bluuebunny/crossref_metadata_2025 huggingface dataset:
Comparative evaluation of static gesture recognition techniques based on nearest neighbor, neural networks and support vector machines
Authors: Savaris Alexandre , von Wangenheim Aldo
Published: June 2010

It is a common behavior for human beings to use gestures as a means of expression, as a complement to speaking, or as a self-contained communication mode. In the field of Human–Computer Interaction, this behavior can be adopted to build alternative interfaces, aiming to ease the relationship between the human element and the computational element. Currently, various gesture recognition techniques are described in the technical literature; however, the validation studies of these techniques are usually performed isolatedly, which complicates comparisons between them. To reduce this gap, this work presents a comparison between three well-established techniques for static gesture recognition, using Nearest Neighbor, Neural Networks, and Support Vector Machines as classifiers. These classifiers evaluate a common dataset, acquired from an instrumented glove, and generate results for precision and performance measurements. The results obtained show that the classifier implemented as a Support Vector Machine presented the best generalization, with the highest recognition rate. In terms of performance, all methods presented evaluation times fast enough to be used interactively. Finally, this work identifies and discusses a set of relevant criteria that must be observed for the training and evaluation steps, and its relation to the final results.
Cognitive coping in anxiety‐disordered adolescents
Authors: Legerstee Jeroen S. , Garnefski Nadia , Verhulst Frank C. , Utens Elisabeth M.W.J.
Published: June 2010

The present study investigated differences in cognitive coping strategies between anxiety‐disordered and non‐anxious adolescents. In addition, the interaction effect with gender as well as differences between specific anxiety diagnoses was examined. A clinical sample of 159 anxiety‐disordered adolescents and a general community sample of 370 non‐anxious adolescents were recruited. Nine cognitive coping strategies were assessed in all adolescents (aged 12–16 years). Results showed that anxiety‐disordered adolescents had significantly higher scores on most of the cognitive coping strategies than non‐anxious adolescents. The cognitive coping strategies rumination, self‐blame and catastrophizing accounted for most of the variance. Gender did not modify the results. Further analyses within the anxiety‐disordered sample indicated that adolescents with a generalized anxiety disorder scored significantly higher on rumination, but not on other cognitive coping strategies, than social phobic adolescents. The results suggest that cognitive coping is a valuable target for psychological assessment and treatment in adolescents.
Obsessive-Compulsive Disorder (Ocd) Is Still An Unrecognised Disorder: A Study On The Recognition Of Ocd In Psychiatric Outpatients
Authors: Wahl K. , Kordon A. , Kuelz K.A. , Voderholzer U. , Hohagen F. , Zurowski B.
Published: June 2010

Objective

The study aims to investigate the recognition of patients with Obsessive-Compulsive Disorder (OCD) in psychiatric outpatients.

Subjects and methods

A total of 2282 outpatients seen at 14 different psychiatric clinics in South Germany were asked to participate in the study. Five hundred and eighty-nine (30%) of the original 2282 patients met screening criteria for OCD, and of those, 237 (42%) participated in the final interview including DSM-IV diagnosis, and comorbidity.

Results

Sixty-nine of 589 participating patients who screened positively for obsessive symptoms actually had an Obsessive-Compulsive Disorder. Only 19 (28%) of the outpatients diagnosed with OCD according to DSM-IV criteria were also given this diagnosis by their consultant. The psychopathology scores indicated that the OCD patients had clinically relevant OCD with a mean Yale-Brown Obsessive Compulsive Score (Y-BOCS) of 17.5 (± 5.4), and a mean Clinical Global Impression Score (CGI) of 5.2 (± 1.2).

Conclusions

In outpatient clinics over 70% of OCD patients remain unrecognised and thus untreated by consultants. Screening questions provide a rapid way of identifying those who may have OCD and should be incorporated into every mental state examination by consultants.
Suicidal Ideation, Self-Harm And Attempted Suicide: Results From The British Psychiatric Morbidity Survey 2000
Authors: Bebbington P.E. , Minot S. , Cooper C. , Dennis M. , Meltzer H. , Jenkins R. , Brugha T.
Published: June 2010

Purpose

To examine relationships between suicidal ideation, self-harm, and suicide attempts, including the timing of the phenomena.

Subjects and methods

The British National Psychiatric Morbidity Survey (NPMS) 2000, a randomised cross-sectional survey of the British population (n = 8,580), included detailed questions about suicidal phenomena.

Results

Suicidal phenomena were common in the survey population: a fifth had experienced tedium vitae, and nearly one in six had had death wishes or considered suicide. 4.4% of the study population had attempted suicide at some time. The relationships between individual elements of suicidality, though not absolute, were strong. The relationships tended to be hierarchical. The results suggested that suicidal thinking represents a strong indicator of vulnerability to suicidal acts, less so to self-harm. Although suicidal phenomena were more common in women, the relationship of the different elements were not affected by gender.

Discussion

Studies in non clinical populations allow full appreciation of the nature and burden of suicidality. The topic of suicide is sensitive, so there may have been under-reporting, although the level of missing data was around 0.1%. Nevertheless, the sample was large and closely representative of the whole British populace.

