bluuebunny/crossref_metadata_2025_split huggingface dataset:
Risperidone in the Treatment of Patients with Chronic Schizophrenia: a Multi-National, Multi-Centre, Double-Blind, Parallel-Group Study versus Haloperidol
Authors: Peuskens J. 
Published: October 2008

BackgroundThis study was performed in order to evaluate the short-term efficacy and safety of fixed risperidone doses compared to haloperidol.MethodIn a multi-national, parallel-group, double-blind study, patients with chronic schizophrenia (DSM–III–R) were randomly assigned to risperidone 1, 4, 8, 12 or 16 mg or haloperidol 10 mg daily for 8 weeks. Efficacy was assessed by the Positive and Negative Syndrome Scale for schizophrenia (PANSS) and clinical global impression (CGI), and safety primarily by the Extrapyramidal Symptom Rating Scale (ESRS).ResultsOne thousand three hundred and sixty-two patients were evaluated. The optimum risperidone doses were 4 mg and 8 mg, with response rates of 63.4% (56.8%; 69.7%) and 65.8% (59.2%; 71.9%) respectively. Response rate in haloperidol-treated patients was 58.7% (52.0%; 65.3%); the 95% confidence intervals (CI) of the differences between risperidone 4 mg or 8 mg and haloperidol were (–4.3%; 13.7%) and (–1.9%; 16.0%) respectively. There were no significant differences in CGI scores at endpoint between risperidone 4 mg, 8 mg, 12 mg and 16 mg and haloperidol (3.0, 3.0, 3.2, 3.1 and 3.1 respectively); the 95% CI of the differences between risperidone 4 mg or 8 mg and haloperidol were (–0.4; 0.1) and (–0.3; 0.2) respectively. Mean shifts to the maximum total ESRS scores versus baseline (mean (confidence interval)) were significantly greater in haloperidol-treated patients (5.1 (4.0; 6.2)) than in the risperidone 1, 4, 8 and 12 mg groups (1.1 (0.3; 1.9); 1.8 (0.9; 2.7); 2.7 (1.8; 3.6) and 3.2 (2.3; 4.1) respectively (P< 0.05)).ConclusionRisperidone is an effective antipsychotic for the treatment of chronic schizophrenia; doses of 4 and 8 mg seem to be optimal and have a lower incidence of side-effects than haloperidol.
Increased Intracerebral Cerebrospinal Fluid Spaces Predict Unemployment and Negative Symptoms in Psychotic Illness a Prospective Study
Authors: Van Os Jim , Fahy Thomas A. , Jones Peter , Harvey Ian , Lewis Shôn , Williams Maureen , Toone Brian , Murray Robin 
Published: October 2008

BackgroundIt has been suggested that the dimensions of cerebral ventricles are a risk factor for poor outcome in psychotic illness.MethodA cohort of 140 patients with functional psychoses of recent onset who had undergone CT scanning, were followed up for an average of 46 months and assessed on six dimensions of course and outcome of illness.ResultsLeft and right sylvian fissure volumes and, to a lesser extent, third ventricular volume predicted negative symptoms and unemployment over the course of follow-up, the latter association being mediated by poor cognitive functioning. There was a significant linear trend in risk over the distribution of sylvian fissure volumes in the cohort, and associations were especially evident in schizophrenic patients. No associations were found with global severity of illness, duration of hospital stay, homelessness, or affective symptoms.ConclusionsThese findings support the notion that dimensions of the cerebral ventricles are a continuous risk factor for some measures of outcome in the functional psychoses.
The Omnipotence of Voices II: the Beliefs About Voices Questionnaire (BAVQ)
Authors: Chadwick Paul , Birchwood Max 
Published: October 2008

BackgroundWe describe the development and psychometric investigation of the Beliefs About Voices Questionnaire (BAVQ), a self-report measure of how people understand and respond to their voices. The measure is unique in being driven by and gathering data essential to a cognitive formulation of voices.MethodSixty subjects with chronic hallucinatory voices took part.ResultsPsychometric properties of the scales were established, including test-retest reliability (mean = 0.89), internal reliability (mean Cronbach's α = 0.85), and construct validity using factor analysis and the criterion group method.ConclusionsThe BAVQ was found to be easy to complete and the scale may aid clinical assessment of voices, not least because of the possible value of cognitive therapy as a treatment approach.
Mortality Among Patients with Psychiatric Illness a Ten-Year Case Register Study in an Area with a Community-based System of Care
Authors: Amaddeo Francesco , Bisoffi Giulia , Bonizzato Paola , Micciolo Rocco , Tansella Michele 
Published: October 2008

