bluuebunny/crossref_metadata_2025_split huggingface dataset:
Neuropsychological correlates of syndromes in schizophrenia
Authors: Norman Ross M. G. , Malla A. K. , Morrison-Stewart S. L. , Helmes E. , Williamson P. C. , Thomas J. , Cortese L. 
Published: October 2008

BackgroundOn the basis of Liddle's three-syndrome model of schizophrenia, it was predicted that: (1) symptoms of psychomotor poverty would be particularly correlated with impaired performance on neuropsychological tests likely to reflect functioning of the dorsolateral prefrontal cortex; (2) disorganisation would be particularly correlated with impaired performance on tests sensitive to medio-basal prefrontal functioning; and (3) reality distortion would be particularly correlated with measures sensitive to temporal lobe functioning.MethodThe above hypotheses were tested on 87 subjects with a confirmed diagnosis of schizophrenia. Patients' symptoms were scored for each of the three syndromes. Patients completed six neuropsychological tests designed to measure impairment in specific areas of the brain.ResultsThere was no support for the first two hypotheses. There was, however, evidence of a specific relationship between reality distortion and neuropsychological performance usually considered to be related to left temporal lobe functioning.ConclusionsAlthough not directly supporting the first two hypotheses; the results are, in general, consistent with there being different cortical-subcortical circuits associated with each of psychomotor poverty and disorganisation. Temporal lobe functioning appears to have particular significance for the reality distortion syndrome.
Phenomenological differences appearing with repetitive behaviours in obsessive-compulsive disorder and Gilles de la Tourette's syndrome
Authors: Miguel Euripedes C. , Baer Lee , Coffey Barbara J. , Rauch Scott L. , Savage Cary R. , O'Sullivan Richard L. , Phillips Katharine , Moretti Cara , Leckman James F. , Jenike Michael A. 
Published: October 2008

BackgroundObsessive–compulsive disorder (OCD) is heterogeneous, with some forms related to Gilles de la Tourette's syndrome (GTS). This is a phenomenological study designed to investigate the nature of these possible OCD subtypes and the relationship between OCD and GTS.MethodWe evaluated 20 adult outpatients with OCD, 21 with GTS, and 20 with OCD plus GTS using a semi-structured interview designed to assess cognitive, sensory and autonomic phenomena preceding repetitive behaviours.ResultsMore cognitions and autonomic anxiety and fewer sensory phenomena were reported in OCD than in GTS. Like the GTS group, the OCD plus GTS group reported more sensory phenomena and fewer cognitions than the OCD group.ConclusionsThe presence or absence of cognitions, sensory phenomena, and autonomic anxiety distinguishes repetitive behaviours in patients with OCD from those with OCD plus GTS, and GTS. These subjective experiences may be useful in subtyping OCD and may represent valid predictors of prognosis and treatment response.
HIV infection in psychiatric patients: An unlinked anonymous study
Authors: Ayuso-Mateos José L. , Montañés Francisco , Lastra Ismael , De La Garza Juan J. Picazo , Ayuso-Gutiérrez José L. 
Published: October 2008

BackgroundRecent surveys suggest that psychiatric patients are at increased risk of being infected with HIV, although very little information is available concerning the seroprevalence of HIV infection among this population outside the US. The aim of this study is to determine the seroprevalence of HIV-I among patients admitted to a psychiatric in-patient unit and to gather linked anonymous risk-factor information.MethodAn unlinked serosurvey was made, using HIV-1 antibody testing of remnant blood specimens collected for routine medical purposes, of patients consecutively admitted to an acute psychiatric unit in Madrid.ResultsBlood was obtained from 390 of the 477 eligible patients (81.8%). The prevalence of HIV was 5.1% (20/390). Patients aged between 18 and 39 accounted for 63.4% of the admissions and 75% of the positive results. Of the 29 patients who presented with injecting drug use, 14 were HIV-infected (48.3%; 95% CI 29.4 67.5). Of the 51 patients for whom any risk behaviour was noted on the admission chart, 18 were HIV-infected (35.3%; 95% CI 22.4 49.9).ConclusionsThis study demonstrates that there is a substantial prevalence of HIV infection in psychiatric patients admitted to an acute in-patient unit. History of injecting drug use was strongly associated with seropositivity. Clinicians recognised risk factors for HIV infection in the majority of the HIV-infected cases.
The Nottingham Acute Bed Study: Alternatives to acute psychiatric care
Authors: Beck A. , Croudace T. J. , Singh S. , Harrison G. 
Published: October 2008

