bluuebunny/crossref_metadata_2025_split huggingface dataset:
Implementation and Effectiveness of Interpersonal Psychotherapy in a Community Mental Health Service
Authors: Reay Rebecca , Stuart Scott , Owen Cathy 
Published: August 2003

Objective: Although the efficacy of a number of psychotherapeutic interventions has been well established in tightly controlled, randomized trials, there remains a paucity of literature examining the effectiveness of these interventions in community practice settings. In light of this, the Australian Capital Territory Mental Health Services (Canberra, ACT) set out to investigate the effectiveness of an empirically supported psychotherapeutic intervention, interpersonal psychotherapy (IPT). The present study describes a pilot evaluation of the training programme for health professionals and the IPT treatment programme. Methods: Forty community mental health professionals participated in intensive IPT training. Clinicians who completed a course of supervision were asked to apply the treatment with non-psychotic acutely depressed patients. Measures of patients’ health outcomes were taken before and after treatment using a standardized outcome measure. Results: A total of 17 out of 21 patients who were selected completed a course of 12–16 weeks of IPT. The majority of the patients had a depression originating in the post-partum period. A comparison of pre- and post-treatment scores of treatment completers revealed a significant decrease in mean depression scores. Clinicians who completed a course of training and supervision found that they were able to confidently apply IPT in a clinical setting. Conclusions: Although there were a number of barriers and obstacles to the introduction of an evidenced-based treatment, the results are promising and demonstrate that IPT can be readily taught to experienced mental health professionals. Further study is required to determine the feasibility of IPT in other non-academic settings using larger sample sizes and homogenous groups of patients.
Psychotherapy in the Era of Evidence-Based Medicine
Authors: Starcevic Vladan 
Published: August 2003

Objective: To examine the status of psychotherapy in an era when evidence-based medicine (EBM) largely determines what constitutes efficacious treatment, and to suggest how psychotherapy might respond to the expectations of EBM, while preserving its identity and role in psychiatry. Conclusions: If EBM is espoused dogmatically it is likely that psychotherapy will never meet its requirements. Psychotherapy can survive in the climate of an ever-increasing pressure to demonstrate its usefulness by insisting on its own criteria for doing so. This is legitimate in view of the specific features of psychotherapy, which make the standard EBM procedures for assessing the usefulness of treatment largely inapplicable.
‘In-House’ Solutions for Major Ethical Breaches
Authors: Middleton Warwick 
Published: August 2003

Objective: To evaluate ‘in-house’ decisions made in respect of major ethical breaches, whether occurring in psychiatry or within the hierarchy of major churches. Conclusions: The closer professional bodies, churches and other related organizations that have high expectations of the duty of care of their professional members, get to practising democratic ideals and universal standards of human rights, the more such members become accountable, and the less there are special cases or exceptions to the law.
Initial Experience With Long-Acting Risperidone Microspheres Injection
Authors: Keks Nicholas , Been Cyril , D'Souza Russell , Thomas Rajan , Tune Philip , Babb Jenny , Brennan Edwina , Hope Judy 
Published: August 2003

Objective: To report initial clinical experience with the injectable long-acting microspheres formulation of the atypical antipsychotic risperidone. Methods: Case reports. Results: The seven patients described have had good outcomes to date. A patient who has received the drug for 2 years has improved from a state of severe deterioration to full-time employment and participation in a relationship; he has reported mild erectile difficulties but is keen to continue. In all cases extrapyramidal side-effects have been uncommon and brief; weight gain or other physical adverse events have not been observed. Conclusion: Initial use of long-acting injectable risperidone suggests that the first ‘atypical depot’ is a welcome therapeutic development likely to provide significant clinical benefits, particularly for patients who have previously had unsatisfactory experiences with conventional antipsychotics.
The NUCOG: Construction and Piloting of a Cognitive Screening Instrument in a Neuropsychiatric Unit
Authors: Walterfang Mark , Velakoulis Dennis , Gibbs Andrew , Lloyd John 
Published: August 2003

