bluuebunny/crossref_metadata_2025 huggingface dataset:
Schizophrenia with Good and Poor Outcome II: Cerebral Ventricular Size and its Clinical Significance
Authors: Williams A. O. , Reveley M. A. , Kolakowska T. , Ardern M. , Mandelbrote B. M.
Published: August 2008

Computed tomography brain scans were carried out on 40 patients with schizophrenia or schizo-affective disorder of 2–20 years duration. Ventricular-brain ratio (VBR) was significantly greater than that of the control group. In six patients the VBR exceeded the control mean + 2 s.d. Among the 13 whose VBR was more than 1 s.d. above the control mean, none had schizo-affective disorder, all but one had chronic illness, and patients with negative symptoms and those with premorbid schizoid traits were over-represented. VBR was unrelated to medical history, age, duration of illness, or neuroleptic treatment. It was not associated with neurological ‘soft’ signs or cognitive deficit. Among chronic patients, clinical features showed no association with ventricular size. The findings suggest that large ventricles may be related to a sub-type of chronic schizophrenia rather than to its particular clinical features.
Close Encounters in General Practice: Experiences of a Psychotherapy Liaison Team
Authors: Wilson Stephen , Wilson Katherine
Published: August 2008

Experiences arising from the work of a multi-disciplinary psychotherapy liaison team in the primary care setting are described. Special emphasis is given to the difficulties encountered in working relationships. Attention is drawn to the complexity of the inter-professional relationship, its unconscious roots, and its influence on the quality of patient care.
A Relapsing Folie à Trois
Authors: Fernando F. P. , Frieze M.
Published: August 2008

A case of folie à trois affecting a mother and her children is described. The subjects fully recovered with treatment, but all relapsed two months later, when the primary subject discontinued medication.
Homicide in a Psychiatric Institution
Authors: Modestin Jiří’ , Böker Wolfgang
Published: August 2008

A unique case of a homicide committed by a young male psychotic inpatient on a fellow-patient is reported and discussed with regard to the special victim-offender relationship, the relationship between suicide and homicide, the phenomenon of aggression and the question of the management of a highly suicidal psychotic patient, including the issue of continuous observation.
Schizophrenia with Good and Poor Outcome
Authors: Kolakowska T. , Williams A. O. , Jambor K. , Ardern M.
Published: August 2008

Fifty-six patients with RDC schizophrenia (42) or schizoaffective disorder (14), of two to 20 years' duration, were assessed for neurological ‘soft’ signs and cognitive impairment when in a stable condition—the ‘outcome’. Neurological dysfunction (46% of 50 examined patients) was associated with a history of developmental abnormalities, but was unrelated to outcome, psychiatric symptoms, or treatment. Deficits in particular cognitive fields were related to two independent factors: overall severity of residual psychiatric disorder (outcome) and neurological dysfunction. There was no relationship between the size of the lateral brain ventricles on CT scan and either ‘soft’ signs or cognitive impairment.

The findings do not provide evidence for an association between the presence of organic brain disorder (as indicated by the joint occurrence of neurological dysfunction and cognitive impairment) and either poor outcome or particular symptoms of schizophrenia.
Behaviour and Skills of Severely Retarded Adults in Hospitals and Small Residential Homes
Authors: Rawlings Sally
Published: August 2008

The behaviour and self-help skills of mobile, severely or profoundly retarded adults with behaviour disorders, living in hospitals, were compared with those of a matched group in small homes outside hospital. The residents in the homes more often engaged in simple constructive activities. Although stereotypies were as common in the homes as the hospitals, in the former they were more likely to be combined with constructive pursuits. There were no differences between the groups in self-help skills. In the homes, the staff: resident ratios were higher and the staff had more autonomy in management and responsibility for organising their own services. The care practices in the homes were more resident-centred, and social contacts between staff and residents were more frequent. However, there was no evidence that, for this type of resident, placing a small home in a residential street had advantages over other geographical locations.
The Prevalence of Chronic Psychiatric Morbidity
Authors: Stanley Brian , Gibson Andrew J.
Published: August 2008

Several studies have commented upon the false negatives which can result when the General Health Questionnaire (GHQ) is employed as a community screening device for psychological distress. It would appear that some false negatives are the result of individual or cultural factors, whilst others result from the phrasing of the GHQ questions, which may mislead patients suffering from chronic disorders. This paper reports the use of additional questions, designed to detect such chronicity.
Marital Adjustment and Treatment Outcome in Agoraphobia
Authors: Monteiro William , Marks Isaac M. , Ramm Elizabeth
Published: August 2008

Forty agoraphobics had individual exposure treatment over a period of 28 weeks and were followed up for two years. Outcome in the 27 married patients was as favourable as that in the 13 single patients. However, among the married patients greater improvement occurred in those with better initial marital and sexual adjustment although even those with poor initial marital adjustment improved significantly during treatment and maintained that improvement during follow-up. Good initial work adjustment and social adjustment were also predictive of particularly good outcome. Reduction of phobias was accompanied by stable or improved marital, sexual, social and work adjustment.
Overdoses: Explanations and Attitudes in Self-Poisoners and Significant Others
Authors: James Diane , Hawton Keith
Published: August 2008

