bluuebunny/crossref_metadata_2025_split huggingface dataset:
Antidopaminergic effects of dietary tyrosine depletion in healthy subjects and patients with manic illness
Authors: McTavish S. F. B. , McPherson M. H. , Harmer C. J. , Clark L. , Sharp T. , Goodwin G. M. , Cowen P. J. 
Published: August 2002

BackgroundIn rats, amino acid mixtures lacking tyrosine and its precursor phenylalanine decrease the release of dopamine produced by the psychostimulant drug amphetamine. Amphetamine has been proposed as a model for clinical mania.AimsTo assess whether dietary tyrosine depletion attenuates the psychostimulant effects of methamphetamine in healthy volunteers and diminishes the severity of mania in acutely ill patients.MethodSixteen healthy volunteers received a tyrosine-free amino acid mixture and a control mixture in a double-blind crossover design 4 h before methamphetamine (0.15 mg/kg). Twenty in-patients meeting DSM–IV criteria for mania were allocated blindly and randomly to receive either the tyrosine-free mixture or the control mixture.ResultsThe tyrosine-free mixture lowered both subjective and objective measures of the psychostimulant effects of methamphetamine. Ratings of mania were lower in the patients who received the tyrosine-free mixture.ConclusionsDecreased tyrosine availability to the brain attenuates pathological increases in dopamine neurotransmission following methamphetamine administration and putatively in mania.
Mental health of migrant elders – the Islington study
Authors: Livingston G. , Leavey G. , Kitchen G. , Manela M. , Sembhi S. , Katona C. 
Published: August 2002

BackgroundIn the UK, 6% of those aged 65 years and over were born abroad, most of whom now live in inner-city areas. It has been suggested that ethnic elders are particularly vulnerable to mental illness.AimsTo compare the prevalence of dementia and depression in older migrants with those born in the UK.MethodA cross-sectional community study of 1085 people aged 65 years or older in an inner-London borough.ResultsCompared with those born in the UK, the prevalence of dementia was raised in African–Caribbeans (17.3%, relative risk=1.72, Cl=1.06–2.81) and lower for the Irish-born (3.6%, relative risk=0.36, Cl=0.17–0.87). All those of African–Caribbean country of birth were significantly younger (P=0.000) but no more likely to be taking antihypertensive drugs. They were no more likely to report having cardiovascular problems but had increased rates of diabetes (P < 0.0000). The overall prevalence of depression was 18.3% (95% Cl=16.1–20.7). The highest prevalence rate was found among those born in Greece and Turkey (27.2%, Cl=179–39.6). Migration per se does not appear to be a risk for depression and dementia in this population.ConclusionsThe excess of dementia may be of vascular aetiology. There is the potential for primary or secondary prevention.
Optimising antidepressant use in clinical practice: towards criteria for antidepressant selection
Authors: Mendlewicz Julien 
Published: August 2002

BackgroundCurrent treatment for depression in primary care and other out-patient settings demonstrates a pattern that is incongruous with the magnitude of the burden of depression suggested by its associated disability.AimsTo review important considerations in current depression treatment with a focus on antidepressant use.MethodFactors influencing the under treatment of depression in real-world settings are examined.ResultsPatient and clinician behaviour as well as the incentives created by the health care system affect the likelihood of realising effective antidepressant therapy in practice.ConclusionsGiven the complexities of clinical practice, selection criteria for an antidepressant should include safety, efficacy and tolerability, as well as the ability of the antidepressant to deliver real-world efficacy while balancing health care costs in the long term.
Antidepressant selection and economic outcome: a review of methods and studies from clinical practice
Authors: Crown William H. 
Published: August 2002

