bluuebunny/crossref_metadata_2025 huggingface dataset:
940 – Association Between Leukocyte Telomere Length And Personality Traits
Authors: Sadahiro R. , Suzuki A. , Masanori E. , Matsumoto Y. , Shibuya N. , Kamata M. , Otani K.
Published: July 2013

It has been reported that certain personality traits are related to mortality and disease morbidity, but the biological mechanism linking them remains unclear. Telomeres are tandem repeat DNA sequences located at the ends of chromosomes, and shorter telomere length is a predictor of mortality and late-life disease morbidity. Thus, it is possible that personality traits influence telomere length. In the present study, we examined the relationship of leukocyte telomere length with personality traits in healthy subjects. The subjects were 209 unrelated physically healthy Japanese who were recruited from medical students at 4th-5th grade. None had psychiatric disorders. 128 subjects were males, and 81 were females. The mean±SD (range) of age was 23.3±1.7 (20-30) years. Personality traits were assessed by the revised NEO Personality Inventory (NEO-PI-R) and the Temperament and Character Inventory (TCI). Leukocyte relative telomere length was determined by a quantitative real-time PCR method for a ratio of telomere/single copy gene. In the stepwise multiple regression analysis, shorter telomere length was related to lower scores of Neuroticism (β=0.208, p< 0.01) and Conscientiousness (β=0.146, p< 0.05) of the NEO-PI-R, and lower scores of Harm avoidance (β=0.144, p< 0.05) and Reward dependence (β=0.170, p< 0.05) of the TCI. The present study suggests that leukocyte telomere length is associated with some personality traits, and this association may be implicated in the relationship between personality traits and mortality.
965 – Mortality And Psychiatric Disorders Among Public Mental Health Care Clients In Utrecht: a Register-based Cohort Study
Authors: Termorshuizen F. , van Bergen A.P. , Smit R.B. , Smeets H.M. , van Ameijden E.J.
Published: July 2013

Introduction

The mortality among homeless people is linked to the presence of psychiatric disorders.

Objectives

We compared the risk of specific death causes among clients of the Public Mental Health care (PMHc) in Utrecht with that of the general population, and assessed whether treatment at a local psychiatric service is associated with this risk.

Aims

To clarify the association between the presence of a mental disorder and mortality among the socially marginalized.

Methods

Out of 8,741 clients in the PMHc register, the records of 6,724 could be linked to the registries of Statistics Netherlands (CBS). Controls (N=66,247) from the population register were personally matched to a PMHc client. A Cox regression analysis was used to estimate hazard ratios (HR) of death.

Results

An increased all-cause mortality among PMHc clients compared to controls was found (HR=2.99, 95%-CI: 2.63- 3.41), associated with a broad range of death causes.PMHc clients with record linkage to the Psychiatric Case Registry Middle Netherlands (’PMHc+’) had an increased risk of suicide (HR=2.63, 0.99-7.02), but a lower risk of death from natural causes (HR=0.71, 0.54-0.92), compared to PMHc clients without (‘PMHc-’). Compared to controls, however, ‘PMHc-’ clients experienced increased risks of suicide (HR=3.63, 1.42-9.26) and death due to mental & behavioural disorders (HR=7.85, 3.54- 17.43).

Conclusion

Among PMHc clients, a registered diagnosis at a local psychiatric service appears to be favourably associated with lower mortality due to natural death causes. The high risk of suicide among ‘PMHc-’ clients probably indicates a high prevalence of undiagnosed mental disorders among PMHc clients.
967 – Cause-specific Mortality Among Patients With Psychosis: Disentangling The Effects Of Age And Duration Since Diagnosis
Authors: Termorshuizen F. , Wierdsma A.I. , Smeets H.M. , Visser E. , Drukker M. , Nijman H. , Sytema S.
Published: July 2013

Introduction

There is a large mortality gap between patients with a non-affective psychotic disorder (NAPD) and the general population.

Objectives

To assess whether mortality risks vary for different death causes according to duration since diagnosis and age in a large sample of NAPD patients.

Aims

To get insight into the risk of specific death causes along the treatment trajectory, important for interventions that are tailored to the patients' risk profile.

Methods

Data of NAPD patients (n=12,580) from three Dutch psychiatric registers were linked to the registers of Statistics Netherlands and compared to personally matched controls (n=124,143). Death rates were analysed by duration since the date of diagnosis of the (matched) patient and age using Poisson regression.

Results

Among patients, the rates of all-cause death decreased with longer duration. This was explained by lower suicide rates. E.g., among those aged 40-60 years, the rate ratios (RRs) of suicide during 2-5 and >5 years compared to the early years after diagnosis were 0.52 and 0.46 (P=0.002). Compared with controls, patients experienced higher rates of natural death causes during all stages and in all age categories: RRs 2.35-5.04, P < 0.05. No increase in these RRs for patients compared to controls with increasing duration or increasing age was found.

Conclusions

The high risk of natural death causes among NAPD patients is not (only) an effect of accumulating risks induced by the chronic nature of the disorder and/or antipsychotic treatment, but is already present during the early stages of the treatment and at young age.
978 – Involuntary Hospitalization In Psychiatric Hospitals Of Moscow
Authors: Tsygankov B. , Savelyev D. , Yaltonskaya A.
Published: July 2013

The legislative framework for court-enforced hospitalization of mentally ill individuals was introduced to Russian legal system in 1992. The 29th Article of the Psychiatric Assistance and Civil Rights Act regulates it. The involuntary hospitalization is conducted when mentally ill individuals are at risk of harming themselves or others, unable to fulfill survival needs or are at risk for health and well being without psychiatric care.

