bluuebunny/crossref_metadata_2025_split huggingface dataset:
Neuroleptic drugs in breast-milk: a study of

pharmacokinetics and of possible adverse effects in

breast-fed infants
Authors: YOSHIDA K. , SMITH B. , CRAGGS M. , KUMAR R. 
Published: July 2002

Background. Very little is known about the

pharmacokinetics of neuroleptic drugs in breast-feeding

mothers and their infants or about possible adverse effects in

the infants.Method. Twelve mothers who breast-fed their infants

were prescribed haloperidol, chlorpromazine

or trifluoperazine. Two methods, enzyme immunoassay (EIA) and high

performance liquid

chromatography (HPLC) were used to assay these drugs in samples

from mothers, but infants'

samples were assayed only by the more sensitive EIA. Repeated

clinical and developmental

assessments of the breast-fed infants were carried out up to

30 months of age. The control subjects

were 18 bottle-fed infants whose mothers were also prescribed

neuroleptic or mood-stabilizing drugs.Results. The total concentrations of neuroleptic drugs

and their principal metabolites in maternal

plasma were correlated with concentrations in fore-milk. Infants were

ingesting up to 3% of the

maternal daily dose per kg body weight and small amounts of the

drugs were detected in infants'

plasma and urine. Concentrations of haloperidol in the adult range

were found in plasma from 2

of 5 infants assayed by EIA but there was no evidence of any acute

or delayed adverse effects. Three

other breast-fed infants whose mothers were prescribed both

haloperidol and chlorpromazine

showed a decline in their developmental scores from the first to

the second assessment at 12–18 months.Conclusion. More extensive longitudinal studies are needed

but, in the meantime, there appears to

be grounds for caution if breast-feeding mothers are prescribed doses

of single or two neuroleptic

drugs at the upper end of their recommended ranges.
Sex differences in the association between childhood

experiences and adult depression
Authors: VEIJOLA J. , PUUKKA P. , LEHTINEN V. , MORING J. , LINDHOLM T. , VÄISÄNEN E. 
Published: July 2002

Background. In the present paper, sex differences in the

association between adult depression and

childhood experiences were examined.Methods. The study series of the Finnish UKKI Study consisted

of a population sample of 501 men

and 499 women. Information concerning childhood experiences was gathered

retrospectively in a

baseline survey carried out in 1969–72. After the initial

phase, the mental health of the subjects was

evaluated by interviews, questionnaires and register data at the

5-year follow-up (1974–6) and at the

16-year follow-up (1985–7).Results. Twelve per cent of men and 21% of women had

suffered from depression during the 16-year follow-up period. A

disturbed mother–child relationship and neurotic symptoms in

childhood were associated with depression in women but not in men in

the logistic model that included gender

interaction. In separate analyses by gender several childhood factors

showed statistically significant

associations with depression in women but only a few in men.Conclusions. The finding suggests that childhood experiences

are more highly predisposing factors

to depression in women than in men.
Obstetric complications, treatment response and
brain morphology in adult-onset and early-onset males with schizophrenia
Authors: SMITH G. N. , KOPALA L. C. , LAPOINTE J. S. , MacEWAN G. W. , ALTMAN S. , FLYNN S. W. , SCHNEIDER T. , FALKAI P. , HONER W. G. 
Published: July 2002

Background. Substantial variability in age at onset of

illness and course of illness exists between
patients with schizophrenia. Recent studies suggest that age at illness

onset may be useful in defining
biologically and clinically distinct subgroups of patients.Methods. Two hundred and ten males with schizophrenia were

classified as early-onset or adult-onset according to their age at
first hospitalization. Birth history, clinical functioning and treatment

response was assessed in a subgroup of patients. Brain anatomy was assessed

from CT scans in all patients and in 32 non-psychiatric control subjects.Results. Patients with an early-onset were likely to have a

history of obstetric complications, a poor
response to neuroleptic treatment, and showed no relationship between
ventricle size and duration
of illness. Adult-onset patients were less likely to have obstetric
complications, more likely to
respond to treatment in the first years of illness, and showed an
association between brain structure and duration of illness.Conclusions. The distinction between early- and adult-onset

patients may have important aetiological and treatment implications.
Assessing relatives' needs for psychosocial
interventions in schizophrenia: a relatives' version of
the Cardinal Needs Schedule (RCNS)
Authors: BARROWCLOUGH C. , MARSHALL M. , LOCKWOOD A. , QUINN J. , SELLWOOD W. 
Published: July 2002

