bluuebunny/crossref_metadata_2025_split huggingface dataset:
Compulsory treatment in anorexia nervosa
Authors: Ramsay Rosalind , Ward Anne , Treasure Janet , Russell Gerald F. M. 
Published: October 2008

BackgroundAnorexia nervosa is a mental disorder with a high long-term mortality. Patients are ambivalent about treatment and often avoid it. Of necessity, compulsory treatment sometimes must be considered. A report from the Mental Health Act Commission has helped to reduce previous confusion.AimsTo identify the premorbid and clinical features that predisposed to compulsory admissions, the short-term benefits of the treatment and the long-term mortality rates (derived from the National Register)MethodEighty-one compulsory patients were compared with 81 voluntary patients.ResultsPredisposing factors to a compulsory admission were a history of childhood sexual or physical abuse or previous self-harm. Detained patients had more previous admissions. Detained patients gained as much weight during admission as voluntary patients, but took longer. More deaths among compulsory than voluntary patients (10/79 v. 2/78) were found 5.7 years (mean) after admission.ConclusionsCompulsory treatment is effective in the short term. The higher long-term mortality in the detained patients is due to selection factors associated with an intractable illness.
Using consensus OPCRIT diagnoses
Authors: Azevedo M. H. , Soares M. J. , Coelho I. , Dourado A. , Valente J. , Macedo A. , Pato M. , Pato C. 
Published: October 2008

BackgroundThe Operational Criteria Checklist (OPCRIT) generates diagnoses according to 12 operational diagnostic systems (e. g. DSM–III, DSM–III–R, Research Diagnostic Criteria, ICD–10)AimsTo examine the agreement between diagnoses generated by the OPCRIT, as completed by the interviewer, with a best-estimate lifetime procedure using the OPCRIT.MethodSubjects came from large mufti-generational bipolar or schizophrenia pedigrees (n=100), and from a sample of unrelated subjects with schizophrenia (n=40). We analysed the diagnostic agreement between OPCRIT diagnoses generated by the interviewer and our best-estimate OPCRIT diagnoses, according to DSM–III–R and ICD–10, using Cohen kappa statistics.ResultsExcellent agreement was found between interviewer OPCRIT diagnoses and OPCRIT diagnoses made by the best-estimate lifetime consensus procedure for DSM–III–R (κ=0.83) and ICD-10 (κ=0.81)ConclusionsResults suggest that this procedure for diagnostic assessment is an efficient alternative to classic best-estimate diagnosis procedures.
Evaluation of the opioid addiction test in an out-patient drug dependency unit
Authors: Ghodse A. H. , Greaves J. L. , Lynch D. 
Published: October 2008

BackgroundThe opioid addiction test is based on the measurement of pupil dilatation in opioid-dependent people in response to conjunctivally applied naloxone hydrochloride. A positive response (pupil dilatation) indicates that the subject is dependent on opioids.AimsTo evaluate the test in an out-patient setting and to identify factors affecting its outcome.MethodPupil size was measured using binocular pupillometry in 100 new patients attending an out-patient clinic for assessment and treatment of opioid use. Measurement was repeated 40 minutes after the unilateral instillation of naloxone drops into the conjunctival sac.ResultsWe performed 127 tests, of which 103 (81.1%) were positive. Males, and those not on methadone at the time of the test, were more likely to have a negative test result.ConclusionsThe opioid addiction test proved to be a very useful tool for the rapid diagnosis of opioid dependence in the out-patient clinic. Specialist pupillometric equipment increases the number of patients correctly identified as opioid-dependent on the first visit, but is not essential.
Risk factors for suicide independent of DSM–III–R Axis I disorder
Authors: Foster Tom , Gillespie Kate , McLelland Roy , Patterson Chris 
Published: October 2008

