bluuebunny/crossref_metadata_2025_split huggingface dataset:
Prolactin response to d-fenfluramine is blunted in people with anorexia nervosa
Authors: Monteleone Palmiero , Brambilla Francesca , Bortolotti Francesca , La Rocca Antonietta , Maj Mario 
Published: October 2008

BackgroundSeveral studies have explored serotonin (5-HT) transmission in people with anorexia nervosa, but their results have been inconsistent.MethodAccording to a double-blind placebo-controlled design, plasma prolactin response to the specific serotonergic probe d-fenfluramine was investigated in 10 underweight and two normal-weight women with anorexia, and in 12 age-matched healthy females. Eating-related psychopathology, depressive and obsessive-compulsive symptoms, and aggressiveness were measured by appropriate rating scales.ResultsCompared with healthy control subjects, the women with anorexia showed reduced baseline prolactin and oestrogen levels and increased basal Cortisol concentrations. The prolactin response to d-fenfluramine was blunted and did not correlate with psychopathological measures.ConclusionsThese results support a dysfunction of 5-HT transmission in anorexia nervosa. This dysfunction does not seem to be related to concomitant depressive or obsessive-compulsive symptoms or to the level of aggressiveness of the patients.
Serotonin and panic
Authors: Bell C. J. , Nutt D. J. 
Published: October 2008

BackgroundTricyclic (TCA) and monoamine oxidase inhibitor (MAOI) antidepressants are effective in the treatment of panic disorder. Two selective serotonin reuptake inhibitors (SSRIs) have also been licensed in the UK for this indication and studies with three other SSRIs have recently been completed. These provide further evidence for the role of serotonin in panic.MethodReview of clinical, animal and laboratory studies.ResultsSSRIs have been shown to be effective in the treatment of panic disorder. The reported rates of improvement of 60–70% of patients taking SSRIs are similar to those seen withTCAs and greater than placebo. Other serotonergic agents do not appear to be effective. Animal work and human studies including measures of 5-HT in plasma, cerebrospinal fluid and platelets, challenge paradigms and tryptophan depletion show that the relationship between 5-HT and anxiety is complex.ConclusionClinical trials have shown that of all the serotonergic agents only the SSRIs are effective in panic disorder. They are as beneficial as the TCAs and seem to be better tolerated which may be particularly significant in view of the chronic nature of the condition. Serotonin plays a role in panic disorder and serotonergic dysfunction, however the results and evidence do not fit one theory alone. It is also likely that different brain regions and 5-HTreceptors are involved in specific ways.
Cortical grey matter reductions associated with treatment-resistant chronic unipolar depression
Authors: Shah Premal J. , Ebmeier Klaus P. , Glabus Michael F. , Goodwin Guy M. 
Published: October 2008

BackgroundThe aetiology of treatment-resistant major depression is little understood; its apparent intractability may reflect brain abnormality.MethodMagnetic resonance images of the brains of 20 subjects with major depression lasting for two years or more were compared with 20 healthy control subjects and 20 other subjects who had completely recovered from depression. Subjects were individually matched for age, gender, years of education and premorbid IQ. Grey matter was segmented from the images, and compared between groups on a voxel-by-voxel basis.ResultsSubjects with chronic depression showed reduced grey matter density in the left temporal cortex including the hippocampus. There was also a trend for reduction in the right hippocampus. Left hippocampal grey matter density was correlated with measures of verbal memory, supporting the functional significance of the observed magnetic resonance imaging changes.ConclusionsOur results potentially challenge the accepted view of depression as a functional and fully reversible illness, implying instead that more permanent brain changes may be associated with chronicity. Confirmatory longitudinal and prospective studies are required to determine whether these differences pre-date the onset of depression or are the result of the chronic illness process or its treatment.
Poverty, psychological disorder and disability in primary care attenders in Goa, India
Authors: Patel Vikram , Pereira Jerson , Countinho Livia , Fernandes Romaldina , Fernandes John , Mann Antony 
Published: October 2008

