bluuebunny/crossref_metadata_2025_split huggingface dataset:
Effectiveness of cognitive–behavioural family intervention in reducing the burden of care in carers of patients with Alzheimer's disease
Authors: Marriott Alison , Donaldson Catherine , Tarrier Nicholas , Burns Alistair 
Published: August 2002

BackgroundThe majority of patients with Alzheimer's disease live outside institutions and there is considerable serious psychological morbidity among their carers.AimsTo evaluate whether family intervention reduces the subjective burden of care in carers of patients with Alzheimer's disease and produces clinical benefits in the patients.MethodA prospective single-blind randomised controlled trial with three-month follow-up in which the experimental group received family intervention and was compared with two control groups.ResultsThere were significant reductions in distress and depression in the intervention group compared with control groups at post-treatment and follow-up. There were significant reductions in behavioural disturbance at post-treatment and an increase in activities at three months in patients in the intervention group. Based on an improvement on the General Health Questionnaire resulting in a carer converting from a case to a non-case, the number to treat was three immediately post-treatment and two at follow-up.ConclusionsFamily intervention can have significant benefits in carers of patients with Alzheimer's disease and has a positive impact on patient behaviour.
Effects of a pharmacist's medication review in nursing homes
Authors: Furniss Lee , Burns Alistair , Craig Sarah Kathryn Lloyd , Scobie Susan , Cooke Jonathan , Faragher Brian 
Published: August 2002

BackgroundOlder people in nursing and residential homes often have complex disabilities and behavioural disturbances. Recent publicity has highlighted the dangers of medication in this group, and controls over prescribing have been suggested.AimsTo investigate the effect of a review of medication by a pharmacist.MethodAn 8-month prospective trial of an active medication review by a pharmacist was carried out on 330 residents in nursing homes in Manchester.ResultsThe intervention group experienced greater deterioration in cognitive function and behavioural disturbance than the control group, but the changes in depression and quality of life were similar for both groups. The number of drugs prescribed fell in the intervention group, but not in the control group, with a corresponding saving in drug costs. The number of deaths was significantly smaller in the intervention homes during the intervention period (4 v. 14) but not overall during the study period as a whole (26 v. 28).ConclusionThis clinical intervention reduced the number of medicines prescribed to elderly people in nursing homes, with minimal impact on their morbidity and mortality.
Depression and risk of cognitive decline and Alzheimer's disease
Authors: Geerlings M. I. , Bouter L. M. , Schoevers R. A. , Beekman A. T. F. , Jonker C. , Deeg D. J. H. , Van Tilburg W. , Adèr H. J. , Schmand B. 
Published: August 2002

BackgroundDepression may be associated with cognitive decline in elderly people with impaired cognition.AimsTo investigate whether depressed elderly people with normal cognition are at increased risk of cognitive decline and Alzheimer's disease.MethodsTwo independent samples of older people with normal cognition were selected from the community-based Amsterdam Study of the Elderly (AMSTEL) and the Longitudinal Aging Study Amsterdam (LASA). In AMSTEL, depression was assessed by means of the Geriatric Mental State Schedule. Clinical diagnoses of incident Alzheimer's disease were made using a two-step procedure. In LASA, depression was assessed with the Center for Epidemiologic Studies Depression Scale. Cognitive decline was defined as a drop of ⩾ 3 on the Mini-Mental State Examination at follow-up.ResultsBoth in the AMSTEL and the LASA sample, depression was associated with an increased risk of Alzheimer's disease and cognitive decline, respectively, but only in subjects with higher levels of education.ConclusionsIn a subgroup of more highly educated elderly people, depression may be an early manifestation of Alzheimer's disease before cognitive symptoms become apparent.
Duration of remitting psychoses with acute onset
Authors: Mojtabai Ramin , Susser Ezra , Varma Vijoy K. 
Published: August 2002

