bluuebunny/crossref_metadata_2025 huggingface dataset:
The Role of Intuition and Prognostic Risk Assessment Regarding the Leave of Offenders with Mental Disorders
Authors: Schmitt C.
Published: March 2009

The granting of leave during terms of imprisonment plays an important part in the treatment of mentally ill offenders. According to German law, leave is to be granted in those cases where the abuse of this privilege or an attempt to flee can be negated. These regulations also, however, imply that the risk assessment of a patient's offence-related recidivism can not be the only criterion for the granting of leave.

So far, there have only been few studies about the prognostic risk assessment of the general abuse of leave. This is rather astonishing, as the granting of leave outside the institutional grounds, in particular, is a decision which often leaves those responsible fraught with anxiety. Furthermore, the abuse of a granted temporary release can lead to severe consequences on various levels.

As part of a study to be conducted in the German state of Rhineland-Palatinate, decisions about granting leave are to be analyzed and possible predictors of the abuse of leave are to be examined.

It is assumed that the abuse of leave is likely to be motivated by the conditions of particular situations and can primarily be explained by normal psychological factors.

However, it should be pointed out that, as the abuse of leave is such a rare occurrence, it poses a significant methodological problem. The criterion to be examined therefore needs to be exactly defined and particular attention must be paid to achieve an adequately high interreliability of the decision makers.
Incoercible Voices: Clinical and Phenomenological Architecture of Auditory Hallucinations
Authors: Raballo A.
Published: March 2009

Auditory hallucinations are a common symptom of schizophrenia and florid psychotic conditions. As observed by Jaspers such psychopathological phenomena entail a rich and complex clinical manifestation that is irreducibly linked to an impression of reality grounded in perception. However, most contemporary research has interpreted the jaspersian description in a literal and rather concrete way, equating hallucinatory experiences to mere disordered perceptions. Besides being theoretically problematic, such reduction of hallucinations to “perceptions without an object” substantially neglects fundamental clinical features of the experiential structures implicated in psychotic states (e.g. flagrance, unescapability, feeling of passivity, self-reference, idiosincracy). In this perspective qualitative-phenomenological analysis maintains a crucial role in disclosing the structure of hallucinatory meaning-generation which is relevant for both clinical practice and research.
Philosophical Interpretations and Existential Effects of Hallucinations
Authors: de Haan S.
Published: March 2009

Within philosophy, hallucinations have served as a paradigmatic test-case for epistemology in general and for theories of perception in particular. The differentiation of hallucinations from “real-life-perception” poses some interesting problems. Here, I will focus on two opposing views: first the view of hallucination as a failure of a metacognitive ability, and second a phenomenologically based view of hallucinations as a disturbance of experiential world-directedness.

Our theoretical understanding of hallucinations however, should take the highly unsettling existential effects on the patients themselves into account as well. As one admits to have experienced a hallucination, this calls into question one's entire capability of perception in general. For how can one be sure not to be hallucinating again? The loss of a basic trust in one's own senses can be so stressful as to aggravate the existing symptoms. These existential effects show that perception cannot be taken as a singular faculty and strengthen the phenomenological approach to hallucinations.
Potential Clinical Insights Generated Through the Process of Interdisciplinary Science/art Collaboration
Authors: Anderson S.
Published: March 2009

The filmmaker’s trained intuition in ‘reading’ gesture on the one hand and the highly technical nature of the filmmaking process on the other allows for productive interdisciplinary science/art exchange in exploring neurological and psychopathological conditions. As an illustration, processes and observations of a cinema/neuroscience collaboration in the production of a short fiction film featuring a protagonist with visual agnosia will be presented. It will be suggested that challenges and conflicting approaches employed by the different disciplines in the interdisciplinary collaborative investigation are beneficial to both the neuroscience and the filmmaking process. Parallels will be drawn between the cinema/neuroscience collaboration on visual agnosia and the intentions of the current symposium’s interdisciplinary work. This will be discussed in relation to the depiction and interpretation of ‘the subjective’. A questioning of an individual’s subjective perception underpins both the experience of hallucinations and the neurological condition visual agnosia. The potential for clinical insights will be considered in the light of the particular nature of the medium of film and its preoccupation with the subjective experience in relation to aspects of psychosis.
Thyroid Hormones and the Psychomotor Development of the Newborn
Authors: Ares S. , Quero J. , de Escobar G. Morreale
Published: March 2009

Iodine is a trace element which is essential for the synthesis of thyroid hormones. If maternal iodine deficiency in pregnancy is severe, fetal brain damage will occur. This damage is irreversible after birth. Mild/moderate iodine deficiency during pregnancy and early postnatal life is associated with neuro/psycho-intellectual deficits in infants and children. The severity is not only related to the degree of iodine deficiency, but also to the developmental phase during which it is suffered, the most severe being the consequence of iodine deficiency during the first two trimesters of pregnancy. The close involvement between human brain development and thyroid hormones is widely accepted. The effects of T3 on the central nervous system are mediated by the regulation of the expression of genes that synthesize proteins implicated in cerebral neurogenesis, neuronal migration and differentiation, axonal outgrowth, dendritic ontogeny, and synaptogenesis. They are also necessary for cerebellar neurogenesis (predominantly during early postnatal life), gliogenesis (predominantly during late fetal life to 6 months postnatally), and myelogenesis (during the second trimester of gestation to 2 years of postnatal life). From clinical studies on the effect of iodine deficiency of both mother and fetus it becomes clear that T4 is required for brain development during gestation.

