Developing practice in cancer rehabilitation.

This module explores the concept of rehabilitation and supportive care in a cancer context. It examines policy and practice that inform rehabilitation in cancer care in England and considers how rehabilitation and supportive care issues can be addressed in clinical practice.

Morbidity suppressive effect of lithium carbonate in cycloid psychosis.

The possible morbidity suppressive effect of lithium carbonate on cycloid psychosis has been investigated in 30 patients who had suffered from recurrent episodes. The patients were followed up from 1 to 8.5 years after starting lithium treatment. In the analysis, patients were divided into those who took lithium regularly and those who took it irregularly, the division being based on the lithium plasma levels at the periodic control examinations. The study, which is of the so-called mirror tye, supports the hypothesis that well-conducted lithium maintenance treatment has a favorable morbidity suppressive effect in patients suffering from cycloid psychosis.

Serum dopamine-beta-hydroxylase and the augmenting-reducing response.

In 84 consecutively admitted inpatients, as well as in 7 healthy volunteers, visual evoked potential to stimuli of varying intensities and serum DBH activity were determined. Patients with an augmenting (Aug.) response, i.e., a tendency to enlarge the perception of stimulation, were found to have the lowest serum DBH activities. As Aug. patients have earlier been shown to have low levels of HVA in CSF, indicating a low turnover in the dopaminergic systems in the CNS, the results indicate that the genetic factor determining the serum DBH activity may in some way also reflect the dopaminergic turnover in CNS.

Pain as a symptom in depressive disorders. II. Relationship to personality traits as assessed by means of KSP.

The series included 140 hospitalized patients with depressive disorders, who were rated by means of the Comprehensive Psychopathological Rating Scale (CPRS). Furthermore, a personality inventory, KSP, was completed when the patients had improved markedly. Forty-six per cent of the patients were found to have pain as a symptom. The patients with pain were found to have more somatic anxiety, more muscular tension, more psychasthenia and more inhibition of aggression but no significant differences were found in guilt. Thus pain as a symptom in depressive disorders seems to be linked to muscular tension and the patients seem to have more introjected aggression while no evidence emerges indicating that pain could serve to relieve the feelings of guilt.

ERPs and psychopathology. II. Biological issues.

We have briefly covered important issues and considerations in four topic areas likely to be of use to the ERP researcher who is also interested in biological psychiatry. We cannot ignore diagnosis because of its basic role in the field of psychiatry. Although there are reliability problems, especially in the field of psychiatric diagnosis, ERPs may help in the painstaking task of validating diagnosis based on behavioral observation. In addition, the ERP researcher can use diagnosis to obtain potentially more homogeneous samples of patients so as to reduce between-subject error variance in studies. We have considered research areas like PET scan and CT scan which provide data of more anatomical precision than ERPs for deep neurological sites. While the potential may be there, it is essentially unrealized as yet. Finally, neurochemistry and psychopharmacology seem to be the areas most likely to bear fruit in the immediate future. If this potential is to be realized, it is necessary to formulate new questions and a new methodology to handle these questions. An important question, for example, is whether a biological profile is a more useful criterion than a behavioral profile for predicting response to pharmacological intervention. In biological psychiatry, this question is a human suffering issue of considerable importance.

Patterns of course in patients with a cross-sectional diagnosis of schizoaffective disorder.

The authors conducted a longitudinal study on two samples of patients, fulfilling Research Diagnostic Criteria for schizoaffective disorder and for major affective disorder, respectively. The long-term course in patients defined cross-sectionally as schizoaffective was very heterogeneous. Ten different patterns of course were identified. In schizoaffectives showing a bipolar course with the occurrence of pure affective episodes, the outcome was not different from that in patients with a cross-sectional diagnosis of major affective disorder, whereas in schizoaffectives whose course was characterized by the occurrence of schizodepressive episodes only, or of schizodepressive and schizophrenic episodes, the outcome was significantly poorer than in patients diagnosed as affective.

Life events and biological vulnerability: a study of life events and platelet MAO activity in depressed patients.

The present study investigated the possible relationship between platelet monoamine oxidase (MAO) activity and life events. From the general hypothesis that the impact of life events should be seen against the background of an individual's vulnerability, it was assumed that low platelet MAO patients would need fewer life events to develop a psychopathological condition and that they would experience more negatively those events that occurred. Patients (n = 127) of both sexes suffering from various kinds of depressive disorders participated in the study. There were 39 unipolar patients, 11 bipolar patients, 43 patients suffering from neurotic-reactive disorder, and 34 patients suffering from an unspecified depressive disorder. No statistically significant differences in MAO activity were found in this series among the diagnostic subgroups. Younger patients predominated among those with the lowest MAO values. As expected, low MAO patients reported a lower number of life events than patients in the highest MAO quartile, and had experienced those events more negatively.

