bluuebunny/crossref_metadata_2025_split huggingface dataset:
Emotional Disorder in Chronic Illness: Psychotherapeutic Interventions
Authors: Guthrie Elspeth 
Published: October 2008

BackgroundEmotional disorder associated with physical illness falls into two main groups: ‘psychological reaction to physical illness’ and ‘somatic presentation of psychological disorder’. Psychological treatments are becoming more widespread in the general hospital setting, but there are few systematic evaluations.MethodA manual and computer (MEDLINE) literature search was performed. Studies which provided insight into clinical practice were selected for discussion, and randomised controlled trials of at least 6 weeks duration and inclusion of 30 or more subjects were selected for review.ResultsFourteen empirical studies were found: six involving patients with chronic organic disorder and eight involving patients with somatisation.ConclusionsThere is little empirical evidence that psychotherapeutic interventions are of benefit when applied indiscriminately to patients with organic disease. Further work is required to delineate subgroups of patients who may be responsive. There is mounting evidence that psychotherapy is beneficial in patients with somatisation disorders. Patients with very chronic symptoms may require intensive treatment approaches.
A Systematic Review on Gender-Specific Suicide Mortality in Medical Doctors
Authors: Lindeman Sari , Läärä Esa , Hakko Helinä , Lönnqvist Jouko 
Published: October 2008

BackgroundSo far no comprehensive systematic review has been published about epidemiologic studies on suicides among medical practitioners. The aim here is to describe the variation of published estimates of relative risk of doctors to die from suicide.MethodA systematic review of published original articles on population-based studies, registered mainly in MEDLINE and fulfilling specific methodological requirements. Incidence rates and standardised mortality ratios were calculated for male and female doctors in relation to the reference groups.ResultsThe estimated relative risk varied from 1.1 to 3.4 in male doctors, and from 2.5 to 5.7 in female doctors, respectively as compared with the general population, and from 1.5 to 3.8 in males and from 3.7 to 4.5 in females, respectively, as compared with other professionals. The crude suicide mortality rate was about the same in male and female doctors.ConclusionIn all studies the suicide rates among doctors were higher than those in the general population and among other academic occupational groups.
Phenomenology and Course of Generalised Anxiety Disorder
Authors: Yonkers Kimberly A. , Warshaw Meredith G. , Massion Ann O. , Keller Martin B. 
Published: October 2008

BackgroundThe diagnostic category of generalised anxiety disorder (GAD) was originally intended to describe residual anxiety states. Over the years clinical criteria have been refined in an attempt to describe a unique diagnostic entity. Given these changes, little is known about the clinical course of this newly defined disorder. This study investigates the longitudinal course, including remission and relapse rates, for patients with DSM–III–R defined GAD.MethodAnalysis of the 164 patients with GAD participating in the Harvard Anxiety Research Program. Patients were assessed with a structured clinical interview at intake and re-examined at six month intervals for two years and then annually for one to two years. Psychiatric Status Ratings were assigned at each interview point. Kaplan–Meier curves were constructed to assess likelihood of remission.ResultsComorbidity was high, with panic disorder and social phobia as the most frequently found comorbid disorders. The likelihood of remission was 0.15 after one year and 0.25 after two years. The probability of becoming asymptomatic from all psychiatric symptoms was only 0.08.ConclusionsThis prospective study confirms the chronicity associated with GAD and extends this finding to define the one and two year remission rates for the disorder. Likelihood of remission for GAD and any other comorbid condition after one year was half the annual remission rate for GAD alone.
The Dimensions of Schizophrenia Phenomenology Not one or two, at least three, perhaps four
Authors: Lenzenweger Mark F. , Dworkin Robert H. 
Published: October 2008

