bluuebunny/crossref_metadata_2025 huggingface dataset:
P03-147 - Subjective Cognitive Impairment in Schizophrenic Patients: Clinical and Neuropsychological Correlates
Authors: Vita A. , De Peri L.
Published: June 2010

Introduction and objectives

Cognitive deficits, in particular that of memory and executive functions, have been linked to functional disability. The treatment with antipsychotic drugs leads to subjective changes in cognitive functioning as well as subjective experience of schizophrenic patients, which both contribute to compliance and treatment outcome. Aim of this study was to evaluate the role of clinical, neurocognitive and pharmacological variables on the subjective perception of cognitive functioning in schizophrenic patients.

Methods

The sample was composed of 78 schizophrenic inpatients (M/F=38/35, mean age 41 + 11.6 years) recruited in the Rehabilitative Centres of two Departments of Mental Health in Italy and treated with typical (n= 15) or atypical antipsychotics (n= 63). Patients were diagnosed according to the DSM-IV TR criteria and evaluated with the Frankfurter Beschwerde Fragebogen (FBF) Scale, the SAPS and SANS (Scales fot the Assessment of Positive and of Negative Symptoms). Neuropsychological functioning was assessed by means of the Wechsler Adult Intelligence Scale (WAIS- R).

Results

The results showed that the severity of symptoms was correlated positively with a greater impairment on self perception of mental functioning. Neuropsychological functioning also correlated with self perception of cognitive deficits, with an abnormal subjective experience associated with more neuropsychological disturbances. Atypical antipsychotics were associated with a better insight of cognitive dysfunction.

Conclusions

The results of the study underline the importance to investigate the subjective experience of schizophrenic patients treated with antipsychotic drugs in order to improve treatment adherence and efficacy in schizophrenia.
P03-153 - Special Informative Internet Site for Schizophrenic Patients: Its Feasibility and Contribution to Pharmacotherapy
Authors: Yakirevitch J. , Marchevsky S. , Abramovitch Y. , Kotler M.
Published: June 2010

Introduction

Delivery of information about his/her disease and its treatment to a schizophrenic patient is essential but no consensus exists concerning to what extent and how to deliver the information.

Study aim

To study the therapeutic impact of internet mediated knowledge an internet site was built particularly for the use of schizophrenic patients and contained information about pharmacotherapy, symptoms management and patients’ rights.

Materials and methods

The patients enrolled in the study were randomly divided into 4 groups. Each of the three study groups was given a task to study different topic (pharmacological treatment, symptoms management or patients’ rights) by means of the internet site. The forth group was a control one. Based on analysis of the questionnaires filled out by the patients before and two weeks after the information delivery we have analyzed whether the site is user friendly, emotional responses of the patients, extent of information catching, satisfaction change and contribution to pharmacotherapy.

Inclusion criteria

Patients diagnosed as suffering from schizophrenia and being hospitalized more than once.

Results

28 patients were enrolled, among them 25 being hospitalized. In the study groups, satisfaction from the therapy has improved after browsing the site. Compliance to pharmacotherapy has improved in the groups that had learned about pharmacotherapy and symptoms management. Compliance did not improve in the group instructed on the patients’ rights and in the control group.
P03-155 - Effects of Aerobic Endurance Training on Neurocognitive Functions in Schizophrenic Inpatients
Authors: Zwick S. , Brunnauer A. , Laux G.
Published: June 2010

Objective

The aim of our study was to investigate the impact of aerobic endurance training on cognitive performance, psychopathology and subjective well-being in paranoid schizophrenic inpatients.

Methods

37 inpatients who met the ICD-10 criteria for paranoid schizophrenia were randomly assigned to either a controlled endurance training (n = 20) or an occupational therapy program (n = 17). Before randomisation and prior to discharge psychopathological symptoms, subjective well-being and cognitive performance were assessed with a comprehensive neuropsychological test battery and psychometric measures. Patients in the aerobic endurance group received about four times per week a 30 minute training session. In the control group schizophrenic patients participated for an equivalent amount of time in an occupational therapy program.

Results

All patients significantly improved in psychopathologic symptoms and subjective well-being. Additionally significant time effects in cognitive functions, except for attention, could be found in both patient groups. However, significant group by time effects could only be demonstrated for working memory, short term memory and verbal learning with an advantage for the sport group.

Conclusions

Concerning verbal memory functions patients could profit by aerobic endurance training in a clinical setting. As cognitive impairments, especially memory deficits are a core feature of schizophrenic illness aerobic endurance training should be an integral part of treatment programs for schizophrenic inpatients.
P03-21 - Sensory Gating of Auditory Evoked Potentials in Schizophrenia: Effects of Gating-Out and Gating-In Paradigms in Relation to Psychopathology
Authors: Vedeniapin A. , Gjini K. , Boutros N.
Published: June 2010

