bluuebunny/crossref_metadata_2025_split huggingface dataset:
Psychological interventions in self-injurious behaviour
Authors: Halliday Sabrina , Mackrell Kelvin 
Published: October 2008

BackgroundPsychological approaches to working with people with learning disabilities who self-injure have developed over the past 30 years.MethodThe major literature is reviewed and an ecological framework is described which emphasises the importance of environmental, interpersonal and intrapersonal dynamics to understanding the multi-factorial nature of self-injury. Case examples are given.ResultsSelf-injury is seen as essentially communicative and functionally adaptive; it is the person's best attempt to deal with abusive, neglecting or traumatic environments or events.ConclusionsThe persistence of self-injurious behaviour once established, requires an interdisciplinary approach which addresses comprehensively the variety of factors which have contributed to the development and maintenance of self-injury.
Randomised controlled trial of compliance therapy
Authors: Kemp Roisin , Kirov George , Everitt Brian , Hayward Peter , David Anthony 
Published: October 2008

BackgroundA randomised controlled trial was conducted in an acute treatment setting to examine the effectiveness of compliance therapy, a brief pragmatic intervention targeting treatment adherence in psychotic disorders, based on motivational interviewing and recent cognitive approaches to psychosis.MethodSeventy-four patients with psychotic disorders according to DSM–III–R criteria recruited from consecutive admissions to an acute in-patient unit, received 4–6 sessions of either compliance therapy or non-specific counselling, and were followed-up over 18 months. The principal outcome measures were observer-rated compliance, attitudes to treatment, insight and social functioning.ResultsSignificant advantages were found for the compliance therapy group post-treatment on measures of insight, attitudes to treatment and observer-rated compliance which were retained over the follow-up period. Global social functioning improved relatively more over time in the compliance therapy group compared with the control group. Survival in the community prior to readmission was significantly longer in the compliance therapy group.ConclusionsThe results support the effectiveness of compliance therapy in improving functioning and community tenure after an acute psychotic episode.
Cost-effectiveness evaluation of compliance therapy for people with psychosis
Authors: Healey Andrew , Knapp Martin , Astin Jack , Beecham Jennifer , Kemp Roisin , David Anthony , Kirov George 
Published: October 2008

BackgroundNon-compliance rates with antipsychotic medication can be high, and the personal and societal costs are considerable. A new psychological intervention, compliance therapy seeks to improve compliance and patient outcomes and reduce treatment costs.MethodA randomised controlled study examined the cost-effectiveness of compliance therapy compared to nonspecific counselling over 18 months for 74 people with psychosis admitted as inpatients at the Maudsley Hospital. Bivariate and multivariate analyses were conducted to test for differences and to explore inter-patient cost variations.ResultsCompliance therapy is more effective and is no more expensive. Consequently, compliance therapy is more cost-effective than non-specific counselling at six, 12 and 18 months.ConclusionsThere are compliance, outcome and cost-effectiveness arguments in favour of compliance therapy in preference to non-specific counselling.
Amnestic people with Alzheimer's disease who remembered the Kobe earthquake
Authors: Ikeda Manabu , Mori Etsuro , Hirono Nobutsugu , Imamura Toru , Shimomura Tatsuo , Ikejiri Yoshitaka , Yamashita Hikari 
Published: October 2008

BackgroundEmotional memory is a special category of memory for events arousing strong emotions. To investigate the effects of emotional involvement on memory retention in individuals with Alzheimer's disease we studied peoples' memories of distressing experiences during a devastating earthquake.MethodFifty-one subjects with probable Alzheimer's disease who experienced the Kobe earthquake at home in the greater Kobe area were studied. Memories of the earthquake were assessed 6 and 10 weeks after the disaster in semi-structured interviews, and were compared with memories of a magnetic resonance imaging (MRI) examination given after the earthquake.ResultsForty-four (86.3%) of the subjects remembered the earthquake and 16 (31.4%) of subjects remembered the MRI experience. Factual content of the earthquake was lost in most of the subjects.ConclusionsFear reinforces memory retention of an episode in subjects with Alzheimer's disease but does not enhance retention of its context, despite repeated exposure to the information.
Criminal conviction after discharge from special (high security) hospital
Authors: Buchanan Alec 
Published: October 2008

