bluuebunny/crossref_metadata_2025 huggingface dataset:
2029 – Aripiprazole Withdrawal And Supersensitivity Psychosis: a Case Report
Authors: Lakhal M.H. , Rafrafi R. , Jomli R. , Ouanes S. , El Hechmi S. , Melki W. , El Hechmi Z. , Nacef F.
Published: July 2013

Introduction

Supersensitivity psychosis is a drug-induced phenomenon which consists of psychotic relapse occurring upon decrease or withdrawal of antipsychotics. This phenomenon has been described with many antipsychotics. We report the case of supersensitivity psychosis associated with decreasing doses of aripiprazole in a Tunisian patient.

Case description

Mr. M. is a 26-year old Tunisian male with a diagnosis of bipolar disorder (DSM IV). He was diagnosed at the age of 17. For the last 2 years, his condition was stable with lithium 250 mg/day, valproic acid 500 mg/day and aripiprazole 15 mg/day. The patient had a good adherence to this regimen and could go to work and study. During that period he only had some depressive relapses. He never had psychotic symptoms. He decided himself to stop taking aripiprazole. The withdrawal was abrupt. Two days later, he began to experience auditory and visual hallucinations and persecutory delusion he never experienced before. He was hospitalized and he was put again on aripiprazole with increased doses to 20 mg/day. One week later his symptoms had improved significantly, he was experiencing less hallucinations. Two weeks later all the psychotic symptoms disappeared.

Discussion

This case illustrates the concept of supersensitivity psychosis. This concept refers to the proposal that chronic administration of dopamine-blocking agents increases sensitivity of dopamine receptors in the mesolimbic or mesocortical system. These dopamine-blocking agents over-react to normal levels of dopamine after drug discontinuation or reduction, thus producing psychotic symptoms, analogous to the proposed mechanism of tardive dyskinesia.
2030 – Can TGF- β Be a Valuable Marker For Psychosis?
Authors: Borovcanin M. , Djukic Dejanovic S. , Radosavljevic G. , Jovanovic I. , Stefanovic V. , Arsenijevic N. , Lukic M.L.
Published: July 2013

Role of cytokines has been widely investigated in schizophrenia. Previous data suggest that TGF- β pathways can be hyperactive in schizophrenia. Serum levels of TGF- β showed to be significantly increased in psychotic patients with first episode psychosis and schizophrenia in relapse. As a part of recently publish research, we try to establish if TGF- β can be a valuable marker for psychosis. We investigated psychotic patients, with first episode psychosis and schizophrenia in relapse (133 subjects) and healthy controls (36 subjects). Diagnoses were established using International Statistical Classification of Diseases and Related Health Problems, Tenth Revision (ICD-10). The psychopathological status of psychotic patients was assessed by trained physicians using Positive and Negative Syndrome Scale (PANSS). Serum level of cytokine was measured using sensitive enzyme-linked immunosorbent assay (ELISA). Binary logistic regression showed that increased level of TGF- β strongly correlated with presence of psychosis (OR 1.068 (1.015-1.123)). Analysis showed that TGF- β can be a valuable marker for psychosis (area = 0.775, p < 0.0005). The optimal cutoff value estimated for TGF- β that allows the discrimination of psychotic from non psychotic patients was 22 pg/ml. For this cut-off we got sensitivity 70.4% and specificity 80.6%, i.e. this concentration of 22 pg/ml TGF- β could have prognostic value. We envisage the possible role of TGF- β as a biomarker in preceding schizophrenia and showed that increased level of TGF- β enhanced the risk for psychosis. According to our results, TGF- β could be a valuable marker for schizophrenia.
2035 – Depressive Disorders In Patients With Ischemic Heart Disease And Various Manifestations Of Metabolic Syndrome
Authors: Garganeeva N. , Rozin A. , Schastnyy E. , Belokrylova M. , Donov A.
Published: July 2013

Objective

Study of influence of depression on assessment of cardiovascular risk in IHD patients with components of metabolic syndrome (MS).

Material and methods

Among 376 IHD patients (59,1±10,3 years) 72,9% had AH, 40,2% DM of type 2 or disturbance of tolerance to glucose (DTG), 45,9% obesity, 42,2% dyslipidemia (DLP). Methods of investigation were as follows: clinicalpsychopathological, experimental-psychological, HADS, MADRS.

Results

Depressive disorders have been diagnosed in 109 IHD patients (29%) of cardiologic institution. 79,8% had affective disorders, 20,2% mixed anxiety-depressive reaction, organic depressive disorder. There were more often factors of cardiovascular risk and components of MS: frequency of AH (83,2% vs. 66,3%; p = 0,016), DM of type 2 and DTG (46,8% vs. 37,5%; p = 0,048), obesity (30,7 ± 3,9 vs. 29,5 ± 4,5; p = 0,015), abdominal obesity (100,0 ± 10,7 vs. 92,0 ± 9,6 cm; p = 0,02), DLP (42,2% vs. 31,1%; p = 0,04); TCh (6,03 ± 1,19 vs. 5,72 ± 1,31 mmol/l; p = 0,033); Ch-LPHD (0,83 ± 0,18 vs. 0,94 ± 0,29 mmol/l; p = 0,0015). We have noticed increase of cases of instable angina (16,5% vs. 8,2%; p = 0,02), post-infarction cardiosclerosis (41,3% vs. 39,3%; p = 0,043), surgical revascularization of myocardium (22,9% vs. 15,4%; p = 0,041), need for nitrates (23,4 ± 2,8 vs. 17,6 ± 2,9 tablets/week; p = 0,00001), invalidization (44% vs. 23,2%; p = 0,00001). During intake of antidepressants (SSRIs) higher scores according to depression rating scales remained by month 6 of psychotropic therapy.

