bluuebunny/crossref_metadata_2025 huggingface dataset:
Mental Disorders in Victims of Sexual Violence
Authors: Endrass J. , Rossegger A.
Published: March 2009

Many investigations have shown a strong relationship between childhood sex abuse (CSA) and severe negative health and social outcomes among female and male victims of childhood sex abuse. The risk for unintended pregnancies, risky sexual behavior in general, and HIV-risk behavior is considerably elevated, leading to the contraction of sexually transmitted diseases. Furthermore, CSA victims are likely to be assaulted again as adults and a minority of CSA victims can become a perpetrator themselves. With respect to mental health outcomes, a higher prevalence of alcoholism, drug abuse, addiction, and pathologic gambling is found in CSA survivors. Additionally, CSA survivors are more vulnerable to anorexia nervosa, affective disorders, post-traumatic stress disorder (PTSD), or suffer personality disorders, especially borderline personality disorder (BPD). Furthermore, childhood sex abuse victims are more vulnerable to suicidal behaviour, showing frequent suicidal ideation and suicide attempts.
Zurich Victim Protection Charter
Authors: Urbaniok F.
Published: March 2009

Every person has the right to not become a victim of violent or sex offenses.

There is neither absolute certainty, nor “the solution” when dealing with violent and sex offenders. A society has many options for lowering the risks and for protecting its citizens. The focus on aspects of prevention in handling offenders plays a central role. Unfortunately, many countries show sizable deficits in areas of prevention:

•

No effective, social lobby for subjects on victim protection.

•

Political discussions are often characterized by ideologies and follow stereotypical rightist-leftist-schemata.

•

For legal- dogmatic reasons, the principle of prevention is treated subordinate to that of guilt.

•

This is where the Zurich Victim Protection Charter comes into play.

The Charter formulates 10 principles regarding prevention and victim protection. It's a statement against violent and sex offenses, but not against offenders. It pleads for a pragmatic strategy in dealing with offenses, offenders and risks. It demands adequate consideration of the rights and needs of (potential) victims.

The charter was formulated in Zurich in 2008 and has recently been posted on the internet with the aim of collecting enough signatures to give it political weight.

The initiators are convinced that subjects on victim protection can gain (social) political majorities and that the focus on prevention during criminal proceedings and correctional practices must receive the same status as the guilt principle. This is the central demand of the Zurich Victim Protection Charter, the contents and goals of which will be presented.
What about Ethiology?
Authors: Varandas P.
Published: March 2009

Depression has became the main focus of psychiatry care and research, due to its epidemiologic and economic wheight in health. As a matter of fact depression is now the second condition after cardio-vascular diseases contributing to the costs in haelth in our modern societies attending to the Daly"s measures.

From an old ethiologic prespective psychiatry shift to a pragmatic way to solve the main therotical issues in care and research. By this, we have now standard clinical methods to diagnose and classify depression, easy to use by any clinician (Psychiatrists and GPs), but we don"t know the essencial psychologic and biologic mechanisms of this disease as well as how the supposed ethiologic factors interact with these mechanisms.

Psychopharmacologic treatments opened some doors to this mechanisms, but the knowledge is still unsatisfactory in order to differenciate the several types of depression and to drive specific treatments to patients.

In this presentation included in the Symposium BACK TO THE BASICS: CHALLENGES IN CLASSIFICATION OF DEPRESSION it will be revised the actual knowledge concerning ethiology and phisiopathology of depression.
Recovery - a Model for Common Mental Disorders?
Authors: Amering M.
Published: March 2009

Context:

Recovery-concepts have travelled from margin movements into mainstream mental health policy rapidly in recent years.

Objectives:

Implications of a Recovery model in comparison to a medical model or chronic disease model will be presented and discussed.

