bluuebunny/crossref_metadata_2025_split huggingface dataset:
Treatment strategies in achieving remission in major depressive disorder
Authors: Kelsey J. E. 
Published: March 2003

Objective:  This paper discusses strategies for achieving remission in major depressive disorder, summarizing the results of comparative studies of various antidepressants.Method:  Antidepressant efficacy was determined as either response or remission, measured using the Hamilton Depression Rating Scale, the Clinical Global Impressions scale and other widely used instruments.Results:  Study results suggest an advantage to pharmacotherapy that interacts with more than one neurotransmitter system, either as single mixed‐activity drugs (e.g. clomipramine, mirtazapine and venlafaxine extended‐release) or combinations of medications that are individually specific for a single neurotransmitter system.Conclusion:  Remission should be the goal of antidepressant therapy. Treatment strategies include increasing the dosage of the chosen antidepressant; switching to an antidepressant with a different mechanism of action; augmenting one antidepressant with another agent; or using combination therapy. A substantial body of data indicates that for a subset of depressed patients, activation of multiple neurotransmitter systems is beneficial in achieving remission.
Epidemiological research in mental disorders: lessons for the next decade of research — the NAPE Lecture 1999
Authors: Wittchen Hans‐Ulrich 
Published: March 2003

Objective: To provide an overview of the progress in the field of epidemiology of mental disorders during the last decades, and to discuss challenges for the future. Method: Following a review of the achievements of psychiatric epidemiology up to this point, current shortcomings in the research and publications in the field are presented. Suggestions for changes in research and solutions to current deficits are proposed. Results: Future research needs to cover a broader spectrum of psychopathology, including inquiries into sub‐threshold characterizations; explore etiopathogenic processes and pathways including genetic, neuroscientific and psychological factors for the onset and persistence of psychopathology; and provide a better assessment of help‐seeking behaviors and service utilization. Conclusion: Future epidemiological research should strengthen the emerging collaborative links with the neurosciences, clinical research and public health by acknowledging the full range of available epidemiological designs and methods, beyond the current emphasis on large‐scale, cross‐sectional general population studies.
PET measurements of brain glucose metabolism and blood flow in major depressive disorder: a critical review
Authors: Videbech P. 
Published: March 2003

Objective: To show that PET investigations of brain function in patients with major depression can contribute with valuable pathophysiological knowledge about brain function of these states. Methods: PET studies of cerebral blood flow or glucose metabolism in patients with unipolar or bipolar depression were reviewed. Results: The studies have great discrepancies related to sample size, subject selection, imaging protocol and image analysis. In spite of this shortcoming, there is evidence that patients with major depression have reduced blood flow and metabolism in the prefrontal cortex, particularly when they exhibit psychomotor retardation. Abnormalities are also found in the anterior cingulate gyrus and the basal ganglia. A few studies point to the possibility that response to antidepressant treatment can be predicted from PET scans. Conclusion: This evidence is consistent with the hypothesis that depressive symptoms are caused by dysfunction of regions of the limbic system and the frontal lobes in close connection with the basal ganglia.
Comorbidity of the anxiety disorders in a community‐based older population inThe Netherlands
Authors: Van Balkom A. J. L. M. , Beekman A. T. F. , De Beurs E. , Deeg D. J. H. , Van Dyck R. , Van Tilburg W. 
Published: March 2003

Objective: The aim of the study was to investigate patterns of comorbidity among the anxiety disorders in a community‐based older population, and the relationship of these disorders with major depression, use of alcohol and benzodiazepines, cognitive impairment and chronic somatic illnesses. Method: The data were derived from the Longitudinal Aging Study Amsterdam (LASA) study. A two‐stage screening design was adopted to identify respondents with anxiety disorders. Results: In total, 10% of the elderly with an anxiety diagnosis suffered from two or more anxiety disorders. Major depression (13% vs. 3%), benzodiazepine use (24% vs. 11%) and chronic somatic diseases (12% vs. 7%) were significantly more prevalent in respondents with an anxiety disorder than in respondents without anxiety disorders. Heavy or excessive alcohol intake (5% vs. 4%) and cognitive impairment (11% vs. 13%) were not significantly associated with any anxiety disorder. Conclusion: When anxiety disorders are diagnosed, in older people there is a relatively high probability of comorbid conditions being present.
Sources of coercive behaviours in psychiatric admissions
Authors: Lidz C. W. , Mulvey E. P. , Hoge S. K. , Kirsch B. L. , Monahan J. , Bennett N. S. , Eisenberg M. , Gardner W. , Roth L. H. 
Published: March 2003

