bluuebunny/crossref_metadata_2025 huggingface dataset:
Assessing Response to Cognitive-behavioral Group Therapy for Panic Disorder with Comorbid Mood Disorders
Authors: Heldt E. , Salum G.A. , Blaya C. , Kipper L. , Manfro G.G.
Published: March 2009

Objective:

To evaluate the response to group cognitive-behavioral therapy (CBGT) for panic disorder (PD) in patients with and without comorbid mood disorders (MD).

Method:

A total of 113 patients took part in 12 CBGT sessions for PD. the diagnoses of PD and comorbid MD (depression and/or dysthymia) were established using the Mini International Neuropsychiatric Interview (MINI). Outcome measures were assessed by Clinical Global Impression (CGI), Hamilton-Anxiety and Panic Inventory. Remission was considered when CGI ≤ 2 and there was absence of panic attacks.

Results:

One-hundred patients (91%) completed the CBGT protocol and 37(32.7%) patients had PD with comorbid MD. at the end of the treatment, 41 (36.3%) patients met criteria for symptom remission. the remission rates were 47.4% in patients without MD versus 13.5% in patients presenting with comorbid MD (RR = 3.50; IC95%[1.5 to 8.19]; p < 0.001). both groups showed significant improvement on all clinical outcomes throughout treatment. A differential effect was identified between those with and those without comorbid MD both in the CGI (pgroup x time = 0.020) and in anticipatory anxiety (pgroup x time = 0.017).

Conclusions:

Panic patients without MD improved better to CBGT than those with MD. Maybe more sessions regarding depression should be added to the protocol in this subgroup of patients with MD. However, given that there is a general reduction of PD symptoms in all patients, CBGT must not be excluded.
Utility of Personality Measurement in the Recovery from Surgery
Authors: Cardoso-Moreno M. , Ramos-Fuentes M.I. , Vaz-Leal F.J. , Rodriguez-Santos L. , Blanco G.
Published: March 2009

Objectives:

The aim of this study was to asses the impact of different psychological and/or biological effects in the recovery from surgery.

Methods:

The sample was composed of 42 patients waiting for a surgical intervention. Patients with cognitive impairment were removed from the sample. Prior to surgical intervention (48 to 72 hours), patients were administered the Millon Clinical Multiaxial Inventory-II (Millon, 1986) and salivary cortisol were measured 24 hours before surgery. Following surgical intervention, recovery was coded as good or poor accordingly to Moix et als criteria (1995). Dietary intake, resting and sleeping hours, as well as the existence of fever, perceived pain and related surgery complications were daily registered and controlled for.

Results:

The cortisol values were increased in patients with high score in Histrionic Scale (t = 2.10, p = 0.043). There was a significant relation between personality, cortisol and recovery. the patients with low score in Dependent Scale (t = 2.33, p = 0.029), Histrionic Scale ( t = 2.51, p = 0.020), Alcohol Dependence Scale (t = 2.01, p = 0.049), Drug Dependence Scale (t = 2.08, p = 0.050) and cortisol show better recovery from surgery.

Conclusion:

The results of this study indicate that psychological factors and levels of cortisol may have a critical rol in post-operatory recovery. Taking these data into account, it seems necessary to assess psychopathology on a regular basis in all the patients waiting for surgically interventions.
Prediction of Diagnostic Evolution of Borderline Personality Disorder in Andalusia (Spain)
Authors: Fontalba-Navas A. , Pena-Andreu J.M. , Rodriguez-Rosado A. , Rodriguez-Idigoras M.I. , Martinez-Gonzalez J.L.
Published: March 2009

Introduction:

Along last years psychiatric literature has shown an increased interest about Borderline Personality Disorder (BPD) diagnosis. Nevertheless, few studies in large samples has been developed in our country. This study is a part of a main research: Personality Disorders in Andalusian Community. Diagnostic evolution and its link with use of health services.

Objectives:

•

To study BPD diagnosis in Andalusian inpatients throughout the last 10 years.

•

To establish a predictive model analyzing the BPD diagnostic evolution.

Method:

The information has been obtained from the Basic Information Minimum Set: A record of admissions (with clinical and demographic variables) registered in the Andalusian population. We made an observational naturalistic study about the number of inpatients with BPD diagnosis, and an analytical study (Linear Regression) to determine the trend marked in the last years about evolution in the diagnosis of inpatients with Personality Disorders (PD).

Results:

The number of total psychiatric admissions was 99444 (64968 inpatients): 10755 records had a Personality Disorder (PD) diagnosis.The number of patients with BPD diagnosis has increased from 75 in 1995 to 340 in 2004 (11,8% to 26,13% over percentage of PD). the linear regression had a thread of 0,95, with a determination coefficient of 91,6% (standard error 0,34), with statistical significance (p = 0,00), establishing a prediction linear model about the increase of inpatients with BPD diagnosis.

Conclusions:

1.

The number of inpatients with BPD diagnosis in Andalusia is increasing over last years.

2.

