bluuebunny/crossref_metadata_2025_split huggingface dataset:
Stalking: false claims of victimisation
Authors: Pathé Michele , Mullen Paul E. , Purcell Rosemary 
Published: October 2008

BackgroundFalse allegations of victimisation although uncommon are important to recognise. This paper examines those who falsely claim to have been the victims of stalking.AimsTo highlight the phenomenon of false victims of stalking.MethodTwelve individuals who falsely claimed to be victims of stalking were compared with a group of 100 true stalking victims.ResultsFalse stalking victims presented for help earlier than real victims and were less likely to claim harassment via letters. They reported equivalent levels of violence directed at themselves but seldom claimed others were attacked. Five types of false claimants were recognisable. False victims consumed more medical services than genuine stalking victims and they were more likely to be embroiled in legal action. They reported similar levels of distress with suicidal ruminations in over 40%.ConclusionsThe current interest in stalking is promoting false claims of being stalked. Early identification of these cases and appropriate intervention are essential to both minimising abuses of resources available to true victims and equally to ensure appropriate care for those who express their own disordered state in false claims of victimisation.
Schizophrenia – a disorder of the corollary discharge systems that integrate the motor systems of thought with the sensory systems of consciousness
Authors: Feinberg Irwin , Guazzelli Mario 
Published: October 2008

BackgroundIn spite of intensive research, no causal anatomical lesion has been found in schizophrenia. It may instead be caused by malfunctioning circuits in the corollary discharge, feed forward (CD–FF) systems of thought.AimsTo integrate with the CD–FF hypothesis recent data showing that subcortical motor systems participate in thinking.MethodsWe review CD–FF concepts in relation to recent evidence that ‘motor’ brain structures participate in cognitive processing.ResultsMalfunctioning of CD–FF systems that integrate thinking and consciousness could produce auditory hallucinations, delusions and disorganised thought.ConclusionsWe hypothesise that the pathophysiology of schizophrenia lies in integrative circuits of basal ganglia, thalamus and frontal cortex. Fruitful research directions would include elucidation of CD–FF circuits at even higher brain levels, the behaviour of these circuits during dreaming, and their responses to late maturational events including synaptic elimination.
Continuing treatment of panic disorder after acute response: randomised, placebo-controlled trial with fluoxetine
Authors: Michelson David , Pollack Mark , Lydiard R. Bruce , Tamura Roy , Tepner Rosalinda , Tollefson Gary ,   The Fluoxetine Panic Disorder Study Group
Published: October 2008

BackgroundData concerning appropriate treatment in panic disorder following an initial response to acute therapy are limited.AimsTo assess the safety and efficacy of continued fluoxetine treatment following successful acute therapy of panic disorder.MethodPatients who responded to acute fluoxetine treatment were randomised to 24 weeks of continued fluoxetine or placebo.ResultsFluoxetine responders randomised to continue on their acute-phase fluoxetine dose experienced statistically significant improvement in panic attack frequency and phobia rating scale score over 24 weeks of therapy, while those switched to placebo experienced statistically significant worsening in Hamilton Anxiety (HAM–A), Hamilton Depression (HAM–D) and SCL–90–R rating scores.ConclusionsFluoxetine was associated with improved clinical outcomes compared with placebo during continuation therapy.
Befriending as an intervention for chronic depression among women in an inner city
Authors: Harris Tirril , Brown George W. , Robinson Ruth 
Published: October 2008

BackgroundEarlier work on the protective role of social support in onset and course of depressive disorder suggested that its provision might be relevant for outcome.AimsTo evaluate volunteer befriending as an intervention among women with chronic depression in inner London.MethodA randomised controlled trial, with awaiting list control design, with outcome measured as Present State Examination (PSE)-based full or partial remission after one year.ResultsA statistically significant effect upon remission was found for befriending. Other treatments monitored naturalistically did not relate to remission, nor did initial duration of chronic episode or comorbidity, but there was an association with initial PSE score. The findings are discussed in relation to standard drug-trial results and to another befriending intervention with the elderly.ConclusionsThe results are not unpromising. Additional trials with less restricted intake conditions, and in more naturalistic general practice settings, might confirm volunteer befriending as a useful adjunct to current treatments.
Treatment of neuroleptic-induced akathisia with the 5-HT2antagonist mianserin
Authors: Poyurovsky Michael , Shardorodsky Marina , Fuchs Camil , Schneidman Michael , Weizman Abraham 
Published: October 2008

