bluuebunny/crossref_metadata_2025 huggingface dataset:
PW01-110 - Associations Of Smoking, Exercise, And Alcohol Drinking With Poor Sleep Quality Of Japanese Civil Servants
Authors: Sekine M. , Tatsuse T.
Published: June 2010

Background

Some of lifestyle factors may influence sleep quality. Because poor sleep quality is associated with an increased risk for various physical and mental diseases, it would be beneficial to identify lifestyle factors that may lead to poor sleep quality.

Methods

The subjects were 3341 employees (2280 males and 1061 females) aged 20-65 in local government in Japan. A questionnaire survey was conducted in January 2003. Sleep quality was evaluated using Pittsburgh Sleep Quality Index (PSQI). PSQI consists of 7 subscale scores generating a global PSQI score. In the present study, a subject with a global score of more than 5.5 was defined as having poor sleep quality. Logistic regression analysis was conducted to evaluate whether smoking, exercise, and alcohol drinking habits were independently associated with poor sleep quality, after adjustment for potential confounding factors.

Results

In both men and women, current smokers were more likely to have poor sleep quality. While, in men, physical inactivity (exercise frequency of less than 1/week) were associated with poor sleep quality, there were no significant relationship between physical inactivity and poor sleep quality in women. While, in men, daily alcohol drinking was associated with better sleep quality, no significant associations of drinking frequency with sleep quality were found in women.

Conclusion

Current smoking may lead to poor sleep quality for both men and women, while the associations of physical inactivity and infrequent alcohol drinking with poor sleep quality were significant only for men. Longitudinal study is necessary to confirm the causality.
PW01-113 - Pilot Study Of The Characteristics In Patients With Dual Pathology In Comunidad De Madrid, Spain
Authors: Szerman N. , Mesías B. , Vega P. , Badurte I.
Published: June 2010

The results of a pilot study of dual pathology will be presented in the poster. For that purpose, data of 400 patients from Centers of drug dependency attention - 65,25 %- and centers of mental health and Psychiatry services of Comunidad de Madrid - 34,75%- were gathered. Selection was made by incorporating to the study, retrospectively, the last 25 open histories in each of the participant centers.

Results obtained in that study show with great detail, the characteristics of drug taking in patients with dual pathology of the sample, giving as a result that 57,35% took alcohol, 51,47% cocaine and 33,82 % opiate. These three substances were the ones mostly taken.

Regarding the diagnosis in reference to the mental disorder or to the behavior of patients with dual pathology, The most frequent diagnosis is part of the affective disorders group (49,26%), followed by personality and behavioral disorders, that are diagnosed in a third part of patients with his pathology.

Other mental disorders, like schizophrenia, appear less (9,56%). In comparison with patients of the dual pathology sample, statistics analysis made showed that affective disorder is associated to dual pathology with more statistic significance than in patients without this pathology (49,26% versus a 15,89%). A similar profile was found with personality disorders and adult behavior. Regarding schizophrenia and schizoid disorder, despite low impact of these disorders in the sample, it has been noticed a significant statistic association in the appearance of both diagnosis, being more frequent in patients with dual pathology.
PW01-122 - No-Shows, Drop-Outs And Completers In Psychotherapeutic Treatment: Demographic And Clinical Predictors In A Large Sample Of Non-Psychotic Patients
Authors: Fenger M. , Mortensen E. , Poulsen S. , Lau M.
Published: June 2010

Introduction

High rate of non-attendance in mental health treatment is a major problem in terms of lost economic resources and deteriorated quality of life for the patients.

Aims

The aim of the present study was to conduct an analysis of the influence of demographic and clinical variables on treatment attendance.

Methods

A naturalistic study of 2473 non-psychotic consecutive patients offered psychotherapeutic treatment. Demographic and clinical variables were registered at assessment. Bivariate and multiple logistic regression analyses of the associations between these variables and attendance were conducted.

Results

675 (27.3%) did not show up and 289 (11.7%) dropped out of treatment. Regression analysis showed that younger age, few years of school, taking an education, unemployment, no sick leave, personality disorder, low or high GAF, no earlier treatment, no use of psychoactive medicine, and substance abuse were significant predictors for non-attendance.

Conclusion

No-show was predicted mainly by clinical factors, whereas drop-out was predicted by demographic variables. Results and strategies to reduce non-attendance were discussed.
PW01-134 - Limbic And Paralimbic Cortex Grey Matter Densities Are Negatively Associated With Trauma Load
Authors: Nardo D. , Högberg G. , Larsson S.A. , Hällström T. , Pagani M.
Published: June 2010

Objective

There is converging evidence of gray matter (GM) structural alterations in different limbic structures in Post-Traumatic Stress Disorder (PTSD) patients. The aim of this study was to evaluate GM density in PTSD in relation to trauma load.

Method

Magnetic Resonance Imaging (MRI) scans of 21 subjects exposed to occupational trauma, who developed PTSD (S), and of 22 who did not (NS), were performed. The self-rated Trauma Antecedent Questionnaire (TAQ) was administered to assess lifelong trauma load and resilience. TAQ includes two scales (“trauma and neglect” TAQ−, and “resilience factors” TAQ+) further divided into four subscales measuring trauma load and resilience in four different age periods: zero to six, seven to twelve, thirteen to eighteen and adult. Regression analyses between the two sub-scales and GM density were performed on all 43 subjects by means of an optimized Voxel-Based Morphometry (VBM) analysis as implemented in SPM2.

