bluuebunny/crossref_metadata_2025 huggingface dataset:
Comparison of Brain Morphology in Alzheimer’s Dementia in the General Population and Demented Subjects with Down’s Syndrome
Authors: Mullins D. , Daly E. , Simmons A. , Johnston P. , Murphy K. , Lovestone S. , Murphy D.
Published: March 2009

Aim:

To compare Magnetic Resonance Imaging (MRI) findings in Alzheimer's dementia (AD) in the general population with Down's syndrome dementia.

Background review: AD is characterised by cognitive dysfunction interfering with activities of daily living. Mild cognitive impairment (MCI) is an intermediate state between normal aging and dementia. People with Down's syndrome have an increased risk of developing AD. AD pathology initially appears in the entorhinal cortex, followed by the hippocampus and later in the temporal lobes. These areas are critical for memory functioning.

Method:

Volumetric analysis was performed on MRI brain scans using Measure software. Manual tracing was undertaken for the hippocampus, temporal lobes and lateral ventricles as well as the total brain volume of the cerebral hemispheres and cerebellum. Brain volumes were normalised as a percentage of traced intracranial volumes. Freesurfer software was used to obtain entorhinal cortical thickness measures. Statistical analysis was undertaken using SPSS15.

Results:

Subjects with AD (n=46), MCI (n=28) and controls (n=39) were compared with Down's syndrome demented subjects (DS+, n=20), non-demented subjects with Down's syndrome (DS-, n=45) and age-matched controls (n=43). Hippocampi, entorhinal cortex and temporal lobes were significantly reduced in AD and DS+ compared to controls. Lateral ventricles were significantly increased in AD and DS+ compared to controls. MCI and DS- produced findings between those of dementia and controls.

Conclusions:

Critical memory regions atrophy in dementia corresponding to decreased cognitive functioning. DS+ morphology is comparable to AD in the general population but the atrophy is less pronounced.
Dementia in Alzheimer’s Disease: A Comparison of MRI and 1H-MRS Findings Between Alzheimer’s Disease and Mild Cognitive Impairment
Authors: Mullins D. , Lamar M. , Daly E. , Simmons A. , Murphy K. , Lovestone S. , Murphy D.
Published: March 2009

Aim:

To compare Magnetic Resonance Imaging (MRI) and Magnetic Resonance Spectroscopy (1H-MRS) between people with Alzheimer's disease (AD) and mild cognitive impairment (MCI).

Background review:

AD is characterised by cognitive impairment. 10-15% of people with MCI progress to dementia each year. The hippocampus is involved in memory functioning and is one of the brain regions first affected by AD. MRI based hippocampal volumetric measurement enables accurate quantification of atrophy. In addition, 1H-MRS can be used to measure concentrations of brain metabolites including myoinositol (mI) and N-acetylaspartate (NAA). NAA is a proxy measure of neuronal density.

Method:

Subjects with AD (n=46), MCI (n=28) and controls (n=39) were scanned using a 1.5 Tesla MR system. Manual tracing of hippocampal volumes was undertaken using Measure software. 1H-MRS voxels of interest were defined in the left and right hippocampi. A point-resolved spectroscopy pulse sequence produced spectra from each voxel and clearly resolved NAA and mI peaks. Statistical analysis was undertaken using SPSS15.

Results:

Hippocampal volumes were significantly reduced between AD and controls (p=0.003) and between AD and MCI (p=0.001). Compared to controls, individuals with AD and MCI had a significant reduction in [NAA]. MCI showed a non-significant increase in [mI]. A positive relationship was found between hippocampal volume and [NAA] and between hippocampal volume and [mI] for MCI.

Conclusions:

AD is associated with decreased viable neuronal density/function (as measured by NAA) and a reduction in hippocampal volume associated with impaired cognitive functioning. The elevated [mI] in MCI may be a “tipping point” into dementia.
Neural Activation During the STROOP Task in Bipolar Disorder Patients and Their Unaffected Relatives
Authors: Pompei F. , Haldane M. , Kempton M. , Jogia J. , Girardi P. , Tatarelli R. , Frangou S.
Published: March 2009

Aims:

To examine potential similarities in neural activation during the STROOP colour word test (SCWT) in patients with Bipolar Disorder (BD) and their unaffected first degree relatives of BD patients as an expression of genetic predisposition.

Methods:

39 remitted BD patients were compared to 46 of their healthy relatives and to 42 controls. fMRI data were collected on a 1.5 T GE Signa MR system using a blocked periodic design and analysed in SPM5.

Results:

There was no statistically significant group difference in the behavioural performance. At the corrected cluster level threshold of p< 0.001 controls showed more activation than:

a.

BD patients in the caudate, the inferior (BA 47), middle and superior frontal gyri (BA 8, 6, 46), the parietal cortices (BA 7, 40), the precuneus and occipital cortices (BA 7, 19).

b.

Relatives in the caudate and cingulate cortex (BA 24, 31!). No other contrasts were significant.

