bluuebunny/crossref_metadata_2025_split huggingface dataset:
Cardiff Depression Study
Authors: Farmer Anne , Harris Tanya , Redman Kate , Sadler Stephanie , Mahmood Arshad , McGuffin Peter 
Published: August 2002

BackgroundAn excess of both depression and undesirable life events in first-degree relatives of probands with depression as compared with controls has been reported. This association may have reflected a familial factor in common.AimsTo examine the familiality of life events and depression and whether there may be a common familial factor influencing vulnerability to depression and the experiencing of life events.MethodIn a sib-pairdesign, 108 probands with depression and their siblings were compared with 105 healthy controls and their siblings for psychopathology and life events.ResultsThe lifetime relative risk of depressive disorder in the siblings of depressed subjects as compared with siblings of controls was 9.74, although these groups did not differ in the life events measures. Several categories of events showed significant sibling correlations, but this was due to the same event affecting both members of the pair.ConclusionsAlthough depressive disorder was strongly familial, the familial effects on life events were largely explained by shared experiences. There was no evidence for a common factor influencing both depression and life events.
Familial influence on variation in age of onset and behavioural phenotype in Alzheimer's disease
Authors: Tunstall Nigel , Owen Michael J. , Williams Julie , Rice Frances , Carty Stephanie , Lillystone Sara , Fraser Lindsay , Kehoe Patrick , Neill David , Rudrasingham Varuni , Sham Pak , Lovestone Simon 
Published: August 2002

BackgroundAlzheimer's disease manifests considerable heterogeneity, the cause of which is unknown.AimsTo determine the familial (genotypic) influence on phenomenology (phenotype) in Alzheimer's disease.MethodAffected sibling pairs with Alzheimer's disease were assessed for a range of cognitive and non-cognitive symptoms. Resemblance for phenotypic characteristics was estimated using intraclass correlations for continuous traits and by pairwise concordance for dichotomous traits. The relationship between age of onset and APOE genotype was examined using linear regression analysis.ResultsSignificant familial effects on age of onset (intraclass correlation 0.41) and mood state (intraclass correlation 0.26), and a relatively high pairwise concordance for agitation (excess concordance 0.1) were found. The APOE locus was found to account for 4% of the variance in age of onset.ConclusionsSubstantial familial influence on age of onset, depression and agitation suggests that genotype does influence phenotype in Alzheimer's disease. Establishing the molecular basis for this phenotypic variation may prove relevant to other neuropsychiatric disorders.
Prospective controlled study of psychiatric out-patient non-attendance
Authors: Killaspy Helen , Banerjee Sube , King Michael , Lloyd Margaret 
Published: August 2002

BackgroundPsychiatric clinics have high non-attendance rates and failure to attend may be a sign of deteriorating mental health.AimsTo investigate why psychiatric out-patients fail to attend, and the outcome of attenders and non-attenders.MethodProspective cohort study of randomly selected attenders and non-attenders at general adult psychiatric out-patient clinics. Subjects were interviewed at recruitment and severity of mental disorder and degree of social adjustment were measured. Six and 12 months later their engagement with the clinic and any psychiatric admissions were ascertained.ResultsOf the 365 patients included in the study, 30 were untraceable and 224 consented to participate. Follow-up patients were more psychiatrically unwell than new patients. For follow-up patients, non-attenders had lower social functioning and more severe mental disorder than those who attended. At 12-month follow-up patients who missed their appointment were more likely to have been admitted than those who attended.ConclusionsThose who miss psychiatric follow-up out-patient appointments are more unwell and more poorly socially functioning than those who attend. They have a greater chance of drop-out from clinic contact and subsequent admission.
Extent and contributing factors of drug expenditure of injectors in Glasgow
Authors: Hutchinson S. J. , Gore S. M. , Taylor A. , Goldberg D. J. , Frischer M. 
Published: August 2002

