bluuebunny/crossref_metadata_2025 huggingface dataset:
2697 – Reduced Glucose Metabolism in Left Lateral Parietal Cortex of a Posttraumatic Stress Disorder Patient: A Case Report
Authors: Garip B. , Ozdemir B.
Published: July 2013

Introduction:

Individuals with posttraumatic stress disorder (PTSD) often have symptoms of re-experiencing traumatic life events, recurring nightmares, hyper arousal and insomnia. Evidence is increasing that stress-related hyperglutamatergic states may contribute to dissociative symptoms and neurodegeneration in temporo-parietal cortical areas. Cognitive performance is also be effected in some of the traumatized patients. We are going to present a PTSD case who demonstrates significant memory impairment.

Case:

38 years-old, male patient. He had experienced combat related traumatic life events June in 2009 and diagnosed with PTSD according to DSM-IV criteria. Disturbance in short time memory, perception, attention, concentration deficiency was observed in the clinical interview. As a result of cognitive assessment, calculating and remembering subtests were lower than the others so it could be associated with cognitive impairment. To evaluate the organic brain pathology CT was applied and it was within normal limits. After than PET was conducted to reveal the metabolic abnormalities. Left parietal cortical global hypo-metabolic activity, global hypometabolism in temporal cortex and regional hypometabolism in medial parietal cortical regions was demonstrated. He has been treated and fallowed up for two years and provided significant improvement in PTSD symptoms but cognitive impairment was still showed constancy.

Discussion:

It is well known that left parietal and temporal cortical region would be associated with impaired memory performance. The areas that we have found at PET are known to be involved in episodic memory consolidation and retrieval. Comorbid PTSD and hypometabolism in lateral cortical region has not been well documented in the literature.
2699 – Glutathione Levels in Patients with Chronic and Fist-Episode Schizophrenia and Association with Neurological Soft Signs
Authors: Raffa M. , Mhalla A. , Slama H. , Fendri C. , Kerkeni A. , Mechri A.
Published: July 2013

Introduction:

Recent studies have suggested that the deficit of glutathione (GSH), a major antioxidant, seems to play a role in the pathophysiology of schizophrenia. Moreover, oxidative stress may contribute to the development of neurological abnormalities, including tardive dyskinesia and parkinsonism symptoms.

Objectives:

To determine plasma glutathione levels and to explore their association with neurological soft signs (NSS) in patients with chronic and first-episode schizophrenia.

Methods:

A case-control study carried-out on three groups: sixty clinically stable patients with chronic schizophrenia, twentythree patients with first-episode schizophrenia and thirty matched healthy controls. Glutathione levels: total (GSHt), reduced (GSHr) and oxidized glutathione (GSSG) were determined by spectrophotometry. NSS were assessed in three groups by a standardized neurological examination (Krebs et al., 2000).

Results:

Plasmatic GSHt and GSHr levels were significantly decreased in patients with chronic and first-episode schizophrenia. All NSS scores were significantly higher in two groups of patients compared to controls. No association was found between NSS scores and glutathione levels in patients with chronic schizophrenia. However, in patients with firstepisode, a negative correlation was found between GSHt levels and involuntary movement sub-score (r= -0.62, p=0.008).

Conclusion:

These results suggest that GSH deficit is not related to the stage of disease and may be an important indirect biomarker of oxidative stress in schizophrenia. The association between low GSHt level as a marker of oxidative stress and involuntary movements could suggest that oxidative stress may contribute to the brain damage which leads to an increased prevalence of these NSS.
2700 – Glutathione Levels and Schizotypy Scores in Unaffected First-Degree Relatives of Patients with Schizophrenia
Authors: Raffa M. , Fendri C. , Ben Othmane L. , Slama H. , Kerkeni A. , Mechri A.
Published: July 2013

Introduction:

Several studies have shown a glutathione (GSH) deficit in patients with schizophrenia. It may in part arise from a genetically compromised synthesis of GSH, the major cellular antioxidant and redox-regulator. First-degree relatives of patients with schizophrenia share many susceptibility genes of this disease.

Objectives:

The objectives of this study were to determine plasma glutathione levels in patients with schizophrenia and their unaffected first-degree relatives of compared to healthy controls and to examine the correlation between glutathione levels and schizotypy scores in unaffected relatives.

Methods:

We included 60 patients with schizophrenia, 33 of their unaffected siblings and 30 healthy controls with no family psychiatric history. The blood glutathione levels: total (GSHt), reduced (GSHr), and oxidized glutathione (GSSG) were measured by spectrophotometry. Schizotypy scores were assessed by the schizotypal personality questionnaire (SPQ).

Results:

GSHt and GSHr were significantly lower in patients than in controls, whereas there was no difference in glutathione levels between unaffected relatives and healthy controls. Moreover, no correlation was found between glutathione levels and schizotypy scores in unaffected relatives of patients with schizophrenia.

Conclusions:

These results reveal that unaffected relatives of patients with schizophrenia didn’t have a GSH deficit. in the same group, no correlation was found between glutathione levels and schizotypy scores which considered a vulnerability marker for schizophrenia. These findings disagree with our hypothesis that GSH deficit could be a biological marker of vulnerability to schizophrenia. However, further studies are necessary to explore this hypothesis.
2701 – Negative Association Between Neurological Soft Signs and Cannabis Use in Tunisian Patients with First-Episode Psychosis
Authors: Mhalla A. , Gassab L. , Gaha L. , Mechri A.
Published: July 2013

Introduction:

Neurological soft signs (NSS) are minor or subtle neurological signs indicating non-specific cerebral dysfunction. They have been conceptualized as neurodevelopmental markers that mediate the biological propensity for the development of psychosis. Their interaction with the environmental factors such as cannabis use remains little studied.

