bluuebunny/crossref_metadata_2025 huggingface dataset:
The Influencing Factors on Parental Self-Efficacy of 2–6 Year Old Children's Mothers
Authors: Tahmassian K. , Anari A. , Fathabadi M.
Published: May 2011

Introduction

Parental self-efficacy indicates how effectively parents can manage their parenting responsibility and acts as a predictor of the behavioral and emotional adjustments of children.

Aim

Current study was conducted to examine the influencing factors on parental self-efficacy of 2–6 year old children's mothers.

Method

The present study is a descriptive-post hoc study. 350 mothers were selected from 15 kindergartens of 3 area of Tehran, by multistage sampling method. They completed Rosenberg's self-esteem scale (Rosenberg, 1986), Parental Bonding Questionnaire (Parker et al., 1983), Parenting stress Index (Abiding, 1995), Sources of Social support scale (Koeske & Koeske, 2002), Maternal efficacy Questionnaire (Teti & Gelfand, 1991) and Preschool Behavior Checklist (McGuire & Richman, 1986). Stepwise regression analysis showed that parenting stress, children behavioral problems, mother's self-esteem and parental distress subscale from parenting stress index, in four steps, could explain 32% of variance in maternal self-efficacy.

Conclusion

Parental stress, children's behavioral problems and mother's self esteem are important factors in maternal self-efficacy. Therefore, interventions regarding mentioned factors, can enhance maternal self-efficacy and prevent maladjustments related to mothers and children.
The Influence of Group Psychotherapy to Crisis Frangibility and Coping Style in Community Residents
Authors: Weidong J. , Guoquan Z. , Yunqing G. , Hong Z. , Hua T. , Peirong H. , Hao C.
Published: May 2011

Objective

To understood the influence of group psychotherapy to crisis frangibility and coping style in community residents,seek the methods and value of community psychological coping intervention,and provide the basis of psychological theory and practice for the work of community mental health.

Methods

The scale of crisis frangibility and BCQ were employed to evaluate and compare the mental state before and after intervention.

Results

1)

Crisis frangibility of residents was negatively correlated with positive coping,positively correlated with negative coping.

2)

After group psychotherapy,scores of scale for crisis vulnerability and negative coping droped.

3)

Through the regression model analysis, the linear relationship between positive coping factor and the crisis vulnerable is closest.

Conclusion

9 Group psychotherapy in community is a effective method to reduce resident's crisis frangibility,and the setup of experimental model has provided the theory and the practice basis for development psychology counseling in community.
The Effect of One Left-Sided Preferontal HF-rTMS Session on Emotional Brain Processes
Authors: Baeken C. , Van Schuerbeek P. , De Raedt R. , De Mey J. , Vanderhasselt M.-A. , Santermans L. , Zeeuws D. , Vanderbruggen N. , Luypaert R.
Published: May 2011

Introduction

Although repetitive Transcranial Magnetic Stimulation (rTMS) is frequently used to examine emotional changes in healthy volunteers, it remains largely unknown how rTMS is able to influence emotion.

Objectives, aims & methods

In this sham-controlled single-blind crossover study using fMRI, we examined in 20 right-handed healthy female volunteers whether a single high frequency (HF)-rTMS session applied to the left dorsolateral prefrontal cortex (DLPFC) could influence emotional processing while focussing on blocks of positively and negatively valenced baby faces. The task instruction was to focus on one's own emotional status elicited by the visual stimuli.

Results

A single HF-rTMS session selectively influenced the processing of positively and negatively valenced baby faces. When positive information was being processed, one active left-sided HF-rTMS session resulted in enhanced neuronal activity in the left superior frontal cortex (Brodmann area 10) and right inferior parietal cortex (Brodmann area 39). When negative information was processed, one active stimulation session attenuated neuronal activity in the right insula, while sham stimulation did not.

Discussion

These observations suggest that after one active HF-rTMS session, psychophysiological reactions while processing withdrawal-related stimuli decrease. The increased neuronal activity while processing of positively valenced baby faces might reflect enhanced task-related processing caused by the neuronal activation of the left DLPFC, which could indicate that females are more able to empathize with the depicted happy baby faces. Our results add further evidence as to why HF-rTMS applied to the left DLPFC might improve mood in depressive populations.
Technical Variables Related to the Application of Electroconvulsive Therapy in the “Hospital 12 de Octubre”, Madrid
Authors: Ballesteros Sanz D. , Verdura Vizcaíno E.J. , Marín Mayor M. , Hurtado Calvo M.Á. , del Peso Martínez D. , Sanz-Fuentenebro F.J.
Published: May 2011

Background

Electroconvulsive Therapy (ECT) is a safe and effective technique widely used in our area. Scientific literature related to the application of this technique is continuously developing, specifically with regard to the placement of the electrodes, the amplitude of the stimulus pulse administered, the initial charge used, and the anesthetic agent involved.

Aims

The primary aim of this study was to analyze technical variables associated with the use of ECT in our hospital, and compare them to the guidelines of the protocol developed in our hospital and international standards.

Methods

We performed a review of Clinical Histories of the patients that were treated with ECT in the “Hospital 12 de Octubre” (Madrid, Spain), in the period comprised between January 1st, 2008 and December 31st, 2009. We collected data related to the application of the technique, socio-demographic variables and clinical profiles. We used descriptive statistics to analyze our data.

Results

During this period, 602 ECT sessions were applied. Placement of the electrodes was unilateral in 58% of subjects with Affective Disorders and 8% of subjects with Schizophrenia. The amplitude of the stimulus pulse was 1 ms. Mean charge administered in the initial and final session was 236.85 mC and 357.16 mC, respectively. Etomidate was used as anesthetic in 68% of cases.

