bluuebunny/crossref_metadata_2025 huggingface dataset:
FC01-04 - Differential Effects of Depressive Symptoms on Mortality in Middle-Aged Adults with and without CHD
Authors: Nabi H. , Shipley M. , Vahtera J. , Hall M. , Korkeila J. , Marmot M.G. , Kivimäki M. , Singh-Manoux A.
Published: June 2010

Objectives

Depression and mortality have been studied separately in patients with coronary heart disease (CHD) and in populations healthy at study inception. This does not allow comparisons across risk-factor groups based on the cross-classification of depression and CHD status. We prospectively examined the effects of depressive symptoms, assessed in 2002-2004, on all-cause and cardiovascular -mortality in a large sample of 5936 middle-aged participants, with and without established CHD, followed over 5.6 years

Methods-results

We created 4-risk-factor groups based on the cross classification of depressive symptoms and CHD status. The age-and-sex-adjusted hazard ratios for all causes death were 1.67-fold (p< 0.05) higher for participants with only CHD, 2.10-fold (p< 0.001) higher for those with only depressive symptoms and 4.99-fold (p< 0.001) higher for those with both CHD and depressive symptoms when compared to participants without either condition. The two latter risk-factor groups remained at increased risk after adjustments for relevant confounders. Further comparisons indicated that the risks of all-cause death were also higher, but to a lesser extent, for participants with both depressive-symptoms and CHD when compared to those with only one of these conditions. These associations were also observed for cardiovascular mortality

Conclusions

This study provides evidence that depressive symptoms are associated with an increased risk of all-cause and CVD death and that this risk is particularly marked in depressive participants with co-morbid CHD. Several clinical guidelines have recommended screening, referral, and treatment of depression in primary and cardiovascular care units. These findings suggest that these recommendations need further consideration.
FC02-01 - Trait Aggression in Adult Psychiatry is Predicted by Childhood Hyperactivity, Conduct Disorder, Adult Substance Abuse, and Low Cooperativeness
Authors: Hofvander B. , Ståhlberg O. , Nydén A. , Wentz E. , degl’Innocenti A. , Billstedt E. , Forsman A. , Gillberg C. , Nilsson T. , Råstam M. , Anckarsäter H.
Published: June 2010

The prevention of aggressive behaviours is a core priority for psychiatric clinical work, but the association between the diagnostic concepts used in psychiatry and aggression remains largely unknown.

Objective

We aimed to describe aggression according to the subscales formed in the Life History of Aggression (LHA) in relation to life-time psychiatric diagnoses.

Methods

178 adults referred for psychiatric evaluations of childhood-onset neuropsychiatric disorders (outpatients) and 92 perpetrators of violent crimes referred to pre-trial forensic psychiatric investigations had comprehensive, instrument-based, psychiatric assessments, including the LHA scales. Total and subscale LHA scores were compared to the categorical and dimensional diagnoses of childhood and adult DSM-IV axis I and II mental disorders, general intelligence, GAF, and personality traits according to Cloninger's biopsychosocial model.

Results

The two groups had similar LHA scores (despite higher scores on the Antisocial scale in the offender group). Higher total LHA scores were independently associated with the hyperactivity facet of attention-deficit/hyperactivity disorder (AD/HD), childhood conduct disorder, substance-related disorders, and low scores on the Cooperativeness character dimension according to the Temperament and Character Inventory. IQ and GAF-scores were negatively correlated with the LHA subscale Self-directed aggression. Autistic traits were inversely correlated with aggression among outpatients, while the opposite pattern was noted in the forensic group.

Conclusion

In these study groups, aggression was predicted by childhood behaviour aberrations, adult substance-related problems, and character immaturity rather than by symptoms associated with the major mental disorders. AD/HD in combined or hyperactive, but not inattentive, forms, was associated with high scores on aggressive behaviours.
FC03-03 - Acute Treatment with Cannabinoid Receptor Agonist WIN55212,2 Improves Prepulse Inhibition in Psychosocially Stressed Mice
Authors: Havemann-Reinecke U. , Brzózka M. , Falkai P.
Published: June 2010

Cannabis, similar to psychosocial stress, is well known to exacerbate psychotic experiences and can precipitate psychotic episodes de novo in vulnerable individuals. Cannabinoid receptors 1 are widely expressed in the central nervous system (CB1) and are particularly important to mediate the effects of cannabis. Chronic cannabis use in patients and chronic cannabinoids treatment in animals is known to cause reduced prepulse inhibition (PPI). Similarly, chronic psychosocial stress in mice impairs PPI. In the present study, we investigated the synergistic effects of substances modulating the CB1 receptors and chronic psychosocial stress (social defeat). CB1 agonists serve as a surrogate marker for the effects of cannabis on the brain. For this purpose, C57Bl/6J mice were exposed for three weeks to psychosocial stress using the resident-intruder paradigm and were subsequently acutely treated with cannabinoid receptor agonist WIN55212,2 (3 mg/kg, i.p.). Stressed mice displayed a higher vulnerability to WIN55212,2 in the open field and PPI tests. The effects of WIN55212,2 on PPI were antagonized by Rimonabant (SR141716A, 3 mg/kg), a specific CB1 receptors antagonist suggesting an involvement of CB1 receptors in sensorimotor gating. Interestingly, WIN55212,2 increased PPI in psychosocially stressed mice although previous studies in rats showed the opposite effects Our data may imply that cannabinoids may improve particular surrogate marker of psychotic symptoms under certain conditions like psychosocial stress. However cannabinoids/CB1 receptor agonists may have possibly opposite effects in different experimental animal conditions. Further studies have to be done to study possible factors being involved in the expression of CB1 receptor effects.
FC03-04 - The Importance of Measuring Functional Impairment with the Composite International Diagnostic Interview in Depression Research. A PredictD-Spain Study
Authors: Moreno-Kustner B. , Motrico E. , Bellón J. , Gil-de-Gómez-Barragán M.J. , Díaz-Barreiros M.A. , Martínez-Cañavate M.T. , Vázquez-Medrano A. , March S. , Torres-González F. ,   Predict Spain Group
Published: June 2010

