bluuebunny/crossref_metadata_2025 huggingface dataset:
P02-183 - Impact of a New Approach “Acute Care Model” on Detained Patients in Adult Psychiatry Wards in England
Authors: Jaganathan G. , Alam F. , Krishna S. , Walton C.
Published: June 2010

Introduction

Acute Care Model introduced in 2006 in UK has revolutionised the way Adult inpatient services are provided. Here, we look at the impact of this model on detained patients, which might serve as a service evaluation tool.

Objectives

Our objective is to study the effect of the acute care model on the application of the 1983 Mental Health Act (MHA) in Adult Psychiatry Wards at Clatterbridge Hospital, England.

Aims

Our aim is to measure any difference in the number and duration of detentions, use of tribunal hearings after the inception of this new model.

Method

Data on Section 2 (for assessment) and Section 3 (for treatment) were collected retrospectively from the Register at the hospital MHA Office. As the Acute Care Model was implemented on 6th June 2007, the data were collected from 6th March 2006 to 5th Oct 2008. From these data, the number and duration of stay of detained patients were calculated.

Results

The number of people who were detained in hospital before and after the introduction of acute care did not change (n=122). However, the average duration of detention under Section 3 reduced significantly from 81.44 days to 46.25 days (43.21% reduction). There had also been a 55% decrease in the utilisation of tribunal hearings after the new model (45 tribunals before vs 18 tribunals after).

Conclusion

The Acute Care Model in Adult Psychiatry seems to have had a significant positive impact on detained patients in reducing their in-patient stay and the need for tribunal hearings.
P02-184 - The European Federation of Psychiatric Trainees’ Psychiatric Resident - Industry Relationship Survey (EFPT-PRIRS)
Authors: Riese F. , Jauhar S. , Guloksuz S. , Andlauer O. , Lydall G. , Gama Marques J. , Van Zanten J. , Bendix M. , Giacco D. , Gerber S. , Mendonca L. , Nawka A. , De Vriendt N. , Nazaraliev A. , Psaras R. , Nwachukw I. , Roventa C. , Atay O. , Coccia F. , Barry H. , Nikitopoulos J. , Rusaka M. , Kudinova M. , Mitkovic M. , Ostrovschi N. , Sos P. , Wuyts P. , Rakos I. , Volpe U. ,   European Federation of Psychiatric Trainees (EFPT) Research Group
Published: June 2010

Introduction

There is growing concern about the influence of the pharmaceutical industry on psychiatric teaching and psychiatric professionalism as a whole. As a consequence, several national and international medical and psychiatric associations have issued guidelines to regulate the interactions between physicians and industry.

Objectives

The EFPT-PRIRS study aims to provide the lacking data on the extent and nature of these interactions among psychiatric trainees across Europe.

Methods

Study objectives were determined by the EFPT research group (EFPT-RG), after discussion with national and international experts. A survey was then devised compiling previously published questionnaires extending them by questions with specific relevance to psychiatric trainees. The resulting questionnaire was piloted amongst members of the EFPT-RG, modified accordingly and subsequently distributed to the national study coordinators. All 24 EFPT member countries were invited to participate in the study and data collection is currently ongoing.

Preliminary results

Preliminary analysis reveals the vast differences in industry - trainee relationships across European countries as well as major differences in personal attitudes towards these interactions.

EFPT-PRIRS will potentially have an impact on the regulation of the interactions between the pharmaceutical industry and psychiatric trainees.
P02-199 - Training Medical Students in Psychiatry: an Undergraduate Perspective
Authors: Davis A. , Gilhooley M. , Agius M.
Published: June 2010

Background

Medical education in the UK has undergone dramatic change in recent years with both content and methodology being reviewed, assessed and updated in an iterative revolution. The aim has been to provide graduates with an educational experience more relevant to clinical practice.

Aims

To present the reflections and experiences of some students learning through these new educational approaches.

Objectives

The effects of these changes are felt keenly by students. Here, in comparison with the views of senior collogues, two medical students nearing the end of their training reflect upon their own experiences.

They present a brief explaination of the structure of medical and psychiatric training in the UK followed by an exploration of one individual medical school's course.

Methods

The course structure will be detailed with reference to the guidance document “Tommorrow's Doctors” and to the school's own literature.

Medical students were consulted and an amalgamated “week in the life” based on their experiences produced.

Results

The integration of psychiatric education throughout preclinical and clinical courses, coupled with individual attention and encouragement in gaining useful transferable skills, were seen as most useful.

Conclusion

Reforms have been successful and show that the delivery of both a basis in psychiatry and additional transferable skills (such as audit, research and publication) is best achieved by individual mentorship from an experienced clinican.

A continued reflection on how current practices may be modified to improve student experience is essential, but should also seek ways (such as more indivdualised attention) to improve recruitment and retention.
P02-202 - Using Working-Occupational Rehab Method When Working with Psychiatric Patients
Authors: Matkovic N. , Perisic R.
Published: June 2010

There has been an organized plan, wich helps to developthe rehab methods. Rehab, viewed as a group of measures and acts has it goals. It is to help individuals to function using the maximum of their capabilities and potentials left.

