bluuebunny/crossref_metadata_2025_split huggingface dataset:
Diversity of Psychopathology Associated with use of 3,4-Methylenedioxymethamphetamine (‘Ecstasy’)
Authors: Mcguire Philip K. , Cope Helen , Fahy Thomas A. 
Published: October 2008

Background3,4-methylenedioxymethamphetamine (MDMA or ‘Ecstasy’) has become one of the most widely used illicit substances in the UK. Little is known of the psychiatric morbidity which may be associated with its use. We have examined this association by collecting a series of psychiatric cases in which MDMA use was a prominent feature.MethodPatients presenting between 1990 and 1992 with psychiatric symptoms which developed in the context of MDMA use (n= 13) were interviewed, and their psychiatric, medical and drug history, sociodemographic background and mental state were examined in detail. The psychopathology of cases with psychosis (n= 8) was assessed with the Present State Examination and compared with that of substance-naïve psychotic controls (n= 40).ResultsEight patients presented with psychotic syndromes, two experienced visual illusions, hallucinations and palinopsia, one had panic attacks, one suffered from depression, and one described chronic depersonalisation and derealisation. The psychopathology of the patients with psychoses was very similar to that of controls.ConclusionsUse of MDMA may be associated with a broader spectrum of psychiatric morbidity than heretofore suspected. Cases with psychosis may be clinically similar to psychotic patients with no history of substance use.
Suicide in Scotland 1988–1989
Authors: Milne Steven , Matthews Keith , Ashcroft G. W. 
Published: October 2008

BackgroundThe aim was to identify the amount of psychiatric and physical morbidity identified in suicide victims prior to death.MethodA survey was made of primary care records of Scottish suicide victims in the years 1988 and 1989.ResultsLess morbidity was encountered than in previous studies. Single persons and persons from lower socio-economic groups were less likely to have a diagnosis of depression. No association was found between physical and psychiatric morbidity. Depressed single persons and depressed persons from lower socio-economic groups were less likely to receive antidepressants. GPs prescribed lower dosages of antidepressants than psychiatrists. Patients receiving antidepressants were more likely to die by drug overdose.ConclusionsThere are groups in whom depression may be being overlooked and others in whom depression could be treated more vigorously. There are risks in prescribing antidepressants which are potentially fatal in overdose.
A Controlled Evaluation of Psychoeducational Family Intervention in a Rural Chinese Community
Authors: Xiang Mengze , Ran Maosheng , Li Sigan 
Published: October 2008

BackgroundThe shortage of mental health care in rural China might be tackled by community care. This study tests the hypothesis that family intervention increases patients' treatment compliance, which is crucial in community care.MethodA cohort of psychiatric patients were randomly selected to a controlled trial for four months. Compliance rates, clinical and social outcomes were measured double-blindly.ResultsThe compliance rate was increased significantly in the trial group, and they had better clinical and social outcomes.ConclusionsFamily intervention is an effective method of improving treatment compliance and should be an important part of community mental health care.
Predictors of Psychiatric Morbidity in Cancer Patients
Authors: Harrison Judy , Maguire Peter 
Published: October 2008

BackgroundA significant proportion of cancer patients experience psychiatric morbidity in association with diagnosis and treatment. If this morbidity is to be reduced, a better understanding is needed of the factors which influence adjustment to cancer.MethodA review of the literature was carried out to explore those factors associated with poor psychological adjustment to cancer. These are described under four headings: characteristics of the patient; disease and treatment variables; the interaction between patient and illness; and environmental factors.ResultsA number of risk factors for psychiatric morbidity can be identified from each of the four areas. Methodological limitations are highlighted, in particular the preponderance of cross-sectional study designs.ConclusionsIncreased awareness of the risk factors for psychiatric morbidity should lead to earlier detection and more appropriate treatment. Future research should focus on those risk factors which are potentially modifiable.
The Pathological Extensions of Love
Authors: Mullen Paul E. , Pathé Michele 
Published: October 2008

