bluuebunny/crossref_metadata_2025 huggingface dataset:
FC03-07 - Future Strategies for Vocational Rehabilitation in Schizophrenia
Authors: Urbanek C. , Neumann K. , Schoenhoff M. , Dettling M.
Published: June 2010

Introduction

Social implications and long-term consequences of mental disorders regarding sick days at work, unemployment rates and early retirement are substantial. There is no clear understanding

1)

whether and which social psychiatric strategies of vocational rehabilitation and

2)

whether and how atypical antipsychotics are successful in supporting vocational rehabilitation in schizophrenia.

Objectives

Primary objective was to demonstrate the enhanced ability of schizophrenic patients to be successfully in employment after attending specific “job-consulting” programs. Secondary objective was to demonstrate positive effects of ziprasidone and risperidone on work-related functions.

Aims

Aim of the study was to enlighten the complex relationship between working performance of schizophrenic patients, their social psychiatric and medical treatment, and their cognitive capabilities in a first step.

Methods

The study was conducted in inpatients, day-clinic- or outpatients diagnosed with schizophrenia, paranoid type (ICD 10: F20.0). All patients received regular pharmacological treatment and intense cognitive training, additionally one group completed specific “job-consulting” programs. ANT, CPT, WCST, PANSS and WBN were performed after 3, 6, 12 and 24 months.

Results

At present eighteen schizophrenic patients (6 female and 12 male, mean age: 33.6 years) have been included in the study. Analyzing the data after 3 months the results are:

1)

specific “job-consulting” programs increase the probability of employment

2)

both, ziprasidone and risperidone, exert positive and comparable effects in work-related functions,

3)

the better the cognitive capability the better the vocational outcome.

Conclusions

Specific “job-consulting” programs constitute a clinically relevant therapeutic option in vocational rehabilitation of schizophrenic patients.
FC04-01 - Fast (Fight Against Stigma): Promoting Mental Health Through an Original Public Private Partnership (PPP)
Authors: Moussaoui D. , Gerard D.
Published: June 2010

Rationale

Although mental disorders are a major contributor to the Global Burden of Diseases, in many low- and lower-middle-income countries, mental health care is still accessible to only a minority.

Psychiatric disorders haven’t benefited from dramatic progresses seen in other fields as pandemic diseases.

Objective

To increase equity in access to care for psychotic patients in low- and lower-middle -income countries.

Method

Through mental health facilities at the primary care level, availability of psychosocial support, accessibility of medicines, awareness and reduced stigma, the program addresses what is seen as the main barriers to access to care. To achieve this objective, institutional partners (Ministries of Health), a worldwide NGO (World Association for Social Psychiatry), and a leader of the pharmaceutical industry (sanofi-aventis) are associated through PPPs. The complementary expertise and resources of the partners are pooled to build-up the existing health infrastructures and increase efficacy in patient care.

Results

In partnership with local psychiatric networks, pilot projects have been launched in Morocco and Mauritania, and others are in preparation (such as Armenia and Guatemala).

The programs combine actions dedicated to:

•

Advocacy efforts towards political and administrative decision makers;

•

Increase awareness of communities of mental health issues;

•

Psycho-educate patients and families;

•

Encourage the creation of associations of patients’ families;

•

Train health care professionals;

•

Organize a sustainable supply of high quality antipsychotics.

Conclusion

The FAST project encourages the collaboration of all partners. It could be an example of innovative ways to address mental health challenges in developing countries.
YSFC01-01 - Neural Correlates of Verbal Working Memory Dysfunction in Early-Onset Schizophrenia: a Functional Magnetic Resonance Imaging Study
Authors: Kyriakopoulos M. , Dima D. , Kempton M. , Hadjulis M. , Frangou S.
Published: June 2010

Objectives

Working memory (WM) deficits are among the core cognitive abnormalities in schizophrenia. WM is subserved by widely distributed fronto-parietal networks and is undergoing robust development during adolescence. Studying the neural correlates of WM dysfunction in early-onset schizophrenia (EOS) will advance our understanding of aberrant neurodevelopmental processes in the disorder.

Method

Nineteen patients with EOS aged 13-19 and 20 matched healthy participants underwent functional Magnetic Resonance Imaging (fMRI) as they performed a N-back verbal WM task with 3 levels of difficulty (1-back, 2-back, 3-back). Following matching for task performance, 14 patients were compared to 20 controls, using non-parametric whole brain and region of interest approaches followed by psycho-physiological interaction analysis (PPI) with seed voxel from the left parietal cluster.

Results

Regions within the left prefrontal cortex, the left insula and bilateral anterior cingulate cortex showed reduced activation in EOS patients compared to healthy participants at the 2-back condition. In addition, ROI analysis at the same condition revealed hypoactivation in the EOS group with large effect sizes for left prefrontal and parietal regions. The PPI results revealed negative functional connectivity in the healthy participants’ group but not in EOS between left parietal and right parietal and bilateral frontal regions.

