Showing papers in "Psychological Medicine in 1972"
TL;DR: The hypothesis is advanced that electrical self-stimulation results in the majority of cases from activation of one or both of these catecholamine-containing systems.
Abstract: SYNOPSIS Experimental data on the location in the brain of electrode sites supporting electrical self-stimulation are reviewed. All previous studies are in agreement that the behaviour is most easily elicited from lateral hypothalamic sites corresponding approximately to the fibre pathways known as the ‘medial forebrain bundle’. Some brainstem electrode sites will support self-stimulation. Experiments are summarized which indicate that there is a correlation between the sites of electrode tips positive for self-stimulation and the location of catecholamine-containing neurones in two regions: (1) in the region of the dopamine-containing cells in the ventral mesencephalon (cell-body groups A9 and AIO of Dahlstr¨m and Fuxe, 1964), and (2) in the region of the noradrenaline-containing cells of the locus coeruleus (A6 group). These two cell-body groups give rise to axons which pass through the medial forebrain bundle to form terminal systems with a widespread distribution in the prosencephalon. The hypothesis is advanced that electrical self-stimulation results in the majority of cases from activation of one or both of these catecholamine-containing systems.
199 citations
TL;DR: The results suggest that the hypothesis that there is a positive association between physical and psychiatric disorder is confirmed and furthermore that ‘clustering’ of both types of disorder occurred in some individuals.
Abstract: The purpose of this study was to test the hypothesis that there is a positive association between physical and psychiatric disorder. The study was designed to reduce potential sources of bias and the approach included random sampling of a general practice population; independent assessments of the physical and psychiatric states using objective methods and strict criteria for diagnosis; and the use of a control group. The results suggest that the hypothesis is confirmed and furthermore that ‘clustering’ of both types of disorder occurred in some individuals.
138 citations
TL;DR: In a double-blind crossover trial, lithium carbonate was found to be significantly superior to placebo in the prophylaxis of manic-depressive (bipolar) psychosis as discussed by the authors.
Abstract: In a double-blind crossover trial lithium carbonate was found to be significantly superior to placebo in the prophylaxis of manic-depressive (bipolar) psychosis. A striking feature was the high incidence of manic or hypomanic attacks in patients who relapsed on placebo. Patients participated in the trial with their full knowledge and consent.
132 citations
TL;DR: Endocrine investigation on patients with a syndrome characterized by the psychopathological features of anorexia nervosa reveals a disorder of urinary excretion levels of testosterone and of total gonadotrophic activity, which is comparable to the disturbance of sex hormones that accompanies the menstrual disturbance of female patients with anorexa nervosa.
Abstract: A syndrome characterized by the psychopathological features of anorexia nervosa occurs in male subjects. There have been 25 cases previously reported in the literature which appear to be fairly typical of the condition and the present paper adds the case histories of another six patients. Endocrine investigation on these patients reveals a disorder of urinary excretion levels of testosterone and of total gonadotrophic activity, which is comparable to the disturbance of sex hormones that accompanies the menstrual disturbance of female patients with anorexia nervosa. The exact nature of the endocrine disturbance in the male, however, is still less well understood than that in the female.
116 citations
TL;DR: In this paper, daily measurements of MHPG in urine have been carried out in two patients with manic-depressive psychosis and found that levels in mania were elevated and in depression lowered with interval levels which were intermediate and within the normal range.
Abstract: Daily measurements of MHPG in urine have been carried out in two patients with manic-depressive psychosis. In both cases, levels in mania were elevated and in depression lowered with interval levels which were intermediate and within the normal range. The results lend some support to the suggestion that there might be an increase in brain noradrenaline metabolism in mania and a decrease in depression.
114 citations
TL;DR: The study proved that such a collaboration was feasible, that it was possible to develop research procedures for international use, and that similar types of schizophrenia could be found in each of the countries involved.
Abstract: The results are described of a transcultural psychiatric study of schizophrenia undertaken by WHO in nine countries. The study proved that such a collaboration was feasible, that it was possible to develop research procedures for international use, and that similar types of schizophrenia could be found in each of the countries involved. One thousand two hundred and two patients were studied and over 2 million items of information obtained.
