bluuebunny/crossref_metadata_2025 huggingface dataset:
971 – Depression And Metacognitive Efficiency In Early And Late Adulthood: a Developmental Perspective
Authors: Fastame M.C. , Penna M.P. , Agus M. , Rossetti E.S. , Leone B.
Published: July 2013

The main purpose of current research was to investigate the impact of self-rated metacognitive measures and depressive symptoms in predicting psychological well-being in differently aged healthy adults. Moreover, current research was aimed to explore the effect of genre and age on metacognition and depression scores. Ninety-six healthy adults were recruited in Northern Italy and were respectively assigned to Young (i.e., 20-30 years), Old (i.e., 65-74 years), Very Old (i.e., 75-84 years) and Oldest-Old (i.e., > 85 years) groups. Participants were administered self-referent social-desirability, cognitive efficiency, subjective wellness and psychological distress questionnaires. Results show that depression, cognitive functioning, social desirability and metamnestic scores represent the best predictor of psychological well-being. Furthermore, a significant main effect of age and genre was found on measures of depression and metamemory. Finally, personal satisfaction, coping strategies, emotional control and general well-being levels of the Very Old group were lower.
972 – Difficulties In Cognitive And Social Functioning Of a Patient With Bipolar Disorder
Authors: Sobieraj A. , Wylezek L. , Krysta K.
Published: July 2013

Bipolar disorder may coexists with cognitive deficits, which may be the one of the core symptoms of the disease. Additional, independent organic changes in the brain may appear, which still deteriorate the cognitive and social function of a patient. The objective of our study was to show how the above impairments disorder influenced patient's life quality. 57-year treated psychiatrically for bipolar disorder was described. During his treatment and diagnostics it turned out that he also suffered from dementia and progressing cognitive impairment.

Our case report shows that there exists the dependence between the deterioration of the cognitive impairment caused by the bipolar disorder and increasing level of the patient's quality of life. The result of our investigation is consistent with a number of other studies connected with cognitive functioning in patient with bipolar disease.
975 – Art, Religion And Psychosis
Authors: Zullo L.
Published: July 2013

Introduction

Art and Religion have accompanied the history of human kind since primordial times, undergoing changes with evolution, being interconnected or separated in antithesis in some historical periods. Nevertheless both are eliciting the idea of “Sublime” affecting in a greater or lesser degree the life of individuals in our society. A curious interconnection with psychosis is seen in two peculiar conditions: Stendhal and Jerusalem syndromes.

Objectives

Starting from the consideration of Art and Religion in the Idealistic philosophy the relationship between Stendhal and Jerusalem syndromes, which lead to acute transient psychotic episodes in tourists with psychic and somatic symptoms, is examined.

Aims

This work aims to spread the knowledge about the two syndromes, to highlight analogies between them, and finally to summarize and show a possible connection between the modern findings in neuroaesthetics and Stendhal syndrome.

Method

The work is of qualitative type and mainly descriptive: all the existing evidence on the topic and with possible connections to it was brought together, summarised, and compared leading to new possible ideas for the future.

Results

A hypothetical psycho-pathophysiological mechanism is proposed, based on the psychoanalysis, psychology, genetic, and the new findings in neuroaesthetic (especially connected to Stendhal syndrome), but more research is needed.

Conclusion

The influence of Art and Religion culminating in Stendhal syndrome and Jerusalem syndrome, based on their comparison, could be regarded as “tourist syndromes” or as a “tourist's transient psychotic episode” differentiating the object of psychosis as Art in the first and Religion in the second.
1012 – Evaluation Of a Risk-scale For Anticholinergic Side-effects In Elderly Psychiatric Inpatients
Authors: Hefner G. , Fellgiebel A. , Hiemke C.
Published: July 2013

Introduction

Many commonly prescribed drugs have anticholinergic properties which can induce side-effects e.g. delirium, especially in an ageing brain with increased sensitivity. Risk-assessment before starting therapy may prevent such sideeffects.

Objectives

We rated anticholinergic pharmacological properties of prescribed medication and compared the theoretical risk with side-effects in clinical practice.

Aims

The scale should improve the safety of pharmacotherapy in gerontopsychiatry.

Methods

Based on five publications that considered anticholinergic properties of drugs, a risk-scale was established. Riskpoints for all drugs were summarized to a total score. Patients were selected from TDM-requests and data on patients’ sideeffects obtained from medical files. Reported anticholinergic side-effects including delirium were assessed retrospectively by the UKU-rating scale. Using linear regression and Spearman's correlation-analysis a possible correlation between risk-score points and severity of side-effects was determined.

Results

The screened sample consisted of 53 patients. 38 patients aged from 64 to 89 years (mean 74±6, 63.2% women) could be included for analysis. They had 93 plasma-level determinations (mean 2.4 requests per patient). According to their medication, patients attained by mean 4.51±2.98 risk-points (range 0-16). Mean UKU severity-index of side-effects was 0.81 (±0.99). Risk-points correlated significantly with observed anticholinergic side-effects and delirium (R2=.631, P< 0.001, CI 95%). Spearman correlation-coefficient was 0.731 (P< 0.01, CI 95%).