Objective: Coercion during psychiatric admissions has been a topic of debate for many years. Although there has been considerable research on patients' perceptions of coercion, there has been no work on who places pressures on patients to be admitted. Method: This article integrates interview data from interviews with patients, admitting staff and family and friends to describe the pressures brought to bear on patients to be admitted. Results: Health‐care professionals appear to be the most important source of pressures on patients, and to have the most impact on patients' perceptions of coercion. However, there are differences in type of pressure, and the pressures used by family and friends appear to having the most longstanding impact. Conclusion: Legal and clinical efforts to reduce the level of coercive pressures on patients need to recognize the importance of mental‐health professionals, including especially those who are not legally mandated to participate in the admission process.
Somatoform syndromes and disordersin a representative population sample of adolescents and young adults: prevalence, comorbidity and impairments
Authors: Lieb Roselind , Pfister Hildegard , Mastaler Marianne , Wittchen Hans‐Ulrich 
Published: March 2003

Objective: To present prevalence findings of DSM‐IV somatoform symptoms, syndromes and disorders in a representative sample of adolescents and young adults. Method: Data come from the Early Developmental Stages of Psychopathology (EDSP) study, in which a total of 3021 respondents aged 14–24 years were assessed by the Munich‐Composite International Diagnostic Interview. Results: Although specific DSM‐IV somatoform disorders were relatively rare with a lifetime rate of 2.7%, a considerably higher proportion of respondents met criteria for clinically significant somatoform syndromes as defined by the Somatic Symptom Index SSI4, 6 (lifetime: 1.7%), as well as the undifferentiated somatoform/dissociative syndrome USDS (lifetime: 9.1%), resulting in an overall prevalence rate of 12.6%. Somatoform conditions are often comorbid with other mental disorders and were found to be associated with remarkable impairments and disabilities. Conclusions: Somatoform disorders and syndromes in young adults are frequent, impairing and often associated with the development of other mental disorders.
Maternity blues and attachment to children in mothers of full‐term normal infants
Authors: Nagata M. , Nagai S. , Sobajima H. , Ando T. , Nishide Y. , Honjo S. 
Published: March 2003

Objective: This study was conducted for evaluating incidence of maternity blues in Japan, in addition to clarifying the relationship between maternity blues and maternal attachment, and the factors involved. Method: A questionnaire survey was conducted on 417 mothers having given birth at the Nagoya Daini Red Cross Hospital. The questionnaire consisted of Zung's self‐rating depression scale, and a ‘postpartum maternal attachment’ scale, consisting of subscales on ‘core maternal attachment’ and ‘anxiety regarding children’. The survey was conducted 5.2 days±1.46 postpartum. Results: ZSDS scores over 40 amounted to 66.8% of the responses. Analysis of the two scales revealed significant correlation/inverse correlation between ‘maternity blues’ and ‘anxiety regarding children’/‘core maternal attachment’. Path analysis revealed ‘maternity blues’ to be influencing ‘core maternal attachment’ and ‘anxiety regarding children’. Conclusion: It was found that the incidence of maternity blues may be higher in Japan than was believed previously, and that an intimate association exists between ‘maternity blues’ and ‘postpartum maternal attachment’.
Regional differences in schizophrenia incidence in Denmark
Authors: Schelin E. M. , Munk‐Jørensen P. , Olesen A. V. , Gerlach J. 
Published: March 2003