Conclusions

Suicidality is common in the British population. The strong relationships between elements of suicidality are clinically important.
Quaternary glaciation in the Nubra and Shyok valley confluence, northernmost Ladakh, India
Authors: Dortch Jason M. , Owen Lewis A. , Caffee Marc W.
Published: June 2010

Three glacial stages (Deshkit 1, Deshkit 2 and Dishkit 3 glacial stages) are identified in the Nubra and Shyok valleys in northernmost Ladakh, northwest India, on the basis of geomorphic field mapping, remote sensing, and 10Be terrestrial cosmogenic nuclide surface exposure dating. The glacial stages date to ∼ 45 ka (Deshkit 1 glacial stage), ∼ 81 ka (Deshkit 2 glacial stage) and ∼ 144 ka (Deshkit 3 glacial stage). A mean equilibrium line altitude depression of ∼ 290 m for the Deshkit 1 glacial stage was calculated using the area accumulation ratio, toe-to-headwall ratio, area–altitude, and area–altitude balance ratio methods. Comparison of glaciation in the Nubra and Shyok valleys with glaciations in the adjacent Central Karakoram of northern Pakistan and northern side of the Ladakh Range of northern India indicates that glaciation was synchronous on Milankovitch timescales across the region during MIS-6, but differed greatly in extent, with more extensive glaciation in the Karakoram than the morphostratigraphically equivalent glaciation on the northern slopes of the Ladakh Range. This highlights the strong contrast in the extent of glaciation across ranges in the Himalaya–Tibetan orogen, necessitating caution when correlating glacial successions within and between mountain ranges.
S14-04 - New Pharmacological Strategies in the Treatment of Alcohol Dependence: Results from Recent Clinical Trials
Authors: Janiri L. , Martinotti G.
Published: June 2010

In the last few years aripiprazole and pregabalin showed to be promising medication in alcohol use disorders, due to their action on the mesolimbic dopaminergic reward pathway (aripiprazole) and as a presynaptic modulator of the excessive release, in hyperexcited neurons, of excitatory neurotransmitters (pregabalin).

In a recent trial run by our group (Martinotti et al., 2009a) aripiprazole at low dosage (5-10 mg) was compared with naltrexone, one of the approved drugs used in alcohol relapse prevention. The study showed that the number of subjects remained alcohol free for the entire study period and the number of subjects relapsed was not significantly different in the two groups, whereas the survival function showed that patients treated with aripiprazole remained abstinent from any alcohol amount for a longer time with respect to those treated with naltrexone. In another randomized, double blind, placebo controlled study (Anton, 2008), there was no difference between aripiprazole (at high dosage, up to 30 mg) and placebo on the primary end point possibly because of dose-related attrition. In a recent trial the combination of aripiprazole and topiramate has proposed with positve results (Kenna, 2009).

As to pregabalin, a recent clinical trial of comparison versus naltrexone (Martinotti et al., 2009b) showed, in fevour of pegabalin, an improvement of specific symptoms in the areas of anxiety, hostility and psychoticism. Pregabalin also resulted in better outcome in patients reporting a comorbid psychiatric disorder. In another study (Martinotti 2009c) pregabalin was also efficacious in the treatment of withdrawal symptoms.
S12-02 - The Effects of Methylphenidate Treatment on Latent Inhibition in Adults with ADHD
Authors: Manor I. , Kaplan O. , Tadmor Y. , Lubow R.
Published: June 2010

Attention Deficit and Hyperactivity Disorder (ADHD) is a common disorder, estimated as afflicting 4-6% of the adult population. Latent Inhibition (LI) is a robust phenomenon that is demonstrated when a previously inconsequential stimulus is less effective in a new learning situation than a novel stimulus. Attentional theories of LI state that unattended stimulus preexposures reduce stimulus salience and subsequent associability. A relationship between LI and the dopaminergic system is suggested since dopamine-agonists weaken the LI effect, and dopamine antagonists strengthen it. The effects of medication for ADHD on LI are of interest, since dopamine agonists should weaken LI, but the improvement in attention should potentiate it. To date, only two studies, both with children, have examined the relationship between ADHD and LI.

In the present study, we will compare the LI effect in 100 adults with ADHD, with and without medication, as well as compare them to a matched healthy control group. In addition, all the participants will be administered the Schizotypal Personality Questionnaire, State & Trait Anxiety Inventory, Beck Depression Inventory, the Baron-Cohen Autistic Questionnaire, and the Similarities sub-test from WAIS-R. The LI procedure will be administered to both groups twice with two equivalent versions of the procedure (order counterbalanced). The ADHD patients will take part in the first version of the procedure without medication and in the second version 1.5 hours after taking the medication; the controls will have the same time interval between versions, but without the medication administration. Results will be presented at the meeting.
S32-04 - New Insights in Neurocognitive Mechanisms of Addiction
Authors: Franken I.
Published: June 2010

