bluuebunny/crossref_metadata_2025_split huggingface dataset:
No association between breast-feeding and adult psychosis in two national birth cohorts
Authors: Leask S. J. , Done D. J. , Crow T. J. , Richards M. , Jones P. B. 
Published: August 2002

BackgroundIt has been proposed that breast-feeding might have a protective effect against the development of adult schizophrenia.AimsTo test this hypothesis.MethodUsing prospective data from two UK national birth cohorts, the feeding histories of those who later developed schizophrenia were compared with the remaining population at risk. Analyses in each cohort were considered to be independent tests of the hypothesis.ResultsThere were no differences in feeding histories. In the 1946 birth cohort (n=4447) 30 cases of DSM–III–R schizophrenia arose by age 43; 24.1% of cases v. 23.6% of controls were entirely bottle-fed; 17.3% v. 12.3% were breast-fed for under I month; 58.6% v. 64.1% were breast-fed beyond I month. In the 1958 cohort (n=18 856), 40 cases of CATEGO nuclear schizophrenia arose by age 28; 24.1% of cases v. 31.7% of controls were entirely bottle-fed; 27.6% v. 24.9% were breast-fed for under 1 month; 48.3% v. 43.4% were breast-fed beyond 1 month.ConclusionsThese findings provide no evidence of any effect of breast-feeding in protecting against the risk of later schizophrenia.
Changes in regional cerebral blood flow due to cognitive activation among patients with schizophrenia
Authors: Toone B. K. , Okocha C. I. , Sivakumar K. , Syed G. M. 
Published: August 2002

BackgroundThe regional cerebral blood flow (rCBF) response to the Wisconsin Card Sort Test (WCST) has been used to assess the functional integrity of the prefrontal cortex in patients with schizophrenia.AimsIn this study, patients were divided into two groups according to whether they had made few or many perseverative errors on a modified version of the WCST. A control group consisted of normal volunteers. The groups were then compared with respect to rCBF response to WCST activation.MethodrCBF was measured during administration of a modified version of the WCST and during a card sorting control task, using single photon emission computerised tomography (SPECT).ResultsPerformance of the modified WCST was associated with a widespread and substantial increase in rCBF, particularly in the frontal region. The poorly performing group of patients with schizophrenia showed only a modest increase in rCBF in the left anterior cingulate region.ConclusionSubjects with schizophrenia are able to respond to specific neuropsychological challenge with activation of the frontal regions.
The revised Beliefs About Voices Questionnaire (BAVQ–R)
Authors: Chadwick Paul , Lees Susan , Birchwood Max 
Published: August 2002

BackgroundWe present a revised Beliefs About Voices Questionnaire (BAVQ–R), a self-report measure of patients' beliefs, emotions and behaviour about auditory hallucinations.AimsTo improve measurement of omnipotence, a pivotal concept in understanding auditory hallucinations, and elucidate links between beliefs about voices, anxiety and depression.MethodsSeventy-one participants with chronic auditory hallucinations completed the BAVQ–R, and 58 also completed the Hospital Anxiety and Depression Scale.ResultsThe mean Cronbach's α for the five sub-scales was 0.86 (range 0.74–0.88). The study supports hypotheses about links between beliefs, emotions and behaviour, and presents original data on how these relate to the new omnipotence sub-scale. Original data are also presented on connections with anxiety and depression.ConclusionsThe BAVQ–R is more reliable and sensitive to individual differences than the original version, and reliably measures omnipotence.
Reappraising insight in psychosis
Authors: Cuesta Manuel J. , Peralta Victor , Zarzuela Amalia 
Published: August 2002

BackgroundMany patients suffering from psychosis are unaware of their disorder and symptoms.AimsTo investigate whether insight changes with time, and how it relates to patients' psychopathology, and to examine the correlations between insight scales in patients with psychoses.MethodSeventy-five consecutively admitted in-patients with schizophrenia, affective disorder with psychotic symptoms, or schizoaffective disorder were examined after remission of an acute episode and at follow-up (>6 months). Three different scales were used to assess insight.ResultsTo some extent, insight into past episodes improved over time in patients with psychosis, regardless of diagnosis. Few significant relationships between insight and psychopathology remained stable at follow-up. The higher the negative and disorganisation dimensions at baseline, the less did attitudes to treatment vary when tested at follow-up. No predictive value for variability of psychopathological dimensions was found for insight dimensions. The insight scales used were highly intercorrelated, suggesting that they measure the same construct.ConclusionsInsight and psychopathology seem to be semi-independent domains.
Ethnic differences in admissions to secure forensic psychiatry services
Authors: Coid Jeremy , Kahtan Nadji , Gault Simon , Jarman Brian 
Published: August 2002

