bluuebunny/crossref_metadata_2025 huggingface dataset:
FC25-02 - Functional MRI activation in response to panic-specific, non-panic aversive, and neutral imagery in patients with panic disorder and healthy controls
Authors: Wedekind D. , Gruber O. , Obst K. , Dechent P. , Engel K.R. , Ulrich K. , Bandelow B.
Published: May 2011

Introduction

There is evidence that, besides limbic brain structures, prefrontal and insular cortical activations and deactivations are involved in the pathophysiology of panic disorder.

Objectives and aims

Using fMRI, this study investigated BOLD response patterns to stimulation with individually selected panic-specific pictures in patients with panic disorder with agoraphobia (PDA) and healthy controls. Structures of interest were the prefrontal, cingulate, and insular cortex, and the amygdalo-hippocampal complex.

Methods

21 PDA subjects (12 female, 9 male) and 21 matched controls were investigated using a Siemens 3 T scanner. Before, PDA subjects gave ratings on 120 pictures showing characteristic panic/agoraphobia situations (PA). 20 pictures with the individually highest ratings were selected. 20 matching pictures showing aversive but not panic-specific stimuli (A) and 80 neutral pictures (N) from the International Affective Picture-System (IAPS) were chosen for each subject. Anxiety and depression ratings were recorded.

Results

Group comparisons revealed a significantly greater BOLD response in PDA subjects than in controls in the insular cortices, left inferior frontal gyrus, dmPFC, the left hippocampal formation, and left caudatum (p < .005), when PA and N responses were compared. Group comparisons for stimulation with A compared to PA showed activation of similar brain regions in both groups but with different peak coordinates.

Conclusions

Results indicate specific activation patterns to panic-specific picture stimulation in PDA patients. Distinct peak coordinates between PA and A differ between groups. This might implicate that the brain circuits underlying processing of aversive stimuli might differ in their function in PDA patients compared to healthy subjects.
FC25-03 - Detrimental effects of anxiety disorders on ability to work associated with a protective effect on mortality in the middle decades of life
Authors: Wedegaertner F. , Arnhold-Kerri S. , Sittaro N.-A. , Te Wildt B. , Geyer S. , Lee W.E.
Published: May 2011

Aims

Most available data about psychiatric mortality and invalidity concerns inpatients, although the majority of patients are treated as outpatients only.

It was the aim of this study to estimate the effect of anxiety disorders on early retirement and premature death in the working population with special emphasis on outpatients.

Methods

125.019 workes between age 16 and 58 were followed for an average of 6.4 years. Excess risks of death and permanent disability were calculated with multivariate Cox regression models.

Results

Outpatient and inpatient treatment for anxiety disorders (OR 1.40 resp. OR 2.10) were associated with higher risks of early retirement. Males generally were more often affected by this bad outcome than females.

Further analysis showed decreased risks of premature death for outpatients with an anxiety disorder (OR 0.33). The effect tended to be most prominent during the middle decades of life and got smaller with older age, at which all-cause mortality approximated that of the control group. No significant effect on mortality could be shown for inpatients.

Conclusions

Patients with outpatient treatment for anxiety disorders have an elevated risk of permanent disability early in life, while all-cause mortality is lower. This beneficial effect can only be partly explained by different risk-taking behaviors. Different causes of death early in life and their connections with these disorders need to be discussed, too. Treatment should have a strong focus on preserving ability to work.
FC25-05 - Revise the revised? the neuroanatomical hypothesis of panic disorder
Authors: Dresler T.
Published: May 2011

Introduction/objectives

In 2000 Gorman and colleagues published a widely cited revised version of their original neuroanatomical hypothesis of panic disorder from 1989. A “fear network” centered in the amygdala is supposed to be crucial in mediating fear-related responses. It is assumed that panic attacks result from a dysfunctional coordination of “upstream” (cortical) and “downstream” (brainstem) sensory information, resulting in heightened amygdalar activity with subsequent behavioral, autonomic, and neuroendocrine activation. The authors argue that many aspects of their revised neuroanatomical hypothesis are likely to prove incorrect, but hope it will stimulate research on anxiety disorders.

Methods

We reviewed neuroimaging studies on panic disorder to investigate in how far their results are in line with the neuroanatomical hypothesis and what inconsistencies emerge. Structural (CT, MRT), functional (PET, SPECT, fMRI, NIRS, EEG) and spectroscopic data (MRS) were considered.

Results

To some extent studies investigating panic disorder found structurally and functionally altered brain areas that have been implicated in fear processing as supposed by the neuroanatomical hypothesis. However, inconsistencies regarding increased vs. decreased volume and increased vs. decreased activity in specific areas indicate aspects that cannot easily be explained by the hypothesis.

Conclusions

The neuroanatomical hypothesis is partially supported by empirical data that may have therapeutic consequences. However, inconsistencies should be a starting point to expand the hypothesis and modify some aspects. This may include the consideration of genetics, task-specificity and the definition of subgroups.
FC25-06 - The impact of training cognitive-behavioral strategies on reduction of test anxiety in male high school students
Authors: Aalayi Z. , Gatab T. Ahmadi
Published: May 2011

Introduction

The present study has focused on the impact of training cognitive-behavioral strategies in reducing test anxiety among second-grade high school male math students.

