bluuebunny/crossref_metadata_2025_split huggingface dataset:
Mental disorders and cause-specific mortality
Authors: Joukamaa Matti , HeliöVaara Markku , Knekt Paul , Aromaa Arpo , Raitasalo Raimo , Lehtinen Ville 
Published: August 2002

BackgroundThe impact of clinically diagnosed mental disorders on mortality in the general population has not been established.AimsTo examine mental disorders for their prediction of cause-specific mortality.MethodMental disorders were determined using the 36-item version of the General Health Questionnaire and the Present State Examination in a nationally representative sample of 8000 adult Finns.ResultsDuring the 17-year follow-up period 1597 deaths occurred. The presence of a mental disorder detected at baseline was associated with an elevated mortality rate. The relative risk in men was 1.6 (95% confidence interval 1.3–1.8) and in women, 1.4 (95% Cl 1.2–1.6). In men and women with schizophrenia the relative risks of death during the follow-up period were 3.3 (95% Cl 2.3–4.9) and 2.3 (95% Cl 1.3–3.8) respectively, compared with the rest of the sample. In both men and women with schizophrenia the risk of dying of respiratory disease was increased, but the risk of dying of cardiovascular disease was increased only in men with neurotic depression.ConclusionsSchizophrenia and depression are associated with an elevated risk of natural and unnatural deaths.
Extrastriatal and striatal D2 dopamine receptor blockade with haloperidol or new antipsychotic drugs in patients with schizophrenia
Authors: Xiberas X. , Martinot J. L. , Mallet L. , Artiges E. , Loc'h C. , Mazière B. , Paillère-Martinot M. L. 
Published: August 2002

BackgroundBoth traditional and atypical antipsychotics have been hypothesised to be effective in schizophrenia through limbic and cortical D2 dopamine receptor blockade.AimsTo investigate this hypothesis with the D2/D3-selective positron emission tomography (PET) probe [76Br]-FLB457.MethodPETscans were performed on 6 controls and 18 patients with schizophreniatreated with haloperidol or with risperidone, clozapine, amisulpride or olanzapine.ResultsThe D2 dopamine receptor blockade was high in the temporal cortex with both haloperidol and atypical antipsychotics. The atypicals, however, induced a significantly lower D2 binding index than haloperidol in the thalamus and in the striatum.ConclusionsResults suggest that cortical D2 dopamine receptors are a common target of traditional and atypical antipsychotics for therapeutic action. Higher in vivo binding to the D2 receptors in the cortex than in the basal ganglia is suggested as an indicator of favourable profile for a putative antipsychotic compound.
Comorbid non-alcohol substance misuse among people with schizophrenia
Authors: Duke Peter J. , Pantelis Christos , McPhillips Michael A. , Barnes Thomas R. E. 
Published: August 2002

BackgroundFew epidemiological studies have assessed the extent and nature of comorbid non-alcohol substance misuse in people with schizophrenia in the community in the UK.AimsTo study the extent and nature of comorbid non-alcohol substance misuse in people with schizophrenia in central London.MethodSubjects were identified in an epidemiological census survey of South Westminster. Standardised assessment of each subject included demographic data, ratings of mental state and movement disorder and questioning about drug and alcohol misuse.ResultsIndividuals with schizophrenia or related psychoses were identified (n=352) and 57 (16%) reported a lifetime history of non-alcohol substance misuse. Age and gender were the main variables relevant to the extent and pattern of misuse. Self-reported non-alcohol substance misuse showed no significant relationship with a range of outcome measures.ConclusionsThe high proportion of subjects reporting non-alcohol substance misuse is comparable with figures from the USA. The reports of lifetime misuse most commonly referred to cannabis, psychostimulants, LSD, opiates and anticholinergics. Misuse was concentrated in those younger than 36 years and was reported more often by males.
Efficacy of usual antidepressant dosing regimens of fluoxetine in panic disorder
Authors: Michelson D. , Allgulander C. , Dantendorfer K. , Knezevic A. , Maierhofer D. , Micev V. , Paunovic V. R. , Timotijevic I. , Sarkar N. , Skoglund L. , Pemberton S. C. 
Published: August 2002

