bluuebunny/crossref_metadata_2025 huggingface dataset:
FC01-01 - Does Stress-Related Major Depression Differ from Non-Stress Related Major Depression in Primary Care? Results from the PredictD-Spain Study
Authors: Motrico E. , Moreno B. , Bellón J.A. , Monton-Franco C. , Sánchez-Celaya M. , Vicens C. , Sánchez-Artiaga M.S. , Muñoz-Garcia M.M.
Published: June 2010

Introduction

Research has consistently documented the significance of severe life events for the onset and course of major depression. However, no research has been done on whether social and clinical characteristics differ in depressed primary care attendees who have experienced stressful life events compared to those who have not.

Objectives

We investigated whether social and clinical characteristics differ in depressed primary care attendees who have experienced stressful life events compared to depressed primary care attendees who have not.

Methods

We undertook a prospective cohort study involving 5,442 consecutive primary care attendees with evaluations at baseline and at 6 months. Patients aged 18-75 years were recruited in six Spanish provinces between October 2005 and February 2006. The incidence of major depression was assessed at 6 months with the Depression Section of the Composite International Diagnostic Interview (CIDI). Stressful life events were measured with the List of Threatening Experiences (LTE).

Results

3,804 (70%) were interviewed at 6 months of follow-up. Among 200 attendees with a first episode of major depression, 24.5% had experienced no stressful life events, 30.5% had suffered one, 20.5% had experienced two and 24% had suffered three or more in the 6 months prior to the onset of depression. Depressed primary care attendees who had experienced three or more stressful life events differed from depressed patients with no stressful life events in the following variables: economic difficulties, dissatisfaction with unpaid work, relational variables, psychiatric co-morbidity and family history.

Conclusions

Stress-related major depression differs from non-stress-related depression in primary care.
FC01-06 - The DTNBP1 (Dysbindin-1) Gene Variant rs2619522 is Sssociated with Variation of Hippocampal Grey Matter Volume in Humans
Authors: Gruber O. , Trost S. , Platz B. , Scherk H. , Wobrock T. , Reith W. , Meyer J. , Falkai P.
Published: June 2010

Background and aims

DTNBP1, which encodes dysbindin-1, is one of the best-supported susceptibility genes for schizophrenia, and hippocampal volume reduction is one of the major neuropathological findings in schizophrenia. Consistent with these findings, dysbindin-1 has been shown to be diminished in glutamatergic hippocampal neurons in schizophrenic patients. The aim of this study was to directly investigate the effects of two single nucleotide polymorphisms of the DTNBP1 gene on regional brain volumes in human subjects.

Methods

128 subjects participated in the study. All subjects were genotyped with respect to two single nucleotide polymorphisms of the DTNBP1 gene (rs2619522 and rs1018381) and underwent structural magnetic resonance imaging (MRI). MRI data were preprocessed and statistically analyzed using standard procedures as implemented in SPM5, in particular the voxel-based morphometry (VBM) toolbox.

Results

We found significant effects of the DTNBP1-SNP rs2619522 on regional brain volumes bilaterally in the hippocampus as well as in the anterior middle frontal gyrus and the intraparietal cortex. T/T homozygotes showed significantly lower grey matter volumes in these brain regions than carriers of the G allele.

Conclusions

Compatible with previous findings on a role of the dysbindin-1 gene in hippocampal functions as well as in major psychoses, the present study provides first direct in-vivo evidence that the DTNBP1-SNP rs2619522 is associated with variation of grey matter volumes bilaterally in the human hippocampus.
FC02-02 - Why do Late Adolescents not Seek Professional Help for Mental Health Problems?
Authors: Fröjd S. , Marttunen M. , Kaltiala-Heino R.
Published: June 2010

Objectives

To describe reasons for not seeking professional help at the age of 17-18 years, when a need for mental help is present.

Methods

In a person identifiable survey among 3278 Finnish adolescents 15-16 years old at baseline, reasons for not seeking professional help were studied among respondents of a two-year follow-up, who had reported a need for help for a mental health problem but had not sought professional help(n=128). The respondents were instructed to choose from the following list all alternatives describing their situation: thought that the symptoms will eventually alleviate anyway, unsure about who to turn to, felt too exhausted to get help, anxious of somebody finding out, negative experiences of dealing with health professionals, distrusted the effectiveness of professional help, turned to parents for help, parents estimated that there was no need for professional help, turned to friends for help,. friends estimated that there was no need for professional help.

Results

The three most common reasons for not searching for professional help were, the notion that the symptoms would alleviate without help (71%), exhaustion (43%) and turning to friends for help (26%). Uncertainty about to whom to turn and exhaustion were more common among those with depression compared to those with no depression (33% vs 14%, p=0.025 and 55% vs 35%, p= 0.042).

Conclusion

Mental health literacy of late adolescents must be enhanced in order to make them take mental health problems seriously enough to get professional help.
FC02-05 - Towards Combining Precision and Brevity: A Prospective Study of Adaptive Cognitive Testing
Authors: Wouters H. , Van Campen J. , Appels B. , Van Gool W.A. , Schmand B. , Zwinderman A.H. , Lindeboom R.
Published: June 2010

Objectives

To examine whether cognitive testing can be tailored to individual patients by selecting only items of appropriate difficulty from a large and precise neuropsychological battery. The advantage is a combination of measurement precision with the brevity (of shorter tests).