Conclusion:

These findings suggest that changes in neural activation during response inhibition may reflect genetic predisposition to BD.
Affect Recognition Deficits in First Episode Schizophrenia and in Subjects with Anxiety Disorders: An ERP Study
Authors: Mazza M. , Lucci G. , Pollice R. , Roncone R. , Casacchia M.
Published: March 2009

Aims:

Disturbances in affect recognition may be one of the most pervasive and serious aspects of the schizophrenic patient's interpersonal problems. Many of the studies used chronic patients, and therefore present difficulties in interpretation of results, due to the confounding influence of institutionalization, length of disease, cognitive deficits, and positive symptoms. If emotion recognition deficits are a core feature of schizophrenia, they should be apparent in a first-episode sample.

Aim of the study was to examine affect recognition deficits in first psychotic episode and in young suffering of anxiety disorders (using a case-control design) during event-related potentials (ERPs).

Method:

Pictures from Ekman and Friesen series has been used in an ERPs study to investigate the neurophysiological correlates of the emotional processing of fear and happiness in patients with first episode (N°12) and in patients (N°12) with anxiety disorders versus healthy subjects. The three groups were compared using a visual oddball design.

Results:

Significant differences between groups in ERP components, the P100, N170, and N250 latency and amplitude differences for target stimuli faces were found. Significant differences were also observed in amplitude between positive and negative expression. First episode schizophrenic patients showed reduced amplitude in front of positive vs. negative stimuli. Anxious subjects did not show amplitude difference between the two kinds of emotional stimuli.

Conclusion:

We can hypothesized that subjects with first-episode show specific altered patterns of cognitive effort in the perception of different emotional stimuli compared to normal controls and subjects affected by anxiety disorders.
The Role of Quantitative Electroencephalography in Psychiatry
Authors: Rodrigues T. , Saavedra I.
Published: March 2009

Background:

The more recent advances in the field of Neurosciences include the study of abnormal pathophysiological findings in patients suffering from Psychiatric disorders. Several new brain imaging technologies are conveying numerous data concerning structural and functional abnormalities in such patients.

Aims:

To provide an overview of the role of quantitative Electroencephalography (qEEG) in Psychiatry.

Methods:

Review of the literature.

Results:

Among the various imaging studies, the application of three-dimensional qEEG may be the most practical and economic alternative. The qEEG consists in the statistical analysis of the EEG parameters, with computer-treated data. It is a portable, radiation-free, non-invasive method that measures excitatory and inhibitory cortical neuronal activity directly.

Conclusion:

The latest literature regarding the potential role of the qEEG in Psychiatry debates its applicability in clinical settings. Several authors have been trying to evaluate its usefulness in clinical diagnosis and prediction of response to medication. We review the possible recommendations for the use of this test and the controversies surrounding them.
Meta-analysis of Magnetic Resonance Imaging Studies in Velocardiofacial Syndrome (VCFS)
Authors: Tan G. , Arnone D. , McIntosh A.M. , Ebmeier K.P.
Published: March 2009

Introduction:

Velocardiofacial syndrome (VCFS) is a common genetic disorder due to a micro deletion on chromosome 22q11. This region includes several risk-associated genetic variants, including COMT, and VCFS is associated with a substantially increased risk for schizophrenia. As such, VCFS may serve as a valuable model for clarifying the neuroanatomical changes associated with genetic risk for psychosis.

Methods:

A systematic literature search was conducted. Studies were included if they presented original data and were published by March 2008, compared subjects with VCFS and healthy controls and reported measures of brain regions according to SI units as mean and standard deviation. Data extracted from the studies included diagnosis, demographic variables and IQ. Statistical analysis was conducted using STATA 8.0 supplemented by ‘Metan’ software.

Results:

Twenty studies were retrieved. All measures were expressed in volumes apart from the corpus callosum (area). Subjects with VCFS showed reduced total brain volume (N=156 versus N=138), ([ES]=1.04, 95% CI:1.40, -0.67), with no significant heterogeneity or publication bias. This reduction was reflected in total hemisphere grey and white matter. Prefrontal, parieto-occipital and temporal cortices appeared to be particularly affected. A number of sub-cortical areas also showed decreased volumes including the hippocampus and putamen. In contrast, callosal areas were increased in VCFS.

Conclusion:

In relation to controls, subjects with VCFS present with an overall reduction in brain volumes and specific abnormalities in multiple cortical and subcortical brain regions. These abnormalities may explain partly why VCFS is associated with a greatly increased risk of psychosis and other psychiatric disorders.
Gender Differences in [123I]-ADAM Binding to Serotonin Transporters in Patients with Major Depression Before and After Treatment with Citalopram
Authors: Uebelhack K. , Franke L. , Herold N. , Plotkin M. , Amthauer H. , Uebelhack R.
Published: March 2009

Aims:

The aim was to determine the relation between characteristics of [123I]-ADAM binding to serotonin transporters (SERT) in several brain regions to different symptoms in patients diagnosed with major depressive disorder (MDD) and to analyze data for males and females separately. Differences of [123I]-ADAM binding in patients before and after treatment with Selective Serotonin Reuptake Inhibitor (SSRI) antidepressant Citalopram were assessed.

