bluuebunny/crossref_metadata_2025 huggingface dataset:
Performance of healthy elderly with Alzheimer's disease at an early stage in executive function and language
Authors: Santos M.T. , Couto G.C. , Achieri J.C. , Júnior C.A.
Published: May 2011

Dementia are increasingly prevalent in population. The most common causes of dementia is Alzheimer's disease (AD). Screening tests have been used for the premature diagnosis of Alzheimer Disease (AD), specifically in the executive functions and language, which are compromised at an initial stage. However, the necessity standardized means and validated for our middle, to show oneself a pressing subject.

Objective

To analyze the impact of the length of sentences in the abstraction of proverbs in the Screening Test for Alzheimer's disease with Proverbs (TRDAP), healthy elderly and with Alzheimer's disease at early stage.

Method

Survey document in the database, analyzing the responses of the elderly (abstract or concrete interpretation of proverbs), relating the length of sentences (sayings) of stage B of TRDAP with the diagnosis of Alzheimer's disease and the interference of age and schooling.

Results

Healthy older people showed greater capacity for abstraction than those with AD. There was Significant differences, in the sayings 1 (p = 0.033) and 2 (p = 0.001), corresponding to lower sentences, which did not occur with the proverb 3. As for age no verified significant difference among the healthy and only saying 3 in AD patients, however schooling differenced the healthy.

Conclusion

Elderly with Alzheimer's disease at an initial stage have lower performance in the comprehension of ambiguous sentences, interpretation and abstraction of proverbs, corroborating with the data of the literature. The size of these sentences appears to be inversely proportional to the correctness of interpretation in elderly patients with and without AD.
The Evaluation of the effectiveness of the program of the cognitive rehabilitation of patients with MCI and early dementia of Alzheimer's type
Authors: Wojtynska R. , Wlazlo A. , Trypka E. , Zimny A. , Frydecka D.
Published: May 2011

Introduction

Applying programs of early cognitive intervention, concentrated on psychological influences, constitutes the important component of comprehensive medical influences nonpharmacological, influencing to the improvement in psychological functioning, in cognitive areas and qualities of life.

Aims

Evaluation of the effectiveness of the multimedia program of the cognitive rehabilitation (cognitive training, psychoeducation), directed at patients with MCI and with early stage in the AD.

Objectives

Outpatients, N = 75, average of the age: 68.6 (10.14 SD), above 45 years,; MMSE > 20, I group - MCI (N = 34): with the intervention (N = 18), without (N = 16), II group - AD (N = 29): with intervention, (N = 15), without (N = 14), III group - CG: patients without cognitive disorders (N = 12).

Methods

Randomized, clinical trial. Diagnosis on the base: of clinical interview, of examining a mental state, physical, TK, MRI, of laboratory tests, screening neuropsychological (MMSE, CDT, Demtect, Fluencial). Patients participated in 6 week’s program of the cognitive rehabilitation (4 × during the week) and 18 household conditions. The evaluation of the cognitive functioning, mental state, of functioning in the everyday life, of approval of illness, of satisfaction from the life, qualities of life, caregiver burden were being before and after intervention.

Results

An improvement in cognitive functioning was get in selected aspects: of cognitive functioning (linguistic functions, memory, attention, of visual-motor coordination), of mental state, qualities of life.

Conclusions

Nonpharmacological influences, spreading through cognitive training and psychoeducation, at patients with dementia or MCI constitute essential element correcting their functioning in the process psychological rehabilitation.
Comparing psychological disorders between two wards of internal medicine and A&E (2005 —2006)
Authors: Dasht N. Amanat Lome , Ghorbani R. , Behnam B. , Imani A. , Sari M. Ghanbari Ghale , Khankeh H.R.
Published: May 2011

Introduction

One of the important problems of patient in internal medicine is less attention to emotional and psychological issues. The method of treatment would change when the patients have psychological problem.

Objectives

The comparing of prevalence of mental disorders in internal medicine patients with parallel groups of A&E's patients.

Aims

The evaluation of prevalence of psychological problem in internal ward and A&E.

Methods

Three hundred patients have been checked in internal and emergency wards. They have chosen by a Purposive accessible sampling method. The psychopathological profile was assessed using the SCL-90 questionnaire by Iranian version. Data have been computed and analyzed by SPSS V.17 and Student t test for parametric variables and Mann-Whitney for the analysis of nonparametric variables and linear regression have been used to identify the impact of independent variables. The results have been considered significant when the two tailed p-value was less than 0.05.

Results

Physical disorder was the main complain of internal ward (76.7%) and A&E (53.3%) patients. The main important complain of women patients in A&E were paranoid (64.3%) and in the men were physical problem (53%).

In 50 or older, the main complain in internal ward was psychiatric problem (%80.6), and in the emergency units obsessive- compulsive were %50.