Objective

To determine the association between functional impairment, as reported in a lay-administered structured interview (CIDI), and severity of depression, depressive symptoms and risk factors for depression.

Methods

We undertook a cross-sectional study of 5442 consecutive attendees at general practices in seven Spanish provinces participating in the PredictD-Spain study on predictors of depression. Participants were administered the depression section of the Composite International Diagnostic Interview (WHO-CIDI 2.1), allowing diagnoses by the ICD-10 and DSM-IV classifications for depressive episodes. Impairment was measured using the CIDI question about whether symptoms seriously interfered with important areas of functioning, such as work or looking after the house and family. We measured a set of 39 known risk factors for depression.

Results

Firstly, the 6-month prevalence of a depressive episode according to ICD-10 was 28.7% (1563) and of major depression according to DSM-IV it was 13.6% (742). Secondly, out of the 1563 patients with a depressive episode according to ICD-10, nearly half (47.9%; n=749) had no impairment in important areas of functioning.

Conclusions

As the ICD-10 criteria for depressive diagnoses do not include the criteria that symptoms cause impairment in social, occupational or other important areas of functioning, a large number of false positive cases are included in reported prevalence rates; and secondly, the measurement of functional impairment, at least operationalized using a lay-administered structured interview such as CIDI, is not enough, in epidemiological research studies, to assess the clinical importance of depressive symptoms.
FC03-06 - Epigenetic Programming of the HPA Axis
Authors: Murgatroyd C.
Published: June 2010

Early-life stress (ELS) has long lasting effects on the brain. Maternal separation in mice persistently altered the offspring's hormonal responses to stress; this included elevated vasopressin (AVP) in the hypothalamus. Treatment with an AVP receptor antagonist was able to reverse the effects of early-life stress. The altered AVP expression was associated with sustained DNA hypomethylation of a region in the AVP gene enhancer that serves as a binding site for the methyl-CpG binding protein 2 (MeCP2). Neuronal activity was able to control the ability of MeCP2 to regulate transcription of the AVP gene and induce epigenetic marking. Thus, ELS can dynamically control DNA methylation in postmitotic neurons to generate stable changes in AVP expression that trigger neuroendocrine and behavioral alterations which are frequent features in depression.
YSFC01-04 - Psychiatry is a Branch of Medicine, Not a Specialty
Authors: Pio Abreu J.L. , Fradique E. , Freire Lucas R.
Published: June 2010

The imprecise status of Psychiatry may be due to Cartesian dualism and the mind / body assumption. We can clarify this status resorting to an alternative ontology. Popper's Worlds 1, 2 and 3, and the corresponding concepts of matter, energy and information, from Von Bertalanffy and his General Systems Theory, are candidates for a new ontology. Applying them to the history and present structure of Western Medicine, we can assume that General Surgery is the branch of medicine which deals with bodily matter, Internal Medicine deals with energy and Psychiatry is the branch which deals with information. The respective basic disciplines are Anatomy, Physiology and Psychology. None of them is a medical specialty, because specialties, such as Neurology, Urology and Cardiology, deal with a sub-system of the organism and may have a surgical, medical or even psychiatric emphasis. In the same way that the body / mind problem seemed important for Cartesian dualism, this triadic structure of Medicine may also inform a new ontology. The recent history of Philosophy may be interpreted as an attempt of looking for it.
YSFC01-06 - Perspectives of Using Neuroimaging Methods in Differential Diagnosis of Depression
Authors: Lebedev A. , Korzenev A. , Abritalin E. , Tarumov D. , Fokin V. , Sokolov A.
Published: June 2010

Introduction

Depression is one of the most common mental health problem and it grows greater every year around the world.

Aims

The main aims were to analyze the possibility of using functional and structural neuroimaging methods in diagnosis of different depression types and to find the predictors of pharmacological resistance.

Materials & methods

46 patients with depression syndrome were distributed into 3 groups: 1) Neurotic Depression (Diagnosis: Adjustment disorders) - ND group; 2) Endogenous Depression (Diagnosis: Recurrent Depression, Bipolar Affective Disorder - current depressive episode, Schizoaffective disorder, depressive type) - PD group, 3) Depression due to organic pathology (Diagnosis: Organic depressive disorder, Organic mixed affective disorder) - OD group. Controls were 18 years old- and gender-matched healthy participants. We used several methods of functional (positron-emission tomography, functional magnetic resonance imaging) and structural (voxel-based morphometry, diffusion-tensor imaging) neuroimaging.

Results

We found several functional and structural abnormalities in limbic structures within all three groups. Some of them were the same, some were different. Also we found several functional and structural predictors of pharmacological resistance.