Method:

12 non medicated patients (5 females and 7 males) diagnosed with MDD were examined by SPECT with specific Serotonin transporter radioligand [123I]-ADAM before and after treatment with SSRI Citalopram. We administered the dose of 10 mg Citalopram per day intravenously at first day, followed by a 6 days period of oral application. After 7 days of treatment patients were examined for second time with SPECT. The relationships between [123I]-ADAM binding and different aspects of major depression represented by HAMD items, assessed twice by Hamilton Depression-Scale (HAMD) once at baseline and second after treatment period, were evaluated.

Results:

We found significant correlations with significant gender differences between singular sub items of HAMD and indices of [123I]-ADAM binding in midbrain before and after treatment. These findings points to the need of data analysis separately in males and females. No correlations between HAMD total scores at baseline and indices were found.

Conclusion:

SERT availability for 123-ADAM binding in the midbrain in drug naives as well as in treated patients with major depression disorder seems to be related to intensity of sub items in the HAMD and the outcome of treatment.
Effectiveness of Cognitive-behavioral Intervention on Depressive Symptomatology, Stress and Coping Strategies among Jordanian University Students
Authors: Hamdan-Mansour A.
Published: March 2009

The study examined the effectiveness of a group- administered cognitive behavioral intervention (CBT) with depressed university students in Jordan. 84 university students were recruited and assigned randomly to control and intervention groups. Intervention impact was assessed on measures of depressive symptoms, perceived stress, and coping strategies at three times points; baseline, postintervention, 3- months postintervention. Overall, using CBT showed a significant improvement in the used measures. At postintervention, students had lower scores on perceived stress, depression, and avoidance coping and higher scores in approach coping. The findings are discussed in terms of treatment implications and recommendations for use at academic settings.
Acceptance and Mindfulness-based Psychotherapies
Authors: Santo S. , Pinto A.
Published: March 2009

Aims:

Exploration of the essential features of Mindfulness-based therapies, considered the third wave of cognitive therapy.

Methods:

Databases were searched for literature on the principles through which mindfulness-based therapies may operate, the possible mechanisms of action underlying these interventions, their clinical applications and evidence of their therapeutic and adverse effects. Mindfulness-based cognitive therapy (MBCT), which has been developed for depression relapse prevention, is highlighted.

Results:

These techniques have been used for various applications such as chronic pain control, stress reduction and prevention of depression relapse. Some of their important features are cultivation of conscious awareness and attention on a moment-to-moment basis, with openness, curiosity and a non-judgemental attitude and their aim is to change cognitive processes, rather than cognitive content. There have been some well-designed empirical evaluation studies published addressing the effectiveness of these interventions but current evidence of their mechanisms is limited.

Conclusions:

There is evidence that mindfulness-based approaches add an important dimension to available psychotherapies in the management of the psychological aspects of a range of mental and physical health problems.
Risk Behaviours in Adolescence: Prediction Cognitive and Psychosocial
Authors: Albuquerque C.M. Sousa , Franco V.D. , Albuquerque C.P. Ferreira O , Mota C.P. Baptista
Published: March 2009

This investigation's main goal was to determine if some psychosocial (self-concept, control locus, assertiveness and satisfaction towards social support) and cognitive variables (health beliefs and attitudes towards health) were associated to health related behaviours. The sample was constituted by 829 teenagers, 382 male and 447 female, whose average age is 14.66 years old, who attended the 9th grade of the public and daily schools in the district of Viseu, Portugal.

Results:

1.

Study on the association between health and risk behaviours and psychosocial variables: The better the self-concept, the better the behaviours; The higher the satisfaction with social support, the better the behaviours; The higher the assertiveness, the better the behaviours; The association between control locus and healthy and risk behaviours is not significant.

2.

Study on the association between health and risk behaviours and cognitive variables: The more favourable the attitudes towards health, the better the behaviours; The more adequate the health beliefs, the better the behaviours.

3.

Study on the psychosocial variables interaction effects with cognitive variables in health and risk behaviour prediction: The interaction variable was revealed as the best health and risk behaviour predictor is the variable resulting from Factor 1 - behavioural aspect (Self-Concept) and Factor 4 - preventive attitude (Attitudes Towards Health) interaction, with a determination coefficient (R2) of .409. The patterned coefficient analysis Beta (beta=.427) indicates that the higher this interaction effect (F1 - behavioural aspect * F4 - preventive attitude) the better the behaviours.
Depression and Cytokines: A Psychoneuroimmune Perspective [P02-21]
Authors: Castro L.C.
Published: March 2009

Background:

Cytokine-induced sickness behaviour is an adaptative response to infection. Activation of the immune system, particularly the increased activity of several cytokines, has been implicated in the provocation or exacerbation of mood disorders.

Aim:

To discuss the relevance of psychoneuroimmunologic research in the understanding of the patophysiology and therapeutic targets of certain mental health disorders.

Methods:

Review of the literature. MEDLINE and PubMed databases searches for peer-reviewed studies, published between 2000 and 2008, using combinations of the Medline Subject Heading terms cytokines, sickness behaviour, immune system and depression, depressive illness.

