bluuebunny/crossref_metadata_2025_split huggingface dataset:
Urban environment and mental health
Authors: Dalgard Odd Steffen , Tambs Kristian 
Published: October 2008

BackgroundIn a follow-up survey from Oslo, 503 persons were re-interviewed using the same questionnaire after 10 years.MethodThe questionnaire includes questions about social support, social characteristics of the neighbourhood and mental health. Information about the neighbourhood was also gathered from key informants.ResultsOf the five types of neighbourhoods surveyed, only one showed marked change over time with respect to social characteristics. This was an initially poorly functioning neighbourhood with poor mental health among the residents, where substantial improvement took place as part of the further development of the area. Parallel with the improvement in social environment there was a significant improvement in mental health among those who continued to live in the same area, as opposed to those who continued to live in the other areas. Selective migration could not explain this finding.ConclusionsThe findings support the environment stress hypothesis, implying that the quality of a neighbourhood has an impact on mental health. The implications for psychiatric prevention are discussed.
Postnatal depression and elation among mothers and their partners: Prevalence and predictors
Authors: Lane Abbie , Keville Rita , Morris Mary , Kinsella Anthony , Turner Michael , Barry Siobhan 
Published: October 2008

BackgroundCorrelates and predictors of mood disturbance at 3 days and 6 weeks postpartum were assessed in Irish mothers and their partners.MethodThe Edinburgh Postnatal Depression Scale (EPDS) and the Highs Scale were used to assess 370 mothers and their partners. Socio-demographic, clinical and obstetric data were collected at patients' first antenatal visit. Factors associated with EPDS scores of ≥ 13 and Highs scores of ≥ 8 were examined.ResultsOn the EPDS 11.4% of mothers scored ≥ 13 at 3 days postpartum and 11% at 6 weeks, while 18.3% of mothers scored ≥ 8 on the Highs Scale at 3 days and 9% at 6 weeks. Scores on the EPDS and Highs Scale were interrelated. Factors associated with EPDS scores of ≥ 13 at 6 weeks were single status, unemployment, unplanned pregnancy, public status and bottle-feeding. The best predictors of EPDS ≥ 13 at 6 weeks were mothers' scores on the EPDS and the Highs Scale at 3 days. Three per cent of partners scored ≥ 13 on the EPDS at 3 days postpartum and 1.2% at 6 weeks.ConclusionsFactors associated with mothers' mood disturbance were readily identifiable and collected routinely at antenatal intake. Mothers' mood within 3 days of delivery was the best predictor of later postnatal depression. Paternal mood disturbance was rare. Certain women may be at increased risk for postnatal mood disturbance and may be amenable to early identification and intervention.
One-year, low-dose neuroleptic study of in-patients with chronic schizophrenia characterised by persistent negative symptoms
Authors: Speller Jeremy C. , Barnes Thomas R. E. , Curson David A. , Pantelis Christos , Alberts J. L. 
Published: October 2008

BackgroundAmisulpride is a potent substituted benzamide antipsychotic drug claimed to improve the negative symptoms of schizophrenia, particularly at low dosage.MethodSixty long-term in-patients with schizophrenia and selected for predominant negative symptoms were randomised to receive either haloperidol or amisulpride. Over a year there was systematic dose reduction, as symptoms allowed.ResultsThere were no significant differences between the treatment groups in the proportion receiving low-dose treatment, the control of positive symptoms, or ratings of social behaviour, side-effects or tardive dyskinesia. For negative symptoms, there were consistent but non-significant trends in favour of amisulpride. The amisulpride patients required significantly less anticholinergic medication.ConclusionsIn chronically-hospitalised in-patients with schizophrenia characterised by persistent negative symptoms, amisulpride was a well-tolerated maintenance antipsychotic medication. The drug had only a limited effect in reducing negative symptoms, which were relatively stable, enduring phenomena in this sample, despite dosage reduction.
Health of the Nation Outcome Scales (HoNOS)
Authors: Wing J. K. , Beevor A. S. , Curtis R. H. , Park S. G. B. , Hadden J. , Burns A. 
Published: October 2008