Methods

39 patients with cognitive complaints and 8 partners who visited a geriatric day care clinic were randomly assigned to administration of the CAMCOG or an extended CAMCOG i.e. with ADAS-cog and neuropsychological tests. Item difficulties were estimated and their validity examined with Rasch analysis. Tailored testing was achieved by Computerised Adaptive Testing (CAT). CAT repeatedly selected an easier item after an incorrect response and a more difficult item after a correct response to estimate the total score. CAT finished the item selection after reaching sufficient reliability (standard error < 0.15).

Results

For test reductions by CAT ranging from 25 to 15 items, intraclass correlations between the CAT estimated total score and actual total score (CAT administered plus remaining items) ranged from .99 to .98 for the CAMCOG and from 0.98 to 0.91 for the extended CAMCOG. Testing time reduction ranged from 42-55% for the CAMCOG (M testing time CAMCOG 39.6 minutes, M testing times CAT 22.9 to 17.8 minutes) and from 45-68% for the extended CAMCOG (M testing time extended CAMCOG 111.3 minutes, M testing times CAT 61-35 minutes).

Conclusions

Substantial test reductions and excellent agreement with the whole battery supports the use of tailored cognitive testing to economically administer batteries that are time consuming in their entire form.
FC03-01 - The Association Between School Bonding and Smoking Amongst Adolescents in Chilean Schools
Authors: Gaete J. , Araya R. , Montgomery A.
Published: June 2010

Objective

To study the association between school bonding dimensions (school commitment and school attachment) and current adolescent smoking in Chile, controlling for confounding variables using the Fifth Chilean School Population National Substance Use Survey, 2003 (CHSS-2003) dataset.

Methods

The CHSS-2003 is a stratified cross-sectional survey which gathers information about personal, familial, peer, school factors and cigarette use using a self-reported questionnaire. Complete data from 21,956 adolescent students for all the variables of interest were used in the analyses. An Exploratory Factor Analysis (EFA) was performed in order to test the construct validity of the questionnaire and create the main exposure and potential confounding variables. Multivariable logistic regression analyses were undertaken to study the association between school bonding and smoking.

Results

The construct validity of the school attachment and school commitment scales was supported by the EFA. Multivariable analyses showed strong evidence that, after adjusting for factors from different domains, school commitment (student's good grades and school attendance) appears to have a clear inverse association with current smoking (OR=0.46; 95%CI: 0.38-0.56). On the other hand, school attachment (their feelings towards their school and their teachers) was not associated with adolescent smoking (OR=1.16; 95%CI: 0.88-1.53)

Conclusions

School commitment was strongly associated with current smoking. It is important to study further this variable with the aim of ascertaining whether or not interventions that improve school commitment may prevent or reduce smoking amongst adolescent students.
FC03-05 - Quality of Care and Patient Outcomes: a Randomised Trial of Clinical Supervision in Mental Health Settings in Queensland, Australia
Authors: White E.
Published: June 2010

Objectives

Historically, the treatment of mental illness in Australia has been inadequate. Clinical Supervision [CS], a structured staff support arrangement, has shown promise as a contribution to the clinical governance agenda; however, little is yet known about CS implementation issues. This study aimed to examined the effects of providing regular Clinical Supervision to nursing staff who worked in mental health settings, on their levels of personal well being, the quality of care they delivered and the outcomes for patients

Methods

A large scale landmark Australian randomised controlled trial [RCT] of CS, funded by the Queensland Treasury/Golden Casket Foundation [A$248,000], was located in 17 mental health facilities, across the State. The RCT trained 24 Supervisors and tracked their subsequent year-long personal experience [the Intervention] using psychometrically established instruments, supplemented by qualitative data, which was also collected from mental health nurses, other clinical staff, patients and administrators.

Results

Supervisors and Supervisees were found to value Clinical Supervision. The positive effect this had on the quality of care and patient outcomes was demonstrated in a controlled setting within this RCT, but remained elusive across a broad front. The importance of the prevailing service/managerial culture to the outcome of CS implementation was revealed.

Conclusions

Novel findings will help to conceptualise Clinical Supervision education, management and policy decision making in the future. They will provide the basis for the best contemporary advice for service development and/or a framework for future CS evaluation, sufficient to be tested in another environment with other mental health disciplines.
JS01-01 - Psychotropic Drugs and Chronic Pain
Authors: Mico J.-A.
Published: June 2010

Introduction

Pain complaints are frequent in psychiatric and primary care settings. Furthermore, in pain clinic, depression and pain disorders are common comorbidities. On the other hand, several antidepressants are effective in the management of chronic pain and in alleviating pain complaints in depressed patients.

Objectives

In this lecture, we summarize the current knowledge with regard to the use of antidepressants in chronic pain conditions and in pain as a somatic complaint in depression. We review the pharmacological mechanisms and the neurobiological substrate of these properties.

Aims

To give arguments for the recognition of antidepressants as useful tool to treat pain in depression and depression in chronic pain patients, and to provide information about the right choice of an antidepressant in chronic pain.