Background. The methodology for measuring the needs of

patients with severe mental illness is now
well established through the MRC Needs for Care Assessment Schedule and
its modification in the
form of the Cardinal Needs Assessment. This paper reports the rationale
and construction of a
relatives' version of the Cardinal Needs Schedule and looks
at preliminary data reporting on reliability and validity.Methods. Potential problem areas for relatives were identified

from the literature. The criteria
determining Cardinal Needs for each problem included objective threshold,

carer concern, and carer
cooperation. The reliability of the Schedule was assessed in a study whereby

27 relatives of patients
with established schizophrenic illness completed two Schedules administered
by two independent
raters within a short time period.Results. The Schedule was acceptably reliable for most areas
of
need although there were some
difficulties associated with the cooperation criteria. Concurrent measures

of relatives and patients
including EE, relative distress and patient psychopathology indicated
that the Relatives' Cardinal
Needs Schedule shows acceptable validity when used with a sample of 45
relatives.Conclusions. The paper suggests that the Schedule may prove
to
be a useful tool for both clinicians
and researchers interested in establishing and evaluating family interventions.
Development of the World Health Organization WHOQOL-BREF
Quality of Life Assessment
Authors: THE WHOQOL GROUP  
Published: July 2002

Background. The paper reports on the development of the

WHOQOL-BREF, an abbreviated version of the WHOQOL-100 quality of life assessment.Method. The WHOQOL-BREF was derived from data collected using
the WHOQOL-100. It
produces scores for four domains related to quality of life:
physical health, psychological, social
relationships and environment. It also includes one facet on overall
quality of life and general health.Results. Domain scores produced by the WHOQOL-BREF correlate

highly (0·89 or above) with
WHOQOL-100 domain scores (calculated on a four domain structure). WHOQOL-BREF
domain
scores demonstrated good discriminant validity, content validity,
internal consistency and test–retest reliability.Conclusion. These data suggest that the WHOQOL-BREF provides

a valid and reliable alternative
to the assessment of domain profiles using the WHOQOL-100. It is envisaged
that the
WHOQOL-BREF will be most useful in studies that require a brief assessment

of quality of life, for example,
in large epidemiological studies and clinical trials where quality of
life is of interest. In addition, the
WHOQOL-BREF may be of use to health professionals in the assessment and
evaluation of
treatment efficacy.
A simple test of copying ability and sex define survival in patients

with early Alzheimer's disease
Authors: CLAUS J. J. , WALSTRA G. J. M. , BOSSUYT P. M. , TEUNISSE S. , VAN GOOL W. A. 
Published: July 2002

Background. We studied whether heterogeneous profiles
of cognitive function are relevant to
survival in patients with early Alzheimer's disease.Methods. CAMCOG subscales of cognitive function were used as
predictors of survival, together
with gender in 157 consecutively referred patients with early Alzheimer's
disease. Statistical analysis
was performed with Cox proportional hazards analysis and Kaplan–Meier
survival curves. Survival
rates were compared with those in the general population.Results. Eighty patients (51%) died during the follow-up that
extended to 5·7 years, with a median
survival of 4·4 years after entry. Only the praxis subscore was
statistically significant related to
survival (P<0·0001). Its predictive power was based
on only two items, including copying ability
for a spiral and a three-dimensional house, independent of age, sex, education,
overall CAMCOG
score, dementia severity and symptom duration. Kaplan–Meier curves
for the combined score of
these items (0, 1, or 2) showed three groups with significantly different
survival rates for both men
and women. Comparison of gender specific survival rates with data from
the general population
showed that excess mortality was statistically significant (P<0·01)
higher in men (51%) than in
women (21%) after follow-up extending to 5 years.Conclusions. A simple test of copying ability defines subgroups
of AD patients with large differences
in survival rates. This suggests that parietal lobe impairment is an important
predictor of mortality
in AD. Also, the course of AD may be more benign in women than in men.
Clinical characteristics in patients with anorexia
nervosa and obsessive–compulsive disorder
Authors: MATSUNAGA H. , KIRIIKE N. , IWASAKI Y. , MIYATA A. , YAMAGAMI S. , KAYE W. H. 
Published: July 2002