BackgroundThis confirmatory investigation examined the underlying structure of schizophrenia phenomenology through examination of the fit of several prominent dimensional models to observed symptom data.MethodConfirmatory factor analysis was conducted on a correlation matrix of schizophrenia signs and symptoms derived from case history ratings of 192 individuals with schizophrenia who were the subjects in the major twin studies of schizophrenia.ResultsSchizophrenia phenomenology appears best described by four underlying factors, namely negative symptoms, premorbid social adjustment deficits, reality distortion, and disorganisation. Of interest, the premorbid deficit dimension was directly associated with negative symptoms and disorganisation, but was inversely associated with reality distortion.ConclusionsThese data clearly support the multidimensionality of schizophrenia phenomenology and provide objective support for a four-factor model over other models. This four-factor model may be useful in organising existing and future data concerning the genetic, neurobiological, neurological, and psychosocial features of schizophrenia.
The Galway Study of Panic Disorder III
Authors: O'rourke D. , Fahy T. J. , Brophy J. , Prescott P. 
Published: October 2008

BackgroundThe aim was to evaluate long-term outcome of DSM–III–R panic disorder at a mean of 5.3 years following a controlled trial of treatment that included antidepressants and behavioural counselling.MethodSixty-eight (86%) subjects were evaluated by lengthy research interview.ResultsThirty-four per cent recovered and remained well, 46% were minimally impaired and 20% had persistent panic disorder of whom half remained significantly impaired. Anxious–fearful personality dysfunction was the most important predictor of poor outcome, followed by poor clinical status at discharge and inability at baseline to recall vividly the initial panic attack. Those who dropped out from the original trial did badly.ConclusionsComplete recovery can occur even after many years of severe illness in a large minority of subjects who receive both antidepressants and behavioural counselling in the acute stage of treatment. The comparative prognostic value of personality, severity and chronicity need to be more fully addressed in future studies.
A Magnetic Resonance Imaging Study of White Matter Lesions in Depression and Alzheimer's Disease
Authors: O'brien John , Desmond Patricia , Ames David , Schweitzer Isaac , Harrigan Susan , Tress Brian 
Published: October 2008

BackgroundWhite matter changes, as revealed by magnetic resonance imaging (MRI), may occur in depression and Alzheimer's disease.MethodT2-weighted MRI scans were performed in 39 control subjects, 61 subjects with NINCDS/ADRDA Alzheimer's disease and 60 subjects with DSM–III–R major depression. Deep white matter lesions (DWML) and periventricular lesions (PVL) were rated on a standard 0–3 scale by two radiologists blind to clinical diagnosis.ResultsAfter controlling for differences in vascular risk factors and current blood pressure, DWML were significantly more common in depressed subjects and PVL in Alzheimer's disease subjects compared to controls. DWML were most common in those presenting in late life with their first ever depression and 50% of such subjects had severe (grade 3) DWML.ConclusionAn association between DWML and depression and PVL and Alzheimer's disease is supported. The increase with DWML that occurs with ageing may predispose some elderly subjects to depression.
Seasonal Changes in Affective State Measured Prospectively and Retrospectively
Authors: Nayyar Kausar , Cochrane Raymond 
Published: October 2008

BackgroundThe study was designed to investigate whether seasonal mood and behavioural changes are detectable prospectively in a non-clinical population in the way they have been reported in retrospective studies. The specificity of any seasonal fluctuation in affective state was also investigated by measuring anxiety as well as depression.MethodTo measure seasonal fluctuations in affect and behaviour prospectively, 25 women were interviewed every month for one year using four scales (depression, anxiety, stress, and behavioural change). Retrospective accounts of mood and behaviour at the end of the year were collected with the Seasonal Pattern and Assessment Questionnaire (SPAQ).ResultsSeasonal depression peaked in winter as did atypical behaviour when measured either prospectively or retrospectively, but the difference between winter and summer was much more pronounced in the retrospective data. No seasonal effect was found for anxiety or psychosocial stressors.ConclusionsThe results obtained by retrospective techniques have limited reliability. In future, more prospective studies with unbiased, standardised instruments are recommended to measure seasonal variations in affect and behaviour.
Psychosocial Study of Depression in Early Pregnancy
Authors: Kitamura Toshinori , Sugawara Masumi , Sugawara Kensuke , Toda Mari Aoki , Shima Satoru 
Published: October 2008

