bluuebunny/crossref_metadata_2025 huggingface dataset:
1059 – Clinical Psychiatric Research School
Authors: Okkels N. , Ahlers F.S. , Andersson N.A.W. , Harboe L.F. , Knudsen M.S. , Lundberg A.S. , Midtgaard J. , Okkels A.S.L. , Munk-Jørgensen P. ,   Clinical Psychiatric Research School
Published: July 2013

Introduction

During the past three decades psychiatry has suffered from a decline in the recruitment of young physicians across Europe. The challenges for clinical psychiatric research are even worse. After psychiatry has declared itself a medical (neuro) speciality the situation is now shifting towards the better.

Active innovation programs are however needed to accelerate this recent positive trend.

Objective

To introduce and train medical students in clinical psychiatric research methodology by practical research work supported by theoretical teaching.

Aims

To describe a local initiative done by AUH Risskov, Department M in Denmark implementing a clinical research teaching program for medical students.

Methods

We invited students of medicine known as dedicated and pro-active and posted the program on our website. Students responding positively to our invitation were interviewed by the first and senior author before being accepted into the program.

Results

The group consists of 8 medical students and one psychology student in their third to the tenth term (of 12) at university. They are all given minor research questions relevant to the clinical department. The trainees are supervised in groups and individually parallel to systematic teaching. Further details will be given at the presentation.

We have deliberately sought out the most qualified students with an elitist approach. The participants commit themselves to act in an active, independent and disciplined way when accepted into the program.

The participants will be present at the Nice congress ready for discussion and with answers to any questions about the program.
1060 – The Role Of Clinical And Dimensional Personality Factors On Chronic Medical Comorbidty In Patients With Major Depressive Disorder
Authors: Enatescu V.R. , Enatescu I. , Enatescu V. , Romosan R.S. , Papava I. , Ienciu L.M.
Published: July 2013

Introduction

Major depressive disorder, the most prevalent psychiatric disorder in general population, raises a series of clinical challenges, chronic medical comorbidity being regular one.

Objectives

Our main objective was to analyze the weight of anxiety and depressive symptoms levels, and that of premorbid personality traits, in co-occurrence of medical diseases in subjects with major depressive disorder.

Methods

A cross-sectional research was performed on 32 inpatient subjects admitted in Timisoara Psychiatric Clinic during 2010 - 2012 with major depressive disorder. Anxiety symptoms level were self-assessed with Beck Anxiety Inventory and depressive symptoms level were self-assessed with Beck Depression Inventory. Temperament and character personality traits were self-assessed using Cloninger TCI tool, which was administrated once that clinical remission has occurred.

Results

Majority of studied subjects (71%) have had at least one comorbid chronic medical diseases. Despite the results of other studies, the level of depressive and anxiety symptoms has no significant impact in medical comorbidity occurrence. Major depressive subjects with medical comorbidity, have had significant higher scores in Harm Avoidance, more exactly in Shyness with Strangers (p = 0.007) and Fatigability (p = 0.013). Significant higher total scores were revealed, in the same subjects, for all three character dimensions like as Self-Directedness (p = 0.004), Cooperativeness (p = 0.039) and Self-Transcendence (p = 0.030).

Conclusions

According to our research results, rather than temporary clinical symptoms constituting clinical picture of subjects with major depression there is possible that premorbid personality traits could weigh more significant to the appearance of medical comorbid conditions.
1062 – Predictors For Remission Of Major Depression And Anxious Disorders And For Developing Disorders In An Epidemiologic Catchment Area In Montreal, Canada: a Longitudinal Study
Authors: Caron J. , Aihua L. ,   Équie des IRSC en Épidémiologie Sociale et Psychiatrique
Published: July 2013

Objectives

The aim of this study is identifying the predictors of major depression and anxiety disorders and the predictors of the remission of these disorders.

Methods

A longitudinal study under the form of a community survey includes a randomly selected sample of 2,434 individuals between 15 and 65 years of age (T1); 1,815 agreed to be re-interviewed two years later (T2). Mental disorders were identified with the Composite International Diagnostic Interview, including mood disorders (major depression, and mania), and some anxiety disorders: panic disorder (PD), social phobia (SP), and agoraphobia (AG). Logistic regression was used to identify predictors (T1) of remission of mood disoders and anxiety disorders at T2 and predictor of new cases at T2.

Results

The prevalence of mental disorders for the two waves of the research program will be presented. For major depression (MD), among the 145 subjects who had MD at T1, 69% recovered at T2 and among the 1553 that did not have MD at T1, 5.7% developed MD at T2. For anxiety disorders, among the 93 subjects who had these disorders at T1, 78.4% recovered at T2 and among the 1635 subjects who were free of an anxiety disorder at T1, 1.8% developed it at T2. Predictors identified for remission of disorders and for developing new disorders at T2 will be presented.

Conclusion

The predictors of new cases identified will allow to develop more effective prevention program and those associated to remissions will help to improve mental health services.
1064 – Does Internet Promote Self-harm Behavior?
Authors: Guerra C. , Ferreira P. , Moura M. , Silva A.
Published: July 2013

Introduction

Self-harm is a major public health problem, being a frequent condition among youth and young adults. Psychiatric conditions, like borderline personality, depression, substance misuse and anxiety disorders, are commonly associated with self-harm. The effects of media and contagion are also important and the internet has an important role in divulging and sharing self-harm behaviors.

Aims

We pretend to study the role the internet in potentiating or preventing self-harm behaviors.