Conclusions

We found several functional and structural abnormalities in all three depressive groups. Almost all of them were parts of so-called frontal-subcortical circuits, dysfunction of which, according to the present knowledge, could play crucial role in depression pathogenesis.

Summarizing our own results and analyzing the data of our colleagues, we complement a theory of depression pathogenesis and propose an original point of view for neurobiological basis of different types of depressive disorders and its pharmacological resistance.
P01-03 - Biomarkers for Changes in Self-regulation Through Cognitive Behavioral Therapy for Depression
Authors: Nocon A. , Keck K. , Pfister H. , Heldmann B. , Rosenhagen M. , Uhr M. , Lucae S. , Ising M.
Published: June 2010

Depressed patients show a disturbed hypothalamic-pituitary-adrenal (HPA) axis regulation, resulting in increased cortisol levels, inadequate cortisol suppression following a low dose of dexamethasone, increased concentrations of corticotropin releasing hormone (CRH) in the cerebrospinal fluid, and a blunted adrenocorticotropic hormone (ACTH) response following CRH administration. Treatment with antidepressants, but seemingly also cognitive behavioral therapy (CBT), is associated with an improvement of a disturbed HPA-axis regulation, which can be most sensitively evaluated with the combined dexamethasone (dex)/CRH test. Favorable response to antidepressant treatment can be predicted at an early stage by determining the degree of normalization of HPA-axis function under treatment in a second dex/CRH test.

We report about the predictive validity of HPA-axis normalization on the favorable response of CBT in medicated depressed patients.

Medicated depressed patients receiving CBT at the Max-Planck-Institute of Psychiatry in Munich are studied using the State-Trait-Angstinventar (STAI), Beck Depression Inventory (BDI), Volitional-Components-Questionnaire (VCQ-3), Emotion-Regulation Questionnaire (EPQ) and the Self-Control and Self-Management Scale (SCMS). Neuroendocrine parameters including measures of HPA-axis regulation are measured before and after therapy via dex/CRH test.

Up to the present moment data for N=38 depressed patients have been collected (N=21 male, 25-78 years; N=17 female, 21-80 years). The mean level of depression and anxiety showed a significant decrease between pre- and post-treatment measurement. Measures of perceived self-regulation and self-estimation increased and measures of perceived self-inhibition and inhibition of will decreased.

The expected changes in depression, anxiety and self-regulation after treatment with antidepressants and CBT were observed. Endocrine data are currently under analysis.
P01-106 - Verbal Working Memory Capacity in Patients with Chronic Schizophrenia, Chronic Depression, and Healthy Participants
Authors: van den Noort M. , Bosch P. , Kueppenbender N. , Mondt K. , van de Craen P. , Yeo S. , Lim S.
Published: June 2010

Objectives

The new standard computerized reading span test (RST), which is a complex verbal working memory test, was used for the first time in the assessment of verbal working memory capacity (Van den Noort et al., 2008) in two clinical populations.

Methods

Sixty participants, divided over three different groups; 20 patients with chronic schizophrenia, 20 patients with chronic depression, and 20 healthy participants, entered the study. The selection of the participants was based on strict inclusion and exclusion criteria. There was no comorbid depression in the patients with schizophrenia, as measured by the BDI-II. A comparison was made between the 3 different groups with respect to their verbal working memory capacity. The new standard computerized RST (Van den Noort et al., 2008) was used.

Results

In this study, in line with previous studies, a significant decrease in verbal working memory capacity and a general slowing down was found in chronic patients with schizophrenia and chronic patients with depression in comparison with healthy participants. In addition, patients with schizophrenia showed a nearly significant higher reading span score but were significantly slower than the chronic patients with depression.

Conclusions

The new standard computerized RST (Van den Noort et al., 2008) is a suitable complex verbal working memory test that could be used for clinical applications, for instance, for the assessment of verbal working memory capacity in patients with chronic schizophrenia and chronic depression.
P01-111 - Study of the Factors that Contributes to the Relapse of the Major Depression
Authors: Kyloudis P. , Georgiadis M. , Rekliti M. , Wozniak G. , Mouzas O. , Roupa Z.
Published: June 2010

Objectives

To probe the factors that contributes to the relapse of the major depression after being hospitalized for a period of three consecutive months in a psychiatric clinic.

Material & methods

22 patients (8 men) who were in the clinic were examined (average age 49.2, SD=7.2) suffering from major depression and who fully recovered between episodes. The criteria for their participation in the sample were according to DSM-IV®, and the >2 relapses/year.

Results

By the stepwise multiple regression analysis it was found that by hierarchy the factors that cause the relapse are, the fact that the patient does not respond to the first antidepressant treatment (parameter estimate p< 0.002), child or teenage depression background (p< 0.002), the presence of stressful facts (diseases, financial problems, loss of 1st degree relatives, p< 0.004) and the co morbidity with character disorders in the II (p< 0.01) axis.

Conclusions

The importance of a negative outcome of the major depression should be co estimated with the danger of self-destruction as a result of the illness, the difficulties of the interpersonal relationships, the professional activities, the impact on the family, alcoholism, drug abuse etc. and mainly the empirical impact on the patient.
P01-15 - Neural Correlates of Cognitive Control in Major Depressive Disorder
Authors: Brühl A. , Rufer M. , Baur V. , Kaffenberger T. , Herwig U.
Published: June 2010

Objectives

Cognitive control of emotions by reappraisal strategies is a psychotherapeutic technique reducing emotional load and anxiety in stressful situations. A previous study in healthy subjects resulted in a top-down regulatory effect by reappraisal during the anticipation of negative and unknown cued emotional stimuli as expressed by increased medial prefrontal cortical activation and accordingly reduced amygdalar activity. We were now interested in neurobiological changes in patients with major depressive disorder (MDD) compared to healthy controls during the application of cognitive control.

