bluuebunny/crossref_metadata_2025 huggingface dataset:
FC02-04 - Assessment of schizophrenia in adults with intellectual disability and autism - an empirical study
Authors: Bakken T.L. , Martinsen H. , Friis S. , Lovoll S. , Eilertsen D.E.
Published: May 2011

Introduction

In adults with intellectual disability and autism, psychosis is rarely detected due to misinterpretation of psychotic symptoms being autism or idiosyncratic communication. The patients can poorly communicate the delusions and hallucinations they experience. Observable indicators are therefore necessary.

Objectives

To establish reliable and valid behavioural indicators of psychosis in adults with intellectual disability and autism.

Aims

The aim was to investigate behavioural indicators of psychosis in adults with intellectual disability and autism.

Methods

Forty-three patients with intellectual disability and autism from a hospital-based study were recruited. Eight of these patients were assessed as having schizophrenia-like psychosis. They were further examined through a case-report study. Both statistical analysis and data from the case reports were included. Case report data were compared with scores from a validation study of the Psychopathology in Autism Checklist, PAC.

Results

Behavioural disorganisation, severe decreased global functioning, suspected hallucinations and decreased sociability were observed in the eight psychotic patients. The level of disorganisation was significantly higher in the psychotic patients than in the non-psychotic patients - this included patients with “plain” autism. Adequate treatment significantly decreased the level of disorganised behaviour.

Conclusions

Disorganised behaviour, occurring concurrent with disorganised speech, severe decreased global functioning, suspected hallucinations and negative symptoms, were found to be reliable and valid indicators of psychosis.
FC02-05 - Grasping behavior in schizophrenia suggests selective impairment in the dorsal visual pathway
Authors: Christensen B. , King J. , Westwood D.
Published: May 2011

Introduction

This study frames anomalous functional brain organization among persons with Schizophrenia (SCZ) within an evolutionary model of brain development, the Dual Trends Theory (DTT). The DTT argues that neural architecture develops along two separate pathways: the dorsal’archicortical’ trend and the ventral’paleocortical’ trend. The DTT dovetails with visual system organization, which is also comprised of two independent pathways: a visuomotor dedicated dorsal stream and a perceptual dedicated ventral stream.

Objectives

The present study examined the integrity of these pathways using a size-contrast visual illusion. Prior research has shown that, normally, perceptual estimations of object size are susceptible to visual illusions, whereas goal-directed actions are resistant. We hypothesized that, unlike control participants, SCZ patients’ goal-directed actions would be susceptible to the illusion, reflecting selective dorsal stream dysfunction.

Methods/results

Here, 42 SCZ patients and 42 healthy control participants grasped and estimated the size of target blocks in both control and illusion conditions. Movement kinematics were measured using a magnetic motion trracking system (Flock of Birds). During estimation, both groups were equally perturbed by the illusion; however, grasping movements of patients alone were influenced by the illusion.

Conclusions

These results suggest disrupted dorsal brain circuitry in SCZ but relatively intact ventral brain circuitry.
FC02-07 - Can darwinian theory help unlock the mystery of schizophrenia?
Authors: Abed R. , Abbas M.
Published: May 2011

A reformulation of the Social Brain Theory of schizophrenia is proposed that contends that schizophrenia is a novel human phenomenon that arose following the establishment of large permanent human settlements and the abandonment of the hunter-gatherer way of life. It is contended that the blurring of the demarcation between ingroup and outgroup membership and living in close proximity to strangers is a stressor that leads to perturbation in the development of the social brain in vulnerable individuals leading to the syndrome of schizophrenia. Contrary to previous authors who have considered schizophrenia to be an inherently human condition that has existed throughout human history we suggest that schizophrenia is a relatively recent phenomenon and that the vulnerability to it remained hidden amongst hunter-gatherers. Hence, we contend that schizophrenia is the result of a mismatch between the post-Neolithic human social environment and the design of the social brain. The importance of the distinction between ingroup and outgroup membershipin human evolutionary history lies at the heart of inter-group conflict, violence and xenophobia. This formulation explains a range of epidemiological findings on schizophrenia related to the risk of migration and urbanisation. The present hypothesis can therefore, account for a range of disparate findings regarding schizophrenia that have thus far defied explanation by other extant theories. However, as this formulation claims to have identified the ultimate causation of schizophrenia the hypothesis does not specify the proximate mechanisms that lead to it. We conclude with a number of testable and refutable predictions.
FC03-02 - Internet addiction - the new digital disorder
Authors: Wölfling K.
Published: May 2011

Internet Addiction has become a serious health concern in Europe due to widespread currency and accessibility of various internet applications like online computer gaming, monetary driven gambling or social communities. Under the leadership of the American Psychiatric Association it has recently been proposed to subsume pathological gambling as a behavioral addiction under the new category: Addiction and Related Disorders’ acknowledging commonalities in clinical expression, aetiology and comorbidity with substance related disorders. Also, Internet addiction has been proposed as a new (research) diagnosis in DSM V. The outstanding psychological symptom patients concerned report is an irresistibly urge to be online’. This can lead to constrained behavior which entails psychobiological harm for the user and leads to an addictive behaviour (behavioural addiction). Patients show psychopathological patterns (tolerance, withdrawal, interpersonal conflict, mood modification, relapse) comparable to substance-related disorders.

