bluuebunny/crossref_metadata_2025 huggingface dataset:
P01-134 - Psychiatric Co- morbidity in Post Traumatic Stress Disorder
Authors: Firdosi M.M.
Published: June 2010

Objectives

The Kashmir Valley is a chronic conflict zone with a community prevalence of post traumatic stress disorder of 15.9%. The present study was conducted with the aim to find the psychiatric co-morbidity in patients suffering from Post Traumatic Stress Disorder seeking treatment at Government Psychiatric Diseases Hospital Srinagar, Kashmir India.

Methods

Sample comprised of 100 consecutive cases of post traumatic stress disorder (PTSD) with an age group of 16 -65 years diagnosed according to DSM - IV laid criteria. Patients with a prior history of any DSM-IV Axis- I or Axis- II disorder before the development of PTSD were excluded from the study. A detailed semi structured interview with all relevant items from MINI PLUS (MINI International Neuropsychiatric Interview based on DSM - IV), was administered to all the cases included in the study to find the co-morbidity.

Results

Psychiatric Co-morbidity was highly prevalent in patients of Post Traumatic stress Disorder in our study. Major Depressive disorder (80%) formed the commonest co morbidity followed by Panic Disorder (32%), substance abuse and conversion disorder (16% each). Other co-morbidities include agoraphobia (8%), generalized anxiety disorder (8%), obsessive compulsive disorder (4%).

Conclusions

Post Traumatic Stress Disorder is a complex disorder with high prevalence of co-morbidity. The classification of PTSD as anxiety disorder with overlap in the mood disorders needs to be further studied.
P01-139 - Social Anxiety among Medical Undergraduate Students in Malaysia
Authors: Gill J. , Mohammad S.
Published: June 2010

Objectives

To study the prevalence of social anxiety problem and potential risk factors that may be associated with social anxiety among Malaysian medical undergraduate students.

Methods

Social Phobia Inventory (SPIN) and a questionnaire assessing gender, religion, number of siblings, type of previous school and partner status were given to 167 final year medical students at University Malaya.

Results

There were 101 respondents of which 56% of the medical students scored > 19 in the Social Phobia Inventory (SPIN) suggesting that they may be having social anxiety. However, none of the variables analysed were significantly associated with social anxiety.

Conclusion

More than half of the medical students have significant social anxiety symptoms. Students with social anxiety symptoms may find clinical training difficult and this may lead to additional stress and anxiety. This may further decrease academic performance. There is also evidence to suggest that stress during undergraduate training may result in psychological or emotional impairment during professional life and therefore affect the quality of patient care. Furthermore, untreated social anxiety may lead to other complications such as depression and substance abuse. It may also affect their choice of future specialties and prevent them from pursuing what they really want. It is recommended that medical undergraduates be routinely screened for social anxiety in view of its high prevalence, and interventive measures can then be instituted.
P01-140 - Negative and Positive Automatic Thoughts in Social Anxiety Disorder
Authors: Iancu I. , Lupinsky Y. , Barenboim D.
Published: June 2010

Social Anxiety Disorder (SAD) is characterized by fear and avoidance in social situations where one is in danger of scrutiny by others. Automatic thoughts could either cause the disorder or maintain it, thus their examination is warranted.

Methods

30 SAD patients (diagnosed with the MINI) and 30 healthy controls were administered the Liebowitz Social Anxiety Scale, The Automatic Thoughts Questionnaire (ATQ - Negative and ATQ-Positive), the Sheehan Disability Scale and the Beck Depression Inventory.

Results

SAD patients had higher total scores on the ATQ-Negative and lower total scores on the ATQ-Positive. Many items differentiated the two study groups. The interaction with depression will be presented.

Discussion

Automatic thoughts are an important area of research and therapeutic intervention. The strengthening of positive thinking and the ablation of negative thinking are crucial in the treatment of this shy disorder.
P01-142 - Investigate the Prevalence Anxiety in Pregnancy and Communicating Factors in Sabalan Hospital Patients
Authors: Kazemi R. , Rezaei Ghalechi E. , Lotfi Tarazooyi S.
Published: June 2010

Background

Anxiety in pregnancy and the evil following results in the pregnancy process is a problem for pregnant woman and their families. The aim of this study is the investigation of prevalence of anxiety in pregnancy and communicating factors.

Methods

This investigation is a descriptive and correlation studies those 156 pregnant women in Sabalan hospital in Ardabil as the accident samples by questionnaire are collected. First part of questionnaire id the demographic information and the second part is the state-trait anxiety test. Result of this investigation study by application apss and statistical analysis.

Results

Between 156 pregnant women in this study, 57.1 percent had state anxiety and 52.5 percent of them had trait anxiety in high medium, low severe, severe, high severe of limitation. In this study, between economic problems in family, pregnancy problems such as Hypertension in pregnancy, bleeding and the others, not having reliable friend, physical disease in pregnant women and their husbands, and both of the state and trait anxiety have meaning relation. Between not intended pregnancies, psychiatric diseases in pregnant women and trait anxiety have meaning relation.

