bluuebunny/crossref_metadata_2025_split huggingface dataset:
Neuroanatomical correlates of different vulnerability states for
psychosis and their clinical outcomes
Authors: Koutsouleris Nikolaos , Schmitt Gisela J. E. , Gaser Christian , Bottlender Ronald , Scheuerecker Johanna , McGuire Philip , Burgermeister Bernhard , Born Christine , Reiser Maximilian , Möller Hans-Jürgen , Meisenzahl Eva M. 
Published: August 2009

BackgroundStructural brain abnormalities have been described in individuals with an
at-risk mental state for psychosis. However, the neuroanatomical
underpinnings of the early and late at-risk mental state relative to
clinical outcome remain unclear.AimsTo investigate grey matter volume abnormalities in participants in a
putatively early or late at-risk mental state relative to their
prospective clinical outcome.MethodVoxel-based morphometry of magnetic resonance imaging data from 20 people
with a putatively early at-risk mental state (ARMS–E group) and 26 people
with a late at-risk mental state (ARMS–L group) as well as from 15
participants with at-risk mental states with subsequent disease
transition (ARMS–T group) and 18 participants without subsequent disease
transition (ARMS–NT group) were compared with 75 healthy volunteers.ResultsCompared with healthy controls, ARMS–L participants had grey matter
volume losses in frontotemporolimbic structures. Participants in the
ARMS–E group showed bilateral temporolimbic alterations and subtle
prefrontal abnormalities. Participants in the ARMS–T group had prefrontal
alterations relative to those in the ARMS–NT group and in the healthy
controls that overlapped with the findings in the ARMS–L group.ConclusionsBrain alterations associated with the early at-risk mental state may
relate to an elevated susceptibility to psychosis, whereas alterations
underlying the late at-risk mental state may indicate a subsequent
transition to psychosis.
Social anxiety disorder in first-episode psychosis: incidence,
phenomenology and relationship with paranoia
Authors: Michail Maria , Birchwood Max 
Published: August 2009

BackgroundSocial anxiety disorder constitutes a significant problem for people with
psychosis. It is unclear whether this is a by-product of persecutory
thinking.AimsTo compare the phenomenology of social anxiety disorder in first-episode
psychosis with that in a group without psychosis. The relationship
between social anxiety and psychosis symptoms was investigated.MethodA sample of people with first-episode psychosis (FEP group) was compared
with a sample with social anxiety disorder without psychosis (SaD
group).ResultsOf the individuals in the FEP group (n = 80) 25% were diagnosed with an
ICD–10 social anxiety disorder (FEP/SaD group); a further 11.6% reported
severe difficulties in social encounters. The FEP/SaD and SaD groups
reported comparable levels of social anxiety, autonomic symptoms,
avoidance and depression. Social anxiety in psychosis was not related to
the positive symptoms of the Positive and Negative Syndrome Scale (PANSS)
including suspiciousness/persecution. However, a significantly greater
percentage of socially anxious v. non-socially anxious
individuals with psychosis expressed perceived threat from persecutors,
although this did not affect the severity of social anxiety within the
FEP/SaD group. The majority of those in the FEP/SaD group did not have
concurrent persecutory delusions.ConclusionsSocial anxiety is a significant comorbidity in first-episode psychosis.
It is not simply an epiphenomenon of psychotic symptoms and clinical
paranoia, and it has more than one causal pathway. For a subgroup of
socially anxious people with psychosis, anticipated harm is present and
the processes that underlie its relationship with social anxiety warrant
further investigation.
Selective drop-out in longitudinal studies and non-biased
prediction of behaviour disorders
Authors: Wolke Dieter , Waylen Andrea , Samara Muthanna , Steer Colin , Goodman Robert , Ford Tamsin , Lamberts Koen 
Published: August 2009

