bluuebunny/crossref_metadata_2025 huggingface dataset:
FC08-04 - Trajectories of depressive episodes and hypertension over 24 years: the whitehall II prospective cohort study
Authors: Nabi H. , Chanstang J.-F. , Lefèvre T. , Dugravot A. , Melchior M. , Marmot M.G. , Shipley M.J. , Singh-Manoux A.
Published: May 2011

Introduction

Prospective data on depressive symptoms and blood pressure (BP) are scarce, and the impact of age on this association is poorly understood.

Objectives

The present study examines longitudinal trajectories of depressive episodes and the probability of hypertension associated with these trajectories over time.

Methods

Participants were 6,889 men and 3,413 women London based civil servants followed for 24 years between 1985 and 2009. The age of participants over the follow-up ranged from 35 to 80 years. Depressive episode (defined as scoring 4 or more on the General Health Questionnaire-Depression subscale or using prescribed antidepressant medication) and hypertension (systolic/diastolic blood pressure ≥ 140/90 mm Hg or use of antihypertensive medication) were assessed concurrently at five medical examinations.

Results

In longitudinal logistic regression analyses based on Generalized-Estimating-Equation using age as the time scale, participants with depression trajectory characterised by increasing depressive episodes overtime had a greater increase in the likelihood for hypertension with advancing age; an adjusted-excess increase of 7% (95% CI 3-12, p < 0.001) for each five-year increase in age compared to those with a low/stable depression trajectory. In a model adjusted for relevant confounders, a higher risk of hypertension in the first group of participants did not become evident before age 55. A similar pattern of association was observed in men and women although the association was stronger in men.

Conclusions

This study suggests that the risk of hypertension increases with repeated experience of depressive episodes over time and materializes in later adulthood.
FC08-05 - Work-related threats and violence and incident use of psychotropics
Authors: Madsen I.E.H. , Burr H. , Rugulies R.
Published: May 2011

Introduction

The consequences of work-related violence and threats for clinically significant mental health problems are unclear: One study showed associations with hospitalisation for depressive and stress-related disorders, but a different study found no association with use of antidepressants. This null-finding, however, could be due to lack of statistical power.

Objectives

Re-examining the relation between exposure to work-related threats and violence in a large sample of Danish employees (n = 15527).

Aims

Assessing whether employees reporting exposure to work-related threats or violence are more likely to start treatment with psychotropics.

Methods

We synthesized three Danish studies with self-reported data on exposure to work-related threats or violence within the past 12 months and linked it with purchases of psychotropic medications through registry-data. After excluding 1750 respondents who had used psychotropic medication previous to 12 months before questionnaire-response, the final study population was 15527 employees. We examined four mutually exclusive outcomes:

1)

antidepressants (N06a),

2)

anxiolytics (N05b),

3)

antidepressants and anxiolytics,

4)

hypnotics only (N05c).

Using four separate logistic regressions we adjusted risk estimates for confounding by gender, age, cohabitation, education, and income.

Results

Preliminary analyses show increased risk for treatment with antidepressants (OR = 1.46; 95%CI: 1.15–1.86) and antidepressants combined with anxiolytics (OR = 1.79; 95%CI:1.16–2.76), but not anxiolytics (OR = 1.04; 95%CI: 0.74-1.45) or hypnotics only (OR = 1.08; 95%CI: 0.77–1.50). Final results will be available for the conference.

Conclusions

In this large sample of Danish employees, exposure to threats or violence in the workplace is associated with treatment with antidepressants, and antidepressants combined with anxiolytics, but not anxiolytics or hypnotics only.
FC08-06 - Distress or depression? does socioeconomic position matter?
Authors: Kyriaki Kosidou K. , Dalman C. , Lundberg M. , Hallqvist J. , Isacsson G. , Magnusson C.
Published: May 2011

Introduction

It is not well known whether the association between common mental disorders and low socioeconomic status vary with symptom severity, type of socioeconomic indicator or gender.

Objectives

To study the association between socioeconomic status and risk for different severity levels of psychological distress as well as depression.

Methods

A population-based survey was conducted among a random sample of Stockholm County residents aged 18–84 years in 2002, and respondents were reassessed via a follow-up questionnaire in 2007. Participants in both surveys (n = 23 794) were categorized according to socioeconomic status at baseline and followed up for onset of psychological distress (according to the twelve-item general health questionnaire) and depression (according to health data registers).

Results

Occupational class had little impact on risk for distress regardless of severity or gender, but was strongly associated with onset of depression - albeit only in men (ORs being 3.0 [95% CI 1.5–5.9] in men and 1.1 [95% CI (0.7–1.7]) in women, comparing unskilled manual workers with higher non-manual workers). Income was associated with risk for onset of all outcomes and the association grew stronger with symptom severity. High household income was particularly protective of depression in women. Education was unrelated to either outcome in men and women overall.