Methods

20 patients suffering from a depressive episode in the course of MDD and 20 healthy subjects underwent functional magnetic resonance imaging. All subjects were instructed and trained to apply a ‘reality check’ as cognitive control strategy during the cued anticipation of known negative and possibly negative, thus unknown (50% positive/negative) emotional stimuli.

Results

Applying cognitive control during the anticipation of negative and unknown cued stimuli, depressed patients had lower brain activity compared to healthy controls in thalamic and occipital regions as well as in the right extended amygdala, in the anterior cingulate cortex and the right anterior insula. Brain activity was increased in depressed patients in the right precentral gyrus and the left superior temporal gyrus/posterior insular region (close to Wernicke region).

Conclusion

We found several areas with reduced and also increased activations in MDD compared to healthy controls. We found no obvious deficits in this preliminary analysis in regions as the amygdala and the MPFC, corresponding to the hypothesized deficits in cognitive control mechanisms in MDD.
P01-16 - Similarity of the Neural Correlates of Neuroticism and Affective Measures, but not with Extraversion
Authors: Brühl A. , Viebke M.-C. , Kaffenberger T. , Herwig U.
Published: June 2010

Objectives

Extraversion and neuroticism are differentially correlated with affective disorders: Neuroticism is strongly correlated with depression and anxiety disorders, whereas extraversion is rather negatively correlated with anxiety disorders. Theories have implicated a common biological basis of neuroticism and affective disorders.

Methods

This study examined neural correlates of neuroticism and extraversion as well as of affective measures with functional magnetic resonance imaging using a task addressing pessimistic emotion processing during the cued anticipation of emotional stimuli in 14 healthy subjects. The measures of personality and affectivity were used as primary covariates for the correlation with brain activity during the anticipation of emotional versus neutral stimuli to identify brain regions in which individual brain activity was strongly correlated with psychometric measures.

Results

Neuroticism, depression and anxiety were correlated with brain activity in parieto-temporo-occipital regions, functionally involved in visual-perceptual processing and attentional modulation, and also in caudate regions. Extraversion was correlated with brain activity particularly in prefrontal regions.

Conclusions

Our results point to possible common neural correlates of neuroticism and the affective measures, whereas extraversion seems to have a differential neurobiological basis. Particularly, the correlation with caudate regions, involved in implicit patterns of reaction, points to possible “automatized” biases in neuroticism and depression.
P01-29 - Depression in Parkinson's Disease- Searching for the most Potent Antidepressant
Authors: Djokic G. , Zivkovic N. , Pavicevic D. , Lazic D.
Published: June 2010

Depression occures in 28- 60% of patients with PD. There is little evidence of the efficacy and safety of antidepressant therapies in Parkinson's disease. This interventive, paralel, RTC, safety/efficiency study included 339 patients aged 36-90, with ICD10/DSMIV criteria for PD and depression. Purpose of the study was to estimate depression, quality of life, and severity od PD symtoms after 3 months of antidepressant therapy.

Methods

We have randomly divide patients into control group(N=45) without antidepressants, and experimental groups in accordance with applied antidepressants: clomipramine(N=48), fluoxetine (N=49), sertraline (N=51), escitalopram (N=49), mirtazepine (N=45), and tianeptine (N=52). We have used HAMD for estimation of depression, QOL scale for quality of life, and UPDRS subscales I(behaviour and mood) and II(daily activities) for PD symptoms at pretrial, and after 3 months scores in all groups. Data were processed with SPSS for Windows.

Results

There is no statistical significance in pretrial scores between groups. After 3 months there is: significant increase in control and significant discrease(p=0.000) of HAMD scores in all experimental groups, in favour of antidepressant with higher mediana(escitalopram 9; sertralin 8; tianeptin 6;clompramin 3; mirtazapin 3;fluoxetine 1; control -2); significant increase of QOL scores in favour of antidepressant with higher mediana(escitalopram 1.24; sertraline 1.12; tianeptine 0.65; clomipramine 0.40; mirtazapine 0.27; fluoxetine 0.27), and significant difference in UPDRS II pretrial and after 3 months subscores(p=0.016), in favour of escitalopram.

Conclusion

All tested antidepressant are efficient in reducing HAMD score, but only escitalopram,sertraline,and tianeptine improved HAMD, QOL, UPDRS I, and II scores without side effects.
P01-35 - Fatigue in Female Patients with Major Depression: the Effect of age at Onset
Authors: Ferentinos P. , Kontaxakis V. , Havaki-Kontaxaki B. , Papadimitriou G. , Lykouras L.
Published: June 2010

Objectives

This study aimed to investigate the independent correlation of the severity of fatigue in female patients with Major Depressive Disorder (MDD) with age at illness onset.

