bluuebunny/crossref_metadata_2025_split huggingface dataset:
Prevalence and Cluster Typology of Maladaptive Behaviours in a Geographically Defined Population of Adults with Learning Disabilities
Authors: Smith Susan , Branford David , Collacott Richard A. , Cooper Sally-Ann , McGrother Catherine 
Published: October 2008

BackgroundMaladaptive behaviours are frequently present in individuals with learning disabilities; however, their prevalence varies between studies and the aetiology, classification and most appropriate management of such behaviours remain unclear. The aims of the study were twofold: firstly to determine the prevalence of maladaptive behaviours, and secondly to develop a classification typology.MethodA population of 2202 adults with learning disabilities was surveyed to determine the prevalence of maladaptive behaviours. These were subjected on the basis of 13 behavioural characteristics to cluster analysis. The clusters were further examined in respect of secondary variables.ResultsOver 60% of individuals demonstrated the presence of at least one maladaptive behaviour and in 40% this problem was of either severe degree or frequent occurrence. Men were more likely to demonstrate physical aggression, property destruction, tantrums and verbal abuse than women. Although some severe maladaptive behaviours diminished with age, many persisted through all age groups. Six behavioural clusters were devised which demonstrated face validity and which differed in respect of demographic and developmental variables, and the prevalence of maladaptive habits and autistic symptoms.ConclusionsThese findings demonstrate a high prevalence of maladaptive behaviours and ‘objectionable habits’ among people with learning disabilities. A classification of behavioural symptoms may be possible on the basis of symptom clusters.
Physical and Psychiatric Comorbidity in General Practice
Authors: Kisely S. R. , Goldberg D. P. 
Published: October 2008

BackgroundThe aim of this study was to determine the association between physical and psychiatric morbidity among general practice patients and to explore the influence of possible intervening variables.MethodPhysical and psychiatric morbidity in 1620 consecutive patients attending their general practitioner (GP) was assessed using a two-stage design. Ninety-four per cent of the patients (n=1523) were successfully screened using the General Health Questionnaire (GHQ–12); 428 of the 602 patients (71%) eligible for the second stage were interviewed using the Composite International Diagnostic Instrument adapted for use in primary health care (CIDI–PHC), the Brief Disability Questionnaire (BDQ) and the Groningen Social Disability Schedule (GSDS) to assess psychiatric, physical and social status. Assessments of physical and psychiatric morbidity were also obtained from the patients' GPs.ResultsThere was a significant association between physical and psychiatric morbidity, although patients with four symptoms or less of physical illness were no more likely to be psychiatric cases than those with none. The association was accounted for by patients at the severe end of the physical continuum with five or more medically explained somatic symptoms: these were twice as likely to be psychiatric cases as those with no such symptoms. Female gender, social disability and physical disability were all significantly more likely to be associated with psychiatric disorder, whether measured by GP or research interview; and these relationships remained after the data were corrected for age differences.ConclusionsPatients in general practice with moderate to severe physical morbidity are at increased risk of developing psychiatric illness, and when medical illness is present, psychiatric symptoms are more severe. As physical and psychiatric comorbidity is relatively common in general practice, the specific needs of these patients should receive greater attention.
The Benzodiazepine Dependence Questionnaire: Development, Reliability and Validity
Authors: Baillie Andrew J. , Mattick Richard P. 
Published: October 2008

BackgroundA short self-report questionnaire was developed to assess dependence on benzodiazepines (BZDs), the Benzodiazepine Dependence Questionnaire (BDEPQ). The BDEPQ is the first scale to assess dependence on BZDs comprehensively, as all existing scales focus exclusively on withdrawal symptoms.MethodTo evaluate its internal consistency and construct validity, 302 regular BZD users were recruited from media advertisements and assessed on a number of measures. The BDEPQ was compared with measures of depression, anxiety, sleep quality, BZD withdrawal symptoms and neuroticism to assess its construct validity. A 3–4 month follow-up was conducted to assess the ability of the BDEPQ to predict changes in BZD consumption and future BZD withdrawal.ResultsThe BDEPQ was found to have high internal consistency and to be relatively stable over the follow-up period. Three subscales were identified, each with good internal consistency and temporal stability. The BDEPQ was able to predict the severity of withdrawal symptoms.ConclusionThe BDEPQ was found to be a reliable and valid self-report instrument for the assessment of BZD dependence in samples approximating the general population of people using BZDs.
Fragile States of Mind: Neuroticism, Vulnerability and the Long-Term Outcome of Depression
Authors: Surtees P. G. , Wainwright N. W. J. 
Published: October 2008

