bluuebunny/crossref_metadata_2025_split huggingface dataset:
Manual-assisted cognitive-behaviour therapy
(MACT): a randomized controlled trial of a brief
intervention with bibliotherapy in the treatment of
recurrent deliberate self-harm
Authors: EVANS K. , TYRER P. , CATALAN J. , SCHMIDT U. , DAVIDSON K. , DENT J. , TATA P. , THORNTON S. , BARBER J. , THOMPSON S. 
Published: July 2002

Background. The treatment of deliberate self-harm (parasuicide)
remains limited in efficacy. Despite
a range of psychosocial, educational and pharmacological interventions
only one approach,
dialectical behaviour therapy, a form of cognitive-behaviour therapy (CBT),
has been shown to
reduce repeat episodes, but this is lengthy and intensive and difficult
to extrapolate to busy clinical
practice. We investigated the effectiveness of a new manual-based treatment
varying from
bibliotherapy (six self-help booklets) alone to six sessions of cognitive
therapy linked to the
booklets, which contained elements of dialectical behaviour therapy.Methods. Thirty-four patients, aged between 16 and 50, seen
after an episode of deliberate self-harm,
with personality disturbance within the flamboyant cluster and a previous
parasuicide
episode within the past 12 months, were randomly assigned to treatment
with manual-assisted
cognitive-behaviour therapy (MACT N=18) or treatment as usual
(TAU N=16). Assessment of
clinical symptoms and social function were made at baseline and repeated
by an independent
assessor masked to treatment allocation at 6 months. The number and rate
of all parasuicide
attempts, time to next episode and costs of care were also determined.Results. Thirty-two patients (18 MACT; 14 TAU) were seen at
follow-up and 10 patients in each
group (56% MACT and 71% TAU) had a suicidal act during the 6 months. The
rate of suicidal
acts per month was lower with MACT (median 0·17/month MACT;
0·37/month TAU; P=0·11)
and self-rated depressive symptoms also improved (P=0·03).
The treatment involved a mean of 2·7
sessions and the observed average cost of care was 46% less with MACT (P=0·22).Conclusions. Although limited by the small sample, the results
of this pilot study suggest that this
new form of cognitive-behaviour therapy is promising in its efficacy and
feasible in clinical practice.
Attentional and mnemonic deficits associated with
infectious disease in humans
Authors: CAPURON L. , LAMARQUE D. , DANTZER R. , GOODALL G. 
Published: July 2002

Background. Infectious diseases are accompanied by behavioural
and psychological changes
that suggest the implication of the central nervous system. Among them,
cognitive alterations have
been reported, but their specificity and implication in everyday life are
still largely unclear. The
purpose of the present study was to evaluate and specify the everyday memory
disturbances in sick
human subjects and to determinate the role of fever in the appearance of
these alterations.Methods. The study was carried out in a military training centre
for naval recruits. Ninety-one
volunteer subjects, healthy (N=30) or suffering from flu-like
syndrome, with (N=29) or without
fever (N=32), participated in this experiment and were administered
a cognitive test (the ERBMT)
according to a cross-sectional design for assessing various aspects of
everyday memory.Results. Sick subjects were specifically impaired in daily
memory tasks that require the temporary
management of a large amount of information. This impairment was similar
for the feverish and
apyretic sick subjects who both differed from the controls.Conclusion. These findings suggest that infectious disease
disturbs the complex cognitive processes
that might be associated with attentional functions. Moreover, these results
show that fever is not
a necessary condition for the appearance of these cognitive disturbances.
Capacity to make health care decisions: its
importance in clinical practice
Authors: WONG J. G. , CLARE I. C. H. , GUNN M. J. , HOLLAND A. J. 
Published: July 2002

