bluuebunny/crossref_metadata_2025_split huggingface dataset:
Post-traumatic stress disorder symptoms and the Clapham rail accident
Authors: Selley Carolyn , King Elizabeth , Peveler Robert , Osola Karen , Martin Nick , Thompson Chris 
Published: October 2008

BackgroundPost-traumatic stress disorder is a well recognised condition which can have long-term consequences. A rail accident to commuter trains in south London provided an opportunity, within the context of a Psychological Therapies Service, to study the prevalence and associations of the condition in a follow-up study.MethodPostal questionnaires were completed by 187 survivors (52% response rate) 10 to 22 months after the accident, and their symptoms were compared with a commuter control group.ResultsThe accident group scored significantly higher on the Impact of Events scale (IES) than the control group. Severity of physical injury was significantly associated with high IES scores. Thirty per cent of those moderately or severely injured showed high levels of intrusion or avoidance symptoms (sub-scores of 20 or more). Thirty per cent of those nearest the accident focus had high sub-scores, associated variables being the accident experience of risk of death, feeling trapped and seeing death. For those less directly involved the proportions with symptoms were similar to those of controls.ConclusionsIt is recommended that disaster services should provide for long-term psychological effects, particularly for those survivors who are injured, who experience risk of death, feeling trapped or who witness death.
Prevalence and significance of weight and shape concerns in girls aged 11–16 years
Authors: Cooper Peter J. , Goodyer Ian 
Published: October 2008

BackgroundThe prevalence of the core ideational component of eating disorders among the at-risk population (11 – to 16-year-old girls) is not known.MethodA community survey of 11 – to 16-year-old girls was conducted to establish the prevalence of significant concerns about body weight and shape characteristics of eating disorders. A total of 1068 girls were screened and 368 interviewed using standardised measures.ResultsSignificant weight and/or shape concerns were estimated to be present in 14.5% of the 11-to 12-year-olds, 14.9% of the 13-to 14-year-olds and 18.9% of the 15-to 16-year-olds. Only among those aged 15 to 16 was the presence of such concerns associated with a significant level of concurrent behavioural and ideational disturbance.ConclusionsSignificant concerns about weight or shape are present in almost one in five 15-to 16-year-old girls, many of whom evidence high levels of ancillary disturbance.
Trends in deliberate self-harm in Oxford, 1985–1995
Authors: Hawton Keith , Fagg Joan , Simkin Sue , Bale Elizabeth , Bond Alison 
Published: October 2008

BackgroundDeliberate self-harm (DSH) has been a major health problem in the UK for nearly three decades. Any changes in rates of DSH or the demographic characteristics of the patient population are likely to have important implications for clinical services and suicide prevention.MethodData collected by the Oxford Monitoring System for Attempted Suicide were used to review trends in DSH between 1985–1995ResultsThere was a substantial increase in DSH rates during the 11-year study period, with a 62.1% increase in males and a 42.2% increase in females. The largest rise was in 15–24-year-old males (+194.1%). Changes in DSH rates correlated with changes in national suicide rates in both males and females in this age group. Rates of repetition of DSH increased in both genders during the study period. Paracetamol self-poisoning has continued to increase, half of all overdoses in 1995 involving paracetamol, and antidepressant overdoses have become more common.ConclusionsThe increase in DSH, especially in young males, has important implications for general hospital DSH and medical services. It may herald a reversal of recent progress towards achievement of national suicide targets.
Sulpiride augmentation in people with schizophrenia partially responsive to clozapine
Authors: Shiloh Roni , Zemishlany Zvi , Aizenberg Dov , Radwan Marguerite , Schwartz Bruria , Dorfman-Etrog Pnina , Modai Ilan , Khaikin Marina , Weizman Abraham 
Published: October 2008

