bluuebunny/crossref_metadata_2025_split huggingface dataset:
Effects of level of socio-economic development on course of non-affective psychosis
Authors: Varma Vijoy K. , Wig N. N. , Tripathi B. M. , Misra Arun K. , Khare C. B. , Phookun Hemen R. , Menon D. K. , Brown Alan S. , Susser Ezra S. 
Published: October 2008

BackgroundThis study explored the relation of level of socio-economic development to the course of non-affective psychosis, by extending the analysis of urban/rural differences in course in Chandigarh, India.MethodThe proportion of ‘best outcome cases between urban (n=110) and rural (n=50) catchment areas were compared at two-year follow-up, separately for CATEGO S+ and non-S+ schizophrenia.ResultsThe proportion of subjects with ‘best outcome’ ratings at the urban and rural sites, respectively, was similar for CATEGO S+ schizophrenia (29 v. 29%), but significantly different for non-S+ psychosis (26 v. 47%)ConclusionsThe fact that in rural Chandigarh, psychoses have a more favourable course than in the urban area may be explained in large part by psychoses distinct from ‘nuclear’ schizophrenia.
Efficacy and safety of two new methods of rapid intravenous detoxification in heroin addicts previously treated without success
Authors: Seoane Albert , Carrasco Genís , Cabré Lluís , Puiggrós Ana , Hernández Eustaqui , Álvarez Miguel , Costa Josep , Molina Ricard , Sobrepere Gaudi 
Published: October 2008

BackgroundNew methods of rapid opiate detoxification, under intravenous sedation, can detoxify heroin-addicted patients in 24 hours. Their clinical application has been limited by the lack of studies establishing both efficacy and safety.MethodIn a randomised, controlled study, 300 treatment-refractory, heroin-addicted patients received rapid intravenous detoxification treatment (naloxone infusion, 0.06–0.08 mg/kg, then oral naltrexone 50 mg/day) under either monitored light intravenous sedation or unmonitored deep intravenous sedation.ResultsAll patients were successfully detoxified and 93% remained abstinent one month later. Severity of withdrawal, according to the Wang Scale modified by Loimer, was 4.9 (s.d. 3.0) points in the light sedation group and 4.8 (s.d. 2.9) in the deep sedation group (P=0.26). Two patients (1.3%) in the light sedation group and four (2.6%) in the deep sedation group required tracheal intubation (P=0.31). There was only one severe complication, a case of nosocomial aspirative pneumonia which improved with antibiotic treatment.ConclusionsSuccessful rapid intravenous detoxification can be achieved using relatively light levels of sedation.
Brain blood flow in anxiety disorders
Authors: Lucey J. V. , Costa Durval C. , Adshead Gwen , Deahl Martin P. , Busatto Geraldo , Gacinovic Sveto , Travis Michael , Pilowsky Lyn S. , Ell Peter J. , Marks Isaac M. , Kerwin Robert W. 
Published: October 2008

BackgroundWe compared regional cerebral blood flow (rCBF) in three groups of patients with DSM–III–R anxiety disorders.MethodFifteen patients with obsessive–compulsive disorder (OCD), 15 with panic disorder with agoraphobia (PA), and 16 with post-traumatic stress disorder (PTSD) and a similar group of healthy controls were assessed on brain-dedicated high-resolution SPET.ResultsMANOVA revealed significant rCBF differences between diagnostic groups (F=4.4; d.f.=3, 57; P=0.007) and between cerebral regions (F=6.4; d.f.=1, 57; P=0.01) in OCD and PTSD compared with PA and healthy controls, limited to bilateral superior frontal cortices and right caudate nuclei. Whole brain blood flow correlated positively with anxiety (r=0.24, n=46, P=0.05). Beck depression scores correlated significantly negatively with left caudate rCBF (r= –0.24, n=46, P=0.05) and right caudate rCBF (r= –0.31, n=46, P=0.02). PTSD syndrome severity correlated significantly negatively with the left caudate (r=-0.49, n=16. P=0.03) and with right caudate rCBF (r=-0.7, n=16, P=0.001)ConclusionsFunctional rCBF differences in anxiety disorders could relate to repetitive, intrusive, distressing mental activity, prominent in both OCD and PTSD.
Strategies for preventing suicide
Authors: Lewis Glyn , Hawton Keith , Jones Peter 
Published: October 2008