Conclusions

High frequency of association of factors of cardiovascular risk and components of MS in IHD patients with depressive disorders significantly exceeds indices in group without depression. Metabolic disturbances (DM of type 2, DTG, DLP), revealed in 65,1% of IHD patients with depression, decrease efficacy of antidepressant therapy.
2036 – Anesthesia In Pediatric Oncologic Patients Undergoing Radiotherapy
Authors: Taniguchi S. , Feltrin M. , Centroni Yamazaki A.F. , Negrão A.J. , Ropero J.
Published: July 2013

Introduction

Pediatric oncological patients undergoing radiotherapy require immobilization.

Objectives

This study investigated the drugs administered and vital signs of these patients.

Methods

Our study included 38 patients with mean age 29.40 ± 3.94 months, weight mean 14.64 ± 0.55 kg, height 90.47 ± 14.71 cm undergoing anesthesia for radiotherapy immobilization purpose.

Results

All patients received sevoflurane 8% for induction and anesthesia maintenance and procedure period was 32.62 ± 2.41 minutes.

Measured vital signs before anesthesia were: systolic arterial pressure 101.38 ± 2.05, diastolic arterial pressure 53.28 ± 1.80, heart rate 116.14 ± 1.80, respiratory rate 23.12 ± 0.93 and body temperature 36.01 ± 0.19.

Vital signs after anesthesia were: systolic arterial pressure 96.00 ± 2.02, diastolic arterial pressure 49.20 ± 2.88, heart rate 111.63 ± 2.80, respiratory rate 23.51 ± 1.10, body temperature 36.43 ± 0.82 and oxygen saturation 97.74% ± 1.00.

Emergence agitation related to the use of sevoflurane was observed in 84.21% (32) patients.

Either propofol 0.5 - 4.4 mg/kg or nalbuphine 0.1-0.15 mg/kg or fentanyl 2-3.6 mg/kg controlled agitation after sevoflurane in 43.75% (14) patients.

Flumazenil 0.02 mg/kg given to 5.26% (2) patients and haloperidol 1.44 mg/kg administered to 10.53% (4) and enhanced the agitation after sevoflurane.

Conclusion

There were no significant difference between vital signs measured before and after anesthesia with sevoflurane. Emergence agitation due to the use of sevoflurane was observed.

The use of benzodiazepines antagonist and neuroleptics should be evaluated in emergence agitation due to sevoflurane.
2038 – Help For The Individual In The End Of Life
Authors: Semke V.
Published: July 2013

Way to conceptualization of process of rendering of assistance for aging patients allows broadening of front of joint action of psychotherapists, psychologists, sociologists, clinical geriatricians, creating valid perspectives of Russian nation. Such help is considered within the entire humankind, acute problem of mental health in contemporary world we may regard perspective of formation of successful scientific developments in the domain of geriatric help, as well as perspective of new branches of knowledge of “Homo noetic” in the new third millennium. We need breakage in psychology of workers of healthcare, researchers and patients. We need another graduate and postgraduate education, another upbringing at home and in the society. These positive shifts occur currently, giving the hope for huge success in the XXIst century.

Namely on border of centuries (largely millenniums) we witness scaled rethinking of system of scientific paradigms, attitudes, priorities and values in the field of human mental health, passing various phases of his/her existence. Conditions of interaction in system “doctor-patient” change, people want to take part in their own fate, in assessment of level of their health, illness and even coming death, having possibility to choose informed partner collaboration. Largely, this is associated with change of essence and content of the entire psychiatric science, including gerontopsychiatry.
2040 – Clinical Characteristics Of Patients With Schizophrenia Associated With Drug And Alcohol Dependence
Authors: Dobrovolskaya A. , Sofronov A. , Savelyev A. , Zinovyev S. , Pashkovskiy V.
Published: July 2013

Objective

To analyze social, demographic and clinical characteristics of patients with schizophrenia and comorbidity drug dependence.

Methods

Clinical interview with specially elaborated formalized card. Patients were diagnosed according to ICD-10 criteria. 182 patients were treated in St Petersburg state mental hospital № 3 in 2005-2010.

Results

Alcohol, cannabis, and heroin tend to be the primary substances of abuse. According to the drug usage we form two groups. The first group (n = 105, 57,7%) consisted of patients who abuse alcohol only. The second group consisted of patients who use different types of drugs (n = 77, 42,3%). Both groups had high rates of unemployment, disability, length of stay in a psychiatric hospital.

Schizophrenia patients with multidrug dependence (2nd group) were younger than patients with alcohol dependence only (1st group). Middle age of patients of 2nd group was 31, 38 ± 0, 94 and middle age of patients of 1st group was 42, 45 ± 1,14. Patients of both group were unemployed 92 (87, 61%) and 62 (80,52%) respectively.

We identified statistically significant between-group differences in patients with paranoid schizophrenia. Patients of 1st group had paranoid schizophrenia higher 76 (72, 38%) than patients of 2nd group 39 (50, 65%). On the contrary, simple schizophrenia was diagnosed more often in patients of 2nd group 29, 87% and 14, 28% respectively.