Objectives

This study has attempted to test the hypothesis that training cognitive-behavioral strategies can help a reduction on test anxiety among anxious students.

Methods

The subjects were 72 second-grade high school students who had obtained high scores on the test anxiety scale(sarason,1978) participants were selected by a multi-stage cluster sampling method from three high schools at Tehran after administering the self-report test anxiety scale as pre-test, the subjects were then divided into two groups of control and experimental with 36 students in each groupdid not receive any treatment then, both groups were asked to complete the test anxiety scale as post-test.

Results

Analysis of variance (anova) with repeated measures was performed to analyze the data. the results revealed that there was a significant difference between the two groups and this difference was two the advantage of experimental group showing a significant reduction in test anxiety.

Conclusions

The results showed that training cognitive-behavioral strategies can reduce test anxiety.
FC26-01 - Are eccentric eating habits a manifestation of an underlying eating disorder?
Authors: Kreitler S.
Published: May 2011

Introduction

Eccentric eating habits (EEH) represent various unusual eating habits that have been widely documented. The estimates about its prevalence range from 20 to 70% depending on the defining criteria. There is disagreement about the nature of EEH, whether it represents a pathology that may develop into an ED or just fussy habits.

Objectives

To examine whether tendencies for EEH are a manifestation of an underlying tendency for EDs.

Aims

To test the hypothesis that a high level of EEH will be related to high scores on the Cognitive Orientation Questionnaire of Eating Disorders (COQ-EDs) which represents tendencies shared by the major EDs and assesses the underlying motivations for EDs.

Methods

Participants were 340 high school students (52% girls, 48% boys), 16–18 years old, from three different schools. They were administered the questionnaire of EEH, the COQ-EDs and the EAT 26 which assesses clinically significant EDs.

Results

Analyses of variance showed significant differences in the COQ-EDs scores between three groups: high scorers on EAT 26, high EEH scorers and low EEH scorers, especially between the first and the last two. A stepwise discriminant analysis provided correct identification of group membership in 77.9% (versus 33% expected by chance).

Conclusions

The findings disconfirmed the hypothesis. EEH differs from tendencies for actual EDs. In the worst case they may be a mild form of EDs. It is doubtful whether it is necessary or desirable to treat EEH.
FC26-02 - Impaired driving recidivism
Authors: Römer K.D. , Stutz E. Zemp , Briellmann T. , Dittmann V.
Published: May 2011

Introduction

Impaired driving is a threat to road-safety. In order to target preventive measures, predictive factors of recidivism are needed.

Objectives

We aimed to study relapse rates in subjects who were detected with impaired driving between 2000 and 2006 and followed up to the end of 2009.

Aimes

We aimed to analyse predictive factors of recidivism after impaired driving.

Methods

Follow-up of 1787 Swiss residents (89% men, mean age 35), in whom impaired driving was detected by laboratory analysis regarding alcohol, drugs and medications between 2000 and 2006. Criminal records (2009) were used to collect recidivism data. Mean observation time was 4.13 (SD 1.7) years. Kaplan Meier methodology and Cox analyses were conducted to analyse predictors of relapse.

Results

Within the observation period, 605 relapses were detected (33.9%). Men oftener relapsed than women, young oftener relapsed than elderly people. Most relapses were detected after driving under the influence of alcohol with BACs within prescriptive limits (48.5%). Based on Kaplan-Meier analyses the probability of recidivism was about 20% after two years less time driving licence was abstracted. According to Cox analyses, relapses were predicted by driving under the influence of drugs and by previous irregularities.

Conclusions

The present study underlines the importance of socialdemographic characteristics and previous irregularities for recidivism in road traffic. In terms of driving under the influence of alcohol it points out the difficulty of prescriptive limits for BACs and discloses a high risk for recidivism in terms of driving under the influence of alcohol and drugs.
FC26-03 - Comparison of quality of life and global function in chronic psychiatric patients before and after rehabilitation center in kashan (2009)
Authors: Ahmadvand A. , Sepehrmanesh Z. , Saei R.
Published: May 2011

Introduction

The concept of quality of life has considerably important in evaluation of efficacy of therapeutic and rehabilitation programs in all medical fields, especially psychiatric disabilities therefore any intervention which cannot improve patient’s quality of life, their effectiveness is doubt. The aim of this study is evaluation of quality of life of chronic mental patients, before and after residence in rehabilitation center.

Methodes

This study is quasi experimental that carried out on all of patients in rehabilitation center in Kashan(Iran). Demographic, Quality of Life and Global Function Scale questionnaires were used at the time of admission and next 6 months. Data were analyzed by paired T-Test and correlation tests.

Results

The mean of function level was at the time of admission 31/47+/−7/5 and after of 6 months 36/52+/−7/15, that this difference was significant (p = 0/0001).