Recent theories of addictive behaviors suggest that neurocognitive mechanisms, such as attentional processing, cognitive control, and reward processing play a role in the maintenance or development of addiction. Several studies will be discussed demonstrating the role of these neurocognitive mechanisms in addiction. Moreover, clinical issues such as the feasibility to use neurocognitive measures as predictor of treatment success and relapse will be discussed.
S15-01 - Emotional Lability in Children and Adolescents with ADHD. Clinical Correlates and Familial Prevalence
Authors: Banaschewski T.
Published: June 2010

ADHD is often associated with symptoms of emotional lability (EL), such as irritability, hot temper, low frustration tolerance, and sudden unpredictable shifts towards negative emotions such as anger, dysphoria and sadness. EL has been consistently noted in the changing definitions of the ADHD construct and its diagnosis and is currently considered an associated feature of the disorder. However, it is still unclear how EL and ADHD are interconnected. Thus, 1186 children with ADHD-combined type and 1827 siblings (aged 6-18 years) were assessed for symptoms of EL, ADHD, associated psychopathology and comorbid psychiatric disorders with a structured diagnostic interview as well as parent and teacher ratings of psychopathology. EL was associated with increased severity of ADHD core symptoms, particularly hyperactivity-impulsivity, and more symptoms of comorbid psychopathology, primarily symptoms of oppositional defiant disorder (ODD), but also affective symptoms, and substance abuse. However, EL was only partly explainable by the severity of ADHD core symptoms and associated psychopathology, and seems to be more closely related to oppositional symptoms. Severity of EL in probands increased severity of EL in siblings but not prevalence rates of ADHD or ODD.
S13-03 - EPA forensic Psychiatry Section Symposium: Evaluation of Outcomes in Violent and Sexual Offender Populations
Authors: Vollm B. , Durbeej N. , Endrass J. , Sheldon K.
Published: June 2010

The topic of this symposium is the evaluation of outcomes in individuals presenting with violent or sexual offending in a range of different settings. Violent offenders are of particular concern to psychiatrists who may face pressure from society to detain such individuals. At the same time evidence for the efficacy of any interventions to improve outcome and reduce re-offending remains limited. In recent years new initiatives (e.g. the programme for Dangerous and Severe Personality Disorders (DSPD) in the UK) have been developed to understand better what works for violent offenders, including those with personality disorders. Research in this area is complex not least as randomised controlled trials might not be seen as practical or ethical.

This symposium comprises speakers from three different countries, Sweden, Switzerland and UK. The Swedish contribution will present data from a naturalistic study comparing offenders with mental disorder and substance misuse who engage in community treatment following release to those who don’t. Researchers from Switzerland will introduce the “therapy evaluation project” of the Zurich Criminal Justice System and show data on recidivism (both convicted and non-convicted). Presenters from the UK are from one of the high secure DSPD sites and will present different methodologies, including single case studies, to evaluate the efficacy of this service and its different therapies. The implications of these findings for future research and service delivery will be discussed.
S02-03 - Internet Addiction and Comorbidities
Authors: Poppe H.
Published: June 2010

Objectives

Several studies show, that there exist different diagnosed psychological concomitant diseases with internet addiction. In order to point out the different kinds and frequentness of comorbidities with Internet addiction the Anton Proksch Institut Vienna and the University Mainz - Ambulanz für Spielsucht started a combined, compareable research project, which should show the similarities and differences of comorbidities of the interned addicted patients of both institutions.

Methods

In order to become comparable results of both Institutes, the same inquiry methods were used. For the diagnostic of Internet addiction the Scale for the Assessment of Computergame-Addiction (ACA-S), developed by the university medical center of Mainz, is used. In order to be able to cover a broad spectrum on possibly arising concomitant diseases, standardised surveytools are used from different, relevant areas of application. Therefore the Adult Attachement Scale (AAS), the Cambridge Depersonalisation Scale (CDS-9), the d2 (Test of attention), the subscale “Social Insecurity” of EDI-2 (Eating Disorder Inventory-2), the Liebowitz Social Anxiety Scale (LSAS), the NEO Five Factors Inventory (NEO-FFI), the Symptom Checklist 90R (SCL 90-R), the Sensation Seeking Scale V (SSS-V) and the Wender Utah Rating Scale (WURS-k) were used.

Results

First current results of the investigation of comorbidities with internet addiction show a frequent arise of social anxiety, depression and attention deficit hyperactivity disorder (ADHD), which are in both samples remarkably.

Conclusions

The study illustrates, that the patients, which suffer from internet addiction disorder, often show comorbidities, which should be considered in the therapeutic work with Internet-addicted patients.
S37-01 - Gene Brain Interaction in Schizophrenia and its Relation to Psychopathology
Authors: Kircher T. , Krug A.
Published: June 2010

Schizophrenia is an ethologically heterogeneous disorder with a complex gene environment interaction as the most likely cause. A number of susceptibility genes, such as DTNBP, NRG1, DISC1, G72 and others have been identified. However their pathophysiological mechanisms are not yet fully understood. Further, a number of environmental factors (birth complications, cannabis abuse, etc) have been replicated as risk factors. Traditionally, Schizophrenia is being diagnosed according to psychopathological criteria. Yet, there is little data on the interaction between etiological factors, psychopathology and brain function/structure. On the behavioural level, psychopathological symptoms can hardly separate the many pathophysiological subgroups. Contrary to nosological categories, biologically based phenotypes - referred to as intermediate phenotypes - consisting of neuropsychological, electrophysiological, functional and structural brain imaging parameters, could represent the etiological basis more directly, but these findings have to be linked to psychopathology. In this presentation, we will try and bridge the gap between these levels of description in an attempt to disentangle nosological and dimensional features of psychosis.
S07-04 - Safety/risk of Psychiatric Drugs in Pregnancy and Lactation. Adrienne Einarson, the Motherisk Program
Authors: Einarson A.
Published: June 2010

