bluuebunny/crossref_metadata_2025 huggingface dataset:
Factors affecting asthma psychomorbidity, control and illness-related quality of life: what is the interaction?
Authors: Pilipenko N. , Karekla M.
Published: May 2011

Asthma is a chronic inflammatory disorder of the airways, ounknown etiology and growing prevalence (GINA, 2009). Appropriate asthma management can control the disorder and enable patients to enjoy a good quality of life (WHO, 2007).Yet, many asthma patients are unable to maintain asthma control (Rabe et al., 2003) for various reasons, including psychological ones (Feldman et al., 2005).

This study examined the prevalence of psychomorbidity, and its interaction with asthma control difficulties and asthma-related quality of life in a sample of 200 asthma patients in Cyprus. Asthma diagnoses and severity were established by medical chart review.

Psychomorbidity was evaluated using the Patient Health Questionnaire (Spitzer, 1999). Additionally, the impact of asthma-specific (e.g. asthma knowledge), health-specific (e.g. smoking history) and socio-demographic (e.g. perceived poverty) factors was examined as prior research literature suggests these may significantly impact asthma control and asthma-related quality of life.

Currently, the present study is in its final stages of data collection (to conclude 2010). The results will offer valuable insights into the mechanisms and factors which affect asthma control, quality of life, and psychomorbidity. In doing so, the present study will contribute to the improved understanding of asthma patients’ experiences, essential to guide medical and psychological interventions.
Psychotherapeutic and psychologic care in cases of treatment patients which survived extraordinary situations: fare in night-club in perm and suffered from explosions in moscow’ subway
Authors: Frantsuzov V.N. , Prokudin V.N.
Published: May 2011

Since 1997 in City Clinical Hospital №36 in Moscow acted the Department of Psychotherapy (DP). Psychotherapeutists and psychologists of DP contantly took place part in joint (together with internists) therapy the patients suffering from different extraordinary situations. So, 06.12.09 by airplanes of Minisry of Extraordinary Situations from Perm in Burn-Center of CCH №36 were delivered 12 patients. For our regret 3 patients died in the first days no come to consciousness. The others 9 patients have received intensive and long (22–97 bed-days) therapy in BC due to: burns from flame I-II-III-IV degree, 6–77% surface of body. Psychiatric diagnosis were: acute reaction on stress F43.0, posttraumatic stress-syndrom F43.1, disorder of adaptation F43.2 with/or not short depressive reaction 43.20 and also organic emotional labile (asthenic) disorder F06.6, organic disorder of personality F07.0, others organic disorders of personality and behavior F07.8. In result of therapy these patients by combustilogists and other internists with psychotherapeutists and psychologists (different kind of psychotherapy and psychocorrection) we received distinct improvement of somatopsychical state.

In the morning 23.03.10 after explosions in two Moscow’ subway stations in CCH №36 were admitted 12 patients with diagnosis: mine-explosive, skeleton, burn and baro- traumas with concussions of brain, fractures of bones, termo-ingalation defeats and others. Psychiatric diagnosis: F43.0, F43.1, F 43.2, F 43. 20, F 06.6, F 07.0 F07.8 and also postcommotional syndrom F07.2. Rational and autogenic psychotherapy and psychological correction in all these patients added by Phenazepam and Azaphen resulted to improvement of somatopsychical state and quality of life.
Quality of life in the west of iran: a cross-sectional descriptive and analytic study
Authors: Shams Alizadeh N. , Rezaei F. , Mohsenpour B. , Ghaderi E.
Published: May 2011

Introduction

Quality of life is an important factor in evaluating health and therapeutic problems; therefore quality of life evaluation is an important issue in medical articles. The present study investigates quality of life in 15–64 years old subjects in Kurdistan province.

Aims

Determining factors impacting quality of life in Iran.

Objectives

The present study investigates quality of life in 15–64 years old subjects in Kurdistan province.

Methods

This is a cross-sectional descriptive and analytic study. The target population was 15 to 64 years old population in Iran. 700 individuals participated in this study. The information gathered with Euro His questionnaire. The data was then analyzed by using independent t test and multiple regression.

Results

Subjects included 352 males (50.4%) and 346 females (49.6%). Quality of life mean score in all subjects was 28.18 (± 4.6). The mean score in men and women were 28.78 and 27.57 respectively. Asthma, smoking, female sex, residency in urban and low income had negative effect on quality of life in multiple regression (R2 = 0.151) but age, diabetes, hypertension and sport activity didn’t have any effect on quality of life after adjustment for other variables.

Conclusion

Quality of life score in women was lower than men. It is thus necessary to examine effective factors on decreased quality of life in women and making plans to eliminate the negative factors. According to the results, low income, smoking, residency in urban and asthma have adverse effects on quality of life. These factors should thus be considered in health programs.
The relationship between 2D:4D ratio and systemizing and empathy quotients in parents of people with autism spectrum disorders
Authors: Romero-Martínez Á. , Sariñana-González P. , Roa Natividad J.M. , Sanchis-Calatayud M.V. , De Andrés-García S. , González-Bono E. , Moya-Albiol L.
Published: May 2011

Introduction

Interdigital 2D:4D ratio has been considered as an indicator of prenatal exposure to androgens, entailing then a smaller ratio more androgenisation. Although it has been related to systemizing and empathy dimensions in the general population, it has never been studied in parents of people with Autism Spectrum Disorders (ASDs).

