bluuebunny/crossref_metadata_2025_split huggingface dataset:
Postal self-exposure treatment of recurrent nightmares
Authors: Burgess Mary , Marks Isaac M. , Gill Michael 
Published: October 2008

BackgroundMarry nightmare sufferers do not consult a health care professional. Though behaviour and cognitive therapy can help, they have not been tested as a self-treatment method at home using a manual.MethodOne hundred and seventy adults with primary nightmares were randomised to four weeks' self-exposure or self-relaxation at home using manuals posted to them, or to a waiting-list as a control group for four weeks. Individuals recorded nightmare frequency and intensity in four-week diaries.ResultsAt one- and six-month follow-up, the self-rated nightmare frequency felt more significantly in exposure subjects than relaxation or waiting-list subjects. The self-exposure group had the most drop-outs but remained superior in an over-cautious intent-to-treat analysis. The individuals' partners confirmed the superiority of self-exposure to self-relaxation at one- and six-month follow-up.ConclusionsRecurrent nightmare sufferers improved more with self-exposure manuals than with self-relaxation manuals or by being on a waiting-list. Self-exposure may be needed for longer than four weeks in order to reduce nightmare intensity as well as frequency. Despite a high drop-out rate, some sufferers of other conditions may benefit from self-treatment manuals.
Validity of childhood disintegrative psychosis
Authors: Mouridsen Svend Erik , Rich Bente , Isager Torben 
Published: October 2008

BackgroundEmpirical evidence for the validity of the diagnostic label ‘disintegrative psychosis' is sparse. The issue of whether it is a separate form of infantile autism is unresolved.MethodTo investigate the validity of disintegrative psychosis as defined in ICD–9, the natural history of 13 cases were compared with 39 matched cases of infantile autism on various outcome variables. Average follow-up time was 22 (11–33) years.ResultsStatistically significant differences were found between the two groups in terms of number of admissions to non-psychiatric departments, occurrence of comorbid epilepsy social style, and score on the Global Assessment of Functioning scale. In most other areas assessed there was a tendency, although statistically insignificant, towards a better outcome in the infantile autism comparison group.ConclusionsOur findings provide some support for maintaining a diagnostic category of disintegrative psychosis as distinct from infantile autism.
Adults with Williams syndrome
Authors: Davies Mark , Howlin Patricia , Udwin Orlee 
Published: October 2008

BackgroundIn recent years there has been an upsurge of interest in the study of distinctive patterns of behavioural and psychological characteristics associated with specific, biologically determined, intellectually disabling conditions. This study investigates whether such a profile can be identified in adults with Williams syndrome.MethodParents and other care-givers were interviewed about the social, emotional and behavioural characteristics of 70 adults with Williams syndrome, aged 19 years to 39 years 9 months.ResultsThe adults were reported to have high rates of behavioural and emotional difficulties, particularly in terms of poor social relationships, over-friendliness and social disinhibition, preoccupations and obsessions, and high levels of anxiety and distractibility.ConclusionsThe findings provide preliminary support for the existence of a specific pattern of behavioural and personality characteristics and associated difficulties in adults with Williams syndrome, which persist from childhood and often require intervention from mental health professionals. Implications for clinical practice are considered.
Premorbid adjustment and personality in people with schizophrenia†
Authors: Malmberg A. , Lewis G. , David A. , Allebeck P. 
Published: October 2008

BackgroundSchizoid personality and poor social adjustment have been thought of as common antecedents of schizophrenia but the existing literature is inconclusive. We have carried out a large cohort study with improved methodology.MethodThe premorbid personality and adjustment of 50 054 Swedish men were assessed on entry into the army at the age of 18. Individuals who developed schizophrenia or another psychosis after 15-year follow-up were identified. Odds ratios for variables independently associated with the later development of schizophrenia were calculated, adjusting for potential confounders.ResultsFour variables reflecting early problems with interpersonal relationships were strongly associated with later schizophrenia and, to a lesser extent, non-schizophrenic psychoses, but also occurred commonly in the cohort as a whole. These associations with schizophrenia persisted after early-onset cases were excluded, though their predictive value was low (3.0%, 95% CI 1.5–4.5).ConclusionsSome aspects of premorbid personality and adjustment may act as risk factors for schizophrenia. The results appear to be most consistent with a multi-factorial aetiology for schizophrenia and offer tentative support for a psychological disturbance mediating genetic and environmental effects on the causal pathway to the illness.
Prenatal exposure to maternal stress and subsequent schizophrenia
Authors: Van Os Jim , Selten Jean-Paul 
Published: October 2008