Marked differences were found between the reasons chosen to explain overdoses by the closest relatives or friends (the ‘significant others’) of 34 self-poisoners and those reasons chosen by the self-poisoners themselves. Whilst 41% of the latter claimed suicidal intent, in only one case was the significant other in agreement. The significant others were more likely to attribute manipulative reasons, commonly viewing the overdoses as directed at themselves, but the two groups agreed that the overdoses were often a means of alleviating distress. As well as evoking sympathy, the overdoses often caused the significant others to feel considerable guilt and anger. Discrepancies in the way self-poisoners and significant others interpret overdoses, and the strong feelings that overdoses evoke in the latter, should be considered during assessment and treatment of overdose patients.
A ‘Pseudo-AIDS' Syndrome following from Fear of AIDS
Authors: Miller David , Green John , Farmer Roger , Carroll Gillian
Published: August 2008

We report two cases showing psychiatric symptoms associated with a fear of Acquired Immune Deficiency Syndrome (AIDS). There have now been over 42 cases of AIDS in the United Kingdom (Communicable Disease Surveillance Centre, 1984) since the first case appeared in December 1981, a year after the syndrome was first identified in the United States of America. It was the BBC television programme “Death in the Village” which brought the risks home to many UK homosexual men in mid-1983. Following the programme, the London Gay Switchboard received a high level of telephone calls from men who were afraid that they had AIDS (London Gay Switchboard, 1984).
The Present Status of Monoamine Oxidase Inhibitors
Authors: Pare C. M. B.
Published: August 2008

The present status of monoamine oxidase inhibitors in the treatment of depression is reviewed. With adequate doses they are effective antidepressants, but dosages have in the past been too low. Provided proper dietary precautions are taken, the incidence of fatality from dietary interactions is very small and should not deter doctors from using these drugs, especially in those depressed patients who do not respond to tricyclic-type antidepressants. The present status of combining monoamine oxidase inhibitors with tricyclics is discussed, as are the newer specific inhibitors particularly clorgyline and deprenyl.
A Controlled Trial of Social Intervention in the Families of Schizophrenic Patients: Two Year Follow-up
Authors: Leff Julian , Kuipers Liz , Berkowitz Ruth , Sturgeon David
Published: August 2008

The two-year follow-up results are reported of a trial of social intervention in families of schizophrenic patients in high social contact with high-expressed emotion (EE) relatives. For those patients who remained on antipsychotic medication throughout the two years, the social intervention significantly reduced the relapse rate. In those experimental families where relatives' EE and/or face-to-face contact was lowered, the relapse rate was 14%, compared with 78% for control patients on regular medication (P = 0.02).
An Investigation of Hysteria using the Illness Behaviour Questionnaire
Authors: Wilson-Barnett J. , Trimble M. R.
Published: August 2008

Seventy-nine patients with a diagnosis of hysteria were compared, on a number of variables, with a control group of neurological patients without psychiatric morbidity, and with psychiatric patients free from somatic complaints. Demographic information was obtained, and rating scales for the assessment of personality and mood, were administered, as well as Pilowsky's Illness Behaviour Questionnaire. The data confirm the high incidence of affective disturbance in particular, depression and anxiety in patients with hysteria. There was no link between hysteria and early hospitalisation, although associations were found with sexual disturbances, a past history of vague or undiagnosed illness, affective inhibition, and denial. Relationships between personality and illness behaviour reveal links between personality dimensions and the reporting of illness.
Multiaxial Classification of Male Sexual Dysfunction
Authors: Benkert Otto , Maier Wolfgang , Holsboer Florian
Published: August 2008

Sexual dysfunction in male subjects is a multifaceted illness, not appropriately classifiable by any of the current diagnostic systems, in most of which a major disadvantage is their poor inter-rater reliability. This results in over-or underestimation of minor biological (e.g. hormonal) disturbances, which occur in conjunction with the disorder, but are unlikely to be only its pathophysiological correlate. These biological factors can be important in some cases, however, as they indicate therapeutic strategies (e.g. correction of a minor hormonal deficit). The broad acceptance of classificatory systems with multi-axial dimensions has prompted the construction of a new system. In accordance with DSM III this consists of seven equivalent axes and sub-axes, supplemented by five sub-types, from which the diagnostic attribution can be derived.
Erotomania in Schneider-positive Schizophrenia
Authors: Hayes Mary , O'Shea Brian
Published: August 2008

A case of erotomania (de Clérambault's syndrome) in a female with Schneider-positive schizophrenia is presented. The factors in her environment which may have precipitated the illness are discussed. The secondary nature of the syndrome is further illustrated by a discussion of the literature. In erotomania, the deluded victim, usually a woman, believes that a man, unattainable because of his social status, is in love with her. The nosological purity of the syndrome, despite its relative rarity, remains a subject of considerable debate. We present a case of erotomania in a female with schneiderian first rank symptoms (FRS) of schizophrenia (Schneider, 1959).
Developments in Psychiatric Day Care
Authors: Vaughan Phillip J.
Published: August 2008

