bluuebunny/crossref_metadata_2025_split huggingface dataset:
The Clinical Characteristics of Major Depression as Indices of the Familial Risk to Illness
Authors: Kendler Kenneth S. , Neale Michael C. , Kessler Ronald C. , Heath Andrew C. , Eaves Lindon J. 
Published: October 2008

BackgroundFrom both a clinical and an aetiological perspective, major depression (MD) is probably a heterogeneous condition. We attempt to relate these two domains.MethodWe examined which of an extensive series of clinical characteristics in 646 female twins from a population-based register with a lifetime diagnosis of MD predicts the risk for MD in co-twins. MD was defined by DSM–III–R criteria.ResultsFour variables uniquely predicted an increased risk for MD in the co-twin: number of episodes, degree of impairment and co-morbidity with panic disorder or bulimia. One variable uniquely predicted decreased risk: co-morbidity with phobia. Variables that did not uniquely predict risk of MD in the co-twin included age at onset, number and kind of depressive symptoms, treatment seeking, duration of the longest episode and co-morbidity with generalised anxiety disorder and alcohol dependence.ConclusionsOur results suggest that the clinical features of MD can be meaningfully related to the familial vulnerability to illness, particularly with respect to recurrence, impairment and patterns of co-morbidity.
Safety and Side-effects of Alprazolam Controlled Study in Agoraphobia with Panic Disorder
Authors: O'Sullivan G. H. , Noshirvani H. , Basoglu M. , Marks I. M. , Swinson R. , Kuch K. , Kirby M. 
Published: October 2008

BackgroundThe widespread use of benzodiazepines has led to increasing recognition of their unwanted effects. The efficacy of alprazolam and placebo in panic disorder with agoraphobia, and the side-effect and adverse effect profiles of both drug groups were measured.MethodIn London and Toronto 154 patients who met DSM–III criteria for panic disorder with agoraphobia were randomised to alprazolam or placebo. Subjects in each drug group also received either exposure or relaxation. Treatment was from weeks 0 to 8 and was then tapered from weeks 8 to 16.ResultsMean alprazolam dose was 5 mg daily. Compared with placebo subjects, alprazolam patients developed more adverse reactions (21 % v. 0%) of depression, enuresis, disinhibition and aggression; and more side-effects, particularly sedation, irritability, impaired memory, weight loss and ataxia. Side-effects tended to diminish during treatment but remained significant at week 8. Despite this, the drop-out rate was low.ConclusionsAlprazolam caused side-effects and adverse effects during treatment but many patients were willing to accept these.
Service use and Costs of Home-Based Versus Hospital-Based Care for People with Serious Mental Illness
Authors: Knapp M. , Beecham J. , Koutsogeorgopoulou V. , Hallam A. , Fenyo A. , Marks I. M. , Connolly J. , Audini B. , Muijen M. 
Published: October 2008

Background.The Daily Living Programme (DLP) offered problem-oriented, home-based care for people aged 17–64 with severe mental illness facing emergency admission to the Bethlem–Maudsley Hospital. The multidisciplinary DLP team acted as direct provider and link with other services. Each patient had a key worker. Cost-effectiveness was assessed.Method.The comprehensive costs of DLP and standard in-patient care were compared within a randomised controlled trial. Cost measures ranged over all service inputs and living expenses. The costs of informal care and lost employment were also considered. Assessments of service use, costs and outcomes were conducted at referral, 4, 11 and 20 months.Results.The DLP was significantly less costly than standard treatment in both short and medium term (P = 0.000). Cost savings accrued almost exclusively to the NHS, with no other agency's costs being higher.Conclusions.Coupled with mildly encouraging outcome results over the 20 month period, the DLP was clearly cost-effective in this medium term.
The South London Somatisation Study
Authors: Craig T. K. J. , Drake H. , Mills K. , Boardman A. P. 
Published: October 2008

