bluuebunny/crossref_metadata_2025 huggingface dataset:
Sudden death in psychiatric patients
Authors: Manu P. , Kane J. , Correll C.
Published: May 2011

Introduction

Studies using death certificates have indicated an excess of sudden cardiac deaths among users of antipsychotic drugs compared to the general population, but may have underestimated the presence of other known causes of sudden and unexpected death.

Objectives

To assess the cause and risk factors for sudden death discovered by contemporaneous investigation of all deaths occurring over a 26-year period (1984–2009) in adult patients registered for care in one large psychiatric hospital in New York.

Methods

Circumstances of death, psychiatric diagnoses, psychotropic drugs and past medical history were extracted from the root cause analyses of sudden unexpected deaths. After the exclusion of suicides, homicides and drug overdoses, explained and unexplained cases were compared regarding clinical variables and the utilization of antipsychotics.

Results

One hundred cases of sudden death were identified among of 119, 500 patient-years. The death remained unexplained in 52 cases. The incidence of unexplained sudden death was 125/100,000 (95% CI 88.9–175.1/100,000) patient-years in 2005–2009, 53/100,000 (95% CI 31.7–88.5/100,000) patient-years in 1999–2004 and 7/100,000 (95% CI 3.7–19.4/100,000) patient-years in 1984–1998. Explained and unexplained cases were similar regarding psychiatric diagnoses and treatment with any psychotropic class, including first- and second-generation antipsychotics. Dyslipidemia (p = 0.012), diabetes (p = 0.055) and co-morbid dyslipidemia and diabetes (p = 0.008) were more common in the unexplained than in the explained cases.

Conclusions

In a consecutive cohort of psychiatric patients, the unexplained sudden deaths were associated with known risk factors for coronary artery disease, but not with higher utilization of first- or second-generation antipsychotics.
Study of cardiovascular risk factors in mental disorders
Authors: Ruiz Feliu M.A. , Campos Mangas M.C.
Published: May 2011

Introduction

Psychiatric patients have high rates of cardiovascular disease compared with the general population, but little is known about the prevalence of metabolic syndrome that predisposes them to this condition.

Objectives

Assess the presence of metabolic syndrome in psychiatric patients on an outpatient basis and compare their rates with those for the general population.

Methods

A sample of 80 patients followed for six months in a mental health center of San Sebastian were interviewed and assessed, diagnose metabolic syndrome according to the criteria of the ATP-III guide. The results were compared with those of a representative sample of the general population of that health care settings.

Results

The mean age of patients was 52 years, with 57% of women. The prevalence of current smoking was 36.4% (general population = 32%) of obesity of 41.4% (PG = 16.6%), hypertension 30.8% (PG = 15.3%), diabetes mellitus 12.4% (PG = 6.8%), and dyslipidemia of 30.4% (PG = 11.1%). 41.4% of patients in the study met diagnostic criteria for metabolic syndrome, while this figure was 24% in the general population and took place at a later age. 60% of patients with metabolic abnormality was not receiving adequate treatment.

Conclusions

The prevalence of cardiovascular risk factors in psychiatric outpatients is very high and requires the application of treatment protocols to improve their physical health.
Risperidone prescription in autism spectrum disorder in Tehran, Iran
Authors: Memari A.H. , Kordi R.
Published: May 2011

Introduction

Risperidone was one of the most popular psychotropic medications approved by FDA for Autism. It may be used to treat specific disruptive behaviors (i.e. irritability) usually associated with autism.

Objective

Due to recent findings, about one-third of children with ASD take an antipsychotic medication and Risperidone may be responsible for the major part, but its place in autism treatment especially out of US has not been clear due to uncertainty about costs and benefits of prescription. We aimed to investigate the risperidone prescription in children with ASD in Iran.

Methods

A representative sample of Students of autism specific schools aged 6-15 surveyed through the parents to provide drug list, demographic and developmental information of children; parents were also asked to indicate whether they were currently using or had just used in the past but not currently or never used the risperidone.

Results

Risperidone has been prescribed for 85.2% (98/115) children with ASD while 50.4% were currently using. Sex difference analysis showed that prescription was done for 87% of boys versus 73.9% of girls (p = 0.06). There was a significant lower socioeconomic state in families with current using of risperidone (p < 0.001). Prescription was not associated with comorbidities in children.

Conclusions

We found a very high rate of risperidone use in children with autism. It may be due to treatment approaches rely heavily on the most available psychotropic agent (i.e. risperidone). Further research is warranted in Cost-Benefit Analysis of risperidone use in Autism.
Family psychopathology among parents of children with generalized anxiety disorder (GAD)
Authors: Aleyasin S.A.
Published: May 2011

The present study aimed to investigate the role of family psychopathology in parents of children with Generalized Anxiety Disorder (GAD) in Iran. A cross-sectional two-group comparison design was employed to administer two questionnaires:

(1) Socio Demographic Questionnaire (SDQ) to identify the socio-demographic variables:

(2) Family Assessment Device (FAD) with 60 items and seven subscales to assess the family psychopathology.