The plan methods are:

-

stimulations

-

reeducations

-

compensations

-

neuropsychological rehab

The model has been applied to 50 patients, of bouth sexes. They were all diagnosed with schizophrenia. Behaviour evaluation scale was used during the first four weeks of the working-occupational treatment.

A good rehab model can decrease the negative symptoms (reducing of anxiety, reducing inferiority, bringing the confidence back). At the same time it can improve the quality of the patients life.
P02-203 - The Contribution of Psychoanalytic Self Psychology to the Treatment of Patients with Severe Mental Health Disorders in Psychiatric Communities
Authors: Mazzariol M.
Published: June 2010

Psychiatric communities represent in Europe a consistent part of psychiatric mental health services. In spite of this, studies which investigate the therapeutic processes which take place in such specific setting are still lacking. This paper is an attempt to contribute to fill this gap, describing how the main principles of Psychoanalytic Self Psychology could help mental health workers of different professional backgrounds to integrate their roles, actions and rehabilitative and therapeutic affords with the view of offering a cohesive and personalized treatment to their patients. It will be discuss how the concepts of “understanding and making the patient feeling understood” constitute a basic ingredient, particularly in the early stages of treatment, for allowing the therapeutic alliance to develop. It will be explained how the recognition and the working through of the often archaic and intense self object transfers, which develop towards specific workers or towards the community as a whole, are an important tool for comprehend and making sense of the patients’ behavior, enabling the team to withstand the challenges posed by difficult clients and utilizing such circumstances as a therapeutic opportunity. It will be considered the role of relatives and significant others in regulating the mental states of the patients and also the role of inter-patients relationships as a potentially useful instrument to enhance mentalization among guests. It will be discussed the importance of creating a cohesion among the members of the multidisciplinary team, through the facilitation of an atmosphere of dialogue, openness and reciprocal listening and understanding.
P02-211 - A Prospective Comparison Study to Investigate Protected Engagement Time on Acute Mental Health Inpatient Wards in England
Authors: Nolan F. , Johnson S. , Lloyd-Evans B.
Published: June 2010

Aim

This presentation will describe a prospective study, due to commence in March 2010, to evaluate the use of Protected Engagement Time in adult acute inpatient wards in three mental health trusts in England.

Background

Patients on acute psychiatric wards in the UK have recurrently reported that they are unhappy with the ward environment, that they are bored and have little to do, that wards are intimidating, and above all, that contact between staff and patients is often identified as too limited in both quantity and quality, and as lacking therapeutic content.

Protected Engagement Time (PET) has emerged as a promising initiative for improving quantity and usefulness of staff-patient contact. During fixed periods of the day, staff are asked to focus solely on patient contact, and are relieved of their administrative duties. However, we do not have any evidence about whether it works or how it should be implemented to achieve the best results.

This study aims to address this lack of evidence and will have three components:

a)

A national survey investigating how widespread PET now is in England

b)

Evaluation of the effects of PET on patients and staff by comparing 12 wards with PET and 12 wards without, by investigating staff-patient interactions, patient satisfaction, staff burnout and perceptions of the ward environment.

c)

In-depth qualitative case studies on three wards with PET.

The objectives for each component and the measures used will be described in detail in the presentation, in addition to an update of study progress.
P02-212 - Authorship, Gender and Geography: the Imbalance in British Psychiatric Journals
Authors: Ochuko-Emore M. , Beezhold J. , Morakinyo J.
Published: June 2010

Objectives

To determine female authorship of original articles, editorials and the geographical region of female first authors in selected British Psychiatric journals.

Method

The gender of the first author of original articles and editorials published between January 1997 and December 2008 in British Journal of Psychiatry and Psychiatric Bulletin was determined. Editorials from Advances in Psychiatric Treatment and the geographical region of the female first authors of original articles were also included in the study.

Results

The gender was determined for 99.2% of the 2324 first authors of original articles and 100% of the editorials. The percentage of original articles by female first authors fluctuated over the study period, ranging from 22.5% to 42.1% with an average of 33.6% in British Journal of Psychiatry and a range of 25.5% to 45% with an average of 37.6% in Psychiatric Bulletin. There was a gross under-representation of females as first authors of editorials. Female first authors of original articles from low- and middle income countries range from 0.3% to 3.4% in both British Psychiatric literatures.

Conclusions

There is an increasing trend in female first authorship of original articles. However, female remain under-represented especially in editorials, in the British psychiatric journals examined. Female first authors from low and middle income countries are disproportionately low.
P02-214 - Sensponding Assemblies as a Tool to Stimulate the Senses and Affect the Emotions of an Individual
Authors: Oungrinis K.-A. , Liapi M. , Linaraki D. , Voradaki G.
Published: June 2010

Objectives

Our project describes a methodology for creating personalized spatial elements within people's immediate surrounding environment that are able to ‘sense’ the hormonal and thus the emotional changes of a human organism and ‘respond’ in such a way so as to help the individual to either overcome ‘negative’ emotions and feel comfortable or to express ‘positive’ emotions and become more sociable.

Methods

The first path of the methodology examines the ways in which one can pinpoint the chemical imprint of feelings in terms of calculating the quantity of mood-affecting hormones in the blood. The second path employs micro sensponding (sense-and-respond) assemblies that monitor bio-indicators and control an exogenous spatial system that will respond accordingly to help the brain react. The third path examines the symbolisms of aesthetics and the social implications of this project.

