bluuebunny/crossref_metadata_2025_split huggingface dataset:
Juvenile Obsessive—Compulsive Disorder
Authors: Wever Chris , Rey Joseph M. 
Published: January 2008

Objective: To describe the characteristics of a series of children and adolescents with obsessive—compulsive disorder (OCD) and evaluate the outcome of treatment. Method:Type of symptoms, severity before and after treatment and factors associated with outcome were examined in a large group (n = 82) of consecutive OCD cases referred for treatment. Results:Most children (95%) had both obsessions and compulsions. Symptoms had been present for 2 years on average. Seventy-one per cent (n = 57) of all eligible patients completed a combined behavioural and pharmacological protocol. Among these, there was a 68% remission rate and a 60% decrease of symptoms at 4 weeks. Comorbidity with oppositional defiant disorder and high aggression scores were associated with poor outcome. Conclusions:Juvenile OCD can be treated effectively in a standard clinical setting. Treatment programs of the kind described are accepted by young people. It remains to be seen whether in this age group a combined treatment produces better results than medication alone or cognitive—behaviour therapy alone.
Swimming against the Tide? A Review of the Therapeutic Community
Authors: Schimmel Paul 
Published: January 2008

Objective:The therapeutic community is an established psychiatric treatment method which may be in decline. This paper reviews the nature of inpatient therapeutic community treatment, and re-evaluates its role. Method:The principles and practice of such treatment are summarised, with a focus on the functions of staff. Results:The inpatient therapeutic community is conceptualised as combining socio-therapeutic treatment, psychotherapeutic treatment, and the advantages of the inpatient setting. This unique treatment environment allows for therapeutic regression while mitigating against anti-therapeutic behavioural regression. Research evidence supports the efficacy of therapeutic community treatment for patients with borderline personality disorder. Conclusion:Further research is needed to assess its efficacy for other diagnostic groups. This intensive treatment approach may be most appropriate for patients who have proved treatment resistant by other means. Possible reasons for the marginal-ization of therapeutic community treatment are considered. Access to quality inpatient therapeutic community treatment is essential in the provision of a comprehensive psychiatric service.
Myeloneuropathy from Whipped Cream Bulbs Presenting as Conversion Disorder
Authors: Brett Adam 
Published: January 2008

Objective:To highlight the complications of nitrous oxide abuse. Clinical picture:A case is presented of a myeloneuropathy in a 21-year-old woman who had been abusing nitrous oxide, obtained from whipped cream bulbs, who was referred to a psychiatric hospital with a diagnosis of conversion disorder. Nitrous oxide toxicity has been reported in medical and dental professions and a few cases of myeloneuropathy due to induced vitamin B12 deficiency have been reported. This would appear to be the first reported case of myeloneuropathy resulting from nitrous oxide abuse from whipped cream propellants as a recreational drug in the community. Treatment:Three doses of intramuscular hydroxy cobalamin (1000 μg) over the course of 1 week. Outcome:Her neurological symptoms and anxiety settled. Conclusions:Nitrous oxide is becoming more popular as a recreational drug; its complications should be noted and a thorough neurological examination performed if abuse is suspected.
A Family with Autosomal Dominant, Non-Alzheimer's Presenile Dementia
Authors: Dark Frances 
Published: January 2008

