bluuebunny/crossref_metadata_2025_split huggingface dataset:
Pathways to psychiatric care in South-Verona, Italy
Authors: Balestrieri M. , Bon M. G. , Rodriguez-Sacristan A. , Tansella M. 
Published: July 2009

SynopsisThis paper compares the pathway to psychiatric care of patients contacting the South-Verona Community Psychiatric Service (CPS) with the pathways described in other countries, using the method of the WHO cross-cultural study of pathways in psychiatric care. One hundred and sixteen South-Verona residents starting new episodes of care were traced and included in the study. The first port of call for 92% of patients was a doctor. More than one-third arrived at the CPS directly, not filtered by other carers. One-third went first to the GP and then straight to the CPS. Both the median total interval since onset of symptoms and the median interval between onset of the problem and first seeking care was 8 weeks. Patients presenting first at the two major ports of call tend to have a quite similar latency period before seeking care. Problems presented are represented mostly by depression and anxiety. The diagnosis of affective disorders occurred in more than half of the sample, followed by neurotic and somatoform disorders and schizophrenia and related disorders. The intervals after seeing the first carer are short and quite homogeneous among all patients. More than three-quarters of the patients said that they received some form of treatment for their presenting problems prior to arrival at the CPS, mostly psychopharmacotherapy with sedatives/hypnotics. These results are discussed in the light of those obtained in the WHO cross-cultural study.
The effect of personality disorder on clinical outcome, social networks and adjustment: a controlled clinical trial of psychiatric emergencies
Authors: Tyrer P. , Merson S. , Onyett S. , Johnson T. 
Published: July 2009

SynopsisOne hundred psychiatric emergencies presenting to an inner London teaching hospital had formal assessments of psychopathology, personality disorder (using both ICD-10 and the Personality Assessment Schedule), social networks and social functioning before being randomly assigned to a multidisciplinary community-based team (Early Intervention Service (N = 48) or conventional hospital-based psychiatric services (N = 52) and treated for a period of 12 weeks. The ICD-10 classification yielded a higher proportion (50%) of personality disordered patients than the Personality Assessment Schedule (34%) and those from ethnic minorities (mainly Afro-Caribbean) and upper social classes had a lower incidence of personality disorder. Social networks were smaller in personality disordered patients and there were fewer attachment figures. Improvement in social function, and to a lesser extent with depressive symptomatology, was better in patients with no personality disorder referred to the community service compared with the hospital service. No differences were found between the numbers and duration of social contacts in the two services and it is concluded that the better outcome in the community-treated patients was independent of changes in social networks.
Fractal analysis of the boundary between white matter and cerebral cortex in magnetic resonance images: a controlled study of schizophrenic and manic-depressive patients
Authors: Bullmore E. , Brammer M. , Harvey I. , Persaud R. , Murray R. , Ron M. 
Published: July 2009

SynopsisThis paper reports development of a computerized (‘box-counting’) method for estimation of fractal dimension (FD) of the magnetic resonance image (MRI) boundary between cerebral cortex and white matter; and the application of this method to MRIs of 39 schizophrenics (SZs), 23 manic-depressives (MDs) and 31 controls (CONs). Mean FD across all diagnostic groups was 1·402; 95% confidence interval (CI) 1·399 to 1·406. Mean FD was greater in boundaries extracted from manic-depressive patients than in boundaries extracted from controls (difference between MD and CON mean FDs = 0·008; 95% CI −0·002 to +0·018); and less in schizophrenics than in controls (difference between SZ and CON mean FDs = −0·003; 95% CI −0·011 to +0·005). Mean FD was positively correlated with subcortical volume and anterior cerebral volume, and negatively correlated with sulcal cerebrospinal fluid volume. Significant differences in mean FD between diagnostic groups were demonstrated by analysis of covariance (ANCOVA; P < 0·01), with age and volumetric measures of brain size as covariates; and manic-depressive boundaries were shown to have significantly greater values for residual FD (after controlling for effects of brain size) than boundaries extracted from controls (t test; P < 0·05). It is proposed that FD is a useful measure of clinically relevant differences in the complexity of MRI boundaries.
Dysfunctional attitudes in depressed and recovered depressed patients and their first-degree relatives
Authors: Power M. J. , Duggan C. F. , Lee A. S. , Murray R. M. 
Published: July 2009

