bluuebunny/crossref_metadata_2025_split huggingface dataset:
Antidepressant-treated Patients in Ambulatory Care
Authors: Bingefors Kerstin , Isacson Dag , Von Knorring Lars , Smedby Björn , Ekselius Lisa , Kupper Lawrence L. 
Published: October 2008

BackgroundDespite the problems involved in treating depression and concomitant medical disease, there are virtually no longitudinal studies on drug utilisation among depressed patients.MethodUse of prescription drugs among all first-time users of antidepressants in a defined population five years before and six years after the index (first) treatment was compared to a referent group without antidepressant treatment. The generalised estimating equations (GEE) method was used for analysis.ResultsThe antidepressant-treated group used considerably more non-psychotropic drugs during the whole study period than the referent group. They also used more psychotropic drugs, a use which increased in connection with the initiation of antidepressant treatment and stayed high for a further five years.ConclusionsThe high use of prescription drugs indicated widespread somatic and psychiatric health problems during the whole study period. Antidepressant-treated patients are at risk for drug interactions and adverse effects, and would benefit from a closer collaboration between psychiatry and medicine.
General Practitioners and Young Suicides
Authors: Appleby Louis , Amos Tim , Doyle Una , Tomenson Barbara , Woodman Miriam 
Published: October 2008

BackgroundThe suicide rate in young men, but not young women, is rising. One possible route to suicide prevention is through general practice but recent evidence suggests that young suicides are not likely to attend GP surgeries prior to death.MethodWe carried out a retrospective examination of general practice contacts by a 2-year sample of suicides under 35 years of age in the 12 health districts of Greater Manchester. In the 61 young suicides who were known to attend a GP in the three months before death, we recorded (a) the number of consultations each week in the three months before suicide; (b) sex differences in rates of and reasons for consultation; (c) frequency of recorded risk assessment at the last GP visit before suicide.ResultsThe number of GP visits increased significantly before death. A monthly increase was more evident in males, but the increase in the week before death was more marked in females. There was no sex difference in the rate of GP visits before suicide; both sexes were most likely to attend for psychological reasons. Significant suicide risk had been noted at none of the final GP visits.ConclusionsThere remains a potential role for GPs in preventing suicides by young people of both sexes. The recent increase in suicide by young males does not appear to be related to a lower rate of GP attendance before death. Future training of GPs in this area should focus on risk assessment.
Somatisation in Primary Care in Spain
Authors: García-Campayo Javier , Campos Ricardo , Marcos Guillermo , Peréz-Echeverría Ma Jesus , Lobo Antonio ,   the GMPPZ
Published: October 2008

BackgroundThis study is the first attempt to document the differences between somatisers (STs) and psychologisers (PGs) in Spanish primary care patients.MethodA sample of 1559 consecutive patients attending eight randomly selected health centres in Zaragoza, were examined in a two-phase screening using Spanish versions of GHQ–28, CAGE questionnaire, substance abuse, MMSE and SPPI. STs and PGs were diagnosed according to operationalised Bridges & Goldbergs criteria.ResultsST was found to be three times more prevalent than PG, but the ratio ST: PG was highest (10.5) in the DSM–IV category dysthymia. Generalised anxiety disorder was the most frequent diagnosis in STs and major depressive episode the most frequent in PGs. No significant differences between the two groups have been found in demographic characteristics. Total GHQ scores were significantly higher in PGs, but global SPPI scores were not. Most psychopathological scores were higher in PGs, but both somatic symptoms and suspiciousness were higher in STs. The psychopathological findings are consistent with hypotheses related to blame avoidance and defensiveness in STs.ConclusionsST is three times more prevalent than PG, but the ratio ST: PG depends heavily on diagnostic categories. While most psychopathological scores are higher in PGs, both patient groups are similarly disturbed. Previously assumed socio-demographic differences between STs and PGs have not been found in this study.
Screening for Psychiatric Morbidity in Subjects Presenting with Chronic Fatigue Syndrome
Authors: Farmer Anne , Chubb Helen , Jones Irene , Hillier Janis , Smith Andy , Borysiewicz Leszek 
Published: October 2008