Objective:A rare family pedigree is described with a multigenerational history of an early onset, non-Alzheimer's dementia consistent with autosomal dominant inheritance. Information on five generations, with 26 suspected or proven cases of dementia, are presented. Method:Previous work on the family was collated and verified. The pedigree was updated. Thirty-three family members agreed to be interviewed for the present study. Standardised clinical information was obtained using the Cambridge Mental Disorders of the Elderly Examination (CAMDEX) National Adult Reading Test (NART), vocabulary and digit substitution subscales of the Wechster adult intelligence scale — revised edition (WARS-R). Abbot samples were taken for biochemical and genetic analysis. Results:Fifteen males and 11 females have been affected. The age of onset of dementia in those for whom data were available (n = 12) ranged from 39 to 64 years with a mean of 53 years. The duration of illness ranged from 4 to 14 years and the age at death ranged from 49 to 69 years (mean 62 years). Autopsy data exist for nine cases. In one case the neuropathology was consistent with Alzheimer's disease. In two cases the diagnosis of Pick's disease was made on the basis of frontal or frontal/temporal lobe atrophy without Pick bodies or cells. One case diagnosed as Pick's disease had frontal/temporal lobe atrophy with cells resembling Pick's bodies. In the five remaining cases there were no distinctive neuropathological features to differentiate the type of dementia. Conclusions:The importance of recognising familial dementia, collating information on multiple generations and prospectively collecting standardised data is discussed.
Child Physical and Sexual Abuse and Eating Disorders: A Review of the Links and Personal Comments on the Treatment Process
Authors: Brown Lisa 
Published: January 2008

Objective: The aim of the present paper is to review the available literature on abusive experiences and the development of eating disorders, with particular reference to the theoretical basis of the possible links between them.Method: The review covers the literature of both interpersonal violence and eating disorders, with special reference to that linking the two fields. Brief case reports and clinical experience from a specialised eating disorders unit are also described.Results: Despite much theoretical speculation of a causal relation between abuse and eating dysfunction there is a lack of empirical research to confirm such theories, and a dearth of treatment suggestions to deal with the comorbid problems of the patient with an eating disorder and a history of abuse.Conclusions: There is a need for more clinical and experimental focus in this area, particularly in the study of aetiology and the management of dually affected individuals.
Psychiatric Collaboration in a Paediatric Department
Authors: Menahem Samuel , Roth Dina , Haramati Sara 
Published: January 2008

Objective: To review the impact of integrating child psychiatry services into a paediatric department. Method: Following the arrival of a new head of paediatrics, a mandatory multidisciplinary meeting was set up to review, diagnose and manage selected patients under the care of the paediatricians and/or a child psychiatrist. A prospective audit was undertaken of the patients discussed with a brief review of their outcome. The educational value of the meetings and their overall impact on the department was reviewed. Results: Over an 8-month period 30 patients were discussed in some detail with diagnoses ranging from a psychiatric disorder to a chronic organic illness, each subjected to the deliberations of the multidisciplinary team of the attending paediatrician, resident staff, child psychiatrist/psychologists, nurses, social worker, etc. Recommendations included further assessment by the psychiatric team, or management by the paediatricians with or without guidance of the former, involvement of an outside agency, etc. Such interventions generally had positive outcomes: at times dramatic, although early discharge often resulted in limited goals. There was also an overall increased awareness within the department of the psychological needs of the child and family and the importance of serious physical illness; this awareness is essential in the training of paediatricians and psychiatric staff. Conclusion: Closer integration of the two disciplines led to benefits both to the patients and staff. The initiation of a mandatory multidisciplinary meeting facilitated the process, overseen by a psychologically-minded new head of paediatrics. His departure led to a loss of some goals achieved, raising the question as to how such collaboration may be self-generating and ongoing. In addition, the issue of how to deal with those patients with ongoing difficulties not addressed during their limited inpatient stay was unresolved.
Referred Adolescents as Young Adults: The Relationship between Psychosocial Functioning and Personality Disorder
Authors: Rey Joseph M. , Singh Michelle , Morris-Yates Allen , Andrews Gavin 
Published: January 2008

Objective: To examine the functioning of young adults who had been referred for psychiatric treatment during adolescence. Method: A group of 145 adolescents referred at a mean age of 14 years were interviewed at a mean age of 20 years to ascertain their functioning and whether they suffered from a personality disorder. Results: Having a personality disorder was associated with poor functioning at follow-up independently of adolescent diagnosis. Antisocial personalities were typified by problems with the law, a poor work record and early cohabitation, while other personality disorders were characterised by social isolation and problems in interpersonal relationships. Poor quality of the family environment and having received treatment during the follow-up period were the only developmental variables associated with poor functioning. Conclusions: Developing a personality disorder and having a poor family environment, rather than having an adolescent disorder, appear to be the factors that result in poor functioning in young adults.
Family Dynamics, Hopelessness and Psychiatric Disturbance in Parasuicidal Adolescents
Authors: Pillay Anthony L. , Wassenaar Douglas R. 
Published: January 2008

