bluuebunny/crossref_metadata_2025_split huggingface dataset:
Clinical and Psychosocial Origins of Chronic Depressive Episodes
Authors: Brown George W. , Moran Patricia 
Published: October 2008

BackgroundWe consider how far it is possible to predict a chronic course of a depressive disorder from psychosocial and clinical material available at the point of onset.MethodA population survey found 404 working-class mothers living in an inner-city area of London. The majority were interviewed three times over a 3-year period.ResultsChronicity (more than 12 months' duration) was strongly related to both childhood adversity (parental indifference, family violence or any sexual abuse) and current adult interpersonal difficulties. The lack of positive events during the course of the episode was also independently related to chronicity, but to a lesser degree. Clinical characteristics were relatively unimportant compared with psychosocial factors.ConclusionsThe childhood risk factors were particularly important (judged by a path analysis), and a challenge for future research will be to establish the intervening processes involved with this distal link.
Clinical and Psychosocial Origins of Chronic Depressive Episodes
Authors: Brown George W. , Moran P. , Harris T. O. , Hepworth C. , Robinson R. 
Published: October 2008

BackgroundWe consider how well the psychosocial and clinical factors found to predict a chronic course for depressive episodes in the community, held for female psychiatric patients.MethodA consecutive series of depressed patients, aged 18 to 60, treated as in-patients, out-patients or day-patients at psychiatric departments of two London hospitals, were interviewed initially and at follow-up two years later.ResultsIndices of childhood adversity and current interpersonal difficulties predicted episodes taking a chronic course (of more than 12 months' duration). Half of the episodes associated with one or the other factor were chronic, compared with 22% of those with neither. The patients were at higher risk than the community series (75% v. 34%) and this explains their much greater rate of chronicity. There was also some evidence that social support reduced risk. Clinical features and the presence of a personality disorder were unrelated to chronicity.ConclusionsSimilar psychosocial factors are important for predicting chronicity in both community and patient series.
Age at Onset, Sex, and Familial Psychiatric Morbidity in Schizophrenia
Authors: Sham Pak Chung , Jones Peter , Russell Ailsa , Gilvarry Karyna , Bebbington Paul , Lewis Shôn , Toone Brian , Murray Robin 
Published: October 2008

BackgroundAlthough a genetic component in schizophrenia is well established, it is likely that the contribution of genetic factors is not constant for all cases. Several recent studies have found that the relatives of female or early onset schizophrenic patients have an increased risk of schizophrenia, compared to relatives of male or late onset cases. These hypotheses are tested in the current study.MethodA family study design was employed; the probands were 195 patients with functional psychosis admitted to three south London hospitals, diagnosed using Research Diagnostic Criteria (RDC), and assessed using the Present State Examination (PSE). Information on their relatives was obtained by personal interview of the mother of the proband, and from medical records. Psychiatric diagnoses were made using Family History – Research Diagnostic Criteria (FH-RDC), blind to proband information.ResultsThere was a tendency for homotypia in the form of psychosis within families. The lifetime risk of schizophrenia in the first degree relatives of schizophrenic probands, and the risk of bipolar disorder in the first degree relatives of bipolar probands, were 5–10 times higher than reported population risks. Relatives of female and early onset (<22 years) schizophrenic probands had higher risk of schizophrenia than relatives of male and late onset schizophrenic probands. However, this effect was compensated in part by an excess of non-schizophrenic psychoses in the relatives of male probands.ConclusionsThese results suggest a high familial, possibly genetic, loading in female and early onset schizophrenia, but do not resolve the question of heterogeneity within schizophrenia.
Quantitative Magnetic Resonance Imaging Volumetry Distinguishes Delusional Disorder from Late-Onset Schizophrenia
Authors: Howard Robert J. , Almeida Osvaldo , Levy Raymond , Graves Phillipa , Graves Martin 
Published: October 2008