Background.A study of the influence of life-event stress on the onset and course of acute somatisation in primary care.Method.Forty-four somatisers were compared with 11 subjects who had psychiatric disorder but complained only of psychological symptoms, 39 patients who had ‘mixed’ conditions involving independent physical and psychiatric illness, 90 patients who had physical illness, and 123 healthy members of the general population.Results.Severely threatening life events were more common among all subjects with psychiatric disorder. A novel contextual rating of the potential of stressors to produce symptoms for ‘secondary gain’ was developed. In the 38 weeks before symptom onset, somatisers and psychologisers were more likely to have experienced at least one event which had this potential. Somatisers were also less likely to adopt neutralising coping efforts when faced with such a crisis.Conclusions.The likelihood of adopting neutralising efforts was closely related to the presence of a joint index of parental problems in care and exposure to physical illness in the subject's childhood. In a two-year follow-up, subsequent functional illnesses were also associated with experiences which had secondary-gain potential, and subjects with childhood risk factors continued to have higher rates of crises with secondary-gain potential and to fail to adopt neutralising coping strategies.
Merycism or Rumination Disorder
Authors: Parry-Jones Brenda 
Published: October 2008

BackgroundIn the ‘fashionable’ field of eating disorders, there has been a notable gap in the historiography of rumination, allowing considerable scope for constructing a comprehensive historical profile of this disorder.MethodA wide-ranging examination of printed material, both etymological and medical, backed by a Medline computer search, uncovered extensive sources, some of considerable rarity, including case reports from the early 17th century onwards. Extracted data focused on incidence, sex distribution, age range, outcome and causation, and the findings are discussed in relation to diagnostic criteria in DSM–III–R and ICD–10.ResultsWhile confirming the frequency of rumination in infants and the mentally retarded, the study demonstrated, particularly, the need to recognise its occurrence in normal adults, occasionally as a collateral behaviour in anorexia and bulimia nervosa, and suggested that its prevalence, distorted by secrecy, exceeded estimated levels.ConclusionsIn future reviews of classification, existing anomalies and inadequacies in the status and description of rumination would benefit from integrating some of the historical conclusions.
Depression in Parkinson's Disease
Authors: Ring H. A. , Bench C. J. , Trimble M. R. , Brooks D. J. , Frackowiak R. S. J. , Dolan R. J. 
Published: October 2008

BackgroundThis study investigated biological correlates of depression in patients with idiopathic Parkinson's disease (PD). We tested the hypothesis that in patients with PD and depression, there was regional dysfunction involving brain areas previously implicated in functional imaging studies of patients with primary depression.MethodUsing positron emission tomographic measurements of regional cerebral blood flow (rCBF), patterns of resting rCBF were measured in ten patiens with PD and major depression, and ten patients with PD alone. The results were compared with findings from ten patients with primary depression and ten normal controls, scanned using identical methods as part of an earlier study. Groups were matched for age, sex and symptom severity.ResultsBilateral decreases in rCBF were observed in anteromedial regions of the medial frontal cortex and the cingulate cortex (Brodmann's areas (BA) 9 and 32) in the depressed PD group, compared with those with PD alone and compared with normal controls. This regional disturbance overlapped that observed in patients with primary depression.ConclusionsThe findings indicate that the medial prefrontal cortex is a common area of neural dysfunction in the manifestation of both primary depression and depression in PD.
Exorcism-resistant Ghost Possession Treated with Clopenthixol
Authors: Hale Anthony S. , Pinninti Narsimha R. 
Published: October 2008

BackgroundAn Indian man now in Britain explained his criminal behaviour as episodic ghost possession. Traditional exorcisms failed to help.Method‘Western’ diagnosis of dissociative state or paranoid schizophrenia was made. Treatment commenced using trifluoperazine and clopenthixol.ResultsThe patient underwent remission during neuroleptic treatment, despite previous evidence of genuine possession.ConclusionsMany cultures give rise to apparently genuine cases of ghost possession. Neuroleptics may relieve symptoms of exorcism-resistant possession.
Suicide in Children and Adolescents in England and Wales 1960–1990
Authors: McClure G. M. G. 
Published: October 2008

BackgroundFollowing reports of recent increases in adult male suicides in England and Wales, suicide rates for children and adolescents are reviewed.MethodBy using estimated mid-year populations for five-year age bands, the suicide rates for 10–14 year-olds and 15–19 year-olds are calculated between 1960–1990. The same method is used to obtain rates for ‘undetermined’ death and ‘accidental’ death by causes comparable to suicide.ResultsThe only group to show an increase in suicide rate since the 1970s has been males aged 15–19 years. This increase persists even when ‘undetermined’ and ‘accidental’ death rates for causes similar to suicide are examined. The increase is associated with an increase in hanging and self-poisoning with vehicle exhaust gas.ConclusionsThe increase in suicide rate in 15–19 year-old males may indicate increased psychosocial stress, particularly affecting this age/gender group.
Tiapride in the Prevention of Relapse in Recently Detoxified Alcoholics
Authors: Shaw G. K. , Waller S. , Majumdar S. K. , Alberts J. L. , Latham C. J. , Dunn G. 
Published: October 2008

