bluuebunny/crossref_metadata_2025 huggingface dataset:
FC13-11 - Effectiveness of mazindol in children with ADHD : open-label study
Authors: Konofal E. , Lecendreux M. , Kaguelidou F. , Mentré F. , Laouenan C. , Jacqz-Aigrain E.
Published: May 2011

Mazindol is a central nervous system stimulant, which blocks reuptake of dopamine and norepinephrine. Mazindol (1–6 mg/d) has previously been studied in the treatment of excessive daytime sleepiness with relative therapeutic benefit. Our hypothesis suggests that mazindol may be effective for the treatment of Attention Deficit Hyperactivity Disorder symptoms.

Based on clinical assessments after oral administration of mazindol to 24 children (9–12 years) with ADHD (according to DSM-IVTR criteria), this open-label study evaluates the efficacy, safety and tolerability of mazindol (1 mg/d, 7 days). Safety evaluations included routine hematology, electrocardiograms, blood pressure, and pulse rate. Efficacy rating measurements included ADHD-RS score (primary outcome measure), CPRS-R:L, CGI-S and CGI-I (secondary outcome measures). This clinical trial reports data obtained from 21 boys (10 ± 1 years).

Based on primary outcome (ADHD-RS), change in ADHD-RS mean total score after one week of mazindol was −24.6 (p < 0.0001) ; greater than a 90% improvement from baseline. Change in CPRS-R:L (80 items) mean total score after one week of mazindol was −55.5 (p < 0.0001); CGI-S after one week of mazindol was -3,02 (p< 0.01). Adverse events were mild to moderate in severity and decreased appetite, weight loss, headache, and abdominal pain were most common (95%).

Changes in laboratory values, ECG, blood pressure, pulse rate and body weight were not clinically meaningful. Blood pressure and pulse rate were unchanged (p > 0.05) after one week of treatment.

This preliminary investigation suggests that mazindol is still a new well-tolerated and active psychostimulant for the treatment of ADHD in children.
FC14-02 - Biological stress markers, executive functions and self-perceived stress in adults with ADHD (attention-deficit /hyperactivity disorder)
Authors: Hirvikoski T. , Nordenström A. , Lindholm T. , Olsson E. , Nordström A.-L. , Lajic S.
Published: May 2011

Introduction

The management of normal daily tasks may be complicated for adults with ADHD (attention-deficit/hyperactivity disorder) due to executive dysfunctions. ADHD may thus increase the risk of chronic stress in everyday life.

Objective

To study endocrinological and psycho physiological stress markers in adults with ADHD in association to performance in test of executive functions (EF) and self-perceived stress.

Methods

Cardiovascular stress markers were assessed in 30 adults with ADHD with no psychoactive medication, and 30 healthy controls during: (1) non-stress baseline; (2) cognitive stress; and (3) non-stress recovery. The Visual Analogues Scale was used to assess self-perceived stress. Salivary cortisol was measured pre- and post-experiment. To measure stress in everyday life we assessed diurnal cortisol values, stressors and self-ratings of stress.

Results

The group with ADHD showed higher self-perceived stress but attenuated or atypical cardiovascular stress reactivity during experimentally induced stress, and stress reactivity predicted performance in the executive test. Baseline cardiovasular values did not differ from the controls. The diagnosis of ADHD significantly increased the risk of belonging to the group with high post-stress cortisol levels. The two groups were comparable with respect to overall diurnal cortisol levels and rhythm. The ADHD group reported significantly higher self-perceived stress and these values correlated with level of stressors in everyday life.

Conclusions

The overall baseline values in biological stress markers may be comparable between adults with ADHD and healthy controls, while the stress reactivity and recovery pattern may differ between the two groups.
FC14-04 - Tobacco smoking and suicidal ideation and planning in schoolchildren 12–15 years old from ten low- and middle-income countries: impact of cultural differences
Authors: Innamorati M. , De Leo D. , Serafini G. , Rihmer Z. , Lester D. , Amore M. , Girardi P. , Tatarelli R. , Pompili M.
Published: May 2011

Objective

The authors examined the association between tobacco smoking and suicidal ideation and planning in schoolchildren from 10 countries in Africa, the Americas, and the Western Pacific region.

Method

Data were collected through the Global school-based Student Health Survey (GSHS), a collaborative surveillance project between the World Health Organization (WHO), the United Nations, UNICEF, UNESCO, UNAIDS, and the US Centers for Disease Control and Prevention (CDC). Suicidal ideation and planning, tobacco smoking, and drug and alcohol use were included in loglinear models to analyze, separately for each sex, higher order interactions among suicidality and regional and country differences.

Results

Schoolchildren who reported suicidal ideation and/or suicidal planning had a higher risk of smoking cigarettes even after controlling for drug and alcohol misuse. Furthermore, analyses indicated higher order interactions between suicidal ideation and planning and countries belonging to different regions with different exposure to tobacco smoking among schoolchildren.

