bluuebunny/crossref_metadata_2025 huggingface dataset:
P03-334 - Neuroleptic Malignant Syndrome Diagnosis: an International Consensus Study Using the Delphi Technique
Authors: Gurrera R. , Caroff S. , Cohen A.
Published: June 2010

Objectives

To develop consensus-based clinical diagnostic criteria for neuroleptic malignant syndrome (NMS).

Methods

A 17-member international expert panel of psychiatrists, neurologists, anesthesiologists and emergency medicine specialists was asked to identify clinical features that are most important or valuable in diagnosing NMS; when the feature was quantitative in nature, they were also asked to provide the corresponding critical value. The Delphi technique is a formal consensus procedure that employs a postal survey method to solicit opinions from each panel member, and to feed this information back to the entire panel in the form of anonymous, statistically aggregated data. This iterative process of information exchanges (opinions collected, group responses analyzed, feedback given to panel), or “rounds”, continues until consensus has been reached. In the present study, the predetermined consensus criterion was a round-round mean change of 10% or less for any survey item, and 5% or less across all items.

Results

The expert panel reached consensus on the following diagnostic criteria in five iterations:

(1)

exposure to a dopamine antagonist, or dopamine agonist withdrawal, within past 72 hours;

(2)

hyperthermia;

(3)

rigidity;

(4)

mental status alteration;

(5)

creatine phosphokinase elevation;

(6)

sympathetic nervous system lability (2 or more of blood pressure elevation, blood pressure fluctuation, diaphoresis, urinary incontinence);

(7)

tachycardia and tachypnea; and

(8)

negative work-up for infectious, toxic, metabolic and neurological causes.

Conclusions

These are the first consensus-based diagnostic criteria for NMS, and may be preferred to previous ad hoc approaches to diagnosing this disorder.
P03-336 - Characteristics of Patients with Depression in the UK Initiating Treatment with Duloxetine and Venlafaxine XR
Authors: Durden E. , Happich M. , Shi N. , Torres A.
Published: June 2010

Objectives

To describe and compare the demographic and clinical characteristics of adult patients with depression in the UK treated with duloxetine and venlafaxine XR.

Methods

Depressed adults treated with duloxetine or venlafaxine XR between 1/1/2006 and 9/30/2007 were identified using the General Practice Research Database (GPRD), which represents all primary care practices in the UK. Demographic (age and sex) and clinical characteristics (psychiatric and physical comorbid conditions and concomitant medication use) were examined and the characteristics of the two treatment groups were compared using chi-square or t tests, as appropriate.

Results

Of 2,195 patients identified (mean age 47.2 years; 65.8% female), 41% were prescribed duloxetine and 59% were prescribed venlafaxine XR. On average, patients treated with duloxetine were older than patients treated with venlafaxine XR (49.6 years versus 45.5 years; p< 0.001). Compared to patients treated with venlafaxine XR, patients treated with duloxetine had higher prevalence of a variety of comorbid physical health conditions, including diseases of the circulatory, digestive, respiratory systems, as well as a higher prevalence of diabetes (p< 0.01 for all). Additionally, patients treated with duloxetine had higher prevalence of unexplained pain (p< 0.001). Greater proportions of patients treated with duloxetine had prescription utilization of medications in a variety of classes, including anticonvulsants, analgesics, migraine medications, as well as medications used to treat cardiovascular and gastrointestinal disorders (p< 0.01 for all).

Conclusions

Depressed patients treated with duloxetine in the UK are slightly older and appear to be in poorer health overall than patients treated with venlafaxine XR.
P03-349 The Potential Effects of Antidepressants in Attenuating Synaptic Degeneration in Depression and Alzheimer's Disease
Authors: Wuwongse S. , Chang R. , Law A.
Published: June 2010

Depression is a highly prevalent psychiatric disorder. Furthermore, it is one of the most common neuropsychiatric presentations in Alzheimer's disease (AD). Common underlying neuropathological processes appear to exist between these conditions. Synaptic degeneration has been implicated in AD pathogenesis, while its role in depression is not well understood.

Objectives

This study aims to investigate synaptic degeneration as a possible underlying mechanism for depression and whether antidepressants could alleviate the stated pathology.

Methods

Primary rodent hippocampal neurons treated with corticosterone were used as an in vitro model of depression. Toxicity of corticosterone was determined through the lactate dehydrogenase and caspase-3 activity assays. Immunocytochemical analysis of synaptic proteins was employed to investigate effects of corticosterone on synapses.

Results

Neurotoxicity was observed in hippocampal neurons after treatment with corticosterone (10μM) for 24 hours. Aggregations of synaptotagmin and synaptophysin were observed 24 hours after treatment with corticosterone (10μM). Similar effects were observed after sub-lethal treatments with corticosterone (0.5μM and 1μM) for 48 and 72 hours. Pre-treatment for 1 hour with imipramine and escitalopram (20μM and 40μM for both agents) were able to alleviate these toxic effects.

Conclusions

These results suggest the involvement of synaptic degeneration in corticosterone-induced toxicity and that commonly used antidepressants are able to alleviate synaptic derangements. Taken together, synaptic degeneration could be a common pathway for neuronal demise occurring in AD and depression, which can be attenuated by antidepressant administration. Future research to elucidate the precise mechanism for the synaptic protective effect of antidepressants is warranted.
P03-352 Aripiprazole in Prodromal Syndrome of Schizophrenia at the Male Patients with Obstetrical Traumas in Personal Medical History
Authors: Marinescu D. , Marinescu I. , Pirlog M. , Chimorgiachis A.
Published: June 2010

Objectives

The prodromal syndrome in schizophrenia can be correlated with a series of neurobiological risk factors, the obstetrical traumas having an important role. The antipsychotic therapy at the male patients with obstetrical traumas in personal medical history can amplify the risk of cerebral structural changes.