Conclusions

Prevalence of nine psychiatric disorders in internal ward patients was significantly higher more than A&E patients. Most of patient that accepted in internal ward had psychiatric problem. Therefore, it’s necessary to pay attention to this kind of disorders for early treatment of patients.
Views of general public, mental health professionals and patients’ relatives about schizophrenia: An Italian multi-centric survey
Authors: Fiorillo A. , De Rosa C. , Malangone C. , Luciano M. , Giacco D. , Del Vecchio V. , Maj M.
Published: May 2011

Introduction

Views on the causes and psychosocial consequences of schizophrenia of the Italian population, patients’ relatives and mental health professionals can influence detection and outcome of these disorders.

Aims

To investigate the opinions on schizophrenia in a sample of 614 lay respondents, 465 mental health professionals and 709 key-relatives.

Methods

The survey was conducted in 30 randomly selected geographical areas with the Questionnaire about Opinions on mental illness (QO).

Results

The results show significant differences among the three groups as regards opinions about patients’ civil rights and social competence of patients with schizophrenia. In particular, the belief that patients’ behaviors are unpredictable is maintained by 18% of mental health workers and by 35% of family members and the general public. As regards causes, 68% of relatives, 20% of mental health workers and 34% of general public believe that schizophrenia is caused by psychosocial factors only. Forty-eight percent of the relatives affirmed that they are fully convinced of the usefulness of pharmacological treatment compared to 28% of professionals and 25% of the Italian population. With respect to civil rights, about half of the relatives is fully convinced that patients with schizophrenia should not have children compared to 17% of mental health workers and to 19% of the general public.

Conclusions

These results underline the need to conduct sensitization campaigns about schizophrenia focused on specific aspects of the disease, such as unpredictability, civil rights and opportunities to recovery of patients, taking into account the target population to which they are addressed.
Stigma perception and depression among patients suffering from chronic somatoform disorders
Authors: Freidl M. , Aigner M.
Published: May 2011

Introduction

Several studies indicate a significant longitudinal comorbidity of depression and chronic pain. Also, perceived stigma is a barrier to recovery. This study wanted to evaluate the correlations.

Objectives

To investigate to what degree chronic pain patients suffer from depression and stigma fears 132 (66% females) consecutive in- and out-patients with somatoform pain disorders who presented at the Department of Psychiatry and Psychotherapy (MUV) were investigated using the Stigma Questionnaire by Link and the Beck Depression Inventory (BDI).

Aims

The aim of this study was to survey the attitudes of 132 patients with the diagnosis somatoform pain disorder, toward mental illness stigma and the influence of depressive symptoms.

Methods

The BDI was employed for measuring of the severity of depression and the modified 12-item version of Links Stigma Questionnaire to evaluate stigma perception.

Results

Three third of the patients expect discrimination because of their psychiatric diagnosis and two third of the chronic pain patients also showed depressive symptoms. The overall results show a significant correlation between stigma perception and depressive symptoms.

Conclusion

Fear of stigma increases with depressive symptoms and both are a risk for treatment delay. Goal of future research should be the question how to reduce depression and fear of stigma in order to help them enter psychiatric treatment early and gain self-confidence and mental health back again.
Traumatic events in chilhood and psychosis in adult life: A descriptive study
Authors: Harto M. , Tatay A. , Almonacid C. , Castillo A. , Lloret M. , Calabuig R.
Published: May 2011

Introduction

There is a growing interest in establishing a relationship between several mental disorders and traumatic life events in childhood and adolescence.

It has been seen a high prevalence of these traumatic events when reviewing the clinical history of patients with mental illness.

Aims

Measuring the prevalence of traumatic events in a sample of patients with a diagnosis of psychotic disorder.

Methodology

A retrospective descriptive study was made. The sample comprised 50 patients admitted to our psychiatric inpatient unit. These patients were separated into different categories according to clinical diagnosis and demographic variables. Data was obtained through clinical interview before their hospital discharge. We tried to detect the presence or absence of real or imaginary memories of traumatic events during their childhood or adolescence.

Results

52% of patients had a diagnosis of paranoid schizophrenia. 64% reported a history of substance abuse in their family. 20% referred the experience of having suffered sexual abuse by a member of their family, and up to 44% of them by someone other than family. 22% reported having suffered some kind of physical abuse by their parents, and more than 70% reported having suffered some type of traumatic event in the school environment.

Conclusions

There is an important amount of traumatic events in childhood and adolescence in this sample of patients. However, concluding that such traumatic events could eventually produce severe psychiatric disorders is still quite controversial. In order to understand better the association between childhood trauma and severe mental illnesses more research is needed.
The view of Iranian counseling psychologist toward working with transsexual and homosexuals clients
Authors: Koolaee A. Khodabakhshi
Published: May 2011

Introduction

Homosexuality is forbidden in Islamic countries. In Iran people who homosexual captures with police and in Islamic Law they are accuse and they transfer to prison. But Transsexual is accepted. So, people who are homosexual encourage changing their sexuality and identity with plastic surgery, and gaining new sexuality. Then government gets them Identification Card.

Amis

The aim of this study examines the view of Iranian counselors to working with Transsexual and Homosexuals clients.

Method

For gathering data, use a questionnaire. A questionnaire was about the view of counselors to Transsexual and Homosexuals clients. For analysis data, use the descriptive statistical methods.

