bluuebunny/crossref_metadata_2025 huggingface dataset:
Mode of inheritance in mood disorder families according to fluvoxamine response
Authors: Serretti A. , Franchini L. , Gasperini M. , Rampoldi R. , Smeraldi E.
Published: November 2007

Mood disorders are known to cluster within families, but the mode of transmission remains largely unknown. The purpose of our analysis was to determine whether selection of a sample that was homogeneous in its response to an antidepressant provided stronger evidence for a single major locus. Complex segregation analysis was applied to a sample of 171 Italian families of bipolar and unipolar probands that were responsive to the antidepressant fluvoxamine. We used regressive logistic analyses to determine the best fit from among environmental, arbitrary Mendelian, dominant, recessive and additive models. For the 171 affective families with probands that were responsive to the antidepressant fluvoxamine, a Mendelian model of inheritance was rejected. When considering 68 families of bipolar probands, the best fit was obtained for a Mendelian dominant model of transmission. The identification of a Mendelian mode of transmission in bipolar subjects who were selected according to their response to fluvoxamine supports the use of a pharmacological criterion as a tool for identifying true genetic disorders.
Inadequate dosaging in general practice of tricyclic vs. other antidepressants for depression
Authors: Isometsä E. , Seppälä I. , Henriksson M. , Kekki P. , Lönnqvist J.
Published: November 2007

Several prescription database studies suggest major differences between antidepressants in the proportion of patients in general practice treated with doses likely to elicit a true drug response. However, in these studies it has been difficult to differentiate prescriptions for depression from those for other indications, or to distinguish lower starting doses from the final treatment doses. We investigated possible differences between types of antidepressant in the proportions of patients receiving adequate treatment doses for depression from the primary health care services of Helsinki. Doctors at 22 (71%) of the 31 health centres in Helsinki were surveyed with regard to their antidepressant prescriptions over a period of 2 working weeks. There were marked differences in dosaging adequacy between the various types of antidepressant prescribed for depression at final treatment doses. Overall, 71% of the prescriptions for the tricyclic antidepressants, but only 13% of those for the other antidepressants, mainly selective serotonin reuptake inhibitors, were for low doses that are generally considered to be ineffective (P > 0.001). These findings endorse the emerging perception that, in general practice, tricyclic antidepressants are usually prescribed for depression in too low doses, and that a greater reliance on other antidepressants would probably improve the effectiveness of treatment in primary health care.
Suicidal ideation and sense of coherence in male conscripts
Authors: Mehlum L.
Published: November 2007

Antonovsky's Sense of Coherence (SOC) scale, reflecting a dispositional orientation which, according to theory, is associated with coping and resiliency, was highlighted in a study focusing on the association between stressful life events and the development of suicidal ideation and behaviour in the young. During their first stressful week of basic training, 663 male Norwegian conscripts answered a questionnaire focusing on their lifetime and current suicidal ideation and behaviour. The lifetime prevalence of suicidal ideation and attempted suicide was 21.7% and 2.6%, respectively. Suicide ideators and attempters had on average significantly lower SOC scores compared to respondents with no suicidal ideation or behaviour. Furthermore, a stepwise multiple regression analysis revealed SOC to be a good predictor of current suicidal ideation in this non‐clinical population, accounting for 21% of the total variance.
Regional differences in the distribution of suicide in the former Soviet Union during perestroika, 1984–1990
Authors: Wasserman D. , Värnik A. , Dankowicz M.
Published: November 2007

The former USSR covered 22.4 million square kilometres and had a population of 288 362 296 in 1990. During 1984–1990 the former USSR consisted of 15 republics, which formed culturally, geographically and historically different regions. Yearly, approximately 45000–50000 males an (14000–15000 females committed suicide. Suicide rates in the former USSR during 1984–1990 varied greatly between different regions, from 3.5 cases per 100000 inhabitants in the Caucasus (Georgia, Azerbaijan and Armenia) to 11.8 in Central Asia (Kazakhstan, Kirgizia, Turkmenistan, Uzbekistan and Tajikistan), 18.1 in Moldova, 25.6 in the Slavic region (Russia, the Ukraine and Belarus) and 28.0 in the Baltic region (Latvia, Lithuania and Estonia). The same pattern of great variation between different regions was observed for both men and women in the former USSR, with suicide rates for men ranging from 4.9 in the Caucasian region to 45.9 in the Baltics, and suicide rates for women ranging from 2.1 in the Caucasus to 12.3 in the Baltics.
Outcomes and costs of a community support worker service for the severely mentally ill
Authors: Clarkson P. , McCrone P. , Sutherby K. , Johnson C. , Johnson S. , Thornicroft G.
Published: November 2007

There has recently been an expansion of paraprofessional staff involved in the provision of care for the severely mentally ill. In this paper we shall evaluate the effects of a community support worker (CSW) service in South London. A sample of patients with severe mental illness receiving the service was assessed over a 6‐month period in order to examine the effects of continuing use of CSWs on outcomes, service use and costs. During the study period there were improvements in outcome reflecting service satisfaction, needs, quality of life and social behaviour. Whilst provision of the CSW service did not lead to extra total service costs, service use and cost data suggest that CSWs are associated with the substitution of in‐patient use by community‐based services.
Treatment received by alcohol‐dependent suicide attempters
Authors: Suominen K. H. , Isometsä E.T. , Henriksson M. M. , Ostamo A. I. , Lönnqvist J. K.
Published: November 2007