Method

We have studied 12 male patients (age 18-20 years), with prodromal schizophrenia syndrome or ARMS, negative symptoms, cognitive disabilities and poor social cognition. All the studied patients present obstetrical traumas in medical personal history, soft extrapyramidal symptoms, facial immobility and facial incapacity to express emotions (behavioral marker for poor social cognition and frontal-amygdala disconectivity). We administered aripiprazole (5mg/day) for 12 months associated with psychokinetotherapy technics, a series of facial mobility standard exercises.

Results

These patients were evaluated at 6 and 12 months with PANSS, GAF, BARNES scales. The final results are: on the PANSS scale the evolution of negative and cognitive symptoms was ameliorated. The facial mobility and the capacity of emotional expression are also significantly ameliorated. The cognitive abilities and the level of social cognition are evaluated as very good. The extrapyramidal symptoms evaluated on the BARNES scale are not amplifying during the treatment.

Conclusion

The facial imobility and the facial incapacity to expressed emotions may be a clinical marker for neurodevelopmental abnormalities in the schizophrenia prodrome. Aripiprazole associated with the psychokinetotherapy technics improve in a significantly way the prodromal symptoms of schizophrenia at the male with obstetrical traumas in medical personal history.
P03-354 How Frequently are Atypical Antipsychotics used to Treat OCD in a British Community Mental Health Team?
Authors: Birtwhistle M. , Agius M. , Zaman R.
Published: June 2010

Introduction

After initial psychological treatment patients with Obsessive Compulsive Disorder are treated with selective serotonin re-uptake inhibitors (SSRIs). Treatment may later be augmented with clomipramine and/or an antipsychotic. This study focuses on the biological treatment received after, or in parallel to, the psychological.

Aim

To collate and evaluate the levels of biological treatment currently received by OCD outpatients in the Bedford east catchment of Bedfordshire and Luton mental health and social care partnership NHS trust.

Objectives

In particular we wished to establish how many of the patients were receiving an atypical antipsychotic as well as maximal SSRIs.

Method

An anonymised database of 45 outpatients with symptoms of OCD was prepared. Treatment groups were identified and the percentage of the cohort occupied by these groups was calculated. The possibilities for increased medication were noted.

Results

Only 7% of patients had one SSRI, at maximum dose, plus clomipramine, plus an antipsychotic, even here the dosing was not maximal. Another 7% had a second SSRI instead of the tricyclic and may benefit from a trial of clomipramine. In the remaining 86% there was further scope for increasing biological therapy.

Discussion

Relatively few of our patients were having maximal SSRI treatment and an antipsychotic, despite guideline recommendations.

Conclusion

There is plenty of leeway for the escalation of patients’ biological therapy. Given the number of patients currently receiving secondary care, an escalation of their treatment should result in better patient health and a subsequent increase in discharges.
P03-357 Hepatitis C, Insomnia and Mirtazapin
Authors: Miljatovic A. , Simic S.
Published: June 2010

Objectives

HepatitisC, a viral infection,is one the most important causes of the chronic liver disease.As a consequence of interferon alpha 2a treatment of chronic hepatitis C, there is a number of side effects:headache, muscle aches, exhaustion, weight loss, hair loss, irritability, insomnia and other.

Aim

The aim of this study was to establish the frequency and the level of insomnia in patients with chronic hepatitis Cthat were treated with Interferon and Ribavirin for 24 weeks. We also evaluated the efficacy of Mirtazapin in the treatment of insomnia,in these patients.

Method

30 patients in all, with serologically and patohistologically established diagnosis of hepatitis C, were included in this study. These patients were treated with 180mg of Pegasus interferon injected subcutaneously, once a week. They also received 800mg of Ribavirin perorally a day. This treatment lasted 24weeks.

PITTSBURGH SLEEP QUALITY INDEX-PSQI was used as a measuring instrument for the evaluation of the level of insomnia.All the patients tested were at the beginning of the Interferon treatment,and after 3,5,and 7 months of treatment.Patients with diagnosed severe sleeping disorders were given small doses of Mirtazapin-15 mg every evening for 6 weeks.

Results

On the initial rounds,two patients had a PSQI score higher than 5.After a three month long Interferon treatment,five patients had a PSQI score higher than 5. After 7 months from the beginning of interferon treatment, ten patients had a PSQI score higher than 5, which indicates a significant sleeping disorder.

Conclusion

The administration of small doses of Mirtazapin/15 mg every evening shows useful effects in reduction of sleeping disorders caused by the Pegasus interferon treatment in patients suffering from chronic hepatitis C.
P03-359 Randomized, Double-Blind, Placebo-Controlled Study of Risperidone Long-Acting Injectable in Relapse Prevention in Patients with Bipolar I Disorder
Authors: Montgomery S. , Vieta E. , Sulaiman A.H. , Cordoba R. , Huberlant B. , Schreiner A. , Martinez G.
Published: June 2010

Objectives

To evaluate risperidone long-acting injectable (RLAI) versus placebo in prevention of mood episodes in adults with bipolar I disorder.