Results

The results indicate that 60 percent of counselors disagree to working to homosexual people, 25 percent answered no Idea and 15 rest of them said they were accepted the homosexual clients.

Conclusion

To conclude, counselors did not interest in to working with homosexual clients, but when they are changed their sex with surgical operation and gain new Identity, counselors tend to working with them. But the reality is people who changed their Identity with surgical operation, after few months regretful and 35 percent of them attempts to suicide.
Comorbidity of anxiety disorders and depression
Authors: Licanin I.
Published: May 2011

Introduction

Comorbidity of anxiety and depression is common and frequently poses diagnostic and treatment challenges in the clinical setting and are associated with significant morbidity.

The aim of this study was to analyze the comorbidity between DSM-III-R anxiety disorders in separate subgroups of patients with major depression, bipolar II and bipolar I disorder in a clinical sample of a Bosnian population.

Methods

Randomly selected subjects (aged between 18 and 64 years, N = 2202) which were hospitalized at the Psychiatric clinic in Sarajevo was analyzed. Subjects were interviewed by the Diagnostic Interview Schedule (DIS) which generated DSM-III-R diagnoses.

Results

The prevalence of generalized anxiety disorder, agoraphobia and social phobia was the highest among bipolar II patients (18.8, 32.5 and 18.7%), simple phobia was most prevalent in (nonbipolar) major depression (20.6%). The rate of panic disorder was almost the same in the (nonbipolar) major depressive and bipolar II subgroups (11.2 and 10.5%). Bipolar I patients showed a relatively low rate of comorbidity.

Conclusions

The findings support previous results on the particularly high rate of comorbidity between anxiety disorders and unipolar major depression and particularly bipolar II illness, which has significant negative implications for both the course of these disorders and levels of dysfunction.
Somatic comorbidity of patients attending a mental health unit studying their consultation to an emergency department in the previous year
Authors: Martínez Gómez P. , Vigo Santamariña L. , Portillo Díez J. , Brenlla González J.
Published: May 2011

Introduction

It is interesting to note somatic comorbidity of psychiatric patients that attend an outpatient Mental Health Unit (MHU). In medical literature there are few studies that reflect which diseases make these patients go to an Emergency Room (ER).

Objectives

To determine the percentage of patients presenting to an ER in the year prior to psychiatric consultation in a MHU, noting which is the most common assitance and the differences regarding sex, age and marital status.

Methods

Retrospective and descriptive study of ER assistances at the Hospital Clínico de Santiago in the previous year of patients attending our MHU. Time period: from February 1st 2010 to August 31th 2010. Once collected the data, these are analyzed using the Excel 2008 Statistical Package for Mac.

Results

From 577 patients studied (68.3% women), 224 had gone at least once to the ER in the last year (72.3% women): 19.6% consulted for psychiatric conditions and 80.4% for somatic causes. Among the predominant somatic complaints we found musculoskeletal causes (24.4%), cardiovascular (8.8%), respiratory (9.4%) and gynecological (2.7%). 3% of them were hospitalized in medical or surgical services and 3% in psychiatric units. There was not statistically significant differences regarding their age. Married and divorced patients went to the ER more than bachelors or widowers.

Conclusions

Profile of the studied patient: “Woman, 53 years old, married, user of an outpatient MHU and that has consulted at least once in the last year to an ER due to musculoeskeletal cause.”
A study on mental health in elder long term unemployed persons
Authors: Meiler B. , Steil C. , Wiesten I. , Wiltfang J. , Kis B.
Published: May 2011

Introduction

There are complex associations between work and mental health. Self-efficacy, experience of own abilities and appropriate challenges are important prerequisites of mental health. Availability of these factors is specifically decreased in the elder long term unemployed and results in higher vulnerability for mental impairment.

Objectives

Investigation on mental health of elder long term unemployed persons

Aims

To examine incidence of mental disorders in elder long term unemployed persons

Methods

Senior long term unemployed participants in a vocational reintegration program were examined. Clients were allocated by choice to the study by their placement officers. An extensive psychiatric examination including structured clinical interviews (SKID) and clinical and personality questionnaires (BDI, STAI, MSWS, SCL 90-R, SF36, AUDIT, FTNA) was performed with each subject.

Results

90 subjects were included into the study so far and 42 completed the psychiatric examination. The mean age was 54.7 years and gender ratio was balanced. 94% were diagnosed with a psychiatric disorder and 80% were diagnosed with more than one disorder according to ICD-10. In particular, 78.6% of the subjects had depression, 40.5% anxiety disorders, 35.7% combined personality disorders, 26.2% posttraumatic disorders, 21.4% addiction disorders, 16.7% single personality disorders and 7.1% psychotic disorders.

Conclusion

A large proportion of the long term unemployed persons examined is affected by mental disorders. Along with the high incidence of depressive, anxiety and addiction disorders there was a considerable number of personality and specifically trauma-related disorders. Accordingly, personality disorders may be a risk factor for unemployment in elder people too.
Prevalance of psychiatric symptoms in elderly veterans and their associaton with general medical conditions
Authors: Mokhber N. , Azarpazhooh M.R. , Shandiz E. Esmaeeli , Hanaee J.
Published: May 2011

Background

War is a major effective factor on general health and its morbidity and mortality have constant psychosomatic effects. In this study we aimed to assess psychological signs of Iranian elderly veterans in order improve their health.