The purpose of this study was to examine the clinical features of alcohol‐dependent suicide attempters and the treatment they received before and after the index attempt. A total of 47 subjects with current DSM‐III‐R alcohol dependence were identified from a systematic sample of 114 suicide attempters in Helsinki. All of them were comprehensively interviewed after the attempt, and the treatment they had received was established from psychiatric and other health‐care records and follow‐up interviews. Most had a history of psychiatric (83%) or substance abuse (83%) treatment. During the final month before the attempt, half of the subjects (51 %)) had been treated by health care services; 11% had received disulfiram‐treatment and 6% had received psychotherapy. Subjects complied with recommended aftercare more often when they had been actively referred. After 1 month, 64% were being treated by health care services. However, only 14% were receiving disulfiram‐treatment and 9% were receiving psychotherapy. These findings suggest that the quality and activity of treatment offered to suicide attempters with alcohol dependence should be improved.
Catatonia under medication with risperidone in a 61‐year‐old patient
Authors: Bahro M. , Kämpf C. , Strnad J.
Published: November 2007

This report describes the case of a 61‐year‐old female schizophrenic patient with status post‐frontal lobotomy some 35 years ago with prominent paranoid delusions. This woman developed severe catatonia under medication with a serotonergic/dopaminergic neuroleptic, risperidone, at a dose of up to 5 mg daily. The catatonic disorder was dose‐dependent and subsided immediately after switching the medication to another atypical antipsychotic, clozapine. Given the negative history for catatonia in this patient, the temporal coincidence of administration of risperidone and catatonia is a novel finding.
Time trends in suicide mortality J in Lithuania
Authors: Kalediene R.
Published: November 2007

Objective: The aim of this study was to analyse the time trends of suicides during the period 1970–1995 in Lithuania, and to assess the importance of the effects of age, period and birth cohort as risk factors.

Method: Trends in suicides and average annual changes were based on logarithmic regression analysis. For assessment of the effects of age, period and birth cohort on suicide mortality, a log‐linear regression model with parameters representing age, period and cohort effects was fitted.

Results: Between 1970 and 1995 age‐standardized suicide rates almost doubled. There was an increase in suicides in birth cohorts of males from 1910 to 1950, and in cohorts born after 1965. In females, an increase was observed in all successive birth years from 1905 to 1925 and after 1970. The period effect in males and the cohort effect in females were dominant. Conclusion: It is unlikely that suicide rates will decrease in the near future.
Prelingually profoundly deaf schizophrenic patients who hear voices: a phenomenological analysis
Authors: DuFeu M. , McKenna P. J.
Published: November 2007

Objective: The aims of the study were to examine claims that profoundly deaf schizophrenic patients report auditory hallucinations, and to evaluate proposed explanations that such patients arc really describing other symptoms, or that the phenomenon is restricted to those who had heard and understood language prior to becoming deaf.

Method: A total of 17 schizophrenic/schizoaffective patients with onset of profound deafness prior to the age of 2 years underwent structured psychiatric interview.

Results: Ten patients (59%) gave accounts of verbal auditory hallucinations with description of content. These did not appear to be attributable to other psychotic experiences and showed typical characteristics of schizophrenic hallucinations. The symptom was present in six patients who had been deaf from birth or early infancy.

Conclusion: These findings suggest that auditory hallucinations are a common phenomenon in profoundly prelingually deaf schizophrenic patients, which cannot be accounted for by the above explanations.
Early visual information processing and the Defence Mechanism Test in schizophrenia
Authors: Bogren L. Y. , Bogren I.‐B. H.
Published: November 2007

Objective: The aim of this study was to determine whether impairment in visual information processing measured by backward masking was related to high threshold values in the Defence Mechanism Test (DMT) in patients with schizophrenia.

Method A total of 20 patients with schizophrenia according to DSM‐IV, most of whom were out‐patients, were studied with backward masking and a modified version of the DMT (DMTm).

Results: Nine of the patients showed an impairment in backward masking. There was a relationship between impairment in backward masking and the DMTm with either no or a late C‐phase (correct perception in DMTm) in the first series, and a late perception of the peripheral person in the second series. There was no relationship for the other 14 threshold values. The patients did not have high threshold values in the DMTm as was expected. Conclusion: In this sample consisting mainly of out‐patients, there were few relationships between impairment in backward masking and high threshold values in DMTm. Their visual information processing was not as disturbed as expected. Most previous studies on both backward masking and the DMT in patients with schizophrenia have been conducted among in‐patients, who could be expected to be more disturbed than the out‐patients in the present study. The results of studies on in‐patients with schizophrenia must not be generalized to include out‐patients, and vice versa.
The World Health Organization International Consorthm in Psychiatric Epidemiology (ICPE): initial work and future directions ‐ the NAPE Lecture 1998a
Authors: Kessler R. C.
Published: November 2007

Objective: To provide an overview of the World Health Organization (WHO) International Consortium in Psychiatric Epidemiology (ICPE), to introduce the World Mental Health 2000 (WMH 2000) Initiative and to discuss methodological issues that the ICPE is grappling with in planning the WMH2000 Initiative.

