bluuebunny/crossref_metadata_2025 huggingface dataset:
Neurotrophic approach in preventive therapy of alzheimer disease
Authors: Gavrilova S. , Kolykhalov I. , Fedorova Y. , Odinak M. , Emelin A. , Gustov A.
Published: May 2011

Introduction

During the last years a great number of new facts of involving nerve growth factors (NGF) in pathogenesis of Alzheimer Disease (AD) and other neurodegenerative diseases have been received. Discovery of neurotrophic effects of Cerebrolysin similar to NGF attracted new attention to it (Rockenstein E. et al. 2000).Clinical study of long-term effects of Cerebrolysin has proved that Cerebrolysin has positive modifying action on the dementia progression (Gavrilova S.I. et al., 2003). That's why we suggest that Cerebrolysin may prevent or slow down clinical manifestation of dementia in patients with mild cognitive impairment (MCI) of amnestic type.The aim of the present study was to investigate in an open comparative prospective clinical trial ability of Cerebrolysin to slow down or prevent transition of MCI syndrome into the clinically evident AD in 2 groups of patients repeatedly treated with 1 month courses of Cerebrolysin or Cavinton during a period of 3 years.

Methods

110 patients who met the diagnostic criteria of MCI of amnestic typewere included. During the clinical trial patients were assessed with a set of clinical scales and a battery of neuropsychological cognitive tests. Genotyping for the APOE polymorphism was performed as well.

Results

The superiority of Cerebrolysin over Cavinton in slowing down of the cognitive deficit progression and delaying the time or transition of MCI patients to the diagnostic category of Alzheimer disease during 3 years was demonstrated. Cerebrolysin was particularly effective in MCI patients with the ApoE4 (+) genotype.

Conclusion

Cerebrolysin could be recommended as a preventive AD therapy.
A case of dementia or simple schizoprenia?
Authors: Lee C.
Published: May 2011

Introduction

This is a case report of a Chinese middle-aged female who was first seen in 2006 for suspected depression. Over the course of the illness, her diagnosis was revised to that of Simple Schizophrenia and then Frontoparietal Dementia.

Case

A 53 years old Chinese lady was first brought by a male friend (who has known her for past 21 years) in 2006 to continue management for her depression. For the preceding 3–4 years, her behaviour has been very child-like. She was described premorbidly to be stubborn and independent. Mental state examination then revealed that she was oriented to time, place and person. Her mood appeared depressed and reactive (secondary to some social stressors). Patient refused any basic blood investigations and her antidepressant was continued. Over the course of few months, she started to complain of forgetfulness and she was reported to go ‘missing’ for 1 to 2 hours. A differential diagnosis of chronic negative symptoms schizophrenia was entertained. In August 2007, she was arrested for shoplifting and was treated as an inpatient. Upon discharge, she was referred to a nursing home. By October 07, she was totally disoriented to time and place. Computed Axial Tomography (CAT) scan of brain was eventually performed which reported as ‘knife-shaped appearance’ of cortical gyri suggestive of frontoparietal dementia, possible Pick’s Disease. Patient is currently on antidementia therapy.

Conclusion

The case report illustrates the importance of entertaining diagnosis of dementia in a middle-aged person especially with symptoms of regression and wandering behaviour.
White matter hyperintensities predict dementia in poststroke patients with cognitive impairment no dementia (CIND)
Authors: Chen Y.K. , Lee E. , Lu J.Y. , Chu W.C.W. , Mok V.C.T. , Wong K.S. , Tang W.K.
Published: May 2011

Introduction

Longitudinal studies of predicting dementia conversion of poststroke cognitive impairment no dementia (CIND) are limited.

Objective

To investigate the clinical and imaging predictors of dementia conversion in poststroke patients with CIND.

Aim

To understand dementia conversion of CIND.

Methods

143 patients with CIND (defined as impairment in at least one cognitive domain without meeting the criteria of dementia) at three months after stroke were recruited and followed up for one year. Dementia was diagnosed using the criteria of Diagnostic and Statistical Manual of Mental Disorders (4th edition, DSM-IV). MRI measurements including infarction, microbleeds, white matter hyperintensities (WMHs) and hippocampal volume were conducted. Logistic regression was performed to find the predictors of dementia at follow-up.

Results

16 (11.2%) out of the 143 patients developed dementia 15 months after stroke. In univariate comparisons, subjects with dementia at follow-up had older age (78.0 ± 5.3 vs.71.5 ± 8.5 years, p = 0.003) and higher NIHSS score (7.1 ± 3.5 vs.4.7 ± 3.3, p = 0.005) on admission. They also had higher frequency of old infarcts in the thalamus (31.3% vs. 11.0%, p = 0.025), larger volume of old infarcts (4.2 ± 11.2 vs. 0.7 ± 2.6 cm3, p < 0.001) and WMHs volume (33.2 ± 34.0 vs. 14.2 ± 14.1 cm3, p = 0.016). In logistic regression, age (odds ratio [OR] =1.203, 95%C.I.=1.054-1.373, p = 0.006), NIHSS score on admission (OR = 1.324, 95%C.I.=1.082-1.619, p = 0.006) and WMHs volume (OR = 1.045, 95%C.I.=1.007-1.084, p = 0.019) were significant predictors of dementia at follow-up.