BackgroundLate paraphrenia is recognised as a heterogeneous disorder. This is reflected by the division of such patients into schizophrenia and delusional disorder in ICD-10. Earlier imaging studies have suggested that major structural abnormalities may be associated with the onset of psychosis in later life.MethodFifty late paraphrenics and 35 age-matched healthy controls underwent structural magnetic resonance imaging of the whole brain in the coronal plane. Measurements were made of intracranial and brain volumes and the volumes of the intracerebral and extracerebral cerebrospinal fluid spaces.ResultsNo differences in intracranial, brain or extracerebral cerebrospinal fluid volumes between patients and controls were found. Late paraphrenic patients had greater lateral and third ventricle volumes than controls and the left lateral ventricle was larger than the right. When the patients were divided into appropriate ICD-10 diagnoses: paranoid schizophrenia (n= 31) and delusional disorder (n= 16), lateral ventricle volumes in the delusional disorder patients were much greater than those of the schizophrenics and almost twice those of controls.ConclusionsStructural brain differences underly diagnostic heterogeneity within late paraphrenia. The brains of late onset schizophrenics are only subtly different from those of healthy elderly individuals.
Proton Magnetic Resonance Spectroscopy (1H MRS) of the Hippocampal Formation in Schizophrenia: A Pilot Study
Authors: Nasrallah Henry A. , Skinner Thomas E. , Schmalbrock Petra , Robitaille Pierre-Marle 
Published: October 2008

BackgroundRecent post-mortem and magnetic resonance imaging (MRI) studies strongly suggest a decrease in the volume of the hippocampus and other limbic temporal structures in schizophrenia. Therefore, we hypothesised that N-acetyl aspartate (NAA) which is found mainly in neurons and which can be measured by proton magnetic resonance spectroscopy (1H MRS) would be decreased in the limbic temporal region in schizophrenia.MethodConsenting subjects fulfilling DSM-III-R criteria for schizophrenia (n = 11) and matched healthy volunteers (n = 11) who were recruited in a tertiary university referral centre, participated in a 1H MRS brain study. Proton MRS spectra were obtained from a 12 cm3 voxel (2 × 2 × 3 cm) in the right and left hippocampus/amygdala region. A researcher blind to the source of the spectra, measured the NAA intensity in all subjects, which were then statistically compared across the two groups.ResultsNAA intensities were significantly reduced in the right hippocampus/amygdala region of schizophrenic patients (P = 0.038). The difference of the left side did not reach significance at the 95% confidence level.ConclusionsThe findings of decreased NAA in this study suggest that there may be a decrement in neuronal number or tissue volume of the right hippocampal/amygdala region in schizophrenia. Biochemical alterations in the metabolism of NAA in schizophrenia may be an alternative explanation. The findings are consistent with other types of post-mortem and in vivo evidence for hypoplasia of the limbic temporal structures in schizophrenia, postulated to be of neurodevelopmental pathogenesis.
War Trauma in a Civilian Population
Authors: Somasundaram D. J. , Sivayokan S. 
Published: October 2008

BackgroundAn epidemiological survey was made of war trauma and its consequences in the general population.MethodOne member aged over 15 years from each of 101 randomly selected families in a Primary Health Area in Sri Lanka were interviewed using the Stress Impact Questionnaire.ResultsNearly one-half had experienced between five and nine war stresses, and one-quarter experienced over 10 (mean 6.66). Only 6% had not experienced any. Sixty-four per cent had developed psychosocial sequelae, including somatisation (41 %), post-traumatic stress disorder (27%), anxiety disorder (26%), major depression (25%), hostility (19%), relationship problems (13%), alcohol and drug misuse (15%) and functional disability (18%).ConclusionThe trauma experienced correlated strongly with psychosocial and somatic symptoms.
Affective Disorders Among Elderly General Practice Patients
Authors: Turrina C. , Caruso R. , Este R. , Lucchi F. , Fazzari G. , Dewey M. E. , Ermentini A. 
Published: October 2008

BackgroundWe investigated the prevalence of depression among 255 elderly general practice patients and the practitioners' performance in identifying depression.MethodElderly patients attending 14 general practices entered a screening phase with GHQ-12 and MMSE. Those positive were then interviewed with GMS and HAS.ResultsDSM-III-R major depression affected 22.4%, dysthymic disorder 6.3%, not otherwise specified (n.o.s.) depression 7.1 %. General practitioners performed fairly well: identification index 88.4%, accuracy 0.49, bias 1.85.ConclusionsDepression was markedly high. A selective progression of depressed elderly from the community to general practitioners is implied.
Mental Health Problems of the Edinburgh ‘Roofless’
Authors: Newton J. R. , Geddes J. R. , Bailey S. , Freeman C. P. , McAleavy A. , Young G. C. 
Published: October 2008

