bluuebunny/crossref_metadata_2025_split huggingface dataset:
Treatment of Sexual Dysfunctions by Sex Therapy and Other Approaches
Authors: Hawton Keith 
Published: October 2008

BackgroundThe treatment of sexual dysfunctions underwent a great change when sex therapy was developed more than 25 years ago. Since then the treatment programme has been modified in various ways, the response to treatment evaluated and other treatment approaches introduced.MethodA review of the literature concerning the application and outcome of sex therapy and other treatments for sexual dysfunction was conducted.ResultsThe format of effective conjoint sex therapy is now fairly clear and there is good understanding of the sexual dysfunctions that respond best to this treatment and the couples most likely to benefit. Less is known about the effects of treatment of individuals without partners, bibliotherapy and combining sex therapy with marital therapy and with physical methods of treatment.ConclusionsSex therapy is now a well-established form of treatment. It should be more widely available for patients seen in psychiatry departments.
The Maine and Vermont Three-Decade Studies of Serious Mental Illness
Authors: DeSisto Michael J. , Harding Courtenay M. , McCormick Rodney V. , Ashikaga Takamaru , Brooks George W. 
Published: October 2008

BackgroundThis study compared long-term outcome of serious mental illness in two states using a matched design to assess psychiatric rehabilitation programmes; Vermont subjects participated in a model psychiatric rehabilitation programme, while the Maine group received more traditional care.MethodMaine and Vermont subjects (n = 269) were matched by age, sex, diagnosis, and chronicity. Demographic, illness, and life history information were abstracted from hospital records by clinicians blind to outcome. DSM–III criteria were applied retrospectively. Outcome was assessed by clinicians blind to history.ResultsVermont subjects alive at follow-up (n = 180) were more productive (P < 0.0009), had fewer symptoms (P < 0.002), better community adjustment (P < 0.001) and global functioning (P < 0.0001) than Maine subjects (n = 119).ConclusionsOutcome differences may be due to Vermont's model programme and a policy of allowing an earlier opportunity for community life.
Somatic Delusions in Schizophrenia and the Affective Psychoses
Authors: McGilchrist Iain , Cutting John 
Published: October 2008

BackgroundDelusions relating to the body, a ready source of information about the immediate experiences of psychotic patients, have not been systematically studied. We attempted an account of the phenomena, looking for differences between diagnostic groupings in the type and lateralisation of such phenomena, and for evidence of localisation.MethodSomatic delusions elicited at interview with 550 Research Diagnostic Criteria-diagnosed psychotic patients were categorised according to content, and the results were compared across diagnostic groupings.ResultsSignificant differences were demonstrated, both at the level of individual delusions and in the nature and overall pattern of such delusions. There were also differences between diagnostic groups in the choice of body parts involved. Among male patients there were significant differences in laterality between the groups, with schizophrenic subjects locating abnormal phenomena principally on the left and depressive subjects on the right. A provisional taxonomy of bodily delusions was developed.ConclusionPhenomenological differences between the psychoses were demonstrated and the results offer some support for current hypotheses of localisation of brain dysfunction in the psychotic illnesses.
Child and Adolescent Psychiatric Presentations of Second-Generation Afro-Caribbeans in Britain
Authors: Goodman Robert , Richards Hilary 
Published: October 2008

BackgroundA clinical sample was used to investigate whether second-generation Afro-Caribbean children differed from other British-born children in their psychiatric presentation or vulnerability to risk factors.MethodSecond-generation Afro-Caribbean patients (n = 292) were compared with a predominantly white group of patients (n = 1311) who lived in the same inner-city area and attended the same child psychiatric clinic between 1973 and 1989. Data on psychiatric presentation and background factors were systematically recorded at the time of the initial clinical assessment.ResultsAfro-Caribbean patients were exposed to more socio-economic disadvantage but less family dysfunction. The ratio of emotional to conduct disorders was lower among Afro-Caribbean than among the comparison patients – an effect that was not evidently due to demographic factors or diagnostic bias. Most risk factors for emotional or conduct disorders had comparable effects on Afro-Caribbean and comparison patients. Psychotic and autistic disorders were disproportionately common among the Afro-Caribbean patients.ConclusionsSecond-generation Afro-Caribbean children differ somewhat from other British-born children in their psychiatric presentation – a difference that has persisted over the 1970s and 1980s and that deserves more investigation than it has received to date.
Nine Suicide Pacts a Clinical Study of a Consecutive Series 1974–93
Authors: Brown Martin , King Elizabeth , Barraclough Brian 
Published: October 2008

