bluuebunny/crossref_metadata_2025 huggingface dataset:
Genomics, Transcriptomics and Methylomics: Alternative Approaches for the Analysis of Serotonin System and Antipsychotic Response
Authors: De Luca V. , De Souza R. , Viggiano E. , Volavka J. , Lieberman J. , Potkin S.G. , Meltzer H. , Wong A. , Kennedy J.L.
Published: March 2009

Serotonin receptors blockade is the major basis for the action of atypical antipsychotic drugs. Genetic factors affecting the density and/or function of serotonergic receptors, transporters and enzymes may therefore affect antipsychotic response. This exploratory study investigates the effect of ten polymorphisms from HTR1A, HTR1D, HTR2A, HTR3A, HTR3B, HTR4, HTR6, SLC6A4, TPH1, TPH2 genes on antipsychotic response in a sample of 289 patients with DSM-diagnosis of schizophrenia. Clinical Response was assessed using Brief Psychiatric Rating Scale (BPRS). Response was determined as 20% reduction improvement of BPRS compared to baseline. Selection of the biological relevant interactions, regardless the phenotype was performed using different statistics strategies regardless the phenotype to investigate epistasis within the serotonin system. the test for relevant interaction selection showed that 5HT4 and 5HT6 can be in epistatic relationship. the single locus analysis of these two receptor polymorphisms showed no significant results and the logistic regression model incorporating both genes, the clinical and demographic variables was not significant. Even this result is not significant, this strategy aimed to investigate the epistatic effect among genes could be useful for finding relevant biological interaction among genetic variants. Furthermore we are currently analyzing the methylation level of HTR2A in responders and non-responders, this epigenetic analysis will be very valuable in adding more information to the classic pharmacogenetic studies.
Naturalistic Observational Study of Patients Receiving Risperidone Long-acting Injection (RLAI)
Authors: Gupta N. , Riley C. , Agell I.
Published: March 2009

Background:

Risperidone is the first atypical antipsychotic available in a long-acting injection formulation. in United Kingdom, it is licensed for use in treatment of psychosis in patients tolerant of oral Risperidone. the Summary of Product Characteristics clearly defines the methods of initiation and titration.

Methods:

We performed a naturalistic observational study of 61 patients suffering with psychosis. the cohort comprised patients being prescribed Risperidone long-acting Injection (RLAI) within various Community Mental Health Teams and Assertive Outreach Team of the Trust. the data was collected related to three broad areas: reasons for choice of RLAI, initiation and titration of RLAI, continuation of RLAI.

Results:

•

35/61 patients have been prescribed oral atypical antipsychotic (including 16/61 being prescribed oral Risperidone) prior to the injectable formulation and 3/61 had received Clozapine.

•

In 12/61 non-compliance was suspected and only 11/25 patients stated a preference for an injectable formulation.

•

33/61 received oral supplementation during initiation.

•

29/61 were initiated on dose of RLAI commensurate with the current dose of oral Risperidone

•

In 35/61, dose was changed in less than 4 weeks intervals.

•

43/61 continued to receive RLAI. 18/61 discontinued due to patient refusal (6/18), patient not tolerated (3/18), not effective (2/18), patient non-attendance (1/18), patient moved area (1/18), other reasons (2/18), no reasons specified (3/18).

Conclusions:

Prescribing of RLAI did not follow recommendation from manufacturers during initiation and titration. Non-Compliance with previous medication was main reason for use of RLAI. However, discontinuation with RLAI was primarily related to refusal/intolerance of treatment.
Comparison of Intramuscular Olanzapine and Haloperidol for the Treatment of Delirium
Authors: Jin K. Jung , Kook L. Hyun , Un P. Chi , Uk L. Chang , Ho P. In , Chul L.
Published: March 2009

Objectives:

Delirium occur frequently in hospitalized patients. High-potency antipsychotic drugs have been used for the treatment of delirium; however, there is a risk of acute side effects. Therefore, atypical antipsychotic drugs could be used to the treatment of delirium.

The present study aimed to provide comparison of intramuscular injection of olanzapine and intramuscular injection of haloperidol for patients with delirium was conducted with a randomized, open prospective study.

Methods:

Sixty-two patients admitted at the Catholic University of Korea Kangnam St. Mary's hospital, Seoul, South Korea were enrolled in this study. They were diagnosed as delirium by two independent psychiatrists using DSM-IV-TR. the Delirium Rating Scale-revised-98(DRS-R-98) and clinical global impression-severity (CGI-S) were checked daily. the Simpson-Angus Rating Scale, the Barnes Akathisia Rating Scale and the Abnormal Involuntary Movement Scale were used for the assessment of side effects.

Results:

The DRS-R-98 and CGI-S scores were significantly decreased over time in both treatment groups without any significant group difference and time by the group interaction effect (F=28.35, P< 0.0001). Adverse events occurred lower in olanzapine group. both treatments were well tolerated and there were no serious adverse events occurred by intramuscular olanzapine or haloperidol.