Psychiatric disorders are relatively common among women of childbearing age, who may become pregnant while they are taking psychotropic drugs. There remains a high level of anxiety regarding their safety among women and healthcare providers alike, most likely because of the conflicting studies that have been published in the literature and warnings from government organizations. In addition, most recently in the case of paroxetine, a successful lawsuit against the manufacturer, holding them responsible for a baby born with a heart defect, following use of the drug by the mother in the first trimester of pregnancy. Consequently, treating a psychiatric disorder during pregnancy with pharmacotherapy, is a complex decision making process, which has to be made between the pregnant woman and her health care provider following careful evaluation of the evidence-based information.

The objective of this presentation is two-fold,

1)

to discuss models used for studying the use of drugs in pregnancy and

2)

to provide current information on the safety/risk of psychotropic drugs used in pregnancy.

The body of evidence in the literature to date suggests that psychotropic drugs as a group are relatively safe to take during pregnancy and women and their health care providers should not be unduly concerned if a women requires treatment. Optimal control of the psychiatric disorder should be maintained during pregnancy, the post partum period and thereafter. All pregnancies where a mother has a serious psychiatric disorder should be considered high risk and the mother and fetus, carefully monitored.
S35-01 - Clinical Influencing Factors of Acute Treatment Outcome in First-Episode Schizophrenia Patients
Authors: Schennach-Wolff R. , Seemüller F. , Mayr A. , Maier W. , Buchkremer G. , Heuser I. , Klosterkötter J. , Gastpar M. , Häfner H. , Sauer H. , Schneider F. , Gaebel W. , Moeller H.-J. , Riedel M. ,   German Research Network on Schizophrenia
Published: June 2010

Background

Aim was to evaluate influencing factors of response and symptomatic remission in first-episode schizophrenia patients treated with risperidone or haloperidol.

Methods

229 first-episode schizophrenic patients were examined within a double blind controlled trial of the German Study Group on first-episode schizophrenia with biweekly PANSS ratings. Response was defined according to the definition by Lieberman et al. (2003) and symptomatic remission as the severity component of the consensus remission criteria by the Remission in Schizophrenia Working Group. Sociodemographic, psychopathological and functional variables as well as the treatment applied were evaluated regarding their potential predictive validity for treatment outcome. Univariate tests, logistic regression and CART-analyses were consulted as statistical methods.

Results

126 patients (55%) achieved response and 118 patients (52%) symptomatic remission at discharge with no significant differences between the risperidone (51%) and haloperidol (49%) treated patients. Better baseline functioning, early treatment response, less depressive symptoms and a shorter duration of untreated psychosis were revealed significant predictors of response. Patients with symptomatic remission also had a significantly shorter duration of untreated psychosis and significantly less depressive symptoms at baseline. Logistic regression and CART-analyses revealed low general psychopathology, early treatment response and a high score in the Strauss-Carpenter-Prognostic-Scale at admission to be significantly positive predictive for symptomatic resolution.

Conclusion

Early treatment response, depressive symptoms and the level of psychosocial functioning were revealed to significantly predict outcome, with no significant differences between risperidone and haloperidol. The importance of an early adequate symptom control and the implementation of early intervention programs is highlighted.
S38-02 - Recreational MDMA ‘Ecstasy’: Psychiatric Aspects and the Diathesis Stress Model
Authors: Parrott A.
Published: June 2010

Introduction

MDMA/Ecstasy is associated with a range of psychiatric disorders. There is debate over this is caused by drug usage, or reflect pre-existing premorbid characteristics.

Aims and objectives

To examine how the diathesis-stress model can explain the patterns of psychiatric distress observed in recreational Ecstasy/MDMA users.

Methods

The empirical literature on psychiatric problems in MDMA users will be reviewed.

Results

Numerous empirical stuides have found significantly raised psychiatric profiles in recreational Ecstasy/MDMA users (Parrott et al, 2000, 2001; Rosier et al, 2005; Schifano, 2000). Some authors have noted that the problems emerge following drug usage (Alati et al, 2007), whereas others have found adverse psychiatric profiles prior to drug initiation (Lieb et al, 2002). A third group of studies have employed the more interactive ‘diathesis-stress’ model, where prior sensitivities are exacerbated by the biological stress of regular drug usage. MacInnes et al (2001) presented a vulnerability model of depression, where individuals with prior vulnerability factors, were more susceptible to adverse drug reactions. The HPA axis is important for health and homeostasis, and stimulant drugs such as MDMA can disrupt its biological integrity. In dance clubbers, MDMA induces an 800% release in the stress hormone cortisol (Parrott et al, 2008), and this may be particularly disruptive for endogenously susceptible individuals.

