bluuebunny/crossref_metadata_2025 huggingface dataset:
P03-345 Levels of Plasma Serum Dehydroisoandrosterone-Sulfate and Cortisol in Combat Veterans
Authors: Kolov S.
Published: June 2010

Objectives

Recent studies suggest that such neuroactive steroids as dehydroepiandrosterone-sulfate (DHEAS) and cortisol play an important part in conditioning psychiatric disorders in combatants. Cortisol may have a neurotoxic effect whereas DHEAS can produce a neuroprotective impact.

Method

We have investigated the morning plasma level of DHEAS and cortisol as well as DHEAS/cortisol ratio in the group of forty combat veterans in the remote period of combat stress and the same parameters - in the control group consisting of 30 healthy males (N=30).

Results

In comparison with the control group, the combatants reliably showed considerably higher level of cortisol (p< 0,05), lower level of DHEAS (p< 0,001) and lower DHEAS/cortisol ratio (p< 0,001). Then the veterans were divided into two groups with the help of the “Mississippi Scale for Combat-Related Posttraumatic Stress Disorder”: those having post-traumatic stress disorder (PTSD) and those without this diagnosis. As a result, no trustworthy difference between levels of DHEAS, cortisol and their proportion was found in PTSD-positive and PTSD-negative veterans. Each of these groups displayed the reliable reduction of DHEAS level as compared to the control group.

Conclusions

The results of our investigation demonstrate that the veterans differed significantly from the control group in the level of neurosteroids. This fact apparently cannot be linked to PTSD symptoms. Thus there is an urgent need for further examination of clinical and psychological components correlated with altered levels of DHEAS and cortisol in combat veterans.
P03-348 Agitation and Insomnia During Therapy with Alprazolam: Case Report
Authors: Kozumplik O. , Uzun S. , Jakovljevic M.
Published: June 2010

Patient, 43 years old, with diagnoses of posttraumatic stress disorder and recurrent depressive disorder was hospitalized due to worsening of mental condition. At admission he was agitated, depressed, irritable, and presented problems with insomnia. He said that he decided to stop taking antidepressant without consulting his psychiatrist one month earlier because he felt better and he thought he did not need antidepressants any more. During that period he continued taking alprazolam. Soon after discontinuation of antidepressant, his condition worsened, he started feeling tensed, anxious, depressed, and problems with insomnia appeared. He decided to increase the daily dosage of alprazolam from 1,5 mg to 3 mg, but his mental condition deteriorated - he was feeling agitated, irritable, he was depressed and had insomnia. He increased the daily dosage of alprazolam to 4 mg, but his condition was getting worse. He decided to come to hospital because he could not bare such symptoms any longer. After admission, tianeptine was introduced (37,5 mg daily) with zolpidem 10 mg in the evening, and daily dosage of alprazolam was gradually decreased. After this changes in therapy agitation gradually decreased, as well as insomnia. His mood gradually improved. He was discharged after four weeks of hospital treatment.
P03-355 Antidepressants Risks Adverse Hematological Effects
Authors: Marqués P. , Ladrón de Cegama U. , Martinez V. , Valera C. , Piñol C.
Published: June 2010

Introduction

Numerous reports have pointed out the risks adverse hematological effects associated with psychotropic drugs. We report a severe case of thrombocytopenia in a healthy 79 year-old patient happened after mirtazapine administration. Suggesting an immune mechanism.

Objetives

Report a case of mirtazapina-induced inmuno tromnbocitopenia, review of bibliography and to propose monitoring and management strategies.

Aims and methods

:

Care report: PPD (n°HC 16996) treatment with mirtazapina 15 mg/d.Clinical: equimosis cutaneous multiple. Without focalidad. From the point of view etiológico discards organicity (aplasia megacariocítica, processes linfoproliferativos and infectious). An analytical previous examination supports normal platelets until April, 2009, in February the dose doubles from 15 to 30 mg (of mirtazapina). Fatal conclusion: exitus for hemorrhage intracraneal in September, 2009. Clinical judgment: Several Trombopenia, uncertain origin.

Literature review: The first well-documented case of mirtazapine-induced immune thrombocytopenia is “Glycoprotein IIb/IIIa complex is the target in mirtazapine-induced immune thrombocytopenia” (Blood Cells, Molecules, and Diseases, 2003).The analysis “Proportion of drug-related serious rare blood dyscrasias” (American Journal of Hematology, 2004) suggests that a substantial fraction of blood dyscrasias may be attributable to drug therapy.

Results

Hematologic side effects from psychotropics may present as serious or even fatal consequences of treatment. Incidences of hematological changes for antidepressants were much lower (about 0.01%).

