bluuebunny/crossref_metadata_2025_split huggingface dataset:
Effects of behavioural family management on family communication and patient outcomes in schizophrenia
Authors: Bellack Alan S. , Haas Gretchen L. , Schooler Nina R. , Flory Janine D. 
Published: August 2002

BackgroundFamily interventions for schizophrenia have proved to be highly effective in preventing relapse, but it is not clear how they work or how they should be structured.AimsTo examine the effects of a behavioural family intervention and a family support programme on communication, problem solving and outcome in order to determine the impact of structured communication training.MethodPatients and family members participating in the Treatment Strategies in Schizophrenia study were videotaped engaging in 10-minute problem-solving conversations at baseline and after the conclusion of the family intervention. Tapes were subsequently evaluated for changes in communication patterns.ResultsThe intensive behavioural intervention did not produce differential improvement in communication, and change in communication was unrelated to patient outcomes.ConclusionsThe data suggest that intensive behavioural family interventions may not be cost efficient, and that change in family communication patterns may only be important for a subset of families.
Effects of cognitive therapy on psychological symptoms and social functioning in residual depression
Authors: Scott Jan , Teasdale John D. , Paykel Eugene S. , Johnson Anthony L. , Abbott R. , Hayhurst H. , Moore R. , Garland A. 
Published: August 2002

BackgroundAbout 30% of psychiatric out-patients with major depression demonstrate partial remission.AimsTo explore whether the addition of cognitive therapy (CT) had any differential effect on residual symptoms or social adjustment.MethodPatients with residual symptoms of major depression (n=158) were randomised to receive clinical management (CM) alone, or CM plus 18 sessions of CT. Subjects' depressive symptoms and social functioning were assessed regularly over 16 months.ResultsThe addition of CT produced statistically significant differential effects on: two out of four measures of overall severity of depression; specific psychological symptoms (guilt, self-esteem and hopelessness); and social functioning (including dependency, interpersonal behaviour and friction).ConclusionsIn patients showing only partial response to antidepressants, the addition of CT produced modest improvements in social and psychological functioning. The implications for research on the mechanisms of action of CT are discussed.
Effects of acute tryptophan depletion on mood and suicidal ideation in bipolar patients symptomatically stable on lithium
Authors: Hughes J. H. , Dunne F. , Young A. H. 
Published: August 2002

BackgroundPrevious studies suggest that brain serotonin neurotransmission may mediate the actions of lithium carbonate. Acute tryptophan depletion reduces brain serotonin and allows the study of this neurotransmitter in patient groups.AimsTo examine the effects of acute tryptophan depletion on mood and suicidal ideation in bipolar patients who were symptomatically stable on lithium.MethodNineteen subjects satisfying DSM–IV criteria for bipolar I disorder participated in a within-subject, double-blind, placebo-controlled random-order crossover study. Symptoms were evaluated following acute tryptophan depletion, which was induced by a 100 g amino acid drink following an overnight fast.ResultsPlasma tryptophan fell significantly after the depleting drink, but not after the control drink (P < 0.05, paired t-test, mean reduction 83%). No significant changes in mood or suicidality scores were recorded after acute tryptophan depletion.ConclusionsAcute tryptophan depletion does not reverse lithium's effects on mood and suicidality in bipolar disorder.
Psychiatric symptoms in adults with learning disability and challenging behaviour
Authors: Moss Steve , Emerson Eric , Kiernan Chris , Turner Steve , Hatton Chris , Alborz Alison 
Published: August 2002

