bluuebunny/crossref_metadata_2025_split huggingface dataset:
The Stanley Foundation Bipolar Network
Authors: Post Robert M. , Denicoff Kirk D. , Leverich Gabriele S. , Nolen Willem A. , Kupka Ralph W. , Keck Paul E. , McElroy Susan L. , Rush A. John , Suppes Trisha , Altshuler Lori L. , Frye Mark A. , Grunze Heinz , Walden Jörg 
Published: August 2002

BackgroundThe Stanley Foundation Bipolar Network (SFBN) was created to address the paucity of help studies in bipolar illness.AimsTo describe the rationale and methods of the SFBN.MethodThe SFBN includes five core sites and a number of affiliated sites that have adopted consistent methodology for continuous longitudinal monitoring of patients. Open and controlled studies are performed as patients' symptomatology dictates.ResultsThe reliability of SFBN raters and the validity of the rating instruments have been established. More than 500 patients are in continuous daily longitudinal follow-up. More than 125 have been randomised to one of three of the newer antidepressants (bupropion, sertraline and venlafaxine) as adjuncts in a study of mood stabilisers and 93 to omega-3 fatty acids. A number of open clinical case series have been published.ConclusionsWell-characterised patients are followed in a detailed continuous longitudinal fashion in both opportunistic case series and double-blind, randomised controlled trials with reliable and validated measures.
The Stanley Foundation Bipolar Network
Authors: Kupka Ralph W. , Nolen Willem A. , Altshuler Lori L. , Frye Mark A. , Denicoff Kirk D. , Leverich Gabriele S. , Post Robert M. , Keck Paul E. , McElroy Susan L. , Rush A. John , Suppes Trisha 
Published: August 2002

BackgroundThe Stanley Foundation Bipolar Network (SFBN) evaluates treatments, course and clinical and neurobiological markers of response in bipolar illness.AimsTo give a preliminary summary of emerging findings in these areas.MethodStudies with established and potentially antimanic, antidepressant and mood-stabilising agents range from open case series to double-blind randomised clinical trials, and use the same core assessment methodology, thereby optimising the comparability of the outcomes. The National Institute of Mental Health Life Chart Method is the core instrument for retrospective and prospective longitudinal illness description.ResultsThe first groups of patients enrolled show a considerable degree of past and present symptomatology, psychiatric comorbidity and functional impairment. There are associations of both genetic and early environmental factors with more severe courses of illness. Open case series with add-on olanzapine, lamotrigine, gabapentin or topiramate show a differential spectrum of effectiveness in refractory patients.ConclusionsThe SFBN provides important new data for the understanding and treatment of bipolar disorder.
Long-term clinical effectiveness of lithium maintenance treatment in types I and II bipolar disorders
Authors: Tondo Leonardo , Baldessarini Ross J. , Floris Gianfranco 
Published: August 2002

BackgroundThe effectiveness of lithium is being questioned increasingly and requires clarification.AimsTo assess the effectiveness of lithium treatment in depression and mania, syndromal types I and II, with predominantly mixed or psychotic episodes or rapid cycling, during treatment resumed following discontinuation, and across three decades.MethodThe longitudinal course of 360 patients with bipolar disorder compliant with lithium treatment for at least 1 year and without comorbidity for substance use disorder was reviewed.ResultsRisk of single-episode recurrences, a common index of treatment failure, was similar to that in other reports. Both episode frequency and ‘time ill’ improved more in type II than type I cases. Reduced morbidity during treatment was similar in patients with mixed or psychotic episodes, or rapid cycling, and in less complex cases. Retreatment yielded minor decrements in response, and there was no tendency for lesser responses in more recent years.ConclusionsBased on overall affective morbidity, long-term lithium treatment in compliant patients without comorbid substance use disorder, though imperfect, remains effective, even in subgroups of supposedly poor prognosis.
Bipolar disorder: clinical uncertainty, evidence-based medicine and large-scale randomised trials
Authors: Geddes John , Goodwin Guy 
Published: August 2002

