bluuebunny/crossref_metadata_2025 huggingface dataset:
P01-73 - The Novel Antidepressant Agomelatine Normalizes Hippocampal Neuronal Activity and Promotes Neurogenesis in Chronically Stressed Rats
Authors: Dagyte G. , Van der Zee E. , Meerlo P. , Postema F. , Gabriel C. , Mocaer E. , Luiten P.G. , Trentani A. , den Boer J.A.
Published: June 2010

Agomelatine is a melatonergic (MT1/MT2) receptor agonist and 5-HT2C receptor antagonist with demonstrated antidepressant properties in animal models and in clinical studies. Several preclinical studies report agomelatine-induced effects on brain plasticity, mainly under basal conditions. Yet, it is important to unravel agomelatine-mediated changes in the brain affected by psychopathology. Since stress is implicated in the etiology of depression, it is valid to investigate antidepressant-induced effects in animals subjected to chronic stress. Here, we determined changes in the brain (hippocampal neuronal activity and neurogenesis) after agomelatine treatment in chronically stressed rats. Adult male rats were injected with BrdU (300 mg/kg i.p.), and 4 days later subjected to daily footshock stress and agomelatine (40 mg/kg i.p.) or vehicle (1% HEC) treatment for 21 days. Blood samples were taken in order to assess plasma ACTH and corticosterone levels. One day after the last stress exposure and agomelatine treatment, brains were collected and processed for immunohistochemistry. Rats exposed to footshock stress showed robust increases in ACTH and corticosterone, which were not influenced by agomelatine treatment. Chronic agomelatine therapy normalized the reduced c-Fos expression in the hippocampal dentate gyrus observed after chronic stress exposure. Moreover, agomelatine enhanced hippocampal cell proliferation and survival in stressed but not in control rats. Furthermore, agomelatine reversed the stress-induced decrease in doublecortin (a marker of newly-born immature neurons) expression in the hippocampal dentate gyrus. Taken together, these data show a beneficial action of agomelatine in the stress-compromised brain, where it restores stress-affected hippocampal neuronal activity and promotes adult neurogenesis.
P01-79 - Pet-measured Occupancy of the D2 Receptor: a Comparison of Quetiapine Fumarate Immediate-and Extended-release Formulations in Healthy Subjects
Authors: Nyberg S.
Published: June 2010

Objectives

Developed as an antipsychotic, quetiapine displays moderate, transient occupancy of dopamine D2 receptors. Characterization of norquetiapine indicates this major human metabolite potently inhibits the norepinephrine transporter and binds to D2 receptors with affinity similar to quetiapine. Clinical pharmacology studies indicate pharmacodynamic differences between the immediate-release (IR) and the recently developed extended-release (XR) quetiapine formulation. The objectives of this study were to further investigate the pharmacokinetics of these formulations, and to relate D2-receptor occupancy to quetiapine and norquetiapine exposures.

Methods

Eleven healthy male volunteers, aged 20-45 years, underwent PET using the radioligand [11C]raclopride. After baseline measurements, quetiapine XR was administered once-daily for 8 days, with titration to 300 mg on Days 5-8. Quetiapine IR was administered at 300 mg daily on Days 9-12. PET measurements were repeated after the last doses of XR and IR at predicted times of Cmax. D2-receptor occupancy was calculated using a reference tissue model. Concomitant pharmacokinetic measurements were performed.

Results

For quetiapine XR, mean D2-receptor occupancy at Cmax was 32% (SD ±11%; n=11). For quetiapine IR, mean D2-receptor occupancy at Cmax was 47% (SD ±9%; n=10). Quetiapine XR produced lower peak D2 occupancy than quetiapine IR in all subjects.

Conclusions

Pharmacokinetic differences between quetiapine XR and IR formulations translate to different profiles of brain receptor occupancy. Quetiapine XR was associated with lower peak D2-receptor occupancy than quetiapine IR at corresponding doses. This observation may provide important mechanistic underpinnings for emerging clinical data comparing the 2 quetiapine formulations.

Supported by funding from AstraZeneca Pharmaceuticals LP.
P01-80 - Elderly Mania: Throughly Revised; three (very) Difficult Clinical Cases
Authors: Cintra P. , Marques J. , Ramos A.
Published: June 2010

Objectives

Symptoms of mania in geriatric patients (> 65 years old) have received much recent attention, in part due to Akiskal's Bipolar Spectrum classification (Akiskal, 2000), in which subtype VI is «bipolarity in the setting of dementia». The authors present a through revision of the issue, and 3 clinical cases are presented.

Methods

Data was collected through Medline/Pubmed website research, literature revision and other sources. Three clinical cases are presented (identifying data and sociodemographic details, history of present illness, personal history, …), which were obtained through direct observation of the patient and consultation of hospital inpatient clinical file.

Results

We found 11272 articles, of which 458 were reviews. We were involved in direct care to 3 elderly manic patients, in our clinical activity in 2 Psychiatric Hospitals in Lisbon.