Results

The analyses showed that GM density negatively correlated only with adult TAQ- in bilateral posterior cingulate, left anterior insula, and right anterior parahippocampal gyrus.

Conclusions

Irrespective of the PTSD diagnosis, trauma load was found to correlate with GM density in several limbic structures suggesting a high vulnerability of these structures to the effects of stress and trauma, These regions are implicated in integration, encoding and retrieval of autobiographical and episodic memories, emotional processing, interoceptive awareness and self-referential conscious experience. Thus, our study supports lower GM densities in limbic and paralimbic cortices as a potential structural basis for memory and dissociative dysfunction in PTSD.
PW01-145 - Neural Correlates Of Assessing Environmental And Technological Hazards
Authors: Herwig U. , Brühl A. , Viebke M.-C. , Scholz R.W. , Knoch D. , Siegrist M.
Published: June 2010

Background

In personal and in political context, we often evaluate the risk of certain conditions. Therefore, two principal psychological approaches are suggested: the analytical consideration and the intuitive estimation, both with according discriminative brain activation. We investigated the neural basis on which non-experts evaluated high risk of different environmental hazards for the society compared with respective low risk.

Methods

Twenty healthy subjects underwent functional magnetic resonance imaging while evaluating the risk of fifty more or less risky conditions presented as written terms. We analyzed brain activations during the individual estimations of ‘high’ against ‘low’ risk. Further, the individual brain activations associated with ‘negative’ versus ‘not negative’ emotional valence of the terms were analyzed.

Results

Estimating hazards to be of high risk was associated with activation in medial thalamus, anterior insula, nucleus caudatus, posterior cingulate cortex and precuneus. These areas were not involved according to the analysis of the emotion ratings.

Conclusions

The results point to a substantial contribution of viscerosensitive areas to signal high risk and supports models of an intuitive “gut” feeling independent of the subjective emotional valence when estimating a high risk of environmental hazards.
PW01-153 - Effect Of Daao On Regional Brain Function In Healthy Individuals And Patients With Schizophrenia And Bipolar Disorder
Authors: Papagni S.A. , Mechelli A. , Prata D. , Kambeitz J. , Picchioni M. , Fu C. , Kane F. , Kalidindi S. , McDonald C. , Kravariti E. , Toulopoulou T. , Murray R. , Collier D. , McGuire P.
Published: June 2010

Introduction

Recent studies have identified DAAO as a probable susceptibility gene for schizophrenia and bipolar disorder. However, little is known about how this gene may affect brain function to increase vulnerability to these disorders.

Objective

The present investigation examined the impact of DAAO genotype on brain function in patients with schizophrenia, patients with bipolar I disorder and healthy volunteers.

Aim

We tested the hypotheses that the high-risk variant of DAAO would be associated with altered prefrontal function and functional connectivity in schizophrenic and bipolar patients.

Methods

We used functional magnetic resonance imaging to measure brain responses during a verbal fluency task in a total of 121 subjects comprising 40 patients with schizophrenia, 33 patients with bipolar I disorder and 48 healthy volunteers. We then used statistical parametric mapping (SPM) and psycho-physiological interaction (PPI) analyses to estimate the main effects of diagnostic group, the main effect of genotype and their interaction on brain activation and functional connectivity.

Results

In schizophrenic patients relative to bipolar patients and controls, the high-risk variant of DAAO was associated with lower deactivation in the left precuneus and greater activation in the right calcarine and posterior cingulate gyrus during task performance. In addiction, these areas expressed altered functional connectivity with the rest of the brain in schizophrenic patients relative to bipolar patients and controls.

Conclusions

Our results suggest that genetic variation in DAAO has a significant impact on brain function and provide preliminary evidence for a disease-specific pattern of gene action in specific brain regions.
PW01-162 - Destigmatizing Mental Ilness
Authors: Selo M.
Published: June 2010

In view of the fact that the “Münchner Bündniss gegen Depression” started on Oct 12, 2009, with the aim of destigmatizing depression and informing the population at large about mental illness, I propose the following:

A session/workshop which I would lead with representatives (patients and relatives) of the Munich self-help- groups, a psychiatrist (Dr. Waldemar Greil), and a representative from the pharmaceutical industry.

Aim would be to find out how to best fulfill the mission of the “Münchner Bündniss” gegen Depression and how to ensure sustainability.

For your information I am including my resume. I am the President of the Werner Alfred Selo Foundation in Switzerland. The foundation gives grants for research proposals in the area of comorbidity of depression and migraines. I have served two terms on the Board of NARSAD (National Alliance for Research in Schizophrenia and Depression. I have been a mental health advocate since I came out of a mental hospital in New York in 1980. My most recent activities were being the protagonist in the movie Bipolar by psychiatrist and filmmaker Dr.Ernst Juenger (www.bipolar.de/bipolar) and being a panel discussant at the World Health Summit in Berlin (Oct 15-18, 2009). I also participated in a round-table discussion organized by the Kanton of Zug on bipolar illness in Zug, Switzerland on November 8, 2009.
PW01-168 - Disturbance Of Intentionality: A Phenomenological Approach For The Development Of Schneiderian First-Rank Symptoms In Schizophrenia
Authors: Hirjak D. , Fuchs T.
Published: June 2010

Objectives

In 1950, Kurt Schneider proposed that a considerable number of schizophrenic patients develop first-rank symptoms (FRS). In such cases, patients experience third-person auditory verbal hallucinations, audible thoughts, made experiences, replaced control of will, thought insertion, broadcast and withdrawal. This group of symptoms might therefore be seen as pathognomonic of schizophrenic psychopathology. Although a number of studies tend to explain these symptoms in terms of neurobiological and neuropsychological processes, the cause and development of FRS still remains unknown.