BackgroundIt has been suggested that prenatal exposure to maternal stress increases the risk of subsequently developing schizophrenia.MethodThe five-day invasion and defeat of The Netherlands by the German army in May 1940 constituted a severe, well-circumscribed national stressful event. Individuals exposed and non-exposed to this stressor in the first, second and third trimester of pregnancy were followed up for lifetime schizophrenia outcome through the National Psychiatric Case Register.RegisterCumulative incidence of schizophrenia was higher in the exposed cohort (risk ratio (RR): 1.15, 95% CI: 1.03–1.28), especially in those exposed in the first trimester (RR: 1.28, 95% CI: 1.07–1.53). Significant interaction with gender was apparent in second trimester exposed cohorts (RR men: 1.35, 95% CI: 1.05–1.74; RR women: 0.83, 95% CI: 0.61–1.12).ConclusionMaternal stress during pregnancy may contribute to the development of vulnerability to schizophrenia. The apparent longer window of exposure in male foetuses may be related to the slower pace of male early cerebral development.
African–Caribbean men remanded to Brixton Prison
Authors: Bhui Kamaldeep , Brown Phillip , Hardie Tim , Watson J. P. , Parrott Janet 
Published: October 2008

BackgroundAfrican–Caribbean men are over-represented in psychiatric and forensic services and in the prison population. A failure of community services to engage mentally ill African–Caribbean men and their presentation through the criminal justice system culminates in a repeated pattern of forensic service and criminal justice system contact.MethodWe carried out a cross-sectional survey during a one-year period of a sample of potentially mentally ill men remanded to HMP Brixton in south London. Men were interviewed to establish their place of birth, first language, socio-demographic profile, ethnicity, psychiatric diagnosis, levels of alcohol and substance misuse, criminality, violence involved in their index offence, past psychiatric and forensic contacts and outcome of court appearance.ResultsTwo hundred and seventy-seven men were interviewed. In comparison with White men, African–Caribbean men were more often diagnosed as having schizophrenia and were more often sent to hospital under a mental health act order. African–Caribbean men were remanded in custody despite more stable housing conditions and more favourable indices of lifetime criminality, substance misuse and violence.ConclusionsCommunity services, including diversion schemes, should be especially sensitive to African–Caribbean men with schizophrenia who ‘fall out of care’, who are not diverted back into care and are therefore unnecessarily remanded.
Self-injury and violence in people with severe learning disabilities
Authors: Read Stephen 
Published: October 2008

BackgroundPsychiatry in severe and profound learning disability is essentially behavioural psychiatry. Some clinical and research observations of disorders of behaviour in this group are summarised in this study.MethodAfter inspection of the literature, I postulated a clinical syndrome of violence and self-injury in the severely learning disabled. A check-list of behavioural symptoms was developed and used in a community survey.ResultsBehaviour, assessed by the check-list, supported the existence of organic behaviour disorder, as did small-scale psychophysiological testing.ConclusionsSelf-injury is strongly associated with violence, and with severe and profound learning disability. Pathophysiology of violence and self-injury may include high levels of psychophysiological arousal demonstrated by unstable EEGs. Reduction of arousal by antipsychotic medication is associated with clinical improvement in violent and self-injurious behaviours.
Serious criminal offending and mental disorder
Authors: Wallace Cameron , Mullen Paul E. , Burgess Philip , Palmer Simon , Ruschena David , Browne Chris 
Published: October 2008

