bluuebunny/crossref_metadata_2025 huggingface dataset:
Klinefelter's Syndrome and psychiatric pathology: a case report
Authors: Isasi M. , Arroita A. , Periañez N. , Ugarte K.
Published: May 2011

Introduction

The presence of an extra X-chromosome, also known as Klinefelter's Syndrome, occurs in approximately 1 in 500 live male births. Epidemiological studies have reported an increased vulnerability to psychiatric disturbances in this group of patients and suggest that the X chromosome may be involved in the aetiology.

Material and Methods

Comprehensive review of the scientific literature (Medline, Ovid) on Psychiatric pathology in Klinefelter's Syndrome published over the last 20 years.

Results

This is a case report of a 27 year-old-male with Klinefelter's Syndrome confirmed by karyotyping (XXY), suffering from different neuropsychiatric disorders, such as mental retardation, dyslexia, ADHD and social dysfunctioning. Since the age of 16 he has required multiple psychiatric hospitalizations due to his impulse control difficulties and exaggerated mood swings.This case raises the question of whether Klinefelter's syndrome patients are predisposed to psychiatric pathology (including Schizophrenia, Bipolar Disorder, Anorexia Nervosa or social-emotional processing) at a genetic level.

Conclusions

Reviews of the neuropsychiatric problems associated with Klinefelter's Syndrome confirm an association between disorders in this area and the chromosomal abnormality. Further studies are needed to identify involvement of X-linked epigenetic influence and susceptibility to several psychiatric diseases.
SAT-1 -1415T/C polymorphism and suicidal behavior
Authors: Riaza Bermudo-Soriano C. , Vaquero-Lorenzo C. , Baca-García E. , Díaz-Hernández M. , Pérez-Piqueras J. , Sáiz-Ruiz J.
Published: May 2011

Background

A growing interest in the potential role of polyamines in stress, mood disorders and suicidal behavior has recently emerged. In particular, the expression of polyamine's rate-limiting catabolic enzyme (SAT-1, Spermidine/spermine N1-acetyltransferase-1) may be reduced in ventral prefrontal cortex and posterior cyngulate gyrus of patients who committed suicide. However, there is some controversy regarding the involvement of potential cis-acting loci controlling SAT-1 gene expression (rs6526342 or rs17286006) in suicidal behavior. Moreover, a significant association between SAT-1 rs1960264 SNP and anxiety disorders has been found in a male caucasian spanish sample.

Methods

In order to test the potential association of SAT-1 -1415T/C SNP (rs1960264) with suicidal behavior, genotype frequencies for that SNP were compared between 193 suicidal attempters (126 female and 67 male) and 650 non-suicidal patients (314 female and 336 male) from an in-patient sample.

Results

We could not find a significant difference in the distribution of the genotypes for rs1960264 SNP between suicide attempters versus non-suicidal individuals (Linear-by-Linear association X2 = 0,203; df = 1; P = 0,652, females; Linear-by-Linear association X2 = 0,000; df = 1; P = 0,990, males). Neither could we demonstrate a relationship between rs1960264 genotype and past history of suicidal attempts (Linear-by-Linear association X2 = 2,966 ; df = 1; P = 0,085, females; Linear-by-Linear association X2 = 1,171; df = 1; P = 0,279, males).

Conclusions

Although we did not find a link between rs1960264 genotype and suicidal behavior, SAT-1 may be an interesting target to investigate the biology of this phenotype. Future studies should take into account other genetic polymorphisms at SAT-1, and definitively evaluate whether or not rs6526342 and rs1960264 have any functional implications.
A functional polymorphism of FK506-binding protein 51 (FKBP5) gene affects personality traits of harm avoidance and cooperativeness in healthy subjects
Authors: Shibuya N. , Suzuki A. , Sadahiro R. , Kamata M. , Matsumoto Y. , Goto K. , Hozumi Y. , Otani K.
Published: May 2011

Aims

Previous studies have shown that the function of hypothalamic-pituitary-adrenal (HPA) axis is involved in the characterization of personality traits. FK506-binding protein 51 (FKBP51 or FKBP5) is a co-chaperone of heat-shock protein 90, and plays an important role in the negative feedback regulation of HPA axis function. It has been reported that a C/T single nucleotide polymorphism in the intron 2 of FKBP5 gene (rs1360780) affects FKBP5 protein levels and cortisol response to dexamethasone and psychological stress tests. Therefore, it is hypothesized that the FKBP5 polymorphism affects personality traits. In the present study, we studied the association between this polymorphism and personality traits in healthy subjects.

Methods

Subjects were 826 Japanese healthy volunteers. Personality traits were assessed by the Temperament and Character Inventory (TCI), and the FKBP5 genotype was detected by a real-time PCR and cycling probe technology for SNP typing.

Results

In total subjects, the group with the T allele predictive of impaired negative feedback regulation of the HPA axis had higher scores of harm avoidance (p = 0.043) and lower scores of cooperativeness (p = 0.019) compared to that without the T allele. The T allele was associated with higher scores of harm avoidance in females (p = 0.020) and lower scores of cooperativeness in males (p = 0.015).

