bluuebunny/crossref_metadata_2025_split huggingface dataset:
Relatives' distress and patients' symptoms and behaviours: a prospective study of patients with schizophrenia and their relatives
Authors: Boye B. , Bentsen H. , Ulstein I. , Notland T. H. , Lersbryggen A. , Lingjærde O. , Malt U. F. 
Published: March 2003

Objective: The aim of this study is to explore the relationship between relatives' distress and patients' symptoms and behaviours. Method: Fifty relatives in close contact with 36 patients with schizophrenia DSM‐III‐R filled in the General Health Questionnaire (GHQ) and the Perceived Family Burden Scale (PFBS) at the patient's hospital admission, 4.5 and 9 months post‐discharge. The patients were assessed by means of the Positive and Negative Syndrome Scale (PANSS). Results: The PFBS anxiety‐depression cluster was at all three assessments positively correlated with relative's distress (GHQ), not with PANSS anxiety and depression measurements. In multiple regression analysis PFBS, but not PANSS, was related to relatives' distress. Conclusion: Relatives' distress was related to their reports of problematic patient behaviours, especially anxiety‐depressive behaviour, not to symptoms as measured by clinical interviews. High distress is related to high expressed emotion, suggesting that relatives' report of patient's behaviour should be addressed to improve patient's outcome.
Gender‐related differences in the onset of panic disorder
Authors: Barzega Giulio , Maina Giuseppe , Venturello Sara , Bogetto Filippo 
Published: March 2003

Objective: To investigate gender‐related differences in premorbid conditions and in the role of triggering events in the onset of panic disorder (PD). Method: One hundred and eighty‐four out‐patients with a principal diagnosis of PD (DSM‐IV) were evaluated with a semi‐structured interview to generate Axis I and Axis II diagnoses according to DSM‐IV, to collect family history of psychiatric disorders and life events. The statistical analysis was performed comparing men and women. Results: Men and women showed similar age at onset of PD. A family history of mood disorders characterized females. Men had higher rates of cyclothymia, body dysmorphic disorder and depersonalization disorder preceding PD, while women had higher rates of bulimia nervosa. Dependent and histrionic PDs were more common among women, while borderline and schizoid PDs were more common among men. Life events showed a significant role in precipitating PD onset in women. Conclusion: Premorbid clinical conditions of PD seem to differentiate between males and females in the role of precipitating events.
Predictors and outcome characteristics associated with suicidal behaviour in early psychosis: a two‐year follow‐up of first‐admitted subjects
Authors: Verdoux H. , Liraud F. , Gonzales B. , Assens F. , Abalan F. , Van Os J. 
Published: March 2003

Objective: To assess the baseline characteristics associated with a greater risk of suicidal behaviour (suicide and parasuicide) over the 2 years following a first admission for psychosis, and the associations between suicidality and outcome. Method: First‐admitted subjects with psychosis (n=65) were assessed at 6‐monthly intervals over a 2‐year follow‐up period. Results: Over this period, 11.3% of the patients displayed suicidal behaviour. Baseline predictors of suicidal behaviour were a lifetime history of parasuicide before first admission (OR=5.9, 95% CI 1.5–23.4), lower Positive And Negative Symptom Scale positive subscores (OR=0.8, 95% CI 0.6–0.97) and a longer duration of first admission (OR=1.1, 95% CI 1–1.2). Subjects with suicidal behaviour presented with a longer duration of psychotic symptoms (OR=1.1, 95% CI 1.02–1.2) and a greater risk of being readmitted (OR=4.6, 95%CI 1.1–19.1). Subjects with substance misuse over the follow‐up period were seven times (95%CI 1.3–39) more likely to engage in suicidal behaviour. Conclusion: Subjects with a previous history of parasuicide, with a deteriorating clinical course, or with substance misuse are at increased risk of suicidal behaviour in the 2 years after the onset of a first psychotic episode.
A comparison of needs of patients with schizophrenia in five European countries: the EPSILON Study
Authors: McCrone Paul , Leese Morven , Thornicroft Graham , Schene Aart , Knudsen Helle Charlotte , Vázquez‐Barquero José Luis , Tansella Michele , Becker Thomas ,   EPSILON Study Group
Published: March 2003