BackgroundThe aim was to investigate the effect of tiapride (100 mg three times a day for at least one month) on outcome following detoxification.MethodThe setting was a tertiary referral centre. The study design was randomised, double-blind, and placebo-controlled. One hundred routinely admitted alcohol-dependent patients were entered, and 54 completed the trial. Outcome was assessed by considering drinking status at three months and six months follow-up, and by comparing psychological status at intake and follow-up using the Crown-Crisp Experiential Index, the Litman Self-esteem scale and a Satisfaction with Life Situations scale. We also compared performance over the six months before admission with the three and six months of follow-up on measures of health, social and drinking variables.ResultsTiapride proved better (usually at statistically highly significant levels) than placebo at promoting: abstinence, self-esteem, and satisfaction with life situations; and at reducing: alcohol consumption, use of health service resources, and levels of neuroticism.ConclusionsTiapride merits serious consideration in the longer-term treatment of alcoholic patients.
Linguistics, Human Communication and Psychiatry
Authors: Thomas Philip , Fraser William 
Published: October 2008

BackgroundPsycholinguistics and sociolinguistics have extended our understanding of the abnormal communication seen in psychosis, as well as that of people with autism and Asperger's syndrome. Psycholinguistics has the potential to increase the explanatory power of cognitive and neuropsychological approaches to psychosis and new methods of assessment and therapy are now being developed, based on linguistic theory.MethodMEDLINE literature search was used.ResultsOf 205 relevant articles identified, 65 were selected for review.ConclusionsGreater familiarity with linguistic theory could improve psychiatrists' assessment skills and their understanding of the relevance of human communication to the new cognitive models of psychosis.
The Function of the Hypothalamic–Pituitary–Adrenal Axis in Alzheimer's Disease
Authors: O'Brien John T. , Schweitzer Isaac , Ames David , Mastwyk Maree , Colman Peter 
Published: October 2008

BackgroundTo investigate an association between HPA axis dysfunction, depression and cognitive impairment, we assessed subjects with mild Alzheimer's disease (AD).MethodSixteen non-depressed subjects with AD according to NINCDS/ADRDA criteria and 18 normal controls underwent the insulin hypoglycaemia (IH) test and the dexamethasone suppression test (DST).ResultsThe AD subjects showed a blunted response of adrenocorticotrophic hormone (ACTH) to IH compared with controls (P = 0.019). ACTH response (area under curve) correlated with a score for cognitive ability (CAMCOG) (r = 0.64, P < 0.01). AD subjects had a shorter time to peak cortisol level than controls (P = 0.004), although total cortisol response was normal.ConclusionsThe AD subjects show evidence of adrenal hyper-responsiveness and normal immediate (rate-sensitive) glucocorticoid feedback. An association between HPA axis dysfunction and organic brain pathology in AD subjects may be mediated by cell loss in the hippocampus.
Suicide in the Mentally Ill
Authors: King Elizabeth 
Published: October 2008

BackgroundInformation on risk factors associated with high rates of suicide is necessary, if suicide rates among the mentally ill are to be reduced.MethodWe used ICD-9 E-codes to define deaths on which suicide or open (undetermined death) verdicts were returned, among residents of a catchment area defined by OPCS area codes. Relative risks of suicide and undetermined deaths for recent patients (those in contact with a psychiatric service in the year preceding death) were calculated.ResultsOf the 286 persons, 108 were recent patients. Eighty-four per cent suffered from schizophrenia or depression. Risks of suicide and undetermined death for these patients were 31 and 20 times, respectively, those of other residents. Social risk factors varied with diagnosis.ConclusionOver 90% of recent patients were receiving medical care at time of death; not all were treated appropriately. Recognising medical and social risk factors in recent patients, and effective monitoring of treatment, is important.
Prevalence of Asperger's Syndrome in a Secure Hospital
Authors: Scragg Peter , Shah Amitta 
Published: October 2008

