bluuebunny/crossref_metadata_2025_split huggingface dataset:
Improving the Quality of Statistics in Psychiatric Research
Authors: Hand David , Sham Pak 
Published: October 2008

David HandThe paper by McGuigan in this issue of the BJP examines the frequency of errors in statistical methods presented in papers published in the BJP in 1993. In that year, 248 papers appeared, 164 contained numerical results, and 65 of these contained statistical errors. So, one might infer, some 26% of the papers in the BJP draw potentially doubtful conclusions. Moreover, the level of misunderstanding implied by some of the examples McGuigan cites is frightening.
Media Influence on Parasuicide
Authors: Simkin Sue , Hawton Keith , Whitehead Linda , Fagg Joan , Eagle Matthew 
Published: October 2008

BackgroundParacetamol self-poisoning, which carries a significant risk of fatal liver damage, is increasing in the UK, especially among adolescents. There is concern that media portrayal of suicidal behaviour may influence its occurrence. We have investigated the effects of two broadcasts of a television drama showing a teenage girl's overdose of paracetamol.MethodData from the Oxford Monitoring System for Attempted Suicide were used to examine changes in the number of overdoses and the use of paracetamol in the three week period before and after both broadcasts. An analysis of log-linear models was carried out, using additional data from two previous years, in order to control for the effects of gender, age group, time period, season, year and drug. A questionnaire was used to ascertain whether the programme had influenced patients' decisions to take an overdose or their choice of drug.ResultsAn increase in paracetamol overdoses occurred following the first broadcast, but when data from the two previous years were examined and the log-linear analysis was used there was no evidence of significant effects attributable to the broadcasts. The questionnaire study revealed that very few people had seen either episode, and only two claimed that it had influenced them (one in terms of getting help).ConclusionsIt is important to use sound methodology to avoid interpreting chance fluctuations as a media effect. The potential positive benefits of such programmes should also be investigated.
Correlates and Short-Term Course of Self-Poisoning in Adolescents
Authors: Kerfoot Michael , Dyer Elizabeth , Harrington Val , Woodham Adrine , Harrington Richard 
Published: October 2008

BackgroundThe features of adolescents who had taken an overdose were assessed to determine the focus for a treatment trial.MethodOverdose cases were compared with psychiatric and community controls who had not taken an overdose in respect of mental disorders and family background.ResultsOverdose cases had high rates of major depression, but most of them recovered from depression within six weeks of the overdose. There was a specific association between taking an overdose and family dysfunction.ConclusionsFamily dysfunction could be a useful focus in a clinical trial of the aftercare of adolescents who have taken an overdose.
Psychopathology, Social and Cognitive Functioning in a Hostel for Homeless Women
Authors: Adams Clive E. , Pantelis Christos , Duke Peter J. , Barnes Thomas R. E. 
Published: October 2008

BackgroundThis study surveyed all residents in a hostel for homeless women. Demographic data, and information on past and present psychiatric and social morbidity and current and premorbid cognitive functioning were collected.MethodA four week prevalence study using: SCID–PD; a semi-structured interview; GHQ; SBS; Manchester Scale; MMSE; and NART; the data were analysed using SPSS.ResultsThe women originated from across the social spectrum and disruption of early family life was common. Fifty per cent had a ‘severe mental illness’ and most were not receiving drug treatment. High levels of active psychotic symptoms were present. Women with psychosis had suffered a greater intellectual decline from their premorbid levels of functioning than those without psychosis.ConclusionsThe study affirmed findings of earlier studies employing case-series methodology. Women with high levels of psychiatric morbidity and social dysfunction were being managed by care workers in a way that may promote stability rather than a drift into street-life.
Perceptions of the Significant Other of the Effects of Psychodynamic Psychotherapy
Authors: Roberts Jane 
Published: October 2008

