bluuebunny/crossref_metadata_2025 huggingface dataset:
Psychiatric Assessment of Anxiety and Depression in Medical Patient
Authors: Telles-Correia D. , Barbosa A. , Mega I.
Published: March 2009

Anxiety and depression are very common in patients with medical illness and can be associated to a reduction in quality of life and a poor clinical evolution.

The actual concept of anxiety is based on many theoretical models as Goldstein's anxiety model, State/trate anxiety model, Lazarus' transactional stress model. The concept of depression is based on models such as Beck's Cognitive Model and Seligman's learned helplessness model of depression.

The link between anxiety/depression and medical illness can be of two kinds: biological (immunological, neuroendocrine, inflammatory systems) and behavioural (coping strategies, adherence to medical advice and prescription, etc).

A dimensional approach should be used to access anxiety and depression in medical once the thresholds of depression and anxiety that are associated with medical outcomes are not known.

Both self report and rating scale/interview measurements have certain advantages as well as certain inherent disadvantages. Neither approach is universally better than other.

Some of the most used instruments are Hamilton Anxiety Scale (HAM), Hamilton Depression Scale (HDS), Montgomery and Asberg Depression Rating Scale (MADRS), Hospital Anxiety and Depression Scale (HADS), Beck Depression Inventory (BDI), and State Trait Anxiety Inventory (STAI).

The only scale validated exclusively to access depression and anxiety in medical population, and that can overcome the influence that medical disease has in depression and anxiety is HADS.
Catatonia in Autism and Other Neurodevelopmental Disorders
Authors: Wachtel L.E.
Published: March 2009

Objective:

This paper reviews the presence of catatonia in neurodevelopmental disorders, with emphasis on autism spectrum disorders. Clinical presentations are reviewed, followed by catatonia treatment algorithms including lorazepam and ECT.

Method:

A literature review of catatonia in autistic, developmentally disabled and neurologically impaired populations was conducted. This was combined with the author's experience with patients with autism as well as traumatic, infectious and congenital brain injuries, all of whom developed frank catatonia.

Results:

Catatonia is a unique neurobiological syndrome with multiple psychiatric, neurological, medical and drug-related etiologies. Most commonly associated with bipolar affective illness, catatonia has also been found in 12-17% of patients with autism. Other neurodevelopmental disorders may similarly present with catatonia. Blueprints for treatment of catatonia include lorazepam and electroconvulsive therapy. While current literature supports the appropriateness, safety and efficacy of ECT for catatonia in autistic and developmentally disabled populations, treatment barriers may persist. The following cases are presented:

Pt 1: A 14 year-old female with encephalitis of unknown origin and profound catatonia. Cultural barriers prevented treatment.

Pt 2: A 20 year-old male with high-functioning autism and catatonia characterized by alternating stupor and extreme psychomotor agitation with self-injury.

Pt 3: A 15 year-old male with congenital agenesis of the cerebellum and vermis in frank catatonic stupor mistakenly attributed to his disability.

Conclusion:

Catatonia is readily diagnosed in a variety of neurodevelopmental conditions including autism, and is eminently treatable with lorazepam and/or ECT in this population. Treatment barriers should be recognized and remedied.
Determination of the Dysfunction of Social Roles with Mentally Ill
Authors: Prieb G. , Zaytsev A.
Published: March 2009

Object:

The object of the research is the determination of the level of social dysfunction with the patients suffering from mental disorders.

Materials and methods:

There have been examined 327 out-of-clinic (the under-test group) and 211in-clinic (the comparison group) patients.

The structured interview and the social expert technique, statistic. The determination of the limits of the vital functions was performed with the help of the psychiatric scale of the limitation of the vital functions.

Prior to the rehabilitation measures, the performance of the social roles with the 6.1% of the patients of the under-test group has revealed “no dysfunction”, and following the rehabilitation - with the 24.5% of the ill. The comparison's group indices are 6.5% and 11.3% respectively. The minimal dysfunction has been determined with 7.5% and 22.2% respectively of the under-test group and 8.1% and 12,8% ( all ð< 0,05) of the comparison one. The redistribution of the patients into the minimal/no dysfunction subgroup was largely due to the patients with evident, serious and very serious dysfunction. The decrease of the dysfunction of the social roles of all the patients of the under-test group means that the true restoration of the patients’ functioning in the different domains of the society is possible only if there are developed rehabilitation measures targeting at the planning stage the so-called “troubled” social roles.

Results:

The true restoration of the patients’ social functioning is possible only if the rehabilitation measures target the “troubled” social roles.
Mathematical Model of Ethiopathogenic Factors Involved in Eating Disorders
Authors: Andreica B. , Rauca I. , Cupsa A.-M. , Andreica M.
Published: March 2009

The purpose of this study is to track down some correlations between physiological markers, familial dynamics and personality traits, coping mechanism and build a particular mathematical pattern, allowing us a better understanding and prediction of the illness. We assesed twenty adolescents, diagnosed with eating disorders (using KID-SCID), using Constructive Thinking Inventory and Parental Stress Index. Using stochastic shaping through Markov models, classification trees we designed a model, which will hopefully contribute to better control of the diseases.
Anorexia Nervosa and Pregnancy: A Case Report
Authors: Castro L.C. , Moreira S. , Lopes A. , Branco M.
Published: March 2009

Background:

Several studies report that women with a history of eating disorders are at higher risk of pregnancy complications and major adverse perinatal outcomes.