The model predicts a growing of BPD diagnosis along next years.
Empathic Capacity from other Non-personal Factors in Talking with an Accent
Authors: Ibrahim R.
Published: March 2009

The study examines a hypothesis that the degree of accent in L2 is related to a measure of ego permeability. Native Hebrew speakers, native Russian-speaking immigrants and Arabic-speaking Israeli natives were participated. All were students at the University of Haifa, where the language of instruction is Hebrew. the participants were recorded producing two speech segments and the recorded segments of speech were played to a group of 20 native Hebrew speakers, who rated the degree of accent in each segment on a scale from 1 (no accent) to 5 (heavy accent). These participants also completed the Interpersonal Reactivity Index (IRI) developed by Davis (1980), which has been translated into Hebrew and validated (Even, 1993). the scale yields a single numerical score that is a reflection of empathic capacity. We looked at the correlations between the ‘heaviness’ of the accent of L2 speakers and a measure of empathy. These revealed strong correlations between degree of accent and empathy scores in the Russian-speaking group, but not in the Arabic-speaking group. the sociolinguistic implications of these findings are discussed.
Comparison of Coping Strategies and Emotional Intelligence in Borderline Personality Disorder and Normal Subjects
Authors: Jamilian H.
Published: March 2009

Aim:

The goal of the study was to compare coping strategies and emotional intelligence of patients suffering from borderline personality disorder (B.P.D.) and those of normal subjects in Arak city (2007 - 2008).

Method:

40 patients (20 male and 20 female) with B.P.D. and 40 normal subjects (20 male and 20 female) participated in the study. All 80 subjects were assessed using the Millon clinical multiaxial - III, coping strategies questionnaire, and emotional quotient. the method of the research was case-control; data were analyzed by t-student test and regression.

Results and conclusion:

The results showed that patients with B.P.D. mainly used ineffective coping strategies such as escape-avoidance strategy in comparison with the normal subjects. Additionally the patients with B.P.D. used positive reappraisal, planful problem solving, and seeking social support less than the normal subjects, and their emotional intelligence was low. There were no significant differences between the emotional intelligence and applying coping strategies of male and female patients. Furthermore the study showed that there is a positive correlation between the applying effective coping strategies and emotional intelligence.
Personality Disorders and Painful Bodily Experiences: About 100 Cases in a Psychiatric Emergency Service [P03-78]
Authors: Joubrel D. , Caroline D. , Gaspard J.L.
Published: March 2009

This communication presents an epidemiological, clinical and therapeutic study about 100 cases of suicidal patients in crisis who have received psychiatric emergency care. Results of this research emphasize the relationship between patient's borderline personality disorder and sensorial/painful bodily experiences (like body marks, self-mutilations and scarifications). A specific emergency treatment in Guillaume Régnier hospital (Rennes - France) supports patients for reducing risk of suicidal behaviour.
Personality Characters as a Predictor of Tendency to Addiction
Authors: Nikpour G.A. , Homayouni A. , Khanmohammadi A. , Amiri S.J. Mosavi
Published: March 2009

Introduction:

The aim of this research is to test this question that are there specific personality characters that lead to addiction?

Method:

Method research is causative-comparative (Ex post facto). 153 addicted people and 153 nonaddicted people were randomly selected and MoKoly's Characterlogy Inventory (MCI) was administered on them.The inventory assess personality based on eight characters: sanguine, indifferent, nervous, indolent, indignant, passionate, sentimentee, amorphous.

Results:

Findings showed addicted people are much more indifferent, sanguine and passionate than nonaddicted people.

Conclusion:

In regard to people with these characters are much more at risk, they should be trained with special plans and be cared so that tendency to addiction in them decrease or control.
Borderline Personality Disorder in Adolescents - Personality Traits in the Adolescents and in the Parents
Authors: Ramos V. , Leal I. , Maroco J.
Published: March 2009

The research goal is to describe and characterize the psychological dynamics of the adolescents diagnosed with Borderline Personality Disorder (BPD) and their parents, observing the dominant personality styles in adolescents with BPD and the personality traits of the parents (mother and father).

Considering that recent studies underline the importance of family interactions in the pathogenesis of BPD we will analyze the relation between personality characteristics of the adolescents with Borderline Personality Disorder and the parents’ personality traits.

The exploratory and comparative study has a sample comprised of 21 adolescents (11 boys and 10 girls) with ages between 16 and 18 years old, observed in child mental health services and 34 parents (N = 55).

Adolescents will be assessed with the Millon Adolescent Clinical Inventory (MACI) and the parents with the Millon Clinical Multiaxial Inventory (MCMI-III).

The results showed that the parents obtained high mean scores in the Compulsive and Narcissistic Personality Traits. the adolescents showed high mean scores on the Unruly, Forceful and Egotistic personality styles scales.

The studies on BPD have some limitations, namely the fact that they normally observe the adult population, with fewer research dedicated to adolescents.

