bluuebunny/crossref_metadata_2025_split huggingface dataset:
Two psychological treatments for hypochondriasis
Authors: Clark David M. , Salkovskis Paul M. , Hackmann Ann , Wells Adrian , Fennell Melanie , Ludgate John , Ahmad Sameena , Richards H. Candida , Gelder Michael 
Published: October 2008

BackgroundHypochondriasis is generally considered difficult to manage. This study aimed to assess the effectiveness of cognitive therapy and to compare it with an equally credible, alternative treatment.MethodForty-eight patients with hypochondriasis were initially randomly assigned to either cognitive therapy, behavioural stress management or a no treatment waiting list control group. At the end of the waiting period, patients in the control group were randomly assigned to one of the two treatments. Assessments were at pre-, mid- and post-treatment or waiting list and at three-, six- and 12-month post-treatment follow-up.ResultsComparisons with the waiting list group showed both treatments were effective. Comparisons between the treatments showed that cognitive therapy was more effective than behavioural stress management on measures of hypochondriasis, but not general mood disturbance at mid-treatment and at post-treatment. One year after treatment patients who had received either treatment remained significantly better than before treatment, and on almost all measures the two therapies did not differ from each other.ConclusionsCognitive therapy is a specific treatment for hypochondriasis. Behavioural stress management is also effective but its specificity remains to be demonstrated.
5-HT2A receptor blockade in patients with schizophrenia treated with risperidone or clozapine
Authors: Travis Michael J. , Busatto Geraldo F. , Pilowsky Lyn S. , Mulligan Rachel , Acton Paul D. , Gacinovic Sveto , Mertens John , Terrière Dirk , Costa Durval C. , Ell Peter J. , Kerwin Robert W. 
Published: October 2008

Background5-HT2A receptor antagonism may be crucial to the action of atypical antipsychotics. Previous work has related 5-HT2A receptor blockade to clinical efficacy and protection from extrapyramidal side-effects.MethodWe developed a SPET imaging protocol for assessing 5-HT2A receptor binding using the selective ligand 1231-5-1-R91150. Six healthy volunteers, five clozapine- and five risperidone-treated subjects with DSM–IV schizophrenia were studied. Multi-slice SPET was performed on each subject.ResultsCortex: cerebellum ratios were significantly lower in both clozapine-and risperidone-treated subjects compared with the healthy volunteers in all cortical regions. There was no difference in occupancy between the two drug-treated groups. No correlation was found between the percentage change in the Global Assessment Scale (GAS) and 5-HT2A receptor binding indices in the drug-treated groups.ConclusionsClozapine and risperidone potently block 5-HT2A receptors in vivo. The lack of relationship between receptor binding indices and change in GAS suggests that 5-HT2A receptor blockade may be unrelated to clinical improvement. Future studies will substantiate this finding by studying 5-HT2A receptor binding in large groups of patients treated with both typical and novel atypical antipsychotics.
Culturally sensitive validation of screening questionnaires for depression in older African– Caribbean people living in south London
Authors: Abas Melanie A. , Phillips Courtney , Carter Janet , Walter Joanna , Banerjee Sube , Levy Raymond 
Published: October 2008

BackgroundWe tested the validity of two screens for depression in older African–Caribbean adults, the 15-item Geriatric Depression Scale (GDS) and a new Caribbean Culture-Specific Screen for emotional distress (CCSS). Two independent criteria were used for validity: (a) a psychiatric diagnosis derived from GMS–AGECAT, and (b) a culturally sensitive assessment of mental disorder, derived from a tool developed with local African–Caribbean religious healers.MethodOne hundred and sixty-four consecutive African–Caribbean primary care users, aged 60 years or older, were screened with the GDS and the CCSS. Diagnostic interviews were carried out on 80% of high scorers and 20% of low scorers.ResultsThe number of cases detected by the two separate diagnostic approaches was similar. However, the agreement between who was and who was not a case was only modest. At a cutoff of $5, the GDS was an adequate case detector for psychiatric depression, and, at a cut-off of $4, for ‘depressed/lost spirit’, as defined by culture-specific criteria. It performed as well as the new CCSS.ConclusionsAt a cut-off of $4 the 15-item GDS can be recommended as a case detector for significant forms of depression in older African–Caribbean people living in south London.
Somatisation disorder in primary care
Authors: Escobar Javier I. , Gara Michael , Silver Roxanne Cohen , Waitzkin Howard , Holman Alison , Compton Wilson 
Published: October 2008