Conclusions

Since the established risk-scale correlated well with reported anticholinergic side-effects we recommend to implement this in the planning of psychopharmacological treatment to improve the safety of pharmacotherapy in gerontopsychiatry. For practical reasons it should be amalgamated with therapeutic drug monitoring as Geronto-TDM.
1017 – Long-term Outcome Of a Multidisciplinary Rehabilitation Program For Chronic Fatigue Syndrome: a One-year Follow-up Study
Authors: Coremans E.L. , Vause M.
Published: July 2013

Objective

To evaluate the long-term outcome of a multidisciplinary rehabilitation program for patients with chronic fatigue syndrome.

Method

98 patients fulfilling chronic fatigue syndrome criteria (Fukuda) participated at a six-month CBT associated with GET based on adaptive pacing strategy in a group therapy and were included in a prospective outcome study at the university outpatient Chronic Fatigue Reference Center.

Measures

Multidimensional assessments at baseline, after treatment and at 6 and 12 months follow-up : Checklist Individual Strength; Epworth Sleepiness Scale; Pittsburgh Sleep Quality Index; HADS; Symptom Checklist; Short Form General Health Survey ands Self Efficacy Scale.

Results

After the revalidation program, subjective outcome parameters as fatigue severity, concentration troubles, somatic complaints, sleep disturbances and behavioral consequences of fatigue as activity reduction improve significantly (p< 0,001). The QoL related to health perception, measured in items as vitality, role-physical limitations and social functioning, also improve significantly (p< 0,001). Treatment doesn’t change HADS-scales but the scores don’t differ significantly from a healthy population at baseline. At 6 and 12 months follow-up, we didn’t notice significant decreases in outcome results. Significant improvements correlate significantly with an increase of sense of control of the symptoms (Self Efficacy Scale).

Conclusions

Symptoms, health-related QoL and psychosocial functioning in patients with chronic fatigue syndrome improve after a six-month multidisciplinary rehabilitation program. The one-year follow-up study without any therapeutic intervention proves that outcome can be maintained. The correlation between the persisting outcome results and the increase of Self Efficacy will be discussed.
1026 – Electroconvulsive Therapy As An Effective Treatment In Neuroleptic Malignant Syndrome: Purposely a Case
Authors: Ogando Portilla N. , Martinez Cortés M. , del Nido Varo L. , Torío Palmero I. , Ortega Bernardo M.C. , Jimenez-Arriero M.A.
Published: July 2013

Introduction

NMS is an infrequent, life-threatening neurologic emergency usually associated with the use of neuroleptics and some other agents that affect central dopaminergic neurotransmission. Because of its low frequency, heterogeneous nature and clinical variability it might be difficult to diagnose.

Objetives

To identify risk factors to develop a NMS and to set effective treatments.

Methods

Literature search was performed in PubMed and UpToDate. Report of a case at our center: 69 year old man with psychotic depression which do not improve with optimal doses of SSRIs, Mirtazapine and Benzodiazepines. Olanzapine (10mg) was added and symptoms compatible with a neuroleptic malignant syndrome were appeared. Supportive care was needed because of medical complications. A treatment with bromocriptine, sertraline, lorazepam and dantrolene was begun with little improvement. It was decided to begin ECT.

Results

It was applied a ECT therapy (12 bifrontotemporal sessions, 380mCu) with a high and effective response. Pshycosis and pshycomotor symptoms disappeared and depression decreased significantly.

Discussion

Hence a high index of suspicion is needed in the diagnosis of NMS in order to reduce mortality and secuelae. Differential diagnosis must be performed with confusional states due to medical cause, catatonia, serotoninergic syndrome and other neurologic states. As for the treatment, general support meassures and several farmacologic options have been used, though none of them have proved to decrease mortality. ECT remains a good option for improvement of the syndrome as well as the pychiatric condition. No systematic clinical trials evaluating the efficacy of different treatments have been done so far.
1033 – Restless Legs Syndrome Induced By The Combined Use Of Quetiapine And Venlafaxine
Authors: Michopoulos I. , Gournellis R. , Ferentinos P. , Douzenis A. , Tsaklakidou D. , Kaparoudaki A. , Papadopoulou M. , Papazahos C. , Liappas I.
Published: July 2013

Introduction

Restless legs syndrome (RLS) is a sensorimotor disorder characterized of an urge to move the legs during periods of rest or inactivity, such as lying or sitting.

Objectives

Drug-induced RLS, still remains an under- or misdiagnosed condition.

Aims

We present a case of a female patient, who received a combination of low dose of quetiapine in addition to venlafaxine and manifested RLS.

Methods

Our patient was admitted because of a mixed episode of bipolar II disorder. At admission she was under valproic (1.5gr/QD, plasma levels: 79mg/litre), topiramate (100mg/QD) and venlafaxine (300mg/BID). Quetiapine 150 mg/QD was started at bed time and within 48 hours the patient showed RLS. The physical, neurological and laboratory examination was normal.

Results

The tapering of venlafaxine resulted in the elimination of RLS within 48 hours. After discharge the patient remained in a normothymic state, without RLS, taking valproate 1,5gr/QD, topiramate 100mg/QD and quetiapine 150mg/QD. After 6 months, because of depression, quetiapine was reduced to 100mg/QD and venlafaxine 75mh/QD was added. The previously described RLS symptoms emerged again within 48 hours. This time the tapering of quetiapine and its substitution by olanzapine 10 mg/QD resulted in a prompt and complete elimination of RLS symptoms.

