bluuebunny/crossref_metadata_2025 huggingface dataset:
Psychological Well-being and Active Ageing: Maintaining Quality of Life in Older Age
Authors: McFarquhar T. , Bowling A.
Published: March 2009

Aims:

To investigate the relationship between psychological well-being and measures of active ageing in a British sample of older people. Active ageing is the process of optimising opportunities for health, participation and security to embrace quality of life as people age.

Methods:

A national survey of quality of life and psychological well-being including 999 people aged ≥65 years living in private households in Britain commenced in 1999. in the most recent follow up of 2007, 323 survivors aged ≥72 years completed a postal survey regarding their quality of life and specifically the process of active ageing. A subset of 42 participants was also interviewed qualitatively in 2008 about their perceptions of active ageing. Psychological well-being at baseline was measured using the 12 item General Health Questionnaire (GHQ12) and correlated with measures of active ageing at baseline and in subsequent follow ups. Measures of active ageing included number and frequency of leisure and social activities, physical ability and access to support networks.

Results:

A significant positive relationship between psychological well being and measures of active ageing was found at baseline (p< 0.05). Measure of active ageing in 2007 were also correlated with psychological well-being at baseline (p< 0.05). Qualitative interviews in 2008 provided additional insights into this relationship.

Conclusions:

Results suggesting a strong relationship between psychological health and ageing actively. Good psychological health may allow the elderly to maintain an active and fulfilling lifestyle and reduce isolation and dependence, which in turn may protect against some aspects of poor mental health.
Regional Survey of Demographical and Epidemiological of Geriatric Psychiatric Disorders in Iran
Authors: Mirabzadeh A. , Malakouti S.K. , Fatollahi P. , Zandi T. , Salavati M. , Kahani S.
Published: March 2009

Objectives:

Today, about 10% of the world population are older than 65 and even it is about 30% in some of society. According to growing of population in the word and in Iran and also high prevalence of psychiatric disorders in this group, demographic and epidemiological studies are necessary.

Methods:

From 1422 subjects 59 years or older, who were live in Ekbatan district of Tehran, 313 subjects were chosen randomly. Finally 204 subjects were enrolled and completed the questionnaires of GDS-15, GHQ and CES-D. from study sample, 104 subjects were selected randomly and interviewed by CIDI to validate psychiatric disorders.

Results:

According to our study, 53.4% of subjects were women and 46.6% of them were male and 63% of the population were between 60-75. the life time prevalence for all psychiatric disorders were 35% and the period prevalence were 17.5%. 25.2% of subjects had only one psychiatric disorder and 6.8% and 2.9% of them had two and three or more psychiatric disorders, respectively. the most prevalence of psychiatric disorders were Major depressive disorder, Dysthymic disorder, OCD and PTSD, respectively. Some subjects had not engaged in treatment.

Conclusion:

The results of this study revealed that the psychiatric disorders in Iranian geriatric population are common. It seems that these results can be helpful for mental health services.
Prevalence of Depression among Older People Living in Retirement Homes within Penacova County
Authors: Pinto A. , Cravador A. , Ferreira J. , Marques L. , Cunha-Oliveira J.
Published: March 2009

Objectives:

To estimate the prevalence of depression and of depressive symptoms among older people living in retirement homes within Penacova county. to estimate the percentage of elderly depressed people receiving adequate treatment. to study associations between recorded clinical variables and depression.

Method:

We visited all the retirement homes of Penacova County to interview institutionalized men and women older than 64 years, applying a semi-structured protocol that included GDS (geriatric depression screening scale), MMSE, pain scale, Clock Drawing Test, Barthel Index and BSI (Brief Symptom Inventory).

Results:

We included 78 subjects (22 Men and 56 Women) with a mean age of 81.3 years. among them 29 were illiterate, 34 had < 4 years of education, 13 had 4 years of education and 2 had a university degree. 56 were widowers and 49 were born in Penacova. the mean GDS value was 17.27. 19,2% were not depressed, 46.1% were depressed and 34,6% were severely depressed.

Conclusion:

These results suggest that depression is a common problem affecting older people living in retirement homes. A significant percentage of depressed patients were not adequately treated. This study highlights the importance of screening this population for depression.
Lay Help for the Caregivers of Demented Outpatients: Impact on Health Status of Patients, Caregivers and Lay Helpers
Authors: Stoppe G. , Paseka V. , Knaus R.
Published: March 2009

International studies showed that caregiver interventions are efficacious especially when they provide the possibility to be free from caregiver role for some hours. Up to now there is no research available concerning the impact on the psychological and physical health of the involved persons.

In a program developed by the memory clinic of University of Goettingen, Germany, and a diaconic social service provider, 64 lay helpers were trained for their role in a 40-hours-course. after informed consent, at three times (T0, T1 (after 6 months), T2 (after 1 year), lay helpers, caregivers and the demented patients were interviewed and standard scales were used (SCL-90, BDI, MMSE, GDS, BEHAVE-AD, NOSGER, IADL, RuD, Adult Attachment Scale etc.).