The mean of physical quality of life was 49/28+/−16/01 at the time of admission and after 6 months was 56/64+/−16/99, so the mean of mental quality of life at the time of admission was 37/20+/− 11/10 and after follow up 46/19+/−4/05.the mean of global quality of life was 42/75+/− 10/34 at the time of admission and after 6 months 54/59+/− 12/84, which this difference was significant.(p = 0/0001)

In this study relation between age and quality of life was significant. (p = 0/0001)

Conclusion

Results showed that various factors may have role in this change. Such as type of provided services, quality of treatment, emotional support of staff and family, homogenous group therapy, organized life.
FC26-04 - Predicting of life satisfaction with respect to early maladaptive schemas among iranian college students
Authors: Sahraee O. Alizadeh , Yusefnejad M. , Khosravi Z.
Published: May 2011

Introduction

Early maladaptive schemas (EMSs) are thought to act as templates for information processing that influence individuals’ emotional reactions to life satisfaction.

Objectives

Thus,the main purpose of the present study was to predict Life Satisfaction with respect to early maladaptive schemas among Iranian college students.

Method

The research population consisted of 1700 students. Three hundred undergraduate students (150 female and 150 male) selected by multiple cluster sampling method. Short questionnaire form of early maladaptive schema (YSQ-SF) and life satisfaction questionnaire were used in this study. For analyzing the data, Pearson correlation, Step wise regression and dependent t were used.

Results

Results of correlation showed negative significant correlation between life satisfaction and early maladaptive schemas including emotional Depravation, Social isolation, Defectiveness/sham, failure, Dependence/incompetence

Vulnerability To harm illness, Subjugation, Self-sacrifice, Emotional inhibition, Unrelenting Standards /hyper criticalness and Insufficient Self-Control / Self-Discipline. Only three subscales Including Abandonment/ Instability, entitlement/ grandiosity, enmeshment/ undeveloped self, showed no significant correlation with life satisfaction. Result of regression analysis revealed that among 15 schemas, emotional Depravation, Defectiveness/sham and Dependence/incompetence schemas were best predictor of life satisfaction. In addition, the results indicated a significant difference between two groups of male and female students in subdivisions such as mistrust/abuse, failure, vulnerability to harm or illness, and unrelenting standards/hypocriticalness.

Conclusions

The findings of this study show that the assessment of EMS based on Young’s conceptualization of EMS can increase our understanding about students problems and interventions should be focused on changing these schemas.
FC26-05 - Differences in depression symptoms between RTMS responders and rTMS non-responders in a sample of tinnitus affected people
Authors: Acker J. , Scholz F. , Piehl A. , Richter K. , Niklewski G.
Published: May 2011

Introduction

The clinic of psychiatry and psychotherapy and the clinic of otolaryngology of the clinic of Nuremberg offer an interdisciplinary consultation for patients suffering from tinnitus aurium and comorbid major depression and/or insomnia.

Objectives

Prediction variables are needed regarding the treatment of subjective ear noises by low frequency rTMS.

The aim of the present study was to examine

a)

if rTMS responders and non-responders differ in significant parameters prior to the rTMS treatment

b)

and if improvement of tinnitus complaints is associated with mood change.

Methods

From June 2008 to July 2010 109 outpatients with chronic tinnitus were treated with rTMS (1 Hz, 2000 impulses, intensity 110% motor-treshold, 10 proceedings, stimulation of left auditory cortex). Prior to and afterwards the proceedings clinical assessment regarding the severity of tinnitus (TQ) and depressive symptoms (BDI II, MADRS) took place.

Results

Response to rTMS was defined as reduction in the TQ score of ≥ 5 points (54 responder, 18 female, 36 male; 55 non-responder, 16 female, 39 male). The samples did not differ in age (MR = 56,4, SDR = 13,3; MNR = 57,3, SDNR = 12,2). The subsamples differed significantly regarding depression symptoms before rTMS, as non-responder being more depressive than rTMS-responder (table 1; MADRS: p = 0.008 **; BDI II: p = 0.01**).

Furthermore there is a significant interaction between BDI and the response/non-response criterion indicating a higher decrease of depression symptoms in rTMS responders.
FC26-06 - Development of interneurons expressing serotonin 3A subtype receptor and sleep regulation
Authors: Vucurovic K. , Béra-Potelle C. , Andrei O. , Kaladjian A. , Vitalis T.
Published: May 2011

Introduction

Serotonin (5-HT) is known to play a key role in a number of psychiatric disorders. The effects of abnormal 5-HT neurotransmission on the modulation of circadian rhythm have been proposed to be one of the mechanisms underlying these disorders.

Objectives and aims

Here we describe developmental characteristics of interneurones (IN) expressing 5-HT type 3A receptor (5-HT3AR) in mice. This receptor is a ligand-gated ion channel which activation leads to a rapid excitatory response in neurons.

The expression of 5-HT3AR during embryonic development in mice is mainly restricted to caudal ganglionic eminence (CGE) and entopedoncular area (EPA). We hypothesized that these regions are those specifically involved in the neurogenesis of the IN expressing 5-HT3AR.

Methods

To assess this hypothesis, we used homochronic in utero grafts. Cells were collected from CGE and EPA regions of transgenic mice embryos expressing Green Fluorescent Protein under the control of 5-HT3AR gene promoter. After in utero transplantation in non transgenic embryo, we examined at adult age the location of the grafted cells, as well as their morphological properties.