The total sample consisted of 401 parents: 209 parents with normal children and 192 parents with GAD children. The primary objective of the present study was to identify family psychopathology in parents of children with GAD. The research hypotheses discussed the significant differences between the two groups regarding their family psychopathology and associated variables. Later, the data collected were subjected to statistical techniques such as General Linear Model-Multivariate Analysis of Variance. The results revealed significant differences in family psychopathology and some associated variables between the groups. In addition, the differences between the groups were shown to be influenced by some socio-demographic characteristics of respondents. These findings, while being consistent with results obtained by other research, further support the hypothesis that GAD could be viewed as a familial disorder.
Effect of starch dietary regimen on treatment of premenstrual syndrome
Authors: Shahhosseini Z. , Abedian K. , Danesh M.
Published: May 2011

Introduction

Premenstrual symptoms (PMS) are characterized by a set of behavioral, somatic, and affective symptoms of varying severity that occur during the 7–10 days before the onset of menstruation and subside after the beginning of the menstrual flow. Although the etiology of PMS is largely unknown, current evidence suggests that they may arise from a decrease in brain serotonin neurotransmission. Starch dietary regimen may increase brain serotonin.

Materials and methods

In this quasi-experimental study, we investigated associations between Starch dietary regimen and PMS in 14–19 years old high school students from October to January 2007 in Sari, the city in the North of Iran. 478 girls were selected for this trial. Participants were advised to consume a dietary regimen full of starch every 3 hours a day unless they were asleep. Symptoms were prospectively documented over 3 menstrual cycles with a daily rating scale that had 20 symptoms of PMS After 3 months data analysis was done.

Results

PMS score was 12.85 ± 8.01 prior to dietary regimen, and at the end of first, second and third month following dietary regimen were 11.03 ± 7.59, 12.47 ± 7.79 and 11.13 ± 6.71 respectively (p = 0000). Mood score was 15.8 ± 10.02 prior to dietary regimen, and at the end of first, second and third following dietary regimen were 12.61 ± 9.34, 13.06 ± 8.13 and 11.46 ± 7.09 respectively (p = 0000).

Conclusion

Results of this study revealed that carbohydrate-rich diet can improve PMS symptoms. Therefore, we recommended codified teaching programs via health care staffs to students about the beneficial effects of diet on relieving PMS.
Perceived quality of life and ageism among elderly people living in sheltered housing and in the community
Authors: Bodner E. , Cohen-Fridel S. , Yaretzky A.
Published: May 2011

Introduction

Although there are studies on ageist attitudes and perceptions of quality of life (QoL) among elderly people, no publications exist that compare ageist attitudes and QoL perceptions among elderly people who live in private sector sheltered housing (PRSSH) and in the community.

Objectives

To map the differences and understand the relations between QoL and negative social perceptions of one’s own age group among older adults, living in PRSSH and in the community.

Aims

(1) To examine if there are differences in ageist attitudes and perceptions of quality of life (QoL), and

(2) to understand the role of QoL in explaining ageist attitudes among these two groups of elderly people.

Methods

The sample included 126 participants, aged 64–94, who live in PRSSH or in the community. The participants completed Fraboni et al. scale of ageism, a QoL inventory (SF-36 inventory), which provides scores on measures such as physical functioning, mental health and social functioning, and answered demographic questions.

Results

Multivariate analyses of covariance (MANCOVA) partially supported our hypotheses that elderly people who live in PRSSH will demonstrate more ageist attitudes towards people of their own age, and report a lower QoL than elderly people who live in the community.

Gender also had a distinctive effect on ageism and QoL among individuals in PRSSH. These findings were supported by regression analyses.

Conclusions

Although PRSSH may offer luxurious living conditions, the current study shows that living in an age segregated environment, may trigger negative self-perceptions of old age and decrease QoL.
Survey of special needs in elderly people: a qualitative research
Authors: Farhoudian A. , Soleimaninia L. , Jafari F. , Savari M.E. , Saberi Zafarghandi M.B. , Sadeghi M.
Published: May 2011

The only way for going to rehabilitation and social participation expansion in elderly people is the identification of their special needs in a scientific and accurate way. This study conducted in order to identify the special needs in elderly people.

This article is a part of a qualitative research with grounded theory method. 15 elderly of Tehran city that were selected through a purposeful sampling participated in study. The main method for collecting data was semi-structured interview that continued until theoretical saturation of information. Data was analyzed with Strauss & Corbin coding manner or continued comparison and the assessor’s viewpoints method is used for validity promotion of data. Totally, most important domains of special needs in aging group were: family and relatives, education, movement and transportation, building and places (houses and public places), social participation and occupation, amusement, health and treatment services, and people’s attitude toward their problems.

Those elderly people's special needs that are disabling are often caused by their characteristics and obstacles which are created by society. Therefore, resolving these man-made barriers such as non efficient systems and services, discriminatory policies, prejudice attitudes, etc will help them in the field of rehabilitation and individual independence enhancement.
“SVAROSKI”: A computerised method of assessment of rehabilitation outcomes
Authors: Gandolfi A. , Arnone F. , Chierici M.L. , De Bernardis E. , De Bernardis M. , Ferrari S. , Mori A. , Pingani L. , Turrini G. , Rigatelli M.
Published: May 2011

Introduction

The use of standardized tools for assessment and monitoring of a rehabilitation program is strongly recommended, though not so often accomplished in clinical practice.

Aims

To describe the development and feasibility of a computerised method of assessment of rehabilitation activities based on psychometrics.