BackgroundSuicide pacts are rarely discussed in the medical literature. We report here the medical and social aspects of a consecutive series of double or pact suicides.MethodCoroners' records were examined for 722 consecutive suicides. Data were extracted from them and from medical and psychiatric records.ResultsNine pacts (2.5% of suicides) were located: 11 of the 18 people appeared to have been mentally ill at the time of death and three more had a history of mental illness. Five had a significant medical history (three cancer).ConclusionsMental disorder is common in those who enter suicide pacts (mainly depression, with alcohol dependence rare). Motivations for suicide appear to be relief of mental disorder and pain.
Immigrant Families Coping with Schizophrenia Behavioural Family Intervention v. Case Management with a Low-Income Spanish-Speaking Population
Authors: Telles Cynthia , Karno Marvin , Mintz Jim , Paz George , Arias Miguel , Tucker Douglas , Lopez Steven 
Published: October 2008

BackgroundThis investigation compared the effectiveness and cross-cultural applicability of behavioural family management (BFM) and standard case management in preventing exacerbation of symptoms and relapse in schizophrenia.MethodForty low-income Spanish-speaking people with a diagnosis of schizophrenia were randomly assigned to receive standard case management or behavioural family management after stabilisation with neuroleptic medication.ResultsSurvival analyses indicated that among the less acculturated patients BFM was significantly related to greater risk of exacerbation of symptoms. Among the more acculturated patients, risk of exacerbation could be predicted by medication compliance but not by type of intervention. In analyses of symptom severity and functional status at 1-year follow-up, the level of patient acculturation was found to be significantly related to various measures of treatment outcome.ConclusionSociocultural factors affect responses to different types of intervention. The results did not support earlier findings of a beneficial effect of BFM when applied to a socioculturally diverse population.
Cyproheptadine Treatment in Neuroleptic-Induced Akathisia
Authors: Weiss David , Aizenberg Dov , Hermesh Haggai , Zemishlany Zvi , Munitz Hanan , Radwan Margaret , Weizman Abraham 
Published: October 2008

BackgroundCyproheptadine, an antiserotonergic agent, was used to treat neuroleptic-induced akathisia.MethodIn an open clinical trial 17 neuroleptic-treated patients with akathisia were administered cyproheptadine (16 mg/day) over 4 days. Assessment of akathisia, psychosis and depression were monitored by BAS, BPRS and HAM-D.ResultsAll subjects showed improvement in the severity of akathisia, which in the majority (15/17) was of a marked degree. There was no aggravation of psychosis or depression. Symptoms of akathisia returned when cyproheptadine was discontinued.ConclusionsCyproheptadine may be useful in neuroleptic-induced akathisia.
Neuraesthenia Revisited: ICD–10 and DSM–III–R Psychiatric Syndromes in Chronic Fatigue Patients and Comparison Subjects
Authors: Farmer Anne , Jones Irene , Hillier Janis , Llewelyn Meirion , Borysiewicz Leszek , Smith Andrew 
Published: October 2008

BackgroundDifferent definitions of chronic fatigue syndrome (CFS) have different psychiatric exclusion criteria and this affects the type and frequency of associated psychiatric morbidity found. The operational criteria for neuraesthenia in ICD–10 vary in this and other respects from the Centers for Disease Control and Prevention (CDC) criteria for CFS. Neuraesthenia and associated psychiatric morbidity in CDC-defined CFS are evaluated.MethodCFS subjects and controls were interviewed with the Schedule for the Clinical Assessment of Neuropsychiatry (SCAN). The computerised scoring program for SCAN (CATEG05) facilitates the assignment of operational definitions according to DSM–III–R and ICD–10. Subjects were re-interviewed with SCAN an average of 11 months later. No specific treatments or interventions were given during this period.ResultsThe majority of subjects fulfilled ICD–10 operational criteria for neuraesthenia and had two and a half times the rate of psychiatric morbidity as the healthy comparison group according to the CATEG05 Index of Definition (ID). Approximately 80% of subjects fulfilled both DSM–III–R and ICD–10 criteria for sleep disorders. There was a significant fall in the number of subjects fulfilling criteria for depression and anxiety disorders and a significant increase in the number of subjects with no diagnosis for DSM–III–R criteria over time. There were no significant changes over time for any diagnosis according to ICD–10 criteria or for overall levels of psychopathology as reflected in CATEG05 ID levels.ConclusionsThe ICD–10 ‘neuraesthenia’ definition identifies almost all subjects with CDC-defined CFS. Fifty per cent of CFS subjects also had depressive or anxiety disorders, some categories of which remit spontaneously over time.
The Post-Concussional State: Neurophysiological Aspects
Authors: Watson M. R. , Fenton G. W. , McClelland R. J. , Lumsden J. , Headley M. , Rutherford W. H. 
Published: October 2008