Results

The exogenous spatial system can either be portable and have direct contact with the body, like a piece of smart fabric formed in a type of suit or it can be placed within the immediate living environment, like a type of meditation room. In both ways, the spatial system has a plethora of reactions to work towards the emergence of desired emotional states, all resulting by affecting one or a combination of the human senses (sound therapy, color therapy, aromatherapy and so on).

Conclusions

Space is no longer conceived as a static protecting element but it is augmenting its use through technology to affect human emotions.
P02-219 - A Study Gauging Perceived Social Support and Loneliness with Life Satisfaction Among Students of Golestan University of Medical Sciences
Authors: Shahini N.
Published: June 2010

Introduction

Social humans are embedded with a variety of relationships. Satisfactory social support is crucial for having physical and psychological well being.

Aim

The purpose of the present study was to find empirical support for the connections between perceived social support and loneliness with life satisfaction.

Material & methods

226 students of Golestan University of Medical Sciences participated in the study. They were assessed using demographic questions, Multidimensional scale of Perceived Social Support, Life Satisfaction Scale, and Loneliness Scale. Using SPSS (16) and Pearson correlation test, linear regression the data were analyzed.

Findings

122 male and 104 female students filled the questionnaires. 91 percents of the students were single and also 95 percents were residents of university dormitories. There was a significant relationship between life satisfaction with loneliness in the subjects (p< 0.05). The higher social support from the family and friends was also correlated with more life satisfaction and less loneliness (p< 0.05). Linear regression showed a significant correlation among social support, life satisfaction with loneliness.

Conclusion

Findings suggest, appropriate social support can reduce loneliness and increase life satisfaction. It is also one of the well being predictors. Therefore the universities should provide strategies to facilitate social support from family and the significant others. The empowerment of the students using teaching social communication skills may be helpful as well. The results were discussed within the context of findings from the studies conducted in eastern and western cultures.
P02-222 - New Social Awareness as an Imperative for the Promotion of the Rights of Mentally ill Persons in Serbia
Authors: Stanojevic A. , Djokic N. , Vukic D.
Published: June 2010

The challenge of modern civilization is to enable mentally ill persons conducting designed and productive lives and enjoy the benefits offered by social environment. Unfortunately, although we have stepped into 21 st century in many parts of the world, a considerable number of mentally ill people are still facing a great difficulty in achieving even elementary human rights. In Serbia there are still very large psychiatric hospitals with a capacity of over 700 beds. Also, treatment of mentally ill persons is implemented in terms of completely undeveloped system based on community psychiatry. To Serbia improved Quality of life of mentally ill persons is required radical change of attitude not only professional services but also in many other parts of social community. Therefore requires urgent development of entirely new legislation in the field of mental health care. This paper presents practical recommendations that would allow the addition of protection of the rights of mentally ill persons and define contemporary principles for their improvement.
P02-223 - Dimensions of Psychopathology Among Video Game Players
Authors: Starcevic V. , Berle D. , Porter G. , Sammut P.
Published: June 2010

Objective

To examine the associations between problem video game use and psychopathology.

Methods

The Video Game Use Questionnaire (VGUQ) and the Symptom Checklist 90 (SCL-90) were administered in an international anonymous online survey, open to everyone over 14 years of age with a good understanding of English. The VGUQ was used to identify problem video game users on the basis of provisional criteria, whereas SCL-90 was used to assess various dimensions of psychopathology.

Results

In comparison with other video game players (n=1789), those with problem video game use (n=156) had significantly elevated scores on all subscales of the SCL-90. Participants with and without problem video game use had higher scores on measures of obsessive-compulsive tendencies, interpersonal sensitivity (social anxiety), and depression than on other SCL-90 subscales. When compared to the U.S. male nonpatients, a significantly greater proportion of all male adult video game players and male adolescent problem video game players scored in the “pathological” range on all dimensions of the psychopathology. Relative to the U.S. male adolescent nonpatients, a significantly greater proportion of male adolescents without problem video game use scored in the “pathological” range on the measures of depression, interpersonal sensitivity, and paranoid ideation.

Conclusions

People with and without problem video game use may have similar patterns of associated psychopathology, but those with problem video game use exhibit more psychopathology. It is unclear to what extent these associations may be specific. Relative to other dimensions of psychopathology, anger and hostility are not particularly prominent in video game players.
P02-227 - The Practice of Electroconvulsive Therapy in a General Hospital in Singapore Over a One Year Period, 2008
Authors: Tay W.K.
Published: June 2010

Introduction

Although ECT is used as a modality of treatment for psychiatric patients in Singapore, there is little research documenting its use and practice.

Objectives/aims

To examine the practice of ECT in a general hospital over a one year period.

Method

All patients who had ECT were identified retrospectively from our hospital records. The demographics and diagnoses of the patients, indications for ECT, numbers of ECT received and complications from ECT were obtained, recorded and analysed.

Results

23 inpatients were identified retrospectively from our hospital records. The majority of the patient were above 51 years old and 96% had major depression. 51% were not responding to medication, 23 % were suicidal and 3% had catatonia. The average number of ECT given is 5.4. 82% of patients had definite improvement after ECT. The common reported side effects were headaches, bodyaches and minor memory problems. 2% were moderately confused after the ECT.

