bluuebunny/crossref_metadata_2025_split huggingface dataset:
Prodromes, coping strategies and course of illness in bipolar affective disorder – a naturalistic study
Authors: LAM D. , WONG G. , SHAM P. 
Published: October 2003

Background. Psychosocial interventions for bipolar patients often include teaching patients to recognize prodromal symptoms and tackle them early. This prospective study set out to investigate which bipolar prodromal symptoms were reported frequently and reliably over a period of 18 months. Furthermore, we have also investigated which types of coping strategies were related to good outcome.Method. Forty bipolar patients were interviewed for their bipolar prodromal symptoms and their coping strategies at recruitment and 18 months later. Patients were also assessed as to whether they had experienced relapses.Results. Bipolar patients were able to report bipolar prodromal symptoms reliably. Mania prodromal symptoms tended to be behavioural symptoms. A quarter of patients reported difficulties in detecting depression prodromes, which tended to be more diverse and consisted of a mix of behavioural, cognitive and somatic symptoms. Significantly fewer patients who reported the use of behavioural coping strategies to curb excessive behaviour during the mania prodromal stage experienced a manic episode. Similarly, significantly fewer patients who reported the use of behavioural coping strategies experienced depression relapses. How well patients coped with mania prodromes predicted bipolar episodes significantly when the mood levels at baseline were controlled. Ratings of how well subjects coped with mania prodromal symptoms also predicted manic symptoms significantly at T2 when manic symptom at T1 was controlled.Conclusion. Our study suggests that bipolar patients are able to report prodromal symptoms reliably. It is advisable to teach patients to monitor their moods systematically and to promote good coping strategies.
Sex differences in genetic and environmental risk factors for irrational fears and phobias
Authors: KENDLER K. S. , JACOBSON K. C. , MYERS J. , PRESCOTT C. A. 
Published: October 2003

Background. For irrational fears and their associated phobias, epidemiological studies suggest sex differences in prevalence and twin studies report significant genetic effects. How does sex impact on the familial transmission of liability to fears and phobias?Methods. In personal interviews with over 3000 complete pairs (of whom 1058 were opposite-sex dizygotic pairs), ascertained from a population-based registry, we assessed the lifetime prevalence of five phobias and their associated irrational fears analysed using a multiple threshold model. Twin resemblance was assessed by polychoric correlations and biometrical model-fitting incorporating sex-specific effects.Results. For agoraphobia, situational and blood/injury fear/phobia, the best fit model suggested equal heritability in males and females and genetic correlations between the sexes of less than +0·50. For animal fear/phobias by contrast, the best fit model suggested equal heritability in males and females and a genetic correlation of unity. No evidence was found for an impact of family environment on liability to these fears or phobias. For social phobias, twin resemblance in males was explained by genetic factors and in females by familial–environmental factors.Conclusion. The impact of sex on genetic risk may differ meaningfully across phobia subtypes. Sex-specific genetic risk factors may exist for agoraphobia, social, situational and blood-injury phobias but not for animal fear/phobia. These results should be interpreted in the context of the limited power of twin studies, even with large sample sizes, to resolve sex-specific genetic effects.
Early detection of isolated memory deficits in the elderly: the need for more sensitive neuropsychological tests
Authors: DE JAGER C. A. , MILWAIN E. , BUDGE M. 
Published: October 2003