BackgroundA relationship exists between mental disorder and offending behaviours but the nature and extent of the association remains in doubt.MethodThose convicted in the higher courts of Victoria between 1993 and 1995 had their pyschiatric history explored by case linkage to a register listing virtually all contacts with the public psychiatric services.ResultsPrior psychiatric contact was found in 25% of offenders, but the personality disorder and substance misuse accounted for much of this relationship. Schizophrenia and affective disorders were also over-represented, particularly those with coexisting substance misuse.ConclusionsThe increased offending in schizophrenia and affective illness is modest and may often be mediated by coexisting substance misuse. The risk of a serious crime being committed by someone with a major mental illness is small and does not justify subjecting them, as a group, to either increased institutional containment or greater coercion.
Randomised, double-blind, placebo-controlled treatment trial of fluoxetine and graded exercise for chronic fatigue syndrome†
Authors: Wearden Alison J. , Morriss Richard K. , Mullis Ricky , Strickland P. L. , Pearson David J. , Appleby Louis , Campbell Iain T. , Morris Julie A. 
Published: October 2008

BackgroundThe Joint Working Group of the Royal Colleges of Physicians, Psychiatrists and General Practitioners (1996) recommended graded exercise and antidepressants for patients with chronic fatigue syndrome. We assessed efficacy and acceptability of these treatments.MethodSix-month prospective randomised placebo and therapist contact time controlled trial with allocation to one of four treatment cells: exercise and 20 mg fluoxetine, exercise and placebo drug, appointments only and 20 mg fluoxetine, appointments and placebo drug. Drug treatment was double blind and patients were blind to assignment to exercise or appointments.ResultsNinety-six (71%) of 136 patients completed the trial. Patients were more likely to drop out of exercise than non-exercise treatment (P=0.05). In an intention to treat analysis, exercise resulted in fewer patients with case level fatigue than appointments only at 26 weeks (12 (18%) v. 4 (6%) respectively P=0.025) and improvement in functional work capacity at 12(P=0.005) and 26 weeks (P=0.03). Fluoxetine had a significant effect on depression at week 12 only (P=0.04). Exercise significantly improved health perception (P=0.012) and fatigue (P=0.028) at 28 weeks.ConclusionsGraded exercise produced improvements in functional work capacity and fatigue, while fluoxetine improved depression only.
Population-based study of the prevalence and presentation of dementia in adults with Down's syndrome
Authors: Holland Anthony J. , Hon Johnny , Huppert Felicia A. , Stevens Fran , Watson Peter 
Published: October 2008

BackgroundThe reported prevalence rates of dementia in people with Down's syndrome have varied considerably across studies. The aim of this study was to investigate the extent of clinical change with age using an established diagnostic instrument in an unbiased, population-based sample of older people with Down's syndrome.MethodChanges in memory, personality, general mental functioning and daily living skills were assessed using a modified version of the informant interview of the Cambridge Examination for Mental Disorders of the Elderly (CAMDEX).ResultsAge-specific prevalence rates of dementia varied according to the diagnostic criteria used. Using CAMDEX criteria for Alzheimer's disease, prevalence rates increased from 3.4 to 10.3 to 40% in the 30–39, 40–49 and 50–59 age group, respectively.ConclusionsOverall, the age-related pattern of presentation and dementia diagnoses differs from that seen in the general elderly population. However, age-specific prevalence rates of Alzheimer's disease were similar but 30–40 years earlier in life.
Midline brain anomalies and schizophrenia in people with CATCH 22 syndrome
Authors: Vataja R. , Elomaa Eero 
Published: October 2008

BackgroundSince people with chromosome 22q11 deletion (CATCH 22 syndrome) have unexpectedly high incidence of major psychosis it has been suggested that 22q area might be involved in the pathogenesis of schizophrenia and bipolar disorders.MethodA single case report.ResultsA 32-year-old male patient with CATCH 22 syndrome and schizophrenia had extensive midline anomalies of the brain in the regions relevant to psychotic disorders.Conclusions22q11-dependent abnormalities in the midline structures of the brain may cause dysfunction in the limbic system and interfere with the interhemispheric information exchange thus predisposing people with CATCH 22 syndrome to psychotic disorders.
Post-partum psychoses
Authors: Terp Inger Merete , Mortensen Preben Bo 
Published: October 2008