Methods

The software “SVAROSKI” was implemented by means of a relational ER (Entity-Relationship) model with a user interface managed by MS-Access. The rehabilitation activities were: Physical therapy; Locomotion, Occupational Therapy and Reality-Orientation Therapy. Patients were administered at the beginning and at the end of admission the following tests: MMSE, MODA, Barthel Index, Tinetti.

The software enables processing of test data with those obtained from rating scales at each session.

Results

For each patient, two graphical reports are made available:

Punctual performance of each item divided by subject areas;

Overall pace of the three scales assessing rehabilitation (physical therapy was maintained for an evaluation board, partly qualitative, for the sake of the physiotherapist of the structure).

The software allows:

1) the rapid storage of the scores obtained from patients during the course of rehabilitation activities,

2) the real-time consultation of the development of therapeutic and rehabilitation,

3) the comparison of the iteration of several rehabilitation interventions on the patient.

Conclusions

SVAROSKY is a useful tool for analysis and monitoring of developments in the rehabilitation of the patient as a valid tool for the development of a synthesis report of the rehabilitation process.
Differences in facial expression recognition between patients suffering from Parkinson's disease and healthy subjects
Authors: Laskowska I. , Wiłkość M.
Published: May 2011

Introduction

Patients with Parkinson's disease (PD) may show impairment in their ability to recognize facial expressions. It has been speculated that this deficit is linked to hypodopaminergic state which may be connected with an increase in amygdalic activity.

Objectives

The objective of the study was to assess ability in the perception and recognition of facial expressions among thirty-eight PD subjects and thirty-eight healthy control subjects matched by age, sex, and education level.

Aims

To investigate differences in perception of positive, negative and neutral facial expressions, such as sadness, happiness, anger, disgust, fear, astonishment, distrust, uncertainty, curiosity, satisfaction, tenderness, disbelief, embarrassment, disrespect.

Methods

The Polish Emotional Intelligence Scale - Faces (SIET) was used.

Results

The results obtained indicate more deficits in recognition of sadness, anger, distrust, embarrassment and tenderness in PD subjects, while happiness was better recognized by PD subjects than by healthy control subjects. Overall, negative expressions were more poorly recognized by PD patients while there were no differences in recognition of positive and neutral emotions in both groups. In addition, astonishment, embarrassment and distrust were more poorly recognized in females with PD when compared with female control subjects. Whereas in male PD subjects, the recognition of disbelief and negative expressions was more impaired when compared with male subjects from the control group.

Conclusions

The results suggest that a hypodopaminergic state affects ability to recognize facial expressions, particularly those expressing negative emotions.
Remission of poststroke cognitive impairment no dementia: Clinical and imaging correlates
Authors: Chen Y.K. , Lee E. , Ungvari G.S. , Lu J.Y. , Chu W.C.W. , Mok V.C.T. , Wong K.S. , Tang W.K.
Published: May 2011

Introduction

Cerebral microbleeds (CMBs) may contribute to cognitive deficits in stroke. Cognitive impairment that does not meet the criteria for dementia (cognitive impairment no dementia [CIND]) is common in stroke, and patients with such impairment can revert to normal cognition.

Objective

To investigate the association of CMBs and remission of poststroke CIND.

Aim

To understand the evolution of poststroke cognitive impairment no dementia (CIND) is bi-directional.

Methods

143 patients with CIND at three months after stroke were recruited and followed up for one year. Remission of CIND was defined as a conversion of cognitive status from CIND to cognitively intact at follow-up. MRI variables in terms of infarction, cerebral microbleeds (CMBs), and white matter hyperintensities (WMHs) and hippocampal volume were analyzed. Logistic regression was performed to find the predictors of the remission of poststroke CIND.

Results

30 (21.0%) out of the 143 patients converted to cognitive intact at follow-up. In univariate comparisons, subjects with remission of CIND had younger age (67.1 ± 9.5 vs.73.6 ± 7.6 years, p < 0.001) and higher education years (5.1 ± 4.0 vs.3.6 ± 4.0, p = 0.039). They also had lower WMHs volume (8.2 ± 8.2 vs. 18.6 ± 19.7 cm3, p < 0.001), lower frequency of CMBs (10.0% vs. 31.0%, p = 0.021) and lower volume of the lateral ventricle (33.3 ± 16.5 vs.42.6 ± 19.4 cm3, p = 0.017). In logistic regression, age (odds ratio [OR] = 0.913, 95%C.I. = 0.866–0.962, p = 0.001) and absence of CMBs (OR = 4.292, 95%C.I. = 1.174–15.625, p = 0.028) were significant predictors of remission of CIND.

Conclusions

Younger age and absence of CMBs predict the remission of poststroke CIND.
Atrophy of left dorsolateral prefrontal cortex is associated with poor performance in verbal fluency in elderly poststroke women
Authors: Chen Y.K. , Lee E. , Ungvari G.S. , Lu J.Y. , Shi L. , Wang D.F. , Chu W.C.W. , Mok V.C.T. , Wong K.S. , Tang W.K.
Published: May 2011

Introduction

Prefrontal cortex and sex difference are involved in verbal fluency network described in normal participants. Stroke patients often have prefrontal cortex atrophy.

