bluuebunny/crossref_metadata_2025_split huggingface dataset:
Dose-effect relationships of trauma to symptoms of depression and post-traumatic stress disorder among Cambodian survivors of mass violence
Authors: Mollica Richard F. , McInnes Keith , Pool Charles , Tor Svang 
Published: October 2008

BackgroundThe dose – effect relationships of cumulative trauma to the psychiatric symptoms of major depression and post-traumatic stress disorder (PTSD) in a community study of Cambodian survivors of mass violence were evaluated.MethodIn 1990, a survey of 1000 households was conducted in aThai refugee camp (Site 2) using a multi-stage random sampling design. Trauma history and psychiatric symptoms were assessed for two time periods. Analysis used linear dose – response regression modelling.Results993 Cambodian adults reported a mean of 14 Pol Pot era trauma events and 1.3 trauma events during the past year. Symptom categories of depression, PTSD, dissociative and culturally dependent symptoms exhibited strong dose – effect responses with the exception of avoidance. All symptom categories, except avoidant symptoms, were highly correlated.ConclusionsCumulative trauma continued to affect psychiatric symptom levels a decade after the original trauma events. The diagnostic validity of PTSD criteria, with the notable exception of avoidance, was supported. Inclusion of dissociative and culturally dependent symptoms increased the cultural sensitivity of PTSD.
Onset and recovery from panic disorder in the Baltimore Epidemiologic Catchment Area follow-up
Authors: Eaton William W. , Anthony James C. , Romanoski Alan , Tien Allen , Gallo Joseph , Cai Guojun , Neufeld Karen , Schlaepfer Thomas , Laugharne Jonathan , Chen Li-Shiun 
Published: October 2008

BackgroundThe objective is to estimate parameters of the natural history of panic disorder, including its prodrome, incidence, recovery and recurrence.MethodIn 1981 the Baltimore Epidemiologic Catchment Area Study interviewed 3481 individuals probabilistically selected from the household population. During 1993–1996, 1920 of these individuals (73% of survivors) were interviewed again. Baseline and follow-up interviews included the National Institute of Mental Health Diagnostic Interview Schedule. During the follow-up, a subsample was assessed by psychiatrists using the World Health Organization Schedules for Clinical Assessment in Neuropsychiatry (SCAN).ResultsThere were 35 new cases of panic disorder in 24 475 person years of exposure, yielding an annual incidence of 1.43 per 1000 per year. Data from the SCAN assessments suggest the incidence estimate is conservative. Incidence is greater in females and declines with age. About one-third of the new cases arise without agoraphobia, but about half have anxiety of some sort present for many years prior to meeting criteria for diagnosis. People with agoraphobia have less intense onsets but slower recoveries than those without agoraphobia.ConclusionsPanic is heterogeneous in its pattern of onset and recovery. Some of the heterogeneity is associated with the presence of other anxiety over a long period of the life.
Suicide attempts preceding completed suicide
Authors: Isometsä Erkki T. , Lönnqvist Jouko K. 
Published: October 2008

BackgroundThis study investigated three questions with major implications for suicide prevention: the sensitivity of the history of previous suicide attempt(s) as an indicator of suicide risk, the time interval from a preceding suicide attempt to the fatal one, and switching of suicide methods by those eventually completing suicide.MethodThe lifetime history of suicide attempts and the methods the victims (n=1397) used were examined in a nationwide psychological autopsy study comprising all suicides in Finland within a 12-month research period in 1987–1988.ResultsOverall, 56% of suicide victims were found to have died at their first suicide attempt, more males (62%) than females (38%). In 19% of males and 39% of females the victim had made a non-fatal attempt during the final year. Of the victims with previous attempts, 82% had used at least two different methods in their suicide attempts (the fatal included).ConclusionsMost male and a substantial proportion of female suicides die in their first suicide attempt, a fact that necessitates early recognition of suicide risk, particularly among males. Recognition of periods of high suicide risk on the grounds of recent non-fatal suicide attempts is likely to be important for suicide prevention among females. Subjects completing suicide commonly switch from one suicide method to another, a finding that weakens but does not negate the credibility of restrictions on the availability of lethal methods as a preventive measure.
Medication received by patients with depression following the acute episode: adequacy and relation to outcome
Authors: Ramana Rajini , Paykel Eugene S. , Surtees Paul G. , Melzer David , Mehta Mitul A. 
Published: October 2008

