bluuebunny/crossref_metadata_2025 huggingface dataset:
Facial affect recognition: Electrophysiological findings in schizophrenia
Authors: Komlosi S. , Csukly G. , Stefanics G. , Czigler I. , Czobor P.
Published: May 2011

Introduction

While deficits in facial emotion recognition in schizophrenia have consistently been shown, the underlying neuronal mechanisms remain unclear. Electrophysiological measures, such as event-related brain potentials related to facial emotion recognition yield insight into the time course of recognizing emotional faces.

Objectives

In our study we aimed to delineate the neurophysiological correlates of facial emotion recognition and to investigate where, when, and what components in the course of emotional information processing show impairment in schizophrenia.

Methodology

We collected data using a 128-channel EEG recording system for testing an experimental facial emotion recognition paradigm with 20 patients with schizophrenia and 20 matched healthy controls. Subjects were presented fearful and neutral emotional facial expressions on a monitor and asked to make decisions via a button press relating to either the gender or the emotion of the presented face.

Results

Our findings revealed that ERPs of pateints with schizophrenia significantly differed from those of matched healthy controls in several components and areas characteristic to facial emotion processing, showing differences in both early and late ERP components of emotional face processing. Significant main effects of task (gender vs emotion) and emotion (fear vs neutral) were also found.

Conclusion

The finding that patients with schizophrenia, as compared to healthy controls, show differences in emotional face processing in several cortical areas and time intervals underlines the hypotheses that a deficit in affect recognition may originate from the impairment of a distributed facial emotion recognition network, including both early perceptual and later phases of facial emotion processing.
Hemispheric differences in frontal theta-band power discriminate between stimulus-versus memory-driven saccadic eye movement
Authors: Velasques B. , Machado S. , Cunha M. , Santos J.L. , Bittencourt J. , Budde H. , Basile L.F. , Cagy M. , Piedade R. , Sack A.T. , Cheniaux E. , Nardi A.E. , Ribeiro P.
Published: May 2011

Introduction

Although several electrophysiological studies have demonstrated the role of theta band during the execution of different visuospatial attention tasks, this study is the first to directly investigate the role of theta power during the planning, execution and cognitive control of SEM.

Objective

Saccadic eye movements (SEMs) represent the first stage of visual sensorimotor integration and are relevant for the visuospatial attention. The current study aims to address this issue by investigating absolute theta power over the frontal cortex during the execution of stimulus- and memory-driven SEMs.

Methods

12 healthy volunteers (3 male; mean age: 26.25), performed two tasks involving different conditions in the planning, execution and cognitive control of SEMs while their brain activity pattern is recorded using quantitative electroencephalography.

Results

We found an interaction between SEM condition (memory- vs stimulus-driven) and electrode (F3, F4, Fz), and a main effect of time point and electrode. Our key finding revealed that the stimulus presentation induces different patterns over frontal theta power increase between the left and right hemisphere.

Conclusions

We conclude that right and left frontal regions are an important factor to discriminate between memory- versus stimulus-driven SEMs, and speculate on their role for different levels within the visuospatial attention.
Global inter-rater reliability, scale validity, and local perception: Panss ratings and reactions from 4 Countries
Authors: De Fries A. , Liechti S. , Opler M. , Lane S. , Ivanova E. , Yang L.
Published: May 2011

Introduction/objectives/aims

We compared cohorts of raters from different countries who received training on the PANSS. We attempted to determine if there was any consistent by-country impact on specific items, factors, or subscales. We also queried raters about their perceptions of the instrument they were asked to use vis-à-vis their local patient population.

Methods

The data set comes from standardized rater training events involving raters from four countries: India (n = 83), Russia (n = 59), the US (n = 63), and Romania (n = 76). Raters scored interviews of schizophrenic patients using the PANSS. Scores were compared and intra-class correlation coefficients (ICCs) and rater agreement with “gold standard” scores were evaluated. The results were viewed against raters’ responses to questions about how well the PANSS items correlated to the presentation of symptoms.

Results

Raters from the US and Russia demonstrated a higher level of inter-rater consistency with ICCs of 0.883 and 0.835, respectively. For eight PANSS items, all raters demonstrated at least 80% agreement with the gold standard scores. For ten PANSS items, there was at least one country whose raters scored below 60% agreement. The PANSS items with the lower inter-rater reliability were the same items raters indicated as problematic in local settings.

Conclusion

The differences in rater performance indicate that standardized rater training is broadly effective but that there are some important differences in the way in which different groups conceptualize symptomatology and corresponding PANSS items. This suggests a need to tailor training to ensure reliability and validity in the use of this instrument.
Shyness and social phobia in israeli jewish versus arab students
Authors: Iancu I. , Ram E.
Published: May 2011

Background

Social Anxiety Disorder has been repeatedly shown to be very prevalent in the Western society with prevalence rates of 10% or above. However, very few studies have been performed in the Middle East and in Arab countries.

Methods

Three hundred Israeli students participated in our study and were administered the Liebowitz Social Anxiety Scale (LSAS), the Cheek Buss Shyness questionnaire (CBSQ) and a socio-demographic questionnaire.

