bluuebunny/crossref_metadata_2025_split huggingface dataset:
Hypnagogic and Hypnopompic Hallucinations: Pathological Phenomena?
Authors: Ohayon Maurice M. , Priest Robert G. , Caulet Malijaï , Guilleminault Christian 
Published: October 2008

BackgroundHypnagogic and hypnopompic hallucinations are common in narcolepsy. However, the prevalence of these phenomena in the general population is uncertain.MethodA representative community sample of 4972 people in the UK, aged 15–100, was interviewed by telephone (79.6% of those contacted). Interviews were performed by lay interviewers using a computerised system that guided the interviewer through the interview process.ResultsThirty-seven per cent of the sample reported experiencing hypnagogic hallucinations and 12.5% reported hypnopompic hallucinations. Both types of hallucinations were significantly more common among subjects with symptoms of insomnia, excessive daytime sleepiness or mental disorders. According to this study, the prevalence of narcolepsy in the UK is 0.04%.ConclusionsHypnagogic and hypnopompic hallucinations were much more common than expected, with a prevalence that far exceeds that which can be explained by the association with narcolepsy. Hypnopompic hallucinations may be a better indicator of narcolepsy than hypnagogic hallucinations in subjects reporting excessive daytime sleepiness.
Suicides in Hong Kong, Taiwan and Beijing
Authors: Yip Paul S. F. 
Published: October 2008

BackgroundDifferences and similarities were examined of suicide in Hong Kong, Beijing and Taiwan, the populations of which are all ethnically Chinese and share some characteristics of culture but which have very different social and political environments.MethodsThe official death statistics were used for the periods 1981–94 (Hong Kong and Taiwan) and 1987–94 (Beijing).ResultsHong Kong has experienced a slight increase in suicide rate, whereas a significant decline was observed in Taiwan and Beijing. The suicide rates in all three increased with age, the rate among the elderly being four to five times the average. A relatively low male:female ratio (1.0–1.9) was also observed. Jumping and hanging were the most common methods of suicide in Hong Kong and Taiwan, respectively. Hong Kong had the most years of potential life lost.ConclusionsDespite the remarkable economic growth in all three places during the study period, the differences in suicide trends suggest that the social and political environments may be more important than the economic environment in suicide. In Hong Kong the suicide rate is likely to remain high or even to increase.
Limbic Dysfunction in Schizophrenia and Mania
Authors: Al-Mousawi Adil H. , Evans Noel , Ebmeier Klaus P. , Roeda Dirk , Chaloner Fiona , Ashcroft George W. 
Published: October 2008

BackgroundDiagnostic classes (derived from catego) can be correlated with regional brain metabolism in patients with major psychiatric disorders.MethodSeventeen patients with schizophrenia, 15 with mania, 10 with depression and 10 healthy volunteers were examined with positron emission tomography (PET) and 18F-labelled fluorodeoxyglucose, as a marker for glucose metabolism. The number of possible comparisons of regions of interest was reduced by principal-components analysis, and differences in factor scores were determined between diagnostic groups.ResultsFour independent factors, representing distributed brain systems, emerged: an anterior–posterior (1), a left–right temporal (2), a temporofrontal (3), and a mediofrontal (4) system, of which (1), (2) and (3) were abnormal in schizophrenia, (1) and (2) in mania, and (1) in depression.ConclusionsAbnormal patterns of metabolism could be detected, in decreasing order, in schizophrenia, mania and depression. Some of these abnormalities are likely to be due to medication, but others will be associated with structural or functional abnormalities of the frontolimbic system in the diagnostic groups.
First-Contact Incidence Rates of Schizophrenia in Trinidad and One-Year Follow-up
Authors: Bhugra Dinesh , Hilwig Marcel , Hossein Bill , Marceau Helene , Neehall John , Leff Julian , Mallett Rosemarie , Der Geoff 
Published: October 2008

