bluuebunny/crossref_metadata_2025 huggingface dataset:
P01-217 - Etiology of Adolescent Substance Use: Neighborhood Effects on Initiation
Authors: Burdzovic Andreas J. , Watson M.
Published: June 2010

Objectives

We investigated the timing of cigarette, alcohol, and marijuana use initiation in adolescents, focusing on three levels of predictors: (1) individual-, (2) family- and (3) neighborhood characteristics.

Method

A community-representative sample of 440 mother-child dyads was assessed 4 times over 6 years. Children were on average 10 (+ 2) years old at baseline (T1), with equal SES, gender and ethnic representation.

We examined the timing of first alcohol, cigarette, and marijuana use as reported by children on the Youth Risk Behavior Survey (YRBS) at T3 in relation to predictors collected at baseline (T1).

Individual-level predictors at T1 included child gender, race, and child reports of sensation seeking. Family-level predictors included household size, maternal education, family income, and child-reported exposure to home violence. Finally, maternal and child reports regarding gangs and drugs in the neighborhood, and child reports of neighborhood violence were factor-analyzed into a single scale, where higher scores reflected unsafer neighborhoods.

To examine the timing of first cigarette, alcohol, and marijuana use as a function of the above predictors, three separate Cox regression (i.e., survival) models were estimated.

Results

Controlling for all other predictors, neighborhood safety remained significant predictor of substance use initiation among adolescents across all three examined substances. Children living in unsafe neighborhoods started, on average, smoking, drinking, and using marijuana at an earlier age, as indicated by positive and significant regression coefficients.

Conclusions

These results point to the importance of broader contextual influences - such as neighborhoods - on underage substance use initiation.
P01-219 - Clinical Efficacy of Tenoten for Children in Treatment of Attention Deficit and Hyperactivity Disorder
Authors: Kheyfets I. , Chutko L. , Surushkina S. , Dugina J. , Kachanova M. , Sergeeva S. , Epstein O.
Published: June 2010

Objectives

To assess efficacy and safety of tenoten for children (TC, ultra-low doses of antibodies to S100 protein) in ADHD patients.

Methods

In a double-blind placebo-controlled study 50 children (6-12 years) met DSM-IV criteria, mild/moderate CGI-ADHD-Severity and ADHDRS-IV-Parent:Inv > 22 points were enrolled. Patients were randomized to receive either TC (2 tablets BID, n=25) or placebo (n=25) for 12 weeks. ADHD symptoms were assessed by ADHDRS-IV-Parent:Inv, CPRS-R:S and CGI-ADHD-Severity.

Results

According to both parents and investigators assessment TC decreased ADHD symptoms: ADHDRS-IV total score reduced by 13.5 points, hyperactivity by 6.7 points, inattention by 6.8 points (5.4, 2.3 and 3.2 in placebo); CPRS-R:S total score reduced by 12.8 points, hyperactivity by 3.6 points, inattention by 6.1 points (4.8, 1.8 and 1.7 in placebo). ADHD severity reduced in 9 patients received TC and 3 patients received placebo. No adverse effects were reported in both groups.

Conclusions

The study demonstrated good clinical efficacy and safety of TC in children with ADHD.

 Total score (M±m)Hyperactivity (M±m)Inattention (M±m) Baseline12 weekBaseline12 weekBaseline12 weekADHDRS-IVTC34.2±1.3920.7±1.84**15.8±1.009.1±1.06*18.4±0.6311.6±0.96**Placebo33.6±1.2628.2±1.8215.0±0.8712.7±0.9918.7±0.5115.5±0.96CPRS-R:STC47.6±2.4634.8±2.61**9.7±0.796.1±0.58***23.5±1.0717.4±1.15***Placebo51.9±2.2547.1±2.5911.3±0.759.8±0.7924.9±0.9323.2±0.99

*,*,*** - p< 0.05; p< 0.01; p< 0.001 vs placebo
P01-221 - Anxiety and Depression Symptoms in Children-commorbidity with Learning Disabilities
Authors: Koulopoulou A.
Published: June 2010

Previous studies at General Children's Hospital of Penteli have indicated that children in primary school with learning difficulties often present secondary psychological problems (e.g. anxiety, depression, anger). This study aimed to systematise the typology of these psychological problems, to confirm the same hypothesis to adolescents and finally to explore the role of children's sex.

The sample consisted of 421 children (292 boys, 129 girls) aged 7 to 14 years old. Children were categorised into 3 groups: children with a) slight learning difficulties, b) dyslexia and c) mental disabilities. Children completed Beck Youth Inventory, while their parents were invited to fill Ascenbach's questionnaire. To compare the 3 groups, we used the t-test, as well as ANOVA.

According to Beck Youth Inventoiry, 29% of children mentioned low self-esteem, 32,3% presented anxiety, 22,1% depression symptoms, 21,6% anger and 20,9% disruptive behavior. According to Ascenbach's questionnaire, 21,4% of parents mentioned that their children presented anxiety, 21,4% depression symptoms, 18,5% aggressiveness and 16,2% deliquent behaviour. Based upon these results, it could be argued that parents tend to underestimate these secondary psychoemotional symptoms and mainly focus on the treatment of learning difficulties.