BackgroundThe Health of the Nation includes a target for reducing population suicide rates. We have examined and quantified various high-risk and population-based strategies for prevention based upon a number of stated assumptions and hypothetical interventions.MethodThe published literature was used to estimate the population attributable fractions for both high-risk and population-based strategies. The number needed to treat for the high-risk strategies was calculated, assuming an intervention that reduced suicide rates by 25%ResultsInterventions that would reduce rates of suicide by 25% would reduce population rates by about 2.6% for those recently discharged from hospital and by up to 5.8% for those presenting to general hospital with deliberate self-harm. The population attributable fraction for unemployment was 10.9%ConclusionsHigh-risk strategies will have only a modest effect on population suicide rates, even if effective interventions are developed. Evaluating interventions for deliberate self-harm patients seems worthwhile. The UK Government's target for suicide reduction is more likely to be achieved using population-based strategies. Reducing the availability of methods commonly used for committing suicide is the most practicable current policy, although more radical approaches, for example reducing unemployment, may also substantially reduce suicide rates.
Mental disorders among the community-dwelling elderly in Dublin
Authors: Kirby Michael , Bruce Irene , Radic Alicja , Coakley Davis , Lawlor Brian A. 
Published: October 2008

BackgroundThe prevalence of mental disorders among the community-dwelling elderly in the catchment area of a psychiatry for the elderly service in Dublin was determined.MethodA sample of 1232 individuals aged 65 years and over, identified from general practitioner practice lists, was interviewed using the Geriatric Mental State–AGECAT package.ResultsDepression and organic disorder occurred with prevalences of 10.3 and 4.1%, respectively. Depression diagnostic cases had comorbid anxiety at case level in 17.3% and at sub-case level in a further 59.9%. Organic diagnostic cases had comorbid depressive or anxiety symptoms, at case or sub-case level, in 32%ConclusionsDepression is the most common mental disorder among the elderly in Dublin. The frequency of anxiety symptoms in the presentation of depression may be a factor in the under-diagnosis or misdiagnosis of depression in the community-dwelling elderly. Comorbid anxiety and depression in organic disorder may represent treatable symptoms.
Subjective memory complaints in the elderly: Depressive symptoms and future dementia
Authors: Schmand B. , Jonker C. , Geerlings M. I. , Lindeboom J. 
Published: October 2008

BackgroundPopulation studies indicate that subjective memory complaints by elderly people are correlated with cognitive performance. These complaints have some predictive power regarding the development of dementia. The present study attempted to replicate this finding, and investigated which variables determine subjective memory complaints.MethodParticipants in the Amsterdam Study of the Elderly (n=2114; 65–84 years of age), who were not demented and had a normal MMSE score (> 23) at baseline, were re-examined after four years. Subjective complaints were measured using a previously developed scale. Dementia and depression were measured using the Geriatric Mental State Schedule (GMS). Premorbid intelligence was measured by the Dutch Adult Reading Test (DART)ResultsMemory complaints at baseline contributed a small but significant amount of diagnostic information with respect to the prediction of future dementia. Depressive symptoms at baseline had no predictive value when these memory complaints were accounted for. Subjective memory complaints were associated with depression, baseline MMSE score, and premorbid intelligence.ConclusionsSubjective memory complaints are not just secondary to depression, but in part reflect realistic self-observations of cognitive decline.
Cognitive deficits in patients suffering from chronic fatigue syndrome, acute infective illness or depression
Authors: Vollmer-Conna Ute , Wakefield Denis , Lloyd Andrew , Hickie Ian , Lemon Jim , Bird Kevin , Westbrook Reginald 
Published: October 2008