Conclusion

This investigation shows sizable prevalence of anxiety in pregnancy and the effect of different interfering factors. we make a tender for studying controlled in vestigation by equal number of women in first, second and third trimester such as these studies that the women and different interfering factors in anxiety in pregnancy are studied by equal numbers.
P01-143 - Gender Differences in Prevalence of Anxiety Disorders among Earth Quake Survivors
Authors: Khan M. , Masood M. , Mukhtar M. , Sana N. , Chaudhry H.
Published: June 2010

Introduction

Earthquake disaster of Pakistan in 2005 caused massive destruction. Death toll was more than 70000. Many survivors were diagnosed as having variable anxiety disorders including panic disorder and PTSD. Frequency of female patients was much higher than male. The major factors responsible are loss of life and property and uncertainty regarding future, harsh weather and repeated tremors.

Method

Data was collected from various agencies including WHO, Turkish Red Crescent, Canadian team of relief and some other NGOs working with earth quake hit area. Diagnosis was made using semi-structured interviews.

Results

Data analyses of women (1056), men (281) and children (204) indicate high prevalence of anxiety disorders including PTSD (853 women, 153 men) and depression (73 women, 31 men). Results vary from the observations made from other disasters. Sex ratio shows huge difference in prevalence between males and females.

Discussion

Patients with PTSD have dysregulation of HPA axis response. This alteration is more pronounced in case of women. Studies show that estrogen plays important role in the genesis of disease. Dexamethasone suppression test also indicates greater dysregulation of glucocorticoid receptor. Studies reveal predisposition in women for PTSD and depression.

Women and children were affected most because most of them were at home and in schools. Hence, they sustained more physical injuries and psychiatric consequences.

In our study depression came out to be more prevalent in females. This can be explained as comorbidity of PTSD and because of its own dynamics.

Conclusion

After exposure to trauma male and female respond differently.
P01-151 - Toward the Contextualization of the Relation between Thought-action-fusion (TAF) Believes and Obsessive Compulsive Disorder
Authors: Noorian Z. , Rezaee O. , Dolatshahi B.
Published: June 2010

Regarding the importance of obsessive compulsive disorders (OCD), the aim of this paper is to examine some of the roots of OCD with relation to the socio-cultural factors. By using the two dimensions of TAF, likelihood and moral, we conducted a survey research based on three groups: 1) OCD patients (39 samples), 2) patients with other anxiety disorders rather than OCD (19 samples) 3) and normal participants (30 samples) to allow us different comparisons between these three groups.

Results show that there are positive correlation between TAF beliefs and the obsessive compulsive symptoms. Also, compared with normal participants, patients with OCD and patients that have other anxiety disorders had a higher level of TAF-likelihood-other belief. The occurrence of thought suppression was more or less equal in OCD and other anxiety patients, although it was higher compared with normal groups.

Most of previous researches found a higher level of TAF-likelihood than TAF-moral in OCD patients indicating that the interpretation thoughts about the likelihood of the occurrence of a negative event is a stronger mechanism than the engagement in the anxiety raised from immoral thoughts. However, the results of this study showed a contrary finding as in our samples, the mechanism of TAF-moral was stronger than TAF-likelihood.

Explaining this finding, we got deeper to the cultural and religious beliefs of the targeted population and through qualitative interviews with some of the audiences we realized that there are a plenty of religious and cultural elements that foster the mechanism of TAF-morality.
P01-153 - Effect of Pregabalin on Patients with Refractory-severe Generalized Anxiety Disorder and Concomitant Severe Symptoms of Depression in Daily Medical Practice
Authors: Olivares J.M. , Carrasco J.L. , Álvarez E. , Perez M. , López-Gómez V. , Vilardaga I. , Rejas J.
Published: June 2010

Purpose

To analyse the effect of Pregabalin (PGB) on anxiety and depression symptoms in patients with refractory-severe Generalized Anxiety Disorder (GAD) and severe concomitant depressive disorder.

Methods

Post-hoc analysis of a multicentre, prospective and observational study conducted in outpatient psychiatric clinics to ascertain the impact of broadening GAD criteria. Men and women above 18 years, with GAD (DSM-IV criteria), PGB naïve and refractory to a previous course of benzodiazepines and/or anti-depressive drugs (minimum 3 months) and severe symptoms of anxiety (HAM-A ≥ 24) and depression (MADRS ≥ 35) were included. Changes in HAM-A and MADRS were assessed after 6 months of receiving PGB as per psychiatrist's judgement.

Results

159 patients [69.2% women, 45.9 (12.6) years] fulfilled criteria for analysis. Respectively, 92% and 90% of subjects were previously exposed to benzodiazepines and anti-depressives before adding PGB [mean dose: 223.1 (126.3) mg/day]. PGB therapy reduced both anxiety and depressive baseline symptoms by a mean of, respectively in HAM-A and MADRS scales, 57.9% (from 35.5±5.8 to 14.8±9.4; p< 0.001, effect size: 3.57) and 58.1% (from 39.4±4.3 to 16.5±10.3; p< 0.001, effect size: 5.33). As a result, the percentages of patients without symptoms of both anxiety and depression were 34.4% and 40.9%, respectively at the 6 month visit (p< 0.001 in all cases). Similarly, responder rates (≥ 50% reduction of baseline scoring) were 63.1% and 62.9%.

Conclusion

Despite limitations, Pregabalin therapy had a meaningful and significant effect of symptoms of anxiety and depression in patients with severe refractory GAD and concomitant severe depressive disorder.
P01-155 - Treatment Outcome and Predictors of Response in Canadian Combat and Peacekeeping Veterans with Military-related PTSD
Authors: Richardson J. , Elhai J.D. , Sarreen J.
Published: June 2010

Objective

This study examined the initial clinical presentation and monthly re-assessments of treatment outcome for a group of combat veterans and deployed peacekeepers with posttraumatic stress disorder (PTSD).