Conclusions

WMHs volume predicts dementia in poststroke patients with CIND, suggesting subcortical ischemic vascular disease was an important origin of poststroke delayed dementia.
The relations between psychosocial factors, care burden and depression on the dementia family caregivers
Authors: Martin J.G. , Rodriguez F.M. , Gomez N.D. , Villa P.S. , Caro M.P.
Published: May 2011

Objectives

To describe the relation of psychosocial factors of care (phase illness, years of care, free time, extra help and symptoms of depression) influence the care burden of dementia family caregivers. To measure the relation of the level of depressive symptoms on an intense level of burden of the dementia family caregivers

Methods

Is selected a sample of 102 primary caregivers by criteria of inclusion to which a surveys do to those that the following information gathered: sociodemographic dates of the caregivers and of the dementia patients, care burden (Zarit Interview) and depressive symptoms (Beck Depression Inventory) of the family caregivers.

Results

Most of the sample experiences an intense burden level (74%) opposite to a light level (26%). Psychosocial characteristics are as per statistics significant in increasing the care burden there were free time, extra help and presence of symptoms of depression.

Presence of serious symptoms of depression on the intense burden level are differently front or those who had a minor burden, 22% and 5% respectively.

Conclusions

There are most of the daughter-father/mother and spouse-spouse caregiver couples with a high percentage of caregivers of feminine sex (as in most of the studies realized on caregiver of dependent persons at European and international level). The need for free time and psychic self-care are cost-effective strategies to prevent the depressive disorders, as well as, to improve their caregiver’ws work. The psychoeducation programs that have being realized at European level directed to family caregiver are necessary in our country.
Antipsychotics medication on discharge for in-patients with dementia: a one year study
Authors: Ochuko-Emore M.
Published: May 2011

Introduction

Concerns regarding the use of antipsychotics in people with dementia have been widely reported. However, there is paucity of studies examining antipsychotics prescribed on discharged from psychogeriatric in-patient units.

Objectives

To determine the extent and types of antipsychotic medication prescribed for patients with dementia discharged from an in-patient psychogeriatric unit.

Methods

This was a retrospective study. Data from all in-patients with dementia discharged from a psychogeriatric unit between July 2009 and June 2010 were analysed. Antipsychotics administered to patients in the unit and antipsychotics prescribed on discharge were recorded.

Results

During the study period, a total of 49 patients with dementia were discharged. Thirty-eight patients (77.6%) received antipsychotic as in-patients; four of these patients (10.5%) had two antipsychotics. Thirty-two patients (65.3%) were discharged on antipsychotic medication with two (6.3%) of the patients on two antipsychotics. Of the antipsychotics prescribed on discharge, 75% were atypical and 25% typical.

Conclusion

Almost two third of patients with dementia were discharged from the in-patient psychogeriatric unit on antipsychotic medication. A drive to reduce antipsychotic medication prior to discharge is needed.
Antipsychotics and dementia
Authors: Ramalho e Silva F. , Martins Correia L. , Correia D.
Published: May 2011

Introduction

According to the literature, up to 90% of patients with Alzheimer's disease present at least one behavioral or psychiatric symptom (BPSD) and their overall frequency tends to increase during the course of illness. Three main BPSD syndromes are usually described: agitation, psychosis and mood disorders. These syndromes have an important impact on patients and their caregivers, representing a distress factor leading to reduced quality of life and, ultimately, the need for institutionalization. Antipsychotic drugs have been used for this purpose, but their benefits are still uncertain and some studies brought up concerns about their safety - particularly increased risk of cerebrovascular adverse events and death.

Aims and objectives

The authors aim to present a review of the relevant literature, concerning the treatment of BPSD, focusing particularly on the antipsychotic treatment. We aim to discuss their indication, efficacy and safety. We illustrate this review with 1 clinical vignette.

Methods

Systematic review of the most recent and relevant literature.

Discussion and conclusions

According to some studies, atypical antipsychotics are equal or more effective than placebo in the treatment of psychosis and aggression. However, adverse effects seem to limit their effectiveness. Therefore, the prescription of antipsychotics for these patients should be restricted to people with severe symptoms causing risk or extreme distress that have not responded to other measures, and treatment should only be continued beyond 12 weeks in exceptional circumstances.
A new apathy scale for institutionalized dementia patients: validation of the APADEM-NH scale short-version
Authors: Ramos-García M.I. , Agüera-Ortiz L. , Gil-Ruiz N. , Cruz-Orduña I. , Valentí-Soler M. , Osorio-Suárez R. , Reneses-Prieto B. , Martinez-Martín P. ,   UIPA-CAFRS Study Group
Published: May 2011

Aims

To describe validation process of the new apathy scale for institutionalized dementia patients (APADEM-NH).

Methods

100 elderly, institutionalized patients with diagnosis of probable Alzheimer Disease (AD) (57%), possible AD (13%), AD with cerebral vascular disease (CVD) (17%), Lewy Bodies Dementia (11%) and Parkinson associated to dementia (PDD) (2%). All stages of the disease severity according to the Global Deterioration Scale (GDS) and Clinical Dementia Rating (CDR) were assessed. The Apathy Inventory (AI), Neuropsychiatric Inventory (NPI), Cornell scale for depression, and the tested scale were applied. Re-test and inter-rater reliability was carried out in 50 patients. The feasibility and acceptability, reliability, validity, and measurement precision were analyzed.