BackgroundThe increasing use of the methods of evidence-based medicine to keep up-to-date with the research literature highlights the absence of high-quality evidence in many areas in psychiatry.AimsTo outline current uncertainties in the maintenance treatment of bipolar disorder and to describe some of the decisions involved in designing a large simple trial.MethodWe describe some of the strategies of evidence-based medicine, and how they can be applied in practice, focusing specifically on the area of bipolar disorder.ResultsOne of the key clinical uncertainties in the treatment of bipolar disorder is the place of maintenance drug treatments and their relative efficacy. A large-scale study, the Bipolar Affective Disorder: Lithium Anticonvulsant Evaluation (BALANCE) trial, is proposed to compare the effectiveness of lithium, valproate and the combination of lithium and valproate.ConclusionsProviding reliable answers to key clinical questions in psychiatry will require new approaches to clinical trials. These will need to be far larger than previously appreciated and will therefore need to be collaborative ventures involving front-line clinicians.
Tryptophan depletion and its implications for psychiatry
Authors: Bell Caroline , Abrams Jolane , Nutt David 
Published: August 2002

BackgroundOver the past 10 years the technique of tryptophan depletion has been used increasingly as a tool for studying brain serotonergic systems.AimsTo review the technique of tryptophan depletion and its current status as a tool for investigating psychiatric disorders.MethodSystematic review of preclinical and clinical studies.ResultsTryptophan depletion produces a marked reduction in plasma tryptophan and consequently brain serotonin (5-HT) synthesis and release. In healthy volunteers the effects of tryptophan depletion are influenced by the characteristics of the subjects and include some mood lowering, some memory impairment and an increase in aggression. In patients with depression tryptophan depletion tends to result in no worsening of depression in untreated subjects but a relapse in those who have responded to antidepressants (particularly serotonergic agents). In panic disorder the results are similar.ConclusionsThe findings that tryptophan depletion produces a relapse of symptoms in patients with depression and panic disorder who have responded to treatment with antidepressants suggests that enhanced 5-HT function is important in maintaining response in these conditions.
International representation in psychiatric literature
Authors: Patel Vikram , Sumathipala Athula 
Published: August 2002

BackgroundDespite the growing recognition of the global burden of psychiatric disease, there are questions about the strength of the evidence base from non-Western societies.AimsTo compare the contribution of Euro-American countries and the rest of the world (RoW) to psychiatric literature.MethodSurvey of the country of origin of papers submitted to and published in six leading psychiatric journals over a 3-year period (1996–1998).ResultsOnly 6% of the literature is published from regions of the world that account for over 90% of global population. The three journals published in Europe had a significantly higher proportion of international articles when compared to the three American journals. Less than 1% of all published articles described mental health interventions in the RoW. Acceptance rates were significantly lower for papers submitted from the RoW.ConclusionsThere is a gross under-representation of research from the RoW. This has implications for the development of a truly international psychiatry.
Structural brain abnormalities associated with deletion at chromosome 22q11
Authors: Van Amelsvoort Therese , Daly Eileen , Robertson Dene , Suckling John , Ng Virginia , Critchley Hugo , Owen Michael J. , Henry Jayne , Murphy Kieran C. , Murphy Declan G. M. 
Published: August 2002

BackgroundVelo-cardio-facial syndrome (VCFS) is associated with deletions in the q11 band of chromosome 22, learning disability and psychosis, but the neurobiological basis is poorly understood.AimsTo investigate brain anatomy in adults with VCFS.MethodMagnetic resonance imaging was used to study 10 patients with VCFS and 13 matched controls. We carried out three analyses: qualitative; traced regional brain volume; and measurement of grey and white matter volume.ResultsThe subjects with VCFS had: a high prevalence of white matter hyperintensities and abnormalities of the septum pellucidum; a significantly smaller volume of cerebellum; and widespread differences in white matter bilaterally and regional specific differences in grey matter in the left cerebellum, insula, and frontal and right temporal lobes.ConclusionsDeletion at chromosome 22q11 is associated with brain abnormalities that are most likely neurodevelopmental and may partially explain the high prevalence of learning disability and psychiatric disorder in VCFS.
Predictors of later schizophrenia and affective psychosis among attendees at a child psychiatry department
Authors: Cannon Mary , Walsh Elizabeth , Hollis Christopher , Kargin Maresc , Taylor Eric , Murray Robin M. , Jones Peter B. 
Published: August 2002

