Forbes Winslow and his Journal: With an introduction by.

During the 19th century, there were few periodicals dedicated to the inchoate discipline of alienism (now called 'psychiatry'). Given the newness of alienism and the idiosyncratic structure of the British publishing industry at the time, for a private individual to start a new specialized journal was a major enterprise. Against all odds, Forbes Winslow managed to publish his journal from 1848 to 1860, and during this period the scholarly nature of his publication could not be matched by the Asylum Journal, the official publication of the Association of Medical Officers of Asylums and Hospitals for the Insane. Under the title Psychological Medicine, Winslow offered a new view of alienism which he clearly conceived as a discipline broader than medicine. He strove to inform his readers about the conceptual and practical complexities that then (as now) beset and besiege the care of the mentally ill. He taught his readers that to understand and manage insanity, knowledge of philosophy and of the human sciences was as important as knowledge about the brain. In the 1850s this was a new message to impart.

Validation of the Spanish version of the Addenbrooke's Cognitive Examination in a rural community in Spain.

BACKGROUND: The Addenbrooke's Cognitive Examination (ACE) is a brief cognitive test battery designed to detect and differentiate Alzheimer's disease (AD) and frontotemporal dementia (FTD). Translations of this instrument into French and Malayalam have been recently published OBJECTIVE: To adapt and validate the ACE into Spanish in a rural population of low-educational level. SUBJECTS: A clinical group, composed of 70 patients affected by dementia and 25 patients with memory complaints without dementia, was compared with 72 controls matched for gender, age and educational level METHOD: The clinical group was studied with standard neuropsychological instruments, all patients underwent neuroimaging [Computerized Tomography (CT) or Magnetic Resonance Imaging (MRI), and Single Photon Emission Tomography (SPECT) in all cases of suspected FTD], as well as routine neurological examination. Both groups were studied with the ACE and Clinical Dementia Rating scale (CDR). Sensitivity, specificity, area under curve, reliability and Verbal-Language/ Orientation-Memory (VLOM) ratio were calculated. Subsequently, the sample was stratified regarding educational level in two groups. Receiver Operating Characteristics (ROC) curves were calculated for these conditions. Different cut-off points were calculated addressing educational level. RESULTS: ROC curves demonstrated the superiority of the ACE in the sub sample of patients that finished school at over 14 years old. VLOM ratio confirmed its usefulness for differential diagnosis between AD and FTD CONCLUSIONS: The Spanish version of the ACE is a useful instrument for dementia diagnosis. In our sample VLOM ratio results were useful for differential diagnosis between AD and FTD. Different cut-off points must be used for different educational levels.

Dysexecutive syndrome in schizophrenia: A cross-cultural comparison between Japanese and British patients.

This study tested the hypothesis that the dysexecutive syndrome of schizophrenia is impervious to cultural differences. 18 Japanese and 22 British patients and 14 Japanese and 19 British control subjects were compared on the BADS (Behavioural Assessment of Dysexecutive Syndrome), a comprehensive neuropsychological assessment battery, designed for 'ecological validity', and other measures of frontal executive functions (EFs). Both cultural groups of schizophrenic patients showed equally severe impairment in most executive tests including the BADS (verbal fluency and intelligence were less impaired). Irrespective of cultural origin, similar neuropsychological deficits were found in patients with minimal intellectual deterioration. Our study suggests that socio-cultural background does not affect the dysexecutive profile of schizophrenia very much, and that neuropsychological assessment may possibly provide added clinical information relevant to the management and rehabilitation of schizophrenic patients across different cultures.