Schelin EM, Munk‐Jørrgensen P, Olesen AV, Gerlach J. Regional differences in schizophrenia incidence in Denmark. Acta Psychiatr Scand 2000: 101: 293–299. © Munksgaard 2000.Objective: To examine the regional distribution of schizophrenia incidence in Denmark.Method: A cohort consisting of 2441 Danish psychiatric patients, with first‐time admissions between January 1, 1978 and December 31, 1982, and diagnosed as having schizophrenia (ICD‐8) at least once in a 10‐year period of observation was divided into three regional groups by degree of urbanization.Results: Incidence increased for both sexes with increasing urbanization. A diagnostic delay was most pronounced in the least urbanized areas and was most pronounced for women.Conclusion: Our study confirms the existence of regional differences in schizophrenia incidence on a national basis. Marked regional differences in diagnostic delay were also demonstrated. A possible explanation could be regional differences in diagnostic procedures, underlining the importance of uniform diagnostic patterns as a means for reliable mapping of psychiatric morbidity and, hopefully, adequate treatment.
Changes in negative symptoms and the risk of tardive dyskinesia: a longitudinal study
Authors: van Ss J. , Walsh E. , van Horn E. , Tattan T. , Bale R. , Thompson S. G. 
Published: March 2003

Van Os J, Walsh E, van Horn E, Tattan T, Bale R, Thompson SG, on behalf of the UK700 Group. Changes in negative symptoms and the risk of tardive dyskinesia: a longitudinal studyActa Psychiatr Scand 2000: 101: 300–306. © Munksgaard 2000.Objective: To examine whether the development of tardive dyskinesia (TD) is accompanied by a parallel process of worsening negative symptoms in a longitudinal study.Method: A sample of 708 psychotic patients were followed over a period of 2 years, using the Abnormal Involuntary Movement Scale and the Scale for the Assessment of Negative Symptoms (SANS).Results: Of 361 individuals with no prior evidence of dyskinesia, 46 (13%) developed TD by year 2. Independent of the effects of male sex (odds ratio (OR) = 2.18, 95% confidence interval: 1.004.74), age (OR per quartile group = 1.39, 95% CI: 1.01–1.90), duration of exposure to antipsychotic medication (OR = 2.35 per 8 months, 95% CI: 1.174.72) and average SANS score (OR per quartile group = 1.38, 95% CI: 0.99–1.93), worsening of negative symptoms over the 2 previous years was asSociated with TD onset (OR per quartile group = ‐l.46, 95% CI: 1.07–2.00).Conclusion: The development of TD is linked, independent of the effect of antipsychotics and older age, to an illness‐related pathological process, characterized by worsening negative symptoms.
Does increasing dose improve efficacyin patients with poor antidepressantresponse: a review
Authors: Corruble E. , Guelfi J. D. 
Published: March 2003

Objective: Therapeutic strategies in depressed patients with no or partial response to adequate first‐line antidepressant medication remain a matter of concern. This paper focuses on the strategy of dose increase. Method: This review was based on a systematic Medline search of papers dealing with antidepressant dose issues in major depression since the 1960s. Results: The strategy of dose increase is poorly studied in clinical trials. Conclusion: Until this strategy is better studied, caution is advised in its use. However, antidepressants for which this strategy seems to be the most relevant are tricyclic drugs and serotonin and noradrenaline reuptake inhibitors. These results are discussed both in terms of therapeutic strategies for the clinician and in terms of clinical research.
Suicide attempts and impulse control disorder are related to low cerebrospinalfluid 5‐HIAA in mentally disorderedviolent offenders
Authors: Lidberg L. , Belfrage H. , Bertilsson L. , Mattila Evenden M. , Åsberg M. 
Published: March 2003

