bluuebunny/crossref_metadata_2025_split huggingface dataset:
Patterns of hypnotic drug prescription in Italy
Authors: Balestrieri M. , Bortolomasi M. , Galletta M. , Bellantuono C. 
Published: October 2008

BackgroundIn Italy a number of studies have been published on psychotropic drug use in general practice and community settings. However, the present study is the first Italian study to focus on hypnotic drug prescriptions in a large community sample.MethodData were collected from 145 of the total of 404 pharmacies of five large cities in north-eastern Italy. All consecutive patients presenting a prescription for a hypnotic drug were interviewed by the pharmacists during a two-week period.ResultsThe pharmacists interviewed 7/44 consecutive patients. The highest prevalence of prescriptions for hypnotic drugs was found in the elderly and in women. The majority (96%) of prescriptions were for benzodiazepines, with lorazepam and triazolam accounting for 50%. Short-acting and ultra-short-acting benzodiazepines were more frequently prescribed for sleep induction by general practitioners (GPs) than by psychiatrists and other physicians. Frequently the benzodiazepine used as a hypnotic was also prescribed for day time sedation. Approximately 72% of subjects reported they had been taking the prescribed drug for one year or more.ConclusionsIn Italy benzodiazepines are the most frequently prescribed drugs for sleep induction; as they are widely prescribed for elderly people by GPs often for long periods of time, educational programmes and guidelines on the rational use of benzodiazepines in general practice are needed.
Cytogenetic abnormalities on chromosome 18 associated with bipolar affective disorder or schizophrenia
Authors: Mors Ole , Ewald Henrik , Blackwood Douglas , Muir Walter 
Published: October 2008

BackgroundA few recent linkage studies have shown a possible locus for bipolar disorder on chromosome 18. Cytogenetic studies may assist in the further localisation of susceptibility loci on this chromosome.MethodA search was made for abnormalities of chromosome 18 in two separate large cytogenetic databases. In Denmark detection of mental illness in subjects with chromosome abnormalities was done by cross-linking the two separate register of psychiatric and chromosome disorders. In Scotland the Cytogenetic Registry of the MRC Human Genetics Unit undertakes long-term clinical follow-up of all cases with chromosome abnormalities.ResultsCross-linking the two Danish register's revealed a family with the rare karyotype abnormality inv(18) (p11.3;q21.1) with one inversion carrier who also suffered from bipolar disorder. In this family there were two other cases of bipolar disorder, but the karyotype of these cases could not be established. One family in Scotland showed a case of schizophrenia in a carrier of inv(18) with the same breakpoints as the Danish family.ConclusionsWe suggest further studies of the 18p11.3 and 18q21.1 regions in order to identify genes involved in bipolar affective disorder and schizophrenia.
Maintenance electroconvulsive therapy and cognitive function
Authors: Barnes Richard C. , Hussein Ali , Anderson David N. , Powell David 
Published: October 2008

BackgroundECT is rarely used as a prophylactic treatment. A 74-year-old woman with unstable bipolar affective disorder receiving maintenance ECT presented a unique opportunity to measure the cognitive effects of continuing ECT.MethodA single case report with serial psychometric testing during over 400 ECT treatments as a single maintenance treatment.ResultsSerial testing did not demonstrate progressive cognitive deterioration, but consistent cognitive deficits typical of acute treatment were evident. The degree of cognitive difficulty may be related to the frequency of treatment.ConclusionsMaintenance ECT can be an effective prophylactic treatment for selected patients. Cognitive effects would appear to be no greater than with acute treatment and seem to be non-progressive.
The Hampstead Schizophrenia Survey 1991
Authors: Jeffreys Siobhan E. , Harvey Carol A. , McNaught Alan S. , Quayle Anthony S. , King Michael B. , Bird Anne S. 
Published: October 2008