Results:

Several lines of evidence support the relationship between cytokines and mood disorders. Cytokine elevations are more marked in severe depression and their activity may also relate with illness chronicity, neurovegetative features and high stress perception. It is argued that the activation of the inflammatory system, eliciting cytokine release and synthesis, provoke neuroendocrine and neurotransmitter changes, contributing to the development of depression. Some studies support that the brain cytokine system can become sensitized in response to non-immune stressors or to immune stressors occurring early in life.

Discussion:

The cytokines actions in the brain can help to clarify the patophysiology of certain psychiatric disorders, including depression. The research findings show an association between the activation of the brain cytokine system and depression, although the precise relationship between sickness behaviour and depression is still not clear. Further research in such a promising area of study is needed and can contribute to new therapeutical targets and a broader understanding of psychiatric disorders.
A Web Based Education Program in Adolescent Depression and Suicide for Primary Care Physicians [P02-22]
Authors: Kutcher S.
Published: March 2009

Adolescent depression and suicide are two important and related issues that can be effectively addressed by primary care physicians who have received appropriate training which includes the use of simple clinical tools that can be applied in usual primary care settings. This presentation reviews the evidence pertaining to primary care intervention for adolescent depression and suicide and provides a detailed description of a new Canadian web-based educational program for primary care physicians in the domain of adolescent depression and suicide.
The Risk of Using Antidepressants During Pregnancy: Serious Concern or Much Ado about Little? [P02-24]
Authors: Steiner M. , Shea A. , Soares C.N.
Published: March 2009

Perinatal psychiatric disorders are a leading cause of maternal morbidity, they transmit across generations and may pose the first adverse life event for a child. The myth that pregnancy is “protective” in terms of mental health has long been refuted and it is now well established that the incidence of depression during pregnancy is at least as high when compared to other phases in a woman's lifetime. Moreover, depression during pregnancy has been associated with a number of adverse outcomes both for the mother and the baby. Untreated depression during pregnancy is also one of the strongest predictors of a subsequent postpartum depression.

Data on the “relative safety” of antidepressants during pregnancy are accumulating but at the same time sporadic, at times inconsistent reports on potential risks associated with their use are cause for concern. Recognizing the limitations of our knowledge regarding the “relative safety” of antidepressants during pregnancy it is paramount to weigh the risk of not treating vs. the benefit of treating in each case.

We report here on more than 400 pregnant women at risk for depression seen at our clinic. One third of these women received antidepressants during different phases of their pregnancies and the outcome/well-being of their babies assessed. There were no significant increases in long-term untoward outcomes in these babies.

We also demonstrated in a smaller subpopulation that the use of antidepressants has a “positive” effect on both neuroendocrine and neurophysiological parameters, using the cortisol awakening response and heart rate variability as biological markers.
Analyses of the Giessen Physical Complaints Inventory for Children and Adolescents (GBB-KJ) in the Ordinal Mixed Rasch Model
Authors: Barkmann C. , Mack B. , Braehler E. , Schulte-Markwort M.
Published: March 2009

The Giessen Physical Complaints Inventory for children and adolescents (GBB-KJ) is currently the only German test for the standardised, multidimensional measurement of physical complaints in the self and external assessment of children and adolescents. The present study analysed the scalability of the five complaint dimensions in a mixed Rasch model with up to four clusters and four response models (partial credit, dispersion, equidistance and rating scale). The self-report data of N=1027 11- to 18-year-olds used in the study stem from the nationally representative Hamburg Health Survey (Barkmann, 2004). Of the five original 7 item scales, only cold problems could be Rasch scaled in a 3 cluster rating scale model without the exclusion of nonconform responding cases. In the 5 item rescaling approach, more than one valid model could be identified for each of the five dimensions. In principle, physical complaints proved to be adequate for probabilistic measuring models. Future studies must decide which of the solutions offers the more significant and consistent results in scientific research and clinical practice.
Psychosis in Patients with Acquired Brain Injury (ABI), Requiring Multidisciplinary Inpatient Rehabilitation
Authors: Faruqui R. , Tajer A. , Moffat B. , Haider S. , Haider K. , El-Kadi K.
Published: March 2009

Background:

Patients with ABI present with a relatively higher risk of developing psychotic illness. A co-morbid psychotic illness may pose multiple challenges in rehabilitation of these patients. The medical literature provides limited information on the nature, presentation, diagnosis, course, and prognosis of psychotic disorders after ABI.

Methods:

Clinically generated data was used to study the prevalence and nature of co-morbid psychotic illness and cause of ABI amongst inpatients requiring multidisciplinary neurobehavioral rehabilitation. The data were collected in an anonymized fashion and analyzed using SPSS version 16.

Results:

We examined data from 64 patients (51 Male, 13 Female). The age range was 21-61 years (Mean 39, S.D. 10.6). 40% patients had a history of mental illness or self harm prior to ABI. 16% had sustained their ABI as a result of suicide attempts. 12% had history of schizophrenia or bipolar mood disorder prior to ABI.