Background. Assessment of capacity plays a pivotal role
in determining when decisions need to be
made on behalf of an individual. It therefore has major clinical management
implications for health
care professionals and civil liberties implications for the person concerned.
In many countries, there
is a presumption that adults have the capacity to make health care decisions.
However, in persons
with a mental disability, capacity may be temporarily or permanently impaired.Methods. A selective review is presented which considers:
(i) the broad approaches taken to
determining capacity; (ii) the abilities commonly assessed in

determining capacity; and (iii) the
principles underlying health care decision-making for adults who are without
capacity.Results. Capacity is a functional concept, determined by the
person's ability to understand, retain,
and weigh up information relevant to the decision in order to arrive at
a choice, and then to
communicate that choice. We have reviewed the studies that examined decision-making
abilities in
people with dementia, chronic mental illness or intellectual disabilities.
Approaches to
decision-making in adults who lack capacity include: anticipatory decisions
made through advance health
care statements or decisions by proxy based on ‘best interests’

or ‘substituted judgement’.Conclusions. The understanding of clinical and legal aspects
of capacity is still developing. This
paper examines current concepts of capacity and decision-making on behalf
of those without
capacity. We propose a framework, in line with current ethical and legal
guidelines, as an aid to
clinicians when they are seeking consent for a health care intervention.
Can children with autistic spectrum disorders
perceive affect in music? An experimental
investigation
Authors: HEATON P. , HERMELIN B. , PRING L. 
Published: July 2002

Background. Children with autistic spectrum disorders typically show impairments in processing
affective information within social and interpersonal domains. It has yet to be established whether
such difficulties persist in the area of music; a domain which is characteristically rich in emotional
content.Methods. Fourteen children with autism and Asperger syndrome and their age and intelligence
matched controls were tested for their ability to identify the affective connotations of melodies in
the major or minor musical mode. They were required to match musical fragments with schematic
representations of happy and sad faces.Results. The groups did not differ in their ability to ascribe the musical examples to the two affective
categories.Conclusions. In contrast to their performance within social and interpersonal domains, children
with autistic disorders showed no deficits in processing affect in musical stimuli.
Biological rhythm disturbance in depression:
temporal coherence of ultradian sleep EEG rhythms
Authors: ARMITAGE R. , HOFFMANN R. F. , RUSH A. J. 
Published: July 2002

Background. Recent studies have suggested that major depressive disorders are associated with a
breakdown in the organization of ultradian rhythm in sleep EEG. The present study used cross-spectral analysis of sleep EEG to confirm this finding, in a larger-scale study, evaluating the
influence of gender and age on ultradian rhythms in depression.Methods. Temporal coherence of ultradian (80–120 min) rhythms in beta, theta and delta, recorded
from central and parietal sites, were compared in 120 symptomatic, unmedicated, depressed out-patients and 59 healthy normal controls.Results. Few macro-architectural differences were noted between patients and controls. However,
interhemispheric beta and theta coherence and intrahemispheric coherence between beta and delta
rhythms were significantly lower in depressed patients. Coherence measures were lowest in women
with depression and highest in men in the control group, but were not strongly influenced by age.
Over 65% of depressed patients were [ges ]2 standard deviations below normal on at least one
coherence measure, in sharp contrast to less than 10% of patients on macro-architectural variables.Conclusions. It was concluded that dysregulation of ultradian rhythms characterizes the majority
of depressed out-patients, primarily women, even when macro-architecture did not differentiate
groups. The outcome of this study supports the view that the pathophysiology of depression is
strongly influenced by gender. It was suggested that low temporal coherence in depression reflects
a breakdown in the organization of sleep EEG rhythms within and between the two hemispheres.
Altered brain energy metabolism in lithium-resistant
bipolar disorder detected by photic stimulated 31P-MR spectroscopy
Authors: MURASHITA J. , KATO T. , SHIOIRI T. , INUBUSHI T. , KATO N. 
Published: July 2002

Background. Previous 31P-MRS (magnetic resonance spectroscopy) studies suggested altered brain
energy metabolism in bipolar disorder. This study characterized brain energy metabolism in
lithium-resistant bipolar disorder using the photic-stimulation paradigm.Methods. Subjects were 19 patients with DSM-IV bipolar disorder (nine responders and 10 non-responders, 13 with bipolar I and six with bipolar II) in the euthymic state and 25 healthy
volunteers. Energy metabolism in the occipital region was examined by 31P-MRS during photic
stimulation (PS). Six 31P-MR spectra were obtained, one was before PS (Pre), two during 12 min
of PS (PS1, PS2), and three after the PS (Post 1, Post 2, Post 3).Results. Significant effect of diagnosis (lithium-responsive bipolar disorder, lithium-resistant
bipolar disorder, and control) was found for the phosphocreatine peak area ratio during the course
of the photic stimulation (P<0·05 by repeated measures ANOVA). The phosphocreatine peak area
ratio was significantly decreased at Post 1 and Post 2 compared with Pre in lithium-resistant bipolar
patients (P = 0·01 and P = 0·01 by Dunnett's multiple comparison).Conclusions. The finding that phosphocreatine decreased after photic stimulation may be
compatible with mitochondrial dysfunction. It is possible that mitochondrial function is impaired
in lithium-resistant bipolar disorder.
A multicentre, double-blind, randomized comparison
of quetiapine (ICI 204,636, ‘Seroquel’) and
haloperidol in schizophrenia
Authors: COPOLOV D. L. , LINK C. G. G. , KOWALCYK B. 
Published: July 2002