BackgroundAn instrument was required to quantify and thus potentially measure progress towards a Health of the Nation target, set by the Department of Health, “to improve significantly the health and social functioning of mentally ill people”MethodA first draft was created in consultation with experts and on the basis of literature review. This version was improved during four stages of testing: two preliminary stages, a large field trial involving 2706 patients (rated by 492 clinicians) and tests of the final Health of the Nation Outcome Scales (HoNOS), which included an independent study (n=197) of reliability and relationship to other instruments.ResultsThe resulting 12-item instrument is simple to use, covers clinical problems and social functioning with reasonable adequacy, has been generally acceptable to clinicians who have used it, is sensitive to change or the lack of it, showed good reliability in independent trials and compared reasonably well with equivalent items in the Brief Psychiatric Rating Scales and Role Functioning Scales.ConclusionsThe key test for HoNOS is that clinicians should want to use it for their own purposes. In general, it has passed that test. A further possibility, that HoNOS data collected routinely as part of a minimum data set, for example for the Care Programme Approach, could also be useful in anonymised and aggregated form for public health purposes, is therefore testable but has not yet been tested.
Lifetime risk of suicide for affective disorder, alcoholism and schizophrenia
Authors: Inskip Hazel , Harris Clare , Barraclough Brian 
Published: October 2008

BackgroundThe lifetime risks of suicide are generally quoted as 15% for affective disorder and alcoholism and 10% for schizophrenia, based on data from 1921–1975 and on calculations performed before computerised modelling techniques became available. This study recalculates the risk using contemporary data and modern techniques.MethodTwenty-seven mortality studies provided data for affective disorder, 27 for alcohol dependence and 29 for schizophrenia. The proportion of the cohort who had died was plotted against the proportion of deaths from suicide. Modelling techniques fitted curves through the data points extrapolating them to cohort extinction, thus estimating the lifetime risk of suicide for each disorder.ResultsThe lifetime risk was estimated at 6% for affective disorder, 7% for alcohol dependence and 4% for schizophrenia.ConclusionsThe lifetime suicide risk figures often quoted in the literature appear to be too high.
Prospective study into factors associated with aggressive incidents in psychiatric acute admission wards
Authors: Kho King , Sensky Tom , Mortimer Ann , Corcos Christopher 
Published: October 2008

BackgroundFactors associated with aggression among psychiatric in-patients are still poorly understood. Inconsistent published findings are partly attributable to methodological problems. Much previous research has been undertaken in specialist settings, where conditions are likely to differ from those in acute admission wards.MethodLevels of aggression were ascertained weekly by staff report, using a reliable measure, for every patient on five acute admission wards and one locked intensive care ward at two hospitals prospectively over a five-month period.ResultsLevels of aggression varied considerably among the admission wards. Aggression was more common on the locked ward and among younger patients. Factors associated with aggression changed with time since admission (seldom examined in previous studies). Complex associations were found with gender, ethnic group and diagnosis.ConclusionsSome of the findings might be explicable by differences in ward environment, and staff–patient interactions. Further investigation into these is warranted.
Cost and benefit in the choice of ECT schedule
Authors: Shapira Baruch , Tubi Nurith , Drexler Heinz , Lidsky David , Calev Avraham , Lerer Bernard 
Published: October 2008

BackgroundWe compared the anti-depressant and cognitive effects of up to eight sessions of bilateral, brief pulse electroconvulsive therapy (ECT) administered twice (ECT x 2) or three times weekly (ECT x 3), to confirm that ECT x 3 acts more rapidly although the two schedules are equivalent in antidepressant outcome, and to establish whether ECT x 3 is indeed associated with more severe memory impairment.MethodPatients with major depression, endogenous subtype were randomly assigned to ECT x 3 or ECT x 2 plus one simulated ECT per week, both up to a maximum of eight real ECT. Depression was evaluated by the Hamilton Depression Scale the day after each treatment and cognitive function by a test battery administered before and after the ECT series and at one month follow-up.ResultsAssessed categorically or parametrically, there was no significant difference in antidepressant outcome between the two schedules. Rate of response was significantly more rapid with ECT x 3 but was associated with more severe memory impairment.ConclusionsTwice weekly administration is an optimum schedule for bilateral ECT unless clinical indications require the more rapid antidepressant effect of three times weekly treatment.
Outcome of common mental disorders in Harare, Zimbabwe
Authors: Patel Vikram , Todd Charles , Winston Mark , Simunyu Essie , Gwanzura Fungisai , Acuda Wilson , Mann Anthony 
Published: October 2008