Conclusion

The monoaminergic system participates both in the regulation of mood and in the modulation of pain. Antidepressants have several properties modulating monoamines. Some of these properties are critical to understand the mechanisms of action of these compounds in chronic pain and in alleviating pain as a somatic symptom in depressed patients. The discussion about whether antidepressants alleviate pain acting on mood or pain transmission is a matter open to discussion, however there is no doubt about the utility of these drugs in pain. Recent studies in modified genetic animals reinforce the idea the not only monoamines but also other neurotransmission systems underlie these effects.
P01-10 - Absence of Social Support in the Course of Dysthymic Disorder
Authors: Batinic B. , Vukosavljevic-Gvozden T. , Nikolic-Balkoski G.
Published: June 2010

Introduction and objectives

Absence of social support has its role in the etiology and maintaining of depression, showing inability of the depressive subjects to built and to sustain interpersonal relationships, and to mobilize social support at the time of crisis. The objective of our investigation was to establish the level of social support in the patients suffering from dysthymic disorder, in the course of the disorder.

Methods

The sample participants included 40 patients who fulfilled DSM-IV criteria for the dysthymic disorder (mean age 40.65, SD 3.70), and 40 corresponding healthy controls (M 37.50, SD 8.05). The following instruments for assessment of social support were used: Social Support Index, Family Hardiness Index, Family Coping Coherence Index, Relative and Friend Support (McCubbin, et al., 1982,1986).

Results

The dysthymic disorder patients compared to the healthy controls, had statistically significant lower values (p< 0.001) of Social Support Index, Family Hardiness Index, Family Coping Coherence Index and of Relative and Friend Support.

Conclusion

In the course of the disorder, those suffering from dysthymic disorder compared to the healthy controls, had a significantly lower level of social support, indicating absence of a reparative role of social support in maintaining the psychological well-being.
P01-100 - Serenity: Evaluating the Effectiveness of GP-based Management of Atypical Antipsychotics in the Community
Authors: Pitchot W. , Taeter C. , Duquenne V. , Goodman N.
Published: June 2010

Objectives

This SERENITY study was designed to investigate the effectiveness of atypical antipsychotics (AAPs) as defined by the three areas of patient functioning, efficacy and tolerability in general practice.

Methods

Between January 2007 and June 2008, 252 patients were enrolled, as planned, in this non-interventional study in Belgium. Inclusion criteria were patients 18-65 years old, willing and able to participate, diagnosed with Schizophrenia or Bipolar Disorder and currently in a manic episode and for whom the general practitioner (GP) decided to prescribe an AAP.

Patient demographics, selection criteria, psychiatric and medical history and condition were assessed at Visit 1. Additional psychotropic drugs, name and dose of AAP, the QoL questionnaire Q-LES-Q-16, the Sheehan Disability Scale (SDS) for patient wellbeing, the Clinical Global Impression (CGI) and Patient Global Impression of Change (PGIC) scores for clinical efficacy and tolerability were assessed at Visit 1 (day 0), Visit 2 (week 4) and at Visit 3 (week 8).

Results

A mean change of 24.62 was observed in the Q-LES-Q results. The SDS total score decreased substantially with a mean change of -9.26. Number of days lost, and the number of unproductive days, at work or school decreased with a mean change of -1.88 and -2.31, respectively. CGI-S scores decreased by a mean -1.92 and the CGI-I and PGIC scores also decreased. A weak but positive correlation was seen between the medication satisfaction and the efficacy, tolerability and patients’ well-being.

Conclusions

This study indicates that GP-based management of antipsychotic treatment is effective in the community.
P01-103 - Factors Associated with Positive Screen on the Mood Disorder Questionnaire in Treatment-resistant Depression
Authors: Kiejna A. , Pawłowski T. , Dudek D. , Siwek M. , Roczeń R. , Łojko D. , Rybakowski J.
Published: June 2010

Objective

In recent years increased indices of bipolarity in treatment-resistant depression were found. The objective of the study was to assess and compare Mood Disorder Questionnaire (MDQ) positive screen between patients with treatment-resistant (TR) depression and non-treatment-resistant (NTR) depression and identify significant predictors of MDQ positive screen.

Methods

The population studied included patients aged 18-65 who had a diagnosis of first or recurrent major depressive disorder. Each psychiatrist included 5 consecutive patients, from all the patients he is treating, where the depressive episode was assessed as treatment-resistant (study group) and 5 consecutive patients with a non-treatment-resistant episode (control group). The symptoms of bipolarity were assessed by the MDQ. A positive screen of MDQ showing the features of bipolarity requires seven or more items be endorsed, at least several of the items co-occurred, and the symptoms caused at least moderate psychological impairment. One thousand and fifty-one patients entered the study: 570 in treatment-resistant group and 481 in non-treatment-resistant group.

Results

The percentage of patients having MDQ positive screen was significantly higher in the treatment-resistant than in the non-treatment-resistant group (13.7% vs. 5.6%, respectively, p< 0.001). Significant predictors of MDQ positive screen identified in logistic regression were: family history of bipolar disorder (OR=4.04, p< 0.001), early onset of first major depression (< 20 years) (OR=3.27, p=0.001), and incomplete last remission (OR=3.11, p< 0.001).

Conclusions

Our results may suggests bipolar diathesis in treatment- resistant depression.
P01-20 - Affective Disorder and Polycythaemia Vera
Authors: Ceylan M.E. , Maner F. , Turkcan A.
Published: June 2010

Objective

This case is a presentation of three siblings diagnosed as affective disorder with polycythaemia vera during the episodes. Polycythaemia dissappearing with the remission of affective disorder is focus of attention of these cases.

