bluuebunny/crossref_metadata_2025 huggingface dataset:
P01-335 - Interconfessional Analysis of Alcohol use and Related Problems: the Christians and Muslims
Authors: Osain Welcome M. , Alekseevic Pereverzev V.
Published: June 2010

Objectives

The influence of religion on the rate of alcohol use can not be overemphasized. In recent times, some studies have suggested that the inter-religion differences in alcohol use might be fading away. And that closer relationship might exist between the Christian and Muslim societies, especially in a population where alcohol use has become part of the life of people. We analyzed the prevalence of alcohol use and related problems among Muslims and Christians in Minsk, Belarus.

Methods

After the aims and objectives had been explained, 65 Christians and 70 Muslims agreed to participate in the anonymous and randomized study which was conducted among students at major four universities in Minsk, Belarus. All respondents were administered the AUDIT, CAGE and MAST questionnaire. Statistical analysis was performed using SPSS 16.0 version for Windows and the Pearson χ2.

Results

The present study revealed that no differences in both the number of alcohol users and problem drinkers exist (according to the results of all three screening instruments) among the Christians and Muslims. Alcohol users were 67.7% Christians and 57.1% Muslims. Problem drinkers were 27.7 Christians and 34.3% Muslims.

Conclusion

This study is an exceptional one where for both Christians and Muslims, the percentages (as well as the average scores) of alcohol users and problem drinkers were the same on the AUDIT, CAGE and MAST.
P01-337 - The Slavs and Arabs: Verifying the Ledermann Pyramidal Hypothesis of Alcohol use Distribution in Belarus
Authors: Osain Welcome M. , Alekseevic Pereverzev V.
Published: June 2010

Introduction

In 1956 Ledermann Sully suggested a hypothesis of alcohol use - the pyramidal hypothesis of alcohol use distribution. According to this hypothesis, the increase in social alcohol users in a given society leads to a disproportional increase in percentages of heavy users. In the same way, decrease in the number of social drinkers will have the greatest effect on heavy drinkers. In most western countries, where there are high percentages of heavy drinkers, the pyramid is broad. While in Asian countries where there are fewer heavy drinkers the pyramid is a narrow one. The pattern of alcohol use according to the Ledermann hypothesis among various ethnicities - Slavs, Arabians and Nigerians in Minsk, Belarus were examined.

Materials and methods

1345 Slavs, 120 Arabians and 44 Nigerians in Minsk were administered questionnaire containing the AUDIT and other alcohol related questions. On the AUDIT, a score of 1-7 defines social drinkers; 8-19 - heavy drinkers; 20-40 - alcohol dependence.

Results and discussion

Social drinkers, alcohol abusers and people with alcohol dependence in the general Belarusian population were Slavs - 74.8%, 13.8%, 2.5% respectively; Arabians - 29.2%, 20.8%, 10.8% respectively; Nigerians - 30.8%, 11.5%, 3.8% respectively. According to the Ledermann hypothesis, this study shows that the pattern of alcohol use by Arabs could be denoted with a narrow pyramid (pattern of alcohol use in most Asian countries) and a broad pyramid (pattern of alcohol use in most western countries) for both Slavs and Nigerians.
P01-343 - Cultural Variations in the Idioms of Distress in Migrants in the Netherlands
Authors: van Loon P.
Published: June 2010

The Department of Transcultural Psychiatry & Psychotherapy has built up expertise in the diagnosis of psychiatric disorders since its inception 25 years ago. More than 50% of the population of Rotterdam was born outside The Netherlands or has one or both parents from outside The Netherlands. Some examples of idioms of distress based upon practice in the Department will be described.

The effect of globalization on the idiom of distress will also be reviewed. Careful and culturally sensitive diagnostic classification is essential in providing optimal care for this large group.
P01-344 - Help Seeking Behaviour of Chinese Living in Belfast, Northern Ireland
Authors: Yeung E.Y.-W.
Published: June 2010

Background

The Chinese community is the largest ethnic minority community in Northern Ireland. Previous research findings showed that they had a low uptake of mental health services.

Aim

This study aims to examine the help seeking behaviours of Chinese people when they experience mental illness.

Methods

About 96% of Chinese in Northern Ireland worked in catering business. Questionnaires (both in Chinese and English) were sent to ninety-one addresses occupied by catering businesses in Belfast. Focus group meetings were held with mental health workers and community leaders.

Findings

Twenty-four questionnaires were returned. 66.6% reported that they visited their GPs the previous year. Only one person visited the GP for a mental / psychological problem. Poor recognition of mental illness (41.7%) and mental illness stigma (25%) were the main reasons for not seeking professional advice.

Focus group meetings revealed that most Chinese people who came into contact with mental health professionals had severe mental health problems. 40% of their Chinese patients were referred by hospitals, 30% by GPs and another 30% by mental health workers.The community generally had little knowledge about mental illness, which often resulted in delay in seeking appropriate professional help.

Conclusion: Findings revealed that the Chinese do seek help from their GPs but may not see their doctors when they or someone they know actually become mentally unwell. Further investigation is needed to explore different ways to provide information about mental illness symptoms and mental health services for the community.
P01-349 - Apathy in the Spectrum Dementia-Depression
Authors: Da Ponte G. , Paiva A. , Lobo M. , Mendes S. , Fernandes S.
Published: June 2010

Objectives

To alert to apathy as a sub-syndrome in the spectrum dementia-depression.