31 demented patients were included, however from only 16 results at T2 could be obtained. Most patients werde moderately to severely impaired. However, during the study, their mood, mobility and circadian stability improved. the situation of the caregivers remained stable, the lay helpers showed no “negative” trends except for the result that their attitude to ageing significantly deteriorated.

The data should be interpreted with caution because of the low number of persons included and the lack of a control group. in addition lay help is typically variable and other external factors might influence the results. However, because of the broad range of parameters investigated, interesting results are nevertheless worth discussion.
the Malignant Neuroleptic Syndrome: Etiopathogenesis, Diagnosis and Clinics
Authors: Adomaitiene V. , Kulak A. , Anciulyte O.
Published: March 2009

MNS is a rare, acute or chronic idiosyncratic reaction to a neuroleptic medication. the syndrome is characterised by fever, muscular rigidity, altered mental status and autonomic dysfunction. MNS is caused by neuroleptics, dopamine antagonistic medications, combination of MAO and antidepresants.

The main groups of theories, explaining MNS are reviewed. There is a genetic predisposition and association between MNS and human DRD2 gene A1 and A2 alleles polymorphism. There were attempts to prove MNS and serotoninergic syndrome as different forms of malignant hypertermia. Dopaminergic activity inhibition increases quantity of calcium in the sarcoplasmic reticulum, therefore muscular contraction increases and it leads to clinical MNS signs. There are theories of neuromediators interaction (changes in HVA, adrenaline, MHPG, 5-HIAA levels in cerebrospinal fluid detected during MNS), increased sympathetic activity, malignant hyperthermia, and direct toxic effect of neuroleptic medications to sceletal muscules in vitro.

The main risk factors and clinical signs of MNS are summarised. MNS develops suddenly during few hours from the start of treatment with neuroleptics, in rare cases - during first 4 weeks. Usually MNS starts during first 24-72 hours. Classic MNS signs are muscular rigidity (“lead pipe”), hypertermia, elevation of CPK.

MNS diagnosis is determined based on anamnesis, clinical signs, laboratorical findings and differentiation which is based by excluding other pathological conditions.
How Should Large ‘naturalistic’ Trials of Antipsychotics Change the Practice of the Practicing Clinician?
Authors: Agius M. , Zaman R. , Lane D.
Published: March 2009

A number of large naturalistic trials of anti-psychotic medication have been carried out in recent years. These include SOHO, CATIE, CAFÉ, EUFEST, and CUTLASS.

These studies have attempted to demonstrate the efficacy in practice of second generation drugs as compared to first generation drugs. the results of these studies have been hotly debated and various conclusions have been drawn.

However, it is necessary to question what methodological issues have arisen in these studies, and hence how safe are the conclusions.

It is now also necessary to examine what findings appear to have been demonstrated by these trials, and whether certain findings are corroborated by several trials, while other trial results contradict each other.

In the presentation, each of the five studies will be critically appraised by a contributor who is a practicing clinician, but who has not participated as a principal investigator in the study concerned. Conclusions will be drawn as to whether the trials are useful for developing guidelines for the use of antipsychotics in the management of psychotic illness, what findings are corroborated by several trials, and indeed, whether methodological flaws might undermine some conclusions from some of the studies.
is Feigned Psychosis a Pathway to Schizophrenia?
Authors: Almeida J. Traça , da Silva J. Alves , Xavier M. , Gusmão R.
Published: March 2009

Factitious disorders (FD) are characterized by intentional production of either physical, psychological or mixed symptoms that mimic various clinical syndromes, with no apparent advantage for the individual concerned other than allowing him to assume the sick role. Large body of work has been accumulated on FD, but the majority of published data deal with the physical variant of the disease, with comparable few reports on psychiatric FD. Although there are many different presentations for psychiatric FD, the factitious psychosis subset justifies particular attention. Factitious psychosis may be prodromic of a genuine chronic psychosis, usually in the context of a personality disorder. Published data shows Munchausen psychosis, a severe subset of FD psychosis, with a prevalence of 0.25% of all inpatient admissions and global FD psychosis attaining 4.1% of all diagnosed psychoses, generally with a poor prognosis.

The scantiness of studies on the subject of psychiatric FD and factitious psychosis in particular, despite its significant prevalence, coupled with the fact that its recognition embarks on a radically different approach compared with the physical variant, stresses the need for case reporting.

We present four clinical cases with discussion of the underlying pathology and outcome, and a systematic review of the literature of FD psychosis case reports. This is followed by further discussion addressing the recognition of factitious psychosis, its etiological contributing factors, management, effects on staff and diagnostic criteria.
Damage to Object Oriented Programming in the Brain Explains many of the Psychopathological Features of Schizophrenia
Authors: Arun C.P.
Published: March 2009

Introduction:

Modern computers often use programs that incorporate a programming technique called Object Oriented Programming (OOP), allowing users to manipulate complex ‘computational objects’ such as menus, screen windows, etc with very little effort, say the click of a mouse. OOP deals with structures called objects and allows time and computational effort saving devices such as inheritance, polymorphism and encapsulation. We examine whether the brain itself may use OOP and if representation of objects suffers a breakdown in schizophrenia.