BackgroundWe hypothesised that a combined regimen of clozapine, a relatively weak D2-dopaminergic antagonist, and sulpiride, a selective D2 blocker, would demonstrate a greater antipsychotic efficacy by enhancing the D2 blockade of clozapine.MethodTwenty-eight people with schizophrenia, previously unresponsive to typical antipsychotics and only partially responsive to current treatment with clozapine, received, double-blind, 600 mg/day sulpiride or placebo, in addition to an ongoing clozapine treatment. The clinical status was evaluated before, during, and at the end of 10 weeks of sulpiride addition using the Brief Psychiatric Rating Scale (BPRS), Scale for the Assessment of Positive Symptoms (SAPS), Scale for the Assessment of Negative Symptoms, and Hamilton Rating Scale for Depression.ResultsThe clozapine–sulpiride group exhibited substantially greater and significant improvements in positive and negative psychotic symptoms. About half of them, characterised by a younger age and lower baseline SAPS scores, had a mean reduction of 42.4 and 50.4% in their BPRS and SAPS scores, respectively.ConclusionsA subgroup of patients with chronic schizophrenia may substantially benefit from sulpiride addition to clozapine.
Intensive case management for the severely mentally ill
Authors: Holloway Frank , Carson Jerome 
Published: October 2008

BackgroundThe aim was to compare the efficacy of intensive clinical case management (ICM) with standard community care in the management of ‘hard to treat’ patients with a severe mental illness.MethodA randomised controlled trial was carried out in East Lambeth, a deprived area of inner London. Seventy people with psychosis designated as ‘hard to treat’ by referring teams were included; 35 were randomised to ICM (case load eight patients per worker), and 35 to standard care, which offered follow-up by a community psychiatric nursing service (30 patients per worker). Outcome measures were admissions and hospital bed utilisation; contact with services; symptomatology; social behaviour; social functioning; quality of life; patients' satisfaction with care at 9 and 18 months.ResultsThere were no differences in patients' symptoms, social behaviour or social functioning. Quality of life was significantly improved in patients receiving ICM at 9 months. Satisfaction with care was significantly greater among case-managed patients. All ICM patients remained in contact with services throughout the study, while six control patients were refusing all contact with services at 18 months.ConclusionsICM failed to improve the clinical outcome of ‘hard to treat’ patients. The service was successful in maintaining contact with patients, was greatly appreciated and had a positive effect on their perceived quality of life.
Informing patients about tardive dyskinesia
Authors: Chaplin Robert , Kent Andrew 
Published: October 2008

BackgroundThis paper evaluates the effects on knowledge and clinical stability of an educational intervention about tardive dyskinesia.MethodFifty-six patients receiving antipsychotic maintenance completed a questionnaire assessing their knowledge about tardive dyskinesia. After random allocation to either an educational intervention or a control group, their knowledge was reassessed at six months.ResultsNinety-five per cent of patients completed the study. The study patients gained significantly more knowledge than the controls, who made modest gains. There were no significant differences in clinical outcome between the groups.ConclusionPatients can learn about serious toxic effects of antipsychotic treatment with a low risk of non-compliance. Discussion about tardive dyskinesia is necessary in the process of obtaining informed consent to treatment.
‘Cloze’ procedure refined and modified
Authors: Newby David 
Published: October 2008

Background‘Cloze procedure assesses the predictability of text by deleting words at set intervals and having a panel of raters fill the blanks. Two refinements to the procedure are described: ‘modified Cloze and ’ ‘reverse Cloze’, the latter examining the subject's ability to interpret a partial transcript.MethodSamples of speech were obtained from patients with schizophrenia, manic-depression and orthopaedic disorders using a standard prompt, and the output analysed using modified Cloze. In addition, subjects completed a reverse Cloze passage.ResultsBoth modified Cloze and reverse Cloze discriminated the performance of patient groups, with patients with schizophrenia performing worst.ConclusionsThese techniques extend earlier findings suggesting reduced predictability in psychotic speech, particularly for patients with schizophrenia. The reverse Cloze procedure suggests a ‘mirror-image’ deficit and is a potential objective index of psychopathology that is much simpler to apply than traditional Cloze.
First episodes of psychosis in Afro-Caribbean and White people
Authors: Takei Noriyoshi , Persaud Rajendra , Woodruff Peter , Brockington Ian F. , Murray Robin M. 
Published: October 2008