SynopsisA series of depressed probands and their first-degree relatives were categorized as follows: (a) currently depressed; (b) recovered depressed; and (c) never-ill relatives. Their scores on a subscaled version of the Dysfunctional Attitude Scale (the DAS-24) were compared. The DAS total scores mirrored previous findings in that the total scores for recovered individuals returned to normal or near-normal levels. However, the dependency subscale scores remained elevated for the recovered depressed group. It is proposed that these results support the conclusion that self-report measures of cognitive vulnerability should focus on specific rather than global effects, if progress is to be made in the search for true vulnerability factors.
Predictors of survival with Alzheimer's disease: a community-based study
Authors: Jagger Carol , Clarke Michael , Stone Andrew 
Published: July 2009

SynopsisFactors associated with reduced survival were investigated in elderly people diagnosed as having Alzheimer's disease (AD) and in those free of dementia at diagnosis. The study population comprised 155 people free of dementia and 222 with AD; all were aged 75 years and over and were part of a two-stage prevalence study of dementia during 1988 in Melton Mowbray, Leicestershire. An increased risk of death was found for those with a history of heavy alcohol use, lower cognitive function, a history of heart failure and those in institutional care, these factors acting in the same manner for persons free of dementia and those with AD. For the non-demented group a greater risk of death was found with increasing age and for those with a history of cancer. A greater risk of death was found for males with AD compared to females with the risk increasing over time. The longer survival of women over men may explain the sex differences found in the prevalence of AD without accompanying differences in incidence.
Psychiatric comorbidity in patients with eating disorders
Authors: Braun D. L. , Sunday S. R. , Halmi K. A. 
Published: July 2009

SynopsisThe Structured Clinical Interview for DSM-III-R (SCID and SCID II) was administered to 105 eating disorder in-patients in order to examine rates of comorbid psychiatric disorders and the chronological sequence in which these disorders developed. Eighty-six patients, 81·9% of the sample, had Axis I diagnoses in addition to their eating disorder. Depression, anxiety and substance dependence were the most common comorbid diagnoses. Anorexic restrictors were significantly more likely than bulimics (all subtypes) to develop their eating disorder before other Axis I comorbid conditions.Personality disorders were common among the subjects; 69% met criteria for at least one personality disorder diagnosis. Of the 72 patients with personality disorders, 93% also had Axis I comorbidity. Patients with at least one personality disorder were significantly more likely to have an affective disorder or substance dependence than those with no personality disorder.
The nucleus accumbens–possible site of antipsychotic action of neuroleptic drugs?
Authors: Crow T. J. , Deakin J. F. W. , Longden A. 
Published: July 2009

synopsisThe hypothesis that neuroleptic drugs exert their therapeutic effects by blocking dopaminergic transmission has been investigated by examining the effects of 3 neuroleptic drugs on dopamine turnover in 2 dopaminergically innervated regions of brain – the neostriatum and nucleus accumbens. The drugs chlorpromazine, thioridazine and fluphenazine, known to be therapeutically active in the treatment of schizophrenia, but to have differing incidences of extrapyramidal side effects, were administered to rats in dose ratios approximating to those effective in man. All 3 drugs induced a similar rise in the content of the dopamine metabolite homovanillic acid (HVA) in the nucleus accumbens, whilst the changes in HVA observed in the neostriatum were in the rank order in which these drugs produce extrapyramidal side effects. While the concentrations of dopamine metabolites in the frontal cortex were too low to assess the possibility that neuroleptic drugs have actions at this level, our results are consistent with the hypothesis that these drugs exert their therapeutic effects by dopamine receptor blockade in the nucleus accumbens.
Anterior pituitary hormone secretion in chronic schizophrenia – an approach to neurohumoral mechanisms
Authors: Johnstone Eve C. , Crow T. J. , Mashiter K. 
Published: July 2009