Method

In this cross -sectional -descriptive study, we analyzed the psychological signs of elderly veterans of khorasan Razavi province in 2009.

We studied 123 old veterans under coverage of Marty and Veteran Foundation.

Our cases were selected randomly and data were gatherer using SCL-90-R, MMSE and GDS questionnaires we also had a total medical examination and a Psychiatric interview form all of the participants.

Results

The most prevalent psychological signs according to SCL-90-R Questionnaires were the following: moralization 84.4%, anxiety 66.7% and Hostility 57.8% According to GDS test the prevalence of depression sings among old veterans were 50.4%, and according to MMSE test the prevalence of cognitive disorder in this old population was 17.1%. There was a significant relationship between the prevalence of respiratory and vestibule- auditory diseases with the rate of psychological signs. We also found a relationship between the prevalence of respiratory and skin diseases with depression, and prevalence of neurological diseases with cognitive impairment.

Conclusion

36.6%prevalence of psychiatric signs in the old veterans shows the need for special attention to this group of society.
Sense of coherence as a predictor of quality of life in adolescents with congenital heart defects: A register-based 1-year follow-up study
Authors: Neuner B. , Busch M. , Wellmann J. , Nowak-Göttl U. , Hense H.-W.
Published: May 2011

Objective

Sense of coherence (SOC) is a resource for health and quality of life (QoL) in adults. Aim of this investigation was to evaluate the association of SOC and QoL in adolescents with congenital heart defects (CHD).

Method

Observational study among 770 adolescents aged 14 – 17 years from a national CHD register. SOC was measured at baseline with the SOC-L9 questionnaire. At baseline and at 12-months follow-up, QoL was measured with the KINDL-R questionnaire, evaluating overall well-being and six subscales. The association of SOC with QoL was evaluated in multi-level linear models separately for overall well-being and KINDL-R subscales. Initial models comprised SOC as only fixed effect while the final models were adjusted for age, gender, medical and socioeconomic status and behavioral factors.

Results

Overall well-being, self-esteem and school-related well-being was significantly higher at follow-up compared with baseline. SOC at baseline (median 50 [range: 16 – 63] points) was positively associated with overall well-being and all KINDL-R subscales. There were significant negative interactions between SOC at baseline and time to follow-up for overall well-being and all KINDL-R subscales except psychological well-being. But even in fully adjusted models associations of SOC at baseline with overall well-being and all KINDL-R subscales at follow-up remained significant.

Conclusion

SOC is an independent predictor of QoL in adolescents with CHD. Except for psychological well-being, this effect attenuates over one year but remains positive inoverall QoL and sub-dimensions. Further studies should evaluate whether interventions aimed to increase SOC in children with CHD improve QoL.
Burnout syndrome: A comparison between intensive unit and general unit nurses
Authors: Salehi K. , Esmaeli H. , Mahmodifar Y. , Maarofi S. , Sayedamini B.
Published: May 2011

Introduction

Burnout syndrome is a psychological state resulting from prolonged exposure to job stressors. High rates of professional burnout syndrome have been found among health service professionals.

Objectives

To assess and compare the burnout syndrome level between Intensive Care Unit and general unit nurses, and study its association with the sociodemographic.

Aims

The aim of this study was to determine that working in different units can affect on burnout syndrome.

Methods

The study was carried out using a descriptive-analytic method. 110 nurses were participated in the study from Mahabad Imam hospital in Iran. 55 nurses belong to the intensive care units, and 55 nurses belong to the general units. Two evaluation tools were used: a sociodemographic and the Maslach Burnout Inventory: includes three dimensions: emotional exhaustion, depersonalization, and reduced personal accomplishment. Data was analyzed using SPSS package.

Results

The comparative analysis of the burnout dimensions shows that emotional exhaustion level and depersonalization level do not have significant differences between both groups. Reduced personal accomplishment dimension have a significantly differences between both groups. (29.64 +/- 8.53 vs 34.31 +/- 14.16) p < 0.05. The intensive care unit nurses reported their high emotional exhaustion (21.8%), high depersonalization (14.5%) and reduced personal accomplishment (41.5%). And the general unit nurses reported their high emotional exhaustion (9.1%), high depersonalization (18.2%) and reduced personal accomplishment (51.1%).

Conclusions

The burnout levels are moderate to high among the nursing professionals studied. The general care unit nurses are the most vulnerable to suffering high levels of reduced personal accomplishment.
The impact of hospitalisation on discrimination experiences
Authors: Sibitz I. , Lakeman R. , Parkinson M. , Walsh J. , Mc Gowan P. , Redmond M. , Stevenson C. , Mac Gabhann L.
Published: May 2011

Background

The aim of the study was to assess the experiences of discrimination as reported by people with mental health problems and to explore the impact of hospitalisation.

