whom all cases were mild except for three, which were moderate. Although TD was common, it rarely progressed in this naturalistic setting, suggesting that even for older patients maintenance neuroleptic treatment may be feasible for chronic psychosis.
Subsyndromes of chronic schizophrenia: a phenomenological study
Authors: Arora A. , Avasthi A. , Kulhara P.
Published: November 2007

Statistical grouping of clinical symptoms and signs is one method of classifying schizophrenia. This study attempted to find factors of symptoms generated through clinical ratings on three scales, namely the Scale for the Assessment of Positive Symptoms (SAPS), the Scale for the Assessment of Negative Symptoms (SANS) and the Comprehensive Psychopathological Rating Scale (CPRS) in a sample of 80 stable chronic schizophrenics diagnosed by DSM‐III‐R. It was found that the positive‐negative dichotomy could not be replicated. Inappropriate affect was found to be a clear misfit in the cluster of negative symptoms. Inclusion of CPRS led to the generation of a factor loading high on depressive and asthenic items, and this could be clearly distinguished from the factor of negative symptoms. This factor had not hitherto been identified.
Depressive symptoms among international exchange students, and their predictors
Authors: Furukawa T.
Published: November 2007

The study described in the present paper prospectively examined the depressive symptoms displayed by a cohort of Japanese high school students (n= 144) before and during their 1‐year placements with volunteer host families in various countries under the aegis of an international cultural exchange programme. The subjects’level of depression showed a statistically significant increase 6 months after such a placement, but had returned to pre‐departure levels by the completion of their 1‐year placement. The variables that significantly predicted depressive symptoms during the placement in multiple regression analyses were the neuroticism score and the depressive symptoms measured prior to departure. However, the parental rearing practices and the fluency in the English language did not show a significant correlation. When measures of social support during the placement were entered, the perceived adequacy of social support was found to make an additional contribution to the prediction of depressive symptoms.
Prevalence of long‐term mental health care utilization in The Netherlands
Authors: Wiersma D. , Sytema S. , van Busschbach J. , Schreurs M. , Kroon H. , Driessen G.
Published: November 2007

The objective of this study is to estimate the proportion of the population in The Netherlands who receive long‐term care for chronic psychiatric problems. The care needs of this population are assessed in terms both of diagnosis and of specific impairments and disabilities. Data from three surveys and two psychiatric case registers in five different areas of The Netherlands provide an estimate of about 3.5 long‐term users of psychiatric care per 1000 members of the population aged 20 years or over. One‐third of them receive a diagnosis of schizophrenia and related psychotic disorders. Patients most frequently suffer from impairments of mood and affect, volition and drives. Nearly all patients are disabled in their occupational role (work), and about half of the population have problems with self‐care and household tasks. Long‐term care is to a large extent (40%) provided in hospitals and sheltered accommodation, and the role of day services is relatively insignificant.
The prediction of suicidal intent in depressed patients
Authors: van Gastel A. , Schotte C. , Maes M.
Published: November 2007

The aim of the present study was to examine the relationships between suicidal ideation or suicidal attempts and severity of depression, presence of personality disorders, and sociodemographic factors in a population of depressed in‐patients. A total of 338 adult depressed psychiatric in‐patients were examined and classified according to DSM‐III criteria as having major depression with or without melancholic or psychotic features, adjustment disorder with depressed mood or dysthymic disorder. Scores on the Hamilton Depression Rating Scale (HDRS), Beck Depression Inventory (BDI) and Zung Self‐Rating Depression and Anxiety Scales (SDS and SAS) were measured. We found that suicidal ideation was significantly related to severity of depression (according to the HDRS and all self‐rating scales), a lower global assessment of functioning the year before hospitalization, and previous psychiatric hospitalizations. The items with the strongest predictive value for suicidal ideation were hopelessness, depressed mood, feelings of guilt, loss of interest and low self‐esteem. These symptoms predicted 43% of the variance in suicidal ideation. None of the above predictors of suicidal ideation was related to suicidal attempts. Depressed patients with a personality disorder attempted significantly more suicidal attempts and showed more suicidal ideation than depressed patients without personality disorder. No significant correlations were found between suicidal ideation or suicide attempts and gender, marital status, employment status or psychosocial stressors during the previous 6 months.
Dysfunctional parenting and a lifetime history of depression in a volunteer sample of Japanese workers
Authors: Sato T. , Uehara T. , Sakado K. , Nishioka K. , Ozaki N. , Nakamura M. , Kasahara Y.
Published: November 2007

This study explored whether dysfunctional parenting, as measured by the Parental Bonding Instrument, is linked to a lifetime diagnosis of major depressive disorder (MDD) provided by the Inventory to Diagnose Depression, Lifetime Version, in a non‐clinical sample from a non‐Western culture. Of a total of 239 Japanese volunteer workers, 22 subjects were diagnosed as having had lifetime MDD. Subjects with lifetime MDD reported a significantly lower ‘maternal care’ score than did those without lifetime MDD. Logistic regression analysis revealed that subjects who reported a lower‘maternal care’score were at a significantly higher risk for lifetime MDD. The results suggest that the link between dysfunctional parenting and MDD may be independent of cultural differences, lending some support to the hypothesis that dysfunctional parenting in childhood may cause adult depression.
Are sleep disturbances risk factors for anxiety, depressive and addictive disorders?
Authors: Gillin J. C.
Published: November 2007

