bluuebunny/crossref_metadata_2025_split huggingface dataset:
Does Imagined Exposure to the Consequences of Not Ritualising Enhance Live Exposure for OCD? a Controlled Study
Authors: Ito L. M. , Marks I. M. , De Araujo L. A. , Hemsley D. 
Published: October 2008

BackgroundThis study tested whether adding imagined exposure to live exposure would increase the concordance between behavioural and subjective improvement in obsessive–compulsive disorder (OCD).Method46 OCD out-patients were randomly allocated to 9 weekly sessions of either combined live + imagined exposure/ritual prevention (Exi, n = 23), or only live exposure/ritual prevention (Ex, n = 23). Patients were asked to do 90 min of daily self-exposure at home (corresponding to Exi or Ex). Measures were: (A) behavioural; (B) subjective; (C) clinical global impression (CGI).ResultsAfter 9 weeks of treatment, improvement was greater on behavioural than subjective measures (similar for the Exi and Ex groups). At 20 weeks (3-month follow-up) each group had improved slightly more on subjective measures and slightly less on behavioural ones. Two subjective measures improved less during Exi than Ex, but this difference disappeared at follow-up. The greater difference between behavioural and subjective improvement scores in Exi than in Ex did not relate to clinical outcome at the end of treatment or follow-up.ConclusionsCompared to live exposure alone, combined imagined plus live exposure did not enhance behavioural/subjective concordance.
Sexual Abuse in Patients with Eating Disorder, Patients with Depression, and Normal Controls
Authors: Vize Christine M. , Cooper Peter J. 
Published: October 2008

BackgroundA history of sexual abuse has been widely reported in patients with eating disorders. However, the association does not appear to be specific, because a high rate of such abuse has also been found in other psychiatric patients.MethodA standardised interview method was used to elicit details of sexual abuse in a psychiatrically normal control group and samples of patients with anorexia nervosa, bulimia nervosa, or depression.ResultsAn equally high rate of abuse was found in all three clinical samples. Among the patients with anorexia nervosa the presence of bulimic episodes was not found to be associated with reports of abuse; and among the patients with bulimia nervosa there was no relationship between abuse and a history of anorexia nervosa. Among the patients with eating disorders, borderline personality disorder, assessed by means of self-report questionnaire, was not found to be related to reports of abuse, although there was an association between abuse and both indices of impulsive behaviour and the overall level of personality disturbance.ConclusionsChildhood sexual abuse appears to be a vulnerability factor for psychiatric disorder in general and not eating disorders in particular. The way in which abuse interacts with other aetiological factors to produce different psychopathological trajectories remains to be elucidated.
Gender and Schizophrenia Results of an Epidemiologically-based Family Study
Authors: Kendler Kenneth S. , Walsh Dermot 
Published: October 2008

BackgroundGender may have a significant impact on the prevalence, age at onset, symptoms, course and outcome of schizophrenia, as well as on the pattern of psychopathology in relatives.MethodWe examined these questions in the Roscommon Family Study, in which the probands were epidemiologically sampled from a case registry and followed up an average of 15 years after onset. Face-to-face interviews were conducted with 86% of traceable living relatives.ResultsThe treated lifetime prevalence of DSM–III–R schizophrenia was 0.54 ± 0.06% in men and 0.28 ± 0.04% in women. No significant differences were seen in the age at onset, symptoms, course or outcome of schizophrenia. The risks for schizophrenia, schizophrenia spectrum disorders, affective illness and alcoholism were similar in relatives of male and female schizophrenic probands.ConclusionsGender has little impact on the presentation and course of schizophrenia in the west of Ireland. The familial liability to schizophrenia did not differ in affected men and women. No evidence was found that schizophrenia in women, compared to men, is, from a symptomatic or familial perspective, more closely related to affective illness. The substantial gender difference in the prevalence rate of schizophrenia in Ireland cannot be explained by women having a greater resistance to the familial predisposition to illness.
Sensorimotor Cortex and Supplementary Motor Area Changes in Schizophrenia
Authors: Schröder J. , Wenz F. , Schad L. R. , Baudendistel K. , Knopp M. V. 
Published: October 2008