BackgroundAlthough serotonin reuptake inhibitors are effective in panic disorder, questions concerning whether doses associated with antidepressant efficacy are also effective for panic disorder remain.AimsTo assess the efficacy of the usual antidepressant dose of fluoxetine in treating full panic attacks.MethodPatients with panic disorder were randomised to placebo or to fluoxetine initiated at 10 mg daily for I week and then increased to 20 mg daily. The trial lasted 12 weeks, but after 6 weeks patients who had failed to achieve a satisfactory response were eligible for dose escalation to a maximum of 60 mg of fluoxetine daily.ResultsFluoxetine was associated with a statistically significantly greater proportion of panic-free patients compared with placebo after 6 weeks and at end-point.ConclusionsFluoxetine at a dose of 20 mg daily is safe and efficacious in reducing symptoms of panic disorder. Patients who fail to obtain a satisfactory response at 20 mg daily may benefit from further dose increases.
Spontaneous lapses in dosing during chronic treatment with selective serotonin reuptake inhibitors
Authors: Meijer Welmoed E. E. , Bouvy Marcel L. , Heerdink Eibert R. , Urquhart John , Leufkens Hubert G. M. 
Published: August 2002

BackgroundIn previous research, lapses in dosing of paroxetine or sertraline were associated with significantly more discontinuation symptoms and deterioration of depressive symptomatology compared with fluoxetine.AimsTo evaluate dosing lapses in patients chronically treated with selective serotonin reuptake inhibitors (SSRIs) in uncontrolled circumstances.MethodIn a prospective observational study we evaluated compliance data in chronic users of SSRIs using electronic drug exposure monitors.ResultsDuring a 3-month follow-up we found that 50/69 (72.5%) patients missed at least one dosing day and 20/69 (29.0%) missed two or more consecutive days.ConclusionsAbout 30% of patients treated with short-acting SSRIs had dosing lapses of 2 or more days, which, as described in prior studies, is long enough to result in clinically relevant deterioration of mental status.
Long-term affective disorder in people with mild learning disability
Authors: Richards Marcus , Maughan Barbara , Hardy Rebecca , Hall Ian , Strydom Andre , Wadsworth Michael 
Published: August 2002

BackgroundIncreased risk of affective disorder in learning disability has been reported, although the extent to which this is due to adverse social and material circumstances is uncertain and there have been potential limitations in the measurement of affective disorder.AimsTo determine risk of affective disorder in those classified with mild learning disability in the British 1946 birth cohort and to investigate whether this risk was accounted for by disadvantage in childhood and adulthood.MethodLearning disability was defined as the equivalent of an IQ ≤ 69 at age 15 years. The Present State Examination at age 36 years and the Psychiatric Symptom Frequency Scale at age 43 years provided psychiatric outcome measures.ResultsLearning disability was associated with a fourfold increase in risk of affective disorder, not accounted for by social and material disadvantage or by medical disorder.ConclusionsLearning disability is strongly associated with risk of affective disorder, persisting well into midlife.
Outcome in consecutive emergency department attenders following a road traffic accident
Authors: Mayou Richard , Bryant Bridget 
Published: August 2002

BackgroundLittle is known about the consequences of road traffic accidents.AimsTo determine psychological and social outcome at 3 months and I year following a road traffic accident.MethodA cohort study of a 1-year sample of consecutive attenders (n=1148) aged 17–69 years at the accident and emergency department of a teaching district general hospital (excluding major head injury). Data were extracted from medical notes and from self-report at baseline, 3 months and 1 year.ResultsMost (61%) injuries were physically minor. At 1 year 45% reported major physical problems and 32% reported psychiatric consequences. Non-injury variables were the principal predictors of outcome.ConclusionsOutcome across a range of variables is considerably worse than would be expected from the nature of the physical injuries. There is a need for changes in clinical care and socio-legal policy to prevent, identify and treat distressing and disabling chronic problems.
Hidden psychiatric morbidity in elderly prisoners
Authors: Fazel Seena , Hope Tony , O'Donnell Ian , Jacoby Robin 
Published: August 2002