BackgroundThe aim was to measure the criminal convictions received by people who leave special hospital and to test previously identified correlates of conviction.MethodA cohort study design was used and the subjects were all 425 patients discharged from the special hospitals in 1982 and 1983. The outcome measure was a criminal conviction received within 10.5 years of discharge.ResultsFive and a half years after discharge 26% of ex-patients had been convicted of any offence, 9% of a violent offence, 5% of a sex offence and 10% of any serious offence. Ten and a half years after discharge 34% of patients had been convicted of any offence, 15% of a violent offence, 7.5% of a sex offence and 15% of any serious offence. When other variables are controlled for, gender and destination on discharge do not predict conviction. Age, a legal category of psychopathic disorder and prior criminal record do predict, but the effect is small.ConclusionThe rate of conviction of patients leaving special hospital has fallen over the past 20 years; this is the case for crime in general and for serious crimes in particular. The change in rates of conviction over time for patients of different legal categories, previously thought to be different, is the same. The low predictive power of the variables examined here suggests that actuarial methods are of limited value in predicting offending in this group.
Oral olanzapine versus oral haloperidol in the maintenance treatment of schizophrenia and related psychoses
Authors: Tran Pierre V. , Dellva Mary Anne , Tollefson Gary D. , Wentley Anita L. , Beasley Charles M. 
Published: October 2008

BackgroundThree studies compared olanzapine and haloperidol given orally in maintenance therapy for schizophrenia and related psychoses.MethodData were from double-blind extensions of acute studies. The subjects met criteria for schizophrenia, schizophreniform disorder or schizoaffective disorder. Subjects had responded to acute therapy (Brief Psychiatric Rating Scale total score decreased $ 40% from baseline (Studies 1, 2, and 3) or was $ 18 (Studies I and 2)) and were out-patients at their last acute phase visit. Relapse was defined as hospitalisation for psychopathology. Subjects treated with olanzapine in the three studies were pooled to form the olanzapine group and subjects treated with haloperidol were pooled to form the haloperidol group.ResultsOlanzapine-treated subjects experienced less relapse (P=0.034). The Kaplan-Meier estimated one-year risk of relapse was 19.7% with olanzapine and 28% with haloperidol.ConclusionOlanzapine was superior to haloperidol in the maintenance therapy of schizophrenia and related psychoses.
Nithsdale Schizophrenia Surveys 17
Authors: Kelly Ciara , McCreadie Robin , MacEwan Tom , Carey Stephen 
Published: October 2008

BackgroundIn recent years there has been a shift to ‘community care’ and the introduction of several ‘atypical’ antipsychotic drugs. We report the impact of these changes.MethodIn Nithsdale, Dumfries and Galloway, Scotland, the population of patients with schizophrenia was identified in 1996. This census replicated a study carried out in 1981. The population with schizophrenia were compared on clinical and social variables. The whereabouts in 1996 of the 1981 population was determined.ResultsIn comparison with the 1981 population, more patients in 1996 had positive, negative and non-schizophrenic symptoms. More showed tardive dyskinesia. Social adjustment had not changed. They had spent less time in hospital; fewer (13%) were living with their parents; and fewer (8%) were employed. By 1996, 35% of the 1981 cohort had died (standardised mortality rate male – 154, female – 162).ConclusionsThe mental health of a community of people with schizophrenia living in a rural area in 1996 was poorer than in 1981.
Genetic epidemiology of binging and vomiting
Authors: Sullivan Patrick F. , Bulik Cynthia M. , Kendler Kenneth S. 
Published: October 2008

