bluuebunny/crossref_metadata_2025_split huggingface dataset:
Cognitive dysfunction in patients with relapsing-remitting multiple sclerosis
Authors: Nocentini U , Pasqualetti P , Bonavita S , Buccafusca M , De Caro M F , Farina D , Girlanda P , Le Pira F , Lugaresi A , Quattrone A , Reggio A , Salemi G , Savettieri G , Tedeschi G , Trojano M , Valentino P , Caltagirone C 
Published: December 2005

Cognitive dysfunction is considered one of the clinical markers of multiple sclerosis (MS). However, in the literature there are inconsistent reports on the prevalence of cognitive dysfunction, and separate data for the relapsing-remitting (RR) type of the disease are not always presented. In this study, we submitted 461 RRMS patients to a battery of neuropsychological tests to investigate their impairment in various cognitive domains. As a consequence of the exclusion criteria, the sample is not fully representative of the entire population of RRMS patients. In this selected sample, when only the eight scores of a core battery (Mental Deterioration Battery) were considered (with respective cutoffs), it emerged that 31% of the patients were affected by some degree of cognitive deficit. In particular, 15% had mild, 11.2% moderate and 4.8% had severe impairment. Information processing speed was the most frequently impaired area, followed by memory. When two other tests (SDMT and MCST) were added and cognitive domains were considered, it emerged that 39.3% of the patients were impaired in two or more domains. When four subgroups were obtained by means of cluster analysis and then compared, it emerged that information processing speed and memory deficits differentiated the still cognitively unimpaired from the mildly impaired MS patients. Significant associations were found between cognitive and clinical characteristics. However, due to the large sample size, clinically irrelevant relationships may also have emerged. Even with the limitations imposed by the sample selection and the possible underestimation of the prevalence and severity of cognitive dysfunction, these results seem to provide further evidence that information processing speed deficit may be an early and important marker of cognitive impairment in MS patients.
The effect of consent guidelines on a multiple sclerosis register
Authors: Ford Helen L 
Published: December 2005

Background The 1998 Data Protection Act and guidelines from the General Medical Council on informed consent have caused concern for medical researchers and particularly those involved in the management of disease registers. Objective The aim of this study was to determine rates of consent for a multiple sclerosis (MS) community-based register and to investigate authorization bias by examining the characteristics of those refusing consent. Methods A consent letter was developed with the advice and support of an advisory group which included people with MS. All people with MS on the prevalent register (n=820) were informed about the register and its purposes and asked to indicate whether they would like their details to be removed from the register. Results Thirty-four (4.1%) people with MS asked for their details to be removed from the register. There was a significant difference in disease course in this group with more patients with benign relapsing-remitting disease compared to the prevalent population. There was no significant difference in age or sex distribution. The proportion of people not giving consent was similar to a local stroke register. Prospectively all new patients have given written informed consent. Conclusion Patients refusing consent may have different disease characteristics than those who consent. The potential for response bias needs to be considered in the development of a UK MS register.
Personality disorder and the outcome of depression:
Meta-analysis of published studies
Authors: Newton-Howes Giles , Tyrer Peter , Johnson Tony 
Published: December 2005

BackgroundThere is conflicting evidence about the influence of personality disorder
on outcome in depressive disorders.AimsMeta-analysis of studies in which a categorical assessment of personality
disorder or no personality disorder was made in people with depressive
disorders, and categorical outcome (recovered/not recovered) also
determined.MethodSystematic electronic search of the literature for relevant publications.
Hand searches of Journal of Affective Disorders and
recent reviews, with subsequent meta-analysis of selected studies.ResultsComorbid personality disorder with depression was associated with a
doubling of the risk of a poor outcome for depression compared with no
personality disorder (random effects model OR=2.18, 95% C11.70–2.80), a
robust finding maintained with only Hamilton-type depression criteria at
outcome (OR=2.20, 95% C11.61–3.01). All treatments apart from
electroconvulsive therapy (ECT) showed this poor outcome, and the ECT
group was small.ConclusionsCombined depression and personality disorder is associated with a poorer
outcome than depression alone.
Obstetric variables associated with bipolar affective puerperal psychosis
Authors: Blackmore Emma Robertson , Jones Ian , Doshi Monica , Haque Sayeed , Holder Roger , Brockington Ian , Craddock Nick 
Published: December 2005