Conclusions

Our results support compromised function within the left prefrontal-cingulate network and left insula during the N-Back verbal WM task in patients with EOS compared to healthy participants. They also indicate the possibility of more widespread fronto-parietal network dysfunction, most noted in the left hemisphere in the disorder.
CS05-03 - Human sexuality: New Developments in Neurobiology, Diagnosis and Treatment
Authors: Balon R.
Published: June 2010

Mainstream psychiatry has shown only a sporadic interest in the understanding and treatment of sexual disorders. This lack of interest is puzzling, especially at the time of new developments in the study of human sexuality and the emergence of a new interdisciplinary field of sexual medicine.

Human sexuality encompasses various areas related to contemporary psychiatry, such as quality of life, quality of relationship, sexual side effects of psychotropic medications, and the association of sexual dysfunction with various mental and physical illnesses, including substance abuse. Sexual dysfunction, with its complex regulation involving the central and the peripheral nervous systems, hormones, psychological, cultural, psychosocial and developmental factors actually seems to be a primary target for psychosomatic medicine and psychiatry. As noted, “Sexuality is the ultimate unity of body and mind.”

This lecture will review the recent developments in the area of human sexuality, including diagnostic considerations in the context of proposed revisions of the existing diagnostic systems, neurobiology, imaging, psychology and psychopharmacology; and will also focus on combining the new findings into an integrated model of management of sexual dysfunctions.
P01-02 - Depression and obstructive sleep apnea - results from a 12-month survey in routine clinical practice
Authors: Acker J. , Piehl A. , Herold J. , Scholz F. , Ficker J. , Niklewski G. , Richter K.
Published: June 2010

Objectives

Patients with untreated obstructive sleep apnea often report depressive symptoms, such as low mood, loss of interest and reduction of drive. In this study we examined the frequency of significant depressive symptoms amongst patients with untreated obstructive sleep apnea over a one year period.

Methods

From January to December 2008 we screened 1260 consecutive patients with untreated obstructive sleep apnea (AHI > 9) seen at our Center for Sleep Medicine were screened for depression. Based on self-administered questionnaires, patients with significant depressive symptoms were defined as having either a BDI II score ≥ 14 or WHO-5 ≤ 13. Additionally, severity of depression was rated based on BDI II scores.

Results

Depressive symptoms were reported frequently. Based on BDI-II, 27.9% of patients report significant depressive symptoms. Of these, 46.2% were mild, 35.9% moderate and 17.9% severe. In addition, 52.6% of patients self-reported feeling unwell based on their WHO-5 scores.

Conclusions

Significant depressive symptoms measured by standardised self-rating scales were detected in over a quarter of our patients with untreated sleep apnea. It remains unknown whether treatment of OSA alone abolishes depressive symptoms, or whether depressive mood may reduce the compliance with treatment. Patients may need an interdisciplinary approach to initial treatment.
P01-04 - A Descriptive Study of Patients with Bipolar Affective Disorder Admitted in Brief Hospitalization Unit, University Hospital of la Princesa
Authors: Albillo J.D. , Eaton K. , Lázaro M. , Peregrin E. , Perez B. , Ruberte A. , Betancor D. , Collazos R. , Nieto M. , Martín de Francisco L.
Published: June 2010

Introduction

Patients with Bipolar Affective Disorder have high rates of somatic comorbidity and it's necessary to know the characteristics of these patients to develop preventive and therapeutic strategies.

Objectives

To describe twelve patients diagnosed with BAD admitted to a Brief Hospitalization Unit.

Methods

Evaluation by a questionnaire which recorded sociodemographic data (sex, age, marital status, education, occupation, employment status); medical management indicators (average stay, number of previous admissions and if re-entering during the study); previous treatments (antipsychotics, antidepressants and benzodiazepines); somatic background (presence of cardiovascular risk factors that contrasted with taking blood pressure, BMI calculation, ECG and complete analytical) and consumption of toxic substances.

Results

58.33% are women with a mean age of 41.91 years and 58.33% in single cases. 58.33% has secondary education, although the 41.66% isn’t working.

The average stay of admission is 20.83 days. 50% had between 1 and 4 more admissions and 33.33% re-enters.

25% doesn’t take medications. Of the rest, 77.77% taking neuroleptics, being the most common option with 57.14% treatment with quetiapine. The 88.88% takes mood-stabilizing and the 44.44% benzodiazepines.

No patient has altered the glucose profile. The 8.33% has high blood pressure control and 25% altered lipid profile. The average BMI is 28.64

The 66.66% smoke. The 33.33% consumed alcohol and cannabis on 16.66%.

Conclusions

Patients with BAD have high proportions of cardiovascular risk factors and important consumption of toxic substances. Reflected the impact of the disease in the sociolabour field and the need for many hospital admissions because of the chronic course and poor therapeutic adherence.
P01-05 - Destructive and Deficiency Person's Factors of Patients with Dysthymia
Authors: Antokhin E.
Published: June 2010