Results

APADEM-NH final version consists of 26 items and 3 dimensions: Deficit of Thinking and Self-Generated behaviors (DT): 13 items, Emotional Blunting (EB): 7 items, and Cognitive Inertia (CI): 6 items. Mean application time was 9.56 minutes and 74% of applications were fully computable. All subscales showed floor and ceiling effect lower than 15%. Internal consistency was excellent for each dimension (Cronbach’s α DT = 0.88, α EB = 0.83, α CI= 0.88);Test-retest reliability for the items was kW=0,48-0,92; Inter-rater reliability reached kW values 0.84-1.00; The APADEM-NH total score showed a low/moderate correlation with apathy scales (Spearman ρ, AI =0.33; NPI-Apathy= 0,31), no correlation with depression scales (NPI-Dementia = -0.003; Cornell= 0,10), and high internal validity (ρ =0.69 0.80).

Conclusions

APADEM-NH is a brief, psychometrically acceptable, and valid scale to assess apathy in patients from mild to severe dementia and discerning between apathy and depression.
Use of antipsychotics in patients with behavioural and psychiatric symptoms of dementia - a retrospective study
Authors: Siddiqui S. , Craig S. , Ahmed U.
Published: May 2011

Aims and objectives

To review current practice of Antipsychotics prescribing in patients with Behavioural and Psychiatric symptoms of Dementia in secondary care hospital.

Methodology

This was a retrospective audit targeting all patients who were diagnosed with a dementing illness in a large secondary care hospital from September 2008 to December 2008 inclusive. Data was collected from patients’ health care records and central computer database. Current practice was then compared with the standards proposed by the NICE Guidelines (National Institute of Clinical Excellence, 2006).

Results

Out of 18 patients who were diagnosed with dementia, 66% (n = 12) were prescribed antipsychotics. Out of these, 66%(n = 8) were males and 34%(n = 4) were females. 75%(n = 9) had explicitly documented indications for antipsychotics use in their health care records with only 25% cases (n = 3) alternative treatment options such as psychosocial interventions were considered.

Discussions

with patients and/or the carers’ were documented in 50%(n=6) cases. Periodic reviews were carried out in 66% (n = 8) cases.

Conclusion

Antipsychotics are commonly used in behavioural and psychiatric symptoms of dementia. Considering higher risk of morbidity and mortality with antipsychotics use in this population group, it is of paramount importance that reasons for prescribing and discussion with patients and/or their carers should be clearly documented. If antipsychotics are prescribed patients should be reviewed on regular basis.
Comparative study of the effects of intranasal insulin on memory deficits in type 2 diabetes and early Alzheimer's dementia concept and study scope
Authors: Siemann H. , Müller B. , Stein E.M. , Esselmann H. , Loos S. , Ennen J. , Lehnert H. , Hallschmid M. , Wiltfang J.
Published: May 2011

Introduction

Recent data support the view that the neurodegeneration underlying sporadic Alzheimer's Disease (AD) is in part related to brain insulin deficiency and brain insulin resistance. There is a higher incidence of AD in patients with diabetes mellitus type II (T2D) and both diseases show a decline in memory function. In a preceding trial intranasal insulin improved memory function in healthy volunteers so that an increase of central-nervous insulin concentration may improve cognitive function in both amnestic patient groups.

Aims

We want to analyse the effects of intranasal insulin on patients with early Alzheimers's disease (eAD) and patients with T2D in the state of amnestic mild cognitive impairment (aMCI).

Methods

Recruitment of 30 patients with eAD, 30 patients with T2D in aMCI state and 30 age-matched healthy controls. All patients undergo a run-in period of 2 weeks with 4 × daily administration of placebo. It follows a double blinded trial with daily intranasal administration of 4 × 40 I.U. insulin vs. placebo for 8 weeks and another 8 weeks of follow-up. At 4 defined time points memory function is assessed by word lists comprising 30 items of emotional, nutritional and neutral content which have to be memorized and are recalled after one week. To assess structural changes of the brain, a quantitative analysis for hippocampal N-acetyl-aspartate, choline and creatine is performed by 3 Tesla magnetic resonance spectroscopy.

Results: Since the study has not finished yet, we present experiences from the initiation and the beginning phase.
Exploring the needs of people with dementia regarding assistive technology to save quality of life and independent living at home
Authors: Streffing G. , Siebers M. , Gräßel E. , Schmid U.
Published: May 2011

Research on assistive home technology (AT) aims to reduce care costs and increase quality of life of people with dementia. Currently it is unclear what the needs of people with dementia are and what kind of support they desire. The reported survey aims to identify personal attitudes towards AT in daily living: As how disturbing is the loss of competence in activities of daily living (ADL) experienced? For which ADLs would AT be accepted? Which kind of sensor technology and interaction devices would be tolerated at home? Interviews with open questions and rating scales were conducted with 53 persons (m = 14, f = 39; aged 19–59). Subjects were professional care givers (n = 23), relatives of people with dementia (n = 15), and persons without dementia background (n = 15). The answers were evaluated statistically. Loosing the ability to take care of own body hygiene was judged as most disturbing. Washing clothes was judged as least disturbing. In general people preferred being helped by family members. However, AT was mostly preferred over professional care. People can best imagine AT help for using the telephone and managing medicine taking. Help by AT is nearly excluded for social relationships and finances. Transponders on objects are accepted best, closely followed by motion sensors. Video sensors are approved least. The PDA is the most accepted shape of AT. When developing AT, it is worthwhile to include potential user groups in decisions about areas of support as well as technical design to increase acceptance.
Smell identification test as a progression marker in Alzheimer's disease
Authors: Velayudhan L. , Pritchard M. , Lovestone S.
Published: May 2011