Results

153 Jewish and 147 Arab students participated in the survey. SAD was found in 12.33% of the sample, according to the LSAS cutoff score of ≥60. The two subsamples had similar LSAS and CBSQ scores and similar positive SAD-positive rates (LSAS≥60). Females had higher scores on the LSAS, as were those without a spouse and those that had been in psychological treatment. Based on a regression analysis, the significant predictors of the LSAS score were the CBSQ score and female gender. A very high correlation was found between the LSAS score and the CBSQ score.

Conclusions

SAD and shyness are similarly prevalent in Jewish and Arab students in Israel. SAD scores were higher among females, those without a spouse and those that received psychological treatment. Further studies on the clinical and cultural characteristics of SAD in Israeli sub-cultures would add to the growing body of knowledge on SAD in various cultures.
Prevalence of psychotic symptoms: comparation of immigrants and native- born primary care service users
Authors: Martinena-Palacio P. , Eiroa F. , Qureshi A. , Collazos F. , Revollo H.W. , Ramos M. , Dip M.E. , Casas M.
Published: May 2011

Introduction

Epidemiological studies reveal higher rates of psychotic disorders among immigrants of ethnic minorities. However, the variation in prevalence of psychosis differs, and the proposed explanations and risk factors vary across the literature.

Objectives

1) to examine the prevalence of psychotic symptoms in a sample of immigrants and native-born in a primary care setting context

2) to explore the effect that certain socio-demographic characteristics have in the difference in prevalence.

Aims

It is expected that the presence of psychotic symptoms will be greater for the immigrant population than for the native-born population. Low educational level, a low socio-economic status and the presence of a physical illness will partly explain these differences.

Methods

3000 patients (1500 immigrants and 1500 native-born outpatients paired in age and gender) were interviewed in a primary care setting. They completed the Mini International Neuropsychiatric Interview, including the psychotic disorders sections, and a questionnaire that probed demographic characteristics and physical health status.

Results

Immigrants showed significantly higher rates of psychotic symptoms than native-born patients in both sections of diagnosis: life-span psychotic symptoms only (9.8% in immigrants and 5.3% in native-born) and life span with current psychotic symptoms (7% of the immigrants and 4.8% of the native-born). Immigrants also showed a lower education level, and a lower socio-economic status. When controlling for these factors, a relationship between these factors and the symptoms was found.

Conclusions

Findings are discussed in the context of culture and etiology of psychotic symptoms, and suggestions with regard to future research are made.
Suicide in frontotemporal dementia
Authors: Fonseca L. , Machado Á.
Published: May 2011

Introduction

Behavioral and personality changes are the core symptoms of frontotemporal dementia. Suicide and suicide attempts have been reported in demented patients.

Clinical case

We present a case of an 80 years-old-male patient, with a suicide attempt at the age of 76 as the presentation symptom of FTD.

Clincal study

There are few studies of suicide or selfharm in frontotemporal dementia where such behavior might be expected to be more common. We are conducting a clinical study in FTD patients about the relation between FTD and suicide. The results of such study will be presented and discussed.

Discussion

To our knowledge, there are no reliable data or reports about suicide in FTD patients. Also, we didn’t find any case report of a suicide attempt as the first presentation symptom of FTD. We discuss the known data about this issue considering our clinical study and report.
Follow-up study on plasma and cerebrospinal fluid levels of B amyloids and tau proteins in patients with alzheimer's disease
Authors: Fu Y. , Xiao S.
Published: May 2011

Aims

Compare baseline and 6-month follow-up plasma and cerebrospinal fluid (CSF) levels of amyloid β peptides 1–40 (Aβ1–40) and 1–42 (Aβ1–42), total tau protein (T-tau) and phosphorylated tau at threonine 231 (P-tau231) in patients with Alzheimer's disease (AD) and vascular dementia (VD).

Methods

21 patients with AD and 7 patients with VD based on the criteria of Diagnostic Statistical Manual 4th edition were assessed at baseline and 7 with AD and 6 with VD were re-assessed 6 months later. Assessments included the Mini-Mental State Exam (MMSE), the Global Deteriorate Scale (GDS), plasma and CSF levels of Aβ1–40 and Aβ1–42, and CSF levels of T-tau and P-tau231 (using a sandwich enzyme-linked immunosorbent assay).

Results

At baseline there were significant differences between AD and VD patients in the mean CSF levels of T-tau (t=2.580, P=0.016), P-tau231 (t=4.014, P=0.000) and Aβ1–40 (t=2.766, P=0.010). At baseline in AD patients, duration of illness was negatively correlated with CSF P-tau231 levels (r=-0.485, P=0.026), MMSE scores (r=-0.565, P=0.008) and GDS scores (r=-0.482, P=0.027); and CSF Aβ1–42 levels were positively correlated to MMSE scores (r=0.565, P=0.008) and negatively correlated with GDS scores (r=-0.634, P=0.002). In the AD patients plasma Aβ1–40 levels increased significantly over the 6-month follow-up period (t=-2.735, P=0.041).

