bluuebunny/crossref_metadata_2025 huggingface dataset:
1019 – Safety Of Discontinuation Of Pregabalin After Long-term Treatment In Subjects With Generalised Anxiety Disorder (gad)
Authors: Kasper S. , Iglesias-García C. , Schweizer E. , Wilson J. , Dubrava S. , Prieto R. , Pitman V.W. , Knapp L.
Published: July 2013

Introduction

Pregabalin is indicated for the treatment of generalised anxiety disorder (GAD) in adults in Europe. When pregabalin is discontinued, a 1-week (minimum) taper is recommended to prevent potential discontinuation symptoms.

Aims/objectives

To evaluate whether a 1-week pregabalin taper, after 3 or 6 months of treatment, is associated with the development of discontinuation symptoms (including rebound anxiety) in subjects with GAD.

Methods

Subjects were randomised to double-blind treatment with low- (150-300 mg/d) or high-dose pregabalin (450-600 mg/d) or lorazepam (3-4 mg/d) for 3 months. After 3 months ~25% of subjects in each group (per the original randomisation) underwent a double-blind, 1-week taper, with substitution of placebo. The remaining subjects continued on active treatment for another 3 months and underwent the 1-week taper at 6 months.

Results

Discontinuation after 3 months was associated with low mean changes in Physician Withdrawal Checklist (PWC) scores (range: +1.4 to +2.3) and Hamilton Anxiety Rating Scale (HAM A) scores (range: +0.9 to +2.3) for each pregabalin dose and lorazepam. Discontinuation after 6 months was associated with low mean changes in PWC scores (range: -1.0 to +3.0) and HAM A scores (range: -0.8 to +3.0) for all active drugs and placebo. Incidence of rebound anxiety during pregabalin taper was low and did not appear related to treatment dose or duration.

Conclusions

A 1-week taper following 3 or 6 months of pregabalin treatment was not associated with clinically meaningful discontinuation symptoms as evaluated by changes in the PWC and HAM A rating scales.

This study was funded by Pfizer Inc.
1022 – Epistatic Effects Of Bdnf, 5httlpr And Maoa In Interaction With Environmental Adversityon Adolescent Criminality
Authors: Oreland L. , Comasco E. , Hallman J. , Aslund C. , Nilsson K.
Published: July 2013

Objectives and aims

Epistatic effects between gene variants of 5-HTTLPR (L=long, S=short), MAOA-VNTR (L=long, S=short), and BDNF Val/Met have been found with regard to behaviour in experimental animals as well as indicated in human samples in relation to neuroticism and depression. In the present study we studied epistatic effects of the above gene variations in an interaction with environmental adversity on adolescent criminality.

Methods

Family maltreatment, sexual abuse and criminality were measured by self-reports in a Swedish adolescent population-based sample (n=1819). Genomic DNA was isolated from saliva and used for genotyping of the BDNF, the 5-HTT and MAOA genes.

Results

BDNF genotype showed a main effect on adolescent criminality. BDNF also showed a two-way interaction with 5- HTT and Family maltreatment. 5HTT showed two-way interactions with MAOA and Family maltreatment. MAOA also showed a two-way interaction with Family maltreatment. Significant three-way interactions were found for; BDNF-5-HTT-Family maltreatment; BDNF-MAOA-Family maltreatment; BDNF-MAOA-Sexual abuse; and 5HTT-MAOA-Family maltreatment. Significant four-way (G*G*G*E) interactions were found for BDNF-5-HTT-MAOA-Family maltreatment and BDNF-5-HTTMAOA- Sexual abuse, respectively.

Boys showed a stronger effect of environmental adversity compared to girls. However, there were no significant sex-gene interactions. Furthermore, the two most genotypically divergent groups, according to expression levels, showed the highest criminality scores (MAOA-LL + 5-HTT-LL + BDNF Val-Val vs. MAOA S/LS + 5-HTT-S/LS + BDNF Val-Met/Met-Met), when exposed to environmental adversity.

Conclusions

There are significant epistatic effects between 5-HTT, MAOA and BDNF genotypes and environmental adversity for criminal behavior. Two distinct “types” can be recognized with regard to genotype.
1027 – Interests Of a Program Of Physical Activity In Patients With Schizophrenia: a Pilot Study
Authors: Chéreau-Boudet I. , Chareyron G. , Blanc O. , Charpeaud T. , Duclos M. , Llorca P.-M.
Published: July 2013

Compared to the general population, patients with schizophrenia have excess mortality linked to an increase of vascular cardio risk factors and a more sedentary lifestyle. Despite recent recommendations for physical activity, very few studies are devoted to the impact of this type of measurement in schizophrenic patients.

We present a study comparing 12 patients with schizophrenia, sedentary, followed in day care hospital, benefiting from a program of physical activity (PAP) with a control group of 8 patients with schizophrenia, which follow standard activities. The PAP runs on 12 weeks 3 sessions structured, by week, for 45 minutes. In pre and post PAP, (V1 and V2), clinical (BMI, waist circumference (TT), blood pressure), biological (glucose, total cholesterol, HDL, LDL, triglycerides), psychiatric (PANSS) and physical evaluations were conducted.