BackgroundRecent concern about drug use has focused attention on the illegal income generated by users.AimsTo investigate factors associated with drugs expenditure and to estimate the cost of illegal acquisitions used to pay for drugs.MethodWe collected self-report data from 954 current injectors, interviewed at multiple street, needle/syringe exchange and drug treatment sites throughout Glasgow.ResultsInjectors' mean weekly drug spending was £324. The mean annual illegal drugs spend was estimated to be £11 000 per injector. We provide a central estimate – £194 million per annum – of the retail value of goods acquired illegally by injectors in Glasgow in order to pay for drugs. Higher drug spends were associated with having been imprisoned more often and with those reporting acquisitive crime, drug dealing and prostitution. Treatment with methadone, among individuals who injected in the previous two months, was associated with a 20% reduction in atypical spend on drugs.ConclusionsTreatment effectiveness needs to be measured both in terms of health benefit and in terms of reduction in drugs expenditure and recidivism.
Determinants of quality of life at first presentation with schizophrenia
Authors: Browne Stephen , Clarke Mary , Gervin Maurice , Waddington John L. , Larkin Conal , O'Callaghan Eadbhard 
Published: August 2002

BackgroundQuality of life (QOL) has gained importance as a global measure of social and clinical outcome in schizophrenia.AimsTo identify the clinical correlates of QOL at the time of first presentation with schizophrenia.MethodOver two years, consecutive first-episode psychosis patients presenting to a catchment area psychiatric service underwent validated clinical assessments of premorbid adjustment, illness duration, symptoms and QOL.ResultsAt presentation, subjects already had a diminished QOL. Although independent of gender and age at onset of psychosis, QOL was influenced by premorbid adjustment, duration of untreated psychosis and symptoms.ConclusionsReducing the duration of untreated psychosis may have a beneficial effect on the subsequent QOL of patients presenting with schizophrenia. First-episode patients with a protracted duration of untreated psychosis or impaired premorbid adjustment may warrant specific treatment interventions to prevent the development of secondary handicaps.
Phobic nature of social difficulty in facially disfigured people
Authors: Newell Robert , Marks Isaac 
Published: August 2002

BackgroundOver 390 000 people in the UK are disfigured. Facial disfigurement distresses sufferers markedly but has been studied little.AimsTo compare fearful avoidance of people with a facial disfigurement with that of a group of patients with phobia.MethodComparison of Fear Questionnaire agoraphobia, social phobia and anxiety depression sub-scale scores of 112 facially disfigured people (who scored high on Fear Questionnaire problem severity in three survey studies) with those of 66 out-patients with agoraphobia and 68 out-patients with social phobia.ResultsFacially disfigured people and patients with social phobia had similar Fear Questionnaire scores. In contrast, facially disfigured people scored lower on the agoraphobia sub-score but higher on the social phobia sub-score than did patients with agoraphobia.ConclusionsFacially disfigured people with psychological difficulties resembled people with social phobia on Fear Questionnaire social phobia, agoraphobia and anxiety/depression sub-scores but were less agoraphobic and more socially phobic than were people with agoraphobia. Facially disfigured people thus appeared to be socially phobic and to deserve the cognitive – behavioural therapy that is effective for such phobias.
Effect of acute tryptophan depletion on CO2-induced anxiety in patients with panic disorder and normal volunteers
Authors: Miller H. E. J. , Deakin J. F. W. , Anderson I. M. 
Published: August 2002

BackgroundUncertainties remain about the role of serotonin in the aetiology and treatment of panic disorder.AimsTo investigate the effect of reducing brain serotonin function on anxiety at rest, and following 5% CO2 provocation in normal controls and patients with panic disorder.MethodTwenty drug-free patients with DSM–III–R panic disorder and 19 controls received a tryptophan-free amino acid drink on one occasion and a control drink on the other in a double-blind, balanced protocol. 5% CO2 was given as a panic challenge after 270 minutes.ResultsPlasma tryptophan fell by more than 80% both patients and controls after the tryptophan-free drink. Tryptophan depletion did not alter resting anxiety. In patients alone, tryptophan depletion caused a greater anxiogenic response and an increased rate of panic attacks (9 v. 2, P<0.05) after 5% CO2 challenge. No normal volunteers panicked.ConclusionsSerotonin may directly modulate panic anxiety in patients with panic disorder. This may underlie the efficacy of serotonergic antidepressants in treating panic disorder.
Rapid eye movement sleep behaviour disorder, depression and cognitive impairment. Case study
Authors: Clarke Nicholas A. , Williams Adrian J. , Kopelman Michael D. 
Published: August 2002