BackgroundPrevious cross-sectional studies have highlighted a number of obstetric variables that may be associated with the development of broadly defined puerperal (post-partum) psychosis. These include: (a) primiparity (b) pregnancy complications, (c) delivery complications, (d) Caesarean section, (e) female baby and (f) shorter gestation period.AimsTo examine these risk factors in women with well-characterised bipolar affective puerperal psychosis.MethodA sample of 129 women with bipolar affective puerperal psychosis were investigated using a design that takes advantage of within-subject comparisons of affected and unaffected deliveries.ResultsTwo of the variables studied were independently associated with an episode of puerperal psychosis: primiparity (odds ratio=3.76,P<0.001) and delivery complications (odds ratio=2.68,P=0.022).ConclusionsThis study provides further evidence of the association between primiparity and puerperal psychosis and suggests that complications during delivery may be associated with a severe post-partum episode.
Efficacy of ethyl-eicosapentaenoic acid in bipolar depression:
Randomised double-blind placebo-controlled study
Authors: Frangou Sophia , Lewis Michael , McCrone Paul 
Published: December 2005

BackgroundEpidemiological and clinical studies suggest that increased intake of
eicosapentaenoic acid (EPA) alleviates unipolar depression.AimsTo examine the efficacy of EPA in treating depression in bipolar
disorder.MethodIn a 12-week, double-blind study individuals with bipolar depression were
randomly assigned to adjunctive treatment with placebo
(n=26) or with 1g/day (n=24) or 2
g/day (n=25) of ethyl-EPA. Primary efficacy was assessed
by the Hamilton Rating Scale for Depression (HRSD), with changes in the
Young Mania Rating Scale and Clinical Global Impression Scale (CGI) as
secondary outcome measures.ResultsThere was no apparent benefit of 2g over 1g ethyl-EPA daily. Significant
improvement was noted with ethyl-EPA treatment compared with placebo in
the HRSD (P=0.04) and the CGI (P=0.004)
scores. Both doses were well tolerated.ConclusionsAdjunctive ethyl-EPA is an effective and well-tolerated intervention in
bipolar depression.
Natural history of depression in the oldest old
Authors: Stek Max L. , Vinkers David J. , Gussekloo Jacobijn , Van Der Mast Roos C. , Beekman Aartjan T. F. , Westendorp Rudi G. J. 
Published: December 2005

BackgroundDespite its negative consequences, little is known about the natural
history of depression in the oldest old.AimsTo study the incidence, course and predictors of depression in the
general population of the oldest old.MethodThe Leiden 85-plus Study is a prospective population-based study of 500
people from their 85th to their 89th birthdays. Depressive symptoms were
annually assessed with the 15-item Geriatric Depression Scale, using a
cut-off of 4 points.ResultsDuring a mean follow-up of 3.9 years, the annual risk for the emergence
of depression was 6.8%. Poor daily functioning and institutionalisation
predicted depression. Among the 77 participants with depression at
baseline (prevalence 15%) the annual remission rate was ony 14%. In more
than half of the participants with a remission of depression, we observed
a relapse of depression during follow-up. No predictors of remission
could be identified.ConclusionsAmong the oldest old, depression is frequent and highly persistent. More
active case-finding and treatment would be potentially rewarding.
An ethical framework for psychiatry
Authors: Bloch Sidney , Green Stephen A. 
Published: December 2005

