bluuebunny/crossref_metadata_2025 huggingface dataset:
P02-58 - Sexual Misconduct Induced by Iatrogenic Hyperprolactinaemia
Authors: Nevely A. , Frei A. , Graf M.
Published: June 2010

Background

Drugs which affect the level of dopamine have also an impact on the level of prolactine and hence influence the sexual conduct of patients. Hypersexuality is a well known side effect of the treatment of Parkinson's' disease, whereas hyposexuality is a side effect of the drug-treatment of schizophrenia by classical and some atypical antipsychotics. The novel antipsychotic drug Aripiprazole, however, has a partial dopaminergic effect, causes no hyperprolactinaemia and might alter the sexual conduct of some schizophrenic patients.

Methods

Three case reports of patients with iatrogenic forensic-psychiatric relevant hypersexuality.

Case 1: Comparatively young Parkinson-Patient with sexual desinhibition, frequent visits in brothels contracting debts and sexual harassment towards women after treatment with Ropinirol.

Case 2: Chronic hebephrenic patient with homoerotic paedophilia, who only started molesting boys after changing medication from Olanzapine to Aripiprazole.

Case 3: Chronic-paranoid young schizophrenic patient with no criminal record who seriously assaulted a foreign woman short time after changing from Amisulpiride to Aripiprazole.

Discussion

Hypersexuality as side effect of the treatment of Parkinson's disease is well known, it might be more important an issue, if the patient is young. Hypersexuality as side effect of the treatment with partial dopaminergic drugs should be considered in the drug treatment of schizophrenic patients.
P02-61 - Hospital Order for Mentally Disordered Offenders
Authors: Graipaspong D.
Published: June 2010

Objectives

The purposes of this study were to determine criminal behaviors patterns, clinical diagnosis and to compare clinical features of a new after discharged care program to that of the regular program for the mentally disorders offenders under compulsory treatment order.

Materials and methods

The sample was consisted of 35 mentally disordered offenders sent by the court under a hospital order refer to the section 48 of Criminal Code. They were discharged during 1st October 2001 to 30th September 2007. Data were collected from medical records of Galya Rajanagarindra Institute. Quantitative data were analyzed by using descriptive statistics and Chi-square Test.

Results

Most of the samples, convicted to life and body-harm offenses which were taken places at houses and in the communities. The used weapons were knives. Their motivated to crime were psychosis symptoms with no planning. Most of the victims were acquaintances who had no active participation. Three quarters were diagnosed of schizophrenia. After these patients were discharged to the community, more than half were readmitted but only one was recidivist. Most could access to mental health services regularly. There was not statistical different between clinical features of the new after discharged care program and that of the regular one.

Conclusion

The new after discharged care program showed that more than half of cases were readmitted but only one case for recidivist. Most patients could access to mental health services regularly. The new program did not differ from the previous one, therefore, the new program need to be revised.
P02-62 - Autism Spectrum Disorder and Ethnicity in a Forensic Psychiatric Assessment
Authors: Grochowska A.
Published: June 2010

Objectives

There is a growing knowledge about the prevalence and manifestations of autism spectrum disorder (ASD) in adults. However, major diagnostic problems are encountered in a forensic evaluation of persons from different social and cultural backgrounds.

At the conclusion of this presentation, the participant should be able to

1)

apply diagnostic criteria for ASD in a forensic evaluation,

2)

recognize cultural differences in signs and symptoms presentation,

3)

apply risk assessment methods in non-native persons diagnosed with ASD.

Methods

I performed a MEDLINE search of English-language literature from 1980 to 2009 to identify reports on autism and criminal behaviour in adults with emphasis on the role of ethnicity. Furthermore, I evaluated cultural differences in a series of illustrative vignettes of persons from different social and cultural backgrounds who met diagnostic criteria for ASD in a forensic evaluation.

Results

Very few studies examined whether environmental factors predict later outcomes of ASD. IQ is the strongest predictor of outcome. Psychiatric and somatic comorbidity, and poor accessibility of mental health services are associated with negative outcomes. The lack of empathy is a core symptom that accounts for a higher risk for criminal behaviour. The diagnostic process, as well as risk assessment, in non-native adults with ASD is affected by cultural factors.

Conclusions

More cross-cultural research on ASD is needed to further our understanding of forensic problems related to this disorder during the life course.
P02-65 - Battered Women Who Kill Their Children: the Cycle of Violence
Authors: Kachaeva M. , Dmitrieva T. , Satianova L. , Rusina V.
Published: June 2010

Infanticide and neonaticide is a worldwide troubling phenomenon as well as in Russia. Researches found out that domestic abuse against women is often one of the main causes of crimes of violence in women.

Aims

To find out clinical and social factors contributing to specific female crimes - infanticide and neonaticide.

Methods

Psychopathological, psychological, statistical.

Results

A cohort of 16 females who had killed their children was examined. All women were victims of violence by their husbands or partners. Domestic abuse resulted in long-term mental problems of women. Clinical assessment has revealed depression, anxiety, fear, PTSD, alcohol abuse.