Method and results

First sister is 28 years old, single, treated for manic and subclinic depressive episodes for almost ten years. Polycythaemia vera has been developed with beginning of every manic episode and disappeared with the remission of episode. The patient made venopunction of 500cc weekly during the manic episode. Second brother is 26 years old, single, polycythaemia and psychotic depression were developed rapidly after a stressful life event. Venopunction was made for four times during one month medication. Polycythaemia and depression remitted at the same time. Third brother is 24 years old, single, polycythaemia and nonpsychotic depression were developed after his brother's depression. Venopunction was made for three times during three weeks of treatment. Again polycythaemia and depression remitted at the same time.

Conclusion

The siblings had no internal disease. Only first sister was on lithium treatment, 600mg/day for chronic affective disorder but her first polycythaemia attack was prior to lithium treatment. We found only one report upon the relationship between affective disorder and polycythaemia vera in which mania, delirium and polycythaemia rubra vera were documented. #Freeman MP, Wiegand C, Gelenberg AJLithium. İn Textbook of Psychopharmacology. Third Edition. Schatzberg AF, Nemenoff CB (editors) American Psychiatric Publishing, Washington DC. 2004, 547-565.
P01-21 - The Level of Psychological well being in Subjects with Affective Disorders and in Controls
Authors: Cosci F. , Mar F.-R. , Berrocal C.
Published: June 2010

Objectives

The present study was aimed at evaluating psychological well being (PWB) among subjects with affective disorders and healthy controls.

Methods

83 subjects with affective disorders were compared to 83 healthy controls. Measures of PWB, psychological symptom status, basic social skills underlying social and emotional competence, and health-related quality of life (QoL) were obtained from standardised, self-administered rating scales. Statistical analyses focused on between-groups differences and on correlations among the major variables under study.

Results

Cases showed significantly higher levels of psychological symptoms, and lower PWB, social competence, and QoL than healthy controls. Between-groups differences in emotional competence did not attain statistical significance. When correlations were evaluated, cases showed negative correlations between PWB and psychological symptoms, and positive correlations between PWB and QoL. Only some PWB constructs correlated with the social competence, while no correlation was found between PWB and emotional control.

In healthy controls, similar correlations between PWB and social competence as well as between PWB and QoL were found. On the other hand, no correlation was found between PWB and emotional competence, between psychological symptoms and the two PWB constructs named “purpose in life” and “personal growth”.

Conclusions

Subjects with affective disorders seemed to link their PWB to psychological symptoms, QoL, and social skills with the exception of emotional control. Healthy subjects seemed, on the other hand, to link their PWB to QoL and social competence, only in part to psychological symptoms, and not at all to the emotional competence.
P01-22 - 12 Years of Refractory Mania in Extensive Metabolizers
Authors: Da Ponte G. , Lobo M. , Paiva A.
Published: June 2010

Objectives

Alert for the efficiency of the clozapina, in high doses, in refractory mania to pharmacological treatment.

Methods

Review of literature relevant after the description of a clinical case example.

Results

Description of a clinical case: Woman 30 years, ethnicity african, with bipolar disease type 1, with 12 years of evolution, and 11 treatments with around 1 year duration. Specifics took place with medication, such as intolerance to mood stabilizers, including lithium and valproate. Last inpatient care, with 5 months, it was for outbreak manic characterized by huge dysphoria and easy irritability with aggressiveness. There were administered antipsychotics, in high doses, and attempted electroconvulsive therapy, without success. Clinical remission has been achieved by the gradual increase of clozapina, in accordance with the patient tolerance, until 1400 mg daily without occurrence of agranulocytosis. The only intercurrence was a epileptic seizure, controlled with phenytoin.

Conclusions

Refractory mania is treated with clozapina in high doses, which must be administered according to the patient tolerance and clinical improvement. The risk of agranulocytosis (1-3%) is low, and is the only formal indication to suspend the treatment. The extensive metabolizers do not respond to conventional doses of psychotropic substances, they need larger doses and are more frequent in african people.
P01-24 - Quetiapine XR in Rapid Cycling Bipolar Disorder-depressive Episode - Study Case
Authors: Dan I. , Grimberg M.
Published: June 2010

Background

A partial solved issues in the treatment of Bipolar Disorder (BD) is depressive episode if is rapid cycling. Often, antidepressant monotherapy increases the risk of switching into mania/hypomania. Using quetiapine XR in these cases may help to avoid these disease burdens.

The aim

To estimate the clinical efficacy and acceptability, in rapid cycling depressive episode of quetiapine XR.

Methods

34 yrs. woman, Bipolar Disorder-Depressive Episode, rapid cycling (DSM-IV), scores YMRS=10 and HAMD-17=32 at baseline.

Instruments

Depression (HAMD-17), mania (YMRS), CGI-S, CGI-I, side effects and relapse (follow-up: 12 month). The patient has a history of 12 yrs. of BD with 5 depressive and 6 manic episodes. Last year depressive episodes were 3 manic and 1 depressive episodes.

Results

After 4 weeks, of treatment with quetiapine XR 300mg/day in the evening, the depressive scores improved 75%, sleep became normal, no co-medication was needed. The patient continued to receive quetiapine XR and assessments were performed monthly. The follow-up priod demonstrated no relapses (depressive or manic).

Conclusions

1. In this case of Bipolar Disorder-rapid cycling, the treatment of depressive episode quetiapine XR-300mg/day was effective and well tolerated; no switch in manic or hippomanic was noticed.
P01-26 - Clinical Perceived Differences between Mirtazapine Conventional Tablets and Mirtazapine Orally Disintegrating Tablets
Authors: De Pedro J.M. , Caballero L.
Published: June 2010

Objectives

To collect the opinions of a sample of Spanish psychiatrists and their patients about the acceptability, preference and adherence to treatment of mirtazapine orally disintegrating tablets in relation to mirtazapine conventional tablets.