Results

We observed that CGE-derived cells gave rise to IN that mostly populated the neocortex and the hippocampus, whereas EPA-derived cells integrated the amygdala, the pyriform cortex and the Ventro-Lateral Pre-Optic (VLPO) nucleus. Moreover, the VLPO EPA-derived cells are similar to “sleep active cells” found in this region and responsible of sleep induction.

Conclusion

These results lead to the better understanding of the IN expressing 5HT3AR development. Its activation is possibly implicated in triggering sleep mechanismes.
FC27-01 - Youth matters in London: Mental health, addiction and homelessness
Authors: Forchuk C. , Giustizia S. , Annett N. , Connoy M. , Csiernik R. , Diaz K. , Edwards B. , Elkin D. , Fisman S. , Godin M. , Jeng M. , Laverty K. , Mitchell B. , Norman R. , Ouseley S. , Richardson J. , Rudnick A. , Wilk P.
Published: May 2011

This project will work closely with existing service partners involved in street level services and focus on testing and evaluating three approaches for street level interventions for youth who are homeless and who have severe or moderate mentally illness. Youth will be asked to choose their preferred service approach:

Housing First related initiatives focused on interventions designed to move youth to appropriate and available housing and ongoing housing supports.

Treatment First initiatives to provide Mental Health/Addiction supports and treatment solutions, and; Simultaneous attention to both Housing and Treatment Together

Our primary objective is to understand the service delivery preferences of homeless youth and understand the outcomes of these choices. Our research questions include:

1.

Which approaches to service are chosen by youth?

2.

What are the differences and similarities between groups choosing each approach?

3.

What are the critical ingredients needed to effectively implement services for homeless youth from the perspectives of youth, families and service providers?

Focus groups with staff and family members will occur to assist in understanding the nature of each of service approach, changes that evolve within services, & facilitators and barriers to service delivery. This work will be important in determining which approach is chosen by youth and why. Evaluating the outcomes with each choice will provide valuable information about outcomes for the service options chosen by youth. This assist in better identifying weaknesses in the services offered and inform further development of treatment options that youth will accept.
FC27-02 - Psychiatric co-morbidity predicts acute hospitalization among adolescents with type 1 diabetes mellitus
Authors: Butwicka A. , Fendler W. , Zalepa A. , Mlynarski W. , Gmitrowicz A.
Published: May 2011

Introduction

During the 90's, there was a dramatic increase (more than 200%) of the incidence of type 1 diabetes in the Polish pediatric population. During the first decade of onset of the disease, 48% of the prospectively monitored children developed psychiatric disorders.

Objectives

To determine the influence of psychiatric co-morbidity on hospitalization for complications among children and adolescents with type 1 diabetes (T1DM).

Methods

One hundred seventy patients (age range: 8-18 years) with T1DM were evaluated using semi-structured diagnostic interview (K-SADS-PL). Current and past episodes of psychopathology were assessed according to DSM-IV criteria. The effect of psychiatric symptoms for number and times of hospitalizations due to medical complications per year was assessed by using General Linear Model. The mean time of observation was 4,0 ± 2,0 years.

Results

The median number of days per year of acute hospitalizations was 4,0 (Interquartile Range 0.0-6.8) for group with co-morbidity and 2.6 (0.0–4.6) for group without; also the median of average number of hospitalizations was 0.4 (0.0–0.8) and 0.3 (0.0–0.5) respectively. Psychiatric co-morbidity was associated with number (beta = 0.19; p < 0.05) and duration of hospitalizations (beta = 0.16; p < 0.05) per year.

Conclusions

Young people with type 1 diabetes and psychiatric co-morbidity are at increased risk of hospitalization for disease complications. Interventions aimed at routine psychiatric screening followed by treatment may decrease the number of acute hospitalizations.
FC27-03 - A follow-up study of former child and adolescent psychiatric patients’ psychiatric care in adulthood
Authors: Engqvist U.
Published: May 2011

Introduction

In Sweden there are three psychiatric disciplines, general psychiatry (GenP), forensic psychiatry and child and adolescent psychiatry (CAP). There are many similarities between GenP and CAP, but despite this, there is a virtual lack of information regarding possible early symptoms of mental disorders, and how they change during the process of maturing from childhood to adulthood.

Aims and objectives

An overall aim was to provide information about CAP-patients and their outcome as adults. This study describes and discusses the transition between CAP and GenP and illustrates the question if and which CAP-patients will proceed as patients within GenP.

Methods

1,400 patients, originally treated as in- and outpatients by CAP services were subsequently followed-up into mid-adulthood using official registries and hospital records.

Results

At least a third of all CAP patients were later admitted to GenP. However, this group constituted only eleven percent of the corresponding age groups of GenP-patients. There seems to be a weak connection between diagnoses given to patients in CAP and later in GenP care.

Conclusions

At least three different pathways for becoming in need of GenP care as adults were identified. First, a “developmental trajectory” with early symptoms of parental neglect, later need of unspecific paediatric hospital treatment, school failure, behavioral problems and referral to CAP. Another way relates to the relatively uncommon development of psychotic disorders. However, the most common way relates to “adult problems” in the categories neurotic and stress-related disorders where the problems seem to have developed from accumulated stressful life-events.
FC27-04 - School-based professional screening of risk behaviours in European adolescents - does risk behaviour account for adolescent psychopathology?
Authors: Kaess M. , Resch F. , Brunner R. ,   The SEYLE Study Group
Published: May 2011

Objectives

To develop a school-based screening for adolescent risk behaviour and psychopathology and to investigate the predictive value of different adolescent risk behaviours in terms of suffering from psychopathology that requires mental health care.