Deficit of sensory gating in schizophrenia patients was explored in gating-out and gating-in paradigms. A pair of identical clicks was presented in gating-out paradigm. In two gating-in paradigms a second click in a pair was either higher or lower frequency. Sensory gating, an attenuation of evoked responses to the second stimuli in a pair, was measured as a S2/S1 ratio of P50, N100 and P200 evoked potentials, recorded from Cz lead. The data from 34 schizophrenic subjects (averaged age = 46, s.d.10.5; 10 females) and 38 controls (averaged age 41, s.d.13; 22 females), were analyzed. Sensory gating was averaged across four identical EEG sessions. P50 gating was independent from the gating of N100 and P200 components in both groups. Schizophrenics had less gating in all three evoked responses in gating-in paradigms and deficit in N100 gating only in gating-out paradigm. A stepwise regression analysis of gating and PANSS scores has shown that P50 gating in both gating-in paradigms was related to Emotional component, P50 gating in gating-out paradigm was related to Negative component, and N100 gating in gating-out paradigm was related to General Psychopathology Score and Cognitive and Hostility components. A factor analysis has shown that less gating-in (attenuation instead of augmentation) in all three evoked responses in schizophrenic subjects was positively related to all three Total PANSS scores, when the second click in a pair was higher frequency. The results have shown the importance of both gating-in and gating-out paradigms in study of sensory gating in schizophrenia.
P03-22 - Perturbations in p50 Auditory Evoked Potential and Hallucinatory Behavior in Schizophrenia
Authors: Vedeniapin A. , Boutros N.
Published: June 2010

Earlier findings suggested auditory evoked potentials as diagnostic measure in schizophrenia. However, the relationship between different components of middle latency auditory evoked response (MLAER) and clinical symptoms of schizophrenia is unclear. In this study we explored the relationship between the amplitude of P50 potential and hallucinatory behavior in medicated schizophrenic patients. MLAER from thirty seven outpatient, clinically stable medicated schizophrenic patients (mean age 43.5 years, SD = 11.7), twenty six males, were measured. The evoked potentials were elicited in a paired click paradigm. The amplitude of P50, measured from pre-stimulus baseline, was studied. The bandpass filter was 1-50 Hz. Twenty seven (20 males) patients experienced hallucinatory behavior. Schizophrenic patients with hallucinatory behavior had significantly (p< 0.05) smaller P50 amplitude, elicited by both first and second clicks in the pair. No significant differences were found for P50 amplitudes, measured from preceding negative deflection. Preliminary analysis suggests that the amplitude of the P50 auditory potential, measured from the pre-stimulus baseline in a paired click paradigm is related to hallucinatory behavior in schizophrenic patients.
P03-38 - Atypical Antipsychotics and Screening of Metabolic Effects
Authors: Campos Mendes J. , Prata J.
Published: June 2010

Despite a better overall tolerance as compared to classical antipsychotics, atypical antipsychotics are not devoid of side-effects, notably metabolic factors - weight gain, alteration of lipid and glucose profile - that increase the risk of cardiovascular disease, as well as a number of other adverse long-term health consequences. Psychiatrists need to be aware of the potential metabolic side effects of antipsychotic medication and include them in the risk/benefit assessment when planning a patient's treatment strategy. Implementation of the necessary screening assessments and referral for treatment of any physical illness is essential and baseline screening and regular follow-up monitoring is advised.
P03-42 - Catatonia: A Case Report
Authors: Dalò V. , Lavatelli L. , Zeppegno P. , Torre E.
Published: June 2010

Objectives

To underline the importance of a correct diagnosis and management of catatonia and complications increasing its morbidity and mortality. Catatonia is a syndrome of altered motor behaviour, mainly classified as a form of schizophrenia. Recent literature suggests catatonia is an independent syndrome, frequent among patients diagnosed with mania/depression or accompanying many general medical conditions and neurological disorders.

Methods

We describe the case of a 58-year-old woman with NIDDM in antidiabetic oral therapy and history of schizophrenia, diagnosed when aged 20 and treated with Haloperidol (10 mg/day), Levomepromazine (100 mg/day) and Lorazepam (2.5 mg/day) who was admitted to our clinic for a condition characterized by mutacism, staring into space, muscular rigidity and bilateral arm cogwheeling, initially suggesting a neuroleptic malignant syndrome.

Results

At hospitalization there was no fever, leukocytosis or CPK elevation. She quickly developed altered consciousness, autonomic dysfunction (hypertension, dysphagia, uncontrolled hyperglycaemia) and waxy flexibility finally recognized as a catatonic syndrome, according to DSM-IV-TR criteria. Multiple infections (urinary trait infection, teeth infections leading to sepsis) worsened her clinical condition. The first therapeutic strategy was suspending neuroleptics. Psychomotor symptoms, rated with the Catatonia Rating Scale (CRS), gradually resolved by intravenous administration of Lorazepam high doses (up to 12 mg/day). General medical conditions improved with specific antibiotic therapy, endovenous hydratation and parenteral nutrition. A physiatric rehabilitation program was started, with significative motricity improvement.

Conclusions

This report underlines the importance of the differential diagnosis between catatonia and similar conditions (such as NMS) and the fundamental role of multidisciplinary approach to complications.
P03-45 - Psychosocial Functioning of Schizophrenic Patients in Post-Acute Treatment with Long-Acting Injectable Risperidone in Ambulatory Care
Authors: Juckel G. , Diekamp B. , Ibach B. , Hargarter L.
Published: June 2010

Introduction

Improvement of social and occupational functioning is a major goal in the treatment of schizophrenic patients and therefore may improve reintegration of patients and their ability to lead an independent life.