Methods

306 people with mental health problems provided sociodemographic data and data on discrimination using the discrimination and stigma scale version 12 (DISC-12) with the domains negative experienced discrimination, anticipated discrimination, overcoming stigma and discrimination, and positive experienced discrimination. Logistic regression analysis was used to test the impact of hospitalisation on discrimination, controlled for age, gender, education, employment, diagnosis and having been prescribed medication.

Results

Hospitalisation had a major impact on negative discrimination: People were more likely to be treated unfairly in making or keeping friends, in marriage or divorce, by people in their neighbourhood, in social life, by mental health staff and in terms of privacy, if they had been hospitalised. They were also more likely to be avoided or shunned by people who knew about the mental health problem. People with a history of hospitalisation also reported more anticipated discrimination: They had stopped themselves more often from having a close personal relationship and concealed their mental health problem from others more often than those without a history of hospitalisation. However, people who had been hospitalised also experienced more positive discrimination in terms of being treated more positively in getting welfare benefits or disability pensions and in housing.

Conclusion

Findings suggest that treatment in hospital contributed to a higher extent to experienced discrimination than treatment in the community.
Project “social point”: Partnership of sociality activities of mental health service recipients
Authors: Poggi V. , Ambrosino R. , Ciambellini M. , Ferrari S. , Melati E. , Pingani L. , Rigatelli M.
Published: May 2011

The project “Social Point” deals in promoting integration of Mental Health Service recipients within contexts of social relationship, voluntary work and community activism. The project is still taking place in the district of Modena.

Aims

Assessment of the effectiveness of the project SP: production of a change in quality of life; development of purposeful relationships out of families and health services; development of Mental Health Service recipients’ awareness of being not only a user of the health service but also a resourceful person; change of method and approach within relationship between Mental Health and community and public services.

Methods

At the beginning and at the end of the integration courses (autumn/winter 2010 and after 6–8 months), both individuals and collectives, every Mental Health Service recipient was asked to fill in a form with socio-demographic characteristics and the WHOQOL-bref. A social network diagram was subsequently drawn.

Expected results

At the end of the research (September 2010) joining courses directed to the development of social relationship is forecast to improve the quality of life of the recipients, to increment purposeful relationships and to strengthen empowerment of persons with mental disease by promoting a different project of life no more illness-based but resource-based.

Conclusion

The study will provide evidences about the performance of the project with regard to the promotion of the social integration of citizens with mental disease in contexts, to the empowerment and to the promotion of processes of social.
Utilisation of psychiatric examination and counseling in senior unemployed persons
Authors: Steil C. , Meiler B. , Wiesten I. , Wiltfang J. , Kis B.
Published: May 2011

Introduction

Unemployment is associated with various psychosocial strain factors. Previous studies show correlations between unemployment and impaired mental health. Present examinations on this set of problems mainly focused on younger unemployed, while specific psychosocial strains of senior unemployed persons were scarcely presented.

Objectives

Investigation on psychiatric services for senior long term unemployed persons

Aims

To examine the exigency and feasibility of specific mental health interventions for senior long term unemployed persons

Methods

Senior long term unemployed participants in a vocational reintegration program underwent psychiatric examination and counseling. Placement officers recommended participation by choice to their clients and diagnostic examinations including clinical interviews and questionnaires were performed. Clients then received either direct treatment by the project staff, e.g. focal short-term therapy, or were placed in appropriate treatments. Numbers of clients who consented and who refused participation, dropout rates, psychiatric diagnoses and treatment placements were recorded.

Results

Attendance in the program was recommended to 161 clients to the date of this report. 136 clients consented with participation and 90 were included into examination. 21% discontinued participation in the course of examination. Of the unemployed persons surveyed, 96% received a psychiatric diagnosis and 80% multiple psychiatric diagnoses. 7% were placed to inpatient-treatment and 31% to ambulatory treatment.

Conclusion

Psychiatric services were highly requested and senior unemployed persons are specifically affected by mental disorders that presumably interfere with vocational reintegration. According to this, vocational reintegration programs should be flanked by psychiatric services to give consideration to the specific psychosocial strains of unemployed persons.
Relationship amongst patient and caregiver's expectations of illness to clinical diagnosis
Authors: Verma R. , Mina S. , Agarwal A. , Jiolha R.C.
Published: May 2011

Introduction

Symptoms have a major influence on expectations to the degree to which they affect patients’ perceptions of what might be wrong (cognitive states) and reactions to illness (emotional states).

Objectives

This study investigated the relationship of patient and caregiver's expectations of illness to the diagnosis.

Method

Two hundred new cases with their caregivers were consecutively included from the Out-Patient Department of psychiatry and assessed through a semi-structured proforma and Clinical Global Impression scale.

Results

Somatic symptoms were the predominant complaints compared to psychic complaints. Patients presenting with more psychological symptoms had more uncommon and unmet expectations compared to those with biological symptoms. Most considered their illness to be of medical nature (71% in patients; 83% in caregivers). Patients gave social causes a higher priority (23.5% in patients and 6.5% in caregivers) while caregivers give higher priority to supernatural cause (5.5% in patients and 13% in caregivers). 54.5% patients and 63.5% caregivers considered the illness to be severe which on objective assessment was for only 38%. 54% patient had co morbid psychiatric illness and 46% had only psychiatric illness and 9% had only medical illness. More was the severity of illness; more the treatment in form of medication prescription was expected.

