bluuebunny/crossref_metadata_2025 huggingface dataset:
ECP09-05 - Psychiatric training in europe: the opinions of early career psychiatrists
Authors: Giacco D.
Published: May 2011

Introduction

The recent reforms of mental health legislation occurred in most European countries, together with the continuous advances of technologies and the development of research in all the domains of psychiatry have deeply modified the role of mental health professionals with consequent changes in training needs for early career psychiatrists. The competencies required to psychiatrists today include not only the knowledge of the advances in neuroscience, psychopharmacology, psychotherapy and social psychiatry, but also the ability to understand the different clinical and social needs of the patients. Young psychiatrists report a gap between their knowledge and the skills required during the first years of their job.

Aims

The European Psychiatric Association-Early Career Psychiatrists Committee, in cooperation with the European Federation of Psychiatric Trainees, conducted a survey among European young psychiatrists and psychiatric trainees, aimed at evaluating difficulties and perspectives related to psychiatric training residency.

Methods

86 respondents completed the Psychiatric Training Questionnaire, a multiple-choice and self-reported questionnaire, which evaluates: 1) satisfaction with training received; 2) self-confidence in theoretical and practical skills included in psychiatric training curriculum; 3) educational opportunities received during training.

Results

Respondents were almost equally split between trainees (54%) and young psychiatrists (46%). Seventy per cent of them were completely or partially satisfied with training received. Early Career Psychiatrists reported higher levels of self-confidence in clinical psychiatry (98%), psychopharmacology (69%) and emergency psychiatry (61%), whereas the most problematic areas were forensic psychiatry (64%) psychotherapy (61%) and child and adolescent psychiatry (57%). 41% of respondents was not assigned a tutor for clinical activities, 73% of them could not rely on a dedicated supervisor for training in psychotherapy and 58% had not the possibility to use a log-book to record the competencies acquired during training. Only 37% participated in exchange programs; all early career psychiatrists who had this opportunity found this experience very useful for their professional growth.

Conclusions

Standards of training in psychiatry in Europe are generally satisfactory. However, our results highlight the need to:

1)

upgrade training in some areas, such as psychotherapy, forensic psychiatry and child and adolescent psychiatry;

2)

guarantee an adequate clinical supervision;

3)

spread the use of log-book;

4)

improve the opportunities for exchange programs.
FC05-04 - The gamse (grodberg autism mental status examination). Preliminary development of a standardized autism-focused exam
Authors: Grodberg D. , Weinger P. , Kolevzon A. , Soorya L. , Buxbaum J.
Published: May 2011

Background

The traditional mental status examination, used universally in psychiatry, does not provide flexibility to accommodate the developmental perspective necessary for the examination of patients with Autism Spectrum Disorder (ASD). The Grodberg Autism Mental Status Examination (GAMSE), developed at the Seaver Autism Center for Research and Treatment, prompts the observation and recording of social, communicative and behavioral functioning in patients with ASD. The GAMSE contains 8 items, which produce a total score ranging from 0 to 16.

Objectives

1. To determine the validity of the GAMSE in accurately predicting diagnostic classification based on a gold standard observational assessment.

2. To establish inter-rater reliability.

Methods

Eighty consecutive patients receiving autism diagnostic evaluations at the Seaver Autism Center were administered the GAMSE and the Autism Diagnostic Observation Schedule (ADOS) as part of standard intake procedures. The classification accuracy of the GAMSE was assessed using the ADOS as the gold standard. Inter-rater reliability on the GAMSE was also examined (n = 44).

Results

A receiver-operating characteristic (ROC) curve analysis was used to determine a cut-off score based on the 8 items of the GAMSE. The most effective cut-off score of greater than or equal to 5 predicted outcome on the ADOS with a sensitivity of 0.94 and a specificity of 0.81. Co-rating of 44 participants on the AMSE resulted in an average measures intra-class correlation of 0.85.

Conclusions

Preliminary results indicate excellent classification accuracy and suggest that the GAMSE may act as a useful standardized autism assessment tool for clinical and research endeavors.
FC10-02 - Ghrelin affects sleep, secretion of cortisol and growth hormone and psychopathology in patients with major depression
Authors: Kluge M. , Schüssler P. , Dresler M. , Schmidt D. , Yassouridis A. , Uhr M. , Steiger A.
Published: May 2011

Introduction

Ghrelin showed antidepressant-like effects in mice. Furthermore, ghrelin influences sleep and the activity of hypothalamic-pituitary-adrenal (HPA) and somatotropic axis in healthy humans as indicated by increased cortisol and growth hormone (GH) plasma levels. Both sleep and the activity of these endocrine axes are disturbed in depression.

Objective

To study the effect of ghrelin on psychopathology, sleep and secretion of cortisol and GH in patients with major depression.

Methods

Depressive symptoms as assessed by a validated self rating scale (’Befindlichkeits-Skala’, [well-being scale]), secretion profiles of cortisol and GH and sleep-EEGs were determined in 14 unmedicated patients with major depression (7 women) twice, receiving 50 μg ghrelin or placebo at 2200, 2300, 0000, and 0100 hours.