Methods

The method applied for the development of an explanatory model of FRS consists first in the overview of psychiatric and philosophical literature and secondly in the further development of the concept of disturbed intentionality and its implication to the FRS in schizophrenia. Intentionality is understood as a basic characteristic of conscious experience as being directed towards its object and, at the same time, implying a sense of mineness. This report also reviews and discusses some generally accepted views of FRS.

Results

Current psychiatric research shows a significant increase of interest phenomenological explanations of FRS. In this contribution we introduce a phenomenological model of FRS based on the concept of intentionality. We also show that this concept offers an insight into the interrelatedness between particular FRS.

Conclusions

We propose that the experience of FRS in patients with schizophrenia is rooted in the disturbed and inverted intentionality of their mental and bodily actions. This theoretical model of FRS will open up new directions in psychiatric research.
PW01-264 - How Would European Trainees Treat Bipolar Disorder For Their Patients And Themselves, And What Influences Decision-Making?
Authors: Jauhar S. , Lydall G. , Riese F. , Gama Marques J. , Bendix M. , Andlauer O. , Gerber S. , De Vriendt N. , Dumitrescu I. , Nawka A. , Guloksuz S. , Mendonca L. , Nwachukw I. , Psaras R. , Roventa C. , Giacco D. , Mufic A. , Dobrzynska E. , Nazaraliev A. , Van Zanten J. ,   European Federation of Psychiatric Trainees (EFPT) Research Group
Published: June 2010

Objectives

Guidelines produced for management of Bipolar Disorder illustrate change in evidence-base for treatment of acute and maintenance phases of illness. Our Pan-European Research Group assessed clinical practice and desired treatments amongst amongst Psychiatry trainees.

Methods

A semi-structured survey was piloted, and homogenous sample size (at least 50) agreed upon from each country, with 50% minimum response rate. It was distributed via web-link, questioning preference of mood stabiliser for patients, trainees themselves and factors influencing choice.

Results

Tables 1 summarise choices.

Number (n)PercentageDrug(s)263/22440.8/34.8Lithium121/10118.8/15.7Semisodium Valproate133/8520.7/13.2Sodium Valproate21/503.3/7.8Lamotrigine27/184.2/2.8Lithium and Sodium Valproate10/151.6/2.3Carbamezapine24/123.7/1.92nd Generation Atypical antipsychotics8/41.2/0.7Various combinations34/1345.3/21Left blank

[Choice of mood stabiliser for patient/themselves]

Factors influencing decision-making mapped onto cost, efficacy and side-effect profile (less than 4% other reasons). 66% (n=538) of respondents felt efficacy most important, 25% (n=202) felt side-effect profile most important and 3% (n=24) considered cost of most importance.

Conclusions

No clear difference exists in choice of mood stabiliser for European trainees and their patients, and decisions based on perceived efficacy are generally in keeping with established guidelines.
PW01-177 - Jumping To Conclusions In Psychotic Patients: A Comparison With Siblings And Healthy Controls
Authors: Barrigon M.L. , Rubio J.L. , Ruiz-Veguilla M. , Hernández L. , Ferrin M. , Salcedo M.D. , Moreno J.M. ,   Neurodevelopmental Psychiatry Research Uni
Published: June 2010

Objectives

To explore a cognitive bias-Jumping to Conclusions-in patients with schizophrenia and to compare with non-psychotic siblings and healthy controls by means of the Picture Decision Task (PDT).

Methods

42 patients with schizophrenia, 20 non-psychotic siblings and 77 healthy controls were compared in the PCT. This task consists of showing drawings of common objects that are displayed on a computer screen in decreasing degrees of fragmentation: new features are added in eight successive stages, until the entire object is eventually manifest. There are two kinds of trials (“cued” and “uncued”; that is, with and without interpretative clues). According to the responses, five parameters were calculated: Jumping To Conclusions at first stage-that is, with the very first drawing-(JTC-1), Plausibility Rating at first stage (PR-1), Draws To Decision (DTD), Time Response at first stage (TR-1) and Time Response for Draw to Decision (TR-DTD)

Results

In comparison with siblings and controls, more of the schizophrenia patients made a definitive decision at the first stage (represented by a significantly higher JTC-1), and they showed a higher Plausibility Rating (represented by a higher PR-1) than siblings and controls. For the uncued trials, patients needed fewer stages (a lower DTD) when making a decision than siblings (5.53±0.20 vs. 7.04±0.28; p=0.001) and controls (5.53±0.20 vs. 6.83±0.14; p=0.001).