BackgroundThe roofless have not been previously surveyed in detail looking specifically at their psychiatric status.MethodAll roofless people in a discrete area were interviewed in their ‘skippers’ using a semi-structured interview. Other roofless people helped in case finding and diagnostic validity was confirmed using a computerised case register.ResultsSixty-five people were interviewed. High rates of substance abuse (n = 48, 75%), and very low rates of psychotic illness (n = 2, 3%) were found. High rates of serious physical morbidity, of imprisonment and of being the victim of a crime were found.ConclusionThe roofless have multiple severe medical, social, and psychiatric problems. These all must be addressed when considering the provision of services.
Lethal Catatonia and Neuroleptic Malignant Syndrome
Authors: Osman Abdelkarim A. , Khurasani Mohamed H. 
Published: October 2008

BackgroundLethal catatonia and neuroleptic malignant syndrome (NMS) have been suggested to have a common neurochemical cause. We hypothesise that both conditions may be due to a sudden and massive blockade of dopamine neurotransmitters.MethodNMS was diagnosed in psychotic in-patients treated with neuroleptics if four features were present: diffuse severe rigidity, altered level of consciousness, hyperpyrexia and autonomic instability.ResultsOver three years, five NMS cases were diagnosed. Two presented with catatonic features and were diagnosed as acute reactive psychosis. Their neuroleptic doses were small, arguing for a particular sensitivity in these two cases.ConclusionThe sensitivity of two patients with catatonic features who developed NMS with small doses of neuroleptics supports a common neurochemical basis for the two conditions.
Cross-cultural Psychiatry
Authors: Dein Simon 
Published: October 2008

“Insanity is then a part of the price we pay for civilisation. The causes of the one increase with the developments and results of the other” (Jarvis, 1851).Emil Kraepelin, while visiting southeast Asia at the turn of the century, noted the absence of depression among various Asian populations. He believed that mental disorders were organic diseases for which specific pathogens would ultimately be found. Despite the cultural variations in mental disorders he observed during his world trip in 1904, he considered mental disorder to be universal: “mental illness in Java showed broadly the same clinical picture as we see in our country … The overall similarity far outweighed the deviant features.”
Recognition of Mental State Terms
Authors: Baron-Cohen Simon , Ring Howard , Moriarty John , Schmitz Bettina , Costa Durval , Ell Peter 
Published: October 2008

BackgroundThe mind's ability to think about the mind has attracted substantial research interest in cognitive science in recent decades, as ‘theory of mind’. No research has attempted to identify the brain basis of this ability, probably because it involves several separate processes. As a first step, we investigated one component process – the ability to recognise mental state terms.MethodIn Experiment 1, we tested a group of children with autism (known to have theory of mind deficits) and a control group of children with mental handicap, for their ability to recognise mental state terms in a word list. This was to test if the mental state recognition task was related to traditional theory of mind tests. In Experiment 2, we investigated if in the normal brain, recognition of mental state terms might be localised. The procedure employed single photon emission computerised tomography (SPECT) in normal adult volunteers. We tested the prediction (based on available neurological and animal lesion studies) that there would be increased activation in the orbito-frontal cortex during this task, relative to a control condition, and relative to an adjacent frontal area (frontal-polar cortex).ResultsIn Experiment 1, the group with autism performed significantly worse than the group without autism. In Experiment 2, there was increased cerebral blood flow during the mental state recognition task in the right orbito-frontal cortex relative to the left frontal-polar region.ConclusionsThis simple mental state recognition task appears to relate to theory of mind, in that both are impaired in autism. The SPECT results implicate the orbito-frontal cortex as the basis of this ability.
Henry Maudsley on Swedenborg's Messianic Psychosis
Authors: Johnson John 
Published: October 2008