This paper reviews recent literature which suggests that sleep disturbance in members of the general population, whether or not they have ever had a formal psychiatric disorder, is a risk factor for the onset of a formal psychiatric diagnosis at a later time. Based upon the current literature, the strongest link is between subjective insomnia, lasting at least 2 weeks, and the later onset of depression. Less well‐established data suggest that lifetime reports of at least 2 weeks of insomnia, hypersomnia, or both hypersomnia and insomnia, are risk factors for the later development of depression, anxiety disorders or substance abuse. More tentatively, preliminary data suggest that increasing subjective sleep disturbance may signal a relapse in remitted depressed patients. Sleep disturbances are common manifestations of major depressive and anxiety disorders. Therefore, sleep complaints may be among the most robust prodromal symptoms reflecting partial depressive or anxiety disorders, which eventually declare themselves as full‐blown clinical episodes.
Towards a genetics of anxious temperament: from mice to men
Authors: Gershenfeld H. K. , Paul S. M.
Published: November 2007

An enduring question in the study of human personality is ‘to what extent and how do genetic factors influence such personality constructs as “trait anxiety”?’. We selectively survey progress and obstacles in the genetic dissection of fear‐like behavior, especially as it pertains to more constitutional forms of anxiety or anxious temperament. We emphasize the selection of phenotypic dimensions and the utility of ‘temperament’ and personality constructs as mediating variables for psychopathology. We summarize studies on the use of mouse models of ‘anxious temperament’ to map genetic loci, and briefly review recent genetic association studies of related phenotypes in humans utilizing candidate genes. We suggest that further progress in genetic research on ‘trait anxiety’ disorders may come from the following: (i) developing alternate constructs for investigating psychiatric illness focusing on dimensional scales, mediating variables and premorbid traits: (ii) examining ‘at‐risk’ populations for protective genetic factors influencing ‘resilience’ or loci providing a reduced risk of a given trait or disorder; and (iii) utilizing lower animal models as a bridge to dissect the genetic factors contributing to related human phenotypes.
Recent clinical trials of hydroxyzine in generalized anxiety disorder
Authors: Ferreri M. , Hantouche E.‐G.
Published: November 2007

Numerous clinical trials in the 1960s and 1970s have attested to the anxiolytic efficacy of hydroxyzine and its beneficial effect on sleep, as well as in reducing stress and anxiety associated with coronary disease. Experience with hydroxyzine has also shown a lack of organ toxicity and an absence of dependency. Recent controlled clinical trials with hydroxyzine have confirmed its efficacy (at a fixed dose of 50 mg) in generalized anxiety disorder superiority over placebo on all anxiety measures from the first week with early target symptoms which are grouped in a cognitive component of anxiety. Efficacy was maintained throughout the 4 weeks of treatment and after abrupt discontinuation. In another controlled trial vs. lorazepam, hydroxyzine demonstrated greater and more rapid cognitive improvement.
Parasuicide and mental disorders
Authors: de Castro E. Ferreira , Cunha M. A. , Pimenta F. , Costa I.
Published: November 2007

This study aims to provide a better follow‐up of parasuicidal subjects, focusing on their diagnostic profile with regard to whether the parasuicide intention was death or not. A total of 235 parasuicidal out‐patients (PS) and a comparison group of 235 non‐parasuicidal out‐patients (CG) were surveyed. A structured interview was applied to both groups. Parasuicide intention was appraised by means of the Suicide Intent Scale of Beck. The PS patients were divided into two groups, depending on whether their intention was death (PSD) or not (OPS), and they were matched with their CG counterparts. The diagnostic profile of each group was analysed and differences in diagnosis distribution were found. The rates of major depression, alcohol dependence and schizophrenia were higher among PSD than in OPS patients. The same was true for comorbidity of major depression and alcohol dependence. On Axis II, borderline personality ranks first among PSD patients. The diagnostic profile of PSD approaches that of completed suicide as shown in retrospective and prospective studies. The methodology employed here could therefore be recommended for estimating parasuicide intention. As well as the diagnosis, a detailed profile could also be obtained in the light of that intention. Bearing in mind such a profile among PSD patients could contribute to a drop in the suicide rate among these subjects.
Chronic patients in psychiatric institutions: psychopathology, level of functioning and need for care
Authors: Ruud T. , Martinsen E. W. , Friis S.
Published: November 2007