BackgroundPersons of African – Caribbean origin are more frequently imprisoned, and increasing evidence suggests they are detained more frequently in psychiatric hospitals, following offending behaviour.AimsTo estimate population-based prevalence rates of treated mental disorder in different ethnic groups compulsorily admitted to secure forensic psychiatry services.MethodA survey was recorded of 3155 first admissions, from 1988 to 1994, from half of England and Wales, with 1991 census data as the denominator adjusted for under-enumeration.ResultsCompulsory admissions for Black males were 5.6 (CI 5.1–6.3) times as high as, and for Asian males were half, those for White males; for Black females, 2.9 (CI 2.4–4.6) times as high and for Asian females one-third of those for White females. Admissions of non-Whites rose over the study period. Patterns of offending and diagnoses differed between ethnic groups.ConclusionsVariations in compulsory hospitalisation cannot be entirely attributed to racial bias. Community-based services may be less effective in preventing escalating criminal and dangerous behaviour associated with mental illness in African–Caribbeans.
Substance misuse as a marker of vulnerability among male prisoners on remand
Authors: Brooke Deborah , Taylor Caecilia , Gunn John , Maden Anthony 
Published: August 2002

BackgroundMore treatment for substance misuse should be provided within prisons.AimsTo examine differences between prisoners on remand with substance misuse problems and other prisoners on remand.MethodRandom selection and interview of unconvicted male prisoners (n=750, a 9.4% sample), plus examination of the prison medical record.ResultsOf the sample of 750, 253 subjects (33.7%) reported either drug- or alcohol-related health problems or dependency. Compared with other prisoners on remand, they reported more childhood adversity, conduct disorder, self-harm, past psychiatric treatment and current mood disorder, and had fewer qualifications, were more likely to be unemployed and have more housing difficulties.ConclusionsOne-third of unconvicted men in prison report substance-related problems, and these are a marker for vulnerability within a disadvantaged population. Health care providers should involve this group in treatment and rehabilitation, both inside prison and following release.
The Clinician Assessment of Fluctuation and the One Day Fluctuation Assessment Scale
Authors: Walker M. P. , Ayre G. A. , Cummings J. L. , Wesnes K. , McKeith I. G. , O'Brien J. T. , Ballard C. G. 
Published: August 2002

BackgroundThe identification of fluctuating confusion is central to improving the differential diagnosis of the common dementias.AimsTo determine the value of two rating scales to measure fluctuating confusion.MethodThe agreement between the clinician-rated scale and the scale completed by a non-clinician was determined. Correlations between the two scales were calculated; variability in attention was calculated on a computerised cognitive assessment and variability in delta rhythm on an electroencephalogram (EEG).ResultsThe Clinician Assessment of Fluctuation and the computerised cognitive assessment were completed for 155 patients (61 Alzheimer's disease, 37 dementia with Lewy bodies, 22 vascular dementia, 35 elderly controls). A subgroup (n=40) received a further evaluation using the One Day Fluctuation Assessment Scale and an EEG. The two scales correlated significantly with each other, and with the neuropsychological and electrophysiological measures of fluctuation.ConclusionsBoth scales are useful instruments for the clinical assessment of fluctuation in dementia.
Brain weight in suicide
Authors: Salib Emad , Tadros George 
Published: August 2002