BackgroundSerotonin (5-HT): dopamine imbalance may underlie neuroleptic-induced akathisia.AimTo evaluate the efficacy of the 5-HT2antagonist, mianserin in neuroleptic-induced akathisia.MethodsThirty neuroleptic-treated patients with schizophrenia were randomly allocated in a double-blind design to receive either mianserin (15 mg/day) or placebo for five days. Patients were assessed at baseline and on Days 3 and 5 by the Barnes Akathisia Scale (BARS), as well as by other relevant clinical rating scales.ResultsCompared with the placebo group, the mianserin-treated patients showed a significant reduction in all four BARS subscales by Day 5, with mean reductions in the BARS global score of 9.9% and 52.2%, respectively (P=0.006). Response to treatment (a reduction of at least two points on the BARS global subscale), was noted in six patients (40%) in the mianserin group and only one patient (9.1%) in the placebo group (P=0.04, log odds ratio 2.23).ConclusionsMianserin at a low dose may be a promising therapeutic option for patients with acute neuroleptic-induced akathisia.
Effectiveness of antidepressants
Authors: Bollini Paola , Pampaliona Sandro , Tibaldi Giuseppe , Kupelnick Bruce , Munizza Carmine 
Published: October 2008

BackgroundAntidepressant drugs are usually prescribed at low doses, possibly to avoid adverse reactions. No comprehensive review has addressed the issue of dose, clinical response and tolerability in a quantitative way.AimsTo determine whether high doses of antidepressants are more effective than lowdoses, and how safety is affected by dose.MethodTrials comparing two or more doses of the same antidepressant were located, and all antidepressants administered were converted to the equivalent dose of imipramine. Generalised estimating equations were used to analyse percentage improvement and adverse event rate according to dose level.ResultsThirty-three studies were identified. The dose level 100-200 mg imipramine equivalents showed an average improvement of 53% by ‘intention-to-treat’. Higher doses were not accompanied by increased efficacy, while lower doses showed reduction in efficacy. Adverse events significantly increased with dose.ConclusionsWith a low dose of antidepressants, clinicians trade off a slightly reduced chance of improvement for a higher chance of avoiding adverse reactions.
Depression in Europe
Authors: Copeland J. R. M. , Beekman A. T. F. , Dewey M. E. , Hooijer C. , Jordan A. , Lawlor B. A. , Lobo A. , Magnusson H. , Mann A. H. , Meller I. , Prince M. J. , Reischies F. , Turrina C. , Devries M. W. , Wilson K. C. M. 
Published: October 2008

BackgroundThis is the first report of results from the EURODEP Programme.AimsTo assess the prevalence of depression judged suitable for intervention in randomised samples of those aged ⩾65 in nine European centres.MethodThe GMS-AGECAT package.ResultsDifferences in prevalence are apparent, 8.8% (Iceland) to 23.6% (Munich). When sub-cases and cases are added together, five high- and four low-scoring centres emerge. Women predominated over men. Proportions of sub-cases to cases revealed striking differences but did not explain prevalence. There was no constant association between prevalence and age. A meta-analysis (n=13 808) gave an overall prevalence of 12. 3%, 14.1% for women and 8.6% for men.ConclusionsConsiderable variation occurs in the levels of depression across Europe, the cause for which is not immediately obvious. Case and sub-case levels taken together show greater variability, suggesting that it is not a matter of case/sub-case selection criteria, which were standardised by computer. Substantial levels of depression are shown but 62–82% of persons had no depressive level. Opportunities for treatment exist.
Development of the EURO–D scale – a European Union initiative to compare symptoms of depression in 14 European centres
Authors: Prince M. J. , Reischies F. , Beekman A. T. F. , Fuhrer R. , Jonker C. , Kivela S. -L. , Lawlor B. A. , Lobo A. , Magnusson H. , Fichter M. , Van Oyen H. , Roelands M. , Skoog I. , Turrina C. , Copeland J. R. M. 
Published: October 2008

