bluuebunny/crossref_metadata_2025 huggingface dataset:
Functioning in patients with recently diagnosed vs. chronic schizophrenia treated with paliperidone ER
Authors: Tessier C. , Franco M. , Millet B. , Sachetti E. , Turczynsky J. , Vauth R. , Hoeben D. , Lahaye M. , Schreiner A.
Published: May 2011

Objective

To explore functioning in adult patients with recently diagnosed (< 5 years) and more chronic (> 5 years) schizophrenia treated with flexible doses of paliperidone ER.

Methods

International prospective open-label 6-month study. Endpoints were the Positive and Negative Syndrome Scale (PANSS), patient functioning (Personal and Social Performance Scale; PSP) and treatment-emergent adverse events (TEAEs).

Results

Of 713 recently diagnosed patients, most were male (60.9%), mean age was 33.6 ± 11.2 years and mean time since diagnosis was 2.3 ± 1.7 years. Chronic patients (n = 1003) were predominantly male (59.2%) with a mean age of 43.8 ± 11.4 and mean time since diagnosis of 15.6 ± 9.2 years. Mean mode doses of paliperidone ER were similar between recently diagnosed and chronic patients (7.0 ± 2.9 mg/day and 7.2 ± 2.9 mg/day). At endpoint PANSS total scores were improved by 13.7 and 12.9 points, respectively, in recently diagnosed and chronic patients. The rate of patients with mild or less functional impairment increased from 17.7% to 39.8% in recently diagnosed and from 14.4% to 32.9% in chronic patients. Major functional improvements were observed for socially useful activities and personal and social relationships. TEAEs reported in >5% of recently diagnosed or chronic patients were insomnia (10.7% and 8.1%), anxiety (8.6% and 6.0%) and somnolence (5.8% and 3.4%), respectively.

Conclusion

These data suggest that both recently diagnosed and chronic patients previously unsuccessfully treated with other oral antipsychotics may benefit from paliperidone ER, with a tendency for recently diagnosed patients showing some higher treatment response in psychotic symptoms and patient functioning, particularly in socially useful activities and personal and social relationships.
Is escitalopram exchangeable by citalopram? A systematic survey
Authors: Volz H.-P. , Flürenbrock W.
Published: May 2011

Objective

Efficacy differences between antidepressants have only been detected exceptionally (Bauer et al., 2009). Due to the fact that escitalopram is the enantiomer of the racemate citalopram the question arose whether this compound possesses besides pharmacodynamic differences (e.g. Sánchez, 2006) also clinical relevant advantages.

Methods

In order to investigate this issue thoroughly the relevant studies of evidence level Ia (systematic surveys of randomized controlled studies) and Ib (randomized controlled trials) were summarized regarding three main outcome parameters: response (decrease of the depressive symptomatology of at least 50% on a depression scale), remission (reduction of the depressive symptomatology below a certain threshold on a depression scale) and change in depression symptomatology (point difference on a depression scale during the treatment period).

Results

Overall, approximately 20% more patients responded under escitalopram than under Citalopram. Regarding remission, this difference is approximately 30%. The point difference on the Montgomery-Åsberg depression scale was between 1 and 2 (statistically significant). In a subanalysis it was found that the superiority of escitalopram increased with increasing initial depression severity.

Conclusion

These very robust data are discussed regarding their clinical implications.
Relapse frequency and quality of life in day-treatment programme for psychotic disorders: One-year outcomes
Authors: Motlová L. Bankovská , Dragomirecká E. , Blabolová A. , Ĉermák J. , Holub D.
Published: May 2011

Introduction

We introduce clinically-based 6-week structured group day-treatment programme for out-patients with schizophrenia-spectrum disorders in the stabilization phase of the treatment. It consists of family psychoeducation, lifestyle improvement intervention, social skills training and art therapy.

Objectives and aims

To assess relapse frequency, psychopathology (PANSS) and quality of life (Schwartz Outcomes Scale-10, WHO-QOL BREF and Social Integration Survey) we designed one-year prospective follow-up field study.

Methods

After informed consent procedure 144 patients entered the project. Psychopatology and Quality of life were assessed at the entry of the programme, at the end of the programme and at one-year follow-up (N = 86).

Results

Psychopathology decreased after programme significantly and PANSS scores remained low in one-year follow-up. Quality of life assessed by SOS-10 improved after programme significantly. Scores of WHOQOL-BREF raised significantly in Subjective health domain and Psychological health. In one-year follow-up Environment domain improved significantly. Social quality of life (SIS) improved in Behaviour to strangers, Communication, Activities of daily living and Empathy. Quality of life in patients was lower compared to common population, improved after the programme and this improvement was stable in one-year follow-up. One-year relapse rate in participants was 12%.

Conclusions

We conclude that participation at the group day-treatment programme early after discharge is beneficial as it improves quality of life, prevents social isolation and early non-compliance and ensures continuity of care.