Drug dependence disorders come before schizophrenia manifestation significantly more often (51,95%) than alcohol use disorders (AUD) (31,43%).

AUD occurred after schizophrenia manifestation (33, 33%) significantly more often than drug dependence disorders (12,9%).
2049 – Are Personality Traits Predictive Of Diagnosis In Adjustment Disorder And Depressive Episode
Authors: Doherty A. , Jabbar F. , Casey P.R.
Published: July 2013

Aims

In this study we aimed to examine the characteristics of patients diagnosed with depressive episode or adjustment disorder, and to explore the interplay between these diagnoses and personality disorder/traits.

Methods

Patients referred to the liaison psychiatry services at three Dublin hospitals and diagnosed with either a depressive episode or an adjustment disorder were recruited to this study. They were interviewed at time of diagnosis and again after six months using validated instruments, including SCAN (Schedule for Clinical Diagnosis in Neuropsychiatry - a semi-structured diagnostic interview schedule) and possible personality disorder as measured by SAPAS (Standardised Assessment of Personality - Abbreviated Scale).

Results

370 patients were recruited to the study, 185 of whom had a diagnosis of an adjustment disorder; the remainder were diagnosed with a depressive episode according to ICD-10 criteria. SCAN (Schedule for Clinical Diagnosis in Neuropsychiatry - a semi-structured diagnostic interview schedule) was not useful in distinguishing between these two diagnoses. Patients with a SAPAS score above 3 (cut-off for likely personality disorder) and a diagnosis of adjustment disorder had an increased risk of suicidal behaviour (p = 0.001). When both diagnostic groups were analysed together, patients with a SAPAS score above 3 had an increased risk of suicidal behaviour (p = 0.007).

Conclusions

There has been little prior research into personality disorder and its association with adjustment disorder. Personality traits are associated with a diagnosis of depression rather than adjustment disorder, but have a stronger association with suicidal behaviour in patients with a diagnosis of adjustment disorder.
2058 – Réhabilitation Psychiatrique Chez Des Patients Sous Mesures Judiciaires
Authors: Bougherab A.
Published: July 2013

La psychiatrie pénitentiaire accueille des patients qui souffrent de troubles psychiatriques, qui ont commis des délits en lien avec leurs pathologies.

Quelle approche thérapeutique à suivre pour ce type de patients lorsqu’on sait que qu’il y a deux grandes catégories de Troubles les patients qui souffrent de troubles psychotiques et les patients qui ont un probleme de trouble de personnalité notamment personnalité dyssociale.
2061 – Level Of Functioning In Early Onset Psychoses: Seven Years Follow-up Study
Authors: Remberk B. , Bażyńska A.K. , Bronowska Z. , Potocki P.
Published: July 2013

Introduction

There is a relative dearth of studies assessing the course of early onset psychoses especially other than schizophrenia.

Objectives

Follow-up assessment of level of functioning in early onset psychosis.

Aims

Analysis of the course and outcome in early onset psychoses. Assessment of prognostic significance of psychopathological symptoms profile in the early course of illness.

Methods

144 patients with schizophrenia spectrum diagnosis (F20 - F29 according to International Classification of Diseases Tenth Revision ICD-10), hospitalized in the period June 1998 - June 2008 in Child and Adolescent Psychiatry Department was interviewed a mean 7.3 years after the index hospitalization. During interview data concerning course of illness after discharge and present level of functioning were obtained. For 50 of the patients with available results of baseline assessment with Positive and Negative Syndrome Scale these data were also analyzed.

Results

Mean age at the index hospitalization was 16.9 years, mean age at the follow-up assessment 24,3 years. Psychotropic drugs were currently receiving 72% of patients. In some kind of educational or vocational activity were engaged 68% of patients. Mortality rate was 2%. Baseline diagnosis of schizophrenia was associated with higher number of hospitalizations, current pharmacotherapy and lower probability of being in romantic relationship. Negative symptoms present during index hospitalization were associated with more intensive further treatment, but not with the current level of functioning.

Conclusions

Baseline diagnosis and baseline level of negative symptoms were associated with mental health services utilization but had little impact on functional outcome.
2076 – Psychometric Properties Of The Spanish Version Of The Movie For Assessment Of Social Cognition (masc)
Authors: Lahera G. , Boada L. , Pousa E. , Mirapeix I. , Marinas L. , Parellada M.
Published: July 2013

Background

The Movie for the Assessment of Social Cognition (MASC) has been shown to have good psychometric properties.

Objectives

To translate, adapt, and validate a Spanish version of the MASC (MASC-SP) for use in patients with Asperger's syndrome.

Aims

To develop an ecological and standardized assessment of social cognition for the Spanish-speaking community.

Methods

MASC-SP was administered to a sample of twenty-two patients diagnosed with Asperger's syndrome (3 women, 19 men; mean age 21.94) and twenty-six healthy volunteers (9 women, 17 men; mean age 22.92). Other measures of social cognition were also administered: the Strange Stories Task, the Reading the Mind in the Eyes Test, and a emotion recognition task. A brief scale for cognitive evaluation in psychiatric patients was also administered (SCIP).