Method

Participants were 102 Canadian combat and peacekeeping Veterans attending specialized PTSD treatment clinic (Operational Stress Injury Clinic).

Results/conclusions

Help seeking veterans with PTSD presented with significant comorbid major depressive disorder and results at 12 months demonstrated significant improvement in symptoms of PTSD, depression and anxiety. There was no significant predictor of PTSD symptoms decline. Initial depression significantly predicted anxiety symptom declines, and initial anxiety predicted depression symptom declines. There was also a demonstrable improvement in health-related quality of life as measured by the SF 36.
P01-156 - Electrophysiological Indices of Involuntary Emotional Processing in Anxiety and Depressive Disorders
Authors: Russo D. , Galderisi S. , Mucci A. , Centanaro F. , Plescia G. , Montefusco V. , Maj M.
Published: June 2010

Objectives

Abnormalities of emotional processing have been reported in both anxiety and depressive disorders. Anxiety might be related to a hyperactive preattentive fear response or to a reduced efficiency of late regulatory processes, whereas depression might be related to a reduced response to positive emotions. In the present study event-related potentials (ERPs) were used to investigate involuntary processing of stimuli with different emotional valence in 33 healthy controls [HC] and 55 clinically stable patients (16 with panic disorder [PD], 15 with obsessive-compulsive disorder [OCD], 13 with unipolar depression [UD] and 11 with bipolar depression [BD]).

Methods

The ERPs were recorded during a target detection task, in which erotic, threatening, disgusting and neutral stimuli were used as distracters.

Results

Patients showed abnormalities of the sequence, duration and topography of the ERP components related to emotional processing. Patients with anxiety disorders showed abnormalities of the early components in response to threatening stimuli. Patients with BD showed abnormalities of both early and late ERPs components. OCD and UD patients demonstrated similar abnormalities of the late ERP components in response to erotic stimuli.

Conclusions

According to our results, abnormalities of emotional processing are observed in both anxiety and affective disorders and might have both distinct and shared characteristics in these disorders.
P01-160 - Comparison of Sertraline's Efficacy with Clomipramine's Efficacy, During Treatment of OCD Patients, Related to Gender- Symptoms Differences
Authors: Spaho E. , Alikaj V. , Suli A.
Published: June 2010

Aim

The study's aim was the comparison of OCD patients treated with Sertraline toward those treated with Clomipramine, divided in two subgroups with gender related symptoms differences.

Method

The study was focused on the inpatients and outpatients presented at Psychiatric Clinic, diagnosed with OCD during September 2005-March 2006. The criteria of being selected were randomization of those with > 20 points according to Yale-Brown Obsessive Compulsive Scale and > 4 points according to Clinical Global Impression Scale. There were two groups: first group was treated with clomipramine and the second with sertraline. Sertraline doses were 50 and 200 mg/day and clomipramine 100, 125 and 150 mg/day. The study was conducted during a period of 12 weeks including three evaluations through YBO C scale and CGI.

Results

91.8% of the patients completed the study. Men had a higher frequency of sexual symptoms, symmetry and exacteness obsessions, while women suffered a later onset of the disorder and presented a higher rate of aggressive obsessions. The patients treated with sertraline reported less side effects frequency and intensity and more tolerance than the patients treated with clomipramine.

Conclusions

Both treatments showed therapeutic efficacy in treating the OCD symptoms, but depends on symptoms and gender. Clomipramine caused more side effects and the number of patients dismissed from the study was higher in the group of clomipramine. Sertraline is as effective as clomipramine for treating the OCD but has more compliance and less side effects.
P01-161 - Functions of Compulsions in Different Symptom Subtypes of Obsessive-compulsive Disorder
Authors: Starcevic V. , Brakoulias V. , Berle D. , Sammut P. , Milicevic D. , Moses K. , Hannan A.
Published: June 2010

Objectives

To ascertain what motivates patients with obsessive-compulsive disorder (OCD) to perform compulsions.

Methods

Fifty-nine OCD patients underwent a comprehensive assessment, which included a structured interview designed to elicit one or more functions of their compulsions. Each patient was interviewed about the maximum of 3 compulsions.

Results

The functions of 138 compulsions were identified, and compulsions were classified in accordance with OCD symptom subtypes as washing/cleaning (n=35), checking (n=33), mental/covert (n=23), ordering/symmetry (n=17), hoarding (n=10), and miscellaneous (n=20). Compulsions were most frequently performed to decrease distress or anxiety (n=87, 63%) or automatically, without patients thinking why they were doing it (n=87, 63%). However, the reasons for performing compulsions varied significantly, depending on the OCD subtype. In comparison with patients from other subtypes, those with checking compulsions were more likely to perform them because they believed something bad would happen if they failed to do so, patients with washing/cleaning compulsions were more likely to perform them to alleviate the feeling of disgust, and patients with mental and ordering/symmetry compulsions were more likely to perform them to achieve a “just right” feeling.