Objectives and aims

To analyse the relationship between the 2D:4D ratio and these psychological variables in this population.

Methods

The sample was composed by parents of both genders of people with (n = 46) or without (n = 42) ASDs. The ratio was calculated as the mean of 3 measurements of each hand evaluated by 3 different researchers. Psychological dimensions were evaluated by means of the Systemizing and Empathy Quotients (SQ and EQ, respectively).

Results

Parents of ASDs persons showed lower scores in the EQ than controls, being these differences replicated only in men. No differences between groups for the 2D:4D ratio were found. Nevertheless, regression analyses indicated that in parents of ASDs a higher 2D:4D left ratio predicted a higher EQ. This result was also observed in men but not in women. In any case, the model was not significant in the control group.

Conclusions

Parents of ASDs persons showed lower EQ than controls, being this quotient predicted by the left 2D:4D ratio only in the former. When analysing in each gender, these results are only obtained in men. Among other parameters, the D2:D4 ratio (especially the left hand one) could be considered a valid indicator of the ASDs parent's idiosyncrasy.
Acute and transient psychotic disorder in Latvia: Dynamic changes of diagnosis and clinical features of first-episode
Authors: Rusaka M. , Rancans E.
Published: May 2011

Background

Acute and transient psychotic disorder (ATPD; F23, ICD-10) have been described as acute psychosis with brief onset, polymorphous symptomatology and rapid resolution. ATPD is not very well studied disorder and it has not been studied in Latvia up to now.

Methods and materials

Retrospective chart review study of all first time hospitalised patients fulfilling ICD-10 criteria for ATPD treated at the Riga Centre of Psychiatry and Addiction Disorders, Latvia during a 3-year period. Patients were assessed using standardised instruments during 4.1 years follow-up period.

Results

During a 3-year period 294 patients were first time hospitalized with ATPD. Over an average of 4.1 years follow-up period 62% (182) of patients were not rehospitalised. In the subgroup of rehospitalised patients diagnosis in 71% (80) of them later changed to schizophrenia. Comparing ATPD subgroups we found that the percentage of patients “with schizophrenic symptoms” (F23.1) was higher 55% (161). ATPD “without schizophrenic symptoms” (F23.0) diagnosis was more frequent for “pure” ATPD patients 79% (38), than for ATPD, which later developed into schizophrenia (p < 0.001). Clinical features like affective disturbance was present in 25%, anxiety 58% and hallucinations in 53% of patients, who later developed schizophrenia and only in 24% with “pure” ATPD (p < 0.001).

Conclusions

More than half of the patients were hospitalized once during follow-up period. In subgroup of rehospitalised patients most common diagnostic change was to schizophrenia. Further prospective research on the topic is warranted to understand evaluation of the diagnosis in ICD-10 and possible changes in ICD-11.
Effect of worship level in female student mental health
Authors: Sadeghi R.
Published: May 2011

People have learned in all situation take refuge from God and ask Him to help them and sharing with him their needs, desires and interests to get calm. The aim of this study was to examine the effects of worship level on the mental health of female students at the Islamic Azad University, Dezfoul Branch, Iran. ‘The statistical society of this study was all female students, Islamic Azad University of Dezfoul. The study sample included 120 female students that selected randomly in different parts of University. Descriptive and inferential statistical frameworks were applied to analyze and interpret the data. Tools for this research contain two researcher-designed questionnaires (assessment worship questionnaire) including 36 items with Likert 5 and MMPI questionnaire (questionnaire measuring psychological characteristics) included 71 questions. The research method was descriptive-field, and with questionnaire examining research factors. The study variables were the amount of worship (independent) and psychological characteristics (dependent). After selecting research participants randomly in the classroom, library, mosque, students’ canteen) and other places in universities, subjects satisfactory completion of the questionnaires. The results indicated a significantly negative relationship between the worship and hypochondria and depression. There was a significantly negative relationship between the worship depression and anxiety of the questionnaires. No significant relationship was found between worship and K index as well as average education of the questionnaires. The results of this study clarify that the prevention and treatment of mental disorders can catch our attention regarding the role of religion in human happiness and mental health.
A study gauging perceived social support and loneliness with life satisfaction among students of golestan university of medical sciences
Authors: Shahini N. , Shahini I. , Asayesh H.
Published: May 2011

Introduction

Social humans are embedded with a variety of relationships. Satisfactory social support is crucial for having physical and psychological well being.

Aim

The purpose of the present study was to find empirical support for the connections between perceived social support and loneliness with life satisfaction.