Method: We review the history, mission and organization of the ICPE and the rationale behind the WMH2000 Initiative. We review methodological research underlying major design and implementation decisions regarding the WMH2000 surveys.

Results: The ICPE is an international consortium created to facilitate cross‐national comparative epidemiological research using the WHO Composite International Diagnostic Interview (CIDI). The first‐phase core TCPE surveys, which we are currently analysing, include over 33 000 interviews in seven countries, with an additional set of over 30000 interviews in seven countries ready to be added to the master file within the next year. The WMH2000 Initiative will include a third series of CIDI surveys that include an anticipated 100000 additional interviews in 10 countries. A series of complex methodological challenges confront us in designing and implementing the WMH2000 surveys. These include issues in the conceptualization and measurement of impairment and disablement, the implementation of standardized quality control procedures across countries, and the blending of epidemiological and clinical interviewing methods to obtain a valid cross‐national characterization of disorder prevalences. Our current plans regarding these issues are discussed.

Conclusion: Valid and representative general population epidemiological data on patterns, predictors and adverse consequences of psychiatric disorders are needed as a foundation for public health initiatives. The efforts of the ICPE promise to provide data of this sort for many regions in the world. Formidable methodological and logistical challenges arise in implementing this agenda, but we are confident that these challenges can be met by building on the firm foundation already established in the ongoing ICPE collaboration.
Measuring health status in psychiatric community surveys: internal and external validity of the Spanish version of the SF‐36
Authors: Ayuso‐Mateos J. L. , Lasa L. , Vázquez‐Barquero J. L. , Oviedo A. , Diez‐Manrique J. F.
Published: November 2007

The aims of the present study were to determine the acceptability of the Spanish version of the Short Form (SF‐36) health survey questionnaire for its use in mental health research on the general population, and to evaluate its internal and external validity, using data obtained from a representative community sample of 1250 adults of working age. The internal consistency of the different dimensions of the questionnaire was high. Concurrent validity was tested by examining its correlation with the 12‐item General Health Questionnaire (GHQ‐12). Construct validity was determined by studying the extent to which scores on different variables reflected the expected distribution of health status for and between certain groups. Our findings provide strong evidence for the acceptability and validity of the SF‐36 whcn used as part of a community mental health survey.
Psychopathy and psychopathological profiles in prisoners on remand
Authors: Andersen H. S. , Sestoft D. , Lillebaek T. , Mortensen E. L. , Kramp P.
Published: November 2007

A total of 178 Danish male remand prisoners were examined using comprehensive interviews and questionnaires on psychopathological, personality and social measures. and file data. These data were compared with scores on the Hare Psychopathy Checklist — Revised (PCL‐R). Subjects were divided into four groups according to quartile PCL‐R scores. In general there were high rates of psychiatric morbidity in all PCL‐K quartile groups. The medium‐high scorers represent a more vulnerable group with a high prevalence of dependence disorders, relatively high neuroticism score and relatively high prevalence of neurotic and stress‐related disorders. The high scorers were more psychosocially maladjusted, had more often made previous suicidal attempts, and had a higher psychoticism score. Chronic psychotic disorders did occur, mostly in the high‐scoring group. The population had lower scores on the PCL‐R than in most previous studies, suggesting a lower prevalence of psychopathic features among Danish criminals and possibly a lower cut‐off point when using the PCL‐R as a categorical measure. Both findings are consistent with the results of other European studies. Further studies on cross‐cultural differences with regard to PCL‐R psychopathic features and on psychic vulnerability related to PCL‐R scores and factor l/factor 2 of the PCL‐R are suggested.
A prospective, long‐term study of Dersonality traits in patients with intractable obsessional illness treated by capsulotomy
Authors: Mindus P. , Edman G. , Andréewitch S.
Published: November 2007

The crux when contemplating neurosurgery for otherwise intractable mental illness is whether there is a price which the patient may have to pay, in terms of adverse personality changes, for symptom relief. In the present study of 19 patients undergoing thermo‐capsulotomy for intractable obsessional illness, personality characteristics were studied pre‐operatively, and at 1‐year and 8‐year follow‐up, using the Karolinska Scales of Personality (KSP). Small mean score changes toward normalization were apparent on all 15 KSP scales at the 1‐year follow‐up. and significant improvements in anxiety proneness were noted at the 8‐year follow‐up. One patient who sustained a surgical complication showed deviant postoperative scores on scales related to psychopathic traits. There were no such deviant scores for the remaining subjects. The incidence of adverse personality changes following capsulotomy is low and does not increase with time. This conclusion, based on groups of patients, does not of course preclude the possibility that adverse personality changes may occur in individual patients.
Apnea syndrome in a patient with Alzheimer dementia under chlormethiazole treatment: a clinical experience report
Authors: Kaldune A. , Strnad J. , Cornu C. , Bahro M.
Published: November 2007