BackgroundThe acute and transient psychotic disorders (ATPD) in ICD–10 advanced the nosology of remitting psychoses with acute onset. But the proposed criteria for ATPD – especially in regard to duration – are tentative and need to be validated.AimsTo evaluate: (a) the duration of remitting psychoses with acute onset; (b) the applicability of the ATPD criteria for these cases; and (c) differences in duration and ATPD diagnoses across sociocultural settings.MethodData from the World Health Organization Determinants of Outcome study were used.ResultsThe 98 cases of remitting psychoses with acute onset had a modal duration of 2–4 months, with 43% falling in this range. Mainly because of this, few met the ATPD criteria. Duration and diagnostic findings were similar across settings.ConclusionsATPD criteria need refinement, especially in regard to duration. Further studies aimed at early detection and assessment of onset and duration of these disorders are needed.
Integration of mental health care into primary care
Authors: Chisholm D. , James S. , Sekar K. , Kumar K. Kishore , Murthy R. Srinivasa , Saeed K. , Mubbashar M. 
Published: August 2002

BackgroundTargeting resources on cost-effective care strategies is important for the global mental health burden.AimsTo demonstrate cost–outcome methods in the evaluation of mental health care programmes in low-income countries.MethodFour rural populations were screened for psychiatric morbidity. Individuals with a diagnosed common mental disorder were invited to seek treatment, and assessed prospectively on symptoms, disability, quality of life and resource use.ResultsBetween 12% and 39% of the four screened populations had a diagnosable common mental disorder. In three of the four localities there were improvements over time in symptoms, disability and quality of life, while total economic costs were reduced.ConclusionEconomic analysis of mental health care in low-income countries is feasible and practicable. Our assessment of the cost-effectiveness of integrating mental health into primary care was confounded by the naturalistic study design and the low proportion of subjects using government primary health care services.
Psychological debriefing for road traffic accident victims
Authors: Mayou R. A. , Ehlers A. , Hobbs M. 
Published: August 2002

BackgroundPsychological debriefing is widely used for trauma victims but there is uncertainty about its efficacy. We have previously reported a randomised controlled trial which concluded that at 4 months it was ineffective.AimsTo evaluate the 3-year outcome in a randomised controlled trial of debriefing for consecutive subjects admitted to hospital following a road traffic accident.MethodPatients were assessed in hospital by the Impact of Event Scale (IES), Brief Symptom Inventory (BSI) and questionnaire and re-assessed at 3 months and 3 years. The intervention was psychological debriefing as recommended and described in the literature.ResultsThe intervention group had a significantly worse outcome at 3 years in terms of general psychiatric symptoms (BSI), travel anxiety when being a passenger, pain, physical problems, overall level of functioning, and financial problems. Patients who initially had high intrusion and avoidance symptoms (IES) remained symptomatic if they had received the intervention, but recovered if they did not receive the intervention.ConclusionsPsychological debriefing is ineffective and has adverse long-term effects. It is not an appropriate treatment for trauma victims.
Factor structure and familiality of first-rank symptoms in sibling pairs with schizophrenia and schizoaffective disorder
Authors: Loftus Josephine , Delisi Lynn E. , Crow Timothy J. 
Published: August 2002

BackgroundSince their introduction as diagnostic criteria by Schneider in 1937, nuclear symptoms have played a key role in concepts of schizophrenia, but their relationship to each other and to genetic predisposition has been unclear.AimsTo ascertain the factor structure and familiality of nuclear symptoms.MethodsNuclear (Schneiderian) symptoms were extracted from case notes and interviews in a study of 103 sibling pairs with DSM–III–R schizophrenia or schizoaffective disorder.ResultsPrincipal components analysis demonstrated two major factors: one, accounting for about 50% of the variance, groups thought withdrawal, insertion and broadcasting, with delusions of control; and the second, accounting for <20% of the variance, groups together third-person voices, thought echo and running commentary. Factor I was significantly correlated within sibling pairs.ConclusionsThe correlation within sibling pairs suggests that, contrary to the conclusion of some previous studies, some nuclear symptoms do show a degree of familiality and therefore perhaps heritability.
Causes of schizophrenia reported by patients' family members in China
Authors: Phillips Michael R. , Li Yongyun , Stroup T. Scott , Xin Lihua 
Published: August 2002

