bluuebunny/crossref_metadata_2025_split huggingface dataset:
One and Two Year Outcomes for Adults with Learning Disabilities Discharged to the Community
Authors: Donnelly Michael , McGilloway Sinead , Mays Nicholas , Knapp Martin , Kavanagh Shane , Beecham Jennifer , Fenyo Andrew 
Published: October 2008

BackgroundLong-stay patients with learning disabilities (n=214) were assessed in hospital and 12 and 24 months after discharge in order to examine the effects of relocation.MethodEach resident acted as his/her own control in a prospective repeated-measures design. Skills and behavioural problems were assessed by keyworkers. Self-perceived quality of life was obtained during interviews with researchers who also completed an environmental checklist of the residents' accommodation.ResultsThere was little or no change in peoples low pre-discharge skill levels. Certain aspects of problem behaviour improved after 12 months, although socially unacceptable behaviour increased slightly. People were less depressed (P⩽ 0.01) 12 months after discharge (n=119) and were more satisfied (P⩽ 0.05) with their new ‘homes’ (n=108). There were few changes in the pattern of activities or the social networks of people 12 months later. Little or no further change in outcomes was reported 24 months after discharge.ConclusionsThe implementation of the deinstitutionalisation policy in Northern Ireland has been limited by the predominance of residential and nursing homes and the lack of ‘ordinary’ accommodation. There is a need for purchasers and providers to give more attention to ways in which the principles of normalisation could be incorporated in the process of contracting and delivering services.
Mass Hysteria: One Syndrome or Two?
Authors: Ali-Gombe Abubakar , Guthrie Elspeth , McDermott Niall 
Published: October 2008

BackgroundIt has been suggested that mass hysteria can be divided into two syndromes; one with predominant features of anxiety and the other with predominant abnormalities of motor behaviour. In the former condition, prior tension is absent and spread is by visual contact In the latter, prior tension is present, initial cases can be identified and spread is gradual.MethodThe development and resolution of neurological symptoms in 156 Nigerian school girls were studied and a diagnosis of ‘mass hysteria’ made.ResultsThe signs and symptoms manifested by the school girls during the outbreak of illness had features of both ‘anxiety’ and ‘motor’ predominant forms of mass hysteria.ConclusionsAlthough there may be two patterns of symptom presentation in mass hysteria, other supposedly discrete features overlap. This weakens the argument that there are two separate syndromes.
Bipolar Affective Disorder Minus Left Prefrontal Cortex Equals Schizophrenia
Authors: Pang Alfred , Lewis Shôn W. 
Published: October 2008

BackgroundAn investigation of the relationship between bipolar affective disorder and schizophrenia, following a severe head injury and removal of the left prefrontal cortex.MethodA single case report.ResultsAn individual with past history of bipolar affective disorder suffered traumatic damages to the left prefrontal cortex with a second lesion in the left temporal lobe. The patient developed typical schizophrenia nine months later. The relevance of his brain lesions in determining the schizophrenic symptoms is discussed.ConclusionWe propose that the specific pattern of brain injury in this patient was sufficient to change the phenotype from bipolar affective disorder to schizophrenia.
Tardive Dyskinesia and Positive and Negative Symptoms of Schizophrenia
Authors: Yuen Owen , Caligiuri Michael P. , Williams Richard , Dickson Ruth A. 
Published: October 2008