Methods

Non-interventional, 52-week study (RIS-SCH-4091) in schizophrenic patients after treatment of exacerbation or first manifestation of schizophrenia (ICD-10 F20.x; duration of disease ≤10 years) with long-acting injectable risperidone (RLAI) in monotherapy. Presented here is the assessment of the treatment based on the Clinical Global Impression (CGI), the Global Assessment of Functioning (GAF), and skills assessing the ability of patients for reintegration as quantified by the short version of the International Classification of Functioning, Disability and Health for Mental Disorders (Mini ICF-APP).

Results

Interim-analysis after 12 months of 75 patients (ITT, m 64%; 32.7±9.1 years; N=88 safety set). Duration of observation was 278.8±119.3 days. GAF total scores improved significantly (24.4±23.7); 76.0% of the patients improved in CGI-C. Mini-ICF-APP total scores improved significantly from 1.96±0.68 to 1.18±0.94 at final observation. All Mini-ICF-APP sub-items improved significantly, particularly within: participation in public roles, non-occupational activities, self maintenance, competency, flexibility, family relations. 119 adverse events (AEs; 28 serious AEs) were reported in 47 patients. Most common AEs at least possibly related to RLAI were lack of effectiveness 8.0%, weight increase 8.0%, psychotic disorder 5.7%, anxiety 3.4%, EPS 3.4%.

Conclusions

Results indicate that treatment with RLAI may improve global functioning of patients by reducing typical disorder of functioning, capacity and participation. Treatment with RLAI may help patients to reintegrate into social and occupational environments.
P03-50 - Serum Fas and Fas Ligand Levels in Patients with Schizophrenia
Authors: Djordjevic V. , Lazarevic D. , Trajanovic L. , Cosic V. , Ristic T. , Djordjevic V.
Published: June 2010

Objectives

Since apoptosis is considered to play a role in the pathogenesis of schizophrenia the aim of this study was to examine the Fas and Fas ligand (FasL) system in patients with schizophrenia. FasL is transmembrane protein that induces apoptosis by binding to its specific receptor Fas. The Fas-FasL complex is an important effector of cell death in different cell types.

Methods

Serum Fas and FasL levels were determined in 30 patients with schizophrenia (11 females, 19 males), and 30 healthy controls (11 females, 19 males) by the ELISA method.

Results

Serum Fas levels were significantly higher in patients with schizophrenia (4.63±0.96 ng/mL, p< 0.05) than in controls (4.12±0.81 ng/mL). A significant increase in FasL levels was also found in schizophrenic patients (0.099±0.029 ng/mL, p< 0.05) in comparison with those in healthy controls (0.085±0.023 ng/mL). Schizophrenic males showed significantly higher both Fas (4.97 ± 0.83 ng/mL, p< 0.05) and FasL (0.103 ± 0.032 ng/mL, p< 0.01) compared to the control males (4.30 ± 0.93 ng/mL; 0.079 ± 0.011 ng/mL, respectively). A significant positive correlation between patient serum FasL and lymphocyte caspase-3 activity was found.

Conclusion

These results clearly show a disregulated extrinsic apoptotic pathway in patients with schizophrenia.
P03-52 - Aggressiveness and Cognitive Impairment in Schizophrenia
Authors: Dutczak B. , Bidzan L.
Published: June 2010

Background

Scientific researches show that the acts of aggression in schizophrenia appear more often than in case different mental disorders. In the literature, however, exists little data which would describe wider this phenomenon. The most often the aggression in schizophrenia is connected with psychopathological symptoms, but also with characteristic the features of frontal lobe syndrome. The most typical symptom in this range is emotional disorders, particularly lability of mood which can lead to occurrence of aggressive behaviours.

The purpose of this research was to assess the intensification and identification of forms of aggression in schizophrenia. Moreover explanation of connection between aggressive behaviours and cognitive functions relating with frontal lobe.

Materials

30 patients from first episode of schizophrenia in age 18-30. Researches were realized in Department of Developmental, Psychotic and Geriatric Psychiatry, Medical University in Gdansk.

Methods

*

Positive and Negative Syndrome Scale (PANSS)

*

The Overt Aggression Scale (OAS)

*

Wisconsin Card Sorting Test (WCST)

*

Trail Making Test (TMT)

*

Color Reading Interference (Stroop)
P03-53 - Management of Folie A Deux. A Purpose of Three Cases
Authors: Erausquin Sierra C. , Benitez Cerezo E. , Martínez de Velasco Soriano R. , Chinchilla Moreno A.
Published: June 2010

Introduction

Shared psychotic disorder (DSM-IV-TR) or induced delusional disorder (ICD-10) is a condition involving the appearance of delusions to two or more subjects who generally live in close proximity. We compare three cases and their management described in Ramón y Cajal Hospital in Madrid.

Clinical cases

The first case involves a mother and daughter shared delusion of injury with respect to the neighborhood. In the second case involves two sisters living together, with delusion of persecution and prejudice and without psychiatric history. The third one was admitted to our unit after a suicide attempts. It was a middle-aged man who shared with four members of his family the perception of supernatural entities in his home.