Acknowledgement

This project was supported by Ministry of Education and Youth, CR: CNS 2005–2009 1M0517; Ministry of Health, CR: IGA MZ CR, NS 1036-3 and VZCR MZ0PCP 2005.
Case report of treatment resistant schizophreniaresponding to high dose quetiapine following clozapine withdrawal due to neutropenia
Authors: Chandrappa P. , Ho L.
Published: May 2011

Introduction

Patients suffering from treatment-resistant schizophrenia pose a difficult therapeutic challenge. Although Clozapine is a well-established treatment in such cases, there is a significant proportion of patients who have to discontinue Clozapine due to life-threatening side-effects, despite achieving good therapeutic response. There is very limited literature on the therapeutic alternatives to Clozapine in the treatment of resistant schizophrenia.

Objective

To report a case of resistant schizophrenia responding to high dose Quetiapine, following discontinuation of Clozapine due to neutropenia.

Clinical details of the case: We are presenting a case of a forty-two year old female patient with treatment resistant schizophrenia who achieved remission following treatment with Clozapine, but had to discontinue treatment due to neutropenia, which occurred on two occasions. Clozapine discontinuation resulted in rapid and severe relapse in her condition and re-admission to hospital. Quetiapine was initiated as this stage, but only partial improvement was noted at the manufacturer's stated maximum daily dose of 800 mg/day. Since the drug was being well tolerated the dose was gradually further increased.

Results

The dose of Quetiapine was eventually increased up to 1400 mg/day, which produced significant response and the patient was discharged from hospital. Quetiapine at this dose was well tolerated with minimal side effects.

Conclusion

The above report indicates that high-dose Quetiapine is a viable alternative to Clozapine in treating refractory schizophrenia. The findings from this report support further investigation of this approach in the form of larger scale clinical trials.
Representativeness of the patients admitted to psychiatric inpatient units for hypothetical participation in practical clinical trial CATIE
Authors: Díaz M.C. , Morales N. , Nieto K. , Iniesta E. , Martin M.A. , Ruiz J. , Fraguas D.
Published: May 2011

Introduction

Pharmacological treatment of patients with schizophrenia and other psychoses get scientific backing of its main clinical trials. Methodological guarantees these test tend to strengthen the internal validity of the results at the expense of external validity and the ability to generalize the results to the clinical population. For this reason, and to minimize the shortcomings of external validity while maintaining internal validity, has been promoted in recent years to carry out large clinical trials based on clinical practice. This type of test expands the criteria for inclusion, limiting the exclusion criteria to incorporate as many patients as possible. The first and most significant of these trials was the CATIE trial (Lieberman et al, 2005).

Objectives

Discuss eligibility patients admitted during the year 2009 in a psychiatric inpatient unit with a diagnosis of schizophrenia for participation in CATIE.

Methods

A total of 145 patients (27.6% females, mean age 39.6+/−12.8 years), consecutively admitted to an inpatient psychiatric ward with a clinical diagnosis of schizophrenia or other psychoses were assessed to test if they would fulfill criteria for participation in CATIE.

Results

60 (41.4%) patients did not fulfill CATIE inclusion criteria. Mental retardation (n = 22, p < 0.001), absence of consent (n = 15, p < 0.001) and refusal to take oral medication (n = 12, p < 0.001) were the main factors responsible for not meeting criteria. Meeting the criteria was not significantly related to gender or specific diagnosis.

Conclusions

The 41.38% of patients did not meet criteria for participation in the CATIE study.
Serum levels of BCL-2 protein in patients with schizophrenia
Authors: Djordjević V.V. , Lazarević D. , Ćosić V. , Vlahović P. , Tošić S. , Ristić T. , Djordjević V.B.
Published: May 2011

In order to identify a patophysiological mechanism that could explain the progressive elements of schizophrenia and its relationship with neurodevelopment, oxidant stress, glutamate excitotoxicity, neurochemical sensitisation and a disregulation of apoptosis were considered.

To test apoptotic process in schizophrenia, Bcl-2 protein was determined in sera from 30 patients with schizophrenia and from 30 age and gender matched healthy subjects by an ELISA method. Although mean serum Bcl-2 protein concentration in patients with schizophrenia was lower than in healthy volunteers, there was no any significant difference between patient (0.276 ± 0.07 ng/mL) and control (0.332 ± 0.22 ng/mL) values. No significant difference was found between males and females. Similar Bcl-2 concentrations were obtained in the group showing almost equally positive and negative symptoms, in the group with a relative predomination of positive symptoms and in the group with a relative predomination of negative symptoms. Serum Bcl-2 protein concentration in patients treated with first generation antipsychotics was 0.301 ± 0.075 ng/mL, and it was significantly higher in comparison with the values obtained in patients receiving the second generation antipsychotics (0.233 ± 0.052 ng/mL, p< 0.05). A significant correlation was found between serum levels of Bcl-2 and FasL (r = 0.418, p < 0.01). There was not any significant correlation between serum Bcl-2 concentration and heredity, the first onset of the disease, the number of psychotic episodes and the duration of psychosis. To our knowledge to date, this has been the first demonstration of Bcl-2 concentration in sera of patients with schizophrenia, showing significantly different values between patients treated with typical or atypical antipsychotics.
Schizophrenia quality indicators for integrated care - results from a feasibility study
Authors: Kösters M. , Lahmeyer C. , Zhang Y. , Weinmann S. , Becker T.
Published: May 2011

Introduction/objectives

There is currently a variety of initiatives to improve the quality of care for schizophrenia, but there is no established core set of quality indicators in schizophrenia. In 2009, Weinmann and Becker published a set of indicators for quality monitoring of schizophrenia care. This study aims to evaluate the feasibility of these indicators.