Methods

A 12-week open-label period with RLAI (N=585) was followed by an 18-month randomized, double-blind period with RLAI (25, 37.5 or 50 mg/2 weeks; N=137) or placebo (N=140); a third group (N=138) was randomized to olanzapine for reference and exploratory comparisons. Primary efficacy endpoint: time to relapse of any mood episode for risperidone LAI vs. placebo in the double-blind period (Kaplan-Meier analysis). Relapse was defined by criteria including DSM diagnosis, further treatment, hospitalisation, or Clinical Global Impression score ≥4 combined with YMRS or MADRS >12.

Results

Dosing was fixed during the double-blind period at patients’ final open-label dose (25 mg, 66%; 37.5 mg, 31%; 50 mg, 4%). Time to recurrence (any mood episode) was longer with RLAI versus placebo (log-rank test stratified by region and patient type, p=0.062; stratified by region only, p=0.032); the difference was significant for time to recurrence of elevated mood episodes (p=0.005) but not depressive episodes (p=0.587). Discontinuations due to adverse events (AEs) occurred in 2% of patients in the open-label period, and 4% and 1% in the RLAI and placebo groups, respectively, in the double-blind period. The most frequently reported AE in the open-label period was insomnia (15%). During double-blind treatment, the most frequently reported AEs with RLAI were weight increased (24%; placebo, 9%) and insomnia (16%; placebo, 17%).

Table 1.

Type of recurrence

Type of episode, n (%)Risperidone LAI (N=135)Placebo (N=138)All mood episodes52 (38.5)77 (55.8)Elevated mood episode27 (20.0)54(39.1)Hypomanic2(1.5)4 (2.9)Manic17(12.6)43(31.2)Mixed8 (5.9)7(5.1)Depressive25(18.5)23(16.7)

Conclusion

RLAI significantly delayed time to relapse of elevated mood episodes and was well tolerated.
P03-360 - The Effect of Lamotrigine Augmentation to Haloperidol Deaconate in the Treatment of Resistant Schizophrenia: Randomized, Double-Blind, Placebo-Controlled, Study
Authors: Aliyev N.
Published: June 2010

Objective

The current paper reports on a double-blind, randomized study of the role of lamotrigine as an augmentation agent to haloperidol deaconate in the treatment of out patient's schizophrenia with verbal resistant hallucinosis.

Method

Three hundred fifty patients were studied. The patients were then randomly divided into two groups on 175 subjects in each group. First group patients received either haloperidol deaconate 100 mg in month intramuscular and lamotrigine 150-200 mg in day per so for 12 weeks. Second group patients were given haloperidol deaconate 100 mg in month intramuscular and placebo per os for 12 weeks. The expressiveness of psychopathology was estimated on PANSS.

Results

75 (44%) of the 168 first group participants responded by 12 weeks, versus one (0.6%) of the 167 second group treated participants.

Conclusions

Our data suggest that haloperidol with the combination of lamotrigine was more effective than placebo.
P03-363 - Minding the Levels: About a Clinical Case with Neuropsychiatric Manifestations
Authors: Ramalho e Silva F. , Ribeiro A.E. , Serra de Lemos M.
Published: June 2010

Introduction and aims

Psychiatry makes use of a wide range of medications, such as anti-epileptic drugs in the treatment of affective disorders, impulsive behavior or epilepsy. The authors aim to present a particular clinical presentation in order to reinforce the awareness of the side effects of our prescriptions.

Case report

54 year-old man, epileptic, medicated with Sodium Valproate (VPA) and Phenobarbital, admitted to our hospital due to insomnia, irritability and aggressiveness with two weeks of duration. Early evaluations showed disorientation, slow and poor speech, and prejudice ideas towards his family. Disequilibrium, asterixis and slurred speech imposed evaluation by Neurology. Analytic evaluations demonstrated high phenobarbital and ammonia levels. Both anti-epileptics were slowly withdrawn, with clinical resolution.

Discussion

VPA may be associated with elevation of ammonia levels, and eventually with encephalopathy without evidence of liver failure. There is a wide range of clinical presentations of hyperammonemic encephalopathy ranging from decreased level of consciousness, irritability, agitation, focal neurological deficits, cognitive slowing, vomiting, drowsiness, and lethargy. On the other hand, high doses of phenobarbital may have similar presentations which could be potentiated by VPA.

Conclusion

There was a good correlation between the fall in serum ammonia levels, clinical improvement, and anti-epileptics withdrawal, suggesting the implication of medication in this clinical picture. The case illustrates the need to check ammonia and anti-epileptic levels, and to consider this diagnosis in patients taking VPA and Phenobarbital who present with new neuropsychiatric manifestations.
P03-372 - Evolution of Patients who Underwent Electroconvulsive Therapy (ECT) in a Brazilian General Hospital from 1993 to 2007
Authors: Santos A. , Oliveira M.C. , Andrade T.S. , Freitas R.R. , Salán T.M. , Azevedo R.C.S.
Published: June 2010

Objectives

To determine the outcome of patients who underwent ECT in a Brazilian General Hospital between 1993 and 2007.

Methods

Telephone contact with all patients (or their relatives) who were submitted to ECT during psychiatric hospitalization in HC-Unicamp-Brazil. Data were compiled for statistical analysis at SPSS.