Although day care for the mentally ill has been used for almost forty years the potential of the service has not been fully utilised and the movement lacks any sense of overall direction. Day hospitals, the major provider of day care places, have expanded because of practical and financial pressures rather than by their own merit. Meanwhile, day centres have failed to make any significant impact on the psychiatric system, due to a lack of funding to local authorities and their consequent lack of commitment. The result has been a ratherad hocdevelopment of services and a failure to rationalise their activities.
L-5HTP in Depression Resistant to Re-Uptake Inhibitors
Authors: Nolen Willem A. , van de Putte Jan J. , Dijken Wim A. , Kamp J. J.Hans
Published: August 2008

L-5HTP and tranylcypromine were compared in an open, but controlled and cross-over study, in patients suffering from major depression; all were non-responders to several reuptake inhibitors, including oxaprotiline and fluvoxamine. After four unsuccessful sleep-deprivations, L-5HTP or tranylcypromine were given during four weeks in a crossover design. Of 17 patients given L-5HTP during both treatment periods, none responded, whereas of 26 patients treated with tranylcypromine, 15 responded. Thus, L-5HTP is not a therapeutically effective alternative in depressed patients who have not responded to reuptake inhibitors.
Normalisation of the Dexamethasone Suppression Test: A Correlate of Clinical Improvement in Primary Depressives
Authors: Bowie Peter C. W. , Beaini Amal Y.
Published: August 2008

Thirty-six patients with a primary depressive illness, admitted consecutively to hospital, were studied. All patients had a pre-treatment DST, followed by weekly DSTs during a six-week treatment period. Three categories of DST response were identified, on the basis of the serial DSTs. All three groups showed improvement with treatment: the two non-suppressor groups showed normalisation of the DST over the treatment period, but only the normalising non-suppressors showed a significant correlation between DST normalisation and clinical improvement.
Familial Alcoholism: Evidence from 237 Alcoholics
Authors: Latcham R. W.
Published: August 2008

When male alcoholics with and without a positive family history were compared, differences were found in age of onset, age of presentation, severity of alcoholism, and severity of self-reported antisocial behaviour. No such differences were found for women. The implications of these findings for the concept of ‘familial alcoholism’ are discussed.
Psychosocial Vulnerability to Life Events during the Climacteric
Authors: Cooke David J.
Published: August 2008

The mid-life period is regarded as a period of profound physical and psychosocial change for women. Psychological disturbance at this time has been associated with discrete life events. The influence of other psychosocial variables on psychological disturbance is examined in a general population sample. Five psychosocial variables are shown to have a relationship with psychological disturbance, either in conjunction with or independently of life events. The implications of these findings for the understanding of psychological disturbance at this time are discussed.
Irritability: Definition, Assessment and Associated Factors
Authors: Snaith R. P. , Taylor C. M.
Published: August 2008

The heading of ‘Irritable Mood’ was introduced into the Index Medicus in 1985 and it is noted that this term is frequently used but seldom defined. It is therefore important that a consensus is reached concerning its definition in the context of psychopathology and a definition is offered. It seems important to distinguish irritable mood and its outward manifestations from violently assaultive behaviour although there may be a continuum of disturbance from mildly to severely disordered behaviour. Irritability has so far not attracted much attention from clinicians and yet it is a common mood associated with many psychiatric and non-psychiatric conditions. Severe irritability may cause considerable distress both to the patient, his associates and sometimes also those attempting to treat or otherwise help him. It may overshadow other symptoms and the correct diagnosis and management may be missed. The validity and reliability of a convenient self-assessment scale is re-examined in the light of further data. Data from previous studies in the context of mood disorders suggests that irritability is a mood state which is independent of the other major moods of depression and anxiety; the severity of irritability probably has an inverse correlation with age. The most important associated factors are listed in order to inform researchers of the possible methodological pitfalls.
The Bereaved Child:
Authors: Van Eerdewegh Michele M. , Clayton Paula J. , Van Eerdewegh Paul
Published: August 2008

This is a 13-month follow-up study of 105 two to 17 year-old children bereaved of one parent, with 85 controls. Data were gathered on physical and mental health in the children and surviving parents, the child's sex and age and the bereaved parent's sex and psychopathology being included as risk factors. Dysphoria, falling school performance and withdrawn behaviour were significantly increased in bereaved children of both sexes at all ages, while temper tantrums, bed wetting and the depressive syndrome only increased in the age and sex categories normally associated with these conditions. A global index of psychopathology was increased compared with controls on most subgroups of bereaved children (P < 0.0001), the highest scores for both sexes being associated with having a mentally ill (usually depressed) widowed mother. The results are discussed and suggestions made for future research.
Ventricular Enlargement in Schizophrenia
Authors: Reveley Michael A.
Published: August 2008