The purpose of research was to study destructive and deficiency person's factors of patients with dysthymia. There were investigated 50 patients (basic group) and 50 healthy subjects (control group). We used clinical-psychopathological (SCL-90-R), experimental-psychological (ISTA Questionnaire, Buss&Durkee Aggression Questionnaire), statistical (descriptive statistics, Mann-Whitney U-test) methods. It was estimated that unconscious central ego-functions of patients with dysthymia get expressed destructive or deficiency character. Low aggression and comparatively high level of animosity are peculiar to the patients with dysthymia. In addition feeling of fault is expressed, perhaps, it connected, on the one part - with comparatively powerfully expressed insult and suspiciousness concerning other, and on the other part - with responsibility, high sense of duty, which are based on raised uneasiness, uncertainty, propensity to doubts, difficulty of decision making, sensitivity of person. Patients with dysthymia are characterized with insufficiently advanced ability of self-identification, inability to develop representations about own person, insufficiently flexible regulation of inherent activity, which is necessary for integration of mental life- on the one part, and expressed insult and suspiciousness - on the other part, they result to difficulties of interaction with people, emotional closeness, mistrust surroundings, self-doubt.
P01-101 - Unique: Assessing the Efficacy of Quetiapine Fumarate Augmentation of SSRI or SNRI Treatment in SSRI- or SNRI-resistant Major Depressive Disorder
Authors: Lejeune J. , Taeter C. , Duquenne V. , Goodman N.
Published: June 2010

Objectives

The UNIQUE study assessed the effect of Quetiapine fumarate augmentation on the overall depression status of patients with major depressive disorder and who did not respond to any acute treatment with selective serotonin reuptake inhibitors (SSRIs) or selective noradrenalin reuptake inhibitors (SNRIs) and naïve to any atypical antipsychotics.

Methods

Between March 2006 and November 2007, 39 male and female patients, aged 18-65, were enrolled into this four-week, open label, non-comparative, multicentric, phase II prospective study. Treatment with Quetiapine fumarate began at enrolment, with a titration to a target dose of 300mg. The following scales were completed during all five visits: Montgomery-Asberg Depression Rating Scale (MADRS); Clinical Global Impression (CGI); Brief Psychiatric Rating Scale (BPRS); Sheehan Disability Scale (SDS).

Results

All questionnaire mean scales were significantly reduced (Friedman P< 0.0001) at the end of the study from baseline: MADRS 16.9 (12.8-21.0); CGI 1.94 (1.52-2.37); BPRS 10.3 (6.7-13.6); SDS 8.5 (5.6-11.5). Response, defined as a reduction in MADRS total score >50% was observed in 45.9% of the 37 patients completing at least 2 weeks of the study and 37.8% were considered in remission e.g. MADRS total score ≤ 12 at visit 5.

Conclusions

Quetiapine fumarate augmentation improved the overall depression status of patients resistant to SSRI or SNRI treatment.
P01-102 - Mania as a First Symptom of Wilson's Disease: a Case Report
Authors: Tatay A. , Lloret M. , Merino T. , Harto M.A.
Published: June 2010

Introduction

Progressive hepatolenticular degeneration or Wilson's disease is a rare autosomal recessive genetic disorder of copper metabolism, which is characterised of hepatic and neurological disorders due to the accumulation of copper in organs such as the liver or the basal ganglia. The manifestations of Wilson's disease are multiple and sometimes insidious, which makes the diagnosis very complicated.

Objective and method

A clinical case was followed and reviewed to illustrate the psychiatric symptoms in Wilson's disease.

Results

A 23-year-old male came to the emergency room presenting insomnia, logorrhea, euphoria, irritability and a slight tremor in the upper limbs. Symptoms started two weeks before. The previous year, he was diagnosed of bipolar disorder after a manic episode which required inpatient treatment with risperidone and lithium. During the actual hospitalization, the tremor increased progressively and affected all four limbs and his head. He was then examined by neurology and an ophthalmology service, who ordered some specific complementary exams. Low levels of ceruloplasmin and serum copper and high levels of urinary copper confirmed the diagnosis of Wilson's disease. Treatment with copper chelants was introduced and the psychiatric symptoms and the analyses got better in several weeks.

Conclusions

Even a typical presentation of a psychiatric syndrome can be part of the spectrum of an organic illness. So an organic etiology should always be considered in the differential diagnosis, as sometimes it is possible to be treated.
P01-105 - Characteristics and One-year Outcome of Untreated Anxiety and Depression
Authors: van Beljouw I.M.J. , Verhaak P.F.M.
Published: June 2010

Objective

To study reasons for not receiving treatment, and examine characteristics and one-year outcome of untreated anxiety and depression.

Methods

Data were used of 743 primary care patients with a six-month anxiety or depressive disorder in the Netherlands Study of Anxiety and Depression (NESDA). Diagnoses were confirmed by the Composite Interview Diagnostic Instrument (CIDI). Patients’ perceived need for care, service utilisation, and reasons for no treatment were assessed by the Perceived Need for Care Questionnaire (PNCQ).

Results

43% of the respondents received no treatment. Of these untreated patients, 25% did not perceive a mental problem; 26% perceived no need for care; and 49% expressed a need for care which was not met. Untreated patients with a treatment need showed the same symptom severity and disability as treated patients, and reported even more loneliness. Compared to other untreated patients, they were more handicapped regarding clinical and psychosocial functioning.

After one year, treated and untreated patients with a treatment need showed a poorer outcome than untreated patients without a self-perceived mental problem or need for care.