Methods

Review of literature relevant in medline database.

Results

The modern concept of apathy implies a reduced volition. Apathy may occur in depression and dementia and the differential diagnosis is difficult. Symptoms of apathy may constitute a sub-syndrome in the spectrum depression-dementia, that are characterized by lack of interest, psychomotor retardation, loss of energy and loss of appetite. Apathy may occur in dementia without depression and is significantly associated with more severe cognitive deficits. In dementia, depression may primarily result from a combination of symptoms of anxiety and apathy. Most patients with dementia and apathy had concomitant depression, but less depressed patients had concomitant apathy. The key to diagnosis may be the mood symptoms: dysthymia could be a negative emotional reaction to the progressive cognitive decline in dementia, whereas major depression could more strongly related to biological factors.

Conclusions

The nosological position of apathy remains obscure, with some studies suggesting that apathy and depression are independent constructs, and other studies showing a significant overlap between apathy and depression. The major interest to the type of syndrome has therapeutics implications.
P01-350 - Mania Like Symptoms in Frontotemporal Dementia
Authors: Da Ponte G. , Paiva A. , Lobo M. , Mendes S. , Fernandes S.
Published: June 2010

Objectives

To alert to manic like symptoms in frontotemporal dementia (FTD).

Methods

Review of literature relevant in medline database.

Results

Frontotemporal dementia (FTD) is a behavioural syndrome caused by generation of the frontal and anterior temporal lobes.

Bipolar disorder in dementia and the temporal relation between the two conditions have rarely been studied. There is a increased probability of developing a manic episode in patients with dementia.

Those with temporal FTD have impairments in emotional processing and hypomania like behavior. Moria (childish excitement or tendency to joke) or frivolous excitement are common presenting symptoms, and is difficult to distinguish to features in bipolar disease.

The correlation between mania like symptoms and FTD can be make with the help of informations of the family and computed tomography imaging. Those with temporal involvement are particularly at risk of developing deficits in emotional processing secondary to atrophy in the amygdale, anterior temporal cortex, and adjacent orbitofrontal cortex.

Conclusions

Early temporal involvement in FTD is associated with frivolous behavior and right temporal involvement is associated with emotional disturbances.

Moria or frivolous behavior are common presenting symptoms of FTD and the differential diagnosis is made with the help of informant's reports and computed tomography imaging.
P01-351 - A Review of Involuntary Admissions to a Psychiatry of Old Age Specialist Unit
Authors: Davoren M. , Wrigley M.
Published: June 2010

Objectives

In this review we examined the involuntary admissions to a purpose-built Psychiatry of Old Age (POA) specialist unit under the care of the North Dublin Psychiatry Of Old Age Service, Dublin, Ireland.

Our objectives were to examine the source of referral, progress in hospital and outcomes of all involuntary admissions, under the Irish Mental Health Act, to this Psychiatry of Old Age specialist inpatient unit over a one year period. All patients were divided into two groups, those who were diagnosed with Dementia and those patients who had a functional mental illness. We specifically examined the characteristics of both groups to identify any differences their outcomes.

Methods

A retrospective chart review of all involuntary admissions over a one year period from January 1st 2008 to December 31st 2008 was conducted.

Results

67% of all admissions to the Psychiatry of Old Age unit during 2008 were involuntary admissions. The detained patients were mostly male (71.4%).

The most common diagnoses were Alzheimer's Dementia (38.1%), Dementia Mixed Aetiology (14.3%) and Psychotic Illness (14.3%).

88.2% of Patients who had a diagnosis of Dementia required Long Term Care at the end of their admission, but only 25% of those patients who had a Functional Mental Illness were transferred for Long Term Care at discharge.

Conclusions

Patients with dementia had significantly longer involuntary admissions than patients with affective or psychotic disorders. Patients with dementia were also more likely to require long-term care on discharge than those patients who did not have dementia.
P01-352 - Schizophrenia-like Alcoholic Dementia or Dementia Praecox? Case Report
Authors: Fonseca L. , Duarte J. , Simões S.
Published: June 2010

Introduction

A clear distinction between schizophrenia and some clusters of dementia is sometimes difficult to do in clinical practice.

Case report

A 38-years-old-male patient, with history of alcohol dependence, was admitted in our unit for generalized tremor, sweating, agitation, auditive, visual and cenestesic hallucinations, thought broadcasting and persecutory delusion. Agitation and the vegetative symptoms gradually subsided within 48 hours. Lab work showed no clinically significant changes. EEG and EKG were normal. MRI showed augmented cortical encephalic sulci. 5 days after the admission 10 mg of olanzapine was prescribed due to psychotic symptoms persistence. Haloperidol was stopped. A gradually improvement occurred and 26 days after the admission the patient was discharged home asymptomatic. Neuropsychological testing revealed severe fronto-temporal cognitive defect suggestive of alcoholic dementia.