Review of literature:

Previous models fail to provide a unifying explanation with a computational basis that could explain the psychopathology in schizophrenia. METHODS Using the object oriented programming language JavaTM we designed a system of self-objects named ‘hand’, ‘action monitor’ etc interacting with non-self objects ‘scissors’, ‘hammer’, ‘wall’, etc. in computational experiments, we allow the ‘action monitor’ to fail; the features of disparate objects are allowed to merge, some features of an object are allowed to be shared with other objects, etc.

Results:

By transposing only a few lines of code, it is possible to duplicate various features of the psychopathology of schizophrenia.

Discussion:

Our model can demonstrate overinclusion (overabstraction), concrete thinking (underabstraction), loss of ego boundaries (conjoining of disparate objects), delusions (misattribution of object function), lack of insight (poor monitoring of object activity) and passivity (loss of monitoring and misattribution of object activity).

Conclusion:

The brain must use the OOP model in its computations. Failure of object representation and manipulation must lie at the core of the psychopathology of schizophrenia.
A Bedside Schizophrenia thought Disorder Scale
Authors: Arun C.P.
Published: March 2009

Present classification systems for thought disorder lack consistency and require one to remember long-winded definitions limiting their use to research settings. as an extension of recent work in this area (World Congress, 2008), we classify the characteristic thought disorder patterns seen in schizophrenia according to the location of the lesion in notional "threads" of mental computational processes that string speech together. These threads must take both semantics and syntax into consideration in performing their function. When we speak - just as when we write - there is a natural hierarchy topic thread (the topic of the ‘essay’) and multiples of paragraph threads, sentence threads, clause threads, word threads and phoneme threads. Intuitively, we grade the severity of thought disorder depending upon whether a particular thread gets stuck (S), reconnects abnormally (R) or is absent altogether:

I.

paragraph thread R: Disjointed sentences S: Circumstantiality;

II.

topic threadR: Tangentiality S: Preoccupatory thinking;

III.

sentence threads R: Knight's move thinking S: Clause perseveration;

IV.

clause threads R: Word salad S: Word perseveration, fusion;

V.

word threads R: Incoherent sounds/ neologisms/ paraphasias S: Phoneme/syllable perseveration;

VI.

phoneme threads - Failure of production: Mutism.

Of course, one must record all the lesions that are present at any given time. This scale incorporates a intuitive progression from mild to severe thought disorder in Schizophrenia. Using the STDS would allow the straightforward ‘bedside’ quantification of the severity of thought disorder and enforce discipline into the thought assessment section of the Mental State Examination.
Valacyclovir-associated Psychosis and Manic Symptoms in an Adolescent Female with Genital Herpes Simplex: A Case Report
Authors: Aslam S. , Carroll K. , Naz B. , Alao A.
Published: March 2009

We report the first case of valacyclovir-induced psychosis with symptoms of mania in an adolescent female with no psychiatric history. the patient presented with irritable mood, decreased need for sleep, auditory hallucinations, and grandiose delusions 72 hours after starting oral valacyclovir for newly acquired genital herpes. She was on no other medications. Delirium was ruled out by history and physical, urine toxicology was negative, head CAT scan was unremarkable, as were thyroid hormones and basic laboratories. the symptoms continued after stopping the valacyclovir, but improved with risperidone. after withdrawal of risperidone, the patient has been symptom free for 4 months. According to the Naranjo Adverse Drug Reaction (ADR) probability scale, this case report scores as a possible drug reaction. Although there are no reports of neuropsychiatric side effects with valacyclovir, there are for the medications structural analogs, acyclovir and ganciclovir. These cases were primarily in elderly patients who are immunocompromised, have renal dysfunction and receive the medication by the intravenous route. other anti-viral medications, such as interferon, have also been shown to induce mood symptoms, including depression and mania. Genital Herpes is a common and painful infection, with no known cure. Three medications, acyclovir, valacyclovir and famciclovir, have been shown to reduce the duration and severity of the disease. Clinicians should be aware that Valacyclovir and its analogs may induce psychosis with manic symptoms in young, healthy patients with no previous psychiatric history. Further research is needed to demonstrate a clear association, causal relationship and possible mechanism for the reaction.
Shared-induced Paranoid Disorder (Folie á Deux) between Two Sisters. A Case Report
Authors: de Velasco Soriano R. Martínez , Cerezo E. Benítez , Velasco M.F. Pando , Sierra C. Erausquin , Ferrando I. Gobernado , Martín F. Suárez , Ruano A. Soto , Moreno A. Chinchilla
Published: March 2009

Introduction:

Induced delusional disorder (also known as shared paranoid disorder or folie à deux) is an uncommon disturbance characterized by the presence of similar psychotic symptoms in two or more individuals. Most commonly a primary case can be distinguished from other one or more cases, in whom the symptoms are induced. the patients implied in the shared delusional symptoms are frequently linked by close relationship bonds, mostly family ties. Its epidemiology remains unclear, because very few data is available. There are some requirements concerning the persons involved for the development of this disorder:

1.

Close coexistence and intimate emotional links between the two people are observed;

2.

