bluuebunny/crossref_metadata_2025_split huggingface dataset:
Dysthymia in Clinical Practice
Authors: Akiskal Hagop S. , Costa e Silva Jorge Alberto , Frances Allen , Freeman Hugh L. , Keller Martin B. , Lapierre Yvon D. , Ibor Juan José Lopez , Paykel Eugene S. , Stabl Max ,   The WPA Dysthymia Working Group
Published: October 2008

BackgroundDysthymia has been reconceptualised in recent years from a personality disorder to a chronic affective disorder. It is incorporated into both the DSM and ICD diagnostic systems. Method. The members of the WPA Dysthymia Working Group combined the results of their manual literature searches with a search using Medline.ResultsAvailable data are summarised under the headings of classification, epidemiology, validity, comorbidity, course and outcome, pharmacotherapy and psychotherapy. The coexistence of major depressive disorder, constituting ‘double depression’ is of particular importance.ConclusionsImproved knowledge of this disorder has led to a more positive approach to treatment, in which antidepressants can usefully be complemented by psychosocial measures. A high proportion of cases remain unrecognised in most populations, leading to prolonged morbidity and distress, much of which is now treatable.
Symptoms of Psychoses
Authors: Kitamura Toshinori , Okazaki Yuji , Fujinawa Akira , Yoshino Masahiro , Kasahara Yomishi 
Published: October 2008

BackgroundThe literature on the statistical analysis of symptoms of psychoses was limited to positive and negative symptoms in schizophrenia. The present study explored the relationship between positive and negative symptoms as well as affective symptoms in a wider category of psychotic disorders.MethodThe symptoms of 584 psychiatric patients, consecutively admitted to any of the 95 mental hospitals in Japan, were studied. They manifested at least one of the following: (a) delusions, (b) hallucinations, (c) formal thought disorder, (d) catatonic symptoms, or (e) negative (defect) symptoms.ResultsFactor analysis yielded five factors interpretable as (a) manic symptoms, (b) depressive symptoms, (c) negative (defect) symptoms and formal thought disorders, (d) positive (psychotic) symptoms, and (e) catatonic symptoms.ConclusionThese results suggest that although major symptoms seen among psychotic patients can be categorised into positive, negative, manic, and depressive groups, corresponding to current knowledge of phenomenology, catatonic symptoms constitute a discrete syndrome, while formal thought disorders merge into the negative syndrome.
[18F]FDG PET Study in Obsessive–Compulsive Disorder
Authors: Perani Daniela , Colombo Cristina , Bressi Sergio , Bonfanti Annamaria , Grassi Franco , Scarone Silvio , Bellodi Laura , Smeraldi Enrico , Fazio Ferruccio 
Published: October 2008

BackgroundWe used [18F]FDG and PET in patients with obsessive–compulsive disorder (OCD) to evaluate cerebral metabolic involvement before and after treatment with serotonin-specific reuptake inhibitors.MethodIn 11 untreated, drug-free adults, regional cerebral metabolic rate for glucose (rCMRglu) was compared with that of 15 age-matched normal controls.ResultsrCMRglu values were significantly increased in the cingulate cortex, thalamus and pallidum/putamen complex. After treatment a significant improvement in obsessive–compulsive symptoms on the Y-BOC scale (t= 3.59,P< 0.01) was associated with a significant bilateral decrease of metabolism in the whole cingulate cortex (P< 0.001). Clinical and metabolic data were significantly intercorrelated (Kendall'sτ= 0.65;P< 0.01).ConclusionsThese findings indicate that OCD is associated with functional hyperactivity of a selected neuronal network and that treatment to reduce symptoms may have a selective neuromodulatory effect on cingulate cortex.
The Charles Bonnet Syndrome: A Large Prospective Study in the Netherlands
Authors: Teunisse Robert J. , Cruysberg Johan R. M. , Verbeek André , Zitman Frans G. 
Published: October 2008