BackgroundTwenty-six young men admitted to an Accident and Emergency Department for observation following a minor closed head injury (post-traumatic amnesia (PTA) less than 12 hours) were investigated within 24 hours of admission (day 0) and followed up at 10 days, 6 weeks and 1 year after the trauma.MethodInvestigations at day 0 included physical examination, completion of post-concussional symptom and stress-arousal checklists, computerised EEG (CEEG) and auditory brainstem evoked potential (BAEP) recordings. These were repeated at ten days and six weeks. At 12 months follow-up, the Present State Examination (PSE) was carried out and a further post-concussional symptom checklist completed.ResultsPost-concussional symptomatology declined progressively from day 0 but half had residual symptoms at 1 year. Seventy-two per cent ran an acute course with recovery by 6 weeks, 8% a chronic unremitting course and 20% initially improved but had an exacerbation of symptoms between 6 weeks and 12 months. The CEEG alpha-theta ratios decreased significantly between days 0 and 10, reaching a baseline thereafter. Measures of CEEG recovery from all channels correlated with symptom counts at six weeks; the slower the recovery the greater the symptoms. A relative delay in left temporal recovery was associated with residual psychiatric morbidity (PSE ID scores) at 12 months. Prolonged central brainstem conduction times occurred in 27% of patients at day 0. These correlated positively with PTA and degree of psychiatric morbidity (PSE ID scores) at 12 months.ConclusionsSymptom chronicity was accompanied by continuing brainstem dysfunction, while the degree of transient cortical dysfunction appeared to have a direct influence in the intensity of early organic symptom reaction to the trauma. Levels of perceived stress at the time of the injury, or afterwards, were not related to symptom formation.
Excess Mortality Among Elderly Psychiatric In-Patients with Organic Mental Disorder
Authors: Rössler W. , Hewer W. , Fätkenheuer B. , Löffler W. 
Published: October 2008

BackgroundMany studies have shown hospitalised mentally ill patients to have a higher mortality risk than the general population.MethodData of patients with organic mental disorders of ICD–9 categories 290, 293, 294 and 310 from seven psychiatric hospitals with defined catchment areas were analysed. During an observation period of 2.5 years 1821 treatment periods in these diagnostic categories were recorded.ResultsDuring hospitalisation 137 patients died from natural causes. The age- and sex-adjusted mortality rates show an increased mortality risk of 7.5 times, compared to the general population. The odds ratio of a logistic regression demonstrate the overwhelming influence of the medical diagnosis.ConclusionMedical factors, particularly pneumonias, contribute most to the excess mortality.
Associations of Psychotic Symptoms in Dementia Sufferers
Authors: Ballard Clive , Bannister Carol , Graham Candida , Oyebode Femi , Wilcock Gordon 
Published: October 2008

BackgroundPsychotic symptoms in dementia have been considered as a single category which may have masked important associations. An exploratory analysis was undertaken to look separately at delusions, visual hallucinations and delusional misidentification.MethodPsychotic symptoms were assessed with the Burns' Symptom Checklist in 124 patients with DSM–III–R dementia.ResultsEighty-three (66.9%) patients had psychotic symptoms. Deafness and life events were associated with delusions and visual impairment was associated with visual hallucinations, while senile dementia of Lewy body type and older age were associated with both.ConclusionsDifferences are evident in the associations of delusions and visual hallucinations. Sensory impairments were associated with both symptoms.
Characteristics of Outcome in Schizophrenia at 13 Years
Authors: Mason Peter , Harrison Glynn , Glazebrook Cristine , Medley Ian , Dalkin Tim , Croudace Tim 
Published: October 2008