BackgroundThis study examined the association of common mental disorders in primary health clinic attenders with indicators of poverty and disability in Goa, India.MethodAdult attenders (n=303) in two primary health clinics were recruited.ResultsThere were 141 (46.5%) cases of common mental disorder. The following were associated with common mental disorder: female gender; inability to buy food due to lack of money; and being in debt. Cases scored significantly higher on all measures of disability. Primary health clinic staff recognised a third of the morbidity but used multiple oral drugs, injectable vitamins and benzodiazepines to treat common mental disorders.ConclusionsPoverty is closely associated with common mental disorder which in turn is associated with deprivation and despair. Primary mental health care priorities in low-income countries need to shift from psychotic disorders which often need specialist care to common mental disorders. Health policy and development agencies need to acknowledge the intimate association of female gender and poverty with these disorders.
British psychiatric morbidity survey
Authors: Jenkins Rachel , Bebbington Paul , Brugha Traolach S. , Farrell Mike , Lewis Glyn , Meltzer Howard 
Published: October 2008

There is mounting evidence of the massive global health burden of mental illness (Murray & Lopez, 1996; Jenkins, 1997). Within Great Britain, the Department of Health's overall objectives for mental illness were summarised as follows (Department of Health, 1993):(a) To reduce the incidence and prevalence of mental disorders.(b) To reduce the mortality associated with mental disorders.(c) To reduce the extent and severity of other problems associated with mental disorders, for example:(i) poor physical health;(ii) impaired social functioning;(iii) poor social circumstances;(iv) family burden.(d) To ensure appropriate services and interventions are provided.(e) To reverse the public's negative perception of mental illness, for example:(i) counter fear, ignorance and stigma;(ii) create a more positive social climate in which to seek help;(iii) improve quality of life for people with mental health problems.(f) To research causes, consequences and care of specific mental disorders.
Sertraline in the treatment of panic disorder
Authors: Londborg Peter D. , Wolkow Robert , Smith Ward T. , Duboff Eugene , England Donald , Ferguson James , Rosenthal Murray , Weise Charles 
Published: October 2008

BackgroundThis study compared the efficacy and safety of sertraline to placebo in treating panic disorder.Method178 out-patients with panic disorder who exhibited at least four panic attacks during the four weeks prior to screening and three during the two weeks of lead-in were randomly assigned to 12 weeks of double-blind treatment with sertraline (50, 100 or 200 mg) or placebo.ResultsSertraline was superior to placebo in reducing the number of panic attacks, situational attacks, unexpected attacks, limited symptom attacks, and time spent worrying (all P < 0.01) and the Hamilton Anxiety Scale (P < 0.05), although Clinical Global Impression (Improvement) did not significantly differentiate groups at 12 weeks and at end-point. No serious adverse events were associated with sertraline. No dose relationship was found for adverse events; overall drop-out rates were not different for sertraline or placebo, although more sertraline-treated subjects discontinued for adverse events, typically early in the study. Only dry mouth and ejaculation failure (primarily ejaculation delay) were associated significantly with sertraline. Conclusions Sertraline was effective and safe in reducing panic attacks. Higher doses were no more effective than the 50 mg dose.
SPET study of verbal fluency in schizophrenia and epilepsy
Authors: Mellers John D. C. , Adachi Naoto , Takei Noriyoshi , Cluckie Alice , Toone Brian K. , Lishman W. Alwyn 
Published: October 2008

BackgroundThe association between temporal lobe epilepsy and schizophrenia suggests that the critical abnormality may be pathology within the temporal lobes. People with schizophrenia-like psychosis of epilepsy (SLPE) provide a useful group in which to examine the importance of temporal and frontal lobe dysfunction in schizophrenia.MethodA verbal fluency activation paradigm and a 99mTc HMPAO SPET were used to study frontotemporal function in people with SLPE (n = 12), schizophrenia (n = 11) and epilepsy (n = 16).ResultsPeople with SLPE differed from both other groups by showing lower blood flow in the left superior temporal gyrus during performance of a verbal fluency task compared with a word repetition task (F=5.4, P=0.01). During the verbal fluency task people with primary schizophrenia showed a greater increase in blood flow in anterior cingulate (F=4.5, P=0.02) than the other two groups. There were no between-group differences in frontal brain regions.ConclusionOur findings support an association between left temporal lobe abnormality and SLPE. The different patterns of activation observed in people with primary schizophrenia and SLPE suggests that different pathophysiological mechanisms may operate in these two groups. In SLPE the pathophysiology may be relatively confined to the dominant temporal lobe.
Predictors of a healthy workplace for Swedish and English psychiatrists
Authors: Thomsen Sarah , Dallender Janie , Soares Joaquim , Nolan Peter , Arnetz Bengt 
Published: October 2008