BackgroundLittle is known about the outcome of common mental disorders (CMD) in primary care attenders in low income countries.MethodTwo and 12 month (T1 and T2) follow-up of a cohort of cases of CMD (n=199) recruited from primary health, traditional medical practitioner, and general practitioner clinics in Harare, Zimbabwe. The Shona Symptom Questionnaire (SSQ) was the measure of caseness.ResultsThe persistence of case level morbidity was recorded in 41% of subjects at 12 months. Of the 134 subjects interviewed at both follow-up points, 49% had recovered by T1 and remained well at T2 while 28% were persistent cases at both T1 and T2. Higher SSQ scores, a psychological illness model, bereavement and disability predicted a poor outcome at both times. Poorer outcome at T1 only was associated with a causal model of witch-craft and an unhappy childhood. Caseness at follow-up was associated with disability and economic deprivation.ConclusionsA quarter of cases of CMD were likely to be ill throughout the 12 month follow-up period. Targeting risk groups for poor outcome for interventions and policy interventions to reduce the impact of economic deprivation may provide a way of tackling CMD in primary care in low income countries.
Effects of postnatal depression on children's adjustment to school
Authors: Sinclair Dana , Murray Lynne 
Published: October 2008

BackgroundLittle is known of the behavioural adjustment of children of postnatally depressed mothers. Previous studies have relied on maternal reports, and have produced inconsistent findings.MethodIn a prospective, longitudinal study of the five-year-old children of a community sample of postnatally depressed and well women, evidence was collected concerning the children's adjustment in the context of school, teachers being asked to complete questionnaires after the children had finished their first term.ResultsFamily social class and the child's gender had the most pervasive influences on adjustment. However, both postnatal and recent maternal depression were associated with significantly raised levels of child disturbance, particularly among boys and those from lower social class families.ConclusionsThe findings indicate a persistent effect of postnatal depression on child adjustment. They highlight the need for resources devoted to supporting mothers of young children and particularly routine screening and treatment for postnatal mood disorder.
Psychological sequelae of torture and organised violence suffered by refugees from Iraq
Authors: Gorst-Unsworth Caroline , Goldenberg Eva 
Published: October 2008

BackgroundRefugees who have suffered traumatic events present complex therapeutic challenges to health professionals. There is little research into post-exile factors that may be amenable to change, and therefore reduce morbidity. We examined the importance of social factors in exile and of trauma factors in producing the different elements of psychological sequelae of severe trauma.MethodEighty-four male Iraqi refugees were interviewed. Adverse events and level of social support were measured. Various measures of psychological morbidity were applied, all of which have been used in previous trauma research.ResultsSocial factors in exile, particularly the level of ‘affective’ social support, proved important in determining the severity of both post-traumatic stress disorder and depressive reactions, particularly when combined with a severe level of trauma/torture. Poor social support is a stronger predictor of depressive morbidity than trauma factors.ConclusionsSome of the most important factors in producing psychological morbidity in refugees may be alleviated by planned, integrated rehabilitation programmes and attention to social support and family reunion.
Brain abnormality in schizophrenia
Authors: Lawrie Stephen M. , Abukmeil Suheib S. 
Published: October 2008