Results

Overall, depressive symptoms did not change significantly after ghrelin administration (placebo: 37 ± 8; ghrelin: 33 ± 10, p = 0.178). However, there was an improvement at trend level in men (placebo: 36 ± 9 to ghrelin: 30 ± 9, p = 0.093) but not in women. In men, ghrelin was associated with less time awake (placebo: 149.0 ± 11.1; ghrelin: 88.0±12.2 min, p = 0.029) and more non-REM sleep (placebo: 263.2 ± 24.1; ghrelin: 304.9 ± 14.1 min, p = 0.027), in women with less REM sleep (placebo: 108.6 ± 15.7; ghrelin: 74.1 ± 13.8 min, p = 0.031) and longer REM latency (placebo: 49.9 ± 6.5; ghrelin: 85.6 ± 14.1 min, p = 0.019). In both sexes, ghrelin caused strong transient increases of GH and cortisol.

Conclusion

Our study may provide an initial indication that ghrelin can exert antidepressant effects in patients with major depression. Ghrelin strongly affected sleep and secretion of GH and cortisol in a partly different way as previously reported in healthy subjects.
FC13-02 - Karolinska interpersonal violence scale predicts suicide in suicide attempters
Authors: Jokinen J. , Åsberg M. , Nordström P.
Published: May 2011

Both childhood trauma and violent behaviour are important risk factors for suicidal behaviour. The aim of the present study was to construct and to validate a clinical rating scale that could measure both the exposure to and the expression of violence in childhood and during adult life and to study the ability of the Karolinska Interpersonal Violence Scale to predict ultimate suicide in suicide attempters.

161 suicide attempters and 95 healthy volunteers were assessed with the Karolinska Interpersonal Violence Scale (KIVS) measuring exposure to violence and expressed violent behaviour in childhood (between 6-14 years of age) and during adult life (15 years or older). The Buss-Durkee Hostility Inventory (BDHI), “Urge to act out hostility” subscale from the Hostility and Direction of Hostility Questionnaire (HDHQ) and the “Early Experience Questionnaire” (EEQ) were used for validation. All patients were followed up for cause of death and a minimum of fours years from entering in the study.

Patients who committed suicide had significantly higher scores in exposure to violence as a child, in expressed violent behaviour as an adult and in KIV total score compared to survivors. Suicide attempters scored significantly higher compared to healthy volunteers in three of the four KIV scales. There were significant correlations between the KIVS subscales, BDHI, Urge to act out hostility and EEQ.

Exposure to violence in childhood and violent behaviour in adulthood are risk factors for suicide in suicide attempters. The KIVS is a valuable new tool in suicide risk assessment.
FC13-10 - Frequency of prolonged qtc in children and adolescents hospitalized for psychiatric disorders: a nested case-control study
Authors: Manu P. , Figen V. , Harris J. , Kane J.M. , Correll C.U.
Published: May 2011

Background

The rate-corrected Q-T interval (QTc) prolongation is a risk factor for sudden death and may be produced by antipsychotic drugs.

Objective

To determined the frequency and psychopharmacological correlates of baseline prolongation of QTc in a large pediatric cohort.

Methods

The QTc was measured on the electrocardiograms obtained on 811 children and adolescents (404 males and 407 females, mean age: 15.5 ± 2.4 years) consecutively evaluated in the admissions unit of a psychiatric hospital. Each patient with QTc > 440 msec was age- and gender-matched with 5 patients with QTc< 420 msec. The psychiatric diagnoses and psychotropic treatment of patients with prolonged QTc and control subjects were compared in univariate and logistic analyses.

Results

QTc duration was > 440 msec (mean 454 ± 10 msec, range 442–481 msec) in 16 patients (1.97%; 95% confidence interval (CI): 1.17%–3.25%). The 80 control subjects had a mean QTc of 391 ± 21 msec. The groups were similar with regard to the proportion of patients on antipsychotics (43.8% vs. 40.8%, p = 0.78) and chlorpromazine equivalents (165.5 ± 109.7 mg vs. 167.6 ± 217.8 mg, p = 0.98). Logistic regression identified schizophrenia as the only psychiatric predictor of baseline QTc prolongation (odds-ratio: 6.17, 95% CI: 1.24–30.69, p = 0.042).

Conclusions

In a large cohort of children and adolescents with psychiatric disorders, baseline QTc prolongation was infrequent and, at most, of moderate severity. The findings argue against performing electrocardiograms prior to the initiation of antipsychotics in all patients from this age group.
FC14-01 - Internal losses and the creation of “Nowhere land”: psychodynamic themes of adults with ADHD discovered during drama-therapy
Authors: Manor I. , Yazpan G.
Published: May 2011

ADHD is a well-known, chronic disorder that persists in adulthood. During the past 20 years its existence in adults is becoming clearer, yet its dynamic aspects are rarely discussed. The treatment of adults is vital, as much as that of children; however the literature discussing it, especially its non-pharmacological aspect, is scarce.