Patients, 15 men and 5 women, are aged 43,00 ± 9.00 years. Compared with controls, the PAP show a significant reduction in weight (p = 0. 001), BMI (p = 0. 006) and TT (p = 0. 002). A significant decrease in the intensity of negative symptoms have been tested between control and PAP group. A significant increase in aerobic capacity, muscular strength of lower limbs and flexibility was tested PAP and control. Attendance to the PAP, on the set of sessions in summer of 100%.

These results are in favour of developping physical activity for its effect on biological and clinical factors; this exploratory study has to be tested in a more straight methodology with a larger number of patients.
1038 – Perfectionism And Body Shape Concerns In Female Students With Dysfunctional Eating Attitudes And Behaviour
Authors: Batinic B. , Lazarevic J. , Vukosavljevic-Gvozden T.
Published: July 2013

Introduction and background

Before fulfilling the criteria for anorexia nervosa syndrome, many young females already display symptoms of dysfunctional eating attitudes and behaviour. If also accompanied by increased perfectionism and body shape concerns and dissatisfaction, this can indicate a high-risk group for eating psychopathology.

Method

The study group consisting of 45 randomly selected female students of University of Belgrade, mean age of 22.27 years (min 19, max 27), scored above the cut-off of 30 on the Eating Attitude Test (EAT-40), indicating symptoms of anorexia nervosa.The Frost Multidimensional Perfectionism Scale (FMPS), which measures different dimensions of perfectionism, and the Body Shape Questionnaire (BSQ), which evaluates body concerns and dissatisfaction, were applied, and the Quetelet Index (QI) was calculated.

Results

Descriptive statistics indicate as follows: EAT (M=42.71; SD=13.541), FMPS (M=104.80; SD=14.609), BSQ (M=100.69; SD=29.215), QI (M=21.21; Min 15.64, Max 29.38). Only 24.4% (N=11) of the students were not concerned with body shape. 80% of the study group were of normal weight, 11.1% were underweight, 8.9% were obese, and one member of the group (2.2%) had QI=15.64, indicating anorexia nervosa syndrome. Correlation analysis indicates that there is a positive correlation (r=,393) between perfectionism scores and concerns about body shape (p< 0.01).

Conclusions

Our results confirm previous research on the positive correlation between perfectionism and body shape concerns in females with disturbed eating attitudes and behaviour.This means that these features should be systematically assessed in female students and focus be given to prevention campaigns against eating psychopathology.
1041 – The Incidence, Resource Utilization And Financial Costs Of Treating Children With Attention Deficit/hyperactivity Disorder (adhd) In The United Kingdom (uk)
Authors: Holden S.E. , Setyawan J. , Coghill D. , Hodgkins P. , Currie C.J.
Published: July 2013

Introduction

ADHD is a common disorder that often presents in childhood and is associated with increased healthcare resource use.

Objectives/aims

To evaluate ADHD incidence and estimate resource utilization and costs of care in the UK.

Methods

The Clinical Practice Research Datalink was searched between 1998 and 2010 for patients aged 6-17 years, newly diagnosed with ADHD. Age- and sex-matched, controls were also identified (ratio 1:3). ADHD incidence was calculated as the number of incident cases/100,000 people (/100k) in the at-risk population. Resource utilization in the first year post-diagnosis was estimated for general practice (GP) contacts, investigations, drug treatments, outpatient appointments, and inpatient admissions. Monetary costs were derived from various sources (at 2011 prices).

Results

2,873 subjects with ADHD and 6,598 matched controls were identified. Mean (standard deviation [SD]) age was 9.8 (2.8) years and most (87%) were boys. The incidence of ADHD amongst boys and girls, respectively, increased from 69/100k and 7/100k in 1998 to 132/100k and 24/100k in 2007, and then fell to 98/100k and 20/100k in 2010. The mean (SD) annual, cost was £1,291 (£2,121) for cases and £315 (£2,345) for controls. For cases and controls, respectively, annual costs comprised GP contacts (£199, £70), investigations (£10, £8), drug treatments (£306, £37), outpatient appointments (£572, £62) and inpatient admissions (£203, £139).

Conclusions

The incidence of ADHD increased between 1998 and 2007, then declined slightly in 2010. Medical costs in the first year post-diagnosis were notably higher in children with ADHD compared with controls

Funding

Shire Development LLC.
1044 – A Prospective Comparison Between Formerly And Never Violent Patients Living In Psychiatric Residential Facilities
Authors: de Girolamo G. , Candini V. , Buizza C. , Giobbio G.M. , Maggi P. , Greppo S. , Boero M.E. , Melegari A. , Goldschmidt N.
Published: July 2013

Introduction

Persons with severe mental disorders and a history of violent offending are usually seen as a difficult-tomanage population: most have schizophrenia or severe affective disorders, while some suffer from severe personality disorders.

Aims

To investigate the sociodemographic, clinical, and treatment-related characteristics of a sample of patients living in RFs with a history of antisocial behaviour (‘violent’ group); to compare the characteristics of the ‘violent’ group with residents never violent; and to compare the rate of violent behaviour in the two groups over two years and to assess the likelihood of discharge in the two groups.

Methods

This is prospective observational cohort study involved 23 RFs of the St John of God Order in Northern Italy. The sample was divided into two groups: non-violent patients and ‘violent’ patients. The last included patients at last one time admitted in FMH or arrested for violent crimes or acted violent behaviors against people.

For each inpatient was filled out a “Patient Schedule”: socio-demographic and clinical data were collected, including a specific session to assess aggressive behavior lifetime and in the last year.