Conclusions:

This study showed that either intramuscular olanzapine or intramuscular haloperidol would be effective and tolerable for treating delirium, however, olanzapine showed lower side effects than haloperidol. Adequately powered studies will be mandatory to draw any definite conclusion.
“Restless Arms Syndrome” Associated with Olanzapine
Authors: Konstantakopoulos G. , Oulis P. , Michalopoulou P. , Papadimitriou G.
Published: March 2009

Restless legs syndrome (RLS) is a common neurological disorder characterized by dysesthetic sensations in the legs and irresistible urge to move them. Arm restlessness has been reported as an accompanying feature in up to 48.7% of patients with RLS, although involvement of upper limbs is rarely reported as an initial symptom of RLS. the term “restless arms syndrome” (RAS) has been proposed for the restlessness of the arms with clinical features similar to RLS. Drug-induced RLS has been described under treatment with various drugs, including the atypical antipsychotics olanzapine, risperidone, quetiapine, and clozapine. However, there are as yet no reports on drug-induced RAS without RLS. We report on the case of a 24-year-old male with chronic paranoid schizophrenia, whereby olanzapine at 10 mg/d induced RAS within 24 hours, however reversible upon its discontinuation. A retrial of olanzapine at 5 mg/d resulted in reemergence of the syndrome, which resolved again when olanzapine was definitely discontinued. Clinicians should be aware of olanzapine's potential to induce RAS and thus be knowledgeable in its differential diagnosis, especially from antipsychotic-induced akathisia.
Can Quetiapine Induced Hypothyroidism be Reversible?
Authors: Kontaxakis V. , Karaiskos D. , Havaki-Kontaxaki B. , Skourides D. , Ferentinos P. , Pappa D. , Papadimitriou G.
Published: March 2009

Objective:

Quetiapine induced hypothyroidism is a rare side effect requiring either drug discontinuation or initiation of thyroid replacement therapy. We highlight the potential reversibility of quetiapine induced hypothyroidism in two such cases.

Methods:

Two case reports.

Results:

Case 1.Quetiapine (200mg/day) was initiated to a psychotic female patient due to exaggeration of positive symptomatology. Although her thyroid function tests (TFTs) upon admission were normal after a month significant decreases in T3 and T4 level and an elevation in TSH was observed. 45 days later the TFT returned to normal, although she remained on quetiapine. Case 2. Quetiapine (300mg/daily) was prescribed to a bipolar male patient due to a mixed affective episode with a very good response. Despite his normal admission TFTs, three weeks later a decrease in total T4 and a marked increase in TSH was observed .45 days later, although no measures were taken, TFTs returned within reference range.

Conclusions:

These are the first cases reporting reversibility of quetiapine induced hypothyroidism. TFTs alterations are dose related, relatively slight and linked to a positive history of thyroid abnormality. Our patients did not fulfil any of these criteria. Besides, hypothyroidism resolved although the antipsychotic therapy was continued and no thyroid replacement therapy was given. We suggest a careful thyroid monitoring for patients initiating quetiapine. However, physicians should wait in cases of thyroid dysfunction, since thyroid dysregulation may soon be resolved.
Clozapine as an Antiagressive Agent in an Adolescent with Autism
Authors: Lambrey S. , Quilici G. , Bonnefoy C. , Rosier A. , Guillin O.
Published: March 2009

Violent behaviours such as aggression or self-harming are commonly observed in persons with autistic disorders. They constitute the main reason for emergency admissions of these patients to the hospital and can sometimes result in substantial physical injuries toward the patients themselves or towards others. Atypical antipsychotics have been emerging for some years as the first-line pharmacologic treatment for violence in children with autism or other pervasive development disorders. in particular, the anti aggressive effect of risperidone and olanzapine has been found significant in double-blind, placebo-controlled trials and North American and European agencies recently approved the use of risperidone for the treatment of aggressiveness in children with autism. by contrast, clozapine has received very little attention so far.

Here we report the case of a 15-years old adolescent with autism whose severe tantrums and violent behaviours were not improved by risperidone or haloperidol but were drastically improved with clozapine (more than 40% reduction of violent events). the anti aggressive effect of clozapine has been sustained for one year of follow-up. No significant side effects were reported in this patient and co prescription was reduced by 50%. This case report suggests the importance to conduct controlled trials assessing the efficiency of clozapine for the treatment of aggressiveness in patients with autism. More generally, specific anti aggressive properties of clozapine are discussed in the light of the relevant literature.
Clozapine Treatment for Resistant Schizophrenia May Reveal UN Unusual Hematological Disease: Polycythemia Vera. Case Report
Authors: Marian G. , Ionescu B. , Ghinea D. , Alina N.
Published: March 2009

Background:

Clozapine remains the gold standard of treatment for schizophrenic patients with treatment-resistant symptoms. Sometimes patients develop unusual hematological reactions with increased mostly red blood cells, which rises differential diagnostic issues: is it a side effect of clozapine treatment or is it a primary medical condition?

Aim:

To elucidate the etiology of the hematological disturbances in order both to control psychotic symptoms as well as to maintain an optimal somatic profile of the patient.

Method:

41 years female with a long history of schizophrenia became refractory of treatment, so clozapine was instituted as treatment of first choice. by monitoring paraclinical parameters we found progressive increased of the blood cells, mainly red blood cells, which has un unpredictable risk for somatic complications. We approached this case by interdisciplinary management-psychiatric and hematological to find the etiology of this peculiar comorbid condition.

Results:

The evaluations performed led us to the conclusion that there are two different nosologic entities, treatment of the psychiatric condition revealing polycythemia vera. This conclusion required reducing clozapine dose and adding another atypical antipsychotic. All subsequent evaluations demonstrated the efficiency in managing the psychiatric disorder and even an improvement in hematological condition.