Objectives

To investigate whether atrophy in subdivisions of prefrontal cortex and sex difference contribute to verbal fluency in non-aphasic stroke patients.

Aim

To understand the relationship between the atrophy of left dorsolateral prefrontal cortex and verbal performance in elderly poststroke women.

Methods

30 elderly (age> = 60 years old) women with non-aphasic ischemic stroke and 30 age-controlled stroke men recruited. Automatic segmentation methods were used to assess the volume of both sides of the whole prefrontal cortex, anterior cingulate cortex, orbital frontal cortex and dorsalateral prefrontal cortex (DLPFC), as well as white matter lesions (WMLs) volume. Mini-mental state examination (MMSE) and semantic verbal fluency test (VFT, category: foods and animals) were administered at 3 and 15 months after the index stroke.

Results

The mean (s.d) age was 73.3 ± 7.2 in women and 72.1 ± 6.9 in men. Men had higher education years, less diabetes and higher MMSE scores (p < 0.05). At 3 months after stroke, volume of the left DLPFC was significantly correlated with VFT score in women rather than men, even after controlled by age, education years, neurological deficit, diabetes, WMLs volume and infarct location (partial r = 0.477, p = 0.018). At 15 months, this correlation remained significant (partial r = 0.548, p = 0.006) in women.

Conclusion

Sex difference may be present in the neuropsychological mechanism of verbal fluency impairment in patients with cerebrovascular disease.
Anxiety and depression in elderly patients with type 2 diabetes
Authors: Masmoudi J. , Mnif L. , Damak R. , Charfi N. , Zouari H. , Zouari N. , Jaoua A.
Published: May 2011

Objective

The objective of this work was to study the prevalence of anxiety and depression in a population of elderly diabetics and their impact on the glycemic control and the disease evolution.

Methods

It was a prospective, descriptive and analytical study on 62 elderly patients with type 2 diabetes. A structured questionnaire was used to collect socio-demographic data to describe the participants and aspects of their diabetes. Anxiety and depression symptoms were assessed with the Hospital Anxiety and Depression Scale (HADS).

Results

The patients’ mean age was 66.82 years with a standard deviation of 4.8. The diabetes study population was predominantly female (74.2%). Average duration of diabetes was 12 years with a standard deviation of 8.11. Prevalence of anxiety and depression in diabetic elderly patients was respectively 40.3% and 22.6% with a female dominance. 67.7% of elderly diabetes had poor glycemic control. Comparing anxiety mean scores, patients with worse glycemic control had significantly higher scores (9 06 ± 3. 14 vs 6.55; p = 0. 017). We didn’t found a relationship between depression and glycemic control. In our population, the presence of complications were significantly associated with anxiety and depression.

Conclusion

Several studies have shown that the prevalence of anxiety and depression symptoms in elderly patients with diabetes is considerably higher than in general population samples. Depression represent a risk factor for morbidity specially in elderly subjects, which justify a detection of psychiatric symptoms in order to improve the quality of life and the evolution of the disease.
Depression and obstructive sleep apnea (OSAS) in the elderly: Study on a population of elderly patients recovered in acute setting
Authors: Santangelo A. , Albani S. , Atteritano M. , Cappello A. , Pavano S. , Testai M. , Tomarchio M. , Maugeri D.
Published: May 2011

Introduction

The obstructive sleep-apnea (OSAS) is a syndrome common in elderly, dangerous and frequently misunderstood by the superficiality of the evaluation of nonspecific symptoms of onset.

Objectives and aims

In this study we studied the prevalence of sleep-apnea (OSAS) in a sick elderly population admitted to a Acute Geriatrics, the correlation with cardiovascular disease and the effects on performaces psychometric

Methods

62 subjects were examined in Acute Cure of Geriatrics of University of Catania. All subjects, after a careful medical history, were administered MMSE to cognitive and affective aspect for GDS. Also consider the autonomy and self-reliance by Barthel-Index, IADL and ADL. All subjects also performed 24-hour Holter-ECG examination and examination for Holter blood pressure in 24 hours, made basic spirometric assessments and finally carried out the examination with polysomnography VitalNight-8.

Results

The results in this study have ample evidence on the prevalence of OSAS in the elderly population admitted to the ward for acute cases. Shall also be significant correlations with cognitive status and mood, both largely influenced negatively by the presence of OSAS. They seem much more depressed elderly patients with OSAS compared with the general population. Finally, the highly statistically significant correlation with the presence of OSAS arrhythmias, high pressure is not controlled by drug therapy, obesity and Chronic Bronchitis.

Conclusions

This study reports the evidence of higher correlation between OSAS and Depression in population studied. All these data make us conclude the obvious danger of this disease still so 'little studied in the elderly population.
Increased prevalence of depression in cohorts of elderly. A longitudinal epidemiological study: The hunt-study
Authors: Solhaug H.I. , Johansen E.B. , Romild U. , Stordal E.
Published: May 2011

Introduction

As the elderly population is growing world-wide, depression in the elderly is becoming an increasing health problem. Studies of depression shows varying results in development patterns with age (1, 2).

Aims

To study changes in prevalence and new cases of depression in elderly age cohorts.

Methods

The Nord-Trøndelag Health Survey (HUNT) is a general health survey conducted in Nord-Trøndelag County with a follow-up after 11 years. The participants aged 45 years or above at baseline were included. Depression was covered by the depression sub-scale of the Hospital Anxiety and Depression Scale (HADS-D; 3). Prevalence and incidence of depression was estimated in the different age cohorts.