Aim:

To report a case of anorexia nervosa during pregnancy, in order to underline the impact of eating disorders on pregnancy.

Methods:

Case study and review of the literature.

Results:

A 32 year old woman was hospitalized in an obstetric service of a general hospital for high risk pregnancy complications. She maintained a disturbed eating behaviour, with periods of restrictive eating and bulimic-purging episodes. She was underweight, did not reach the recommended weight gain during pregnancy and showed intrauterine growth restriction. The Psychiatry Liasion Unit was asked to follow the case during the obstetric hospitalization.

Discussion:

Pregnant women with eating disorders have higher risk of pregnancy and neonatal complications. Pregnancy is a privileged opportunity to maximize intervention in eating disorders, since women show higher levels of motivation for therapy. Some cases of anorexia nervosa may warrant special obstetric care to ensure adequate prenatal nutrition and fetal development. Since there are few studies on this topic and they report conflicting results, it is a relevant area for future research.
Women and Chocolate Advertising: Exposure to Thin Models Exacerbates Ambivalence
Authors: Durkin K. , Rae K.
Published: March 2009

Chocolate craving is very common among women. It is known to be associated with ambivalent attitudes and with eating disorders.

Aims:

The present study investigated the impact of different types of media images (associating the product with thin versus overweight models) on females’ attitudes to chocolate.

Method:

Eighty-four female participants were recruited from the general community. Age ranged from 17 to 63 years (mean=35). Mean BMI was 23.4. Participants were allocated randomly to one of three conditions: Chocolate with thin models, Chocolate with overweight models, and Control (non-chocolate related products). Groups did not differ on age and BMI. They were assessed before and after exposure using the Orientation to Chocolate Questionnaire, which measures three dimensions of chocolate craving: guilt, approach and avoidance.

Results:

Participants in the thin exposure condition experienced more guilt and were more likely to report both heightened approach and avoidance of chocolate after exposure. In contrast, participants in the overweight exposure condition had lower guilt and lower approach to chocolate, with no change in avoidance, after exposure. No changes were obtained for the females in the control condition.

Conclusion:

These findings suggest that viewing thin images in association with chocolate intensifies women's ambivalence towards the product. It is argued that ambivalence is stressful and fosters disordered eating patterns.
Behavioral Approach to Infantile Anorexia and its Outcome on Maternal Psychopathology
Authors: Herguner S. , Ozyildirim I. , Gokcay G.
Published: March 2009

Background:

This study aims to examine the effectiveness of a behavioral approach for the treatment of toddlers with infantile anorexia; and the psychopathology and psychological functioning of their mothers before, during and after a structured treatment program.

Method:

Three groups of 30 toddlers of either sex, aged 12 - 36 months (inclusive) were included to the study. The groups consisted of toddlers with 1- Infantile Anorexia 2- Picky Eating and 3- Healthy Eating who were referred for a psychiatric evaluation by pediatricians and gastroenterologists at the Department of Pediatrics, Istanbul School of Medicine. Groups were matched by age, sex, and socioeconomic status. Beck Depression Inventory (BDI), State-Trait Anxiety Inventory (STAI), Symptom Check List - 90 (SCL-90), and Structured Clinical Interview for DSM-IV Axis I Disorders (SCID-I) are used for assessing the maternal psychopathology of cases.

Discussion:

In our sample, mothers of toddlers with IA and PE had more psychiatric symptoms than healthy group. The difference between IA and PE shows that the nutritional status of the child contributes to the psychopathological well-being of the mothers. There was a resolution of depression and anxiety during and after the treatment protocol. Then the psychological status seems to be not the reason but may be the result of the feeding problems. Also interventions that focus primarily on maternal psychopathology may not be effective as a behavioral treatment that focuses on both child and mother.
Fat Tissue Peptides Do Not Differentiate Two Types of Anorexia Nervosa - the Preliminary Study
Authors: Kozik M. Janas , Stachowicz M. , Matuszczyk I. Krupka , Mazurek U. , Krysta K. , Jelonek I.
Published: March 2009

The pathogenesis of AnorexiaNervosa (AN) is still not entirely understood. DSM-IV classification differentiates two AN types: the restricting type (AN-R) and the binge-eating/purging type (AN-BP). We investigated four young women suffered from AN (two with AN-R and two with AN-BP) and the other four were our control group who did not suffer from eating disorder. The oligonucleotide microarray method (HG-U133A, Affymetrix) was used to determine the expression profile of genes coding fat tissue protein. On the oligonucleotide microarray HG-U133A were analyzed 15 transcripts representing 9 fat tissue genes (leptin, resistin, tumor necrosis factor, adiponectin, angiotensinogen, interleukin 6, chemerin, visvatin and SERPINE 1), which are potentially involved in mechanism of food intake and energy balance.

The total RNA was extracted from peripheral blood mononuclears. The oligonucleotide microarray method analyzes genes expression by using the phenomenon of hybridization of single-thread RNA fragments with complementary DNA probes. The results were normalized using RMAExpress. The U Mann-Whitney test was used for statistical analysis. The p < 0.05 was accepted as the essential level of statistical significance. Statistical analysis was measured by using Statistica version 7.1 PL.