Objective:

To study the relationship between the NSS and the use of cannabis which is considered an environmental risk factor of psychotic disorder.

Methods:

Sixty one in-patients (fifty three men and eight women; mean age: 28.9 ± 9.4 years) with a first-episode non affective psychosis according with DSM-IV were recruited. Neurological evaluations were carried-out by using the NSS scale of Krebs et al. (2000). We ascertained the use of cannabis with the cannabis subsection, included within the section of substance use, in the Composite International Diagnostic Interview (CIDI).

Results:

The prevalence of cannabis use was 16.4%. The mean NSS total score was 15.3 ± 6.7. Significant lower NSS total score was found in cannabis users: 11.2 ± 5.6 versus 16.0 ± 6.7 (p=0.04). There was also an inverse but not significant relation between the use of cannabis and the motor coordination and the involuntary movements sub-scores.

Conclusions:

Similar results have been reported in patients with schizophrenia and first-episode psychosis suggesting the existence of fewer NSS in the cannabis user patients. The cannabis could enhance the effects of genetic risk factors for psychosis. More work in the area of genetic-environment interactions in predicting psychosis is necessary.
2709 – Impact of Attention-Deficit Hyperactivity Disorder “ADHD” Across Lifespan on Substance Use Disorders “SUD”
Authors: Abdelkarim A. , Salama H. , Abdel Latif S. , Abou El Magd O.
Published: July 2013

Introduction:

Attention-deficit hyperactivity disorder (ADHD) affects not only children but persists for up to 4.4% in the general population. Comorbidity is common among adults with ADHD, including substance abuse.

Objectives:

Assessment of impact of both childhood and adult ADHD on SUD.

Aim:

The aim of this study was to estimate prevalence rate of past history of childhood ADHD and current adult ADHD among substance use inpatients and to compare between the two groups regarding onset and severity of substance use disorder.

Methods:

This cross-sectional comparative study was conducted in addiction treatment center at El Maamoura psychiatric hospital. One hundred and two adult males were assessed using Arabic version of Wender Utah Rating Scale (WURS) for retrospective assessment of symptoms of childhood ADHD. Arabic version of Adult ADHD Self-Report Scale (ASRS-v1.1) Symptom Checklist was used to screen for adult ADHD. DSM IV TR criteria were used for final diagnosis.

Results:

Sixty Four patients of the total studied sample had past history of childhood ADHD. of which, only 36 patients fulfilled the DSM - IV TR criteria for adult ADHD. Presence of adult ADHD was associated with an earlier mean age of onset of SUD (13.22 vs. 14.86 years), larger number of hospital admissions, (4.21 vs. 6.83 times) and a shorter mean period of abstinence (124.53 vs. 271.50 days).

Conclusions:

In comparison to childhood ADHD, presence of adult ADHD was associated with a more complicated course of substance use disorders and poorer outcome.
2710 – Gender Differences in the Psychopathology of Emerging Psychosis
Authors: González-Rodríguez A. , Studerus E. , Spitz A. , Rapp C. , Bugra H. , Aston J. , Borgwardt S. , Riecher-Rössler A.
Published: July 2013

Introduction:

Gender differences in psychopathological symptoms have frequently been found in chronic schizophrenia and first-episode psychosis (FEP) patients. However, many of the existing studies suffer from methodological problems. Furthermore, very few studies have investigated gender differences in at-risk mental state (ARMS) individuals.

Aims:

To investigate whether male and female ARMS and FEP patients differ in self- and observer-rated psychopathological symptoms when adjusted for potential confounders.

Methods:

Psychopathological symptoms were assessed in 117 ARMS and 87 FEP patients by two observer-rated scales:the Brief Psychiatric Rating Scale (BPRS) and the Scale for the Assessment of Negative Symptoms (SANS), and one self-report scale,the Frankfurt Complaint Questionnaire (FCQ). Gender differences were investigated by applying Analyses of Variance using the BPRS, SANS and FCQ subscales as dependent variables and, group and sex as between-subject factors. Furthermore, Analyses of Covariance were conducted by including age, antipsychotic, antidepressant and cannabis use as covariates.

Results:

No significant gender × patient group interactions were found, suggesting that gender effects did not differ between patient groups. Women showed higher scores in positive psychotic symptoms (BPRS Psychosis/Thought Disturbance) while men had higher scores in negative symptoms (BPRS negative symptoms, SANS total score, and subscales Affective Flattening, Avolition-Apathy and Asociality-Anhedonia). However, the differences did not withstand correction for multiple testing. Furthermore, these results did not change when corrected for potential confounders.

Conclusions:

Our findings suggest that male and female ARMS and FEP patients do neither differ in self-report nor in observer-rated psychopathological symptoms when corrected for multiple testing and potential confounders.
2726 – Study of The Personal and Social Performance in Patients with Schizophrenia
Authors: Contreras Barbas M. , Megia López P.
Published: July 2013

Introduction:

There are several studies evaluating the functioning in patients with schizophrenia. Nowadays, there are new tools and therapeutic alternatives to be considered.