BackgroundSomatisation is a common and frustrating clinical problem in primary care.MethodUsing structural diagnoses and functional measures, we examined the prevalence and associated features of somatisation disorder defined by three current nosologies and an abridged construct in subjects using primary care services.ResultsSomatisation disorder, diagnosed according to the standard criteria, was found to have a very low prevalence (range 0.06–5%), while more than one-fifth of the sample (22%) met the criteria for the abridged diagnosis. There was poor agreement between succeeding versions of the DSM system for identifying cases of somatisation disorder, each system ending up with rather disparate sets of individuals as well as variable levels of psychopathology and disability.ConclusionsAccording to these data, standard somatisation disorder diagnoses add little to the prediction of disability/psychopathology beyond the contributions of an abridged construct of somatisation.
Typology of common psychiatric syndromes
Authors: Sullivan Patrick F. , Kendler Kenneth S. 
Published: October 2008

BackgroundDiagnostic comorbidity is prevalent in psychiatry and may be inadequately captured by the DSM-III/III-R nosology.MethodsThe lifetime presence of 11 psychiatric diagnoses was determined by structured personal interviews of a population-based sample of 1898 female twins. We used latent class analysis to derive an empirical typology.ResultsSix classes provided the best fit to the data. Their mnemonics were: minimal disorder (60% of the sample), major depression -generalised anxiety disorder (19%), alcohol–nicotine (7%), highly comorbid major depression (5%) and eating disorders (3%). The validity of this typology was strongly supported by demographic, health, personality and attitudinal validators along with the significant monozygotic twin concordance for class membership. The typology superficially resembled DSM-III-R, but contained many differences. Major depression appeared in three forms (alone, with generalised anxiety disorder and with considerable comorbidity). Alcoholism-nicotine dependence and the various anxiety disorders formed discrete classes, but were also prominent in other classes. Bulimia and anorexia were exceptional in their appearance in a single class.ConclusionsThe DSM-III-R and closely related DSM-IV nosology did not capture the natural tendency of these disorders to co-occur. Fundamental assumptions of the dominant diagnostic schemata may be incorrect.
Effects of community services on disability and symptoms
Authors: Wykes Til , Leese Morven , Taylor Ruth , Phelan Michael 
Published: October 2008

BackgroundCommunity care for people with psychosis can be provided via several different service models. The study compared two models: standard community treatment with high patient:staff ratios, and intensive community treatment in which there was more of an emphasis on community involvement and lower patient:staff ratios.MethodAll people fulfilling diagnostic criteria for psychosis and living in two defined geographical areas in south London were identified. These people were provided with either an intensive or standard service depending on their address. Their social behaviour and symptoms were measured at the beginning of the study and after two years.ResultsThere is little evidence of any effects of the two service models on levels of symptoms. However, the standard service did seem to be advantageous in reducing social disability for those with medium or low levels of disability.ConclusionsThe effect of intensive community services was the opposite to that predicted. Despite improvements in outcomes (e.g. hospital admission), there were no advantages for this type of service in the measures of disability or symptoms. In fact, the standard service was effective in reducing disability, whereas in the intensive service there was no change.
Social roles and gender difference in the prevalence of common mental disorders
Authors: Weich Scott , Sloggett Andrew , Lewis Glyn 
Published: October 2008

