bluuebunny/crossref_metadata_2025 huggingface dataset:
CS04-03 - New developments in the classification of personality disorders
Authors: Simonsen E.
Published: May 2011

Personality disorders are regarded as being among the more important categories within the DSM-IV diagnostic nomenclature, because they have the unique distinction of being placed on a separate diagnostic axis. However, empirical data have pointed out a number of disadvantages and concerns with the categorical system: excessive co-occurrence, inadequate coverage, heterogeneity within diagnoses, arbitrary and unstable diagnostic boundaries and inadequate scientific basis.

Alternative dimensional approaches have been considered. There is a surprising consistency over the number and descriptions of the main factors or dimensions both in normal population and among psychiatric patients, at least the following four: an externalizing factor aggression (antagonism), an internalizing anxious-emotional unstable second factor, an inhibited and constraint third factor and fourth factor of compulsivity and perfectionism. Beside this, severity of functional deficits, a number of trait domains and disturbances of self and identity are considered to be included as additional descriptors of personality pathology. It is proposed that only 5 or 6 of the current categories with highest clinical validity will be kept in the system. The aim is to maximize clinical utility, but the current suggestions seem to be too complex for the average clinician to follow.
CS04-04 - Subtreshold states in psychiatry: clinical and theoretical implications
Authors: Küey L.
Published: May 2011

If one of the major current challenges in the classification and diagnosis of mental disorders is the issue of multi-morbidities, a further one is the subtreshold states. These challenges could be partially considered as the by-products of the prevailing current categorical approaches in our classification systems.

The categorical approach needs and is based on vertical and horizontal boundaries to differentiate different states of human behavior. While, at a horizontal level the boundaries between mental disorders are elicited by strict diagnostic criteria, the issue of drawing a threshold at a vertical level requests some dimensional approaches. These thresholds in the description of many mental disorders in our current categorical approaches are defined by a combination of some dimensions; i.e., the duration of the symptoms, the severity of the symptoms, and the effects of the symptoms on social functioning and abilities.

Another problem in defining the thresholds for mental disorders is the consequence of the cross-sectional approach. Since, the clinical pattern of many mental disorders change in time, the cross-sectional approach does not reply to the requirements of a historical perspective from which the variation of a mental disorder over and under a given cut-off line in due course could be understood. It is a widely shared opinion that the necessity of defining thresholds for mental disorders is not only taking the clinical, scientific and research motives into consideration, but also the forensic and administrative grounds.

This presentation will mainly discuss the phenomenon of threshold and subtreshold states in the context of psychopathology, clinical practice and classification systems.
CS05-01 - Interpersonal therapy
Authors: Aldenhoff J.
Published: May 2011

Interpersonal therapy of depression was created and established in American psychiatry in the 80ties. At that time european and especially german psychiatry was still dominated by the concept of endogenous depression, which suggested a somehow biologically determined aetiology which was not very likely to be influenced by psychotherapeutic access.

However, the empiric approach to evaluate therapy regardless of aetiology, which is very typical for IPT, produced strong evidence for the effectiveness of IPT in unipolar depression and many other psychiatric disorders.

On this basis, a diversity of biological studies became possible which aimed to the elucidation of neurobiological mechanisms of psychotherapy.

The first data indicate that biological state markers change when the patient responds, regardless if he received Psycho- or pharmacotherapy. However, no empirical findings suggested, how IPT might be linked to neurobiological phenomena.

We followed the suggestion by E. Kandel, that the phosphorylation of cAMP-responsive-binding-protein (pCREB) could be a crucial factor in the process of psychic improvement. Therefore we studied pCREB in human T-lymphocytes under different treatment conditions in unipolar depression. The results will be presented.
CS05-02 - Schema therapy for chronic depression
Authors: Huibers M.
Published: May 2011

Although schema or schema-focused therapy is now a well-established treatment for personality disorders such as borderline personality disorder, it was originally developed with long-lasting or chronic forms of depression in mind. In this presentation, I argue why schema therapy is a promising treatment for depression by giving an overview of currently available treatments; describing the theoretical framework of how schema therapy might apply to chronic depression; presenting empirical evidence on the early maladaptive schemas found in depressive patients receiving outpatient treatment; and by describing the design of an ongoing study in which the effectiveness and underlying mechanisms of change of schema therapy for chronic depression are examined.
CS05-04 - Cognitive behavioral analysis system of psychotherapy (CBASP)
Authors: Berger M. , Brakemeier E.-L. , Schramm E.
Published: May 2011

Chronic depression accounts for roughly a third of all mood disorders. It is a particularly disabling disorder, which is associated with greater comorbidity and suicidality, more significant impairments in functioning, and increased health care utilization than acute major depressive episodes. In the past, chronic depression was often considered as treatment-resistant since traditional pharmacological and psychological treatment approaches show at most modest success. In addition, relatively few psychotherapy studies have focused on chronic (mostly dysthymia) forms of depression. However, in chronic Major Depression a specific form of psychotherapy, the Cognitive Behavioral Analysis System of Psychotherapy (CBASP), proved to be equally effective than medication; the combination of CBASP and medication revealed significant superiority over both monotherapies.