Objectives:

Our hypothesis is administration of Depot antipsychotic improve patient adherence to treatment which reflect better social and personal performance, higher satisfaction with medication and less severity of the mental illness.

Methods:

Sample of 68 patients with schizophrenia: 32 with Depot and 36 with oral antipsychotic.Scales: PSP assesses global function in terms of four functional domains: work/study, personal/social relationship, self care and disturbing/aggressive behavior. Other scales applied: CGI and MSQ.

Results:

PSP: Self care (t (67)=6.092,Pa=0.01),Personal Relationships (t(67)=3.368,Pa=0.05), Social Relationship(t(67)=5.0167,Pa=0.01) and disturbing behavior(t(67)=1.263,Pa>0.05).

Conclusions:

Better response to the four areas studied in patients treated with Depot vs. patients treated with oral medication.The Global score of PSP in oral medication group was 68 which means barriers indentified by anyone but do not interfere with the role of the subject. and in the group of Depot the global score was 78 that mean mild difficulties indentified by relatives or close people to patient.
2727 – Tianeptin Abuse: A Case Report
Authors: Lapsekili N.
Published: July 2013

Introduction:

Very few cases have been reported in connection with excessive consumption of tianeptine. Tianeptine use can be a risk in terms of high doses especially for addicted patients.

Case:

A 28 year-old man administered after 5-years of medical prescription of the recommended dosage of 12.5 mg 2 times daily of oral tianeptine for an anxiety disorder. The patient spontaneously increased the dosage which after two months reached 120 tablets per day. No severe toxic effects were observed. As adverse effects, the patient, in the beginning of this high treatment period suffered from nausea, vomiting, abdominal pain, anorexia with weight loss, constipation. These side effects progressively disappeared. The biological tolerance was excellent, and hepatic parameters were not affected. The patient experienced and seek a psychostimulant effect for five-years but after his family realized that he was using 2 boxes of drug every day he was hospitalized for treatment.

Conclusion:

Tianeptine is an antidepressant agent like the selective serotonin reuptake inhibitors (SSRIs) and tricyclic antidepressants. The anxiolytic efficacy of tianeptine is similar to that of tricyclic and tetracyclic antidepressants. But in contrast to SSRIs and tricyclic agents, systemic administration of tianeptine modestly enhanced the mesolimbic release of dopamine (DA). It is told that abuse or dependence of tianeptine is an important issue in patients who have histories of alcohol or substance abuse. However, as in our case, the use of tianeptine in patients without a history of substance abuse might be also a risk for addiction.
2732 – Persistence Or Change? Focusing on the Relation Between Suicide Methods of Last Attempted and of Completed Suicide
Authors: Paraschakis A. , Michopoulos I. , Christodoulou C. , Koutsaftis F. , Lykouras L. , Douzenis A.
Published: July 2013

Introduction:

Research on suicide method substitution between last attempted and completed suicide is scarce (five studies).

Objectives:

The results are conflicting (three studies report persistence and two studies report switch).

Aim:

To investigate this topic studying a sample of suicide victims from Greece.

Methods:

We studied all recorded cases of completed suicide of the period November 2007-October 2009 in Athens Department of Forensic Medicine. We performed phone interviews with relatives of the deceased focusing, among other topics, on the characteristics of prior attempts.

Results:

335 individuals were recorded as suicide victims: 250 men (74.7%) & 85 women (35.3%). Interviews were conducted with the relatives of 246 victims: 24% had history of prior attempts (59 cases), 39 men (66.1%) & 20 women (33.9%). Most frequent last attempted suicide methods were: self-poisoning (57.6%), jumping from a height (20.3%), wrist-cutting (15.3%) & hanging (6.8%). 74.6% of the attempters became completers using a different method (p=0.016). Individuals with previous attempt by self-poisoning or wrist-cutting died by hanging or jumping while attempters by hanging or jumping became completers primarily by the same methods.

Conclusion:

Most of the suicide completers had never been attempters in the past. Those who had attempted with low lethality methods- committed suicide choosing a different, more lethal method. Restrictions in the availability of lethal means may result in more surviving attempters while some suicides could also be prevented because a particularly lethal method is not in hand.
2734 – Is it Worse with Time in Chronic Haemodialysis?
Authors: Roventa C. , Poenar C. , Ciocalteu A.
Published: July 2013

Introduction:

Depression represent an important and predictable complication in chronic haemodialysis.

Objectives:

The prevalence of depression, QoL indicators, correlations between number of years of hemodialysis, depression and quality of life.

Aims:

To determine if higher depressive levels are correlated with years spent on haemodialysis.

Methods:

We used Beck questionnaire two times, one at the beginning of the year, and one at the end for 102 patients, excluding diabetes, who were undergoing hemodialysis three times a week, for 4 hours and SF 36 questionnaire. We considered these values for depression: Normal: 0-10, Mild: 11-15, Moderate: 16-23, Severe: 24-63 according to Romanian Guidelines in Nephrology.