Conclusions

These results suggest that patients make quick decisions with a high level of conviction and may manifest a data-gathering bias. Our results may indicate some degree of faulty appraisal and an inability to tolerate ambiguity when faced with decision-making.
PW01-192 - Development Of A Valid Early Improvement Threshold To Predict Response And Remission In Fes
Authors: Schennach-Wolff R. , Mayr A. , Seemüller F. , Jäger M. , Moeller H.-J. , Riedel M. ,   German Competence Network on Schizophrenia
Published: June 2010

Background

To test in first-episode schizophrenia (FES) patients whether early treatment improvement accurately predicts subsequent treatment outcome and to develop a valid definition for early improvement.

Methods

188 first episode schizophrenia inpatients were assessed with the Positive and Negative Syndrome Scale (PANSS) at admission and biweekly until discharge within a randomized, double-blind trial. 93 patients were treated with risperidone, 95 with haloperidol. Response was defined as a 40% improvement in PANSS total score from admission to discharge, remission according to the recently proposed consensus criteria and early improvement as an improvement in the PANSS total subscore after the second week. Receiver operator characteristic (ROC) analyses were used to evaluate predictive validity of early improvement and to find the most reasonable cutoff definition according to specificity and sensitivity. A confidence interval for the optimum cutoff was furthermore estimated.

Results

ROC analyses revealed reasonable predictability for response (AUC=0.707) and remission (AUC=0.692) concerning early improvement as a predictor for response/remission. No significant differences were found between the two treatment groups. Early improvement defined as a 46% PANSS total score reduction for response and a PANSS total score reduction of 50% for remission obtained the best results in terms of sensitivity and specificity.

Conclusion

We were able to confirm that early improvement is a valid predictor of subsequent treatment response and remission. FES patients should at least improve up to 30% in the PANSS total score at week 2 to achieve treatment response and remission.
PW01-194 - Cannabis Use And Non-Clinical Dimensions Of Psychosis In University Students Presenting To Primary Care
Authors: Skinner R. , Conlon L. , Gibbons D. , MacDonald C.
Published: June 2010

Objective

To explore the relationship between cannabis use and self-report dimensions of psychosis in a population of university students presenting for any reason to primary care.

Method

One thousand and forty-nine students attending the Student Health Unit, National University of Ireland, Galway, completed self-report questionnaires on alcohol and substance misuse, non-clinical dimensions of psychosis (Community Assessmemnt of Psychic Experiences), anxiety and depression (Hospital Anxiety and Depression Scale). Association of cannabis use with psychiatric symptoms was explored whilst controlling for confounds.

Results

More frequent cannabis use was independently associated with greater intensity of positive, negative and depressive psychotic symptoms. The earlier the age of onset of cannabis use, the more positive psychotic symptoms were reported.

Conclusion

These findings support the hypothesis that cannabis use increases the risk of developing psychotic symptoms and that this risk is further increased in those individuals who use cannabis more heavily and commence it at a younger age.
PW01-208 - Some Kind Of Social Conflict At Settlement After Disaster
Authors: Portnova A.
Published: June 2010

Objective

Investigation of general laws of formation of the social conflict among inhabitants of small settlements owing to extreme situations.

Methods

Social-psychological investigation for revealing interpersonal and intergroup (victims and nonvictims) conflicts among in townsfolk of Sydybyl (Yakutia) and Beslan (North Ossetia) after disaster with death of children.

Results

It was shown that the basic psychological need of persons who loss their relatives during a disaster is a search of guilty of tragedy. In consequence of this, occurs the stratification of society with apportionment of such groups as “victims” and “guilty”. The “victims” additionally mark out the group of “light victims” and accuse them of insufficient efforts to rescue of children of “victims”. It was suggested that the persistent search of guilty represents a form of psychological defense against the unbearable feeling of their own guilt towards died children. The universal (non-conditioned by ethnic or cultural factors) character of described phenomena was emphasized. It was marked that the social conflict (named by author as indigenous) deteriorates the social and economic consequences of disaster.

Conclusion

The indigenous conflict tends to persistence and passes the certain phases, final of which is characterized by a high level of neurotic diseases in the population and migration of an efficient part of the population.
PW01-213 - Evaluation Of Smoking Habits Among Lithuanian Adult Smokers In 2008, According To Gender, Age And Education
Authors: Adomaitienė V. , Dambrauskienė K. , Klumbienė J. , Veryga A. , Jaras A. , Vilkas V. , Taranda V.
Published: June 2010

Objective

The aim of the study was to evaluate smoking habits among Lithuanian adult smokers, according to gender, age and education.

Methods

The study analyses data from the Lithuanian adult population health behavior survey carried out in 2008. The national random sample of 3000 inhabitants aged 20-64 was taken from the National Population Register. The study material was collected through mailed questionnaires covering smoking habits, social status. In 2008 daily smokers were 38,8 % of Lithuanian adult men and 14,9 % of women.

Results

Daily smoking was least common in the oldest age group in both sexes. Indirect educational gradient was found among men. Among women, no association was observed between smoking and educational level.

Conclusions

Assessment of inequalities in smoking habits helps to identify subgroups of society that should have a priority of tobacco control policies.
PW01-221 - The Relationship Between Personality Traits And Anxiety/Depression Levels In Different Types Of Substance Abuse
Authors: Tatalovic Vorkapic S. , Dadic-Hero E. , Ruzic K.
Published: June 2010

To analyse the relationship between personality structure and emotional state of dyferent types of drug abusers, the objectives of this study were to examine: the levels of Eysenck's personality dimensions and the levels of anxiety and depression of heroin addicts and recreate drug users; the relationship between personality and emotion variables; and differences between those two groups of subjects concerning their personality traits and emotional state.