Conclusions

Elderly mania is a relatively rare and ill-defined syndrome, with many possible causes (genetic, iatrogenic, metabolic, infectious, oncological, traumatic SNC injuries, epilepsy, and many other neurological disorders). Appropriated exclusion of organic pathology through a correct differential diagnosis is mandatory to obtain a suitable therapeutic approach and favorable prognosis. The growing life expectancy suggests that this neuropsychiatric syndrome should be a focus of attention for psychiatrists, internists, and other health care technicians, especially those directly involved in the care of elderly patients in settings such as state/private hospitals, private clinics, day care facilities and nursing homes.
P01-81 - The Role of Insomnia in Manic or Hypomanic Relapses of Bipolar Disorder
Authors: Pedrosa R. , Ferreira P. , Teixeira de Sousa V. , Silva A. , Viana M.
Published: June 2010

Sleep disturbance is recognized as an essential aspect of affective illness.

Multiple lines of evidence suggest that a change in sleep pattern may indicate an imminent mood change. In fact, the impaired sleep can be seen as a sign as well as a cause of manic episodes. Thus, sleep can be a predictor of mania or a marker of response and therapeutic target.

This retrospective study explores the role of insomnia in patients with Affective Bipolar Disorder presenting with current mania or hypomanic episode, based on ICD-10 criteria. It was randomly selected a sample of 61 adults admitted at Psychiatry Department of Hospital de São João between 2005-2007. It was assessed the presence of insomnia before and during the treatment and compared with the duration of the hospitalization, the number of attendances to the Emergency Department and hospitalizations one year after.

Given the importance of insomnia in bipolar illness, appropriate evaluation and management of sleep can be helpful in preventing relapses in this disorder. Therefore sleep improvement in mania may be clinically useful as therapeutic target.
P01-83 - Associations Between Guideline-concordant Care and Clinical Outcomes for Depression and Anxiety
Authors: Prins M. , Verhaak P. , Smolders M. , Spreeuwenberg P. , Laurant M. , van der Meer K. , van Marwijk H. , Penninx B. , Bensing J.
Published: June 2010

Aims

To determine possible associations between guideline-concordant care and clinical outcome in general practice patients with anxiety and depression, and identification of patient characteristics associated with poor clinical outcome.

Methods

Data from the Netherlands Study of Anxiety and Depression (NESDA) was used. NESDA is a longitudinal cohort study to measure the long-term course and consequences of anxiety and depressive disorders. Adult patients were interviewed to measure DSM-IV diagnoses during the baseline assessment, and completed questionnaires measuring symptom severity, sociodemographic variables and social support at baseline and 12 months later. The definition of guideline adherence was based on an algorithm on care that was received.

Results

721 patients with a current (6-month recency) anxiety or depressive disorder participated. While patients who received guideline-concordant care (N=281) suffered from more severe symptoms than patients who received non-guideline concordant care (N=440), both groups improved equally on their depressive or anxiety symptoms after 12 months. Patients who (still) had moderate or severe symptoms at follow-up, were more often unemployed, had smaller personal networks and more severe depressive symptoms at baseline than patients with low symptoms at follow-up.

Conclusions

The added value of guideline-concordant care could not be demonstrated in this study. While patients with comorbidity of both anxiety and depressive disorders, those with smaller social networks and the unemployed were more likely to suffer from moderate or severe symptoms after 12 months, severity of depressive symptoms at baseline was most strongly associated. Findings have practical implications as well as implication for future research.
P01-87 - Evaluation of the Rate of Depression in Heart Diseases’s Patients and Dialysis Candidates Against the Healthy People
Authors: Kazemi R. , Rezaei Ghalechi E.
Published: June 2010

Background

The aim of this study is the investigation of depression prevalence in heart diseases patients and dialysis candidate’s we researched depression effects on heart and renal diseases and suggested new ways to patients’ management.

Methods

This study is a descriptive and correlation study that 21 heart disease patient and dialysis candidates as the samples by questionnaire are selected we used Beck depression Anxiety test and gained results by SPSS and statistical analysis.

Results

In this study 21 patients are selected and 67.7% of them had depression. 30% minor depression, 17.5% mild depression and 7.5% had major depression. Around the 12.5% of them needed psychiatric consultations. Most of them were middle-aged (45%),men (22%),illiterate (32.5%), citizen (92.5%),illness (52.5%) and dialysis candidates (27.5%).

Conclusion

Our study shows that there isn’t meaningful relation between age, academic education, type of living and disease duration of patients. We knew that there is meaningful relation between periods of heart diseases’ patients, dialysis candidates and depression against the healthy people. this research says us to notice emotional problems of patients especially patient of heart diseases and dialysis candidates,
P01-89 - Preliminary Analysis of the Functional Consequences of the CACNA1C Gene Polymorphism on Emotional Processing in Bipolar Disorder
Authors: Ruberto G. , Lelli-Chiesa G. , Vassos E. , Maierú M. , Tatarelli R. , Girardi P. , Collier D. , Kempton M.J. , Frangou S.
Published: June 2010

Objectives

A single nucleotide polymorphism within the CACNA1C gene (rs1006737) has been found to confer increased risk of Bipolar Disorder (BD) and has been linked to altered neuronal gating and emotional behaviour. As current models of BD suggest abnormal integration within frontolimbic networks, our aim was to explore the effect of the CACNA1C genotype on prefrontal and limbic activation.