Conclusions

Objective severity of patients' disease condition, and their awareness of illness, can predict their adherence and can contribute to better targeting of health messages and treatment advice by providers.
Area-specific occupancy of the serotonin transporter by escitalopram and citalopram in major depressive disorder
Authors: Akimova E.
Published: May 2011

Introduction

The serotonin transporter (SERT) occupancy after long-term antidepressant treatment (steady-state) at minimum clinical doses has been reported to be approximately 80% (e.g., Meyer 2007, J.Psychiatry Neurosci;32(2):86-102, review). However, this value is mostly calculated in the striatum, therefore the occupancy values in other brain areas might be better associated to clinical parameters.

Objectives

To compare the SERT occupancy of the striatum to occupancy values in six other brain areas.

Methods

18 patients with major depressive disorder (MDD) received either escitalpram (10mg/d) or citalopram (20mg/d) in a double-blind, longitudinal study. They underwent three PET scans using the radioligand [11C]DASB: PET1 baseline, PET2 six hours after the first drug intake and PET3 after three weeks of treatment. Occupancy of SERT at PET3 was analyzed in seven regions partly associated with alterations in MDD: striatum, subgenual part of the anterior cingulate cortex (sgACC), ACC, amygdala, inferior frontal cortex (IFC), superior frontal cortex (SFC), superior parietal cortex (SPC). ROI-based quantification was performed in PMOD.

Results

There was a huge range in occupancy values of different areas: amygdala (93.5% ± 6.9%, mean ± SD), SPC (90.8% ± 8.0%), ACC (86.0% ± 13.2%), sgACC (79.1% ± 23.6%), striatum (78.8% ± 4.9%), SPF (64.0% ± 26.4%), IFC (54.4% ± 21.7%). We found significant differences in occupancy values between striatum and the ACC, amygdala, IFC, SFC, SPC (t-test, p < 0.05).

Conclusions

In this study we show significant differences in SERT occupancy between brain areas ranging between 54.4% and 93.5%. According to the area-specific effects of changes in serotonergic neurotransmission, regional occupancy values, especially in limbic areas, might be considered in the association to clinical response.
Which is the optimal depression rating scale for psychiatrists? a diagnostic validity comparison of hospital anxiety and depression scale (HADS) and psychiatric judgement against the MINI
Authors: Al-Salihy Z. , Rahim T. , Mitchell A. , Mahmud M. , Muhyaldin A.
Published: May 2011

Introduction

Ustun et al estimated that depression is the fourth leading cause of global disease burden. The burden of depression on the healthcare system is equally significant with an estimated US annual cost of approximately $26 billion (1990). In a European epidemiologic study of mental disorders involving six countries, major depression was the single most common disorder assessed, with a 12-month prevalence of 3.9%.

Objectives

Our aim was to find the optimal tool with the highest accuracy in comparison to the (MINI) for depression.

Aims

We aimed to find the depression rating scale with the highest accuracy when applied by psychiatrists in Iraq.

Methods

We recruited 400 subjects; The (MINI) was used as a gold standard to define the presence of major depression according to DSMIV criteria stratified into 200 patients with primary depression and 200 non-depressed subjects in Kurdistan region of Iraq. We examined the symptoms of depression using the Hospital Anxiety and Depression Scale (HADS) and Clinical Global Impression (CGI). Interviews were performed by three psychiatrists who were blinded to the group allocations. ROC curve analysis was used.

Results

Both HADS and CGI performed with high accuracy compared with the MINI interview for DSMIV major depression. Clinicians using the CGI were accurate in their clinical judgement with sensitivity of 97% and specificity of 99%.

Conclusions

We found the psychiatrist's opinion alone was very accurate with higher sensitivity and specificity than the HADS and therefore it is unclear from our sample if questionnaires would help clinicians in their diagnoses.
Effects of once-daily adjunct quetiapine XR on sleep disturbance in patients with mdd: a pooled analysis from two acute studies
Authors: Bauer M. , McIntyre R.S. , Szamosi J. , Eriksson H.
Published: May 2011

Introduction

Disrupted sleep is common in depression.

Objectives

Investigate effects of adjunct extended release quetiapine fumarate (QTP-XR) on sleep disturbance and quality in patients with MDD and inadequate response to antidepressant (AD) therapy.

Methods

Data were pooled from two (D1448C00006/D1448C00007) 6-week, double-blind, randomised, placebo (placebo+AD)-controlled studies of adjunct QTP-XR (15 0 mg/day and 300 mg/day). Primary endpoint: MADRS total score change versus placebo+AD. Secondary endpoints (post hoc): change from randomisation in MADRS item 4 (reduced sleep), HAM-D items 4, 5 and 6 (early-, middle- and late-insomnia), sleep disturbance factor (HAM-D items 4+5+6) and sleep quality (PSQI global score). MADRS total score change in patients with baseline HAM-D sleep disturbance factor score > = 4 or < 4 (high and low sleep disturbance, respectively) was evaluated.