BackgroundThere is a need for a valid self-rating questionnaire to screen for psychiatric morbidity in patients with chronic fatigue syndrome (CFS). This study had the aim of assessing the utility and validity of two commonly used measures.MethodScores obtained on the General Health Questionnaire (GHQ) and the Beck Depression Inventory (BDI) were compared with various diagnostic and severity ratings obtained via a validating clinical interview, the Schedules for the Clinical Assessment of Neuropsychiatry (SCAN) in 95 consecutively referred subjects at a medical out-patient clinic who fulfilled standard criteria for CFS, and 48 healthy controls. Outcome measures were validating coefficients and receiver operating characteristics (ROC) for different thresholds and scoring on GHQ and BDI and index of definition (ID) as measured by SCAN; and Pearson and point by serial correlation coefficients for different diagnostic groups derived via SCAN and defined according to ICD–10 and DSM–III–R.ResultsGHQ and BDI perform poorly as screeners of psychiatric morbidity in CFS subjects when compared with various SCAN derived ratings although results for controls are comparable with other studies.ConclusionsNeither the GHQ nor BDI alone can be recommended as screeners for psychiatric morbidity in CFS subjects.
Prenatal Exposure to the 1957 Influenza Epidemic and Adult Schizophrenia: A Follow-Up Study
Authors: Cannon M. , Cotter D. , Coffey V. P. , Sham P. C. , Takei N. , Larkin C. , Murray R. M. , O'callaghan E. 
Published: October 2008

BackgroundWe investigated the hypothesis that prenatal exposure to the 1957 A2 influenza increases the risk of schizophrenia in adulthood.MethodWe traced a cohort of individuals known to have been exposed to the 1957 influenza epidemic during gestation and an unexposed cohort matched for period of gestation and hospital of birth. Follow-up information on psychiatric illness in subjects was sought from two sources: maternal interview and psychiatric hospital admission data.ResultsFollow-up information was obtained on 54% of the sample: 238 subjects from the influenza-exposed group and 287 subjects from the unexposed group. There was no increased risk of schizophrenia among the exposed cohort compared to the unexposed cohort (relative risk 1.1; 95% CI 0.41–2.95), although there was an increase in depressive illness (relative risk 1.59; 95% CI 1.15–2.19).ConclusionsThe association between prenatal influenza and an increased risk of schizophrenia in adulthood has thus far been found only in population-based data and is not supported by the present observational study which has information about exposure and outcome in individuals.
Obsessive–Compulsive Disorder, Tattooing and Bizarre Sexual Practices
Authors: Caplan Richard , Komaromi Judith , Rhodes Mike 
Published: October 2008

BackgroundA case is presented describing an association between obsessive–compulsive disorder, tattooing and unusual sexual practices.MethodA single case report.ConclusionsTattooing and unusual sexual practices are compulsive behaviours associated with the subject's obsessive–compulsive disorder. Such associations have not previously been described in the literature.
Are SSRIs a Cost-Effective Alternative to Tricyclics?
Authors: Hotopf Matthew , Lewis Glyn , Normand Charles 
Published: October 2008

BackgroundSelective serotonin reuptake inhibitors (SSRIs) are more expensive than tricyclics. Reports have suggested that SSRIs are cost-effective because they are better tolerated and safer in overdose.MethodA systematic review of all randomised controlled trials (RCTs), meta-analyses, and cost-effectiveness studies comparing SSRIs and tricyclic antidepressants (TCAs).ResultsNone of the RCTs provided an economic analysis and there were methodological problems in the majority which would preclude this approach. Meta-analyses suggest that clinical efficacy is equivalent but slightly fewer patients prescribed SSRIs drop out of RCTs. Cost-effectiveness studies have been based on crude ‘modelling’ approaches and over-estimate the difference in attrition rates and the cost of treatment failure. It appears impossible to evaluate the economic aspects of suicide because of its rarity.ConclusionsThere is no evidence to suggest that SSRIs are more cost-effective than TCAs. The debate will only be concluded when a prospective cost-effectiveness study is done in the setting of a large primary care based RCT.
The Camden Schizophrenia Surveys
Authors: Harvey Carol A. 
Published: October 2008