BackgroundCreativity, religiosity and madness have long been thought to be aetiologically interrelated.MethodHenry Maudsley's little known pathography of the 17th century Swedish philosopher and polymath, Emanuel Swedenborg, was examined.ResultsSwedenborg developed a messianic psychosis in middle life, considered by Maudsley to be a monomania, possibly due to epilepsy. Many of Swedenborg's contemporaries thought of him, however, as a religious eccentric. Under criticism from Swedenborg's followers, Maudsley avoided further reference to Swedenborg, and the pathography was lost from view.ConclusionsRenewed interest is deserved in the contentious issues of the nature of religiosity and its relationship to psychotic experience.British Journal of Psychiatry (1994), 165, 690–691
Extrapyramidal Symptoms with Selective Serotonin Reuptake Inhibitors
Authors: Arya Dinesh K. 
Published: October 2008

BackgroundSeveral case reports in the literature suggest that selective serotonin reuptake inhibitors can produce extrapyramidal symptoms.MethodComputerised literature searches were used to identify reports on extrapyramidal symptoms and serotonin reuptake inhibitors. Subsequently, manual searches were made for articles in which there was any indication of the mechanisms responsible for these extrapyramidal symptoms.ResultsOnly a few reports could be identified in which serotonin reuptake inhibitors were implicated in extrapyramidal symptoms in some patients.ConclusionsEvidence is discussed from preclinical and clinical studies suggesting the interaction between serotoninergic and dopaminergic neurotransmitter system, as a possible mechanism for production of extrapyramidal symptoms.
Outcome of Deliberate Self-Poisoning
Authors: Owens David , Dennis Michael , Read Susan , Davis Norah 
Published: October 2008

BackgroundOne of the most important outcomes following an episode of non-fatal deliberate self-poisoning is its repetition.MethodIn a prospective follow-up study the subjects were 992 people responsible for 1096 consecutive episodes of deliberate self-poisoning recorded at a teaching hospital accident and emergency department. Risk factors examined were socio–demographic variables, psychiatric and self-harm history, aspects of the self-poisoning episode, and appearance and behaviour at accident and emergency; the frequency of each was compared between those patients who repeated within one year (n= 116) and those who did not (n = 876).ResultsThose who repeated were more likely to have ingested more than one drug, to report a previous episode of self-poisoning, to be aged 25–54, and to have experienced previous psychiatric care or psychiatric admission. They were less likely to be in paid employment, or to have expressed a threat to another person or written a note. The best predictor – previous psychiatric contact – only had a positive predictive value of 21 % (95% confidence interval 16–25%).ConclusionsRisk factors for repetition of self-poisoning should be kept up-to-date despite modest predictive power. More attention might be paid to clinical rather than socio–demographic aspects of self-harm.
Autoscopic Phenomena
Authors: Dening T. R. , Berrios G. E. 
Published: October 2008

BackgroundAutoscopy is defined here as a visual experience where the subject sees an image of him/herself in external space, viewed from within his/her own physical body. This paper reviews the literature both historically and conceptually, and includes a quantitative study of accumulated cases.MethodCases published since 1935 and meeting the above definition for autoscopy (n = 53) were included, together with three personally-observed patients. A clinical protocol was completed for each case, including information about the autoscopic image. Cases were compared using non-parametric statistics on dichotomised variables.ResultsThere were 38 men and 18 women, with a mean age of 39.5 years (range 13–78). Of the subjects, 33 (59%) had a neurological illness, most frequently epilepsy (18 cases). Right and left sided lesions were equally represented. Psychiatric disorder was often present (33 cases, 59%), most commonly delirium, depression or psychosis. The features of the images seen were diverse, but speaking images were associated with younger age, male sex, psychotic illness, longer duration of image, and hypnagogic/hypnopompic experiences.ConclusionsAutoscopy may arise from a convergence of several variables, including gender, personality factors, neurological and/or psychiatric disease, exhaustion and dissociation, whose interaction may override the normal inhibition of temporal lobe activity. A cognitive neuropsychological hypothesis is proposed, together with avenues for future research.
A Neural Model of Memory Impairment in Diffuse Cerebral Atrophy
Authors: Ruppin Eytan , Reggia James A. 
Published: October 2008

