bluuebunny/crossref_metadata_2025_split huggingface dataset:
Conventional versus atypical neuroleptics: subjective quality of life in schizophrenic patients
Authors: Franz M. , Lis Stefanie , Plüddemann K. , Gallhofer B. 
Published: October 2008

BackgroundThe effectiveness of anti-psychotic drugs against positive psychotic symptoms has been demonstrated in many studies, but their effects on quality of life have yet to be clarified. The impact of different neuroleptic therapies on the subjective quality of life of schizophrenic patients is evaluated in a cross-sectional open study.MethodDuring a four-month period a standardised quality of life interview for schizophrenic patients was applied on day 10 after admission; 33 patients on atypical neuroleptics (AAP) were compared with 31 matched patients on conventional neuroleptics (CAP).ResultsThe AAP group had significantly higher scores in general quality of life as well as in different life domains: physical well-being, social life and everyday life. In separate comparisons of the AAP group, patients on clozapine and risperidone were found to have a higher quality of life score than patients on CAP or zotepine.ConclusionsThe pharmacological profile of clozapine and risperidone may provide a basis for explaining the higher subjective quality of life found in this study. The lower quality of life of the CAP group may possibly be related to intrinsic effects of the conventional antipsychotics.
Uptake of 99mTc-exametazime shown by single photon emission computed tomography before and after lithium withdrawal in bipolar patients: Associations with mania
Authors: Goodwin Guy M. , Cavanagh Jonathan T. O. , Glabus M. F. , Kehoe R. F. , O'Carroll R. E. , Ebmeier K. P. 
Published: October 2008

BackgroundEarly manic relapse following lithium discontinuation offers an important opportunity to investigate the relationship between symptoms, effects of treatment and regional brain activation in bipolar affective disorder.MethodFourteen stable bipolar patients on lithium were examined with neuropsychological measures, clinical ratings and single photon emission computed tomography (SPECT) before and after acute double-blind withdrawal of lithium. Brain perfusion maps were spatially transformed into standard stereotactic space and compared pixel-by-pixel. A parametric analysis was used to examine the change in brain perfusion on lithium withdrawal, and the relationship between symptom severity and brain perfusion separately both between and within subjects.ResultsLithium withdrawal was associated with an important redistribution of brain perfusion, with increases in inferior posterior regions and decreases in limbic areas, particularly anterior cingulate cortex. Seven of the 14 patients developed manic symptoms during the placebo phase, correlating with relative increases in perfusion of superior anterior cingulate and possibly left orbito-frontal cortex.ConclusionsThe important effect of lithium withdrawal on brain perfusion implies that after withdrawal of lithium, the brain develops an abnormal state of activity in limbic cortex. The structures involved did not co-localise with those apparently modulated by manic symptoms.
The Bentham Unit: A pilot remand and assessment service for male mentally disordered remand prisoners
Authors: Weaver Tim , Taylor Fiona , Cunningham Barbara , Maden Anthony , Rees Sian , Renton Adrian 
Published: October 2008

BackgroundFindings are presented from an evaluation of a pilot remand and assessment service - the Bentham Unit, The aims of the Bentham Unit are to provide rapid assessment, identify mentally disordered remand prisoners, and speed their transfer from prison to NHS care, where a need is indicated.MethodThe number, rate and speed of referral, assessment and transfer to NHS care of offenders remanded to Wormwood Scrubs prison during periods before and after the Bentham Unit opened were compared.ResultsThe service attracted a large volume of referrals. Between the two periods, significant increases in the numbers of referrals and hospital disposals, and major reductions in the interval between reception on remand into the prison, NHS assessment and transfer to NHS care, were observed.ConclusionsThe aims of the unit were met. Implications for service configurations are discussed.
Post-traumatic stress disorder and depression
Authors: Bleich Avi , Koslowsky Meni , Dolev Aliza , Lerer Bernard 
Published: October 2008