Methods

It was carried out an on-line survey recruiting a total of 422 psychiatrists who responded to a questionnaire of 14 closed questions. Fieldwork for this project was conducted out between January and March 2009.

Results

The 422 psychiatrists who responded to the present survey had an average age of 45. 54% of them were men and 46% were women. The scope of activity of the participants (multiple choice possible) was: 27.5% hospital, 68% mental health center, 27% private practice and 6% other kind of activity. The 42.5% of visited patients suffered major depression and concomitant chronic organic disease.

When prescribing an antidepressant, psychiatrists of the sample did not usually take account the patient preferences: 26% did not and 33% asked the patient “in less than 50% of the time.”

The doctors emphasized that mirtazapine orally disintegrating tablets was more convenience for the patient (94%), support for better compliance (91%), had a pleasant taste (87%) and had patient preference (86%) among the main issues that took into account when they opting for that drug formulation.

The change from mirtazapine conventional tablets to mirtazapine orally disintegrating tablets did not caused any problem for 70% of doctors.

Conclusions

Differences in galenic presentations of the same drug should lead significant perceived differences in clinical practice, by doctors and their patients
P01-27 - Depression and Subclinical Hypothyroidism
Authors: Demartini B. , Islam L. , Gambini O. , Scarone S.
Published: June 2010

Objectives

To estimate the prevalence of depressive symptoms in patients affected by subclinical hypothyroidism by means of Hamilton Rating Scale for Depression (HAM-D) and Montgomery-Asberg Depression Rating Scale (MADRS); to assess which depressive symptoms are prevalent in our population, with references to the factorialization of HAM-D by Cleary and Guy (1977); to verify whether levothyroxine replacement therapy alone can induce total remission of depressive symptoms.

Methods

The study enrolled 63 patients affected by subclinical hypothyroidism undergoing follow-up at the endocrinology service of San Paolo Hospital in Milan. All patients underwent an evaluation by means of HAM-D and MADRS scales and serum TSH, free T4, free T3, TPO-Ab and Tg-Ab levels were measured.

Results

We estimated a prevalence of depressive symptoms in our population of 63.5%. Concerning the qualitative assessment of psychiatric disturbances in the population we considered, our results showed that the most frequent symptoms were part of four factors, according to the Cleary and Guy factorialization of HAM-D: these factors are representative of anxiety and somatisation (factor I), cognitive impairment disturbances (factor III), psychomotor retardation (factor V) and sleep disorders (factor VI). Levothyroxine replacement therapy alone wasn’t effective in inducing total remission of depressive symptoms.

Conclusions

This study suggests the importance of a psychiatric evaluation in patients affected by subclinical hypothyroidism.
P01-32 - The Effect of Valproat Versus Lithium in the Long-term Treatment of Subtypes of Bipolar Disorders (BD)
Authors: Elezi F. , Sotiri E. , Braho A. , Dobi F. , Dyrma A. , Tomori S.
Published: June 2010

Background

Bipolar disorder begins during adolescence but often escapes diagnosis at this time because episodes are misinterpreted with other psychiatric disorders. Lithium, carbamazepine, valproate, and other drugs are used for the treatment of acute episodes and maintain treatment of bipolar disorders.

Aims

To compare the efficacy of Valproate vs. Lithium in the long-term treatment of patients with subtypes of bipolar disorders.

Method

120 patients with more than two episodes of BD (according to DSM-IV) in a longitudinal, comparative and randomized clinical trial, for 2 years (104 weeks) divided in two equal parallel-groups with open label pre-randomized phase. Primary outcome measure was time to relapse/recurrence of any mood episodes. Survival analyses (Kaplan-Mayer and Cox Proportional Hazard) were used for statistical analysis.

Results

Cumulative survival for valproate's group was S(104)=0.3570, (35.70% and lithium's group S(104)=0.3136, (31,36%). Valporate is superior to lithium for the treatment of non classic BD I (Log Rank 0.0309, p=0.0100). Valproate prolongs median survival time with 11±9 and mean survival time to 7±4 weeks more than lithium. Treatment with lithium has 20.4% higher relative risk for relapse/recurrence than treatment with valproate Vp (β = 0.186, p = 0.434). Valproate is superior for the treatment of BD with psychiatric comorbidity (Log Rank =0.0007. p=0.0026).

Conclusions

We found that valproate is significantly more effective than lithium in prophylactic treatment of bipolar I disorders in non-classic subtype and in bipolar disorder with psychiatric comorbidity.
P01-38 - Efficacy of Adjunctive Aripiprazole in Patients with Major Depressive Disorder: Pooled Analysis of Subgroup Data from Three Clinical Trials
Authors: Gismondi R. , McQuade R. , Loze J.-Y. , Owen R. , Berman R.
Published: June 2010

Aims

To conduct a subgroup analysis of the efficacy of adjunctive aripiprazole as treatment in patients with major depressive disorder (MDD) who demonstrated an inadequate response to standard antidepressant therapy (ADT).

Methods

Data were pooled from three identical, short-term, double-blind, placebo-controlled studies (CN138-139, CN138-163, CN138-165) with an 8-week phase of placebo plus ADT and a 6-week double-blind phase with ADT plus adjunctive placebo or aripiprazole. Only MDD patients without psychotic features were eligible for entry. The primary efficacy endpoint was the mean change in the Montgomery Asberg Depression Rating Scale (MADRS) total score in the double-blind phase. Subgroup analyses of the primary efficacy endpoint were performed for age, race, ethnicity, MADRS response, number and choice of previous ADTs, episode duration, and use of selective serotonin re-uptake inhibitors (SSRI).