Key messages:

The course of common mental disorders is variable. Remissions are possible as are recurrences and long-term disabilities. Research struggles with problems of definitions of types of courses and methodological problems of long-term studies. The clinical use of prognostic indicators and determinants of remission and recurrence and long-term courses for individual patients is limited. Many patients hesitate to understand their mental health problems within a model of medical care for chronic conditions. As a result a considerable proportion of their efforts towards coping and finding meaning in their struggle for recovery occur outside the patient-clinician relationship. A collaborative approach allowing for individualized interventions and accommodating hopes, fears, and subjective evidence in a personalized context might be better suited to bundle the resources of patients, their families and friends and professional helpers of different professional background.

Conclusions:

The Recovery model with its emphasize on mental health promotion, subjective quality of life, patient-self-determination and choice has a lot to offer in terms of collaborative management of disorders with highly variable courses and little prognostic certainties.
Changes in the Immune System and Gene Expression in Bipolar Disorder
Authors: Drexhage H.A.
Published: March 2009

The etiology of bipolar disorder is thought to involve multiple genes and environmental factors. Recently the immune system has been implicated in the pathogenesis. Various abnormalities indicate the presence of an activated inflammatory response system. In this presentation evidence will be presented on:

1.

A higher susceptibility for autoimmune diseases (thyroiditis, gastritis, type 1 diabetes), not only in patients but also in first degree relatives independent from mood disturbances.

2.

An inflammatory gene-expression signature comprising of 19 pro-inflammatory genes in monocytes, the monocyte (and its descendent cells) being important in the activation of the inflammatory response. The inflammatory gene-expression profile was also found in the monocytes of bipolar offspring, especially in those developing a mood disorder (prognostic value of the test?).

3.

Common environmental factors (infection, stress and dietary components?) as the factors causing the inflammatory monocyte gene-expression signature (evidenced in a twin study).

4.

A general T cell activation not only linked to the trait of the disorder, but also to the state of the disorder (i.e. with mania) and in part due to genetic factors (evidenced in a twin study). Also T cell activation is not linked to monocyte activation.

5.

A poor T regulator activation which is genetically determined and correlates with the presence of above-described autoimmune diseases.

In sum, there is clear evidence for an activated inflammatory response system in bipolar disorder, yet different components are separately activated in a complex fashion linked to the phenotype of the disorder and involving both genes and environmental factors.
The Therapeutic Potential of Non Steroidal Anti-inflammatory Drugs in the Treatment of Depression and Schizophrenia
Authors: Müller N. , Riedel M. , Schwarz M.J.
Published: March 2009

COX-2 inhibition seems to balance the type-1/type-2 immune response, possibly via inhibition of prostaglandin E2. COX-2 inhibition reduces proinflammatory cytokines. COX-2 inhibition has an impact to the glutamatergic neurotransmission and influences the tryptophan/kynurenine metabolism: all three components seem to be involved in the pathophysiology of psychiatric disorders, particularly in schizophrenia and major depression.

Due to the increase of proinflammatory cytokines and PGE2 in depressed patients, antiinflammatory treatment would be expected to show antidepressant effects. An antidepressant effect of rofecoxib was found in patients with osteoarthritis. An own randomized double blind pilot add-on study using the selective COX-2 inhibitor celecoxib in MD showed a significant therapeutic effect of the COX-2 inhibitor on depressive symptoms. Although those preliminary data have to be interpreted cautiously, those results are encouraging for further studies dealing with the inflammatory hypothesis of depression.

Secondly, we and other research-groups performed several studies of COX-2 inhibitors in schizophrenia. In a prospective, randomized, double-blind study with the COX-2 inhibitor celecoxib in acute exacerbation of schizophrenia, a therapeutic effect of celecoxib was observed. The finding of a clinical advantage of COX-2 inhibition could not be replicated in a second study. Further analysis of the data revealed that the efficacy of therapy with a COX-2 inhibitor seems most pronounced in the first years of the schizophrenic disease process.