A total of 107 chronic in‐patients in a catchment area of 106000 inhabitants were rated for psychopathology on the Brief Psychiatric Rating Scale expanded version (BPRS‐E), for level of functioning on the Rehabilitation Evaluation Hall And Baker (REHAB), and for geriatric problems on the Geriatric Rating Scale (GRS). The results showed low levels of severe psychopathology and low to moderate levels of functioning, indicating that the main obstacle to community placement was the lack of functioning. Global assessment by ward nurses with regard to the future level of care needed divided the patients into three categories: 40 patients in need of a psychiatric nursing home, 30 patients in need of a general nursing home, and 37 patients who could potentially be discharged to apartments with community support. This study indicates that the REHAB may help to identify patients who are potential candidates for community placement, while the BPRS‐E may help to identify patients who are still in need of care in a psychiatric institution.
Age at onset of delusional disorder is dependent on the delusional theme
Authors: Yamada N. , Nakajima S. , Noguchi T.
Published: November 2007

The main aim of this study was to investigate whether or not subtypes of delusional disorder diagnosed by DSM‐III‐R show differences in age at onset and sex distribution. All out‐patients first seen at the psychiatry clinic between 1989 and 1994 were diagnosed by DSM‐III‐R. Of 4144 out‐patients, 51 patients (1.2%) were selected as having delusional disorder, and the demographic data and clinical profiles for these subjects were evaluated prospectively by the psychiatrists. Females outnumbered males by a ratio of 3:1. The type of delusional disorder most frequently encountered was the persecutory type, followed by the somatic type, jealous type and unspecified type. The age at onset differed significantly according to the type of delusional disorder, the oldest age at onset being associated with the persecutory type, and the youngest with the somatic type.
Double‐blind study of the efficacy and safety of milnacipran and imipramine in elderly patients with major dipressive episode
Authors: Tignol J. , Pujol‐Domenech J. , Chartres J. P. , Léger J.‐M. , Plétan Y. , Tonelli I. , Tournoux A. , Pezous N.
Published: November 2007

The novel antidepressant agent milnacipran is a dual and equipotent serotonin and noradrenaline reuptake inhibitor. The aim of this double‐blind study was to compare the efficacy and safety of milnacipran (50 mg twice daily) with that of imipramine (50 mg twice daily) in elderly patients with major depressive episode. A total of 219 patients were randomly assigned to 8 weeks of double‐blind treatment with either milnacipran or imipramine; 72 patients withdrew from the study. At the end of treatment no significant differences were found between milnacipran and imipramine in antidepressant efficacy. A significantly greater number of side‐effects, particularly anticholinergic effects, was observed in the imipramine group. Milnacipran may be preferable to imipramine in elderly depressed patients, as it provides the same antidepressant activity as imipramine with a lower incidence of side‐effects, and does not impair cognitive ability.
Eating disorders and insulin‐dependent diabetes mellitus (IDDM): relationships with glycaemic control and somatic complications
Authors: Friedman S. , Vila G. , Timsit J. , Boitard C. , Mouren‐Siméoni M. C.
Published: November 2007

This study was designed to assess (by means of a diagnostic interview based on DSM‐III‐R criteria) the prevalence of eating disorders in 69 insulin‐dependent diabetic (IDDM) out‐patients, and the relationship with somatic risks. We found no cases of anorexia nervosa or bulimia nervosa, current or lifetime, in male patients with IDDM. No female patients with IDDM had anorexia, and 4.8% had current and lifetime bulimia. Eating disorders not otherwise specified (bulimic type) were significantly more frequent in women than in men (lifetime incidence 43% vs. 21%; current incidence 33% vs. 5%), and generally occurred after the onset of IDDM. Self‐reports of bulimic behaviours according to the Bulimic Investigatory Test of Edinburgh (BITE) were associated with high levels of glycosylated haemoglobin. There was no association between eating disorders (current or lifetime), with somatic complications being more likely to be explained by a long duration of illness and impaired glycaemic control.
Amitriptyline vs. lorazepam in the treatment of opiate‐withdrawal insomnia: a randomized double‐blind study
Authors: Srisurapanont M. , Jarusuraisin N.
Published: November 2007

Benzodiazepine use in the treatment of insomnia may cause benzodiazepine dependence, especially in opiate users. The aim of this study was to investigate the sedative‐hypnotic effects of amitriptyline in treating opiate‐withdrawal insomnia. A total of 27 patients with opiate withdrawal were given either amitriptyline or lorazepam in a randomized double‐blind trial. Sleep was assessed by means of the Sleep Evaluation Questionnaire and three insomnia items of the Hamilton Depression Rating Scale. The scores of two sleep measures showed that all aspects of sleep, except for ease of awakening from sleep, in the two treatment groups were not significantly different. In conclusion, apart from the hangover effect, amitriptyline is as effective as lorazepam in the treatment of opiate‐withdrawal insomnia.
Possible antecedents of DSM‐III‐R personality disorders
Authors: Modestin J. , Oberson B. , Erni T.
Published: November 2007