BackgroundSchizophrenia has been linked with psychological problems in childhood but there is little information on precursors of affective psychosis.AimsTo compare childhood psychological antecedents of adult schizophrenia and affective psychosis.MethodChildhood item sheets, which give standardised information on signs and symptoms of mental illness in the year preceding assessment are completed for all attendees at the children's department of the Maudsley and Bethlem Royal Hospital. We examined item sheet data on individuals with an adult diagnosis of schizophrenia (n=59) or affective psychosis (n=27) and a comparison group with no adult mental illness (n=86) (all had attended the department).ResultsAbnormal suspiciousness or sensitivity and relationship difficulties with peers are associated with later schizophrenia. In contrast, affective psychosis is associated with childhood hysterical symptoms and disturbances in eating.ConclusionsChildhood psychological precursors for schizophrenia and affective psychosis differ and do not simply reflect non-specific psychiatric disturbance in adolescence.
Psychosocial characteristics and needs of mothers with psychotic disorders
Authors: Howard Louise M. , Kumar R. , Thornicroft Graham 
Published: August 2002

BackgroundIt is not known whether mothers with psychotic disorders are clinically and socially distinct from women with psychoses who have not had children.AimsTo determine the proportion of mothers in an epidemiologically representative population of women with psychotic disorders, to examine the factors associated with having children, and to examine the factors associated with having children ‘looked after’ by social services.MethodDescriptive analysis and two case–control studies.ResultsSixty-three per cent of women with psychotic disorders were mothers. There were no clinical differences between women with or without children, but mothers were more likely to be older and live in unsupported accommodation. Having had a ‘looked after’ child was associated with Mental Health Act detention, younger age, a forensic history and being Black African.ConclusionMany women with psychoses are mothers. Mothers with psychoses are as disabled and have as many needs as women with psychoses without children.
Aggressive incidents in first-episode psychosis
Authors: Milton John , Amin Shazad , Singh Swaran P. , Harrison Glynn , Jones Peter , Croudace Tim , Medley Ian , Brewin John 
Published: August 2002

BackgroundRecent research has reported increased risk of aggressive incidents by individuals with psychotic illness.AimsTo examine acts of aggression in first-episode psychosis.MethodSubjects with a first-episode psychosis were ascertained from a defined catchment area (Nottingham, UK) and reassessed at 3 years (n=166) using clinical interview, informants, health care and forensic records.ResultsOf the subjects, 9.6% demonstrated at least one act of serious aggression (defined as weapon use, sexual assault or victim injury) during at least one psychotic episode and 23.5% demonstrated lesser acts of aggression (defined as all other acts of aggression). For all aggressive subjects (33.1%), unemployment (OR=3.6, 95%CI 1.6–8.0), comorbid substance misuse (OR=3.1, CI 1.1–8.8) and symptoms of overactivity at service contact (OR=6.9, CI 2.7–17.8) had independent effects on risk of aggression.ConclusionsWe confirmed some previously reported demographic and clinical associations with aggression in first-episode psychosis but no relationship with specific psychotic symptoms or diagnostic groups was observed.
Factors that influence the cost of caring for patients with severe psychotic illness
Authors: Byford Sarah , Barber Julie A. , Fiander Matthew , Marshall Sarah , Green John 
Published: August 2002

BackgroundMany factors influence the type and quantity of services received by patients and, thus, the total cost of care. Knowledge of these factors can aid budgetary and service-planning decisions.AimsTo investigate factors that influence the cost of caring for patients with severe psychotic illness.MethodUnivariate and multivariate analyses were used to examine associations between baseline characteristics and subsequent 2-year total direct costs in 667 patients from the UK700 case management trial.ResultsSignificantly more money was spent on younger patients, those with longer duration of illness, those who had spent less time living independently and those who had spent longer in hospital for psychiatric reasons.ConclusionsTotal costs of caring for patients with severe psychotic illness appear to be influenced to a large extent by age, duration of illness and past levels of dependence on statutory services. The strength of these relationships is greater than the impact of illness severity.
Effects of rapid tryptophan depletion on brain 5-HT2receptors: a PET study
Authors: Yatham Lakshmi N. , Liddle Peter F. , Shiah I-Shin , Lam Raymond W. , Adam Michael J. , Zis Athanasios P. , Ruth Thomas J. 
Published: August 2002