BackgroundClinical practice suggests that partners of psychotherapy patients often have powerful feelings about the therapy and therapist. The repercussions of psychotherapy on those close to the patient are rarely considered. A small exploratory study was therefore conducted.MethodAll patients who had completed at least two months of weekly psychodynamic psychotherapy in 1990 at an out-patient unit of a psychiatric hospital (n = 35) and had a partner with whom they were living at the time of starting therapy (n = 23) were contacted. Eight gave permission for their partner to be contacted directly. All eight partners agreed to participate in a semi-structured interview exploring their perceptions of the effects of the therapy on a number of family relationships. The impact of the process of the study was also investigated by means of a questionnaire sent to all partners some weeks after the interview.ResultsConsiderable changes were perceived to have taken place in association with therapy affecting not only the relationship between the couple but also their parenting relationship, the children, and at times members of the extended family. Partners' views about the direction of such changes seemed to influence other perceptions about the therapy.ConclusionsThe repercussions of individual psychotherapy may well spread extensively within a family. This further blurs the boundary between individual and family therapy, both theoretically and clinically. Research procedures are themselves a major intervention and may have a considerable emotional impact on participants.
Minor Physical Anomalies and their Relationship to the Aetiology of Schizophrenia
Authors: Murphy Kieran C. , Owen Michael J. 
Published: October 2008

BackgroundPrevious reports have suggested an increased prevalence of minor physical anomalies (MPAs) in schizophrenia.MethodA review of the literature was performed to examine the relationship between MPAs, schizophrenia and other disorders.ResultsPrevious studies demonstrate a number of methodological shortcomings. Moreover, MPAs are found in several other psychiatric disorders. Proponents of the neurodevelopmental model of schizophrenia have focused on an environmental explanation for the increased prevalence of MPAs. We argue that this may be overly simplistic and propose various ways in which genetic factors may also be involved.ConclusionsBetter studies should be performed to examine more precisely the nature of MPAs in schizophrenia and other disorders and also the relationship between MPAs and other developmental abnormalities. At present, it is unclear if MPAs are directly related to the pathogenesis of the disorder or even if they are related to the timing of critical events.
Moclobemide in Elderly Patients with Cognitive Decline and Depression: An International Double-blind, Placebo-controlled Trial
Authors: Roth M. , Mountjoy C. Q. , Amrein R. ,   The International Collaborative Study Group
Published: October 2008

BackgroundThe new reversible MAOI moclobemide was compared with placebo in the treatment of elderly patients with DSM–III diagnosis of dementia and/or of major depression.MethodSix hundred and ninety-four elderly patients with symptoms of depression and cognitive decline entered an international, multi-centre, double blind trial in which they were randomly allocated to treatment with either moclobemide 400 mg daily or placebo for 42 days. Five hundred and eleven patients met DSM–III criteria for dementia and were also depressed (DEM+D); 183 did not meet DSM–III criteria for dementia but met the criteria for DSM–III major depressive episode and also suffered from cognitive decline (MDE+CD).ResultsAnalysis of the 17 and 24-item Hamilton Depression Scale scores showed that moclobemide, compared with placebo, produced significantly greater improvement in both the demented and depressed groups (P= 0.001 both diagnostic groups). There was an improvement in cognitive function as measured by the SCAG Factor 1 in moclobemide treated patients (P= 0.005 DEM+D;P= 0.02 MDE+CD). There was no evidence of decline in cognitive function as the result of treatment Clinical global assessment of tolerance was ‘excellent’ and ‘good’ in 88% of the moclobemide and in 92% of the placebo treated patients. The proportion of patients discontinuing treatment prematurely was similar in both treatment groups. There were no significant differences in side-effects between treatment groups. There were no significant changes in vital signs, ECG or laboratory findings in either treatment group. There were no dietary restrictions and no report of any tyramine reaction.ConclusionsMoclobemide was shown to be a safe, well tolerated and effective antidepressant, which did not cause impairment of cognitive function in elderly patients with a DSM–III diagnosis of dementia and/or DSM–III major depression.
Social Phobia in General Health Care: An Unrecognised Undertreated Disabling Disorder
Authors: Weiller E. , Bisserbe J. -C. , Boyer P. , Lepine J. -P. , Lecrubier Y. 
Published: October 2008