Conclusions

Plasma Aβ1–40 levels increased significantly in AD patients after 6-months of follow-up, that means levels of plasma Aβ1–40 could imply the development of Alzheimer disease. Moreover, CSF P-tau231 and CSF Aβ1–42 levels are associated with the severity of dementia and cognitive impairment.
Rationale for combination therapy with galantamine and memantine in alzheimer’s disease: the efficacy of treatment of addition
Authors: Zarra J.
Published: May 2011

Objective

The efficacy, safety, and tolerability of nootropic cholinergic agent: GALANTAMINE (with a dual mechanism of action on the cholinergic a system) and moderate affinity NMDA- receptor antagonist: MEMANTINE, were assessed taking into account the profile of patients with neurocognitive disorder: Alzheimer's disease, from the clinical aspects and the different classifications.

Methods

The experience included 428 patients who were enrolled in a prospective, observational, multicenter, and open-label study to receive 16 mg/day of galantamine and 30 mg/day of memantine for 12 months of treatment of addition.

Results

The therapeutic response was measured using the Mini Mental State Examination (MMSE), Clinical Dementia Rating (CDR), Alzheimer's Disease Assessment Scale (ADAS-GOG), Functional Activities Questionnaire(FAQ) the Clinical Global Impression Scale (CGI) and the UKU scale of adverse effectstaking into account the efficacy, safety and adverse events of the treatment.

The final results of the study showed that galantamine with addition memantine improves cognition, behavioural symptoms, and the general well-being of patients with cognitive impairment: Alzheimer's disease. The incidence of adverse events was not significant and a very good profile of tolerability and safety was observed.

Conclusion

At the conclusion of this session, the participant should be able to demonstrate with use the association memantine - galatamine in neurocognitive disorder: Alzheimer's disease, improve cognition, behavioural symptoms, and the general state recognized as neurocognitive disorder.
Non compliance of treatment depending on diagnosis and family containment
Authors: de la Vega D.C. , Álvarez T. , Meyer J. Andrada , de la Serna I.
Published: May 2011

Introduction

Treatment adherence plays an importance role in the field of Mental Health, as therapeutic failure increases the number of relapses as well as hospital admissions.

Objective

To know if treatment failure is related to the type of mental illness suffered by the patient.

Material and methods

An interview was constructed to collect clinical data (diagnosis, prescribed drug group and drug group which has been altered, how this modifies the treatment and the reasons reported to alter the prescription)

Results

-Marital status: 48,9% married/consensual union, 30,5% widowed, 19.1% single and 0.7% separated or divorced.

-Coexistence: no statistically significant differences were found in compliance among those living alone and those living together.

Group-diagnosis: Psychosis 12,9%, Affective disorders 39,3%, Anxiety disorders 5,0%, Personality disorders 0,7%, secondary to organic disease 15,7%, dementia 21,4%, Other 4,3%.

Compliance depending on diagnosis: Psychosis (83,3% Yes - No16,7%), Affective disorders (67,3% Yes - No 32,7%), Anxiety disorders (42,9% Yes - No 57,1%), Organic disorders (59,1% Yes - No 40,9%), dementia (56,7% Yes - No 43,3%), Other (Yes 50% - 50% No) Conclusions: A prioiri, cohabitation is an interesting factor in adherence, because living with relatives can lead to greater supervision, and hence greater compliance with treatment.

However,only diagnostic group seems to have a role in compliance. Of the analized sample, the group with greater adherence to treatment was “psychosis”.

Despite the emphasis that needs to be done in compliance with treatment of psychotic disorders, it is also necessary to enforce compliance in other disorders.
Mental illness and moral panic: a qualitative study of perceptions of a lnk between violent crime and mental illness
Authors: Faruqui R.
Published: May 2011

Introduction

The crime committed by mentally ill offenders has continued to attract higher degrees of media interest and concerns over public safety.

Objectives

To explore study participants’ views over public perceptions of mental illness, and psychiatric illness and violent crime link.

Aims

To study public percetions of mental illness.

Methods

The study was coducted using a qualitative research design, using audi-taped, semi-structured interviews of 8 University students and healthcare professionals. Qualitative research themes and categories were obtained through qualitative data analysis of interview transcripts.

Results

Qualitative categories were obtained using open, axial, and selective coding of transcribed data. The analysis identified a public fear of mental illness displaying in rejection of mentally ill and through expressive communication using stigmatizing language. The study identified that the public sources of knowledge about mental illness are derived from family and peer contact and also through media exposure rather than formal learning opportunities in schools.

The study highlights the need for a public policy debate on harmful effects of social stigma of mental illness and further need for ongoing attempts to educate general public and policy makers. Three major categories emerged through this process are:.

1.

Negative media portrayal of mental illness

2.

Sufferer stigma and caraer burden

3.

Mental illness and Moral Panic

The study identified that an atmosphere of moral panic exists against mental illness and that this moral panic is reflected in media coverage of crime by mentally ill offenders.