Management

At the first and second cases it was necessary mechanical and pharmacological restraint. One of the therapeutic indications is the separation of subjects and It generated significant moments of tension and resources of the emergency department. In the third case was not accurate mechanical and pharmacological restraint. The most effective in this case was the regulation of sleep-wake cycle and separation of the individual during a time of home and family. In all three cases the perception of illness worked individually and kept contact with the therapists to plan responsible for monitoring the treatment plan and management in the future.

Conclusions

We must be prepared before the arrival of an event of this kind to the emergency of the hospital.It's necessary to elaborate an effective joint therapeutic strategy both during their hospital stay or as outpatients.
P03-60 - Infant Trauma and Psychopathology in Paranoid Schizophrenia
Authors: Henry M. , Diaz-Mesa E. , Morera-Fumero A.L. , Garcia-Hernandez A. , Fernandez-Lopez L. , Yelmo S. , Trujillo F. , Monzon J. , Barrau V. , Gracia-Marco R.
Published: June 2010

Background

Stress and trauma have been reported as leading contributing factors in schizophrenia. And certainly child abuse (neglect, emotional, physical and sexual abuse among others) has a lasting negative impact, which is well established in literature.

Objectives

To consider the presence of infant trauma and its relationship with psychopathology in paranoid schizophrenics.Methods. 37 patients (mean age 29±6.3; years from onset 9.20±4.7), meeting DSM IV paranoid schizophrenia criteria, undergoing treatment in a university hospital are studied. The PANSS is administered in order to rate psychopathology.

Results

27 patients had infant trauma (55.8%). Main traumas are: sexual abuse (12.8%), child abuse (7.7%), both sexual and child abuse (5.18%), parental separation (7.7%), extra-rigid parents (2.6%), alcoholic parents (18.2%), child abuse and mother's death in childhood (2.6%). Infant trauma and psychopathology showed a significant relationship concerning Hostility (No 1.75±1.209, Yes 2.26±1.759), Unnatural Movements and Posture (No 1.55±0.945, Yes 1.16±0.545), Depression (No 1.25±0.550, Yes 1.74±1.284) and Preoccupation (No 2.75±1.410, Yes 3.26±1.996).

Conclusions

Infant trauma is common in paranoid schizophrenia and our findings give some evidence to a relationship with psychopathology, especially with dimensions as Hostility, Unnatural Movements and Posture, Depression and Preoccupation. Despite sample size, a high proportion (55.8%) of the patients presented infant trauma and future research is needed in order to open new avenues in this field, particularly studies concerning infant trauma and symptomatology specificity will be greatly appreciated as well as the plausible link to personality traits and personality disorders.
P03-61 - Characteristic CSF and peripheral blood cytokine levels in neurological and psychiatric patients
Authors: Maxeiner H.G. , Kurfiss S. , Brettschneider J. , Bechter K. , Lehmensiek V. , Tumani H.
Published: June 2010

Background

We investigated neuropsychiatric patients with non-bacterial meningitis (N-MEN)), assumed chronic low level neuroinflammation (schizophrenic SCH-S and affective spectrum disorders PSYCH-A) and tension headache (CEPH). Cytokines investigated were IL-1beta, IL-2, IL-8/CXCL8, the antiinflammatory IL-10 and IL-17.

Purpose

to differentiate chronic and acute neuropsychiatric diseases by cytokine profiles and to evaluate cytokine levels in the CSF and peripheral blood to characterize the two compartments

Methods

Included were 10 N-MEN, 10 CEPH, 15 PSYCH-A and 16 PSYCH-S patients. Peripheral blood and CSF was taken in parallel. Measurement on a commercial multiplex immunoassayplatform (Mesoscale) by a modified protocol. Statistics: Mann-Whitney-U-Test and Kruskal-Wallis H-Test.

Results

Highest levels of IL1b, IL-2, IL-8 and IL-17 were observed in the CSF of N-MEN, whereas in serum, levels were not or slightly elevated. Significant (p< 0.05) tested in CSF for N-MEM versus CEPH,PSYCH-A,PSYCH-S for IL-8 and versus PSYCH-A,PSYCH-S for IL-17. IL-10 CSF levels were also highest in N-MEM, and significant also versus CEPH,PSYCH-A,PSYCH-S, but IL-10 in serum was even higher than in CSF. We observed in all cytokine (except IL-2) significant differences either in serum or in CSF or both between the diseases; but more frequent CSF than in the serum.

N-MEN patients displayed highest ratios of CSF to serum levels for all cytokines (mean between 1.6 and 63).

Conclusions

Investigation of cytokines in CSF is more sensitive than in serum to detect differences between neuropsychiatric diseases. Cytokine patterns are disease specific. Elevated IL-1beta, IL-2 and IL-8 CSF/serum ratios in N-MEM may indicate an intrathecal synthesis of cytokines.
P03-64 - Impact of negative symptoms on psychosocial functioning in schizophrenia
Authors: Hunter R. , Barry S. ,   EGOFORS Research Group
Published: June 2010

Introduction

Despite advances in the last decade, people with schizophrenia remain disabled by negative symptoms and function poorly in community settings. Until recently negative symptoms were neglected as a treatment target despite apparent recognition of their importance among clinicians.

Aims

To examine the impact of negative symptoms on psychosocial functioning in order to assess the importance of such symptoms as a potential treatment target.

