bluuebunny/crossref_metadata_2025_split huggingface dataset:
Access to mental health care in an inner-city health district. II: Association with demographic factors
Authors: Commander M. J. , Dharan S. P. Sashi , Odell S. M. , Surtees P. G. 
Published: October 2008

BackgroundIn addition to clinical and service factors, planners need to take account of the influence of demographic variables, especially ethnicity, on access to mental health care.MethodEstimated prevalence rates were calculated from epidemiological surveys undertaken in three settings: psychiatric services, primary care and the general population. Associations between demographic factors and service use were examined using the pathways to care model.ResultsConsiderable differences in access to mental health care were found, particularly according to ethnicity. The major impediment to Asians accessing care occurred at the interface between primary and secondary care, whereas the most striking feature for Blacks was the poor level of case recognition by GPs.ConclusionsIn order to improve the uptake of mental health care, new initiatives should target those who are most likely to be unwell but least likely to access services. Purchasers and providers need to address differential patterns of use when developing and reviewing services.
Road traffic accidents: Early psychological consequences in children and adolescents
Authors: Gallo Alain Dl , Barton Joanne , Parry-Jones William Li. 
Published: October 2008

BackgroundAlthough road traffic accidents are a major cause of injury and death in children and adolescents, research into their psychological consequences consists mainly of case reports.MethodA prospective study was made of young road traffic accident victims; 57 subjects, aged 5–18 years, who had been injured in road traffic accidents, and their parents, were interviewed 2–16 days post-accident and re-examined after 12–15 weeks.ResultsPost-accident stress symptoms occurred at both times. There was a decrease of symptom severity between the two interviews, but at the later time, 14% still suffered from moderate or severe post-traumatic stress disorder, 17% from serious traffic-related fears, and parents reported increased mood disturbance in their children compared with the pre-accident period. High levels of distress during and immediately after the accident were associated with severe post-traumatic stress symptoms.ConclusionsThere is an urgent need for healthcare staff working with children and adolescents involved in road traffic accidents to be aware of the potential psychological consequences and the importance of the immediate accident experience on subsequent coping.
Epidemiology of psychiatric disorders in elderly compared with younger adults with learning disabilities
Authors: Cooper Sally-Ann 
Published: October 2008

BackgroundThe literature regarding psychiatric illness among elderly people with learning disabilities is limited and conflicting because of methodological differences. There have been no recent studies comparing psychiatric epidemiology between younger and older adults with learning disabilities, using the same methodology and definitions.MethodComprehensive psychiatric examination using a semi-structured rating scale was undertaken on everyone with learning disabilities, aged 65 years or over (n= 134), living in a defined geographical area. Comparison was made with a randomly selected control group of adults with learning disabilities aged 20–65 years (n=73) drawn from the same geographical area.ResultsElderly people with learning disabilities have a greater prevalence of psychiatric morbidity than younger controls (68.7v. 47.9%). Rates for depression and anxiety disorders are high, and dementia is common: there are equal rates for schizophrenia/delusional disorders, autism and behaviour disorders in the two groups.ConclusionsThe higher psychiatric morbidity among elderly (compared with younger) people with learning disabilities has not previously received adequate recognition. This warrants further investigation by service planners and clinicians.
Guilty but insane: the insanity defence in Ireland, 1850–1995
Authors: Gibbons Pat , Mulryan Niamh , O'Connor Art 
Published: October 2008

BackgroundThis is a retrospective study describing sociodemographic and clinical characteristics of an almost complete sample of insanity acquittees in Ireland between 1850 and 1995.MethodCase records and legal files were examined for each of the 437 patients admitted to the Central Mental Hospital under guilty but insane criteria, and a profile of sociodemographic, forensic and clinical data completed on each.ResultsThe number of insanity acquittees has fallen five-fold since the 19th century. Acquittees were usually single males from rural areas, aged in their 30s, who had committed a violent crime while suffering from a major psychiatric illness. Female insanity acquittées were relatively few in number and were equally likely to have been charged with violent crime, especially against their own children. The mean length of detention was 14.5 years.ConclusionsThe insanity defence is rarely used in Ireland, is largely confined to serious offences (especially homicide), and generally results in prolonged detention.
Autistic traits in adults with learning disabilities
Authors: Bhaumik Sabyasachi , Branford David , McGrother Catherine , Thorp Catherine 
Published: October 2008