Conclusions

Before initiating therapy with antidepressants, a carefully case history, with special attention to heart disease, family record and medical treatments, should be obtained. Clinical best practice regarding the safe and effective use of psychotropic medications is based on appropriate monitoring of drug-related problems.
P03-356 A Review of the Mechanisms of Stem Cell Regenerative Properties
Authors: Osain Welcome M. , Alekseevich Pereverzev V.
Published: June 2010

The regenerative ability of stem cell after transplantation into ischemic and necrotic tissues is not fully understood. We therefore examined various literature data on the effect of stem cell transplantation, to help better understand the process by which cell regenerates. Literature data on the effect of stem cell transplantation were critically analyzed. Our analysis reveals that stem cells posses multiple action sites with multiple mechanisms of action. The extraordinary regenerative ability of stem cells might largely be due to the auto-paracrine effects exacerbated in the surrounding tissues after transplantation. The autocrine/paracrine effects result from dimeric, oxidation-reduction reactions involving autophosphorylation and dephosphorylation of surface proteins, leading to activation of several downstream signaling pathways, signal transducers and activators of transcription (e.g. cAMP response binding protein). The resultant effect is the stimulation of the inhibition of apoptosis, proliferation and differentiation, which are the net result of several protein kinases cascade reactions. The paracrine effects are evident in the mechanical stimulation of ischemic and necrotic tissues by transplanted stem cells. Molecules like sulphonyl hydrazone and CD34 used in transplantation upregulate and trigger auto-paracrine factors like VEGF, IGF, angiotensin II, atrial natriuretic polypeptide, resulting from Ca+ related trafficking of nucleotides and the activation of sodium transport system, which in turn determines the amount of energy available in the transplantant-host cell medium. The end result of transplantation effect is not only dependent on the stimulation of these molecules, but also degree of the internal homeostatic regulation.
P03-368 - Paliperidone in Patients with Psychotic Disorders and HIV/AIDS
Authors: Fernández J.L. , Rojo Á. , Miralles C. , Ocampo A.
Published: June 2010

Objectives

To assess how effective paliperidone is for psychotic symptoms of patients with HIV/AIDS and to assess neuropsychiatric, liver and metabolic side effects associated with paliperidone.

Method

The participants were 9 patients with HIV/AIDS who had psychotic symptoms. These patients were assessed with the brief psychiatric rating scale (BPRS), and the cut-off point was 21. Neurocognitive impairment was assessed with the mini-mental state examination (MMSE), using a cut-off point of 28. Hemathological tests serum transaminases were performed to determine liver function and metabolic syndrome study was implemented as defined by the National Cholesterol Education Program. All patients started taking medication with paliperidone up to 3-9 mg/kg. After a one, three and six-month period of treatment, the patients were reassessed using UKU side-effect rating scale, BPRS, hemathological tests and a full metabolic symdrome study.

Results

Paliperidone is an effective antipsychotic drug: only one patient had psychotic symptoms. Paliperidone didn’t cause any side-effect in none of the nine patients, had a good profile of tolerance regarding liver function, any patient suffered changes in hemathological tests serum transaminases and there wasn’t any significant change in metabolic parameters of the nine patients. Any patient suffered cognitive impairment using MMSE.

Conclusions

Paliperidone can be considered a highly effective treatment for patients with psychotic symptoms and HIV/AIDS. This drug has a good antipsychotic profile, doesn’t affect liver function, doesn’t cause neuropsychiatric side-effects and doesn’t cause metabolic syndrome after a six-month treatment. These findings support this drug as first choice treatment of this kind of patients.
P03-369 - Compliance to Treatment with Quetiapine vs Quetiapine XR of 24 Patients with Diagnosis of First Episode of Psychosis in SPDC
Authors: Russo A. , Pirone S. , Passione N.M. , D’Amato F. , Pirarella F. , Fiore F.
Published: June 2010

Objective

To value medication adherence and discontinuation of treatment among first episode psychosis patients (FEP) treated with quetiapine or extended release of quetiapine (XR).

Method

Patients with a first episode of psychosis, age 26+/- 2(N=24) were randomly assigned to treatment with quetiapine 300 mg for twice daily(n=12), or quetiapine rp 300mg/day in one administration daily(n=12),for a 6 months period

Results

The drop-out of patients for any cause thought the 6-months study was:2 for quetiapine and 6 for quetiapine XR. However, symptom reduction were the same in both groups.

To conclude: According to a interview conducted with patients, there is more compliance to therapy for patients treated with quetiapine XR, they prefer to be given a day instead of twice daily administration. Fewest drop-out with quetiapine XR is probably also due to steady-state quetiapiana rp is reached more quickly and better maintained, resulting in greater clinical control.
P03-371 - Electroconvulsive Therapy (ECT): a Retrospective Study of the Psychiatric unit of a Brazilian General Hospital from 1993 to 2007
Authors: Santos A. , Oliveira M.C. , Andrade T.S. , Freitas R.R. , Salán T.M. , Azevedo R.C.S. ,   ECT Study Group
Published: June 2010

Objectives

To describe the socio-demographic and clinical characteristics, complications and therapeutic response of patients treated with ECT in the Psychiatric Unit of the General Hospital from University of Campinas-Brazil (1993-2007).

Methods

All medical records of the patients who underwent ECT were reviewed and compiled for subsequent statistical analysis by SPSS program.

Results

156 patients were studied. Ages ranged from 13 to 78 years-old, with a mean of 39.9±17.8 years-old [95% CI: 37.2-42.8 years]. There were 64 (41%) men and 92 (59%) women. The main diagnostic categories of the patients submitted to ECT were: schizophrenia (33.9%), depression without psychotic symptoms (30.8%), depression with psychotic symptoms (39.1%), bipolar disorder (18.6%) and schizoaffective disorder (3.2%). Complications occurred during the procedure in 98 cases (62.8%), immediately after the application in 85 cases (54.5%) and three days after the last session in 33 cases (21.2%).