Conclusion

ECT is a safe, well-tolerated and effective form of treatment for major depression.
P02-229 - The Implementation of Management Through Processes in an Inpatient Psychiatric Medium-Stay Unit
Authors: Torreblanca M. , Euba O. , Zallo E. , Chicharro F. , López M.
Published: June 2010

Objectives

The European Foundation for Quality Management (EFQM) Excellence Model is a non-prescriptive framework based on nine criteria. The aim of this work is to describe the implementation of the EFQM model as a quality framework for the improvement of an inpatient medium-stay psychiatric unit.

Methods

In 2005 a multidisciplinary performance improvement work group was convened to begin a project with these aims:

-

The definition of the unit's mission.

-

The identification of the unit's main processes.

-

The identification of performance and quality results.

-

The establishment of an audit period of clinical outcomes.

-

The creation of a protocol for admissions.

Results

Between 2005 and 2008 the group designed the following:

-

A map showing the medium-stay unit process as well as the main processes.

-

The key performance indicators.

-

An ECT protocol.

-

The Quality Indicators.

-

A patient satisfaction survey.

Every year we decide the objectives of each indicator and revise them every month. Efficiency in the use of resources improved, due to an increase in annual admissions (from 190 in 2005 to 213 in 2009) as well as a decrease in length of hospital stays (from 62 days in 2005 to 48 days in 2009).

Conclusions

The management through processes according to the EFQM model is an instrument for the improvement of the quality of assistance. This type of management allows for the definition of the unit's mission, the measure and analysis of results and for the establishment of areas of improvement.
P02-234 - A Descriptive Comparative Study of Pharmacological Versus Non-Pharmacological Intervention Initiation in a Tertiary Care General Hospital Psychiatry Unit in India
Authors: Verma R. , Agarwal S. , Kumar P.
Published: June 2010

Introduction

India, with its rich and distinct socio-cultural heritage, bestow diverse impact over individual symptom complexes, coloring the picture and causing wide variation in presentation and prognosis of psychiatric illnesses. With the widespread use of atheoretical categorical diagnostic systems such as DSM-IV, ICD-10, etc. and success of psychopharmacological treatment approach, psychiatrists in developing and underdeveloped countries have tended to overlook the role of psycho-social and cultural factors and their interplay with neurobiological factors in governing illness patterns, and are reluctant initiators of non-pharmacological treatment measures.

Objective/ aims

The study aims to descriptively analyze and compare the use of pharmacological to non-pharmacological intervention initiation in outpatients in a general hospital setting.

Method

The study sample will comprise of consecutive patients referred to psychiatry outpatient department from February to July 2009. The socio-demographic and clinical profile will be analyzed using a semi-structured proforma and diagnosis will be made as per ICD-10-DCR. An analysis of pharmacological and non-pharmacological intervention initiation will be made and compared. Descriptive statistical analysis for continuous and categorical variables will be done as needed.

Result/conclusion

The study is currently been undertaken and the results and conclusion will be presented at the conference.
P03-12 - Prevalence of the Metabolic Syndrome in Day Hospital Patients
Authors: Barreiro A. , Arnaiz A. , Arroita A. , Zumarraga M.
Published: June 2010

Introduction

Shizophrenia has traditionally been associated with higher rates of risk factors for cardiovascular disease and the metabolic syndrome, as a consequence of lifestyle habits, impaired access to health care and antipsychotic agents.

Objective

To determinate the prevalence of metabolic syndrome in patients with schizophrenia who are in Day Hospital regimen in Vizcaya area (Basque Country, Spain).

Method

A cross-sectional study conducted from december 2008 to April 2009, in Zamudio and Barakaldo Day Hospitals (Vizcaya). Metabolic parameters were measured in 67 patients aged 20 to 65, with a diagnosis of schizophrenia. The definition of Metabolic Syndrome, as proposed by the International Diabetes Federation (IDF) was applied.

Results

The analysis of 67 patients showed a prevalence of the metabolic syndrome of 41,79% at baseline.Obesity (49%), insuline resistance or diabetes (37,31%), and dislipemia (41,79%) can all contribute to the metabolic syndrome.

Conclusions

Compared to the general population, our sample of patients with schizophrenia present higher rates of the metabolic syndrome. The psychiatrist should be responsible for the implementation of the necessary screening assessments and referral for treatment of any physical ilness.
P02-239 - A Review of 50 Borderline Personality Disorder Cases Recorded in 2009, in a Rural Indian District Clinic
Authors: Acharya A.
Published: June 2010

Introduction

Bordern line personality disorders are seldom diagnosed in a rural setting. But on a routine longnitudinel & through & trough follow up, BPD cases are distinctly identified if the clinician is vigilant & aware of BPD.

Objectives

Personality disorder in general & BPD in particuler, have less chance of diagnostic evaluation on the first visit due to colouration of mini psychoepisodic type presentation, mainly Hypomaniac type, or a depressive colour, but with a distinct subjective distress, & sufferings of the peripherial family members of the society it is identifiable.