BackgroundClarification is still required of the nature of pathological love.MethodA series is presented of 16 personally assessed cases with pathologies of love (erotomania).ResultsThe pathologies of love usually involve a mixture of morbid infatuation and a morbid belief in being loved. They occur both in a symptomatic form, as part of an underlying mental illness, as well as in a pure form, where their emergence is to some extent understandable in a vulnerable personality. These disorders often go unrecognised to the detriment of clinical management.ConclusionsPathologies of love create distress and disruption to the patient, and place the objects of their unwarranted affection at risk of at best harassment and at worst violence. Although this series of cases, which is drawn predominantly from forensic practice, overemphasises the risk of overt violence, the distress occasioned by pursuit and harassment alone should not be underestimated.
Male Mentally Handicapped Sex Offenders
Authors: Day Kenneth 
Published: October 2008

BackgroundSex offences are overrepresented in the mentally handicapped, but information about the characteristics and offence behaviour of this group is limited.MethodA retrospective case note survey was made of 47 male patients referred for antisocial sexual behaviour.ResultsOf 191 offences and/or incidents committed, 55.5% were heterosexual, 24% indecent exposure, 12.4% homosexual, 13.6% serious and 3.6% involved physical assault. Average age of the offenders was 23.9 years, with a mean IQ of 59.5, and there was a high prevalence of family psychopathology, psychiatric illness, minor physical disabilities, sexual experience, impaired relationship skills and sexual recidivism. Recidivists showed a low specificity for offence type and age and sex of victim. Categorical analysis differentiated a ‘sex offences only’ group from a ‘sex plus other offences’ group in the key areas of psychopathology, offence behaviour and outcome; this was supported by factor analysis.ConclusionThe finding of two subgroups of mentally handicapped male sex offenders has important implications for prevention, assessment and treatment.
A Validity Study of the Hospital Anxiety and Depression Scale in General Hospital Units and a Community Sample in Nigeria
Authors: Abiodun O. A. 
Published: October 2008

BackgroundThe utility of the Hospital Anxiety and Depression Scale (HADS) as a screening instrument for anxiety and depressive disorders in non-psychiatric units (medical & surgical wards; gynaecology & antenatal clinics of a teaching hospital) and a community sample in Nigeria was investigated.MethodA two-stage screening procedure was employed. This involved the use of GHQ–12/GHQ–30 and HADS against the criteria of a standardised (PSE schedule) psychiatric interview, with psychiatric diagnosis assigned in accordance with ICD–9 criteria.ResultsSensitivity for the anxiety sub-scale ranged from 85.0% in the medical and surgical wards to 92.9% in the ante-natal clinic, while sensitivity for the depression sub-scale ranged from 89.5% in the community sample to 92.1% in the gynaecology clinic. Specificity for the anxiety sub-scale ranged from 86.5% in the gynaecology clinic to 90.6% in the community sample, while specificity for the depression sub-scale ranged from 86.6% in the medical and surgical wards to 91.1 % in the ante-natal clinic and community sample. Misclassification rates ranged from 9.9% in the community sample to 13.2% in the medical and surgical wards. Relative Operating Characteristic (ROC) analyses showed the HADS and the GHQ–12 to be quite similar in ability to discriminate between cases (anxiety and depression) and non-cases.ConclusionsThe HADS is valid for use as a screening instrument in non-psychiatric units and although initially developed for use in hospital settings, it could be usefully employed in community settings of developing countries to screen for mental morbidity.
Understanding the Symptoms of Schizophrenia Using Visual Scan Paths
Authors: Phillips Mary L. , David Anthony S. 
Published: October 2008