We consider that there is a need to search for the aetiological factors of the disorder and possible developmental patterns and if it is a personality disorder research should look to the personality traits of the adolescents and to their relational environment as a way to overcome those limitations.
Pharmacotherapy of Borderline Personality Disorder: a Metaanalysis of Randomised Controlled Trials [P03-87]
Authors: Stoffers J. , Völlm B. , Rücker G. , Timmer A. , Lieb K.
Published: March 2009

Background:

In Borderline Personality Disorder (BPD), pharmacotherapy is used for the treatment of specific BPD pathology facets, such as cognitive-perceptual, affective, or impulsivity symptoms. Due to the polymorphic phenomenology of the disorder, different classes of drugs are used, e.g., antipsychotics, antidepressants, or mood stabilizers.

Aims:

To evaluate the up-to-date evidence of drug treatment efficacy for BPD.

Method:

A systematic review and metaanalysis of randomised controlled trials was done. All randomised comparisons of drug vs. placebo, drug vs. drug, or drug vs. a combination of drugs in adult BPD patients were eligible for inclusion. Outcomes comprised BPD core pathology as depicted by DSM criteria, associated pathology, i.e., depression and anxiety, general measures of overall psychopathology severity and mental health status, tolerability, and adverse effects. with support of the Cochrane Collaboration, a thorough search was conducted to identify both published and unpublished trials. the findings were scrutinized by two reviewers independently.

Results:

Twenty-six trials were included, investigating first- and second-generation antipsychotics, mood stabilizers, antidepressants, and omega-3 fatty acids.

Conclusion:

Findings indicate beneficial effects for all classes of drugs investigated, and suggest mood stabilizers and second-generation antipsychotic agents as first-line treatments for BPD due to their efficacy in the treatment of different domains of BPD and associated pathology. However, psychotherapeutic treatment should clearly be targeted at predefined specific symptoms.
5-HT and Aggression: New Data
Authors: Tsopelas C. , Kapsali F. , Tsetsou S. , Aggeli A. , Kardaras K.
Published: March 2009

Aims:

Growing evidence points to the conclusion that biological factors do predispose some individuals towards violent behavior. Contemporary research suggests that serotonin is a neurotransmitter associated with expressed aggression, challenging the concept of a person's knowledge of right or wrong and the free will to choose between the two.

Methods:

Thorough research of the main databases (Medline, Embase, Psychinfo), and web search engines such as Goggle, Lycos for relevant studies, agencies and organizations, interested in neurotransmitter, serotonin (5-HT), aggression, hostility, violence and violent behaviour issues.

Results:

The neurotransmitter serotonin (5-HT) has been implicated in the modulation of aggression in animals and humans. the 5-HT system seems to be involved in either the performance or the termination of aggressive behaviours. So although an association with serotonin and aggression appears to be present, it isn't clear the way of this association or the expression of the interplay of the genes with the individuals’ environment. Genes and environment appears to be in a dynamic interplay that concludes in the observed behaviour.

Conclusions:

A longstanding dogma that aggression and serotonergic activity are inversely related has to be abandoned in light of many new findings. Trait and state aggression are differentially regulated by the 5-HT system and different 5-HT receptors seem to be involved. We are still far from understanding the complex role played by the serotonergic system in the modulation of a complex set of behaviors like aggression.
Anxiety Disorders in the Elderly: Sub-diagnosis and Sub-treatment
Authors: Castro L.C. , Salgado T. , Simões M. , Paz C. , Ribeiro O.
Published: March 2009

Background:

Although anxiety disorders prevalence and incidence decline in later life, anxiety is a major health problem for the elderly. Epidemiology, neurobiology, and treatment of anxiety disorders are poorly studied in the geriatric population. Nevertheless, anxiety has a high impact on functional status and health-related quality of life.

Aim:

To underline the significant impact of anxiety in the elderly. to discuss the sub-diagnosis and sub-treatment of late-life anxiety and subclinical symptoms.

Methods:

Literature Review. MEDLINE and PubMed databases searches for peer-reviewed studies, published between 1998 and 2008, using combinations of the Medline Subject Heading terms anxiety, anxiety disorders and old age.

Results:

There are few studies in the literature addressing this topic. Late-life anxiety has a high prevalence and is associated with increased morbidity, mortality, functional impairment, poorer quality of life and significant societal costs. Clinical studies show that most cases of anxiety disorders in late life are undetected and under-treated. Intervention research in late-life anxiety disorders is lacking.

Conclusions:

It is extremely important and urgent a more efficacious assessment and management of anxiety disorders in the elderly. It is also fundamental an increased attention to subtreshold anxiety, which will allow an earlier intervention and prevention of new cases of anxiety disorders. Well designed interventions will be capable of reducing the burden, morbidity and incidence of late-life anxiety.
Subjective Memory Complaints and Mild Cognitive Impairment
Authors: Simoes M. , Castro L.C. , Ribeiro O. , Salgado T. , Paz C.
Published: March 2009

Background:

Subjective Memory Complaints (SMC) are common in clinical practice. the clinical significance of these subjective complaints among older individuals is not well understood.

Aim:

To study and discuss the association between SMC and MCI, underlining the importance of an adequate clinical assessment of SMC in the elderly.

Methods:

Review of the literature.