Conclusions

Many patients with anxiety or depression do not seek treatment. Half of them are probably right: they do not perceive a mental problem or treatment need, suffer from relatively mild symptoms, and show a favourable one-year course. Untreated patients with a perceived treatment need, however, suffer from severer symptoms, and show a poorer outcome than other untreated patients. Therefore, care providers should pay considerable attention to this worrisome group.
P01-107 - Effects of Pre-sleep Negative Mood on Subsequent Sleep
Authors: Vandekerckhove M. , Houthuys J. , Weiss R. , De Valck E. , Cluydts R. , Berckmans D. , Haeck B. , Verbraecken J.
Published: June 2010

Objectives

Untreated disrupted sleep is an important precursor for the development of depression. Several studies have confirmed the negative impact of pre-sleep cognitive and emotional activity such as worry and negative affect on subsequent sleep. Emotional stress may affect latencies to sleep onset, to REM-sleep and other markers of sleep disruption such as arousals. The way we cope with emotional stressors and events may have important effects on subsequent sleep.

Methods

In this study we investigated the effects of a failure-experience on polysomnographically recorded sleep in volunteers. Furthermore we explored whether dispositional coping factors such as emotion regulation moderate this effect.

Results

In contrast to the control condition the effect of the failure induction was clearly observed in emotional experience as well as within the physiological sleep architecture. Furthermore, we notice a tendency in which not only emotional experience, but also sleep physiology was affected by low and high emotional approach as emotion regulation style (cf. Stanton, 2000).

Conclusions

The present study has shown that emotional stress as a failure experience before sleep-goes together with a worsening of mood, an increase of level of rumination and enhanced sleep fragmentation with a moderating effect of emotion regulation as dispositional factor.
P01-108 - The Influence of the Conflicting Paradigms over the Prognosis in Major Depressive Disorder
Authors: Vasile D. , Vasiliu O. , Vasile M.L. , Mangalagiu A.G. , Badescu E. , Petrescu B.M. , Bogdan V. , Ojog D.G.
Published: June 2010

Objective

To evaluate the impact of conflicting patient and psychiatrist conceptualizations of the depression over the treatment response and general prognosis.

Methods

A group of 25 patients, mean age 36.8, diagnosed with major depressive disorder, first depressive episode, according to DSM IV TR criteria, have completed a closed-ended questionnaire that included their perspective over the depression (on a 7 points Likert scale, from the pure medical/pharmacological, to the pure psychological/reactive paradigm). Psychiatrists who managed their treatment responded to a similar questionnaire regarding their preferred method of treatment. Patients were evaluated initially and after 3 and 6 months using Hamilton Depression Rating Scale-17 items (HAMD), Beck Depression Inventory (BDI), Global Assessment of Functioning. Patients satisfaction over the treatment (on a 10 points visual analogic scale) was evaluated at endpoint.

Results

Patients who received a treatment corresponding to their preferred paradigm (n=17) responded better (−5.6 on HAMD, −4.5 on BDI, +7.6 on GAF, p< 0.01) to the treatment, compared to the group where the paradigms weren’t the same. The satisfaction over the treatment was also significant higher in the first group (+2.5, p< 0.01). Patients who have discussed their beliefs about the disorder and were informed by their psychiatrists about the advantages of the treatment had a greater rate of response to treatment (p< 0.05).

Conclusion

Psychiatrists should routinely explore the patient conceptualization of the depression and to discuss together the best treatment approach. Prognosis, patient satisfaction and treatment response are significantly influenced by exploring the patient beliefs about its disorder.
P01-109 - Clinical-dynamic Characteristics of Depressive Disorders Comorbid with Anxiety Disorders
Authors: Vasilieva S.N.
Published: June 2010

The aim of this study was to find clinical-dynamic characteristics of depressions comorbid with anxiety disorders.

Methods

140 patients have been observed: basic group - 70 patients with depressive disorder with anxiety disorder; control group - 70 patients with depressive disorder alone. All patients were treated with SSRIs. We used in study 17-item HRS-D and CGI.

Results of investigation

Baseline average score according to CGI has constituted 4,8±0,6 and 4,5±0,7. Comparative assessment of clinical picture of depression in groups has shown that in basic group more frequently (p< 0,05) dysphoric (31,4% and 12,9%) and conversion (21,4% and 11,4%) syndromes were noticed, while in the control group - adynamic (30% and 12,9%,). Statistical analysis of data of age at the onset of depressive disorder has revealed intergroup differences (p< 0,05), testifying to emerging depressive disorders in patients of basic group at younger age (39,6±12,1 years), as compared with patients of control group (43,9±12,9 years).

Index of cyclicity of disease in patients with RDD was calculated as ratio of disease duration in years to cycles of disease. Average value of the corresponding index in basic and control groups differed reliably (p< 0,05) and has constituted 3,2±1,1 and 7,6±1,6. I.e., in the basic group exacerbation of depressive symptoms in recurrent depressive disorder was noticed more frequently as compared with control group.

Thus, comorbidity of depressive and anxiety disorders results in complicating symptoms, change of its syndromal validation, more adverse course (acceleration of depressive phases in recurrent depressive disorder).
P01-12 - Gender Differences in Mental Distress among Heart Surgery Patients in Northern Norway
Authors: Bergvik S. , Wynn R. , Sørlie T.
Published: June 2010

Objectives

There is a need for more research on women with coronary disease and potential gender differences. This paper report a study of gender differences in psychological distress, health behavior, and coronary health in patients having coronary artery bypass graft surgery (CABG).