Conclusion:

Treatment-resistant schizophrenia remains a challenge for psychiatrists, clozapine treatment requiring for an active monitoring because it can be a trigger for an unusual somatic disease-polycythemia vera.
Development of a Tool to Improve Screening Rates for Cardiometabolic Risk Factors Associated with Mental Illness
Authors: Newcomer J. , Haupt D.
Published: March 2009

Major mental illness is associated with premature mortality, primarily from cardiovascular disease. Modifiable risk factors include obesity, smoking, hyperglycemia, dyslipidemia and hypertension, all prevalent in this population, and commonly underrecognized and undertreated. Public health guidelines for screening and interventions to lower risk have reduced cardiovascular mortality in the general population, but these improvements have not extended to mentally ill populations. Recent recommendations to screen in this population have come from psychiatric professional groups, and in relation to regulatory warnings on potential adverse drug effects. However, recent studies suggest low levels of monitoring, both pre- and post-guidelines and warnings.

Public health interest is now directed at improving screening in this population. One of the barriers to increasing screening is limited awareness among mental health professionals of the details of existing public health guidelines that define specific risk thresholds, diagnostic values and treatment targets for adiposity, blood pressure, plasma glucose and plasma lipids levels. Quality assurance/quality improvement (QA/QI) tools to facilitate screening include data collection forms that educate about risk parameters and organize patient data in a manner that helps to track risk over time.

This presentation will describe a specific QA/QI tool for screening and monitoring cardiometabolic risk in the mentally ill, based on published guidelines from the European Association for the Study of Diabetes (EASD) and the European Society for Cardiology (ESC). Cardiometabolic screening, along with treatment approaches and interventions to reduce risk, offers an established public health approach to lower morbidity and mortality in vulnerable populations.
A Review of Metabolic Parameters in Quetiapine Studies Across Diagnoses
Authors: Newcomer J. , Ratner R. , Åström M. , Eriksson H.
Published: March 2009

Background:

Data pertaining to changes in weight during long-term treatment with quetiapine (QTP) have been published previously (1).

Methods:

Pooled data are presented from 26 short-term clinical studies (up to 12 weeks) of QTP or quetiapine extended-release (QTP XR)-as monotherapy or adjunct therapy-conducted by AstraZeneca up to November 2007. Studies were conducted in adult patients (18-65 years) across a number of psychiatric diagnoses. Variables were analyzed irrespective of fasting status with similar analyses planned in the fasting subset. LSM changes from baseline for the difference between QTP and placebo are presented.

Results:

Approximately 10000 patients were included in the analyses, 70% of whom were treated with QTP or QTP XR. Across the entire short-term dataset, the difference in LSM change in weight for QTP vs. placebo was 1.07 kg. Corresponding differences in glucose regulation parameters were 1.39 mg/dL for glucose and 0.04% units for HbA1C. the overall difference in total cholesterol was 5.48 mg/dL, with differences in HDL and LDL cholesterol of -0.62 mg/dL and 1.69 mg/dL. the difference in LSM change in triglycerides was 22.62 mg/dL.

Discussion:

Within the context of balancing potential risks against the acknowledged benefits of atypical antipsychotics, the degree and significance of variations in metabolic parameters is an area of continued interest. This analysis helps clinicians to better understand changes in important metabolic parameters across trials with QTP and QTP XR, and the size and uniqueness of the dataset permits further analyses within this important area.

Supported by funding from AstraZeneca Pharmaceuticals LP.
Evaluation of Dyslipidaemia Risk among Patients Treated with Aripiprazole: Meta Analysis of Placebo- and Olanzapine-controlled Studies
Authors: Peyro-Saint-Paul H. , Loze J.-Y. , Kaplita S. , Han J. , Baker R.A. , Cahn R. , Owen R.
Published: March 2009

Aims:

To evaluate dyslipidaemia risk among patients with schizophrenia treated with aripiprazole or olanzapine.

Methods:

Pooled analysis of the aripiprazole clinical database, including studies of ≥7 days with at least an oral aripiprazole monotherapy arm. Mean changes from baseline to endpoint and shifts from normal to abnormal lipid levels were calculated.

Results:

Seventeen placebo- and five olanzapine-controlled studies (3 weeks->3 years) of adult patients (≥18 years) were included. Mean changes (LOCF) in lipids were similar between aripiprazole and placebo for all lipid parameters; aripiprazole showed significant improvements versus olanzapine (p≤0.01). the incidence (OC) of switching to abnormal lipid levels from baseline normal was similar between placebo and aripiprazole, and significantly lower with aripiprazole than olanzapine for most measures.

Conclusion:

Despite limitations inherent to pooled analyses, these findings lend further support to the differential profile of atypicals, with aripiprazole showing effects on lipids comparable with placebo.
Clozapine Induced Rash: Case Report of Successful Desensitization
Authors: Singh R. , Raju K. , Southern J. , Darroch J.
Published: March 2009

Aim:

Clozapine is the drug of choice for patients with treatment-resistant schizophrenia. However a minority of them have been unable to continue with Clozapine due to side-effects, for example rash. This report looks at the use of graded desensitization in a patient who developed cutaneous reactions to Clozapine.