Low T4 levels during neonatal life could be a negative factor contributing to the neurodevelopmental problems of very preterm infants. Indeed, retrospective studies have shown a relationship between hypothyroxinemia and developmental delay and an increased risk of disabling cerebral palsy.
Markers of Oxidative Stress in Bipolar Disorder and in Schizophrenia
Authors: Gama C.
Published: March 2009

There has been strong evidence in recent years that oxygen free radicals may play an important role in the pathophysiology of schizophrenia and bipolar disorder. More recent evidence of altered antioxidant defenses in major mental illnesses has been accumulating. Much of the focus on antioxidant defense mechanism has been on the key scavenging antioxidant enzymes: Superoxide dismutase (SOD), Catalase (CAT) and Glutathione peroxidase (GSH-Px). Of these, SOD activity has been the most frequently examined.

The imbalance between antioxidant and oxidant mechanisms increases what is called oxidative stress, when the oxygen free species react and could damage lipids, proteins, carbohydrates and DNA. Lipids are the main compound of cellular membrane and the oxygen free radicals reaction to them is called lipid peroxidation. Several plasma lipid peroxides, like MDA, are measured by Thiobarbituric acid reactive substances (TBARS). Increased levels of TBARS have been reported in the plasma of drug-free and medicated bipolar disorder and schizophrenic patients. It is hypothesized that psychotic symptoms seen in both disorders might be a consequence of peroxidative injury to membrane phospholipids. Moreover, neuronal functioning is affected by this injury either by changes in membrane fluidity or by alterations in membrane receptors, which can cause neurotransmitter uptake and release impairment and even cell death.
New World of Mental Health Legislation England and Wales David Jolley and Reinhard Heun
Authors: Jolley D. , Heun R.
Published: March 2009

After eight years of tortured negotiations between government, professional psychiatrists and lay pressure groups, England and Wales will begin to use new Mental Health Legislation November 2008. This will not be a new Mental Health Act, but a substantial modification of the 1983 act. There are nine key changes:

1.

A single definition of mental disorder: ‘any disorder of mind or brain’.

2.

Criteria for compulsion: ‘appropriate medical treatment’ test.

3.

Age-appropriate services: special arrangements for under 18 years.

4.

Professional roles: approved clinicians and responsible clinicians (non-medical).

5.

Nearest relative: recognises Civil Partnerships, allows displacement.

6.

Supervised Community Treatment Orders.

7.

Mental health Review Tribunal: unified.

8.

Advocacy: Independent Mental Health Advocates.

9.

ECT: new safeguards.

The Code of Practice identifies five key principles:

1.

Purpose - to minimise adverse effects of Mental Disorder.

2.

Least Restriction.

3.

Respect - diverse needs, values and circumstances.

4.

Participation - involving patient in planning, developing and reviewing treatment and care.

5.

Effectiveness, efficiency and equity - optimal use of resources.

Earlier drafts had been described as: ‘little more than a Public Oder Bill dressed up as Mental Health legislation’; ‘ethically unworkable and practically unworkable’. Much of the dissent related to suggestions that people with Personality Disorder behaving in a dangerous or antisocial way should be subject to compulsory detention. Fears included breach of liberties and Human Rights and transformation of Mental Health Services disadvantaging people with major mental illnesses.
Evaluation of School Based Suicide Prevention Programs Effectiveness
Authors: Kutcher S.
Published: March 2009

Youth suicide is a significant public health issue that requires effective evidence based interventions. School based suicide prevention programs are popular in many jurisdictions and there is a perception that they are effective in reducing youth suicide rates. This presentation will apply a comprehensive evaluation framework to determine the effectiveness of school suicide prevention programs as described in the literature and will identify those conceptual and research issues that need to be addressed to develop and deliver effective school based suicide interventions.
Depressive Disorders in Portugal: EAAD and the Depanx Project Regional Baseline Data and the WMH Survey National Data
Authors: Gusmão R. , de Almeida J.M. Caldas
Published: March 2009

Firstly, recent data on depressive disorders and suicidality burden in Portugal is presented and treatment gap is stressed as well as the insufficient information until recent years (1).

At the national level, the first epidemiological study on psychiatric disorders embedded within the World Mental Initiative Survey is ongoing and prevalence and needs for care data will be presented.

Implementation process of the EAAD 4-level intervention in Portugal is ongoing along with restructuring of both liaison and specialized mental health care on a regional sector of 350.000 inhabitants with a mental health specialised care department and four large primary care health centres, where liaison between 4 mental health teams and 200 GP was taking place accordingly with varying models (substitute care in most) and different clinical criteria for admission and follow-up.

The restructuring of mental health teams and their missions implied that while a set of sub-teams stood responsible for severe mental disorders, another subgroup was deemed to comply exclusively with common mental disorders and primary care liaison aided by standardisation of clinical criteria for referrals evaluation and reply, specialised therapeutic interventions, as well as collaborative stepped care.