Objective: To compare the occurrence of needs of patients with schizophrenia in Amsterdam, Copenhagen, London, Santander and Verona. Method: Patients with schizophrenia were interviewed with the Camberwell Assessment of Need. The mean numbers of total, met and unmet needs were compared across the sites. Ratings for individual domains were also examined. Means were adjusted, using multiple regression analysis, to control for patient differences between sites. Results: The highest levels of unmet need were in Amsterdam and London. The number of met needs were similar. Adjusting for patient differences reduced the estimated number of unmet needs and total needs in Copenhagen, but made little difference elsewhere. There were many site differences for individual domains. Conclusion: Needs vary between different countries. Unmet needs are greater in large urban areas like London and Amsterdam. Differences in the pattern of individual needs may be partly explained in terms of service provision.
Late mortality in severe depression
Authors: Brådvik Louise , Berglund Mats 
Published: March 2003

Objective: To assess late mortality among psychiatric in‐patients with severe depression/melancholia. Method: 1206 in‐patients rated at discharge on a multidimensional diagnostic schedule had received the diagnosis severe depression/melancholia between 1956 and 1969. A first follow‐up was made in 1984. The present follow‐up constitutes 675 survivors 15–42 years after the first admission. They were followed‐up by means of the general population register and local parish registers to January 1st 1998. Results: At this second follow‐up another 279 patients were deceased, standardized mortality ratio 1.3, indicating a continuous increased mortality late in the course of depression. Eleven suicides (4%) were included, eight men and three women, which was less than the 22% found in the first investigation. Male patients showed a higher suicide rate than female patients late in the course. Conclusion: The general mortality and suicide rate remain increased late in the course.
Suicidal behaviour and family factors among Dutch and Slovenian high school students: a comparison
Authors: Tomori M. , Kienhorst C. W. M. , De Wilde E. J. , Van Den Bout J. 
Published: March 2003

Objective: East European countries have much higher suicide rates than West European countries. Whether this also applies for suicidal ideation and suicide attempts is not known. In addition, the role of family factors in relation to suicidal behaviour has not been investigated in East European countries. Method: Two representative samples of 19250 Dutch and 4706 Slovenian high school students were compared on the basis of self‐report data. Results: Slovenian students report more suicidal behaviour (ideation and attempts) as well as more unfavourable family circumstances than Dutch students. This applies especially to the death of parent(s), the number of changes in their living situation, and to conflicts between or with parents. Conclusion: A relation between family characteristics and suicidal behaviour is established in both samples, but proved to be strongest in Slovenian girls. Complicated cultural and socioeconomic differences between the two countries may account for the reported differences.
Citalopram versus nortriptyline in late‐life depression: a 12‐week randomized single‐blind study
Authors: Navarro V. , Gastó C. , Torres X. , Marcos T. , Pintor L. 
Published: March 2003

Objective: The aim of this single‐blind study was to examine the efficacy and tolerability of citalopram compared to nortriptyline in moderate to severe major depressive patients aged 60 years or over. Method: In‐ and out‐patients (N=58) with unipolar major depression were randomized to 12‐week flexible dose treatment with nortriptyline or citalopram. Results: No significant differences between the number of drop‐outs in either group were observed, but the autonomic side‐effects were significantly higher for nortriptyline than for citalopram. A significantly higher remission rate to nortriptyline than to citalopram was demonstrated, particularly if severe patients (endogenous or psychotic patients) were assessed. Conclusion: The remission rate to a therapeutic plasma level of nortriptyline appears to be higher than the remission rate to a standard dose of citalopram in a group of elderly major depressed patients, especially those with endogenous or psychotic features. On the other hand, citalopram appears to be better tolerated.
Post‐traumatic stress disorder: a review of psychobiology and pharmacotherapy
Authors: Hageman I. , Andersen H. S. , Jørgensen M. B. 
Published: March 2003