Material & methods

226 students of Golestan University of Medical Sciences (in Northern Iran) participated in the study. They were assessed using demographic questions, Multidimensional scale of Perceived Social Support, Life Satisfaction Scale, and Loneliness Scale. Using SPSS (16) and Pearson correlation test, linear regression the data were analyzed.

Findings

120 male and 104 female students filled the questionnaires. 91 percents of the students were single and also 95 percents were residents of university dormitories. There was a significant relationship between life satisfaction with loneliness in the subjects (p < 0.05). The higher social support from the family and friends was also correlated with more life satisfaction and less loneliness (p < 0.05). Linear regression showed a significant correlation among social support, life satisfaction with loneliness.

Conclusion

Findings suggest that, in general, appropriate social support can reduce loneliness and increase life satisfaction. It is also one of the well being predictors. Therefore the universities should provide strategies to facilitate social support from family and the significant others. The empowerment of the students using teaching social communication skills may be helpful as well. The results were discussed within the context of findings from the studies conducted in eastern and western cultures.
Patient centred teaching: is it effective in teaching psychiatry to medical students?
Authors: Sharma J. , Manarkattu M. , Dave S.
Published: May 2011

Aims

of this 2-staged study were to assess knowledge gain of medical students following an individual episode of patient-centred teaching. Participant satisfaction was also assessed.

Background

The education of medical students is an important role for trained medics using adabtable teaching methods, appropriate to the demands of students and medical universities. Delivery of patient-centred teaching in UK is ad-hoc, minimal and not standardised. However, medical education still tends to be delivered in the in-patient environment, where there is little supervision and students often have to identify patients on their own. Paucity exists in the evidence of whether bedside teaching assists in knowledge gain.

Method

In Derby, a Patient-centred clinic was developed in 2008. We conducted a pre-intervention/post-intervention comparison study to measure the knowledge gained during a teaching session. Participants were medical students from University of Nottingham, and in-patients at the Unit. Following this, standards were set and assessing questions were changed to multiple choice style questions in January 2010.

Results

show that there is an immediate knowledge gain, of an average of 22%. Students are satisfied with this method of teaching and patients have felt that their input has been valued. The second part of the study has confirmed these findings.

Conclusions

The study demonstrates usefulness of patient-centred education in improving clinical knowledge. Adoption of this form of teaching will benefit not only medical students in their psychiatry placement in Derby, but also the wider medical student population. This method can also be implemented in other acute medical specialties.
Audit on the documentation of patients medication in the letters from psychiatrists to the generalpractitioners
Authors: Sharma N. , George M. , Owen B.
Published: May 2011

Introduction

Clinical correspondence between general practitioners and specialists remains fundamental to the process of referral from primary care and transmission of management advice from consultants.

Discrepancies over medication records for patients with mental illness living in community were highlighted by a previous audit and recommendation for improvement were accepted and implemented by the trust.

Aims

An audit of the documentation of patient's medications in the Psychiatric clinic letters compared to the general practitioners records was done two years back and several recommendations were made to improve the communication.

The aim of this study was to examine if the recommendations from the previous audit was implemented and if the quality of communication about medication conveyed by the Psychiatrist to the General Practitioner improved.

Methods

Latest Psychiatric clinic letter of 50 patients were randomly selected from the computer database and they were checked against the latest GP records.The expectation is that the Psychiatric and GP records would correspond 100%.

Results

This re-audit revealed most of the recommendations from the previous audit were implemented and as a result of that, the numbers of errors were reduced. However there were still significant errors detected including wrong medication, omission and incorrect dosage, schedule and frequency.
ADHD and driving
Authors: Strohbeck-Kuehner P.
Published: May 2011

People with ADHD are more often found to be involved in automobile accidents as well as attained a higher number of driving violations as compared with the statistical norm. The main reasons which might cause these differences are: attention deficit due to distractions, impulsive actions, as well as the elevated co-morbidity with alcohol and drugs. ADHD should be considered and reviewed as an influential factor of driver fitness. By treating ADHD with certain stimulatory medications very successful results have been obtained. These results include a better ability to adapt to traffic situations, avoiding accidents as well as following traffic regulations.

In an own study, we compared 27 untreated clinical referred adults with ADHD with 27 controls matched by age and gender. Nineteen of the ADHD-subjects performed a test battery to assess driving related cognitive measures and were reassessed after at least six weeks of treatment with methylphenidate (n = 9) or after a six week medication free period (n = 10). We found, that the ADHD subjects were more often fined and registered by traffic authorities and were more frequently involved in traffic accidents. Methylphenidate treatment resulted in improved performance, e.g. better visu-motor coordination, improved visual orientation and sustained attention, compared to baseline and the untreated control group.
A narrative literature review on the applications of medical laboratory tests in the clinical practice of psychiatry: general areas and specific considerations
Authors: Tabibian S.H. , Malekian A.
Published: May 2011

Introduction

Laboratory medical tests have different applications in the field of psychiatry. Some lab tests are done for psychiatric inpatients and outpatients as a routine basic assessment. These tests may be important for diagnosing or ruling out some possible organic causes of psychiatric symptoms and/or co morbidities, or as comparative basic data for further evaluation of some important psychotropic medications effects and/or side effects. Some other important areas of lab tests applications are monitoring serum levels of some psychotropic drugs for evaluation of patient's compliance/noncompliance to drug, for establishing and maintaining effective therapeutic blood levels of medications, for assessment of the etiology of non-responsiveness to pharmacotherapy as well as several other clinical implications.

