bluuebunny/crossref_metadata_2025_split huggingface dataset:
Physical disorders associated with mental illness. A register investigation
Authors: Fink Per 
Published: July 2009

SynopsisOn the basis of nationwide patient register data the diagnostic pattern of the medical admissions of a general population (17–49 year-olds; N = 30427) during an 8-year period was studied by comparing those individuals who had been admitted to the psychiatric department (i.e. psychiatric patients) with those individuals who had not. The results suggest that the high utilization of medical admissions by psychiatric patients could not be explained simply by coincident chronic physical illness or particular types of physical disease including the somatic complications of mental disorders. It is more likely to be attributable to other factors such as an increased general susceptibility to physical illness, different forms of illness behaviour, and the process of somatization.
The epidemiology of fatigue and depression: a French primary-care study
Authors: Fuhrer Rebecca , Wessely Simon 
Published: July 2009

SYNOPSISThe prevalence of fatigue as a presenting complaint and as a symptom is evaluated in French general practice patients. The data for a sample of 3784 persons 18–64 years-of-age who were seen by 367 general practitioners were examined for fatigue as a presenting complaint, diagnosis, and reported symptoms of persistent fatigue. Gender, age, and socio-professional category were considered as potential risk correlates. At least one of the symptoms of persistent fatigue was reported by 41·2% of the patients, but only 7·6% had presented with fatigue to the doctor. Women reported more symptoms of fatigue than men, but they were only slightly more likely to present with, or be diagnosed with fatigue; women were more frequently diagnosed with depression. There was a strong relationship between the symptoms of depression as measured by the Center for Epidemiologic Studies – Depression Scale (CES-D) and fatigue, but fatigue was neither sensitive nor specific for the diagnosis of depression. Age and fatigue as a presenting complaint and diagnosis were strongly associated for men. After adjusting for sex and age, we found that lower social classes were less likely to be diagnosed as fatigued, though they were more likely to report symptoms of fatigue.
The existence of a fatigue syndrome after glandular fever
Authors: White P. D. , Thomas J. M. , Amess J. , Grover S. A. , Kangro H. O. , Clare A. W. 
Published: July 2009

SYNOPSISThis prospective cohort study was designed to test whether a distinct fatigue syndrome existed after the onset of glandular fever. Two hundred and fifty primary care patients, with either glandular fever or an ordinary upper respiratory tract infection (URTI) were interviewed three times in the 6 months after the clinical onset of their infection. At each interview a standardized psychiatric interview was given and physical symptoms were assessed.There were 108 subjects with an Epstein-Barr virus (EBV) infection; 83 subjects had glandular fever not caused by EBV and 54 subjects had an ordinary URTI. Five subjects were excluded because they had no evidence of an infection. Principal components analyses of symptoms supported the existence of a fatigue syndrome, particularly in the two glandular fever groups. The addition of symptoms not elicited by the standard interviews gave the full syndrome. This included physical and mental fatigue, excessive sleep, psychomotor retardation, poor concentration, anhedonia, irritability, social withdrawal, emotional lability, and transient sore throat and neck gland swelling with pain. A fatigue syndrome probably exists after glandular fever.
Can the chronic fatigue syndrome be defined by distinct clinical features?
Authors: Hickie I. , Lloyd A. , Hadzi-Pavlovic D. , Parker G. , Bird K. , Wakefield D. 
Published: July 2009