The delusional content is plausible and can be based on past events or expectations;

3.

Typically, the induced individual has an easily influenciable personality.

Case report:

We describe and comment one case of shared paranoid disorder between a 29 year old schizophrenic patient and her 43 years old sister. both share a persecution and prejudice delusion involving the Chinese community of their hometown. after a few days of inward treatment at separated psychiatric wards, the delusional symptoms in the older sister started to improve.

Conclusion:

Our intention is making a review on a diagnosis that remains controversial nowadays. Treatment should begin with the separation of the induced and the inducer. Anyhow, a psychopharmacological treatment is required in both individuals. It seems clear, however, that the prognosis of the induced and the inducer is different, according to a variety of factors.
Diagnostic Stability and Clinical Characteristics in First-episode Psychosis
Authors: Berge D. , Mane A. , Salgado P. , Vilarroya O. , Merino A. , Bulbena A.
Published: March 2009

Introduction:

Diagnostic stability in first-episode psychosis shows a wide variability between studies. Amini and cols reported a 50% rate of patients schizophreniform disorder shifting to schizophrenia during the first 12 months period. We report the preliminary follow-up results of our recently ongoing first- episode psychosis unit.

Methods:

Forty-six patients admitted for a first-episode psichosis to our Inpatient Psychiatric Unit from January 2006 to January 2008 were recruited. Clinical and socio-demographic characteristics were registered during admission period and during the follow-up period.

Results:

At admission 52% of the first-episode subjects had a diagnosis of psychosis NOS and 32% a schizophreniform disorder diagnosis. after discharge, most of the patients (72%) had a diagnosis of schizophreniform disorder, 16% psychosis NOS and 8% brief psychotic disorder. Six months later, half of the followed-up patients had a schizophreniform disorder diagnosis, and 23% had a diagnosis of schizophrenia. 30% of the patients were drop-outs, mainly referred to other out-patient services. Patients shifting to schizophrenia were younger, predominantly male (75% vs 50% in non-schizophrenia shift), had a lower proportion of university studies and presented a longer hospitalization period at admission. No differences in familial history of psychosis and cannabis use were found. after one-year follow-up period, 50% preserved a schizophreniform disorder diagnosis and 30% were diagnosed as schizophrenia.

Conclusions:

Schizophrenia spectrum disorders have a high stability in first-episode psychosis during first year follow-up. as in previous studies, male gender is one of the factors that best predicts the shift to schizophrenia.
the ‘schizophrenia Postdrome’: A Study of Low-level Positive Symptoms after Remission of First Episode Schizophrenia
Authors: Burley K. , Upthegrove R. , Birchwood M. , Patterson P. , Skeate A.
Published: March 2009

Background:

Despite remission being the primary objective following the first episode of schizophrenia, clinically stabilised patients are rarely studied.

Aims:

To assess the extent and fluctuation of low-level positive symptoms in patients who are in remission following their first episode of schizophrenia, and consider whether symptoms displayed are similar to those exhibited in the prodromal population.

Methods:

Eleven patients who had recovered for at least six months following one episode of schizophrenia and subsequently fulfilled remission criteria were interviewed four times over the course of three months. Interviews were based on the Structured Interview of Prodromal Symptoms (SIPS), an in-depth assessment of low-level symptoms that is widely used in the prodromal group. Data was compared to equivalent results from the prodromal population (with data provided by the local ED:IT service).

Results:

Over the course of the interviews 73% of participants displayed attenuated positive symptoms, predominantly unusual thought content and suspiciousness. 18% experienced brief limited intermittent psychotic symptoms (BLIPS). Analysis with Friedman's test revealed no significant fluctuation in positive symptoms, indicating that they are stable over time. Furthermore, the symptoms exhibited in the sample were closely comparable to those in the prodromal group in the ED:IT service.

Conclusions:

The majority of patients in remission are experiencing a form of ‘postdrome’, which appears to be an enduring state. the presence of these symptoms may put patients at an increased risk of relapse. Larger-scale research is required to follow-up this novel preliminary study.

Declaration of interest:

None.
Paranoid Schizophrenia and Projective Distortion - an Evaluation of Self-concept Disturbance in Paranoid Schizophrenics and Projective Distortion in the Family
Authors: Canta G.
Published: March 2009

The research main goal is to study patients diagnosed with Paranoid Schizophrenia, more specifically the impact of projective distortion in the self description, and the self-concept disturbance, personality traits and family dynamics, also evaluating the influence of mental representations from both the patient and parents.

It is essential to describe the semiology and phenomenology of Paranoid Schizophrenia in adults, the mental representations of these patients and their family psychodynamics. Special attention will be given to self-concept and the representation of family interactions, which several investigations mention as very relevant in Schizophrenia.

Projective Distortion is considered to be the result of the interplay of defence mechanisms inside family relationships, conceptualized as an interactional and interpersonal phenomenon.

Although there are some studies on the disturbances of self-concept in patients with Paranoid Schizophrenia, it has not been usual to simultaneously analyse both the Projective Distortion operating in the family and its impact on the patient mental representations, something that can be very relevant to therapeutic interventions.