Objectives

Of this study were to analyze the frequency of involuntary admission into psychiatric hospitals in Moscow through the Emergency Medical Service during a 2 -year period. As well as distinguish clinical, social and legal particularities associated with compulsory hospitalization.

Methods

The analysis of the database records of Psychiatric Department of the Station of Emergency Medical Service named after A.S. Puchkov for the period from July 2010 till June 2012.

Results

General population of Moscow city consists of 11,5 millions people. 200 thousands individuals receive psychiatric care. Every year about 42,000 mentally ill people get admitted to the psychiatric hospitals in Moscow through emergency medical service. Around 60% (25 000) of the patients went through involuntary hospitalization. 82% of them were due to the autoagressive or aggressive behavior, including suicidal behavior and suicide attempts. 18% of involuntary hospitalization happened due to the psychiatric helplessness and risk for the health and well being of an individual in case of absence of psychiatric help. The numbers of involuntary admission remained stable over the two-year period. The most common entry diagnoses were unspecified schizophrenia and delirium tremens.
984 – Psychopathological Symptoms And Co-morbid Disorders Associated With Internet Addiction And Pathological Gambling: Analyses Of a Clinical Sample
Authors: Müller K.W. , Beutel M.E. , Wölfling K.
Published: July 2013

Introduction

Despite growing interest in internet addiction (IA), there is still no consensus in perceiving it as a distinct clinical disorder. Proposals of including IA in the DSM-V and possibly also ICD-11 have strengthened the notion that it has a lot of features justifying its nosological classification as a primary disorder.

Objectives

Besides a large number of epidemiological surveys, clinical examinations investigating psychopathological symptoms and co-morbidity in a standardized way are still missing. Hence, clinical data is very important in the research on IA as it might support data gained in representative studies.

Aims

The purpose of the study was to provide further clinical characterisation of IA.

Methods

A clinical sample from a specialized outpatient clinic in Germany was examined by clinical ratings (GAF; psychiatric co-morbidity) and questionnaires (SCL-90R, PHQ). Two clinical groups were included: Patients meeting criteria for IA (n=80) and patients with pathological gambling (n=80). For further statistical comparison, healthy controls (n=80) were recruited too.

Results

Both clinical groups scored significantly higher in SCL-90R and PHQ than the controls. Patients with IA showed similar profiles in SCL-90R as pathological gamblers with no significant differences in any sub-scale. Also, scores of GAF were similar. Expert ratings on co-morbidity indicate that depression is associated with both disorders. In IA also social phobia is common.

Conclusions

Patients with IA and pathological gamblers display comparable levels of psychopathological symptoms and impairment. IA seems to cause significant psychopathological strain similar to pathological gambling that is accepted as a clinical disorder since the 1980ies.
988 – Coping Strategies Among Primary Caregivers Of Hiv/aids Infected Individuals
Authors: Mathew V.M.
Published: July 2013

Introduction

Care giving for the HIV/AIDS individual in developing countries has become the responsibility of the family, and an identified primary care giver amongst them, who is subjected to enormous stress in fulfilling that role. Those who adopt healthy coping strategies, render better care to their wards, improving their quality of life.

Aims

To study the coping styles among primary caregivers of HIV/AIDS patients.

Objectives

To assess patterns of coping among primary caregivers of patients infected with HIV/AIDS.

Methods

A cross sectional study design was employed. 60 consecutive patients were recruited for the study after consent, from the ART centre of a tertiary care hospital. Socio demographic details were collected, and coping strategies assessed using Active behavioral, Active cognitive and Avoidance coping strategies Scale (Billings & Moos, 1984).

Results

Three patterns of coping were used. Avoidance as a strategy was predominant in older care givers, males, bread winners, influenced by their age, gender and financial independence, respectively. Professionally employed individuals used more coping strategies while those with lower levels of education and employment used fewer strategies, probably an indication of their access to information regarding the illness. Primary carers, for less than a year, used more avoidance; those for more than five years used more cognitive strategies, those between these groups used more behavioral ones.

Conclusion

Intervention for those primary care givers who employ fewer coping strategies, predominantly avoidance would help improving the quality of care rendered to the afflicted individuals and thereby their quality of life.
996 – Capgras Syndrome In a Three-decades Non-treated Schizophrenia: a Case Report
Authors: Morgado P. , Freitas D. , Carvalho J. , Silva L. , Gonçalves M.M. , Gonçalves J.
Published: July 2013

Introduction

Capgras syndrome is a misidentification syndrome typically characterized by the delusional belief that a close relative has been replaced by an impostor. This monothematic delusion can be found in numerous disorders such as paranoid schizophrenia, schizoaffective disorder, affective disorders, Alzheimer's disease, Lewy body dementia, head trauma, epilepsy, cerebrovascular disease and dementia, pituitary tumor, multiple myeloma, multiple sclerosis, viral encephalitis, frontal lobe pathology and AIDS. We present a case of a patient that presents Capgras Syndrome at the first psychiatric evaluation in the context of three-decades untreated paranoid schizophrenia.

Case report

A 56-year-old woman was brought to the psychiatric department for evaluation for aggressive behavior directed to relatives. She has a history of auditory hallucinations, experiences of self-reference and paranoid delusions with more than 30 years of evolution. More recently, she started becoming aggressive with relatives, saying her real family members had been taken by strangers to an unknown hospital. She also said that her ID photo had been replaced by another person's photo. After detailed psychiatric evaluation, blood analysis and imaging study, the diagnosis of Paranoid Schizophrenia was established. She was treated with olanzapine 20mg/day with behavioral improvement.