Methods

295 community based participants with DSM4R schizophrenia were recruited in 11 different European centres and assessed using the following scales: PANSS, GAF, Personal and Social Performance (PSP), Quality of Life Scale (QLS), Functional Recovery Scale in Schizophrenia (FRSS) and PsychoSocial Remission in Schizophrenia (PSRS). Relationships between and negative symptoms and functionality were examined using standard statistical approaches.

Results

In this European cohort negative symptom scores were highly correlated with poor psychosocial functioning in participants living in the community. This significant trend occurred across different scales for measuring functional assessment.

Conclusions

The pharmacological treatment of schizophrenia appears rather becalmed at present. First and second generation antipsychotics appear to have similar efficacy for positive symptoms, different side effect profiles, but little impact on negative symptoms. This study shows a close relationship between negative symptoms and psychosocial functioning: high negative symptom scores are associated with poor functioning. This work supports the view that negative symptoms are a key target for drug development with significant potential benefit for the functioning of individuals. Drug development will increasingly focus on negative symptoms and develop effective adjunctive medication used with existing antipsychotics.
P03-79 - The value of self and object organization in the divelopment of SCH process - case report
Authors: Kostic J. , Krasic D. , Milosavljevic L.
Published: June 2010

Objectives

We observe the schizophrenia process through specific structural terms - specific models and shapes of the internalisation deficit and consequental structural variability.

Method

We describe the specific influence of the developmental deficit on the schizophrenic process by presenting the case of a 17 year old female patient diagnosed with schizophrenic psychosis hebefrenic form. By observing the patient's life history, we interpreted her psychological development throug early introjective configurations, identification process, the phase of forming realistic images of the self and the outher world and the forming of the Ego identity. The current state is explained throug deficit Ego functions.

Results

The bringing up of the patient in an unstable and disturbing primary family group, with the mother suffering from Sch psychosis and a grandmother addicted to alchocol, caused pathological modifications in the introjective process and forming of a confused Ego identity. Fragility, non-differentiality and polar exclusiveness of mental representations, which is dependant on the characteristics of the primary object relationschipts, form an insecure mental structure which the patient uses to schape her perception of herself and the world, which can be phenomenologically recognised in the direct and inner presentation of the devil and god as clear and utterly scharp opposites.

Conclusion

The schizophrenic process is connected to the developmental deficit which is conditioned by the failure to organize and integrate the inherent structures forming the core of individual self organization. This essentialy directs development toward the schizophrenic process.
P03-93 - Basal Metabolism In A Sample Of Patients Treated With Atypical Antipsychotics
Authors: Mauri M. , Cargioli C. , Orsolini G. , Ciberti A.
Published: June 2010

Introduction

Second generation antipsycotics (SGAs) represent an essential treatment for Psychotic Disorders. However SGAs cause weight gain and metabolic disorders with an unknown mechanism.

Objective

The aim of this study is to investigate whether weight gain may be caused by a reduction in resting energy expenditure (REE).

Methods

We recruited 34 pazients who received a clinical diagnosis of Bipolar Disorder I, Schizoaffective Disorder or Schizophrenia. Patients were in antipsychotic monotherapy (clozapine, olanzapine or aripiprazole). We measured REE by indirect calorimetry and we calculated theorical REE utilizing LARN and Harris-Benedict (H-B) equation.

Results

The difference between the average value of REE measured in patients (1295Kcal/die) and the average value of REE estimated by LARN and H-B equation (1719Kcal/die and 1741Kcal/die) was respectively 423Kcal/die and 445Kcal/die: both the differences resulted statistically significative (p< 0.01). This reduction of REE results in a weight gain of 1,7 kg in a month.

Conclusions

It is necessary to inform patients about the side effects of SGAs. Lifestyle counseling and pharmacological assistance, or switching to another antipsychotic are possible strategies.
P03-165 - Coercive Measures In Acute Inpatient Care In Italy
Authors: Del Vecchio V. , Luciano M. , Giacco D. , Vinci V. , Volpe U. , Fiorillo A.
Published: June 2010

Objectives

To provide a comprehensive review of past and current implementation of coercive measures in Italy.

Methods

Literature review (cross-referencing in PubMed, Embase, and Index Medicus) concerning the application of coercive measures in Italy. Description of the past and current regulations as well as of the routine implementation of coercive measures in Italy has been also empirically summarized.

Results

The Italian 1978 reform law on mental health care clearly established that medical treatment and tests are mainly voluntary. Only under special circumstances, the medical authority can order a patient involuntary admission and the physician is obliged to provide necessary tests and medical treatment. However, even if coercive measures are usually placed without patient's consent, the first objective should remain to protect patient's interest and rights, in accordance to the Italian Constitution. In Italy, there are no officially recognised protocols on coercive measures for acute inpatient care and each psychiatric ward adopts its own rules and internal norms.