Methods

Adult schizophrenic patients insured by the Federal Association of Local Health Insurance Funds (AOK) were recruited in two large psychiatric hospitals. Participants were evaluated using PANSS, CGI, Camberwell Assessment of Need-European Version (CAN-EU) and the Verona Service Satisfaction Scale (VSSS) at discharge and after six month. Furthermore, 18-month AOK administrative data was available for all patients included. Feasibility of structural and quality indicators described by Weinmann and Becker (2009) will be tested by applying the full set of indicators.

Results

82 patients with a mean age of 40 and an average GAF score of 44.3 were included. We were able to calculate all indicators. Outpatient data was available with a delay of over six month. Patients had on average 1.6 additional psychiatric diagnoses (S1) and a mean length of stay of 44 days (S6). 67% of the patients were satisfied with the treatment received (Q17). 25% of the patients were re-admitted to an inpatient psychiatric care within 30 days after discharge.

Conclusions

The usage of Quality Indicators seems to be feasible in routine care. However, delay in the availability of outpatient data has to be considered if these indicators are implemented.
Attenuation of long-range temporal correlations in neuronal oscillations in patients with schizophrenia
Authors: Nikulin V.V. , Jönsson E.G. , Curio G. , Brismar T.
Published: May 2011

Introduction

Although schizophrenia was previously associated with affected spatial neuronal synchronization, surprisingly little is known about the temporal dynamics of neuronal oscillations in schizophrenia. However, since coordination of neuronal process in time represents an essential aspect of practically all cognitive processes, it might be strongly affected in schizophrenia patients.

Objectives

To test the hypothesis of abnormal temporal neuronal dynamics in patients with schizophrenia.

Aims

We aimed at quantification and comparisons of long-range temporal correlations (LRTCs) in patients and normal subjects.

Methods

We measured 21 patients with schizophrenia (n = 18) or schizoaffective disorder (n = 3) and 28 age and gender matched controls. Ongoing neuronal oscillations were recorded with multi-channel EEG at rest condition. EEG was analyzed with spectral analysis and with the detrended fluctuation analysis allowing quantification of LRTCs.

Results

The amplitude of neuronal oscillations in alpha and beta frequency ranges did not differ between the patients and controls. However, LRTCs were strongly attenuated in schizophrenia patients: in centro-parietal areas and fronto-central areas for alpha and beta oscillations, respectively. In addition we observed a negative correlation between the strength of the negative symptoms and LRTCs.

Conclusions

Small values of LRTCs and their correlation with the negative symptoms in schizophrenia patients demonstrate that the temporal dynamics of neuronal oscillations are essential for normal brain functioning. Attenuated LRTCs might indicate a more intermittent neuronal dynamics possibly allowing for more random associations between neuronal activations, which in turn might relate to the occurrence of positive symptoms in schizophrenia.
Functional resting-state dysconnectivity in schizophrenic patients with persistent auditory verbal hallucinations
Authors: Osterfeld N. , Frasch K. , Sambataro F. , Vasic N. , Schmid M. , Schoenfeldt-Lecuona C. , Thomann P.A. , Wolf R.C.
Published: May 2011

Introduction

Previous functional neuroimaging studies in schizophrenia have suggested abnormal patterns of functional connectivity during the resting state. However, little is known about the relationship between specific symptom dimensions and resting-state network (RSN) connectivity.

Objectives

Using fMRI, this study investigated the relationship between multiple RSN and auditory verbal hallucinations (AVH) in patients with schizophrenia.

Methods

Resting state data were acquired from 10 patients with treatment resistant AVH and 14 healthy controls. The data were analyzed using a spatial group independent component analysis, and random effects t-tests were used to compare spatial components between groups (p < 0.001).

Results

16 RSN were identified, from which four networks were selected for further analyses. Within three RSN patients showed increased connectivity of right lateral prefrontal areas and bilateral superior temporal regions as well as decreased connectivity of the anterior cingulate cortex. Correlations were found between measures of AVH severity and functional connectivity of the left anterior cingulate, left superior temporal gyrus and the right lateral prefrontal cortex.

Conclusions

These findings indicate that functional changes of multiple RSN associated with language processing, attention and executive control could underlie persistent AVH in patients with schizophrenia. The relationship between AVH severity and functional connectivity measures suggests that distinct cortical loci of dysfunction could contribute to the phenomenological diversity of AVH.
Empty words in schizophrenia. Semantic satiation as the mechanism of formal language disorders
Authors: Prochwicz K.
Published: May 2011

The aim of the research was to explain the cognitive mechanisms responsible for formal language disorders in schizophrenia by relating them to the semantic satiation effect.

