bluuebunny/crossref_metadata_2025 huggingface dataset:
Symptomatic Remission Amongst Elderly Schizophrenia Patients Treated with Long-acting Risperidone
Authors: Barak Y. , Baruch Y. , Tadger S.
Published: March 2009

Background:

In elderly schizophrenia patients remission is difficult to determine due to long disease duration, exposure to differing treatments, long-standing side-effects, non-adherence, cognitive decline and physical co-morbidity.

Methods:

Retrospective chart review of elderly (60+ years) schizophrenia patients admitted to a university affiliated tertiary psychiatric center. Patients were experiencing an exacerbation at admission. Remission criteria were as defined by the APA's “Remission in Schizophrenia Working Group”. Clinical status and improvement were quantified using the Clinical Global Impression scale.

Results:

During 2006 forty-eight elderly schizophrenia patients were admitted to our center. of these, 25 patients were treated with long-acting risperidone (LAR), 18 women and 7 men, mean age 72 years (range: 62-81), mean disease duration 30.4 years (range:14-42) and mean number of previous hospitalizations 8.9 (range:1-21). Co-morbid physical illness was present in 12 patients (hypertension, diabetes, CHF and hypothyroidism). of 25 patients treated with LAR, 19 (76%) continued uninterrupted treatment for 6 months or longer. in 6 patients treatment was discontinued due to insufficient response. All patient's (N=25) clinical severity ratings with the CGI-S were in the range of 5 to 7 prior to treatment. Following 6 months of LAR treatment, mean dose 36.0 mg/2 weeks (range: 25-50), 18 patients were rated as “improved” or “very much improved” on the CGI-I scale. in 15/25 patients (60%) symptomatic remission was achieved.

Conclusions:

LAR may be effective in achieving remission among elderly schizophrenia patients. Tolerability was high and adherence rates improved. the inherent bias in a retrospective analysis need temper our observations.
Weight Gain and Hyperprolactinemia in Schizophrenic Patients Treated During Twelve Months with Long Acting Risperidone
Authors: Garcia F. Duarte , Duval F. , Lopera F. Gonzales , Mokrani M.-C. , Hode Y. , Fattah S. , Diep T. Son
Published: March 2009

Background:

Risperidone (RISP) may induce both elevated prolactin (PRL) levels and weight gain. the aim of this study was to evaluate body weight and mass index (BMI), and PRL modifications in schizophrenic patients treated for 1 year with long-acting risperidone (LAR).

Methods:

Body weight and BMI (calculated as weight in kilograms divide by height in meter squared) were determined at baseline and at endpoint in 19 schizophrenic patients (9 men and 10 women; mean[SEM] age 33.4[2.9] years). PRL levels were determined at baseline, after oral risperidone treatment (mean length of treatment: 79[30] days; mean dose: 5.8[0.5] mg daily) and during a 12 month treatment with LAR (mean dose: 50[10] mg every 2 weeks; PRL levels were measured before each injection).

Results:

At endpoint, a significant weight gain (Δweight: 8,1[1,4] kg) and BMI (ΔBMI: 2,9[0,5] kg/m²) was observed (both p< 0.0002). Compared with baseline, PRL levels were significantly increased (p< 0.0007; mean ΔPRL: 33[8] ng/ml). There was an association between ΔBMI>1,5 kg/m² and ΔPRL>40 ng/ ml (p< 0.04). Moreover ΔBMI was linked to the length of treatment (rho=0.47; n=19; p< 0.05).

Conclusions:

Our results suggest a link between weight gain and long term hyperprolactinemia in patients treated with LAR. It has been hypothesized that PRL may have a role in the regulation of food intake by increasing leptin synthesis and secretion.
Quetiapine and Hypothyroidism: A Literature Review
Authors: Kontaxakis V. , Karaiskos D. , Havaki-Kontaxaki B. , Skourides D. , Ferentinos P. , Pappa D. , Papadimitriou G.
Published: March 2009

Objective:

Recently, there is an interest on the possible association between quetiapine and hypothyroidism. the aim of this study is to critically review all the reported cases in the international literature.

Methods:

A Medline search for all studies dealing with quetiapine induced hypothyroidism was carried out from January 1997 to June 2008.

Results:

Published literature on quetiapine's impact on thyroid function consists of 1 double-blind study, 1 observational study, 2 open studies, 3 case reports and data from the product monograph. A study on elderly psychotic patients revealed only small decreases in T4 levels, while another one in adolescents show trends for decrease in T4 and a marked increase in TSH. an observational study of thyroid function in patients treated with quetiapine and other antipsychotics, found a decrease in T4 with no changes in TSH and T3 and another one only slight increases in TSH. in the case reports all patients excibited clinical hypothyroidism. in one case there was a positive history for hypothyroidism, while in another one the patient had experienced lithium induced hypothyroidism in the past. According to quetiapine manufacturer 0.4% of the patients experienced TSH increases with half of them requiring thyroid replacement treatment. in studies, where quetiapine was adjunct to lithium or divalproate, 12% of patients had elevated TSH levels.

Conclusion:

We suggest a careful thyroid monitoring for patients initiating quetiapine, since hypothyroidism may emerge and masquerade psychopathologic manifestations. However, there is an open question whether thyroid dysfunction is a permanent or reversible condition.
Prevalence of Extrapyramidal Side Effects in Patients Receiving Depot Antipsychotic Medication
Authors: Luft B. , Berent E.
Published: March 2009

Introduction:

Long-acting depot antipsychotic medication is associated with extrapyramidal side effects (EPS). This may reduce adherence to medication, and precipitate relapse (1). Clearly, EPS is a major drawback and early detection is essential. However, in an earlier review of patients’ medical notes, we identified only one patient with an examination that recorded the presence of EPS. Despite the fact that a number of rating scales are available. We proposed that the application of these rating scales, would allow us to improve the assessment of EPS.