BackgroundPatients with chronic fatigue syndrome (CFS) report neuropsychological symptoms as a characteristic feature. We sought to assess cognitive performance in patients with CFS, and compare cognitive performance and subjective workload experience of these patients with that of two disease comparison groups (non-melanchonic depression and acute infection) and healthy controls.MethodA computerised performance battery employed to assess cognitive functioning included tests of continuous attention, response speed, performance accuracy and memory. Severity of mood disturbance and subjective fatigue were assessed by questionnaire.ResultsAll patient groups demonstrated increased errors and slower reaction times, and gave higher workload ratings than healthy controls. Patients with CFS and non-melancholic depression had more severe deficits than patients with acute infection. All patient groups reported more severe mood disturbance and fatigue than healthy controls, but patients with CFS and those with acute infection reported less severe mood disturbance than patients with depression.ConclusionsAs all patients demonstrated similar deficits in attention and response speed, it is possible that common pathophysiological processes are involved. The differences in severity of mood disturbance, however, suggest that the pathophysiological processes in patients with CFS and acute infection are not simply secondary to depressed mood.
Structural neuroimaging in learning disability
Authors: Deb Shoumitro 
Published: October 2008

BackgroundNeuroimaging has proven useful in confirming diagnoses of certain neuropsychiatric conditions, but neuroimaging studies in learning disability are at an early stage.MethodA review of recent structural neuroimaging research in relation to learning disability was carried out.ResultsBrain abnormalities can be detected in cases of idiopathic and non-idiopathic learning disability, but their significance is not clear due to discrepancies in study findings and the small cohorts involved.ConclusionAlthough the role of structural neuroimaging in the assessment of people with learning disability is not clear, new magnetic resonance imaging technology holds great promise for future research.
Outcome of anxiety and depressive disorders in primary care
Authors: Ronalds Clare , Creed Francis , Stone Kit , Webb Sarah , Tomenson Barbara 
Published: October 2008

BackgroundFactors related to the outcome of depression and anxiety in primary care are not fully understood.MethodAdult patients in general practice with depressive, anxiety or panic disorder (n=148; DSM–III–R criteria) were studied prospectively for six months to determine the factors most closely associated with outcome. The Psychiatric Assessment Schedule, Hamilton Depression Rating Scale, Clinical Anxiety Scale and Life Events and Difficulties Schedule interviews were performed at index consultations and repeated six months later. Variables associated with outcome were assessed by multiple regression analysis.ResultsGood outcome was predicted by mild depression at initial assessment, high educational level, and being in employment. At follow-up the most important predictor of improvement was reduction in marked difficulties over the six months. Recognition and management by the GP was most frequent in patients with severe disorder; such patients were least likely to improve because of the severity of their depression and marked social difficulties.ConclusionsThis naturalistic study helps to provide a framework for further studies with more precisely defined groups of people with depression. An effective treatment strategy for people with marked depression and ongoing social difficulties is especially needed.
Excess mortality of schizophrenia
Authors: Brown Steve 
Published: October 2008

BackgroundThis paper presents a structured review of the published information on the mortality of schizophrenia.MethodA meta-analysis of the literature.ResultsSchizophrenia has a significantly increased mortality from natural and unnatural causes. Twenty-eight percent of the excess mortality is attributable to suicide and 12% to accidents. The rest of the excess mortality is from the same broad range of conditions which cause deaths in the general population. Further interpretation is hampered by confounding variables, wide confidence intervals and reservations about generalising from individual cohorts.ConclusionsThe available evidence suggests that schizophrenia is associated with a large increased mortality from suicide and a moderate increased mortality from natural causes. A number of possible interventions have been identified, but we do not yet have reliable means of detecting any changes in mortality which might result.
Determinants of general practitioner recognition of psychological problems in a multi-ethnic inner-city health district
Authors: Odell S. M. , Surtees P. G. , Wainwright N. W. J. , Commander M. J. , Sashidharan S. P. 
Published: October 2008