During their ambulatory admission, 288 (219 males and 69 females) patients were completed Eysenck's Personality Questionnaire (EPQ R/A) and Beck's Anxiety (BAI) and Depression Inventory (BDI). 191 of them were in the group of heroin addicts and 97 of them in the group of recreate drug users identified by the DSM-IV classification. Their averaged age was 22, ranged from 14 to 44.

Significantly higher levels of psychoticism, neuroticism, criminality and addiction, that were determined in the group of heroin addicts, were significantly correlated with the higher levels of anxiety and depression. Higher extraversion and social conformity were determined in the group of recreate drug users who still had dispositions to resist of developing the addiction problem. Finally, even great differences in personality structure were determined between heroin addicts and recreate drug users, and even higher depression was found in the first group, there was no significant difference in the anxiety level between those two groups. The findings implied at the used measurement instruments here as the useful diagnostic tool that could provide with advantageous treatment directions.
PW01-230 - [18F]Fallypride Pet Measurement Of Striatal And Extrastriatal Dopamine D2/3 Receptor Availability In Patients With Alcohol Use Disorder
Authors: Koller G. , La Fougere C. , Rominger A. , Holdtschmidt-Täschner B. , Soyka M. , Cumming P. , Bartenstein P. , Pogarell O.
Published: June 2010

Aim

Dopaminergic pathways are implicated in motivational aspects of substance use disorders, and might contribute to withdrawal phenomena, as well as an increased long-term risk of relapse. Molecular imaging with positron emission tomography (PET) revealed reductions in the availability of binding sites for D2/3receptor ligands in striatum of withdrawn abusers of cocaine; corresponding results in alcoholics have been inconsistent so far. In the present study, we used the D2/3ligand [18F]fallypride to investigate dynamic changes in receptor availability in the striatum of patients with alcohol use disorder before and after undergoing a detoxification protocol.

Methods

18 male patients (mean age 44±5.3y) with alcohol use disorder were recruited and scanned with 180MBq [18F]fallypride upon hospital admission, and again 1-2 weeks later after detoxification. The control group consisted of 10 age-matched healthy volunteers. PET acquisition time was 180min, consisting of 39 frames of increasing duration. Within each group binding potentials (BPND) were calculated in the striatum using the cerebellum as reference.

Results

In the patients, the mean BPND in whole striatum was 17.2±4.2 at baseline, with a trend towards a decline at follow-up. In addition there were inverse correlations of BPNDwith age (r-0.45) and with daily alcohol consumption (r-0.2). The age-dependence of BPNDwas less pronounced in healthy controls. However, mean striatal BPNDwas only slightly lower in the patient group. No pronounced group differences were evident for extrastriatal [18F]fallypride binding.

Conclusions

Regressions with age suggest an accelerated loss of dopamine D2/3 receptors in the striatum of subjects with alcohol use disorder.
PW01-237 - Low-Dosage Topiramate In Alcohol Dependence: A Randomized, Double-Blind, Placebo-Controlled Trial
Authors: Martinotti G. , Di Nicola M. , De Vita O. , Tedeschi D. , Guerriero L. , Guglielmo R. , De Filippis R. , Janiri L.
Published: June 2010

Introduction

Topiramate (up to 300 mg per day) is more efficacious than placebo as an adjunct to standardised medication compliance management in treatment of alcohol dependence. However, adverse events can limit its use in different clinical situation. In this randomised, double-blind, placebo controlled trial we aimed to investigate the efficacy of low-dosage topiramate on alcohol drinking indices. Craving and psychiatric symptoms improvements were the secondary endpoints.

Methods

Forty alcohol dependent subjects where detoxified and subsequently randomised into two groups, respectively receiving topiramate (100mg/die) or Placebo. The level of craving for alcohol was evaluated by a 10-cm Visual Analogue Scale (VAS) and the Italian -version of the Obsessive and Compulsive Drinking Scale (OCDS). Psychiatric symptomatology was evaluated by the Symptom Check List 90 Revised (SCL-90 R).

Results

The improvement of alcohol drinking indices and craving scores was higher in the topiramate group than placebo. The survival function showed that patients treated with topiramate remained abstinent from any alcohol amount for a longer time with respect to placebo (Z= -2.197; P< 0.05). The SCL-90-R general index of “Positive Symptom Total” significantly reduced in the topiramate group (F= 3.41, p< 0.05). The number of patients dropped-out from the study for adverse events was not different between groups.

Discussion

To our knowledge, this is the first randomised, parallel group trial to evaluate the efficacy of topiramate at low dosage for alcohol dependence. The use of topiramate at low dosage could increase the number of subjects in treatment, given the reduced possibility of adverse events.
PW01-240 - Rate Of Alcohol And Substance Use Disorders Among The Journalists In Erbil City
Authors: Rahim T.
Published: June 2010

Objectives

A number of studies have shown variations in the rate of alcohol and substance use disorders among different occupations, but no study till now stressed on such a variation in Iraq. The present study aimed to study variations in the rate of alcohol and substance use disorders between journalists and some other occupations in Erbil city.

Methods

200 journalists and 486 of other professionals were interviewed between the period of September to November 2008 by a structured interview (M.I.N.I.) for the detection of alcohol and substance use disorders.