BackgroundNumerousin vivobrain imaging studies suggest that cerebral Structure is abnormal in schizophrenia, but implicate different regions to varying extents.MethodWe identified published MRI studies in schizophrenia with searches of the computerised literature and key Journals. Reports giving the volumes of cortical structures in people with schizophrenia and controls were included. The percentage differences in volumes were calculated and the median taken as a summary measure for each brain region.ResultsForty relevant studies were identified. The median percentage volume differences revealed overall reductions in the whole brain (3%), temporal lobe (6% left. 9.5% right), and the amygdala/hippocampal complex (6.5%, 5.5%); and increases in the lateral ventricles (44%, 36%), that were greatest in the body and occipital horns. Segmentation studies suggest that grey matter is reduced but that white matter volumes may actually be increased. In men, substantial reductions were also evident in the amygdala and hippocampus, as well as the largest reductions of all in the parahippocampus (14%, 9%). Few studies gave figures for women alone.ConclusionsSeveral brain structures in schizophrenia are affected to a greater extent than expected from overall reductions in brain volume. Further studies are required in affected women, and to try to identify clinical and aetiological associations of these findings.
Linguistic performance in children who develop schizophrenia in adult life
Authors: Done D. John , Leinonen Eeva , Crow Timothy J. , Sacker Amanda 
Published: October 2008

BackgroundLess syntactically complex speech in patients with schizophrenia has been thought to represent a premorbid dysfunction, of possible prognostic value and indicative of a neurodevelopmental origin for schizophrenia.MethodNarratives written at age 11 by children who then developed psychiatric disorders in adult life (using PSE CATEGO diagnoses), especially schizophrenia, were compared with matched controls on syntactic complexity syntactic maturity, grammatical deviance and spelling ability.ResultsChildren who later developed either schizophrenia, affective psychosis or a neurotic type of disorder in adulthood did not differ from normal controls on any of the measures of syntactic production, grammatical errors or spelling.Conclusionsit is probable that previous reports of reduced syntactic complexity in schizophrenic speech are a consequence of being in a psychotic state and do not represent a premorbid deficit.
Disability pensions in severely disturbed in-patient adolescents
Authors: Pelkonen M. , Marttunen M. , Pulkkinen E. , Laippala P. , Lönnqvist J. , Aro H. 
Published: October 2008

BackgroundKnowledge of working capacity from adolescence until adulthood among severely disturbed in-patients is scarce.MethodIn a follow-up study of 61 adolescent in-patients, we studied associations between being on a disability pension 20 years after hospitalisation, and the patients' psychopathology and treatment-related factors during the hospitalisation and seven-year follow-up.ResultsOf the former in-patients. 27% had not been on a disability pension, 20% had short-term pension periods, and 53% were pensioned. Subjects whose overall psychosocial functioning had improved and who had not utilised in-patient services until the seven-year follow-up, had a better prognosis in terms of working capacity Half of the subjects who had not been on pension during the follow-up had received a diagnosis of conduct disorder at discharge, and half of those pensioned had a psychotic disorder.ConclusionsThe patients' level of psychosocial functioning and capability to work in young adulthood were associated with long-term prognosis in terms of working capacity Adolescence seems to be the critical time for intensive psychiatric care combined with vocational rehabilitation programmes.
Chromosome 22qll deletions
Authors: Murphy K. C. , Jones R. G. , Griffiths E. , Thompson P. W. , Owen M. J. 
Published: October 2008

BackgroundVelo-cardio-facial syndrome (VCFS), a syndrome of multiple congenital abnormalities including characteristic dysmorphology, congenital heart defects and learning disability is associated with small interstitial deletions of chromosome 22qll. We tested the hypothesis that VCFS may be significantly under-diagnosed by screening a learning-disabled population for chromosome 22qll deletions.MethodTwo hundred and sixty-five people with learning disability residing in two learning disability hospitals in South Wales were reviewed. They were selected for inclusion in the study if they fulfilled any of the following criteria: psychotic disorder (schizophrenia or affective disorder), family history of psychotic disorder, cleft palate and/or lip, congenital heart disease, broadly defined facial dysmorphism or a history of hypocalcaemia. Fluorescencein situhybridisation studies were performed on 74 selected individuals.ResultsCytogenetic analysis revealed that two people demonstrated a previously undetected chromosome 22qll deletion. A third person demonstrated a previously undetected cytogenetically visible deletion on chromosome 15.ConclusionsVCFS appears to be aetiologically significant in a proportion of individuals with idiopathic learning disability especially in those where psychosis is associated with mild learning disability. We suggest that clinicians should consider a chromosome 22qll deletion in people who meet selection criteria.
Polydactyly and psychosis
Authors: Cardno Alastair G. , Murphy Kieran C. , Jones Lisa A. , Gray Jonathon , McGuffin Peter , Owen Michael J. , Cobb Andrew M. 
Published: October 2008

