Effects of exercise on cognitive and motor function in chronic fatigue syndrome and depression.

Objectives: Patients with chronic fatigue syndrome complain of physical and mental fatigue that is worsened by exertion. It was predicted that the cognitive and motor responses to vigorous exercise in patients with chronic fatigue syndrome would differ from those in depressed and healthy controls.

Methods: Ten patients with chronic fatigue syndrome, 10 with depressive illness, and 10 healthy controls completed cognitive and muscle strength testing before and after a treadmill exercise test.

Brain abnormality in schizophrenia. A systematic and quantitative review of volumetric magnetic resonance imaging studies.

Background: Numerous in vivo brain imaging studies suggest that cerebral structure is abnormal in schizophrenia, but implicate different regions to varying extents.

Method: We identified published MRI studies in schizophrenia with searches of the computerised literature and key journals. Reports giving the volumes of cortical structures in people with schizophrenia and controls were included.

Obstetric complications and age at onset in schizophrenia: an international collaborative meta-analysis of individual patient data.

Objective: An excess of obstetric complications in the histories of schizophrenic patients is a well-replicated finding, but less consistent results have been found concerning the relationships between obstetric complications and family history of schizophrenia, age at onset of schizophrenia, and gender. Small sample size limited the power of previous studies that attempted to assess such relationships. The aim of this study was to use data on individual patients from all available studies to examine the links between a history of obstetric complications and family history of schizophrenia, age at onset, and gender.

Qualitative cerebral morphology in schizophrenia: a magnetic resonance imaging study and systematic literature review.

Patients with schizophrenia have larger lateral ventricles, less cerebral substance and smaller mesial temporal lobe structures than groups of normal controls, but it has proved difficult to link these volumetric abnormalities with clinical features of the illness. Such quantitative techniques may overlook qualitative abnormalities of importance. We therefore compared a neuroradiologists' clinical assessment of gross structural abnormalities, generalised 'atrophy' and high intensity signal (HIS) foci, as detected on the first and second echo of a long TR sequence, in 42 patients with schizophrenia (22 treatment responsive, 20 treatment resistant) and 50 normal controls.

A population-based incidence study of chronic fatigue.

Background: Most research on syndromes of chronic fatigue has been conducted in clinical settings and is therefore subject to selection biases. We report a population-based incidence study of chronic fatigue (CF) and chronic fatigue syndrome (CFS).

Methods: Questionnaires assessing fatigue and emotional morbidity were sent to 695 adult men and women who had replied to a postal questionnaire survey 1 year earlier.

Factors associated with admission to hospital following emergency psychiatric assessment.

Psychiatric emergencies account for a large proportion of total referrals and admissions yet there has been little research in the United Kingdom into factors associated with admission after emergency psychiatric assessment. We conducted a one year prospective study of all emergency referrals from Borders Region in Scotland. Four hundred and eighty-seven emergencies were assessed and 153 (31%) of these were admitted.

A controlled trial of general practitioners' attitudes to patients with schizophrenia.

Objective: To examine general practitioners' attitudes to patients with schizophrenia.

Design: A random sample of primary care physicians were alternately sent a case vignette of a patient with or without schizophrenia, in an otherwise identical clinical abstract, and asked to indicate their level of agreement with fifteen statements based on it.

Subjects And Setting: A one-in-five sample of general practitioners who were identified from the Primary Care Services Register of Lothian Health Board.

Obstetric complications and schizophrenia: a meta-analysis.

Background: This systematic review of the association between schizophrenia and obstetric complications (OCs) was performed to assess the degree of heterogeneity between studies and to quantify the increased risk of schizophrenia in exposed subjects.

Method: Twenty case-control, one prospective cohort and two historical cohort studies were identified using a MEDLINE search supplemented by a manual search and direct communication with other researchers. Individual odds ratios were calculated for each study and a pooled estimate produced.

Psychosis and substance abuse: cause, effect or coincidence?