Conclusions

Although Capgras Syndrome is not a psychiatric diagnosis but a feature of several different conditions, psychiatrists should be aware of this syndrome as it can signalize underlying psychiatric disorders and is usually associated with violent behaviors that should be managed.
998 – Can We Still Talk About Paraphrenia? a Case Report
Authors: Freitas D. , Morgado P. , Carvalho J. , Silva L. , Fernandes N.
Published: July 2013

Introduction

Paraphrenia is a disorder similar to paranoid schizophrenia characterized by phantastic, paralogical and extraordinary imaginative delusions, with better-preserved affect and rapport and much less personality and cognitive deterioration. Most affected patients are women, with onset of symptoms in late adulthood. It was firstly systematically described by Kraepelin in 1913 in order to define a group of psychotic patients who exhibited characteristic symptoms of dementia praecox, but with minimal disturbances of emotion and volition, and marked delusions. Later, it was considered to be unfounded and the term paraphrenia was not included in the current DSM-IV-TR and ICD-10 diagnostic criteria. However, several authors suggest that the concept of paraphrenia has not lost its usefulness and it seems to be that some psychiatrists recognize the illness, but labelled it as atypical psychosis or delusional disorder for the lack of a better diagnostic category.

Objectives/aims

The aim of this poster is to underline the modernity of Kraepelin's paraphrenia concept, suggesting that it could be possible to define and recognize the illness if practitioners would be induced to use a viable diagnostic entity.

Methods

Herein we report a case of a 51-year-old woman who presented three years ago with a psychotic disorder whose clinical features resemble de classical description of paraphrenia.

Results/conclusion

Very few systematic studies on paraphrenia have been carried out in the past 70 years. Further research in this field is needed in order to recognize the viability of this diagnosis and provide patients a better care and therapeutic management.
1002 – Sociodemographic And Psychopathological Characteristics In Psychiatry Emergencies: An Observational Study
Authors: Martínez Cortés M. , Pérez Maciá V. , Pecino Esquerdo B. , Serralta Gomis M.J. , Calvo Fernández A. , López Pastor G. , Bernabeu M.J. , Tercelan E. , García Fernández L. , Oliveras Valenzuela M.A.
Published: July 2013

Introduction

A psichiatric emergency is a situation where disorders of thought, mood or behavior are so disruptive that require immediate assistance.

Objectives

To analyze clinical and sociodemographic characteristics, predictors of hospitalization, and poli-attendance in patients attended in a reference area psychiatric emergency service.

Methodology

All assistances from 01.12.2011 to 31.01.12 were recorded in a database. Patient poly-attendance was defined by two or more assistances during the study period. Logistic regression analysis was performed to find out hospitalization and poli-attendance predictors.

Results

N = 219. 50.68% male, 49.32% female; 86.75% between 20-64 years. 45.62% finished primary studies. 80.82% owned social support network. 80.73% unemployed. 71.89% voluntary assistances. 58.97% already tracked by mental health, 24.66% first contact. Reason care: anxiety (24.20%), behavioral disorders (22.57%), suicide (20.55%) and psychosis (12.79%). Final diagnoses: psychosis (24.20%), anxiety (15.48%), depression (10.05%), drugs abuse (9.13%), personality disorders (17.35%), mental retardation (8.22%), social issues (16.89%).26.94% were poly-attendance, assisted by: organic mental disorder (OR= 21,10, IC95%), personality disorders (OR=4,313, IC95%), mental retardation (OR=5,545, IC95%), social issues (OR=2,94, IC95%). 24.20% of the patients hospitalized. Factors associated to risk: age range 15-20 (OR 12.10, IC95%); psychosis (OR = 51.03, IC 95%), depression (OR = 14.61, IC95%), bipolar disorder (OR=20,38, IC 95%).

Conclusions

Minor diseases, social issues or stables axis II disorders accomplished most attendances. Hospitalitation was associated with severe mental illness and lower age.Poly-attendance is not associated with axis I patology, but it is with axis II and IV disorders.
1004 – Effects Of Internalized Stigma Of Mental Disorder On Quality Of Life And Self-esteem In Schizophrenic Patients
Authors: Batinic B. , Lemonis E. , Opacic G.
Published: July 2013

Introduction and objectives

Research suggests that internalized stigma of mental disorder (which reflects the degree to which a person holds internalized stigmatizing beliefs about mental illness) leads to decreased self-esteem, depression, delayed seeking of treatment, prolonged course of illness, poor outcome, social withdrawal, reduced self-efficacy and worsening of quality of life.

Methods

On a sample consisting of 40 outpatients with ICD-10 diagnosis of schizophrenia, with average age of 40.73 (SD= 9.168) and mean illness duration of 15.525 (SD=8.202) years, we administered the Internalized Stigma of Mental Illness Scale, the Rosenberg Self-Esteem Scale, the Manchester Short Assessment of Quality of Life and Beck Depression Inventory II. The questionnaire also included several socio-demographic and clinically-related variables.

Results

Schizophrenic patients showed a moderate level of internalized stigma (M= 40.125, SD= 9.946). Patients with higher levels of internalized stigma had significantly poorer quality of life (r= -0.422) and lower self-esteem (r=-0.318). There was a positive correlation between the level of depressive symptomatology and the level of internalized stigma (r=0.385). Correlation with the duration of illness was not statistically significant (r=-0.145).