Objective: To review the literature on the psychobiology and pharmacotherapy of PTSD. Method: Relevant studies were identified by literature searches (Pub‐med, web of science) and through reference lists. The search was ended by May 2001. Results: There is evidence of involvement of opioid, glutamatergic, GABAergic, noradrenergic, serotonergic and neuroendocrine pathways in the pathophysiology of PTSD. Medications shown to be effective in double‐blind placebo‐controlled trials includes selective serotonin reuptake inhibitors, reversible and irreversible MAO‐inhibitors, tricyclic antidepressants and the anticonvulsant lamotrigine. Still more agents appear promising in open‐label trials. Conclusion: The complexity of the psychobiology is reflected by the difficulties in treating the disorder. According to the present knowledge, suggestions for drug treatment of PTSD are made.
Dimensionality, responsiveness and standardization of the Bech–Rafaelsen Mania Scale in the ultra‐short therapy with antipsychotics in patients with severe manic episodes
Authors: Bech P. , Baastrup P. C. , De Bleeker E. , Ropert R. 
Published: March 2003

Objective:  Typical antipsychotics have their indication in the ultra‐short (first week) treatment of severe episodes of mania. In this setting the Bech–Rafaelsen Mania Scale (MAS) was psychometrically compared with the Clinical Global Impression scale (CGI) to assess its ability to measure response. Method:
Ratings on patients with marked to severe mania (n=80) who participated in the clinical trials to evaluate the ultra‐short antimanic effect of zuclopenthixol acetate were assessed. The MAS was analysed for internal validity (total score a sufficient statistic) and for external validity. Results:  The MAS was shown to have a high internal validity showing onset of action already after days of treatment. After 6 days of treatment 53% of the patients responded according to the MAS but only 30% according to the CGI. The difference was statistically significant. Conclusion:  The MAS has been found to be a valid scale to measure early onset of action and response in the ultra‐short antimanic treatment with typical antipsychotics.
Dysfunction of transcallosally mediated motor inhibition and callosal morphology in patients with schizophrenia
Authors: Höppner Jacqueline , Kunesch Erwin , Großmann Annette , Tolzin Christoph‐Jonas , Schulz Merten , Schläfke Detlef , Ernst Klaus 
Published: March 2003

Objective: In order to assess the functional integrity of motor pathways through the corpus callosum (CC) in patients with schizophrenia transcallosally mediated inhibition (TI) of voluntary tonic EMG activity of first dorsal interosseus muscle following ipsilateral focal transcranial magnetic stimulation (fTMS) was investigated. In addition thickness and length of CC were calculated. Method: Twelve patients suffering from schizophrenia and 12 healthy controls were investigated. CC morphology was measured in mid‐sagittal MRI‐slices. Latency and duration of TI were calculated. Results: In schizophrenics the duration of TI was significantly prolonged, whereas latencies were not. In addition, a lack of TI was found unilaterally in three patients. Measurements of CC revealed a significantly reduction of the length and thickness in the anterior part of CC in patients. Conclusion: These findings indicate that measurement of TI could be used to detect clinical silent affection of transcallosal motor pathways in schizophrenics. The effect of neuroleptic drugs has to be explored.
Subject and observer‐rated quality of life in schizophrenia
Authors: Fitzgerald P. B. , Williams C. L. , Corteling N. , Filia S. L. , Brewer K. , Adams A. , De Castella A. R. A. , Rolfe T. , Davey P. , Kulkarni J. 
Published: March 2003

Objective: We aimed to explore the relationship between objectively rated quality of life and subjective measures of social functioning and life satisfaction. Method: Participants of the Schizophrenia Care and Assessment Program (SCAP) study at Dandenong in Australia were included in this analysis. Subjective ratings of several domains of social functioning and life satisfaction were taken from the SCAP instrument and comparisons made with data from the Quality of Life scale rated by research staff as well as several psychopathology measures. Results: Subjectively reported life satisfaction was not related to positive or negative symptoms of schizophrenia but did correlate with depressive symptoms. Quality of Life scale measures correlated with negative symptoms on most domains. There was very limited overlap in domain items between the life satisfaction and quality of life measures. Conclusion: Life satisfaction and objectively rated quality of life are not closely related and appear to have different determinants in patients with schizophrenia.
A comparison of community‐dwelling older schizophrenia patients by residential status
Authors: Auslander Lisa A. , Lindamer Laurie L. , Delapena Jody , Harless Kelly , Polichar Dina , Patterson Thomas L. , Zisook Sidney , Jeste Dilip V. 
Published: March 2003