As it was expected, children with dyslexia presented higher levels of anxiety, regardless of their age. Nevertheless, children's self-esteem seemed to be aggravated by age, as adolescents often present lower self-esteem. Furthermore, children's sex was found to be an important factor, as girls with dyslexia had lower self-esteem and more anxiety and depression symptoms, whereas boys presented disruptive and deliquent behavior more regularly.
P01-225 - Hospital Admissions and Personality Pathology in Adolescents with Psychiatric Disorders
Authors: Magallón-Neri E. , Canalda G. , Forns M. , De la Fuente J.E. , García R. , González E. , Castro-Fornieles J.
Published: June 2010

The use of psychiatric services has been associated with a wide range of clinical variables. However, information about the impact of adolescent personality pathology related to hospital admissions is limited.

Objective

To analyze the different combination of personality pathology associated to variables of psychiatric hospital admissions (number of admissions, total of days spent as psychiatric inpatient, average of days for admission, and number of admissions in a day care hospital).

Method

The ICD-10 and DSM-IV modules of the semi-structured interview IPDE (International Personality Disorders Examination) were administered, in a sample of 107 adolescent psychiatric patients (M=15.8, SD=0.8 years old; age rank 15-17; 79% female).

Results

Personality pathology group identified by the IPDE showed significantly higher number (p< .001) of psychiatric admissions (M=1.48) than no personality pathology group (M=0.57), but not significant higher number of admissions in a day care hospital. Psychotic patients showed the highest rate of admissions (M=2.88). In present sample, between 30% and 38% of all hospital admitted patients showed a Cluster B personality disorder (PD).The users of psychiatric inpatient services with a complex PD (two o more PD from different clusters) presents in average: 2-2.5 admissions, 34-53 total days spent as psychiatric inpatient, and 11-16 days on each admission.

Conclusion

Patients with psychotic disorders or complex PD were the highest users of inpatients services, but not of day care hospital admissions.
P01-228 - Oxidative Stress and Family Environment in Unaffected Relatives of Psychotic Patients
Authors: Martínez-Cengotitabengoa M. , Vega P. , Besga A. , Peciña J.R. , Gonzalez-Oliveros R. , Lopez P. , Garcia G. , Uribe F. , Alvarez N. , Gonzalez-Pinto A.
Published: June 2010

Objectives

Oxidative stress suposses an imbalance between oxidants and antioxidants molecules. Negative and positive family environment have been related with worse and better outcomes respectively in schizophrenic patients.

Our objetive is to determine antioxidant defense in healthy controls and unaffected relatives of early onset psychosis patients and to asses its relationship with familiar environment.

Methods

We included 82 healthy controls (HC) and 14 healthy controls with second degree family history of psychosis (HCWFHP), aged between 9 to 17.

Total antioxidant status and lipid peroxidation test were determined in plasma and antioxidant enzime activities and glutathione levels were determined in erytrocytes.

We used the Global Assesment Functioning scale (GAF) and the Family Environment Scale (FES). The FES is made up of ten subscales: cohesion, expressiveness, conflict, independence, achievement, intellectual-cultural, social, moral, organization and control.

Results

The analyses showed a significant decrease in total antioxidant level in HCWFHP compared with the HC (U Mann Withney = 281.00, p=0.009, effect size= -0.78).

HC and HCWFHP did not differ in the GAF scale, nevertheless the scores of HCWFHP were significantly higher in cohesion and intellectual-cultural dimensions of the FES (p=0.007, p=0.025).

Adjusting by this two FES dimensions, antioxidant status remained significantly different between groups: OR= 10.86, p=0.009.

Discussion

Although we cannot induce causative relations, we can state that family environment is not playing a role in inducing oxidative stress in these subjects. It could be hypothesized that families with affected relatives protect themselves with positive envionmental factors such as cohesion and intellectual-cultural activities.
P01-230 - The ADHD Boys with Externalizing Disorders are More Pessimistic Then ADHD Boys with Internalizing Symptoms and Their Healthy Peers
Authors: Dabkowski M. , Dabkowska M.
Published: June 2010

An adolescence - the time of identity seeking is often determined by questions about subjective influence on an event. A teenager with ADHD experiences states that are appercepted as lack of self control over the events which may be the source of shaping of specific means of attribution (as formulated in cognitive psychology)

Methods

The Child Behaviour Checklist (CBCL), Teacher Rating Form (TRF), Youth Self Report (YSR) by Achenbach, 1991 and the style of explaining events (measured by Seligman's Attributional Style Questionnaire) were administered to a cohort of ADHD outpatients boys (34) and randomly matched-paired community reference sample of primary school male pupils. The results were statistically proved.

Results

Adolescence of boys with ADHD was overfilled in a characteristic way with pessimism more than in healthy boys. The boys had more externalized and internalized disorders, however, only the externalized disorders indicated direct correlation with pessimistic attribution. The intensification of internalized disorders didn’t change the coloring of adolescence neither among boys with ADHD nor among healthy boys.

Conclusion

Pessimistic way of interpreting the world that is distinctly present among boys with ADHD is closely connected with the intensification of behavior disorders.
P01-232 - Correlation among neuropsychological tests and questionnaires in attention deficit hyperactivity disorder
Authors: Najafi M.
Published: June 2010

Background

Current study aimed to assess the possibility of prediction of continuous performance test in primary school children with attention deficit hyperactivity disorder, with parents and teacher reports of inattention, hyperactivity and oppositional behavior.

Methods

Fifteen school aged children with Attention Deficit Hyperactivity Disorder without co-morbid psychiatric disorders were selected from Roozbeh child and adolescent psychiatry clinic. Teachers and parent Conner's questionnaires, Continuous Performance Test and 4 class dictation scores were registered from each subject.