Baseline and some outcome data on suicide and depression will be presented such as rates, psychopharmacological prescriptions, general population knowledge and beliefs, media reporting, and pre and post training evaluation of primary care professionals.
Promoting Recovery for People with Long-term Mental Illness in Institutional care: An International Delphi Study of Stakeholder Views
Authors: Turton P. , Wright C. , White S. , Killaspy H.
Published: March 2009

Aims:

To identify the specific components of care that key stakeholders in ten European countries at different stages of de-institutionalization regard as most important in promoting recovery in this group; to measure consensus between and across stakeholder groups and countries; and to develop a conceptual framework of ‘domains’ of care.

Method:

Each participating country completed a series of conventional three-round Delphi exercises with four separate panels of experts; service users, mental health professionals, carers and advocates. In Round 1 an initial open question asked respondents to identify up to 10 components of care they considered most important in promoting recovery. In Round 2 these ideas were fed back to the group and rated on a 5-point scale. In Round 3 the group re-rated the components in the light of information about the whole group's response. Components achieving high importance rankings and high consensus were grouped into domains.

Results:

The 40 participating panels generated around 4,000 separate items of care. From these, eleven broad domains of recovery practice were identified. Results will be presented descriptively to show the domains and components of care considered to be most important to recovery, and to show consensus within and across countries, and between stakeholder groups. It will be seen that there was generally high consensus between groups and countries but some modest differences in priorities.

Conclusions:

Delphi methodology is useful in eliciting and evaluating different perspectives on recovery-based practice. Strengths and weaknesses of the approach will be discussed.
The Development of the DEMoBinc. Toolkit and the Results of Reliability Testing
Authors: Taylor T. , Killaspy H. , King M. , White S.
Published: March 2009

Aims:

To develop a toolkit to assess the quality of institutionalised care, in both hospital and community settings, for individuals with long-term mental illness.

Methods:

The toolkit was developed by the UK research teams. Items were included to assess the six domains (Living Environment; Therapeutic Environment; Treatments and Interventions; Self-management and Autonomy; Social Policy, Citizenship and Advocacy; Clinical Governance) and three cross-cutting themes (Social Inclusion; Human Rights; Recovery-based Model) which emerged from the international literature review, Delphi exercises and cross-country care standards. Following translation and piloting in each country, the toolkit was refined and tested for reliability in 20 units in each country (a total of 200 units).

Results:

Test-retest reliability was assessed using intra-class correlations and Cohen's Kappa coefficients. Factors with low reliability or extreme response biases were dropped. Remaining items were subjected to an exploratory factor analysis to test the allocation of items to domains and cross-cutting themes and improve their internal consistency. Correlations between domains were explored to determine whether or not domains could be combined.

In the next phase of the study,the toolkit domain ratings will be analysed for associations with standardised assessments of service users' quality of life, autonomy and markers of recovery to investigate whether the toolkit can provide a proxy measurement of the institution's promotion of human rights and recovery.
Neurobiology of Affective Disorders - Insights from Pet Imaging
Authors: Hietala J.
Published: March 2009

Recent brain imaging studies indicate subtle functional and also structural brain changes in affective disorders. We report specific neurotransmitter receptor findings in vivo in major depression testing directly the ‘old’ monoamine and also newer peptide neurotransmitter hypotheses of unipolar major depression.

Positron Emission tomography imaging demonstrates relatively consistently a widespread reduction of brain serotonin 5-HT-1A receptors in drug-free or never-treated patients with clinical depression. The reduction of 5-HT-1A receptors is not confined to frontal or temporal cortex but seem to be widespread including multiple brain regions. Our data shows that the 5-HT-1A receptor finding seems to be robust even in primary care patients with mild/moderate depression. Pilot findings in our laboratory suggest that this alteration can be ‘normalized’ with a psychotherapeutic intervention. Substance P NK1 receptors appear not to be altered in never-medicated MDD patients. However, HAM-D total scores correlated positively with NK1 receptor binding in neocortical as well as limbic brain areas suggesting a modulatory role for NK1 receptors in major depression.

Our results indicate specific neurotransmitter changes in clinical depression that could also represent therapeutic targets but the specificity of these findings e.g. in relation to anxiety disorders (or comorbid conditions) needs to be explored further.
Functional Imaging Studies of the Limbic System
Authors: Frangou S.
Published: March 2009

Current models for mood disorders and particularly bipolar disorder focus on increaesed activation within the limbic system coupled with reduced inhibitory control from the prefrontal cortex. This presentation will focus on functional magnetic resonance imaging studies that highlight limbic-prefrontal interactions in Mood Disorders and on the potential effect of antidepressants and mood stablisers on these neural networks.
Imaging Usual Addictions: Tobacco, Canabis and Alcohol
Authors: Leroy C. , Chanraud S. , Artiges E. , Martelli C. , Cachia A. , Andoh J. , Kostogianni N. , Berlin Y. , Reynaud M. , Aubin H.J. , Trichard C. , Martinot J.-L.
Published: March 2009

Background:

Brain models of drug addiction are being tackled in humans, using PET and MRI.

Results:

1.