Results

The Asperger group scored lower on the MASC-SP (p = 0.000), had fewer correct answers on the emotion recognition test (p = 0.000), and poorer understanding of social situations (p = 0.000). The area under the ROC curves was 0.814 for the MASC-SP, 0.795 for the emotion recognition test, 0.912 for the Reading the Mind in the Eyes Test, and 0.806 for the Strange Stories Task. The Asperger group did not show cognitive deterioration and MASC-SP was proven to be independent for other general cognitive functions. Cronbach's alpha coefficient was 0.86, demonstrating satisfactory internal reliability (> 0.80) very similar to the original instrument (0.84).

Conclusions

The Spanish adaptation of the MASC can be a useful, ecologically valid tool for assessing social cognition.
2079 – Oral Health Condition And Hygienic Habits Among Adult Patients With Respect To Their Level Of Dental Anxiety
Authors: Kanaffa-Kilijańska U. , Kaczmarek U. , Kilijańska B. , Frydecka D.
Published: July 2013

Purpose

Dental anxiety is a common phenomenon influencing the relationship between a patient and a doctor as well as the course of treatment. The aim of the study was to assess the oral health status and hygienic habits among adult patients with respect to their level of dental anxiety.

Material and methods

In the study we included 117 consecutive adult patients referred to the Department of Conservative Dentistry and Pedodontics of Wroclaw Medical University. There were 58 women (49.57%) and 59 men (50.43%). The mean age of the patients was 36.57±16.76 years. The level of dental anxiety was assessed by Modified Dental Anxiety Scale (MDAS). To evaluate dental health status and oral hygiene the following indices were used: total number of decayed, missing and filled teeth (DMF/T) as well as surfaces (DMF/S), Approximal Plaque Index (API), Oral Hygiene Index (OHI) - Debris Index (DI) and Calculus Index (CI).

Results

The higher was the level of dental anxiety measured by MDAS, the lower was the number of filled teeth (F/T) and the number of filled dental surfaces (F/S) and the higher was the Calculus Index (CI). There was no significant difference between dental anxiety measured by MDAS and age, gender or level of education; however, smokers had significantly higher anxiety level than non-smokers.

Conclusions

Dental anxiety has disadvantageous influence on oral health status. Low dental and periodontal health status may have many somatic as well as psychosocial consequences, both lowering quality of life of the patient.
2080 – A Neuropsychiatric Presentation Of Wilson's Disease - Case Report
Authors: Aljukić N. , Sutović A. , Avdić L. , Pajević I. , Hasanović M.
Published: July 2013

Introduction

Wilson's disease (hepatolenticular degeneration), is an autosomal recessive hereditary disease of human copper metabolism, being characterised by excessive accumulation of copper in the body particularly the brain, liver, kidney and cornea. The diagnosis of Wilson's disease is easily overlooked. About half the people with Wilson's disease (40%), have neurological or liver symptoms. Psychiatric symptoms due to Wilson's disease are present in 15% of patients.

Aim

To present the case of an adolescent admitted to Clinic of Psychiatry, University Clinical Center Tuzla, initially presented with psychiatric and neurological symptoms, diagnosed at etiologic cause on the basis of biochemical abnormalities of a copper metabolisam, treated with etiological therapy and obtained therapeutic effect.

Case report

An 18 years old boy admitted to Department of Psychiatry, University Clinical Center Tuzla, with prior history of behavioral disturbances in the form of disinterest in the surroundings, decreased interactions with family and with signs of aphasia. Neurological examination revealed drooling of saliva, tongue protrusion and generalized cogwheel rigidity.

Symptomatic treatment started with no therapeutic efficacy. After laboratory testings were done, findings showed low serum copper and ceruloplasmin levels, and with positive Kayser-Fleischer rings on ophtalmoscopic examination by slit lamp, and computerized tomography of the head indicate neuro-degenerative disease, Wilson disease has been diagnosed. After psychiatric observation and treatment started, patient was transferred to Department of Neurology, University Clinical Centre Tuzla. The patient responded very well to therapy with D - penicillamin, Clozapin, essential phospholipids, vitamins and pyridoxin. Regular follow up advised to evaluate the outcome.
2082 – Lifetime Use Of Antipsychotic Medication And Change Of Verbal Learning And Memory In Schizophrenia In 9-years Follow-up In General Population Sample
Authors: Husa A. , Moilanen J. , Rannikko I. , Haapea M. , Murray G. , Barnett J. , Isohanni M. , Veijola J. , Koponen H. , Miettunen J. , Jääskeläinen E.
Published: July 2013

Introduction

Cognitive deficits, such as verbal memory dysfunction, are a core feature of schizophrenia. Yet the longitudinal course and associations of cognitive deficits with antipsychotic medication remain unclear.

Aims

Our aim was to analyze how lifetime antipsychotic dosage associates with the change of verbal learning and memory in individuals with schizophrenia during a 9-year follow-up.

Methods

Forty-two subjects with schizophrenic psychoses (22 males) from the Northern Finland 1966 Birth Cohort went through diagnostic interviews and cognitive assessment including California Verbal Learning Test (CVLT) at the ages of 34 and 43 years. Data of the subjects’ lifetime antipsychotic doses in chlorpromazine equivalents were collected from patient history records, interviews and national registers. The association between verbal learning and memory (immediate free recall of trials 1-5 and free recall after long delay) and dose-years of antipsychotics was analyzed by logistic regression model.

Results

Higher dose-years of any and typical antipsychotics, but not atypical antipsychotics, associated statistically significantly to worse verbal learning and memory in cross-sectional analyses at age 34 years, even when onset age, sex, and severity of symptoms were controlled for. However, there was no statistically significant association between lifetime antipsychotic use and verbal learning and memory change between ages 34 and 43 years.