Conclusions

ECT technical variables applied in our hospital are adjusted to guidelines of our area and international recommendations. Longitudinal studies are warranted in order to objectively assess techinical variables associated to ECT.
Electroconvulsive Therapy and Depression with Psychotic Symptoms: a Case Report
Authors: Castillo A. , Lloret M. , Harto M. , Tatay A. , Almonacid C. , Calabuig R.
Published: May 2011

Introduction

Psychotic symptoms in depression are indicators of severity and poor prognosis. It usually requires psychopharmacotherapy with antidepressants and antipsychotic agents and it may even require electroconvulsive therapy (ECT).

Aims, methodology

To review the indications of ECT in major depression through the study of a clinical case of a patient admitted in an indoor psychiatric unit.

Results

A 64-year-old woman diagnosed as bipolar affective disorder 20 years ago. Her first manic episode required hospitalization. Afterwards, she remained clinically stable for 18 years with pharmacotherapy with lithium. Lately she was admitted due to a major depressive episode with psychotic features (injury delusions, ruin and catastrophe). Antidepressant and antipsychotic treatment was added, improving her symptoms. However, she had to be readmitted two months later with severe psychotic symptoms that did not improve with pharmacological treatment. ECT was added to her treatment. She improved after a few sessions. During the last years, she has presented depressive episodes with psychotic symptoms at least once a year, and all of them have required ECT.

Conclusions

ECT is an alternative to pharmacological therapy in depression with psychotic symptoms in patients with no response to drugs. According to studies and clinical practice, ETC has been effective as we see in this case. Therefore, ECT is a technique to consider in major depression, not only in patients who do not respond to drug therapy but also in those who do not tolerate psychopharmacological, who suffer from severe or psychotic symptoms, suicide thoughts or those, psychomotor agitation or stupor.
DBS in Treatment-Resistant Depression
Authors: Delimpalta C. , Zampetaki C. , Varouchaki E. , Zampogiannis A.
Published: May 2011

Introduction

Of patients with depression, up to 20–30% are treatment-resistant. DBS is being investigated as a novel therapeutic modality that could be effective in this group.

Objective and aims

Summary of clinical experience with DBS for treatment-resistant depression.

Methods

Review of published literature.

Results

DBS is undergoing trials for use in patients with major depression unresponsive to pharmacotherapy, cognitive therapy and electroconvulsion. Targets include the subcallosal cingulate gyrus, the nucleus accumbens, the anterior limb of capsula interna, the hibernula and the lower thalamus stem, areas shown by PET-scan studies to be crucial in development of depression, anxiety and anhedonia.

In published studies, more than 50% of patients have responded or entered remission, as observed by score drops in the Hamilton and Montgomery-Asberg Depression Rating Scales, results that have been sustained over time. Post-op scans of responsive patients demonstarate reduction of both blood flow and metabolic hyperactivity in aforementioned areas- especially the cingulate gyrus- and other cortical and subcortical regions, and an increase in prefrontal blood flow, suggesting that DBS acts by disrupting pathological activity and normalizing function in near and adjacent circuits.

DBS is reversible and adjustable with rare complications: wound skin infections, headaches and hemorrhage, while temporary mood changes, paresthesias, anxiety and autonomie disturbances are easily treated with stimulation adjustments.

Conclusions

DBS has shown promise as new therapeutic means for unresponsive patients. With clinical trials multiplying and neuroimaging providing insight for possible targets, its applications are to become more common in resistant depression and other psychiatric disorders.
Cognitive Abilities Changes after Electroconvulsive Treatment
Authors: Sabol P. , Dragasek J. , Kovanicova M. , Palova E.
Published: May 2011

Introduction

Electroconvulsive therapy (ECT) is a safe and effective treatment for certain psychiatric disorders. It has long been known that ECT can produce deficits in anterograde, retrograde memory and non-memory-related cognitive functions.

Aims

Our research is focused to test selected cognitive abilities of patients undergoing electroconvulsive therapy. Our main concern was focused on changes in memory, attention, psychomotor speed and intellect.

Methods

Changes in cognitive abilities were assessed in 30 patients from the 1st Department of Psychiatry, University of P.J.Safarik in Kosice before and after ECT treatment session. To assess changes in cognitive abilities we have used Rey-Osterrieth Complex Figure Test (REY), Attention-Concentration Test (ACT), Trail Making Test (TMT) and Intelect Potential Test (TIP).

Results

We have observed statistical significant improvement in visual and short-term memory test (preECT REY 10,92 ± 6,7 vs postECT REY 12,73 ± 5,06, p = 0,047), statistical non-significant improvement in psychomotor speed test (preECT TMT 68,88 ± 45,13 vs postECT TMT 65,15 ± 49,74, p = 0,062), statistical significant improvement in attention-concentration test (preECT ACT 0,74 ± 0,3 vs postECT ACT 0,85 ± 0,16, p = 0,021) and statistical non-significant improvement in intellect potential test (preECT TIP 7,45 ± 7,37 vs post ECT TIP 8,28 ± 6,45, p = 0,142).

Conclusion

Further research is required to determine changes in cognitive abilities associated with ECT in homogenous patients’ population. The validity and limitations are discussed.
2009: The Resurgence of Electroconvulsive Therapy in a Medium Stay Unit
Authors: Euba O. , Zallo E. , Torreblanca M.
Published: May 2011

Introduction

The electroconvulsive therapy (ECT) is an ancient treatment used in psychiatry but sometimes has been forgotten, considered outdated. Since 2008 with the new electroconvulsive protocol in use elaborated in the Hospital of Zamudio, this therapy is part of the usual clinical practice, mainly in the medium stay unit.