Methods

We used combined literature searches in PubMed and B-on using the terms “self-harm”, “self injury”, “self mutilation” and “internet” and we also present a clinical case from our service.

Results

Most of the individuals that have self-harm behaviors may never present in psychiatric ward. Today, there is more information about self-harm available to the public domain than ever and web sites about self-harm include personal pages, forums, blogs, communities and even video-sharing sites. These web sites have supportive content that allow the users feeling that they are not alone, sharing feelings and narratives. However, most of them have potentially harmful material, including self-injury related tips, reinforcing messages and triggering material, normalizing or even glamorizing self-injury.

Conclusions

Most of the websites normalize and promote self-harm behaviors. Only the better knowledge of these phenomena would allow the use of internet as an effective tool for self-harm prevention, especially for socially-isolated and vulnerable individuals.
1066 – Inflammation As Common Denominator Of Ed And Mdd
Authors: Khan M.H. , Mukhtar M.Z. , Javad R. , Naiz S.
Published: July 2013

Introduction

Comorbidity between ED and depression is high. Causal relation between two is bidirectional. Person with ED can have MDD because of psychological factors. MDD symptoms and associated hypogonadism affect on libido and erectile function. Diseases like ankolysing spondolysis, asthma, rheumatoid arthritis, coronary heart disease, psoriasis, diabetes, and multiple sclerosis have strong co morbid ED and MDD. Inflammation is common overlapping factor in these illnesses.

Method

An internet search was made on pubmed, and psychiatrist.com, using key words, major depression, endothelial dysfunction, inflammation, erectile dysfunction, and cytokines. This was followed by study of relevant martial in different journal and books.

Result

Men with ED had high levels of depressive, somatic, and anxious symptoms. Approximately one-third of people with MDD had higher levels of peripheral inflammatory marker. Incidences of ED are two fold higher in depressed people as compared with nondepressed.

Discussion

Levels of pro inflammatory cytokine like IL-1,I patient L-6,TNF,CRP, interferon-gamma and homosystien are raised in MDD. Cytokines effect on the HPA axis, glucocorticoid resistance, neurotransmission and hippocampal neurogenesis. Patients treated with interferon have higher risk of developing MDD .Antidepressant therapy results in decreased inflammatory response.

Erectile function depends on integrity of endothelium which is target of inflammation. Endothelial dysfunction is linked to ED as they share a common pathway through the release of nitric oxide. Proinflammatory cytokines and homosystien play role, both in ED and MDD.

Conclusion

Inflammation and its markers need to be considered in cases of co morbid ED and MDD.
1070 – Expression Of Caspase-12 And Grp94 In Medial Prefrontal Cortex Of Ptsd Rats
Authors: Zhao D. , Han F. , Shi Y.
Published: July 2013

Introduction

Post-traumatic stress disorder is an important manifestation of mental and behavioral disorders after the disaste Single-prolonged stress (SPS) is an received established animal model for post-traumatic stress disorder.

Objectives

To investigate endoplasmic reticulum apoptosis pathway and unfolded protein reaction plays an important role in medial Prefrontal Cortex of PTSD rats by Single-prolonged stress (SPS).

Aims

Determined by the change of free intracellular Ca2+ the glucose-regulated Protein (GRP)94 and apoptosis-related cacaspase-12 expression.

Methods

A total of 60 healthy, male Wistar rats were selected for this study,randomly divided into a normal control group and SPS groups of 1d,4d,7d,14day and 28day. Behavioral of learning and memory capabilities of rats was observed by using Morris water maze. The expression of, GRP94 and cacaspase-12 was detected using immunohistochemical,Western Blotting and reverse transcription-polymerase chain reaction.

Results

In this study compared with control groups the intracellular free calcium level in mPFC was increased 1 day after SPS exposure (P< 0.05) decreased 7 days after SPS. The expression cacaspase-12 peaked at SPS 7d and then gradually decreased. GRP94 express in normal control group and increased 1 day after SPS exposure peaked at SPS 7d and then gradually decreased, at SPS 28d still higher than normal control group.

Conclusions

In SPS-PTSD rats the learning and memory capabilities of the rats decline;mPFC free intracellular Ca2+ may relate to endoplasmic reticulum stress;Endoplasmic reticulum stress launch unfolded protein reaction Endoplasmic reticulum apoptotic process which may relate to the pathogenesis of medial prefrontal cortex abnormal function in PTSD.
1072 – OPRM1 Gene Polymorphisms In Opioid Addiction
Authors: González D. , Cañadas M. , Aguilera M. , Reyes J.A. , Calleja M.Á. , Plaza A.
Published: July 2013

Introduction

Opioid addiction is a serious health/social problem, associated with high morbidity and mortality.Several gene polymorphisms on the mu-opioid receptor gene(OPRM1), which plays an important role in reward system, have been related to opioid dependence (A118G, C17T, C2044A). A118G is the most studied and probably the most promising biomarker of better response in these patients, despite discrepancies has been manifested even in studies conducted on the same ethnicity.

Objectives and aims

Description of A118G, C17T and C2044A allele frequencies in an opioid-dependent population. Evaluation of the association of A118G gene polymorphism with opioid dependence.

Methods

Case-control Study.

Case group: 16 patients with opioid addiction, included in a Heroin Prescription Program in Andalusia, based on the protocolized individual prescription of diacetylmorphine. Control group: 32 non opioid-dependent subjects.Genotyping of A118G, C17T and C2044A was performed by Polymerase Chain Reaction and Restriction Fragment Length Polymorphism.