BackgroundThis paper describes the 13-year outcome of an epidemiologically defined and representative cohort of patients selected when they were experiencing their first episode of schizophrenia.MethodIn a 13-year follow-up study of a cohort identified in Nottingham in 1978–80, the outcome (symptoms, disability, residence and treatment) was assessed using standardised instruments.ResultsFour of the original 67 patients with ICD–9 schizophrenia were lost to follow-up and five were dead: 52% were without psychotic symptoms in the last two years of follow-up, 52% were without negative symptoms and 55% showed good/fair social functioning. However, only 17% were alive at follow-up, without symptoms and disability, and receiving no treatment.ConclusionsThe findings reported are similar to those of other long-term follow-up studies of schizophrenia and also to 5-year follow-up studies. Kraepelin's emphasis on the longitudinal implications of a diagnosis of schizophrenia are supported, but may be over-pessimistic.
Insight and Psychotic Illness
Authors: David Anthony , van Os Jim , Jones Peter , Harvey Ian , Foerster Alice , Fahy Thomas 
Published: October 2008

BackgroundInsight has recently re-emerged as an important aspect of psychopathology amenable to empirical study. We sought to examine the relationship between various aspects of insight into illness and clinical, sociodemographic and neuropsychological variables.MethodFrom an inner-London catchment area population, 150 in-patients with recent onset of psychosis were assessed on a variety of measures, including the Present State Examination (PSE). Subjects were followed up for a mean of four years and reassessed.ResultsHigh IQ was associated with better insight as rated on the PSE, while gender, ethnicity and a diagnosis of schizophrenia appeared to be unrelated. At follow-up, similar associations were found, as well as correlations with attitudes to treatment and a more elaborate measure of insight. Cerebral ventricular enlargement and tests of frontal lobe function did not correlate with insight, but there was a curious, strong association with left-handedness at both assessment points. Initial insight correlated significantly but weakly with insight at follow-up.ConclusionsThe assessment of insight in psychosis has concurrent validity and is a distinct aspect of psychotic phenomenology. It may, in part, have a neuropsychological basis.
A Prevalence Study of Age-Associated Memory Impairment
Authors: Barker Andrew , Jones Roy , Jennison Chris 
Published: October 2008

BackgroundAge-associated memory impairment (AAMI) describes a non-disease ageing-related decline in memory. Pharmacological treatment trials have been reported and DSM–IV has introduced a term for the disorder. No prevalence study with the original criteria has previously been published.MethodAn age-stratified sample was taken of 50–95-year-olds registered with a local health centre. Diagnosis of AAMI was made by questionnaire, cognitive testing, and medical and psychiatric assessment.ResultsPrevalence rates for the total population and for the over-50s were estimated to be 5.8% and 18.5%, respectively. These rates are dramatically affected by minor alterations to individual criteria.ConclusionsIt appears AAMI is less common than previous estimates suggested, although the diagnostic criteria do not satisfactorily define people with an age-related decline in memory. Complaint of memory decline is more strongly correlated with measures of affect and personality than with measures of current memory test performance or estimates of memory decline.
Depression in Later Life
Authors: Baldwin R. C. , Tomenson Barbara 
Published: October 2008

BackgroundDepression in later life is often thought to differ from that at other times of adulthood. The evidence for this is controversial but is important to any proposed organic model of depression in the elderly. Here, early- and late-onset depressions in later life are compared.MethodFifty-seven depressed patients with a mean age of 74 were studied, 21 with an early onset (aged 59 or less) and 36 with a late onset. All were suffering from major depression according to DSM–III–R. The measures at entry included severity and symptoms, cognitive function, antecedent life events, physical health and vascular risk factors and/or vascular disease. We also recorded any family history of mood disorders, as well as the course of illness.ResultsThe anxiety item scores of the Hamilton Depression Rating Scale were significantly higher in those with an early onset, but otherwise symptoms differed little. Heritability was greater in the early-onset group. There was a striking association of vascular disease and/or risk with late-onset patients.ConclusionsVascular disease is associated with late-onset depression. This is consistent with the hypothesis that depression in later life is a more ‘biological’ disorder.
Further Evidence that Reading Ability is not Preserved in Alzheimer's Disease
Authors: O'Carroll R. E. , Prentice N. , Murray C. , Van Beck M. , Ebmeier K. P. , Goodwin G. M. 
Published: October 2008