Results

Compared with the adjunctive placebo group, adjunctive aripiprazole was associated with greater reductions in MADRS total score in all subgroups. Mean change in MADRS total score ranged from -10.71 to -5.89 with adjunctive aripiprazole and -7.57 to -4.10 with adjunctive placebo. No statistically significant treatment-by-subgroup interaction effects were observed for any subgroup except gender (p=0.039). This difference is, however, primarily because of results from study CN138-139 results; consistent results between men and women were reported in CN138-163 and CN138-165.

Conclusions

Pooled data indicate that in patient populations with similar baseline characteristics, treatment with adjunctive aripiprazole and ADT is efficacious in improving the symptoms of MDD in subgroups of patients having an inadequate response to ADT.
P01-39 - Adjunctive Aripiprazole in Patients with Major Depressive Disorder: Efficacy Data from three Short-term Studies
Authors: Gismondi R. , McQuade R. , Loze J.-Y. , Owen R. , Marcus R.
Published: June 2010

Aims

To evaluate the efficacy of aripiprazole as adjunctive treatment in patients with major depressive disorder (MDD) without psychotic features and an inadequate response to standard antidepressant therapy (ADT).

Methods

Data were collected from three identical, short-term, double-blind, placebo-controlled studies (CN138-139, CN138-163, CN138-165). After a single-blind prospective phase with placebo plus ADT, patients with inadequate response were randomized to 6-weeks’ treatment with adjunctive aripiprazole or placebo. The primary efficacy endpoint was the mean change in the Montgomery Asberg Depression Rating Scale (MADRS) total score during the double-blind phase. Secondary endpoints were response (≥50% reduction in MADRS total score), remission (MADRS total score ≤10 and ≥50% reduction in MADRS total score), and mean change in Hamilton Depression Rating Scale (HAM-D17) total score.

Results

In all three studies, adjunctive aripiprazole was associated with a significantly greater reduction in MADRS total score than adjunctive placebo, with a treatment difference ranging between -3.73 and -2.84 (p≤0.001 in each study). Response and remission rates with adjunctive aripiprazole (32.4-46.6% and 25.4-36.8%, respectively) were also significantly higher than with adjunctive placebo (17.4-26.6% [p< 0.05 in each study] and 15.2-18.9% [p< 0.05 in each study]). Mean change in HAM-D17 total score ranged from -7.64 to -6.77 with adjunctive aripiprazole and from -5.12 to -4.41 with adjunctive placebo (p< 0.001 for each study).

Conclusions

Results of the three studies indicate that treatment with adjunctive aripiprazole and ADT is effective in improving the symptoms of MDD in patients who have had an inadequate response to ADT.
P01-42 - G72/G30 Candidate Gene for Bipolar I Disorder is not Associated with Psychosis in the Romanian Population
Authors: Grigoroiu-Serbanescu M. , Herms S. , Diaconu C.C. , Bleotu C. , Neagu A.I. , Abou Jamra R. , Gherghel M. , Sima D. , Dan I.A. , Prelipceanu D. , Nöthen M.M. , Cichon S.
Published: June 2010

Background

The G72/G30 gene is one of the common loci shared both by schizophrenia and bipolar disorder. Studies accumulating since the discovery of this gene complex in 2002 produced controversial results in both disorders in different populations.

Objective

We investigated the association between G72/G30 gene and bipolar I disorder (BPI) in the Romanian population paying special attention to the association of G72/G30 locus with lifetime psychosis in BPI patients.

Method

Fourteen G72-SNPs were genotyped in a Romanian sample of 198 BPI patients and 180 controls screened for psychiatric disorders in the Institute of Human Genetics, Life & Brain Center of the University of Bonn, Germany. Statistical analysis was performed with FAMHAP and Haploview-v3.32. The significance level of the results was corrected for multiple testing through permutations in 100,000 Monte Carlo simulations.

Results

None of the fourteen SNPs was associated with the global diagnosis of BPI in our total patient sample or with the psychotic BPI subtype. But four SNPs reached nominal significance in the non-psychotic BPI subgroup [rs3916965 (M12) (P=0.044), rs1935057 (P=0.037), rs3916967 (M14) (P=0.043), rs2391191 (M15, non-synonymous) (P=0.043)]. In the non-psychotic subgroup, the haploblock including M14 and M15 (GA) remained significantly associated with BPI after correction through permutations (P=0.0524; OR=1.82).

Conclusion

Our results are the first replication of the study by Williams et al. (2006) reporting the same G72-SNPs [M12(A) and the functional SNP M15(A)], with the same alleles, to be associated with non-psychotic BPI disorder.
P01-50 - Hormonal Study of Depression with co Morbid Erectile Dysfunction
Authors: Khan M. , Sana N. , Gull M. , Mukhtar Z. , Chaudhry H.
Published: June 2010

Background

Erectile dysfunction is twice common in patient with depression. Testosterone plays vital role in erectile function. Low testosterone level is found in patients of depression. High level of prolactin has depressive effect on libido function. Hypogonadism and hyperprolactinemia can be the causative factor for depression. Hormonal changes can be both cause and effect of depression with ED.