BackgroundAlthough modern psychiatric services seek alternatives to hospitalisation wherever appropriate, the national trend toward higher bed occupancies on acute psychiatric wards has refocused attention on community-based alternatives and methods of assessing reed for acute care.MethodWe surveyed key decision makers in a community-oriented district service with a low acute psychiatric bed to population ratio, in order to examine alternatives to hospitalisation in a cohort of consecutive admissions over a six-month period.ResultsAlternatives to acute ward hospitalisation were identified for 29% of admissions, and for 42% of those with an admission duration of more than 60 days. Residential options were chosen more often than intensive community support. Simulated bed day savings were considerable.ConclusionsIn a community-oriented service, key decision-makers could identify further alternatives to acute ward hospitalisation, although relatively few non-residential, community support options were chosen. Although this methodology has limitations, data based upon keyworker judgements probably have greater local ‘ownership’, and the option appraisal process itself may challenge stereotyped patterns of resource use.
Mental health review tribunals
Authors: Myers D. H. 
Published: October 2008

BackgroundMental health legislation allows for treatment needs to override civil liberty. Mental health review tribunals act as a counterbalance. This study examines the long-term outcome of patients reviewed by a tribunal, and in particular whether the tribunal, in its concern for civil liberty, might be discharging patients prematurely.MethodAll non-offender patients from a defined catchment area reviewed by the tribunal between the inception of the 1983 Mental Health Act and 31 December 1991 were followed-up until 31 May 1993.ResultsThose discharged by the tribunal did not differ significantly from those refused discharge in subsequent survival period in the community, in readmission rate or in final outcome.ConclusionsWithin the limitations of a non-experimental study, the main hypothesis was not supported. An intensive study of family and personal life in the three months after discharge would cast useful additional light on the soundness of tribunal decisions.
Generalisability of results from randomised drug trials
Authors: Licht Rasmus Wentzer , Gouliaev Georg , Vestergaard Per , Frydenberg Morten 
Published: October 2008

BackgroundExemplified by a randomised trial on antimanic treatment, this paper addresses the question of whether selection of patients for drug trials may limit the applicability of study results from the randomised patients to a wider population.MethodDuring two-year period, all consecutively admitted patients from a defined catchment area were screened for inclusion criteria concerning age, diagnosis and severity of illness. The subsequently excluded subgroups of patients were compared with the randomised patients by multivariate data analysis.ResultsOne hundred and sixty-four patients met the inclusion criteria. However, after exclusion for various reasons, only 27 (17%) patients remained for randomisation. The randomised patients and the excluded patients differed substantially.ConclusionsThe generalisability of trial results is limited. Reports of randomised drug trials should carefully describe the screening procedure for inclusion and, when possible, present relevant comparisons-between the randomised patients and the various subgroups of excluded patients.
A transcultural pattern of drug use: Qat (khat) in the UK
Authors: Griffiths Paul , Gossop Michael , Wickenden Simon , Dunworth John , Harris Ken , Lloyd Charles 
Published: October 2008

BackgroundThis study investigates patterns of qat use among 207 Somalis living in London.MethodSubjects were recruited using privileged access interviewing. Somalian interviewers were recruited who shared the same culture as the subjects. Data were collected by means of a structured interview.ResultsOne hundred and sixty-two subjects (78%) had used qat. The majority (76%) used more qat than in Somalia. Some users reported moderate dependence; a minority reported severe problems. Adverse psychological effects included sleep problems, anxiety and depression. Medical problems associated with qat use were rare.ConclusionsQat users who continue to use this drug when it is transplanted from a traditional context may experience difficulties. Qat use can also be seen as playing a positive role in supporting the cultural identity of the Somalian community. Severe problems were rarely reported. Qat consumption should be considered when addressing health-related topics with patients from those communities in which qat use is common.
The predictive validity of a diagnosis of schizophrenia
Authors: Mason Peter , Harrison Glynn , Croudace Tim , Glazebrook Cristine , Medley Ian 
Published: October 2008