BackgroundThe psychosocial correlates of depression during pregnancy were explored.MethodPregnant women attending the antenatal clinic of a general hospital (n=1329) received a set of questionnaires including Zung's Self-Rating Depression Score (SDS). SDS high scorers (>49) (the cases: n=179) were compared with low scorers (<38) (the controls; n=343).ResultsThe cases were characterised by: first delivery; more nausea, vomiting, and anorexia; more menstrual pains and premenstrual irritability; early paternal loss; lower maternal care and higher paternal overprotection; higher public self-consciousness score; more smoking and use of medication in pregnancy; unwanted pregnancy; negative psychological response to the pregnancy by the woman and husband; poor intimacy by the husband; and having remarried.ConclusionsDepression in early pregnancy is determined mainly by psychosocial factors.
Cardiff Puerperal Mood and Hormone Study. III. Postnatal Depression at 5 to 6 Weeks Postpartum, and its Hormonal Correlates Across the Peripartum Period
Authors: Harris Brian , Lovett Lisetta , Smith Jonathan , Read Graham , Walker Richard , Newcombe Robert 
Published: October 2008

BackgroundWe assessed associations of mood at 5–6 weeks postpartum with peripartum saliva cortisol and progesterone profiles.MethodA prospective study involved 120 primiparous women free of major marital, socioeconomic and health problems, who collected saliva twice daily from 2 weeks before delivery to day 35 postpartum. This allowed intensive characterisation of cortisol and progesterone profiles. At the conclusion of the study, mood was assessed according to standard criteria.ResultsSeven women developed major depression according to DSM–III–R criteria No associations emerged between progesterone and mood at 5 to 6 weeks. Lower levels of evening cortisol in the immediate peripartum period, were associated with postnatal depression.ConclusionThe study provides no support for the treatment strategy of progesterone augmentation following delivery, as a prophylactic against postnatal depression. The HPA axis and its associations with postnatal mood warrants further investigation.
The Reliability and Validity of the Bethlem Mother–Infant Interaction Scale
Authors: Stocky Andrew J. , Tonge Bruce J. , Nunn Russell J. 
Published: October 2008

BackgroundThe Bethlem Scale was designed as a validated measure of mother–infant adjustment in mother–baby units.MethodA multi-centre trial was conducted to investigate aspects of the reliability, validity and clinical usefulness of the Bethlem Mother–infant Interaction Scale within five in-patient psychiatric mother–baby units.ResultsThis revealed good inter-rater, test-retest and inter-item reliability. Correlations of the scale items with psychiatrist's ratings and changes in scoring over time suggest reasonable validity, despite some design problems with individual items.ConclusionMother–infant interaction scales may have an important role in improving the quality of care for mothers and their babies in the psychiatric setting. The development of a more extensive scale, the Monash Mother–infant Interaction Scale, is discussed.
Hospitalisation for Deliberate Self-Poisoning in Scotland from 1981 to 1993: Trends in Rates and Types of Drugs Used
Authors: McLoone Philip , Crombie Iain K. 
Published: October 2008

BackgroundRates of self-poisoning fell during the 1980s, although recent reports suggest this trend may have reversed.MethodsData on all hospital discharges with a diagnosis of deliberate self-poisoning were obtained from the Information and Statistics Division of the NHS in Scotland. Rates of self-poisoning were investigated by overall trend, and for trends by age and by type of drug.ResultsDeliberate self-poisoning rates for men and women began increasing in the late 1980s, and did so steadily during the early 1990s. Because the rates are increasing faster in men, the traditional excess of self-poisoning among women is being eroded. For men rates increased in all age groups up to the age of 60, but the greatest rise occurred between ages 15–29. For women the increase was largely restricted to 15–24-year-olds, and rates fell among women over the age of 50. Self-poisoning with paracetamol increased most rapidly; in contrast to aspirin which showed little change. Opiate analgesics, antirheumatics, antidepressants and antipsychotics have also shown some increase in their use in both genders. There has been a substantial fall in the use of benzodiazepines in women, but little change among men.ConclusionRapid increases in self-poisoning particularly among young adults present a serious public health problem. Controlling this epidemic is made difficult because the principal drug involved, paracetamol, is readily available.
Symptoms of the Schizophrenic Negative Syndrome
Authors: Peralta Victor , Cuesta Manuel J. 
Published: October 2008