BackgroundMost studies which showed an excess mortality in psychiatric patients have been conducted on hospitalised samples.MethodThis was a case register study. All South Verona patients with an ICD diagnosis who had psychiatric contacts with specialist services in 1982–1991 were included. Mortality was studied in relation to sex, age, diagnosis, pattern of care and interval from registration. Standardised Mortality Rates (SMRs) and Poisson regression analysis were calculated.ResultsThe overall SMR was 1.63 (95% CI = 1.5–1.8), which is the lowest value reported so far. Mortality was higher among men (SMR = 2.24; 95% CI = 1.9–2.6), among patients who were admitted to hospital (SMR = 2.23; 95% CI = 1.9–2.6), among younger age groups (SMR = 8.82; 95% CI = 4.9–14.6) and in the first year after registration (SMR = 2.32; 95% CI = 1.8–2.9). Higher mortality was found in patients with a diagnosis of alcohol and drug dependence (SMR = 3.87; 95% CI = 3.0–4.9). The SMR for suicide was 17.41. Using a Poisson regression model, diagnosis, pattern of care and interval from registration were all found to be significantly associated with mortality. When all these variables were entered together in the model, each maintained its predictive role.ConclusionsThe overall mortality of psychiatric patients treated in a community-based system of care was higher than expected, but lower than the mortality reported in other psychiatric settings. The highest mortality risk was found in the first year after registration.
The Belmarsh Scheme a Prospective Study of the Transfer of Mentally Disordered Remand Prisoners from Prison to Psychiatric Units
Authors: Banerjee Sube , O'Neill-Byrne Kiki , Exworthy Tim , Parrott Janet 
Published: October 2008

BackgroundContracting in psychiatric services from the NHS into prisons has been advocated to improve the care of the mentally disordered in custody. The Belmarsh Scheme is such a service.MethodA prospective study investigating the characteristics of a six-month cohort of remand prisoners requiring transfer to hospital and evaluating the service's effectiveness.ResultsFifty-three (4.3%; 95% CL 3.2% to 5.6%) of the 1229 new remands required transfer to hospital; all were accepted. The transfer group contained a higher proportion of black men (51%) than all other remands (30%) (difference 21%; 95% CL 8% to 35%, P = 0.002). Transfer times were lower than those reported for a neighbouring prison.ConclusionsThe Belmarsh Scheme secured in-patient psychiatric care rapidly for all those identified as needing it.
The Social Disablement of Men in Hostels for Homeless People
Authors: Hamid Walid Abdul , Wykes Til , Stansfeld Stephen 
Published: October 2008

BackgroundStudies of mental health problems of homeless people have used diagnosis as the sole measure of these problems. In this study, the feasibility and reliability of measuring social disablement in the psychiatric assessment of homeless people was investigated.MethodA random sample of 101 homeless men living in four long-stay hostels was assessed for their social disablement by the Social Behaviour Schedule (SBS). The prevalence of SBS problems in these men and the interobserver reliability were assessed.ResultsThe results show that the SBS is a reliable screening instrument which is relatively easy to use. The most frequent SBS problems were ‘Other problems’, ‘Hostility’ and ‘Depression’. Less than 10% of the hostel sample had disablement items similar to those of patients in long-stay wards.ConclusionsThe SBS is a useful and reliable tool in the psychiatric assessment of men in hostels for the homeless.
An Evaluation of Community-Based Psychiatric Care for People with Treated Long-Term Mental Illness
Authors: Wilkinson Greg , Piccinelli Marco , Falloon Ian , Krekorian Haroutyon , McLees Sheila 
Published: October 2008