BackgroundThe aims were to determine the prevalence of the Charles Bonnet syndrome (CBS) in low-vision patients and analyse possible associated ophthalmic and sociodemographic factors.MethodA semi-structured interview on visual hallucinations was given to 300 adult low-vision patients and 200 elderly general ophthalmic patients. Positive cases were examined with the Geriatric Mental State Schedule and the Mini Mental State Examination. Diagnostic criteria were as follows: complex, persistent, or repetitive visual hallucinations; full or partial retention of insight; no hallucinations in other modalities; and no delusions. Ophthalmic and sociodemographic data were gathered for all patients.ResultsThe prevalence of CBS in low-vision patients was 11%. CBS was significantly associated with an age over 64 years and a visual acuity in the best eye of 0.3 or less. No significant associations with ophthalmic diagnoses, patient sex, marital status, or social circumstances were found.ConclusionOur findings support association of CBS with sensory deprivation and advanced age.
Adolescent Psychiatry Services
Authors: Jaffa Tony 
Published: October 2008

BackgroundThe way in which psychiatric services for adolescents in the UK are developing will be affected by recent changes in the organisation of the National Health Service.MethodThe history of these services, and the different opportunities for development are reviewed.ResultsWays in which high-quality clinical care can still be provided are indicated.ConclusionAdolescent psychiatric services should be judged on their ability to provide such care, not merely on their ability to survive.
Anxiety Disorders After Stroke: Results from the Perth Community Stroke Study
Authors: Burvill P. W. , Johnson G. A. , Jamrozik K. D. , Anderson C. S. , Stewart-Wynne E. G. , Chakera T. M. H. 
Published: October 2008

BackgroundThe prevalence of anxiety disorders in 294 patients who survived to four months in the Perth Community Stroke Study (Perth, Australia), and a follow-up of these patients at 12 months, are presented.MethodDiagnoses are described both in the usual DSM hierarchic format and by a non-hierarchic approach. Adoption of the hierarchic approach alone greatly underestimates the prevalence of anxiety disorders.ResultsMost cases were of agoraphobia, and the remainder were generalised anxiety disorder. The prevalence of anxiety disorders alone was 5% in men and 19% in women; in community controls, it was 5% in men and 8% in women. Adopting a non-hierarchic approach to diagnosis gave a prevalence of 12% in men and 28% in women. When those who showed evidence of anxiety disorder before stroke were subtracted, the latter prevalence was 9% in men and 20% in women.ConclusionOne-third of the men and half of the women with post-stroke anxiety disorders showed evidence of either depression or an anxiety disorder at the time of the stroke. At 12 month follow-up of 49 patients with agoraphobia by a non-hierarchic approach, 51 % had recovered, and equal proportions of the remainder had died or still had agoraphobia. The only major difference in outcome between those with anxiety disorder alone and those with comorbid depression was the greater mortality in the latter.
Effectiveness of Zuclopenthixol Compared with Haloperidol in the Treatment of Behavioural Disturbances in Learning Disabled Patients
Authors: Malt Ulrik F. , Nystad Roy , Bache Torkel , Noren Ole , Sjaastad Mary , Solberg Knut Ove , T⊘nseth Sverre , Zachariassen Peter , Mæhlum Eli 
Published: October 2008

BackgroundWe compared the efficacy of two neuroleptics with different receptor profiles (zuclopenthixol and haloperidol) in learning disabled patients with behavioural disturbance.MethodA double-blind crossover study (2×8 weeks; n = 34), interrupted by a two-week single-blind washout period, was employed. Assessments included the Schedule for Handicaps, Behaviour, and Skills (SHBS) and Clinical Global Impression (CGI).ResultsThe SHBS score was significantly reduced for the zuclopenthixol cohort only. End-point analysis between the two drugs also showed an enhanced effect for zuclopenthixol over haloperidol. CGI scores did not reveal significant differences between the two drugs.ConclusionZuclopenthixol may be superior to haloperidol for the treatment of behavioural disturbances in mentally retarded subjects.
Post-Viral Onset of Anorexia Nervosa
Authors: Park R. J. , Lawrie S. M. , Freeman C. P. 
Published: October 2008

BackgroundThe pathogenesis of anorexia nervosa (AN) is controversial.MethodA retrospective case series was studied to investigate the post-viral onset of AN.ResultsFour consecutive in-patients with severe restrictive AN spontaneously volunteered histories of ‘glandular fever’-like illnesses immediately before the onset of their eating disorder. This association has not previously been described. Possible pathogenic pathways include both non-specific and specific viral disruptions in central homeostasis, particularly involving corticotrophin-releasing hormone (CRH) regulation.ConclusionSuch mechanisms are speculative, but biologically and historically plausible.
Neuropsychiatry and SPECT of an Acute Obsessive–Compulsive Syndrome Patient
Authors: Simpson Steve , Baldwin Bob 
Published: October 2008