The talk will outline recent results of psychological research and psychiatric as well as clinical characterization of Internet Addiction. A special focus within the lecture will be on different strategies of intervention. This includes counselling of patients and their relatives as well as outpatient group treatment and individual psychotherapy of Internet Addiction. Complementary, first outcomes of the evaluation of a cognitive behavioral based outpatient therapy from the Ambulanz für Spielsucht Mainz’ will be presented.
FC03-03 - Opiate receptor alleles and alcohol dependence
Authors: Kapur S. , Pal A.
Published: May 2011

Alcohol use is a major cause of morbidity and mortality and is less understood than other addictive disorders. Humans vary in alcohol responses which could be related to genetic susceptibility for alcoholism. The objective of the present study was to examine the prevalence of OPRM1 polymorphisms in addicts. The opioid receptor mu1 (OPRM1) mediates the action of morphine and is a major determinant of striatal dopamine responses to alcohol. Two polymorphism, C17T and A11G of exon I were screened in subjects with addiction to alcohol and opioids and compared with subjects without a history of any sort of drug addiction using restriction fragment length polymorphism, which was further validated by DNA sequencing. The allelic frequencies between the two groups were compared and the difference was found to be of statistical significant (p < 0.0001), with the 17T allele having a 3.06-fold higher risk of alcohol addiction (risk ratio (RR) = 3.069, 95%CI of RR = 2.0339 to 4.6127, odds ratio (OR) = 3.9554; 95%CI of OR = 2.4175 to6.4718) and 118G allele having a 1.81-fold higher risk of alcohol addiction (risk ratio (RR) = 1.8096, 95%CI of RR = 13459 to 2.433, odds ratio (OR) = 2.2025; 95%CI of OR = 1.479 to 3.2799). Similar differences were observed in the case of opiate addiction, RR = 1.1369 to 2.7647, OR = 1.9367; 95%CI = 1.1625 to 3.2263 and RR = 1.7363, 95%CI of RR = 1.3043 to 2.3112, OR = 2.0725; 1.42 to 3.0248) for 17T and 118G respectively. Further studies to unravel the epigenetic control of expression of these candidate genes are underway.
FC03-04 - Lamotrigine treatment of acute alcohol hallucinosis comorbid depersonalizations disorders: A randomimized double-blind, placebo-controlled study
Authors: Aliyev N. , Aliyev A.A. , Aliyev Z.N. , Aliyev A.
Published: May 2011

Aims

We compared the efficacy and safety of lamotrigine versus placebo for the treatment of acute alcohol hallucinosis comorbid depersonalization disorders.

Methods

10 days, randomized, double-blind, parallel study. A total of 40 patients with an ICD-10 diagnosis of acute alcohol hallucinosis comorbid depersonalization disorders were randomized to lamotrigine 300 mg/d (n = 40), or placebo (n = 40). The primary efficacy measure was the PANSS subscale for hallucinosis and Cambridge Depersonalization Scale (CDS).

Results

Iamotrigine treated patients demonstrated a statistically significant greater improvement in PANSS subscale for hallucinosis and CDS than placebo-treated patients.

Conclusion

Lamotrigine demonstrated greater efficacy than placebo in treatment of acute hallucinosis comorbid depersonalization disorders and was generally well tolerated.
FC03-06 - Treatment of opioid dependence using a Tele-Psychiatry Model
Authors: Schwager H.A. ,   TeleMental Health: From Research to Clinical Practice
Published: May 2011

Introduction

Opioid dependence has increased greater that 150% from 1965–2008. Almost 2 Million Americans are currnetly opioid depndent. Approxmately 4.4 million teenagers and adults have used opioid prescription painkillers for nonmedical purposes. Greater than 75% of opioid dependnet patients in the U.S. go untreated. Greater than 60 % of opioid dependent patients don’t seek reatment due to lack of accessibility of treatment centers or programs.

Method

100 opioid dependent patients (illicit street and iatrognenic) volunteered and entered a “TELE-PSYCIATRY MODEL” for treatment of their depencence (age range 19,– 61. 58 males,42 females). Utilizing the Bupernorphen protocol, all patients were intrviewed, examined, induced, and regularly followed, ALL utilizing SECURE VIDEOCONFERENCNG interactive treatment methodologies. No in-person contact was made with any patients.

Results

2 patients dropped out, 98 remain in treatment, and opioid free after a 7 month average. All patients found the Tele Psychiaty model to be acceptable, effective and prefeable.
FC04-01 - Restricted women's rights: is there a link with young women's (15–24) suicide? Comparing two catholic continents
Authors: Pritchard C. , Pritchard C.
Published: May 2011

Question

Are restricted Women's Rights, i.e. limited access to family planning, including abortion, associated with Young Women's (YW)(15–24) suicides in two Catholic formal continents, Catholic Western Europe (CWE) and South American Countries (SAC).