Method:

This report describes the management of a patient with treatment resistant-schizophrenia, mild learning disabilities and epilepsy, following a cutaneous reaction to Clozapine. Having been maintained on Clopixol depot until 4 years ago, he required a change in antipsychotics following a relapse of psychotic symptoms. He was then treated unsuccessfully with various anti-psychotics, before starting Clozapine, to which he showed a good response. Unfortunately he developed an eczematous rash on two separate occasions when the drug was introduced. Again he was tried on other anti-psychotics, to which he also developed a rash. He was then put on a graded desensitization regimen of liquid Clozapine.

Results:

Graded desensitization, using incremental increases in drug dose, allowed maintenance treatment with therapeutic doses of Clozapine to be achieved in the absence of cutaneous hypersensitivity reactions. the patient's previously treatment-resistant psychotic symptoms were improved by this method.

Conclusion:

We should be aware of possibilities for the management of both the common and uncommon side-effects associated with Clozapine, as the result might vastly improve the patients’ quality of life. Desensitisation regimens can be an effective means of overcoming drug hypersensitivity but should be used with great caution, especially when patients exhibit delayed-type hypersensitivity reactions.
Functional Recovery in Schizophrenia and Schizoaffective Disorder: Results from the Risperidone Long-acting Injectable Versus Quetiapine Relapse Prevention Trial (constatre)
Authors: Rouillon F. , Eriksson L. , Burba B. , Raboch J. , Kaprinis G. , Schreiner A.
Published: March 2009

Objective:

To report the functional recovery results from an open-label, randomized-controlled, relapse prevention trial (ConstaTRE) in stable patients with schizophrenia or schizoaffective disorder treated with risperidone long-acting injectable (RLAI) or the oral atypical antipsychotic quetiapine.

Methods:

Clinically stable adults with schizophrenia or schizoaffective disorder previously treated with oral risperidone, olanzapine, or oral conventional antipsychotics were randomized to treatment with either RLAI (25 mg every-two-weeks) or quetiapine (300-400 mg/day) for 24 months. Functional recovery was assessed using the Social and Occupational Functioning Assessment Scale (SOFAS) and two quality-of-life (QoL) measures (Short -Form 12 [SF-12] and Schizophrenia Quality-of-Life Scale Revision 4 [SQLS-R4]).

Results:

710 subjects were randomized to treatment with RLAI or quetiapine (n=355 patients/group). Baseline demographics were similar between treatment groups. Relapse occurred in 16.5% RLAI and 31.3% quetiapine patients. A total of 105 RLAI and 107 quetiapine patients dropped out of the study for other reasons than relapse, most commonly due to withdrawal of consent. A significant improvement in SOFAS, SF-12, and SQLS-R4 scores was observed from baseline to month-24 with both RLAI and quetiapine. at months 6, 12, and endpoint, SOFAS had significantly increased more for RLAI than quetiapine (p< 0.05).

Conclusions:

Among stable patients with schizophrenia or schizoaffective disorder, the likelihood of functional recovery appears to be higher in those switching to RLAI. Improvement in functional status and QoL from baseline was observed with both RLAI and quetiapine.
Survey of Safety and Efficacy of Long-acting Injectable Risperidone in Daily Practice: An Open-label, Non-interventional Prospective Study
Authors: Parellada E. , Kouniakis F. , Siurkute A. , Schreiner A. , Don L.
Published: March 2009

Objective:

This post-authorization safety survey evaluated the long-term safety, tolerability, and efficacy of risperidone long-acting injectable (RLAI) in routine clinical practice.

Methods:

In this 6-month, multicenter, European, naturalistic survey, patients were included if, during routine clinical practice, long-term antipsychotic therapy with RLAI was deemed necessary by the treating physician. Efficacy measures (at baseline and after 1, 3, 6 months) included Clinical Global Impression-Severity (CGI-S) and Global Assessment of Functioning (GAF). Safety was evaluated by recording treatment-emergent adverse events (TEAEs) at every visit.

Results:

RLAI was initiated in 5,134 predominantly male (58.6%) patients (aged 14-94 years) with a diagnosis of paranoid schizophrenia (69.8%). RLAI initial doses were 25 mg every-two-weeks in 37.0%, or 50 mg in 44.4% of patients. at endpoint, RLAI dosages were 50 mg in 49.3% of patients, 25 mg in 27.0%, and 37.5 mg in 22.1%. Six-month treatment with RLAI was completed by 4,314 patients (84.0%). RLAI was discontinued due to loss to follow-up (n=346;6.7%), insufficient response (n=116;2.3%), and AEs (n=106;2.1%). CGI-S significantly improved from baseline to endpoint (p< 0.001). Patient functioning in the GAF scale also significantly improved from baseline to endpoint (45.4±16.0 versus 62.4±17.7, respectively, p< 0.001). TEAEs were recorded by 20% of patients. AEs occurring in ≥5% of patients were akathisia, extrapyramidal disorders, depression, psychotic disorder, anxiety, and weight gain. Serious AEs were reported by 384 (8%) patients.

Conclusions:

This large prospective survey confirms the good safety, tolerability, and efficacy of RLAI as reported in previous controlled clinical trials when used in routine clinical practice.
Effects of Topiramate in Prevention of Obesity in Schizophrenic Patients Treated by Olanzapine
Authors: Talaei A.
Published: March 2009

Aims:

Schizophrenic patients treated with atypical antipsychotics commonly suffer weight gain. Additive flow of using these drugs lead to more researches to solve this problem. Weight gain is associated not only with several medical conditions (such as hypertension, diabetes, cardiovascular disease, etc) but also may be related to treatment noncompliance. Topiramate is an anticonvulsant drug that has been used in psychiatric disorders and also leads to weight reduce. Many researches have been studied this effect of topiramate and positive outcomes of weight reduce without creation or development of psychotic signs have already been reported. as there is no approved therapeutic dose of topiramate for appropriate weight loss and also no study referred to its prophylactic effect of weight gain in these patients, in this study we proceed to check forenamed subjects.