Methods

A two-stage professional screening was developed and constituted in the randomized-controlled prevention trial “Saving and Empowering Young Lives in Europe (SEYLE). A school-based screening consisting of a self-report screening questionnaire and a semi-structured professional interview in case of being identified as at-risk were performed in a representative sample of almost 2,000 adolescents within the SEYLE sample of about 8,000 students from 7 European countries and Israel.

Results

A very high percentage of students were detected to be at-risk by either showing risk behaviour or psychopathology or both in the first stage of the screening. From these students, only about one third came to the study center and took part in the interview. About half of of the interviewed students reached were referred to mental health care.

Conclusions

Risk behaviours are very common among European adolescents and may also have increased during the last years. Nevertheless, most risk behaviours are weak predictors for suffering from psychopathology that requires mental health care compared to psychopathology or suicidal behaviour theirselves. Although they are certainly unhealthy and badly influencing adolescent development risk behaviours seem to be an ubiquitous phenomenon during adolescence and cannot simply be regarded as signs for severe psychopathology.
FC27-05 - Do parental practices influence child mental health? A Greek longitudinal study
Authors: Bakoula C. , Vassi I. , Veltsista A. , Palili A. , Gika A. , Kolaitis G.
Published: May 2011

Introduction

Research about the continuity of mental health problems from childhood to adolescence and the influence of parenting practices on these is limited, but necessary for appropriate family counselling.

Objectives

To examine the relationship between aspects of parental control, such as monitoring, physical punishment, and unlimited material provision, on the emotional and behavioural health of children up to adolescence.

Methods

A representative sample of 2695 Greek adolescents was followed-up from birth to 18yrs. Mental health problems at 7 and 18yrs were assessed by the Rutter A2 and YSR psychometric tools, respectively.

Results

A strong correlation was found between behavioural problems in childhood and adolescence for both genders, while emotional problems were more likely to persist in boys. Age and sex-specific models revealed significant positive associations between frequent use of physical punishment during childhood and Total, Emotional, and Conduct problems in both genders, while parental monitoring was associated with higher scores on Conduct and Total problems mostly in boys at 7yrs. Parental monitoring was more strongly linked to psychological problems in adolescence, while the relationship between punishment and mental health problems was stronger in 7-year-olds than in adolescents. Material provision in childhood was not associated with the outcomes. The long-term effect of parenting strategies on adolescent mental health was mediated or confounded by mental health status at 7yrs.

Conclusions

Early interventions are necessary as mental health problems strongly persist from childhood to late adolescence. The adverse effects of unsuitable parental practices need to be recognised and improved.
FC27-06 - Using mobile phones to detect, treat, and manage adolescent mental halth: A randomised controlled trial of the mobiletype program in rural and metro primary care
Authors: Reid S. , Kauer S. , Patton G.
Published: May 2011

The mobiletype program is a cell/mobile phone mental health assessment and management tool designed specifically for young people aged 14–24 years to assist in detecting, managing, and treating of youth mental health problems. The mobiletype self-starts 4 times per day and the patient completes a brief survey of their current mood, stresses, coping, alcohol and cannabis use, exercise, sleeping and eating patterns. This data is transmitted in real- time to a website interface which collates it and produces individual reports for young people to share with their doctor.

Methods

118 young people identified with mild or more mental health symptoms were blindly randomly allocated at the individual level, to either the intervention group (mobiletype plus usual care) or the comparison group (abbreviated mobiletype plus usual care) according to CONSORT guidelines. Participants and doctors completed baseline and follow-up questionnaires measuring mental health, patient-doctor relationship, and pathways to care (i.e. referrals, medication, and testing). Participants were followed-up at 6 weeks and 6 months.

Results

Results from fixed effects analyses of covariance examining the differences between the experimental and control groups on the main outcome measures, with the baseline values as the covariates will be presented. The extent to which the mobiletype program reduces mental health symptoms, enhances the patient-doctor relationship and assists patients in pathways to care will be explored in detail.

Conclusions

Mobile and new information and connected technologies have much to offer clinical care in terms of increased efficiencies in data collection, increased engagement of participants and overall enhanced care.
FC28-01 - Psychosocial interventions for people with dementia in Irish residential settings: What nurses and health care assistants know, do and want to learn
Authors: Hunter A.
Published: May 2011

Introduction

35.6 million people are living with dementia worldwide. Up to 40% of people with a dementia go into residential care. There is a need to understand PSI practice and training requirements of practioners.

Objectives

Interview and observe stake holders (service users, carers, educationalists and practitioners). Participants were asked to explore their understanding of the value of PSIs. Develop grounded theory to inform the development of a structured education programme for PSIs.

Aims

Identify current practice and the potential to develop PSI training. Contribute to a structured education programme. Develop a framework for the implementation of PSIs.

Methods

Classical Grounded theory.