Discussion

The difficulty to clearly distinct schizophrenia from some dementias may be because, as Kraepelin stated in the 19th century, schizophrenia is itself a form of early dementia. His concept of dementia praecox is supported nowadays by the knowledge acquired from several neuropsychological and neuroimaging tests that a progressive cognitive deterioration appears to occur in schizophrenic patients.
P01-354 - The Relations Between Psychosocial Factors, Care Burden and Depression on the Dementia Family Caregivers
Authors: Guerrero-Martin J. , Chaudri A. , Muñoz F. , Durán N. , Ezquerro A. , Suero P.
Published: June 2010

Objectives

To describe the relation of psychosocial factors of care (phase illness, years of care, free time, extra help and symptoms of depression) influence the care burden of dementia family caregivers. To measure the relation of the level of depressive symptoms on an intense level of burden of the dementia family caregivers.

Methods

Is selected a sample of 102 primary caregivers by criteria of inclusion to which a surveys do to those that the following information gathered: sociodemographic dates of the caregivers and of the dementia patients, care burden (Zarit Interview) and depressive symptoms (Beck Depression Inventory) of the family caregivers.

Results

Most of the sample experiences an intense burden level (74%) opposite to a light level (26%). Psychosocial characteristics are as per statistics significant in increasing the care burden there were free time, extra help and presence of symptoms of depression. Presence of serious symptoms of depression on the intense burden level are differently front or those who had a minor burden, 22% and 5% respectively.

Conclusions

There are most of the daughter-father/mother and spouse-spouse caregiver couples with a high percentage of caregivers of feminine sex (as in most of the studies realized on caregiver of dependent persons at European and international level). The need for free time and psychic self-care are cost-effective strategies to prevent the depressive disorders, as well as, to improve their caregiver's work. The psychoeducation programs that have being realized at European level directed to family caregiver are necessary in our country.
P01-357 - Temporal Relationship of Depression, Cognitive Impairment and Dementia in Older Persons
Authors: Ladea M. , Sinca C.M.
Published: June 2010

Objective

There is a growing appreciation that depression may be a presenting syndrome of dementia.

This study intends to show that the presence of cognitive impairment in a depressive episode in older people may have important prognostic implications in developing dementia.

Methods

In this study a first group of 17 depressed patients with mild cognitive impairment (MMSE over 26) was compared with a second group of 18 depressed patients with mild to moderate cognitive impairment (MMSE bellow 26). The mean age for both groups was 68. The depression was measured using the MADRS scale. All the patients included were severely depressed at the inclusion. Both groups showed important improvement of the depressive episode, following the treatment with antidepressants (escitalopramum, sertralinum, venlafaxinum).

Both groups were followed for 2 years after the depression resolution.

Results

In the first group of patients the MMSE was 26 at baseline and 26 or over at discharge.

In the second group of patients the score of MMSE had a value of minimum 17 at baseline and a maximum of 26 at discharge.

Five patients (three in the first group and two into second group) did not complete the 2 years follow up period.

Over the period of 2 years, 37% of patients from the second group developed a dementia, comparing with only 14% of the patients from the first group.

Conclusions

After 2 years, the patients with depression and significant cognitive impairment had twice the risk of developing dementia as those who had only depression.
P01-359 - Overall Quality of Life Among Spanish Patients with Mild Cognitive Impairment and Dementia
Authors: Lucas Carrasco R. , March J.
Published: June 2010

Objectives

Doing there is no consensus for a multidimensional definition of Quality of Life (QoL) in dementia, and that informant- and self-perceptions of QoL differed substantially, lately it has been proposed to analyze Overall QoL using a simple item. Our objective was to investigate Overall QoL and how this perception among people with Cognitive Impairment and Dementia is associated with other variables. Thus, obtained predictor variables of QoL will act as confirmatory indexes to corroborate the self-reported QoL in clinical setting.

Methods

We conducted a cross-sectional survey where 106 participants with Cognitive Impairment (CI) and Dementia completed a face to face interview including diagnosis of dementia (DSM-III-R / DSM-IV), sociodemographic information, health perception and a list of chronic medical conditions, depressive symptoms (GDS-15) and functional ability (Barthel Index). Quality of life was measured with the self-assessment of overall QoL item from WHOQOL-BREF.

Results

Mean age was 78.7 y.o. (SD: 7.1, range 55-91); 64.8% were female and 50% had primary school or more. Ordinal Logistic Regression analysis showed four factors correlated with a better QoL: (1) patients rating their health as good or more than good, (2) patients considering themselves healthy, (3) patients reporting not having depression, and (4) patients having less depressive symptoms (lower GDS scores).

Conclusions

A single-item global rating of patient QoL could prove useful in assessing QoL of most mild-to-moderate-stage CI and dementia patients. Affective states should be considered when assessing QoL in patients with CI and dementia; consistently, negative mood have a detrimental impact on QoL.
P01-360 - Training in Cognitive Reasoning for Elders: is More Better?
Authors: Hohaus L. , Weekes A.
Published: June 2010

Objectives

Increasing evidence suggests that training in complex reasoning skills may delay the onset of cognitive impairment. A key challenge is to develop cost effective brief interventions which lead to optimal performance.

Aims

Hence the major aims of this research were to examine the benefits of a brief intervention for elders, and to compare any improvements with those achieved after more training is provided.