Conclusions

While psychological distress appears to occur at a similar rate regardless of socioeconomic position, risks for severe distress and especially clinically overt depression are markedly linked with occupational class in men and with family income in women. The socioeconomic gradient in common mental disorders increases with symptom severity.
FC09-02 - Efficacy of distraction by means of virtual reality in the control and reduction of pain using the cold-pressor test
Authors: Gutiérrez-Maldonado J. , Cabas-Hoyos K. , Gutiérre Martínez O. , Loreto-Quijada D. , Peñaloza-Salazar C.
Published: May 2011

Introduction

Attention plays an important rol in pain perception. Focusing attention in pain intensifies the painful experience whereas distraction may decrease its subjective sensation (Eccleston & Crombez, 1999).The purpose of the two studies is to establish the efficacy of distraction by means of VR in the control and reduction of pain using the cold-pressor test. In both studies threshold, tolerance, perceived pain intensity and time estimation were measured.

Study 1

37 healthy participants were induced pain in two consecutive immersions using the cold-pressor test. The experiment was counterbalanced and all participants went through two experimental conditions: VR (stereoscopic screen) and black screen. A virtual environment “Surreal World” was designed based on distraction of attention techniques. Results showed that VR significantly increased threshold and tolerance, diminished pain intensity and perception of time.

Study 2

35 healthy participants underwent two consecutive immersions using cold pressor: VR (using the updated version of Surreal World and 3D laptops) and black screen. VR significantly increased the threshold and tolerance, whereas variations in the estimation of time were barely significant.

Differences in the results of the two studies could be accounted for by the immersive effect of the stereoscopic screen. Findings are discussed in relation to previous studies on VR and pain. Results support VR as an adjunctive method in pain treatment and allow proving its efficacy in patients with chronic pain.
FC09-03 - Psychological morbidity in ambulance drivers in a conflict zone - experiences from Kashmir
Authors: Wani Z.A.
Published: May 2011

Ambulance drivers represent a crucial link in health care. Their role becomes more important in war, conflict and similar settings. Increased exposure to high risk situations is a norm rather than an exception in a conflict zone. Kashmir has been undergoing a low intensity conflict since last 20 years in which thousands have lost lives and many more have been injured. Violence has affected nearly everybody living in Kashmir. The present study was done to assess the difficulties faced by the ambulance crew along with along with the psychological impact of the conflict. A questionnaire was formulated and was administered to the ambulance drivers of the major hospitals of the valley. Damage to ambulances, Frequent arguments with Indian security forces. Bodily injuries including fractures due to being beaten by police, torture were regular occurances for a signifiant number of drivers. Long working hours (80–90), disturbed sleep patterns along with night mares, Fear apprehension Somatic complaints, Anxiety were the most common symptoms. In spite of all these problems none of the drivers had seeken a psychiatric consultation for their symptoms. Although a few had self started on anxiloltic drugs but no proper psychiatric treatment was instituted in any of the suffers.Prolonged working hours, working in a high stress environment with hostile mobs on one side and non accountable security forces on another takes the toll on the mental health of these drivers.
FC09-04 - The verbalization filter model in informational levels of the psychic
Authors: Enatescu V.V. , Enatescu V.R. , Enatescu I.
Published: May 2011

In the structure of psychic's level passing from the gnosic level to the semantic level is done through the verbalization filter which allow the internalization of the speech.

We develop our original model of psychic compatible with Piaget theory. Staging the speech development, we can divide in the next phases: a somatic development of the phonatory organs with a synchronization of the respiratory organs, a developments: a somatic development of some sounds pronunciations of some sounds pronunciations with external feedback for the correlation of the phonatory motors centers with the auditory sensorial centers. Till here we talk about a stage of phonation exercising. Generating of words with them gradual connection to object, person, concept with a stage of semantic connections. A period of external language, when thoughts are expressed with a loud voice and external feedback is more important and necessary essential for thinking. A gradual internalization of speech with a developing of abstract thinking and a final stage of intelligence development based on concepts (words) and logic operations with words.

This entire are doubled by phenomena of figurative representation that represent the multimodal functions which involve beside specific sonorous of inner speech other parameters: visuals, tactile, olfactory, etc.

In internalization is not necessary the muscular efector peripheric screen except in the first phase of the forming and consolidating of the filter. Lack of auditory self-control lead to speech disorders and total lack of external stimulation (sensorial deprivation) could generate auditory hallucinations.
FC09-05 - The effect of TNFα blockers on psychometric measures in treatment resistant ankylosing sponylitis patients: A pilot study
Authors: Arisoy O. , Beş C. , Çifci Ç. , Sercan M. , Soy M.
Published: May 2011

Introduction

There is a high co-morbidity between chronic inflammatory disorders and depression1. Proinflammatory cytokines like TNFα seems to play a central role in the pathogenesis of these disorders and its neutralization provides a potent treatment for inflammatory disorders2. Trying et al (2006) showed that a TNF-α blocker -etanercept- caused at least a 50% improvement in depression scores in psoriasis patients.3 These observations together with the theoretical background led to the hypothesis that TNF-α blockers may reverse depressive symptoms associated with chronic inflammatory disorders.

Aim

To evaluate the effectiveness of TNF-α blockers on symptoms of ankylosing spondylitis (AS) and depression.

Methods

9 treatment resistant AS patients with no contraindications for TNFα blockers, who were not using any psychotropic or nonbiological drugs were enrolled for the study. TNF-α blockers were given at weeks 0, 2 and 6 and Hamilton Depression and Anxiety Scales (HAMD, HAMA), Hospital Depression and Anxiety Questionnaire (HAD), Quality of Life Scale (SF36), AS severity index (BASDAI) was applied to the patients at week 0, 2 and 6.