BackgroundThe vast majority of suicides suffer from at least one mental disorder at the time of death.AimsTo identify risk factors for suicide, particularly those independent of current DSM–III–R Axis I disorder(s)MethodA case–control psychological autopsy study comparing suicides with matched community controls.ResultsIndependent risk factors for suicide included: Axis II (personality) disorder (particularly antisocial, avoidant and dependent); at least one of 12 life events (from the List of Threatening Experiences) during the previous 52 or 4 weeks (in particular, a ‘serious problem with close friend, neighbour or relative’); current unemployment; previous history of deliberate self-harm; and contact with a GP within 26 weeks. Relative to individuals with no current mental disorder, the estimated risk of suicide in those with Axis I–Axis II comorbidity (OR 346.0) was significantly greater than that in those with Axis I disorder(s) only (OR 52.4)ConclusionsSuicide risk assessment may be enhanced by enquiry about the aforementioned independent risk factors, and attention to Axis I–Axis II comorbidity.
Use of electroconvulsive therapy in young people
Authors: Duffett Richard , Hill Peter , Lelliott Paul 
Published: October 2008

BackgroundElectroconvulsive therapy (ECT) is a controversial treatment for psychiatric disorders, particularly when it is administered to young people.AimsTo assess how frequently ECT is administered to people under the age of 18 years in the UK, and why it is given.MethodElectroconvulsive therapy clinics, private hospitals, adolescent units and UK members of the Royal College of Psychiatrists were surveyed to ask if they were aware of ECT being administered during 1996 to a young person under the age of 18 years. Consultants identified as having prescribed ECT were sent a follow-up questionnaire.ResultsTwelve young people were identified as having received ECT; three were aged 15 years or younger and eight were female. Nine patients were rated as improved following ECT. The indications for its use were similar to those for adults.ConclusionsElectroconvulsive therapy is rarely administered to young people in the UK.
Follow-up study of depression in the elderly
Authors: Halloran Eleanor , Prentice Neil , Murray Catherine L. , O'Carroll Ronan E. , Glabus Michael F. , Goodwin Guy M. , Ebmeier Klaus P. 
Published: October 2008

BackgroundImaging studies in depression of the elderly are often small and highly selective.AimsTo investigate a large group of elderly depressed patients in order to assess changes in clinical, imaging and neuropsychological variables at follow-up.MethodPatients (n=175, age range 65–91 years) with clinical depression were identified from consecutive local referrals. Clinical interviews, neuropsychological tests and SPECT scans were carried out at referral and at two-year follow-up.ResultsOf 84 re-examined patients, 46.5% were well, 9.5% were ill, 33% partially recovered and 11% had developed dementia. Duration of illness before index assessment was the only factor to predict outcome. Thirty-nine patients could be scannedandfollowed up. There were no differences between patients with good or poor depressive outcome on SPECT. Ten clinically improved patients could be re-examined with SPECT. There were relative increases in right cingulate gyrus and right cerebellum at follow-up.ConclusionsThe patient group was comparable with other studies showing high levels of residual depressive symptoms. Activity changes in limbic cortex are implicated in depression of old age.
Suicide and unemployment in young people
Authors: Gunnell David , Lopatatzidis Tom , Dorling Daniel , Wehner Helen , Southall Humphrey , Frankel Stephen 
Published: October 2008

BackgroundThe influence of the macro-economic climate on suicide is unclear. During the recent recession, rates have increased in young males but declined in females.AimsTo investigate associations between unemployment and suicide in 15 – to 44-year-old men and women over a period spanning two major economic recessions (1921–1995). To minimise confounding by changes in method availability, analyses are restricted to suicides using methods other than poisons and gases.MethodTime-series analysis using routine mortality and unemployment data.ResultsThere were significant associations between unemployment and suicide in both males and females. Associations were generally stronger at younger ages.ConclusionsSecular trends in youth suicide may be influenced by unemployment or other factors associated with changes in the macroeconomic climate. These factors appear to affect women to the same extent as men. Although it is not possible to draw firm aetiological conclusions from time-trend data, our findings are in keeping with those of person-based studies.
Suicide among drug addicts in the UK
Authors: Oyefeso Adenekan , Ghodse Hamid , Clancy Carmel , Corkefy John M. 
Published: October 2008