BackgroundControversy surrounds the relationship between tardive dyskinesia (TD) and symptoms of schizophrenia. While some studies reported that negative symptoms of schizophrenia may be a risk factor for TD, others reported a relationship between TD and positive symptoms.MethodEighty-four patients were studied, of whom 47 met criteria for TD. Clinical and instrumental procedures were used to increase the sensitivity of our assessments of the presence and severity of TD. Stepwise logistic and linear regression procedures were used to identify demographic variables, psychopathology, and motor parameters associated with the presence and severity of TD.ResultsA 3-factor model consisting of age, clinical tremor, and negative symptoms explained 25% of the variance in clinical TD severity. A 6-factor model consisting of female gender, instrumental and clinical measures of parkinsonism, positive, and negative symptoms explained 49% of the variance in severity of instrumentally derived dyskinesia.ConclusionsThese results suggest that the presence of TD may be associated with positive symptoms; that the severity of TD may be related to negative symptoms; and that the relationship between negative symptoms and TD severity may be influenced by the presence of parkinsonism.
Clinical Usefulness of an Aftercare Worker for Psychotic Patients Discharged from Half-way Houses in Hong Kong
Authors: Mak Ki-Yan , Gow Lyn 
Published: October 2008

BackgroundThe aim was to assess the clinical usefulness and economic viability of an aftercare worker for psychotic patients discharged from half-way houses in Hong Kong.MethodA sample of 32 chronic psychotic patients was provided with a full-time aftercare worker. A matched control group received no such service.ResultsThe experimental group was found to have greater and better employment prospects, better mental status with less hospitalisation and less law-breaking behaviour than the control group. Some of these benefits were converted into economic terms and the tangible costs incurred in the project were calculated.ConclusionsThe provision of an aftercare service is clinically useful and economically viable.
Prediction of ECT Response: Validation of a Refined Sign-Based (CORE) System for Defining Melancholia
Authors: Hickie Ian , Mason Catherine , Parker Gordon , Brodaty Henry 
Published: October 2008

BackgroundThe clinical validity of melancholia has been argued on the basis of its capacity to predict response to electroconvulsive therapy (ECT). We have argued that a sign-based (CORE) rating system of psychomotor disturbance can identify patients with melancholia. Therefore, the clinical validity of the CORE system was tested here in terms of its capacity to predict response to ECT.MethodThe response of 81 patients with primary affective disorders to an individualised course of ECT was investigated. CORE scores and other clinical predictors were evaluated in terms of their capacity to predict effect size changes in symptoms and disability.ResultsCORE scores predicted ECT response, as did the presence of psychotic features. The combination of marked psychomotor change (high CORE scores) and psychotic features predicted the best response to ECT.ConclusionThis study supports the clinical validity of the CORE system for diagnosing melancholia.
The Bereavement Response: A Cluster Analysis
Authors: Middleton Warwick , Burnett Paul , Raphael Beverley , Martinek Nada 
Published: October 2008

BackgroundLiterature and clinical experience suggest that some people experience atypical, complicated or pathological bereavement reactions in response to a major loss.MethodThree groups of community-based bereaved subjects – spouses (n=44), adult children (n=40), and parents (n=36) – were followed up four times in the 13 months after a loss. A 17-item scale of core bereavement times was developed and used to investigate the intensity of the bereavement response over time.ResultsCluster analysis revealed a pattern of bereavement-related symptoms approximating a syndrome of chronic grief in 11 (9.2%) of the 120 subjects. None of the respondents displayed a pattern consistent with delayed or absent grief.ConclusionsIn a non-clinical community sample of bereaved people, delayed or absent grief is infrequently seen, unlike chronic grief, which is demonstrated in a minority.
A Genetic Linkage Study of the D2Dopamine Receptor Locus in Heavy Drinking and Alcoholism
Authors: Cook C. C. H. , Palsson G. , Turner A. , Holmes D. , Brett P. , Curtis D. , Petursson H. , Gurling H. M. D. 
Published: October 2008