The response to ECT was: good response in 132 (84.6%) patients, unchanged psychiatric symptoms in 14 (9%) patients and worsening in 3 (1.9%). The mean time of permanence inside the Psychiatric Unit was 57.5±38.2 days [95% CI: 51.4-63.2 days].

Table1 1:

Complications during the procedure

ComplicationsN%Incomplete seizure7950.6%Arrythmia3220.5%Prolonged seizure2214.1%Ineffective session after three applications2113.5%Hypertensive episode1811.5%

Table 2:

Complications immediately after the proce

ComplicationsN%Mental confusion3824.4%Amnesia2616.7%Headache2314.7%Gastrointestinal alterations1811.5%Pneumonia21.3%Pulmonary thromboembolism21.3%Manic turn21.3%Bronchospasm10.6%Subarachnoid hemorrhage10.6%

Table 3:

Complications at least three days after t

ComplicationsN%Amnesia1710.9%Mental confusion106.4%Headache63.8%

Conclusions

The diagnostic categories for which ECT therapy corresponded to those described in the literature. Data suggest that the incidence of complications was moderate and the response to treatment was positive in most cases, reinforcing the importance of this therapeutic method for the treatment of patients with severe mental illness.
P03-373 - Relation Between Symptomatic and Functional Outcomes in Adults with ADHD Treated with OROS MPH - a Partial Correlation Analysis
Authors: Buitelaar J.K. , Roesler M. , Kooij S. , Casas M. , Dejonckheere J. , van Oene J. , Schaeuble B. , Trott G.-E.
Published: June 2010

Objective

To explore the relationship between symptomatic and functional outcomes in a five week, double blind, fixed dose, placebo controlled study in adults (age 18-65 years) with ADHD.

Methods

Post hoc-analysis of a five-week, double-blind (DB), parallel arm, placebo-controlled trial in adult subjects with ADHD (DSM-IV) and a Conners’ Adult ADHD Rating Scale (CAARS) score >= 24 at baseline. Subjects were randomized to OROS-MPH (18mg, 36mg, 72 mg/day) or placebo. Symptomatic outcomes were assessed by total CAARS score (TCS). Functional outcomes were assessed by Sheehan Disability Scale (SDS) total score and subscales (work, social life and family life), quality of life by Q-LES-Q total score. The relationship of CAARS with SDS and Q-LES-Q was assessed by Pearson's partial correlation analysis, with adjustment for baseline scores of CAARS, SDS, Q-LES-Q, CGI-S, age, sex, and randomization group.

Results

401 subjects were enrolled (54.4% male, mean (SD) age 34 (10.24) yrs). There was a significant treatment effect as measured in TCS at DB endpoint for all OROS MPH treatment groups compared to placebo (P< 0.05). The absolute value of partial correlations of symptomatic outcome with functional outcomes and quality of life varied between 0.54 and 0.36; all correlations were significant (p< 0.0001). These correlations were compared between the functional and quality of life measures, but none differed significantly.

Conclusion

Subjects’ symptomatic improvements during treatment with PR OROS MPH are reflected in improvements in their vocational and social function as measured by the SDS, and quality of life.
P03-379 - The use of Clozapine in Children and Adolescents with Serious Conduct Disorder for Control of the Aggressiveness
Authors: Teixeira E.H. , Santos A. , Salán T.M. , Jacintho A.C.d.Á. , Celeri E.H.R.V. , Dalgalarrondo P. ,   Child and Adolescent Psychiatry Study Group
Published: June 2010

Objectives

To analyze the use of Clozapine in six children and adolescents with Serious Conduct Disorder, whose symptoms had been refractory to other pharmacology treatment. Scalar analysis is supplied for the more important psychopathology aspects and the changes with therapeutic one.

Methods

Six patients diagnosed with Serious Conduct Disorder are described who had begun the use of Clozapine. They had been widely studied and received application of standardized instruments of infantile psychiatry (CBCL - Child Behavior Check List) before and after the use of this medication.

Results

The patients had mainly significant improvement in relation to the level of aggressiveness and social behavior.

Conclusions

Although ample studies on the use of this medication in children and adolescents do not yet exist, more precisely for cases of Serious Conduct Disorder, the preliminary results are very positive and indicate that Clozapine could be an important tool in the handling of the aggressiveness in those refractory patients with Serious Conduct Disorder.
P03-385 - Aripiprazole in the Treatment of Risperidone Associated Tardive Dyskinesia
Authors: Yilmaz O. , Ates M.A. , Algul A. , Semiz U.B. , Basoglu C. , Ebrinc S. , Cetin M.
Published: June 2010

Objectives

Tardive dyskinesia(TD) is a syndrome characterized by repetitive involuntary movements, usually involving mouth, face and tongue and sometimes the extremities. Atypical antipsychotics are of significantly lower risk for causing tardive dyskinesia, about one-fifth comparing with first generation antipsychotics. Furthermore, there is growing evidence that they may have a therapeutic effect on TD. We present a case that demonstrated a marked improvement in risperidone-induced TD following treatment with aripiprazole.