Methods

Through an extensive and comprehensive literature review in this non-systematic review study, authors have classified the application of laboratory tests in the psychiatry practice from several aspects.

Results

Laboratory tests were classified regarding different aspects like the frequency of prescription by psychiatrists, cost-effectiveness of some routine assessments, legal obligation and claims issues, follow up considerations, psychotropic drugs false/real interactions with some laboratory tests and some false positive /negative laboratory results with great importance in the psychiatry practice as well as several other issues.

Discussion

Both psychiatrists and laboratory practitioners need to have some basic information about each other’s field of practice, concerns and needs. This review presents a more clear sense of the interactions and necessary co-operations between psychiatrists and medical laboratory professionals.
Inclusion of an alcoholic Rehabilitation Unit in a general psychiatric inpatient service
Authors: Teixeira J. , Casquinha P.
Published: May 2011

Introduction

Patients with psychiatric disorders are admitted to psychiatric units for evaluation and treatment in the acute phase of illness.

Aims

To perform a descriptive analysis of psychiatric hospitalization characteristics before (phase1) and after (phase2) the inclusion of the Rehabilitation Unit for Alcoholic Patients (RUAP).

Methods

A retrospective study with clinical and statistical data analysis of patients admitted to a general Psychiatric Hospital twelve months before and after the inclusion of RUAP.

Results

The sample had 741 patients (376 males, 365 females). Hospitalization characteristics data is presented in table1.

[Hospitalization characteristics of phase 1 and 2]

Conclusion

Sample demographic characteristics were similar in both phases. Although mood disorders were the more prevalent diagnosis, after inclusion of RUAP, Alcoholic Dependence Syndrome became the most frequently assigned diagnosis. It is also relevant the higher mean occupancy rate and the higher number of patients admitted to the service. Patients social characteristics in phase 1 and 2 need further investigation.
The examination of the observation forms for the risky patients in the psychiatry clinics comprehensively and quantitatively in terms of nursing problem areas
Authors: Tün H. , Oflaz F. , Bozkurt A.
Published: May 2011

Aim

The goal of the study is to determine the problems that the nurses tend to look and to constitute a common language in the acute care unit.

Method

In the study, document analysis method was used. The observation forms filled by both nurses and physicians for the risky patients were examined. For the examination and categorization, a coding chart containing the problems in both forms was used. Risky patient assessment form of thirty two patients (filled by the physician) and three hundred fifty five nurse observation forms used for same patients were included into the study.

Results

The mean of days in which observations recorded by the nurse were 15.29 ± 6.98 (min.4-max.29). The risky patient form was filled by the physician generally in the day that the patient was hospitalized. The majority of the patients for which observation form was filled had psychotic disorders. It has been seen that “self-care deficit” (70.7%) was mostly marked and, “eating the meal” (74.1%), “anxious facial expression” (44.5%) and “sleeping at night” (52.7%) were tagged mostly in nurse's form. In the physician's form, aggression and agitation was mostly marked (63.1%).

Conclusion

The problems declared in the nurse observation form are rather concerned with the daily life activities not including sufficient information in terms of the risk creating characteristics. It has been concluded that the changes should be assessed quickly and clearly. The observation forms do not provide practical information about the course of the disease although these are kept daily.
A typology of patients’ relatives with conversive and/or dissociative disorder built from the relationship established with these patients in the southeast Brazil: A clinical-qualitative study
Authors: Vianna F.C. , Böttcher-Luiz F. , Turato E.R.
Published: May 2011

Introduction

Hysteria is manifested by physical (conversion disorder) and/or psychical symptoms (dissociative disorder), without changes in organic basis, given that they are symbolic manifestations of repressed conflicts that return from the Unconscious. Due to frequent childish and theatrical character that accompanies those events, hysterical patients often mobilize negative attitudes and feelings in peoples of their conviviality.

Aim

to discuss the psychological meanings of living with such patients.

Method

Clinical-qualitative method.

Results

A typology of relatives emerged from the interviews: the ambivalent, by one side relate well with the patients wanting to take care of them and showing, by the other side that they feel emotionally overloaded, considering the remoteness; the promoter who seek to save the patient from experiences unpleasant and situations likely to produce emotional crises, thus, are more likely to be the target of the action of the patient, the responsible who wish to leave the patients, but do not because they think nobody will care of them, which would worsen the health condition of these patients.