Methods

229 patients (41 women) having CABG treatment at a hospital in Northern Norway completed a questionnaire 3-15 months after discharge (mean = 8.8, SD = 3.2), and medical data were gathered from their hospital records. Age ranged from 35 to 65 years (Mean = 60.5, SD= 7.4).

Results

No gender differences were found on age, education, work status, or living alone, on coronary health measured by LVEF, NYHA, blood pressure, diabetes, on health related life style measured by smoking, BMI, and physical activity, or the number of days treated at the hospital, or time since hospital discharge.

In univariate analysis, women (compared with men) reported higher levels of mental distress (SCL10; mean = 1.85 versus 1.57, t = 2.73, p< .006). Furthermore, women experienced the time at home following hospital discharge as more difficult than what men did. In a logistic regression analysis of gender, SCL10 together with LVEF were significant predictors, controlling for time since hospital discharge and days treated at the hospital

Discussion

The higher rate of depression among female CABG patients in this study from Northern Norway is comparable to studies elsewhere. Results are discussed in light of theories of coping and self-regulation, other studies on gender differences in CAD, and implications for treatment.
P01-17 - Hypertension in Comorbidity with Depression
Authors: Burgic-Radmanovic M. , Trkulja D. , Banjac V. , Burgic S. , Dragojevic S. , Nikolic A.
Published: June 2010

Introduction

Numerous researches show significant presence of cardiovascular disorders, especially hypertension in depressed patients that show up several years after first depressive episode.

Mortality caused by cardiovascular disorders in depressed patients is 50% higher than in general population. Comorbid depression and cardiovascular disorders is making worse health condition, increasing suffering, making hard treatment, and outcome is not good.

Objective

The goal is to confirm presence of hypertension in depressed patients as the most common comorbid cardiovascular diseases.

Method

A retrospective study has been conducted using data from medical history of 274 depressed patients hospitalized and treated at the Psychiatric Clinic, Clinical Center Banjaluka. These parameters were assessed: sex, age, number of hospitalizations, marital and employer status, comorbid disease, BMI, presence of hypertension, lipid status and glicemia's level. Data were presented using tables and graphs.

Results

Results obtained in our study were:

Hypertension in comorbidity with depression was found in 106 patients (38,5%), 75 of them were males and 31 of them were females. The majority were at age 40-60 years. Obesity was found in 21% of them. High lipid's level was found in 20% of them. 11% of patients had high level of glicemia. More than half of the patients had lower socio-economic status.

Conclusion

Depression is often accompanied by cardiovascular disorders. It is very important to recognize this comorbidity in order to treat it successfully and to make better treatment's outcome.
P01-18 - Combined Antidepressant and Quetiapine Therapy in Bipolar I Mixed
Authors: Callista G. , Daneluzzo E.
Published: June 2010

Introduction

Mixed state, since Kraepelin's pioneering contribution, refers to an affective condition in which various admixtures of depressive and manic symptoms occur simultaneously.

Objective

To evaluate the efficacy and safety of quetiapine plus ADs, both SSRIs and SNRIs in the treatment of acute mixed episodes of Bipolar I Disorder patients.

Method

We pooled data from two ours independent studies for a total of 44 inpatients, 21 male and 23 female, diagnosed with type I mixed Bipolar Disorder (DSM-IV-TR). After receiving open-label quetiapine for 2 weeks, patients were subsequently randomised to receive either treatment with quetiapine + ADs or quetiapine alone for 18 weeks. Pooling the data, 22 received quetiapine alone (10 XRquetiapine) and the other were treated with an association of quetiapine plus an antidepressant. We evaluated these patients every week during the first month and every two weeks after that, using YMRS, HAMD-21.

Results

The efficacy over depressive symptoms was similar in both groups. Compared with the baseline YMRS, at week 6 the percentage of improved YMRS responder was better in the group receiving quetiapine plus antidepressants than quetiapine alone. Three YMRS item scores improved significantly at week 6 in the group quetiapine plus AD(irritability, disruptive-aggressive behaviour and insomnia).

Conclusion

We suggest that adding an AD in order to treat every main features of mixed episode further improved the outcome, probably due to a specific action on a particular subtype of mixed state. In particular, the dysphoric subtype along with irritability and insomnia manic factors, seem to be better responsive to AD supplementation.
P01-25 - ‘Non-compliance and Dysthimia, in Long-term Diabetics and Diabetic Limb Losses’- have we got a Role Here?
Authors: de los Santos R. , Ashrafi M. , Lamont P. , Pawape G.
Published: June 2010

Objectives

Chronic diabetics at some point gives up their vigilance in the sugar control. Many of them end up with intractable diabetic feet with limb losses incurring health budget, enormous morbidity and mortality.

Methods

300 patients who presented with diabetic feet been interviewed and noticed that ‘few weeks or months prior to their start of symptoms a major change in the treatment mechanism happens which lead to catastrophic complications of Diabetes’. They do not qualify according to DSM IV classification to be called MDE. But can be called Dysthymia. Surgical, Medical, Vascular and Psychiatric units in an Australian Hospital have been involved in these interviews (a simple questionnaire). Personal audit in two countries (Fiji Islands & Bangladesh) where Diabetes is pretty alarming in number have been included in the data.