There has been a considerable range in both the prevalence of ventricular enlargement and values for ventricular size of both schizophrenics and controls, in studies using computerised tomography (CT). The CT scans of 19 unrelated chronic schizophrenics, all of monozygotic (MZ) twin birth, and 36 age-and-sex-matched normal twins from 18 MZ pairs were examined by linear, planimetric, and semi-automated computerised methods. All methods distinguished schizophrenics from controls at approximately the same level of significance, but partial volume artefact led to a greater than two-fold variation in apparent ventricular size, and significantly reduced the validity and reliability of mechanical planimetric and linear measures. Measurement error may be an important source of artefact in uncontrolled studies using those techniques, and when comparing absolute values across studies, but the use of computerised methods should significantly reduce this source of artefact and allow more meaningful comparison.
Day and Full Time Psychiatric Treatment: A Controlled Comparison
Authors: Dick Peter , Cameron Lewis , Cohen David , Barlow Marion , Ince Anne
Published: August 2008

Ninety-one patients admitted as emergencies, suffering from neurosis, personality disorder, or adjustment reaction, were randomly allocated to day hospital or to continued in-patient care. Follow-up was for up to one year. Clinical outcome was similar in the day care and in-patient groups, but patient satisfaction was significantly greater in day patients. Day hospital care was only about two-thirds of the cost of the cheaper of the two in-patient regimes, even though contact with it was on average twice as long as for in-patients.
Plasma Amino Acids in Relation to Cerebrospinal Fluid Monoamine Metabolites in Schizophrenic Patients and Healthy Controls
Authors: Bjerkenstedt Lars , Edman Gunnar , Hagenfeldt Lars , Sedvall Göran , Wiesel Frits-Axel
Published: August 2008

Compared to healthy controls, unmedicated schizophrenic patients had significantly higher plasma concentrations of taurine, methionine, valine, isoleucine, leucine, phenylalanine, and lysine. Except for taurine, these amino acids share the L-transport system for neutral amino acids. In the patients, homovanillic (HVA) acid levels in CSF were decreased and the plasma levels of the amino acids competing with tyrosine and tryptophan for transport into the brain, were all negatively correlated to the CSF concentrations of HVA and 5-HIAA. These findings could be explained by a change in the affinity of the L-system or by a decrease in its overall capacity in schizophrenia. Raised plasma levels of the competing amino acids may limit the brain uptake of tyrosine, leading to a diminished dopamine turnover, and resulting in a compensatory development of supersensitive dopamine receptors.
Sulpiride and Haloperidol in Schizophrenia: A Double-blind Cross-over Study of Therapeutic Effect, Side Effects and Plasma Concentrations
Authors: Gerlach Jes , Behnke Kirsten , Heltberg Jon , Munk-Andersen Ebbe , Nielsen Henrik
Published: August 2008

In a double-blind cross-over trial, 20 chronic schizophrenic patients were treated with sulpiride and haloperidol in two 12-week periods. The final median dose of sulpiride was 2000 mg/day (range 800–3200) and of haloperidol 12 mg/day (range 6–24). Sulpiride had an antipsychotic effect and therapeutic profile not significantly different from that of haloperidol. In spite of the high doses of sulpiride, extrapyramidal side-effects were seen less frequently during the first four weeks of the sulpiride period than during the corresponding haloperidol period (P < 0.05), whereas autonomic side-effects were equally rare for both drugs. A positive correlation was found between daily dose and plasma concentration of both sulpiride (P < 0.001) and haloperidol (P < 0.05), but no correlation could be established between clinical effects and plasma levels of either neuroleptic.
The Maudsley Marital Questionnaire (MMQ): An Extension of its Construct Validity
Authors: Arrindell Willem A. , Schaap Cas
Published: August 2008

In a successful attempt at extending the construct validity of the Dutch version of the Maudsley Marital Questionnaire (MMQ), its sub-scales were correlated with the Marital Deprivation Scale, the Sexuality Experiencing Scale, the Marital Communication Inventory, and the Hopkins Symptom Checklist.
Long Term Follow-up Study of a Ward-based Behaviour Modification Programme for Adolescents with Acting-out and Conduct Problems
Authors: Moyes Therèsa , Tennent T. Gavin , Bedford Anthony P.
Published: August 2008

Although it is widely believed that behaviour modification is successful in an institutional setting, the lasting efficacy of such programmes for adolescents with acting-out and conduct problems has long been questioned. A follow-up enquiry was carried out at one and two years on adolescent patients who had been through an institutional behaviour modification programme. The results were compared with those obtained for a similar group of patients who were accepted for the programme but not admitted; significantly more of the treatment group than the comparison group had improved in terms of behavioural outcome measures, and their level of independent living was greater.
The Effect of Desipramine upon Melatonin and Cortisol Secretion in Depressed and Normal Subjects
Authors: Thompson Christopher , Mezey Gillian , Corn Timothy , Franey Christine , English Judith , Arendt Josephine , Checkley Stuart
Published: August 2008

Melatonin and Cortisol values in plasma were measured hourly over 24 hours in six depressed patients and six normal volunteers before treatment and after one and three weeks of treatment with desipramine. The normal volunteers were further tested one week after withdrawal of desipramine. The mydriatic effects of tyramine and phenylephrine eye drops were also recorded in the normal volunteers.