BackgroundThe number of elderly prisoners has increased significantly in Western countries over the past decade. Little is known about the psychiatric morbidity of this population.AimsTo determine the prevalence of psychiatric morbidity in elderly sentenced prisoners.MethodA stratified sample of 203 male sentenced prisoners aged over 59 years, from 15 prisons in England and Wales, representing one in five men in this age group, was interviewed using semi-structured standardised instruments for psychiatric illness and personality disorder.ResultsMore than half of the elderly prisoners had a psychiatric diagnosis. The most common diagnoses were personality disorder and depressive illness.ConclusionsThe prevalence of depressive illness was five times greater than that found in other studies of younger adult prisoners and elderly people in the community. Underdetected, undertreated depressive illness in elderly prisoners is an increasing public health problem.
Hospital Anxiety and Depression (HAD) scale: Factor structure, item analyses and internal consistency in a large population
Authors: Mykletun Arnstein , Stordal Eystein , Dahl Alv A. 
Published: August 2002

BackgroundThe Hospital Anxiety and Depression (HAD) rating scale is a commonly used questionnaire. Former studies have given inconsistent results as to the psychometric properties of the HAD scale.AimsTo examine the psychometric properties of the HAD scale in a large population.MethodAll inhabitants aged 20–89 years (n=92 100) were invited to take part in The Nord-Tr⊘ndelag Health Study, Norway. A total of 65 648 subjects participated, and only completed HAD scale forms (n=51 930) formed the basis for the psychometric examinations.ResultsPrincipal component analysis extracted two factors in the HAD scale that accounted for 57% of the variance. The anxiety and depression sub-scales shared 30% of the variance. Both sub-scales were found to be internally consistent, with values of Cronbach's coefficient (a) being 0.80 and 0.76, respectively.ConclusionsBased on data from a large population, the basic psychometric properties of the HAD scale as a self-rating instrument should be considered as quite good in terms of factor structure, intercorrelation, homogeneity and internal consistency.
Straight talking: An investigation of the attitudes and practice of psychoanalysts and psychotherapists in relation to gays and lesbians
Authors: Bartlett Annie , King Michael , Phillips Peter 
Published: August 2002

BackgroundEarly psychodynamic writing on same-gender sexual preference contributed to its pathologisation and an interest in treatment directed at changing sexual orientation.AimsTo establish the therapeutic approaches taken by contemporary psychotherapists and psychoanalysts to gay and lesbian clients/patients.MethodA random sample of individuals listed as working with adults in the British Confederation of Psychotherapists' register were sent postal questionnaires.ResultsData are available from 274 (69%) of 395 questionnaires. Only one of 218 respondents said that he/she was homosexual. One-third said that gay and lesbian patients did have a right to a gay or lesbian therapist. A total of 179 (82% of 218) respondents described work with gay and lesbian clients/patients, and in the majority of cases sexual orientation was an important aspect of the work.ConclusionsGays and lesbians seeking psychoanalysis or psychotherapy in the National Health Service or outside it for personal and/or training purposes will be unlikely to find a gay or lesbian therapist if they want one. The British Confederation of Psychotherapists' practitioners take on gay and lesbian clients/patients, although many do not see these social identities as relevant to the therapeutic process. Evidence from this study indicates that such clients/patients may encounter overt or covert bias, including the pathologisation of homosexuality per se.
Death of neurasthenia and its psychological reincarnation
Authors: Taylor Ruth E. 
Published: August 2002

BackgroundThe diagnosis of neurasthenia appeared in 1869 and rapidly became fashionable and highly prevalent. It disappeared almost completely, producing ongoing debates about what happened to the disease, which have not so far been informed by empirical data.AimsTo use empirical historical hospital data from one specific hospital to explore several controversies about neurasthenia, including what happened to the disorder.MethodThe annual reports of Queen Square Hospital were examined from 1870 to 1947. The prevalence of neurasthenia diagnoses as a proportion of total discharges was recorded. The possible diagnostic categories into which neurasthenia could have been reclassified were identified. Textbooks and writing by neurologists working at the hospital during this period were examined.ResultsNeurasthenia accounted for 6–11% of total discharges from the late 1890s to 1930, when it virtually disappeared. Men accounted for 33–50% of cases.ConclusionsNeurasthenia affected both the upper and working classes and both men and women. Neurologists, not psychiatrists, continued to see the disorder well into the 20th century. Neurasthenia did not disappear, but was reclassified into psychological diagnoses.
Improving the delivery and organisation of mental health services: Beyond the conventional randomised controlled trial
Authors: Gilbody Simon , Whitty Paula 
Published: August 2002