Results

Delivery of PSIs is dependent upon the influence of: attributes, experience and education. These factors are affected by the need to be flexible and individual ideas of what is effective. All of these factors are shaped by the need to make the most of limited resources and complete basic physical tasks.

Conclusions

A complicated range of influences impact upon the delivery of PSIs. Theory developed indicates that PSI education must address practitioner attitude and emphasise the benefits to staff efficiency and reducing agitation in people with dementia along with improving the quality of life of people with dementia.
FC28-02 - Generalized anxiety disorder in the elderly. An Italian population-based study
Authors: Forlani M. , Atti A.R. , Attili T. , Morini V. , Forlani C. , Cimino L. , Dalmonte E. , De Ronchi D.
Published: May 2011

Introduction

The longevity of population is an evidence over the past decades. Elderly physical and mental health are imperative. Despite anxiety is common and has adverse consequences, literature is meagre.

Objectives

To estimate the prevalence of generalized anxiety disorder (GAD) in elderly and to investigate the association with physical comorbidity, depression, daily habits.

Methods

426 subjects from the population-based Faenza Community Aging Study (De Ronchi et al 2005), mean age 85,1 (Standard Deviation = 6,9). The Geriatric Anxiety Inventory short-form (GAI-sf) was utilized to define GAD (score ≥ 3). Logistic-regression were used to estimated odds ratio and 95%Confidence Intervals (CI).

Result

Subjects with anxiety were 84 (21,2%), 63,1% were women. For age < 80 the prevalence of GAD was 38,1% while for age> 95 was 4,8%. When we compared elderly with GAD to elderly not affected we found the following results: no hobbies (83,3% vs 79,6%) p = 0,124, no friendship (21,8% vs 15,8%) p = 0,425, they don’t make physical activity (53,7% vs 45,6%) p = 0,214 than subjects without anxiety. To have comorbidity was associated with anxiety: one disease OR (CI95%) = 2,71 (1,15–6,24), two or three OR (CI95%) = 2,57 (1,07–6,16) and > three OR (CI95%) = 7,5 (1,81–31,05). Hypertension was positively associated with anxiety OR (CI95%) = 1,94 (1,04-3,62). Depression was highly correlated with anxiety OR (CI 95%) = 5,82 (3,39–9,98). Moderate alcohol consumption was negative associated with anxiety OR(CI 95%) = 0,49 (0,25–0,95).

Conclusion

Anxiety in elderly is frequent and should be actively investigated especially in elderly with comorbidity.
FC28-03 - Are there effective strategies for communicating with Alzheimer patients?
Authors: Trascu R. , Spiru L.
Published: May 2011

Introduction

Diagnosing Alzheimer Disease (AD) is a long-lasting process, mainly due to the variability of initial symptoms (i.e. memory problems, speech difficulties, behavioral changes). Patients are usually either unaware of their difficulties or attempting to conceal them.

Aims

We wanted to establish whether, based on existing knowledge, a better understanding of the leading causes of miscommunication can overcome communication barriers for AD patients.

Objectives

We tried to summarize the existing recommendations and gold-practices and to contract them into key messages in order to improve quality of communication.

Method

We performed a systematic overview of medical literature (PubMed search, disclos* OR communic* NOT communicate AND Alzheimer), selecting of the 516 resulting titles those papers focused on doctor/patient and doctor/caregiver communication issues.

Results

Specific communication requirements were identified for effective collaboration between

(1)

physician and patient,

(2)

physician and patient's caregivers/family and

(3)

caregivers/family and patient.

A minimal set of communication skills and predictable courses of action was further developed, depending on

(a)

best practices and

(b)

recommended practices.

Conclusions

Although communicating with people with Alzheimer is difficult, quite often the communication barriers are mainly due to an inaccurate perception of the disease and of patient limitations and disabilities. Understanding the mechanisms involved and acquiring certain interpersonal habits may significantly improve communication effectiveness, particularly in mild and moderate AD.
FC28-04 - Quality of life assessment after cardiac surgery in octogenarians: Is it really feasible?
Authors: Pontoni G. , Ferrari S. , Gabbieri D. , Pedulli M. , Gambetti D. , Ghidoni I. , Rigatelli M.
Published: May 2011

Introduction

Cardiac surgery is being performed more frequently in octogenarians with huge pressure on health care resources. Quality of Life (QoL) improvement should be the primary goal in this high-risk patients.

Aims/objectives

This study evaluates the feasibility of QoL assessment in octogenarians after cardiac surgery.

Methods

QoL was assessed by three self-administered psychometric tests: modified Seattle Angina Questionnaire, SF-36, and Hospital Anxiety and Depression Scale. QoL was evaluated after a mean time of 5.5 years after operation in 86 patients, and before and 6 months after surgery in 21 patients.

Results

Retrospective evaluation of QoL showed absence of physical limitation in 50% of patients, treatment satisfaction in 80%, symptoms-free conditions in 62%, poor or absent disease perception in 94%, satisfactory wellbeing and enjoyment of life in 78%. QoL six-month variance analysis showed significant improvement in 4 of 5 modified SAQ domains (except of Treatment Satisfaction), 6 of 8 SF-36 domains (except of Emotional Role Limitation and Vitality), and in both depression and anxiety HADS subscales. However, test's self-administration failed, always necessitating physician and relatives’ help. Moreover, several questions showed to be unfit for this subset of patients.