Results:

98 pacients answered to the Beck questionnaire. Years of haemodialysis: min=0.25, max=18, average=5.7, standard deviation= 4.37 (n=102). SF 36 has close values distributed between the intervals 80-100, 60-80, < 60%. The linear correlation between average depression and years of hemodialysis is very, very weak, square of the coefficient of regression is 0.00- (by the linear model we can explain < 0.1% of the dates) and also between SF36 total and years of hemodialysis:square of the coefficient of regression is 0.04- (by the linear model we can explain 4% of the dates). We followed other models (logaritmic, polinomial, exponential), for both correlations, but we couldn’t notice better results.

Conclusions:

The study proved high levels of mild depression, lack of linear correlation between years of haemodialysis, depression and QoL indicators. Although this, there is an influence of time spent in haemodialysis and QoL.
2738 – Reliability and Validity of the Chinese Translation of Insomnia Severity Index (C-ISI) in Chinese Patients with Insomnia
Authors: Badiee Aval Baghyahi S. , Gao Y. , Bahrami Taghanaki H.R. , Badiee Aval M.
Published: July 2013

Introduction:

The Insomnia Severity Index ISI is a Questionnaire to screen insomnia in clinics;so,it has been translated to many languages.

Objectives:

To determine the Reliability and validity of the Chinese Translation of Insomnia Severity Index(C-ISI) in patients with Insomnia and compare it with Chinese version of Pittsburgh Sleep Quality Index(C-PSQI).

Aims:

To show the Reliability and validity of C-ISI for using it in chinese speakers.

Method:

English version ISI was translated into Chinese base on standard guidelines then Chinese version was filled in 83 patients with insomnia as a clinical group and 45 persons without sleep complain as the control group by themselves in Neuropsychiatery Department of DongzhiMen hospital. For finding Test-Retest reliability they refilled ISI questionnaire 2 weeks later.

Results:

Cronbach-α coefficient of C-ISI for the clinical group, control group and both of them was 0.72, 0.75 and 0.91 respectively. The C-ISI component and total scores in test were significantly correlated with their related components and total scores in re-test (P < 0.05). Mean Ranks for All C-ISI components, total score were significantly higher in clinical group than control group that presents low sleep quality in clinical group. There are Significant correlations between C-ISI component and total scores and C-PSQI components and Total scores in related Items.

Conclusions:

C-ISI has acceptable reliability and good sensitivity for assessing insomnia patients ;besides,C-ISI can evaluate the insomnia patients similar to the PSQI-C so it can be used as a good scale to measure sleep quality in Chinese speakers.
2741 – Clinical Investigation of Serum Trace Elements, Antioxidants and Immunoglobulins in Generalized Anxiety Disorder Patients in Bangladesh
Authors: Islam M.R. , Bin Sayeed M.S. , Ahmed M.U. , Hasnat A.
Published: July 2013

The purpose of the study was to determine the serum concentration of trace elements, antioxidants and immunoglobulins in generalized anxiety disorder (GAD) patients and compare those values of healthy volunteers matched by age, sex and socioeconomic conditions. 50 GAD patients and 51 healthy volunteers were recruited. Socio-economic data revealed that most of the patients are middle aged and literate. Patients were recruited from Bangabandhu Sheikh Mujib Medical University by random sampling diagnosed by trained psychiatrist. 4 ml of venous blood was aspirated from the subjects and controls. Serum trace elements (Zn, Cu, Mn, Fe, Ca, Mg) were determined by flame atomic absorption spectroscopy. Serum retinol and α- tocopherol were determined using RP-HPLC method, whereas serum vitamin-C was estimated by UV spectrophotometry. Immunoglobulins were determined by turbidimetric method using immunoglobulin kit. Data were analyzed by independent ttest using SPSS. The concentration of Zn decreased significantly (p< 0.05), whereas concentration of Cu, Mn and Fe increased significantly (p< 0.05) in GAD patients. Serum α-tocopherol decreased significantly (p< 0.05) and ascorbic acid increased significantly (p< 0.05) and serum retinol decreased non-significantly (p> 0.05). There was significant(p< 0.05) increase in serum IgM level, but the increase in serum IgA and IgG level were non-significant (p>0.05). From the study it is found that serum concentrations of Cu, Fe, Mn, ascorbic acid and IgM were increased significantly and those of Zn and α- tocopherol decreased significantly in compare to control. Moreover this study may provide prognostic tool for the diagnosis and treatment of this disease.
2745 – Socio-Demographic Characteristics of Adolescents with a First Psychotic Episode
Authors: Ellini S. , Cherif W. , Chennoufi L. , Jomli R. , Cheour M.
Published: July 2013

Introduction:

Time of profound change, adolescence is a critical period of development and transition between childhood and adulthood. Age life source of conflict, opposition and misunderstanding highlights some psychological fragility of life and the subject is likely to develop psychiatric disorders including psychosis.

Objectives:

Meeting the demographic characteristics of a population of adolescents who had been hospitalized for a first episode of psychosis.

Materials and methods:

Retrospective and descriptive performed on patient records adolescents whose ages are between 16 and 19 years hospitalized for a first episode of psychosis in psychiatric wards of Hospital Razi between January 2004 and June 2008. The socio-demographic data were collected using a pre-established form and analyzed using SPSS software version 11.

Results:

Our series consisted of 27 boys and 13 girls with a sex ratio was 2.07. The average age of our sample was 17.9 years. About 65% of their patients were students, 20% held irregular work and 15% were unemployed. For socio-economic conditions, they were poor in 60% of cases, moderate in 35% of cases and good in only 5%.