BackgroundWith few exceptions, evaluation of the capacity of general practitioners (GPs) to recognise psychiatric disorder in their patients has failed to consider the role of ethnic diversity in the consultation process and whether such knowledge can improve understanding of the degree to which psychiatric morbidity is recognised within GP settings.MethodsThis research was completed in five general practices representative of all those within an inner-city health district. Psychiatric morbidity in patients consecutively attending the practices was then assessed using the General Health Questionnaire; in addition, GPs were asked to complete a checklist of current problems identified during each consultation.ResultsAnalysis suggested that Asian and Black patients were less likely than White patients to have psychological problems identified; that social problems and a psychiatric history facilitated recognition; and that current physical illness hindered recognition.ConclusionsGP recognition of psychological problems varies according to patient ethnicity but can be substantially masked by both the physical and social circumstances of patients at consultation.
Psychiatric staff as attachment figures
Authors: Adshead Gwen 
Published: October 2008

BackgroundAttachment theory argues that psychological development and functioning are affected by our earliest attachments to care-givers. Failed or pathological attachment in childhood may give rise to repetition of maladaptive attachment patterns in adulthood.MethodAnalysis of therapeutic relationships in the light of attachment theory.ResultsRelationships between patients and both psychiatric care-givers and institutions may resemble attachment relationships.ConclusionAn attachment perspective may be useful for understanding common behavioural disturbances in general psychiatric settings, and support the use of clinical strategies which focus on containment of arousal and the management of anxiety states.
Placebo-controlled trial of moclobemide in social phobia
Authors: Schneier Franklin R. , Goetz Deborah , Campeas Raphael , Marshall Randall , Fallon Brian , Liebowitz Michael R. 
Published: October 2008

BackgroundMoclobemide, a reversible inhibitor of monoamine oxidase A, previously has been reported to have efficacy in the treatment of social phobia.MethodSeventy-seven non-responders to one week of single-blind placebo were randomly assigned to moclobemide or placebo for eight weeks of double-blind treatment. Outcome was assessed by independent evaluator, treating psychiatrist and self-ratings. After eight weeks, patients who were at least minimally improved continued treatment for a further eight weeks.ResultsIntention-to-treat sample response rates at week 8 were 7/40 (17.5%) for the moclobemide group and 5/37 (13.5%) for placebo (NS). Moclobemide was significantly superior to placebo on 2 of 10 primary outcome measures. Moclobemide was well tolerated.ConclusionsMoclobemide may have efficacy in the treatment of social phobia, but absence of significant differences on most primary outcome measures and small effect sizes for all outcome measures suggest that the magnitude of its clinical effect is small.
Lateralised semantic and indirect semantic priming effects in people with schizophrenia
Authors: Weisbrod Matthias , Maier Sabine , Harig Sabine , Himmelsbach Ulrike , Spitzer Manfred 
Published: October 2008

BackgroundIn schizophrenia, disturbances in the development of physiological hemisphere asymmetry are assumed to play a pathogenetic role. The most striking difference between hemispheres is in language processing. The left hemisphere is superior in the use of syntactic or semantic information, whereas the right hemisphere uses contextual information more effectively.MethodUsing psycholinguistic experimental techniques, semantic associations were examined in 38 control subjects, 24 non-thought-disordered and 16 thought-disordered people with schizophrenia, for both hemispheres separately.ResultsDirect semantic priming did not differ between the hemispheres in any of the groups. Only thought-disordered people showed significant indirect semantic priming in the left hemisphere.ConclusionsThe results support: (a) a prominent role of the right hemisphere for remote associations; (b) enhanced spreading of semantic associations in thought-disordered subjects; and (c) disorganisation of the functional asymmetry of semantic processing in thought-disordered subjects.
Alcohol use disorders among the Yami aborigines in Taiwan
Authors: Liu Shen-Ing , Cheng Andrew T. A. 
Published: October 2008

