bluuebunny/crossref_metadata_2025_split huggingface dataset:
Loss as a determinant of PTSD in a cohort of adult survivors of the 1988 earthquake in Armenia: implications for policy
Authors: Armenian Haroutune K. , Morikawa Masahiro , Melkonian Arthur K. , Hovanesian Ashot P. , Haroutunian Nune , Saigh Philip A. , Akiskal Knarig , Akiskal Hagop S. 
Published: March 2003

Objective: To study the relationship of post‐traumatic stress disorder (PTSD) to severity of the disaster experience. Method: A sample of 1785 adult participants of an epidemiological study initiated in the immediate aftermath of the 1988 earthquake in Armenia were interviewed about 2 years following the disaster based on the NIMH DIS‐Disaster Supplement. All 154 cases of pure PTSD were compared with 583 controls without symptoms satisfying psychiatric diagnoses of interest. Results: PTSD cases included more persons from areas with the worst destruction. Having the highest level of education compared to lowest (OR 0.6 [95% CI 0.4–0.9]), being accompanied at the moment of the earthquake (OR 0.6 [95% CI 0.4–0.9]) and making new friends after the earthquake (OR 0.6 [95% CI 0.5–0.8]) were protective for PTSD. PTSD risk increased with the total amount of loss to the family (OR for highest level of loss 4.1 [95% CI 2.3–7.5]). Conclusion: Based on this large population sample, we believe that early support to survivors with high levels of loss may reduce PTSD following earthquakes.
Measurement of violence during in‐patient treatment and association with psychopathology
Authors: Steinert T. , Wölfle M. , Gebhardt R‐P. 
Published: March 2003

Objective: Four available instruments for the measurement of violence were compared. The association between psychopathological status at admission and violence during in‐patient treatment was examined. Method: In 199 consecutively admitted patients (143 with schizophrenia or schizoaffective disorder, 56 with non‐psychotic disorders), the PANSS was recorded at the time of admission. Violent behaviour against self and others was assessed for the total period of in‐patient treatment using the scales MOAS, SDAS, SOAS and VS. Results: The sumscores of the scales correlated highly (r between 0.78 and 0.91), but the scales differed in sensibility and inter‐rater reliability. There was a strong association between thought disorders and violent behaviour during in‐patient treatment in psychotic patients (beta=0.34; P<0.001). Conclusion: Although constructed to measure different aspects of violence, all investigated instruments correlated highly. The psychopathological status at admission is associated with violent behaviour during in‐patient treatment.
Suicide prevention — a medical breakthrough?
Authors: Isacsson G. 
Published: March 2003

Objective: The author hypothesized, based on research until 1991, that a five‐fold increase in the use of antidepressants might reduce Swedish suicide rates by 25%. A subsequent 3.5‐fold increase in the use of antidepressants provided a ‘natural experimental situation’ forprospectively testing this hypothesis. Method: Swedish statistics on suicide, use of antidepressants,unemployment and alcohol consumption were obtained for1978–96. Time‐series of the latter variables were compared with suicide rates. Demographic subgroups regarding age, gender and county were analysed. Suicide rates were also compared with the use ofantidepressants in Denmark, Norway and Finland. Results: Suicide rates decreased in accordance with the a priori hypothesis. Alcohol consumption and unemployment rates did not correlate well with suicide rates. Conclusion: This naturalistic study is not conclusive. Theincreased use of antidepressants appears, however, to be one of the contributing factors to the decrease in the suicide rate. It is of great scientific and clinical importance that this be evaluated byfurther studies.
Comparison of the standard and the computerized versions of the Symptom Check List (SCL‐90‐R): a randomized trial
Authors: Schmitz Norbert , Hartkamp Norbert , Brinschwitz Carsten , Michalek Silke , Tress Wolfgang 
Published: March 2003

