bluuebunny/crossref_metadata_2025_split huggingface dataset:
Meta-analysis of randomised controlled trials of fluoxetine v. placebo and tricyclic antidepressants in the short-term treatment of major depression
Authors: Bech P. , Cialdella P. , Haugh M. C. , Birkett M. A. , Hours A. , Boissel J. P. , Tollefson G. D. 
Published: August 2002

BackgroundPrevious meta-analyses of fluoxetine as an antidepressant have many methodological problems, including diagnosis of major depression, validity of outcome measures and lack of intention-to-treat analyses.AimsTo provide an estimate of the effect of fluoxetine compared with placebo and tricyclic antidepressants (TCAs), and to investigate reasons for early discontinuation from acute treatment.MethodRandomised trials were analysed using both intention-to-treat, efficacy and end-point.ResultsFluoxetine was superior to placebo but effect size was low. In trials comparing fluoxetine v. TCA, the results for all trials and for the USA trials showed a trend in favour of fluoxetine. Those for the non-USA trials showed a trend in favour of TCA. When combined, the results showed that significantly fewer patients on fluoxetine discontinued treatment because of adverse events.ConclusionFluoxetine is superior to placebo, irrespective of the analytical approach use, whereas the results obtained v. TCAs depend on the approach used. Hence, the results should be interpreted in this light.
Sixteen-year mortality in patients with affective disorder commenced on lithium
Authors: Brodersen A. , Licht R. W. , Vestergaard P. , Olesen A. V. , Mortensen P. B. 
Published: August 2002

BackgroundLithium treatment is claimed to reduce mortality in patients with affective disorder, but the evidence is conflicting.AimTo estimate mortality rates from a cohort of patients with affective disorder commenced on lithium with an observation period of two years and a follow-up after 16 years.MethodThe mortality rates of patients were compared with those of the general Danish population, standardised for age, gender and calendar time with respect to death from all causes, suicide and death from cardiovascular disease.ResultsForty of the study's 133 patients died during the 16-year observation period (11 from suicide). Mortality among patients commenced on lithium was twice that of the general population. The statistically significantly elevated mortality was due largely to an excess of suicides; mortality from all other causes was similar to the background populations. Thirty-two patients died after the first two years of observation and were included in the analysis of the association between death and treatment compliance. Suicide occurred more frequently among those patients not complying with treatment.ConclusionMortality, especially suicide, was significantly increased in unselected patients with affective disorder commenced on lithium relative to the general population.
Complementary approaches to the assessment of personality disorder
Authors: Hill Jonathan , Fudge Hazel , Harrington Richard , Pickles Andrew , Rutter Michael 
Published: August 2002

BackgroundCurrent concepts and measures of personality disorder are in many respects unsatisfactory.AimsTo establish agreement between two contrasting measures of personality disorder, and to compare subject–informant agreement on each. To examine the extent to which trait abnormality can be separated from interpersonal and social role dysfunction.MethodFifty-six subjects and their closest informants were interviewed and rated independently. Personality functioning was assessed using a modified Personality Assessment Schedule (M–PAS), and the Adult Personality Functioning Assessment (APFA).ResultsSubject–informant agreement on the M–PAS was moderately good, and agreement between the M–PAS and the APFA, across and within subjects and informants, was comparable to that for the M–PAS. This was equally the case when M–PAS trait plus impairment scores and trait abnormality scores were used.ConclusionsThe M–PAS and the APFA are probably assessing similar constructs. Trait abnormalities occur predominantly in an interpersonal context and could be assessed within that context.
How mental illness is portrayed in children's television
Authors: Wilson Claire , Nairn Raymond , Coverdale John , Panapa Aroha 
Published: August 2002