There will be presented 5 case studies, using interviews with patients diagnosed with Paranoid Schizophrenia and their parents. These interviews will be conducted and analyzed using the Grounded Theory Method. That analysis aims to isolate significant conceptual categories, and to build a theoretical model which allows the understanding of Projective Distortion.
How “DUP” and “ee” Predict the Dynamic OD Syndromes in the Long - Termcourse of Schizophrenia? [P03-123]
Authors: Cechnicki A. , Polczyk R. , Bielańska A.
Published: March 2009

Objective:

The study in Krakow investigated the way in which EE and DUP correlated with long term outcomes of the treatment and the course of illness.

Subjects and methods:

58 out of 80 DSM III schizophrenia diagnosed patients took part in 1, 3, 7 and 12 follow-up. the Follow-Up Chart, BPRS, and CFI were used. as the outcome criteria only dynamic of symptoms were included. the dynamic of the symptoms and the relation between DUP and EE were analyzed by repeated measures of ANOVA.

Results:

1.

General, positive and negative syndromes decreased rapidly after the first hospitalization, and increased slightly between 7 and 12 yrs. (ps < 0.001). the negative syndrome decreased less rapidly during the first year.

2.

The dynamic of general and positive syndrome were modified by the DUP and by EE. in long DUP (general syndrome: p = 0.028; positive syndrome: p = 0.001) the dynamic was worse. High EE subjects had more severe syndromes at the admission. after the first hospitalization their results became as good as in the case of low EE (general syndrome: p = 0.004; positive syndrome: p = 0.044).

3.

The dynamic of negative syndrome was neither modified by DUP (p = 0.896) or by EE (p = 0.309).

Conclusion:

The dynamic of general and positive syndromes were modified by DUP during 12 years follow-up and by EE only in acute state in the first episode. the dynamic of negative syndrome was not modified by DUP and EE.
GABRB2 in Schizophrenia and Bipolar Disorder: Disease Association, Gene Expression and Clinical Correlations
Authors: Chen J.-H. , Tsang S.-Y. , Zhao C.-Y. , Pun F.W. , Yu Z.-L. , Mei L.-L. , Lo W.-S. , Ng S.-K. , Liu H. , Stöber G. , Xue H.
Published: March 2009

Aims:

Previously the GABA(A) receptor beta-2 subunit gene GABRB2 was found to be associated with schizophrenia (SCZ). for SNPs and haplotypes in GRBRB2, the associations with bipolar disorder (BPD), the functional consequences on GABRB2 expression and their relationship to demographic and clinical characteristics in BPD and SCZ remain to be elucidated.

Method:

Case-control analysis was performed for association study of GABRB2 with BPD, and its mRNA expression in postmortem BPD brains was examined using quantitative real-time PCR. Quantitative trait analysis was subsequently employed to assess the covariate effects of demographic and clinical characteristics on genotypic correlation of GABRB2 expression in SCZ and BPD.

Results:

Significant association of GABRB2 with BPD and reduction in GABRB2 mRNA expression in BPD brains were observed in the present study. Duration of illness (DOI) was found to be a significant covariate for the correlation of the disease-associated SNPs rs1816071, rs1816072 and rs187269 with GABRB2 expression in both SCZ and BPD. for individuals with homozygous major genotypes of these SNPs, while GABRB2 expression increased with age in the controls, it decreased with DOI and age in SCZ, and with DOI in BPD. with age of onset as covariate, these three SNPs were significantly correlated with antipsychotic dosage in SCZ.

Conclusion:

These results have thus revealed correlations of GABRB2 SNPs and expression not only with the occurrence of SCZ and BPD, but also with the clinical characteristics of patients, therefore providing support for a shared etiological role played by the gene in both diseases.
First Psychotic Episode and Early Intervention: An Opportunity to Change the Course of the Illness
Authors: Coentre R. , Barrocas D. , Chendo I. , Levy P.
Published: March 2009

Aims:

Early intervention in psychosis constitutes an important opportunity to change the classic limited outcome associated with the patients who suffer of psychotic disease.

Methods:

Based on literature review the authors analyse the evidence for early intervention in first psychotic episode.

Results:

The evidence for the effectiveness of interventions in early psychosis can be considered in two stages:

1.

first stage before the onset of full symptoms of psychosis, in people with high risk of developing psychosis or in the prodrome phase of the illness;

2.

second stage includes the therapeutic focus on the period after the first psychotic episode, reducing the duration of untreated psychosis (DUP) and ameliorate the recovery.

Preventing psychosis by intervene in the prodrome or in people with high risk of developing psychosis remains ethically contentious because of the non-specificity of the symptoms. by the contrary there is evidence that early and specialised intervention in first psychotic episode improves outcome. Besides the controversy of the relation between long DUP and poor outcome, there is agreement that clinicians should identify and treat psychosis early with a great impact in patients and their family's life. Effective care during first psychotic episode includes proactive engagement and initiation of low doses of antipsychotics and psychosocial treatments, aiming for maximal symptomatic and functional recovery and the prevention of relapse.