BackgroundAlthough many adults with learning disabilities show features of autistic syndrome, there have been very few population-based studies. We explored the prevalence of autistic traits and their association with maladaptive behaviours in a geographically defined population of adults with learning disabilities.MethodThe carers of 220l adults with learning disabilities were interviewed, and information was sought concerning aspects of their behaviour and ability. Individuals were scored according to the number of core autistic traits displayed. The prevalence of autistic traits was examined in respect of aspects of behaviour and ability.ResultsAutistic traits were common among adults with learning disabilities. Those with a higher number of autistic traits were more likely to be profoundly learning disabled and demonstrate awide range of challenging behaviours.ConclusionsMany adults with learning disabilities demonstrate autistic traits. The relationship of autistic traits with challenging behaviour has major implications in service planning and delivery.
The effect of Citalopram in panic disorder
Authors: Wade A. G. , Lepola U. , Koponen H. J. , Pedersen V. , Pedersen T. 
Published: October 2008

BackgroundCitalopram is a serotonin reuptake inhibitor which has been demonstrated to be highly selective and with a superior tolerability profile to the classical tricyclic antidepressants. This study was designed to test whether there was any difference in eff icacy in the management of panic disorder (PD) between Citalopram and placebo.MethodThis was a double-blind, placebo and clomipramine controlled, parallel group eight-week study. A total of 475 patients with PD, with or without agoraphobia, were randomised to treatment with either placebo, clomipramine 60 or 90 mg/day, or Citalopram 10 or 15 mg/day, 20 or 30 mg/day, or 40 or 60 mg/day. Doses were increased over the first three weeks, stabilised during the fourth week and fixed between weeks five and eight.ResultsTreatment with Citalopram at 20 or 30 mg, 40 or 60 mg and clomipramine were significantly superior to placebo, judged by the number of patients free of panic attacks in the week prior to the final assessment. All rating scales examined suggested that Citalopram 20 or 30 mg was more effective than Citalopram 40 or 60 mg.ConclusionThe most advantageous benefit/risk ratio for the treatment of PD was associated with citalopram 20 or 30 mg/day.
Social networks and service use among representative cases of psychosis in South London
Authors: Becker Thomas , Thornicroft Graham , Leese Morven , McCrone Paul , Johnson Sonia , Albert Maya , Turner David 
Published: October 2008

BackgroundLarge social networks in patients with severe mental illness have been reported to be associated with a low rate of hospitalisation. We aim to determine whether social network size is related to the likelihood of hospitalisation and the amount of service use.MethodAs part of a prospective controlled study, baseline interview data for a random sample of one-year prevalent cases with non-organic psychosis were analysed with respect to social network characteristics and service use during a six-month period.ResultsThe likelihood of hospitalisation decreased with an increase in network size, while the number of services used by patients grew as the social network size increased.ConclusionsWhile larger social networks may be associated with a lower likelihood of hospitalisation, they may also be related to wider use of non-hospital services.
Cost of community care for older people
Authors: Livingston Gill , Manela Monica , Katona Cornelius 
Published: October 2008