There were two types of homicides. Women of the first subgroup (9) had committed infanticide and they displayed pathological altruistic motivation of the crime. Women of the second subgroup (7) had committed neonaticide. Alongside with clinical factors neonaticide reflects mostly social factors. Women of the second subgroup were younger and often exposed to psychogenic situations with high level of stress (financial and housing problems, concealment of illegitimate pregnancy, violence of the partner). In accordance with the Criminal Code of Russia the special article (106) governs infanticide and neonaticide. This law takes into account the psychogenic situation which caused the crime (battered women syndrome) and the fact that at the time of child murder the mental state of mother was affected by childbirth.

Conclusion

In cases of infanticide and neonaticide the court is free to make verdict more lenient and its reflects more humane approach to such complicate phenomenon as child murder.
P02-66 - General Approach to Forensic Evaluation of Different Forms of Schizotypal Disorders
Authors: Klembovskaya E.
Published: June 2010

Background

Schizotypal disorder comprises a wide spectrum of schizophrenic disorders from personality to sub-psychotic disorders. As a result, psychiatric evaluation of this psychopathology is ambiguous and a challenge to forensic psychiatry.

Aims

The aim of study was to define criteria for forensic evaluation of schizotypal disorder according the form of disease by examining 82 patients who committed crimes and who had been diagnosed “schizotypal personality disorder”(12), “schizotypal disorder” (pseudopsychopatic (38), pseudoneurotic (13), schizophrenia with bare symptoms (16), schizophrenic reaction (3)

Results

There was evidence of different forms of schizotypal disorders related to the degree of responsibility for the crime committed (9 patients with schizotypal personality disorders) compared with (46 patients with mild forms of schizophrenia) considered not responsible. The sample of patients were considered as having diminished responsibility (27 patients with different forms of mild schizophrenia). The criteria for psychiatric evaluation were: intensity of negative symptoms, quasi-psychotic symptoms during period of crime, dynamic aspects of disease, connection between psychopathology and character, motives, causes of crime, level of critical and prognostic abilities, intensity of personality disorders, level of social function and adjustment.

Conclusion

Forensic conclusion depends on the form of schyzotypal disorder. The patients with schizoptypal personality disorder demonstrate integrity of cognitive sphere and singularity of emotions, rather high level of social adjustment. That's why the are mostly considered as responsible. The patients with mild forms of schizophrenia show pathology in sphere of thinking and emotions, social problems, so forensic conclusion can be different from irresponsibility to diminished responsibility.
P02-105 - Adherence to the Trust Guidelines for the Use of High Dose Antipsychotic Medication-completed Audit Cycle
Authors: Mehta G. , Kumar P. , Cullen C.
Published: June 2010

Aim and background

To establish the adherence of Assertive Outreach Service to the local protocol for the use of high dose antipsychotic (HDAT) medication. This audit cycle was started with an intention to minimise metabolic syndrome due to antipsychotic medication.

Standard

’Guidelines for the use of high dose antipsychotic (HDAT) medication’-February 2008. The following standards from the guidelines were measured from the sample:

1.

HDAT monitoring sheet should be completed for all HDAT patients

2.

ECG should be done for all HDAT patients

3.

Blood tests (LFTs and U&Es) should be done for all HDAT patients

4.

Physical examination should be done for all HDAT patients

5.

Consent should be obtained from all HDAT patients and filled on the monitoring sheet.

6.

Physical health risk factors should be filled for all HDAT patients

Data sample and collection

Out of 179 patients under the team, 17 patients were prescribed HDAT. All the data were collected from the case notes of all HDAT patients and entered into the HDAT monitoring sheets in January 2009 as a baseline assessment by Dr. Praveen Kumar and re-audited in June 2009 by Dr. Gaurav Mehta.

Conclusions

As evidenced by the results of audit in January 2009 and re-audit in June 2009, all the parameters were up to the standards in June 2009 except the physical examination not performed on all 17 HDAT patients as revealed inthe re-audit.
P02-109 - Psychodiagnostics Professional Adaptation
Authors: Panchenko L. , Basarab I. , Garazha M.
Published: June 2010

Objective of research is study reveal professional suitability of experts of the industrial enterprise with potentially dangerous working conditions.

Objective

107 persons (35-65 years old) working on chemical plant.

Methods

The tables Gorbova-Shulte, techniques «Proof test» B.Burbona and «10 words», a method of colour elections by Lusher, technique «State of health - Activity - Mood», a scale of uneasiness Spilberger-Hanin, a technique «Level neurotic and psychopathyz» were used.Conclusions about conformity or discrepancy of psychophysiological features of this or that examinee to certain kind of activity became on the basis of the complex analysis of results of psychodiagnostics.

Results

Among all examinees of infringement of psychophysiological indicators cognetive functions, emotionally-strong-willed sphere and discrepancy to standard criteria for professional adaptation are fixed at 22 people (20,6%). Among persons at whom discrepancy to standard criteria at 14 people (13,1%) is fixed it is marked истощаемость mental activity; at 22 people (20,6%) - efficiency decrease mnestic functions; at 7 people (6,6%) - high level of emotional intensity with the tendency to increase; at 8 people (7,5%) - high level of alarm; at 5 people (4,7%) - high level neurotic and psychopatization (р < 0,05).