The semantic satiation is the subjective and temporary experience of loss of meaning of words which are repeatedly and rapidly pronounced. Saying it aloud or fixating it the person ceases to understand the word's meaning still being able to recognizing its formal features. The loss of access to the meaning of words and building the utterances on the basis of formal aspects of words is a common feature of schizophrenic language. Therefore it could be assumed that schizophrenic patients would be prone to satiation effect more than healthy subjects.

Semantic satiation was determined for patients suffering from schizophrenia and for healthy controls. Participants task was to compare the meanings of two words presented on a computer screen and decide if they are semantically related. Negative, positive and emotionally neutral words were used as the first element for each pair and they were satiated by the prolonged presentation. It was expected that the loss of meaning of satiated word would delay participants’ lexical decision and that this effect should be stronger for the schizophrenic than for control group.

The results confirmed that people suffering from schizophrenia are more susceptible for semantic satiation effect. Also it was observed that in this group the satiation effect depends on valence of words. Emotionally positive and negative words were satiated faster than neutral ones.
Relationship between positive symptoms and anxiety sensitivity in psychosis: A research centered on the symptom
Authors: Sanz-Largo V. , Rivas-Marîn F. , Pastor-Morales J. , Castillo-Gordillo E. , Fernândez-Jiménez E.
Published: May 2011

Introduction

Researching from a symptom approach avoids possible spurious associations, given the co-occurrence of symptoms in a disorder (Costello, 1992). Here, we deepen the evidenced relationships among anxiety, delusions and hallucinations.

Objectives

We intended to assess differences in Anxiety Sensitivity dimensions between patients with psychosis depending on presence/absence of hallucinations and/or delusions.

Methods/ participants

49 patients with DSM psychosis diagnosis (42 men and 7 women; mean age: 40), who attended a Mental Health Rehabilitation Service in 2008, of whom 7 only deluded, 6 only hallucinated, 11 deluded-hallucinated and the remaining 25 neither hallucinated nor deluded.

Design, materials and procedure

A Cross-sectional design (one measurement) for a co-relational method of comparison between groups.

We used the Spanish validated Anxiety Sensitivity lndex-3 -ASI 3- (Sandín et al., 2007), a 18-item Likert self-report that assesses fears of anxious symptoms. It presents a hierarchical structure (a general factor and three subscales -Physical, Cognitive and Social Concerns-). It's also used the first and third items (delusions and hallucinatory behaviour) of The Positive and Negative Syndrome Scale -PANSS- (Kay, Opler and Lindenmayer, 1988) to detect positive symptoms.

Results

All analysis were accepted at p < .05. Patients only hallucinators showed a higher anxiety sensitivity in Social Subscale than non-hallucinative/non-delusional patients; the former presented lower punctuations in ASI-total and ASI-cognitive than patients with hallucinations and delusions. The latter showed a higher anxiety sensitivity in Cognitive Subscale than patients who only deluded.

Conclusions

It's hypothetized that both delusional and hallucinative activity is necessary for emergence of cognitive anxiety sensitivity.
Immunological and psychological responses to psychosocial stress in caregivers of autistic offspring
Authors: De Andrés-García S. , Sariñana-González P. , Romero-Martínez Á. , Sanchis-Calatayud M.V. , Moya-Albiol L. , González-Bono E.
Published: May 2011

Introduction

Caregivers of relatives with chronic diseases has shown lower rest levels of immunoglobulin A than non-caregivers (Gallagher et al., 2008). In response to mental stress, IgA levels used to be increased in healthy population (Okamura et al. 2010). Scarce studies have been focused on immunological effects of caregiving in response to stress, and the results are controversial. To our knowledge, there are no studies stressing this field in chronically stressed populations such as caregivers of autistic offspring.

Objectives and aims

Evaluate whether caregivers present different psychosocial and immunological responses to acute stress than non-caregivers, as well as what is the role of gender in these responses.

Methods

38 caregivers of persons with autism and 35 non-caregivers were exposed to a psychosocial laboratory stress. IgA levels were measured before, during and after a set of several mental tasks, while the state of mood was evaluated before and after the stressors.

Results

Caregivers showed blunted IgA response to stress in men and women compared with non-caregivers, although the response pattern was different for each gender. Moreover, caregivers presented worse mood (depression, anger, fatigue, vigor and total score) than non-caregivers. Moreover, psychological effects of stress are inversely associated with levels of IgA, fundamentally during the task.

Conclusions

Caregiving reduces IgA secretion in response to psychosocial stress, although differently in men and women. Further studies are necessary to explore other neuroendocrine factors, together with mood, that could be involved in this buffered response.
Stress related disorders in students under the terrorist act
Authors: Kulygina M.A. , Semiglazova M.V.
Published: May 2011

Aim

To investigate clinical manifestations and stress reaction's dynamics in students after the terrorist attack in Moscow metro in March 2010.

Methods

14 cases were observed at the University counseling center (UCC) by a psychiatrist and a psychologist during 2 months after the attack. Respondents were aged 16–20 years and 9 of them were female. Complex clinical psychopathological and psychological examination was used. Psychotherapeutic interventions and medication were applied in all samples.

