bluuebunny/crossref_metadata_2025_split huggingface dataset:
Analysis of longitudinal data
Authors: Everitt B. S. 
Published: October 2008

BackgroundLongitudinal data arise frequently in psychiatric investigations, and are most often analysed by multivariate analysis of variance (MANOVA) procedures. However, as routinely applied, the method is not satisfactory, particularly when the data are affected by subjects dropping-out of the study. More suitable methods are now available.MethodProblems with the MANOVA approach are discussed and the advantages of alternative procedures stressed.ResultsUsing MANOVA on complete cases to analyse unbalanced longitudinal data can be seriously misleading. More recently developed methods are far more suitable, but only if the missing values are non-informative.ConclusionsRoutine use of MANOVA for the analysis of longitudinal data, particularly when there is a substantial proportion of drop-outs, is ill advised. Statisticians have considerably enriched the available methodologies during the past decade, and psychiatric researchers dealing with such data should be aware of the advantages of the newer methods.
Protocol for assessing services for people with severe mental illness
Authors: Wing John , Rix Susannah , Curtis Roy H. , Lelliott Paul , Beadsmoore Alan 
Published: October 2008

BackgroundThe Clinical Standards Advisory Group was asked by UK health ministers to advise on the standards of clinical care being achieved for people with schizophrenia. A subcommittee commissioned a review of standards, followed by research into how far these were reflected in contracts and met by providers.MethodNo comprehensive but practical set of standards was found. A protocol of 143 items of good service practice was constructed, and applied by teams visiting services in 11 UK districts. The team appraisals were summarised in 20 key points, each scored 0 (absent) to 4 (excellent performance). Seven points were used to assess standards of commissioning and 13 for standards of service provision.ResultsWhen placed into rank order, the mean key point scores for commissioners and providers in the same district tended to be very similar. Total district scores were then used to assign districts to one of three groups. Four performed reasonably well, five were moderate and two were poor.ConclusionsOne of the key elements associated with these differences was the local level of morale. After wide consultation, a revised protocol of 26 key points for direct rating was drawn up and has since been further tested.
Epidemiology of recurrent major and minor depression with a seasonal pattern
Authors: Blazer Dan G. , Kessler Ronald C. , Swartz Marvin S. 
Published: October 2008

BackgroundPrevious estimates of the prevalence of seasonal affective disorder (SAD) in community samples have been in the range 2–10%, using methods not derived from DSM algorithms. We report the first community-based study to estimate major and minor depression with a seasonal pattern in a community-based sample using a diagnostic instrument derived from DSM–III–R.MethodA modified version of the Composite International Diagnostic Interview was administered to 8098 subjects in the 48 coterminous states of the USA (the National Comorbidity Survey) to assess the prevalence of major and minor depression with a seasonal pattern.ResultsThe lifetime prevalence of major depression with a seasonal pattern was 0.4%, and the prevalence of major or minor depression with a seasonal pattern was 1.0%. Among respondents with major depression, male gender and older age were associated with a higher prevalence with a seasonal pattern.ConclusionsPrevalence estimates of major and minor depression with a seasonal pattern are much lower than those found in previous studies of SAD in the community probably due to the approach to diagnosis used in the present study which more accurately represents DSM–III–R criteria for major depression with a seasonal pattern. The distribution of the disorder is similar to that found in previous studies except for the higher prevalence among males.
Mental disorder and violence
Authors: Taylor Pamela J. , Leese Morven , Williams Deborah , Butwell Martin , Daly Rachel , Larkin Emmet 
Published: October 2008

BackgroundFrom a first clinical description of a complete resident sample of special (high security) hospital patients, we examined the association between mental disorder and violence.MethodA record survey of all 1740 patients resident at any time between 1 January and 30 June 1993. inclusive, and, for most, the official criminal record.Results1015 patients (58%) had functional psychosis, one-quarter of whom also had an independent personality disorder: 461 (26%)had personality disorders uncomplicated by psychosis, and 264 (16%) had learning disabilities. Pre-admission substance misuse, which was probably under-recorded, had been most common among those with psychosis and an independent personality disorder. Less than 10% had never been convicted of a criminal offence, although 25% had been admitted directly from other hospitals. Direct personal violence was more common among men, and fire-setting among women. Schizophrenia was most strongly associated with personal violence. More than 75% of those with a psychosis were recorded as being driven to offend by their delusions. In the absence of delusions, hallucinations had no such effect.ConclusionsFor people with personality disorder better clinical descriptions seem essential. For people with a pure psychosis, as symptoms were usually a factor driving the index offence, treatment appears as important for public safety as for personal health.
Sudden death in psychiatric patients
Authors: Ruschena David , Mullen Paul E. , Burgess Philip , Cordner Stephen , Barry-Walsh Justin , Drummer Olaf , Palmer Simon , Browne Chris , Wallace Cameron 
Published: October 2008