Results

The study involved 403 patients: 89 ‘violents’ and 314 non-violent. ‘Violent’ group was mainly male, younger, with a prevalence of personality disorders. Coherently, in the group of ‘violent’ there were more people lifetime arrested and admitted to a FMH.

Discussion

There are some differences in the monitoring of violent behavior in the two years of assessment. We observed more threatening, slap, punch, inappropriate sexual harassment, etc. in the ‘violents’ group.
1051 – Lurasidone In The Treatment Of Early-stage Schizophrenia: a Post-hoc Analysis Of Three Pooled Acute Treatment Studies
Authors: Lieberman J.A. , Pikalov A. , Hsu J. , Cucchiaro J. , Werner P. , Grossman F. , Loebel A.
Published: July 2013

Introduction

Lurasidone has demonstrated efficacy treating adults with schizophrenia, the majority of them with chronic, multi-episode schizophrenia.

Objective

To assess baseline characteristics and evaluate efficacy of lurasidone in patients with early-stage schizophrenia (ESS).

Aims

Evaluate efficacy of lurasidone in patients with ESS.

Methods

A pooled analysis of patients with ESS (defined as onset of illness within 3 years of study entry) from three, 6-week, randomized, placebo-controlled, phase 3 trials was performed. Additional analysis was conducted for patients with onset within 5 years. Efficacy was evaluated using a mixed-model repeated-measures analysis of change in PANSS total score and CGISeverity score. Treatment response was defined as ≥20% improvement in PANSS total score from baseline.

Results

857 subjects were randomized to lurasidone and 366 to placebo of which 102(11.9%) lurasidone and 44(12.0%) placebo subjects had ESS (onset within 3 years). Among 146 ESS subjects, 70.5% were male, mean age was 28.6 years. Baseline PANSS total and CGI-S scores were 96.8 and 5.0 respectively. Lurasidone treatment of early-stage schizophrenia subjects showed significant improvement vs placebo in PANSS total score (-25.9 vs -17.3; p< 0.05, effect size=0.42), PANSS positive (-9.6 vs 6.0; p< 0.01) and negative (-5.6 vs -3.2; p=0.014) subscale scores, and improvement in CGI-S score (-1.7 vs -1.3; p=0.089, effect size=0.36). Responder rates were 69% for lurasidone vs 48% for placebo (NNT=5). Similar results were observed in subjects with within 5 years of onset of illness.

Conclusion

In this subgroup analysis, lurasidone was effective in the treatment of patients with early-stage schizophrenia.
1068 – The Influence Of Family And School Environment On The Development Of Social Anxiety Disorder
Authors: Bracik J. , Zaczek A. , Krysta K. , Krupka-Matuszczyk I.
Published: July 2013

Introduction

The prevalence of Social anxiety disorder (SAD) is believed to be underestimated, although it is a very common condition. The subjects suffering from it often have trouble to search for support. The onset occurs mainly in early adolescence.

Objectives

The aim of this paper was to evaluate the impact of school and family background on the development of SAD.

Methods

Our questionnaire available on a popular social network site, was divided into 4 parts:

1)

demographic data (gender, age, site of residence),

2)

genetic and organic background (comorbid mental disorders, addictions),

3)

situation at school and in the family environment during adolescence,

4)

the part designed to define the group that may suffer from SAD with the use of the Mini-Social Phobia Inventory (Mini- SPIN).

Results

226 people were recruited. The age range was 16–61, with the average of 25,8. 71% of the respondents lived in cities with a population of more than 100 000. Male to female ratio was 3:1. According to Mini-SPIN 26,5% of the interviewees might suffer from SAD (28.2% of women and 21.4% of men). Our study showed, that both family and school environment factors have an influence on the development of SAD.

Conclusions

The amount of internet community users that are likely to suffer from SAD, significantly exceeds the clinical data. Both family and school environment factors were shown to be risk factors for the development of this disorder.
1096 – Safety, Tolerability And Treatment Response With Flexible Doses Of Paliperidone Palmitate In Non-acute Patients With Schizophrenia
Authors: Schreiner A. , Hargarter L. , Bergmans P. , Cherubin P.
Published: July 2013

Objective

To explore tolerability, safety and treatment response of flexible doses of paliperidone palmitate in adult non-acute patients with schizophrenia previously unsuccessfully treated with oral antipsychotics.

Methods

Interim analysis of a prospective 6-month, open-label study. Outcomes were change in the Positive and Negative Syndrome Scale (PANSS) score, Clinical Global Impression-Severity Scale (CGI-S) and patient functioning (Personal and Social Performance Scale; PSP) from baseline to endpoint, weight change and adverse events (AEs).

Results

Of the first 403 patients enrolled (63.3% male, mean age 39.4±12.0 years). 74.4% completed the study. Most frequent reasons for discontinuation were subject choice (10.7%), and AE (5.5%). The recommended initiation regimen was administered in 94.0% of subjects. Mean PANSS total score decreased from 71.9±15.2 at baseline to 60.8±18.4 at endpoint (mean change -11.1±15.4; 95% confidence interval [CI]-12.6;-9.6; p< 0.0001); 61.2% of the patients showed an improvement of ≥20% in PANSS total score. The percentage of patients rated mildly ill or less in CGI-S increased from 33.2% to 62.1%. Patient functioning improved from a mean PSP baseline score of 57.9±13.7 to 65.2±15.3 at endpoint (95%CI of change 6.0; 8.7; p< 0.0001). AEs reported in ≥5% were injection site pain (13.9%), insomnia (7.9%), anxiety (6.9%), psychotic disorder (5.7%) and somnolence (5.2%). Mean weight change from baseline to endpoint was 1.4±5.2kg (95%CI 0.8; 1.9).

