bluuebunny/crossref_metadata_2025 huggingface dataset:
In vivo [123I]CNS‐1261 binding toD‐serine‐activated and MK801‐blocked NMDA receptors: A storage phosphor imaging study in rats
Authors: Knol Remco J.J. , De Bruin Kora , Van Eck‐Smit Berthe L.F. , Pimlott Sally , Wyper David J. , Booij Jan
Published: March 2009

Disturbances of activity of the glutamatergic neurotransmitter system in the brain are present in many neuropsychiatric disorders. TheN‐methyl‐D‐aspartate (NMDA) receptor is the most abundant receptor of the glutamatergic system. In the neurodegenerative events of Alzheimer's disease, excessive activation of NMDA receptors may contribute to neuronal death. Inhibition of NMDA receptor activation may have neuroprotective effects and (semi)quantitative imaging of the activated system may help in the selection of patients for such inhibition therapies. In this study we evaluated [123I]CNS‐1261 binding in the rat brain. This radiotracer binds in vivo to the MK801 binding site of activated NMDA receptors. To determine the optimal time point for ex vivo assessments after bolus injection [123I]CNS‐1261 binding in rats, we performed a time course biodistribution study using dissection techniques. [123I]CNS‐1261 binding was also studied in the rat brain using autoradiography by means of storage phosphor imaging, with prior facilitation of NMDA receptor activation by injection of the potent coagonistD‐serine and after blocking of the NMDA receptor binding site by MK801 injection inD‐serine pretreated rats. Measurements of [123I]CNS‐1261 uptake matched the distribution of similar tracers for the MK801 binding site of the NMDA receptor and revealed an optimal time point of 2 h post injection for the assessment of tracer distribution in the rat brain. The blocking experiments indicated specific binding of [123I]CNS‐1261 to NMDA receptors but also a considerable amount of nonspecific binding. Facilitation of NMDA receptor activation byD‐serine did not result in an enhancement of binding of the radiotracer in the NMDA receptor‐rich rat hippocampus compared to the untreated group, as measured by autoradiography. In conclusion, our study has shown that [123I]CNS‐1261 binding is influenced by NMDA receptor availability. However, high nonspecific binding limits quantification and small changes in receptor availability are unlikely to be detected. Synapse 63:557–564, 2009. © 2009 Wiley‐Liss, Inc.
Reported childhood abuse is associated with low serotonin transporter binding in vivo in major depressive disorder
Authors: Miller Jeffrey M. , Kinnally Erin L. , Ogden R. Todd , Oquendo Maria A. , Mann J. John , Parsey Ramin V.
Published: March 2009

Background: Physical or psychological adversity in childhood is associated with a higher risk for depression in adulthood, and with persistent serotonergic abnormalities in humans and in animal models. We hypothesized that reported childhood abuse would be associated with lower brain serotonin transporter (5‐HTT) binding potential (BPP, proportional to the number of available transporters) in adults. We examined healthy volunteers and subjects with major depressive disorder, a sample enriched for childhood abuse. Methods: Regional brain 5‐HTT BPP was measured using positron emission tomography (PET) with [11C]McN 5652 and a metabolite‐corrected arterial input function in 43 healthy volunteers and 23 subjects in a major depressive episode, ten of whom reported a history of sexual and/or physical abuse before age 15, and 13 of whom did not. As only two healthy volunteers reported childhood abuse, primary analyses were restricted to the depressed sample, with healthy controls presented as comparators. Results: Depressed subjects reporting childhood abuse had lower 5‐HTT BPP than nonabused depressed subjects across all brain regions examined (P = 0.017). The groups did not differ in relevant demographic or clinical variables. Genotype frequencies of a functional polymorphism in the 5‐HTT gene promoter (5‐HTTLPR) did not differ between the groups. Conclusions: Reported childhood abuse is associated with lower 5‐HTT BPP in this sample of subjects with major depression, consistent with other reports that childhood adversity can lower serotonergic function permanently. Lower 5‐HTT BPP may represent a biological pathway through which early life stress predisposes to the development of subsequent psychiatric illness, including major depressive disorder. Synapse 63:565–573, 2009. © 2009 Wiley‐Liss, Inc.
Coalescence Behavior of Gold Nanoparticles
Authors: Wang Y. Q. , Liang W. S. , Geng C. Y.
Published: March 2009

The tetraoctylammonium bromide (TOAB)-stabilized gold nanoparticles have been successfully fabricated. After an annealing of the as-synthesized nanoparticles at 300 °C for 30 min, the coalescence behavior of gold nanoparticles has been investigated using high-resolution transmission electron microscopy in detail. Two types of coalescence, one being an ordered combination of two or more particles in appropriate orientations through twinning, and the other being an ordered combination of two small particles with facets through a common lattice plane, have been observed.
Pre‐adipocytes commitment to neurogenesis 1: Preliminary localisation of cholinergic molecules
Authors: Aluigi Maria Grazia , Coradeghini Rosella , Guida Chiara , Scanarotti Chiara , Bassi Anna Maria , Falugi Carla , Santi PierLuigi , Raposio Edoardo
Published: March 2009