Conclusions

In Italy, patients with aggressive or dangerous behaviours are approached by the staff according to a “de-escalating” model, in which physical and mechanical restraint should be adopted only when any other therapeutic options previously failed. Proposals aimed to improve the implementation of coercive measures in clinical practice will be provided.
P03-167 - Correlation Between Patients’ Insight And Clinical / Sociodemographic Variables During The Intervention Of A Regional Mobile Psychiatric Unit
Authors: Filopoyloy M. , Syros I. , Tsiafaki V. , Panagoutsos P.
Published: June 2010

Objectives

The study of the correlation between the insight of the patients attended by a Regional Mobile Psychiatric Unit, and various clinical and sociodemographic variables. The evaluation of the insight included the compliance of the patient to the treatment, his awareness regarding his illness as well as to the therapist notion concerning the way the patient was coming in terms with his disease.

Methods

45 psychotic patients aged 17-67 were studied. Spearman rank correlation, x2 statistical test and stepwise multiple regression analysis were used in order to determine the relation between the variables at the beginning as well as at the end of the 5-year study.

Results-conclusions

•

The subjects who had no insight of their disease prior to research were not prescribed. During the intervention, the patients’ insight as well as their compliance to the prescription was improved. However, this correlation did not remain significant at the end of the study.

•

The diagnosis of the patients as well as the family history of a mental disease was related to the degree of their insight before the intervention.

•

The more socialized a patient was before the intervention, the more insightful he was not only before, but also after the intervention.

•

The more motivated a patient was regarding his leisures on his free time after the intervention the more insightful he was before the intervention.

•

The patients’ insight was positively correlated to the duration and the number of the previous admissions prior and after the intervention respectively.
P03-168 - Quality Of Life And Stress Coping Regarding People With Psychiatric Disorders In A One-Year Training
Authors: Garber K. , Reich M. , Giacomuzzi S.
Published: June 2010

Objectives

Evaluation of QOL, stress and coping strategies of people with psychiatric disorders after a one-year training course for social and occupational reintegration.

Methods

The main elements of the study focused on the SVF 120 (Stress Processing Questionnaire) and PLC (Quality of Life with Chronic Disease questionnaire).

Results

In total a number of 20 people were enrolled in the study. Mean age of the participants was 33.4 years. The reintegration programme showed a retention rate of 100%. The PLC questionnaire showed no statistically significant results (p>0.050). The SVF 120 showed a slightly better score after one year regarding social encapsulating (p= 0.056) and trivializing (p = 0.021). After the one-year training course 60% of the participants could be reintegrated in an occupational activity and 40% could achieve a better social status.

Conclusions

Our results showed that participant of the programme used stress coping strategies morte than before the course. Reintegration data make clear that training courses of people with psychiatric disorders can achieve valuable results.
P03-169 - Training Courses On Basic Qualifications And Empowerment For People With Psychiatric Disorders And Its Impact On Occupational Re-Entry And Self-Determination
Authors: Garber K. , Mangler E.-M. , Gaicomuzzi S.
Published: June 2010

Objectives

Evaluating the effectiveness of training courses for basic qualification for occupational re-entry, empowerment and self-determination.

Methods

Participants with psychiatric disorders attended a one-year course on basic qualifications and empowerment for occupational re-entry. The main elements of the course were empowerment topics and training of self-determination. On behalf of the psychiatric disorders data sets were collected in a narrative manner.

Results

A total of 28 people were enrolled in the study. 57.2% of the participants were male and 42.8% female. Male mean age was 34.2a and female 33.3a (p>0.050). Among other psychiatric disorders 45.5% of the participants showed problems with alcohol. Before the programme 100% of the participants were jobless. The retention rate after one year was 9.1%. 27.3% could be placed in kind of a occupational training. The same rate of participants could get into a job after the one-year course. Participants judged self-determination significant higher after the one-year course. Training costs amounted to 4.867Euro/Person/year.

Conclusions

A high percentage of the study participants could be re-integrated into the working market. Basic qualification and empowerment programmes could be an effective tool for people with mental disorders regarding social and occupational issues.
P03-173 - Social Psychiatry And Social Policy In The 21st Century: New Concepts For New Needs
Authors: Johnson R. , Haig R. ,   Royal College of Psychiatrists’ Enabling Environments Action Group
Published: June 2010

Objectives

This paper reports and reflects upon 50 years’ evolution of social psychiatry in the UK context, including internal debates, and parallel policy and service developments in the “outside”, nonhealth world. It reviews the history and development of the therapeutic community approach since the immediate post-war era, summarises the current position in emerging UK policy, and looks to the future with new conceptual tools to describe current initiatives in public mental health and community-oriented mental health.

Methods

A review and analysis of historical, research and “grey” literature (ie: especially government policy pronouncements), including discussions with clinicians and policy makers over future trends.

Results

Two new conceptual frameworks are emerging - the “Psychologically Informed Planned Environment” and the “Enabling Environment” - which between them both embody and encourage current new thinking on the health and well-being contexts of community cohesion, and the introduction of enlightened management for enhanced well-being in hospitals, prisons, schools and workplaces, housing projects and places of faith.

Conclusions

From the remnants of the post-war therapeutic community movement, a new terminology is emerging to address the demands of community psychiatry for the 21st Century. Recognising the social determinants of health and the challenge to health inequalities, and the health and well-being contexts of social capital and community cohesion, this framework raises quasi-philosophical questions over shared values, and highlights the necessity to work with reflective practice and collective accountability for an inter-dependent world.
P03-178 - Participation Restrictions At Work And At Home In Primary Care Patients
Authors: Linden M. , Muschalla B.
Published: June 2010

Background

Health problems are often associated with activity limitations and participation restrictions (ICF, WHO, 2001). An example are problems at work or sick leave. The research question has been whether in these cases activity limitations and participation restrictions refer only to the workplace, or whether and to which degree other areas of life are similarly affected.