BackgroundOutcome is important in the validation of psychiatric diagnosis, as most disorders lack clinicopathological correlates. We describe the predictive validity of four definitions of schizophrenia (DSM-III-R, ICD-10, ICD-9 and CATEGO S+), in a representative cohort of patients selected during their first episode of psychosis.MethodEach definition of schizophrenia was applied to 99 patients. Their respective ability to predict 13-year outcome (Global Assessment of Functioning scales) was assessed.ResultsDSM-III-Rand ICD-10 diagnoses of schizophrenia have high predictive validity for long-term outcome, and both provide relatively stable diagnoses. ICD-9 is reasonably good at predicting disability, but not symptoms, and CATEGO S+ showed no predictive validity. Adding six-month duration criteria to ICD-10, ICD-9 and CATEGO S+ improved their predictive validity, and removing the six-month duration criterion from DSM-III-R commensurately reduced predictive validity.ConclusionsModern diagnostic systems (DSM-III-Rand ICD-10) have high predictive validity, and are superior to ICD-9. The six-month duration criterion of DSM-III-R schizophrenia accounts for its predictive validity and stability over 13 years, but restricts its use in first-episode studies. The one-month duration criterion of ICD-10 is less restrictive, without major compromises in predictive validity or stability.
Empirically based subgrouping of eating disorders in adolescents: A longitudinal perspective
Authors: Van Der Ham Thecla , Meulman Jacqueline J. , Van Strien Din C. , Van Engeland Herman 
Published: October 2008

BackgroundSuccessive DSM versions struggle with the heterogeneity of the eating disorders. Criteria were mainly based on clinical impressions and on descriptive and inferential studies.MethodIn a study of 55 eating-disordered adolescents, we investigated whether patients could be grouped on an empirical basis, using principal components analysis (PCA) with optimal scoring (scaling), i.e. PCA with no aprioriassumptions. Clustering was based on Morgan-Russell subscales, each measured four times over the course of illness.ResultsContrary to DSM – IV criteria, patients did not cluster primarily on the basis of anorectic symptoms; the occurrence of bulimic symptoms was more dominant. Core symptomatology (preoccupation with food, disturbed body perception and inadequate sexual behaviour) did not differ between patients, either at referral or over time.ConclusionsThese results support the spectrum hypothesis of the eating disorders, which considers them as one syndrome with different manifestations.
Reasoning and delusions
Authors: Kemp Róisín , Chua Siew , McKenna Peter , David Anthony 
Published: October 2008

BackgroundDelusions are assumed to reflect disordered reasoning, but with little empirical support. We attempted to study this in 16 relatively intelligent deluded patients and 16 normal volunteers.MethodStandard tests were used which required subjects to choose between logically fallacious and valid responses, both of which were plausible. The tests were: (a) conditional statements (if… then), (b) syllogisms (e.g. no A are C, some B are C, some C are not A), and (c) judgements of probability. All three tasks incorporated neutral and emotive content.ResultsBoth normal and deluded subjects frequently made logical errors. With conditionals, deluded subjects tended to endorse fallacies more often than normal controls and this was accentuated when the content was emotive. Similarly, with syllogisms, the effect of emotional content on the endorsement of unbelievable responses was increased slightly in the deluded group. Finally, the deluded patients showed a trend to be less prone to the conjunction fallacy than normals, suggesting less reliance on existing schema.ConclusionsDifferences in reasoning between deluded patients and controls are surprisingly small. Patients are somewhat more prone to endorse invalid or fallacious responses, especially when emotive themes are involved.
Mental disorders and suicide in Northern Ireland
Authors: Foster Tom , Gillespie Kate , McClelland Roy 
Published: October 2008