Aims

Here is presentation of 26 female & 24 males, 50 in total persons those were diagosed in this year uptosept09, & their profile analysis to review them in the back-ground of such cases in other urban settings, and to make the clinitian aware of the possibility of BPD, specialy in cases where therapy results for long time are not yielding satisfactory expected results.

Methods

50 BPD cases those were diagonosed as per criteria of DSM 4TR constiuting 26 females & 24 males with 20-38 years age, were recorded upto sept09 in a rural clinic of a District HQTRS 126 k.m away from state capital city were analysed with a view of their presenting styles & distress in himself aswell as to the family members. There is a dificulty in maintaining interpersonal relationship for sustained period & smoothly. Substance & alcohol abuse, reckless spending, polygamy, family discord & violence even leading to seperation/divorce, banckrupcy or joblessstate exists.

There is a fanatic efford to avoid loneliness & strive for Identity.

Conclusion

BPD needs further evaluation.
P02-259 - Correlation of Sexuality and Personality: Parallel Assessment of Patients with QSAF- 2009 and MCMI-III
Authors: Pirkalani K.
Published: June 2010

Objective

To evaluate mutual interaction between sex and personality we tried to study 111 patients with QSAF 2009 and MCMI-III.

Methods

Hundred and eleven consecutive patients with sexual problems (76) or personality disorders (35) were examined with two tests. Only volunteer personality disorder patients were enrolled to this trial. The results were compared with 325 examinees evaluated with QSAF and 1600 patients evaluated with MCMI-III.

Results

All patients with sexual problems showed at least two scores higher than 72 in their MCMI-III. This was more prominent in sexual deviations than dysfunctions. Homosexuals had higher scores in schizoid and schizotypal, pedophiles in schizoid and antisocial, voyeurs in schizoid and avoidant, masochists in dependent and self defeating personality scales…

Conclusion

We conclude that many deviated persons remain clinically latent and show themselves as alien, aloof and eccentric. Almost all deviated persons show high scores in personality disorder scales. On the contrary, only a minority of personality disorder patients show prominent sexual problems in the form of deviation. They predominantly have disturbed sexual self image, show inhibited sexual desire problems (dependent, schizoid and avoidant) personality, dyspareunia and vaginism (avoidant and schizotypal personality), spouse abuse (borderline and antisocial personality) postcoital disorders (borderline, dependent and narcissistic personality) and extramarital relationship in a series of disorders including histrionic personality …. as studied by the QSAF 2009 which evaluates 64 sexual scales.
P02-262 - Development of Substance Abuse in Borderline Personality Disorder
Authors: Walter M. , Gunderson J. , Zanarini M. ,   CLPS Group
Published: June 2010

Background

Half or more of patients with borderline personality disorder (BPD) suffer from co-occurring alcohol use disorder and/or drug use disorder. The aim of the study was to investigate the development of substance use disorders (SUD) in patients with borderline personality disorder (BPD) in the long-term course.

Methods

175 patients with BPD and 396 patients with other personality disorders (OPD) were assessed with semistructured interviews at baseline and at 6, 12, 24, 36, 48, 60, 72, and 84 months. They were compared on the frequency of new onsets of SUD. Kaplan-Meier analyses were used to to generate time to new onsets, and Cox regression analyses were used to examine relevant predictors for new onsets.

Results

BPD patients did show a shorter time to new onsets of SUD than the OPD group. Thirteen percent of BPD patients developed a new alcohol use disorder, and 11% developed a new drug use disorder, as compared to rates of 6% and 4% respectively for OPD. The number of antisocial personality disorder (ASPD) criteria predicted new onsets of SUD in BPD.

Conclusions

Patients with BPD have a two to three times higher risk than patients with selected other personality disorders of developing a new SUD. The severity of antisocial psychopathology is related to new onsets of substance use disorder in BPD. These findings support the concept of a spectrum relationship between ASPD, BPD and SUD.
P02-266 - A True Philoshophical Aproach May Leads to a New Insight in the Research & Treatment of Psychiatry
Authors: Acharya A.
Published: June 2010

Introduction

Philoshophy is the ancient disciple that could answer the questions relating to human sufferings, their causes or a remedy. Doctors in dictionary meaning stands for a learned person. A psychiatrist may mean a more learned person on the matters of happyness or peace in mind or disturbances in the emotional sphere of a person, the cause of his behavioral disturbances.

Objectives

Psychiatry in future will traverse faraway from patienthood to personhood. It will be more person concenerned, well person in some transient emotional crisis or a relationship conflict in a couple or a fear in mind in a teenager before examination or a person incapable of sustaining meaninful interpersonal-relationship. It will move from the tiny clinic &will fly like a dynamic butterfly to sit besides the emotionaly upset person.

Aims

A noble amalgamation of past philoshopical master's teaching and the knowledge of our neuro-transmitter imbalance may come out with a suitable blend that might be sustainable to remove the misery of mind in a less costly way.

Methods

Time tested some philoshopical ideas may be analysed with our objective of blending.

There were Hedonistic or pleasure seeking scool or school of dispassionate.

In 2500BC BUDDHA pointed, “Midle path is the best path”.(among sacrificing in totality or totalpeasureseeking sensces.)

Budha's 4 noble truth, that there is misery & sufferings, there is causation for sufferings, there is way to stop sufferings, & that is possible points towards aeitiology of passion and attachment as the cause of mental disorders.