Whereas tobacco and cannabis do not interact directly with dopamine sites, positron emission tomography detected lower availability in sites regulating the catecholamines homeostasis, notably in dopamine transporter sites in striatal and in extrastriatal regions. This further supports repeated and long term substance use progress towards an adaptative diminished basal dopamine level that would contribute to the switch to an addicted brain.

2.

Alcohol: abnormalities in brain macro- and micro- structure were searched in detoxified alcohol-dependents with preserved psychosocial functioning:

-

Brain function (fMRI): fronto-cerebellar overactivation detected during an auditory language task in alcohol-dependents may reflect the compensatory effort required for patients to maintain the same level of performance as controls.

-

Brain macrostructure (MRI). Widespread lower white matter volumes, and lower grey matter volumes in the frontal lobe, insula, hippocampus, thalami and cerebellum, were detected. Poorer neuropsychological performance correlated with smaller grey matter volumes in these regions and with lower white matter volume in the brainstem.

-

Brain microstructure (DTI): tractography of white matter fiber bundles revealed that brainstem bundles alteration may contribute to cognitive flexibility impairment. Regression analyses showed memory scores were related to brain microstructure in parahippocampal areas, frontal cortex, and left temporal cortex. This suggest diffusion imaging (DTI) is a useful probe to early alcohol-induced brain alterations.

Conclusion:

While indices of dopamine down-regulation are consistency detected in several drug addictions, even “socially-adapted” alcohol dependence may induce change in brain structure.

Psychol Med. 1998 28:1039-48.

Neuropsychopharmacology. 2007 32:429-38.

IEEE Trans Med Imaging. 2007 26:553-65

J Nucl Med. 2007 48:538-46.

Neuropsychopharmacology (Chanraud S et al., 2008 Jul 9. [Epub ahead of print]).

J Clin Psychopharmacol (Leroy C et al, in press).
Antineuronal Antibodies in Obsessive-compulsive Disorder: Comparisons in Children with OCD-only, OCD + Chronic tics and OCD + PANDAS
Authors: Singer H. , Gause C. , Grados M.
Published: March 2009

We will present a comparison of serum antineuronal antibody profiles in children with OCD-only (n=13), PANDAS + OCD (n=20), CTD + OCD (n=23), and age-matched controls (n=29). Detection methods used to evaluate anti-brain antibodies included immunohistochemistry (striatum), ELISA (BA 9/10, BA 11, caudate, and cingulate gyrus), and Western immunoblotting (BA 9/10, BA 11, caudate, and cingulate gyrus).

Immunublotting was further used to assess the presence and concentration of putative antigens identified in post-streptococcal patients, i.e., *- and *-enolase, aldolase C, pyruvate kinase M1 and tubulin. Anti-lysoganglioside GM1 activity was measured by competitive inhibition.
Autoimmunity in Tic Disorders: Where do we Stand?
Authors: Hoekstra P.
Published: March 2009

New findings on serum antibodies against pyruvate kinase and lysogangliosides plus cytokine data in children with tic disorders compared to helathy control children are presented. Also blood-based gene expression data related to autoimmunity in children with tic disorders are discussed.
Antineuronal Antibodies in Pediatric OCD and Tourette Syndrome
Authors: Morer A.
Published: March 2009

The objective of our study was to test the autoimmune hypothesis of OCD and TS as disorders related with PANDAS, and find clinical features or specific immunological markers related with them. Child onset OCD in adults has been associated with higher mean ASLO titers, higher frequencies of history of tic disorders, tonsillitis in childhood and compulsive symptoms. Also, two proteins, with molecular weights of 86kDa and 55kDa, have shown antibody binding in sera from 7 patients.The fact that some clinical and biological features related with PANDAS are found in adults and that antineuronal antibodies exist in patients with OCD or TS diagnosis that don't meet PANDAS criteria, lends further evidence that autoimmunity related with OCD is wider than PANDAS.
Which Symptoms do Best Predict Major Depressive Disorder (MDD) in Males? Results from an Icelandic Community Study
Authors: Pálsson S. , Sigurðsson B. , Aevarsson Ó. , Ólafsdóttir M.
Published: March 2009

Background/objectives:

The concept of male depression is based on the hypothesis that typical symptoms of depression in men often seem to be masked by non-typical male distress symptoms not considered in common depression inventories. Despite clinical evidence, scientific evidence is still lacking. The study describes symptoms reported by males (on the Gotland Male Depression Scale (GMDS) in a community study and these were further validated against MDS criteria.

Methods:

In a community study in Reykjanes Iceland, 534 males were rated by the GMDS. In the second phase a sub-sample of healthy and depressive males were examined by a trained psychiatrist in a semi-structured interview (N=137). Diagnosis was according to the DSM-IV for MDD. The symptoms on GMDS are self-rated from 0-3.

Results:

In the community sample the prevalence (>1 GMDS) of single symptoms was following: More stressed out than usual (16.8%), aggressiveness (11.8%), feeling of being burned out (14.5%), tiredness (18.2%), more irritable (15.3%), difficulty making decisions (10.8%), sleep problems (21%), anxiety/uneasiness (10.5%), increased use of alcohol/substances, hyperactivity ( 10.3%), behavioural changes (4.7%), feeling sad/hopeless (10.4%), self-pity (4.8%). All symptoms on GMDS correlated strongly with MDD. In a stepwiselogistic regression model, controlling for medication and age, three items contributed independently to MDD diagnoses. These were aggressiveness, being more irritable and anxiety/uneasiness.