Results

16517 participants were included and divided in age cohorts based on their age at baseline. A significant increase in depression was found in all age cohorts from 76 years at follow-up. The oldest age cohort (86–90 years at follow-up) had the greatest increase with a change from 11.3% to 20.9%. New cases of depression is increasing with age, with over 10% new cases in all age cohorts aged 81 years and above at follow-up.

Conclusions

We found increased prevalence of depression and a large number of new cases of depression in the oldest age cohorts.
Higher depression score in recurrent miscarriage patients is associated with the level of anti-double-stranded-DNA-antibody, soluble-gp130, soluble-leptin-receptor and hookah smoking
Authors: Bagheri K. , Ebadi P.
Published: May 2011

Introduction

Depression stands out as an important health issue that affects the entire family.

Objectives

to assess the prevalence and level of depression and its relationship with autoantibodies, individual, environmental, laboratory and lifestyle parameters in miscarriage-patients

Aims

to evaluate the causes or effects of depression in recurrent miscarriage-patients.

Methods

50 variables containing sociodemographics, health-related habits, depression, serum molecules and blood parameters were evaluated in recurrent miscarriage-patients and healthy women with natural childbirth.

Results

Although no significant differences for 4 sociodemographic and 18 health-related lifestyle parameters were found between patients and controls but depression score and its prevalence was higher in patients than controls. Depression scores were higher in miscarriage-patients (ranging 3–36, mean = 11.92 ± 1.37) than controls (ranging 0–8, mean = 3.05 ± 0.63) which 80.96% of them had no or mild, 2.38% mild-moderate, 4.76% moderate and 11.9% severe depression. There was also a significant association between anti-double-stranded-DNA-antibody (anti-dsDNA) or rheumatoid-factor (RF) level and depression in miscarriage-patients. Interestingly, depression score was inversely correlated with the level of soluble-leptin-receptor (sLeptinR) and soluble-glyeoprotein-130 (sgp130) after controlling for covariates in patients. Depression of miscarriage-patients was correlated with hookah consumption rate. Surprising that, the association between abortion histories and depression in miscarriage-patients become not significant after controlling for age.

Conclusions

Depression score and its prevalence are higher in miscarriage-patients than controls. The depression levels are correlated with certain autoantibodies such as anti-dsDNA or some habits like hookah smoking in miscarriage-patients. Inverse association between depression and some soluble molecules like sgp130 or sLeptinR in recurrent miscarriage-patients also remained to be elucidated.
Higher depression score is associated with the level of antinuclear-antibody, soluble-gp130, soluble-leptin-receptor, hookah and cigarette smoking in systemic lupus erythematosus
Authors: Bagheri K. , Ebadi P.
Published: May 2011

Introduction

Depression stands out as an important health issue. Systemic lupus erythematosus (SLE) is a prototypic autoimmune disorder with possible involvement of each body organ and system.

Objectives

to determine prevalence and level of depression and its relationship with autoantibody titers, individual, environmental, laboratory and lifestyle parameters in SLE-patients

Aims

to evaluate the causes or effects of depression in SLE-patients.

Methods

50 variables containing sociodemographics, health-related habits, depression, serum molecules and blood parameters were evaluated in SLE-patients and healthy controls.

Results

Although no significant differences for 4 sociodemographic and 18 health-related lifestyle parameters were found between patients and controls but depression score and its prevalence in SLE-patients was higher. SLE-patients had higher depression score than controls. 94.12% of SLE-patients had no or mild depression, while the rest had mild-moderate or moderate depression. Furthermore, more depressed SLE-patients had higher level of autoantibodies. Between lupus-related-parameters such as autoantibodies, complement level and other hematological parameters, only the correlation of antinuclear-antibody (ANA) titer and depression score remained significant after controlling for variables. Interestingly, depression score was inversely correlated with the level of soluble-leptin-receptor (sLeptinR) and soluble-glyeoprotein-130 (sgp130) after controlling for variables in SLE-patients. Depression of SLE-patients had a direct association with alcohol, cigarette and hookah consumption.

Conclusions

Depression score and its prevalence are higher in SLE-patients than controls. These depression levels are correlated with ANA or some habits like hookah smoking in patient group. Inverse association between depression and some soluble molecules like sgp130 or sLeptinR in SLE-patients also remained to be elucidated.
Psychosis and autoimmune disorders
Authors: Oliveira S.G. , Pereira S.M. , Mendes J.C.
Published: May 2011

Introduction

Psoriasis is a common, chronic, erythematous dermatosis with prevalence estimates ranging from 0, 3% to 2, 5%. This recurring disorder is associated with significant psychological distress, a decrease in health-related quality of life and psychiatric morbidity. The most common psychiatric comorbidities are mental retardation, personality disorder and affective disorders.

Objectives

The authors’ aim is to present a clinical vignette of a 27-year-old male suffering from psoriasis who was admitted to the psychiatric yard exhibiting psychotic symptoms. A literature's review about the association between psychosis and autoimmune disorders, particularly with psoriasis vulgaris, was also made.