Results

Case group: 12 patients were AA homozygous (12/16;75%) and 4 patients were heterozygous AG (4/12;25%) for A118G. All patients were homozygous CC for C17T and C2044A (16/16;100%). The distribution of the genotype frequencies of OPRM1 gene polymorphisms in the case series were not statistically different from those reported for European populations in HapMap for A118G (p=0.6418) and the GENO PANEL for C17T. Control group:19 patients were AA homozygous(19/32; 59.4%) and 13 patients were heterozygous AG (13/32;40.6%) for A118G. This polymorphism was not associated to opioid addiction (p=0.3503).

Conclusions

Distribution of genotype frequencies in opioid dependants corresponded to specific frequencies from European population for A118G and C17T polymorphisms. OPRM1 gene polymorphisms were not associated to opioid addiction in this population.
1073 – Assessment Of Behavioral Symptoms In Dementia Patients With The Help Of Icts
Authors: König A.
Published: July 2013

Introduction

Behavioral and psychological symptoms in dementia patients (BPSD), represent a strong predictor of dementia progression. Current interview-based assessment methods lack objectivity to ensure reliable early differential detection. Therefore, the use of Information and Communication Technologies (ICT) such as actigraphy and automatized video monitoring are of interest in addition to current assessment methods because they allow capturing the patients’ performances and actions in real time and real life situations.

Objectives

To improve the quality of clinical assessments of BPSD by validating the use of objective measurements obtained by ICTs in dementia patients in an experimental design, undergoing an „ecological assessment“.

Methods

Demented and pre-demented patients (with and without apathy) and healthy controls underwent an experimental trial wearing an actigraph and being filmed over a free period of 15 minutes in a in 16-zone divided room. Apathy was assessed using NPI apathy subscore. Frequency of zone displacement, and of goal-oriented zones, object manipulation, mean motor activity and speed of walking were assessed with the help of ICT.

Results

Significant differences were found between apathy and non-apathy AD patients for the parameter of object manipulation (OM) and OM in goal-oriented zones (GOZ) but not for frequency of zone displacement (FZD).

Conclusions

Moderate evidence for a reliable detection of apathy in dementia patients through data obtained by ICTs was found. Therefore, it represents a promising addition to conventional neuropsychological methods for future studies, focusing in particular on object manipulation and visuomotor deficits.
1078 – Is There Evidence For a Link Between Stress And Addiction?
Authors: Christoforou R. , Hagan C.C. , Jones P.S. , Williams G.B. , Ersche K.D. ,   KD Ersche s Addiction Research Lab
Published: July 2013

Introduction

Stress and reward processing are two of the principal mechanisms involved in the modulation of homeostasis in the body. According to neurobiological research, these two mechanisms overlap in the cortico-striatal-limbic circuit, which can be disrupted due to chronic stress and substance abuse. Stress is primarily modulated by the hypothalamic-pituitary-adrenal (HPA) axis, from which cortisol is an end-product.

Objectives

The aim of the study was to investigate the effects of chronic stimulant abuse on the cortico-striatal limbic circuit. This was examined by relating cortisol levels with grey matter volume in brain structures associated with addiction and stress.

Aims

We hypothesised that stimulant-dependent individuals show increased cortisol levels and abnormalities in the corticostriatal- limbic circuit. We further hypothesised relationships between altered grey matter volume and increased cortisol levels in the patients.

Methods

Twenty-two stimulant-dependent individuals and 21 healthy volunteers (matched for age and gender) underwent an assessment session and structural MRI brain scan. Cortisol was assessed in saliva and blood plasma. Mood, impulsivity and compulsivity were measured by clinical instruments.

Results

Stimulant-dependent individuals showed higher levels of cortisol in both saliva and blood, which were associated with distinct alterations in grey matter volume in fronto-limbic structures. Plasma cortisol was positively correlated with the duration of cocaine use. No relationships were found with current mood, trait-impulsivity and drug-related compulsivity.

Conclusions

The relationships observed between cortisol and fronto-limbic structures may, in part, be explained by HPA axis dysfunction and its downstream effects on brain structures involved in stress modulation in stimulant-dependent individuals.
1081 – Detention And Mental Health Of Torture Survivors - What Do We Know And What Do We Do?
Authors: Engberg M.
Published: July 2013

Introduction

Torture survivors often present a complex clinical picture with mental and physical symptoms and illness in addition to social incapacities. Torture survivors can be subjected to deprivation of liberty in a variety of situations. Detention might remind the torture survivor of former torture experiences and thus add further to the strain of being detained.

Objective

To evaluate and discuss the present knowledge of mental health consequences of detention of torture survivors and to present and discuss practices relating to detention.

Aim

To focus attention on existing evidence and problematic practices in relation to this.

Methods

Results from key publications within the field will be resumed and discussed and implications outlined.

Results

Research on the impact of detention on torture survivors is almost non-existent. A negative impact of detention on mental health of torture survivors can however be deducted mainly from the existing evidence on asylum seekers. Whether screening for torture experiences and following systematic monitoring of mental health are going on worldwide remains obscure, but from a Danish perspective it is likely that torture survivors are not identified.