A third (33%) had a Post-ABI diagnosis of a psychotic illness. The most common diagnosis was organic psychosis (21%) followed by schizophrenia (9%) and bipolar mood disorder (3%). The factors that influenced diagnostic differentiation in organic or non-organic psychotic illness included consideration of past psychiatric history, family history, psychopathology, and course of the disorder. The overall patient group showed a significant difference in post admission and latest HONOS-Secure (P< 0.01) and HONOS ABI (P< 0.01) ratings, showing improvement in outcomes during rehabilitation programme. This difference persisted when sub-groups of psychotic and non-psychotic patients were analysed separately.
The Neglected Relationship Between Compulsiveness and Impulsiveness - Implications in Psychiatric Diagnosis
Authors: Ferreira M. , Pissarra C. , Cunha-Oliveira J.
Published: March 2009

The goal of the authors is to stimulate reflection on the distribution in continuum of compulsive and impulsive behaviours and highlight how important it is to constantly question psychiatric diagnoses, to avoid running the risk of dangerous categorisations.

They describe the case of a 31 year-old patient who attended the Emergency department of Coimbra University Hospitals complaining of depression and obsessive-compulsive symptoms that interfered with his daily life and with his sleep. He said that he used to attend psychiatry appointments and that he was “antisocial”, but added: “I'm as impulsive as much as I'm emotional”.

The patient's records show that he was always diagnosed with antisocial personality disorder, established by the first consultant he saw,specifically mentioning: “problems obeying rules”, “impulsiveness”, “getting into fights and brawls entailing legal action” with the obsessive-compulsive symptoms being secondary. However, the follow-up of the patient conduced by me revealed obsessive-compulsive symptoms in special compulsive checking rituals (which began in childhood), excessive concern with the size of his nose (and other parts of the body) that started in adolescence, as well as a personality marked by impulsiveness and a poor frustration tolerance, leading to highly aggressive episodes triggered by events/circumstances that he himself did not regard as particularly relevant. The results of the studies on the relationship between impulsiveness and compulsiveness could have a strong impact on reformulating the psychiatric nosology. Whenever we come across a new patient, as complete a clinical history as possible should be taken and easy diagnoses should be avoided.
The Use of the CNS-vital Signs Assessment to Enhance Cognitive Therapy (Mini-workshop)
Authors: Freeman A. , Nigro C.
Published: March 2009

Complete assessment is a key to the conceptualization process in Cognitive Psychotherapy. Given the data-orientation of the model and the need for outcome measures, the assessment of neuropsychological functioning plays a large part in the process. Using a computer-based program, several scales measuring neurocognitive functioning can be assessed rather quickly. The obtaimned scores then become baseline for the evaluating the reults of the therapy. The required reading level is approximately fourth grade, and the norm population includes children, adolescents and adults. Available in 58 languages, the CNS-VS can be demonstrated to be a powerful tool in the psychotherapeutic process.
Neuropsychological Markers for Cognitve Performance (Symposium or Panel)
Authors: Freeman A.
Published: March 2009

Chair: Dr. Norey Nigro (USA)

Discussant Prof. dr. Arthur Freeman (USA)

Panelists: Prof. dr. Andrzej Kokoszka (Poland)

Prof. dr. Daniel David (Romania)

Dr. Corey Nigro (USA)
Improving the Diagnosis of Fibromyalgia (FM) in Europe: Identification of Factors that Aid in the Detection of FM [P02-30]
Authors: Serra E. , Perrot S. , Guillemin I. , Barbosa C. Dias , Arnould B. , Baron R.
Published: March 2009

Aim:

Prior to facing the challenges of FM management, an initial diagnosis must be made. To guide general practitioners (GPs) in the early detection of FM in Europe, we developed an easy-to-use screening tool specific to FM.

Method:

A European multidisciplinary expert group was constituted with the aim of providing clinical expertise, defining methodology, and identifying key issues around the detection of FM. Three conceptual models describing factors that may contribute to the identification of FM patients were derived from; a) a comprehensive literature review, 2) clinician focus groups (N=6), and 3) face-to-face interviews with German, French, and English-speaking patients (N=29) conducting by psychologists to explore their attitudes and perceptions of the disease. A FM screening tool was developed in all three languages and tested for comprehension and applicability in FM-diagnosed and FM-suspected patients.

Results:

The models derived from the literature, clinician focus groups, and FM patient interviews showed high consistency. The resulting FM screening tool is comprised of 14 questions that describe patients' pain, fatigue, associated symptoms, impact on everyday life, personal history, and attitudes towards their FM.

Conclusion:

Based on this qualitative study, the detection of FM is likely to require the assessment of multiple psychological factors in addition to symptoms, including patient reporting of personal history and patient behaviour. The quantitative validation of these findings is currently underway.
Uintary Psychosis - New Evidences
Authors: Martins A. , Silva A.
Published: March 2009

The idea that schizophrenia and bipolar disorder stand as two distinct entities of mental illness came from German psychiatrist Emil Kraepelin in the late 1800s. So began the separation of the diseases that still marks today's psychiatry. However, in practice, it's not always easy to distinguish the two disorders. Schizophrenia and bipolar disorder have a number of symptoms and epidemiological characteristics in common, and both respond to dopamine blockade. Family, twin and molecular genetic studies suggest that the reason for these similarities may be that the two conditions share certain susceptibility genes.