BackgroundThe present study investigated histories of prior psychiatric treatment in cases of sudden death reported to the coroner.MethodsA matching survey linked the register of deaths reported to the coroner with a comprehensive statewide psychiatric case register covering both inpatient and community-based services.ResultsSudden death was five times higher in people with histories of psychiatric contact. Suicide accounted for part of this excess mortality but deaths from natural causes and accidents were also elevated. Schizophrenic and affective disorders had similar suicide rates. Comorbid substance misuse doubled the risk of sudden death in affective and schizophrenic disorders.ConclusionsThe rates of sudden death are sufficiently elevated to raise questions about current priorities in mental health care. There is a need both for greater attention to suicide risk, most notably among young people with schizophrenia, to the early detection of cardiovascular disorders and to the vigorous management of comorbid substance misuse.
Long-term course of acute brief psychosis in a developing country setting
Authors: Susser Ezra , Varma Vijoy K. , Mattoo S. K. , Finnerty Molly , Mojtabai Ramin , Tripathi B. M. , Misra Arun K. , Wig N. N. 
Published: October 2008

BackgroundThis study in North India compared acute brief psychosis – defined by acute onset, brief duration and no early relapse – with other remitting psychoses, over a 12-year course and outcome.MethodIn a cohort of incident psychoses, we identified 20 cases of acute brief psychosis and a comparison group of 43 other remitting psychoses based on two-year follow-up. Seventeen people (85%) in the acute brief psychosis group and 36 (84%) in the comparison group were reassessed at five, seven and 12 years after onset, and were rediagnosed using ICD–10 criteria.ResultsAt 12-year follow-up, the proportion with remaining signs of illness was 6% (n=1) for acute brief psychosis versus 50% (n=18) for the comparison group (P=0.002). Using ICD–10 criteria, the majority in both groups were diagnosed as having schizophrenia.ConclusionsAcute brief psychosis has a distinctive and benign long-term course when compared with other remitting psychoses. This finding supports the ICD– 10 concept of a separable group of acute and transient psychotic disorders. To effectively separate this group, however, the ICD–10 criteria need modification.
Cocaine use, abuse and dependence in a population-based sample of female twins
Authors: Kendler Kenneth S. , Prescott Carol A. 
Published: October 2008

BackgroundAlthough cocaine use in women has increased substantially over the past half-century, we understand little about the aetiology in women of cocaine use and abuse, and know almost nothing about the role of genetic factors.MethodWe obtained by telephone interview a history of lifetime cocaine use, abuse and dependence from 1934 individual twins from female–female pairs ascertained through a population-based registry, including both members of 485 monozygotic (MZ) and 335 dizygotic (DZ) pairs.ResultsThe prevalence of lifetime cocaine use, abuse and dependence were 14.0%, 3.3% and 2.3%. Probandwise concordance rates, in MZ and DZ twins, respectively, were: cocaine use 54% and 42%; cocaine abuse 47% and 8% and cocaine dependence 35% and 0%. In MZ and DZ twins, odds ratios were: cocaine use 14.2 and 6.7 and cocaine abuse 40.8 and 2.7. Biometrical model-fitting suggested that twin resemblance for liability to cocaine use was due to both genetic and familial–environmental factors while twin resemblance for cocaine abuse and symptoms of dependence was due solely to genetic factors. Estimated heritabilities were: cocaine use 0.39, cocaine abuse 0.79 and symptoms of dependence 0.65.ConclusionsThe vulnerability to cocaine use and particularly cocaine abuse and dependence in women is substantially influenced by genetic factors.
From efficacy to effectiveness in community mental health services
Authors: Thornicroft Graham , Wykes Til , Holloway Frank , Johnson Sonia , Szmuckler George 
Published: October 2008