Conclusion

Philoshopical amalgamation in psychiatry will open newer avenues.
P02-276 - The Predictors of Negative and Positive Changes Following Adverse Life Events
Authors: Arikan G. , Carnelley K. , Stopa L. , Karl A.
Published: June 2010

The aim of the study was to investigate negative and positive changes in individuals who experienced psychological trauma; specifically it is interested in protective factors for posttraumatic stress disorder (PTSD) and in factors that facilitate posttraumatic growth (PTG), a positive transformation following a traumatic event. The participants were 434 University of Southampton students and staff. The study used a cross-sectional design. Participants completed an online survey which assessed demographic characteristics, information about trauma and PTSD, depression and anxiety, posttraumatic cognitions, attachment, posttraumatic growth, self-concept clarity, and self-esteem. Multiple linear hierarchical regression revealed that PTSD severity is multiply predicted by subjective severity of traumatic event, number of early traumas, both anxiety and avoidance dimension of attachment, self-esteem, posttraumatic cognitions, and depression. In addition, it was found that the negative self-view (as measured by the PTCI) partially mediates the relationship between attachment styles and PTSD, self-esteem and PTSD, and number of early traumas and PTSD. Surprisingly, it was revealed that only PTSD severity, and demographic variables significantly predict PTG in the final model. The research support the assumption that vulnerability factors may be related to psychopathology after a traumatic event. It showed that individuals who have experienced early traumatic events, are insecurely attached, and have low self-esteem report higher amounts of negative post-trauma cognitions and PTSD. The role of insecure attachment and low self-esteem for PTSD may have important therapeutical implications and should be included in assessment and formulation.
P02-285 - Investigator Assessment of Clinical Parameters After Initiating Aripiprazole Therapy. Prevention Metabolic Syndrome
Authors: Marqués P. , Galicia M. , Martinez V. , Coullaut V. , Piñol C.
Published: June 2010

Introduction

The schizophrenia has associated traditionally with major rates of comorbilidad physics. In addition the antipsychotic ones of the second generation are causers of the so called metabolic syndrome (increase of weight, dislipemia and diabetes) that favor directly the cardiovascular disease in our patients.

Objectives

To develop a therapeutic plan to diminish the sobremortalidad and sobremorbilidad of our schizophrenic patients (according to different studies between 25-50 % of cardiovascular risk). To detect the factors of risk, which influence the metabolic Syndrome: a high level of cholesterol HDL, IMC, smoking and hyperglycemia.

To apply measures of prevention for the diabetes, for the arterial hypertension and the dislipemias.

Methods

Retrospective study is realized, checking the clinical histories of the patients beginning medication with aripiprazol for symptomatology psychotic and support the treatment at least 6 months later. We realized preventive specific measures in the patients including education to the patient, careful selection of the antipsychotic with substitution if there appear signs of metabolic syndrome.

Results

39 patients that initiated treatment with aripiprazol, therapeutic doses. Of 39 patients 24 (61,54 %) is smoking, 18 (46,16 %) has an IMC> 25, 11 (28,39 %) hipertriglicerinemia, 5 (12,82 %) index of glycemia basal> 125 and 6 (15,38 %) with hipercolesterolemia.

Conclusion

The antipsychotic atypical alter the metabolic regulation. The treatment with aripiprazol suggests minor risk of metabolic syndrome, in relation to previous similar studies, with antipsychotic others. We think it performs vital importance the prevention of the overweight orientated to patients with the first psychotic episode.
P02-289 - Alcohol Screening and Brief Interventions in Primary Health Care Facility Doboj, Republic of Srpska, Bosnia and Herzegovina
Authors: Onrust S. , Demonjic S. , Janjetovic N. , Jeremic M. , Sredic A.
Published: June 2010

Objectives

Determine whether and how primary health care workers (PHCW) provide alcohol screening and brief interventions (SBI) and assess their interest in improving.

Methods

A questionnaire built built on WHO recommendations for alcohol prevention and harm reduction in primary health care was distributed to 130 primary health care workers (26.9% doctors, 73.1% nurses) in family medicine and emergency medicine departments in the Primary Health Care Facility Doboj.

Results

The participation rate was 61% (79/130), of which 28 (35%) doctors and 51 (65%) nurses answered the questionnaire. 3 (10.7%) doctors and 3 (5.9%) nurses provide alcohol screening always, 15 (53.6%) doctors and 22 (43.1%) nurses sometimes, while 10 (35.7%) doctors and 25 (49%) nurses never do alcohol screening. None of the PHCW uses AUDIT, 1 uses CAGE, and others use clinical screening procedures. 12 (42.9%) doctors and 40 (78%) nurses never provide brief interventions. 22 (28%) PHCW are interested in providing alcohol screening, while 20 (71.4%) doctors and 15 (29.4%) nurses are interested in improving their SBI skills.