Conclusions

Neither quetiapine alone, nor venlafaxine alone induced RLS to our patient. Clinicians should not overlook the possibility a RLS to be induced by quetiapine-vanlafaxine combination. The removal of one of the two drugs might be beneficial in the RLS's successful treatment.
1040 – A Study Of Effectiveness Of Structured Group Psychoeducation For Bipolar Patients. a Controlled Trial In Italy
Authors: Candini V. , Buizza C. , de Girolamo G. , Ferrari C. , Caldera M.T. , Nobili G. , Pioli R. , Sacchetti E. , Saviotti F.M. , Seggioli G. , Zanini A.
Published: July 2013

Background

Recent reviews of evidence-based guidelines for the clinical management of Bipolar Disorders (BD) have recommended that “all patients with BD should be offered group or individual psychoeducation” to prevent relapse, improve treatment adherence, quality of life and functioning.

The present study aimed at evaluating the psychoeducation in routine mental health.

Methods

One hundred and two outpatients were recruited from two Italian DMHs. Inclusion criteria were a lifetime diagnosis of BD type I or II assessed by SCID-I, being euthymic for at least 3 months. Exclusion criteria were a DSM-IV Axis I comorbidity, mental retardation (IQ < 70), organic brain damage. All subjects received standard psychiatric care, with standard pharmacological treatment; one group received additional 21 weekly sessions of psychoeducation group, according to Colom and Vieta model.

Results

Data show that the number of patients hospitalized during the 1-year follow-up, the mean number of hospitalizations per patient and the mean number of days in hospital were significantly lower for psychoeducated patients.

Conclusion

Our study supports the view that group psychoeducation is an efficacious intervention to prevent patients’ hospitalization and decrease hospital days in pharmacologically treated patients with bipolar disorder, also in routine clinical settings. The results seem to confirm that the psychoeducation promotes an improvement in the course of illness, avoiding acute phases, and producing a greater stabilization of the disease and consequently an improvement in quality of life in people with BD.
1043 – Expression Of Obesity Related Genes And Leptin Serum Levels Are Decreased In Turkish Schizophrenia Patients, Case-control Study
Authors: Akan G. , Ozgen O. , Colak A. , Acar S. , Oncu F. , Yesilbursa D. , Turkcan S. , Atalar F.
Published: July 2013

Antipsychotic medications can induce metabolic abnormalities (weight gain) in schizophrenia (SCH). Leptin receptor (LEPR), leptin (LEP) and peroxysome proliferator-activated receptor g2 (PPARg2) are the potential genetic determinants which might be liable of the metabolic dysregulation. The aim of this study was to evaluate the effect of LEP c.-2548G>A, LEPR p.Q223R polymorphisms and the impact of mRNA levels of LEP, LEPR, and PPARg2 along with the serum leptin levels on metabolic adversities in SCH patients (n=132) and controls (n=114).

Methods

Metabolic profiles, LEP, LEPR gene polymorphisms and the gene expressions of LEP, LEPR and PPARg2 were studied in SCH patients and controls.

Results

BMI, cholesterol and fasting glucose levels were higher in SCH patients compared to controls. LEP c.-2548 (GA+AA) genotypes were two fold lower in SCH patients versus controls (p< 0.05), and no significant difference was observed in LEPR p.Q223R genotypes. Interestingly, leptin serum levels were lower in SCH patients compared to controls (p< 0.05). Leptin, leptin receptor and PPARg2 gene expressions were found to be decreased in SCH patients compared to controls (p< 0.001, p< 0.001 and p≤0.05, respectively).

Conclusion

Leptin receptor, leptin and PPARg2 genes could be potential risk factors in developing metabolic adversities in SCH.
1056 – Comparative Effectiveness Of Long-term Treatment With Atypical Antipsychotics In Patients With Schizophrenia
Authors: Pikalov A. , Citrome L. , Hsu J. , Werner P. , Cucchiaro J. , Loebel A.
Published: July 2013

Introduction

Long-term head-to-head studies comparing atypical antipsychotics are important for clinical decision making.

Objectives

To evaluate long-term treatment of schizophrenia with lurasidone (LUR) vs. quetiapine XR (QXR; Study 234), or risperidone (RIS; Study 237).

Aims

To assess efficacy and safety of lurasidone relative to other antipsychotics.

Methods

In study 234(efficacy and safety), subjects received 12 months double-blind, flexible-dose lurasidone(40-160 mg/day) or QXR(200-800 mg/day) after completing a 6 week, randomized, double-blind, placebo-controlled trial with LUR or QXR. In Study 237 (safety) clinically stable adult outpatients received 12-months double-blind treatment with flexible-dose LUR 40-120 mg/day or RIS 2-6 mg/day.

Results

Study 234: continued treatment of LUR responders (n=139) reduced relapse risk by 27.2% vs. continued QXR treatment of QXR responders (n=79). Hospitalization risk was 56.7% lower with LUR vs. QXR. More LUR subjects achieved sustained remission vs. QXR (61.9% vs. 46.3%; p=0.043; 12 months, LOCF), and lower all-cause discontinuation (48% vs 61%). Triglycerides were reduced with LUR; total and LDL cholesterol were unchanged or reduced. Median prolactin change was +0.6 for LUR vs. -0.7 ng/mL for QXR. Study 237: clinically significant weight gain was observed with LUR 13%) vs. RIS (19%) with median change in prolactin 0.4 vs. 14.8 ng/mL, respectively. Comparable efficacy was observed for LUR and RIS (change from baseline in PANSS total score:-4.7 vs. -6.5, and CGI-Severity score:-0.4 vs. -0.4, respectively).