BackgroundThere has been no published study that considers actual costs in a representative sample of people aged ???? 65 years. The present study describes the financial cost of formal community services for elderly people with dementia, depression, anxiety disorders or physical disability.MethodPsychiatric morbidity, physical disability and services received were assessed by standardised questionnaire in randomly selected Islington enumeration districts. Subjects were interviewed at home (.=700).ResultsDementia was the most expensive disorder per sufferer in terms of formal services. Those with depression were also high users of health services. Despite presenting to health services, 90% were not treated with appropriate drugs. In contrast, social services were received by people who were activity-limited or with dementia. The highest service cost for the population as a whole was for the physically disabled. In multivariate analysis the significant predictors of high service costs were living alone, being physically ill, depression, dementia and increasing age.ConclusionsFailure to detect and treat depression and the anxiety disorders in older people, despite their presentation to medical services, may have major economic consequences as well as contributing to individual suffering.
Efficacy and safety of acamprosate in the treatment of detoxified alcohol-dependent patients
Authors: Pelc I. , Verbanck P. , Bon O. Le , Gavrilovic M. , Lion K. , Lehert P. 
Published: October 2008

BackgroundAcamprosate is a newly registered drug that appears to reduce alcohol-drinking in both animal models and clinical conditions.MethodIn order to assess the efficacy and safety of the drug in the treatment of detoxified alcoholics, we performed a 90-day double-blind trial comparing two dosages of acamprosate (1332 mg/day and 1998 mg/day).ResultsFor all efficacy parameters, acamprosate appeared to be significantly superior to placebo, with a trend towards a better effect at the higher dosage. Furthermore, acamprosate appeared to be extremely safe.ConclusionThis study confirms that acamprosate could be an interesting adjuvant for maintaining abstinence in detoxified alcoholics.
Helpfulness of interventions for mental disorders: Beliefs of health professionals compared with the general public
Authors: Jorm Anthony F. , Korten Ailsa E. , Jacomb Patricia A. , Rodgers Bryan , Pollitt Penelope , Christensen Helen , Henderson Scott 
Published: October 2008

BackgroundThe study aimed to compare the beliefs of health professionals about the potential helpfulness of various mental health interventions with those of the general public.MethodSurveys were carried out in Australia of 872 general practitioners, 1128 psychiatrists, 454 clinical psychologists and 2031 members of the public. Respondents were presented with a case vignette describing either a person with depression or one with schizophrenia. Respondents were asked to rate the likely helpfulness of various types of professional and nonprofessional help and of pharmacological and non-pharmacological interventions.ResultsThe professionals gave much higher ratings than the public to the helpfulness of antidepressants for depression, and of antipsychotics and admission to a psychiatric ward for schizophrenia. Conversely, the public tended to give much more favourable ratings to vitamins and minerals and special diets for both depression and schizophrenia, and to reading self-help books for schizophrenia.ConclusionThe beliefs that health practitioners hold about mental disorders differ greatly from those of the general public. There is a need for mental health education campaigns to help close the gap between professional and public beliefs.
Poor memory, negative symptoms and abnormal movements in never-treated Indian patients with schizophrenia
Authors: McCreadie R. G. , Latha S. , Thara R. , Padmavathi R. , Ayankaran J. R. 
Published: October 2008

BackgroundCognitive impairment, frequently found in patients with schizophrenia, may be associated with negative symptoms and dyskinesia. However, antipsychotic medication may be a confounding variable. These putative associations may be clarified by examining never-treated patients.MethodNever-treated elderly schizophrenic patients (n=19) living in south-east India were compared with treated patients (n=25) and normal subjects (n=55). Memory was assessed by the Wechsler Memory Scale, negative symptoms by the Positive and Negative Syndrome Scale, and dyskinesia by the Abnormal Involuntary Movements Scale.ResultsNormal subjects had a higher mean memory quotient than patients. There were no significant differences between never-treated and treated patients. Negative symptoms were associated with a poorer memory in the never-treated group. There was no association between memory and dyskinesia.ConclusionsThere is an association in never-treated patients between a poorer memory and negative symptoms, but not between a poorer memory and dyskinesia.
Age-related cognitive decline and vision impairment affecting the detection of dementia syndrome in old age
Authors: Reischies Friedel M. , Geiselmann Bernhard 
Published: October 2008

