bluuebunny/crossref_metadata_2025_split huggingface dataset:
Molecular Biological Investigations into the Role of the NMDA Receptor in the Pathophysiology of Schizophrenia
Authors: Catts Stanley V. , Ward Phillip B. , Lloyd Andrew , Huang Xu Feng , Dixon Gavin , Chahl Loris , Harper Clive , Wakefield Denis 
Published: January 2008

Objective:There is increasing acceptance that schizophrenia is associated with a generalised disorder in cortical neurodevelopment. The aim of this paper is to review the evidence that this disorder may be accounted for by abnormalities in mechanisms mediated by the main family of excitatory neuroreceptors in cortical brain systems, the N-methyl-D-aspartate (NMDA) glutamatergic receptors. Method:The neurobiological evidence is presented for an abnormality in cortical development related to synaptic pathology in schizophrenia. The unique functions of the NMDA receptor in information processing are described, especially its role in learning and memory, and in neural plasticity and brain development. It is argued that the cellular and molecular mechanisms which underlie learning and memory also govern normal brain development. Studies examining abnormalities in glutamatergic transmission in schizophrenia are reviewed. Results:There is a substantial literature in support of the possibility that NMDA receptor abnormalities may be involved in the neurodevelopmental predisposition to schizophrenia, as well as in symptom production. Conclusions:Research to determine the role of the NMDA receptor in the pathophysiology of schizophrenia is warranted and now feasible. To be successful, this research will require the application of molecular biology techniques to postmortem brain tissue studies, in addition to traditional histochemical approaches.
Women and Schizophrenia: A Review
Authors: Kulkarni Jayashri 
Published: January 2008

Objective:This is a selective review article which aims to explore current areas of research involving women with schizophrenia and to identify areas requiring future research. Method:Research studies conducted both nationally and internationally are reviewed with an emphasis on a gender-based approach. Results:The review is divided into three sections. First there is an introduction including a brief consideration of the possible reasons for the noted lack of studies focussing on women with schizophrenia and a summary of the epidemiological evidence that has prompted interest in gender-based schizophrenia research. Second, there is a review of some studies that utilise gender as a paradigm to understand the pathophysiology of schizophrenia, and third, a discussion of the role of gender in management approaches is presented. Conclusions:The main conclusion is that women have not been well represented in schizophrenia research. Female-specific management issues and a better understanding of the impact of schizophrenia on women require more gender-based research.
Season of Birth and Schizophrenia in Tasmania
Authors: Jones Ivor H. , Hay David A. , Kirkby Kenneth C. , Daniels Brett A. , Mowry Bryan J. 
Published: January 2008

Objective:The purpose of the present study was to determine whether there was a significant seasonal variation in the birth dates of patients with schizophrenia born in Tasmania. Method:The season of birth in Tasmanian-born patients with schizophrenia (n = 1412), born between 1919—1970, was compared with general population data. Results:No significant variation in month or quarter of birth was detected for the subjects with schizophrenia. Neither was there any significant seasonal excess when data from different decades were analysed separately, nor for subsidiary analyses of gender or paranoid/non paranoid subtype. Conclusion:These results are compared with those of six other published studies of Australasian-born subjects identified through registers in different States. While both positive and negative results are reported, no clear pattern emerges. The relevance of season of birth to the development of schizophrenia in Australia remains an open question.
Aggressive Behaviour in Schizophrenia: The Role of Psychopathology
Authors: Cheung Peter , Schweitzer Isaac , Crowley Kathleen , Tuckwell Virginia 
Published: January 2008