A great effort has recently been made to obtain human stem cells able to differentiate into cholinergic neurons, as a number of diseases are associated to the cholinergic neuron loss, degeneration or incorrect function (Alzheimer's disease and motor neuron disease). A stem cell population (i.e. pre‐adipocytes) is present in the adipose stromal compartment. Pre‐adipocytes, like the mesodermic derivative cells, retain high plasticity and potentiality to convert in vitro from one phenotype into many others, and they can be isolated from adult adipose tissue. Pre‐adipocytes committed in vitro to neural differentiation were followed up to the acquisition of neural morphology. Acetylcholinesterase and choline acetyltransferase are expressed from the native cell stage, with different localisations and roles during neural commitment. Western blots show the beginning of a new synthesis of these enzymes at 4 weeks of culture of neurogenic pre‐adipocytes, in parallel with neural morphology. The passage of the choline‐acetyltransferase immunoreactivity from cytoplasmic to membrane localisation shows the possible onset of catalytic activity and the histochemical reaction confirms the activity of acetylcholinesterase. This explains the possibility of obtaining cholinergic‐like phenotype from pre‐adipocytes.
Striatum is more vulnerable to oxidative damage induced by the metabolites accumulating in 3‐hydroxy‐3‐methylglutaryl‐CoA lyase deficiency as compared to liver
Authors: Leipnitz Guilhian , Seminotti Bianca , Fernandes Carolina G. , Amaral Alexandre U. , Beskow Ana Paula , da Silva Lucila de B. , Zanatta Ângela , Ribeiro César A.J. , Vargas Carmen R. , Wajner Moacir
Published: March 2009

The present work investigated the in vitro effects of 3‐hydroxy‐3‐methylglutarate, 3‐methylglutarate, 3‐methylglutaconate and 3‐hydroxyisovalerate, which accumulate in 3‐hydroxy‐3‐methylglutaric aciduria, on important parameters of oxidative stress in striatum and liver of young rats, tissues that are injured in this disorder. Our results show that all metabolites induced lipid peroxidation (thiobarbituric acid‐reactive substances increase) and decreased glutathione levels in striatum, whereas 3‐hydroxy‐3‐methylglutarate, besides inducing the strongest effect, also altered thiobarbituric acid‐reactive substances and glutathione levels in the liver. Furthermore, 3‐hydroxy‐3‐methylglutarate, 3‐methylglutarate and 3‐methylglutaconate oxidized sulfhydryl groups in the striatum, but not in the liver. Our data indicate that 3‐hydroxy‐3‐methylglutarate behaves as a stronger pro‐oxidant agent compared to the other metabolites accumulating in 3‐hydroxy‐3‐methylglutaric aciduria and that the striatum present higher vulnerability to oxidative damage relatively to the liver.
The contribution of voltage‐gated Ca2+ currents to K+ channel activation during ovine adrenal chromaffin cell development
Authors: Keating Damien J. , Rychkov Grigori Y. , Roberts Michael L.
Published: March 2009

Prior to the development of adrenal innervation, the adrenal medulla is capable of responding to low blood oxygen directly. However, this response is lost once adrenal innervation is established. Previous work by our group has outlined mechanisms involved in this direct hypoxic response and the means by which innervation causes the loss of the direct hypoxic response in the ovine adrenal. The current study further investigates mechanisms which may underlie the developmental loss of the direct hypoxic response by concentrating on two aspects of cell function which regulate catecholamine secretion: the contribution of different types of Ca2+ channels to the total Ca2+ current and the contribution of each Ca2+ channel type to K+ channel activation. We identified that Ca2+ current size at −40 to −10 mV is increased in amplitude in fetal chromaffin cells. This is not due to the increased prevalence or size of T‐type Ca2+ currents present at these voltages. The relative contribution of L‐, N‐ or P/Q‐type Ca2+ channels to total Ca2+ current and to activation of the K+ current is unchanged during chromaffin cell development, however K+ current density increases with age. Our results indicate that there is a developmental shift in relative expression of T‐type, but not L‐, N‐ or P/Q‐type, Ca2+ channels in ovine chromaffin cells. The increased K+ current density in adult cells may result in an altered response to an equal stimulus, while larger Ca2+ current at negative voltages in fetal cells may facilitate Ca2+ entry and catecholamine secretion in response to small depolarisations such as those induced by hypoxia.
Application of LabVIEW: Complex Software Controlling of System for Optical Coherence Tomography
Authors: Hosek P. , Prykäri T. , Alarousu E. , Myllylä R.
Published: March 2009

This article briefly describes the system for optical coherence tomography (OCT), an interferometric imaging technique and focuses on software controlling of this complex apparatus and data acquisition (DAQ) by means of LabVIEW. It states advanced LabVIEW techniques for parallel DAQ, multi-instrument communication, and postprocessing needed to assure OCT measurements being carried out at the University of Oulu.
Automation and Expert Systems in a Core Clinical Chemistry Laboratory
Authors: Streitberg George S. , Bwititi Phillip T. , Angel Lyndall , Sikaris Kenneth A.
Published: March 2009