We describe the results of our treatment with drama-therapy of two groups of adults with ADHD. These groups included 11 adults (from both groups), men and women, from most socioeconomic strata, aged ≥ 60 yrs., who were diagnosed as suffering from ADHD and were treated for it for the first time in their life. Drama-therapy was selected as we believed it to be a useful method with associative, distracted ADHD patients, since it enabled the use of transitional space through non-verbal images and acts.

This presentation discusses the basic themes with which patients began therapy. Interestingly, all patients, however different, shared the same themes that were built on self doubt and the pre-presumption of disappointment. The impairment related to ADHD, that was felt, but not understood, led to a strong experience of heavy losses, which we tried to define separately: of a clear path, of control, of the inner perception of borders and of the loss of an integrative inner self. All these losses were accumulated in the transitional space in a place we named “Nowhere land”.

We would like to present these themes of losses and of becoming lost and to discuss their meaning.
FC25-04 - Comorbid mood and anxiety disorders in adult ADHD patients
Authors: Meshkat D. , Kutzelnigg A. , Eckert C. , Konstantinidis A. , Kasper S.
Published: May 2011

Introduction

ADHD is a highly heritable neurodevelopmental syndrome with significant lifetime risk for psychiatric comorbidities. Several psychiatric conditions are significantly more common in patients with ADHD than in control subjects.

Methods

To evaluate the incidence of comorbid affective disorders, patients with adult ADHD who were first seen at the outpatient clinic of the Department of Psychiatry and Psychotherapy were evaluated for symptoms of major depression, brief recurrent depression, bipolar depression and anxiety disorders. Patients aged between 18 and 75 years were included into the study. All patients were evaluated according to DSM IV TR criteria. So far, from February 2007 until May 2010, 330 patients (192 males and 138 females) were included into the study.

Results

The mean age of the patients at diagnosis was 33, 7 years for males (range: 18-75) and 35, 9 years for females (range: 18–64). Affective disorders were most frequently diagnosed as comorbid conditions in our patients and occurred in 26% of the patients in our sample. 13% had a minor depressive episode, 7% a major depressive episode and 6% were diagnosed with bipolar disorder. 21% of our patients were diagnosed with one or several comorbid anxiety disorders.

Conclusion

Most adults with ADHD are not diagnosed properly and therefore remain untreated although they are usually diagnosed and treated for comorbid psychiatric disorders. In the present study, we systematically analyzed comorbid anxiety and depression in a sample of adult ADHD outpatients in order to estimate the incidence of these disorders in an undiagnosed patient population.
JS01-02 - Pharmacogenetics in psychiatry: how far from clinical practice?
Authors: Serretti A.
Published: May 2011

The practical application of pharmacogenetics is not as straightforward as expected, particularly in psychiatric disorders. Despite the large benefit expected, only a very small numbers of clinical applications are available. The reasons for this are many, in particular the key questions are: Is science robust enough for routine application? Are physicians and patients ready? Are stakeholders (e.g. Government, insurance industry, etc) ready to pay and implementing? What is the position of the pharmaceutical industry?

The presentation will cover such aspects offering a coverage of present status and realistic expectations in the field.
Prediction and Prevention of Suicide in Elderly Depressives
Authors: Rihmer Z. , Gonda X.
Published: May 2011

In the majority of countries, suicide rates increase progressively with age, the highest suicide rates occurring in men above 75 years. Given the progressive aging of population in industrialized countries, old age suicide is one of the greatest public health problems. Although suicide attempt, and particularly completed suicide are relatively rare events in the community, they are very common among older psychiatric patients who contact different levels of health care system, particularly some weeks or months before the suicide event. More than one-third of suicide victims have at least one prior suicide attempt, which significantly increases the risk of future attempts and completed suicide. However, the rate of attempted to completed suicide decreases with increasing age indicating that the lethality of suicidal behaviour is much higher in older persons. Suicide is a very complex, multifactorial human behaviour with several biological and psychosocial components, associated with a number of

1/ Psychiatric (e.g., major mental disorders),

2/ Psycho-social (e.g., adverse life situations), and

3/ Demographic (e.g., male gender) suicide risk factors.

Although depressive disorders and substance-use disorders are the two most common diagnoses among suicide victims, depression is more common and substance abuse is less prevalent in later-life suicide victims. Beside depression and prior suicide attempt, social isolation, loss of relatives/friends and physical illnesses are the most important risk factors for suicide in this age-range. Available studies suggest that appropriate acute and long-term treatment of depression in combination with psychosocial interventions reduces suicide mortality even in this very high-risk population.
Twenty years of forensic aftercare in Hessen, Germany
Authors: Freese R.
Published: May 2011

In Germany, the Forensic Hospital in Haina/Germany has a tradition of more than two decades of continuously outpatient treatment of mentally ill offenders. In our system, patients were conditionally released after a successful hospital order treatment. Time under parole for these patients normally spread between two to five years. In nower days, after a reform of penal law, time under parole can be unlimited.