Conclusion

As the hysterical patient has clinical manifestations in order to attract attention to themselves and to manipulate the people around them so that they act in their favour, the attitude of the relative can be both stimulating and repressing of those behaviours, possibly interfering in the clinic evolution of the patients. It is, therefore, important that the doctors and nurses know the relationship between caregivers and patients, in order to instruct them on how to better act with those patients.
The viennese psychiatric intensive care unit - diagnostic distribution
Authors: Winkler D. , Naderi-Heiden A. , Strnad A. , Winkler-Pjrek E. , Scharfetter J. , Kasper S. , Frey R.
Published: May 2011

Background

Psychiatric intensive care is supposed to offer treatment and to hold patients with psychiatric illness, if they pose a threat to themselves or to others.

Methods

A chart review was performed including 100 consecutive inpatients (52% females, age: 45.7 ± 17.8 years) treated at the Viennese psychiatric intensive care unit (PICU) in the years 2008 and 2009. Clinical key features and the distribution of mental disorders (according to ICD-10) in these patients are reported here.

Results

The mean duration of stay was 18.9 ± 14.8 days. 52% of patients were admitted involuntarily. 18% suffered from organic mental disorder (12% from delirium), 20% were diagnosed with mental disorders due to psychoactive substance use (9% alcohol dependency, 6% benzodiazepine dependency, 5% multiple drug use), 16% had a diagnosis of schizophrenia, 10% of schizoaffective disorder and 5% of transient psychotic disorder. 20% suffered from recurrent depressive disorder, 15% from bipolar affective disorder and 3% from a single depressive episode. 8% fulfilled diagnostic criteria of a neurotic, stress-related or somatoform disorder. 12% had eating disorders, 9% had personality disorders and 1% was diagnosed with mental retardation. Only 15% of patients had a first episode of psychiatric illness. 4% were admitted after an accident and 21% after a suicide attempt (45% poisoning, 25% jumping from height, 20% cutting/piercing with sharp object, 5% vehicular impact, 5% self-immolation).

Conclusions

All major psychiatric diagnoses can be found at the Viennese PICU, either if patients are in a life-threatening condition, or if additional somatic illnesses require intensive care management.
The viennese psychiatric intensive care unit - therapeutic modalities
Authors: Winkler-Pjrek E. , Naderi-Heiden A. , Strnad A. , Winkler D. , Scharfetter J. , Kasper S. , Frey R.
Published: May 2011

Background

Intensive care at a psychiatric intensive care unit (PICU) traditionally includes the treatment of severely ill psychiatric patients with suicidal or violent behavior [1].

Methods

A chart review was performed including 100 consecutive inpatients (52% females, age: 45.7 ± 17.8 years) treated at the Viennese PICU between 2008–2009.

Psychopharmacotherapy and the rate of electroconvulsive therapy (ECT) in these patients is reported here.

Results

87% of patients were treated with antipsychotics: 44% with quetiapine (447.7 ± 421 mg), 32% with risperidone (4.3 ± 2.3 mg), 25% with olanzapine (16.9 ± 7.5 mg), 20% with haloperidol (10.5 ± 5.4 mg), 16% with aripiprazole (15 ± 8.4 mg), 6% clozapine (416.7 ± 147.2 mg) and 3% ziprasidone (120 ± 56.6 mg). 36% of patients received treatment with mood stabilizers: 15% with valproic acid, 8% with lamotrigine, 6% with lithium, 4% with pregabaline, 3% with topiramate, 2% with gabapentine and 2% with oxcarbazepine. In 49% of patients antidepressants were prescribed: in 23% selective serotonin reuptake inhibitors, in 12% selective dual acting reuptake inhibitors, in 5% tricyclic antidepressants and in 33% other antidepressants (mostly trazodone or mirtazapine). 84% of patients were treated with benzodiazepines (30.3 ± 22.4 mg diazepam equivalents), in 17% the opioid nalbuphin was applied. Intravenous psychopharmacotherapy was used in 31% of cases. 10% of patients received ECT.

Conclusions

Psychotropic compounds with sedative properties are frequently used at the Viennese PICU. However, the dosages for antipsychotics do not appear to be higher than on normal psychiatric wards.
Crisis treatments: improvements in symptomatic, defense mechanisms, recovery style and social functioning
Authors: Zanello A. , Bacchetta J.-P. , Quast S. , Merlo M.
Published: May 2011

The challenge in crisis intervention is to seize the potential of change while giving the patients enough support and security as well as maintaining social integration. Crisis Intervention Centers (CIC) provide an alternative to psychiatric hospitalization for patients that are treated in an affiliated outpatient structure.

The aim of this study was to verify the short term effects of a brief (6 weeks) intensive crisis psychodynamic oriented treatment including individual and group therapy associated with pharmacotherapy.

One hundred and fourteen middle age (m = 41 years, SD = 11.7) patients were included: 68 women and 46 men with disorders like depression (75.4%), anxiety (18.4%) or others (6.2%) according to CIM-10. They were administered measures of psychopathology (BPRS 4.0 and SCL-90 R), defense mechanisms (DSQ-40), global functioning (GAF) and recovery style (RSQ) at intake and 2 weeks after discharge.