Conclusion

Future studies analyzing the mechanism and sequencing of the relationship among suicidal ideation and tobacco smoking should explore cultural factors.
FC14-05 - Parent-mediated communication-focused treatment for preschool children with autism (MRC PACT); a randomised controlled trial
Authors: Green J. , Charman T. , Mc Conachie H. , Aldred C. , Slonims V. , Howlin P. , Le Couteur A. , Leadbitter K. , Hudry K. , Byford S. , Barrett B. , Temple K. , Macdonald W. , Pickles A. ,   The PACT Consortium
Published: May 2011

Introduction

Evidence from previous small trials has suggested the effectiveness of early social communication interventions for autism.

Objectives

The Preschool Autism Communication Trial (PACT) investigated the efficacy of such an intervention in the largest psychosocial autism trial to date.

Aims

To provide a stringent test of a pre-school communication intervention for autism.

Methods

152 children with core autism aged 2 years - 4 years 11 months in a 3 site 2 arm single (assessor) blinded randomised controlled trial of the parent-mediated communication-focused intervention added to treatment as usual (TAU) against TAU alone. Primary outcome; severity of autism symptoms (modified social communication algorithm from Autism Diagnostic Observation Schedule-Generic, ADOS-G). Secondary outcomes; blinded measures of parent-child interaction, child language, and adaptation in school.

Results

At 13 month endpoint the treatment resulted in strong improvement in parental synchronous response to child (adjusted between-group effect size 1.22 (95% CI 0.85, 1.59) and child initiations with parent (ES 0.41 (0.08, 0.74) but small effect on autism symptomatology (ADOS-G, ES -0.24 (95% CI -0.59, 0.11) ns). Parents (not blind to allocation) reported strong treatment effects on child language and social adaptation but effects on blinded research assessed language and school adaptation were small.

Conclusions

Addition of the PACT intervention showed clear benefit in improving parent-child dyadic social communication but no substantive benefit over TAU in modifying objectively rated autism symptoms. This attenuation on generalisation from ‘proximal’ intervention effects to wider symptom change in other contexts remains a significant challenge for autism treatment and measurement methodology.
FC15-01 - The „viennese instrument for suicidality in correctional institutions“ (VISCI) - evaluation of two years routine administration in austrian correctional institutions
Authors: Fruehwald S. , Drexler K. , Frottier P.
Published: May 2011

Suicide rates in prisoners are considerably higher than in the general population. A better identification of mental illnesses and alcohol use problems and avoidance of placing prisoners at high risk in single accommodation, are considered as key components of successful suicide prevention in these high-risk circumstances. The “Viennese Instrument for Suicidality in Correctional Institutions” (VISCI) is based on results of a large case-control study assessing suicide in prison inmates and comparisons with surviving controls. The screening instrument has well established psychometric properties differentiating well between suicides and non-suicides. VISCI routine administration in Austrian Correctional Institutions was introduced in December 2007 and data from the first two years of routine use were analysed for various aspects. During this period, VISCI was administered in > 15.000 admissions, recommending for 21.5% to avoid placement in single accommodation, and for 6.6% additionally a quick referrals to medical and psychiatric care. During these two years, 6 (2008) and 7 (2009) suicides occurred in all 28 Austrian jails and prisons, resulting in a suicide rate of 75.2 per 100.000 inmates, a marked reduction of suicide incidents compared to the years before implementation of screening procedures and interventions (mean suicide rate between 1992 and 2007 was 166.2, SD 5.5). However, it has to be stated that results of VISCI administrations are available for only two years up to now. With a longer period studied we hope we will have the possibility to demonstrate the effectiveness of this screening tool with even more strength.
FC15-02 - Health costs trends of those with and without mental health problems
Authors: Cawthorpe D. , Wilkes C.
Published: May 2011

FWe report prevalence and cost results for 8 years of administrative billing data, comparing the health costs of groups with and without mental health problems.

Methods

A data cube containing registration and visit data for all mental health cases was constructed and matched on age and sex in a ratio of 1:8 with non-mental health cases (n TOTAL = 681,676). Four groups emerged in the final dataset:

Group 1 - Those with mental health problems treated in publicly funded tertiary care (n = 61,479);

Group2 - those with mental health problems treated in their doctors’ offices (n = 272,120);

Group 3 - those with mental health problems treated in publicly funded tertiary care without treatment in their doctors’ offices (15,135); and

Group 4 - those without mental health problems (n = 332,942).

Results

At present we have examined the Physician billing data for those old and younger than or equal to 18 years of age, with the overall finding that the health costs (total costs - mental health costs) were greater for those with mental health problems in

Group 1 Case ($3,039 average per individual (API) over 8 years) and

Group 2 comparison ($2,554 API over 8 years) as compared to

Group 3 case ($1326) and

Group 4 comparison ($1089) API over 8 years).

Conclusions

Having a mental health problem has a profound impact on health-related expenditures.
FC15-03 - Mental distress and quality of life in a deaf population
Authors: Fellinger J.
Published: May 2011

Introduction

High risks of mental illness within the deaf community are reported. The assessment of the level of mental distress and quality of life in the deaf community is difficult due to communication problems in spoken and written language. The deaf community is characterized by the use of sign language.