Conclusion

These data support results from recent randomized controlled studies that flexibly dosed paliperidone palmitate is safe, well tolerated and associated with a clinically relevant treatment response in non-acute patients with schizophrenia previously unsuccessfully treated with oral antipsychotics.
1102 – Suicidal Intent Is Increased In Suicide Attempters With Posttraumatic Stress Disorder After Childhood Abuse
Authors: Lopez-Castroman J. , Jaussent I. , Guillaume S. , Beziat S. , Olié E. , Baca-Garcia E. , Malafosse A. , Courtet P.
Published: July 2013

Introduction

The diagnosis of Posttraumatic Stress Disorder (PTSD) and the experience of childhood maltreatment have been independently associated with a higher risk for suicide attempts.

Objectives

To investigate if PTSD diagnoses following childhood abuse are correlated with markers of suicide severity, such as the age at the first suicide attempt, the number of attempts or the suicidal intent.

Methods

We studied a sample of 726 suicide attempters. Lifetime clinical diagnoses and history of childhood abuse were registered. The association of PTSD and childhood abuse dimensions with age at first suicide attempt, number of suicide attempts and suicide intent was studied. An adjusted multinomial logistic regression was performed to ascertain if combined childhood abuse and PTSD increased the severity of the suicidal behavior.

Results

Several types of childhood abuse (emotional, physical and sexual abuse) when combined with a lifetime diagnosis of PTSD showed an increased risk for more suicide attempts and a higher level of suicidal intent compared with the absence of any or both risk factors.

Conclusions

The combination of PTSD and childhood abuse should be investigated in clinical settings due to an augmented risk for more severe suicidal behavior.

[Suicide intent associated with PTSD and/or abuse]
1117 – Psychopathological Dimensions Of Burn Out Syndrome: Depression And Anxiety Correlates
Authors: Stoyanov D.S. , Hristozova S. , Arabadziev Z. , Tilov B.G.
Published: July 2013

Burn out syndrome (BOS) is considered as a major issue for stress-related professions, with severe clinical and management implications. According to Maslach BOS is manifested with: emotional exhaustion (EE), depersonalization (DP) and low personal accomplishment (PA). Our recent studies have revealed links between personality, psychological climate and vulnerability to burn out (Stoyanov and Cloninger 2011, Tilov et al.2012, Raycheva et al. 2012). At the same time there is growing awareness of the psychopathological features of burn out, considered by some authors as clinical depression (Acker, 2011).

The present study aims at comprehensive assessment of the psychopathological correlates of burn out, more specifically depression and anxiety.

We have employed the self-assessment questionnaire for depression and anxiety of T. Tashev (DAQ) and Maslach Burnout Inventory (MBI) as standardized for Bulgarian population. DAQ is composed of the following pertinent to our objective scales: general anxiety (GA), vegetative (V); obsessive (O) and depressive (D); MBI is based on the dimensions EE, DP and PA. Our study consists of 70 employees from the system of health care and medical education. The statistical analysis has been performed according to the method of Spearman.

The results reveal significant positive correlations of GA, V, D, O from DAQ with EE and DP from MBI and negative correlations of the DAQ scales with PA.

It confirms the hypothesis that BOS has clinical manifestations consistent with measures for depression and anxiety disorders. However these trends may indicate the presence of the initial stage of BOS - “flame out”.
1118 – The Impact Of Intra- And Postoperative Albumin Levels As a Biomarker Of Delirium After Cardiopulmonary Bypass: Results Of An Exploratory Study
Authors: Baranyi A. , Rothenhäusler H.-B.
Published: July 2013

Introduction

Delirium is a frequently under-recognized finding in post-cardiopulmonary bypass patients that is potentially reversible but often associated with short-term complications, increased mortality and prolonged hospitalisation.

Aims

In this prospective study the frequency of delirium after cardiac surgery with cardiopulmonary bypass (CPB) was determined. Furthermore, we investigated the impact of intra- and postoperative levels of albumin as a biomarker of delirium.

Methods

34 patients who underwent elective CPB at the Department of Cardiac Surgery, Ludwig-Maximilians-University of Munich, Germany, were enrolled in this prospective study. During the Intensive Care Unit (ICU) stay and shortly after discharge from the ICU, delirious state was evaluated daily using the Delirium-Rating-Scale. Albumin was assayed preanaesthesia, immediately after induction of anaesthesia, at the beginning of the heart-lung-apparatus period, immediately before the opening and 5 minutes after the opening of the aortic clamp, 24h and 48h postoperatively and on the day before discharge.

Results

After CPB, a clinical significant delirious state was observed in 11 patients (32.4%). The albumin level decreased during the surgical intervention and increased postoperatively with a maximum level at the time of discharge. CPB patients with delirious state showed a significantly lower albumin level 24h and 48h postoperatively than those without delirium.