Method:

All patients prescribed a depot antipsychotic or long-acting risperidone injection, were identified. the Barnes Akathisia Scale (2) was chosen to rate akathisia, a modified Simpson-Angus scale (3) was chosen to rate parkinsonism and the Abnormal Involuntary Movement Scale (4) was chosen to rate tardive dyskinesia.

Results:

A total of 43 patients were evaluated. 23 (53%) patients showed drug induced EPS. the total number of positive cases of akathisia was 12 (28%), and 10 (23%) patients were found to have tardive dyskinesia. 13 (30%) patients were found to have drug induced parkinsonism.

Conclusions:

Our screening programme has identified high rates of previously undiscovered drug induced EPS.
Do Antipsychotic Drugs Lengthen QT Interval?
Authors: Sarotar B. Novak , Pregelj P. , Kocmur M.
Published: March 2009

Objectives:

Prolongation of myocardial repolarization, i.e. lengthening of the QTc interval on surface electrocardiogram, with increased risk of cardiac arrhythmias, has been recognized as a side effect of many drugs. Most conventional and atypical antipsychotic drugs can cause dose-related prolongation of QTc, although there are important differences in the potency of individual agents. Antipsychotic polipharmacy increases the risk for sever cardiac side effects.

Subjects and methods:

In this prospective clinical investigation, we analyzed ECGs in 46 patients suffering from schizophrenic disorder who were treated with different antipsychotic drugs one week after the admission to the psychiatric hospital. Hearth rate, QT interval and QTc interval were assessed. the average daily dose of prescribed antipsychotic drugs was calculated and transformed to chlorpromazine units.

Results:

Average QTc interval in patients undergoing our clinical investigation was 417 msec, only 3 out of 46 (6,5%) patients had QTc over 450 msec and only one patient (2,2%) had QTc over 500 msec.

We found no differences in QTc interval between patients who were treated either with conventional or atypical antipsychotic or with combination of both, and no gender differences for QTc interval were found.

Conclusions:

Our results raise the question of the clinical relevance of a single ECG for diagnostics of cardiac complications in schizophrenia patients and suggest the need to conduct ECG monitoring in patients with high risk for cardiac complications during antipsychotic treatment.
Off-label use of Atypical Antipsychotics at the Crisis Intervention Unit
Authors: Sarotar B. Novak , Segrec N. , Pregelj P.
Published: March 2009

Objectives:

Antipsychotic medications are registered for the use in psychosis, mania and agitation. the aim of our study was to assess the off-label use of atypical antipsychotics (AA) at the Crisis Intervention Unit (CIU).

Methods:

Hospital records of 280 patients that were treated at the CIU in year 2007 were included to the observational study. Patients were screened for diagnosis (ICD-10), gender, age, suicidal behaviour and for prescribed psychotropic medications. Off-label use of atypical antipsychotics for diagnoses other than psychosis was evaluated.

Results:

Most hospitalised patients suffered for stress related disorders: adjustment disorder F43.2 (34%), acute stress disorder F 43.0 (2%), mixed anxiety-depression disorder F41.2 (19%), depression (24%), anxiety disorders (4%) and other disorders (17%). Patients were treated with antidepressants (92%), benzodiazepines (55%), hypnotics (44%) and mood stabilising drugs (9%) during their stay at the CIU. at discharge from hospital benzodiazepines (31%) and hypnotics (12%) were prescribed in lower percentages. 51% of patients received AA at least once during their stay at the CIU, 49% received AA for off-label use and it was prescribed for most of the hospital stay (for 87% of the time). Average daily CPU at admission to the hospital was 107.52 and at the discharge it was 100.33. No significant differences were noted among the different diagnoses for off-label AA use.

Conclusions:

Atypical antipsychotics are widely used for indications other than psychosis, even though the long-term effects of their use are not yet known and safety issues remain to be examined further.
Adherence with Antipsychotic Treatment Medication in Outpatients with Schizophrenia: 36- Month Results from the Schizophrenia Outpatients Health Outcomes (soho) Study
Authors: Novick D. , Suarez D. , Haro J.M. , Haddad P.M.
Published: March 2009

Objective:

To assess frequency and baseline factors associated with adherence with antipsychotic medication during long-term treatment in outpatients with schizophrenia.

Methods:

SOHO is a 3-year, prospective, observational study that included 10 972 patients changing or starting a new antipsychotic medication Treatment adherence during 4 weeks prior to the visit was assessed at each visit by participating psychiatrists as:

•

the patient has not been prescribed medication;

•

the patient almost always adheres;

•

the patient adheres half of the time; and

•

the patient never adheres to antipsychotic medication.

Logistic regression models were fitted to analyze the baseline factors associated to compliance during follow-up.

Results:

6731 patients with at most one missing visit were analysed. Data from the missing visit were imputed from the previous visit; 71.2% were considered to be adherent and 28.8% non-adherent over the 3-year follow-up period. the strongest predictor of medication adherence during follow-up was adherence at baseline (OR = 4.01, 95% CI: 3.46-4.64). other baseline predictors of adherence included not using antipsychotics in the previous 4 weeks, receiving treatment for first time, being socially active, and a higher body mass index. Baseline predictors of non-adherence were alcohol dependence, substance abuse, hospitalisation in previous 6 months, living independently housing and having hostile behaviours.

