bluuebunny/crossref_metadata_2025_split huggingface dataset:
Contacts to the health care system prior to suicide: a comprehensive analysis using registers for general and psychiatric hospital admissions, contacts to general practitioners and practising specialists and drug prescriptions
Authors: Andersen U. A. , Andersen M. , Rosholm J. U. , Gram L. F. 
Published: March 2003

Objective: The purpose of this study was to describe suicides' contacts with various parts of the health‐care system. Method: Data on 472 people who committed suicide in a Danish County (Funen) in the period of April 1 1991 to December 31 1995 were searched in the Danish Psychiatric Central Register, the National Patient Register, the National Health Insurance and Odense Pharmacoepidemiologic Database. Results: In total, 97.5% of the suicides were recaptured in at least one of these registers. Forty‐two per cent had been hospitalized in psychiatric departments. Within the last month before death, 66% consulted a general practitioner, 13% and 7%, respectively, were discharged from a psychiatric hospital and general hospital. Conclusion: The registers used provided a comprehensive registry‐based description of suicides' contacts with the health‐care system. The most prominent features were the high prevalence of psychiatric morbidity and the high rate of contacts with GPs close to suicide.
Death wishes in the very elderly:data from a 3‐year follow‐up study
Authors: Forsell Yvonne 
Published: March 2003

Objective: The aim of this study was to study the 3‐year outcome of death wishes in an elderly population. Method: 1099 very elderly people were examined extensively by physicians, including a structured psychiatric interview. Three years later those who had survived were re‐examined (n=683) using a similar procedure. Results: Of the sample, 11.6% (n=128) had death wishes at the first examination and 8.9% (n=54) at the follow‐up. Of the 54, 17 have had death wishes persistently during the 3‐year period; all of them had psychiatric diagnoses. Of those having death wishes at one of the examinations 70% had psychiatric diagnoses. Attrition was more common in the group with death wishes than in the group without when age, gender, somatic disorders including dementia and disability in daily living were taken into account. Conclusion: This study shows that there is a need for a psychiatric examination when elderly people express death wishes.
The construction of the SEDAS:a new suicide‐attitude questionnaire
Authors: Jenner J. A. , Niesing J. 
Published: March 2003

Objective: Only two scales exist for measuring attitudes towards suicidal behaviour. Because of theoretical and methodological limitations of both scales, the SEDAS was constructed to offer an alternative instrument. Method: The semantic differential scale, from which the SEDAS was devised, consisted of 36 items (pairs of adjectives) constructed to measure attitudes towards suicidal behaviour of different actors in various situations. It was administered to 142 Dutch SOS‐telephone volunteers for seven different actor/situation sets. Results: Item analysis reduced the number of suitable items to 15. Simultaneous component analysis revealed two dimensions on which the actor/situation sets were scored: health/illness and acceptance/rejection, jointly accounting for 47% of variance. Psychometrics of the instrument in terms of internal consistency (values between 0.70 and 0.86), item–rest correlation and test–retest correlation (between 0.63 and 0.87) are acceptable to good. Conclusion: The SEDAS may be of value in population surveys, and facilitate effect evaluation of staff training and suicide prevention programmes.
Social phobia treated as a problem in social functioning: a controlled comparison of two behavioural group approaches
Authors: Stravynski A. , Arbel N. , Bounader J. , Gaudette G. , Lachance L. , Borgeat F. , Fabian J. , Lamontagne Y. , Sidoun P. , Todorov C. 
Published: March 2003

Objective: Treatments for social phobia result typically in significant anxiety and avoidance reduction; the repercussions in terms of social functioning, however, are not clear. This controlled study compared two approaches designed to improve the social functioning of social phobics. Method: Sixty‐eight socially phobic patients were randomly assigned to two treatments focused on improving interpersonal relationships either with or without social skills training or a waiting list; 60 completed treatment and 59 a 1‐year follow‐up. Treatment was administered in small groups, 14 sessions altogether. Results: No clinically meaningful change was observed during the waiting period. A statistically significant and equivalent improvement obtained in both treatment conditions. Conclusion: Both treatments resulted in reduced anxiety, avoidance, general psychopathology and better social functioning that maintained over follow‐up. Continuing improvement in remission rates was noted; fully 60% of the patients no longer fulfilled criteria for social phobia at the end of 1‐year follow‐up.
The relationship between insight and medication adherence in severely mentally ill clients treated in the community
Authors: Trauer Thomas , Sacks Tobie 
Published: March 2003