None of 15 transcripts coding fat tissue protein differentiate two type of AN: the restrictive type of AN and binge-eating type of AN (p=0.7901) and none of investigated transcripts differentiate either the restrictive type of AN and control group (p=0.7001) or binge-eating type of AN and control group (p=0.8641).

The fat tissue protein did not seem to be responsible for food intake.
Intact: Individually Tailored Stepped Care for Women with Eating Disorders
Authors: Machado P.
Published: March 2009

INTACT is a multi-disciplinary and inter-sectorial network of 9 European partners from 8 EU countries aiming at the development of new strategies for the prevention and treatment of eating disorders.

Acknowledging that not all women at risk for an eating disorder actually develop the disorder and that not all of those who get ill need the same type and intensity of care, INTACT studies stepped care treatment and individually tailored interventions based on research into the process of getting ill, getting well, and staying well.

The development of such innovative approaches in which treatments are provided sequentially according to patients’ needs promises to optimise health care for ED patients.

Specifically, the INTACT studies focus on the development of:

1.

risk models,

2.

step-up interventions,

3.

therapy process-outcome models, and

4.

step-down interventions and apply methods from the fields of psychotherapy research, genetics, biology, linguistics and computer sciences.

INTACT is funded by the European Commission (MRTN-CT-2006-035988).
Obesity and its Connections to Some Personality Traits, Locus of Health Control in Adolescents
Authors: Mojs E. , Gajewska E. , Samborski W.
Published: March 2009

The substantial health enhancing potential of physical and psychological activity can be realized by incorporation of physical activity in everyday style of life. Health can be understood as an aim of activities but also adolescents may not take into consideration activities toward health improvement.

The aim of the study was to estimate differences in psychological functioning locus of health control in adolescents with obesity.

The method were: The Scale MHLC - Multidimensional Scale of Health Control Localization. CISS - questionnaire of coping with stress.

60 persons growing with obesity (over 90 percentile) participated in investigations in age of 12-18 years. 100 healthy persons well-chosen made up the group of the reference under in relation to age, sex, educations. The results were important on the level 0,05.

Results show that the locus of health control was internal in both groups, but internal locus in healthy group has appeared more often. Children with obesity had lower abilities of coping with stress in comparison to healthy ones.
Psychopathologic Disturbance of Patients with Exchange Obesity
Authors: Romanova I.
Published: March 2009

We investigated clinical fenomenology of psychopathologic disturbance of patients, suffering affliction by a exchange obesity, the differentiated schemes of a psychotherapy are designed and influencing psychotherapeutic tactics on efficiency of complex therapy of this group patients is detected.

92 patients were inspected with a exchange obesity with usage of the clinico-anamnestic data, research of the neurologic and mental statuses, research of a vegetative nervous system, psychological methods, electrophysiological research. In activity the conducted complex examination with usage of psychological methods also is studied influencing psychopathologic changes on a clinical picture of an obesity. The conducted correlation analysis psychopathologic and clinico-encephalografical of changes at exchange obesity. The values of an excess weight in frame of psychosomatic distresses are studied. The efficiency of emotional - stressful therapy is studied at the miscellaneous forms of an excess weight for the inspected patient's category.

As a result of the conducted research the yardsticks of psychological diagnostic of patients exchange obesity are designed, and also complex of therapy with actuation of emotional - stressful psychotherapeutic influencing, which one in practice will increase efficiency of the help of the given category ill. The designed yardsticks of diagnostic and treatment enable to offer a number of the practical guidelines for an intrusion in practical activity of preventive entities.
Glucocorticoid Receptor Gene Polymorphisms in Italian Patients with Anorexia and Bulimia Nervosa
Authors: Nacmias B. , Cellini E. , Ricca V. , Castellini G. , Tedde A. , Bagnoli S. , Sorbi S.
Published: March 2009

The etiopathogenesis of eating disorders (ED) is complex and poorly understood. The hypothalamic-pituitary-adrenal (HPA) axis, involved in the biological response to stress, could influence the onset and the course of ED.) Several variants in the Glucocorticoid receptor (GR) gene have been related to different metabolic parameters suggesting a possible role in ED. We studied if genetic variants of GR could represent potential risk factors for the development of Anorexia Nervosa (AN) and Bulimia Nervosa (BN).

We investigated the distribution of several single nucleotide polymorphisms (SNPs) of the GR including N363S (rs6195), Er22/23EK (rs6189-6190), A/G SNP in exon 9beta (rs6198) and the intronic BclI polymorphism (rs41423247), in 118 Italian patients affected by AN and in 108 patients with BN. Moreover we studied 116 normal individuals and 177 obese subjects. The distributions of genotypes and allele frequency of the SNPs in all studied groups followed Hardy-Weinberg equilibrium and did not significantly differ from that of controls. A trend towards association was observed in case-control association analysis (p=0.07) for rs6198. A correlation of metabolic parameters to the GR genotypes was performed.

We report the analysis of different GR SNPs for the first time in Italian patients with AN and BN. We failed to detect an allelic association between the studied SNPs in the GR gene and AN and BN.