Conclusions:

Despite the study of socio-demographic characteristics of this population, the onset of first episode psychosis in adolescents has still practical difficulties in preventing the occurrence of this disorder remains uncertain outcome which the clinician cannot predict how scalable.
2746 – Entry Into Schizophrenia in Adolescence: Clinical and Therapeutic Features
Authors: Ellini S. , Cherif W. , Chennoufi L. , Jomli R. , Cheour M.
Published: July 2013

Introduction:

Time of profound change, adolescencethis is a period of development where a psychodynamic point of view, can be activated archaic defense mechanisms to meet psychological difficulties that may be encountered adolescents. Once the defense mechanisms fail, the evolution towards schizophrenia can be.

Objectives:

Study of clinical and therapeutic aspects of first psychotic episodes occurring in adolescence, having evolved later to schizophrenia.

Materials and methods:

Descriptive retrospective study on 40 subjects whose ages are between 16 and 19 years admitted to our psychiatric institution for entry into schizophrenia. The information was collected through a pre-established form. Data analysis was performed by SPSS software version 11.

Results:

71.4% of subjects who received the initial diagnosis of schizophrenia were male, family history of schizophrenia and mood disorders were found with respective rates of 19% and 14.2%. The average time of treatment was 13.5 months. The first problems identified by families were: sleep disturbance, irritability, aggressiveness tend to hetero, difficulties in attention and concentration, exaggeration of social isolation and somatic complaints. Psychotic symptoms were found most emotional blunting, delusions and auditory hallucinations. After 2 years of follow up, 38% of subjects who carried the diagnosis of schizophrenia were reinstated at least once, and only 28.5% of subjects had continued their studies.

Conclusions:

Schizophrenia is the major fear facing psychotic disorders occurring in adolescence. and it is important to note the diagnostic difficulties and the frequent confusion between schizophrenia and bipolar disorder in adolescence. Great care practitioner is required before any diagnostic decision.
2747 – The Psychiatric Expertise in Tunisia: Socio-Demographic Characteristics of 120 Appraised Persons
Authors: Ellini S. , Cherif W. , Chennoufi L. , Jomli R. , Ridha R.
Published: July 2013

Introduction:

The psychiatric expertise, medical discipline in the legal system, is an act in which the expert must establish the existence of mental illness at the time of the offense and the latter results.

Objective:

Describe the socio-demographic profile of the subjects appraised in order to help to improve and clarify the mission of expertise.

Materials and methods:

Retrospective study, involving 120 subjects examined records within a forensic psychiatric assessment over a period ranging from January 2004 to May 2009. Socio-demographic data collected were processed using Microsoft Excel. Our results were compared with those of literature.

Results:

Our series consisted of 113 men and 7 women representing 94.1% and 5.9% (sex ratio F / M = 1/16). The average age was 34 years 2 months with a peak at 20-29 years (41% of cases). A solitary life characterized 70.0% of the subjects examined, with a predominance of single (64.2%). Educational level was relatively low and the employment situation was precarious for the majority of subjects with a frequency up to 35% without occupation.

Conclusion:

At the end of this study, we find that the socio-demographic and clinical profile of subjects appraised consistent with conventio.
2748 – Affective Temperaments Among Patients with Familial Bipolar I Disorder and their Unaffected First-Degree Relatives
Authors: Mechri A. , Ben Haouala S. , Mrad A. , Gassab L.
Published: July 2013

Introduction:

Given the concept of bipolar spectrum which extends across the family, healthy relatives of bipolar patients, which are a population at high risk for developing mood disorders, may have temperamental deregulations.

Objective:

To compare the mean scores of affective temperaments among patients with familial bipolar I disorder and their unaffected first-degree relatives.

Methods:

This was a cross-sectional study, concerning 50 families of bipolar I disorder which have at least two patients with bipolar I disorder (DSM-IV-TR). We have included 80 clinically recovered patients with bipolar I disorder and 120 unaffected first-degree relatives. The affective temperaments were assessed by Tunisian version of TEMPS-A. Dominant affective temperament is the temperament witch score was more than 2 SD of mean scores.

Results:

Mean scores of cyclothymic and hyperthymic temperaments were higher in bipolar I patients than in their healthy relatives. The difference was significant for only hyperthymic temperament (p=0.038) but it was not significant after adjustment for age, sex and school level. The rate of dominant affective temperament was not differed between bipolar I patients (26.3%) and their healthy relatives (20%). Investigating the role of family, we showed a significant association with depressive (p< 10-3), cyclothymic (p=10-3), irritable (p=0.023) and anxious (p=0.003) temperaments.

Conclusions:

Our findings suggest that patient with family bipolar I disorder and their unaffected first-degree relatives had a temperamental deregulation which confirms the concept that affective temperaments are a potential phenotype of bipolar condition.
2750 – Folie a Deux- Case Presentation and Discussion
Authors: Luther R. , Roy B.
Published: July 2013

Introduction:

“Folie à deux” is also known in the ICD-10 as Induced Delusional Disorder. A subtype is “folie imposee” where the primary individual holds delusional beliefs shared by a secondary individual. When the delusional beliefs of the primary individual cease it is observed that the beliefs of the secondary individual also disappear. Mr A was a 36 year old Caucasian male presenting with an array of psychotic symptoms centred on a task which involved finding an energy source at the centre of the earth. Mrs A was highly resistant to his treatment and further investigation revealed a case of folie à deux.