Results

Prevailing number of students (11, that is 78,6%) appealed for care by themselves or by reference of relatives, University staff and physicians. Another part of students - 3(21, 4%) - visited UCC during the month. Acute state of somatic and mental discomfort, anxiety, fears, obsessive reminiscence of tragic pictures were the reasons for reference to a caregiver. Sleep disturbances were the key symptom (in all the cases), somatovegetative equivalents of anxiety which were more intensive inside the metro were registered in 11 (78,6%) cases, and withdrawal behavior - in 8 (57,1%) cases. Premorbid mood fluctuations and anxiety traits were elicited in past history of the patients. State enhancement in the most of students - 10 (71,4%) - was observed in a week.

Conclusion

Somatic component of anxiety and its eventual context masked a personality reaction type of the students and their values and meanings reappraisal under stress conditions. Predisposition for stress reaction was connected with personal stress vulnerability and mood fluctuations’ propensity. Positive dynamics was accompanied by the brief staged psychotherapy in conjunction with general medication.
Electrodermal activity in response to a set of mental tasks in caregivers of persons with autism spectrum disorders
Authors: Moya-Albiol L. , Sanchis-Calatayud M.V. , Sariñana-González P. , De Andrés-García S. , Romero-Martínez Á. , González-Bono E.
Published: May 2011

Introduction

Analysing reactivity to laboratory stressor in lab is a valid model for understanding how people act in real-life situations. Electrodermal activity is a good index of emotionality, which has not been analysed in caregivers of persons with Autism Spectrum Disorders (ASDs).

Objectives and aims

This work aims to compare the response of electrodermal activity to mental stress between caregivers of ASDs people and controls, as the former could show a different response due to their particular situation characterised by a state of continuous alert.

Methods

Parents of both genders of people with (n = 44) or without (n = 42) ASDs carried out a set of different mental tasks. Skin Conductance Level (SCL) was continuously registered before, during, and after the tasks. Skin Conductance Responses (SCR) were obtained from SCL levels using Acqknowledge software.

Results

For SCL, a significant effect of “gender” and of “period x group” and “period x group x gender” interactions was observed. SCL was higher in men than in women and in controls when compared to caregivers. Controls presented more SCL Reactivity than caregivers, being these results were replicated in men (who also showed worse recovery in controls) but not in women. In caregivers, men showed lower SCR Reactivity than women.

Conclusions

Caregivers of ASDs showed a lower electrodermal reactivity to mental stress than controls, and this effect was stronger in men. These results could reflect a lower reactivity to stressful situations in caregivers and, consequently, a loss of the adaptative potential of the stress response in this population.
Level cortisol at patients under the influence of ultralow temperature in the conditions of criochamber
Authors: Onishchenko V. , Panchenko O.
Published: May 2011

Introduction

The general air criothepapy - the method of short-term assignment of warmth from all surface body of the patient by a laminar stream dry air, temperature from −110 to −120 °C. Such influence is stressful for a human.

Aims

Estimation level changes cortisol at patients in the course of treatment in ultralow temperature in conditions criochamber.

Methods

Researches have been spent with use criochamber «Zimmer Mеdizin Systeme» (Germany). In research has taken part 145 peoples. Duration of sessions influence of ultralow temperature made in the first day of 0,5 mines, then, increasing by 0,5 mines daily and reached 3,0 minute durations by 6–7 day of a course. The course crio influence made 20 sessions. Level cortisol blood was defined once a week after each 5 sessions with the analyzer «Biotec ЕL 800».

Results

Level cortisol before carrying out criotherapy at patients averaged 436 ± 26,6 nmol/l, after carrying out 5 sessions crio influence its values have been fixed at level - 420 ± 21,05 nmol/l, after 10th session level cortisol has on the average decreased to values - 401 ± 21,05 nmol/l, after 15 sessions to - 391 ± 21,5 nmol/l. After course end crio influence the average level cortisol has made 365 ± 31,5 nmol/l that was authentic more low, than indicator reference values (р < 0,05).

Conclusions

In the course crio influence there was a gradual decrease in level cortisol that speaks about decrease in stress at these persons, and also about human body adaptation to ultralow temperature influence at such a mode to 20th session.
Stress perception and sensation seeking in portuguese police officers involved in peace keeping mission in East-Timor
Authors: Queiros C. , Melo A.P. , Marques A.
Published: May 2011

Introduction

Policing is a stressful activity. Police officers must deal with aggressive people, delinquents, and danger, or with victims and citizens asking for help. Often they don’t have enough material or human resources and they must decide under stressful conditions. In international peacekeeping missions stressful situations are even more frequent, increased also by hostile reactions of the inhabitants of the country, who sometimes refuse the presence of foreign police forces. Despite those situations, some police officers don’t feel stress and show higher sensation seeking, suggesting that personality traits protect from stress.

Aims

Identify levels of stress perception and sensation seeking personality traits in a sample of police officers involved in peace keeping mission in East-Timor, included in United Nations police forces.

Methods

Data were collected using a translation of Perceived Stress Scale (Cohen et al, 1983) and Sensation Seeking Scale (Zuckerman, 1994), applied to 70 male police officers from portuguese “Guarda Nacional Republicana”, after comeback from a peace keeping mission (mean age 31.3 years).