BackgroundThe hypothesis that Asperger's syndrome (AS) may go unrecognised in forensic populations was examined by ascertaining the prevalence in Broadmoor Special Hospital.MethodThe entire male patient population was screened by examination of case notes. Identified cases were subject to the next stage of the study, which involved observation and interviewing of patients, and a semi-structured interview of key staff.ResultsA prevalence of 1.5% (0.6% to 3.3%, 95% CI) was found. The addition of equivocal cases increased the prevalence to 2.3%.ConclusionThe prevalence of AS in Broadmoor Hospital is greater than that reported for the general population.British Journal of Psychiatry (1994), 165, 679–682
The Reliability and Validity of the Proposed Axis V (Disabilities) of ICD–10
Authors: Daradkeh Tewfik K. , Saad A. 
Published: October 2008

BackgroundThe purpose of this study was to examine the reliability and validity of the newly proposed axis V (disabilities) of ICD-10.MethodEighty-six acutely ill men and women were prospectively recruited from the Al Ain psychiatric units, UAE. Both versions of ICD–10, the Clinical Descriptions and Diagnostic Guidelines and the Diagnostic Criteria for Research (DCR) were used for coding axis I psychiatric diagnosis and its grade of severity; the WHO Disability Assessment Schedule was used to assess disabilities.ResultsInter-rater reliability of the DAS items ranged from moderate to good, and axis V ratings correctly predicted 84% of the observed classification on axis I.ConclusionAxis V is a valid measure of disabilities, but is limited by its modest reliability.British Journal of Psychiatry (1994), 165, 683–685
Inner London Collaborative Audit of Admissions in Two Health Districts
Authors: Flannigan C. B. , Glover G. R. , Feeney S. T. , Wing J. K. , Bebbington P. E. , Lewis S. W. 
Published: October 2008

BackgroundThere is pressure on acute admission services in inner-city areas. Two deprived London districts with markedly different acute bed ratios but similar sociodemographic backgrounds were compared to test the hypothesis that more facilities mean better service.MethodAn instrument for auditing the use of short-stay hospital beds was constructed to collect information concerning admissions to, and short-stay patients in, the chosen districts during a three-month period.ResultsThere was a higher admission rate and substantially greater use of beds per unit population in south Southwark than in Hammersmith & Fulham. Much of the difference was attributable to a higher rate of admission of patients with affective disorders in south Southwark.ConclusionsThe results are not explained by variations in population need, longer in-patient stay, or poorer aftercare leading to early relapse. The question of whether there is over-provision of services compared with real need in south Southwark, or under-provision (particularly for people with affective disorders) in Hammersmith & Fulham, is considered but left open for discussion following a study of ethnic issues and the reasons for admission.
Adolescent Girls I Self-Reported Mood Disturbance in a Community Population
Authors: Monck Elizabeth , Graham Philip , Richman Naomi , Dobbs Rebecca 
Published: October 2008

BackgroundThis study was undertaken to fill gaps in our knowledge of the rate of mood disorder in teenage girls in transition from school to further education, employment or unemployment.MethodGirls aged 15–20 years (n = 529) whose names were drawn from general practitioner age/sex registers were interviewed at home and completed the Great Ormond Street Mood Questionnaire. Their mothers completed the 28-item General Health Questionnaire (GHQ). Social background variables were obtained.ResultsOf the girls, 20.8% scored over the cut-off point previously established to indicate risk of psychiatric disorder. Scoring over the cut-off point was not associated with age or parental social class. It was associated with parental separation/divorce (P < 0.004), with maternal self-report on the GHQ (P < 0.001), and with parental unemployment (P < 0.04). Lowest self-report scores were obtained by girls who had left school and were in employment (P < 0.01).ConclusionsAbout one in five of girls aged 15–20 are at risk of affective disorder. Self-reported mood disturbance is associated with a wide range of social and familial background variables, but not with age or parental socioeconomic status.
The Salford Family Intervention Project: Relapse Rates of Schizophrenia at Five and Eight Years
Authors: Tarrier Nicholas , Barrowclough Christine , Porceddu Kathleen , Fitzpatrick Elizabeth 
Published: October 2008