Introduction

Factors influencing or predicting progression in Alzheimer's disease (AD) is not well understood. Olfactory dysfunction, impaired smell identification in particular, is known to occur in AD. Mesial temporal lobe, important for memory function is also critical for the processing of olfactory information. In view of the common anatomical substrate, we hypothesized that olfaction dysfunction worsens faster in people with AD with rapid cognitive decline compared to those with slower cognitive decline.

Aims

To test whether smell identification test can be used as a predictor for illness progression in AD patients.

Methods

Forty one participants with late onset mild to moderate AD were recruited from mental health services for older adults. Subjects were classified as ‘Rapid Progressors’ defined on ‘a-priori’ with a loss of 2 or more points in Mini-Mental State Examination (MMSE) within six months. Assessments included MMSE, Neuropsychiatric Inventory, Bristol Activities of Daily Living, and the University of Pennsylvania Smell Identification Test (UPSIT), at baseline and after 3 months.

Results

Twenty subjects were ‘Rapid Progressors’, and had lower UPSIT scores compared to ‘Non-Rapid Progressors’ both at the baseline (p = 0.02) and at follow up after 3 months (p = 0.05). Baseline UPSIT correlated with follow up UPSIT (r = 0.5, p < 0.01) and MMSE (r = 0.4, p = 0.04). Also it was the baseline UPSIT score that best predicted (p < 0.05) the follow up smell and cognitive function on linear regression analysis.

Conclusions

Smell identification function could be useful as a clinical measure to assess and predict progression in AD.
Change of learning and memory ability and IGF-1 level in type 3 diabetes rats and effect of analog P165 of APP 5-mer peptide
Authors: Wang R.
Published: May 2011

Objective

To investigate the effect of Analog P165 of APP5-mer peptide on change of learning and memory ability in type 3 diabetes rats.

Method

Healthy adult male rats were randomly divided into 3 groups: Control group; type 3 diabetes (T3DM) group; T3DM administrated P165 group. T3DM models were induced by intracerebroventricular injection of Streptozotocin (STZ, 3 mg/kg) bilaterally. P165 groups were treated with gastric P165 (355 μg/kg) Then, learning and memory ability was detected by Morris water maze test. Body weight and serum glucose were recorded. The rat serum Insulin, Gluocagon, insulin-like growth factor-1 (IFG-1) was detected by ELISA method.

Results

In the Morris water maze test, compared with control group, the escape latency increased significantly (p < 0.05) in model group at the 3rd day. Compared with model group, the escape latency decreased significantly (p < 0.05) in the models administrated P165 group at the 3rd day. Although there was no significant difference, the escape latency decreased in P165 group at the 4th and 5th day. From the result of rats blood serum detection, the serum IGF-1 level decreased significantly in the model group (p < 0.01) than the control group. The serum IGF-1 level increased significantly in P165 treated group(p < 0.05).The body weight and the serum glucose, insulin, gluocagon had no significant difference among the groups in the period of experiment.

Conclusion

There is learning and memory impairment in the T3DM rats. P165 can raise the rats blood serum IGF-1 level, ameliorate learning and memory ability but don’t influence the serum glucose.
Relationship between heat shock protein 70 and B amyloids in patients with alzheimer disease and vascular dementia
Authors: Fu Y. , Xiao S.
Published: May 2011

Aims

Explore the relationship between levels of plasma Aβ1–40, Aβ1–42 and heat shock protein 70 (HSP70) in patients with Alzheimer disease (AD) and vascular dementia (VD) and in elderly non-demented controls.

Methods

23 patients with AD and 21 patients with VD who meet diagnostic criteria of the Diagnostic Statistical Manual 4th edition and 20 control subjects were enrolled, administered the Mini-Mental State Exam (MMSE) and the Activity of Daily Living (ADL) inventory and their levels of plasma Aβ1–40, Aβ1–42 and HSP70 were measured by sandwich enzyme-linked immunosorbent assay.

Results

The levels of plasma Aβ1–40, Aβ1–42 and the Aβ1–40/Aβ1–42 ratio were not significantly different across groups, but levels of plasma HSP70 in VD patients was significantly higher than in AD patients and in normal controls (3.19 vs 1.91 vs 1.43ng/ml, respectively; F=6.464, P=0.003). In the AD group MMSE scores were inversely correlated with ADL scores (r=-0.617, P=0.002) and with levels of plasma HSP70 (r=-0.437, P=0.037); but HSP70 levels were positively correlated with age (r=0.616, P=0.002) and with plasma Aβ1–40 (r=0.497, P=0.016) in AD group. In the VD group levels of plasma HSP70 were positively correlated with plasma Aβ1–40 (r=0.436, P=0.048).