Results

Commission errors were correlated with hyperactivity scale in the parent report (r=-0.50, p< 0.05), and with ADHD score (r=-0.49, p< 0.05). Omission error was correlated with inattention (r=0.66, p< 0.05) and ADHD score (r=0.51, p< 0.05) on teachers report. Reaction time was correlated with oppositional (r=0.51, p< 0.05) subscale in parents Conner's questionnaire. Dictation scores were correlated with inattention on parents report (r=-0.52, p< 0.05) and omission on Continuous Performance Test (r=-0.79, p< 0.05).

Conclusion

Current study reported a significant correlation between neuropsychological tests and questionnaires, in ADHD.
P01-233 - Improving the dictation in attention deficit hyperactivity disorder by using computer based interventions: a clinical trial
Authors: Najafi M.
Published: June 2010

Objective

The aim of the current study was to assess the impact of computer games and computer-assisted type instruction on dictation scores of elementary school children with attention deficit - hyperactivity disorder (ADHD).

Method

In this single-blind clinical trial, 37 elementary school children with ADHD, selected by convenience sampling and divided into group I (n=17) and group II (n=20), underwent eight one-hour sessions (3 sessions per week) of intervention by computer games versus computer-assisted type instruction, respectively. 12 school dictation scores were considered: 4 scores preintervention, 4 scores during interventions, and 4 scores post-intervention. Dictation test was taken during each session. Data was analyzed using repeated measure ANOVA.

Results

Two groups were matched for age, gender, school grade, medication, IQ, parent's and teacher's Conners’ scale scores, having computer at home, history of working with computer, and mean dictation scores. There was no significant difference in dictation scores before and after interventions and also between the study groups. The improvement in school dictation scores had no significant correlation with age, gender, Ritalin use, owning a computer at home and past history of computer work, baseline dictation scores, Ritalin dose, educational status, IQ, and the total score of parent's and teacher's Conners’ rating scale.

Conclusion

Absence of significant improvement in dictation scores in study groups may be due to the confounding effect of other variables with known impact on dictation scores. Further studies in this field should also assess the change of attention and memory.
P01-237 - Dissecting the pain: self-mutilation in adolescents
Authors: Pedroso S. , Soares M. , Garrido J.
Published: June 2010

Introduction

Self-mutilation refers to a variety of behaviors in which individuals deliberately inflict body lesions against themselves, with not accepted or even socially reproved purposes, but with no suicidal intent. Adolescence is a known risk factor for these behaviors.

Objectives and aims

Clinical and bibliographic review of self-mutilation in adolescence.

Methods

Review of medical files of adolescents followed in the Department of Child and Adolescent Psychiatry. Bibliographic review of papers about self-mutilation in adolescents.

Results

The authors present 5 clinical vignettes (4 girls and 1 boy) of adolescents presenting with self-mutilations. Proposed theoretical models explaining the causes of these behaviors and their alleged functional role for the individual are presented based on the bibliographic review. Implicated psychosocial factors (predisposing and precipitating), associated symptoms and psychiatric syndromes (eg.: depression, personality disorders) and relation to suicide are discussed. Finally, different therapeutic approaches are presented as well as the major challenges to intervention in these situations.

Conclusions

: Self-mutilation represents a heterogeneous clinical condition with a multifactorial and complex pathophysiology requiring a comprehensive biopsychosocial intervention.
P01-249 - Emotional and behavioral symptoms related to sociodemographic factors for the children/adolescents presented at Tirana child/adolescent psychiatric clinic
Authors: Skendi V. , Alikaj V. , Suli A.
Published: June 2010

Children/adolescents make an important part of Albanian society. The objective of this study was to identify emotional and behavioral problems and their relation with socio-demographic factors.

Methods

Strength and Difficulties Questionnaire (Goodman et al, 1998) completed from children and their parents. SDQ included 25 items, generating scores for emotional-behavioral problems.

Statistical analysis

Was completed using SPSS 10.0. Comparisons were made between groups, problems and predictive factors influencing emotional and behavioral problems.

Results

A total of 200 children referred to CAP from 2 - 17 years old were screened, from which 53.1% males and 46.3% females. Mean age was 9.5 ± 4.4 years old. 15.4% were identified being with borderline emotional symptoms and 62.9% were within abnormal range of emotional symptoms. 16.7% of the children were identified with borderline behavioral symptom and 60.6% were within abnormal range of behavioral symptoms. 10.5% were identified with borderline hyperactivity symptoms and 48.7% were within abnormal range of hyperactivity/inattention symptoms. From the total sample resulted that 8% of them had borderline difficulties and other 84.6% of the subjects had experienced abnormal and major overall social, emotional, behavioral difficulties. There was a significant statistical difference between symptoms and gender (p< 0.002).

Conclusions

This study represents a serious approach in identifying problems of emotional and behavioral health for Albanian children/adolescents and the need of further studies in community for the prevention of mental health problems in children/adolescents.
P01-250 - Tourette Syndrome - Description of a Case Report
Authors: Soares M. , Pedroso S. , Simoes M. , Joaquim A.
Published: June 2010

Introduction

M. is a 12 year old girl, whom since the age of 3 has been increasing the frequency of tics (screeches, closing the eyes, clenching the fists, exposing her teeth, repeating countlessly “I’m kidding!”, “You’re a whore”).