BackgroundPre-morbid intelligence level is routinely assessed in Alzheimer's disease using the National Adult Reading Test (NART). This practice is based on the assumption that pronunciation of irregular words remains unaffected by the disease process. Recent reports have suggested that reading ability may become compromised in moderately demented subjects.MethodSixty-eight probable Alzheimer patients were classified into stages of severity (minimal, mild and moderate) using the Mini-Mental State Examination (MMSE). NART and demographic equations were used to estimate pre-morbid ability.ResultsA significant correlation emerged between dementia severity and reading ability, NART v. MMSE scores, r = 0.46, P < 0.01. When the total sample was subdivided into moderate, mild and minimal subgroups, significant between-group differences emerged, despite the groups being well matched for age, sex, and years of full-time education. Pre-morbid IQ, as estimated by demographic regression equations, did not correlate with dementia severity.ConclusionNART performance is compromised in moderate Alzheimer disease, and the measure provides a serious underestimate of pre-morbid IQ in patients with an MMSE of 13 or less.
Psychiatric Symptoms Associated with Dementia in Older People with Learning Disability
Authors: Moss Steve , Patel Pradip 
Published: October 2008

BackgroundThis paper describes a study of non-cognitive features of dementia in a population of 105 people over 50 years of age, with learning disability.MethodThe study involved psychiatric assessment using the Psychiatric Assessment Schedule for Adults with a Developmental Disability (PAS-ADD), a semi-structured psychiatric interview developed specifically for people who have learning disability. Dementia was diagnosed using a combination of informant interviewing and observation of cognitive change over a three year period.ResultsSample members with definite dementia had higher levels of sleep difficulty, hypersomnia, irritability, inefficient thought, loss of interest and anhedonia. Discriminant function analysis showed that non-cognitive features could help discriminate between definite and probable cases.ConclusionsResults support the previously reported observation for the general population that cognitive and non-cognitive features are only weakly related. The study suggests that psychiatric symptom information may be useful in screening for dementia in people with learning disability.
Morbid Jealousy in Alcoholism
Authors: Michael Albert , Mirza Sudeshni , Mirza K. A. H. , Babu V. S. , Vithayathil Empee 
Published: October 2008

BackgroundMorbid jealousy is an incompletely understood syndrome. The association between morbid jealousy and alcoholism is unclear.MethodMorbid jealousy was assessed in 207 male patients with alcohol dependence (DSM–III–R) using a semi-structured interview schedule administered both to patients and their spouses.ResultsThirty-four per cent (71 out of 207) suffered from morbid jealousy. Morbid jealousy had different manifestations. Some patients expressed it only when intoxicated, others even when sober and in some the jealousy took the form of a delusional disorder.ConclusionsAlcoholism appears to have an aetiological role in the development of morbid jealousy. Detecting morbid jealousy when it is expressed only under the influence of alcohol has preventive implications.
Epidemiology of Presenile Alzheimer's Disease in Scotland (1974–88)
Authors: Whalley Lawrence J. , Thomas Brenda M. , Starr John M. 
Published: October 2008

Background and MethodWe related geographical variation of ‘probable’ presenile Alzheimer's disease (AD PSD) to exposures to possible risk factors for AD PSD and vascular dementia (VaD) and to geographical differences in survival times after presentation with AD PSD.ResultsWe found that an ecological measure of socio-economic deprivation was related to VaD but not to AD PSD. Among men with AD PSD and VaD, specific occupations conveyed no altered risk but having fathers who were coal miners was associated with AD PSD and VaD in offspring. Increased paternal age was associated with AD PSD but only in men. These factors acted independently of one another and did not distinguish between geographical areas of high and low incidence.ConclusionsThe length of survival after presentation with AD PSD distinguished between these areas, and when migration between these areas was taken into account, a plausible multifactorial model of the harmful effects of environment emerged, which acted independently of risk factors acting earlier in life.