SYNOPSISTo determine whether patients diagnosed as having chronic fatigue syndrome (CFS) constitute a clinically homogeneous class, multivariate statistical analyses were used to derive symptom patterns and potential patient subclasses in 565 patients. The notion that patients currently diagnosed as having CFS constitute a single homogeneous class was rejected. An alternative set of clinical subgroups was derived. The validity of these subgroups was assessed by sociodemographic, psychiatric, immunological and illness behaviour variables. A two-class statistical solution was considered most coherent, with patients from the smaller class (27% of the sample) having clinical characteristics suggestive of somatoform disorders. The larger class (73% of sample) presented a more limited combination of fatigue and neuropsychological symptoms, and only moderate disability but remained heterogeneous clinically. The two patient groups differed with regard to duration of illness, spontaneous recovery, severity of current psychological morbidity, utilization of medical services and CD8 T cell subset counts. The distribution of symptoms among patients was not unimodal, supporting the notion that differences between the proposed subclasses were not due simply to differences in symptom severity. This study demonstrated clinical heterogeneity among patients currently diagnosed as CFS, suggesting aetiological heterogeneity. In the absence of discriminative clinical features, current consensus criteria do not necessarily reduce the heterogeneity of patients recruited to CFS research studies.
Bulimia nervosa in Rochester, Minnesota from 1980 to 1990
Authors: Soundy T. J. , Lucas A. R. , Suman V. J. , Melton L. J. 
Published: July 2009

SYNOPSISNumerous studies have estimated the frequency of bulimia nervosa among high school girls and college women, but population-based trends in incidence in a community have not been reported.In this study we determined the incidence of bulimia nervosa by identifying persons residing in the community of Rochester, Minnesota, who had the disorder initially diagnosed during the 11-year period from 1980 to 1990. Using our comprehensive population-based data resource (the Rochester Epidemiology Project), we identified cases by screening 777 medical records with diagnoses of bulimia; feeding disturbance; rumination syndrome; adverse effects of cathartics, emetics, or diuretics; polyphagia; sialosis; or vomiting.We identified 103 Rochester residents (100 female and 3 male) who fulfilled DSM-III-R diagnostic criteria for bulimia nervosa during the 11-year study period. Mean ± S.D. age for females at the time of diagnosis was 23·0 ± 6·1 years (range, 14·4 to 40·2 years). Yearly incidence in females rose sharply from 7·4 per 100000 population in 1980 to 49·7 in 1983, and then remained relatively constant around 30 per 100000 population. The annual age-adjusted incidence rates were 26·5 per 100000 population for females and 0·8 per 100000 population for males. The overall age-and sex-adjusted annual incidence was 13·5 per 100000 population.Bulimia nervosa is a common disorder in adolescent girls and young women from 15 to 24 years of age. Histories of alcohol or drug abuse, depression, or anorexia nervosa were higher than expected in the general population.
Predicting the long-term outcome of schizophrenia
Authors: Harrison G. , Croudace T. , Mason P. , Glazebrook C. , Medley I. 
Published: July 2009

SynopsisPredictors of long-term (13 year) outcome of schizophrenia are reported for a representative cohort of ‘treated incidence’ patients ascertained on their first contact with Nottingham psychiatric services between 1978–80. An initial (baseline) model including previously reported predictors of 2-year outcome (age, gender, ever married, acuteness of onset) and length of untreated illness was used to predict a range of outcome measures covering the domains of disability, psychopathology, hospitalization, employment, social activity, and global outcome. This model demonstrated significant prognostic ability across all non-hospitalization outcomes under both ICD-10 and ICD-9 diagnoses of schizophrenia, but was attenuated under broad (ICD-9 and CATEGO S, P or O) and restrictive (S+) diagnostic classifications. Female gender predicted more favourable outcome under all diagnostic classifications except S+. In an extended analysis, the addition of initial 2-year course type substantially increased the prognostic ability of the model under all diagnostic classifications and enabled over 30% of the variance in global ratings of disability and symptoms to be predicted. In this extended model female gender predicted more favourable outcome over and above the effect of course type, across most domains under ICD-10, and for disability and psychopathology under other diagnostic classifications. The inclusion of measures of psychopathology at the time of first assessment, pre-morbid functioning, and duration of index admission conferred only marginal additional predictive ability for respective outcomes in the domains of psychopathology, social activity, employment and hospitalization. Hospitalization during the past year was the most difficult outcome to predict under any model suggesting that resource utilization represents the ‘administrative outcome’ of schizophrenia and serves as a poor proxy for broader concerns in the era of community care. These data demonstrate that key demographic variables and the mode of onset influence the long-term course of schizophrenia, but that early course type is a particularly strong predictor.
The changing mental health of children and adolescents: evidence for a deterioration?
Authors: Prosser Jonathan , McArdle Paul 
Published: July 2009