Method:

Forty - eight schizophrenic patients treated with olanzapine in beginning of hospitalization in Ibn-e-Sina Hospital were selected and randomly placed in four groups: placebo, 50, 100, 200 mg topiramate daily was added to their treatment regimen. Patients were followed for 12 weeks for body weight changes, BMI, waist and wrist diameters. Data were analyzed by SPSS software.

Results:

Only BMI and waist diameter had significant difference in patients treated with 200 mg topiramate daily in compare with placebo group in 12th week. other data had no significant difference in handling.

Conclusion:

Prophylactic treatment of obesity in schizophrenic patients with topiramate is effective in 200 mg daily dosage and no significant adverse effects were found.
Antipsychotic Combinations in an Acute Psychiatric Unit
Authors: Manteiga A. Tatay , Magán T. Merino , Diez-Canseco M. Lloret , Sopena L. Laguna , Díez S. Cepeda , Boada P. Cervera , Garibo M. Medina , Crespo R. Calabiug
Published: March 2009

Introduction:

Available data does not recommend antipsychotic drug combinations in treatment of psychotic symptoms and monotherapy is nowadays considered the option with the highest scientific evidence. Nevertheless, antipsychotics combination is a common practice in countries such as USA (40-60%), Japan (90%) and Spain (50-70%).

Aims:

To determine antipsychotic combinations frequency in patients with a diagnosis into the psychotic spectrum admitted in an acute psychiatric unit. to determine the differences among these combinations according to diagnosis. to analyze which are the associations more commonly prescribed as well as the theoretical basis that supports them according to receptorial profiles.

Methods:

Demographic and clinical data of patients with a psychotic-spectrum diagnosis admitted to the Doctor Peset University Hospital acute unit during 2004-2007 were retrospectively analyzed. We observed the percentage of patients treated with more than one antipsychotic drug, as well as the combinations more frequently prescribed.

Results:

Out of 677 analyzed patients, 302 were treated with an antipsychotic combination therapy (45%). the associaton most commonly prescribed was an oral atypical antipsychotic + an intramuscular atypical antipsychotic (121 patients). According to diagnosis, 50% from each diagnostic group was treated with a combination antipsychotic therapy.

Conclusions:

There is a high percentage of inpatients treated with more than one antipsychotic. We found no significant differences by diagnosis nor any clearly-defined key according to receptorial profiles.
Anger Expression in Obsessive-compulsive Spectrum Disorders (SOGS): Common and Differential Traits
Authors: Krug I. , Julia-Capmany I. Bueno , Aymami-Sanroma N. , Jimenez-Murcia S. , Jaurrieta N. , Forcano L. , Aguera Z. , Villarejo C. , Castejon V. , Menchon-Magrina J.M. , Fernandez-Aranda F.
Published: March 2009

Objective:

The objective of this study was to examine the experience and expression of anger in eating disorders (EDs) including bulimia nervosa purging (BN-P) and anorexia nervosa restrictive (AN-R) subtypes, impulsive disorders such as pathological gambling (PG), obsessive-compulsive disorder (OCD) and a non psychiatric healthy control group.

Method:

The sample comprised 80 female SODs individuals (20 BN-P, 21 AN-R, 19 PG, 21 TOC) consecutively admitted to our Department and 21 healthy controls. Patients were diagnosed according to DSM-IV-R criteria. We administered the State-Trait Anger Expression Inventory-2 (STAXI-2). in the control group, the GHQ-28 was also employed.

Results:

Compared to the healthy control group, elevated Trait Anger scores were revealed for the BN-P (p< .011) and OCD (p< .003) groups. in addition, the OCD group scored higher on this scale than the PG patients (p< .039). as regards to State Anger, higher scores were uncovered for the OCD patients than for the control group (p< .017). Finally, when Anger Expression was assessed, higher scores were found for the OCD (p< .001) and BN (p< .001) individuals when compared to healthy controls. in addition, compared to AN-R, the BN-P and OCD exhibited higher scores on this scale (p< .001 and p< .037, respectively).

Conclusions:

Our results indicate that, OCD and BN-P patients may have inadequate anger expressions and deficits in coping with anger and frustration when compared to a healthy control group. Conversely, no significant differences were revealed between AN-R, PG and controls. Finally, some differences across diagnoses were also obtained.
Benefit of Clomipramine-quetiapine Combination in Obsessive-compulsive Disorder with Non Response to Serotonin Selective Reuptake Inhibitors. Case Report
Authors: Marian G. , Ionescu B. , Ghinea D. , Alina N.
Published: March 2009

Background:

Patients who suffer of obsessive-compulsive disorder (OCD) experience obsessive thoughts and/or urges to engage in compulsive behaviours. the condition causes severe discomfort and, in many cases, leads to serious impairment in social and work-related functioning.

Although antipsychotic monotherapy has been associated with ineffectiveness and even increase of psychotic symptoms (especially in psychotic patients), antipsychotics as adjuvant to antidepressant medication have proven to be effective in several case series and pilot clinical trials.