BackgroundThis paper considers the extent to which vulnerability to the outcome of major affective disorder is conferred through personality deviance. Results are based upon a 12 year longitudinal follow-up study of 80 patients with a primary depressive disorder, originally selected from a consecutive series seeking care at a hospital in Scotland.MethodsThe study included detailed clinical course assessments in association with the formal application of diagnostic criteria. Assessments on recovery from the index episode included measures of self-confidence and of neuroticism. Experience of selected severe loss events over the study period was also determined.ResultsLimited self-confidence was strongly related, unlike neuroticism, to the subsequent first recurrence of affective disorder. Relationships between psychosocial, clinical and demographic factors and long-term outcome revealed psychosocial factors, in particular neuroticism and a lack of self-confidence, to have the greatest prognostic significance.ConclusionsThese results reveal the heightened risk over the long-term of a poor outcome for depressive disorder consequent upon measures of personality deviance and of exposure to adversity. While giving only limited support to narrowly defined psychosocial models of depression, they clarify the risk gradients involved and through this may provide a firmer basis than hitherto for relapse prevention.
Long-Term Stability of Diagnosis and Symptom Dimensions in a Systematic Sample of Patients with Onset of Schizophrenia in Childhood and Early Adolescence. II: Positive/Negative Distinction and Childhood Predictors of Adult Outcome
Authors: Maziade Michel , Bouchard Stéphane , Gingras Nathalie , Charron Liliane , Cardinal Andrée , Roy Marc-André , Gauthier Benoît , Tremblay Guy , Côté Serge , Fournier Christiane , Boutin Pierrette , Hamel Martin , Mérette Chantal , Martinez Maria 
Published: October 2008

BackgroundThe aim of this study was to verify the presence and stability across life of the positive/negative distinction in early-onset schizophrenia (EO-SZ) through a longitudinal factor analysis of the schizophrenic dimensions, and to identify the factors predicting several indices of long-term outcome for EO-SZ.MethodForty children consecutively referred for DSM–III–R schizophrenia (SZ) in a specific catchment area comprised the sample.ResultsAcross a 14.8-year follow-up, longitudinal factor analysis identified two separate factors corresponding to the positive and negative symptom dimensions. We also observed that: the GAS rated over the last three years of adult illness and the severity of negative symptoms during the stabilised interepisode intervals in adulthood were the indices of adult outcome that were most easily predicted; and the best childhood predictors of adult outcome were premorbid functioning and severity of positive and negative symptoms during acute episodes.ConclusionsThe presence of premorbid non-psychotic behaviour disturbances (NPBD) and premorbid developmental problems was not related to severity of outcome, in contrast to the former variables.
Performance on Neuropsychological Tests Related to Single Photon Emission Computerised Tomography Findings in Frontotemporal Dementia
Authors: Elfgren Christina I. , Ryding Erik , Passant Ulla 
Published: October 2008

BackgroundThis study examines relations between regional cerebral blood flow (rCBF) and neuropsychological test results, age at onset and duration of disease in patients with frontotemporal-type dementia (FTD).MethodSixteen patients with a diagnosis of probable FTD were examined using single photon emission computerised tomography (SPECT) with 99mTc-HMPAO as the tracer. The rCBF of 14 regions of interest relative to cerebellar blood flow was calculated. Psychological tests assessing language, verbal fluency, memory and visuospatial constructive ability were given.ResultsCorrelations were demonstrated between a global impairment score and relative blood flow in lateral frontal, medial frontal and left orbital frontal areas. Verbal fluency scores correlated with left lateral frontal medial frontal and left anterior inferior temporal blood flow. No relationships between decrease in CBF and age at onset or duration of disease, or between impaired cognitive function and age at onset or duration of disease, were found.ConclusionsThe present study demonstrates a close coupling between reduced rCBF and specific neuropsychological deficits in FTD.
Early Psychological Reactions in a Group of Individuals with Pre-existing and Enduring Mental Health Difficulties Following a Major Coach Accident
Authors: Chubb Helen L. , Bisson Jonathan I. 
Published: October 2008