Conclusions

Timely revealing of deviations cognetic and emotional indicators from standard criteria, and also timely reaction, allows to fix group of risk with high probability of erroneous actions, to prevent and essentially to lower level of professional disorganisation of activity.
P02-112 - Mechanical Restraint at a Greek Psychiatric Hospital
Authors: Papaliagkas V. , Teliousis T. , Saratsopoulou M. , Komitis M. , Mastrogianni A. , Karastergiou A.
Published: June 2010

Objective

The aim of the study was to register all incidences of mechanical restraint imposed upon patients hospitalized at an Acute Psychiatric Ward during the year 2008. Associations with social and clinical characteristics of patients were explored.

Methods

The study was conducted at one of the five open Acute Wards of the Psychiatric Hospital of Thessaloniki, All incidences of mechanical restraint were recorded. For each incidence the reason, the duration, the severity and procedural aspects were documented. Socio-clinical characteristics of all patients admitted to the Ward during the year 2008 were registered and possible associations with the implementation of coercive measures were explored.

Results

During 2008 342 admissions were made to the D’ Acute Ward % involuntary. Overall, 157 incidents of mechanical restraint were documented (106 patients; 72 male, 34 female) and the most common diagnosis was ‘psychotic disorder’ (group 1). The main reason for the implementation of the measure was the patient not to leave the clinic However, it is interesting that a highly statistical significant difference was observed in the previous history of psychiatric disease between the two groups (Mann Whitney Z=-6.650, sig< 0.001).

Conclusions

Twenty years after the initiation of the psychiatric reform in Greece the Psychiatric Hospitals still are the main recipient of patients with severe mental illness who are sometimes forced to be hospitalized many miles away from their place of residence. This raises their distress, leads to overcrowded under-staffed Wards and affects negatively the use of coercive measures.
P02-115 - Audit of Discussion About Contraception and the Risks of Pregnancy with Female Service Users
Authors: Reddy J. , Singh H.
Published: June 2010

Objectives

To compare the current standards of clinical practice with the recommendations of NICE guidelines (CG 45).

NICE guidelines (CG 45) on Antenatal and Postnatal Mental health suggest that Healthcare professionals should discuss contraception and the risks of pregnancy including relapse, risk to the foetus and risks associated with the stopping or changing medication with all women of child-bearing potential who have an existing mental disorder and or who are taking Psychotropic medication.

Method

A standardised questionnaire was answered by 50 female patients out of 60, attending New bridge unit in Birmingham for the Outpatient appointment in the month of November -2007. The age group was between 18 and 50. The questionnaire was handed out at the reception and Doctors encouraged patients to fill out the questionnaire. Confidentiality was not compromised.

Results

12 (24%) patients were aware of contraception. 17 (34%) knew about the risks of relapse during pregnancy. 15 (30%) women recognised the risks of stopping or changing the medication and 13 (26%) agreed that the risks to foetus were informed to them. This indicated there was room for improvement.

Conclusions

To improve the standards of practice

·

The Audit report that highlighted standards, was disseminated to all the clinicians through formal power point Audit presentation and through emails.

·

The importance of passing on the relevant information to the patients was incorporated in Doctors Handbook for Junior Doctors.
P02-120 - “The Other Shore of Mental Illnes”: Improving Adherence and Insight in an Acute Psychiatric Unit of a General Hospital
Authors: Serrano Carton C. , Serrano Carton M.M. , Serrano Vázquez M. , Diaz del Valle J.C.
Published: June 2010

Objective

Improving adherence in mental patients, growing up insight and reducing stigmatization.

Giving simple and clear messages to families and patients for learning about symptoms and the management of daily difficulties.

Methods

Three were the main pillars of our work: patients’ opinion, professional knowledge and families contributions. First, patients were questioned about “What is for you mental illness?” “May you explain your illness?” and the answers were completed with a collage/picture. Those opinions were evaluated by the group and the therapist. We already made reunions with a mental patients association and family groups to expose their opinions and daily life difficulties.

Results

Analyzing drawing-collage characteristics, medical histories and reflections from patients and families, we achieved an individual management for patients. Families could expose doubts and suggestions about patients care. We offered a multidisciplinary management to develop insight and adherence.

“The other shore of mental illness” is a book with a psicoeducative propose about useful concepts of mental illness. It emerges from the professional need to approach to the other shore, families and patients’ opinions and feelings.

Conclusions

Drawing has been used as worktherapy, becoming a benefit for diagnosis and evolution in mental illness. In this book we used them as a means in the improvement of insight and adherence.

The work with families, patients and caregivers let therapists to attend the real difficulties in their daily lives.

