bluuebunny/crossref_metadata_2025 huggingface dataset:
896 – Prevalence And Age-of-onset Distributions Of Suicidal Thoughts, Plans And Attempts Among Students Of Nine Public Universities In Wroclaw, Poland: Wmh-cidi Findings
Authors: Zagdańska M.J. , Kiejna A.
Published: July 2013

Suicidality among university students represents an important and growing public health concern for which epidemiological data are needed.

This study aimed to estimate the prevalence of suicide thoughts, plans and attempts among students of nine public universities in Wroclaw, Poland.

A representative quota sample of 370 (2,78%) out of 102160 students of nine public universities participated in the face-toface structured interview using the polish version of WMH-CIDI 3.0.

Estimated lifetime prevalence of serious suicidal thoughts is 9,19%. Those thoughts occur for the first time on average at the age of 16,4. Serious plans of committing suicide were reported by 3,24% of all students who participated in the study.

Moreover 1,35% admitted planning suicide in 12 months prior to the interview. The average age in which such ideations occur for the first time is 15,5 years old. Lifetime revalence of suicide attempt is 1,62%. One third of respondents who have ever try to kill themselves made such an attempt within a year before being interviewed.

Percentage gf students experiencing serious suicidal thoughts I slightly higher than in the general sample CIDI studies in Europe. Suicidal symptoms occur early in lifetime. Therefore prevention campaigns aimed in reaching those who are suicidal for the first time, should be addressed to high schools students. High percentage of 12 months suicide attempts prevalence among those who tried to kill themselves indicates need of prevention directed for university students.
900 – Cortical Surface Area Correlates Of Ston2 Gene Ser307pro Polymorphism In Patients With Schizophrenia And Healthy Controls
Authors: Bo X.
Published: July 2013

Background

Previous evidence shows that STON2 was associated with synaptic function and schizophrenia. The aim of this study is to explore the relationship STON2Ser307Pro, Ala851Ser and cortical surface area in schizophrenia patients and healthy volunteers.

Methods

MRI whole cortical surface area which was computed by an automated surface-based technique (FreeSurfer) and genotypes were obtained from 74 individuals with first-episode schizophrenia and 55 controls. Multiple regressions analysis was performed using genotype subgroups to effect on cortical surface area.

Results

There was significant genotype-by-diagnosis effect on cortical surface area, Pro-allele-carriers having larger right inferior temporal surface area in schizophrenia patients, but there was no significant on the same area in healthy volunteers, have not detected that Ala851Ser was associati[on with cortical surface area in our subjects.

Conclusion

These data demonstrate that STON2 gene may be alter cortical asymmetry on the right inferior temporal, and that abnormal gene may be a core role that contributes to the pathogenesis of schizophrenia.
902 – A Combined Fmri And Vbm Study To Show Motor Deficits In Schizophrenic Versus Control Subjects During a Simple Motor Task
Authors: Singh S. , Goyal S. , Modi S. , Kumar P. , Singh N. , Bhatia T. , Deshpande S. , Khushu S.
Published: July 2013

Schizophrenia is one of the psychotic mental disorders, characterized by social problems and disorders of thought, behaviour, motor and cognitive functions such as long-term memory, verbal memory, executive functioning and vigilance etc. However, the relation between structural and functional alterations in schizophrenia remains unclear. Therefore, the present study sought to investigate whether functional alterations in schizophrenia are also associated with structural brain aberrations directly in related brain regions or in anatomically closely connected areas.

The current study was conducted to investigate the possible relationship between functional and structural changes for a simple motor task in schizophrenics.

16 controls and 16 schizophrenic patients were chosen for the study. The structural and functional MRI scans were acquired using 3 Tesla whole-body MRI system with a 16 channel head array coil. For fMRI, a block paradigm with alternating blocks of motor task (right finger tapping; 120 taps/min) and rest was carried out. Pre-processing and post-processing of MRI scans were performed using SPM8 software.

The fMRI study showed relatively less activation in the left precentral and postcentral gyrus and right cerebellum in schizophrenic patients as compared to controls during finger tapping task. Voxel-based morphometry (VBM) revealed grey matter decreases in the left precentral and postcentral gyrus and left middle frontal gyrus while white matter decreases in the right cerebellum and right inferior temporal gyrus of schizophrenics as compared to controls.

The present study provides strong evidence for an association between motor functional deficits and structural alterations in schizophrenic patients as compared to controls.
906 – Hyponatremia And Antidepressants: Are They Worth Their Salt? a Class-per-class Review Of The Literature
Authors: De Picker L. , Van Den Eede F. , Sabbe B.G.C.
Published: July 2013

Introduction

Hyponatremia due to antidepressant-induced SIADH can cause significant morbidity and serious complications. It is commonly associated with SSRIs, but the frequency and class-specificity are unclear.

Objectives

To determine the relationship between hyponatremia and antidepressants, defining incidence and odds ratios for antidepressant classes, along with patient risk factors.

Methods

A review of the literature was performed in Web of Science and Pubmed until April 2012, using combinations of search strings “antidepressants” and antidepressant class and generic drug names with “hyponatr(a)emia”, “SIADH” or “inappropriate antidiuretic hormone secretion”.