Sleep apnea syndromes in conjunction with dementia have attracted considerable interest among geropsychiatrists in recent years. This clinical case report describes a demented and delirious elderly patient with a history of alcoholism who developed a sleep apnea syndrome under treatment with chlormethiazole. The risk of chlormethiazole treatment may be underestimated in vulnerable patients, e.g. those suffering from severe respiratory diseases or dementia. Alternative treatments for delirious states need to be evaluated instead.
Synopsis of function and dysfunction of the frontal lobe
Authors: Fuster J. M.
Published: November 2007

The cortex of the frontal lobe reaches maximum phylogenetic development in the brain of the human. It is cortex devoted to the organization of action in all neurobiological and cognitive domains — skeletal movement. eye movement, speech and logical reasoning. Thus the frontal cortex may be called ‘motor cortex’ in the widest sense. The association cortex of the frontal lobe, commonly called prefrontal cortex, is in charge of the temporal organization of behaviour, speech and thinking. Prefrontal lesions frequently lead to disorders of temporal organization, especially in thinking and the spoken language. The prefrontal cortex serves temporal organization by coordinating three cognitive operations that are essential for the formation of ‘gestalts’ in the time domain: (i) preparatory set; (ii) working memory; and (iii) inhibitory control of interference. Temporal organization is disturbed in the schizophrenic patient, probably because of a functional disorder of the connectivity between the prefrontal cortex and other cortical areas, as well as limbic and striatal structures (a ‘disconnection syndrome’).
Schizophrenia and the disconnection hypothesis
Authors: Friston K. J.
Published: November 2007

This article reviews the disconnection hypothesis of schizophrenia and presents a mechanistic account of how dysfunctional integration among neuronal systems might arise. This neurobiological account is based on some simple observations about schizophrenia and the central role that neuronal plasticity plays in shaping the connections, and the ensuing dynamics, that underlie brain function. The particular hypothesis put forward here is that the pathophysiology of schizophrenia is expressed at the level of modulation of associative changes in synaptic efficacy, specifically the modulation of plasticity in those brain systems that are responsible for learning, memory and emotion. This modulation is mediated by ascending neurotransmitter systems that (i) have been implicated in schizophrenia and (ii) are known to be involved in consolidating synaptic connections during learning. The proposed pathophysiology would translate, in functional terms, into a disruption of the reinforcement of adaptive behaviour that is consistent with the disintegrative aspects of schizophrenic neuropsychology.
Subjective experience and mental side‐effects of antipsychotic treatment
Authors: Gerlach J. , Larsen E. B.
Published: November 2007

Many schizophrenic patients have a negative attitude towards antipsychotic drugs. This attitude is not only due to lack of insight into the disease, lack of recognition of the beneficial effects of the drugs, and to objective side‐effects. The negative attitude is to a high degree due to mental side‐effects and a sceptical opinion about antipsychotic medication in general. In a study of 53 chronic schizophrenic out‐patients receiving maintenance depot antipsychotic treatment, we found that 60% were positive about the treatment, 32% were ambivalent and 8% had a negative attitude. Only 60% complained of side‐effects, even though 94% had objective side‐effects. Mental side‐effects such as subjective akathisia, dysphoria and emotional indifference were most often observed by the patients, while hypokinesia and hyperkincsia wcre least noticed by thcm, but most often obscrvcd by the physician. No correlation was found between the patients’ subjective assessment of their quality of life and the degree of psychosis and side‐effects. With the new atypical antipsychotics this situation seems to be changing. These new drugs are primarily characterized by a lower level of motor extrapyramidal side‐effects (EPS), and with fewer motor EPS, fewer mental EPS can be expected. In recent studies comparing the new antipsychotics with haloperidol, better effects have been observed with regard to negative symptoms and depression, and this may at least in part be a reflection of a lower level of mental side‐effects of the atypical antipsychotics. This improved clinical profile of new antipsychotics is extremely valuable in the context of an integrated treatment in schizophrenia, consisting of early intervention, psychosocial rehabilitation and family/patient psycho‐education.
Cognitive dysfunction in schizophrenia: a new set of tools for the assessment of cognition and drug effects
Authors: Gallhofer B. , Lis S. , Meyer‐Lindenberg A. , Krieger S.
Published: November 2007

Cognitive impairment in schizophrenia must be seen as a disturbance of cortico‐sub‐cortical connectivity with a neurotransmitter imbalance in a circuitry system, which connects thalamic input with prefrontal processing and supplementary motor cortex and basal ganglia output. The concept of maze‐solving behaviour as a continuous cognitive task evoking a conflict between prefrontal cortex and basal ganglia activity is explained and introduced to distinguish between the effects of D2 blocking agents and substances with a predominant 5HT2A receptor affinity, such as clozapine and risperidone. Complex mazes show a cognitive deficit in untreated schizophrenic patients that are impaired by conventional and improved by atypical antipsychotic substances. Processing speed improves most on clozapine, while parallel processing is best supported by the non‐sedative atypical substance risperidone. Maze paradigms are presented.
What patient characteristics make therapists recommend psychodynamic psychotherapy or other treatment forms?
Authors: Svanborg P. , Gustavsson J. P. , Weinryb R. M.
Published: November 2007