Conclusions

Study confirms negative public perceptions and stigma of mental illness.
Home visit in mental health care: the “italian way”
Authors: Ferrari S. , Malavolta L. , Laghezzi Ortolani M.R. , Mimmi S. , Rigatelli M.
Published: May 2011

Introduction

Home visits are an essential component of community mental health care for their potentials in prevention and rehabilitative interventions. In the tradition of the Italian organisation, home visits are commonly carried out by psychiatric nurses, usually case managers for patients receiving them. Poor training and scarce integration to other clinical activities are common problems addressed by mental health professionals.

Methods

A written survey on attitudes, beliefs and reality of home visiting was submitted to all 95 mental health professionals working in the community mental health centres of the Modena District, North of Italy. The survey included the following sections: general information (including seniority of service); personal experience and emotions; description of “what actually happens”; opinions on training; comparison between reality and ideals.

Results

Ninety-eight percent of contacted professionals responded to the questionnaire. Home visiting should be improved and better integrated according to 55% of respondents. Good integration with social services but poor planning and lack of periodical assessments of effectiveness were emphasized by respondents. Seniority of service was significantly associated to different opinions on aim (p = .043) and numbers of home visits (p = .02) as well as the specific mental health centre was strongly associated to different perceptions on quantitative load of home visits (p < .0001). Almost no perception of danger was addressed by respondents, particularly if older.

Conclusions

Home visit is a powerful tool for assertive community treatments in psychiatry and should be a focus for training and research.
A destructive urban transformation project resulting with a social transformation process in Ankara-Turkey
Authors: Ilhan I. , Yildirim F. , Dertli N. , Turan M. , Tarihci S.
Published: May 2011

Introduction

Dikmen Valley is a slum district where the Municipality of Ankara intended to start an urban transformation project. Dikmen neighborhood includes nearly 1000 houses which the Municipiality attempted to pull down suddenly at night in the winter of 2007.

Residents of Dikmen Valley resisted and managed to stop this attempt. Whole event was experienced as an acute trauma as well as a continuous experience of anxiety because of ongoing risk of another attack.

Aim

The aim of the present study was to investigate the psychological consequences of the whole process.

Methods

The study sample consisted of 201 individuals from 106 households, and a total of 178 individuals from 102 households was taken as comparison group from another slum neighborhood where residents did not experience any threat to their houses. The Beck Depression Inventory, the Spielberger Trait Anxiety Scale, and the General Self-Efficacy Scale were used for assessment.

Results

Dikmen sample was found to have a statistically significant higher mean score of anxiety and depression compared to the comparison group. Dikmen had a higher level of general self-efficacy belief than the comparison group after controlling for depression and anxiety scores.

Conclusions

Although the traumatic process after an attack of pulling down and the threat of losing one's house resulted with a depressive state and anxiety in Dikmen residents, unexpectedly they had a high level of general self-efficacy. To the researchers’ observations, a social transformational process has been realized resulting with an overall high general self-efficacy level in Dikmen neighborhood.
The German “netzwerk psychische gesundheit”: Establishing home treatment for patients with severe chronic mental disorders from a systemic approach
Authors: Kleinschmidt M. , Floeth T. , Greuél M.
Published: May 2011

Introduction

Home treatment models in treating severe chronic mental disorders including crisis intervention show more and more evidence to offer an excellent alternative to hospital treatment. In Germany, having higher hospitalization rates than almost any other country in Europe, it is even more necessary to evaluate such alternative option to hospital treatment.

Objective/aim of study

After establishing a home treatment model based on Swedish, Finnish and Italian experiences in cooperation with a big German health insurance in Berlin, we present data evaluation after the first year of implementation.

Methods

150 Patients out of a model region in Berlin being included in the first year of the project are evaluated with respect to their socio-demographic data and diagnostic spectrum, psychopathology ratings and quality of life assessments, as well as to health economic dimensions (different financial positions of spending economic treatment resources). Using an advanced statistical method of predictive modeling, we can compare the actual hospitalization rates to the statistically predicted ones.

Results

There are predominantly patients with psychosis (50%), depressive disorders (30%) and BPD (15%). Actual hospitalization rates are extremely low compared to the statistical prediction. Health economic balance is difficult, mainly due to high starting expenses of a treatment setting which had to be built completely new.

Implications

The model in the meantime is being applied to the entire city of Berlin as well as to 4 other German counties (Schleswig-Holstein, Bremen, Bayern, Niedersachsen), other regions will follow shortly.
Long-term outcomes of ADHD: Global and regional study publication trends
Authors: Shaw M. , Caci H. , Hodgkins P. , Kahle J. , Callamaras N. , Woods A.
Published: May 2011

Introduction

As awareness of ADHD has increased throughout the world, interest has grown beyond the constellation of ADHD symptoms, including long-term effects and impact on people's lives.

Objectives

To examine the consequences of childhood ADHD and the relevance of these outcomes in different world regions.

Aims

This analysis examined the publication trends of studies of long-term outcomes of ADHD over time and among world regions.

Methods

Study identification followed Cochrane guidelines. Twelve databases were searched for reports published in English 1980–2010. Limiting criteria were designed to maximize study inclusion while maintaining a high level of study rigor: the studies were to

(1)

be peer-reviewed,

(2)

be primary study reports,

(3)

include a comparator group or baseline, and

(4)

report outcome results measured for a mean of 8 years (prospective studies, range of all studies was 6 months-40 years) after the start of the study, in late adolescence, or adulthood.