Objectives

The principal aim of this project is to describe the profile and the programs of ECT sessions given to hospitalized patients in a medium stay unit during 2009.

Results

19 of the 344 patients hospitalized in this unit in 2009 need electroshock therapy. Each patient received an initial amount of sessions, in average 5-6, considered as part of what is commonly known as Treatment electrotherapy (sessions required to psychopathological stabilization or remission).

Most of this patients (68,42%) required Maintenance electrotherapy (sessions needed to consolidate the clinical improvement and stabilization achieved with the Treatment electrotherapy) but 15,38% of them refused to continue with the sessions and the treatment. During maintenance electrotherapy, sessions are initially weekly and gradually less frequent.

The profile of the standard patient receiving ECT is woman, between 40 and 65 years old and who suffers from Recurrent Major Depression.

Conclusions

Since the protocol established in 2008, a year has been enough to normalized the use of ECT in a medium stay unit.

ECT is a personalized therapy with different applications in each patient, although the indications and objectives followed are almost the same and are protocolized, because the response, the adverse effects etc have to be taken into account.
Differential Impact of Deep Brain Stimulation or Anterior Capsulotomy on General Functioning, Personality Features and Quality of Life in OCD
Authors: Gabriels L. , Cosyns P. , Nuttin B.
Published: May 2011

Introduction

Research on deep brain stimulation (DBS) for treatment refractory obsessive-compulsive disorder (OCD) shows promising effects on symptoms severity.

Objectives

To compare outcomes between DBS and bilateral capsulotomy on general functioning, personality traits and quality of life.

Methods

Consecutive patients with severe and treatment refractory OCD underwent DBS in the anterior limb of the internal capsule (DBS; n = 14) or anterior capsulotomy (CAPS; n = 14). They were tested before surgery (baseline-BL) and after a mean follow-up time (FU) of 19 months (range 14-31 months). Changes in OCD severity were recorded and global assessment of functioning, personality traits, and quality of life were compared between groups.

Results

Statistically significant differential improvements (p < 0.05, Bonferroni corrected) were seen in

*General assessment of functioning (Mn ± 95%CI) GAF: DBS_BL:32.9 ± 3.6; DBS_FU:68.6 ± 7.2; CAPS_BL:35.0 ± 2.7; CAPS_FU:56.4 ± 5.9)

*Personality traits on MMPI (T-score Mn ± 95%CI) Scale 2-depression: DBS_BL:83.7 ± 6.5; DBS_FU:61.9 ± 6.3; CAPS_BL:81.2 ± 8.6; CAPS_FU:77.6 ± 8.7 Scale 9-mania: DBS_BL:48.8 ± 7.3; DBS_FU:57.0 ± 4.2; CAPS_BL:53.8 ± 7.5; CAPS_FU:45.6 ± 6.2 Scale 0-social introversion: DBS_BL:66.8 ± 5.2; DBS_FU:56.1 ± 4.1; CAPS_BL:67.7 ± 7.0; CAPS_FU:66.4 ± 5.8)

* Quality of life: Q-LES-Q Endicott (Mn ± 95%CI) overall score (1-5): DBS_BL:1.2 ± 0.3; DBS_FU:3.4 ± 0.6; CAPS_BL:1.5 ± 0.3; CAPS_FU:2.6 ± 0.4 and in the sub domains feelings (%): DBS_BL:36.8 ± 4.2; DBS_FU:68.6 ± 8.8; CAPS_BL:39.1 ± 5.1; CAPS_FU:54.0 ± 5.9 leisure activities (%): DBS_BL:30.6 ± 5.9; DBS_FU:68.5 ± 7.9; CAPS_BL:40.2 ± 5.4; CAPS_FU:58.3 ± 7.1 social relationships (%):DBS_BL:43.9 ± 5.5; DBS_FU:70.2 ± 8.0; CAPS_BL:46.9 ± 6.8; CAPS_FU:60.1 ± 6.9

Conclusion

These findings suggest a superior impact of DBS over capsulotomy on general functioning, personality traits and quality of life. Limits of this study are the small numbers, the fact that DBS and CAPS patients were from a slightly different OCD population and were not randomized to treatment, and differences in postoperative follow-up.
Treatment of Depression Using Sleep Electroencephalogram Modulated Repetitive Transcranial Magnetic Stimulation
Authors: He M. , Gu Z. , Wang X. , Shi H.
Published: May 2011

Background and purpose

The conventional repetitive transcranial magnetic stimulation (rTMS) has some inadequate of efficacy weak and inadequate for the treatment of depression, easy symptomatic recurrence when stop the treatment. Ours invented the device of sleep electroencephalogram-modulated rTMS (SEM-rTMS) were safe and effective by proved of the animal experiments and clinical pre-test for the treatment of depression. The purpose of this study was to examine the efficacy and safety of SEM-rTMS for the treatment of depression.

Methods

After 7 days without psychoactive medication, 164 patients with clinically defined depression, were randomly assigned to receive SEM-rTMS (N = 57), conventional rTMS (C-rTMS (N = 55), or sham-rTMS (N = 52) for 30 minutes/time/day for 10 days. Before and after scores on the 24-item Hamilton rating scale for depression (HAMD-24) and the clinical outcome at the 10th-day of therapy for all subjects were analyzed.