Method

WHO female Suicide rates per million (pm) were compared and ratios of YW to Total (All Age Suicides) calculated. To explore possibility that undetermined deaths, categorised as ‘Other-External-Causes of Death’ (OECD), might be a source of under-reported suicides, OECD and suicides are correlated. Each SAC mortality patterns, using chi square test and average CWE rates are compared to determine any differences between the two continents, sharing the same formal religious culture.

Results

Total CWE suicides at 64pm and OECD 15pm were significantly different from SAC suicides 27pm and OECD 24pm rates.

Most SAC YW mortalities were higher than their Total rates, the reverse was true for the majority of CWE.

SAC Average YW to Total suicide ratios were 1.82: 1 compared to 0.54:1 in CWE and SAC YW to Total OECD ratios were 1.09: 1 and amongst the CWE 0.43:1. There were significant positive correlations between suicides and OECD rates for both CWE age bands but non-significant negative correlation for SAC, showing a marked disparity between the two continents.

SAC YW births rates correlated positively and significantly with their OECD rates.

Conclusions

In the majority of SAC patterns of YW suicide and OECD were significantly different from CWE and SAC YW OECD results might well contain more ‘hidden’ suicides possibly linked to restricted Women's Rights.
FC04-02 - Traumatic experiences as a risk factor for suicide in adolescence
Authors: Delalle M. , Dodig-Ćurković K. , Filaković P.
Published: May 2011

Introduction

Today, the general interpretation of the etiology of various psychopathological symptoms in adolescence does not talk about causes, but the risk factors.

Aim

We tried to determine whether traumatic experiences among adolescents represent a risk factor for suicide.

Methods

The study was conducted at the University Department for Child and Adolescent Psychiatry, University Hospital Osijek in 2006. and 2007. years.

In the study period we included 100 patients, the experimental group consisted of 50 patients who were admitted to the department for attempted suicide in the order of admission to hospital treatment, the control group consisted of 50 patients admitted to the department for other psychiatric disorders, also in the order of admission to treatment / diagnosed according to DSM IV/.

Results

Age range of 13–18 years. There was no statistically significant difference between the two groups of subjects according to age (χ2 = 5289, df = 5, p = .382) and according to sex (χ2 = .694, df = 1, p = .405). In the suicidal group 38 patients (76%) reported traumatic experiences /most in family context/ while in nonsuicidal group 27 patients (54%) what is statistical difference (χ2 = 5319, df = 1, p = .021).

Conclusion

In daily psychiatric work we must focus on adolescents who have experienced traumatic experiences and is therefore extremely important in anamnesis always ask for the lived traumatic experience. Family practitioners, specialists in educational institutions, parents and adolescents themselves have a role in early recognition of these risk factors.
FC04-03 - Serotonin, trauma and violence in attempted suicide
Authors: Moberg T. , Nordström P. , Kristiansson M. , Jokinen J.
Published: May 2011

Introduction

Serotonin is implicated in impaired impulse control, aggression and suicidal behaviour. Low cerebrospinal fluid (CSF) concentrations of the serotonin metabolite 5-hydroxyindoleacetic acid (5-HIAA) have been found in violent suicide attempters, suicide victims and in violent offenders. CSF 5-HIAA concentrations have both genetic and environmental determinants. Childhood trauma may have an effect on central monoamine function as an adult.

Aims

The aim of this study was to assess the relationship of CSF 5-HIAA and the exposure to and the expression of violence in childhood and during adult life measured with the Karolinska Interpersonal Violence Scale (KIVS).

Methods

42 medication free suicide attempters underwent lumbar puncture and were assessed with the Karolinska Interpersonal Violence Scale (KIVS) to assess history of childhood exposure to violence and lifetime expressed violent behaviour.

Results

In women CSF 5-HIAA showed a significant negative correlation to exposure to violence during childhood. Furthermore, suicide attempters with low CSF 5-HIAA were more prone to commit violent acts as an adult if exposed to violence as a child compared to suicide attempters with high CSF 5-HIAA. In the non-traumatized group, CSF 5-HIAA showed a significant negative correlation to expressed violent behaviour in childhood.

Conclusions

Although central serotonergic function has important genetic determinants, exposure to childhood trauma may also affect serotonergic function. Low serotonergic function may facilitate aggression dyscontrol in traumatized suicide attempters.
FC04-06 - Candidate gene association study of suicidality in treatment resistant MDD
Authors: Schosser A. , Calati R. , Serretti A. , Massat I. , Linotte S. , Mendlewicz J. , Souery D. , Montgomery S. , Kasper S.
Published: May 2011

Suicidal behaviour runs in families and the existence of genetic vulnerability to suicidality is well-established. Mental disorders, especially depression, are present in more of 90% of suicides. The incidence of treatment emergent suicidal ideation in major depression (MDD) varies from 4% to 20%, depending on the definition of suicidal ideation and sample characteristics.