In order to study factors that psychodynamic therapists considered to be important for recommendation of treatment, psychiatric diagnoses (DSM‐III‐R Axes I and II and the GAF) as well as character traits assessed by the Karolinska Psychodynamic Profile (KAPP) were retrospectively assessed in interview case‐notes of patients applying for psychodynamic psychotherapy. Recommendation of psychotherapy was predicted by the absence of a personality disorder and high GAF scores, but not by the presence of a psychiatric syndrome. The KAPP differentiated between patients with and without disorders on Axis II, but not on Axis I. Patients who were recommended psychodynamic psychotherapy were healthier on all central KAPP variables compared to those who were recommended other treatments, and they were also characterized by predominantly neurotic personality organization, with inhibition as the most prominent defence.
Long‐term prognosis of bipolar I disorder
Authors: Turvey C.L , Coryell W. H. , Solomon D. A. , Leon A. C. , Endicott J. , Kelle M. B. , Akiskal H.
Published: November 2007

This study examined the contribution of demographic. syndromal and longitudinal course variables to the long‐term prognosis of 165 bipolar patients prospectively observed over 10 years as part of the National Institute of Mental Health Collaborative Study of Depression. Although most baseline clinical and demographic variables were not strong prognostic indicators, switching polarity within episodes was. Most episodes among the poor‐prognosis patients were polyphasic, while most episodes among the comparison group with a better prognosis were monophasic. There was no evidence of shortening of cycle lengths over follow‐up for either the poor‐prognosis group or the entire sample. The relevance of these findings to the ‘kindling’ model is discussed.
A long‐term follow‐up study of adolescent psychiatric in‐patients. Part III. Predictors of disability
Authors: Kjelsberg E.
Published: November 2007

A total of 1095 adolescent psychiatric in‐patients were followed up 15–33 years after hospitalization by record linkage to the National Register of Disability Benefits. On the basis of hospital records, all patients were rediagnosed according to DSM‐IV and scored on data postulated to have predictive power with regard to disability. The factors were investigated by Kaplan‐Meyer survival analysis and Cox regression. A psychotic or organic disorder, low score on DSM‐IV Axis V (GAF) and the use of psychotropic medication at hospitalization were among the strong predictors of later disability, as were low IQ, poor achievement at school, somatic disorders, and self‐harming behaviour (all P<0.01). Cox analysis showed that, of these, the following factors remained strong and independent predictors of disability: psychotic and organic disorders (relative risk (RR) = 3.1, 95% confidence interval (CI) = 2.4–4.0), IQ<90 (RR = 1.8, CI = 1.5–2.3); and GAF < 30 (RR = 1.9, CI = 1.5–2.4). Former adolescent psychiatric in‐patients with a psychotic or organic disorder had a very high risk of later disability (71–81%), whereas those with other psychiatric diagnoses, and with IQ≥90 and GAF ≥ 30 at hospitalization, had a relatively low risk of disability (22–29%).
Preliminary study of non‐psychotic disorders in people from the Indian subcontinent living in the UK and India
Authors: Creed F. , Winterbottom M. , Tomenson B. , Britt R. , Anand I. S. , Wander G. S. , Chandrashekhar Y.
Published: November 2007

Objective: The prevalence of anxiety and depressive disorders in people of South Asian origin in the UK is not accurately known.

Method: A population‐based study of UK residents from the Indian subcontinent was screened for anxiety and depressive disorders with the Self‐Rating Questionnaire (SRQ) and for life events using the brief list of threatening life events. Similar measures were administered to siblings in India.

Results: The UK sample included 223 Sikhs, 100 Hindus and 49 Muslims. Elevated SRQ scores were recorded in 5%, 13% and 23%, respectively, of men from these groups and in 16%, 27% and 57%, respectively, of females. Subjects reporting one or more threatening life events (most commonly unemployment and financial problems) also had raised SRQ scores. A total of 117 siblings in India reported similar SRQ scores to their index subjects in the UK, but reported more threatening life events, notably deaths and illness in the family and financial problems.

Conclusion: This preliminary study indicates that psychiatric disorder in ethnic groups varies across religious groups. The prevalence may be high in some religious groups in association with social difficulties. The patterns of stress in India and the UK are different.
Circulatory levels of catecholamines, serotonin and lipids in attention deficit hyperactivity diiorder
Authors: Spivak B. , Vered Y. , Yoran‐Hegesh R. , Averbuch E. , Mester R. , Graf E. , Weizman A.
Published: November 2007

Attention deficit hyperactivity disorder (ADHD) may be associated with a dysregulation of the catecholaminergic and serotonergic systems. Furthermore, ADHD is frequently complicated by aggressive impulsive behaviour, which is suggested to be related to low serum cholesterol levels. We examined the relationship between blood serotonin, norepinephrine, dopa and lipid levels and the degree of hyperactivity, impulsiveness, lack of concentration, and aggressiveness in boys with ADHD of low and high severity as determined by a specially designed formulated scale based on the DSM‐IV criteria for ADHD. No differences were noted between the groups in any of the peripheral biological parameters except blood serotonin, for which a tendency (P =0.08) towards lower levels was observed in the children with more severe disorder. We conclude that children with severe ADHD may have a different serotonin turnover compared to children with mild ADHD. These results may have implications for our understanding of the pathogenesis of ADHD, at least the more severe type.
Dose‐response relationship of phototherapy for seasonal affective disorder: a meta‐analysis
Authors: Lee T. M. C. , Chan C. C. H.
Published: November 2007

Objective: The therapeutic effect of phototherapy for seasonal affective disorder (SAD) has been widely investigated. However, the antidepressant effect of various light intensities is inconclusive. The purpose of this study was to evaluate the dose‐response relationship of phototherapy for SAD.

