bluuebunny/crossref_metadata_2025_split huggingface dataset:
Common mental disorder symptom counts in populations: are there distinct case groups above epidemiological cut-offs?
Authors: MELZER D. , TOM B. D. M. , BRUGHA T. S. , FRYERS T. , MELTZER H. 
Published: October 2002

Background. At the lower end of IQ distributions in general populations, there is a clear excess of cases, representing the distinct pathology of severe learning disability. This study aimed to establish whether such a subpopulation exists in distributions of common mental disorder and depression symptom scores, above epidemiological ‘case’ cut-offs.Method. Data from 9556 non-psychotic respondents to the 1993 OPCS (Office of Population Censuses and Surveys) National Household Psychiatric Morbidity Survey were analysed. The distribution of total neurotic symptom and depression scores from the revised Clinical Interview Schedule were examined. Automated least squares methods were used to fit the best single statistical distribution to the data.Results. A single exponential curve provided the best fit for the whole population, but floor effects produced deviations at symptom counts of 0–3. After truncation, exponential distributions fitted excellently. Proportions of the population above conventional cut-offs of [ges ]12 symptoms differed by <12% from expected for a range of low and high prevalence groups. The single exponential model also fitted the depression score.Conclusions. Symptom counts for the common mental disorders fall within single population distributions, with little apparent numerical excess in the case range. High and low prevalences of these disorders appear to be population characteristics, with shifts in exponential means predicting proportions above case cut-offs.
The effects of co-morbidity on the onset and persistence of generalized anxiety disorder in the ICPE surveys
Authors: KESSLER R. C. , ANDRADE L. H. , BIJL R. V. , OFFORD D. R. , DEMLER O. V. , STEIN D. J. 
Published: October 2002

Background. Although it is well known that generalized anxiety disorder (GAD) is highly co-morbid with other mental disorders, little is known about the extent to which earlier disorders predict the subsequent first onset and persistence of GAD. These associations are examined in the current report using data from four community surveys in the World Health Organization (WHO) International Consortium in Psychiatric Epidemiology (ICPE).Method. The surveys come from Brazil, Canada, the Netherlands and the United States. The Composite International Diagnostic Interview (CIDI) was used to assess DSM-III-R anxiety, mood and substance use disorders in these surveys. Discrete-time survival analysis was used to examine the associations of retrospectively reported earlier disorders with first onset of GAD. Logistic regression analysis was used to examine the associations of the disorders with persistence of GAD.Results. Six disorders predict first onset of GAD in all four surveys: agoraphobia, panic disorder, simple phobia, dysthymia, major depression and mania. With the exception of simple phobia, only respondents with active disorders have elevated risk of GAD. In the case of simple phobia, in comparison, respondents with a history of remitted disorder also have consistently elevated risk of GAD. Simple phobia is also the only disorder that predicts the persistence of GAD.Conclusions. The causal processes linking temporally primary disorders to onset of GAD are likely to be state-dependent. History of simple phobia might be a GAD risk marker. Further research is needed to explore the mechanisms involved in the relationship between simple phobia and subsequent GAD.
Impairments of response conflict monitoring and resolution in schizophrenia
Authors: YÜCEL M. , VOLKER C. , COLLIE A. , MARUFF P. , DANCKERT J. , VELAKOULIS D. , PANTELIS C. 
Published: October 2002