Objective: To study the relationship between aspects of insight and medication adherence and elements of psychopathology. Method: Clients completed insight and adherence measures in interview; doctors and case managers independently completed ratings of adherence and psychopathology. Other client information was obtained from the clinical file. Results: The subscale structure of the insight scale was well reproduced. Clients endorsed items relating to need for treatment more than items relating to relabelling of symptoms and awareness of illness. Self‐reported insight was lower in those clients for whom either the treating doctor or the case manager or both thought the client was non‐adherent. Insight was related positively to clinician ratings of depressed mood, and negatively to clinician ratings of personal functioning. Conclusion: Our data support the subscale structure of the insight questionnaire used, and previous suggestions that insight is positively related to depressive affect, and inversely related to impaired psychosocial functioning.
Psychotropic interactions with warfarin
Authors: Sayal K. S. , Duncan‐McConnell D. A. , McConnell H. W. , Taylor D. M. 
Published: March 2003

Objective: Improving knowledge about the cytochrome p450 system means that potential drug interactions can be predicted. Interactions involving warfarin may be thus avoidable. As many patients who have suffered from a stroke or other thromboembolic events may also develop psychiatric disorder, knowledge about possible interactions with psychotropics is essential for prescribers. Method: A Medline and hand search of published literature was complemented by contacting manufacturers. Results: The antidepressants citalopram, nefazodone and sertraline have relatively low interaction potential with warfarin; fluoxetine and fluvoxamine relatively high. Carbamazepine appears to reduce warfarin's anticoagulant effect. Other antipsychotics, antidepressants and anxiolytics have only a theoretical risk of interaction. Lithium, gabapentin, sulpiride and amisulpride are predominantly renally excreted and so are not likely to interact with warfarin. Conclusion: Many psychotropics are involved in predictable interactions with warfarin. Drugs with a known low interaction potential should be chosen instead of those known or predicted to interact.
The Collaborative Longitudinal Personality Disorders Study: baseline Axis I/II and II/II diagnostic co‐occurrence
Authors: McGlashan Thomas H. , Grilo Carlos M. , Skodol Andrew E. , Gunderson John G. , Shea M. Tracie , Morey Leslie C. , Zanarini Mary C. , Stout Robert L. 
Published: March 2003

Objective: To describe baseline diagnostic co‐occurrence in the Collaborative Longitudinal Personality Disorders Study. Method: Six hundred and sixty‐eight patients were reliably assessed with diagnostic interviews for DSM‐IV Axis I and II disorders to create five groups: Schizotypal (STPD), Borderline (BPD), Avoidant (AVPD), Obsessive‐Compulsive (OCPD) and Major Depressive Disorder (MDD) without personality disorder (PD). Results: Mean number of Axis I lifetime diagnoses was 3.4; STPD and BPD groups had more diagnoses than AVPD, OCPD, and MDD groups. Significant Axis I co‐occurrences emerged for Social Phobia/AVPD, PTSD/BPD and Substance Use/BPD. Mean number of co‐occurring PDs was 1.4; STPD had more than BPD group which had more than AVPD and OCPD groups. Significant PD co‐occurrence emerged for: STPD/ Paranoid and Schizoid PDs, BPD with Antisocial and Dependent PDs, and lower frequency for OCPD/Antisocial PD. Conclusion: Diagnostic co‐occurrences generally followed base rates, while significant departures resemble those of controlled literature.
In‐patient suicide in psychiatric hospitals
Authors: Deisenhammer E. A. , DeCol C. , Honeder M. , Hinterhuber H. , Fleischhacker W. W. 
Published: March 2003