Method

Mr. A is a 21-year-old single male with a DSM-IV-TR diagnosis of schizophrenia, of approximately 2 years duration. He was mainly maintained on risperidone 4-6 mg/day during this time. Upon his admittance to our clinic, he was suffering auditory hallucinations, persecutory delusions, social withdrawal and he was noticed to have had some involuntary mouth movements. The patient scored three out of four (moderate) on the ‘lips and peri-oral area’ subcategory of the- Abnormal Involuntary Movement Scale (AIMS). A cranial CT scan was unremarkable and there was no past history or family history of neuro-psychiatric disorders. He was started on aripiprazole 15 miligrams per day.

Results

Within two weeks a marked improvement was seen in his psychotic symptoms and he scored 2 on the AIMS. Two months after starting aripiprazole, he was free of psychotic symptoms and dyskinetic movements.

Conclusion

Altough atypical antipsychotics are known to be associated with lower risk of developing tardive dyskinesia, psychiatrists should be aware of these rare conditions. Aripiprazole, as a partial dopamine agonist, might be an alternate pharmacotherapy in threating psychosis and atypical antipsychotic-induced TD.
P02-298 - Clinical Course of Patients with Anorexia Nervosa in an In-Patient Adolescent Eating Disorder Unit
Authors: Clancy M. , Codd M. , McNamara D.
Published: June 2010

Introduction

This study examined adolescents with anorexia nervosa admitted to a tertiary referral unit in Dublin over a 3 year period.The aims of the study were to assess changes if any in patient clinical and laboratory parameters specifically weight change, body mass index (BMI), cardiovascular, haematological and biochemical measurements over the course of in-patient stay.

Methods

Hospital computerized databases and clinical case notes were examined for each patient.Results were compared with Royal College of Psychiatrists (RCP) and National Institute for Clinical Evidence (NICE) guidelines for treatment of in-patients with anorexia nervosa.

Results

There were at total of 42 admissions over the 3 years.7 males and 35 females were admitted.Median length of admission was 88 days. Female patients gained on average 7.2 kilograms during their admission.The average female BMI on admission was 14.9 on admission and 17.6 on discharge. 82.3% of female admissions had blood abnormalities, the most common being anaemia and hypokalaemia.45.7% of female patients had an abnormal electrocariograph.25% of female patients required transfer out during their admission for medical review.

Conclusion

The eating disorder unit fulfilled the RCP and NICE guidelines for 97.6% of patients in terms of blood results performed and 92.8% in terms of electrocardiographs performed.The average BMI on discharge for both males and females was above 17.5 which is regarded as the normal cut off point for anorexia nervosa.The importance of this study despite its limited sample size is that it is the first study of investigations and outcomes in an Irish in-patient adolescent eating disorder sample.
P02-304 - Alexithymia is Associated with Eating Disorder Symptoms in Adolescents
Authors: Karukivi M. , Hautala L. , Korpelainen J. , Haapasalo-Pesu K.-M. , Liuksila P.-R. , Joukamaa M. , Saarijärvi S.
Published: June 2010

Objectives

Increasing amount of evidence indicates an association between alexithymia and eating disorder (ED) symptoms. The aim of this study was to evaluate possible association between alexithymia and EDs in a non-clinical sample of late adolescents.

Methods

The questionnaire was sent to 935 adolescents of whom 729 (78%) completed it, thus forming the final sample. The mean age in the sample was 19 years (range 17−21 years). Alexithymia was measured using the 20-item Toronto Alexithymia Scale (TAS-20) and ED symptoms were assessed using the SCOFF questionnaire, a novel tool for screening ED symptoms. A TAS-20 score of 61 or more was used as the cut-off point for classifying a subject as alexithymic, and for SCOFF, the cut-off point for a SCOFF positive subject was of two or more positive answers.

Results

The rate of alexithymia was 8.2% (8.2% for females and 8.5% for males). The mean TAS-20 scores were 44.65 for females and 45.98 for males without any gender difference. Among the alexithymic adolescents, the share of SCOFF positive subjects was significantly higher as compared to the non-alexithymic group (32.2% vs. 11.3%). The mean SCOFF scores also differed significantly between alexithymic and non-alexithymic subjects (0.93 vs. 0.42). The association was clear in the DIF and DDF subscales of TAS-20.

Conclusions

The results suggest that ED symptoms are more common in alexithymic adolescents. However, the evaluation of causal links calls for longitudinal studies.
P02-306 - Eating Disorders - Types of Obsessive-Compulsive Disorder a Case Display
Authors: Krasic D.
Published: June 2010

Both anorexia mentalis and bulimia nervosa are types of eating disorder (F 50.)

Anorexia is a disorder characterized by deliberate loss of body weight.

Bulimia is a disorder featured by repeated attacks of excessive eating as well as preoccupation with body weight. Obsessive-compulsive disorder is qualified by recurrent obsessive thoughts and/or actions which repeatedly appear in ones’ mind.

A display of a 25 year old female with an eating disorder and obsessive-compulsive disorder conjoint on the basis of an anancastic personality, followed by combination of pharmacotherapeutic and psychotherapeutic treatment.