Objective

This study aims to compare levels of psychological distress and the quality of life with levels reported by the signing deaf people and the hearing population.

Methods

A measure of acceptable reliability using sign language is described. The interactive computerised package including special versions of the WHOQOL-BREF, the GHQ-12 and five subscales of the BSI was administered to a large community sample of deaf people (n = 236), and results were compared with normative data for German speaking hearing people.

Results

The deaf sample has a significantly poorer quality of life than the general population for the physical and psychological domains (p < 0,01) as measured by the WHOQOL-BREF. However, in the domain of social relationships no significant difference (p = 0,19) was demonstrated. All findings with the GHQ-12 and the BSI show much higher levels (p = 0,01) of emotional distress among the deaf.

Conclusion

Although a poorer quality of life and a higher level of mental distress is demonstrated the similarity to the general population in the domain social relationships shows that this does not affect all domains. These findings show the need for easily accessible health services for the deaf which offer sensitive communication with them.
FC15-04 - The leiden routine outcome monitoring study
Authors: van Noorden M.S. , Giltay E.J. , van der Wee N.J.A. , den Hollander-Gijsman M.E. , Zitman F.G.
Published: May 2011

Introduction

It is likely that’real-life patients’ differ from randomized controlled trial (RCT) patients and from non-treatment seeking populations. However, much of what is known about characteristics of patients with depression and anxiety is based on RCTs and studies in the general population. Data on’naturalistic’ or’real-life patients’ are scarce.

Objectives & aims

In several studies so far, we investigated specific characteristics of patients with depression and anxiety in routine psychiatric specialty care. We studied gender differences in depression, and differences in age of onset of depression. Another study aimed to establish predictors for deliberate self-harm and suicidal ideation (DSHI) in patients with depression and anxiety.

Methods

We used baseline data of the Routine Outcome Monitoring (ROM) study. From 2004–2007, 3798 patients had been routinely assessed with ROM, by specially trained nurses. ROM consists of both self report and observational instruments.

Results

Female patients with depression reported more severe complaints on self-report instruments, as well as worse general health. Observational instruments showed no differences. In addition, patients with depression onset before the age of 18 reported more current suicidality and previous suicide attempts. Finally, low education, being unmarried, comorbidity, more severe symptoms of anxiety and depression, and emotional instability were independent predictors of DSHI.

Conclusions

Our findings in naturalistic outpatients differed from previous findings based on RCTs and studies in the general population. Since our findings are based on routinely obtained measurements in treatment seeking patients, these data may reflect the phenomenology of real life patients more closely.
FC15-05 - Determinants of guideline-concordant care in routine treatment of mood, anxiety and somatoform disorders
Authors: van Fenema E.M. , van der Wee N.J.A. , Giltay E.J. , van Noorden M.S. , Bauer M. , Zitman F.G.
Published: May 2011

Introduction

Understanding factors that affect treatment adherence may help to prevent non-adherence and increase the quality of care as well as cost-effectiveness.

Objectives & aims

To measure the level of adherence to clinical guidelines and to examine the correlates of adherence among outpatients with mood, anxiety and somatoform disorders in a routine clinical setting.

Methods

We developed quality measures and assessed adherence during up to 3 years of follow-up in a randomly selected sample of 300 outpatients who started routine psychiatric treatment. Patients were treated with pharmacotherapy, psychotherapy or a combination. At baseline, a standardized diagnostic interview (MINI-PLUS), the brief symptom inventory (BSI), general health status (SF-36) and demographics were assessed, as part of the usual intake procedure. Using multivariable regression analysis we identified independent predictors associated with guideline adherence.

Results

Most indicators were highly positive, indicating that most treatment was delivered according to guidelines. The combined treatment group as compared to the two other groups had lower scores on indicators “correct treatment module” and “stepped care” (p < 0.005). Patients receiving psychotherapy scored best on the separate indicators. Only a minority was treated in complete accordance with guidelines. Low-adherence was independently predicted by a low score on the SF-36 vitality-subscale. No significant differences were found within socio-demographic variables, comorbidity and BSI-scores between the adherence groups.

Conclusions

Assessment of guideline adherence is feasible with this cross-diagnostic set of process indicators. Patients with low scores on the vitality-subscale of the SF-36 were at the highest risk to receive low guideline-concordant care.
FC15-06 - The socio-economic realities of mental health in ireland
Authors: Datta A. , Frewen J.
Published: May 2011

Introduction

Mental Health entails significant economic costs, not only the provision of health services but also lost economic output. Mental Health has been estimated to cost Ireland up to €3 billion annually. Social determinants are a major contributory factor to mental health problems and inequity.

Objectives

To illustrate economic cost of mental health in Ireland, importance of social determinants in mental health inequity and provide guidelines on how to improve the overall level of mental health.

Aim

Examine economic cost of mental health in Ireland and discuss how negative social determinants might be tackled to reduce mental health inequities.

