bluuebunny/crossref_metadata_2025_split huggingface dataset:
Residential Care in Hospital and in the Community – Quality of Care and Quality of Life
Authors: Shepherd Geoff , Muijen Matt , Dean Rachel , Cooney Margaret 
Published: October 2008

BackgroundThe reduction of beds in long-stay hospitals has led to concerns over the quality of care offered to the remaining residents as well as that provided in the community. This study seeks to compare the quality of care and quality of life (reported satisfaction) from residents in both types of setting.MethodA cross-sectional comparison was made of community residential homes and hospital wards drawn randomly from lists provided by local authorities in the outer London area. Samples were drawn from all the main provider types (local authority, housing association, private and joint NHS/voluntary sector). Measures were taken of the quality of the physical environment, staff and resident characteristics, external management arrangements and internal management regimes, resident satisfaction and staff stress. Direct observations were also made of the amount and quality of staff-resident interactions.ResultsIn general, the most disabled residents were found to be still living in hospital in the worst conditions and receiving the poorest quality of care. Although there were some problems with missing data, hospital residents also seemed most dissatisfied with their living situation. There were few differences between community providers regarding either the quality of care provided or the levels of reported satisfaction. Quality of care in the community homes seemed to be much more determined by the personality and orientation of project leaders.ConclusionsPurchasers and providers still need to give attention to the problems of selectively discharging the most able residents to the community, leaving the most disabled being looked after in progressively deteriorating conditions. All residential providers need to review their internal management practices and try to ensure that residents are offered, as far as possible, the opportunity to make basic choices about where and how they will live. Staff training and quality assurance practices need to be reviewed in order to improve the direct quality of care offered to the most disabled individuals.
The Diagnosis and Prevalence of Hyperactivity in Chinese Schoolboys
Authors: Leung Patrick W. L. , Luk S. L. , Ho T. P. , Taylor Eric , Mak Felice Lieh , Bacon-Shone John 
Published: October 2008

BackgroundThis study was undertaken to examine the validity of different diagnostic definitions of hyperactivity in a Chinese population. Estimates of the prevalence of hyperactivity were made according to these different diagnostic definitions.MethodIn a two-stage epidemiological study of hyperactivity in Hong Kong, 3069 Chinese schoolboys were screened by questionnaires; and a stratified sample of 611 of them entered a second stage for more detailed diagnostic assessment.ResultsChildren with hyperkinetic disorder (ICD–10) or ADDH (DSM–III) both displayed significant hyperactive symptoms, but with somewhat different external correlates; hyperkinetic disorder tended to show more neurodevelopmental impairments, ADDH more cognitive and educational difficulties. These findings raise the possibility of heterogeneity in the disorders present with hyperactivity. The DSM–III–R category of ADHD was more common, and those extra cases, that did not overlap with ADDH or hyperkinetic disorder, included children with no obvious behavioural, cognitive or neurodevelopmental impairments. Hence ADHD may be an over-inclusive category. Prevalence rates for hyperkinetic disorder, ADDH and ADHD were respectively 0.78%, 6.1% and 8.9%.ConclusionsA disorder of hyperactivity does exist in the Chinese culture, displaying the same kinds of symptomatology and external correlates as in the West. The prevalence rates of hyperkinetic disorder and ADDH in Chinese schoolboys are on the low side when compared to those reported in Western studies.
Should Amenorrhoea be Necessary for the Diagnosis of Anorexia Nervosa?
Authors: Garfinkel Paul E. , Lin E. , Goering P. , Spegg C. , Goldbloom D. , Kennedy S. , Kaplan A. S. , Woodside D. Blake 
Published: October 2008

BackgroundThis study compares the characteristics of women with anorexia nervosa with those of women who have all the diagnostic features of that disorder except amenorrhoea.MethodThe study uses data from a large community epidemiological survey of the mental health status of household residents in Ontario, Canada. A multi-stage stratified sampling design generated a sample of 4285 females aged 15–64. DSM–III–R diagnoses were made using the Composite International Diagnostic Interview.ResultsEighty-four out of 4285 female respondents met full or partial-syndrome criteria for anorexia nervosa. Comparison of these two groups revealed few statistically significant differences in terms of demographics, psychiatric comorbidity, family history or early experiences.ConclusionsAmenorrhoea did not discriminate between women with anorexia nervosa and women with all the features except amenorrhoea across a number of relevant variables. The authors question the utility of amenorrhoea as a diagnostic criterion.
Abnormal Electroretinogram in Cocaine-Dependent Patients
Authors: Roy Monique , Smelson David A. , Roy Alec 
Published: October 2008