Psychiatric interview, psychological tests (personality test, IQ evaluation test), psychiatric treatment (individual psychodynamic therapy, family therapy; support therapy.) At the beginning of the treatment, the patient had low body weigh (BMI 18), was depressed and dysfunctional, further to occasional bulimic behavior and obsessive-compulsive behavior. Previously she had been treated with antidepressants and basal neuroleptics, clinically and in a dispensary, for a year. After successfully creating a contact and forming a therapeutic alliance, she was submitted to an individual psychiatric treatment as well as family therapy. In addition, pharmacotherapy, which included small doses of atypical neuroleptic and a tricyclic antidepressant, was introduced.

During the first two months of treatment, the subject's body weight increased (BMI 18), symptoms of obsessive-compulsive disorder disappeared, depressive symptoms reduced, and functionality restored. The patient is still being psychiatrically treated.

Different types of obsessive-compulsive disorder may be developed in an anancastic personality at the same time. However, this does not obstruct psychotherapeutic nor pharmacotherapeutic treatment.
P02-308 - Role of Neurotic Disorders in Formation of Circadian Profile of Arterial Pressure in Patients with Hypertonic Illness
Authors: Kupriyanova I. , Semke G.
Published: June 2010

Contribution of neurotic disorders has been rated in patients with essential arterial hypertension (EAH) into formation of variant of chronobiological profile and severity of course of EAH. 49 patients have been examined, 27 men (56,5 %), 22 women (43,5 %), from 23 to 71 years. Average length of disease 14,17±3,23 years. All patients were exposed to circadian monitoring of AP and rating of neurotic disorders. In patients with anxiety disorders statistically significantly low values of circadian index have been revealed. In patients with signs of depression indices of midnight SAP and index of time of SAP at night are higher. There was not found significant contribution of depression into formation of chronobiological rhythm. In patients with asthenia, disturbances of chronobiological profile according to SAP and DAP have been revealed. Vegetative disturbances are associated with excessive decrease of SAP at night («over-dipper»).
P02-309 - Functional Relaxation in Psychosomatic Medicine - Results From Randomized-Controlled Trials
Authors: Lahmann C. , Henningsen P. , Loew T.
Published: June 2010

Functional relaxation is a somatopsychotherapeutic intervention technique commonly used in Germany, Austria and Switzerland for the treatment of psychosomatic disorders. The therapeutic effects are assumed to be delivered by positive stimulation of the autonomic nervous system, as well as by facilitation of proprioreceptive awareness. Minute movements of small joints, hardly noticeable to observers, are performed during relaxed expiration, accompanied by a focus on and exploration of the perceived differences of bodily feelings triggered by these movements. Unlike exercise-based methods, such as progressive muscle relaxation, the bodily perceptions are explicitly verbalized and processed in the therapeutic relationship.

By now, a number of randomized controlled studies have proven the effectiveness of Functional Relaxation in various disorders such as tension headache, bronchial asthma, irritable bowel syndrome, non-specific-chest pain and dental anxiety.
P02-311 - The questionnaire of Eating Behaviours: Creating and Validating a New Screening Instrument For Eating Disorders
Authors: Focà F. , Luci G. , D’Alessandris L. , Blanco P. , Del Basso G. , Vasale M.
Published: June 2010

Objectives

Eating Disorders concern a growing number of people. Several instruments were created to assess symptomatology of Anorexia Nervosa and Bulimia Nervosa. Our aim is to create and validate a short questionnaire about all the eating symptoms of Eating Disorders, including Binge Eating Disorder.

Methods

The Questionnaire of Eating Behaviours (Scheda dei Comportamenti Alimentari, SCA) is a self-administered questionnaire composed of 13 items regarding all the eating symptoms of Eating Disorders. Items are divided into 3 scales: Restrictive Eating, Weight Control Practices and Binge Eating. The SCA was given to 200 female outpatients with Eating Disorders and to 218 non-clinical adult women. Student's t test was performed to compare clinical and non-clinical subjects, one-way ANOVA was performed to compare three diagnostic subtypes (Anorexia Nervosa, Bulimia Nervosa, Binge Eating Disorder). Cronbach's Alpha and factor analysis were used to validate the questionnaire.

Results

Clinical and non-clinical subjects get significantly different scores in all the three subscales. Besides, the three diagnostic subtypes scores significantly differ on each scale. Cronbach's Alpha values show a significant inner consistency in the subscales of Restrictive Eating and Binge Eating, while the Weight Control Practices one is not very homogeneous, as expected. The factor analysis has shown the presence of three factors, corresponding to the 3 scales.

Conclusions

The SCA has shown to be effective in distinguishing people with Eating Disorders from non-clinical subjects. For its characteristics of being short, easy to fill in and to interpret, the SCA seems to be an instrument suitable for screening purposes.
P02-317 - Eating Disorders and Psychoeducation- Patients’ Experiences of Healing Processes
Authors: Pettersen G. , Rosenvinge J. , Wynn R.
Published: June 2010

In the treatment of eating disorders, little is know about the role and impact of psychoeducative programmes and whether patients experience such programmes as helpful in their healing processes. Examining these questions is the purpose of this study, using an explorative and descriptive design based on content analysis. Thirteen female patients participated in qualitative interviews. The analysis of healing processes experienced during the programme participation resulted in six main categories i.e. “Self-awareness”, “Setting boundaries”, “Feelings and self-mobilisation”, “Self-regulation”, “Self-reflexivity” and “Motivation and Self-improvement”. The present study clearly indicates that according to the patients’ experiences, a psychoeducative programme may facilitate healing processes. The study also supports an impression of an indirect impact on healing processes in terms of more readiness to seek treatment. There is a need for more knowledge about how treatment and psychoeducative programmes may be coordinated.
P02-319 - Development and Evaluation of Aplicability for A Psychoeducative Manual As First Intervention on the Treatment of Binge Eating Disorder
Authors: Stefano S. , Devoraes A.M. , Blay S.
Published: June 2010

Objective

The objective of this Project was to develop and evaluate the applicability of a psychoeducative manual adapted to the Brazilian population reality, as first intervention on the treatment of BED patients.