Conclusions:

Alcohol dependence, substance abuse and living independently were associated with non-adherence. Previous adherence, being socially active and receiving medication for the first time was associated with better adherence. Limitation: medication adherence was assessed by the psychiatrist through a single item question.
Relapse Prevention in Schizophrenia and Schizoaffective Disorder with Risperidone Long-acting Injectable Versus Quetiapine: Randomized, Long-term, Open-label, Clinical Trial Results (constatre)
Authors: Gaebel W. , Bergmans P. , de Arce R. , Rouillon F. , Cordes J. , Eriksson L. , Schreiner A. , Smeraldi E.
Published: March 2009

Objective:

The ConstaTRE study was designed to compare long-term relapse in stable patients treated with risperidone long-acting injectable (RLAI) or the oral atypical antipsychotic quetiapine.

Methods:

This was a randomized, open-label, prospective, active-controlled, multicenter, 2-year trial in symptomatically stable patients with schizophrenia or related disorder who were switched from stable treatment with oral risperidone, olanzapine, or oral conventional antipsychotic to RLAI or quetiapine. Primary efficacy measure was time-to-relapse. Positive and Negative Syndrome Scale (PANSS) scores and safety (adverse events [AEs] and Extrapyramidal Symptom Rating Scale [ESRS]) evaluations were reported.

Results:

710 patients were randomized (n=355 per group), with 666 patients (n=329 RLAI and n=337 quetiapine) being evaluable. Mean doses were 32.8±8.0 mg every-two-weeks for RLAI and 396.8±141.9 mg/day for quetiapine. Kaplan-Meier analysis indicated a significantly longer relapse-free period with RLAI treatment (log rank: p< 0.0001). Relapse occurred in 16.5% of RLAI and 31.3% of quetiapine patients. Mean duration of treatment was 483.8±277.8 and 400.7±290.6 days for RLAI and quetiapine, respectively. Total PANSS scores improved significantly from baseline to endpoint for the RLAI-treated group (p< 0.001). the endpoint difference favors RLAI over quetiapine (p< 0.001). Treatment-emergent AEs were similar between groups. ESRS total scores decreased for both groups. Possibly prolactin-related AEs occurred more often with RLAI than quetiapine (4.6% versus 1.5%, respectively). Somnolence was reported less often with RLAI than quetiapine (1.8% versus 11.3%, respectively).

Conclusions:

Time-to-relapse was significantly longer and relapse rates were significantly lower for RLAI compared with quetiapine. both treatments were well tolerated.
Long-term Remission in Schizophrenia and Schizoaffective Disorder: Results from the Risperidone Long-acting Injectable Versus Quetiapine Relapse Prevention Trial (constatre)
Authors: Smeraldi E. , Cavallaro R. , Smalc V. Folnegovic , Bidzan L. , Ceylan E. , Schreiner A. , Lex A.
Published: March 2009

Objective:

To report the long-term remission results from the relapse prevention trial (ConstaTRE) in stable patients treated either with risperidone long-acting injectable (RLAI) or the oral atypical antipsychotic quetiapine.

Methods:

Clinically stable adults with schizophrenia or schizoaffective disorder treated with oral risperidone, olanzapine, or oral conventional antipsychotics were randomized to treatment with RLAI or oral quetiapine. Dosing was according to package-insert recommendation. Efficacy and tolerability were recorded for up to 24 months of treatment. Remission was defined as achieving and maintaining mild or less symptoms of schizophrenia over a 6-month period as defined by Andreasen et al, (2005).

Results:

710 patients were randomized (n=355 per group) to either RLAI or quetiapine. Demographics were similar between treatment groups. Relapse occurred in 54 RLAI (16.5%) and 102 quetiapine (31.3%) patients (p< 0.001). Full remission was achieved by 51% RLAI and 39% of quetiapine-treated patients (p=0.003) and was maintained until the end of the trial by 44% of RLAI and 31% of quetiapine patients. Mean duration of full remission was 540.8±181.4 and 508.1±188.0 days for RLAI and quetiapine groups, respectively (p=0.1325). Tolerability was similar between treatment groups. Most adverse events (AEs) were transient. Six RLAI and 10 quetiapine patients discontinued study treatment due to AEs.

Conclusions:

Among stable patients with schizophrenia or schizoaffective disorder, remission was more likely to occur in patients switching to RLAI when compared with quetiapine. both RLAI and quetiapine treatments were well tolerated.
Descriptive Analyses of the Aripiprazole Arm in the Risperidone Long-acting Injectable Versus Quetiapine Relapse Prevention Trial (constatre)
Authors: de Arce R. , Eding E. , Marques-Teixeira J. , Milanova V. , Rancans E. , Schreiner A.
Published: March 2009

Objective:

A recent randomized, open-label, relapse prevention trial (ConstaTRE) of risperidone long-acting injectable (RLAI) versus quetiapine and the oral atypical antipsychotic aripiprazole was carried out. Here we report the descriptive analysis of the aripiprazole arm.

Methods:

Clinically stable adults with schizophrenia or schizoaffective disorder previously treated with oral risperidone, olanzapine, or oral conventional antipsychotic were randomized to treatment with RLAI, quetiapine, or aripiprazole (in some countries). Efficacy and tolerability were monitored for up to 24 months of treatment.