Results

919 patients received adjunct QTP-XR: 150 mg/day (n = 309), 300 mg/day (n = 307), placebo+AD (n = 303). At Week 6, adjunct QTP-XR (both doses) reduced MADRS item 4, HAM-D sleep disturbance factor, HAM-D items 4, 5 and 6 and PSQI global scores from baseline versus placebo+AD (p < 0.001). In patients with baseline HAM-D>=4 (n = 226, 215 and 210, respectively) adjunct QTP-XR (both doses) improved (p< 0.01) MADRS total score versus placebo+AD from Week 1 onward. In patients with baseline HAM-D< 4 (n = 83, 92, 93, respectively) adjunct QTP-XR (both doses) improved (not statistically significantly) MADRS total score versus placebo+AD at Week 6.

Conclusions

Adjunct QTP-XR significantly restored sleep and improved sleep quality in patients with MDD and inadequate response to AD. Significant improvement in depressive symptoms was demonstrated with adjunct QTP-XR in patients with MDD and high baseline sleep disturbance. AstraZeneca funded.
An audit to identify factors that are more commonly associated with depressed patients on augmentation therapy under the befordshire east community mental health team (BECMHT)
Authors: Butler S. , Holt C. , Agius M. , Zaman R.
Published: May 2011

Background

Whilst it is important that we treat patients with depression in primary care if possible there are many patients with depression who will need the more expert support provided in secondary care.

Aims and methods

An Anonymised Database held by the Bedford East Community Mental Health Team was studied to assess what factors were related to the use of Augmentation Strategies to treat resistant depression.

Results

Of the total 282 patients 109 (38.7%) were on augmentation therapy. In the F32 and F33 group just over a third of the patients (35.8% and 37.1%) were on augmentation therapy and in the F41.2 group over a half of patients (56.7%) were on augmentation therapy.

Discussion

There does seem to be a relationship between the number of risk factors a patient has and the likelihood that they are on augmentation. Particularly strong factors are another psychiatric diagnosis and ‘other suicide risk factors’.

Conclusion

Generally the patients coming to secondary care with more of the specified risk factors are more likely to need augmentation.
Effectiveness of a psychoeducational group intervention in patients with mild/moderate depression in primary care (PC): randomized controlled trial
Authors: Casañas R. , Catalan R. , Casas M. , Raya A. , Fernandez E.M. , Escudero E. , Romero M.T. , Lalucat L.
Published: May 2011

Background

Due to the high prevalence of depressive symptoms in PC (Ayuso, 2001) is relevant to know the impact of the psychoeducation in the management of these symptoms to decrease the prevalence in the PC population.

Objective

To compare the effectiveness of a psychoeducational group intervention in patients with mild/moderate depression in PC.

Methods

242 participants older than 20 years with ICD-10 mild/moderate depression were recruited through nurse/general practice in 12 urban primary health care centers in Barcelona city. Randomization was realised by means of a computer program. Exclusion criteria: severe mental disorder, major depressive disorder, use of secondary mental health services and acute medical illness. The intervention group (IG) received a psycoeducational group program (12 weekly 1,5h sessions) leads by two nurses. The program was an adaptation of Coping With Depression (CWD) (Lewinsohn, 1989). The control group (CG) received TAU. Outcome measures: Sociodemographic, BDI and EuroQol-5D questionnaires pre-post intervention.

Results

232 patients were included, IG (n = 121) and CG (n = 112), of whom 86 patients had mild depression (BDI≤ 18) and 146 moderate depression (BDI≥ 19). The sample characteristics were as follow: 90% women with mean age of 53,27 (SD = 12,72)The intervention was associated with significant improvements in BDI (t(230) =-2.25; p = 0.025). Separately analyze the sample: Patients with mild depression: (t(83) =-2.52; p = 0.014).Patients with moderate depression: (t(141) =-2.62; p = 0.010). Posttest results show that this intervention has statistically significant effect on depressive symptoms in overall sample and in mild/moderate depression separately.

Conclusions

The psychoeducational intervention is effective treatment in both mild and moderate depressive symptoms in primary care.
The prevalence of depression in patients with cushing’s syndrome
Authors: Danciulescu Miulescu R. , Calarasu M.E. , Rosca R.I. , Danoiu S.
Published: May 2011

Background and aims

Cushing's patients demonstrate major depression more than any other medical condition. Major depression is a common, complication of Cushing’s syndrome, with no significant differences between pituitary -dependent and -independent forms. The aims of the study is to estimate the prevalence of depression in patients with Cushing’s syndrome.

Materials and methods

23 patients with Cushing’s syndrome (14 with pituitary-dependent and 9 with pititary-independent forms) were recruited for this study. The subjects were between 52 and 67 years. Patients were screened initially with a questionnaire detailing their age, medical history, concomitant medications. The Zung self-rating depression scale was used to assess depressive symptomatology. It contains 20 items: index scores below 50 reflect no depression, 50–59 reflect mild depression, 60–69 reflect marked to moderate depression and scores of ≥ 70 reflect severe to extreme depression. Results were compared with measurements in 21 subjects without Cushing’s syndrome.