Background. The purpose of this study was to assess clinical
characteristics, including co-morbid
personality disorders in patients with both anorexia nervosa (AN) and obsessive–compulsive

disorder (OCD) in comparison with age- and sex-matched patients with OCD.Methods. Fifty-three female patients with AN were divided into
two groups based on the presence
or absence of a current diagnosis of OCD, as assessed by the Structured
Clinical Interview for
DSM-III-R Patient version (SCID-P). Twenty-one women (40%) who met the
DSM-III-R criteria
for both AN and OCD were compared with 23 female patients with OCD, using
the Yale-Brown
Obsessive Compulsive Scale (Y-BOCS) and the SCID Axis II disorders.Results. There were no significant differences on the mean
Y-BOCS severity scores between these
groups. However, AN patients with OCD were significantly more likely than
OCD patients to have
obsessions with need for symmetry or exactness and ordering/arranging
compulsions, whereas both
aggressive obsessions and checking compulsions tended to be more frequently
identified in OCD
patients compared with AN patients with OCD. AN patients with OCD were
significantly more
likely than OCD patients to meet the criteria for obsessive–compulsive
personality disorder
(OCPD).Conclusions. These results suggest that there are some differential
characteristics of the OCD
symptomatology between these disorders, although many patients with AN
manifest significant
impairment from primary OCD symptoms with similar magnitude in severity
to that found in OCD
patients.
Diagnostic depressive symptoms of the mixed bipolar episode
Authors: CASSIDY F. , AHEARN E. , MURRY E. , FOREST K. , CARROLL B. J. 
Published: July 2002

Background. There is not yet consensus on the best diagnostic definition of mixed bipolar episodes.
Many have suggested the DSM-III-R/-IV definition is too rigid. We propose alternative criteria
using data from a large patient cohort.Methods. We evaluated 237 manic in-patients using DSM-III-R criteria and the Scale for Manic
States (SMS). A bimodally distributed factor of dysphoric mood has been reported from the SMS
data. We used both the factor and the DSM-III-R classifications to identify candidate depressive
symptoms and then developed three candidate depressive symptom sets. Using ROC analysis we
determined the optimal threshold number of symptoms in each set and compared the three ROC
solutions. The optimal solution was tested against the DSM-III-R classification for cross-validation.Results. The optimal ROC solution was a set, derived from both the DSM-III-R and the SMS, and
the optimal threshold for diagnosis was two or more symptoms. Applying this set iteratively to the
DSM-III-R classification produced the identical ROC solution. The prevalence of mixed episodes
in the cohort was 13·9% by DSM-III-R, 20·2% by the dysphoria factor and 27·4% by the new ROC
solution.Conclusions. A diagnostic set of six dysphoric symptoms (depressed mood, anhedonia, guilt, suicide,
fatigue and anxiety), with a threshold of two symptoms, is proposed for a mixed episode. This new
definition has a foundation in clinical data, in the proved diagnostic performance of the qualifying
symptoms, and in ROC validation against two previous definitions that each have face validity.
Factors associated with neuropsychological
performance in HIV-seropositive subjects without AIDS
Authors: PEREDA M. , AYUSO-MATEOS J. L. , GÓMEZ DEL BARRIO A. , ECHEVARRIA S. , FARINAS M. C. , GARCÍA PALOMO D. , GONZÁLEZ MACIAS J. , VÁZQUEZ-BARQUERO J. L. 
Published: July 2002