Objective:The aim of this study was to determine the psychopathological correlates of aggressive behaviour in schizophrenia. Method:Thirty-one aggressive patients in rehabilitation wards meeting DSM-III-R criteria for schizophrenia were compared with 31 matched non-aggressive patients in relation to their psychopathology using the Clinical Global Index (CGI), Positive and Negative Symptoms scale (PANSS) and the Montgomery-Asberg Depression Rating Scale. Results:The aggressive group had significantly higher CGI, positive symptom, negative symptom, general psychopathology and total PANSS scores than the non-aggressive group. The two groups could be distinguished by three sets of symptoms: symptoms with verbal or/and physical aggression as part of their definition; symptoms suggesting frontal lobe impairment; and excitement. The two groups did not differ in their level of depressive symptomatology. Conclusions:The aggressive group were overall more ill than the non-aggressive group, and the former could be distinguished from the latter by certain aspects of their psychopathology.
Geographical Resource Allocation for Public Mental Health Services in Victoria
Authors: Meadows Graham 
Published: January 2008

Objective:To provide background information on the approach of area based funding models for mental health services, to describe the considerations which have come to bear in the development process of the Victorian model, to explore the impacts of different models, and to suggest courses for further development. Method:The history of this approach to funding in the UK and the USA is summarised, then an account is given of the development of the Victorian model. The position is put that the validation of such models is hampered by having only sparse relevant data. Suggestions are made for improving this situation. Results:The Victorian model has come to include adjustments for socioeconomic disadvantage, the age, sex and marital status structure of the population, and a variable discounting for estimated substitutive activity of the private sector. Different methods of combining these adjustments into a working formula can be seen to have very different impacts. Conclusions:The approach taken in development of this model can be expected to have major influence on funding within Victoria, but also more widely in Australia. The impacts of differing assumptions within these models are significant. Specifically targeted epidemiological research, and activity analysis of the private sector will be necessary to enhance the validity of models of this type.
Is There a Role for Child Psychiatry in Vietnam?
Authors: McKelvey Robert S. , Sang David L. , Tu Hoang Cam 
Published: January 2008

Objectives:(i) To describe the need for child psychiatric services in Vietnam; (ii) to review child psychiatry's present role within the Vietnamese health care system; (iii) to identify cultural, economic and manpower obstacles to the development of child mental health services; and (iv) to recommend a course for the future development of child psychiatry in Vietnam. Method:The existing literature relevant to the Vietnamese health and mental health care systems, traditional practices and beliefs regarding health and mental health, and the current status of psychiatry and child psychiatry in Vietnam was reviewed. In addition, discussions regarding these topics, and the future of child psychiatry in Vietnam, were held with leading Vietnamese health and mental health professionals. Results:The current role of child psychiatry in Vietnam is limited by the health care system's focus on infectious diseases and malnutrition, and by cultural, economic and manpower factors. Treatment is reserved for the most severely afflicted, especially patients with epilepsy and mental retardation. Specialised care is available in only a few urban centres. In rural areas treatment is provided by allied health personnel, paraprofessionals and community organisations. Conclusions:While the present role of child psychiatry in Vietnam is limited, it can still make important contributions. These include:research defining the need for child and adolescent mental health services, identifying priority child psychiatric disorders and assessing the effectiveness of priority disease treatment; and training to enhance the skills of primary health care providers in the treatment of priority disorders.
Fluoxetine and Involuntary Recall of Remote Memories
Authors: Robertson Andrew R. 
Published: January 2008

Objective: To describe a striking, and hitherto unreported, side-effect of fluoxetine. Clinical Picture:Four patients given fluoxetine developed involuntary vivid recall of earlier life events. Treatment and Outcome:The side-effect ceased after fluoxetine was discontinued. Conclusions:The implications of this finding are discussed, particularly with regard to the nature of long-term memory.
Morbid Jealousy as a Variant of Obsessive-Compulsive Disorder
Authors: Parker Gordon , Barrett Elaine 
Published: January 2008