BackgroundIn an 11-country European collaboration, 14 population-based surveys included 21 724 subjects aged ⩾65 years. Most participating centres used the Geriatric Mental State (GMS), but other measures were also used.AimsTo derive from these instruments a common depression symptoms scale, the EURO–D, to allow comparison of risk factor profiles between centres.MethodCommon items were identified from the instruments. Algorithms for fitting items to GMS were derived by observation of item correspondence or expert opinion. The resulting 12-item scale was checked for internal consistency, criterion validity and uniformity of factor-analytic profile.ResultsThe EURO–D is internally consistent, capturing the essence of its parent instrument. A two-factor solution seemed appropriate: depression, tearfulness and wishing to die loaded on the first factor (affective suffering), and loss of interest, poor concentration and lack of enjoyment on the second (motivation)ConclusionsThe EURO–D scale should permit valid comparison of risk-factor associations between centres, even if between-centre variation remains difficult to attribute.
Cost-effectiveness of assertive community treatment for homeless persons with severe mental illness
Authors: Lehman Anthony F. , Dixon Lisa , Hoch Jeffrey S. , Deforge Bruce , Kernan Eimer , Frank Richard 
Published: October 2008

BackgroundHomelessness is a major public health problem among persons with severe mental illness (SMI). Cost-effective programmes that address this problem are needed.AimsTo evaluate the cost-effectiveness of an assertive community treatment (ACT) programme for these persons in Baltimore, Maryland.MethodsA total of 152 homeless persons with SMI were randomly allocated to either ACT or usual services. Direct treatment costs and effectiveness, represented by days of stable housing, were assessed.ResultsCompared with usual care, ACT costs were significantly lower for mental health in-patient days and mental health emergency room care, and significantly higher for mental health out-patient visits and treatment for substance misuse. ACT patients spent 31% more days in stable housing than those receiving usual care. ACT and usual services incurred $242 and $415 respectively in direct treatment costs per day of stable housing, an efficiency ratio of 0. 58 in favour of ACT. Patterns of care and costs varied according to race.ConclusionACT provides a cost-effective approach to reducing homelessness among persons with severe and persistent mental illnesses.
Health of the Nation Outcome Scales
Authors: Trauer Tom , Callaly Tom , Hantz Paul , Little John , Shields Robert B. , Smith Jenny 
Published: October 2008

BackgroundIn Victoria, Australia, systematic assessment of outcomes in mental health services are being instituted.AimsTo carry out a large-scale field trial of the Health of the Nation Outcome Scales (HoNOS).Method2137 clients were rated by mental health workers on the HoNOS, and about half were rated again within a few months.ResultsWhile interrater reliability of the total score was satisfactory, that of some individual items was unacceptable. Significant associations with age and gender were found, and clients with non-psychotic disorders obtained higher (i.e. worse) ratings than those with psychotic disorders. There were relationships between service use and HoNOS total score. For the group as a whole, total scores had not changed at the second rating, but admissions and discharges were associated with increases and decreases in total score. Among clients in the community, there was no relationship between change in HoNOS total score and frequency of contacts.ConclusionsCertain items, notably 11 and 12, were unreliable. The absence of evidence of sensitivity to change may be due to the short re-rating interval, little real change in the clients, or the characteristics of the scale itself.
Evaluating the Health of the Nation Outcome Scales
Authors: Amin S. , Singh S. P. , Croudace T. , Jones P. , Medley I. , Harrison G. 
Published: October 2008