Conclusions

Despite the emerged limitations using these tests, cardiac surgery seems to improve QoL in octogenarians with cardiac disease. After 5 years the prevalence of physical disability, cardiac symptoms and functional limitation due to cardiac symptoms, are comparable to the overall octogenarian population. QoL improvement appears more evident 6 months after the operation. New suitable tests are required for old patients.
FC29-01 - Reduced cortical inhibition in violent offenders: A study with transcranial magnetic stimulation
Authors: Philipp-Wiegmann F. , Römer K.D. , Retz W. , Rösler M.
Published: May 2011

Introduction

Aggression and violent behaviour are often noticed as a threat of society. Therefore, the understanding of violent behaviour has high social relevance.

Objectives

The investigation sample comprised 80 right-handers: 40 prisoners who committed severe violent crimes and 40 controls with no history of violence. All subjects were male and matched for age.

Aimes

We performed a study with transcranial magnetic stimulation (TMS) in a sample of violent offenders in order to measure cortical inhibition in the motoneural system which is part of the frontal cortex.

Methods

To investigate the intracortical inhibition and the intracortical facilitation we conducted paired-pulse stimulation according to the technique of Kujirai et al. (1993). The investigation sample comprised 80 right-handers: 40 prisoners who committed severe violent crimes and 40 controls with no history of violence. All subjects were male and matched for age.

Results

Using the paired-pulse paradigm with interstimulus intervals (ISI) of 1–15 ms, a reduced cortical inhibition (ISI 3 ms) was found in violent offenders compared with control subjects in the left cortex.

Conclusions

These findings corroborate the hypothesis of inhibition deficits in violent offenders when compared with control subjects due to a lack of impulsive control.
FC29-02 - Is prenatal exposure to alcohol a factor which re-program the brain?
Authors: Sliwowska J.H.
Published: May 2011

Introduction

Fetal programming refers to the concept that early environmental factors, including prenatal exposure to stress and drugs, can permanently organize or imprint physiological and behavioural systems and increase vulnerability to disorders such as depression and anxiety later in life.

Aims

Is prenatal exposure to alcohol a factor which re-programs the brain?

Objectives

Effects of prenatal alcohol exposure (PAE) on:

1)

the hypothalamus-pituitary-adrenal (HPA) axis;

2)

the hypothalamus-pituitary-gonadal (HPG) axis;

3)

serotonergic (5-HT) system and

4)

adult hippocampal neurogenesis are presented.

Methods

Offspring from prenatal ethanol (PAE), pair-fed (PF) and ad lib-fed control (C) dams are studied across the development or in adulthood. Immunocytochemistry and in situ hybridization techniques are used.

Results

In term of the HPA axis: PAE alters the balance of mineralocorticoids/glucocorticoids (MRs/GRs) receptor levels in the hippocampus of adult females. In the case of the HPG axis: PAE delays puberty and changes hormonal profiles in males and females. PAE also decreases numbers of 5-HT-immunoreactive neurons in the dorsal raphe nucleus of the brainstem in ovariectomized rats and estradiol and progesterone modulate those effects. Finally, in adult PAE males, but not females stress-induced decrease in neurogenesis is altered.

Conclusions

In our animal model PAE re-programs the brain. Effects of PAE are long-lasting, affect HPA and HPG axes, 5-HT system and adult hippocampal neurogenesis and if seen in humans could contribute to increased vulnerability to depression and anxiety.
FC29-03 - Effects of chronic oral treatment with aripiprazole on expression of nmda receptor subunits and binding sites in rat brain
Authors: Zink M. , Segnitz N. , Ferbert T. , Schmitt A. , Gass P. , Gebicke-Härter P.J.
Published: May 2011

Introduction

The glutamatergic theory of schizophrenia proposes a dysfunction of ionotropic N-Methyl-D-aspartate (NMDA)-receptors (NR). Several therapeutic strategies address NR function and effects of antipsychotic agents on NR expression have been described.

Objectives

The partial dopaminergic and serotonergic agonist aripiprazole (APZ) was able to counteract behavioural effects of NR antagonists, but effects of APZ on NR expression have not been investigated.

Aims

To evaluate effects of APZ on NR mRNA and protein expression

Methods

We treated Sprague-Dawley rats for 4 weeks or 4 months with APZ in daily oral doses of 10 and 40 mg per kg body weight. Expression of the NR subunits NR1, NR2A, NR2B, NR2C and NR2D was assessed by semiquantitative radioactive in situ-hybridization, and in parallel receptor binding using 3H-MK-801 receptor autoradiography.

Results

Increased expression levels of NR1 (4 weeks), NR2A (4 weeks), NR2C (4 weeks and 4 months) and NR2D (4 months) were observed in several hippocampal and cortical brain regions. The parallel reduced expression of NR2B mRNAs (4 months) resulted in a relative increase of the NR2A/NR2B ratio. Marked differences between specific brain regions, the doses and time points of assessment became obvious. On the receptor level, increased MK-801-binding was found after 4 weeks in the 40 mg-group and after 4 months in the 10 mg-group.