Objective:To present a representative case vignette and review several previous reports, and to then suggest that a percentage of those with morbid jealousy may have a variant of obsessive—compulsive disorder (OCD). Clinical picture:A patient presented volunteering a diagnosis of depression and anxiety following recent work and marital stresses, before describing recent jealousy and harassment of his wife over an earlier relationship. Obsessional thinking patterns and compulsive behaviours are described, and it is proposed that the picture supports a diagnosis of obsessive—compulsive disorder. Treatment and outcome:The patient was treated as if he had an obsessive-compulsive disorder, and reported dissipation of his concerns after cognitive—behavioural intervention. Conclusions:The proposition is an important one as a diagnosis of morbid jealousy often invites therapeutic pessimism, and as managements effective for OCD (both drug and behavioural) may well be helpful.
Point of View: Should There be a Clinical Typology of Posttraumatic Stress Disorder?
Authors: Alarcon Renato D. , Deering Catherine G. , Glover Susan G. , Ready David J. , Eddleman H. Clay 
Published: January 2008

Objective: The current classification of posttraumatic stress disorder in acute, chronic and delayed-onset types is incomplete and of limited usefulness. The present paper explores the possibilities of a clinically-based typology that would reflect both the patients' syndromic presentation and modern research findings. Method: Review of current clinical and research literature, with a critical examination of proposed typologies, parameters utilised, applicability and relevance; elaboration of theoretical and practical bases of a clinical typology of posttraumatic stress disorder. Results: None of the existing posttraumatic stress disorder typologies presents a clinically comprehensive scope. A typology supported by literature findings and clinical observations is proposed. The six clinical types are depressive, dissociative, somatomorphic, psychotomorphic, organomorphic and ‘neurotic-like’. Substance abuse and personality disorder-like variants remain as areas of investigation. Conclusions: The proposed typology, while accepting the nuclear manifestations of posttraumatic stress disorder, highlights prominent coexisting symptoms that define the clinical appearance of different patients. The typological approach in posttraumatic stress disorder does not carry the ambiguities of comorbidity, and facilitates a more specific and appropriate management of the cases.
Psychiatry: An Impossible Profession?
Authors: Bloch Sidney 
Published: January 2008

Objective: To examine the disconcerting question as to whether psychiatry is a fully-fledged profession or not. Method: A review of pertinent literature regarding the criteria of a profession, the vulnerability of psychiatry to abuse, and potential models for the proper practice of psychiatry. Results: Psychiatry lost its professional anchorage entirely with its misuse to suppress dissent in the former Soviet Union and in the so-called euthanasia program in Nazi Germany. It remains vulnerable to abuse unless psychiatrists recognise the professional criteria they must satisfy. A new symbol, a humble stool, is proposed. Its three legs represent the three equally significant dimensions of psychiatric practice: science, art and ethics. Conclusion: Psychiatry just ‘scrapes home’ in constituting a profession but only subject to three provisos: namely (i) that psychiatrists appreciate the need to achieve a coherent body of special knowledge through a genuine creative process which necessarily results in uncomfortable tension from time to time; (ii) that we promote the art of psychiatry by cultivating an ethos of caring and sensitivity; and (iii) that we function within an articulated ethical framework with respect for codes of ethics as guidelines.
Characteristics of Childhood Sexual Abuse and Adult Psychopathology in Female Psychiatric Patients
Authors: Pettigrew Jill , Burcham Joyce 
Published: January 2008

Objective: The present study investigated the relationship of characteristics of childhood sexual abuse and subsequent psychopathology. Method: Referrals to a female psychiatrist in private practice in an urban working class area provided 73 adult female subjects who reported having been sexually abused in childhood. Data were collected on age at onset, duration, physical invasiveness of the abuse, violence, and the number and relationship of abusers. Results: Having had multiple abusers in childhood was significantly (p < 0.01) associated with every outcome measure of severe psychopathology: an initial Global Assessment Functioning score of 50 or below; both single and repeated incidents of deliberate self-harm; overdose; self-mutilation; and psychiatric hospital admission. Conclusions: Notably, having had multiple abusers was the only characteristic showing a reliable independent association with any of these measures. Subjects who had had multiple abusers were significantly more likely to have an earlier age of onset and longer duration of abuse, and to have experienced violent abuse.
A Review of the Use of Augmentation Therapy for the Treatment of Resistant Depression: Implications for the Clinician
Authors: Schweitzer Isaac , Johnson Gordon , Tuckwell Virginia 
Published: January 2008