She has a younger sister. Her mother was diagnosed with anxious depression and her father suffers from chronic alcohol abuse.

The complementary diagnostic tests performed (CT, EEG, MRI), requested by the physicians that she consulted previously, were normal.

With sorrow, M. states on her first appointment “I’m hyperactive and I cannot control myself”.

Objectives

The authors aim to present a short revision of the literature on Tourette syndrome, describing a clinical case, highlighting the therapeutic intervention (psychopharmacological and psychotherapeutic) and the clinical course.

Methods

Clinical case presentation and revision of the literature.

Conclusion

Managing patients with Tourette syndrome requires a comprehensive intervention, which includes medication and a psychotherapeutic approach.

In the case described, a psychoeducational intervention was performed with M.’s family and M. teachers (information about the disease and strategies to reduce stress inducers and undervalue the tics), family counseling (exploring the impact of the tics in their lives and how this could be minimized), cognitive-behavioral techniques and administration of a dopamine antagonist agent.

In this particular case, family intervention was paramount to the favorable clinical outcome, since it was a dysfunctional family.
P01-252 - Symptom of Eating Disorders and Eating Attitudes
Authors: Spremo M.
Published: June 2010

Introduction

Eating disorder becomes a problem in the moment when the changes in the way of food consumption are changing the quality of life.

Methods

In the population of secondary school students, 610 students,have been chosen by the method of systematic sampling. The study is prospective, control, clinical-epidemiological, descriptive and analytic. The applied instruments are Eating Attitudes Test and Eating Disorders Inventory by Garner. The respondents who have the score of 20 or higher on the EAT-26 are the experimental group, and control group is consisted of adolescents who did not show high scores on these scales. What is being compared between the groups are the scores of the Eating Disorders Inventory by Garner and EAT-26 scales.

Results and discussion

There were(59%) females and males (41%). 56 (9.2%) had a high score on the EAT-26, Salčić S. (2005) found 10.3% of respondents with a high sum on the EAT-26. 67.9% of respondents who are in the group of critical score on the EAT-26 (x2 = 8,049, p = 0005) show a desire for slenderness. Dissatisfaction with their own body shows 91.1% (x2 = 5,638, p = 0018). 53.6% from the experimental group show an interceptive awareness (x2 = 24,207, P = 0000). 42.9% (x2 = 11,602, P = 0001) have an expressed perfectionism.

Conclusion

Changes in the nutrition attitudes are also followed by certain changes in body perception and mood, which is reflected in the development of clinical forms of eating disorders.
P03-02 - Therapeutic Alliance in the Cognitive Behavioral Treatment of Pediatric Obsessive-Compulsive Disorder
Authors: Geffken G. , Storch E. , Keeley M. , Ricketts E.
Published: June 2010

Objectives

The purpose of the current study was to investigate the influence of therapeutic alliance (TA) as a treatment process variable on outcome in cognitive-behavioral therapy (CBT) for pediatric obsessive-compulsive disorder (OCD). Although CBT for pediatric OCD disorder is considered a first-line treatment, not all youth have positive treatment responses, suggesting the need for investigating factors that enhance or reduce treatment effects.

Methods

Twenty-five youth aged 7-17 years (M = 13.16, SD = 2.69) with a principal diagnosis of OCD and parents participated in the study. Using a multiple-informant, multiple-time point design, the current study examined the role of TA in family-based CBT for pediatric OCD.

Results

Findings indicated

(1)

stronger child-rated, parent-rated, and therapist-rated TAs were predictive of better treatment outcome,

(2)

larger, more positive early alliance shifts (rated by changes in child-rated TA between sessions 1 and 5) were predictive of better treatment outcome.

Conclusions

TA was a predictor of subsequent change in OCD symptoms in youth treated with CBT. These findings correspond with alliance-outcome research among youth treated with evidence based therapies for behavior disorders.
P01-265 - Chronic Low Back Pain in Chronic Combat Related Posttraumatic Stress Disorder
Authors: Bras M. , Loncar Z. , Gregurek R. , Milunovic V. , Boban M. , Djordjevic V.
Published: June 2010

Objectives

Chronic pain disorders have been accepted as one of major comorbid disorder in chronic posttraumatic stress disorder (PTSD). The main purpose of this research was to evaluate subjective processing of the pain in war veterans suffering from chronic PTSD and low back pain.

Methods

227 Croatian war veterans participated in this study. Based on their personal history, psychiatric and surgical assessment they were divided in three groups: subjects suffering from PTSD and chronic low back pain (N=88), subjects suffering from chronic low back pain (N=50) and healthy controls (N=89). The following questionnaires were used in assessment of PTSD, depressive disorders and pain: Trauma Symptom Inventory, Hospital Anxiety and Depression Scale and the short-form McGill Pain Questionnaire.

Results

We have shown the significant differences between three groups. The group of PTSD patients experience the higher level of the intensity of pain and have an altered perception of pain complaining more of the affective and sensory pain than the group suffering from the chronic low back pain only. Both groups suffering from pain show depressive pattern rather than the the control group. We have shown that the affective and sensory pain is in the strong positive correlations with the specific PTSD symptoms and depression.