BackgroundThis study assessed the long-term effects of family intervention on schizophrenic relapse.MethodForty schizophrenic patients who had participated in a family intervention trial and who had not experienced relapse at two years after discharge from the index admission were traced through case notes and hospital records. The percentage of patients experiencing a relapse was estimated for patients in the family intervention group, the high-EE control group, and the low-EE control group, at five years and eight years after discharge.ResultsThere were significantly fewer relapses in the family intervention group than in the high-EE control group at both five years and eight years. The number of relapses in the low-EE control group was lower than in the high-EE control group, but this just failed to reach significance.ConclusionsThe benefit of family intervention and the predictive power of EE are sustained over eight years. Expressed emotion (EE) has remained a remarkably robust predictor of relapse in schizophrenia. Kavanagh (1992) cited 20 out of 23 prospective studies that showed patients who returned to live with high-EE relatives had higher relapse rates over 9–12 months after discharge than did patients returning to live with low-EE relatives. Seventeen of these studies reported this difference to be significant.British Journal of Psychiatry (1994),165, 829–832
Multiple Axis-II Diagnoses of Personality Disorder
Authors: Dolan Bridget , Evans Chris , Norton Kingsley 
Published: October 2008

BackgroundSimultaneous diagnosis of more than one personality disorder (PD) has been termed ‘comorbidity’ or ‘co-occurrence’ implying that single diagnoses are the norm and multiple diagnoses interesting exceptions. Surveys of PD subjects in fact show 1.5–5.6 diagnoses per subject. Our study explores the hypothesis that multiple PD diagnosis is common and increases with increasingly personality disordered populations.MethodThe PDQ–R questionnaire was administered to three UK samples: referrals for specialist PD in-patient treatment (n = 275); high tariff offenders attending a probation centre (n = 57); and undergraduate students (n = 274).ResultsMeans of 6.0 (95% CI 5.7–6.3), 4.0 (3. 1–5.0) and 3.4 (3.0–3.8) PDQ–R diagnoses per subject were found respectively. High rates of PD diagnosis in individual subjects suggest that multiple diagnosis is the norm rather than the exception.ConclusionsMultiple diagnosis of PD is better construed as ‘breadth’ of psychopathology rather than comorbidity and is a function of sampling frame. High rates of multiple diagnoses question the interpretation of studies of any single PD. The graded construct of ‘breadth’ of axis–II pathology may further our understanding of PD.
Trends and Availability of Suicide Methods in Finland
Authors: Ohberg A. , Lonnqvist J. , Sarna S. , Vuori E. , Penttila A. 
Published: October 2008

BackgroundTrends and availability of the methods used for suicide in Finland were analysed in order to base proposals for prevention of access to methods.MethodsFinnish suicides from 1947 to 1990 were analysed by sex, age, time period and suicide method using confidence intervals for rates, χ2 test for trends and suicide risks for different medicines.ResultsSuicide rate by parathion, a highly lethal pesticide and commonly used for suicide in the 1950s, decreased after its availability was restricted, but this was offset by an increased rate by other methods. Since 1982, the suicide risk for antidepressants and neuroleptics increased coincident with their availability, although that for barbiturates remained stable but high despite a reduction in availability. Suicide risk for antidepressants other than tricyclics decreased despite increased availability.ConclusionRestriction of a method reduces its use for suicide, but other methods tend to replace it. Restrictive measures should focus on some specific situations. Antidepressants other than tricyclics are recommended for the treatment of suicidal depressive patients.
Polymerase Chain Reaction (PCR) Search for Viral Nucleic Acid Sequences in Schizophrenia
Authors: Sierra-Honigmann A. M. , Carbone K. M. , Yolken R. H. 
Published: October 2008

BackgroundPrevious studies looking for evidence of viral infection in schizophrenics have yielded conflicting results. We searched for viral nucleic acids to test the hypothesis of the viral aetiology of schizophrenia.MethodWe used the polymerase chain reaction (PCR) to search for cytomegalovirus (CMV), human immunodeficiency virus (HIV), influenza A, Borna disease virus (BDV), and bovine viral diarrhoea virus (BVDV) in: hippocampus from three schizophrenic and three non-schizophrenic subjects; cerebrospinal fluid (CSF) from 48 schizophrenic patients; CSF and peripheral blood mononuclear cells (PBMC) from nine sets of identical twins discordant for schizophrenia; and SK-N-SHEP cells co-cultured with schizophrenic and non-schizophrenic brain homogenates. All patients met DSM–III–R criteria.ResultsVirus-specific nucleic acids were not found in any of the samples tested.ConclusionsThe absence of viral nucleic acids in the samples tested suggest that, in these patients, schizophrenia is not associated with a persistent or latent infection due to these viruses.