bluuebunny/crossref_metadata_2025_split huggingface dataset:
Does Rational Role-play Enhance the Outcome of Exposure Therapy in Dysmorphophobia?
Authors: Cromarty Paul , Marks Isaac 
Published: October 2008

BackgroundDysmorphophobia may improve after a variety or combination of treatments, but which elements of a treatment are useful is usually not certain.MethodIn a single out-patient case study rational role-play (‘paradoxical discourse’) was added to exposure plus cognitive restructuring (CR) for a dysmorphic delusion study comprised of 20-minute sessions one week apart.ResultsPrevious exposure plus attempted CR had improved anxiety, phobias, work and social leisure, but not dysmorphic belief. Added brief rational role-play was followed by resolution of the dysmorphic belief. All measures remained much improved at 18-month follow-up.ConclusionsRational role-play deserves a controlled trial in dysmorphophobia and other problems and exploration of its mechanism of action.
Antipsychotic Drug-Induced Dysphoria
Authors: King D. J. , Burke M. , Lucas R. A. 
Published: October 2008

BackgroundDysphoric reactions to antipsychotic medication are well recognised in association with akathisia, but can also occur independently.MethodFifty-one healthy volunteers were given haloperidol 5 mg in two consecutive pharmacokinetic studies.ResultsDysphoria occurred in about 40% of the subjects on both occasions, but akathisia was only detected in 8% (first study) and 16% (second study). All adverse effects were transient and were abolished in nine of the ten subjects given procyclidine.ConclusionsWhile dysphoria is a well-recognised reaction in healthy volunteers, it is probably insufficiently recognised in patients, particularly if it occurs in the absence of akathisia. Better detection could improve compliance in patients.
Recurrent Brief Episodes with Psychotic Features in Adolescence: Periodic Psychosis of Puberty Revisited
Authors: Abe Kazuhiko , Ohta Mikio 
Published: October 2008

BackgroundThere are many reports of adolescents with periodic episodes each followed by complete remission within 2 weeks, but the nosology and long-term prognosis of such cases have not been elucidated.MethodA prospective follow-up study on 11 cases (nine girls and two boys) meeting predetermined criteria is reported.ResultsThe first several episodes were found to meet ICD–10 symptomatic criteria for recurrent depressive disorder in all cases, and, except for two cases, showed psychotic features. The episodes were linked to one phase of the menstrual cycle in only two of six girls with regular menses. There were no recurrences while on lithium in eight of nine cases. Of eight patients followed up 5–14 years after the first onset, three had been well, three had become bipolar and two were still suffering from brief depressive episodes.ConclusionsRecurrent brief episodes in adolescence tend to show a near-monthly rhythm and psychotic features. Most of them appear to be manifestations of affective illness and may be treated and prevented as such.
Validation of a French Version of an Informant-Based Questionnaire as a Screening Test for Alzheimer's Disease
Authors: Law Samuel , Wolfson Christina 
Published: October 2008

BackgroundDevelopment of informant-based screening tests for dementia is an emerging field. The reliability and validity of the Informant Questionnaire on Cognitive Decline in the Elderly (IQCODE), an instrument that screens for dementia in general, have been established. We conducted a study to validate a French version of the IQCODE as a screening test for Alzheimer's dementia in the elderly living in the community.MethodIn the Canadian Study of Health and Aging, subjects were screened in their own homes using the Modified Mini-Mental State Exam (3-MS). Those who screened positive, along with a sample of subjects who screened negative, were referred for a complete clinical examination. In Quebec, an informant was asked to complete the French version, IQCODE (F), at that time. Based on the final clinical diagnoses, performances of the IQCODE (F) and Mini-Mental State Examination (MMSE, converted from 3-MS) in screening for Alzheimer's disease were evaluated.ResultsOf the 237 subjects, the mean IQCODE (F) score was 3.4 (s.d. = 0.6), on a 5-point scale (1 = improvement in condition over the past 10 years, 5 = marked deterioration, 3 = no change). The mean MMSE score was 23.1 (s.d. = 4.5). The scores on the two scales were correlated (r = –0.44, P < 0.001). The IQCODE (F) scores were unrelated to education (r = –0.07, P > 0.3) in contrast to the MMSE scores (r = 0.28, P < 0.001). With respect to a diagnosis of probable Alzheimer's disease, the IQCODE (F) (cut-off point 3.6) had a sensitivity of 75% and a specificity of 95.6%. The sensitivity and specificity of the MMSE (cut-off point 23) were 70% and 82.3% respectively.ConclusionThe findings of the IQCODE (F) are consistent with those of the English version in correlation with the MMSE and apparent freedom from educational bias. The IQCODE is superior to the MMSE as a screening test for probable Alzheimer's disease in the elderly living in the community. It may be a useful addition to the screening tests already available, especially for the less well educated.
Prevalence of Psychiatric Morbidity Among Remand Prisoners in Scotland
Authors: Davidson Mark , Humphreys Martin S. , Johnstone Eve C. , Owens David G. Cunningham 
Published: October 2008

