bluuebunny/crossref_metadata_2025_split huggingface dataset:
Do the Spontaneity and Anger and Aggression subscales of the Ward Atmosphere Scale form homogeneous dimensions? A cross‐sectional study of 54 wards for psychotic patients
Authors: Røssberg J. I. , Friis S. 
Published: March 2003

Objective:  The main aim of this study was to examine the psychometric properties of the two subscales of the Ward Atmosphere Scale (WAS), Spontaneity and Anger and Aggression, which measure the level of expressed emotion. We wanted to examine if the items measuring attitude and behavior form different dimensions.Method:  A total of 550 patients in 54 different psychiatric wards for psychotic patients completed the WAS and the Good Milieu Index.Results:  Removing, respectively, four items from the Spontaneity subscale, three items from the Anger and Aggression subscale the psychometric properties improved. The two revised subscales were named Spontaneous Behavior (SB) and Angry, Aggressive Behavior (AAB). A new ‘attitude’ subscale, comprising three items, was named Staff Attitude to Expressed Feelings (SAEF).Conclusion:  For patients the attitude and behavior items seem to form separate dimensions. The three subscales examined are probably of central importance for patient satisfaction.
Methylphenidate and intracortical excitability: opposite effects in healthy subjects and attention‐deficit hyperactivity disorder
Authors: Moll G. H. , Heinrich H. , Rothenberger A. 
Published: March 2003

Objective: To test the effects of a standard dosage of the psychostimulant methylphenidate (MPH) – which significantly enhances intracortical inhibition but had no effects on intracortical facilitation in children with attention‐deficit hyperactivity disorder (ADHD) – on intracortical excitability in healthy subjects.Method: In 12 healthy subjects, aged 20–40 years, intracortical inhibition and facilitation were investigated before and 70 min after the intake of 10 mg MPH using the technique of transcranial magnetic stimulation (TMS) with the paired‐stimulus paradigm.Results: In comparison of the two TMS measurements, a significant enhancement in intracortical facilitation but no effects on intracortical inhibition could be stated under MPH administration.Conclusion: This study provides first evidence for opposite effects of MPH on intracortical excitability in healthy adult subjects showing enhanced intracortical facilitation in contrast to ADHD children in whom enhanced intracortical inhibition has recently been shown.
Alterations of rCBF and mitochondrial dysfunction in major depressive disorder: a case report
Authors: Gardner A. , Pagani M. , Wibom R. , Nennesmo I. , Jacobsson H. , Hällström T. 
Published: March 2003

Objective:  A mitochondrial disease might be considered when depressive disorder is associated with diabetes mellitus or other symptoms commonly found in mitochondrial disease. Scattered regional cerebral blood flow (rCBF) decreases and increases have been reported in depressive and mitochondrial disorders. A 61‐year‐old male patient with early adult onset of depressive disorder and a slowly developing multiorgan syndrome including diabetes mellitus was investigated.Method:  99mTc‐HMPAO rCBF SPECT and muscle biopsy to assess mitochondrial functions were performed in the patient.Results:  Alterations of rCBF were found in the patient, with the most pronounced decreases in the left dorsolateral frontal and inferior parietal lobes, and the most pronounced increases in the bilateral superior parietal lobes. Muscle biopsy revealed myopathy and decrease of mitochondrial adenosine triphosphate production rates (MAPRs).Conclusion:  The MAPRs decreases support the suspicion of mitochondrial dysfunction in the patient. A subgroup of depressed patients may have mitochondrial dysfunctions.
Crazy? So what! Effects of a school project on students' attitudes towards people with schizophrenia
Authors: Schulze B. , Richter‐Werling M. , Matschinger H. , Angermeyer M. C. 
Published: March 2003

