bluuebunny/crossref_metadata_2025_split huggingface dataset:
Biochemical hypotheses on antidepressant drugs: a guide for clinicians or a toy for pharmacologists?
Authors: Garattini Silvio , Samanin Rosario 
Published: July 2009

SynopsisThe development of knowledge about the mechanism of action of tricyclic and the so-called ‘atypical’ antidepressants (AD) is reviewed. The discovery of clinically active antidepressants with little or no effect on noradrenaline or serotonin uptake has disproved the widely accepted concept that inhibition of monoamine uptake is a prerequisite for antidepressant activity. Another serious objection to this hypothesis is that blockade of monoamine uptake occurs in a matter of minutes after administration while 2–3 weeks of repeated treatment are necessary for the clinical AD effect. Nevertheless, the effect of repeated treatment with AD is compatible with the hypothesis that changes in central monoamine transmission are involved in the clinical activity of these drugs. Major changes in monoamine function after repeated treatment with AD include: desensitization and reduced density of noradrenaline receptors coupled to the adenylcyclase system, opposite changes in the sensitivity of α1(increased) and α2-adrenoreceptors (decreased), down regulation of serotonin2receptors and complex changes in the behavioural and electrophysiological responsiveness to serotonin agonists, subsensitivity of presynaptic dopamine receptors and enhanced activity of the mesolimbic dopamine system, decreased and increased density of GABA-A and GABA-B receptors respectively and down regulation of [3H]benzodiazepine binding.It remains to be clarified whether some of these changes have larger roles than others or whether they all contribute to the AD activity. An important role of dopamine in the activity of AD drugs is suggested by findings in the forced swimming test, whereas both catecholamines seem to be involved in the attenuation of escape deficit provoked by inescapable shock (learned helplessness). No clear evidence for a role of serotonin (with the possible exception of serotonin1Areceptors) or GABA has been obtained in these experimental models of depression. The general validity of these findings obviously rests on the assumption that these models represent significant aspects of human depression.
Obstetric complications and schizophrenia: a computed tomographic study
Authors: Owen Michael J. , Lewis Shôn W. , Murray Robin M. 
Published: July 2009

SynopsisAll patients aged 16–50 years who had been discharged from the Maudsley Hospital over a 4-year period with a diagnosis of schizophrenia were ascertained retrospectively. Case records were rated blindly for a history of obstetric complications (OCs). Sixty-one patients who satisfied the RDC for schizophrenia had undergone CT scanning. Those with a definite history of OCs presented at an earlier age. In this group widening of cortical sulci and fissures was more strongly correlated with VBR than in subjects without OCs. Moreover, large VBRs when accompanied by widened cortical sulci and fissures occurred more commonly in subjects with OCs than in those without. These results support the hypothesis that OCs, or a factor associated with them, lead to brain damage of aetiological significance in some cases of schizophrenia.
Structural brain changes in patients with anorexia nervosa
Authors: Dolan R. J. , Mitchell J. , Wakeling A. 
Published: July 2009

SynopsisTwenty-five patients with anorexia nervosa were compared with 17 normal healthy control subjects in terms of their cerebral computed tomographic (CT) scan appearances. The patients displayed significantly greater ventricular and sulcal enlargement when compared to control subjects. There were no relationships between the CT scan appearance and clinical indices of illness severity or weight loss in the patient group. In 14 patients who had repeat scans after attaining normal body weight, no significant change was observed in the ventricular appearance, but there was a significant lessening in the degree of sulcal widening.
The relationship between breast feeding persistence, sexuality and mood in postpartum women
Authors: Alder Elizabeth , Bancroft John 
Published: July 2009

Synopsis91 women were assessed early in pregnancy and again 3 and 6 months postpartum. Women who persisted in breastfeeding were less neurotic on the EPI but did not differ from artificial feeders in psychiatric history or sexuality before pregnancy. Breast feeders showed greater impairment of sexuality and slightly more depression at 3 months postpartum. These differences had largely disappeared at 6 months. Possible reasons for these negative effects of breast feeding are discussed and are likely to be multifactorial.
The transition to parenthood in dual-earner couples
Authors: Lewis Suzan N. C. , Cooper Cary L. 
Published: July 2009