Methodology

Review hardcopy and internet reports and studies since 2000 on Irish mental health policy, the economic costs and social determinants of mental health, the obstacles to reducing health inequities and what should be prioritised to achieve good mental health in Ireland.

Results

Mental Health problems incur a significant cost. Furthermore, mental health problems occur more frequently amongst those groups with negative social determinants. These health inequities need to be tackled to reduce the overall level of mental health illness.

Conclusions

Given current global economic difficulties it is more important than ever to reduce economic costs. Mental health is one such significant cost. Negative social determinants lead to mental health inequities and therefore greater economic costs in terms of health care and lost economic productivity. They must be tackled by an holistic approach, one which not only involves the health sector but also other relevant social and economic sectors.
FC16-01 - Efficacy of cognitive therapy in the regulation of hypothalamic-pituitary-adrenal activity in patients with generalized anxiety disorder
Authors: Tafet G.E. , Feder D.J.
Published: May 2011

Hyperactivity of the hypothalamic-pituitary-adrenal (HPA) axis, with the consequent hypercortisolism, is one of the most consistent findings in chronic stress and depression. The stress response will depend on characteristics of stressors, their subjective appraisal and the resulting coping strategies. The aim of this study was to evaluate the efficacy of cognitive therapy (CT) in the treatment of a chronic stress condition, such as generalized anxiety disorder (GAD), as it would be reflected through both psychological and biological parameters. For this purpose, a group of outpatients with GAD were treated with CT for up to a maximum of 24 sessions. In order to assess psychological and biological changes, anxiety-related symptoms were evaluated according to the Hamilton Anxiety Rating Scale (HAM-A), and the HPA function was determined through assessment of circulating cortisol levels.

Upon completion of the treatment, a significant decrease in HAM-A scores, along with significant changes in plasma cortisol levels, were observed in treated subjects. These observations contribute to demonstrate that CT may be effective to treat a chronic stress disorder, such as GAD, as it was observed at both psychological and biological levels, and moreover, this could represent an effective approach to treat hypercortisolism due to hyperactivity of the HPA axis. Therapeutic and preventive strategies will also be discussed.
FC16-02 - Workshop: culutrally adapting CBT
Authors: Naeem F. , Hussain N.
Published: May 2011

There is sufficient evidence to suggest that CBT is an effective treatment for mental health problems. Current evidence suggests that ethnic minorty clients are less likely to engage in psychological interventions. We have adapted CBT for ethnic minorities in the UK. The aim of this workshop is to help the participants to realize the barriers posed by ethnic minority clients in therapy and how to overcome these.

Our work has highlighted that culture, capacity of the system and cognitions and beliefs are the areas which need addressing in this regard. We found that although therapists do not need to make major changes in therapy techniques they need to be aware of issues related to culture and patients beliefs about therapy. This workshop will especially focus on difficult areas such as assessment of ethnic minority clients and their engagement with therapy.
FC16-03 - Psychodynamic approach of suicide
Authors: Dedic G.
Published: May 2011

Objective

There are three well-known theories of psychodynamic of suicide: Freud's (suicide as a result of displacement of murderous impulses from a love object that are directed toward an internalized object), Menninger's (wish to destroy the lives of the survivors) and Fenichel's (fulfillment of reunion whish with a lost loved figure).

Methods

We described results from an empirical study of psychodynamic concepts of suicidal behavior in the sample consists of 30 hospitalized persons following a suicide attempt by self poising treaded at Clinic for toxicology in Military Medical Academy Belgrade Serbia.

Results

In the view of three well-known theories of psychodynamic of suicide we presented some vignettes that described each of the theory.

Conclusions

To put suicide attempt in a psychodynamic context, clinicians must understand psychodynamic of suicide behavior, which can help them in their work with patients’ crisis intervention
FC16-04 - The clinical effectiveness of individual cognitive behaviour therapy for depressed older people in primary care and the use of a talking control (TC)
Authors: Serfaty M.A. , Deborah H. , Buszewicz M. , Blanchard M. , Murad S. , King M.
Published: May 2011

Objective

To determine the clinical effectiveness of Cognitive Behaviour Therapy (CBT) delivered in primary care for older people with depression and evaluation of a talking control (TC).

Methods

A single-blind, randomized, controlled trial with 4- and 10-month follow-up. 204 people, aged 65 years or more, with a Geriatric Mental State diagnosis of depression were recruited from primary care. The interventions were: treatment as usual (TAU), TAU plus TC, or TAU plus CBT. The TC and CBT were offered over 4 months. The TC was to control for common effects in therapy. The Beck Depression Inventory-II (BDI-II) was the main outcome. Subsidiary measures were the Beck Anxiety Inventory, Social Functioning Questionnaire, and Euroqol. Intention to treat analysis (ITT) and Compliance Average Causal Effect (CACE) analyses was employed. The Cognitive therapy scale (CTS) evaluated common and specific factors in therapy.