BackgroundThe retina contains high concentrations of dopamine. We previously reported that recently withdrawn cocaine-dependent patients had significantly reduced blue cone b wave amplitude responses on the electroretinogram (ERG). In this study we wished to examine if there was a relationship between cocaine craving and reduced blue cone b wave ERG responses.MethodsA series of 14 recently withdrawn cocaine-dependent patients completed a 45-item cocaine craving questionnaire shortly before the ERG.ResultsCocaine dependent patients who had a reduced (<0.5 microvolts) blue cone b wave ERG response had significantly higher cocaine craving scores than patients without a reduced blue cone ERG response. There was also a significant negative correlation between blue cone b wave amplitude responses and scores on the cocaine craving questionnaire.ConclusionA reduced blue cone b wave ERG response may identify recently withdrawn cocaine-dependent patients with biological dysregulation and increased cocaine craving.
Consent to Neuroleptic Medication for Schizophrenia: Clinical, Ethical and Legal Issues
Authors: Brabbins Clare , Butler Jonathan , Bentall Richard 
Published: October 2008

BackgroundThe effects of neuroleptic medication on schizophrenic patients are both positive (reduction in symptoms) and negative (adverse side-effects). Given that altered cognitive functioning may be a feature of schizophrenia, the use of neuroleptics raises important ethical and legal issues.MethodA selective review was carried out of papers addressing ethical arguments for and against obtaining consent from schizophrenic patients, and the ethical and legal requirements which must be met for consent to occur.ResultsAlthough a balance must be met between arguments for and against obtaining consent, clinicians should seek informed consent in all but exceptional circumstances. Obtaining consent depends on the adequate presentation of information, the absence of duress and the patients' capacity to consent. Various tests of capacity to consent have been proposed.ConclusionsIt is proposed that clinicians employ a proforma to record attempts to obtain informed consent during routine clinical practice.
Verbal Creativity, Depression and Alcoholism
Authors: Post Felix 
Published: October 2008

BackgroundAn earlier study of 291 world famous men had shown that only visual artists and creative writers were characterised, in comparison with the general population, by a much higher prevalence of pathological personality traits and alcoholism. Depressive disorders, but not any other psychiatric conditions, had afflicted writers almost twice as often as men with other high creative achievements. The present investigation was undertaken to confirm these findings in a larger and more comprehensive series of writers, and to discover causal factors for confirmed high prevalences of affective conditions and alcoholism in writers.MethodData were collected from post-mortem biographies and, where applicable, translated into DSM diagnoses. The frequencies of various abnormalities and deviations were compared between poets, prose fiction writers, and playwrights.ResultsA high prevalence in writers of affective conditions and of alcoholism was confirmed. That of bipolar affective psychoses exceeded population norms in poets, who in spite of this had a lower prevalence of all kinds of affective disorders, of alcoholism, of personality deviations, and related to this, of psychosexual and marital problems, than prose fiction and play writers.ConclusionsA hypothesis is developed, which links the greater frequency of affective illnesses and alcoholism in playwrights and prose writers, in comparison with poets, to differences in the nature and intensity of their emotional imagination. This hypothesis could be tested by clinical psychologists collaborating with experts in literature on random samples of different kinds of writers.
Idazoxan and Response to Typical Neuroleptics in Treatment-Resistant Schizophrenia
Authors: Litman Robert E. , Su Tung-Ping , Potter William Z. , Hong Walter W. , Pickar David 
Published: October 2008