Objective: To develop a cognitive screening instrument suitable for a neuropsychiatric inpatient, outpatient and consultation—liaison population. Methods: A number of cognitive screening instruments used clinically and published in the literature were reviewed. A new tool, the Neuropsychiatry Unit Cognitive Screen (NUCOG), was developed on the basis of this review, and piloted in a diverse population of patients in the unit. Conclusions: The NUCOG demonstrated a high degree of face validity, correlation with the Mini-Mental State Examination, and significant scoring differences between demented and non-demented patients.
Comorbidity in attention deficit–hyperactivity disorder
Authors: Ishii Takashi , Takahashi Osamu , Kawamura Yuuichi , Ohta Tatsuro 
Published: August 2003

AbstractAttention deficit–hyperactivity disorder (ADHD) has been noted for its high rate of comorbidity. The present study is the first report in Japan evaluating the proportion of comorbidity in ADHD cases presenting in the clinical setting, aiming at clarifying the picture of ADHD in Japan. The subjects consisted of 68 child and adolescent cases meeting criteria for ADHD (Diagnostic and Statistical Manual of Mental Disorders, 4th edn) under treatment at a child psychiatry clinic (IQ > 50, mental age ≥ 4 years old). Disorders evaluated as comorbid disorders were mood disorders, anxiety disorders, elimination disorders, sleep disorders, tic disorders, oppositional defiant disorder (ODD), conduct disorder (CD), school refusal, and epilepsy. Comorbidity with mood disorders, anxiety disorders, ODD, and CD, were found to be lower than the high rates conventionally reported in North America. The lower age of the present subjects, primarily in infancy and elementary school age with few adolescent cases, and a bias towards milder cases from an outpatient clinic without inpatient facilities are believed to be factors accounting for this disparity. Furthermore, it was a notable fact that mentally delayed cases (IQ: 51–84) amounted to 34% of the cases, indicating the necessity to consider intelligence level when formulating a treatment strategy for ADHD.
Study on feelings of school avoidance, depression, and character tendencies among general junior high and high school students
Authors: Honjo Shuji , Sasaki Yasuko , Kaneko Hitoshi , Tachibana Kota , Murase Satomi , Ishii Takashi , Nishide Yumie , Nishide Takanori 
Published: August 2003

AbstractSchool refusal is a phenomenon that first drew attention in Japan around 1960 and it remains one of the major issues in child psychiatry today. Moreover, it is now said that there exists a large group of latent school refusers currently attending school but harboring feelings of school avoidance. To address this issue, a questionnaire survey was conducted on students enrolled in a junior high and high school affiliated with the Nagoya University School of Education. The questionnaire consisted of the Children's Depression Inventory (CDI), a scale for evaluating feelings of school avoidance (School Avoidance Scale), and a scale for assessment of personality characteristics associated with school refusal (School Refusal Personality Scale). The subjects were 425 first‐year junior high to second‐year high school students. Factor analysis of each scale revealed the CDI to consist of three factors: ‘core depression’, ‘feelings of interpersonal maladaptation’, and ‘self‐revulsion’, and the School Avoidance Scale to consist of two factors: ‘school dislike’, and ‘school avoidance’. The School Refusal Personality Scale consisted of three factors: ‘obsessive–compulsive’, ‘passive/unsocial’, and ‘socially introverted’. Mean CDI score and standard deviation (SD) was 19.44 ± 7.49, and that for ‘feelings of school avoidance’ was 20.18 ± 5.61. The two subordinate factors of the School Avoidance Scale were intimately associated with both ‘feelings of interpersonal maladaptation’ and ‘core depression’ of the CDI, and negatively correlated with the ‘obsessive–compulsive’ factor of the School Refusal Personality Scale.
Relationship between attention and arousal level in schizophrenia
Authors: Nakamura Mitsuru , Matsushima Eisuke , Ohta Katsuya , Ando Katsumi , Kojima Takuya 
Published: August 2003