It has to be considered, however, that therapy with COX-2 inhibitors is currently under discussion - as therapy with other non-steroidal antiphlogistics - due to cardiovascular side-effects.
Social Cognition and Psychosocial Functioning in Schizophrenia
Authors: Juckel G. , Brüne M.
Published: March 2009

Ability for empathy and theory of mind are diminshed in patients with schizophrenia. These kinds of social cognition are, however, necessary to interact with other people and obtain a well-balanced psychosocial functioning level, i.e. to have friends, to go for work, to be in partnership and so on. Own studies revealed that disturbances in social cognition are accompanied by fMRI activation deficits in distinct regions of the underlying neuronanatomical loop in schizophrenia. The most significant difference compared to healthy controls was found in the region of the anterior cingulate cortex (ACC) and medial prefrontal cortex (mPFC). We think that training of social cognition would improve both the neurobiological hypoactivation and the ability for empathy and theory of mind. As consequence, psychosocial functioning of the patients should be become better as measured e.g. by the personal and social performance scale (PSP). To emphazise the close relationship between social cognition, ist underlying neuobiology and psychosocial functioning is the main purpose of this lecture.
Alcoholism and Depression: Recent Results on the Mutual Interaction between Alcohol use, Stress-axis Dysfunction, and Affective Disorders
Authors: Kiefer F. , Mann K.
Published: March 2009

Alcohol intake is known to modulate plasma concentrations of neuroendocrine peptides. However, recent results suggest that the endocrine system may not only respond passively to alcohol intake, but that -vice versa- it also actively modulates alcohol intake behaviour. The most coherent body of data concerns the hypothalamo-pituitary-adrenocortical (HPA) axis, with low corticotropin releasing hormone (CRH) being associated with more intense craving and increased probability of relapse after acute detoxification. It is important to bear in mind that dysregulation of the HPA system, as observed in alcohol dependence, is also a feature of anxiety and depression, two conditions which are frequently linked with alcohol dependence and have been reported to be associated with a poor prognosis. In depression, increased secretion of CRH seems to be one crucial mechanism. It has been found as a marker of depressive symptoms, which normalises when depression is successfully treated. Hypersecretion of CRH is associated with a general hyperactivity of the HPA system, notably elevated plasma levels of ACTH and cortisol, a blunted cortisol stress response and a blunted dexamethasone suppression test. In any case, HPA dysregulation, alcohol dependence, and depression are closely interrelated. Exactly which component of this triad is the driving force behind the various neuroendocrine correlates of drinking behaviour is currently unclear, and will need to be elucidated by future research. This will allow for an enlightened choice of potentially therapeutic agents for the treatment of co-morbid anxiety, depression, and alcohol dependence, acting primarily on the HPA system.
Pharmacological Disruption of Alcohol-related Memories - Therapeutic Impact of the Theory of Memory Reconsolidation
Authors: von der Goltz C. , Vengeliene V. , Kiefer F. , Spanagel R.
Published: March 2009

Long-lasting memories that associate environmental stimuli with the effects of alcohol are known to be a main cause of relapse and are a major challenge in the treatment of alcohol addiction. It is reasonable to hypothesize that disrupting consolidated alcohol-related memories might help to prevent relapses. The reconsolidation theory states that a consolidated memory could again become labile and susceptible to disruption by protein synthesis inhibition or NMDA-antagonism after memory retrieval. This has been shown for cocaine- and morphine-associated memories in several recent studies. The aim of our investigations was to examine in an animal model for cue-induced relapse to alcohol-seeking behavior whether the behavioral impact of previously conditioned alcohol associated cues is significantly reduced by blocking the reconsolidation of learned alcohol associations. We show that reconsolidation of alcohol memories is disrupted by post-retrieval ICV-administration of the protein synthesis inhibitor anisomycin. Similarly, post-retrieval i.p.-administration of the NMDA antagonist MK-801 reduced alcohol seeking behavior during the following test day as compared to vehicle treated rats. Pharmacological disruption of reconsolidation of alcohol-associated memories may thus provide a potential therapeutic strategy for the prevention of relapse in alcohol addiction.
Epidemiology of Substance use in Pregnancy [S64-04]
Authors: Kumar M.T.
Published: March 2009