Results

A mean of 7 sessions of TC or CBT were delivered. ITT analysis found improvements of −3.07 (95% confidence interval [CI], −5.73 to −0.42) and −3.65 (95% CI, −6.18 to −1.12) in BDI-II scores in favour of CBT vs TAU and TC respectively. CACE analysis found a benefit of 0.4 points (95% CI, 0.01 to 0.72) per therapy session of CBT over TC. Ratings for CBT on the CTS were high (mean [SD], 54.2 [4.1]) and showed no difference for nonspecific, but significant differences for specific factors in therapy.

Conclusion

CBT is an effective treatment for depressed older people. Improvement appears to be associated with specific factors in CBT.
FC16-06 - Understanding pathways to therapeutic change through changes in self-representation in the treatment of adolescents and young adults
Authors: Harpaz-Rotem I. , Blatt S.J.
Published: May 2011

Introduction

Processes that lead to normal development of the representations of self and others are also central to understanding processes of therapeutic change. These processes primarily manifest themselves through the dialectical interpersonal exchanges of gratification and frustration, of disruptions and repair that are central to the development of the self.

Objectives

To evaluate the contribution of different attributes of interpersonal relationships to the development of the self and patients’ well-being during the course of psychotherapy of adolescents and young adults.

Aims

To map the different paths to positive therapeutic gains in psychotherapy.

Methods

36 adolescents and young adults were evaluated during the course of 12-month intensive psychodynamic psychotherapy. Main outcome measures were changes in the Differentiation-Relatedness scores of mother, father, significant other, self and therapist and GAF scores.

Results

We found that changes in the level of differentiation-relatedness in patients’ self-representation were primarily associated with changes in the level of differentiation-relatedness of their description of their therapist. A best-fit model indicated that beyond change in the patient's description of the therapist and of a self-designated significant other outside the family added significantly to the explained variance predicting change in self-representation. Exploratory structural equation modeling also suggested that patients’ growing recognition of the therapeutic relationship (measured by a more matured representation of the therapist) is associated with the patients’ overall level of clinical functioning.

Conclusions

These results add further support to the importance of the therapeutic relationship in building more differentiated and integrated representations of self and of significant others.
FC18-01 - Twelve-month follow-up study of drug treatment in pathological gamblers
Authors: Dannon P. , Kotler M.
Published: May 2011

Background

Pathological Gambling (PG) is a relatively common and highly disabling impulse control disorder. A range of psychotherapeutic agents including selective serotonin reuptake inhibitors (SSRIs), antiepileptic drugs, and opioid antagonists are shown to be effective in the short-term treatment of PG. The use of a wide range pf pharmacologic treatments for PG is consistent with the observation that PG shares features of obsessive-compulsive spectrum disorders, impulse control disorders, and addictive disorders. The aim of the study is to assess the rate of relapse in treatment-responder pathological gamblers after discontinuation of the active treatment.

Methods

The 43 full -responders were then followed prospectively for an additional 9 months, which included a 3-month open-label continuation phase and a 6-month medication-free, follow-up phase. Raters were blind to the previous drug treatment.

Results

The majority of patients did not relapse during the 6-month medication- free follow-up phase. Three out of six patients with fluvoxamine, three out of nine with topiramate, seven out of eighteen with bupropion SR, and four out of ten with naltrexone relapsed. Relapse was strictly defined as gambling behavior at any time during the 6-month medication- free follow- up period. Most of the patients did not gamble during the follow- up period, and the patients that did gamble reported a decrease in gambling losses.

Conclusion

This naturalistic, long-term follow-up outcome study demonstrates that among pathological gamblers who respond to a six- month trial of medication, the majority of patients appear to maintain full-response during a six-month medication- free follow-up phase.
FC18-02 - Cognitive distortions among online gamblers
Authors: MacKay T.-L. , Hodgins D. , Bard N. , Bowling M.
Published: May 2011

Addictive disorders are being increasingly influenced by technology and one of the most recent developments is for gamblers to access games via the Internet. Prevalence data show that up to 10% of the population gamble online and studies have consistently indicated that Internet gamblers are particularly susceptible to developing gambling problems. Therefore, the purpose of this study was to explore differences between Internet and non-Internet gamblers to help determine why online gamblers are more likely to have gambling problems. Three hundred and seventy four participants (143 online gamblers, 172 males) from a large Canadian university completed an online questionnaire to investigate demographic, medium-related, comorbid psychological and cognitive factors with strong empirical support for contributing to problem gambling severity. Variables that significantly differentiated Internet and non-Internet gamblers in a univariate analyses were entered into a logistic regression to predict online gambling. A test of the full model was statistically significant, correctly classifying 77% of gamblers (64% of Internet gamblers and 85% of non-Internet gamblers). Cognitive distortions made an independent contribution to predicting Internet gamblers from those that had never wagered online. A hierarchical linear regression analysis revealed that cognitive distortions added significantly to problem gambling severity among online gamblers after controlling for other contributing variables. The findings have implications for clinicians working with Internet gamblers to specifically address thoughts related to luck, perseverance and illusion of control. As gambling technologies change and evolve, research needs to inform practice by identifying possible causal factors contributing to problem severity.
FC18-03 - Internet addiction as comorbid disorder in patients with a substance-related disorder: results from a survey in german inpatient clinics
Authors: Müller K.W. , Dickenhorst U. , Medenwaldt J. , Wölfling K. , Koch A.
Published: May 2011

Introduction

Internet Addiction (IA) is discussed as a serious health problem. Epidemiologic investigations show prevalence rates of 3% of internet users that fulfil criteria for IA. Reported symptoms like tolerance, withdrawal, and craving resemble those of substance-related disorders. Although there is no final agreement on the classification of IA, it has often been referred to as a non-substance-related addiction fostering current issues on the next revision of DSM (Holden, 2010).