Conclusions

The effects of APZ converge in enhanced NMDA-receptor expression and a shift of subunit-composition towards adult-type receptors. Our results confirm regulatory connections between dopaminergic, serotonergic and glutamatergic neurotransmission with relevance for cognitive and negative symptoms of schizophrenia.
FC29-04 - Gene-brain -environment interactions in violent behavior
Authors: Staniloiu A. , Markowitsch H.J.
Published: May 2011

Introduction

The prediction, prevention and treatment of violence pose several challenges that are partly due to incompletely described neurobiological underpinnings of human violent behavior.

Objectives

This work's objectives are establishing greater recognition of the neurochemical substrates of violent behavior and importance of the gene-environment interplay in the development of violence, distinguishing the components of the functional neural networks involved in violent behavior and facilitating the interpretation of relations between brain damage and alterations in social behavior from a perspective that takes into account variables such as developmental phase, brain-environment interactions and neuroplasticity.

Aims

We provide an overview of the neurobiological underpinnings of violence and the roles and advantages of using static and functional brain imaging in studying violent behavior.

Methods

A comprehensive review of the scientific literature on the neurobiology of violence was performed. A theoretical framework for the possible role of epigenetic factors in mediating the predisposition for violence is advanced.

Results

Research data from various fields (such as genetics, cognitive and affective neurosciences, static and functional neuroimaging) suggest that the predisposition for violent behavior is influenced by both genetic and environmental factors. Epigenetic mechanisms underlying lasting environmentally-induced modifications in gene expression have recently been implicated in the pathogeny of various psychiatric and non-psychiatric diseases and social behavior disturbances.

Conclusions

The genetic, neurochemical and neuroimaging findings from various studies emphasize the complex role of the gene-environment interplay in the pathogenesis of violence and open a path of hope for the development and optimal timing of violence prevention strategies.
FC29-05 - Season, sunlight, and brain serotonin function
Authors: Praschak-Rieder N. , Willeit M. , Sitte H. , Meyer J.H. , Kasper S.
Published: May 2011

Introduction

Many experience low mood and energy during winter. Brain serotonin is involved in the regulation of many physiologic and pathologic functions that vary with season. Seasonal variations in peripheral serotonergic markers have been described in clinical and nonclinical populations, and a postmortem study shows seasonal differences in hypothalamic serotonin concentration.

Aim

We investigated the molecular background of seasonal changes in serotonin function by conducting a series of studies on serotonin transporter (5-HTT) density and function in depression and health.

Methods

In a large study in drug-free patients with seasonal affective disorder (SAD) we aimed at detecting state-related alterations in 5-HTT-mediated inward and outward transport in platelets. Another study in healthy subjects aimed at detecting seasonal variations in 5-HTT binding in the living human brain using [11C] DASB positron emission tomography. Regional 5-HTT binding, an index of 5-HTT density, was assessed in a large sample of drug-naïve healthy volunteers, and was related to meteorological and astronomical data.

Results

In patients with SAD we showed that the 5-HTT is in a hyperfunctional state during winter depression, and normalizes after light therapy and in natural summer remission. In healthy subjects, 5-HTT binding was higher in autumn/winter as compared to spring/summer. Regional 5-HTT binding correlated negatively with daily sunshine, such that higher values occurred at times of lesser light.

Conclusions

Since high 5-HTT density is associated with low synaptic serotonin levels, regulation of 5-HTT density and 5-HTT function by light is a mechanism that may explain seasonal changes in normal and pathologic behaviours.
FC29-06 - Psychological stress causes relative infertility through direct change in the frequency pattern of GnRH release from the hypothalamus
Authors: Pirkalani K.K. , Talaee Rad Z.
Published: May 2011

Objectives

Evaluation of oscillation pattern of GnRH release by the hypothalamus in different mental states

Materials and methods

Twenty two patients were evaluated by a computer algorithm to find oscillation of LH/GnRH pulsation measured on four sessions (day 6 and 14) every 10 minutes within two consecutive cycles in addition to the MCMI-III and Hamilton test.

Results

The pattern of oscillation was indirectly correlated with Hamilton scale and the anxiety state and showed statistically significant lowering of frequency during anxiety and depression states. Besides, the slope of GnRH between two consecutive sessions (d0GnRH0/GnRH1dt) showed also a prominent reduction and even flattening. In addition the time to ovulation was also postponed in cycles with prominent anxiety.

Conclusions

1.

Psychological stress exerts its effect through a reduction of pulsation frequency in GnRH release.

2.

Pattern of GnRH pulsation changes in the range of ¼ to 1/15 of the baseline and external stimuli have strength of changing hormonal milieu in this range.

3.

MCMI-III is an excellent tool for evaluating psychological state of the patient.

4.

Patients with borderline, schizoid, dependent, depressed and passive aggressive personality suffer most from irregularity of menstruation cycles.

5.

Patients with chronic major depression are subject to menstrual irregularity highest during stabilization of disease and in the early phases of recovery after treatment with SSRI.

6.

Treatment of depression/anxiety causes a reduction of menstrual cycles length.

7.

Measurement of GnRH, FSH, LH and Estradiol on two sessions one week apart is a nice marker for regularity and ovulation.