BackgroundIn people with learning disability one of the most frequent reasons for psychiatric referral is challenging behaviour.AimsTo determine what proportion of people with challenging behaviour actually have psychiatric symptoms.MethodUsing an instrument specifically designed for use by informants, a sample of 320 people with administratively defined learning disability, with and without challenging behaviour, was surveyed for the presence of psychiatric symptoms.ResultsIncreasing severity of challenging behaviour was associated with increased prevalence of psychiatric symptoms, depression showing the most marked association. Anxiety symptoms were associated with the presence of self-injurious behaviour.ConclusionsThere is clearly the potential for reducing challenging behaviour by improved identification and treatment of coexisting psychiatric disorders. The possibility of modifying diagnostic criteria for depression in people with learning disability, by including aspects of challenging behaviour, merits attention.
Personality disorders and normal personality dimensions in obsessive-compulsive disorder
Authors: Samuels Jack , Nestadt Gerald , Bienvenu O. Joseph , Costa Paul T. , Riddle Mark A. , Liang Kung-Yee , Hoehn-Saric Rudolf , Grados Marco A. , Cullen Bernadette A. M. 
Published: August 2002

BackgroundLittle is known about personality disorders and normal personality dimensions in relatives of patients with obsessive-compulsive disorder (OCD).AimsTo determine whether specific personality characteristics are part of a familial spectrum of OCD.MethodClinicians evaluated personality disorders in 72 OCD case and 72 control probands and 198 case and 207 control first-degree relatives. The self-completed Revised NEO Personality Inventory was used for assessment of normal personality dimensions. The prevalence of personality disorders and scores on normal personality dimensions were compared between case and control probands and between case and control relatives.ResultsCase probands and case relatives had a high prevalence of obsessive-compulsive personality disorder (OCPD) and high neuroticism scores. Neuroticism was associated with OCPD in case but not control relatives.ConclusionsNeuroticism and OCPD may share a common familial aetiology with OCD.
Effect of death of Diana, Princess of Wales on suicide and deliberate self-harm
Authors: Hawton Keith , Harriss Louise , Appleby Louis , Juszczak Edmund , Simkin Sue , McDonnell Ros , Amos Tim , Kiernan Katy , Parrott Hilary 
Published: August 2002

BackgroundThe death of the Princess of Wales in 1997 was followed by widespread public mourning. Such major events may influence suicidal behaviour.AimsTo assess the impact of the Princess's death on suicide and deliberate self-harm (DSH).MethodAnalysis, using Poisson regression, of the number of suicides and open verdicts (suicides’) in England and Wales following the Princess's death compared to the 3 months beforehand, and the equivalent periods in 1992–1996. Similar analysis on DSH presentations to a general hospital.ResultsSuicides increased during the month following the Princess's funeral (+ 17.4%). This was particularly marked in females (+33.7%), especially those aged 25–44 years (+45.1%). Suicides did not fall in the week between the death and the funeral. Presentations for DSH increased significantly during the week following the death (+44.3%), especially in females (+65.1%). Examination of case notes suggested that the influence of the death was largely through amplification of personal losses or exacerbation of existing distress.ConclusionsThe death of a major public figure can influence rates of suicidal behaviour. For DSH, the impact may be immediate, but for suicide it may be delayed.
Gender differences in depression
Authors: Piccinelli Marco , Wilkinson Greg 
Published: August 2002

BackgroundWith few exceptions, the prevalence, incidence and morbidity risk of depressive disorders are higher in females than in males, beginning at mid-puberty and persisting through adult life.AimsTo review putative risk factors leading to gender differences in depressive disorders.MethodA critical review of the literature, dealing separately with artefactual and genuine determinants of gender differences in depressive disorders.ResultsAlthough artefactual determinants may enhance a female preponderance to some extent, gender differences in depressive disorders are genuine. At present, adverse experiences in childhood, depression and anxiety disorders in childhood and adolescence, sociocultural roles with related adverse experiences, and psychological attributes related to vulnerability to life events and coping skills are likely to be involved. Genetic and biological factors and poor social support, however, have few or no effects in the emergence of gender differences.ConclusionsDeterminants of gender differences in depressive disorders are far from being established and their combination into integrated aetiological models continues to be lacking.
Needs assessment for mentally disordered offenders: measurement of ‘ability to benefit’ and outcome∗
Authors: Cohen Andrea , Eastman Nigel 
Published: August 2002