Since 1988 far more than 1000 patients were released from the forensic hospital and treated under parole conditions in the community.

The paper will describe the careers of these patients, demonstrate rates of success and failure, and explain our treatment and risk-management approach.
Reality in psychosis
Authors: Figueira M.L. , Madeira L.
Published: May 2011

The medical model approach in Psychiatry brought up pressure for clear descriptors in diagnostic procedures. This presentation will address two particular psychopathological phenomena, described from the viewpoint of the observer and considered to be key psychotic features: patients’ “loss of contact with reality” and “bizarre” attribute of the content of the delusional phenomena. Challenges seem to occur from present hermeneutical, epistemological and conceptual limitations. Relevant to this is the practical impossibility to fully access a patient frame of reference and our (psychiatrists) subjective knowledge of the world, leading to a value-laden analysis of patients. We’ll be analyzing the historical, cultural and linguistic background and stressing the relevant links to the current psychiatric phenomenology.

The validity of both descriptors, used in classification systems, seems questionable as we find a practical impossible to represent those ways of experiencing, and something remaining unsurpassable, not understandable and inapprehensible. But if we find no consistent judgment in these psychopathological signs and remain confortable with frequent biases in clinical findings that do occur, then the weakness of both descriptors raises ethical problems. This presentation aims to suggest clues to an unbiased use and conceptualization of both. But a vital conclusion is that the gap between inner/subjective reality and objectively valuable and classifiable experience is perhaps beyond epistemic and constituent of personhood.
Effects of genetic variants on neural circuits in major depression
Authors: Frodl T.
Published: May 2011

Introduction

The underlying neurobiology of major depressive disorder (MDD) is likely to represent an interaction between genetic susceptibility and environmental factors like stress. There is growing evidence that epigenetic processes might mediate the effects of the social environment during childhood on gene expression.

Objectives

We investigated in multimodal high-resolution MRI-genetic studies whether microstructural and functional brain changes are the result of gene-environment interactions.

Methods

Patients with major depressive disorder (MDD), high-risk subjects for developing MDD and healthy participants were investigated using high-resolution magnetic resonance imaging (MRI), high angular resolution diffusion imaging (HARDI) and functional MRI. Furthermore, we assessed early life adversity and measured the serotonin transporter polymorphisms (5-HTTLPR).

Results

We demonstrated that patients with MDD have smaller hippocampal and frontal cortex volumes associated with gen-environment interactions. Healthy Subjects at risk for developing depression, who manage to stay healthy, show better activation of the frontal cognitive control system. Those who had stronger fibre connections between frontal and temporal brain regions also better managed incidences of adversity in early life.

Conclusions

Stress x gene interactions seem to account for at least some of the structural brain changes. Resilience against environmental stressors might be associated with stronger neural fibre connections and more effective cognitive control networks.
Empowerment and mental health
Authors: Sartorius N.H.
Published: May 2011

The word empowerment has been used to describe the efforts to give disadvantaged groups in the population a better chance to state their opinion and influence decisions affecting the population as a whole as well as themselves. In psychiatry the word is used both when talking about the process of raising self-confidence of an individual and in speaking about the need to increase the role of people with a mental illness and of their families in the shaping of the services which are to serve them.

In these and other instances it would be possible to expect two positive outcomes if empowerment were to happen: firstly, disadvantaged individuals (including people with mental illness) who were empowered would feel better and be more likely to participate in the work of the group that has helped them to gain or regain self-confidence; and secondly, if given a chance people who were empowered would help to shape services that are to help them in harmony with their needs and the environment in which they are to work. The presentation will exemplify some of these points by a description of the experience gained in programmes that fought stigma and consequent discrimination.
Systematic review of psychotherapeutic treatments for “minor” personality disorders
Authors: Lieb K. , Stoffers J. , Völlm B.
Published: May 2011

Introduction

Among personality disorders (PDs), antisocial and borderline personality disorder are well-studied. However, the remaining PDs (in the following called “minor PDs”) pose major problems in everyday-health care settings. People affected often present with additional axis-I disorders such as substance-related, mood or anxiety disorders, and are among those most difficult to treat.

Objectives

To systematically review the current evidence of psychotherapeutic treatments for “minor” personality disorders

Methods

In the context of Cochrane Collaboration reviews for Cluster A, B and C PDs, exhaustive literature searches were done to identify the current RCT evidence for PD treatments. The electronic search strategies were extended to identify also non-RCT evidence for minor PD treatments. Retrievals were assessed and evaluated by two reviewers independently.

Results

The current evidence for psychotherapeutic treatments of minor PDs is sparse and based on mixed PD samples with co-morbid axis-I disorders in the majority of cases. Reported outcomes focus on specific axis-I disorders or general measures such as overall functioning.