Conclusions

Our results confirm the data of numerous researches, as well as our earlier findings on the negative effects of internalized stigma of mental disorder on self-esteem and quality of life in panic disorder patients. In order to improve the quality of life of schizophrenic patients, we should increase awareness of the negative effects of internalized stigma and focus interventions on altering stigmatizing attitudes and enhancing coping skills.
1010 – Polydipsia As a First Signal Of Psychosis - a Case Report
Authors: Silva L. , Morgado P. , Freitas D. , Carvalho J. , Silva L.
Published: July 2013

Introduction

Psychogenic polydipsia associated with hyponatremia is a potentially dangerous and fatal condition observed on patients with psychiatric illness, specially schizophrenia. This results on a peripheral oedema and can lead to cerebral oedema, mental status deterioration and intracranial hypertension if not identified and treated urgently. We present a case of polydipsia as first signal of psychosis.

Case report

20-year-old man without significant past medical or psychiatric history attended to emergency service presenting exuberant lower limbs oedemas. The analytical study stated an hyponatremia and hipo-osmotic urine. A psychiatric evaluation was made after organic illness exclusion. The patient presented serious behaviour changes, delusions and eating disturbances (“eat raw meat to recover the red cells that they had stolen from him”), polydipsia and auditory hallucinations with 2 weeks of evolution. The patient was compulsory hospitalized, treated with risperidone and lorazepam and discharged 28 days after admission without psychotic symptoms.

Conclusions

The recognition and management of the polydipsia as a first signal of psychosis are difficult because sometimes patients are uncooperative and tend to hide their water intake, but is important to be awhare to this signal to prevent the morbidity and mortality associated with this disease.
1020 – Causal Reattributions In Psychosomatics
Authors: Coremans E.L.
Published: July 2013

Objective

To measure changes in causal attribution in chronic fatigue syndrome. The cause of chronic fatigue syndrome (CFS) is still unknown. Behavioral, cognitive and affective factors may play a major role in perpetuating fatigue.

Method

175 patients fulfilling Fukuda CFS criteria participated in a six-month CBT associated with GET based on adaptive pacing strategy, in a group setting. Causal attribution was measured with the Causal Attribution List (CAL). Therapy didn’t aim change in causal attribution. All patients were included in a prospective outcome study at the university outpatient Chronic Fatigue Reference Center (UCL), with multidimensional assessments at baseline and after treatment: Checklist Individual Strength (CIS); Short Form General Health Survey (SF36), Causal Attribution List (CAL).

Results

At baseline, SFC patients were more likely to attribute their fatigue to physical than psychosocial causes (p< 0.001). After treatment, fatigue severity and behavioural consequences (CIS) and the most factors of health-related quality of live (SF36) improved significantly (p< 0,001). After treatment, patients had more causal attributions (CAL) than at baseline (p< 0,001). Correlation analyses indicated that improvement of subjective fatigue (CIS-severity, SF36-vitality) was not correlated significantly neither with physical or psychosocial causal attributions scores at baseline, nor with individual changes of physical or psychosocial causal attributions after treatment.

Conclusion

Causal reattribution is not necessary in chronic fatigue syndrome CBT. In our study (n=175) improvement of subjective fatigue is not correlated with changes in causal attribution. The advantages of abstention from causal reattribution in psychosomatics will be discussed.
1023 – Therapeutic Drug-monitoring Of Bupropion For Depression
Authors: Laib K. , Brünen S. , Pfeifer P. , Vincent P. , Hiemke C.
Published: July 2013

Introduction

Therapeutic Drug-Monitoring (TDM) for bupropion is limited by bupropion's instability at room temperature and by the absence of a well-defined therapeutic reference range. Further it is unclear to what extent bupropion and its metabolites contribute to therapeutic effects, though hydroxybupropion seems to account for the major antidepressant effects.

Aim

The aim of this examination was to check if measurement of only hydroxybupropion is useful to guide the antidepressant therapy with bupropion.

Methods

Hydroxybupropion plasma levels were measured by high performance liquid chromatography with ultra violet detection and related to therapeutic effects measured by the Clinical Global Impression Scale for improvement.

Results

The study included 52 patients (50% female). Patients who were very much improved according to CGI had significantly (p=0.042) higher hydroxybupropion serum levels than patients with moderate or minimal improvement (mean±SD, 1113±576 ng/ml, 825±398 ng/ml and 475±331 ng/ml, respectively). Receiver operating characteristics analysis revealed significant predictive properties of hydroxybupropion serum levels (p=0.002) for improvement with a lower threshold level of 858 ng/ml. Women attained significantly higher serum levels than men and also exhibited a better therapeutic effect (p= 0.018), though they did not receive significantly higher doses.

Conclusions

Measurement of hydroxybupropion plasma levels can be used to optimize the therapeutic outcome of patients treated with bupropion. Plasma levels between 850 and 1500 ng/ml can be regarded as optimal. Potential sex differences in bupropion pharmacokinetics, probably due to differential activities of CYP2B6, should be taken into account.
1025 – The Isle Of Wight Suicide Study: a Case Study Of 68 Suicides Between 2006 And 2009
Authors: Shahpesandy H. , Van Heeswijk A.
Published: July 2013

Background

The aim of the study was to identify sociodemographic, clinical and service delivery risk factors for suicide in the population of service-users (SUs) and non-service users (NSUs) plus gender-related characteristics of suicidal behaviour; in a limited geographic region.