Results

Among the journalists, 34.5% were alcohol dependents, 7.5% were alcohol abusers, 1% was substance dependent, and another 1% was substance abuser. Among the non-journalists, 7.6% were alcohol dependents, 2.26% were alcohol abusers, 1.44% was substance dependents, and 1.02% was substance abusers. Most of the substances, other than alcohol, used by both groups were the prescription pills. 50% of journalists and 75% of non-journalists, who were either substance dependents or abusers, were alcohol dependents or abusers at the same time. Male gender and those who achieve higher educational levels were more affected in both groups.

Conclusion

The present study concluded that occupation is an important determinant for alcohol and substance use disorders in Iraq. Working as a journalist, is a risk factor particularly for alcohol dependence. Gender is an important determinant within each occupation as well.
PW01-252 - Association Between Orexin, Leptin and Craving For Nicotine
Authors: von der Goltz C. , Koopmann A. , Dinter C. , Grosshans M. , Wiedemann K. , Kiefer F.
Published: June 2010

Although the majority of studies associated the function of orexin neurons with arousal and sleep and leptin with balancing energy expenditure and food craving these neuropeptides were also shown to directly affect dopaminergic transmission in mesolimbic reward pathways. This indicates a possible role for orexin and leptin in reward function and motivation and thus in addictive diseases. Aim of our study was to test whether both peptides are involved in nicotine craving in a standardized setting. We studied orexin and leptin plasma concentrations (RIA) in tobacco smokers (n = 60) compared to healthy controls (n = 64). In smoking subjects we assessed craving for nicotine applying the Questionnaire of Smoking Urges (QSU) after three hours of withdrawal from nicotine. As main results we found a significant negative correlation between orexin plasma concentration and nicotine craving (r = -0.28; p < .05) and a positive association between nicotine craving and leptin (r = 0.29; p < .05). Our results show a bidirectional association between craving for nicotine and plasma concentrations of orexin and leptin suggesting that both neuropeptides may be regulators for the dopaminergic transmission in nicotine withdrawal and, thus, modulators for craving for nicotine.
PW01-258 - Electrodermal Hyporeactivity is a Valid Theoretical and Clinical Platform in Suicidology and Suicide Prevention
Authors: Thorell L.-H.
Published: June 2010

Recent findings in 345 depressive patients and 89 healthy subjects from three international independent laboratories and hospitals offer clear and consistent information that possesses strong explanatory potentials for suicidal behaviour with death intent and for clinical use in suicide risk assessment and therapeutic intervention. Its extraordinary high sensitivity (97%) and specificity (93%) for suicide and the extraordinary highly significant relationship with operationally defined suicidal propensity (p= 8.3 x 10-17 and p= 6.1 x 10-20), its consistency over a row of published studies and its independence of serotonin, depression rating scores, antidepressive medication and other relevant variables makes the measurement of electrodermal hyporeactivity in an specifically designed acoustic habituation test a useful clinical tool for suicide risk detection as an important complement to the clinical suicide risk assessment.

Its theoretical links over specific brain structures to indifference towards everyday life (indifference vulnerability for suicide) and known cognitive dysfunctions like overgeneralized autobiographic memory offers a new psychobiological platform for theoretical work and support for cognitive therapeutic interventions in depressed and euthymic patients for preventive and possibly cure of suicidal propensity, beside known and possible biological treatment methods. Thorell's Hyporeactivity Theory is compared to other models and theories of suicide.

Some parts of the presentation are extracted from Thorell LH (2009): Valid electrodermal hyporeactivity for depressive suicidal propensity offers links to cognitive theory, Acta Psychiatrica Scandinavica, May;119(5):338-349.
PW01-260 - Depression During Pregnancy: Comparison Between Pregnant Depressed Women and Non Pregnant Depressed Women
Authors: Borri C. , Mauri M. , Banti S. , Rambelli C. , Ramacciotti D. , Oppo A. , Montagnani M.S. , Camilleri V. , Cortopassi S. , Cianelli E. , Ciberti A. , Giorgi Mariani M. , Cassano G.B.
Published: June 2010

Object

Depression during pregnancy is associated to physical symptoms that can impair the functioning of women; furthermore some of the depression somatic symptoms (i.e., sleep disturbance, fatigue, weight change and appetite) are also features of pregnancy. The overlap of symptomatology can interfere with the identification and the diagnosis of the mood episode. Aim of this study is to compare the the depressive phenomenology and the presence of Axis I comorbidity between pregnant and non pregnant depressed women.

Method

We diagnosed Major Depression (MD) using the Structured Clinical Interview for Axis I Diagnosis DSM IV (SCID I) in 32 pregnant women at third month of pregnancy and 87 non pregnant women and we compared the depressive phenomenology in the two groups. Then we administered the Mood Spectrum Self Repost Last Month (MOOD SR-LM) in the two group in order to study the mood spectrum symptomatology.

Results

Pregnant depressed women have higher psychomotor retardation, higher levels of concentration and lower agitation than non pregnant depressed women.

The severity of depression symptoms was similar in the two depressed groups.

Conclusion

Our results agree with current litterature about the presence of psychomotor retardation in depressed pregnant women.