Clinical pathology has a major influence on clinical decisions and the past 60 years have seen an evolution brought about by advances in information technology and automation. The impact of the ever-changing technology in regard to responsibilities and training therefore needs continual appraisal. In this article, the authors have drawn on their experience on automation in clinical chemistry and the experience at Monash Medical Centre in Melbourne, Australia where one of the authors is based. Automation in other industries has also been reviewed, since the reasons to automate and the impact of automation have similarities and these include reduction in errors, increase in productivity, and improvement in safety. Advances in technology in clinical chemistry that have included total laboratory automation call for changes in job responsibilities to include skills in information technology, data management, instrumentation, patient preparation for diagnostic analysis, interpretation of pathology results, dissemination of knowledge and information to patients and other health staff, as well as skills in research.

Research in clinical chemistry should not only emphasize evaluation of performance of automation but also should include pre- and postanalytical phases and training also needs to reflect this.
Membership in voluntary organizations and democratic performance: European post-Communist countries in comparative perspective
Authors: Valkov Nikolay
Published: March 2009

The article challenges the hypothesis that there is cohabitation of civic engagement and democratic institutions and practices. While valid at a general level, the relationship is not confirmed once it is scrutinized thoroughly and heterogeneous categories are disaggregated. For the European post-Communist cases, the pattern of the relationship between the regime type and the propensity to associate closely resembles the one in Latin mature democracies and non-authoritarian countries, provided that voluntary associations are chosen as measurements of vitality of social capital and robustness of civil society. A possible consequence of this provocative finding would be re-evaluating the well-established concepts in social sciences.
Reducing Seclusion and Restraint in Mental Health Care: A European Challenge
Authors: Steinert T.
Published: March 2009

The discussion on the use of coercive interventions such as seclusion and restraint accompanies the history of psychiatry from its beginning. It is the oldest and still topical issue of psychiatric institutions. Nowadays, the political growing together of Europe puts questions of common ethical standards on the agenda. The quality of psychiatric care and particularly the use of freedom-restricting coercive measures for mentally ill people are a challenge for modern civilized societies. There is a wide variety in the use of coercive interventions in different European countries in the past and the presence. An important supra-national institution dealing with the issue of coercive interventions in mental health care is the CPT (Committee for the Prevention of Inhumane or degrading Treatment or Punishment). Available data on the use of coercive interventions in different countries were found by literature review. The percentage of admissions exposed to seclusion or restraint varies from zero (Iceland) to 35% (Austria). The median duration of a coercive measure varies from 15 minutes (physical restraint, UK) to 16 days (seclusion, Netherlands). Recently, in several European countries (Finland, Germany, Netherlands, Norway, Switzerland, UK) initiatives have emerged to reduce seclusion and restraint. Obstacles for decreasing coercion in clinical psychiatry are discussed, suggestions for action are given.
Involuntary Treatment of Adolescents in Psychiatric and Social Care
Authors: Kaltiala-Heino R.
Published: March 2009

Background:

Little is known about use of coercion on minors in psychiatric care. Questions of coercion, self-determination and competence are more complicated in minors than in adults. Choice between psychiatric and child welfare care is not always clear.

Objective:

To present findings in Finnish studies on involuntary treatment of adolescents.

Methods:

Register data, medical file data and interviews with the young people, their parents, and professionals participating in decision-making are used in an ongoing series of studies.

Results:

Involuntary psychiatric treatment and taking into care of adolescents has vastly increased since mid 1990's. Their use varies greattly within the same legislation. Involuntary care is more common in socially deprived ares. Involuntary treatment takes place justified by paternalistic motivations. Girls are more easily committed due to disruptive behaviours than boys.

Conclusion:

Involuntary care of minors is a sizeable and ignored ethical problem.
Status and Trends of Coercive Measures Across Europe
Authors: Kallert T.
Published: March 2009

The presentation will adress the following questions: 1.Do coercive measures in European countries increase? 2.Could coercive measures be minimized? 3.Are coercive measures less effective than voluntary measures? 4.Are alternatives to coercive measures available, and if so which ones? 5.Is coercion always coercion, and does it influence prognosis? 6.What is the current status of the development of clinical guidelines pertaining to the use of coercive measures? 7.Is the use of coercive measures an indicator for the quality of mental health care? 8.Are the main legal problems associated with the use of coercive measures solved? 9.What are the consequences of having answered questions 1.-8.? 10. Are there issues in the field of coercion in psychiatry which have gained recent importance?
Subjectivity and Intersubjectivity in Psychiatric Diagnosis
Authors: Fuchs T.
Published: March 2009

The establishment of criteriological and manualized systems of diagnosis since the 1980ies has lead to a valuable increase in the precision and reliability of psychiatric diagnosis. On the other hand, the limits of this approach for clinicians and researchers are increasingly becoming apparent. In particular, the assessment of subjective experience is nearly excluded on the theoretical level and downplayed on the pragmatic level, with serious consequences for the validity of psychiatric diagnosis, for empirical research and, above all, for therapeutic purposes.