Conclusions

Primary health care workers do not provide routinely alcohol screening and brief interventions aimed at prevention and reduction of alcohol related problems. Those who do provide SBI do not follow WHO recommendations. There is a certain interest to improve, but the fact that 39% PHCW did not even answer the questionnaire is indicative. Motivation, training on SBI and follow-up of PHCW are needed.
P03-323 - Antipsychotics and Readmission in a Population of Psychotic Patients in a Psychiatric Unit of a General Hospital
Authors: Câmara Pestana L. , Carmo A.L. , Sequeira Mendes R. , Zuzarte P.
Published: June 2010

Introduction

The poor compliance to antipsychotic medication is a major problem in ambulatory treatment of patients with psychotic symptoms, leading to an increased risk of exacerbation and inpatient readmission.

Objectives

Our objective is to clarify if the administration of prolonged release antipsychotics (PRAP) is a relevant factor in the decrease of inpatients readmissions.

Methods

Through a retrospective study, we assessed the socio-demographic and psychopathological features of a sample of patients with diagnostic of Schizophrenia and Schizoaffective disorder (DSM-IVTR), who were admitted to a psychiatric inpatient unit, in the period of two years (January 2007 to December 2008). This sample was divided in two groups (with readmissions/without readmissions), considering as having readmissions the patients that were readmitted in the nine months after the first medical discharge. We compared the use of PRAP versus oral antipsychotics (OAP) at the time of the first medical discharge, assessing if these differences had any impact in the readmissions.

Results

Sample of 88 patients, 55,68% (n=49) male, 53,41% (n=47) unemployed, 64,77% (n=57) single. The most frequent diagnostic was Paranoid schizophrenia (73,86%, n= 65), followed by Schizoaffective disorder (17.05%, n= 15). Of the patients that had readmissions (n=15; 17,05%), 40,00% were medicated with PRAP (n=6) compared with 49,32% (n=36) of the patients with no readmissions (n=73). These differences had no statistic significance.

Conclusions

Taking in consideration the small sample of patients, the frequency of readmissions was low. About 50% of the patients were medicated with PRAP+OAP, with no evidence that this decision had reduced the readmissions.
P03-326 - Treatment-Emergent Sexual Dysfunction Related to Antidepressants: a Meta-Analysis
Authors: Chiesa A. , Serretti A.
Published: June 2010

Background

Sexual dysfunction (SD) is an important underestimated adverse effect of antidepressant drugs. Patients, in fact, if not directly questioned, tend to scarcely report them. The aim of the present meta-analysis was to quantify SD caused by antidepressants on the basis of studies where sexual functioning was purposely investigated through direct inquiry and specific questionnaires.

Methods

A literature search was conducted using MEDLINE, ISI Web of Knowledge, and references of selected articles. Selected studies performed on patients without previous SD were entered in the Cochrane Collaboration Review Manager (RevMan version 4.2). Our primary outcome measure was the rate of total treatment-emergent SD. Our secondary outcome measures were the rates of treatment-emergent desire, arousal, and orgasm dysfunction.

Results

Our analyses indicated a significantly higher rate of total and phase-specific treatment-emergent SD compared with placebo for the following drugs in decreasing order of impact: sertraline, venlafaxine, citalopram, paroxetine, fluoxetine, imipramine, phenelzine, duloxetine, escitalopram, and fluvoxamine, with SD ranging from 25.8% to 80.3% of patients. No significant difference with placebo was found for the following antidepressants: agomelatine, amineptine, bupropion, moclobemide, mirtazapine, and nefazodone.

Discussion

Treatment-emergent SD caused by antidepressants is a considerable issue with a large variation across compounds. Some assumptions, such as the inclusion of open-label studies or differences in scales used to assess SD, could reduce the significance of our findings. However, treatment-emergent SD is a frequent adverse effect that should be considered in clinical activity for the choice of the prescribed drug.
P03-330 Case Report: Serotonin Syndrome vs Neuroleptic Malignant Syndrom
Authors: García-Murillo L. , Calero-Fernandez R. , Jimenez Fernandez S. , Rojas Estape M. , Serrano E. , Sanchez E. , Iglesias C.
Published: June 2010

Background

Serotonin Syndrome (SS) is an adverse drug reaction that drives mental-status changes, autonomic hyperactivity and neuromuscular abnormalities.

Neuroleptic Malignant Syndrome (NMS) is an idiopathic reaction to dopamine-antagonist that consists of extra-pyramidal symptoms, autonomic dysfunction, hyperthermia, diaphoresis and fluctuating consciousness.

Differential diagnosis is sometimes difficult for their overlapping clinical features. Potentially lethal, both require heightened clinical awareness for prevention, recognition and prompt treatment.

Case report

Caucasian 59 years-old woman with Catatonic profile (Scored: severity-17points/ 5 screening in Bush-Francis Catatonia-Rating-Scale).

Past Medical History

-

Hypothyroidism

-

Bipolar Disorder type-2 (25 years of evolution)

15 days before hospitalization, anafranil and fluoxetine treatment was replaced by Trazodone 200 mg/day and venlafaxine 150mg/day. She was also on valpromida and lorazepam 15 mg/day.

Current history

Mutism, negativism. No reaction to painful stimuli, stuporous. Diaphoresis, pallor, tremor, axial rigidity without pyramidalism (>lower limbs), high fever (40°C), tachycardia (>100lpm), rhabdomyolysis (CPK reached 17.000, 48 hours after the admission), leukocytosis, upper transaminasas, hiponatremia with hiperpotasemia.