Background. Previous research has suggested that several factors may influence the presence of
cognitive impairment in human immunodeficiency virus (HIV) infection. The objective of this study
was to assess the impact of cognitive reserve capacity and other variables on neuropsychological
performance in early HIV infection.Methods. The neuropsychological performance of 100 HIV-seropositive subjects without AIDS (71
men and 29 women) was compared with that of 63 seronegative controls (51 men and 12 women).
Measures included a neuropsychological battery, a medical examination and a psychiatric
assessment. Cognitive reserve scores were based on a combination of years in school, a measure of
educational achievement, and an estimate of pre-morbid intelligence.Results. HIV-positive subjects had longer reaction time latencies than HIV-negative subjects. Those
in the HIV-positive group with low cerebral reserve scores showed the poorest performance on the
neuropsychological tests. The prevalence of cognitive impairment was significantly higher in the
HIV-positive group (27%) than in the controls (3·2%). Multiple regression analysis and logistic
regression analysis were used to identify factors associated with global neuropsychological
performance and cognitive impairment. Older age, lower cerebral reserve scores and not being on
zidovudine treatment were associated with lower global neuropsychological scores and with the
presence of cognitive impairment.Conclusions. Our results suggest that although cognitive impairment is not characteristic of early
HIV infection, there is a subgroup of subjects who perform more poorly than expected. A lower
reserve capacity, older age and not being on zidovudine treatment are factors that lower the
threshold for neuropsychological abnormalities in cases of early HIV infection.
Perceived need for mental health care, findings from
the Australian National Survey of Mental Health
and Well-being
Authors: MEADOWS G. , BURGESS P. , FOSSEY E. , HARVEY C. 
Published: July 2002

Background. The Australian National Survey of Mental Health and Well-being was designed to
detect and describe psychiatric morbidity, associated disability, service use and perceived need for
care. The survey employed a single-phase interview methodology, delivering a field questionnaire
to a clustered probability sample of 10641 Australians. Perceived need was sampled with an
instrument designed for this survey, the Perceived Need for Care Questionnaire (PNCQ). This
questionnaire gathers information about five categories of perceived need, assigning each to one of
four levels of perceived need. Reliability and validity studies showed satisfactory performance of the
instrument.Methods. Perceived need for mental health care in the Australian population has been analysed
using PNCQ data, relating this to diagnostic and service utilization data from the above survey.Results. The survey findings indicate that an estimated 13·8% of the Australian population have
perceived need for mental health care. Those who met interview criteria for a psychiatric diagnosis
and also expressed perceived need make up 9·9% of the population. An estimated 11·0% of the
population are cases of untreated prevalence, a minority (3·6% of the population) of whom
expressed perceived need for mental health care. Among persons using services, those without a
psychiatric diagnosis based on interview criteria (4·4% of the population), showed high levels of
perceived met need.Conclusions. The overall rate of perceived need found by this methodology lies between those found
in the USA and Canada. The findings suggest that service use in the absence of diagnosis elicited
by survey questionnaires may often represent successful intervention. In the survey, untreated
prevalence was commonly not accompanied by perceived need for mental health care.
Intra-uterine physical growth in schizophrenia:
evidence confirming excess of premature birth
Authors: ICHIKI M. , KUNUGI H. , TAKEI N. , MURRAY R. M. , BABA H. , ARAI H. , OSHIMA I. , OKAGAMI K. , SATO T. , HIROSE T. , NANKO S. 
Published: July 2002

Background. Many studies have suggested a possible aetiological role for obstetric complications
in the development of schizophrenia. We focused on prenatal physical growth in schizophrenia, a
contentious issue in the literature.Methods. We compared gestational age at birth, birth weight (BW) and birth head circumference
(BHC) between 312 schizophrenics and 517 controls, and between 187 schizophrenics and their
matched healthy siblings. Information on obstetric histories was obtained from the Maternal and
Child Health Handbooks (i.e. contemporaneous records).Results. Gestational age at birth was significantly earlier in the schizophrenics than in the controls
(P = 0·017). Pre-term birth (gestational age of 36 weeks or less) was more common in schizophrenics
than in controls (8·0% v. 3·4%, P = 0·005, odds ratio 2·5). Low BW (2500 g or less) was more
frequent in schizophrenics than in controls (9·6% v. 4·6%, P = 0·005, odds ratio 2·2). The
schizophrenics had significantly lighter BW (P = 0·0003) and tended to have smaller BHC
(P = 0·081) compared with controls. However, multiple regression analysis showed that there was
no significant difference in BW or BHC between the schizophrenics and controls when gestational
age and maternal weight were controlled. There was no significant difference in BW or BHC
between schizophrenics and their siblings, although the schizophrenics tended to be born at earlier
gestational age than their siblings.Conclusions. Our results suggest that prematurity at birth is associated with a risk of developing
schizophrenia in adulthood. When gestational age and maternal body weight were allowed for,
there was no evidence that schizophrenics tend to have lower mean BW or smaller BHC.
Unequal access and unmet need: neurotic disorders and the use of primary care services
Authors: BEBBINGTON P. E. , MELTZER H. , BRUGHA T. S. , FARRELL M. , JENKINS R. , CERESA C. , LEWIS G. 
Published: July 2002