Conclusion:

There is evidence that early intervention in first psychotic episode improve clinical effectiveness over standard care. Further studies are important to make evidence more robust.
Factors Involved in Treatment Adherence in Psychosis: Importance of Treatment Effectiveness for the Patients
Authors: Coentre R. , Vanelli I. , Chendo I. , Levy P.
Published: March 2009

Aims:

Treatment adherence is crucial to the therapeutic success in psychiatric disorders. Evaluating factors involved in treatment adherence will allow to modify treatment strategies for greater compliance. the aim of the study was to evaluate factors involved in treatment adherence, including subjective patients’ satisfaction.

Method:

The study included in- and outpatients who met the criteria according to DSM-IV TR of schizophrenia, schizophreniform disorder, schizoaffective disorder, delusional disorder, psychosis not otherwise specified, brief psychotic disorder and bipolar disorder. the following questionnaires were applied:

1.

Demographic and clinical questionnaire;

2.

Treatment Satisfaction Questionnaire for Medication Version II (TSQM vII);

3.

Medication Adherence Rating Scale (MARS);

4.

Schedule for Assessment of Insight (SAI);

5.

World Health Organization Quality of Life-BREF Scale (WHOQoL-BREF).

TSQM vII is a self-reporting questionnaire to assess the major dimensions of patients’ satisfaction with their medication, includes 11 items that make up three specific scales (effectiveness, side-effects and convenience).

Results:

Twenty patients, between 18 and 65 years of age, were included. an interview was made and the 5 questionnaires were applied. the statistical analysis, using Regression Analysis Stepwise, showed a significant positive correlation between medication adherence, evaluated by MARS, and treatment effectiveness to the patients, evaluated by TSQMvII effectiveness scale (p=0.028). the correlations between the others parameters were not statistically significant.

Conclusion:

In this study the authors found that the self-experience of treatment effectiveness, which is a major dimension for treatment satisfaction, had a positive correlation with treatment adherence. Strategies to enhance subjective treatment effectiveness are needed to improve medication adherence.
Induced Gamma Band Deficits in Early Psychosis
Authors: Constante M. , Shaikh M. , Williams I. , Murray R. , Bramon E.
Published: March 2009

Objective:

Abnormalities in event related potentials (ERPs) have long been looked at as markers of disease in Schizophrenia. Over recent years there is a trend in the field to move from averaged trials ERPs analysis in the time-voltage domain, to time-frequency single trials analysis. Oscillations in the Gamma band (30-50Hz) have received particular attention in the context of the theories of core deficits in neuronal synchronization in Schizophrenia. in this study we aimed at replicating previously found Gamma band deficits in a sample of Early Psychosis patients.

Methods:

EEG was collected from 15 patients and 15 age matched controls using an auditory oddball paradigm. Time-frequency analysis in the Gamma band was performed using a Morlet wavelet transform. We tested differences between the groups using the Wilcoxon rank sum test, given the nonparametric nature of the data, to compare each group's average single trial Gamma power, maximizing the signal-to-noise ratio.

Results:

Patients with Early Psychosis showed, following target tones, a reduction in the total power of Gamma band activation (p< 0.01) as well as in induced Gamma band activation (p< 0.01). This was observed in a late latency interval at 400-500ms. the late burst of Gamma activity was not found in the frequent condition, for neither subjects group.

Conclusion:

The findings are compatible with previous studies suggesting deficits in the late intrinsically generated cognitive processing of auditory stimuli in Schizophrenia, already present in its early stage. They add further evidence of deficits in neuronal synchronisation in the early stages of psychotic disorders.
Predictors of Metabolic Syndrome in Severe Mental Disorders
Authors: Corominas A. , Cavero M. , Alvarez O. , Reyes M.
Published: March 2009

Aims:

To assess the potential factors related to the development of metabolic syndrome (MS) in patients with chronic mental disorders.

Method:

Descriptive, cross-sectional study; sample: 140 outpatients with schizophrenia or affective disorders attended for more than 2 years. Dependent variable: metabolic syndrome (Adult Treatment Panel III diagnostic criteria). Independent variables: age, gender, syndromic diagnosis, main treatment, duration of treatment, Global Functioning, type of diet, sedentarism, alcohol consumption, smoking, Primary Care monitoring.

Results:

43.6% of patients who had an unhealthy diet showed MS, whereas only 25.6% of those patients that followed healthy food habits met criteria for MS (p< 0.05, chi square; OR=1.23, 95% CI =1.01-1.5). Logistic regression identifies type of diet and GAF scores as the only predictive variables for MS. Bivariant analysis confirms previous data concerning the relationship between age and MS, and shows a negative relationship between alcohol consumption and Body Mass Index, and between alcohol and fasting plasma glucose, particularly among young women.