BackgroundParticipant drop-out occurs in all longitudinal studies, and if
systematic, may lead to selection biases and erroneous conclusions being
drawn from a study.AimsWe investigated whether drop out in the Avon Longitudinal Study of
Parents And Children (ALSPAC) was systematic or random, and if
systematic, whether it had an impact on the prediction of disruptive
behaviour disorders.MethodTeacher reports of disruptive behaviour among currently participating,
previously participating and never participating children aged 8 years in
the ALSPAC longitudinal study were collected. Data on family factors were
obtained in pregnancy. Simulations were conducted to explain the impact
of selective drop-out on the strength of prediction.ResultsDrop out from the ALSPAC cohort was systematic and children who dropped
out were more likely to suffer from disruptive behaviour disorder.
Systematic participant drop-out according to the family variables,
however, did not alter the association between family factors obtained in
pregnancy and disruptive behaviour disorder at 8 years of age.ConclusionsCohort studies are prone to selective drop-out and are likely to
underestimate the prevalence of psychiatric disorder. This empirical
study and the simulations confirm that the validity of regression models
is only marginally affected despite range restrictions after selective
drop-out.
Minor depression during adolescence and mental health outcomes
during adulthood
Authors: Johnson Jeffrey G. , Cohen Patricia , Kasen Stephanie 
Published: August 2009

SummaryData from a community-based prospective longitudinal study were used to
investigate the association of minor depressive disorder during adolescence
with adverse mental health outcomes during adulthood. Structured diagnostic
interviews were administered to a community-based sample of 755 individuals
during adolescence and adulthood. Results indicated that minor depressive
disorder during adolescence was associated with elevated risk for subsequent
psychiatric disorders during adulthood, including major depressive disorder,
⩾1 disruptive disorders and clinically relevant impairment after
corresponding and co-occurring disorders were controlled statistically.
Impact of persistent substance misuse on 1-year outcome in
first-episode psychosis
Authors: Turkington Aidan , Mulholland Ciaran C. , Rushe Teresa M. , Anderson Rick , McCaul Rosalind , Barrett Suzanne L. , Barr Ruth S. , Cooper Stephen J. 
Published: August 2009

BackgroundSubstance misuse is a common comorbid problem in people presenting with
first-episode psychosis and is associated with a poor short-term
outcome.AimsThe aim of this study is to examine differences in baseline
characteristics and 1-year outcome between individuals with first-episode
psychosis who have never misused substances, those who stop misusing
substances after initial presentation and those who persistently misuse
substances over the 1-year assessment period.MethodPatients were recruited to the Northern Ireland First Episode Psychosis
Study (n = 272). Clinical assessments were performed at baseline and at 1
year (n = 194) and data were collected from the case notes.ResultsIndividuals with persistent substance misuse had more severe depression,
more positive symptoms, poorer functional outcome and greater rates of
relapse at 1 year than those who stopped and those who had never misused
substances. There were no differences in outcome between people who had
never misused substances and those who stopped misusing after
presentation.These results support assertive intervention targeted at comorbid
substance misuse in individuals with first-episode psychosis.
Magnetic resonance imaging studies in bipolar disorder and
schizophrenia: meta-analysis
Authors: Arnone D. , Cavanagh J. , Gerber D. , Lawrie S. M. , Ebmeier K. P. , McIntosh A. M. 
Published: August 2009

BackgroundSeveral magnetic resonance imaging (MRI) studies have identified
structural abnormalities in association with bipolar disorder. The
literature is, however, heterogeneous and there is remaining uncertainty
about which brain areas are pivotal to the pathogenesis of the
condition.AimsTo identify, appraise and summarise volumetric MRI studies of brain
regions comparing bipolar disorder with an unrelated control group and
individuals with schizophrenia.MethodA systematic review and random-effects meta-analysis was carried out to
identify key areas of structural abnormality in bipolar disorder and
whether the pattern of affected areas separated bipolar disorder from
schizophrenia. Significant heterogeneity was explored using
meta-regression.ResultsParticipants with bipolar disorder are characterised by whole brain and
prefrontal lobe volume reductions, and also by increases in the volume of
the globus pallidus and lateral ventricles. In comparison with
schizophrenia, bipolar disorder is associated with smaller lateral
ventricular volume and enlarged amygdala volume. Heterogeneity was
widespread and could be partly explained by clinical variables and year
of publication, but generally not by differences in image
acquisition.ConclusionsThere appear to be robust changes in brain volume in bipolar disorder
compared with healthy volunteers, although most changes do not seem to be
diagnostically specific. Age and duration of illness appear to be key
issues in determining the magnitude of observed effect sizes.
Mental capacity and psychiatric in-patients: implications for the new mental health law in England and Wales
Authors: Owen Gareth S. , Szmukler George , Richardson Genevra , David Anthony S. , Hayward Peter , Rucker James , Harding Duncan , Hotopf Matthew 
Published: August 2009