Conclusions

Identifying functions of compulsions improves understanding of the psychopathology of OCD and has important treatment implications. Cognitive-behaviour treatment approaches differ in accordance with the reasons for performing compulsions: exposure and response prevention tends to achieve better results when compulsions are driven by a need to decrease distress, anxiety or the feeling of disgust, whereas cognitive techniques may be more useful when compulsions are performed for other reasons.
P01-162 - A Case Control Study of Cognitive Deficits and Memory Disturbances in Patients with Post-traumatic Stress Disorder
Authors: Talaei A. , Fayyazi Bordbar M.R.
Published: June 2010

Introduction

Some studies have demonstrated high cognitive deficits in patients with post-traumatic stress disorder (PTSD). Considering the limited available information about this issue, we decided to assess the cognitive deficits and memory disturbances in these patients.

Methods

The present study is a case control research conducted on 50 patients with post-traumatic stress disorder who were admitted to Ibn-e-Sina psychiatric hospital in Mashhad, in north-eastern part of Iran in 2008. The control group included 50 people of first degree relatives of these patients who met the inclusion criteria of the study. Case and control groups were selected by simple sampling method; and for all of them, a questionnaire of demographic information, Wechsler memory scale, and mini mental status examination (MMSE) were completed. The gathered data were analyzed using SPSS 14th edition by chi square, T test, and analyze of variance.

Results

The mean score of Wechsler memory scale in patients with PTSD (80.78±18.39) was signifantly higher than control group (67.92±7.38) (P=0.000). The mean score of MMSE was significantly lower in patients with PTSD compared to control group (P=0.000). The determined disability level assessed by Iranian veterans organization and also comorbidity of other psychiatric disorders with PTSD did not have a significant relationship with cognitive deficits, but the duration of PTSD and age of patients were signifantly related to the level of cognitive deficits.

Discussion

Cognitive deficits and memory disturbances are higher in patients with PTSD than general population.
P01-163 - Determinants of Post Traumatic Stress Disorder Wajid Ali Akhunzada, Mohammad Khalil Akhter
Authors: Ali W.
Published: June 2010

Objective

To verify the association of various risk factors with Post Traumatic Stress Disorder in adults among Internally Displaced Persons of Bajour and Swat.Design: Case Control study

Place and Duration of study

Conducted on adult males and females among internally displaced persons, selected from the IDPs Camp in Peshawer and the IDPs visiting Psychiatric setting at Hayatabad Medical Complex, Peshawer from 1st of May to 15th of June, 2009.

Materials and Methods

Cases selected among the respondents through a screening questionnaire, suffering from PTSD. The controls were those respondents which screened out negative from the questionnaire for PTSD but were from the same camp. A total of 208 cases & equal number of controls were enrolled in the study. The statistical analysis was done in a stepwise manner (Uni-variate analysis, bi variate analysis, Logistic regression) using SPSS version 17.

Results

The results show that the factors significantly associated with PTSD were Exposure to Injury (OR=19.181, 95% CI=5.740-22.797, p=0.000), Witnessing Death (OR=21.113, 95% CI=5.550-19.826, P=0.000), Hopelessness (OR=26.918, 95% CI= 3.403-13.101, p=0.000), Torture (OR= 5.008, 95% CI=1.795-3.962, p=0.009) and Loss of relative (OR=3.934, 95% CI=1.077-4.893, p=0.008).

Conclusion

The Posttraumatic stress disorder is highly prevalent in the vulnerable populations and various determinants are responsible for the morbidity associated with it. The degree that risk factors function to determine both the development and recovery from trauma, it is plausible that targeting risk factors may help both in the treatment of PTSD and in preventing recurrences of PTSD over time.
P03-01 - Behavioral Treatment of Obsessive-compulsive Symptoms in Youth with Prader-Willi Syndrome: Results from a Pilot Study
Authors: Storch E.
Published: June 2010

Objectives

Obsessive-compulsive (OC) symptoms are common in both children and adults with Prader-Willi Syndrome (PWS), to the degree that they are considered central to the syndrome's behavioral phenotype and constitute diagnostic criteria for the disorder. Although efficacious behavioral treatments (e.g., exposure and response prevention) exist for OC symptoms in typically developing youth, these treatments are not tailored to meet the specific needs of youth with PWS and their families. The purpose of the current study is to report on a modified CBT protocol that addresses obsessive-compulsive symptoms in youth with PWS.

Methods

Three children received a modified version of cognitive-behavioral therapy targeting obsessive-compulsive symptoms in PWS. Measures were administered at screening, baseline, and post-treatment and included the Schedule for Affective Disorders and Schizophrenia for School-Aged Children, Children's Yale-Brown Obsessive Compulsive Scale (CYBOCS), Family Accommodation Scale, Clinical Global Impression - Severity (CGI-S), Clinical Global Improvement (CGI), and measures of impairment and adaptive functioning. Treatment consisted for 12 family-based CBT sessions that included exposure and response prevention; cognitive restructuring; and other operant treatment elements.

Results

Participants experienced reduced CYBOCS scores at baseline to post-treatment, 25 to 15.3. All three youth were considered treatment responders on the CGI-Improvement scale. Similar reductions on secondary variables such as OCD impairment were reported.