The authors present a revision of several articles that reveal new evidences supporting the unitary psychosis theory. This theory has its origins in 1830s with Guislain, Zeller and Griesinger and defends a continuum of mental illness from schizophrenia to bipolar disorder. More recently genetic studies show overlapping of some predisponent genes of both diseases and some imagiological findings are also present in both. The existence of a continuum of mental illness may be useful for new treatment strategies and prognosis.
Assessment of Therapeutic Efficacy of Mental Disorders as Necessary Stage to Develop a Classification of Mental Diseases of XI Revision
Authors: Maruta N. , Semikina O.
Published: March 2009

A conception of a mental health is treated very ambiguous. Along with this an assessment of treatment efficacy for mentally ill persons includes a significant number of criteria which are changed continuously in time. Always there is a number of factors influencing on a development, course and outcome of disease. All of them might be considered as predictors of treatment efficacy and must be taken into account in a choice of criteria for therapeutic efficacy.

At the “Institute of Neurology, Psychiatry, and Narcology of the AMS of Ukraine” State Institution an investigation of 184 patients with neurotic disorders had been performed with analysis of predictors of therapeutic efficacy and on the base of data obtained criteria for assessment of treatment efficacy were improved. 81 male and 103 female patients from 18 to 60 years old were examined.

Clinical-psychopathological and pathopsychological predictors with a negative and positive influence on therapeutic efficacy were defined. The most significant of them were included into an integrative index of therapeutic efficacy for patients with neurotic disorders. It consists of such parameters as structure of psychopathological manifestations, level of psychotrauma generalization, level of compliance between the patient and his/her physician and surrounding, peculiarities of personality accentuations, level of a subjective self-control, patient's anxiety and rigidity, importance of a social and personal self-realization, type of attitude to the disease. These actual issues must be taken into account in a psychotherapeutic process. That will allow to increase its efficacy and to prevent recurrence of the disease.
Hwa-byung (anger syndrome) and a Proposal for a New anger Disorder
Authors: Min S.K.
Published: March 2009

Hwa-byung (HB), which literally means anger disorder and this is known as the culture-related chronic anger syndrome of Koreans. Based on these studies and a review of the literature on the anger syndromes of other cultures, author propose a new anger disorder. The rationale for this proposition is first that the clinical correlates of HB, including the epidemiological data, the etiological factors, the symptoms and the clinical course, are unique and different from any other DSM or ICD disorders including depressive disorders. Second, the symptoms of HB are characterized by pent-up anger and somatic and behavioral symptoms related to the release and suppression of anger. Third, a group of patients with only HB and who visit psychiatrists for treatment have been identified. Fourth, anger is thought to be the basic target of treatment for HB patients. Last, anger syndromes like HB have been identified, with various names, in other cultures. By reducing the cultural variation of HB and integrating the common clinical correlates of the syndromes related to anger, a new anger disorder for the mood of anger can be conceptualized, like that for other mood disorders for the corresponding pathological moods. The research diagnostic criteria for HB and the new anger disorder are also suggested. International collaborative studies are needed not only to identify such anger disorder in various cultures, but also to explore giving better treatment to these patients based on the bio-psycho-social model of anger disorder.
Comparative Study Between North American and Brazilian Children in the Computerized and Manual Versions of the Wisconsin Card Sorting Test
Authors: Miranda M.C. , Coelho L.F. , Bueno O.F.A.
Published: March 2009

The WCST has shown to be useful in detecting frontal-lobe dysfunctions in patients with ADHD, schizophrenic patients, Parkinson's disease. The computerized version of the WCST is based on the same normative data developed previously for the standard (manual) 128-card version. However, the equivalence of the measures of both versions has not yet been investigated.

The present study investigated the performance of a sample of Brazilian children aged 6-10 years, using the computerized version of the WCST. The results were compared to those of Brazilian and American children which used the manual version.

The Brazilian sample in the present study was composed of 400 children. The comparison between groups was carried out by age-group using t student test.

Results showed significant differences of North American children (manual version) in almost all measures in the age groups, where the Brazilian children presented a poorer performance. The comparison between the Brazilian samples (manual and computerized version) showed differences only in some measures; however, children of the present study obtained higher scores than those which used the manual version.

In conclusion, the differences between computerized and manual versions in both Brazilian samples indicate that the norms provided for the manual version should not be used for the computerized version. The comparison between American and Brazilian samples also indicates that regional normative data must be provided for computerized WCST adaptations.
Diverse Dimensions of the Cotard’s Syndrome - an Approach Towards a Clear Classification of the Phenomenon
Authors: Nagy A. , Voros V. , Tenyi T.
Published: March 2009

Aim:

The authors present the Cotard's syndrome, a rare psychiatric condition, pointing out the latest results in terms of psychoneurology and classification of the phenomenon. The central feature of the syndrome is a nihilistic delusion, in which the patient denies his or her own existence and that of the external world.

Method:

We searched electronic scientific databases using the appropriate search terms; relevant articles were carefully reviewed. We also present three cases from our clinical practice.

Results:

After the overview of the latest biological and neuropsychological findings, the terminology, the nosology, the classification and the differential diagnostics are discussed. To sum up with useful information for the clinical practice, the possible treatment strategies, the course and the prognosis of the disease are also presented.