In neither group of subjects did desipramine treatment reduce melatonin secretion, suggesting that functionally significant down-regulation of beta andrenoceptors was not caused by this treatment. Melatonin secretion was significantly increased after three weeks of treatment in depressed patients. This increase was not found in normal subjects.
The Sexual Side-Effects of Antidepressant Medication: A Double-Blind Comparison of Two Antidepressants in a Non-Psychiatric Population
Authors: Kowalski Andrew , Stanley Robb O. , Dennerstein Lorraine , Burrows Graham D. , Maguire Kay P.
Published: August 2008

Clinical reports have suggested that antidepressant medication may contribute to the sexual dysfunction experienced by some depressed patients. A double-blind trial in a non-psychiatric male population compared amitriptyline (tricyclic), mianserin (tetracyclic) and placebo for their effects on nocturnal sexual arousal. In a three-way crossover design active drug or placebo were taken for two weeks preceding measurement of the frequency, amplitude and duration of nocturnal penile tumescence and synchronous sleep indices. Both active compounds significantly decreased the amplitude and the total duration of nocturnal erections. The effects on sleep indices were as previously reported. Few differences were found between the tricyclic and tetracyclic drugs. Some implications of these findings are considered.
Life Events, Depression and Hypothalamic–Pituitary–Adrenal Axis Function
Authors: Dolan R. J. , Galloway S. P. , Fonagy P. , De Souza F. V. A. , Wakeling A.
Published: August 2008

The relationship between antecedent life events, clinical profile, and hypothalamic–pituitary–adrenal function was examined in 72 depressed patients. Antecedent life events were associated with first episodes of depression and with greater severity of illness, but their presence did not distinguish between patients diagnosed as endogenous or neurotic, and status on the dexamethasone suppression test was not associated with a greater or lesser likelihood of antecedent events. However, urinary free Cortisol levels were higher in those patients with life events and difficulties.
Oil Wives and Intermittent Husbands
Authors: Morrice J. K. W. , Taylor R. C. , Clark D. , McCann Kathryn
Published: August 2008

An investigation was conducted in the Aberdeen area on wives of oil men working either off-shore or on-shore. No differences were found in measures of general health; but ‘off-shore wives' were shown to experience mood and behavioural changes, linked to the pattern of swiftly recurring partings and reunions. While a majority of such wives appeared to tolerate or even thrive on their style of life, 10% had reactions sufficiently pronounced to deserve the label of Intermittent Husband Syndrome or ‘caseness'. Many others would have benefited from more effective preventive and support services.
Long-Term Attendance in the Psychiatric Outpatient Department for Non-Psychotic Illness
Authors: Pomeroy John C. , Ricketts Bruce
Published: August 2008

A comparison was made of initial assessment, treatment, and pattern of care of two groups of non-psychotic patients, referred to a Central London psychiatric outpatient department. The patients, none of whom had been in recent psychiatric treatment, were differentiated into those receiving short-term care (less than one year) and those having long-term care (greater than one year). Chronic psychiatric disorders predominated in both groups. It was also common to have physical illness and contact with other hospital departments. Short-term care consisted of very brief contact for 70% of patients, and psychiatrists seemed unable to engage these referrals in treatment. Long-term attendance was associated with acutely ill young, or chronically ill older patients, more active initial intervention, and referral within the same hospital group. Follow-up revealed that long-term patients reported little symptomatic improvement, experienced considerable disruption in course of care, made increased demands on all aspects of psychiatric service, and often proved to have personality disturbance and social problems that were not perceived on initial contact. Types of intervention and their effects on other hospital departments were examined.
Recent Undesirable Life Events and Psychiatric Disorder in Childhood and Adolescence
Authors: Goodyer Ian , Kolvin Israel , Gatzanis Sonia
Published: August 2008

A sample of children and adolescents (n= 157) attending a child psychiatry outpatient clinic with conduct or emotional disturbance were compared with community controls (n= 76) for the number and type of recent life events. A Life Events Schedule for children and adolescents was developed and used as a semi-structured interview. Four clinical groups were identified according to their predominant presenting symptoms (conduct, mild mood, severe mood, or somatic). An excess of events carrying a severe degree of negative impact was found for all four groups, compared with matched controls. Eleven classes of events were examined: there is a suggestion that two classes (marital/family, accident/illness) may be more important for conduct and mild mood disorders, and that a further class (permanent separations, termed exits) may be more important for somatic and severe mood disorders.
Standardised Psychiatric Interview in Elderly Demented Patients
Authors: Winslow George S. , Ballinger Brian R. , McHarg Anne M.
Published: August 2008

Twenty patients with dementia were assessed by two raters, using the Standardised Psychiatric Interview of Goldberg et al (1970). Inter-rater reliability was good or fair for many items, but test–retest reliability and validity were less good. A single interview does not appear to provide a full picture of psychiatric (excluding cognitive) symptoms in demented patients.
Acquired Hearing Loss and Psychiatric Illness: An Estimate of Prevalence and Co-morbidity in a Geriatric Setting
Authors: Eastwood M. R. , Corbin S. , Reed M. , Nobbs H. , Kedward H. B.
Published: August 2008