Method

In sample of 76 patients having depression with co morbid ED blood levels of prolactin, and free testosterone were determined.

Half of patients were treated with sex friendly antidepressants while in other half mesterolone and piribedil were used as adjunct medicines.

Results

In 9.2% free testosterone level was below than reference value. In 28.9% prolactin level was high .51 .31% were found having border line free testosterone level.

In younger age group free testosterone level was lower than older age group. There exist inverse relation between prolactin level and free testosterone level. Patients who were given adjunct medication showed rapid improvement both for depression and erectile dysfunction.

Discussion

Reduced level of free testosterone and high level of prolactin has bilateral relation with depression with co morbid ED. Although prevalence of hypogonadism and hyperprolactinemia is low in the study yet high numbers of borderline cases are of great significance. It is postulated that fall in sexual function is directly proportional to change in levels of these hormones from the base line that are reversed by adjunct medicines.

Conclusion

In patients with concomitant major depression and erectile dysfunction hormonal changes plays important role.
P01-59 - A Multistage Chronobiologic Intervention for the Treatment of Depression: a Pilot Study
Authors: Lucian M.
Published: June 2010

Background

Several chronobiologic techniques were proposed as an alternative to antidepressant medications. The current article reports the design and the initial outcome results of a new chronobiologic multistage intervention (CMI) that is comprised of the following techniques:

(i)

partial sleep deprivation during the second half of the night(wake therapy),

(ii)

medium (green) wavelength light in combination with dawn simulation (DS),

(iii)

bright light therapy (BLT), and (iv) sleep phase advance (SPA).

Methods

The study was conducted as a set of 12 single-case designs with moderate-to-severe depressive volunteering patients. Depression, anxiety and tension measurements were taken on a daily basis beginning with a baseline measurement (T0), followed by a set of four consecutive morning measurements during the therapeutic intervention (T1-T4),and with a final measurement carried out at the end of 4 weeks of follow-up (T5).

Results

A clinically significant rapid improvement of the depressive symptoms was demonstrated and maintained for at least 4 weeks after the end of the intervention. No dropouts or compliance difficulties were observed. Sleepiness in the late afternoon hours was reported by several of the participants, but did not reach a level that interfered with their ability to function.

Conclusions

These initial findings showed the procedure to be effective and well tolerated. It affords many advantages, such as the achievement of a rapid response, no extinction of the therapeutic effect after 4weeks of follow-up, safety, high patient compliance and cost effectiveness.
P01-71 - Are Treatment Preferences Relevant for Response to Serotonergic Antidepressants and Cognitive-behavioural Therapy in Depressed Primary Care Patients?
Authors: Mergl R. , Henkel V. , Allgaier A.-K. , Kramer D. , Hautzinger M. , Kohnen R. , Coyne J. , Hegerl U.
Published: June 2010

Objectives

Little is known about the influence of patients’ preferences and expectations about offered treatments for depression on treatment outcome. Therefore, we investigated whether in primary care patients with depressive disorders receiving a preferred treatment is associated with a better clinical outcome.

Methods

Within a randomized, placebo-controlled, single-centre, 10-week trial with five arms (sertraline; placebo; cognitive-behavioural group therapy (CBT-G); moderated self-help group control; treatment with sertraline or CBT-G according to patients’ choice), 145 primary care patients with mild-to-moderate depressive disorders according to DSM-IV criteria were investigated. Preference for medication versus psychotherapy was assessed at the time of patients’ screening using a single item. To assess therapy outcome, the post-baseline sum scores of the Hamilton Depression Rating Scale (HAMD-17) were used.

Results

Depressed patients receiving their preferred treatment (sertraline or CBT-G) (N=63) responded significantly better than those who did not receive their preferred therapy (N=54) (p = 0.001). The difference in outcome between both groups was 8.0 points on HAMD-17 for psychotherapy and 2.9 points on HAMD-17 for treatment with antidepressants. This result is not explained by differences in depression severity or drop-out rates.

Conclusions

Patients’ preference for pharmaco- versus psychotherapy should be considered when offering a treatment because receiving the preferred treatment conveys an additional and clinically relevant benefit (HAMD-17: +2.9 points for drugs; +8.0 points for CBT-G) in outcome.
P01-75 - Quetiapine XR or Lithium Combination with Antidepressants in Treatment Resistant Depression
Authors: Montgomery S. , Dell’Osso L. , Kasper S. , Pitchot W. , Dencker-Vansvik E. , Köhler J. , Jörgensen L. , Bauer M.
Published: June 2010

Objectives

Compare quetiapine+antidepressant (AD) with lithium+AD, and quetiapine monotherapy with lithium+AD in open, rater-blinded treatment.

Methods

Patients with treatment resistant depression (Thase et al 1997 stage 1 and 2) with severity of MADRS ≥25 received: quetiapine XR 300mg/day plus AD (SSRIs or venlafaxine) (n=229), lithium (monitored to between 0.6 to 1.0 meq/l) plus AD (n=221) or quetiapine XR alone (300mg/day) (n=225) for 6 weeks. Primary efficacy measure was change from baseline in MADRS total score. The pre-specified non-inferiority limit was 3 points on the MADRS.

Results

Fewer patients discontinued on quetiapine+AD (15.2%) than lithium+AD (20.5%) and quetiapine monotherapy (21.5%). Quetiapine+AD and quetiapine monotherapy, were not inferior to lithium+AD in the primary (per protocol) analysis with a mean difference (97.5%CI) on the MADRS of -2.32 (-4.6 to -0.05) favouring add-on quetiapine and -0.97 (-3.24 to 1.31) favouring quetiapine monotherapy. This mandated superiority testing on the modified ITT population showing no significant difference at endpoint.