An association between substance abuse and major psychiatric illness is increasingly well recognised, but most studies have been conducted in the USA and have focussed upon patients with schizophrenia rather than other disorders. We conducted a survey of 38 consecutively admitted patients with DSM-III-R functional psychoses. A semi-structured substance abuse interview was administered and a urine specimen for drug metabolite screening requested.

Laterality of visuo-spatial attention in acute and chronic schizophrenia, major depression and in healthy controls.

Previous studies have suggested that schizophrenia is characterized by an asymmetry of visuo-spatial attention, in particular that acute unmedicated schizophrenics demonstrate relative inattention to right hemispace, whereas chronically medicated patients demonstrate the opposite pattern. In the present study, 30 unmedicated schizophrenic patients, 32 chronically medicated schizophrenic patients, 30 patients suffering from major depression and 60 healthy controls were assessed using two measures of hemispatial attentional neglect, namely letter and star cancellation. The results demonstrated that the chronic schizophrenic group made more total omissions for star cancellation (in both right and left hemispace), but that there was no difference between the groups in terms of omission asymmetry for either letter or star cancellation.

Magnetic resonance imaging and single photon emission tomography in treatment-responsive and treatment-resistant schizophrenia.

Background: Patients with schizophrenia differ from controls in several measures of brain structure and function, but it is uncertain how these relate to clinical features of the illness. We dichotomised patient groups by treatment response to test the hypothesis that treatment-resistant patients exhibit more marked biological abnormalities than treatment-responsive patients.

Method: Twenty treatment-responsive and 20 treatment-resistant patients with schizophrenia, matched for sex, age, and illness duration, were compared by magnetic resonance imaging, single photon emission tomography, and detailed neuropsychological assessment.

Chronic fatigue syndrome in the community. Prevalence and associations.

Background: Chronic fatigue syndrome (CFS) is a poorly understood condition, apparently related to both psychiatric disturbance and infectious illness. Little progress has been made in identifying aetiology, owing to a lack of epidemiological studies using case-definition criteria.

Method: A community postal survey of a random sample of over 1000 patients registered at a local health centre comprised a fatigue questionnaire and the 12-item General Health Questionnaire (GHQ).

Hypofrontality revisited: a high resolution single photon emission computed tomography study in schizophrenia.

Hypofrontality or reduced activity in the prefrontal cortex, measured as reduced frontal perfusion or glucose uptake, has gained the status of an established finding in the medical literature on schizophrenia. Many relevant studies, however, have potential sources of bias, such as small subject numbers, or unreliable performance of activation tasks by the patients during the scanning procedure. Seventy patients with non-affective and non-organic psychoses were recruited--most qualifying for DSM III-R schizophrenia or schizophreniform psychosis (n = 60)--together with 20 healthy volunteers.

Post-viral onset of anorexia nervosa.

Background: The pathogenesis of anorexia nervosa (AN) is controversial.

Method: A retrospective case series was studied to investigate the post-viral onset of AN.

Results: Four consecutive in-patients with severe restrictive AN spontaneously volunteered histories of 'glandular fever'-like illnesses immediately before the onset of their eating disorder.

A multicentre study of the in-vitro activity of cefotaxime, cefuroxime, ceftazidime, ofloxacin and ciprofloxacin against blood and urinary pathogens.

The in-vitro susceptibilities of aerobic bacteria isolated from 1804 blood and 4529 urine specimens collected at nine hospitals in the UK were examined. An agar dilution method was used to determine the MICs of each isolate to three cephalosporins, cefotaxime, cefuroxime and ceftazidime, and to two fluoroquinolones, ofloxacin and ciprofloxacin. Sensitivities were then calculated using British Society for Antimicrobial Chemotherapy recommended breakpoints.

Melanocytic lesions excised from the skin: what percentage are malignant?

We estimated the diagnostic skill of clinicians managing melanocytic skin naevi by measuring the percentage of malignant melanomas, premalignant and potentially malignant naevi, in 1896 excised melanocytic lesions submitted to a pathology service over 11 weeks. They comprised 8 per cent. The percentage increased with age: 4 per cent in the under-40s, 17 per cent in those aged 40-59, and 30 per cent in those over 60, (P < 0.