BackgroundCurrently the Mini Mental State Examination (MMSE) is widely used as a screening instrument for dementia syndrome. Diagnostic validity may be lowered in old age by normal age-related cognitive decline. Furthermore, visual impairment, occurring frequently in old age, leads to missing values which prevent an interpretation of the test result.MethodIn the Berlin Ageing Study (n=516, age range 70–103 years) MMSE and clinical dementia diagnosis, made by a psychiatrist investigating all subjects by the Geriatric Mental State–A and History and Aetiology Schedule interviews, were investigated independently. The MMblind was analysed, an MMSE version for vision impairment in which all items requiring image processing are omitted. The study sample is population-based; dementia cases (DSM–III–R) were excluded on the basis of the clinical diagnosis.ResultsNorms are reported for very old age regarding MMSE as well as MMblind. There is a considerable age effect on MMSE scores. In contrast to MMSE, sensitivity and specificity of the shorter MMblind version are not reduced.ConclusionsThe considerable age effect requires the adaptation of cut-off values for old age. The blind version of the MMSE seems to be a valid instrument improving the applicability of the MMSE in old age.
Costs of schizophrenia
Authors: Knapp Martin 
Published: October 2008

BackgroundSchizophrenia is a common and burdensome illness, with implications not only for the health service but for a host of other care agencies – public and private – as well as for patients, families and the wider society.MethodThe paper reviews available UK evidence on the cost of schizophrenia (broadly defined) and on the cost-effectiveness of treatment options and alternative care arrangements. New evidence potentially alters our view of the costs of this illness.ResultsAggregating the identifiable direct and indirect costs of schizophrenia for England suggests an annual cost of £2.6 billion, but even this sum omits some indirect impacts which cannot currently be costed. Just over half the identified total is accounted for by the direct costs falling to the NHS, local authorities, charities and the criminal justice system. In helping to tackle this cost burden, there is now a body of evidence on cost-effective community care arrangements, antipsychotic drugs and psychological interventions.ConclusionsAlthough the costs of schizophrenia are considerable, there are treatments and care arrangements which can reduce this aggregate burden while maintaining or improving effectiveness.
Test of Xq26.3–28 linkage in bipolar and unipolar affective disorder in families selected for absence of male to male transmission
Authors: Smyth Ciaran , Kalsi Gursharan , Brynjolfsson Jon , O'Neill Jane , Curtis David , Rifkin Larry , Moloney Eamon , Murphy Patrice , Petursson Hannes , Gurling Hugh 
Published: October 2008

BackgroundThere have been several reports of linkage between genetic markers on the X chromosome at Xq26.3-28 and bipolar affective disorder in family samples obtained from distinct ethnic and geographical origins. As part of a genome search in a series of 23 UK and Icelandic families, specifically selected for their large size and power to resolve the issue of linkage heterogeneity, we have tested the hypothesis that there is a locus for a genetic subtype of bipolar affective disorder which is linked to this region.MethodIn families selected on the basis of absent male to male transmission for affective disorder, we performed two-point and FASTMAP multipoint linkage analyses with markers spanning the region between the genetic loci DXS102 and F8ResultsWe found negative lod scores for several models of affection status in families selected under stringent and relaxed criteria for the absence of male to male transmission.ConclusionsIn the family sample we have obtained, our study provides no support for the presence of a locus increasing genetic susceptibility to bipolar affective disorder in this region of the X chromosome. It is likely that our finding reflects heterogeneity of linkage for bipolar and genetically related unipolar disorder that exists in specific ethnic populations. Alternatively the X-linked subtype of the disorder may have been present only in a few of our small families resulting in loss of power to detect the Xq26.3-28 linked subtype.
Recurrence in affective disorder
Authors: Kessing Lars Vedel , Bolwig Tom Gert , Andersen Per Kragh , Mortensen Preben Bo 
Published: October 2008