Conclusions:

Sleep problems and tiredness were most commonly reported symptoms. The best predicting symptoms for MDD were anxiety and acting out symptoms, aggression and irritability. This is of interest as these symptoms are not in the criteria for MDD.
How Gender-Specific is Male Depression?
Authors: Moeller-Leimkuehler A.M. , Yuecel M.
Published: March 2009

Although there is a large amount of clinical evidence for a male-type depression, scientific evidence is still limited, especially in non-clinical populations with regard to gender differences in symptoms.

In a sample of college students (518 males, 499 females) the relationship between male depression, sex and gender-role orientation was examined. Contrary to expectations, female students had a greater risk of male depression than male students (28.9% vs. 22.4%; p< 0.05). Overall, depressive symptoms as well as male-type distress symptoms were more pronounced in females. In the subgroup of those at risk for male depression sex and kind of symptoms were unrelated. With regard to the impact of gender-role orientation, feminine and undifferentiated orientation predict significant higher risk of male depression (30.7% and 38.1%), independent of biological sex, and were associated with different symptom factors.

The results suggest that male depression might not only be a male phenomenon, at least in college students, since young women have adopted male attributes. In conclusion, gender studies in depression should not rely on biological sex, but include measures of gender-related selfconcepts and normative orientations.
Do Suicidal Females have “Male-type” Depression?
Authors: Rihmer Z. , Rutz W. , Rihmer A. , Gonda X. , Webb R. , Kapur N.
Published: March 2009

Recent studies suggest an evidence for a “male depressive syndrome” in patients with major depressive disorder.

Because males are markedly overrepresented among suicide victims and the opposite is true for suicide attempters, we investigated the rate and global severity of Gotland Male Depression as measured by the Gotland Male Depression scale in 86 suicide victims (74 males, 12 females), 86 suicide attempters (21 males, 65 females) with current DSM-IV major depressive episode and in 144 normal controls (116 males, 28 females). The rate of Gotland “Male” Depression (total score of 13 or more) was significantly higher in depressed suicide victims (98%) and in depressed suicide attempters (93%) than in normal controls (2%, p=0.00001). Among depressed suicide victims 100% of males and 83% of females have had Gotland “Male” Depression (p=0.02) while the same figures among the depressed suicide attempters were 91% and 94%, respectively (not significant). The total Gotland Male Depression scores were significantly higher in depressive suicide victims (22.26) and depressive suicide attempters (23.23) than in normal controls (4.01, p=0.00001 and p=0.0001, respectively), with significant gender differences only among depressed suicide victims (males: 22.85, females: 18.58, p=0.009) and normal controls (males: 4.33, females: 2.71, p=0.05).

However, since male and female depressed inpatients do not show clinically significant difference in their mean total scores on Gotland scale symptoms (11.99 vs 12.04, Möller-Leimkühler et al, 2004), it would be premature to conclude from our present findings that compared to nonsuicidal female depressives, suicidal female depressives have male-type depression profile.
The Challenge of Psychiatric Treatments in the Deaf Population
Authors: DuFeu M.
Published: March 2009

Delivering appropriate psychiatric treatments to a Deaf population faces many challenges:

•

The geographical spread of this client group, who comprise about one in a thousand of the general population.

•

The complexity of the treatment needs of Deaf people, who may have neurological, psychiatric, social, emotional and psychological difficulties, in addition to a deprived history, which can include significant language delay or deprivation.

•

The challenge of delivering multi disciplinary treatment programs in conjunction with locally based mainstream resources. Most specialist Mental Health services for Deaf people do cannot provide out of hours or crisis services, and some do not have sufficient community based staff, or any day or in patient provision.

The specialist Deaf mental health services need to undertake major awareness, teaching and liaison programs:

•

With any agency in contact with Deaf people, including Health, Mental Health and Social work and voluntary organistions.

•

With the Deaf Community to raise awareness of mental health issues, to give information and remove stigma.

All these initiatives need to take place locally as well as at national policy making level.
A Mental Health Unit for the Deaf. The Spanish Experience
Authors: Muñoz J. , Garcia A. , Ferre F.
Published: March 2009

In 2002 the first spanish mental health unit for the Deaf was set up at the Gregorio Marañón Hospital in Madrid.

From this moment that unit has seen more than 400 profoundly deaf patients which means more than 6500 consultations.

Only 3 professionals works in the unit. a psychologist, a social worker and a part time psychiatrist.

We have 3 principal goals in our presentation:

1.

First: Present the results of the unit. Number and kind of patients, disorders and treatments.

2.

Second: Explain how difficult is to set up this kind of spcialized units in a big general hospital.

3.

Third: Prsent our plans to improve our unit in the short term.
Substance Use, Suicidality and Adolescent-onset Schizoprenia - an Israeli Ten-year Retrospective Study
Authors: Shoval G. , Weizman A. , Zalsman G.
Published: March 2009

Objective:

To investigate the link between the use of specific types of substances and suicidality in adolescent inpatients with schizophrenia and schizoaffective disorder.

