Acta Psychiatrica Scandinavica

Objective:  To describe the prevalence of paternal postpartum depression (PPD) as well as its association with maternal PPD.

Method:  A population‐based random sample of 386 couples was assessed from the sixth to the 12th week postpartum for demographic characteristics, alcohol misuse (AUDIT) and depressive symptoms [Beck Depression Inventory (BDI)]. Logistic regression was employed to control for potential confounders.

Results:  In the BDI, 26.3% of mothers and 11.9% of fathers scored above the selected threshold of 10. Mild maternal depression [odds ratio (OR) 3.31, 95% CI 1.52–7.20] and moderate to severe maternal depression (OR 8.44, 95% CI 3.53–20.21) were associated with paternal PPD.

Conclusion:  Paternal PPD is a clinically meaningful phenomenon. Fathers should be evaluated for mood disorders in the postpartum, especially when their partner is depressed.

EEG was continuously recorded in 15 patients for a period extending from just before to 1/2 hour after unilateral ECT. Fourier analysis was performed on the EEG following 15 right‐sided treatments and five left‐sided treatments. During the induced seizure, epileptic slow‐wave activity had significantly greater power on the treated side. Immediately after the seizure, there was significantly more delta activity and less alpha and beta activity on the treated side. This asymmetry, though becoming less marked, was usually still present at the end of the recording period. Analysis of other variables associated with the treatment showed that there was a significant correlation between the time to eye‐opening after ECT and both the duration of the seizure and the amount of anaesthetic administered. The similarity between these induced unilateral seizures and unilateral seizures occurring spontaneously in some epileptics is discussed.

A fluorimetric method is presented for the simultaneous and specific assay in serum of clopenthixol decanoate, clopenthixol and a clopenthixol metabolite, deprived of the ethanol group in the side chain. The sepration is achieved by extractions and thin layer chromatography and fluorescence brought about by treatment with sulphuric acid. The limit of detection in 3 ml serum samples is about 2 ng/ml for clopenthixol and metabolite, and somewhat higher for the ester.

In addition serum data are presented for patients treated with intramuscular injections of 100‐600 mg clopenthixol decanoate in Viscoleor̀ every second week. Relatively stable (maan max./min. ratio about 2; maximum after 3‐7 days) clopenthixol levels were recorded through‐out the dosage interval. Somewhat lower meabolite levels were found. There was no evidence for the presence of clopenthixol decanoate.

In a study of 18 patients with manic symptomatology and 31 patients with melancholic symptomatology the Bech‐Rafaelsen Mania Scale (BRMS) and the Hamilton Depression Scale (HDS) have been compared. The results showed that the inter‐observer reliability of the BRMS was adequate compared with the HDS. Both scales are constructed for assessing the severity of manic or melancholic states, and no difference was found in the total BRMS or HDS score between the various diagnostic groups, when the patients were classified by an index of the course and symptomatology of their disorder, using the Multi‐axial Classification System for Affective Disorders (MULTI‐CLAD). The homogeneity of the BRMS seemed more adequate than that of the HDS, when each item was correlated to the corresponding total score. Although the homogeneity of the BRMS needs to be evaluated by other statistical models than correlation analysis, our results seem to indicate that the improvement in assessing manic‐melancholic states quantitatively is a matter of redefining items or incorporating new items in the melancholic rather than the manic part of these rating scales.

The objective of this study was to evaluate the features and calculate the frequency of sex‐reassigned subjects who had applied for reversal to their biological sex, and to compare these with non‐regretful subjects. An inception cohort was retrospectively identified consisting of all subjects with gender identity disorder who were approved for sex reassignment in Sweden during the period 1972‐1992. The period of time that elapsed between the application and this evaluation ranged from 4 to 24 years. The total cohort consisted of 218 subjects. The results showed that 3.8% of the patients who were sex reassigned during 1972‐1992 regretted the measures taken. The cohort was subdivided according to the presence or absence of regret of sex reassignment, and the two groups were compared. The results of logistic regression analysis indicated that two factors predicted regret of sex reassignment, namely lack of support from the patient's family, and the patient belonging to the non‐core group of transsexuals. In conclusion, the results show that the outcome of sex reassignment has improved over the years. However, the identified risk factors indicate the need for substantial efforts to support the families and close friends of candidates for sex reassignment.

Objective: To investigate the association between mental illness and cancer incidence, mortality and case fatality.

Method: A population‐based record linkage study was undertaken based on 172 932 patients of mental health services in Western Australia. Records of mental health service contacts were linked with cancer registrations and death records.

Results: While there was little difference in overall cancer incidence rates between psychiatric patients and the general community (RR in males 1.05, 95% CI 1.02–1.09, RR in females 1.02, 0.98–1.05), cancer mortality was 39% higher in males (95% CI: 32–46%) and 24% higher in females (17–32%).

Conclusion: People with mental illness in Western Australia do not show an increased incidence rate of cancer, but do have higher cancer mortality. This was attributed to a higher cancer case fatality rate among people with mental illness.

A decreased incidence of cancer of the prostate has been demonstrated in a cohort of 6168 chronic schizophrenic patients followed up from 1957 to 1984. A case‐control study was performed based on this cohort to determine the possible influence of neuroleptic treatment and other factors on the risk of developing prostate cancer. Thirty‐eight male schizophrenic patients who had developed prostate cancer during the observation period were compared with 76 age‐ and sex‐matched controls from the same cohort. The only significant association was that of a reduced risk of prostate cancer among those who had been treated with a cumulative dose of high‐dose phenothiazines (primarily chlorpromazine) of 15 g or more. These patients had been treated with an average daily dose of 145 mg chlorpromazine for an average of 12.5 years. No other significant risk factors were identified.

Two groups of elderly chronic schizophrenic patients, one with and one without tardive dyskinesia (TD), were studied. In addition to estimation of the neuroleptic‐like radioreceptor activity (RRA) of the serum, serum concentrations of thioridazine (THD) and its major metabolites, THD‐2‐sulfoxide, THD‐2‐sulfone and THD‐5‐oxide, were measured with high performance liquid chromatography. Blood samples were collected at two different occasions when the patients were considered to be in a pharmacological “steady state”. The concentrations of THD and its metabolites, as well as RRA values, were similar at both occasions. In general, THD‐2‐sulfoxide and THD‐5‐oxide were present in higher concentrations than the parent compounds, and the serum concentrations of THD, its metabolites and the RRA values were positively correlated with the administered daily dose of THD. However, no significant difference in serum levels of THD, its metabolites, or RRA values existed between the patients with and without TD. These data suggest that pharmacodynamic rather than pharmacokinetic differences may be more important in producing high risk for TD in patients on long‐term neuroleptic treatment.

Patients with first‐episode (FE) schizophrenia (n=27), unipolar depression (n=10) and bipolar disorder (n=17) and age‐ and gender‐matched healthy control subjects (n=27) were administered a battery of neuropsychological (NP) tests. FE schizophrenics performed significantly less well than patients with affective disorders in the area of visual motor processing and attention. Affective disorder patients without psychotic features did not perform significantly differently to controls. However, affective disorder patients with psychotic features performed as poorly as schizophrenics, with the most pronounced impairment in the area of visual motor processing and attention. Our data tentatively suggest the existence of a dichotomy in neuropsychological impairment, with psychotic patients showing similar neuropsychological deficits, while non‐psychotic affective patients perform comparably to controls.