Results

There were 53 successful telephone contacts (33.9% of 153 patients who underwent ECT). Losses were due to changes of telephones/addresses. No refuses occurred. The mean time between the procedure and the contact was 55.4 months (3-170). Twenty patients (37.3%) and 37 relatives (69.8%) were interviewed. Most were women (60.4% n=32), 4 were inpatients by the occasion of the call and 4 died. The mean age was 42.9±19.4. The assessments of current mental state by patients were: excellent in 5-9.4% cases, good in 12-22.6%, poor in 2-3.8%. The evaluation by family members was: excellent in 11-20.8% cases, good in 11-20.8%, poor in 7-13.2% and very poor in 5-9.4%. In 42 cases (79.2%) the patient was still under psychiatric treatment (taking psychotropic medication in 39-73.6%). In 28 cases (54%) there was need for new admission in a psychiatric inpatient ward. In 38 cases (74%) the patient reported knowing that he/she had undergone ECT, and only in 5 cases (9.4%) there was a lasting side effect of treatment reported, which was change in memory.

Conclusions

Data of the evolution of patients corroborate the importance of treatment with ECT for severe mental disorders, and also shows the low rate of long-term complications related to the procedure.
P03-377 - Escitalopram Induced Bradycardia, Hypotonia and Syncope
Authors: Szabo Z. , Eriksson M. , Milusic Z.
Published: June 2010

Objectives

Escitalopram is considered to be more effective than citalopram and to have less side effects. Previous studies have found that common cardiac manifestations of escitalopram overdose are QT prolongation and bradycardia. Some case reports inform about bradycardia without ECG abnormalities with therapeutic doses of escitalopram.

Methods

We report of a 29-year-old female patient diagnosed with major depression, hospitalized for 2 weeks. She had no history of any treatment with antidepressive drugs. After administration of 5 mg/day escitalopram the patient's blood pressure and pulse rate were mildly reduced and we observed presyncopal episodes daily. After 1 week of treatment the dose of escitalopram was raised to 10 mg/day and she complained about dizziness. In this case we found that presyncopal episodes lasted longer and both hypotension and bradycardia increased. These symptoms disappeared within 24 hours after escitalopram treatment was discontinuated. Results from routine laboratory tests, ECG, EEG, brain CT were normal. No other farmacologic causes were supposed to induce the above mentioned vegetativ symptoms.

Conclusion

Bradycardia and hypotonia have been previously reported with citalopram, but there are only a few case reports about these side effects induced by a therapeutic dose of escitalopram. Both central and - by directly inhibiting the entry of Ca into vascular smooth muscles resulting in vasodilatation - periferial effects of escitalopram are supposed to be responsible for these rare phenomena. This case report supports the importance of monitoring heart rate and blood pressure when escitalopram treatment is introduced, especially in cases of previously untreated depressive patients.
P03-381 - Quality of Life Improvement Through Depression Treatment in Oncologic Patients
Authors: Vasile D. , Vasiliu O. , Vasile M.L. , Mangalagiu A.G. , Stanescu B. , Petrescu B.M. , Nastase D.M. , Bogdan V.
Published: June 2010

Objective

To evaluate the impact of depression treatment over the quality of life in oncologic patients.

Methods

A group of 27 patients, 14 male and 13 female, mean age 56,3, diagnosed with lung (n=7), gastric (n=7), prostate (n=5), colon (n=4) and breast (n=4) cancer, were also diagnosed with moderate or severe depression (Hamilton Depression Rating Scale-17 items score at the inclusion was over 14). These patients received a combined, psychopharmacological (escitalopram mean daily dose 15 mg, n=15 or mirtazapine, mean daily dose 30 mg, n=12) and psychotherapeutic (cognitive behavior therapy) approach for 3 months and were monitored using monthly HAMD, Global Assessment of Functioning and Lehman Quality of Life Interview (QOLI). Patients didn’t present any significant axis I, II or III comorbid condition.

Results

Patients responded well to the combined therapy, as the final HAMD (-11.2, p< 0.01) and GAF (+12.3, p< 0.01) scores reflected, with no significant inter-group difference (p=0.23). The quality of life scales regarding health, family relations and social relations from the QOLI registered significant improvement compared to baseline (+10%, +12.2% and +12.5% respectively, p< 0.01). Patients who had the higher response rate to the treatment also had the higher rate of life quality improvement (r=0.65).

Conclusion

The treatment of depression in oncologic patients is a necessity, due to the impact of depressive symptoms over the patient quality of life and is associated with a significant rate of success. The improvements are observed especially in the patient perception of health, family and social relationship and functioning.
P03-382 - Impulsive Aggression in a Patient Treated with Levetiracetam
Authors: Villegas Martinez J.L. , Blanco Garoote J.A. , Marques Cabezas P. , Cabus Piñol G. , Coullaut Garcia J.
Published: June 2010

Introduction

Comparative studies prove that levetiracetam therapy presents a major frequency of behavioral disturbances, producing problems of impulsive aggressiveness with a relative frequency. Principally if a previous psychiatric history is associated.

Objetives

Report a case of Impulsive homicide aggression in a patient treated with Levetiracetam. Extensive bibliographical review.

Methods

We describe the case of a patient admitted in our Psychiatric acute unit because a major depressive disorder and mild cognitive impairment associated with vascular factors that developed strange impulsive aggressive behavior after the initiation of treatment with levetiracetam, even to try to assassinate his wife. Follow-up visits were performed at 6 and 12 months after discharge to assess aggressive behavior and the change in the Barratt impulsivity scale and the hostility inventory of Buss-Durkee. We conducted a literature review of behavioral and aggression problems associated with treatment with levetiracetam and its possible mechanisms.