SummaryPsychiatry has not reached a consensus hitherto concerning an optimal
theoretical framework for ethical decision-making and corresponding action.
Various theories have been considered, but found wanting. Moreover, classic
theories may contradict one another, contribute to confusion and immobilise
the clinician. We have examined major theories commonly applied in
bioethics, conferred with moral philosophers and psychiatrists and striven
to apply more recent insights drawn from moral philosophy. We report that
instead of pursuing a single theoretical framework, we should garner the
strengths of compatible approaches in a synergistic way. We propose a
particular complementarity of principlism – with its pragmatic focus on
respect for autonomy, beneficence, non-maleficence and justice – and care
ethics, avariant of virtue theory, which highlights character traits
pertinent to caring for vulnerable psychiatric patients.
Mental health, burnout and job satisfaction among mental health
social workers in England and Wales
Authors: Evans Sherrill , Huxley Peter , Gately Claire , Webber Martin , Mears Alex , Pajak Sarah , Medina Jibby , Kendall Tim , Katona Cornelius 
Published: December 2005

BackgroundPrevious research suggests that social workers experience high levels of
stress and burnout but most remain committed to their work.AimsTo examine the prevalence of stress and burnout, and job satisfaction
among mental health social workers (MHSWs) and the factors responsible
for this.MethodA postal survey incorporating the General Health Questionnaire, Maslach
Burnout Inventory, Karasek Job Content Questionnaire and a job
satisfaction measure was sent to 610 MHSWs in England and Wales.ResultsEligible respondents (n=237) reported high levels of
stress and emotional exhaustion and low levels of job satisfaction; 111
(47%) showed significant symptomatology and distress, which is twice the
level reported by similar surveys of psychiatrists. Feeling undervalued
at work, excessive job demands, limited latitude in decision-making, and
unhappiness about the place of MHSWs in modern services contributed to
the poor job satisfaction and most aspects of burnout. Those who had
approved social worker status had greater dissatisfaction.ConclusionsStress may exacerbate recruitment and retention problems. Employers must
recognise the demands placed upon MHSWs and value their contribution to
mental health services.
Specialised care for early psychosis: Symptoms, social
functioning and patient satisfaction
Authors: Garety Philippa A. , Craig Tom K. J. , Dunn Graham , Fornells-Ambrojo Miriam , Colbert Susannah , Rahaman Nikola , Reed Jason , Power Paddy 
Published: December 2005

BackgroundThe provision of early intervention services for people with psychosis is
UK government policy, although evidence for benefit of such services is
sparse.AimsTo evaluate the effects of a service providing specialised care for early
psychosis (the Lambeth Early Onset team) on clinical and social outcomes,
and on service user satisfaction.MethodOne hundred and forty-four people with psychosis, presenting to mental
health services for the first or second time (if previously failed to
engage in treatment), were randomly allocated to care by the early onset
team or to standard care. Information was obtained on symptoms, treatment
adherence, social and vocational functioning, satisfaction and quality of
life. Relapse and rehospitalisation data have been reported
separately.ResultsOutcomes for the participants treated by the early onset team were
significantly better at 18 months for aspects of social and vocational
functioning, satisfaction, quality of life and medication adherence.
Symptom improvement did not significantly differ between the groups.ConclusionsThe provision of specialised care for early psychosis can achieve better
outcomes. The study therefore provides support for current policy.
Impact of immigration detention and temporary protection on the mental health of refugees
Authors: Steel Zachary , Silove Derrick , Brooks Robert , Momartin Shakeh , Alzuhairi Bushra , Susljik Ina 
Published: December 2005

BackgroundOver the past decade, developed Western countries have supplied increasingly stringent measures to discourage those seeking asylum.AimsTo investigate the longer-term mental health effects of mandatory detention and subsequent temporary protection on refugees.MethodLists of names provided by community leaders were supplemented by snowball sampling to recruit 241 Arabic-speaking Mandaean refugees in Sydney (60% of the total adult Mandaean population). Interviews assessed posttraumatic stress disorder (PTSD), major depressive episodes, and indices of stress related to pasttrauma, detention and temporary protection.ResultsA multilevel model which included age, gender, family clustering, pre-migration trauma and length of residency revealed that past immigration detention and ongoing temporary protection each contributed independently to risk of ongoing PTSD, depression and mental health-related disability. Longer detention was associated with more severe mental disturbance, an effect that persisted for an average of 3 years after release.ConclusionsPolicies of detention and temporary protection appear to be detrimental to the longer-term mental health of refugees.
Anomalies of asymmetry of pyramidal cell density and structure
in dorsolateral prefrontal cortex in schizophrenia
Authors: Cullen Thomas J. , Walker Mary A. , Eastwood Sharon L. , Esiri Margaret M. , Harrison Paul J. , Crow Timothy J. 
Published: December 2005