CBASP-developed by James McCullough-is the only psychotherapeutic intervention specifically designed for chronic depression. The approach integrates behavioral, cognitive, psychodynamic, and interpersonal strategies. It focuses on problems resulting from an inhibition of maturation in early childhood often caused by early traumatization by using the therapeutic relationship in a disciplined personal way. In addition, other interpersonal strategies are applied to overcome preoperational thinking. By means of a specific behavioral technique, the Situation Analysis, patients learn to focus on the consequences of their behavior and to use efficient social problem-solving. The techniques of CBASP will be demonstrated.

Results of two pilot studies will be presented

First, a randomized pilot outpatient study comparing CBASP with the interpersonal psychotherapy (IPT) in early onset chronically depressives was conducted showing significant superiority of CBASP against IPT. Second, a first open pilot study in the inpatient setting investigated a new modified multidisciplinary CBASP inpatient program. The data of the first patients suggest that the three-month CBASP inpatient program is a feasible and effective treatment for severely chronically depressed patients with severly to extreme traumatization.
CS06-01 - New insights into the cellular and molecular mechanisms underlying the etiology of schizophrenia
Authors: Marin O.
Published: May 2011

Growing evidence suggest that disruption of cortical interneuron function is common to several psychiatric conditions, such as schizophrenia. Cortical interneurons play major roles in the function of the cerebral cortex. Through mostly inhibitory mechanisms, interneurons regulate the activity of pyramidal cells, prevent hyperexcitability, and synchronize the rhythmic output of cortical activity. In particular, the function of some classes of interneurons has been shown to be crucial for the generation and maintenance of gamma rhythms, a pattern of brain waves that is associated with perception and memory.

Work in my laboratory aims at elucidating the mechanisms controlling the development of cortical interneurons. We have recently found that several genes associated with schizophrenia, such as Nrg1 and ErbB4, control several aspects of the development of cortical interneurons. In this talk, I will summarize our current view on the biological mechanisms that may underlie the etiology of schizophrenia, linking susceptibility genes, cortical inhibitory function and brain development.
CS06-03 - Relationship between cognition and psychopathology
Authors: Galderisi S.
Published: May 2011

The prevailing view today is that cognitive impairment and symptoms of schizophrenia represent largely independent aspects of the disorder. However, significant associations of cognitive impairment with negative symptoms have been frequently reported and associations with positive symptoms or disorganization were also found, although less consistently. The possibility that cognitive impairment is an epiphenomenon of other psychopathological dimensions has been largely ruled out by robust evidence that cognitive impairment is found before the onset of psychosis and in non affected first degree relatives of patients with schizophrenia. The possibility that the other psychopathological dimensions are a consequence of cognitive impairment is consistent with current models of schizophrenia pathophysiology. Moreover, cognitive impairment may play an important role in cognitive accounts of schizophrenia symptoms. Future research on this topic might greatly benefit from more refined psychopathological characterization of study subjects and from cognitive constructs more relevant to psychopathology.
CS06-04 - Short and long-term treatment outcomes in schizophrenia
Authors: Moeller H.-J.
Published: May 2011

Schizophrenia is a chronic disorder with a high risk of poor outcome in terms of symptoms and social functioning and possibly also progressive brain alterations. The relapse rate is high and each relapse can induce further aggravations, both in psychosocial as well as in neurobiological terms. Thus, acute and long-term treatment with the highest degree of effectiveness should be provided to the patients in acute and long-term treatment.

Neuroleptic medication is the most important part of the treatment regimen for schizophrenic patients. The efficacy of neuroleptics in the acute and long-term treatment of schizophrenia is very well proven and the effect size is comparatively high. The second-generation antipsychotics (SGAs) have advantages over the neuroleptics of the first-generation (FGAs), and high expectations have therefore been put into them for the treatment of schizophrenia. Their better extrapyramidal-motor tolerability and efficacy in treating negative, depressive and cognitive symptoms, in addition to positive symptoms, supposedly result in a more favourable influencing of the overall course of the disease and in a higher quality of life for the patients, thus improving their acceptance by patients and leading to increased compliance. Differences in the pharmacological profile can be identified among others by receptor imaging approaches.
DB01-01 - Is EBM killing the art of treatment in psychiatry?
Authors: Gaebel W.
Published: May 2011

Evidence based medicine (EBM) is the conscientious, explicit, and judicious use of current best evidence in making decisions about the care of individual patients. The practice of EBM means integrating individual clinical expertise with the best available external clinical evidence from systematic research. Applied to treatment in psychiatry, somatic, pharmacological and psychotherapeutic therapy as well as prevention and rehabilitation are to be assessed systematically. Evidence-based practice guidelines for the treatment of mental disorders are available in many countries and were developed based on the principles of EBM. This includes literature reviews, which are time-consuming and beyond the scope of everyday clinical psychiatrists' work capacity. Thus, evidence-based guidelines support the art of treatment in psychiatry by providing expertise.