Objective: Differences in residential status may contribute to the diversity of findings observed in community‐based samples of patients with schizophrenia. We compared older out‐patients living independently with those in assisted‐care facilities. Method: Two hundred and fifty‐one out‐patients with schizophrenia or schizoaffective disorder, aged 40–97 years, who had been referred to our Intervention Research Center were examined. Results: Assisted living status was associated with an earlier age at onset of illness, longer illness duration, lower probability of having ever been married, more severe negative symptoms, worse cognitive impairment, and a poorer health‐related quality of wellbeing. Independent living and assisted‐care patients had similar levels of positive and depressive symptoms, and were on comparable doses of neuroleptic medication. Significant ‘predictors’ of residential status were marital status, cognitive impairment and quality of wellbeing. Conclusion: Among schizophrenia out‐patients, one needs to consider residential status in evaluating heterogeneity in cognitive performance or quality of wellbeing.
Suicides are seldom prescribed antidepressants: findings from a prospective prescription database in Jämtland county, Sweden, 1985–95
Authors: Henriksson Svante , Boëthius Göran , Isacsson Göran 
Published: March 2003

Objective: This study presents data relating to prospectively monitored treatment and post‐mortem toxicology of individuals who committed suicide. Method: A case–control study of prospectively monitored pharmacological treatment in suicides and controls. Psychiatric records and post‐mortem toxicology were also studied. Results: Fifty‐nine subjects who committed suicide purchased twice the number of prescriptions as the 118 controls. Sixteen cases received psychiatric in‐patient care compared to four of the controls. In the last 3 months prior to suicide, 38 cases (64%) were dispensed drugs: anxiolytics‐hypnotics in 17 cases (29%), antipsychotics in six cases (10%) and antidepressants in seven cases (12%). More psychiatrists than GPs prescribed antidepressants. About one‐third of psychotropic drugs were retrieved in post‐mortem toxicology. Conclusion: There is a frequent use of psychotropics and psychiatric care among suicides; however, few used antidepressants and complied. Many suicides are still misdiagnosed and are not adequately treated.
Differences of symptoms and standardized weight index between patients with early‐onset and late‐onset anorexia nervosa
Authors: Matsumoto H. , Takei N. , Kawai M. , Saito F. , Kachi K. , Ohashi Y. , Takeuchi H. , Mori N. 
Published: March 2003

Objective: There have so far been no studies that directly compared clinical features between patients with early‐ and late‐onset anorexia nervosa (AN). Method: We identified 64 patients with DSM‐III‐R AN. We defined individuals as an early‐onset group, who had an age of onset before 14 years (N=31), and the remaining as a late‐onset group (N=33). The clinical symptoms, body weight and weight index, were compared between the two groups. Subjects were dichotomized into those with extremely low weight and those remaining. We compared the proportion of the patients with extremely low weight between the two groups. Results: The rates of ‘self‐induced vomiting’ and ‘purging’ were significantly lower in a group of patients with early‐onset AN than in those with late‐onset AN. There were significantly fewer subjects with extremely low weight in early‐onset than in late‐onset AN group. Conclusion: We found clear differences in clinical features between early‐ and late‐onset AN groups.
Testing the stress‐vulnerability hypothesis in ICD‐10‐diagnosed acute and transient psychotic disorders
Authors: Das S. K. , Malhotra S. , Basu D. , Malhotra R. 
Published: March 2003

Objective:
To examine if family‐history‐positive (FHP) vis‐à‐vis family‐history‐negative (FHN) probands with ICD‐10‐diagnosed acute and transient psychotic disorders (ATPD) differ significantly with respect to number of life events and cumulative stress score prior to the onset of ATPD. Method:
Forty probands with ICD‐10‐based clinical diagnosis of acute and transient psychotic disorders were studied with respect to: (a) history of psychiatric disorders in first‐degree relatives, and (b) antecedent life events and cumulative stress. The FHP and FHN probands were compared on the latter variables using Mann–Whitney U‐test. Results:
FHP probands reported significantly less number of total life events compared to FHN probands (P=0.006). Similarly, FHP probands had significantly less stress score than FHN probands (P=0.002). There were no significant demographic or clinical differences between the two groups. Conclusion:  The findings support the stress‐vulnerability hypothesis in the aetiology of ATPD.
A prospective study of 86 new patients with social anxiety disorder
Authors: Allgulander Christer , Nilsson Bo 
Published: March 2003