BackgroundWe evaluated integrated, multidisciplinary, community-based care for a cohort of people with treated long-term mental illness over two years in a field trial set in a semi-rural setting. The aim was to organise local psychiatric services on an extramural basis with general practitioner teams as the key element.MethodTrained research workers used a structured interview to collect standardised baseline and three-monthly socio-demographic, clinical, social, family adjustment and burden, and treatment measures from patients, informants, and key-workers. Analysis included descriptive statistics and, for longitudinal data, analysis of best-fitted straight lines.ResultsWe studied 34 patients (14 with schizophrenia, 11 with major affective disorders, and 9 with minor (non-major) affective disorders and anxiety disorders) who had a mean of 12 years continuous illness. At baseline, they were mainly characterised by research workers as mildly ill with fair social adaptive functioning, and by lay informants as having moderate target symptom severity and disturbance of social performance. Over two years, there were statistically significant, slight improvements in clinical global impressions ratings by research workers, and in informants ratings of target symptoms and social performance. Most patients continued to receive prescriptions for psychotropic drugs throughout follow-up, and they had a mean of 47 therapeutic contacts, mainly from nurses. Two patients were admitted to psychiatric hospital. There were few differences between patients in different diagnostic groups.ConclusionsIntegrated, multidisciplinary, community-based psychiatric care for people with treated long-term mental illness is feasible in a semi-rural setting: patients receiving pharmacotherapy and regular psychosocial treatments remained relatively stable on clinical and social measures over two years. The unique way in which the service was monitored, by making regular, systematic assessments of patients and carers, serves as an example for other services.
A Pilot Study of Exposure Control of Chronic Auditory Hallucinations in Schizophrenia
Authors: Persaud Rajendra , Marks Isaac 
Published: October 2008

BackgroundMany patients complain less of their auditory hallucinations per se than of lack of control of the experiences. There is reason to believe that a non-distraction (exposure) approach could help patients gain more control over persistent auditory hallucinations and teach them that their experience is a form of thinking and has no external source. This study is a pilot test of that idea.MethodFive DSM–III–R schizophrenic outpatients with medication-resistant auditory hallucinations improved with a mean of 31 hour-long sessions over 3 months of therapist-guided exposure to their hallucinations and situations likely to evoke them.ResultsImprovement was greatest in patients' anxiety and sense of control over their hallucinations, less in social use of leisure and hallucinating time.ConclusionsThese mildly encouraging pilot results warrant a controlled study of exposure for drug-resistant chronic auditory hallucinations and other psychotic experiences which are associated with anxious avoidance.
Neuropsychological Function in Manic-Depressive Psychosis Evidence for Persistent Deficits in Patients with Chronic, Severe Illness
Authors: McKay A. P. , Tarbuck A. F. , Shapleske J. , McKenna P. J. 
Published: October 2008

BackgroundWhile neuropsychological deficits are recognised to occur in manic-depressive psychosis during episodes of depression and to reverse with clinical recovery, it is uncertain whether they can ever be seen outside episodes of illness.MethodForty-five patients meeting DSM–III–R criteria for major depression or bipolar disorder were screened using tests of memory, executive function and overall intellectual function. All testing was carried out during remission of affective symptoms.ResultsNone of 24 young patients and 11 elderly patients scored in the impaired range on any of the tests. However, five of ten patients with chronic, severe affective disorder were impaired on one or more of the measures. On more detailed neuropsychological investigation, these five patients were found to show a variable pattern of impairment, ranging from memory and executive deficits in relative isolation, to widespread poor performance.ConclusionsEnduring neuropsychological deficits may be a feature of chronic, severe manic-depressive illness.
A Reanalysis of Data from the Epidemiologic Catchment Area Study
Authors: Hornig Christopher D. , McNally Richard J. 
Published: October 2008

BackgroundAnalysing data from the Epidemiologic Catchment Area (ECA) study, Weissman and colleagues reported that panic disorder was strongly associated with suicide attempt. However, they did not control optimally for comorbid disorders known to increase suicide risk.MethodReanalysing the ECA data, we controlled for comorbid disorders in the aggregate rather than one at a time when we estimated the association between panic disorder and suicide attempt.ResultsPanic disorder was not associated with an increased risk of suicide attempt.ConclusionsComorbid conditions strongly influence whether people with panic disorder are at especial risk of suicide attempt.
A Scale for the Assessment of Hedonic Tone the Snaith–Hamilton Pleasure Scale
Authors: Snaith R. P. , Hamilton M. , Morley S. , Humayan A. , Hargreaves D. , Trigwell P. 
Published: October 2008