The book would be not only a vehicle to reduce stigma, but also a reflection on avoiding discriminatory politicals in mental patients assistance.
P02-121 - International Best Practice in Recovery-oriented Mental Health Services
Authors: Slade M.
Published: June 2010

Objectives

Mental health policy in the English-speaking world emphasises the the importance of ‘recovery’ as a guiding philosophy. Translating this rhetorical consensus into reality has proved challenging, with some mental health service users reporting that the concept of recovery is being co-opted by professionals without substantive changes in practice. The aims of this talk are (a) to define personal recovery; (b) to present a theoretical framework for understanding personal recovery; and (c) to identify the four ways in which mental health professionals can support recovery.

Methods

The most widely cited definition of recovery will be elaborated, and key recovery domains identified from a systematic review of consumer narratives of recovery.

Results

A new theoretical framework for recovery - the Personal Recovery Framework - will be presented, which identifies the centrality of identity, the contribution of clinical models to recovery (and how they can be toxic to recovery), and why hope is necessary. The framework identifies four approaches which mental health professionals can use to support recovery: fostering relationships, promoting well-being, offering treatments, and improving social inclusion. Examples will be given of how actual services around the world are undertaking these tasks to support recovery.

Conclusions

Developing recovery-supporting mental health services will involve a fundamental shift in power, values, attitudes, skills and behaviours. It will require system transformation, and genuine partnership between those using, working in and managing services.
P02-124 - The Need for Evaluation of Metabolic Parameters During Long Term Treatment with Clozapine
Authors: Steylen P. , Verhoeven W. , van der Heijden F. , Kok H. , Egger J.
Published: June 2010

Treatment with psychotropic drugs is frequently associated with obesity, dislipidemia, hyperglycaemia and hypertension, resulting in the development of the metabolic syndrome which in turn is an important risk factor for cardiovascular disease and type 2 diabetes mellitus. The atypical antipsychotics clozapine and olanzapine have the most pronounced effect on metabolic parameters. Over the past years, several studies using the definitions of the so called Third Adult Treatment Panel (ATP-III) of the National Cholesterol Education Program, demonstrated a high prevalence of metabolic syndrome in schizophrenic patients treated with atypical antipsychotics.

The present study includes a total of 96 clozapine-treated inpatients. A total of 34 patients had to be excluded because of refusal tot participate (n=23) or not meeting the DSM-IV criteria for psychotic disorders (n=11). Finally, 62 patients (male: 46; female: 16; mean age: 49 ± 14.2 years; mean duration of clozapine treatment: 9.2 years; current dose: 331.5mg daily) were evaluated according to ATP-III criteria. Other parameters that were collected comprised co-medication, smoking status and alcohol use.

Metabolic syndrome was found in 60% of the patients and was associated with female gender. No association was found between metabolic syndrome and duration of clozapine treatment. Frequencies of the individual components were 92% for dyslipidemia, 43% for obesity, 36% for hypertension, 18% for impaired fasting glucose and 18% for diabetes mellitus type 2.

Metabolic syndrome is highly prevalent among patients with psychotic disorders who are treated with clozapine. Additional factors like unhealthy life stile, inactivity and co-medication, emerge as major treatment targets.
P02-128 - The Physical Co-morbidity of People with a Mental Disorder: Variation, Causes, Risk Factors and Prevention strategies across 14 European Countries
Authors: Weiser P. , Lucas R. , Becker T. , Kilian R. ,   for the HELPS Network
Published: June 2010

Objective

Little is known about the physical co-morbidity in mentally ill living in psychiatric and social health care facilities with regard to variation, causes, risk factors and prevention strategies. Aim of this study was to determine patients’ and professionals’ perceptions, attitudes and thoughts of (i) co-morbid physical health problems and illness, (ii) risk factors and causes of somatic problems and (iii) prevention measures across Europe.

Methods

A total of 52 focus groups in 14 European countries were conducted. Participants were recruited from psychiatric and social health care facilities. Data were content analyzed deductively and inductively.

Results

The physical health problems that were often mentioned were weight problems, diabetes, cardiovascular and gastrointestinal problems, problems of the circulatory system, and general aches and pains. Regarding the causes of somatic problems and illnesses, focus groups repeatedly emphasized side-effects from medications. Besides treatment-related factors, country-specific aspects also were mentioned, mainly in the field of the living environment. Findings concerning “prevention” demonstrated the greatest distinctions between the participant groups, particularly with regard to the implementation and realization of health promotion interventions. Discussions revealed that patients preferred active learning (hands-on experiences) coupled with group classes for education and social support.