BackgroundThere have been few prospective studies of the long-term outcome of psychosis in people of Afro-Caribbean origin in the UK.MethodWe followed-up a population-based, consecutive series of 34 Afro-Caribbean and 54 White people with psychosis who had been extensively investigated during their first admission in 1973/74. Diagnoses were made by direct interview using the Present State Examination at both first admission and follow-up.ResultsNinety-seven per cent of the original sample were traced. A slightly greater proportion of the Afro-Caribbean people were assigned to the S+ Catego class (schizophrenia), both on first assessment and at follow-up. No difference was found between the two groups in the consistency of diagnosis over the 18 years or in the proportion of patients considered psychotic but Afro-Caribbean people tended to have fewer negative symptoms at follow-up. There were striking differences between the two groups in their experience of psychiatric care; Afro-Caribbean people were more likely to have been readmitted, to have experienced longer hospitalisations, and to have undergone more involuntary admissions than their White counterparts.ConclusionsAfro-Caribbean people who met clinical and research criteria for schizophrenia had a less satisfactory experience of, and response to, psychiatric care over 18 years than their White counterparts.
Longitudinal study of interpersonal dependency in female twins
Authors: O'Neill F. Anthony , Kendler Kenneth S. 
Published: October 2008

BackgroundInterpersonal dependence is thought to be important in a number of physical and psychological disorders. There are several developmental theories that suggest environmental influences in childhood are important.MethodA twin study methodology was used to look at the genetic and environmental influences on interpersonal dependence as measured by a sub-scale of the Interpersonal Dependency Inventory with a population-based sample of 2230 twins.ResultsPsychometric analysis revealed that this was a stable measure and that there was a substantial degree of construct validity Both univariate and longitudinal twin analysis suggested that there was a modest genetic influence and a large, specific environment influence on interpersonal dependency as measured by this scale. The longitudinal analysis revealed that the genetic influence was stable over the time-scale sampled and the environmental influence was moderately stable.ConclusionsThis finding is at odds with theories that suggest shared environment is important in the aetiology of interpersonal dependency.
Meta-analysis of trials comparing antidepressants with active placebos
Authors: Moncrieff Joanna , Wessely Simon , Hardy Rebecca 
Published: October 2008

BackgroundUnblinding effects may-introduce bias into clinical trials. The use of active placebos to mimic side-effects of medication may therefore produce more rigorous evidence on the efficacy of antidepressants.MethodTrials comparing antidepressants with active placebos were located. A standard measure of effect was calculated for each trial and weighted pooled estimates obtained. Heterogeneity was examined and sensitivity analyses performed. A subgroup analysis of in-patient and out-patient trials was conducted.ResultsOnly two of the nine studies examined produced effect sizes which showed a consistent significant difference in favour of the active drug. Combining all studies produced pooled effect size estimates of between 0.41 (0.27–0.56) and 0.46 (0.31–0.60) with high heterogeneity due to one strongly positive trial. Sensitivity analyses excluding this and one other trial reduced the pooled effect to between 0.21 (0.03–0.38) and 0.27 (0.10–0.45).ConclusionsMeta-analysis is very sensitive to decisions about exclusions. Previous general meta-analyses have found combined effect sizes in the range 0.4–0.8. The more conservative estimates produced here suggest that unblinding effects may inflate the efficacy of antidepressants in trials using inert placebos.
Reduced latent inhibition in people with schizophrenia: an effect of psychosis or of its treatment
Authors: Williams Jonathan H. , Wellman Nigel A. , Geaney David P. , Cowen Philip J. , Feldon Joram , Rawlins J. N. P. 
Published: October 2008