None of the variants seems to influence these pathologies, not supporting a role for the GR gene as genetic risk factors for ED.
Evaluation of Coexisting Psychiatric Conditions in Women with Bulimia Nervosa and Partial Bulimia, Eating Disorder Not Otherwise Specified
Authors: Naessén S. , Carlström K. , Hirschberg A. Lindén
Published: March 2009

Objective:

The classification of eating disorders has been a matter of debate. Recent research indicates the clinical significance of eating disorder not otherwise specified (EDNOS). However, EDNOS is defined by exclusion, i.e.that not to fulfil criteria for anorexia nervosa (AN) or bulimia nervosa (BN). The aim of the present study was to compare bulimic behavior and psychiatric diagnosis in women with BN and EDNOS.

Methods:

All participants fulfilled the diagnosis according to DSM-IV. Women with BN (purging type, n=34) and age and body mass index matched women with EDNOS (n=31) were examined with respect to clinical condition, bulimic behaviour, purging methods and coexisting psychiatric conditions such as depression, anxiety disorders.

Results:

Apart from expected differences in binge eating and compensatory behavior, there were no differences between the two groups. Women with BN had higher scores for weight fobia, previous attempt to commit suicide, impulsive behaviour other than theft, and disturbed impulse control than women with EDNOS, while there were no differences in ten other psychiatric items such as depression, anxiety.

Conclusions:

Individuals with partial bulimia (EDNOS) seem to have the same spectrum of psychiatric diagnosis as women with BN even though they fail to meet diagnostic criteria for frequency of binge eating. There is a need to further specified the diagnostic criteria for BN.
Cognitive Disorders in Hospitalized Adolescent Anorectic and Bulimic Patients
Authors: Namyslowska I. , Remberk B. , Krempa-Kowalewska A.
Published: March 2009

Objective:

The problem of cognitive dysfunction in eating disorders remains controversial and the research results are not univocal. Because of that, research was undertaken on a homogenous group of young patients suffering from eating disorders, hospitalized in the adolescent unit.

Method:

The cognitive functions were assessed by Wisconsin Card Sorting Test (WCST) and Digit Span Test in the group of 60 adolescent girls (30 anorectic, 30 bulimic) of the same age and compared with the control group of 39 healthy adolescent girls. Also the relation of cognitive disorders with some clinical features of the illness such as the degree of weight loss, BMI at the admission and discharge and the results of EDI test were assessed.

Results:

Research results did not show statistically significant differences in the performance in the WCST between anorectic and bulimic patients and the control group. However, the group of anorectic patients show the tendency to perform worse in some parameters of WCST (TA, TE, PE, %PE, %CLR) than the control group, althought the results do not reach statistical significance. The results of the bulimic patients were better (p=0.04) than the control group in the Digit Span Test.

No correlation was found between clinical data and results in WCST in eating disorder groups of patients while the correlation was found between results of Digit Span Test and BMI at admission in both clinical groups.

Conclusions:

The research does not fully confirms that patients suffering from eating disorders show deficits in cognitive functions.
Decision to Admit and Aims of Hospitalization in the Treatment of Eating Disorders: Making Sense of a Seven Years Experience
Authors: Nunes P. , Duarte-Silva S. , Brandão I. , Roma-Torres A.
Published: March 2009

Eating disorders are one of the most intriguing and challenging psychiatric illnesses.

Treatment recommendations for eating disorders are still based heavily on expert clinical judgment instead of on scientific evidence from controlled trials.

According to APA's 2006 Practice Guidelines, patient's level of care is determined considering overall physical condition, psychology, behavior, and social circumstances, rather than simply relying on one or more physical parameters, such as weight. Of the five levels of care proposed, inpatient treatment is considered the last resort.

Therefore, inpatient treatment should not be intended to replace outpatient treatment, but to precede and prepare for long-term recovery.

The decision to hospitalize is usually based on several criteria, including medical (e.g. severe weight loss, significant psychiatric comorbidity), psychotherapeutic (e.g. lack of response to outpatient treatment) and psychosocial criteria (e.g. marked family disturbance). Indeed, hospitalization may have its own positive indications, especially when a supporting and stimulating therapeutic milieu is offered.

The primary aim of this study is to characterize a group of 97 eating disorders inpatients admitted in Hospital São João Psychiatry Department between 2000 and 2007, respecting gender, age, diagnosis, previous treatment length, motive for hospitalization and its duration, BMI and number of hospitalizations. Secondarily, significant correlations will be explored and further discussed.
Expressed Emotion and Patient Psychopathology in Eating Disorders
Authors: Santos L. Rodríguez , Vaz Leal F.J. , Fuentes M.I. Ramos , Moreno M.J. Cardoso , Sánchez N. Fernández
Published: March 2009

Objectives:

To isolate clinical predictors of Expressed Emotion (EE) in relatives of patients with eating disorders.

Methods:

Forty-three families of patients with anorexia and bulimia nervosa were assessed using the Camberwell Family Inventory (CFI). In addition, the eating symptoms, the general psychopathology and the personality of the patients was assessed using the Eating Disorders Inventory (EDI-II), the Symptom Checklist (SCL-90-R) and the Structured Clinical Interview for the Diagnosis of Axis II DSM-IV Disorders (SCID-II). Binary logistic regression methods (Forward Wald) were used for statistical analysis.

Results:

Maturity fear, depressive features and anxiety of patients were predictors of parental EE level.