In the present study, we further elucidated the impact of depression candidate genes in treatment emergent suicidal ideation in MDD. One hundred-seventy MDD patients were collected in the context of a resistant depression study and treated with antidepressants at adequate doses for at least 4 weeks. MDD subjects were genotyped for SNPs within the COMT gene, BDNF, DTNBP1, 5HT1A, 5HT2A, GNB3, GRIK4, PTGS1, PTGS2, CREB, and cytochrome P450 CYP1A2, CYP2C9, CYP2C19 and CYP2D6 gene. Response, remission and treatment resistance, as well as suicidality information derived from Mini International Neuropsychiatric Interview (MINI) and Hamilton Rating Scale for Depression (HAM-D) were recorded.

A quantitative and measure of suicidal behaviour was defined using the Hamilton rating scale (score 0 to 4) and the MINI-item (yes/no) on suicidality in a large cohort of depression cases. In addition, we tested for association with ‘serious suicidal attempts’ corresponding to a HAMD score of 4 (discrete trait analyses). Results of this candidate gene approach in treatment emergent suicidal ideation in MDD will be presented and discussed.
FC05-01 - Overlap between attention deficit hyperactivity disorder and autism
Authors: Fitzgerald M.
Published: May 2011

Objectives/aims

In this presentation Michael Fitzgerald will investigate the evidence for the clinical, genetic, and other evidence for the overlap between Autism and Attention Deficit Hyperactivity Disorder.

Methods

He will examine the questions of a similar underlying pathophysiological process and alternately a number of pathologies leading to the same clinical presentation. He will examine clinical and epidemiological overlap, overlap mechanisms, deficits in social interaction in Attention Deficit Hyperactivity Disorder, and genome wide gains in Attention Deficit Hyperactivity Disorder and Autism, candidate gene studies as well as neurochemical and treatment issues.

Conclusions

The issue of overlap between ADHD and Autism is being increasingly recognised.
FC05-02 - An applied behavior analysis training package in the treatment of autism. The use of principles of pivotal response treatment in a child psychiatric clinic
Authors: Huskens B. , Verburg M.
Published: May 2011

Introduction

In a child psychiatric clinic for Autism Spectrum Disorders (ASD) a long waiting list and outplacement difficulties were a substantial problem in the past years. This problem has been tackled by going back to the main focus of our treatment, ensuring that children are able to go back home to their parents after clinical treatment.

By redefining the main goal of clinical treatment in return to the family this problem has been overcome. In the search of tools to empower child and parents we adjusted the principles of Pivotal Response Treatment to our clinical setting.

Objective

To empower child and parents in order to make a return to the family possible.

Aim

The aim was to improve the learning environment in the clinical treatment groups and at home in order to increase child initiatives.

Methods

An Applied Behavior Analysis (ABA) training package was developed for the staff in order to increase learning situations in the clinic. Elements within the package are a two-day training workshop in ABA techniques, live feedback and video feedback during three months after training. For parents an ABA parent group training was developed in order to increase learning situations at home. In the training parents were introduced with ABA techniques and received video feedback. Parents participated in eight group sessions and two individual sessions.

Results and conclusions

At the time of writing this study is still in progress. At the Congress the first preliminary results will be discussed and the first conclusions will be drawn.
FC05-03 - 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.
FC05-05 - Fronto-temporal disconnectivity and symptom severity in autism spectrum disorders
Authors: Poustka L. , Jennen-Steinmetz C. , Henze R. , Stieltjes B. ,   Work Group Autsims Spectrum Disorders, CIMH, Mannheim, Germany
Published: May 2011

Background

There is increasing evidence that many of the core behavioral impairments in autism spectrum disorders (ASD) emerge from disconnectivity of networks that are important for social communication. It is less clear, which specific fiber tracts are involved and how possible alterations of white matter are associated with clinical symptomatology and neuropsychololgical characteristics in ASD.

Methods

18 children with ASD and 18 carefully matched typically developing controls aged 6–12 years were examined using diffusion tensor imaging (DTI) and voxel-based morphometry (VBM). Fractional anisotropy (FA) values were correlated with symptom severity as indexed by the children's scores on the Autisms Diagnostic Observation Schedule (ADOS) and the Autism Diagnostic Interview-Revised (ADI-R) and results from the Childrens Embedded Figures Test (CEFT).

Results

Decreased FA values were identified for the fornix (FO), the superior longitudinal fasciculus (SLF) the corpus callosum and the uncinate fasciculus (UF) in the ASD group compared to controls, with most prominent differences in the UF bilaterally and the right SLF. FA values of affected fiber tracts were negatively associated with clinical measures of autistic smypotmatology and response time of the CEFT. Additionally, we observed decreased grey matter concentration in the left supramarginal gyrus.

Conclusion

Our findings support the hypothesis of abnormal white matter microstructure of fronto-temporal cortical networks in ASD, which are associated with core symptoms of the disorder.
FC05-06 - Comparison of two-year outcomes for children with autism receiving high versus low-intensity behavioral intervention
Authors: Granpeesheh D. , Kenzer A. , Tarbox J.
Published: May 2011

Introduction

Behavioral intervention is an evidence-based treatment for children with autism but there still exists some disagreement regarding how intensive the treatment needs to be. Little previous research has directly compared the effects of high to low-intensity behavioral intervention.