BackgroundThe PRiSM Psychosis Study investigated the outcomes of community mental health services for epidemiologically representative cases of psychosis in London.MethodThe results presented in the preceding nine papers are interpreted.Results(a) The health and social gains reported in experimental studies of community health services are replicable in ordinary clinical settings, and are more effective than hospital-oriented services which they replace, (b) Dilution does occur - these gains are less pronounced than in experimental (efficacy) studies, (c) Both models of community services produced a range of improved outcomes, (d) Some limited extra advantages (in terms of met needs, improved quality of life, and social networks) were found in the intensive sector, (e) There is no consistent evidence that community-oriented services (which include in-patient beds) fail service users, their families or the wider public. On balance the results weigh slightly in favour of the two-team model (for acute and continuing care) in terms of clinical effectiveness, but the general model is almost as effective and is less expensive.ConclusionsThe evidence supports a community-oriented rather than a hospital-oriented approach and there is little difference between the community mental health team models.
Chronic mania
Authors: Perugi Giulio , Akiskal Hagop S. , Rossi Luciano , Paiano Antonic , Quilici Cinzia , Madaro Donato , Musetti Laura , Cassano Giovanni B. 
Published: October 2008

BackgroundMania with chronic course has been overlooked in the recent literature. Our aim was clinically to characterise and validate this form of mania.MethodWe evaluated 155 people with DSM–III–R mania and assessed their family history, temperament, symptomatology and course. We used a semi-structured interview for mood disorders, as well as the Comprehensive Psychopathological Rating Scale and the Scale for the Assessment of Positive Symptoms.ResultsTwenty (13%) had a chronic course arising from a background of hyperthymic temperament and recurrent mania, with a deteriorative pattern. Clinically, they were characterised by a significantly high rate of almost constant euphoria, grandiose delusions and related delusions, but had relatively low rates of sleep disturbance, psychomotor agitation and hypersexuality.ConclusionEven with current therapies a significant number of people with bipolar disorders have a deteriorative outcome associated with the gradual disappearance of acute mania with an increase in mregalomanic delusions, alienation from loved ones and decreased likelihood of medical and psychiatric care.
Consensus criteria for traumatic grief
Authors: Prigerson Holly G. , Shear M. Katherine , Jacobs Selby C. , Reynolds Charles F. , Maciejewski Paul K. , Davidson Jonathan R. T. , Rosenheck Robert , Pilkonis Paul A. , Wortman Camille B. , Williams Janet B. W. , Widiger Thomas A. , Frank Ellen , Kupfer David J. , Zisook Sidney 
Published: October 2008

BackgroundStudies suggest that symptoms of traumatic grief constitute a distinct syndrome worthy of diagnosis.AimsA consensus conference aimed to develop and test a criteria set for traumatic grief.MethodThe expert panel proposed consensus criteria for traumatic grief. Receiver operator characteristic (ROC) analyses tested the performance of the proposed criteria on 306 widowed respondents at seven months post-loss.ResultsROC analyses indicated that three of four separation distress symptoms (e.g. yearning, searching, loneliness) had to be endorsed as at least ‘sometimes true’ and four of the final eight traumatic distress symptoms (e.g. numbness, disbelief, distrust, anger, sense of futility about the future) had to be endorsed as at least ‘mostly true’ to yield a sensitivity of 0.93 and a specificity of 0.93 for a diagnosis of traumatic grief.ConclusionsPreliminary analyses suggest the consensus criteria for traumatic grief have satisfactory operating characteristics, and point to directions for further refinement of the criteria set.
Cantabria First-Episode Schizophrenia Study: three-year follow-up
Authors: Vázquez-Barquero José L. , Cuesta Maria J. , Castanedo Sara Herrera , Lastra Ismael , Herrán Andrés , Dunn Graham 
Published: October 2008