BackgroundNeurological soft signs (NSS) such as a disturbed finger-to-thumb opposition are frequently found in schizophrenia. To identify the underlying cerebral changes we investigated sensorimotor cortex and supplementary motor area (SMA) activation during finger-to-thumb opposition using functional magnetic resonance imaging (fMRI).MethodTen DSM–III–R schizophrenics and seven healthy controls were included. All subjects were right-handed. fMRI was carried out in a resting condition followed by an activation state (finger-to-thumb opposition) and the activities in the sensorimotor cortices and SMA recorded.ResultsAll subjects showed a significant activation of the SMA and both ipsilateral and contralateral sensorimotor cortices. In the controls, ipsilateral finger-to-thumb opposition was associated with a greater left than right hemispheric sensorimotor cortex coactivation. When compared with the healthy controls, the schizophrenic patients showed a decreased activation of both sensorimotor cortices and SMA, as well as a reversed lateralisation effect.ConclusionSensorimotor cortex and SMA dysfunction are associated with motor disturbances in schizophrenia.
Episodes of Care for First-Ever Psychiatric Patients a Long-Term Case-Register Evaluation in a Mainly Urban Area
Authors: Tansella Michele , Micciolo Rocco , Biggeri Annibale , Bisoffi Giulia , Balestrieri Matteo 
Published: October 2008

BackgroundPsychiatric case registers (PCRs) are particularly useful for studying patterns of care over time. Methods of ‘survival analysis’ have rarely been used for assessing such data.MethodA longitudinal study was conducted over 10 years (1 January 1982 to 31 December 1991) on 1423 first-ever psychiatric patients, using the PCR of South Verona, Italy. The product-limit method, the log-rank test, the Cox regression model and the Poisson regression analysis were used to analyse episodes of care and relapses.ResultsThe duration of the episodes of care increased consistently from the first to the fifth episode. The probability of opening a new episode of care after the first one increased consistently from the second to the sixth episode. The only variable significantly associated with the length of the first episode of care was diagnosis (highest probability of having longer episodes for schizophrenic patients), while the length of the breaks following the first episode of care was associated with diagnosis, sex and occupational status (highest probability of opening a second episode of care for schizophrenic subjects and those with alcohol and personality disorders, for males, and for unemployed patients). The probability of opening a new episode of care decreased with time since last contact and increased with number of previous contacts.ConclusionsThe community psychiatric service in South Verona is fulfilling its original aim, that is, to give priority to the continuity of care for patients with chronic and severe mental illnesses. Survival analyses proved to be useful methods for assessing episodes of care.
Brain Perfusion Abnormalities in Gilles de la Tourette's Syndrome
Authors: Moriarty John , Costa Durval Campos , Schmitz Bettina , Trimble Michael R. , Ell Peter J. , Robertson Mary M. 
Published: October 2008

BackgroundFunctional brain imaging with technetium-99m d,l-hexamethyl propyleneamine oxime (HMPAO) Single Photon Emission Tomography (SPET) allows us to explore the cerebral pathophysiology of Gilles de la Tourette's Syndrome (GTS).MethodFifty patients and 20 controls were examined. Patients were rated for tic severity and mood. Scans were analysed quantitatively using internal ratios to the occipital cortex.ResultsPatients differed from controls on measures of relative blood flow to the left caudate, anterior cingulate cortex and the left dorsolateral prefrontal cortex. Severity of tics was related to hypoperfusion of the left caudate and cingulate and a left medial temporal region. Hypoperfusion in the left dorsolateral prefrontal region was related to mood.ConclusionsThe areas found to be hypoperfused in this study are consistent with known functions of fronto-striatal circuits. A wide range of perfusion patterns is seen, however, and no characteristic patterns for behavioural subgroups has been documented with this technique.
The Edinburgh Primary Care Depression Study: Personality Disorder and Outcome
Authors: Patience Douglas A. , McGuire Ralph J. , Scott Allan I. F. , Freeman Christopher P. L. 
Published: October 2008