BackgroundIn recent years, studies of the risk of recurrence in affective disorder in relation to the number of prior episodes have given contradictory results.MethodSurvival analysis was used to calculate the rate of recurrence after successive episodes in a case register study including all hospital admissions with primary affective disorder in Denmark during 1971–1993. A total of 20 350 first-admission patients were discharged with a diagnosis of affective disorder, depressive or manic/cyclic type.ResultsThe rate of recurrence increased with the number of previous episodes in both unipolar and bipolar disorder. Initially, the two types of disorders followed markedly different courses, but later in the course of the illness the rate of recurrence was the same for the two disorders.ConclusionsThe course of severe unipolar and bipolar disorder seems to be progressive in nature despite the effect of treatment.
Treatment of severe clozapine-induced neutropenia with granulocyte colony-stimulating factor (G-CSF)
Authors: Sperner-Unterweger B. , Czeipek I. , Gaggl S. , Geissler D. , Spiel G. , Fleischhacker W. W. 
Published: October 2008

BackgroundA 17-year-old boy suffering from a severe schizophrenic disorder of the paranoid type and mental retardation did not respond to treatment with typical antipsychotics, whereas under clozapine treatment he showed a favourable response. Discontinuation of clozapine led to an acute psychotic relapse. During clozapine treatment the patient developed severe neutropenia.Method and ResultsDue to the history of unsatisfactory response to traditional antipsychotics, clozapine treatment was continued despite white blood cell (WBC) decline. Concomitant treatment with G-CSF was followed by a rapid normalisation of WBC.ConclusionsThis case report is not intended to challenge the clinical practice of discontinuing clozapine upon the development of neutropenia/agranulocytosis, but rather to stimulate further research in the pathophysiology and clinical consequences of a clozapine rechallenge after a WBC decline, especially in patients with a rather complex symptomatology where no sufficient therapeutic results can be achieved with any other pharmacological intervention than clozapine.
Behaviour phenotype for Down's syndrome
Authors: Collacott Richard A. , Cooper Sally-Ann , Branford David , McGrother Catherine 
Published: October 2008

BackgroundFor more than a century, the idea of particular personality/behavioural characteristics being associated with people with Down's syndrome has been explored, but with inconclusive results.MethodThe Disability Assessment Schedule was used to ascertain the behavioural profiles of 360 adults with Down's syndrome and 1829 adults with learning disabilities of other aetiologies, who were the whole identified population within a defined geographical area. Comparison was made between the two total groups and additionally for the subgroups aged < 35 years and aged ⩾35 years. Comparison was also made with regards to cluster analysis findings.ResultsDespite an equal age and developmental quotient, the Down's syndrome group were less likely to demonstrate maladaptive behaviours. The behaviour characteristics of the adults with Down's syndrome remained constant in the younger and older age groups. Cluster analysis demonstrated adults with Down's syndrome to have an increased prevalence in cluster groupings with lower rates of maladaptive behaviours.ConclusionsThis study confirms there to be a behaviour phenotype among adults with Down's syndrome. The reasons for this (e.g. genetic/psychological/social) require further research. Such research may establish a better understanding of the aetiologies of maladaptive behaviours among people with learning disabilities in general.
Epilepsy and non-organic non-affective psychosis
Authors: Bredkjær Søren , Ensen Pre Ben Bo Mort , Parnas Josef 
Published: October 2008

BackgroundThis study tests the hypothesis that epilepsy increases the risk of developing schizophrenia and other non-affective functional psychoses using a nationwide sample of people with epilepsy.MethodA record linkage study between a sample from the National Patient Register, consisting of 67 116 people with epilepsy, and the Danish Psychiatric Register identified all people with non-affective psychoses with onset after the first epilepsy diagnosis. The relation between risk of psychiatric disorder in people with epilepsy and the general Danish population was estimated.ResultsThe incidences of the spectrum of non-organic non-affective psychosis, non-affective psychosis and schizophrenia were significantly increased both for men and women, even after exclusion of people diagnosed as suffering from a learning disability or substance misuse.ConclusionThis study supports the notion of an association between epilepsy and the risk of subsequent non-affective psychosis.