Conclusions

High lifetime antipsychotic dose did not associate to decrease in verbal learning and memory in schizophrenia in 9 years of follow-up. To our knowledge, this is a first report on association between cumulative lifetime antipsychotic use and change in cognition in a long-term naturalistic follow-up.
2089 – Multidisciplinary Approach Of Children With Cerebral Palsy And Mental Retardation In Our Clinic
Authors: Nae M. , Morcov V. , Preduca L. , Padure L.
Published: July 2013

Introduction

The large number of children with neuromotor pathology associated with mental retardation met in our clinic made us approach this topic. We have chosen this study in order to reveal the benefit of multidisciplinary treatment of these children.

Objectives

assessment of children with cerebral palsy and mental retardation aiming an appropriate and individualized therapeutic plan.

to draw a warning regarding the needs of therapeutic methods of children with cerebral palsy and mental retardation.

Material and methods

We studied 75 children diagnosed with cerebral palsy and mental retardation, evaluated between 2010-2011 in National Medical Center of Neuropsychomotor Rehabilitation for Children Dr. Nicolae Robanescu in Bucharest. Our methods were: observation, clinical interview with parents and children, Hamburg test and Portage guide.

Results

In our sample there were 30 girls and 45 boys, 46,66% from urban region, 53,33% from rural region, 53,33% with moderate mental retardation, 33,33% with mild mental retardation and 13,33% with severe mental retardation. Multidisciplinary therapeutic approach (kineto therapy, ergo therapy, psychological intervention and medication) led to improvement in motor and psychic skills. Periodical evaluation at 6 month contributed to an appropriate therapeutic intervention.

Conclusions

Data from our study confirms that early diagnosis and therapeutic intervention lead to improvement in skills of children with cerebral palsy and mental retardation and implicitly a better life quality. The approach of these children problems in a multidisciplinary team is determinant for obtaining better performances.
2094 – Perfectionism And Stress - a Study In College Students
Authors: Amaral A.P. , Soares M.J. , Pereira A.T. , Bos S.C. , Marques M. , Valente J. , Nogueira V. , Macedo A.
Published: July 2013

Introduction

Perfectionism trait is commonly viewed as a personality style characterized by striving for flawlessness and setting of excessively high standards for performance which is accompanied by a tendency to be overly critical of one's behavior. Perfectionists are more likely than non-perfectionists to experience several kinds of stress in a variety of forms. Thus, the link between perfectionism and stress in influencing emotional distress /psychopathology can be quit complex.

Objectives/aims

1)

to analyze the association between perfectionism dimension and stress vulnerability;

2)

to explore the relation between perfectionism dimension and other stress related mechanisms (for example, coping and social support).

Methods

217 students filled in the Frost Multidimensional Perfectionism Scale, the Questionnaire of Stress Vulnerability, and four items to evaluate stress related mechanisms.

Results

We found positive associations between maladaptive dimensions of perfectionism and stress vulnerability (from r=.181, p< .005 to r=.661, p< .005). The adaptive dimensions of perfectionism are not significantly associated with stress vulnerability. These results confirm that only maladaptive perfectionists are more vulnerable to stress. Doubts about actions and concerns over mistakes (perfectionism dimensions) showed significant and positive association with all the dimensions of stress, and are negatively related with the social support.

Conclusions

Only the maladaptive perfectionists are more vulnerable to stress, find life events as more stressful and obtain less social support from others. Maladaptive perfectionism dimensions, in particular self-critical perfectionism might have an important role in stress generation.
2098 – The Use Of Genetics In Pharmacological And Psychotherapeutic Treatments
Authors: Serretti A. , Fabbri C.
Published: July 2013

Evidence suggests that genetic factors contribute for about 50% of the antidepressant response therefore the knowledge of the patient genetic profile may lead to an individualized therapy in the next years.

A growing number of evidence has been reported for the functional polymorphism in the upstream regulatory region of the serotonin transporter gene (5-HTTLPR), particularly l allele has been associated with a better response in Caucasian. A significant number of replication findings are present in literature also for 5-HT2a, 5-HT1a, BDNF, COMT, MAOA, NET, Gbeta3, FKBP5, Pgp, TPH, ACE and GSK-3β variants, although an high number of failure of replication is reported for these genes. Furthermore new candidate genes have been recently identify through the genome-wide scan approach and multi-sites projects like STAR*D and GENDEP. Among these the more promising are GRIK4, GRIK2 and DTNBP1. We also performed a pathway analysis on STAR*D dataset to investigate possible pathways involved in resistant depression with interesting findings on glutamate gene variants and early response.

Some preliminary evidence suggest also a modulatory effect of gene variants on psychotherapy efficacy. There is therefore increasing evidence of a genetic modulation on treatment response, both directly and through a modulation or an interaction with clinical variables that could influence the response to antidepressant, like personality and social modulators.
2100 – Parental Contributions And Effects In Adolescents’ Cannabis Users: a Preliminary Study Based On French High School Students
Authors: Laguerre C.-E. , Vavassori D.
Published: July 2013

Introduction

Behavior disorders (addiction, eating disorders) which the teenagers suffer would come from a dysfunction from the early relations and an installation of mental representations of the attachment relations marked by insecurity, discontinuity and Separation Anxiety (SA). Quality of the early and current relations of attachment is going to influence the process of adolescence, which is connected to a second period of separation-individuation. Nevertheless, the SA of the adolescents remains a very rare and unknown diagnosis.