Conclusions:

The reported cases together with the reviewed literature suggest that a dimensional system of classifying Cotard's syndrome is preferable. At the one end of the spectrum is the presence of the pure nihilistic delusions, appearing as a symptom of an underlying psychiatric or neurological condition. The full-blown, classical syndrome as a diagnostic category forms the other end of the spectrum. The presented theoretical and practical aspects give a lead on deeper understanding, easier recognition and more adequate therapy of the Cotard's syndrome.
Catatonia with Left Temporal Lesion on MRI: Crossing Borders
Authors: Neto B.
Published: March 2009

Catatonia is a neuropsychiatric syndrome characterized by a combination of disturbed motor functioning and changes in thought, mood and vigilance. Two patterns - one consisting in catalepsy, posturing, mutism and negativism and a second consisting of echophenomenon, automatic obedience, verbigeration, and other stereotypies - have been abstracted. Catatonia has been associated with psychiatric disorders - schizophrenia and bipolar disorder for example - as well as secondary to various underlying medical conditions.It will be described a case report of a 55 years old woman with prior psychiatric history of hospitalization with an unspecified nonorganic psychosis (F29-ICD10), presenting features of catatonia - immobility with fixed posture and gaze (sometimes presenting posturing), an almost absence of spontaneous movements and speech, echophenomenon (echolalia, palilalia, coprolalia) erupting in a otherwise mute state and showing, on occasions, periods of purposelessness motor excitement and restlessness, verbigeration and screaming with a grim of terror. She was disoriented and performed poorly on the MMSE. No neurologic focal signs were disclosed other than prominent primitive reflexes. Prior to admission, her family reported a sudden mood change: she became irritable, argumentative, with delusional thought content of persecutory nature, grandiose ideas. Viral and immune-mediated encephalitis were discharged. The MRI scan showed a right temporal medial lesion (amygdala atrophy). It will be addressed the hypothetical relationship between the dramatic clinical presentation and the cerebral lesion, grounded on the scientific research regarding limbic encephalitis, catatonic symptoms and neurophysiology. It will also be underscored the clinical relevance of differentiated psychopathology of catatonia.
Anhedonia at Psychiatric In-patients
Authors: Orlova N. , Shkliar M.
Published: March 2009

Objectives:

Anhedonia - loss of the capacity to experience pleasure, the inability to gain pleasure from normally pleasurable experiences - is a core clinical feature of some psychiatric illnesses and very important symptom of many somatic disorders. Its classification and treatment are very actual problems of modern psychiatry.

Methods:

For assessment anhedonia level at psychiatry in-patients we used the “Scale for physical and social anhedonia” Chapman L&J.

Results:

279 psychiatry in-patients with mental illnesses (Schizophrenia, Mood disorders and etc.) (174 men, 105 women) with a mean age of 36, 42 (±0, 9) and 123 healthy controls (75 men, 48 women) with a mean age of 36, 49 (±1, 8) were examine by this scale. 50, 54 % cases (n=141) had anhedonia (p≤0, 05). At patients with diagnostic category 298 (DSM-IV-TR) anhedonia was in 67% cases (n=93), diagnostic category 296 (DSM-IV- TR) anhedonia was in 21% cases (n=31). Other diagnostic categories DSM-IV-TR were insignificant. At healthy controls anhedonia was in 21, 1% cases (n=26). The factor analysis was selected subtypes of anhedonia in mental illnesses. We studied the correlation of level anhedonia and prolactin level in blood at patients who had treatment by atypical antipsychotic. This correlation was significant (p≤0, 05).

Conclusion:

Results of analyze the modern literature and owner data may tell us about pathogenetics subtypes of anhedonia. There are: in depression, in schizophrenia and in hyperprolactinemia. This clinical classification may ability for effective treatment these patients.
Cotard’s Delusion: A Clinical and Conceptual Overview
Authors: Rodrigues T. , Passos M. , Pereira H.
Published: March 2009

Background:

In 1880, the French neurologist Jules Cotard described a specific kind of nihilistic delusion which the patient believed that she no longer existed. Since then, this rare condition known as Cotard's Syndrome or Cotard's Delusion (CD) has intrigued clinicians and investigators.

Aims:

To present CD's features, including historical, clinical, etiopathological, and treatment issues.

Method:

Case report of a 49-year-old woman with fully developed CD; review of the literature.

Results:

There is still a considerable debate concerning the nature of this phenomenon - whether it should be conceptualized as a psychiatric symptom or as a syndromatic entity.

CD may appear in different severity levels, and most authors accept the idea of a spectrum of clinical presentations, ranging from the belief of loosing intellectual capacities to the extreme belief of non-existence of life and the universe.

This manifestation has been identified in patients with distinct diagnosis, mostly in severe depression, but also in schizophrenia and psycho-organic syndromes.

Treatment should be chosen according to the underlying pathology.