Conclusion

The present study thus suggests that the FKBP5 polymorphism affects harm avoidance and cooperativeness in healthy subjects, with gender specificity.
Imprinting in the schizophrenia candidate gene GABRB2
Authors: Pun F. , Zhao C. , Lo W. , Ng S. , Tsang S. , Nimgaonkar V. , Chung W. , Ungvari G. , Xue H.
Published: May 2011

Imprinting, characterized by unequal expression of the offspring's genes in a parent-of-origin dependent manner, has been functionally implicated in brain development and in psychiatric disorders. In this study, unambiguous distortion in paternal but not maternal transmission of the disease-associated single-nucleotide polymorphism (SNP) rs6556547 (T/G) clearly indicated the presence of parent-of-origin effect (POE) in the GABAA receptor β2 subunit gene (GABRB2). ‘Flipping’ of allelic mRNA expression in heterozygotes of SNP rs2229944 (C/T) and the observed two-tiered distribution of mRNA expression levels in heterozygotes of the disease-associated SNP rs1816071 (G/A) furnished important support for the occurrence of imprinting at GABRB2. Imprinting in effect introduced heterozygotes from different parents-of-origin endowed with dissimilar mRNA expression capabilities. The deficit of upper-tiered expressions accounted for the lowered mRNA expression levels in the schizophrenic heterozygotes. This pointed to the necessity of differentiating between two kinds of heterozygotes of different parental origins in disease association studies on GABRB2. Bisulfite sequencing revealed hypermethylation in the neighborhood of SNP rs1816071, and methylation differences between controls and schizophrenia patients. Notably, allele-specific methylation was observed at the disease-associated SNPs rs6556547 and rs1816071. These findings raised the possibility that CpG methylation status of these sites could have an impact on the expression of GABRB2 and the risk of schizophrenia. Furthermore, the occurrence of imprinting and allele-specific methylation in the schizophrenia candidate gene GABRB2 was compatible with the epigenetic hypothesis for schizophrenia pathophysiology, thereby calling for the need to explore the role of epigenetic factors in mediating susceptibility to schizophrenia.
A study of the relationship between weight loss and behavioral symptoms in patients with severe alzheimer's disease
Authors: Furuhashi Y. , Shin K.
Published: May 2011

Introduction

Alzheimer's disease (AD) is often accompanied and worsened by malnutrition.

Aims

The aim of this study is to investigate the relationship between weight loss and behavioral symptoms in institutionalized severe AD patients.

Methods

All subjects were recruited from Asahi Hospital, a long-term care facility.

The diagnosis of AD was made in accordance with the National Institute of Neurological and Communicative Disorders and Stroke and the Alzheimer's Disease and Related Disorders Association (NINCDS-ADRDA) criteria. The inclusion criteria were (1) an MMSE score of 12 or less, (2) stable physical condition for at least three months. Exclusion criteria were (1) presence of acute disorders such as infection, heart failure, or requiring special treatment and intensive care. Weight was measured monthly. At baseline, 12 weeks, and 24 weeks, each patient received the Mini-Mental State Examination (MMSE), the Barthel Index, and Neuropsychiatric Inventory (NPI).

Results

We included 48 patients who were judged appropriate for the study. At baseline, the mean age was 83.3 ± 6.2, the mean weight was 41.8 ± 7.9, the mean body mass index (BMI) was 18.7 ± 3.5. During the 24 weeks of follow-up, 16 patients lost at least 3 kg of body weight, 20 patients remained stable, and 12 patients gained at least 3 kg of body weight. The mean NPI scores was significantly higher in the weight-loss group than in the weight-gain and weight-stable groups.

Conclusion

These preliminary results suggest that behavioral disturbances play a role in low body weight and weight loss in AD patients.
Neuropsychological performance variability is associated with reduced treatment consent capacity
Authors: Gurrera R. , Karel M. , Azar A. , Moye J.
Published: May 2011

The capacity of older adults to make health care treatment decisions is often impaired in dementia and has been linked to performance on specific neuropsychological tasks. Within-person across-test neuropsychological performance variability has been shown to predict future dementia. This study examined the relationship of within-person across-test neuropsychological performance variability to treatment decision (consent) capacity in community-dwelling older individuals. Men (N = 79) and women (N = 80) with (N = 83) or without (N = 76) probable mild to moderate dementia completed a neuropsychological test battery and a standardized capacity assessment that evaluates each of the following treatment decisional abilities separately: Understanding, Reasoning, Appreciation, and Expression of Choice. Standard scores were used to compute mean neuropsychological performance and within-person across-test variability. Neuropsychological performance and within-person variability were independently associated with continuous and dichotomous measures of capacity. The results of this study provide support for the emerging view that multiple distinct cognitive abilities are required to support this function, and indicate that the sensitivity and accuracy of consent capacity assessments can be improved by evaluating each of these components separately.
An evaluation of the beyondblue depression training program for aged care workers
Authors: Mellor D. , Mccabe M. , Davison T. , Karantzas G. , George K.
Published: May 2011

Introduction

The prevalence of depression among older people receiving care is high, yet the rate of treatment of this disorder is low. One way to improve the pathway to care is to train care staff to recognise the symptoms of depression and raise their confidence in responding to them.

Objective

To evaluate the efficacy of the beyondblue Depression Training Program.