BackgroundThe mechanism by which rapid tryptophan depletion (RTD) paradigm induces depressive relapse in recently remitted patients with depression is unknown.AimsTo determine the effects of RTD on brain 5-HT2receptors using positron emission tomography (PET) and18F-labelled setoperone.MethodTen healthy women underwent two PET scans. Each scan was done 5 h after the ingestion of either a balanced or a tryptophan-deficient amino acid mixture, and the two test sessions were separated by at least 5 days.ResultsThe RTD decreased plasma free tryptophan levels significantly but it had no significant effects on mood. Subjects showed a significant decrease in brain 5-HT2receptor binding in various cortical regions following the RTD session.ConclusionsWhen taken with the evidence that antidepressant treatment is associated with a decrease in brain 5-HT2receptors, these findings suggest that a decrease in 5-HT2binding following RTD might be an adaptive response that provides protection against depressive symptoms.
Decreased sensitivity of 5-HT1D receptors in melancholic depression
Authors: Whale Richard , Clifford Elizabeth M. , Bhagwagar Zubin , Cowen Philip J. 
Published: August 2002

BackgroundBrain serotonin (5-HT) function is abnormal in major depression, but the involvement of different 5-HT receptor subtypes has been little studied. The availability of selective ligands now makes it possible to test the sensitivity of 5-HT1D receptors in patients with depression.AimsThe aim of the study was to use the 5-HT1D receptor agonist, zolmitriptan, to test the sensitivity of 5-HT1D receptors in patients with depression before and after treatment with selective serotonin reuptake inhibitors (SSRIs).MethodWe measured the growth hormone response to zolmitriptan (5 mg orally) in patients with major depression before and after SSRI treatment. A matched sample of healthy subjects acted as a control group.ResultsThe growth hormone response to zolmitriptan was blunted in patients with a melancholic depressive syndrome. SSRI treatment produced a marked reduction in zolmitriptan-induced growth hormone release.ConclusionsPatients with melancholic depression have impaired sensitivity of the post-synaptic 5-HT1D receptors that mediate growth hormone release. The reduction in 5-HT1D receptor sensitivity following SSRI treatment is probably an adaptive response to increased levels of synaptic 5-HT.
Relationship of suicide rates to social factors and availability of lethal methods
Authors: Schapira Kurt , Linsley K. R. , Linsley J. A. , Kelly T. P. , Kay D. W. K. 
Published: August 2002

BackgroundThe UK Government's White Paper Saving Lives: Our Healthier Nation included among its targets a reduction in suicide.AimsTo study causes of change in suicide rate over a 30-year period in Newcastle upon Tyne.MethodSuicide rates and methods, based on coroners' inquest records, were compared over two periods (1961–1965 and 1985–1994) and differences were related to changes in exposure to poisons and prescribed drugs, and to socio-demographic changes.ResultsDemographic and social changes had taken place which would adversely affect suicide rates. However, a dramatic fall was found in the rate for women, and a modest decline in that for men. Reduced exposure to carbon monoxide and to barbiturates coincided with the fall in rates.ConclusionsReduced exposure to lethal methods was responsible for the fall in rate in both genders, while the gender difference in favour of women may be related to their preference for non-violent methods or to their being less affected by the social changes.
Open verdict v. suicide – importance to research
Authors: Linsley K. R. , Schapira Kurt , Kelly T. P. 
Published: August 2002