BackgroundFew studies have attempted to analyse the organisational aspects of the workplace that may affect the well-being of psychiatrists and even fewer have offered insights into what a positive workplace might look like. This study provides an outline of such a workplace, with reference to individual and organisational factors. In addition, a comparison is made between two European cities to check for cultural differences.MethodThree hundred and eighty psychiatrists from Stockholm and Birmingham responded to a previously tested questionnaire on their work environment.ResultsPredictors of a positive workplace for psychiatrists were: high self-esteem, satisfactory support with work-related problems, lower perceived workload, positive view of leadership, low work-related exhaustion and having a sense of participation in the organisation. There were few cultural differences.ConclusionsMeasures should be taken to improve leadership skills for managers, to offer more support for work-related problems, and to allow psychiatrists to participate more in the organisation.
Reduced levels of GABA-benzodiazepine receptor in alcohol dependency in the absence of grey matter atrophy
Authors: Lingford-Hughes Anne R. , Acton P. , Gacinovic S. , Suckling J. , Busatto G. F. , Boddington S. J. A. , Bullmore E. , Woodruff P. W. , Costa D. C. , Pilowsky L. S. , Ell P. J. , Marshall E. J. , Kerwin R. W. 
Published: October 2008

BackgroundWe tested the hypothesis that reduced levels of the GABA-benzodiazepine receptor occur in alcohol dependency using single photon emission tomography (SPET) and the specific GABA-benzodiazepine ligand, 123l-iomazenil.MethodNeurologically and cognitively unimpaired abstinent alcohol-dependent (n=12) and non-alcohol-dependent male subjects (n=14) underwent a 123l–iomazenil SPET scan. SPET and magnetic resonance images were co-registered and voxel-based statistical tests performed. Subjects' clinical and alcohol history were obtained with standard questionnaires. The relationships between clinical and alcohol variables and the regional level of GABA-benzodiazepine receptors were investigated using multiple regression analysis.ResultsAbstinent alcohol-dependent subjects had decreased levels of GABA-benzodiazepine receptor compared with non-alcohol-dependent subjects within the frontal, parietal and temporal cortices, including regions in which grey matter atrophy was absent.ConclusionsAlcohol dependency is associated with reduced GABA-benzodiazepine receptor levels in the absence of grey matter atrophy in some cortical regions, such as within the parietal lobe. Regional variability of reduction in GABA-benzodiazepine receptors demonstrates that alcohol does not have a global, toxic effect on the brain.
People with schizophrenia and their families
Authors: Brown Steve , Birtwistle Jon 
Published: October 2008

BackgroundThis paper presents 15-year outcome data on place of residence, clinical and social morbidity and carer distress in a cohort of 179 people with schizophrenia who were living with their families in 1981–1982MethodData on morbidity and carer distress were derived from replicated patient and informant interviews using standardised research instruments. Details of residence came from patient and informant interviews corroborated by case note information.ResultsThirty-nine (22%) of the original 179 patients were dead and six (3%) lost to follow-up. Of the remaining 134 patients, 74 (55%) still lived with their families, 31 (23%) lived in institutional accommodation, 26 (19%) lived alone and 3 (2%) were homeless. There was little change in the level of clinical or social morbidity or carer distress.ConclusionsThese findings suggest that most people with schizophrenia who live with their families remain significantly disabled by their illness, while their carers suffer ongoing distress. Mental health services should seek to support families who want to care for relatives with schizophrenia. Appropriate alternative accommodation must be provided when family care is not possible.
Limitations of the symptom-oriented approach to psychiatric research
Authors: Mojtabai Ramin , Rieder Ronald O. 
Published: October 2008