Results

After the phasing out of levetiracetam and replacement by oxcarbazepine, aggressive behaviors disappeared. No significant psychopathology was showed in the patient in the follow-up visits, except secondary to preexisting cognitive impairment.

Conclusions

According to studies reviewed a 7-13% of patients treated with levetiracetam may develop behavioral disorders with impulsive aggression that usually resolve after discontinuation of drug.

Comparative studies show that levetiracetam has a greater frequency of such effects, leading to problems of impulsive aggression relatively often, especially if there is a comorbid psychiatric pathology.
P03-383 - Addition of a Selective 5-HT2A/D4 Antagonist Accelerates the Antidepressant Effects of Citalopram
Authors: Wade A. , Nemeroff C. , Schatzberg A.F. , Schlaepfer T. , Haazen L. , Buntinx E.
Published: June 2010

Objectives

Improvement in symptoms of depression is typically delayed with antidepressant treatment. Pipamperone (PIP) at low doses acts as a highly selective 5HT2A/D4 receptor antagonist. The purpose of this study was to investigate whether the addition of PIP to the SSRI citalopram (CIT) would increase the rate of resolution of depressive symptoms.

Methods

This was an 8-week, double-blind, parallel-group, single-dummy study in patients with MDD who received either CIT 40 mg daily or PIP 5 mg bid plus CIT 40 mg daily (PIPCIT).

Results

The mean total MADRS score (±SD) of the 165 patients (81% women; mean age, 40 y) was 32.6±5.5. More CIT than PIPCIT patients discontinued treatment in the first 4 weeks [15 (18%) vs 3 (4%); P=0.003]. Reductions in mean total MADRS scores were significantly (ITT LOCF) larger in patients receiving PIPCIT after 1 week [-6.42±6.18 vs -3.99±5.15; P=0.007] and 4 weeks [-15.06±8.48 vs - 12.11±8.30; P=0.025] compared with those receiving CIT alone. Significant differences in favor of PIPCIT were observed in MADRS items “reduced sleep,” “reduced appetite,” “concentration difficulties,” and “pessimistic thoughts.” Mean CGI-I scores were also improved after 1 week of PIPCIT [3.09±0.85 vs. 3.47±0.72; P=0.002]. There were no significant differences observed at 8 weeks. No additional, clinically significant adverse events were noted in the PIPCIT group.

Conclusions

A low dose of PIP added to CIT provided superior antidepressant effects and less discontinuations compared with CIT alone during the first 4 weeks of treatment, and especially in the first week, at apparently no tolerability/safety cost.
P02-294 - The Drawings of the Inside of the Body by Subjects with Eating Disorders
Authors: Amann Gainotti M. , Pallini S.
Published: June 2010

According to DSM IV, in the definition of eating disorders, a basic characteristic, common to anorexia and bulimia nervosa is a disturbed perception of body image frequently associated with amenorrhoea, and it's psychological concomitants, among which, the refusal of one's genitality.A noteworthy aspect in the genesis and maintenance of troubles in body representation is unsatisfaction and non acceptance of one's physical characteristics, related to sociocultural dynamics of overemphasizing a perfect and slim feminine body.The purpose of the research was to examine, in a comparative perspective, the structure, contents and qualitative aspects of the drawings of the inside of the body of subjects with eating disorders, with the hypothesis that their drawings might traduce characteristics related to their specific troubles and difficulties, characteristics that did not compare in the drawings of subjects from previous studies by Amann Gainotti,1988, and Amann Gainotti & al.,1992,1993, 2002, 2004 on normal children and adolescents,on young adults, and on subjects from different culturesSubjects of the study were a group of 40 women with eating disorders, aged 16 to 38 years, patients of a specialized medical structure for eating disorders in Rome (Italy).Half of the group suffered of anorexia and the other half of bulimia.Results The drawings of the inside of the body of patients with eating disorders show peculiar features and specific characteristics that are different by certain aspects from children and adolescents’ drawings and that are also different from control subjects of previous studies.
P02-300 - Severe Non-Adherence to Treatment Phenomena in Russian Patients with Advanced Atherosclerosis
Authors: Drapkina O. , Ashikhmin Y. , Smirnova V.
Published: June 2010

Objective

To assess the prevalence and structure of non-adherence in Russian population of patients with advanced atherosclerosis.

Methods

Sixty patients (mean age was 69±11 yrs, 30 males) with advanced cerebral arteriosclerosis and ischemic heart disease were randomly selected from cardiovascular department and enrolled in the study for subsequent psychiatric counseling, questionnaires and MRI procedures. Patients with stoke, focal neurological deficit and any psychiatric disorders in anamnesis were excluded.

Results

We have shown that 80% of patients have decreased or completely absent adherence to medical care. This patients were subsequently divided into three subgroups. First subgroup (30%) was characterized by partial denial of illness, where 3 (5%) patients suggest that they understanding somatic disease clinical course better than doctors. Significantly decreased compliance was most apparent in secound subgroup (30%), manifesting in self-changing drug and dosage regimen (for instance, skipping the medication without the doctor advise. In this subgroup 6 patients (10%) showed denial of treatment pattern underscored that conventional treatment for atherosclerosis as a whole is harmful for them and prefer to avoid all medications after discharge. Third subgroup included patients with vascular dementia (20%), where MRI analysis revealed white matter lesions with preferable localisation in emotional areas of cerebral (sub)cortex. There was a strong and significant correlation between the MRI white matter leasions score and treatment non-adherence level (r = 0.75).