BackgroundA point prevalence study al schizophrenia was carried out in 1986 in the former Hampstead Health District using a key informant method to identify cases. The point prevalence al broadly defined schizophrenia was 4.7 per 1000.MethodA repeat census al people with schizophrenia, using the same method, was carried out in 1991 and the point prevalence calculated. The accuracy al the census method was estimated. Contact with services, social and occupational activity, and medication usage in the 1986 and 1991 samples were compared.ResultsThe point prevalence rate al broadly defined schizophrenia in 1991 was 5.1 per 1000. The results al both censuses showed we underestimated the number of individuals with DSM-III-R positive schizophrenia by about 14%. The level of contact with specialist services was greater in 1991 than 1986. Patients in 1991 were discharged on higher doses of medication, and their most recent admission was more likely to be due to non-compliance, than the 1986 group.ConclusionThe point prevalence confirmed the high rate reported in 1986. The accuracy of the census was within acceptable limits for service planning. Contact with specialist services increased between 1986 and 1991.
Symptom severity and cognitive impairment in chronically hospitalised geriatric patients with affective disorders
Authors: Powchik Philip D. Harvey. Peter , Parrella Michael , White Leonard , Davidson Michael 
Published: October 2008

BackgroundAffective disorders typically have a better outcome than schizophrenia, although recent evidence suggests that some patients with affective disorder have a relatively poor outcome, with cognitive impairments and persistent symptomatology.MethodFifty chronically hospitalised geriatric patients with mood disorders (major depression or bipolar disorder) were compared on the clinical symptoms and aspects of cognitive impairment with 308 geriatric schizophrenic patients who were hospitalised at the same institution. The two samples did not differ in current age or in premorbid education level, but the affective patients had a later age of onset and more females in the sample.ResultsThere were no overall differences in cognitive functioning between the groups, although the clinical symptom profiles resembled those seen in better outcome patients.ConclusionsCognitive impairment is present in poor-outcome patients with affective disorders as well as schizophrenia, suggesting that cognitive impairments predict poor outcome across psychiatric disorders and not just in schizophrenia.
A neuropsychological perspective on three schizophrenic patients with midline structural defects
Authors: Edelstyn N. M. J. , Oyebode F. , Riddoch M. J. , Soppitt R. , Moselhy H. , George M. 
Published: October 2008

BackgroundThe relationship between midline structural defects and schizophrenia remains unclear, although a number of neuroradiological studies have reported an association between schizophrenia and a range of anomalies.MethodThree patients are reported, each diagnosed with schizophrenia and neuroradiological evidence of midline structural anomalies. MRI scans are reported in conjunction with performance over a range of neuropsychological tests designed to assess frontal and lateralised cognitive functions.ResultsEvidence of anterior dysfunction was present in all three cases, while on an individual basis patients displayed varying patterns of preserved and dysfunctional cognitive processing.ConclusionThe reported findings raise a number of interesting issues regarding the nature of hemispheric involvement in schizophrenia.
Suicide in Avon
Authors: Vassilas Christopher A. , Morgan H. G. 
Published: October 2008

BackgroundSuicide rates among young men are rising. Further information about their contacts with services and possible associated stressful life events is necessary.MethodThe sample consisted of all cases where the coroner in the County of Avon had given an inquest verdict of suicide over a 20-month period, together with those who were categorised as suicide by a panel of psychiatrists even though they had received open or accidental inquest verdicts. The coroners dossiers and hospital notes were examined and the relevant general practitioners interviewed.ResultsInterpersonal stress in the last 72 hours was much higher in younger suicides. Young male suicides were also much less likely than others to seek help. Levels of alcohol misuse were no higher in younger than older suicides.ConclusionsVarious subgroups of suicide behave differently in the way they seek and utilise help. The implications of these findings for suicide prevention and service strategy are discussed.
A controlled family study of late-onset non-affective psychosis (late paraphrenia)
Authors: Howard R. J. , Graham C. , Sham P. , Dennehey J. , Castle D. J. , Levy R. , Murray R. 
Published: October 2008