Objective: Adolescent parasuicide has often been associated with family disturbance, hopelessness and psychiatric disturbance, but little empirical work has been done to verify these clinical impressions. Method: The present study compares matched groups of hospitalised parasuicidal adolescents, non-psychiatric medically hospitalised adolescents and a control group on measures of family disturbance, hopelessness and psychopathology. Results: The findings reveal significantly higher levels of family disturbance, hopelessness and depressive symptoms in the parasuicidal group. Conclusions: The results suggest that prevention and treatment of adolescent parasuicide should focus on both individual and family dynamics.
Depression in Adults with Intellectual Disability. Part 2: A Pilot Study
Authors: Davis Julian P. , Judd Fiona K. , Herrman Helen 
Published: January 2008

Objectives: To identify adults with intellectual disability (ID) with a depressive disorder referred to a tertiary consultation clinic for psychiatric assessment; to investigate common presenting features of depression in adults with ID; to assess the utility of visual analogue scale (VAS) measures of emotion/behaviour, the CORE measure of psychomotor disturbance, and substitutive diagnostic criteria in the assessment of depressive disorders in this patient group. Method: Over a 6-month period 47 patients were seen for psychiatric evaluation. Patients in whom a diagnosis of depression was made were further assessed using: VAS measures of depression, irritability, verbal aggression, physical aggression, temper outbursts, regressed behaviour; CORE measure of psychomotor disturbance; and substitutive diagnostic criteria designed by the authors. Results: Ten patients were found to have a depressive disorder. Substitutive criteria resulted in a greater rate of diagnosis than standard DSM-IV criteria. The VAS measure of irritability was highly scored for all 10 depressed patients. All 10 depressed patients were assigned to the melancholic subgroup according to CORE score. Conclusions: Standard assessment measures and diagnostic criteria may require modification to enhance their utility in this patient group. Melancholic features require further investigation.
Transcranial Magnetic Stimulation as Therapy for Depression and Other Disorders
Authors: Kirkcaldie Matthew T. K. , Pridmore Saxby A. , Pascual-Leone Alvaro 
Published: January 2008

Objective: To provide an overview of the progress and prospects of transcranial magnetic stimulation as a psychiatric therapy for depression. Method: Published and unpublished studies of the usefulness of transcranial magnetic stimulation as a therapy for depression were assessed, and characterised in terms of a consistent measure of dosage. Additional information was obtained through correspondence, personal meetings and visits to facilities. Results: Transcranial magnetic stimulation, a means for inducing small regional currents in the brain, has been used in clinical neurology for some time, and can be used on conscious subjects with minimal side-effects. Early researchers noticed transient mood effects on people receiving this treatment, which prompted several inconclusive investigations of its effects on depressed patients. More recently, knowledge of functional abnormalities associated with depression has led to trials using repetitive transcranial magnetic stimulation to stimulate underactive left prefrontal regions, an approach which has produced short-term benefits for some subjects. The higher dosage delivered by high-frequency repetitive transcranial magnetic stimulation appears to produce greater benefits; scope exists for more conclusive studies based on extended treatment periods. Conclusions: Repetitive transcranial magnetic stimulation is a promising technology. The reviewed evidence indicates that it may be useful in the treatment of depression, and perhaps other disorders which are associated with regional hypometabolism. Should repetitive transcranial magnetic stimulation prove an effective, non-invasive, drug-free treatment for depression, a range of disorders could be similarly treatable.
Recovery from Post-Earthquake Psychological Morbidity: Who Suffers and who Recovers?
Authors: Lewin Terry J. , Carr Vaughan J. , Webster Rosemary A. 
Published: January 2008