Methods

Staff (N = 148) from low level care facilities and community care facilities in metropolitan Melbourne completed the beyondblue Depression Training Program, while staff in other facilities (N = 96) acted as controls. Pre-, post- and follow-up questionnaire data were collected and referrals for depression by staff were recorded.

Results

Training improved carers’ knowledge about depression, their self-efficacy in responding to signs of depression and their attitudes towards working with depressed aged care recipients. In addition, training increased the number of referrals for depression made by carers.

Conclusions

Training aged care staff in depression can improve the pathways to care for depressed care recipients, and has the potential to improve the quality of life of older people.
Low frequency repetitive transcranial magnetic stimulation in elderly: Effects on mood and cognitive functions
Authors: Pallanti S. , Cecchelli C.
Published: May 2011

Increasing the options for effective treatment of depression in elderly with the aim of improving quality of life remains a critical public health goal. Late-life depression is associated with cognitive impairment and dementia. Pharmacological therapy is a common modality of treatment for depression during the late-life period. Antidepressants seem to have some efficacy in improving cognitive functions. However pharmacological treatment in elderly causes some trouble because of the risk of metabolic side effects. Continuing use of antidepressant medication is associated with an increased relative risk of type 2 diabetes.

Repetitive Transcranial Magnetic Stimulation (rTMS) represents an effective, well-tolerated non-pharmacological treatment for depression. Recently rTMS has been proposed as a possible treatment for the cognitive deficits associated with Alzheimer disease (AD). The findings of a recent study provide initial evidence for the persistent beneficial effects of rTMS on sentence comprehension in AD patients.

We propose the use of rTMS for treatment of depression in elderly in order to reduce the risk of metabolic side effects and to improve cognitive functions. In our experience, elderly depressed patient treated with rTMS, at 1 Hz at 110% of Rest Motor Threshold (RMT) over the right Dorso-Lateral Pre-Frontal Cortex (DLPFC) for three or four weeks, show a significant reduction in depressive symptomatology and furthermore a significant improving in cognitive functions (verbal fluency, visual-spatial memory and score in the MINI-Mental State Examination).
Late-life depression and cerebrovascular diseases
Authors: Shakhurova N.I. , Lebedeva V.F. , Popova N.M. , Pavlova O.A.
Published: May 2011

Introduction

One of relevant challenges of psychogeriatric assistance is recognition of depression and cognitive disturbances in elder patients because clinical similarity of their manifestations masks nature of syndrome.

Objective

To study of clinical severity and nosological belonging of depressive syndrome against the background of accompanying cerebrovascular pathology with availability of cognitive disorders in elder patients under treatment at the specialized department of affective states.

Methods

Total number of observations has constituted 55 persons (males - 24, females - 31, mean age 66,3 ± 5,8 years). Criteria of inclusion: age older than 60 years, complaints about memory disturbances and decreased background of mood as a basic cause of seeking psychiatric assistance. We excluded patients with mental disorders of psychotic register, presence of substance dependence syndrome, dementia.

Results

According to results of clinical-psychopathological investigation along with ICD-10 diagnostic criteria, nosological structure of revealed disorders has been represented by the following rubrics: organic affective disorder (F06.3) was diagnosed in 355 of patients; depressive disorders of rubric F3 were registered in 45% of patients, comorbid with organic asthenic disorder (F06.6) or with mild cognitive disorder (F06.7), in 15% of cases depression was leading syndrome within adjustment disorder also in combination with mild cognitive disorder, in 55 of cases depressive symptoms was regarded as secondary whereas predominating ones were cognitive and behavior disturbances within organic asthenic disorder (F06.6).

Conclusions

Thus, clinical assessment and nosological belonging of depressive syndrome combined with organic disorders in the elderly are an important factor mainly determining the choice of therapeutic strategy.
P02-262 Age group differences in psychiatric hospital settings in ontario: Evidence based on the interrai mental health (MH)
Authors: Sluchevskaya S. , Hirdes J. ,   InterRAI Network of Excellence in Mental Health
Published: May 2011

Although the clinical characteristics of persons in mental health settings are likely to vary in relation to a number of different, age is often considered to be one of the primary factors associated with the strengths, preferences and needs of psychiatric patients. The present study employs data from the mandated use of the interRAI Mental Health (MH) assessment instruments as part of normal clinical practice in Ontario psychiatric hospitals/units. The interRAI MH is a comprehensive assessment tool designed to support care plan development and outcome measurement at the person level, as well as quality monitoring and resource allocation at the organizational level. A sample of 27,530 Ontario psychiatric inpatients aged 18+ was examined with respect to socio-demographic, clinical, patient safety and service utilization characteristics. Younger and middle aged persons were compared with a subsample of 3,219 adults aged 65 years or more, including 112 nonagenarians.

Although there were a number of notable differences across age groups, there were substantial variations within the elderly population when considering source of admission. Elderly patients admitted from the general community were often relatively comparable to their younger counterparts; however, those admitted from nursing homes were a distinctive subgroup from both younger and older patients admitted from the community. This suggests that age alone is rather limited in its utility for describing mental health populations and more comprehensive clinically based measures should be employed to fully understand the needs and experiences of older adults in psychiatric settings.
Anger and depression in the old people with hypertension
Authors: Tel H.
Published: May 2011

Introduction

Hypertension is closely related with the anger control of the individual. While anger causes hypertension, the incapability to express anger in an appropriate way leads to depression. Depression is a mental problem occurring frequently in the old age period.