BackgroundPeople with schizophrenia show impaired attention. This could result from reduced latent inhibition (a measure of ability to filter out irrelevant stimuli). Previous studies have found reduced auditory latent inhibition in people with acute schizophrenia: we tested whether this results from psychosis or from drug treatment.MethodWe measured auditory latent inhibition in two studies. One compared antipsychotic-naive people with acute schizophrenia with patients within two weeks of starting antipsychotic treatment. The second compared healthy volunteers given either saline or 1.0 mg haloperidol, intravenously.ResultsLatent inhibition was absent in treated patients, but was clearly present in patients who were naive to antipsychotics. Latent inhibition was absent in volunteers given haloperidol, but was clearly present in those given saline.ConclusionsThe reduced auditory latent inhibition seen in acute schizophrenia is more plausibly due to antipsychotic treatment than to the disorder. Unless neuropsychological models of schizophrenia incorporate evidence from drug-free patients and drug-treated healthy controls, they may be invalid.
Psychiatric disorders as a factor in sick-leave due to other diagnoses
Authors: Hensing Gunnel , Spak Fredrik 
Published: October 2008

BackgroundThe aim was to analyse the role of psychiatric disorders in sick-leave in different sick-leave diagnoses.MethodA stratified population-based sample of women (n=292) in Göteborg were interviewed, and diagnoses were made according to DSM–III–R. Sick-leave data, including diagnoses, were obtained for two years.ResultsWomen with psychiatric disorders had an increased number of sick-leave spells and sick-leave days in all the sick-leave diagnostic groups. The largest differences between the two groups of women were found in mental disorders, diseases of the locomotor system and gastro-intestinal diseases. The association between psychiatric disorders and sick-leave was strongest in older age groups.ConclusionsUnrecognised psychiatric disorders associated with an increased number of medical complaints and visits can be an important factor in the increase in sick-leave.
Recovered memories of childhood sexual abuse
Authors: Brandon Sydney , Boakes Janet , Glaser Danya , Green Richard 
Published: October 2008

BackgroundThe growth in the USA of ‘recovered memory therapy’ for past sexual abuse has caused great public and professional concern. It became apparent that the polarisation of views and fierce controversy within the American psychiatric community was in danger of bringing psychotherapy into disrepute and it seemed important to examine objectively the scientific evidence before such polarisation developed in the UK.MethodA small working group reviewed their own experience, visited meetings and centres with expertise in this field, interviewed ‘retractors' and accused parents, and then began a comprehensive review of the literature.ResultsThere is a vast literature but little acceptable research. Opinions are expressed with great conviction but often unsupported by evidence.ConclusionsThe issue of false or recovered memories should not be allowed to confuse the recognition and treatment of sexually abused children. We concluded that when memories are ‘recovered’ after long periods of amnesia, particularly when extraordinary means were used to secure the recovery of memory, there is a high probability that the memories are false, i.e. of incidents that had not occurred. Some guidelines which should enable practitioners to avoid the pitfalls of memory recovery are offered.
Early signs of psychotic relapse in schizophrenia
Authors: J⊘rgensen Per 
Published: October 2008

BackgroundPeople with schizophrenia are at high risk of psychotic relapse. The purpose of this study was to evaluate the predictive validity and temporal link of early signs to this.MethodsA study sample of 60 out-patients with schizophrenia was examined every second week over a period of six months. The study design included self-reporting (Early Signs Scale) and objective assessment (General Psychopathology of Positive and Negative Symptom Scale) of behavioural and phenomenological changes (early signs). Criterion cut-off points were based on a comparison to the subjects' individual baseline scores.ResultsTwenty-seven subjects (45%) experienced a relapse. Composite increased score ($ 10 points) of self-reported/objectively assessed early signs predicted the relapse with a sensitivity of 81% and a specificity of 79%. Thus the predictive validity of early signs of relapse was considerable, particularly self-reporting of early signs of relapse: sensitivity 74% and specificity 79%. The inclusion of objective assessment added only marginally to the prediction. Early signs were detected most often (70%) within the four weeks immediately before the individuals' relapse.ConclusionPsychotic relapse is most often preceded by early signs. Clinical practice should integrate this knowledge by an ongoing monitoring including self-reporting.
Psychopharmacology of severe self-injury associated with learning disabilities
Authors: Clarke David J. 
Published: October 2008