Background. Early detection of cognitive decline in the elderly is important because this may precede progression to Alzheimer's disease. The aim of this study was to see whether sensitive neuropsychological tests could identify pre-clinical cognitive deficits and to characterize the cognitive profile of a subgroup with poor memory.Methods. A neuropsychological test battery was administered to a community-dwelling sample of 155 elderly volunteers who were screened with CAMCOG at enrolment (mean age 74·7 years). The battery included tests of episodic memory, semantic and working memory, language and processing speed.Results. Episodic memory test z scores below 1 S.D. from the cohort mean identified 25 subjects with ‘non-robust’ memory performance. This group was compared to the remaining ‘robust memory’ group with a General Linear Model controlling for age, IQ, education and gender. Test performance was significantly different in all tests for episodic and semantic memory, but not in tests for working memory, processing speed and language. CANTAB paired associates learning and spatial recognition tests identified the highest percentages of those in the ‘non-robust memory’ group. Processing speed partialled out the age effect on memory performance for the whole cohort, but the ‘non-robust memory’ group's performance was not associated with age or processing speed.Conclusions. Sensitive neuropsychological tests can detect performance below the norm in elderly people whose performance on MMSE and CAMCOG tests is well within the normal range. Age-related decline in memory performance in a cohort of the elderly may be largely due to inclusion within the cohort of individuals with undetected pre-clinical Alzheimer's disease or isolated memory impairment.
Elasticity and confabulation in schizophrenic delusions
Authors: SIMPSON JANE , DONE D. JOHN 
Published: October 2003

Background. This experiment examines two aspects of delusional cognition that have been reported clinically but not investigated empirically. These are the incorporation of potentially conflicting information into the recall of delusion-related scripts and the type and amount of material produced additional to that presented for recall, referred to here as confabulation.Methods. Three groups of patients – deluded schizophrenics, non-deluded schizophrenics and matched non-psychiatric controls – were asked to recall two 15-item scripts, which comprised 10 typical and five atypical components. It was hypothesized that deluded subjects whose delusion was relevant to one of the scripts would recall more of the atypical components of the script and would also be less likely to make script-atypical confabulations in the recall of this particular script.Results. Recall was assessed for the amount and type of content remembered and the amount and type of confabulation. The results did not support the hypothesis that atypical items would be incorporated into the recall of delusion-relevant material. However, deluded subjects did retain their schema boundaries in the recall of script items relevant to their own delusion but were less able to adhere to a script framework in the recall of material unrelated to their delusion.Conclusions. These results are discussed within a schema specific account of delusions, which conceptualizes the delusion as an overused schema whose preferential use leads to a failure to develop other scripts but whose own contents remain well-defined.
Neuroticism, major depression and gender: a population-based twin study
Authors: FANOUS A. , GARDNER C. O. , PRESCOTT C. A. , CANCRO R. , KENDLER K. S. 
Published: October 2003

Background. A portion of the genetic risk factors for the personality trait neuroticism (N) may also increase risk for major depression (MD). Females have both higher levels of N and higher rates of MD than males, suggesting that these traits may be more genetically correlated in females.Methods. Structured interviews, including a lifetime assessment for MD by DSM-III-R criteria, were administered to 863 male–male MZ (monozygotic), 649 male–male DZ (dizygotic), 506 female–female MZ, 345 female–female DZ, and 1408 opposite-sex twin pairs. N was assessed using the short-form of the Eysenck Personality Questionnaire. A sex-limited Cholesky model was fitted which allowed us to decompose into additive genetic, common environmental, and individual-specific environmental components two main classes of correlations: within-sex between-variable and between-sex within-variable.Results. Our best-fitting model contained only additive genetic and individual-specific environmental factors for both N and MD. The within-sex genetic correlations between N and MD were estimated at +0·68 in men and +0·49 in women. This model fitted only slightly better than one in which the N–MD within-sex genetic correlation was constrained to be equal across the sexes, and estimated at +0·55. There may be sex-specific genes influencing both N and MD.Conclusion. Our best-fitting model failed to establish a significant sex difference in the genetic correlation between N and MD. These results, as well as evidence for sex-specific genetic factors for both traits, have implications for the diagnosis, classification, and treatment of the affective disorders, and molecular genetic approaches to the study of these traits.
Implicit memory for words presented in short texts is preserved in Alzheimer's disease
Authors: CAMUS J.-F. , NICOLAS S. , WENISCH E. , MORRONE I. , BLANCHARD F. , BAKCHINE S. 
Published: October 2003