BackgroundIn England and Wales mental health services need to take account of the Mental Capacity Act 2005 and the Mental Health Act 1983. The overlap between these two causes dilemmas for clinicians.AimsTo describe the frequency and characteristics of patients who fall into two potentially anomalous groups: those who are not detained but lack mental capacity; and those who are detained but have mental capacity.MethodCross-sectional study of 200 patients admitted to psychiatric wards. We assessed mental capacity using a semi-structured interview, the MacArthur Competence Assessment Tool for Treatment (MacCAT–T).ResultsOf the in-patient sample, 24% were informal but lacked capacity: these patients felt more coerced and had greater levels of treatment refusal than informal participants with capacity. People detained under the Mental Health Act with capacity comprised a small group (6%) that was hard to characterise.ConclusionsOur data suggest that psychiatrists in England and Wales need to take account of the Mental Capacity Act, and in particular best interests judgments and deprivation of liberty safeguards, more explicitly than is perhaps currently the case.
Depression under stress: ethical issues in genetic
testing
Authors: Newson Ainsley J. 
Published: August 2009

SummaryGenetic testing for risk of depression requires a reconsideration of ethical
issues in genetics and how they manifest in psychiatric practice. A
precautionary approach is advocated in that there should be limits on the
use of the 5-HTT genetic test until its clinical utility and broader social
impact are better understood.
The psychiatric case register: noble past, challenging present,
but exciting future
Authors: Perera Gayan , Soremekun Mishael , Breen Gerome , Stewart Robert 
Published: August 2009

SummaryCase registers have been fundamental to mental health research from the
early asylum studies onwards. Having declined in popularity over the past 20
years, they are likely to see a resurgence of interest with the advent of
electronic clinical records and the technological capacity to derive
anonymised databases from these.
Audit of handover documentation during patient transfers between learning disability psychiatry community teams
Authors: Miles Ömür Budanur 
Published: August 2009

Aims and MethodThe local experience of having to take over the care of patients newly moved to the Bristol area revealed the lack of clear information on their complex needs. Official guidelines do not exist, therefore a consensus list of expected handover information was produced. the records of two patients were analysed in each of the six teams that agreed to be audited. A standardised handover form was devised and introduced (Part 1). Part 2 of the audit was performed 18 months after the implementation of changes to practice.ResultsPart 1 revealed that diagnosis (11/12) and medications (12/12) were the best-documented items during handover correspondence. Follow-up duration (3/12), crisis plan (3/12), professionals involved (0/12) and risk assessment (3/12) if documented were done so only for patients with complex needs. Part 2 showed improved documentation of information (11/11 for the first two items and 10/11 for the remainder).Clinical ImplicationsAbsent or concealed information in patient notes may contribute to disruption to the continuity of care following patient transfers. the use of a succinct, structured and easily distinguishable handover form in patient records may facilitate communication between professionals.
Psychiatrists and electronic patient records: the South London and Maudsley experience
Authors: Mistry Himanshu , Sauer Justin 
Published: August 2009