Conclusion

Torture survivors constitute a vulnerable group mentally, physically and socially. A negative impact of detention on mental health can be deducted mainly from studies on asylum seekers. Identification of torture survivors is necessary before decision on detention is taken. Scientific evidence on the subject is missing. Research initiatives and monitoring of practices are necessary.
1085 – Haematological And Biochemichal Changes In Depressed Patients
Authors: Papaliaga M.N. , Saleptsis V.G. , Tsougenis N.A. , Giannoukas A.D. , Mouzas O.D.
Published: July 2013

Introduction

Several studies so far have addressed the issue of haematological and biochemical changes in depressed patients, but the results have been contradictory.

Method

Twenty four depressed patients (7 male/17 female, age:42.72±12.22) and 30 control subjects (6 male/24 female, age:43.60±10.25) were studied. Beck Depression Inventory (BDI) was used to assess their emotional state and haematological, biochemical tests were conducted. Because of the small sample sizes, statistical significance was examined using non-parametric Mann-Whitney test.

Results

As expected, patients had higher BDI total score than controls (mean±SD: 22.0±17.21 vs. 8.77±6.79, mean rank: 25.32 vs. 15.15) and higher values in most (13/21) BDI statements. Patients also had higher Hct (mean rank: 33.90 vs. 22.38), Hgb (mean rank: 33.52 vs. 22.68), urea (mean rank: 32.19 vs. 23.75), cholesterol (mean rank: 32.04 vs. 23.87) levels than controls, but lower serum glucose levels (mean rank: 21.69 vs. 32.15).

Conclusion

Although higher serum lipid levels have previously been connected with depression, to our knowledge, no such association has so far been established for higher serum urea, lower serum glucose levels, or higher Hct and Hgb.
1087 – You Are What You Eat! What Does This Mean In Stimulant Dependence?
Authors: Whitelock C.F. , Ersche K.D. ,   KD Ersche s Addiction Research Lab
Published: July 2013

Introduction

Nutrition has been linked to the development and deterioration of cognitive functions in normal and disordered populations. Drug-dependent individuals show a variety of cognitive deficits and seem to differ in their diets from healthy people. Despite this, there has been very little investigation into the potential relationship between nutrition and cognition in drug dependence.

Objectives

To investigate the effects of nutritional factors on cognitive performance in drug-dependent individuals.

Aims

To test the hypothesis that stimulant (cocaine or amphetamine)-dependent individuals’ and healthy volunteers’ diets significantly differ, and that these differences are related to their cognitive performance.

Methods

Stimulant-dependent individuals (N=58) and age-matched healthy volunteers (N=63) completed a Food Frequency Questionnaire to assess usual food intake, a set of computerised neurocognitive tests, and a selection of clinical questionnaires.

Results

Controlling for their levels of education, stimulant-dependent individuals performed significantly worse than healthy volunteers on tests of learning, memory and attention. The nutritional content of stimulant-dependent individuals’ diets also differed significantly, controlling for differences in caloric and alcoholic intake. However, whilst healthy volunteers’ ingestion of nutrients such as fruit and electrolytes were related to their processing speed in a test of sustained attention, no such relationship was found in the stimulant-dependent group.
1092 – Cortisol Awakening Response (car) And Gender Differences In Adults With Attention Deficit Hyperactivity Disorder (adhd)
Authors: Palomar G. , Paris J. , Corominas M. , Ramos-Quiroga J.A. , Ferrer R. , Catalan R. , Real A. , Ramirez C. , Casas M.
Published: July 2013

Introduction

Ahe adult patients with attention deficit hyperactivity disorder (ADHD) are characterized by an increased vulnerability to daily life stressors. Cortisol awakening response (CAR) can be used as an index of the adrenocortical activity that relates to chronic stress. Although gender differences in cortisol response have been explored in children with ADHD, there is a lack of gender studies in adults with this disorder.

The aim of the present study is to evaluate possible gender differences in CAR in adults with ADHD.

Methods

A total of 50 patients (22 female, age 37.00±8.62 years, and 28 male, age 33.86±9.57 years), with ADHD were recruited from the program for adults with ADHD in the Department of Psychiatry of the Hospital Universitari Vall d’Hebron. Patients fulfilled current DSM-IV diagnostic criteria for ADHD. Psychiatric and organic comorbid disorders were excluded and all the patients were naïve to psychostimulant treatment. Four salivary cortisol samples were collected at 0, 30, 45 and 60 minutes after awakening (work days).

Results

Mean increase in CAR was 10.39±8.68 nmols/l for men and 10.29±9.13 nmols/l for women. T-test comparisons showed no significant gender differences in CAR in adults with ADHD (t= 0.033, z=0.974).

Conclusions

As reported in children, adults with ADHD show no differences in CAR. Albeit these results are still preliminary, they suggest some gender differences in CAR between adults with ADHD and cortisol response in general population.
1093 – Eating Disorders: Hormonal Alterations And Psychopatological Features
Authors: Del Basso G. , Focà F. , Craba A. , Blanco P. , Strangio A.M. , Rinaldi L. , Bria P.
Published: July 2013

Objective

To demonstrate the complex correlation existing in patients with eating disorders between hormonal alterations and psychopathological symptomatology, that has been little studied until now.

Methods

60 women aged between 16 and 35 years and diagnosed with Anorexia Nervosa and Bulimia Nervosa according to the DSM-IV were assessed using the SCL-90-R, EDI, BAT and DES II. A blood sample was taken from each patient in the morning, on the seventh day of the menstrual cycle or on the corresponding day from the women with amenorrhea; the following hormone levels were measured: TSH, FT3, FT4, LH, FSH, 17-beta-estradiol, cortisol, DHEAS. Pearson's Correlation Coefficient has been used to test the correlation between hormonal level and test scores.