BackgroundAbnormalities presumed to occur during foetal life have been associated with schizophrenia. Polydactyly is a developmental abnormality but no previous association has been reported between Polydactyly and functional psychotic illness.MethodIndividuals with both Polydactyly and a functional psychosis were ascertained during a study of familial schizophrenia.ResultsFive such individuals were ascertained in the course of assessing 234 individuals with familial psychosis, giving a rate of Polydactyly in the sample of around 10 times the general population rate.ConclusionsThis study provides preliminary evidence that Polydactyly is over-represented in individuals with familial schizophrenia and related psychotic illnesses.
Substance misuse and risk of aggression and offending among the severely mentally ill
Authors: Scott Helen , Johnson Sonia , Menezes Paulo , Bindman Jonathan , Thornicroft Graham , Marshall Jane , Bebbington Paul , Kuipers Elizabeth 
Published: October 2008

BackgroundThe aim of this study was to investigate whether ‘dual diagnosis' (substance misuse and severe mental illness) is associated with aggression and offending.MethodTwenty-seven people meeting the criteria for both psychotic illness and a substance use disorder and 65 people with psychosis only were interviewed. Case notes were also examined and key workers asked to rate substance misuse and aggression.ResultsThe severity of aggression and offending among this community treatment sample was low. Individuals with a dual diagnosis were significantly more likely than those with psychosis only to report any history of committing an offence (P=0.001), or recent hostile behaviour (P=0.001). Keyworkers were more likely to report recent aggression among the dually diagnosed (P=0.01). Significant differences persisted when we used logistic regression to control for potentially confounding demographic and clinical variables.ConclusionsDual diagnosis may be an important factor in aggression and offending among severely mentally ill individuals in inner-city areas. Accurate risk assessment requires examination of substance use.
Neuroendocrine, appetitive and behavioural responses to d-fenfluramine in women recovered from anorexia nervosa
Authors: Ward Anne , Brown Nigel , Lightman Stafford , Campbell Iain C. , Treasure Janet 
Published: October 2008

BackgroundIncreased central serotonin (5-HT) function has been hypothesised to be a vulnerability trait in anorexia nervosa.MethodsEighteen women with a history of DSM–III–R anorexia nervosa and 18 female controls were examined. The subjects had recovered weight and menstrual function. A placebo-controlled d-fenfluramine test was used. Subjects ingested d-fenfluramine or placebo and after three hours were offered a ‘free’ meal. The amounts eaten were recorded and plasma Cortisol and prolactin levels were measured. Questionnaires related to eating attitudes and behaviour, to personality, and to mood were administered.ResultsUnlike the control subjects, those recovered from anorexia nervosa did not show the expected appetite-suppressing responses to d-fenfluramine; their eating attitudes and behaviour were more restrained, ‘negative’ perfectionism was more pronounced, and post-meal plasma Cortisol levels did not rise as expected.ConclusionsOur results do not suggest that increased central 5-HT function is a trait marker in anorexia nervosa, but dysregulation in part of the central 5-HT system may be a vulnerability factor. The flattened post-meal response to Cortisol in the subjects who had recovered from anorexia nervosa suggests that their hypothalamic–pituitary–adrenal axis may be altered and deserves further investigation.
Self-injurious behaviour as part of genetic syndromes
Authors: Deb Shoumitro 
Published: October 2008

BackgroundThe purpose of this paper is to review the association between genetic syndromes and self-injurious behaviour.MethodThe information available from the literature on the subject of self-injurious behaviours and genetic syndromes was collated and presented with a critical appraisal.ResultsSelf-injurious behaviours are associated with some genetic syndromes. However, the causal relationship between the genetic syndromes and the self-injurious behaviour remains far from clear.ConclusionsAlthough self-injurious behaviour has been shown to be the part of a broader phenotype in many genetic disorders, the specificity and sensitivity of these behaviours in this context remain unclear.