BackgroundWe investigated whether antagonism of α2adrenergic receptors would augment treatment response in schizophrenia, by administering idazoxan, an α2antagonist drug, to treatment-resistant patients on typical neuroleptics.MethodSeventeen hospitalised treatment-resistant patients with DSM–III–R schizophrenia or schizoaffective disorder were studied on typical neuroleptic treatment, on treatment with idazoxan plus typical neuroleptic, and after discontinuation of idazoxan, in fixed, non-random order, and under double-blind, placebo-controlled conditions.ResultsThe addition of idazoxan to fluphenazine treatment resulted in significant reductions of global psychosis and total, positive and negative symptoms on the Brief Psychiatric Rating Scale, compared to neuroleptic treatment alone. Symptom improvement significantly correlated with idazoxan-induced changes in indices of noradrenergic function. In a subgroup of patients, idazoxan plus typical neuroleptic treatment compared favourably with clozapine treatment, when both were compared to typical neuroleptic treatment alone.ConclusionsThe antagonism of α2receptors augmented therapeutic response to typical neuroleptic treatment in treatment-resistant patients with schizophrenia. This antagonism may contribute to clozapine's superior antipsychotic effects.
Present Use of the Hamilton Depression Rating Scale: Observations on Method of Assessment in Research of Depressive Disorders
Authors: Snaith R. P. 
Published: October 2008

BackgroundThe Hamilton Depression Rating Scale retains its primacy in research. There have been recent important critiques. It is clear that instructions provided by its author are widely overlooked.MethodA survey of the present use of the HDRS was conducted by inspection of five major journals publishing studies in the field of psychiatry. Note was especially made of whether a recognised version of the Scale was quoted; also of whether authors had selected specific scores on one or other of the versions to indicate a criterion for inclusion of a subject in a study, and likewise whether a specific score had been selected as an indication of recovery following some procedure or treatment.ResultsOne hundred and fourteen articles were reviewed in which 71 had used a depression scale. This was the HDRS in 66% of the studies. There was considerable evidence that the instruction that the HDRS was only to be used in situations where the patient had received a diagnosis of a primary depressive illness had been ignored. There was considerable degree of arbitrary selection of Scale scores.ConclusionsThe survey causes concern about the methodology of much research in the field of assessment of severity of psychiatric disorder. The rationale of assessment by the rating scale method is considered and suggestion made for improvement in research practice.
Validity of the Arabic Version of the Eating Disorders Inventory (EDI)
Authors: Al-Subaie Abdullah S. , Bamgboye Elijah , Al-Shammari Sulaiman , Al-Sabhan Khalid N. , Al-Shehri Sulaiman Nasser , Bannah Azzah Ramadan Sayed 
Published: October 2008

BackgroundWe aimed to validate the Eating Disorders Inventory (EDI) in Arabic.MethodsSubjects were chosen randomly from female school students. Only healthy Saudi students were included. They were asked to fill the EDI and undergo a semi-structured interview by a psychiatrist who was unaware of the EDI scores. Of 146 students approached 12 did not meet our criteria and were excluded; 16 other students were excluded for incomplete responses.ResultsThe difference between the two diagnostic methods in the proportion of caseness was statistically significant (P < 0.0001). The scores on Perfectionism, Maturity Fears and Interoceptive Awareness were significantly higher in the Saudi students compared with Canadians (P < 0.05).ConclusionsThe EDI-DT subscale has a sensitivity of 100% and a specificity of 85%. Despite its low positive predictive value of 5%, it may be useful for screening large non-clinical groups for eating disorders.
Clinical and Magnetic Resonance Imaging Correlates of Hypothalamic–Pituitary–Adrenal Axis Function in Depression and Alzheimer's Disease
Authors: O'Brien John T. , Ames David , Schweitzer Isaac , Colman Peter , Desmond Patricia , Tress Brian 
Published: October 2008