Aims

This study evaluated the relationship between cannabis abuse or dependence (A/D) and family functioning in adolescent cannabis users.

Method

A sample of 336 adolescents filed up the questionnaires about frequency of their cannabis use, SA symptoms in adult populations, dysfunctional separation-individuation process in early adolescents, parental types perceived by the children and depression symptoms.

Results

Cannabis A/D adolescents got significantly higher scores than non-cannabis A/D adolescents at the Anxiety Separation Adulthood (p < 0,005) and lower scores at the “care” subscale about parents representations (“mother” p < 0,01; “father” p < 0,001). The logistic regression analysis highlighted that SA disorders and care were significantly encouraging cannabis A/D.

Conclusion

The cannabis use would be a solution hindering the SA disorder's unbearable feeling. If a successful separationindividuation allows autonomy, the results have shown that cannabis would dress the individuation problem. Thanks to the substance the adolescent can express his personality and differentiate himself from the others by a marginal behavior.
2112 – Psycho-emotional Challenges Within Person-centered Therapy Through The Eyes Of Older Adults
Authors: von Humboldt S. , Leal I.
Published: July 2013

Aims

This research aims to evaluate psycho-emotional challenges for older adults and the relevance of person-centered therapy (PCT) for older adults.

Methods

Forty senior adults, aged above 65 years (M = 71.7; SD = 4.6) were assessed with the the Self-Esteem Scale (‘SES’) and the Mini-Mental State Examination (MMSE). Socio-demographic data, including gender (57.5% women), marital status (37.5% married) and education (39.2% mandatory school) were also assessed. Bivariate associations were performed.

Results

Results yielded a set of five descriptive categories that captured the distinct ways older adults perceived psychoemotional challenges and that reflected the individual's perceived importance of PCT: ‘time perspective’, ‘the aging body’, ‘autonomy and control’, ‘cognitive endurance’ and ‘loss and reminiscing’. Regarding bivariate associations, results indicated that ‘autonomy and control’ was associated with the ‘aging body’ (r=.552, p< .001) and ‘cognitive endurance’ with ‘time perspective’ (r=.425, p< .001). This latter was also associated with ‘loss and reminiscing’ (r=.616, p< .001).

Conclusions

This study highlights the importance of PCT for older adults facing psycho-emotional challenges in old age. Interventions with older adults may benefit from clearly understanding older adults’ specific issues as an important component for promoting successful aging and reducing health disparities.
2114 – A Pilot Study On Promoting Sense Of Coherence Through Person-centered Therapy In Older Adults
Authors: von Humboldt S. , Leal I.
Published: July 2013

Objectives

Older adults’ sense of coherence (SOC) is often challenged by changes in later adulthood. Therefore, this study aims to explore if a brief eight-session individual person-centered therapy (PCT) intervention on older adults can promote their SOC, as compared with a control group (waiting list). We posited that participants and randomized to PCT would report improvements in SOC from pre- to post-intervention compared to those in waiting list.

Methods

The Sense of Coherence Scale (SOCS).and demographics were assessed at the baseline (t1), post-treatment (t2) and at the 12-month follow-up (t3), in a group of 87 participants between 65-86 years (M=71.9 SD=4.77).

Results

Results indicated that participants in PCT evidenced greater improvements as to their SOC (31.4%) than those in waiting list (2.3%). Both at the post-intervention, and at follow-up, participants who underwent PCT had a significantly higher SOC (M=4.76, SD=.524). In addition, results revealed no significant between group differences in any socio-demographic variable (P's>.05) in t1, t2 and t3.

Conclusions

Changes in SOC were positive and maintained, thus, findings suggest that PCT is favorable to enhancing SOC. In this context, PCT is also a personal resource to promote SOC. Moreover, since SOC is shown to be associated with healthrelated well-being among older populations, SOC development in old age should be focused.
2125 – Bipolar Disorder In a Young Girl With Dandy-walker Syndrome
Authors: Eslami Shahrbabaki M. , Estilaee F. , Mehdizadeh Zare Anari A.
Published: July 2013

Introduction

Dandy-Walker syndrome is a congenital brain malformation. The major presentations are mental disorder, cerebellar ataxia and symptoms related to hydrocephaly. It can be associated with psychiatric symptoms. Although, since this presentation is less prevalent, it has been insufficiently discussed

Case presentation

The subject is a 17 year old girl suffering from mental retardation. Her signs started 3 months ago when she was considered as having decreased need to sleep and walking during the night mostly. Her appetite increased as well. she was found to be getting more talkative than past; especially she talked to herself more.

She was admitted to hospital with the diagnosis of bipolar I disorder (the most recent episode: mania) in axis I and deep MR in axis II. In her brain MRI, enlargement of fourth ventricle and cisterna magna and atrophy cerebellar vermis were seen. EEG showed unspecific changes and there was no positive finding in her blood count, electrolytes,renal and liver function tests and blood sugar.

Despite two weeks of treatment with risperidone 3 mg/day and biperidine 4 mg/day and partial control of some symptoms, irritability and anger remained consistently. So, valproic acid (VPA) 400 mg/ day was added to treatment and after one month the patient was discharged from hospital with complete remission of newlypresented symptoms.