BackgroundLittle is known about the impact of personality pathology on the treatment outcome of major depressive illness in primary care in the UK.MethodPatients meeting criteria for DSM–III major depressive disorder were randomly allocated to one of four treatments each lasting 16 weeks, then followed up for 18 months. Assessments were made of depressive symptoms, personality and social functioning. Personality was assessed at maximum improvement or 16 weeks.ResultsThe prevalence of personality disorder (PD) in the sample of 113 patients was 26%. Patients with a PD were significantly younger and rated more depressed at entry than patients with no personality disorder (NoPD). On completion of treatment patients with a PD were significantly more depressed and had poorer social functioning than the NoPD group. After 18 months there were no differences in ratings of depression or social functioning between the groups.ConclusionsThere was substantial improvement in both the PD and NoPD groups. The presence of personality pathology delays recovery from major depressive illness.
Effect of Exposure to Dothiepin and Northiaden in Breast Milk on Child Development
Authors: Buist Anne , Janson Helen 
Published: October 2008

BackgroundThis study looks at the outcome of infants exposed to dothiepin in breast milk in an attempt to guide clinicians on the risk-benefit ratio of breast-feeding when on antidepressants.MethodThirty women, who had had HDRS scores > 15 within the first five years postpartum from the same women's hospital, were assessed with their children 3–5 years postpartum; half had breast-fed while on dothiepin (study group). Thirty-six non-depressed women were also assessed. Rating scales assessed depression, anxiety, self-esteem, personality, social support, marital relationship, child behaviour and temperament. The children were assessed by the McCarthy Scale.ResultsComparisons of the two depressed groups showed no significant differences on any measures except marital conflict and child behaviour, which were the most disturbed in the study group (P < 0.001). Overall cognitive scores for the children did not differ between the groups. Higher levels of dothiepin and northiaden were associated with higher cognitive scores on subscales (P = 0.02).ConclusionsWe are cautiously optimistic about the lack of any negative associations between cognitive development and exposure to dothiepin via breast milk.
Supportive Psychotherapy the Search for Positive Meanings
Authors: Holmes Jeremy 
Published: October 2008

BackgroundThe attempt to define psychotherapeutic skills appropriate for psychiatrists has aroused an interest in supportive psychotherapy, a previously undervalued and underdeveloped member of the psychotherapeutic family. This has been coupled with an increasing recognition of the importance of support within formal psychotherapies, especially when working with highly disturbed patients.MethodA review of supportive psychotherapy (ST) was performed, based on a Medline literature search.ResultsIt is argued that, from the perspective of attachment theory, support is an integral part of all psychotherapies. ST is also a specific mode of treatment suitable for some patients suffering from psychotic illnesses and borderline personality disorder. ST is an eclectic treatment drawing on many theoretical approaches. A common theme based on a narrative co-constructionist perspective, the search for positive meaning, is identified.ConclusionsSupportive psychotherapy is an essential component of good psychiatric practice. Further research is needed to define its benefits and limitations.
Social Deprivation and Psychiatric Admission Rates Among Different Diagnostic Groups
Authors: Harrison Judy , Barrow Steve , Creed Francis 
Published: October 2008

BackgroundIn the search for population-based indicators of need for mental health services, psychiatric admission rates have been correlated with sociodemographic variables. We explored such correlations for different diagnostic groups.MethodAdmissions data for the 19 districts in the North West Region were derived from the Korner Episode System for 1992/3 and divided into eight broad diagnostic groups using ICD–9 codes. Admission rates per 1000 were correlated with measures of deprivation derived from the 1991 census data and with standardised mortality ratios. For the two largest diagnostic groups, correlations with age-standardised admission rates were also calculated.ResultsFor schizophrenia/delusional disorder, eight of the 10 sociodemographic measures were significantly correlated with admission rates (Pearson'sr0.52–0.79). On all measures these correlations were greater than those seen for total mental illness. Significant positive correlations of a lower order were seen for organic brain syndromes and mania. Admission rates for depression, personality disorder and substance misuse were not significantly correlated with any of the sociodemographic measures. Admission rates for neurotic illness were negatively correlated with all deprivation measures, with the negative correlation statistically significant at the 5% level for ethnic composition and overcrowding. Standardising admission rates for age and repeating the analysis after removal of influential data points did not greatly alter these findings.ConclusionsThe association between psychiatric admission rates and measures of deprivation varies considerably with diagnosis. Measures of social deprivation may indicate need for services for patients with psychotic disorders; admission rates for non-psychotic illnesses may reflect the availability of beds rather than need.
Long-Term Follow-up after a Drug Trial for Panic Disorder
Authors: Katschnig Heinz , Amering Michaela , Stolk Jon M. , Klerman Gerald L. , Ballenger James C. , Briggs Andrew , Buller Raimund , Cassano Giovanni , Garvey Michael , Roth Sir Martin , Solyom Carol 
Published: October 2008