BackgroundStudies suggest that neuronal density in left dorsolateral prefrontal
cortex is increased in schizophrenia.AimsTo replicate these findings and extend them to both hemispheres.MethodNeuronal density, size and shape were estimated in the prefrontal cortex
(Brodmann area 9) of the left and right hemispheres of brains taken
postmortem from 10 people with schizophrenia and 10 without mental
illness (6 men, 4 women in both groups).ResultsOverall neuronal density (individually corrected for shrinkage) did not
differ between the groups. In the control brains, density was generally
greater in the left than the right hemisphere, the reverse was seen in
the schizophrenia brains; this loss or reversal of asymmetry was most
significant in cortical layer 3. Pyramidal neurons in this cell layer
were significantly larger on the left and more spherical in shape than on
the right side in control brains, but size and shape did not differ
between the two sides in schizophrenia. Non-pyramidal and glial cell
densities were unchanged.ConclusionsWe failed to find an increase in neuronal density, but found evidence at
a cellular level of loss or reversal of asymmetry, consistent with the
hypothesis of a primary change in the relative development of areas of
heteromodal association cortex in the two hemispheres.
Rural/non-rural differences in rates of common mental disorders
in Britain
Authors: Weich Scott , Twigg Liz , Lewis Glyn 
Published: December 2005

BackgroundSome UK studies have reported an urban excess in the prevalence of the
most common mental disorders of anxiety and depression.AimsTo investigate rural/non-rural differences in the onset and maintenance
of episodes of common mental disorders, after adjusting for the
characteristics of respondents and their households.MethodA 12-month cohort study of 7659 adults aged 16–74 years living in 4338
private households, nested within 626 electoral wards in England, Wales
and Scotland. Common mental disorders were assessed using the General
Health Questionnaire (GHQ). Electoral wards were characterised by Office
for National Statistics classification and by population density. Data
were analysed using multilevel statistical modelling.ResultsRural residents had slightly better mental health than non-rural
counterparts. The effects of geographical location on the mental health
of participants were neither significantly confounded nor modified by
socioeconomic status, employment status or household income.ConclusionsThere are small but statistically significant differences in rates of
common mental disorders between urban and rural residents. Quantifying
between-place differences using population density alone risks missing
important contextual effects on mental health.
Genetic variation of brain-derived neurotrophic factor (BDNF) in bipolar disorder
Authors: Green Elaine K. , Raybould Rachel , Macgregor Stuart , Hyde Sally , Young Allan H. , O'Donovan Michael C. , Owen Michael J. , Kirov George , Jones Lisa , Jones Ian , Craddock Nick 
Published: December 2005

BackgroundBrain-derived neurotrophic factor (BDNF) influences neuronal survival, proliferation and plasticity Three family-based studies have shown association of the common Valine (Val) allele of the Val66Met polymorphism of theBDNFgene with susceptibility to bipolar disorder.AimsTo replicate this finding.MethodWe genotyped the Val66Met polymorphism in our UK White bipolar case-control sample (n=3062).ResultsWe found no overall evidence of allele or genotype association. However, we found association with disease status in the subset of 131 individuals that had experienced rapid cycling at some time (P=0.004). We found a similar association on re-analysis of our previously reported family-based association sample (P<0.03, one-tailed test).ConclusionsVariation at the Val66Met polymorphism ofBDNFdoes not play a major role in influencing susceptibility to bipolar disorder as a whole, but is associated with susceptibility to the rapid-cycling subset of the disorder.
Men with severe learning disabilities and challenging behaviour
in long-stay hospital care
Authors: Hubert Jane , Hollins Sheila 
Published: December 2005