Objectives:

To demonstrate the phenomenon of folie à deux.

Methods:

Individual and combined interviews were held with Mr and Mrs A where the psychotic symptoms were discussed. A comprehensive study of Mr A's past and current psychopathology was also undertaken.

Results:

Mrs A shared the delusions of her partner and was strongly against treatment as it would nullify his delusions rendering him incapable of completing his task. Once treatment was facilitated, Mr A experienced a drop from his unusually high levels of energy which reflected an equal and immediate drop in energy levels of his partner which led her to further discourage him from medication. When Mr A's delusional beliefs lifted, it was apparent that his partner no longer held the same delusional beliefs.

Conclusions:

We concluded this case fulfilled ICD-10 and DSM IV criteria for a shared delusional disorder (folie à deux) with specific sub-type “folie imposee”.
2751 – Factors Influencing the Selection of Antidepressant by Pakistani Psychiatrists
Authors: Rahman R.U. , Siddiqi N. , Ansari M. , Hussain N.
Published: July 2013

Objective:

To examine the factors that influence mental health professional's prescription of antidepressant.

Background:

There are many studies on factors affecting decision of mental health professionals regarding selection of antidepressant. The clinical experience of the developing countries is different from that of the developed countries where nonpharmacological attributes of a drug like affordability and availability play a greater role in prescription of drug.

Methods:

A semi-structured questionnaire was used to investigate which antidepressant was the preferred choice of psychiatrists and nurses and factors which influenced their decision making. Ethical permissions were obtained from local research and ethics committees.

Results:

The results of this study show that health professional would consider efficacy (64%) and tolerability (24%) to be the most important factors in choice of anti psychotics for themselves while efficacy (56%) and cost (24%) would be considered important factor while prescribing drugs to the patient.

Conclusions:

Beside efficacy other factors like cost & affordability found to be the important factor in influencing the decision of the psychiatrists.
2754 – Title: A Study to Assess the Stress, Coping Strategies and Domestic Violence in Wives of Alcohol Dependent Individuals
Authors: Nanjundaswamy M. , Sreedevi P.A. , Gangadharaiah H.M. , Viswanath B. , Benegal V.
Published: July 2013

Introduction:

Divorce rates are high among wives of alcoholics and the most frequently identified cause is domestic strife in the form of harassment, torture or beating from the husband and or in-laws. However, there is only limited literature in this regard.

Aims and objectives:

To study the stress, various coping styles and domestic violence among the wives of alcohol dependent individuals, who are admitted to the de-addiction centre of a tertiary care psychiatric centre in India.

Methods:

An exploratory descriptive design was adopted. Wives of 75 alcohol dependent individuals, admitted in the deaddiction centre of National Institute of Mental Health and Neuro Sciences, Bangalore were selected. Data was collected by personal interviews with all 75 wives using socio-demographic information schedule, Perceived Stress Scale, Coping with Drinking Questionnaire, and Domestic Violence Questionnaire.

Results:

Wives of alcohol dependent patients had high levels of perceived stress. Avoidance, discord, fearful withdrawal and sexual withdrawal were the most common coping components identified. Domestic violence was experienced by 90% women, mostly intellectual (69%), emotional (59%), social (58%), physical (47%), economic (42%) and sexual violence (27%). Domestic violence was found to increase the stress and influences the coping styles of these women.

Conclusions:

Domestic violence is a major problem in wives of alcoholics. Routine screening for domestic violence is needed during the intake of alcoholic for substance abuse treatment so that appropriate interventions can be planned. There is a need for substance abuse treatment providers to be trained on the issue of domestic violence.
2758 – Personality and Treatment Dropout in Depressed Outpatients
Authors: Ramos-Grille I. , Gomà-Freixanet M. , Enero C.G. , Cardona S.S. , Aragay N.V. , Guillamat R.T.
Published: July 2013

Introduction:

Premature termination is common among patients treated for depression with either pharmacotherapy or psychotherapy. Yet little is known about factors associated with premature treatment termination among depressed patients. in other hand, there is conflicting evidence about the influence of personality disorder on outcome in depressive disorders.

Aims:

The present study assesses whether personality may predict the dropout of a psychotherapy group for patients with depressive disorder.

Methods:

A personality disorders (PDs) self-report questionnaire based on the Structured Clinical Interview for DSM-IV Personality Disorders (SCID-II) was completed by 39 depressed outpatients. All patients attended a group-based CBT program for depression consisted of 10 weekly 90 minutes sessions. Patients were categorized in groups as completers vs. dropouts. Dropout was defined as attendance at less than 7 sessions. Differences between groups were tested using Student's t-test and in order to measure the specific contribution of personality on dropout a logistic regression analyses were performed.

Results:

Comparing treatment completers (67%) vs. dropouts (33%), groups differed significantly on number of items in schizotypal, narcissistic and borderline PDs. The dropout group scored significantly higher on these PDs than the completer group. Scores on borderline personality disorder emerged as a significant predictor of dropout.

Conclusions:

Depressed outpatients with comorbid borderline traits are at higher risk of premature termination and may require modified treatment strategies.
2770 – Psychosocial Risk Factors for Postpartum Depression: A Descriptive Sample of Pregnants
Authors: Testa R. , Chiappini S. , D’Oria L. , Righino E. , Bruschi A. , Di Nardo F. , Oliva G. , Janiri L.
Published: July 2013

Introduction:

Postpartum Depression (PPD) is a common problem connected to pregnancy. Related previous data showed a prevalence of depressive symptoms between 8% and 51% and a prevalence of Major Depressive Disorder between 10% and 17%.