In order to extend our knowledge of the effects of environmental influences upon personality disorder (PD) pathology, childhood traumatic events and parental bonding were studied in 90 PD in‐patients of both sexes. Childhood traumatic experiences (primarily physical and/or sexual abuse) and parental bonding dimensions were correlated with PD pathology depending on PD type and cluster. Important differences were found between the sexes. The quality of the paternal relationship (high control, low care) was significantly associated with PD pathology in men, whereas childhood traumatic experiences and the quality of maternal parenting were associated with PD pathology in women. The study of traumatic events such as childhood abuse has recently been the focus of considerable attention. More emphasis in empirical research needs to be given to parental relationships, especially in the case of men.
Semiology and subtyping of panic disorders
Authors: Seguí J. , Salvador‐Carulla L. , García L. , Canet J. , Ortiz M. , Farré J. M.
Published: November 2007

To date, the quantitative psychopathology of panic disorder (PD) has been less well studied than that of other psychiatric conditions such as schizophrenia or major depression. The aim of the present study was to assess the frequency and factorial grouping of symptoms in a naturalistic sample of PD patients. A total of 274 consecutive cases of PD who contacted an out‐patient clinic in Barcelona, Spain were assessed by two experienced interviewers. The assessment instruments included the Structured Clinical Interview for DSM‐III‐R Upjohn version (SCID‐UP‐R) and an inventory of panic attack symptoms based on DSM‐III‐R. Of the patients who presented at the unit during the assessment period, 8.5% presented with PD. Palpitations, shortness of breath, fear of dying and dizziness were the most frequent and intense symptoms reported by the PD patients. Principal‐component analysis revealed four factors which accounted for 57% of the variance, including‘cardiorespiratory’(26.1%) and‘vestibular’(15.1%) factors, and two additional factors with mixed symptoms. The frequency of presentation of symptoms was similar to that reported in other studies. However, some discrepancies were observed that may be attributed to transcultural differences as well as to terminological problems and the range of symptoms assessed. These factors may also explain some of the differences found in factor analysis groupings in previous studies. Our findings support the symptom subtyping of PD.
Blood levels of cytokines in elderly patients with major depressive disorder
Authors: Brambilla F. , Maggioni M.
Published: November 2007

Plasma concentrations of interleukin‐iβ (IL‐lβ), interleukin‐6 (IL‐6) and tumour necrosis factor a (TNFα) were measured in 10 elderly women with major depressive disorder (MDD) and in two groups of controls, one consisting of 10 age‐matched healthy female volunteers and one consisting of 10 young healthy female volunteers. The cytokine concentrations were measured in MDD patients before and after 30 days of treatment with phosphatidylserine (BC‐PS), 600 mg daily p.o. The plasma IL‐1β IL‐6 and TNFα concentrations did not differ significantly in young controls, elderly controls and MDD patients. BC‐PS therapy, while significantly improving the depressive symptoms, did not alter the cytokine concentrations.
Sex difference in age at onset of schizophrenia: discrepant findings from India
Authors: Murthy G. V. S. , Janakiramaiah N. , Gangadhar B. N. , Subbakrishna D. K.
Published: November 2007

Consecutive male (n=100) and female (n= 100) DSM‐IV schizophrenics newly registered for treatment in a large psychiatric hospital were examined with regard to age at onset of the first psychotic symptom. Age at onset of the first psychotic symptom did not differ between the sexes regardless of whether schizophrenia was diagnosed by DSM‐IV or by several alternative systems. Age at onset defined by other criteria, namely age at first contact with a physician, and age at first admission for psychiatric care, also did not show any differences between the sexes. Survival analysis of subjects having a documented date of birth revealed a female preponderance at younger ages. A higher positive symptom score predicted older age at onset of the first psychotic symptom in the total sample. These findings call into question the universality of the traditional view of a younger age at onset of schizophrenia among males. Tentative neurodevelopmental and cultural explanations are presented to explain why there is no sex difference in age at onset of schizophrenia in India.
Anticipation and imprinting in Spanish families with schizophrenia
Authors: Valero J. , Martorell L. , Mariné J. , Vilella E. , Labad A.
Published: November 2007

Evidence of imprinting and anticipation, two genetic phenomena that are correlated with clinical sequelae, was assessed in familial schizophrenia. A sample of patients (n=291) who fulfilled the ICD‐9 criteria for schizophrenia and corresponding to the familial‐type and sporadic‐type of the disorder was recruited. Clinical anticipation and imprinting variables such as age at onset (AAO), schizophrenia subtype, course of disease and onset type were assessed over parental (G1) and filial (G2) generations in both schizophrenia types. Anticipation assessment indicated significant differences in mean AAO between parent‐offspring pairs in unilineal families. These differences were not explained by a cohort effect. Imprinting assessment indicated nonsignificant differences in AAO between the offspring of affected mothers and the offspring of affected fathers. The results obtained for other clinical variables were non‐conclusive. The results suggest that anticipation, but not imprinting, is operative in schizophrenia.
Eye movements in patients with schizophrenia: visual stimuli, semantic content and psychiatric symptoms
Authors: Ishizuka K. , Kashiwakura M. , Oiji A.
Published: November 2007