BackgroundCommunity-based health and social care professionals have little
knowledge of the past experiences of people with severe learning
disabilities and challenging behaviour who are living in
institutions.AimsTo gain a greater understanding of the experiences and needs of men who
are living in a locked ward.MethodThe study sample consisted of 20 men who were living in a locked ward of
a long-stay institution. Qualitative (ethnographic) methods were used,
involving participant observation (for around 250 hours) on the ward. All
traceable families were interviewed. The analysis used grounded theory,
and material was fed back into the resettlement process throughout.ResultsThe men's lives were emotionally, socially and physically deprived. Their
individual, gender and social identities were not recognised, and their
general health and mental healthcare needs were inadequately
addressed.ConclusionsPeople who live in long-stay institutions, segregated from society, lose
their individual and social identity, which complicates the presentation
of mental health and behavioural problems, and raises important adult
protection issues.
The 10/90 divide in mental health research: Trends over a
10-year period
Authors: Saxena Shekhar , Paraje Guillermo , Sharan Pratap , Karam Ghassan , Sadana Ritu 
Published: December 2005

SummaryA search (precision value 94%, recall value 93%) of the ISI Web of Science
database (1992–2001) revealed that mental health publications accounted for
3–4% of the health literature. A 10/90 divide in internationally accessible
mental health literature was evident and remained undiminished through 10
years as low- and middle-income countries (n= 152)
contributed only 6%, high-income countries (n=54) 94%, and
14 leading high-income countries (with more than 1% contribution for
majority of years under consideration) contributed 90% of internationally
accessible mental health research. Steps should be taken to improve the
research infrastructure and capacity to conduct and disseminate mental
health research in general, and on a priority basis in low- and
middle-income countries.
Progress in the treatment of borderline personality
disorder
Authors: Fonagy Peter , Bateman Anthony 
Published: December 2005

SummaryWe outline recent evidence suggesting that the natural course of borderline
personality disorder is more benign than formerly believed. We explore
possible reasons for the change in findings which include both the
iatrogenic effects of earlier treatment models and the recent availability
of effective interventions. Clinicians should be optimistic about
improvement and long-term outcomes.
Survey of the provision of psychological therapies for older people
Authors: Evans Ceri , Reynolds Paul 
Published: December 2005

Aims and MethodThe aim of the present study was to assess the current state of provision of psychological therapies for older people in Wales. A postal questionnaire was sent to all consultant old age psychiatrists in Wales, requesting information regarding the consultant's community mental health team (CMHT) and access to psychological therapies.ResultsA response rate of 85% was achieved: 45% of CMHTs had team members providing psychological therapy; 31% of CMHTs had access to psychological therapy via the team and also generic services. The estimated average wait for generic services was 29 weeks. There was no access to psychological therapies for 17% of CMHTs.Clinical ImplicationsIn some areas of Wales there is limited or no access to psychological therapies via mental health services for older people. This may represent an important unmet need. Long-term strategies, taking into account recruitment and retention, training and new ways of working, need to be implemented.
Capacity, compliance and electroconvulsive therapy (ECT): the practice of ECT among consultant psychiatrists
Authors: Law-Min Richard , Stephens John Patrick 
Published: December 2005

Aims and MethodThe aim of this study was to seek the views of consultant psychiatrists on the legal framework they would use when considering treatment with electroconvulsive therapy (ECT). A questionnaire, consisting of three clinical vignettes, was sent to 70 consultants in the Wessex rotation (East Dorset/Hampshire region).ResultsA total of 56 questionnaires were returned; a response rate of 80%. Most consultant psychiatrists agree when giving ECT to capacitated and non-consenting patients. However, there was a lack of consensus when dealing with seemingly incapacitated but compliant patients.Clinical ImplicationsMore clarification in this area is needed. Trusts can assist clinicians by devising their own policies based on nationally agreed standards of best practice. The treatment of mentally incapacitated but compliant patients is an area of practice where uncertainty exists. If proceeding under common law in such cases, it is good practice to discuss with relatives/carers and obtain a second opinion from a consultant colleague. The most recent Bournewood judgement and the new Mental Health Bill will have further implications for clinical practice.