Methods

We genotyped 90 participants from the Vulnerability to Bipolar Disorder Study comprising of 41 euthymic BD patients and 49 healthy controls. Functional magnetic resonance imaging data were obtained while participants performed a fearful versus neutral facial affect processing task.

Results

We found a significant diagnosis by genotype interaction with BD patients homozygous for the risk allele having reduced prefrontal activation compared to the other groups.

Conclusions

The present findings support the hypothesis that the rs1006737 polymorphism in the CACNA1C gene confers increased risk of BD by modulating amygdala and PFC activation during emotional processing.
P01-91 - Management of Acute Depression in Bipolar Disorder. Formalized Recommendations from the French Society of Biological Psychiatry: Methodology and Perspectives
Authors: Samalin L. , Guillaume S. , Martin P. , Abbar M. , Meynard J.-A. , Gay C. , Courtet P. , Llorca P.-M.
Published: June 2010

As part of a process to improve the quality of care, the French Society of Biological Psychiatry developed recommendations for clinical practice in bipolar disorder.

Method

The method chosen for these guidelines is a formalized consensus of experts. It enables, through a series of specific clinical situations proposed to the experts, to provide recommendations for the management of bipolar disorder. The situations where defined because they are not associated to evidence-based recommendations according to the lack of controlled studies.

Results

40 experts participate to this consensus. As in most of the guidelines for the treatment of bipolar disorder, more than 50 % of experts (51,3 to 72,9%) recommend the same therapeutic strategies to treat major depressive episode whichever the type (bipolar I or II).

Unlike to other guidelines, French experts propose different therapeutic according to the presence or absence of rapid cycling. For major depressive episode without rapid cycling, 63% experts recommend a combination of an antidepressant with a mood stabilizer. In rapid cyclers, 51% experts recommend the use of a mood stabilizer in monotherapy or in combinaison, but never associated with antidepressant.

Conclusion

This methodological approach enables to get closer to everyday clinical practice and integrate specificities of prescription through a national panel of experts. On the other hand, this type of methodology highlights the research perspectives: i.e. management of acute depression with rapid cycle in bipolar disorder.
P01-93 - Social, Occupational and Educational Function in a Representative Sample of Bipolar Patients Compared with the General Population
Authors: Schoeyen H. , Birkenaes A.B. , Vaaler A.E. , Auestad B.H. , Malt U.F. , Andreassen O.A. , Morken G.
Published: June 2010

Objective

There is a positive correlation between level of education and working function in the general population. Bipolar disorder (BD) is often associated with disability in social and working function. There is conflicting evidence considering educational achievements in BD patients.

Aims

Our aim was to investigate how education was related to social and occupational function in BD.

Method

Patients with DSM-IV BD (N=257; 69.3% BD I, 25.7% BD II, 5.1% BD NOS, 51.4% females) were consecutively recruited from mental health clinics throughout Norway. The majority of patients were recruited when in-patients. About 1/2 had at least once experienced a psychotic episode. The BD sample was compared with a geographically matched reference sample from the general population (N=56.540) on levels of education, marital status, income, and disability benefits. Further analyses of association were carried out using logistic regression analyses.

Results

A significantly higher proportion of subjects in the BD group than in the reference group was single, had low income, or was disabled. No between-group difference was found in educational level. In the reference group education was inversely correlated with the risk of being disabled, but no such relationship was found in the BD group. In BD patients rapid cycling and recurring depressive episodes were the only clinical characteristics associated with low educational level.

Conclusion

Despite similar levels of education, BD patients had lower socio-economic status than the general population, and no association was found between education and disability for BD patients.
P01-95 - Family Psychoeducational Intervention for Depression
Authors: Shimodera S. , Fukuzawa K. , Fujita H. , Morokuma I. , Mino Y. , Inoue S.
Published: June 2010

Background

We performed family psychoeducation for depression, and investigated the association between the education and expressed emotion of patients’ families and relapse of depression.

Methods

Of 103 patients diagnosed with major depressive disorder, and their primary family members, 53 patients and their primary family members gave consent. The patients were randomly allocated to an intervention or control group, consisting of 24 and 30 patients, respectively. The intervention group underwent 4 educational sessions and education in coping techniques. The relapse rate was compared between the intervention and control groups. In addition, the subjects were divided into high- and low-EE groups based on the EE judgment, and the effect of psychoeducation was compared in each group.

Results

The relapse rate during a 9-month period was 8.3% in the intervention group, being significantly lower than that (50%) in the control group. The relapse rate in the intervention group was slightly lower than that in the control group in the high-EE group, and significantly lower in the low-EE group. Regarding the influence of EE, in the control group, the relapse rate was 70% in the high-EE group, being significantly higher than that (40%) in the low-EE group. On multiple logistic regression analysis, psychoeducation (odds ratio: 25.53, 95% CI: 2.83-229.92) and the Hamilton score at the time of entry (odds ratio: 1.16, 95% CI: 1.045-1.298) were significantly associated with relapse.

Conclusion

It was suggested that the psychoeducation of families is very effective for the prevention of relapse in adult depressive patients.
P01-96 - Social Adaptation of the Patients with Depressive Disorders for the First time Admitted to the Psychiatric Hospital
Authors: Shmunk E.
Published: June 2010

Objectives

To investigate characteristics of prehospital period of patients with depressive disorders and their influence on the level of social functioning.