Background. The level of efficiency of implicit memory in Alzheimer's disease remains unclear as previous studies using stem completion tasks have led to contradictory results.Method. The present study used target words embedded in significant short texts that subjects were required to read aloud (i.e. to enhance semantic processing). Texts were presented in two perceptual situations: ‘simple’ (blank spaces delimitating words) and ‘complex’ (spaces were filled by ‘8’s). In the completion phase, patients had to write the first word that came to mind in order to complete a three-letter stem. The recognition phase explored explicit memory performance. The performance of 24 Alzheimer patients was compared to a matched sample of healthy controls.Results. Reading times differed between groups and were shorter for healthy controls. Recognition was dramatically lower in patients, thus confirming the alteration of explicit memory in this pathology. However, a significant priming effect (e.g. the tendency to complete the stem with the aid of a previously explored word) was present in both groups and did not differ between patients and healthy controls.Conclusions. The absence of a correlation between priming and recognition scores suggests that this result cannot be explained by an explicit memory bias. Moreover, as the priming level was identical whatever the perceptual aspect of the text, we suggest that the priming effect is not only mediated by perceptual processes but also by lexical and conceptual processes, which to some extent are preserved during the light and moderate stages of this disease.
Remission and recurrence of depression in the maintenance era: long-term outcome in a Cambridge cohort
Authors: KENNEDY N. , ABBOTT R. , PAYKEL E. S. 
Published: October 2003

Background. Long-term studies of severe depression have described high rates of non-recovery, recurrence, chronic incapacity and mortality. A more recent cohort was followed-up to ascertain whether the course had improved given developments in pharmacological and psychological treatments in the last 15 years.Method. Subjects from a cohort of 70 mainly severe recurrent depressives originally recruited to a shorter follow-up study from 1990–1992 were followed-up after 8–11 years. Data included longitudinal information on course of depression and other psychiatric disorders, pharmacological and psychological treatment and social functioning during follow-up.Results. Sixty-nine (99%) subjects were successfully followed-up, with 61 of 66 living subjects interviewed and detailed follow-up data obtained in total on 65. Sixty (92%) of 65 subjects recovered during follow-up, with two-thirds subsequently suffering a recurrence. Eleven (17%) suffered from an episode of chronic depression of at least 2 years duration during follow-up. Social function at follow-up was good and there were high levels of pharmacological and psychological treatment. Greater severity of illness was the most consistent predictor of poor outcome. Times to recovery and recurrence and recovery and recurrence rates were very similar to older studies.Conclusions. The long-term outcome of depression still shows high recurrence rates and does not appear to have changed in the last 20 years.
Behavioural factors associated with symptom outcomes in a primary care-based depression prevention intervention trial
Authors: LUDMAN E. , KATON W. , BUSH T. , RUTTER C. , LIN E. , SIMON G. , VON KORFF M. , WALKER E. 
Published: October 2003

Background. A randomized trial of a primary care-based intervention to prevent depression relapse resulted in improved adherence to long-term antidepressant medication and depression outcomes. We evaluated the effects of this intervention on behavioural processes and identified process predictors of improved depressive symptoms.Method. Patients at high risk for depression recurrence or relapse following successful acute phase treatment (N=386) were randomly assigned to receive a low intensity 12-month intervention or continued usual care. The intervention combined education about depression, shared decision-making regarding use of maintenance pharmacotherapy and cognitive-behavioural strategies to promote self-management. Baseline, 3, 6, 9 and 12-month interviews assessed patients' self-care practices, self-efficacy for managing depression and depressive symptoms.Results. Intervention patients had significantly greater self-efficacy for managing depression (P<0·01) and were more likely to keep track of depressive symptoms (P<0·0001), monitor early warning signs (P<0·0001), and plan for coping with high risk situations (P<0·0001) at all time points compared to usual care control patients. Self-efficacy for managing depression (P<0·0001), keeping track of depressive symptoms (P=0·05), monitoring for early warning signs (P=0·01), engaging in pleasant activities (P<0·0001) and engaging in social activities (P<0·0001) positively predicted improvements in depression symptom scores.Conclusions. A brief intervention designed to target cognitive-behavioural factors and promote adherence to pharmacotherapy in order to prevent depression relapse was highly successful in changing several behaviours related to controlling depression. Improvements in self-efficacy and several self-management behaviours that were targets of the intervention were significantly related to improvements in depression outcome.
Internally-generated activity, non-episodic memory, and emotional salience in sleep
Authors: Bednar James A. 
Published: October 2003