Results

There was a significant reduction in HAMD (p = 0.00), HAMA (p = 0.00), HAD-anxiety scores (p = .004) and a significant improvement in SF36- physical role (p = 0.00), physical role limitations (p = 0.01), bodily pain (p = 0.01), general health perception (p = 0.00), vitality (p = 0.02) and emotional role limitations (p = 0.01) subscales and BASDAI scores (p = 0.00) from week 0 to weeks 2 and 6.

Conclusions

This study showed that TNFα blockers may have a potential antidepressant effect besides its antiinflammatory effect in AS patients in a small sample.
FC10-01 - Pharmacogenetic association between 5HTT/SLC6A4, 5HTR2A and THP2 genes and the response to tianeptine in major depressive episode
Authors: Ramoz N. , Burgess E. , Le Strat Y. , Gorwood P.
Published: May 2011

Introduction

Depression is the most frequent psychiatric disorder. Antidepressant drug treatment response is modulated by genetic factors. Tianeptine molecule does not inhibit serotonin reuptake. Possible targets to this treatment are the serotonin transporter (5HTT/SLC6A4), the serotonin receptor 2A (5HT2A) and, the neuronal-specific enzyme that controls brain serotonin synthesis, the tryptophan hydroxylase-2 (TPH2).

Objectives

We screened variants of candidate genes 5HTT/SLC6A4, 5HTR2A and THP2 in 3500 outpatients treated with tianeptine for a major depressive episode (MDE) to search for an association to a positive treatment response.

Aims

The goal of this work was to study the pharmacogenetic response to tianeptine treatment in MDE.

Methods

A total of 3500 outpatients were treated with tianeptine for a MDE. The criteria for a MDE were examined by the clinicians according to the DSM-IV diagnosis and the duration of each symptom was recorded during the inclusion and at 4 to 8 weeks of treatment. The Hospital Anxiety and Depression Scale (HAD) was evaluated at the two visits. DNA was extract from saliva sample and genotyping of single nucleotide polymorphisms (SNPs) was performed by Taqman assay.

Results

All clinical and genotype data were collected for 1855 tianeptine-treated patients. The SNP rs6354 in SLC6A4 gene was significantly associated with response to tianeptine (p = 0.009; Odds ratio = 1.26; 95% confident interval = 1.06–1.50). Two SNPs in 5HT2A and one in TPH2 were also associated to treatment response (rs7322347 p = 0.03, rs7997012 p = 0.04 and rs7955501 p = 0.04).

Conclusions

We detected a pharmacogenetic association between serotonin genes and the response to tianeptine in major depressive episode.
FC10-03 - Translation of an evidence-based collaborative care model for depression into 80 primary care practices. Outcomes and lessons learned
Authors: Williams M.D. , Katzelnick D.
Published: May 2011

Introduction

The DIAMOND (Depression Improvement Across Minnesota--Offering a New Direction) project is a clinical intervention that was developed and implemented by the Institute for Clinical Systems Improvement (ICSI) in Minnesota beginning in 2008. The ambitious goals of the project were to implement an evidence based model of depression into a variety of settings while changing the reimbursement system for these clinics in order to sustain this model over time. Two years later, the model is in 80 different primary care clinics and data is reported to the state.

Objectives/aims

A review of the major outcomes from this translation of evidence into practice. Preliminary research on critical factors leading to best outcomes will be offered.

Methods

Patients with a diagnosis of Major Depression or Dysthymia and a PHQ-9 score of 10 or greater are eligible for this model of care. Outcome measures include remission rates at six and twelve months. Process measures include the use of the primary tool (PHQ-9), the percentage of eligible patients activated into care management, and drop out or opt out rates. Site visits to all clinics were carried out after implementation by ICSI with preliminary results on best practices.

Results

Results are comparable to those found in randomized controlled trials. As of March 2010, 6-month response averaged 36% (range 8–60%) and 6-month remission averaged 27% (range 7–51%). All intent to treat.

Conclusions

The DIAMOND model was successfully disseminated into diverse settings with excellent results. Factors predicting best clinic outcomes will be reviewed.
FC10-04 - Efficacy of auditory stimulation programs for the treatment of depression, dysthymia and symptoms of burnout - RCT results
Authors: Brandes V.M. , Terris D.D. , Fischer C. , Loerbroks A. , Jarczok M.N. , Ottowitz G. , Titscher G. , Fischer J.E. , Thayer J.F.
Published: May 2011

Depression is a prevalent, often chronic and disabling disease. Current psychosocial and antidepressant treatments result in similar response rates with mostly symptom reduction, but not complete remission. Poor treatment adherence complicates depression management and prevention of recurrent episodes. Therefore, new therapies must be developed urgently, that alone or combined with present treatments, can significantly improve therapy outcomes.

Depression is potentially associated with decreased heart rate variability (HRV). Based on our previous studies' results which demonstrated HRV increase following auditory stimulation, we developed two interventions based on specifically for depression treatment composed and arranged music and tested the efficacy in a waiting list and placebo controlled double-blind study with depressed outpatients.