BackgroundThe adequacy of pharmacotherapy received in practice by patients after an acute episode of depression has been little studied.AimsTo describe and assess adequacy of drug continuation and maintenance in patients with depression.MethodPatients with depression were interviewed 18 months after discharge from hospital. Quantitative assessments of drug treatment doses and compliance were made monthly over this period, and qualitative ratings in continuation and maintenance phases.ResultsAbout 20% of patients were prescribed low drug doses after discharge and 10% were prescribed no drugs at all. Reported compliance was around 70%. About 30% failed to receive adequate longer-term treatment, mostly due to the continuation phase being too short. Deficiencies of dosage and compliance were greater in patients who never achieved full recovery. Patient refusal was the most common reason for not using antidepressants. Further episodes of depression were not particularly associated with inadequate treatment.ConclusionsThere were deficiencies in drug treatment that did not appear to be the principal cause of further episodes but may be important in non-recovery. Patient fears require discussion.
Impact of pregnancy on bulimia nervosa
Authors: Morgan John Farnill , Lacey J. Hubert , Sedgwick Philip M. 
Published: October 2008

BackgroundBulimia nervosa affects women at a peak age of reproductive functioning, but few studies have examined the impact of pregnancy on bulimia.AimTo examine the impact of pregnancy on symptoms of bulimia nervosa and associated psychopathology.MethodWomen actively suffering from bulimia nervosa during pregnancy (n=94) were interviewed using the eating disorder examination (12th edn) and structured clinical interview for DSM–III–R, with additional structured questions. Behaviours were recorded at conception, each trimester and postnatally. Relative risks were calculated for prognostic factors.ResultsBulimic symptoms improved throughout pregnancy. After delivery, 57% had worse symptoms than pre-pregnancy, but 34% were no longer bulimic. Relapse was predicted by behavioural severity and persistence, previous anorexia nervosa (‘Type II’ bulimia), gestational diabetes and ‘unplanned’ pregnancy. Unplanned pregnancies were the norm, usually resulting from mistaken beliefs about fertility. ‘Postnatal depression’ was suggested in one-third of the sample, and in two-thirds of those with ‘Type II’ bulimia, and was predicted by alcohol misuse, symptom severity and persistence.ConclusionsPostnatal treatment intervention should focus on women ‘at risk’ of relapse, but all women with bulimia should be assessed for postnatal depression.
Satisfaction with in-patient psychiatric services
Authors: Greenwood Nan , Key Adrienne , Burns Tom , Bristow Mike , Sedgewick Philip 
Published: October 2008

BackgroundThere is growing concern about patient satisfaction with psychiatric in-patient provision. This paper measures satisfaction in psychiatric in-patients and its relationships with patient characteristics and ward experiences.AimsTo: (a) measure overall in-patient satisfaction; (b) examine its relationship to in-patient experiences; and (c) examine its relationship to patient factors.MethodFour hundred and thirty-three patients were interviewed. Satisfaction was assessed by a single question, the Client Satisfaction Questionnaire (CSQ) and by a semi-structured interview.ResultsOver three-quarters of the patients were satisfied, but two-thirds reported adverse events. Females, younger patients and those detained were more dissatisfied. No significant relationship was found for ethnic group. Results were similar in the mental hospital and district general hospital.ConclusionsThere remain problems with satisfaction scales. Qualitative approaches to examine patients' experiences in hospital and the causes of dissatisfaction are recommended.
Depression, cerebral atrophy, cognitive performance and incidence of dementia
Authors: Pálsson Sigurdur , Aevarsson Ólafur , Skoog Ingmar 
Published: October 2008