BackgroundThis paper highlights the role of the visual scan path as a physiological marker of information processing, while investigating positive symptomatology in schizophrenia.MethodThe current literature is reviewed using computer search facilities (Medline).ResultsSchizophrenics either scan or stare extensively, the latter related to negative symptoms. Schizophrenics particularly scan when viewing human faces.ConclusionsScan paths in schizophrenics are important when viewing meaningful stimuli such as human faces, because of the relationship between abnormal perception of stimuli and symptomatology in these subjects.
Inner London Collaborative Audit of Admission in Two Health Districts
Authors: Flannigan C. B. , Glover G. R. , Wing J. K. , Lewis S. W. , Bebbington P. E. , Feeney S. T. 
Published: October 2008

BackgroundIn this series, rates of admission and daily bed use in south Southwark were 30% higher than in Hammersmith & Fulham, principally because of a higher rate of admission for affective disorders. Factors associated with compulsory admission did not differ between the districts. This final paper examines the severity of symptoms, the reasons given for admission and factors relevant to the judgement to admit, in order to test the hypothesis that more resources mean better service.MethodSampling and data collection methods were described in the first paper.ResultsIn both districts, major reasons for admission were self-neglect and risk of self-harm, poor adaptive functioning, and poor acceptance of medication. In south Southwark, a group of patients had affective disorders and less severe symptoms but a stated risk of suicide. Rates for, and severity of, schizophrenia were similar in the two districts. Social and preventive reasons for admission were given more frequently in south Southwark, where patients had more often been in contact with services before admission. Staff there, but not in Hammersmith & Fulham, suggested that many could have benefited from alternative forms of residential care.ConclusionsA ‘buffer’ of hospital beds in south Southwark may have allowed a more acceptable service, particularly for affective disorders. The possibility that this buffer could be replaced by a wider range of residential accommodation, including hostels away from the District General Hospital, is discussed. Ten recommendations are listed.
Adolescent Girls II Background Factors in Anxiety and Depressive States
Authors: Monck Elizabeth , Graham Philip , Richman Naomi , Dobbs Rebecca 
Published: October 2008

BackgroundThis study investigated the prevalence and background variables associated with anxiety and depressive disorders occurring in a community population of older teenage girls.MethodGirls aged 15–20 years (n = 529) whose names were drawn from general practitioner age/sex registers completed self-report Great Ormond Street Mood Questionnaires. From this sample, 143 girls (69 with high self-report scores and 74 controls) were intensively interviewed. Information was obtained on confiding/supportive relationships, family arguments and rows, quality of marital relationship, and degree of parental control. Psychiatric state was assessed by use of the Clinical Interview Schedule to provide a Total Weighted Score. A modified form of the Bedford Life Events and Difficulties Schedule was applied.ResultsThe estimated one-year prevalence rate for psychiatric disorder was 18.9%, and 16.9% for depression and anxiety disorders. Using a logit analysis, it was shown that maternal distress (P < 0.02) and the quality of the mother's marriage (P < 0.02) were independently associated with the presence of depression and anxiety disorders.ConclusionsAbout 17% of girls in a community sample living at home showed a depression or anxiety disorder. Even in late adolescence, the presence of a mood disorder is closely linked to the quality of family relationships within the home.
Post-Mortem Antipsychotic Drug Concentrations and Unexplained Deaths
Authors: Jusic Nedzara , Lader Malcolm 
Published: October 2008

BackgroundThe relationship between antipsychotic drug treatment and sudden unexplained death remains unclear. The estimation of post-mortem blood drug concentrations should be helpful.MethodEight medico-legal cases were reviewed with respect to behaviour of patient, type and dosage of drug treatment, mode of death, post-mortem findings and drug concentrations.ResultsThe problems of evaluating such drug levels are discussed. Five of the eight patients had probably toxic concentrations of antipsychotic and/or antidepressants, which caused death, usually involving cardiac arrhythmias.ConclusionsIn cases of sudden unexpected death, a sample of blood from a peripheral vein should be obtained immediately death is pronounced or the body discovered, and sent for analysis. To minimise such fatalities, the patient should be monitored carefully, with ECG if feasible, and electrolyte balance checked. The drug regimen used should be kept simple and large doses of antipsychotics and/or antidepressants avoided wherever possible.
Comparison of Long-Term Benzodiazepine Users in Three Settings
Authors: Hawley C. J. , Tattersall M. , Dellaportas C. , Hallstrom C. 
Published: October 2008