BackgroundEconomic considerations increasingly play a role in the selection of antidepressant drugs and are often based on analyses from prospective and retrospective studies. However, the non-randomisation found in retrospective studies may result in significant selection bias.AimsTo highlight the use of statistical methods in non-randomised studies and the application of those methods to economic analyses.MethodThe literature on the observational studies of economic outcomes with alternative antidepressants is reviewed and several statistical methodologies to control for biases that can occur in non-randomised study designs are described.ResultsIn comparisons of antidepressant drugs, differences in acquisition costs are consistently found to be at least offset by other components of care when broad measures of health care resource utilisation are considered.ConclusionsEconomic evaluations of antidepressants should be based on broad measures of health care expenditure and can rely on data generated in real-world settings if appropriate statistical methods are used to control for the potential biases of non-randomisation.
Clinical importance of long-term antidepressant treatment
Authors: Hirschfeld Robert M. A. 
Published: August 2002

BackgroundDepression, which only a few decades ago was considered to be a short-term illness requiring short-term treatment, is now recognised as a recurrent, sometimes chronic, long-term illness.AimsTo highlight the clinical importance of long-term antidepressant therapy in the treatment of depression.MethodThe current literature was reviewed to examine the relationship between duration of antidepressant therapy and efficacy.ResultsApproximately one-third to a half of patients successfully stabilised in acute-phase treatment will relapse if medication is not sustained throughout the continuation period. Only 10–15% will relapse if medication is continued. For maintenance-phase therapy, approximately 60% of patients at risk will experience a recurrent episode of depression within I year if untreated, whereas those who continue in treatment will have a recurrence rate of between 10% and 30%.ConclusionsRisk of relapse and recurrence of depression can be significantly reduced if adequate continuation and maintenance therapy durations are achieved.
Antidepressant use in clinical practice: efficacy v. effectiveness
Authors: Donoghue John , Hylan Timothy R. 
Published: August 2002

BackgroundAlthough the efficacy of antidepressants has been demonstrated in randomised, controlled clinical trials, it is how an antidepressant is used in clinical practice that determines its clinical effectiveness, or real-world efficacy.AimsTo explore the frequency with which antidepressants are used at adequate dose and duration to obtain remission of symptoms and prevent relapse in clinical practice and discuss potential implications for clinical outcomes.MethodStudies of antidepressant prescribing were reviewed and comparisons made between antidepressant classes and individual compounds within those classes.ResultsNaturalistic studies show that patients who begin therapy on tricyclic antidepressants often receive sub-therapeutic doses for inadequate duration; conversely patients who begin therapy on selective serotonin reuptake inhibitors more often receive an adequate dose of therapy for a longer duration.ConclusionsHow antidepressants are used in clinical practice can determine the clinical outcomes that are achieved. Antidepressants that are more forgiving of sub-optimal prescribing and use patterns by providers and patients, respectively, may help to improve real-world efficacy.
New insights into the role of the GABAA–benzodiazepine receptor in psychiatric disorder
Authors: Nutt David J. , Malizia Andrea L. 
Published: August 2002

BackgroundIn the 40 years since the first benzodiazepine was brought into clinical use there has been a substantial growth in understanding the molecular basis of action of these drugs and the role of their receptors in disease states.AimsTo present current knowledge about the role of the GABAA–benzodiazepine receptor in anxiety disorders, new insights into the molecular biology of the receptor complex and neuroimaging studies suggesting involvement of these receptors in disease states.MethodAn overview of published literature, including some recent data.ResultsThe molecular biology of this receptor is detailed. Molecular genetic studies suggesting involvement of the GABAA–benzodiazepine receptor in animal behaviour and learning are outlined; possible parallels with human psychopathology are discussed.ConclusionsCurrent insights into the role of the GABAA–benzodiazepine receptor in the action of benzodiazepines and as a factor in disease states, in both animals and humans, may lead to new, more sophisticated interventions at this receptor complex and potentially significant therapeutic gains.
Velo-cardio-facial syndrome: a model for understanding the genetics and pathogenesis of schizophrenia
Authors: Murphy K. C. , Owen M. J. 
Published: August 2002