Depression status was assessed at the beginning of T1 and T2 using the Hamilton Rating Scale for Depression (HAM-D), Beck Depression Inventory (BDI), Hospital Anxiety and Depression Scale (HADS-D) and by a composite (COMP) scale based on HAM-D, BDI and HADS-D z-scores. Changes in depressive symptoms between T1 and T2 (5 week period) were assessed based on COMP and on HAM-D, BDI and HADS-D scores alone. Compared to the control arm, a significant, positive effect in COMP was observed for MT1 at T2. Both MT1 and MT2 were associated with significant positive effects (HAM-D and HADS-D scores). MT2 resulted in positive effects on BDI scores. No significant change in any depression score was detected in the placebo arm. Treatment continuation was associated with an effect increase (mean HAM-D score reduction of 60%) after 10 to 15 weeks of treatment.
FC10-05 - Attenuated serotonin transporter association between midbrain and nucleus accumbens in major depression
Authors: Hahn A. , Akimova E. , Häusler D. , Philippe C. , Savli M. , Baldinger P. , Höflich A. , Zgud S. , Mitterhauser M. , Wadsak W. , Lanzenberger R. , Kasper S.
Published: May 2011

Introduction

Patients suffering from major depressive disorder (MDD) exhibit alterations in serotonin transporter (5-HTT) binding clinically reflected by lack of hedonic experience. We recently demonstrated the importance to evaluate interregional relationships of neurotransmitter systems, providing important complementary information on a network level.

Objective

To identify interregional 5-HTT relationships between the midbrain raphe region and projection areas in MDD patients compared to controls.

Methods

Eighteen medication-free patients with MDD and 16 healthy subjects underwent PET using [11C] DASB. 5-HTT binding potential (BPND) maps were computed with the multilinear-reference-tissue-model-2 in PMOD3.1. Voxel-wise linear regression was calculated in SPM8 using midbrain 5-HTT BPND as regressor; group comparisons were assessed by ANOVA (p < 0.001).

Results

Healthy subjects showed positive associations between serotonin transporters located in the midbrain and transporters expressed in the nucleus accumbens bilaterally. Importantly, this relationship was significantly decreased in MDD patients as compared to controls (t = 5.41/4.84, right/left hemisphere; see figure).

Conclusions

This study demonstrates for the first time 5-HTT alterations on a network level in MDD patients between the midbrain and a major projection area. Our results complement previous findings emphasizing the importance of the nucleus accumbens in MDD and indicate a disturbed serotonergic regulation in this key area of reward processing.
FC11-01 - Depression prevalence and its relationship with delivery method in Iranian women
Authors: Zangene M. , Shams Alizadeh N. , Rezaei F. , Rezaei M.
Published: May 2011

Introduction

Postpartum depression is the most common and major health problem affecting mother, newborn and family health.

Objectives

This study aimed to determine depression prevalence and its relationship with delivery method in Iranian women.

Aims

To identify factors contributing to postpartum depression.

Methods

In this cross-sectional study 531 primiparous women were evaluated 20 to 40 days after delivery. The instruments of gathering data were Edinburg Postpartum Depression Scale which were completed via interview. Analysis of data was performed by SSPS 12.0 software.

Results

In total 40.7% of participants had postpartum depression. The depression rate among emergent caesarean, normal delivery and elective caesarean groups was 50%, 40.5% and 27% respectively. There was a significant relationship between delivery method and depression (P = 0.001). No significant relationship was found between postpartum depression with age and mother's education level.

Conclusion

In this study the rate of depression in emergent caesarean group was greater than normal delivery and elective caesarean groups, therefore the method of delivery must be determined before delivery to decrease the rate of emergent caesarean by appropriate strategies. Furthermore, in emergent caesarean some interventions should be performed to decrease the rate of postpartum depression.
FC11-02 - The role premenstrual syndrome (PMS) and psychological variables in prediction of cesarean labor
Authors: Ghooshchianchoobmasjedi S. , Dehghani M.
Published: May 2011

Introduction

Prevalence of the cesarean labor in Iran has reported 41percent in recent studies which is really higher than expected rate compare to other countries.

Objectives

Our purpose in this research was to examine the role of premenstrual syndrome (PMS) and psychological variables(Depression, Anxiety, Stress) in prediction of the cesarean labor.

Aims

My aim was to examine the role of premenstrual syndrome and psychological variables(Depression, Anxiety, Stress) in prediction of the cesarean labor in Iran.

Methods

Participants were 300 pregnant women from two private (n = 150) and public (n = 150) hospitals who were selected using available sampling method. After informed consent provided from all participate, variables such as age, level of education, month of pregnancy, previous number of deliveries, previous number of cesarean, tendency to cesarean and type of hospital were control for using counter balancing method.

Two questionnaires of Short Premenstrual Assessment Form (SPAF) and Depression, Anxiety, Stress Scale (DASS) were administrated.

Results

A Regression Binary Logistic was revealed that month of pregnancy, previous number of cesareans and also the type of hospital could predict the tendency to cesarean. No significant effect was observed for psychological variables (Depression, Anxiety, Stress) and premenstrual syndrome (PMS).

Conclusions

These results showed that increase in the month of pregnancy and also decrease in the previous number of cesareans and selection of private hospital, predict the cesarean delivery among women.
FC11-03 - Effectiveness of anger management training anger on the severity of symptoms premenstrual syndrome
Authors: Saleh Ahangar K. , Ahmadi Gatab T.
Published: May 2011

Introduction

Premenstrual syndrome following repeated monthly collection of signs and symptoms of physical and psychological in the late luteal phase occurs.