Objective

The present study was carried out in order to determine the anger and depression conditions in the old people diagnosed with hypertension.

Method

418 old people diagnosed with hypertension and living in home with their families were included in the study. The data of the research were gathered with the individual information form, trait anger, anger types scale and depression scale for old people.

Findings

In the study, it has been understood that there are positive correletion between anger and depression in older people, and between hypertension during and depression (p < 0.05). It was found out that the anger mean score is high in old people who were male, using cigarette and alcohol; likewise, the depression score is high in older people who were women, widow, interdependent to someone in order to carry out daily life activities, illiterate and having poor economic conditions.

Results

In old people with hypertension, depression increases as anger increases. As the hypertension diagnosis during of older people rises, depression rises, too. For this reason, it is needed to plan approaches for old people to recognize their anger, to ensure expressing their anger in an appropriate way and to prevent depression.
Screening for depression and anxiety in patients admitted for coronary artery bypass graft: comparison of nurses’ reports vs. hospital anxiety and depression scale
Authors: Nejatisafa A.A. , Shahmansouri N. , Sadeghian S. , Abbasi H.
Published: May 2011

Aims

To evaluate the validity of nurses’ reports as a screening tool for anxiety and depression in hospitalized patients admitted for Coronary Artery Bypass Graft.

Methods

Within 72 hours of admission, the patients were assessed using the Hospital Anxiety and Depression Scale (HADS). Simultaneously, the nurses who provided care for the patients were asked whether they believed the patients had significant levels of depression or anxiety. They were also asked to rate the degree of depression and anxiety of their patients in a 5 point Likert scale. Assessments were completed for 150 patients.

Results

According to HADS score, 67 (44.66%) patients had probable depressive disorders (HADS-D score > 7) and 57(38%) had probable anxiety disorders (HADS-A score>7). Nurses recognized 31(20.66%) patients had depressive disorder and 24(16%) had anxiety disorders. The correlation coefficient between nursing diagnosis and diagnosis according to HADS was small (phi = 0.24, P < 0.01). No significant correlation was observed between HADS scores and the nurses’ assessment of severity of depression and anxiety. Comparing with HADS, the sensitivity, specificity and positive predictive value for nursing reports was 0.25, 0.55 and 0.41 for depression and 0.66, 0.57 and 0.72 for anxiety respectively.

Conclusion

This study indicates nurses’ reports may have not enough validity and sensitivity to be used as the only way for screening anxiety and depression in patients admitted for cardiac surgery. A consultation-liaison psychiatry service that include an active case finding strategy by using standard instrument and educational program for nurses may be helpful.
Psychosis in patients with systemic lupus erythematosus
Authors: Yelmo Cruz S. , Barrau Alonso V. , Salinas Muñoz M.
Published: May 2011

Introduction

Systemic Lupus Erythematosus (SLE) can affect central nervous system (CNS), leading to neurological and/or psychiatric disorders. The use of corticosteroids for the management of SLE may induce psychiatric disorders.

Objectives

Differential diagnosis of the origin of psychosis in patients with SLE (CNS lupus vs. induced by corticosteroid therapy).

Methods and results

A 22 year old female patient presented asthenia, oral bleeding, epistaxis, metrorrhagia, bicytopenia, hypoalbuminemia, low complement, with anti-DNA > 300, ANA, IgG Anticardiolipin, Anti-Sm, anti-RNP, anti-Ro, Anti-La and Anti-Histone positive.

A diagnosis of SLE was made. She presented also diffuse grade IV nephritis. There were administered 3 iv 6-methylprednisolone pulse therapies (750 mg/day) with a cycle of cyclophosphamide. Subsequently she continued with oral prednisone 60 mg/day. Four days after the end of the pulses, the patient developed anxiety, suspicion, injury delusions, auditory hallucinations and behavioral disinhibition. A MRI was normal. Risperidone was started up to 6 mg/day and oral prednisone was tapered. After a progressive improvement she was discharged.

Results

Corticosteroids induce psychiatric disorders in 3–10% of patients. Low levels of complement, hypoalbuminemia and a positive ratio (≥ 9) of albumin in CSF x103/serum albumin are indicators of blood brain barrier damage and psychosis induced by corticosteroids. The presence of ac Antiribosoma P, ac antineuronals, MRI or EEG abnormals suggest the diagnosis of CNS lupus (lupus psychosis)

Conclusions

Differential diagnosis between lupus psychosis vs. psychosis induced by corticosteroids is complicated. In case of doubt, some authors advocate increasing the dose of steroids and awaiting a clinical response. Others advocate rapid tapering and stopping steroids.
Risperidone and weight change in children with learning disability. A retrospective study
Authors: Narayan M. , Ahmed U. , Bachu C.R. , Read S.
Published: May 2011

Aim

Risperidone has been recommended for the management of disruptive behaviour disorders in children with learning disabilities. This study explored the effects of Risperidone on absolute body weight in children with learning disabilities who received Risperidone for disruptive behaviour disorders.

Methodology

Data was collected for children (n = 70) with learning disabilities who were prescribed Risperidone for disruptive behaviour disorders in out patient clinic. Weight, height and BMI were recorded at the first appointment and at the follow up for up to one year. Data was analysed to find any changes in weight and BMI during the course of treatment with Risperidone.