BackgroundThere is little available literature on the effect of suicide methods on brain weight.AimsTo explore variations in postmortem brain weight in different methods of fatal self-harm (FSH) and in deaths from natural causes.MethodA review of a sample of coroners' records of elderly persons (60 and above). Verdicts of suicide, misadventure and open verdicts were classified as FSH. Post-mortem brain weight for 142 FSH victims and 150 victims of unexpected, sudden or unexplained death due to natural causes, and from various methods of FSH, were compared.ResultsBrain weight of victims of FSH was significantly higher than of those who died of natural causes (P<0.01); brain weights in both groups were within the normal range for this age group. There was no significant difference in brain weight between different methods of FSH (P>0.05).ConclusionsThe findings require critical examination and further research, to include data from younger age groups. A regional or national suicide neuropathological database could be set up if all victims of FSH underwent routine neurohistochemical post-mortem examination.
Price, cost and value of opiate detoxification treatments
Authors: Gossop Michael , Strang John 
Published: August 2002

BackgroundTreatments in different settings have different costs. A dilemma arises if expensive treatments lead to better outcomes.AimsTo investigate conflicts between the priorities of cost minimisation, clinical effectiveness, and cost-effectiveness in the detoxification of opiate addicts.MethodCost and clinical effectiveness were examined using published outcome data. The main outcome measures were: achieving a drug-free state on completion of detoxification; the economic costs of treatment.ResultsIn terms of simple cost, in-patient detoxification is much more expensive than out-patient treatment (ratio, 24:1). With adjustment for successful outcome, the costs are almost identical (ratio, 0.9:1). Comparison of specialist and general psychiatry in-patient settings showed that even when adjusted for clinical outcomes, the specialist setting is more costly (ratio, 1.9:1), although the outcomes are better.ConclusionsNaïve adherence to cost and cost-containment considerations is dangerous. Discussion of treatment costs is misleading if not informed by, and adjusted for, evidence of effectiveness. This is especially important where marked differences in outcome between treatment options exist.
Expenditure on mental health care by English health authorities: A potential cause of inequity
Authors: Bindman Jonathan , Glover Gyles , Goldberg David , Chisholm Daniel 
Published: August 2002

BackgroundThe York resource allocation formula includes a calculation of the amount needed to purchase mental health services equitably in each health authority in England. However, the amount which is actually spent on services is at the discretion of the authority.AimsTo compare expenditure on mental health services with allocation, and test the hypothesis that differences between them are to the disadvantage of services in deprived areas.MethodA comparison of routine expenditure and allocation data, and linear regression modelling of the ratio of expenditure to allocation.ResultsThe ratio of expenditure to allocation varies widely. Relative underspending occurs more frequently in deprived areas, although not in the four inner-London health authorities.ConclusionsThe intentions of the York formula are not achieved in practice. The implications of the formula for mental health should be made explicit to health authorities, and shortfalls in mental health expenditure relative to allocation should be justified at a local level.
Relationship between psychotic disorders in adolescence and criminally violent behaviour: A retrospective examination
Authors: Clare Patrick , Bailey Susan , Clark Andrew 
Published: August 2002

BackgroundThe interaction between psychosis and violence in adults is an important area of research receiving attention. To date there is little available data examining this relationship in adolescence.AimsTo investigate the possible relationships between criminally violent types of behaviour, and psychopathology and social factors, among adolescents suffering from a psychotic disorder.MethodA retrospective case note study of 39 in-patients diagnosed as having a psychotic disorder and admitted to one of two adolescent psychiatry units (one secure, one open). Cases were divided into a ‘violent’ and a ‘non-violent’ group, and these two groups were then compared for social and psychopathological variables.ResultsThere was no association between recorded psychopathology and criminally violent behaviour. Criminally violent behaviour was associated with a history of emotional or physical abuse, contact with social or mental health services, and previous criminal behaviour.ConclusionsThese findings fail to echo results of studies in adult schizophrenia; they suggest that violent behaviour in psychosis is associated more closely with social factors than with specific symptoms of the psychotic illness. Potential explanations are discussed.
Aims, outcome measures, study sites and patient sample
Authors: Becker Thomas , Knapp Martin , Knudsen Helle Charlotte , Schene Aart H. , Tansella Michele , Thornicroft Graham , Vázquez-Barquero José Luis ,   Epsilon Study Group
Published: August 2002