BackgroundA 71-year-old man with no previous psychiatric history presented with an acute onset of obsessive–compulsive disorder (OCD) symptoms associated with a right inferior parietal infarct. There were no abnormal neurological signs. There were no noteworthy abnormalities on neuropsychological testing.MethodWhereas a computerised tomography scan showed only a right inferior parietal infarct, a single photon emission computerised tomography (SPECT) scan revealed that in addition to the infarct there was decreased regional cerebral blood flow in the right basal ganglia and temporal areas. There was higher activity in the right orbitofrontal area than in the left.ResultsThe patient improved with standard drug therapy and psychotherapy.ConclusionsSPECT is effective in the diagnosis of neuropsychiatric disorders such as OCD, and the pathological changes in brain metabolism detected by SPECT may be reversed by both drug therapy and psychotherapy.
Child and Adolescent (Juvenile Onset) Schizophrenia
Authors: Hollis Chris 
Published: October 2008

BackgroundThe study tests the hypothesis that juvenile-onset schizophrenia is associated with premorbid developmental impairments. It was predicted that the pattern of developmental impairments would vary with age of onset and with gender.MethodA case-control design was used to examine developmental impairments in 61 consecutive juvenile-onset (age 7–17) referrals with ICD-9 schizophrenia; 61 non-psychotic psychiatric controls were matched on age and gender. Cases and controls were divided into childhood-onset (age 7–13) and adolescent-onset (age 14–17).ResultsThe schizophrenic cases had a significantly higher risk of premorbid social (χ2 = 9.1, P<0.005), motor (χ2 = 9.1, P<0.005) and language impairments (χ2 = 10.1, P<0.005). Specific impairments of language production and comprehension were associated with childhood-onset schizophrenia and were independent of gender.ConclusionsJuvenile-onset schizophrenia is associated with a range of developmental antecedents. There may be a specific link between cases with a very early onset and an impairment in the processes underlying the development of language.
Increased Risk of Affective Disorders in Males after Second Trimester Prenatal Exposure to the Dutch Hunger Winter of 1944–45
Authors: Brown Alan S. , Susser Ezra S. , Lin Shang P. , Neugebauer Richard , Gorman Jack M. 
Published: October 2008

BackgroundPrenatal and perinatal factors have been linked to affective disorders. We therefore undertook an exploratory study to determine whether prenatal exposure to severe famine was associated with an increased risk of affective disorders.MethodMonthly birth cohorts that were exposed and unexposed to the Dutch Hunger Winter of 1944–45 were identified. The cumulative incidences of affective psychoses and neurotic depression (ICD–9 criteria) were compared between exposed and unexposed cohorts during each trimester of gestation.ResultsThe relative risk (RR) of affective psychosis (broad and restricted definitions) among persons exposed to famine during the second trimester was significantly increased (broad: RR (95% confidence interval) = 1.62 (1.19, 2.20); restricted: 1.59 (1.14, 2.21)). Separate analysis by gender showed a significant association among males (broad: 2.26 (1.43, 3.57); restricted: 2.40 (1.49, 3.89)), but not females (broad: 1.28 (0.84, 1.94); restricted: 1.17 (0.73, 1.86)). The risk of neurotic depression was not increased after prenatal famine exposure.ConclusionsThese results suggest a possible relationship between prenatal famine during the second trimester and affective psychosis, lending plausibility to reports that have associated affective psychoses with prenatal exposures. Further studies of this relationship are warranted.
A Brief Mental Health Outcome Scale
Authors: Jones Steven H. , Thornicroft Graham , Coffey Michael , Dunn Graham 
Published: October 2008