Results

19 effect studies and over 50 case reports were considered, the majority concerning SSRIs. Variation in study design, population and cut-off values caused divergence of hyponatremia incidences of 0.06-40% for SSRIs and 0.08-70% for venlafaxine. Incidence numbers for mirtazapine and TCAs were tenfold lower. Odds ratios for SSRIs (1.5 -4.0) were consistently higher than for TCAs (1.1-1.9). The risk associated with MAO-inhibitors, reboxetine and bupropion could not be established due to insufficient information. Patient risk factors included older age (OR 6.3) and concommitant use of (thiazide) diuretics (OR 11.2-13.5).

Conclusion

Hyponatremia is an underdiagnosed and potentially dangerous side-effect of antidepressants and this risk is not exclusive to SSRIs. Current evidence suggests a relatively high risk for hyponatremia with the use of SSRIs or venlafaxine, especially combined with patient risk factors, in which cases clinicians should actively screen for this complication. Mirtazapine and TCAs entail a moderate risk and can be considered as alternative treatment for patients with increased risk or history of hyponatremia.
907 – Barriers To Self Care, Illness Perceptions And Their Relationship With Self Care In Type 2 Diabetes Mellitus
Authors: Abraham A.M. , Sudhir P.M. , Bantwal G.
Published: July 2013

Introduction

Type 2 Diabetes mellitus (T2DM) is a chronic disease that requires long-term medical care and lifestyle change. Many patients find it challenging to implement required behaviour changes and consequently, do not achieve glycaemic control. It is essential to research social cognitive factors that impact self care in T2DM.

Aims

To study the impact of barriers and illness perceptions on self care in T2DM

Objectives

To explore barriers to self care and illness perception and examine their relationship with self care, metabolic control and quality of life in T2DM.

Methods

A cross-sectional design was employed. The sample consisted of 60 patients with type 2 DM, meeting specified inclusion and exclusion criteria, recruited from the out-patient services of a hospital at Bangalore. The Barriers of self care questionnaire (Glasgow, 1994), The Revised Illness Perception Questionnaire (Morris et. al, 2002), The Summary of Diabetes Self Care Activities (Toobert & Glasgow, 1994) and The Diabetes Quality of Life Questionnaire Brief Clinical Inventory (Burroughs, Desikan, Waterman, Gilin & McGill, 2004) were administered. Metabolic control was assessed using glycosylated haemoglobin levels (HbA1c).

Results

Findings revealed that barriers to self care, negative perceptions of consequences of the illness and negative emotional representations were associated with poorer self care. Adherence was associated with better metabolic control and quality of life.

Conclusions

Barriers to self care and maladaptive illness representations pose a challenge in achieving self-care goals. Understanding barriers is the first step in facilitating practitioners to identify their role in enabling patients to overcome them.
912 – The Impacts Of Fear Of Crime On The Mental Health And Avoidance Behaviors Of Older Chinese
Authors: Qin N. , Yan E.
Published: July 2013

Introduction

Fear of crime is a kind of unpleasant and often intense emotion caused by perceived risk of being victimized. It is evidenced that fear of crime has tremendous impacts on the mental health of older people who resort to avoidance behaviors for self-protection.

Objectives

This study examined the impact of fear of crime on the mental health and avoidance behavior of the communitydwelling older adults living in urban China.

Methods

For the present study, data were collected from a representative sample of 453 older persons aged 60 years and above from Kunming, Yunnan province using face-to-face interview. Associations between fear of crime and mental health, and avoidance behavior were measured using linear regression.

Results

The final sample ranged from 60 to 100 years of age (Mean = 72.29, SD = 8.27) and included 198 (43.7%) males and 255 females. Preliminary results showed that 258 participants (57.0%) reported fear of one or more types of depicted crimes; 397 (87.6%) carried on one or more kinds of avoidance behaviors; and 234 (51.7%) presented deteriorating mental health. Results of hierarchical regression analyses indicated that fear of crime was a significant predictor of both poorer mental health (p < .05) and more avoidance behaviors (p < .001), independent of gender, age, education, household finance, length of residence in neighborhood, household size, living arrangement, physical health and social networks.

Conclusions

Fear of crime had detrimental impacts on mental health of older Chinese and resulted in reduced social participation due to their avoidance behaviors.
921 – Physical Health Monitoring Of Patients Taking Antipsychotic Medication In Primary And Secondary Care: a Complete Audit
Authors: Jesudason P. , Narayan V.
Published: July 2013

Introduction

Mortality due to physical illness is greater in schizophrenia than in the general population. Antipsychotics have been linked with weight gain, diabetes and hyperlipidaemia. UK guidelines recommend annual health screens in primary care, and secondary care ensure patients receive this and document results in notes.

Objectives

To establish whether patients taking antipsychotics received annual monitoring of U&E, FBC, Lipids, Glucose, LFT, weight and blood pressure. Standards for the audit were derived from the Maudsley Prescribing Guidelines and NICE Guidelines on Schizophrenia.

Aims

To improve physical health monitoring for our patients.

Methods

We retrospectively reviewed 82 case notes. Intervention following initial audit included education of professionals involved in monitoring and inclusion of a Prescribed Medication Monitoring Form in case notes. Re-audit occurred 12 months after initial audit. Statistical analysis used χ2-test with Yates’ Continuity Correction.

Results

Following intervention recommendation of physical health monitoring to primary care increased from 40.2% to 76.8% (P < 0.0001), as did monitoring frequency: Weight (7.3% to 54.3%), BP (7.3% to 49.4%), U&E (64.6% to 82.5%), FBC (61.0% to 78.5%,) Lipids (47.6% to 72.2%), Glucose (59.8% to 79.7%) and LFT (61.0% to 81.3%) (P < 0.05 for all parameters). Documentation of blood results in secondary care notes was also increased (P < 0.05).