Conclusions

Stimulant drugs such as MDMA are powerful metabolic stressors which disrupt the HPA axis and other neurobiological systems. Individuals with prior susceptibility factors may be more susceptible to the psychobiological stress of regular stimulant drug usage.
S06-04 - Normality and the Camera: the Making of “States of Mind”
Authors: Mishto E.
Published: June 2010

“States of Mind” is a documentary about the idea of normality/abnormality in a mental hospital. It was shot inside several mental clinics in Italy in 2005. A small team of filmmakers spent several months inside the clinics with a camera and audio equipment. The team shared with patients and staff every moment and aspect of daily life, from breakfast till night shift. During this intense period patients and operators were constantly exposed to the camera's eye, while neutral observation and friendship quickly melt. Ideas of normality and abnormality, of surface and depth, of exposure and censorship started to blend into each other, creating interesting and unexpected effects. “States of Mind” had its world premiere at the prestigious IDFA (Amsterdam Documentary Film Festival) and has been released in USA and Europe.
S36-01 - Mood Disorders: Specific Challenges for Responsibility
Authors: Allilaire J.-F.
Published: June 2010

Mood disorders can be considered as a pathology of Freedom in human being.

Manic patients feel under-responsible and depressives feel hyper-responsible. Both require from psychotherapist care for risk of suicide and innapropriate behaviour, but also empathy, support, and help from responsible others, relations and doctors. This responsibility is moral, juridic and penal.

We will discuss what Ethic for responsibility can be the right one for clinicians and therapists. We will also discuss which symptom or clinical features are the most hindering for responsibility in depressives. We will conclude that ethical basis is fundamental for right management in therapy.
S17-01 - Quality of Life and Psychiatric Consultation in Elderly
Authors: Icelli I.
Published: June 2010

Aging is a process that affects bio-psycho-social functioning. When people reach upper age groups, the definition of normal and abnormal aging are confounded by the presence of multiple diseases, injuries and losses. As the people leave longer, physical, psychological and social losses may affect the quality of life. In geriatric population, one indicator of quality of life is the ability to perform required activities of daily living. The absence of that feature create negative efects on the psychology of the elderly.

In the consultation process, the geriatric psychiatrists must know the major events which influence elderly's quality of life in late life. Those events are pharmacology, end of life issues and suicides, and clinical syndromes such as delirium, dementia, depression, anxiety, etc. It can be said that life events are closely connected to quality of life and health.

To offer a high quality health and social care to the older patients, we need the knowledge about the conditions, the values and the quality of life of these people which influence their lives.
S17-02 - Quality of Life and Quality of Care: Are they the Two Faces of the Same Coin?
Authors: de Mendonça Lima C.A.
Published: June 2010

Good health is an important component of a good quality of life. The availability and the easy access to high quality of care contribute to a good mental health. WHO & WPA have defined the criteria to consider as good the quality of care delivered by services for old people with mental disorders. Services should be:

-

comprehensive and take into account all aspects of the patient's physical, psychological and social needs and wishes;

-

accessible, user-friendly and readily available, minimizing the geographical, cultural, financial, political and linguistic obstacles to obtaining care;

-

responsive, that means to be ready to listen to and understand the problems brought to its attention and acts promptly and appropriately;

-

individualized and should focus on each person with a mental health problem in her/his family and community context;

-

transdisciplinary and should go beyond traditional professional boundaries to optimize the contributions of people with a range of personal and professional skills.

-

accountable and should accept the responsibility for assuring the quality of the service it delivers and monitors this in partnership with patients and their families.

-

systemic and should integrate all available services to ensure continuity of care and coordinates all levels of service providers including local, provincial and national governments and community organizations.

The challenge today is to extend these criteria to help the Primary Care team to develop strategies in order to promote mental health, to prevent mental disorders and to make their detection as early as possible.
S17-03 - Quality of Live of Caregivers of Patients With Dementia
Authors: Leszek J.
Published: June 2010

Alzheimer's disease and related syndromes have heavy social and human consequences for the patient and his family. Beyond the neuropsychiatric effects of specific therapies for dementia, one of today's challenges is the Quality of Life(QOL) for both patients and especially their informal caregivers.

Caregivers often find themselves cutt off from friends and regular social activities. Caregivers of persons with dementia experience stressful demands, especially because of the length of time that care is required, the behavioral symptoms of patients, and the severity of decline of patients during the course of the illness.

Insufficient attention has been given to how end-of-life care affects caregivers or to caregivers responses to the death of the patient. A study conducted by some authors(eg. Schulz and al.2008) indicated that caregivers needed intervention and support services were needed most often immediately before the patient's death. Caregivers may need help in resuming their own livers after the patient's death. Psychiatrists who are called in as consultants or who have a long-term relationship with the patient or caregiver are uniquely positioned to assist the caregiver with his or her emotional needs that are associated with end-of-life care or the patient's demise.