Conclusions

Our findings provide further evidence that high plasma HSP70 levels may play a role in the diagnosis and differential diagnosis of AD. HSP70 levels in AD patients is inversely associated with cognitive performance and positively correlated with plasma Aβ1–40. Plasma HSP70 in VD patients is significantly elevated and positively correlated with plasma Aβ1–40.
The evolution of memory disorder in the ederly people: do you recover, will remain stationary or dementia?
Authors: Zarra J. , Schmidt L.
Published: May 2011

Introduction

Even though most than a hundred years have passed since we know Alzheimer's disease today it's considered as the human's frightful flagellum. While most of mental disease seem to be losing its evilness, the neurocognitives disorders caused by Alzheimer's disease, far from attenuating has duplicated it's appearance every each five years. And its symptoms are still being more depriving.

So, in opposition to the rest of the illness that affect the nervous system and the psychic apparatus, which due to the new treatment has been attenuated the clinical forms’ Alzheimer. With its severe pronostic and the illness evolution, haven’t been soften.

Objectives

Our intention is firstly, share some concepts to consider Alzheimer's disease as a cruel illness that can reache all the elderly people around the world.

Secondly, to analyze the different forms of presentation than can mask a clinical state. Which many times could end-up in dementia. And will soon destroy the whole psychic apparatus of a person.

Methods

Present our study group in the three institutional medical centers, with ambulatory patients, who consult about a cognitive disease. We describe the evolution trough time, taking into account the pharmacological treatments.

Results

The importance of the early detection of memory disorder, as one of the first signs of alarm which give us the opportunity to intervene therapeutically in on time.

Conclusions

We can recognize the Mild Cognitive Disorder as a clue which reveal a first therapeutic instance probably in efficacy in this cruel evolution towards dementia.
Survey of knowledge, attitude and behavior of homosexual seminar's audiences
Authors: Andri A.
Published: May 2011

Objective

To know about knowledge, act and behavior of homosexual seminar audience about homosexual behavior.

Method

This was a cross sectional survey. Participants were chosen by purposive sampling method. Survey was conducted using list of questionnaires which was made according to references used in the seminar presentation.

Result

One hundred and sixty five participants conducted the survey. There were 77 males (46.7%) and 88 females (53.3%). The mean of age of the participants was 21.22 (SD 3.7). Most of the participants were college students (147 students, 89.1%) and never married before (96.4%). Sixty six participants (40%) said that homosexual behavior was induced by environmental situation, fifty eight participants (35.2%) said that it was a biological factor and rest of them did not answer the question. One hundred and four (63%) participants said that homosexual behavior could be cured, twenty four of participants (16.4%) said it could not be cured and the rest of them said did not have any idea. More than half of participants (87 participants, 52.7%) said that homosexual behavior was a mental disorder and most of the participants (87 participants, 79.4%) said that homosexual behavior need to be cured. Most of the participants said that they felt fine if they meet and talked with homosexual man or woman, nineteen participants felt afraid, ten participants felt disgust and twenty five participants felt pity on them.

Conclusion

Most of the participants considered homosexual behavior as mental disorder and need to be cured.
Chronic medical conditions mediate the association between depression and cardiovascular disease mortality
Authors: Atlantis E. , Shi Z. , Penninx B. , Wittert G. , Taylor A. , Almeida O.
Published: May 2011

Purpose

To determine whether chronic medical conditions mediate the association between depression and cardiovascular disease (CVD) mortality.

Methods

Data analyzed were from 6,394 subjects aged 25–74 years who participated in extensive health examinations in the NHEFS conducted between 1971 and 1975 and follow-up studies to 1992. CVD mortality was the endpoint. Depression predictors were clinically significant depressive symptoms at baseline by the GWB-D, and/or at 1982–84 by the CES-D (‘baseline’, ‘new’, or ‘twice’ depression). Chronic conditions were prevalent/incident high blood pressure, diabetes, and nonfatal CVD by examination and/or self-report. Mediation effects were assessed by stepwise adjustments of covariates and additive interactions in competing-risks regression models (accounting for other mortality causes) and logit models.

Results

Baseline, new, and twice depression were significant predictors of CVD mortality in competing-risks models adjusted for demographics (HRs 1.3, 1.4, and 2.0), but effects were progressively weakened and became non-significant after adjustment for lifestyle factors, prevalent and incident medical conditions, respectively. CVD mortality risk was 80% higher for depression plus incident nonfatal CVD than without (HR 4.0 vs. 3.2, additive interaction), and mediation effects of depression via chronic medical conditions (particularly via incident nonfatal CVD) increased the risk by 2 to 11% in logit models, independent of all covariates.

Conclusions

Several levels of evidence suggest that the association between depression and CVD mortality is partially mediated by prevalent/incident chronic medical conditions, as well as unhealthy lifestyle behaviors. Patients presenting with clinically significant depressive symptoms, particularly if persistent, should be assessed for both chronic conditions and lifestyle risk factors.
Leading cause of re-hospitalization in an Italian acute psychiatric unit: preliminary results
Authors: Attili T. , Atti A.R. , Moretti F. , Pedrini E. , Forlani M. , Bernabei V. , Bonafede R. , De Ronchi D.
Published: May 2011

Objectives

To describe the leading cause of re-hospitalization in an Acute Psychiatric Unit of a general hospital in Bologna, Northern Italy.