Results

The results reveal that sensation seeking” exists in our sample, confirming that the police officers had a tendency to search for new experiences and adventure. Low levels of emotional exhaustion and low stress perception were identified, and the sample has a high tolerance for boredom.

Conclusions

Personality traits can protect from stress and sensation seeking is typical of some activities, including policing. The knowledge of personality traits can be useful to choose individuals who must deal with stressful situations, such us peace keeping missions.
Audit on inpatient risk assessment of mentally ill patients
Authors: Jayan R. , Jawed S.H.
Published: May 2011

Introduction

Risk assessment of mentally ill in-patients is an ongoing process in stated time scale. It includes risk of self harm, aggression, violence, self neglect and exploitation and abuse by others. Accurate recording is essential for patient management.

Aims and methods

The aim was to assess the practice of risk assessment in our trust. Retrospective data of 50 consecutive admissions were collected from case notes over a period of 6 months.

Results

28 females (56%) and 22 males (44%) of average age 41 were included in the audit. The mean duration of admission was 55 days (range 7–270 days). 11 patients (22%) had schizophrenia and 8 patients (16%) each had a diagnosis of depressive disorder and substance misuse. The other patients had diagnoses of schizoaffective, personality disorder and bipolar illness. Four patients (8%) had no risk assessment forms filled in during the admission. Out of 46 forms completed, the time and date of assessment were not recorded in 8 (17%). Completion date was recorded in 9 forms (20%) and review was done in 11 cases (24%). 45% of forms did not have the name and signature of assessor. Suicide risk, neglect and aggression/violence were documented in most forms (90%), however only 20% cases had a further action plan.

Conclusions

Significant number of risk assessment forms lacked important information which is crucial for risk management. This data was presented to the clinical governance team and was highlighted as a priority for improvement which has been implemented in the trust.
Relationship between levels of salivary cortisol with depression and suicidal ideation
Authors: De Usabel Guzmán P. , Mota Rodríguez M.J. , Pampin Alfonso A. , Brenlla Gonzalez J.B. , Núñez M.J. , del Río Nieto M.D.C.
Published: May 2011

Introduction

Suicide is a major public health problem in most of the countries because it has a high prevalence in young people. It has been studied that high levels of cortisol are associated with depression and increase of the suicidal risk.

Objective

To analyze the relationship between cortisol levels in a population of university students and the questionnaire results for the Beck Depression Inventory (BDI).

Method

The sample was composed by 106 students of the Nursing School of Santiago de Compostela University. The 88.7% of the sample are women with a mean age of 21.50 + /−2.52, the 99% are unmarried. The protocol consisted in 3 sections: demographic variables, BDI questionnaire with spanish scale and determination of salivary cortisol levels. Statistical analysis was done with SPSS 15.

Results

The are higher levels of salivary cortisol in students with a greater or equal score to 13 on the BDI with statistically significances differences (p = .000). Students with suicidal ideation (item 9 of the BDI) have highest rates of cortisol, with statistically significant differences (p = 0.001).

Conclusions

This study supports other researchs about the association between biological neuroendocrine markers and affective disorders. Explaining suicidal behavior could help us to prevent it by using early intervention strategies for vulnerable populations. They could also identify markers to establish the risk of suicide.
Suicid among Japanese university students-from the results of a 21-year survey
Authors: Uchida C.
Published: May 2011

More than 30,000 suicides a year have occurred continuously in Japan. Suicide among university students has been a top priority for those engaged in mental health in universities. In this study, I clarified the characteristics of university students’ suicide and identified risk groups through the 21 years’ survey. I also aimed to probe background factors to help setting up preventive measures.

The subject was undergraduate students at national universities in either 4 or 6 years programs, and the data were annually collected by means of a questionnaire from universities. The survey results of the 21 years from 1985 to 2005 were gathered, and I statistically analyzed the longitudinal changes in the suicide rate over this time period and the correlation between the suicide rates and sex, major, academic year, psychiatric disorders, the methods of suicide, etc. using the chi-square test and residual analysis. Altogether 735,496 students were surveyed, and 987 among them had committed suicide. Since 1996, the suicide rate has been the top cause of death. Holdover students, among whom we often find withdrawing students so-called “Hikikomori”, were a high-risk group for suicide as well as male medical students, male arts students and male dentistry students. More than eighty percent of the students who committed suicide had not been to university health centers or diagnosed by psychiatrists. For the method of suicide, hanging and taking a death-leap were frequently seen among them.

A clue to prevent suicide among university students was found from these results.
Predicting suicidal ideation in community-dwelling older adults with elevated levels of distress
Authors: Walker J.G. , Batterham P.J. , Christensen H.
Published: May 2011

Objectives/aims

Identifying predictors of suicidal ideation in community-dwelling older adults with elevated psychological distress over two years.

Methods

900 adults (60–74 years) with elevated psychological distress (Kessler Distress 10 Scale; scores>15) participated in a randomized controlled trial of psychological (mental health literacy) and lifestyle-based (physical activity promotion, folate supplementation) interventions for reducing depressive symptoms. Suicidal ideation across a two-year period (five time points) was assessed using an item from the Patient Health Questionnaire.