An understanding of the epidemiology of alcohol and drug use in young women is important to appreciate the considerable morbidity and mortality associated with it and to understand the impact of such use on offspring. Although abstention rates are consistently higher among women than men in general substance misuse is increasing in young women. Differences in definitions, measurement techniques, availability, social acceptability and affordability partly explain the great variability in reported prevalence rates. Alcohol exposure among pregnant women varies from 0.2% to 14.8%. An Australian national survey revealed that nearly half of pregnant and or breast-feeding women up to 6 months postpartum were using alcohol. A Swedish study reported risky use of alcohol during the first 6 weeks of pregnancy, at 15%. Cannabis use among pregnant women varies from 1.8% to 15%. The reported prevalence of opiate use during pregnancy ranges from 1.65 to 8.5%. Cocaine use among pregnant women is reported to be between 0.3% and 9.5. Most pregnant women stop or reduce their substance use during pregnancy and this might be an opportune moment for detection and treatment. Substance use tends to increase sharply in the postpartum period with adverse consequences on mother and baby. Perinatal substance misuse interventions can reduce adverse neonatal outcomes. On the basis of relatively high rate of substance use disorders during pregnancy and postpartum period, effective screening and intervention strategies should be implemented.
Altered Levels of Neurotrophic Factors in Alzheimer's Disease Patients with a Lifetimne History of Depression
Authors: Rapp M.A. , Haroutunian V. , Heinz A.
Published: March 2009

Aims:

We have recently shown both increases in the number of neuropathological changes in Alzheimer's disease patients with a history of recurrent major depression, and evidence for Alzheimer's disease-related neuropathological changes in patients with geriatric major depression. However, the correlates and possible underlying mechanisms for these neuropathological changes in Alzheimer's disease patients as a function of depression remains to be studied.

Method:

Levels of several neurotrophic factors, including nerve growth factor (NGF), brain-derived neurotrophic factor (BDNF), and neurotrophin-3 (NT-3) were measured in a sample of Alzheimer's disease patients with and without a lifetime history of major depressive disorder.

Results:

Alzheimer's disease patients with co-morbid depression showed lower levels BDNF (P < .001) and NGF (P < .001) than Alzheimer's disease patients without co-morbid depression. Results remained stable when controlling for age, gender, level of education, and other medical co-morbidities.

Conclusion:

In Alzheimer's disease, the presence of depression co-morbidity corresponds to decreases in neurotrophic factors beyond effects of age, education, and medical co-morbidities, suggesting that the previously described link between major depression and the neuropathological processes in Alzheimer's disease may be related to changes in neuronal survival mediated by neurotrophic factors.

Funded by the National Institute on Aging (U01 AG016976 and NIA P01-AG05138) and NARSAD.
Effects of Vitamin d Supplementation on Symptoms of Depression in Obese Subjects: Randomized Double Blind Trial
Authors: Jorde R. , Sneve M. , Figenschau Y. , Svartberg J. , Waterloo K.
Published: March 2009

The objective of the present study was to examine the cross-sectional relation between serum 25-hydoxyvitamin D (25(OH)D) levels and depression in obese subjects, and to assess the effect of vitamin D supplementation on depressive symptoms. 441 subjects (body mass index 28 - 47 kg/m2, 159 men and 282 women, aged 21 - 70 years) were recruited by advertisements or from the out-patient clinic at the University Hospital of North Norway, and in a double blind controlled trial randomized to 20.000 or 40.000 IU vitamin D per week versus placebo for 1 year.

Subjects with serum 25(OH)D levels < 40 nmol/L scored significantly higher (more depressive traits) than those with serum 25(OH)D levels ≥ 40 nmol/L on the Beck Depression Inventory (BDI) total (6.0 (0 - 23) versus 4.5 (0 - 28) (median and range)) and the BDI subscale 1 - 13 (2.0 (0 - 15) versus 1.0 (0 - 29.5)) (P < 0.05). In the two groups given vitamin D, but not in the placebo group, there was a significant improvement in BDI scores after one year. There was a significant decrease in serum parathyroid hormone in the two vitamin D groups, without a concomitant increase in serum calcium.