Objective: To determine the prognosis in 86 new patients with social anxiety disorder. Method: Untreated subjects with social anxiety were recruited by advertising in Stockholm, randomized to 3 months treatment with paroxetine or placebo, and then offered continued specialist care. Metabolizing capacity was determined by genotyping CYP2D6 in the subjects on paroxetine. After a mean 32 months all were contacted for a personal interview. Results: Of the 92 evaluable subjects, 86 (93%) were interviewed. A favourable prognosis was seen in the subjects randomized to paroxetine who chose to continue with serotonergic medication. The least favourable prognosis was in those given placebo who chose not to be treated after the trial. Twenty‐four subjects were still symptomatic and dysfunctional and had not sought treatment. Drug‐induced adverse effects caused treatment termination in six subjects, one of whom had a poor metabolizing genotype. Conclusion: Due to their condition, some subjects with social anxiety refrain from effective treatments. The efficacy of serotonergic medication was maintained and augmented after a mean period of 32 months.
MACS‐II: does coping enhance subjective control over psychotic symptoms?
Authors: Bak Maarten , Van Der Spil Farida , Gunther Nicole , Radstake Steven , Delespaul Philippe , Van Os Jim 
Published: March 2003

Objective: Associations between subjective experience of control and the use of self‐initiated coping strategies were examined in patients with psychotic symptoms. Method: Twenty‐three patients were interviewed to assess (i) the subjective experience of distress with and control over symptoms and (ii) the coping strategies used. Results: There was a positive association between coping type and control (OR=1.07, 95% CI: 1.03–1.12). Active coping strategies had the strongest association with experience of control (active problem‐solving: OR=1.41 95% CI: 1.18–1.68; active problem‐avoiding: OR=1.45 95% CI: 1.18–1.68). Symptomatic coping was negatively associated with control (OR=0.40, 95% CI: 0.30–0.55), but was the most frequently used strategy. Depressive symptoms were associated with the highest number of coping strategies. Conclusion: Coping strategies differ in the degree and direction of associated subjective control, and symptoms differ in the degree with which coping is mobilized. Assessment of coping strategies may be useful as a prelude to psychological therapy.
Lithium and suicidal behavior in major affective disorder: a case–control study
Authors: Coryell William , Arndt Stephan , Turvey Carolyn , Endicott Jean , Solomon David , Mueller Tim , Leon Andrew C. , Keller Martin 
Published: March 2003

Objective: A number of studies have suggested that lithium may be particularly effective in reducing suicide risks among patients with major affective disorders. The design of many of these studies left them open to biases associated with treatment compliance, however. Method: Subjects were drawn from a naturalistic, long‐term follow‐up of patients with major affective disorders. Fifteen who committed suicide while receiving somatotherapy where matched to non‐suicidal patients who were similarly receiving somatotherapy at the same point in follow‐up. The same procedure was followed for 41 patients who made a serious suicide attempt during follow‐up. Results: Six (40.0%) of the patients who committed suicide, and eight (53.3%) of their controls, were thought to have been taking lithium in the preceding week. Among attempters and their controls, nine (22.0%) and eight (19.5%), respectively, were taking lithium. Conclusion: These results do not support previous suggestions that lithium has uniquely antisuicidal properties. Other existing datasets should be explored with this design to establish whether lithium does, or does not, offer special protection against suicide.
Association of personal and familial suicide risk with low serum cholesterol concentration in male lithium patients
Authors: Bocchetta Alberto , Chillotti Caterina , Carboni Gianfranco , Oi Antonio , Ponti Marco , Del Zompo Maria 
Published: March 2003

Objective:  We sought to establish whether low cholesterol concentration may be associated with a personal history of attempted suicide or a family history of completed suicide in psychiatric out‐patients on maintenance lithium treatment, who represent a population at risk for suicide. Method:  We retrospectively reviewed charts regarding 783 out‐patients consecutively admitted to a lithium clinic from 1976 to 1999. Individual age‐ and gender‐specific quartile of serum cholesterol concentration were correlated against personal lifetime suicide attempts and completed suicide in first‐degree relatives. Results:  The proportion of men with a personal lifetime history of attempted suicide, especially if violent, and that of men with history of completed suicide in a first‐degree relative were significantly higher among the group with cholesterol concentration in the lowest quartile compared to the group with cholesterol levels above the 25th percentile. Conclusion:  Low cholesterol concentration should be studied further as a potential biological/genetic marker of suicide risk.