Conclusions

Focus groups identified behavioural, environmental and iatrogenic health risks. Efforts need to be directed toward interventions for physical illness prevention and health promotion on the background of the heterogeneity of mental disorders and the multitude of physical problems, and need to be based on an understanding of residents’ cultural beliefs and life situations.
P02-86 - Aspects of Aetiology of Neuro-psychic Disorders in Liquidators of Chernobyl Nuclear Station Accident Consequences
Authors: Anatolievich Skavysh V.
Published: June 2010

A selected group of 213 men who had worked at Chernobyl Atomic Power Station within 1986-1987 during 7-60 days (average index is 30+10.4 days) was examined. Mental disorders were found in 196 patients (asthenic, dysthymic, psychovegetative, psychoorganic syndromes). Various neurological symptoms, for example of Marinesku-Rodovichi, were often met. Angiopathia of the retina among 61.7% was found and discircular encephalopathia among 39.3% cases was discovered. The latter suggested by the obtained instrumental data (REG, EEG, SPECT). The author considered aetiology of these disorders, demonstrated scientific value of studying Chernobyl liquidators cohort, as they were protected from internal radiation and reside on radiation “pure” territories. External radiation dose in those liquidators was 18.7+10.8 cGrey. Catamnesis enabled to doubt “radiation aetiology” of all syndromes revealed by clinical and instrumental studies. So, the prolonged over 1-2 months external radiation of such low doses could not case health deterioration in adult males. The MMPI-test profile of our liquidators was very similar to the MMPI-test of american veterans of Vientam war. Diagnosed psychoorganic syndrome in 53.6% cases could have alcohol aetiology. This conclusion is not extrapolated to the whole Chernobyl liquidators cohort. Also the author disputed with psychiatrist V.A.Soldatkin about situation in Rostov-on-the-Don region, with psychiatrists V.L.Malygin, B.D.Tsygankov about situation in Tula region, with psychiatrists V.A.Buikov, P.P.Balashov on the aetiology of psychopathology among the population of South Urals region (after radioactive incidents). The influence of the low doses of the gamma-radiation, of the Post-Traumatic Stress Disorders, of the Alcohol abuse et cetera was discussed.
P02-88 - Hearing Impairment: Successful Communication is a Main Source for Positive Experiences
Authors: Eisenwort B. , Schlanitz F.G. , Niederkrotenthaler T.
Published: June 2010

Objectives

In recent years some studies could show that beside the negative effects of the stressful encounters resulting from disorders and handicaps also positive experiences can be made. The aim of our study is to determine which strategies help the hearing impaired to gain positive experiences.

Methods

The Trierer Persönlichkeitsfragebogen (Becker 1989) and a german translation of a questionnaire which was designed to measure the positive experiences in life with acquired hearing impairment (Stephens and Kerr 2003) were distributed to persons with aquired hearing impairment, which were recruted at acousticians and ENT-doctors.

Results

Positive experiences are gathered mainly by successful communication behaviour.

(Eisenwort et al. in press)

Conclusions

Successful communication helps the hearing impaired to gain positive experiences.
P02-89 - Investigation of Personality Traits and Mental Health: Comparison Between Athletes and Nonathletes University Students
Authors: Homayounnia Firouzjah M. , Tahmasbi F.
Published: June 2010

Introduction

The purpose of this research is to compare personality traits and mental health in athletes and nonathletes students.

Method

67 athletes and 64 nonathletes students were randomly selected and NEO-PIR inventory and General Health Questionnaire (GHQ)were administered on them. Data were analyzed with independent T formula.

Results

Findings showed significant differences between variables. Nonathletes have more neuroticism personality trait and were high in components of mental illness.

Discussion

It is concluded sport rehearsals and physical fitness have positive effects on temperament and mood and reduce mental illness symptoms and give sense of happiness and newness in life.
P02-91 - The Study of IV Drug Abusers’ of Mental Health in Kashan Prison in 2007
Authors: Ghoreishi F. , Ahmadvand A. , Sepehrmanesh Z.
Published: June 2010

The main purpose of the current study is to evaluate of mental health among the IV drug abusers of Kashan prison.

Methods

Without any sampling, we included all IV drug abusers of Kashan prison in our study. They were assessed through GHQ-28 and demographic characteristic questionnaire. In addiction, they were interviewed via DSM-IV check list and evaluated by three psychiatrists.

Findings

Through psychiatric interviews, the most common disorders, in this study, include anti-social personality disorder in 28 persons (93/6%), mood disorder in 21 ones (47/7%), anxiety disorder in 8 ones (18/8%) and adjustment disorder in 3 ones (6/8%)19 ones (43/1%) multi disorder and 25 ones (56/8%) one disorder. In this study, no meaningful relationship between disorder and marital status, job and educational level could be found, but it should be emphasized that the emergence of mental disorder among the unemployed male IV drug abusers and those male IV drug abusers younger than 30 has been more than other IV drug abusers.

Conclusion

Based on the findings of this study, IV drug abusers are not in good mental health. This subject investigation needs more comprehensive and extensive study in this area.
P02-94 - Creativity Construct and its Links to Alexithymia and Depression
Authors: Harrison D. , Ingwersen J.
Published: June 2010