BackgroundThe aim was an investigation of the symptom composition of the negative syndrome of schizophrenia.MethodA hundred schizophrenic patients were assessed with various rating scales for positive and negative symptoms and typological criteria. A subgroup with a negative syndrome was defined, and a discriminant analysis performed using symptoms from the Scale for the Assessment of Negative Symptoms (SANS) as discriminant variables.ResultsThe discriminant function classified 92% of patients correctly. All but four SANS symptoms (inappropriate affect, both attentional items and blocking) were significantly correlated with the discriminant function.ConclusionsWith the exception of some items, the SANS seems to capture adequately the negative syndrome of schizophrenia.
Pharmacological Treatment of Depression in Cancer Patients
Authors: Van Heeringen Kees , Zivkov Milana 
Published: October 2008

BackgroundDepression has a reported mean prevalence of 24% in patients diagnosed with cancer. However, little systematic research on the efficacy of antidepressants in patients with cancer has been performed.MethodThe efficacy and safety of mianserin were studied in 55 depressed women with breast cancer (stage I or II and without known metastases), in a randomised, double-blind, six-week, placebo-controlled study.ResultsStatistically significant differences in the decrease in score from baseline on the Hamilton Rating Scale for Depression and the number of responders, favouring mianserin, were present after 28 and 42 days of treatment Significantly more placebo-treated patients prematurely terminated the study due to lack of efficacy while the safety profile of mianserin was similar to that of placebo.ConclusionsTreatment with mianserin resulted in a significant improvement in depressive symptoms in cancer patients, and was well tolerated.
Monitoring Psychosis in General Practice: A Controlled Trial
Authors: Nazareth Irwin , King Michael , Tai Sharon See 
Published: October 2008

BackgroundThis trial evaluated the feasibility, acceptability and effectiveness of a structured approach to the management of schizophrenia in general practice.MethodAll patients with non-affective psychosis (mainly schizophrenia) in four inner-city general practices were recruited. A check-list and a set of outcome measures were used by the general practitioner and the practice nurses. Information on attendances at the general practice and psychiatric out-patient departments was also collected.ResultsTwo practices took part in the intervention and two served as control practices. Sixty-seven patients with non-affective psychosis were identified. Thirty-three (81%) of the 41 patients in the two intervention practices attended the initial assessment by the doctor and nurse, but only 13 (32%) attended the first review assessment. The attendance for the second review, after six months, was six out of 15 (40%) in one practice, but rose to 16 out of 18 (89%) in the other practice. Significant improvements were recorded in the intervention group on the Global Assessment Scale (GAS) and the Behaviour, Speech and Other Syndromes (BSO) subscore of the Present State Examination (PSE). The absolute risk reduction and relative risk reduction as a result of the intervention as measured by the GAS scores, was 29% (95% CI 4% to 54%) and 36% (95% CI 5% to 66%), respectively, and in the case of the BSO subscores of the PSE, this was 23% (95% CI – 1.8% to 47.2%) and 28% (95% CI – 2.2% to 57%), respectively. For one patient to show an improvement in GAS and BSO scores 3.5 patients (95% CI 1.85 to 25) and 4.3 patients (95% CI – 55 to 2.1), respectively, would need to receive the intervention. There was a significant increase in consultation rates for patients in the intervention practices.ConclusionsHealth surveillance of patients with non-affective psychosis is possible in general practice.
Childhood/early adolescence-onsetand adult-onset schizophrenia
Authors: Maziade Michel , Martinez Maria , Rodrigue Caroline , Gauthier Benoît , Tremblay Guy , Fournier Christiane , Bissonnette Luc , Simard Carl , Roy Marc-André , Rouillard Eric , Mérette Chantal 
Published: October 2008

BackgroundThe dopamine D3 receptor gene (DRD3) is a meaningful candidate gene because it unifies the dopamine and the limbic hypotheses for schizophrenia. We tested for an allelic association between schizophrenia and the DRD3 Mscl alleles, hypothesising heterogeneity between childhood/early adolescence-onset schizophrenia (CO-SZ) and adult-onset schizophrenia (A-SZ).MethodThe frequencies of the DRD3 alleles were compared between 70 DSM-III-R schizophrenics (35 CO-SZ and 35 A-SZ) and 79 controls.ResultsCompared with the controls, the subsample of A-SZ, but not CO-SZ, showed an over-proportion (P = 0.025) of allele 1. The association was not found in the total sample, combining the two subsamples.ConclusionsConsistently with former studies, our data suggest an aetiological heterogeneity between CO-SZ and A-SZ and a possible specificity of the excess of allele 1 to the familial form of schizophrenia and to schizophrenia with a better outcome.
Evaluating models of working at the interface between mental health services and primary care
Authors: Gask Linda , Sibbald Bonnie , Creed Francis 
Published: October 2008