BackgroundThis study investigates the naturalistic course of panic disorder over four years and attempts to identify predictors for outcome.Method423 DSM–III–R panic disorder patients who had taken part in an international multicentre drug trial were selected for follow-up; we were able to re-interview 367 (87%). For panic attacks, phobic avoidance and disabilities the same rating scales were administered as had been used for the clinical trials.ResultsWhile 61 % of all patients experienced at least occasional panic attacks at follow-up, few suffered from serious phobic avoidance (16.7%) or serious disabilities (work 7.9%; family 8.7%; social 13.9%). Panic attack frequency at baseline, original trial medication and continuous use of psychotropic medication during follow-up are not related to outcome, whereas longer duration of illness and more severe phobic avoidance at baseline are unfavourable.ConclusionThe course of panic disorder is not uniform. Since long duration of illness and severe phobic avoidance at baseline are predictors for an unfavourable outcome, more rigorous efforts should be undertaken to detect and treat panic disorder at an early stage.
Incorporating Psychological Debriefing Techniques within a Brief Group Psychotherapy Programme for the Treatment of Post-Traumatic Stress Disorder
Authors: Busuttil Walter , Turnbull Gordon J. , Neal Leigh A. , Rollins John , West Adrian G. , Blanch Nick , Herepath Ronald 
Published: October 2008

BackgroundThe Royal Air Force Wroughton Post-Traumatic Stress Disorder (PTSD) Rehabilitation Programme is described. It comprised a 12-day structured in-patient ‘course’ of group psychotherapy and day-case group follow-up sessions over a one-year period. Psychological debriefing was the main therapeutic technique employed.MethodThis is a ‘before and after’ open outcome study. A comprehensive assessment protocol confirmed the presence and severity of PTSD and measured co-morbid psychopathological status, occupational and social function longitudinally.ResultsA highly significant global response to treatment is demonstrated in the 34 subjects included in the study, with 85.3% not fulfilling the DSM–III–R criteria for PTSD at one year after treatment.ConclusionsFurther controlled studies assessing the value of psychological debriefing techniques in the treatment of established PTSD are required.
Selective Serotonin Reuptake Inhibitors and Tricyclic Antidepressants in Combination
Authors: Taylor David 
Published: October 2008

BackgroundThe selective serotonin reuptake inhibitors (SSRIs) are now widely used in the treatment of depressive illness. Interest has grown in the use of SSRIs as alternatives to tricyclic antidepressants (TCAs) and in the therapeutic use of combinations of SSRIs and TCAs in refractory depression.MethodMEDLINE and PSYCLit literature searches were conducted. Reference sections from papers retrieved were scrutinised for other relevant reports.ResultsOf 41 relevant articles identified, 35 were selected for review.ConclusionsFluoxetine, fluvoxamine, paroxetine and sertraline may substantially increase TCA plasma levels when given concurrently. Such interactions may give rise to adverse effects. The effect of sertraline may be less profound than that of fluoxetine, fluvoxamine and paroxetine. Limited data suggest that citalopram may not affect TCA serum levels. There is scant literature evidence to support the use of SSRIs in combination with TCAs as a treatment for refractory depression.
The Camberwell Assessment of Need: The Validity and Reliability of an Instrument to Assess the Needs of People with Severe Mental Illness
Authors: Phelan Michael , Slade Mike , Thornicroft Graham , Dunn Graham , Holloway Frank , Wykes Til , Strathdee Geraldine , Loftus Linda , McCrone Paul , Hayward Peter 
Published: October 2008