BackgroundReports of an association between restriction fragment length polymorphisms (RFLPs) at the dopamine D2receptor (DRD2) locus and alcoholism have suggested involvement of that locus in the aetiology of alcoholism.MethodSib pair linkage analyses were conducted in families multiply affected by alcoholism, using both the Taql ‘A’ RFLP and a microsatellite repeat polymorphism at the DRD2 locus.ResultsThe ‘Identical By Descent’ analysis provided significant evidence of an effect of the DRD2 locus on the liability to develop heavy drinking (P<0.0016) and Research Diagnostic Criteria alcoholism (P<0.0003) in the first sample of families studied. However, this result was explicable by the segregation of alleles in a single large sibship, and it was not replicated in a second sample of families.ConclusionsThe results do not support linkage between the DRD2 locus and alcoholism in most of the families studied. It remains possible that this locus influences the predisposition to alcoholism in some families.
Impulsivity in Disordered Eating, Affective Disorder and Substance use Disorder
Authors: Bushnell J. A. , Wells J. E. , Oakley-Browne M. A. 
Published: October 2008

BackgroundFailure to control impulsive behaviour has been postulated as an underlying mechanism common to substance use disorder, sociopathy and to a substantial subgroup of women with bulimia nervosa.MethodThree hundred and one women recruited to a general population study were selected either at random or because they had lifetime substance use disorder, affective disorder or symptoms of bulimia. A subsequent interview determined the existence of problems with impulsivity. Behaviour that is an integral part of a DSM–III axis 1 disorder was excluded from the impulsivity measure.ResultsSimilar rates of impulsivity were found in all three of these types of disorder, and this was little different from the rate found in the women selected randomly from the general population. However, among those with comorbid disorder there was more impulsivity, and the more comorbid disorders found, the higher the proportion with problems of impulsivity.ConclusionsBecause those in treatment facilities are more likely to have other comorbid disorders (Berkson's bias), findings derived from observations of women with bulimia who are in treatment may be compromised by selection bias and may have limited applicability to those with the disorder who are not in treatment.
Psychological Predictors of Insight and Compliance in Psychotic Patients
Authors: Kemp Róisín , David Anthony 
Published: October 2008

BackgroundA possible neuropsychological basis for poor insight in psychosis has been proposed Consistent supporting evidence for this is lacking.MethodSeventy-four consecutive acutely psychotic in-patients who were recruited for a randomised controlled trial of compliance therapy were given a battery of neuropsychological tests, along with a comprehensive clinical assessment before and after the intervention.ResultsPerformance on neuropsychological tests improved during the patients' admission and treatment in hospital as did symptoms and levels of insight Cognitive function showed no relationship to insight and compliance initially, and very little after the intervention. Factors related to insight and compliance prior to discharge included: diagnosis, attitudes to medication, side-effects, being a detained patient and whether or not compliance therapy was given.ConclusionsClinical variables and attitudes to treatment appear to be more relevant to compliance and the development of insight in acute psychosis than neuropsychological impairment.
Measuring the Mental Health Status of a Population: a Comparison of the GHQ–12 and the SF–36 (MHI–5)
Authors: McCabe C. J. , Thomas K. J. , Brazier J. E. , Coleman P. 
Published: October 2008

BackgroundA comparison of the performance of the 5-item mental health dimension of SF–36 (MHI–5) with that of the 12-item General Health Questionnaire (GHQ–12) in a defined, non-patient population, using standard statistical tests.MethodsA postal survey of 3000 patients aged 16–64 years was conducted. Patients were randomly selected from the practice lists of two general practices chosen to represent populations with different socio-economic characteristics.ResultsConsiderable evidence was found for the internal consistency of both instruments (Cronbach's α 0.91 and 0.84 for GHQ–12 and the MHI–5 respectively) and for their construct validity in terms of distinguishing between groups with measured health differences. Both instruments showed a significant difference in the mean scores for men and women. In contrast to the GHQ–12, no correlation was found between age and score for the MHI–5. Both instruments were equally sensitive to socio-economic characteristics and to levels of social support The scores on the two instruments were highly correlated (Spearman rank correlation – 0.73).ConclusionThe MHI–5 has comparable psychometric performance to the GHQ–12, and can be used to measure and compare mental health in defined populations. Operational advantages of the MHI–5 over the GHQ–12 are that it is in the public domain, is part of a general health measure (SF–36) and is shorter.
Aspects of Perinatal Psychiatric Illness
Authors: Pritchard Dewi B. , Harris Brian 
Published: October 2008