Demographics, mental and physical functioning (SF-12), and cognitive functioning (Telephone Interview Cognitive Schedule—Modified) were measured.

Results

Intervention type did not predict suicide ideation at any follow up. Those with single or multiple occurrences of suicidal ideation during the two-year period had elevated distress (Single OR = 1.06, p = .044; Multiple OR = 1.10, p = .001) and depression levels (Single OR = 1.07, p = .042; Multiple OR = 1.20, p = .001) at baseline, and more likely to be separated from their partner (Single OR = 1.81, p = .024; Multiple OR = 2.12, p = .016] than those with no ideation. Those with ideation were more likely to experience greater distress at every time point (e.g., 24 months OR = 1.18, p = .006) compared to those with no ideation. At 24 months, individuals reporting ideation were significantly more likely to have lower education levels (OR = .81, p = .015), poorer cognitive functioning (OR = .88, p = .036), and greater mental (OR = .89, p = .004) and physical (OR = .92, p = .025) disability.

Conclusion

Elevated distress is consistently related to suicidal ideation. Individuals experiencing suicidal ideation are more likely to be separated, have lower education levels, poorer mental and physical functioning, and poorer overall cognitive functioning than those with no suicidal ideation.
Sexuality and hysterectomy
Authors: Moutinho A. , Jorge G. , Pereira A.V.
Published: May 2011

Hysterectomy is the most frequent surgical procedure in gynecology, and it can be performed using several surgical techniques and for various clinical indications. The aim of this poster is to understand in what way the removal of the uterus conditions anatomical, physiological and psychological changes in the woman, and in what way these changes influence her sexuality.
Reducing psychiatric discharges to homelessness
Authors: Forchuk C. , Vann R. , Wilura E. , Hoch J. , Jeng M. , Kingston-MacClure S. , Jensen E.
Published: May 2011

In London, Ontario, discharges from psychiatric wards to shelters or NFA occurred 194 times per year. This discovery led to the creation of a pilot project that provided immediate access to a housing advocate and changed normal policies related to housing and start-up fees for a select group of income support recipients. The intervention was successful; seven participants who received this additional assistance were still housed six months later, whereas 6 of 7 who received usual care were still homeless. The goal of the current study was to determine the strengths and areas for improvement of a method to prevent discharge from hospital to NFA and suggest improvements in preparation for wider implementation.

Phase 2: intervention to all acute psychiatric patients within a general hospital.

Phase 3: intervention to all patients within a specialized tertiary care psychiatric hospital. Intervention included on-ward access to a housing advocate and income support staff which was facilitated through computer linkages to housing and income databases.

Findings revealed the success of the intervention across both acute and tertiary sites. All hypotheses were supported: the rate of discharge to homelessness decreased; those accessing the service were poor; and the cost savings from the program exceeded the cost of implementation. Advantages of the approach included: accessibility and convenience of services on site, positive influence on overall treatment plan and feelings of independence and support. Results reveal the positive influence a cross-sectoral approach has on preventing discharge from psychiatric wards to the streets and shelters.
Knowledge and practice of emergency nurses caring for drug seeking behavior patients
Authors: Hamdan-Mansour A.M.
Published: May 2011

Background

Pain management is connected to use of Opioids and analgesics at the emergency care units and interfere with ability of emergency care provider to manage patient if patient identified as drug seeking. Pain has been reported as the main reason for seeking emergency care; therefore, emergency care providers have great difficulty defining or accurately predicting those patients who present with factitious complaints to obtain pain medications, and fear of additions and abuse.

Purpose

Was to investigate meaning and knowledge level of emergency nurses in Jordan in relation to drug seeking behaviors at the emergency units in Jordan.

Methods

A descriptive-correlational study used to collect data related to drug seeking from 305 emergency nurses using self-report questionnaires.

Results

The analysis showed that emergency nurses in Jordan have wide variation and moderate level of agreement on meaning of drug seeking. Emergency nurses also lack the knowledge and ability to detect drug seeking patients, and lack the effective interventions required to manage drug seeking if identified. Although nurse had low level of knowledge and low level of management skills, the analysis also showed that there was a positive association between level of knowledge and management skills. Also nurses ‘knowledge had negative association with nurses’ age, number of years of experience in nursing, and number of years of experience in emergency units.

Conclusion

The study provoke attention to quality of pain management and interventions provided at the emergency units
Mental health care adherence in delusional disorder
Authors: Machín Vazquez-Illá M. , Pelaez Álvarez J.C. , Carrillo Gómez A. , Pereira Fernández M. , Sánchez-Espósito C.L.
Published: May 2011

Introduction

Delusional disorder, also known as paranoia, is a low prevalence psychotic disorder in our environement. Usually, patients who have this disorder are very difficult to treat adequately besides its poor adherence to medical treatment, and the ineffectiveness of some therapies are well documented.

Objectives

The aims of this study were to describe clinical, socio-demographic and pharmacological variables among a large stable sample in the community, and quantify the association between these variables and mental health care adherence.