BackgroundThe aim of this part of the Northern Ireland Suicide Study was to investigate the prevalence of DSM - III - R axis I (clinical syndrome) and axis II (personality) disorders among suicides (14 years and older) in Northern Ireland during a one-year period.MethodA psychological autopsy study based on a variety of documentary sources and interviews with bereaved informants and health care professionals.ResultsNinety per cent of suicides (106/118) had a current axis I and/or an axis II mental disorder. At least one current axis I disorder was diagnosed in 86% of suicides (102/118), and at least one axis II disorder was diagnosed in 44% (52/118). Suicides under 30 years (92% male) were less likely to have a current axis I disorder (68%; 26/38) than those 30 years and older (95%; 76/80). Psychiatric comorbidity was present in 55% of suicides (65/118). The time between the last contact with a health care professional and death was greater among suicides under 30 years and male suicides.ConclusionsNotwithstanding the aetiological complexity of suicide, the prevention, recognition and treatment of mental disorder will continue to play key roles in suicide prevention.
No association between bipolar disorder and alleles at a functional polymorphism in the COMT gene
Authors: Craddock Nick , Spurlock Gillian , Mcguffin Peter , Owen Michael J. , Nosten-Bertrand Marika , Bellivier Frank , Meloni Rolando , Leboyer Marion , Mallet Jacques , Mynett-Johnson Lesley , Murphy Valerie , Mckeon Patrick , Kirov George , Powell John , Kunugi Hiroshi , Collier David , Larosa Monica , Nacmias Benedetta , Sorbi Sandro , Schwab Sibylle , Ackenheil Manfred , Maier Wolfgang ,   Biomed European Bipolar Collaborative Group
Published: October 2008

BackgroundThere is compelling evidence for the existence of susceptibility genes for bipolar disorder. Association studies using functional DNA variations are an important approach for identifying these genes. The enzyme catechol-O-methyltransferase (COMT) plays a key role in the degradation of catecholamine neurotransmitters and is a candidate for involvement in bipolar disorder. Recently a common functional genetic polymorphism that underlies population variation in COM Tactivity has been elucidated and a simple assay developed.MethodIn a collaboration involving seven European centres, we have undertaken an association study of this functional polymorphism in 412 unrelated West European caucasian DSM - III-R bipolar patients and 368 ethnically matched controls.ResultsWe found no evidence of allelic or genotypic association.ConclusionsWe can conclude that variation at this functional polymorphism does not make an important contribution to bipolar disorder in the Western European population. Future studies using this powerful experimental approach can be expected to contribute to identification of bipolar susceptibility genes.
Confusional State Evaluation (CSE): An instrument for measuring severity of delirium in the elderly
Authors: Robertsson B. , Karlsson I. , Styrud E. , Gottfries C. G. 
Published: October 2008

BackgroundDelirium or confusional state is a common mental disorder in the elderly. To follow changes in symptoms over time and to evaluate the efficacy of treatment of delirium, a reliable and valid instrument for measuring degrees of delirium is essential.MethodAn observer's rating scale with 22 items, the Confusional State Evaluation (CSE), was developed. Scores on 12 of the items were summarised to a “confusion score”. Based on ratings of 7l demented and non-demented elderly patients with delirium, the interrater reliability and validity of the scale was studied.ResultsAgreement between two independent raters was fair to excellent (weighted kappa 0.38–0.93). The correlation between the “consfucsoion score” of the scale and the global rating by a psychogeriatrician was good (r=0.79).ConclusionsThe CSE seems to be a reliable and valid measuring instrument which can be useful in following the course of confusion in elderly patients.
Clinical specificity of prison inmates with severe mental disorders
Authors: Côté Gilles , Lesage Alain , Chawky Nadia , Loyer Michel 
Published: October 2008