Aims/ methods

This experimental research study design, pre-test - post test control group is. First 250 people in a community of women, the menstrual record daily symptoms for two consecutive months have been filled, then between them, the final sample (24 = n) on most women who have been signs of anger; established To determine the effectiveness of anger management anger on the severity of symptoms of premenstrual syndrome (PMS) is.has been.

Groups including

Group receiving 12 sessions of one and a half hours of anger management training and group not receiving training. Test 2 anger Ashpylbrgr for all participants (experimental and control) was performed.

Results/ conclusions

12 weekly sessions of anger management anger effectively PMS symptoms were reduced. No significant difference in the severity of PMS symptoms before and after the anger management training anger has been viewed.In this study, the fact that the anger of the symptoms of this syndrome are highlighted. The results indicated that the mean scores in anger before and after the intervention has been significant change. The positive effect of education on mental to control PMS symptoms is emphasized.
FC11-04 - Patterns of depression and trajectories of treatment over the perinatal period
Authors: Bowen A. , Bowen R. , Muhajarine N.
Published: May 2011

Introduction

Perinatal depression is an important problem with potentially deleterious health outcomes; however, we know little about the trajectories of depression and treatment.

Purpose

We report the patterns of maternal depression and trajectories of treatment response in early and late pregnancy and during postpartum in 649 women recruited from the general population of pregnant women in Western Canada. Women who scored ≥ 12 on the Edinburgh Postnatal Depression Scale were classified as depressed.

Findings

Fifty-two percent of participants were primiparas, 90% were partnered, 83.3% Caucasian, 67% earn more than $40,000 per year, 90% completed high school, and 77% had planned pregnancy. The unadjusted prevalence of depression in early pregnancy (17 weeks) was 14%, late pregnancy (30 weeks) 11.5%, and postpartum (4.1 weeks) was 9.8%. All of the psychosocial factors measured - history of depression, mood instability, lack of social support, relationship problems, worry, and stressors heighten depression symptoms throughout parturition. Our practice of referring women who screened positive for depression changed prevalence rates of women who were depressed and in treatment. The number of women in treatment increased from 12.2% in early pregnancy to 24.8% at postpartum. Women were significantly more likely to get symptom relief counselling in pregnancy compared to psychotropic medication use in postpartum, with the exception of those women with history of depression and treatment engagement.

Increased understanding of the patterns and nature of maternal depression and treatment response is essential to early identification of women who are depressed and lead to treatment that is more effective.
FC11-06 - Female - only psychiatric intensive care unit (PICU): Prospective study of patient demographics and outcomes at elizabeth casson house, bristol, UK
Authors: Gintalaite-Bieliauskiene K. , Tandon V. , Woochit V.
Published: May 2011

Introduction

There are above 170 PICUs identified in the UK. A modest body of research has emerged documenting characteristics of PICU populations. Comprehensive data describing patients admitted to PICUs remains incomplete. There is no data on Female only PICU population's characteristics.

Objective

To offer the first and the only project data country wide up to date on Female only PICU population. It describes socio-demographic characteristics, mental state and outcome of treatment for 49 patients admitted to the first Female PICU in NHS in UK in 2008

Method

Prospective case note analysis

Results

65% of patients were single, 73% were Caucasian and 26% had BME background. Most of patients were admitted from police stations and detained under S2 or S3 of the MHA. Most dominant diagnoses were Schizophrenia and Personality Disorder. 77% of admissions were due to physical aggression and severe self harm. Most patients had more than 5 previous admissions to Mental Health wards. Half of the patients received intramuscular Rapid Tranquilization during the admission and 22% were placed in Enhanced Care Area. Median length of stay did not exceed recommended 8 weeks but some patients with the diagnosis of Personality Disorder experienced an excessive length of PICU stay. Most patients were transferred to open acute wards.

Conclusions

Patients admitted to Female PICU were most likely to have major psychosis or personality disorder, admitted due to violence or self harming behavior, more likely to exceed recommended max length of stay if diagnosis of PD was given, BME group being represented.
FC12-01 - Neural processing of social rejection: The role of schizotypal personality trait
Authors: Premkumar P. , Ettinger U. , Inchley-Mort S. , Sumich A. , Williams S.C. , Kuipers E.A. , Kumari V.
Published: May 2011