BackgroundThe impact of major trauma on individuals with pre-existing and enduring mental health difficulties is poorly understood.MethodTwenty individuals with pre-existing and enduring mental health difficulties were assessed with the Clinician Administered Post Traumatic Stress Disorder Scale, the 28-item version of the GHQ, the Hospital Anxiety and Depression Scale, and the Impact of Event Scale between four and eight weeks after their involvement in a major coach accident.ResultsTen (50%) individuals satisfied the full DSM–IV criteria for a diagnosis of PTSD. The questionnaire scores indicated a high level of psychological suffering among the group. On dividing the sample into those individuals with previous diagnoses of anxiety or depressive disorders and those with a previous diagnosis of chronic schizophrenia, the schizophrenia group displayed less marked psychological sequelae on all measures.ConclusionThere was a high incidence of early psychological sequelae among the group as a whole. Some diagnoses (e.g. depression and anxiety) may predispose to psychological sequelae while others (e.g. chronic schizophrenia) may not.
Neutropenia and Agranulocytosis in Patients Receiving Clozapine in the UK and Ireland
Authors: Atkin Karen , Kendall Francis , Gould Duncan , Freeman Hugh , Lieberman Jeffrey , O'Sullivan Desmond 
Published: October 2008

BackgroundClozapine can cause reversible agranulocytosis and neutropenia. This study documents the occurrence of blood dyscrasias and identifies predisposing risk factors.MethodAn analysis was made of the haematological, demographic, and dosage data from a central database on 6316 patients receiving clozapine over four and a half years in the UK and Ireland.ResultsDuring the study period 2.9% of the patients developed neutropenia and 0.8% developed agranulocytosis. The peak incidence of both disorders was in the first 6–18 weeks of treatment. Fatal agranulocytosis occurred in 0.03% of patients. After the first year of treatment the incidence of agranulocytosis significantly decreased to the order noted with some phenothiazines.ConclusionsThe use of a patient monitoring service kept the haematological risks associated with using clozapine within acceptable limits, particularly in view of the benefits of this medication in treatment-resistant schizophrenia.
Erotomanic Symptoms in 42 Chinese Schizophrenic Patients
Authors: Phillips Michael R. , West Charles L. , Wang Ruiwen 
Published: October 2008

BackgroundReports on erotomania frequently include schizophrenic patients with secondary erotomania, but there are no reports on the prevalence and characteristics of erotomanic symptoms in schizophrenic patients.MethodA structured item on erotomanic delusions was added to the Chinese version of the Scale for Assessment of Positive Symptoms and administered to 448 randomly selected schizophrenic patients on admission to four psychiatric hospitals in China.ResultsErotomanic symptoms were identified in 9.4% of the patients (42/448; 95% CI 6.9–12.4%); 4.5% (20/448; CI 2.8–6.8%) had erotomanic ideation and 4.9% (22/448; CI 3.1–7.4%) had fixed erotomanic delusions. Compared with patients without erotomanic symptoms, erotomanic patients were more likely to be male and unmarried, and they had a higher level of education, more severe grandiose delusions, more prominent hostility, and less severe negative symptoms.ConclusionThe relatively common occurrence of erotomanic symptoms in Chinese schizophrenic patients may be related to the indirect manner of expressing sexual interest in Chinese culture and, thus, be an example of the cultural moulding of psychiatric symptoms.
Psychotherapy Integration: Its Implications for Psychiatry
Authors: Albeniz Alberto , Holmes Jeremy 
Published: October 2008