In my paper, I will argue that a thorough assessment and inclusion of subjective experience in our diagnostic systems will be indispensable for clinical, therapeutic as well as research purposes. To this purpose, I will distinguish three major approaches to the assessment of mental illness:

1.

The positivistic, objectifying or 3rd person approach as endorsed by DSM IV and ICD 10, focusing mainly on observable behavioural symptoms.

2.

The phenomenological, subject-oriented or 1st person approach, focusing on the patient's self-experience and exploring its basic, often implicit structures.

3.

The hermeneutic, intersubjective or 2nd person approach, mainly aiming at the co-construction of shared narratives or interpretations regarding the patient's self-concept, conflicts and relationships, as e.g. in psychodynamic approaches.

These three approaches will be compared regarding their respective values for psychopathological description, diagnosis, research and therapeutic purposes.
On Rhythms and Seasons: Associations Between ADHD, Eveningtypes, Seasonal Mood Changes, and Health
Authors: Kooij S.
Published: March 2009

The majority of the adults with ADHD have chronic difficulty to go to bed on time. This leads to a shorter sleep duration and daytime sleepiness that may aggravate the inattention problems of ADHD. This sleep pattern is also known as a delayed sleepphase, and the patients as ‘eveningtypes’. The other way round, eveningtypes have been associated with impulsiveness. The scope of this presentation is to study the impact of this sleep pattern in adults with ADHD on mood (i.e. seasonal affective disorder), eating habits (like timing of meals and binge eating), activity patterns (like nightshift work and light at night) and health in general, i.e. obesity and cancer.
ADHD and Nicotine: Implications for Treatment
Authors: Caci H.
Published: March 2009

It is now acknowledged that Attention-deficit Disorder with Hyperactivity (ADHD) is not limited to children or adolescents. Regardless of culture, up to 4% of the adults in the general population might be diagnosed with ADHD, a disorder often accompanied by comorbid psychiatric disorders. Among those is Substance Abuse including cigarette smoking. Indeed, ADHD patients tend to start with drugs earlier than normal controls. Pharmacological treatments of ADHD chiefly encompass amphetamine salts, methylphenidate and atomoxetine with a good tolerance and effectiveness. These treatments are even better tolerated now that long-acting, extended-release formulations and transdermal delivery systems become available. But it is likely that some patients will still not respond, especially when comorbid disorders are associated. Other agents are being tested as future pharmacotherapies of ADHD. Here we propose a review of the literature concerned with the relationships between cigarette smoking and ADHD in adolescent and adult patients, and an overview of the future pharmacotherapies of ADHD related with nicotine receptor agonists.
Efficacy and Safety of N-3 Phosphatidylserine in Children with Attention Deficit and Hyperactivity Disorder (ADHD)
Authors: Manor I. , Rozen S. , Manor Y. , Pelled D. , Weizman A.
Published: March 2009

Attention-deficit/hyperactivity disorder (ADHD) encompasses a broad constellation of behavioral and learning problems. These patients are also characterized by low blood long-chain polyunsaturated fatty acid concentrations; however their supplementation effect on ADHD symptoms is not clear. It was recently (1) shown in children with inattention that consumption of n-3 phosphatidylserine (PS) for 3-mo favorably affected their visual sustained attention performance. We aimed to evaluate in children with ADHD the effect of n-3 PS on ADHD symptoms and wellbeing.

Methods:

In this 15-week, randomized, double-blind, placebo-controlled, parallel study the impact and tolerability of 150 mg b.i.d. n-3 PS were investigated in 200 children (6-13-y) with ADHD. Efficacy was assessed by teachers’ Conners Rating Scale (CRS) and strength and difficulties questionnaires (SDQ) - school version and clinicians who filled Clinical Global Impression of Improvement. Additional measures included parental rating of behavior (CRS and SDQ - home version) and wellbeing (Child Health questionnaire - Parental Form 50), and continuous performance test (Test of Variables of Attention). Safety evaluation included adverse event reports, vital signs, and parents’ Barkley’ side effects rating scale.

Results:

The interim results of the first group of children that were randomly assigned in a 2:1 ratio to n-3 PS or placebo will be presented.

Conclusions:

n-3 PS impact on ADHD symptoms at school and home as evaluated by teachers, clinicians, and parents will be discussed.

Acknowledgement:

This work was sponsored by Enzymotec LTD.
Adult ADHD: An Under-Diagnosed Condition
Authors: Filipe C.N.
Published: March 2009

ADHD is a neurodevelopmental disorder that impairs executive functions, leads to maladaptive behavior and, in about 50%, has a livelong persistence. Nevertheless, adult ADHD is a very much under-diagnosed condition.

We conducted a study aimed to identify ADHD in a special population of adults. Questionnaires were applied to the parents of children attending CADIn, a Clinical Centre for Developmental Disorders for evaluation or intervention (48% of their children were diagnosed as having ADHD and 22% were diagnosed as having Pervasive Developmental Disorder). We expected a higher incidence of ADHD in this population as well as a better awareness for the condition.