In order to explore a possible association between psychiatric symptoms and eye movements, 32 patients with schizophrenia were examined using an eye mark recorder in combination with the Positive and Negative Syndrome Scale, and were compared with 32 controls. Four types of figures were presented to the subjects: geometrical figures, drawings, story drawings, and sentences. Mean eye fixation time was significantly longer and mean eye scanning length was significantly shorter for the patients than for controls, not only in response to the geometric figures, but also in response to the story drawings. Eye fixation time and scanning velocity were positively correlated with degrees of thought disturbance. The number of eye fixations, eye fixation time and scanning velocity were negatively correlated with degree of depressive tendency.
Serotonergic‘vulnerability’ in affective disorder: a study of the tryptophan depletion test and relationships between peripheral and central serotonin indexes in citalopram‐responders
Authors: Åberg‐Wistedt A. , Hasselmark L. , Stain‐Malmgren R. , Apéria B. , Kjellman B. F. , Mathé A. A.
Published: November 2007

A double‐blind study of the tryptophan depletion (TD) challenge was performed on a sample consisting of 20 patients with a major depressive disorder in clinical remission after citalopram treatment. TD was induced by the intake of 43 g of an amino acid mixture containing the five large neutral amino acids. The control group received the same mixture, to which 2.3 g tryptophan had been added. Five of the 12 challenged patients showed a worsening of depressive symptoms during the day of the test. In contrast, there was no mood alteration in the eight control patients. Baseline Cortisol levels were significantly higher in responders to TD compared to those in non‐responders and controls. Platelet serotonin‐receptor function and plasma prolactin levels were correlated. There was a significant positive correlation in the baseline data between rated mood state and plasma Cortisol and a significant inverse correlation between related mood state and plasma tryptophan concentration. Thus low mood appeared to be associated with low serotonin precursor availability as well as with high Cortisol levels.
Comorbidity between obsessive‐compulsive disorder (OCD) and personality disorders
Authors: Bejerot S. , Ekselius L. , van Knorring L.
Published: November 2007

The aims of the present study were to examine the frequency of personality disorders in 36 patients with obsessive‐compulsive disorder (OCD), and to investigate whether patients with a coexisting personality disorder could be characterized by certain personality traits assessed by means of the Karolinska Scales of Personality (KSP). In total, 27 (75%) of the OCD patients fulfilled the DSM‐III‐R criteria for a personality disorder, and 13 patients (36%) had an obsessive‐compulsive personality disorder. Subjects with a comorbid personality disorder had significantly higher scores on most of the KSP scales, including all anxiety scales, as well as scales measuring indirect aggression, irritability, guilt and detachment, whereas subjects without personality disorders did not differ significantly from healthy controls with regard to personality traits.
Childhood parental loss and alcohol dependence among Japanese men: a case‐control study
Authors: Furukawa T. , Harai H. , Hirai T. , Fujihara S. , Kitamura T. , Takahashi K. ,   Group for Longitudinal Affective Disorders Study (GLADS)
Published: November 2007

There have been many studies in the literature examining childhood parental loss as a risk factor for adult psychiatric disorders such as depression, schizophrenia or anxiety disorders. However, with regard to alcohol dependence, only a limited number of such studies exists, and these have reported inconsistent findings. The present paper aims to examine the relationship between early parental loss and subsequent development of alcohol dependence among Japanese men. We directly interviewed 75 men with alcohol dependence (according to DSM‐III‐R), who were visiting 23 psychiatric hospitals and clinics all over Japan, and 52 healthy controls without any lifetime psychiatric diagnosis, drawn from a general population. When stratified for sex and age, there was no statistically significant difference between the patients and the controls in the rates of maternal or paternal death or separation before the age of 16 years. These findings and the review of the literature suggest that the relationship between childhood parental loss and alcohol dependence is not a straightforward one.
The Extended Staff Observation Aggression Scale (SOAS‐E): development, presentation and evaluation
Authors: Hallsteinsen A. , Kristensen M. , Dahl A. A. , Eilertsen D. E.
Published: November 2007

The Staff Observation Aggression Scale (SOAS) was developed as a scale for reporting aggressive incidents involving psychiatric in‐patients. The SOAS — Extended Version (SOAS‐E) has the same aim, but has additional categories and subcategories. The SOAS‐E clearly distinguishes between violent and non‐violent aggressive behaviour and characterizes in more detail the associated situation. However, the main contribution of the SOAS‐E is the introduction of a category of‘warning signals’ that precede the releasing‘provocation factor’ as a separate and primary aspect of the cyclus of aggressive incidents. The development of the SOAS‐E is described, and the testing and inter‐rater reliability of the warning signals category are examined. Compared to the SOAS, the additional categories of the SOAS‐E are found to increase the scope for a detailed characterization of aggressive behaviour in psychiatric wards.
Regional cerebral blood flow in first‐episode schizophrenia patients before and after antipsychotic drug treatment
Authors: Livingston M. G. ,   Scottish Schizophrenia Research Group
Published: November 2007