Results

Mean weight gain for the sample was 6.1 kg (sd = 2.7), 1.7 kg more than expected in one year which was statistically significant (t = 6.2, df = 69, p < 0.001). Mean BMI change was 1.51 kg; significantly larger than the mean expected BMI change of 0.62 of this sample (t = 4.98, df = 1.6, P = 0.001). Change in BMI was more for girls, 2.17 (sd = 1.00) compared with boys 1.36 (sd = 1.18), but this was not significant (t = 1.90, df = 49, p = 0.06). There is no significant relationship between Risperidone dose and weight gain (Pearson's r = 0.21, p = 0.42) and BMI (Pearson's r = 0.03, p = 1.00).

Conclusion

Risperidone should be used with caution in children where weight gain could have long lasting impact. Prescribing clinicians should obtain baseline measures of weight, height, BMI and monitor them at regular intervals. Emphasis should be placed on life style interventions such as diet, physical activities etc. Further comparable studies with larger sample sizes using more homogenous diagnostic samples are needed.
Characteristics of brain comuterized tomography diagnoses and comorbid conditions of alcohol dependant males treated on psychiatry department Tuzla during 2005–2009
Authors: Hasanović M. , Pajević I. , Zukić S. , Hamidović J. , Kuldija A. , Delić A. , Kravić N.
Published: May 2011

Introduction

Consequences of alcohol dependence may be complex, and difficult for treatment, thus complex diagnostic procedures are needed.

Aim

To assess the prevalence of silent brain strokes and cortical cerebral atrophy amongst male inpatient alcoholics.

Methodology

We analyzed 86 file records of males treated from 01 January 2005 to 31 December 2009 year on Tuzla Psychiatry Department, who had dismissed diagnosis Alcohol dependency (F 10.2) according ICD-10, with computerized tomography (CT) of brain, related to age, war engagement, brain trauma, employment, smoking, psychological findings and presence of silent stroke and cortical brain atrophy according CT diagnosis.

Results

The mean age of observed patients was 50.1 ± 6.6 years. Amongst them (70.9%) were active soldiers in Bosnia-Herzegovina Army during 1992–1995 war. There were 71 (72.6%) with atrophy of brain cortex, 27 (31.4%) had ischemic silent stroke. In the sample, 61 (70.9%) of inpatients met criteria for PTSD according ICD-10, 53 (61.6%) had cognitive disturbances, 29 (33.7%) had psychotic symptoms, 50 (58.1%) of them had clinically manifested depression, 47 (54.7%) had difficulties in social contacts, 23 (26.7%) had somatic disorders. Age of inpatients was in positive correlation with duration of work, presence of silent ischemic stroke and brain cortex atrophy. Presence of PTSD was in positive correlation with involvement in the combatants, with cognitive disturbances, with depressiveness and somatic complains. Atrophy of brain cortex positively correlated with silent stroke and glucose blood level.

Conclusion

Brain cortical atrophy and silent brain stroke were frequent CT findings amongst male alcohol dependants clinically treated in Psychiatry department.
Functional brain connectivity and deactivation in new onset schizophrenia: A pilot study
Authors: Norton A. , Reis S. , Bastos-Leite A.J. , Silveira C. , Andrade A.
Published: May 2011

Background/introduction

There has been previous evidence of aberrant functional connectivity in the so-called “default-mode” network (DMN) in patients with schizophrenia.

Objective

The purpose of this study was to test whether such aberrant connectivity, if existent, can be modulated by a task involving the challenge of attention, working memory and executive functioning.

Methods

A functional magnetic resonance imaging (fMRI) experiment alternating between periods of “rest” and periods of visual stimulation with successive series of pictures extracted from the Wechsler Adult Intelligence Scale-III was carried out in seven patients with new onset schizophrenia according to the DSM-IV criteria and in six healthy control subjects matched for sex, age, and education. The DMN was extracted by using independent component analysis (ICA). The degree of deactivation during periods of stimulation was tested by means of a correlation analysis. To determine the existence of differences in deactivation between patients and controls, we used a non-parametric statistical test.

Results

An overall increased activation of the DMN in patients with schizophrenia relative to control subjects seems to occur. There was also an almost significant difference in the degree of deactivation between the two groups (controls>patients, p = 0.05).

Conclusions

Aberrant connectivity of the DMN is indeed a consistent feature in schizophrenia. An altered deactivation of the DMN during a highly demanding task in patients with schizophrenia confirms previous results suggesting an abnormal behaviour of networks in the transition from “rest” to goal-directed activity.
Mild cognitive impairment - Correlations of imagistic and clinical data
Authors: Podea D.M.
Published: May 2011

Mild cognitive impairment is the clinical state between normal cognition and dementia in elderly people which does not interfere notably with activities of daily life; subjects perform more poorly on a variety of cognitive, functional and behavioral measures than normal persons of the same age.

The study comprises 141 subjects between 60 and 92, diagnosed with mild cognitive impairment with Mini Mintal State Evaluation (MMSE), clock drawing test (CDT) and computer tomography.

MMSE score between 28-21 points is considered mild cognitive impairment.