Method

Type and degree of participation restrictions in different domains of life were assessed in 382 primary health care patients (aged 18-65) with the IMET, a questionnaire which measures participation restrictions across several domains of life. Additionally, the patients were interviewed about health-related problems at work. IMET scores were compared between patients with and without health related problems at work.

Results

27% of 299 presently employed patients were suffering from workplace problems. These patients had significantly longer durations of sick leave than patients without problems at work and also reported significantly more problems in functioning in general daily activities.

Conclusion

Workplace problems are a frequent topic in primary health care and related to sick leave. Health related problems at work are indicative for problems in functioning in other areas of life as well. Participation restrictions in non-work areas can be early indicators for participation problems at work.
P03-181 - The Impact Of Day Clinic Treatment On Internalized Stigma
Authors: Provaznikova K. , Sibitz I. , Amering M.
Published: June 2010

Background

The stigma of mental illness is a complicating feature of psychiatric treatment, especially in schizophrenia. A detrimental consequence is internalized stigma-the inner subjective experience of stigma resulting from applying negative stereotypes and stigmatizing attitudes to oneself. The empowerment and recovery oriented program of the day clinic might contribute to a reduction in internalized stigma. Until now the influence of day clinic treatment on internalized stigma has not been studied.

Methods

Data from two groups of patients had been collected at baseline and after five weeks. The experimental group attended the day clinic treatment (TKL-group, 20 patients), the control group waited for the day clinic treatment (KO-group, 20 patients). At both times the Internalized Stigma Of Mental Illness scale, the CES-Depression Scale, the WHOQOL-BREF questionnaire capturing the subjective quality of life and the Positive and Negative Syndrome Scale were applied. Furthermore, sociodemographic and clinical data were collected.

Results

Changes during the five weeks within the TKL-group showed a significant reduction of internalized stigma and psychopathology and a significant improvement in quality of life. Within the KO-group it was only a significant reduction of depression. Significant differences between the two groups concerned changes in the quality of life and psychopathology with a clear advantage for the TKL-group. However, with regard to changes in internalized stigma, no significant differences between the TKL- and the KO-group could be observed.

Conclusions

Exploring a sample size of two groups each of 110 patients appears to be a feasible and valuable research plan with regard to internalized stigma.
P03-199 - Rct: quetiapine vs. Placebo in alcohol relapse prevention. Rational, methods and preliminary results
Authors: Croissant B. , Boehler J. , Lorenz J. , Diehl A. , Wedekind D. , Mann K. , Havemann-Reinecke U.
Published: June 2010

Introduction

Quetiapine is a novel antipsychotic drug, which is efficacious in the treatment of schizophrenia and also helps reduce craving and consumption of stimulants and alcohol. Due to Quetiapine's promising receptor profile, we set out to examine its efficacy in relapse prevention treatment of alcoholic dependent patients suffering from craving and affective symptoms.

Methods

The three center pilot-RCT evaluated 40 alcohol dependent patients after withdrawal (Quetiapine vs. placebo). They were followed up for six months. We used operationalized questionnaires including OCDS-G, Form 90-CR, Form 90 short form-CR, PSQI, MADRS, STAI, BDI and FTND.

Hypotheses

We tested the one sided hypothesis that it takes longer for the first severe relapse to occur using Quetiapine compared to a placebo. The primary outcome measure is time to first severe relapse. Further, we tested the two sided hypothesis that Quetiapine will prolong time until first consumption of ethanol, decrease the number of drinking days and increase the number of abstinence days, decrease the cumulative amount of ethanol, decrease craving, improve depression symptoms, improve anxiety symptoms, improve quality of sleep, avoid deterioration of safety variables and decrease nicotine addiction.

Conclusion

Our pilot study is designed to provide evidence for the efficacy of Quetiapine in alcohol relapse prevention. Alcohol dependent patients after withdrawal should display a decrease in persistant craving and should be less afflicted by sleep disorders, excitement or symptoms of depression or anxiety. The poster provides the rational for conducting this study and describes the study protocol including the subject's characteristics.
P03-205 - Did Video Kill The Radio Star? - Assessing Gambling And Multimedia Use In Luxembourg'S High School Students
Authors: Paulos C. , Duscherer K.
Published: June 2010

For years, addiction prevention was centered on substance abuse. This focus has shifted recently, especially in regard to children and teenagers, with a growing concern on potentially knotty behaviors, namely gambling and computer, Internet or video game abuse. With the recent soar and availability of the new technologies, it is however extremely difficult to assess which kind of behavioral patterns can be considered as normal, or not, in the contemporary teenage population. To gather benchmark results, we therefore initiated two nationwide surveys, reaching all the students enrolled in the public or private high schools in the Grand Duchy of Luxembourg.

The first survey aims at assessing the frequency and modalities of gambling in Luxembourg's high school students. These data will be especially relevant for the pending legislative discussions whether the national gambling regulations should include a paragraph about the protection of minors or not.