BackgroundThe relationship between those schizophrenia-like conditions that have their onset in late life and early-onset schizophrenia is unclear. Very few family history studies of patients with late-onset psychosis have been reported, and it is not known whether their relatives have an increased risk of psychosis.MethodInformation was collected on the psychiatric morbidity of 269 first-degree relatives of patients with schizophrenia or delusional disorder with an onset after the age of 60 (late paraphrenia), and 272 first-degree relatives of healthy elderly control subjects, using a research diagnostic instrument.ResultsWith a narrow age range (15–50 years) at risk, the estimated lifetime risk of schizophrenia was 1.3% in the relatives of both cases and controls. With a wider age range (15–90 years) at risk, estimated lifetime risk of schizophrenia was 2.3% for the relatives of cases, and 2.2% for the relatives of controls. However, depression was significantly more common among the relatives of cases than controls.ConclusionThose schizophrenia-like psychoses with onset in late life are not genetically associated with schizophrenia.
Brain morphometric comparison of first-episode schizophrenia and temporal lobe epilepsy
Authors: Barr W. B. , Ashtari M. , Bilder R. M. , Degreef G. , Lieberman J. A. 
Published: October 2008

BackgroundConverging evidence has suggested that the abnormalities in brain morphology observed in schizophrenia are similar to those seen in temporal lobe epilepsy (TLE). The purpose ofthis study was to compare the features of these groups directly with measures of the brain using magnetic resonance (MR) morphometry.MethodMorphometric measures of ventricular and hippocampal volumes obtained from FLASH MR images were studied in 32 patients with first-episode schizophrenia (FES), 39 patients withTLE (21 left, 18 right), and 42 healthy controls.ResultsVentricular volumes in the FES and TLE groups were both significantly larger than those seen in controls and did not differ from each other. The FES group showed significantly larger temporal horns, while theTLE group had relatively larger frontal horns. Analyses of hippocampal volumes revealed a significant group by hemisphere effect. The FES group showed relative reductions in left hippocampal volume that were comparable only toTLE patients with seizures originating from the left hemisphere.ConclusionThe results indicate that FES and TLE groups both show evidence of ventricular enlargement. Lateralised morphological abnormalities of the hippocampal formation in FES and left TLE are comparable, and may be specific to temporolimbic regions.
Type of hospital setting and treatment outcome with heroin addicts
Authors: Strang John , Marks Isaac , Dawe Sharon , Powell Jane , Gossop Michael , Richards David , Gray Jeffrey 
Published: October 2008

BackgroundGeneral psychiatrists have recently been encouraged to provide treatment to heroin addicts, including in-patient detoxification. No comparison has previously been made of specialist versus general psychiatric in-patient care.MethodDuring a randomised study of cue exposure, 186 opiate addicts were also randomised to either specialist in-patient (DDU; n=115) or general psychiatric (GEN; n=71) wards in the same hospital.ResultsFrom pre-treatment (post-randomisation) onwards, patient outcomes differed across the two in-patient settings. Of the original randomised sample, significantly more DDU than GEN subjects accepted their randomisation (100 v. 77%), were subsequently admitted (60 v. 42%), and completed in-patient detoxification (45 v. 18%). Of patients admitted, more DDU than GEN patients completed detoxification (75 v. 43%). During seven-month follow-up, of those 43 patients who reached the end of treatment, significantly more ex-DDU than ex-GEN subjects were opiate-free.ConclusionsFrom pre-treatment onwards, significant differences in process and outcome were found after allocation to treatment on either DDU or GEN. Further randomised studies are required to replicate and explain these findings.
Financial cost of treating out-patients with schizophrenia in Nigeria
Authors: Suleiman Toyin G. , Ohaeri Jude U. , Lawal Rahman A. , Haruna Adam Y. , Orija O. B. 
Published: October 2008

BackgroundAn assessment of the monetary costs of treating a group of Nigerian out-patients with schizophrenia, in comparison with insulin-dependent diabetics, was made.MethodFifty out-patients with schizophrenia (mean age 42.9) and 40 with diabetes (mean age 41.9), attending government hospitals in Lagos, were assessed at six-monthly intervals, for direct and indirect costs (US$=82 naira; minimum monthly wage=500 naira)ResultsTwenty (40%) of those with schizophrenia and eight (20%) of the diabetics had no income at all. The mean total cost of schizophrenia in six months (2951.4 naira) or US$ 35.9) was significantly less than that of diabetes (11 791 naira or US$ 143). The cost of antipsychotic drugs accounts for 52.8% of the cost of schizophrenia; insulin injections accounted for 92.8% of the total cost of diabetes. Patients with schizophrenia and their relatives suffered significantly more loss of working days. Cost of illness was not significantly correlated with age and duration of illness.ConclusionsBecause of drastic currency devaluation, and lack of disability benefits and nursing homes, the findings contrast with Western reports where cost of drugs constitutes 2–5%, and indirect costs constitute over 50% of the total cost of schizophrenia.
Publication trends of papers on schizophrenia
Authors: Morlino Massimo , Lisanti Felice , Gogliettino Angela , De Girolamo Giovanni 
Published: October 2008