The computer tomography imaging showed specific types of cortical and subcortical atrophies. Tomography examination multislides was performed with 2.5 mm axial sections of brain and axial and coronary reconstruction with sections at 1mm, presenting accurate diagnosis criteria, highlighting the group studied the following:

Ø 53.1% (75 patients) specific lesions to vascular dementia : moderate atrophy of the temporal lobe, hippocampus atrophy, frontal diffuse ischemia and subcortical hipodense ischemic lesions ;

Ø 12.1% specific changes to Alzheimer’s disease, as: obvious atrophy of hippocampus, ipsilaterale enhancement of temporal cone of lateral ventricle, temporal lobes atrophy, diffuse cerebral atrophy (lateral ventricles less extended), widening perimezencefalics cysternes;

Ø specific pathological changes due to age (34.8%): widening external and internal fluid spaces (lateral ventricles, ventricle III) enlargement of fronto-temporal fluid space, heterodense millimeter images on basal nuclei.

The study emphasizes the importance of imagistic examination to increase the accuracy of clinical diagnosis allowing early diagnosis of Alzheimer and vascular dementia, in order to recomand specific therapy from the early stages of cognitive disfunctions.
P02 - 361 White matter microstructural abnormalities in antisocial personality disorder: A pilot diffusion tensor imaging study
Authors: Sundram F. , Deeley Q. , Sarkar S. , Daly E. , Latham R. , Barker G.J. , Murphy D.G.M.
Published: May 2011

Introduction

Antisocial personality disorder (ASPD) and psychopathy involve significant interpersonal and behavioural impairments. However, little is known about white matter (WM) abnormalities in tracts linking grey matter regions. A previous diffusion tensor imaging (DT-MRI) tractography study in ASPD and psychopathy revealed abnormalities in the right uncinate fasciculus, indicating fronto-limbic disconnectivity.

Objectives

It is not clear whether WM abnormalities are restricted to only this tract or are more widespread. Therefore, we planned to use whole brain DT-MRI voxel-based analyses.

Aims

To clarify if WM abnormalities extend beyond the frontal lobe.

Methods

We used whole brain DT-MRI to compare WM fractional anisotropy (FA) of 15 adults with ASPD and healthy age, handedness and IQ-matched controls. Also, within ASPD subjects, we related differences in FA to severity of psychopathy measures.

Results

Significant WM FA reductions were found in ASPD subjects relative to controls. These were found bilaterally in the anterior corpus callosum. Right hemisphere FA reduction was found in the anterior corona radiata, uncinate fasciculus, inferior fronto-occipital fasciculus and internal capsule. Left hemisphere, FA deficits encompassed the inferior longitudinal fasciculus, inferior fronto-occipital fasciculus and internal capsule. There was a significant negative correlation between WM FA in the right uncinate fasciculus and corpus callosum and measures of psychopathy.

Conclusions

We report FA reduction in the uncinate fasciculus and anterior corpus callosum which may be associated with frontal and inter-hemispheric disconnectivity in ASPD, in addition to abnormalities in other tracts which directly or indirectly connect to prefrontal regions.
Frontotemporal resting state hypoperfusion in patients with major depression - a study using arterial spin labeling
Authors: Walther S. , Höfle O. , Federspiel A. , Horn H. , Strik W. , Müller T.J.
Published: May 2011

Introduction

Major depression is associated with altered neural function in frontal and limbic areas.

Objectives

The findings have been inconsistent, especially those derived from cerebral blood flow (CBF) measures.

Aims

To identify differences in regional CBF between patients and controls using arterial spin labeling (ASL) at rest.

Methods

20 patients with major depression and 20 matched healthy controls were scanned in the morning with a pCASL-sequence at a 3 T Siemens scanner. Mean Hamilton Depression Score (21 item version) was 26.2 ± 5.7 for patients, mean Beck Depression Inventory scores were 28.9 ± 8.9. Mean age did not differ between groups (39.6 vs. 44.4 years). Whole brain voxelwise T-Tests were correct for multiple comparisons using a False Discovery Rate of q < 0.05.

Results

Mean global resting CBF was not different between groups (66.1 vs. 63.0 ml/100 mg/min, T = 0.95, p = 0.35). FDR correction at q < 0.05 led to a T-value threshold of 3.71 (p < 0.001) for group comparison. Hypoperfusion in patients was detected in left middle temporal gyrus, left middle frontal gyrus, right precentral gyrus. Hyperperfusion in patients was seen in the right superior temporal gyrus.

Conclusions

ASL revealed frontotemporal hypoperfusion in patients with major depression. This is in line with previous work and the current concept of depression. However, we were unable to replicate hyperperfusion in limibic areas.
Lack of mental flexibility as endophenotype in autism spectrum disorder and obsessive comulsive disorder families
Authors: Goussé V. , Hagi A. , Stilgenbauer J.-L. , Delorme R.
Published: May 2011

Introduction

Results from clinical and molecular genetic studies suggest that autism spectrum disorder (ASD) and obsessive compulsive disorder (OCD) could have a shared pattern of heritability. Among a large number of clinical variables evaluated, obsessive compulsive/repetitive behaviors have been found to be highly correlated among autism probands and their relatives. Empirical evidence from neuropsychological studies suggest that an appropriate model for repetitive behaviours is a deficit of executive functions specifically flexibility. Given the lack of flexibility observed in ASD and OCD probands, we hypothesised that it could represent a shared endophenotype in both families.