BackgroundThe development of appropriate community care requires knowledge of the characteristics of the severely mentally ill.MethodAll patients with a broad diagnosis of schizophrenia (n=528) were identified via key informants within an inner London health district; Feighner and DSM–III–R criteria for schizophrenia were applied. Clinical and social status, psychopathology (Manchester Scale) and problem behaviours (Social Behaviour Schedule) were assessed in a 4:5 representative sample.ResultsFifty-seven per cent had experienced at least one compulsory admission. Forty-five per cent (excluding long-stay in-patients) had marked positive psychotic symptoms; social isolation and lack of daytime activity was more common than among comparable populations elsewhere. One hundred and eleven (25%) of the non-hospitalised patients were not in contact with specialist services.ConclusionsDifficulties in establishing and maintaining a therapeutic alliance between patients and professionals present a challenge to services in inner London. Many social and occupational needs were not being met by existing community provision.
The Camden Schizophrenia Surveys
Authors: Harvey Carol A. , Pantelis Christos , Taylor Jason , Mccabe Patrick J. , Lefevre Karen , Campbell Patrick G. , Hirsch Steven R. 
Published: October 2008

BackgroundInvestigation of the geographical distribution of schizophrenia and its relationship to socio-demographic factors is useful for planning services.MethodIndividuals with schizophrenia (n=980) were identified by key informants within an inner London borough and point prevalence calculated for broad, Feighner and DSM–III–R schizophrenia. The distribution of cases was tested for significant variation using the Poisson process model. Regression models using the Jarman-8 score and its component variables were tested for their ability to predict the prevalence of schizophrenia.ResultsA high point prevalence of schizophrenia (5.3 per 1000 resident population) was demonstrated. Case distribution showed a marked and significant variation associated with socio-demographic factors. The prediction of prevalence was more accurate for broad than for narrower definitions of schizophrenia; unemployment rate performed best.ConclusionsUnemployment rates and Jarman-8 scores may provide crude estimates for resource allocation in planning mental health services, highlighting the need for additional services in deprived inner city areas.
Does Familiality Predispose to both Emergence and Persistence of Psychosis?
Authors: Verdoux Hélène , Van Os Jim , Sham Pak C. , Jones Peter B. , Gilvarry Karyna , Murray Robin 
Published: October 2008

BackgroundIt has been suggested that in schizophrenia an association exists between family history of schizophrenia and poor outcome on the one hand, and family history of affective disorders and good outcome on the other.MethodWe tested for associations between four-year outcome and familial loading for psychotic disorders in a mixed sample of 150 consecutively admitted patients with functional psychosis (schizophrenia, psychotic affective disorders, other psychotic disorders) of recent onset. For each proband, a familial loading score for (i) broadly defined psychotic disorder, (ii) schizophrenia, and (iii) affective disorder was calculated using information on relatives obtained through the Family History Research Diagnostic Criteria method and direct interviews of relatives with the Schedule for Affective Disorders and Schizophrenia.ResultsIn our sample of psychotic patients, familial loading for psychotic disorder predicted persistent negative symptoms over the follow-up period (OR 1.5; 95% CI 1–2.2), especially in schizophrenia, and was also associated with more time hospitalised (P > 0.05), and more social disability at follow-up (P < 0.05). Greater familial loading for schizophrenia predicted a greater likelihood of non-recovery (OR 2.2; 95% CI 1.1–4.4) and a greater likelihood to have had persistent negative symptoms over the follow-up period (OR 1.7; 95% CI 0.9–3.1). No association was found between outcome and familial loading for affective disorder.ConclusionsWe conclude that familial loading may be a continuous risk factor for some dimensions of clinical outcome in the functional psychoses. This suggests that there is a continuum of genetic liability not only to the emergence of psychotic illness, but also the subsequent chronicity of the disorder.
Patients' Views Towards Care Received from Psychiatrists
Authors: Barker Dave A. , Shergill Sukhwinder S. , Higginson Irene , Orrell Martin W. 
Published: October 2008