Conclusions

Monitoring of physical health comorbidity in patients with serious mental illness was poor in the initial audit. This can be improved in both primary and secondary care by relatively simple measures and by increasing clinicians' understanding of the importance of monitoring.
929 – Principles Of Supervision In Cognitive Behavioural Therapy
Authors: Vyskocilova J. , Prasko J.
Published: July 2013

The task of supervision is obvious - to increase the value of the therapeutic process in the client's best interest. At the same time, supervision is an educational process in the truest sense of the word, including an opportunity to select one's own supervisor. This is a very important procedural aspect since the therapist identifies with his/her supervisor, either consciously or unconsciously. Establishing the supervisor-supervisee relationship is based on principles similar to those in the therapeutic relationship. There is an important parallel reflecting the therapist-client relationship. This is because any changes in the supervisory process are analogically transferred into the therapist-client relationship. Additionally, supervision is oriented towards increasing the therapist's competencies. The CBT therapist's basic skills involve good theoretical knowledge, professional behaviour towards clients, ability to use specific therapeutic strategies for maintaining the therapeutic relationship, sensitivity to parallel processes and accomplishment of changes, and adherence to ethical norms. Given the fact that during supervision, the supervisee may be in any stage of his/her training, supervision must take into consideration where the therapist is in his/her training and development and what he/she has or has not learnt. Supervision may only lead to the supervisee's professional growth if it supports his/her individuality and helps him/her to discover things. Therefore, numerous approaches are used in supervision which are associated with the abilities to self-reflect and to realize transference and countertransference mechanisms.

Supported by project IGA MZ ČR NS 10301-3/2009
935 – Cerebellar Motor Learning Deficits In Patients With Recent-onset Schizophrenia
Authors: Röder C. , Coesmans M. , Koekkoek S.K.E. , de Zeeuw C.I. , Frens M.A. , van der Geest J.N.
Published: July 2013

Introduction

The notion that cerebellar deficits may underlie clinical symptoms in schizophrenia is tested by evaluating two forms of cerebellar learning in recent-onset schizophrenia patients. A potential medication effect is evaluated by including patients with or without antipsychotics.

Methods

Saccadic eye movement adaptation and eyeblink-conditioning were assessed in 39 male patients with recent-onset schizophrenia who were on antipsychotic medication (clozapine n=10 haloperidol n=16) or antipsychotic-free (n=13), and in 29 age-matched male control subjects.

Results

All participants showed significant saccadic adaptation. Adaptation strength did not differ between healthy controls and schizophrenia patients. The speed of saccade-adaptation, however, was significantly lower in schizophrenia patients. Patients showed a significantly lower increase in the number of conditioned eyeblink responses (CR). Over all experiments no constistent effects of medication were observed. These outcomes did not correlate with age, duration of education, psychopathology or dose of antipsychotics.

Conclusions

In this study we find several cerebellar learning deficits in patients with schizophrenia that we cannot attribute to the use of antipsychotics. Although this finding, combined with the fact that deficits are already present in recent-onset schizophrenia, could suggest that cerebellar impairments are a trait deficit in schizophrenia, this should be confirmed in longitudinal studies.
943 – Mental Disorders In Rheumatoid Arthritis Patients: Stress Factors And Pain Relations
Authors: Veltishchev D. , Lisitsyna T. , Kovalevskaya O. , Seravina O. , Zeltyn A. , Krasnov V. , Nasonov E.
Published: July 2013

Objective

To analyze the prevalence of stress factors, mental disorders (MD) and their influence on pain in rheumatoid arthritis (RA) patients (pts).

Methods

125 RA-pts with a mean age of 47.4±1.01 yrs and disease duration of 138.4±10.1 month were enrolled. The RA disease activity was assessed by DAS-28. BPI was used for pain severity assessment. MD were diagnosed in accordance with ICD-10 criteria.

Results

MD were diagnosed in 117 (93.6%) RA pts: depressive episode (n=46,39%) (RDD incl. - 27%); dysthymia (n=41,35%), adjustmend disorders(n=21,18%); GAD (n=9,8%). Mild cognitive disorder was diagnosed in 83 (66.4%) of RA-pts. The significant stress factors preceding RA manifestation were found in 97 (77.6%) cases; in 76 (61%) - stress factors preceded RA exacerbation. Significant chronic stress events during childhood had 84 (67.2%) patients. Patients with MD more often (p< 0.05) had the fourth X-ray stage of RA and maximal stage of functional disability. Mean age of the first prednisone intake was significantly higher (p< 0.05) in patients with MD. RA-pts with severe pain (=7 BPI-points) were 3 times more likely to have depressive disorder than RA-pts with mild pain (1-4 BPI-point) (48.6% vs 15.6%, ?R=3.1, 95% CI=0.97-9.93, ?=0.004).