Methods

Seven cognitive tests belonging to executive functions, central coherence and theory of mind were proposed to 58 unaffected first-degree relatives of probands with ASD and 61 unaffected first-degree relatives of OCD patients and compared with 34 healthy controls. A principal component analysis (PCA) was performed.

Results

ASD relatives - specifically mothers - performed significantly worse on all the tests than OCD relatives and controls. Moreover, inside the OCD group, female individuals performed significantly worse than males. Finally, the PCA indicate that the cognitive profiles of the ASD relatives and the OCD relatives were similar but distinct from controls.

Conclusion

Lack of cognitive flexibility is observed in ASD and OCD families and might constitute a shared intermediate cognitive phenotype. Our study constitutes an effort to clarify the relationship between ASD and OCD having implications for our nosological understanding of both disorders.
Agomelatine in the treatment of obsesive-compulsive-disorder: Potential for clinical effectiveness: An 4-week, multicenter, randomized, placebo-controlled trial
Authors: Marqués Cabezas P. , Cabus Piñol G. , Coullaut-Valera García J. , Dominguez Martín C. , Villegas Martinez J.L.
Published: May 2011

Objective

To evaluate the efficacy, safety, and tolerability of fixed-dose agomelatine 25 and 50 mg/d in the treatment of outpatients with obsesive-compulsive disorder (OCD) compared to placebo.

Method

In this 8-week, multicenter, double-blind, parallel-group trial, patients with DSM-IV-defined OCD were randomly assigned (1:1:1) to receive a once-daily dose of agomelatine 25 mg, agomelatine 50 mg, or placebo. The primary efficacy measure was the change from baseline to week 8 in the clinician-rated 17-item Hamilton Depression Rating Scale (HDRS(17)); other efficacy measures were The Yale-Brown Obsessive Compulsive Scale (Y-BOCS) and the Clinical Global Impression scale. The study was conducted between December 2009 and January 2010.

Results

Agomelatine 25 mg/d was more efficacious based on the HDRS(17) total score (P = .01) compared to placebo throughout the treatment period, whereas for agomelatine 50 mg/d, statistically significant reduction in HDRS(17) total score could be observed from weeks 2 to 6 but not at week 8 (P = .144). A higher proportion of patients receiving agomelatine 25 mg/d showed clinical response (P = .013), clinical remission (P = .07), and improvement according to the Clinical Global Impressions-Improvement scale (P = .065) compared to those receiving placebo. No statistically significant difference between patients receiving agomelatine 50 mg/d compared to placebo on clinical response. Both agomelatine doses were safe and well tolerated, although clinically notable aminotransferase elevations were observed transiently in the agomelatine 50 mg/d group.

Conclusions

Agomelatine 50 mg/d provided evidence for its antidepressant efficacy until week 6 and was also safe and well tolerated.
Objective and subjective improvement after a new form of cognitive and behavioral therapy for obsessive compulsive disorder patients
Authors: Morgieve M. , Clair A.-H. , Saulton A. , N’Diaye K. , Pelissolo A. , Mallet L.
Published: May 2011

Introduction

Cognitive and Behavioral Therapy (CBT) is one of the two treatments recognized as most efficient to improve Obsessive Compulsive Disorder (OCD) symptoms.

Objectives

The major aim of this study is to facilitate CBT for OCD checkers. To this purpose, we developed a new psycho-pedagogic tool to be used during CBT sessions and assessed its objective efficacy and the patients’ perception of their therapy.

Methodology

Experimental CBT sessions included a “checking task”, composed of a “matching task” followed by a “checking phase” during which subjects were given the opportunity to check or to confirm their prior answer. This tool was appended to a classical CBT (as described in the literature).

30 OCD patients with checking compulsions each followed 15 individual CBT sessions with a psychologist. They were randomized in two groups: a “reference CBT” (CBT classically described in literature) and an “experimental CBT” (reference CBT + checking task) group. Symptom severity was assessed by the Y-BOCS and CGI at three main stages of the therapies: before, at half-therapy, at the end of therapy and 6 months later. Assessment was performed blindly by an expert psychologist to avoid any bias, and the patients’ impressions were collected at the same time.

Results

At the end of therapies, symptom severity decreased significantly (24.08 to 12.5) and participants had a better global functioning, especially in their social and familial lives.

Conclusions

Both CBT offer an important clinical improvement of OCD symptoms. Patients and psychologists expressed their satisfaction at having participated to the study.
Pregabalin augmentation in treatment-resistant obsessive-compulsive disorder
Authors: Oulis P. , Mourikis I. , Konstantakopoulos G.
Published: May 2011

Objectives

The therapeutic limitations of mainstay psychopharmacological treatments of obsessive-compulsive disorder (OCD) warrant the clinical testing of further add-on agents in order to improve patients’ clinical outcomes. The novel antiepileptic drug pregabalin (PGB) could be such an adjunctive agent in view of its attested efficacy in other anxiety disorders, especially generalized anxiety disorder.

Methods

We report on an open-label add-on trial of the novel antiepileptic pregabalin (PGB) in 10 (4 male and 6 female) OCD-patients resistant or only partial responders to an - at least 6-month long - combination of serotonin reuptake inhibitors with atypical antipsychotic.