BackgroundThere are no published studies concerning the depiction of mental illness in children's television programmes.AimsTo determine whether mental illness was depicted in children's television.MethodSample of one complete week of children's television (57 hours, 50 minutes; 128 series episodes: 69 cartoon animations, 12 non-cartoon animations, 47 real life) provided for children under the age of 10 years. Disclosure analysis of portrayals of mental illness through repeated viewings identified patterns in the use of linguistic, semiotic and rhetorical resources.ResultsOf the 128 episodes, 59 (46%) contained one or more references to mental illness, predominantly in cartoons (n=47, 80%) compared with other episode types (χ2=17.1, d.f.=2, P<0.05). Commonly occurring terms such as ‘crazy’ (n=28), ‘mad’ (n=19) and ‘losing your mind’ (n=13) were employed to denote loss of control. The six consistently mentally ill characters were almost entirely devoid of admirable attributes.ConclusionYoung viewers are being socialised into stigmatising conceptions of mental illness.
Camberwell Assessment of Need for the Elderly (CANE)
Authors: Reynolds Tom , Thornicroft Graham , Abas Melanie , Woods Bob , Hoe Juanita , Leese Morven , Orrell Martin 
Published: August 2002

BackgroundThere exists no instrument specifically designed to measure comprehensively the needs of older people with mental disorders.AimTo develop such an instrument which would take account of patients', staff and carers' views on needs.MethodFollowing an extensive development process, the assessment instrument was subjected to a test–retest and interrater reliability study, while aspects of validity were addressed both during development and with data provided by sites in the UK, Sweden and the USA.ResultsThe Camberwell Assessment of Need for the Elderly (CANE) comprises 24 items (plus two items for carer needs), and records staff, carer and patient views. It has good content, construct and consensual validity. It also demonstrates appropriate criterion validity. Reliability is generally very high: κ > 0.85 for all staff ratings of interrater reliability. Correlations of interrater and test–retest reliability of total numbers of needs identified by staff were 0.99 and 0.93, respectively.ConclusionsThe psychometric properties of the CANE seem to be highly acceptable. It was easily used by a wide range of professionals without formal training.
Three-year prognosis of depression in the community-dwelling elderly
Authors: Denihan Aisling , Kirby Michael , Bruce Irene , Cunningham Conal , Coakley Davis , Lawlor Brian A. 
Published: August 2002

BackgroundDepression is the most common mental disorder in the community-dwelling elderly.AimsTo determine the three-year prognosis of depression in a cohort of 127 community-dwelling elderly subjects and identify factors relevant to outcome.MethodThe subjects, diagnosed depressed at year 0 using the GMS–AGECAT package, were followed up three years later. A number of factors were investigated for an association with recovery from, or persistence of, depression.ResultsAt follow-up, 30.2% of the depressed subjects had died, 34.9% had persistent or relapsed case-level depression, 24.5% had other case- or subcase-level mental illness and 10.4% had recovered completely. Physical ill-health, bereavement and positive family history of depression were associated with poor outcome, whereas treatment with antidepressant medication significantly improved prognosis.ConclusionsLate-life depression in community-dwelling subjects is a chronic condition. However, the positive response to antidepressant medication suggests that it should be vigorously treated.
Functional correlates of musical and visual ability in frontotemporal dementia
Authors: Miller Bruce L. , Boone Kyle , Cummings Jeffrey L. , Read Stephen L. , Mishkin Fred 
Published: August 2002

BackgroundThe emergence of new skills in the setting of dementia suggests that loss of function in one brain area can release new functions elsewhere.AimsTo characterise 12 patients with frontotemporal dementia (FTD) who acquired, or sustained, new musical or visual abilities despite progression of their dementia.MethodTwelve patients with FTD who acquired or maintained musical or artistic ability were compared with 46 patients with FTD in whom new or sustained ability was absent.ResultsThe group with musical or visual ability performed better on visual, but worse on verbal tasks than did the other patients with FTD. Nine had asymmetrical left anterior dysfunction. Nine showed the temporal lobe variant of FTD.ConclusionLoss of function in the left anterior temporal lobe may lead to facilitation of artistic or musical skills. Patients with the left-sided temporal lobe variant of FTD offer an unexpected window into the neurological mediation of visual and musical talents.
Low blood pressure and risk of depression in the elderly
Authors: Paterniti Sabrina , Verdier-Taillefer Marie-Hélène , Geneste Catherine , Bisserbe Jean-Claude , Alpérovitch Annick 
Published: August 2002