BackgroundThe proliferation of psychotherapies has been balanced by an equal and opposite tendency towards integration. Integrative approaches are particularly relevant to psychotherapy in psychiatric settings.MethodMedline and manual literature searches yielded over 250 articles on psychotherapy integration, which are reviewed in the light of the authors' experience in a district psychotherapy service.ResultsPsychotherapy integration is an umbrella term covering a wide range of meanings: rapprochement between different theoretical positions; convergence of ideas and techniques; eclectic selection from many different methods; and integration proper in specifically integrative therapies. Many effective psychotherapeutic treatments for psychiatric disorders are integrative, including those for depression, schizophrenia, bulimia nervosa and borderline personality disorder.ConclusionsIntegration at the level of practice is common and desirable. At the level of theory, clarification and creative conflict are essential. Different therapeutic approaches should work closely together but retain their separate identities.
Eye Movement Desensitisation Treatment Utilises the Positive Visceral Element of the Investigatory Reflex to Inhibit the Memories of Post-Traumatic Stress Disorder: A Theoretical Analysis
Authors: MacCulloch Malcolm J. , Feldman Philip 
Published: October 2008

BackgroundEye movement desensitisation and reprocessing (EMDR) has attracted controversy and has led to publications covering a wide range of psychological problems treated by EMDR, in particular, post-traumatic stress disorder (PTSD). There is growing clinical evidence of the effectiveness of EMDR, but a lack of a convincing theoretical basis to explain its rapid effect.MethodThis paper argues that a combination of Pavlovian and Darwinian theory provide a theoretical explanation for the therapeutic effectiveness of EMDR.ResultsWe suggest that the investigatory component of the orienting reflex is an evolutionary development enabling organisms to assess their environment for both opportunities and threats. We propose that EMDR is rapidly effective because it is a clinical method of Pavlovian conditioning by which the positive visceral element of the investigatory reflex can be paired with clinically-induced noxious memories to remove their negative affect.ConclusionCompared with established forms of treatment for PTSD, EMDR is rapid, with resulting clinical and economic benefits. Our suggested theoretical basis for EMDR has implications for further explanatory research and for developments in EMDR treatment.
Caudate Nucleus Morphology in Tardive Dyskinesia
Authors: Brown Keith W. , White Thomas , Wardlaw J. M. , Walker Nicholas , Foley D. 
Published: October 2008

ObjectiveThe objective of this project was to test whether there are differences in the size of the caudate nucleus in schizophrenic in-patients with and without tardive dyskinesia.MethodThe study was cross-sectional in design, examining group differences between institutionalised schizophrenic patients with and without tardive dyskinesia, using non-enhanced computerised tomography scans of the brain. The group comprised 15 schizophrenic patients with persistent tardive dyskinesia and 21 in-patient schizophrenic controls who were group-matched for demographic variables.ResultsThe dyskinetic subjects had a significantly larger left caudate nucleus and tended to have a larger right caudate nucleus than the controls. There were no differences between the groups on any of the measures of cerebral atrophy.ConclusionsThe findings can be understood within the context of models of neostriatal function. It is possible that a larger caudate nucleus could be used to identify patients at risk of developing tardive dyskinesia.
Unwantedness of a Pregnancy and Schizophrenia in the Child
Authors: Myhrman Antero , Rantakallio Paula , Isohanni Matti , Jones Peter , Partanen Ursula 
Published: October 2008

BackgroundMaternal stress during pregnancy has been suggested as a risk factor for schizophrenia We tested the hypothesis that being the child of an unwanted pregnancy would be associated with later schizophrenia.MethodsData were collected prospectively in the Northern Finland 1966 Birth Cohort of 11 017 individuals. In the sixth or seventh month of pregnancy mothers were asked whether the pregnancy was wanted, mistimed but wanted or unwanted. Schizophrenia diagnoses in the cohort members were obtained from the Finnish Hospital Discharge Register.ResultsSeventy-six cases of DSM–III–R schizophrenia were identified in the whole cohort between the ages of 16 and 28 years; a cumulative incidence of 0.7%, compared with 1.5% for those bom from unwanted pregnancies. The risk of later schizophrenia among unwanted children was raised compared with wanted or mistimed children, even after adjustment for confounding by sociodemographic, pregnancy and perinatal variables (OR 2.4; 95% CI 1.2–4.8).ConclusionsThe results suggest that unwantedness may operate either directly as a psychosocial stress during development making children more liable to schizophrenia or it may be a marker for behaviours associated with risk in either the mother or the child.
Cholesterol and Mental Disorder
Authors: Boston Paul F. , Dursun Serdar M. , Reveley Michael A. 
Published: October 2008