SynopsisThis paper reviews the evidence for changing patterns of mental health over time in childhood and youth in Western societies. The evidence suggests that the prevalence of major depression, substance abuse and offending behaviour, as well as the incidence of suicide, is increasing in adolescent populations, particularly among males. There are also indications that problem behaviours among younger children are becoming more common. There is no evidence of a deterioration in the adjustment of the pre-school population.
The cost of treatment of psychiatric emergencies: a comparison of hospital and community services
Authors: Merson S. , Tyrer P. , Carlen D. , Johnson T. 
Published: July 2009

SynopsisThis study aimed to compare the costs of treatment by community-based and hospitalbased psychiatric services. The design entailed random allocation of patients presenting with psychiatric emergencies over a subsequent 3-month period to one of two services, followed by retrospective quantification of service use and its cost for each group. One hundred patients with emergency presentations to the psychiatric service via the Accident and Emergency Department, liaison psychiatrist and approved social worker were included in the study. Their use of a range of items of service was recorded and disaggregated costings of these items of service was calculated. The use of non-psychiatric services was similar for both groups, but the use of psychiatric services differed, with the hospital group making greater use of in-patient beds and the community group employing more frequent home-based interventions. The total cost of treatment for the community group (£56000) was much lower than for the hospital group (£130000), although the median patient cost was 50% higher in the community group (£938 v. £610), and a greater proportion of the community service expenditure (10% v. 2%) was due to failed contacts. Taken together with clinical outcome, which showed no advantages for the hospital-based service over the community-based service, our findings suggest that this form of community psychiatric service is a cost-efficient alternative to hospital-based care for this group of patients.
Pseudohallucinations: a conceptual history
Authors: Berrios G. E. , Dening T. R. 
Published: July 2009

SynopsisThe term ‘pseudohallucination’ is currently used to name imaginal experiences whose relationship to one another and to hallucinations ‘proper’ remains obscure. Clinicians, including specialists in psychopathology, disagree on how pseudohallucination must be defined and on its diagnostic role. Empirical research is unlikely to help as the term does not have a stable referent. Historical and conceptual analyses, on the other hand, are of great use to show how this untidy state of affairs has obtained. This paper includes a full account of the history of pseudohallucination and concludes that: (a) the problem has resulted from the fact that the history of theword, concept(s) and putativebehaviour(s) failed to ‘converge’ (i.e. there never has been a time when the three components have formed a stable complex); (b) failure to converge has been caused by the fact that the concept of pseudohallucination is parasitical upon that of hallucination, and that the latter has proved to be far more unstable than what is usually recognized; (c) hence, pseudohallucination is a vicarious construct (i.e. one created by a temporary conceptual need, and which is not associated with a biological invariant); (d) pseudohallucination is used as the ‘joker’ in a poker game (i.e. made to take diagnostic values according to clinical need) – this has led to diagnostic complacency and retarded important decisions as to the nature and definition of hallucinations; and (e) the language of current descriptive psychopathology is not fine-grained enough to generate a stable frame for pseudohallucination. This suggests that its boundaries and usage will remain fuzzy and unbridled.
Inter-rater reliability of expressed emotion ratings based on the Camberwell Family Interview
Authors: Bentsen H. , Boye B. , Munkvold O. G. , Uren G. , Lersbryggen A. B. , Oskarsson K. H. , Berg-Larsen R. , Lingjærde O. , Malt U. F. 
Published: July 2009