Conclusion

The results have shown high prevalence of stress related MD in RA-pts and confirm the stress-diathesis approach to pathogenesis of MD in rheumatic disease. The RA patients group with MD had high level of pain severity, X-ray stage and functional disability in comparison with patients without MD.
945 – Association Study Between The c3435t Polymorphism Of The Multidrug Resistance 1 (mdr1) And Interpersonal Sensitivity
Authors: Masanori E. , Suzuki A. , Sadahiro R. , Matsumoto Y. , Shibuya N. , Kamata M. , Otani K.
Published: July 2013

P-glycoprotein, which is encoded by the multidrug resistance 1 (MDR1) gene, serves as a barrier to entry and as an active elimination for xenobiotics and cellular metabolites including cortisol, which is implicated in multiple brain functions. Meanwhile, previous studies suggested that genetic factors and cortisol are involved in formation of interpersonal sensitivity, a personality trait predisposing to depression. In the present study, we examined the effects of the C3435T MDR1 polymorphism on interpersonal sensitivity. The subjects were 842 healthy Japanese volunteers. The mean age ±SD of the subjects was 26.7±8.1 (490 males and 352 females). The C3435T polymorphism of MDR1 gene was detected by a PCR method, and interpersonal sensitivity was assessed by the Interpersonal Sensitivity Measure (IPSM). In total subjects, the C allele of the C3435T MDR1 polymorphism was associated with higher scores of the IPSM. In females the C/C genotype group had higher IPSM scores than the C/T genotype group and the T/T genotype group, and the C/T genotype group had higher IPSM scores than the T/T genotype group. In males no significant association was found between the MDR1 genotype and the IPSM scores. The present study suggests that the C3435T polymorphism of the MDR1 gene affects formation of a depression-prone personality trait in Japanese females.
948 – Homocysteine And Cognitive Impairment In Chronic Kidney Disease
Authors: Yeh Y.-C. , Kuo M.-C. , Hwang S.-J. , Hsioa S.-M. , Tsai J.-C. , Huang M.-F. , Chen C.-S.
Published: July 2013

Objective

Patients with chronic kidney disease (CKD) have more cognitive impairments. However, the etiologies are not fully clear. Plasma homocysteine levels and vascular burden rise in CKD; meanwhile, high homocysteine levels and vascular factors are known risk factors of dementia in non-CKD patients. Thus, we aimed to investigate the association between homocysteine, vascular burden and cognitive impairment in CKD and to see if the effect of elevated homocysteine on cognitive impairment mediated by vascular factor.

Methods

146 patients with CKD and 69 normal comparisons were recruited. Cognitive function was evaluated by comprehensive neuropsychological tests assessing processing speed, executive function, language, visuospatial function, memory, and attention domains. Vascular burden was assessed by Framinghan cardiovascular risk scale (FCRS) which indicates risk of atherosclerotic diseases including stroke.

Results

In controlled analysis, patients with CKD had lower scores in all cognitive domains, and had higher homocysteine levels (18.5±6.4 vs. 9.8±2.9, p< 0.0001) and FCRS(17.0±4.7 vs. 14.0±4.7, p< 0.0001). Among patients with CKD, higher homocysteine levels (p=0.026) were associated with lower score on digit symbol task which is related to processing speed and executive function with controlling for age, sex, education and stage of CKD. The association persisted (p=0.047) after controlling for vascular risks.

Conclusion

Patients with CKD had extensive cognitive impairments. Elevated homocysteine levels may be an risk factor, which is independent of vascular burden, of cognitive impairment on processing speed and executive function. Further studies to investigate if normalization of homocysteine can improve cognitive function will be suggested.
949 – Cannabis Use And Corpus Callosum (cc) Microstructural Integrity In Patients With First Episode Psychosis: a Diffusion-tensor Imaging (dti)-tractography Study
Authors: Rigucci S. , Reis-Marques T. , Di Forti M. , Taylor H. , Dell’Acqua F. , Mondelli V. , Bonaccorso S. , Simmons A. , David A.S. , Girardi P. , Pariante C.M. , Murray R.M. , Dazzan P.
Published: July 2013

Introduction

The impact of cannabis use on brain structure, particularly white matter (WM), is poorly understood. The CC is the largest WM structure in the brain. Abnormalities revealed in the CC may underlie functional anomalies of cannabis use. This is the largest study to explore the effect of cannabis on callosal WM connectivity among first episode psychosis (FEP) and controls.

Objectives

To investigate the relationship between cannabis use and WM micro-structural integrity of the CC, in FEP and healthy controls.

Methods

We evaluated 56 FEP patients (67% current cannabis users), and 43 healthy controls (44% current cannabis users). We used Diffusion Tensor Imaging combined with a WM mapping-tractography technique to investigate the microstructural integrity of the CC.

Results

Total CC Fractional anisotropy (FA) was lower in patients than controls (p=0.05). Cannabis-using patients had lower FA of the total CC than cannabis-using controls (p=0.04). There were no differences in FA between cannabis-using patients and those who had never used. However, cannabis-using patients had higher mean diffusivity (MD) of total CC (p= 0.02), Rostral-Body (p=0.003), Anterior Mid-Body (p=0.03) and the Splenium (p=0.06) than patients who never used cannabis. There were no differences in MD between patient users who started before the age of 16 and those who started later.

Conclusion

Cannabis is associated with a significant effect on callosal WM integrity only in patients with psychosis. Disturbed callosal connectivity may explain some of the abnormalities with regard to the functional and clinical outcomes in FEP cannabis users, including measures of cognitive impairment.
951 – Audit Of The Introduction Of Agomelatine In a District General Hospital
Authors: Odelola A. , Goli A. , Etuk E. , Ugwunze N. , Riaz I.
Published: July 2013

Introduction

Agomelatine is a novel antidepressant which was licensed in the United Kingdom in February 2009, but has not yet been included in national prescribing guidelines in the UK. The cost of Agomelatine and the need for monitoring of liver function during treatment have informed the development of strict local guidelines in respect of the initiation of Agomelatine.