BackgroundWe examined psychiatric morbidity following war-related psychic trauma, with a special focus on the depressive comorbidity of post-traumatic stress disorder (PTSD).MethodSubjects consisted of 60 Israeli veterans who sought psychiatric treatment 4–6 years after having been exposed to war trauma. PTSD and psychiatric comorbidity were diagnosed using the Structured Interview for PTSD and the Schedule for Affective Disorders and Schizophrenia.ResultsBoth lifetime (100%) and current (87%) PTSD were the most prevalent disorders. Comorbidity was extensive, with major depressive disorder (MDD) most prevalent (95% lifetime, 50% current), followed by anxiety disorders, minor affective disorders, and alcoholism or drug misuse.ConclusionsWithin post-traumatic psychiatric morbidity of combat origin, PTSD and MDD are the most prevalent disorders. In addition it appears that PTSD, although related to post-traumatic MDD beyond a mere sharing of common symptoms, is of the same time differentiated from it as an independent diagnostic category.
An open trial of clozapine in neuroleptic-resistant childhood-onset schizophrenia
Authors: Turetz M. , Mozes T. , Toren P. , Chernauzan T. , Yoran-Hegesh R. , Mester R. , Wittenberg N. , Tyano S. , Weizman A. 
Published: October 2008

BackgroundStudies performed with schizophrenic adults who were resistant to classical neuroleptics showed improvement in 30% of the patients when treated with clozapine. Very early onset schizophrenic patients benefit only partially from conventional antipsychotics and are at increased risk of developing extrapyramidal symptoms; clozapine may offer an alternative treatment for these patients.MethodEleven neuroleptic-resistant children (< 13 years) with schizophrenia were treated with clozapine. Improvement was monitored during the first 16 weeks using the Brief Psychiatric Rating Scale, Positive and Negative Syndrome Scale and Clinical Global Impression. The mean clozapine dosage was 227.3 (s.d. 34.4) mg/day at the end of the 16 weeks.ResultsThere was an overall statistically significant reduction in all parameters, especially positive symptoms, implying a favourable outcome. Most of the improvement occurred during the first 6 to 8 weeks. The major side-effects were somnolence and drooling (no agranulocytosis).ConclusionClozapine may be a promising drug for the treatment of resistant childhood-onset schizophrenia.
Predictive power and construct validity of the Level of Expressed Emotion (LEE) scale
Authors: Gerlsma Coby , Hale William W. 
Published: October 2008

BackgroundThe Level of Expressed Emotion scale (LEE) is a questionnaire designed to measure the perception of expressed emotion, an important predictor of the course of several psychiatric disorders.MethodIn this study, the scales predictive and construct validity were examined in a sample of 26 clinically depressed out-patients and their partners, and in a sample of 40 couples from the general communityResultsIn the sample of depressed out-patients, the LEE was predictive of depression improvement at six-month follow-up. With regard to the construct validity, results in both samples showed quite strong relationships between the LEE and depressive symptomatology, relational dissatisfaction, and coping styles.ConclusionsThe LEE may be a useful tool in the study of interpersonal processes and depression, both in clinical and research settings.
Mental health in primary care
Authors: Vázquez-Barquero José Luis , Garcia José , Simón Jesús Artal , Iglesias Celso , Montejo Javier , Herrán AndréS , Dunn Graham 
Published: October 2008

BackgroundThe main objectives of the survey were: (a) to analyse the sociological, clinical and illness-related correlates of mental illness in primary care; (b) to study, during one-year follow-up, outcome and use of health resources.MethodThe survey comprised a two-phase cross-sectional study. In the first phase patients were classified using the GHQ-28 or by the general practitioner (GP). In the second phase they were assessed by the SCAN system.ResultsThe prevalence rate of mental illness (in attenders) using the GHQ was 33.2%. The corresponding rate for the GP was 14.1%, and for the SCAN 31.5%. Mental illness mainly comprised depression, anxiety and alcohol-related diagnoses. The presence of mental illness and the use of health resources during follow-up were dependent on demographic characteristics and on their original psychiatric status.ConclusionsIn primary care, mental illness constitutes a major health problem. Despite this fact. GPs do not recognise a substantial proportion of these health problems.
The effect of physical ill health on the course of psychiatric disorder in general practice
Authors: Kisely S. R. , Goldberg D. P. 
Published: October 2008