Background. It has been argued recently that the attentional dysfunction in schizophrenia occurs as a result of an inability to inhibit automatic attentional shifts to compelling external stimuli. However, this hypothesis is based on performance on paradigms that require overt or covert shifts of spatial attention.Method. We investigated responses to foveally presented stimuli in patients with schizophrenia and healthy controls as they performed unidimensional and bidimensional versions of the flanker task. In both tasks, centrally presented target stimuli were flanked by peripheral stimuli that were either congruent or incongruent with the behavioural goal of the subject. In the bidimensional task, the flanking stimuli could be congruent and incongruent on multiple stimulus characteristics.Results. On the unidimensional flanker task, the behavioural goal modulated the responses of the schizophrenia group such that response times (RTs) to target stimuli that were flanked by congruent stimuli were faster than RTs to target stimuli flanked by incongruent stimuli. However, on the bidimensional flanker task, the responses of schizophrenia patients were no longer constrained by the behavioural goal and RTs to both congruent and incongruent stimuli were equivalent.Conclusions. It appears that the attentional dysfunction in schizophrenia may reflect difficulty in resolving multiple and simultaneous response conflicts. These findings suggest a possible role for the anterior cingulate cortex in the attentional impairments associated with schizophrenia.
Childhood adversity and anxiety versus dysthymia co-morbidity in major depression
Authors: HARKNESS KATE L. , WILDES JENNIFER E. 
Published: October 2002

Background. Childhood adversity places individuals with major depression at risk for anxiety and dysthymia co-morbidity. The goal of the present paper is to broaden this area of research by examining specificity between the type of adversity (e.g. abuse versus neglect/indifference) and the resulting co-morbid disorder (e.g. anxiety versus dysthymia co-morbidity).Method. The volunteer sample consisted of 76 women meeting Diagnostic and Statistical Manual (DSM-IV) criteria for major depression. Of these, 28 were diagnosed with a co-morbid anxiety disorder and 21 were diagnosed with co-morbid dysthymia. Childhood physical abuse, sexual abuse, psychological abuse, antipathy and indifference were assessed using a contextual interview and rating system.Results. Severe sexual abuse and psychological abuse were significantly and preferentially associated with co-morbid anxiety, while severe physical abuse was significantly and preferentially associated with co-morbid dysthymia. Indifference and antipathy were significantly associated with both co-morbid anxiety and dysthymia. Multivariate analyses revealed that severe sexual abuse was the adverse childhood experience most strongly associated with co-morbid anxiety.Conclusions. These results suggest that particular adverse experiences in childhood do set up specific vulnerabilities to the expression of anxiety versus dysthymia co-morbidity in adulthood major depression. Cognitive mediators of these associations are discussed as avenues of future research.
Exclusion criteria in the diagnostic classifications of DSM-IV and ICD-10: revisiting the co-occurrence of psychiatric syndromes
Authors: SLADE TIM , ANDREWS GAVIN 
Published: October 2002

Background. Exclusion criteria are present in almost all diagnostic categories in both DSM-IV and ICD-10. These exclusion criteria state that one diagnosis is not made if it is ‘due to’ another disorder. However, there is little empirical evidence demonstrating that the hierarchy imposed by the exclusion criteria is meaningful. The current study examines associations between ten common mental disorder pairs to determine whether they are higher for disorder pairs that are classified in DSM-IV and/or ICD-10 as having a hierarchical relationship, than for those that are not hierarchically related.Method. Data were analysed from the Australian National Survey of Mental Health and Wellbeing, a large (N = 10641) epidemiological survey of mental disorders. Bivariate odds ratios between disorder pairs were calculated from logistic regression analyses. Multivariate odds ratios were also calculated from separate logistic regression analyses in which the sample was restricted to likely positive cases, and co-morbid mental disorders and neuroticism scores were both controlled.Results. The odds ratios between disorder pairs related according to the exclusion criteria were higher than those of unrelated disorders, for both DSM-IV and ICD-10. When constraints were placed on the data to control for the effects of co-morbid disorders and neuroticism the same pattern was evident in DSM-IV, but not in ICD-10.Conclusion. The patterns of association between disorder pairs found in the exclusion criteria for DSM-IV appear to more closely mirror the patterns of association found in epidemiological data. While this does not guarantee that the exclusion criteria are valid it is argued that identifying significant associations should be the first step in establishing meaningful exclusion criteria.
Lower prevalence of pre-morbid neurological illness in African-Caribbean than White psychotic patients in England
Authors: McKENZIE K. , JONES P. , LEWIS S. , WILLIAMS M. , TOONE B. , SHAM P. , MURRAY R. M. 
Published: October 2002