In a post hoc analysis discounting multiplicity, quetiapine+AD was significantly more effective than lithium+AD on the MADRS change from baseline, p=0.046. The advantage was observed at day 4 (p=0.007) and persisted throughout. Efficacy was supported by CGI-I (p=0.07). Quetiapine+AD showed a numerically greater advantage over lithium+AD in those with two failed treatments (Stage 2) rather than one (Stage 1).

Conclusions

Quetiapine+AD and quetiapine monotherapy, were non-inferior to lithium+AD in treatment resistant depression. There was an early significant and persistent efficacy advantage on MADRS for quetiapine augmentation compared with lithium augmentation of SSRI or venlafaxine treatment.
P01-78 - Cognitive Impairment and Altered Vigilance in Treatment Resistant Major Depression
Authors: Neu D. , Kornreich C. , Montana X. , Hoffmann G. , Sentissi O. , Verbanck P.
Published: June 2010

Introduction

Major depression (MDD) presents among other symptoms with cognitive impairment and diurnal fatigue. Residual fatigue in non-remitted patients often shows neuropharmacological treatment resistance. The relationships between cognitive dysfunction, vigilance, fatigue and affective symptom intensity is poorly described in treatment-resistant MDD (TRD).

Methods

During a prospective study protocol, 17 in-patients hospitalized for TRD were compared to a healthy control group (n=17). Patients were under SNRI or SSRI and free from diurnal benzodiazepines. All subjects underwent structured psychometry (HAMD, HAD), cognitive assessment and vigilance measurements (behavioral sleep résistance task, BSRT; psychomotor vigilance test, PVT; Auditory Verbal Learning, AVLT; trail making test, TMT). Subjective fatigue and sleepiness were assessed by the Fatigue Severity and the Epworth Sleepiness Scales respectively. All measures have been performed at two time points (T1 and T2) with a 10-day interval.

Results

T1 and T2 showed higher fatigue and sleepiness in MDD (p< 0.05). With exception for the BSRT, between group comparisons showed significant differences for all variables.Comparison for repeated measures (T1 and T2) showed improvement in depressive symptom intensity (HAMD, p< 0.0005) but cognitive and psychomotor performances only improved for the TMT (TMT-B, p=.001).

Conclusions

TRD presents here with psychomotor slowing, with impaired mental flexibility (executive function) and declarative memory dysfunction. Interestingly, despite subjective complaints (ESS), objective sleepiness (BSRT) had not been revealed. Furthermore affective symptom improvement was not associated to an increase in declarative memory or psychomotor performances.
P01-82 - Heterogeneity of DSM-IV Major Depressive Disorder as a Consequence of Subthreshold Bipolarity
Authors: Zimmermann P. , Brueckl T. , Nocon A. , Pfister H. , Lieb R. , Wittchen H.-U. , Holsboer F. , Angst J.
Published: June 2010

Context

There is growing evidence that major depressive disorder (MDD) might be overdiagnosed at the expense of bipolar disorders (BPD).

Aim

To identify a subgroup of subthreshold BPD among DSM-IV MDD, which is distinct from pure MDD regarding validators of bipolarity.

Method

Data come from the ten-year prospective-longitudinal EDSP-Study, a community survey from Munich, and were assessed with the DSM-IV/M-CIDI. Subthreshold BPD was defined as fulfilling criteria for MDD plus presence of manic symptoms, but never having met criteria for hypomania.

Results

Among 488 respondents with MDD, about 60% had pure MDD and 40% subthreshold BPD. Compared to pure MDD, the subthreshold BPD group was found to have

(a)

an increased family history of mania,

(b)

considerably higher rates of nicotine dependence and alcohol use disorders,

(c)

twice as high rates of panic disorder, and

(d)

a tendency towards higher rates of criminal acts.

(e)

In prospective analyses, subthreshold BPD converted more often into BPD during follow-up with the criterion D (symptoms are observable by others) being of critical predictive relevance.

Conclusion

Data suggest that MDD is a heterogeneous concept including a large group of subthreshold BPD, which is clinically significant and shares similarities with BPD. Findings might support the need for a broader concept and a more comprehensive screening of bipolarity.
P01-86 - The Evaluation of Relation between the Rate of Marital Satisfaction and Depression in Tekab, Iran
Authors: Rezaei Ghalechi E. , Kazemi R. , Taghavi N.
Published: June 2010

Background

Our main goal is evaluation of marital satisfaction in depressed patients and researches of the rate of depression between men and women.

Methods

This investigation is descriptive and correlation study that 93 people (48M, 45F) as the accidental samples by GRIMS and Beck depression questionnaire are collected. Results of this study by Mann Whitney Test, Kruskal-wallis Tests, Chi-square Tests and Spearman’s rho are achieved.

Results

Our study shows that 50.06% of people had relative marital satisfaction and 47.64% had minor depression. The marital satisfaction of women were more than men 49.23% the rate of women depression was high too 47.5%.

Discussion

In this study there is no meaningful relation between age, duration of marriage, sex, educations, occupational situation and marital satisfaction and depression too but there is meaningful relation between marital dissatisfaction and depression. We advise to go to psychiatrists when spouses have several problems in their sexual relation ship.