The fully-defined electronic search yielded 4615 citations, which were then reviewed manually based on the titles and abstracts, yielding a final of 371 studies.

Results

Study publication trends analysed included: publication year, country and world region of origin, outcome types, and study types. In general, the numbers of studies published per year globally has increased substantially (from 2 in 1980 to more than 40/year in 2007 and 2008) with differences observed between Europe and North America.

Conclusions

Analysis of publication trends can provide insight into outcomes of ADHD and the focus of specific world regions.

Supported by Shire Development Inc.
Reforming mental health services in Portugal
Authors: Xavier M. , Mateus P. , Caldas-Almeida J.
Published: May 2011

Introduction

Analysis of the mental health system in Portugal reveals some positive aspects in its development through recent decades, namely in what concerns the creation of decentralised services and rehabilitation programs. Despite this, Portuguese mental health services (MHS) still suffer from significant deficiencies, in terms of accessibility, equity and quality of care. There is a large gap between the number of people affected with mental disorders and those receiving treatment: for an estimated prevalence of 16.07%, the number of people receiving treatment in MHS was estimated to be 1.7%.

Objectives

The major objectives of the new National Mental Health Plan are:

1)

Assure equal access to care,

2)

Promote and protect human rights

3)

Reduce the impact of mental health disorders

4)

Promote community delivery of care,

5)

Promote the integration of MHS in the general health services.

Methods

A National Coordination Body for Mental Health has been empowered to assure the implementation of the National Mental Health Plan, with external monitoring by WHO.

Results

Since the last three years, there has been significant changes and improvements at the following levels: new legislation, creation of new MHS, forensic services, financing model, residential facilities (long term care), deinstitutionalization, training, programs for homeless people, domestic violence, advocacy and stigma.

Conclusions

The implementation of the mental health plan can help to overcome some of the problems present in MHS in Portugal. Special attention should be given to the financing model, has it represents a crucial restraint to the development of the MHS.
Adjunct quetiapine xr in patients with major depressive disorder: a pooled analysis of data from patients with anxious depression
Authors: Bandelow B. , Vieta E. , El-Khalili N. , Bauer M. , Nyberg S. , Eriksson H.
Published: May 2011

Objective

This pooled analysis evaluated efficacy of adjunct quetiapine XR (QTP-XR) in subgroups of patients with anxious depression and lower levels of anxiety.

Methods

Pooled data from two 6-week, double-blind, randomised, placebo-controlled trials (D1448C00006/D1448C00007) in patients with inadequate response to antidepressants were analysed. Patients received adjunct QTP-XR (150 or 300 mg/day) or placebo+antidepressant (SSRI or SNRI). Using criteria defined in the STAR*D study, analyses conducted in patients with anxious depression or lower baseline anxiety levels (HAM-D anxiety/somatic factor score >/ = 7 and < 7, respectively) included LSM change at Week 6 in: MADRS total (primary endpoint), HAM-A and CGI-S total scores.

Results

For patients with anxious depression (n = 697; 76% patients), adjunct QTP-XR 150mg/day (-14.44, p < 0.01) and 300 mg/day (-15.09, p < 0.001) significantly improved MADRS total scores versus placebo+antidepressant (-11.78) at Week 6, with significant improvement demonstrated from Week 1 onwards. Significant improvements were seen in HAM-A (QTP-XR 150 mg/day: -9.05, p < 0.01; 300 mg/day -9.43, p < 0.01) and CGI-S total scores (QTP-XR 150 mg/day: -1.60, p< 0.001; 300 mg/day -1.63, p < 0.001) versus placebo+antidepressant (-7.40, -1.22, respectively) at Week 6.

A smaller subgroup (n = 222; 24% patients) had lower baseline anxiety levels. At Week 1, adjunct QTP-XR (150 mg/day -9.09; p < 0.01; 300 mg/day -8.60; p < 0.05) significantly improved MADRS total score versus placebo+antidepressant (-5.93). At Week 6 there were no significant changes (QTP-XR 150 mg/day -14.49; p = 0.243; 300 mg/day -14.01; p = 0.388) versus placebo+antidepressant (-12.78).

Conclusions

For patients with anxious depression, adjunct QTP-XR (150 and 300 mg/day) was effective at reducing symptoms of anxiety and depression, with symptom improvement observed from Week 1 onwards. AstraZeneca funded.
Depression, inflammation and coronary heart disease: prognostical value of c reactive protein and depressive symptoms
Authors: Bruschi A. , Mazza M. , Harnic D. , Grandinetti P. , Battaglia C. , De Risio L. , di Nicola M. , Martinotti G. , Camardese G. , Pozzi G. , Janiri L.
Published: May 2011

Introduction

The aim of this preliminary study is to assess, in a sample of patients with Coronary Heart Disease (CHD), the specific association between depressive symptoms and systemic inflammation.

Methods

Sixty-One inpatients with CHD, 31 Unstable Angina and 28 Myocardial Infarction, participated in the study. The plasma levels of C Reactive Protein were measured using Dade Behring’s High Sensitivity CRP assay (hs-CRP) at T0, T30 and T90.