Patients’ regimens were stable for at least the last six months before their enrolment in the study and were maintained unchanged throughout the trial. Patients’ assessment took place weekly during the trial. PGB's dosage titration was conditional upon both degree of clinical response and side-effects during past week. Patients’ pre- and post- PGB ratings on the Y-BOCS were compared by means of paired samples t-test.

Results

Adjunctive PGB at 225–675 mg/d was well-tolerated and led within 4–12 weeks to patients’ substantial improvement in their OCD symptoms, as reflected in their scores on the Y-BOCS (t = 9.83, p < 0.001). Equally robust was Cohen's d measure of effect-size (d = 2,99).

Conclusions

Despite the several limitations of the study, its results suggest that adjunctive PGB might be a safe and efficacious new agent in the treatment of drug-resistant OCD.
Tourette syndrome (TS) mimicking tardive dystonia
Authors: Paparrigopoulos T. , Persefonis G. , Tzavellas E. , Karaiskos D. , Liappas I.
Published: May 2011

Tourette syndrome (TS) is a neurodevelopmental disorder characterized by early onset motor and vocal tics. Tics are brief, stereotypical, repetitive and non-rhythmic movements or phonations that typically follow a waxing and waning pattern of severity, intensity and frequency; they can be distinguished from other hyperkinetic movement disorders on the basis of their temporary voluntary suppression. TS should be differentiated from various movement disorders. We report a case of a young man who presented with torticollis, which was eventually attributed to TS.

Case report

A 21-year-old man was admitted to our clinic due to treatment resistant cervical dystonia attributed to neuroleptics. During the last five years he had been treated for depressed mood, somatic delusions and aggressive behaviour. He had been given SSRIs and atypical antipsychotics at low doses; six months prior to his admission he had been switched to risperidone.

Present clinical examination revealed torticollis, motor stereotypies, vocal tics (sniffing, repetition of words), mental koprolalia and obsessive-compulsive symptoms. He complained of repetitive intrusive thoughts of harming his sister and thoughts of a ‘delusional’ nature regarding somatic complaints were also present. The patient was diagnosed as TS and was successfully treated accordingly.

TS can mimic many hyperkinetic states. Whether patients with TS are at higher risk of developing dystonia, or tics and dystonia share a common pathophysiological mechanism (dopamine-inhibiting processes are probably involved in both conditions) is still debatable.
Quantitative assessment of psychosocial distress of individuals with poly-trauma and with chronic pain, according to the ama guides sixth edition
Authors: Miciano A.
Published: May 2011

The objective was to examine the psychosocial distress (PD) status of Poly-Trauma individuals > two years (PTI) and with chronic pain using the Pain Disability Questionnaire (PDQ), a formal assessment for rating pain-related impairments (PRI) by the AMA Guides to Evaluation of Permanent Impairment, Sixth Edition.

Results from the Self-Administered Comorbidity Questionnaire (SCQ) were used to identify 60 out of 100 outpatient PTI with chronic pain. The PDQ and Physical Performance Tests (PPT): 6-Minute Walk Test, Berg Balance Scale, & Dynamic Gait Index scores were also recorded.

The PDQ was sub-categorized to: 19% mild PRI, 38% moderate, 38% severe and 5% extreme PRI and was also further divided into Functional Status (FS) versus Psychosocial Distress (PD) Status. The PD scores ranged from 8 to 55/60 points with an average 37/60 points. Comparing the effect of the PD over FS revealed that 25% of the total PDQ score (range 5–37%) was due to PD of the PTI.

The PRI rating demonstrated a close trend relationship between total PDQ and low PPT scores. The majority of PTI scored in the moderate & severe PRI. The FS/PD ratio in relationship to total PDQ remained consistent when subjects were separated based on PRI, and there was little variation in PPT. These findings suggest that the pain disability of PTI, regardless of severity, results in significant loss in health-related quality of life attributed to the PD status. Further research on FS & PD sub-scores and their correlations to decreased PPT scores would be beneficial.
Comparison of coping strategies for pain introversion and extraversion among addicted people in the state of withdrawal
Authors: Shefiei Amiri M. , Ahmadi Gatab T. , Nazian Najafi M.
Published: May 2011

Introduction

Pain is a personal experience influenced by many factors such as cultural experiences and impressions, the educational and family situations and psychological problems are numerous and complex perceptual field above factors than the concept of individual forms of pain. Process

Objective

This study aimed to compare strategies to deal with pain and addiction introspective extraversion is being left.

Methods

This study is a comparison of Ali in the analysis of statistical methods MANOVA findings will be made and the strategies for coping with pain (the revocation, reinterpretation of pain, talk to your ignore pain, tragedy and pray for Entrepreneurship - Hope) and a behavioral strategy (increasing behavioral activity) classified in two groups of addicts introspective (15) and extraversion (15 cases) were compared for leaving.

Results

Total average component methods to deal with the pain of eccentric left at addicts are left are more introverted. This suggests that addicts are left eccentric methods to deal with pain more than the poor addicts are left introverted enjoyed.

Discussion

Deal with pain component) the revocation, reinterpretation of pain, talk to your ignore pain, disaster, playing, praying and hope (the personality types of introverts and extroverts have enjoyed significant difference. So therefore rejected and be accepted with maximum reliability.