SynopsisThe impact of the transition to parenthood for dual-earner couples was examined in a longitudinal study. Data were collected by questionnaire from couples expecting their first child, during pregnancy and after maternity leave, and from childless couples at two separate time points. The impact of the transition was minimal overall, although women experienced more pressure than men and there were some cases of extreme stress. New single-earner parents reported a greater decline in life satisfaction than dual-earners.
Henry Maudsley – psychiatrist, philosopher and entrepreneur
Authors: Turner Trevor 
Published: July 2009

SynopsisDespite his acknowledged pre-eminence among British psychiatrists of the 19th century, Henry Maudsley (1835–1918) remains a ‘shadowy figure’, a name known through the Hospital and annual lecture funded by his beneficence. Apart from the homage paid by Sir Aubrey Lewis in 1951, there has been no recent attempt at any biography nor any critical reappraisal of Maudsley's life and work. On the basis of reviewing his role in the Medico-Psychological Association (MPA), his rather pessimistic and degenerationist philosophy, his undoubted wealth and his ‘hypercritical nature’, it is possible to define an alternative view of his significance and influence.‘…comical, almost pitiable at times, is the ludicrous display of vanity by men of great eminence…they leave behind them carefully preserved letters and elaborate memoirs of what they thought and felt’. (Maudsley, 1918)
Response to drugs in schizophrenia: the influence of family history, obstetric complications and ventricular enlargement
Authors: Nimgaonkar V. L. , Wessely S. , Tune L. E. , Murray R. M. 
Published: July 2009

SynopsisA prospective study of antipsychotic drug treatment showed no difference in response between schizophrenic in-patients with or without a familial predisposition to the illness (N = 53). All patients received at least 600 mg chlorpromazine equivalents antipsychotic medication for 6 weeks. Ventricle brain ratios, ratings of cortical sulcal widening and a history of obstetric complications also failed to account for the variability, but early age of onset was associated with unsatisfactory response.
A prospective study of severe mental disorder in Afro-Caribbean patients
Authors: Harrison Glynn , Owens David , Holton Anthony , Neilson David , Boot Daphne 
Published: July 2009

SynopsisSeveral previous studies have reported increased rates of schizophrenia among Afro-Caribbean immigrants, although doubt has been cast upon the value of case-note diagnoses and retrospective case-finding. A prospective study was therefore undertaken, including all patients of Afro-Caribbean ethnic origin with a first onset psychosis presenting to the psychiatric services from a defined catchment area. Utilizing several diagnostic classifications, rates for schizophrenia were found to be substantially increased in the Afro-Caribbean community, and especially in the ‘second generation’ British born. Mode of onset and symptom profiles of psychoses suggest that atypical syndromes, and by implication ‘misdiagnoses’, do not account for reported higher rates of schizophrenic illness in these patients.
Autobiographical memory in depression
Authors: Williams J. M. G. , Scott J. 
Published: July 2009

SynopsisRecent research has shown that suicidal patients are not only biased in the speed with which they can remember positive and negative events from their past, but that they also find it more difficult to be specific in their memories. That is, they tend to recall sequences of events, or time periods, rather than single episodes. This tendency has been found to be more evident with positive than with negative events. This paper examines whether the same phenomenon can be observed in patients with a diagnosis of primary Major Depressive Disorder. Twenty depressed patients and twenty matched controls were presented with positive and negative cue words and asked to retrieve specific personal memories. Results showed that depressives (unlike controls) took longer to respond to positive than to negative cues. In addition, the depressed patients were less specific in their memories, especially in response to positive cues. These results are explained within a ‘descriptions’ theory of autobiographical memory, and the remedial implications are discussed.
The development of a computerized assessment for minor psychiatric disorder
Authors: Lewis Glyn , Pelosi Anthony J. , Glover Eric , Wilkinson Greg , Stansfeld Stephen A. , Williams Paul , Shepherd Michael 
Published: July 2009