Results:

A total of 45 patients were treated with aripiprazole (10-30 mg/day) and 329 patients with RLAI. Relapse occurred in 27.3% aripiprazole and 16.5% RLAI-treated patients. Kaplan-Meier estimates of mean relapse-free period were 314 versus 607 days for aripiprazole and RLAI patients, respectively. Full-remission, as defined by Andreasen et al, (2005), was achieved by 34% aripiprazole and 51% RLAI patients and was maintained until the end of the trial by 30% aripiprazole and 44% RLAI patients. According to Clinical Global Impression-Severity, there were 61% aripiprazole and 62% RLAI patients moderately ill or worse at baseline, and 59% aripiprazole and 45% RLAI at endpoint, respectively. Tolerability was generally similar between aripiprazole and RLAI treatment groups. However, weight gain, extrapyramidal adverse events (AEs), and possibly prolactin-related AEs were more common with RLAI treatment. Gastrointestinal disorders were more common in aripiprazole-treated patients.

Conclusions:

Time-to-relapse in stable patients with schizophrenia or schizoaffective disorder tended to be longer in RLAI-treated patients when compared with aripiprazole-treated patients. both RLAI and aripiprazole treatments were generally well tolerated.
Risperidone Long-acting Injectable in Stable Patients with Schizophrenia from Related Disorders Switched from Oral Olanzapine
Authors: Rosa F. , Thomas P. , Schreiner A. , Sherif T.
Published: March 2009

Objective:

To explore the efficacy of risperidone long-acting injectable (RLAI) in patients previously treated with oral olanzapine requiring therapy change.

Methods:

This 6-month, multicenter, prospective, open-label trial evaluated adult patients with psychotic disorders treated with a stable dose of olanzapine, who required a treatment change due to lack of efficacy and/or tolerability. Three weeks after RLAI initiation, olanzapine use was tapered over 1 or 3 weeks at the discretion of the investigator. Primary efficacy evaluation was Positive and Negative Syndrome Scale (PANSS) total score change. Secondary endpoints included PANSS subscales, Clinical Global Impression-Severity (CGI-S), and Global Assessment of Functioning (GAF). Safety was evaluated by recording treatment-emergent adverse events (TEAEs).

Results:

96 patients were enrolled (53 tapered olanzapine within 1-week and 43 over 3-weeks). Mean olanzapine baseline dose was 19.2±11.8 and 29.9±17.5 mg/day in 1-week tapering and 3-week tapering groups, respectively. 40.6% of patients were initiated on 25 mg RLAI every-two-weeks. Treatment was completed by 79 patients (82.3%). Treatment discontinuation was mainly due to withdrawal of consent (n=4), AE (n=3), injection refusal (n=2), or lost to follow-up (n=2). Improvements in PANSS total and subscale scores, CGI-S and GAF were significant from baseline to endpoint (p< 0.0001). 74 TEAEs were reported in 42 patients (42.9%). TEAEs reported in ≥2% of patients were agitation (3.6%), insomnia (3.6%), and schizophrenia (9.1%). Serious AEs occurred in 10 patients.

Conclusions:

Switching treatment from oral olanzapine to RLAI led to clinically-relevant symptomatic and functional improvement in more than half of all patients. RLAI treatment was generally well-tolerated.
Prolactin Screening in a Cohort of Schizophrenia Patients in Birmingham
Authors: Waheed I. , Khan A.
Published: March 2009

Aim:

To establish the numerical prevalence and severity of raised prolactin levels in patients apparently asymptomatic.

Method:

All outpatients with schizophrenia receiving antipsychotics at Small Heath Health Centre had routine annual prolactin measurements. the sampling was done 0900-1300 either in clinic or at patient's homes. the Upper Limit of Normal (ULN) for prolactin was set by the hospital pathology service at 324 mIU/L (males) and 496 mIU/L (females). Sampling was done 0900-1200 either in clinic or at patient's homes. We recorded the patient's name, age, unit number, ethnicity, details of current medication, recent changes to medication and symptoms of hyperprolactinaemia.

Results:

Prolactin levels were obtained for 43 patients (M: 24 F:19). All of these patients had no clinical symptomatology that had led to prolactin measurements previously. Abnormal values were found in 47 per cent of females and 58 per cent of males, or 56 per cent (n=24) of the whole cohort. the mean prolactin was 789 mIU/L with a mean of 497 mIU/L in males and 1100 mIU/L in females. All patients on oral risperidone had hyperprolactinaemia.

Conclusion:

Routine prolactin screening showed abnormal values in 56 per cent of patients and significantly abnormal levels (>1000 mIU/L) that should lead to consideration of drug/dosage alterations in 26% of patients. the prevalence of hyperprolactinaemia in an unselected group of outpatients with schizophrenia suggests that consideration may be given to routine monitoring.
Do ADHD and Autism Symptoms Predict Specific OC Symptom Dimensions from OC Symptom Severity in OCD?
Authors: Anholt G. , Cath D. , van Oppen P. , Eikelenboom M. , Smit J. , van Megen H. , van Balkom A.
Published: March 2009

Backgrond:

Autism spectrum disorder (ASD) symptoms and attention deficit/ hyperactivity disorder (ADHD) symptoms are frequently comorbid with obsessive-compulsive disorder (OCD). However, limited research exists with respect to the relations between these symptoms, and their impact on OC symptom severity.

Method:

109 outpatients with primary OCD and 87 healthy controls were administered OCD, ADHD, and ASD questionnaires. Univariate analyses, correlations, and stepwise regression analyses were conducted.