Objectives

To compare the effects of high versus low-intensity behavioral intervention.

Aims

Compare outcomes in the area of diagnostic classification, intellectual functioning, executive functions, challenging behavior, language, socialization, and independent living skills after two years of treatment.

Methods

60 children with autism, under five years old, comprised two groups who received behavioral intervention services. The high-intensity group received 25–35 hours per week for two years and the low-intensity group received 8–15 hours per week of treatment. For all participants, a comprehensive battery of assessments was conducted prior to treatment and at annual intervals.

Results

The high-intensity group outperformed the low-intensity group on all measures after two years of treatment.

Conclusions

This study provides further evidence that high intensity behavioral intervention produces greater gains than low-intensity treatment and the results suggest that children with autism under the age of five years should receive access to high-intensity treatment
FC06-01 - Comparison feels stress levels in parents of mentally retarded children and normal
Authors: Hasannattaj Gelodari F. , Ahmadi Gatab T. , Abasnejad Roshan B.
Published: May 2011

Introduction

The existence of mentally retarded children in the family caused despair, frustration and isolation of individual and family are and their push for diversity issues on individual family members and parents as a marital unit and the total family system as a family show.

Objective

This study compared the amount of stress parents feel mentally retarded children with parents is normal.

Method

The study after the event (Ali - a comparison) is.The sample of 120 parents of retarded children and 120 parents of normal children using a sampling Chndmrhlh chosen. To check the source of feeling stress questionnaire stress (QRS) was used and analysis of data by independent t tests May Pearson.

Results

Results showed that parental stress in two groups of mentally retarded children and parents have significantly different normal and feeling stress parents of mentally retarded children than parents were normal. Between mothers and fathers of mentally retarded children in terms of Nshdv significant difference in stress levels stress parents of mentally retarded children were the same.the child's gender had no impact on parent stress levels, but between the retarded child's age and parental stress there was a significant relationship, whatever the case retarded child's age increased parental stress will increase. Similarly, parental education and children backward stress there was no significant difference whatever the parents are more educated than parents with lower education have less stress.

Discussion

The results show parents of mentally retarded children than normal children, parents significantly more stress they endure.
FC06-03 - Course of auditory vocal hallucinations in childhood: A 5-year follow-up study
Authors: Bartels-Velthuis A.A. , Van de Willige G. , Jenner J.A. , Van Os J. , Wiersma D.
Published: May 2011

Background

In a baseline study among 7–8 year old children with auditory vocal hallucinations (AVH), only limited functional impact of AVH was observed.

Aims

To assess AVH 5-year course and its predictors, as well as AVH 5-year incidence and its risk factors.

Method

A sample of 337 12- and 13-year-old children were reassessed on AVH after a mean follow-up period of 5.1 years. Parents completed the Child Behaviour Checklist (CBCL). School performance was assessed.

Results

The AVH 5-year persistence and incidence rates were 24% and 9% respectively, more new cases arising in urban areas. Both persistent and incident AVH were associated with problem behaviour in the (CBCL) clinical range, particularly at follow-up, as well as with other psychosis-like symptoms, particularly at baseline. AVH persistence was predicted by baseline AVH severity, notably in terms of external attribution of voices and hearing multiple voices, and was associated with worse primary school test scores and lower level secondary school.

Conclusions

First-onset AVH in middle childhood is neither rare nor neutral in terms of psychopathological and behavioural comorbidity. Persistence of AVH in early childhood similarly is not rare and associated with psychopathological, behavioural and cognitive alterations.
FC06-04 - “Help-s for children” - results of a multicentre study about the situation of families with a mentally ill parent
Authors: Boenisch-Alert S. , Holtz K. , Müller A.-G. , Schützwohl M. , Hegerl U. , Kocalevent R.-D.
Published: May 2011

Introduction

26.5% of psychiatric patients in Germany have minor children. More than half of these children have specific needs, which are seldom met.

Objectives/aims

To examine problems, needs and used interventions for families with a mentally ill parent in the federal state of Saxony, Germany. The study focused on outpatients and included mothers and fathers and all psychiatric disorders.

Methods

We asked all psychiatrists in the federal state of Saxony to take part in our study. All patients with minor children who came to one of the 58 participating psychiatrist's practices at an appointed date were asked to fill out a detailed questionnaire including sociodemographic data, the Strengths and Difficulties Questionnaire (SDQ), specific needs, used interventions and reasons for not using interventions. The questionnaire was developed using data from 26 expert interviews.

Results

128 psychiatric outpatients took part in our study (78% female). The most common diagnoses were depression and anxiety disorders. More than 40% of the patients rated their children in the SDQ in an abnormal or borderline range. 22% of the children have been treated because of emotional or behavioural problems. Reasons not to use interventions were missing knowledge and fear of stigmatisation.