Method

Data were collected on 68 cases of suicide (ICD-10 X60-X84) for residents on the Isle of Wight between January 2006 and December 2009.

Results

Significantly (p=0.0006) more men than women (male/female ratio 3:1) died by suicide. Relatively (p=0.07) more women (56.2%) than men (32.7%), and significantly more (p=0.05) SUs (45.3%) than NSUs (13.3%) were unemployed. Significantly more (p=0.0006) SUs (64%) than NSUs (20%) had a history of suicide and relatively (p=0.06) more (50.9%) SUs than NSUs (20%) had attended the A & E prior to their death. 69% had an adverse life event within a year prior to their suicide. Depression was significantly (p=0.008) more frequent in women (66.6%) than men (23.7%). Suicide by hanging was the commonest cause acounting for death of 71% of men and 50% of women. 57.3% of deaths occurred at their place of residence and 75% of on weekdays. 50% of women died in autumn, compared to 28.8% of men. There were three inpatient deaths (4.4%). Relatively (p=0.08) more women (56.2%) than men (32.7%) have contactacted serivces before their death.

Conclusions

80% suicides were conducted by people suffering from a mental disorder. Men are at a significant risk of suicide. Anxiety disorders in men and depression in women are the most common mental disorders.
1045 – A Unique Case Of Paraneoplastic Extra-limbic Encephalitis Presenting With Neuropsychiatric Symptoms Subsequent To Biopsy
Authors: Lubarsky K. , Coira D. , Spariosu M.
Published: July 2013

Introduction

Paraneoplastic disorders of the CNS are a heterogeneous group of neurological disorders associated with systemic cancer which cannot be attributed to direct effects of the neoplasm. Although there is extensive literature focusing on the neurological manifestations of these disorders, the initial presentation is psychiatric in many instances and discussion in the psychiatric literature is relatively sparse.

Objectives

-

To bolster recognition and enhanced characterization of paraneoplastic disorders from within the psychiatric community.

-

To explore temporal aspects of symptom presentation in relation to biopsy.

-

To identify how psychoneuroimmunological factors may contribute to the development of paraneoplastic disorders.

Case description

We report the case of a 48 year-old female with no past psychiatric history who presented with neuropsychiatric symptoms immediately subsequent to biopsy and inflammatory breast cancer diagnosis. Patient was initially admitted to the psychiatric unit for suspected acute stress reaction, yet eventually diagnosed with paraneoplastic extra-limbic encephalitis.

Conclusions

-

As early oncologic treatment and immunotherapies improve outcomes, early diagnosis is paramount for both treating the paraneoplastic syndrome and identifying possible underlying malignancy.

-

Time course of symptom presentation raises the intriguing possibility that perturbation of tumor tissues during biopsy may accelerate the immune response to onconeuronal auto-antigens and inflammation-mediated neuronal injury.

-

Given the patient's acute stress state, the rapid time course of symptom onset, and known connection between psychological stress and autoimmunity, we propose that the immune system stress-response may additionally contribute to the paraneoplastic syndrome development. This connection warrants further investigation from within the psychoneuroimmunology community.
1049 – Correlates Of Postpartum Depressive Symptomatology
Authors: Roque C. , Pereira A.T. , Marques M. , Soares M.J. , Maia B. , Bos S. , Azevedo M.H. , Valente J. , Nogueira V. , Madeira N. , Macedo A.
Published: July 2013

Introduction

Postpartum depressive symptomatology is highly prevalent and has negative impact in the entire family.

Objective

To identify correlates of postpartum depressive symptomatology.

Methods

201 3-months postpartum women completed the Portuguese versions of Postpartum Depression Screening Scale/PDSS, Profile of Mood States, Difficult Infant Temperament Questionnaire/DITQ, Multidimensional Perfectionism Scale and questions on sociodemographic variables (marital status, work status, educational level, parity), Lifetime history of insomnia/LTHD, Lifetime history of depressive symptomatology /LTHDS, Current insomnia, Sleep needs, Health perception/HP, Stress perception/SP, Perceived social support/PSS, Quality of life/QOL, Health problem/complication postpartum, Sensibility to hormonal fluctuations, Type of delivery and Type of feeding.

Results

Total PDSS significantly correlated with LTHDS (rs=.35), LHI (rs=.22), Current insomnia (rs=.37), SP (rs=39), PSS (rs=.25), Perceived QOL (rs=.31), Health perception (rs=.28), Health problem or complication in the postpartum (rs=.16), Negative Affect/NA (r=.59), Positive Affect/PA (r=-.67), Conditional Acceptance/CA(r=.29) and DIT (r=.40) (all p< .01). Mean comparisons revealed that women with vs. without LHDS, with vs. without LTHI, good sleepers vs. with insomnia syndrome, high vs. low SP, bad/very bad vs. good/very good QOL, bad/very bad vs. good very good HP, high (< M+1DP) vs. low (>M-1DP) DIT, CA, NA and low vs. high PA had significantly higher mean scores in AI (all p< .01). Linear regression model composed of all correlated variables explained 53.9% of depressive symptomatology variance and showed that NA, PA, DIT and HP are significant (p< .05) predictors of AI.

Conclusion

These results are in line with previous findings and contribute to the progress on this topic.
1053 – In Vitro Receptor-binding Profile Of Lurasidone And Other Commonly-used Antipsychotics
Authors: Werner P. , Ishiyama T. , Loebel A. , Cucchiaro J. , Horisawa T. , Tokuda K. , Ogasa M. , Ishibashi T. , Stahl S.M.
Published: July 2013

Introduction

Atypical antipsychotics bind to multiple receptor types and subtypes. Improved outcomes in schizophrenia are linked to activity at D2 and serotonin receptors 5-HT7, 5-HT2A and 5-HT1A.