BackgroundIndividuals with velocardio-facial syndrome (VCFS), a genetic disorder associated with microdeletions of chromosome 22q11, are reported to have high rates of psychiatric disorder, particularly schizophrenia.AimsTo review the evidence for an association between VCFS and schizophrenia: to outline recent neuropsychological, neuroanatomical and genetic studies of individuals with VCFS; and to make recommendations for future work.MethodA selective literature review was undertaken.ResultsIndividuals with VCFS have high rates of psychotic disorders, particularly schizophrenia. In addition, specific neuropsychological and neuroanatomical abnormalities have been reported although it is unclear whether such abnormalities relate to the presence of psychiatric disorder in affected individuals.ConclusionsDeletion of chromosome 22q11 represents one of the highest known risk factors for the development of schizophrenia. It is likely that haploinsufficiency (reduced gene dosage) of a neurodevelopmental gene or genes mapping to chromosome 22q11, leading to disturbed neuronal migration, underlies susceptibility to psychosis in VCFS.
Signs of asphyxia at birth and risk of schizophrenia
Authors: Dalman Christina , Thomas Hollie V. , David Antony S. , Gentz Johan , Lewis Glyn , Allebeck Peter 
Published: August 2002

BackgroundPrevious research has found an association between obstetric complications and schizophrenia, but in many studies the sample size was limited, and no assessment of specific exposures was possible.AimsTo assess the role of different complications, and in particular to distinguish between disordered foetal development and hypoxia at birth.MethodFrom the Stockholm County In-Patient Register and community registers, we identified 524 cases of schizophrenia and 1043 controls, matched for age, gender, hospital and parish of birth. Data on obstetric complications were obtained from birth records.ResultsThere was a strong association between signs of asphyxia at birth and schizophrenia (OR 4.4; 95% C11.9–10.3) after adjustment for other obstetric complications, maternal history of psychotic illness and social class.ConclusionsSigns of asphyxia at birth are associated with an increased risk of schizophrenia in adults.
Obstetric complications and risk of schizophrenia
Authors: Thomas Hollie V. , Dalman Christina , David Anthony S. , Gentz Johan , Lewis Glyn , Allebeck Peter 
Published: August 2002

BackgroundObstetric complications have been studied frequently as possible risk factors for schizophrenia.AimsTo test the hypotheses that individual obstetric complications are most strongly associated with an increased risk of schizophrenia in males, in patients with an early age at first diagnosis and in subjects with a maternal history of psychosis.MethodCases of schizophrenia diagnosed between January 1971 and June 1994 were identified in the Stockholm County In-Patient Register. Controls were matched on age, gender, hospital of birth and parish of birth. Obstetric data were recorded blind to case–control status for 524 cases and 1043 controls.ResultsThis study did not find any large or consistent effect of gender, age at diagnosis or maternal history of psychosis on the risk of schizophrenia associated with individual complications.ConclusionsFuture studies should examine these effects using a much larger sample that includes patients with schizophrenia and control subjects whose genetic risk of schizophrenia has been assessed accurately.
Shortfall in mental health service utilisation
Authors: Andrews Gavin , Issakidis Cathy , Carter Greg 
Published: August 2002

BackgroundTreatment coverage for mental disorders is poor in most developed countries.AimsTo explore some reasons for the poor treatment coverage for mental disorders in developed countries.MethodData were taken from Australian national surveys and from the World Health Report.ResultsOnly one-third of people with a mental disorder consulted. Probability of consulting varied by diagnosis: 90% for schizophrenia, which is accounted for by external factors; 60% for depression; and 15% for substance use and personality disorders. The probability of consulting varied by gender, age, marital status and disability, from 73% among women aged 25–54 years, disabled and once married to 9% among males without these risk factors. Those who did not consult but were disabled or comorbid said that they “preferred to manage themselves”. Data from five countries showed no evidence that overall health expenditure, out-of-pocket cost or responsiveness of the health system affected the overall consulting rates.ConclusionsSocietal, attitudinal and diagnostic variables account for the variation. Funding does not. Public education about the recognition and treatment of mental disorders and the provision of effective treatment by providers might remedy the shortfall.
On becoming depressed or anxious in late life: similar vulnerability factors but different effects of stressful life events
Authors: De Beurs Edwin , Beekman Aartjan , Geerlings Sandra , Deeg Dorly , Van Dyck Richard , Van Tilburg Willem 
Published: August 2002