BackgroundThe Global Assessment of Functioning (GAF) is a quick and simple measure of overall psychological disturbance. However, there is little research on the reliability and validity of this measure in severely mentally ill populations.MethodMultidisciplinary keyworkers assessed 103 patients at monthly intervals over a 6-month period. Overall GAF scores were obtained, with additional separate ratings for symptoms and disability. These were compared with changes in antipsychotic medication and support needs over the same period.ResultsSatisfactory reliability was obtained for total GAF score and for symptom and disability measures, in spite of raters having only one brief training session. All GAF scores were associated with current support needs of patients. Symptom and disability scores were associated with changes in antipsychotic medication in the previous month. Only symptom score was associated with increases in antipsychotic medication at time of rating.ConclusionAF proved to be a reliable and, within the limits of the indicators used, a valid measure of psychiatric disturbance in our sample of the severely mentally ill. Differences in relationships between the three GAF scores and medication/support needs indicate the usefulness of obtaining all three scores for monitoring levels and type of psychiatric disturbance in this population.
Dependency and Community Care in Presenile Alzheimer's Disease
Authors: Newens Andrew J. , Forster Donald P. , Kay David W. K. 
Published: October 2008

BackgroundIn a study of patients with presenile dementia of Alzheimer type (PDAT), we aimed to investigate functional dependency in relation to the time since diagnosis and place of residence. Use of community and support services and the time between diagnosis and entry to permanent residential care were also studied.MethodInterviews with 109 cases of PDAT (diagnosed before age 65) and their carers.ResultsThe need for assistance in activities of daily living (ADL) was progressive with time from diagnosis. Five years after diagnosis, 57% of patients remained at home, 20% of whom required some assistance in each of six areas of ADL. The need for assistance in each ADL category was significantly greater for cases in permanent residential care than for those at home. There were no significant differences between the Mini-Mental State Examination (MMSE) scores of patients at home and those of patients in permanent care. Incontinence and the relationship of the carer to the patient were the strongest predictors of permanent residential care. Respite care had been offered in 63% of cases; 71% of these offers had been accepted.ConclusionsPatients with PDAT who have a living relative are cared for at home for a considerable period of time despite severe cognitive impairment and loss of independence measured by ADL. The reports of carers suggest there is scope for improvement in supportive services to meet this community need.
A Clinical Study of Chronic Fatigue Syndrome
Authors: Shanks M. F. , Ho-Yen D. O. 
Published: October 2008

BackgroundThis study examines the hypothesis that more recently ill patients with chronic fatigue syndrome (CFS) might have different characteristics from more chronic patients in tertiary referral centres.MethodSixty-four patients who fulfilled strict diagnostic criteria for CFS had detailed medical, viral, immunological and psychiatric assessment. Patients were advised to remain within their energy limits. Patient and doctor monitored progress using a scoring system.ResultsUsing the Schedule for Affective Disorders and Schizophrenia, patients were placed into four groups: group A (no psychiatric disorder, 35 patients), group B (psychiatric disorder before onset of CFS, 7 patients), group C (coincident psychiatric disorder and CFS, 11 patients), and group D (psychiatric disorder after onset of CFS, 11 patients). There were no viral or immunological differences between the groups. Patients in groups B, C and D had more severe illness than those in group A (P< 0.05), but patients in group A had more muscle pain (P< 0.05) than patients in group C. Counselling resulted in 52 patients becoming better; nine remained the same and three became worse.ConclusionsA lower incidence of psychiatric disorder may characterise patients who are more recently ill, as may the type of associated emotional disorder and better outcome.
A Darwinian Approach to the Origins of Psychosis
Authors: Crow T. J. 
Published: October 2008

BackgroundThe onset of psychotic illness in the reproductive phase of life with a decrease in fecundity (and approximately constant incidence across populations) requires an evolutionary explanation. What is the survival value of the predisposing gene or genes?MethodEvolutionary theories, including the author's, are reviewed and critically compared.ResultsSome theories (e.g. Huxleyet al, 1964) postulate an advantage outside the nervous system: such theories fail to explain either the characteristic age distribution or constant incidence. More plausible are theories that relate the advantage to diversity of personality structure or social ability, or even to general intelligence, i.e. to the areas of function in which the phenomena of psychosis arise.ConclusionsIt is argued that psychosis arises as the boundary of a distribution of variation in cerebral structure generated in the course of hominid evolution. Language played a central role, with the critical changes taking place on the basis of a mutation that allowed the two cerebral hemispheres to develop with a degree of independence. Sexual selection (differing criteria in females and males in choosing a mate) acting on this genetic innovation has generated a dimension of competence in social interaction in relation to which there has been a progressive increase in cerebral size by delayed maturation (neoteny). A sexual dimorphism in cerebral asymmetry and the sex difference in age of onset of psychosis can be parsimoniously explained if a gene regulating the relative growth of the two hemispheres is X–Y homologous.
Psychological and Sexual Symptoms Associated with the Menopause and the Effects of Hormone Replacement Therapy
Authors: Pearce Jane , Hawton Keith , Blake Fiona 
Published: October 2008