Methods

We studied 70 female patients (34 inpatients), aged 23-65 years (mean 48.2±10.6 years), with MDD as assessed with the M.I.N.I. version 5.0.0. All patients were currently in a Major Depressive Episode, with a 17-item Hamilton Depression Rating Scale (HDRS) score ≥17, and free of major fatigue-associated conditions. Reported fatigue was assessed with the 14-item Fatigue Questionnaire (FQ). Pearson's (r) or Spearman's (rho) correlations between FQ, age, inpatient status, HDRS and age at onset were calculated. A multiple regression analysis was then performed, with FQ as the dependent variable.

Results

The FQ score was significantly correlated with HDRS (r=0.406, p< 0.001) and age at onset (r=-0.281, p=0.02). In the multiple regression model, HDRS and age at onset turned out as significant independent predictors of the FQ score, with standardised beta coefficients of 0.419 (p< 0.001) and -0.3 (p=0.006), respectively (R2=0.255).

Conclusions

The severity of fatigue in female patients with major depression is independently correlated with earlier age at illness onset.
P01-37 - Effects of Testosterone Supplementation on Depressive Symptoms in Hypogonadal men with the Metabolic Syndrome: The Moscow Study
Authors: Giltay E.J. , Tishova Y.A. , Mskhalaya G.J. , Gooren L.J.G. , Saad F. , Kalinchenko S.Y.
Published: June 2010

Introduction

Low testosterone levels in men are associated with the metabolic syndrome (MetS) as well as with depressive symptoms, low vitality and sexual dysfunction.

Objectives

To assess the effects of testosterone administration on these subjective symptoms, which have not extensively been studied in hypogonadal men with the MetS.

Method

In a randomized, placebo-controlled, double-blind, phase III trial, 184 men suffering from both the MetS and hypogonadism were included. They were treated for 30 weeks with either parenteral testosterone undecanoate (TU; 1000 mg IM testosterone undecanoate, at baseline, and after 6 and 18 weeks; Nebido®) or placebo injections. 105 (92.9%) men receiving TU and 65 (91.5%) receiving placebo completed the 30 week trial. The Beck Depression Inventory (BDI), Aging Males’ Symptoms (AMS) scale, and International Index of Erectile Function 5-item (IIEF-5) scale at baseline, 18 and 30 weeks were analysed using multilevel analysis.

Results

The mean age was 52.1 years (range: 35-69), with a mean body mass index of 35.5 kg/m2 (SD 6.7), and a mean total testosterone level of 8.0 nmol/L (SD 4.0). There were significant improvements in BDI (mean difference vs. placebo after 30 weeks: -2.5 points; 95% confidence interval [CI]: -0.9;-4.1; P=0.003), AMS (-7.4 points; 95% CI: -4.3;-10.5; P< 0.001), and IIEF-5 (+3.1 points; 95% CI: +1.8;+4.4; P< 0.001). The effects were strongest in men with baseline total testosterone levels < 7.7 mmol/L.

Conclusions

TU administration may improve depressive symptoms, aging male symptoms and sexual dysfunction in hypogonadal men with the MetS.
P01-41 - Age of Onset in Psychotic Unipolar Depression: a Comparative Clinical Study
Authors: Gournellis R. , Oulis P. , Rizos E. , Tournikioti K. , Michopoulos I. , Lykouras L.
Published: June 2010

Objective

The issue whether the clinical characteristics of unipolar psychotic major depression (PMD) vary according to the age of onset remains still unclear. In this study we assess comparatively the clinical characteristics of young early-onset (n=30), elderly early-onset (n=34) and elderly late-onset (n=35) psychotic depressives.

Methods

Ninety-nine inpatients suffering from DSM IV unipolar PMD were assessed on the basis of SCID IV, HRSD and a physical impairment rating scale.

Results

The elderly late-onset patients suffered from overall more severe depression compared to both categories of early-onset ones, more gastrointestinal symptoms compared to young early-onset patients and more psychic anxiety compared to elderly early-onset patients. Moreover, they expressed significantly more frequently delusions of somatic content and had higher scores on the HRSD item of hypochondriasis than their young early-onset counterparts. The group of elderly early-onset PMD patients was found to hold an intermediate position between the young early-onset and elderly late-onset PMD patients with regard to hypochondriacal ideation, gastrointestinal symptoms and delusions of somatic, guilt and paranoid content.

Conclusions

The findings of the present study suggest considerable differences between young, elderly early-onset and elderly late-onset PMD patients with respect to their clinical features.
P01-43 - Management of Comorbid Addictive Disorders in Bipolar Disorder Recommendation Formalized of French Expert in Bipolar
Authors: Guillaume S. , Samalin L. , Abbar M. , Meynard J.A. , Gay C. , Martin P. , Llorca P.M. , Courtet P. ,   l’ Association Francaise de Psychiatrie Biologique (AFPB)
Published: June 2010

Objective

As part of a process to improve bipolar disorders (BPD) treatment and outcome in France, AFBP developed recommendations in the management of patients with bipolar disorders for French practitioners. The recommendations aim to reflect both evidence-based practice and real-world experience. Here, we will focus on the management of BPD with comorbid addictive disorders.

Method

A formalized method by expert consensus panel was used. 239 questions were developed and sent to a panel of 40 French experts in order to assess six domains:

1)

screening and diagnosis,

2)

acute phase treatment,

3)

maintenance and non pharmacological treatment,

4)

somatic comorbidities,

5)

psychiatric comorbidities and suicide risk management and

6)

special populations.

Special attention was made to situations where evidence based treatment are lacking.