The objective of this case was to evaluate the effectiveness of clomipramine-quetiapine combination in OCD refractory to serotonin selective reuptake inhibitors treatment patient.

Method:

23 years unemployed male was diagnosed with OCD after 1 year from onset and received 3 trials with serotonin selective reuptake inhibitors at therapeutical doses, without any improvement and even more with worsening of affective associated symptoms. We managed this case by using a tricyclic antidepressant (clomipramine up to 100 mg/day) with an atypical antipsychotic (quetiapine up to 200 mg/day). We employed the Yale-Brown Obsessive Compulsive Scale (Y-BOCS), Obsessive-Compulsive Checklist (OCC) and Hamilton Depression rating Scale (HDRS) at baseline, weekly for the first 2 months and monthly after (follow up 2 years).

Results:

Patient achieved a very fast and sustained improvement both in obsessive-compulsive and affective symptoms, which provided a very good social and work rehabilitation.

Conclusion:

Clomipramine-quetiapine combination may be a benefit for OCD refractory to serotonin selective reuptake inhibitors and a safe strategy.
Bradykinesia and Mental Slowness in Patients with Obsessive-compulsive Disorder
Authors: Pasquini M. , Fabbrini G. , Moretti G. , Berardelli I. , Mandarelli G. , Chiaie R. Delle , Leone C. , Biondi M. , Berardelli A.
Published: March 2009

Background:

Clinical and experimental findings suggest that Obsessive-Compulsive Disorder (OCD) is due to an abnormality of the cortico-striato-thalamo-cortical circuit. Bradykinesia and mental slowness can be present in patients with basal ganglia disorders affecting the cortico-striato-thalamo-cortical circuit. Aim of this study is to investigate whether bradykinesia and mental slowness are present in patients with OCD.

Methods:

Participants comprised 19 non-depressed anti-psychotic free patients with OCD.

Bradykinesia was assessed with the motor section of the Unified Parkinson's Disease Rating Scale (UPDRS). Mental slowness was investigated with the WAIS-R and the Y-BOCS. Psychiatric evaluation was performed with: SCID-I, Y-BOCS, HAMD, HAM-A, and MMPI. Cognitive functions were assessed with the WAIS-R.

Results:

Bradykinesia and mental slowness were present respectively in the 39% and 89% of the patients. Bradykinesia was positively correlated to Y-BOCS mental slowness score (rho=0.48, p< 0.05), and inversely related to the WAIS-R Performance IQ score (rho=-0.65, p< 0.01). Patients with bradykinesia scored significantly lower in the Similarities and Digit symbol coding WAIS-R subscales as compared to non-bradykinetic patients. in our sample pathological doubt was not associated with IQ measures nor with bradykinesia. Twelve out of 19 patients (63%) showed impairments in the nonverbal function scores.

Conclusions:

The novel findings of this study is that bradykinesia can be present in patients with OCD, and it is correlated with mental slowness and nonverbal performance impairment. These preliminary data support the notion that dysfunction of basal ganglia is possibly present in OCD patients.
Dissociation is Related to Self-directedness and Self-transcedence Character Traits in Obsessive-compulsive Disorder
Authors: Raszka M. , Prako J. , Kopřivová J.
Published: March 2009

Introduction:

The purpose of this study was to investigate the temperament and character patterns in patients with obsessive-compulsive disorder (OCD) and to determine whether any presupposed relationship between harm avoidance, self-directedness, self-transcedence scores and dissociation in patients with OCD is present.

Methods:

The study sample comprised of 43 patients with OCD (26 females) and 44 healthy controls (29 females). All subjects were assessed with the Temperament and Character Inventory (TCI), Beck Depression Inventory-II (BDI-II), and Beck Anxiety Inventory (BAI). Dissociation was quantified by the Dissociative Experiences Scale (DES). Obsessive-compulsive symptoms in OCD group were assessed with the Yale-Brown Obsessive-Compulsive Scale (Y-BOCS). Correlation, unpaired t-test with Bonferroni correction for seven comparisons, and multiple linear regression analyses were performed.

Results:

OCD patients had significantly higher scores of harm avoidance and self-directedness compared with healthy comparison subjects. Dissociative experiences were more frequent in OCD patients comparing with controls. DES scores had negative correlation with self-directedness and positively correlated with self-transcedence scores, as well as with BDI-II and BAI scores in OCD group. Multiple regression analyses revealed that the severity of depressive symptoms, self-directedness and self-transcedence scores predicted the DES score. There was no significant correlation between severity of OCD symptoms and patterns of temperament and character.

Conclusion:

Dissociation is associated with self-directedness and self-transcedence dimensions of the Temperament and Character Inventory in OCD subjects. It emphasize the importance of considering the influence of dissociation in further studies of personality factors in neuropsychiatric conditions.

This research was supported by grant MZ ČR IGA 9323-3/2007.
the Psychodynamic Aspects of Combined Psychotherapeutic and Psychopharmacological Treatment
Authors: Adomaitiene V. , Kulak A.
Published: March 2009

Scientific studies revealed that combined psychotherapeutic and psychopharmacological treatment may be more effective than psychotherapy or psychopharmacology separately. in clinical practice there is lack of integrity in psychological and medico-biological view. the artificial division of psychiatrists into psychopharmacologists and psychotherapists may be interpreted as the expression of competitive infant emotions that were not experienced through and were deferred.