BackgroundThe aim of this study was to determine the effect of physical morbidity on the outcome of patients with psychiatric disorder, and to compare the effects of non-medically and medically explained symptoms.MethodOne hundred and fifty psychiatric cases were recruited using a two-stage design from 1620 consecutive patients attending their GP. Subjects were assessed at the time of screening, and one year subsequently, using the Composite International Diagnostic Instrument adapted for use in primary care (CIDI - PHC) and the Groningen Social Disability Schedule (GSDS). Assessments of psychiatric morbidity were also obtained from GPs.ResultsMedically explained somatic symptoms were strongly related to psychological outcome one year later. Whereas just over a half of patients with no medically explained symptoms had recovered from a psychiatric disorder, the percentage recovery fell to 41% in those with 1 −4 medically explained symptoms, and only 21% in patients with five or more medically explained symptoms.ConclusionsPhysical ill-health has been shown to make an independent contribution to psychological outcome. The specific needs of these patients should receive greater attention.
Prolactin response to d-fenfluramine in obsessive-compulsive patients, and outcome of fluvoxamine treatment
Authors: Monteleone Palmiero , Catapano Francesco , Martino Stefania Dl , Ferraro Ciro , Maj Mario 
Published: October 2008

BackgroundAlthough several studies have directly explored serotonin (5-HT) transmission in patients with obsessive compulsive disorder (OCD), their results have been inconsistent and their clinical relevance is doubtfulMethodAccording to a double-blind placebo-controlled design, plasma prolactin (PRL) response to a specific serotonergic probe, d-fenfluramine, was measured in 20 drug-free obsessive compulsive patients and in 20 matched healthy controls. After the neuroendocrine test, 5 patients completed a lO-week treatment with fluvoxamine. Psychopathological assessment was performed before and after therapy.ResultsPRL response in OCD patients was blunted under the drug-free condition; correlated inversely with pretreatment ratings of obsessive-compulsive and depressive symptomatology; and correlated inversely with the improvement in obsessive-compulsivescore observed after fluvoxamine treatment.ConclusionsThese results support the idea of a dysfunction of 5-HT transmission in OCD, and suggest that the greater this impairment, the better the response to drugs which selectively block the reuptake of 5-HT.
Predicting PTSD in trauma survivors: prospective evaluation of self-report and clinician-administered instruments
Authors: Shalev Arieh Y. , Freedman Sara. , Peri Tuvia , Brandes Dalia , Sahar Tali 
Published: October 2008

BackgroundThis study examined the ability of commonly used questionnaires and a structured clinical interview to predict PTSD in recent trauma survivors.MethodHorowitz's Impact of Event Scale (IES), Speilberger's State Anxiety (SANX) and the Peri Traumatic Dissociation Questionnaire (PDEQ) were administered one week post-trauma to 239 traumatised individuals recruited from a general hospital emergency room. The IES, the SANX, the civilian version of the Mississippi Scale for Combat Related PTSD (MISS), and the Clinician Administered PTSD Scale (CAPS) were administered one month and four months post-trauma. Receiver operator characteristic (ROC) analysiswas used with these data.ResultsAll questionnaires were better than chance at predicting PTSD. The so called PTSD questionnaires (IES and MISS) were not better than the more general ones. No difference in predictive value was found when questionnaires were carried outone week or one month after a trauma. Recovery was better predicted than PTSD, and the CAPS was better than the questionnaires.DiscussionThe use of psychometrics and clinical interviews to predict PTSD should be guided by clinical relevance and by the availability of resources.
Subjective experience of persistent schizophrenia and depression among US Latinos and Euro-Americans
Authors: Jenkins Janis Hunter 
Published: October 2008

BackgroundThe aims were to investigate cross-culturally the subjective experience of long-term psychiatric patients to determine whether or not they would define their current life situation predominantly in terms of illness.MethodThe design is a two-by-two comparison by ethnicity (Latino and Euro-American) and diagnosis (schizophrenia and unipolar depression) of 80 subjects for DSM–III–R criteria according to the SADS. Patients were interviewed using a semi-structured interview (Context of Illness Experience) yielding data coded for qualitative and quantitative analyses.ResultsWhile significant ethnic differences were observed, nearly half the sample did not include illness in their description of their life situation. Other domains (e. g. activities, events) and the extent to which patients perceived themselves as in- or out-of-step with the “rhythm of life” were identified as central patient concerns.ConclusionsEmpirical research on the subjective experiences and representations of the life situation of patients offers clues to the course and treatment of persistent psychiatric disorder.
Intensive in-patient and community intervention versus routine care after attempted suicide
Authors: Van Der Sande Rob , Van Rooijen Liesbeth , Buskens Erik , Allart Esther , Hawton Keith , Van Der Graaf Yolanda , Van Engeland Herman 
Published: October 2008