Results:

OCD, ADHD, and autism symptoms were highly correlated, with OCD patients showing elevated ADHD as well as autism scores when compared with healthy controls. OCD patients with comorbid ADHD presented with higher autism symptoms and OCD symptoms, yet similar OCD severity scores as OCD without ADHD patients. the attention switching and lack of social skills subscales of the Autism Questionnaire (AQ) were particularly correlated with ADHD and OCD symptoms in the patient group. the AQ subscale attention switching proved to be the most significant predictor of OCD severity and symptoms (with the exception of hoarding). Contrary to expectations, the AQ subscale attention to detail did not predict OCD symptoms, nor did any of the AQ subscale scores predict hoarding symptoms.

Conclusions:

OCD patients present with elevated scores of ADHD and ASD symptoms, and these symptoms (particularly attention switching) are important in predicting OC symptoms and severity. It is suggested that problems in attention may be related to the uncertainty about one's own memory as demonstrated by OCDs patients, as well as a common factor underlying comorbid ADHD and ASD symptoms.
Alexithymia and Suicide Risk among Patients with Obsessive-compulsive Disorder
Authors: De Berardis D. , Serroni N. , Pizzorno A.M. , Moschetta F.S. , Sepede G. , Gambi F. , Aiello G. , D'Albenzio A. , Mancini E. , Salerno R.M. , Ferro F.M.
Published: March 2009

Objective:

The aim of our study was to evaluate relationships between alexithymia and suicidal ideation a sample of adult outpatients with obsessive-compulsive disorder (OCD).

Methods:

A sample of 86 adult outpatients with OCD (44 females and 42 males), was evaluated with a series of rating scales such as the Yale-Brown Obsessive Compulsive Scale (Y-BOCS), the Toronto Alexithymia Scale (TAS-20), the Scale for Suicide Ideation (SSI) and Montgomery-Åsberg Depression Rating Scale (MADRS). the score of item #11 on the Y-BOCS was considered as a measure of insight.

Results:

Alexithymics showed a more early onset, a longer duration of illness and were more suitable to have a chronic course than nonalexithymics; they also reported higher MADRS and SSI scores. Alexithymics without insight (n=21) reported higher SSI scores than alexithymics with insight, nonalexythimics without insight and nonalexithymics with insight. A linear regression showed that chronic OCD course together with DIF dimension of TAS-20 and higher MADRS scores were significantly associated with higher suicide risk.

Conclusions:

Alexithymia and depressive symptoms were highly correlated in OCD patients and were significantly associated with higher suicide risk. DIF dimension of TAS-20 seems to be significantly associated with presence of suicidal ideation as well as chronic course of disorder. However, further longitudinal studies on larger samples are needed to definitely clarify this topic.
Directional Persistence in the Rewarded Alternation Model of Obsessive-compulsive Disorder is Responsive to both Dopaminergic and Serotonergic Manipulations
Authors: Kontis D. , Boulougouris V. , Papadopoulos S. , Papakosta V.-M. , Kalogerakou S. , Poulopoulou C. , Tsaltas E. , Papadimitriou G.
Published: March 2009

Rationale:

In the rewarded alternation model of obsessive compulsive disorder (OCD), the serotonin agonist m-chlorophenylpiperazine (mCPP) increases persistent behaviour, while chronic pretreatment with selective serotonin reuptake inhibitor (SSRI-fluoxetine) but not benzodiazepine or desipramine abolishes mCPP effects. However, we noted that acute SSRI administration also causes transient persistence increases, counteracted by mCPP pretreatment.

Objectives:

This study

a.

further explores the apparent cross-tolerance between fluoxetine and mCPP and

b.

extends the model by investigating its sensitivity to dopaminergic manipulations (D2,3 agonism - quinpirole).

Methods:

In both experiments, baseline and drug testing was carried out under daily T-maze alternation training.

Exp.1:

Matched group (n=8) pairs of rats received one of the following 20-day pretreatments (daily intraperitoneal administration):

1.

saline,

2.

low-dose fluoxetine (2.5mg/kg),

3.

low-dose mCPP (0.5mg/kg) or

4.

combined fluoxetine+mCPP.

One group per pretreatment then received a 4-day challenge with high-dose fluoxetine (10mg/kg), the other with high-dose mCPP (2.5mg/kg).

Exp.2:

One group (n=12) of rats received 20-day treatment with saline, another with quinpirole (0.5 mg/kg).

Results:

Exp.1:

Saline and low-dose mCPP- or fluoxetine-pretreated animals showed significant persistence increases under both challenges, while combined low-dose fluoxetine+mCPP pretreatment afforded full protection from either challenge.

Exp.2:

Quinpirole significantly increased directional persistence after 13 administration days.

Conclusions:

These results establish the sensitivity of the rewarded alternation OCD model to D2,3receptor activation, thereby extending its profile of pharmacological isomorphism with OCD. Furthermore, they suggest a common mechanism of action of an SSRI and a serotonin agonist in the control of directional persistence.
an Investigation of 5-ht2 Involvement in the Acute Behavioural Effects of Fluoxetine and MCPP in an Animal Model of OCD
Authors: Tsaltas E. , Papakosta V.-M. , Kalogerakou S. , Papadopoulos S. , Kontis D. , Boulougouris V. , Papadimitriou G.
Published: March 2009

Background:

We reported that the non-specific 5HT agonist m-chlorophenylpiperazine (mCPP) and the SSRI fluoxetine (FLX) both cause acute persistence increases in the rewarded alternation (RA) model of OCD. Chronic pretreatment with either substance or their combined subclinical doses protects from this ‘pathogenic’ effect, so mCPP and fluoxetine exhibit cross-tolerance and synergy.

Aims:

Using specific 5HT2A and 5HT2C receptor antagonists we investigated whether these receptors participate in a common mechanism of action mediating the acute mCPP/fluoxetine effect in our model.

