Psychological medicine
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We examined for risk factors for suicide among psychiatric in-patients by comparing 37 in-patients from an Ontario Provincial Psychiatric Hospital who had committed suicide with 37 age and sex matched in-patient controls. Significantly more of the suicide victims had made a previous suicide attempt (62.2 v. 35.1%), suffered from schizophrenia (75.7 v. 35.1%), were involuntary at their last admission (70.3 v. 43.2%) and lived alone (70.3 v. 43.2%). ⋯ Almost a third of the patients, the majority schizophrenic, committed suicide after having been in the hospital for more than a year. These results suggest that in the psychiatric hospital setting the in-patient at risk for suicide has previously exhibited suicidal behaviour, suffers from schizophrenia, was admitted involuntarily, lives alone and that the risk of suicide may remain high among long-stay schizophrenics.
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Psychological medicine · Nov 1994
Cognitive function in depression: its relationship to the presence and severity of intellectual decline.
Cognitive dysfunction is an integral feature of depression, in some cases of sufficient severity to warrant a diagnosis of dementia. There has been little systematic investigation of whether cognitive dysfunction is an inevitable consequence of depression, or is specific to a subgroup of depressed patients. Related to this is the distribution of cognitive dysfunction, whether there is a continuum of impairment or a distinct demented subgroup. ⋯ In general, the cognitive measures showed a gradient of dysfunction across the three patients groups. Significant differences between the depressed groups were shown on measures of immediate recall, attention and behavioural regulation. The possible significance of attentional factors for the observed memory dysfunction is discussed.
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One hundred and one patients with late paraphrenia were examined using the Present State Examination. The established high prevalence rates of female gender, the unmarried state and sensory impairment were confirmed. All of the symptoms of schizophrenia, with the exception of formal thought disorder, were found in the subjects with approximately the same prevalence as reported in schizophrenics with a symptom onset in younger life. ⋯ Patients in these diagnostic categories differed in their pre-morbid IQ estimations, current cognitive state measured by the Mini-Mental State Examination and in the number of scored positive psychotic PSE symptoms and their systematization of and preoccupation with delusions and hallucinations. There were no significant differences between the patients in the ICD-10 schizophrenia and delusional disorder groups in terms of age at symptom onset, sex ratio, response to treatment, being unmarried, the presence of insight or sensory impairment. The high degree of clinical similarity between patients with late paraphrenia combined with the inability of ICD-10 to define diagnostic subgroups that correspond to patient clusters derived from clinical symptoms or which are meaningfully different from each other in terms of demographic and prognostic factors provide a strong argument for the retention of late paraphrenia as the most appropriate diagnosis for such patients.
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Psychological medicine · Feb 1993
A prospective study of delirium in elderly patients admitted to a psychiatric hospital.
Seventy consecutive elderly patients meeting the DSM-III criteria for non-alcohol delirium were examined during the acute stage and followed to four years later. The mean age of the patients at the beginning of the index admission was 74.8 +/- 6.4 years. The most common aetiologies for delirium were stroke, infections and metabolic disorders. ⋯ Mini Mental State Examination score 9.7 +/- 6.6 at admission and 13.9 +/- 7.2 at discharge, P < 0.001), but during the follow-up period of four years progression of the basic central nervous system disease was observed together with declining cognition and deteriorating functions of daily living. Four patients died during the index admission and 42 patients during the follow-up period. In decreased patients there was a statistically significant connection between the levels of cognitive functioning and functions of daily living at the end of the index admission and the life span after delirium.
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Psychological medicine · Feb 1992
Historical ArticlePsychiatric journals and the evolution of psychological medicine.
The history of psychiatric journals is outlined from their inception in the late eighteenth century. In the development of psychological medicine they serve as intellectual markers of the complex relations between institutional psychiatry, neurology, the psychosocial sciences and the psychotherapeutic movement. Their current status is briefly discussed.