Creativity plays an important positive role in people's social and personal life (Flach, 1990; Runco, 2004). On the other hand, alexithymia and depression may affect psychological well being in a negative way and lead to mental health problems (e.g. Honkalampi et al., 2007; Warnes, 1986). The current study investigated the relationship between these three constructs (creativity, alexithymia and depression) and hypothesised that there are negative relationships between creativity and alexithymia as well as between creativity and depression. 39 participants, aged between18-58 (mean age 30) completed the 20-Item Toronto Alexithymia Scale (TAS-20) for the assessment of alexithymia and the Beck's Depression Inventory (BDI-II) for the assessment of depression. To investigate levels of creativity, participants completed a test of drawing preferences (Barron-Welsh Revised Art Scale (RAS)). The results showed a negative correlation between creativity and alexithymia and positive correlation between alexithymia and depression. Although previous research has found support for a link between creativity and depression it has been described controversially in literature (e.g. Andresen, 2008; Pickering, 1974). The current study did not find a significant correlation between creativity and depression. The results reflect the complexity of the creativity - depression relationship and the need for further research, with more precise control for the type and severity of depression.
P02-97 - Evaluation of Mental Health Status in Caregivers of Patients with Chronic Psychiatric disorders
Authors: Hosseini S.H.
Published: June 2010

Objective

The prevalence of psychotic disorders is %2-%2.5 in general population. This study has been performed to evaluate mental health status in caregivers of patients with chronic psychiatric disorders. Materials and methods: This research was a descriptive - Analytic study performed in Mazandaran province northern Iran. Two hundred caregivers of patients with sever psychiatric disorders completed (GHQ-28) and Demographic Questionnaire. The caregivers had to care at least one year continuously. Sever psychiatric disorders is referred to patients with schizoaffective or schizophrenia or bipolar mood disorder that at least 2 years was passed from onset of disease. Data were analyzed in descriptive statistical method with SPSS soft ware.

Results

Our study showed that %35 of caregivers had GHQ>23 and didn’t have mental health. We found significant association between patients age, Age of onset of disease with GHQ Score (p=0.0001). And there was an association between caregivers’ GHQ score with marital status in patients, although this was not significant (p=0.08). In addition, the X2 test didn’t show significant relationship between duration and type of disease and patient's sex and caregiver's sex with GHQ score.

Conclusions

According to the results of pervious studies and ours, it seems that further investigations with more samples and other Questionnaire is needed to evaluate of caregivers needs and it is suggested that a logical planning be conducted by the authorities, to decrease caregivers’ burden.
P02-129 - Broad-band Ratingscales for the Measurement of Clinical Syndromes in Childhood and Adolescence
Authors: Barkmann C. , Schulte-Markwort M. , Braehler E.
Published: June 2010

Up until now, there has been no available overview of broadband rating scales used for the evaluation of clinical syndromes in childhood and adolescence in German speaking countries. With the aid of a systematic empirical review, all broadband rating scales that fulfilled defined inclusion criteria were described by experts. On average, the N = 14 identified instruments are constructed in a mixed approach and contain 87 items on 4.1 pages to be answered on a 4-point rating scale. Reliability of the subscales (Cronbach's α) is rather dissatisfying, although the internal consistency of total scales is moderate to good. Almost all rating scales are of approved construct validity using German samples. Approximately half of all tests are validated by external criteria. In summary, the existing instruments turned out to be of superior quantity and quality than initially expected, although for a range of diagnostic settings there is no adequate and valid instrument available.
P02-130 - Measuring Complexity in the Age of Information and Accountability: a New Approach to Monitoring Treatment Responses and Client Tracking (TRACT)
Authors: Cawthorpe D.
Published: June 2010

Objectives

Measuring clinical and functional outcomes in mental health is becoming an increasingly complex and costly endeavour. It is with considerable regularity that tens and hundreds of millions of dollars are spent to develop electronic health records, yet today functional integrated products that can operate across domains of health have yet to be identified. The purpose of this paper is to describe ways and means of measuring functional and clinical outcomes across complicated case mixes and treatment domains in hospital and community treatment settings.

Methods

Data from several electronic records and data sources (n = 100,000) are used to illustrate the burden of measurement, data quality and related issues that practitioners face when collecting, analyzing and interpreting data in the age of information and accountability in health care. A practical, flexible, modular, and dynamic tool for measuring functional and clinical outcomes across treatment and education settings is described (TRACT: treatment response application for client tracking).

Results

Relatively simple, modular approaches to clinical and functional outcome measurement that are integrated into medical practice have the lowest burden and highest yield in terms of demonstrating evidence-based practice, treatment effectiveness, and system level accountability.

Conclusions

Simple modular approaches to measuring complex phenomena, such as the effect of multiple treatment interventions in complex environments and against backgrounds of comorbid disorders, are likely to have high quality yields in terms of identifying promising and evidence-based practices through use of the highest standards available to an examination of practice in the field.
P02-133 - Turning Each Patient into a Clinical Study Through Daily Self-rating on 41 Parameters
Authors: Ishizuka Y.
Published: June 2010

In Lifetrack therapy, each patient and his/her partner perform daily subjective self-rating on 41 parameters offering the means of accurate tracking of dynamic mental status and subtle changes in personality throughout the course of therapy.

During each therapy session, progress (or lack thereof) of on-going therapy is graphically examined via Internet, making the patient, the therapist, and the therapy method fully accuntable turning each patient/therapist case into an on-going clinical study offering source of innvation and accountability. Analysis of therapeutic results of 1,200 cases will be presented.