Conclusion:

Althoug more clinical research is needed, the results of our study suggest that the severity of the symptomathology and some personality features of the patients with eating disorders can influence the EE observed in their relatives.
Neurobiological and Clinical Predictors of Impulsivity in Bulimia Nervosa [P02-69]
Authors: Vaz Leal F.J. , Santos L. Rodríguez , Fuentes M.I. Ramos , Moreno M.J. Cardoso , Sánchez N. Fernández
Published: March 2009

Objective:

The main aim of this study was to analyze the association between a set of neurobiological/clinical factors and impulsivity in patients suffering from bulimia nervosa, as well as the capability of this factors to predict the severity of impulsivity.

Methods:

The Impulsive Behaviors Scale (IBS), the Diagnostic Interview for Bordeline Patients - Revised (DIB-R), the Beck Depression Inventory (BDI), the Millon Multiaxial Clinical Inventory (MMCI-II) and the Family Environment Scale (FES) were applied to 70 female patients with DSM-IV BN (purging subtype). Twenty-four hour urinary excretion of norepinephrine (NE), 3-methoxy-4-hydroxyphenylglycol (MHPG), serotonin (5-HT), 5-hydroxi-indol-acetic acid (5-HIAA), dopamine (DA), homovallinic acid (HVA), and morning serum cortisol levels before and after the administration of 1 mg of dexamethasone were determined.

Results:

Impulsivity was associated to lower levels of urinary 5-HT and 5-HIAA, borderline features, and lower family expressed emotion.

Conclusions:

The consideration of impulsivity as a core clinical feature in patients with bulimia nervosa could lead us to identify clinical subtypes of patients, with specific clinical profiles and specific treatment needs.
Excessive Body Weight in Brain Codes
Authors: Shekhovtsev I.
Published: March 2009

At present there is no unique view point to clinic, etiology and pathogenesis of the obesity evaluation, which can be use for the differential care. Dozen pathologic features should simulate initial forms of obesity such as normal fatness. 37 young people at the age from 19-21 year, self-esteemed their body exterior view, their figure, in 0 to 5 scales, that it is close to ICD-10 with code F 50.4. To all wrote down rest electroencephalogram. We are obtained in training, blind and common group linear regression equation with 300 oscillations parameters. The relations in training and blind subgroups have been close. Prognostic validity firs five predictors, calculated on the correlation coefficient between the computer approach and the reality, R=0.59. Physiological predictors introduced like the same beta rhythm in all brain areas and frequency of 14 Hz in the right occipital region with weights of 59% and 37%, respectively. Three others cover 4%. Main codes related to coherence oscillations and close to man cognitive space. At the level of contemporary ideas it is necessary to individualize selection of excess weight in each case. Thus, the neurophysiologic approach to obesity under nosologic form will draw therapeutic interferences to the case of suffering.
Eating Behaviour and Perfectionism in Students: A Prospective Study [P02-72]
Authors: Soares M.J. , Maia B. , Pereira A.T. , Gomes A. , Marques M. , Valente J. , Pato M. , Azevedo M.H. , Macedo A.
Published: March 2009

Aim:

To investigate the role of perfectionism in the development of disordered eating behaviours.

Method:

382 female university students completed the Hewitt & Flett MPS and the EAT-40 at baseline, one year after (T1) and two years later (T2).

Results:

Perfectionism at baseline was significantly associated with long-term abnormal eating attitudes/behaviours. Self-Oriented Perfectionism (SOP) and Socially Prescribed Perfectionism (SPP) were significant predictors of disordered eating behaviours. SOP at baseline was predictive of diet concerns, at T1 and T2. Baseline SPP was correlated with overall eating disturbance at T1 and T2. Regression analysis revealed that only SPP was a significant predictor of bulimic behaviours and social pressure to eat at T1, but not at T2.

Conclusion:

Our findings contribute to a more clear understanding of the association between perfectionism and eating disorders. SOP and SPP were prospectively associated with abnormal eating attitudes/behaviours and SOP was found to be predictive of diet concerns.
The Health Locus of Control in Anorexia Women
Authors: Wojciak R.W. , Mojs E. , Cierpialkowska L.
Published: March 2009

The Multidimensional Health Locus of Control Scale (MHLC) designed by Wallston, Wallston, and DeVellis (1978) belongs to the most popular tests, assessing the health locus of control in respondents on three levels: internal, external, and accidental. The MHLC is used in health promotion programs, in prophylaxis effect. According to authors, the background of this conception is the conviction that internal locus of health control favours pro-health behaviour like taking physical activity, reduce smoking and alcohol drinking, weights control, HIV protection etc. In this preliminary study we would like to exam the health locus of control in anorexia women.

The MHLC was curry out in 15 anorectic women (diagnosed by EAT-26) and 39 non-anorectic women, aged 21,7 ± 1,0 years. The results were analysed with the use the Chi-square test.

We found the statistically significance differences between anorectic and non-anorectic women in the health locus of control (p< 0,001; Chi=13,24). However, the most of subjects (non-anorectic vs. anorectic, respectively 69% vs. 60%) located the health control inside, more anorectic felt that control on their health depend on the accidence than non-anorectic (respectively, 20% vs. 5%).