BackgroundIncidence rates of schizophrenia among UK African–Caribbeans have been reported as high. Various explanations including selective migration and genetic vulnerability have been proposed.MethodIn one calendar year, all new cases of psychosis presenting to various psychiatric services in two clearly defined geographical catchment areas in Trinidad – one in the rural south and the other an urban area – were studied. Standardised diagnostic instruments were applied and information collected using WHO screening and measurement instruments.ResultsA total of 56 cases were collected, giving an incidence rate of 2.2/1000 of broad schizophrenia with a rate of 1.6 for S+ schizophrenia.ConclusionThese rates are similar to those from the WHO study in Honolulu and Aarhus, and much lower than the rates for African–Caribbeans in London. The cases were followed up for one year and the poor outcome rate for schizophrenia was 19%. The findings are discussed in a cross-cultural context and suggestions for future research made.
Cognitive Therapy and Recovery from Acute Psychosis: a Controlled Trial
Authors: Drury Val , Birchwood Max , Cochrane Ray , MacMillan Fiona 
Published: October 2008

BackgroundThe application of cognitive therapy (CT) to psychosis is currently being developed in the UK. This paper reports a trial of CT in acute psychosis with the objective of hastening the resolution of positive symptoms and reducing residual symptoms.MethodOf 117 patients with acute non-affective psychosis, 69 satisfied inclusion criteria and 40 proceeded to stratified randomisation. The experimental intervention involving individual and group CT was compared with a group receiving matched hours of therapist input providing structured activities and informal support; routine pharmacotherapy was provided by clinicians blind to group allocation. Patients were monitored weekly using self-report and mental state assessments during admission and over the subsequent nine months.ResultsBoth groups showed a decline in positive symptoms but this was more marked in the CT group (P < 0.001). At 9 months 5% of the CT group, v. 56% of the control group, showed moderate or severe residual symptoms.ConclusionCT appears to be a potent adjunct to pharmacotherapy and standard care for acute psychosis. Issues concerning internal and external validity of the study and opportunities for further research are discussed.
Seasonal Variation in Bipolar Disorder
Authors: Partonen Timo , Lönnqvist Jouko 
Published: October 2008

BackgroundIn patients with bipolar disorder, admissions for manic and depressive episodes frequently display a seasonal pattern. We examined this variation and compared the patterns with the seasonal admission rates for schizophrenia.MethodPatients with bipolar disorder or schizophrenia were identified from the Finnish Hospital Discharge Register of in-patient admissions to all psychiatric hospitals during the years 1969–91. They were included in the analysis if the first admission had occurred before 30 years of age. A total of 295 bipolar patients were found and a sample of 295 schizophrenic patients was randomly selected for comparison.ResultsThere was no seasonal variation among all hospital admissions for bipolar disorder or schizophrenia However, the first admission for a depressive compared with a manic episode of bipolar disorder occurred significantly more often in the autumn (33% v. 21% respectively). The peak difference occurred during the week after the autumnal equinox in September.ConclusionOur findings suggest that there is no seasonal variation in bipolar disorder, although in some patients the clinical course might be influenced by the autumn, as far as the likelihood of a first admission for depression is concerned.
Maternal Psychopathology and Prediction of Outcome Based on Mother-Infant Interaction Ratings (BMIS)
Authors: Hipwell A. E. , Kumar R. 
Published: October 2008

BackgroundVery little is known about the adequacy and safety of maternal parenting behaviour in the context of severe postpartum psychiatric illness, about specific difficulties in relation to different types of mental illness, or about the potential for improvement over the course of an episode of illness. The Bethlem Mother–Infant Interaction Scale (BMIS) was thus developed as an aid to assessment on a specialist psychiatric Mother and Baby Unit.MethodNurses' ratings of the quality of mother–infant interaction using the BMIS were collected throughout the consecutive admissions of 78 in-patient pairs. The ratings from three points during the admissions were examined according to the mothers' RDC diagnoses and also according to the eventual outcome of the admission.ResultsThe nature of the mother's illness was associated with the quality of her infant care-taking using the BMIS ratings. The nurses' ratings during the second week of admission together with maternal psychiatric diagnosis, were strongly predictive of the eventual outcome of the admission. The majority of women who were separated from their infants on discharge or who required formal supervision belonged to the schizophrenic group.ConclusionsThe results suggest that the BMIS can be used in this in-patient setting to aid clinical decisions about the safety of parenting by individual mothers with severe mental illness in the postpartum period.
Validation of the Arabic versions of the Thirty- and Twelve-Item General Health Questionnaires in Primary Care Patients
Authors: El-Rufaie Omer E. F. , Daradkeh Tewfik K. 
Published: October 2008