Methods

Hospital Clinico San Carlos Hospital covers three local health areas; the sample was taken from one of them, wich provides health care to 268,000 people, approximately.We identified 130 out-patients with delusional disorder, but only 90 of these fulfilled DSM IV criteria. We recorded socio-demographic, clinical, pharmacological and legal data from 71 medical history patients. We also included number of visits and number of times patients didn't attend to an appointment among the total in one year. We defined mental health care adherence as good, irregular, or abandoned, in relation to missed appointments.

Results

Delusional disorder incidence was 1,6 per 100,000 habitants, with a prevalence of 36 per 100,000 habitants, according to other studies results. Among all treatments, risperidone was the most prescribes neuroleptic. We found association almost significant between tratment with benzodiacepinesn and good adherence (x2 = 0,059).

Conclusions

These results give as a more realistic view of delusional disorder in our enviroment, and let us to reconsider aspects of mental health care adherence and a posible association with benzodiazepine treatment.
Validation of the neuroticism scale of the NEO-PI-R among Tunisian students
Authors: Mnif L. , Yaich S. , Ammar Y. , Masmoudi J. , Damak J. , Jaoua A.
Published: May 2011

Introduction

Neuroticism is one of the five fundamental dimensions of personality based on the model of the Big Five. It is defined as the general tendency to experience unpleasant emotions such as hostile emotions, feelings of anxiety or depression.

The objective of this work is to validate the Neuroticism scale of the NEO-PI-R (Costa and McCrae, 1985) among Tunisian students.

Methods

Neuroticism among students was evaluated using the Neuroticism scale of the NEO-PI-R (Costa and McCrae, 1985). This scale provides an overall score of Neuroticism Lire phonétiquement Dictionnaire - Afficher le dictionnaire and also different scores for each of the six Neuroticism facets are: anxiety, depression, anger / hostility, impulsivity, social shyness and vulnerability to stress.

The validation was made on a representative sample of university students (n = 500) randomly selected.

The main properties studied were: acceptability, reliability (Pearson’s coefficient ‘r’), face validity and content validity (Cronbach’s alpha).

Results

The acceptability of the questionnaire was good, less than 10% of students were unable or unwilling to complete the questionnaire. The Pearson coefficient showed good reliability for this scale r = 0.96, p < 0.05. The Cronbach’s alpha was acceptable for all items of the scale α = 0.73.

Conclusion

The Neuroticism scale of the NEO-PI-R (Costa and McCrae, 1985) is valid in Tunisian students. It is now available for clinicians to measure the level of neuroticism among students.
CS01-03 - Genetics of addiction
Authors: Munafo M.
Published: May 2011

It is well known from twin, family and adoption studies that addictive behaviours are under a degree of genetic influence, which is reflected in moderate to high heritability coefficients for these phenotypes. In the last twenty years, considerable effort has been invested in attempting to determine the molecular genetic basis of this influence, with mixed success. While early candidate gene studies for the most part failed to identify genetic variants which were reliably associated with risk of substance use, more recent genomewide association methods have begun to yield promising findings and novel insights into the mechanisms of addictive behaviours.

The history of genetic studies of risk of substance use will be presented, including a brief overview of twin, family and adoption studies, and of candidate gene and linkage studies. More recent findings, in particular focusing on genomewide association studies, will be discussed in detail. Finally, emerging findings from gene x environment and intermediate phenotype studies will be highlighted. This presentation will provide a comprehensive overview of the current state of the field of addiction genetics, placed in the historical context of heritability, candidate gene and linkage studies.

While the study of the genetics of addictive behaviours remains in relative infancy, some compelling findings are beginning to emerge. Genetic variants which influence the metabolism of specific substances, such as alcohol and nicotine, appear to influence the intake of those substances. A number of genes which encode drug targets also appear to influence drug-taking behaviour, such as the alpha-5 nicotinic acetylcholine receptor subunit, which has been robustly shown to associate with heaviness of smoking. However, the proportion of phenotypic variance explained by these variants remains small. Potential reasons for this will be discussed.
ECP02-04 - Implications for training. Relevance of transcultural psychiatry for European early career psychiatrists and trainees
Authors: Kastrup M.C.
Published: May 2011

During the last decades, the field of psychiatry has grown tremendously, but despite prevailing optimism we are faced with many challenges. A major challenge is that psychiatric services in many European countries are faced with increasing immigrant populations. Here there is a need to integrate knowledge hereof in the undergraduate, graduate and postgraduate training curriculum.

A main educational goal is to construct the core elements of a graduate training curriculum in psychiatry regarding cultural aspects to ensure high quality of psychiatric services via the creation of competent psychiatrists in all areas of Europe and promote the standard of training for cultural psychiatry by providing recommendations for training agreed upon by all stakeholders.

No explicit health policy has been formulated in many countries with respect to immigrants of which a large proportion has a traumatized background with a variety of problems linked to this.

Till now, the psychiatric curriculum in most areas comprises little training on cultural issues. On both under- and post-graduate level, the curriculum should comprise training in transcultural aspects of psychiatry.

With increased globalization there is a need to pay more attention to cultural aspects at all levels and develop strategies to increase the cultural competence of mental health professionals.

Consensus statements on psychiatric training and related issues related to cultural issues should be produced.

The paper will discuss the content of a culture sensitive curriculum and strategies to implement it.