Results:

There is no consistent definition of SMC in the literature. Some prospective studies showed an association with objective memory impairments, conceptualizing SMC as a Pre-Mild Cognitive Impairment. SMC are also currently considered to be a core feature of Mild Cognitive Impairment (MCI). Cross-sectional studies and longitudinal studies showed conflicting results concerning the association between SMC and MCI.

Discussion:

The understanding of the predictive value of SMC in cognitive decline is still poorly understood. It is important to define criteria aimed to increase specificity of memory complaints, allowing an earlier identification of populations with higher risk of MCI. Future research on this complex association is important to identify SMC individuals at increased risk of conversion to MCI and dementia.
Evolution of Psychiatric Admissions for Dementia in the Last Decade
Authors: Touzon R. , Rico-Villademoros P. , Garnica E.
Published: March 2009

Aims:

To describe the admissions due to dementia in an acute psychiatric unit in the last decade, in patients aged over seventy.

Method:

Medical records of all patients over seventy admitted in an acute unit of a Psychiatric Hospital in 1997 and 2007 are analyzed.

Results:

Over the last ten years, the percentage of patients diagnosed with dementia compared to the total number of patients over seventy admitted in this acute unit, has hardly decreased.

Conclusions:

Despite the fact that in the last decade neurologists have widespread the use of various drugs in the treatment of dementia, the number of patients admitted to our psychiatric unit, in order to control the accompanying symptoms (delusions, abnormal conduct, etc), remains stable.

Moreover, given the progressive aging of the population and the consequent increase in the number of cases of dementia among the elderly population, perhaps the fact that the number of admissions in the unit has not increased is positive itself.
Description of the Admissions of Elderly Psychiatric Patients in an Acute Unit
Authors: Rico-Villademoros P. , Touzon R. , Garnica E.
Published: March 2009

Aims:

To describe the characteristics of the admission of those older than 70 in the past year, in an acute psychiatric care unit.

Method:

Medical records of all over 70 patients admitted in our unit during 2007 are reviewed to find out their diagnosis, how many are first admissions and their average stay time, and this is compared to general average stay time for this unit.

Results:

About 10% of patients admitted to this unit is more than 70. the most frequent diagnosis is depression, followed by bipolar disorder, dementia, psychosis and other diagnoses. Nearly half of all these patients are in their first admission. the average stay of these patients is twice that of the total patients admitted to this unit.

Conclusion:

Despite the fact that in some places the number of admissions of elderly patients is not considered enough to justify the creation of specific units, objectively their admissions are frequent and their average stay time is much higher than usual. This is probably both the difficulty of drug treatment and social problems that sometimes hampers their discharging. as the elderly population is increasing, we believe that treating these people in specific units should be reconsidered.
Three Cases of Abulia in the Elderly: A Call to Care
Authors: Kakoullis A. , D'Souza G. , Hegde N. , Tadros G.
Published: March 2009

The symptom of abulia is a state of diminished motivation where an individual may appear apathetic, disinterested, asocial and emotionally remote. It can exist independently but more commonly occurs as part of a constellation of symptoms accompanying a specific disorder, normally neurological or psychiatric. Although it is not a normal part of ageing, it has been observed in a number of conditions seen in later life. These include Alzheimer's disease, vascular dementia, Parkinson's disease, dementia with Lewy bodies, and frontotemporal dementia. Abulia and depression are separate entities but abulic patients are often thought to be depressed and experience long periods of anti-depressant treatment without benefit. the key difference is that abulic patients fail to disclose any sign of sadness or negative thoughts and show an obvious lack of concern for their condition.

Abulia has significant clinical implications as it is associated with decreased function, poor prognosis and worse carer stress. It is also potentially treatable. the pharmacological agents that have received the most attention are dopaminergic drugs including Carbidopa/Levodopa, Amantadine, Bupropion and Bromocriptine. the research predominantly consists of case reports but no studies have focussed on the elderly. in this paper, the authors review the current literature and describe three cases of abulia in older people that have been successfully treated with Bromocriptine. the cases highlight the importance of recognising abulia and differentiating it from depression. They also show the need to consider treatment.
Clonal Pluralization as an Interpretative Delusion after Autoscopic Experience - An Extremely Rare Psychopathological Phenomenon
Authors: Nagy A. , Tenyi T. , Fekete S. , Kovacs A. , Voros V.
Published: March 2009

Introduction:

Delusional misidentification syndromes are widely present in several psychiatric and neurological disorders in the geriatric population. Numerous studies witness growing evidence of organic background in different misidentification syndromes and reduplications.

Case report:

The authors present a case of a patient with dementia, vascular type where clonal pluralization of the Self appeared as a secondary interpretative delusion after a hallucinatory type of autoscopic experience. the 86-year-old patient was referred to our department because he was talking continuously to his so-called ‘twin’. He considered his experience as a miracle to be investigated by a special medical staff. We discuss the distinctive characteristics of the presented case from other delusional misidentification syndromes and from other psychopathologic and neurological symptoms.