BackgroundThere is an ethical imperative to evaluate service and policy initiatives, such as those highlighted in the recent National Service Framework, just as there is to evaluate individual treatments.AimsTo outline the best methods available for evaluating the delivery and organisation of mental health services.MethodWe present a narrative methodological overview, using salient examples from mental health services research.ResultsCluster randomised studies involve the random allocation of groups of clinicians, clinical teams or hospitals rather than individual patients, and produce the least biased evaluation of mental health policy, organisation or service delivery. Where randomisation is impossible or impractical (often when services or policies are already implemented), then quasi-experimental designs can be used. Such designs have both strengths and many potential flaws.ConclusionsThe gold standard remains the randomised trial, but with due consideration to the unit of randomisation. Use of quasi-experimental designs can be justified in certain circumstances but should be attempted and interpreted with caution.
The Maudsley long-term follow-up of child and adolescent depression
Authors: Knapp Martin , McCrone Paul , Fombonne Eric , Beecham Jennifer , Wostear Gail 
Published: August 2002

BackgroundDepression in childhood or adolescence often has morbidity implications continuing into adulthood, generating needs for specialist services and support.AimsTo estimate the patterns of service use and costs in adulthood of former patients.MethodService use and other cost-related data were collected from former patients. Comparisons were made between those people with and without comorbid conduct disorder in childhood and with data for the general population.ResultsData on 91 people with depression (only) and 49 with comorbid conduct disorder revealed high adulthood service utilisation rates and costs. Inpatient care and criminal justice services were used more frequently by the comorbid group and total costs were significantly higher. There were also indications of higher service use by the comorbid group than the general adult population.ConclusionsThe high and enduring long-term costs associated with childhood depression and conduct disorder give further reason for early and effective intervention.
State and trait abnormalities in serotonin function in major depression
Authors: Bhagwagar Zubin , Whale Richard , Cowen Philip J. 
Published: August 2002

BackgroundNeuroendocrine studies of brain serotonin (5-HT) function in depression generally show evidence of impaired 5-HT function but it is disputed whether or not this impairment resolves with clinical recovery.AimsTo use the endocrine response to the selective 5-HTreuptake inhibitor, citalopram, to study brain 5-HT function in acute and recovered depressed subjects relative to healthy controls.MethodWe used a double-blind, placebo-controlled design to measure the prolactin and cortisol responses to citalopram (10 mg intravenously) in patients with major depression, in unmedicated subjects recovered from depression and in healthy controls.ResultsThe prolactin responses to citalopram were blunted similarly in both acutely depressed and recovered subjects. The cortisol responses were blunted in the acutely depressed patients but not in the recovered subjects.ConclusionsOur data support the proposal that some aspects of impaired 5-HT neurotransmission may be trait markers of vulnerability to depression. The recovery of the cortisol response to citalopram may indicate resolution of hypothalamic – pituitary-adrenal axis dysfunction.
Chronic fatigue and anxiety/depression: A twin study
Authors: Roy-Byrne Peter , Afari Niloofar , Ashton Suzanne , Fischer Mary , Goldberg Jack , Buchwald Dedra 
Published: August 2002

BackgroundUp to three-quarters of patients with fatigue syndromes have comorbid mood or anxiety disorders, suggesting that chronic fatigue is a forme fruste of anxiety or depressive states.AimsTo establish whether the association of chronic fatigue with psychological distress is causal or due to a common genetic or environmental factor.Method69 monozygotic (MZ) and 31 dizygotic (DZ) female twin pairs, with only one co-twin reporting at least 6 months of fatigue, completed questions on fatigue, the General Health Questionnaire (GHQ) and a structured psychiatric interview. We examined the effects of three progressively more stringent definitions of chronic fatigue on four GHQ sub-scales.ResultsFatigued MZ and DZ twins by all definitions were significantly more depressed, anxious, somatically preoccupied and socially dysfunctional than their non-fatigued co-twins. Intrapair differences were similar in DZ and MZ twins, but non-significant differences were observed for the somatic symptoms and anxiety/insomnia sub-scales.ConclusionsIn this sample, chronic fatigue and psychological distress are strongly associated without evidence for genetic covariation, implying that the association is environmental, or due to overlapping definitions. Any genetic covariation missed is likely to involve anxiety rather than depression.
Heritability of Schneider's first-rank symptoms
Authors: Cardno Alastair G. , Sham Pak C. , Farmer Anne E. , Murray Robin M. , McGuffin Peter 
Published: August 2002