BackgroundIt is not known why the most common mental disorders, anxiety and depression, are more prevalent among women than men. The aim was to test the hypothesis that this gender difference could be explained by differences between men and women in social role occupancy, after adjusting for age and socio-economic status.MethodA cross-sectional survey of 8979 adults aged 16–74 years living in private households in England. Wales and Scotland was carried out. Prevalence of common mental disorders was assessed using the General Health Questionnaire.ResultsThe gender difference in the prevalence of the common mental disorders (unlike social role occupancy) did not vary with age to a statistically significant degree (unadjusted odds ratio 1.35, 95% C11.23–1.48) (P < 0.0001). Although those of either gender occupying the fewest, and women occupying the most social roles (after adjusting for age) had the highest prevalence of common mental disorders, neither number of social roles, occupancy of traditional ‘female’ caring and domestic roles, nor socio-economic status explained the gender difference in these conditions (adjusted OR 1.26, 95% C11.14–1.41) (P < 0.001).ConclusionsThe gender difference in the prevalence of the common mental disorders is not explained by differences between men and women in the number or type of social roles occupied.
Age at onset and outcome in schizophrenia are related to the degree of familial loading
Authors: Suvisaari Jaana M. , Haukka Jari , Tanskanen Antti , Lönnqvist Jouko K. 
Published: October 2008

BackgroundRecent research suggests that high familial loading is associated with early onset of schizophrenia. Results concerning outcome have been controversial.MethodWe assessed the relationship between familial loading, age at onset and outcome in all Finnish patients with schizophrenia born between 1950 and 1969. Patients and their first-degree relatives were identified using nationwide registers. Familial loading scores were calculated for schizophrenia and for combined psychotic disorders, and patients were accordingly classified into three groups: high (n = 761), intermediate (n = 14 247), and low familial loading (n = 725). Linear mixed models and the Cox proportional hazard model were used in the analyses.ResultsOnset was earliest, hospitalisation longest and risk of retirement in receipt of a disability pension highest in the group with high familial loading, with opposite extremes found in the group with low familial loading.ConclusionsHigh familial loading for schizophrenia is associated with early onset and poor outcome of schizophrenia.
Changes in public attitudes to depression during the Defeat Depression Campaign
Authors: Paykel E. S. , Hart Deborah , Priest R. G. 
Published: October 2008

BackgroundAims of the Defeat Depression Campaign between 1991 and 1996 included the reduction of stigma associated with depression, education of the public about the disorder and its treatment and encouragement of earlier treatment-seeking. Newspaper and magazine articles, radio and television programmes and other media activities were employed.MethodSurveys of public attitudes were conducted by MORI in late 1991, early 1995 and mid-1997. Each covered approximately 2000 subjects, sampled to be representative of the population of Great Britain. Structured interviews covered views on depression, treatment and general practitioners (GPs).ResultsThere were significant positive changes regarding attitudes to depression, reported experience of it, attitudes to antidepressants, and less consistently, to treatment from GPs. Changes were of the order of 5–10%. Throughout, attitudes to depression and to treatment by counselling were very favourable, whereas antidepressants were regarded as addictive and less effective.ConclusionsPositive attitude change was achieved during the Campaign, although there is still room for improvement in some aspects.
Genetic and non-genetic subtypes of major depressive disorder
Authors: Andrew Martin , McGuffin Peter , Katz Randy 
Published: October 2008

BackgroundWe aimed to examine the hypotheses that major depression is aetiologically heterogeneous consisting of a mixture of ‘genetic’ and ‘non-genetic’ forms or, alternatively, a mixture of one form that is ‘pure’ depression and another that has a familial relationship with alcohol dependency or other disorders.MethodOne hundred and eleven twin pairs (44 monozygotic, 67 dizygotic) where the proband had received treatment for DSM–IV major depression were ascertained via a hospital register. Family history information on parents and siblings was obtained from the proband, co-twin or both. Diagnoses on parents and siblings were made blind to twin zygosity or concordance and compared in the relatives of concordant versus discordant twins.ResultsThe lifetime prevalence and age-corrected risk of depression were no different in the relatives of concordant and discordant twin pairs. There was a marginally significant increase in the rate of alcohol abuse or dependence among the relatives of concordant twins but no difference between concordant and discordant pairs in respect of other axis I diagnosis among family members.ConclusionsThe results argue against genetic heterogeneity and suggest that major depression cannot usefully be divided into genetic and non-genetic forms or into ‘pure’ depression and depression associated with other disorders such as alcohol dependency.
Family history as a predictor of poor long-term outcome in depression
Authors: Duggan Conor , Sham Pak , Minne Carine , Lee Alan , Murray Robin 
Published: October 2008