Objectives

To characterize the receptor-binding profile of lurasidone and other antipsychotics.

Aims

To compare receptor-binding profiles of antipsychotics.

Methods

Replicated, side-by-side receptor-binding assays used human recombinant receptors (for 5-HT7, α2A, and α2C) or membrane-fractions of animal CNS tissue. Affinities were determined via Hill plot analysis for IC50values; Ki values were determined using Ki=IC50/(1+ S/Kd) (S=concentration of competing radioligand, Kd=dissociation constant).

Results

Lurasidone displayed potent binding and full antagonism at dopamine D2(Ki, 1.68nM) and serotonin 5-HT2A(Ki, 2.03nM) receptors (the highest D2affinity of all tested agents). Lurasidone's dopamine binding was selective for D2receptors. Unlike other antipsychotics tested, lurasidone had very high affinity and full antagonism at serotonin 5-HT7(Ki, 0.49nM), and nanomolar affinity (Ki=6.75nM) with weak-moderate partial agonism at serotonin 5-HT1Areceptors., Lurasidone showed higher affinity for 5-HT7, 5-HT2A, and 5-HT1Areceptors relative to D2receptor-binding than other agents. Lurasidone displayed moderate affinity for α2C adrenoceptors (Ki, 10.8nM); moderate-weak affinity for α1adrenoceptors (Ki, 48nM); and minimal or unappreciable affinity for receptors associated with undesirable effects (5-HT2C [Ki, 415nM], histamine H1[IC50>1000nM] and muscarinic [cholinergic] M1[IC50>1000nM] receptors).

Conclusions

The unique pharmacological profile of lurasidone is consistent with observed antipsychotic efficacy, low-tomoderate likelihood of EPS, low weight-gain potential, and possible mood, anxiety, and cognitive benefits.
1055 – Effect Of Lurasidone On Weight And Metabolic Parameters: a Comprehensive Analysis Of Short- And Long-term Trials In Schizophrenia
Authors: Pikalov A. , Cucchiaro J. , Ogasa M. , Silva R. , Hsu J. , Xu J. , Loebel A.
Published: July 2013

Introduction

Patients with schizophrenia are at high risk for diabetes, dyslipidemia, hypertension, and obesity, which can be exacerbated by some atypical antipsychotics.

Objectives

To evaluate the effect of lurasidone on weight and metabolic parameters.

Aims

To establish the cardiometabolic safety of lurasidone.

Methods

Short-term data were pooled from seven, double-blind, 6-week studies of subjects with acute exacerbation of schizophrenia treated with lurasidone 20-160 mg/day (N=1508); haloperidol 10 mg/day (N=72); olanzapine 15 mg/day (N=122); risperidone 4 mg/day (N=65); quetiapine XR 600 mg/day (N=119) or placebo (N=708). Long-term data (6-22 months) were pooled from patients treated with lurasidone 40-120 mg/day (flexibly dosed).

Results

Proportions of patients experiencing ≥7% weight gain during short-term treatment were: lurasidone 4.8%, haloperidol 4.2%, olanzapine 34.4%, risperidone 6.2%, quetiapine XR 15.3%, and placebo 3.3%. Median lipid changes were: triglycerides (mg/dL), lurasidone -4.0, haloperidol -3.0, olanzapine +25.0, risperidone +4.0, quetiapine XR +9.5, and placebo -6.0; total cholesterol (mg/dL), lurasidone -5.0, haloperidol -8.0, olanzapine +9.0, risperidone +6.5, quetiapine XR +6.0, and placebo -5.0; trends were similar for LDL. Median changes in glucose (mg/dL) were similar for lurasidone (0.0) and placebo (0.0), and higher for haloperidol (+2.0), olanzapine (+4.0), risperidone (+3.0), and quetiapine XR (+3.0). Minimal-to-no changes in HbA1c were observed. With long-term lurasidone treatment, mean weight change after 12-month exposure was -0.73 kg and median metabolic changes were: -2.0 mg/dL for total cholesterol and -5.0 mg/dL for triglycerides.

Conclusions

Short- and long-term treatment with lurasidone showed minimal changes in weight and decrease in mean total and LDL cholesterol and triglycerides.
1065 – Relationship Between Insight, Psychopathology And Executive Functions In a Sample Of Forensic Patients
Authors: Martins V. , Pimenta S. , Massano R. , Martins I. , Canhão A.
Published: July 2013

Introduction

The study of the relationship between insight, psychopathology and executive functions has revealed contradictory results, which seems to demonstrate the complex and multidisciplinary nature of insight. Several studies in psychotic patients confirmed the association between lower insight and poor prognosis, emphasizing the impact of poor adherence to treatment in greater symptom severity and greater likelihood of aggressive behavior.

Objectives

To study the relationship between insight, psychopathology and executive functions. Analyze the association between these variables and the type of crime committed in a sample of forensic patients.