Objective: In‐patient suicides continue to be a matter of concern in hospital psychiatry. In‐patients at risk for suicide need to be identified. Method: In‐patient suicides in two psychiatric hospitals were assessed over a time‐span of 8 years. Cases were detected by comparing police suicide data with the hospitals' admission and discharge records. Further information was then gathered from patients' records. Results: During the period under investigation 44 in‐patients committed suicide, the majority of them being diagnosed with affective disorders (45.4%) or schizophrenia (27.3%). The most commonly used method was ‘jumping in front of a vehicle’ (34.1%); 79.5% were treated in an open ward at the time of their suicide, 15.9% in a locked unit. The majority of open ward suicides happened outside the hospital; 39.4% of patients had left the ward without giving notice. Conclusion: Additional cautionary measures are warranted especially for patients in open wards.
Fatal antidepressant overdose among drug abusers and non‐drug abusers
Authors: Oyefeso Adenekan , Valmana Anton , Clancy Carmel , Ghodse Hamid , Williams Hugh 
Published: March 2003

Objective: This study examined the predictors, extent and patternof fatal antidepressant overdose (FAO) in all psychoactivedrug‐related deaths and compared these in drug abusers and non‐drugabusers. Method: Inquest data on 491 psychoactive drug‐related cases in England and Wales were analysed. We examined predictors of FAO relative to other drug‐related deaths in drug abusers and non‐abusers using logistic regression, and compared the relative fatality of different antidepressant classes using the Proportionate Fatality Index (PFI). Results: The overall FAO prevalence ratio was 10% (male=7.1%, female=18.5%). FAO was twice as likely to occur among cases aged 45 years and over than in younger cases (MOR=2.6, 95% CI=1.4–4.9), and eight times more likely to occur in cases with no history of drug abuse (MOR=8.2, 95% CI=4.0–18.4). Ingestion of prescribed antidepressants is the only common predictor of FAO among drug abusers and non‐abusers, and co‐ingestion of a combination of antidepressants of two different classes is a potent risk for FAO in the cases studied. Conclusion: The results highlight the need to develop appropriate therapeutic strategies for managing treatment‐resistant depression.
The relationship between cognitions and panic attack intensity
Authors: Hedley Liv Margaret , Hoffart Asle , Dammen Toril , Ekeberg Øivind , Friis Svein 
Published: March 2003

Objective: To investigate the relationship between panic attack intensity, catastrophic belief and cognitions. Method: Data from 540 panic diaries were collected from 42 patients with panic disorder with agoraphobia. Results: When we controlled for individual variation, effects of treatment and number of symptoms, catastrophic belief contributed significantly to more intense panic attacks (r2change=0.10, P<0.0001). There were no significant differences in panic attack intensity between primary and secondary cognitions. Conclusion: Our results indicate that catastrophic belief is a reliable predictor of panic attack intensity.
CAMCOG as a screening instrument for dementia: the Odense Study
Authors: Lolk A. , Nielsen H. , Andersen K. , Andersen J. , Kragh‐Sørensen P. 
Published: March 2003

Objective: The Cambridge Cognitive Examination (CAMCOG) score is correlated with age and sociodemographic variables. The aim of the study was to determine an individualized CAMCOG cut‐off score for dementia, taking such correlates into account. Method: From the general population 150 people aged 65–84 years were examined with CAMDEX which includes CAMCOG, and a neuro‐psychological test battery. Data from 130 non‐demented people were entered in setwise multiple regression analyses to identify variables predicting the CAMCOG score. Results: The variables age, social class, matrimonial status, general knowledge and intellectual level explained 66% of the variance of the CAMCOG scores. A cut‐off defined as a difference between actual and predicted CAMCOG score −4.41 resulted in a sensitivity of 88.2% and a specificity of 89.2% for very mild to moderate dementia. Conclusion: It is possible to determine an individualized CAMCOG cut‐off score for dementia in its early stages.
Progressive deterioration of soft neurological signs in chronic schizophrenic patients
Authors: Chen Eric Y. H. , Kwok Carol L. , Au Joyce W. Y. , Chen Ronald Y. L. , Lau Benjamin S. T. 
Published: March 2003