Results

Twenty two cases in the SEM-rTMS group improved mood as compared to 6 in the C-rTMS group and 2 in the sham-rTMS group (c2 = 15.89, p = 0.0004). After completion of the rTMS phase of the protocol, a (51 ± 5) % reduction of HAMD-24 scores from the baseline in the SEM-rTMS group compared with a (34 ± 4)% in the C-rTMS group ((q = 26.09, p = 0.001) and a (14 ± 3)% in Sham-rTMS group (q = 57.53,p = 0.000). The 88% total efficacy ratio in the SEM-rTMS group was significant higher than 68% in the C-rTMS group and 20% in the sham-rTMS group (c2 = 12.01, p = 0.0025). No significant side effects were noted.

Conclusion

It is efficient and safe to treat depression with repetitive transcranial magnetic stimulation. (The registration. No: ChiCTR-TRC-00000438).
Effects of Repetitive Transcranial Magnetic Stimulation on Hypothalamic-Pituitary-Adrenal axis of Patients With Depression
Authors: He M. , Gu Z. , Wang X. , Tian X.
Published: May 2011

Objective

To investigate the effects of sleep electroencephalogram-modulated repetitive transcranial magnetic stimulation (SEM-rTMS) and conventional rTMS (C-rTMS) on the activity of hypothalamic-pituitary-adrenal (HPA) axis in patients with depression.

Methods

In a double-blind, randomized controlled trial, 164 patients diagnosed with depression were randomized to treatment with SEM-rTMS (n = 57), C-rTMS (n = 55) or sham rTMS (n = 52) for 30 min every day for 10 d. Before and after treatment plasma concentrations of adrenocorticotropic hormone (ACTH) and cortisol (CORT) were measured, and the 24-item Hamilton Depression Rating Scale (HAMD-24) was used for assessment.

Results

The HAMD-24 scores and plasma ACTH and CORT concentrations of these depressive patients before treatment were significantly different from those of the normal control group (P < 0.05). The HAMD-24 scores and plasma ACTH and CORT concentrations in the SEM-r TMS group and conventional rTMS group were decreased significantly (P < 0.05). There was a significant positive correlation between the HAMD-24 scores and plasma ACTH (n = 240, r = 0.105, P = 0.048) and CORT concentrations (n = 240, r = 0.126, P = 0.023) in the patients with depression before and after treatment.

Conclusion

The antidepressant effect of rTMS, including SEM-rTMS, may be related to its decreasing HPA axis activity. (This trail was registered. No: ChiCTR-TRC-00000465).
EEG Synchronized TMS for Individualized Therapy in Major Depressive Disorder
Authors: Jin Y. , Phillips J. , Huang Yueqin , Heurta Steven
Published: May 2011

Introduction

Efficacy of conventional repetitive transcranial magnetic stimulation (rTMS) in major depressive disorder (MDD) is limited. The authors report here on an alternative treatment using low energy synchronized TMS (sTMS) at the intrinsic frequency of subjects’ alpha electroencephalogram (EEG).

Objectives

Establish efficacy and safety profile of sTMS in MDD.

Aim

(1)

Examine the clinical effectiveness of sTMS.

(2)

Identify adverse effects associated with sTMS.

Methods

Fifty-two MDD subjects with 17-item Hamilton Depression Rating Scale (HAMD17) scores >17 were enrolled into a randomized, sham controlled, double-blind trial. Current medication remained unchanged during the trial. Depressive symptoms were evaluated by HAMD17 administered weekly.

EEGs were recorded at baseline to determine the stimulus frequency and at week 4 to evaluate the physiological effect. sTMS was delivered through three 6000-G cylindrical neodymium magnets synchronously rotating at a rate equal to the subject's intrinsic alpha frequency.

Results

Forty-five subjects completed at least 1 week of treatment and were evaluable. Those who received active treatment had superior clinical response to sham (t = 2.54, P = 0.01), where 55.2% in the active treatment group were clinical responders versus 12.5% in sham (X2 = 7.82, P = 0.005). No significant side effects were reported. The clinical improvement was correlated with the degree of EEG improvement (r = .46, P = 0.009).

Conclusions

A therapeutic effect in MDD subjects can be achieved through administration of sTMS at the subject's alpha EEG frequency. Because of minimal side effects, this appears to be a safe and effective treatment option.
Repetitive Transcranial Magnetic Stimulation (rTMS) in the Treatment of Medication-Resistant Neuropatic Pain
Authors: Klírová M. , Fricová J. , Šóš P. , Novák T. , Kohútová B. , Masopust V. , Haeckel M. , Rokyta R.
Published: May 2011

Introduction

Transcranial magnetic stimulation (TMS) is a non-invasive method that induces functional changes in a relatively small area of the cerebral cortex. It is supposed that the effect of the method in therapy of neuropatic pain is based on the induction of spinothalamic tract inhibiton, which leads to the symptom withdrawal.

Aim

To prove the clinical and electrophysiological effect of rTMS in the therapy of chronic neuropatic pain.

Methods

29 patients with medication-resistant neuropatic pain were examined by Visual analog scale (VAS), McGill Pain Questionnaire (MPQ) and QST(Quantitative sensory Testing, consisted of von Frey and thermic treshold examination),then treated by high frequency rTMS in the study using double-blind randomized sham-controlled parallel design. rTMS parameters: 5 rTMS sessions (2 weeks treatment), where each session consisted of three 10 Hz rTMS series using:

1)

85%MT (motor treshold),

2)

90%MT and

3)

95%MT.