It appears to be a relation between serum levels of 25(OH)D and symptoms of depression. Supplementation with high doses of vitamin D seems to ameliorate these symptoms, indicating a possible causal relationship.
Reinventing the Wheel in Clinical Trial Design
Authors: Davis L. , Leon A.
Published: March 2009

Recent publications by the Institute of Medicine have unearthed several fundamental flaws in clinical trial methodology that, if corrected by the next generation of clinical investigators, can transform the field of mental health intervention research. Using a clinician-friendly approach, this workshop will succinctly review the essential elements of optimal design and implementation of a randomized controlled clinical study and the strategies to enhance signal detection. These include minimizing bias in the estimate of treatment effect while maintaining a nominal level of type I error (i.e., false positive results) and maintaining sufficient statistical power (i.e. reducing the likelihood of false negative results). Particular attention will be paid to reducing the problems of attrition and the hazards of multiplicity. Methods to examine moderators of the treatment effect will also be explored. Examples from psychopharmacologic, psychotherapy, and vocational rehabilitation trials for the treatment of posttraumatic stress disorder, depression, and panic disorder will be provided to illustrate these issues. Techniques to reduce the study's costs, risks, and participant burden will be described. Following the didactic session, the participants are encouraged to bring forth their own questions regarding clinical trial design for a 45-minute interactive discussion with the presenters. The objectives of the workshop are to improve the participants’ understanding of the goals of clinical trial design and methods to achieve those goals in order to improve their own research techniques, grantsmanship, and abilities to more accurately judge the results of studies presented in the literature.
Forensic Psychiatry in the Elderly-ethical Issues
Authors: Tataru N.
Published: March 2009

We discuss about psychiatric and psychological expertise exams and about the assessment of competence in the elderly and ethical aspect of care and research in elderly demented or not demented people and about involuntary commitment of incompetent patients.

We also refer to the complications and difficulties when trying to apply the civil commitments compulsive hospital admission measure, foreseen in the law for mental health, when the dementia diagnostic falls within this age group. Historically, involuntary commitment of incompetent patients took in the consideration the best interest of the patient, but also the well-being of the family and the potential risk for others.

After a short review of legislation and of conditions of hospitalization concerning involuntary commitment of the mentally ill people during our history before and after 1989, we'll analyze the activity on involuntary commitment in a Forensic Psychiatry Hospital in district Bihor, in last five years from a 30 years experience working in the field. Standards and practice in our country regarding the involuntary commitment have been changed more that three times after the second War and has been improved in 2002, when there appeared the new Mental Health Law, emphasizing protection of patients’ rights. There are legal and ethical limits to involuntary hospitalisation, because involuntary treatment and hospitalisation restricts a person's liberty. There should be a lot of things to do to improve the quality standards: improvement of elementary care needs, improvement of their quality of life.
Depression as a Moderator in the Relationship between Direction of Social Comparison and Self Esteem
Authors: Tallat G. , Kamal A. , Mccarthy S.
Published: March 2009

The present study explored the moderator role of depression in the relationship of self esteem and the direction of social comparison in the context of marital relationships among married couples. The relationship between the direction of social comparison and depression was also explored. The sample consisted of 100 married individuals (50 Married Couples) having diverse educational and occupational background and form all the three socio economic background. The sample was taken from different cities of Pakistan. The couples were requested to complete Beck Depression Inventory (BDI) and Index of Self Esteem (ISE) along with another scale, Social Comparison in Marital Relationship Measure (SCMRM). SCMRM was developed by the researcher to explore the couples’ inclination of comparing their spouses with others around them on different dimension of marital relationship satisfaction. The standardized method was used for the development of SCMRM. The study provided evidence of significant negative relationship of depression with social comparison in marital relationship and with self esteem. The findings also supported the hypothesis that depression will play a role of moderator in the relationship between direction of social comparison in marital relationship and self esteem. Beck's (1967) cognitive model of depression suggested that depressives’ systematic bias against the self is reflected in their tendency to compare themselves with better off others. Thus our results confirm the cognitive depressive model which proposed that depressives engage in dysfunctional social comparison (upward).
Constructivism and Positive Psychology: Contribution of Depathologizing Metatheory and Practice
Authors: Henriques A.
Published: March 2009