At the same timings, they were tested by an examiner, unaware of their diagnosis, with a psychometric battery (SCL90-R, HDRS, MADRS, BDI, QlesQ).

Results

The elevation of hs-CRP occurs during the whole observation period, with maximum significance at T90 (p = 0,031).

A multivariate analysis at T0 indicates a statistical correlation between SCL90-R scores and hs-CRP levels (p = 0.02).

The SCL90-R is also associated with the risk of further cardiac events (p = 0.013).

Also the BDI could be useful as a prognostic factor (p = 0.026).

We found a trend towards correlation between CRP values and depressive symptoms, but it never reaches statistical significance for the other scales.

Conclusions

The feelings of loss and the fear of death, related to the environmental and emotional situation of the hospitalization, may prevail in the acute phase of CHDs.

Some patients may overcome this reactive depression, while others may exhibit a biological depression, related to the high level of CRP and thus to an increased risk of re-infarction and other coronary events.
Effects of lithium on the HPA axis in patients with unipolar major depression
Authors: Bschor T. , Ritter D. , Lewitzka U. , Bauer M. , Uhr M. , Ising M.
Published: May 2011

Background

(I)

Profound alterations of the hypothalamic-pituitary-adrenocortical (HPA) axis regulation were repeatedly shown in depressed patients. The most sensitive challenge test of the HPA axis, the combined dexamethasone/CRH test (DEX/CRH test), shows an overstimulation of ACTH and cortisol in depressed patients. Under tricyclic antidepressant treatment, a normalization of the HPA axis overdrive was found to precede the clinical improvement.

(II)

Lithium is a well established drug for the treatment of affective disorders. Yet, its exact mode of action and its effects on the HPA axis are still unknown.

Design and methods

Three 4-week studies with each 30 acutely depressed patients (unipolar, SCID I confirmed) were conducted. In study 1, patients refractory to a treatment trial with an antidepressant of at least four weeks were treated with lithium augmentation. In study 2 and 3, drug free patients were treated with lithium monotherapy or citalopram monotherapy respectively. Weekly HAM-D ratings were performed. In each study, the DEX/CRH test was conducted right before and four weeks after initiation of the pharmacotherapy.

Results

All three pharmacological strategies showed good antidepressive efficacy. Both lithium monotherapy and lithium augmentation led to a (for most parameters significant) increase in the HPA axis activity. In contrast, citalopram monotherapy resulted in a decrease of the hormone response to the DEX/CRH test.
Neurobiological and somatic particularities at women with depressive disorder
Authors: Marinescu I. , Marinescu D. , Pirlog M.C.
Published: May 2011

Background

Depressive disorder at women associated important neurobiological (cortical atrophy) and somatic vulnerabilities. (metabolic syndrome, hypertension, coronary heart disease and diabetes mellitus associated with weight gain).

Methods

Retrospective study on 100 women patient lot, 36–55 years, hospitalized in Psychiatry Clinic of Craiova from January 1st 2007 to December 31st 2009. The inclusion criteria are: depressive disorder (HDS score 20–24), without somatic disorders. The final assessment was realized for this items: remission level (full, partially remission, persistent depression), cognitive impairment (MMSE), weight gain (+7.5 kg from baseline), somatic disorders.

For patients with cognitive impairment, persistence depression and weight gain we effectuated the psychostress evaluation and brain computer tomography.

Results

Full remission - 40% of patients; partially remission - 37%; persistence depression: 23% (HAD >18).

Cognitive impairment - MMSE < 25 - all the patients with persistence depression and 5 patients with partially remission, 72 patients does not have cognitive impairment.

Weight gain: >7kg from baseline - 45 patients.

Somatic disorders: hypertension: 32 patients; coronary heart disease: 27 patients; diabetes mellitus: 21 patients.

At patients with persistence depression, cognitive impairment and weight gain (12 patients) the CT revealed cortical atrophy, calcification of choroid plexus and ventricular enlargement.

All the patients had high scores on the Lloyd Stress Scale.

Conclusions

Weight gain and high scores for psychosocial stress can be in the future markers for the prediction of evolution risk in depression at women and is required the association of psychopharmacological treatment with psychokinetotherapeutic and psychotherapeutic methods for the decrease of psychostress.
Bone marrow, depression” - transmission of psychiatric diseases through hematologic stem cell transplantation ? - Aetilogic considerations and a clinical case report
Authors: Weydt P. , Connemann B. , Schönfeldt-Lecuona C.
Published: May 2011

Allogeneous hematogenic stem cell transplantation (HSCT) is a curative therapeutic strategy for numerous benign and malignant hematologic diseases. The transplantation procedure is characterized by significant physical, social and psychological stressors, especially for the graft recipient. This can lead to depression and anxiety. Every HSCT represents a potential risk for transmission of known and unknown diseases. Hematologically transmissible diseases of the donor therefore are considered a contraindication. Recent animal experiments have demonstrated that psychiatric diseases can transmitted via HSCT from donor to recipient. So far there are no such observations in human patients.