Objective: We sought to identify the psychosocial characteristics of high earthquake exposure subjects that were associated with the development of post-disaster morbidity and with recovery. Method: Data reported are from 515 participants in a longitudinal study of the psychosocial effects of the 1989 Newcastle (Australia) earthquake. Subjects were allocated to three subgroups (low morbidity; recovered; and persistent morbidity) on the basis of their Impact of Event Scale scores across the four phases of the study. Differences between these subgroups were examined on a broad range of variables. Results: Several background, dispositional, coping style and exposure-related factors characterised those who developed psychological morbidity, only a small subset of which differentiated between those who recovered and those with persistent morbidity. Conclusions: Post-earthquake morbidity persists longer in those who are older, have a history of emotional problems, have higher neuroticism, use more neurotic defenses, and report higher levels of post-disaster life events.
The Prevalence of Comorbid Anxiety in Schizophrenia, Schizoaffective Disorder and Bipolar Disorder
Authors: Cosoff Susan J. , Hafner R. Julian 
Published: January 2008

Objective: The aim of this study to determine the prevalence of anxiety disorders in publically treated psychiatric inpatients with a DSM-IV diagnosis of schizophrenia, schizoaffective disorder or bipolar disorder. Method: Using the Structured Clinical Interview for DSM-III-R (SCID), 100 consecutive inpatients with a psychotic disorder were examined for the presence or absence of an anxiety disorder. Questionnaire measures of phobias, obsessive-compulsive and general anxiety symptoms were also applied. Results: The prevalences of social phobia (17%), obsessiv-ompulsive disorder (13%) and generalised anxiety disorder in schizophrenia were relatively high, as were prevalences of obsessive-compulsive (30%) and panic disorder (15%) in bipolar disorder. The proportion of subjects with an anxiety disorder (4345%) was almost identical across the three psychoses, with some evidence of gender differences. Although self-ratings of overall psychiatric symptoms were significantly elevated in those with anxiety disorders, hospital admission rates were not. Conclusions: Almost none of those with anxíeGty disorders were being treated for them, primarily because the severity of the acute psychotic illness required full diagnostic and therapeutic attention. Patients were generally discharged as soon as their psychotic episode was resolved, with little recognition of the presence of an anxiety disorder. Given that anxiety disorders are relatively responsive to treatment, greater awareness of their comorbidity with psychosis should yield worthwhile clinical benefits.
The Effectiveness of Group Psychological Intervention in Enhancing Perceptions of Control following Spinal Cord Injury
Authors: Craig Ashley , Hancock Karen , Chang Esther , Dickson Hugh 
Published: January 2008

Objective: This research investigated the effects of a structured psychological intervention, delivered during hospital rehabilitation, on the perceptions of control in people with spinal cord injury (SCI). Method: A longitudinal study was designed to assess perceptions of control (using an objective measure of locus of control) in SCI persons who participated in specialised group cognitive-behavioural therapy (CBT) during hospital rehabilitation. The treatment SCI group's responses on locus of control were compared with a control group of SCI persons who only received traditional rehabilitation services during their hospitalisation. Results and Conclusions: Mean locus of control scores were not high (i.e. external) for both groups and there were no overall group differences on locus of control responses across time in comparison to the control group. However, subjects in both groups who initially perceived life as externally controlled were extracted to form subgroups. The members of the subgroup who received CBT were significantly more likely to feel in control of themselves 2 years post injury compared to similar persons in the control group. Furthermore, an external locus of control was significantly but mildly associated with depressive mood 2 years after the injury. This research suggests that the provision of a structured psychological program in the rehabilitation stage will be beneficial for many SCI persons who feel that they have little control over their lives.
Dysmorphic Concern: Prevalence and Associations with Clinical Variables
Authors: Oosthuizen Piet , Lambert Tim , Castle David J. 
Published: January 2008