BackgroundWe assessed the publication trends of papers on schizophrenia through an analysis of the articles published by three general psychiatric journals (Archives of General Psychiatry (AGP), the British Journal of Psychiatry (BJP), and the Australian and New Zealand Journal of Psychiatry (ANZJP) from three continents.MethodFor each of the journals, we covered the period between 1980 and 1994. We carried out both a quantitative analysis, assessing the trends over time in the publication of papers on schizophrenia, and a qualitative analysis, classifying the articles into eight scientific fields.ResultsDuring the study period a total of 943 articles dealing with schizophrenia were published in the three journals evaluated; the proportion of papers focusing on schizophrenia was higher in the AGP and in the BJP (18 and 15%) as compared with the ANZJP (5.6%). A substantially higher proportion of basic science articles was published in the AGP as compared with the BJP and the ANZJP, whereby a somewhat larger representation of epidemiological and psychosocial research was found in the latter journals.ConclusionsGiven the importance of schizophrenia in psychiatric research and practice, it will be useful to regularly monitor the research trends in this specific field.
Suicide by age, ethnic group, coroners' verdicts and country of birth
Authors: Neeleman Jan , Mak Vivienne , Wessely Simon 
Published: October 2008

BackgroundInformation on suicide in ethnic and immigrant groups in England and Wales is limited.MethodA three-year (1991–1993) survey was conducted of all unnatural deaths of residents of an urban area. ‘True likely’ and official’ age-adjusted suicide rates were compared by ethnicity and, for Whites, birthplace.ResultsIrrespective of verdict, 329 likely suicides were identified. Relatively few ethnic minority and White immigrant suicides had received a suicide verdict. Afro-Caribbeans had relatively low, and young Indian women relatively high suicide rates. Rates of Scottish- and Irish-born residents were 2.1 to 2.9 times higher than the local base rate. Young White males' rates were higher than those of the elderly.ConclusionsClassification of suicide is biased with respect to ethnicity and national origin. Rate patterns for ethnic minority groups reflect patterns seen in attempted suicide. In this deprived area, young White male suicide rates have surpassed those among the old.
Family functioning and life events in the outcome of adolescent anorexia nervosa
Authors: North Clive , Gowers Simon , Byram Victoria 
Published: October 2008

BackgroundThis study investigates the outcome of anorexia nervosa in adolescents in relation to precipitating life events and changes in family functioning over time.MethodThirty-five adolescents with anorexia nervosa and their mothers were administered measures of life events and family functioning at initial assessment and 1 and 2 year follow-up, when outcome was also assessed.ResultsFifty-five per cent of patients had a good outcome. Patients from initially well-functioning families or those with precipitating life events improved more in the first year, than those with dysfunctional families or without events. Subjects perceived a deterioration in family functioning at 1 year follow-up but an improvement at 2 years. Mothers reported no changes.ConclusionsApproximately half of a series of early onset cases of anorexia nervosa can be expected to recover by 2 years. Healthy family functioning and presence of a precipitating life event predict good short-term outcome. The relationships between subjects' perceptions of family functioning and their recovery from anorexia nervosa is discussed.
Suicide among psychiatric in-patients in a changing clinical scene
Authors: Morgan H. G. , Stanton Ruth 
Published: October 2008