Method

The manual is printed in a brochure format, using a non-medic language, where the information is presented with images and fictitious characters, allowing patients to make use of it without supervision of a specialized professional.

The first part gives information about the disease, characteristics and symptoms, allowing the patient to identify if he has or not the disorder, partial or complete.

The second part gives the mechanisms that predispose, start and perpetuate the eating disorder, helping the patient to recognize them and develop strategies to modify his behavior.

Results

Several versions have been improved by the authors; when a definitive format was achieved, the manual was evaluated by eight eating disorders specialized professionals, who presented their comments and suggestions on the format and contents. After implemented the changes, the 12th version was settled as final, consisting of 10 items. Then, this manual was submitted to 10 patients, to be evaluated regarding information assimilation through a questionnaire specially developed for this purpose.

Conclusions

This is the first psychoeducative manual for BED patients in Brazil. Its final version was considered by the patients a quick and easy to understand reading. Due to the low range of specialized professional assistance, such manual can be very relevant. Studies to evaluate the efficaciousness of this manual are currently under process.
P02-321 - Chronic Fatigue Syndrome: Novel Treatment Perspectives
Authors: Stubhaug B. ,   Frihamnsenteret Clinical Research Center of Psychological Medicine
Published: June 2010

Chronic Fatigue Syndrome (CFS) often presents with severe subjective symptoms and may be accompanied by severe global impairment. No specific treatment has yet been proven to be universally effective; CBT and graded exercise has so far lead to moderately positive results. We present a treatment model based on a comprehensive, educational, cognitive-oriented and mindfulnes-based intervention program, where illness perception and illness behaviour are being challenged. Knowledge of the illness, a comprehensible illness model and understanding unexplainable symptoms constitute the education program. Mindfulness training and stress reduction, combined with cognitive group therapy are essential part of the program. Knowledge, thoughts and feelings are being adressed, including the experience of life satisfaction and positive and negative emotions.

We present data on stress parameters, mindfulness items and lifte satisfaction factors, pre and post treatment.
P02-327 - Persistence and Reversibility of Neuroimaging Alterations in Anorexia Nervosa Patients After Weight Recovery: A Review of Literature Studies
Authors: Meuti V. , Loriedo C. , Costa E.
Published: June 2010

Introduction

Anorexia nervosa (AN) is a chronic and relapsing disorder, characterized by aberrant patterns of weight regulation and eating behaviour, body image distortion and resistance to treatment.

Aims

This study aims to investigate the reversibility of the most important structural and functional cerebral alteration found in the illness state after weight recovery, in order to distinguish between state-dependent abnormalities and neurological signs of traits vulnerability.

Methods

The most significant neuroimaging studies are reviewed from the scientific literature of the last ten years, using the following keywords: “neuroimaging”, “anorexia”, “reversibility”, “weight recovery”, “cerebral blood flow”, differently matched together.

Results

Structural neuroimaging techniques show a widening of internal cerebrospinal fluid filled spaces and a brain gray and white matter volume loss. These alterations take place in the low-stages of AN, as body weight decreases, and generally reverse with weight restoration, as a function of re-feeding. Functional neuroimaging studies reveal a reduced global and regional cerebral glucose metabolism in the acute state, that reverses with recovery. On the other hands, techniques based on stimuli provocation reveal a greater activation in the medial prefrontal and anterior cingulate cortices in response to food stimuli, that persists after recovery, suggesting that these alterations could be primary abnormalities related to trait vulnerability.

Conclusions

Other studies needs to distinguish between primary neural disturbance and secondary phenomena due to starvation, in order to individuate patterns of vulnerability and to develop new strategies of treatment and prevention.
P02-339 - Internet-Based Therapy Process Monitoring of Psychotherapy Using the Synergetic Navigation System (SNS) -Methodology and Case Report
Authors: Dold M. , Demal U. , Lenz G. , Schiepek G. , Aigner M.
Published: June 2010

Introduction

To improve the quality of psychotherapy, computer-assisted feedback and monitoring systems to evaluate continuously an ongoing course of therapy have gained increased importance in psychotherapy research. They can provide both therapists and the patients themselves with feedback about the progress of the treatment to date while psychotherapy is still taking place. The information gained from them can be used to match the treatment better to patients’ individual needs.

Method

This work presents an Internet-based real-time monitoring method, the Synergetic Navigation System (SNS). This is based on a daily self-assessment by the patient, and is thus characterized by recording the therapy process at particularly narrow time intervals. The technology is illustrated by means of a single case example of a patient with obsessive-compulsive disorder who took part in a two-month inpatient behavioural therapy.