Conclusion:

In the presented case the linear evolution and the interpretative aspect of the arising delusional misidentification phenomena were predominant. Overviewing the broad spectrum of concepts on delusional misidentification syndromes, we emphasize the importance of those approaches which enhance the disappearance of the classical functional-organic dichotomy on the double phenomenon and which try to clarify the neurocognitive background of delusional misidentifications.
the Risk for Mild Cognitive Impairment in Elderly Patients with Metabolic Syndrome
Authors: Podea D.M. , Nanu P.D. , Chenderes R.M. , Mila C.
Published: March 2009

Objective:

Recent studies suggest that the metabolic syndrome and inflammation affect cognitive decline in old age due to vascular risk factors that might cause leukoaraiosis. It is not known which components of the metabolic syndrome are mostly involved.

Material and method:

There were included 60 subjects aged 65-90 years divided in two groups: group A-30 subjects diagnosed with metabolic syndrome according to NCEP-ATP-III criteria; group B-30 subjects used as control for the study group. Inflammation was assessed by measuring the C-reactive protein (CRP) plasma levels. Cognitive assessments included general cognition exam using Mini-Mental State Examination. the subjects underwent head CT-scan in order to observe the presence of the leukoaraiosis. the mild cognitive impairment (MCI) was considered when the MMSE score was between 28-21points.

Results:

In group A 25 of the subjects presented MCI, while in group B only 13. in group A hyperglycemia was most strongly associated with cognitive function being identified in 80% of the subjects, followed by inflammation (CRP levels>1mg/L), present in 76.6% of the subjects. the subjects from group B presented hyperglycemia in 20% of the cases and high CRP levels in only 16.6% of the subjects. Leukoaraiosis was present in 60% of the subjects in group A, and in 23.3% in group B.

Conclusions:

Subjects with metabolic syndrome had a poorer cognitive performance than subjects without metabolic syndrome at general cognition exam. in those subjects with metabolic syndrome hyperglycemia and inflammatory status were most frequently encountered when considered the association with cognitive impairment and was noticed a higher incidence of leukoaraiosis.

Acknowledgment:

The work reported in this paper was supported by grant PNCDI2-41-057/2007 from the Romanian Ministry of Education and Research.
Treating Prodromal Psychosis in Slovenia
Authors: Blinc M. , Novak B. , Avgustin B. , Agius M.
Published: March 2009

This presentation describes an ongoing program in Ljubljana.

The program originated with one psychiatrist [MB] who began to offer treatment with antipsychotics- typicals with the earliest patients, and later atypicals, in particular olanzapine, in very low doses [e.g.2.5 mg olanzapine], often combined with group psychotherapy, in patients considered to be at the initial [prodromal or ‘at risk mental state’] phase of developing a psychotic illness. Often, where indicated, antidepressants and occasionally anxiolytics were also added to the treatment. Thus this program differed substantially from other well known studies of treatment in the prodrome [e.g. Melbourne and Yale], and developed independently of them.

It has been shown by repeated clinical evaluation of the patients that these patients were indeed originally in the prodromal phase of psychotic illness.

Many patients have now been followed over several years as they developed into full first episodes of psychosis and for some years later.

The presentation will describe the process of how the patients were treated, and how their illness developed.

The presentation will describe results, of a study comparing outcomes of treatment in the prodrome by this method, with treatment of patients who presented with psychotic illness in the usual way, with long DUP. This shows long term advantages in terms of severity of symptoms, reduced relapse and readmission rates, better employment results, and improved relationships among the patients treated in the prodrome.
A Preliminary Study of p200 in First-episode Patients, their Relatives and Healthy Controls: Search of New Endophenotypes [P03-113]
Authors: Silveira C. , Santos F. , Barbosa F. , Pedro A. , Palha A. , Marques-Teixeira J.
Published: March 2009

Background/Objective:

Despite the well established genetic basis of schizophrenia, the relationship between genes and the disorder itself is still elusive. Individual endophenotypes, which reduce the complexity of genetic analyses, allow statistical approaches with quantitative trait methodologies. P200 abnormalities of event-related potentials have been reported in schizophrenia with conflicting results. the present study aims to characterize the P200 in first-episode patients and to compare it with that of first-degree relatives and controls.

Methods:

ERPs were recorded at 19 sites with an auditory oddball for 21 first-episode patients with schizophrenia (mean age=25.14; SD=6.20), 41 of their first degree relatives (mean age=47.65; SD=15.53) and 19 healthy controls (mean age=26.32; SD=7.16). Potentials were averaged for frequent stimuli and P200 amplitude and latency measures were obtained.

Results:

Analysis of midline electrodes revealed significant group effects for P200 peak amplitudes (F(2, 78)=3.315, p=.042), but not for peak latencies. Post-hoc analyses revealed that patients with schizophrenia present significantly lower P200 amplitudes (M=2.466; SD=1.564) than controls (M=5.037; SD=2.500) at Pz (T(38)=3.851, p=.003). No other significant differences were found.