BackgroundWe investigated whether family history had prognostic significance in depression in a study which addressed some of the methodological shortcomings of previous studies.MethodWe collected family history data on a consecutive series of 89 patients admitted with RDC major depression, blind to the outcome of the proband. This comprised 116, 283 and 120 first-degree relatives examined with the SADS–L, FH–RDC and case note data, respectively. The outcome of 74 of these probands (83%), previously categorised into four operationally defined groups, was then examined.ResultsA positive family history of severe psychiatric illness (i.e. a relative with a history of either a psychosis, hospitalised depression or suicide) was associated with poor outcome in the proband. This association persisted after controlling for variable family size, age structure and gender. As family history was correlated with neither Kendell's neurotic/psychotic index nor the probands neuroticism score, an individual with high scores an all three would have a greatly increased chance of having a poor outcome.ConclusionsA family history of severe psychiatric illness in a first-degree relative may be useful as one of the vulnerability factors for predicting poor long-term outcome in depression.
Randomised double-blind comparison of the incidence of tardive dyskinesia in patients with schizophrenia during long-term treatment with olanzapine or haloperidol
Authors: Beasley Charles M. , Dellva Mary Anne , Tamura Roy N. , Morgenstern Hal , Glazer William M. , Ferguson Kevin , Tollefson Gary D. 
Published: October 2008

BackgroundTardive dyskinesia is important in the side-effect profile of antipsychotic medication.AimsThe development of tardive dyskinesia was evaluated in patients treated with double-blind, randomly assigned olanzapine or haloperidol for up to 2.6 years.MethodsTardive dyskinesia was assessed by the Abnormal Involuntary Movement Scale (AIMS) and Research Diagnostic Criteria for Tardive Dyskinesia (RD-TD); it was defined as meeting RD-TD criteria at two consecutive assessments. The risk of tardive dyskinesia, the relative risk, incidence rate, and incidence rate ratio were estimated.ResultsThe relative risk of tardive dyskinesia for the overall follow-up period for haloperidol (n=522) v. olanzapine (n=1192) was 2.66 (95% CI=1.50–4.70). Based on data following the initial six weeks of observation (during which patients underwent medication change and AIMS assessments as frequently as every three days), the one-year risk was 0.52% with olanzapine (n=513) and 7.45% with haloperidol (n=114). The relative risk throughout this follow-up period was 11.37 (95% Cl=2.21–58.60).ConclusionOur results indicated a significantly lower risk of tardive dyskinesia with olanzapine than with haloperidol.
Natural history of behavioural changes and psychiatric symptoms in Alzheimer's disease
Authors: Hope Tony , Keene Janet , Fairburn Christopher G. , Jacoby Robin , McShane Rupert 
Published: October 2008

BackgroundAlzheimer's disease and other types of dementia are characterised by numerous psychiatric and behavioural changes. Little is known of their natural history.AimsTo investigate the sequence and pattern of these changes throughout the course of dementia.MethodOne hundred people, initially living at home with carers, entered a prospective, longitudinal study. At four-monthly intervals, behavioural and psychiatric symptoms were assessed using the Present Behavioural Examination and Mini-Mental State Examination. Follow-up continued for up to nine years (mean 3.3 years; s.d. 2.4). Patterns of onset and disappearance of these symptoms, their sequence and association with time of death and cognitive decline were analysed. Autopsy confirmed a diagnosis of pure Alzheimer's disease in 48 subjects. Data for this subgroup are presented.ResultsSome changes tend to occur earlier than others but changes can occur at almost any time in the course of dementia.ConclusionsThe natural history of behaviour changes in Alzheimer's disease shows great individual variation although some changes tend to follow a recognisable sequence.
Validity of current clinical criteria for Alzheimer's disease, vascular dementia and dementia with Lewy bodies
Authors: Holmes Clive , Cairns Nigel , Lantos Peter L. , Mann Anthony 
Published: October 2008