Case report

The patient is a 27-year-old single male with normal IQ. He had no physical ilnesses during childhood and adolescence. There was no history of psychiatric or developmental disorders in the patient and his family. In early adulthood he was diagnosed with psoriasis vulgaris. The patient's father also suffered from the same skin disorder. At the age of 27 he began to hear voices commenting on his behaviour and he exhibited psychomotor agitation, delusions of persecution, and sexual disinhibition. Admission in psychiatric yard was necessary to treat psychotic symptoms.

Conclusions

The skin and the brain are embryologically related. Consequently, a relationship between psychological factors and skin diseases has long been hypothesized. Schizophrenia has been associated with nearly 50% higher lifetime prevalence of one or more autoimmune disorders but further studies are necessary to elucidate the possible association between psoriasis vulgaris and psychosis.
Significant decreases of circulating endothelial cells but no changes of endothelial progenitor cells or mesenchymal stem cells during antidepressant treatment
Authors: Kollmar R. , Herrmann M. , Stöckl T. , Weinzierl U. , Schwab S. , Kornhuber J. , Kalb R.
Published: May 2011

Objective

We examined leukocyte numbers, circulating endothelial progenitor cells (CD34+, CD133+), circulating mesenychmal stem cells (CD105+) and circulating endothelial cells (CD146+) at the beginning, after 4 weeks and at the end of an inpatient antidepressant treatment.

Methods

24 insufficiently pretreated inpatients with major depression were included. At admission, after four weeks and at demission blood samples were obtained, and cell numbers were counted by flow cytometric analysis (FACS). At each examination the severity of the depression was evaluated with the Beck Depression Inventory (BDI). We were especially interested in the changes of cell numbers during the antidepressant treatment. The data were statistically analyzed using SPSS 14.0.

Results

The mean BDI score fell from 34 ± 7 at the beginning to 26.5 ± 6.6 after four weeks and 13.5 ± 5.7 at demission. The longer the overall duration of the depressive illness, the higher the number of leukocytes at admission (P < 0.0001). The lower the depression score at demission, the lower the final number of leukocytes (P < 0.001). During the antidepressant treatment the BDI depression score improved significantly (P < 0.0001). The number of CD146+ cells showed a significant decrease (P < 0.006). We did not find any significant changes of circulating CD34+, CD105+, or CD133+ cells during the antidepressant treatment.

Conclusions

The leukocyte results suggest an activation of the immune system in major depression and a deactivation due to antidepressant treatment.
The impact of wildfires on mental health of residents in a rural area of Greece. A case control population based study
Authors: Adamis D. , Papanikolaou V. , Mellon R.C. , Prodromitis G.
Published: May 2011

Introduction

Psychopathological disturbances are common in the aftermaths of a disaster. The consequences of these disorders can be long lasting. In August of 2007 an intense and destructive wildfire broke out in the Peloponnesus peninsula in Greece.

Objectives

To investigate psychological and psychiatric morbidity in individuals who had experienced severe exposure to a wildfire disaster in a part of Greece and to indentify risk factors for the post disaster psychological problems.

Aims

To investigate a broader spectrum of mid-term psychological and psychiatric morbidity in victims, to evaluate the proportion of psychopathology that could be accredited to the disaster, to estimate the association of losses with different psychological symptoms, to indentify risk factors for psychopathology.

Methods

A Cross sectional case control study of adult population (18–65 years old). Data collected among others were demographic, Symptom Checklist 90-Revised for assessment of psychological difficulties, type and number of losses.

Results

Those damnified from the disaster scored significantly higher (p < 0.05) in the symptoms of somatisation, depression, anxiety, hostility, phobic anxiety, paranoia, and had significantly more symptoms (PST) and were more distressed by them (GSI) compared to controls. In addition risk factors for someone to be a psychiatric case were to be a victim from the fire, to have finished primary school, to be windowed and to have damages to his property.

Conclusions

Wildfires can cause considerable psychological symptoms in victims and there are reasons for public health policy makers to create services in order to help and improve the mental health of those affected.
Bringing “simple steps” -a multimedia package for autism specific behaviour therapy- to Europe
Authors: Röttgers H.R. , Brugger B. , Keenan M. , Gallagher S. , Dillenburger K. , Stromgren B. , Perez Gonzales L.A. , Martin N.
Published: May 2011

Individualised behavioural interventions are known to promote development, enhance skills and communication and reduce rigid and stereotypical patterns in children with autism spectrum disorder especially if they start in early pre-school age and are offered in high intensity. In many countries, however, these interventions are not available to families with autistic children. This may be due to lack of funding, lack of qualified staff and/or insufficient traditions of evidence-based procedures in institutions working with autistic children.

Facing this situation, the European Union Leonardo Transfer of Innovation Programm funded the adaptation and localisation of a highly successful Northern Irish multimedia tool for England and Scotland, Norway, Spain and Germany.

The multimedia package consists of a brochure with basic information on ASD, diagnostics and intervention. In addition, a DVD offers expert interviews, parents’ testimonials and an introduction to autism specific behavioural therapy, well established as Autism Applied Behaviour Analysis in the anglo-american countries. An accompanying CD-ROM contains additional background information and practical tools for therapy implementation.