Conclusions

Although these results are preliminary, initial results suggest that behavioral treatment of OC symptoms may be effective in the PWS population. This treatment holds promise for being a safe and tolerable method for reducing compulsive symptoms in youth with PWS.
P01-164 - Volatile Inhalant Dependence and Intoxication among a Sample of Egyptian Street Children
Authors: Abou-Hatab M. , Okasha Y.
Published: June 2010

One hundred Subject attending drop out units for street children were investigated using: (1) Short interview sheet for street children,(2) Inhalant Dependence and Intoxication Checklist for Street children,(3) Inhalant Dependence and Intoxication diagnostic criteria DSM IV (Diagnostic and Statistical Manual for Mental Disorders-4th edition) (4) urine screen for hippuric acid. The study aims at identification of common manifestations of volatile inhalants (glue, fuel, and thinner) dependence and intoxication among a sample of Egyptian street children. Research subjects were using volatile inhalants (100%) with variable amounts and sometimes in combination with other substances such as: Nicotine and Hashish (25%) and oral drugs (cough sedatives) (15%). According to DSM IV criteria, inhalant dependence and intoxication were reported among all research subjects. Dizziness, in-coordination, lethargy, slurred speech, tremors, blurred vision and euphoria were the commonly reported signs of intoxication. Street children diagnosed as intoxicated were vulnerable to many disadvantages. They are using inhalants despite their knowledge of its harmful effects on physical and psychological wellbeing. There is a great need to develop integrated rehabilitation medical services directed towards such vulnerable individuals especially detection, detoxification and mental health services.
P01-165 - Teenagers’ Suicidal Behavior, Anxiety and Depression Symptoms
Authors: Adomaitienė V. , Jaras A. , Lauciūtė E. , Dambrauskienė K. , Taranda V. , Vilkas V.
Published: June 2010

Statistical data of recent years evidences that Lithuania is leading in Europe in the suicide rate. Suicide is one of the main causes of death in adolescence.

Objective

The goal of the study was to establish the relationship between teenagers’ anxiety and depression symptoms and suicidal behavior.

Methods

Two groups of teenagers from 14 to 17 took part in the study: the study group (after suicide attempts, N=109) and the control group (no suicide attempts, N=218). Hospital Anxiety and Depression Scale (HADS) was used in evaluating anxiety and depression symptoms.

Results

Evaluating adolescents’, who attempted suicide, anxiety and depression symptoms according to HADS, no significant differences between genders were determined: anxiety symptoms were determined to 22.8% of girls and 26.9% of boys (X2=3.50, df=2, p=0.2), depression symptoms were determined to 21.1% of girls and 26.9% of boys (X2=1.01, df=2, p=0.6). Evaluating possible impact on teenagers’ suicidal behavior, the odds rate was calculated, the chance was determined whether a suicide is possibly attempted. The possibility of suicidal behavior was increased significantly by anxiety and depression symptoms, determined with HADS: 3,9 times more anxiety symptoms (95%, CI 1,6-9,7) and 9,2 times more depression symptoms (95% CI 2,9-29,7) in boys, and in girls, respectively - 2,5 times (95%, CI 1,1-5,9) and 7,6 times (95%, CI 2,4-24,8).

Conclusions

Anxiety and depression symptoms, according to HADS, may have possible impact on teenagers’ suicidal behavior.
P01-174 - Executive Dysfunctions in Disorders Central in Child and Adolescent Psychiatry
Authors: Bogte H.
Published: June 2010

Many cognitive operations are needed for the successful completion of goal-oriented behaviour. These operations are commonly referred to as executive functions (EF). It is assumed that the prefrontal cortex has a central role in EF. Given its many connections to other parts of the brain, is in an excellent position to coordinate processing across wide regions of the central nervous system. EF enable the individual to shift attention, inhibit pre-potent response, generate goal-directed behaviour, and solve problems in a planned, strategic way (Goldman-Rakic, 1993). Patients with frontal lobe damage fail on tests that tap these abilities (e.g. Damasio, 1994). Another deficit is their inability to calculate ‘chance’.

Concerning many disorders in child and adolescent psychiatry it has been assumed, that EF deficits are essential in their etiology. For instance it has been proposed, that such deficits are central in autism (Ozonoff, Pennington & Rogers, 1994; Pennington & Ozonoff, 1996; Ozonoff, 1997), and that this deficit may underlie the social (mentalising) deficit in autistic individuals (Hughes, Russel & Robbins, 1994). EF deficits can also be found in individuals with ADHD, but these deficits are supposed to show a different ‘profile’ than the EF deficits in autism. In adolescence the brain undergoes a major transformation, and in this stage the EF deficits may lead to disruptive behaviors (e.g. Spear, 2007).

In this presentation there will be an emphasis on results of research by the author concerning EF deficits in autism and in adolescence.
P01-180 - Use of Mechanical Restrain among Psychiatric Hospitalized Polish Adolescents
Authors: Butwicka A. , Gmitrowicz A.
Published: June 2010

Objectives

To evaluate factors associated with the use of restrain and its duration among psychiatrically hospitalized adolescents.

Methods

Retrospective, chart-based analysis of patients treated during a 2-year period in Department of Adolescent Psychiatry with average number of patients of 22.6±4.7 and an average admission rate of 320/year.