What do Constructivism and Positive Psychology, both movements of recent coinage, share? On some fundamental metaphoric assumptions, constructivism shares with positive psychology the humanist legacy, and an acknowledgement of the creative potential in human beings. Through practical approaches focusing not on the need of treatment and correction, but on the developing potential of subject's experiences, personal constructs, and emotions, constructivism shares with positive psychology a less negative and pathologizing view of psychological problems. This and other assumptions characterizing constructivism are presented as good contributes to theoretical and methodological developments both in positive psychology and psychotherapy in its different settings.
Personality Disorders in Consultation-liaison Psychiatry - an Empirical Investigation [PW01-01]
Authors: Diefenbacher A. , Golombek U. , Strain J.J.
Published: March 2009

Up to now hardly any quantitative research regarding diagnosis of personality disorders in the environment of Consultation-Liaison Psychiatry and Psychosomatic Medicine is available.

The data of 3032 patients aged 17-65 years seen between 1988 and 1997 at the Mount Sinai Hospital in New York, NY, were recorded and analyzed using the Micro-Cares Database System.

19,7% (N=598) of patients exhibited a personality disorder. Out of those 7,7% distributed to Cluster A (Odd or Eccentric Behavior), 54,3% to Cluster B and 38,0% to Cluster C.

89% of patients with personality disorders showed at least one additional specific psychiatric disorder.

Patients with a personality disorder had a lower incidence of somatic disease, but exhibited a higher level in psychosocial impairment and a higher comorbidity in substance abuse. During the previous year they used psychiatric treatment more often and were in need of a more intense social and psychotherapeutical treatment.

The age group of 17-40 year old patients with a personality disorder was hospitalized shorter and had less of a lag between hospitalization and time of psychiatric consultation.

More reasons for a psychiatric consultation were given when patients with a personality disorder were referred.

In the environment of Consultation-Liaison Psychiatry and Psychosomatic Medicine every 5th to 6th patient requires a specific, psychiatric, psychotherapeutic or social treatment because of a personality disorder.

The classification of personality disorders into clusters did not yield an additional benefit.
Personality Disorders and Painful Bodily Experiences: About 100 Cases in a Psychiatric Emergency Service [PW01-06]
Authors: Joubrel D. , Caroline D. , Gaspard J.L.
Published: March 2009

This communication presents an epidemiological, clinical and therapeutic study about 100 cases of suicidal patients in crisis who have received psychiatric emergency care. Results of this research emphasize the relationship between patient's borderline personality disorder and sensorial/painful bodily experiences (like body marks, self-mutilations and scarifications). A specific emergency treatment in Guillaume Régnier hospital (Rennes - France) supports patients for reducing risk of suicidal behaviour.
Evaluation of 2 Years’ Residential Care Treatment for Adolescents and Young Adults with Schizophrenia [PW02-01]
Authors: Hemmerle M. , Röpcke B. , Eggers C. , Oades R.D.
Published: March 2009

Aims:

In 2002 the Professor Eggers Foundation started a 2-year-programme for patients suffering from early-onset schizophrenia (EOS) following discharge from a clinic (outpatient care). The aim is with intense residential care and treatment to support recovery and independence. Interactive and psychoeducational family care, coping with persistent symptoms, development of social and emotional competence, independent house keeping, and support of school and vocational training are the main features.

Methods:

Psychopathology, social and neuropsychological function were assessed with a set of questionnaires and tests at the start, after 1 year and after 2 years on completion of the programme for 12 participants. Living and working situation were monitored. The results were compared with the progress of 12 EOS patients treated as usual (comparison group).

Results:

Positive and negative symptoms showed a significantly greater decrease with respect to the comparison group. Social function improved considerably stronger in the participants. Working memory, attention and some executive functions also improved in the participants, while there was a deterioration of speed and selective attention (trend) in the comparison group. Neither group showed changes in measures of intelligence or the subjective quality of life with the exception of increased contentedness with family relations in the participants.