AbstractThe purpose of the present paper was to clarify the link between the attention and arousal level that supports the basis of the cognitive dysfunction in schizophrenia, by investigating the relationship between the simple reaction time and the closed‐eye eye movements in 30 patients with schizophrenia and 20 healthy controls. In terms of closed‐eye eye movements during the simple reaction time test, healthy controls showed an increase of s‐type (small and slow) eye movements after the end of the preparatory interval (PI) in both regular and irregular series, while the patients with schizophrenia, particularly those in whom the cross‐over phenomenon was observed, showed no changes and maintained a hyperarousal level during the regular PI test. These results indicate that the patients with schizophrenia could not maintain appropriate attention during the burden tasks and their hyperarousal level persisted. It is therefore suggested that there is a close relationship between attentional deficit and hyperarousal among patients with schizophrenia.
Olanzapine in Chinese treatment‐resistant patients with schizophrenia: An open‐label, prospective trial
Authors: Chiu Nan Ying , Yang Yen Kuang , Chen Po See , Chang Cheng‐Chen , Lee I. Hui , Lee Jiunn‐Ren 
Published: August 2003

AbstractThe role of olanzapine in treatment‐resistant schizophrenia has still not been clearly resolved. In addressing this issue, the current report presents an open‐label, prospective, 13 week trial with olanzapine use in Chinese schizophrenic patients who were resistant to more than two different classes of antipsychotics during a minimal 4 week treatment period for each antipsychotic drug at adequate dosage. Fifty‐one inpatients were recruited after a cross‐titration period and given 10–25 mg of olanzapine daily, without any concomitant antipsychotic medication. Patients were evaluated with the Brief Psychotic Rating Scale (BPRS), the Positive and Negative Symptoms Scale, the Clinical Global Impression Scale (CGI), the Abnormal Involuntary Movement Scale, the Simpson–Angus scale, and the Barnes Akathisia Scale. The olanzapine‐treated patients showed significant improvement in both the positive and negative symptoms of schizophrenia by the end of the study. Overall, 20 of 51 (39.2%) responded to 10–25 mg of olanzapine per day as measured by the BPRS and CGI scores. Five patients dropped out due to the worsening of their psychotic symptoms, two patients discontinued owing to poor drug compliance, and the remaining patient complained of a lack of efficacy. Extrapyramidal side‐effects were mild, and anticholinergic medications required has decreased. The present open study suggests that olanzapine may be effective and well‐tolerated in Chinese treatment‐resistant schizophrenic patients. Further double‐blinded trials are needed to confirm this result.
An intervention to improve the interrater reliability of clinical EEG interpretations
Authors: Azuma Hideki , Hori Shiro , Nakanishi Masao , Fujimoto Shinji , Ichikawa Norimasa , Furukawa Toshiaki A. 
Published: August 2003

AbstractSeveral studies have noted modest interrater reliability of clinical electroencephalogram (EEG) interpretations. Moreover, no study to date has investigated a means to improve the observed interrater agreement. The purpose of the present study was to examine (i) the interrater reliability of EEG interpretations among three raters (two psychiatrists and one pediatrician); and (ii) how to improve the reliability by establishing a consensus guideline for EEGinterpretation. Three raters, two psychiatrists and a pediatrician, interpreted 100 consecutive EEG recorded at Tajimi General Hospital. After discussing the results of the first trial, the raters established a consensus guideline for EEG interpretation. They then interpreted 50 consecutive EEG recorded at Nagoya City University Hospital following this guideline. Kappa for global judgment of EEG abnormality in three grades (abnormal/borderline/normal) was 0.42 on the first and 0.63 on the second trial. Kappa significantly improved by using the guideline (P = 0.004). It is suggested that discussing and establishing the consensus guideline among the raters offers a feasible method to improve interrater reliability in clinical EEG interpretations.
Cognitive deterioration and changes of P300 during total sleep deprivation
Authors: Lee Heon‐Jeong , Kim Leen , Suh Kwang‐Yoon 
Published: August 2003