BackgroundLittle research has been done on the uniqueness of risk profiles for depression and anxiety in late life.AimsDelineating risk factors for the decline of mental health in older persons, comparing risk profiles for developing symptoms of pure depression, pure anxiety and both anxiety and depression in a prospective design.MethodSelf-Report data on depression and anxiety were collected from community-dwelling older respondents (⩾55 years) on two occasions, 3 years apart. Data from emotionally healthy respondents (n=1810) were used to investigate the effects of long-standing vulnerability factors and stressful life events.ResultsAfter 3 years 9% of the subjects had scored beyond the thresholds for symptoms. Vulnerability for depression and anxiety was quite similar, but life events differed: onset of depression was predicted by death of a partner or other relatives; onset of anxiety was best predicted by having a partner who developed a major illness. No support for moderator effects between vulnerability factors and stress was found; the effects were purely additive.ConclusionsDepression and anxiety have many risk factors in common, but specific risk factors also were found, especially in subjects developing both depression and anxiety.
Nicotine, alcohol and drug dependence and psychiatric comorbidity
Authors: Farrell Michael , Howes Samantha , Bebbington Paul , Brugha Traolach , Jenkins Rachel , Lewis Glyn , Marsden John , Taylor Colin , Meltzer Howard 
Published: August 2002

BackgroundThere is a well-recognised relationship between substance use disorders and other psychiatric disorders. This relationship has been well documented in a range of population-based studies.AimsThis study aims to report on consumption patterns of and dependence on nicotine, alcohol and non-prescribed drugs and to report on the levels of psychiatric morbidity in these groups.MethodA national household study of psychiatric morbidity was conducted in England and Wales. Psychiatric assessment was based on the Clinical Interview Schedule – Revised (CIS–R). Measures of nicotine, alcohol and drug use and dependence were obtained. This paper compares the levels of psychiatric morbidity in the non-dependent and the nicotine-, alcohol— and drug-dependent cases.ResultsTwelve per cent of the non-dependent population were assessed as having any psychiatric disorder compared with 22% of the nicotine-dependent, 30% of the alcohol-dependent and 45% of the drug-dependent population.ConclusionsThere is a clear relationship between dependence on nicotine, alcohol and drugs and other psychiatric morbidity.
Cause-specific mortality in psychiatric patients after deinstitutionalisation
Authors: Hansen Vidje , Jacobsen Bjarne K. , Arnesen Egil 
Published: August 2002

BackgroundSince the late 1970s, the psychiatric service system in Norway has been changed gradually according to the principles of deinstitutionalisation.AimsTo document the mortality of psychiatric patients in a deinstitutionalised service system.MethodsThe case register of a psychiatric hospital covering the period 1980–1992 was linked to the Central Register of Deaths. Age-adjusted death rates and standardised mortality ratios (SMRs) were computed.ResultsPatients with organic psychiatric disorders had significantly higher mortality regardless of cause of death. SMRs ranged from 0.9 for death by cancer in women to 36.3 for suicide in men. For unnatural death, SMRs were highest in the first year after discharge. Compared to the periods 1950–1962 and 1963–1974, there has been an increase in SMRs for cardiovascular death and suicide in both genders.ConclusionsDeinstitutionalisation seems to have had as its cost a relative rise both in cardiovascular death and unnatural deaths for both genders, but most pronounced in men.
Features of childhood sexual abuse and the development of psychiatric and substance use disorders
Authors: Bulik Cynthia M. , Prescott Carol A. , Kendler Kenneth S. 
Published: August 2002