A fear of being rejected can cause perceptions of more insecurity and stress in close relationships. Healthy individuals activate the dorsal anterior cingulate cortex (dACC) when experiencing social rejection, while those who are vulnerable to depression deactivate the dACC presumably in order to down-regulate salience of rejection cues and minimize distress. Schizotypal individuals, characterised by unusual perceptual experiences and/or odd beliefs, are more rejection sensitive than normal. We tested the hypothesis, for the first time, that individuals with high schizotypy also have an altered dACC response to rejection stimuli. Twenty-six healthy individuals, 14 with low schizotypy (LS) and 12 with high schizotypy (HS), viewed depictions of rejection and acceptance and neutral scenes while undergoing functional MRI. Activation maps in LS and HS groups during each image type were compared using SPM5 and their relation to participant mood and subjective ratings of the images was examined. During rejection relative to neutral scenes, LS activated and HS deactivated the bilateral dACC, right superior frontal gyrus and left ventral prefrontal cortex. Across both groups, a temporo-occipito-parieto-cerebellar network was active during rejection, and a left fronto-parietal network during acceptance, relative to neutral scenes, and the bilateral lingual gyrus during rejection relative to acceptance scenes. Our finding of dACC-dorso-ventral PFC activation in LS, but deactivation in HS individuals when perceiving social rejection scenes suggests that HS individuals attach less salience to and distance themselves from such stimuli. This may enable them to cope with their higher-than-normal sensitivity to rejection.
FC12-02 - The neural response to relatives’; criticisms and compliments in individuals with a schizotypal personality
Authors: Premkumar P. , Lythgoe D. , Williams S.C. , Kuipers E.A. , Kumari V.
Published: May 2011

A high level of expressed emotion (EE) in the form of criticism and hostility by family members towards schizophrenia patients increases the risk of relapse to a psychotic episode. Studying the neural response to relatives’ criticisms would help to understand how patients interpret and cope with EE in terms of the salience patients attach to criticisms and how this information is encoded and stored. Formerly depressed patients fail to activate the dorso-lateral prefrontal cortex (DLPFC) and anterior cingulate cortex (ACC) on hearing maternal criticisms. We tested the hypothesis, for the first time, that individuals with high schizotypy would have an altered DLPFC and ACC response to relatives’ criticisms. Twenty-four healthy individuals, 12 with low schizotypy (LS) and 12 with high schizotypy (HS), listened to a close relative's criticisms, compliments and neutral comments about them while undergoing functional MRI. The relative's EE level was assessed using the Camberwell Family Interview. HS relatives were more likely to show high EE than LS relatives. Activation maps in LS and HS groups during each comment type were compared using SPM5. During criticisms relative to neutral comments, HS activated and LS deactivated the DLPFC and ACC. During compliments relative to neutral comments, LS activated and HS deactivated the insula, lingual gyrus, cerebellum, thalamus, postcentral gyrus and medial frontal gyrus. Our finding of DLPFC-ACC activation in HS, but deactivation in LS individuals when listening to relatives’ criticisms suggests that HS individuals may have difficulty suppressing emotional interference during cognitive control.
FC12-03 - DTI-based in vivo mapping of subregions within the human hypothalamus
Authors: Schoenknecht P. , Anwander A. , Petzold F. , Schindler S. , Knoesche T. , Hegerl U. , Turner R. , Geyer S.
Published: May 2011

Introduction

The hypothalamus is involved in many aspects of behavioral responses but parcellations of hypothalamic subnuclei have only been feasible in post-mortem brains. Thus it would be-from a clinical point of view-highly desirable if hypothalamic subnuclei could be delineated also noninvasively in living subjects. This study is a first step in this direction: We exploited the directionality information inherent in high-resolution DTI data to map subregions of the hypothalamus in healthy volunteers.

directionality information using DTI data to map subregions of the hypothalamus.

Methods

We scanned 10 subjects with a Siemens 3 T scanner, acquired DTI and T1 scans. We computed the similarity of fiber orientations between all voxels and subjects, and clustered the similarity matrix in 3 regions using a k-means algorithm.

Results

The diffusion images showed anisotropic tissue orientation within the hypothalamus which was consistent across subjects. The clustering in 3 regions resulted in an anatomically coherent arrangement of clusters across hemispheres and subjects. In each ROI, we found an anterior, a posteromedial, and a lateral subdivision with consistent microscopic tissue orientations across subjects.

Conclusion

This is to our best knowledge the first study that demonstrates the fine-grained microstructural organization within the human hypothalamus noninvasively in living subjects.
FC12-04 - Striatal dopamine transporter (DAT) availability and affective symptoms in movement disorders: A 123I-FP-CIT spect study
Authors: Camardese G. , Di Giuda D. , Fasano A. , Cocciolillo F. , Bentivoglio A.R. , Bruno I. , Guidubaldi A. , De Risio L. , Pucci L. , Giordano A. , Bria P. , Janiri L.
Published: May 2011

Aim

Recent studies suggest an association of affective symptoms with striatal dopaminergic activity in Parkinson's Disease (PD). On the other hand, the psychopathological features of other common Movement Disorders (MD), such as Essential Tremor (ET) and Primary Dystonia, are less explored.

We investigated striatal dopamine transporter (DAT) availability and affective symptoms in these three different MD.

Materials and methods

22 pts with ET, 14 pts with focal dystonia and 34 idiopathic PD pts underwent 123I-FP-CIT SPECT. A control group of 15 healthy subjects was also analyzed.

Psychiatric assessment included the HAM-D scale for severity of depression, the HAM-A scale for anxiety levels, the Snaith Hamilton Pleasure Scale (SHAPS) for anhedonia.

SPECT was carried out 3 hours after 111 MBq 123I-FP-CIT intravenous injection. Specific 123I-FP-CIT binding in the striatum and striatal subregions was calculated based on ROI analysis.

Results

Significant reduction of 123I-FP-CIT binding ratios was found only in PD. Spearman's analysis showed an inverse correlation between anxiety and DAT availability in the left striatal regions of both ET and dystonic patients. On the contrary, a significant positive correlation was found in PD subjects.