SynopsisHigh expressed emotion in relatives has been shown to predict a poorer outcome in a range of disorders and cultures. However, variation in predictive power is considerable, and this could partly be due to low inter-rater reliability. Sixty-nine relatives of 47 acutely admitted schizophrenic patients were interviewed using the Camberwell Family Interview. Audiotapes were assessed by pairs of raters drawn from a group of seven approved raters. Inter-rater reliability was good for criticism, hostility, emotional over-involvement (as a six level scale) and expressed emotion index (EOI cut-off score 2–3); and it was fair, but unsatisfactory, for emotional over-involvement (binary scales), warmth, positive remarks and expressed emotion (EOI cut-off score 3–4). These findings suggest that the warmth scale and the dichotomized versions of the EOI scale should be used with caution. The influence of warmth on the outcome in schizophrenia may have been underestimated because of low reliability.
Increased plasma kynurenine and its relationship to neopterin and tryptophan in Tourette's syndrome
Authors: Rickards H. , Dursun S. M. , Farrar G. , Betts T. , Corbett J. A. , Handley S. L. 
Published: July 2009

SynopsisFasting plasma levels of tryptophan, kynurenine and the pteridines, neopterin and tetrahydrobiopterin were measured in seven patients with Gilles de la Tourette syndrome (GTS) and 10 healthy controls. Plasma kynurenine was significantly elevated in the GTS patients. The lowest patient value was higher than the highest control value. Values for tryptophan, neopterin and tetrahydrobiopterin were similar in TS patients and controls. However, in TS patients only, there was a significant negative correlation between tryptophan and neopterin and a significant positive correlation between kynurenine and neopterin when controlling for tryptophan. This finding indicates that activation of cellular immune processes is a possible explanation for the rise in plasma kynurenine.
Pagophagia, or compulsive ice consumption: a historical perspective
Authors: Parry-Jones Brenda 
Published: July 2009

SynopsisPagophagia, or the excessive consumption of ice or iced drinks, is popularly regarded as a novel manifestation of pica, which has emerged, predominantly in the USA, over the last 30 years. However, a sampling of historical sources reveals that not only are there warnings in the writings of both Hippocrates and Aristotle concerning the dangers of excessive intake of cold or iced water, but a series of medical works, from the sixteenth century on, incorporate discussion and illustrative case histories about the detrimental effect of immoderate usage of cold water, ice and snow, frequently in the context of disordered eating.
Early onset bulimia nervosa: who is at risk? A retrospective case–control study
Authors: Schmidt Ulrike , Hodes Matthew , Treasure Janet 
Published: July 2009

SynopsisThe aim of the study was to compare the clinical features and predisposing characteristics of patients with an early onset of bulimia nervosa with those with a more typical onset. Twenty-three cases of early onset bulimia nervosa (onset age 15 or below) were compared with 23 sex- and class-matched cases of typical onset (onset age 17 to 21) using a retrospective case–control design. No difference was found in eating symptomatology between the two groups. Deliberate self-harm was more frequent in the early onset group, and there was a trend towards more depression among their relatives. Inadequate parental control occurred more often in the early onset group, but other indicators of intrafamilial disturbance did not differ in the two groups. There was also a trend for the early onset group to be exposed to more cultural stress as a result of family migration. Early onset patients were found to have a higher loading on risk factors than typical onset patients.
Coping subtypes for men with coronary heart disease: relationship to well-being, stress and Type-A behaviour
Authors: Denollet Johan , De Potter Bea 
Published: July 2009