BackgroundRapid eye movement (REM) sleep behaviour disorder is a relatively new diagnostic category. It has never before been associated with a treatable depressive condition.AimsTo repot on a 74-year-old man with a history of depression and REM sleep behaviour disorder, associated with mild cognitive impairment.MethodAssessment using brain CT, MRI, PET, electroencephalography, neuropsychological testing and nocturnal polysomnography.ResultsDepression was treated with sertraline. Sleep laboratory studies supported a diagnosis of REM sleep behaviour disorder, which was treated with clonazepam. Sleep apnoea, revealed later, was treated with nasal continuous positive airways pressure. Brain MRI showed mild atrophy, but neuropsychological testing indicated no progressive cognitive deterioration.ConclusionsThis case draws attention to REM sleep behaviour disorder and its potential interaction with depression and cognitive impairment, producing symptoms which can be mistaken for early dementia. The diagnosis of REM sleep behaviour disorder is easily missed, and it requires careful history-taking and sleep investigation in all suspected sufferers. Associated neurological, sleep and psychiatric conditions (including depression and cognitive impairment) may confound the diagnosis.
Stalking – a contemporary challenge for forensic and clinical psychiatry
Authors: Kamphuis J. H. , Emmelkamp P. M. G. 
Published: August 2002

BackgroundStalking is causing pervasive and intense personal suffering and is an area of psychiatry that is currently overlooked.AimsTo review demographic and clinical characteristics of stalkers as well as the psychological consequences for victims of stalking.MethodA Medline and PsycLit search was conducted on stalking, forensic psychiatry, personality disorders, de Clérambault syndrome and erotomania, with respect to the relevance of the articles selected for stalking.ResultsStalkers are best thought of as a heterogeneous group whose behaviour can be motivated by different forms of psychopathology, including psychosis and severe personality disorders.ConclusionsThere is a clear need to arrive at a consensus on a typology of stalkers and associated diagnostic criteria. The effectiveness of psychological and pharmacological treatments have not yet been investigated. Treatment may need to be supplemented with external incentives provided by the legal system.
Three-year outcome of first-episode psychoses in an established community psychiatric service
Authors: Singh Swaran P. , Croudace Tim , Amin Shazad , Kwiecinski Rosemary , Medley Ian , Jones Peter B. , Harrison Glynn 
Published: August 2002

BackgroundChanges in service provision, secular trends in substance misuse and changing social structures might affect outcome in psychosis.AimsTo assess the three-year outcome of an inception cohort of first-episode psychoses treated in a modern, community-oriented service; to compare outcomes with an earlier cohort treated in hospital-based care; and to examine the predictive validity of ICD–10 diagnostic criteria.MethodThree-year follow-up (1995–1997) of an inception cohort of first-episode psychoses and comparison with two-year follow-up (1980–1982) of the Determinants of Outcome of Severe Mental Disorders (DOSMED) Nottingham cohort.ResultsOn most outcome measures, non-affective psychoses had a worse outcome than affective psychoses. Affective psychoses had better outcome than previously reported. Substance-related psychoses had very poor occupational outcome. Similar proportions of the current and DOSMED cohort were in remission but the former were rated as having greater disability.ConclusionsIn a modern community service, 30–60% of patients with first-episode psychoses experience a good three-year outcome. The ICD–10 criteria have good predictive validity.
Long-stay patients discharged from psychiatric hospitals
Authors: Leff Julian , Trieman Noam 
Published: August 2002

BackgroundThere have been no large-scale prospective studies evaluating the transfer of care from psychiatric hospitals to district-based services.AimsWe aimed to compare the quality of life of patients in two north London hospitals scheduled for closure with that in the community homes to which they were discharged.MethodThe total long-stay population of Friern Hospital and several hundred long-stay patients in Claybury Hospital were assessed with a batch of eight schedules while in hospital. They were followed up after one year in the community and then at five years.ResultsOf the 670 discharged patients, 126 died before the five-year follow-up. Data were obtained on 523 (97%) of the survivors. There was no change in the patients' clinical state or in their problems of social behaviour. However, they gained domestic and community living skills. They also acquired friends and confidants. They were living in much freer conditions and the great majority wanted to remain in their current homes.ConclusionsCommunity care has enhanced the quality of life of this group of patients, involved in a well-planned and adequately resourced reprovision programme.
Outcome of hospital-treated depression at 4.5 years
Authors: Tuma T. A. 
Published: August 2002