A total of 38 patients in a first presentation of schizophrenia prior to drug treatment underwent a single photon emission computerized tomography (SPECT) scanning programme whilst undertaking a verbal fluency task. Their scans were compared with those of 38 normal volunteer controls matched for age, sex and father's social class. Schizophrenic patients displayed a trend towards a reduced blood flow in comparison with controls. Comparing right with left hemispheres, asymmetrical blood flow patterns were more likely to be found in patients in frontal regions than elsewhere. When 27 of the 38 patients underwent a repeat SPECT scanning programme after receiving 6 months of antipsychotic drug treatment, the hypofrontal blood flow pattern persisted. Increased blood flow was observed bilaterally in the putamen. The more symmetrical blood flow pattern of the patients compared to the control subjects did not alter substantially.
Body image and psychopathology in adolescence: a controlled clinical study
Authors: Laukkanen E. , Lehtonen J. , Amnell G. , Viinamäki H.
Published: November 2007

The aim of this study was to investigate mentally disturbed adolescents’ problems of acknowledging and accepting the physical changes and sexual maturation of their bodies, in comparison with healthy adolescents. The study sample consisted of 60 adolescents (30 boys and 30 girls), 15–18 years of age, who had been referred for psychiatric examination, and 60 healthy controls, matched on the basis of age, sex, place of residence and level of education. The study methods were the self‐rated questionnaire and psychiatric in‐depth interview modified on the basis of the diagnostic profile of adolescents. Mentally disturbed adolescents had more negative attitudes towards developmental body changes than healthy adolescents. They were unable to describe the physical changes they had undergone. Healthy adolescents were more aware of developing sexual characteristics. On discriminant analysis, independent background variables explaining problems relating to sexual maturation in mentally disturbed adolescents were found to be a lack of or low number of peer relationships, and long‐term stress. In the healthy adolescents, independent variables associated with problems in sexual maturation were found to be a lack of or low number of peer relationships and a single‐parent home. We conclude that adolescents with psychiatric problems seem to have a poorer capacity to process mentally the ongoing bodily and sexual maturation of their bodies than matched healthy controls.
Improvement of inter‐rater reliability of PANSS items and subscales by a standardized rater training
Authors: Müller M. J. , Wetzel H.
Published: November 2007

The present evaluation focused on the inter‐rater reliability of single items and subscales of the Positive and Negative Syndrome Scale (PANSS) before and after a standardized rater training. The results of two independent studies comprising n=23 (study I) and n= 12 (study II) psychiatrists and videotaped interviews with schizophrenic patients were analysed. Chance‐corrected coefficients of rating agreement with expert standards (weighted κ) were computed for single items and subscales of the PANSS. The results clearly demonstrate the importance of rater trainings. After three training sessions, 90% of the PANSS items reached an acceptable level of reliability (κw>0.40) in both evaluated studies, and for 80% of the PANSS items values of κw>0.60 were achieved.
Computerized self‐assessment in psychiatric in‐patients: acceptability, feasibility and influence of computer attitude
Authors: Weber B. , Fritze J. , Schneider B. , Simminger D. , Maurer K.
Published: November 2007

In recent years various approaches using computerized assessments and tests in psychiatry have been published. In our study, the acceptability and feasibility of computerized self‐assessments and attitude to computers were examined in psychiatric in‐patients, using an improved interactive schedule, the Interactive Self‐Assessment Scale (ISAS), based on the Windows™ operating system. In general we found a good level of acceptability and feasibility of the computerized self‐assessment. Our results confirm the influence of attitude to computers on acceptability, and indicate a lack of self‐confidence in interacting with computers, accompanied by a less positive attitude to computers than reported by healthy subjects and psychiatric out‐patients. Computerized self‐assessment is suitable for psychiatric in‐patients. Nevertheless, further research is necessary in order to improve attitude to computers and the patient‐computer interaction.
Debriefing with brief group psychotherapy in a homogenous group of non‐injured victims of a terrorist attack: a prospective study
Authors: Amir M. , Weil G. , Kaplan Z. , Tocker T. , Witztum E.
Published: November 2007

This study describes a follow‐up of 15 non‐injured women, all from the same socio‐economic background, who were exposed to a terrorist attack in Israel. All of the women participated in group debriefing with brief group psychotherapy, involving six meetings during the first 2 months following the event. Two days after the attack, and 2 months and 6 months after the event, the women were administered a post‐traumatic stress disorder (PTSD) diagnostic scale, the Impact of Event Scale (IES) and the SCL‐90. At 6 months, four subjects (27%) were diagnosed with full PTSD. The IES showed significantly higher scores at the first measure than at the other two measures. Furthermore, the phobic anxiety subscale score immediately after the event was significantly associated with the General Severity Index of the SCL‐90 and the severity of PTSD symptomatology at 6 months. The present paper discusses the effectiveness of psychological intervention following trauma, and raises questions concerning the need to invest public resources in this kind of intensive intervention. Suggestions are proposed regarding the desired emphasis of the psychological treatment in order to improve its benefits to victims.
Personality disorders and relationship to personality dimensions measured by the Temperament and Character Inventory in patients with obsessive‐compulsive disorder
Authors: Bejerot S. , Schlette P. , Ekselius L. , Adolfsson R. , von Knorring L.
Published: November 2007