Methods

All repeated admissions (>3consecutive admissions in 18 months) were recorded thanks to the Hospital Informatic System. Case-history were reviewed to collect information, diagnoses were based on the ICD-10.

Results

In the indexed period, 392 admissions were registered for 152 patients (mean age 44; 46,1% women). At least one precipitating cause was present in 64% of admissions. The most frequent were psycho-social stress such as family conflicts, parental separations, relational problems, job or economic difficulties (39%). The co-occurrence of 2+ of such factors was common (20%). Tricky situation within the psychiatric rehabilitation service (20%), low compliance to treatments (7%), alcohol/drugs abuse (7%), and low insight (3%) were the remaining associated factors. All the re-admissions of patients with poor insight or reduced compliance were due to the same cause. Poor adherence to therapies was more frequent in bipolar disorder compared with other diagnosis (17%vs7%, p<0.005). In patients affected by personality disorders the contemporary presence of 2 or more factors was needed in 40% of admissions. Patients with schizophrenia showed the most hetherogeneous pattern of precipitating factors.

Conclusions

Regardless of diagnoses, in almost a half of the admissions a single psycho-social stress is sufficient to lead to re-hospitalization; in personality disorders the contemporary presence of 2+ stressors is needed to overcome the capacity compensation of the patient. Low insight is frequently associated to re-admissions. Tailored treatments might reduce the frequency of re-hospitalization.
Anxiety and depression in hospitalized patients in Department of Oncology University Clinical Hospital Mostar
Authors: Babić D. , Perić I. , Mikulić M.
Published: May 2011

Background

In recent decades, growing interest in the research association of somatic and psychiatric disorders. Contemporary research and clinical practice shows that approximately half of cancer patients are associated with mental disorders, mostly depression and anxiety disorder.

Aim

To establish presence of depression and anxiety in patients hospitalized on oncology in University Clinic Hospital in Mostar.

Examinees and methods: In total, 80 patients hospitalized on oncology in University Clinic Hospital in Mostar between January 1st and March 31st 2010. (Examine group) and 80 patients who were admitted in ordination of family medicine in Mostar between March 1st and March 20th 2010. (Control group), participated in the research. In research we used Becks Anxiety and Depression Inventory.

Results

Examinees hospitalized on oncology had higher presence of depression in comparison to control group (Fisher exact test, χ2 test = 23,852: P < 0,001). We found no significant difference in presence of anxiety between examine and control group (χ2 test = 3,890; P = 0,143).

Conclusion

Control group showed statistically higher presence of depression, while we didn’t prove statistically significant difference in presence of anxiety between examine and control group.
Is psychological distress, depression and generalised anxiety associated with gastrointestinal symptoms in Type 2 Diabetes Mellitus?
Authors: Bener A.
Published: May 2011

Aim

Aiming to explore whether gastrointestinal (GI) symptoms are related to psychological distress, depression and generalized anxiety in Type 2 Diabetes Mellitus (T2DM) patients.

Design

Case-control study.

Setting

Primary Health Care (PHC), Qatar.

Subjects

The study was based on matched by age, gender and ethnicity of 453 cases and 453 controls aged 20 years and above.

Methods

The study was based on a face to face interview with designed diagnostic screening questionnaires for GI symptoms and T2DM, Patient Health Questionnaire (PHQ-9) for depression and General Anxiety Disorders (GAD-7) for anxiety.

Results

Among the total 453 diabetic and 453 control subjects interviewed, the prevalence of GI symptoms in T2DM was 48% and in control 34.2% (p < 0.001). Obesity and overweight were higher in patients with GI symptoms in T2DM (47.1%) compared to controls (42.7%) (p < 0.001). Mental health severity was significantly higher in patients with GI symptoms when compared to controls; depression (8.2 ± 3.7 vs 6.0 ± 3.6) and anxiety (7.6 ± 3.3 vs 6.0 ± 3.7). The prevalence of severe levels of depression was nearly twofold (8.2%) in patients with GI symptoms in T2DM vs compared to controls (2.4%) (p < 0.001). Similarly, the prevalence of severe levels of anxiety was 19.6% with GI symptoms in T2DM patients compared to controls (13.7%) (p < 0.001).

Conclusion

The present study findings revealed that the prevalence rate of gastrointestinal disorders is high in T2DM. Also, GI symptoms are associated significantly with depression and generalized anxiety in T2DM patients. Anxiety was more common than depression with GI disorder in T2DM patients.
Scientometric study of scientific production in psyciatry
Authors: Biglu S. , Biglu M.H. , Falk C.
Published: May 2011

Psychiatry is a branch of medicine that deals with the treatment of various kind of mental disorder such as diagnosis, treatment, prevention of mental and emotional disorders. In the contemporary world we witness a lot of casualties that lead to the human mental disorder but there are very little evidences to show the trend of psychiatry researches in the world.

The objective of this study is to depict the scientific production of scientists in the field of psychiatry for a period of 10 years. The database of Web of Science (WoS) was used to extract all publication under the topic of psychiatry throughout 2000 – 2009.