Conclusion:

The lack of a well-balanced dietetic habit appears to be an essential factor in the development of metabolic syndrome. for its prevention, educational programs addressed to patients with severe mental disorders should focus on healthy diet. A sum of effects of age, diet, central adiposity, estrogenic balance and moderate alcohol consumption might argue for the rest of our results.
the Effect of Quetiapine on Auditory p300 Response in Patients with Schizoaffective Disorder: Preliminary Study
Authors: Korostenskaja M. , Dapsys K. , Siurkute A. , Dudlauskaite A. , Pragaraviciene A. , Maciulis V. , Kähkönen S.
Published: March 2009

Abnormalities in attention, memory and information processing are considered to be the primary deficits in schizophrenia. Event-related potential (ERP) P300 could reflect deficits in auditory information processing related to active attention in schizophrenia patients. Atypical antipsychotics tend to ameliorate cognitive deficits, however their effects on neural aspects of cognitive dysfunction have not been consistent.

Aim:

To investigate the effects of quetiapine on auditory information processing by using auditory P300.

Methods:

We examined 7 patients with schizoaffective disorder, depressive type and 7 age- and sex-matched healthy controls. ERPs were elicited during active auditory “oddball” paradigm. P300 was recorded before and after two weeks of treatment with quetiapine (468.7±143 mg/day).

Results:

Baseline P300 latencies were significantly delayed in patients compared with controls. Quetiapine did not change P300 amplitudes. However, it normalized P300 latency. These results suggest that already after two weeks of treatment, quetiapine could have a beneficial effect on the active attention reflected in P300 in patients with schizoaffective disorder. Previous studies with antipsychotic drugs such as olanzapine and risperidone failed to show changes in P300 after this treatment interval.

Conclusion:

Quetiapine may be faster than other neuroleptics in ameliorating attentional dysfunction in patients with schizoaffective disorder. However, studies with a larger sample size must be conducted in order to confirm or reject the results of the current study.
Psychopharmacotherapy and Remission of Patients with Schizophrenia
Authors: Degmecic D. , Pozgain I. , Filakovic P. , Dodig-Curkovic K.
Published: March 2009

Aim of our study was to determine which antipsychotic are used in the treatment of patients with schizophrenia, as well as to assess are there differences between patients treated with typical and atypical antipsychotics and how many of them are in remission according to the defined remission criteria.

All outtreated patients with schizophrenia treated at the University Department of Psychiatry Osijek in the period of three months were assessed. the patients were divided in two groups, one group of patients treated with typical antipsychotics, and the other group treated with atipycal antipsychotics. All of them were assessed with specially designed questionnaire about sociodemographic data, than with 8 item of PANSS (remission criteria), and with Clinical Global Impression scale. the authors analysed 193 patients with schizophrenia, 65 (33.7%) of them were treated with typical antipsychotics, and 128 (66.3%) patients were treated with atypical antipsychotics. Our results suggest that there is statisticaly significant difference in the duration of psychiatric treatment between those two groups of patients as well as statistically significant difference in the number of visits to the psychiatrist in the last two years. Only item from the PANSS remision criteria in which we observed statistically significant difference between two groups of patients was G 9 (Unusal thought content). in our group of patients 98 of them (50.8%) were in remission according to the PANSS remission criteria.

Conclusion:

The introduction of standardized remission criteria may offer significant opportunities for clinical practice, health services research and clinical trials.
Gamma Band Response during Auditory Information Processing in Schizophrenia
Authors: Domján N. , Csifcsák G. , Garab E.A. , Szendi I. , Janka Z.
Published: March 2009

Aims:

In the present study we investigated the correlation between evoked gamma activity and P50 suppression and between induced gamma activity and P300 amplitude on one schizophrenic population. These kind of auditory processing impairments are substantial in schizophrenia.

Methods:

Thirty-one patients with schizophrenia and twenty-one controls were involved. Electroencephalogram was recorded with 19 Zn electrodes, which were placed according to the international 10-20 system.

Results:

P50 suppression was significantly reduced in schizophrenic patients (F(1,53)=9.89, p=0.03). There was a not significant reduction in the early evoked gamma response. Furthermore, we found no correlation between P50 amplitudes and gamma amplitude for the first stimulus in neither groups, while there was a significant correlation for the second click in the control group (R=0.43, p=0.03 for controls, R=0.18, p=0.30 for patients). the amplitude of the P300 auditory evoked potential was significantly reduced at Pz electrode in schizophrenic patients (F(1,53)=11.91, p=0.01). Induced gamma response around the peak P300 latency was diminished in the patient group (F(1,53)=11.12, p=0.002). There was no correlation between P300 amplitudes and gamma amplitude in neither group.

Conclusion:

According to our results evoked and induced gamma activity is differentially affected in schizophrenia during auditory information processing. the absence of late induced gamma response during target stimulus detection among patients might reflect abnormal functional connectivity between different cortical areas, and result in inefficient integration and utilization of sensory stimuli.
Analysis of Sound's Emotional Perception (pleasantness/unpleasantness) in Schizophrenic Patients in Early Stages of the Disease
Authors: Freitas C. , Griffiths T. , Ribeiro J.A.
Published: March 2009

Introduction:

Many studies have shown that schizophrenic patients are noted to have deficits in the recognition and discrimination of facial emotions. in contrast, studies examining emotional sound perception are scarce.

Objective:

Evaluate emotional sound perception (pleasantness/unpleasantness) in schizophrenic patients in early stages of the disease.