BackgroundThe Department of Health defines needs as “the ability to benefit from healthcare interventions”. Outcome measurement is an integral component of needs assessment because it underpins ‘ability to benefit’.AimsTo propose a framework for addressing the measurement of outcome in relation to mentally disordered offenders (MDOs).MethodBased on a literature search, the paper reviews the definition and measurement of outcome in general mental health care and specifically in relation to MDOs. It analyses the problems of conducting outcome research in relation to MDOs.ResultsA framework for outcome measurement in relation to MDOs is presented. Outcome is placed within a broader framework that relates to service evaluation.ConclusionsCurrent measurement of outcome in relation to MDOs is inadequate. A comprehensive framework that acknowledges the multi-dimensional nature of outcome is essential. Researchers must be able to justify the dimensions they prioritise.
Recent life events, cortisol, dehydroepiandrosterone and the onset of major depression in high-risk adolescents
Authors: Goodyer I. M. , Herbert J. , Tamplin A. , Altham P. M. E. 
Published: August 2002

BackgroundIt is not clear whether cortisol or dehydroepiandrosterone (DHEA) hypersecretion increases the risk for major depression in the presence of undesirable life events.AimsTo determine whether there is a specific pattern of psychoendocrine factors that predicts the onset of major depressive disorder.Method180 adolescents (73 boys, 107 girls) at high risk for psychopathology were assessed for cortisol, DHEA, depressive symptoms, life events and psychiatric disorder at entry and 12 months later.ResultsMajor depression was predicted for both genders by the additive effects of: higher depressive symptoms; personal disappointments and losses only in the month before onset; one or more daily levels of cortisol at 08.00 h or DHEA at 20.00 h greater than the 80th percentile of the daily mean.ConclusionsA subgroup of adolescents may carry a physiological risk for major depression which may be either of genetic and/or earlier psychosocial origin.
Morning cortisol as a risk factor for subsequent major depressive disorder in adult women
Authors: Harris T. O. , Borsanyi S. , Messari S. , Stanford K. , Cleary S. E. , Shiers H. M. , Brown G. W. , Herbert J. 
Published: August 2002

BackgroundWhether individual differences in cortisol contribute to subsequent major depressive disorder (MDD) is unknown.AimsTo determine whether premorbid levels of salivary cortisol and dehydroepiandrosterone (DHEA) were associated with subsequent MDD and how these related to psychosocial factors known to increase the risk for MDD.MethodAdult women (n=116) were recruited from general practices. None was currently depressed; 83 were ‘psychosocially vulnerable’ to MDD, 33 were not. Salivary steroids (cortisol and DHEA at 08.00 h and 20.00 h), recent life events, current mood and social support were assessed at entry. Onset of MDD was recorded during 13 months' follow-up.ResultsThere were no associations between salivary cortisol or DHEA and recent life events or vulnerability. Twenty-eight onsets of MDD occurred during the follow-up period. This was associated with: severe adverse life events and difficulties during the follow-up period; mean morning cortisol levels at entry; and the presence of any of three vulnerability factors.ConclusionsIndividual differences in morning salivary cortisol levels may represent an independent risk factor for subsequent MDD. The origin of these differences in cortisol is not yet understood.
Causes and consequences of duration of untreated psychosis in schizophrenia
Authors: Drake Richard J. , Haley Clifford J. , Akhtar Shahid , Lewis Shôn W. 
Published: August 2002

BackgroundIt is unclear what determines duration of untreated psychosis (DUP) in schizophrenia and why long DUP predicts poor outcome.AimsFirst, to test the hypothesis that specific patterns of symptoms and social functioning acting before treatment prolong DUP. Second, to clarify the mechanisms linking DUP with recovery after treatment.MethodTwo hundred and forty-eight consecutive first admissions with schizophrenia were interviewed to assess DUP, symptoms and social functioning at admission, and symptoms were re-assessed after 6–12 weeks.ResultsMedian DUP was 12 weeks. Long DUP was predicted by poor insight, social isolation and preserved coping skills, but not by demographic factors. Even allowing for all these variables, long DUP predicted poor outcome.ConclusionsLonger DUP results partly from a pattern of symptoms and social functioning which reduces concern by the sufferer and relevant others. DUP's relationship to outcome is strongest in the initial months of psychosis. This has implications for targeting early intervention.
Cognitive approach to depression and suicidal thinking in psychosis
Authors: Birchwood Max , Iqbal Zaffer , Chadwick Paul , Trower Peter 
Published: August 2002