Results

There were 543 events of restrain during a 2 year period in 164 patients (27/10000 patient days).Restrain was used during 413 (28%) out of 1462 of 12-hour-long analyzed duties. Median duration of restrain per patient was 240 (IQR 90-465) minutes. Factors associated with the risk for restrain in multivariate model were: nurse workload (OR 1.17; 95%CI: 1.09-1.26), fraction of female patients in the unit (OR 3.26; 95%CI: 1.06-10.07), weekday duty (OR 1.67; 95%CI: 1.30-2.13), spring or autumn season (OR 1.51; 95%CI: 1.19-1.93). Child and adolescent psychiatrist on duty (beta= -0.10; p< 0.001) and greater nurse workload (beta= -0.11; p< 0.01) were associated with shorter duration of restrain per patient. Night-time duties were associated with longer use of restrain than day-time ones: 270.0 (25%-75% 92.5-558.8) vs 225.0 (25%-75% 90.0-360.0) minutes. Similarly weekend 292.5 min (120.0-555.0) vs weekday 206.3 min (90.0-427.5) or spring/autumn 295.0 min (25%-75% 105.0-510.0) vs summer/winter 180.0 min (25%-75% 75.0-408.8) duties were associated with highly statistically significant (p< 0.01) longer duration of restrain per patient.

 Duration of restrain per patient (min.)p level Mean+SDMean+SDMean+SDMean+SD Type of specialist on dutyGeneral psychiatristChild and adolescent psychiatrist 306.5+238.9255.0 (90.0-480.0)221.0+237.3120.0 (60.0-270.0)0.0026Type of dayWeekdaysWeekend 274.8+226.0206.3 (90.0-427.5)346.7+259.7292.5 (120.0-555.0)0.0080Season of yearSpring or autumnSummer or winter 326.8+241.7295.0 (105.0-510.0)259.8+232.3180.0 (75.0-408.8)0.0002Type of shiftDayNight 257.7+203.9225.0 (90.0-360.0)338.7+26,8270.0 (92.5-558.8)0.0009

[Duration of restrain per patient and characterist]

Conclusions

Health service-related factors are important predictors of the use and duration of restrain. Adequate number of well-qualified nursing staff should be consider as means to counter this problem.
P01-182 - Genetic Syndromes Associated with Autism
Authors: Cozaru C.G. , Papari C.-A. , Papari A.
Published: June 2010

Autism is a heterogeneous neurodevelopment disorder that can reveal impairments in social interactions, communication, and behavior. This paper aims to review the current understanding of the etiologies and the multiple pathogenetic pathways that are likely to lead to the autistic phenotype. Multiple studies evidence that most cases of autism likely have an underlying genetic cause or predisposition. Just as mental retardation, autism is likely to be caused by many different genetic mechanisms and genes rather than a single, or few, major genes or environmental effects. Applying routine genetic testing in clinical (CLIA-certified) diagnostic laboratories it's possible to identify the specific etiology and recurrence risk in 10% to 15% of autism cases and is clinically indicated for any child with autism. In this study we report 5 cases with different genetic syndromes in which autism has been described as one of the possible manifestations: Down syndrome, 22q13 deletion, “cri du chat” syndrome - 5p15 deletion, Cornelia de Lange syndrome, Sotos syndrome.

Conclusions

The etiologies of autism are complex and presence of a wide variety cytogenetic abnormalities are providing us with extremely valuable information about the role played by genetics in autism and collaboration with psychiatrists. Such recognition and understanding will help clinicians implement syndrome-specific treatments of patients identified with a genetic cause of autism spectrum disorder. Early identification of this genetic disorder is critical not only to the individual patient but for the entire family.
P01-184 - Do I Really Matter to you? The Potential Influence of Social Desirability on Treatment Outcome
Authors: Seeger T. , Brocke W. , Groves L. , Cawthorpe D. , Wilkes C.
Published: June 2010

Objectives

Continuous client feedback aims to increase the effectiveness of therapy by emphasizing common factors in treatment across theories that contribute the most to change. In this paper, we present data using two independent measures, which appears to isolate the influence of social desirability on treatment outcomes.

Methods

Continuous client feedback data was collected in the Student Health Partnership program and compared with independent data reflecting client function (Child Global Assessment of Function). Data was collected at two times by the same staff using two sampling methods. In the first sample, staff preferentially assigned clients to case (continuous client feedback) and comparison treatment as usual) on the basis of preference and convenience whereas in the second sample assignment to case and comparison was random.

Results

When the data from the two sample frames was compared, systematically different trajectories in the measured outcomes reflecting continuous client feedback and function were obtained with those in sample one being substantially higher than comparisons or population reference values.

Conclusions

The difference in results emerging from the two sampling frames is explained in terms of social desirability. Outcomes for clients were much better in the first sample, where staff choose clients they apparently liked for specialized treatment.
P01-185 - Predicting Risk for Poor Outcomes in Children's Mental Health
Authors: Nguyen H. , Wilkes C. , Cawthorpe D.
Published: June 2010

Objectives

Using baseline and outcome data collected in the Calgary Region Children and Adolescent Mental Health Program (CAMHP) over the last six years, a profile was developed for those who are at risk for poor treatment outcomes.

Methods

Based on the data collected in CAMHP, 6229 completed measurable treatment plans (MTP) were analyzed for consistency (by year) and theoretical meaningfulness (by clinical level). A table was developed to describe by quartiles those who improved and those who got worse in terms of problem severity and function. A multi-variable linear regression model was developed for function with linked data that predicted the profile of those at risk for poor treatment outcomes.

Results

MTP scores reflecting problem severity and function were consistent over time. Further, MTP scores were theoretically meaningful (e.g., inpatients were more severe on admission than those receiving community or day hospital-based treatment). In total, 659 MTPs indicated no improvement for a negative state and an additional 830 changed negatively in problem severity and Children's Global Assessment Scale (C-GAS) scores. The multivariable model based on admission data provided a risk profile for this group that accounted for 52% of the variance for discharge function.