SynopsisWe used cluster analysis to delineate coping subtypes in a sample of 166 men with coronary heart disease who completed the Antwerp out-patient rehabilitation programme. These subtypes were identified on the basis of three well-defined superordinate traits that were selected from a comprehensive taxonomy: negative affectivity, social inhibition, and self-deception. Using Ward's minimum variance method and the cubic clustering criterion, we identified four coping subtypes; low-negative affectivity (N = 48), high-negative affectivity (N = 30), inhibited (N = 62), and repressive (N = 26) individuals. The accuracy of the resulting classification was demonstrated across parallel data sets and was further validated against external, health-related correlates that were not included in the clustering. The identified coping subtypes were significantly related to self-reports of subjective distress/perceived stress, ratings of Type A behaviour and anger-in, return to work, prevalence of chest-pain complaints, and use of minor tranquillizers and sleeping pills. The major findings of this study suggest that (a) male coronary patients represent a heterogeneous population with distinctly different coping subtypes, and that (b) a relatively small number of homogeneous subtypes can account for a substantial amount of variance in subjective well-being, coronary-prone behaviour, and return to work. These findings indicate that psychosomatic research should focus on how superordinate traits interact within individuals and corroborate the appropriateness of a class model to describe coping styles of male coronary patients. It is argued that discrepant findings across studies of Type-A behaviour and hostility may be related to the coping subtypes of the subject sample. Further attempts to cross-validate this classification scheme and to examine its health-related correlates are needed.
QALYs in mental health: a case study
Authors: Wilkinson Greg , Williams Brian , Krekorian H. , McLees S. , Falloon I. 
Published: July 2009

SynopsisThe applicability of the Charing Cross health indicator (CH-X) to the field of mental health was investigated in a community setting using descriptive statistics and principal components analysis. The CH-X is based on assessments of (i) distress and (ii) disability. Our results suggest that with respect to quality of life in mental health settings measurements of distress may be of greater importance than disability. In addition, the CH-X may be insensitive to variations in the severity of mental disorder and may primarily reflect physical disability as opposed to social disability. QALYs methodology may require the adoption of a multidimensional measure of health in order to fulfil its proposed role in comparing medical and mental health programmes.
A two-year prospective study of treatment compliance in patients with schizophrenia
Authors: Buchanan Alec 
Published: July 2009

SynopsisThe study is a prospective investigation of the factors associated with treatment compliance in 61 patients discharged from hospital with a ward diagnosis of schizophrenia. All cases were classified using reliable diagnostic criteria and all were followed up for two years. Compliance was assessed by inspection of records and by analysis of urine. Sociodemographic factors and illness variables were unrelated to compliance. Some aspects of a patient's insight and attitude, namely, a belief that medication had helped during the admission, a stated willingness to take treatment after discharge and a generally optimistic outlook, were associated with improved compliance. Other variables which showed such an association were the absence of the drug side-effect akinesia, good previous compliance and voluntary, as opposed to compulsory, admission to hospital.
A cancellation test: its reliability in assessing attentional deficits in Alzheimer's disease
Authors: Sala Sergio Della , Laiacona Marcella , Spinnler Hans , Ubezio Chiara 
Published: July 2009

SynopsisThe aim of the study is to provide (i) a standardized procedure for a Cancellation Test of Digits, designed to assess in the visual modality selective attention deficits in patients with Alzheimer's disease, and (ii) a detailed analysis of how patients cope with it.Age-, education-, and sex-adjusted normative scores earned by 352 healthy controls are set forth, as well as data yielded by the Digit Cancellation Test in 74 Alzheimer patients, in 26 patients with a CT-assessed frontal lobe lesion and in a group of 24 healthy subjects urged to perform the task with a shortened time-constraint. Findings include discriminant power of Alzheimer patients versus healthy controls, sensitivity to cognitive evolution of the dementing process and analysis of errors. Attention data failed to supply psychometric support for the posterior-to-anterior algorithm of progressive cortical encroachment of Alzheimer's disease suggested by PET-findings.Emphasis is put on methodological aspects of neuropsychological research on Alzheimer patients and on the analysis of processing components of the tests employed. Results are discussed in the light of the relationships between psychometric assessments and related functions, and underlying neuronal degeneration.