BackgroundBulimia nervosa is typically defined as the combination of the behaviours of binging and vomiting. We sought to clarify the relationship of these behaviours from a genetic epidemiological perspective.MethodUsing data on the lifetime history of binging and vomiting from a personally interviewed population-based sample of female twins (n = 1897), we applied bivariate twin modelling to estimate the sources of variation for these traits.ResultsThe association between having ever binged (23.6%) and having ever induced vomiting (4.8%) was very strong (odds ratio=8.78, P < 0.0001). The best-fitting model indicated that lifetime binging and vomiting were both heritable (46% and 72%) and influenced by individual-specific environmental factors (54% and 28%). The overlap between the genetic (ra = 0.74) and individual-specific environmental factors (re = 0.48) for the two traits was substantial. No violations of the equal environment assumption were evident.ConclusionsIncluding binging and vomiting under the rubric of bulimia nervosa appears to be appropriate. Our data are consistent with the identification of binging and vomiting as complex traits resulting from the interplay of multiple genes and individual-specific environmental influences. In contrast to ‘environmentalist’ theories, our results suggest that genetic influences may be of particular relevance to the aetiology of binging and vomiting.
Burden of disease
Authors: Andrews Gavin , Sanderson Kristy , Beard John 
Published: October 2008

BackgroundThe Global Burden of Disease studies are important because they encompass morbidity as well as mortality. Burden due to morbidity is calculated from incidence, duration and disability. There is a dearth of epidemiological measurements of disability.MethodData from a quasi-community sample (n=1364) were analysed. Diagnoses of mental and physical disorders, and reports of disability, were based on established methods.ResultsThe disabilities reported in mental and physical disorders were comparable. Disability was correlated with comorbidity. The disability in mental disorders was examined by three methods: pure disorders, main problem and regression. It appears that major depression and substance disorder weights were overestimated, and anxiety disorder weights were underestimated in the Global Burden of Disease studies.ConclusionsA method for disentangling the effects of concurrent comorbidity is presented. The size of burden attributed to mental disorders is of potential benefit for funding mental health services. It is important that we get the estimates right.
Brain changes in schizophrenia
Authors: Sharma Tonmoy , Lancaster Eric , Lee David , Lewis Shôn , Sigmundsson Thordur , Takei Noriyoshi , Gurling Hugh , Barta Patrick E. , Pearlson Godfrey , Murray Robin M. 
Published: October 2008

BackgroundStructural brain abnormalities have been reported in schizophrenia. We tested the hypothesis that these abnormalities represented a marker for the genetic liability to schizophrenia in a sample of people with schizophrenia and their relatives from families multiply affected with the disorder.MethodWe compared 31 people with schizophrenia, 57 relatives and 39 unrelated control subjects. Volumetric measurement of brain structures was carried out using stereological principles from three-dimensional reconstructed magnetic resonance images.ResultsSubjects with schizophrenia had larger lateral ventricles than their relatives and the normal control subjects. Relatives who were ‘presumed obligate carriers' had larger left lateral ventricles than other relatives and the control subjects. Subjects with schizophrenia showed smaller whole brain and cerebellar volumes and larger lateral ventricles than their age–and gender-matched unaffected siblings.ConclusionsIn families multiply affected with schizophrenia lateral ventricular enlargement distinguishes people with schizophrenia and presumed obligate carriers from other relatives and unrelated control subjects. These changes may be a marker for a genetic liability to schizophrenia.
‘Pfropfschizophrenie’ revisited
Authors: Doody Gillian A. , Johnstone Eve C. , Sanderson T. L. , Owens David G.C. , Muir W J. 
Published: October 2008