BackgroundThis paper examines the feasibility of evaluating innovative models of working at the interface between primary care and secondary mental health services.MethodMethodological problems relevant to evaluation of innovative models of working at the interface are discussed.ResultsAlthough there is some evidence that neurotic disorders can be more cost-effectively treated in primary care, many general practitioners (GPs), and possibly some patients, prefer referral to community mental health teams and community psychiatric nurses, which are provided by the secondary health care services. Since the latter are provided with the intention of improving serious mental illness their involvement in the care of neurotic illness can lead to tensions between GPs, local health authorities and service providers. There is little evidence to suggest that psychiatrists working in health centres using the ‘shifted out-patient’ model have eased this problem. By contrast the ‘consultation-liaison’ (C-L) model has a number of theoretical advantages; referrals to secondary care should be limited to those most in need of this level of expertise and GP management skills should improve, so leading to better quality of care for patients who are not referred.ConclusionStudies comparing the different models of service delivery are required to address the tensions that have arisen following changes in government policy. Further work is also needed to develop the necessary research tools.
Neuropsychological performance in Lewy body dementia and Alzheimer's disease
Authors: Walker Zuzana , Allen Ruth L. , Shergill Sukhwinder , Katona Cornelius L. E. 
Published: October 2008

BackgroundLewy body dementia (LBD) is emerging as a common cause of degenerative dementia. However, LBD cannot yet be diagnosed with certainty in life. There is some preliminary evidence that the pattern of cognitive impairment in LBD is different from that in Alzheimer's disease (AD). We set out to compare the performance on different subtests of the Cambridge Cognitive Examination (CAMCOG) of LBD patients and AD patients who were similar in overall degree of cognitive impairment.MethodsAll patients were recruited from a memory clinic LBD (n = 17) was diagnosed according to the McKeith clinical criteria. AD (n = 17) was diagnosed according to NINCDS-ADRDA criteria. The performances of LBD and AD patients on the neuropsychological subscales of the CAMCOG were compared by applying Hotelling's multivariate test of significance and subsequent univariate F tests.ResultsThere were no statistically significant differences between the two groups on Mini-Mental State Examination and global CAMCOG rating. Hotelling's test with LBD and AD as the between-group factor and the neuropsychological subtests from CAMCOG as dependent variables revealed a statistically significant group effect (P < 0.05). Univariate F tests showed that recall (P < 0.02) and praxis (P < 0.003) significantly contributed to this effect.ConclusionsThese results suggest that there may be different neuropsychological profiles in the two conditions, with LBD subjects being better on recall but worse on praxis than those with AD.
Access to mental health care in an inner-city health district. I: Pathways into and within specialist psychiatric services
Authors: Commander M. J. , Dharan S. P. Sashi , Odell S. M. , Surtees P. G. 
Published: October 2008

BackgroundNeeds for mental health care are likely to be high in urban areas. Purchasers must assess the extent to which these are being met. The pathways to care model provides a framework for this purpose.MethodEpidemiological surveys of adults living in deprived multi-ethnic innercity catchment area were undertaken in psychiatric services, primary care and community settings. Estimated prevalence rates were calculated and the association between clinical and demographic factors and the use of psychiatric services examined.ResultsAround a third of people with mental health problems did not consult a GP. and half failed to have their problems recognised by their doctor. Access to psychiatric services and especially to inpatient care was highly restricted. Diagnosis and ethnicity had a marked influence on the use of specialist services.ConclusionsMany people with psychiatric morbidity are not receiving treatment either from primary care or specialist services. High levels of severe morbidity and compulsory admissions highlight the pressures placed on inner-city psychiatric services.