Method: A meta‐analytical methodology was applied to 39 studies of phototherapy for SAD. The studies collected were screened for study quality by a threats‐to‐validity method before inclusion. The fixed‐effects‐model analysis of variance procedures were used for data analysis.

Results: The results indicated that different light intensities produced different effects in reducing the typical symptoms, as measured by the Hamilton Depression Rating Scale, of patients with SAD. However, no significant differences in these effects were revealed between strong, medium and dim light in reducing the atypical symptoms of patients.

Conclusion: These findings showed that light intensity varied positively with the antidepressant effect for typical but not for atypical symptoms of SAD, suggesting that light intensity tended to have different therapeutic effects on the typical and atypical symptoms of SAD.
Risk factors for violence among long‐stay psychiatric patients: national study
Authors: Rabinowitz J. , Mark M.
Published: November 2007

This study identified risk factors for violence among long‐stay (1 year or more) psychiatric patients in Israel (n= 2946) using data from a national re‐evaluation of such patients. Patients were rated as being violent if hospital staff or patient charts indicated an incident of physical violence at least every few months. The relationship between violence and patients' functioning, living conditions, treatment, background and hospitalization history was studied. In total, 22.8% of patients were violent. Based on logistic regression analysis, the risk factors for being violent were younger age, younger age at first hospitalization, poorer self‐care, having more frequent visitors, and the patient not having his or her own clothing. The data for age and lack of gender differences confirm previous findings. However, the results regarding clothing, visitors, poor self‐care and age of onset are unique. The results of this study suggest that the violent behaviour of in‐patients is related to both individual and environmental variables.
Increasing rates of hospital admission for men with major mental illnesses: data from Scottish mental health units, 1980–1995
Authors: Cavanagh J.T. O. , Shajahan P. M.
Published: November 2007

Objective: We studied first admission rates for major mental illness in order to explore links with an increase in psychiatric morbidity and mortality in men.

Method: Patient discharge data from Scottish Mental Health Units during 1980–1995 were analysed.

Results: Admission rates for schizophrenia remained constant in men and decreased in women. Affective disorders remained constant in men and decreased in women. Paranoid states increased in men and remained constant in women. Non‐organic psychoses increased in both men and women.

Conclusion: Further evidence is provided for an increase in the proportion of men, particularly younger age groups, admitted with major mental illness. Possible reasons include (i) comorbidity, (ii) biological variables, (iii) responses to and change in health‐seeking behaviour in men and (iv) an increased prevalence of major mental illness in men.
Intensive case management in Australia: a randomized controlled trial
Authors: Issakidis C. , Sanderson K. , Teesson M. , Johnston S. , Buhrich N.
Published: November 2007

This study compared intensive case management (ICM) with standard clinical case management in a well‐resourced community mental health service in Australia. A total of 73 severely disabled clients of an existing clinical service were randomly allocated to either ICM (caseload 10 clients per clinician) or standard case management (caseload up to 30 clients per clinician) and followed up for 12 months. A greater proportion of clients receiving ICM showed improved social functioning, these clients had fewer psychiatric hospital admissions involving police, and were more likely to engage and remain in treatment compared to those who received standard case management. Clients receiving ICM did not show a reduction in hospitalization duration or total number of episodes. It is suggested that future studies of ICM should focus on which aspects of treatment produce positive outcomes, how they can be applied to routine clinical settings, and over what period of time outcomes are sustained.
A puzzling case of seizures and visual hallucinations during clomipramine treatment with a high dose but causing a low serum concentration
Authors: Terao T. , Ohmori O. , Shinkai T.
Published: November 2007

We present a puzzling case of a 25‐year‐old depressive man suffering from seizures and visual hallucinations during clomipramine treatment with a high dose but causing a low serum concentration. We examined alleles of cytochrome P450 (CYP) isozymes. It was revealed that he was not an ultrarapid metabolizer for CYP2D6, and that the genotypes were homozygous for CYP2D6 J and heterozygous for CYP2C19m1. Throughout the treatment period, his compliance was good. Since he was a smoker, it seems likely that his low clomipramine level was due to smoking‐induced CYP1A2 activity. These findings suggest that smoking‐induced CYP1A2 activity overcomes the possibly inhibiting effects of homozygosity for CYP2D6J and heterozygosity for CYP2C19ml, and that high‐dose clomipramine is not always a direct cause of seizures.
The prehistory of psychiatry in Ethiopia
Authors: Giel R.
Published: November 2007