The occurrence of personality disorders was investigated in 36 patients with obsessive‐compulsive disorder by means of the SCID Screen questionnaire. In addition, the personality dimensions were explored by means of the Temperament and Character Inventory (TCI). In total, 75% of the patients fulfilled the criteria for a personality disorder according to the SCID Screen questionnaire, mostly (55%) within cluster C. Several significant correlations were found between the separate personality disorders (PD) and subscales of the TCI, the most pronounced being between avoidant and obsessive‐compulsive PD and novelty‐seeking and self‐directedness. Strong correlations were also found between self‐directedness and paranoid and borderline PD. In multiple regressions where the presence of PD in clusters A, B and C, respectively, were used as dependent variables and where the separate subscales of the TCI were used as independent variables, the multiple R reached 0.68, 0.76 and 0.80 in clusters A, B and C, respectively. Thus 46–64% of the variance in the personality disorder clusters could be explained by the TCI subscales.
The different uses of day hospitals
Authors: Mbaya P. , Creed F. , Tomenson B.
Published: November 2007

A 1‐day census was performed on 341 patients at 10 day hospitals in a UK Region to compare day hospitals and to predict length of stay. Only 13% of day hospital places were used as an alternative to in‐patient admission. The majority of places were used for ‘rehabilitation’, but nearly half of the patients with psychotic disorders were only receiving general support — such patients could have their needs served in a day centre. In total, 40.2% of the variation in length of stay could be explained on multiple regression. Even when age, diagnosis and source of referral were accounted for, there remained significant variation in length of stay reflecting the stated policy of each hospital. These findings are in contrast to similar analyses of in‐patient data. If psychiatric day hospitals are to be used as a cost‐effective alternative to in‐patient admission, many of them would need to change their policy.
Once vs. three times weekly ECT in melancholia: a randomized controlled trial
Authors: Janakiramaiah N. , Motreja S. , Gangadhar B. N. , Subbakrishna D. K. , Parameshwara G.
Published: November 2007

Once weekly and three times weekly schedules of ECT, each at two stimulus dose levels (high and low), were compared for therapeutic efficacy in melancholia. Three times weekly ECTs were more efficacious than once weekly ECTs. A high stimulus dose did not enhance the efficacy of once weekly ECTs. However, the patients who remitted did so over a comparable time‐course regardless of the ECT schedule. Although three times weekly ECTs are superior, 55% of patients responded to once weekly ECTs. There is therefore a need for research to identify the patients for whom once weekly ECT may be sufficient.
The fate of chronic in‐patients after closure of psychiatric nursing homes in Norway: a personal follow‐up 6 years later
Authors: Martinsen E.W. , Ruud T. , Borge L. , Watne O. , Friis S.
Published: November 2007

We evaluated all 107 chronic in‐patients in a catchment area before and 6 years after a planned reduction in the number of psychiatric institution beds was implemented. At follow‐up, 32 of the patients had died. One had probably committed suicide, while the others were elderly people who had died of natural causes. In the remaining patients the level of functioning was low, and below that which could be deduced from their level of symptoms, which was also low. The majority of the patients still lived in institutions, mostly in general nursing homes. Among those who had moved out, there were non‐significant trends towards a reduction in symptoms and an increase in functioning. In general, the patients were satisfied with their new accommodation. Most of them needed extensive help and support to establish an acceptable standard of living in the community.
Effectiveness of cognitive therapy with coping training for persistent auditory hallucinations a retrospective study of attenders of a psychiatric out‐patient department
Authors: Jenner J. A. , van de Willige G. , Wiersma D.
Published: November 2007

Recent studies have suggested positive effects of cognitive therapy on psychotic symptoms. However, the effects of coping training are less clear, and generalization to daily functioning has not been attempted for either intervention. A total of 40 patients with therapy‐refractory auditory hallucinations received standard care plus cognitive therapy with coping training. In a retrospective, descriptive study, multiple assessments of outcome were measured. The experimental therapy seems to improve both overall symptomatology and quality of life, and is acceptable to both patients and relatives. Generalization to daily functioning and continuation over time was observed. Improvements with regard to the occurrence of hallucinations, fear, disturbance of thought, social interactions and daily activities were significant. Complete disappearance of hallucinations occurred in 20% of participants, and in 40% of those who were regularly discharged from treatment. The level of satisfaction with therapy was high (78%), and the drop‐out rate was low (9%). Improvement was not significantly correlated with psychiatric diagnosis (schizophrenia vs. other diagnoses), and was sustained at follow‐up after 1 year.
Mental health services and research in the Arab world
Authors: Okasha A. , Karam E.
Published: November 2007