Conclusion

Patients suffering from PTSD seem to have an altered processing of the pain, especially the affective component of pain, probably because of functional pain disorders in many those patients. However, the neurobiological mechanism is needed to thoroughly understand the processing of pain in chronic PTSD.
P01-269 - Psychopathological Distress, Body Image Perception and Social Phobia in Patients with Hearing Aids and Cochlear Implants
Authors: Eleuteri F. , Forghieri M. , Ferrari S. , Marrara A. , Monzani D. , Rigatelli M.
Published: June 2010

Objectives

Hearing-impaired adults with hearing aids or cochlear implants have been proved to suffer from social isolation and that the under-use of these devices is possibly related to its impact on one's body image. The aim of the research was to evaluate the presence of social phobia and body image preoccupation, handicap perception, social functioning and psychopathological distress in patients with hearing aids or cochlear implant.

Method

A clinical group of 70 hearing aid and/or cochlear implant wearers was compared with a control group of 75 healthy adults (age: 18-65) referred to the ENT Clinic of Modena University from 01/01/09 to 01/ 09/09. Both groups were administered the following psychometric instruments: Social Functioning Questionnaire, Brief Symptom Inventory, Liebowitz Social Phobia Scale, Body Uneasiness Test. Hearing-impaired subjects were also assessed by means of the following tests: International Outcome Inventory for Hearing Aids, Attitude towards Hearing Loss Questionnaire, Hearing Handicap Inventory for Adults.

Results

the case group statistically differed from the control group as to lower level of social functioning (p< .05), higher level of somatization (p< .01), obsessive compulsive behaviour (p< .01), interpersonal sensitivity (p< .01), depression (p< .01), anxiety (p< .05), phobic anxiety (p< .01), paranoid ideation (p< .01), psychoticism (p< .01), social phobia (p< .001) and body image preoccupation (p< .05).

Conclusion

Social phobia and body image preoccupation are critical aspects in determining the psychosocial well-being and the compliance, the benefit and the personal satisfaction of hearing-impaired subjects in using the hearing aid and/or cochlear implant.
P01-270 - Quality of Life and Sociodemographic Factors of Patients with Unexplained Symptom in General Practice
Authors: Erinfolami A. , Olagunju A. , Oguntuase A. , Akinbode A.
Published: June 2010

Objectives

We aimed to assess the quality of life and psychosocial factor of patients presenting with medically unexplained symptom at a private general practice in Lagos Nigeria.

Method

A total of 150 subjects presenting with unexplained symptoms out of 1,450 G.P consulted had world health organization Quality of life (Brif) questionnaire obtained. The Quality of life score and social factors were compared with patients without unexplained symptoms.

Results

Majority of patients with unexplained symptom were female, with mean age of 42(±8) and unemployed. Among the patients, 80% had unexplained pain symptoms. Quality of life was poor in subject with unexplained symptoms and was significantly different in comparison with those without medically unexplained symptoms.

Conclusion

General practice patients with medically unexplained symptom had remarkably poorer quality of life and associated sociodemographic factors include age, sex and unemployment. Early identification and prompt treatment should be encouraged.
P01-271 - Evaluation of HIV Positive Recipients of Orthotopic Liver Transplant (OLT): an Observational Study in the Modena Consultation Liaison Psychiatric Service
Authors: Borsari L. , Ferrara M. , Barbanti Silva V. , Pingani L. , Cocchi S. , Guaraldi G. , Gerunda G.E. , Rigatelli M. , Ferrari S.
Published: June 2010

Objectives

To evaluate psychiatric features in liver post transplant HIV recipients.

Methods

An observational study was conducted. Different psychiatric rating scales to evaluate cognitive status (MMSE), anxiety and depressive symptoms (HAM-A, HAM-D), social phobia (BSPS), quality of life (SF-36), sexual satisfaction (ISS), coping strategies (Brief Cope) and alcohol-drug abuse (LDQ) were submitted to a population of 11 HIV outpatients that underwent to OLT (19% of the Italian HIV transplant recipients). Scores were statistically related to socio-demographic and clinical data.

Results

All patients were male, aged between 33 and 54 years. In the past 8 patients were drug abusers, three suffered from depression. At the moment of the evaluation 8 patients didn't suffer from any psychiatric disease while the three youngest patients presented a mild depressive status. BASIS-32 scores were related to HAM-D and to a history of drug abuse (p< 0.01). SF-36 was related to age (p< 0.05), HAM-D (p< 0.01), BSPS and BASIS 32 (p< 0.02).

Conclusions

Despite the higher risk for a HIV patient of developing an anxious or mood disorder, our population isn’t affected by psychiatric diseases; this is an encouraging data considering that post transplant period can be very stressful. This result may be due to a personality organization or a coping style strengthened by a long term disease such as HIV. Further studies are needed to investigate psychosocial outcome of OLT in HIV and to improve our knowledge of this controversial issue and guarantee a better take in care of these complex patients.
P01-273 - Anxiety and Hope in the Relatives of the Patients in Intensive Care Unit
Authors: Tel H. , Pekin İşeri Ö.
Published: June 2010

Objectives

The this study was carried out to determine the anxiety and hope status of the relatives of the patients in intensive care unit.

Methods

First degree relatives of 116 patients in the intensive care unit of a hospital were involved in the present study. The data of the research was collected using a personal information form, the Spielberger State Anxiety Scale and Hope Scale.

Results

It was found that the relatives of the patients were anxious. There was a statistically significant negative relationship between the numbers of visit by the relatives of the patients and their hope scores (r=-.357, p=.000). The more they visited the patient the more they lost hope. It was found that hope score was low in the patient's relatives who were female, spouse or parents of the patient, anxiety was high and hope was low in the patient's relatives who were literate and who had low income, hope was high in the patient's relatives who lived in a city and who had social security.