BackgroundThe HoNOS has been developed as a routine measure of outcomes in mental health.AimsTo explore the validity and interrater reliability of HoNOS in a first-onset psychosis follow-up study.MethodBetween 1992 and 1994 we ascertained a cohort of all persons with first-onset psychosis. We re-assessed these people at 3 years (n=166) with several outcome scales, including HoNOS. Patients' keyworkers also completed the HoNOS. We estimated concurrent validity by calculating correlations between HoNOS and other scales, and interrater reliability.ResultsResearcher HoNOS correlated highly with other scales (0.46 < p < 0.86; P < 0.001). Keyworker HoNOS correlations were lower (0.41 < p < 0.51; P < 0.05), but still significant for all scores except the HoNOS-social subscale (0.12 < p < 0.28). Agreements between researcher and keyworker HoNOS were modest (0.47 < ICC < 0.85).ConclusionsIn this research cohort HoNOS correlates well with established outcome scales. Keyworker ratings show similar, but weaker, relationships; its use in routine settings may require further training for calibration of severity.
Validity and reliability of the Health of the Nation Outcome Scales in psychiatric patients in the community
Authors: Orrell Martin , Yard Paula , Handysides Julia , Schapira Robert 
Published: October 2008

BackgroundThe Health of the Nation Outcome Scales (HoNOS) have been developed for assessing the effectiveness of mental health services.AimsTo investigate the validity and reliability of the HoNOS in patients in contact with mental health services.MethodSubjects (age range 19–64) came from day hospitals, acute in-patient units and out-patient clinics in general practice. We obtained the opinions of experienced professionals, advocacy groups and patient groups to evaluate consensual and content validity.ResultsOne hundred patients were assessed using the package of rating scales. Interrater and test–retest reliability were good for some items and poor for others. The HoNOS had good criterion validity: acute in-patients had higher scores than day patients and out-patients. HoNOS also had good concurrent validity, correlating well with other scales. Comments suggested that the HoNOS was a useful and suitable scale for this population but psychotic symptoms and certain social factors were not sufficiently covered.ConclusionThe HoNOS had good validity but variable reliability. It may be better than existing scales because of the wide range of areas which it covers.
Paddington Complexity Scale and Health of the Nation Outcome Scales for Children and Adolescents
Authors: Yates P , Garralda M E , Higginson I 
Published: October 2008

BackgroundThere is an increasing interest in measuring health care outcomes in mental health services for children as well as adults.AimsWe examined the sensitivity of the Paddington Complexity Scale (PCS) and the Health of the Nation Outcome Scales for Children and Adolescents (HoNOSCA) in describing the intakes of child and adolescent mental health clinics.MethodWe carried out a prospective study of two out-patient units and one day patient unit, by means of questionnaires administered to clinicians, parents and children.ResultsClinician-rated PCS and HoNOSCAs were obtained for 248 new attenders. Both proved sensitive to intake differences between clinics. There were correlations of moderate intensity (r=0.6) between total PCS and HoNOSCA. There were weaker associations between these and parent/child rated measures of behaviour (r=0.4 and 0.3), quality of life and self-esteem (r=0.3 or less).ConclusionsBoth PCS and HoNOSCA are useful for describing clinical profiles of children and adolescents receiving mental health services.
Childhood shyness and maternal social phobia: A community study
Authors: Cooper Peter J. , Eke Marian 
Published: October 2008

BackgroundFamily history data suggest the possibility of an association between childhood shyness and parental social phobia.AimsTo examine the prevalence of maternal affective disorder in a community sample of four-year-old shy and non-shy children.MethodBy screening 867 children, 43 shy children, 59 children with another form of disturbance (i.e. fearfulness, feeding problem or conduct problem) and 26 children with no disturbance were identified. Interviewers who were unaware of child status used a standardised mental state assessment to determine the rate of affective disorder in the mothers of these children.ResultsCompared with the mothers of the children in both comparison groups, the mothers of the children who were purely shy (i.e. shy children with no comorbid condition) had a significantly raised lifetime rate of anxiety disorder in general, and social phobia in particular. The odds ratio of a social phobia in the mothers of the purely shy children was raised over the normal control group by a factor of more than seven.ConclusionsThese findings suggest a specific association between childhood shyness and maternal social phobia.
Unreliable admissions to homicide
Authors: Gudjonsson Gisli H. , Kopelman Michael D. , MacKeith James A. C. 
Published: October 2008