Ethiopian psychiatry has changed considerably during the last few years with an increasing number of Ethiopian doctors and nurses trained in psychiatry. In the paper is given an outline of the history of psychiatry in Ethiopia from 1965 onwards. Important improvements in the Amanuel Mental Hospital in Addis Ababa which for long was the only psychiatric facility in the country, the establishment of the Department of Psychiatry at the Medical Faculty of the University of Addis Ababa and the introduction of psychiatry in the curriculum of the medical faculty are important steps. Recently training of nurses and doctors in psychiatry has led to the establishment of psychiatric clinics in 26 district hospitals throughout the country staffed with psychiatric nurses supervised by psychiatrists from Amanuel Hospital in Addis Ababa. The development of psychiatric research in Ethiopia is also outlined.
Major mental disorders in Addis Ababa, Ethiopia. III. Neurotic and somatoform disorders
Authors: Kebede D. , Alem A.
Published: November 2007

This report presents estimates of the lifetime and point (one‐month) prevalence of phobic anxiety, dissociative, other anxiety and somatoform disorders based on a survey conducted in Addis Ababa between September and December of 1994. An Amharic version of the CIDI was used to collect data from a random community sample of 1420 individuals aged 15 and above. Phobic anxiety disorders were found to be the most common of all anxiety disorders, with lifetime prevalence of 4.8%). The lifetime prevalence for dissociative disorders was 0.8% and for other anxiety disorders it was 2.7%. The prevalence of somatoform disorders was 3.1%. The lifetime prevalence for all the above neurotic and somatoform disorders was 10.8%. Point prevalence estimates (percent) for the disorders were as follows: phobic anxiety disorders, 4.4; other anxiety disorders, 1.2; dissociative disorders, 0.4; and somatoform disorders, 2.5. After adjusting for several potential confounders, women had over a two‐fold risk of having neurotic and somatoform disorders compared to men, odds ratio (OR), 95% confidence interval (CT)=2.38 (1.78, 3.12). Age was also inversely associated with the disorders. Those aged 60 and above had a 60% lower risk compared to those aged 15–24 years, OR (95% CI): 0.41 (0.20, 0.81). The 25% decreased risk for the employed, compared to the unemployed, was also not statistically significant. Education, marital status, and ethnicity were not significantly associated with neurotic and somatoform disorders.
How are mental disorders seen and where is help sought in a rural Ethiopian community? A key informant study in Butajira, Ethiopia
Authors: Alem A. , Jacobsson L. , Araya M. , Kebede D. , Kullgren G.
Published: November 2007

One hundred key informants were interviewed about their awareness, attitudes and practices regarding mental illness using the Key Informant Questionnaire developed by WHO. Case vignettes of seven common neuropsychiatric disorders were presented to the key informants. Tnformants' awareness about these disorders and help‐seeking practices for mental and physical symptoms or conditions were assessed. An additional question on the prototype symptoms of mental disorders was also posed. Among the presented seven conditions, epilepsy was perceived as the most common condition and major depression was regarded as the least common one. Schizophrenia was judged as the most severe problem, and mental retardation was considered the second most severe condition. Talkativeness, aggression and strange behaviour were the most frequently perceived prototype symptoms of mental illness. Traditional treatment methods were preferred more often for treating symptoms of mental disorders and modern medicine was preferred more often for treating physical diseases or symptoms. Findings of this study are similar to other studies conducted in socio‐culturally different communities. Working in close connection with traditional healers would give the primary health care worker a better opportunity to gain acceptance from the community and modify certain harmful practices.
Major mental disorders in Butajira, southern Ethiopia
Authors: Awas M. , Kebede D. , Alem A.
Published: November 2007

Previous studies conducted in Ethiopia lack information on the prevalence of specific mental disorders in rural communities. The lifetime and one‐month prevalence of specific ICD‐10 mental disorders and their associated socio‐demographic factors were determined using the translated Amharic version of the Composite International Diagnostic Interview (CIDI) in a rural population. A total of 501 community subjects selected from a predominantly rural district by stratified random sampling were interviewed by non‐clinician interviewers. The weighted aggregate lifetime prevalence of psychiatric morbidity was 31.8% (26.7% when substance dependence was not included). The most frequent specific diagnoses were: dissociative disorders (6.3%), mood disorders (6.2%), somatoform disorders (5.9%), and anxiety disorders (5.7%). After adjustment in a multivariate logistic model, female sex was shown to have a statistically significant association with mood disorders (Odds Ratio, OR = 3.84, 95% CI: 1.90, 7.73) and somatoform disorders (OR=2.30, 95% CI: 1.13, 4.60). Severe cognitive and mood disorders were significantly associated with being elderly, i.e. 60 or more years of age (OR=7.71, 95%) CI: 1.58, 7.53; and OR=3.68, 95%) CI=1.36, 9.95, respectively). Khat dependence was associated with being Muslim and with earning a low income. (OR = 3.5, 95% CI: 1.02, 11.98; and OR=0.32, 95% CI: 0.10, 0.96, respectively). It is concluded that psychiatric morbidity is a major public health problem in the rural community.
Awareness and attitudes of a rural Ethiopian community toward suicidal behaviour: A key informant study in Butajira, Ethiopia
Authors: Alem A. , Jacobsson L. , Kebede D. , Kullgren G.
Published: November 2007