Methods:

Naïve, male Wistars were used. Drugs used (intraperitoneally): FLX (10mg/kg), mCPP (2.5mg/kg), M100907 (5HT2A antagonist, 0.03mg/kg), SB242084 (5HT2C antagonist, 0.5mg/kg), vehicle. Experiments included a drug-free training/baseline phase in T-maze RA (group-matching for spontaneous persistence: SP).

Experiment 1: Effects of M100907, SB242084, vehicle were assessed on 3 matched low SP and 3 high SP groups.

Experiment 2: the acute effect of FLX, mCPP and saline were examined on RA in 3 SP-matched groups.

Experiment 3: Effects of Vehicle+FLX, M100900+FLX, SB242084+FLX and Vehicle were examined on RA, in 4 SP-matched groups.

Experiment 4: Correspondingly for mCPP.

Results:

Experiment 1: Neither M100907 nor SB242084 affected high or low SP.

Experiment 2 replicated the pathogenic effects of FLX/mCPP.

Experiment 3: Neither M100907 nor SB242084 affected the pathogenic effect of FLX.

Experiment 4: in contrast, SB242084 (but not M100907) significantly reduced the pathogenic mCPP effect.

Conclusions:

The acute pathogenic action of mCPP, but not of FLX, involves 5HT2C but not 5HT2A receptors. the similar acute action of mCPP and FLX on persistence cannot be attributed to 5HT2 mediation.
Self-esteem in Obsessive Compulsive Disorder
Authors: Rahman R.U. , Husain N.
Published: March 2009

Background:

Despite important relation between obsessive compulsive disorder and self esteem there is death of local data.

Method:

The present study was carried out in Jan-March 2008 on 64 patients suffering from obsessive compulsive disorder and 30 attendants (control group) attending psychiatric outpatient clinic at civil hospital in Karachi, Pakistan. on inclusion in study, individuals having obsessive compulsive disorder aged 18-70 years were asked to complete two questionnaires to measure self-esteem that measure different aspect of self esteem. a) the Urdu version of Rosenberg self-esteem scale and b) the Janis and Field Social Adequacy scale. Statistical analyses of the scores of the two self-esteem scales were performed.

Results:

The results of the present study demonstrate that patient with obsessive compulsive disorder suffer significant degree of lowered self-esteem Mean 51.4(SD 12.0)] than control group [Mean 94.1(SD 11.8)] on Janis and field scale. That means that patients suffering from obsessive compulsive disorder have low social adequacy as compare to normal people this was more in female who score low (mean 49.48) than man (mean 53.9). Similar results of statistically significant (p< .000) difference in of control (Mean19.33) & OCD patient (Mean 34.08) was revealed by Rosenberg self esteem scale. in this study both scales of self esteem assessment have high correlation (correlation coefficient = -0.55).

Conclusion:

The results of this study support the result of other study that there is a vicious cycle between low self-esteem and obsessive compulsive disorders. Low self-esteem makes individuals susceptible to develop obsessive compulsive disorder.
Improved Postural Control after Behavioural Short Term Intervention in Patients with Psychiatric Dizziness
Authors: Best C. , Tschan R. , Dellani P. , Stieber N. , Beutel M. , Eckhardt-Henn A. , Dieterich M.
Published: March 2009

Background:

Patients with psychiatric dizziness often report subjective instability of stance and gait and fear of falls. They showed increased activity of their body sway in static posturography compared to normals (1, 2). Aim of the present study was to evaluate the efficiency of a behavioural therapy by static posturography.

Methods:

14 patients with psychiatric dizziness were included in the prospective study on static posturography to quantify the postural sway (sway path) during upright stance under different conditions. the psychosomatic examination comprised of standardized interviews (SCID-Interview) and a psychometric examination battery (SCL-90, VSS, VHQ). Results of static posturography were compared to those of an age-matched control group (n=23), baseline measurements were compared to the results after behavioural short term intervention.

Results:

At baseline patients revealed significantly lower sway-path values in the anterior-posterior and lateral planes (p< 0.001 - p=0.042) but significantly elevated values in the vertical plane (p=0.015 - p=0.042). They had to be supported more often in the examination setting to prevent falls (p< 0.001). after the short term intervention therapy a normalization of sway path values was present, especially the increased vertical sway activity was reduced (p=0.028).

Conclusion:

Patients with psychiatric dizziness activate significantly more anti-gravity muscles which reflects a change in postural strategy with an increased “stiffness” and a consecutively higher rate of “falls”. the patient's conscious control of stance augments coactivation of anti-gravity muscles. This typical pattern of postural control could be normalized by a short term behavioural therapy.

1. Krafczyk, 1999; 2. Querner, 2000.
Integral Self Therapy: A Novel Transpersonal Psychotherapeutic Method [P03-42]
Authors: Bhat S.
Published: March 2009

This paper summarizes the results of Integral Self Therapy in the treatment of a group of 30 patients with mild anxiety and depression, and explains the steps involved in this novel psychotherapeutic method.

Integral Self Therapy (IST) is best defined as a transpersonal, nondual, psychotherapeutic method.

It is a form of transpersonal psychotherapy since practitioners of IST incorporate a spiritual understanding of the nature of the self into the therapeutic practice. IST has its theoretical foundations in the eastern paradigm of self-concept.

“Non-Dual” refers to the eastern concept of the lack of an inherent difference between the observer and observed - a personal identity is considered to be a part of a larger whole. While this has traditionally been seen as a metaphysical concept, it has powerful therapeutic implications.