Objective: The aim of this study was to investigate the relationship between low cerebrospinal fluid 5‐hydroxyindoleacetic acid (CSF 5‐HIAA) and aggressive acts in mentally disordered violent offenders. Method: CSF concentrations of 5‐hydroxyindoleacetic acid (5‐HIAA), homovanillic acid and 4‐hydroxy‐3‐methoxyphenyl glycol weremeasured in 35 drug‐free men convicted of homicide and currently undergoing forensic psychiatric investigation in a high security hospital. Results: The mean metabolite concentrations in the homicide offenders did not differ from those of age‐ and body‐height matched malecontrol subjects. One‐third of the murderers had made oneor several suicide attempts, and their mean concentration ofspinal fluid 5‐HIAA was significantly lower than that ofthe remaining murderers. Subjects with impulse controldisorder also had lower mean CSF 5‐HIAA. A consistentpattern of higher CSF 5‐HIAA in subjects with moreself‐reported anxiety traits was observed. Conclusion: The association between serotonin and suicidal behaviour holds for yet another subject group. Determining CSF 5‐HIAA might be worth while in the routine assessment of psychiatrically ill homicide offenders.
Low novelty‐seeking differentiates obsessive‐compulsive disorder from major depression
Authors: Kusunoki K. , Sato T. , Taga C. , Yoshida Y. , Komori K. , Narita T. , Hirano S. , Iwata N. , Ozaki N. 
Published: March 2003

Objective: To make a direct comparison of patients with obsessive‐compulsive disorder (OCD) and major depression (MD) and a normal control group in terms of the Temperament and Character Inventory (TCI) personality dimensions. Method: Additionally to 43 patients with primary OCD, 43 MD patients and 43 normal subjects who were matched against the OCD patients for sex and age filled out the TCI. Results: Compared to the controls, the OCD and MD patients scored significantly higher on harm avoidance and significantly lower on self‐directedness and co‐operativeness. The OCD patients scored significantly lower on novelty‐seeking than the MD patients and the controls. Conclusion: Whereas OCD and MD share similar personality deviations on harm avoidance, self‐directedness and co‐operativeness, OCD is distinguishable from MD in terms of low novelty‐seeking. Low novelty‐seeking may have a profound relationship to the specific aetiology of OCD.
The prevalence of comorbid substance misuse and its influence on suicidal ideation among in‐patients with schizophrenia
Authors: Kamali M. , Kelly L. , Gervin M. , Browne S. , Larkin C. , O'Callaghan E. 
Published: March 2003

Objective:To estimate the prevalence, and identify the clinical correlates of comorbid substance misuse (abuse or dependence) among readmissions with schizophrenia, particularly to establish whether comorbid substance misuse is associated with higher rates of depressive symptoms and suicidal ideation. Method:Over 12 months, consecutive readmissions from a catchment area psychiatric service with DSM‐IV schizophrenia/schizoaffective disorder were assessed using clinical assessments of symptomatology including depression, insight and compliance. Comorbid substance misuse was diagnosed using DSM‐IV criteria. Results:Of 102 readmissions 40% had lifetime, while 20% had current comorbid substance misuse and were predominately young males. Comorbid substance misuse had no statistically significant impact on positive, negative or depressive symptomatology. However, those currently misusing substances reported more suicidal ideation compared with past or non‐substance misusers. Conclusion:Readmissions with comorbid substance misuse were more likely to report suicidal ideation, and may represent a group of individuals who are at higher risk of suicide.
Long‐term psychiatric patients in vocational rehabilitation programmes: a naturalistic follow‐up study over 3 years
Authors: Reker Th. , Hornung W. P. , Schonauer K. , Eikelmann B. 
Published: March 2003

Objective: This paper aims at assessing the vocational integration attained after a 3‐year period by psychiatric patients who participated in different vocational rehabilitation programmes. Method: In the north‐western German region of Westphalia‐Lippe a naturalistic follow‐up study was carried out on 471 patients from three different types of vocational rehabilitation programmes. The sample comprised chronically ill patients with a history of repeated and long‐term hospitalization. Results: After 3 years 11% of the patients were in competitive employment, 67% (still) in sheltered employment, 7% in out‐patient work therapy programmes and 15% were unemployed. It is important to notice that 74% achieved their subjective rehabilitation goals expressed at baseline. Conclusion: Vocational rehabilitation programmes are an essential part in the treatment of people with chronic mental illness. Integration into work varies markedly while patients' satisfaction is comparably good. Competitive employment represents a realistic objective only for patients with high motivation and favourable preconditions.
Service use and costs of people with dual diagnosis in South London
Authors: McCrone P. , Menezes P. R. , Johnson S. , Scott H. , Thornicroft G. , Marshall J. , Bebbington P. , Kuipers E. 
Published: March 2003