Methods

The sample is comprised by patients hospitalized for more than 6 months in the Department of Forensic Psychiatry of the Centro Hospitalar e Universitário de Coimbra, diagnosed as measured by DSM-IV-TR, in the category “Schizophrenia and other Psychotic Disorders”. Of these, we excluded those that according to DSM-IV-TR had a diagnosis of “Mental Retardation” (IQ as measured by WASI - Wechsler Abbreviated Scale of Intelligence) or “Substance Dependence”. Patients were evaluated using PANSS (Positive and Negative Syndrome Scale), SUMD (Scale to Assess Unawareness of Mental Disorders) and TMT (Trail Making Test). Biographical data, type of crime that led to the hospitalization and the security measure applied, was gathered through the review of patient's clinical files.

Results and conclusions

Data will be analyzed using the Statistical Package for Social Sciences (SPSS - 19th version) and the results will be interpreted according to the current literature.
1067 – Effect Of Calreticulin On Hippocampus Of Post-traumatic Stress Disorder Rats
Authors: Liu H. , Han F. , Shi Y.
Published: July 2013

Objective

To detect molecular chaperone calreticulin(CRT) expression on the hippocampus in the rat model of post-traumatic stress disorder(PTSD), and discuss the regulation of CRT on Ca2+ in hippocampus of PTSD rats, further provide the experiment basis for pathogenesis of memory anomaly in PTSD rats.

Methods

The single-prolonged stress(SPS) is one of the animal models was used to set up the rat PTSD models. Male Wistar rats were randomly divided into 1, 4, 7 days groups after exposure to SPS and a normal control group. The expression of CRT was detected by using immunohistochemistry, Western blotting and RT-PCR. The intracellular free calcium was examined by fluorescence spectrophotometer.

Results

The expression of CRT in the hippocampus obviously increased after SPS stimulation, and reached the peak at SPS 4d. The intracellular free calcium level in the hippocampus obviously increased, and reached the peak at SPS 1d, then gradually decreased.

Conclusions

PTSD caused endoplasmic reticulum stress(ERS), calcium overload, up-regulated expression of CRT, activation of unfolded protein response(UPR), which maybe result in cell apoptosis and maybe the pathogenesis basis on memory anomaly in PTSD rats.
1075 – Directions For Community Psychiatry In The u.s.: a Pilot Qualitative Study
Authors: Bouloudnine R. , Rowe M.
Published: July 2013

Community psychiatry is at a crossroads in the U.S. This crisis can be characterized by the discipline's relationship to: tension between social and biological psychiatry; and the Recovery Movement. Confronted with the strong presence of biological psychiatry, with social conditions that are not a core focus of their training, and with a strong push from patients, advocates, and some policy makers to create recovery-oriented care that, often, seems to minimize the importance of psychiatrists, the question - “What is community psychiatry in the U.S. - must be posed.

Method

This research, conducted at Yale University with IRB approval, involved 12 in-depth qualitative interviews with community psychiatrists at a public mental health center. The main interview question - “What is a psychiatrist? - was followed by questions involving the themes noted above.

Result

For the psychiatrists, psychiatry seems deeply embedded in medicine. If the biological model has been able to improve some parts of psychiatric practice, many psychiatrists will identify the limits of this model and feel frustration from its tendency to marginalize their role into one of medication management.

Conclusion

Regarding this lack of knowledge and understanding of mental illnesses, regarding the crisis that the health system is undergoing, it seems necessary to go above a simple definition of a psychiatrist as someone with skills for treating mental illness. With which skills can psychiatrists improve symptoms, the life context that contributes to patients’ symptoms, and the mental health delivery system that often misses people's needs? Or going further, how can psychiatrists best advocate for their clients?
1083 – Withdrawal From Benzodiapezines In Spa Treatment
Authors: Dubois O.
Published: July 2013

The recent results stemming from the STOP-TAG [Dubois O, et al.; Balneotherapy versus paroxetine in the treatment of generalized anxiety disorder, Complementary Therapies in Medicine (fév 2010) 18, 1-7] study have shown the way to demonstrating the considerable efficacy of psychiatric spa therapy compared to a reference treatment (Paroxetine) in generalized anxiety disorders. The study carried out on 237 patients has clearly indicated the impact of balneotherapy in this indication with indisputable evidence.

The questionable problem of withdrawal from benzodiapezines is a well-known issue throughout European countries, particularly in France. For instance, 11.2% of the French are regular benzodiapezine consumers and 70% of the prescriptions are made out to them for as long as 5 years!No therapy has ever actually shown a satisfactory efficacy to treat the problem. The given elements converge to propose programmes of a psycho-educative kind.

As a result, this has led us to the conclusion that a protocol, which would be set up and supervised by university academics, ensured by trained psychologists with medical withdrawal follow-up to be carried out within the spa therapy, could well allow withdrawal from this medication. The spa therapy, through its proven anxiolytic activity, is able to favour the substituting of treatment by benzodiapezine, and as a result would make withdrawal easier.

We propose here to set out the psycho-educative protocol with the support of an experiment on 73 patients, carried out in 2010 and 2011 in France together with the results of this study.
1086 – Barriers To Somatic Health Care In Psychiatric Inpatient Wards
Authors: Okkels N. , Thygesen N.B. , Jensen B. , Wendelboe M.H. , Munk-Joergensen P.
Published: July 2013

Introduction

Cardiometabolic diseases are under-diagnosed and under-treated in psychiatric inpatients. A common solution is implementation of screening guidelines. However, we often forget to ask the essential question: Why were our patients underdiagnosed in the first place?

Objective

To identify causes of under-diagnosing and under-treatment in the context of local clinical practices.