Results

Diabetic patients over time develop Dysthymia when they feel hopeless about control of their illness. Often they are overwhelmed by thoughts of long-term complications like retinopathy, neuropathy that they give up hope that they could combat its complications. Diabetic educators should be involved during their early stage of their illness before complications set in and should be trained to pick up dysthymic signs and symptoms for prompt referral for early psychological and psychiatric intervention.

Conclusions

:

•

Diabetic feet are preventable.

•

Early psychiatric assessment is helpful.

•

Preventive steps are cost effective.

•

Should Psychiatry Department have a role in the multidisciplinary management team of Diabetes?
P01-28 - Behavioural Addictions in Bipolar Disorder Patients: Role of Impulsivity and Personality Dimensions
Authors: Di Nicola M. , Tedeschi D. , Mazza M. , Martinotti G. , Harnic D. , Catalano V. , Bruschi A. , Pozzi G. , Bria P. , Janiri L.
Published: June 2010

Objectives

Behavioural addictions (BAs) can be understood as disorders characterized by repetitive occurrence of impulsive and uncontrolled behaviours. Very few studies have investigated their association with mood disorders. The present study was undertaken to determine the prevalence of the main behavioural addictions in a sample of bipolar outpatients in euthymic phase or stabilised by medications and to investigate the role of impulsivity and temperamental and character dimensions.

Methods

One-hundred-fifty-eight Bipolar Disorder (BD) (DSM-IV) outpatients were assessed with tests designed to screen the main behavioural addictions: pathological gambling (SOGS), compulsive shopping (CBS), sexual (SAST), internet (IAD), work (WART) and physical exercise (EAI) addictions. TCI-R and BIS-11 were administered to investigate impulsivity and personality dimensions mainly associated with BAs. The clinical sample has been compared with 200 matched healthy control subjects.

Results

In bipolar patients, 33% presented at least one BA respect to the 13% of controls. Significantly higher scores at the scales for pathological gambling (p< .001), compulsive buying (p< .05), sexual (p< .001) and work addictions (p< .05) have been found. Self-Directness (p=.007) and Cooperativeness (p=.014) scores were significantly lower while impulsivity level was significantly higher (p=.007) in bipolar patients with BA than those without BA.

Conclusions

To our knowledge, this is the first study investigating the prevalence of behavioural addictions in BD showing a significant association of these disorders. BAs are more frequent in bipolar patients than in healthy controls and are related to higher impulsivity levels and character immaturity.
P01-31 - Use of Aripiprazole and Paroxetine in the Treatment of Patient with Bipolar Depression (Bipolar Disorder II, BDII) Case Report
Authors: Elezi F. , Tomori S. , Sotiri E.
Published: June 2010

Background

Treatment of BDII may place the physician in difficulty because of the treatment resistence.

Methods

2 male patients 48 and 52 years old diagnosed with BDII (according to DSM IV) lastest episode, major depressive episode, with a poor or partial response to long-term treatment with antidepressant, mood stabilizer and sometimes antipsychotic drugs during the presence of psychotic symptoms.

During last year their treatment was: Paroxetine 40mg/ 2x day and Lamotrigine 150mg/day. Because of the lack of response the treatment was changed as follows:

Remove of lamotrigine; decrease of paroxetine to 20 mg; adding Aripiprazole 15 mg.

BPRS, HAMD and CGI-severity were used to evaluate their symptoms and gravity.

Results

After 2 weeks of treatment significant improvement was noticed. This includes depressive and psychotic symptoms, sleep, anxiety and cognitive symptoms. Increase of professional performance.

After using this combination, they started psychosocial rehabilitation program. Since September 2007 their situation is stabile and there have not been noticed recurrences.

Conclusions

Favorable clinical results were noticed to both patients, with no noticeable adverse side effects. Aripiprazole combined with Paroxetine has improved depressive and psychotic symptoms of these patients with bipolar depression.

Our findings suggest that Aripiprazole - Paroxetine is a safe and tolerable combination; however, control trials are needed to validate our findings.
P01-36 - Depression and Psychosomatic Diseases
Authors: Gabos Grecu M. , Gabos Grecu I. , Moica T. , Vesa A. , Gabos Grecu C.
Published: June 2010

The aim of our retrospective study was to evaluate patients with depressive mood disorder, hospitalized in First Psychiatry Clinic of Tirgu Mures, Romania, between 01.01.2008 - 31.12.2008. We tried to demonstrate the link between depressive mood disorders and certain psychosomatic diseases associated, such as hypertension, coronary artery disease, hypothyroidism, gastrointestinal disorders, diabetes and duodenal ulcer.

Methods

517 patients with a diagnosis of major depressive disorder were evaluated in the period January to December 2008 in First Psychiatry Clinic of Tirgu Mures. The data obtained were entered into computer, processed and were compared statistically with data from literature.

Results

380 of the 517 patients suffer from one or more psychosomatic diseases. The majority patients with depressive mood disorders and psychosomatic illness associated were between 50 and 59 years old. The incidence of these diseases is more common in female sex. 75% of all patients hospitalized for these diseases are women. The most common disease associated with depression was hypertension. It is followed by coronary artery disease, gastrointestinal disorders, hypothyroidism, type 2 diabetes mellitus and duodenal ulcer. The most common gastrointestinal disorders were chronic gastrointestinal, chronic recto colitis and gastro duodenal ulcer.