The study showed that the USA with producing more than 38% of world profiles in the field is the most prolific country followed by England (10.72%) and Germany (10.67%). English is the dominant language of publications. The majority of publications (68%) are in the form of journal articles. Harvard University with sharing 3.37% of world publications in the field is the most active university followed by Columbia University (2.20%) and Yale University (2.07%) respectively. Based on the Bradford law the Journal of Psychiatric Services is the most productive one among core Journals in the field.
Reorganization based on patient focused care programs, in the context of mental health services reform: Effects on patients
Authors: Bonin J.-P. , Lavoie-Tremblay M. , Lesage A. , Miquelon P. , Briand C.
Published: May 2011

Background

WHO (2001) suggested that the population should get easier and faster access to services improvements in the management of mental disorders in primary health care. In this context, the Government of Quebec (Canada) published in 2005 a Mental Health Action Plan, based on an organization into a hierarchy and some hospitals began to reorganize their mental health services into patient focused care programs.

Aims of the study

The presentation will focus on the effects on outpatients (N = 290) who were receiving mental health services from two hospitals in Montreal.

Methods

As part of a broader study on mental health services and patient outcomes, mental health services’ patients from a psychiatric hospital and a general university hospital in Montreal, were recruited to complete the Basis24, Euroqol, SF12 and other scales. A standard recruitment protocol was followed. All incoming patients at the outpatient clinics/programs during a typical week were considered eligible. This procedure was done before the reorganization of services, in 2006 (T1), and after the reorganization of services (T2; 2 years later), in 2008. We used T-test to assess the difference of a six-month evolution between the two-time measures.

Results

Respectively, 1057 (T1) and 557 (T2) participated to the project. Generally patients showed no significative differences between the two times in their symptoms, functioning and QOL. Only some marginal aspects changes in one site or another.

Conclusion

Patients were not very disturbed by changes and the new program were not fully implemented two years after T1.
Interaction between personality, family, and neighborhood factors in substance use initiation among adolescents
Authors: Burdzovic Andreas J. , Watson M.W.
Published: May 2011

Aims

This project investigated longitudinal predictors of smoking, drinking and marijuana use initiation among adolescents.

Method

A community-representative sample of 440 mother-child dyads with equal gender, SES, and ethnic representation was assessed 4 times covering the span of more than 6 years.

Children's reports of age of first smoke, drink and marijuana use were collected as part of the Youth Risk Behavior Survey (YRBS) at T3.

Child-level predictors at T1 included child gender, race, and sensation seeking personality. Family-level predictors at T1 included maternal education, family income, and children's self-reports about exposure to home violence. Information regarding presence of drugs and gangs in schools/neighborhoods were collected from mothers and children at T1 and combined into a single measure.

To examine the timing of events - specifically, the time when children started smoking, drinking and using marijuana as a function of the above T1 predictors - three separate survival models were estimated using the Cox proportional hazards model.

Results

Controlling for all other predictors, the sensation-seeking temperament and neighborhood quality remained significant predictors of substance use initiation among adolescents across all three substances, such that children initiated these behaviors sooner if they were high sensation-seekers or came form dysfunctional neighborhoods. Significant person X environment interactions were also evident for smoking and marijuana use, such that neighborhood and family risks were especially potent risks among children with high sensation seeking temperaments. These results point to the importance of broader contextual influences on the negative outcomes such as substance use during adolescence.
Frequent users of an acute psychiatric inpatient unit: A 5-year retospective study
Authors: Cardoso G. , Graça J. , Klut C. , Xavier S. , Neto A. , Martins M. , Ramos J. , Ribeiro J. , Vieira C.
Published: May 2011

Introduction

A small subset of patients with above average admissions to psychiatric inpatient units is recognized in clinical practice. These frequent users tend to be younger and to have a diagnosis of schizophrenia or affective disorder. Social conditions and the severity of the illness seem to be associated with this increased number of admissions.

Aims/Objectives

To study demographic and clinical characteristics of frequent and non-frequent users of a psychiatric inpatient unit.

Methods

Retrospective data of all the patients admitted to a psychiatric inpatient unit from January 2004 to December 2008 were reviewed. Frequent-users were defined as patients with 3 or more admissions over that period of time, and non-frequent users as those with less than 3 admissions. The two groups were compared in terms of age, gender, ethnicity, psychiatric diagnosis and compulsory admissions

Results

In a total of 2018 admissions and 1348 patients, the frequent-user group represented 10.2% (n = 137) of the patients and 28.9%(n = 584) of the admissions. Frequent-users were significantly younger (39.5 vs. 44.5 years, p = .001), more frequently black (22.6 vs. 19.4%, p < .001) and compulsorily admitted (27.7 vs. 14%, p < .001) than non-frequent users. Patients with bipolar disorder (p = .001), schizophrenia (p = .003) belonged significantly more to frequent-users group, while unipolar depressive patients (p = .016) and other diagnosis (p = .011) was more significantly represented in the non-frequent users group. Frequency of admission did not differ with gender.

Conclusions

The results concerning age and psychiatric diagnosis are consistent with previous studies. Compulsory admissions and black ethnicity were significantly higher among frequent- users.
Systematization of collection of relevant information about community maintenance treatment of people egress of psychiatric hospitalization
Authors: Cardoso L.
Published: May 2011

In therapeutic advances context of mental care patients, community services are essential to maintenance treatment of people with severe mental disorders especially in people egress of psychiatric hospitalization cases. This research aim was to evaluate use of instruments to collect relevant information about maintenance treatment in a community mental health service.