BackgroundCross-national research into the care of people with severe mental illnesses is hampered by a lack of standardised measures. The European Psychiatric Services: Inputs Linked to Outcome Domains and Needs (EPSILON) Study is a European Union funded project within the BIOMED-2 programme. The project aims to develop standardised instruments to facilitate future cross-national research.AimsTo describe the aims, outcome measures, study sites and patient samples of the EPSILON Study.Method, results, conclusionsSee companion papers in this supplement.
Methodology of a multi-site reliability study
Authors: Schene Aart H. , Koeter Maarten , van Wijngaarden Bob , Knudsen Helle Charlotte , Leese Morven , Ruggeri Mirella , White Ian R. , Vázquez-Barquero José Luis ,   EPSILON Study Group
Published: August 2002

BackgroundThe European Psychiatric Services: Inputs Linked to Outcome Domains and Needs (EPSILON) Study aims to produce standardised versions in five European languages of instruments measuring needs for care, family or caregiving burden, satisfaction with services, quality of life, and sociodemographic and service receipt.AimsTo describe background, rationale and design of the reliability study, focusing on reliable instruments, reliability testing theory, a general reliability testing procedure and sample size requirements.MethodA strict protocol was developed, consisting of definitions of the specific reliability measures used, the statistical methods used to assess these reliability coefficients, the development of statistical programmes to make inter-centre reliability comparisons, criteria for good reliability, and a general format for the reliability analysis.ConclusionThe reliability analyses are based on classical test theory. Reliability measures used are Cronbach's α, Cohen's κ and the intraclass correlation coefficient. Intersite comparisons were extended with a comparison of the standard error of measurement. Criteria for good reliability may need to be adapted for this type of study. The consequences of low reliability, and reliability differing between sites, must be considered before pooling data.
Caregiving in schizophrenia: development, internal consistency and reliability of the Involvement Evaluation Questionnaire – European Version
Authors: van Wijngaarden Bob , Schene Aart H. , Koeter Maarten , Vázquez-Barquero José Luis , Knudsen Helle Charlotte , Lasalvia Antonio , McCrone Paul ,   EPSILON Study Group
Published: August 2002

BackgroundIn international research on the consequences of psychiatric illnesses for relatives of patients, the need for an internationally standardised measure has been identified.AimsTo test the internal consistency and the test-retest reliability of the Involvement Evaluation Questionnaire (IEQ) in five European countries.MethodThe IEQ was administered twice to a sample of relatives or friends of patients with an ICD-10 diagnosis of schizophrenia. Reliability was tested using Cronbach's α, intraclass correlation coefficients and standard error of measurement. Reliability estimates were tested between sites.ResultsTest sample sizes ranged from 30 to 90 across sites, and retest sample sizes ranged from 21 to 77. Cronbach's α values of IEQ sub-scales and sumscore were substantial at most sites; but at two, α values were moderate. Intraclass correlation coefficients were substantial to high at all sites. The standard errors of measurement differed across sites, indicating differences in performance.ConclusionThe reliability of the IEQ in five languages varies across sites, but is sufficiently high in at least four out of five.
Client Socio-Demographic and Service Receipt Inventory – European Version: development of an instrument for international research
Authors: Chisholm D. , Knapp M. R. J. , Knudsen H. C. , Amaddeo F. , Gaite L. , van Wijngaarden B. ,   EPSILON Study Group
Published: August 2002

BackgroundCross-cultural comparison of mental health service utilisation and costs is complicated by the heterogeneity of service systems. For data to be locally meaningful yet internationally comparable, a carefully constructed approach to its collection is required.AimsTo develop a research method and instrument for the collection of data on the service utilisation and related characteristics of people with mental disorders, as the basis for calculating the costs of care.MethodVarious approaches to the collection of service use data and key stages of instrument development were identified in order to select the most appropriate methods.ResultsBased on previous work, and following translation and cross-cultural validation, an instrument was developed: the Client Socio-Demographic and Service Receipt Inventory – European Version (CSSRI–EU). This was subsequently administered to 404 people with schizophrenia across five countries.ConclusionThe CSSRI – EU provides a standardised yet adaptable method for collating service receipt and associated data alongside assessment of patient outcomes.
Reliability of the Camberwell Assessment of Need – European Version
Authors: McCrone Paul , Leese Morven , Thornicroft Graham , Schene Aart H. , Knudsen Helle Charlotte , Vázquez-Barquero José Luis , Lasalvia Antonio , Padfield Sarah , White Ian R. , Griffiths Gwyn ,   EPSILON Study Group
Published: August 2002