BackgroundThe extent of suicide among addicts in the UK has not been sufficiently examined.AimsTo examine suicide trends among registered addicts in the UK over a 25-year period.MethodWe quantified suicide using International Classification of Diseases (ICD) external death codes E950–959, calculated annual age-standardised suicide rates, standardised mortality ratios (SMRs) and described trends in methods of suicide and drug overdose suicides in five successive cohorts of registered addicts.ResultsMale and female suicide rates are 69.0 and 44.8 per 100 000 person-years, respectively. There was a consistent decline in suicide rate throughout the 25-year period. Among males, the SMR for suicide declined from 17.2 in 1968–1972 to 4.4 in 1988–1992 (SMR ratio=3.9, 95% CI=2.5–6.1); among females it declined from 52.6 to 11.3 in the same period (SMR ratio=4.7, 95% CI=1.9–10.8). Drug overdose was the most common method of suicide, accounting for 45% of cases. Significant increase in antidepressant (percentage difference=23.5%, 95% CI=15.2–31.8) and methadone (percentage difference=1.0%, 95% CI=0.5, 21.5) overdose in 1988–1992 compared with 1968–1972 was reported.ConclusionsThe findings confirm that addicts are still at higher risk of suicide than the general population and that prescribed drugs, notably antidepressants and methadone, influence this heightened risk.
Outcome of admission to a medium secure psychiatric unit
Authors: Maden A. , Friendship C. , McClintock T. , Rutter S. 
Published: October 2008

BackgroundA follow-up of patients discharged from medium secure psychiatric units is used to compare outcome in patients of different ethnic origin.AimsTo test the hypothesis that there are systematic differences in clinical outcome between ethnic groups.MethodA descriptive, longitudinal cohort study of discharges from a medium secure unit is used to compare the 125 patients of White/European ethnic origin and the 104 patients of Black/African–Caribbean origin.ResultsPatients of African – Caribbean origin were admitted at three times the rate of White patients, had a higher prevalence of psychosis and a lower prevalence of personality disorder. There was no difference in outcome as measured by location at follow-up, readmission or re-offending.ConclusionsThe higher rate of admission of African–Caribbean patients is consistent with a higher level of demand. There is a need for studies of the pathways by which patients from ethnic minorities reach medium-security accommodation, with a view to early intervention.
Lithium-associated clinical hypothyroidism
Authors: Johnston Ann M. , Eagles John M. 
Published: October 2008

BackgroundRates of, and risk factors for, lithium-associated clinical hypothyroidism are uncertain.AimsTo determine prevalence of and risk factors for clinical hypothyroidism in patients treated with lithium carbonate.MethodRetrospective case-note review of 718 patients who had undergone serum lithium estimation during a 15-month period. Patients on thyroxine had a more detailed review.ResultsThe prevalence of clinical hypothyroidism during lithium treatment was 10.4%. The main risk factor was female gender (women 14% v. men 4.5%). Women were at highest risk during the first two years of lithium treatment, and women starting lithium aged 40–59 years had the greatest prevalence (> 20%). No equivalent risk factors emerged in men, although, like women, their prevalence of hypothyroidism was substantially higher than community rates.ConclusionsThe high rates of clinical hypothyroidism identified may call for a review of the drug information given to women, particularly to those starting lithium in middle age. Consideration should be given to screening for thyroid antibodies before treatment in high-risk cases. Monitoring of thyroid function should take into account gender, age and stage of lithium treatment.
Bereavement and grief in adults with learning disabilities
Authors: Bonell-Pascual Enrique , Huline-Dickens Sarah , Hollins Sheila , Esterhuyzen Alexander , Sedgwick Philip , Abdelnoor Adam , Hubert Jane 
Published: October 2008

BackgroundThis paper reports on the follow-up of a cohort of parentally bereaved adults with learning disabilities.AimsTo investigate whether significant psychopathology, present up to 2.1 years after the death, had resolved five years later.MethodOf an original sample of 50 adults with learning disabilities, 41 were reassessed. The Aberrant Behaviour Checklist and the Psychopathology Instrument for Mentally Retarded Adults were re-administered to carers.ResultsAt follow-up, there was a small increase in the measures of aberrant behaviour. Measures of psychopathology showed improvement, and in particular there was a reduction in anxiety.ConclusionsThe response to bereavement by adults with learning disabilities is similar in type, though not in expression, to that of the general population. Learning disability is a significant predictor of mental health problems following bereavement. Participants adapted more easily when basic emotional needs had been constructively met by carers.
Genetic and environmental risk factors in the aetiology of illicit drug initiation and subsequent misuse in women
Authors: Kendler Kenneth S. , Karkowski Laura M. , Corey Linda A. , Prescott Carol A. , Neale Michael C. 
Published: October 2008