Objectives

Although IA has been investigated in epidemiologic studies there is no research of its prevalence in patients in treatment because of a substance-related disorder. Regarding similarities between IA and substance-related disorders, theories suggest increased prevalence of comorbid IA in these patients.

Aims

This study focused on the identification of prevalence of comorbid IA among patients with a primary substance-related disorder in different in-patient clinics across Germany.

Methods

Sponsored by the German Federal Ministry of Health 1826 patients were screened with a diagnostic inventory for IA. For further description additional questionnaires were given assessing aspects of personality (NEO-FFI) and psychopathology (SCL-90R, BDI-II).

Results

4.1% of the patients fulfilled criteria of IA. In these most common primary diagnoses were pathological gambling and dependency of cannabis. Concerning personality IA-subsample showed increased neuroticism and introversion. Highest symptom burden was found in depression and social insecurity.

Conclusions

Among patients with substance-related disorder prevalence of IA is more common than in healthy samples. Results recommend separate screening for IA in inpatient clinics for substance-related disorders to guarantee full psychological care for patients with IA.
FC18-05 - The investigation of relationship between personality types (introvert - extravert) and people's tendency to narcotics addiction
Authors: Ghorbani Amiri H. , Ahmadi Gatab T.
Published: May 2011

Introduction

. Today, the addiction is considered as biological-psychological-social disease and numerous factors are effective in tendency to narcotics abuse.about individual factors, we can suggest the relationship between personality types and narcotics abuse.

Objective

The aim of present study is the investigation of relationship between personality types (introvert-extravert) and people's tendency to narcotics addiction.

Method

In this study, statistical population is all of male- addicts in Babolsar city. Of these, 100 persons are selected as sample of study by sample random sampling from withdrawl addiction centers and camps in Babolsar city.

Results

The results show that: it is significant relationship between people's high scores in both groups of personality types (introvert - extravert) and people's tendency to narcotics addiction so that, however people's scores are high in both groups of personality types (Introvert - extravert), to the same extent, there is probability of tendency to narcotics addiction.

Discussion

Almost, in all of the studies about addiction, personality characteristics are as factors that cause person's addiction. Also, lack of development of personality is considered as an important factor. Among personality eminent characteristics, Introversion-extraversion can be as variable and important factor in tendency to narcotics addiction.
FC19-01 Antipsychotic and antidepressive pharmacotherapy in relation to suicide risk in schizophrenia
Authors: Reutfors J. , Bahmanyar S. , Bodén R. , Brandt L. , Ekbom A. , Jönsson E.G. , Isung J. , Ösby U.
Published: May 2011

Introduction

Patients with schizophrenia are at increased risk of suicide, but data from controlled studies of how pharmacotherapy is related to suicide risk is limited.

Aim

To explore suicide risk in relation to prescription of antipsychotics and antidepressants.

Methods

Of all patients with a first clinical discharge diagnosis of schizophrenia or schizoaffective disorder in Stockholm County between 1984 and 2000 (n = 4,000), patients who died by suicide within five years from diagnosis were defined as cases (n = 84; 54% male). Individual matching was performed with schizophrenia controls from the same population. Information on prescribed medication was retrieved from psychiatric records in a blinded way. Odds ratios (OR) of the association between medication and suicide risk were calculated by conditional logistic regression.

Results

No significant association was observed between suicide and having ever been prescribed any antidepressant (33 cases and 30 controls) or any antipsychotic (83 cases and 82 controls). A lower suicide risk was found in patients who had ever been prescribed a second generation antipsychotic (risperidone, ziprazidone, olanzapine or clozapine; 12 cases and 23 controls): OR 0.2 (95% confidence interval [CI], 0.1–0.7). When the 6 cases and 8 controls who had been prescribed clozapine were excluded, the OR was 0.1 (95% CI, 0.03–0.6).

Conclusions

The lower suicide risk for patients who had been prescribed second generation antipsychotics may be related to a pharmacological effect of these medications, to differences in compliance, or to differences in other characteristics associated with a lower suicide risk.
FC19-02 - Electrocardiographic signs of autonomic imbalance in first-episode schizophrenia spectrum disorders— relations to first treatment discontinuation and five-year remission status
Authors: Bodén R. , Lindström L. , Rautaharju P. , Sundström J.
Published: May 2011

Introduction

Schizophrenia has since over a hundred years been associated with autonomic dysregulation, but the prognostic importance of this phenomenon is unclear.