BackgroundDirect comparisons of the prognosis for treated depression in adult and elderly cohorts are few, but suggest higher morbidity and mortality in the elderly.AimsTo examine outcome in two such groups after 4.5 years and compare results with those reported elsewhere.MethodFifty-six adults (aged under 65) and 54 elderly people (over 65) with primary depression were assessed 4.5 years after receiving hospital treatment, and factors influencing the outcome were explored.ResultsRecovery rates were higher in the adults than in the elderly (42.8% v. 24%), largely due to higher rates of death (33%) and dementia (14.8%) in the latter group, who also suffered more serious health problems (62.9% v. 28.5%). Survival analysis showed no difference in the recovery time between cohorts, with over 90% recovered after 25 weeks. After deducting the natural deaths, melancholic illness proved a poor outcome predictor in the adults.ConclusionsThe outlook for elderly depressed patients is poorer than for younger patients because of concurrent physical disease, a higher death rate and the development of dementia.
Lifetime panic–depression comorbidity in the National Comorbidity Survey
Authors: Roy-Byrne Peter P. , Stang Paul , Wittchen Hans-Ulrich , Ustun Bedirhan , Walters Ellen E. , Kessler Ronald C. 
Published: August 2002

BackgroundMost prior studies of panic-depression comorbidity have been limited methodologically by use of small clinical samples and incomplete analyses.AimsGeneral population data were used to study the association of lifetime and recent (12 months) panic–depression comorbidity with symptom severity, impairment, course and help-seeking in the National Comorbidity Survey (NCS).MethodThe NCS is a nationally representative survey of the prevalences and correlates of major DSM–III–R disorders in the US household population.ResultsStrong lifetime and current comorbidity were found between panic and depression. Comorbidity was associated with greater symptom severity, persistence, role impairment, suicidality and help-seeking, with many findings persisting after controlling for additional comorbid diagnoses. Findings did not differ according to which disorder was chronologically primary.ConclusionsBoth lifetime and current panic–depression comorbidity are markers for more severe, persistent and disabling illness. Neither additional comorbid diagnoses nor the primary–secondary distinction were important moderators of these associations.
Synaptophysin gene expression in schizophrenia
Authors: Eastwood Sharon L. , Cairns Nigel J. , Harrison Paul J. 
Published: August 2002

BackgroundDecreased expression of proteins such as synaptophysin in the hippocampus and prefrontal cortex in schizophrenia is suggestive of synaptic pathology. However, the overall profile of changes is unclear.AimsTo investigate synaptophysin gene expression in the cerebral cortex in schizophrenia.MethodThe dorsolateral prefrontal (Brodmann area [BA] 9/46), anterior cingulate (BA 24), superior temporal (BA 22) and occipital (BA 17) cortex were studied in two series of brains, totalling 19 cases and 19 controls. Synaptophysin was measured by immunoautoradiography and immunoblotting. Synaptophysin messenger RNA (m RNA) was measured using in situ hybridisation.ResultsSynaptophysin was unchanged in schizophrenia, except for a reduction in BA 17 of one brain series. Synaptophysin mRNA was decreased in BA 17, and in BA 22 in the women with schizophrenia. No alterations were seen in BA 9/46.ConclusionsSynaptophysin expression is decreased in some cortical areas in schizophrenia. The alterations affect the mRNA more than the protein, and have an unexpected regional distribution. The characteristics of the implied synaptic pathology remain to be determined.
Neighbourhood variation in incidence of schizophrenia
Authors: Van Os Jim , Driessen Ger , Gunther Nicole , Delespaul Philippe 
Published: August 2002