BackgroundWe present the findings from the three-year follow-up of all first episodes of schizophrenia occurring during a two-year period in Cantabria (in Spain).Aims(a) To describe the clinical characteristics of the illness from the early stages of the disease, and (b) to study the long-term psychosocial adjustment and psychopathological evolution of these patients, identifying predictors for the course of the illness.MethodOf the original cohort of 86 patients, 76 (88.3%) were fully evaluated at three-year follow-up. Psychiatric assessment was performed (PSE–9 and SANS/SAPS). Social adjustment was evaluated using the Disability Assessment Schedule (DAS). Information regarding the clinical evolution and use of health resources was also gathered.ResultsThe majority of patients with a first-contact diagnosis of schizophrenia failed to meet the criteria for a CATEGO diagnosis at follow-up. The SANS/SAPS assessments revealed a doubling in the proportion of patients with ‘negative schizophrenia’. The pattern of clinical course was also evaluated, with 24 (31.5%) of the patients having a good outcome. Being male and having low social class tended to be associated with poor clinical outcome.ConclusionsThe outcome of schizophrenia is less pessimistic than was originally thought.
Befriending as an intervention for chronic depression among women in an inner city
Authors: Harris Tirril , Brown George W , Robinson Ruth 
Published: October 2008

BackgroundVolunteer befriending promoted remission of chronic depression when clinical and other treatment variables were controlled.AimsTo examine the role of other psychosocial factors relevant for outcome.MethodFactors measured at baseline interview were examined in multivariate analyses along with psychosocial factors occurring during follow-up, such as ‘fresh-start’ experiences and new severe events and difficulties.ResultsFresh-start experiences and a standard attachment style were found to enhance chances of remission, with new severe stressors and markedly poor coping strategies liable to prevent it, with volunteer befriending continuing to play a role.ConclusionsThe positive result reported in the preceding paper is unlikely to be an artefact. However, fresh-start experiences, absence of new severe stressors and standard attachment style were more important predictors of remission. This knowledge might profitably be incorporated into the evaluation of existing treatments.
Serious sex offending against women by men with schizophrenia
Authors: Smith Alan D. , Taylor Pamela J. 
Published: October 2008

BackgroundLittle is known about men who commit sex offences in the context of psychosis.AimsTo examine the relationship of illness and psychotic symptoms to sex offending in men with schizophrenia.MethodA search of Home Office records was completed for all 84 male restricted hospital order in-patients with schizophrenia, resident in any hospital in England and Wales during May 1997, with an index conviction for a contact sex offence against a woman.ResultsAt the time of their index offences 80 men were psychotic and half of them had delusions or hallucinations related to the offences. Specific delusional or hallucinatory drive was pertinent in only 18 men but the majority of men committed their first sex offence after onset of schizophrenia. Exclusive sex offending was uncommon.ConclusionsWhen a man with schizophrenia commits a serious sex offence the illness is, more commonly than not, relevant to that offence even though a direct symptom relationship may be relatively unusual.
Diagnostic significance of Schneider's first-rank symptoms in schizophrenia
Authors: Peralta Victor , Cuesta Manuel J. 
Published: October 2008

BackgroundDespite the lack of consistent empirical support, modern diagnostic criteria of schizophrenia give particular emphasis to Schneider's first-rank symptoms (FRSs).AimsTo examine the diagnostic significance of FRSs for schizophrenia by trying to overcome the limitations of previous studies.MethodsThis study examined the diagnostic accuracy of FRSs for schizophrenia in 660 in-patients with the full spectrum of functional psychotic disorders. Schizophrenia was diagnosed according to three criteria: DSM–III–R broad, DSM–III–R narrow and Feighner, the latter being considered as the gold standard because it does not give particular emphasis to FRSs.ResultsFRSs were highly prevalent in both schizophrenia and non-schizophrenic psychoses. The likelihood ratios (and 95% Cl) of one or more FRSs for Feighner, DSM–III–R narrow and DSM–III–R broad schizophrenia were 1.06 (0.94–1.20), 1.23 (1.09–1.39) and 1.73 (1.44–2.08), respectively. These data indicate that FRSs do not significantly increase the likelihood of having schizophrenia.ConclusionsFRSs are not useful in differentiating schizophrenia from other psychotic disorders. Diagnostic systems for schizophrenia that are heavily based on these symptoms may arise from a tautological definition of the disorder.
Motor seizure monitoring during electroconvulsive therapy
Authors: Mayur Prashanth M. , Gangadhar B. N. , Janakiramaiah N. , Subbakrishna D. K. 
Published: October 2008