Objective: Neurological signs are found to be increased in schizophrenia in cross‐sectional studies. Whether they progress with time is an important issue in addressing the course of the illness. Method: The current study investigated different groups of neurological signs in 43 stable chronic schizophrenic patients over a 3‐year period using an operationalized instrument. Results: While symptoms and medication have remained largely unchanged in the 3‐year period, significant increase in soft neurological signs (SNS) (‘motor coordination’, ‘sensory integration’ and ‘disinhibition’) has been observed. This contrasted with the stability of ‘pyramidal’, ‘extrapyramidal’, ‘dyskinesia’ and ‘catatonia’ signs. The increase in SNS appears not to be related to age, illness duration, symptoms or medication. Conclusion: This finding suggests that SNS represent a marker sensitive to a possible late deterioration process in the course of a schizophrenic illness.
Differences between patients with identified and not identified psychiatric disorders in primary care
Authors: Karlsson Hasse , Joukamaa Matti , Lehtinen Ville 
Published: March 2003

Objective: The aim of this study was to discover the differences between the primary care patients with a psychiatric disorder whose illness was detected and the patients whose disorder was not detected. Method: We collected 1000 randomly selected PC patients. We used SCL‐25 as a screening method and PSE as a diagnostic tool. Results: Ninety‐one (89.2%) of the interviewed patients received a psychiatric diagnosis. The physicians detected a disorder in 36 (36.9%). A larger part of the undetected group belonged to the highest social groups. Also the SCL‐25 mean scores differed significantly, indicating that the symptoms of the undetected cases were milder. The detected cases had higher levels of anxiety and depression, but the difference in anxiety symptoms was greater between the groups. Detection was associated with treatment. Conclusion: The GPs should also be aware of psychiatric morbidity in patients with a higher social status, a good level of education and milder symptoms.
The perception of needs for care in staffand patients in community‐based mental health services. The South‐Verona Outcome Project 3
Authors: Lasalvia Antonio , Ruggeri Mirella , Mazzi Maria Angela , Dall'Agnola Rosa Bruna 
Published: March 2003

Objective: The present study aims to assess needs for care rated by patients and staff and their agreement on needs assessment in a community‐based mental health service by using the Camberwell Assessment of Need (CAN). Method: The Italian version of the CAN was used in a sample of 247 patient–staff pairs. Results: Patients and staff showed poor agreement on both the presence of a need and on whether need had been met or not. Higher disability predicted a higher number of patient‐rated needs, while higher disability, higher number of service contacts and patient unemployment predicted a higher number of staff‐rated needs. Lower global functioning predicted higher disagreement in patients and staff ratings of needs. Conclusion: Patients and staff show different perceptions of needs for care and therefore multiple perspectives should be taken into account for planning and providing effective needs‐led mental health care.
Social networks and functional status in patients with psychosis
Authors: Howard Louise , Leese Morven , Thornicroft Graham 
Published: March 2003

Objective: To investigate whether large social networks are associated with better functional outcome in psychotic disorders. Method: A prospective cohort study of epidemiologically representative patients with psychosis was analysed to examine the relationship between social networks and functional outcome. Standardized validated measures were used for diagnosis, social networks and outcome. Results: There was strong evidence of cross‐sectional associations between the size of the social network and the number of active interactions, and functional outcome. Structural equation modelling found weak evidence of an additional longitudinal association. Conclusion: There was consistent evidence of a positive correlation between the total size of patients' social networks and the number of active interactions, and functional outcome. The direction of causality cannot be determined by this analysis, although it is suggested that the effect of social networks on functioning is stronger than vice versa. Patients' functioning may improve with interventions that improve social networks.
Prolactin and beta‐endorphin serum elevations after ECT in manic patients
Authors: Chaudhry Haroon R. , Hofmann Peter , Loimer Norbert , Kotter Mark , Quehenberger Franz , Fueger Gerhard 
Published: March 2003