97 citations
TL;DR: In this article, the authors examined the relationship between affective connotations of material and the ease of its recall two weeks later in a group of psychiatric inpatients suffering from affective disorder and found that the tendency to recall more pleasant than unpleasant material was less marked in patients showing overt depression than in patients who were hypomanic or recovered from depression at the time of the experiment.
Abstract: The relationship between the affective connotations of material and the ease of its recall two weeks later has been examined in a group of psychiatric inpatients suffering from affective disorder. The tendency to recall more pleasant than unpleasant material has been less marked in patients showing overt depression than in patients who were hypomanic or recovered from depression at the time of the experiment. This has been chiefly because of the higher negative tone of recalled material in the depressed patients. Other attributes of the material, relative to its impact on the subject, have also appeared to be less influential in recall in the presence of depression.
88 citations
TL;DR: Factor analysis of the intercorrelations between items disclosed a clear-cut psychoticism factor, relatively independent of the others, which is rationale and psychiatric importance are discussed.
Abstract: A study is reported of a random sample of 170 normal men and 192 normal women who were given a 110-item questionnaire incorporating items intended to measure personality variables P (psychoticism), N (neuroticism), E (extraversion), and L (a lie and dissimulation scale). Factor analysis of the intercorrelations between items disclosed a clear-cut psychoticism factor, relatively independent of the others. The rationale and the psychiatric importance of this factor are discussed.
80 citations
TL;DR: A factor analysis was carried out of ratings on the Hamilton Scale on a group of 134 male and 213 female depressed patients and a preliminary experiment showed that factor scores could isolate anxiety features and personality factors.
Abstract: A factor analysis was carried out of ratings on the Hamilton Scale on a group of 134 male and 213 female depressed patients The original data covered a wide range of severity of illness and the distribution of severity scores was not biased from normal Hamilton's general factor was confirmed but his bipolarity between agitated and retarded depression did not emerge Sex differences in factor patterns were found and a preliminary experiment showed that factor scores could isolate anxiety features and personality factors
78 citations
TL;DR: The findings of the present study are not conclusive but show a clear need for further research in this field and the paucity of evidence for the effectiveness of anti-cholinergic drugs in both Parkinson's disease and in drug-induced Parkinsonism.
Abstract: A double-blind comparison was made of the effects of amantadine hydrochloride, orphenadrine hydrochloride, and placebo in the control of the effects on the extrapyramidal nervous system of fluphenazine decanoate. Patients were assessed with regard to the main symptoms of Parkinsonism, the leading clinical signs, performance in walking, writing and squeezing, changes in mood, and unwanted effects of medication. Neither of the pharmacologically active substances was superior to placebo. Attention is drawn to the paucity of evidence for the effectiveness of anti-cholinergic drugs in both Parkinson's disease and in drug-induced Parkinsonism. The special difficulties in performing trials of substances used in relieving the unwanted effects of other drugs are discussed in relationship to defects in methodology in both this and earlier trials. The findings of the present study are not conclusive but show a clear need for further research in this field. The possible theoretical and practical importance of such research is discussed.
68 citations
TL;DR: The word ‘psychogenic’ was introduced into psychiatry in 1894 by Robert Sommer and many attempts have been made to clarify the concept it denotes and apply it to clinical purposes.
Abstract: The word ‘psychogenic’ was introduced into psychiatry in 1894 by Robert Sommer. Many attempts have been made to clarify the concept it denotes and apply it to clinical purposes. These attempts have been bedevilled by unsettled philosophical problems. It is suggested that the word should be decently buried.
TL;DR: In this article, drug effects on tests, psychophysiological measures, and self-ratings of mood were studied in normal subjects and related to plasma levels of the drug and psychasthenic personality traits.
Abstract: Two double-blind experiments are reported in which different doses of diphenylhydantoin were compared with placebo. Drug effects on tests, psychophysiological measures, and self-ratings of mood were studied in normal subjects and related to plasma levels of the drug and psychasthenic personality traits. Significant sedative effects were obtained in some self-rating variables. The combined effect in the objective psychological tests was significantly correlated (rank) to the plasma level in the higher dose experiment.
TL;DR: A special analysis made by a medical sociologist into the problems of these 29 patients as perceived by their relatives showed a dependence on parents of pensionable age which is an obstacle to rehabilitation.