BackgroundIt is reported that people with mild learning disability have a higher point prevalence of schizophrenia than the normal population, the reasons for which are unclear.MethodThirty-nine subjects with mild learning disability and schizophrenia, 34 control subjects with schizophrenia and 28 control subjects with mild learning disability were seen. Interviews with relatives and carers were also conducted. Assessments were made of clinical variables, psychopathology, neurological ‘soft'signs, IQ, memory and family history. Blood was taken for karyotypic analysis from comorbid subjects.ResultsThe comorbid group had more negative symptoms, episodic memory deficits, soft neurological signs, epilepsy and receive more community supports than control subjects with schizophrenia. Comorbid subjects had a tendency to belong to multiply affected families and show high rates of chromosomal variants on routine karyotypic testing.ConclusionsFuture work on the generality of schizophrenia should include people with premorbid learning disability, as a discrete subtype from whom valuable genetic aetiological clues may be obtained.
Substance use, health and social problems of service users at 54 drug treatment agencies
Authors: Gossop Michael , Marsden John , Stewart Duncan , Lehmann Petra , Edwards Carolyn , Wilson Alison , Segar Graham 
Published: October 2008

BackgroundThe National Treatment Outcome Research Study (NTORS) is the first large-scale, prospective, multi-site treatment outcome study of drug users in the UK.MethodSubstance use, health and social problems of 1075 service users were assessed at intake to 54 agencies chosen to be representative of the main national drug treatment modalities.ResultsHeroin dependence was the most frequently reported problem often with poly-drug and alcohol problems. Most service users injected drugs and & quarter of the injectors shared injecting equipment. Poly-drug use and heavy drinking were more common among service users admitted to residential treatments. High criminality rates were reported Psychological and physical health problems were common and many service users had prior contact with psychiatric and medical services.ConclusionsThe range and severity of problems adversely affect individual users, their families, and present & challenge to addiction treatment services. These problems create costs for the health care, social service and criminal justice system responses.
Objectivity in psychoanalytic judgements
Authors: Hobson R. Peter , Patrick Matthew P. H. , Valentine John D. 
Published: October 2008

BackgroundThere is widespread scepticism concerning the reliability and validity of psychoanalytic judgements of patient–therapist transactions. We predicted that (a) in reviewing the initial part of 14 videotaped assessment interviews with borderline and dysthymic subjects, dynamic psychotherapists would agree in their ratings of psychoanalytically relevant characteristics of subjects' interpersonal relations; (b) inter-correlations among the ratings would conform with those expected from psychoanalytic descriptions of ‘paranoid-schizoid’ and ‘depressive position’ states of mind; and (c) these ratings would differentiate between borderline and dysthymic groups.MethodSix trained psychotherapists who were blind to the design of the study, independently rated qualities of interpersonal relatedness during the first 30 minutes of each interview, on & 30-item ‘personal relatedness profile’ResultsThere was satisfactory interrater reliability in judgements among the raters, and evidence that the items were interrelated. There was also & significant difference between the two subject groups.ConclusionsIt is possible to make reliable psychoanalytic judgements about qualities of interpersonal relatedness. Moreover, there is evidence that paranoid–schizoid and depressive positive aspects of psychological functioning do constitute & meaningful constellation of clinically grounded phenomena.
Specific fears and phobias
Authors: Curtis George , Magee William J. , Eaton William W. , Wittchen Hans-Ulrich , Kessler Ronald C. 
Published: October 2008

BackgroundData on eight specific fears representing DSM–III–R simple phobia were analysed to evaluate: (a) their prevalence and (b) the validity of subtypes of specific phobia defined by DSM–IV.MethodA modified version of the Composite International Diagnostic Interview was administered to a probability sample of 8098 community respondents. Correlates of responses to questions concerning these fears were analysed.ResultsThe most prevalent specific fears were of animals among women, and of heights among men. Slight evidence was found for specific phobia subtypes. Number of fears, independent of type, powerfully predicted impairment, comorbidity, illness course, demographic features, and family psychopathology.ConclusionNumber of specific fears may mark a general predisposition to psychopathology. More detailed information is needed to resolve the question of specific phobia subtypes.
Temporal relationships between physical symptoms and psychiatric disorder
Authors: Hotopf Matthew , Mayou Richard , Wadsworth Michael , Wessely Simon 
Published: October 2008