Treatment algorithms published in treatment guidelines are often misunderstood as strict rules. In fact, guidelines cannot provide non-exceptional regulations. They imply the option to deviate from guideline recommendations. Guidelines and EBM will only be able to support clinical decision making. The “art” of making therapeutic decisions remains an essential competence of the practising psychiatrist.

Adhering to guideline recommendations in psychiatric treatment leads to optimized patient outcomes. EBM thus provides a firm basis for often complicated treatment decisions in psychiatry and critically supports the art of treatment in psychiatry. It will never kill this art but rather help it to survive as a highly specialized, scientifically based medical competence.
DB02-01 - Drug treatment is not necessary for maintenance treatment of depression
Authors: Fava G.A.
Published: May 2011

Prolongation or lifelong pharmacotherapy has emerged as the main therapeutic tool for preventing relapse in depression. However, outcome after discontinuation of antidepressants is unfavourably affected by the duration of their administration. Loss of clinical effects, despite adequate compliance, has also emerged as a vexing clinical problem. Use of intermittent pharmacotherapy with follow-up visits is another therapeutic option, that, however, entails the problems of resistance and of discontinuation syndromes.

In recent years, several controlled trials have suggested that a sequential use of pharmacotherapy in the treatment of the acute episode and psychotherapy in its residual phase may improve long-term outcome. Antidepressant drugs may be tapered and discontinued during the course of psychotherapy. The sequential treatment of depression not fall within the realm of maintenance strategies. It is an intensive, two-stage approach, which is based on the fact that one course of treatment with a specific tool (whether pharmacotherapy or psychotherapy) is unlikely to provide solution to the complex array of symptoms of patients with mood disorders.
DB02-02 - Drug treatment is not necessary for maintenance treatment of depression - con
Authors: Möller H.-J.
Published: May 2011

The efficacy of antidepressants is clinically relevant. The highest effect size was demonstrated for severe depression. Based on responder rates and based on double-blind placebo-controlled studies, the number needed to treat (NNT) is 5–7 for acute treatment and 4 for maintenance treatment. Monotherapy with one drug is often not sufficient but has to be followed by other antidepressants or by comedication/augmentation therapy approaches.

Generally, antidepressants reduce suicidality, but under special conditions like young age or personality disorder, they can also increase suicidality. However, under the conditions of good clinical practice, the risk-benefit relationship of treatment with antidepressants can be judged as favourable also in this respect.

The capacity of psychiatrists to individualise and optimise treatment decisions in terms ofthe right drug/treatment for the right patient’ is still restricted since currently there are no sufficient powerful clinical or biological predictors which could help to achieve this goal. There is hope that in future pharmacogenetics will contribute significantly to a personalised treatment. With regard to plasma concentration, therapeutic drug monitoring (TDM) is a useful tool to optimize plasma levels therapeutic outcome.
DB03-01 - We still need benzodiazepines in the treatment of mental disorders: The case against (invited debate)
Authors: Lader M.
Published: May 2011

Benzodiazepines have anxiolytic, hypnotic, muscle-relaxant and anticonvulsant properties. They also lessen agitation in the psychotic patient. They are much safer than previously available drugs such as the barbiturates. All sedative drugs have characteristic pharmacodynamic effects, causing sedation, psychomotor slowing and memory impairment.

The widespread use of benzodiazepines long-term is problematic. Even though some tolerance develops, long-term users are impaired in cognitive and psychomotor function compared to non-users. Tapering the drugs, even after several years of use, results in improvement in functioning. Newer anxiolytics such as SSRIs and pregabalin cause less impairment. Benzodiazepines are associated with dependence on prescribed doses with a clear-defined withdrawal syndrome lasting a few weeks; this is evident in 20–30% patients on benzodiazepines, and is severe in 10%. Benzodiazepines should never be withdrawn abruptly because fits paranoid or confusional psychoses may ensue. Secondary abuse of all sedative drugs is common and contributes to specific drug-related harms in abusers.

Few longterm studies have been performed so the longterm risk/benefit ratio is imprecise. The paucity of “gold standard” clinical trials means that the benzodiazepines seem no more effective than placebo in the longterm as anxiety-- and insomnia-reducing agents.