BackgroundComputer-supported neural network models have been subjected to diffuse, progressive deletion of synapses/neurons, to show that modelling cerebral neuropathological changes can predict the pattern of memory degradation in diffuse degenerative processes such as Alzheimer's disease. However, it has been suggested that neural models cannot account for more detailed aspects of memory impairment, such as the relative sparing of remote versus recent memories.MethodThe latter claim is examined from a computational perspective, using a neural associative memory model.ResultsThe neural network model not only demonstrates progressive memory deterioration as diffuse network damage occurs, but also exhibits differential sparing of remote versus recent memories.ConclusionsOur results show that neural models can account for a large variety of experimental phenomena characterising memory degradation in Alzheimer's patients. Specific testable predictions are generated concerning the relation between the neuroanatomical findings and the clinical manifestations of Alzheimer's disease.
The Prevalence and Costs of Psychiatric Disorders and Learning Disabilities
Authors: Smith Kirsteen , Shah Ajit , Wright Ken , Lewis Glyn 
Published: October 2008

BackgroundThe economic burden of psychiatric disorders and learning disability is assessed in order to aid decisions on priorities for research funding.MethodA wide variety of data sources both on prevalence and on the usage and costs of relevant services were used to measure the economic burden of each condition.ResultsDespite methodological problems and problems with the data, an attempt is made to estimate the relative economic burden imposed by each condition. No attempt is made to sum up the costs for each condition across the agencies and individuals involved.ConclusionsOur findings show that learning disability, schizophrenia and neurotic conditions (including depression) are major burdens on the National Health Service; senile dementia and depression in older people impact largely on local authority social services. Senile dementia, schizophrenia and learning disability are also heavy charges on the social security system. It is also notable that the large numbers with less severely disabling neurotic disorders generate a burden that, according to our figures, is comparable to schizophrenia and other psychotic disorders.
Psychiatric Illness in Patients with Persistent Somatisation
Authors: Fink Per 
Published: October 2008

BackgroundThis study explores the incidence and nature of mental illness among persistent somatisers, and analyses their use of mental health services.MethodIndividuals with at least ten admissions to non-psychiatric departments during an 8-year period were studied. Persistent somatisers (n = 56) were compared with other frequent users (n = 57) of non-psychiatric services.ResultsOf the persistent somatisers, 82% had been examined by a psychiatrist at least once (median, 3 times). Sixteen per cent were mentally retarded, 48% were dependent on alcohol or drugs, and 48% had DSM–III–R personality disorder. The most prevalent ICD–10 diagnoses were anxiety states (54%), depressions (30%), phobias (18%) and psychoses (20%).ConclusionsPersistent somatisation is associated with severe mental illness and a broad spectrum of heterogeneous psychiatric diagnoses and syndromes. Persistent somatisers impose a serious burden on the mental health care system.
Decision Analysis in Psychiatry
Authors: Hatcher Simon 
Published: October 2008

BackgroundDecision analysis is an explicit, quantitative approach to examining difficult decisions about course of action. Its applicability to psychiatry is considered.MethodAn example of how decision analysis could be used in psychiatry is given, criticism of the technique is discussed, and previous attempts to apply it to mental illness problems (from a Medline search from 1966 onwards) are reviewed.ConclusionThe future for decision analysis in psychiatry lies in teaching, audit and research, rather than clinical work.
Effects of Biperiden and Amantadine on Memory in Medicated Chronic Schizophrenic Patients
Authors: Silver H. , Geraisy N. 
Published: October 2008

BackgroundThe effects on memory of an anticholinergic (biperiden) and a dopaminergic (amantadine) anti-Parkinsonian agent were compared.MethodTwenty-six chronically medicated schizophrenic (DSM–III–R) in-patients received amantadine (200 mg/day) or biperiden (4 mg/day) for two weeks in a double-blind cross-over design.ResultsBiperiden treatment was associated with significantly lower scores on Benton Visual Retention Test (P< 0.003) and the visual subscale of Wechsler Memory Scale (WMS) (P≤ 0.02), with a trend to poorer scores on WMS total (P= 0.086) and the digit span (P= 0.07) and logical memory (P= 0.06) subscales.ConclusionsIn usual clinical doses, biperiden interferes with memory, particularly visual, more than amantadine.