BackgroundDepression in schizophrenia is a rather neglected field of study, perhaps because of its confused nosological status. Three course patterns of depression in schizophrenia, including post-psychotic depression (PPD), are proposed.AimsWe chart the ontogeny of depression and psychotic symptoms from the acute psychotic episode over a 12-month period and test the validity of the proposed course patterns.MethodOne hundred and five patients with ICD–10 schizophrenia were followed up on five occasions over 12 months following the acute episode, taking measures of depression, positive symptoms, negative symptoms, neuroleptic exposure and side-effects.ResultsDepression accompanied acute psychosis in 70% of cases and remitted in line with the psychosis; 36% developed PPD without a concomitant increase in psychotic symptoms.ConclusionsThe results provided support for the validity of two of the three course patterns of depression in schizophrenia, including PPD. Post-psychotic depression occurs de novo without concomitant change in positive or negative symptoms.
Cognitive approach to depression and suicidal thinking in psychosis
Authors: Iqbal Zaffer , Birchwood Max , Chadwick Paul , Trower Peter 
Published: August 2002

BackgroundIn paper I we reported that depression in the acute stage remitted in line with the psychosis and that 36% of patients developed post-psychotic depression (PPD).AimsWe apply our cognitive framework to PPD and chart the appraisal of self and psychosis and their link with the later emergence of PPD.MethodPatients with ICD–10 schizophrenia (n=105) were followed up over 12 months following the acute episode, taking measures of depression, working self-concept, cognitive vulnerability, insight and appraisals of psychosis.ResultsBefore developing PPD, these patients felt greater loss, humiliation and entrapment by their illness than those who relapsed or did not become depressed, and were more likely to see their future selves in ‘lower status’ roles. Upon becoming depressed, participants developed greater insight, lower self-esteem and a worsening of their appraisals of psychosis.ConclusionsDepression in psychosis arises from the individual's appraisal of psychosis and its implications for his/her perceived social identity, position and ‘group fit’. Patients developing PPD feel forced to accept a subordinate role without opportunity for escape. Implications for treatment are discussed.
Experience of caregiving: relatives of people experiencing a first episode of psychosis
Authors: Tennakoon Lakshika , Fannon Dominic , Doku Victor , O'Ceallaigh Seamus , Soni William , Santamaria Mar , Kuipers Elizabeth , Sharma Tonmoy 
Published: August 2002

BackgroundThere has been relatively little research on caregivers of people experiencing their first episode of psychosis.AimsTo investigate dimensions of caregiving and morbidity in caregivers of people with first-episode psychosis.MethodCaregivers of 40 people with first-episode psychosis were interviewed at home about their experience of caregiving, coping strategies and distress.ResultsCaregivers used emotional and practical strategies to cope with participants' negative symptoms and difficult behaviours and experienced more worry about these problems. They increased supervision when the participants displayed difficult behaviours. Twelve per cent of caregivers were suffering from psychiatric morbidity as defined by the General Health Questionnaire. Those living with the participant had more frequent visits to their general practitioner.ConclusionsAt first-episode psychosis, caregivers are already having to cope with a wide range of problems and are developing coping strategies. Caregivers worried most about difficult behaviours and negative symptoms in participants.
Using the Strengths and Difficulties Questionnaire (SDQ) to screen for child psychiatric disorders in a community sample
Authors: Goodman Robert , Ford Tamsin , Simmons Helen , Gatward Rebecca , Meltzer Howart 
Published: August 2002