BackgroundPhysical symptoms and psychiatric disorder are associated. We aimed to investigate which comes first.MethodsData from the Medical Research Council National Survey of Health and Development, a population-based birth cohort study were used at two time points: 36 and 43 years. Six physical symptoms were reported at both time points. The Present State Examination and Psychiatric Symptom Frequency interviews were administered at 36 and 43 years respectively. Odds ratios corrected for a variety of confounders were used to describe the associations between physical symptoms and psychiatric disorder across these two time points.ResultsPsychiatric disorder increased the odds of reporting symptoms 3–7-fold. The relationship strengthened when the outcome was defined as suffering from multiple symptoms. Population attributable risk of psychiatric disorder and subsyndromal disorder in causing multiple somatic symptoms was 40.3%. Prospectively, psychiatric disorder at 36 years was a predictor for five of the six physical symptoms. Three physical symptoms at 36 years predicted new onset of psychiatric symptoms at 43 years.ConclusionsPsychiatric disorder is strongly related to physical symptoms. The direction of causality may operate in both directions. Assuming a causal relationship, psychiatric disorder (including subthreshold disorders) could account for at most 40% of cases of multiple physical symptoms.
Psychological treatment of depression in children and adolescents
Authors: Harrington Richard , Whittaker Jane , Shoebridge Philp 
Published: October 2008

BackgroundThis paper reviews research on the psychological treatment of depression in children.MethodManual and computer literature searches were performed.ResultsThe most promising psychological interventions for depression in children are individual rather than family therapies. Cognitive – behavioural therapy seems to be an effective treatment for depressive symptoms and mild depressive disorders. It may also be a useful preventive intervention, though this remains to be conclusively demonstrated. There have been no systematic studies comparing psychological treatments with medication.ConclusionsStudies comparing psychological treatments and medication are now required.
Neuroimaging in autism
Authors: Deb Shoumitro , Thompson Bill 
Published: October 2008

BackgroundChildhood autism is a developmental disorder with distinctive clinical features and characteristic cognitive deficits. Neuroimaging techniques have been extensively used in the study of autism and related disorders.MethodRecent important literature reported on structural and functional neuroimaging in autism was reviewed and discussed in the context of other neurobiological research findings.ResultsVarious abnormalities of brain structure and function have been proposed, but no focal defect has been reliably demonstrated. Important findings, so far, include increased brain volume, structural abnormality in frontal lobe and corpus callosum in a proportion of autistic individuals. Functional neuroimaging findings emphasised the imbalance in interregional and inter-hemispheric brain metabolism and blood flow as well as abnormality in the anterior cingulate gyrus.ConclusionThe research to date has been hindered by methodological difficulties. However, hypothesis-driven research, particularly involving activation studies and neurotransmitter/neuroreceptor activities, using functional neuroimaging will be very useful in unravelling the enigma associated with this intriguing and distressing condition.
Mortality in schizophrenia
Authors: Waddington John L. , Youssef Hanafy A. , Kinsella Anthony 
Published: October 2008

BackgroundAlthough increased mortality is one of the most consistent and accepted epidemiological findings in schizophrenia, a high rate of suicide appears unable to account fully for this burden which remains poorly understood.MethodA cohort of 88 in-patients was followed prospectively over a 10-year period and predictors of survival sought among demographic, clinical and treatment variables.ResultsOver the decade, 39 of the 88 patients (44%) died, with no instances of suicide. Reduced survival was predicted by increasing age, male gender, edentulousness and time since pre-terminal withdrawal of antipsychotics; additionally, two indices of polypharmacy predicted reduced survival: maximum number of antipsychotics given concurrently (relative risk 2.46, 95% C1 1.10-5.47; P=0.03) and absence of co-treatment with an anticholinergic (relative risk 3.33, 95% C1 0.99-11.11; P=0.05).ConclusionsReceiving more than one antipsychotic concurrently was associated with reduced survival, in the face of little or no systematic evidence to justify the widespread use of antipsychotic polypharmacy. Conversely, over-cautious attitudes to the use of adjunctive anticholinergics may require re-evaluation.