Methods:

We performed a ten-year naturalistic retrospective study of 178 adolescent inpatients diagnosed as suffering from either schizophrenia or schizoaffective disorder. A comparison was made between the suicide-attempting adolescent inpatients and the non-attempting subjects, by the use of specific types of substances, measurements of psychotic, depressive and aggressive symptoms and clinical data reported during their hospitalization.

Results:

The suicide attempters reported considerably greater usage of inhalants and lysergic acid diethylamide (LSD). Alcohol and methylene-dioxy-methylamphethamine (MDMA) were also used significantly more by this group. However, no differences were found in the usage of cannabis, amphethamines, cocaine and opiates. The suicide attempting patients were found to have had more previous psychiatric admissions, a greater level of deliberate self-harm behavior and a higher level of suicide ideation, but rather a decreased severity of psychotic symptoms.

Conclusions:

This study is the first report of the association between specific types of substances and suicidality in the high-risk population of adolescent psychotic inpatients. The strong association between inhalants, LSD, alcohol and MDMA with suicidality is relevant to suicide prevention and intervention programs in adolescent-onset schizophrenia.
Alcohol and Suicide in Belarus
Authors: Razvodovsky Y.
Published: March 2009

Background:

It is well recognized that both acute and chronic alcohol use are among the major behaviorally modifiable factors that are associated with suicidal behaviour. High suicide rate in the former Soviet Republics and its profound fluctuation over the past decades have attracted considerable interest. There is mounting evidence that the role of alcohol is a crucial in understanding this phenomenon.

Aim:

To estimate the aggregate level effect of alcohol on the suicide rate in the former Soviet republic Belarus.

Method:

Trends in alcohol consumption per capita and suicides rate from 1979 to 2007 were analyzed employing ARIMA time series analysis.

Results:

According to Bureau of Forensic Medicine autopsy reports the number of BAC-positive suicides increased by 47.7% (from 10.7 to 15.8 per 100.000) and number of BAC-negative suicides increased by 31.4% (from 7 to 9.2 per 100.000). Alcohol in blood was found in 62% suicide victims for the whole period, with the minimum figure 49.3% in 1988 and maximum 68.5% in 1981. The results from the time series analysis indicated the presence of a statistically significant association between the alcohol consumption and BAC-positive suicide rates, while changes in the number of BAC-negative suicides were not related to fluctuation in alcohol consumption level. The analysis suggests that a 1 litre increase in alcohol consumption per capita would result in a 10,9% increase in a number of BAC-positive suicides.

Conclusion:

The results of present study support the idea that alcohol was responsible for the fluctuation in suicide rate in Belarus.
Depressive Symptoms Predict Cognitive Decline in an Elderly Non Disabled Population with White Matter Changes. Results of the LADIS Study
Authors: Verdelho A. , Madureira S. , Moleiro C. , Ferro J.M.
Published: March 2009

Aims:

Depressive symptoms (DS) in the elderly have been implicated in cognitive decline, and are more frequent in patients with white matter changes (WMC). Our aim was to ascertain if DS influence cognition in an elderly population with WMC.

Methods:

The LADIS (Leukoaraiosis and Disability) is a prospective European study that evaluates the impact of WMC on the transition of independent elderly subjects into disability. Subjects were enrolled due to minor complaints without impact in daily-living activities, and presence of WMC. Subjects were evaluated at baseline and yearly during 3 years with a comprehensive clinical and functional protocol. DS were recorded with the Geriatric Depression Scale (GDS). Major depression was classified according to the DSM-IV criteria. Dementia and cognitive decline not dementia were diagnosed according to usual clinical criteria. MRI was performed at entry and at the end of the study. WMC severity was rated according to the Fazeka's scale.

Results:

639 subjects were included (74.1 ± 5 years old, 55% women, 9.6±3.8 years of schooling). 89% (568), 78.4% (501), and 75% (480) of the patients from the initial sample were followed-up in clinical visit at year 1, 2 and 3. At the end of the study 90 patients were demented and 147 patients had cognitive impairment not dementia. Using survival Cox regression we found that depressive symptoms were independent predictors of cognitive impairment independently of age, education, gender, WMC severity and temporal atrophy.

Conclusion:

Depressive symptoms are independent predictor of cognitive decline in an independent elderly population with WMC.
Prefrontal Dysfunctions and Temperament in Pathological Obesity - the Results of Neuropsychological, TEMPS-A and Genetics Studies
Authors: Borkowska A. , Tretyn A. , Golebiewski M. , Bielinski M. , Akiskal H.
Published: March 2009

In this study the performance on Wisconsin Card Sorting Test (WCST) in relation to the polymorphism of serotonin system genes - 5HT2A, 5HT2C, 5HTT, temperament using TEMPS-A scale in relation to the intensity of depression on Beck Depression Scale were evaluated in 150 subjects with pathological obesity, BMI>40. For assessment prefrontal dysfunction the WCST, and for 5 dimensions of temperament (depressive,cyclothymic, hyperthymic, irritable and anxious) the TEMPS-A scale were used. The results of WCST and TEMPS-A were compared with the results of healthy sex, age and education matched controls.