Abstract: As part of a survey of the need for rehabilitation services in Camberwell, a representative group of 56 unemployed psychiatric patients were selected from the Camberwell Register during 1968; most of these were chronic schizophrenics, and 29, or just over half of them, were living with their parents or siblings. This paper describes a special analysis made by a medical sociologist into the problems of these 29 patients as perceived by their relatives. Assessment of the patient's handicaps and the burden felt by the family showed a dependence on parents of pensionable age which is an obstacle to rehabilitation. Patients were content, but relatives were dissatisfied and experienced considerable financial burden and symptoms of reactive anxiety and depression. The need for special services is emphasized to help the patient towards a more independent existence when the relative dies.
TL;DR: In this article, spontaneous and metacholine-stimulated salivation rates were measured in endogenous depression, symptomatic depression, mania, and healthy controls, and concentrations of salivary electrolytes were measured.
Abstract: Spontaneous and metacholine-stimulated salivation rates were measured in endogenous depression, symptomatic depression, mania, and healthy controls. In manic-depressive patients concentrations of salivary electrolytes were measured. Salivation rates were decreased in untreated endogenous depression and mania. After remission by ECT but not by drug treatment flow rates increased towards normal values. Estimations of electrolytes revealed no specific pattern of excretion in manic-depressive patients.
TL;DR: Factor analysis revealed three major factors: factor 1 relates to N (neuroticism) score, more extreme drinking, and likelihood of drink-related trouble and factor 2 is associated with more privileged and factor 3 with less privileged class status.
Abstract: Three hundred and six male subjects in a community survey reported on their ‘motivation for drinking’. Factor analysis revealed three major factors. Factor 1 relates to N (neuroticism) score, more extreme drinking, and likelihood of drink-related trouble. Factor 2 is associated with more privileged and factor 3 with less privileged class status.
TL;DR: A feasibility study for a controlled trial of a certain type of formal psychotherapy is described and it is indicated that the trial as initially envisaged is not feasible.
Abstract: A feasibility study for a controlled trial of a certain type of formal psychotherapy is described. Patients referred by consultant psychiatrists in the Inner London Area were carefully selected and fully assessed before random allocation to one of three treatment procedures. The results indicate that the trial as initially envisaged is not feasible. The reasons for this conclusion are discussed.
TL;DR: Eight phobic outpatients were treated by six sessions of desensitization followed by exposure or vice versa, and the main phobia was rated as significantly improved for both treatments together.
Abstract: Eight phobic outpatients were treated by six sessions of desensitization followed by exposure or vice versa. Treatment was by visualization of phobic images up a hierarchy for 20 minutes at a time. During desensitization patients were relaxed before and after each image, while during exposure they looked at a neutral slide instead. Skin conductance activity was significantly lower during relaxation than during observation of the neutral slide. The patients, therapist, and a ‘blind’ assessor rated the main phobia as significantly improved for both treatments together. Each of the two treatments contributed similarly to improvement during and after treatment sessions, on measures of main phobia, subjective anxiety, and heart rate. Relaxation training appears to be redundant to the desensitization procedure.
TL;DR: In this article, the authors test two theories of the mode of action of imipramine and conclude that the therapeutic effect does not depend on either its anticholinergic or other action revealed by the common side effects, and that variability of response cannot be accounted for by differences in the rate of metabolism of DMI.
Abstract: In order to test two theories of the mode of action of imipramine 58 depressive patients were treated at two dosage levels with desmethylimipramine (DMI), its active metabolite. Clinical judgments were used to distinguish therapeutic responders from non-responders, who showed clear differences in depressive rating scales and body weight changes. Measurements of urinary output of DMI, of salivation, and of the incidence of side-effects were compared in responders and non-responders: no differences appeared between the two groups. It is concluded that the therapeutic effect of imipramine does not depend on either its anticholinergic or other action revealed by the common side-effects, and that variability of response cannot be accounted for by differences in the rate of metabolism of DMI.
TL;DR: The Leyton Obsessional Inventory, together with 46 questions taken from Sections M-R of the Cornell Medical Index and the short version of the Maudsley Personality Inventory were administered to a group of orthopaedic patients made up of Irish, English, and Irish immigrants as mentioned in this paper.