BackgroundThis study explored the prevalence of social phobia (SP) in general health care, sociodemographic characteristics of patients with SP, the age at onset and severity of SP, its comorbidity with other psychiatric disorders, and the recognition by general practitioners.MethodThe study was conducted in Paris as part of the WHO study on Psychological Problems in General Health Care. Among 2096 consecutive primary care patients, 405 were interviewed using the CIDI. DSM–III–R diagnoses, severity and disability were assessed.ResultsThe one-month prevalence of SP is high (4.9) in primary care, although underdiagnosed by GPs. It has an early onset and leads to substantial disability. Patients with SP are at risk of developing further depression, alcoholism or suicidal behaviour.ConclusionSP appears to be a true and frequently severe pathological condition. The awareness of GPs and the general population should be improved.
Community Knowledge of Mental Illness and Reaction to Mentally Ill People
Authors: Wolff Geoffrey , Pathare Soumitra , Craig Jom , Leff Julian 
Published: October 2008

BackgroundWe test the hypothesis that negative attitudes to mentally ill people may be fuelled by a lack of knowledge.MethodA census of knowledge of mental illness was conducted in two areas prior to the opening of long-stay supported houses for the mentally ill in each area. Three attitudinal factors (Fear and Exclusion, Social Control and Goodwill) which had been extracted by factor analysis of the Community Attitudes toward the Mentally III (CAMI) inventory (see previous paper) were analysed in respect of their associations with knowledge of mental illness.ResultsMost respondents (80%) knew of somebody who had a mental illness but a substantial proportion of respondents had little knowledge about mental illness. Social Control showed an association with knowledge of mental illness. Groups who showed more socially controlling attitudes (especially those over 50 years old, those of lower social class, and those of non-Caucasian ethnic origin) had less knowledge about mental illness. Regression analysis revealed that when knowledge was taken into account age had no effect on Social Control, and the effect of social class and ethnic origin was diminished Respondents with children, who showed more Fear and Exclusion, were not less knowledgeable about mental illness.ConclusionsThe results support the hypothesis that negative attitudes, especially in older people, are fuelled by a lack of knowledge. Negative attitudes among people with children are not related to a lack of knowledge.
The Impact of Education Groups for People with Schizophrenia on Social Functioning and Quality of Life
Authors: Atkinson Jacqueline M. , Coia Denise A. , Gilmour W. Harper , Harper Janice P. 
Published: October 2008

BackgroundEducation groups for people with schizophrenia have tended to concentrate on compliance with medication. This study examines impact on social behaviour and quality of life.MethodA catchment-wide service was set up for community-based patients. Patients who indicated an interest in education groups were randomly allocated to either an education group or a waiting list control group. Those who attended groups were compared with the control group.ResultsAbout one-quarter of community-based patients showed interest in attending education groups. Those who attended showed no change in mental state or compliance with medication (already high) but significant gains in quality of life, social functioning and social networks.ConclusionsFor patients who choose to attend education groups significant gains in social functioning and quality of life are possible without specific skills training.
Testing the Effect of Season of Birth on Familial Risk for Schizophrenia and Related Disorders
Authors: Hettema John M. , Walsh Dermot , Kendler Kenneth S. 
Published: October 2008

BackgroundAn excess of late winter and early spring births in schizophrenia has been repeatedly demonstrated. Previous evidence has suggested that the risk for schizophrenia may differ in relatives of schizophrenic probands born in this high risk period v. at other times of the year.MethodIn an epidemiologically based family study conducted in the west of Ireland, we examined the relationship between season of birth in schizophrenia and schizophrenia spectrum probands and the risk for schizophrenia and related disorders in first-degree relatives. Risk was assessed using the Cox proportional hazard method. We examined four birth seasons previously shown to significantly predict risk for schizophrenia.ResultsNeither the risk for schizophrenia nor that for schizophrenia spectrum disorders in relatives was significantly associated with season of birth in probands.ConclusionsSeason of birth does not, in this sample, identify schizophrenic probands with particularly high or low familial vulnerability to illness.
Quality of Life as an Evaluative Measure in Assessing the Impact of Community Care on People with Long-Term Psychiatric Disorders
Authors: Barry Margaret M. , Crosby Charles 
Published: October 2008