The results of this preliminary study could suggest that the health locus of control may play the important role in initiate the anorexia behaviour in women.
The Influence of Free-will Starvation on the Relative Mood in Young Women
Authors: Wojciak R.W.
Published: March 2009

The one of the most popular way to slim is used the free-will starvation especially in young women population. The aim of this preliminary study was to assess the influence of free-will starvation on the relative mood in women.The 32 volunteers, non anorectic, aged 26 ± 2,9 (20-30), randomly separated onto two 16-persons groups, were asked to starve one or two days a week by six eight-days periods (48 days). We assessed the relative mood during starve and common days using the 15-centimetres scale from “definitely unfavourable” and the ending as “definitely favourable”. The volunteers were also asked to answer on 15 items Likert’s five-points scale describing psychology, interpersonal, emotional, and functional being. It was no differences in the assess of relative mood in the one-day starve volunteers between starve and non-starve days (average on 10-centimetres point), it was significance differences (p< 0,05) in the two-days starve volunteers (12 vs. 9,5 centimetres, relatively days without vs. with starvation). In the details items it was observed the significant differences in assessing of the mood in both of groups of women between starve and non-starve days in psychological and emotional status especially in increasing feeling of tiredness, nervousness, interpersonal contacts, as well as decreasing feeling of happiness, understanding, support of family and friends.The results of this preliminary study suggest that uncontrol starvation could be reason of family problems and other interpersonal incorrect behaviour.This work was supported by grant from the National Committee of the Science Research of Poland No 2 P06T 02330.
Different Subtypes of Anorexia Nervosa in Adolescent Patients
Authors: Zechowski C. , Namyslowska I. , Bragoszewska J. , Witkowska M.
Published: March 2009

Aim:

Proper diagnosis and choice of adequate treatment have essential influence on the course and prognosis in eating disorders. Resent research (Thompson-Brenner, Eddy, Satir, Boisseau, Westen 2008) and our clinical practice (Jakubczyk, Zechowski, Namyslowska 2003) has shown that anorectic patients are not homogenous group, and they differ in the character of clinical symptoms and personality profile. Aim of the study is differentiation of anorexic patients on the basis on personality pathology, comorbidity and outcome.

Methods:

50 hospitalized anorexic adolescent girls (14-19 y.o.) were investigated by SWAP-200-A procedure, EDI, YBOCS, STAI, GAF, Hamilton Scale, Beck Scale, PAS, Developmental Impairment Questionnaire. Authors also assessed parameters of outcome such as a body mass change (kg/BMI), recurrence of menses, pharmacotherapy, kind of therapy preferred by patients and length of hospital treatment.

Results:

Preliminary results revealed three subgroups of anorexic patients different in personality pathology (well functioning/perfectionist, emotionally deregulated and avoidant), comorbidity and outcome. (Detail description of the study will be presented at the conference).

Conclusions:

The study confirms clinical observations and the results of other studies that there are three groups of anorexic patients different in clinical symptoms, comorbidity and profiles of personality.
Can Salivary Cortisol Assessment from a Single HF-rTMS Session Predict Clinical Outcome in Melancholic Depressed Patients? A Pilot Study
Authors: Baeken C. , Santermans L. , Zeeuws D. , de Raedt R. , Vanderbruggen N.
Published: March 2009

Aim:

The underlying physiological mechanisms as to why repetitive transcranial magnetic stimulation (rTMS) can treat depressed patients remains unclear and no clear biological markers are available to indicate a positive outcome for a given patient. Some data suggest that rTMS can influence hypothalamic-pituitary-adrenal (HPA) processes. In this study, we wanted to evaluate whether one session of high frequency (HF)-rTMS applied on the left dorsolateral prefrontal cortex (DLPFC) can predict a successful treatment outcome in a sample of antidepressant free unipolar depressed patients of the melancholic subtype.

Methods:

Twenty one right-handed treatment resistant depressed patients were studied. Fifty two percent of the patients were considered as treatment responders, as defined by a 50% reduction in her/his baseline 17-item Hamilton Depression Rating Scale (HDRS) score. To examine acute HF-rTMS effects on the HPA- axis, we analyzed salivary cortisol levels, using a sham-controlled, ‘single’ blind, crossover design. Areas under the curves (AUC) were calculated for both real and sham HF-rTMS.

Results:

Real HF-rTMS resulted in salivary cortisol decreases, however only in HF-rTMS non-responders. No HF-rTMS influences were found in the responder group. Sham stimulation did not affect the HPA-axis. Non-responders were found to display a higher level of co-morbid personality disorders.

Conclusion:

Our results may provide more insight into the underlying working mechanisms of HF-rTMS and could add further information about endocrinological functioning in affective disorders. Furthermore, personality features in combination with a ‘super-sensitive’ HPA system could be of importance to predict clinical outcome.
Transcranial Magnetic Stimulation for Borderline Personality Disorder: Rationale, Stimulation Site and Methods
Authors: Cailhol L. , Bui E. , Roussignol B. , Moncany A.-H. , Klein R. , Simonetta-Moreau M. , Thalamas C. , Birmes P. , Schmitt L.
Published: March 2009

Borderline personality disorder (BPD) is characterized by pervasive instability in moods, interpersonal relationships, self-image, and behavior. This disorder is associated with a significant rate of suicide attempts and completed suicides (4 to 10%), a major impairment in social functioning and an increased healthcare utilization cost. Treatments available include psychotherapy and pharmacotherapy. Research has shown some efficacy of repetitive Transcranial Magnetic Stimulation (rTMS) on post-traumatic stress disorder and mood disorder which both share common biological or clinical features with BPD. It is then likely that rTMS might prove efficient on BPD symptoms.