Methods

A fully randomised controlled trial was conducted with 30 healthy older adults (M = 64 years) Participants completed measures of the WASI Matrix Reasoning subtest before and after the brief intervention, and again after the extended intervention. Those allocated to training were asked to complete a two week program of sudoku problems of increasing difficulty using tactics demonstrated in guidelines provided. This was followed by an advanced suduko program with harder problems and more sophisticated tactics.

Results

A 2 × 3 (Training × Time) mixed ANOVA on WASI scores was conducted. This showed a significant interaction between Training and Time (F(2,56) = 4.18, p< .05, partial eta squared = .13). Further ANOVAs were conducted to examine this interaction. These showed that the training group improved over time but that the control group did not. Furthermore the training group improved significantly after the brief intervention, and improved more after the extended intervention.

Conclusions

A brief two week training program in suduko enhanced cognitive reasoning in older adults as assessed by the WASI reasoning subtest. A further two week advanced program in suduko further improved cognitive reasoning.
P01-367 - Vitamin D Deficiency in Elderly Psychiatric Patients: First Results
Authors: Gaasbeek B. , Marijnissen R. , Havers H. , Kaassenbrood A.
Published: June 2010

Background

Elderly people are likely to have inadequate storage of vitamin D. Physical consequences may include pain, loss of bone tissue, decrease of muscle power, increase of fall risk and fractures. Also, among women an association of low vitamin D levels and a higher incidence of mood disorders has been reported.Prevalence of vitamin D deficiency is highest among institutionalized elderly. Elderly psychiatric patients could be at increased risk because of inadequate diet, polypharmacy, diseases that interfere with vitamin D metabolism and less exposure to sunlight due to homeboundness.In July 2008 we started a study on a clinical department of geriatricpsychiatry ward with the aim to establish the nutritional and vitamin status (including vitamin D) at and during admission.

Methods

All patients admitted to the clinical department of geriatric psychiatry of De Gelderse Roos Mental Health Care Institute (Arnhem, The Netherlands) were included.

Results

During six months (July 2008-January 2009) the vitamin D level was established in 50 patients. At admission a vitamin D deficiency was found in 40 patients (80%).

Conclusion and discussion

Because vitamin D deficiency could have serious implications, both physical and psychiatric, we recommend routine assessment of vitamin D levels at psychiatric admission. If found too low, supplementation needs to be considered. In further research we will establish whether there is an association between vitamin D deficiency and the occurrence of psychiatric disorders. Also we will investigate if non-deficient patients at admission develop deficiency during admission.
P01-374 - Needs of the Elderly in Polish and German Rehabilitation Centers
Authors: Rymaszewska J. , Mazurek J. , von Renteln-Kruse W.
Published: June 2010

Aim

Needs of the elderly are complex and difficult to identify since connected with many different dimensions. The aim was to identify met and unmet needs of patients referred to old age rehabilitation services in Poland (Wroclaw-Wr) and Germany (Hamburg-Ha).

Methods

Patients (n=80) over the age of 60 were assessed using the Camberwell Assessment of Need for the Elderly (CANE), Mini Mental State Examination (MMSE), Global Deterioration Scale (GDS), Good Milieu Index (GMI) and Activities of Daily Living Scale (ADL). Patients were at least 2 weeks under rehabilitation due to orthopedic or neurologic reasons.

Results

Both groups were similar concerning age, gender, education and marital status. Satisfaction of the ward was the same. Wr-patients were significantly more demented (25.1 vs.26.8; p=0.011), depressed (4.12 vs 3.0; p=0.033) and disabled (24.88 vs 76.62; p< 0.0001).

The mean number of total, unmet and met needs before rehabilitation was similar in both centers. However, significantly more needs in accommodation, eyesight /hearing /communication and benefits were reported in Wr, whereas psychological distress and food in Ha.

During rehabilitation program over twice more unmet needs were reported in Wr vs. Ha (1.38 vs. 0.57; p =0,0029) in the areas of eyesight /hearing /communication and benefits, continence, money.

Ha received twice more formal assistance than Wr before (0,0027), but Wr twice more during rehabilitation (p< 0,0001).

Assessing individuals needs may help in creating individual complete rehabilitation program within continuing care post discharge and improve quality of life.
P01-376 - Screening for Dementia in Very Old Age in Primary Care
Authors: Stoppe G. , Buss K. , Wolf S. , Stiens G. , Maeck L.
Published: June 2010

Background

There are many screening instruments available for the detection of dementia. However, they were not tested in very old age and often not in the primary care setting for which they are developed.

Method

We condensed a screening battery of all elements of common tests (MMSE, TFDD, DEMTECT, Clock Test…). Nine primary care practices took part in the study. The practice assistants were trained to approach all patients over 75y visiting the practice. Only patients with already diagnosed dementia, severe hearing or vision disability or communication deficits were excluded. After informed consent they applied the screening. Within the next days a second independent neuropsychological examination was arranged in the memory clinic of the University of Goettingen. This included established neuropsychological tests (CERAD-NP, WMS-R, TMT.) and further scales were applied (NPI, CDR..). All patients with CDR=0.5 were approached 1.5y later for a follow-up by phone.