Conclusions

A postoperative delirium is a frequently observed finding in post-CPB patients. A low levels of postoperative albumin seems to be an useful biomarker to identify patients with high risk of delirious state after CPB.
1121 – Effects On Cognitive Function In Treatment Resistant Bipolar Depression: Ect Compared To Algorithm Based Pharmacological Treatment
Authors: Kessler U. , Schoeyen H.K. , Andreassen O.A. , Eide G.E. , Hammar Å. , Malt U.F. , Oedegaard K.J. , Morken G. , Sundet K. , Vaaler A.E.
Published: July 2013

Introduction

Electroconvulsive therapy (ECT) is a treatment alternative in bipolar disorder (BD) depression. Cognitive side effects are the major concern limiting its use.

Objectives

We present data from the Norwegian randomized controlled trial of ECT in treatment resistant depression in bipolar disorder.

Aims

To compare effects on cognitive function of ECT or algorithm based pharmacological treatment at the end of a six-week acute, BD depression treatment trial.

Methods

Prospective, randomised controlled multi-centre, six-week acute treatment trial. Pre- and post-treatment assessments with the MATRICS Consensus Cognitive Battery (MCCB); a neuropsychological test battery designed to be sensitive to changes in cognitive function.

Sample

N = 51 patients ≥ 18 years fulfilling criteria for treatment resistant BD depression (MADRS score ≥ 25).

Intervention

ECT group: Three sessions per week for up to six weeks, total up to 18 sessions, and right unilateral electrode placement. Algorithm-based pharmacological treatment group: Based on Goodwin & Jamison, 2007.

Results

Both groups showed a net gain on MCCB scores without significant differences between the study groups. Mean change in MCCB composite T-score was 4.0 (5.7) in the ECT group and 2.7 (3.6) in the pharmacological group (F = 0.78, eta2 = 0.021, p = 0.383).

Conclusion

In treatment resistant BD depression ECT and algorithm-based pharmacological treatment have comparable effects on cognitive function assessed with the MATRICS.
1124 – A Multicentric, Retrospective Data Collection From Patients Diagnosed With Schizophrenia Switched To Solian® In Romanian Practice- switch Study
Authors: Vasile D. , Vasiliu O. , Mangalagiu A.G. , Petrescu B.M.
Published: July 2013

Objective

The primary objective was to assess the reasons for antipsychotics switch to amisulpide and to evaluate the outcome at 6±1 months following the switch from any antipsychotic drug(s) to amisulpride (Solian®).

Methods

This is an open, non-randomized, multicentric, retrospective, non-interventional study that included 1165 subjects who were already stabilized on amisulpride for at least 6±1 months. These patients were previously switched from other antipsychotic to Solian®. Data were collected retrospectively on the patients’ status 6±1 months ago and their present status.

Results

Reasons for switching previous antipsychotic treatment: inadequate control of symptoms in 79.3% of the patients, relapse of the disease under treatment 54.5%, adverse reactions 61.9%, reduced compliance 49.1%, comorbities 7.7%, patients request 28%, family request 24.5%, high cost 1.8%. Reasons for choosing Solian®: quality of life improvement 20.3%, cognitive function preservation 18.7%, better efficacy on positive symptoms 18.7%, better efficacy on negative symptoms 15.1%, low risk of extrapyramidal symptoms 12.3%, reduced weight gain 9.8%, minimal interactions with other drugs 4.2%. The compliance was significantly improved (61%), moderately improved (16%), unchanged (7.6%). Adverse reactions were significantly improved (53.5%), moderately improved (18.5%), unchanged (8.9%), minimum worsening (0.2%), medium worsening (0.1%). The efficacy was significantly improved (69.8%), moderately improved (19.2%), unchanged (2.2%), minimum worsening (0.1%).

Conclusions

The main reasons for antipsychotic switch were the inadequate control of symptoms, relapse of the disease under treatment and adverse reactions. Psychiatrists’ evaluation of the switch outcome at 6±1 months following the switch underlined significant improvement of compliance, adverse reactions and treatment efficacy.
1126 – The Efficacy Of Social Skills Training Over Self-image Distorsions In Avoidant Personality Disorder
Authors: Vasile D. , Vasiliu O. , Mangalagiu A.G. , Blandu M. , Magazin O.
Published: July 2013

Background

The lack of social skills and self-image distorsions are frequently met in the avoidant personality disorder (APD) and although the personality disorders are egosyntonic, subjects could experience prolonged dysforic episodes and a will to change their relationship patterns.

Objective

To evaluate the efficacy of social skills training on the overall APD features and on the self-image distorsions, in particular.

Methods

A group of 12 subjects with APD, diagnosed using Structured Clinical Interview for Axis II Disorders of DSM IV (SCID II), were included in a psychotherapy program focused on social skills training with 2 sessions per week, for 3 months, with a follow-up visit after 6 months from baseline. These patients were included in an individual therapy (12 sessions) and group therapy (12 sessions). All of these subjects were monitored using a semi-structured interview focused upon the avoidant-type cognitive schemata and self-image related automatic cognitions. A diary was held by every patient and cognitive restructuring was monitored, as well as the effect of role-playing, imaginative and in vivo exposures.

Results

The social skills training decreased the occurrence of social exposure associated discomfort, self-image self-reported automatic cognitions (as reflected by the diary entries). The overall evolution reflected an increase in self-confidence and a more stable sense of self in relationships, although the SCID II confirmed the maintenance of the APD diagnosis at follow-up visit.