Results

Positive correlations exist between BMI and FT3 and LH, which decrease when BMI decreases. We can observe positively significant correlations between LH and FSH levels and the BAT scale scores.No one significant correlation was found between hormonal levels and dissociative symptoms as measured by DES. With regard to EDI, the following psychopathological features correlate with hormonal assessment: the wish to be thin, body dissatisfaction and perfectionism.

Conclusions

Our findings suggest a significant correlation between psychopathological features we considered and hormonal readings, especially LH, FSH, TSH, FT3. When these hormonal readings decrease, the patients’ self-ratings and their body dissatisfaction decrease. That attributes a protective meaning to the dietary symptom akin to an effective measure that relieves the person's feelings of inadequacy.
1100 – Safety, Tolerability And Treatment Response With Flexible Doses Of Paliperidone Palmitate In Patients With An Acute Exacerbation Of Schizophrenia
Authors: Schreiner A. , Hargarter L. , Bergmans P. , Cherubin P.
Published: July 2013

Objective

To explore tolerability, safety and treatment response with flexible doses of paliperidone palmitate in adult patients with an acute episode of schizophrenia.

Methods

Interim analysis of a prospective 6-month, open-label, multicenter study in adult patients with schizophrenia. Outcomes were change in the Positive and Negative Syndrome Scale (PANSS) total score from baseline to endpoint, Clinical Global Impression-Severity Scale (CGI-S), patient functioning (Personal and Social Performance Scale; PSP), weight change and adverse events (AEs).

Results

Of the first 104 patients included (54.8% male, mean age 37.6±11.8 years, 81.7% paranoid schizophrenia, recommended paliperidone palmitate initiation regimen used in 89% of subjects), 65.4% completed the study. Most frequent reasons for discontinuation were AE (13.5%), subject choice (8.7%) and loss to follow-up (5.8%). Mean total PANSS score decreased from 99.5±15.5 at baseline to 71.0±26.9 at endpoint (mean change -28.6±26.2; 95% confidence interval [CI] -33.8; - 23.4; p< 0.0001) with 60.6% of the patients showing improvement of ≥30%. Mean CGI-S score changed from 5.0±0.8 at baseline to 3.6±1.3 at endpoint (95%CI -1.7; -1.1; p< 0.0001). Patient functioning improved from a mean PSP baseline score of 42.7±13.9 to 59.0±18.7 at endpoint (95% CI of change 12.7; 19.9; p< 0.0001). AEs reported in ≥5% were psychotic disorder (15.4%), insomnia (14.4%), injection site pain (13.5%), headache (8.7%), salivary hypersecretion (6.7%) and anxiety (6.7%).

Conclusion

These data support results from recent randomized controlled studies that flexibly dosed paliperidone palmitate is safe, well tolerated and associated with clinically meaningful treatment response in patients suffering from an acute episode of schizophrenia.
1109 – Sleep Disorders And Suicidal Behavior In Patients Admitted To The Emergency Department
Authors: Forte A. , Innamorati M. , Longo L. , Mazzetta C. , Serafini G. , Girardi P. , Pompili M.
Published: July 2013

Introduction

Patients with sleep disorders have a significant increase in suicidal ideation and suicide attempts, at the assessment and lifetime (Goodwin et al, 2008; Chellappa et al, 2007; Wojnar et al, 2009; Li et al, 2010).

Objectives

To evaluate the relationship between sleep disorders and suicidal behavior.

Aims

To study factors associated with a diagnosis of insomnia in patients admitted to the Emergency Department.

Methods

Participants were 843 patients consecutively admitted to the Emergency Department of the Sant’Andrea University Hospital in Rome, Italy, between January and December 2010. All patients admitted were referred to a psychiatrist. A clinical interview based on the MINI and a semi structured interview were performed. Patients were asked about “ongoing” suicidal ideation or plans for suicide. Clinical diagnoses were assigned according to ICD-10 criteria.

Results

48% received a diagnosis of a mood disorders (BD and MDD) or anxiety disorders, 17.1% Schizophrenia or other non-affective psychosis. Patients with insomnia had more frequently a diagnosis of BD (23.9% vs. 12.4%) or MDD (13.3% vs. 9.5%; P< 0.001). Patients with insomnia less frequently had attempted suicide in the past 24 hours (5.3% vs. 9.5%; P< 0.05) than other patients, but suicide attempters with insomnia more frequently used violent methods (64.3% vs. 23.6%; P< 0.01) than suicide attempters without insomnia.

Conclusions

Our results support a relationship between sleep disorders and suicidal behavior. Clinicians should pay attention to sleep disorders when assessing suicide attempters; in fact, such conditions may have important clinical implications.
1112 – Every Contact Counts: Audit Investigating Extent Psychiatry Trainees Maximise Opportunity For Physical Health Assessment When Admitting Patients To Psychiatric Hospital
Authors: Beck K. , Stephenson L. , Brayford B. , Wilford L. , Potter L. , Suleman S.
Published: July 2013

Background

Patients with severe mental illness have significantly reduced lifespans. Excepting suicide, cardiovascular risk is the biggest cause. The problem is exacerbated by psychotropic medication and poor primary care engagement. Therefore psychiatrists should maximise every opportunity to promote physical health.