Conclusions

The baseline and outcome data gathered from the Regional Access and Intake System (RAIS) serving CAMHP may be used effectively to predict clinical outcomes in ways that can draw attention to those at risk for poor outcomes.
P01-189 - Behavioral and Neuropsychological Evaluation in ADHD Diagnosis
Authors: Bastos C. , Coelho C.
Published: June 2010

In our clinical experience, behavioral scales tend to be overrated in Attention-Deficit Hyperactivity Disorder (ADHD) diagnostic procedures. Our main goal is to demonstrate, through two schoolchildren's clinical cases, the contributions of neuropsychological evaluations towards the diagnosis of ADHD. We consider that the diagnosis must be essentially clinical, which means that it can not be done solely based on any scale or test. The attention process consists of several interactive functions while the deficit itself indicates a syndromic scenario, not a specific disease. As so, attention deficit may manifest itself as a primary clinical picture or as a secondary symptom to several disorders and circumstances. Several contradictions were found between the evaluations of behavioral scales, such as the Benczik and DSM IV scales, and other ones based on neuropsychological criteria, such as WISC-III.
P01-194 - Why Patients do not Attend - Understanding the Reasons for Non-attendance at a Child and Adolescent Psychiatry Clinic
Authors: Doherty A.M. , McCarthy M.R.
Published: June 2010

Objectives

To examine the reasons for non attendance at clinic appointments, and to identify any ways in which these rates might be reduced.

Methods

We examined the records of those patients who, having consented to a referral to a child and adolescent psychiatry service, then either failed to attend any appointments, or who ceased to attend after having attended one or more appointments, but without being discharged, over an 18-month period. The parents of these children were contacted by telephone and a semi-structured interview was conducted to ascertain the reason in each case for defaulting on the appointment.

Results

The reasons given by the parents of the patients for missing appointments included their opinion that the referral was unnecessary (31.8%), resolution of the problem which led to the referral (22.7%), the child refusing to attend (22.7%) and problems with clinicians (9%). In the majority of cases where the parent did not consider the referral necessary, the referral had been made by the child's school (71%), with the parent reporting that they had felt pressurised into consenting to the referral.

Conclusion

The high levels of non-attendance at clinics have serious implications, especially if it means that those in need of services are not accessing them. The factors which we have identified in this study are chiefly patient rather than service factors, which are likely to be related to socio-economic factors.
P01-197 - Prosaccades and Antisaccades in Individuals with ADHD and Autism Using the Gap/overlap Paradigm
Authors: Azadi B. , Ettinger U. , Asherson P. , Ashwood K. , Cartwright S. , Bolton P.
Published: June 2010

Saccadic reaction time (SRT), is a good index of visual attention pattern. “Gap/overlap paradigm” is supporting the idea that state of attention (engaged/disengaged) influences the SRT toward stimulus. In “overlap”, fixation point (FP) and target overlap; while in “gap”, FP extinguished before target onset. 200ms gap is associated with reduced RT compared with the overlap (“gap effect”).

Boys aged 7-16, with diagnosis of ADHD, ASD or comorbid ASD+ADHD (FSIQ>70) were tested on antisaccades and prosaccades under gap, overlap, and step conditions.

Preliminary result of 15 ADHD, 7 ASD and 8 co-morbid subjects is reported with data collection still ongoing. For latency, there was an effect of Task (P< 0.05), i.e. slower latency during antisaccades than prosaccades, and there was an effect of condition (P< 0.05) suggesting increase in latency from gap to step to overlap. These effects were highly significant but independent of group (p=0.7). For error rate there was an effect of task ((P< 0.05; more directional errors in antisaccade than prosaccade) but no effect of condition. Task effect was independent of group, but there was a strong trend towards an effect of Group (p=0.055); this effect indicates that the comorbid group had the lowest error rates compared to the other two groups, who in turn were very similar to each other.

These data replicate previously demonstrated saccadic task in patients with ADHD, and ASD. Comparison of the data with a control group will enable us to explain the different patterns of attentional processing in these clinical groups.
P01-202 - School Refusal
Authors: George M. , Khan A. , Nicholls J. , Thambirajah M.S.
Published: June 2010

Introduction

The issue of school attendance is currently the focus of intense activity in Schools & Local Educational Authorities in England. The latest figures from the Department for Schools, Children and Families shows the overall absenteeism as 6.26%, in England. It is thought approximately 1 to 5 percent of all school-aged children have school refusal (Fremont, 2003) and is one of the reason of School non attendance.

Aim

To investigate if the current practice regarding the assessment and management of school refusal is compliant with the local CAMHS School refusal protocol.

Method

20 case notes of clients diagnosed with anxiety based school refusal were reviewed against standards

Results

Majority (80%) of the patients attended their first CAMHS Clinic during which evaluations of Child (100%), family (100%) & school factors (70%) contributing to School refusal was carried out. We found anxiety disorders (83%) & depression (66%) as the main contributing child factors. We also found that nearly half of the children had parental mental illness as a signification contributory factor.

Following the initial assessment, school reports including attendance were requested in 84% of the cases. Unfortunately 33% of the patients who attended the 1st clinic did not attend further appointments. All the patients (67%) were offered gradual return to school, attendance at pupil referral unit and home tuition.25% were offered family therapy and 16% of the patients have their parents referred to the adult mental health unit. Individual works including behavioural and cognitive approach was undertaken in 42% of the cases.
P01-204 - Internet Addiction in the Island of Hippokrates: Impact of Gender and Age in Teenage use and Abuse of the Internet
Authors: Floros G. , Fisoun V. , Siomos K.
Published: June 2010

Objectives

To determine the differential impact of gender and age on pathological internet use (PIU) in the island of Kos, birthplace of Hippokrates and cradle of Medicine.