Morbidity risk for psychiatric disorders in families of probands with affective disorders divided according to levels of platelet MAO activity.

In a series comprising 166 subjects with affective disorders, the lowest and highest quartiles in the male and female platelet monoamine oxidase (MAO) distribution, respectively, were included. The morbidity risk in the first-degree relatives (parents and siblings) of these low and high platelet MAO subjects was determined. First-degree relatives of low platelet MAO probands were found to have an increased morbidity risk for neurotic-reactive depressions and for alcoholism. The results seem to be in line with the biological high-risk paradigm, indicating that platelet MAO could be a biological marker for increased vulnerability. First-degree relatives of high platelet MAO probands were found to have an increased morbidity risk for bipolar affective disorders.

Transhistorical variations in personality and their association with experiences of parental rearing.

A population sample comprised of 765 subjects (367 males and 398 females), in the age range of 15-81 years, completed the EMBU, a reliable questionnaire aimed at assessing experiences of parental rearing, and the TCI, a self-report questionnaire aimed at assessing dimensions of temperament and character. The study had three main aims: 1) to verify, on a larger scale, previous findings suggesting the occurrence of significant associations between experiences of parental rearing and aspects of temperament and character, 2) to assess possible variations in temperament and character in cohorts of subjects who have grown up in different historical epochs, and 3) to investigate to what extent transgenerational differences in parental rearing are detectable in different associations with various dimensions of personality. Several, albeit small, significant and meaningful associations between experiences of parental rearing and both temperament and character dimensions have been found, adding support to the robustness of previously reported results obtained in an independent smaller series. Also, several significant differences among subjects in different age groups have been found, both concerning temperament variables and character dimensions. Finally, the results show that associations between experiences of parental rearing and dimensions of temperament and character are most pronounced in subjects belonging to the youngest cohort and almost nil in the cohort comprising the oldest subjects.

The distinction between unipolar and bipolar mood disorders. A 25-years perspective.

The paper deals with a critical appraisal of the state of art of the distinction between bipolar (manic-depressive) and unipolar recurrent affective disorders. However already propounded several years earlier by Leonhard, a distinction between bipolar and unipolar affective disorders has first been taken into general consideration during the last quarter of a century. It is currently firmly established in the most widely accepted international classification systems, and is taken into account in the major psychiatric textbooks. Looking back at the evolution of this distinction, to which research work by the present author has greatly contributed, there are reasons to feel both satisfied and unsatisfied at the same time. Satisfaction arises from the fact that a distinction between bipolar and unipolar affective disorders has contributed to advance our understanding of the nosology of the depressive states, hence, contributing to a higher degree of homogeneity in the populations of patients in research. Dissatisfaction, instead, is born by the ever increasing widening of the scope of the concept of bipolar and unipolar to which current classification systems greatly contribute.

Cross-national generalizability of dimensions of perceived parental rearing practices: Hungary and The Netherlands; a correction and repetition with healthy adolescents.

In a previous study, an attempt was undertaken to examine whether dimensions of parental rearing style as measured with the Egna Minnen Beträffande Uppfostran (EMBU) on dimensions of Rejection, Emotional Warmth, Overprotection, and Favoring Subject can be generalized from Dutch adult samples, for whom they were originally interpreted from factor analyses, to an Hungarian adult sample. The findings suggested either differences in the meaning of the constructs between Hungarians and the Dutch or the presence of errors of translation in the Hungarian version. To rule out the possibility of inadequate translation, the Hungarian item-content was cross-checked by our Hungarian coworkers and, after reformulating several items, used for obtaining new data with a sample of adolescents. On the whole, negative findings with the old version disappeared with the new; clear evidence was found here for qualitative similarity/identity of the Rejection, Emotional Warmth, and Overprotection dimensions across the Dutch and Hungarian samples. Further studies with Hungarian persons are needed to examine whether these dimensions generalize from (nonpatient) adolescent to adult samples.

[Expectant mothers--women seeking abortions, a sociopsychiatric comparison in Umeå?]. / Blivande mödrar--abortsökande kvinnor i socialpsykiatrisk jämförelse i Umeå.

PIP: A study is reported which relates socioeconomic factors to the frequency of abortion. 118 expectant mothers were compared with 399 women in the same age range who underwent abortion. The largest percentage, 49%, of the women seeking abortion belonged to the social group (after SCB) II during childhood, while 53% of the expectant mothers belonged to social group III. A significantly larger percentage of the women seeking abortion came from broken homes. A subjective evaluation of home life showed that more childhood family conflicts occurred among the women seeking abortion. Gainfully employed women and women with stable living conditions were more likely to bear their children. 44% of the women seeking abortion were between 20-30, the traditional childbearing age, which may indicate a change in the women's attitiude of their role in society.^ieng