BackgroundPrevious studies have suggested that the risk for psychosis, especially affective psychosis, is highly increased during the first 30 days after delivery. The aim of our study was to replicate these findings.MethodLinkingThe Danish Medical Birth Register and The Danish Psychiatric Central Register from 1 January 1973 to 31 December 1993 revealed 1253 admissions diagnosed as psychosis within 91 days after delivery. The admission rate after delivery was compared with the admission rate among non-puerperal women in the general Danish female population.ResultsThe relative risk of all admissions was only slightly increased, RR=I.09 (95% C11.03–1.16). The admission rate concerning first admissions was highly increased, RR=3.21 (95% CI 2.96–3.49) whereas the admission rate concerning readmissions was reduced, RR=0.66 (95% CI 0.61–0.72).ConclusionsChildbirth is a strong risk factor for first admission with psychosis, but the risk may be less increased than previously assumed.
Electroretinogram in withdrawn cocaine-dependent subjects
Authors: Smelson David A. , Roy Monique , Roy Alec , Santana Sandra 
Published: October 2008

BackgroundWe have previously reported that people who are cocaine-dependent have reduced blue cone b-wave electroretinogram (ERG) responses. In this preliminary study, we examined the relationship between blue cone ERG amplitudes and craving response to cocaine cues.MethodA new series of 14 recently withdrawn subjects who were cocaine-dependent completed a cocaine craving questionnaire at baseline, and again following exposure to laboratory cues; an ERG was also performed.ResultsCocaine-dependent subjects with a blunted ERG blue cone response (<0.5 μV) showed significantly greater increases in craving following cue-exposure than subjects without the blunted ERG blue cone response.ConclusionsSubjects with a blunted ERG response may represent a subgroup more vulnerable to cocaine craving and relapse.
Excess mortality of mental disorder
Authors: Harris Clare , Barraclough Brian 
Published: October 2008

BackgroundWe describe the increased risk of premature death from natural and from unnatural causes for the common mental disorders.MethodWith a Medline search (1966–1995) we found 152 English language reports on the mortality of mental disorder which met our inclusion criteria. From these reports, covering 27 mental disorder categories and eight treatment categories, we calculated standardised mortality ratios (SMRs) and 95% confidence intervals (CIs) for all causes of death, all natural causes and all unnatural causes; and for most, SMRs for suicide, other violent causes and specific natural causes.ResultsHighest risks of premature death, from both natural and unnatural causes, are for substance abuse and eating disorders. Risk of death from unnatural causes is especially high for the functional disorders, particularly schizophrenia and major depression. Deaths from natural causes are markedly increased for organic mental disorders, mental retardation and epilepsy.ConclusionAll mental disorders have an increased risk of premature death.
London-East Anglia randomised controlled trial of cognitive-behavioural therapy for psychosis
Authors: Kuipers Elizabeth , Fowler David , Garety Phiuppa , Chisholm Daniel , Freeman Daniel , Dunn Graham , Bebbington Paul , Hadley Clare 
Published: October 2008

BackgroundA randomised controlled trial of cognitive — behavioural therapy (CBT) for people with medication-resistant psychosis showed improvements in overall symptomatology after nine months of treatment; good outcome was strongly predicted by a measure of cognitive flexibility concerning delusions. The present paper presents a follow-up evaluation 18 months after baseline.MethodForty-seven (78% of original n=60) participants were available for follow-up at 18 months, and were reassessed on all the original outcome measures (see Part I). An economic evaluation was also completed.ResultsThose in the CBT treatment group showed a significant and continuing improvement in Brief Psychiatric Rating Scale scores, whereas the control group did not change from baseline. Delusional distress and the frequency of hallucinations were also significantly reduced in the CBT group. The costs of CB Tappear to have been offset by reductions in service utilisation and associated costs during follow-up.ConclusionsImprovement in overall symptoms was maintained in the CBT group 18 months after baseline and nine months after intensive therapy was completed. CBT may be a specific and cost-effective intervention in medication-resistant psychosis.
Peer review and editorial decision-making
Authors: Howard Louise , Wilkinson Greg 
Published: October 2008