BackgroundThe five-country European Psychiatric Services: Inputs Linked to Outcome Domains and Needs (EPSILON) Study aimed to develop standardised and reliable outcome instruments for people with schizophrenia. This paper reports reliability findings for the Camberwell Assessment of Need – European Version (CAN-EU).MethodThe CAN – EU was administered in each country, at two points in time to assess test – retest reliability, and was rated by two interviewers at the first administration. Cronbach's α, test–retest reliability and interrater reliability were compared between the five sites. Reliability coefficients and standard errors of measurement for summary scores were estimated.ResultsSites varied in levels and spread of needs. Alphas were 0.48, 0.58 and 0.64 for total, met and unmet needs respectively. Test–retest reliability estimates, pooled over sites, were 0.85 for the total needs, 0.69 for met needs and 0.78 for unmet needs. Pooled estimates for interrater reliability were higher, at 0.94, 0.85 and 0.79 for total, met and unmet needs respectively. There were statistically significant differences in interrater reliability between sites.ConclusionThe results confirm the feasibility of using CAN–EU across sites in Europe and its psychometric adequacy.
Development, internal consistency and reliability of the Verona Service Satisfaction Scale – European Version
Authors: Ruggeri Mirella , Lasalvia Antonio , Dall'Agnola Rosa , Van Wijngaarden Bob , Knudsen Helle Charlotte , Leese Morven , Gaite Luis , Tansella Michele ,   EPSILON Study Group
Published: August 2002

BackgroundSatisfaction with mental health services is an important quality and outcome variable. The Verona Service Satisfaction Scale (VSSS) is a well-established method for measuiring service satisfaction.AimTo report the development and reliability study of the European Version of the VSSS (VSSS–EU).MethodA sample of people with schizophrenia on the case-load of local mental health services in the five European participating countries was assessed. The VSSS–EU was administered at one site in each country at two points in time. Internal consistency and test–retest reliability were assessed and compared between the five sites.ResultsThe α coefficient for the VSSS–EU total score in the pooled sample was 0.96 (95% CI 0.94–0.97) and ranged from 0.92 (95% CI 0.60–1.00) to 0.96 (95% CI 0.93–0.98) across the sites. Test–retest reliability for VSSS–EU total score, pooled over sites, was 0.82 (95% CI 0.78–0.85) and ranged from 0.73 (95% CI 0.6–0.86) to 0.93 (95% CI 0.89–0.97) across the sites.ConclusionVSSS–EU is a reliable instrument for measuring service satisfaction in people with schizophrenia, for use in comparative cross-national research projects and in routine clinical practice in mental health services across Europe.
Quality of life in schizophrenia: development, reliability and internal consistency of the Lancashire Quality of Life Profile – European Version
Authors: Gaite Luis , Vázquez-Barquero José Luis , Arrizabalaga Andrés Arriaga , Schene Aart H. , Welcher Birgitte , Thornicroft Graham , Ruggeri Mirella , Vázquez-Bourgon Elena , Retuerto Modesto Pérez , Leese Morven ,   EPSILON Study Group
Published: August 2002

BackgroundThis paper, part of the European Psychiatric Services: Inputs Linked to Outcome Domains and Needs (EPSILON) Study, reports the development, reliability and internal consistency of the Lancashire Quality of Life Profile – European Version (LQoLP–EU) in a representative sample of people with schizophrenia from five European sites.MethodThe LQoLP–EU was administered to a total sample of 404 patients to check its internal consistency, and a sub-sample of 294 patients was interviewed a second time within 7–15 days to verify its test–retest reliability.ResultsInternal consistency of the total domains, perceived QoL scale (Life Satisfaction Scale, LSS) was good at 0.87. Of the nine subjective QoL domains Work and Leisure showed the lowest internal consistency (0.30 and 0.56 respectively), the values of the remaining sub-scales ranging between 0.62 and 0.88. The pooled ICC score for LSS was 0.82, and for the nine subjective QoL domain sub-scales it ranged from 0.61 (Safety) to 0.75 (Living Situation). There were significant differences between the sites inαand ICCs for sub-scales, but not for the LSS.ConclusionThe LQoLP-EU has good internal consistency and reliability in the five European centres.