Results

The treatment of BPD and comorbid addictive disorders should be concurrent. The only exception is during an alcohol withdrawal where mood state may be reassessed for a second time. Experts recommend the use of atypical antipsychotics or anticonvulsants during a manic, mixed or depressive episode as well as in prophylaxia. During a depressive episode, the adjunction of an antidepressant may be considered. If adjunctive sedative treatment is necessary, a sedative classical antipsychotic seems to be a better choice that benzodiazepine. Substitution treatment for opioid must not be stopped. A psychotherapy focused on the addiction should be systematic in susbtance dependence and proposed in substance abuse.

Conclusion

The French expert panel recommends different therapeutic options for patients with dual diagnosis compared to usual BPD patients.
P01-47 - A Comparison of Life Events in Patients with adult-onset Unipolar Disorder, adult-onset Bipolar Disorder and Controls
Authors: Horesh-Reinmann N.
Published: June 2010

Objective

The present study aimed to explore the association between stressful life events (LE) and the development of affective psychopathology.

Method

Thirty patients with unipolar disorder and 30 patients with bipolar disorder were compared to 60 matched healthy controls as regards the rate of stressful LE. Measures included the Beck Depression Inventory, the Adult Life Events Checklist and the Childhood Life Events Questionnaire.

Results

The entire sample had more LE in general, more negative and loss-related LE in the year preceding their first depressive episode as compared to normals. Subjects with unipolar disorder had more positive LE and more achievement LE, whereas subjects with bipolar disorder had more uncontrollable LE in the year preceding the first depressive episode. The relationship between LE and manic episodes was prominent in the year preceding the first manic episode, with bipolar subjects reporting more LE in general and more ambiguous events in that year. A significant relationship was found between childhood LE and the development of affective disorders in adulthood, with unipolars exhibiting less positive and achievement LE.

Conclusions

The major impact of LE on the onset of affective disorders was found in the year prior to the first depressive or manic episodes, in the unipolar and bipolar groups. This suggests that the accumulation of LE at this crucial period contributes to the precipitation of a pathological response mechanism. Once established, this mechanism would be reactivated in the future by even less numerous and less severe stressors, compatible with the kindling hypothesis.
P01-60 - Irrational Beliefs of Patients with Major Depressive Disorder
Authors: Mandic V. , Perunicic I. , Lukic B. , Rakovic I. , Marjanovic S. , Lecic Tosevski D.
Published: June 2010

Objective

According to CBT theory, belief system has an important role in etiology of depression. Absolutistic, rigid and irrational beliefs might have influence on development and persistence of depressive psychopathology. The aim of our study was to examine characteristics of irrational beliefs in the cognitive scheme of patients with Major Depressive Disorder (MDD).

Method

The sample consisted of sixty inpatients diagnosed as MDD by using the ICD-X criteria. The assessment of irrational beliefs was carried out by Beck's Personality Belief Questionnaire (PBQ).

Results

Our findings have shown that irrational beliefs related to histrionic, schizoid and paranoid cognitive system were the most prevalent in patients with MDD. We also found significant and high correlation between opposite way of thinking - histrionic beliefs pattern correlated with avoidant and schizoid beliefs patterns. Also, dependent belief pattern was in a significant correlation with avoidant, schizoid and paranoid beliefs. In addition to rigidity, absolutistic and imperative cognitive schemes, we also found ambivalent cognitive tendencies. The existing ambivalence could be an important factor in the maintenance of depressive symptoms.

Conclusion

Our study has shown high prevalence of irrational beliefs in MDD patients. By recognizing the exact cognitive biases underlying depression, it might be possible to direct the therapeutic interventions more specifically and provide a highly personalized approach in the treatment of patients with MDD. We also believe that there is a need for a psychotherapeutic work on irrational beliefs during remission, which might prevent relapses.
P01-64 - Treatment of Depression in a British Community Mental Health Team; can Patients be Treated in Primary Care?
Authors: Butler S. , Agius M. , Zaman R.
Published: June 2010

Background

Patients who can be treated in Primary care should receive their treatment in Primary Care.

Aims/Objectives

We aim to identify depression treatments used by Bedford East Community Psychiatric Team (BECMHT) and hence identify those patients who could be appropriately managed in Primary care.

Methods

We identified 299 patients from the BECMHT database with depression (F32,F33, F41.2 and uncoded). Potential patient groups to discharge were identified by analysing these patients’ data; their medications were compared to NICE guidelines and other evidence-based-treatments.

Results

Many patients were on different combinations of medications but there were 153 (51.2%) on one antidepressant only. Half of the patients’ medication was in accordance with NICE guidelines (157/52.5%), 11 patients were on medication with a different evidence-base and 101 patients were on medication without either of these. However, 36.5% of patients had an inter-current psychiatric diagnosis.

Conclusions

Prescribing patterns within BECMHT demonstrate groups of patients who are more likely to need Secondary care, including those with inter-current psychiatric diagnosis and patients on medications that are not backed by NICE or a known evidence-base. Provided adequate symptom control, the patients who could be discharged include those on one antidepressant and patients on medications in conformity with NICE guidelines who do not need monitoring in secondary care. The patient's notes should be reviewed before discharge to ensure adequate future treatment. There should be good communication with Primary care, with joint protocols and the possibility for patients to easily access services appropriate to their needs.
P01-69 - Long-term Asenapine Treatment for Bipolar Disorder: a Double-blind 40-week Extension Study
Authors: McIntyre R. , Cohen M. , Zhao J. , Alphs L. , Macek T. , Szegedi A. , Panagides J.
Published: June 2010

Objectives

Asenapine is indicated in adults for acute treatment of schizophrenia and manic or mixed episodes associated with bipolar I disorder with or without psychotic features. We report the safety, tolerability, and efficacy of asenapine in patients with bipolar I disorder completing up to 52 weeks of treatment.