Conclusions

The current evidence is scarce and does not allow for distinct treatment recommendations but undermines the importance of meeting special demands of PD patients by PD-specific treatments. Possible reasons for the paucity of research in this regard will be discussed, also in the light of future developments after DSM-V.
The meaning of bipolar ii disorders in the diagnostic and therapeutic approach towards patients with addictions: Empirical and anthropological considerations
Authors: Musalek M.
Published: May 2011

In the last decades a large number of co-morbidity studies were published indicating a strong relationship between affective disorders and alcohol addiction. Patients with affective disorders suffer also from dependence disorders at about 6 times more often than the rest of the population. In 30 to 60 percent of patients with alcohol addiction also affective disorders are present. In this context authors emphasized that depressive states observed in the course of alcohol addiction may be reactions to problems occurring in the frame of dependence disorders. In contrast to that depressive mood disorders in general (and above all states of anxiety and increased tension often connected with depressive states) can also be considered as starting points of addictive behaviour. Furthermore alcohol itself may induce and catalyze depressive mood. Less attention has been paid to the role of manic or hypomanic states in dependence disorders. The few studies indicate an increased co-morbidity rate between bipolar II disorders and alcohol addiction. In a psychopathological study carried out on 200 alcohol addicts in the Anton Proksch Institute Vienna we focused on the co-morbidity with bipolar II as well as on the pathogenetic role of hypomanic states in the frame of constellations of conditions of alcohol dependence using among other scales and a standardized interview, the Hypomania Self Rating Scale (HSRS, Angst). Preliminary results underline a strong relationship between Bipolar II Disorders and Alcohol Addiction: hypomanic states induce high risk behaviours which may become responsible for relapse and increased alcohol consumption.
Mental health in Berlin
Authors: Heinz A.
Published: May 2011

Berlin is a capital characterized by migration; about 40% of all adolescents have a migratory background. In recent years, mental health care for migrants has received increasing attention, although costs e.g. for translation in hospitals are still not covered by the insurances, and problems of inpatient care for migrants without a legal status remain. In Berlin, psychiatric hospital care is sectorized, and in each sector, a central conference tries to organize outpatient care and facilities. In spite of these efforts, transition between in- and outpatient care often remains complicated, and outpatient psychotherapy care offered by psychologists frequently does not reach the most severely affected patients. Patients suffering from addiction face additional problems, as detoxification is financed by health care insurances, while treatment of the addictive disorder itself is mainly financed by retirement funds, with pervasive problems characterizing the individual patient's shift from one system to the other. So-called “integrated” approaches that link specialized outpatient and inpatient care are currently established by different health care insurances and may help to bridge such gaps. However, the multitude of different offers from competing insurances threatens to fractionize health care, and multimorbid patients may have to select e.g. an insurance with an excellent program for schizophrenia but a badly structured offer for cancer treatment. Multimorbid patients will thus be forced to decide which of their health care problems is most pressing and to neglect other diseases. Research on the impact of these “integrated” health care programs therefore is urgently warranted.
Pain processing in posttraumatic stress disorder
Authors: Vermetten E.
Published: May 2011

Although posttraumatic stress disorder (PTSD) is associated with chronic pain, preliminary evidence suggests reduced experimental pain sensitivity in this disorder. The questions addressed in the present study were whether pain perception would also be reduced in PTSD patients who are not suffering from chronic pain symptoms, and whether a reduction in pain sensitivity would also be present in combat veterans who did not develop PTSD. For this, we determined thermal detection and pain thresholds in 10 male combat-related PTSD patients, 10 combat control subjects (no PTSD) and 10 healthy controls without combat experience. All subjects were pain free. First, we measured thermal sensory thresholds with ramped heat and cold stimuli using the method of limits. Ramped thermal sensory stimulation revealed no deficits for the detection of (non-noxious) f2.1thermal stimuli between groups. In contrast, heat and cold pain thresholds in both combat groups (PTSD and combat controls) were significantly increased compared to healthy controls. However, these stimuli could not distinguish between the two groups due to ceiling effects. When using longer-lasting heat stimulation at different temperatures (30 s duration; method of fixed stimuli), we found significantly lower frequency of pain reports in PTSD patients compared with both combat and healthy controls, as well as significantly lower pain ratings. Our results suggest an association of PTSD with reduced pain sensitivity, which could be related to PTSD-related (neuro-)psychological alterations or to a pre-existing risk factor for the disorder.
Brain structural changes and antipsychotics
Authors: Brambilla P.
Published: May 2011

Accumulating evidence suggest a life-long impact of disease related mechanisms on brain structure in schizophrenia which may be modified by antipsychotic treatment. In particular, in a large study we showed that cumulative exposure to antipsychotics correlated positively with gray matter volumes in the cingulate gyrus for typical agents and in the thalamus for atypical drugs in schizophrenia. This suggests, along with findings from other studies, that antipsychotic medication has a significant impact on brain morphology. In this presentation we will debate the effects of antipsychotic administration on the brain anatomy of patients suffering from schizophrenia as mainly detected by structural imaging studies; the perspectives in this field of research will also be drawn.
Inhibitory and monitoring cortical networks during conversion and hypnotic paralysis in FMRI
Authors: cojan Y. , Waber L. , Forster A. , Vuilleumier P.
Published: May 2011