A review of the literature on neuroimaging and neuropsychology of BPD shows a hypoactivity of the dorsolateral prefrontal cortex which may be a potential target site for rTMS.

We will conduct a pilot randomized sham-controlled trial on 30 BPD patients assessing the efficacy of a 10-day course of daily rTMS on neuropsychological tasks, BPD symptoms severity, risk taking behaviour, depression and general psychopathology.
Electroconvulsive Therapy in Treatment-resistant Schizophrenia: Prediction of Response and the Nature of Symptomatic Improvement
Authors: Chanpattana W. , Sackeim H.
Published: March 2009

The clinical features of patients with schizophrenia who respond to electroconvulsive therapy (ECT) are uncertain. There is also little information on the nature of symptomatic improvement with this treatment. Using a standardized protocol, 253 patients with treatment-resistant schizophrenia (TRS) were treated with combination ECT and flupenthixol, and 138 (54.5%) patients met response criteria. Independent of gender, duration of the current episode and severity of baseline negative symptoms were predictive of outcome. Duration of illness had weak relations with outcome and only among females. There were marked sex differences in other clinical features and symptoms associated with response. In contrast, no gender differences were observed in the nature of symptomatic improvement. Treatment resulted in marked improvement in specific positive symptoms, with an intermediate effect on affective symptoms, and no effect or worsening of specific negative symptoms. The findings challenge recommendations that long duration of illness or absence of affective symptoms portends poor response to ECT in patients with TRS. Gender may play a critical role in determining the features of the illness that predict outcome.
A Survey of the Practice of Electroconvulsive Therapy in Asia
Authors: Chanpattana W.
Published: March 2009

Background:

To describe a comprehensive survey of the practice of electroconvulsive therapy (ECT) in Asia.

Method:

Between 2001 and 2003, a 29-item questionnaire was sent to 977 psychiatric facilities in 45 Asian countries.

Results:

Completed questionnaires were returned by 334 (34.2%) institutions in 29 (64.4%) countries. ECT was available in 257 institutions in 23 countries. During the year before the survey, 39,875 patients (62% male) received a mean of 7.1 ECT treatments. Most patients (73.1%) were 18-44 years old; few were < 18 (6.0%) or >64 (4.4%) years old. Indications for ECT were schizophrenia (41.8%), major depression (32.4%), mania (14.0%), catatonia (6.9%), drug abuse (1.8%), dysthymia (1.6%), and others. Brief-pulse ECT devices were used in only 103 (40.1%) institutions. Routine EEG monitoring was conducted in only 59 (23.0%) institutions. Bilateral electrode placement was invariable in 202 (78.6%) institutions. Unmodified ECT was administered to 22,194 (55.7%) patients at 141 (54.9%) institutions in 14 countries. Continuation ECT was available in only 115 (44.7%) institutions in 17 countries. No institution had a formal ECT training program.

Conclusions:

The practice of ECT in Asia may appear suboptimal: schizophrenia, not depression, is the commonest indication; most institutions offer sine-wave ECT; unmodified ECT is commonly administered; bilateral electrode placement is invariable in most institutions; EEG monitoring is uncommon; continuation ECT is infrequent; and no formal training in ECT is available. We speculate that the suboptimal practices reflect felt needs, and ground realities in standards of medical care in developing countries, rather than a misuse of ECT.
Family Environment and ECT
Authors: Maglov T. , Ilic D. , Miskovic M. , Zivlak-Radulovic N. , Zoric D.
Published: March 2009

The ECT is still considered the fastest and the most efficient way in treatment of great depression, although there are some controversies about its effects on brain.

Most of patients suffering from great depression have family, and family members willingly or not, have impact on patient's quality of life, way and prognosis of disease.

Clinic for psychiatry Banja Luka in last year have reaffirmed use of ECT (pulse electricity in hospital condition) with machine which simultaneously monitor EEG, EMG, ECG and PSI.

With this work we want to present two cases (total 15 till now) of different diseases who were submitted to ECT treatment, with accent on family environment.

As long as we live inside sick family, everything that healing can achieve is only “first aid”, bandaging of psychological wounds so patient can function only in the same environment which made him sick in the first place.
Reaffirmation of Electroconvulsive Therapy in Clinic for Psychiatry Banja Luka
Authors: Miskovic M. , Maglov T. , Zivlak-Radulovic N. , Zoric D. , Popovic V. , Marjanac B. , Ilic D.
Published: March 2009

Electroshock therapy is in fashion again, but modern psychiatry for this kind of treating is using up to date instruments and methods. Half a century ago this procedure was used for healing serious depression, but was substituted with pharmacotherapy due to side effects like short or long time lost of memory.

Today we have modern technology (ECT with pulse electricity), so side effects are milder, and effects of therapy are better.

With this work we want to present the latest concepts in use of ECT therapy and to present our modest, one year long experience in this area.

We also started prophylactic ECT therapy (in imitation on Military medical academy Belgrade), since we was forced to accept already started treatment some of our patients in above mentioned institution.
Clinical Response of Neuronavigated rTMS in the Treatment of Auditory Hallucinations
Authors: Klírová M. , Horáček J. , Čermák J. , Novák T. , Tilerová B.
Published: March 2009

Aim:

To prove the clinical effect rTMS neuronavigation vs. standard coil positioning vs. controlls in the therapy of madication-resistant auditory hallucinations.