Conclusion:

The results obtained do not straight-forwardly support the P200 peak amplitude nor peak latency as an endophenotype of schizophrenia. However, the trends of our results may suggest that the P200 amplitudes of relatives may present intermediate values between healthy controls (with higher amplitudes) and patients (with lower amplitudes). Further statistical analyses will be required in order to disentangle the effects of possible confounding variables.
Sons and Daughters Cared by Psychotic Inpatients: How is their Mental Health Status?
Authors: Veríssimo F. , Almeida S. , Teiga R.
Published: March 2009

Backgroud:

Parental pychosis can have a major impact on the household and studies indicate that they increase the risk of children developing behavioural, social, emotional and educational problems (Royal College of Psychiatrists, 2004). to our knowledge, there is scarce information available about the mental health status of the sons and daughters cared by psychotic inpatients. Potential interventions that mental health services could adopt by screening this at risk population are missed.

Aim:

To assess the mental health status of the children cared by the psychotic inpatients admitted to an acute mental health ward in Porto. to determine the number of children that fulfill criteria of mental illness and of those at risk. to refer this population to a specialist clinic.

Methods:

Prospective study: we will screen the sons and daughters of all the inpatients admitted with psychosis between the 1st September 2008 and the 30th November 2008 to a busy acute inpatient ward at Hospital Megalhães Lemos, Porto. We will use the Robert Goodman Strenghts and Weaknesses Questionnaire for the 18- year old and below and the SCL-90 for the adult population. the population that fulfills criteria for mental health problems and the ones that are identified as at risk will be referred to a specialist clinic and followed-up by an experienced psychiatrist.

Conclusions:

To identify and quantify a vulnerable population at high risk of developing mental health problems and offering an early intervention may proove to have an important impact in the household wellbeing.
Prevalence of Traumatic Life Events and Posttraumatic Stress Disorder in the Severe Mental Illness
Authors: Alvarez M.J. , Osés A. , Foguet Q. , Santos J.M. , Roura P. , Arrufat F.X. , Valiente A. , Perez R. , Villalba O.
Published: March 2009

Aims:

In some different studies, a high prevalence of interpersonal trauma especially childhood abuse as well as posttraumatic stress disorder (PTSD) has been found in patients with several mental illness (SMI): schizophrenia, schizoaffective and bipolar disorder.

The aim of this study was to determine the prevalence of the traumatic life events and PTSD in a sample with SMI.

Methods:

We enrolled adults patients with schizophrenia, schizoaffective disorder or bipolar I disorder. We excluded patients who score 3 or more in conceptual disorganization, hallucinations and/or unusual contents of the Brief Psychiatric Rating Scale (BPRS) and 4 or more in another item of this scale. Interventions: sociodemographic date and Traumatic Life Events Questionnaire and Distressing Event Questionnaire.

Results:

78 patients (52.6% men) with a mean age of 40 years. Diagnostic of the sample: 47.5% schizophrenia, 41% bipolar disorder and 11.5% schizoaffective disorder. Traumatic life events in the childhood: physical abuse, 22.1% (22.5% males and 21.8% females); psychological abuse, 26.9% (14.6% males and 40.5% females, p< 0.05); sexual abuse, 28.2% (21.9% males and 35.1% females).Some abuse in childhood, 48.0% (38.1% males and 62.2% women, p< 0.05).

Sexual abuse in adulthood: 25.6% (43.24% females and 9.7% men, p=0'05).

PTSD, 12.9% (8.3% males and 20.7% females).

Conclusions:

Almost the half of the patients have biographical history of traumatic life events in the childhood. These traumatic events are significantly more prevalent in females. in adulthood, almost half of women had suffered sexual abuse.

A fifth part of the women with SMI have comorbidity with PTSD.
Backward Masking Performance in Schizophrenic Patients and their Healthy Relatives
Authors: Chkonia E. , Roynishvili M. , Kezeli A. , Herzog M.H. , Brand A.
Published: March 2009

Over the past years, studies of unaffected first-degree relatives of schizophrenic patients have reported cognitive deficits in the domains of executive functions, memory, and attention. However, these deficits may rely on lower level information processing deficits. Here, we investigated visual information processing with a visual backward masking task. A vernier target was followed by a grating mask. Observers had to indicate the offset direction of the vernier. We determined the SOA between the vernier and the grating onset for schizophrenic patients, their healthy first order relatives, and a healthy control group. Schizophrenic patients needed SOAs about three times longer than healthy controls to reach a predefined criterion level. Backward masking performance of unaffected relatives was significantly better than the one of patients but significantly worse than performance of controls. This result adds further evidence that low level deficits as determined by visual backward masking are endophenotypes of schizophrenia.
Cognitive Functioning in Schizophrenia Patients with Suicidal Behavior
Authors: Cozman D. , Manea M. , Nica S. , Coman H. , Nemes B.
Published: March 2009

Introduction:

Suicide is one of the leading causes of death for schizophrenia patients: 9-13% of these patients eventually commit suicide, at least 20-40% make suicide attempts and 1-2% go on to complete in their attempt within the next 12 months. Therefore, suicide in schizophrenia has long been a major area of concern and research efforts. Although neurocognitive deficits are seen as core to schizophrenia, the association between suicidality and neurocognition has received little attention. People with schizophrenia often have impaired working memory and lower IQ. in particular, deficits in long-term memory, working verbal memory, executive functioning, and vigilance have been consistently associated with poor functional outcome in this patient population.