Differential diagnosis

-

NMS: Intensity, duration and high CPK are suggestive (Sternbach). This syndrome has been described due to Venlafaxine.

-

SS: Combination of Venlafaxine and Trazodone favors but she doesn't have acatisia, hiperreflexia, diarrhea and it wasn't resolved after 96 hours.

Drugs were removed and Lorazepam on high doses (5mg/day) was prescribed. One month later the patient was totally recovered of the episode.

Conclusions

If unsure diagnoses it's priority to remove the causing drugs and supportive care. Afterwards, it can be used benzodiacepines, also dantroleno in SNM.
P03-339 - Accuracy of Psychotropic Medication in Adults with Intellectual Disabilities
Authors: Hove O. , Biringer E. , Havik O.E.
Published: June 2010

Objectives

It is generally acknowledged that individuals with intellectual disabilities (ID) benefits from psychotropic treatment for mental disorders (MD) in the same way as people in the general population. It has also been shown that problem behavior (PB) does not respond to psychotropic treatment. Thus, we hypothesized that the presence of MD was assocated with psychotropic treatment, whereas PB (not MD) was not.

Method

In a community sample of adults with ID (N=593), the presence of dementia, psychoses, depression, mania, obsessive-compulsive disorders, five anxiety disorders and eight problem behaviors were screened using the Psychopathology Checklists for Adults with Intellectual Disability (P-AID). Information regarding the use of psychotropic medicine (ACT-N) was collected. Staff members in group homes served as informants both for the screening and the use of drug.

Results

Psychotropic medication was reported in 40% of the sample. Of the 23% that presented with MD only, 44% received psychotropic medication (p=.310). Of the 12% that presented with both MD and PB, 51% received such medication (p=.032). The strongest association was found between psychotropic treatment and having PB only. Among the 8% that showed PB only, 52% received psychotropic medication (p=.022).

Conclusion

Contrary to our expectations, the presence of PB rather than MD were associated with the use of psychotropic treatment. The present findings suggest that people with ID often receives no psychotropic treatment for MD, or they receives such treatment for the wrong reason, leaving the accuracy of psychotropic treatment to a minimum.
P03-340 - Efficiency of Trazodon in Treatment of Alcoholics
Authors: Ivic B.
Published: June 2010

The aim of our work was to find out about the efficiency of Trazodon in treating depressive disorder with alcoholics who were patients at the department for alcohol addiction at the Psychiatric Hospital G. Toponica (15 patients). For completing this research we used Beck's scale to evaluate the degree of depression. The research lasted for 6 weeks. Alredy after the first week of consuming there was a progress concerning sleeping and reduction of anxiety. The anti-depressing score was evident already after two weeks, there also has been a remarkable dropping of the amount on Beck's scale for evaluation of depression. Throughout the research of the efficiency with depression symptomatology the dayly dosage for alcoholics wasn’t over the amount of 150mg. A clinical study in the duration of 6 weeks showed that Trazodon successfully reduced the symptoms of depression with alcohol addicts and that it after hospitalized treatment helped to maintain in conditions after leaving the institution. It was equaly used on young and elderly patients without any negative effects.
P03-341 - Metabolic and Neuroendocrinologic Effects of Long-Acting Injectable Risperidone Under Real-Life Conditions
Authors: Jasovic-Gasic M. , Maric N. , Doknic M. , Britvic D. , Pekic S. , Stojiljkovic D. , Damjanovic A. , Popovic V.
Published: June 2010

Objective

Present study focuses on metabolic and neuroendocrinologic effects of long-acting injectable risperidone (LAIR) treatment in a naturalistic sample of patients with schizophrenia spectrum disorders.

Method

Twenty three outpatients with schizophrenia or schizoaffective disorder (ICD X) (age 32.3±6.5years, illness duration 8.7±5.1 years, PANSS 78.1±14.7) were included. At the time of evaluation the patients were treated with LAIR for 1.4±0.7 years, average dose 38.6±9.9mg. Total duration of antipsychotic therapy was 8.0±4.8 years. Control group (n=23) were healthy volunteers matched by age, sex and education.In the morning serum we measured leptin, prolactin, cortizol, IGF1, T4, FSH, LH, HbA1c, total cholesterol, HDL, LDL and triglicerides. Both groups were tested by oral glucose load (OGTT), with measuring insulin levels and anthropometric parameters.

Results

In comparison to control group, the patients had higher BMI (p< .001), waist circumference (WC, p=.004), increased leptin (p=.013), prolactin (p< .001), triglycerides (p=.029) and fasting glucose (p=.004). After controlling for BMI, WC and sex, only prolactin (p< .001, ηp2= .50) and leptin (p=.040, ηp2=.13) were significantly increased in the patient group.

Conclusion

This is the first study of LRAI effects on metabolic and neuroendocrine parameters. Our cross-sectional study has shown that the most consistent side effects of LAIR were increased prolactin and leptin, while other deviations might be attributed to confounding covariates. Whether pharmacokinetic and pharmacodynamic advantages of LAIR over oral drug formulation are accompanied with favorable metabolic and neuroendocrine profile remains to be assessed by head to head studies.

Funding

This study was supported by a grant from the Ministry of Science, Republic of Serbia (Project 145019).