Background. Quetiapine (ICI 204,636, ‘Seroquel’) is a new atypical antipsychotic agent with a
similar binding profile to the original atypical antipsychotic, clozapine. Its clinical efficacy has
already been demonstrated at multiple fixed doses (150–750 mg/day) and has been suggested to be
comparable with haloperidol (12 mg/day).Methods. This international, 6-week, multicentre, double-blind, randomized, parallel-group trial
compared quetiapine with haloperidol (455 mg and 8 mg mean total daily doses, respectively) in 448
hospitalized patients with acute exacerbation of chronic or subchronic schizophrenia (DSM-III-R),
in order to establish their equivalence in terms of efficacy, and the nature of their tolerability
profiles, especially in terms of extrapyramidal symptoms (EPS) and serum prolactin levels.Results. Both quetiapine and haloperidol produced a clear reduction in the Positive and Negative
Syndrome Scale (PANSS) scores and Clinical Global Impression (CGI) Severity of Illness and
Global Improvement scores. At day 42, the PANSS total score was reduced by −18·7±1·63 in the
quetiapine group, and −22·1±1·63 in the haloperidol group (P = 0·13, between-treatment).Quetiapine was better tolerated than haloperidol in terms of EPS as demonstrated by the
significant differences in the Simpson Scale and Abnormal Involuntary Movement Scale scores
(P<0·05). Although patients in both groups had elevated serum prolactin concentrations at baseline,
mean serum prolactin concentration decreased (by 16·5 μg/l) in quetiapine-treated patients, yet
increased (by 5·9 μg/l) in patients treated with haloperidol.Conclusion. Quetiapine is an effective and well tolerated antipsychotic of comparable efficacy to
haloperidol and lacks the latter compound's effect on prolactin and EPS.
Homeless youth in London: II. Accommodation,
employment and health outcomes at 1 year
Authors: CRAIG T. K. J. , HODSON S. 
Published: July 2002

Background. While there is considerable evidence of a high prevalence of psychiatric disorder
among homeless youth, much less is known about its long-term course or the impact it may have
on accommodation outcomes.Method. A random sample of 161 homeless people 16–21 years of age were recruited from
consecutive attendees at two of London's largest facilities for homeless young people. These young
people were traced and re-interviewed a year later to examine accommodation, occupation and
health outcomes.Results. A total of 107 (67%) people were successfully re-interviewed. Psychiatric disorder was
identified in 55% at follow up. Two thirds of those with a psychiatric disorder at index interview
remained symptomatic at follow-up. Persistence of psychiatric disorder was associated with adverse
childhood experiences and rough sleeping. Satisfactory accommodation outcomes were achieved by
45 subjects (42%). Better accommodation outcomes were associated with three variables measured
at the index assessment: ethnic minority status; educational achievement; and, the presence of
accommodation plans negotiated through a resettlement agency. While psychiatric disorder at
index interview was not associated with accommodation outcome, persistent substance use in the
follow-up year was associated with poor accommodation outcome. Over half of the young people
had been involved in petty crime and just under a third had been convicted for more serious criminal
activity. Offending and antisocial behaviour in the follow-up year were related to a history of
conduct disorder, persistent substance abuse and poor accommodation outcomes.Conclusions. Young homeless people are characterized by multiple social and medical needs.
Successful resettlement of this population may depend upon integrated services that address
problems of persisting substance use and mental illness as well as the immediate housing need.
Monoamine oxidase: associations with alcohol
dependence, smoking and other measures of psychopathology
Authors: WHITFIELD J. B. , PANG D. , BUCHOLZ K. K. , MADDEN P. A. F. , HEATH A. C. , STATHAM D. J. , MARTIN N. G. 
Published: July 2002