Conclusion

This preliminary study provided evidence for an association between pre-synaptic striatal dopaminergic function of the left hemisphere and anxiety in MD, thus confirming the “transnosologic” relevance of dopaminergic dysfunction.

Unexpected findings in PD patients are in contrast with previous results. A down-regulation of DAT could be hypothesized in both ET and dystonic patients. This pattern seems to be concordant with preliminary findings in primary anxiety disorders.
FC12-06 - On the relevance of comorbidity in psychiatry: EEG loreta in generalized anxiety disorder with and without nonorganic Insomnia
Authors: Saletu-Zyhlarz G. , Anderer P. , Saletu B.
Published: May 2011

Introduction

Comorbidity is increasingly regarded as important for both diagnosis and treatment of psychiatric disorders.

Objectives

Electrophysiological neuroimaging such as low-resolution brain electromagnetic tomography (LORETA) may be utilized to obtain insight into the pathogenesis of mental diseases.

Aims

The aim of the present study was to compare EEG tomographic data obtained in generalized anxiety disorder (GAD) with and without nonorganic insomnia.

Methods

In the first study, LORETA was performed in 44 untreated patients (25 females) with the primary diagnosis of nonorganic insomnia (F51.0) associated with GAD (F41.1) and 44 age- and sex-matched normal controls. In the second study, 18 patients (9 females) with the primary diagnosis of GAD without mandatory insomnia were compared with 18 controls.

Results

While patients with F51.0 and concomitant F41.1 showed an increase in LORETA power in the delta, theta, alpha-1 and alpha-2 frequencies, GAD patients without mandatory insomnia demonstrated a decrease in LORETA power - specifically in delta (more left than right hemisphere, involving occipital cortex, insula, cingulate and frontal cortex) and beta (occipital cortex), mirroring neuroimaging findings on the neural circuitry of anxiety.

Conclusions

Different EEG LORETA findings were obtained in GAD patients, depending on the comorbidity: While in daytime recordings patients with nonorganic insomnia demonstrated increased slow activities reflecting daytime tiredness and sleepiness, GAD patients without insomnia exhibited a decrease in slow activity and thus hypervigilance. According to the key-lock principle different pharmacological strategies have to be applied, which will be demonstrated on the basis our own data sets.
FC13-01 - Dialectical behavior therapy-based skills training for family members of suicide attempters
Authors: Rajalin M. , Jokinen J.
Published: May 2011

A suicide attempt is a challenge both for the patient and for family members. Family members of suicide victims have an increased risk for depression and anxiety. This pilot study evaluated the effect of Family Connections (FC), a Dialectical Behavior Therapy-based manualized skills training program, for family members of suicide attempters. The DBT-based skills training program aims to enhance the knowledge of wide range research based aspects of suicidal behavior and treatment recommendations. Furthermore it includes skills training for interpersonal relationships and also offers family members an opportunity to share their experiences.

Thirteen participants completed the 9-week program with pre- and post selfreport questionnaires. The results showed significant reduction in Burden Assessment Scale (BAS) and in three out of four subscales of Questions about Family Members (QAFM):perceived criticism (PC), critical comments (CC), and emotional over involvement (EOI).

These results provide support for the need and importance of a DBT-based skills training program addressed specifically to family members of suicide attempters.
FC13-03 - Stress, suicidal behaviour and genes
Authors: Wasserman D. , Ben-Efraim Y. , Wasserman J. , Sokolowski M.
Published: May 2011

According to a stress diathesis model, genes and environment, as well as possible interactions in-between (GxE), may result in vulnerability towards suicidal behaviors (SB), characterized by behavioral trigger endophenotypes such as increased depression-intensity and aggression/ anger/ impulsivity. Excessive stress has the potential to induce unfavorable effects in a variety of higher brain-functions, incurred as side effects to maladaptive responses in the genetically controlled stress-responsive neurosystems e.g. in the hypothalamic- pituitary-adrenal (HPA) axis. HPA-axis dysregulation is regarded as an endophenotype of depression-, anxiety- and alcohol abuse disorders, commonly found also in suicide behaviors. Various neurobiological alterations, suggesting abnormal HPA-axis activity and reactivity, have also been demonstrated to occur in suicidal behaviors incl. completed suicides. The HPA axis is a major systemic stress-modulator being mainly controlled by the regulatory corticotrophin releasing hormone receptor 1 (CRHR1) gene. An overview will be presented of the role of the HPA axis in suicidal behaviors with a focus on CRHR1 gene.
FC13-04 - Suicide risk in relation to age and psychiatric hospitalization
Authors: Reutfors J. , Brandt L. , Sparring Björkstén K. , Ekbom A. , Ösby U.
Published: May 2011

Introduction

Suicide risk is increased in patients with a history of psychiatric hospitalization.

Aim

To explore how suicide risk varies by age during psychiatric hospitalization and in the year post-discharge.

