Fwd: The British Journal of Psychiatry Highlights of this issue for 1 December 2008; Vol. 193, No. 6


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BJP Online -- Highlights of the Current Issue

December 2008; Vol. 193, No. 6

The complete Table of Contents for the current issue is available
online at:
http://bjp.rcpsych.org/content/vol193/issue6/

The following content is available online at:
http://bjp.rcpsych.org/cgi/content/full/193/6/A22

Highlights of this issue

Kimberlie Dean

Obstetric events and mental disorder

Fergusson et al (pp. 444–451) conducted an analysis of longitudinal
data from the Christchurch Health and Development Study in order to
examine the links between pregnancy and mental health outcomes. The
authors comment that this is an area of research which has been beset
by inconsistent findings, methodologically flawed studies, and
ideologically driven researchers. Induced abortion was found to be
associated with a small increase in risk of mental disorder but other
pregnancy outcomes were not related to risk of mental health problems.
In an Australian study, Dingle et al (pp. 455–460) compared
psychiatric outcomes in women after induced abortion and miscarriage.
In this birth cohort study, young women reporting a pregnancy loss,
either abortion or miscarriage, had nearly three times the odds of a
lifetime drug use disorder. Abortion was also associated with having
an alcohol use disorder and 12-month depression.

Borderline personality disorder

In a Spanish study by Pascual et al (pp. 471–476), those being
admitted to a psychiatric emergency service were found to be diagnosed
with borderline personality disorder less frequently if they were of
immigrant compared with indigenous background. Particularly low rates
of diagnosis were found among those of Asian and sub-Saharan African
origin. Two papers in the Journal this month describe interventions
for borderline personality disorder. Chanen et al (pp. 477–484) report
on a randomised controlled trial (RCT) to investigate the
effectiveness of cognitive analytic therapy (CAT) compared with
manualised good clinical care for out-patients aged 15–18 years. Both
interventions were equally effective in reducing externalising
symptomatology and no adverse effects were detected for either. There
was some evidence of more rapid improvement among those receiving CAT.
Schulz et al (pp. 485–492) report on a large multicentre RCT designed
to assess the efficacy of variable-dosed olanzapine v. placebo for
adult out-patients with borderline personality disorder. Both trial
arms showed improvements and did not differ at the end-point. Time to
response was, however, significantly shorter for those receiving
olanzapine but the occurrence of weight gain and elevated prolactin
levels was higher.

Interventions for bereavement and bulimia nervosa

McDaid et al (pp. 438–443) conducted a systematic review of
interventions for individuals bereaved through suicide. Eight
controlled studies were identified and all but one had significant
methodological flaws. Compared with no intervention, there was some
evidence of benefit for specific interventions from single studies
whereas studies that included two or more active interventions were
more equivocal. Schmidt et al (pp. 493–500) report findings from an
RCT designed to assess the effectiveness of a CD–ROM-based
cognitive–behavioural self-care intervention for individuals with
bulimia nervosa and eating disorders not otherwise specified. The
study was conducted in a routine setting and individuals were
randomised to either CD–ROM without support for 3 months or waiting
list, with both receiving therapist-delivered cognitive–behavioural
therapy after this period. Although the CD–ROM group appeared to do
better at the 3-month point, the opposite appeared to be true at 7
months, and on post hoc analysis no differences were found at either
time point.

IQ and risk of death from homicide

In a large cohort of Swedish men administered an IQ test at military
conscription, mortality was examined over a 20-year period (Batty et
al, pp. 461–465). A high IQ score was found to be associated with a
reduced risk of death from homicide, with a gradient seen across IQ
groups. The association was reduced by only a small amount after
adjustment for confounders.

Cornelia de Lange syndrome

Abnormalities on chromosomes 5, 10 and X have been found to be
associated with Cornelia de Lange syndrome – characterised by a
physical phenotype, intellectual disability, poor expressive
communication and self-injurious behaviour. In a case–control study by
Oliver et al (pp. 466–470), the behavioural phenotype of the syndrome
was explored. No differences were found on global measures of
behavioural disorder when those with the syndrome were compared with a
control group with intellectual disability, but severe autism was more
common in the syndrome group. Higher levels of compulsive behaviour
were also found.

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