Methods

Patients completing either of two 3-week efficacy trials and a 9-week double-blind extension were eligible for this 40-week double-blind extension. Patients in the 3-week trials were randomized to flexible-dose asenapine (5 or 10 mg BID), placebo, or olanzapine (5-20 mg QD; included for assay sensitivity only). Patients entering the extension continued their preestablished treatment; those originally randomized to placebo received flexible-dose asenapine (placebo/asenapine, 5 or 10 mg BID). Safety and tolerability endpoints included adverse events (AEs), extrapyramidal symptoms, laboratory values, and anthropometric measures. Efficacy was measured as the change in Young Mania Rating Scale (YMRS) total score from 3-week trial baseline to week 52; the placebo/asenapine group was included in the safety analyses.

Results

Incidence of treatment-emergent AEs was 71.9%, 86.1%, and 79.4% with placebo/asenapine, asenapine, and olanzapine, respectively. The most frequent AEs included headache and somnolence (placebo/asenapine); insomnia, sedation, and depression (asenapine); and weight gain, somnolence, and sedation (olanzapine). Mean ± SD changes in YMRS score at week 52 among observed cases in the intent-to-treat population were -28.6±8.1 for asenapine and -28.2±6.8 for olanzapine.

Conclusions

In this 52-week study, asenapine was well tolerated and long-term maintenance of efficacy was supported in patients initially presenting with bipolar mania.
P01-70 - Complexity Analysis of Brain's Activity in Major Depression using Magnetoencephalography (MEG)
Authors: Méndez Hernández M.A. , Fernández Lucas A. , Hornero R. , Zuluaga P. , Rodriguez-Palancas A. , Ortiz T.
Published: June 2010

Introduction

Previous studies have suggested structural and physiological changes in Major Depressive Disorder (MDD). Unfortunately, there isn’t a consensus when defining the neuropathophysiology of depression. Hence, there isn’t a biological measure used in the clinical practice to define the differences between patients with depression and controls.

Objective

To test differences in Lempel-Ziv complexity (LZC) values between patients with major depression and controls.

Methods

Comparison of spontaneous oscillatory neuromagnetic activity using MEG between groups.

Participants

20 patients matching DSM IV-TR criteria for MDD, and 19 sex- and age-matched controls.

Results

We found a significant positive correlation between age and LZC values within controls. This correlation was not found in MDD patients. Depressive subjects showed a tendency of higher LZC values when compared to controls. We found significant differences between groups in anterior and right regions. After six months of treatment with Mirtazapine (30 mg V.O. O.D.), we studied the Hamilton-17 rating scale values and found that this treatment was clinically effective in most patients. The main pharmacological treatment's effect was besides reducing the LZC values in patients, to recuperate the tendency observed in controls.

Conclusions

We could suggest that there is a relationship between a physiological metric and depression as well as symptom relief or remission after an effective treatment. According to our results we found physiological changes in the brain dynamic in depressive patients when compared to controls which means there are neurophysiological changes in depressive patients with time.
P01-74 - Beneficial Effects of Chronic Treatment with Agomelatine on the Anxiety-and Depression-like State Induced by Corticosterone in C57BL/6NTAC Mice
Authors: Rainer Q. , Gabriel C. , Mocaer E. , Xia L. , Hen R. , Enhamre E. , Guilloux J.P. , Gardier A.M. , David D.J.
Published: June 2010

Recently, we have developed a novel paradigm appropriate and useful for screening early-stage and novel treatments for depression and anxiety based on the chronic delivery of corticosterone via the drinking water. Here, we investigated in mice the behavioral effects of agomelatine an antidepressant melatonergic (MT1/MT2) receptor agonist and 5-HT2C receptor antagonist on various paradigms predictive of antidepressant and anxiolytic activities such the Novelty Suppressed Feeding (NSF) test, the coat state, the splash test (grooming behavior), the Open Field paradigm (OF) and the home cage activity.

Adult mice were treated for 8 weeks with vehicle or corticosterone (35 ug/ml/day) via the drinking water. During the final four weeks, animals were treated with either HEC1%, agomelatine (10 and 40 mg/kg, i.p) or fluoxetine (18 mg/kg, i.p.). Behavioral tests were performed during the last experimental week.

Our results show that a chronic corticosterone treatment established a depressive/anxious-like phenotype in the NSF, OF and grooming behaviors. This state was reversed by a 4-week antidepressant treatment with agomelatine. Moreover, agomelatine blocked the impaired mice coat state induced by corticosterone. In agreement with its mechanism of action, agomelatine increased home cage activity (ratio dark phase/light phase) in both corticosterone and vehicle-treated mice suggesting an increase activity rhythms’ amplitude. Fluoxetine validated the behavioral models but without any effect on the synchronization of circadian rhythms. The present study suggests that agomelatine was able to reverse a depressive and anxious-like state in mice induced by elevation of glucocorticoid levels, results in line with the antidepressant/anxiolytic-like properties of the drug.
P01-76 - An Audit to Compare the Discharge Rates between Different Antidepressant Monotherapies Prescribed for Unipolar Depression
Authors: Agius M. , Gardner J. , Liu K. , Zaman R.
Published: June 2010

Background

A recent metanalysis has demonstrated that there are differences in efficacy and acceptability of commonly prescribed anti-depressants (Cipriani et al. 2009). Escitalopram, sertraline, venlafaxine and mirtazapine were the most effective.