Conclusions

The first-degree relatives of the patients in the intensive care unit experience anxiety. As the number of visits by the relatives of the patients increases, their hopes about the recovery of the patient decrease. Therefore, continuous communication with the medical personnel and being continuously informed about the status of the patient will be helpful for the relatives of the patients in the intensive care unit to deal with the present situation.
P01-274 - Medically Unexplained Symptoms - a Perspective from General Practitioners in the Developing World
Authors: Husain M.I. , Duddu V. , Husain M.O. , Chaudhry I.B. , Rahman R. , Husain N.
Published: June 2010

Objectives

In this study, we explored the attitudes towards Medically Unexplained Symptoms (MUS) of 500 GP's in Karachi, Pakistan. Using a questionnaire previously developed by Reid et al (2001), we aimed to investigate whether GP's attitudes towards medically unexplained symptoms are similar to those of GP's in the developed world.

Methods

500 GP's on the database of primary care centres at the Pakistan Institute of Learning and Living in Karachi, were all sent a covering letter explaining the purpose of the survey with a case vignette, a questionnaire, and a stamped addressed envelope. One month later, non-respondents received a telephone call from an investigator to remind them of the study.

Results

Of the 429 respondents, 68.5% (294) were male and 31.5% (135) female. Although 80.2% of respondents felt that the main role of GP's was to provide support and reassurance, 76.9% of respondents also agreed that GP's had a role in referring patients with MUS for further investigations to identify a cause. 204 (47.55%) respondents agreed that somatization was useful concept, only 146 (34.03%) felt that there was effective treatment for it.

Conclusion

For the most part Pakistani GPs’ attitudes towards MUS are similar to those of their counterparts in the West. Both agree that the GP had an important role in providing reassurance and counselling. However, our survey also shows that Pakistani GP's are less likely to place emphasis on an underlying psychiatric diagnosis and tend to focus on looking for an underlying physical cause.
P01-283 - The Relation Betweeen Severity of Cardiac Illness and Anxiety
Authors: Linden M. , Muschalla B.
Published: June 2010

Background

Pathological anxiety is characterized by the absence of a reason for anxiety. However, the presence of fear provoking stimuli does not exclude the possibility for a pathological course of anxiety, i.e. “Pathological Realangst”. An example are hypochondriac anxieties in patients with severe somatic disorders. An open question is to what degree severity of somatic morbidity is related with anxiety.

Method

In 209 patients (37,8% women) from a cardiology inpatient unit general anxiety, heart-related anxiety, progression anxiety, and job-anxiety were measured. Physicians rated the degree of severity of the somatic (heart-)disorder using the Multidimensional Severity of Morbidity Rating (MSM rating). Relationships between the degree of anxiety and somatic morbidity parameters were investigated.

Results

Anxiety did not or to a very low degree correlate with objective indicators of somatic morbidity. Subjective suffering showed a moderate significant correlation with heart-related anxiety and progression anxiety, and was also correlated with sick leave duration.

Conclusion

Severity of somatic illness is a multidimensional phenomenon and not regularly related in a special way with anxiety, except the dimension of subjective suffering. Pathological fears, even when occurring in the context of somatic disorders, are not related to objective endangerment, but have to be described as mental problems.
P01-285 - Depression and Acute Ischemic Coronary Syndrome
Authors: Lougon M. , Antonio de Mattos M. , Rangel Tura B.
Published: June 2010

Objective

This research aimed to evaluate the prevalence of psychic depression in patients with acute coronary syndrome (ACS) and the interdependency with risk factors for coronary artery disease (CAD).

Methods

Prospective stdy of patients consecutively admitted with ACS and screening for depression through the Beck Depression Scale, which was used within the first 5 days after admission. Patients who presented simultaneous diagnosis of severe neoplasia, use of antidepressant medication, incapability to communicate or comprehend, were excluded from the research. Statistical analysis included the t test of Student or Mann-Whitney, qui-square test or Fisher's exact test and the log-linear model to evaluate interdependency among risk factors for CAD.

Results

98 out of the 135 patients admitted with ACS presented acute myocardial infarction, while 37 presented unstable angina, mean age of 61.8 years,of which 40% were female.Prevalence of depression in this study was 53.3%. (n=72) distributed in three groups according to the degree of intensity:28.1% with mild depression,14.1%moderated depression, and 11.1% with severe depresion. Among in-hospital deaths, 88.9% (n=8) were in patients with depression and only 11.1% (n=1) in patients without depression, with relative risk 0f 6.99 (p=0.027) Depression was more prevalent in female patients. Depression was present in association with great numbers of risk factors: dislipidemia, sedentary habits, sex (p=0.0259), family history systemic arterial disease and hypertension (p=0.0098)

Conclusion

The results of this study show a high prevalence of psychic depression among patients with acute coronary syndrome with elevated mortality risk and interdependency with other risk factors.
P01-288 - The Development of a Pro-forma for the Assessment of suicide Intent and Mental State in Selfharmers by Casualty Doctors
Authors: Ulhaq S. , Subramanyam D. , Agius M.
Published: June 2010

Introduction

Patients presenting with self harm account for a significant proportion of attendances to the emergency department. NICE guidelines recommend these patients must undergo full psychosocial and risk assessment with mental state examination.