Discussion

This report indicates the importance of taking psychiatric symptoms into consideration while evaluating organic brain disorders. With respect to treatment, the same treatment as primary mood disorders was indicated effective.
2126 – How Low Dose Of Propranolol Can Induce a Manic Episode? Case Report Of An Unexpected Side Effect
Authors: Eslami Shahrbabaki M. , Estilaee F. , Mehdizadeh Zare Anari A. , Eslami Shahrbabaki A.
Published: July 2013

Introduction

Propranolol prescribed by physicians in various fields. The extensive use of beta adrenergic antagonists are their various side effects such as nausea, vomiting, diarrhea, constipation, agitation and confusion, Sleep disorders, nightmares, depression and anxiety auditory hallucination. Also a case of induction of mania phase due to discontinuing propranolol has been reported.

Case report

A 11 year old boy was admitted with the diagnosis of Bipolar I disorder. Patient was started on 200 milligrams of Sodium Valproate twice daily and 1 miligram of Respridone twice daily. During the next 2-3 weeks his symptoms were gradually relieving and after 1 month patient left the psychiatric ward symptom free. At the one-month follow-up patient was still without any symptoms but had developed mild tremor and 10 milligrams of Propranolol was prescribed.

A week later patient accompanied by euphoria, restlessness, insomnia and increased energy after discontinuing it the symptoms had waned. He toke propranolol again but in a lower dose of 10 milligrams. Interestingly after taking a single dose of 10 milligrams propranolol patient developed the same symptoms. The symptoms were relieved by discontinuing the medication. Low doses of potent benzodiazepines were used to control tremor, which was a successful strategy.

Discussion

The patient with the diagnosis of BMD, who contrary to our expectations developed symptoms of manic episode after taking low doses of Propranolol.

We propose that clinicians take into consideration proper percussions before prescribing this drug to patients with mood disorders.
2131 – A Prospective Evaluation Of The Three-factor Interactive Model Of Bulimic Symptomatology Among Men
Authors: Dakanalis A. , Zanetti A.M. , Timko A.C. , Riva G. , Clerici M. , Madeddu F.
Published: July 2013

Introduction

Prospective studies have supported the validity of Vochs and colleagues’ three-factor interactive etiologic model of bulimic symptomatology (BS) among female undergraduates.

Objectives

Given the comparable rate of binge eating between young adult men and women, we sought to examine for the first time the validity and sensitivity of the interactive model of BS in men.

Aims

We examined whether the interaction between Perfectionism x Male Body Dissatisfaction x Low Self-Esteem predicted increases in BS over 1-year (Study 1) and over 6-weeks (Study 2). Two different samples of college men were used. Time-1 BS scores as well as Time-1 and Time-2 Body Mass Index, Depression and Social Desirability scores were controlled for.

Methods

Data from college men (Study 1: N = 308, Mage = 21.04; Study 2: N = 344; Mage = 20.87) were analysed using hierarchical multiple regression/correlation procedure on participants’ Time-2 BS scores.

Results

Both studies revealed that an increase of BS in men was predicted by the Perfectionism x Male Body Dissatisfaction x Low Self-Esteem interaction. BS increased in men who initially had high levels of BS and perfectionism, low levels of selfesteem, and were dissatisfied with their body. However, men with initially low or average levels of BS did not have an increase in BS even if they were perfectionistic, body dissatisfied and had low self-esteem.

Conclusions

The results support the interactive model's ability to predict increases of BS; however, the support is in regard to the maintenance of BS, not the onset of BS.
2134 – Cholesterol And The Cycle Of Violence In Suicide Attempters
Authors: Asellus P. , Nordström A.-L. , Nordström P. , Jokinen J.
Published: July 2013

Background

An association between low levels of serum cholesterol and violent or suicidal behaviour has frequently been reported. However the role of serum cholesterol in the cycle of violence (Widom 1989) has not been studied. The aim of this study was to investigate association between exposure to violence during childhood and expressed violent behaviour in suicide attempters with low and high serum cholesterol levels.

Method

A total of 81 suicide attempters were assessed with the Karolinska Interpersonal Violence Scale (KIVS) measuring exposure to violence and expressed violent behaviour in childhood (between 6–14 years of age) and during adult life (15 years or older). We used median split to dichotomise groups below and above median serum cholesterol.

Results

In patients with serum cholesterol below median, the correlation between exposure to violence as a child and violent behaviour as an adult was significant (rho = 0.52, p = 0.0024), while in patients with serum cholesterol above median, the correlation between exposure to violence as a child and expressed violent behaviour as an adult was not significant (rho = 0.23, p = 0.23).Comorbid substance abuse predicted violent behaviour as an adult only in patients with serum cholesterol above median.

Conclusion

Cycle of violence hypothesis is modified by serum cholesterol.
2141 – Ekbom's Syndrome
Authors: Delgado Durán T. , Márquez Ligero F.J.
Published: July 2013

According to the literature, this syndrome is based on a delusive idea from a tactile (hallucinations haptic) and visual (dermatozoopsias) alucinatorio mechanism, from a primary delirious occurrence, or from a delusive secondary idea to poisoning, dementia or depression. Two big groups exist: one ectoparasitario (skin) and another endoparasitario (orifices or internal organs).

Physically numerous injuries are observed in some accessible regions of the skin open to the plastered and the patients come to the doctor with imaginary pathogenic. Alternative treatment does not exist for this entity even though pimozine and risperidona take the best effect.