BackgroundAlcohol use disorders (AUDs) among the Yami aborigines in Taiwan were investigated and compared with four other Taiwanese aboriginal groups.MethodA sample survey was conducted using a semi-structured clinical interview for AUDs among 252 subjects, aged 15 and above, from two Yami villages on Orchid Island.ResultsThe prevalences of DSM–III–R and DSM–IV alcohol use disorders were 13.1% and 10.3% by one year, and 17.5% and 15.2% by lifetime, respectively with a male excess. The risk for AUDs in Yami men was significantly associated with a lower educational level, a non-married status, and the length of stay in mainland Taiwan. A protective effect of Christian belief was evident for lifetime risk for AUDs.ConclusionsThe lower prevalences of AUDs in Yami than in other aboriginal groups in Taiwan might be explained by social isolation of the former, and differences in drinking tradition, availability of alcohol, biological vulnerability, and the extent of acculturation between these groups.
Fluoxetine in breast-milk and developmental outcome of breast-fed infants
Authors: Yoshida K. , Smith B. , Craggs M. , Kumar R. Channi 
Published: October 2008

BackgroundSelective serotonin reuptake inhibitors are currently the most widely prescribed antidepressant drugs. There are only four published studies of breast-feeding mothers and their infants in which the mothers were taking fluoxetine.MethodFour mothers who took fluoxetine and their breast-fed infants were studied. Samples of plasma, breast-milk and urine were taken from the mothers and of plasma and urine from infants for assays of drug and metabolite concentrations. Bayley Scales of Infant Development were repeatedly used to assess cognitive and psychomotor development of the infants.ResultsFluoxetine and norfluoxetine were detected in all samples of maternal plasma (range of total concentration 138–427 ng/ml) and in breast-milk (range 39–177 ng/ml). Amounts of both fluoxetine and norfluoxetine in infants' plasma and urine were below the lower limit of detection. All infants were observed to be developing normally and showed no abnormal findings on neurological examination.ConclusionsMuch larger databases are needed but these four cases do not provide any evidence to suggest that women who are maintained on therapeutic doses of fluoxetine should discontinue breast-feeding their infants if they wish to breast-feed.
Questionable validity of ‘dissociative amnesia’ in trauma victims
Authors: Pope Harrison G. , Hudson James I. , Bodkin J. Alexander , Oliva Paul 
Published: October 2008

BackgroundWe reviewed evidence from prospective studies to test whether individuals can develop amnesia for traumatic experiences, a process variously termed ‘repression’, dissociative amnesia’ or ‘psychogenic amnesia’.MethodUsing specified criteria, we selected and analysed studies which prospectively assessed memory in victims of documented traumatic experiences.ResultsIn studies in which people were asked directly about a past traumatic experience, they consistently reported memories. Non-reporting occurred only in studies where subjects were not asked directly about the experience. This latter design leaves open the well-documented possibility that subjects simply did not disclose events that they actually remembered. Some prospective studies were also limited by incomplete documentation of trauma and failure to rule out other more ordinary causes of amnesia.ConclusionsProspective data as yet fail to demonstrate that individuals can develop dissociative amnesia for traumatic events.
Thirteen-year follow-up of deliberate self-harm, using linked data
Authors: Hall David J. , O'Brien Fiona , Stark Cameron , Pelosi Antony , Smith Helen 
Published: October 2008

BackgroundWe describe a national cohort of individuals surviving an episode of deliberate self-harm (DSH). Subsequent admissions for DSH and mortality over the following 13 years were studied.MethodIn 1981, 8304 individuals were discharged from Scottish general hospitals with a diagnosis of attempted suicide (E950–959). They were followed-up to the end of 1994 using the Scottish Linked Data Set. Mortality was compared to the Scottish population using person-years analysis.Results2624 people (31.6%) were readmitted with further episodes of DSH. The median number of readmissions was I, range 1–137. The observed: expected ratio for all-cause mortality was 2.26 (95% CI 2.13–2.26). One hundred and sixty-eight people (2%) died from suicide, and 46 (0.6%) from undetermined causes. The observed: expected ratio for suicide plus undetermined deaths was 12.17 (95% CI 10.64-13.91). Accidental deaths in men and homicide deaths in men and women were elevated. The pattern of deaths from other causes suggested that alcohol misuse was a contributory factor.ConclusionsPeople admitted to general hospitals in Scotland after attempted suicide are at high risk of readmission for further episodes of DSH. Long-term follow-up of such large cohorts is impractical, but services should review the scope for intervention in alcohol misuse following DSH.