We used the Adult ADHD Self-report Scale (ASRS-v1.1) and the questionnaires contained questions concerning degree of impairment, persistence of symptoms and comorbid psychiatric conditions. 114 parents were inquired, 29% fathers, 68% mothers 3% missed gender. 17% of the parents quoted above the cut-off-point for the ASRS-v1.1 screener and amongst those, 45% referred the ADHD symptoms as causing them severe impairment. Only 3 subjects had been previously diagnosed as ADHD. The prevalence of ADHD symptoms was similar for males and females. 56% of the ADHD population was diagnosed formerly as suffering from psychiatric disorder, compared to 35% of the total population. The more common diagnoses were depression (45%) and anxiety (30%).

We conclude that ADHD is much under-diagnosed in the adult population. Considering its high heritability, a closer evaluation of the parents of children diagnosed with ADHD is suggested.
Treatment of Cocaine Dependence: No Standard, but Promising Innovations
Authors: Haasen C. , Reimer J. , Schäfer I.
Published: March 2009

Treatment of cocaine dependence focuses on achieving abstinence and reducing problems associated to cocaine use. Despite extensive research and clinical experience, no “gold standard” has emerged from the different treatment options that have been researched. In general, research has shown that the evidence level for the efficacy of psychosocial interventions is higher than for pharmacologic interventions. With respect to psychosocial interventions, the evidence shows that all those interventions studied show efficacy to some extent, without greater differences in efficacy.

With respect to the pharmacologic options, none of the tested drugs have shown sufficient evidence to clearly be indicated in the treatment of cocaine dependence. Several substances have so far only been tested in smaller descriptive studies or pilot trials and will have to be studied in larger controlled trials. The substance presently with the highest level of evidence is disulfiram, and its effect has been shown to be independent of concomitant alcohol use. Of the substances that find themselves in the pilot stage and need to be confirmed by larger trials, the antidepressant reboxetine and the antiepileptic topiramate can be considered as two very promising ones. Of great interest has been the development of a cocaine vaccine. This vaccine leads to the production of cocaine antibodies, which in turn make cocaine metabolites inactive. A randomised controlled study showed the vaccine to produce cocaine antibodies in humans. A recent open-label study resulted in a significantly higher likelihood for cocaine free urines among vaccinated subjects, so that results are encouraging.
Advanced Psychopharmacology: Practical Strategies for Rational Polypharmacy in Mood Disorders
Authors: Fagiolini A.
Published: March 2009

Patients with mood disorders frequently present with treatment resistant syndromes or develop tolerance to once effective first line medications. Refractory depressive, manic or mixed episodes challenge psychiatrists to find means of augmenting traditional therapies, despite the paucity of evidence based data that support this practice. The balance between risks and benefits in most cases seems acceptable, provided that the physician and the patients have a clear understanding of the possible adverse and therapeutic interactions and that treatment resistance is not the result of inadequate (dose/time) prescription of a first line monotherapy. The workshop will review the pharmacokinetic and pharmacodynamic interactions among the psychotropic drugs and the strategies to safely and successfully use a rational polypharmacy for the management of treatment resistant mood disorders.
Functional Sspects of the Endocannabinoid System in Schizophrenia
Authors: Leweke F.M. , Giuffrida A. , Pahlisch F. , Kranaster L. , Hoyer C. , Jöpen C. , Hellmich M. , Klosterkötter J. , Piomelli D. , Koethe D.
Published: March 2009

Introduction:

The endocannabinoid system represents the target for the hallucinogenic Δ9-Tetrahydrocannabinol. It consists of naturally occurring endocannabinoid lipids (eCBs) - of which anandamide is the first characterized example - and their attending CB1 cannabinoid receptors. Activation of CB1 receptors produces intense emotional and cognitive responses, suggesting that dysfunction in the eCB system may contribute to the pathogenesis of mental disorders.

Methods:

We examined levels of anandamide in cerebrospinal fluid (CSF) and serum of healthy volunteers (n=84) and various groups of patients suffering from acute psychiatric disorders (n=180).

Results:

Compared to controls, the levels of anandamide in CSF were significantly elevated in acute, antipsychotic-naïve, first-episode schizophrenic patients (n=47) and negatively correlated with psychotic symptoms. This was reversed by the administration of antipsychotics, which antagonize dopamine D2-like receptors (n=37), but not by those, which preferentially antagonize 5HT2A receptors (n=34). In addition, a significant elevation of anandamide was already apparent in a sample of persons clinically at high risk for developing psychosis (prodromal states, n=27). Furthermore, the levels of anandamide in CSF were found significantly lower in antipsychotic-naïve schizophrenic patients reporting more than 20 times of cannabis use in life when compared to those with no more than 5 times.