Objective

To assess the use of Agomelatine following introduction in a district general hospital outpatient setting.

Aims

To determine whether Agomelatine use is in accordance with recently formulated local guidelines and to explore prescribing patterns for Agomelatine.

Method

Case notes were reviewed for consecutive patients prescribed Agomelatine over a 3 month study period. Using a specifically designed proforma, prescribing data, laboratory indices, outcome data and patient feedback were assessed against standards derived by consensus based on new prescribing guidelines.

Results

27 patients were studied. Agomelatine was initiated in 93% of cases for major depressive disorder as third-line treatment. 89% of patients completed baseline liver function tests and 63% had these reviewed at all of 3 time-points as recommended. 14% did not require an increment to the 50mg dose. 33% discontinued Agomelatine. 44% experienced mild side-effects such as headaches and nausea. 56% did not require an additional anxiolytic and 14% were successfully discharged. Positive feedback was obtained verbally and with rating scales.

Conclusions

Initiation of agomelatine in accordance with recommended standards proved possible in a district general hospital setting. Agomelatine was well tolerated and positive patient feedback was received.
956 – History Of Suicidal Behavior And Analgesic Use In Community-dwelling Elderly
Authors: Olié E. , Courtet P. , Poulain V. , Ritchie K. , Artero S.
Published: July 2013

Background

Analgesics are easily obtainable and frequently used as a means of suicide. Elderly persons are high consumers of analgesics, notably opiods and also have a high suicide risk.

Aim

To determine whether elderly persons with a history of suicide attempts have higher rates of analgesic use compared to depressed and normal controls.

Methods

857 non-institutionalized individuals without dementia from a cohort of community-dwelling persons aged over 65 years (the ESPRIT study) were randomly selected from electoral rolls and divided into three groups: 41 subjects with a lifetime history of suicide attempts (SA), 410 affective controls (AC) with a history of depression without suicide attempts, and 406 healthy controls (HC). Data on socio-demographic and clinical characteristics including analgesic use (based on data from the national healthcare insurance scheme over 3 year follow up) were collected. Logistic regression was used to compare analgesic consumption by grade (I: non opioid drugs; II: opioid drugs) in the three groups.

Results

After controlling for gender, age, education, chronic disease, hospitalization, living alone and subjective health, opioid consumption was observed to be significantly higher in both SA and AC in comparison to HC (respectively: OR=2.33 [1.15-4.73] and OR=1.39 [1.01-1.91]). After exclusion of cancer cases, the relationship remained significant only for the SA group.

Conclusions

Our findings suggest that suicidal vulnerability may be associated with an increased sensitivity to pain.
957 – Post Hoc Comparison Of The Efficacy Of Lisdexamfetamine Dimesylate And Osmotic-release Oral System Methlyphenidate In Children And Adolescents With Adhd
Authors: Coghill D. , Banaschewski T. , Lecendreux M. , Soutullo C. , Johnson M. , Zuddas A. , Anderson C. , Civil R. , Higgins N. , Bloomfield R. , Squires L.
Published: July 2013

Introduction

In a European, phase 3 study (SPD489-325), lisdexamfetamine dimesylate (LDX) and osmotic-release oral system methylphenidate (OROS-MPH) were more effective than placebo in improving core symptoms in children and adolescents with attention-deficit/hyperactivity disorder (ADHD).

Objectives and aims

To compare post hoc the efficacy of LDX and OROS-MPH in study SPD489-325.

Methods

This 7-week, randomized, double-blind, parallel-group, dose-optimized, placebo-controlled trial enrolled patients aged 6-17 years with ADHD of at least moderate severity. Patients were randomized (1:1:1) to receive a once-daily dose of LDX (30, 50, 70 mg/day), OROS-MPH (18, 36, 54 mg/day) or placebo. Efficacy was assessed using the ADHD Rating Scale version IV (ADHD-RS-IV) and the Clinical Global Impression-Improvement (CGI-I) scale. Endpoint was defined as the last ontherapy treatment visit with a valid assessment.

Results

The full analysis set comprised 317 patients (LDX, n=104; placebo, n=106; OROS-MPH, n=107). The difference between LDX and OROS-MPH in least squares mean change (95% confidence interval [CI]) in ADHD-RS-IV total score from baseline to endpoint was statistically significant in favour of LDX (-5.6 [-8.4, -2.7]; p < 0.001; effect size, 0.541). The difference (LDX minus OROS-MPH) in the percentage of patients (95% CI) with an improved CGI-I score at endpoint was also statistically significant in favour of LDX (17.4 [5.0, 29.8]; p < 0.05).

Conclusions

This post hoc analysis indicated that LDX is significantly more effective than OROS-MPH in improving core symptoms and global functioning in children and adolescents with ADHD.

Supported by: Funding from Shire Development LLC.
963 – The Effect Of Ssris On Hot Flashes In Women With Perimenopausal Depression
Authors: Karaoulanis S.E. , Rizoulis A.A. , Angelopoulos N.V.
Published: July 2013

Objective

Menopause is characterized by a decline in ovarian function resulting in vasomotor symptoms. Vasomotor symptoms include hot flashes and night sweats.The purpose of this study was to examine the effect of SSRIs on hot flashes in perimenopausal women with depression.