Hearing impairment and mental disorders are common among residents of nursing homes and homes for the aged; however, the relationship between sensory deficit and psychiatic illness has been little investigated in this population. The prevalence of hearing impairment, psychiatric illness, and co-morbidity was investigated in a sample of 102 elderly residents from consecutive admissions to a home for the aged. Examining the coincidence of these disorders showed evidence of an association between hearing loss and paraphrenia, and hearing loss and dysphoric states, but not between hearing and cognitive impairment. The results of this survey provide only suggestive evidence regarding aetiology, but strongly support conjoint assessment of the elderly.
Resilience in the Face of Adversity
Authors: Rutter Michael
Published: August 2008

Almost since the beginnings of psychiatric practice, there has been a recognition that negative life experiences and stressful happenings may serve to precipitate mental disorders (Garmezy & Rutter, 1985). Nearly 200 years ago, Pinel wrote about the psychiatric risks associated with unexpected reverses or adverse circumstances, and it is reported that his initial question to newly admitted psychiatric patients was: “Have you suffered vexation, grief or reverse of fortune?” Nevertheless, although an appreciation that a variety of stressors may play a role in the genesis of psychiatric disorder has a long history, the systematic study of such effects is much more recent.
Depression: Distress or Disease? Some Epidemiological Considerations
Authors: Brown George W. , Craig Tom K. J. , Harris Tirril O.
Published: August 2008

Surveys using clinical-type interviews have documented a high rate of depression among working-class women, and this is discussed in the light of a recent survey in an inner-city area. While women with caseness of depression contacting a psychiatrist did not differ in number of core depressive symptoms from those who did, they did in certain characteristics that would make them worrying for a general practitioner to deal with. It is concluded that there is a considerable overlap in the severity of depressive conditions between those seen by psychiatrists and those defined as cases in population surveys; any differences that do exist may relate more to the way symptoms are expressed than to the severity of the depressive disorder as such.
The Effect of Propranolol and Thioridazine on Positive and Negative Symptoms of Schizophrenia
Authors: Eccleston D. , Fairbairn A. F. , Hassanyeh F. , McClelland H. A. , Stephens D. A.
Published: August 2008

Patients with chronic schizophrenia were treated with either propranolol (640 mg daily) or thioridazine (400 mg daily). In a double-blind study lasting five weeks, propranolol was superior to thioridazine on both psychiatrists' and nurses' ratings. Significant improvements were noted with propranolol in both positive (Type I) and negative (Type II) symptoms.
Categories of Depression: Reported Life Events in a Controlled Design
Authors: Brugha Traolach S. , Conroy Ronan
Published: August 2008

In a case control study, 32 onset cases of depression, separated into PSE-CATEGO Categories N and R, were compared with individually matched symptom free general practice attenders. Combining both categories of depressives together a significantly greater number reported an Undesirable Life Event and a Threatening Life Event in the six months prior to onset, compared with their matched controls. Significantly more CATEGO R (retarded or endogenous) depressives reported an Independent Threatening event than their matched controls. These findings do not support the view that depression secondary to a major life event is more likely to be mild in character.
A Comparison of Catego Class ‘S' Schizophrenia in Three Ethnic Groups: Psychiatric Manifestations
Authors: Teggin A. F. , Elk R. , Ben-Arie O. , Gillis L. S.
Published: August 2008

We compared the psychiatric manifestations of 56 CATEGO S schizophrenic in-patients from three ethnic groups (white, coloured and black). A marked similarity among the groups on both schizophrenic and non-schizophrenic symptoms was found, as well as a high prevalence of depressive and anxiety symptoms. Differences occurred on the syndromes of (1) olfactory hallucinations and (2) subcultural delusions and hallucinations. Black patients had both syndromes more frequently than either white or coloured patients.
Temporal Orientation in the Pre-Senium and Old Age
Authors: Brotchie Janet , Brennan James , Wyke Maria A.
Published: August 2008

Temporal orientation in 235 normal elderly subjects was examined and compared with previous results from a young adult population. Orientation for time in the elderly remains reasonably intact; the major exception to this was inaccurate recall of the date, which was most pronounced among women in the older group studied (71 +).
Cerebrospinal Fluid Vasopressin—Changes in Depression
Authors: Gjerris Annette , Vendsborg Per , Hammer Mogens , Christensen Niels Juel , Rafaelsen Ole J.
Published: August 2008

Cerebrospinal flud (CSF), thyrotropin releasing hormone (TRH), CSF-vasopressin (AVP), plasma-AVP, CSF-osmolality, plasma-osmolality, CSF-adrenaline (A) and -noradrenaline (NA) were measured in psychiatric patients and controls. Psychiatric patients were classified according to ICD-9 and grouped into endogenous depression, non-endogenous depression, mania and schizophrenia. The depressive groups were classified according to the Newcastle Rating Scale for Depression 1965. Severity of disease was quantified by BRMES, BRMS and BPRS. No difference in CSF-TRH levels was seen among the different diagnostic groups and controls. A positive correlation between CSF-TRH and CSF-A was demonstrated. CSF-AVP concentrations were significantly lowered in both endogenous and non-endogenous depression; no correlation with CSF-A or -NA was seen. Neither did any difference between plasma levels of AVP, plasma-osmolality or CSF-osmolality appear among the groups investigated.
P3 and other Long Latency Auditory Evoked Potentials in Presenile Dementia Alzheimer Type and Alcoholic Korsakoff Syndrome
Authors: Clair David M. St , Blackwood Douglas H. R. , Christie Janice E.
Published: August 2008