At endpoint, a statistical significant reduction in the severity of symptoms was found in all variables except for hostility and phobic dimensions of SCL-90 R. This was associated with significant improvements in recovery style scores, global functioning and a shifting towards more mature defense mechanisms. None of the improvements were related to gender.

These findings provide clear evidence of the effectiveness of brief psychodynamic oriented crisis interventions in specific units like CIC. Further research is needed to clarify whether the improvements remain stable on the long run and whether crisis treatments pave the way for future psychotherapeutic treatments.
SWN (subjective well-being under neuroleptics) in clinical practice
Authors: Zeppegno P. , Prosperini P. , Allera O. , Colombo M. , Lombardi A. , Gili S. , Torre E.
Published: May 2011

Objectives

To assess the use of SWN in the acute phase of psychiatric disease as a predictor of clinical outcome.

Methods

This study started in June 2009 and at the moment we have recruited 150 patients. The patients were divided into 4 groups according to their psychiatric diagnosis (schizophrenic psychosis, mood disorders, personality disorders, acute stress reaction) and each diagnostic group into three subgroups according to length of stay (T1< 7 days, T2 = 7–14 days, T3> 14 days). The subjective well-being indicators (subscales SWN: emotional regulation; self-control; mental functioning; social integration and physical functioning) and the severity of illness (CGI-S) were evaluated at admission and discharge.

Results

At discharge there is a statistically significant difference in the SWN subgroups among the four diagnostic groups except for social integration and total score with equal CGI-S scores. Schizophrenic patients and personality disorders show a subjective improvement at T2; mood disorders at T3; acute stress reactions T1 = T2. CGI shows a statistically improvement regardless of the length of stay.

Conclusions

Preliminary data suggest that SWN represents a predictor of clinical outcome and remission and together with the clinical evaluation it can help clinician to settle therapeutic programs.
CS01-01 - Pathological gambling: impulse controle disorder or addiction?
Authors: van den Brink W.
Published: May 2011

Gambling is a recreational activity with many participants all over the world. However, some people, especially with certain games, loose control over their gambling behavior resulting in serious problems for the person and his or her environment. The problematic nature and the underlying psychopathology is recognized by the fact that pathological gambling is an existing diagnosis in most psychiatric classification systems. In most of these systems, pathological gambling is categorized under the group of impulse control disorders. However, in DSM5, is likely to become one of the addiction and pathological become a gambling addiction.

In this presentation, we discuss the similarities and differences between pathological gambling and substance use disorders in terms of the phenomenology, comorbidity, genetics, temperamental antecedents, neurochemistry, cognitive abnormalities, neurobiological substrates, course and response to psychological and pharmacological treatments. It is concluded that pathological gambling is more similar to substance use disorders than to impulse control disorders and that a move in the classification towards the category of addictions seems to be justified.
CS01-02 - Alcohol and nicotine
Authors: Gual A.
Published: May 2011

Introduction

The prevalence of smoking in patients presenting with alcohol problems can reach up to 80%, commonly with high nicotine dependence. Consequently, mortality and morbidity due to smoking are elevated in this population, being the first cause of mortality in recovered alcohol dependents.

State of the art

Nicotine and alcohol have cross-tolerance, share common pathophysiological mechanisms, and are suggested to have combined effects on the reward circuit. Several studies have shown that a relevant percentage of patients with alcohol problems is willing to stop smoking and that a simultaneous treatment of smoking and alcohol do not jeopardize alcohol treatment outcomes.

However, some controversy has emerged concerning the best timing to start a smoking cessation intervention, simultaneous vs. delayed, in patients attending an alcohol treatment program. Patients with past alcohol problems can benefit from both brief and intensive smoking cessation interventions while patients with short-term abstinence from alcohol may need intensive and sustained treatments and also have lower quit rates than general population.

Conclusions

It is no longer possible to ignore smoking consumption in patients with alcohol and other substance dependencies. Tobacco use should always be screened and monitored. Brief advice to all patients and intervention for smoking cessation if deemed appropriate should be offered during alcohol treatment. Future research should study new medications targeting both substances trough the understanding of shared genetic and neurobiological mechanisms, as well as the improvement of tobacco cessation treatments to prevent the high prevalence of relapses in this population.
CS01-04 - Drug treatment of alcoholism
Authors: Kiefer F.
Published: May 2011

Multiple neurochemical pathways have been identified to be involved in mediating craving and relapse to alcohol. Additionally, animal models greatly assist in investigating pharmacological interventions of relapse behaviour. Opioidergic and glutamatergic systems play a key role in alcoholism as demonstrated by clinically effective compounds. Moreover, many new targets have been identified and several new compounds are currently undergoing clinical testing. Given the heterogeneity in treatment response, genetic and protein markers as well as endophenotypes are currently characterised for individualised pharmacotherapy.
CS02-02 - Risk and resilience markers: Use of whole-brain structural MR scans to predict familial risk and disease expression in Bipolar Disorder
Authors: Frangou S.
Published: May 2011

Aims

Conventional brain imaging analyses have confirmed that genetic risk and disease expression for Bipolar Disorder (BD) are associated with changes in brain structure. The current challenge is to develop new approaches to using brain imaging information to aid diagnostic classification and prediction of risk or resilience to BD.