Conclusion

The results of these two 12-month trials suggest that lurasidone is safe and well-tolerated with efficacy comparable to quetiapine XR and risperidone for long-term treatment of schizophrenia.
1079 – Effects Of Psychological Distress And Social Support On Mental Fitness Among Patients Of Mental Health Services
Authors: Park W.-R. , Yu J.-C. , Lee M.-R. , Kim D.-Y.
Published: July 2013

Introduction

Life events and accompanying psychological and behavioral reactions frequently have an impact upon people's daily lives and are believed to predispose them to disease. Psychological stressors impact many physiological and pathological disease outcomes, including mental illness. Positive social interactions have in turn been shown to exert powerful beneficial effects on health outcomes and longevity.

Objectives

The Objective of this study was to analyze the relationships of Psychological Distress, Social Support, and Mental Fitness among patients of mental health services.

Aims

This article aims to discuss the evidence supporting the mediating effect of social support between psychological stress and mental health.

Methods

This study was performed on patients who visited the mental health services in Daejeon from October to December 2011. In total, 395 patients were evaluated with Mental Fitness Scale, Kessler Psychological Distress Scale(KPDS), and Multidimensional Scale of Perceived Social Support(MSPSS).

Results

Correlations among variables of psychological distress and social support on subordinate variable of mental fitness of patients were significant. The result of the regression analysis, psychological distress and social support have a positively significant influence on mental fitness of patients. social support showed mediating effects between psychological distress and mental fitness.

Conclusion

These results suggest that health care providers ought to seek social support for patients, in order to provide positive mental fitness of patients.
1082 – 40-week, Randomized, Double-blind, Placebo-controlled, Multicenter, Efficacy And Safety Study Of Methylphenidate Hydrochloride Modified Release (mph-la) In Adults With Attention Deficit Hyperactivity Disorder (adhd)
Authors: Huss M. , Ginsberg Y. , Philipsen A. , Tvedten T. , Arngrim T. , Greenbaum M. , Carter K. , Chen C.-W. , Kumar V.
Published: July 2013

Introduction

Recent epidemiology studies have reported the prevalence of adult ADHD to be approximately 4%, however approved treatments are limited.

Objectives

Primary objectives were to confirm the clinically-effective and safe dosage range of MPH-LA in adults with ADHD and evaluate the 6-month maintenance of effect.

Methods

Treatment Period (TP) 1: Patients were randomized to double-blind placebo, MPH-LA 40, 60, or 80 mg/day for 9- weeks (3-week titration, 6-week fixed-dose) to evaluate change in DSM-IV ADHD-RS and Sheehan Disability Scale (SDS) total score in TP1. TP2: 5-week titration to individual optimal dose. TP3: Patients were randomized to their optimal dose or placebo for 6-months double-blind withdrawal period to evaluate percentage of treatment failures during TP3.

Results

Improvement from baseline in total score on the DSM-IV ADHD-RS and SDS was significantly greater than placebo for all MPH-LA dose levels (table). Patients treated with MPH-LA had significantly lower treatment failure rates (21.34%) compared to placebo in TP3 (49.6%; odds-ratio (95%CI=0.3 (0.2, 0.4); p< 0.0001). The safety results were consistent with the established safety profile for MPH-LA.

[Improvement by week 9: DSM-IV ADHD-RS and SDS].

N=Full Analysis Set for TP1 (All randomized patients receiving one dose of study drug in TP1)MPH-LA (40mg) (N=174)MPH-LA (60mg) (N=175)MPH-LA (80mg) (N=179)Placebo (N=172)Attention-Deficit/Hyperactivity Disorder Rating scale (DSM-IV ADHD-RS) (n)160155156161LS Mean15.4514.7116.369.35LS mean difference from placebo (95% CI)6.10 (3.68, 8.53)36 (2.92, 7.79)7.01 (4.59, 9.42) p valuep<0.0001p<0.0001p<0.0001 Sheehan Disability Scale (n)151146148152LS Mean5.894.906.473.03LS mean difference from placebo (95% CI)2.86 (1.33, 4.39)1.87 (0.33, 3.41)3.44 (1.91, 4.97) p value0.00030.0176<0.0001 Significance level (gatekeeping procedure)0.01670.02080.0313 

Conclusions

MPH-LA administered at 40-80mg/day demonstrated superior ADHD symptom control and reduction in functional impairment compared to placebo and demonstrated maintenance of effect over 6 months. No unexpected adverse events were observed.
1088 – ECT And Information Processing In Patients With Treatment-resistant Psychiatric Disorders Assessed By Event-related Potential p300
Authors: Dapsys K. , Šiurkutė A. , Kaukėnas R. , Mačiulis V.
Published: July 2013

Introduction

The study of non-memory cognitive functions after ECT has been relatively neglected. Event-related potentials (ERP) are thought to reflect some cognitive processes. ERP P300 is a sensitive indicator of disturbances of attentional and working memory processes.

Objectives

Aim of this study was to examine the effect of course of ECT on auditory ERP P300.