BackgroundHospital-based studies suggest that depression in old age relates to organic brain changes.AimsTo determine whether these findings are confirmed in a population-based sample.MethodA population sample of non-demented 85-year-olds (227 mentally healthy and 62 with DSM–III–R depression were given a neuropsychiatric examination and computerised tomographic scans of the brain, and followed for three years.ResultsOn the Mini-Mental State Examination, those with a low educational level with major depression performed worse than the mentally healthy; this distinction was not evident among those who had received higher education. Measures of brain atrophy were similar in depressed and mentally healthy individuals. The three-year incidence of dementia was increased in those with early-onset major depression.ConclusionsHigher education may protect against cognitive symptoms in depressed individuals. The association between depression and cerebral atrophy in the elderly is not very strong. The higher incidence of dementia in those with early-onset major depression may be due to a longer lifetime duration of depression, emphasising the importance of detecting and treating depression in the community.
Review of community prevalence of depression in later life
Authors: Beekman A. T. F. , Copeland John , Prince M. J. 
Published: October 2008

BackgroundDespite considerable interest, there is no consensus regarding the prevalence of depression in later life.AimsTo assess the prevalence of late-life depression in the community.MethodA systematic review of community-based studies of the prevalence of depression in later life (55+). Literature was analysed by level of caseness at which depression was defined and measured.ResultsThirty-four studies eligible for inclusion were found. The reported prevalence rates vary enormously (0.4–35%). Arranged according to level of caseness, major depression is relatively rare among the elderly (weighted average prevalence 1.8%), minor depression is more common (weighted average prevalence 9.8%), while all depressive syndromes deemed clinically relevant yield an average prevalence of 13.5%. There is consistent evidence for higher prevalence rates for women and among older people living under adverse socio-economic circumstances.ConclusionsDepression is common in later life. Methodological differences between studies preclude firm conclusions about cross-cultural and geographical variation. Improving the comparability of epidemiological research constitutes an important step forward.
Cross-cultural comparison of depressive symptoms in Europe does not support stereotypes of ageing
Authors: Copeland J. R. M. , Beekman A. T. F. , Dewey M. E. , Jordan A. , Lawlor B. A. , Linden M. , Lobo A. , Magnusson H. , Mann A. H. , Fichter M. , Prince M. J. , Saz P. , Turrina C. , Wilson K. C. M. 
Published: October 2008

BackgroundStereotypes of older people suggest that they are depressed.AimsTo examine depression symptoms among people aged ⩾65 in the general population and to ask the following questions. Are there high proportions of depressive symptoms among otherwise well people? Do these levels reflect the prevalence of depression? Do key symptoms vary with age and do they confirm stereotypes?MethodNine centres contributed data from community-based random samples, using standardised methods (GMS–AGECAT package)ResultsProportions of depressive symptoms varied between centres. Some often associated with ageing were rare. Many were more common in women. Low-prevalence centres tended to have fewer symptoms among ‘well’ people, but there were inconsistencies. Low levels of symptoms among the well population of a centre did not necessarily predict lower levels in the depressed.ConclusionsVariations in the prevalence of depressive symptoms occurred between centres, not always related to levels of illness. There was no consistent relationship between proportions of symptoms in well persons and cases for all centres. Few symptoms were present in > 60% of the older population – stereotypes of old age were not upheld.
Depression symptoms in late life assessed using the EURO–D scale
Authors: Prince M. J. , Beekman A. T. F. , Deeg D. J. H. , Fuhrer R. , Kivela S.-L. , Lawlor B. A. , Lobo A. , Magnusson H. , Meller I. , Van Oyen H. , Reischies F. , Roelands M. , Skoog I. , Turrina C. , Copeland J. R. M. 
Published: October 2008

BackgroundData from surveys involving 21 724 subjects aged ⩾65 years were analysed using a harmonised depression symptom scale, the EURO–D.AimsTo describe and compare the effects of age, gender and mental status on depressive symptoms across Europe.MethodWe tested for the effects of centre, age, gender and marital status on EURO–D score. Between-centre variance was partitioned according to centre characteristics: region, religion and survey instrument used.ResultsEURO–D scores tended to increase with age, women scored higher than men, and widowed and separated subjects scored higher than others. The EURO–D scale could be reduced into two factors: affective suffering, responsible for the gender difference, and motivation, accounting for the positive association with age.ConclusionsLarge between-centre differences in depression symptoms were not explained by demography or by the depression measure used in the survey. Consistent, small effects of age, gender and marital status were observed across Europe. Depression may be overdiagnosed in older persons because of an increase in lack of motivation that may be affectively neutral, and is possibly related to cognitive decline.
Health of the Nation Outcome Scales: A case study in general psychiatry
Authors: Sharma Vimal K. , Wilkinson Greg , Fear Simon 
Published: October 2008