BackgroundChild psychiatric disorders are common and treatable, but often go undetected and therefore remain untreated.AimsTo assess the Strengths and Difficulties Questionnaire (SDQ) as a potential means for improving the detection of child psychiatric disorders in the community.MethodSDQ predictions and independent psychiatric diagnoses were compared in a community sample of 7984 5- to 15-year-olds from the 1999 British Child Mental Health Survey.ResultsMulti-informant (parents, teachers, older children) SDQs identified individuals with a psychiatric diagnosis with a specificity of 94.6% (95% CI 94.1–95.1%) and a sensitivity of 63.3% (59.7–66.9%). The questionnaires identified over 70% of individuals with conduct, hyperactivity, depressive and some anxiety disorders, but under 50% of individuals with specific phobias, separation anxiety and eating disorders. Sensitivity was substantially poorer with single-informant rather than multi-informant SDQs.ConclusionsCommunity screening programmes based on multi-informant SDQs could potentially increase the detection of child psychiatric disorders, thereby improving access to effective treatments.
Unconsciousness, amnesia and psychiatric symptoms following road traffic accident injury
Authors: Mayou Richard A. , Black John , Bryant Bridget 
Published: August 2002

BackgroundAlthough road traffic accident injury is the most common cause of traumatic brain injury, little is known of the prevalence of psychiatric complications or the significance of unconsciousness and amnesia.AimsTo describe amnesia and unconsciousness following a road traffic accident and to determine whether they are associated with later psychological symptoms.MethodInformation was obtained from medical and ambulance records for 1441 consecutive attenders at an emergency department aged 17–69 who had been involved in a road traffic accident. A total of 1148 (80%) subjects completed a self-report questionnaire at baseline and were followed up at 3 months and 1 year.ResultsAltogether, 1.5% suffered major head (and traumatic brain) injury and 21% suffered minor head injury. Post-traumatic stress disorder (PTSD) and anxiety and depression were more common at 3 months in those who had definitely been unconscious than in those who had not, but there were no differences at 1 year.ConclusionsPTSD and other psychiatric complications are as common in those who were briefly unconscious as in those who were not.
Gender differences in risk factors for suicide in Denmark
Authors: Qin Ping , Agerbo Esben , Westergård-Nielsen Niels , Eriksson Tor , Mortensen Preben Bo 
Published: August 2002

BackgroundGender is one of the most frequently replicated predictors for suicide.AimsTo identify risk factors for suicide among males and females and to investigate whether risk factors for suicide differ by gender.MethodA time-matched nested case–control design was performed using Danish longitudinal register databases to obtain 811 suicide cases and 79 871 controls. Data were analysed using conditional logistic regression.ResultsA history of hospitalised mental illness was the most marked risk factor for suicide for both genders. Unemployment, retirement, being single and sickness absence were significant risk factors for men, whereas having a child <2 years old was significantly protective for women. The relative risks for suicide differed significantly between genders according to psychiatric admission status and being the parent of a child < 2 years. However, adjustment for these factors did not eliminate the gender difference in suicide risk.ConclusionsRisk factors for suicide differed by gender and gender differences could not be explained by differential exposure to known risk factors.
Deliberate self-harm and antidepressant drugs
Authors: Donovan Stuart , Clayton Andrew , Beeharry Min , Jones Sheron , Kirk Chris , Waters Keith , Gardner David , Faulding June , Madeley Richard 
Published: August 2002

BackgroundIt is not clear if the frequency of deliberate self-harm (DSH) is the same in patients taking different pharmacological classes of antidepressant drugs.AimsTo compare the frequency of DSH in patients who had been prescribed a tricyclic antidepressant (TCA) or a selective serotonin reuptake inhibitor (SSRI) prior to the DSH event.MethodThis was a prospective study in 2776 consecutive DSH cases attending an accident and emergency department. The incidence of DSH in TCA-treated cases and SSRI-treated cases is expressed as number of DSH events per 10 000 prescriptions of each antidepressant.ResultsSignificantly more DSH events occurred following the prescription of an SSRI than that of a TCA (P < 0.001). The occurrence of DSH was highest with fluoxetine and lowest with amitriptyline.ConclusionsMerely prescribing safer-in-overdose antidepressants is unlikely to reduce the overall morbidity from DSH.