BackgroundSubsequent to initial exposure to the use of a psychoactive substance, psychoactive substance use disorder (PSUD) may or may not develop.AimsTo investigate the relationship between the risk factors for initiation and the subsequent misuse of psychoactive substances.MethodThe lifetime history of illicit substance use and misuse was obtained by telephone interview with 1934 members of female–female twin pairs. We apply a novel model, which estimates the role of genetic and environmental risk factors that influence initiation and those specific to misuse, to three classes of illicit psychoactive substances.ResultsThe individual-specific environment and family environment influenced the probability of initiation, but only individual-specific environment had an impact on the probability of subsequent misuse. Genetic factors which influence the risk of initiation and of misuse were identified.ConclusionsAetiological factors that influence drug initiation and subsequent misuse are correlated but not identical. Family environment is an important determinant of risk for drug experimentation. Two classes of genetic risk factors act on the liability to PSUD: those that influence the probability of initiation and those that influence the risk of misuse.
Transcallosal inhibition and motor conduction studies in patients with schizophrenia using transcranial magnetic stimulation
Authors: Boroojerdi B. , Töpper R. , Foltys H. , Meincke U. 
Published: October 2008

BackgroundTranscranial magnetic stimulation of the motor cortex may not only elicit excitatory responses in hand muscles contralateral to the stimulated hemisphere, but may also suppress tonic voluntary electromyogram activity in muscles ipsilateral to the stimulation. This inhibition is mediated between the motor cortices via the corpus callosum.AimsTo investigate motor excitability and interhemispheric (transcallosal) connections in patients with schizophrenia.MethodTranscallosal inhibition and motor conduction parameters were investigated in ten patients with schizophrenia and in ten age- and gender-matched healthy subjects.ResultsTranscallosal conduction time (TCT) and duration of the inhibition were significantly longer in patients with schizophrenia (mean (s.d.)): TCT, 12.4 (2.9) ms in normal subjects and 15.3 (2.6) ms in patients (P=0.03); mean duration, 34.1 (4.9) ms in normal subjects and 51.9 (16.8) ms in patients (P=0.01).ConclusionsMagnetic motor conduction parameters are unaltered in schizophrenia, but transcallosal inhibition is significantly delayed and prolonged. This may indicate abnormal function of the corpus callosum in these patients.
Predictors of quality of life in people with severe mental illness
Authors: Fahy Thomas , Kent Andy , Tattan Theresa , Van Horn Elizabeth , White Ian 
Published: October 2008

BackgroundIt is not clear which model of case management is most likely to improve quality of life in people with severe mental illness.AimsTo use baseline data derived from the UK700 Case Management Trial to assess the relative importance of clinical, social and unmet needs variables as predictors of subjective quality of life in patients with severe mental illness.MethodPatients (n=708) were assessed on quality of life (Lancashire Quality of Life Profile), needs (Camber well Assessment of Need), psychopathology and social functioning. Variables that were amenable to change through case management were investigated as predictors of quality of life.ResultsSocial variables accounted for 7% of the variance for subjective quality of life, compared with 19% for clinical variables, and 20% for unmet needs. The strongest predictors of subjective quality of life were unmet basic, social and functioning needs, depression and positive psychotic symptoms.ConclusionsSubjective quality of life in severely mentally ill patients is predicted by clinical variables and unmet needs. The results identify priority areas for the attention of case managers who seek to improve quality of life in these patients.
Seasonal affective disorder among primary care attenders and a community sample in Aberdeen
Authors: Eagles John M. , Wileman Samantha M. , Cameron Isobel M. , Howie Fiona L. , Lawton Kenneth , Gray Douglas A. , Andrew Jane E. , Naji Simon A. 
Published: October 2008