Although there are 22 Arab countries in the Arab League, the mental health services provided in those countries show several forms of variation. Economic, political, social and cultural factors seem to play a major role in determining the state of the psychiatric profession and the access of the service to citizens. The different needs expressed by Arab colleagues at times seem incompatible with the available allocated resources. Some Arab countries enjoy the highest income per capita, yet this is inconsistent with the quality of mental health services available there. The per capita mental health services, the availability of a Mental Health Act, and the space allocated for mental health in medical curricula are but a few of the concerns that have been expressed by colleagues from the different countries of the Arab region. The following review will attempt to draw up a profile of the situation for mental health services and research in the region, and to suggest some measures for intervention.
Debt and suicidal behaviour in the Finnish general population
Authors: Hintikka J. , Kontula O. , Saarinen P. , Tanskanen A. , Koskela K. , Viinamäki H.
Published: November 2007

We studied the significance of debt as a risk factor for suicidal ideation and suicide attempts in a nation‐wide sample (n= 4868) of the Finnish general population. Those experiencing difficulties in repaying their debts more often than others (37 vs. 16%, P > 0.001) had a probable minor mental disorder (GHQ‐12 score 3≥3). Nevertheless, difficulties in repaying debts were found to be a factor independently associated with suicidal ideation (OR, 2.8; 95% CI, 1.9–4.2). The clinical implication of these findings is that individuals experiencing difficulties in repaying their debts may require psychiatric evaluation as well as socio‐economic counselling.
A combined analysis of double‐blind studies with risperidone vs. placebo and other antipsychotic agents: factors associated with extrapyramidal symptoms
Authors: Lemmens P. , Brecher M. , van Raelen B.
Published: November 2007

Combined data from double‐blind risperidone studies were used to analyse the severity of extrapyramidal symptoms (EPS) associated with treatment in patients with chronic schizophrenia. Factors associated with maximum EPS severity were increasing risperidone dose (≤8 mg/day was similar to placebo), lower baseline EPS scores, and longer duration of psychotic symptoms, particularly in older patients. EPS severity was significantly greater in patients receiving haloperidol or other antipsychotics than in those receiving risperidone (4 to 8 mg/day) or placebo. Antiparkinsonian medications were required by significantly fewer patients treated with risperidone (4 to 8 mg/day) than by patients treated with haloperidol or other antipsychotics. Combined efficacy data showed that 4 to 8 mg/day was also the most efficacious dose range; there was no increase in efficacy with doses over 4 mg/day. Based on these data and post‐marketing experience, 4 mg/day is an appropriate initial target dose for most patients with schizophrenia. Higher doses may be appropriate for patients with chronic illness, and lower doses may be appropriate for patients with a first psychotic episode or for elderly patients.
Are risk factors for suicide universal? A case‐control study in India
Authors: Vijayakumar L. , Rajkumar S.
Published: November 2007

Objective: The majority of suicides in India occur in the young. Indian society, religion and culture are very different to those in the West. The aim of the present study was to identify the risk factors for completed suicide.

Method A population‐based case‐control study employing the ‘psychological autopsy’ technique was conducted. In total, 100 completed suicides and 100 neighbourhood controls were studied.

Results: The odds ratios for the risk factors were 19.5 (CI, 7.32–73.35) for presence of an Axis I disorder, 12.75 (CI. 4.69–48.59) for family history of psychopathology and 15.1 (CI, 2.4–93.9) for life events in the previous month.

Conclusion: The presence of an Axis I disorder, family history of psychopathology and recent life events were all found to be significant risk factors. These findings suggest that risk factors for completed suicide are universal across countries and cultures.
Symptom classification of schizophrenia changes with the duration of Illness
Authors: Hori A. , Tsunashima K. , Watanabe K. , Takekawa Y. , Ishihara I. , Terada T. , Uno M.
Published: November 2007

Our starting hypothesis was that schizophrenic symptomatology changes over time. This hypothesis explains conflicting reports 011 schizophrenic symptom structures as a consequence of different durations of illness in the samples studied to date. Therefore a sample of ‘258 schizophrenic in‐patients (with ICD‐10 diagnoses F20) was categorized according to illness duration. A factor analysis was performed on the 8 items of the Manchester Scale for three subgroups (duration < 10 years, 10‐20 years and ≥ 20 years). For those patients whose illness duration was less than 10 years, ‘formal thought disorder’ was not related to any other mental state, whereas for those whose duration was 10 years or longer, it was correlated with ‘negative symptoms’. In the < 10 years group, ‘anxiety and depression syndrome’ and ‘positive symptoms’ formed one complex, but these symptoms were separated into two distinct syndromes in the ≥20 years group. Thus we were able to demonstrate that the classification of symptoms changes with increasing duration of illness.