Background. Many reports have appeared on associations between platelet monoamine oxidase
(MAO) activity and susceptibility to psychiatric conditions; principally alcohol dependence but also
conduct disorder, other drug use and depression. Recently, it has become apparent that MAO
activity is inhibited by some component of cigarette smoke, and smokers have low platelet MAO
activity. Since the prevalence of smoking is higher in many of the conditions in which MAO has
been implicated, the MAO susceptibility associations may be partly, or entirely, false.Methods. We have measured platelet MAO in 1551 subjects, recruited from the Australian
NHMRC Twin Registry, who have provided information on alcohol use and dependence, smoking,
conduct disorder, depression, attempted suicide, panic disorder and social phobia.Results. Current smoking reduced platelet MAO activity in a significant and dose-related manner,
with no evidence of lower MAO in ex-smokers or in non-smoking subjects with co-twins who
smoked. Alcohol use and lifetime DSM-III-R alcohol dependence history were not associated with
MAO activity when smoking was taken into account. Depression, panic disorder and social phobia
showed no significant associations with platelet MAO activity. Subjects with a history of serious
attempts at suicide had low platelet MAO activity; but although the difference from controls was
as great as the reduction associated with smoking it was not significant after correction for smoking
effects.Conclusions. Although synaptic MAO activity undoubtedly plays a role in psychopathology, the
concept that platelet MAO activity is a direct genetic marker of vulnerability to alcohol dependence
cannot be sustained.
Physical health and the onset and persistence of
depression in older adults: an eight-wave prospective
community-based study
Authors: GEERLINGS S. W. , BEEKMAN A. T. F. , DEEG D. J. H. , VAN TILBURG W. 
Published: July 2002

Background. Poor physical health has long been recognized to be one of the most important risk
factors for depression in older adults. Since many aspects of physical health can be targeted for
improvement in primary care, it is important to know whether physical health problems predict the
onset and/or the persistence of depression.Methods. The study is based on a sample which at the outset consisted of 327 depressed and 325
non-depressed older adults (55–85) drawn from a larger random community-based sample in the
Netherlands. Depression was measured using the Center for Epidemiologic Studies Depression
scale (CES-D) at eight successive waves.Results. From all incident episodes, the majority (57%) was short-lived. These short episodes could
generally not be predicted by physical health problems. The remaining incident episodes (43%)
were not short-lived and could be predicted by poor physical health. Chronicity (34%) was also
predicted by physical health problems.Conclusions. The study design with its frequent measurements recognized more incident cases than
previous studies; these cases however did have a better prognosis than is often assumed. The
prognosis of prevalent cases was rather poor. Physical health problems were demonstrated to be a
predictor of both the onset and the persistence of depression. This may well have implications for
prevention and intervention.
Childhood sexual abuse and pathogenic parenting in the childhood recollections of adult twin pairs
Authors: McLAUGHLIN T. L. , HEATH A. C. , BUCHOLZ K. K. , MADDEN P. A. F. , BIERUT L. J. , SLUTSKE W. S. , DINWIDDIE S. , STATHAM D. J. , DUNNE M. P. , MARTIN N. G. 
Published: July 2002

Background. We examined the relationship between childhood sexual abuse (CSA), and
interviewees' recollections of pathogenic parenting, testing for possible retrospective biases in the
recollections of those who have experienced CSA.Methods. Information about CSA, parental divorce and interviewees' recollections of parental
rejection, parental overprotection and perceived autonomy (as assessed through a shortened version
of the Parental Bonding Instrument) was obtained through telephone interviews with 3626
Australian twins who had also returned self-report questionnaires several years earlier. Recollections
of parental behaviours were compared for individuals from pairs in which neither twin, at least one
twin, or both twins reported CSA.Results. Significant associations were noted between CSA and paternal alcoholism and between
CSA and recollections of parental rejection. For women, individuals from CSA-discordant pairs
reported levels of parental rejection that were significantly higher than those obtained from CSA-negative pairs. The levels of parental rejection observed for twins from CSA-discordant pairs did
not differ significantly from those obtained from CSA-concordant pairs, regardless of respondent's
abuse status. For men from CSA-discordant pairs, respondents reporting CSA displayed a tendency
to report higher levels of parental rejection than did respondents not reporting CSA. Other
measures of parenting behaviour (perceived autonomy and parental overprotection) failed to show
a clear relationship with CSA.Conclusions. The relationship between CSA and respondents' recollections of parental rejection is
not due solely to retrospective bias on the part of abused individuals and, consistent with other
studies, may reflect a pathological family environment with serious consequences for all siblings.
Fitness to plead. A prospective study of the inter-relationships between expert opinion, legal criteria and specific symptomatology
Authors: JAMES D. V. , DUFFIELD G. , BLIZARD R. , HAMILTON L. W. 
Published: July 2002