It can be used by parents, kindergarten and school special needs staff and therapeutic institutions for education and for therapy planning and evaluation. In Germany, Spain, Norway and the UK it is offered free of charge under EU funding.
Hypokalemia-induced psychosis
Authors: Ali S.
Published: May 2011

Introduction

Hypokalemia can induced Psychotic symptoms even before the physiological manifestations appears. An association is established between hypokalemia and acute psychosis in this case.

Aim

To Identify the clinical, physiological and metabolic risk factors for all the patients presenting with psychiatric disturbances.

Objective

To do medical and base line laboratory investigations to all the patients presenting with acute psychiatric disturbances.

Method

A 74 years old gentleman assessed in emergency department following emergency refferal by a general practioner, for an acute psychotic decompensation and suicidal ideation. Patient had a histroy of psychotic episode 30 years ago with one week hospitalization and six month priscription of psychotropic medication. Patient had a relatively stable functioning without any further contact with the psychiatric services till the current episode. After psychiatric assessment patient was discharge home with a priscription of olanzapine 2.5 mg and citalopram 10 mg, for further assessment and investigations by psychiatry of old age.

Results

One week later patient presented to Emergency Department with shortness of breath and chest dyscomfort. Detailed medical and laboratory investigations revealed Hypokalemia with potassium level at 2.0 mmol/L.The patient showed a prompt improvement in psychosis following intravenous potassium replacement.

Conclusion

This case highlights the importance of thorough medical and laboratory evaluation when assessing a psychotic patient. A narrow focuss on psychosis and ignoring organic and metabolic factors can be potentially dangerous to a patient.
Are children of depressed mothers exposed to higher contextual, family and mother-based risks?
Authors: Barker E.D. , Copeland W. , Maughan B. , Uher R.
Published: May 2011

Objective

In general, depressed mothers experience greater environmental and family risks, and lead riskier lifestyles. Whether the exposure of these risks add to child maladjustment, beyond exposure to maternal depression, is an important unanswered question, and is examined in the present study.

Method

In a total of 9,000 mother-offspring pairs in the Avon Longitudinal Study of Parents and Children, we examined (i) if children of depressed mothers had higher risk exposures than children of non-depressed mothers (32 weeks gestation, child age 1.5 years); (ii) whether maternal depression increased risk for diagnoses of externalizing and internalizing disorders (child age 7.5 years); (iii) the decrease in these odds when we controlled for the risk exposures; and (iv) whether risk exposure increased the odds of a diagnosis, above the influence of maternal depression.

Results

Children of depressed mothers were exposed to higher levels of risks and maternal depression increased the risk for diagnoses of both externalizing and internalizing disorders. The decrease in these odds was between 25–50% when controlling for child risk exposures. At the same time, risk exposures to the child significantly increased the odds of both externalizing and internalizing diagnoses, above the influence of maternal depression.

Conclusions

Maladjustment in offspring of depressed mothers is influenced by risk exposures closely associated with maternal mental health, suggesting that these children are “doubly” hit by risk. It is suggested that the present results may aide in interpreting why treating depressed mothers shows certain levels of beneficial effects for children, but not complete remission.
Emotional intelligence in psychiatry: A review
Authors: Castro L.
Published: May 2011

Background

Emotional intelligence is a term coined by Salovey & Mayer and is defined by these authors as a form of social intelligence that involves the ability to perceive and identify emotions, to discriminate among them and to use the information to improve cognitive processes, and manage one's and others’emotions. There are also mixed models of emotional intelligence that imply a broader concept of intelligence, including mental abilities and personality characteristics.

Aim

To discuss the relevance of emotional intelligence in Psychiatry. To review recent studies of emotional intelligence in psychiatric disorders.

Methods

Review of the literature. MEDLINE and PubMed databases searches for peer-reviewed studies, published between 2000 and 2010, using combinations of the Medline Subject Heading terms emotional intelligence, trait emotional intelligence, ability emotional intelligence and psychiatry, mental disorders, schizophrenia, bipolar disorder, social phobia, eating disorders.

Results

There are few studies in the literature addressing this topic. Emotional intelligence is a complex concept, with different theories defending distinct conceptualizations. The studies reviewed showed lower levels of emotional intelligence across different psychiatric disorders.

Conclusions

The field of affective neuroscience is of major importance in Psychiatry and has added important clues to the understanding of psychopathology. Although emotional intelligence is a recent and understudied topic in Psychiatry it can help to understand mental disorders and bring new insights to the comprehension of psychopathology.
The german version of the conners adult ADHD rating scales (CAARS)
Authors: Christiansen H. , Kis B. , Hirsch O. , Philipsen A. , Hebebrand J. , Schimmelmann B.G.
Published: May 2011

Introduction

Instruments for diagnosing Attention-Deficit/Hyperactivity Disorder (ADHD) in childhood are well validated and reliable, but psychometric assessment of ADHD in adults remains problematic. To date the Conners Adult ADHD Rating Scales (CAARS) are frequently used in the assessment of ADHD.

Objectives

The CAARS were translated into German and a series of studies planned to establish psychometric properties of the CAARS-self and -observer rating scales.

Aims

To evaluate the German version of the CAARS.

Methods

We recruited 847 healthy German subjects and 466 adult ADHD patients to fill out the CAARS-self report and questions on socio-demographic variables. Additionally, 896 CAARS-observer reports were filled out by significant others and clinical experts. Factor analyses were conducted to obtain factor structure and to replicate the structure of the original American-model. Comparisons between patients and controls, and analyses on influences of gender, age, and education level were calculated. Additional analyses established psychometric properties.