BackgroundHedonic tone and its absence, anhedonia, are important in psychopathological research, but instruments for their assessment are lengthy and probably culturally biased.MethodA new scale was constructed from the responses of a large sample of the general population to a request to list six situations which afforded pleasure. The most frequent items were reviewed and those likely to be affected by cultural setting, age, or sex were removed. A pilot study led to an abbreviated scale of 14 items, covering four domains of pleasure response. This questionnaire was subjected to psychometric evaluation in new samples from the general population and psychiatric patients.ResultsThe scale was found to have a score range that would distinguish a ‘normal’ from an ‘abnormal’ response. Validity and reliability were found to be satisfactory.ConclusionsThe new scale, the Snaith-Hamilton Pleasure Scale (SHAPS), is an instrument which may be recommended for psychopathological research.
Two Faces of Emil Kraepelin
Authors: Shepherd Michael 
Published: October 2008

Eponymous lecturers are expected to make some reference to the person in whose name the lecture is being delivered. In this case my task has been facilitated by the fact that the first Mapother lecture was devoted to Edward Mapother himself. It was given by his successor, Sir Aubrey Lewis, who, as was his wont, furnished a comprehensive account of his subject, demonstrating how this remarkable man laid the foundations of the institution to which he devoted his professional life. Lewis's lecture, entitled “Edward Mapother and the Making of the Maudsley Hospital” (Lewis, 1969), provides a link with this one via the mention of the visit paid by Frederick Mott in 1909 to Emil Kraepelin's Forschungsanstalt in Munich, where he was so impressed by what he saw that he resolved to use Henry Maudsley's bequest to found a corresponding institution in this country. Edward Mapother was to assume a major responsibility for this large enterprise which he justified as follows:
“The only hope for the sort of dispassionate long-term research which psychiatry needs, is the creation of teams of career investigators … most of whom should not be primarily psychiatrists at all, but real experts in various branches of science, who have brought its technique to the service of psychiatry and then received enough training in this to enable them to see its problems … Then we should get progress, not pot-boiling.”
The Incidence of First Contact Schizophrenia in Jamaica
Authors: Hickling Frederick W. , Rodgers-Johnson Pamela 
Published: October 2008

BackgroundAfro-Caribbean immigrants are reported to have a high rate of schizophrenia compared with other population groups.MethodIn a prospective first contact study of schizophrenia in Jamaica in 1992, 335 patients were examined using the Present State Examination.Results285 patients were evaluated as having a PSE ‘restrictive’ S + diagnosis of schizophrenia, and 32 as having a ‘broad’ S?, P, or O diagnosis of schizophrenia. With a population of 2.46 million, this represents a first-contact incidence rate for ‘restrictive’ schizophrenia of 1.16 per 10 000 population, and an age-corrected (15–54) incidence rate of 2.09 per 10 000.ConclusionIncidence rates for schizophrenia in Jamaica are lower than those reported in Afro-Caribbean immigrants in the UK and Holland, and within the reported range for other population groups worldwide.
Magnetic Resonance Imaging and Single Photon Emission Tomography in Treatment-Responsive and Treatment-Resistant Schizophrenia
Authors: Lawrie Stephen M. , Ingle Gordon T. , Santosh Celestine G. , Rogers Andrew C. , Rimmington J. Ewen , Naidu Kaliprasad P. , Best Jonathan J. K. , O'Carroll Ronan E. , Goodwin Guy M. , Ebmeier Klaus P. , Johnstone Eve C. 
Published: October 2008

BackgroundPatients with schizophrenia differ from controls in several measures of brain structure and function, but it is uncertain how these relate to clinical features of the illness. We dichotomised patient groups by treatment response to test the hypothesis that treatment-resistant patients exhibit more marked biological abnormalities than treatment-responsive parients.MethodTwenty treatment-responsive and 20 treatment-resistant patients with schizophrenia, matched for sex, age, and illness duration, were compared by magnetic resonance imaging, single photon emission tomography, and detailed neuropsychological assessment.ResultsBrain-imaging variables were not statistically related to treatment response, although poorly responsive patients had lower volumes of most brain structures. Several highly significant differences emerged between patient groups on neuropsychological testing. Episodic memory functioning distinguished patient groups even after we controlled for global cognitive impairment.ConclusionsCerebral structure and blood flow have a limited effect on treatment response in schizophrenia, but long-term episodic memory impairment is associated with, and may predict, poor prognosis.
Relationship between Movement Planning and Psychopathology Profiles in Schizophrenia
Authors: Malla Ashok K. , Norman Ross M. G. , Aguilar Omar , Carnahan Heather , Cortese Leonard 
Published: October 2008