BackgroundSchneider's first-rank symptoms are given particular weight when making a diagnosis of schizophrenia, but the nuclear syndrome, characterised by one or more first-rank symptoms, has been found previously to have no heritability.AimsTo estimate the heritability of the nuclear syndrome.MethodA total of 224 twin pairs (106 monozygotic, 118 same-gender dizygotic) were ascertained from the Maudsley Twin Register in London via probands with any psychosis. Lifetime-ever first-rank symptoms were rated using the OPCRIT checklist. Probandwise concordance rates were calculated for the nuclear syndrome and a heritability estimate was derived from biometric model fitting.ResultsProbandwise concordance rates were 13/49 (26.5%) for monozygotic and 0/45 to 2/46 (0.0–4.3%) for dizygotic pairs. The heritability estimate for the best-fitting model was 71% (95% CI 57–82).ConclusionsThese results indicate that the nuclear syndrome shows substantial heritability, although this is slightly lower than that for schizophrenia as defined by the DSM and ICD systems.
Region-specific changes in phospholipid metabolism in chronic, medicated schizophrenia
Authors: Jensen J. Eric , Al-Semaan Yousef M. , Williamson Peter C. , Neufeld Richard W. J. , Menon Ravi S. , Schaeffer Betsy , Densmore Maria , Drost Dick J. 
Published: August 2002

BackgroundMembrane phospholipid abnormalities in people with schizophrenia, measured with 31P magnetic resonance spectroscopy (31P-MRS), have been previously reported in brain regions involved in this disorder.AimsIn this 4.0 Tesla 31P-MRS study of people with schizophrenia, membrane phospholipid metabolism was examined in brain regions previously inaccessible due to their small volumes.MethodThree-dimensional chemical-shift imaging (3D–CSI) examined 15 cc volumes in 12 brain regions in 11 people with chronic schizophrenia and 11 healthy control volunteers.ResultsGlycerophosphoethanolamine was decreased in the anterior cingulate, right prefrontal cortex and left thalamus, but increased in the left hippocampus and cerebellum in those with schizophrenia. Phosphoethanolamine and glycerophosphocholine were decreased in the right prefrontal region and phosphocholine was decreased in the anterior cingulate. No significant difference in membrane phospholipid levels existed between groups in the parieto-occipital and posterior cingulate regions.ConclusionsAltered membrane phospholipid metabolism was demonstrated in all regions implicated in schizophrenia.
Signs and Symptoms of Psychotic Illness (SSPI): A rating scale
Authors: Liddle Peter F. , Ngan Elton T. C. , Duffield Gary , Kho King , Warren Anthony J. 
Published: August 2002

BackgroundIn the rating scales commonly used for assessing response to antipsychotic treatment, individual items embrace symptoms that apparently arise from distinguishable pathophysiological processes and might be expected to respond differently to treatment.AimsTo test the reliability sensitivity to change and factor structure of a new scale for the assessment of the Signs and Symptoms of Psychotic Illness (the SSPI).MethodInterrater reliability was evaluated by determining the intraclass correlation for the ratings of 63 patients. Sensitivity to change was assessed in a longitudinal study of 33 patients. Factor structure was determined from scores for 155 patients.ResultsThe intraclass correlation was satisfactory for all individual items and excellent for the total score. Scores were sensitive to change. A change in Clinical Global Impression of one unit corresponded to an SSPI total score change of 31%. Factor analysis revealed five clusters of symptoms.ConclusionsThe SSPI provides a sensitive and reliable measure of the five major clusters of symptoms that occur commonly in psychotic illness.