BackgroundChildhood sexual abuse (CSA) is associated with an increased risk of subsequent psychiatric disorders.AimsTo explore the risk associated with features of CSA and examine whether specific associations exist between particular profiles of CSA and the development of specific syndromes.MethodIn a population-based sample of adult female twins, we used logistic regression to explore the association between features of CSA (reported by the twin and her co-twin) and lifetime major depression, generalised anxiety disorder, bulimia nervosa, panic disorder and alcohol and drug dependence.ResultsIn univariate and stepwise multiple regressions, patterns of predictors differed, although not significantly, across diagnoses. Greater risk was associated with attempted or completed intercourse, the use of force or threats, abuse by a relative, and a negative response by someone who was told about the abuse. Similar patterns were observed with co-twin reports.ConclusionsSpecific features of CSA differentially increase risk of later psychopathology; however, there do not appear to be unique predictive relationships between features of CSA and the emergence of specific psychiatric disorders.
Birth weight and the risk of depressive disorder in late life
Authors: Thompson Christopher , Syddall Holly , Rodin Ian , Osmond Clive , Barker David J. P. 
Published: August 2002

BackgroundLow birth weight is a risk factor for coronary heart disease, diabetes, stroke and hypertension. Depression is highly associated with these conditions.AimsTo examine the association between birth weight and depression in late life.MethodA total of 882 singleton term births in the 1920s had contemporary records of birth weight and weight at 1 year. At 68 years all completed the Geriatric Depression Scale and 867 completed the Geriatric Mental State Examination. A logistic regression was used to analyse the associations between depression, birth weight and weight at 1 year while adjusting for known risk factors.ResultsCurrent social class, social class at birth, recent bereavement, social isolation and physical illness increased the risk of depression. After adjusting for these and weight at 1 year, the odds ratios for depression among men, but not women, rose incrementally with decreasing birth weight (1.0, 12.8; for continuous variable,P< 0.007).ConclusionsFoetal undernutrition predisposes men to depression in late adult life. If replicated, these results would suggest a neurodevelopmental aetiology of depression, possibly mediated by programming of the hypothalamic–pituitary–adrenal axis.
Reducing demands on clinicians by offering computer-aided self-help for phobia/panic
Authors: Kenwright Mark , Liness Sheena , Marks Isaac 
Published: August 2002

BackgroundMany patients with phobia/panic find it hard to access effective treatment.AimsTo test the feasibility of computer-guided exposure therapy for phobia/panic.MethodSelf-referrals were screened for 20 min and, if suitable, had six sessions of computer-guided self-help (from a system called Fear Fighter). Pre— and post-treatment ratings of 54 patients were compared with those of 31 similar out-patients with phobia/panic who received the same treatment guided by a clinician.ResultsAt pre-treatment, computer-guided cases were slightly less severe than clinician-guided patients. In a post-treatment intent-to-treat analysis, both groups improved comparably but computer-guided patients spent 86% less time with a clinician than did purely clinician-guided patients, who had no access to the computer system.ConclusionsComputer-guided self-exposure therapy appeared feasible and effective for self-referrals and saved much clinician time. A controlled study is now needed.
Cycle of child sexual abuse: Links between being a victim and becoming a perpetrator
Authors: Glasser M. , Kolvin I. , Campbell D. , Glasser A. , Leitch I. , Farrelly S. 
Published: August 2002

BackgroundThere is widespread belief in a ‘cycle’ of child sexual abuse, but little empirical evidence for this belief.AimsTo identify perpetrators of such abuse who had been victims of paedophilia and/or incest, in order to: ascertain whether subjects who had been victims become perpetrators of such abuse; compare characteristics of those who had and had not been victims; and review psychodynamic ideas thought to underlie the behaviour of perpetrators.MethodRetrospective clinical case note review of 843 subjects attending a specialist forensic psychotherapy centre.ResultsAmong 747 males the risk of being a perpetrator was positively correlated with reported sexual abuse victim experiences. The overall rate of having been a victim was 35% for perpetrators and 11 % for non-perpetrators. Of the 96 females, 43% had been victims but only one was a perpetrator. A high percentage of male subjects abused in childhood by a female relative became perpetrators. Having been a victim was a strong predictor of becoming a perpetrator, as was an index of parental loss in childhood.ConclusionsThe data support the notion of a victim-to-victimiser cycle in a minority of male perpetrators but not among the female victims studied. Sexual abuse by a female in childhood may be a risk factor for a cycle of abuse in males.