Subjects with obesity obtained significant worse results on WCST than controls. The results of TEMPS-A scale show the high prevalence of irritable and depressive temperament in patients group. Female patients show highest prevalence of depressive and anxious temperament, while males the irritable and hiperthymic temperament. The medium or serious intensity of depression was found in 50% of cases. The intensity of depressed symptoms correlated with depressive temperament in female. Interesting results were obtained in the case of 5HT2C: a known polymorphism (-759C>T) could not explain the banding pattern observed. It is possible that we have found a novel polymorphism that strongly correlates with obesity.

The results obtained show highest prevalence of depression, specific temperamental picture and prefrontal dysfunctions in patients with pathological obesity which may be related to the polymorphisms of serotonin and dopaminergic system genes and possible association of the obesity with the new polymorphism of 5HT2C gene.
Prevalence of Overweight, Obesity, and Associated Psychological Problems in Qatari’s Female Population
Authors: Bener A.
Published: March 2009

Background:

Dissatisfaction with body weight and the use of unhealthy weight reduction practices have been reported among adolescents.

Objective:

The aim of the present study was to examine the severity of dieting and its association with obesity, body satisfaction and psychological problems in female adolescents.

Subjects:

A representative sample of 800 girls aged 14-19 years were approached during the period October to December 2004 and 566 girls gave consent and participated in the study, thus giving a response rate of 70.8%.

Methods:

Self-reports were obtained from 566 teenage girls using the Adolescent Dieting Scale (ADS) and the Self-Reporting Questionnaire (SRQ-20) for psychopathology.

Results:

The prevalence of overweight and obesity for female adolescents were 13.4% vs 1.8%;-; 39.9% were intermediate dieters, and 8.3% were extreme dieters. Dieting was not associated with age but was significantly associated with body mass index (BMI) (p=0.045). Extreme dieting was strongly associated with peer perception of respondent's figure (p< 0.001) and self perception of figure (p=0.016). Additionally, in adult Qatari population overweight and obesity for males were (34.4% vs 34.6%) and for females were (33.0% vs 45.3%). This is significantly higher than adolescent girls. (p< 0.01). The SRQ score was significantly highest in the extreme dieters group (p=0.005). The extreme dieters get most of their education (or information?) about dieting from school(14.0%) and TV(43.6%).

Conclusion:

The present study revealed strong evidence for the association between frequent dieting and overweight, body image dissatisfaction and psychological problems among adolescent females.
Increased Dopamine Transmission Impairs Behavioral Flexibility and Synaptic Plasticity
Authors: Giros B.
Published: March 2009

In addition to its key roles in motor and reward systems, brain dopamine (DA) has also been implicated in integrative functions contributing to adaptive behaviors such as attention, learning and memory, which processing involved the plastic changes of synaptic strength. Since the first formal evidence for Long Term Plasticity mechanism (LTP) in the Hippocampal Formation (HF), the phenomenon of synaptic plasticity has been described in various brain areas. It is appealing to consider that this is particularly true for brain regions that receive DA inputs, including the striatum and the frontal cortex being those most studied beside the hippocampus.

We have observed, using mice lacking the dopamine transporter (DAT) which constitute a unique genetic model of persistent functional hyperdopaminergia, a strong deficit of LTD and an enhancement of LTP in the CA1 region of hippocampal slices. This finding suggests that the augmentation of endogenous dopamine by DAT knockout modulates the plastic property of bidirectional synaptic plasticity by inducing a metaplastic shift in the HF. This deficit of LTD can be reversed by the D2 antagonist haloperidol, whereas the LTP increase is not altered. In the same animals, we observed a major impairment of cued-learning in the Morris watermaze, as well as more subtle, but solid, deficits in the spatial learning. These deficits of behavioral flexibility are reversed using haloperidol. Finally, in control animals, the direct blockade of the DAT using GBR12935, can reproduce the LTD and the behavioral deficits, indicating that they are not a consequence of developmental changes.
Maternal Deprivation in Rat: Model of Vulnerability to Opiate Addiciton
Authors: Dauge V.
Published: March 2009

Aims:

The concept of individual vulnerability applied to mental pathology involves genetic background and/or environmental context. We studied the impact of environmental factors such as maternal deprivation on the appearance of a vulnerability to addiction. Maternal deprivation represents an early stress, a lack of nursing occurring during a period of intense neuronal development and then could lead to long term brain functioning abnormalities. It has been recently shown that > 900 genes are stably regulated by maternal care in rat.

Methods:

Pups were separated from their mother and littermate the day after birth 3h/day for 14 days. Place preference and oral auto-administration tests were performed at the adulthood. Opioidergic and dopaminergic systems were studied.

Results:

We showed that maternal deprivation leads in adult male rats to a hypersensitivity to the rewarding and reinforcing effects of morphine correlated with a basal hypoactivity of the striatal enkephalinergic system. Maternal deprivation did not change oral self-administration behavior of cocaine and alcohol. Adolescent chronic tetrahydrocannabinol exposure suppressed morphine dependence in adult deprived rats.