Conclusion

Non-adherence is very prevalent in patients with advanced atherosclerosis estimating for up to 80%, while severe non-adherence is observed in 35% of patients.
P02-302 - The Impact of Binge Eating Symptomatology in the Quality of Life of Obese Patients Suffering From A Mood Disorder
Authors: Gonidakis F. , Ginieri-Coccosis M. , Rali E. , Spilioti E. , Varsou E. , Papadimitriou G.
Published: June 2010

Introduction

A significant number of patients suffering from a mood disorder gain weight either due to the medication side effect and/or the lack of exercise. Binge Eating disorder has a high comorbidity with mood disorders. Both disorders have been found separately to have a high negative impact ob the patients quality of life

Aim

The aim of the study was to investigate the possible impact of binge eating symptomatology in the quality of life of obese patients suffering from a mood disorder.

Method

We approached 117 obese patients treated for mood disorder (unipolar and/or bipolar). All patients were recruited from a free of charge anti-obesity program specifically designed for mental patients that have gained weight. Each participant filled in the WHO Quality of Life Brief Scale (WHOQOL-Bref), a questionnaire on Binge Eating symptomatology based on DSM-IV research criteria, the General Health Questionnaire (GHQ) and the Social Physique Anxiety Scale (SPAS).

Results

According to DSM-IV criteria 40 patients were suffering from Binge Eating Disorder. The comparison between Binge Eating and non Binge Eating group (t-test) showed that the former group had higher SPAS measurements (p=0.007) and lower WHOQOL-Bref measurements in the psychological (p=0.01) and physical (p=0.006) domains. All other measurements as well as age, body mass index and gender did not show any statistical significant difference between the two groups.

Conclusion

The presence of Binge Eating symptomatology might worsen patients quality of life especially when they are already carrying the burden of a mood disorder and obesity.
P02-305 - Clinical Features of the Phenomenon of the Somatization
Authors: Kim A. , Sulimanova M.
Published: June 2010

The frequency of organ somatization in multimedical network was the object of study.

Materials

The results of clinical and epidemiological study of 2181 patients (average age-54 ± 0.8) are presented.

Methods

Inventory for clinical-anamnestic behavior sign of adaptation form of disease of patients with comorbid phenomenon and standard scales for value of anxiety and depressions were used.

Results

Patients with somatoform pain more complicated in pharmacologic treatment, have complex diagnostic procedures, sometimes surgical interventions, were are often cases of analgesic dependence 5,8 (P< 0,05). The patient with idiopathic pain (antidepressant therapy's reply 4,2 (P< 0,05) and cognitive therapy's 2,8(P< 0,05)) and organ somatizations (analgesic dependence 3,5 (P< 0,05), antidepressant therapy's effect 4,3 (P< 0,05) and the cognitive therapy's reply 3,4(P< 0,05)) almost never has decided the idea about the mental nature of agonizing somatic sensations, seldom collaborate with psychiatrists.

Conclusion

The phenomenon of somatization is a group of disorders in the base of which mechanisms of the psychical adaptation and behavior are. The admission of axial somatization's symptoms as mechanisms of the psychical adaptation and behavior and additional, forming by the purposeful interview of the patient, is appearing to be reasons, that is making actual questions of the effective competent communication for the optimization of therapeutic interventions. Thereby, the phenomenon of the somatization as mechanisms of the psychical adaptation and behavior is axial symptoms and cultural dependent features forming in the structure of the purposeful interview and the doctor's clinical estimation of the patient - are additional.
P02-314 - Temperament and Character in Outpatients with Anorexia and Bulimia Nervosa
Authors: Martínez-Gómez P. , Ramos-Ríos R. , Tajes-Alonso M. , Gastañaduy-Tilve M.J. , González-Lado I. , Martínez-Formoso S. , Arrojo-Romero M.
Published: June 2010

Objectives

The aim of this study is to assess the personality traits in a sample of Spanish anorexic and bulimic outpatients.

Method

The revised version of the Temperament and Character Inventory was administered to 76 women attended in an Eating Disorders Unit and to 46 healthy controls. Both groups were matched by gender, age and instruction.

Results

Diagnoses in the sample were distributed as follows: bulimia nervosa (BN) 33, binging-purging type anorexia nervosa (BPAN) 23 and restricting anorexia nervosa (RAN) 18. RAN patients were significantly younger (21.6 vs. 26.3 p < 0.01). Differences in the harm avoidance, persistence and selfdirectedness subscales of the TCI were found (see table).

 RANBPANBNCp Novelty seeking89.397.399.697.40.15n. s.Harm avoidance116.1118.3118104.40.002BPAN, BN > CReward dependence112.5111.7103.7110.50.12n. s.Persistence120.7113.7108.4102.90.005RAN > CSelfdirectedness125.5120.8117149.5< 0.001C > RAN, BPAN, BNCooperativeness141.4145.9138.3142.90.34n. s.Selftranscendence63.867.266.959.50.17n. s.

[Results]

Conclusions

In concordance with previous reports, compared with healthy controls, patients show lower scores in self-directedness. Persistence seems to be associated with restricting behaviours, whereas harm avoidance with binging and purging. RAN trends to have low scores in novelty seeking items and BN shows lower reward dependence, but this differences are not statistically significant, perhaps because of sample size.
P02-318 - Stress, Mental Disorders & IBS”
Authors: Solati K. , Adibi P. , Palahang H.
Published: June 2010

Objective

The aim of this study was to find relationship between life events stress, mental disorders and irritable bowel syndrome.