SynopsisThis paper describes the development, validation and use of a computerized assessment for minor psychiatric disorder based on the Clinical Interview Schedule (CIS; Goldberg et al. 1970). There was good agreement between the computerized assessment and the CIS administered by psychiatrists, both in assessing overall severity and in defining ‘cases’ of psychiatric disorder. Individual symptoms elicited by the computer and the CIS were compared, and the levels of agreement found were similar to those from inter-observer studies of standardized interviews. Subjects from a variety of non-psychiatric settings regarded the assessment as acceptable, accurate and easy to use. It is concluded that this computerized assessment of neurotic symptoms is valid and reliable. It eliminates observer bias, it is an efficient use of research resources and it may have clinical applications in primary care.
Factors related to successful outcome in the treatment of sexually unresponsive women
Authors: Whitehead Antonia , Mathews Andrew 
Published: July 2009

SynopsisCouples in whom the main complaint was of a lack of female sexual response were treated using a practical counselling approach. A number of pre-treatment measures were studied to determine which factors were predictive of treatment outcome. While age and chronicity were not predictive, the quality of the general relationship and measures of sexual attitude did give useful indications of likely outcome.
The early development of Kraepelin's ideas on classification: a conceptual history
Authors: Berrios G. E. , Hauser R. 
Published: July 2009

SynopsisPsychiatry still lives in a Kraepelinian world and scholarship on the work of Kraepelin has consequently been unhistorical. Selective exegesis of the various editions of his textbook has led to a rigid view of his contribution. However, Kraepelin lived and wrote during an important period of European intellectual history and his work can only be understood against this background. This paper analyses the development of his views in terms of the ‘Research Programme’ he planned early in his life and whose objective was the creation of a stable description and classification of the psychoses. This Kraepelin eventually achieved by longitudinally studying patient cohorts in terms of methodological criteria such as illness course and incurability. In the event, this methodology allowed him to identify by correlation ‘clinical pictures’ that both represented the ‘essence’ of the disease and provided a taxonomic criterion. Although avowedly atheoretical, Kraepelin thus managed to construct (influenced by Kahlbaum and Wundt) an empirical support for his Kantian categorization of the psychoses. A discussion of the cultural variables that moulded these ideas is included.
Expressed emotion research in schizophrenia: theoretical and clinical implications
Authors: Kuipers Liz , Bebbington Paul 
Published: July 2009

SynopsisThe expressed emotion (EE) measure is a robust predictor of relapse in schizophrenia. At least twelve studies from a range of cultures have now shown this, although the authors of one maintain their findings are the result of confounding factors. A thirteenth study which failed to demonstrate a predictive effect was seriously weakened by methodological defects. There is now also evidence for the construct validity of EE, which has been shown to reflect ongoing family interactions. High EE relatives display less effective coping responses, and may adversely affect the patient by creating an unpredictable environment. EE may change with time, and probably reflects the interaction of external stresses, the real problems with the patient, and inappropriate coping responses. The association of high EE with arousal in the patient, as indicated by skin conductance abnormalities, has now been replicated. Although the EE phenomenon can be subsumed under a vulnerability-stress model, the way in which it might mediate relapse has not as yet been specified. Interventions have been successful in reducing relapse, and do so by increasing the tolerance and coping skills of the relatives, and by establishing more realistic expectations. As most have also involved the patient in the process of treatment, they have not fully resolved the question of causal direction.Future studies will clarify these issues, but will not detract from the value that EE has already had in energizing research. It has also provided a framework within which clinicians have begun to recognize and deal with the disabling problems that beset schizophrenic patients and their families.
A community study of minor psychiatric morbidity in Taiwan
Authors: Cheng Tai Ann 
Published: July 2009