Methods

We used a whole-brain classification approach employing a support vector machine (SVM) to the predictive value of structural MRI scans in two independent samples of BD patients and controls. Subsequently, using the same technique, we investigate whether it was possible to classify individuals at genetic risk for BD from BD patients and healthy controls.

Results

SVM correctly classified BD individuals at a specificity of 70% and a sensitivity of 81%. This approach differentiated individuals at risk for BD with a specificity of 73% and a sensitivity 64% of when compared to BD patients, and with a specificity 79% of and a sensitivity of 701% when compared to and controls.

Conclusions

Our results suggest that multivariate neuroanatomical pattern classification may provide a valuable tool in diagnosing BD and differentiating between affected and unaffected individuals given the same predisposing genotype.
CS02-03 - Imaging depression
Authors: Martinot J.-l.
Published: May 2011

Context

PET and MRI investigations performed in patient groups with major depressive disorder (MDD) by our team in Orsay searched for differences of regional brain measures during treatments.

Results

In the patient samples investigated, thorough analysis of cortical surface and metabolism suggested marked deviations in patients with resistant depression, while abnormalities of white matter microstructure were still present in euthymic patients (1–4). Relationship with treatment response was investigated (5). Recent ALE meta-analysis of Talairach’ spatial coordinates reported in the literature on adolescent MDD confirms that imaging techniques of brain function and brain structure revealed a consistent network of frontal limbic and subcortical regions (1)

Conclusion

While the diagnosis of MDD is symptom-based by definition, brain imaging research provided a bunch of convergent information on the regions mediating the depressive syndrome, and supports a significant proportion of MDD patients have brain deviations in both regional function and regional structure measurements.
CS03-02 - Sleep and chronic pain
Authors: Hajak G.
Published: May 2011

Recent nation-wide epidemiological data confirm the well-known clinical observation of a strong relationship between pain syndromes and disordered sleep.

In experimental settings of pain patients as well as healthy subjects, pain perception shows a strong circadian pattern exhibiting significant variation over the 24-hour sleep-wake period. Several lines of scientific evidence indicate that homoeostatic components of sleep may mask circadian pain perception, which results in a two-process model of pain regulation depending on the circadian sleep-wake status.

Since pain may worsen sleep, sleep deprivation increases pain, and quality of sleep not only affects nocturnal pain but influences pain during daytime hours, models of interactive pathomechanisms of pain and sleep are widely accepted.

Clinical consequences include various treatment methods that consider both, pain and sleep. E.g., intake of pain medication should follow circadian aspects which assure sufficient pain reduction at early morning hours; ideal pain medication at night should have hypnotic properties, including the promotion of deep sleep; pain medication during daytime hours should activate patients to support good sleep during the following night. Psychotherapy needs to support both, the management of pain and of sleep.
CS03-03 - Sleep and sleep disorders in somatoform pain disorder
Authors: Saletu-Zyhlarz G. , Prause W. , Aigner M. , Anderer P. , Grätzhofer E. , Klug S. , Saletu B.
Published: May 2011

Introduction

Somatoform pain disorder (SPD) is frequently associated with sleep disorders, specifically restless legs syndrome and insomnia, which in turn lowers the pain threshold and worsens pain.

Objectives

The aim of the present study was to investigate differences in wake-EEG by low-resolution electromagnetic tomography (LORETA) and objective and subjective sleep and awakening quality in SPD patients as compared with controls and study acute and chronic effects of trazodone CR on these variables and pain measures.

Methods

Fifteen patients with SPD (F45.4) and co-morbid insomnia (F51.0) were compared with 15 controls and participated in a single-blind, placebo-controlled, cross-over study on the acute effect of 100 mg trazodone CR, followed by a six-week open titration period. Statistics involved clinical, EEG-LORETA, PSG and psychometry.

Results

LORETA showed reduced power, mainly in the beta band in almost all pain matrix areas (SI, SII, ACC, SMA, PFC, PPC, insula, amygdala, hippocampus). PSG demonstrated a lack of deep sleep and increased arousals and stage shifts, with opposite changes induced by trazodone after acute and chronic therapy. Improvement of sleep was associated with improvement of pain, evaluated by visual-analog scales.