SynopsisProlactin, FSH, LH and TSH were determined in repeated samples of serum from 16 unmedicated male patients with chronic schizophrenia. Changes in the mental states between the 2 occasions were related to changes in hormone levels. Significant inverse correlations were established between prolactin and incoherence of speech, between prolactin and total positive symptoms and between FSH and poverty of speech. A significant positive correlation was established between FSH and delusions. These findings are discussed in the context of evidence concerning the role of monoamines in the control of anterior pituitary function, and of the dopamine and other monoamine hypotheses of schizophrenia. Although prolactin secretion was not as low, as would be predicted on the basis of the dopamine overactivity hypothesis of schizophrenia, the relationship between symptom change and change in prolactin secretion was consistent with the hypothesis that increasing symptom severity is associated with increasing dopamine release from the tubero-infundibular system.
Predicting success in psychiatric training for foreign medical graduates: II. Patterns in course
Authors: Weiss James M. A. , Davis David 
Published: July 2009

synopsisFaculty ratings of 22 foreign medical graduates (‘FMGs’), all of whom entered psychiatric residency training at the University of Missouri–Columbia from 1966 through 1973, were compared with those of a similar group of North American medical graduates (‘AMGs’). An on-going evaluation programme provided data for a variety of parameters ranging from ‘theoretical knowledge’ to ‘clinical skills’. Results indicated that in most areas of performance the median FMG started at a level substantially lower than that of the median AMG and very slowly caught up. When achievement criteria were utilized it became apparent that, at least by the third year of training, ‘superior’ FMGs could equal or surpass the median performance of ‘superior’ AMGs, whereas ‘marginal’ residents, whether foreign or native-born, seldom attained even competence in most major spheres of functioning. Implications of these findings and those in related studies are discussed.
The validity of the diagnosis of mild dementia
Authors: Rosenman Stephen 
Published: July 2009

SYNOPSISFive operational methods for clinical diagnosis of mild dementia were compared to find out their diagnostic concordance when applied to a single group of seventy-five subjects. The clinical validity of the diagnoses was assessed in terms of their capacity to predict continued cognitive deterioration over three years after diagnosis and their capacity to reject the diagnostic influence of ‘non-dementia’ factors (that is, the cognitive consequences of depression, poor intellect, limited education and non-neurological physical illness). By all criteria of clinical validity the diagnostic methods for mild dementia performed poorly. Kappas measuring agreement between methods averaged only 0·15 and up to 57% of diagnostic deviance was explained by ‘non-dementia’ factors. Prediction of continued deterioration was poor, with a false positive rate which was too high for the diagnoses to be clinically usable. By no criterion of validity did the diagnostic methods exceed the performance of a clinician's judgement of the presence of pathological cognitive impairment or diagnosis by a cutpoint on the Mini-Mental State Examination.
Structural brain imaging abnormalities associated with schizophrenia and partial trisomy of chromosome 5
Authors: Honer William G. , Bassett Anne S. , MacEwan G. William , Hurwitz Trevor , Li David K. B. , Hilal Sadek , Prohovnik Isak 
Published: July 2009

SYNOPSISChromosomal abnormalities occurring in association with mental illness provide a unique opportunity to study the interaction of genetic abnormalities and the brain in mental illness. Four individuals from a family in which schizophrenia was found to cosegregate with a partial trisomy of chromosome 5 were studied with computed tomography and magnetic resonance imaging. Temporal lobe atrophy was found in the two trisomic males and in the asymptomatic balanced translocation female. In addition, a large cavum septum pellucidum and a cavum vergae were found in the older trisomic individual. Scans from the normal male were free of abnormalities. These results suggest that molecular studies of the translocation breakpoints in this chromosomal abnormality may be of interest, and encourage further studies of brain structure in other chromosomal abnormalities associated with psychosis.
The effect of temporal lobe surgery on electrodermal activity: implications for an organic hypothesis in the aetiology of schizophrenia
Authors: Toone B. K. , Cooke E. , Lader M. H. 
Published: July 2009