BackgroundHealth of the Nation Outcome Scales (HoNOS) were incorporated in a data set recording the routine clinical activities of a mental health team in Liverpool.AimsTo evaluate the use of HoNOS in general adult psychiatry.MethodAll consecutive patients who came in contact with the mental health team were administered HoNOS by the consultant psychiatrist. A cohort (n=204) of patients was identified over a period of 8 months. All patients (n=156) who had a repeat HoNOS after an interval of 6 months were included in the study.ResultsThere was an overall reduction in HoNOS scores after an interval of 6 months, more so among patients with psychotic and affective disorders. Patients scoring on other disorders showed no change on HoNOS. The measured change in clinical state based on the Clinical Global Impression scale was broadly consistent with HoNOS scores.ConclusionsIt was feasible to administer HoNOS during routine assessments, but HoNOS data were of limited value in care-planning in day-today clinical practice. The widespread adoption of HoNOS for use in routine clinical practice would be premature.
Reduced cortical excitability in depression
Authors: Shajahan P. M. , Glabus M. F. , Gooding P. A. , Shah P. J. , Ebmeier K. P. 
Published: October 2008

BackgroundIn healthy controls, preactivation of muscles by exercise results in enhanced motor-evoked potential (MEP) responses to transcranial magnetic stimulation (TMS).AimsWe tested the hypothesis that medicated, depressed patients would show reduced post-exercise MEP facilitation compared with controls.MethodTen patients with DSM-IV depression (two male, eight female) and ten controls (three male, seven female) participated. MEPs were elicited at rest, then after exercising the contralateral abductor pollicis brevis muscle, using TMS of the primary motor cortex.ResultsThe mean MEP amplitude recorded after exercise (expressed as a percentage of baseline) was 210% in controls and 130% in patients. There was a significant difference in post-exercise MEP between patients and controls (P=0.03).ConclusionsPost-exercise MEP facilitation was demonstrated in controls but not in patients. This supports the hypothesis that the modulation of cortical excitability may be impaired in depression.
Psychosocial adversity and child psychopathology
Authors: Rutter Michael L. 
Published: October 2008

BackgroundDespite strong claims that genetic theory' should replace socialisation theory’, there are good grounds for taking seriously the notion that there are psychosocial influences on child psychopathology.AimsTo re-evaluate this issue in the light of developments over the past half-century.MethodA wide-ranging review of topics related to this issue, 1948–1998.Results and conclusionsThe findings are used to consider the challenges still to be met as we enter the next century. It is argued that it is necessary to put aside the absurd brain–mind dualisms of the past.
Fever and acute brief psychosis in urban and rural settings in north India
Authors: Collins Pamela Y. , Varma Vijoy K. , Wig Narendra N. , Mojtabal Ramin , Day Richard , Susser Ezra 
Published: October 2008

BackgroundThis case-control study used data from Chandigarh, North India to investigate the association between antecedent fever and acute brief psychosis.AimsTo assess whether antecedent fever may be a biological correlate of acute brief psychosis, and contribute to the nosology of acute brief psychosis.MethodThe study was based in an incidence cohort from two catchment areas, an urban and a rural site, that were part of the World Hearth Organization Determinants of Outcome study. The cases (n=17) met criteria for acute brief psychosis; controls (n=40) were patients with other acute and subacute psychoses. The Life Events Schedule was used to determine the presence of antecedent fever.ResultsThe crude odds ratio for fever as a risk factor for acute brief psychosis was 6.2 (P=0.004). The odds ratio in a logistic regression analysis – adjusted for site, gender and CATEGO classification – was 11.2 (P=0.003).ConclusionsAntecedent fever may be a biological correlate of acute brief psychosis. This finding supports the validity of this entity, and has implications for its aetiology and diagnosis.
Aetiological risk factors for personality disorders
Authors: Coid Jeremy 
Published: October 2008