BackgroundPeople with severe mental illness often have a complex mixture of clinical and social needs. The Camberwell Assessment of Need (CAN) is a new instrument which has been designed to provide a comprehensive assessment of these needs. There are two versions of the instrument: the clinical version has been designed to be used by staff to plan patients' care; whereas the research version is primarily a mental health service evaluation tool. The CAN has been designed to assist local authorities to fulfil their statutory obligations under the National Health Service and Community Care Act 1990 to assess needs for community services.MethodA draft version of the instrument was designed by the authors. Modifications were made following comments from mental health experts and a patient survey. Patients (n= 49) and staff (n= 60) were then interviewed, using the amended version, to assess the inter-rater and test-retest reliability of the instrument.ResultsThe mean number of needs identified per patient ranged from 7.55 to 8.64. Correlations of the inter-rater and test-retest reliability of the total number of needs identified by staff were 0.99 and 0.78 respectively. The percentage of complete agreement on individual items ranged from 100–81.6% (inter-rater) and 100–58.1% (test-retest).ConclusionsThe study suggests that the CAN is a valid and reliable instrument for assessing the needs of people with severe mental illness. It is easily learnt by staff from a range of professional backgrounds, and a complete assessment took, on average, around 25 minutes.
The Nithsdale Schizophrenia Surveys. XIV: Plasma Lipid Peroxide and Serum Vitamin E Levels in Patients with and Without Tardive Dyskinesia, and in Normal Subjects
Authors: McCreadie Robin G. , MacDonald Elizabeth , Wiles David , Campbell Graham , Paterson John R. 
Published: October 2008

BackgroundTardive dyskinesia (TD) may be mediated through free radical damage to neurons. Plasma lipid peroxide levels are a measure of radical damage to fats. Vitamin E is a free radical scavenger.MethodOne hundred and twenty-eight schizophrenic patients were examined for TD using the Abnormal Involuntary Movements Scale. Blood samples were taken to measure plasma lipid peroxide, serum vitamin E and cholesterol, and vitamin Exholesterol ratios. Twenty-four patients were also examined in October 1993, January 1994, and April 1994. Biochemical results were compared in 81 patients and 79 normal subjects.ResultsPatients with and without TD did not differ in median plasma lipid peroxide and serum vitamin E levels, or vitamin Exholesterol ratios. Correlations between seasonal change scores in TD and biochemical measurements were low. Lipid peroxide levels were higher and vitamin Exholesterol ratios lower in patients than in normal subjects. Vitamin E levels were lowest in in-patients and in those living in supported accommodation.ConclusionsThe results do not support the hypothesis that TD is mediated through free radical damage to neurons, but suggest increased free radical activity in schizophrenia.
Long-term Effects of Cognitive-Behavioural Therapy and Lithium Therapy on Depression in the Elderly
Authors: Wilson K. C. M. , Scott M. , Abou-Saleh M. , Burns R. , Copeland J. R. M. 
Published: October 2008

BackgroundWe examine the effects of cognitive-behavioural therapy (CBT) as an adjuvant to acute physical treatment and lithium maintenance therapy in reducing depression severity over a follow-up year in elderly depressed patients.MethodThe study consists of three phases. During the acute treatment and continuation phase, 17 of 31 patients received CBT as an adjuvant to treatment as usual. During the maintenance phase of 1 year, subjects were entered into a double-blind, placebo-controlled study of low-dose lithium therapy.ResultsReceiving adjuvant CBT significantly reduced patients' scores on the Hamilton Rating Scale for Depression during the follow-up year (repeated measures analyses of variance; P = 0.007). No significant differences were found between lithium and placebo maintenance therapy.ConclusionsCBT can be adapted as an adjuvant therapy in the treatment of severely depressed elderly patients and reduces depression severity during follow-up. The prophylactic failure of long-term lithium therapy may be explained through poor compliance.
The use of Statistics in the British Journal of Psychiatry
Authors: McGuigan S. M. 
Published: October 2008

BackgroundStatistical error rates in the medical literature are generally high.MethodAll papers published in the British Journal of Psychiatry in 1993 which presented numerical results were reviewed by the author for statistical errors.ResultsA total of 248 papers were published, of which 164 (66%) presented numerical results.Sixty-five (40% of 164) papers contained statistical errors. Many errors were not serious in nature, but some were serious enough to cast doubt on conclusions. The error rates are similar to those found in an earlier study.ConclusionsThe statistical error rate is unacceptably high. There is no evidence of a change in the statistical error rate over time.