Results

N=90 patients (25M, 65F) took part in the initial evaluation. From N=54 with CDR=0.5 only N=14 could be reached for follow-up. None of them returned to CDR=0, most progressed up to CDR=4. There were some correlations to education and dementia severity. All available screenings showed a good effect size of >0.70 (MMSE, DEMTECT, TFDD, RDST).

Conclusion

Elements for an optimal screening of the oldest old are discussed.
P01-377 - Separated Wards for the Elderly in Psychiatric Hospitals: the Patient View
Authors: Stoppe G. , Sutter M. , Maeck L. , Krebs-Roubicek E.
Published: June 2010

Background

At least at the larger hospitals specialised gero-psychiatric units have been introduced, usually taking care of those at age 65y and higher. The advantages of this approach have been discussed and examined. The patients’ view has only rarely been investigated and mostly only from a single perspective (e.g. patient satisfaction on gero-psychiatric wards).

Methods

We performed semistructured qualitative interviews in our hospital in a balanced sample of (n=14) patients at 18-40y, (n=10) patients at 41-60y, (n=16) patients at 61-75y, (n=8) patients over 75y. There were (n=) 24 male and (n=) 24 female patients. 12 patients hat been treated exclusively in old age psychiatry, and 10 patients had been treated in old age psychiatry after their 65th birthday.

Results

The majorities of the patients saw advantages in mixed sex and age care for the younger and for the older patients. Disadvantages where not seen for younger patients, however for the elderly the view was ambivalent (26 yes versus 22 no). Female and higher age patients and those with multiple hospitalisations tended to expect more disadvantages. While a mixed ward would be regarded as more (stimulating), disadvantages could be the combination of aggressive young and frail elderly patients as well as the overburdening of the staff.

Conclusion

This is the first investigation on patient view on the segregation of old age psychiatric patients. Further studies should lead to a consumer guided care provision allowing specialisation as well as defending ageism.
P01-387 - Bipolar Affective Disease and AIDS - Concerning a Clinical Case
Authors: Ferreira M. , Matos G. , Tavares A. , Cunha J.
Published: June 2010

The Human Immunodificiency Virus infects primarily the immune system. However, the infection may also affect the central nervous system, materialising itself, in this particular case, in neurological and neuropsychiatric disturbances.

The authors describe the case of a 48 year-old female patient with bipolar affective disease, identified since she was 21. She has a long history of regular examination in speciality consultations, including several psychiatric hospital stays. More recently, she is conducted to the psychiatric emergency department, being admitted for a maniform state. During the stay her general condition deteriorates progressively, being often taken to the regular emergency department. The serious weight-loss associates itself to altered states of consciousness, ataxia and disartry, as well as diahrrea, fever syndromes and breathing difficulty. As a consequence, the patient stays in bed. Despite several diagnosed infections and the histologic result of the cervical cancer biopsy, requested in an ambulatory regime (“lymphoproliferative disease involving the cervix”), she is always conducted to the psychiatric ward. She is admitted in the medicine ward only a month later and is, afterwards, transferred to the infectious diseases ward, with the aim of studying the neuropsychiatric condition in connection with the HIV/AIDS infection.

The authors come to the conclusion that, it is rather important that the anti-HIV antibodies research is included in the routines of complementary diagnosis examinations requested by psychiatrists.

They also reflect about the little relevance that other medicine areas give to the physical diseases of the psychiatric patients, weakening them even more.
P01-389 - Psychogenic Non-epileptic Seizures: Clinical Classification Based on the Video-EEG Analysis of 145 Seizures
Authors: Hubsch C. , Baumann C. , Maillard L.
Published: June 2010

The “psychogenic non-epileptic seizures (PNES), paroxysmal behavioral changes that resemble an epileptic seizure but are not associated with electrophysiological epileptic changes seem to be caused by a psychological process. They still are misdiagnosed. The video-EEG allows their direct observation.

After studying the characteristics of the affected population, we have studied the semiological aspect of PNES and have sought to demonstrate inter and intra-individuals reproducibility who attest to common “laws” and would look a neurological substrate for these events.

We analyzed the symptomatology of 145 PNES, recorded by video-EEG in 52 patients. Statistical analysis of data consisted first, to describe the characteristics of seizures and patients. Secondly, we conducted a multiple correspondence analysis and hierarchical clustering. The SAS ® v9.1 was used.

Results

5 subtypes of PNES emerged from the statistical analysis showing reproducibility of seizures in 61.54% of patients:

-

brief crisis with automatisms and dystonia

-

“pauci-kinetic”, sensitive crisis with preserved contact

-

brief and brutal crisis with break contact and clonic jerks

-

“major crisis” with extended axial spasms

-

prolonged, fluctuating with hyperventilation preceded by prodrome.

The identification of a typology can move from a clinical based diagnosis to a real positive diagnosis. The reproducibility of the crisis allow to make common pathophysiological hypotheses. The history of psychological trauma query on a relationship between the management of neuro-psychological affects and PNES “dysfunction” of connections between the frontal lobe, the limbic system and the basal ganglia. Beyond the positive diagnosis, the fundamental and therapeutic perspectives are many.
P01-391 - The Diagnosis of Melancholic and Atypical Depression During Pregnancy
Authors: Kammerer M. , Glover V. , Pinard C. , Künzli H. , Taylor A. , von Castelberg B. , Marks M.
Published: June 2010

Introduction

Atypical and melancholic subtypes of depression based on the Diagnostic and Statistical Manual (DSM) IV are important concepts, especially for biological psychiatry. The aim of this study was to determine whether the symptoms used for the diagnoses of atypical and melancholic depression can distinguish these subtypes during pregnancy.