BackgroundBetter methods of assessing patients' and family members' causal models of illness are needed to improve adherence with biomedical interventions and to design services that meet the needs of consumers.AimsTo develop a quantitative measure suitable for assessing the relationship of causal beliefs to expressed emotion, stigma, care-seeking and adherence.MethodThe Causal Models Questionnaire for Schizophrenia, which includes 45 causes identified during in-depth interviews with family members, was administered to 245 family members of 135 patients with DSM–III–R schizophrenia in Suzhou and Siping, China at the time of admission to hospital.ResultsRespondents, who identified a mean of 2.5 causes (range 1–10, mode 2), attributed 84% of the cause of schizophrenia to social, interpersonal and psychological problems. Hence, their beliefs do not concur with Chinese professionals' ideas about the biomedical causes of schizophrenia. Multivariate analyses identified the socio-economic factors that influence family members' causal beliefs.ConclusionsDespite the complexity of causal models, measures can be developed that will help improve clinicians' communication with patients and understanding of help-seeking behaviours.
Cognitive and behavioural functioning in men with schizophrenia both before and shortly after first admission to hospital
Authors: Rabinowitz Jonathan , Reichenberg Avi , Weiser Mark , Mark Mordechai , Kaplan Zeev , Davidson Michael 
Published: August 2002

BackgroundThe extent of premorbid changes associated with the onset of schizophrenia are debated.AimsThe study examined cognitive and behavioural functioning prior to, and after, first hospitalisation for schizophrenia.MethodData from the Israeli Draft Board Register of intelligence, social functioning and behaviour testing for all Israeli males aged 16–17 was linked with data from the National Psychiatric Hospitalisation Case Register. This identified 692 men who had been admitted to hospital for schizophrenia. Cases and non-cases matched on age and school were compared, as were cases aggregated by the time that had elapsed between testing and first admission to hospital.ResultsCases performed worse than non-cases on all measures. On Social Functioning and on Raven's Progressive Matrices–R, differences between cases and non-cases were progressively greater for cases admitted closer to the time of testing. These differences were greatest for persons tested after first psychiatric hospitalisation.ConclusionsThe results confirm premorbid deficits associated with schizophrenia and support the hypothesis that decline is progressive.
Psychiatric patients at greatest risk and in greatest need
Authors: Bindman Jonathan , Beck Andrew , Thornicroft Graham , Knapp Martin , Szmukler George 
Published: August 2002

BackgroundMental health provider trusts in England were required in 1994 to establish local Supervision Registers of patients at risk.AimsTo identify the factors associated with registration, and obtain clinicians' views on its effectiveness.MethodAt a random sample of 14 trusts data were collected from case notes, keyworkers and responsible medical officers.ResultsA sample of 133 registered patients were more disabled and had more extensive histories of violence and self-harm than 126 comparison patients on the upper tier of the Care Programme Approach (CPA). Those registered were a heterogeneous group. For some there was little evidence of risk. In most cases clinicians did not believe registration had improved care.ConclusionsThe Supervision Register policy has not resulted in the identification of a well-defined group. Its effectiveness is limited by the lack of operationalised measures of risk.
Schizophrenia is not disappearing in south-west Scotland
Authors: Allardyce J. , Morrison G. , Van Os J. , Kelly J. , Murray R. M. , McCreadie R. G. 
Published: August 2002

BackgroundRecent work has reported a decline in the incidence of schizophrenia, but it is unclear if these findings reflect a true decrease in its incidence or are an artefact arising from methodological difficulties.AimsTo take account of these methodological difficulties and report service-based incidence rates for schizophrenia in Dumfries and Galloway in south-west Scotland for 1979–98.MethodUsing both clinical diagnoses and diagnoses generated from the Operational Checklist for Psychotic Disorders (OPCRIT) computer algorithm for ICD–10 and DSM–IV schizophrenia, we measured change in the incidence rates over time. We used indirect standardisation techniques and Poisson models to measure the rate ratio linear trend.ResultsThere was a monotonic and statistically significant decline in clinically diagnosed schizophrenia. The summary rate ratio linear trend was 0.77. However, using OPCRIT-generated ICD–10 and DSM–IV diagnoses, there was no significant difference over time.ConclusionsOPCRIT-generated consistent diagnoses revealed no significant fall in the incidence of schizophrenia. Changes in diagnostic practice have caused the declining rates of clinically diagnosed schizophrenia in Dumfries and Galloway.
Stigmatisation of people with mental illnesses
Authors: Crisp Arthur H. , Gelder Michael G. , Rix Susannah , Meltzer Howard I. , Rowlands Olwen J. 
Published: August 2002