Conclusion

Our LORETA findings demonstrate a dysfunctional pain modulation in SPD. Trazodone induced changes in subjective and objective sleep and awakening quality that were opposite to the differences between SPD patients and controls (key-lock principle) and associated with pain improvement.
CS03-04 - Concept of somatoform disorder
Authors: Kapfhammer H.-P.
Published: May 2011

Patients presenting with bodily symptoms and complaints that are not sufficiently explained by organic pathology or well known pathophysiological mechanisms present a major challenge to any health delivery system. From a perspective of psychiatric classification these medically unexplained somatic symptoms may be diagnosed as primary psychiatric disorders such as depressive and anxiety disorders on the one hand, as somatoform disorders on the other. Among medical specialties a separate diagnostic approach is taken to conceptualize functional somatic syndromes. Unfortunately, both diagnostic systems do not conform to each other very well.

The concept of somatoform disorders as outlined in DSM-III to DSM-IV-TR and in ICD-10 refers to a group of heterogeneous disorders with prominent somatic symptoms or special body-focussed anxieties, or convictions of illness. These disorders seem to indicate medical conditions that cannot, however, fully be explained either in terms of medical diagnostics or of other primary psychiatric disorders. There is one major conceptual assumption that postulates a decisive impact of psychosocial stress on the origin, onset and/or course of these somatic symptoms and complaints. And there is one major path of diagnostic steps to be taken, i.e. just to count the number of medically unexplained somatic symptoms, to determine their reference to any main organ system, to prove that they are not self-induced, to put special stress on prevailing pain symptoms and to separately assess dominant health anxieties or illness convictions.

Since introduction of the diagnostic concept of somatoform disorders there have been arising many critical issues regarding the soundness of this diagnostic category. These issues, among other things, refer to a problematic mind-body dichotomy overemphasizing psychosocial and psychological factors and neglecting major neurobiological processes, to the impracticable criterion of “medically unexplained”, to the demand of conceptual clarity and coherence of this diagnostic category, to the rather trivial diagnostic procedure of just counting the number of medically unexplained somatic symptoms whereas not assessing typical dimensions of illness behaviour in a corresponding way, to the major overlap between subgroups of somatoform disorders on the one hand and factitious disorders, anxiety disorders and depressive disorders on the other, to a principal focus on the epidemiologically rare condition of somatisation disorder as core disorder thereby undervaluing much more prevalent subthreshold conditions, to the difficult communication of the whole diagnostic group to medical colleagues dealing with the same problems by using a different conceptual approach, however.

These critical issues surrounding the concept of somatoform disorder will be reflected in respect of some major revisions projected in future diagnostic classification systems of DSM-V and ICD-11.
CS04-01 - Conceptual history of classification
Authors: Sass H.
Published: May 2011

In most of the somatic disciplines of medicine there is no doubt about the importance of diagnosis for patient care, research, teaching and regulatory affairs. In psychiatry however, the status of diagnosis has been antiguous for long times. In this paper the reasons for this difference will be discussed in the light of the historical development of diagnosis and classification in the beginnings of modern psychiatry. Especially during the period of antipsychiatric reasoning it was even regarded as harmful and dangerous for patients for be diagnosed in a scientific terminology. As a consequence the research in the field of mental disorder was hindered and blurred, and in addition also the scientific basis of our discipline was questioned. The American Psychiatric Association published in 1952 the „Diagnostic and Statistical Manual of Mental Disorders” (DSM-I), which was the first official manual of mental disorders to contain a glossary of descriptions of the diagnostic categories. A major breakthrough was the publication of DSM-III in 1980, which was not only characterized by explicit criteria for inclusion and exclusion, but also by strictly defined algorithms and by systematic field trials during the development of the manual. The DSM-approach to diagnosis in psychiatry became of major importance for research and practice in our field. Later, ICD-9 was transformed into ICD-10 by WHO with a certain tendency to adopt the basic principles of the DSM-system. Contemporary psychiatry is completely ruled by these two schemes of operationalized diagnosis. Advantages and disadvantages of this approach to classification for patient care, research and administration as well as possible alternatives and future directions will be analyzed. Special attention is given to the question, whether psychopathology and phenomenology are still relevant as methodological elements in psychiatry, even in an era of major progress of neurobiology in the sense of natural sciences.
CS04-02 - Classification and child psychiatry
Authors: Van Der Gaag R.J.
Published: May 2011

Classification is an important tool for scientific progress. It makes groups of individuals that share clinical symptomatology comparable and facilitates clinical communication. It should enable monitoring of treatment en guidance outcome through routine outcome measurement. But over the past decades classification systems have become increasingly popular with health and governmental authorities and insurance companies. The classification systems have acquired a fourth label that of a passport that gives access tot services. This should be a matter of concern for professionals and scientists in the field as it biases the primary scientific purpose of the exercise. ICD 10 and DSM IV and unfortunately also DSM V in progress have special sections for disorders occurring mostly in children and adolescents. This is an unfortunate categorization as most of the conditions met in childhood are in fact developmental disorders that persist well into adulthood. In this presentation the necessity for multilayer (genetic – brain – neuropsychology – behavioural signs and environment) will be presented and a stron plea made for disclosing child and adolescent conditions from their separate categories towards more developmentally geared dimensional perspectives.