Alternative medications for the Anxiety Disorders have been developed and evaluated, principally SSRIs and pregabalin. Similarly, newer drugs are available for treating Sleep Disorders. Longterm use can be avoided by using non-pharmacological or non-dependence inducing medications. The fundamental problem which precludes routine longterm use is that it is impossible to identify those users who will develop dependence beyond 1–3 months prescription.
DB03-02 - We still need benzodiazepines in the treatment of mental disorders: The case against (invited debate)
Authors: Lader M.
Published: May 2011

Benzodiazepines have anxiolytic, hypnotic, muscle-relaxant and anticonvulsant properties. They also lessen agitation in the psychotic patient. They are much safer than previously available drugs such as the barbiturates. All sedative drugs have characteristic pharmacodynamic effects, causing sedation, psychomotor slowing and memory impairment.

The widespread use of benzodiazepines long-term is problematic. Even though some tolerance develops, long-term users are impaired in cognitive and psychomotor function compared to non-users. Tapering the drugs, even after several years of use, results in improvement in functioning. Newer anxiolytics such as SSRIs and pregabalin cause less impairment. Benzodiazepines are associated with dependence on prescribed doses with a clear-defined withdrawal syndrome lasting a few weeks; this is evident in 20–30% patients on benzodiazepines, and is severe in 10%. Benzodiazepines should never be withdrawn abruptly because fits paranoid or confusional psychoses may ensue. Secondary abuse of all sedative drugs is common and contributes to specific drug-related harms in abusers.

Few longterm studies have been performed so the longterm risk/benefit ratio is imprecise. The paucity of “gold standard” clinical trials means that the benzodiazepines seem no more effective than placebo in the longterm as anxiety-- and insomnia-reducing agents.

Alternative medications for the Anxiety Disorders have been developed and evaluated, principally SSRIs and pregabalin. Similarly, newer drugs are available for treating Sleep Disorders. Longterm use can be avoided by using non-pharmacological or non-dependence inducing medications. The fundamental problem which precludes routine longterm use is that it is impossible to identify those users who will develop dependence beyond 1–3 months prescription.
ECP02-01 - Globalisation and the impact of economic factors on psychiatric disorders
Authors: Bhugra D.
Published: May 2011

Introduction

With the process of globalisation in full flow, the movement of people and products across the globe has brought a series of difficulties. With migration the socio-economic status of the individuals may change with the likelihood that this status will be lower rather than higher, although depending upon the reasons for migration this may change too.

Objectives

Literature shows that low socio-economic status is associated with a higher level of psychiatric morbidity.

Aims

Whether migration acts as a mediator needs to be investigated further.

Methods

Various studies have shown that rates of psychosis are elevated in migrants though these rates are differentially increased in different groups indicating that factors other than migration may be at play.

Results

In this presentation the literature and link the acculturation and cultural identity with post-migration experiences will be reviewed.

Conclusion

A link exists between the perceptions within cultures and level of economic development of what constitutes mental health. The state of advancement of mental health services of a country will certainly have a large impact on prevalence rates. Further investigation should be carried out to examine in greater depth the relationship between social inequality and disorder prevalence, as distinct from income inequality.
ECP02-03 - Research perspectives in transcultural psychiatry for young psychiatrists?
Authors: Tarricone I. , Braca M. , Mencacci E. , Marseglia M.V. , De Gregorio M. , Colonna N. , Panigada S. , Stivanello E. , Berardi D. ,   Bologna Devereux Research and Study Group
Published: May 2011

Introduction

Migration is a growing phenomenon in western countries. Several studies report a greater prevalence of psychiatric disorders among migrants. Some studies indicate a interesting relation between such disorders in migrants and their migration history, particularly the process of integration in the host country (Bhugra and Jhons 2005; Morgan et al 2010).

Aims

To present the Bologna Migration History Questionnaire, that is a research tool to study the migration history and identify the related determinants of psychiatric disorders.

Methods

We conducted a literature review on questionnaires used to study the determinants of psychiatric disorders in migrants and on etiopathogenetic hypotheses. We identified the main determinants to be investigated and expanded a research tool already used in a Mental Health Centre (MHC) of Bologna accordingly. A first version of this tool was discussed during a workshop with fieldworkers from different MHCs in Italy and with international experts on migration and mental health.

Results

The developed tool includes three sections: 1) Pre-migration phase; 2) Migration phase; 3) Post-migration phase. Through the tool, information is gathered on: socio-economic factors that precede and follow the migration, reasons and organization of the migration, relations and social support in the host country, detected changes and satisfaction achieved within different fields of experience. Information can be retrieved either from medical records or through semi-structured interviews with the patients within a month from the first contact.