Material and methods

Sixty five perimenopausal women participated in this study. The subjects included 41 perimenopausal women with depression and 24 healthy women. The diagnosis of depression was made by a psychiatric interview and with the help of Hamilton Depression Rating Scale 17 (HAM-D 17). Hot flashes were examined with the use of Menopause Rating Scale (MRS) and they were divided as absent, mild, moderate, severe and very severe.

Results

Perimenopausal women were divided in three groups. The first group consisted of normal controls, the second of depressed perimenopausal women who were taking SSRIs and the third of depressed women not taking SSRIs. The control group had fewer hot flashes than the other two groups (p< 0.0001).The two groups of depressed women did not show any statistically significant difference in the presence and severity of hot flashes in relation to the use of SSRIs.

Conclusions

It was found that depression is associated with the presence of hot flashes in perimenopausal women. On the other hand the use of SSRIs did not relieve perimenopausal women with depression of hot flashes. Therefore, it seems that hormonal replacement therapy has the first role in the treatment of vasomotor symptoms in perimenopausal women.
964 – Cost-consequences Of Adjunctive Therapy With Pregabalin In Generalized Anxiety Disorder Patients With Partial Response To Ssri Treatment In Clinical Practice
Authors: Carrasco J.L. , Olivares J.M. , Álvarez E. , Pérez M. , López-Gómez V. , Rejas J.
Published: July 2013

Aim

To analyze the effect of adjunctive therapy with pregabalin versus usual care (UC) on healthcare costs and clinical consequences in generalized anxiety disorder (GAD) patients with partial response (PR) to previous SSRI.

Methods

Post-hoc analysis of patients enrolled in a prospective 6-month observational study. Patients with a PR [CGI score >3 and insufficient response with persistence of anxiety symptoms (HAM-A score ≥16)] to SSRI monotherapy were considered eligible for inclusion. Two groups (based on psychiatrist judgment) were analyzed 1) adding pregabalin (150-600 mg/day) to existing therapy; or 2) UC (switching to a different SSRI or adding another anxiolytic. Costs estimation used year-2009 prices for GAD related healthcare resources utilization. Measures of clinical consequences were, changes in total scores of anxiety in HAM-A (primary outcome) and GAD co-morbid depressive symptoms in MADRS (secondary outcome) scales.

Results

Four-hundred-eighty-six newly prescribed pregabalin and 239 UC GAD patients [mean (SD) HAM-A 26.7 (6.9) and CGI 4.1 (0.5)] were analyzed. Adding pregabalin was associated with significantly higher adjusted mean changes (95% CI) vs. UC in HAM-A [-11.2 (-12.2;-10.2) vs. -14.9 (-15.6;-14.2), respectively; p< 0.001] and MADRS [-7.8 (-8.7;-6.8) vs. -11.6 (- 12.2;-10.9), respectively; p< 0.001]. Adjusted mean baseline healthcare costs were significantly reduced in both cohorts; -€487 (-652;-317) and -€531 (-648;-413), respectively (both p< 0.001), yielding to similar 6-month costs; €1543 (1375;1711) UC and €1497 (1380;1614) pregabalin, p=0.661.

Conclusion

In this post-hoc analysis, GAD patients with PR to SSRI experienced greater symptom improvement with adjunctive therapy with pregabalin versus UC without increasing healthcare cost.
966 – Cortisol Awakening Response (car) In Adults With Attention Deficit Hyperactivity Disorder (adhd)
Authors: Corominas M. , Ribes V. , Palomar G. , Ramos-Quiroga J.A. , Ferrer R. , Catalan R. , Lopez-Craver M.V. , Olivares B. , Caballero A. , Corral N. , Casas M.
Published: July 2013

Introduction

ADHD in adults is associated with a significant impairment in many life activities increasing the risk of chronic stress in everyday life. Previous studies reported normal cortisol awakening response (CAR) in children with ADHD without comorbidities, nevertheless there is a lack of studies in adults.

The aim of the present research is to examine CAR in adults with ADHD and to assess possible differences between the combine and inattentive subtypes.

Methodology

Patients were recruited from the Program for adults with ADHD in the Department of Psychiatry of the Hospital Universitari Vall d’Hebron. The clinical sample consisted of 50 adults, age between 18 and 51 years (mean 35.24 ± 9.21) fulfilling current diagnostic criteria for ADHD (DSM-IV criteria). All patients were naïve to stimulant medication. Psychiatric and organic comorbid disorders were excluded. To assess CAR, four salivary cortisol samples were collected at 0, 30, 45 and 60 minutes after awakening.

Results

The mean increase in CAR for the whole group of patients was 10.34±8.79 nmols/l. T-test comparisons showed no significant differences in the mean increase of CAR between the inattentive (mean: 9.47±9.04 nmols/l) and combine (mean: 11.25±8.67 nmols/l) subtypes (t=0.610; z=0.546).

Conclusion

Despite there were no significant differences in salivary CAR between ADHD subtypes in adults, the mean increase of CAR was higher in combine than in the inattentive subtype. Salivary CAR needs to be further explored as an index of vulnerability to stress in these patients.
974 – Psychological Health And Quality Of Life Of Children And Adolescents With Short Stature
Authors: Bullinger M.
Published: July 2013

Introduction and aims

Findings regarding impairments in quality of life of children and adolescents with short stature are not unequivocal. The present paper examines prevalence of such impairments, their mutual relationship, potential determinants and differences between patient self-report and parent report.