Conclusion:

Our results suggest that anandamide release in the central nervous system (CNS) may serve as an adaptive mechanism countering neurotransmitter abnormalities in acute schizophrenia. They indicate that frequent cannabis exposure may down-regulate CNS anandamide signaling in schizophrenia and thereby further impact the course of the disease.
Endophenotypical and Genetic Differentiation of Eating Disorder not Otherwise Specified
Authors: Schmidt U.
Published: March 2009

Aims:

The concept of endophenotypes has attracted considerable interest in psychiatry. It is thought that endophenotypes might be more closely related to the underlying biological processes and the genetic basis that give rise to a particular disorder than the relatively crude diagnostic categories defined in our conventional classificatory systems. In order to qualify as an endophenotype a characteristic has to be measurable and heritable, cosegregates with the illness, is state independent, is observed in unaffected family members and is a biologically plausible causal mechanism. In the field of eating disorders the study of endophenotypes is still in its infancy. The aims of this paper are to:

a.

give an introduction to the concept of endophenotypes and its criticism,

b.

review what is known about endophenotypes in eating disorders, and

c.

present recent data from our own recent work on putative social cognitive endophenotypes.

Methods and results:

Based on a review of the literature and our own research findings a handful of different temperamental and personality traits, neurocognitive and social characteristics can be identified that fulfill all the criteria to qualify as an endophenotypes. Other candidate endophenotypes need further study to ascertain whether they qualify.

Conclusions:

The implications of this research for the classification of eating disorders are potentially far reaching.
Current Therapeutic Approach in EDNOS
Authors: Fernandez-Aranda F. , Krug I. , Riesco N. , Sanchez-Diaz I.M.
Published: March 2009

Background and aims:

Despite the high prevalence of EDNOS only a small proportion of individuals with this disorder seek treatment, which may be due in part to difficulties in finding specialized treatment settings for EDNOS and the high costs and logistics associated with face-to-face individual psychotherapy. This omission is critical since there is evidence that the severity of psychopathology and degree of secondary psychosocial impairment in those with EDNOS are comparable to those seen in patients with anorexia nervosa (AN) or bulimia nervosa (BN). There has been hardly any research on the treatment of atypical EDs other than the promising effort on BED, for which Cognitive Behavior Therapy (CBT) is proposed to be the most effective treatment. The aim of this presentation is to show several pilot studies and our experience of treating EDNOS cases, but also to analyze variables associated to good-outcome.

Method:

We performed several clinical studies with EDNOS patients at the University Hospital of Bellvitge to assess the effectiveness and efficiency of specific outpatient CBT programs of short and long term duration.

Results and conlusions:

The few case-control studies where the effect of diagnosis on the prognosis has been analyzed have shown differential course and outcome in EDs. EDNOS (with exception of BED) showed the poorest long-term prognosis, due to their heterogeneity and, in many cases, to their lower motivation to change. Specific therapy programs, based on our experience, will be discussed.
Defining Replication in Gene × Environnment Interaction Research: The Risk of Spurious Associations
Authors: Munafo M.
Published: March 2009

There has been considerable interest in recent years in the investigation of the role of gene x environment (G x E) interactions in aetiology of psychiatric disorders. While the fact that genetic effects may moderate the effects of environmental exposure is widely accepted, and supported by family and twin studies, there is controversy regarding the degree of evidence for specific G x E interactions reported in the literature. Here it is argued that examples of environmental interactions with genes identified at the molecular level are not as well established as widely believed.

A number of relevant factors influencing the weight of evidence for specific G x E interactions will be discussed, including the degree of stringency employed in the definition of “replication”, the impact of different statistical models used to test for interactions, and the statistical power of individual studies. It is concluded that in only a minority of studies is a replication reported that is qualitatively comparable to that in the original report. Given reasonable assumptions regarding likely genetic and environmental effects, simulations indicate that published studies are most likely underpowered, suggesting that positive results for widely reported G x E interactions may be compatible with chance findings.
Schizophrenia and Motherhood
Authors: Riecher-Rössler A.
Published: March 2009

Increasingly women with schizophrenia are becoming mothers. This can cause different problems for them, their partners, their relatives and other caregivers.

Traditionally women with schizophrenia suffered from infertility - partly due to the illness itself and its psychosocial impacts such as social isolation and lack of partnership, partly due to treatment with hyperprolactinaemia-/infertility-inducing neuroleptics. Recently this has changed dramatically, due to better community-based psychosocial treatments and also due to prolactin-sparing neuroleptics. Many women with schizophrenia now become pregnant - planned or unplanned. This, as well as motherhood, can be a considerable strain to the women concerned and her caregivers.

Counselling a women with schizophrenia therefore always has to include her fertility situation, her desire to become a mother or not, contraception or planning pregnancy and motherhood (considering the course of her illness, her medication, her psychosocial situation, partnership, social support etc.). Counselling in case of unwanted pregnancy is of utmost importance as well as addressing issues such as medication, prenatal care, etc. during pregnancy. Cooperation with the obstetrician, midwife, paediatrician and childcare agencies is necessary. After delivery, parenting assessment in mother-baby-units can be very helpful to evaluate the need for additional care. Long-time programmes for training parenting skills and “parenting rehabilitation” are urgently needed and should also support the relatives and others who care for the woman and her child.
Fathers and Mothers of Patients with Schizophrenia
Authors: Wancata J. , Freidl M. , Krautgartner M. , Friedrich F. , Matschnig T. , Unger A. , Strobl R. , Cerny G.
Published: March 2009

Aims:

To investigate caregiving and its consequences among fathers and mothers of the same patients suffering from schizophrenia.