Conclusions

HELP-S for children is the first study which examines the situation of children with a mentally ill parent in an outpatient setting. Therefore, our results are an improvement in research in the field of families with a mentally ill parent and heading towards the improvement of care.
FC06-06 - The unwilling child adult's misinterpretations and the child's voice
Authors: Brand Flu R.
Published: May 2011

Introduction

Unwillingness is a fairly common misinterpretation of a child who does not know what is expected from him, does not know any better or who is incapable to perform. Behaviour to communicate distress can get overlooked and a communicative element can get over-rated. Recursive reciprocal dysfunctional interactions can ensue when the behaviour remains misinterpreted.

Aim

To illustrate a few groups of misinterpretations from conversations with children.

Objectives

Any child with behaviour difficulties is assessed on his view of behaviour (ongoing assessment).

Method

For the assessment drawings, diagrams, projective, open and hypothetical questions.Role play is also used to help the child identify with the situation.

Results

83 children, including children with a learning disability and autism, age range6-16 years displayed opposition, challenging behaviour and self-harm. 52 had autism, one additional one was examined by Mum. 28 children had a diagnosis of ADHD All 7 children with oppositional behaviour had autism. Only 4 self-harmers were examined. 8 children with autism articulated problems respecting rules. All other children except for one young person with deliberate self-harm (+autism) explained their behaviour as a offloading and communicative. 6 described their behaviour solely as stress relief’. Adolescents without autism articulated their need to anger their parents for letting them down’. 16 articulated specific learning problems.

Conclusion

Behaviour problems can be a substitute for expressing emotions communicatively in children who have insufficient emotional language repertoire. The offloading behaviour does not necessary have a communicative element. Their behaviour can be a result of deficient skills.
FC07-01 - Cognitive functions in first episode psychosis
Authors: Elsawy H.F. , Abd Elhay M.A. , Abd Elkrem A.B.
Published: May 2011

Background

Cognitive impairment is recognized as an important feature of psychosis in its early stages and is a determinant of prognosis and management of these disorders.

Aim of the study

To test the cognitive functions in first psychotic episode in patients with disorders of schizophrenia, schizoaffective disorder, bipolar disorder and depression with psychotic disorder and to compare them to controls.

Subjects and methods

The study included 254 patients diagnosed according to Diagnostic and Statistical criteria of Mental disorders, 4th edition (91 schizophrenics, 21 with schizoaffective disorder, 107 with bipolar disorder and 31 with psychotic depression) and experiencing their first psychotic episode. Seventy healthy volunteers matched as regards age and sex with patients were used as controls. All are subjected to cognitive evaluation by Trail Making Test, part B, Wisconsin card sorting test 128, Benton Visual Retention Test and Wechsler Adult Intelligence Test.

Results

All patients showed significant cognitive deterioration in all tests compared to control group. On comparing patients to each other, there was no significant difference between schizophrenics and patients with bipolar disorder, but both showed marked deterioration in comparison to depressive group.

Conclusion

Cognitive impairments are present in early stages of psychosis and need careful assessment and management.
FC07-02 - Increased parahippocampal and lingual gyrification in first-episode schizophrenia
Authors: Schultz C.C. , Koch K. , Wagner G. , Roebel M. , Nenadic I. , Gaser C. , Schachtzabel C. , Reichenbach J. , Sauer H. , Schlößer R.G.M.
Published: May 2011

Introduction

Surface based MRI methods are a promising approach for the identification of cerebral shape alterations in schizophrenia [1]. In particular, investigating gyrification might offer important evidence for disturbed neurodevelopmental mechanisms in schizophrenia.

Objective

The present study is the first to compare on a vertex - wise basis mean curvature as a sensitive parameter for the identification of local gyrification changes in first episode schizophrenia.

Methods

54 patients with first-episode schizophrenia and 54 healthy control subjects underwent high-resolution T1-weighted MRI scans. Surface extraction and mean curvature calculation was performed using the Freesurfer Software package. Statistical cortical maps were created to estimate gyrification differences between groups.

Results

A significantly increased gyrification was detected in patients relative to controls in a large right parahippocampal-lingual cortex area. A further analysis of cortical thickness of this cluster revealed concurrent significant reduced cortical thickness in patients.

Conclusions

This is the first study to reveal an aberrant gyrification of the medial surface in first episode schizophrenia on basis of a vertex - wise analysis of local gyrification changes of the entire cortex. Both affected areas, the parahippocampal and the lingual cortex, are of high pathophysiological relevance for schizophrenia. Thus, our data provided new in vivo evidence for an early maturational deficit of these cortical areas in schizophrenia [2].
FC07-03 - Neurological soft signs and morphological changes of basal ganglia and thalamus in patients with first-episode psychosis
Authors: Hirjak D. , Stieltjes B. , Fritzsche K.H. , Wüstenberg T. , Seidl U. , Essig M. , Schröder J. , Thomann P.A.
Published: May 2011

Objectives

Minor motor and sensory deficits or neurological soft signs (NSS) are frequently found in individuals suffering from schizophrenia at any stage of their illness. The basal ganglia and the thalamus are accepted as being important for both motor control and integration of sensory input. However, whether NSS are related to structural alterations of these brain regions remains controversial.