Conclusions

Currently the tool has been distributed to different Italian MHC to assess its feasibility with regard to data collection and the appropriateness of questions. Young psychiatrists and trainees show great interest in this study. We discuss discuss research perspectives for young psychiatrists within international research projects to better investigate the relation between migration and mental health in western countries.
ECP05-01 - Reforms for mental health care systems and the impact for training in psychiatry
Authors: Priebe S.
Published: May 2011

Since the 1950s, political reforms have changed mental health care in most European countries. The political drivers, onset, pace, underpinning legislation and exact outcomes of reforms varied greatly among European countries, but there are also some common elements. Former large asylums have been closed or downsized, and different forms of services in the community have been established, particularly for patients with severe mental illnesses. Working in the community - in one form or another - is part of the job of many psychiatrists, and this aspect comes with specific challenges. These include working in a multidisciplinary team, establishing and maintaining positive relationships with patients in variable settings, combining different approaches in the treatment of often complex disorders, coordinating care across services, and taking responsibility for the quality of care in often difficult circumstances. This requires competence and skills that may be different from those of traditional psychiatrists working in hospitals. Psychiatrists should have appropriate skills in therapeutic communication, the management of small groups and the integration of different approaches of treatment and support. All these skills require appropriate training which most current curricula arguably do not provide. The stronger focus on the skills specifically required to work in the community is likely to change the traditional role of psychiatrists, but might increase the attractiveness and fascination of being a psychiatrist in the 21st century.
ECP05-02 - Coercive measures and legal aspects
Authors: Kallert T.W.
Published: May 2011

In detail two issues will be addressed

The analysis of standardized reports on the national legal situations on involuntary admission to psychiatric hospitals. This work revealed major cross-national differences, e.g. for basic conditions as well as for additional criteria for involuntary admission, time periods for making decisions, the association between involuntary placement and treatment, patients’ rights to register complaints, roles of relatives, and safeguard procedures of these processes.

One of the clinical results (established by the assessment of 2326 legally involuntary patients) was that in the different countries, between 39% and 71% of the patients found the admission right after one month, and between 46% and 86% after three months. Female patients, those living alone and those with a diagnosis of schizophrenia had more negative views. Adjusting for confounding factors, differences between countries were significant. The presentation will outline that a potential explanation of these differences is the extent to which national mental health legislation protects the rights and interests of the patients concerned.

Thus, the important, but complex link between coercive measures and legal aspects will be demonstrated. Further, the discussion section of this presentation will focus on legal issues which could be (cross-nationally) harmonized in the sensitive field of coercive treatment.
ECP05-03 - Treatment of suicidal patients: Legal and ethical aspects
Authors: Wasserman D.
Published: May 2011

According to WHO estimates, 1.5 million people worldwide will complete suicide in the year 2020 and approximately 10-20 times this number will attempt suicide. Given that suicide still remains the most serious outcome of mental disease, it is essential that psychiatrists are specifically trained regarding legal and ethical aspects related to the treatment of suicidal psychiatric patients.

Clinical decisions guided by evidence based knowledge and ethical judgments according to the principles of beneficence, non-maleficence and autonomy intimately interact when a psychiatrist performs suicide risk assessment, recommends treatment and follow- up rehabilitation measures. Ethical dilemmas of respecting acute suicidal or chronic suicidal patient's autonomy when she/he is unable to control self-destructive impulses, confidentiality, Do Not Resuscitate (DNR) orders and involuntary confinement for the institutional ward will be discussed.

Existing research indicates that suicide risk is higher in the immediate aftermath of discharge from the hospital and when patients are transferred to outpatient care without securing the follow- up visit. Psychiatrists are sometimes under considerable pressure, due to economical downsizing of the psychiatric care, to discharge suicidal patients from inpatient care, which can lead to serious legal and ethical repercussions. Following evidence-based procedures is crucial, as well as maintaining a high standard of documentation for all processes and decisions taken.

Continuous education of health care staff, scrutiny of existing routines and knowledge about own attitudes towards suicidal patients are needed in order to prevent suicide.
ECP05-04 - Malpractice - An issue for all psychiatrists
Authors: Beezhold J. , Maughan N.
Published: May 2011

Introduction

Psychiatrists practice in a world of ever increasing scrutiny of their daily practice. Premiums for malpractice insurance are increasing year after year. Yet there are common themes that emerge from complaints and malpractice litigation that may be usefully elucidated in order to contribute towards improvements in psychiatric practice.

Objectives

By the end of this presentation the audience will have a good practical and theoretical understanding of the common causes of malpractice complaints and litigation, and will be well placed to improve their practice accordingly.

Aims

This presentation aims to examine and discuss malpractice issues in psychiatry. The focus will be on learning the lessons from the experience of other psychiatrists in order to improve the standard of our own practice, and improve our ability to deal appropriately with any future concerns and complaints.