Objective

We wished to find out whether the data from our own practice corresponded with the data from the metanalysis.

Aim

To compare the efficacy of anti-depressant monotherapies in patients with unipolar depression at Bedford Hospital, using discharge rates as the outcome measure.

Method

We included all patients with unipolar depression on an antidepressant monotherapy in Bedford hospital in our analysis (145 in total). We examined the clinical notes for each patient to assess whether they had been discharged from the out-patient clinic after being prescribed the antidepressant. This allowed us to calculate discharge rates for each antidepressant monotherapy.

Results

A higher percentage of patients prescribed Escitalopram were discharged from clinic compared to theother anti-depressant monotherapies.

Discussion

Our results support the findings of the meta-analysis. The discharge rates from Bedford hospital suggest that Escitalopram in particular is the most efficacious.

Conclusion

This audit in a small group of patients suggests that Escitalopram leads to the highest discharge rate compared to the other monotherapies prescribed.
P01-77 - Working Memory Impairments in Patients with Major Depressive Disorder (M.D.D)
Authors: Nazarboland N.
Published: June 2010

Objectives

Since it has been shown that depressed individuals experience deficits in executive cognitive functions, current study investigates the impairments of working memory in patients suffering from major depressive disorder (M.D.D) in comparison with normal control group in terms of DSM-IV criteria.

Method

The two groups (25 patients and 25 normal) were matched via gender, age and education. All completed Beck Depression Inventory and participated in two working memory tasks: “Paced Auditory Serial Adding Test (PASAT)” and “Wechsler Digit Span Scale”.

Results

Using T test for independent groups, the results indicated that the patient group were experiencing significant impairments in working memory in comparison with control group(p< 0.0001) and results of Regression Analysis showed that severity of depression has a significant effect on the amount of impairments that subjects had experienced in working memory.

Conclusion

Depression had impaired working memory performance in individuals and the amount of impairment will increase as the severity of depressive symptoms are increasing.
P01-94 - Social Adaptation Level among Inpatients with Atypical and Non-atypical Depression
Authors: Shepenev A. , Simutkin G.
Published: June 2010

Expansion of depressive disorders and widespread of atypical depression (AD) (by DSM-IV) are the major problems of contemporary psychiatry. The level of social adaptation disturbance may be one of indices of severity depressive impairments.

Objectives

To compare social adaptation level among psychiatric inpatients with an atypical and non-atypical depression.

Methods

140 inpatients at the age of 18-65 years were evaluated with SIGH-SAD (Williams J. et al., 1991) and Social Adaptation Self-evaluation Scale (SASS) (Bosc M. et al., 1997). Patients who got more than 7 points by SIGH-SAD atypical features were considered as AD-patients, they formed the main group. Patients who got 7 or less scores by SIGH-SAD atypical features formed the comparison group. Mann-Whitney test was used.

Results

10 men and 60 women (1:6) at the average age 44.5±11.4 generated the main group. The comparison group was generated by 20 man and 50 women (2:5) at the average age of 48±10.7. Significant difference at the age was not observed. The average age for women of main and comparison groups are 44.6±11.2 and 49.6±10.6 years (p=0.01891). The middle score on SIGH-SAD at admission was 31.4±6.2 in main group and 24.9±6.2 in the comparison group (p=0.0000). The middle score on the SASS in the main and comparison group was 30.4±8 and 33±7.2 properly (p=0.04687). Significant differences in social adaptation level subject to gender among and in the groups were not found.

Conclusions

Women with AD were younger than non-AD women. More severe impairments on SASS were found in a group with AD.
P01-98 - Influence of the Commorbid Posttraumatic Stress Disorder on the Clinical Presentation of the Depressive Epizode
Authors: Simonovic M. , Grbesa G.
Published: June 2010

The objective of the paper is to determine the pattern of influence of the chronic posttraumatic stress disorder on the clinical presentation of the depressive epizode. The focus of investigation is the comparision of the characteristics of the depressive epizode commorbid with chronic posttraumatic stress disorder with the depressive epizode which is a part od the primary depressive disorder.

Method

The investigation included 60 patients. Assessment was made by means of the following instruments:Montgomery-Asberg Depression Rating Scale for DSM-IV (MADRS), Hamilton Rating Scale for Depression (HAMD) and Clinician-Administrated PTSD Scale for DSM-IV (CAPS). The differences between groups were evaluated using Student t test and by means of the correlational analysis of the data with p < 0.05.

Results obtained showed significal clinical severity of the depression commorbid with postraumatic stress disorder. The group of the symptoms: lassitude, inability to feel, suicidal thoughts and inner tension contributed mostly to the global severity of the comorbid clinical depression.

Conclusion

The interpretation of results in the light of patophysiological mechanisms underlying the symptoms will enable the insight onto possible mechanisams of interaction of two disorders. Both classical and current trends of the psychoanalytical thinking, reffering to melanholia and to transformation of the trauma in the internal world, enabled explanation of the deepening of depression observed after ten years follow-up of the traumatized population.