Methods

This is a population-based case-control study of all suicides (n = 20,675; 70% male) in Sweden aged ≥18 years during 1991–2003. Each suicide was individually matched to 10 population controls by age, sex, and county of residence. Discharge diagnoses of a mental disorder (except dementia and other organic disorders) in the year prior to suicide were identified by register linkage. Odds ratios (OR) were calculated by conditional logistic regression to estimate the relative risk of suicide in those with psychiatric diagnoses compared to the general population. ORs were estimated by age group (18–34 years, 35–49 years, 50–64 years, and ≥ 65 years) and timing of the suicide in relation to discharge.

Results

During hospitalization, the youngest age group had the greatest suicide risk elevation [OR 64 (95% CI 44-92)]. In the first month post-discharge, the oldest age group had the highest suicide risk elevation [OR 162 (95% 66–399) in the first week and OR 127 (95% 67–242) in the second to fourth weeks]. In the remaining eleven months, suicide risk elevation was lower and relatively similar in different age groups.

Conclusions

During the year following psychiatric hospitalization, an especially high attention should be paid to the suicide risk of the elderly patients in the first month post-discharge.
FC13-07 - The review of relapse after discontinuation of naltrexone
Authors: Tatari F. , Torkamani F. , Abdoli G. , Nasiri A. , Qhelichi L.
Published: May 2011

Introduction

In recent years, both abstinence- and harm-reduction strategies for managing opium dependency are being generalized. In those who use detoxification, maintenance therapy with Naltrexone, an opioid antagonist protects them against relapse. This is important to know the best time of Naltrexone discontinuation to lower the risk of relapse.

Objection

This study tried to determine the efficacy of Naltrexone in prevention of opioid relapse and the factors interfere to the outcome.

Material and method

150 opium addicts who were admitted in Kermanshah Rehabilitation Centre for Naltrexone maintenance therapy contributed in this 18 month length study. They received Naltrexone for 6 months and followed then after for another 12 months. Opium test (TLC) were done monthly in the first 6 months, and then in 3 month intervals for 12 subsequent months to find out the relapse.

Results

1)

The relapse rates were 56.7%(85) after 6-month, and 4.7%(7)after one-year.

2)

The succession rate was 38.6%(58).

3)

The lowest succession rate was in 18–25 year old, The highest was in 35–40 year old adults(10).

4)

In person with diploma and higher the succession rate(43.8%) was higher than poor educated(34.7%) ones.

5)

The succession rate was higher in those who: were employee(72.7%), were addicted to heroin(44.9%), didn’t have positive family history(41.3%), and had more incomes(46.7%).

Discussion

1)

In those who the relapse is delayed until 9 months after detoxification, the chance of long term abstinence is higher.

2)

The employees and those who have more social disciplines are more successful in ceasing opium abuse.
FC13-08 - Not polypharmacy, just symptomatic treatment
Authors: Launer M. ,   Kemple View Psychiatric Services
Published: May 2011

The concept of polypharmacy has generated much argument and this is has now come to a head with specific symposia and now a CINP thematic meeting. Briefly, those in academia, pharmacy and general adult practice tend to frown on this whereas the forensic members rely on it. Steven Stahl has even famously called it “the dirty little secret”.

More recently the concept of rational polypharmacy has arisen where the clicinician can justify his prescriptions. All of this depends on treating a named condition eg schizophrenia. Indeed affective disorders are often treated with polypharmacy and many physical conditions are routinely given polypharmacy.

If we assume that Kraepelin was wrong about his original assertion that there is a schism and whether other conditions are also not proven like personality disorders, then patients can simply be treated by their symptoms without a diagnosis. There are many advantages to this like the abolition of stigma but more importantly this allows the use of traditional drugs used for other conditions like lithium or anti manic agents to be used as required according to response rather than for specific diagnoses. There are other advantages eg in research and especially genetics.

The presentation examines this in detail with some real life examples.
FC13-09 - Antidepressant tianeptine (TIA) action is based on the acceleration of serotonin turnover in the synapse: a hypothesis
Authors: Uzbekov M.
Published: May 2011

Introduction

Neurochemical mechanism of TIA action is not clear.

Aim

To develop possible mechanism of TIA action in patients with anxious depression (Uzbekov et al., 2006, 2009).

Results

It was found twofold increase of platelet monoamine oxidase (MAO) activity in depressed patients and its significant decrease under TIA action.

Discussion

Synapse is considered as a complex biological system (nerve ending + astrocytes). It is supposed that at normal conditions about 75% of serotonin released in synaptic cleft undergoes functional inactivation by its reuptake in presynaptic ending. The remaining serotonin is taken up by astroglia and is undergone its irreversible (chemical) inactivation under MAO action.

According to our hypothesis TIA enhancing serotonin reuptake decreases serotonin level in synaptic cleft. Simultaneously in patients-responders we have established the decrease (inhibition) of MAO activity that promotes increase of serotonin concentration in synaptic cleft. It has been shown that TIA activates serotonin release from presynaptic ending (Labrid et al., 1992). Thus TIA enhances not only serotonin reuptake but simultaneously activates its surge from the ending into synaptic cleft. We conclude that under TIA action serotonin turnover rate in the synapse is increased that promotes increase in the unit of time serotonin concentration on postsynaptic receptors; this process is accompanied by decrease of MAO activity.

Conclusion

The first time in the literature we propose the hypothesis about neurochemical mechanism of TIA action. Proposed mechanism mainly refers to the first acute phase of TIA action directed on the normalization of serotonergic neurotransmission.