Hypnosis may induce striking changes in consciousness and volition under the effect of particular suggestions. Popular theories often consider hypnosis as a state of consciousness where volition is abolished, while cognitive theories postulate that it involves inhibitory control processes mediated by frontal lobe areas. Moreover, since the time of Freud and Charcot, hypnotic effects have often been likened to the abnormal behaviour seen in some psychiatric disorders such as hysteria. However, the neural mechanisms of these different conditions and their putative relationships still remain unclear. By using functional neuroimaging methods in volunteers and patient, we can now identify specific changes in brain activity that underlie the behavioural and perceptual alterations observed during hypnosis and directly compare the latter with findings in hysteria conversion. Our recent results suggest both commonalities between these two conditions, as suggested by Freud and Charcot, but also clear differences that are consistent modern views on hysteria and brain functions. Moreover, hypnosis appears to reflect a state of heightened self-control and monitoring, in agreement with some cognitive theories. This research does not only provide novel insights on how the human mind can regulate itself, but also help better understand the neural underpinning of hysteria, a condition standing at the frontiers of psychiatry and neurology since more than a century.
Macrosocial factors of affective spectrum disorders in university students: Integrative study based on original multifactorial model
Authors: Kholmogorova A. , Garanyan N. , Volikova S.
Published: May 2011

609 high school students and 270 college students were tested with M. Kovack Child Depression Inventory. 20% of adolescents and 15% of college students demonstrated increased scores in CDI. Desintegration of families, high prevalence of alcoholism and extreme growth of social orphanhood are among the major factors of depressive and anxiety disorders in population. About 50% of observed social orphans were at high risk for depression. Stratification of Russian society is another macrosocial factor of emotional disorders. Two opposing tendencies might be observed. From one side, significant part of population is on the impoverishment and degradation. From another side, well-to-do families are growing in numbers with special quest for elitist educational institutions with perfectionistic standards. Success and achievement orientation along with intensive training loads also generate threat to emotional health of children. 60% of observed students of these elitist schools were at high risk for depression. Parents of students with increased scores in CDI exhibited higher indices of perfectionism compared with parents of emotionally healthy students. Significant correlations between parental perfectionism and depression/anxiety symptoms in offspring have been registered.
Bipolar disorder
Authors: Goodwin G.
Published: May 2011

Bipolar disorder is rapidly becoming the primary diagnosis in adult psychiatry. It represents a wide spectrum of disorder all sharing common features of elated and depressed mood. The early descriptions of symptom-free euthymia have long been dismissed and the chronic and enduring deficits associated with the disorder are beginning to be better understood. The course of the disorder remains uncertain especially in light of the recently observed increases in children receiving the diagnosis. There is growing interest in the elated states seen as a common adolescent phenotype.

There is a simplified view of the illness as an episodic course interspersed with euthymia, short-term treatments being used in acute episodes and long-term treatments being indefinite and intended to prevent new episodes. However, subsyndromes, co-morbidities and a variety of chronic symptoms are common in bipolar disorder. In practice, they often drive treatment decisions. Chronic symptoms are usually related to anxiety, depression or cognition and are a disabling aspect of the long-term outcome. Unfortunately, there is little to guide the selection of treatment to reduce the impact of these symptoms since they have almost never been the subject of clinical trials.

The use of medication in combinations is the usual practice in bipolar disorder. The argument to favour this in guidelines is highly pragmatic, but there is a growing evidence base to support it. Lithium remains a key benchmark treatment for comparing alternatives in long term efficacy. Its effects against suicide are particularly important.
Nice, schizophrenia and the evidence behind the treatments
Authors: Kendall T.
Published: May 2011

This talk will describe the methodology used for the development of the new NICE guideline on the treatment of schizophrenia for the UK, paying particular attention to meta-analytic and, where possible, economic methods or considerations used to develop recommendations on the use of Family therapy, CBT and the arts therapies. Some time will also be given to examining the evidence behind the first formal meta-analytic review of early intervention services for people with early schizophrenia, and a suggestion that these services may be beneficial as a result of them including evidence-based treatments rather than such services having a particular approach or service ideology. If time allows, we will also examine the evidence behind the choice of antipsychotic in the schizophrenia guideline, and speculate on the continuing usefulness, if any, of using terms such as ‘typical’, ‘atypical’, ‘first generation’ or ‘second generation’.
Prevalence and socio-demographic studay of deression in rapidly developing country, state of Qatar
Authors: Al-Abdulla M.
Published: May 2011

Background

The state of Qatar is a developing country with population 1.6 million people. 30% of population are nationals others are expatriate with different cultural and religious background.