BackgroundFollowing the success of the NINCDS–ADRDA criteria for Alzheimer's disease, groups interested in vascular dementia and dementia with Lewy bodies have now adopted similar criteria.AimsTo assess whether the validity of these criteria are influenced by the prevalence of mixed pathologies or by the prevalence rate.MethodA community based postmortem study.ResultsMixed pathologies were common (33.8%). The high specificities obtained for the CDLB and NINDS–AIREN criteria (1.00 and 0.95, respectively) were associated with low sensitivities (0.22 and 0.43, respectively). Low prevalence and the presence of mixed pathologies had a deleterious effect on positive predictive values.ConclusionsCurrent clinical diagnostic criteria are good at detecting pathology per se but not at detecting pure pathology. A large proportion of subjects from the general population fulfilling probable CDLB, probable NINCDS–ADRDA or probable NINDS–AIREN will have mixed pathologies.
Comparison of intensive and standard case management for patients with psychosis
Authors: Creed Francis , Burns Tom , Butler Tom , Byford Sarah , Murray Robin , Thompson Simon , Tyrer Peter 
Published: October 2008

BackgroundCase management, particularly in intensive form, has been widely introduced for the treatment of severe mental illness. However, the optimal intensity of case management has not been determined.AimsWe aimed to assess whether intensive case management (small case load) reduces hospitalisation and costs compared with standard case management.MethodDevelopment and rationale of a large randomised controlled trial comparing intensive case management (case load per worker? 15 patients) with standard case management (case load 30–35 patients)ResultsTwo-year outcome data will be obtained on patients representative of the seriously mentally ill in inner-city mental health services.ConclusionsThe study planned with 700 patients should be sufficient to detect small differences in the readmission of patients to hospital (10%), the number of days spent in hospital over a two-year period (10 days) and the average weekly cost of care per patient. The sample is large enough to compare the cost-effectiveness of intensive and standard case management in mild and severe disability and in people of African–Caribbean origin and White Caucasians.
Homicides by people with mental illness: myth and reality
Authors: Taylor Pamela J. , Gunn John 
Published: October 2008

BackgroundTragic and high-profile killings by people with mental illness have been used to suggest that the community care model for mental health services has failed.AimsTo consider whether such homicides have become more frequent as psychiatric services have changed.MethodData were extracted from Home Office-generated criminal statistics for England and Wales between 1957 and 1995 and subjected to trends analysis.ResultsThere was little fluctuation in numbers of people with a mental illness committing criminal homicide over the 38 years studied, and a 3% annual decline in their contribution to the official statistics.ConclusionsThere are many reasons for improving the resources and quality of care for people with a mental disorder, but there is no evidence that it is anything but stigmatising to claim that their living in the community is a dangerous experiment that should be reversed. There appears to be some case for specially focused improvement of services for people with a personality disorder and/or substance misuse.
Early life family disadvantages and major depression in adulthood
Authors: Sadowski Hartwin S. , Ugarte Blanca , Kolvin Israel , Kaplan Carole E. , Barnes Jacqueline 
Published: October 2008

BackgroundThere is evidence that exposure to social and family disadvantages in childhood are a risk factor for adult depression.AimsTo explore the effects of multiple adversity in early childhood on adult depression, and the relative effects of the different adversities.MethodThis study utilises data from the Newcastle Thousand Family Study. Information on childhood disadvantages was collected when the participants were 5 years old, and information on mental health was gathered when they were 33 years old. Mental health data were scrutinised blind to the evidence of early disadvantage, and best-estimate diagnoses of major depressive disorder were made according to DSM–III–R criteria.ResultsMultiple family disadvantages in childhood substantially increase the risk of suffering a major depressive disorder in adulthood. Such disadvantages include family or marital relationship instability, a combination of poor mothering and poor physical care, and a combination of dependence on social welfare and overcrowding. For females major depression was linked in particular to the quality of parenting in early life.ConclusionsSocial and family (especially multiple family) disadvantages during childhood predispose individuals to an increased risk of major depression in adulthood.