SynopsisA community study of minor psychiatric morbidity (MPM) was carried out on three population samples aged 15 and above randomly selected from rural (Yenpu), suburban (Chishan), and urban (Kaohsiung) communities (N= 350 for each) in Taiwan. A two-stage case finding strategy was applied with a newly developed and validated screening questionnaire (CHQ), and a modified Chinese version of the Clinical Interview Schedule (CIS-CV). The total response rate was 99·4% and there was no time lag between the CHQ screening and the second stage clinical interview conducted by a psychiatrist. The weighted validity of the CHQ was found to be acceptable (sensitivity 69·6%, specificity 94·8%, misclassification rate 11·4%). The overall weighted prevalence rate was 18·0% for men and 33·3% for women. Both the CIS and the CHQ data are used as the morbidity indices to investigate the sociodemographic risk factors of MPM. A higher risk of MPM, which occupied 92% of the total morbidity, was found to be associated with women aged 35 and above, the unemployed men, and the lower socioeconomic status after linear modelling.
Marriage, motherhood and psychiatric morbidity in New Zealand
Authors: Romans-Clarkson S. E. , Walton V. A. , Herbison G. P. , Mullen P. E. 
Published: July 2009

SynopsisThe prevalence of psychiatric disorder, as assessed by both the GHQ-28 and the short PSE, is described for a random community sample of New Zealand women. In contrast to previous studies, married and widowed women and mothers showed lower rates than the never married and childless women. A plausible explanation is provided by available analysis of New Zealand gender roles. Such an explanation would reconfirm the importance of socio-cultural factors in community psychiatric disorder.
Cannabis affects the severity of schizophrenic symptoms: results of a clinical survey
Authors: Negrete Juan C. , Knapp Werner P. , Douglas Donald E. , Smith W. Bruce 
Published: July 2009

SynopsisData on the history of cannabis use and a spot urine test for cannabinoids were obtained for 137 schizophrenics in treatment. Subjects who were using cannabis during the 6-month observation period presented with a significantly higher degree of delusional and hallucinatory activity than those who did not. Moreover, the group using cannabis made a higher average number of visits to the hospital during the same period. The status of cannabis use appeared to contribute to such variance more than did other relevant factors (age, stage of the illness, amount of medication prescribed, occasional use of other psychoactive substances).
The contributions of sex and drinking history to the CT brain scan changes in alcoholics
Authors: Jacobson Robin 
Published: July 2009

SynopsisConsecutive series of male and female alcoholics, Alcoholic Anonymous (AA) members and controls were examined by interview and with a CT brain scan. Male controls were shown to have larger CT brain parameters than healthy females of the same age. Female alcoholics revealed equivalent CT scan abnormalities, apart from less sulcal widening, after a markedly shorter drinking history and at a lower estimated peak alcohol consumption than male alcoholics. The CT scan findings persisted after accounting for body weight and after matching for age and length of drinking history. The CT scan parameters of female AA members approached control values more completely and after briefer abstinence than did those of male AA members. Methodological problems and sex differences in selection and other processes are discussed. The findings are consistent with sex differences in the vulnerability of the brain to alcohol toxicity, and in its recovery with abstinence.
Measuring psychiatric disorder among Southeast Asian refugees
Authors: Beiser Morton , Fleming Jonathan A. E. 
Published: July 2009

SynopsisFour measures of mental health – Panic, Depression, Somatization and Well-Being – have been developed for use in a population of Southeast Asian refugees. The scales, a product of work with 1348 refugees, demonstrate conceptual significance, good reliability, concurrent validity and stability of structure across samples. They are culturally sensitive, enabling intra-cultural study as well as screening for clinical purposes. The measures also permit comparisons, for research purposes, with non-Asians.
Loss of parent in childhood and adult psychiatric disorder: the role of lack of adequate parental care
Authors: Harris Tirril , Brown George W. , Bifulco Antonia 
Published: July 2009