Daily self-rating by the patient overcomes some of the following limitations of ‘Control Group Comparison’ method of evaluating therapeutic efficacy of a given therapy and therapist on each case;

1.

Abstract comparison between ‘groups’ of idealized ‘average’ patients and therapists may not be relevant to each individual patient and therapist.

2.

Prevailing research design requirement tends to exclude severe and exceptional cases that often yields vital clues for innovations and breakthroughs.

3.

Majority of therapists may not strictly adhere to protocols of treatment methods in actual practice (75% of CBT therapists do not, according to some experts), making relevance of efficacy results limited if not questionable.

4.

Randomly Assigned ‘Control Group’ comparison is costly and time consuming to conduct, making it extremely difficult if not impossible for innovative approaches to challenge established and well funded therapy approaches.
P02-135 - A Pattern Recognition Matrix for Placebo-response in Schizophrenia
Authors: Opler M.
Published: June 2010

Objectives

There is a need for real-time capability to detect inconsistencies in efficacy outcome measures and to predict individual-level or group-level placebo response. Training and calibration to improve reliability is one method; though this can be undermined by the enrollment of placebo responders.

Methods

A pattern recognition matrix for placebo-response in schizophrenia was developed based on a Phase II study of schizophrenia conducted in the US. A data monitoring algorithm based on the Positive and Negative Syndrome Scale (PANSS) was retrospectively applied to the unblinded data and score patterns for the placebo responders versus placebo non-responders were analyzed.

Results

A total of 35 placebo responders and 35 randomly selected placebo non-responders were compared. For specific patterns during the first 2 visits, patients were significantly likely to be placebo responders. Within this sample of patients who were randomized to placebo, those who demonstrated the pattern within the initial study visits were approximately three times more likely (OR=2.9, p=0.027) to demonstrate a placebo response.

Conclusion

This initial finding suggests that this method could aid in the detection of placebo response early in a trial. In concert with a data-monitoring process we would expect more robust signal detection. The use of the same system, coupled with ongoing training has demonstrated significant improvements in reliability, increasing the ICC by 19% in a 3-month period. If deployed at startup, this method provides a cost-effective way of managing the data quality in RCTs.
P02-136 - Questionnaire on Sexual Attitude and Function 2009: a Novel Clinical and Epidemiological Computer Based Tool
Authors: Pirkalani K. , Talaei Rad Z.
Published: June 2010

Objective

To study sexual problems of our patients and standardizing it for patients with or without religious and cultural restrains we developed a questionnaire with 240 phrases that were extracted from a pool of 1400 sentences addressing sexual problems. Sixty four scales under four headings (sexual general characteristics, deviations, dysfunctions and psychodynamic syndromes) (16 items each) were evaluated based on criteria of DSM-IV and ICD 10. Five validity scales (honesty, desirability, debasement, guilt feeling and overall validity) were also used for better assessment.

Methods

A total of 1300 patients in the four variants of the test were evaluated during a time span of 7 years. The questions were presented to examinees at 8th. Grade and higher in a calm environment and the results were evaluated by a computer software specifically developed for this purpose.

Results

The last version of the test was completed by 734 patients with excellent compliance. It was of nice politeness and comprehensiveness. For almost all scales the sensitivity and specificity were around 85 and 92% respectively.

Conclusion

We conclude that QSAF 2009 is an excellent tool both in clinics (diagnosis and follow up) and epidemiology with high sensitivity and specificity. It has also application in cross cultural studies, medico - legal issues and medical documentation. It prevents face to face interviews, breaks patients’ resistance and is less time consuming than scheduled interviews.
P02-145 - The Neural Correlates of Visuo-spatial Working Memory in Patients with Amnestic Mild Cognitive Impairment
Authors: Alichniewicz K.K. , Nebl H. , Klünemann H.H. , Greenlee M.W.
Published: June 2010

Objectives

The extent of working memory (WM) impairment has rarely been studied in patients with amnestic mild cognitive impairment (aMCI). The aim of the present study was to evaluate the cortical activation in these patients compared to healthy controls while performing a visuo-spatial WM task.

Methods

Functional magnetic resonance imaging (fMRI) with a 3-Tesla head scanner (Allegra, Siemens) was used to investigate the neural correlates of WM in 25 aMCI subjects and 12 matched controls while performing a visual-spatial n-back task (2-back). Both groups were pretested to ensure that all participants were able to understand and perform the task.

Results

In comparison to the healthy subjects, a random-effects analysis revealed that patients with aMCI showed less cortical activation especially in the left superior parietal cortex and left inferior frontal cortex. These areas are known to be involved in the control of attention and visuo-spatial WM.

Conclusions

Our findings suggest that attenuated cortical activation during working memory tasks may provide an early marker for aMCI.
P02-146 - Neurobiological Aspects of the Psychotherapy of Obsessive-compulsive Disorders
Authors: Dold M. , Aigner M.
Published: June 2010

Introduction

Following consensus on a fronto-striato-thalamo-frontal dysfunction as the neuronal basis of the pathogenesis of obsessive-compulsive disorder, neurobiological psychotherapy research is concentrating increasingly on recording the neuronal modification mechanisms induced by psychotherapeutic intervention.