Conclusions

Social skills training has a positive impact over the self-image, decreasing the social exposure discomfort and inadequacy feelings in the patient relationships.
1139 – Reactive Attachment Disorder: Effects And Limits On Treatment Options
Authors: Zuber N. , Durham M.
Published: July 2013

The failure to bond with a caring adult can lead to failed bonding in future relationships throughout life. This inability to relate or connect to others may affect the child's development. More and more children are being diagnosed with reactive attachment disorder due to affective instability related to their inability to make secure attachments. The diagnosis is complex and treatments are limited which presents a challenge for providers and patients alike.

Objectives

Describe cases related to reactive attachment disorder.

Describe diagnosis of reactive attachment disorder and its limitations.

Describe treatment options for reactive attachment disorder.

Aims

Be familiar with diagnosis of reactive attachment disorder.

Be familiar with treatment options.

Be familiar with challenges in complex scenarios.

Methods

Case of a 15 year old black female with history of neglect, legal issues, school truancy, witness to domestic and community violence who presents with escalating aggressive behavior and affective instability.

Literature review focusing on treatments options in complex scenarios.

Results

Many children are suffering from “maltreatment” and there are difficulties with making an appropriate diagnosis due to co-occurring symptoms and potential differential diagnoses; therefore treatments are limited.

Conclusions

The disorder warrants further research especially in addressing the timing and critical period for an intervention. The disorder necessitates a multi-modal approach in particular a collaborative approach involving in home services with the child and caregiver. The disorder becomes even more complex when dealing with patient populations with intergenerational adversity and the patterns of disordered attachment are evident.
1150 – The Relationship Between Temperament And Character Pattern With Migraine In Patients With Migraine Headache And Control Group
Authors: Sadramely M. , Nilipour M. , Naji F.
Published: July 2013

Introduction

Among the causes of headache, migraine headache are most common. Migraine is most common referrals to neurology clinics in all human societies. Today it is confirmed that many of chronic headache is associated with psychological and behavioral problems. Personality is defined as the capacity of individual protest :and temperament &character are subsets of personality. TCI(temperament &character Inventory)is a questionnaire that evaluate these dimensions.The relationship between temperament and migraine were also considered.

Objectives

To evaluate The relationship between temperament and character pattern with migraine

Aims

To provide information for psychiatrists, neurologists and other clinician to aware of this relationship.

Methods

This is a prospective case control study which was done on 63 migraine patients as case group and 63 controls. TCI was used for evaluation.

Results

In case group the average score in patients were: Novelty seeking 41.51,mean Harm avoidance was 52.16 and Reward dependence 62.14. The average score of Selfdirectedness was 53.14, cooperativness 78.45, Preseverence 63.21 and Selftranscedence was 60.95.

In control group the average score in patients were: Novelty seeking 44.77,mean Harm avoidance was 49.28 and reward dependence 62.42.The average score of Selfdirectedness was 54.81,Harm avoidance 73.92, Preseverence 54.09 and Selftranscedence was 62.42.

Harm avoidance and Cooperativness had a significant difference between groups(P ha=0/048, P co=0/043).

Conclusions

Results showed a significant difference between groups in HA and CO. We can conclude that migraine patients had a higher score in HA and CO subsets. HA is related to serotonergic system and this results presents the role of serotonin in migraine pathology, This shows the role of serotonin in the incidence of HA in migraine patients.
1151 – Clinicians’ Attitudes Toward The Use Of Long-acting Injectable Antipsychotics
Authors: Samalin L. , Charpeaud T. , Heres S. , Llorca P.-M.
Published: July 2013

Introduction

In schizophrenia, depot formulations are not widely used in everyday practice. Clinicians’ attitudes play a major role in this low level of use of Long Acting Injectable (LAI). As a consequence, only 35% of patients declare to be well- informed about those formulations.

Objectives

This study aims to assess psychiatrists’ attitudes toward the use of long-acting injectable antipsychotics in schizophrenia.

Methods

During the French Congress of Psychiatry (November 2010, Lyon), we interviewed 113 psychiatrists about the factors that influenced their prescription of LAI. We used a structured interview, adapted from the two questionnaires developed by Heres et al. in two studies about the attitudes of German Psychiatrists. Multidimensional and cluster analyses were performed to identify correlations.

Results

Hazard risk for others, depot experienced, non-compliance and relapse in the past incited psychiatrists to prescribe LAI antipsychotic. Two different clusters of patients were identified: cluster I corresponded to patients with a past history of relapse and poor compliance and cluster II corresponded to patients with a high level of insight and of therapeutic alliance. The most important factor against the use of LAI was a sufficient estimated compliance with the oral formulation. The risk of extrapyramidal symptoms is, in our sample, one of the main reasons for a limited use of depot neuroleptic.

Conclusions

Most factors influencing clinicians’ attitudes toward the use of LAI are shared in many countries. Some attitudes related to organisational aspects, particularly the relevance of healthcare costs may vary from one country to another.
1157 – Diet Behaviors And Danger Of Developing Eating Disorders In School Students
Authors: Szczegielniak A. , Pałka K. , Krysta K. , Krupka-Matuszczyk I.
Published: July 2013

Introduction

The problem of eating disorder is increasingly affecting teenagers in Polish schools. This phenomenon needs to be screened and analyzed to allow early detection and diagnosis and providing proper treatment.