BackgroundThe occurrence of a seizure during electroconvulsive therapy (ECT) should be confirmed. Most clinicians use motor seizure monitoring alone and recent guidelines have not considered electroencephalogram (EEG) monitoring mandatory.AimsTo examine the potential pitfalls of motor seizure monitoring.MethodConsenting consecutive patients (n=232) were prospectively studied at the first ECT session using both motor and EEG seizure monitoring. It was ensured (by titration) that all the patients had an adequate EEG seizure. Adequate and prolonged seizures were defined according to the latest recommendations of the Royal College of Psychiatrists.ResultsMotor seizure was inadequate in 15 (7%) of patients. EEG seizure was prolonged in 38 (16%) of patients. Fifteen patients (39%) did not have a prolonged motor seizure. Motor seizure correlated well (r=0.8, P < 0.001) with EEG seizure when the latter was adequate, but not when prolonged (r=0.12, P > 0.5).ConclusionsMotor seizure monitoring without EEG is undependable. The study provides a rational basis for the Royal College of Psychiatrists' definition of prolonged EEG seizure.
‘Subthreshold’ mental disorders
Authors: Pincus Harold Alan , Davis Wendy Wakefield , McQueen Laurie E. 
Published: October 2008

BackgroundSubthreshold conditions (i. e. not meeting full diagnostic criteria for mental disorders in DSM–IV or ICD–10) are prevalent and associated with significant costs and disability. Observed more in primary care and community populations than in speciality settings, varying conceptualisations have been applied to define these conditions.AimsTo examine definitional issues for subthreshold forms of depression (e. g. minor depression) and to suggest future directions for research and nosology in psychiatry and primary care.MethodA Medline search was conducted. The relevant articles were reviewed with regard to specific categories of information.ResultsStudies applied a myriad of names and definitions for subthreshold depression with varying duration, symptom thresholds and exclusions. Prevalence rates also vary depending upon the definitions, settings and populations researched.ConclusionsFuture research needs to apply methodological and intellectual rigour and systematically consider a broader clinical and nosological context. In addition, collaboration between psychiatry and primary care on research and clinical issues is needed.
Routine clinical outcome measures for patients with severe mental illness: CANSAS and HoNOS
Authors: Slade Mike , Beck Andrew , Bindman Jonathan , Thornicroft Graham , Wright Steve 
Published: October 2008

BackgroundTwo recently developed measures intended for clinical use are HoNOS (Health of the Nation Outcome Scales), measuring social functioning, and CANSAS (Camberwell Assessment of Need Short Appraisal Schedule), for measuring need.AimsWe investigated the association between CANSAS and HoNOS.ResultsFor some domains there were substantial associations, with high HoNOS rating correlated with CANSAS rating of the presence of a need. For other areas the agreement was less than might be expected. Seven factors were identified within the 22 CANSAS domains, and the presence of needs in the Drug/alcohol and Activities of daily living factors was associated with high scores in the related HoNOS domains.ConclusionsCANSAS and HoNOS assessments differ. HoNOS can track changes in social functioning over time, but may be less useful for treatment planning, and should not be used to infer the level of morbidity in a case-load. CANSAS indicates when treatment should be commenced or continued. It can also be used as a case-load measure, but may be insufficiently sensitive to be used as an outcome measure at the individual level.
Reduction of the parahippocampal gyrus and the hippocampus in patients with chronic schizophrenia
Authors: Razi Kamran , Greene Kimberly P. , Sakuma Michael , Ge Shuming , Kushner Maureen , Delisi Lynn E. 
Published: October 2008

BackgroundThere have been many studies reporting reduced volume of the hippocampus or other limbic structures in patients with schizophrenia, but the literature is inconsistent.AimsTo compare patients with either first-episode or chronic schizophrenia with controls using high-resolution volumetric magnetic resonance imaging (MRI) scans.MethodThirteen patients with first-episode schizophrenia, 27 with chronic schizophrenia and 31 controls had 1.5 mm coronal slices taken through the whole brain using a spoiled-grass MRI acquisition protocol.ResultsThe parahippocampal gyrus was reduced significantly on the left side in patients with chronic schizophrenia compared with controls for both male and female patients, whereas the hippocampus was reduced significantly on both sides only in female patients. There were no significant reductions in any structure between patients with first-episode schizophrenia and controls.ConclusionsVolumetric reduction seen in patients with chronic schizophrenia may be due to an active degenerative process occurring after the onset of illness.