Methods

Data and experience from medical malpractice insurers, research findings, perspectives from cognitive neuroscience and stories from the popular media will be reviewed. The presentation will highlight key issues and themes in order to draw out the lessons for all psychiatrists.

Results

Certain simple principles are fundamental to safeguarding psychiatric practice from malpractice complaints and litigation.

Conclusions

All psychiatrists are potentially vulnerable to malpractice complaints and litigation. There is much media attention paid to certain cases. This may in turn contribute to the public perception of psychiatry and psychiatrists. Yet there are also a number of straightforward steps that many psychiatrists can take in their day to day practice that will protect both themselves and their patients now and in the future. Improving our practice can not only benefit our patients and ourselves personally, but can also contribute to combating stigma and enhancing the image of psychiatry.
ECP06-01 - Genomewide - asscociation studies of psychiatric phenotypes: What they have told us and what to do next
Authors: Schulze T.G.
Published: May 2011

Genome-wide association studies of psychiatric disorders have highlighted several novel susceptibility genes and taught us several importnat lessons.

1)

Psychiatric disorders are polygenic disorders. The contribution of each locus to risk of disease is modest and disease risk increases substantially with the total burden of risk alleles carried.

2)

The best findings from GWAS do not necessarily fall within those genes that have previously been widely studied.

3)

Pursuing a “top-hits-only” strategy may prevent us from understanding the genetic complexity of psychiatric disorders and polygenic disorders in general. A detailed consideration of the wider distribution of association signals across studies may prove to be a valuable strategy in complex genetics.

4)

Allelic heterogeneity may be an important factor in psychiatric disorders. Allelic heterogeneity means that a phenotype can be caused by different alleles within a gene; this phenomenon has been extensively observed in monogenic disorders such as cystic fibrosis as well as in BRCA1/2-associated breast cancer.

5)

Finally, as with other complex phenotypes, GWAS in psychiatric disorders demonstrate that the variants identified so far only account for a small fraction of genetic variability.

Future research will need to embark on several complementary approaches in order to fill the yet “unexplained” part of the variance. These will among others include sequencing projects, pharmacogenetic studies, detailed genotype-phenotype dissection approaches, and the study of prospectively assessed phenotypes.
ECP07-01 - Cbasp workshop - introduction into the cognitive - behavioral analysis system of psychotherapy (cbasp) to treat depression
Authors: Brakemeier E.-L. , Berger M.
Published: May 2011

The Cognitive Behavioral Analysis of Psychotherapy (CBASP) by James McCullough is the only psychotherapeutic intervention specifically designed for chronic forms of depression. CBASP integrates behavioural, cognitive, interpersonal, and psychodynamic theories and strategies.

The approach focuses on problems resulting from maltreatment and inhibition of maturation in early childhood by using the therapeutic relationship in a personal disciplined way. In addition, other interpersonal strategies such as the Significant Other History, the proactive Transference Hypothesis, and the Interpersonal Discrimination Exercise are used to overcome preoperational thinking. By means of another specific technique, the Situation Analysis, patients learn to focus on the negative consequences of their usual behaviour and to use efficient social problem-solving strategies.

In a large study involving over 600 patients with chronic Major Depression, CBASP proved to be effective. The combination of an antidepressant and CBASP was the most beneficial treatment condition. Particularly effective was CBASP for the subgroup of chronically depressives with an early childhood trauma.

In the workshop the theoretical basis will be taught, the specific techniques will be shown by live and video demonstrations, and they will be practised.
ECP09-02 - Psychiatry training in europe: Implementation and evaluation of training programs
Authors: Rojnic Kuzman M. , Giacco D. , Wuyts P. , Simmons M. , Favre G. , Bausch Becker N. , Malik A. , Barrett E. , Nawka A.
Published: May 2011

Training schemes in psychiatry are developed and evaluated by national education policy makers in the majority of European countries. However, the requirements that a training program in psychiatry should meet are also defined on the European level in a form of recommendations by the Board of Psychiatry - European Union of Medical Specialists (UEMS).

Recently, the European Federation of Psychiatric Trainees (EFPT) which represent trainees from more then 30 European countries, reported data pertaining to the structure of training programs and to the evaluation of training programs in 30 European countries. Whereas in the majority of European countries the structure of training programs and methods of assessment of trainees' competencies are partially compatible with one another and with the existing recommendations at the European level, the quality assurance of training programs varies significantly among countries. Regular evaluations of training programs and mentors, however, contribute to the proper implementation of training programs and help that the theoretical training principles are followed through in practice. As quality assurance of training schemes is an important mechanism how to improve the delivery of training programs, it should gain more focus by responsible authorities who structure the psychiatric training on the national and international European level.
ECP09-03 - Information technologies in psychiatry
Authors: Favre G. , Bausch Becker N. , Giacco D. , Nawka A. , Rojnic Kuzman M. , Simmons M. , Wuyts P.
Published: May 2011

Even if technology and information are omnipresent, they rarely meet harmoniously. Either the lack of sufficient means prevents good information to reach its target or the technology is too complex to integrate flawlessly in the daily workflow.