Objective:  Aiming at promoting young people's mental health and reducing stigma towards people with schizophrenia, project weeks were carried out with secondary school students aged 14–18 years (n=90). Key to the project week is meeting a (young) person with schizophrenia.Method:  Students' attitudes and behavioural intentions towards people with schizophrenia were assessed before and after the project. Parallelly, a control group of students were questioned (n=60). Assessment was repeated after 1 month.Results:  Despite expected ceiling effects, the project led to a significant reduction of negative stereotypes. For social distance, a positive trend could be observed. These developments were not present with the controls. Attitude changes were still evident at the 1‐month follow‐up.Conclusion:  Results support the hypothesis that young people's attitudes about schizophrenia are susceptible to change. Antistigma projects at school level could thus be a promising approach to improving public attitudes and to preventing stereotypes from becoming reinforced.
Treatment of interictal psychiatric disorder in epilepsy. I. Affective and anxiety disorders
Authors: van der Feltz-Cornelis Cm 
Published: March 2003

Background:Interictal affective disorders are common in patients with epilepsy and there is a need for evidence-based treatment guidelines.Objective:This paper gives an overview of research concerning treatment of interictal affective disorders and interictal anxiety disorders in epilepsy.Methods:Literature review supplemented by clinical experience.Results:Interictal psychiatric disorder can be characterized as intermittent pleomorphic psychopathology. The most common manifestations are interictal dysphoric disorder (IDD) and depression. There is a lack of randomized control trials (RCTs) concerning effectiveness and side-effects of antidepressants in epilepsy patients.Conclusion:Treatment implications of the concept of IDD and other interictal disorders are an optimized dosage of anti-epileptics in combination with antidepressants. This coincides with recent guidelines concerning combinations of psychotropic medication, such as for depression and bipolar disorder, in general psychiatry. Systematic research involving the DSM-IV categories of generalized anxiety disorder, panic disorder and agoraphobia and depression is not yet available. Prevalence and treatment of interictal anxiety disorders and depressive disorder in epilepsy should be the subject of further research, in order to enable development of evidence-based treatment guidelines for these disorders in epilepsy patients.
Treatment of interictal psychiatric disorder in epilepsy. III. Personality disorder, aggression and mental retardation
Authors: van der Feltz-Cornelis Cm 
Published: March 2003

Background:Personality disorder, mental retardation and aggression are frequently encountered therapeutic problems in epilepsy patients.Objective:This paper gives an overview of symptomatology and treatment of personality disorder, interictal aggression and mental retardation in epilepsy.Methods:Literature review supplemented by clinical experience.Results:Personality changes in patients with epilepsy are often symptoms of an organic psychosyndrome. Aggression is not more frequent among epilepsy patients than in the general population, but if it does happen it is often more severe. There is a need for controlled treatment studies. A treatment strategy is suggested. In the mentally retarded, diagnostic instruments should be used to overcome diagnostic difficulties.Conclusion:Prevalence studies based on DSM-IV personality disorder, conducted in the community, are needed, as well as systematic research on diagnosis and treatment of personality disorder in epilepsy patients. Randomized controlled trials (RCTs) considering the effectiveness and adverse effects of antidepressants and neuroleptics in epileptic patients with mental retardation are seriously needed. In the meantime, the Expert Consensus Guideline Series on Treatment of Psychiatric and Behavioural Problems in Mental Retardation is useful. The use of neuroleptics for the treatment of aggressive or destructive behaviour in nonpsychotic mentally retarded patients remains controversial.
Assessment of borderline personality disorder: considering a diagnostic strategy
Authors: Schotte C. K. W. 
Published: March 2003

Background:Borderline personality disorder (BPD) represents a highly prevalent, severe and difficult-to-treat mental health problem.Objective:This paper considers methods, instruments and strategies for assessing BPD as described within the frame of the DSM-IV classification.Conclusions:Following the general diagnostic approach introduced by Van Praag in biological psychiatry, a two-tier diagnostic strategy for the descriptive diagnostic assessment of BPD is recommended. Axis one results in a DSM-IV Axis II categorical diagnosis, whereas axis two refers to a symptomatological, dimensional or functional approach, in which the psychological dysfunctions of the nosological syndrome are depicted. Moreover, in a clinical context a basic aim of the diagnostic evaluation is to obtain therapeutically valid information that leads to a constructive conceptual framework, to a case formulation in which therapeutic interventions are understood, selected and implemented. This framework should be based on a biopsychosocial theoretical model and its application in the clinical context involves feedback to the patient, in which the descriptive evaluation is integrated with etiological; and pathogenic elements using an idiographic approach. This therapeutically orientated diagnostic strategy is illustrated by the use of the ADP-IV (Assessment of DSM-IV personality disorders) questionnaire within a cognitive behavioral orientation.
Psychiatric management of severe somatoform disorders in childhood and adolescence
Authors: Garralda M. Elena 
Published: March 2003