Methods

We surveyed the entire teen population (aged 14-19) of the island of Kos for symptoms of Internet addiction using Young's brief diagnostic questionnaire (YDQ) and an expanded demographics questionnaire. The sample consisted of 1221 adolescents, 587 male and 634 females, with a similar age distribution among the sexes.

Results

One-hundred fourteen teens (11,3% of Internet users) were classified as possibly addicted to the Internet. Results indicate that gender plays a more significant role than age in Internet abuse; there is a distinct pattern among the sexes with the girls scoring lower scores in the YDQ in all ages (chi square=22.758, p< .001) with a marked difference in the 17-19 age range. Although the symptoms of PIU in girls subside in that age range, boys’ symptoms increase dramatically. Furthermore boys in that age range with higher YDQ scores report a subjective feeling of happiness, showing that PIU can be ego-syntonic. Usage patterns of those Internet users reporting heavier use are analyzed and presented graphically.

Conclusions

The discontents of modern civilization have spread to the furthermost corner of Europe, an island isolated from the continent during winter time. Results indicate that gender tends to heavily mitigate the effect of age on Internet abuse, with females being only transiently affected as their scores tend to fall dramatically with the onset of adult life.
P01-208 - Childhood Subcrinical Characteristics in Schizophrenia
Authors: Hamasaki Y.
Published: June 2010

Aim

Childhood subclinical characteristics have not been fully investigated in patients with schizophrenia. To elucidate the picture of them, and to find out indicators which predict later development of schizophrenia, childhood behaviors of the adult schizophrenia subjects were investigated in a questionnaire-based retrospective study.

Method

Schizophrenia outpatients (n=20) in his/her twenties and normal healthy subjects (n = 120) were investigated. All patients are diagnosed according to DSM-IV-TR as schizophrenia, and who present now mainly negative symptoms after passing an acute stage. By modified use of the CBCL (Child Behavior Checklist) as a retrospective assessment questionnaire, the parents of the patients and of control subjects rated their childhood behavior.

Results

The hit-rate when classifying the schizophrenic and normal subjects by discriminant function using all items of CBCL totaled 97.0%. Notable in an item-level analysis was an extremely attenuated aggression in personal relations in the schizophrenia subjects. Among eight subscales of the CBCL, those of Withdrawal, Social Problems, Attention Problems and Aggressive Behavior contributed most to the accuracy of the prediction of group membership.

Conclusion

It was suggested that subclinical behavioral and psychological characteristics of schizophrenia already exist in the patients’ childhood.
P01-209 - Validation Study of the Modified Social Communication Questionnaire
Authors: Hanley S. , Mulligan A. , Houlihan B. , Sodipo T.
Published: June 2010

Background

The 40 item Social Communication Questionnaire (SCQ) screens for autism spectrum disorder (ASD) and is quicker to administer than the (two hour) Autism Diagnostic Interview-Revised (ADI-R). A recent study, however, found that two questions on the SCQ were answered “autism positive” in 40% of a normal population children's sample. A modified SCQ (MSCQ) without these questions may be more specific than the SCQ.

Objective

To compare the performance of the MSCQ with that of the ADI-R.

Methods

42 children were recruited to the study, 22 from Mater CAMHS and 20 from St Paul's Hospital and Special School. 20 were diagnosed with autism, 10 with ASD, and 12 with other clinical diagnoses. The MSCQ was sent out as a postal questionnaire to be completed before attending for ADI-R interview. To assess the diagnostic validity of the MSCQ correlations between the MSCQ and ADI-R were calculated. Receiver operating characteristic (ROC) curves were then applied to assess its discriminate ability.

Results

A strong correlation of 0.84 was found between ADI-RTotal and MSCQTotal scores. Using ROC Curves, a cut-off of 14.5 on the MSCQ had a sensitivity of 0.90 and a specificity of 0.82 for identifying ASD from other clinical disorders. A cut-off of 21.5 on the MSCQ had a sensitivity of 0.75 and a specificity of 0.77 for identifying autism from other diagnoses.

Conclusion

These preliminary findings suggest that the MSCQ is a clinically useful and accurate method of assessing for ASD.
P01-210 - Self Disclosure, Depression, Anxiety and Aggression in Adolescents
Authors: Horesh N.
Published: June 2010

Objectives

To examine the personality variable of self disclosure, and its relationship to depression, anxiety, aggression in adolescents.

Methods

80 adolescent inpatients in four university affiliated hospitals and 57 healthy adolescent controls were evaluated. The following measurements were employed: Beck Depression Inventory, State and Trait Anxiety Inventory, The Impulse Control Scale, State and Trait Anger Expression Inventory, The Feeling and Acts of Violence Scale and Shulman Self Disclosure Scale.

Results

There were significant negative correlations between depression, anxiety, impulsivity, and self disclosure to family members and significant positive correlations between control of anger and self disclosure towards family members, in the patient group.

Conclusions

The ability to self-disclose may be a protective variable. A focal point of intervention in preventing and treating psychopathology in adolescents may be fostering self- disclosure.