According to literature, the caregiver's QOL is correlated to the QOL of the patient they cared for, the importance of behavioral disorders and the duration of dementia evolution. Assessment of parameters influencing caregiver's QOL and its possible link with patients QOL are very important because of necessary interventions to improve QOL.
S39-02 - Timing is Critical: Gene, Environment and Timing Interactions in Genetics of Suicide in Children and Adolescents
Authors: Zalsman G.
Published: June 2010

Suicidal behavior runs in families and is prevalent in adolescence. Case-control and family-based studies in this age group failed to find a genetic association that survived replications. Gene-environment approach gave new hope for possible associations especially with the short allele of the serotonin transporter promoter polymorphism (5HTTLPR). However, a recent meta-analysis raised doubts about the consistency of these findings. Some new structural and functional imaging data may shade light on the age-related and gender-related development of the brain. This review suggests a new approach to Gene-by-Environment and timing interaction to understand the interplay that leads to suicidality in adolescents and young adults.
S22-03 - Are Psychiatric Hospitals, Forensic Institutions and Penitentiaries in Europe an Interlocked System?
Authors: Salize H.J. , Schanda H. , Dressing H.
Published: June 2010

Introduction and aims

Despite numerous advantages, the shift from hospital based to community mental health care has caused problems as well. To analyse whether or not the process of de-institutionalisation might have gone too far, studies are needed that cover general psychiatry, forensic psychiatry, and penitentiaries and analyse the interdependencies between them.

Methods

We combined epidemiological and service utilization data from three recent European studies that explored legal frameworks and practices of involuntary treatment in general mental health care, the care of mentally disordered offenders in forensic care and the care of mentally ill inmates in the European prison systems.

Results

Time series from several EU-Member States suggest that civil detention rates remained more or less stable during the 1990s, though on rather different levels internationally. Admissions to forensic psychiatric facilities have increased during the same period. Data on the mental state (or on rates of psychiatric morbidity) in European prison populations are not available - aside from the prison suicide rate. Data from selected countries are likely to suggest that changes to the legal framework in one sector may considerably affect admission rates in others.

Conclusions

Much more national studies are needed to analyse the linkage between sectors and to identify inappropriate patient shifting, as this is strongly affected by the varying national health care and criminal justice systems.
S08-01 - Cochrane Reviews of Pharmacological and Psychological Interventions for Antisocial Personality Disorder (ASPD)
Authors: Vollm B. , Gibbon S. , Khalifa N. , Duggan C. , Stoffers J. , Huband N. , Ferriter M. , Lieb K.
Published: June 2010

Introduction

ASPD has a prevalence of 2-3% in the general population but rates in prison have been reported as 50% to 75%. ASPD is associated with significant psychiatric and medical comorbidity, high offending rates, poor psychosocial adaptation and premature death. Outcomes are poor. There is little consensus regarding the most effective intervention for the condition.

Aims and objectives

To conduct systematic literature reviews to identify randomised controlled trials for either pharmacological or psychological interventions for ASPD.

Methods

Systematic literature reviews (Cochrane reviews).

Results

For the review on psychological interventions only 11 studies could be included with a total of 411 participants, but only five reported data separately for the subgroup of ASPD. Nine of the studies looked at participants with substance misuse problems who also suffered from ASPD. Only three types of interventions were effective (contingency management, CBT and a specific programme for those convicted for driving whilst intoxicated). These interventions showed positive results for substance misuse related outcomes but not for any others behaviours or symptoms. For the pharmacological review 10 studies were identified, anticonvulsants were the most commonly used drugs with some evidence of effectiveness on aggression, however, study quality was poor.

Conclusions

Despite the considerable personal and societal consequences of ASPD, very little research is carried out with regards to interventions in this patient group and subsequently the evidence base to support any interventions is extremely limited.
S05-01 - The Body in Distress [E104]
Authors: Oyebode F.
Published: June 2010

Psychiatry deals with morbid psychological experience. This suggests that central
to psychiatry's concern is the mind as opposed to the body. Yet, it is
often the afflicted body rather than the mind that the patient presents to the
clinician. In addiction, psychiatry classification has an underlying
hierarchical bias for organic (somatic) disorders. Furthermore, many disorders
such as generalised anxiety disorder and mood disorders have bodily
manisfestations that are taken for granted in the consultation process or
translated and relabelled as pointing towards psychological/emotional distress.
This suggests that Cartesian mind-body dualism continues to significantly
influence psychiatric concepts, classification and practice. In this
presentation, the role of the body as model, metaphor, symbol, object and
experiencing subject will be analysed with illustrative examples from clinical
practice and literature. I will rely on Kafka's Letter to
Father, Elfriede Jelinek's Piano Teacher,
and Minkowsky's Lived Time.
S05-03 - Social Evolution of Somatization [E106]
Authors: Cimilli C.
Published: June 2010

Somatization concept should be considered in biopsychosocial integrity. This
presentation reviews the social aspects of somatization. The description of
somatization evolved in time in order to include the social aspects. The
differences of somatization between societies, somatization concept in western
and Eastern medical thought, modernist theory on the evolution of somatization,
research which confirm and which do not confirm the modernist theory were
reviewed. The pos-modern approach which constitutes a new paradigm in cultural
psychiatry, prefers to study the mental disorders through the culture, instead
of comparing them cross-culturally. In this context, first the culture-bound
somatization diagnosis of non-Western cultures, then the fashionable diagnosis
of Western culture in which the somatization is hiding were reviewed.
S09-02 - Diagnostic Stability of Psychiatric Disorders
Authors: Baca-García E. , Lopez Castroman J.
Published: June 2010