Method

A modified version of the Structured Clinical Interview for DSM IV (SCID interview) was used that allowed assessment of all DSM IV symptoms of melancholic and atypical depression with depressed and non depressed women in pregnancy. A Swiss cohort of 449 women was interviewed. Four diagnostic groups were compared: women with melancholic, atypical, or non specified depression, and those without depression.

Results

Seventeen per cent of the cohort met SCID criteria for a depressive episode of depression at least once in pregnancy, with melancholic depression 2.4%, atypical depression 4.4%, and non specified depression 10.2%. Many of the symptoms used to distinguish atypical and melancholic depression did not discriminate between these groups during pregnancy. However some, such as mood reactivity, distinct quality of mood and sleep pattern, did discriminate.

Conclusions

Differential diagnosis between melancholic and atypical depression in pregnancy needs to be based on pregnancy specific definitions. The possible therapeutic consequences and the neurobiological basis for these findings warrant further research.
P01-394 - Sexuality Disorders in Patients Admitted to Intensive Group Psychotherapy
Authors: Muldner-Nieckowski L. , Rutkowski K. , Sobanski J. , Jablonski Z. , Mielimaka M.
Published: June 2010

Objectives

The aim of this presentation is to introduce a new instrument, used for assessment of symptoms connected with characteristics of sexual life in population of patients with neurosis and related personality disorders.

Methods

During the first week of psychotherapy the patients fill a questionnaire, containing statements which cover different areas of sexual life such as: overall satisfaction, present sexual relationships, present sexual activity, dysfunctions of sexual intercourse, experience of sexual trauma, feelings towards one's own body and attractiveness. Data from the pilot study were analyzed in search for preliminary, statistically significant differences between groups of symptoms.

Results

The pilot study on 80 patients (43 females, 37 males) confirmed, that different symptoms connected with sexuality are important component in distress of patients beginning intensive group psychotherapy. In overall, 58% of patients perceived their sexual life as unsatisfactory. Nearly 50% do not experience pleasure connected with sexual activity. Over 85% regard sexuality as important matter. Significant difference was found, as up to 85% patients expect improvement of their sexual life, but only 35% are explicitly interested in including sexuality as one of the themes in psychotherapy.

Conclusions

Results of the pilot study confirm clinical importance of symptoms connected with sexuality in neurotic disorders. Further group psychotherapy effectiveness assessment will bring an opportunity to recognize the specific role of these symptoms in diagnosis and psychotherapy treatment.
P01-398 - A Classification Model of Schizophrenia Using a Multivariate Eye Movement Phenotype
Authors: Benson P. , Beedie S. , Geigling I. , Rujescu D. , St.Clair D.
Published: June 2010

Eye movements are used as an index of neural pathways and mental processes active during visual tasks. The atypical or dysfunctional eye movements observed in the schizophrenia spectrum of disorders are manifest because of abnormal neurodevelopment of particular features of those processes. Schizophrenia patients’ eye movements often also mirror the inflexible or perseverative cognitive style associated with the illness. So far no single test of oculomotor function has emerged as a marker for schizophrenia. For example, not all patients show deficits in sustained smooth pursuit ability, and a significant proportion of unaffected controls are prone to the same errors made by patients on identical tasks. The same is true during pro- and anti-saccade tasks. This poses a significant challenge for statistical models. We assessed the power of combined tests in discriminating cases from controls. Eye tracking was recorded in 95 out-patients with a diagnosis of paranoid schizophrenia and 88 unaffected, age-matched controls. Participants performed smooth pursuit, visual exploration and fixation tasks. A decision tree was trained using only eye movement measures from each task to account for performance variation in both groups. The model perfectly distinguished between cases and controls. Additional data from 31 re-test sessions and 70 new observers were also scored. Overall accuracy was 89%. It was possible to unambiguously account for individuals who were misclassified. The discriminatory power of the multivariate model is very impressive. Covariates did not improve classification. The model can be extended to include other illnesses to examine the relationship between psychophysiology and nosology.
P01-399 - Psychopathology-based Nosological Spectra
Authors: Pio Abreu J.L. , Freire Lucas R.
Published: June 2010

The nosologies founded by Kraepelin (Psychotic Disorders) and Freud (Neurotic Disorders) still remain actual in categories F20-29, F30-39 and F40-49 of the International Statistical Classification of Diseases and Related Health Problems, 10th revision (ICD-10). The psychopathological mechanisms observed in classic disorders are shared with disorders considered in other categories regarding recognized etiologies (F10-19), ages of onset (F90-98), symptoms as precocious and enduring traces (F60-69) or specific symptoms (F50-59). Each classic pathology and its psychopathological mechanisms may be prototypical for a specific nosological spectrum that includes diseases which seem different at first glance. Accordingly, based on the combined knowledge of psychopathology and neurosciences, we assume that it is possible to conceive a more logical, rational and simpler way of organizing psychiatric nosology based on different psychopathological mechanisms emerging from five major questions:

1.

does the patient recognize his territory? (Dementia and delirium spectra),

2.

does the patient accurately recognise himself and the other? (Schizophrenic vs. autistic spectra),

3.

does the patient conserve his synchronicity with environmental and interpersonal rhythms? (Manic and depressive spectra),

4.

how does the patient feel about and react to threatening experiences? (Phobic vs. paranoid spectra), and

5.

how does the patient behave towards appetizing experiences? (Obsessive vs. Dissociative spectra).