Methods

This descriptive and cross sectional study was performed during six months on the 76 patients IBS. The life events stress or Paykel, GHQ-28 and Rome III criteriaand clinical interview was used assessment.

Results

The differences were statistically significant between life events stress and mental disorders with IBS (P< 0/05).

Conclusion

Psychology distress and life events stressor is important component of the IBS symptom experience and shoud be considered when treatment strategies are designed.
P02-322 - Integrative Approaches in the Therapy of the Comorbid Conditions
Authors: Kim A. , Sulaimanova M.
Published: June 2010

Objectives

Study of the clinical features in the group of somatoform and psychosomatic disorders.

Materials

The results of clinical and epidemiological study of 2181 patients (average age-54 ± 0.8) are presented.

Methods

inventory for clinical-anamnestic behavior sign of adaptation form of disease of patients with comorbid phenomenon and standard scales for value of anxiety and depressions were used.

Results

The homogeneous group of disorders in which somatic as well as psychical symptoms are equivalent 6,7 (P< 0,05).The phenomenon of comorbidity as the independent clinical adaptive mechanism was revealed 8,3 (P< 0,05). In the research group the positive response for the psychotropic therapy was registered 5,3 (P< 0,05).

Conclusion

The phenomenon of comorbidity in practice area reduces to new understanding of the coexistence of the psychic and somatic register, illustrates the possibility of the valuation of indicator of quality of manifestation of symptom and syndrome in context of social functioning. The social functioning is the indicator of quality and optimization of the diagnostic and therapeutic processes, which are demanding independent culturally dependent diagnostic directives from existing classifications (ICD-10, DSM-IV). The somatic symptom is the integral part of psychopathologic syndromes.
P02-323 - The Prevalence of Disorders Eating in Patients with Diabetes Mellitus
Authors: Danoiu M. , Danoiu S. , Danciulescu Miulescu R. , Poiana C. , Cristescu V.
Published: June 2010

Objectives

The aim of this study was to estimate the prevalence of disorders eating among patients with diabetes mellitus.

Method

Studies have shown that The Eating Attitudes Test (EAT-26) can be an efficient screening instrument as part of a two-stage screening process in which those who score at or above a cut-off score of 20 are referred for a diagnostic interview. 44 patients with diabetes mellitus (28 women and 16 men) were recruited for this study. Height, current weight, body mass index (BMI) were determined. The EAT- 26 for Eating Disorders was completed. Results were compared with measurements in 32 nondiabetic subjects (22 women and 10 men).

Results and conclusions

The prevalence of disorders eating among patients with diabetes mellitus was 18.18%. Of the 44 patients with diabetes mellitus, 8 scored higher on EAT (average score 32.01, BMI 31.36 kg/m2) than the remaining 36 patients with diabetes mellitus, whose score averaged 14.22 (BMI 26.32 kg/m2). In this study we found significant differences for the recorded parameters between diabetic patients with and without disorders eating. Age were similar in both groups, but BMI were higher, and scored on EAT were higher in diabetic patients with disorders eating. The prevalence of disorders eating among nondiabetic subjects was 6.25%. Two patients with diabetes mellitus develop a clinical eating disorder and needs cognitive-behavioral, interpersonal psychotherapy and pharmacologic treatment. The EAT-26 score at or above of 20 needs expertise in eating disorders, and nutrition.
P02-326 - Impact of IBS-like Symptoms on Quality of Life in Patients with Crohn's Disease in Remission
Authors: Trikos L. , Bojic D.
Published: June 2010

Objectives

Irritable bowel syndrome (IBS) is one of the most prevalent functional gastrointestinal disorder. The aim of our study was to assess the prevalence of irritable bowel syndrome (IBS)-like symptoms in Crohn's disease (CD) patients in remission. Furthermore, the possible relation of IBS-like symptoms with quality of life was studied.

Methods

Sixty-four patients with known Crohn's disease were invited to complete the SF-36 (to assess quality of life) while in clinical remission and were studied for the possibility of IBS-like symptoms. Diagnosis of IBS was made according to ROME III Criteria. Physical health summary score (PCS) and mental health summary scores (MCS) of CD patients with IBS-like symptoms were compared with PCS and MCS of CD patients without IBS-like symptoms.

Results

IBS-like symptoms were found in 55% of Crohn's disease patients in remission. CD patients with IBS-like symptoms had lower well-being scores than those without IBS-like symptoms.

Conclusion

The presence of irritable bowel syndrome-like symtoms impaired the quality of life of patients with Crohn's disease.
P02-328 - Effect of Group Therapy on Anxiety and Depression in Dialysis Patients
Authors: Ahmadvand A. , Saei R. , Sepehrmanesh Z. , Ghanbary A.
Published: June 2010

Objectives

Hemodialysis as a treatment manner in chronic renal failure is a stressful process and has several various psycho-cognitive and social complications. This procedure can made mental disorder in these patients. Therefore it is better that moreover prescription of medication in hemodialysis centers, psychological interventions is done for patient's rehabilitation too.

Methods

This research is a quasi experimental and clinical trial study. Samples were young adults who were 18- 45 aged. The Beck depression & anxiety inventories were used as a measure of psychological symptoms at pretest and post test. Cognitive-behavioral group therapy as intervention was done at 12 week. Information were analyzed with SPSS-16 and Paired t-test and Analysis variance one way.

Results

The result showed a significant difference between anxiety and depression before and after intervention in case group (p=0/0001) and there was not a significant difference among variables such as: age, sex, education and economic level, dialysis long time with anxiety and depression among in studied group.