BackgroundMeasurement of the quality of psychiatric care including assessment of patients' views have become increasingly important as expectations of the standard of care rises.MethodAttitudes and satisfaction of acute psychiatric in-patients were investigated using a questionnaire looking at satisfaction, patients' views on personal and professional qualities of psychiatrists, empowerment and insight.ResultsThe response rate was 79.2% (137 out of 173). Patients with a diagnosis of a non-affective psychotic illness, particularly those lacking insight were significantly less satisfied with their care. Respondents were more satisfied with the personal rather than the professional qualities of the doctors, and less satisfied with their empowerment and doctors' availability.ConclusionsIn-patients' attitudes towards their psychiatric care involves a complex relationship between clinical and sociocultural characteristics. Satisfaction studies can serve as an important monitor and reminder of patient dissent.
Incidence of Mental Disorders in the Finnish UKKI Study
Authors: Lehtinen Ville , Veijola Juha , Lindholm Tomi , Moring Juha , Puukka Pauli , Väisänen Erkki 
Published: October 2008

BackgroundThe aim was to give estimates of the incidence of different mental disorders from a Finnish prospective epidemiological follow-up study, the UKKI Study.MethodThe original probability sample consisted of 1000 persons, aged 15–64 years. The baseline survey took place in 1969–71, and follow-up surveys were conducted 5 and 16 years after the baseline survey. The research methods included a personal psychiatric interview and data collection from different registers. The diagnostic system was based on the ICD–8 classification.ResultsThe estimated annual incidence of all mental disorders was close to 15 per 1000 both between baseline and the 5-year follow-up as well as between the 5-year and the 16-year follow-up. During the entire 16-year follow-up period the annual incidence of all disorders was 14 per 1000 in men and 17 per 1000 in women. The annual incidence of neurotic disorders was 10 per 1000 in men and 14 per 1000 in women, and that of psychotic disorders 2 per 1000.ConclusionsIn the literature, there are huge differences in the results concerning incidence of mental disorders. The results of the present study were rather close to those of the Swedish Lundby Study, but nowhere near the results of the American ECA Study.
Patterns of Positive and Negative Symptoms in First Episode Schizophrenia
Authors: Vázquez-Barquero José Luis , Lastra Ismael , Nuñez Ma Jesús Cuesta , Castanedo Sara Herrera , Dunn Graham 
Published: October 2008

BackgroundThe aim is to examine, in first episodes of schizophrenia the appropriateness of the simple two-dimensional model of schizophrenia (‘negative’ and ‘positive’ dimensions) and more complex variants.MethodAll patients with a first episode of schizophrenia who, over a two-year period, made contact with any of the public mental health services of the autonomous region of Cantabria in northern Spain were investigated. The psychiatric evaluation included, among other instruments, the Present State Examination (PSE–9), and the scales for the assessment of the ‘positive’ and ‘negative’ symptoms of schizophrenia (SAPS and SANS respectively). The dimensionality of the SAPS/SANS item scores and sub-scales was examined through the use of principal component analysis.ResultsThe principal component solution that best fits the data obtained with the initial SANS/SAPS sub-scales reflects the existence of three different (‘negative’ ‘positive’, ‘disorganisation’) factors. The strategy adopted of repeating the analysis after extracting the principal components of the original sub-scales, revealed that although the nature and item composition of the initial ‘negative’ and ‘disorganisation’ factors were in general confirmed, the ‘positive’ dimension presented a more complex structure with at least two ‘positive’ (‘Non-Paranoid’ and ‘Paranoid’) independent factors.ConclusionThe psychopathological structure of the early stages of schizophrenia, as evaluated by the SANS/SAPS, is characterised by the presence of four dimensions: two ‘positive’, one ‘negative’ and one ‘disorganisation‘.
Severe Personality Disorder
Authors: Norton Kingsley , Hinshelwood R. D. 
Published: October 2008