Background. It has been suggested that the increased incidence of psychosis in African-Caribbeans living in England may be due to illnesses in which social stress plays an important aetiological role. If this is the case, the prevalence of factors associated with psychosis that predate illness onset such as obstetric complications, pre-morbid neurological illness and poor childhood social adjustment may be expected to be lower in African-Caribbean than Whites psychotic patients.Method. Details of obstetric complications, pre-morbid neurological illness, and pre-morbid social adjustment were obtained for 337 psychotic patients by patient interview, interviews of mothers and chart review. The proportions of patients with each ‘risk factor’ in the African-Caribbean (N = 103) and White (N = 184) groups were compared using regression analysis; age, sex, social class, diagnosis and referral status were possible explanatory variables.Results. African-Caribbean patients were less likely to have suffered a pre-morbid neurological disorder than their White counterparts (odds ratio 0.19, 95% CI 0.06–0.61). There was no significant difference in pre-morbid social adjustment or obstetric complications between the two groups, though fewer obstetric complications were reported in the African-Caribbean group (21.5%) than the White group (30.9%).Conclusions. African-Caribbean patients with psychosis have experienced less pre-morbid neurological illness.
Frequency and heritability of depression symptomatology in the second half of life: evidence from Danish twins over 45
Authors: JOHNSON W. , McGUE M. , GAIST D. , VAUPEL J. W. , CHRISTENSEN K. 
Published: October 2002

Background. Self-reported depressive symptoms among the elderly have generated considerable interest because they are readily available measures of overall well-being in a population often thought to be at special risk for mental disorder.Method. The heritability of depression symptoms was investigated in a sample of 2169 pairs of Danish twins (1033 MZ and 1136 same sex DZ) ranging in age from 45 to over 95. Twins completed an interview assessment that identified symptoms of depression, which were scored on Affective, Somatic and Total scales.Results. Overall heritability estimates (a2) for the Affective (a2 = 0.27, (95% CI 0.22–0.32)). Somatic (a2 = 0.26, (0.21–0.32)), and Total (a2 = 0.29, (0.22–0.34)) scales were all moderate, statistically significant and similar to results from other studies. To assess possible variations in heritability across the wide age span, the sample was stratified into age groups in increments of 10 years. The magnitude of heritable influence did not vary significantly with age or sex. Somatic scale heritability tended to be greater for females than for males, though this difference was not statistically significant. The genetic correlation between the Affective and Somatic scales was 0.71, suggesting substantial common genetic origins.Conclusions. Though the frequency of self-reported depressive symptoms increased with age in this sample, their heritability did not.
Childhood parental loss and risk for first-onset of major depression and alcohol dependence: the time-decay of risk and sex differences
Authors: KENDLER K. S. , SHETH K. , GARDNER C. O. , PRESCOTT C. A. 
Published: October 2002

Background. Whereas a number of studies have suggested that parental loss is associated with increased risk for major depression (MD), much less is known about possible gender differences, diagnostic specificity and the time course of the impact of loss.Method. First-onsets for MD and alcohol dependence (AD) were assessed at personal interviews in 5070 twins from same-sex (SS) and 2118 from opposite-sex (OS) twin pairs ascertained from a population-based registry. Cox Proportional Hazard (PH) and Non-Proportional Hazard (NPH) models, examining first onsets of MD and AD, were used with twins from SS pairs and conditional logistic regression for OS pairs. Parent–child separations prior to age 17 were divided into death and separation from other causes.Results. The PH assumptions of constant increased risk were rejected for the impact of loss on risk for MD but not for AD. NPH models found significantly increased risk for MD after both death and separation with the risk lasting much longer for separations. For AD, the PH model found significantly increased risk after parental separation but not death. In both SS and OS twin pairs, no sex differences were seen in the impact of parental loss on risk for MD whereas the association between separation and risk for AD was significantly stronger in females than in males.Conclusion. Consistent sex differences in the association with parental loss were seen for AD but not MD. The analysis of the time-course of increased risk after loss suggests three different patterns which may reflect different relationships: parental death and MD (return to baseline within ∼12 years), separation and MD (return to baseline within ∼30 years) and separation and AD (no change in risk over time).
A twin study of sex differences in social support
Authors: AGRAWAL A. , JACOBSON K. C. , PRESCOTT C. A. , KENDLER K. S. 
Published: October 2002