The higher level of concentration in pregnant women could be explained by the high comorbidity with Generalized Anxiety Disorder (GAD). In the pregnant depressed women the Obsessive-Compulsive Disorder (OCD) and Panic Disorder (PD) comorbidity are more rappresentated.
SS01-02 - Early Symptom Relief For Superior Outcome Of Depression
Authors: Rouillon F.
Published: June 2010

Successful management of major depressive disorder (MDD) requires antidepressant efficacy at each stage of treatment: rapid improvement of the symptoms in the acute phase, good quality remission in the continuation phase, leading to complete recovery in the maintenance phase. The early improvement of symptoms during the acute phase is predictive of chances of remission, as well as better long-term compliance and reduced risk of suicide.

Agomelatine is the first melatonergic antidepressant acting as a melatonergic MT1 and MT2 receptor agonist and as a 5-HT2C receptor antagonist. Its efficacy in the acute phase of treatment was examined in 4 short-term studies: 1) two 6-week, randomized, double-blind studies comparing agomelatine (25-50 mg/d) with venlafaxine (75-150 mg/d), (2) a 6-week comparison study of agomelatine (25-50 mg/d) with sertraline (50-100 mg/d), and (3) an 8-week comparison with fluoxetine (20-40 mg/d) in patients with severe depression.

After 1 week of treatment, agomelatine was significantly more effective than venlafaxine on the following parameters: CGI-I (total score and response rate), daytime alertness, feeling good, getting to sleep, and quality of sleep. After 2 weeks, using HAM-D, there were twice as many responders to agomelatine as to sertraline. After 6 weeks of treatment, these differences in favor of agomelatine were maintained. After 8 weeks, agomelatine showed superior antidepressant efficacy on HAM-D total score and CGI-I over fluoxetine in treating patients with severe episodes. These convergent results make agomelatine a promising antidepressant for improving all stages of MDD and ultimately helping more patients to achieve complete and sustained remission.
SS01-03 - More Complete And Sustained Remission: The Key To Success In Depression
Authors: Kennedy S.H.
Published: June 2010

After the initial response, the next goal is to ensure sustained remission with normal functioning and minimal residual depressive symptoms. During this phase, continued adherence to treatment is needed, which is easier if the patient perceives improvement and tolerates the treatment well. The efficacy of agomelatine, the first melatonergic antidepressant with an innovative mode of action, has been assessed in the long term in 4 studies:

(1)

the 18-week extension phases of two short-term studies comparing agomelatine (25-50 mg/d) with venlafaxine (75-150 mg/d),

(2)

a similar extension phase after 6 weeks of treatment versus sertraline 50-100 mg/d, and

(3)

a specific 10-month placebo-controlled relapse prevention study.

At 6 months, more patients responded to treatment with agomelatine either in term of improvement in CGI-I scores as compared to venlafaxine (P< 0.05), or in terms of response rate on the HAM-D as compared to sertraline (P< 0.05). Agomelatine therefore appears to produce in more patients a relief of depressive symptoms than either SNRIs or SSRIs.

A meta-analysis showed that a higher percentage of agomelatine-treated patients completed the extension period of 6 months as compared with venlafaxine or sertraline suggesting that clinical improvement induced by agomelatine lead to a better compliance to treatment.

The antidepressant efficacy of agomelatine is maintained in the long term, as demonstrated by the prevention of risk of relapse by 56.3% versus placebo over a 10-month treatment period (p< 0.0001).

All these features make agomelatine, the option to consider for achieving a full recovery from major depressive disorder.
SOA01-01 - Towards A Personalised Treatment Of Alcoholism In Europe
Authors: Mann K.
Published: June 2010

Treatment for alcohol dependent patients represents a largely unmet challenge in psychiatry and psychotherapy. Less than 10% of individuals in need are actually receiving treatment, fewer than in any other field of psychiatry (Kohn et al., 2004). Evidence-based psychotherapy and pharmacotherapy is available and will be reviewed (incl. the United Kingdom Alcohol Treatment Trial UKATT and the COMBINE Study). In general, effect sizes are low and lag behind success rates in fields such as smoking cessation. The main reason is the heterogeneity of patients being offered rather specific treatments in conventional RCTs. While some patients may clearly benefit others may not and some even get worse, making means of results rather meaningless.

Early attempts to introduce “personalised” treatment into the psychotherapy of alcoholism failed (Project MATCH). Current approaches use several domains for the sub-classification of patients such as psychopathology, genetics, neuroimaging, neuropsychology etc. (Mann et al., 2009). A new RCT (PREDICT Study) did not show a significant difference between naltrexone, acamprosate and placebo. However, by using f-MRI cue reactivity, genetics and psychopathology more homogeneous subgroups of patients could be defined. In these subgroups significant differences for naltrexone over placebo were found.

Personalized treatment seems to be a promising approach in alcoholism therapy. It may help to improve results considerable and thus create more motivation and hope in patients as well as in psychiatrists.
YSW01-03 - A Home Telepsychiatry In Arizona And Alaska (Usa)
Authors: Schwager H.A.
Published: June 2010