BackgroundDetermining the prevalence of psychiatric disorders among remand populations has been made a priority in England and Wales. Differences in legal process and psychiatric services in Scotland make similar research there important.MethodDemographic data were collected on 389 prisoners, the Clinical Interview Schedule was completed and cognitive function assessed.ResultsThe prevalence of major psychiatric disorders was low. Less severe symptoms were more common. The sample was of average IQ, but low educational attainment. Reported drug abuse was high.ConclusionsFew of those interviewed required hospital care, but other symptoms and drug-related problems may place heavy demands on prison medical and psychiatric services.
Crisis in Admission Beds
Authors: Powell Robin B. , Hollander Doris , Tobiansky Robert I. 
Published: October 2008

BackgroundThis study was carried out to measure bed occupancy in Greater London's psychiatric units, in response to the apparent shortage of admission beds.MethodThe bed occupancy of London's 54 National Health Service (NHS) acute psychiatric units within 29 districts was ascertained by telephone on 16 bank holidays covering the period 1990–93.ResultsThe mean occupancy level for all London over the 4 years was 97.54% (95% CI = ±0.94%). The number of beds occupied in inner London was significantly greater (99.79 ± 1.11%) than in outer London (95.1 ± 1.49%) (t = 3.85, d.f. = 462, P < 0.001). Bed occupancy for inner London units was ≥ 100% on over 49% of occasions. There has been a steady decline in the number of beds over the four-year period. There was a clear correlation between occupancy levels and the Jarman UPA8 Underprivilege Score (r = 0.504) and between bed provision and the UPA8 (r = 0.67).ConclusionOccupancy rates have become unacceptably high and require careful monitoring. Corrective action may be required in order to prevent a breakdown in services.
Psychological Consequences of the Kegworth Air Disaster
Authors: Gregg W. , Medley I. , Fowler-Dixon R. , Curran P. , Loughrey G. , Bell P. , Lee A. , Harrison G. 
Published: October 2008

BackgroundThe study sought to quantify psychiatric morbidity among survivors of a major air crash and to identify aetiological factors linked with post-traumatic stress disorder (PTSD).MethodSixty-eight of the 79 survivors (86%) were assessed at a clinical interview within one year of the disaster. The majority also completed the General Health Questionnaire, the Impact of Events Scale (IES) and the Zung Anxiety and Depression Scales.ResultsFifty-four of the study group (79%) met DSM–III–R criteria for a psychiatric disorder within one year of the disaster, of whom 27 (50%) had PTSD. Those who saw injured or dead people at the scene, or had sustained less severe injuries as measured by their Injury Severity Scores, or were under 35 years old, were significantly more likely to develop PTSD.ConclusionsHigh rates of psychiatric morbidity are found in survivors of transportation disasters. Further studies are needed to identify those at most risk and to evaluate the benefits of psychological intervention.
Mental Health of Preschool Children and their Mothers in a Mixed Urban/Rural Population
Authors: Sonuga-Barke Edmund , Stevenson Jim , Thompson Margaret J. J. 
Published: October 2008