For example, a person with depression and anxiety might feel a great deal of relief if they are able to experience what Maslow called “peak experiences”.

Integral Self Therapy uses meditation, and gentle confrontation to create transcendent experiences.

These experiences are then placed into context by the therapist, comparing these experiences with the patient's own sense of depression and anxiety.

In this manner, patients are moved towards a more expansive self-concept. This has a significant therapeutic benefit, with a concomitant decrease in symptoms of depression and anxiety, with results seen in 6 to 8 sessions.
When Young Children have Conduct Problems - Who are the Nonresponders after Parent Training?
Authors: Drugli M.-B. , Larsson B.
Published: March 2009

Although most parent training programs produce positive effects, about one third of the children still show conduct problems at clinical levels after treatment.

In the present study, predictors and mediators of treatment non-response among children aged 4-8 years were investigated one-year after treatment with the Incredible Years parent training program (PT), or combined parent training and child treatment (PT+CT) in a randomized controlled trial. the study was conducted in two university cities in Norway.

KIDDIE-SADS, Eyberg Child Behavior Inventory (ECBI), Child Behavior Checklist (CBCL), Parent Practices Interview (PPI), Parent Stress Index (PSI), Preschool Behavior Questionnaire (PBQ), Teacher Report Form (TRF), were used.

Before treatment all children fulfilled the criteria for an ODD diagnosis or a sub-threshold diagnosis. at the one-year follow-up 33 % of the treated children still showed such a diagnosis, and they were defined as treatment non-responders.

Both family and child variables predicted treatment non-response at the one-year follow-up, although being involved with the child protection services was found to be the strongest predictor in multivariate analysis. Pretreatment child characteristics predicting treatment non-response at the one-year follow-up were high levels of child internalizing and aggression problems as reported by mothers. Further, mothers of children still showing a ODD diagnosis at the one-year follow-up, reported less change in negative parenting practices as compared to mothers of treatment responders.
Prediction of Demographic Factors on the Outcome of Short- and Long-term Psychotherapy
Authors: Joutsenniemi K. , Lindfors O. , Laaksonen M. , Haaramo P. , Knekt P.
Published: March 2009

Background:

Demographic factors have been shown to predict the outcome of short-term psychotherapy in the treatment of depressive and anxiety disorders. So far, however, information on the prediction for long- term therapy is missing. to be able to choose an optimal psychotherapy length for the patient, it is essential to know, which demographic factors predict different outcome in short- and long-term therapy.

Aim:

To compare the prediction of demographic factors on changes in psychiatric symptoms in short- and long-term psychotherapy.

Methods:

In the Helsinki Psychotherapy Study, 326 psychiatric outpatients, aged 20-46 years, and suffering from depressive or anxiety disorders, were randomly assigned to short-term therapy (short-term psychodynamic psychotherapy or solution-focused therapy combined) or long-term psychodynamic psychotherapy. the demographic factors (i.e. age, gender, education, income, and living arrangement) were assessed at baseline by a questionnaire. Psychiatric symptoms were assessed with the Symptom Check List, Global Severity Index (SCL-90-GSI) at baseline and 7 times during a 3-year follow-up.

Results:

Demographic factors were found to predict symptom development during follow-up irrespective of baseline symptom level. Female gender, being aged 25 or more, living with a spouse/partner, high education, and medium level personal income predicted benefiting sufficiently from short-term therapy, whereas being aged under 25, medium education, and living with other(s) than a partner or child(ren) predicted the need of long-term therapy.

Conclusions:

Demographic factors may be a useful tool in the selection of patients for short- and long term therapy.
the Experience of art in Psychotherapy - How to see Angel in the Marble and Curve to set him Free?
Authors: Stalekar V. , Jovanovic N.
Published: March 2009

Michelangelo said "I saw angel in the marble and carved until I set him free.", as he didn’t see himself creating something new, but unwrapping beauty that was already there. Art and psychotherapy have many things in common - both are based on relationships and sincerity, communicate through interpretation, creativity and imagination. Experience of art - as mode of learning about reality and one's inner world - can be incorporated into psychotherapy. Our Day hospital program includes psychodynamic analytic oriented group psychotherapy, psychoeducation, sociotherapy and art workshop. the latter implies patients’ artistic creation and visits to museums. It stimulates patients’ relationships with art and brings back a need for esthetic experience which can have protective and reparative role. Here we present several clinical vignettes, thus showing specific relations between psychotherapy and patients’ experience of art; and give an overview of psychiatric patients’ works stored in artistic collections (from Prizhorn until now), as well as art brut, and new psychotherapeutical technique - art therapy. Taking into account analytic and iconographic interpretations, we discuss their similarities and ask - what does a patient achieve by interpreting unconscious contents and what does interpretation of art mean to a recipient? Art and psychotherapy undoubtedly have an impact on us - they cause not only a direct physical reaction, but a sense of pursuit of meaning and contemplation leading to cognition. Every work of art leaves empty space for recipient to fill in. We believe this encourages an integrative process which is also aim of psychotherapy.
Hypnosis and Addictions: A Two Cases Report
Authors: Kammoun M.-F. , Anastasiu A. , Dumoulin T. , Garrigou J.L.
Published: March 2009

The addiction's problems are more and more frequent at the psychaitric's consultation. Alcoholism and drug-addiction are the two types of addictions most frequently found.

The bases of addiction's therapy are the weaning of the product, and the consolidation of weaning or the avoidance of the relapses.

the results remain however very heterogeneous and sometimes disappointing. the usual therapies seem little adapted to the dynamics of addictive pathology, and the rechuttes are increasingly frequent, in the same way the risk of replacement of a symptom by another is not excluded.