AbstractThe study was conducted to evaluate the cognitive deteriorations induced by sleep deprivation with the computerized neurocognitive tests and the P300 event‐related potential. Thirty healthy college students (22 men, eight women) participated in the present study. Subjects remained awake for 38 h under continuous surveillance. In the morning and the evening of the two study days, the computerized neurocognitive tests and the P300 were performed. In vigilance test and reaction unit test, there were significant cognitive impairments during sleep deprivation. However, in the cognitrone test there was significant functional improvement, which might be due to the practice effect. The P300 latency was significantly prolonged and the amplitudes decreased during sleep deprivation. The cognitive impairment during 38 h of sleep deprivation was mainly in terms of vigilance and reaction time. In contrast, higher complex cognitive function such as fine perceptual analyses, visual discrimination and working memory might be not affected by 38 h of total sleep deprivation. The changes of P300 were significantly correlated with the results of vigilance and reaction unit tests but not with the cognitrone test. Taken together, these results suggest that the P300 changes that occur during sleep deprivation are a reflection of the decrement in vigilance, which prolongs reaction time.
Unipolar depression with bipolar family history: Links with the bipolar spectrum
Authors: Benazzi Franco 
Published: August 2003

AbstractThe aim of the present paper was to find if unipolar major depressive disorder (MDD) with bipolar family history could be included in the bipolar spectrum, by comparing it to unipolar MDD without bipolar family history, and to bipolar II disorder, on typical bipolar variables. A sample of 280 consecutive bipolar II outpatients, and a sample of 135 consecutive unipolar MDD outpatients, presenting for major depressive episode (MDE) treatment, were interviewed with the Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders (4th edn). Hypomanic symptoms during the MDE were systematically assessed. Clinical variables used to validate the inclusion of unipolar MDD with bipolar family history in the bipolar spectrum were young age of onset, many MDE recurrences, atypical features, and depressive mixed state (DMX; an MDE plus >2 concurrent hypomanic symptoms), following many previous studies reporting that these variables were typical features of bipolar disorders. Means were compared by t‐test and frequencies by χ2 test (stata 7). Two‐tailed P < 0.05 was chosen. Unipolar MDD with bipolar family history was present in 20% of MDD patients. Comparisons among unipolar MDD with bipolar family history (UP+BPFH), unipolar MDD without bipolar family history (UP–BPFH), and bipolar II (BPII), found that UP+BPFH versus UP–BPFH had a significantly lower age, lower age of onset, fewer recurrences, and more DMX; that UP+BPFH versus BPII had no significant differences (apart from recurrences); and that UP–BPFH versus BPII had significantly different age, age of onset, recurrences, atypical features, and DMX. Findings suggest that UP+BPFH shows many bipolar signs, and that it could therefore be included in the bipolar spectrum. Unipolar MDD with bipolar family history had a clinically significant 20.0% frequency in the unipolar MDD sample, supporting the clinical usefulness of this depression subtype. The subtyping of MDD based on bipolar family history could have treatment implications.
Mood stabilizers in hospitalized children with bipolar disorder: A retrospective review
Authors: Davanzo Pablo , Gunderson Brent , Belin Thomas , Mintz Jim , Pataki Caroly , Ott Derek , Emley‐Akanno Catherine , Montazeri Nazila , Oppenheimer Jami , Strober Michael 
Published: August 2003

AbstractA paucity of naturalistic data supported a rationale for the present retrospective review of clinical changes during hospitalization in 44 bipolar pre‐adolescents, treated with monotherapy lithium, carbamazepine (CBZ) or divalproex sodium (DVP). Daily staff progress notes and discharge summaries on each patient were read by four trained clinicians blind to treatment group, and rated according to the Clinical Global Impression Improvement (CGI‐I) scale. Consensus rating was measured by kappa reliability. Data were analyzed using a general linear model (sas mixed) analysis of variance (anova) with repeated measures. The medication groups did not differ in length of hospitalization, overall severity of illness at the time of admission, or comorbidity. Prior treatment was considered as a covariate. Each group approached serum therapeutic levels at day 7 of the medication period. The estimated mean CGI‐I scores for CBZ were systematically higher (i.e. worse) than those for lithium and DVP, which overlapped and crossed over time. The difference became increasingly apparent and was statistically significant by week 2 (P = 0.036). The present study was limited in that the sample sizes, particularly in the case of CBZ, were small, commensurate with the low prevalence of the disorder. Lack of structured interviews, as an independent assessment of diagnoses was an intrinsic limitation of the study. Although constrained by its retrospective nature, our findings suggest that by week 2 of hospitalization both lithium and DVP may be more efficacious than CBZ in bipolar pre‐adolescents. Any significant finding must be viewed as tentative and subject to confirmation in other studies.
Japanese version of the Body Attitude Test: Its reliability and validity
Authors: Kashima Akiko , Yamashita Tatsuhisa , Okamoto Akiko , Nagoshi Yasuhide , Wada Yoshihisa , Tadai Toshiaki , Fukui Kenji 
Published: August 2003