BackgroundMany sedative and antipsychotic agents have been used in the management of severe self-injury associated with learning disabilities. Their efficacy has been questioned. Recent research has identified some biological abnormalities associated with severe self-injury and allowed a more rational selection of treatment.MethodReview of published literature, including trials, previous reviews and case reports.ReportsThere is evidence for the efficacy of opiate antagonists in the management of severe self-injury, and recent research has identified potential methods of predicting treatment response. Dopamine D1 antagonists and some agents affecting serotonin turnover may also be of benefit.ConclusionsMore rational psychopharmacological treatments for severe self-injurious behaviour may become available. Such treatments are difficult to evaluate for methodological and ethical reasons. They usually involve the clinical use of compounds for unlicensed indications, rather than trials of agents developed specifically to treat severe self-injurious behaviour. Combining psychopharmacological and psychological interventions may provide additional benefits.
Auditing electroconvulsive therapy
Authors: Duffet Richard , Lelliott Paul 
Published: October 2008

BackgroundThis is the third large-scale audit in the past 20 years and compares the practice of electroconvulsive therapy (ECT) in England and Wales with the standards derived from the Royal College of Psychiatrists' 2nd ECT handbook.MethodFacilities, equipment, practice, personnel and training were systematically evaluated during visits to all ECT clinics in the former North East Thames and East Anglia regions and Wales. All other English ECT clinics were surveyed with a postal questionnaire. Information was obtained for 184 (84%) of the 220 ECT clinics identified.ResultsAlthough some aspects of ECT administration had improved since the last audit in 1991, overall only one-third of clinics were rated as meeting College standards. Only 16% of responsible consultants attended their ECT clinic weekly and only 6% had sessional time for ECT duties. Fifty-nine per cent of all clinics had machines of the type recommended by the College and 7% were still using machines considered outdated in 1989. Only about one-third of clinics had clear policies to help guide junior doctors to administer ECT effectively.ConclusionsTwenty years of activity by the Royal College of Psychiatrists and three large-scale audits have been associated with only modest improvement in local practice.
Epidemiology of paranoid symptoms in an elderly population
Authors: Forsell Yvonne , Henderson A. Scott 
Published: October 2008

BackgroundElderly people with paranoid symptoms are a taxing group for medical and social services, but studies of the prevalence of these symptoms in the general elderly population are rare. This study aimed to estimate the community prevalence and to identify some associated variables.MethodA community sample of 1420 elderly people, was extensively examined by nurses and physicians.ResultsParanoid ideation was found in 6.3% of the sample. The prevalence in people with cognitive dysfunction (n=381, 12.1%) was higher than in those without (n=1039, 2.6%). Once cognitive impairment had been controlled the associated variables were: being divorced, being female, having depressive symptoms, using psychotropic drugs, having no friends or visitors, using community care and being an immigrant.ConclusionParanoid symptoms in this elderly population were associated most strongly with cognitive impairment. Other associated variables pointed to a higher level of social isolation than others in the community.
Detecting postnatal depression in Chinese women
Authors: Lee Dominic T. S. , Yip S. K. , Chiu Helen F. K. , Leung Tony Y. S. , Chan Kathy P. M. , Chau Irene O. L. , Leung Henry C. M. , Chung Tony K. H. 
Published: October 2008

BackgroundWe evaluated the utility of the Chinese version of the Edinburgh Postnatal Depression Scale (EPDS) and measured the prevalence of major depression six weeks after confinement among Chinese women in Hong Kong.MethodA prospective cohort of 145 women completed the EPDS, the 12-item General Health Questionnaire (GHQ) and the Beck Depression Inventory (BDI) six weeks after giving birth. They were then assessed with the Structured Clinical Interview for DSM–III–R, non-patient version (SCID–NP) to establish psychiatric diagnosis. The criterion validity of EPDS was tested against this clinical diagnosis, and the concurrent validity against the GHQ and BDI scores was also evaluated. The internal consistency of the scales was measured by Cronbach's α coefficient.ResultsThe Chinese EPDS had satisfactory psychometric properties and a cut-off score of 9/10 is recommended for screening depressive illness in a general postnatal population. At six weeks postpartum, 5.5% of the study population suffered from major depression.ConclusionsThe Chinese EPDS will be useful for screening for postnatal depression.