Methods:

This study was performed on schizophrenic outpatients from the Psychiatry Departments of Hospital Santa Maria and Hospital Júlio de Matos, Lisbon. Sample group comprised 29 schizophrenic patients and 29 matched healthy controls, equal in sex and age. Evaluations included the Mini Mental State Examination; the Positive and Negative Syndrome Scale (PANSS); the Newcastle Battery of Pleasant and Unpleasant Sounds (NBPUS), which we developed to study this issue, and a visual scale of self-assessment of the emotional experience.

Results and discussion:

There was no statistical difference between groups. Results suggest that schizophrenic patients in early stages of the disease have a preserved emotional perception of sounds. No correlation was found between clinical severity measures (disease duration, PANSS total and sub scores) and mean unpleasantness/pleasantness rating, which may suggest that the emotional perception of sounds is rather stable during the first five years of illness.

Conclusion:

These results need further investigation on bigger samples studies. Future research in this area is important for the larger study of emotion and cognition.
Switching from Antipsychotic to Quetiapine XR Treatment in Patients with Schizophrenia and High from Low Depression Symptoms
Authors: Ganesan S. , Eggens I. , Huizar K. , Meulien D.
Published: March 2009

Purpose:

Assess the efficacy of once-daily extended release quetiapine fumarate (quetiapine XR) in patients with schizophrenia and depressive symptoms.

Methods:

12-week, multi-centre, open-label study in adult patients with schizophrenia (D1444C00147). Patients were cross titrated to quetiapine XR over three days (Day 1: 300 mg; Day 2: 600 mg; Days 3-84: 400-800 mg/day [flexible dosing]). Two patient subsets: high depression symptoms (PANSS depression cluster score ≥ 12) and low depression symptoms (PANSS depression cluster score < 12) at baseline. Change from baseline of PANSS total score and PANSS depression cluster score were analysed by subgroup.

Results:

Mean (SD) change at Day 84 (LOCF) in PANSS depression cluster score was -4.8 (3.3) for patients with high depression (n=109) and -1.1 (2.7) for patients with low depression (n=362). Mean (SD) change from baseline at Day 84 (LOCF) in PANSS total score was -24.3 (18.5) for patients with high depression and -10.5 (18.0) for patients with low depression. at Day 84: in patients switched to quetiapine XR owing to “lack of efficacy”, mean change (SD) from baseline in PANSS depression cluster score was -5.2 (3.2) and -1.3 (2.8) for patients with high and low depression, respectively; in patients switched due to “insufficient tolerability”, mean change (SD) in PANSS depression cluster score was -4.1 (3.5) and -0.6 (2.5) for patients with high and low, respectively.

Conclusions:

Quetiapine XR showed promising results in patients with schizophrenia and depressive symptoms switched from other antipsychotics due to suboptimal efficacy or tolerability. Further randomised, clinical trials are warranted.
Developing Access to Care in Mental Health in Mauritania: The Nouadhibou Pilot Program
Authors: Hamady A. Ould , Gerard D.A.
Published: March 2009

Rationale:

Mental disorders are emerging as a major contributor to the Global Burden of Disease in developing countries. Nevertheless in Mauritania, as in most low-income-countries, access to mental health care remains inadequate. Psychotic patients suffer from stigmatization, paucity of qualified health professionals, and difficulties to have access to medicines.

Objective:

The aim of the Nouadhibou pilot program is to demonstrate that access to care of schizophrenic patients could be drastically improved within partnerships between public and private sectors.

Method:

The program was set up in October 2008 in Nouadhibou, Mauritania's second largest city.

It combines:

•

A strong awareness campaign about mental disorders, including, radio broadcasts, articles in national news papers, advocacy meetings with elected representatives, stakeholders and the civil society, and information meetings for the population.

•

The development of a psychiatric department in the Nouadhibou general hospital with a staff trained to diagnose and treat psychotic disorders, deliver psycho educational modules, and liaise with health professionals from Nouadhibou area trained to diagnose psychosis.

•

A sustainable supply of high quality antipsychotics (with a preferential pricing policy from sanofi-aventis).

•

A strict assessment of the impact of the program.

Results:

The presentation will include the present situation of mental health care in Mauritania, the program's content, the assessment tools and the first results.

Conclusion:

Once the impact of this program is established, scaling the project to the rest of Mauritania will require commitments from different partners including the Ministry of Health, pharmaceutical industry, international organizations and funders.
Early Treatment of Schizophrenia: Links between Insight and Cognitive Disorders
Authors: Langlois C. Guerin , Mondoloni A. , Uzan S. , Laffy-Beaufils B.
Published: March 2009

In the early treatment of schizophrenia, insight and cognitive disorders are key components in the observance and the functional prognosis of patients.

This study aims to evaluate the impact of neurocognitive rehabilitation and psycho information programs on the quality of insight in a population of 20 schizophrenic patients.

Results show a correlation between the extent of cognitive disorders and the quality of insight as well as with the efficiency of specific treatment programs.

The study emphasizes close links between improvement of cognitive skills and the quality of insight in this population.