Today's use of internet technology brings with it “cost effectiveness” for Tele-psychiatry applications. Today, with a relatively current laptop computer, a web-cam, broadband connectivity (128 kbs or faster), and a free downloadable, secure video conference application, makes this technology available literally and virtually everywhere, anywhere, and at any time. We provide individual assessment, medication management, psychotherapy services and a unique “Co-Therapy” model in the treatment of Opoid Dependence. Study patients are located throughout the states of Arizona, and Alaska. Availability of broadband connectivity is the only limiting factor to access.We have compared the effectiveness of “Home-Telepsychiatry”, to more traditional “office based” Tele-Psychiatry over 8 years with 800 Home Telepsychiatry cases, and 1200 Office based cases. There is a clear patient preference for the Home-Telepsychiatry model. Compliance is dramatically improved as is the no-show statistic dramatically decreased. Outcome data clearly favors the Home-Telepsychiatry model.Mentally ill patients favor treatment provided in “their private space”. Providers learn more about their patients when we are a “guest” in the patient's home. Access to “patient support providers”, spouses, parents etc. is easy and more valuable using Home-Telepsychiatry.
YPSP01-10 - Blood Cholesterol And Serum Creatine Kinase Levels In Violent Psychiatric Patients
Authors: Reznik I. , Kertzman S. , Grinspan H. , Birger M. , Shlapnikov N. , Kotler M. , Meltzer H.
Published: June 2010

Objectives

Individuals with severe mental illness display significantly higher rates of violence than general population. In previous reports, violent behavior was found associated with mean serum creatine kinase activity (MSCK) and with reduced levels of total blood cholesterol (LTBC). The aim of study was to assess an association between MSCK and LTBC in two groups of male violent forensic psychiatric offenders.

Methods

The study population was 256 offenders from the closed ward, of whom 214 were schizophrenia patients and 42 were patients with personality disorders. The prevalence of murderers was 21.7% in the schizophrenia group and 21.3% in the group with personality disorders.

Results

Schizophrenia patients had significantly higher MSCK and LDH levels then subjects with personality disorders. There were no significant between-groups differences on other biological parameters. No significant differences on these parameters were found between murderers and nonmurderers in both groups. In the overall sample, significant negative correlation was found between MSCK activity and total cholesterol levels. Similar correlation pattern was found in the schizophrenia group, but not in subjects with personality disorders.

Conclusions

The results show for the first time identifiable MSCK/LTBC pattern in violent schizophrenia patients but not in subjects with personality disorders. It is possible that different character of association between MSCK and LTBC in two groups of violent forensic psychiatric offenders (schizophrenia patients vs. subjects with personality disorders) reflects different biological origins of violent behavior. Further investigation of described MSCK/LTBC pattern in larger population of forensic and non-forensic, psychiatric and non-psychiatric subjects, is warranted.
YPSP01-11 - “Am I just paranoid?!”: a study about psychiatric contaminations on colloquial language
Authors: Ferrari S. , Menozzi M. , Piemonte C. , Pontoni G. , Masoni L. , Rigatelli M.
Published: June 2010

Objectives

Common language is a mirror of culture and society. Death and mental illness are the human deepest and most ancient taboos, which both patients and professionals have to face in the medical world. Psychiatry has strong and circular connections with culture and society. The aim of this work was to collect and analyze expressions in colloquial language originally derived from psychiatric technical terminology.

Methods

A hundred and ten fifth-year medical students (M/F% = 42/58; mean age = 23.5 ± 3.1) attending their semester in psychiatry were asked to list as many expressions as possible of their everyday colloquial use which they thought referred to psychiatry. The terms were collected and analyzed critically.

Results

A list of 150 espressions was drawn and then classified in the following categories: technical psychiatric terms; medical-neurological terms; psycoanalytic references; terms referring to abnormality and need for care; irrelevant terms. Though an overall good level of pertinence in the use of technical psychiatric terms was observed, these usually refer to common situations, both individual and happening to others. Often these locutions are used as jokes or offences.

Conclusion

Due to fears and prejudices evoked by psychiatric themes, an attempt on exorcising and taking distance leads to the use of psychiatric terms as potentially offensive and despising. This work suggests the need to work - especially in training settings - on filling the gap between common and medical languages and to analyze critically the contaminations as suggestive of very relevant cultural issues.
Rhinosporidiosis of the upper airways and trachea
Authors: Madana J , Yolmo D , Gopalakrishnan S , Saxena S Kumar
Published: June 2010

Objective:

We report an extremely rare case of rhinosporidiosis with involvement of both larynx and trachea, together with coexisting nasal, nasopharyngeal and oropharyngeal lesions, in a 32-year-old man.

Method:

Case report and review of the world literature concerning laryngotracheal and disseminated rhinosporidiosis.

Results:

A 32-year-old, South Indian man presented with a nasal mass of four years' duration, with progressive hoarseness for one year. Strawberry-like rhinosporidial masses were seen in both nasal cavities. Fibre-optic laryngoscopic examination revealed reddish masses with whitish surface specks, involving the glottis, subglottis and trachea. Computed tomography revealed soft tissue opacities involving both nasal cavities and the nasopharynx and extending to the oropharynx, with involvement of the larynx and trachea. Direct laryngoscopy and rigid bronchoscopy guided excision of the laryngeal and tracheal lesions was performed.

Conclusion:

Rhinosporidiosis is a chronic, granulomatous disease which usually affects the mucous membranes of the nose and nasopharynx. Lower dissemination into the trachea is extremely rare. Laryngotracheal involvement poses many diagnostic and therapeutic challenges, due to the potential risk of bleeding and aspiration. In the presented case, local spread of rhinosporidiosis, due to direct spillage of spores from the nasopharynx into the larynx during episodes of bleeding or previous surgery, may have resulted in laryngotracheal involvement, although systemic spread cannot be excluded.