BackgroundA randomised clinical trial was carried out in suicide attempters to assess clinical efficacy of an intensive psychosocial intervention compared with treatment as usual.MethodTwo hundred and seventy-four suicide attempters presenting for medical treatment were randomly assigned to either intensive psychosocial treatment or ‘care as usual’. Intensive psychosocial treatment consisted of brief admission to a special crisis-intervention unit and problem-solving aftercare. ‘Care as usual’ included any form of treatment the assessing clinicians thought appropriate. Psychological well-being was evaluated by the SCL–90 and the Hopelessness Scale at 3, 6 and 12 months following entry in the study.ResultsNo differences in outcome were found. The probability of repeat suicide attempts in the 12-month follow-up was 0.17 for patients in the experimental group and 0.15 for the control group. There were no differences in ratings on the SCL–90 and the Hopelessness Scale. Patients in the experimental group attended significantly more out-patient treatment sessions.ConclusionsGeneral implementation of an intensive in-patient and community intervention programme for suicide attempters does not seem justified.
Family planning needs and STD risk behaviours of female psychiatric out-patients
Authors: Coverdale John H. , Turbott Sarah H. , Roberts Helen 
Published: October 2008

BackgroundThere are few studies concerning the family planning needs of female chronic psychiatric patients. We aimed to determine the contraceptive needs and sexually transmitted disease (STD) risk-behaviours of female psychiatric out-patients.MethodSixty-six female out-patients with major psychiatric disorders, including schizophrenia, bipolar disorder and mood disorders, completed a semi-structured interview (response rate=63%) and were individually matched for age and ethnicity with 66 women who had never been treated for psychiatric illness. They answered questions on child-rearing and on their methods of contraception in relation to their attitudes towards pregnancy, as well as on their risk for STDs.ResultsCompared with controls, the female patients reported having had significantly more induced abortions and were significantly more likely to have given up their own children for others to raise. Heterosexually active psychiatric patients were significantly more likely than controls to have had more than one male sexual partner, to have been pressured into unwanted sexual intercourse, and to report having had sexual intercourse with a suspected bisexual over the preceding year.ConclusionsThese results underscore the priority for developing programmes that reduce female psychiatric patients' risk for unwanted pregnancies and STDs.
Randomised controlled trial of psychological debriefing for victims of acute burn trauma
Authors: Bisson Jonathan I. , Jenkins Peter L. , Alexander Julie , Bannister Carol 
Published: October 2008

BackgroundPsychological debriefing (PD) is widely used following major traumatic events in an attempt to reduce psychological sequelae.MethodOne hundred and thirty-three adult burn trauma victims entered the study. After initial questionnaire completion, participants were randomly allocated to an individual/couple PD group or a control group who received no intervention; 110 (83%) were interviewed by an assessor blind to PD status three and 13 months later.ResultsSixteen (26%) of the PD group had PTSD at 13-month follow-up, compared with four (9%) of the control group. The PD group had higher initial questionnaire scores and more severe dimensions of burn trauma than the control group, both of which were associated with a poorer outcome.ConclusionsThis study seriously questions the wisdom of advocating one-off interventions post-trauma, and should stimulate research into more effective initiatives.
Eye movement desensitisation and reprocessing versus exposure in vivo
Authors: Muris Peter , Merckelbach Harald , Van Haaften Hans , Mayer Birgit 
Published: October 2008