Background. Psychiatrists are asked to give opinions as to fitness to plead, a legal concept. There
is a dearth of research into fitness to plead in the UK, with no prospective studies and no studies
involving the comparison of fit and unfit subjects. In particular, there have been no investigations
into the meaning of ‘unfit to plead’ in terms of psychiatric symptomatology, or as to the relative
importance of each legal fitness criterion in psychiatrists' conclusions as to fitness.Method. The study comprised a prospective evaluation of 479 consecutive referrals to psychiatrists
at court. Individual legal fitness criteria were examined as predictors of unfitness. Associations of
unfitness, and of individual legal fitness criteria, were examined with Brief Psychiatric Rating Scale
(BPRS) symptom scores.Results. The two most important of the legal criteria in clinical decisions as to unfitness were
whether the person could follow the proceedings of the trial or give adequate instructions to their
solicitor. The legal criteria concerning trial were more predictive of unfitness than those concerning
plea. Unfitness was significantly associated with the presence of positive psychotic symptomatology,
in particular conceptual disorganization and delusional thinking, but not with symptoms of anxiety,
depression or withdrawal.Conclusion. Unfitness is most significantly associated with symptoms affecting comprehension and
communication. The fitness criteria could be simplified without loss of power. These results,
predominantly concerned with mental illness, may not generalize to the mentally impaired.
Source monitoring deficits in patients with
schizophrenia; a multinomial modelling analysis
Authors: KEEFE R. S. E. , ARNOLD M. C. , BAYEN U. J. , HARVEY P. D. 
Published: July 2002

Background. Schizophrenia patients, particularly those with symptoms such as thought insertion,
passivity experiences and hallucinations, may share an underlying cognitive deficit in monitoring the
generation of their own thoughts. This deficit, which has been referred to as ‘autonoetic agnosia’,
may result in the conclusion that self-generated thoughts come from an external source. Previous
work supports this notion, yet the statistical approaches that have been used have not enabled a
distinction between specific deficits suggesting autonoetic agnosia and more general cognitive
dysfunction.Methods. Autonoetic agnosia was assessed using source-monitoring paradigms in 28 patients with
schizophrenia and 19 control subjects. Multinomial model analyses, which allow the distinction
between deficits in recognizing information, remembering its source, and response biases, were
applied to the data.Results. Schizophrenia patients were impaired in discriminating between words that came from two
external sources, from two internal sources, and one internal and one external source. In a condition
requiring subjects to distinguish between words they had heard from those they had imagined
hearing, when schizophrenic patients did not remember the source of the information, they showed
a stronger bias than controls to report that it had come from an external source.Conclusions. The application of multinomial models to source monitoring data suggests that
schizophrenia patients have source monitoring deficits that are not limited to the distinction
between internally-generated and externally-perceived information. However, when schizophrenia
patients do not remember the source of information, they may be more likely than controls to report
that it came from an external source.
The ghost of Sigmund Freud haunts Mark Solms's dream theory
Authors: Hobson J. Allan 
Published: July 2002

Recent neuropsychological data indicating that an absence of dreaming follows lesions of frontal subcortical white matter have been interpreted by Solms as supportive of Freud's wish-fulfillment, disguise-censorship dream theory. The purpose of this commentary is to call attention to Solms's commitment to Freud and to challenge and contrast his specific arguments with the simpler and more complete tenets of the activation-synthesis hypothesis.[Hobson et al.; Nielsen; Solms]