Objectives

The purpose of the study was to assess the correlation between school students’ results in EAT-26 self-report questionnaire and their daily diet behavior and to analyze the occurrence of eating disorders among students in Silesian schools.

Methods

Our survey was based on the EAT-26 (Eating Attitude Test) and Behavioral Four Questions Test. 150 questionnaires were given to students of Secondary Schools, 116 were filled out properly. The interviewed group consisted of 85 girls and 31 boys. Average age was 17,24 +/- 1,18. All of the data were analyzed statistically.

Results

Average BMI was 21,06; half of the recruited subjects had correct BMI whereas over 40% of them presented underweight. Within 116 responses from the EAT-26 nearly 93% were the a group of the small risk of the future eating disorders. Nevertheless, over 6% of survey participants were in the group of the high risk. In the Behavioral Four Questions Test 10% were in the compulsive overeating group, others in the group of a probable development of anorexia (7%) or bulimia nervosa (3%).

Conclusions

Specific socio-cultural factors are challenging for the public service- both, in terms of health promotion programs and the organization of free after school hours.
1158 – A Morphologically Based Scale Of Alzheimer’s Disease Stages “the Tomography Dementia Rating Scale” (tdr)
Authors: Maksimovich I.V.
Published: July 2013

Introduction

To identify AD stages, we propose morphologically determined “Tomography Dementia Rating scale (TDR)” based on the determination of dementia stages according to the severity of atrophic changes in the temporal lobes obtained during CT or MRI.

Methods

The research included 81 patients aged 34–79 (average age 67), 28 male (34.57%), 53 female (65.43%), with AD different stages.

All the patients underwent MRI, CT with subsequent calculation of the temporal lobes atrophy degree.

Results

CT and MRI showed that objective brain morphological features characteristic for all patients with AD are atrophic changes in the temporal lobes, which at AD different stages range from 4 to 62%. These data made it possible to set up a scale that allows to identify certain atrophic changes at each disease stage:

Preclinical AD stage - TDR-0 - temporal lobes atrophy with 4–8% tissue mass decrease.

Early AD stage - mild dementia - TDR-1 - temporal lobes atrophy with 9–18% tissue mass decrease (corresponds to CDR-1).

Middle AD stage - mild dementia - TDR-2 - temporal lobes atrophy with 19–32% tissue mass decrease (corresponds to CDR-2).

Late AD stage - severe dementia - TDR-3 - temporal lobes atrophy with 33–62% tissue mass decrease (corresponds to CDR-3).

Conclusions

The application of morphologically determined AD stages scale - TDR - is an effective method to objectively identify AD stages by means of widespread CT and MRI.
1159 – Description Of The Brain Functional Connectivity Across Sleep Stages Using a Coherence Analysis
Authors: Jurysta F. , Van Wettere L. , Lanquart J.-P. , Linkowski P. , Marinazzo D.
Published: July 2013

Objectives

The statistical dependencies among even remote brain regions are reflected by the functional connectivity. We studied the functional brain network across sleep stages for each relevant sleep EEG frequency band.

Methods

Nine healthy young subjects without somatic, psychiatric and sleep disorders were recruited. Sleep stages were defined in accordance with the Rechtschaffen and Kales criteria. The first 20 epochs of each sleep stage (Wake, stages 1 to 4 and REM sleep) were used for analysis in regard of specific sleep EEG frequencies as delta, theta, alpha, sigma and beta. Coherence analysis was applied between each electrode and each other of the 19 EEG electrodes.

Results

Coherence analysis showed high values within the same hemisphere at wake and sleep stage 1. During stages 2, 3 and 4 and REM sleep, high correlations were extended to more regions, particularly for slow oscillations. In delta band, coherences values differed between right and left cerebral hemispheres during all sleep stages. In other frequency bands, none differences were observed between both sides. In the right hemisphere, coherence values changed across sleep stages in delta frequency but remained unchanged for other sleep EEG frequencies. In the left hemisphere, none changes in coherence were observed across sleep stages and each frequency except for sigma and beta.

Conclusions

Changes in coherence measurements showed different mapping in the three sleep main states (Wake, NREM and REM sleep) and for sleep EEG frequencies. Further analyses will investigate connectivity across sleep stages transitions and also, in psychiatric conditions.
1168 – A Sample Of Electroconvulsive Therapy Practice From Turkey
Authors: Yazici E. , Hacihanifioglu S.B. , Karabulut U. , Yazici A.B. , Kirpinar I.
Published: July 2013

Objectives

We sought to obtain an overview of electroconvulsive therapy (ECT) practice in Psychiatry Clinic of Derince Research and Training Hospital which has 25 inbeds and is a new kind of governmental administration for new health policy of Turkey.

Methods

From January 2011 to October 2012, a form enquiring about evaluation of ECT was filled retrospectively.

Results

The total number of patients, admitted for psychiatry during the survey period was 77012. A total of 82 patients (10.06% among inpatients and 0.106% in all psychiatric admissions) received 514 sessions of ECT from 815 psychiatric inpatients. Seven patients had multiple hospitalizations. Patients with severe depressive episode with/without psychotic symptoms (include bipolar affective disorder current episode severe depression) received ECT most frequently (54.9%), followed by patients with bipolar affective disorder, current episode manic with/without psychotic symptoms (19.5%), schizophrenia (18.3%), and schizoaffective disorders (3.7%) respectively. All of the patients were reported to have insufficient response to medication and 19 patients had suicidalty (23.1%). There were no pregnant patients. All patients received modified ECT. There were no ECT-related deaths or injuries. 5 (6%) patients needed intervention for bradicardia and one patient had hypersensitivity to anesthetic medication during the survey.