Background. In this paper we use data from the National Survey of Psychiatric Morbidity to
examine how many people with neurotic disorders receive professional evaluation, and how this is
affected by clinical and sociodemographic differences. We hypothesized that psychiatric symptoms
and attendant dysfunctions would both have an effect on contacting, and that key demographic
variables would not.Method. The household component of the British National Surveys of Psychiatric Morbidity was
based on a random sample of > 10000 subjects. Psychiatric symptoms and ICD-10 diagnosis were
established by lay interviewers using the CIS-R. Social dysfunction was tapped by asking about
difficulties in performing seven types of everyday activity. We examined symptom score, ADL
deficit score and demographic variables in relation to contact with primary care physicians for
psychiatric symptoms.Results. The major determinant of contacting a primary care physician was severity, mainly due to
the level of psychiatric symptoms, but with an independent contribution from social dysfunction.
There were also significant contributions from sex, marital status, age, employment status and
whether the subject had a physical condition as well.Conclusions. The major influence on whether people seek the help of their family doctors for mental
health problems is the severity of disorder. Although there are some social inequalities in access to
family doctors, these are less important. The most salient finding from our study is that even people
suffering from high levels of psychiatric symptoms very often do not have contact with professionals
who might help them.
Lifetime co-morbidities between social phobia and
mood disorders in the US National Comorbidity
Survey
Authors: KESSLER R. C. , STANG P. , WITTCHEN H.-U. , STEIN M. , WALTERS E. E. 
Published: July 2002

Background. General population data were used to study co-morbidities between lifetime social
phobia and mood disorders.Methods. Data come from the US National Comorbidity Survey (NCS).Results. Strong associations exist between lifetime social phobia and major depressive disorder
(odds ratio 2·9), dysthymia (2·7) and bipolar disorder (5·9). Odds ratios increase in magnitude with
number of social fears. Reported age of onset is earlier for social phobia than mood disorders in
the vast majority of co-morbid cases. Temporally-primary social phobia predicts subsequent onset
of mood disorders, with population attributable risk proportions of 10–15%. Social phobia is also
associated with severity and persistence of co-morbid mood disorders.Conclusions. Social phobia is a commonly occurring, chronic and seriously impairing disorder that
is seldom treated unless it occurs in conjunction with another co-morbid condition. The adverse
consequences of social phobia include increased risk of onset, severity and course of subsequent
mood disorders. Early outreach and treatment of primary social phobia might not only reduce the
prevalence of this disorder itself, but also the subsequent onset of mood disorders.
Differences in the epidemiology of theileriosis on smallholder
dairy farms in contrasting agro-ecological and grazing strata
of highland Kenya
Authors: GITAU G. K. , McDERMOTT J. J. , KATENDE J. M. , O'CALLAGHAN C. J. , BROWN R. N. , PERRY B. D. 
Published: July 2002

A prospective cohort study was conducted in five purposively-sampled agro-ecological zone
(AEZ)-grazing system strata in Murang’a District, Kenya, between March 1995 and June 1996.
The study strata were selected based on a preliminary characterization study to represent the
widest range of risks to East Coast fever (ECF) in the District and included zero-grazing and
open-grazing farms. In total, 225 calves from 188 smallholder farms were examined from birth
to 6 months of age and visited within the first 2 weeks of life and thereafter at bi-weekly
intervals for up to 14 visits.The purpose of the study was to characterize the differences in epidemiology (risks of
infection, morbidity and mortality) and potential control of ECF between the selected strata.
Evidence of Theileria parva infection was assessed by increased antibody levels as measured in
an indirect ELISA assay by the percent positivity (PP) of serum samples relative to a strong
positive reference serum.Sero-conversion risks of T. parva were highest in the open-grazing strata. Antibody
prevalence in adult cattle and ECF morbidity and mortality risks were also highest in open-grazing strata. While different, all five AEZ-grazing strata were considered to be endemically
unstable for ECF. East Coast fever challenge was low in all zero-grazing strata and this
challenge is likely to remain low due to continuing intensification of smallholder farming in the
central highlands. In the open-grazing strata, there was higher challenge and a greater impact
of ECF.