Objective: The purpose of this study was to examine whether computer administration of the Symptom Check List (SCL‐90‐R) is equivalent to paper‐and‐pencil originals. Method: 282 psychosomatic outpatients were randomly assigned to computer or paper‐and‐pencil conditions. Statistical equivalence tests were used to examine psychometric equivalence for the means. Reliabilities and correlations were compared for the two methods of administration. Results: No systematic differences were observed in group means for most of the subscales. Subjects of the computer‐administered group scored higher on the SCL‐90‐R subscale ‘Obsessive‐Compulsive’ and ‘Anger‐Hostility’ than the control subjects. Gender and administration mode interaction was observed for one subscale, while age and administration interaction was observed for another subscale. Conclusion: Using computer‐administered tests makes administration and scoring of tests more efficient. The differences between the two administration modes were small, although noticeable. Further research is needed to determine whether computer environment, computer experience and age may influence the test results.
Juvenile bipolar disorder
Authors: Janardhan Reddy Y. C. , Srinath S. 
Published: March 2003

Objective: Bipolar disorder in children and adolescents is less well studied than bipolar disorder in adults. This review addresses issues related to its underdiagnosis, precursors of bipolarity, comorbidity, natural course and treatment. Method: Literature from Medline and other searches, and earlier relevant articles including references from recent review articles on juvenile bipolarity were reviewed. Results: Bipolar disorder in juveniles is underdiagnosed and misdiagnosed on various counts. Few recent studies have reported high rates of comorbid attention deficit and disruptive disorders, prompting some researchers to consider them as probable developmental precursors of juvenile bipolarity. There is also evidence to suggest that some juvenile depression could be pre‐bipolar, and that certain temperamental predispositions are probable precursors to bipolarity. Limited data on the natural course and outcome suggest that juvenile bipolar disorder is a highly recurring illness as in adults, and that it is associated with significant functional impairment. The psychopharmacological treatment of juvenile bipolar disorder is remarkably understudied, and treatment is often based on studies of adults. Conclusion: There is a need for epidemiological studies of juvenile bipolar disorder. Similarly, there is an urgent need for the methodologically rigorous studies to establish the efficacy of various antimanic drugs. Finally, issues related to comorbidity and temperamental predispositions to juvenile bipolarity need greater clarity, as they may have important treatment and research implications.
The prevalence of mental health problems in Rwandan and Burundese refugee camps
Authors: De Jong J. P. , Scholte W. F. , Koeter M. W. J. , Hart A. A. M. 
Published: March 2003

Objective: We examined the prevalence of mental health problems in refugees living in camps that emerged in Tanzania during the Rwanda crisis that started in 1994. Method: Using the 28‐item version of the General Health Questionnaire (GHQ‐28), we examined two samples: a random sample (n=854) and a sample of clients of a psychosocial support programme in these camps (n=23). Sensitivity, specificity and positive‐ and negative predictive values were estimated for several cut‐off scores of the GHQ‐28. Results: The prevalence of serious mental health problems was estimated at 50% (SE 12%). When using the GHQ‐28 as a screener, a cut‐off score of 14 is recommended. Conclusion: Given the high prevalence of mental health problems, psychosocial programmes for large refugee populations should aim at strengthening community structures and supporting groups instead of focusing at individuals. The screening capacity of the GHQ‐28 could be used to identify mentally vulnerable groups.
Dissociative disorders in the Sultanate of Oman
Authors: Chand Suma P. , Al‐Hussaini Ala Aldin , Martin Rodger , Mustapha Sawsan , Zaidan Ziad , Viernes Nonna , Al‐Adawi Samir 
Published: March 2003

Objective: To study the clinical manifestations and psychosocial aspects of dissociative (conversion) disorders (DD) in the Sultanate of Oman. Method: A retrospective analysis was made of data derived from case records of patients admitted as in‐patients to the Sultan Qaboos University Hospital, Oman, over a period of 8 years. Results: A higher prevalence of DD was noted in Oman compared to western countries. The female preponderance was less marked in Oman. The most common presentations were dissociative convulsions, dissociative motor and dissociative trance disorders. Interpersonal difficulties with family and academic problems were the important identified precipitants. Conclusion: The study highlights the characteristic clinical and psychosocial features of the dissociative phenomena in Oman.
Relation of factor‐analyzed symptom dimensions of obsessive‐compulsive disorder to personality disorders
Authors: Mataix‐Cols David , Baer Lee , Rauch Scott L. , Jenike Michael A. 
Published: March 2003