BackgroundThe extent to which certain maternal, child and family characteristics are associated in families with a 3-year-old child were examined.MethodA total population of families with a 3-year-old child and living in the New Forest were identified. Measures of child behaviour and the maternal GHQ-30 were obtained.ResultsWhereas behaviour problems were found to be significantly associated with all maternal and family factors (except social class), difficult temperament was only related to mother's recall of their own childhood as unhappy and overactivity was only significantly associated with maternal disturbance.ConclusionsThe results are consistent with maternal disturbance and difficult temperament acting independently and additively to influence the development of behaviour problems in preschool children.
Mental Health of Preschool Children and their Mothers in a Mixed Urban/Rural Population
Authors: Stevenson Jim , Thompson Margaret J. J. , Sonuga-Barke Edmund 
Published: October 2008

BackgroundThere is a lack of clear and explicit models of the way various family and social influences on children's behaviour interact with factors such as temperament to produce behaviour disturbance in young children.MethodThe following measures had been obtained on a total population sample of 1047 families with a 3-year-old child: the child's perceived cuddliness, difficult temperament, mother's unhappy childhood, maternal disturbance, social class, behaviour problems and overactivity. A latent variable analysis using the LISREL 7 program was applied to the data.ResultsA model that allowed the latent variables child ‘temperament’ and ‘mother's mental state’ to have separate additive effects on ‘child adaptation’ proved an excellent fit (goodness of fit index = 0.956). This model suggests that there is a common factor (‘child adaptation’) underlying behaviour problems and overactivity. Using this model 72% of child adaptation in boys could be explained. For girls however temperament and mother's mental state accounted for only 30% of the variance in child adaptation.ConclusionThere is a need to investigate different mechanisms for the origins of behaviour problems in preschool boys and girls.
Enhancement of the Prolactin Response to d-Fenfluramine in Drug-Naive Schizophrenic Patients
Authors: Abel Kathryn M. , O'Keane Veronica , Murray Robin M. 
Published: October 2008

BackgroundWe wished to investigate central serotonergic function in untreated schizophrenia.MethodThirteen drug-naive, DSM–III–R schizophrenic patients were compared with sex, race, age, weight and menstrual phase matched controls. Plasma prolactin and cortisol responses to a specific serotonergic probe, d-fenfluramine, were measured along with BPRS ratings.ResultsProlactin responses were enhanced in schizophrenic patients compared to controls (P < 0.05) and were correlated positively with BPRS items for depression, anxiety and guilt. Baseline cortisol was also raised in those with schizophrenia (P < 0.001).ConclusionsCentral serotonergic tone may be raised in acute, drug-naive schizophrenia and may be associated with the presence of affective symptomatology.
Relationships Among Negative, Positive, and Depressive Symptoms in Schizophrenia and Psychotic Depression
Authors: Sax Kenji W. , Strakowski Stephen M. , Keck Paul E. , Upadhyaya Vidya H. , West Scott A. , McElroy Susan L. 
Published: October 2008

BackgroundWe examined relationships among positive, negative, and depressive symptoms in schizophrenia and major depression with psychosis.MethodPatients with schizophrenia (n = 17) and major depression and psychotic features (n = 25), with no prior psychopharmacologic treatment were assessed on scales measuring positive psychotic, negative, and depressive symptoms.ResultsAnalyses revealed that depressive symptoms positively correlated with anhedonia/asociality and avolition/apathy in both patient groups. Positive psychotic symptoms significantly correlated with depressive symptoms in the schizophrenic group.ConclusionsSeveral specific symptoms used in defining both depressive and negative syndrome constructs appear to be shared. The relationship between positive symptoms and depression in schizophrenia and not psychotic depression suggests the severity of depression may be involved in this relationship.
The Borderline Syndrome Index: a Validation Study using the Personality Assessment Schedule
Authors: Marlowe M. J. , O'Neill-Byrne K. , Lowe-Ponsford F. , Watson J. P. 
Published: October 2008

BackgroundThis study examines the validity and screening properties of the Borderline Syndrome Index – BSI (developed in the USA) for categories of the Personality Assessment Schedule – PAS (developed in the UK).MethodPatients were recruited by case control sampling. Chance corrected agreement between instruments and screening properties of the BSI were calculated.ResultsThe BSI proved a moderately sensitive but non-specific screen. Questionnaire scores were highly correlated with symptom measures.ConclusionsThe results do not support the validity of the BSI or its use as a screening instrument. BSI scores may be distorted by current symptoms.
Sequential Treatment for Bulimia Nervosa Incorporating A Self-Care Manual
Authors: Treasure Janet , Schmidt Ulrike , Troop Nicholas , Tiller Jane , Todd Gill , Turnbull Susan 
Published: October 2008