BackgroundThere are no large published studies of the prevalence of seasonal affective disorder (SAD) among UK populations.AimTo determine the prevalence of SAD among patients attending a general practitioner (GP).MethodPatients aged 16–64 consulting their GPs in Aberdeen during January were screened with the Seasonal Pattern Assessment Questionnaire (SPAQ). SPAQs were also mailed to 600 matched patients, who had not consulted their GP during January. Surgery attenders who fulfilled SPAQ criteria for SAD were invited for interview to determine whether they met criteria for SAD in DSM–IVand the Structured Interview Guide for the Hamilton Rating Scale for Depression–Seasonal Affective Disorder Version (SIGH–SAD).ResultsOf 6161 surgery attenders, 4557 (74%) completed a SPAQ; 442 (9.7%) were SPAQ cases of SAD. Rate of caseness on the SPAQ did not differ between surgery attenders and non-attenders. Of 223 interviewed SPAQ cases of SAD, 91 (41%) also fulfilled DSM–IVand SIGH–SAD criteria.ConclusionsThere is a high prevalence of SAD among patients attending their GPs in January in Aberdeen; this is likely to reflect a similar rate in the community.
Evaluation of ICD-10 PHC mental health guidelines in detecting and managing depression within primary care
Authors: Upton Mark W. M. , Evans Maggie , Goldberg David P. , Sharp Deborah J. 
Published: October 2008

BackgroundThe prevalence of mental disorders in the community is high, yet many remain unrecognised, misdiagnosed or poorly managed within primary care. Hence, guidelines for diagnosing and managing mental disorders in primary care, ICD–10 PHC, have been developed.AimsTo introduce the guidelines into primary care and to assess whether they improve recognition, accuracy of diagnosis and treatment standards.MethodGPs recorded information on all patients presenting with mental disorders before and after guidelines were introduced. A10% sample of patients underwent interviews to establish a formal diagnosis. Recognition of mental disorders was assessed by screening of patients attending their GP.ResultsThe guidelines had no impact on the overall detection of mental disorders, the accuracy of diagnosis or the prescription of antidepressants. There was a significant increase in the number of patients diagnosed with depression or unexplained somatic symptoms. The GPs also made increased use of psychological interventions.ConclusionsThe success of the guidelines in bringing about change is by no means certain. Some areas appeared more susceptible to change than others.
Annual variation in birth rate of people who subsequently develop schizophrenia
Authors: Adams W. , Kendell R. E. 
Published: October 2008

BackgroundPrevious attempts to decide whether there is significant year-to-year variation in the birth rate of people who subsequently develop schizophrenia have given conflicting results, probably because of differences in the statistical methods employed.AimsTo determine whether there is significant year-to-year variation in the birth rate.MethodVariation in the birth rate for the period 1921–1960 was studied in three separate national data sets – English, Danish and Scottish – using cubic splines to smooth the distribution curve before calculating residuals from a Poisson distribution.ResultsOver-dispersion was found in all three data sets, particularly in the Danish and Scottish data. However, the correlation between the sets of standardised residuals derived from the three data sets was only statistically significant for Denmarkv.England.ConclusionsThere was statistically significant year-to-year variation in the birth rate of people who subsequently developed schizophrenia in three countries in north-west Europe in the years 1921–1960. This is potentially a clue to the nature of the environmental determinants of schizophrenia, but better data will be needed before useful explanatory hypotheses can be generated and tested.
Patients with personality disorder admitted to secure forensic psychiatry services
Authors: Coid Jeremy , Kahtan Nadji , Gault Simon , Jarman Brian 
Published: October 2008

BackgroundTreatment of patients with personality disorder remains controversial and severe mental illness is prioritised in secure forensic psychiatry services.AimsTo compare patients with personality disorder and mental illness according to demography, referral, criminality, previous institutionalisation and diagnostic comorbidity.MethodA record survey of 511 patients with personality disorder and 2575 with mental illness admitted to secure forensic psychiatry services between 1 January 1988 and 31 December 1994 from half of England and Wales.ResultsPersonality disorder admissions declined over time; more were female, White, younger and extensively criminal (specifically, sexual and arson offences). Personality disorder was highly comorbid; antisocial, borderline, paranoid and dependent personality disorder were most prevalent.ConclusionsPatients with personality disorder were highly selected and previously known to psychiatric services. Referrer, diagnostic comorbidity and behavioural presentation determined their pathways into care. Future research must determine whether their continuing admission represents effective use of scarce resources and whether new services are required.