Objective: To assess the relation between symptom dimensions of obsessive‐compulsive disorder (OCD) and comorbid personality disorders (PDs). Method: The scores of 75 OCD outpatients on five previously identified symptom dimensions were entered into multiple regression models as predictors of: 1) the presence of any type of PD; 2) the number of PDs; 3) the presence of any cluster A, B or C PD; and 4) the presence of each individual PD. Results: Twenty‐eight patients (37.3%) met criteria for one or more PDs. High scores on the ‘Hoarding’ dimension were strongly related to the presence of any Axis II diagnosis, and to the number of PDs. Cluster C PDs (especially obsessive‐compulsive and avoidant) had the highest partial correlations with ‘Hoarding’. These results were independent of OCD symptom severity. Conclusion: Previous conflicting findings about the prevalence of certain PDs in OCD might be due in part to differences in the constitution of the particular patient groups studied.
Medication adherence in psychosis: predictors and impact on outcome.A 2‐year follow‐up of first‐admitted subjects
Authors: Verdoux H. , Lengronne J. , Liraud F. , Gonzales B. , Assens F. , Abalan F. , Os J. van 
Published: March 2003

Objective: To assess the baseline characteristics predicting poor medication adherence following a first admission for psychosis, and the impact of poor medication adherence on outcome. Method: First‐admitted subjects with psychosis (n=65) were assessed at 6‐month intervals over a 2‐year follow‐up. Medication adherence was assessed using multiple sources of information. Results: Baseline lower occupational status, alcohol misuse and the intensity of delusional symptoms and suspiciousness predicted poor medication adherence during the 2‐year follow‐up. Over this period, subjects with poor medication adherence presented more frequently with an episodic course of illness and were more frequently readmitted, especially with regard to involuntary readmission. Conclusion: In naturalistic conditions one out of two subjects with psychosis interrupts his/her treatment in the months following his/her first discharge from hospital. Therapeutic programmes aimed at improving medication adherence should be implemented early in the course of psychosis to reduce the deleterious consequences of poor medication adherence on clinical outcome.
The causes, consequences and detection of publication bias in psychiatry
Authors: Gilbody Simon M. , Song Fujian , Eastwood Alison J. , Sutton Alex 
Published: March 2003

Objective: Publication bias threatens the validity of published research, although this topic has received little attention in psychiatry. The purpose of this article is to produce a systematic overview of the causes and consequences of publication bias and to summarize the available methods with which it is detected and corrected. Method: Empirical evidence for the existence of publication bias is reviewed and the following methods are applied to an illustrative case example from psychiatry: funnel plot analysis; the ‘file drawer method’; linear regression techniques; rank correlation; ‘trim and fill’. Results: Small studies are particularly susceptible to publication and related bias. All methods to detect publication bias depend upon the availability of a number of individual studies with a range of sample sizes. Unfortunately, large numbers of studies of varying sample size are not always available in many areas of psychiatric research. Conclusion: Where possible researchers should always test for the presence of publication bias. The problem of publication bias will not be solved by anything other than a prospective trials register.
Symptom profiles of gender dysphoric patients of transsexual type compared to patients with personality disorders and healthy adults
Authors: Haraldsen IR , Dahl AA 
Published: March 2003

Objective: Gender dysphoric patients of transsexual type (TS) have been considered to have severe psychopathology. However, these notions have a weak empirical documentation. Method: TS patients (n=86), patients with personality disorder (PD, n=98) and adult healthy controls (HC, n=1068) were compared by means of the Symptom Checklist 90 (SCL‐90). All patients were diagnosed by structured interviews (Axis I, II and V of DSM‐III‐R/IV). PD patients were further characterized according to the LEAD‐standard. Results: TS patients scored significantly lower than PD patients on the Global Symptom Index and all SCL‐90 subscales. Although the TS group generally scored slightly higher than the HC group, all scores were within the normal range. Conclusion: TS patients selected for sex reassignment showed a relatively low level of self‐rated psychopathology before and after treatment. This finding casts doubt on the view that transsexualism is a severe mental disorder.
Predictive factors for borderline personality disorder: patients' early traumatic experiences and losses suffered by the attachment figure
Authors: Liotti G. , Pasquini P. , Cirrincione R. ,   The Italian Group for the Study of Dissociation
Published: March 2003