BackgroundElucidation of aetiological processes leading to development of Axis II disorders is important in category validation and could lead to new treatments.AimsTo establish aetiological associations between Axis II disorders and specific risk factors.MethodMale and female subjects (n=260) in maximum security hospitals and prisons were interviewed to determine DSM-III Axis II and lifetime Axis I diagnoses. Aetiological risk factors were obtained at interview and from case files. Independent statistical associations were established by logistic regression.ResultsAxis II categories were divided into four groups: (a) disorders of character development, secondary to an adverse early environment: antisocial, self-defeating and paranoid; (b) disorders of temperament, secondary to constitutional aetiology: avoidant, dependent, schizoid and schizotypal; (c) a ‘mixed’ disorder of constitutional and environmental aetiology: borderline; and (d) aetiological associations not established: narcissistic, histrionic, compulsive and passive-aggressive.ConclusionsThe study validates several Axis II categories but challenges the inclusion of others within Axis II of DSM-IV, in particular schizoid, schizotypal, avoidant and borderline personality disorders. The findings have implications for future treatment interventions.
People at risk of schizophrenia
Authors: Hodges Ann , Byrne Majella , Grant Elizabeth , Johnstone Eve 
Published: October 2008

BackgroundThe Edinburgh High-Risk Study is designed to explore the underlying pathogenesis of schizophrenia.AimsTo establish the sample characteristics of the first 100 subjects in this study of young adults at risk of schizophrenia for genetic reasons, and to compare them with appropriate controls.MethodDetails of the recruitment of the first 100 high-risk subjects aged 16–25 years into a prospective Scotland-wide study are given. Subjects and 30 age- and gender-matched normal controls were interviewed using the PSE, SADS-L and SIS and an unstructured psychiatric interview.ResultsSome significant differences emerged between the high-risk group and the control group, namely in previous psychiatric history (31 v. 6.3%), forensic contacts (19 v. 3.1%) and delinquent behaviour (20 v. 3.1%). There were also differences in some parameters from the SIS: childhood social isolation, interpersonal sensitivity, social isolation, suicidal ideation, restricted affect, oddness and disordered speech.ConclusionsThese differences may represent increased risk of developing schizophrenia although their true significance will not be revealed until the cohort has been followed through the at-risk years.
North Staffordshire Community Beds Study: Longitudinal evaluation of psychiatric in-patient units attached to community mental health centres
Authors: Haycox Alan , Unsworth Louise , Allen Keith , Hodgson Richard E. , Lewis Martyn , Boardman Anthony P. 
Published: October 2008

BackgroundInnovative approaches to the provision of psychiatric care must justify their ability to improve the quality of life within the resource constraints imposed on psychiatry.AimsTo examine the average costs per patient of the experimental and control group services.MethodAn individual patient costing methodology that identified, measured and valued all public and private resources.ResultsThe experimental group was more likely to remain in contact with services over a 12-month period, had fewer acute readmissions and spent less time in acute in-patient units. There were significantly different levels and patterns of resource consumption between the groups and between the two separate catchment areas.ConclusionThe cost analysis should be assessed in the context of the previous outcome analysis. It is likely, but not inevitable, that such units will increase the overall costs of care provision; this largely depends on the effectiveness with which such units are integrated into existing care provision.
Alcohol and the brain
Authors: Nutt David 
Published: October 2008

BackgroundAlcohol misuse, as well as being a major form of psychiatric morbidity, is also commonly associated with other psychiatric disorders. A greater understanding of the brain mechanisms underlying the adverse effects of alcohol is now possible, thanks to significant research advances made over the past decade.AimsTo elucidate for psychiatrists the growing knowledge of the importance of specific neurotransmitter interactions in the effects of alcohol.MethodA survey of the literature, extracting current knowledge of interest to psychiatrists.ResultsThere is good evidence that the acute effects of alcohol are mediated through interactions with amino acid neurotransmitters plus parallel changes in amines such as noradrenaline, dopamine and serotonin. Neuroadaptive responses at amino acid receptors probably underlie significant components of the withdrawal syndrome and probably also contribute to neuronal death found in chronic alcoholism.ConclusionsAn understanding of the pharmacology of alcohol use may lead to greater ability to treat psychiatric consequences of alcoholism, and may also prevent some of the secondary psychiatric comorbidity and later brain damage.