Objective: To critically review the literature on augmentation therapy in resistant depression in order to assist the clinician to make a reasoned choice. Augmentation therapy is defined as the addition of a second agent to an existing antidepressant regimen with the aim of achieving improved clinical response. Method: The available literature which related specifically to currently popular augmentation strategies in treatment resistant depression for the past 20 years was examined. The scientific evidence supporting the efficacy of these regimens and their safety was reviewed. Results: Considerable research on lithium augmentation has been undertaken, and on triiodothyronine augmentation to a lesser degree. A number of other drugs have been trialled as augmentation agents with claims of success; however, most of the evidence supporting these agents is anecdotal and in the form of case reports. There are very few well-performed double-blind placebo-controlled studies of augmentation therapy. Conclusions: Because of possible complex pharmacodynamic and pharmacokinetic interactions, augmentation therapy is not without its potential complications. Lithium augmentation of tricyclic antidepressants can be recommended as a safe and effective strategy and there is a body of scientific evidence supporting the addition of T3 as an effective augmentation agent. Recent research with pindolol augmentation of selective serotonin re-uptake inhibitors (SSRIs) is encouraging, but these findings require replication. There is no empirical evidence supporting buspirone, carbamazepine, sodium valproate, methylphenidate or amphetamine as effective augmentation agents, or that adding a tricyclic to a SSRI has usefulness in relieving depressive symptoms. There is a need for considerable research in this area, with more prospective well-controlled placebo studies.
Experiences of Physical and Sexual Abuse in Australian General Practice Attenders and an Eating Disordered Population
Authors: Brown Lisa , Russell Janice , Thornton Christopher , Dunn Stewart 
Published: January 2008

Objective: To determine the reported rates of child physical and sexual abuse experienced by hospitalised eating disordered patients compared to a control group of women attending general practitioners. Method: A retrospective survey using the self-report Finkelhor Sexual Life Events Inventory and clinical reports. Results: Nearly one-half of eating disordered patients reported a history of child sexual abuse and one-quarter reported child physical abuse. These rates were significantly higher than those reported by the control group. Conclusions: Direct questioning regarding trauma histories is warranted when assessing patients with eating disorders and attention to such issues should be incorporated into the total management plan.
Is Clozapine Safe in the Elderly?
Authors: Herst Laurence , Powell Geoff 
Published: January 2008

Objective: The aim of this paper is to assess the risk/benefit ratio of clozapine in the elderly. Method: MedLine and Internet searches, followed by cross-checking for further articles, identified the references. Reports on efficacy as well as side effects were examined. Five psychogeriatric patients treated by the authors are presented. Results: The review of the literature highlighted the lack of studies on the use of clozapine in the elderly. Retrospective studies and case reports dominate. There is only one double-blind placebo-controlled study of six patients extant. Although efficacy seemed to parallel that in the younger age groups, the incidence of leukopenia, agranulocytosis, postural hypotension and confusion was greater in the elderly. Two of the five patients reported by the authors developed agranulocytosis, bringing the Australian experience of agranulocytosis in patients over 65 years of age to 4/55. Conclusion: The risk/benefit ratio in the elderly is distinctly higher than found in the younger population. With specific reference to agranulocytosis alone, the frequently quoted risk of 1% for patients is likely to be 5–10 times higher in the over 65 population. Caution is advised when prescribing clozapine in the psychogeriatric population.
Confirmation of the Diagnosis of Schizophrenia after Death Using DSM-IV: A Victorian Experience
Authors: Roberts Susan B. , Hill Christine A. , Dean Brian , Keks Nicholas A. , Opeskin Ken , Copolov David L. 
Published: January 2008