Objective: To test the hypothesis that serious losses in the life of the attachment figure and patients' early traumatic experiences are risk factors for the development of borderline personality disorder. Method: A multicentric hospital‐based case–control study of 66 cases and 146 controls. Results: We estimated an odds ratio of 2.5 (95% CI 1.1–5.8) for mothers' serious losses experienced within 2 years of patients' birth and an odds ratio of 5.3 (95% CI 2.1–13) for patients' early traumatic experiences. Both of them are adjusted for the confounding effect of the other as well as for that of age, size of family and type of patient (in‐ or out‐patient), using a multiple logistic function. Conclusion: Mourning process in the mother within 2 years of the patient's birth and patients' early traumatic experiences are predictive factors for the development of borderline personality disorder.
Mad scenes in early 19th‐century opera
Authors: Erfurth A. , Hoff P. 
Published: March 2003

Objective: It is our objective to examine the phenomenon of mad scenes in bel canto opera from a modern perspective. Method: The development of psychiatry and music at the beginning of the 19th century is described. Common elements of romantic music and mental disorders are discussed. It is shown how bel canto composers represent psychiatric illness by musical means. The psychopathology depicted in a prototypical mad scene is evaluated. Results: Early romantic music is characterized by imagination, illusion and loss of structure; characteristics which can be well expressed in mad scenes. While madness (withdrawal into a utopian world) gained a certain attraction in society, clinical psychiatry increasingly focused on emotional causes of illness and on drug‐induction of mental disorders. Conclusion: Mad scenes in bel canto opera can be understood as expression of an increasing interest in emotional aspects in music and society as well as in clinical psychiatry.
The variability of phenomenology in anorexia nervosa
Authors: Ngai Emily S. W. , Lee Sing , Lee Antoinette M. 
Published: March 2003

Objective: To study the variability of phenomenology in Chinese patients with anorexia nervosa in Hong Kong. Method: Longitudinal case studies of four patients. Results: The anorexic illness was not uniformly about the fear of fatness. Rather, patients' explanations for food refusal could change over time. A typology of anorexic phenomenology emerged; namely, fat phobic type I (fat phobia consistently present), fat phobic type II (fat phobia changing to non‐fat phobic presentation), non‐fat phobic type I (consistently non‐fat phobic) and non‐fat phobic type II (non‐fat phobic initially, but fat phobic later). Conclusion: The variability of anorexic phenomenology challenges the current fat phobia paradigm and has implications on the diagnosis, treatment and psychometric assessment of eating disorders.
Autism and Asperger syndrome: coexistence with other clinical disorders
Authors: Gillberg and C. , Billstedt E. 
Published: March 2003

Objective: To provide a clinically useful analysis of the extent to which autism and Asperger syndrome coexist with other disorders. Method: Selective review of the literature detailing data pertaining to symptoms and disorders sometimes encountered in connection with autism or Asperger syndrome. Results: A large number of medical conditions, psychiatric disorders and behavioural and motor dyscontrol symptoms are associated with autism and Asperger syndrome. Conclusion: Comorbidity is to be expected in autism spectrum disorders — directly or indirectly. Comorbid conditions may be markers for underlying pathophysiology and suggest a more varied treatment approach. There is a great need for in‐depth research into this area, meaning that the exclusion criteria of current diagnostic manuals, i.e. those that rule out a diagnosis of autism in some disorders, and a diagnosis of certain other disorders in autism may have to be revised.
Assessment of dysfunctional working models of self and others in schizophrenic patients: a summary of data collected in nine nations
Authors: Perris C. , Frank N. , Gusmao R. , Henry L. , Lundberg M. , Schaub A. , Simos G. , Richter J. , Rognoni R. , Ruchkin V. , Valls J. ,   International Research Group*
Published: March 2003