A two years quantitative and cross-sectional study developed in a community mental health service in Ribeirao Preto city- Sao Paulo - Brazil. The sample was egress patients and their family caregivers. It was utilizing a monthly nursing interview with following during six months with each patient and caregiver, to apply: sociodemographic and clinical questions; Structured Clinical Interview for Brief Psychiatric rating Scale (SIG-BPRS); Brief Psychiatric rating Scale (SIG-BPRS); Morisky-Green Adhesion Test; Family Burden Rating Scale (brazilian version - FIBS-BR).

In this satudy participated 40 patients and 15 family caregivers. Between patients majority was women and diagnosis most prevalent was Schizophrenia and mood disorders. The psychiatric symptoms manifestation presents low degrees and medication adhesion treatment was low in 78% of patients. Family care givers was women in 96% of sample and 80% presents medium to high degrees of burden.

The instruments utilized was important to evidence how patients and their caregivers was in maintenance of community treatment and collaborate to mental health professionals assistance systematization. The use of validated instruments can offer important information to mental health care in community services and maintenance treatments.
Saving and empowering young lives in Europe (SEYLE). Preliminary results
Authors: Carli V. , Sarchiapone M. , Wasserman D. ,   The SEYLE Research Consortium
Published: May 2011

There have been only a few reports illustrating the effectiveness of mental health promotion and interventions to reduce risk behaviours, including suicidal behavior. The aim of the SEYLE project, which is funded by the European Union under the Seventh Framework Health Program, is to address these issues by collecting baseline and follow-up data on health and well-being among European adolescents and compiling an epidemiological database; testing, in a randomized controlled trial, three different suicide-preventive interventions; evaluating the outcome of each intervention in comparison with a control group from a multidisciplinary perspective; as well as recommending culturally adjusted models for promoting mental health and preventing suicidal behaviors. The study comprises 11,000 adolescents recruited from randomized schools in 11 European countries: Austria, Estonia, France, Germany, Hungary, Ireland, Israel, Italy, Romania, Slovenia and Spain, with Sweden serving as the scientific coordinating center. Each country performs three active interventions and one minimal intervention as a control group. The active interventions include gatekeeper training (QPR), awareness training on mental health promotion for adolescents, and screening for at-risk adolescents by health professionals. Structured questionnaires are utilized at baseline, 3- and 12-month follow-ups in order to assess changes. During this presentation the data from the baseline evaluation of SEYLE will be described.

Trial registrationThe German Clinical Trials Register, DRKS00000214.
Incidence of stress and depression in assessment medicine doctors in the Czech Republic
Authors: Celedova L. , Cevela R. , Ptacek R. , Kuzelova H.
Published: May 2011

Assessment medicine represents an individual area of expertise that requires special skills and knowledge and it also put specific stress load on the assessment doctors. Different responsibility and the style of work, including special kind of contact with clients make this profession to different from other fields of clinical medicine. The specific work load may bring different stressors and cause specific mental load.

We have conducted an extensive research to determine the level of stress load and occurrence of possible signs of depression and other reactive mental illnesses among Czech assessment doctors. The research group consisted of all assessment doctors in the Czech Republic (n = 403) and a control group consisting of other medical and non medical professions (m = 403). The groups were compared on the basis of questionnaires evaluating levels of stress, depression and occurrence of other possible mental illnesses. General personality traits were evaluated too.

The results of the study: Assessment medicine doctors show higher incidence of stress related phenomenon as depression, burnout syndrome and other reactive psychiatrical signs comparing to other medical and non-medical professions (p < 0.01). This may be connected to specificity of the profession bringing specific stress load.

SUPPORTED BY THE RESEARCH GRANT GK MPSV-01-201.
Quality of life and associated factors among chronic mental illness patients in Kaohsiung
Authors: Chou F.H.-C. , Huang R.-R. , Su C.-Y.
Published: May 2011

Objective

The purpose of this study was to predict quality of life (QoL) and associated factors in patients with chronic mental illness (CMI) in Kaohsiung, Taiwan.

Methods

Patients (N = 2,023; 52.9% male, 47.1% female) were recruited using cross-sectional and convenience sampling. Structured questionnaires, including a living conditions questionnaire, a psychotic symptom assessment scale, the Caregiver Burden Scale, the 5-item Brief Symptom Rating Scale (BSRS-5), and the Medical Outcomes Study Short Form-12 (MOS SF-12) were used to collect data.

Results

Single-factor analyses showed that those who were single, employed, and younger had better QoL. Additionally, patients who had fewer psychological problems and lower levels of psychological distress reported better QoL. Current psychotic symptoms, especially positive symptoms, were negatively correlated with QoL. For disease factors, schizophrenic patients and hospitalized patients reported better QoL than both bipolar patients and community patients. For family factors, caregiver's attitude and caregiver's burden were negatively correlated with QoL. For social factors, unstable housing and community social dysfunction were negatively correlated with QoL. The results showed that all four dimensions (social, family, disease and personal factors) were significant predictors of the mental component summary (MCS) and physical component summary (PCS) dimensions of QoL.

Conclusions

Personal factors and disease factors were the most important predictors of QoL in CMI patients of this sample. Family factors were more important than social factors in the MCS dimension, but social factors were more important than family factors in the PCS dimension.