BackgroundThe aim of this study was to investigate the validity of the Arabic versions of the GHQ–30 and GHQ–12 in a sample of primary health care (PHC) patients in Al Ain, United Arab Emirates.MethodA randomly selected sample (n=157) of patients attending a PHC centre in Al Ain was screened using the Arabic version of the GHQ–30, the first 12 items of which constitute the GHQ–12. Then a standardised clinical interview using the Clinical Interview Schedule (CIS) was conducted with all screened patients. The receiver operating characteristic analyses of the Arabic versions of both GHQ–30 and GHQ–12 were compared and their correlation coefficients with the weighted total score of the CIS and the overall severity rate were estimated. Discriminant functional analysis was also performed to assess the discriminatory powers of both the GHQ–30 and GHQ–12.ResultsUsing the simple Likert scoring method, the best cut-off point of the GHQ–30, that balances between sensitivity and specificity, was 31/32 with a sensitivity of 0.83 and specificity of 0.83, and that of the GHQ–12 was 12/13 with a sensitivity of 0.83 and specificity 0.80. The total discriminatory powers of the GHQ–30 and GHQ–12 were approximately 93 and 86%, respectively. Both versions of the GHQ were found to have a significant concurrent validity.ConclusionThe Arabic versions of both GHQ–30 and GHQ–12 are valid psychiatric screening instruments, with almost similar performance, for Arabic-speaking PHC patients.
The Demand for Eating Disorder Care
Authors: Turnbull Sue , Ward Anne , Treasure Janet , Jick Hershel , Derby Laura 
Published: October 2008

BackgroundAn epidemiological study of anorexia nervosa and bulimia nervosa in primary care was performed using the General Practice Research Database (GPRD).MethodThe GPRD was screened between 1988 and 1994 for newly diagnosed cases of anorexia nervosa and bulimia nervosa. The validity of the computer diagnosis was established by obtaining clinical details from a random sample of the general practitioners (GPs).ResultsIncidence rates for detection of cases by GPs in 1993 was 4.2 per 100 000 population for anorexia nervosa and 12.2 per 100 000 for bulimia nervosa The relative risks of females to males was 40:1 for anorexia nervosa and 47:1 for bulimia nervosa A threefold increase in the recording of bulimia nervosa was found from 1988 to 1993. Eighty per cent of anorexia nervosa cases and 60% of bulimia nervosa cases were referred to secondary care.ConclusionThere is a continuing expansion of service need for bulimia nervosa The majority of cases of eating disorders are referred to secondary services. There is scope for more effective management of bulimia nervosa in primary care.
Cardiovascular and Respiratory Risk Factors and Symptoms among General Practice Patients with Long-Term Mental Illness
Authors: Kendrick Tony 
Published: October 2008

BackgroundIn the past psychiatric in-patients suffered increased cardiovascular and respiratory mortality. The present study investigated whether increased risks persist among patients in the community and are being addressed in general practice.MethodA survey of 101 long-term mentally ill adults in 16 general practices in the South Thames (West) Region.ResultsTwenty-six patients were found to be obese (body mass index > 30 kg/m2), 53 were current smokers and 11 were hypertensive (mean systolic blood pressure > 160 mmHg or mean diastolic blood pressure > 100 mmHg, or both). Twenty-one reported daily cough and sputum, 24 shortness of breath, 11 wheezing and seven chest pain on exertion. These rates were significantly higher than population rates in a contemporary national survey. Nearly all the risk factors were recorded in the general practice records but few attempts to intervene were apparent.ConclusionsLong-term mentally ill patients remain at increased risk of cardiovascular and respiratory problems in the community. Primary care teams should make special efforts to tackle risk factors among this group.
Sick-Leave due to Psychiatric Disorder: Higher Incidence among Women and Longer Duration for Men
Authors: Hensing Gunnel , Alexanderson Kristina , Allebeck Peter , Bjurulf Per 
Published: October 2008