Aim

We audited physical examination, investigations, and documentation of past medical history (PMH) & assessments in inpatients. We used the Royal College of Psychiatrist's Physical Health in Mental Health Scoping Group 2009 guidelines as our standard.

Methods

We audited notes of all 125 patients admitted to four wards at Ladywell unit over two months (01/07/2011- 31/08/2011). We surveyed trainees to identify training and resource needs and facilitate focussed interventions.

Results

Physical Examination: 102/125(82%) received physical examination, 60/125(48%) on admission. Average delay before examination 12 days.

Blood tests/Investigations: 89/125(71%) received blood tests: 50/125(40%) thyroid function, 67/125(54%) liver function, 28/125(22%) glucose, 1/125(0.8%) HbA1c, 38/125(30%) lipid profile. 48/125(38%) had urine drug screening, 55/125(44%) ECG.

Documentation: The following was documented: 102/125(82%) PMH, 82/125(66%) allergies, 90/125(72%) smoking status. The following was scanned into records: 23/55(42%) ECG, 72/125(58%) physical observation chart.

Survey: The trainee survey highlighted need for training updates on physical health and problems in equipment provision.

Conclusions

Physical assessment is inconsistent, neglecting metabolic screening. Admission is a vital window for screening/modifying physical health.

Recommendations

Focussed assessment guidelines should be formulated. Following the survey, teaching led by consultant physicians has been organised on identified topics including metabolic syndrome. Lack of equipment will be addressed by creation of comprehensive equipment lists, to be distributed to ward administrators.
1113 – Dynamics Of Cognitive And Behavioural Therapy-related Fmri Changes In Obsessive Compulsive Disorder Using a Personalised Symptom Provocation Task
Authors: Morgiève M. , N’Diaye K. , Haynes W.I.A. , Granger B. , Clair A.-H. , Pelissolo A. , Mallet L.
Published: July 2013

Background

Cognitive and Behavioural Therapy (CBT) is a successful treatment of obsessive-compulsive disorder (OCD). It is known to induce changes in cerebral metabolism, but the dynamics of these changes and their relation to clinical evolution remain largely unknown, precluding the identification of individualized response biomarkers.

Methods

We performed systematic clinical and fMRI evaluation of 35 OCD patients immediately before a three-month course of CBT, halfway through and at its end, as well as 6 months after in order to study the dynamics of treatment response. To sensitize fMRI probing, we used an original exposition task using neutral, generic and personalised obsession-inducing images.

Results

CBT produced a significant improvement in OCD, already predicted by response at midtherapy (r2=0.67, p< .001). Initially, patients were more sensitive to personalised than generic or neutral images and had stronger related activations in the anterior cingulate, orbitofrontal and parietal cortices. In the high responder group (ΔYBOCS>45%), behavioural sensitivity to generic stimuli was reduced, even more so for personalised ones. Clinical improvement was markedly concomitant to a decrease of activity in the anterior cingulate and left but not right orbitofrontal cortices.

Conclusions

Using an innovative and highly sensitive exposition paradigm in fMRI, we show that clinical and metabolic phenotypes have parallel evolutions during CBT. Our results, which suggest that the initial CBT sessions are crucial, prompt us to investigate the anatomo-functional modifications underlying the earlier stages of the therapy.
1114 – Facing Fear And Anger: Impaired Facial Expression Recognition And Neural Abnormalities In Cocaine-dependent Individuals
Authors: Arlt J.M. , Hagan C.C. , Jones P.S. , Calder A.J. , Williams G.B. , Ersche K.D. ,   KD Ersche s Addiction Research Lab
Published: July 2013

Introduction

Cocaine dependence has been associated with emotional dysfunction as well as social inhibition. Given the drug's powerful effect on emotional state, chronic use may impact the neural networks used for emotional processing, and this impact may manifest in altered behaviour.

Objectives

To test the hypothesis that stimulant-dependent individuals less accurately identify expressions intended to elicit inhibitory or avoidant responses (ie fear, anger, disgust), and that this behaviour may, in part, be related to differences in the underlying neural networks for processing these emotions.

Aims

To detect differences in facial expression classification and corresponding neural networks in cocaine-dependent individuals versus healthy controls.

Method

Cocaine-dependent men (N=32) and age-matched, healthy men (N=29) completed two computerized facial classification tasks (Benton Facial Recognition test and Emotion Hexagon task) and underwent structural MRI scanning.

Results

Performance on the Benton task did not differ between groups. There were significant differences between cocainedependent individuals and controls in accurately classifying fear and anger as well as differences in misclassifications of these two ‘inhibitory’ emotions. No group differences were observed when classifying facial expressions of happy, surprise, sad, and disgust. A multivoxel analysis method (Partial Least Squares) confirmed the involvement of neural networks implicated in fear and anger perception, but showed significant differences between the groups.

Conclusion

The Benton task confirmed that differences in facial expression classification are not attributable to differences in facial processing. Cocaine-dependent individuals were less accurate at identifying ‘inhibition’ emotions and showed significant abnormalities in the brain systems implicated in fear and anger.
1115 – A Biopsychosocial Model Of Interferon-α-induced Depression In Patients With Chronic Hepatitis c Infection
Authors: Baranyi A. , Meinitzer A. , Stepan A. , Putz-Bankuti C. , Stauber R. , Kapfhammer H.-P. , Rothenhäusler H.-B.
Published: July 2013

Introduction

The aim of this prospective study was to gain a complete picture of the biopsychosocial effects of interferon-α treatment of patients with chronic hepatitis C. The predictors of depressive development and changes in health-related quality of life, life satisfaction and cognitive ability would be measured with the inclusion of the social context. Furthermore, the effects of interferon treatment on indoleamine 2,3-dioxygenase, the level of tryptophan supply in the brain, the development of neurotoxic kynurenine metabolites, and the thyroid glands were investigated. Therefore, for the first time the conditions for the development of depressive episodes in HCV patients treated with interferon-α were examined over the entire period of treatment as well as three months later, applying a holistic biopsychosocial model.