SynopsisIt has recently been suggested that the bilateral asymmetry of electrodermal activity (EDA) reported in schizophrenia may be related to unilateral temporal lobe dysfunction. To test this hypothesis, 3 aspects of EDA – skin conductance level (SCL), number of spontaneous fluctuations (SF), and skin conductance response (SCR) – were measured bilaterally in 10 patients who had undergone unilateral temporal lobectomy. No differences could be detected between the operated and non-operated sides within the patient group, nor between the patient and control groups. The implications of these findings are discussed.
Application to the alcohol dependence syndrome of a method of determining the sequential development of symptoms
Authors: Chick Jonathan , Duffy John C. 
Published: July 2009

SynopsisTemporal ordering of core items in the alcohol dependence syndrome was investigated in 38 men admitted to an alcoholism treatment unit. An analysis of rank sums yielded a modal sequence which resembled classical descriptions of alcoholism, though ‘loss of control’ appeared very early.
Informing the consultant psychiatrist – the problems of communication
Authors: Kemp I. W. 
Published: July 2009

SynopsisThere is considerable difficulty in providing clinicians with statistics relating to their work which are both relevant in content and suitable in style. As a contribution towards the solution of the problem for psychiatrists, a new type of statistical feedback, the Hospital/National Comparison Tables, has been produced in Scotland. In these tables the work of individual hospitals is compared with the work of all other hospitals of the same type. These are critically examined, together with examples of analyses showing the uses to which the data can be put.
Murder under hypnosis
Authors: Harris Ruth 
Published: July 2009

SynopsisThis article discusses the trial of a woman accused of murder in 1890 whose defence rested on the claim that she acted unconsciously under the hypnotic influence of her older lover. This relatively banal case brought together two rival schools of French psychiatry – that of J.-M. Charcot in Paris and that of Hippolyte Bernheim in Nancy – and provided a wide-ranging examination of views on the nature of unconscious mental activity as well as the social, political and professional implications that their theories on hypnotism and hysteria contained. Discussions on women's sexuality, family relations, crowd behaviour and political radicalism all played a part in the debate and are examined through the case study that the trial of Gabrielle Bompard permits. Moreover, the trial shed incidental light on the campaign by physicians against amateur healers and hypnotists whom they blamed for unleashing a wave of mass hysteria through their theatrical representations. The episode was one important element in the struggle for the passage of the law of 30 November 1892, which outlawed amateur practitioners and established the medical monopoly over healing in France.
Psychiatric aspects of contempt of court among women
Authors: d'Orbán P. T. 
Published: July 2009

SynopsisThe case histories of 72 women admitted to prison for contempt of court in 1979–83 were reviewed. The sample included 45% of all women imprisoned for contempt in England and Wales over the 5-year period. The contemnors were significantly older than other sentenced prisoners, one third were foreign born and 37–5% were suffering from psychiatric disorder. Two thirds of the mentally disordered group had a paranoid disorder, litigiousness was a prominent feature of their illness, and 52% committed contempt in the context of a matrimonial dispute or a dispute with neighbours. Recent legislation may help to prevent the imprisonment of mentally ill contemnors.
Psychiatric symptoms in self-poisoning patients
Authors: Newson-Smith J. G. B. , Hirsch S. R. 
Published: July 2009

SynopsisSelf-poisoning patients admitted to hospital were studied for persistence of psychiatric symptoms over a 3-month period and evaluated at 3 points in time with the General Health Questionnaire and the Present State Examination. Symptoms were identified which had a high or low prevalence at 3-month follow-up. GHQ and PSE scores correlated at 0·8. The implications of the study are discussed, particularly the earlier need for out-patient help in those who had a moderate or high number of symptoms at initial interview.
Movement disorders and psychological tests of frontal lobe function in schizophrenic patients
Authors: Brown K. W. , White T. , Palmer D. 
Published: July 2009