Aims and MethodTo explore the experiences and attitudes of psychiatrists to a new electronic patient records system. A questionnaire was emailed to 115 psychiatrists across the South London & Maudsley National Health Service Foundation Trust.ResultsThe total response rate was 66% (senior house officers 75%, specialist registrars 57%, consultants 56%). Technical problems, difficulty with patient confidentiality, administrative burden and impact on clinical work were identified as concerns. However, psychiatrists recognised the potential benefits and the majority did not wish to return to using paper records.Clinical ImplicationsElectronic patient records are rapidly being integrated into the daily practice of psychiatrists. More administrative assistance and specific training should be provided to support clinicians who use this system.
Training and assessing independent nurse prescribers: a model for old age psychiatry
Authors: Cubbin Sally , Pearce Jane , Bullock Roger , McShane Rupert 
Published: August 2009

Aims and MethodThe brevity of training and assessment for independent nurse prescribers has caused some concern. We aimed to validate an Objective Structured Clinical Examination (OSCE) for potential nurse prescribers in dementia. Nurses' performance after 12 days of training for potential prescribers was compared with that of doctors of different grades.ResultsThe performance of doctors, but not nurses, correlated with years of experience. Many nurses, especially those working in memory clinics, scored better than junior doctors.Clinical ImplicationsThis OSCE provides evidence of potential prescribers' competency for employers. This could make a significant contribution to maintaining high standards of patient safety with nurse prescribing. This may also be an appropriate addition to the assessment of specialty trainees as well as for revalidation.
A training experience to remember: working in Ghana
Authors: Poole Norman , Hughes Peter 
Published: August 2009

Aims and MethodAs part of a pilot project, one of the authors spent 3 months undertaking clinical work, teaching and research in a large psychiatric hospital in Accra, Ghana. the other acted as a UK-based mentor. Both report on the training value of the experience.ResultsIt was possible to assimilate into the local healthcare system and effect some modest but sustainable changes. the experience broadened the trainee's understanding of psychiatry, cultural influences and healthcare systems, while also developing autonomy and resilience.Clinical ImplicationsThe post is now an option available to trainees on the rotation. Projects in training and service delivery to benefit the host institution have been identified.
Floods in 2007 and older adult services: lessons learnt
Authors: Hayes Joseph , Mason Julian , Brown Fay , Mather Rebecca 
Published: August 2009

Aims and MethodTo review the clinical and managerial impact of flooding on a community mental health team (CMHT) for older adults by prospectively recording all flooding related events met by the CMHT.ResultsOf 348 individuals known to the CMHT, 87 lived in flood affected areas. In nine patients symptoms deteriorated. There were two new referrals as a direct consequence of the flooding. Flood effects can be grouped into: new mental illness, management problems, CMHT workload, and secondary benefits.Clinical ImplicationsThe immediate and delayed problems caused by flooding to the elderly with mental illness and dementia include unmasking cognitive impairment and provoking exacerbations in depressive and anxiety disorders. Personal evacuation plans should be used when moving individuals with marked cognitive impairment to avoid difficulties with identification. Overcrowding of care homes used to temporarily accommodate additional residents can contribute to behavioural changes and psychological symptoms in those with pre-existing dementia.
On-site testing for drugs of misuse in the acute psychiatric ward
Authors: Ghali Sharif 
Published: August 2009

Aims and MethodTo explore why and how on-site urine drug testing is performed in in-patient settings. Data were collected by questionnaire in four acute psychiatric wards.ResultsThe most commonly cited reasons for testing were suspected drug use and as a routine part of the admission procedure. On-site testing was typically favoured over laboratory methods owing to the rapid turnaround of results and ease of use. In 81% of cases the result of the tests had no effect on immediate management. the majority of staff had not received formal training in their use.Clinical ImplicationsClinical use of on-site drug tests does not reflect their established limitations. Guidance is required to direct staff in the use of this commonly used assessment tool.
On being the Trainee Editor of the Psychiatric Bulletin
Authors: George Sanju , Halder Neel 
Published: August 2009

SummaryThe Psychiatric Bulletin offers the post of a trainee editor on its Editorial Board, open to all trainees in psychiatry. In this paper we (the immediate past and current Trainee Editor) describe the roles and responsibilities, learning opportunities and our own experiences from our time as Trainee Editor of the Bulletin. We hope we will give readers some understanding of the immense learning potential and academic exposure that this post offers, and encourage trainees to consider whether it is of interest to them.
The role of the clinical professions in the regulation of healthcare in England: walking the tightrope
Authors: Lelliott Paul 
Published: August 2009