BackgroundThere is considerable inconsistency in the results of studies of the psychological and sexual sequelae of the menopause and their treatment.MethodA search of the literature on Medline was made of studies of psychological symptoms in women who were either naturally or surgically menopausal or who were receiving hormone replacement therapy for menopausal symptoms.ResultsThere is evidence of a small increase in psychological morbidity (not usually amounting to psychiatric disorder) preceding the natural menopause and following the surgical menopause. Psychosocial as well as hormonal factors are relevant. While the response of psychosocial symptoms to hormone replacement therapy with oestrogens is variable and most marked in the surgical menopause, in some studies the effect is little greater than that for placebo. Where sexual symptoms are present, there is more consistent evidence that hormone replacement therapy is effective.ConclusionsIn the light of the available evidence, the current use of hormone replacement therapy to treat psychological symptoms detected at the time of (but not necessarily therefore due to) the natural menopause must be questioned. It does appear that oestrogen therapy ameliorates psychological symptoms after surgical menopause.
Medium-Term Course of Disaster Victims
Authors: Duggan C. , Gunn J. 
Published: October 2008

BackgroundOur aim was to describe the medium-term course (2–3 years) in a series of victims who had experienced severe trauma.MethodWe selected a consecutive series of 31 trauma victims and applied a structured clinical schedule (CAPS-2) to their psychiatric evaluations prepared for the court on two separate occasions approximately one year apart.ResultsPost-traumatic stress disorder and depression were the commonest diagnoses, occurring in 39% and 16% of the victims respectively when they were first assessed. Most had improved between the assessments and this was especially the case for the re-experiencing of the trauma and over-arousal, but less so for avoidance; 20% of subjects showed no improvement, often being handicapped by secondary psychiatric illness.ConclusionTraumatised victims generally showed recovery in the 2–3 years after the trauma, but this was slow and was not universal.
A Follow-up Study of Seasonal Affective Disorder
Authors: Thompson Christopher , Raheja Sunil K. , King Elizabeth A. 
Published: October 2008

BackgroundThe long-term course of seasonal affective disorder has not been well studied.MethodUsing the Structured Clinical Interview for DSM–III–R, we interviewed 75% of a sample of 124 subjects diagnosed from five to eight years previously as fulfilling DSM–III–R criteria for recurrent major affective disorder, seasonal pattern.ResultsIn the follow-up period, 38% of the sample continued to fulfil DSM–III–R criteria for seasonal illness; 28% had recurrent major depressive disorder, but no longer displayed a seasonal pattern; 18% were completely well with no further depression; 6% had subsyndromal symptoms; and 5%, although not meeting DSM–III–R criteria for seasonal illness, were still displaying constant periodicity. A short duration of index episode and a high frequency of illness predicted a continuing seasonal course of illness.ConclusionDiagnostic criteria for seasonal affective disorder need to be further refined, possibly restrictively, if they are to be used to predict the future course of seasonal illness.
Neuropsychological Slowness in Obsessive–Compulsive Patients
Authors: Galderisi Silvana , Mucci Armida , Catapano Francesco , D'amato Alessandro Colucci , Maj Mario 
Published: October 2008

BackgroundAlthough it is acknowledged that obsessive-compulsive (OC) patients may be slower than healthy controls in performing neuropsychological tests, speed has usually been treated as a confounding variable. It is possible, however, that the slower performance of OC patients is itself the result of a dysfunction of specific neural circuits (in particular of fronto-subcortical systems).MethodA neuropsychological battery including tests sensitive to fronto- and temporo-subcortical dysfunction was administered to a group of OC patients and a group of healthy controls. Each test provided independent indices of accuracy and speed.ResultsOC patients were significantly slower than controls only when performing tasks involving the fronto-subcortical systems, whereas they did not differ from controls with respect to accuracy indices.ConclusionIt may be that neuropsychological slowness of OC patients is not merely an epiphenomenon of meticulous concern for correct test execution or intrusion of obsessive thoughts, but reflects the dysfunction of fronto-subcortical systems.