Results

The prevalence of depression in patients with Cushing’s syndrome was 52.17% (12 patients). 2 patients (2 women) present mild depression and 10 patients (9 women and 1 men) present moderate or severe depression. Moderate or severe depression was significantly associated with older age, female sex, relatively more severe clinical condition. The prevalence of depression in 21 subjects without Cushing’s syndrome was 4.76% (1 women with mild depression).

Conclusion

This study showed that patients with Cushing’s syndrome have a greater a risk of depression than people without Cushing’s syndrome. Patients with Cushing’s syndrome should be routinely screened and adequately treated for depression.
Therapeutic strategies used on treatment of depression. Dria study
Authors: Salvador R. , Galan J. , Garcia-Toro M.
Published: May 2011

Introduction

There are few clinical studies about strategies used in depression in clinical practice.

Objectives

Describe therapeutic strategies used in psychiatric care in patients with depression who had a suboptimal response to standard antidepressants under real-life conditions.

Methods

Non-interventional study that included a prospective cohort of outpatients diagnosed with Major Depressive Disorder (MDD) who needed a change on the treatment. Strategies were group as: switch of antidepressant, combination of antidepressants, augmentation or a combination of previous strategies. Follow-up period was 22-26 weeks.

Results

364 patients were included by 58 psychiatrists, 336 were analyzed (92.3%) and 315 (86.5%) completed the follow-up.

[Strategies selected in each change]

[Relationship between no. changes and no. strategie]

Conclusions

Strategies more used were: switch to another antidepressant, combination of antidepressant, augmentation and multiple strategies.

Although a change of treatment was decided, frequently it was selected a strategy used in the past.

This study has been sponsored by AstraZeneca Farmaceutica Spain, SA.
Biological alterations during remission of major depressive disorder
Authors: Hartinger B. , Scharinger C. , Diers K. , Kasess C. , Huf W. , Kalcher K. , Boubela R. , Pail G. , Brocke B. , Kasper S. , Moser E. , Pezawas L.
Published: May 2011

Introduction

The natural course of Major Depressive Disorder (MDD) encompasses the occurrence of alternating intervals of major depressive episodes and remission. While several abnormalities in neural circuits related to acute MDD have been identified, the neural mechanisms underlying stable remission remain obscure.

Objectives

Acute MDD is characterized by increased amygdala and subgenual anterior cingulate cortex (sACC) activation and decreased connectivity between the amygdala and the sACC. Consequently, we expect those regions to be affected during remission.

Aims

To determine whether active counter-regulatory mechanisms are implicated in the maintenance of full remission once antidepressant treatment has been discontinued.

Methods

Functional and structural magnetic resonance imaging was used to measure brain activation and volume of the amygdala and the sACC. Images were obtained from 38 healthy subjects without any psychiatric life-time diagnosis and 38 gender-matched drug-free remitted MDD patients. Furthermore, correlation analyses were performed with clinical variables.

Results

Patients with rMDD exhibited lower activation in the amygdala and the sACC and increased functional coupling between the amygdala and sACC compared to controls. This connectivity was particularly pronounced in patients characterized by a long cumulated time of depressive episodes. Similarly, structural connectivity results showed increased association between the amygdala and sACC volume in rMDD patients compared to controls.

Conclusions

Remitted MDD is related to neural alterations within a neural circuit encompassing the amygdala and the sACC compared to controls. These findings suggest active counter-regulatory mechanisms likely contributing to the maintenance of remission once treatment has been discontinued.
Antidepressant treatment and advanced oxidation protein products in depressed patients
Authors: Heymann-Szlachcinska A. , Wykretowicz A. , Rybakowski J.
Published: May 2011

Introduction

Oxidative stress plays a role in producing advanced oxidation protein products (AOPP). High level of AOPP was observed in patients with such pathological conditions as ischemic heart disease, diabetes, cancer or neurodegenerative diseases.

Objectives

A role of oxidative stress in depression and in antidepressant treatment has been implicated. There have been no studies so far on AOPP in psychiatric diseases.

Aim: An assessment of AOPP concentration, as a marker of oxidative stress, in patients with depression and the effect of antidepressant treatment.

Methods

Thirty-one patients hospitalized at Department of Adult Psychiatry, Poznan University of Medical Sciences, were studied. The first depressive episode was diagnosed in 5 patients, recurrent depressive disorder in 6 patients, and depression in the course of bipolar affective disorder in 20 patients. Patients were treated with venlafaxine (10), paroxetine (7), fluoxetine (5), clomipramine (4), citalopram (3), sertraline (1) and mianserine (1). Advanced oxidation protein products (AOPP) levels were measured twice: before treatment and in remission on maintenance doses of drugs. Control group consisted of 18 healthy volunteers, age- and gender matched.

Results

There was no significant difference between depressed patients and healthy controls in the AOPP concentration before treatment. There was no correlation between AOPP levels and diagnosis, duration of illness, duration of the current episode and the age of illness’ onset. After antidepressant treatment, a significant decrease of AOPP concentration was found.

Conclusions

The results of the study may confirm previous data suggesting a decrease of some markers of oxidative stress after antidepressant treatment.