The second survey aims at assessing multimedia use by Luxembourg's high school students. These questions not only inquire the accessibility to various technologies, but also try to depict teenagers’ daily behavior and use of the available technologies. The main objective of this survey is to assess to which extend the technologies are used in different tasks (i.e. work, communication, leisure), but also to appraise whether this population has pleasing access to the current media.
P03-206 - “Widow Alcoholism” Phenomenon In Russia
Authors: Egorov A.
Published: June 2010

Objectives

According to Russian official statistics the average life period in males is about 59 years while in females it is about 73. The average marriage age for males is 24.4 and 22.2 for females. Thus statistically average woman in Russia lives in widowhood more than 15 years.

Methods

16 females aged 43 - 76 who began alcohol abuse in the second life period after (or during) social stress were studied. Specially elaborated Alcohol Intake Motive Self-esteem (AIMSE) scale was used.

Results

According to ICD-10 criteria alcohol intake in all females conformed to F10.1 - Alcohol Dependence, in 12 it conformed to F10.3 - Alcohol Withdrawal. Duration of alcohol misuse before first appeal to addiction specialist varied from 1 to 8 years (mean 3,3±1,2 years). Mean duration of addiction forming was 1,8±,1,1 years; mean daily 100% ethanol tolerance was 100-150 ml. The stress situation was:

1)

A long-term husband illness which terminated lethally (7 persons);

2)

An unexpected death of a husband or constant partner (5 persons);

3)

Relation rupture with a husband or partner (4 persons).

The highest scores in AIMSE-scale have been obtained in the motives “solitude”, “low mood”, ‘bad physical health” and “heed deficit from children and relatives”.

Conclusions

The data have shown the phenomenon typical to the late onset female alcoholism in Russia. “Widow” alcoholism occurs in women in the second half of their life, when emotional bereavement situation and solitude are main provoking factors.
P03-209 - Determinations Of Substances Of Abuse In Relation To The Application Of A Protocol Of Toxic
Authors: Euba O. , Zallo E. , Torreblanca M. , Pinilla E. , Chicharro F.
Published: June 2010

Objectives

Comorbidity between a substance use disorder (SUD) and another psychiatric disorder is known as dual diagnosis. The relevance of SUD with mental illness owe to his influence in the clinical practice, evolution and costs of care.

At the Hospital of Zamudio, the determination of substances of abuse in urine begins in January 1999 and in May 2003 a practical guide to detection and norms substance use was established and revised in late 2006.

The objective of this work is to make a valuation in this issue, reflected in the petitions made during this time and the evolution of the determinations of drug misuse, both of them indicating the understanding of the importance of dual diagnosis

Methods

Determinations of toxics in urine are collected from January 1999 to December 2009.

Results

:

YEAR NUMBER OF TOXIC DETERMINATIONS

1999 2644

2000 2411

2001 3360

2002 6456

2003 10199

2004 9175

2005 8724

2006 8689

2007 8362

2008 10766

2009 14625

The distribution of toxic determinations is mainly between amphetamines, opiates, THC and cocaine, in equal proportion (25% for each approximately).

Conclusions

The gradual increase over the years, could be translated into a greater awareness of the importance of dual diagnosis.

However, the homogeneous distribution of the petitions among the different toxics perhaps could lead to the need of an implementation of the protocol, considering that sometimes the physicians order the screening without taking into account the economical and technical difficulties of the laboratory and the previous history of inpatients.
P03-213 - Temperament And Attachment In Patients With Alcohol Dependence
Authors: Harnic D. , Digiacomantonio V. , di Marzo S. , Sacripanti F. , Saioni R. , Mazza M. , Bruschi A. , Cardella A. , di Felice C. , Andreoli S. , Girardi P. , Tatarelli R. , Bria P. , Janiri L.
Published: June 2010

Objectives

This study aims to evaluate different kinds of temperament and attachment in a sample of alcohol-dependent patients, divided in Cloninger typology 1 and 2, compared to an healthy group.

Materials and procedure

A group of 40 patients was recruited, in a 3 months period, from Alcohology Unit of “Villa Rosa” in Viterbo. This sample was selected by a clinical diagnosis of Alcohol Dependence and compared to a control group of 40 healthy subjects. Each participant was screened by: SCID-I for Axis I Diagnosis, SCID-II for Axis II Diagnosis, TEMPS-A for Temperament, ECR for Attachment Styles.

Results

Statistical analysis showed significative differences between the two groups (p< 0.05). The mean of the scores (t Student) and the Mann-Whitney U test results higher in the experimental group. Regarding the ECR, we found differences in the “avoidance” between Cloninger's typology 1 and 2. Control group: 92.5% of the subjects showed a “secure” attachment, 7.5% a “dismissing” attachment. Experimental group: 40% of the sample showed a “secure” attachment, 35% a “dismissing” attachment, 17.5% a “preoccupied” attachment and 7.5% a “fearful/avoidant” attachment.

Discussion

Our sample showed that the “preoccupied” and the “dismissing” attachment styles were the most prevalent among alcoholists, while the “secure” style was typical of control subjects. Concerning the TEMPS-A we found high prevalence of the hyperthymic and cyclothymic temperaments.