The P300 (P3) and other long latency auditory evoked potentials were measured in 15 patients with presenile dementia Alzheimer type (ATD), 16 patients with alcoholic Korsakoff syndrome (KS) and 23 age-matched control subjects. All were drug free for at least four weeks before testing. The latency of the P3 was significantly longer and the amplitude significantly smaller in the ATD group than in both the KS and control groups. The KS group did not differ significantly from the control group in either latency or amplitude of P3 but both the KS and ATD groups had reduced N1 and P2 compared to controls. Using a combination of P3 latency and amplitude, 70% of the ATD patients could be separated from the other groups with no false positives. These findings suggest that evoked potential recording may be of value in the diagnosis of early ATD.
The Measurement of Social Behaviour in Psychiatric Patients: An Assessment of the Reliability and Validity of the SBS Schedule
Authors: Wykes Til , Sturt E.
Published: August 2008

This paper describes the standard version of the MRC Social Performance Schedule, which covers 21 behaviour areas such as hygiene, initiating conversations, etc. and was designed to be used with long-stay populations, within a hospital or the community. Data on the schedule's consistency over raters, informants, time, and situation showed that the reliability was reasonable over all four areas. The schedule is recommended as a standard instrument to describe the behavioural difficulties of patients likely to be dependent on psychiatric services for some time. Recent data are provided on the levels of problem behaviours found within both long-stay hospitals and community settings, together with references for more detailed behaviour profiles of such groups.
A Validity Study of a Psychiatric Screening Questionnaire (SRQ-20) in Primary Care in the city of Sao Paulo
Authors: de Jesus Mari Jair , Williams Paul
Published: August 2008

A validity study of the Self-Report Questionnaire (20 item version, Hardinget al,1980) against the criterion of a standardised psychiatric interview (Goldberget al,1970) was carried out at three primary care clinics in Sao Paulo; 875 patients filled in the SRQ-20 questionnaires and a subsample of 260 was interviewed by the psychiatrist. The SRQ-20 was shown to be a feasible screening instrument for psycho-emotional disturbance in these settings. Sensitivity was 83% and specificity 80%, and the questionnaire was a good indicator of morbidity. A correlation was found between questionnaire total scores and independent clinical judgment (r= +0.70). A sex difference in the validity coefficients is described.
The Northwick Park Study of First Episodes of Schizophrenia
Authors: Johnstone E. C. , Crow T. J. , Johnson A. L. , MacMillan J. F.
Published: August 2008

Patients referred over 28 months from nine medical centres for a trial of prophylactic neuroleptic medication following first episodes of schizophrenic illness (462) were assessed with the Present State Examination, WHO scales for disability, past history, and socio-demographic factors, and a rating of disturbed behaviour; 253 fulfilled the study criteria; of the 209 who did not, 54 did not meet the diagnostic criteria, 65 had a history of a previous episode, and in 15 the psychotic illness was found to have an organic basis. The interval between onset of illness and admission varied widely, but was often more than one year and associated with severe behavioural disturbance and family difficulty e.g. in arranging appropriate care. Current arrangements for initiating management of first schizophrenic illnesses are frequently unsatisfactory.
II. A Randomised Controlled Trial of Prophylactic Neuroleptic Treatment
Authors: Crow T. J. , MacMillan J. F. , Johnson A. L. , Johnstone E. C.
Published: August 2008

Out of 253 patients fulfilling criteria for a first episode of schizophrenic illness, 120 entered a randomised placebo-controlled trial of maintenance neuroleptic medication on discharge; they were followed to relapse or loss to follow-up, for two years or to the end of the study. Of those on active medication, 46% relapsed, as did 62% of those on placebo; the most important determinant of relapse was duration of illness prior to starting neuroleptic medication. This finding might be because extended duration of symptoms before admission is more likely to be present in illnesses which in any case will have poor prognosis, or because susceptibility to relapse is reduced by early institution of treatment. The study provides no data on which a decision between these alternative explanations can be based.
III. Short-term Outcome in Trial Entrants and Trial Eligible Patients
Authors: MacMillan J. F. , Crow T. J. , Johnson A. L. , Johnstone E. C
Published: August 2008

Of 253 patients from nine medical centres identified with first episodes of schizophrenic illness, 17 did not achieve discharge during the period of trial recruitment. 120 entered a randomised controlled trial of neuroleptic medication and were followed-up, as were 116 who were eligible for the trial but did not enter it. Overall, 60% of the sample had relapsed within two years of discharge; age, sex, ethnic origin, duration of admission, social withdrawal before admission, and type of onset of illness were not significantly related to relapse. Relapse rates were lower on active trial or standard medication than placebo, but however assessed, outcome at this early stage was poor for many patients.
The ‘Italian Experience’ Reconsidered
Authors: Jones Kathleen , Poletti Alison
Published: August 2008