Each rTMS série consisted of 20 pulses in 12 trains. Location of the active coil was administered over the contralateral motor cortex, directed specifically to facial area of homunculus (according to funcional location). Sham coil was angled 90° degrees away from the skull.

Results

Confirmation of a significant decrease of VAS item in active group, trend to improvement in tactile sensation of severed patient faces. The changes of thermic treshold were not found. Sham rTMS did not show any trend for improvement.

Conclusion

Although no general recommendations can be drawn based on our result, our study is another one that suggest rTMS should be considered as an effective and safe treatment option for chronic neuropatic pain.
Clinically effective ect treatment restores visuospatial learning / memory but not attentional flexibility deficits in patients with major depression
Authors: Kontis D. , Kalogerakou S. , Papakosta V.-M. , Theochari E. , Anyfandi E. , Koutroumpi M. , Michopoulos I. , Oulis P. , Poulopoulou C. , Tsaltas E.
Published: May 2011

Introduction

We recently demonstrated that patients with major depression (MDD) with and without electroconvulsive therapy referral (ECTs vs. NECTs) qualitatively differ in neuropsychological profile. ECTs presented severe executive but minor visuospatial memory deficits, suggesting mainly frontostriatal involvement; NECTs presented the opposite pattern, compatible with temporohippocampal involvement. Here we follow up on ECT treatment effects on both cognitive domains.

Method

15 ECTs were assessed with Hamilton Depression (HAMD-24), Hamilton Anxiety (HAMA) and Mini-Mental State Examination (MMSE) scales and 5 tests of the Cambridge Neuropsychological Test Automated Battery (CANTAB) at hospitalisation (PRE-ECT), immediately after ECT (POST-ECT) and 2 months later (FOLLOW-UP). ECTs at FOLLOW-UP were also compared to 15 matched non-psychiatric CONTROLS who underwent neuropsychological testing once.

Results

There was significant clinical improvement (reflected by reduced HAMD-24 and HAMA scores: p < 0.001) between PRE-ECT and FOLLOW-UP. After a minor decline POST-ECT, MMSE scores showed significant increase at FOLLOW-UP (p < 0.02). At FOLLOW-UP, Paired Associates Learning (PAL) showed significant improvement (p < 0.001). Stockings of Cambridge (SOC) performance also improved (decrease in early abandonments, p < 0.04) POST-ECT and at FOLLOW-UP. However, clinical improvement did not result in improvement in Intra / Extradimensional Shift (IED): at FOLLOW-UP, ECT patients were indistinguishable from CONTROLS in all neuropsychological measures except IED (p < 0.04).

Conclusions

Clinically successful ECT treatment was accompanied by improved global cognitive functioning, visuospatial memory and spatial planning, but offered no benefit in attentional flexibility. This residual deficit suggests ‘trait’ frontostriatal involvement in this patient group.
Database of MNI stereotactic coordinates for deep brain stimulation targets in neuropsychiatric disorders
Authors: Moser U. , Savli M. , Lanzenberger R. , Kasper S.
Published: May 2011

Introduction

Deep brain stimulation (DBS) is a promising therapy option for otherwise treatment-resistant neuropsychiatrie disorders, especially in obsessive-compulsive disorder (OCD), major depression (TRD) and Tourette's Syndrome (TS).

Objective

The brain coordinates of the DBS targets are mainly reported using measurements in original, unnormalized brains. In the neuroimaging community stereotactic data are mainly indicated in the standardized Montreal Neurological Institute (MNI) space, i.e. a three-dimensional proportional grid system.

Aims

Improved comparability between targets in DBS studies and molecular and functional neuroimaging data from PET, SPECT, MRI, fMRI, mostly published with stereotactic data.

Methods

A comprehensive and systematic literature search for published DBS case reports or studies in TRD, OCD and TS was performed. We extracted the tip positions of electrode leads as provided in the publications or by the authors, and transferred individual coordinates to the standard brain in the MNI space.

Results

46 publications fulfilled the inclusion criteria. The main targets for the specific disorders and one or two examples of their calculated MNI coordinates are indicated in the table:

[MNI coordinates of the main DBS targets]

Conclusions

We provide DBS data of neuropsychiatrie disorders in the MNI space, improving the comparability to molecular, functional and structural neuroimaging data.
Characterization and findings in the electroconvulsive therapy unit of centro hospitalar psiquiátrico de lisboa (CHPL)
Authors: Moutinho A. , Silva Carvalho F. , Mendonça L. , Cunha I.
Published: May 2011

Introduction

Electroconvulsive therapy is widely used for treatment-resistant psychiatric patients. There is controversy about the minimum seizure duration required for clinical efficacy.

Objectives

Characterize socio-demographically the electroconvulsive therapy unit of CHPL; find a correlation between improvement on PSAS, PANSS and HAM-D and both mean seizure duration and mean electric charge used; evaluate outcome in patients with seizure < 20s.

Methods

Three groups of patients were created according to ICD-10 diagnosis. The scales mentioned were applied at the beginning and end of the treatment: depressed (F31.3-5; F33; F20.4; F25.1) - HAM-D; schizophrenic/ schizoaffective/ bipolar-manic or mixed (F20.X, F25.X, F31.0, F31.6) - PANSS; with any of these diagnosis: PSAS. The correlation between the improvement on each scale and both mean seizure time and mean electric charge was investigated using the Pearson product-moment correlation coefficient. The groups were subdivided by seizure duration (cut-off 20s) and the mean improvement on the different scales was determined for each subgroup.