Methods

Children and adolescents (n=218) with short stature (idiopathic short stature and growth hormone deficit) and their parents provided assessments of psychological health (Strengths and Difficulties Questionnaire - SDQ) and health related quality of life (KIDSCREEN Questionnaire). Variance and regression analysis were used to identify group differences and potential determinants of quality of life.

Results

Child-reported SDQ total score was in the normal range in over 80% of cases, while 7.8% were identified as borderline impaired and 8.2% were classified as abnormal. Parents ratings were 76% normal, 8.6% borderline and 17.8% abnormal. Impairments were found for young children, for boys and for very short patients. Analysis of variance showed higher KIDSCREEN scores in the SDQ normal group. SDQ and KIDSCREEN correlated significantly. Half of the variance in KIDSCREEN scores was explained by a combination of SDQ scores, clinical status and sociodemographic data in child and parent samples.

Conclusion

Parents reported higher impairments in psychological health than children. SDQ related differences in KIDSCREEN scores and the proportion of variance in QoL explained by the SDQ suggest that mental health should be routinely assessed in children with short stature as a part of the diagnostic process. Psychological interventions should be considered when clinically indicated.
985 – ADHD And Atopy Are Related: An Exploratory Study On 102 Children
Authors: Lehéron C. , Morin A.J.S. , Caci H.
Published: July 2013

Introduction

Scarce studies have reported a relationship between Attention Deficit-Hyperactivity Disorder (ADHD) and atopic symptoms (i.e. rhinitis, eczema), food allergy and asthma in children and adults. Results of the studies show a trend toward a positive relationship.

Aims

This study aims to explore the relationship between ADHD and atopy in treatment-naïve children referred to an ADHD consultation.

Methods

For 12 consecutive months, all children diagnosed with impairing ADHD and for who a psychopharmacological treatment was indicated were blood tested for the presence of a mixture of specific IgE (PHADIATOP® test). An allergist subsequently performed prick-tests on only those with positive tests.

Results

63 children out of 102 included (61.8%) had a positive blood test. Age, gender and Body Mass Index did not differ between positive and negative groups. Children were more likely to have ADHD Combined (66/102). Rates of Opponent Defiant Disorder (ODD, 40/102) and Conduct Disorder (CD, 14/102) were similar between groups. Atopy is not with ODD or CD. Familial history of ADHD (36/102) or atopy (39/102) is significant. Prick tests confirmed the blood test in all cases. Rhinitis was most frequent (40/63) with moderate to severe intensity in 23 cases (67.7%), associated with a history of conjunctivitis in 21 cases (61.8%). Most youths had never been referred to an allergist although some of them had a persistent and severe symptomatology.

Conclusion

This is the larger study reporting a strong relationship between ADHD and atopy. All children referred for ADHD shall be screened for atopy and vice versa.
986 – Early Recovery Experiences Of Patients After An Unexpected Cardiac Surgery: a Preliminary Study
Authors: Chang Y.L. , Tsai Y.F.
Published: July 2013

Aim

The aim of this study was to understand the early stage of illness recovery experiences and related needs of patients who underwent emergency cardiac surgery.

Methods

A qualitative approach was used. Patients who had been transferred from intensive care units to a general ward for least 6 days and were expecting to be discharged within one week were interviewed at a medical center in northern Taiwan.

Results

A total of 9 patients participated in this study. Two themes emerged from the analysis related to their illness experiences. Patients felt ‘shock’ when they were informed to have emergency surgery or when they woke up to know surgery had been done on them, including unbelieving and suspicious. They also described various degree of ‘psychiatric symptoms’, such as fragment of memory or memory loss related to the medical procedure, nightmares, insomnia,hallucinations, derealization, daze, sluggish response, and attention deficit. Three themes emerged from the analysis looking at their needs. Patients described the needs for ‘reassurances,’ ‘support,’ and ‘more information about subsequent treatment and care’ to rebuild their new life in the future.

Conclusion

This study has shown that these patients had many of symptoms related to acute stress and their related needs in the early recovery stage. The findings would enhance the health professions can design early interventions to treat acute stress symptoms in critical care units. It would help patients in the restore their social and occupational functions, and prevent the development of PTSD. It is suggested integrated interdisciplinary care and support are crucial helping patients recovery.
990 – Adolescent Sexual Abuse: From Incest To Hebephilia
Authors: Vannucci C. , Cano J.-P.
Published: July 2013

Introduction

On the eve of its entry into the DSM-V, hebephilia is a sexual deviance under debate. Few studies describe hebephiles, then who are these sex offenders?

Objectives

Assess the profile of adolescents sex offenders and their victims, and the characteristics of their penal treatment.

Methods

This is a retrospective study carried out from the court records of adolescents sex offenders followed by the State Department on the Enforcement of Sentences of Tours and Chateauroux (France).

Results

31 offenders and 57 victims have been identified.

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Concerning offenders: the average age was 37.8 ± 9.4 years. 71% had a job and 51.6% lived in couple. 87.1% had normal or borderline intellectual level. 38.7% had been victimized in childhood, of which 58.3% had experienced sexual violence.

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Regarding penal treatment: 42% of subjects were judged by a correctional court, and 58% by a criminal court. 22.6% of subjects were in recidivism. The average length of imprisonment was 7.5 ± 4.2 years. 67.8% of subjects were sentenced to treatment with 48.4% imposed an injunction care. The average duration of treatment was 4.4 ± 3.1 years.

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Concerning victims: 57 victims were identified of which 86% were female. The mean age was 14.1 ± 2.1 years. 58.1% of violences experienced were rapes in with 48.4% of intrafamilial. 67% of violence had repeated character.