Methods

After informed agreement 102 patients with depressive disorders (DD) for the first time admitted to the psychiatric hospital were examined with RDC of ICD-10. For the assesment of the level of social functioning Social Adaptation Self-evaluation Scale (Bosc M. et al., 1997) was used.

Results

The average duration of DD before psychiatric examination was 19,1 months (up to 312 months). The average age was 43,8±11,5 years. Most patient had first depressive episode (61,8%), second 8,9%, third 2,9% and 4,9% had «double depression». The most part of the patients (61,8%) with DD saw their primary care (PC) doctors, 47,1% of them did it more than twice. The average number of visits to PC was 3,6 (up to 49), the average number of investigations was 2,4 (up to 8). The most part of visits to primary care (PC) fell at patients with heart complaints (р=0,02), the less part to patients with loss of energy (р=0,0007). More visits to PC were associated with low level of social functioning (r>-0,2, р<0,05). Low level of social functioning correlated with older age, duration and severity of depression, number of previous episodes and PC attendance.

Conclusions

In ddition to some clinical characteristics of depressive disorders the level of social functioning depends on PC visiting.
P01-122 - Experiential Avoidance in Subjects with Social Anxiety
Authors: Berrocal C. , Bernini O. , Cosci F.
Published: June 2010

Objectives

Experiential Avoidance (EA) has been conceptualised as one of the main vulnerability processes for psychopathology, including social anxiety, in the so-called ACT (Acceptance and Commitment Therapy) model - one of the “new wave” behavioral-cognitive approaches. EA refers to the degree to which an individual fuses with thoughts, avoids negative feelings, and is unable to act in the presence of difficult private events.

This study is aimed at exploring the role of EA in subjects with social anxiety.

Methods

Participants were 113 subjects recruited from the general population and with high levels of social anxiety as measured by means of the Liebowitz Social Anxiety Scale. Participants were classified into high and low experiential avoiders according to results from the Italian version of the Acceptance and Action Questionnaire.

Results

The two groups did not differ in gender, marital status, educational level, or age distributions. Between-groups differences on several psychological measures, including depression, general psychopathology, quality of life and well-being were explored. Results indicated that individuals with social anxiety reporting higher levels of EA showed higher levels of depression and psychopathology, and lower levels of quality of life and well-being than low-EA participants.

Conclusions

Consistent with theoretical predictions in the ACT model, these findings suggest that EA may play a significant role in moderating negative psychological outcomes in subjects with social anxiety.
P01-128 - A Comparative Study on Brain-behavioral Systems Action in Patients with Obsessive-compulsive and Phobia Disorders
Authors: Didehdar Ardebil M. , Fekri Y. , Hasani Goleyakh M.
Published: June 2010

Objective

This study aims at scrutinizing the action of Behavior-Brain systems in patients with obsessive-compulsive disorder and patients with Phobia by comparing them. The study is based on Jeffry Gary personality Theory.

Method

20 patients with obsessive-compulsive disorder and 20 patients with Phobia that matched together by age, education level and gender were selected from patients referred to consulting clinics in Ardebil in 2008. Gary & Wilson personality questionnaire administered for assessing the Behavior-Brain systems action. The collected data were analyzed using descriptive and independent T-test to test the hypothesis generated in the study.

Results

Analyzing the collected data shows that there is no significant difference between Phobic and obsessive patients in behavior activating systems and behavior inhabitation systems; but there is significant difference between two groups in fight -flight system.

Conclusion

The results of this study are in agreement with basic hypothesis of Gary's Reinforcement Sensitivity Theory and neuro-psychological status of patients with disorders. The reason of no significant difference between two behavior activating systems and behavior inhabitation systems in phobic and obsessive patients might be due to the similarity of behavior roots in these two disorders.
P01-132 - The Importance of Anxiety for Psychiatry and Psychotherapy
Authors: Fabian E.
Published: June 2010

Anxiety can be described as an archaic emotion pertaining to human life. Its manifestations are subject to cultural and social, as well as to familial influences. In our days, an increasing general anxiety is met by a widespread tendency to repress it. Open and repressed forms of anxiety are present in every psychiatric disturbance and illness, but are also part of socially accepted “normality”. Psychodynamically, all forms of pathological anxiety are linked to early neglect and traumatisation and are always accompanied by inner loneliness and contact disturbance. The association of anxiety and aggression and its implication for treatment are discussed.
P01-133 - Modifying Respiratory Functionality in Healthy Subjects: Towards Development of Anti-panic Breathing Therapy
Authors: Fadda E. , Catenazzi U. , Cammino S. , Ozino S. , Galimberti E. , Bellodi L.
Published: June 2010

Objectives

Several studies showed respiratory irregularities in patients with Panic Disorder (PD). This led to the development of the Breathing Therapy, a therapeutic strategy aimed to modify dysfunctional respiratory patterns. However, it remains unclear whether and how BT regularize respiration. The aim of this study was to evaluate whether and how a single performance of a specific respiratory technique could modify respiration at rest.

