{"title":"Some methodologic criteria for studies in developmental neuropsychiatry.","authors":"P Szatmari","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Studies which have sought to address the question of how brain dysfunction might be an etiological factor in the development of psychiatric disorders in childhood are reviewed from the point of view of the methodological issues which arise. It is argued that common forms of behavioral disturbance are more likely to have a psychosocial rather than a neurological origin, whereas epidemiologically unusual conditions are more likely to have neuro-developmental causal factors. Possible study designs are reviewed with the recommendation that cohort studies most closely approximate the ideal of the randomized control trial, whereas case control studies are weakest. The assessment of the reliability and validity of measures of brain dysfunction is discussed. Criteria for attributing causation after an association has been identified include temporal sequence, a 'dose-response' relationship, and the specificity of the cause. The clinical as opposed to the statistical significance of the association must be assessed. Confounding variables in such studies, variables which account in part for the association identified, but which undermine the etiological significance which can be attributed, are discussed. The particular importance of psychosocial disadvantage in this field is stressed as a factor to be taken into account in the critical evaluation of studies.</p>","PeriodicalId":77773,"journal":{"name":"Psychiatric developments","volume":"3 2","pages":"153-70"},"PeriodicalIF":0.0,"publicationDate":"1985-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"15159869","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Methodological and conceptual problems in the study of mortality in psychiatry.","authors":"R L Martin","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>The study of mortality has a long tradition in Psychiatry. The specificity required to define risks associated with particular disorders and to monitor the effects of changing patterns of treatment necessitates rigorous attention to methodology. The strengths and limitations of particular study designs and how these must be considered when interpreting results are reviewed. Sampling of the study population involves deciding whether to define a group retrospectively or prospectively, the type of psychiatric population to be utilized (eg inpatients or outpatients), and whether cases are to be chosen randomly as to diagnosis or with selection for certain profiles. Ascertainment of death is critical in mortality studies. Once the index population is defined, cases lost to final ascertainment significantly weaken the study. Cause of death as determined by coroner's verdict is readily obtained but of questionable accuracy. Results may be influenced by the method of psychiatric assessment and diagnosis, especially whether case record or interview data is used, and whether multiple or only single diagnoses are determined. With computerization improved statistical analysis are now possible. There is no perfect mortality study design. Any particular design involves a trade-off of advantages and disadvantages.</p>","PeriodicalId":77773,"journal":{"name":"Psychiatric developments","volume":"3 4","pages":"317-33"},"PeriodicalIF":0.0,"publicationDate":"1985-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"15206044","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Old familiar faces: some aspects of the asylum era in Britain. Part 1.","authors":"E H Hare","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Conditions which had an historical association with Asylums in the years 1850-1950, but which are no longer commonly seen in psychiatric practice, are reviewed. These include: Asylum pellagra, Erysipelas, Insane Ear and Fractured Ribs. The history of each condition and its manifestation is reviewed in the context of its relationship with mental illness and its treatment as seen by authorities writing when these conditions were prevalent. It is not clear why these conditions became common, why they had a particular association with Asylums, or why they have largely disappeared.</p>","PeriodicalId":77773,"journal":{"name":"Psychiatric developments","volume":"3 3","pages":"245-55"},"PeriodicalIF":0.0,"publicationDate":"1985-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"15022378","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Old familiar faces: some aspects of the asylum era in Britain, Part II.","authors":"E H Hare","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>The paper continues a review of clinical conditions and dilemmas which featured in Asylum practice during the years 1850-1950 in Britain. The rise and fall of 'Physiognomy' as a diagnostic aid and as an indicator of quality of asylum care is outlined. The problem of incontinence and the use of the ice cold douche as a therapeutic intervention in this and other forms of 'indolence or perversion' is reviewed from the writings of those who expressed opinions of these subjects at the time. Likewise, Destructive Behaviour, which was dealt with by means of 'strong clothes', presented a familiar problem. As in Part I of this review, the author concludes with a discussion of the causes and consequences of the changing faces of conditions seen in psychiatric hospitals. Viewed from the present, the changing nature of asylum insanity is apt to be forgotten and adverse judgment is apt to be applied to past practices.</p>","PeriodicalId":77773,"journal":{"name":"Psychiatric developments","volume":"3 4","pages":"383-92"},"PeriodicalIF":0.0,"publicationDate":"1985-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"15027023","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Methodological problems in follow-up studies of paranoid psychoses.","authors":"S Opjordsmoen, N Retterstøl","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>301 first-admitted hospitalized patients with paranoid psychoses have been studied by Retterstøl over a period of 5-18 years. Common Scandinavian diagnostic procedures were used. About 200 are still alive, and these subjects are at present being interviewed semistructurally by Opjordsmoen using a modification of SADS-L, and making a total follow-up period of 22-37 years. The diagnoses are confirmed according to ICD-9, RDC, DSM-III and some specific groups of delusional disorders (DD) operationalized by Winokur and Kendler. All interviews have been carried out non-blind to the diagnoses which will make a bias possible. However, in paranoid cases, it is an advantage for establishing contact and a conductive atmosphere to know something about the patient beforehand. Based upon our own experiences and reviewing the literature, we point to some important methodological aspects regarding follow-up studies in delusional persons. The suspiciousness, misinterpretation, dissimulation, rationalization and convincing argumentation seen in many paranoid cases, call for a skilled investigator and a clinical approach. However, operational criteria, new diagnostic concepts and standard procedures for follow-up interviewing and outcome assessments will make comparison for international readers easier.