Results

It can be shown that SNS time-series analysis enables the whole course of therapy to be depicted well, without any serious time delay, and it is possible to record phases in which therapeutic interventions are particularly effective (phases of critical instability).

Discussion

On the one hand monitoring a psychotherapy is useful for psychotherapy research because it enables the dynamics of the therapy progress to be investigated better and it is possible to identify exactly which therapeutic intervention at which time produces what effect on the patient. On the other hand it is useful for the psychotherapist who is working mainly clinically, because the regular feedback enables him to match his therapy to the patient's specific needs.
P02-342 - Lifetrack Therapy Overcomes Depression Through Bringing the Patient Far Closer to his/her Partner than Ever Before
Authors: Ishizuka Y.
Published: June 2010

Objective of this presentation is to demonstrate that depression is a part of natural responses by one's personality when its past experience and current capability to cope is exceeded by life challenges. Accordingly, Lifetrack therapy attempts to modify patient's personality in such ways that thresohold of tolerance can be signficantly raised, eliminating depression by making it unnecessary.

Working with the patient and his/her partner, Lifetrack thereapist focuses almost exclusively on bringing the couple closer than ever before, guided by their own daily self-rating on 41 parameters that allows accurate graphic tracking of dynamic mental status and subtle daily changes in their personalities via Internet. A series of 26 revealing graphs are examined during each session.

As the case example of Mike (35 year old executive who became severely depressed and was hospitalized after attempting suicide in career crisis) illustrates, his closeness with his wife advanced far beyond previous maximum level through Lifetrack therapy, provoking and overcoming waves of defense (symptom spikes including depression) until symptoms became weakened by exhaustion and disappeared in 1.5 month. In 2.5 months, he returned to the same difficult job directly from hospital and thrived on it.

Of the 1,200 cases manifesting various degrees of depressive symptoms, 61.4% of patients treated with partner (871) exceeded their previous maximum level of adjustment according to their own daily selfrating. When couples persisted beyond the first month of therapy, 77.3% exceeded their previous maximum level. 86.6% did so when they persisted beyond three months in thereapy.
P02-343 - The psychoanalytic Treatment of a Seven Year-Old boy, Victim of Sexual Abuse
Authors: Jacintho A.C.d.Á. , Pereira M.E.C.
Published: June 2010

Objective

To report and discuss the use of psychoanalytic treatment for children victims of sexual abuse.

Method

We report the psychoanalytic therapy of a seven year-old boy, sexually abused, discussing the “play technique” developed by Melanie Klein.

Results

The boy does not speak to the analyst about the abuse. He has serious changes in his behavior and attempted suicide after that. In the first session with play materials, he draws a heart and partially paints it black, writing his name in it. He is very uncomfortable with the stains caused by black pencil on the white paper sheet. With scissors he cuts the heart and places it on the stretcher. He throws away the stained paper in the waste paper basket. Then he plays the game of catch-rods. At the end of the session, he puts all the toys in the box, and gives to the analyst the “cut up heart” that was on the stretcher, saying that it should be kept under the analyst's care.

Conclusion

With the use of the toy, Klein was able to extend the psychoanalytic concepts proposed by Freud from the analysis of adults, allowing children to be analyzed. By playing, children symbolically represent their fantasies, anxieties and defenses, expressing their models of relationship with the world. In the session of “play therapy”, children can communicate their anxieties and also find resources for the overcoming of their traumas. With his “cut up heart”, the child communicates his suffering, requiring care from the analyst.
P02-346 - Agoraphobia-Group Treatment as a Challenge
Authors: Kozarov T.
Published: June 2010

Modern life, situations of long lasting distress are causing increase of neurosis in our population. A 3.5 years follow-up study, from 2005 to 2009 or 1207 patients show us that agoraphobia (as fear of being in places or situations from which escape might be difficult or embarrassing) is one of the most prevalent anxiety disorders in the field of mental health (89.47%) and also female syndrom. Then we found specific phobia (from death), social phobia, sexual phobia. The primary purpose of this study was to improve our clinical observation that patients with agoraphobia are the most often patients from all anxiety disorders and that is neww expirience from our country. The most frequent neurotic disorder in 3.5 years of examinations in the city of Nish is agoraphobia 89.47% (1080 patients), female SY cause marriege conflict, which comprehends examinations in the world (every 9th person in 1000 in USA and 6th on GB).
P02-348 - Cognitive Behavioral Wisdom Psychotherapy in the Treatment of Posttraumatic Embitterment Disorders
Authors: Linden M. , Baumann K. , Lieberei B.
Published: June 2010

Background

Negative life events can result in adjustment disorders. If there are feelings of having been treated unfair, been let down or been humiliated one type of reaction are prolonged states of embitterment, which has been described as Posttraumatic Embitterment Disorder, PTED. A new approach in the treatment of PTED is cognitive behavioral psychotherapy which uses special strategies based on wisdom psychology. Wisdom has been defined as the capacity to cope with unsolvable and serious problems and questions in life.

Method

In a controlled clinical trial psychosomatic inpatients which suffered from PTED, were randomly assigned to “wisdom therapy” (N=28), which focusses on the reframing of the traumatic event and to “wisdom and headonia therapy” (N=29), which additionally encourages patients to focus on positive aspects in life. Another group of PTED patients (N=50) and patients with other mental disorders (N=50) received treatment as usual.