BackgroundWe critically reviewed the arguments of the symptom-oriented researchers who propose to replace syndromes and diagnostic categories with symptoms as units of analysis in psychiatric research.MethodThree central arguments were examined: (a) current diagnostic categories lack reliability and validity; (b) using diagnostic categories leads to misclassification and confounding; and (c) symptom-oriented theories are clearer, easier to test, and more likely to lead to an explanation of psychopathology. These arguments are based on three assumptions respectively: (a) symptoms have higher reliability and validity; (b) underlying pathological processes are symptom-specific; and (c) elucidation of the process of symptom development will lead to (and must precede) the discovery of the causes of syndromes.ResultsWe found little evidence supporting these assumptions and arguments based on them.ConclusionThere are no clear advantages in replacing syndromes with symptoms as units of analysis for psychiatric research.
Pathophysiology of ‘positive’ thought disorder in schizophrenia
Authors: McGuire Philip , Quested Digby , Spence Sean , Murray Robin , Frith Christopher , Liddle Peter 
Published: October 2008

BackgroundFormal thought disorder is a characteristic feature of psychosis, but little is known of its pathophysiology. We have investigated this in schizophrenia using positron emission tomography (PET).MethodRegional cerebral blood flow was measured using H215O and PET while six people with schizophrenia were describing a series of 12 ambiguous pictures which elicited different degrees of thought-disordered speech. In a within-subject design, the severity of positive thought disorder was correlated with cerebral blood flow across the 12 scans in each subject.ResultsVerbal disorganisation (‘positive’ thought disorder) was inversely correlated with activity in the inferior frontal, cingulate and left superior temporal cortex, and positively correlated with activity in the parahippocampal/anterior fusiform region bilaterally, and in the body of the right caudate (P<0.001). The total amount of speech produced (independent of thought disorder) was positively correlated with activity in the left inferior frontal and left superior temporal cortex.ConclusionsThe severity of positive thought disorder was inversely correlated with activity in areas implicated in the regulation and monitoring of speech production. Reduced activity in these regions may contribute to the articulation of the linguistic anomalies that characterise positive thought disorder. The positive correlations between positive thought disorder and parahippocampal/anterior fusiform activity may reflect this regions role in the processing of linguistic anomalies.
Placebo run-in period in studies of depressive disorders
Authors: Quitkin Frederic M. , McGrath Patrick J. , Stewart Jonathan W. , Ocepek-Welikson Katja , Taylor Bonnie P. , Nunes Edward , Delivannides Deborah , Agosti Vito , Donovan Steven J. , Ross Donald , Petkova Eva , Klein Donald F. 
Published: October 2008

BackgroundIn spite of the virtually ubiquitous nature of the initial 10-day placebo run-in period (IPR) in drug trials, there is little empirical data establishing its relevance.MethodData from 593 subjects were examined retrospectively to determine whether or not the prognosis of subjects minimally improved during the IPR was different to those who were unimproved. The IPR period was single-blind and was followed by a six-week double-blind phase in all studies.ResultsTwenty-six per cent of the subjects were minimally improved and 74% were unimproved. Approximately 10% of the subjects who were much improved were not followed systematically. Across a range of diagnosis, severity and chronicity subjects minimally improved (versus unimproved) after IPR had a more favourable prognosis whether assigned to drug or placebo.ConclusionsChange during IPR appears to be a meaningful predictor. Stratification should be considered in future antidepressant studies.
Nuclear schizophrenic symptoms as a window on the relationship between thought and speech
Authors: Crow Tim J. 
Published: October 2008