Conclusions

Depression is one of the most common disease for which patients are presented in specialty medical practices and psychiatric hospitals. Frequently, the psychiatric disorder is associated with some psychosomatic diseases that can decrease compliance of these patients and worsen long-term prognosis of the psychiatric disease.
P01-40 - Differential Association of Aggressive Traits with the 5-HTTLPR s Allele in Depressed and Healthy Women
Authors: Gonda X. , Fountoulakis K.N. , Lazary J. , Sasvari-Szekely M. , Veres-Szekely A. , Bagdy G. , Faludi G. , Rihmer Z.
Published: June 2010

Objective

Suicide is a multicausal phenomenon posing a great challenge to medicine and society, yet we still have limited knowledge concerning underlying biochemical, neuroanatomical and genetic factors. Research increasingly points to a role of the serotonergic system, both on the level of suicidal behavior, and such behavioural traits which may serve as important intermedier endophenotypes in suicide research. Although results are conflicting, several studies described an association between the 5-HTTLPR polymorphism and suicide, as well as this polymorphism and certain aggressive traits. Impulsive aggression is also thought to play a major contributory role in suicide. The aim of our research was to investigate the association between the 5-HTTLPR and aggressive traits in depressive patients carrying a higher risk for suicide and healthy controls.

Methods

137 major depressive and 164 healthy controls women were recruited. Participants completed the Buss-Durkee Hostility Inventory and were genotyped for 5-HTTLPR. Association of aggressive traits and indeces with 5-HTTLPR genotype in the two groups were analysed using ANCOVA.

Results

Diagnosis and 5-HTTLPR genotype showed a significant association with aggressive traits. The pattern of association was different in the depressed and control groups. The strongest interaction effect between genotype and diagnosis was observable in case of Resentment.

Conclusion

We found a significant association between 5-HTTLPR and several aggressive traits. In case of depressive patients the association was more marked. In depressed women the 5-HTTLPR shows a stronger association with aggressive traits related to aggression turned inward, which may play a role in the background of suicide.
P01-45 - Comorbidity Between Bipolar Disorders and Personality Disorders: an Observational Study
Authors: Harnic D. , Catalano V. , Mazza M. , di Nicola M. , Bruschi A. , Carnevale E. , di Felice C. , Cardella A. , Marano G. , Janiri L. , Bia P.
Published: June 2010

Objectives

The aim of the present study was to thoroughly investigate the existing comorbidity between Axis II and Bipolar Disorder (BD) pointing out as well the meaningful existing comorbidity between Personality Disorders and Cyclothymia.

Materials and methods

A study group composed of 70 patients affected by Bipolar Disorder (Type I, Type II, and Cyclothymia) was enrolled at the Bipolar Disorders Unit of the Catholic University of the Sacred Heart of Rome. Axis I diagnosis was made by SCID-I; Axis II diagnosis was made by SCID-II.

Results

In a sample of 70 patients in euthymic phase, 39 patients (55.7%) showed comorbidity with Axis II Disorders. Clusters were represented as follows: 2 patients (5.1%) fell within cluster A; 24 patients (61.5%) within cluster B; 9 patients (23%) within cluster C; and 4 patients (10.4%) turned out to be affected by NAS Personality Disorders. On the whole 39 patients - 24 patients (61.5%) affected by BD I, 6 patients (15.3%) affected by BD II, and 9 patients (23.0%) affected by Cyclothymia were found to have comorbidity with Axis II Disorders. Besides, in our sample there was a significant comorbidity between Cyclothymia and Personality Disorders.

Discussion

More than half of patients (55.7%) showed comorbidity with Axis II Disorders. Moreover most of patients turned out to be affected by Personality Disorders falling within cluster B while 23% of Cyclothymic patients were found to have comorbidity with Axis II Disorders.
P01-61 - Impaired Decision-making in the 3 Phases of Bipolar Disorder : a Trait-related Deficit
Authors: Adida M. , Jollant F. , Clark L. , Mazzola-Pomietto P. , Kaladjian A. , Jeanningros R. , Goodwin G. , Azorin J.-M. , Courtet P.
Published: June 2010

Introduction

Bipolar disorder (BD) is associated with impaired psychosocial behaviours. Little is known about deficits in neurocognitive functions like decision-making possibly related both to these behaviours and to the nature of the disorder.

Objectives

To determine whether decision-making impairments exist in manic (M), depressed (D) and euthymic (E) bipolar patients (BP) and to determine whether illness and course-of-illness characteristics can predict participants’ performance

Methods

A power analysis was conducted. A total of 315 subjects, including 45 M and 32 D inpatients and 90 E outpatients with BD I, medicated, and 150 Healthy Controls (HC), age, IQ and gender-matched, were included. Decision-making ability and sensitivity to punishment frequency were assessed with the Iowa Gambling Task (IGT).