BackgroundAn age-related dysregulation of the hypothalamic–pituitary–adrenal (HPA) axis is well recognised in animals, but still remains controversial in humans. There is increasing interest that raised corticosteroid levels, due to activation of the HPA axis, may cause both depressive symptoms and cognitive impairments. Steroid effects on cognition may be via the hippocampus, a major site of corticosteroid action and an important structure involved in learning and memory.MethodTo investigate this further, we examined the relationship between the dexamethasone suppression test, cognitive function, depressive symptoms and hippocampal atrophy on magnetic resonance imaging (MRI) in 32 normal controls, 49 subjects with NINCDS/ADRDA Alzheimer's disease and 51 patients with DSM–III–R Major Depression.ResultsControlling for differences in dexamethasone concentrations, post-dexamethasone cortisol levels were related to advancing age in controls and depressed subjects. However, among subjects with Alzheimer's disease, post-dexamethasone cortisol levels were independently associated with both minor depressive symptoms and hippocampal atrophy on MRI.ConclusionAn association between advancing age and increased HPA axis dysregulation is supported for controls and depressed subjects. In Alzheimer's disease, HPA axis changes were associated with depressive symptoms and hippocampal atrophy. Longitudinal studies are now needed to determine the causal direction of these associations.
Increased Occurrence of Schizophrenia and other Psychiatric Illnesses Among Twins
Authors: Kläning Ulla , Mortensen Preben Bo , Kyvik Kirsten Ohm 
Published: October 2008

BackgroundWe wished to establish whether the occurrence of schizophrenia among twins is the same as among the general population.MethodThrough record linkage between the New Danish Twin Register and the Danish Psychiatric Case Register, the twins who have ever received a diagnosis of schizophrenia were identified. Through indirect standardisation for age, sex and dates of admission, the rate of first admission with diagnosis schizophrenia among twins is compared to the same rate in the general population.ResultsA 28% increase in the rate of first admissions for schizophrenia in twins compared to the general population was found. This is statistically significant and does not seem to be caused by any known methodological problems. Twins also had an increased first-admission rate of any psychiatric disorders.ConclusionThis increased risk does not seem to be explained by known methodological problems, but does differ from earlier studies.
A Controlled Study of Education About Drug Treatment in Schizophrenia
Authors: Macpherson Rob , Jerrom Bill , Hughes Anthony 
Published: October 2008

BackgroundVarious problems are associated with schizophrenia which may theoretically lead to impaired educability about treatment.MethodThe Understanding of Medication Questionnaire, designed to measure knowledge about treatment in schizophrenia, is described and presented. An educational programme based on a specially designed information booklet was developed. Sixty-four patients with DSM–III–R diagnosis schizophrenia were randomly allocated to groups receiving none (control), one session or three sessions of education.ResultsPre-intervention low levels of knowledge about illness and treatment increased significantly immediately after a standard education session. Three education sessions led to significantly greater knowledge gain than one session. There was no significant change in the control group. Only the PANSS negative syndrome score independently and consistently explained a significant proportion of the education effect. The influence on educability of attitudes to education, impaired insight, cognitive impairment and other variables were considered. Three sessions of education led to significantly increased insight, but no change in compliance.ConclusionsTechniques appropriate for educating schizophrenic patients were discussed, and the value of involving patients in education emphasised. A series of patient education sessions is needed to consolidate learning, rather than a single informing process. The strong association between impaired learning and more severe negative schizophrenic syndrome emphasises the need for responsible prescribing of antipsychotic treatment in schizophrenia.
Mental Disorder in an Elderly Home Care Population: Associations with Health and Social Service Use
Authors: Banerjee Sube , Macdonald Alastair J. D. 
Published: October 2008

BackgroundHome care services maintain people in their own households by providing practical help such as with housework, shopping and personal care. In this study associations between mental disorder and health and social service use, demographics and activity limitation are investigated.MethodA cross-sectional study with random cluster sampling of people over 65 receiving home care in Lewisham. Mental disorder was rated using the GMS/AGECAT system.ResultsWe interviewed 169/177 eligible individuals, a response rate of 96%. Forty-six percent of this population were rated as cases of mental disorder (15% organic and 26% depressive). Most (84%) of those with depression did not appear to be receiving appropriate treatment. Home care provision to those with depression (unlike dementia) was only partially explicable in terms of activity limitation.ConclusionsThere is a high level of depressive disorder in this population with little in the way of appropriate primary or secondary care management. Those in sheltered housing seem particularly at risk; depression may lead to increased service use independent of disability.
Alcohol-Metabolising Genes and Alcoholism Among Taiwanese Han Men: Independent Effect of ADH2, ADH3 and ALDH2
Authors: Chen Wei J. , Loh E. W. , Hsu Yun-Pung P. , Chen Chiao-Chicy , Yu Jeng-Ming , Cheng Andrew T. A. 
Published: October 2008