IntroductionThis paper describes and analyses the editor's decision-making process at the British Journal of Psychiatry (BJP), and investigates the association between reviewers' assessments and editorial decisions.MethodFour hundred consecutive manuscripts submitted over a six-month period to the BJP were examined prospectively for assessors' comments and editorial decisions on acceptance or rejection. Interrater reliability of assessments was calculated and a logistic regression analysis investigated the effect of the rank allocated by assessors and the comprehensiveness of the assessments on the editor's decision.ResultsThe editor sent 248/400 (62%) manuscripts to assessors for peer review. Kappa for reliability of assessors' rankings was 0.1 indicating poor interrater reliability. Assessors agreed best on whether to reject a paper. A ranking of five (indicating rejection) had the greatest association with editor's rejection (P < 0.001, odds ratio 0.079), and the mean ranking of assessments was also significantly associated with editorial acceptance or rejection (P=0.004, odds ratio 0.24)ConclusionAssessors and editors tend to agree on what is clearly not acceptable for publication but there is less agreement on what is suitable.
Suicidal behaviours in vulnerable adolescents
Authors: Fombonne Eric 
Published: October 2008

BackgroundSuicide rates have increased over the past three decades, especially in young men. Depression, conduct disorder, crime and substance misuse have also increased. This study tested hypotheses on the possible links between the secular increase in the rates of these behaviours.MethodA data set on 6091 subjects aged 8–18 years (58.4% boys) referred to psychiatric services over & 21-year period (1970–1990) was used. & detailed analysis of & random sample of 80 case notes was conducted.ResultsSuicidal behaviours increased significantly among pubertal male adolescents only (n=1313). In this sub-sample, substance misuse accounted for the increase over time. The rates of both suicidal behaviours and of substance misuse almost doubled between 1979 and 1990 in this patient group. The case note analysis showed that solvent and alcohol misuse had also increased over the study period. Moreover, among the subjects misusing substances, alcohol was the only substance with & strong and positive association with suicidal behaviours. Substance misuse pre-dated suicidal behaviours in most patients.ConclusionsA link has been found between the increase over time of suicidal behaviours in adolescent boys and & contemporaneous increase in substance misuse. The strength and direction of the association suggests that alcohol misuse is the causal factor.
Economic burden of drug dependency
Authors: Healey Andrew , Knapp Martin , Astin Jack , Gossop Michael , Marsden John , Stewart Duncan , Lehmann Petra , Godfrey Christine 
Published: October 2008

BackgroundThe use of illegal drugs is seen as & major social problem. The social costs can be high.MethodsSelf-report data from interviews at intake to the National Treatment Outcome Research Study (NTORS) for 1075 drug users and cost data from various sources were used to estimate criminal behaviour and health and addiction service costs for & 12-month period. Multivariate statistical analysis was used to analyse cost variations.ResultsTotal costs for one year for the drug users amounted to over $12 million, the majority attributable to self-reported criminal behaviour. Social costs were positively related to & variety of factors including instability in living circumstances, amount of heroin used and whether or not drugs were taken intravenously.ConclusionsThe study clearly demonstrates the economic and social burden associated with heavy drug users and highlights the need for further investigations into the costs and benefits of policies that can reduce these social costs.
Suicide and other causes of mortality after post-partum psychiatric admission
Authors: Appleby Louis , Mortensen Preben B. , Faragher E. Brian 
Published: October 2008

BackgroundThe risk of suicide in postnatal women is low and those suicides that occur appear to be associated with severe psychiatric illness. No previous study has specifically studied the risk of suicide following post-partum psychiatric disorder.MethodWe calculated standardised mortality ratios (SMRs) for suicide, unnatural deaths and deaths from natural causes for women admitted to psychiatric hospital in the first year after childbirth, using computerised cross-linkages between the Danish Psychiatric Case Register and the Danish registers of birth and causes of death for 1973–1993.ResultsDuring the study period 1567 women were admitted to psychiatric hospital of whom 107 (6.8%) died. The SMRs (compared with 100) were 1719 (95% CI 1284–2254) for suicide, 1329 (95% CI 1038–1676) for all unnatural causes and 238 (95% CI 167–329) for natural causes. Suicides and deaths from all unnatural causes were most likely to occur in the first year after childbirth, the SMR for suicide within one year being 7216 (95% CI 3945–12 108).ConclusionsAlthough postnatal women as a whole appear to have a low rate of suicide, severe post-partum psychiatric disorder is associated with a high rate of deaths from natural and unnatural causes, particularly suicide. The risk is especially high in the first postnatal year, when the suicide risk is increased 70-fold. Close clinical superivision at this time is indicated.