Background. Social support may reduce the risk of psychiatric illness. Though perceived as an environmental measure, genetic factors may influence levels of social support. A relationship between social roles and personality with social support suggests possible sex effects on the sources of individual differences in social support.Method. We used the responses of MZ and DZ same and opposite sex twins to 16 questions regarding their social life. Six factors – friend support, relative support, friend problem, relative problem, confidants and social integration were used for structural equation modelling. Factor derived scales were analysed for genetic, shared and unique environmental influences. Quantitative and qualitative gender differences were analysed using the software package Mx.Results. Except for relative support and confidants, no qualitative sex differences were seen. Genetic and individual specific environmental influences accounted for the variance for friend support, friend problems, relative problems and social integration and no quantitative gender differences were seen. For relative support genetic factors were detected in females but not males, while for confidants, the shared environment was important in females but not males.Conclusions. Except for relative support in males, genetic factors influence variation in all dimensions of social support. Shared environmental factors influence relative support and relative problems in both sexes. Sex differences were detected for confidants and relative support.
Self-perception of poor health and suicidal ideation in medical patients
Authors: GOODWIN RENEE , OLFSON MARK 
Published: October 2002

Objective. To determine the relationship between self-perceived health and suicidal ideation among patients in general internal medicine practice settings.Method. A representative sample of 4007 patients was assessed for current suicidal ideation, self-perception of health, current medical disorders and current mental disorders (major depression, generalized anxiety disorder, panic attacks and alcohol use disorder) with the PRIME-MD Patient Health Questionnaire.Results. Patients with self-perception of poor health, compared with those who reported more favourable health perception, were significantly more likely to report current suicidal ideation (35.2% v. 8.3%; χ2 = 97.4, df = 1, P<0.0001). Multivariate logistic regression analyses revealed that the perception of poor health was associated with a significantly increased risk of suicidal ideation (OR = 3.1, CI 1.9, 5.0), even after adjusting for sociodemographic characteristics, mental disorders and common physical illnesses.Conclusion. Self-perception of poor health is associated with a significantly increased risk of suicidal ideation among general medical patients, even in the absence of common mental and physical disorders. These findings add to a growing literature on the importance of self-perceived health in the treatment and outcomes of mental and physical well-being by documenting self-perceived poor health as a risk factor for suicidal ideation in medical patients.
Remembering or knowing: electrophysiological evidence for an episodic memory deficit in schizophrenia
Authors: TENDOLKAR I. , RUHRMANN S. , BROCKHAUS A. , PUKROP R. , KLOSTERKÖTTER J. 
Published: October 2002