(1) Substituting (as Solms does) forebrain for brainstem in the search for a dream “controller” is counterproductive, since a distributed system need have no single controller. (2) Evidence against episodic memory consolidation does not show that REM sleep has no role in other types of memory, contra Vertes & Eastman. (3) A generalization of Revonsuo's “threat simulation” model in reverse is more plausible and is empirically testable.[Hobson et al.; Solms; Revonsuo; Vertes & Eastman]
The case against memory consolidation in REM sleep: Balderdash!
Authors: Fishbein William 
Published: October 2003

Unfortunately, some researchers think a good scientific theory is one that has been repeatedly confirmed, and a bad theory is one that has not received consistent confirmation. However, confirmation of a theory depends on the extent to which a hypothesis exposes itself to disconfirmation. One confirmation of a highly specific, falsifiable experiment can have a far greater impact than the disconfirmation of twenty experiments that are virtually unfalsifiable. This commentary (1) counteracts misleading biases regarding the REM sleep/memory consolidation theory, and (2) demonstrates how chaotic cerebral activation during sleep is an essential component of long-term memory storage processes.[Vertes & Eastman]
hreat simulation, dreams, and domain-specificity
Authors: Shackelford Todd K. , Weekes-Shackelford Viviana A. 
Published: October 2003

According to Revonsuo, dreams are the output of a evolved “threat simulation mechanism.” The author marshals a diverse and comprehensive array of empirical and theoretical support for this hypothesis. We propose that the hypothesized threat simulation mechanism might be more domain-specific in design than the author implies. To illustrate, we discuss the possible sex-differentiated design of the hypothesized threat simulation mechanism.[Revonsuo]
Communication in Internet message boards
Authors: Lewin Beverly A. , Donner Yonatan 
Published: October 2003

A quantitative analysis of usage in Computer-Mediated Conversation (CMC).While commentators as ‘early’ as 1984 were predicting that the “organizational, social, and personal effects of computers will be deeply felt”, they could only speculate on the strength of its impact. As this account was being written, at the end of 2001, the effects of Computer-Mediated Communication (CMC) were fast overtaking our poor ability to measure them. There are many ways to communicate through computers: Usenet newsgroups, mailing lists, and message boards, which allow users to discuss specific topics with each other. (The term CMC allows for the possibility that some methods of communication, e.g., “chat rooms”, will not meet the definition of ‘mail’. The most popular method of CMC is e-mail. For those who have internet access, CMC is often their preferred choice of indirect (i.e., non face-to-face) communication, thanks to its speed, efficiency, and flexibility. Perhaps for these reasons, e-mail has already overtaken the telephone as the primary means of business communication.
ECONOMIC EVALUATION OF A NURSING-LED INTERMEDIATE CARE UNIT
Authors: Richardson Gerald , Griffiths Peter , Wilson-Barnett Jenifer , Spilsbury Karen , Batehup Lynn 
Published: October 2003