BackgroundMost studies of chronic benzodiazepine users consider selected populations which may be unrepresentative. This study was undertaken to examine possible differences between groups.MethodSubjects chosen were benzodiazepine users in general practice, a hospital clinic, and attending TRANX trials. Descriptive data were collected on characteristics and outcome.ResultsRANX trial patients had the best outcome (P = 0.027). Hospital cases used high doses of anxiolytic benzodiazepines; concomitant mental disorder, including schizophrenia, was common. General practice cases were older and mainly used hypnotics (P < 0.05).ConclusionsBecause groups of benzodiazepine users are different, there cannot be one single management approach. Cases require individual medical assessment.
Coping with Chronic Pain
Authors: Elton Naomi H. , Hanna Magdi M. H. , Treasure Janet 
Published: October 2008

BackgroundA multi-dimensional approach was used to examine coping in chronic pain. The following hypotheses were tested: (a) patients who cope maladaptively also cope generally in a similar way; (b) patients' maladaptive coping is associated with childhood adversity.MethodCross-sectional and retrospective data were collected from 68 consecutive patients (aged 18–70) at a pain clinic where their disease was non-systemic and the pain had lasted for at least three months. Sixty-one patients were interviewed using the Structured Clinical Interview for DSM–III–R, and the Measure of Parental Care in Childhood. All patients completed questionnaires on their pain and personality.ResultsTwo coping styles emerged from factor analysis. One was associated with chronicity, psychiatric morbidity, harm avoidance, immature defence style and reporting parental indifference.ConclusionPatients may be predisposed to cope maladaptively after the experience of parental indifference in early life. Such coping is likely to reflect more general patterns.
Confinement of Winter Birth Excess in Schizophrenia to the Urban-born and its Gender Specificity
Authors: O'Callaghan Eadbhard , Cotter David , Colgan Karen , Larkin Conall , Walsh Dermot , Waddington John L. 
Published: October 2008

BackgroundThe season of birth phenomenon in schizophrenia was reexamined in relation to place of birth, in order to test the hypothesis that a seasonal factor might operate preferentially among those who were urban-born.MethodThe seasonal distribution of births was examined among 3253 patients in two case registers having an ICD–9 diagnosis of schizophrenia and compared with the distribution of births among the normal population born in those catchment areas over the same period; those subjects born in population centres greater than 50 000 were defined as urban-born.ResultsPatients who were urban-born showed an excess of winter births relative to controls that was absent among their rural-born counterparts. On comparing patient groups, those who were urban-born were more likely to be born in the winter, while those who were rural-born were more likely to be born in the spring; this urban–rural distinction was confined essentially to female patients.ConclusionsThese findings might be accommodated most readily in terms of a spatially as well as seasonally varying environmental factor that is associated with urbanicity and to which female offspring are more vulnerable.
Placebo-Controlled Trial of Lithium Augmentation of Fluoxetine and Lofepramine
Authors: Katona Cornelius L. E. , Abou-Saleh Mohammed T. , Harrison Deborah A. , Nairac Bertrand A. , Edwards Denzil R. L. , Lock Toni , Burns Robert A. , Robertson Mary M. 
Published: October 2008