Conclusion

The majority of patients who received ECT were diagnosed with severe depression with/without psychotic symptoms. Suicidalty and insufficient response to medication had an important role at decision of ECT. These results suggest that ECT is still safe and assumes an important role in daily practice of inpatient clinics.
1183 – Deinstitutionalization And Family Burden Following The Psychiatric Reform
Authors: Basta M. , Stefanakis Z. , Panierakis C. , Michalas N. , Zografaki A. , Tsougkou M. , Vgontzas A.N.
Published: July 2013

Introduction

Deinstitutionalization in Crete and the closure of the only Psychiatric Hospital in 2006, has resulted in a significant shift of treatment options that were available for chronic psychiatric patients. Specifically, psychiatric care shifted from long-term or even lifetime hospitalization, to short-term hospitalization and community-based treatment.

Objective

To examine the residential/occupational status of the patients discharged from the Psychiatric Hospital after its closure and the profile of residence, psychiatric profile and sociodemographic data of inpatients of the Psychiatric Department of the University Hospital of Crete (PD/UHC).

Aim

To explore the burden of family members living in the same home with chronic psychiatric patients.

Method

We examined the residence status of the patients discharged from the Psychiatric Hospital. Furthermore, we examined the psychiatric profile and sociodemographic data from 400 inpatients that were admitted between Nov 2011 and August 2012 in the PD/UHC. We analyzed the data by using frequencies.

Results

Among Psychiatric Hospital residents, 72% returned home after its closure, while 2.5% were referred to community services. Among psychiatric inpatients, 82,9% return home after discharge. From a subset of 212 patients, 64% live with their own/paternal families, while 24.5% live alone, and 63% of patients living with family/relatives, remain unemployed/on welfare.

Conclusions

Psychiatric reform and inadequate community-based psychiatric services, has resulted in an increasing family burden, since most psychiatric patients remain unemployed, under the care of their family. There is a need for development of community-based services to provide care and assistance to chronic patients and their families.
1188 – Motor Disturbances In Autistic Children: Cross Sectional, Controlled Study
Authors: Ali D. , Effat S. , El Serafi D.
Published: July 2013

Background

Children with autism have developmental motor profile that differ from other healthy children. This is evident since early childhood, sometime noted by parents and neglected by clinicians. These motor deficits are related to other domains of dysfunction in children with autism as social and language skills .Improving motor deficits can help better prognosis for these children.

Aim

To detect motor deficits in a sample of autistic children and correlate them with the severity of autistic symptoms.

Methods

We recruited 20 autistic children ranging from 3 to 6 yrs from the Institute of psychiatry outpatient child psychiatry and rehabilitation clinics of Ain-Shams university hospital .We excluded patients having total intelligence less than 75 or having other developmental disorder. We matched them with healthy controls for age and sex and compared both motor development and self help skills using Brigance scale. We confirmed diagnosis of autism in each patient by applying ICD-10 criteria of autism by a senior psychiatrist and by having a Childhood Autism Rating Scale (CARS) score above 30. Relation of autism severity and motor deficits was assessed later by Correlation co-efficient test.

Results

Compared to controls, autistic children showed statistically significant low Brigance test scores on; gross movement, fine movement and self-help skills subdomains .Motor delay was significantly correlated with the severity of autism.

Conclusions

Motor deficits were evident in autistic patients and could indicate severity
1190 – Assessing Alexithymia In Different Subgroups Of The Chinese Population: Sample Invariance Of The Chinese Version Of Toronto Alexithymia Scale-short Form (tas-9-c)
Authors: Tam B.K.H. , Wong W.S. , Chan F. , Pang H.T. , Tso Y.K.
Published: July 2013

Introduction

The TAS-9-C is a short form of TAS-20 validated for assessing alexithymia in adolescent populations. Tam & Wong (2012) reported the invariance of the one-factor model of TAS-9-C; yet this resulting model has yet been tested against its original three-factor model of the TAS-20. The objective of this study was to test the goodness-of-fit of both models in three different Chinese samples.

Methods

Data were obtained from adolescents (n = 1294), healthy adults (n = 196) and adult psychiatric outpatients (n = 243). Confirmatory factor analyses (CFAs) tested the fit of a one-factor model and a correlated model that comprised three correlated first-order factors (including difficulty identifying feelings, difficulty describing feelings and externally-oriented thinking) to the data. The factorial invariance of the TAS-9-C between independent samples was investigated using multigroup CFAs.

Results

The CFAs results demonstrated a better fit of the correlated three-factor model (CFI > 0.776) over the one-factor model in both adolescent and adult samples (CFI > 0.871). While the correlated model showed evidence of strong factorial invariance among different adolescents from different grade levels, configural invariance was evidenced in the adolescent, healthy adults and adult psychiatric outpatients samples.

Conclusions

The three meaningful clusters of TAS-9-C mirrored the original factor structure of TAS-20. The use of subscales representing different aspects of alexithymia adds incremental value to the measurement using full scale alone among Chinese across developmental stages and settings. Configural invariance among these samples suggests that growth-related change leads to different developmental trajectories for adult alexithymia. Future research is necessary to ascertain this.