SynopsisThe inconclusiveness of the literature on the role of loss of parent in influencing psychiatric disorder in adulthood is well known. A number of reasons involving sampling, location and other methodological features, are given to account for these contradictory findings. A study specially designed to cope with these features is then described and basic results are reported. These indicate that, in a sample of women aged 18–65, loss of mother before the age of 17, either by death or by separation of one year or more, was associated with clinical depression in the year of interview. Loss of father by death was in no way associated with current depression, but separation from father showed a trend which, however, did not reach statistical significance. Control for other possible confounding factors did not change this patterning of results; these were further supported when psychiatric episodes earlier in adulthood were examined. Examination of the caregiving arrangements in childhood suggests that it is ‘lack of care’, defined in terms of neglect rather than simply hostile parental behaviour, which accounts for the raised rate of depression. Such ‘lack of care’ is more frequent after loss of mother than after loss of father.
Luteinizing hormone responses to luteinizing hormone releasing hormone (LHRH) in acute mania and the effects of lithium on LHRH and thyrotrophin releasing hormone tests in volunteers
Authors: Hunter R. , Christie J. E. , Whalley L. J. , Bennie J. , Carroll S. , Dick H. , Goodwin G. M. , Wilson H. , Fink G. 
Published: July 2009

SynopsisThe endocrine responses to Luteinizing Hormone Releasing Hormone (LHRH) of eight drug-free males with mania were determined. Basal levels of Luteinizing Hormone (LH) and the plasma levels following injection of LHRH were elevated in patients compared with controls; Follicle Stimulating Hormone (FSH) and testosterone were not different. Elevated levels of LH have been described previously in recovered manic patients and have been suggested to be state-independent features of mania. In order to clarify the status of this finding, the effects of lithium administration upon hormone responses to LHRH in six male volunteers were also investigated, together with the effects upon Thyrotrophin Releasing Hormone (TRH) stimulation of Thyroid Stimulating Hormone (TSH) and prolactin release. Lithium increased the basal levels of LH and levels after injection of LHRH without effect upon FSH and testosterone. Lithium also increased basal and TRH stimulated release of TSH and basal prolactin levels. Lithium was without effect upon prolactin responses to TRH. The results are discussed in relation to current information on the mechanism of lithium's action. The implications for neuroendocrine work on recovered patients taking lithium are also explored.
The spectrum of structural brain changes in schizophrenia: age of onset as a predictor of cognitive and clinical impairments and their cerebral correlates
Authors: Johnstone E. C. , Owens D. G. C. , Bydder G. M. , Colter N. , Crow T. J. , Frith C. D. 
Published: July 2009

SynopsisA range of cerebral structures was assessed in a series of 172 CT scans of groups of psychiatric patients (including 101 in-patients with chronic schizophrenia) and related to assessments of clinical state and psychological function. Ventricular indices were increased in patients with schizophrenia by comparison with patients with other psychiatric disorders: brain area, which is modestly positively correlated with ventricular indices, was significantly (P < 0·01) reduced in patients with schizophrenia. Among in-patients with chronic schizophrenia, measures of increased ventricular size were significantly associated with impaired social behaviour and with movement disorder. Memory for famous names in the distant past (a test of remote memory) was the only psychological test which showed significant associations with indices of ventricular size; this suggests that ventricular enlargement and its psychological sequelae occur relatively early in the disease process. Dichotomization of the sample of schizophrenic patients around the mean age of onset revealed that a range of clinical and psychological functions are significantly more abnormal in those with an early age of onset than in those in whom the onset was later. Early onset cases also perform less well academically and occupationally before illness onset. Within the early onset group some significant correlations between cognitive function and brain area were seen.The findings suggest that: (i) some at least of the structural changes in schizophrenia arise at a time when the brain is still developing; and (ii) age of onset is an important determinant of social and intellectual impairment and is relevant to the relationship between brain structure and cognitive deficits.