Method

20 patients with a first-episode psychosis were investigated using high-resolution magnetic resonance imaging (MRI) at 3 Tesla. NSS were examined on the Heidelberg Scale after remission of acute symptoms and correlated with volume and shape of striatum, pallidum and thalamus by using sophisticated MRI analyses, namely VBM-DARTEL (volume) and FSL-FIRST (shape).

Results NSS scores in patients with schizophrenia were significantly associated with volumetric changes and surface alterations in all investigated areas. Associations remained significant when controlling for age, gender, education, medication and intracranial volume.

Conclusion

Our findings lend further support for an involvement of the basal ganglia and the thalamus in NSS.
FC07-04 - Electrophysiological neuroimaging reveals re-set, re-activation and re-processing of procedural and declarative memory traces during post-training sleep
Authors: Anderer P. , Gruber G. , Parapatics S. , Sauter C. , Kloesch G. , Schabus M. , Klimesch W. , Saletu-Zyhlarz G.M. , Saletu B. , Zeitlhofer J.
Published: May 2011

Objectives

Experience-dependent cortical plasticity observed during post-training sleep has been hypothesized to be part of the global process of memory consolidation. Combining the temporal resolution of microstructure detectors and the spatial resolution of low-resolution brain electromagnetic tomography (LORETA) makes it possible to investigate when and where the experience-dependent reactivation occurs under normal (undisturbed) sleeping conditions.

Methods

After an adaptation night, in the 2nd and 3rd night 48 young healthy volunteers were randomly assigned either to a control condition or to an experimental condition (declarative memory task: paired-associate word list or procedural memory task: mirror tracing). Sleep stages and sleep microstructures (slow waves, spindles and theta bursts) were detected automatically by means of the Somnolyzer 24x7. Changes in LORETA sources (experimental minus control night) were correlated with changes in memory performance (morning minus evening recall).

Results

Overnight improvements in the mirror tracing task were correlated with increased slow-wave sources in the right posterior parietal cortex (r = .70,p < 0.01) during NREM sleep and with desynchronized (r = −.76,p < 0.01) and synchronized (r = .62,p < 0.01) rolandic mu rhythm sources during periods with theta bursts in REM sleep. Overnight improvements in the declarative memory task were significantly correlated with increased spindle sources (r = .52, p < .01) in frontal, temporal and cingulate brain regions.

Conclusions

The present study supports the hypotheses of (1) a use-dependent reset of synaptic plasticity during slow-wave sleep (restorative function), (2) an experience-dependent reactivation during spindle episodes (stabilizing function) and (3) an off-line neuronal reprocessing during REM sleep (improvement without further training for novel tasks).
FC07-06 - Differences in the modulatory role of escitalopram and citalopram revealed by effective connectivity analysis
Authors: Windischberger C. , Kasess C. , Sladky R. , Moser E. , Kasper S. , Lanzenberger R.
Published: May 2011

Introduction

Citalopram is a widely applied SSRI in patients suffering from affective disorder. It is a racemic mixture of the S- and R-enantiomer of citalopram, consisting of equal parts of S-citalopram and R-citalopram, respectively. It has been shown that the inhibitory potency in serotonin reuptake of S-citalopram is much higher compared to R-citalopram, and it is assumed that S-citalopram is the main carrier of the antidepressant effect.

Objectives

Here we investigated the effects of the two SSRIs Citalopram (50% S-, 50% R-citalopram) and Escitalopram (100% S-citalopram) on brain networks during emotion processing using pharmacological functional magnetic resonance imaging (fMRI) and dynamic causal modelling (DCM), an advanced tool to investigate functional integration between different brain regions.

Methods

Our results are based on a placebo-controlled, randomized, double-blind, cross-over pharmacological study in 16 healthy subjects during three fMRI scanning sessions performing a facial emotional discrimination paradigm (Windischberger, Neuroimage, 2010). 32 models of pharmacological modulation within the amygdalar-parahippocampal-orbitofrontal network were analysed using Bayesian Model Averaging (BMA) as implemented in SPM8.

Results

S-citalopram showed statistically significant modulatory effects on forward amygdala-orbitofrontal and bidirectional amygdala-parahippocampal connections. No significant modulatory effects of R-citalopram were found.

Conclusions

This is the first fMRI study that showed stimulus-specific differential effects of the two enantiomeres R- and S-citalopram at the neural connectivity level. Our results corroborate studies in rats where escitalopram-induced increases in extracellular serotonin levels were found attenuated when R-citalopram was coinjected. Taken together this might explain the response differences between study drugs as demonstrated in previous clinical trials.
FC08-01 - Socioeconomic position and long-term depression trajectory : A 13-year follow-up of the french gazel cohort study
Authors: Melchior M. , Chastang J.-F. , Head J. , Goldberg M. , Zins M. , Nabi H. , Younès N.
Published: May 2011