Our analysis of the problems of the Italian psychiatric services has drawn a lively correspondence challenging our findings. In September 1985, we undertook a second study tour in Italy. This is now reported, with notes on specific criticisms of the earlier paper.
The General Hospital Psychiatrist: Too Many Tasks and Too Few Roles?
Authors: Sensky Tom
Published: August 2008

What should the general hospital psychiatrist do, and how should he do it? In psychiatric settings, psychiatrists may legitimately confine their attention to those patients whose disorders can be classified according to ICD-9, but in general hospital settings, the same approach defines a very restricted range of activities. Evidence is reviewed which highlights the differences between psychiatric disorders encountered in psychiatric hospitals and those found in primary care or general hospital settings. Different activities proposed for the general hospital psychiatrist, and the results of research comparing these, are reviewed. A recent study is discussed in which alteration of the psychiatrist's method of practice in a general medical unit produced considerable changes in the pattern of psychiatric referrals. Evaluation of the efficacy of their interventions should remain the ultimate goal of general hospital psychiatrists. This can be adequately undertaken only by means of better understanding of the process by which general hospital patients attract psychiatric referral.
An Evaluation of a Time-limited Programme of Dynamic Group Psychotherapy
Authors: Dick Barbara M. , Wooff Kate
Published: August 2008

The outcome for a group of outpatients treated daily for 12 weeks in a dynamic group psychotherapy programme, was evaluated on both objective and subjective parameters. In the post-therapy year, the majority (82%) reduced their dependence on psychiatric services and showed considerable change in self-satisfaction, as assessed by an attitude test. Those available for follow-up three years later had maintained the change. There was a sub-group of patients (17%) who demonstrated an increase in service use in the post-therapy year.
Radio Receptor Assay of Serum Neuroleptic Levels in Psychiatric Patients
Authors: Krska Janet , Sampath G. , Shah A. , Soni S. D.
Published: August 2008

The radioreceptor assay for the measurement of neuroleptic drugs in serum has been used to study the relationship between dose and serum level in schizophrenic patients receiving these drugs. The assay was found to be reproducible and capable of detecting neuroleptics in the sera of patients receiving a range of both oral and depot drugs, with the exception of trifluoperazine spansules. Linear correlations were obtained between daily dose and serum level for each drug both in individual patients on different doses and between patients on a stable dose. Extrapyramidal side effects were related to the serum neuroleptic level within, but not between, patients. The assay may be of use in clinical practice, including the assessment of compliance or poor response to neuroleptics.
Hospital Doctors' Management of Psychological Problems
Authors: Mayou Richard , Smith E. B. O.
Published: August 2008

Psychological and social difficulties are common amongst both medical and surgical patients, but psychiatrists are able to see only a very small proportion, and though hospital doctors have the main responsibility for psychological treatment, very little is known of what they actually do. Physicians and surgeons in Oxford answered a questionnaire on their attitudes and clinical practice: virtually all believed that emotional care is important, but what they do and what they would like to do in the assessment, treatment, and referral of their patients varied widely. There were associations with the extent of responsibility for chronic care, speciality, and seniority.
49, XXXYY Chromosome Anomaly in a Mentally Retarded Man
Authors: Cowie Valerie A. , Singh K. Rameshwari , Wheater Richard
Published: August 2008

A case of 49, XXXYY chromosome anomaly in an adult male is reported. Features of Klinefelter's syndrome are predominant among the clinical findings. Characteristics suggestive of acromegaly have been associated with this chromosomal anomaly. Despite prognathism and an overhanging brow, acromegaly was not present in this case. Psychological traits sometimes reported in males with the XXY and XYY karyotypes were seen in this patient, but the variability of expression of these characteristics calls into question the validity of their correlation with the presence of supernumerary sex chromosomes.
Socio-Psychiatric Aspects of the Young Severely Mentally Retarded and the Family
Authors: Dupont Annalise
Published: August 2008

Interest in the different diagnostic groups of the mentally retarded started in the 19th century, but this made little contribution toward better treatment and care. Medical interest was mainly focused on the prevention of mental retardation. It was not until the 1950's and 60's that interest in research in the care and treatment of these persons intensified. The next step, study of the interaction between handicapped persons and the environment is the key to a better understanding of how to plan for work with the handicapped. New members of the therapeutic team (e. g., psychologists, and sociologists) will take over (Edgerton, 1984) if medical groups, especially psychiatrists, do not become more aware of the importance of the interaction between the handicapped and the environment.
The Diagnosis of Schizophrenia by Language Analysis
Authors: Fraser William I. , King Kathleen M. , Thomas Philip , Kendell Robert E.
Published: August 2008

Our aim was to test the findings of a study which claimed that if the syntactic structure of schizophrenic speech were subjected to a detailed linguistic analysis, clear differences would be demonstrated between schizophrenic, manic and control populations. It was confirmed that schizophrenics do have less syntactically complex speech which contains more errors. Using linguistic variables in a discriminant function analysis, it was possible to predict diagnoses correctly in 79% of cases.