Objective: To investigate the cross‐cultural feasibility of a new scale for assessing dysfunctional working models of self and others, and to evaluate its discriminative power. Method: Schizophrenic patients (N=351), non‐psychotic patients (N=86) and non‐clinical subjects (N=511) collected in 10 centres completed the DWM‐S. Current psychopathology was assessed by means of the BPRS. Results: Alpha coefficients were high in all samples. Mean scores on the DWM‐S appeared to be comparable in all countries, suggesting cross‐national generalizability. No significant correlation was found with sex, age, levels of psychopathology and duration of illness. Discriminant analyses showed that more than 70% of the schizophrenic patients are correctly classified. Conclusion: The DWM‐S is an easily administered self‐report instrument which allows to pinpoint internal dysfunctional working models of self and others in various types of patients. It is a useful tool for case conceptualization, especially when psychotherapeutic interventions are part of the treatment programme.
A general population survey on patterns of benzodiazepine use and dependence in Lebanon
Authors: Naja W. J. , Pelissolo A. , Haddad R. S. , Baddoura R. , Baddoura C. 
Published: March 2003

Objective: In Lebanon, benzodiazepines are often available without medical prescription. We aimed to carry out the first community‐based pharmaco‐epidemiological study on benzodiazepine consumption in the Middle East Area. Method: The prevalence of past‐month benzodiazepine use was assessed in a 1000‐subject randomized sample from the Lebanese community, and risk factors were studied in a group of 496 current users. Results: Benzodiazepine use during the past month was found in 9.6% of subjects. Four variables were significantly associated with use: age higher than 45 years, female sex, cigarette smoking and the existence of a recent life event. Benzodiazepine dependence was found in 50.2% of users. Conclusion: Benzodiazepine use in Lebanon is particularly high, and can be related to well‐known factors such as female sex and age, but other potent specific variables, such as war stress or the lack of control on drug access, can be hypothesized.
Teacher‐reported problem behaviour in Turkish immigrant and Dutch children:a cross‐cultural comparison
Authors: Crijnen Alfons A. M. , Bengi‐Arslan Leyla , Verhulst Frank C. 
Published: March 2003

Objective: To compare problem behaviour in Turkish immigrant children living in the Netherlands versus problem behaviour in Dutch children from the general population as reported by teachers. Method: Teacher's Report Forms (TRF) were filled out by Dutch teachers, and for a subsample also by Turkish immigrant teachers, concerning 524 Turkish immigrant children selected randomly from the immigrant population in two large cities in the Netherlands. TRFs completed for Turkish immigrant children were compared with TRFs filled out for 1625 children selected randomly from the Dutch general population. Results: No significant differences were revealed between children from both cultures on the TRF total problems, internalizing, externalizing and specific syndrome scales. Turkish immigrant teachers, however, reported higher total problems, internalizing and anxious/depressed scores for immigrant children than did Dutch teachers for the same immigrant children. Conclusion: No significant differences were found in the levels of behavioural and emotional problems reported by Dutch teachers for Turkish immigrant versus Dutch children. However, Turkish immigrant teachers reported high levels of anxiety and depression in immigrant children which go largely undetected by their Dutch teachers.
Symptoms of eating disorders in obsessive‐compulsive disorder
Authors: Grabe H. J. , Thiel A. , Freyberger H. J. 
Published: March 2003

Objective: Despite some empirical evidence suggesting an association between primary OCD and eating disorder (ED) within the ‘obsessive‐compulsive spectrum’, the relationship at a symptomatological level has not been investigated. Method: First, comparisons of Eating Disorder Inventory (EDI) scores between 61 patients with primary OCD and 288 control subjects were performed. Secondly, the associations between EDI subscores and Hamburg Obsessive‐Compulsive Inventory (HZI) dimensions in OCD patients were investigated by multiple regression analyses, controlling for the impact of general psychopathology. Results: The OCD patients showed significantly higher EDI‐scores than controls. However, only distinct OCD symptom dimensions were significantly associated with the core symptoms of ED in females. Conclusion: Our results point to a differential gender and symptom‐specific relationship between OCD and ED, calling into question a simple dimensional conceptualization of the ‘obsessive‐compulsive spectrum’.