BackgroundIn view of the current changes in the National Health Service, it was considered an opportune time to review the literature on perinatal psychiatric illness.MethodA systematic review was undertaken of relevant articles on medline, ClinPsych and Excerpta Medica Psychiatry.ResultsSixty-eight articles were used in the review.ConclusionsDevelopments in the field of perinatal psychiatry include a greater understanding of the nosology and aetiology of the conditions, the effect of maternal illness on the child as well as transcultural factors. The perspective of the individual sufferer has been somewhat ignored. New treatments with both pharmacotherapy and hormones are emerging, but perhaps the greatest current challenge is to adapt our management strategies to community care.
Large Variations of Plasma Levels During Maintenance Treatment with Depot Neuroleptics
Authors: Tuninger Eva , Levander Sten 
Published: October 2008

BackgroundStability of neuroleptic medication has been associated with optimal clinical effect and minimal side-effects. Depot administration is assumed to yield better stability.MethodThirty patients on depot neuroleptic treatment were followed during three years with repeated measurements of plasma level and concurrent ratings of clinical symptoms and side-effects.ResultsOf 120 blood samples 35 (29%) measurements were outside ± 2 s.d. measurement error (expected 5%). Perphenazine levels were more variable (46%) than haloperidol (25%) and flupenthixol (12.5%). No relationship was found between side-effect ratings and fluctuations of plasma levels.ConclusionDepot neuroleptic medication does not eliminate a clinically unwanted and sometimes marked variation in plasma level.
Behavioural Vigilance in Schizophrenia
Authors: Mar Corinne M. , Smith David A. , Sarter Martin 
Published: October 2008

BackgroundDespite 30 years of research, some surprisingly fundamental gaps remain in our understanding of schizophrenic input dysfunctions.MethodIn a provisional test of a ‘hyperattention’ hypothesis, schizophrenic patients and control subjects performed a behavioural test that was adapted from a paradigm originally developed for characterising vigilance or sustained attention in animals. On this computerised operant testing procedure, subjects discriminated between signals of various salience and non-signal presentations. Hits and correct rejections resulted in monetary rewards while misses and false alarms entailed monetary costs.ResultsData from in-patients with schizophrenia and age, education and gender-matched controls support hypotheses not only about hyperattentional dysfunctions in schizophrenia with respect to overall signal detectability but also in terms of resistance to the vigilance decrement that normally occurs over trials.ConclusionsThe theoretical importance of impairments of this sort are discussed with respect to the cognitive and perceptual consequences of hypervigilance and ‘input dysfunction’.
Antipsychotic drug-induced movement disorders in schizophrenics in relation to CYP2D6 genotype
Authors: Armstrong Martin , Daly Ann K. , Blennerhassett Richard , Ferrier Nicol , Idle Jeffrey R. 
Published: October 2008

BackgroundApproximately 5–10% of Caucasians (poor metabolisers) show impaired metabolism of at least 20 therapeutically important drugs, including a number of commonly used antipsychotic agents, because they lack the cytochrome p450 enzyme CYP2D6. The molecular basis of this defect is now well understood and simple genotyping tests using the polymerase chain reaction (PCR) have been developed.MethodTo determine whether poor metabolisers are more susceptible to acute dystonic reactions and chronic movement disorders associated with the administration of antipsychotic drugs, we determined CYP2D6 genotypes in a group of 76 schizophrenics using previously described methods involving PCR and restriction fragment length polymorphism analysis.ResultsThere was no difference in genotype frequencies between the schizophrenics and a normal control population, suggesting that CYP2D6 genotype was not a factor in determining susceptibility to the disease. However, four of the five poor metabolisers compared with 44% of the remaining subjects were suffering from a movement disorder at the time of the study, although because of the small number of poor metabolisers in the group the difference was not statistically significant. Poor metabolisers were not more likely to suffer an acute dystonic reaction.ConclusionsCYP2D6 genotype is not a determinant of susceptibility to acute dystonic reactions but may be a contributory factor in antipsychotic drug-induced movement disorders including tardive dyskinesia.
The mental health residential care study: Predicting costs from resident characteristics
Authors: Chisholm D. , Knapp M. R. J. , Astin J. , Lelliott P. , Audini B. 
Published: October 2008