Methods

Twenty-eight healthy subjects were randomly assigned to two groups, performing either a slowed 9-breaths-per-minute respiration (group 1) or a “combined” respiration (group 2) so as to evaluate the most effective respiration able to produce respiratory modifications. Respiratory recording took 40 minutes including basal respiration (T1), breathing technique (T2), natural breathing (T3). We evaluated Tidal Volume (VT), respiratory frequency (RF) and end-tidal PCO2 (PetCO2) standard deviations (SD), Approximate Entropy (ApEn).

Results

In both groups ApEn values significantly decreased from T1 to T3. However, we observed an increase of ApEn values from T2 to T3 and of VT'SD from T1 to T2. In group 2 RF'SD decreased and PetCO2'SD increased from T1 to T3. RF'SD increase in both groups from T2 to T3.

Conclusion

Both techniques could modify respiratory physiology, leading to reduced ApEn values and increased respiration variability. The repeated practice of such respiratory techniques could modify respiratory functioning. Further studies are needed to determine which technique has the highest likelihood to reduce breathing irregularities and its possible use for the treatment of PD.
P01-135 - Anxiogenic Properties of a Virtual Reality Simulation for Panic Disorder with Agoraphobia
Authors: Freire R. , De Carvalho M. , Joffily M. , Zin W. , Nardi A.
Published: June 2010

Objectives

There are several useful methods to induce anxiety in patients with panic disorder with agoraphobia (PDA). Our aim was to ascertain if a virtual reality simulation could induce anxiety and physiologic alterations in PDA patients.

Methods

10 healthy controls (HC) and 10 patients who fulfilled DSM-IV criteria for PDA were recruited for this study. Before and after the experiment the anxiety level was measured with the Subjective Units of Distress Scale (SUDS), the Diagnostic Symptom Questionnaire (DSQ) was used to ascertain panic attack symptoms. The heart rate, skin conductance and respiration parameters were monitored during the exposure to the VR. The virtual reality simulation was a 3D computer animation of a short bus trip, from a first person perspective. The Igroup Presence Questionnaire (IPQ) was used to measure the sense of presence.

Results

PDA patients had higher familial history of panic disorder. From the 10 PDA patients only 3 were not taking medications. In PDA patients the VR exposure increased anxiety levels, they also had higher scores in the DSQ and two of them had panic attacks. Compared to the HC, the PDA patients had higher skin conductance levels, electrodermal response magnitude, respiratory rate, tidal volume, and respiratory rate irregularities. The heart rates were higher for patients who had panic attacks, followed by the HC and the non-panicking patients. Regarding the sense of presence the two groups were similar.

Conclusion

This study indicated that VR exposure may induce anxiety, electrodermal and respiratory alterations in patients with PDA.
P01-136 - A Quatitative Analysis about the Prevalence of PTSD after the Chemical Attack I Halabja/Kurdistan, Iraq
Authors: Hasan F.M.
Published: June 2010

The March 1988 genocide in Halabja, in which at least 4000 and as many as 7000 Kurdish women, children and men were killed by the then Iraqi regime under Saddam Hussein, was the most brutal gas attack on a civil population in modern history. This study is unique in that it challenges currently held understandings of PTSD and how traumatic transformations are expressed in other parts of the world. The study is quantitative analysis of the prevalence of PTSD in two Kurdish towns; Halabja and Suleimaniyah, encompassing 110 participants. The study's primary aim was to compare the prevalence of PTSD in Halabja with that in Suleimaniyah which was not attacked, the expectation being that PTSD would be more prevalent in Halabja than in Suleimaniyah. Secondly, that women and those with shorter education would report a higher prevalence of PTSD, and thirdly that participants with higher levels of social support would report a lower prevalence of PTSD. The results showed that the prevalence of PTSD in total, of reliving and of hyperarousal in the trauma exposed town was significantly higher than in the non-exposed town, thus supporting the primary hypothesis. Furthermore a significant connection was found between sex and PTSD and a clear linear relation between education and prevalence of PTSD, thus supporting the second hypothesis. However, the results showed no support for the third hypothesis. The study thus indicates that researchers and practitioners working with PTSD need a broader cultural understanding to carry out studies in the best possible manner.
P01-141 - Vasomotor Symptoms are Associated with Anxiety in Perimenopausal Women
Authors: Karaoulanis S.E. , Rizoulis A.A. , Lialios G. , Xiromeritis A. , Nasika Z. , Angelopoulos N.V.
Published: June 2010

Objectives

Menopausal symptoms of hot flushes and night sweats are defined as vasomotor symptoms. They are markers of declining serum estradiol, are not universal in menopausal women and may occur in women who are sensitive to the effects of estradiol on thermoregulatory centers and serotonergic, adrenergic, and norepinephrine neurotransmitters. The aim of this research was to find out if vasomotor symptoms were associated with anxiety in perimenopausal women.

Materials and methods

We examined perimenopausal women with anxiety and a comparison group of asymptomatic perimenopausal women. One hundred and two (102) women participated in the study, 44 suffering from anxiety and 58 normal controls. All women were between the ages 40 and 58 and presented with a history of menstrual cycle irregularity of at least six months duration but not longer than one year of amenorrhea. The diagnosis of anxiety was determined by an interview and the Hamilton Anxiety Rating Scale (HAM-A). Vasomotor symptoms were assessed with the Menopause Rating Scale (MRS). The association between vasomotor symptoms and anxiety in perimenopausal women was made using Wilcoxon-Mann-Whitney test.