BackgroundOpen verdicts are often included in with suicides for research purposes and for setting health targets.AimsTo examine similarities and differences in cases defined by the coroner as suicide and open verdicts and the implications of open verdicts for suicide research.MethodAll cases of open and suicide verdicts recorded in the Newcastle Coroner's Court in the period 1985–1994 were compared on demographic and medical parameters.ResultsOpen and suicide verdicts had many similarities, differing only in some respects, of which logistic regression identified the most significant to be a suicide note, method used and age.ConclusionsOpen verdicts should be included in all suicide research after excluding cases in which suicide was unlikely. Objective criteria are needed to facilitate comparison between different studies.
Suicide in children and adolescents in England and Wales 1970–1998
Authors: McClure G. M. G. 
Published: August 2002

BackgroundSuicide rates for England and Wales have been decreasing recently, but rates for young adult males remain high.AimsTo review changes in suicide rates for children and adolescents in England and Wales between 1970 and 1998.MethodRates for suicide, ‘accidental’ death by causes similar to suicide and ‘undetermined’ death for 10–14- and 15–19-year-olds are calculated between 1970 and 1998 using suicide data and estimated mid-year populations obtained from the Office for National Statistics.ResultsThere has been a substantial increase in suicide rate between the 1970s and the 1990s for males aged 15–19 years. This remains true even when ‘undetermined’ and ‘accidental’ death rates for causes similar to suicide are examined. The increase was associated with an increase in self-poisoning with vehicle exhaust gas in the 1980s and an increase in hanging which has continued into the 1990s. Although there was a slight decrease in the official suicide rate for females aged 15–19 years, ‘undetermined’ deaths increased. There is no indication of a major change in suicide rate in 10–14-year-olds.ConclusionsThe substantial increase in suicide rate in 15–19-year-old males may indicate increased psychosocial stress, particularly affecting this group.
Community mental health team management in severe mental illness: A systematic review
Authors: Simmonds Shaeda , Coid Jeremy , Joseph Philip , Marriott Sarah , Petertyrer  
Published: August 2002

BackgroundCommunity mental health teams are now generally recommended for the management of severe mental illness but a comparative evaluation of their effectiveness is lacking.AimsTo assess the benefits of community mental health team management in severe mental illness.MethodA systematic review was conducted of community mental health team management compared with other standard approaches.ResultsCommunity mental health team management is associated with fewer deaths by suicide and in suspicious circumstances (odds ratio=0.32, 95% CI 0.09–1.12), less dissatisfaction with care (odds ratio=0.34, 95% CI 0.2–0.59) and fewer drop-outs (odds ratio=0.61, 95% CI 0.45–0.83). Duration of in-patient psychiatric treatment is shorter with community team management and costs of care are less, but there are no gains in clinical symptomatology or social functioning.ConclusionsCommunity mental health team management is superior to standard care in promoting greater acceptance of treatment, and may also reduce hospital admission and avoid deaths by suicide. This model of care is effective and deserves encouragement.
Recovery from psychotic illness: A 15- and 25-year international follow-up study
Authors: Harrison G. , Hopper K. , Craig T. , Laska E. , Siegel C. , Wanderling J. , Dube K. C. , Ganev K. , Giel R. , Der Heiden W. An , Holmberg S. K. , Janca A. , Lee P. W. H. , León C. A. , Malhotra S. , Marsella A. J. , Nakane Y. , Sartorius N. , Shen Y. , Skoda C. , Thara R. , Tsirkin S. J. , Varma V. K. , Walsh D. , Wiersma D. 
Published: August 2002

BackgroundPoorly defined cohorts and weak study designs have hampered cross-cultural comparisons of course and outcome in schizophrenia.AimsTo describe long-term outcome in 18 diverse treated incidence and prevalence cohorts. To compare mortality, 15- and 25-year illness trajectory and the predictive strength of selected baseline and short-term course variables.MethodHistoric prospective study. Standardised assessments of course and outcome.ResultsAbout 75% traced. About 50% of surviving cases had favourable outcomes, but there was marked heterogeneity across geographic centres. In regression models, early (2-year) course patterns were the strongest predictor of 15-year outcome, but recovery varied by location; 16% of early unremitting cases achieved late-phase recovery.ConclusionsA significant proportion of treated incident cases of schizophrenia achieve favourable long-term outcome. Sociocultural conditions appear to modify long-term course. Early intervention programmes focused on social as well as pharmacological treatments may realise longer-term gains.