Background:Unexplained medical symptoms are common in children. They constitute the main feature of somatoform disorders of childhood (i.e. pain disorders, conversion disorder and chronic fatigue syndrome or neurasthenia).Objective:To describe assessment and treatment strategies for severe somatoform disorders of childhood.Methods:Review of recommendations for clinical practice and clinical trials.Results:A number of specific techniques have been described. Clinical accounts indicate that many children benefit and can recover. There is some empirical evidence supporting the beneficial effects of techniques such as family cognitive-behavioural therapy and relaxation technique for the less severe disorders.Conclusions:Existing helpful clinical guidelines require empiric validation.
A staging approach to measuring patient‐centred subjective outcomes*
Authors: Bilsbury C. D. , Richman A. 
Published: March 2003

Introduction:  In assessing clinical change, measurement is often based on psychometric scales. However, change is best revealed within the constellation of problems salient to the patient, rather than in alterations in the abstract constructs, psychometrically measured. These patients' problems often serially unfold in qualitative stages, even before the full‐blown disorder emerges. These qualitative stages constitute the natural history extending from early to late, fluctuating from mild to severe, and progressing from full‐blown disorder to recovery.Method:  We reviewed the literature on clinimetrics and patient‐centred subjective measures, and related these findings to the use of the discretized‐analogue scaling method.Results:  There is increasing recognition of clinimetric approaches that structure the pre‐clinical and clinical material into a scale that reflects the symptoms, consequences and complications in a manner understandable to the patient, and enabling the quantification of severity or change. This monograph provides criteria and methods for developing these building blocks that enable the assessment of severity, stage or change. We show examples of their use in quantitative clinical outcome measurement.Conclusion:  We encourage further studies in the ideology and procedures for measuring clinical change in terms of personally subjective experiences.
The impact of antihypertensive drug groups on urinary albumin excretion in a non‐diabetic population
Authors: Monster Taco B. M. , Janssen Wilbert M. T. , De Jong Paul E. , De Jong‐van den Berg Lolkje T. W. ,   for the PREVEND Study Group
Published: March 2003

Aims  Microalbuminuria (30–300 mg 24 h−1) is recognized to be independently associated with renal and cardiovascular risk. Antihypertensives may lower microalbuminuria. We questioned whether the use of different antihypertensive drug classes in general practice influences microalbuminuria as related to blood pressure in nondiabetic subjects.Methods  To study this, we used the data from 6836 subjects of an on‐going population based study, focused on the meaning of microalbuminuria (PREVEND). Odds ratios, adjusted for age, sex, blood pressure, cholesterol level, smoking and the use of other antihypertensive or cardiovascular drugs, were calculated to determine the association of drug groups with microalbuminuria. Influence of antihypertensives on the relation between blood pressure and (log) urinary albumin excretion was determined by comparing linear regression lines.Results  Microalbuminuria was significantly associated with the use of dihydropyridine calcium channel blockers (odds ratio: 1.76 [1.22–2.54]), but not with other antihypertensive drug groups. The linear regression line of the relation between blood pressure and (log) urinary albumin excretion was significantly steeper (P = 0.0047) for users of calcium channel blockers, but not for other antihypertensives, compared with subjects using no antihypertensive. Users of a combination of renin‐angiotensin system inhibitors and diuretics however, had a less steep regression line (P = 0.037).Conclusions  This study suggests a disadvantageous effect of dihydropyridine calcium channel blockers on microalbuminuria compared with other antihypertensive drug groups. Thus, if microalbuminuria is causally related to an increased risk for cardiovascular morbidity and mortality, dihydropyridines do not seem to be agents of choice to lower blood pressure. Furthermore, the combination of renin‐angiotensin system inhibition and diuretics seems to act synergistically.
The ‘pressures to change’ approach to working with the partners of heavy drinkers
Authors: BARBER JAMES G. , CRISP BETH R. 
Published: March 2003