Methods

Psychiatric and biological assessments were carried out at six different times: before, during (at one, three, six and nine months), and after the end of interferon-α treatment.

Results

During IFN-α treatment 22 (53.7%) patients fulfilled the criteria for a treatment-related depressive disorder at least once during treatment. Contributing factors are tryptophan depletion (tryptophan to competing amino acids quotient), increased neurotoxic challenge (kynurenine to kynurenic acid quotient), less social support, female gender, preexisting psychiatric vulnerability, means of transmission, low financial security, impaired sexual satisfaction, small circle of friends, impaired role physical, strong body pain, low general health and vitality, reduced social functioning, impaired mental health and role emotional.

Conclusions

The awareness of relevant risk factors of IFN-α treatment-induced depression is essential to develop preventative treatment strategies.
1125 – Characteristics Of The Antipsychotic Switch To Amisulpride In Schizophrenia In Romanian Practice- a Multicentric, Retrospective Data Collection (switch Study)
Authors: Vasile D. , Vasiliu O. , Mangalagiu A.G. , Petrescu B.M.
Published: July 2013

Objective

To evaluate characteristics of the antipsychotic switch from any antipsychotic to amisulpride (Solian®) through the integration of the significantly variables.

Method

This is an open, non-randomized, multicentric, retrospective, non-interventional study that included 1165 subjects who were already stabilized on amisulpride for at least 6±1 months. These patients were previously switched from other antipsychotic to Solian®. Data were collected retrospectively on the patients’ status 6±1 months ago and their present status.

Results

The population consisted of 38.5% hospitalized patients at the moment of antipsychotic switch and 61.5% outpatients; 56.3% of the patients were in acute exacerbation at that moment. Previous treatment of the patients: 100% antipsychotic, 17.9% antidepressant, 38.8% mood stabilizer, 39.4% benzodiazepine and 22.2% other treatments. Switch type: sudden in 63.7% of the patients, gradual in 35.4% and unknown in 0.9%. The mean dosage of Solian at initiation was 581.04 mg/day. For 38.1% of the patients the initial daily dose of Solian® was of 600 mg, for 29.6% of them 400 mg and for 22.7% 800 mg. The mean dosage of Solian during the 6±1 months was 571.39 mg/day. For 39.8% of the patients the daily dose of Solian® was of 600 mg, for 30.5% of them 400 mg and for 20.7% 800 mg.

Conclusions

The switch to Solian® was made suddenly in a majority of patients, preferred start dose being 600 mg, while the mean dose was similar to baseline values (in almost 40% of cases) or smaller during the 6±1 months of the study.
1128 – Methylphenidate For Adhd In Adults With Substance Dependence: a 24-week Randomized Placebo-controlled Trial
Authors: Konstenius M. , Jayaram-Lindström N. , Guterstam J. , Philips B. , Beck O. , Franck J.
Published: July 2013

Introduction

There is a lack of evidence for the efficacy of stimulant pharmacotherapy in patients with substance dependence and comorbid attention deficit hyperactivity disorder (ADHD).

Objective

The aim of the present trial was to test the efficacy and safety of 180 mg extended release methylphenidate for treating ADHD in patients with amphetamine dependence.

Method

54 incarcerated men, mean age 42 years, meeting the DSM-IV criteria for amphetamine dependence and ADHD were randomized to methylphenidate or placebo in a 24-week randomized double-blind, placebo-controlled trial, with parallel groups design. The medication started within 14 days before release from prison and continued in outpatient care with twice weekly visits including once weekly cognitive behaviour therapy. The primary end point was relapse to any drug use measured by urine toxicology. Secondary endpoints included relapse to amphetamine use, retention to treatment, and change in selfrated ADHD symptoms.

Results

The methylphenidate group had significantly fewer drug positive urines compared to the placebo group (95% CI -0.31 to -0.05, P=.034), fewer amphetamine positive urines, (95% CI -0.36 to -0.07, P=.019) and better retention to treatment (95% CI 15.64 to 78.58, P=.001). Compared to the placebo group, the methylphenidate group also significantly reduced their selfrated ADHD symptoms (95% CI -21.09 to -3.37, P=.008) during the 24-week treatment.

Conclusions

This is the first randomized clinical trial to demonstrate the efficacy of a stimulant treatment for substance dependent individuals with ADHD. The treatment with MPH led to reduction in drug use and a clinically relevant improvement of ADHD symptoms.
1129 – Suicide Risk And Psychopathology In Immigrants: The Role Of Hopelessness, Temperament, Personality, And Self-other Perception
Authors: Pompili M.
Published: July 2013

Background

Immigrants may experience several negative consequences as a result of their migration including discrimination, unsatisfactory economic conditions, and rejection from the host countries, which may contribute to psychiatric illness and vulnerability to suicidal behaviors. The purpose of the current study was to determine whether or not the theorized components of measured dimensions of suicidal ideation and psychopathology vary across samples of Italians and immigrants.