BackgroundThere has been evidence that psychopathology in schizophrenia consists of three separable syndromes: reality distortion, disorganisation, and psychomotor poverty. The objective of this study was to explore the relationship between planning and execution of movement and each of the syndromes in schizophrenia.MethodTwenty-one right handed DSM–III–R schizophrenic patients performed a total of 80 trials of a motor movement task, varying distance of movement × size of the target × hand. Times taken to plan the movement (RT) and to carry it out (MT) were examined for their relationship with contemporaneous as well as lifetime profiles of the three syndromes in schizophrenia.ResultsSignificant correlations are reported between RT and current as well as lifetime measures of disorganisation syndrome. Somewhat weaker correlations are reported between RT and psychomotor poverty, but only for the right-handed tasks. Partial correlations suggest that the influence of neuroleptic medication explains all but one of the correlations between psychomotor poverty and RT, but does not account for the relationship between disorganisation and RT. No other relationship emerged between any of the movement and symptom measures.ConclusionsThese findings indicate that dysfunction in movement planning is related primarily to concurrent disorganisation, as well as to the prominence of disorganisation over the patient's history.
Delineation of Acute and Transient Psychotic Disorders in a Developing Country Setting
Authors: Susser Ezra , Varma Vijoy K. , Malhotra Savita , Conover Sarah , Amador Xavier F. 
Published: October 2008

BackgroundWe examined whether acute transient psychoses can be distinguished from schizophrenia and the affective disorders.MethodWe studied 46 cases of nonaffective acute psychosis in the Chandigarh Acute Psychosis Study. With respect to separation from schizophrenia, we examined the distribution of duration of the episode. With respect to separation from affective disorders, we assessed the frequency of affective symptoms.ResultsDuration was bimodal, suggesting the presence of two distinct conditions of short and long duration. Affective symptoms were minimal, suggesting that these were not atypical affective syndromes.ConclusionsAcute transient psychoses conform neither with schizophrenia of brief duration nor with atypical affective psychosis, and thus require separate classification as proposed in the ICD–10.
The Psychological Effects of Disaster at Sea
Authors: Dooley E. , Gunn J. 
Published: October 2008

BackgroundIn March 1987, the P&O car ferry Herald of Free Enterprise capsized killing 193 passengers. Seventy-five survivors and relatives were referred by their solicitors to the authors for assessment of psychological injury.MethodInformation was gathered retrospectively and systematically from clinical notes and legal reports.ResultsThe commonest symptoms suffered were sleep disturbance, loss of concentration and increased anger. The commonest diagnoses were post-traumatic stress disorder, other anxiety states and depression. Depressive symptoms were commoner in those who had been bereaved, anxiety symptoms were commoner in those who had not. Reluctance to discuss symptoms and to attend a psychiatric clinic was a common feature.ConclusionsAs expected, bereavement led to grief and depressive symptoms, whilst passengers who were not bereaved were more likely to suffer anxiety symptoms. Contrary to expectations, the degree of immersion during the accident did not influence the type or degree of symptoms. Those with worse symptoms were more likely to attend the clinic. Women showed more affective symptoms and men more substance abuse.
In Vivo Magnetic Resonance Spectroscopy: Applications in Psychiatry
Authors: Maier Michael 
Published: October 2008

BackgroundNuclear magnetic resonance is a non-destructive and non-invasive technology that is highly suited for research in psychiatry. It is establishing itself as a versatile means of studying brain morphology, chemistry and function and is finding a place in the diagnosis of disease, monitoring of treatment and the study of basic brain processes.MethodA literature review was undertaken.ResultsMagnetic resonance spectroscopy has been shown to distinguish between psychiatric disorders, and has provided evidence of their pathophysiological mechanisms.ConclusionsSpectroscopy in particular opens a window, for the first time, on the study of in vivo brain chemistry.