Objectives/aims

To explore measures in electrocardiograms (ECG) reflecting autonomic balance in early schizophrenia spectrum disorders and to examine their relation to subsequent outcome. Three aspects of routine ECG measures were investigated:

1)

differences between patients with first-episode schizophrenia spectrum disorders and healthy controls,

2)

relations to early discontinuation of first antipsychotic medication and finally

3)

associations to symptomatic remission status five years later.

Methods

Twelve-lead ECGs were recorded at baseline in 58 patients with first-episode schizophrenia spectrum disorders and in 47 healthy controls of similar age. Selected ECG variables included heart rate and measures of repolarization and left ventricular hypertrophy. Pharmacotherapy data were extracted from medical records. At a five-year follow-up the patients were interviewed and assessed with the Positive and Negative Syndrome Scale.

Results

Patients had higher heart rate and a different ST-T pattern than the controls. High T-wave amplitudes in the leads aVF and V5 and ST-elevations in V5 were associated both with higher risk of an earlier discontinuation of first antipsychotic pharmacotherapy (hazard ratios 1.3–2.4) and with non-remission five years later (odds ratios 2.9–6.4).

Conclusion

In this longitudinal cohort study, simple ECG measures reflecting autonomic balance in the early phase of schizophrenia spectrum disorders contained prognostic information. However, as this is the first report of this association and is based on a relatively small sample, the results should be interpreted with caution.
FC19-03 - Advances in cognitive behaviour therapy for psychosis
Authors: Kingdon D.
Published: May 2011

Introduction

CBT for psychosis has been developed over the past two decades and is now recommended by most clinical guidelines for schizophrenia internationally.

Aims & objectives

To provide an up-date on advances and controversies in CBT for psychosis.

Method

Evidence from recent meta-analyses (including Lynch et al, 2010) and randomised controlled trials will be reviewed. These have generally demonstrated effectiveness in early and treatment-resistant schizophrenia of CBT, and other specific indications, e.g. co-morbid substance misuse, aggressive behaviour, command hallucinations. Treatment is based on engaging the patient in a therapeutic relationship, developing an agreed formulation and then the use of a range of techniques for hallucinations, delusions and negative symptoms.

Results

Evidence of effectiveness in treatment-resistant psychosis remains strong but some areas for intervention remain under-researched. A series of studies are on-going which will provide more information about effective ways of working.

Conclusions

CBT is a very important but under-used intervention which can make clinically significant differences to patient's lives.
FC19-04 - Integrated psychological therapy (ipt) with young and middle-aged schizophrenia patients: Are the effects affected by patients’ age?
Authors: Mueller D.R. , Roder V. , Schmidt S.J.
Published: May 2011

Introduction

There is a lack of evidence-based therapy approaches designed for the increasing number of middle-aged and elderly schizophrenia patients. Only very few approaches for this population addressing social skills were published yet.

Objectives

Cognitive deficits are present in most schizophrenia patients independent of age. Only few empirical data exist whether therapeutic interventions can reduce cognitive deficits in middle-aged or elderly schizophrenia patients. An exception represents the Integrated Psychological Therapy (IPT), a group-based cognitive-behavioral therapy approach combining interventions on cognition and social skills.

Aims

a)

Do middle-aged schizophrenia patients benefit from IPT as much as do younger patients?

b)

Do these two populations benefit equal under control conditions (unspecific group intervention and/or treatment as usual)?

c)

Are age-specific therapy settings demanded?

For that purpose we selected all studies including interventions on cognition out of the data pool of 36 independent evaluation studies on IPT.

Methods

A standard meta-analytic procedure was used.

Results

Middle-aged and younger patients participating in IPT showed equal treatment effects. IPT was superior to both control conditions independent of patients’ age. Younger patients reached the level of small effects in both control conditions whereas middle-aged patients showed absolutely no effects. The therapy setting in groups with younger patients differed from that with older patients in duration of therapy and weekly therapy sessions.

Conclusions

Results support efficacy of IPT independently of patients’ age. Evidence-based therapy should be implemented in psychiatric rehabilitation with elderly schizophrenia patients considering their specific needs into therapy setting.
FC19-05 - The importance of neurocognition, social cognition, negative symptoms and subjective process parameters for functional recovery in Schizophrenia
Authors: Schmidt S.J. , Müller D.R. , Roder V.
Published: May 2011

Background

A wealth of research supports the relevance of neuro-, social cognition and negative symptoms as treatment targets in schizophrenia. However, little is known about their interdependent relationships, their relative contribution to adequate functioning and quality of life as well as their associations with subjective, process oriented variables.

Methods

Data were collected in the context of an international RCT evaluating the Integrated Neurocognitive Therapy (INT) in comparison to treatment as usual (TAU). 169 outpatients with a diagnosis of schizophrenia according to ICD-10 or DSM-IV-TR participated in the study. We chose a longitudinal design.