Results

There is no correlation between any of the variables analyzed (α = 0,05). HAM-D variation (N = 102): seizure duration (r = 0,004) and electric charge (r = 0,106). PANSS variation (N = 43): seizure duration (r = 0,07) and electric charge (r = 0,046). PSAS variation (N = 147): seizure duration (r = −0,043) and electric charge (r = 0,143). There is no difference statistically significant in mean HAM-D, PANSS or PSAS improvement between subgroups >20s and < 20s (11.29 vs 13.94; 30.85 vs 29.19 and 19.07 vs 22.65, respectively).

Conclusion

Mean seizure duration and electric charge didn’t correlate with clinical outcome. Seizure duration below 20 seconds didn’t imply poorer outcome.
Barriers to consent taking in ECT
Authors: Pereira S.R. , Slattery A. , Beezhold J.
Published: May 2011

Introduction

There were 16,482 administrations of Electro-convulsive Therapy (ECT) to 2835 individuals in England between January-March 1999. Controversy still surrounds the safety, ethics and necessity of ECT with some patients reporting severe adverse effects and feeling particularly strongly about it being administered without their consent. NICE guidelines along with the ECT accreditation service (ECTAS) sought to address these concerns and raise standards for ECT in UK.

Aims and Objective

To identify any barriers to compliance with NICE guidelines regarding consent for ECT.

Methods

All patients newly started on ECT during a 3 month period at Hellesdon Hospital were enrolled into this study. Case notes were analysed for 16 patients against the 21 standard ECTAS consent criteria.

Results

The hospital rated good (70–89%) or excellent (90–100%) for all guidance except the one which requires patients to complete some sections of the consent form. Only 63% of the patients had completed these, however 100% went on to sign the consent form before every session. Guidance compliance was excellent for 15 (72%) of items examined.

Conclusions

There is good compliance with NICE guideline relating to consent for ECT. The only barrier to full compliance was inadequate documentation by patients in some sections. Steps to improve patient participation can now be implemented. This will provide assurance that ECT is used appropriately and that the process fully enables informed consent. Further research is required to discover the reasons for unsatisfactory patient participation in the consent process.
Electroconvulsive therapy treated patients’ and their relatives’ attitudes toward electroconvulsive therapy
Authors: Saran O. , Celik S. , Guloksuz S. , Cakmak D.
Published: May 2011

Introduction

Electroconvulsive therapy (ECT), which is a safe and effective treatment option for many of the psychiatric illnesses, is still negatively perceived by lay public. It could be hypothesized this negative view can affect the patients and their relatives. This study aimed to evaluate the attitudes of patients’ and their relatives’ toward ECT.

Methods

Sixty-four ECT treated patients were recruited from inpatient units of Bakirkoy Research and Training Hospital for Psychiatry, Neurology and Neurosurgery. Patients were evaluated with Clinical Global Impression Scale, Mini Mental State Examination and Columbia ECT Subjective Side Effects Schedule. Both patients and their relatives were interviewed by using a questionnaire for assessing attitudes toward ECT.

Results

The mean number of ECT sessions was 8.50 ± 1.85. The most common side effects according to the patients were subjective feeling of slowed down and memory problems. The majority of both patients and their relatives stated that they had not received adequate information about ECT. Moreover, their knowledge about technique and mechanism of ECT was very limited. However, their overall perception of ECT was very positive. The relatives of the patients were more satisfied with the benefits of ECT than the patients.

Discussion

Although perception of ECT among patients and their relatives was very positive, it should be noted that this was mostly subjective in regard to inadequate knowledge about ECT. Thus, clinicians should pay utmost attention to inform both patients and their relatives about ECT.
Transcranial direct current stimulation (TDCS) for severe drug resistent major depression: A ten days treatment protocol
Authors: Scelzo E. , Ferrucci R. , Bortolomasi M. , Giacopuzzi M. , Priori A.
Published: May 2011

Introduction

Transcranial direct current stimulation (tDCS) is a non-invasive and safe neuromodulation technique that induces prolonged excitability changes of the human cerebral cortex. We have shown that patients with severe major depression treated with tDCS twice a day for 5 days improve by some 30% their depressive symptoms.

Objectives

To optimize the tDCS protocol for the treatment of major depression.

Aims

To assess the therapeutic efficacy in severe drug resistant major depression of tDCS over the dorso-lateral prefrontal cortex (DLPC) twice a day for ten days.

Methods

We studied 15 hospitalized patients aged 37–68 years, with severe major depression. Mood was evaluated using the Beck Depression Inventory (BDI) and Visual Analogue Scales (VAS). tDCS was delivered over the DLPC (anodal electrode was placed on F3 and cathodal electrode on F4) at the intensity of 2mA, for 20 minutes, twice a day for 10 days. Depression scales were administered at baseline and after the last tDCS session on day 10. Drug treatments were maintained unchanged since six weeks before the tDCS study.

Results

After ten days of tDCS the BDI improved by about 40% [(Mean ± SEM) Before: 29.1 ± 3.5; After: 19.4 ± 3.7, p < 0.01]. The feeling of happyness and sadness as evaluated by VAS improved after tDCS (happiness p < 0.01; Sadness p < 0.05).