SYNOPSISNeuropsychological tests of frontal lobe functions were undertaken in 46 chronic schizophrenic patients who were also rated for movement disorders. Tardive dyskinesia was found to have significant associations with most of these psychological tests. The possible mechanisms are discussed within the context of known neostriatal psychological functions.
Remission and relapse in major depression: a two-year prospective follow-up study
Authors: Ramana R. , Paykel E. S. , Cooper Z. , Hayhurst H. , Saxty M. , Surtees P. G. 
Published: July 2009

SynopsisThis paper reports the course with respect to remission and relapse of a cohort of predominantly in-patient RDC major depressive subjects, who were followed at 3-monthly intervals to remission and for up to 15 months thereafter. Remission was comparatively rapid with 70% of subjects remitting within 6 months. Only 6% failed to do so by 15 months. However, 40% relapsed over the subsequent 15 months, with all the relapses occurring in the first 10 months. Greater severity of the depression and longer duration of the illness predicted a longer time to remission. Greater initial severity of depression also predicted relapse. Subjects with a worse outcome had not received less adequate treatment than the remainder. Our results confirm the comparatively poor outcome subsequent to remission that has been reported in recent literature, in spite of the availability of modern methods of treatment. The clustering of relapses in the first 10 months gives some support to the distinction between relapse and later recurrence.
The structure of common psychiatric symptoms: how many dimensions of neurosis?
Authors: Ormel J. , Oldehinkel A. J. , Goldberg D. P. , Hodiamont P. P. G. , Wilmink F. W. , Bridges K. 
Published: July 2009

SYNOPSISSynopsis In order to replicate and elaborate the two-dimensional model of depression and anxiety underlying the structure of common psychiatric symptoms proposed by Goldberg et al. (1987), we carried out latent trait analyses on PSE symptom data of the original Manchester study and two recent Dutch studies. We used the same analytical strategy as Goldberg et al. to facilitate comparison with the earlier work. It was found that a more comprehensive set of common psychiatric symptoms caused an extra, third dimension to emerge, so that the earlier anxiety dimension became split between a specific anxiety axis characterized by situational and phobic anxiety and avoidance, and a non-specific anxiety axis characterized by free-floating anxiety, various symptoms relating to tension, irritability and restlessness. It is argued that three dimensions are sufficient to account for the covariance between common psychiatric symptoms. A fairly consistent correlation between the non-specific anxiety and the depression dimension was found across sites, as well as independence of the specific anxiety dimension from the other two dimensions. Furthermore, the depression dimension was robust with similar symptom profiles across samples, but there appeared to be local differences in the structure of anxiety symptoms.
Social, psychological and physical correlates of eating problems. A study of the general adolescent population in Norway
Authors: Wichstrøm Lars 
Published: July 2009

SYNOPSISThe characteristics and concurrent predictors of eating problems were identified. Ninety-seven per cent of a representative sample of Norwegian adolescents (N = 11315) completed a questionnaire containing a 12-item version of the Eating Attitudes Test (EAT) and measures of a large number of physiological, psychological and social factors previously suggested to be of aetiological importance. Social class, drug use and indicators of ‘the model child’ (high grades, high occupational aspirations and much homework) were not related to eating problems. Logistic regression analyses identified perceived obesity as the strongest associated factor, followed by gender, depression, excessive exercise and unstable self-perceptions. In addition, adopting idols with perfect bodies, body dissatisfaction, low self-worth, feminine sex-role orientation, lack of parental care, early pubertal timing, age and number of alcohol intoxications all added to the probability of eating problems. About 6% perceived themselves as obese in spite of subnormal BMI. Such misperceptions increased the risk of high scores on EAT.