BackgroundThe impact of community resettlement on the quality of life of people with long-term psychiatric disorders, is evaluated in a longitudinal study.MethodA repeated measures design was used to examine the sensitivity of an adapted version of Lehman's Quality of Life Interview in evaluating change. Completed interviews were carried out with 29 of the original cohort at one year post-discharge. The relationship between quality of life and ratings of client functioning is explored.ResultsSignificant changes in the objective quality of life indices include improved living conditions (F = 40.00, P < 0.001), higher levels of social contact (F = 29.52, P < 0.01) and increased leisure activities (F = 4.57, P < 0.05). Apart from increased satisfaction with living situation (F = 6.94, P < 0.01), there were no significant changes in the subjective indices. Ratings of psychiatric state and social functioning did not significantly correlate with global quality of life at one year post-discharge.ConclusionsConcerns in relation to the sensitivity of life satisfaction ratings in evaluating programme interventions are raised.
Abnormal Movements in Never-Medicated Indian Patients with Schizophrenia
Authors: McCreadie R. G. , Thara R. , Kamath S. , Padmavathy R. , Latha S. , Mathrubootham N. , Menon M. S. 
Published: October 2008

BackgroundHistorical records suggest dyskinesia was observed in severely ill institutionalised patients with schizophrenia in the pre-neuroleptic era More recent work has not found dyskinesia in never-medicated younger and middle aged patients. The present study complements this recent work and avoids the confounders of severity of illness and institutionalism by examining elderly patients in a wide variety of community settings.MethodMovement disorders were examined in 308 elderly individuals in Madras, India, using the Abnormal Involuntary Movements Scale, the Simpson and Angus Parkinsonism Scale and the Barnes Akathisia Scale. Patients' mental state was assessed by the Positive and Negative Syndrome Scale.ResultsDyskinesia was found in 15% of normal subjects (n=101, mean age 63 years), 15% of first degree blood relatives of younger schizophrenic patients (n=103, mean age 63 years), 38% of never medicated patients (n=21, mean age 65 years) and 41 % of medicated patients (n=83, mean age 57 years). The respective prevalences for Parkinsonism were 6%, 11 %, 24% and 36%; and for akathisia 9%, 5%, 21 % and 23%. Dyskinesia was associated with negative schizophrenic symptoms.ConclusionsDyskinesia in elderly schizophrenic patients is an integral part of the illness and not associated with antipsychotic medication.
Prolactin Response to Fenfluramine and Suicide Attempt Lethality in Major Depression
Authors: Malone Kevin M. , Corbitt Elizabeth M. , Li Shuhua , Mann J. John 
Published: October 2008

BackgroundThis study employed an alternative method for assessing serotonergic function to further evaluate our finding that cerebrospinal fluid (CSF) 5-hydroxyindole acetic acid (5-HIAA) in depressed suicide attempters with a lifetime history of higher lethality suicide attempts is significantly lower compared to depressed patients who have a history of low lethality suicide attempts.MethodWe used dl-fenfluramine (60 mg) as a neuroendocrine probe to examine the serotonin system in 41 in-patients with a DSM–III–R major depressive episode, divided into two groups on the basis of a lifetime history of high or low lethality suicide attempts. Fenfluramine challenge test outcome was defined as the maximum prolactin response in the five hours following fenfluramine.ResultsPatients with a history of a higher lethality suicide attempt had a significantly lower prolactin response to fenfluramine, even when controlling for cortisol, age, sex, weight, comorbid cluster B personality disorder, pharmacokinetic and menstrual cycle effects.ConclusionsThe data provide further support for the hypothesis that serotonin dysfunction is associated with more lethal suicide attempts, and suggests that higher lethality suicide attempters or failed suicides resemble completed suicides both behaviourally and biochemically.
The Reliability and Characteristics of the Brief Syntactic Analysis
Authors: Thomas Philip , Kearney Gabby , Napier Elizabeth , Ellis Elin , Leudar Ivan , Johnston Margaret 
Published: October 2008