Conclusions:

We show the benefits of an early intensive residential training programme for EOS patients. Further research may be able to show if these improvements can be maintained and whether the costs of the programme are economical avoiding continued residential care.
Do we Need to Review Outcome Measures in Schizophrenia to Capture ‘Real-life’ Situation? [PW02-05]
Authors: Shrivastava A.
Published: March 2009

Introduction:

Outcome measures in schizophrenia are defining aspects for deciding the status of recovery based upon which people’ scientific body forms opinions. It is also important in dealing with stigma related to schizophrenia. Recently the concept of ‘recovery’ and’ outcome’ has come under scientific scrutiny. Literature does not show a consistent pattern in outcome. Both short term and long-term outcome show variability, which is often, explained by cultural factors. It has been generally considered that devolved countries have poor outcome than developing, non-industrialized countries. This view has also been challenged recently. The paper draws from the conceptual aspects if our outcome measure are capturing ‘real-life’ situation. We conducted two studies in Mumbai, India:

1.

Study of stigma & discrimination, which brought out the facts of families’ expectation and disappointments with level of recovery.

2.

A 10 years long term study, to determine recovery status of recovered patients.

80% patients and families felt that recovery is inadequate and short of social integration despite continued treatment in stigma study. In outcome study, 60% patients showed good recovery as per CGIS. These patients were reassessed on 13 outcome criteria's of Meltzer. It is observed tat half of the patients who recovered continue to live with symptoms, a quarter with varying suicidality and side effects, most of the patients were not socially integrated, majority have not returned to productivity, employment and education It is concluded that outcome criteria's need a thoughtful revision and a new perspective to capture ground reality.
The use of the Free Recall Method in the Analysis of Verbal Memory Deficits in Dual Diagnosis Patients [PW02-06]
Authors: Krysta K. , Klasik A. , Janas-Kozik M. , Przybylo J. , Krupka-Matuszczyk I.
Published: March 2009

In schizophrenia there are specific cognitive deficits including verbal memory deficits. The objective of this study was to examine short-term verbal memory differences between subjects with and without a dual diagnosis.

A group of 80 patients with a diagnose of schizophrenia were examined. 40 of them never used illicit drugs, the other 40 also received a diagnose of addiction to psychoactive substances. The Free Recall Method was used to compare two examined groups. The results of addicted and not addicted schizophrenic patients were analyzed in all trials of the 5 stages of the examination with the use of Free Recall Method. Persons suffering from schizophrenia can usually repeat much fewer words in all five stages of the examination with Free Recall Method. This deficiency of short-term memory in this group of subjects is present from the very beginning of information coding.

As it was expected a deficiency in short-term verbal memory was found in all examined patients. However when comparing both groups no statistical differences concerning verbal memory deficits were found between the group of patients suffering from schizophrenia addicted and not addicted to psychoactive substances.

The fact that no significant differences concerning short-term verbal memory between two examined groups were found, which is consistent with some of the studies found in the literature, may be a good predictor for this group in terms of their possible chances of successful rehabilitation.
Endophenotypes and Diagnostic Categories: Event-related Potentials and the Schizophrenia-bipolar Dichotomy [PW03-01]
Authors: Maltez J. , Dias D. , Silva H.
Published: March 2009

After decades of neuroscientific research and taxonomic endeavour in psychiatry the quest for biologic markers specific enough to accommodate nosologic categories has not succeeded. Yet, neurophysiology and neuroimaging have developed pwoerful tools to investigate brain function. An immense amount of data has been accumulated regarding normal and pathologic information processing, cognition, emotion and other domains. Some have been correlated with genes underpinning diseases and are candidate endophenotypes. These stand at an intermediate level between genes and phenotype. They encompass several kinds of dysfunctions or abnormalities in brain structure. Rather than matching to singular diagnostic categories, as we devise them today, the same endophenotype is usually shared by distinct pathologic entities. