bluuebunny/crossref_metadata_2025_split huggingface dataset:
Rapid tranquillisation: Time for a reappraisal of options for parenteral therapy
Authors: McAllister-Williams R. Hamish , Ferrier I. Nicol 
Published: August 2002

BackgroundWhen parenteral treatments are indicated for acutely disturbed behaviour, previous guidelines have recommended droperidol or haloperidol in combination with benzodiazepines. However, there has been recent concern over cardiotoxicity and sudden death associated with some antipsychotic medication and droperidol has now been withdrawn.AimsTo ascertain what alternatives can be recommended to replace intramuscular droperidol.MethodSelective review of current guidelines and the literature pertaining to rapid parenteral tranquillisation.ResultsCurrent guidelines recommend haloperidol as an alternative to droperidol. There is evidence of cardiotoxicity with haloperidol and it has a propensity to cause extrapyramidal side effects that may exacerbate disturbed behaviour and reduce longer-term compliance. The rapid-acting intramuscular formulations of atypical antipsychotic agents show promise.ConclusionsIt is recommended that the mainstay of pharmacological rapid tranquillisation should be parenteral benzodiazepines used with due care.
Violence and schizophrenia: Examining the evidence
Authors: Walsh Elizabeth , Buchanan Alec , Fahy Thomas 
Published: August 2002

Background
It is now accepted that people with schizophrenia are significantly more likely to be violent than other members of the general population. A less acknowledged fact is that the proportion of societal violence attributable to schizophrenia is small.

Aims
To critically examine the epidemiological evidence for the association between violence and schizophrenia and estimate the impact of this association on society.

Method
A selective review of the key literature on the epidemiology of violence and schizophrenia. Population-attributable risks for violence in schizophrenia are calculated from population-based studies.

Results
Most studies confirm the association between violence and schizophrenia. Recent good evidence supports a small but independent association. Comorbid substance abuse considerably increases this risk. The proportion of violent crime in society attributable to schizophrenia consistently falls below 10%.

Conclusions
Less focus on the relative risk and more on the absolute risk of violence posed to society by people with schizophrenia would serve to reduce the associated stigma. Strategies aimed at reducing this small risk require further attention, in particular treatment for substance misuse.
Perinatal and childhood risk factors for later criminality and violence in schizophrenia
Authors: Cannon Mary , Huttunen Matti O. , Anen Antti J. Tansk , Arseneault Louise , Jones Peter B. , Murray Robin M. 
Published: August 2002

Background
Individuals with schizophrenia appear to be at increased risk for violent and criminal behaviour. Obstetric complications, neuromotor problems and intellectual deficits have variously been reported as increasing the risk for criminality in the general population.

Aims
To investigate whether such risk factors are associated with criminal behaviour in an epidemiological cohort of patients with schizophrenia.

Method
We identified from health care registers all individuals with schizophrenia born in Helsinki between 1951 and 1960, and used the national criminal register to identify those with a criminal record by 1995. Childhood information was obtained from archived birth and school records.

Results
Poor educational attainment, poor grades for attention at school, higher birth weight and larger head circumference were significantly associated with the risk of criminal offending in adulthood in this sample of patients with schizophrenia. An association between labour/delivery complications and later violent offending among male patients was of borderline significance.

Conclusions
Our hypotheses that birth complications and childhood neuromotor problems would increase the risk of criminal offending in schizophrenia were not upheld.
Maternal antenatal anxiety and children's behavioural/emotional problems at 4 years
Authors: O'Connor Thomas G. , Heron Jonathon , Golding Jean , Beveridge Michael , Glover Vivette 
Published: August 2002

BackgroundAnimal experiments suggest that maternal stress and anxiety during pregnancy have long-term effects on the behaviour of the off spring.AimsTo test the hypothesis that antenatal maternal anxiety predicts behavioural problems at age 4 years.MethodData were collected on multiple antenatal and postnatal assessments of maternal anxiety and depression, antenatal and obstetric risks, psychosocial risks and children's behavioural/emotional problems (n=7448).ResultsAntenatal maternal anxiety predicted behavioural/emotional problems in boys (OR=2.14,95% CI 1.48−3.10) and girls (OR=1.88,95% CI 1.3–2.69) after accounting for covariates. When covarying maternal anxiety up to 33 months postnatally, antenatal anxiety continued to predict total problems in boys (OR=1.56,95% CI 1.02–2.41) and girls (OR=1.5l, 95% CI 1.22–2.81).ConclusionsThere could be a direct effect of maternal mood on foetal brain development, which affects the behavioural development of the child.
Eating behaviours and attitudes following prolonged exposure to television among ethnic Fijian adolescent girls
Authors: Becker Anne E. , Burwell Rebecca A. , Herzog David B. , Hamburg Paul , Gilman Stephen E. 
Published: August 2002

Background
There are no published studies evaluating the impact of introduction of television on disordered eating in media-naïve populations.

Aims
To assess the impact of novel, prolonged exposure to television on disordered eating attitudes and behaviours among ethnic Fijian adolescent girls.

Method
A prospective, multi-wave cross-sectional design was used to compare two samples of Fijian schoolgirls before and after prolonged regional television exposure with a modified 26-item eating attitudes test, supplemented with a semi-structured interview to confirm self-reported symptoms. Narrative data from a subset of respondents from the exposed sample were analysed for content relating television exposure to body image concerns.

Results
Key indicators of disordered eating were significantly more prevalent following exposure. Narrative data revealed subjects' interest in weight loss as a means of modelling themselves after television characters.

Conclusions
This naturalistic experiment suggests a negative impact of television upon disordered eating attitudes and behaviours in a media-naïve population.
Thioridazine and sudden unexplained death in psychiatric in-patients
Authors: Reilly J. G. , Ayis S. A. , Ferrier I. N. , Jones S. J. , Thomas S. H. L. 
Published: August 2002

Background
Sudden death has been linked to antipsychotic therapy but the relative risk associated with specific drugs is unknown.

Aims
To assess the risk of sudden unexplained death associated with antipsychotic drug therapy and its relation to drug dose and individual agents.

Method
A case-control study of psychiatric in-patients dying suddenly in five hospitals in the north-east of England and surviving controls matched for age, gender and mental disorder. Logistic regression analysis was used to identify significant risk factors, and odds ratios were calculated.

Results
Sixty-nine case-control clusters were identified. Probable sudden unexplained death was significantly associated with hypertension, ischaemic heart disease and current treatment with thioridazine (adjusted odds ratio=5.3, 95% CI 1.7–16.2, P=0.004). There was no significant association with other individual antipsychotic drugs.

Conclusions
Thioridazine alone was associated with sudden unexplained death, the likely mechanism being drug- induced arrythmia.
Effectiveness of a brief cognitive–behavioural therapy intervention in the treatment of schizophrenia
Authors: Turkington Douglas , Kingdon David , Turner Trevor 
Published: August 2002

BackgroundLittle evidence exists to indicate whether community psychiatric nurses can achieve the results reported by expert cognitive–behavioural therapists in patients with schizophrenia.AimsTo assess the effectiveness and safety of a brief cognitive- behavioural therapy (CBT) intervention in a representative community sample of patients with schizophrenia in secondary care settings.MethodA pragmatic randomised trial was performed involving 422 patients and carers to compare a brief CBT intervention against treatment as usual.ResultsPatients who received CBT (n=257) improved in overall symptomatology (P=0.015; number needed to treat [NNT]= 13), insight (P&lt;0.001; NNT=10) and depression (P=0.003;NNT=9) compared with the control group (n=165). Insight was clinically significantly improved (risk ratio =1.15,95% C1 1.01-1.31).There was no increase in suicidal ideation.ConclusionsCommunity psychiatric nurses can safely and effectively deliver a brief CBT intervention to patients with schizophrenia and their carers.
Randomised controlled study of sleep after nefazodone or paroxetine treatment in out-patients with depression
Authors: Hicks Jane A. , Argyropoulos Spilios V. , Rich Ann S. , Nash Jon , Bell Caroline J. , Edwards Chris , Nutt David J. , Wilson Susan J. 
Published: August 2002

Background
Sleep effects of antidepressants are important clinically and for elucidating mechanism of action: selective serotonin reuptake inhibitors disturb sleep and 5-HT2 receptor-blocking compounds may enhance sleep quality.

Aims
To compare the objective and subjective effects on sleep of paroxetine and nefazodone in patients with moderate to severe depression.

Method
Forty patients with depression were randomised to take paroxetine 20-40 mg/day or nefazodone 400–600 mg/day for 8 weeks. Objective and subjective quality of sleep and depression measures were assessed throughout.

Results
Nefazodone significantly increased objective sleep efficiency and total sleep time, and improved subjective sleep on days 3 and 10. Paroxetine decreased sleep efficiency early in treatment and some sleep disruption remained at week 8. Paroxetine but not nefazodone produced marked suppression of rapid eye movement (REM) sleep.

Conclusions
Nefazodone improves sleep in early treatment compared with paroxetine in patients with moderate to severe depression. These effects are seen within the first 2 weeks of treatment and diminish thereafter.
Prevalence and correlates of personality disorders in a community sample
Authors: Samuels Jack , Eaton William W. , Bienvenu O. Joseph , Brown Clayton H. , Costa Paul T. , Nestadt Gerald 
Published: August 2002

Background
Knowledge of the prevalence and correlates of personality disorders in the community is important for identifying treatment needs and for provision of psychiatric services.

Aims
To estimate the prevalence of personality disorders in a community sample and to identify demographic subgroups with especially high prevalence.

Method
Clinical psychologists used the International Personality Disorder Examination to assess DSM-IV and ICD-10 personality disorders in a sample of 742 subjects, ages 34–94 years, residing in Baltimore, Maryland. Logistic regression was used to evaluate the association between demographic characteristics and DSM - IV personality disorder clusters.

Results
The estimated overall prevalence of DSM - IV personality disorders was 9%. Cluster A disorders were most prevalent in men who had never married. Cluster B disorders were most prevalent in young men without a high school degree, and cluster C disorders in high school graduates who had never married.

Conclusions
Approximately 9% of this community sample has a DSM-IV personality disorder. Personality disorders are over-represented in certain demographic subgroups of the community
Validity of the diagnosis of personality disorder in adults with learning disability and severe behavioural problems
Authors: Flynn Andrew , Matthews Helen , Hollins Sheila 
Published: August 2002

BackgroundPersonality disorder in people with learning disability has received little research attention, with only a handful of cross-sectional surveys of prevalence available. As yet, there have been no studies to include an examination of validity.AimsTo investigate the prevalence of personality disorder in adults with learning disability who are in specialist challenging behaviour in-patient services and to examine the validity of the diagnosis of personality disorder in this group in terms of its association with abusive experience in early life.MethodThe Standardised Assessment of Personality (SAP) was used to diagnose personality disorder in 36 individuals with mild/moderate learning disability Case notes were reviewed for details of clinical diagnosis and early psychosocial history.ResultsThirty-nine per cent of the sample met the criteria for severe personality disorder. This diagnosis showed a significant association with early traumatic experience.ConclusionsSevere personality disorder is a common diagnosis in this group. There is preliminary evidence that the diagnosis is associated with abuse in childhood.
Assessing the evidence on case management
Authors: Ziguras S. J. , Stuart G. W. , Jackson A. C. 
Published: August 2002

BackgroundEvidence on the impact of case management is contradictory.AimsTo discuss two different systematic reviews (one conducted by the authors and one conducted through the Cochrane collaboration) that came to contradictory conclusions about the impact of case management in mental health services.MethodWe summarised the findings of the two reviews with respect to case management effectiveness, examined key methodological differences between the two approaches and discuss the impact of these on the validity of the results.ResultsThe differences in conclusions between the two reviews result from the differences in inclusion criteria, namely non-randomised trials, data from unpublished scales and data from variables with skewed distributions. The theoretical and empirical effects of these are discussed.ConclusionsSystematic reviewers may face a trade-off between the application of strict criteria for the inclusion of studies and the amount of data available for analysis and hence statistical power. The available research suggests that case management is generally effective.
Influence of supplementary vitamins, minerals and essential fatty acids on the antisocial behaviour of young adult prisoners
Authors: Gesch C. Bernard , Hammond Sean M. , Hampson Sarah E. , Eves Anita , Crowder Martin J. 
Published: August 2002

BackgroundThere is evidence that offenders consume diets lacking in essential nutrients and this could adversely affect their behaviour.AimsTo test empirically if physiologically adequate intakes of vitamins, minerals and essential fatty acids cause a reduction in antisocial behaviour.MethodExperimental, double-blind, placebo-controlled, randomised trial of nutritional supplements on 231 young adult prisoners, comparing disciplinary offences before and during supplementation.ResultsCompared with placebos, those receiving the active capsules committed an average of 26.3% (95% CI 8.3-44.33%) fewer offences (P=0.03, two-tailed). Compared to baseline, the effect on those taking active supplements for a minimum of 2 weeks (n=172) was an average 35.1% (95% CI 16.3-53.9%) reduction of offences (P < 0.001, two-tailed), whereas placebos remained within standard error.ConclusionsAntisocial behaviour in prisons, including violence, are reduced by vitamins, minerals and essential fatty acids with similar implications for those eating poor diets in the community.
Efficacy of Citalopram in the prevention of recurrent depression in elderly patients: Placebo-controlled study of maintenance therapy
Authors: Klysner René , Bent-Hansen Jesper , Hansen Hanne L. , Lunde Marianne , Pleidrup Elisabeth , Poulsen Dorte Loldrup , Andersen Marc , Petersen Hans Erik Høpfner 
Published: August 2002

BackgroundThe highly recurrent nature of major depression in the young and the elderly warrants long-term antidepressant treatment.AimsTo compare the prophylactic efficacy of citalopram and placebo in elderly patients; to evaluate long-term tolerability of citalopram.MethodOut-patients, ⩾65 years, with unipolar major depression (DSM – IV: 296.2 x or 296.3 x) and Montgomery – Åsberg Depression Rating Scale score ⩾22 were treated with citalopram 20–40 mg for 8 weeks. Responders continued on their final fixed dose of citalopram for 16 weeks before randomisation to double-blind treatment with citalopram or placebo for at least 48 weeks.ResultsNineteen of the 60 patients using citalopram v. 41 of the 61 patients using placebo had recurrence. Time to recurrence was significantly different between citalopram— and placebo-patients, in favour of citalopram (log-rank test, P < 0.0001). Long-term treatment was well tolerated.ConclusionsLong-term treatment with citalopram is effective in preventing recurrence of depression in the elderly and is well tolerated.
Estimating the relationship between disease progression and cost of care in dementia
Authors: Wolstenholme Jane L. , Fenn Paul , Gray Alastair M. , Keene Janet , Jacoby Robin , HOPE TONY 
Published: August 2002

BackgroundPrevious studies have shown a positive relationship between disease severity and cost.AimsTo explore the factors affecting time to institutionalisation and estimate the relationship between the costs of care and disease progression.MethodRetrospective analysis of a longitudinal data-set for a cohort of 100 patients diagnosed with Alzheimer's disease or vascular dementia.ResultsChanges in both Mini-Mental State Examination (MMSE) and Barthel scores have independent and significant marginal effects on costs. Each one-point decline in the MMSE score is associated with a £56 increase in the four-monthly costs, whereas each one-point fall in the Barthel index is associated with a £586 increase in costs.ConclusionsIt may be inappropriate for economic models of disease progression in dementia to be based solely on measures of cognitive change. MMSE and the Barthel index are independent significant predictors of time to institutionalisation and cost of care, but changes in the Barthel index are particularly important in predicting costs outside institutional care.
Pathways to care in children at risk of attention-deficit hyperactivity disorder
Authors: Sayal Kapil , Taylor Eric , Beecham Jennifer , Byrne Patrick 
Published: August 2002

BackgroundThere is underdiagnosis of and low use of specialist services for attention-deficit hyperactivity disorder (ADHD).AimsTo quantify the filters in the help-seeking pathway through primary care and to investigate factors influencing progress for children at risk of ADHD.MethodA total of 127 children (5–11 years old) with pervasive hyperactivity who passed each filter (primary care attendance and general practitioner (GP) recognition of disorder) were compared with those who had not.ResultsPrimary care attendance was only associated with parental perception of the behaviour as problematic (OR 2.11; 95% CI 1.11-4.03). However, GP recognition was related to both parent and child factors – parental request for referral (OR 20.83; 95% CI 3.05-142.08) and conduct problems (OR 1.48; 95% CI 1.04-2.12). GP non-recognition was the main barrier in the pathway to care; following recognition, most children were referred.ConclusionsParents can be regarded as the main gatekeepers for access to specialist services.
Sexual dysfunction in patients taking conventional antipsychotic medication
Authors: Smith Shubulade , O'Keane Veronica , Murray Robin 
Published: August 2002

BackgroundAntipsychotic drugs are associated with sexual dysfunction but the mechanisms are poorly understood.AimsTo ascertain the frequency of sexual dysfunction in patients taking conventional antipsychotics and to determine the possible underlying mechanisms.MethodSexual dysfunction was assessed in 101 patients receiving conventional antipsychotic medication, 57 normal controls and 55 controls attending a sexual dysfunction clinic.ResultsSexual dysfunction occurred in 45% of patients taking antipsychotic medication, 17% of normal controls and 61% of controls attending a sexual dysfunction clinic. Sexual dysfunction was associated with autonomic side-effects in normoprolactinaemic males, but the presence of hyperprolactinaemia overrode other causes of sexual dysfunction. For women, hyperprolactinaemia was the main cause of sexual dysfunction.ConclusionsConventional antipsychotic medications cause significant levels of sexual dysfunction. Clinicians should routinely enquire about sexual symptoms prior to the prescription of antipsychotics and on follow-up.
Neurasthenia: Prevalence, disability and health care characteristics in the Australian community
Authors: Hickie Ian , Davenport Tracey , Issakidis Cathy , Andrews Gavin 
Published: August 2002

BackgroundNeurasthenia imposes a high burden on primary medical health care systems in all societies.AimsTo determine the prevalence of ICD-10 neurasthenia and associated comorbidity, disability and health care utilisation.MethodUtilisation of a national sample of Australian households previously surveyed using the Composite International Diagnostic Interview and other measures.ResultsProlonged and excessive fatigue was reported by 1465 people (13.29% of the sample). Of these, one in nine people meet current ICD-10 criteria for neurasthenia. Comorbidity was associated with affective, anxiety and physical disorders. People with neurasthenia alone (< 0.5% of the population) were less disabled and used less services than those with comorbid disorders.ConclusionsFatigue is frequent in the Australian community and is common in people attending general practice. Neurasthenia is disabling and demanding of services largely because of its comorbidity with other mental and physical disorders. Until a remedy for persistent fatigue is provided, doctors should take an active psychological approach to treatment.
Economic impact of personality disorders in UK primary care attenders
Authors: Rendu Alison , Moran Paul , Patel Anita , Knapp Martin , Mann Anthony 
Published: August 2002

BackgroundThe economic impact of personality disorders on UK health services is unknown.AimsTo test the hypothesis that people with personality disorders have higher mean health and non-health costs compared with those without personality disorders.MethodProspective cohort study design. A total of 303 general practice attenders were followed-up 1 year after they had been assessed for the presence of personality disorders. Costs were estimated in £ sterling at 1999 price levels.ResultsThe mean total cost for patients with personality disorders was £3094 (s.d.=5324) compared with £1633 (s.d.=3779) for those without personality disorders. Personality disorders were not independently associated with increased costs. Multivariate analyses identified the presence of a significant interaction between personality disorders and common mental disorders and increased total costs (coefficient=499, 95% CI 180.1-626.2, P=0.002).ConclusionsPersonality disorders are not independently associated with increased costs. An interaction between personality disorders and common mental disorders significantly predicts increased total costs.