BackgroundThe relationship between depression and low blood pressure is unclear.AimsTo examine the temporal relation between low blood pressure and depression in a two-year follow-up.MethodThe study group consisted of 1389 subjects aged 59–71 years; 1272 (92%) were examined after two years. Subjects completed the Center for Epidemiological Studies–Depression (CES–D) and the Spielberger inventory scales to assess depressive and anxiety symptoms respectively. Data were collected on socio-demographic characteristics, smoking and drinking habits, medical history, drug use and blood pressure measures.ResultsAmong 1112 subjects who were considered as non-depressed at baseline, logistic regression models showed that low diastolic blood pressure (DBP) and decrease of blood pressure were predictors of high depressive symptomatology at follow-up. Baseline high CES–D scores did not predict low blood pressure two years after.ConclusionsIn our study, low blood pressure was a risk factor for, but not a consequence of, high depressive symptomatology.
APOE ε4 influences the manifestation of Alzheimer's disease in adults with Down's syndrome
Authors: Deb Shoumitro , Braganza John , Norton Nadine , Williams Hywel , Kehoe Patrick G. , Williams Julie , Owen Michael J. 
Published: August 2002

BackgroundRecent studies of the relationship between the apolipoprotein E (APOE) gene and Alzheimer's disease in adults with Down's syndrome have revealed inconsistent results.AimsTo assess the role of the APOE gene in the manifestation of Alzheimer's disease in adults with Down's syndrome.MethodWe studied the APOE genotypes of 24 adults with dementia and 33 non-demented adults with Down's syndrome over 35 years of age, and an additional group of 164 non-learning disabled adults. We also carried out a meta-analysis of all previously published studies of association between APOE and Down's syndrome, incorporating the current data.ResultsWe observed a non-significant excess of APOE ε4 and a reduction of ε2 in adults with dementia compared with non-demented adults with Down's syndrome in our sample. However, meta-analysis showed a significantly higher frequency of ε4 in adults with dementia compared with non-demented adults with Down's syndrome (odds ratio=2.02, 95% CI 1.33–3.07, P=0.001), but no significant reduction in the frequency of ε2.ConclusionsThe APOE ε4 allele acts as a risk factor for the age-specific manifestation of Alzheimer's disease in people with Down's syndrome.
Reliability and validity of the CANDID – a needs assessment instrument for adults with learning disabilities and mental health problems
Authors: Xenitidis K. , Thornicroft G. , Leese M. , Slade M. , Fotiadou M. , Philp H. , Sayer J. , Harris E. , McGee D. , Murphy D. G. M. 
Published: August 2002

BackgroundPeople with learning disabilities and mental health problems have complex needs. Care should be provided according to need.AimTo develop a standardised needs-assessment instrument for adults with learning disabilities and mental health problems.MethodThe Camberwell Assessment of Need for Adults with Developmental and Intellectual Disabilities (CANDID) was developed by modifying the Camberwell Assessment of Need (CAN). Concurrent validity was tested using the Global Assessment of Functioning (GAF) and the Disability Assessment Schedule (DAS). Test–retest and interrater reliability were investigated using 40 adults with learning disabilities and mental health problems.ResultsCANDID scores were significantly correlated with both DAS (P<0.05) and GAF scores (P<0.01). Correlation coefficients for interrater reliability were 0.93 (user), 0.90 (carer), and 0.97 (staff ratings); for test–retest reliability they were 0.71, 0.69 and 0.86 respectively. Mean interview duration was less than 30 minutes.ConclusionsThe CANDID is a brief, valid and reliable needs assessment instrument for adults with learning disabilities and mental health problems.
Changing patterns in the use of the Mental Health Act 1983 in England, 1984–1996
Authors: Hotopf Matthew , Wall Sharon , Buchanan Alec , Wessely Simon , Churchill Rachel 
Published: August 2002

BackgroundThe Mental Health Act 1983 (MHA) is due to be revised by Parliament in the near future.AimsTo explore changes in the use of the Act since its introduction.MethodThe Department of Health and the Home Office routinely collect data on the numbers of patients admitted to psychiatric hospitals under the MHA. We present absolute figures, by year, for the total numbers admitted under each section of the Act. We used the total psychiatric hospital admissions and total prison populations as denominator data.ResultsFormal admissions rose from 16 044 in 1984 to 26 308 in 1996, a 63% increase. Admissions under the MHA have increased as a proportion of all admissions. The increase is mainly accounted for by changes in the use of Part II of the Act, in particular sections 2 and 3. The use of forensic sections (Part III) has also increased, with a marked increase of sections 47 and 48. Use of Part X of the Act (sections 135 and 136) declined in the late 1980s but rose again in the 1990s.ConclusionsFormal admissions are more common than they were in 1984, despite there being fewer psychiatric beds. This is probably due to changes in the provision of psychiatric services, and changing societal pressures on psychiatrists away from libertarianism and towards coercion.
Cassel Personality Disorder Study
Authors: Chiesa Marco , Fonagy Peter 
Published: August 2002