Diagnostic stability is the measure of the degree to which a diagnosis remains the same at subsequent assessments of the patient and constitutes a longitudinal validation of the original baseline diagnosis. Follow-up studies including evidence of diagnostic stability and diagnostic consistency over time have been proposed to test the validity of psychiatric diagnoses. Until this moment definitions for psychiatric diagnoses are based on expert opinion rather than on their biological basis, and the modest knowledge base regarding underlying etiologies has hindered the use of etiological factors in psychiatric classification systems. But it is assumed that the higher the diagnostic stability, the more likely is to reflect a consistent psychopathological or pathophysiological process. Being that the main clinical purpose of diagnosis, as a formulation, is to furnish the informational basis for planning and conducting clinical care, stability of a diagnosis gives a relevant base not only for prediction of the course and outcome of a disorder but also for effective planning and provision of treatment. The availability of longitudinal data, however, may cause significant fluctuations in diagnostic stability as changes in clinical presentation are seen. Thus, evolving longitudinal observations should lead to periodic updating of the comprehensive diagnostic formulation, and yet, despite the inherent problems derived from criteria based on cross-sectional observations, our diagnostic system relies on stable diagnoses. Accounting for the potentially harmful consequences of unsuitable treatment options or clinical interventions, the study of diagnostic stability remains an essential issue in psychiatry.
S31-04 - Mapping Complex Hallucinations Using FMRI to Guide RTMS Treatment
Authors: Jardri R. , Pins D. , Thomas P.
Published: June 2010

Background

Hallucinations are extremely distressing erroneous percepts accompanied by a powerful sense of reality. In schizophrenia, hallucinations were functionally explored in the verbal domain even if they may emerge outside the range of auditory. In the present study, we used advanced-Independent Component Analysis for fMRI-data-sets (ICA) to explore complex hallucinations and define potential rTMS targets beyond the conventional temporo-parietal junction.

Methods

16 adolescents with early-onset schizophrenia and suffering from refractory complex hallucinations were included. They all benefited from a 30-min. rest fMRI examination after which they were accurately interviewed about their psycho-sensory experiences during scanning. Using cortex-based ICA, BOLD signals related to the hallucinatory experience were extracted at the subject level and then submitted to a self-organizing-group ICA procedure to extract clusters at the group-level on the basis of a pure similarity matrix.

Results

This method highlighted auditory, visual and multisensory hyper-active clusters after decomposition by random-effect sog-ICA (ǀZǀ=2.2; p< 0.01). The increased BOLD-signal measured in association sensory areas during hallucinations was concomitant of the de-engagement of the “resting-state” network in hallucinating subjects.

Discussion

Data-driven analysis methods for rest-fMRI-data allowed evidencing the neural correlates of complex hallucinations in adolescents with schizophrenia. Despite inter-individual variability, sog-ICA clearly demonstrates that the hallucinatory experience emerges from increased activity within modality-dependent associative sensory cortices and can be fused in cross-modal areas. These brain regions constitute good candidates to guide dimensional treatment of hallucinations like rTMS.
W01-02 - Barriers to Optimal Mental Health Care for Lesbian, Bisexual, Gay, and Transgender clients in Europe
Authors: Dennert G.
Published: June 2010

Introduction

Optimal mental health care for Lesbian, Gay, Bisexual, and Transgender (LGBT) populations requires access to both competent prevention and treatment mental health services.

Objectives and aims

This paper will explore the barriers for LGBT people to accessing adequate and sensitive mental health care in Europe and the potential for the improvement of mental health services.

Methods

This paper will draw from an investigation on access to health care for lesbians in Germany, which triangulated qualitative und quantitative methods to study self-perceived barriers to culturally sensitive and appropriate care. The debate about LGBT mental health in the last few years will be illustrated by examples from several European countries and differences between countries will be highlighted.

Results

LGBT people encounter numerous specific barriers to accessing mental health services, such as the lack of geographically and financially accessible providers who offer culturally sensitive, non-discriminatory care. Providers often lack specific knowledge, appropriate intervention strategies and general psychosocial skills to adequately serve LGBT clients. The findings show that these factors negatively shape the experiences of LGBT clients with the health care system.

Several countries have started initiatives to improve the quality of services for LGBT clients and their access to optimal mental health care.

Conclusions

Strategies and actions on all levels of the health care system - from public health policy making to the individual provider - are required to address access barriers and to establish equal and universal access for LGBT populations.
W05-01 - Rationale and Design of an RCT Comparing “EMC-Strategy” with TAU in Patients with Major Depression - the EMC Trial
Authors: Tadic A. , Gorbulev S. , Dahmen N. , Hiemke C. , Braus D.F. , Röschke J. , van Calker D. , Wachtlin D. , Kronfeld K. , Gorbauch T. , Seibert-Grafe M. , Lieb K. ,   EMC Study Group
Published: June 2010

Introduction

For Major Depression, current guidelines recommend treatment durations of 3-8 weeks until optimisation in case of insufficient outcome. Many retrospective studies indicate that improvement (HAMD-17 decrease ≥20%) occurs usually within 10-14 days and that non-improvement after 14 days of treatment is highly predictive for poor clinical outcome.