BackgroundThe aim of this study was to evaluate the effectiveness of a stepped care approach to the treatment of bulimia nervosa: a self-care manual followed, if necessary, by a course of attenuated cognitive behavioural treatment (CBT) in comparison with standard CBT.MethodOne hundred and ten patients, presenting at a tertiary referral centre with ICD–10 bulimia nervosa or atypical bulimia nervosa, were randomly assigned to one of two treatment conditions; a) a sequential treatment group: 8 weeks with a self-care manual followed by up to eight sessions of CBT (if still symptomatic) or b) 16 sessions of CBT.ResultsBulimic symptoms improved significantly in both groups with no significant differences between the two groups on any of the measures at the end of treatment or at 18 months follow-up. At end of treatment 30% (95% CI: 18–46%) of the sequential group and 30% (95% CI: 17–47%) of the standard treatment group were free from all bulimic symptoms. Sixteen of those in the sequential group improved significantly with self-care and did not require additional treatment. The median number of sessions taken by the sequential group was three (95% CI: 0–6). At 18 months follow-up 40% (95% CI: 23–59%) of the sequential group and 41% (95% CI: 25–59%) of the CBT group were symptom free.ConclusionsA sequential approach to the treatment of bulimia may be as effective as standard CBT and can considerably reduce the amount of therapist contact required.
Longitudinal Cognitive, Electroencephalographic and Morphological Brain Changes in Ageing and Alzheimer's Disease
Authors: Förstl Hans , Sattel Herbert , Besthorn Christoph , Daniel Sabine , Geiger-Kabisch Claudia , Hentschel Frank , Sarochan Manfred , Zerfaß Rainer 
Published: October 2008

BackgroundThe natural course of cognitive performance, electrophysiological alterations and brain atrophy in ageing and Alzheimer's disease (AD) has been investigated in numerous studies, but only few attempts have been made to examine the relationship between clinical, electroencephalographic (EEG) and morphological changes with quantitative methods prospectively over longer periods of time.MethodFifty-five patients with clinically diagnosed AD and 66 healthy elderly controls were examined biannually using a cognitive test (CAMCOG), EEG band power and volumetric estimates of brain atrophy.ResultsOn average cognitive performance deteriorated by 28 points on the CAMCOG in the AD group, the alpha/theta ratio decreased by 0.2, and the proportion of intracranial cerebrospinal fluid volume increased by 3.5% during a 2-year period. Similar changes were observed after a second 2-year interval. A multiple regression model demonstrated a significant influence of age on cognition and atrophy and a significant influence of the estimated duration of symptoms on cognition, alpha/theta ratio and brain atrophy at the initial examination. Cognitive performance at the first examination exerted significant effects on the performance and also on brain atrophy at re-examination after 2 or 4 years, whereas the EEG and neuroimaging findings at the previous examination were exclusively related to the corresponding findings at the follow-up examinations. In the control group no significant cognitive, EEG and morphological changes were observed after 2 and 4 years.ConclusionAfter 2 consecutive follow-up periods, we were able to verify significant deteriorations of cognition accompanied by neurophysiological and neuroradiological changes in AD, but not in normal ageing. In clinically diagnosed AD, cognitive performance at the follow-up examination could not be predicted by the previous alpha/theta ratio or by the previous degree of global brain atrophy, whereas the cognitive test score determined not only performance, but also structural findings at follow-up. Performance on cognitive tests appears to be a more sensitive indicator of the degenerative process than EEG band-power and morphological changes in manifest AD. Neuroimaging, neurophysiology and genetic risk markers may be more important for the early differential diagnosis than for the prediction of the course of illness.
Stress and Psychiatric Disorder in the Hindu Kush
Authors: Mumford David B. , Nazir Mohammed , Jilani Faiz-Ul-Mulk , Baig Imam Yar 
Published: October 2008