BackgroundSevere personality disorder (SPD) is an imprecise but useful term referring to some notoriously difficult to treat psychiatric patients. Their long-term psychiatric treatment is often unsuccessful, in spite of hospitalisation. The specialist expertise of in-patient psychotherapy units (IPUs) can successfully meet some of SPD patients' needs.MethodRelevant literature on the subject is summarised and integrated with the authors' specialist clinical experience.ResultsMany clinical problems with SPD patients are interpersonal and prevent any effective therapeutic alliance, which is necessary for successful treatment. With in-patients, inconsistencies in treatment delivery and issues surrounding compulsory treatment reinforce patients' mistrust of professionals, compromising accurate diagnosis and an assessment of the need for specialist IPU referral.ConclusionsGeneral psychiatric teams are well-placed to plan long-term treatment for SPD patients which may include IPU treatment. Timely referral of selected SPD patients to an IPU maximises a successful outcome, especially if there is appropriate post-discharge collaboration with general psychiatric teams to consolidate gains made.
Economic Analysis of Treating Depression with Nefazodonev.Imipramine
Authors: Montgomery S. A. , Brown Ruth E. , Clark Michael 
Published: October 2008

BackgroundIt is estimated that treating diagnosed depression costs £420 million annually in England and Wales. This economic study analyses treatment of major depression with nefazodonev.imipramine.MethodThe study updates a previously published model using data obtained from the continuation phase of a double-blind one-year placebo-controlled comparison of nefazodone with imipramine.ResultsAnnual costs for nefazodone are lower than those for imipramine, £218 compared to £254; the cost per successfully treated patient is also lower for nefazodone than for imipramine, £242v.£323. Varying the resources included in the treatment patterns still results in lower costs for nefazodone treatment.ConclusionsBased on clinical trial data for patients completing six to eight weeks of depression treatment and followed for at least one year, the model shows that the annual costs of nefazodone are lower than those for the less expensive imipramine.
The Mortality Experience of Individuals on the Salford Psychiatric Case Register
Authors: Baxter D. N. 
Published: October 2008

BackgroundSeveral studies, mainly non-UK based, have reported higher than expected mortality for individuals with mental illness. This investigation in Salford (England) was undertaken to determine local experiences.MethodAn historical cohort design was employed with record linkage to determine status at study end: maximum follow-up was 18 years. All 6952 individuals with schizophrenia, neuroses, affective or personality disorders, enrolled on the psychiatric case register between 1 January 1968 and 31 December 1975 were recruited: there were 199 exclusions. Death was the study end-point.ResultsObserved mortality was 65% higher than expected and elevated throughout the whole of follow-up. Mortality was highest in younger ages, females and subjects born locally. Circulatory disorders, injury and poisoning each caused approximately one-third of the excess deaths.ConclusionsDocumenting mortality risk has important applications for prioritisation, resource allocation, developing control programmes, evaluating service effectiveness, disease forecasting and future research.
Hyperkinetic or Attention Deficit Disorder
Authors: Sandberg Seija 
Published: October 2008

BackgroundIn the face of rapidly expanding empirical knowledge about this common childhood condition, there is a need for an up-to-date synthesis, especially for the use of practising clinicians.MethodThe main epidemiological, experimental and clinical studies over the past decade are selectively reviewed.ResultsHyperkinetic/attention deficit hyperactivity disorder is common, with young school-age males most frequently affected. The prevalence figures vary depending on the criteria used. Overlap with conduct disorder is high. The causes are likely to stem from a combination of biological, often genetically determined neurochemical disturbances, and environmental disadvantages, with the biological risk tending to be highest in severely hyperactive girls. Good clinical management combines pharmacological, psychological and educational approaches in a sustained manner. Even then, the outcome is often equivocal and the long-term psychosocial adaptation unpredictable.ConclusionsClinically significant hyperactivity is rooted in biological, often genetically transmitted vulnerabilities, upon which environmental disadvantages transact. It may be viewed as a disorder of self-regulation with its roots partly in strained early caregiver–child interactions and disrupted primary attachments.