Objective: The aim of this paper is to examine the costs of introducing a nursing-led ward program together with examining the impact this may have on patients' outcomes.Methods: The study had a sample size of 177 patients with a mean age of 77, and randomized to either a treatment group (care on a nursing-led ward, n = 97) or a control group (standard care usually on a consultant-led acute ward, n = 80). Resource use data including length of stay, tests and investigations performed, and multidisciplinary involvement in care were collected.Results: There were no significant differences in outcome between the two groups. The inpatient costs for the treatment group were significantly higher, due to the longer length of stay in this group. However, the postdischarge costs were significantly lower for the treatment group.Conclusions: The provision of nursing-led intermediate care units has been proposed as a solution to inappropriate use of acute medical wards by patients who require additional nursing rather than medical care. Whether the treatment group is ultimately cost-additive is dependent on how long reductions in postdischarge resource use are maintained.
A FALLACY OF THE MULTIPLICATIVE QALY MODEL FOR LOW-QUALITY WEIGHTS IN STUDENTS AND PATIENTS JUDGING HYPOTHETICAL HEALTH STATES
Authors: Stalmeier Peep F. M. , Chapman Gretchen B. , de Boer Angela G. E. M. , van Lanschot Jan J. B. 
Published: October 2003

Objectives: In quality-adjusted life-years (QALY) models, it is customary to weigh life-years with quality of life via multiplication. As a consequence, for positive health states a longer duration has more QALYs than a shorter duration (i.e., longer is better). However, we have found that for poor health states, many prefer to live only a limited amount of time (i.e., longer is worse). Such preferences are said to be maximum endurable time (MET). In the present contribution, the following questions are asked: a) How low does the utility have to be in order for a MET to arise? and b) Do MET preferences occur when patients judge hypothetical health states?Methods and Results: We reanalyzed data from 176 students for the hypothetical health states of “living with migraines” and “living with metastasized cancer.” For utilities smaller than 0.7 (ranging from 0 to 1), the MET preference rate was larger than 50%. High MET preference rates were also found in two new studies on migraine and esophageal cancer patients, who evaluated hypothetical health states related to their disease.Conclusions: We discuss the interpretation of the MET preferences and the preference reversal phenomenon. Standard QALY models imply that longer is better. However, we find that more often, longer is worse for poorly evaluated health states. Consider the following question: are 3 years with a weight of 0.3 equally as valuable as 1 year with a weight of 0.9? Our results suggest that the 3-year period may be less valuable because for poor health, many will prefer a 1-year over a 3-year period.
COST CONSEQUENCES OF SENTINEL LYMPH NODE BIOPSY IN THE TREATMENT OF BREAST CANCER
Authors: Chirikos Thomas N. , Berman Claudia G. , Luther Stephen L. , Clark Robert A. 
Published: October 2003

Objectives: To assess whether sentinel lymph node biopsy (SLNB), an alternative to axillary lymph node dissection in treating female breast cancer, affords any cost savings.Methods: We profile cumulative treatment costs of 811 breast cancer patients, 555 of whom received SLNB. Univariate and multivariate statistical tests are used to appraise whether these cost profiles differ between SLNB and other patients.Results: The statistical results are mixed. However, none supports the conjecture that SLNB necessarily lowers the cost of treating the average breast patient.Conclusions: SLNB may be cost-effective, but longer term costs and outcomes must be estimated before firm conclusions can be reached.
EFFECT OF INCLUDING (VERSUS EXCLUDING) FATES WORSE THAN DEATH ON UTILITY MEASUREMENT
Authors: Franic Duska M. , Pathak Dev S. 
Published: October 2003

Objectives: Most studies typically measure health preferences excluding health states perceived as worse than death. The objective of this study is to test the impact of including (versus excluding) health states perceived to be worse than death on utility measurementusing standard gamble (SG) and visual analogue scale (VAS) methods.Methods: By means of a cross-sectional descriptive study design, women were asked to rate the utility of three hypothetical breast cancer health states: cure, treatment, and recurrence (n=119). Preference weights were estimated, allowing for negative utilities with death (perfect health) scaled at zero (1.0).Results: Unpaired t-test analysis showed significantly greater change in SG and VAS weights for individuals perceiving cancer recurrence as worse than death than those perceiving death as least desirable state. Excluding negative utilities from the study resulted in significantly smaller changes in utility. Study results show that preference elicitation methods can be successfully adapted to acquire negative utilities.Conclusions: Changes in utility were greater when negative preferences were permitted. Addressing negative preference scores could significantly affect quality adjusted life year estimates in economic analyses.