Results

A significant relationship between vasomototor symptoms and anxiety was found in perimenopausal women. The severity of vasomotor symptoms was strongly associated with the severity of anxiety (p< 0.001).

Conclusions

It appears that hot flushes and night sweats are associated with anxiety in perimenopausal women.
P01-144 - A Lifestyle Intervention for Panic Disorder in Primary Care and an Explanatory Model
Authors: Lambert R. ,   Shared Decision-Making Unit of the Health and Social Sciences Research Institute, UEA, Norwich
Published: June 2010

Objectives

To examine the clinical and cost-effectiveness of a lifestyle-based approach to treating anxiety and Panic Disorder in Primary Care. To present evidence from an explanatory model.

Methods

A Pragmatic Randomised Controlled Trial was conducted comparing a lifestyle intervention with routine GP care. The lifestyle intervention used patient diary data focusing on diet, fluid intake, habitual lifestyle drug use (alcohol, nicotine and caffeine) and exercise, to influence mood and behaviour change. Following the MRC (2008) recommendation on developing and evaluating complex interventions, an explanatory model was developed.

Results

31 Lifestyle arm and 36 GP care arm patients completed to analysis. A significant improvement in Beck Anxiety Inventory scores was observed at end of treatment (Lifestyle 29.5 to 9.2; GP 29.4 to 17.2; p< 0.001) although non-significant at 10 month follow-up (Lifestyle 13.3: GP 16.4; p=0.167). Results were comparable with full CBT and improved compared with medication. Cost-effectiveness analysis showed that If maximum willingness to pay peradditional QALY is £30,000, this represents an 86% chance that a lifestyle intervention provides value for money over 10 months. Modeling shows a broad range of factors influencing anxiety and panic responses, indicating that lifestyle interventions impact at a different point in the system to medication and psychological approaches.

Conclusions

Evidence shows that a lifestyle-based intervention provides an additional, cost-effective intervention and significantly improved symptom profile for anxiety and panic disorder compared with routine GP care. It impacts on both physiological and cognitive symptoms. Modeling suggests broader application to other mental health problems.
P01-145 - Lamotrigine Administration in Panic Disorder with Agoraphobia
Authors: Masdrakis V. , Papadimitriou G. , Georgantopoulos G. , Kalogera E. , Konstantakopoulos G. , Oulis P.
Published: June 2010

Objectives

The potential efficacy of various antiepileptic drugs in the treatment of Panic Disorder (PD) with (PDA) or without Agoraphobia has been studied in clinical trials, though not as yet that of lamotrigine (LTG).

Methods

We administered LTG to four outpatients with PDA according to DSM-IV-TR criteria, as an augmentation therapy (three patients with chronic and severe agoraphobia) or monotherapy (one drug-naïve patient with first-onset PD and moderate agoraphobia). LTG was titrated up to 200 mg/day within a 6-week period and remained at that dosage for another eight weeks. The patients were clinically monitored every week, while standard psychometric evaluations were completed at baseline and after the end of the trial.

Results

The patient under LTG monotherapy exhibited a complete remission of his panic attacks and a significant improvement in agoraphobic avoidances and other outcome measures. Some improvement was evident after the clinical trial in one more patient who exhibited a complete remission of her spontaneous panic attacks and in another patient who exhibited reductions in both her anxiety levels and PD-related cognitions.

Conclusions

Although anecdotal and thus in need of replication in well-designed large studies, our preliminary findings suggest that LTG as monotherapy (at 200 mg/day) might improve significantly PDA symptomatology in a proportion of drug-naïve patients with recent-onset PD and moderate agoraphobia, while LTG as augmentation agent (at 200 mg/day) might improve at least some aspects of the clinical psychopathology of PD patients with chronic and severe agoraphobia.
P01-147 - Olanzapine Augmentation for Treatment-resistant Obsessive-compulsive Disorder
Authors: Darghal M.
Published: June 2010

Objective

We report the case of a patient with treatment-resistant obsessive-compulsive disorder (OCD) that had a significant reduction in obsessive-compulsive symptoms after the addition of the atypical antipsychotic to the Selective serotonin reuptake inhibitors (SSRIs)

Methods

Ms. A, a 31-year-old woman, with no family history of psychiatric disorders has been suffering from OCD for 4 years. His main obsession was contamination, and his compulsions (washing rituals) occupied 12 hours a day, rendering him unfit for work in there house or employment. Various treatments had been ineffective. His Yale-Brown Obsessive Compulsive Scale total score (Y-BOCS) at his first psychiatric interview was 38. He was taking clomipramine, sertraline, haloperidol, amisulpride, and alprazolam. Previous trials did not result in clinically meaningful responses (side effects prevented titration to higher doses), however all psychiatric drugs were discontinued except sertraline (100 mg/day) associated with olanzapine (5 mg/day).