Conclusions

This research shows that group therapy (cognitive- behavioral) has been decreased depression and anxiety remarkably in dialysis patients. Therefore it is suggested that moreover description of medication, psychological interventions are done for this patients.
P02-334 - Functional Neural Correlates of Mindfulness Meditations and A Comparison with Psychotherapy, Pharmacotherapy and Placebo: is there a Link?
Authors: Chiesa A. , Serretti A.
Published: June 2010

Objective

Mindfulness meditations (MM) are a group of meditation practices which are recently receiving growing attention. Following the increasing interest towards the neural correlates of meditation, particularly Mindfulness meditations (MM), the aim of the present work is to review current findings about the neural correlates of MM and compare such findings to those of further specific and non specific treatments.

Methods

A literature search was undertaken using MEDLINE, ISI web of knowledge, the Cochrane database and references of retrieved articles. Studies which focused on the functional neural correlates of MM, psychotherapy, pharmacotherapy and placebo published up to August 2009 were screened by the reviewers in order to be considered for the inclusion.

Results

Main findings suggest that long term MM practice could allow a more flexible emotional regulation by engaging frontal cortical structures to dampen automatic amygdala activation when it is needed. A great overlap could exist between cerebral areas activated during MM, psychotherapy,pharmacotherapy and those activated by expectancy in placebo studies. However, while MM, psychotherapy and placebo could act through a top-down regulation, antidepressants could act through a bottom-up process.

Conclusion

MM could target specific brain areas related to emotions and emotional regulation. Consistent similarities could exist between MM and other interventions, particularly psychotherapy. Despite these promising findings, however, further research is needed in order to extend current findings, to more deeply compare MM to other treatments and to better investigate the neurochemical correlates of MM.
P02-337 - Melancholy Turning into Ashes the Fire of Hysteria
Authors: D‘Ottaviano F.T.M. , Santos A. , Barioni P.M. , Freire J.M.G. , Jacintho A.C.d.Á. , Pereira M.E.C.
Published: June 2010

Objectives

To discuss the paradigm of melancholy in hysteria.

Methods

case report of M., a 45 year-old woman, who is under psychotherapy and psychiatric treatment at the General Hospital of the University of Campinas (HC Unicamp).

Results

K. is a 45 year-old divorced mother and former teacher, who started psychotherapy and psychiatric treatment at HC Unicamp in 2007, two years after the death of her father.Since such loss,K. made several violent suicide attempts: she jumped from the balcony of her apartment, took an overdose of medications, and set fire to her body in front of the mirror, which caused permanent scars. During both the psychotherapy sessions and the psychiatric consultations, K. frequently expressed how her life had lost its meaning after the death of her father. She mentioned she was no longer able to love and had no reason to continue living. She also complained about her ex-husband, from whom she was divorced after being betrayed, and about her children, who did not give her, according to her point of view, enough attention and care.

Conclusions

The patient is inside a typical hysterical scene, a “spectacle” composed by dramatic acts against her life. However, it is undeniable her identification with the lost object, her father. By setting fire to her own body in front of the mirror, she shows a melancholic kind of satisfaction with the pain, caused by a massive and destructive narcissism turned against herself.
P02-338 - Characteristics of Traditional Healing Practices and its Implications for Modern Psychotherapies
Authors: Dalal A.
Published: June 2010

The paper reviewed the relevance and richness of the traditional healing practices in India, and argued that they are based on complex psychological theories of mind and human nature. They provide practical solutions to personal, familial and social problems, and have been integrated within the communal life for centuries. The paper endeavoured to understand the way traditional healing works to alleviate human suffering and tried to delineate the role of cultural belief system. Some salient characteristics of these traditional practices were identified. The traditional healing practices primarily deal with psychological aspects of the problem. No matter what are the actual causes of the problem, be it organic, emotional or social, the suffering is viewed as a state of mind, a subjective experience. These folk therapies aim at changing the way people construe their world, the very objective toward which modern psychotherapies also work. It was argued that an in-depth study of folk wisdom inherent in traditional healing practices could lead to development of new psychotherapies appropriate for the present global society.
P02-347 - Therapeutic Processes in Family Groups for Hospitalized Patients with Major Depression: A Phenomenological Study
Authors: Lemmens G. , Hellemans S. , De Mol J. , Buysse A. , Demyttenaere K.
Published: June 2010

Introduction

Family-based interventions have shown to be effective in the treatment of major depression. In a recent RCT, systemic family groups led to significantly higher rates of treatment responders and higher rates of patients no longer using antidepressant medication at 15 months follow-up compared to standard care.

Objectives

In order to better understand the underlying mechanisms of change, helpful treatment experiences of depressive patients and their partners in the family groups were explored.

Methods

34 depressive patients and their partners were asked to fill out an open-ended questionnaire investigating helpful experiences during treatment at the end of a 6 bi-weekly group session cycle. Responses were analyzed using the interpretative phenomenological approach (IPA) by three different researchers.

Results

Ten recurring themes were reported as helpful by both the depressed patients and their partners:

(1)

Presence,

(2)

Cohesion,

(3)

Support,

(4)

Openness,

(5)

Discussion,

(6)

Self revelation,

(7)

Insight,

(8)

Progress,

(9)

Observational experiences and

(10)

Guidance from therapist.

Conclusions

The results of this study help to get insights in the therapeutic factors, which should be emphasized in family groups.