Conclusions

The improvement reported by patients after ten-days tDCS protocol is greater than that we previously reported after the five-days tDCS protocol. Hence, our preliminary findings suggest that ten-days tDCS protocol should be preferred to the five-days protocol for major depression.
Repetitive transcranial magnetic stimulation influences mood in healthy male volunteers
Authors: Schaller G. , Lenz B. , Friedrich K. , Dygon D. , Richter-Schmidinger T. , Jacobi A. , Müller S.E. , Maihöfner C. , Sperling W. , Kornhuber J.
Published: May 2011

Introduction

The influence of repetitive transcranial magnetic stimulation (rTMS) on mood in healthy people is uncertain, as former studies show divergent results. Previous studies in healthy volunteers focused exclusively on the immediate effect of a single session of rTMS on mood.

Aims

The aim of this study was to analyse the influence on mood of a series of 9 High Frequency (HF) rTMS stimulations of the left dorsolateral prefrontal cortex (DLPFC).

Methods

44 young healthy male volunteers were randomly assigned to receive 9 sessions of active HF-rTMS (n = 22) or sham rTMS (n = 22) over the left DLPFC. Each session in the active group consisted of 15 trains of 25 Hz starting with 100% of motor threshold. Sham stimulation was performed following the same protocol, but using a sham coil. The variables of interest were the Beck Depression Inventory (BDI) and Visual Analogue Scales (VAS) which quantified “mood”, “enjoyment” and “energy”.

Results

We found a significant reduction of the BDI score in the active group (GLM, p < 0.001) whereas no significant changes of the BDI score were caused by sham stimulation (GLM, p = 0.109). We did not find significant differences caused by active or sham stimulation in VAS scales except for the VAS labelled lively/gloomy immediately after stimulation. The active group was found to be more “gloomy” (p = 0.001).

Conclusions

Our data support the hypothesis that a 9-day long series of HF-rTMS of the left DLPFC improves mood, analysed by BDI in healthy young men.
The effects of long acting methylphenidate in adults with ADHD: A study with paired pulse transcranial magnetic stimulation
Authors: Schneider M. , Retz W. , Gougleris G. , Verhoeven W. , Tulen J. , Rösler M.
Published: May 2011

Background

Recent investigations into motor cortex excitability with paired pulse transcranial magnetic stimulation technique (ppTMS), have shown inhibition deficits in ADHD which correlate with the clinical symptomatology. Methylphenidate effects on cortical excitability in adults with ADHD are contradictory. Therefore, we use long-acting methylphenidate (LA-Mph) to consider cortical excitability effects under stable medication conditions.

Objectives

Systematic evaluation of the effects of LA-Mph on motor cortex excitability in adult patients with ADHD with the ppTMS technique.

Aims

Investigation of the putative influence of LA-Mph on motor inhibition and facilitation in adults with ADHD.

Methods

Thirteen drug naïve adult ADHD patients were included in this ppTMS study. Measurements took place before and under treatment with LA-Mph (30–54 mg daily dose). Statistical analyses were performed to investigate treatment effects and correlations with clinical symptomatology.

Results

LA-Mph significantly decreased the relative short intracortical motor inhibition (SICI) magnetically evoked potential (MEP) amplitude at 3ms interstimulus interval (conditioned/ unconditioned MEP amplitude: 0.84 ± 0.76 drug-free vs. 0.29 ± 0.19 with LA-Mph; p = 0.020). The relative intracortical facilitation (ICF) MEP amplitude at 11ms interstimulus interval (conditioned/ unconditioned MEP amplitude: 1.51 ± 0.92 drug-free vs. 1.79 ± 0.95 with LA-Mph) was not significantly increased. The decrease of the relative SICI MEP amplitude with LA-Mph correlated significantly with the improvement of the psychopathological ADHD self-rating total scores (p = 0.034) and hyperactivity/impulsivity subscores (p = 0.029). These results show that in adult patients with ADHD, LA-Mph significantly improves motor disinhibition without influencing motor facilitation.

Conclusion

LA-Mph might have differential stabilizing effects on motor hyperexcitability in adults with ADHD and correlates with the clinical improvements.
Psychiatric doctors’ attitudes towards receiving ECT if they were to need it themselves
Authors: Siddiquee R. , Assalman I. , Ray R.
Published: May 2011

For an established and evidence based treatment ECT has had its fair share of vilification by sections of the population perhaps due to its portrayal by segments of the popular media.

The authors of this study explored psychiatrists attitude towards ECT and in particular their willingness to undergo ECT if they were to need it.

122 doctors in psychiatry from Birmingham and London were surveyed using a questionnaire. They were asked to express whether or not they would consider ECT as a treatment option if it were indicated for themselves and also to elaborate on their reasons to accept or reject ECT as a treatment option.

A majority of the doctors had a positive attitude towards ECT (97.6%) and would consider it as a treatment option should they require it (83.6%). Yet only a two thirds of them used it in their clinical practice. Another finding of interest was that senior psychiatrists were more likely to undergo ECT when compared to junior psychiatrists. The majority of responses in favour cited the reasons for receiving ECT was because it was “fast, effective and safe”. The main reasons for not considering ECT was because doctors preferred to have a combination of pharmacotherapy and psychotherapy instead.
Electroconvulsive therpapy and cinema. From “the snake pit” to “requiem for a dream”
Authors: Torreblanca M. , Zallo E. , Euba O.
Published: May 2011

Introduction

Electroconvulsive therapy is nowadays one of the most useful treatments for severe mental disorders. A lot of patients refer an improvement or even a remission of their psychopathology after this treatment.

Objectives

To demonstrate how cinema has favoured the creation of a social stigma against mental health professionals, against the treatments we use and, most of all, against the people we treat.We based this project on the portrait cinema has meade of electroconvulsive therapy (ECT).

Methods

ECT appears in more than thirty films. We take into account the most representative ones shot from 1948 to 2008.