Objectives:

Find a correlation between Psychosocial Risk Factors and the develop of Mood Disorders during pregnancy and post-delivery.

Aims:

Develop strategies of prevention and treatment of PPD.

Methods:

A population of pregnants has been analyzed, proposing an anamnestic questionnaire, the Edinburgh Postnatal Depression Scale (EPDS) and the Hypomania checklist Symptoms (HCL-32), in two times: between the 35th and the 37th week of pregnancy and 2-3 days after the delivery.

Results:

We found that at the first survey were depressed (EPDS score >9) 21 women of 149 (14.1%) and hyperthymic (HCL score >14) 59 women of 149 (39.9%).We noticed that risk factors for depression were a complicated pregnancy (p=0.004), a conflicting relationship with the partner (p=0.009) and a permanence in Italy < 6 months (p< 0.001). An history of illnesses during the pregnancy (p=0.042) and previous psychological problems (p=0.049) were correlated to an hyperthymic state. At the second survey, data were confirmed: the incidence of depression was 17,4% (12 /69 women) and that of hyperthymia was 44% (30/69 women).

Conclusions:

Our data confirm previous evidences about the incidence of PPD and the contribution of risk factors of the pregnancy in its pathogenesis; moreover, high scores at HCL can express an hyperthymic dimension peculiar of pregnancy, rather than a mood disorder, considering HCL as a dimensional assessment.
2771 – Thyroid Function and Post Postpartum Depression
Authors: Yazdchi K. , Keshavarzi F. , Farnia V.
Published: July 2013

Introduction:

Thyroid function is known to be affected during pregnancy. Risk of depression is particularly high for women during the prenatal period.

Objective:

Various investigators have attempted to establish a link between thyroid function and post partum depression. While the pathogenesis of postpartum mood disturbances remains unclear.

Aims:

This study aimed to investigate whether thyroid function differs in women with postpartum depression compared to a control group.

Methods:

In this case-control study, Forty eight patients suffering from postpartum depression according to Diagnostic and Statistical Manual of Mental Disorders, fourth edition totally revised (DSM-IV-TR), and 65 normal controls underwent diagnostic evaluation using Structured Clinical Interview for DSM-IV-TR. Then the Persian version of Edinburgh Postnatal Depression Scale (EPDS) was completed by the participants. Finally, their thyroid functions were assessed. Data analyses were done using the SPSS program 13.

Results:

No statistically significant differences were observed between thyroid function tests and postpartum depression. According to multiple regression analysis with stepwise method, subjects with lower serum TSH, T3RU and T3 levels tended to have higher EPDS scores (P-value=0.008).

Conclusion:

The present study reports that those women with postpartum depression had a no greater prevalence of thyroid dysfunction than the control subjects. It seems that thyroid dysfunction should be considered in women with postpartum depression individually, but the role of thyroid as an important cause of this condition is not yet established. This suggests that future studies should concentrate on this concept in postpartum depression.
2775 – The Issues Involved in the Management of Foreign Mentally Disordered Offenders in the Uk at the Point of Entry
Authors: Patil P. , Olumoroti O. , Witharana D. , Rasquinha N.
Published: July 2013

Aims and objectives:

This literature review examines the issues facing foreign mentally disordered offenders (FNMDOs) in accessing psychiatric care in the UK.

Methods:

Studies/reports relevant to FNMDOs in Healthcare, Probation services, Inspectorate of prisons, Crime reduction charities, Department of Health were examined. Keywords searched on MEDLINE and Psychinfo: ‘foreign, mental,*offender,*criminal.*’

Results:

According to 2009 statistics, 14% of UK prisons consisted of foreigners of which 80% suffered mental health problems. FNMDOs face a number of issues like negative stereotyping, racism, poor family contact, language/cultural barriers, which hinder accessing psychiatric help. Indefinite detention of foreign prisoners, post-amendment of the UK Borders Act 2007, has been found to result in increased depression and suicidal ideation. Self-inflicted deaths increased since 2006. Research on migration-morbidity hypothesis and refugees/asylum-seekers demonstrates higher psychiatric morbidity. A 2005 meta-analysis reported worse outcomes for institutionalized refugees. Detention centres often have poor healthcare provision, though prevalence of PTSD, depression, anxiety, somatoform disorders is high. FNMDOs face limitations in availability of legal aid and immigration advice across the prison system. Lack of a clear care pathway compounded by poor inter-agency communication and understanding of immigration procedures adversely affects treatment and continuity of psychiatric care.

Conclusions:

FNMDOs are a vulnerable group with complex needs which may go unidentified. Improving care and outcomes for FNMDOs requires adequate prison staff training, ready interpreter access, facilitation of family visits/cultural contact. Effective multi-agency collaboration in early identification, intervention, clarity in care pathway and immigration advice would result in reduced psychiatric morbidity in this vulnerable group of offenders.
2776 – Mental Disorders in Old Age Persons Undergoing Hip Fracture or Femoral
Authors: Kalyn Y.B. , Ponomareva E.V. , Gavrilova S.I.
Published: July 2013

Introduction:

Traumatic injury, advanced age, concomitant somatic disorders promote the development of the elderly with hip fractures of various mental disorders.