Aim:

To evaluate the effect of depression in schizophrenia suicidal patients from the point of view of neuropsychological functions.

Methodology:

A clinical sample of 60 patients with schizophrenia was assessed. among them, 30 patients presented a life long history of deliberate self-harm. We performed the assessment of schizophrenia (PANSS, GAS), depression (MADRS), suicidal risk (SIS, BHS), and neuropsychological markers with CogTest battery.

Results:

Suicidal behaviour in schizophrenia patients was significantly correlated with negative symptoms (anhedonia) accompanied by poor global functioning and positive symptoms (delusions). Some neuropsychological markers (abstract thinking, reduced capacity to maintain information on-line, working memory, facial emotions discrimination) were significantly correlated with hopelessness.

Conclusion:

The most significant neuropsychological dysfunction is represented by working memory impairment which is present in schizophrenia patients with self-harm behaviour even if they have an intact IQ.
Metaglossotherapy in Treatment of Schizophrenia
Authors: Maciulis V. , Marceniene S. , Dapsys K. , Banaitis V. , Utkuviene J.
Published: March 2009

Metaglossotherapy (MGT) is the method of treating schizophrenic patients by teaching them a new foreign language. Training of brain and establishing new associations during the course of MGT treatment has a positive influence on schizophrenic patients.

Aim:

To evaluate the efficacy of MGT in treating schizophrenic patients.

Methods:

7 long-stay male schizophrenic patients took part in the program, which lasted 5 months, 5 sessions of MGT a week. Patients were learning English. Evoked potential N400 was registered at baseline and after MGT in order to evaluate the effectiveness of the therapy. Dynamics of mental state was evaluated with help of PANSS.

Results:

During MGT significant changes in motivation, behavior, non-verbal expressions and emotional state of patients were observed. PANSS: negative and positive symptoms became milder, changes are statistically significant. N400 responses of schizophrenic patient do not depend on the congruity of sentence endings. Compared with healthy subjects patients generate N400 with smaller amplitude and larger latency.

Conclusions:

Application of MGT can create possibilities for schizophrenic patients for better relationships with the environment, to help them overcome social and emotional isolation. It is very important that activities would be led by the persons who have practical experience to work with schizophrenic patients. MGT may affect patient's response to semantic congruent sentences.
Does the Degree of Smoking Effect the Severity of Tardive Dyskinesia?
Authors: Diehl A.
Published: March 2009

Background:

Tardive dyskinesia (TD) is a movement disorder observed in a chronic neuroleptic treatment. Smoking is presumed to increase the prevalence of TD. the question of a cause-effect-relationship between smoking and TD, however, remains to be answered. Purpose of this study was to examine the correlation between the degree of smoking and the severity of TD with respect to differences caused by medication.

Methods:

We examined 60 patients suffering from schizophrenia and TD. We compared a clozapine-treated group with a group treated with typical neuroleptics. Movement disorders were assessed using the Abnormal-Involuntary-Movement-Scale and the technical device Digital-Image-Processing providing rater independent information on perioral movements.

Results:

We found a strong correlation (.80< r< .90, always p< .0001) between degree of smoking and severity of TD. Repeated measurements revealed a positive correlation between changes in cigarette consumption and changes of the severity of TD (p< .0001). Analyses of covariance indicated a significant group-effect with a lower severity of TD in the clozapine-group compared to the typical-neuroleptics-group (p=.010). Interaction-analyses indicated a higher impact of smoking on the severity of TD in the typical-neuroleptics-group compared to the clozapine-group (p=.033) (Diehl et al., 2008).

Conclusion:

Concerning a possible cause-effect-relationship between smoking and TD, smoking is more of a general health-hazard than neuroleptic exposure in terms of TD.
Epidemiological Study for the Evaluation of Metabolic Disorders in Patients with Schizophrenia: The Meteor Study
Authors: de Hert M. , Falissard B. , Mauri M. , Shaw K. , Wetterling T.
Published: March 2009

A large, observational, multinational cross-sectional pharmacoepidemiological study was performed to determine the prevalence of diabetes and other metabolic disorders in patients with schizophrenia receiving atypical antipsychotic drugs in Europe.

The study included adult outpatients with schizophrenia (DSM-IV-TR) treated for at least three months by an antipsychotic drug. Patients treated with classical or atypical antipsychotic drugs were recruited into two parallel strata (ratio of 1:3). A fasting blood sample was taken and height, weight, waist and hip circumference and blood pressure measured during a single visit. Biochemical parameters assessed included glucose, insulin, HbA1c, triglycerides, total cholesterol, HDL-cholesterol and apolipoprotein B.

2463 patients (median age: 41.0 years; 54.6% male) were included in twelve countries. among these, 10.9% of patients were treated for hypertension, 7.1% for a lipid disorder, 0.3% for type I diabetes and 3.5% for type II diabetes. in addition, 26% of untreated patients had dysglycaemia, 67.7% dyslipidemia and 38% had hypertension. 34% of the patients presented a metabolic syndrome. No overall difference was observed in the proportion of patients with glycaemic and lipid disorders between the two treatment strata. Values for weight-related variables were slightly higher in the atypical stratum, whereas hypertension was more frequent in the classical stratum (47.3%) than in the atypical stratum (42.2%).