BackgroundWe wished to determine whether prison inmates with severe mental disorders possess specific clinical characteristics compared with psychiatric in-patients suffering from similar problems.MethodUnder a case-control design, 69 male prison inmates suffering from a schizophrenic or major affective disorder were matched for age and diagnostic spectrum to 60 male psychiatric in-patients. Standardised interviews were used to diagnose psychiatric disorders according to DSM-111-R and social functioning criteria. Case-notes were reviewed to cull data regarding social life, criminal record and service use.ResultsInmates were more likely to suffer from delusional/NOS psychotic disorders (72%) or major depression (70%), and psychiatric in-patients from schizophrenic or bipolar disorder (62% and 71%, respectively). Comorbidity was more prevalent among inmates than among in-patients, while in-patients presented less social autonomy than did inmates.ConclusionsThe clinical specificity of prison inmates with severe mental disor ders clearly differentiates them from psychiatric in-patients, and warrants recognition of their special needs for assessment and integrated treatment approaches.
One hundred cases of attempted suicide in the elderly
Authors: Hepple Jason , Quinton Catherine 
Published: October 2008

BackgroundDespite the high suicide rate in the elderly, there is a relative lack of information on the longer-term outcome of elderly people who have attempted suicide, particularly their psychiatric and physical morbidity and mortality.MethodComprehensive demographic and psychiatric data were available on 100 consecutive referrals to a liaison psychiatric service of patients over 65 years of age who attempted suicide between 1989 and 1992. Detailed follow-up in 1994 included the interviewing of survivors using GMS–AGECAT.ResultsOf the 64 women and 36 men, with a mean age of 75.8 years, 42 subjects were dead at follow-up; 12 were suspected suicides, five having died as a delayed result of their index attempt. Twelve women made a further non-lethal suicide attempt. All five male repeat attempts proved fatal.ConclusionsElderly people who attempt suicide have a high mortality both from completed suicide and death from other causes. The completed suicide rate is at least 1.5% per year, and the repetition rate is 5.4% per year. Those at risk of further self-harm are likely to be in contact with psychiatric services and to be suffering from persistent depression.
Common mental disorders in primary care in Harare, Zimbabwe: Associations and risk factors
Authors: Patel Vikram , Todd Charles , Winston Mark , Gwanzura Fungisai , Simunyu Essie , Acuda Wilson , Mann Anthony 
Published: October 2008

BackgroundThis study aimed to investigate the associations for common mental disorders (CMD) among primary care attenders in Harare.MethodThis was an unmatched case-control study of attenders at primary health clinics, general practitioner surgeries and traditional medical practitioner clinics; 199 cases with CMD as identified by an indigenously developed case-finding questionnaire, and 197 controls (non-cases), were interviewed using measures of sociodemographic data, disability, care-giver diagnoses and treatment, explanatory models, life events and alcohol use.ResultsCMD was associated with female gender (.=0.04) and older age (.=0.02). After adjustment for age, gender and site of recruitment, CMD was significantly associated with chronicity of illness; number of presenting complaints; beliefs in “thinking too much” and witchcraft as a causal model; economic impoverishment; infertility; recent unemployment; an unhappy childhood for females; disability; and consultations with traditional medical practitioners and religious priests.ConclusionsMental disorders are associated with female gender, disability, economic deprivation, and indigenous labels of distress states.
Pharmacokinetic interactions involving clozapine
Authors: Taylor David 
Published: October 2008

BackgroundMetabolism of clozapine is complex and not fully understood. Pharmacokinetic interactions with other drugs have been described but, in some cases, their mechanism is unknown.MethodPublished trials and case reports relevant to the human metabolism of clozapine and to suspected pharmacokinetic interactions were reviewed.ResultsMetabolism of clozapine appears to be largely controlled by the function of the hepatic cytochrome p4501A2 (CYPIA2). Compounds which induce CYPIA2 activity (carbamazepine, tobacco smoke) may reduce plasma clozapine levels. Inhibitors of CYPIA2 (caffeine, erythromycin) have the opposite effect. Drugs which inhibit the hepatic cytochrome p4502D6 (CYP2D6) have also been reported to elevate plasma clozapine levels. The mechanism of this interaction is unclear.ConclusionsThe co-administration of clozapine and compounds reported to alter its metabolism should be avoided where possible. A host of other interactions can be predicted and so caution should be exercised when co-administering drugs which affect the function of CYPIA2 and CYP2D6. The pharmacokinetics of clozapine require further investigation so that its safe use can be assured.