AbstractThe ‘Pressures to Change’ approach to working with the partners of drinkers is a structured procedure for promoting change in resistant drinkers. In this study 22 women and one man were randomly allocated to two treatment conditions and one no‐treatment waiting list control condition in an experimental evaluation of the procedure. Group 1 was treated individually and Group 2 was treated as a group. Almost two‐thirds of the drinking partners of clients in treatment made a significant move towards change, compared with none of the drinkers in the waiting list control condition.
Conditioned responses to drug‐related stimuli: is context crucial“
Authors: POWELL JANE 
Published: March 2003

AbstractResearch into the elicitation of conditioned responses (CRs) by drug‐related stimuli in drug and alcohol addicts has produced apparently conflicting results in relation both to the form of the CR (drug‐like or drug‐opposite) and to its importance in influencing relapse rates after detoxification. Most studies looking at cue‐elicited responses directly have taken place with recently detoxified addicts in a laboratory setting. The present study examined cue‐elicited reactions in eight currently dependent opiate users (receiving prescribed physeptone) during their drug preparation rituals. Seven were seen in their own homes and one in hospital. Subjects rated their mood and physical state before getting out the drug and paraphernalia, during preparation to inject, and after injection. By contrast with the withdrawal‐like reactions, which are the most common finding in laboratory exposure studies where drugs are not subsequently accessible for use, these subjects showed a significant reduction in subjectively rated withdrawal symptoms during the pre‐injection drug preparation ritual. The results are discussed in relation to the impact of the context of exposure in influencing subjective expectancies, with perception of drug availability seen as a critical part of the conditioned stimulus complex.
Prevalence of markers for hepatitis B virus and HIV‐1 among drug injectors in London: injecting careers, positivity and risk behaviour
Authors: RHODES TIM , HUNTER GILLIAN M. , STIMSON GERRY V. , DONOGHOE MARTIN C. , NOBLE ALISON , PARRY JOHN , CHALMERS COLIN 
Published: March 2003

AbstractConcerns about the risks of HIV infection among drug injectors have eclipsed concerns about the prevalence and transmission of hepatitis, and in particular hepatitis B virus infection. Findings are reported from surveys undertaken with two separate community‐recruited samples of drug injectors in London collected in 1992 (n = 505) and in 1993 (n = 507). Anonymized confirmed testing of saliva snows 51.5% of drug injectors in 1992 and 47.9% in 1993 to be antibody positive to the core antigen of hepatitis B virus (anti‐HBc). Approximately half of the drug injectors confirmed as anti‐HBc positive were unaware that they had been infected with hepatitis, Anti‐HIV‐1 prevalence was considerably lower at 7.0% in 1992 and 6.9% in 1993. Multivariate analyses showed anti‐HBc positivity to be most likely among older injectors with longer injecting careers who had a history of having shared used needles and syringes. HIV‐1 positivity was also associated with a history of having shared injecting equipment as well as with recent sharing (i.e. in the last 6 months). Unlike anti‐HBc positivity, there were no associations between HIV‐1 positivity and age or length of injecting career. Younger injectors with shorter injecting careers were more likely to report recent sharing of used injecting equipment than older injectors with longer injecting careers. We note the potential for continued transmission of HBV and HIV‐1, particularly among younger injectors. We recommend an integrated strategy to maximize the health of drug injectors, of which HIV and HBV prevention is a part. There is a need to widen the availability of HBV vaccinations for HBV negative drug injectors and their sexual partners and for clear guidelines to drug injectors about the relative efficacy of bleach to disinfect injecting equipment of HBV and HIV.
An evaluation of the history of a marijuana withdrawal syndrome in a large population
Authors: WIESBECK GERHARD A. , SCHUCKIT MARC A. , KALMIJN JELGER A. , TIPP JAYSON E. , BUCHOLZ KATHLEEN K. , SMITH TOM L. 
Published: March 2003