BackgroundCholesterol plays an important part in cellular structure and function and changes in serum levels may affect neurotransmission in the central nervous system.MethodA medline literature search was made covering the period 1990–95 with systematic searching of citations from the articles identified. Representative articles were selected, focusing on those aspects which had not been thoroughly reviewed elsewhere, namely suicidal ideation, depression, personality and schizophrenia.ResultsLowering cholesterol levels have been associated with an increase in violent deaths in cardiovascular primary prevention studies. However, altered cholesterol levels have also been reported in relation to other psychiatric disorders.ConclusionThere is substantial evidence that serum cholesterol levels may be associated with variations in mental state or personality. Further work is needed to clarify this and to elucidate the mechanisms involved.
An Investigation of Motor Function in Schizophrenia using Transcranial Magnetic Stimulation of the Motor Cortex
Authors: Puri B. K. , Davey N. J. , Ellaway P. H. , Lewis S. W. 
Published: October 2008

BackgroundIn this first investigation of motor function in schizophrenia using transcranial magnetic stimulation (TMS), the general hypothesis tested was that this methodology could be used to investigate the disruption of corticospinal inhibitory processes suggested by cognitive and psychophysiological paradigms.MethodNine drug-free DSM–IV schizophrenic patients were compared with nine age- and sex-matched normal subjects. Electromyographic (EMG) recordings were made from the thenar muscles of the dominant hand during sustained, weak voluntary contraction. TMS over a particular threshold applied to the motor cortex would elicit a compound motor evoked potential (cMEP) followed by a period of suppression of EMG.ResultsThe latency of cMEPs following TMS was significantly shorter in the schizophrenic patients. The two groups did not differ significantly with respect to mean latency of suppression of EMG activity, or stimulus thresholds for either cMEPs or EMG suppression.ConclusionThese findings could be the result of a relative lack of corticospinal inhibition of motor responses; a change in the site of TMS activation; or an abnormality of peripheral nervous function in schizophrenia. Drug effects were unlikely since seven of the patients were drug-naïve.
Early Traumatic Stress Reactions among Swedish Survivors of the m/s Estonia Disaster
Authors: Eriksson Nils-Gustaf , Lundin Tom 
Published: October 2008

BackgroundThis study is a three-month follow-up study in order to assess the short-term impact of traumatic stress among 53 Swedish survivors of the Estonia disaster.MethodA questionnaire consisting of general questions about conditions during and after the disaster and self-assessment by Post Traumatic Symptom Scale (PTSS–10), Impact of Event Scale (IES), Sense of Coherence–short version (SoC–12), and the DSM–IV list of dissociative symptoms of Acute Stress Disorder formulated as questions regarding individual reactions was distributed.ResultsThe response rate was 79.2% (n=42). The participants scored an average of 3.9 on PTSS–10, 28.5 on IES (‘intrusion’ and ‘avoidance’ subscales) and 62.8 on SoC–12, which shows elevated levels of post-traumatic stress reactions but a normal level of sense of coherence. The reported occurrence of dissociative symptoms during the disaster was as follows: emotional numbing in 43% of the survivors, reduction of awareness in 55%, derealisation in 67%, depersonalisation in 33%, and dissociative amnesia in 29%. Survivors scoring low in SoC scored significantly higher in both PTSS–10 and IES than those with high scores in SoC. All dissociative symptoms were predictive of post-traumatic reactions.ConclusionsThis study substantiates the importance of assessing dissociative symptoms during a life-threatening event as a possible predictor for later post-traumatic reactions and possible PTSD. The Sense of Coherence Scale may be useful as an instrument to sort out survivors at risk.