Conclusion:

Over the last few years, new contributions from neuropsychological and imaging studies have brought interesting approaches to understand CD's underlying mechanisms. At the moment, CD does not fit clearly into any category of the current systems of classification. Future investigations should address the pathophysiological nature of CD and its place in the new, etiopathologically-oriented, classification systems.
Searching for Variables Associated with Familial Suicide Attempts Using Data Mining Techniques
Authors: Saiz-Gonzalez D. , Baca-García E. , Perez-Rodriguez M. , Villamor I. Basurte , Saiz-Ruiz J. , Rio J.M. Leiva-del , De Prado Cumplido M. , Santiago-Mozos R. , Rodriguez A. Artes , De Leon J.
Published: March 2009

Introduction:

Adoption, twin and family studies suggest that suicide behavior is familial and heritable. Both completed and attempted suicide appear to be transmitted in a familial form. Genetics and environment influences had been detected in various studies. But suicidal behavior suggests to be inherited independently from the mental disorders usually associated with it. While traditional statistics emphasizes inference and estimations, data mining emphasizes the fulfillment of a task such as classification, estimation, or knowledge discovery.

Objectives:

The goal of this study was to determine in a large sample of suicide attempts which variables are associated with family history of attempted suicide.

Methods:

In an emergency room, 539 adult suicide attempters were recruited. The two dichotomous dependent variables were family history of suicide attempt (10%) and of completed suicide (4%). Independent variables were 101 clinical variables explored with two data mining techniques: Random Forest and Forward Selection.

Results:

A model for family history of completed suicide could not be developed. A classificatory model for family history of attempted suicide included the use of alcohol in the intent and family history of completed suicide, provide a sensitivity of 78.4%, a specificity of 98.7% and accuracy of 96.6%.

Conclusions:

A classificatory model for family history of completed suicide could not be developed using data mining techniques. But it suggested that the use of alcohol in the intent and family history of completed suicide may be associated with familial attempted suicide.
Trichobezoar and Rapunzel Syndrome: When Nobody Comes to Rescue - a Review and Case Report
Authors: Santos T. , Madeira N. , Ferreira J. , Vicente C. , Pires J.F. , Molinar G. , Noronha J.
Published: March 2009

Trichobezoar was first described by Baudomant in 1779. This rare entity consists of a compact mass of hair occupying the gastric cavity to a various extent. When the trichobezoar extends past the duodenum it is better referred to as Rapunzel Syndrome.

It is only reliably diagnosed by CT scan and its size may require removal by open surgery.

Albeit trichobezoars are well described in terms of surgical diagnostic and procedure, there are only but scarce reports on psychiatric literature. It is estimated that 30% of cases of trichotillophagia are of patients suffering from tricotillomania, and that 1% of those will eventually require surgical treatment.

The authors report a clinical case of trichobezoar without known trichotillomania, and revise the existing relevant literature, focusing on psychiatric evaluation and management.
Hoarding and Shopping: What is Compulsive and What is Not - Two Case Reports
Authors: Santos T. , Madeira N. , Ferreira J.
Published: March 2009

Compulsive hoarding has been generally described as the compulsive acquisition of possessions and the inability to discard them. It has been considered as a syndrome consisting of compulsive acquisition, difficulty discarding and clutter. It is described mainly in association with obsessive-compulsive disorders (OCDs) and in geriatric populations, although it may be seen in a range of other disorders.

Compulsive buying or shopping disorder has been characterized by excessive or poorly controlled preoccupations, urges, or behaviours regarding shopping and spending that lead to subjective distress or impaired functioning. Although it has been considered as part of impulse control disorders, it has also been reported associated with other disorders.

These two entities have raised relevant questions regarding whether they are part of dimensional or categorical constructs, symptoms or well established disorders. By presenting two case reports, the authors address some of these issues and the existing scientific literature.
Diagnostic Stability of Mood Disorders in a Psychiatry Day-hospital
Authors: de Sousa V. Teixeira , Marques J. , Martins A. , Domingues I. , Pedrosa R. , Curral R. , Torres A. Roma
Published: March 2009

Mood disorders are common and account for one of the greatest causes of disability worldwide. Accordingly, those conditions are frequent among patients treated in Psychiatry Day-Hospitals facilities. Patients referred for treatment in Hospital de São João Day-Hospital have a previous variable period of follow-up in ambulatory clinic or hospitalization, commonly, with an established diagnosis. Notwithstanding, during the Day-Hospital stay, diagnosis may be reviewed because of new clinical data. Diagnostic stability over time is an important issue in clinical practice because it may influence treatment and, therefore, the final outcome. It is closely related with the contact between the patient and the healthcare system. Diagnostic instability is commonly due to fluctuation of disease manifestation over time or presence of co-morbid psychiatric illness in combination with rigid diagnostic criteria. The main objective of this study is to evaluate the diagnosis stability of Mood Disorders among patients treated in a Psychiatry Day-Hospital, applying ICD-10. The clinical sample includes patients admitted to Hospital de São João Psychiatry Day-Hospital whose main diagnosis is a Mood Disorder (F30-39), in the period between January 2005 and June 2008. Admission and delivery diagnosis were compared for each patient in this diagnostic category. Results suggest a high level of stability in this diagnostic group in the Day Hospital setting. For global conclusions about stability of Mood Disorders it would be interesting to replicate this study with larger samples and in different settings.