Here we report the case of a 33 year old male patient who, because of a rare chronic hypoplastic congenital aenemia, underwent HSCT. The BM donor was the brother of the patient and suffered from recurrent depressive disorder. Because of the short stature resulting from his underlying hematologic disease the patient had been in psychotherapy form several years. Depressive episodes had not been observed during this time. 10 weeks post HSCT the patient experienced a depressed mood and recurring anxiety attacs. The initiation of antidpressant medication was considered but not started due to the mild symptomatology.

While depressive symptoms after HSCT are not infrequent because of the multiple stressors outlined above, we argue that in the light of the recent animals studies on the transmission of psychiatric disease via hematopoeitic stem cells in the present constellation a hematologic transmission of the mood disorder can also be condsidered.

Acknowledment: To the colleagues of the Department of Pediatrics.
Eating disorders in adolescents Portuguese
Authors: Albuquerque C. , Regalo S. , Pires S.
Published: May 2011

Introduction

The eating disorders are serious psychological problems which particularly affect young women. In this context, and in view of epidemiological data are still scarce in Portugal, is of great interest to boost a current and ongoing research.

Objective

This study aims to identify and characterize, in Portuguese adolescents, behavioral and psychological dimensions associated with eating disorders Methods: Using quantitative methods, the study focused on a group of 458 adolescent students, aged between 15 and 20 years (average: 16.86), mostly female (58.70%), attending the tenth grade (37.80%) and without having to diet at the present time (74.70%). As measurement instruments were used anthropometric data and “Eating Disorders Inventory - EDI (Garner, Olmsted & Polivy, 1983).

Results

The female adolescents tend to have higher results in the clinical subscales of EDI, suggesting a higher level of psychological distress. An analysis of age distribution of adolescents shows a peak for the characteristic signs of anorexia at 16 and a peak for the symptoms of bulimia at 20. Finally, adolescents who are currently dieting tend to score higher on all subscales of EDI, which suggests they tend to seek more leanness, feel greater body dissatisfaction, interpersonal distrust increased, fear of maturity and also a greater general feeling of powerlessness, insecurity, low self-esteem and loss of control over their lives.

Conclusions

After it performed this situation diagnosis, we intend to formulate a proposal of intervention in school environment, in the scope of Health Education, that can help these young it will carry out his healthier form life project.
Perception of body shape in bulimia nervosa: An ERP study
Authors: Volpe U. , Galderisi S. , Mucci A. , Vignapiano A. , Montefusco V. , Russo D. , Maj M.
Published: May 2011

Body image distortion represents a key clinical feature of eating disorders (EDs), but its neurobiological underpinnings are poorly understood. Previous functional imaging studies yielded inconsistent findings, indicating a possible involvement of fronto-temporal and/or limbic abnormalities. Since these putative regions are highly interconnected and participate into functional networks, it might be useful to study the temporal evolution of their activation during the processing of body images.

The present study was aimed to explore the neurobiological correlates of body image processing in subjects with bulimia nervosa (BN), using the high-time resolution, electrical neuroimaging technique called LORETA.

Event-related potentials (ERPs) were recorded from 30 unipolar channels in 10 subjects with BN and 10 matched healthy controls, during the performance of an emotional counting Stroop task, in which the distorted, non-distorted and scrambled image of their own body and an unfamiliar body image were randomly presented on a computer screen.

Using the LORETA source imaging technique, we found that subjects with BN had a greater activation in frontal areas and anterior cingulate during late phases of body image processing, with respect to healthy controls.

Our results indicate that patients with BN need to allocate a greater amount of attentive and executive resources, than healthy controls, during the integrative stage of body shape processing.
How do we restraint?
Authors: Becirovic E. , Arnautalic A.
Published: May 2011

Introduction

Restraints is the ultimate method of behavior control, which should be used when patients may be harmful to themselves or others, or when they remain agitated and noncompliant, and violence seems imminent. When used with a compassionate, humanistic approach, restraint can achieve a therapeutic outcome for the patient while protecting the safety of others. But how do we use restraints?

Aims

To asses restraint practice in our Clinic.

Methods

We assessed consecutively every restrained patient in period of 92 days (from 9.7. to 7.10. 2009.) and noted age, sex, duration, and time of beginning and ending of restraints, number of restraints, diagnoses, therapy, and reasons for restraints.

Results

We found that male patients were more often restrained. Also age span was pretty wide (from 14 to 70 years of age). Some periods of restraints were very long, the longest were 120 h. We also found interesting results considering time of beginning and ending of restraints.

Conclusions

The practice is different from theory. There are areas, in our restraints practice, that should be improved.
Management of GHB intoxication and withdrawal in General hospitals
Authors: Teijeiro R. , Upmeijer J.-G.
Published: May 2011

GHB (Gamma 4- Hydroxybutayric Acid) has seen an exponential growth in most European countries over the past few years. Intoxication and withdrawal syndromes occasionally seen at First Aid and liason psychiatry services of General Hospitals were mostly cases of recreational GHB use, i.e. in relatively low dosage, less than 40 mg/kg GHB. The state of the art treatment of states were based on treating the symptoms by means of high dosage benzodiazepines and systemic support.