Objectives:

To establish the prevalence, nosological spectrum, dynamics and prognosis of mental disorders in elderly and senile patients undergoing hip fracture or femur.

Methods:

The study included 101 patients aged 60 years and older (mean age - 76.4 + 8.2 years) with a fractured neck of femur or femur, being treated at the trauma wards of several hospitals of Moscow.

Results:

A survey of patients in elderly undergoing hip fracture or femoral found that 82.2% of the patients at the time of the study had various mental disorders. Fracture of the femoral neck or the femur can be seen as provocative or etiological factors such as mental health states of confusion (19.8%), due to situational depressive disorder (8.9%), which appeared isolated sleep disorders (5.9%), alcohol delirium (3%). Depressive spectrum disorders in the background of hip fracture or hip are more common in younger persons (p < 0.03), whereas the state of confusion - in older individuals (p < 0.01). By the time catamnesis (on average, a year after the first examination) died 27.8% of persons included in the follow-up of the group.

Conclusions:

The study confirmed the expected high rate of adverse outcome of hip fracture or femur in elderly and senile patients with a state of confusion or dementia. Probability of reduction of mental disorders occurring against hip fracture or femoral increases significantly when the surgical treatment.
2778 – Identification of Dependents During Emergency Psychiatric Assessments
Authors: Nabi S.
Published: July 2013

Introduction:

Child protection guidelines within a London mental health trust state that all mental health professionals should identify patients who have dependents, if so it should be established that these dependents are safe, and any concerns should be taken forward to relevant agencies.

Objectives:

Establish if child protection guidelines are being followed in emergency psychiatric assessments.

Aims:

Establish whether patients are being asked whether they have dependents, if the dependents are safe, and whether concerns are being discussed with child protection services.

Methods:

An audit was carried out in which documentation from 3 days of emergency assessments where examined to see whether the above questions were being asked.

Results:

In cycle 1, 11 out of 18 patients asked about dependents, 7 had dependents, 4 were documented as being safe, 3 raised child protection concerns, 0 taken forward.

In cycle 2, 7 out of 17 patients asked about dependent, 6 had dependents, 3 documented as being safe, 0 child protection concerns were raised.
2786 – Gender Influence on Relation of Suicidal Intents to Clinical Characteristics of Suicide Attempters
Authors: Paravaya O. , Lasy Y.
Published: July 2013

Objective:

To evaluate severity of suicide intents and its connection to some clinical characteristics in men and women.

Methods:

Clinical examination, The Pierce Suicide Intent Scale (SIS), Brief Psychiatric Rating Scale (BPRS), Beck Suicide Ideation Scale (SSI), Beck Hopelessness Scale (BHS), Beck Depression Inventory (BDI), The Symptom Checklist 90 Revised (SCL 90 R), Global Quality of Life Self - Rating Scale.

Object of study:

Suicide attempters over 15 years admitted to the psychiatric hospital within one month after parasuicide (N = 264; 114 men, 149 women).

Results:

Based on SIS rating of intent to die patients were divided into three groups (low, intermediate, high intent). The scores of hopelessness (BHS), depression (BDI), SCL-90-R in general, suicide ideations (SSI) and intensity of psychosis (BPRS) increased with the severity of intent to die in the whole sample not taking into account gender.

In women separately general SCL-90-R score, suicide ideations (SSI) and intensity of psychosis (BPRS) correlated positively with increase of intent to die score. Besides, only in women elder age was associated with stronger intent to die.

Exceptionally in the sample of men the lower quality of life was associated with the higher scores on SIS scale. Other characteristics (general SCL-90-R score, suicide ideations and intensity of psychosis) were significantly higher in men with the stronger intent to die.

Conclusion:

Our findings confirm that socioeconomic status is connected to men's pattern of suicidality. Psychiatric disorders together with the strong suicide ideation bring people to more dangerous suicide attempts.
2787 – Advance Statements by Patients in a Forensic Regional Secure Unit in South West England
Authors: Mohandas A. , James A.J. , Talwar N. , Sachin B. , King A.
Published: July 2013

Introduction:

Advance statements are expressions of wishes made by an individual anticipating future mental incapacity to express treatment choices, spiritual or cultural needs and to nominate someone to be consulted in the event of future incapacity.Advance statements about medical treatment are usually positively-framed treatment choices or requests. An advance statement could also inform the process of determining a person's best interests under the Mental Capacity Act 2005 procedure. Advance Directives project was initiated at Langdon Hospital(Regional Secure Unit with medium and low secure as well as open Forensic wards) in early 2011 and rolled out across site by late 2011.

Aims and objectives:

To audit the opportunity for patients at Langdon Hospital to have Advance Statements in place and its recording on Rio electronic system.To find out areas within the procedure that need improvement and changes.

Methods:

Data was collected from Rio electronic records of all patients of all wards at Langdon Hospital during a 3 week period.

Results and conclusions:

Most wards had offered above 80% of patients a chance to make Advance Statements. 2 wards achieved 100%. The uptake by patients who were offered an opportunity was high at 70%. Most patients prefer to have a named advocate.In some cases patients specifically asked for a relative not to be involved.Improvement needed in using recommended format and uploading it to Rio. Some staff were concentrating mainly on physical health/end of life decisions. Improvement needed in including questions related to management of future aggression and violence.