Method

All consecutive admissions (n=63) over 93 days were screened for hypertension, diabetes, dyslipidemias and abdominal obesity. Patients identified with both (a) undiagnosed and untreated disease and (b) admission on a separate occasion within the previous two years to the ward in question, were selected for a retrospective patient file review. These patients (n=32) had their medical records scrutinized for information on how each cardiometabolic measure was assessed at previous admission.

Results

Relevant examination were performed in 38% of cases and test results were abnormal for 54% of these. Abnormal test results were evaluated in 14% of cases and none of the evaluated results were acted upon.

Conclusion

Rigorous examination and testing of patients is only of value if clinicians have the essential knowledge to interpret the results and feel responsibility to do so. These barriers must be broken down before implementing screening guidelines in routine clinical practice.
1099 – Hospital Care For Alcohol-dependent Patients: Attentional Bias Measured With The French Version Of The “alcohol Stroop Test”
Authors: Flaudias V. , Brousse G. , Llorca P.-M. , Planche F. , Brun J. , De Chazeron I.
Published: July 2013

Aims

Previous studies have shown in alcohol dependence patients an attentional bias (AB) under related substance cues which can be a factor of relapse. This AB can be evaluated by the “Alcohol Stroop Test” (AST). The AST is a modified Stroop task while participant have to name the color of the word. This word could be alcohol-related word or a neutral word. AB is the response time's difference between alcohol-related words and neutral words. The goal of the current study was to examine the relation between withdrawal hospitalization and AB.

Methods

Individuals with alcohol-dependence disorders (DSM IV) and admitted for withdrawal in addictology unit of CHU Clermont-Ferrand (n=42) and participant with no alcohol or psychiatric disorder recruited from colleagues and friends from the staff performed the AST (n=16) (‘Control Group’) were recruited. For inpatients, one group performed the AST in admission (n=19) (‘Admission Group’), and another group immediately before discharge (n=23) (‘Discharge Group’).

Results

Results show an AB only for patients saw at admission (t(18) =2.12; p< .05). Moreover, we observe that the AB in ‘Admission Group’ (M=34 ms, SD= 70.06) is greater than the AB in ‘Control group’ AB (M = 23 ms, SD = 93.42), itself greater than the AB in ‘Discharge Group’ (M = -12 ms, SD=93.55), (t(55) = -1.71; p =.09).

Conclusions

Although, results are preliminary, the present study provides evidence for the evolution of AB during alcohol addiction treatment and for the value of incorporated method to improve AB during detoxification cure.
1103 – Obesity, Psychopathology And Neuropsychology: Clinical And Therapeutic Considerations
Authors: Paoli R.A. , Zugno E. , Caletti E. , Paganelli L. , Prunas C. , Ostinelli E. , Altamura A.C.
Published: July 2013

Introduction

Experimental evidence indicates that patients with severe mental illness such as schizophrenia or mood disorders have a higher incidence of overweight and obesity (Daumit et al., 2003).

Objectives

This review describes the neuropsychological functioning and therapeutical approaches (psychotherapeutic, pharmacological, surgical) in obese patients with psychiatric disorders.

Aims

To provide suggestions for good clinical practice in obese subjects with psychopathology, based on data found in the literature.

Methods

MEDLINE and PubMed databases (1962-2012) were searched for English-language articles.

Results

Most of the literature says that the best treatment for these patients should use an integrated approach, starting from an assessment of the psychological and cognitive resources to set up a more effective and personalized therapeutic path.

Conclusions

Obese patients who have psychiatric disorders represent a population that requires specific treatment measures; in fact, the development, the maintenance and the outcome of the problem of weight are influenced not only by physical and life style factors, but also by specific factors related to psychopathology, neuropsycology, and side effects of certain drugs.
1107 – Esense 1 - Randomised Controlled 6-month Study Of As-needed Nalmefene: Subgroup Analysis Of Alcohol Dependent Patients With High Drinking Risk Level
Authors: van den Brink W. , Aubin H.-J. , Bladström A. , Torup L. , Mann K. , Gual A.
Published: July 2013

Introduction

We describe the efficacy and safety of as-needed use of nalmefene in the subgroup of patients with a high drinking risk level (DRL; men:>60g/day; women:>40g/day); i.e. a group of patients with a great unmet medical need for treatment.

Objectives

To evaluate the 6 month efficacy and safety of as-needed use of nalmefene 18mg versus placebo in a subgroup of alcohol-dependent patients with high DRL from a randomised controlled trial [NCT00811720].

Methods

All patients received a motivational and adherence-enhancing intervention (BRENDA) in combination with either nalmefene or placebo. Number of heavy drinking days (HDDs) and total alcohol consumption (TAC) were measured using the Timeline Follow-back method. Additionally, data on clinical improvement, liver function and safety were collected throughout the study.

Results

The study population consisted of 350 patients: placebo N=170; nalmefene N=180 (mean age 51.9±9.4 years; 63% men; mean HDDs: 23±5.7/month; mean TAC: 101±41.7g/day). Mean number of HDDs decreased to 11 days/month and mean TAC decreased to 44g/day at month 6 in the nalmefene group. There was a superior effect of nalmefene compared to placebo in reducing the number of HDDs (-3.7 [95% CI: -5.9;-1.5];p=0.0010) and TAC (-18.3 [-26.9;-9.7];p< 0.0001) at month 6. Improvements in clinical status and liver parameters were greater in the nalmefene group compared to the placebo group (p< 0.05). Adverse events and adverse events leading to dropout were more common with nalmefene than placebo.

Conclusions

As-needed nalmefene was efficacious in reducing alcohol consumption in patients with high risk for alcoholrelated harm.