The use and misuse of information technologies (internet, email, e-learning, social networks) has recently significantly increased among psychiatrists and patients and the changes in behavior of communication and seeking informations are real challenges.

Using the European Federation of Psychiatric Trainees network, the self-questionnaires concerning the usage of information technologies and the local patients-therapists communication were distributed among psychiatric trainees of 31 European countries.

A review of the results of this study, as well as recommendations about netiquette and useful websites for psychiatrists and scientists will be presented in detail.
ECP09-04 - The european federation of psychiatric trainees' psychiatric resident - industry relationship survey (efpt-prirs)
Authors: Jauhar S. ,   European Federation of Psychiatric Trainees Research Group
Published: May 2011

There is no doubt that, in the modern era, psychiatry and the pharmaceutical industry have a relationship, though the nature of this is not universally well defined. Given that psychotropic medication is widely prescribed (ranking 3rd and 4th in US sales in 2007), and the role of the pharmaceutical industry in medical education has come under scrutiny, it is worth noting that the relationship between the industry and psychiatry trainees has not been studied in great depth.

Our Pan-European research group, composed exclusively of psychiatry trainees from at least 18 different countries, as part of the European Federation of Psychiatric Trainees (EFPT) has sought to study this in a systematic fashion. I will present preliminary findings of our survey, PRIRS (Psychiatric Residents-Industry Relationship Survey) which is currently taking place.

It is also hoped that this will facilitate a discussion amongst those attending the session, on the role of the pharmaceutical industry in psychiatric training, education and in general.
FC01-01 - Combat stress injury markers predicting ptsd: Preliminary findings from in-depth interviews of combat medics between deployments
Authors: Figley C. , Cabrera D. , Speciale J.
Published: May 2011

US Army Combat Medics and Navy Combat Corpsmen serve as a critical element of any fighting unit. Their professional responsibilities are for providing the emergency and preventive medical needs of their soldiers with whom they live and serve. These medical professionals are also expected to do any job that maintains the mission of their fighting unit. Because of their importance to sustaining the US fighting forces, Combat Medics may be an ideal group to study because of the high levels of adversity and stress endured while serving both roles. The Medic Mettle Study was established to develop a model of combat stress resilience and a prevention of PTSD. The first step was to identify the psychosocial and bio-behavioral characteristics of combat stress injury. A mixed methods model was utilized and over 700 recently deployed Combat Medics were enrolled. The presentation discusses both the early quantitative results and elaborates on the qualitative interviews conducted with the most resilient combat medics, as nominated by their peers. Preliminary findings of the 16 intensive, videotaped interviews with Combat Medics between war deployments using a Variable Generating Activity (VGA) protocol

(1) found 138 variables that appear to provide some missing pieces in our understanding of combat stress injury and its psychosocial markers;

(2) Identified five variable domains within a nomothetic network of medic resilience;

(3) utility of annual surveys to validate the qualitative findings.
FC01-02 - Homelessness and experiences of psychological trauma in the western world: A research review and a qualitative study
Authors: Sundin E.C.
Published: May 2011

Over the last forty years, and particularly within the last decade, homelessness is recognised as a multifaceted problem. Homelessness is associated with poverty, because the ability to access employment is limited by the lack of a stable address. Secondly, homeless people often experience severe difficulties with housing related services, health services and education. These problems are often sustained or exacerbated by, e.g., poor physical and mental health and the need to support alcohol or drug dependencies. What role does traumatic events, in particular childhood trauma and abuse, have in the lives of the homeless? The negative effects of psychological trauma on psychosocial functioning and wellbeing in the general population are well documented; a quick review of the research on homelessness and trauma suggested that more work is needed.

The objectives of this paper are to review research on homelessness and experiences of psychological trauma and evidence from a sample of single homeless adults.

The aim of this paper is two-fold: to provide a systematic review of studies on the relationship between childhood trauma and homelessness and to present findings from a qualitative study of adult people who are homeless in London and Nottingham, UK.

The systematic review examines research published in the Western world, 1990 - July 2010. The qualitative study collected data through semi-structured interviews with 103 single people, aged 18–69 years.