Methods:

101 patients as well as both parents were investigated using the “Carers' Needs Assessment for Schizophrenia”, the “Beck Depression Inventory”, the “Involvement Evaluation Questionnaire” and the “Family Problem Questionnaire”.

Results:

The mean number of days fathers lived together with the patients was not significant from that of the mothers, but the average duration (hours per week) of contact with the patient was significantly higher for mothers than for fathers. Among 40% of the sample, fathers and mothers spend an equal amount of time caring for the patient. Mothers reported significantly more often problems than fathers concerning stress due to earlier life events and burn-out. Mothers needed some interventions such as individual psychoeducation or family counselling more than twice as often as fathers. Mothers reported overall higher numbers of problems and needs for intervention than fathers. The overall score of caregivers' involvement did not differ significantly between fathers and mothers. The mothers' objective burden was significantly higher than the fathers' objective burden, but parents did not show differences concerning subjective burden. Using the “Beck Depression Inventory”, mothers were more often depressed than fathers.

Conclusions:

This study shows that often fathers and mothers spend an equal amount of time caring for the patient. The differences found between mothers and fathers should be considered when planning services for family caregivers.
Beyond Family Burden - the Complexities of Carer Roles
Authors: Steffen S.
Published: March 2009

In her talk, Sigrid Steffen will speak about the core aims of EUFAMI in respect to family members and carers. Sigrid will base a lot of her talk around her own personal experience as a carer of a son who was diagnosed with schizophrenia, and she will augment this with experiences of other members of EUFAMI from across Europe. She will elaborate on the stresses and strains under which family members (the carers) come under and will discuss the challenges which carers face on a daily basis.

Her talk will also include a description of a typical ‘journey’ which carers and families travel in the execution of their caring role in an attempt to describe the various feelings and pressures they experience. Sigrid will also discuss what she understands to be the critical needs of carers and the level of support required. In particular Sigrid will concentrate on the stigma which families feel and experience during their lifetime, a aspect which is little understood and appreciated by the wider public. In conclusion, Sigrid will detail some of the work which EUFAMI has been and is involved with and which is related to the subject of her talk.
Evaluation of a Culturally Informed Therapy for Schizophrenia: Outcome Data, Therapist Competence/Adherence, and Future Directions
Authors: Dunham R.
Published: March 2009

This speaker will discuss the relationship between therapist fidelity (competence/adherence) and outcome for family therapy for schizophrenia. Some of her research will be presented linking various aspects of therapist performance to dropout rates, consumer satisfaction, and a host of client variables. She will also address how Culturally Informed Therapy for Schizophrenia (CIT-S) is being evaluated at the University of Miami, including outcome measures and timeframes. Most importantly, she will present preliminary outcome data comparing CIT-S to a treatment as usual, psychoeducation-only condition. Implications, limitations, and future directions for research and treatment will also be discussed. An interactive format will be utilized to field a discussion with the audience on how techniques of CIT-S can be used in other contexts outside of work with families coping with schizophrenia. Depending on time and interest, additional role-plays will be conducted further demonstrating CIT-S techniques.
Spiritual Coping, Communication Training and Problem Solving for Schizophrenia
Authors: Tuchman N.
Published: March 2009

This speaker will describe literature regarding the adaptive uses of religion and spirituality, such as religious or spiritual coping and making meaning from stressful life events. She will cover the Spiritual Coping module of the Culturally-Informed Therapy for Schizophrenia (CIT-S). In this phase, therapists begin with a detailed spiritual history in order to gauge each family member's beliefs, involvement in spiritual or religious activities and other practices they may have. Therapists assign homework that encourages the family members to explore their religious or spiritual experience in a positive and adaptive light. For clients who do not identify as religious or who are experiencing religious delusions, therapists proceed with this phase of treatment with a more philosophical or existential approach to spirituality and morality. A demonstration of this module will be conducted using volunteers from the audience.

This speaker will also describe the final two modules of CIT-S, which are based on the work of Falloon etal. (1984) and Miklowitz and Goldstein (1997). The fourth phase of treatment, Communication Training, attempts to unite concepts and skills learned in the three previous phases through specific attention to communication skills. Family members learn to communicate with and support each other in effective ways. The fifth phase of treatment, Problem-Solving, allows the family to learn and practice problem-solving strategies using relevant examples.
Is Empathy Always Good?
Authors: Monti M. Rossi
Published: March 2009

Empathy is a complex phenomenon. First of all empathy means the capacity to understand someone else’s state of mind or to identify with his emotional state. From this point of view, empathy plays a fundamental role in psychotherapy and has been studied as a fundamental therapeutic factor. It is true that an emphatic attitude can help other people and lead to a better understanding of their feelings. But empathy can also be used as a horrible instrument to manipulate and abuse the other. We can see this kind of malign empathy in perverted narcissistic relationships, in sadism or in torture, where the torturer can use empathy in order to figure out the most effective ways to make each of his victims suffer.
Sameness and Otherness in Psychiatry
Authors: Musalek M.
Published: March 2009