Objectives/Aims

Aims included to investigate the demographic factors of those presenting to the emergency department with self harm and explore methods of self harm. Also, to review the psychiatric history, exploration of suicide risk factors and assessment of suicidal intent, the mental state examination and referral for further treatment.

We also wished to make recommendations to improve the history taking process should this be proved necessary.

Methods

Data was collected retrospectively from February to August 2009. Twenty-five casualty cards were collated at random for patients who presented with self harm. Evidence of exploration of the objectives were investigated.

Results

Suicide risk factors and suicidal intent were poorly documented. The mental state examination was not documented in all cases. 18 were referred for psychiatric review.

Conclusions

Psychosocial and risk assessment of those presenting to the emergency department with self harm is poor. As a result of this study, We have designed and introduced a proforma to be completed by doctors in the emergency department. This incorporates the mental state examination and is to aid the assessment of suicidal intent in patients presenting with self harm. The effectiveness of this proforma will be assessed with a re-audit planned in 3 months time.
P01-293 - Psychiatric mis-diagnoses and escitolopram treatment of mood and anxiety disorders in myasthenia gravis: a case report
Authors: Pan E. , Algul A. , Ebrinc S. , Basoglu C. , Semiz U.B. , Ates M.A. , Senol M.G. , Cetin M.
Published: June 2010

Myasthenia gravis (MG), is a chronic, autoimmune disease involving neuromuscular junctions [1]. Psychopathological disturbances and misdiagnosed as a psychiatric disorder are frequently reported in patients with MG because of variable and fluctuating course of disease [2]. However, during the course of the disease, mainly depression and anxiety disorders can be added to the clinics [1].

Case

The complaints such as weakness, difficulty swallowing and speaking that worsening at evening, may be easily supposed neurotic disorders, in a twenty-two year old male patient, has started about two months ago. In neurology clinic, in requested psychiatric consultation; there were complaints like inability to breathe, sweating, palpitations, reluctance, pessimism and unhappiness.

The patient has diagnosed according to DSM IV-TR as “Agoraphobia without panic disorder” and “Major Depression, Single Episod”. Escitolopram titrated by 20 mg/day has started. Depressive and agoraphobic symptoms have disappeared at the end of four weeks (HAM-A-D:24;11-21;9).

Discussion

MG patients, especially during the beginning of disease symptoms in almost all patients with the appeal was referred to the psychiatric services and 1/3 of it has been reported as psychiatric mis-diagnosis [1,2]. Choice of psychotropic drugs is important that do not affect the respiratory center and neuromuscular transmission. Agents, used in the treatment of MG, can inflame psychopathology and can create resistance to psychotropic treatment. Therefore, cooperation of neurologist and psychiatrist is important.
P01-294 - Depression and Agoraphobia in a Patient with Myasthenia Gravis
Authors: Pan E. , Algul A. , Basoglu C. , Ebrinc S. , Ates M.A. , Semiz U.B. , Senol M.G. , Cetin M.
Published: June 2010

Myasthenia gravis (MG), is a chronic, autoimmune disease involving neuromuscular junctions [1]. Psychopathological disturbances and misdiagnosed as a psychiatric disorder are frequently reported in patients with MG because of variable and fluctuating course of disease [2]. However, during the course of the disease, mainly depression and anxiety disorders can be added to the clinics [1].

Case

The complaints such as weakness, difficulty swallowing and speaking that worsening at evening, may be easily supposed neurotic disorders, in a twenty-two year old male patient, has started about two months ago. In neurology clinic, in requested psychiatric consultation; there were complaints like inability to breathe, sweating, palpitations, reluctance, pessimism and unhappiness.

The patient has diagnosed according to DSM IV-TR as “Agoraphobia without panic disorder” and “Major Depression, Single Episod”. Escitolopram titrated by 20 mg/day has started. Depressive and agoraphobic symptoms have disappeared at the end of four weeks (HAM-A-D:24;11-21;9).

Discussion

MG patients, especially during the beginning of disease symptoms in almost all patients with the appeal was referred to the psychiatric services and 1/3 of it has been reported as psychiatric mis-diagnosis [1,2]. Choice of psychotropic drugs is important that do not affect the respiratory center and neuromuscular transmission. Agents, used in the treatment of MG, can inflame psychopathology and can create resistance to psychotropic treatment. Therefore, cooperation of neurologist and psychiatrist is important.
P01-297 - The peculiarities of Organization Consultative Liaision Psychiatry/psychotherapy in Multiprofile General Hospital (12-years Experience)
Authors: Prokudin V. , Boyko Y. , Kyrov N.
Published: June 2010

On base 12-years experiense of activity of Department Psychotherapy (2 psychiatrists, 2 psychotherapeutists and 1 medical psychologist) in Moscow City Clinical Hospital (CCH) №36 revealed the peculiarities of organization psychiatric and psychotherapeutic care of somatic patients with comorbid mental disorders. Since 1997 we worked out “Statute of Department Psychotherapy in CCH” and functional duties of every of specialists; more-over owing to select of specialists created of team of adherents on principle “team work”; in the same way cary out educational seminars for internidts on increasing their knowled-ge in “border-line” psychiatry, somaform and psyhosomatic disordres. We selected the optimal of organization consultative liaison psychiatry/psychotherapy in condition in gene-ral hospital - model “liaison-attachment”. Durind 12 years carry out consultative liaison psychiatric treatment 22638 somatic patients with comorbid mental disorders (5,8% from all treated patients in the hospital for 12 years - 390310). On psychiatric diagnosis comor- bid mental disorders distributed on 2 groups: at 13402 patients(59,2%) revealed comorbid non-psychotic mental disorders (neurosis, neurosis-like, somaform, psychosomatic, per- sonality disorders); at 9236 patients(40,8%) with psychotic mental disorders(acute soma- genic psychosis, alcohol delirium and/or mental retardation). Distribution on age: 18-19 years-1,6%,20-39 -20,2%, 40-59 - 32,8%, 60 years and more - 45,4% patients.