BackgroundEye movement desensitisation and reprocessing (EMDR) is a relatively new therapeutic technique that has been proposed as a treatment for post-traumatic stress disorder and other anxiety complaints.MethodWe compared the efficacy of EMDR with that of exposure in viv. in the treatment of a specific phobia. Twenty-two spider-phobic children who met the DSM – III – R criteria for specific phobia participated in the study. Children were treated with one session of exposure in viv. and one session of EMDR in a crossover design. Treatment outcome was evaluated by self-report measures, a behavioural avoidance test and a physiological index (skin conductance level).ResultsResults showed positive effects of EMDR, but also suggest that it is especially self-report measures that are sensitive to EMDR. Improvement on a behavioural measure was less pronounced, and exposure in viv. was found to be superior in reducing avoidance behaviour. With regard to skin conductance level, EMDR and exposure in viv. did not differ.ConclusionsEMDR has no additional value in treatment of this type of animal phobia, for which exposure in viv. is the treatment of choice.
Increased rate of psychosis among African–Caribbeans in Britain is not due to an excess of pregnancy and birth complications
Authors: Hutchinson G. , Takei N. , Bhugra D. , Fahy T. A. , Gilvarry C. , Mallett R. , Moran P. , Leff J. , Murray R. M. 
Published: October 2008

BackgroundIt has been suggested that the increased rate of psychotic illness among African–Caribbeans living in Britain is due to an excess of pregnancy and birth complications (PBCs).MethodWe therefore compared the frequency of PBCs in a group of White psychotic patients (n=103) and a comparable group of patients of African–Caribbean origin (n=61); the latter consisted of 30 first-generation (born in the Caribbean) and 31 second-generation (born in Britain) individuals.ResultsWhite psychotic patients were more than twice as likely to have a history of PBCs as their African–Caribbean counterparts (odds ratio=2.34, 95% confidence interval (CI) 0.88–6.47, P=0.062). The same trend was observed among patients with a DSM–III diagnosis of schizophrenia (odds ratio=l.65, 95% CI 0.56–4.97, P=0.32). The rate of PBCs was similar among the first- and second-generation Caribbean psychotic patients.ConclusionsThe increased rate of psychotic illness that has been reported among the African–Caribbean population in Britain is not due to an increased prevalence of PBCs.
Incidence and risk factors for severe tardive dyskinesia in older patients
Authors: Caligiuri Michael P. , Lacro Jonathan P. , Rockwell Enid , McAdams Lou Ann , Jeste Dilip V. 
Published: October 2008

BackgroundSevere tardive dyskinesia (TD) represents a serious and potentially disabling movement disorder, yet relatively little is known about the incidence of and risk factors for severeTD.MethodWe report the results of a longitudinal prospective incidence study of severeTD in 378 middle-aged and elderly neuropsychiatric patients. Psychiatric, neuropsychological, pharmacological and motor variables were obtained at intake and at regular intervals for 36 months.ResultsThe cumulative incidence of severeTD was 2.5% after one year, 12.1% after two years, and 22.9% after three years. Individual univariable Cox regression analyses were conducted to identify demographic, psychiatric, motor and pharmacological predictors of severeTD. Results indicated that higher daily doses of neuroleptics at study entry, greater cumulative amounts of prescribed neuroleptic, and greater severity of worsening negative symptoms were predictive of severeTDConclusionsThese findings suggest that conventional neuroleptics may be prescribed to older patients only when necessary and at the lowest effective dosage. Additional caution is recommended in patients exhibiting negative symptoms.
Plasma noradrenaline response to electroconvulsive therapy in depressive illness
Authors: Kelly C. B. , Cooper S. J. 
Published: October 2008

BackgroundAbnormalities of catecholaminergic function have been hypothesised to cause depressive illness. Plasma noradrenaline can be used as a marker of central noradrenergic activity. It is of interest to examine the change in resting plasma noradrenaline in patients with depressive illness over a course of electroconvulsive therapy (ECT) and relate this to their clinical state.MethodPatients referred for ECT who suffered from DSM – III – R major depressive disorder or dysthymia were recruited. Blood samples were taken before and after each treatment, during a course of ECT, to measure plasma noradrenaline and Cortisol. Clinical ratings were carried out weekly during the course of ECT.ResultsPlasma noradrenaline fell significantly in those patients with melancholic/psychotic depressions but increased in those with non-melancholic depressive illness. There was a strong trend indicating that a fall in plasma noradrenaline was associated with improvement in depression ratings in the melancholic/psychotic patients only.ConclusionsElectroconvlusive therapy decreases plasma noradrenaline in melancholic/psychotic depressive illness and this shows a trend associated with clinical improvement.