BackgroundSymptoms of schizophrenia known as nuclear’ or ‘first-rank’ are found in all populations. The genetic variation that gives rise to them must be as old as modern Homo sapiens.MethodThe hypothesis was formulated that language evolved, under constraints on callosal transmission, by a process of hemispheric specialisation. One component, the phonological output sequence, became localised to the dominant hemisphere whereas its associations (the signifieds) were lateralised in part to the non-dominant hemisphere. Concepts (‘thoughts’) are translated through a bi-hemispheric interaction into phonemes (‘speech’) by the speaker in frontal association areas, and decoded back into concepts (‘meanings’) by the hearer in occipito-temporo-parietal association areas.ResultsThe first-rank symptoms demonstrate that an integral component is a system of ‘indexicality’ that distinguishes those phonemic signals generated by the hearer, from his own thoughts, and from signals that he receives from an interlocutor.ConclusionsLanguage, as Buehler proposed, is cast in a coordinate system orientated at its origin, in the dominant hemisphere, to the self of the speaker. Thus conceived, the phenomena of the illness called schizophrenia are key to the neural organisation of the human characteristic of language.
Antecedents of suicide in people with schizophrenia
Authors: Heilä Hannele , Isometsä Erkki T. , Henriksson Markus M. , Heikkinen Marti E. , Marttunen Mauri J. , Lönnqvist Jouko K. 
Published: October 2008

BackgroundSuicides among people with schizophrenia are commonly believed to be impulsive and to occur unexpectedly.MethodAs part of the National Suicide Prevention Project in Finland, a nationwide psychological autopsy study, suicide victims with DSM-III-R schizophrenia (n=86; n=64 in the active illness phase) and others (n=1 109; n=666 without any evidence for psychosis) were compared for communication of suicidal intent (CSI), as well as previous suicide attempts known by the next of kin and/or an attending health care professional during the latest treatment relationship.ResultsMore victims with schizophrenia (84%) had a history of previous CSI, and/or had made previous suicide attempt(s) than others (70%). Also, victims with active illness schizophrenia (56%) had more CSI and/or had made suicide attempts during their last three months than victims with no psychosis (41%).ConclusionsCSI and/or suicide attempts occur at least as often in people with schizophrenia as in those without schizophrenia, even in the active phase of the illness.
Extent and appropriateness of benzodiazepine use
Authors: Taylor S. , McCracken C. F. M. , Wilson K. C M. , Copeland J. R. M. 
Published: October 2008

BackgroundWe sought to determine the extent and appropriateness of benzodiazepine use in an elderly community, by measuring prevalence and incidence of benzodiazepines and examining mental health status as a predictor of benzodiazepine use.MethodData were collected from two longitudinal studies of people from the same community, sampled in 1982–1983 and again in 1989–1991.ResultsBenzodiazepine prevalence did not decrease during the period under study, but there was a significant reduction in anxiolytic use. Prevalence of benzodiazepines in women is twice that in men, and incidence of hypnotics is slightly higher in women. Prevalence and incidence of hypnotics are strongly associated with increasing age. There were high proportions of long-term users (61 and 70%), and continued use was high (52%) among new users. A large proportion of benzodiazepine use was by those who were concurrently depressed. Similarly, anxiety predicted both current and subsequent use of hypnotics.ConclusionsMany older people still use benzodiazepines, contrary to official guidelines with regard to their mental health. Our findings add to the weight of opinion that persistent and long-term use should be discouraged.
Suicide and recency of health care contacts
Authors: Pirkis Jane , Burgess Philip 
Published: October 2008

BackgroundMany countries have set targets for suicide reduction, and suggested that mental health care providers and general practitioners have a key role to play.MethodA systematic review of the literature.ResultsAmong those in the general population who commit suicide, up to 41% may have contact with psychiatric inpatient care in the year prior to death and up to 9% may commit suicide within one day of discharge. The corresponding figures are 11 and 4% for community-based psychiatric care and 83 and 20% for general practitioners.ConclusionsAmong those who die by suicide, contact with health services is common before death. This is a necessary but not sufficient condition for clinicians to intervene. More work is needed to determine whether these people show characteristic patterns of care and/or particular risk factors which would enable a targeted approach to be developed to assist clinicians in detecting and managing high-risk patients.