AbstractCase reports and laboratory research indicate the existence of a cannabis withdrawal syndrome. However, the data tell us little about the prevalence and clinical characteristics of a marijuana withdrawal syndrome in people who have used the drug but who did not enter treatment for cannabis dependence. Face‐to‐face semi‐structured interviews applying standard diagnostic criteria were used in the present study to gather data from 5611 men and women, recruited between 1991 and 1995 through the Collaborative Study of the Genetics of Alcoholism (COGA). Almost 41% of the sample had no history of marijuana use (Group 1), 28% had consumed this drug less than 21 times in any single year (Group 2), and 3t% used it at least that frequently (Groups 3 and 4). Almost 16% of the more frequent marijuana users related a history of a marijuana withdrawal syndrome, and these Group 4 subjects had used the drug almost daily for an average of almost 70 months. The typical withdrawal symptoms included “nervous, tense, restlessness”, “sleep disturbance” and “appetite change”. While Group 4 subjects were more likely to have developed dependence on most types of drugs, even when alcohol and drug use patterns were statistically taken into account, marijuana use was still significantly related to a self‐report of a history of marijuana withdrawal.
Prediction of results from correspondence treatment for controlled drinking
Authors: KAVANAGH DAVID J. , SITHARTHAN THIAGARAJAN , SAYER GEOFFREY P. 
Published: March 2003

AbstractIdentification of people who will benefit most from brief interventions is an important research challenge in the study of addictive disorders. The current study investigated predictors of response to correspondence interventions for alcohol abuse. We examined both subject retention and alcohol intake over a 12–month period. The primary focus was on the predictive utility of self‐efficacy, stages of change and alcohol dependence. Self‐efficacy performed relatively well in the study, predicting both retention and later consumption. When predicting 12–month consumption from pretest assessments or examining subject retention over the last 6 months, self‐efficacy offered a significant contribution to multivariate analyses. However, in some other predictions a significant effect of self‐efficacy was eliminated after the entry of other variables. Stages of change significantly predicted mid‐way through treatment, but did not provide an independent prediction of overall retention or treatment response. Neither the degree of alcohol dependence nor level of alcohol problems figured in any of the predictions. Older subjects stayed longer in the study, and those with looter intake and higher pretest self‐efficacy had the lowest consumption at 12 months. Results are compared with previous research on prediction of outcomes in addictive disorders.
Alcohol consumption and suicide mortality by age among Finnish men, 1950–1991
Authors: MÄKELÄ PIA 
Published: March 2003

AbstractAn earlier comparative time series analysis of the connection between per capita alcohol consumption and suicide mortality reported, unexpectedly, a non‐significant effect of alcohol on the suicide rate of Finnish men. However, the suicide rate of Finnish men is heterogeneous in regard to age groups. There is also indication that the connection between alcohol and suicides is stronger in younger than in older age groups. Time series data on per capita alcohol consumption and age‐specific suicide mortality in 1950‐91 were used to scrutinize the relationship. The results indicate that the suicide rate of Finnish men in age groups 15–34 years and 35–49 years is associated with per capita alcohol consumption, while no connection could be established between the suicide rates of men aged 50–69 years and 70 + yean and either per capita alcohol consumption or a lagged consumption measure. Real income, divorce rate and unemployment rate were regarded as possible confounding variables.
Depression and smoking initiation among US Latinos
Authors: ESCOBEDO LUIS G. , KIRCH DARRELL G. , ANDA ROBERT F. 
Published: March 2003

AbstractWe assessed the relationship between depression and smoking initiation among people of Mexican, Puerto Rican and Cuban ancestry residing in specific geographic areas of the United States. Survey data were examined to calculate incidence of smoking initiation and prevalences and odds ratios for ever smoking by presence of depressed mood, a history of major depression or both conditions. Depressed mood, a history of major depression or both conditions were associated with smoking initiation risks during childhood, adolescence and young adulthood. These findings suggest that the relationship between depressive states and smoking initiation is established early in life. More definitive studies are needed to confirm these findings.