Results

ECT makes its debut in cinema in 1948, ten years after its first use as a psychiatric treatment. During 60 years, ECT comes on stage in more than 30 films. The main indication in cinema to use ECT is to control and punish antisocial behaviors. Medical consent is not asked in most of the films. The ECT modified procedure doesn’t appear.

Conclusions

Cinema has contributed to stigmatize mental illness, psychiatrists and treatments we use, specially electroconvulsive therapy.
Intensive HF-RTMS treatment in affective disorders: Sample cases
Authors: Zeeuws D. , Baeken C.
Published: May 2011

Introduction

Repetitive transcranial magnetic stimulation (rTMS) on the left dorsolateral prefrontal cortex (DLPFC) is safe and efficient for treatment-resistant depression (TRD). More intensive rTMS protocols could improve clinical outcome.

Objectives

We report on an intensive high frequency (HF)-rTMS treatment protocol in patients unresponsive to current treatment strategies.

Aims

Monitoring effectiveness and tolerability.

Methods

Patients were diagnosed with TRD, schizoaffective disorder, bipolar type or bipolar type I disorder, mixed episode. All were unresponsive to adequate therapy (rTMS excluded).HF-rTMS was administrated on the left DLPFC under MRI guidance. In each 20 Hz stimulation session, the patient received 40 trains of 1.9 seconds duration at 120% of the motor threshold. The 20 HF-rTMS sessions were spread over 4 days (5 times/day), yielding a total of 31,200 stimuli.

Results

There were neither seizures nor important adverse events. The bipolar patient clinically responded (Hamilton Depression Rating Scale (HAMD) from 20 to 9) following treatment day 1. After completing the protocol a week earlier, the TRD patient's HAMD went from 28 to 5. There was a 5 point decrease in the score of the schizoaffective patient. He improved on the brief psychiatric rating subscales blunted affect and emotional withdrawal. No positive symptoms occurred. None of the patients had significant elevations in YMRS scores or in psychomotor activity.

Conclusion

‘Intensively’ targeting the left DLPFC was tolerated and safe. Our results suggest a strategy of HF-rTMS protocols in non-responders to classical treatment. Larger sham-controlled HF-rTMS studies should substantiate these recent findings.
Use of paliperidone in bipolar disorder
Authors: Campos Mangas M.C. , Ruiz Feliu M.A.
Published: May 2011

Introduction

In recent years have seen significant advances in the treatment of bipolar disorder with the appearance of new drugs such as atypical antipsychotics. However, there is still a therapeutic challenge to effectively cover the prevention of relapse.

The appearance of new drugs such as paliperidone with demonstrated successful experience in the field of schizophrenia can expect the use of this drug in usual clinical setting like positive contribution

Objectives

The aim of this study is to evaluate the efficacy and safety results after 6 months of combined treatment with paliperidone in patients diagnosed with bipolar disorder

Methods

This study is an observational retrospective of the effectiveness of paliperidone as adjunctive therapy in a sample of 11 patients with bipolar disorder I treated as outpatients in a mental health center.

Paliperidone addiction was caused by lack of efficacy or partial response to treatment. Scundary effects were collected during the study period

Results

In all cases except two, was added paliperidone because of partial response to the treatment. After six months of treatment only one patient discontinued treatment due to problems of tolerability and another for lack of efficacy. The mean dose of paliperidone used was 5.7 mg / day. The addition of paliperidone significantly improved affective symptomatology.

Conclusions

Pharmacological treatment combined with paliperidone is effective and quite well tolerated in patients with bipolar disorder. The limitations of our study (small sample size, open study) do need more research and the realization of controlled clinical trials to confirm these findings.
Prediabetes in patients treated with antipsychotic drugs
Authors: Manu P. , Correll C.U. , van Winkel R. , Wampers M. , De Hert M.
Published: May 2011

Background

In 2010, the American Diabetes Association (ADA) proposed that individuals with fasting glucose 100–125 mg/dl (5.6-6.9 mmol/l) or glucose 140–199 mg/dl (7.8–11.0 mmol/l) 2 hours after a 75 gm oral glucose tolerance test (OGGT) or hemoglobin A1c (A1c) 5.7–6.4% be classified as prediabetic to indicate a high risk for the development of diabetes.

Objective

To determine the prevalence of prediabetes in psychiatric patients receiving antipsychotics and to compare the clinical and metabolic features of patients with normal glucose tolerance, prediabetes and diabetes.

Method

The 2010 ADA criteria were applied to a large consecutive cohort of psychiatric patients treated at one institution in Belgium. All patients were evaluated with OGTT, A1c, insulin levels and lipid profiles.

Results

The study sample was restricted to the 783 adult patients (mean age 37.6) without known history of diabetes. 413 (52.8%) patients had normal glucose tolerance, 290 (37%) were prediabetic and 80 (10.2%) were diabetic. The 3 groups were similar with regard to psychiatric diagnoses, severity of mental illness and antipsychotic treatment. A statistically significant crescendo gradient from normal to prediabetes and from prediabetes to diabetes was observed for age, body mass index, waist circumference, fasting insulin, homeostatic model of insulin resistance (HOMA-IR) and triglyceride levels. The intergroups differences for fasting insulin and HOMA-IR were confirmed for treatment with clozapine, olanzapine, quetiapine, risperidone and amilsulpride, but not for aripiprazole or first-generation antipsychotics.

Conclusion

Prediabetes is highly prevalent in adults treated with antipsychotic drugs and correlates with markers of intraabdominal adiposity and insulin resistance.