The results of this study emphasise the need for careful follow-up of patients with schizophrenia treated with antipsychotic drugs to detect the occurrence of metabolic disorders. the proportion of patients with glycaemic or lipid disorders was very high and largely underdiagnosed.

This study was funded by sanofi-aventis.
Psychosis Related to TBI
Authors: Euba O. , Zallo E. , Sanchez N. , Torreblanca M. , Arroita A. , Barreiro A.
Published: March 2009

Aims:

Traumatic brain injury (TBI) cause a wide range of serious consequences, including psychiatric disorders. Psychosis although uncommon is a very serious consequences with important functional, therapeutical and legal implications.

Methods:

Our work is based on a systemic review of the articles published related to TBI and psychosis.

Results and conlusions:

Three different features about TBI and their relation with the development of psychotic symptoms are analyzed.

1.

Severity: Serious TBI are more related to psychosis. Moderate and minor TBI can develop mental disorders is there is a previous neurological lesions.

2.

Localization: Temporal lobe appears affected in most of the patients.

3.

Lateralization: Left hemisphere is usually affected.

Left hemisphere traumas appear to cause schizophrenia-like psychosis. Right hemisphere traumas are related to delirious and special types of psychosis.
Aberrant Tyrosine Transport - A Biological Marker for an Inherited Susceptibility to Schizophrenia
Authors: Flyckt L. , Edman G.
Published: March 2009

A biological marker may serve as a link between the clinical manifestation of schizophrenia and the underlying susceptibility gene (s) and it may also serve the purpose to delineate subgroups or “endophenotypes”. Aberrant tyrosine transport across the cell membrane in patients with schizophrenia is such a biological marker. Previous studies have showed a reduced tyrosine transport across the fibroblast cell membrane in patients with schizophrenia. the experiments were performed in fibrobasts that had grown for several generations in vitro. Thus, the aberrant tyrosine transportation is likely to reflect a genetic trait that is transmitted through several cell generations. an association between aberrant tyrosine transport across fibroblast membrane and neurocognitive dysfunction was found for patients with schizophrenia in a previous study indicating a connection between deficient tyrosine transport and cognitive dysfunction. the aim of the present study was to investigate the occurrence of aberrant tyrosine transport across the fibroblast membrane in first-degree relatives to patients with schizophrenia to find indications of inheritance. Significant correlations between patients and their mothers were found regarding aberrant tyrosine transport and, furthermore, the mothers with aberrant tyrosine transport showd signs of reduced cognitive functioning. Maternal inheritance is a possible mode for genetic transmissionssion of susceptibility to schizophrenia for a subgroup of patients with low cognitive functioning.
Spiritual Beliefs and Therapeuticall Adhesion
Authors: Fonseca L.
Published: March 2009

Introduction:

Personal and familiar spiritual and religious beliefs are important factors to be considered when prescribing an antipsychotic drug to a schizophrenic patient.

Description:

A case report of a 29 years old male patient with a schizoaffective disorder is presented. in this case the border between what was delusion and what was the result of the patient personal and familiar spiritual beliefs was impossible to made. Only after the medication precribed has produced its effect this distinction has become clearer.

Method:

A literature revision about this issue was made.

Discussion/conclusion:

Spiritual beliefs are important factors that influence therapeuticall adhesion. A clear distinction between them and delusion symptomatology is very difficult to made, mainly in an acute psychotic state. after medication, the delusion symptomatology disappears and personal spiritual beliefs persist.
Evaluation of 2 Years’ Residential Care Treatment for Adolescents and Young Adults with Schizophrenia [P03-146]
Authors: Hemmerle M. , Röpcke B. , Eggers C. , Oades R.D.
Published: March 2009

Aims:

In 2002 the Professor Eggers Foundation started a 2-year-programme for patients suffering from early-onset schizophrenia (EOS) following discharge from a clinic (outpatient care). the aim is with intense residential care and treatment to support recovery and independence. Interactive and psychoeducational family care, coping with persistent symptoms, development of social and emotional competence, independent house keeping, and support of school and vocational training are the main features.

Methods:

Psychopathology, social and neuropsychological function were assessed with a set of questionnaires and tests at the start, after 1 year and after 2 years on completion of the programme for 12 participants. Living and working situation were monitored. the results were compared with the progress of 12 EOS patients treated as usual (comparison group).

Results:

Positive and negative symptoms showed a significantly greater decrease with respect to the comparison group. Social function improved considerably stronger in the participants. Working memory, attention and some executive functions also improved in the participants, while there was a deterioration of speed and selective attention (trend) in the comparison group. Neither group showed changes in measures of intelligence or the subjective quality of life with the exception of increased contentedness with family relations in the participants.

Conclusions:

We show the benefits of an early intensive residential training programme for EOS patients. Further research may be able to show if these improvements can be maintained and whether the costs of the programme are economical avoiding continued residential care.