We also discuss the relationship of these major questions with the encephalic stages (telencephalon, diencephalon, mesencephalon, and rhombencephalon).
P01-403 - Systematic of Basic Personality Disorders
Authors: Semke V.
Published: June 2010

Classification of personality manifestations is impossible without considering theoretic-methodological problems of contemporary personology, first of all, its clinical branch. Its scientific development will help clarification of complex causal interrelationships, carrying out practical therapeutic-diagnostic work, heightening quality of social-correcting interventions. Base for this work may be theory and methodology of young science of valeopsychology and clinical psychology, elucidating type in nosological concepts (unit, variants etc.). Clinical-pathogenetic grouping of borderline states (Semke V. Ya., 1978, 1987, 1999) with subsequent extrapolation of obtained results onto zone of normal personology has allowed distinguishing four groups of borderline states - neurotic, pathocharacterological, neurosis-like, psychopath-like). Especially it is important to mention stage of pre-illness where question is about emergence of abnormal, non-differentiated in their content of personality reactions which clinical manifestations reflect early, “pre-nosological” period of disease development.

Scale of distinguished personality characteristics encompasses pathocharacterological reactions, states, developments and “residua” or type. With positive influence of microenvironment, contrary (in prognostic relation) variant of dynamic in the kind of smoothing and then complete removal of psychopathic aspect (process of “depsychopathization”) is gradually achieved. One of the most important tools of subtle cognition of borders between healthy and ill personality is dynamic analysis of basic studied typologies. Idea of development triumphing in past century in psychology and natural science, allows assessing the most vulnerable “main” moments in evolutional considering normal and abnormal characters. “Dynamic” represents every change, be it a short-term (phase) deviation from initial status or more prolonged and stable, periodically emerging reform of previous clinical picture.
P01-404 - Is there Still a Place for Involutional Melancholia Nowadays?
Authors: Simões S. , Mesquita J. , Santos B. , Silva L.
Published: June 2010

Objectives

Involutional melancholia was first described by Kraeplin in 1896, who, since 1907, omitted this entity from his publications. However, involutional melancholia kept on being accepted under various names. We intend to analyse if there are still evidences for the existence of this entity nowadays and its clinical utility.

Methods

We describe and analyse a case of a woman with the diagnosis of involutional melancholia and make a bibliographic review about this disorder.

Results

Nowadays the broadening concept of mood disorders denies involutional melancholia as a valid independent entity, so it is included in mood disorders as a unipolar endogenous depression with late onset. Psycopathologically, however, it still seems to have several differences that could justify its separation from the current mood disorder concept, such as proeminent motor agitation and restlessness, anxiety and apprehension, an exaggerated hypochondriasis sometimes with bizarre delusions and occasional paranoid ideation These differentiating symptoms arise on a basic depressive substrate, marked by insomnia, anorexia and weight loss. Some studies point out the fact that now patients are treated earlier with antidepressives or ECT and so these classical severe symptoms may not develop, because the syndrome is aborted at a prodromal stage.

Conclusions

Study results are contradictory and further controlled investigations are mandatory. Even if involutional melancholia does not stand as a separate entity, it is important to keep in mind that depressive illness appearing for the first time in the involutional period of life may present as a somewhat atypical clinical picture.
P01-405 - Depression Profile: Development of a New Psychometric Instrument Evaluating Depressive Symptom Clusters Associated with Different Neurotransmitter Systems
Authors: Faludi G. , Gonda X. , Meszaros V. , Bekes V. , Sarosi A. , Olah A.
Published: June 2010

Objective

Distinct subtypes of depression presenting with characteristic symptom clusters have different neuroanatomical and neurochemical background, and these subtypes behave differently also pharmacologically. Based on the neurocircuitry theory, several studies investigated the possible neuroanatomical and neurochemical substrates of major depressive symptoms. Our team has developed a new scale, the Depression Profile that incorporates symptoms associated with depression forming symptom clusters that can be mapped to different neurotransmitter systems.

Methods

339 major depressive patients completed the original 90-item structure of Depression Profile. Confirmatory and exploratory factor analysis was used to establish the final structure. The external validity of the new structure was tested against the Zung Self-Rating Depression Scale and Sheehan Patient Rated Anxiety Scale.

Results

After exploratory factor analysis the number of items decreased to 67. Reliability of the new structure proved to be very good and its construct validity was supported by confirmatory factor analysis. Convergent validity testing of the new structure showed average correlation with the two other questionnaires.