BackgroundThis study was designed to establish whether (as suggested in a number of open and relatively small controlled trials) lithium augmentation is more effective than continued antidepressant alone, where response to a standard course of antidepressant treatment has been absent or partial.MethodLithium or placebo was added on a double-blind basis for six weeks to the drug regime of 62 patients with major depressive illness (in both hospital and primary care settings) who had failed to respond to a controlled trial of fluoxetine or lofepramine. Response was defined as a final Hamilton Depression Rating Scale (HDRS) score of < 10.ResultsResponse was seen more frequently in patients taking lithium (15/29) than in those remaining on antidepressant alone (8/32; P < 0.05). Rapid response to lithium augmentation (LA) was not consistently observed in this cohort. Mean HDRS scores after six weeks were significantly lower (P < 0.01) in the lithium group after excluding those who had not achieved significant exposure to lithium (arbitrarily defined as two or more lithium levels ≥ 0.4 mmol/1). No differences in the efficacy of LA were apparent between fluoxetine and lofepramine.ConclusionsOur results confirm that LA is a useful strategy in the treatment of antidepressant-resistant depression. Partial response was, however, frequently observed with continued antidepressant treatment alone, and the superiority of LA appears to depend on achieving adequate serum lithium levels.
Long-Term Effects of Behavioural Treatment for Panic Disorder with Agoraphobia
Authors: Fava Giovanni A. , Zielezny Maria , Savron Gianni , Grandi Silvana 
Published: October 2008

BackgroundThere are few long-term follow-up studies of panic disorder treatments, particularly when patients have been treated by behavioural methods only and have recovered.Method110 consecutive patients satisfying the DSM–III–R criteria for panic disorder with agoraphobia were treated in an out-patient clinic with behavioural methods based on exposure. After 12 sessions of psychotherapy, 81 patients became panic-free. A 2–9 year follow-up was available. Survival analysis was employed to characterise the clinical course of patients. Regular assessments by a clinical psychologist were based on the Clinical Interview for Depression.ResultsThe estimated cumulative percentage of patients remaining in remission was 96.1% for at least two years, 77.6% for at least five years, and 67.4% for at least seven years. These outcomes greatly improved in the absence of a personality disorder or residual agoraphobia after treatment.ConclusionsThe findings suggest that, even though one patient in four is unable to complete treatment or does not benefit sufficiently from it, exposure treatment can provide lasting relief for the majority of patients. Disappearance of residual and subclinical agoraphobic avoidance, and not simply of panic attacks, should be the aim of exposure therapy.
The Korsakoff Syndrome
Authors: Kopelman Michael D. 
Published: October 2008

BackgroundInvestigations of the Korsakoff syndrome by researchers from different disciplines have proliferated in recent years, making it apposite to review the various findings.MethodThis review is based on the author's knowledge of reports in the major clinical and neuropsychological journals, supplemented by Medline searches to update particular subtopics.ResultsThe Korsakoff syndrome is defined as a disproportionate impairment in memory, relative to other aspects of cognitive function, resulting from a nutritional (thiamine) depletion. The initial manifestations of the disorder are variable, and a persistent memory impairment can result from a non-alcoholic aetiology, although this seems to happen much less commonly than in the past – presumably because of generally higher standards of nutrition. Although there is agreement on the underlying neuropathology, the critical lesion sites for memory disorder have been debated. Recent evidence suggests that the circuit involving the mammillary bodies, the mammillo-thalamic tract and the anterior thalamus, rather than the medial dorsal nucleus of the thalamus, is particularly critical in the formation of new memories. The relationship of these deficits to thiamine depletion remains a topic of current investigation, as does the purported role of neurotransmitter depletions in the cholinergic, glutamate/GABA and catecholamine and serotonergic systems. Neuro-imaging studies have confirmed autopsy findings of more widespread structural and metabolic abnormalities, particularly involving the frontal lobes.ConclusionsThe relationship of these neuropathological, neurochemical, and metabolic abnormalities to cognitive functioning, with particular reference to specific aspects of memory processing, has been considered in some detail. Whereas structural and/or neurochemical abnormalities within the limbic/diencephalic circuits account for anterograde amnesia, some other factor, such as frontal lobe dysfunction, must underlie the severe retrograde memory loss which is characteristically found in this syndrome.