Objective: To compare the service use and costs of individuals who have a dual diagnosis of psychosis and substance abuse with those who have a diagnosis of psychosis but no substance abuse. Method: Patients with psychosis were identified and a representative sample were interviewed. Six‐month service use was measured and costs calculated. Regression models were developed to predict costs from background characteristics and dual diagnosis status. Results: A greater proportion of the patients with dual diagnosis used community psychiatric nurses, in‐patient care and the emergency clinic. The regression analysis revealed that dual diagnosis patients had significantly higher ‘core’ psychiatric service costs (a difference of £1362) and non‐accommodation service costs (£1360) than non‐dual‐diagnosis patients. The difference when all services were analysed was £1046, but this was not statistically significant. Conclusion: Specific interventions for dual diagnosis patients should be introduced and assessed in terms of individual outcomes, service use and costs.
Differences between patients with schizophrenia within and without a high security psychiatric hospital
Authors: Miller P. McC. , Johnstone E. C. , Lang F. H. , Thomson L. D. G. 
Published: March 2003

Objective: To report and discuss differences between schizophrenic patients in the community and those in maximum security care. Method: Comparison of 193 community schizophrenic patients with 169 in high security care. Data included case notes, interviews and cognitive tests. Results: Compared to high security patients, community patients tended to be female and married. They had higher school achievement, higher premorbid IQ and better occupational levels, were less likely to have a family history of alcohol abuse, to have had police contact and to have attempted suicide. They had more frequent shorter psychiatric admissions and fewer current and lifetime schizophrenic symptoms. Logistic regression models discriminated the groups with considerable accuracy. Conclusion: Patients needing high security care may be recognizable when schizophrenia is first diagnosed. Progression to the State Hospital seems to result from schizophrenia together with other factors such as deprivation rather than from a worse schizophrenic process per se.
A longitudinal study of prisoners on remand: psychiatric prevalence, incidence and psychopathology in solitary vs.non‐solitary confinement
Authors: Andersen H. S. , Sestoft D. , Lillebæk T. , Gabrielsen G. , Hemmingsen R. , Kramp P. 
Published: March 2003

Objective: To compare two levels of stress (solitary confinement (SC) and non‐SC) among remand prisoners as to incidence of psychiatric disorders in relation to prevalent disorders. Method: Longitudinal repeated assessments were carried out from the start and during the remand phase of imprisonment. Both interview‐based and self‐reported measures were applied to 133 remand prisoners in SC and 95 remand prisoners in non‐SC randomly selected in a parallel study design. Results: Incidence of psychiatric disorders developed in the prison was significantly higher in SC prisoners (28%) than in non‐SC prisoners (15%). Most disorders were adjustment disorders, with depressive disorders coming next. Incident psychotic disorders were rare. The difference regarding incidence was primarily explained by level of stress (i.e. prison form) rather than confounding factors. Quantitative measures of psychopathology (Hamilton Scales and General Health Questionnaire) were significantly higher in subjects with prevalent and incident disorders compared to non‐disordered subjects. Conclusion: Different levels of stress give rise to different incidence of psychiatric morbidity among remand prisoners. The surplus of incident disorders among SC prisoners is related to SC, which may act as a mental health hazard.
Alcoholism and depression in a Swedish female population: co‐morbidity andrisk factors
Authors: Spak Lena , Spak Fredrik , Allebeck Peter 
Published: March 2003

Objective: Our aims were to study associations between depressive disorders and alcohol dependence/abuse (ADA) in a female population‐based sample, and to identify risk indicators common to both depressive disorders and ADA. Method: Three hundred and sixteen women in a stratified randomized sample were interviewed face to face. They were asked about their childhood/adolescence and alcohol habits. Clinical lifetime diagnoses according to DSM‐III‐R were made. Depressive disorders includes different mood disorders. Results: Half the women with ADA also had a depressive disorder, and 25% of the women with depressive disorders also had ADA. Alcohol intoxication before the age of 15 and psychological and/or psychiatric problems before the age of 18 years increased the risk for ADA and depressive disorders in our study. Conclusion: Our results support previous findings of an association between depressive disorders and ADA, beginning early in life.