Methods

P300 potential was recorded in 22 patients. 12 patients had schizophrenia spectrum disorders and 10 patients had various mood disorders. Mean age of patients was 40±13 years (from 22 to 72 years). ERPs were recorded before the first ECT procedure and after the last ECT. Recordings were made at Fz, Cz and Pz electrode sites. Peak-to-peak (N2-P3) amplitude and latency of P300 wave were analyzed. Correlation between P300 parameters, clinical symptoms (measured using PANSS, MADRS, HAM-D scales) and parameters of ECT procedure - delivered energy, seizure energy index (SEI) and duration of seizure - was evaluated.

Results

After ECT clinical symptoms have improved. There was also a statistically significant increase in P300 amplitude. Increase was greater in the 20-39 years old patient group. Decrease in P300 latency was insignificant. Correlation between P300 latency and SEI, and between P300 amplitude and delivered energy was more reliable in the mood disorders group. According to HAM-D the improvement of depression symptoms correlates with the decreased latency and increased amplitude of the P300 potential.

Conclusions

ECT may improve information processing in patients with treatment-resistant schizophrenia spectrum disorders and mood disorders as assessed by event-related potential P300.
1091 – Is The Severity Of Autistic Traits Determined By Genetic Variants Of The Oxr And Cd38 Polymorphisms In Conjunction?
Authors: Marin J. , Hennig J.
Published: July 2013

Several recent studies demonstrated that different single nucleotide polymorphisms of the oxytocin receptor gene are associated with impairments of social behavior including the heritability of autism. Another focus of attention has been the CD38 protein, which stimulates the release of oxytocin in the blood stream and probably in the brain. The objective of this study was to investigate if the prevalence and severity of autistic traits in a healthy sample of academic students is influenced by two different SNPs, OXR rs53576 and CD38 rs3796863. For that purpose, 134 students of our university (99 women) answered the self-report questionnaires on autistic traits (The Adult Autism Quotient (AQ), Empathy Quotient (EQ), and Systemizing Quotient (SQ)) and were genotyped by cheek swab. Comparisons between men and women did not confirm reported findings that women have higher scores on the EQ and lower scores on AQ and SQ. However, it was observed that women have less autistic traits on the communication subscale (AQ). Excepting for CD38 rs3796863 on one subscale, where the homozygote for the risk allele C showed higher attention to details than the heterozygotes and homozygotes AA, no other significant results were found. Nonetheless, a tendency of interaction between the investigated OXR and CD38 polymorphisms was observed. OXR rs53576 GG and CD38 rs379863 CC genotype was associated with more severe autistic traits in comparison to OXR rs53576 GG and CD38 rs379863 AA/AC genotype, which suggest that these genetic variants modulate the prevalence of autistic traits in conjunction.
1095 – The Impact Of Immigration Detention On The Mental Health Of Torture Survivors: a Systematic Review
Authors: Storm T. , Engberg M.
Published: July 2013

Introduction

Studies point to an adverse effect of detention on the mental health of asylum seekers, yet the use of detention has been rising in several recipient countries. In general, many asylum seekers suffer from psychological disorders and symptoms, and a large percentage has been subjected to torture. The UNHCR recommends that torture survivors generally should not be detained. Due to a lack of systematic screening it is often unknown whether the asylum seeker is a torture survivor. This causes several hindrances for the protection of this vulnerable group from potentially harmful factors such as deprivation of liberty.

Objectives

To examine the impact of detention on the mental health of adult torture survivors.

Aims

To produce a comprehensive review of the literature and bring attention to a potentially harmful praxis.

Methods

The systematic review follows the PRISMA guidelines. The search was made in PubMed (Medline), PsychINFO, PILOTS and IBSS. A screening of reference lists identified additional studies. The search was broadened to ‘asylum seekers’ as very few studies were found on torture survivors specifically.

Results

Presently (Oct. 2012) the review is in the stage of analyzing, thus results are preliminary. Currently the identified studies amount to 26. All studies report mental health problems among the asylum seekers and some identify detention itself as a contributing factor to these problems.

Conclusions

Detention does pose a risk factor in regard to deteriorating the mental health of asylum seekers. Although torture survivors might be an especially vulnerable group, research is almost non-existent.
1098 – Completed Suicide During The Time Of Economic Crisis: Recent Data And Future Prevention
Authors: Pompili M. , Vichi M. , Girardi P.
Published: July 2013

Background

To report recent official data of completed suicide in Italy during the time of economic crisis as related to gender and age.

Methods

Data for the years between 2006-2007 and 2008-2009 were extracted from the Italian Mortality Database to include all deaths by suicide and to obtain information on their age and gender.

Results

In the last period for which official data are available (2008–2009), there was a ten percent increase in suicide deaths among men 25 to 69 years of age suggesting that suicide rates are on the increase for those involved in the labor force. We also found a decrease in suicides among those aged above 70 years pointing to a lesser impact of the economic crisis on suicide among the elderly who retired from their work.

Conclusions

According to this findings there was an increase in suicide rates among Italian men which is suggestive of a possible contributing role of the economic crisis on such trend.
1101 – Preserved Strategic Regulation Of Grain Size In Memory Reporting In Patients With Schizophrenia
Authors: Bacon E. , Akdogan E.
Published: July 2013

Introduction

Current findings place cognitive and introspection disturbances at the very heart of schizophrenia. In real life, a person is usually free to choose which aspects of an event to relate, how much detail to volunteer, and what degree of confidence to impart. The decision will depend on a variety of situational and personal goals.