Background. In schizophrenia, impaired conscious retrieval of past events and facts may represent a selective cognitive deficit of declarative memory against a background of a generalized neuropsychological impairment. We aimed to disentangle the neural subprocesses leading to this deficit applying the ‘Remember/Know procedure’.Method. Event-related potentials (ERPs) were recorded as 14 schizophrenic patients and 14 controls recognized an equal mixture of previously presented old and new words. For recognized old words, participants were required to judge whether recognition was associated with recollection (‘Remember’) or familiarity (‘Know’), either reflecting episodic or semantic memory.Results. Patients showed a lack of ‘Remember responses’, which led to more opportunities to make ‘Know responses’. ERPs for ‘Remember’ compared to ‘New responses’ differed consistently in controls over left temporo-parietal and right frontal electrode sites. Although schizophrenic patients showed the same topography for this Remember old/new effect, it was apparent over temporo-parietal sites for only 800 ms and over right frontal sites for 1100 ms post-stimulus. For controls, the Know old/new effect was elicited over temporo-parietal sites between 500 and 800 ms. For patients, it showed a widespread maximum over frontal sites between 500 and 1100 ms.Conclusions. The shorter time course of the left temporo-parietal Remember old/new effect suggests that the patients' episodic memory impairment was possibly mediated by a dysfunction of the mediotemporal regions. The more widespread frontal Know old/new effect in the patients suggests that the prefrontly mediated processes associated with retrieval of semantic memory may be enhanced compensatorily.
Generalized anxiety disorder and clinical worry episodes in young women
Authors: HOYER J. , BECKER E. S. , MARGRAF J. 
Published: October 2002

Background. This article presents epidemiological data on the prevalence of DSM-IV generalized anxiety disorder (GAD) and sub-threshold GAD (fulfilling three out of four GAD criteria) in young women together with data on co-morbidity and psychosocial functioning. The prevalence of clinically relevant worry and its predictive validity for the diagnosis of GAD were also examined.Method. Young women (N = 2064), aged between 18 and 25, from a representative German community sample were diagnosed with a structured clinical interview (ADIS-L, German research version). An additional interview questioned all the participants about the frequency/intensity and uncontrollability of diverse worry topics.Results. Thirty-seven participants (1.8%) fulfilled the criteria of current GAD (1 week point prevalence) and 56 received a lifetime diagnosis (2.7%); a further 50 participants (2.3%) were diagnosed with sub-threshold GAD. Co-morbidity between GAD and other disorders was high for current (68%) and lifetime GAD (91%). GAD, as well as sub-threshold GAD, showed clearly reduced levels of psychosocial functioning. Whereas worries of low intensity and high controllability were ubiquitous in all subsamples, clinically defined worrying was rarely present in healthy subjects (0.89%) and of adequate predictive accuracy for GAD.Conclusions. Full GAD and sub-threshold GAD were moderately frequent in young women. Although DSM-IV worry criteria proved to be highly useful, the strictness of the complete GAD-criteria should not lead to absence of attention from subclinical generalized anxiety states in research and practice.
Prenatal life and post-natal psychopathology: evidence for negative gene–birth weight interaction
Authors: WICHERS M. C. , PURCELL S. , DANCKAERTS M. , DEROM C. , DEROM R. , VLIETINCK R. , VAN OS J. 
Published: October 2002

Background. Many studies suggest that pregnancy and birth complications (PBCs) are environmental risk factors for child psychopathology. However, it is not known whether the effects of PBCs occur independently of genetic predisposition. The current study examined the possibility of gene–environment interaction in a twin design.Method. The East Flanders Prospective Twin Survey prospectively records the births of all twin pairs born in East Flanders, Belgium. The current study included 760 twin pairs aged 6–17 years. Multilevel regression analysis was used to assess the effects of several PBCs collected around the time of birth. Using structural equation modelling, ACE models assuming additive genetic (A), shared environmental (C) and unique environmental (E) influences, were compared in order to examine whether the contribution of genetic factors to parent-rated child problem behaviour varied as a function of exposure to dichotomously and continuously defined PBCs.Results. A main independent effect of lower birth weight, corrected for gestational age (small for gestational age – SGA), on child problem behaviour was found. In addition, there was an interaction between genetic influence and SGA, in that being smaller for gestational age resulted in less influence of additive genetic factors on individual differences in problem behaviour.Conclusions. Results are suggestive of negative gene–birth weight interaction. Children who are SGA are less sensitive to the genetic effects, and those with high genetic vulnerability are less sensitive to the effects of being SGA in bringing about post-natal mental health effects.