BackgroundPrevious population association studies have indicated that certain alleles of alcohol dehydrogenase (ADH) and aldehyde dehydrogenase (ALDH) may reduce the risk of alcoholism in Asian populations. The association of ALDH2 and ADH2 with the development of alcoholism was found to be independent of each other and has been replicated in different Asian populations, while the effect of ADH3 is less studied.MethodWe genotyped the alcohol metabolism genes among Han men with alcohol dependence (n=46) and their ethnically matched normal controls (n=63) in Taiwan. Multiple logistic regression was then applied to assess the contribution of ADH3 to alcoholism by controlling the effect of ALDH2 and ADH2.ResultsThe results of multivariate analyses demonstrated that the odds ratios for an increment of one allele of ADH2∗1, ADH3∗2 and ALDH2∗1 in the development of alcoholism were 4.18, 3.82, and 6.89, respectively.ConclusionsThese findings clearly indicate that all three alcohol-metabolising genes contribute to susceptibility to alcoholism.
Obsessive–Compulsive Disorder
Authors: Lensi P. , Cassano G. B. , Correddu G. , Ravagli S. , Kunovac J. L. , Akiskal H. S. 
Published: October 2008

BackgroundDemographic data, family history, psychopathological features, comorbidity and course of obsessive–compulsive disorder (OCD) are investigated and data generated to support the possible existence of two subgroups with gender-related differences of a broader nature.MethodTwo hundred and sixty-three OCD patients, consecutive admissions to the Institute of Psychiatry, University of Pisa over a period of 5 years, not excluding those with comorbid Axis I and Axis II conditions, were studied. Patients were evaluated with a specifically designed semi-structured OCD interview.ResultsWe found a significantly greater history of perinatal trauma in men who also had an earlier onset, greater likelihood of never having been married and a higher frequency of such symptoms as sexual, exactness and symmetry obsessions and odd rituals; by contrast, women suffered a later onset of the disorder, were more likely to be married, had higher rates of associated panic attacks after the onset of OCD and a higher frequency of aggressive obsessions at the onset of their illness, and were less frequently associated with bipolar disorders.ConclusionsPathophysiological mechanisms in OCD seem to differ by gender. Perinatal trauma might predispose to earlier onset in men, whereas in women there is a close association between OCD and panic disorder.
Development of a Clinical Rating Scale to Assess Mother-Infant Interaction in a Psychiatric Mother and Baby Unit
Authors: Kumar R. , Hipwell A. E. 
Published: October 2008

BackgroundPsychiatrists are sometimes asked to express an opinion about the competence and motivation of a mentally ill mother to be a consistent, adequate and safe parent of her recently born infant, There are no reliable methods for assessing mother–infant interaction and relationship in a psychiatric context.MethodThe Bethlem Mother–infant Interaction Scale (BMIS) was developed by the staff of a specialised psychiatric mother and baby unit. Of the seven subscales, four measured different aspects of the mother's contribution to the dialogue with her baby, one measured her capacity to organise and maintain routine care, one attempted to rate the perception by staff of risk to the child, and the remaining subscale rated the baby's contribution to their interaction. In normal clinical practice the ratings were made consensually by nurses and they encompassed observations that had been made by them during the previous week.ResultsDespite the simple and global nature of the ratings of the BMIS, moderate to high coefficients of inter-rater reliability were obtained for weekly ratings by nurses as well as for intra-rater reliability of ratings of videotaped interactions between mothers and their infants. Ratings of mothers and babies in day-to-day activity in the unit that were based on one hour's observation only were much less reliable. The internal consistency of the BMIS was high and comparisons with other methods used in non-clinical settings showed good criterion-related validity.ConclusionsUsing the BMIS facilitated attempts to reliably assess disturbances of mother–infant interaction and the scale was acceptable and clinically useful. The nurses' ratings of their perceptions of ‘risk’ to the infant, which are in some ways the most important, were the least reliable. Repeated weekly ratings gave a valuable impression of change or lack of it over time. The predictive validity of the scale has yet to be determined.