Conclusion

Current depression scales do not provide for the separate in-depth screening of depressive symptom clusters associated with different neurotransmitter systems playing a role in depression. We attempted to develop a new depression scale separately assessing depressive symptom clusters reflecting the activity of different neurotransmitter systems. First psychometric tests indicate that our scale is a promising instrument for decomposing depression to subtypes with different neurochemical backgrounds, which would make it a useful tool in selecting a tailor-made pharmacological treatment for each patient that most effectively treats their depressive symptoms.
P02-02 - Factors predicting Adherence with Follow-up Appointments for Patients Assessed by the Liaison Psychiatric Team in the Emergency Department
Authors: Agyapong V. , Rogers C. , MacHale S. , Cotter D.
Published: June 2010

Background

Several factors may predict adherence with adherence with follow-up appointment for patients seen in the emergency department by liaison psychiatric teams. Awareness of these factors would allow for interventions targeted at vulnerable groups.

Aim

To examine the factors which could predict adherence with psychiatric follow-up appointments for patients assessed in the ED by the liaison psychiatric team.

Methods

The records of all patients assessed over a three month period by the liaison psychiatric team in the emergency department of Beaumont Hospital who were then referred for follow-up were examined for relevant demographic and clinical variables. Phone contact was then made with the centres to which patients had been referred to confirm the appointments made and if the patients had attended follow-up appointments. The data was analysed with SPSS (version 17).

Results

Overall, only 55.9% of the patients were found to have attended their follow-up appointments with lrsquo;known to psychiatric services’ being the only statistically significant predictor of adherence. Patients’ who were single, separated, divorced or widowed and those who had consumed alcohol before an act of deliberate self-ham were more likely to attend follow-up appointments compared with those who were either married or cohabiting and those who did not consumed alcohol respectively. However these were not statistically significant when controlling for other predictors.

Conclusion

Patients who are not known to psychiatric services prior to assessment in the emergency department may need a more proactive outreach if compliance with psychiatric follow-up appointments is to be improved.
P02-04 - Characteristics of Secluded, Restrained and Aggressive Patients in a Locked Short Term Psychiatric Unit
Authors: Bordas R. , Very E. , Bui E. , Paux J. , Courtey C. , Lecoules N. , Schmitt L.
Published: June 2010

Objectives

Violent behaviors in psychiatric emergency departments are a common problem. The aim is to study characteristics of patients who need intense preventive care measures and who act violently.

Methods

The study was conducted in a locked short term psychiatric inpatient unit and involved 172 patients admitted in a 8 months period. Sociodemographic and clinical data were obtained through a review of the medical records. Secclusion, restraint and agressive behaviors were noted on specific nurse sheets.

Results

Aggressive behaviors or intense preventive measures concerned 34% (n=59) of the 172 patients. Among these 59 patients, 61% (n=36) are men and the mean age is 34,9 years, 28 had seclusion, 51 had restraint and 11 had physical aggression or against object aggression. The diagnosis are schizophrenic disorders for 63% (n=37), dependence or substance abuse for 11% (n=7), mania for 10% (n=6), depression for 3,5% (n=2). For 27% (n=16) of them it was first time in Emergency Department and 30,5% (n=18) were intoxicated at admission. The mean neuroleptic treatments dosis of these patients at admission were 656mg (equivalent chlorpromazine).

Conclusions

Patients concerned by seclusion, restraint and aggressive behavior are more frequently men with schizophrenic disorders, high neuroleptic dosis, and various past admissions in the Emergency Department.
P02-05 - Inhaled Loxapine (AZ-004, Staccato Loxapine) for Rapid and Acute Treatment of Agitation in Patients with Schizophrenia or Bipolar Disorder
Authors: Cassella J.V. , Fishman R.S. , Kwentus J. , Lesem M.
Published: June 2010

Objectives

Current treatments for agitation in schizophrenia or bipolar disorder (BD) have limitations in onset of action, invasiveness and tolerability. AZ-004 (Staccato loxapine) is a rapidly acting inhaled treatment designed for acute treatment of agitation delivering drug aerosol to the deep lung for rapid systemic absorption with intravenous-like kinetics. The objective was to evaluate the efficacy and safety of AZ-004 in the acute treatment of agitation in schizophrenia and BD.

Methods

Two randomized, double-blind, placebo-controlled trials included consenting male and female adults, 18-65 years old with DSM-IV-defined schizophrenia (N=344) or BD type 1 or mixed (314) who presented with clinically relevant agitation. Patients received a single inhalation of 5 or 10mg AZ-004 or placebo in a clinical setting with up to 2 additional doses within 24 hours if required. The primary efficacy endpoint was the absolute change in Positive and Negative Syndrome Scale Excited Component score from baseline to 2 hours following treatment.

Results

In each trial, both 5 and 10mg AZ-004 were significantly superior to placebo for the primary endpoint (P< 0.001 for each dose in each trial). Significant improvements were noted for each AZ-004 dose versus placebo at all timepoints from 10 minutes through 24 hours. Clinical Global Impression-Improvement (CGI-I) at 2 hours post-dose and CGI-I responder analysis were statistically significant for each AZ-004 dose vs. placebo in both studies. Adverse events observed most often for all treatments were dysgeusia, dizziness, and sedation.

Conclusions

AZ-004 produced rapid and significant improvement in treating agitation in BD or schizophrenia patients.