BackgroundLittle information is available on the costs of residential care for people with mental health problems, and there are very few research data on how or why the costs of provision vary.MethodAs part of a broader study based on data collected from across the residential care sectors in eight districts and using multiple regression analysis, research has examined whether and which resident characteristics are associated with higher or lower costs.ResultsResident characteristics account for approximately 21% of the observed variation in inter-resident costs. Separate analyses were conducted for people in the London and non-London districts. The resident characteristics that were found to be significant predictors of cost include: age, gender, ethnic group, history of psychiatric admissions, diagnosis, emotional lability, daily living skills, social interaction and network, aggression, suicidal tendencies, drug abuse and legal status. Examination of the residual ('unexplained') costs found significant differences between facility types, sectors (private and voluntary being less costly than public, other things being equal) and districts.ConclusionsThe associations uncovered by these analyses can inform commissioners' planning and purchasing activities, at both the macro and micro levels, by revealing those resident needs and circumstances that are associated with higher costs.
Long-term mortality after first psychiatric admission
Authors: Naik Prakash C. , Davies Steffan , Buckley Ann M. , Lee Alan S. 
Published: October 2008

BackgroundLittle is known about the long-term mortality and causes of death after first psychiatric admission.MethodA consecutive series of 87 patients admitted for the first time from a strictly defined catchment area to Saxondale Hospital, Nottinghamshire, who were discharged in 1974 and 1975, were traced in 1992 to either their general practitioner or death. The causes of their deaths were ascertained and the observed mortality was compared with expected mortality.ResultsTwelve subjects had died. None had committed suicide, and there were no open verdicts or accidental deaths. Although the observed mortality was higher than expected, there was no significant excess.ConclusionsThere may be little scope for reducing suicide rates by targeting patients for careful follow-up after discharge from their first psychiatric admission. More research is required before large investments are made in potentially fruitless interventions to achieve the objectives ofThe Health of the Nation.
Relatives' expressed emotion and non-verbal signs of subclinical psychopathology in schizophrenic patients
Authors: Woo Stephanie M. , Goldstein Michael J. , Nuechterlein Keith H. 
Published: October 2008

BackgroundPrevious research has generally found that variations in relatives' affective attitudes (expressed emotion; EE) towards a schizophrenic family member could not be accounted for by differences in the severity or form of the patient's symptomatology. These findings have been based on clinicians' ratings of psychopathology in patients.MethodTo approach the question from a different perspective, videotaped interactions between a patient and family members, obtained four to five weeks after hospital discharge, were coded for subclinical signs of psychopathology expressed by the patient. The Behavioral Subclinical Rating Scale (BSRS) was developed to compare subclinical levels of non-verbal and paralinguistic symptoms expressed by patients from both high- and low-EE families.ResultsHighly significant differences were found in the BSRS data. Patients from high-EE families showed more hostile and unusual behaviour with relatives than those from low-EE homes, who, in contrast, showed more anxious behaviour.ConclusionThese data suggest that a complex transactional model is necessary to understand how family attitudes evolve during the course of a relatives' schizophrenic disorder.
The structure and development of borderline personality disorder: A proposed model
Authors: Ryle Anthony 
Published: October 2008

BackgroundThe theory of cognitive analytic therapy is extended to offer an understanding of borderline personality disorder (BPD).MethodA structural model (the multiple self states model) and a classification of different levels of developmental damage are proposed.ResultsThe model offers an explanation of the phenomenology of BPD.ConclusionsThe multiple self states model provides insights that will be useful for clinicians involved in the psychotherapy and management of BPD patients.