A summary of the results from the review and qualitative study and guidance for further research on the relationships between traumatic experiences and homelessness will be provided.
FC01-05 - The association of traumatic experiences and posttraumatic stress disorder with physical morbidity in old age - a german population based study
Authors: Glaesmer H. , Braehler E. , Gündel H. , Riedel-Heller S.G.
Published: May 2011

Objective

To examine the relationship of traumatic experiences and PTSD among a representative population sample of 1,456 German elderly (60 years and above). Several studies have suggested that PTSD, but also traumatic experiences are related to adverse health outcomes. However, many past studies are based on selected samples like combat veterans, or survivors of natural disasters. To our knowledge this is the first representative population study in the elderly.

Methods

Based on self-report data and using regression analyses, we investigated the association of traumatic experiences and PTSD with several medical conditions.

Results

Traumatized subjects had a significantly increased risk for all the medical conditions under study compared to those participants without a traumatic exposure (OR = 1.37 for hypertension up to 5.12 (CI = 2.25–11.6) for cancer). There are significant associations of current PTSD with cardiovascular diseases (Angina pectoris/coronary artery disease; congestive heart failure, peripheral vascular disease) and cardiovascular risk factors (hypertension, elevated cholesterol) (OR = 1.94 for peripheral vascular disease up to 3.76 for elevated cholesterol), as well as with asthma, cancer, back pain, hard of hearing, osteoporosis, stomach problems and thyroid disorders.

Conclusions

Our study delivers additional evidence for the association of traumatic stress and PTSD with impaired physical health in a general population sample in the German elderly. It underpins the importance of traumatic experiences and PTSD not only for mental health, but also for physical health as a long-term consequence.
FC02-02 - Prevention of violence among out-patients with schizophrenia (previos i): A feasibility study
Authors: Steinert T. , Hamann K. , Frommberger U. , Schwarz M. , Weithmann G.
Published: May 2011

Introduction

The number of beds in forensic psychiatry has increased more than two-fold since 1990 in many countries, mostly due to an increasing number of admitted male patients with psychotic disorders. Most of these patients had previous admissions to general psychiatric units.

Aims

To develop a manual for interventions aiming on the prevention of violence based on cognitive behavioural therapy and to test its feasibility.

Methods

A manual comprising of 11 different domains of possible interventions was developed. For each patient, the three most relevant domains should be identified. A pilot study was conducted in two psychiatric hospitals. Included patients should receive two sessions as in-patients and consecutively three more as out-patients.

Results

Out of 368 male patients with a diagnosis of a schizophrenic or schizoaffective disorder, 89 (24.2%) had a relevant history of violence. Only 15 (17%) could be recruited for the study, 13 (14.6% of eligible patients) completed the intervention. A considerable proportion refused to participate. The manual was considered to be applicable and relevant. Domains used most frequently were anger management, substance abuse, and medication adherence.

Conclusions

The intervention based on a flexible manual and five sessions was feasible and well accepted by participating patients. However, it turned out to be difficult to recruit this group of patients for an intervention programme and for a study. To conduct a randomised controlled trial, a screening of about 4.000 patients with schizophrenia will be necessary.
FC02-03 - Is there an association between neurocognitive factors and homicide in schizophrenia ?
Authors: Richard-Devantoy S. , Gourevitch R. , Vacheron M.-N. , Voyer M. , Senon J.-L. , Garré J.-B.
Published: May 2011

Objective

The objective of this systematic review was to investigate which specific and especially neurocognitive factors related to schizophrenia, were associated with homicide risk.

Methods

A systematic English-French Medline literature search of cohort studies, case-control studies and transversal studies published from January 1999 to December 2009 was performed combining the MeSH terms “schizophrenia”, “homicide”, “violence”, “mental process”, “cognition”, “risk”, “risk factors”,. Abstract selection was based on the STROBE checklist for observational studies and on the consort statement for clinical trials.

Results

Of the 366 selected studies, 65 observational or prospective studies, 10 systematic reviews and meta-analysis and 2 interventional studies met the selection criteria and were included in the final analysis. Firstly, we highlighted that historical (past violence, juvenile detention, physical abuse, parental arrest record), dispositional (male gender, young age, low socioeconomic status) and contextual (recent divorce, unemployment, victimisation) factors could be considered as general homicide-related factors. Clinical factors (clinical paranoid, delusions of persecution or thought insertion, substance abuse, disorganized thinking, long duration of untreated psychosis, stopped monitoring or treatment) were more schizophrenia-specific factors for homicide. Most of the excess risk appears to be mediated by substance abuse. Secondly, our results suggested that schizophrenics with a history of aggressive behaviour compared to those without such history, had better performances on global neuropsychological tests exploring executive functions but performed more poorly as considering orbitofrontal functions.

Conclusions

We suggest that every comprehensive psychiatric assessment should explore the risk of homicide, including historical, dispositional, contextual, clinical and neurocognitive (low insight capacity, impaired frontal functions) factors of violence.