BackgroundLinguistic analysis is of great potential benefit to psychiatry as a research and assessment tool, but the skill and time it demands means that it has not been widely used. This paper describes a much simplified form of syntactic analysis.MethodA detailed protocol for the Brief Syntactic Analysis (BSA) was written, based on earlier work by Morice and Ingram. Three psychiatrists were trained in its use, and inter-rater reliability established through independent ratings of 12 transcripts taken from a mixed group of psychiatric patients and a group of non-psychiatric controls. Concurrent reliability of the BSA against the Morice and Ingram analysis was established by comparing measures from the two methods on 16 transcripts of mixed patients.ResultsThere were high levels of agreement between the three psychiatrists and between the BSA and the Morice and Ingram analysis, although one-way ANOVA indicated that for some variables there were small but statistically significant absolute differences between the two. The reasons for this were discussed. A principal components analysis confirmed the presence of three factors corresponding closely to the three families of linguistic variables.ConclusionsThe results indicate that psychiatrists can be trained to use a syntactic analysis with high levels of agreement. The BSA, which takes much less time to complete, produces measures that are comparable with the original analysis from which it was derived.
Somatisation in Primary Care in Spain
Authors: Lobo Antonio , García-Campayo Javier , Campos Ricardo , Marcos Guillermo , Pérez-Echeverria Ma Jesus ,   the GMPPZ
Published: October 2008

BackgroundThis is the first attempt to study the prevalence and clinical characteristics of somatisation (ST) in a representative primary care sample in Spain.MethodThe sample consisted of 1559 consecutive patients attending eight randomly selected health centres in Zaragoza, Spain, examined by two-phase screening. First phase (lay interviewers): Spanish versions of GHQ–28, CAGE questionnaire, substance abuse, Mini-Mental State Examination. Second phase (research clinicians and psychiatrists): Standardised Polyvalent Psychiatric Interview, which permits the reliable coding of Bridges & Goldberg's ST criteria.ResultsThe prevalence of somatisers was 9.4% (34.5% of the cases) and most patients (68.7%) were diagnosed in the depression or anxiety DSM–IV categories. The severity was moderate in 40.1 % and 66.6% were chronic (six or more months). No significant demographic differences were found with non-cases. Backache was the most frequent somatic presentation (71.4%).ConclusionsST in primary care is a much broader phenomenon than categories such as somatoform disorders reflect. It may be less influenced by sociodemographic factors, but more chronic than previously reported.
Validity of the Schizophrenia Diagnosis of the Psychiatric Assessment Schedule for Adults with Developmental Disability (PAS–ADD)
Authors: Moss Steve , Prosser Helen , Goldberg David 
Published: October 2008

BackgroundFirst rank symptoms are central to the diagnosis of schizophrenia, but their complexity makes it difficult to validly detect them in people with learning disability. This report investigates ability of PAS–ADD to detect schizophrenia, validated against expert clinical opinion.MethodThe sample consisted of 98 patients with learning disability, and a key informant for each sample member. Clinical opinions of the referring psychiatrists were sought using a symptom checklist. Reportage of remission, and the number of core schizophrenia symptoms identified, were used to estimate level of symptom activity at time of interview.ResultsThe proportion of schizophrenia cases detected by PAS–ADD increases with the number of active core symptoms identified by the referrer. Where two or more core symptoms were indicated, PAS–ADD detected 71 % cases. The most frequently fulfilled criterion was third-person auditory hallucinations. Six schizophrenia diagnoses disagreed with the clinician, four of which were referred as being hypomania. Overall symptom frequency detected by PAS–ADD was positively correlated with IQ.ConclusionsResults suggest there may be scope for modifying the ICD–10 diagnostic algorithm for use with learning disability, particularly in relation to thedelusionsandnegative symptomscriteria.