BackgroundWomen take sick-leave more often than men, both in general and because of psychiatric disorders. The aim of the present study was to introduce the new dimension of sick-leave duration in the analysis of gender differences in minor psychiatric disorders.MethodA population-based register was used which included all sick-leave spells exceeding seven consecutive days, 1985–1987, in a Swedish county.ResultsSick-leave duration was longer for men. The greatest gender differences were found in the youngest and oldest age-groups. Women had higher incidence also in the longest spells. An increase in duration over the three years was found among women, leading to decreased gender differences.ConclusionsContrary to other studies on minor psychiatric disorders, small gender differences were found. It is suggested that sick-leave duration can be used as a quantitative measure of health-related working capacity.
Effects of Electroconvulsive Therapy on Peripheral Adrenoceptors, Plasma, Noradrenaline, MHPG and Cortisol in Depressed Patients
Authors: Werstiuk Eva S. , Coote Margaret , Griffith Lauren , Shannon Harry , Steiner Meir 
Published: October 2008

BackgroundThe mechanism of the antidepressant action of electroconvulsive therapy (ECT) remains unknown. Based on previous work with antidepressant drugs and their effects on the noradrenergic system, we undertook this study to further determine the effects of ECT on selected indices of peripheral adrenoceptor function in depressed patients.MethodsBinding parameters (Bmaxand Kd) of plateletα2- and leukocyteβ2-adrenoceptors, plasma noradrenaline (NA), 3-methoxy-4-hydroxy-phenylglycol (MHPG) and cortisol levels were determined in 18 patients, prior to treatment and 14 days after the last of a series of ECTs, and compared with samples obtained from 18 matched control subjects.ResultsPlateletα2-adrenoceptor sites were significantly elevated in untreated patients compared with controls (P< 0.03), but leukocyteβ2-adrenoceptor numbers did not differ. Treatment with ECT led to a significant reduction in plateletα2-adrenoceptor numbers, whereas leukocyteβ2-adrenoceptor densities increased. Pre-ECT plasma NA, MHPG, and cortisol levels were elevated in patients, compared with controls, and decreased following ECT, but these differences were not statistically significant. Post-ECT plasma NA andβ2-adrenoceptor numbers were significantly, negatively correlated (P< 0.05).ConclusionsThese results suggest that plateletα2-adrenoceptors are supersensitive in depressed patients and treatment with ECT results in down-regulation of these receptors, which may be interpreted as a primary therapeutic, ‘normalising’ effect. The post-ECT changes in leukocyteβ2-adrenoceptors are probably only secondary to the lower circulating plasma NA levels.
Nithsdale, Nunhead and Norwood: Similarities and differences in prevalence of schizophrenia and utilisation of service sin rural and urban areas
Authors: McCreadie Robin G. , Leese Morven , Tilak-Singh Deepa , Loftus Linda , MacEwan Tom , Thornicroft Graham 
Published: October 2008

BackgroundThe prevalence of schizophrenia is known to be greater in urban than in rural areas. Less studied are differences between the patients themselves and, more specifically, their use of psychiatric services.MethodThe prevalence of schizophrenia was determined in rural Nithsdale in Scotland and urban Nunhead and Norwood in South London. Information about patients' psychiatric history, use of services during the study year and global assessment of functioning were obtained from case records and staff.ResultsThere were no significant differences in prevalence rates between Nithsdale patients, all White (2.78 per 1000 general population), Nunhead (3.46 per 1000) and Norwood (2.24 per 1000) Whites; rates were significantly higher among the non-Whites in Nunhead (7.36 per 1000) and Norwood (5.53 per 1000), who were mainly Black Caribbeans. Nithsdale patients were at a higher level of functioning and made substantially more use of psychiatric services. During the study year, 42% of Nithsdale patients used more than one of three principal community services, namely day, out-patient and community psychiatric nursing care.ConclusionsThe prevalence of schizophrenia is no different in rural Nithsdale and inner-city Nunhead and Norwood, when only White patients are considered. Nithsdale patients were at a higher level of functioning and made more use of available psychiatric services.
Problems in conducting economic evaluations alongside clinical trials
Authors: Gray Alastair , Marshall Max , Lockwood Austin , Morris Joan 
Published: October 2008