Objective: This study examines the reliability of antemortem diagnoses of schizophrenia using DSM-IV criteria. Method: The case histories of 83 subjects with a provisional diagnosis of schizophrenia at autopsy were retrospectively reviewed using a semi-structured chart review and application of DSM-IV criteria. Agreement between antemortem and postmortem diagnoses of schizophrenia was examined, as well as the concordance between DSM-IV diagnoses and previously obtained diagnoses using DSM-Ill-R and ICD-10 criteria for schizophrenia. Results: According to DSM-IV, 30.1% of cases did not have schizophrenia, compared to 36.1% using DSM-Ill-R criteria and 51.8% of cases using ICD-10 criteria. Concordance between DSM-IV and DSM-Ill-R diagnoses of schizophrenia was excellent (k = 0.81), but only fair between DSM-IV and ICD-10 (k = 0.57). Of the cases that did not meet the formal criteria for schizophrenia, the majority were reassigned diagnoses of schizoaffective disorder and affective disorder. Conclusions: The use of human brain tissue in postmortem studies of schizophrenia must be linked to standardised diagnostic assessment procedures. Diagnoses can be upgraded with the development of new criteria, providing sufficient clinical data is available in case histories.
Directions of Aetiologic Research on Attention Deficit Hyperactivity Disorder
Authors: Levy Florence , Ban Cathy , Sunohara Glen 
Published: January 2008

Objective: The aim of this paper is to review and integrate recent literature on aetiological factors that have been postulated for attention deficit hyperactivity disorder (ADHD). Method: Recent studies relating to perinatal brain damage, intra-uterine toxic effects, neurochemical, brain imaging and genetic studies are reviewed, and those considered most significant are discussed. Where possible, recent findings are integrated and directions of future research are suggested. Clinical implications are briefly discussed. Results: Perinatal studies indicate that children with a birth weight under 750 g may be disadvantaged for attentional skills. Magnetic resonance imaging (MRI) and steady state visually evoked potential studies show differences in prefrontal, caudate and parietal areas in ADHD children, suggesting right hemispheric dysfunction. Functional MRI studies hold promise in further elucidating attentional systems in the central nervous system that are involved in ADHD. Genetic studies suggest genes related to dopaminergic systems may be important. Conclusions: Recent research on ADHD has made considerable advances, particularly in the areas of brain imaging and genetic studies. Genetic studies should provide further aetiological understandings of ADHD, leading to more targeted treatments.
The Relationship between Admission to Hospital with Chest Pain and Psychiatric Disorder
Authors: Kisely Stephen R. 
Published: January 2008

Objective: Psychosocial variables have been identified as important predictors of outcome in patients with chest pain. Most attention has focused on patients with ischaemic heart diseases or those in outpatient settings. This paper compares focuses on inpatients, and compares patients with ischaemic heart disease to those with non-specific chest pain. Method: A search of the literature on chest pain and psychiatric disorder from 1972 onwards using Medline, Index Medicus and the bibliographies of retrieved articles. Results: One-third of patients admitted with acute chest pain have psychiatric disorder as measured by standardised interviews. Patients who have had psychiatric symptoms prior to admission and those with non-specific pain appear to be most at risk of continuing psychiatric morbidity. In patients with ischaemic heart disease, psychiatric symptoms on admission are more strongly related to subsequent social outcome than variables such as severity of infarct or the presence of angina. Psychiatric symptoms may also effect physical morbidity and possibly mortality, although further research is required to clarify the latter finding. In patients with nonspecific pain, further research is indicated to identify aetiological and maintaining factors for continued non-specific pain. There is, however, a strong association with alcohol and cigarette use. Conclusions: The prediction of outcome requires careful assessment of previous or current psychiatric symptoms in patients admitted with chest pain, irrespective of underlying diagnosis. Early intervention with psychological treatment for patients with non-specific chest pain is indicated; this may also involve help to reduce smoking. There is also further evidence that mortality following myocardial infarction is closely linked to psychiatric disorder, although prior psychiatric disorder may be more important than “post-infarction” depression. Larger and more methodologically rigorous studies are required to further clarify these findings.