BackgroundRapid changes in styles of clinical practice mean that we should carefully monitor the way suicides occur among psychiatric patients both in hospital and in the wider community.MethodPatients who had died through suicide either while receiving in-patient care or within 2 months of discharge from hospital were compared with a similar series reported 10 years previously. Clinicians' perceptions of patients' behaviour were compared with concurrent controls.ResultsPatients in the more recent study were younger, more often male, and a greater proportion had been discharged from in-patient status. Hazards which complicated risk assessment included short-lasting misleading clinical improvements, variability in degree of distress, and a reluctance to discuss suicidal ideas. Over a range of perceived behaviours it was not possible to distinguish suicides from controls.ConclusionsIn assessing suicide risk paramount importance should be attached to monitoring suicidal ideation and addressing the several hazards which might complicate this procedure.
Altered dopaminergic function and negative symptoms in drug-free patients with schizophrenia
Authors: Knable Michael B. , Egan Michael F. , Heinz Andreas , Gorey Julia , Lee Kan Sam , Coppola Richard , Weinberger Daniel R. 
Published: October 2008

BackgroundPrevious in vivo studies of schizophrenia with dopamine D2 receptor radioligands have yielded contradictory results. No prior study has used multiple scans to examine within-subject clinical change.MethodTwenty-one patients were studied with [1231]-iodobenzamide single photon emission computed tomography about two weeks after neuroleptic withdrawal. Thirteen of the 21 completed a second scan about four weeks after neuroleptic withdrawal. Sixteen controls were scanned for comparison.ResultsThere was no significant difference between groups in [1231]-iodobenzamide uptake at either scanning session. No significant correlations with demographic variables (age, illness duration, drug-free period), or clinical ratings (positive and negative symptoms, movement disorder) were observed at either scanning session. There was a significant correlation between change in [1231]-iodobenzamide uptake and change in negative symptom ratings for the subjects who underwent two scans (r=0.72, P < 0.05)ConclusionsWorsening of negative symptoms may be associated with increased availability of striatal D2 receptors, perhaps because of decreased concentrations of endogenous dopamine.
Recurrence in affective disorder
Authors: Kessing Lars Vedel 
Published: October 2008

BackgroundThe risk of recurrence in affective disorder has been found to increase with each new episode. It is unclear whether it is universal without regard to gender, age and type of disorder.MethodSurvival analysis was used to estimate the risk of recurrence in a case-register study including all hospital admissions with primary affective disorder in Denmark from 1971–1993. In this period 20 350 first-admission patients had been discharged with a diagnosis of affective disorder, depressive or manic/cyclic type.ResultsThe risk of recurrence increased with the number of previous episodes regardless of the combination of gender, age and type of disorder. Initially in the course of illness, unipolar and bipolar women experienced an equal greater risk of recurrence than men. The risk of recurrence after the first episode was increased for middle-aged and older unipolar women compared with the risk for younger women, while after all other episodes younger age at first episode increased the risk of recurrence.ConclusionsThe course of severe unipolar and bipolar disorder seems to be progressive in nature irrespective of gender, age and type of disorder.
Brain 5-HT neurotransmission during paroxetine treatment
Authors: Sargent P. A. , Williamson D. J. , Cowen P. J. 
Published: October 2008

BackgroundAnimal experimental studies suggest that repeated administration of selective serotonin reuptake inhibitors (SSRIs) produces complex adaptive changes in brain serotonin (5-HT) pathways. The effect of these adaptive changes on different aspects of brain 5-HT neurotransmission and their clinical consequences are not well understood.MethodWe studied the effect of repeated administration of the SSRI, paroxetine (20 mg daily), on the Cortisol responses to the 5-HT precursor, 5-hydroxytryptophan (5-HTP), in healthy subjects and depressed patients.ResultsIn healthy subjects, following one week of paroxetine treatment there was a large increase in the Cortisol response to 5-HTP. This increase had all but disappeared following 3 weeks treatment. In contrast, in depressed patients treated with paroxetine for 8 weeks, the Cortisol response to 5-HTP was significantly increased.ConclusionsSSRI treatment in depressed patients produces a persistent increase in the Cortisol response to 5-HTP, a probable measure of neurotransmission at central 5-HT2receptors. Potentiation of 5-HT2neurotransmission is unlikely to account for the efficacy of SSRIs in major depression but might underlie their actions in obsessive–compulsive disorder and also perhaps certain of their adverse effects, notably sexual dysfunction.