AbstractThe Body Attitude Test (BAT) was developed by Probst et al. (1995) for female patients with eating disorders (ED). This test measures the subjective body experience and attitudes toward one's body. The present authors have developed the Japanese version of the BAT and the purpose of the present paper was to investigate its reliability and validity in control (CON, n = 599) and ED patients (n = 46). The ED patients consisted of 21 anorexia nervosa, restricting type (AN‐R) patients and 25 bulimia nervosa (BN) patients. Internal consistency was determined with Cronbach's α coefficient in CON. Factor analysis was conducted on BAT ratings given by CON. Factor analysis indicated that BAT was composed of two factors. These were body dissatisfaction (factor 1) and lack of familiarity with one's body (factor 2). A comparison was made among AN‐R, BN, and CON. Bulimia nervosa had a significantly higher score than the other two groups. The BAT scores of ED patients correlated significantly with the Self ‐rating Depression Scale, and State–Trait Anxiety Inventory. These results show that ED patients have negative feelings toward their own body, similar to the findings in the original report. On factor analysis, however, it was not possible to distinguish between negative appreciation of body size and general body dissatisfaction as described in the original report. The authors also examine influences on this difference from a cross‐cultural view point.
Role of coping strategies and attitudes in mediating distress due to hallucinations in schizophrenia
Authors: Singh Gagandeep , Sharan Pratap , Kulhara Parmanand 
Published: August 2003

AbstractThe purpose of the present study was to determine the role of coping strategies and attitudes in predicting distress due to hallucinations in schizophrenia. Seventy‐five chronic stable schizophrenia patients were assessed with respect to sociodemographic profile, clinical variables, general psychopathology, phenomenology (severity) of hallucinations, attitude towards hallucinations, distress due to hallucinations (determined by two measures) and coping strategies used to deal with hallucinations. On multiple stepwise regression analysis, ‘severity of hallucinations’ and ‘problem‐solving coping strategies’ contributed significantly to both measures of distress. It can be concluded that distress due to hallucinations in schizophrenia is determined by severity of hallucinations (stressor) and problem‐solving coping strategies. Attitudes do not seem to play any role in this respect.
Predictors of first‐onset major depressive episodes among white‐collar workers
Authors: Tokuyama Madoka , Nakao Kazuhisa , Seto Masako , Watanabe Akira , Takeda Masatoshi 
Published: August 2003

AbstractMajor depression is a multifactorial disorder. Previous studies have mainly evaluated work stress to determine the risk factors for depression among workers. The present study aimed to determine factors predictive of the first depressive episode 1 year later among white‐collar workers, and to examine whether work ‘stress’ is associated with an elevated risk of depression. A 5 year open‐cohort study was carried out in a Japanese company. The odds ratios (OR) of the development of depression 1 year later were calculated. Ninety‐eight first‐onset cases were compared with 1267 never‐ill cases. Forward stepwise multiple logistic regression indicated that the first onset of depression was associated with a past history of panic attack (OR: 5.14; 95% confidence interval (CI): 1.64–16.10), neuroticism (OR: 3.59; 95%CI: 2.06–6.26), perceived overprotection (OR: 2.75; 95%CI: 1.66–4.55), poor support (OR: 2.55; 95%CI: 1.58–4.10), and low care (OR: 2.23; 95%CI: 1.23–4.04). First‐onset cases were more likely to have had objective work events (OR: 1.50; 95%CI: 1.18–1.90) but they did not differ from never‐ill cases in subjective job stress. The development of major depression in white‐collar workers is associated with multiple factors, as is depression in the community.