First, by the means of structural equation modeling (SEM) we tested social cognition and negative symptoms as mediators between neurocognition and functional outcome. Additionally, the relationships of these variables with subjective parameters (hope, psychological strain, helplessness, initiative, knowledge about the disorder, insight, self-efficacy) were assessed. Second, we analyzed the same mediators and subjective variables but used quality of life instead of the traditional functional outcome measures.

Results

1.

Social cognition and negative symptoms both served as mediators between neurocognition and functional outcome. Some subjective variables (e.g. hope) were associated with negative symptoms and functional outcome.

2.

Cognitive functions had no significant predictive or mediating influence on quality of life. Instead subjective variables (hope, psychological strain, self-efficacy) and negative symptoms functioned as significant predictors and were strongly related to each other.

Conclusions

The results of the study provide further evidence for integrated treatments. Including relevant subjective variables seems promising to generalize therapy effects to quality of life.
FC19-06 - Visual backward masking - an excellent endophenotype for Schizophrenia ?
Authors: Bakanidze G. , Roinishvili M. , Chkonia E. , Herzog M.H. , Brand A. , Puls I.
Published: May 2011

Due to the complexity of psychiatric diseases, endophenotypes are of primary interest in psychiatric research. They are stable markers which are assumed to be related to a small number of genes involved in the pathophysiology of the disease. Visual backward masking (BM), like other parameters measuring early information processing, was proposed to be a reliable marker for schizophrenia. Performance deficits in BM are considerably more pronounced in schizophrenic patients and their unaffected relatives compared to controls. As shown before, in the present study BM performance was significantly worse in schizophrenic patients compared to controls; healthy relatives of schizophrenic patients performed intermediately.

Several candidate genes for schizophrenia including nicotinic receptor α7 subunit (CHRNA7), catechol-O-methyltransferase (COMT), dystrobrevin-binding protein 1 (dysbindin, DTNBP1) and metabotropic glutamate receptor 3 gene (GRM3) were investigated for their association with schizophrenia and BM in two independent samples. A strong and reproducible association was observed for CHRNA7 with both diagnosis of schizophrenia and BM performance. In conclusion, BM is an excellent endophenotype which will likely support the search for further candidate genes and related pathophysiological pathways in schizophrenia. Moreover, CHRNA7 has further supported its important role as one of the main candidate genes for schizophrenia.
FC20-01 - Cultural competent assertive community treatment team for severe and persistently mentally ill: Innovations and adaptations
Authors: Chow W. , Sadavoy J.
Published: May 2011

The Cultural Competent Assertive Community Treatment Team (ACTT) is a joint venture sponsored by Mount Sinai Hospital in partnership with Hong Fook Mental Health Association established in 1999. This is the first ever cultural diverse mental health program using the cultural competency model. It was developed in response to the cultural diverse needs from the culturally diverse communities and supported with the best evidence-based research.

Since the implementation of the program, we focused on identifying key issues that have facilitated or hindered the therapeutic alliances, patients’ service utilization and treatment compliance because of cultural differences in health concepts and health care systems.

We will present what we have learned in literature review and the best evidence-based practice guidelines. Key cultural issues we have encountered with our clients will be described. Methods and strategies that are effective in overcoming cultural differences will be highlighted. We will use a case illustration to demonstrate our innovations and adaptations and will highlight lessons and challenges we have learned during the process of developing the cultural competency model. Feedbacks from the audience would be also incorporated to formulate the “best practice” guidelines. The guidelines will contribute significantly to the understanding of the complexity of cultural factors in treating mental illness but also ensure the effective service delivery to cultural diverse population.

Cultural Competent Assertive Community Treatment Team has won American Psychiatric Foundation Advancing Minority Mental Health Award as well as the Leading Practice Award from Ontario Hospital Association in 2007.
FC20-02 - Psychiatric consultations with indigenous peoples: Differences in beliefs about mind and mental health and lessons learned
Authors: Mehl-Madrona L.
Published: May 2011

North American people have different beliefs about mind and mental health than conventional biomedicine. The author reports the results of 300 consecutive psychiatric consultations in Northern Canada during which he characterized the particular beliefs of his consultees. In their views, disease is located in relationships, including relationships with family members, with food (plants and animals), minerals, other people, spirits, the environment, and more. When these relationships are distorted and out of balance, dis-ease ensues. Traditional healers see the changes found in autopsies as footprints of the illness and not the illness itself. From this perspective, traditional healers engage in very different diagnostic procedures than conventional physicians. They seek the areas of disharmony and imbalance in relationships rather than looking for diseases in physical tissues. From this point of view, each person becomes their own story about their suffering and the treatment relates to that story as it unfolds to all the stakeholders in that story. The treatment becomes a story that merges with the illness-person story to move in a direction of balance and harmony. Every treatment is different because every person is different. There is no treatment for arthritis, only for the individual people who suffer. In this presentation, we will consider how to practice psychiatry within this environment, including the matching of biomedical stories to traditional stories and the negotiation of treatment approaches in such a manner as to maximize respect for traditional belief systems and also to optimize potential for outcome.