BackgroundRecognition of the additional social handicaps and distress that people with mental illnesses experience as a result of prejudice.AimsTo determine opinions of the British adult population concerning those with mental illnesses as baseline data for a campaign to combat stigmatisation.MethodSurvey of adults (n=1737 interviewed; 65% response) regarding seven types of common mental disorders. Responses evaluated concerned eight specified perceptions.ResultsRespondents commonly perceived people with schizophrenia, alcoholism and drug addiction as unpredictable and dangerous. The two latter conditions were also viewed as self-inflicted. People with any of the seven disorders were perceived as hard to talk with. Opinions about effects of treatment and prognosis suggested reasonable knowledge. About half the respondents reported knowing someone with a mental illness.ConclusionsNegative opinions indiscriminately overemphasise social handicaps that can accompany mental disorders. They contribute to social isolation, distress and difficulties in employment faced by sufferers. A campaign against stigma should take account of the differences in opinions about the seven disorders studied.
Self-report quality of life measure for people with schizophrenia: The SQLS
Authors: Wilkinson Greg , Hesdon Bernadette , Wild Diane , Cookson Ron , Farina Carole , Sharma Vimal , Fitzpatrick Ray , Jenkinson Crispin 
Published: August 2002

BackgroundQuality of life is the subject of growing interest and investigation.AimsTo develop and validate a short, self-report quality of life questionnaire (the Schizophrenia Quality of Life Scale, SQLS).MethodPeople with schizophrenia in Liverpool were recruited via the NHS. Items, generated from in-depth interviews, were developed into an 80-item self-report questionnaire. Data were factor analysed, and a shorter form measure was tested for reliability and validity. This measure was administered together with other self-report measures – SF–36, GHQ–12 and HADS – to assess validity.ResultsData were analysed to produce a final 30-item questionnaire, comprising three scales (‘psychosocial’, ‘motivation and energy’, and ‘symptoms and side-effects’) addressing different SQLS dimensions. Internal consistency reliability of the scale was found to be satisfactory. There was a high level of association with relevant SF–36, GHQ–12 and HADS scores.ConclusionsThe SQLS was completed within 5–10 minutes. It possesses internal reliability and construct validity, and promises to be a useful tool for the evaluation of new treatment regimes for people with schizophrenia.
Critical approach to antidepressant trials
Authors: Even C. , Siobud-Dorocant E. , Dardennes R. M. 
Published: August 2002

BackgroundDouble-blind placebo-controlled trials are the academic standard for clinical psychopharmacology research.AimsTo identify the potential defects of current double-blind procedures in trials involving antidepressants and to investigate whether safeguards for blindness protection are used.MethodWe reviewed the literature and devised a short seven-item checklist for evaluating the quality of blindness protection. We performed a computerised search for 1998 to identify the placebo-controlled studies that evaluated the efficacy of an antidepressant. The checklist was used to assess all traceable antidepressant trials published in 1998.ResultsRelevant criticisms question the blindness procedures. The available methods which may bolster blindness are very seldom used.ConclusionsImprovement in the blindness procedures used for antidepressant trials is necessary, feasible and measurable.
Child and adolescent mental health service use
Authors: Garralda M. E. , Yates P. , Higginson I. 
Published: August 2002