Conclusion

This French study in which data are comparable to those of the North American literature, provides details on the characteristics of hebephiles that are passed to the act.
992 – Efficacy Of Paliperidone Er In Patients With Psychotic Symptoms
Authors: Medina Ojeda G. , Blanco Garrote J.A. , Agundez Modino A. , Arribas Simon B. , Franch Valverde J.I.
Published: July 2013

Objective

To evaluate the efficacy of paliperidone ER in patients with psychotic symptoms, assessing the improvement of positive and negative symptoms and functioning.

Method

An observational, prospective and multicentre study was carried out, collecting in a systematic way all the information after the prescription of paliperidone ER in patients with psychotic symptoms with a 12 weeks follow up. Baseline visit (V0), 15 day visit (V1), one month visit (V2), two month visit (V3) and three month visit (V4).The primary variable of efficacy used was the assessment of severity in symptoms with the ICG-S scale. Other variables of efficacy used were PANSS and ICG-C scales in all visits and PSP scale at baseline visit and final visit. At baseline visit medical and psychiatric history were collected.

Results

Paliperidone ER treatment was initiated in 26 patients with a mean age of 35.6 years old (SD 11.62). The main reason of treatment initiation with paliperidone ER was the lack of efficacy of other previous treatments in 12 patients (46.15%), followed by lack of tolerability in 5 patients (19.23%). The used dosage ranged between 3 and 18 mg/day, mean dosage of 8.28 (SD 3.16). There was a statistically significant decrease of the PANSS scores throughout the study in positive, negative and global symptoms .There was also a statistically significant reduction of ICG and PSP scores throughout the study.

Conclusions

Paliperidone ER was effective in the treatment of the psychotic symptoms on both positive and negative symptoms and also in functioning.
1014 – Clinical-immunological Criteria Of Prognosis Of Protracted Course Of Adjustment Disorders
Authors: Nikitina V. , Vetlugina T. , Semke V.
Published: July 2013

Various adverse factors and stressful situations result on one side in imbalance of immune system and weakening of mechanisms of immune protection, in formation of secondary immune deficiency and somatic pathology, on another - in stabilization of mental functions of the organism and adjustment disorder.

Material and methods

We have conducted clinical-immunological examination of 90 patients with adjustment disorder (F 43.2).

Results

From positions of clinical-dynamic approach, adjustment disorders have been differentiated depending on stage of development of disease: neurotic reactions (breakdown of mental adaptation), neurotic states (clinical full-blown states with sufficiently persistent neurotic symptoms and completion of formation of leading syndrome) and protracted states (developments, characterizing transition of the disease into chronic course).

Diagnosis of clinical manifestations of secondary immune deficiency has shown increase of incidence rate of allergic and autoimmune syndromes in persons with adjustment disorder with protracted states as compared with previous stages of development of the illness. At this stage, we have more frequently observed combination of several syndromes of immune deficiency.

Comparative analysis of immune and hormonal statuses has revealed the most informative indices, which characterize stages of development of adjustment disorders, and namely: total number of T-lymphocytes (CD2+-phenotype), level of serum IgM, indices of spontaneous and stimulated variants of NBT-test, level of cortisol and free thyroxin (T4).

Conclusions

Totality of alterations of revealed immunobiological indices is typical for every stage of disease that alongside with clinical signs of immune deficiency allows considering of them as an additional criterion in differential diagnostics of adjustment disorders.
1018 – Long-term Efficacy And Safety Study Of Pregabalin In Subjects With Generalised Anxiety Disorder (gad)
Authors: Kasper S. , Iglesias-García C. , Schweizer E. , Wilson J. , Dubrava S. , Prieto R. , Pitman V.W. , Knapp L.
Published: July 2013

Introduction

Pregabalin is indicated for the treatment of GAD in adults in Europe. The efficacy and safety of pregabalin for the treatment of adults and elderly patients with GAD has been demonstrated in 6 of 7 short-term clinical trials of 4 to 8 weeks.

Aims/objectives

To characterise the long-term efficacy and safety of pregabalin in subjects with GAD.

Methods

Subjects were randomised to double-blind treatment with either high-dose pregabalin (450-600 mg/d), low-dose pregabalin (150-300 mg/d), or lorazepam (3-4 mg/d) for 3 months. Treatment was extended with drug or blinded placebo for a further 3 months.

Results

At 3 months, mean change from baseline Hamilton Anxiety Rating Scale (HAM-A) for pregabalin high- and low-dose, and for lorazepam ranged from -16.0 to -17.4. Mean change from baseline Clinical Global Impression-Severity (CGI-S) scores ranged from -2.1 to -2.3 and mean CGI-Improvement (CGI-I) scores were 1.9 for each active treatment group. At 6 months, improvement was retained for all 3 active drug groups, even when switched to placebo. HAM-A and CGI-S change from baseline scores ranged from -14.9 to -19.0 and -2.0 to -2.5, respectively. Mean CGI-I scores ranged from 1.5 to 2.3. The most frequently reported adverse events were insomnia, fatigue, dizziness, headache, and somnolence.

Conclusions

Efficacy was observed at 3 months, with maintained improvement in anxiety symptoms over 6 months of treatment. These results are consistent with previously reported efficacy and safety trials of shorter duration with pregabalin and lorazepam in subjects with GAD.

This study was funded by Pfizer Inc.