Results

PTED patients who were treated with wisdom psychotherapy showed a reduction in the SCL-90-PST score of initially 55,7 and at the end of 40,1 and those treated with hedonia therapy of initially 58,7 and at the end of 41,3. Measures of therapist adherence showed that therapists in both groups used wisdom strategies. PTED controls started initially with a SCL-90-PST score of 52,2 and ended with 50,2. Other patients started treatment with 39,3 and finished with 25,9.

Discussion

This first treatment study on cognitive wisdom therapy suggests that wisdom can be helpful in the treatment of adjustment and embitterment disorders.
P02-355 - 10 Years Re-Evaluation of Number of Psychiatric Residents Involved in Training in Psychotherapy in Romania
Authors: Buftea L. , Cretu C. , Mihai A.
Published: June 2010

Purpose

As this is a time of great change in Romanian psychiatry we considered it was useful to analyze the availability of various types of psychotherapy and the commitment of psychiatry residents to psychotherapy training, comparing with data from 1998.

Method

Same protocol study like in 1998 was used. The data from National Centre for Medical Training were analyzed. We examined the total number of residents undergoing psychotherapy training, year of residency and the type of psychotherapy they chose.

Results

In 2009, there are 726 psychiatry residents in Romania (180 in 1998) distributed in 11 (6 in 1998) university training centres. We registered a response rate of 81.8% (77.7% in 1998), and only 30.13% residents are involved/ in a specific psychotherapy training comparing with 48.5% in 1998. The types of psychotherapy were: cognitive behavioural therapy, positive psychotherapy, transactional analysis, psychoanalysis, psychodrama, hypnosis, existential psychotherapy.

Conclusion

Even though training in psychotherapy is included in curricula like compulsory topic since 2007, the availability of psychotherapeutic training for residents is still restricted, due to high costs, the need to self-finance the training, organizational difficulties and low number of training centres and trainers.
P02-360 - Effect of CBT-Based Sex Offenders Therapy on Cognitive Distortions of Learning Disabled Male Sex-Offencers in a Forensic Unit
Authors: Kundi P.S. , Sharma D. , Magombedze R.
Published: June 2010

Objectives

The aim of our study was to compare the cognitive distortions in learning-disabled male sex-offenders before and after the administration of full 52-weeks Sex-Offenders Treatment Programme(SOTP).

Methods

As a part of the CBT-based Sex-Offenders Treatment Programme, 17 male adults were referred for therapy(over a period of 2 years) out of which 12 were accepted for SOTP. Mean age of the subjects was 32.5 years(Range: 22-50 years) and mean IQ was 65.16(Range: 53-75).

SOSAS(Sexual-Offenders Self-Appraisal Scale) was administered both pre and post treatment. This instrument consists of 20 statements from four sub-scales: Denial, Victim Blaming, Minimization and Realism to which each respondent was asked to indicate his degree of agreement or disagreement.

Results

We noticed an improvement in Denial and Minimization scores in 58% of cases, Victim Blame scores in 25% of cases and Realism scores in 67% of cases.There was a little (< 5%) or no change in 25% of Denial scores, 17% of Victim Blame scores and 9% of Minimization and Realism scores.A deterioration in 17% of Denial scores, 58% of Victim Blame scores, 33% of Minimization scores and 24% of Realism scores.

Conclusions

Our results reveal beneficial effect of SOTP on the cognitive distortions of Denial, Minimization and Realism in more than half of the patients but deterioration in the cognitive distortion of Blame.

While the results suggest CBT-based Sex Offenders Treatments are beneficial in modifying cognitive distortions, further research is needed to validate the effectiveness of this approach, especially in long-term follow up studies.
P03-102 - What's Happened to Paraphrenia? A Case-Report and Review of the Literature
Authors: Pelizza L. , Ferrari A. , Losi R. , Bonacini F. , Welsch B.
Published: June 2010

Paraphrenia is a chronic psychotic disorder similar to paranoid schizophrenia, but with a better-preserved affect and rapport and a much less personality deterioration. It was at first systematically described by Kraepelin in 1913 to define a group of psychotic patients who exhibited characteristic symptoms of dementia praecox, but with minimal disturbances of emotion and volition, and marked delusions. After the publication of Mayer-Gross's report in 1921, the view to differentiate paraphrenia from schizophrenia was considered to be unfounded and the term ”paraphrenia” was not included in the current DSM-IV-TR diagnostic criteria. Consequently, now this disorder is diagnosed infrequently. However, several authors suggest that the concept of paraphrenia has not lost its usefulness. It seems to be that some psychiatrists recognize the illness, but labelled it as ”atypical psychosis”, ”schizoaffective disorder”, ”delusional disorder” or ”psychotic disorder not otherwise specified” for the lack of a better diagnostic category. Very few systematic studies on paraphrenia have been conducted in the past 70 years. Aim of this work is to describe a case of chronic delusional psychosis who meets the Ravindran's modern diagnostic criteria for ”paraphrenia redefined”, suggesting that it is possible to define and recognize the illness if the practitioners are induced to use a viable diagnostic entity. Further research would benefit paraphrenia and schizophrenia patients.