Results

On the IGT, MBP (p< 0.001), DBP (p< 0.01) and EBP (p< 0.05) selected significantly more cards from the risky decks than HC with no significant differences between BP groups. Unlike HC, MBP (p< 0.001), DBP (p< 0.05) and EBP (p< 0.05) showed little capacity to learn from incurred losses with no significant differences between BP groups, but, like HC, BP preferred decks that yielded infrequent penalties over those decks that yielded frequent penalties. In a multivariate analysis, decision-making impairment in the BP was significantly (p=0.001) predicted by low level of education, high total number of admissions and family history of BD.

Conclusions

BP clearly show defects in decision-making predicted by course-of-illness illness characteristics. Impaired decision-making might be a trait-related neurocognitive deficit in BD and partly explain impaired psychosocial behaviours of BP.
P01-63 - An Audit to Compare Discharge Rates between Antidepressant Monotherapies Prescribed for Either Unipolar Depression or for other Indications
Authors: Agius M. , Gardner J. , Katie L. , Zaman R.
Published: June 2010

Background

There are differences in efficacy of commonly prescribed anti-depressants. Escitalopram, sertraline, venlafaxine and mirtazapine (‘the four’) were the most effective.

Objectives

To compare the efficacy of ‘the four’ with other anti-depressant monotherapies prescribed either for the treatment of unipolar depression or other indications, using discharge rates as the outcome measure.

Method

We studied all patients on an antidepressant monotherapy in Bedford hospital (206 in total). We examined the clinical notes for each patient prescribed antidepressants to assess whether they were discharged from the out-patient clinic. Hence we calculated rates of discharge for ‘the four’ and other antidepressant monotherapies for patients with unipolar depression or another psychiatric condition.

Results

For patients with unipolar depression, discharge rates were higher for ‘The four’. For patients with other indications, discharge rates were higher for other antidepressant monotherapies. A greater percentage of patients with unipolar depression were discharged from clinic compared with people treated for other indications

Discussion

This suggests that indication for which the antidepressant monotherapy is prescribed will affect the efficacy of treatment, as measured by discharge rates. The fact that a greater percentage of patients with unipolar depression were discharged from clinic compared with people treated for other indications may suggest that people with ‘treatment resistant depression’ may really have another disorder, for example borderline personality disorder, bipolar disorder or PTSD.

Conclusion

This audit suggests that ‘the four’ are more effective for the treatment of unipolar depression compared with other indications, using discharge rates as the outcome measure.
P01-65 - A Comparison of Outcomes of Patients with Depression, Recurrent Depression, and Depression and Anxiety in a CMHT
Authors: Butler S. , Agius M. , Zaman R.
Published: June 2010

Background

Depression treatment outcomes within British Community Mental Health Teams have not been adequately described.

Aims/Objectives

To describe factors which influence outcome of depression within Bedford East CMHT.

Methods

Patients with Depression F32, Recurrent Depression F33, and Depression and Anxiety F42.1 were identified from a database. Factors affecting outcomes, including Suicidal ideation, Alcohol problems, Drug problems, and use of Augmentation therapy, were identified. Outcome as measured by patient discharge was compared in the three groups.

Results

The percentage of each group discharged was 12.24 for F32, 30.53 for F33, and 29.17 for F42.1.

For F32 patients, the percentage of patients with suicidal ideation was 55.10, with alcohol problems was 32.65, with illicit drug problems was 14.28, while the percentage of patients on augmentation strategies was 38.77.

For F33 patients, the percentage of patients with suicidal ideation was 27.37, with alcohol problems was 9.47, with illicit drug problems was 1.05, while the percentage of patients on augmentation strategies was 27.37.

For F42.1 patients, the percentage of patients with suicidal ideation was 25, with alcohol problems was 8.33, with illicit drug problems was 8.33, while the percentage of patients on augmentation strategies was 54.17.

Comment:

Fewer discharges occurred from the F32 group, mirroring increased suicidality and drug and alcohol use in this group. There is no significant difference in the number of patients using augmentation strategies between the F32 and F33 groups. It does not appear that augmentation strategies for treating depression are having a clear influence on outcomes.
P01-67 - 5HT1A Agonist Activity and the Antidepressant Efficacy of Lu AA21004
Authors: Mayze T.
Published: June 2010

Objectives

To discuss a case study that suggests advantages for the combination of 5HT transporter inhibition plus 5HT1A receptor agonism over transporter inhibition alone.

Methods

Naturalistic clinical case study.

Results

The patient had a documented 10 year history of poor response to SSRI's including s-citalopram. There was no suggestion of placebo response in the past. He responded well to Lu AA21004 and sustained this remission over a period of 9 months. He relapsed after Lu AA21004 was ceased. He recovered and again achieved a sustained remission after being prescribed a combination of s-citalopram plus pindolol.

Conclusions

The addition of pindolol (a 5HT1A receptor partial agonist) to s-citalopram adds 5HT1A receptor agonism to the 5HT transporter inhibition of s-citalopram. This is a similar profile to Lu AA21004. It is noted that Lu AA21004 also has 5HT3 receptor antagonism which is postulated to impact more on side effect profile than antidepressant efficacy. The current case strongly suggests that (in some instances at least) the addition of 5HT1A agonism to 5HT transporter inhibition might convert non-responders to responders and thus offer clinical advantage over transporter inhibition alone.