BackgroundThe effectiveness of hospital-based treatment models for personality disorder is still uncertain.AimsTo compare effectiveness of two models of psychosocial intervention for personality disorder.MethodTwo samples of people with personality disorder allocated to a one-stage treatment model (in-patient treatment with no after care) and to a two-stage model (shorter in-patient admission followed by outreach therapy) are prospectively compared.ResultsSubjects in the two-stage sample did significantly better on global assessment of mental health (according to the Global Assessment Score (GAS)) at 6 and 12 months and on social adjustment (according to the Social Adjustment Scale (SAS)) at 12 months. Significant differences in rates of reliable improvement on the GAS (43% v. 17%) and SAS (39% v. 15%) in favour of the two-stage condition were found at 12 months. Subjects with borderline personality disorder (BPD) allocated to the two-stage model improved significantly more than such patients in the one-stage model.ConclusionsA long-term phased model which combines hospital-based and community-based strategies has advantages over a purely in-patient model for the treatment of BPD.
Obstetric complications and schizophrenia
Authors: Kendell R. E. , McInneny K. , Juszczak E. , Bain M. 
Published: August 2002

BackgroundMost previous case–control studies of obstetric complications in schizophrenia have been small scale and many have relied on retrospective information.AimsTo determine which obstetric complications are more common in probands with schizophrenia than matched controls.MethodTwo hundred and ninety-six probands with an in-patient diagnosis of schizophrenia who had been born in Scotland in 1971–74, and a further 156 born in 1975–78, were closely matched with controls and the incidence of obstetric complications in the two compared using obstetric data recorded in a set format shortly after birth.ResultsNot a single complication of pregnancy or delivery was significantly more common in the probands with schizophrenia than the controls in the 1971–74 birth cohort and only emergency Caesarean section and labour lasting over 12 hours were significantly more common in the schizophrenia probands in the 1975–78 cohort.ConclusionThe evidence that schizophrenia is associated with a raised incidence of obstetric complications is weaker than has recently been assumed.
Obstetric complications and affective psychoses
Authors: Bain M. , Juszczak E. , McInneny K. , Kendell R. E. 
Published: August 2002

BackgroundUnlike schizophrenia, little interest has been taken in the incidence of obstetric complications in affective psychoses.AimsTo find out whether obstetric complications are more common in affective psychoses than matched controls.MethodTwo hundred and seventeen probands with an in-patient diagnosis of affective psychosis who had been born in Scotland in 1971–74, and a further 84 born in 1975–78, were closely matched with controls and the incidence of obstetric complications in the two compared using obstetric data recorded in a set format shortly after birth.ResultsAbnormal presentation of the foetus was the only complication significantly more common in the affective probands in the 1971–74 birth cohort and artificial rupture of the membranes was the only event more common in the probands in the 1975–78 cohort. Both are probably chance findings.ConclusionIt is unlikely that the incidence of obstetric complications is raised in people with affective psychoses of early onset.
Labour and delivery complications and schizophrenia
Authors: Byrne Majella , Browne Roy , Mulryan Niamh , Scully Ann , Morris Mary , Kinsella Anthony , Takei Noriyoshi , McNeil Tom , Walsh Dermot , O'Callaghan Eadbhard 
Published: August 2002