Objectives

To explore whether patients with schizophrenia are able to achieve a compromise between accuracy and informativeness when reporting information from memory, and pave the way for metamemory-based cognitive remediation.

Methods

25 Patients and their healthy matched controls answered general knowledge questions whose answers are numerical first freely, and second through a metamemory-based control. In the second step participants gave their answers with respect to two predefined intervals, one narrow and one large, then made a confidence level judgment for both answers, and had afterwards to select one of the two answers.

Results

Patients were less accurate than healthy participants when reporting information at a self-paced level of precision. However, they benefited remarkably firstly from the framing of the responding, and secondly from the metamemory processes of monitoring and control to improve their memory reporting and to equate healthy subjects' accuracy.

Conclusion

In spite of their memory deficit in the free report, following accurate monitoring, patients strategically regulated the grain size of their memory reporting and proved to be able to manage the competing goals of accuracy and informativeness. These results lead to some optimism regarding the patients' possible adaptation to everyday life situations.
1104 – The Dopamine β-hydroxylase c-1021t Polymorphism In Alzheimer's Disease
Authors: Fehér Á. , Juhász A. , Gálfi M. , Pákáski M. , Kálmán J. , Janka Z.
Published: July 2013

Alzheimer's disease (AD) is a genetically complex neurodegenerative disorder. Degeneration of the locus coeruleus and decreased cortical levels of noradrenaline (NA) were detected in AD. Dopamine β-hydroxylase (DBH) catalyses the conversion of dopamine to NA, and DBH activity were reduced in post-mortem hippocampus and neocortex in AD. The aim of our study was to examine the possible role of the DBH C-1021T polymorphism (rs1611115) and its synergistic effect with the APOE E4 allele in the development of AD.

DNA sample was collected from 246 Hungarian AD probands and from 202 elderly, cognitively intact, ethnically matched controls. The clinical diagnosis of AD fulfilled the criteria for NINCDS-ADRDA. The genetic analyses were performed by PCR-RFLP.

The DBH C/C genotype occurred more frequently in the AD as compared to the HC group, however, the difference did not reach statistical significance (p=0.086). Given the relatively low occurrence of the T/T genotype, the statistical analysis was also performed by the presence or absence of the T allele. The C/C genotype carriers had a slightly significantly increased risk for AD (OR=1.547, 95%CI: 1.027-2.329, p=0.037) considering the T allele carriers as reference category. Logistic regression analysis revealed no interaction between the DBH and APOE polymorphisms (p=0.392).

Our results suggest that the C/C genotype of the DBH rs1611115 polymorphism may confer risk for developing AD. We failed to detect an epistasis between the DBH and the APOE polymorphisms in the development of AD. This work was supported by a grant from TÁMOP-4.2.2A-11/1/KONV-2012-0052.
1105 – Long-term Efficacy Of Nalmefene As-needed In Alcohol Dependent Patients With High Drinking Risk Levels: Results Of a Subgroup Analysis
Authors: van den Brink W. , Sørensen P. , Torup L. , Mann K. , Gual A.
Published: July 2013

Introduction

We describe the efficacy and safety of as-needed use of nalmefene in the subgroup of patients with a high drinking risk level (DRL; men:>60g/day; women:>40g/day); i.e. a group of patients with a great unmet medical need for treatment.

Objectives

To evaluate the 1 year efficacy and safety of as-needed use of nalmefene 18mg versus placebo in a subgroup of alcohol dependent patients with high DRL from a randomised controlled trial [NCT00811941].

Methods

All patients received a motivational and adherence-enhancing intervention (BRENDA) in combination with either nalmefene or placebo. Number of heavy drinking days (HDDs) and total alcohol consumption (TAC) were measured using the Timeline Follow-back method. Additionally, data on clinical improvement, liver function and safety were collected throughout the study.

Results

The study population consisted of 187 patients: placebo N=42; nalmefene N=145 (mean age 46.2±11.9 years; 78% men; mean HDDs 19±6.3/month; mean TAC 101±45.0 g/day). Mean number of HDDs decreased to 7 days/month and mean TAC decreased to 33g/day at 1 year in the nalmefene group. At 1 year, there was a superior effect of nalmefene compared to placebo in reducing the number of HDDs (-3.6 [95% CI:-6.5;-0.7]; p=0.0164) and TAC -17.3 [-30.9;-3.8]; p=0.0129). Improvements in clinical status and in liver enzymes from baseline were larger in the nalmefene compared to the placebo group. Adverse events and adverse events leading to dropout were more common with nalmefene than placebo.

Conclusions

As-needed nalmefene was efficacious in reducing alcohol consumption in patients with high risk for alcoholrelated harm.
1111 – Assertiveness And Eating Disorders: The Efficacy Of a Cbt Group Training. Preliminary Findings
Authors: Bandini L. , Sighinolfi C. , Menchetti M. , Morri M. , De Ronchi D. , Atti A.R.
Published: July 2013

Introduction

Low assertiveness and difficulties in emotion's regulation can perpetuate symptoms and worsen the outcome in patients with eating disorders (ED).

Objectives

Cognitive-behavioral-therapy (CBT) is the most effective treatment for bulimia nervosa (BN) and binge eating disorders (BED). Group training helps patients to cope with interpersonal difficulties.

Aims

To examine the effects of a CBT-group-training on assertiveness, emotion's regulation and binge behaviors in patients with ED.