Conclusion:

Maternal deprivation represents a highly valuable model to study environmentally triggered inter-individual vulnerability to opiate addiction. The suppression of morphine dependence in adult deprived rats after adolescent chronic tetrahydrocannabinol exposure raise the question of the beneficial effects of cannabis in opiate dependence vulnerability context.
Are Animal Models of Cognitive Deficit Relevant for Man? Translational Problems in Schizophrenia
Authors: Boyer P.
Published: March 2009

Since long working memory deficit has been considered as one of the major cognitive dysfunction encountered in schizophrenia. Working memory is critical for human reasoning, judgment and decision and depends upon the integrity of prefrontal and cingulate circuitry. As a consequence coupling pharmacological (amphetamine sensitization, subchronic phencyclidine administration, neurodevelopmental insult) and behavioral approaches of prefrontal functions in animals seems to be a cue totally appropriate for elucidating the mechanisms of this dysfunction in man (Castner,2004).

In rodent models aberrant dopaminergic and glutamatergic signaling in medial prefrontal cortex has undoubtedly an impact on memory and learning, But the analogy between these deficits and a true working memory deficit in man is not obvious. Due to the higher degree of homology between human and non-human primates behavioral tests in apes seem to be more relevant but once again they can not be considered as reflecting strictly the consequences of working memory dysfunction in schizophrenia. Another approach is to extend the insights gained from the study of normal brain organization in animal models to better understand the neural basis on which working memory functions are based (Tanaka, 2006). Dissecting the cellular and circuit basis of prefrontal and cingulate cortices can give an idea how direct and indirect intercellular mechanisms are modulating working memory Nevertheless the behavioral part of this type of study remains non conclusive. It seems in fact that working memory itself is probably not a good candidate and that contextual-binding tasks (which explore encoding and retrieval) are more appropriate (Boyer,2007).
Elder Abuse
Authors: Kalasic A. Milicevic , Todorovic N. , Vracevic M.
Published: March 2009

Elder abuse is a serious problem-each year hundreds of thousands of seniors are abused. Although the problem is described, defined and legislatures exist in many countries elder abuse is not still recognized as public health problem. Red Cross of Serbia has organized education of volunteers in Elder Abuse and Discrimination topic which is very important in sensibilisation among community-dwelling. Volunteers (N=226) were informed with generally accepted definitions, research in the field and legislature in Serbia concerning this issue and proposed network for prevention of elder abuse. Interactive workshops gave us data: distribution and types of elder abuse in their local communities and obstacles in referring and positive examples from practice as problem solving models.
OAP Actual Problems in European Countries
Authors: Firmino H. , Tataru N.
Published: March 2009

Aging of the world population risks to be accompanied by an increase of chronic health problems, and most particularly of mental health problems. To face to these problems the organization of care and education in old age psychiatry is still quite insufficient worldwide. Like in all countries in this part of the world, the geriatric psychiatry is still not enough represented. Only in some countries in Europe old age psychiatry is a recognized specialty (18% of European region countries responded at a WPA survey of teaching and training in OAP). The number of professionals working in the field is still very low to satisfy the needs of care of elderly with mental disorders. There is inadequate training for formal caregivers and lack of support for informal ones. This is the reason to support the development of postgraduate education on old age psychiatry as a priority in Europe. We discuss about teaching and training in old age psychiatry, psychiatric and psychological expertise exams and the assessment of competence in dementia and ethical aspect of care and research in elderly demented people.

We also present some aspects of elderly sexuality and abuse and about mental health from strategy to reality and dementia care in different Europe countries.

Chairs: Horacio Firmino-Portugal, Nicoleta Tataru-Romania.

Speakers:

1.

Alexandra Milicevic-Kalasic, Serbia: ‘Mental Health in Serbia-from Strategy to Reality’.

2.

Horacio Firmino, Portugal: ‘Education on Old Age Psychiatry at Europe: facts and proposals’.

3.

Ilkin Icelly, Turkey: ‘Elderly abuse in Turkey’.

4.

Jerzy Leszek, Poland: ‘Dementia care in Poland’.
Dementia care in Poland
Authors: Leszek J.
Published: March 2009

Poland one of the central European countries has a population of about 40 milion, 7,4% of whom aged 60 and over.

The number of elderly in Poland is expected to rise dramatically to 16% by 2020. The health status of Poland’s middle aged and elderly population is not satisfactory; there is high mortality from cardiovascular diseases and malignancies. Poor health status results in higher consumption of health care especially by the elderly. For all mentally ill people there are about 2000 psychiatrists in university psychiatric clinic, psychiatrics departments and in ambulatory practice. A very small number of of psychiatrics(from general number 2000) are qualified in gerontopsychiatry in Poland. Among growing number of elderly patients are persons with dementia, incl. dementia Alzheimer’s type (about 250 000 patients). For their disposal are 4 psychogeriatry wards with small number of beds (average 15 for one ward). Memory clinic, aimed at elderly diagnosis, therapy and rehabilitation for patients with dementia are planned. First centre of this kind(with programme of training in psychogeriatry) for Alzheimer patients was opened in 2007 yr in Scinawa, near Wroclaw (Lower Silesia Province). Important role in caring of dementia patients is playing by families and self-service organization of families. The first organization of this kind was founded in Lower Silesia in 1991 (Wroclaw) as The Lower Silesia Alzheimer Association Family Support.

Dementia care in Poland as not satisfactory up to know, is currently under discussion and a new concept of caring will be prepared.