Results

Confirmative factor analysis based on the original American-model showed a high model-fit for both the German healthy control and the adult ADHD patient sample. Analyses of normative data showed significant influences of age, gender, and education level on the emerging subscales for the control sample only. Differences on all subscales were highly significant between patients and controls. Test-, test-retest-reliability was very high, and criterion validity could be established with DSM-IV based clinical interviews. Sensitivity and specificity ratings are overall very satisfying.

Conclusion

The German version of the CAARS is a cross-culturally valid instrument for the assessment of adult ADHD.
Multiple sclerosis: psychological and psychopathological study
Authors: Curral R. , Silveira C. , Norton A. , Domingues I. , Silva S. , Maia D.
Published: May 2011

Multiple Sclerosis (MS) is the most common demyelinating disease of the central nervous system and one that presents more neuropsychiatric manifestations.

The authors of this paper proposes to characterize psychological and psychopathologically a group of patients sent from Neurology to Psychiatry at St. João Hospital - Porto.

The initial group consisted of 48 patients (35 women and 13 men). Data collection was done through a semi-formant interview to obtain socio-demographic and clinical data. The psychological and psychopathological evaluation was made with the following tools: MMSE (Mini Mental State Examination), Raven, MOS SF-36 (Medical Outcomes Study 36-Item Short Form Health Survey), SCL-90 (Hopkins Symptoms Distress Checklist 90), HADS (Hospital Anxiety and Depression Scale), scale and EDSS (Expanded Disability Status Scale).

On this sample the median duration of disease was 11 years and the value of EDSS has an average of 2.49. The sample does not show significant levels of psychopathology. However the results suggest that the worse is the overall severity of MS (EDSS) and the greater the duration of illness, the worst seems to be general physical and emotional functioning. In this study, no associations were found between variables of MS and psychopathological findings. However cognitive dysfunction appears to worsen with the greatest severity of MS, as in other works.
Effects of childhood traumatic events in later life hostility
Authors: Dragkioti E. , Damigos D. , Mavreas V. , Kotrotsiou E. , Gouva M.
Published: May 2011

Introduction

Interpersonal childhood traumas have been linked empirically with adults’ reports of a wide range of symptoms.

Objective

This study tested the association between childhood trauma and adult hostility.

Aim

The aim was to investigate the impact of childhood trauma on hostility and aggression among individuals who had been exposed to childhood traumatic life events.

Method

595 community individuals participated to the present study (164 men - 431 women, mean age 34, SD = 12, ranged 18–75). Subjects were classified into two groups — trauma and no-trauma — based on their personal statements of experienced negative life events (300 and 295 individuals respectively). In all individuals, the Hostility and Direction of Hostility Questionnaire (HDHQ) and the Aggression subscale of The Symptom Checklist-90-R (SCL-90-R) were administered.

Results

Higher levels of hostile and aggressive attitude were observed among participants who had reported exposition to a traumatic event during childhood. In specific, the trauma group reported marginally higher levels of aggressive behavior (p = .041) as measured by aggression SCL-90-R. Significantly differences between groups were observed on paranoid hostility (p = .006), self criticism (p = .011), Guilt (p = .011), intropunitiveness (p = .007) and on total score of hostility (p = .040). Finally, logistic regression revealed that, participants who had experienced childhood trauma had a higher risk of overall hostility (OR = 0.92, 95% CI = .89–.99).

Conclusion

High levels of hostility may reflect difficulties in interpersonal relationships. Our findings illuminate the effect of early traumatic experiences in developing these hostile and aggressive attitudes in adulthood.
Parkinson's disease and predictors of impulse control disorders in MMPI-2
Authors: Farnikova K. , Obereigneru R. , Prasko J. , Kanovsky P.
Published: May 2011

This was a case control study involving 46 patients suffering from Parkinson disease (PD); 13 with impulse control disorder (ICD) and 33 without ICD; and 56 controls. The personality traits in these groups were analyzed using the Minnesota Multiphasic Personality Inventory-2 (MMPI-2). 46 patients with PD and 56 control group subjects were included into study. ICD were identified in 13 patients from PD group. There were higher scores than pathological threshold (65) in four domains of MMPI-2 Clinical scales: D (Depression), Pt (Psychastenia), Sc (Schizophrenia) and SI (Social introversion) in PD patients with ICD; but there were not statistical difference in any of these scales in comparison with the group of PD patients without ICD. In the case of MMPI-2 Subscales and Content scales there were higher scores than pathological threshold in eight domains of MMPI-2: SOD (Social Discomfort), PD4 (Psychopatic deviate - social alienation), PA1 (Paranoia - persecutory ideas), SC1 (Schizophrenia), PA_O (Paranoia - subtle), MA_O (Hypomania - obvious), SI1 (Syness/Self-Consciousness), SI3 (Alienation self and others) and Ho (Hostility), but there were statistical differences only in one of these domains in comparison with the PD patients without ICD: SI3 (alienation self and others). There was earlier onset of the disease and higher dose of levodopa in PD patients with ICD than in PD patients without ICD.

Supported by project IGA MZ ČR NS 10301-3/2009