In result: 12-years experience showed that the functioning of specialists of Department Psychothe-rapy in CCH 36 distincly assisted of improving psychosomatic disorders in 5,8% somatic inpatients (betwen them turned out 45,4% elderly persons - 60 years and more). Treatment in CCH conducted without any stigmatization and discrimination.
P01-301 - History of Myocardial Infarction and Cognitive Representation of Illness in Post-MI Patients
Authors: Bagherian R. , Saneei H. , Bahrami Ehsan H.
Published: June 2010

Objectives

Medical patients construct schematic representations of illness which may impact on their recovery and adjustment with their medical condition. The purpose of the present study was to examine relationship between the history of myocardial infarction (MI) and illness representations among post-MI patients.

Methods

One hundred seventy six consecutive patients following MI admitted to the CCU wards were selected based on the inclusive and exclusive criteria. The patients completed demographic questionnaire and Brief Illness Perception questionnaire (B-IPQ). Their medical data were obtained from medical records and history of MI was confirmed by cardiologist based on one of the following criteria: clinical symptoms, Enzima indices, electrocardiographic changes, echocardiography, and angiography. Therefore, the patients were divided into two groups with and without previous MI. Chi-squared test, Student's t-test, MANCOVA and Covariance were used to analyze the data.

Results

The findings showed that 30.1% had previous MI. The results of MANCOVA indicated that Significant difference between two groups in B-IPQ scores (F= 2.653, P= 0.025). Also, the results of covariance showed that significant differences in three domains of illness perception including identity (F= 4.776, P= 0.03), consequences (F= 70671, P= 0.006) and timeline (F= 10.092, P= 0.002). However, there were no significant differences in controllability (F=0.165 P= 0.687) and treatability (F=0.26, P=0.611) between two groups.

Conclusions

Generally, post MI patients with previous MI likely develop negative schema about MI. Also having previous MI may impact on perception of identity, consequences and timeline of MI.
P01-302 - The Effects of Cardiac Surgery on Health - Related Quality of Life, and Emotional Status Outcomes: a Follow-up Study
Authors: Rothenhäusler H.-B. , Stepan A.
Published: June 2010

Objective

The aim of this study was to assess the course of quality of life and emotional status outcomes during the six months after elective CABG.

Method

In a prospective study, we followed up for 6 months 138 of the original 147 CABG patients. A series of psychometric self - rating scales were administered.

Results

The ratings obtained from the BDI reflected significant decreases in levels of depression from preoperative to 6 - month follow - up assessments (before surgery = 6.5 ± 4.9; at 6 - month follow - up = 4.6 ± 4.7; p < 0.001). The PTSS - 10 ratings from the whole sample reflected significant decreases in levels of PTSD symptoms from preoperative to 6 - month follow - up evaluations (before surgery = 18.2 ± 6.7; at 6 - month follow - up = 17.3 ± 8.0; p < 0.01). The measurements of health - related quality of life indicated significantly higher SF - 36 values on all of the eight health - related domains from preoperative to 6 - month follow - up. However, at 6 - month follow - up, patients with clinical depression and posstraumatic stress symptoms had significantly lower SF - 36 values on a variety of SF-36 domains.

Conclusion

Elective CABG is associated with significant improvements in HRQOL relative to the preoperative period, but impairments in HRQOL were found in a subgroup of post - CABG patients with evidence of PTSD, or depression at 6 - month follow - up.
P01-303 - Huntington's Disease in An Asian-Indian Male - a Case Report and Discussion
Authors: Roy B.B. , Rao K.P. , Ward C.D.
Published: June 2010

Objectives

To present a case of Huntington's Disease and discuss neuropsychiatric management.

Methods

Case presentation.

We would like to present a case of Huntington's disease in an adult asian-indian male. The poster consists of a case report followed by a discussion on Huntingtons. We discuss the aetiopathogenesis, presentation and recent management trends of this neuropsychiatric condition.

Mr. H was an Asian Indian immigrant in the United Kingdom. He presented with gradually worsening chorea, personality change and cognitive decline. Psychiatric symptoms closely followed with the development of aggression, paranoid delusions and visual and auditory hallucinations.

Management included a multidisciplinary approach involving psychiatrists, neurologists, the local Huntington's disease service and a host of Para clinical teams.

In the discussion, we trace the aetiology of Huntington's disease, the epidemiology and regional variations in Incidence and prevalence rates. The presentation, disease process and prognosis of Huntington's Disease is discussed. We present recent trends in management including the use of Omega 3 Fatty Acids.

Conclusion

Though there has been a significant increase in the amount of research on the condition, this appears to have been concentrated mainly on those populations with a higher prevalence. Studies on the causes of lower prevalence in Asian, especially Indian populations are still few in number. Such research could provide valuable clues including detection of protective factors in these populations. These in turn could prove useful in the management of the disease on both an individual and wider socio-economic level.