Objective: Alterations in prolactin and β‐endorphin serum levels after ECT are well‐established findings in depression. The present study focuses on electroconvulsive therapy (ECT) response patterns of the mentioned parameters in patients suffering from acute mania. Method: Following the first three ECTs of a treatment series in 19 patients diagnosed according to DSM‐III‐R criteria as suffering from mania, blood samples were drawn before, and 20, 30 and 40 minutes after ECT. Serum prolactin and β‐endorphin levels were established in order to gain information about the effects of ECT on different neurotransmitter systems. Results: A significant transient increase in serum prolactin after ECT was found. Furthermore, in females but not males, Δmax prolactin diminished over the course of treatment as prolactin baseline levels increased. β‐endorphin levels showed a stable transient increase after ECTstimulus regardless from sex or treatment. Conclusion: The reported findings reflect those established in depression. This suggests that they are epiphenomenal to ECT.
Premorbid performance IQ deficit in schizophrenia
Authors: Amminger G. P. , Schlögelhofer M. , Lehner T. , Looser Ott S. , Friedrich M. H. , Aschauer H. N. 
Published: March 2003

Objective: Performance IQ (PIQ) is often lower than verbal IQ (VIQ) in schizophrenic patients. Whether PIQ<VIQ precedes psychotic symptoms in schizophrenia remains uncertain. Method: We investigated premorbid IQ scores in 63 subjects assessed at a child and adolescent psychiatric unit (mean age 13.1 years, SD 3.2), who at follow‐up in adulthood (mean age 30.9 years, SD 3.9) received a lifetime RDC diagnosis of schizophrenia‐related psychosis, affective disorder, or no psychiatric disorder. Results: Premorbid PIQ<VIQ significantly differentiated the groups with schizophrenia‐related psychosis and no psychiatric disorder. Subjects with schizophrenia‐related psychosis had a significantly lower mean value for premorbid PIQ, but not VIQ, compared to subjects who developed affective disorder or subjects without psychiatric disorder. Conclusion: Our results emphasize premorbid intellectual deficits in schizophrenia. Those deficits might largely be in consequence of an impairment on the PIQ scale.
Prevalence of dissociative disorders in psychiatric in‐patients: the impact of study characteristics
Authors: Friedl Monica , Draijer Nel , De Jonge Peter 
Published: March 2003

Objective: Prevalence rates for dissociative disorders among psychiatric in‐patients vary widely. The aim of this meta‐analysis is to offer an explanation for these differences. Method: Prevalence studies using a clinical diagnostic interview among psychiatric in‐patients were included. Hypotheses concerning the impact of blind versus not blind designs, choice of diagnostic instrument and continental background were tested. Results: Nine studies met the inclusion criteria. In blind studies the prevalence rate for dissociative disorders was significantly lower (but not for DID). Studies using the SCID‐D (compared to the DDIS) and European studies had significantly lower prevalence rates for both dissociative disorders as well as for DID. Conclusion: The choice of diagnostic instrument and cultural differences in interpretation of symptoms are major explanations for differences in prevalence of dissociative disorders and DID. Comparative, blind research using both DDIS and SCID‐D in the assessment of dissociative disorders is advised.
Relapse prevention in major depressive disorder after successful ECT: a literature review and a naturalistic case series
Authors: Wijkstra Jaap , Nolen Willem A. , Algra Ale , Van Vliet Irene M. , Kahn René S. 
Published: March 2003

Objective: Medication‐resistance in major depressive disorder (MDD) may be related to high relapse rates after successful ECT when continued medication (C‐MED) is used to prevent relapse. An alternative could be to continue ECT (C‐ECT). Method: Patients with medication‐resistant MDD responding to ECT were offered C‐ECT without medication. Follow‐up was 6 months. Publications from a literature search were screened against prespecified criteria. Results: With C‐ECT the 6‐month relapse‐rate was 50% (6/12, 95%CI:21–79) in our medication‐resistant group. In the review we found with C‐ECT 29% (7/24,CI:13–51) in ‘unknown’ medication resistance and no data about medication‐resistant depression. With C‐MED at 6 months: no data were found concerning medication‐resistant depression, 28% (35/124,CI:20–36) in ‘unknown’ resistance and 13% (2/15,CI:2–41) in non‐resistance. With C‐MED at 12 months, 73% (16/22,CI:50–90), 50% (16/32,CI:32–68) and 27% (8/30,CI:12–46) were found, respectively. Conclusion: The efficacy of C‐MED is related negatively to medication resistance before ECT. This may also be the case for C‐ECT. Further studies with C‐ECT are urgently needed.