BackgroundThe past decade has witnessed a recognition that unsafe criminal convictions may be occasioned by unreliable confessions.AimsTo present a case which illustrates the dangers of using abreaction interview techniques in a legal context and demonstrate the relevance of the memory distrust syndrome to an unsafe confession to murder.MethodWe undertook a detailed assessment of a person appealing against his original murder conviction/the appellant’, and a careful scrutiny of all the relevant papers in the case.ResultsThe appellant served 25 years in prison before his conviction was quashed as ‘unsafe’ on the basis of fresh psychological and psychiatric evidence.ConclusionsAmnesia for an offence had been misdiagnosed, and the use of repeated abreaction interviews had further confused both the appellant and the original court. At the Appeal Court, the advice was that the man had experienced a form of source amnesia which resulted in an unreliable confession.
Randomised controlled effectiveness trial of a needs-based psychosocial intervention service for carers of people with schizophrenia
Authors: Barrowclough Christine , Tarrier Nicholas , Lewis Shôn , Sellwood William , Mainwaring John , Quinn Joanne , Hamlin Charlotte 
Published: October 2008

BackgroundFamily interventions are effective in reducing relapse in patients with schizophrenia, but there is little work demonstrating the effectiveness of the interventions in routine service settings.AimsTo test the effectiveness of a needs-based family intervention service for patients recruited as out-patients and their carers, including those of low expressed emotion status.MethodCarers of out-patient schizophrenia sufferers selected only on illness history factors were randomly allocated to receive either family support alone or in combination with systematic psychosocial interventions based on an assessment of need. Delivery of family interventions attempted to involve the clinical team.ResultsRelapse outcomes were superior for family-treated patients at six-month follow-up, although most of the clinical and symptom patient variables assessed remained stable, as did measures of carer burden.ConclusionsThe study demonstrated the effectiveness of family interventions in routine service settings. Problems with staff, patient and carer engagement and participation were identified.
Cognitive disability and direct care costs for elderly people
Authors: Kavanagh Shane , Knapp Martin 
Published: October 2008

BackgroundPopulation ageing and the high costs of care support for elderly people have concentrated attention on economic issues. Is there an association between costs and cognitive disability?AimsTo compare service utilisation and direct costs for elderly people with different degrees of cognitive disability, and between people living in households and in communal establishments.MethodSecondary analysis of Office of Population Censuses and Surveys (OPCS) Disability Surveys data compared service utilisation and costs for 8736 elderly people with cognitive disability. Cost estimates were constructed for all health and social care services.ResultsA much greater proportion of people at higher levels of cognitive disability lived in communal establishments, where their (direct) costs were much higher than when supported in households. Service utilisation patterns and costs varied with cognitive disability.ConclusionsIt is important to look at the full range of living arrangements and support services when examining costs. The potential cost implications of pharmacotherapies, other treatments or new care arrangements cannot be appreciated without such a broad perspective.
Crisis telephone consultation for deliberate self-harm patients: Effects on repetition
Authors: Evans Mark O. , Morgan H. G. , Hayward Alan , Gunnell David J. 
Published: October 2008

BackgroundNo interventions have been shown to be effective in reducing deliberate self-harm (DSH) repetition in this group of patients as a whole.AimsTo investigate the effect on repetition of offering emergency telephone support in a group of hospital-admitted DSH patients.MethodAtotal of 827 DSH patients admitted to medical wards were randomly allocated to either control or intervention (green card) groups. In addition to treatment as usual, the intervention group was offered telephone support should any further crises occur. The main outcome measure was DSH repetition within six months of the index event.ResultsThe intervention had no significant effect on the overall DSH repetition rate (odds ratio 1.20, 95% CI 0.82–1.75). Sub-group analysis suggested that response to the intervention differed according to the past history of DSH – subjects with a previous history repeating more often and first-timers appearing to benefit.ConclusionsNo overall effect of the intervention was shown. Conclusions concerning sub-groups must be regarded as speculative, but they suggest that further assessment of the value of telephone support in first-timer DSH patients is indicated.