Methods

Scale for Interpersonal Behavior (Arrindell et al, 1984; Sanavio, 2002), Difficulties in Emotion Regulation Scale (Gratz et al, 2004; Sighinolfi et al, 2010), Bulimic Investigatory Test of Edinburgh (BITE) were administered at baseline and one and three months after a CBT-training to 20 patients with ED (BED, NES, BN, EDNOS) (90% women, age 25-69 years).

Results

Patients who took part in the training improves assertiveness and emotion's regulation.

[SIB]

[DERS]

Conclusions

CBT-group-training increases assertiveness, improves emotion's regulation, has little effects on binge behaviors severity.
1123 – Cognitive Impairment In Euthimic Bipolar Patients
Authors: Elce C. , Mazza C. , Ammendola S. , Melillo S. , Caputo F. , Galletta D. , Casiello M.
Published: July 2013

Introduction

Cognitive dysfunction is a core feature in the course of bipolar disorder (BD) and persists during the remission periods. Only few studies valueted separately patients with BDI and BDII.

Obiectives

To analyze the pattern of neurocognitive dysfunction between healthy controls and euthimic patients with BDI and BDII.

Methods

27 patients with BD (17 BDI patients and 10 BDII patients, according to DSM IV TR) and 20 controls underwent a neuropsychological battery. The inclusion criteria for the bipolar groups was an Hamilton Rating Scale For Depression's score ≤ 7. The neuropsychological battery consisted of:

i)

the Mini Mental State Examination

ii)

The Corsi and the verbal span, to assess the short term memory;

iii)

the Rey Auditory Verbal Learning Test (RAVLT) and the logical memory test, to assess the long term memory;

iv)

the progressive Raven Matrices, to assess the logical - abstractive capacity

v)

The frontal assessment battery and the phonetic verbal fluency, to assess the executive functions

vi)

The continuos performance test to assess the selective attention.

Results

Patients affected by BDI performed significantly worse to controls when the short term spatial memory, the long term verbal memory, logical abstractive capacity, the executive functions and the selective attention were measured (p< 0,05). Patients affected by BDII performed significantly worse (p< 0,05) to controls when the long term verbal memory was measured.

Conclusions

Euthimic Patients with BDI disorder seem to have a more severe cognitive profile respect of BDII patients.
1138 – Delirium
Authors: Soler Iborte A. , Galiano Rus S. , Muñoz Negro J.E. , Aznarte López J.I.
Published: July 2013

Introduction

“I watch death” it is an English mnemonic acronym for the myriad causes of Delirium. It characterizes for sudden onset, low consciousness, attention and cognition levels. Although its origin is because of different organic disorders, it is usually consulted to the mental health services because of its psychopatology. An early detection and the subjacent cause treatment are fundamental.

Methods

We performed a retrospective analysis of those patients visiting the Emergency Services and/or hospitalized in San Agustín's Hospital of Linares and being subsequently diagnosed of delirium by the liaison psychiatry team during the year 2011. We studied the following variables: medical diagnostic, sex, age, comorbidity and psychopatology, A follow-up of the patients was also done.

Results

The 5% of 299 liaison psychiatry consultations corresponded to patients with delirium. Traumatology and General Medicine generated the 72% of the consultations to liaison psychiatry team. All patients were male, 50% of them were under 40 and older than 60 years. They had several comorbid factors such as polytraumatism, post-surgery, previous brain damage, ischemic heart disease, HIV, etc. The most widely used drug treatment for mental symptoms was low-dose of haloperidol, according to clinical guides evidence. A 25% of patients died within two weeks after the consultation to liaison psychiatry team despite treatment of the subjacent cause.

Conclusions

As a result of our findings we coordinated a clinical session with others Hospital Departments to improve clinical care for these patients in order to improve the early diagnostic and intervention.
1142 – Object-affordance In Schizophrenia
Authors: Sevos J. , Grosselin A. , Pellet J. , Chesnoy G. , Gay A. , Billard S. , Brouillet D. , Massoubre C.
Published: July 2013

Abnormalities of embodiment of the self and of self-object relations are recently described as a possible common component in schizophrenia. For these patients, the world can then appear as being deprived of practical meaning, which lays its foundation through sensory-motor experiences. Here, we investigate the hypothesis that schizophrenic patients could have a deficit in sensory-motor simulation. To investigate this question, we used two Stimulus Response Compatibility tasks, in schizophrenic and control subjects. When the stimuli and the responses share the same properties, it is well known that response times are shorter than when they do not (« SRC effect »). In experiment 1, we replicate a study from Tucker & Ellis (1998) in order to explore the hypothesis that schizophrenic patients could have a deficit in sensory-motor simulation during perception of graspable objects in contrast to healthy subjects (“Object-Affordance”). In experiment 2, we hypothesize that during a Simon task, the SRC effect would be efficient in both groups.

Our results show that, in a schizophrenic group, the SRC effect appears only when stimuli and responses share a spatial localization but does not when they share motor characteristics.

These results allow us to conclude that the visual asymmetry does not influence the implementation of the motor potentiation, as certain authors suggest in healthy subjects.

Moreover, in schizophrenia, the sensory-motor simulation impairments could emerge from a lack of relation between the object and the subject's environment more than from a difficulty in orienting attention.
1143 – Clinical Characteristics And Cognitive Functions Of Late-onset Psychoses: a Case-control Study
Authors: El Ghonemy S. , Sadek H. , Bassim R. , Soltan M. , Elserafi D.
Published: July 2013

Background

Mental disorders are not uncommon in late life. The emergence of psychotic symptoms for the first time in later life poses a diagnostic challenge for clinicians assessing and treating elderly persons with mental illness.