During the course of psychotherapy the prescription of psychotropic drugs is based on the three main principals:

1.

combined therapy is more effective than psychotherapy alone;

2.

psychotherapists, who have no skills and knowledge in psychopharmacology, must be in contact with psychiatrists;

3.

psychotherapist must understand the subjective meaning of prescription of psychotropic drugs for his patient.

From the psychodynamic viewpoint, therapy is regulated based on a complex feeling shared and experienced by the patient and psychiatrist during the therapeutic process as well as an in-depth comprehension of psychological phenomena:

1.

the psychiatrist, who prescribed the medications, can become the object for intensive transference feelings;

2.

on the other hand the prescription of psychotropic drugs may be determined by powerful and not realized completely emotions (i.e. anger, anxiety, hopelessness, traumatic narcistic injury) of psychiatrist;

3.

the patient's resistance to the treatment, refuse to collaborate, denial of disease is intensive phenomenon in psychotherapy as well as in psychopharmacology and disturbs creation of safe therapeutic alliance.
the Effects of Locus Coeruleus Inactivation on i.v Self Administration of Morphine and Morphine Withdrawal Symptoms in Rats
Authors: Alijarahi A.
Published: March 2009

Biochemical, behavioral, and electrophysiologic studies indicate that activation of the noradrenergic cells in the Locus coeruleus (LC) play an important role in the symptoms of opiate withdrawal. There for in this study the effects of LC inactivation on self-administration of Morphine and on morphine withdrawal syndrome in rats has been investigated.

Male rats (250-300gr) were anaesthetized and implanted with silastic catheters inserted in to the right jugular vein. after 5 days animals were fitted and the external end of the catheter was connected with a syringe-driven pump, then were placed in the self-administration apparatus that had two lever (active, passive) for 2 h every day. Active lever switched on the infusion pump for 10 sec, injecting. 1ml of saline or saline containing 5 mg/ml of morphine (training period was 10days). LC was inactivated by (1ul) lidocaein (%2) five min befor training.

Animals were allowed to self administer morphine (1mg/kg per inf.) ten consecutive daily 2-h session. During all morphine self administration session lever pressing behavior was measured. Our results show that LC inactivation 5min before morphine self administration produced a significant decrease in the initiation of morphine self administration during all session. after the last test session morphine withdrawal symptom signs (MWS) precipitated by naloxone were measured. Our results show that most of MWS (but not all) were decreased by LC inactivation in comparison with morphine group.
Psychodrama and Neurosciences [P03-44]
Authors: Fonseca E.
Published: March 2009

In this work I try to combine Goldberg's findings in “The Executive Brain” about the biological and changing Ego accoording to the Body Image.

Antonio Damasio's Subjectivity (“Descartes’ Error”) that does not need spoken languaje, and the so called Kandel Principles.

Kandel, in his Proyect of the Human Brain, on the long run structural changes of the plastic neurons (Psicones), that appear as a result of treatments with psychochemicals as well as in Psychodramatic Learning with psychodrama's characteristics, that is a method that utilizes the Body.

I would like to explain how Psychodrama can be an integrant Psychotherapy that will bring a Human meaning to advances in neurosciences.
Treatment Options in Depression During the Postpartum
Authors: Frisch U. , Mikoteit T. , Stieglitz R.-D. , Riecher-Rössler A.
Published: March 2009

Objective:

A group therapy specifically adjusted to the needs of depressed mothers was developed in Basel and was compared to individual therapy-as-usual.

Method:

The group program which consisted of 12 group and 1 couple session was administered in 5 consecutive groups to 31 participants. the main therapeutic method used was cognitive behavioral therapy (CBT). Antidepressants were prescribed if necessary. in a second step a control group of 21 participants receiving individual therapy-as-usual has now been evaluated and compared to the specific treatment group in a pre-post-design using Beck-Depression-Inventory (BDI), Symptom-Check-List (SCL-90-R) and other scales. Symptom reduction and other outcome variables were determined. in a further step demographic characteristics of responders and non-responders were analysed.

Results:

Both, treatment group and control group showed significant improvement of depression, there was no significant difference between the two treatment strategies. However differences were seen in acceptance, satisfaction with treatment as well as in terms of treatment costs. There was a trend for more frequent antidepressant use in the control group. Also multipara showed a significantly better outcome in the treatment group than single mothers.

Conclusions:

This manualized group therapy proved to be effective for mothers with depression. It could be an alternative treatment to avoid antidepressants during pregnancy and postpartum and might be less stigmatizing.
Aggressivity and Atmosphere in a General Hospital Psychiatric Emergency Service
Authors: Furlan P.M. , Picci R.L.
Published: March 2009

This research identifies possible indicators of risk of aggressivity in a general hospital psychiatric ward going beyond the analysis of the episode in itself. We suggest that behaviour can be strongly conditioned by the milieu (which is organised in a similar way to other hospital wards) especially since we have found that violence is not correlated with diagnosis. We have used the Overt Aggressivity Scale and our own Ward Atmosphere Evaluation Scale (currently under validation) in order to identify those features which increase or reduce the risk of violent episodes. Factorial analysis and the study of risk probability have enabled us to create a 12 point scale (from red alert to yellow calm) of the probability/possibility of violent episodes. the scale allows psychiatric staff to assess the risk of aggressivity and consequently to modify the management and organisation of the ward if necessary (including emotional and psychological attitudes of the staff).
the Clinical Psychiatry of the Stalking Syndrome: Investigation of an Innovative Treatment Model
Authors: Andreoli A. , Lorillard S. , Ohlendorf P. , Prada P.
Published: March 2009

Objective:

To describe an innovative model of emergency intervention with patients enduring severe stalking.