BackgroundCase management has become the statutory basis of community care in the UK for people with long-term mental disorders, although a randomised controlled trial found no important improvements over standard care. Here we compare the costs and cost consequences of this intervention with standard care.MethodResource-use data were collected over a six-month baseline period and for 14 months after randomisation on all patients in the trial.ResultsAt 14 months the ratio of control group to treatment group weekly costs was 1.09 (95% CI 0.86–1.38) for total costs; 1.12 (0.76–1.65) for state benefits, and 1.21 (0.61–2.42) for health care costs. Costs were thus lower in the treatment group, but these differences were not significant.ConclusionsRetrospective power calculations indicated that the trial could have detected differences of 30% in total cost, but would have required 700 patients per arm to detect a 20% difference in health care costs. Hence this study, which had adequate power to detect clinically meaningful differences, was found to be far too small to detect large differences in costs. Funding agencies increasingly request that clinical trials include economic alongside clinical end-points: these findings may have important lessons for that policy.
The impact of the Symptoms of dementia on caregivers
Authors: Donaldson Catherine , Tarrier Nicholas , Burns Alistair 
Published: October 2008

BackgroundThe symptoms of dementia are the most obvious stressors to which caregivers are exposed and many studies have investigated the association of such symptoms with the adverse consequences of caring. The present paper represents the only dedicated review of this literature.MethodManual and computer (MEDLINE) literature searches were performed.ResultsSeventeen empirical studies were found.ConclusionsVariability in conceptual and methodological approaches and inconsistencies in the reported findings have prevented firm conclusions from being drawn. However, the literature provided support for a relationship between non-cognitive features in dementia and psychological problems in caregivers, and suggested possible associations between cognitive deficits and some negative care-giver outcomes. New methodological and conceptual approaches are required if decisive evidence is to be forthcoming. This information is a prerequisite for investigations into the causal mechanisms that sustain these relationships, and for rationally designed interventions.
Hyperekplexia: abnormal startle response due to glycine receptor mutations
Authors: Andrew Martin , Owen Michael J. 
Published: October 2008

BackgroundHyperekplexia is a rare but well-delineated clinical syndrome of pathological startle response and neonatal hypertonia. Many cases result from mutations in the α1subunit of the glycine receptor (GLRA 1).MethodThe clinical features, management and recent genetic studies of hyperekplexia are reviewed.ResultsDiagnosis of the disorder should not be difficult, if one is aware of the syndrome. The treatment of first choice is with the benzodiazepine drug clonazepam, which often causes a dramatic although incomplete diminution of startle. Both recessive and dominant mutations in GLRA 1 have been found in affected individuals. The study of mouse mutants with startle phenotypes suggests that the remainder of cases may well be due to mutations in the β subunit of the glycine receptor.ConclusionsHyperekplexia is the first human disease shown to result from mutations within a neurotransmitter gene. The demonstration of both dominant and recessive inheritance resulting from different mutations in the same gene is of considerable interest, as other neuropsychiatric disorders may result from mutations in ligand-gated ion channels. Mutation analysis of GLRA 1 is also likely to be useful as an aid to genetic counselling and in diagnostic evaluation of neonatal hypertonia.
Prenatal and neonatal risk factors for schizophrenia
Authors: Hultman Christina M. , Öhman Arne , Cnattingius Sven , Wieselgren Ing-Marie , Lindström Leif H. 
Published: October 2008

BackgroundThe present study examines the effects of independent, single pre- and perinatal risk factors and rates of obstetric complications upon the subsequent development of schizophrenia.MethodThis study was based on prospectively recorded birth records of 107 cases (82 with schizophrenic disorders and 25 with other psychotic reactions) and 214 controls, individually matched by gender and time and place of birth. Variables univariately associated with significantly elevated risk were entered in a logistic regression model.ResultsA high non-optimality summary score (> or = 7 complications of 34 possible) was a significant risk estimate for the total index group (OR 4.58, 95% CI 1.74–12.03) and the 82 schizophrenic patients (OR 3.67, CI 1.30–10.36). Patients with 2–6 complications also had an increased, although lower, risk (OR 1.67, CI 1.02–2.75). A disproportionate birth weight for body length (OR 3.57, CI 1.77–7.19) and a small head circumference (OR 3.93, CI 1.32–11.71) were the strongest independent risk factors.ConclusionsA contribution of obstetric complications to the risk of schizophrenia was confirmed. Only aberrations in physical size remained as individual independent risk factors.