Each year, 3–5% of individuals suffer from depression. Approximately 50% will experience persistent disorder; however, factors associated with depression persistence in the population are not yet fully understood. We tested the hypothesis that long-term depression course is predicted by socioeconomic position. Data come from the Gazel cohort study, which began in 1989 (n = 20 624,35–50 ans, 73% of men). We included 13,142 participants who reported symptoms of depression (CES-D) in 1996, 1999, 2002, 2005 et 2008. These repeated measures were dichotomized (high symptom level : yes vs no) and we identified four longitudinal trajectories (no depression, decreasing symptoms, intermediate/increasing symptoms, persistent depression). Socioeconomic position was measured by occupational grade in 1996 (manual worker/clerk, administrative associate/technician, vs. manager). Analyses were conducted using multinomial regression models, stratifying on sex and controlling for socio-demographic characteristics, negative life events, health behaviors, and preexisting health problems. The probability of being depressed during follow-up followed a socioeconomic gradient. For instance, compared to managers, administrative associates/technicians were more likely to have persistent depression (fully adjusted ORs: men: 1.28, 95% CI 1.05–1.56; women: 1.86, 95% CI: 1.05-3.29) as were manual workers/clerks (fully adjusted ORs: men: 2.32, 95% CI 1.76–3.06; women: 2.63, 95% CI 1.41-4.92). This socioeconomic gradient is consistent with a social causation explanation of persistent depression. The implication for clinicians and public health decision makers is that efforts aimed to reduce the burden of depression should take into account mental health needs across the population, rather than solely focus on high-risk groups.
FC08-02 - Severity of mental disorder and the risk of all-cause, avoidable, ischemic heart disease, violent and suicide mortality
Authors: Björkenstam E. , Ljung R. , Hallqvist J. , Burström B. , Weitoft G.R.
Published: May 2011

Introduction

There are indications that psychiatric patients do not receive adequate treatment of their somatic diseases.

Objectives

To evaluate the effect of mental disorder on the risk of mortality.

Aims

To study whether severity of psychiatric disease increases the risk of mortality.

Methods

A register-based cohort study comprising all individuals alive and registered in Sweden in 2004 and 2005 aged 20–64. We followed 5,181,743 individuals with respect to mortality 2006 and 2007, generating 10,261,263 person-years and 24,475 deaths. Psychiatric patients were defined as those treated with a main diagnosis of psychiatric disease within the last five years and were classified according to type of mental disorder: psychoses, depression/anxiety, substance abuse, and other psychiatric diagnoses. We studied all cause mortality, mortality from ischemic heart disease, suicide, violent deaths, smoking related cancer and policy-related and health care-related avoidable mortality. Estimates of risk of mortality were calculated as incidence rate ratio (IRR) with 95% confidence intervals (CI) using Poisson Regression Analysis.

Results

Patients with schizophrenia or other psychosis in general had the highest mortality for most mortality outcomes. For both women and men, those treated for substance abuse had the highest all-cause mortality risk (Women: IRR = 12.56 (95% CI = 10.82–14.57); Men: IRR = 9.38 (95% C = 8.73–10.08). For all psychiatric diseases and for all mortality outcomes those on social benefits had a higher mortality.

Conclusion

Psychiatric patients have a higher overall mortality and cause-specific mortality. The more severe the psychiatric disease the higher is the risk of mortality even after disregarding violent deaths and suicide.
FC08-03 - Increased risk of amputation of lower limbs and mortality in patients with diabetes and comorbid mental illness
Authors: Salmi P. , Jonasdottir-Bergman G. , Björkenstam E. , Talbäck M. , Lindelius B. , Ljung R.
Published: May 2011

Introduction

There are concerns that people with mental disorders may not receive proper somatic care within health care systems, and face the risk of poor physical health outcomes and premature death.

Objective

To study whether patients with diabetes and comorbid mental illness are at higher risk of amputation of the lower limbs and mortality than diabetic patients without mental illness.

Aim

To pinpoint possible disparities in physical health outcomes and mortality in diabetic patients with or without mental disorders.

Method

National Swedish registers; Prescribed Drug Register, Patient Register and Cause of Death Register. All subjects that were prescribed antidiabetics during 2006, at age 35–79, were included (n = 229,956). Subjects with at least 2 hospital inpatient stays during 1996–2005 for psychotic disorders, i.e. schizophrenia/affective psychosis (n = 2,791), or non-psychotic disorders, i.e. depression/anxiety (n = 2,327) were identified. The study population was followed from 2007–2009. A Poisson regression model estimated the effect of mental illness on the likelihood of amputation or death. Incidence rate ratios (IRR) and 95% confidence intervals (CI) were calculated.

Results

Diabetic patients with comorbid psychotic and non-psychotic illness were more likely to die than patients without mental illness, also when suicides and events of undetermined intent were excluded (IRR = 2.44, CI 2.18–2.72 and IRR = 2.43, CI 2.17–2.71, respectively). The risk of amputation was particularly enhanced in diabetic patients with depression or anxiety (IRR = 4.39, CI 2.58-7.49).

Conclusion

In diabetic patients there exist unsettling disparities in physical health outcomes and mortality that are associated with whether a person is mentally ill or not.