Method

A systematic literature search was used to identify original papers that studied the effects of psychotherapy on the neuronal activation patterns correlating with obsessive-compulsive disorder.

Results

As a consistent result in patients with obsessive-compulsive disorder, a reduction in activity in the caudate nucleus was measured after a successful response to behavioural therapy in those studies that did not use any psychological simulation test. Moreover there is evidence of an altered correlation between the orbitofrontal cortex (OFC), the caudate nucleus and the thalamus after a symptom improvement induced by psychotherapy, and also an improved recruitment capability by those cortex areas that play an important role in cognitive processes, such as the cerebellum and the dorsolateral prefrontal cortex (DLPFC).

Discussion

It can be shown that neuronal activation patterns in the brain are modifiable by psychotherapeutic interventions. It is unclear why these changes in the case of obsessive-compulsive disorder are similar to those produced by pharmacological treatment whereas in the case of depression, for example, heterogeneous results are observed in this respect. Furthermore, the methodological background of the neuro-imaging methods is critically analysed and future research strategies for neuroscientifically oriented psychotherapy research are indicated.
P02-161 - Alzheimer's Madonna
Authors: Bulow P.
Published: June 2010

Alzheimer's disease is hard to talk and think about and even harder to

accept. It pitilessly cuts the afflicted off from the self and points out to all of us how fragile the mind is. There is perhaps no expression more fitting than the term “loss of soul”, used by some tribal societies, to express the universal fear brought on by this disease. Its landscape lies at the furthest limit along the continuum of mental decline that is in its milder form a normal part of aging. Like a mythical land, it lies beyond the sun, far from the hum of life. It calls to mind the river Lethe, the river of forgetfulness of Greek and Roman myth, from which mortals must drink before embarking on the journey to the underworld. I made a sculpture of the Alzheimer's Madonna because I felt a need to address the fear of Alzheimer's Disease. Both figures in the sculpture turn in a spiraling motion, as in a dance. As she stands at the beginning of adult life, he marks the end. Together, they form a kind of whole, as we each, in our own psyche, carry them inside of us- the image of hope, and youthful beauty, which denies any reality but eternal youth; the image of our decline, of the waning of our powers.
P02-169 - Sounding of the Social Phobia Among Students: Cross-study of 200 Cases
Authors: Feki A. , Masmoudi J. , Mnif L. , Haj Kacem H. , Halwani N. , Baati I. , Ayadi N. , Jaoua A.
Published: June 2010

Introduction

Social phobia is the most prevalent anxiety disorder. It is accompanied by a deterioration of the quality of life and social adaptation. This has further impact that this disorder begins at a young age at the time where the topic has not yet acquired a stable socio-professional status.

The aim of our study was to assess the sounding of the social phobia among a population of 200 students.

Methods

It was a cross-sectional study, focusing on a group of 200 students from 5 universities in Sfax city, Tunisia.

We used:

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The Liebowitz Social Anxiety Scale for screening the social phobia,

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The Sheehan scale for the evaluation of the sounding on the social, professional and family life.

Results

Thirty three per cent of this population presented a social phobia.

According to Sheehan scale, the disturbance in school, social and family life was mild to moderate (schooling: 3. 29; social: 2.95; family: 2.62).

Discussion and conclusion: Our study showed that the impact of the social phobia is lightweight at the family and social level but more important in the area of schooling. This suggests the necessity for screening and treatment of social phobia among students for a better socio-family insertion and especially for better academic achievement.
P02-175 - Voluntary Interruption of Pregnancy in Unmarried Girls
Authors: Haj Kacem H. , Ayadi N. , Masmoudi J. , Mnif L. , Marwan R. , Feki A. , Jaoua A.
Published: June 2010

Introduction

The voluntary interruption of pregnancy (or voluntary abortion), authorized in Tunisia since 1973, has always been a public health problem, given the number of women affected each year.

The objective of this work was to develop, through a descriptive study, the profile of girls who aborted in the regional center of family planning (FP)of Sfax.

Material and methods

This is a descriptive study, conducted in the regional center of FP of Sfax, with 130 unmarried girls, who asked for abortion during the period from October 2008 to June 2009.

Results

In our series, the girls had an average age of 25.4 years and the majority was between 20 and 29 years.

Most of them were from urban origin (63.1% versus 36.9% rural origin).

63.9% had a primary or a secondary education and 70.9% had low socioeconomic status.

More than half of the studied girls (55.4%) lived with their families. The rest lived independently or in dormitories.

The majority of surveyed girls’ parents (76.9%) lived together.

The existence of major family problems was reported at 65.3% cases, essentially family violence (49.3%) and financial problems (45.6%).

Conclusion

It appears from this work that the risk factors involved in most of the unwanted pregnancies with abortion are:

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The young adulthood with a longer period of celibacy.

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The urban origin.

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The low education level.

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The low socioeconomics status.

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The lacks of family communication.

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The existence of major family problems, mostly violence and financial problems.