Method:

Catamnestic investigation of the institutional, psychopathological, clinical, legal and therapeutic aspects of severe stalking syndromes among 20 patients referred to emergency room with severe stalking syndromes.

Results:

A well structured model of multimodal psychiatric intervention is described and its results.

Comment: Severe stalking is a common issue in emergency psychiatry. These patients should be better detected and may benefit from the adequate psychiatric treatment. Further studies should investigate this innovative intervention in randomized clinical trials.
Agression in a Dynamically Oriented Crisis Unit. Management and Evolution
Authors: Guimón J. , Mauruottolo C. , Moneo F. , Fernandez J.A. , Boyra A.
Published: March 2009

Acute episodes are treated in AMSA psychiatric services in a emergency service including a call center, domicilliary visits, a crisis unit, three short-term day hospitals and a short-term stay unit in a general hospital. an Intensive Brief Dynamic Group Therapy is offered in the units allowing for a decreased appearance of self and hetero aggression in patients both during the crisis and after one year as shown in a follow-up study.
Effects of Oros-mph on Adult Patients with ADHD - Results of the German Subpopulation of the European Lamda Trial (42603ATT3002/-3004)
Authors: Philipsen A. , Sobanski E. , Roesler M. , Gerwe M. , Trott G.E.
Published: March 2009

Although well-studied in children, MPH is not approved for the treatment of ADHD in adults in Germany. We report the findings from the German subgroup of the European LAMDA trial.

Patients (18-65 years) with ADHD (DSM-IV) were treated in this 5-week double-blind, randomized, placebo-controlled, fixed dose trial with 18, 36, 72-mg/day OROS-MPH or placebo. Eligible patients continued into the subsequent 7-week open-label extension-phase starting with 18 mg/day OROS-MPH.

108 patients entered the double-blind phase, which was completed by 89.9%. the open-label phase was completed by 92.6%. Concerning CAARS:O-SV total scores (LOCF), mean changes from baseline to double-blind endpoint in were -9.6±10.6 (18-mg), -13.3±10.3 (36-mg) and -12.7±10.7 (72-mg) vs. -8.2±8.4 (placebo group). Mean changes from start of open-label phase to endpoint were -17.5 in patients who received OROS-MPH and -16.5, who received placebo in double-blind phase. Mean Q-LES-Q-SF scores (health-related QoL) improved from baseline in all treatment groups in the double-blind phase, and continued to improve in the open-label phase. AE occurred in 77.4% (18-mg), 85.7% (36-mg), 77.4% (72-mg) and 65.5% (placebo group). Most common AE were decreased appetite, headache, nasopharyngitits and weight decreased. No statistically significant changes in mean blood pressure were observed in the double-blind or open-label phases. Mean pulse increased by 7.0 bpm (72-mg group) at week 5 (p=0.025) and by 7.9 bpm in all patients at week 12 (p< 0.001).

This analysis of the German subpopulation is in line with results of the full study, showing that OROS-MPH is effective and well tolerated in adults with ADHD.
A Study on Personal Characteristics of the Freshman and Graduates of in Five Different Universities of Shanxi Province of China
Authors: Han B. , Tang R. , Xu M. , Zhao S.
Published: March 2009

Aims:

To study on Personal Characteristics of the freshman and graduates in five different universities.

Methods:

The 1022 freshman and 956 graduates from five different universities were tested with the Eysenck Personality Questiornaire (EPQ). They came from one was general university, two technological universities, one is medical university, one is agricultural university.

Results:

Distribution of freshman and graduates personal characteristics in various sexes and universities is different. There are 19% and 12% of freshman with some psychological problem were P type and N type respectively according to neuroticism scale of EPQ, 64% of that were unstable temperament; 31% of the freshman who were unstable temperament and 25% were mental health status was extroversion disposition. But in graduates are 42% and 34% ( P type and N type) respectively according to neuroticism scale of EPQ. Unstable temperament is 58% and mental health status was extroversion disposition is 39%.

Conclusion:

The freshman and graduates psychological health of Shanxi Province of China is poor and should be paid more attention. the psychological state is related to different universities. the freshman and graduates are associated with personal characteristics, unstable professions, emotional trouble and passive attitude to the value and so on.
A Study on Mental Health Status of the Freshman and Graduates of in Five Universities of Shanxi Province of China
Authors: Han B. , Tang R. , Zhao S. , Xu M.
Published: March 2009

Aims:

To study on mental health status of the freshman and graduates in five different universities.

Methods:

The 1022 freshman and 956 college graduates from five different universities were tested with the Symptom Checklist 90 (SCL-90). They came from one was general university, two technological universities, one is medical university, one is agricultural university.

Results:

All of the freshman and college graduates’ mental health status is inferior to the contemporaries; there are about 8.5% freshman and 11.4% graduates who have psychological problems. the SCL-90 factor scores of liberal arts students are higher than those of the science in freshman and graduates. There is significant difference between two groups (P< 0.05~P< 0.01). among the five different universities, freshman is same, but in graduates of five different universities, medical graduates have a better mental health status than other college's students do.

Conclusion:

It is necessary that positive educating mental health status to college students’ and trained always-cheerful character and stable mood so level of mental health status of college freshman and graduates will be improved.