Results

After 10 days, Ms. A reported significantly lessened anxiety and, after three months, significantly lessened obsessive-compulsive symptoms. By the fourth month, his symptoms were occurring for only few hours week (Y-BOCS total score of 16). At this point, the addition of olanzapine would appear to be a useful short- and long-term strategy for augmenting SRI effectiveness in resistant OCD patients.

Conclusion

Current options for treatment-resistant OCD include switching to an alternative selective serotonin reuptake inhibitor or augmentation with other agents. Our case suggests that olanzapine may be an option for treatment-resistant OCD, but controlled studies are needed to substantiate this observation.
P01-152 - Clinical Aspects of Anxiety and Depression in Multiple Sclerosis
Authors: Papari C.-A. , Cozaru C.G. , Papari A.
Published: June 2010

Objectives

Specialty studies show that the emotional state of the patient with Multiple Sclerosis is deteriorating in relation to the phisycal condition and medication and motor re-education without psychological re-education is just not effective. The present paper tries to make an evaluation of the anxiety and depression in pacients with Multiple Sclerosis.

Method

Two groups, each composed by 30 subjects(even proportions between men and women). The research group consisted of pacients diagnosed with MS and the control group, with subjects selected from the general population, not diagnosed with any chronic disease. Two tests were used: State Trait Anxiety Inventory and Beck Depression Inventory.

Results

Anxiety, as a trait of a personality is significantly evidenced in patients diagnosed with MS, in comparison to the control group. Depresive states, with variable intensity are also more frequent at the research group, compared to the control group. The highest average of the depression was recorded in subjects diagnosed with MS for 1 year. These results were coherent with the high scores of the patients from the research group, as well as the difference that is significant from the statistical point of view (p>0.10).

Conclusions

The frequency of the psychiatric disturbances in MS is much higher than the general population. Depression and anxiety contribute greatly to the development of the disability in this particular disease.
P01-154 - The Evaluation of Anxiety Prevalence between Students of First and Last Semesters of Ardabil University
Authors: Rezaei Ghalechi E. , Kazemi R.
Published: June 2010

Background

The aim of this study is the investigation of anxiety prevalence between first semester and last semester students in university and this research explains the rate of students’ anxiety in university's terms.

Methods

This investigation is a descriptive study that 120 students (60 F, 60 M) in Ardabil University from the first and final semesters as the accidental samples by questionnaire are selected. We used Cottle Anxiety test and gained results by SPSS and statistical analysis.

Results

First semester students' anxiety rate was (50%) and final semester students too (50%). (57.7%) of cases were native. most of them (93.3%) was jobless and single (87.5%).

Conclusion

This study shows that there isn’t meaningful relation between rate of Anxiety and age, situation of marriage, occupational situation and living place in first or last semester students of Ardabil University.
P01-158 - The Level of Anxiety Symptoms Prior a Thoracic Surgery is Associated with Gender and Age
Authors: Sikaras C. , Moussas G. , Voyagis G. , Maria A. , Anagnostopoulou M. , Tselebis A. , Bratis D. , Moulou A. , Ilias I. , Toutouzas K. , Kiritsi E. , Stefanadis C.
Published: June 2010

Objectives

An operation is undoubtedly a stressful event, which can induce emotional, cognitive and physiological reactions in preoperative patients. Aim of our study is to investigate the associations between the levels of state - trait anxiety and the demographics (gender and age) in patients prior a thoracic surgery.

Methods

Seventy-six (57 males and 19 females) patients, with ASA I-III and with mean age 45.65±15.17 years were included in the study. All subjects fulfilled the Spielberger State-Trait Anxiety Inventory (SSTAI), 12 - 15 hours before the thoracic surgery.

Results

Mean state and trait anxiety scores were 42.35±11.50 and 38.55±9.03, respectively and presented a strong positive correlation (Pearson Correlation, p< 0.001, r=0.585). Percentages of 30.3% and 13.2% of the sample were presented with clinically significant anxiety levels (t-test, p=0.001). Females appeared with higher state (t-test, p=0.001) and trait (t-test, p=0.076) anxiety scores compared to males. As to age, we observed a negative correlation with the levels of state and trait anxiety. (Pearson Correlation, p=0.05, r=-0,226 and p=0.006, r=-0.313, respectively).

Conclusions

Our findings suggest that females and younger patients are more vulnerable to anxiety symptoms prior a thoracic surgery. Thus, gender and age should be taken into account for the preoperative assessment in order to develop supportive psychological interventions.
P01-166 - Transitioning onto OROS MPH is Associated with Improved Functioning and Quality of Life in Adolescents with ADHD
Authors: Alfred A. , Lindermueller A. , Mattejat F. , Dichter S. , Schaeuble B.
Published: June 2010

Objective

To explore functionality and quality of life outcomes in adolescents with ADHD transitioning from IR MPH, ER MPH or ATX onto PR OROS MPH.

Methods

Pooled analyses of two similar 12 week open label, flexible dose, non-interventional trials exploring outcomes in adolescents with ADHD (ICD-10) transitioning from either IR / ER MPH, or Atomoxetine onto PR OROS MPH. Connor's parents rating scale (CPRS), children's global assessment scale (CGAS) and quality of life (ILC) were measured.