Objective: The aim of this paper is to describe the development of a questionnaire, the Dysmorphic Concern Questionnaire (DCQ), for the assessment of dysmorphic concern, and to establish correlations with clinical variables. Method: Consecutive admissions to a psychiatric hospital were surveyed. Results: The DCQ showed good internal consistency, with most of the variance being explained by a single factor. Strong correlations with distress and work and social impairment lend face validity to the questionnaire. Dysmorphic concern was not significantly influenced by the patient's age, sex or diagnosis. In terms of specific psychotic symptoms, there were weak positive correlations with thought interference and persecutory ideation. However, the strongest correlations were with depressed mood, according to the Beck Depression Inventory (BDI) but not the Montgomery Asberg Depression Rating Scale; the discrepancy was largely accounted for by the “cognitive” depressive items on the BDI. In terms of objective assessment of dysmorphic features, ratings on the Waldrop scale for minor physical anomalies showed no correlation with concern expressed by the patient. Conclusions: The strong correlation with depressive cognitions suggests that dysmorphic concern is often a reflection of a depressive cognitive set rather than being a diagnosis in itself.
Single Dose Pharmacokinetic Study of Lithium in Taiwanese/Chinese Bipolar Patients
Authors: Lee Ching-Fa , Yang Yong-Yi , Hu Oliver Yoa-Pu 
Published: January 2008

Objective: The purpose of this study is to investigate the single dose pharmaco-kinetics of lithium in Taiwanese/Chinese bipolar patients for future interracial comparisons. Method: Eight bipolar patients took 900 mg of lithium carbonate after overnight fasting. Blood samples of 5 mL were taken after 15 min, 30 min, 45 min, 1 h, 2 h, 3 h, 4 h, 7 h, 9 h, 15 h, 25 h and 31 h after dosing. The computer programs CSTRIP and PCNONLIN were used for pharmacokinetic analysis. Results: The pharmacokinetic parameters obtained were as follows: Cmax, 0.970 ± 0.170 (SD) mmoi/L; Tmax, 1.59 ± 0.78 h; AUC31h = 548.9 ± 135.4 mmol.m/L; AUC = 722.6 ± 262.7 mmol.m/L; β-half-life = 16.3 ± 7.18 h; K-half-life = 0.613 ± 0.442 h; CIoral = 1.13 ± 0.39 mL/min/kg; Vd/F = 1.43 ± 0.387 L/kg. Most of the pharmacokinetic parameters were within the ranges reported in investigations of Caucasian subjects. Conclusions: This study showed that racial differences in lithium pharmacokinetics might not exist. We suggest that methodological designs, including method of blood sampling, measurement of lithium, and pharmacokinetic and statistical calculations, be standardised if future cross-ethnic comparisons are to be conducted.
Youth Suicide Attempts: A Social and Demographic Profile
Authors: Beautrais Annette L. , Joyce Peter R. , Mulder Roger T. 
Published: January 2008

Objective: The social and demographic characteristics of a New Zealand sample of young people making medically serious suicide attempts were examined and compared with those of a control sample of similar age. Method: Using a case control design, 129 young people making serious suicide attempts were contrasted with 153 randomly selected community controls on a series of social and demographic characteristics including educational achievement, socioeconomic status, income, occupation, religious affiliation and ethnicity. The age and gender distribution of the sample, and the methods of suicide attempt, were examined. Results: Almost equal numbers of young males (45.7%) and females (54.3%) made medically serious suicide attempts. The clear majority of serious suicide attempts were by overdose or poisoning (78.3%), with tricyclic antidepressants (38.6%) and paracetamol (37.6%) together accounting for three-quarters (76.2%) of all drug overdoses. Young people who were less well educated and who were from lower socio-economic backgrounds had elevated risk of serious suicide attempts. Conclusions: Young people from socially disadvantaged backgrounds have elevated risk of serious suicide attempt.