Objectives

To determine the clinical characteristics and cognitive function impairments in elderly patients with late-onset psychosis compared with normal healthy control.

Participants and methods

A cross-sectional case-control study; 50 patients with late-onset non-schizophrenic psychoses compared to 50 normal, healthy volunteers matched for age, sex, and social standard. The case group was interviewed using the Structured Clinical Interview for DSM Axis-I diagnosis (SCID-I), the control group was chosen on basis of assessment using the General Health Questionnaire (GHQ). Both groups underwent a functional assessment of daily living using the following: (a) Activities of Daily Living scale (ADL), (b) Instrumental Activities of Daily Living (IADL), (c) Cambridge Mental Disorders of the Elderly Examination, section B (CAMCOG), and (d) the Wechsler Adult Intelligence Scale (WAIS) for cognitive assessment.

Results

No significant differences between both groups in sociodemographic variables, family, and medical histories, except occupational status, in case group they had significantly more professional and skilled jobs. They also showed significantly higher rates of diseases of the gastrointestinal, renal, and central nervous system. Moreover, they showed very high significant cognitive decline, as well as functional impairment in daily living activities compared with their healthy counterparts.

Conclusion

Patients with late-onset psychoses show more severe cognitive and functional impairments in their daily activities.This paves the way for future studies.
1148 – Recent Advances In Hoarding Disorder: The Emerging Of a New Nosologic Entity
Authors: Brenha M.M. , Canha J. , Encarnação R. , Paz C.
Published: July 2013

Introduction

The concept of hoarding is a matter of study and debate since several years and has been trough various changes concerning its definition and categorization, namely in what concerns the differentiation from “normal” collecting behaviour and the association with other mental disorders as Obsessive-Compulsive Disorder.

Objectives

This comunication reviews the evolution of the concept of hoarding and its implications in the assessment, management and treatment of the patients.

Aims

The authors pretend to highlight the nosological path traced by the scientific research until today and present the state of the art in this field.

Methods

The authors selected articles referring to hoarding disorder in PUBMED and SCIENCEDIRECT databases and made a literature's review about the theme.

Results

Latter findings have identifyed clinical, neurobiological and treatment features in hoarding individuals that seem to be specific and that suggest the conceptualization of a standalone condition that presents independently from other disorders. The recent proposal of a Hoarding Disorder for the new DSM-V advances with some criteria in order to categorize this entity and establish its diagnostc boundaries.

Conclusions

The emerging of a new nosologic entity constitutes a change of perspective in the understanding of this condition that has implications at various levels, such as the aproach to the patient, his management and treatment.
1154 – Single Prolonged Stress Triggers Endoplasmic Reticulum Stress And Endoplasmic Reticulum Associated Death In Rat Hippocampal Neurons
Authors: Xie H.J. , Han F. , Shi X.Y.
Published: July 2013

The efficient functioning of the endoplasmic reticulum (ER) is essential for most cellular activities and survival. The ER is highly sensitive to stresses that perturb cellular energy levels, the redox state or Ca2+ concentration. ER stress and ER stress-induced apoptosis is implicated in the pathophysiology of several neurodegenerative and cardiovascular diseases. We suspect that Single prolonged stress which is extensively used as an established animal model for PTSD triggers endoplasmic reticulum stress and endoplasmic reticulum associated death in rat hippocampal neurons. Grp94 (Glucose-regulated protein 94), is the ER-resident member of the heat-shock-protein 90 (Hsp90) family, highly expressed when ERS happened. Caspase-12 is a protease until now believed to play a central role in the initiation of ER stress-induced cell death. In present study, Changes of GRP94 (Glucose-regulated protein 94) and caspase-12 were detected by immunohistochemistry, reverse transcription-polymerase chain reaction and western blot. Changes of GRP94 and caspase-12 may contribute to the progress of molecular mechanism of PTSD.
1165 – Hidden Siallorrhea For 11 Years - a Case Report
Authors: Yazici E. , Yazici A.B.
Published: July 2013

Objective

Patients with chronic schizophrenia receive medications for long terms. Sialorrhea is a common and usually manageable side effect of clozapine occurring 31–54% of patients receiving clozapine therapy. It usually occurs in the early course of treatment and is more prominent at night. This is a case report about a patient suffering from schizophrenia for 15 years and receiving clozapine for the last 11 years.

Methods

The patient has been receiving clozapine for 11 years and had sialorrhea during all this time. He had been hospitalized once at the beginning of schizophrenia and the latter follow up continued with outpatient clinic controls. During this period he has never talked about sialorrhea, he ‘shamed about talking about it’so he never received any treatment for it. He reports that doctors asked about ‘side effects of the medication but not about sialorrhea’.

Results

He mentioned about sialorrhea when he learned that it is a common side effect of clozapine and he reported it when existence of sialorrhea was asked as a special question in a rehabilitation program for schizophrenia.

Conclusion

This case is important to show the insufficient motivation of health professionals to talk the side effects of medications name by name with the patients so a distributive side effect as siallorrhea may elude observation for years. Using screening scales for common adverse effects in routine examinations may provide a beneficial approach.