Abstract: The Leyton Obsessional Inventory, together with 46 questions taken from Sections M–R of the Cornell Medical Index and the short version of the Maudsley Personality Inventory were administered to a group of orthopaedic patients made up of Irish, English, and Irish immigrants. The results indicated that the Irish subjects had more obsessional symptoms and traits and also that they appeared to be more disturbed by the possession of such attributes than did the English. Among the various cultural factors considered, the bachelor state, in the case of the Irish males, and rural dwelling, in the case of Irish females, were associated with the highest obsessional scores. Ways in which the cultural background may be related to the development of obsessional symptoms and traits are discussed and suggestions are made as to the further epidemiological implications of these findings.
TL;DR: A male patient whose loss of sexual interest and activity was due to gonadal failure is described, and within a few days of starting replacement treatment with testosterone he reported a return ofSexual interest and showed a response to sexually arousing stimuli; sexual attitudes also improved.
Abstract: A male patient is described whose loss of sexual interest and activity was due to gonadal failure, presumably the result partly of Klinefelter's syndrome and partly of orchitis, though the latter was unilateral. He showed no change during a placebo control period, but within a few days of starting replacement treatment with testosterone he reported a return of sexual interest and showed a response to sexually arousing stimuli; sexual attitudes also improved. This case is of interest because of the specific and rapid psychological response to the correction of an androgen deficiency.
TL;DR: The authors compared fifth and fourth word deletions for schizophrenic and non-schizophrenic speech transcripts and found that fourth word deletion gave lower scores overall and this effect was significantly greater for the more disorganized schizophrenic speech.
Abstract: Cloze procedures using fifth and fourth word deletions were compared for schizophrenic and non-schizophrenic speech transcripts. Both methods distinguished between the schizophrenic and non-schizophrenic speech. Fourth word deletion gave lower scores overall and this effect was significantly greater for the more disorganized schizophrenic speech. An encoding deficit involving inappropriate repetition is discussed as a possible explanation for the findings.
TL;DR: A survey is provided of the various attempts which have been advanced to classify psychotropic drugs and the unsatisfactory nature of the schemata and the underlying reasons for this are discussed.
Abstract: A survey is provided of the various attempts which have been advanced to classify psychotropic drugs. The unsatisfactory nature of the schemata and the underlying reasons for this are discussed. The possible use of ‘facet analysis’ to develop a classificatory system is suggested.
TL;DR: During a psychiatric survey in Sarawak, subjects demonstrating latah were examined separately, both clinically and with a questionnaire, andDream content indicated an overt sexual component.
Abstract: During a psychiatric survey in Sarawak, subjects demonstrating latah were examined separately, both clinically and with a questionnaire. Latah occurred only in females, mainly Malays, occasionally Ibans, and never Chinese. Fifty latah subjects were examined, seven were firmly diagnosed as being mentally ill, and another 13 demonstrated mild psychiatric disorders. Dream content indicated an overt sexual component.
TL;DR: In this paper, a sudden loud noise produced a large and rapid rise in plasma glucagon in the conscious primate and a similar rise took place when stresses were applied to anaesthetized animals.
Abstract: A sudden loud noise produced a large and rapid rise in plasma glucagon in the conscious primate. A similar rise took place when stresses were applied to anaesthetized animals.
TL;DR: It was found that the cerebral cortical concentration of cortisol in patients who had died from stressful somatic diseases was raised and that the increase was roughly related to the likely degree and duration of the physical stress endured by the patients.
Abstract: The concentration of cortisol (F) has been found to decrease only to a limited extent in intact brain tissue maintained at ambient temperature after death, and the decrease is mainly accounted for as 20-dihydrocortisols (DHF). The sum of F and DHF has therefore been estimated in samples of frontal cortex removed from human cadaver brains collected at necropsy, and taken as a measure of the concentration of cortisol at death. Corticosterone concentration was also estimated. The concentration of cortisol in the cerebral cortex of physically healthy individuals who had committed suicide was consistently as low or lower than in the cortex of control patients who had died suddenly without antecedent severe illness. It is concluded therefore that neither the presumed severe emotional stress preceding suicide nor depressive illness itself is associated with high levels of cortisol in the cerebral cortex. On the other hand, it was found that the cerebral cortical concentration of cortisol in patients who had died from stressful somatic diseases was raised and that the increase was roughly related to the likely degree and duration of the physical stress endured by the patients. There was some indication that the ratio of cortisol (F+DHF) to corticosterone may be lower in the cerebral cortex of suicides than in that of controls.