Our patient shows an upset case- history, that progressing for twenty years, by depending on opiates and cocaine and he carries out a treatment with agonist opioids (methadone). After years of abstinence, he shows an active cocaine taking developing afterward a extensible parasitoids for four mouths long causing an strong pruritus which he intends to relieve taking the parasites out with the help of skin auto injuries. He brings a flask with skin remains, with the parasites recognized, and a magnifying glass in such a way that the doctor can examine them clearly. Several times he comes to the Medical Service. He upbraids the doctors, who don’t pay attention to him, because he doesn’t agree to be admitted in Infectious Service or Internal Medicine. Finally he is admitted involuntarily in Psychiatric Hospitalization Unit. Once a treatment with pimozide is established and the abstinence from poisons is assured, the delirious disorder, that he suffered, disappears.
2144 – IL-2, IL-6, IFN-gamma And Tgf-beta Genetic Polymorphism With Respect To Susceptibility To Schizophrenia
Authors: Frydecka D. , Beszlej A. , Karabon L. , Pawlak-Adamska E. , Tomkiewicz A. , Partyka A. , Misiak B. , Piotrowski P. , Zagdanska M. , Kiejna A.
Published: July 2013

Background

Schizophrenia is a chronic severe psychiatric disorder with multiple environmental and genetic determinants. Several reports indicate the possible role of immune system dysregulation in the pathogenesis of schizophrenia. An accumulating body of evidence indicates an association of schizophrenia and its psychopathology with altered cytokine production. The variation of the level of cytokines might be partly due to their functional gene polymorphism.

Purpose

The study was carried out to investigate the association of schizophrenia with the following cytokine polymorphisms: IL-2 (-330T/G), IL-6 (-174G/C), IFN-gamma (+874 T/A), TGF-beta (+869 T/C and +915 G/C).

Material and methods

We included 130 patients diagnosed with schizophrenia and 184 controls in our study. The patients were evaluated for lifetime psychotic symptomatology using the Operational Criteria for Psychotic Illness (OPCRIT) checklist. The patients having history of traumatic brain injury, neurologic disorders, substance abuse or immune related diseases were excluded from the study by detailed medical examination.

Results

The polymorphisms were in HWE both in the cases’ and controls’ groups. In single marker analysis, we did not find an association for the tested polymorphisms.

Conclusion

Our data do not support the role of IL-2, IL-6, IFN-gamma and TGF-beta gene polymorphisms in the predisposition to schizophrenia in the Polish population.
2149 – Diagnostic Uncertainty Of Psychotic Disorders
Authors: Albuquerque R.P.
Published: July 2013

Introduction

Since 3000 B.C. Man has been trying to classify mental disorders. However, there is still much to be done and the differential diagnosis of psychotic disorders remains one of the greatest challenges in modern psychiatry.

Objectives

We aim to improve the differential diagnosis of psychotic disorders, namely by rethinking schizophrenia spectrum disorders as syndromes whose hallmark are not delusions or hallucinations.

Methods

We present the clinical report of a 57 year old woman admitted in our unit who was diagnosed with maniac type schizoaffective disorder. Her previous medical records documented different diagnosis, namely schizophrenia and bipolar disorder. Hence, we attempt to understand the evolution of classification systems, how clinical practice deals with these systems and how the future DSM-V and ICD-11 may correct existing flaws.

Results

We demonstrate that the definition of psychotic symptom should be restricted to delusions and/or hallucinations, thus there is a need to rethink the core symptoms of schizophrenia spectrum disorders. Furthermore, the assessment of a patient should always take into account the longitudinal development of the disease, retrieving one of Kraeplin's concepts. We found conflicts between the existing classification systems and extraordinary shortcomings, such as a 50% chance of failure of DSMIV temporal diagnostic reliability.

Conclusions

Current clinical practice continues to give much emphasis to research on delusions and hallucinations - contradicting Bleuler's concepts - and neglecting other dimensions - cognitive dysfunction, disorganization and negative, affective and motor symptoms. The integration of these symptoms in stable diagnoses remains a challenge.
2152 – The Total Serum Cholesterol In Alcoholics With Secundary Depression
Authors: Mandic-Gajic G. , Dedic G. , Eror A. , Stojanovic Z. , Spiric Z. , Samardzic R.
Published: July 2013

Introduction

High rate of depression and suicide found in alcoholics. Low total serum cholesterol is related with suicidal behavior, impulsivity and depression. Alcoholics have elevated serum triglycerides and LDL cholesterol, but lower values of HDL-cholesterol.

Objectives

To investigate the serum cholesterol levels and differences between secondary depressed and non-depressed alcoholics biochemical blood tests were performed.

Methods

A total group of eighty six non-cirrhotic male primary alcoholics, without malnutrition was recruited during inpatient treatment. After 4 weeks alcoholics were divided in the depressive (DA) group and non-depressive NDA group according the Hamilton Depression Rating scale- HAMD cut-off score under 8. Biochemical blood tests were performed for all participants on admission and retrospectively were analyzed. Differences between groups were tested by Student t-test.

Results

There were not significant difference among groups for demographic and biochemical serum parameters. The DA group showed lower level of total serum cholesterol (5,9 ± 1.24) than NDA group (6.4 ± 1.20) on admission, with values between normal rang (3.63-6.7 mmol/l) p = 0.072.

Conclusion

The group of depressive alcoholics showed trend of lower level of total serum cholesterol on admission. It would be useful to investigate low serum cholesterol as possible predictive factor of secondary depression among alcoholics.