One hundred key informants were interviewed regarding their awareness and attitudes toward suicidal behaviour. Eighty‐eight informants were male, 58 were Muslim and 42 were Christian. Informants on average, claimed to know more persons who had completed suicide than those who had attempted suicide. Almost all informants mentioned more than one cause for suicide. Of these, frustration was the most frequently mentioned cause. Most informants believed that suicide attempters arecruel, fearedandnot trustworthy. Their attitude toward suicide completers was expressed ascondemned sinners, do not deserve funeral ceremony, and should be buried separately from others. Christians gave importance to the funeral issue more than did the Muslims. Generally, the attitudes of informants were punitive and disapproving.
Suicide attempts among adults in Butajira, Ethiopia
Authors: Alem A. , Kebede D. , Jacobsson L. , Kullgren G.
Published: November 2007

In a cross‐sectional survey, 10 468 adults of a rural and semi‐urban community were interviewed to determine lifetime suicide attempts. Among the study population, 58% were female, 74.4%) were Muslim and 79.3%) had had no formal education. The majority of the population were in the age group 25–59 years. Lifetime suicide attempt was reported by 3.2% (n = 332) of the study population. Of these, 63% (n=208) were women. The most frequent age of attempt was between 15 and 24 years and the frequency of attempt decreased with increasing age. Hanging and poisoning were the most frequently reported methods of attempting suicide. Marital or family conflict was the most frequently reported cause for attempting suicide and most of those who reported this cause were women (Chi‐square= 17.42; P<0.001). Men were significantly more likely to use hanging to attempt suicide than women (Chi‐square=8.21; P<0.001). Among Christians 3.9%) had a lifetime suicide attempt compared to 2.9%) among Muslims (Chi‐square = 6.15;P<0.05). People who currently had mental distress and problem drinking reported lifetime suicide attempt more often than others.
Cognitive deficits and cognitive training in schizophrenic patients: a review
Authors: Rund B. R. , Borg N. E.
Published: November 2007

Rund BR, Borg NE. Cognitive deficits and cognitive training in schizophrenic patients: a review.

Acta Psychiatr Scand 1999: 100: 85–95. © Munksgaard 1999

Objective: The aim of this paper is to review the current status of knowledge of cognitive deficits and remediation in patients with schizophrenia.

Method: Relevant reports were identified by a literature survey. In addition, some outstanding researchers in these areas were asked to add to the identified list relevant literature that was not included.

Results: Our review focuses on the cognitive deficits observed in the areas of attention, memory and executive functions. We attempt to classify dysfunctions as vulnerability‐ or symptom‐linked factors, and we discuss the methodological question of a general performance deficit vs. a differential deficit. Furthermore, we briefly delineate how antipsychotics affect cognitive functions. Finally, controlled studies of cognitive training are discussed in more detail.

Conclusion: The most outstanding cognitive dysfunctions in patients with schizophrenia can be related to the areas of attention, memory and executive functions. Interest in cognitive remediation has to some extent been rekindled in the 1990s. However, few studies on the effects of cognitive training programs have been conducted.
Self‐perceived interpersonal competence in older schizophrenia patients: the role of patient characteristics and psychosocial factors
Authors: Semple S. J. , Patterson T. L. , Shaw W. S. , Grant I. , Moscona S. , Jeste D.V.
Published: November 2007

Semple SJ, Patterson TL, Shaw WS, Grant I, Moscona S, Jeste DV. Self‐perceived interpersonal competence in older schizophrenia patients: the role of patient characteristics and psychosocial factors. Acta Psychiatr Scand 1999: 100: 126–135. © Munksgaard 1999.

Objective: This study compared older schizophrenia patients with normal subjects in terms of their perceived interpersonal competence.

Method: A total of 95 middle‐aged and elderly schizophrenia patients and 85 age‐matched normal subjects completed the Interpersonal Competence Questionnaire.

Results: Patients scored significantly lower than normal subjects on initiation, provision of emotional support, and conflict management. Severity of psychiatric symptoms and other patient characteristics were examined as predictors of interpersonal competence among patients. Negative symptoms were inversely related to interpersonal competence, whereas emotional support from others and a positive appraisal coping style both yielded positive associations.

Conclusion: These findings suggest the need for clinical interventions designed to enhance the interpersonal skills of older schizophrenia patients, particularly those with marked negative symptoms.
The association between needs and quality of life in an epidemiologically representative sample of people with psychosis
Authors: Slade M. , Leese M. , Taylor R. , Thornicroft G.
Published: November 2007

Slade M, Leese M, Taylor R, Thornicroft G. The association between needs and quality of life in an epidemiologically representative sample of people with psychosis.

Acta Psychiatr Scand 1999: 100: 149–157. © Munksgaard 1999.

The impact of meeting needs on quality of life in the severely mentally ill is investigated in this study. An epidemiologically representative sample of 133 patients meeting ICD‐10 criteria for psychosis completed standardized instruments for measuring needs and quality of life. Covariance structure modelling was used to investigate the extent to which latent factors of met and unmet need were associated with latent quality of life. Patients rated about 0.7 more total (met plus unmet) needs than staff, mainly due to differences in rating unmet need. Patient ratings were more reliable than ratings by others of unmet need and quality of life. Both underlying unmet need and met need were negatively associated with underlying quality of life, but unmet need was the stronger relationship. The patient's perspective on their difficulties (especially their unmet needs) must be central to mental health care.