BackgroundNeighbourhood characteristics may influence the risk of psychosis, independently of their individual-level equivalents.AimsTo examine these issues in a multi-level model of schizophrenia incidence.MethodCases of schizophrenia, incident between 1986 and 1997, were identified from the Maastricht Mental Health Case Register. A multi-level analysis was conducted to examine the independent effects of individual-level and neighbourhood-level variables in 35 neighbourhoods.ResultsIndependent of individual-level single and divorced marital status, an effect of the proportion of single persons and proportion of divorced persons in a neighbourhood was apparent (per 1% increase respectively: RR=1.02; 95% CI 1.00–1.03; and RR=1.12, 95% CI 1.04–1.2.1). Single marital status interacted with the neighbourhood proportion of single persons, the effect being stronger in neighbourhoods with fewer single-person households.ConclusionsThe neighbourhood environment modifies the individual risk for schizophrenia. Premorbid vulnerability resulting in single marital status may be more likely to progress to overt disease in an environment with a higher perceived level of social isolation.
Unpublished rating scales: A major source of bias in randomised controlled trials of treatments for schizophrenia
Authors: Marshall Max , Lockwood Austin , Bradley Caroline , Adams Clive , Joy Claire , Fenton Mark 
Published: August 2002

BackgroundA recent review suggested an association between using unpublished scales in clinical trials and finding significant results.AimsTo determine whether such an association existed in schizophrenia trials.MethodThree hundred trials were randomly selected from the Cochrane Schizophrenia Group's Register. All comparisons between treatment groups and control groups using rating scales were identified. The publication status of each scale was determined and claims of a significant treatment effect were recorded.ResultsTrials were more likely to report that a treatment was superior to control when an unpublished scale was used to make the comparison (relative risk 1.37 (95% C11.12–1.68)). This effect increased when a ‘gold-standard’ definition of treatment superiority was applied (RR 1.94 (95% C11.35–2.79)). In non-pharmacological trials, one-third of ‘gold-standard’ claims of treatment superiority would not have been made if published scales had been used.ConclusionsUnpublished scales are a source of bias in schizophrenia trials.
Trends in special (high-security) hospitals
Authors: Jamieson Elizabeth , Butwell Martin , Taylor Pamela , Leese Morven 
Published: August 2002

BackgroundSpecial hospitals in England provide psychiatric care and treatment in high security. Their future is often questioned.AimsTo test for variation in demand for high-security psychiatric services over one 10-year period.MethodThis study was from the special hospitals' case registers and hospital records. The main measures were numbers and annual rates for referrals and beds offered; the Mental Health Act 1983 (MHA) classification of mental disorder; adjusted population rates by health region; admission episodes; legal category of detention; admission source and type of offence.ResultsReferrals to special hospitals showed no decrease during the 10 years; an apparent increase may reflect under-recording before 1992. Admissions fell by about 16% over the 10 years, but with regional variation. Women, civil cases, admissions under the MHA classifications of psychopathic disorder or mental impairment and directly from a court on a hospital order were most affected. There was an increase in admissions of pre-trial and sentenced male prisoners, and of transferred hospital order patients from other hospitals.ConclusionsThere is continuing demand from all parts of the country for high-security hospital beds. The smaller numbers admitted appear to include more demanding cases.
Trends in special (high-security) hospitals
Authors: Butwell Martin , Jamieson Elizabeth , Leese Morven , Taylor Pamela 
Published: August 2002

BackgroundIt has been argued that many patients in special hospital beds do not need to be there. In the 1990s there were initiatives to discharge women and people with learning difficulties.AimsTo test for trends in special hospital discharges and to examine annual resident cohorts.MethodThis study was from case registers and hospital records. The main measures were numbers and annual rates for referrals and beds offered; the Mental Health Act 1983 (MHA) classification of mental disorder; adjusted population rates by region; admission episodes; legal category of detention; admission source and type of offence.ResultsThe median annual number of residents was 1859 (range 1697–1910), with an 8% fall for the period. This particularly affected people in mental impairment categories. Numbers were sustained in the male mental illness groups. Discharges, mainly to other institutions, increased. There was no overall change over the 10 years in length of stay for treatment, but successive admission cohorts from 1986 did show some reduction, even with solely remand order cases excluded.ConclusionsService planners need a longitudinal perspective on service use. Trends over 10 years to both fewer admissions and more discharges have reduced the special hospital population, but despite new treatments for schizophrenia, men under mental illness classification, as well as transfer from other secure settings, have gone against this trend.