BackgroundControversy continues regarding an association between obstetric complications and risk of schizophrenia in early adult life.AimsTo compare the rate of labour and delivery complications among persons who developed schizophrenia with controls; to establish whether any complication is associated with later schizophrenia.MethodWe located the labour ward records of 431 individuals with schizophrenia and of same-gender controls from the same hospital birth series. Mothers were matched by age, socio-economic group and parity. Individual complications were evaluated blindly using two obstetric complication scales.ResultsOverall, the rate of labour and delivery complications for those who developed schizophrenia did not differ from that of controls. Males who had presented to psychiatric services before the age of 30 had a greater frequency of and more severe labour/delivery complications than their matched controls.ConclusionsOther than among young-onset males we found no increase in labour and delivery complications among cases.
Cost-effectiveness of intensive v. standard case management for severe psychotic illness
Authors:   UK700 Group, Byford Sarah , Fiander Matthew , Torgerson David J. , Barber Julie A. , Thompson Simon G. , Burns Tom , Van Horn Elizabeth , Gilvarry Catherine , Creed Francis 
Published: August 2002

BackgroundIntensive case management is commonly advocated for the care of the severely mentally ill, but evidence of its cost-effectiveness is lacking.AimsTo investigate the cost-effectiveness of intensive compared with standard case management for patients with severe psychosis.Method708 patients with psychosis and a history of repeated hospital admissions were randomly allocated to standard (case-loads 30–35) or intensive (case-loads 10–15) case management. Clinical and resource use data were assessed over two years.ResultsNo statistically significant difference was found between intensive and standard case management in the total two-year costs of care per patient (means £24 550 and £22 700, respectively, difference £1850, 95% Cl – £1600 to £5300). There was no evidence of differential effects in African–Caribbean patients or in the most disabled. Psychiatric in-patient hospital stay accounted for 47% of the total costs, but neither such hospitalisation nor other clinical outcomes differed between the randomised groups.ConclusionReduced case-loads have no clear beneficial effect on costs, clinical outcome or cost-effectiveness. The policy of advocating intensive case management for patients with severe psychosis is not supported by these results.
Factors predicting the clinical course of generalised anxiety disorder
Authors: Yonkers Kimberly A. , Dyck Ingrid R. , Warshaw Meredith , Keller Martin B. 
Published: August 2002

BackgroundCross-sectional data show that generalised anxiety disorder (GAD) is a chronic condition with episodes lasting much longer than the six-month minimum required by DSM–III–R and DSM–IV. Although GAD is chronic, little is known about factors influencing illness duration.AimsTo investigate variables that influence the clinical course of GAD.MethodA total of 167 patients with GAD participated in the Harvard–Brown Anxiety Research Program. Patients were assessed at intake and re-examined at six- to twelve-month intervals for five years. Kaplan–Meier curves were constructed to assess the likelihood of remission. Regression analysis was used to investigate factors predicting full or partial remission.ResultsThe rate of remission was 0.38 after five years. Diminished likelihood of remission was associated with low overall life satisfaction, poor spousal or family relationships, a concurrent cluster B or C personality disorder and a low global assessment score.ConclusionsFull or partial remissions were less likely to occur in patients with poor relationships and personality disorders. These patients should be given more intensive and possibly multi-modal therapy.
Cerebral perfusion in chronic fatigue syndrome and depression
Authors: Machale Siobhan M. , Lawrie Stephen M. , Cavanagh Jonathan T. O. , Glabus Mike F. , Murray Catherine L. , Ebmeier Klaus P. , Goodwin Guy M. 
Published: August 2002

BackgroundPatients with chronic fatigue syndrome (CFS) and depressive illness share many, but not all, features.AimsTo test the hypothesis that patients with CFS have abnormal cerebral perfusion, that differs from that in patients with depressive illness.MethodWe recruited 30 patients with CFS who were not depressed, 12 depressed patients and 15 healthy volunteers. Regional cerebral perfusion at rest was assessed using region of interest (ROI) and voxel-based statistical parametric mapping (SPM) techniques.ResultsOn SPM analysis there was increased perfusion in the right thalamus, pallidum and putamen in patients with CFS and in those with depressive illness. CFS patients also had increased perfusion in the left thalamus. Depressed patients differed from those with CFS in having relatively less perfusion of the left prefrontal cortex. The results were similar on ROI analysis.ConclusionsAbnormal cerebral perfusion patterns in CFS subjects who are not depressed are similar but not identical to those in patients with depressive illness. Thalamic overactivity may be a correlate of increased attention to activity in CFS and depression; reduced prefrontal perfusion in depression may be associated with the greater neuropsychological deficits in that disorder.