</p>","PeriodicalId":77773,"journal":{"name":"Psychiatric developments","volume":"3 2","pages":"187-204"},"PeriodicalIF":0.0,"publicationDate":"1985-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"15159870","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Linkage analysis for psychiatric disorders. II. Methodological considerations.","authors":"N J Cox, B K Suarez","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Recent advances in molecular biology make genetic linkage analysis an increasingly attractive tool for the identification and characterization of genes involved in the etiology of psychiatric illnesses. However, the complex nature of psychiatric illnesses engenders a host of methodological difficulties not encountered in linkage analyses of simple, Mendelian genetic traits. A previous paper reviewed the basic concepts of genetic linkage analysis. This paper focuses on the methodological difficulties associated with the application of genetic linkage methods to psychiatric illnesses.</p>","PeriodicalId":77773,"journal":{"name":"Psychiatric developments","volume":"3 4","pages":"369-82"},"PeriodicalIF":0.0,"publicationDate":"1985-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"14139249","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Risk factors for depression in adolescence.","authors":"V E Wells, E Y Deykin, G L Klerman","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Public health concern regarding depression has recently increased as a result of the rise in the rate of adolescent suicide, with a probable concomitant rise in the rate of depression in this age group. The rise appears to be both a period effect, in that increased rates are now observed across age categories, and a cohort effect, in that being born after 1960 also contributes to the increase. The clinical phenomena and epidemiology of depression in adolescence are reviewed. Diagnostic criteria for depressive mood and depressive syndrome are similar to those in adults. However, the predictive value of a depressive episode in adolescence, and whether the occurrence of depression in adolescence is a transient developmental experience or whether it predicts a particular subtype of future depression, are at present unknown. The familial, social and personal risk factors for adolescent depression are reviewed, The major factors are: parental history of affective illness, childhood experience of parental loss, and female gender. Other factors, such as birth order and sibling factors, socio-economic status, race, religion, geography, concomitant medical illness, intelligence, career aspirations, substance abuse and life events, are reviewed, although their relative contributions as risk factors are less clear-cut. It is proposed that cross-sectional, retrospective and longitudinal studies are required to clarify important areas of uncertainty.</p>","PeriodicalId":77773,"journal":{"name":"Psychiatric developments","volume":"3 1","pages":"83-108"},"PeriodicalIF":0.0,"publicationDate":"1985-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"15005818","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"A critical examination of empirical studies of the diagnosis of borderline disorders in adults.","authors":"A A Dahl","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>The diagnosis of borderline disorders poses complex problems of a semantic and methodological nature. The various diagnostic criteria sets published are examined and compared. Gunderson's borderline personality disorder and the DSM-III schizotypal and borderline disorders are recommended, as used with the structured interviews developed for them. Problems concerning the relationship of borderline disorders to the major psychoses, the importance of brief psychotic experiences, diagnostic efficiency of items, and various cut-off levels of criteria are discussed in detail, and proposals for further research are pointed out.</p>","PeriodicalId":77773,"journal":{"name":"Psychiatric developments","volume":"3 1","pages":"1-29"},"PeriodicalIF":0.0,"publicationDate":"1985-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"15114782","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Linkage analysis for psychiatric disorders. I. Basic concepts.","authors":"B K Suarez, N J Cox","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Within the last decade linkage analysis has become one of the most useful tools in the human genetics arsenal and is beginning to make substantial contributions in all areas of medicine. Its increasing popularity is a direct result of the burgeoning number of polymorphic markers that are now mapped to specific chromosomal locations. Within the near future the entire human genome is likely to be saturated. This paper is intended as an introduction to linkage analysis for non-geneticists. Basic methodological approaches, along with their strengths, weaknesses and assumptions are reviewed. A subsequent paper will critically review methodological difficulties in the application of linkage analysis to the psychiatric disorders.</p>","PeriodicalId":77773,"journal":{"name":"Psychiatric developments","volume":"3 3","pages":"219-43"},"PeriodicalIF":0.0,"publicationDate":"1985-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"15022376","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Carbamazepine in treatment and prophylaxis of manic-depressive disorder.","authors":"L S Strömgren, S Boller","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>The review presents 23 studies on the action of carbamazepine (CZP) in manic-depressive disorder, some of these studies being double-blind investigations, others open investigations and some anecdotal reports. Surveys of therapeutic as well as prophylactic effects in manias and depressions are presented. There seems to be a definite antimanic and a less expressed but indubitable antidepressant therapeutic effect of CZP, and a considerable prophylactic effect in mania as well as depression, an effect which is possibly a little less than that of lithium. It must, however, be stressed that this conclusion is based on a number of different and heterogeneous studies which have been combined. In addition 5 cases are presented concerning rapid cycling cases with early onset of the disorder and without response to or bad compliance with lithium. In spite of the clinical similarity of these cases the effect of CZP was good in 3 and poor in 2 of the 5 cases presented.</p>","PeriodicalId":77773,"journal":{"name":"Psychiatric developments","volume":"3 4","pages":"349-67"},"PeriodicalIF":0.0,"publicationDate":"1985-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"15027022","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}