In psychiatry the interplay of sameness and otherness is of special interest and importance. Patients suffering from mental disorders are deeply affected by the experience of the otherness of oneself and the resulting marked changes in the surrounding world. Otherness is strongly connected with alienation, again a phenomenon which most of our patients with mental disorders suffer from. In this context we should not forget, however, that in former times medical doctors dealing professionally with mental disorders were called alienists indicating on the one hand that they are treating ‘aliens’ but on the other hand indicating the ‘alien role’ of psychiatrists. Alienation leads quite often to objections and hostile behaviour. For these reasons hospitality has to play a profound role in treatment programs for patients suffering from mental disorders and their aftermaths. J.Derrida rightly underlined the structural similarity of the words hostility and hospitality. Treatment settings are usually characterized by mutual and ambiguous relations between sameness and otherness, between acceptance and rejection, welcoming and refusal, integration and disintegration. This means that the problems resulting from the interplay of the sameness and otherness do not affect only patents but also treatment teams. One of the way-outs of the dilemma may be a profound change in treating persons with mental disorders - from the monologue of professionals to the mentally ill patients (no seldom leading to the experience of alienation) to a professional dialogue in a warm atmosphere of hospitality opening the chance for a concerted treatment approach based on reciprocity and confidence.
Risk Factors for the Onset of Bipolar Disorder and Factors Influencing Recognition: Results from NEMESIS
Authors: Regeer E.J. , Spijker J.
Published: March 2009

Aims:

Risk factors for the onset of bipolar disorder and factors influencing recognition were examined in a general population sample.

Method:

In the Netherlands Mental Health Survey and Incidence Study (NEMESIS) symptoms of depression, mania, psychosis and substance use were assessed among 7076 respondents with the Composite International Diagnostic Interview at baseline, after one and after three years. In a reappraisal study among 40 respondents with bipolar disorder confirmed by the Structured Clinical Interview for DSM-IV (SCID) data on illness and treatment history were collected.

Results:

Predictive values of subclinical depression and (hypo)mania for bipolar disorder ranged from 14.3% to 50%. Cannabis use at baseline increased the risk for manic symptoms during follow-up (OR 2.70, 95%CI:1.54-4.75) (Henquet et al., 2006). Comorbid subclinical psychosis in respondents with subclinical mania had predictive value for future diagnosis of bipolar disorder (positive predictive value of 3% versus 10% respectively) (Kaymaz et al., 2007). The majority of the respondents with a SCID diagnosis bipolar disorder consulted a health professional, only 12.5% received a diagnosis of bipolar disorder and agreed with the diagnosis. Only these respondents used a moodstabilizer and had contact with a psychiatrist. Type of bipolar disorder, number of mood episodes and age of onset did not influence recognition.

Conclusion:

Subclinical depression and (hypo)mania, and comorbity of subclinical psychosis and mania are predictive for future diagnosis of bipolar disorder. Cannabis use affects the expression of manic symptoms. Self-recognition of bipolar disorder is an important factor in treatment seeking and receiving adequate treatment.
Do Antipsychotics Modify Age and Weight as Risk Factors for Diabetes Mellitus?
Authors: Cohen D. , Burger H. , de Wied C. Gispen , Stolk R. , Grobbee D.
Published: March 2009

Aims:

Study of risk factors of diabetes mellitus from the general population in a schizophrenic population.

Method:

Measurement of glucose and insuline levels, fasting and 120’ after oral glucose tolerance test (OGTT) and calculating of HOMA-IR and HOMA-B.

Results:

We studied 167 outpatients, mean age 40.2 years, 90.9% Caucasian, suffering from schizophrenia (83%) or schizoaffective disorder (17%).

Age could not be confirmed as a risk factor on any of the glucose or insuline measurements or HOMA in patients with typical or atypical antipsychotics.

With bodyweight, patients with typical differed from those with atypical antipsychotics. Weight was not a risk factor on any measurement or model in with typical antipsychotics. In patients with atypical, a significant correlation with levels of plasma glucose (p=0.017), insuline (p= 0.003 resp. p= 0.010) or glucose homeostasis models (p= 0.004 resp. p= 0.016). Fasting plasma glucose (FPG) was the notable exception (p=0.987).

Conclusion:

Diabetes risk factors age and weight behave differently in schizophrenia or schizoaffective disorder.

The finding that age was not a risk factor, suggests that age is not a suitable criterion for the decision of glucose screening in this population.

The different effect of weight (a risk factor only in patients treated with atypical, but not with typical antipsychotics) suggests in different pathophysiological pathway.

As FPG was the only measurement with no correlation with either risk factors, this suggests that FPG is insufficiently sensitive for detection of disturbed glucosemetabolism in schizophrenia. Additional measurements (fasting insuline, HOMA-IR, HOMA-B, OGTT) seem to be necessary.