Objective

To describe the sociodemographic features depressive disorder in the hospitalized psychiatric population and to investigate different diagnoses of the depressive disorder spectrum.

Method and result

This retrospective descriptive study was conducted in Rumilah hospital, Hamad Medical Corporation among Qatari and expatriate.

A representative sample drawn from medical records of patients who were admitted to the psychiatric unit from the first of November 2009 till the 30 of April 2010.

Population consisted of 720 subjects (Number of patients who were admitted during six month). It shows that 16.2% suffering from depressive disorder (N = 119). Unipolar depression was prominent type (70.6%) comparing to bipolar depression among male and female.

Depression was more prevalent among expatriate than nationals, female than male, highly educated individuals, skilled workers and married compared to non skilled, unemployed and single individuals. Associated stressful life events, abusing drugs and alcohol and having chronic medical condition were over represented in people who suffered from affective disorder in our study.

Qatari women in this sample consulted faith healer more than men.

Conclusion and recommendation

The present study has demonstrated that expatriate community suffers more from depression, which may be due to different reason. This problem has already been identified and an appropriate, well resourced psychiatric service has been established by the government to try to manage this very vital problem.
The use of internet in the treatment of depression in general practice (ICBT in GP)
Authors: Kolstrup N. , Eisemann M. , Waterloo K.K. , Risør M.B. , Høifødt R.S. , Lillevoll K. , Lintvedt O.K.K. , Wilhelmsen M.
Published: May 2011

ICBT in GP is a joint project between General Practice Research Unit and the Research Group of Mental E-Health at the Department of Psychology, Faculty of Health Sciences, University of Tromsø, Norway. In Norway the yearly incidence of depression is 7% and rapidly increasing. Two thirds of the patients experiences recurrence within 10 years. The yearly treatment costs of depression is 200 millions Euros. The burden on specialist health care is heavy with waiting lists of 3 to 6 months. The Norwegian Directorate of Health recommends that patients with mild to moderate depression should be treated in General Practice (GP). Self help programs should be introduced in the treatment. The aim of the present project is to develop a strategy whereby general practitioners will use the internet as a treatment option for mild to moderate depression and to measure the effect of this treatment. We will use the internet-based self help program MoodGYM. The program has five treatment and evaluation modules. MoodGYM reduces symptoms of depression, but few patients complete all modules. If patients have a consultation with their GP between each module, they may be more
motivated to fulfil the program. In addition, MoodGYM provides the GP with a tool to evaluate the
severity of symptoms.The presentation will focus on the economic and structural properties facilitating
the use of internet in treatment of depressed patients in GP.
What is Evidence: Weaknesses of Metaanalyses
Authors: Czobor P.
Published: May 2011

Evidence-based treatment decisions depend on the accumulation of empirical data from individual studies. Individua studies use a variety of methods with variable quality, reflect random fluctuations and systematic biases, and may yield inconsistent findings. Meta-analysis offers a statistical approach to pool relevant studies together, which can reduce the effect of random error and bias, and produce more reliable effect estimates than individual studies. Despite the important contributions that this method provided for evidence-based medicine, it has been criticised as “statistical alchemy for the 21st century” and described as “new bete noir” which should be “stiffled at birth”. Some of this controversy has been driven by poor practice: the arbitrary pooling of dissimilar studies with unrelated outcomes, the application of statistical technique without sufficient expertise, and with insufficient attention to the clinical context. However, controversy also arises from methodological limitations of the meta-analytic approach, which need to be critically examined in order to evaluate the findings. In this presentation, we examine the limitations of meta-analyses both in terms of current procedures (e.g., biased selection, lack of prospective planning, increased likelihood of chance findings due to multiple testing) and methodological shortcomings (e.g., limited ability to handle multivariate outcomes or to incorporate covariates in the meta-analytic model simultaneously at the level of the study, treatment arm and the individual). By bringing together the weaknesses in a systematic way, it is hoped to foster a more reliable and critical appraisal of the empirical evidence both by researchers and clinicians, which will improve treatment decisions.
FOXES, FIREBRANDS, AND FORGERY: ROBERT WARE'S POLLUTION OF REFORMATION HISTORY
Authors: MacCULLOCH DIARMAID
Published: May 2011

This is an analysis of the extensive forgeries of Reformation history by Robert Ware of Dublin in the late seventeenth century, one of which, Archbishop Cranmer's speech at Edward VI's coronation, is still widely quoted and used as historical evidence. Ware's activity is explained in the context of Popish Plot agitation in Ireland and England, and John Strype's part in preserving some of the forgeries in the historical record is delineated. The survival of Ware's forgeries in English and Irish historiography over three centuries to the present day is exposed.
NOSTALGIA AS AN EMOTIONAL EXPERIENCE IN THE GREAT WAR
Authors: ROPER MICHAEL
Published: May 2011