BackgroundIt is widely believed that people in remote areas of the world suffer less emotional distress and fewer psychiatric disorders. Previous studies offer contradictory evidence.MethodFirst stage screening of two mountain villages in Chitral used the Bradford Somatic Inventory (BSI). Psychiatric interviews were conducted with stratified samples using the ICD–10 Diagnostic Criteria for Research.ResultsThe BSI was an effective screening test, with sensitivity of 80% and specificity of 77%. At a conservative estimate, 46% of women and 15% of men suffered from anxiety and depressive disorders. Literate subjects had lower levels of emotional distress than the illiterate. Higher socio-economic status was associated with less emotional distress. Members of joint and nuclear families were similar.ConclusionsThe study offers no support for the belief that people who live in Chitral lead stress-free lives or have low rates of psychiatric morbidity. Women may suffer more anxiety and depressive disorders than in Western societies.
Ultra-Rapid and Ultradian Cycling in Bipolar Affective Illness
Authors: Kramlinger Keith G. , Post Robert M. 
Published: October 2008

BackgroundRapid-cycling bipolar disorder is defined as four or more affective episodes yearly. The conventionally recognised limit in episode duration is usually considered 24 hours (i.e. a cycle duration of 48 hours). We report a small series of intensively observed bipolar patients who showed much faster patterns of mood oscillation.MethodsDetailed, systematic, longitudinal assessment of five bipolar patients during extended in-patient psychiatric evaluation were conducted, including retrospective life charting and prospective evaluation of daily mood by self and blinded observer ratings, and motor activity recording.ResultsOur data demonstrate a spectrum of cycling frequencies in rapid-cyclers, including distinct, clinically robust mood shifts that occur at frequencies faster than once per 24 hours. Affective oscillations spanned a range of cycling frequencies from four episodes per year (rapid cycling) to those occurring within the course of weeks to several days (ultra-rapid cycling), to distinct, abrupt mood shifts of less than 24 hours' duration (ultra-ultra rapid or ultradian cycling). The time of onset and duration of these ultradian affective fluctuations are highly variable and they are observed in bipolar patients without evidence of personality disorder.ConclusionsThe potential clinical and theoretical implications of these first systematic observations of ultra-rapid and ultradian cycling in the context of the evolution of otherwise classical bipolar affective illness are discussed.
Speech and Language in First Onset Psychosis Differences Between People with Schizophrenia, Mania, and Controls
Authors: Thomas Philip , Kearney Gabby , Napier Elizabeth , Ellis Elin , Leudar Ivan , Johnston Margaret 
Published: October 2008

BackgroundSeveral studies have revealed linguistic differences between diagnostic groups. This study investigates the extent to which these differences are accounted for by factors such as chronicity, or disturbances in cognition associated with acute psychosis.MethodTranscripts of interviews with patients suffering from RDC schizophrenia (n=38), mania (n=11) and controls (n=16) were examined using the Brief Syntactic Analysis (BSA). Patients were within two years of first onset of psychotic symptoms, and received tests of working memory and attention.ResultsThe speech of patients with schizophrenia was syntactically less complex than that of controls. Patients with schizophrenia and mania made more errors than controls. These differences were, to some extent, related to group differences in social class, working memory and attention, although significant group differences in language persisted after the effects of covariates were removed.ConclusionsThe study confirms the existence of differences in the speech of psychiatric patients. Low complexity appears to be a particular feature of speech in schizophrenia, even in the earliest stages of the condition. The importance of this finding is discussed in relation to two recent theories of schizophrenia: Crow's evolutionary model, and Friths neuro-psychological model.
A Typology of Sub-Clinical Senescent Cognitive Disorder
Authors: Ritchie Karen , Leibovici Didier , Ledésert Bernard , Touchon Jacques 
Published: October 2008

BackgroundCognitive impairment without dementia is commonly observed in ageing populations. The present study aims to describe types of impairment and evolution over a one-year period.MethodThree hundred and ninety-seven normal French elderly persons demonstrating recent, observable change in cognitive performance were examined annually using a computerised cognitive examination.ResultsFive subtypes were differentiated by cluster analysis. Two of the groups were predicted by logistic regression to be at high risk of senile dementia. Of 16 incident cases of senile dementia diagnosed in the following year, 13 were found to have derived from these two groups. The typology was also found to be useful in the description of age-associated memory impairment.ConclusionsSubclinical cognitive impairment was found to not constitute a unitary phenomenon and heterogeneous subgroups could be differentiated. The concept of ‘normality’ in elderly cohorts is reconsidered in the light of these findings.