Methods

In level 1 of the EMC trial, non-improvers after 14 days of antidepressant treatment will be randomised to “early medication change” (EMC) strategy or treatment according to current guidelines (TAU). EMC schedules treatment optimisations on day 15 and day 29 in case of non-improvement. TAU schedules a medication change after 28 days in case of non-response (HAMD-17 decrease < 50%). Both interventions will last 42 days. In levels 2 and 3, EMC strategies will be compared with TAU strategies in improvers on day 14, who experience a stagnation of improvement during the course of treatment. The EMC trial is a multi-centre, multi-step, randomised controlled trial investigating for the first time prospectively, whether non-improvers after 14 days of antidepressant treatment with EMC are more likely to attain remission on treatment day 56 compared to patients with TAU. The trial is funded by the German Federal Ministry of Education and Research (BMBF), will be conducted in cooperation with the BMBF supported Interdisciplinary Centre for Clinical Trials (IZKS) Mainz and at six trial sites in Germany.

Results/conclusions

If the EMC strategy leads to significantly more remitters, consecutive revision of guidelines, clinical practice and research settings for the treatment of MD can be expected.
Diagnosis and treatment of prepsychotic conditions
Authors: Klosterkötter Joachim
Published: June 2010

Prevention of mental ill health has been declared a major task by the European Commission; and an early detection and intervention in psychosis in terms of an indicated (secondary) prevention in persons already seeking help for mental problems is increasingly approached across Europe both on research as well as clinical level, a mixture of both dominating. The growing interest in this field of research across Western and Western-Central Europe becomes apparent in the rapidly increasing number of publications on this topic since the turn of the century that has nearly increased by the factor of 5. The 3 leading European countries in this are Germany, the United Kingdom and Switzerland.

Despite the very well reception of the ‘prevention idea’ by clinicians, researchers, relatives of patients with psychosis and clients and first promising results of early detection and/or early intervention studies, critics caution against the percentage of false-positive predictions by current prodromal criteria and the possibly unnecessary initiation of an antipsychotic psychological and/or pharmacological treatment along with its risks of unwanted side effects including early stigmatization. Supporters, however, argue that these short-comings will be overcome in the course of time and that the potential of new benign preventive interventions was just about to be discovered as well as caution against self-stigmatization by odd, eccentric behaviours and loss of functioning not recognized as part of an illness but attributed to the person him-/herself.

In future, joint efforts across clinical and scientific disciplines as well as countries will be required to enhance predictive accuracy, to develop broadly applicable and risk-adapted interventions, to provide help to all in need, to extend preventive efforts to other psychiatric disorders and to possibly reach the ultimate aim, a primary prevention of mental disorders.
FC01-02 - Tanscranial Direct Current Stimulation in Depression: a Comparison Between Therapeutic Effects Obtained in Hospitalized vs Non-Hospitalized Patients
Authors: Priori A. , Ferrucci R. , Tadini L. , Vergari M. , Zanoni S. , Dobrea C. , Benatti B. , Arici C. , Bortolomasi M. , Giacopuzzi M. , Dell’Osso B. , Altamura C.
Published: June 2010

Introduction

Transcranial direct current stimulation (tDCS) is a novel somatic treatment proposed for depressive illness.

Aims

We aimed to assess the efficacy of tDCS in patients with severe, depression and whether hospitalized patients respond differently from non-hospitalized subjects.

Methods

28 patients (aged 36-79 year) with drug-resistant Major Depressive Episode in major Depressive Disorder or in Bipolar Disorder, according to DSM IV-TR, were enrolled. Patients were divided into two groups: ‘outpatients’ (N=14) and ‘hospitalized patients’ (N=14).HAM-D (21 items) were administered as outcome measure, before and after tDCS, to assess treatment response. tDCS delivered by a Newronika stimulator (Milano, Italy) was delivered over the dorsolateral prefrontal cortex (anodal electrode was placed on the left DLPC and cathode electrode on the contralateral area) at the intensity of 2mA, for twenty minutes, twice a day for 5 consecutive days.

Results

All the patients well tolerated the treatment with no side effects. Despite the different severity at the baseline between the two groups (p=0.03), after five days of tDCS the mood scores improved in both groups, by 22% in outpatients group ([baseline vs post stimulation: mean± SE] HDRS: 20.3± 1.3 vs 15.9±1.8, p= 0.009) and by 32% in hospitalized patients (HDRS: 28.7± 2.7 vs 19.7±2.8, p= 0.0006). The improvement after tDCS did not differ between the two groups (p=0,3).

Conclusions

tDCS significantly improves patients with severe major depression after five days of treatment without significantly different effects in hospitalized and non hospitalized patients. Hence, tDCS treatment could be suitable also for non hospitalized patients at low suicidal risk.