Materials and methods:

10 patients with medication-resistant auditory hallucinations on stabile antipsychotic medication, examined by MRI, PET, then treated by 1) neuronavigated, 2) standard positioning and 3) sham rTMS (controlls).

Double-blind randomized sham-controlled parallel design was used in the study.

rTMS parameters: 0.9Hz, 100%MT, 1080 pulses/session, 10 rTMS sessions within 2 weeks:

1.

Neuronavigated rTMS: coil focused over the highest contrast of metabolic activity in the left temporo-parietal (T-P) area (according to the SPM analyse 18FDG PET data).

2.

Standard rTMS: coil administered over the left T-P region defined as the midway between the T3 and P3 sites according to the international 10/20 EEG electrode system.

3.

Sham: coil angled 90° away from the skullPsychometric measurement: PANSS, Hallucination Change Scale (HCS) and the Auditory Hallucination rating scale (AHRS).

Results and conclusion:

Confirmation of a significant decrease in the Hallucination item as well as in the total of the positive score of PANSS, HCS and AHRS. Sham rTMS did not show a trend for improvement over time. Between-group comparisons of AHRS scores revealed significant differences, which confirmed efficiency of using neuronavigated rTMS.

Compared to standard positioning in future studies, we believe to find rTMS neuronavigation more precise and effective. Studies monitoring a continuing effect of rTMS over long time periods are needed.

Supported by the CNS, MZČ;R MZ0PCP2005 and MŠMT 1M0517, VZ 00 216 208 16.
Maintenance ECT in Affective Disorders [P02-85]
Authors: Barrocas D. , Coentre R. , Chendo I. , Mendes T. , Abreu M. , Maltez J.
Published: March 2009

ECT is the most powerful therapeutic tool in the treatment of acute mood episodes. However, data on the efficacy and safety of ECT in the long term management of affective disorders is lacking, despite overwhelming rates of chronicity and/or frequent relapses among patients with unipolar and bipolar depression. In this presentation we will review the data of the ECT unit of Hospital de Santa Maria, Lisboa, on maintenace ECT (m-ECT) in these patients. We compare intra and inter-individual evolution prior and after the institution of m-ECT. Considering the number of hospital admissions, mood symptoms and other parameters, our data support the use of this technique as a prophylatic approach for patients with mood disorders and a previous good response to ECT in the acute phase of disease.
Pathways to Psychiatric Care in Child and Adolescent Mental Health - Tirana
Authors: Alikaj V. , Suli A.
Published: March 2009

There has been almost no mental health service research in Albania. A pathway study provides a quantitative description of the filters in the help-seeking and investigate the relative contributions of child, parents, pediatrics, GP etc. in determining service use.

Aims:

To investigate the process of help seeking for child and adolescent psychopathology at Child and Adolescent Mental Health Service (CAMHS) in UHC “Mother Teresa”, Tirana.

Method:

Participants were 5-18years old, newly referred children/adolescents in CAMHS during 2006. Measures: Strengths and Difficulties Questionnaire for parents/children, Pathways Encounter Form. Pathway diagram was drawn showing the main routes of care seeking. Patterns of care seeking, durations and previous treatments for diagnosis within ICD-10 groups were prescribed. Analysis: Comparisons between groups, diagnosis and predictive factors influencing help seeking care.

Results:

The main pathway of seeking care resulted to be from hospital doctors or to be direct access. General practitioners have a limited role as ‘gatekeeper’ for patients. 72% of individuals resulted with conduct, hyperactivity, depressive and some anxiety disorders, but fewer than 30% of individuals with specific phobias, separation anxiety and eating disorders.

Conclusions:

A clear picture of pathway of seeking care in mental health for children/adolescents coming in CAMHS is provided. Findings highlight areas that require further attention if aspirations for community-oriented mental health care are to be realized in Tirana and Albania. Declaration of interest: None.
Epidemiologic Investigation of Depression, Anxiety, Stress Among Iranian Couples: A Life Cycle Perspective
Authors: Bahavarnia E.
Published: March 2009

The aim of this study was examining the relationship between demographic variables and epidemiology of depression, anxiety, and stress among 300 Iranian couples (600 individuals). Mean age of sample was 40 (SD: 12.5), using Depression, Anxiety, Stress Scale (DASS) and demographic variables questionnaire. Results of this study show highest rate of stress among women who were in child rearing years. Also highest depression was among men who their wives’ have job. One explanation for these results may be that every life cycle stage, has specific problems and stressors. Several studies use the family life cycle approach of grouping a cross-sectional sample into four or five categories that correspond roughly to stages of family development. Most of these studies report U-shaped pattern in which marital happiness in highest during the honey moon stage, lowest when the children are school age or teens, and higher when the children are older or gone (Rollins & Feldman, 1970). These findings consistent with our results. That is increased stress among mothers might be increased responsibility of mothers in child caring. This research found no stress among fathers in child rearing years. One explanation may because of traditional form of families in Iran. That is males have no companionship with women for child caring. Also this research show that the greater depression in wives’, the higher anxiety in husbands’. This might be due to when the wives were depressed, husbands anxiety increase in the light of receive any emotional support from their wives’.