SummaryThe Royal Colleges and other professional bodies could use their clinical expertise, authority and influence with clinicians to improve the quality of regulation of healthcare services. At present, their contribution to regulation in England is ad hoc and informal. Better engagement could increase the impact that professional bodies have on patient care and create a new role for them as arbiters of quality in the organisation and delivery of care. the requirement for healthcare provider organisations to register with the Care Quality Commission from April 2010 and the National Health Service Next Stage Review have created an opportunity for closer collaboration. However, there are problems that must be overcome. These include the ownership of information about the quality of care and the uses to which this is put. It would be self-defeating if closer working with the regulator undermined the trust that clinicians have in quality improvement work led by the professional bodies.
Independent Review of E2100: A Phase III Trial of Bevacizumab Plus Paclitaxel Versus Paclitaxel in Women With Metastatic Breast Cancer
Authors: Gray Robert , Bhattacharya Suman , Bowden Christopher , Miller Kathy , Comis Robert L. 
Published: September 2009

Purpose E2100, an open-label, randomized, phase III trial conducted by the Eastern Cooperative Oncology Group (ECOG), demonstrated a significant improvement in progression-free survival (PFS) and overall response rate (ORR) with paclitaxel plus bevacizumab compared with paclitaxel alone as initial chemotherapy for patients with HER2-negative metastatic breast cancer. Methods An independent, blinded review of radiologic and clinical data was performed, assessing progression and response according to Response Evaluation Criteria in Solid Tumors. In addition, ECOG's investigator assessments were reanalyzed using the same methods applied to the independent review. The primary end point was PFS as assessed by an independent review facility (IRF). Results The addition of bevacizumab to paclitaxel resulted in a statistically significant improvement in PFS using both the IRF and investigator assessments. Hazard ratios for PFS (0.48, 95% CI, 0.385 to 0.607; P < .0001 for the IRF v 0.42, 95% CI, 0.34 to 0.52; P < .0001 for ECOG investigators) and the improvement in median PFS (11.3 v 5.8 months for the IRF v 11.4 v 5.8 months for ECOG investigators) were similar. Among patients with measurable disease at baseline, the IRF-assessed ORR was significantly higher in patients treated with paclitaxel and bevacizumab (48.9% v 22.2%; P < .0001). Conclusion The risk of progression was reduced by more than half and the ORR more than doubled with the addition of bevacizumab to weekly paclitaxel in both analyses, confirming a substantial and robust bevacizumab treatment effect. The consistency between the IRF and ECOG analyses validates the original data previously reported by ECOG in this open-label trial.
A Liberal Economist and Economic Policy Reform in Nineteenth-Century Greece: The Case of Ioannes Soutsos
Authors: Psalidopoulos Michalis M. , Stassinopoulos Yorgos 
Published: September 2009

This paper analyses the critique of Ioannes Soutsos (1804–1890), the first academic economist of modern Greece, toward priorities, weaknesses and shortcomings of Greek economic policy of the 19th century. Emphasis is laid in his interventions in 1843 (when the first constitution was introduced), in 1863 (when a new king was appointed as head of the country) and in 1876-9 (when foreign lending was resumed after a long financial embargo against Greece). These interventions reveal a liberal economist who was a precursor in what is today known as constitutional economics, who stressed the role of efficient institutions for the promotion of economic development and favored sound public finance as a basis for a strong currency and a prerequisite of growth.The paper puts Soutsos' economic policy recommendations against his theoretical formation as an economist, and examines his views on methodology and the influences Pellegino Rossi and Jean-Baptiste Say exerted in his thought and writings. In this context European economic liberalism of the 19th century is revisited and the question about its relevance for the new-born states of South-Eastern Europe, where nationalism was a major ideological current, requiring a financially strong state, is examined.