This article is concerned with the longing for home of British soldiers during the First World War. What, it asks, can such longings reveal about the psychological impact of trench warfare? Historians have differed in the significance that they ascribe to domestic attachments. Some argue that a ‘cultural chasm’ developed between the fronts, producing anger and disillusionment among soldiers which would surface fully fledged after the war, while others assert the continuing vitality of the links with home. Evidence for both these perceptions can be found in the letters written by British soldiers to their families. The functions of nostalgia could range from reassurance or momentary relief from boredom and impersonal army routines, through flight from intolerable anxiety, to survival through the power of love. Although animated by solitude, nostalgia provided a means of communication with loved ones. Its emotional tones varied according to the soldier's age and the nature of his attachments to home. The young soldier's reminiscences of home conveyed, not just the comforting past, but the hateful present. Nostalgia, being rooted in early memories of care, could be a potent vehicle for arousing the anxieties of loved ones, especially mothers. Among married men, the desire to return to wives and children could provide a powerful motivation for survival. This analysis suggests a different and more varied account of the genesis of the ‘disillusionment story’ of the war than is put forward in some recent studies. Among men of the ‘war generation’ particularly, disillusionment was not only a post-war construction, an artefact of cultural memory, but a powerful legacy of the emotional experience of the war itself.
The Spectator's Performing Body: the Case of the Via Negativa Theatre Project
Authors: Krpič Tomaž
Published: May 2011

The concept of the performing body consists of two elements: the performer's and the spectator's performing bodies. The performer's body is an active and creative body on stage, while the spectator's body is considered an uncreative body, passive in his or her seat. In this article, findings regarding the duality of the performing body, its interchangeability, and its intertwinement, derive from researching Via Negativa, a Slovenian-based (yet international in its nature) theatrical project established almost a decade ago by theatre director Bojan Jablanovec. The mission of Via Negativa is to investigate the relationship between the performer and the spectator exclusively through theatrical means. Tomaž Krpič is a sociologist of the body with particular interest in postmodern theatre and performance. He was until recently Lecturer in Cultural Sociology in the Faculty of Social Sciences, Ljubljana University, Slovenia.
Disentangling factors controlling fruit and seed removal by rodents in temperate forests
Authors: Perea Ramón , San Miguel Alfonso , Gil Luis
Published: May 2011

Fleshy fruits fall on to the ground together with cleaned seeds previously ingested by primary dispersers, offering a wide range of fruits and seeds to the ground foragers. Although nutritional properties strongly differ between fruits and seeds, this different seed presentation (cleaned seeds versus seeds within the pulp) has not been addressed in seed removal studies. This study reports on the removal of fruits versus their seeds in five fleshy-fruited species in a temperate forest. We found that rodents removed most of the seeds and partially consumed most of the fruits, preferring seeds to fruits. Rodents bit the fruits to extract the seeds, leaving most of the pulp. We found a preference ranking for the seeds (Sorbus aucuparia>Ilex aquifolium>Sorbus aria>Rosa canina>Crataegus monogyna) but no preferences were found for the fruits, probably due to their similarities in pulp constituents. Seed and fruit choice were affected by chemical and physical properties and not by their size. The presence of alternative and preferred seeds (nuts) delayed the encounter of the fruits and seeds and diminished their removal rates. We found that higher rodent abundance is not necessarily associated with higher removal rates of fleshy fruits. Rodent abundance, fruit size and seed size are minor factors in the removal of fleshy fruits and their seeds. This study underlines that scatter-hoarding rodents are important removers of fleshy fruits and their seeds, producing a differential seed removal depending on the seed presentation (with or without pulp), the nutritional properties of the seeds (but not of the fruits) and the presence of alternative food.
Irish consumers’ use and perception of nutrition and health claims
Authors: Lynam Ann-Marie , McKevitt Aideen , Gibney Michael J
Published: May 2011

Objective

To investigate Irish consumers’ use and understanding of and their belief in nutrition and health (NH) claims in the context of the European Union (EU) legislation (Regulation no. 1924/2006), which permits a number of NH claims on food products.

Design

An interview-assisted questionnaire was administered to consumers (n 400). Preference for three types of NH claims across six products was tested. Perception of NH claims was assessed across a further eight food products. Claims were categorised as content, structure–function and disease–risk factor reduction claims.

Setting

Six supermarkets in the Republic of Ireland.

Subjects

Four hundred adult Irish supermarket consumers.

Results

Older (P < 0·001), female (P < 0·01) consumers were more likely to seek NH claims. Structure–function and content claims were preferred across six products. Consumers’ perception was associated with the health benefit claimed rather than with the strength of the claim itself. Preference for claim type and claim perception differed with gender, age and educational level.

Conclusions

Irish consumers prefer content and simpler NH claims rather than more complex disease–risk factor reduction claims. The food industry may thus be better served using these types of claims. Although the reported levels of understanding were high, evidence of positivity bias and misinterpretation was found. Thus, with regard to Regulation 1924/2006, consumers need more information on both simpler and more complex claims. Public health messages should be targeted according to gender, age and educational level.