Results

186 adolescents (84.4% boys; median age 14yrs) were analyzed. Starting dose of OROS MPH was based on clinical judgment. Median dose of PR OROS MPH at baseline and endpoint was 36mg/day. Functionality based on C-GAS as well as burden of disease scores measured in parents and adolescents improved at endpoint (p< 0.001). 80% girls and 67% of boys achieved an at least 30% reduction on CPRS. ILC-LQ0-28 in adolescents and their care givers improved (p< 0.05). 56 adolescents (30,1%) experienced at least one treatment emergent adverse event (AEs≥4% were insomnia (4,8%), headache (3,7%), muscle twitches (3,2%).

Conclusion

Adolescents with ADHD transitioning onto PR OROS MPH showed clinically relevant improvement in daily functioning and quality of life aspects. Burden of disease in patients and their care givers was lowered.
P01-167 - Help Seeking Process for Children and Adolescents Attending Child Adolescent Psychiatry Service in Tirana
Authors: Alikaj V.
Published: June 2010

In Albania there is a need for data to support services for children and adolescents mental health, a needs assessment and also need for epidemiological data relevant to local circumstances.

Objective

of the help-seeking pathway study for children and adolescent mental health problems was to investigate all the potential routes to Child/Adolescent Psychiatry Clinic-University Hospital Center (CAPC-UHC) Tirana and to investigate factors influencing this process for children at risk.

Method

Participants were 5-18 years old, newly referred children/adolescents in CAMHS during 2006. Measures used were Strengths and Difficulties Questionnaire for parents/children, Pathways Encounter Form. Patterns of care seeking, durations and previous treatments for diagnosis within ICD-10 groups were prescribed. Analysis: Comparisons between groups, diagnosis and predictive factors influencing help seeking care.

Results

The child neurologist played an enormous role in referring the child to CAPC, followed by adult psychiatrist or GP. The most frequent diagnosis resulted to be pervasive developmental disorder (28.4%), phobic and anxiety disorders (19.1%), somatoform and dissociative disorders (17.3%), hyperkinetic and conduct disorder (15.4%).

Conclusions

This is the first study investigating the help seeking process to psychiatric care to CAPC Tirana-Albania. There is a need for further research on a general population level, including primary care settings, preschools and schools based services, because a clearer understanding is required about barriers to service use and also identifying children/adolescents with psychiatric disorders not referred to the specialist. These results could contribute to assisting a successful implementation of the National Service Framework for Children/Adolescents.
P01-169 - Psychometric Properties of Two new Screening Instruments for Depression in Childhood and Adolescence: Findings from a Pilot Study
Authors: Allgaier A.-K. , Frühe B. , Pietsch K. , Schulte-Körne G.
Published: June 2010

Objectives

Depression is highly prevalent, but often unidentified in pediatric primary care. Without treatment, early-onset depression often leads to psychosocial impairment and is associated with a high risk of recurrence, chronicity and comorbid mental illnesses. While depression screening is recommended for adults in the primary care setting, screening instruments for children and adolescents are still rare. Therefore, the study group developed two depression screeners in German language, specifically designed for this age group. In a pilot study, psychometric properties of these screeners are computed.

Methods

This is a cross-sectional study of a pediatric clinic sample of 100 children and adolescents aged 9-16 years. To assess screener performance, item analysis and realibility measures were calculated. Further, validity measures were computed, using a standardized clinical interview as gold standard criterion for depression diagnosis.

Results

The pilot study is ongoing until January 2009. Items analysis results are presented as well as internal consistency. Validity measures are illustrated by ROC curve analyses.

Conclusions

Based of the results of the pilot study, the screening instruments will be revised. To confirm our preliminary findings, the screeners will be tested in a larger sample during the main study. If the depression screeners have proven to be reliable and valid, in the long run they can be implemented in pediatric primary care as a diagnostic aid.
P01-170 - Bullying and Depression among Children
Authors: Aoki T. , Miyashita M. , Inoko K. , Kodaira K. , Osawa M.
Published: June 2010

Objectives

To investigate the relations between acting the bully, being bullied, seeing someone bullied and depression in children.

Methods

108 children (6 to 13 years of age, students of one school - 1st to 7th grade) participated in this study. They completed questionnaires regarding acting the bully, being bullied and seeing someone bullied. The questionnaires include 5 psychological bully questions respectively, and they consist of 15 questions. The Center for Epidemiologic Studies Depression Scale (CES-D) Japanese-version was also completed by the children.

Results

12 children scored 16 or higher on CES-D. The children were supposed depression. 50 children answered “yes” to one or more question of 5 ones with regard to acting the bully. They were supposed acting the bully. 67 children and 75 children were supposed being bullied and seeing someone bullied respectively. Logistic regression analysis was performed to determine whether acting the bully, being bullied and seeing someone bullied were associated with depression.Being bullied was significantly associated with depression [Odds ratio 21.82 (95% confidence limits 1.86-256.20)]. Acting the bully was associated with depression [Odds ratio 4.681(95% confidence limits 0.767-28.580)]. Seeing someone bullied had no association with depression [Odds ratio 0.10(95% confidence limits 0.01-0.74)].

Conclusions

Being bullied greatly affected the emotion. Younger children are said to be more likely to be victims of bullying. Appropriate interventions in the school children are needed.