The growth in GHB intake has caused a new patient population arriving at the General Hospital on a very high GHB dosage, showing rather serious delirant states concomitant with very aggressive behaviour. They usually end up under narcosis at the IC.

We will present management guidelines developed by us for treating this problematic, drawn from guidelines for detoxification treatment within rehab care and based on Medicinal GHB.

The system for treatment proposed here has by now been successfully implemented in various hospitals in the Netherlands.
The role of psychosocial treatment in decreasing of future violence behavior risk in forensicly treated psychiatric patients
Authors: Jonovska S. , Jengić V.Š. , Safner L. , Bošković G. , Zudenigo S.
Published: May 2011

The main aim of this study was to establish to what extent psychosocial treatment as a part of complex, multicomponent forensic treatment has an influence on decreasing of the future violence behavior risk in population of forensic psychiatric patients. We examinated 13 patients treated on Department of Forensic Psychiatry of Psychiatric Hospital Rab in Rab, Croatia. 9 of them were males and 4 of them females, 25–60 years of age, all of them were compulsory hospitalized because of committed criminal act connected with violent behavior. All of them have diagnosis of schizophrenic group of diseases with different duration of forensic treatment (from few months to few years). During 2010. all of them participated in psychosocial programe workshops once a week, for 6 months.

Methods

Violence Risk Screening-10 (V-RISK-10), subjective measure of the programme chairmen performed in the beginning and in the end of the programme. The Aggression Questionnaire and Daily Spiritual Experience Scale as self-assesment scales were performed in the end of the programme. Results point on decreasing of V-RISK-10 results in the end of the programe in all participants. Interested observation was that mentioned results and those on self-assesment scales were not always been correlated positively. We also proved negative correlation between aggressivity and spirituality. As a conclusion, we have indications to believe that is real to expect that comining psychosocial treatment with targeted psuchopharmacological interventions could leed to decreasing the risk of future violent bihevior in forensicly treated psuchiatric patients.
A comparison of mental health assessment of mentally ill offenders by mental health professionals
Authors: Najim H. , Childs J.
Published: May 2011

Background

Criminal justice mental health teams were established in The United kingdom in the late nineties of the last century following the publication of the Reed Report 1991.

Two teams were established in South Essex following the geographical locality of each team. Basildon and Thurrock and Southend.

Methods

An evaluation form was devised to record all essential areas of assessment.

Twenty five assessment of each team were picked and evaluated randomly over a period of a three months. A comparison was done between the assessment of the two teams.

Results

Referring agency one from the west didn’t mention it

Three of the west didn’t have the index offence;

One of the east and two of the west didn’t have past forensic history.

Three of the west and one of the east didn’t have risk assessment.

One of the west didn’t have summary of concerns

Three of both didn’t mention whether other professionals involved or not.

Discussion

Comparison between different teams is important to make sure that there is a standard format for assessment and whether it is used in all assessments.

It has been shown that assessments are very good in general in both teams. There are some areas which need to be addressed and managed.

12% of patients on the west didn’t have risk assessment which is very risky.

Conclusion

This comparison has highlighted areas we need to take care off especially risk assessment and liaising with other agencies in managing theses very special group of patients.
The association of NRG1, DTNBP1, RGS4, G72/G30 and PIP5K2A candidate genes with cognition in patients with schizophrenia and healthy controls
Authors: Réthelyi J.M. , Polgár P. , Benkovits J. , Jekkel É. , Czobor P. , Bitter I.
Published: May 2011

Introduction

Previous studies have indicated association of schizophrenia candidate genes with cognition both in patients with schizophrenia and healthy individuals. In the same sample we have shown differential association of candidate genes with symptom severity in patients.

Objectives and aims

To test the most extensively researched schizophrenia candidate genes for association with domain-specific cognitive functions.

Methods

Cognitive functioning was assessed in a subsample of 263 patients with a DSM-IV diagnosis of schizophrenia and 135 healthy controls by a neuropsychological test-battery measuring the domains of sustained vigilance/attention, working memory, short-term memory, verbal memory, cognitive flexibility, and ideation fluency. Using the raw neuropsychological measures we calculated a global index of cognitive impairment and domain-specific composite z-scores. Clinical assessment was performed using the Schedule for Deficit Syndrome and the Positive and Negative Symptom Scale. DNA samples were genotyped for polymorphisms of the candidate genes NRG1, DTNBP1, RGS4, G72/G30 and PIP5K2A. Association between the above composite scores and the SNPs was examined using the General Linear Model (GLM) analysis.

Results

The preliminary analyses uncovered statistically significant associations between DTNBP1 rs909706 and the global index of cognitive impairment (F = 3,39; p = 0,03), and cognitive flexibility (F = 4,81; p = 0,01), and DTNBP1 rs1011313 and short-term memory (F = 3,66; p = 0,02). Moreover RGS4 rs10917670 was associated with working-memory (F = 4,28; p = 0.01). We found no association of NRG1, G72/G30 or PIP5K2A with the domains of cognitive functioning.

Conclusions

Our results support the association of DTNBP1 and RGS4 candidate genes with cognition, as a possible endophenotype of schizophrenia.