Can hypnosis help certain people to release their addictions? Hypnosis allows the subject the reinvestment its senses, as well as a modification of its relationship with the outside world. the patient can thus, to fall under a dynamics of change permattant to him to start a process of opening and exceeded the stage or it was solidified and locked up with the toxic product.

Few work were carried out in the field of the assumption of responsibility patients suffering from drug-addiction and addictions under hypnosis.

The objectives of this work is to study, through the illustration of two clinical cases of our daily practice, the place of hypnosis to help patients suffering from addcitives pathologies.
Psychotherapy, Pharmacotherapy and Rehabilitation of a Child with Cerebral Palsy
Authors: Mojs E. , Gajewska E. , Głowacka M.D. , Samborski W.
Published: March 2009

Cerebral palsy (CP) is one of the most often non-progressive encephalopaties. among clinical symptoms the mobility and posture disturbances are predominantly observed, most typically neurologic and motor disturbances, showing up as spasticity, disturbances in muscle tension, ataxia or somatosensoric problems. CP and its coexisting symptoms, encompassing mental impairment are most severe causes of handicap in children and constitute an important factor deteriorating the fulfilment of developmental tasks. the improvement of the functional status depends on systematic training based on learning processes. Following training, as effect of learning, stable plastic alterations in brain occurs, based on the previously described feature of making new synaptic connections and synaptic stabilization due to apoptosis of some other neural connections. Neverless pharmacotherapy, though it cannot remove the source of the disturbances and acts mainly symptomatically, is a important element of the complex rehabilitation. However, taking into consideration the chronic and stable character of the pathologic process, it should be remembered that the pharmacologic substances used should be characterized by:

•

high safety,

•

low toxicity,

•

beneficial psychotropic properties,organoleptic properties accepted by children.

The most frequently used drug groups in the cerebral palsy are:

•

tranquilizers,

•

anxiolytic drugs,

•

neuroleptics,

•

antidepressive drugs,

•

psychoenergetizing drugs, improving the brain circulation, limiting muscular tonus, - anti-epileptic drugs.

Rational use of relatively wide spectrum of drugs, relaxant, sedative, anxiolytic, toning up, improving cerebral perfusion, anticonvulsory and reducing muscle tonus makes diagnostics, functional psychotherapy, kinesis therapy, ergotherapy, manual therapy, physical therapy, as well as social and occupational rehabilitation easier to a very high extent.
Volumetric Changes in PTSD and in a Subgroup of PTSD Patients not Responding to EMDR Psychotherapy [P03-58]
Authors: Pagani M. , Nardo D. , Flumeri F. , Salmaso D. , Looi J. , Sanchez-Crespo A. , Larsson S.A. , Sundin Ö. , Högberg G. , Bejerot S.
Published: March 2009

Background:

Several studies have reported limbic structures volume decrease in Post-Traumatic Stress Disorder (PTSD). However, in PTSD the effect of therapy on brain structures has seldom been investigated. the aim of the study was to evaluate the grey matter (GM) loss in occupational related PTSD and to assess the volumetric differences between patients responding (R) and non-responding (NR) to psychotherapy.

Methods:

Pre-EMDR MRI data of 21 train drives who did develop PTSD (S) and 22 who did not develop PTSD (NS) after person-under-the-train accidents were compared. Within S further comparisons were made between 10 R to Eye Movement Desensitisation Reprocessing (EMDR) therapy and 5 NR. Data were analysed by optimised voxel-based morphometry as implemented in Statistical Parametric Mapping.

Results:

As compared to NS, S showed a significant GM volume reduction in precuneus, lingual gyrus, posterior cingulate and parahippocampal cortex. the R>NR comparison highlighted a significant GM reduction in NR in bilateral posterior cingulate, left middle frontal cortex and right parahippocampal, insular and temporal cortices.

Conclusions:

Comparing two large groups of subjects significant GM volumetric reductions were found in PTSD in posterior limbic structures. NR showed, as compared to R, volume reduction in cortical structures including posterior cingulate and parahippocampal cortex. These latter two structures seem to be the hallmark for both PTSD diagnosis and therapy outcome prediction.
Dance Movement Therapy of Patients with Hypochondriasis
Authors: Zharikova A.
Published: March 2009

The clinical estimation of efficiency of dance movement therapy (DMT) at treatment of patients with hypochondriasis (F 45.2 in ICD-10) was a objective of this research.

Research joined 26 females, middle age was 34,6 years, patients did not receive accompanying pharmacotherapy.

For an estimation of clinical efficiency were used: Simptom Checklist-90, revised (SCL-90-R), Clinical Global Impression scale (CGI), Hamilton Depression Rating Scale (HDRS), Hamilton Anxiety Scale (HAS), Individually-typological personal questionnaire (ITQ) and questionnaire Level of the subjective control (LSC).

Results of research have shown that the reduction on a subscale of somatization in CSL-90-R has constituted 78%. on CGI scale 42,7% had considerable improvement of a condition, in 34,3% moderate improvement was marked, in 15,7% cases - minimum and 7,3% did not have any changes in a condition. the mean score reduction on HDRS was 54%, on HAS -40%. in a profile of the person (ITQ) difference in orientation and polarisation of tendencies "sensitivity-spontaneity" has essentially decreased and consequently the probability of somatization of frustration has decreased. According to the LSC test subjective control has grown both within the limits of own person, and in formation of a significant environment, that reflects depression of situational anxiety.

Thus, DMT is effective enough, is well transferred and can be used in the form of monotherapy of patients with hypochondriasis.