Methods

We investigated 310 Italians and 322 immigrants, who were administered self-report questionnaires to assess temperament (TEMPS-A), hopelessness (BHS), personality (EPQ-R), and self-other perception (9AP).

Results

Multi-group Confirmatory Factor Analysis presented a final model with an excellent fit to the data (x2(53) = 57.56; CFI = .994; RMSEA = .014), significantly better than the previous models, showing the same pattern of relationships between suicidal ideation and psychopathology across Italians and immigrants.

Conclusions

Although immigrants represent a unique population and may experience specific stressors contributing to psychopathology and suicide risk, our findings suggest that the samples of Italians and immigrants may be more similar on the study variables under investigation than previously thought. Implications are offered for the improved identification and treatment of immigrants and resident citizens in Europe in general and in Italy in particular.
1133 – Association Between Seismicity And Mental Health: Crete, 2008–2010
Authors: Basta M. , Anagnostopoulos G. , Stefanakis Z. , Vassiliadis V. , Rigas A. , Koutsomitros S. , Papadopoulos G. , Panierakis C. , Vgontzas A.N.
Published: July 2013

Introduction

Several investigations have shown the influence of environmental factors, i.e. seismic activity on human health. However, no studies have focused on the effect of earthquakes on mental health. Crete is located within a rectangular region at the boundaries of Eurasian and African tectonic plates with high seismicity.

Objectives

To investigate the effect of seismic activity on mental health.

Aim

To explore possible association between seismic activity and rates of hospital admissions of psychotic patients.

Methods

We compared the seismic activity (EQs with magnitude M>2) in a geographical area of Crete, and admissions to the Psychiatric Inpatient Unit/ University General Hospital of Heraklion, Crete during the years 2008–2010.

Results

Our analysis showed (1) a very low rate of admissions of psychotic patients suffering from acute psychotic disorders, during the period with several great (M>6.4) and middle (4.5< M< 6.4) magnitude period earthquakes (EQs), (2) an increasing trend of admissions of acute psychotic disorders during a period with increasing number of relatively small EQs(r=0.667; p< 0.001), (3) a correlation between the number of total monthly admissions and the number of M>2 EQs.

Conclusions

It appears that strong EQs have a protective effect on the relapse of major psychiatric disorders, whereas small EQs are associated with an increasing number of relapses. We hypothesized that the beneficial/adverse effects are related to anomalous electric fields/Extra Low Frequency (ELF)-Ultra Low Frequency (ULF) emissions.
1149 – Medico-legal Acts And Demeneces In The Psychiatric Hospital Of Razi In Tunisia
Authors: Mâamri A. , Chennoufi L. , Boujemla H. , Melki W. , Ridha R.
Published: July 2013

Introduction

The elderly in general, and those with dementia in particular are more likely to be victims of abuse, neglect or self-neglect.

These demented elderly, because of biological aging, psychological disorders of character, behavior and conduct are themselves sources of violence that may lead to medico-legal.

The objectives of our work are to specify the profile of mentally ill elderly dementia and identify the characteristics of their medico-legal.

Methodologie

Our work has focused on all patients older than 60 years hospitalized under the mode of office between 1995 and 2012 in the service of forensic Razi hospital according to article 29 of the law n° 92-83 of the third of August 1992 as amended by the law 2004-40 of 3 May 2004, following a non-legal place due to insanity within the meaning of the 38 article of the Tunisian Penal Code, and which the diagnosis of dementia was increased.

Results

Our study included 7 patients, whose average age was between 65 and 90 years. The majority being married, having a low socioeconomic level. Acts forensic being uxoricides (2 cases), attempted murder (2 cases), attempted rape (1 case), violence against people (1 case), false and corruption (1 case). Almost all committed crimes against people associated with violence.

The diagnosis of dementia was retained and all patients were referred to the neurology department for further explorations.

The type of dementia was noted in 4 cases: mixed dementia, Alzheimer's disease, dementia due to Huntington's disease and dementia due to Parkinson's disease.
1153 – Effectiveness And Health Economic Evaluation Of Internet-based Cognitive Behavioural Therapy In Regular Psychiatric Care
Authors: El Alaoui S. , Hedman E. , Ljótsson B. , Bergström J. , Lindefors N.
Published: July 2013

Introduction

Anxiety disorders are highly prevalent and among the leading causes of the global disease burden. Cognitive behaviour therapy (CBT) is an effective treatment, but demand is high and resources to deliver CBT are scarce. Embracing new technologies to meet these growing needs, there is an emergent evidence base of the efficacy of internet-based CBT (ICBT).

Objectives

Evaluating (1) treatment effects, (2) cost-effectiveness and (3) cost-utility of ICBT for panic disorder.

Aims

To evaluate clinical effectiveness and health economics of ICBT for patients within regular psychiatric care.

Methods

Longitudinal analysis of 570 patients diagnosed with panic disorder that have been treated between 2007 and 2012 at an ICBT unit within regular psychiatric care. The ICBT was therapist-guided and lasted for three months. Clinical outcome measures were improvements in symptom severity and health related quality of life. Economic outcome measures were direct and indirect costs and incremental cost-effectiveness ratios (ICER).

Results

Analyses of treatment outcome suggest significant reductions in primary symptoms of panic disorder and that ICBT is an economically and clinically effective treatment for panic disorder leading to improvement of symptom severity and quality of life for these patients.

Conclusions

The findings of this study can aid decision makers when considering options of evidence-based treatment delivery formats within psychiatric care.