BackgroundHoNOSCA (Health of the Nation Outcome Scales for Children and Adolescents) is a recently developed measure of outcome for use in child and adolescent mental health services (CAMHS).AimsTo examine HoNOSCA's sensitivity to change, convergent validity and clinical usefulness.MethodProspective study of new CAMHS attenders. Questionnaires completed by clinicians, parents and referrers at initial assessment and after 6 months.ResultsFollow-up HoNOSCAs on 203 children indicated statistically significant change. There were significant associations between change in HoNOSCA scores, changes in other clinician- and parent-rated scales (r=0.51 to 0.32) and in global outcome ratings by referrers, parents and clinicians. Intraclass correlation coefficients for the summated HoNOSCA scores were high. HoNOSCA change was positively correlated with initial HoNOSCA score (r=0.46, P<0.001) and it was linked to psychiatric diagnosis.ConclusionsHoNOSCA is a sensitive, valid measure of change among CAMHS attenders.
Predictors of psychopathology in young adults referred to mental health services in childhood or adolescence
Authors: Visser Jeroen Heijmens , Van Der Ende Jan , Koot Hans M. , Verhulst Frank C. 
Published: August 2002

BackgroundFor children referred to mental health services future functioning may be hampered.AimsTo examine stability and prediction of behavioural and emotional problems from childhood into adulthood.MethodA referred sample (n=789) aged 4–18 years was followed up after a mean of 10.5 years. Scores derived from the Child Behavior Checklist, Youth Self-Report and Teacher Report Form were related to equivalent scores for young adults from the Young Adult Self-Report and Young Adult Behavior Checklist.ResultsCorrelations between first contact (T1) and follow-up (T2) scores were 0.12–0.53. Young adult psychopathology was predicted by corresponding TI problem scores. Social problems and anxious/depressed scores were predictors of general problem behaviour.ConclusionsProblem behaviour of children and adolescents referred to outpatient mental health services is highly predictive of similar problem behaviour at young adulthood. Stability is higher for externalising than for internalising behaviour and for intra-informant than for inter-informant information. Stabilities are similar across gender. To obtain a comprehensive picture of the young adult's functioning, information from related adults may prove valuable.
Long-term predictors of cognitive outcome in a cohort of older people with hypertension
Authors: Cervilla Jorge A. , Prince Martin , Joels Suzanne , Lovestone Simon , Mann Anthony 
Published: August 2002

BackgroundDeteriorating cognitive function in late life substantially increases the risk for dementia, for other non-cognitive morbidity, for dependency, and early death.AimsTo identify early predictors of late-life cognitive outcome.MethodCognitive function, premorbid IQ, and cardiovascular risk exposure were recorded on 1083 subjects on entry to a hypertension treatment trial in 1983–1984. We followed up this cohort 9–12 years later to assess cognitive function with the Mini-Mental State Examination (MMSE), to update exposure status, and to obtain genomic material. Multivariate analysis was used to identify independent baseline predictors of cognitive outcome 9–12 years later.ResultsWe followed up 387 subjects (58.6% of survivors). After adjusting for baseline cognition, poorer cognitive outcome was found to be independently associated with a family history of dementia, increasing age, less decline in systolic blood-pressure, lower premorbid IQ (rather than limited education), and abstinence from alcohol.ConclusionsReduction in systolic blood pressure (among hypertensives) and moderate alcohol intake could protect against cognitive deterioration in late life.
Reliability of lifetime history of bulimia nervosa
Authors: Wade Tracey D. , Bulik Cynthia M. , Kendler Kenneth S. 
Published: August 2002

BackgroundPrevious studies have found that the reliability of the lifetime prevalence of bulimia nervosa is low to moderate. However, the reasons for poor reliability remain unknown.AimsWe investigated the ability of a range of variables to predict reliability, sensitivity, and specificity of reporting of both bulimia nervosa and major depression.MethodTwo interviews, approximately 5 years apart, were completed with 2163 women from the Virginia Twin Registry.ResultsAfter accounting for different base rates, bulimia nervosa was shown to be as reliably reported as major depression. Consistent with previous studies of major depression, improved reliability of bulimia nervosa reporting is associated with more severe bulimic symptomatology.ConclusionsFrequent binge eating and the presence of salient behavioural markers such as vomiting and laxative misuse are associated with more reliable reporting of bulimia nervosa. In the absence of the use of fuller forms of assessment, brief interviews should utilise more than one prompt question, thus increasing the probability that memory of past disorders will be more successfully activated and accessed.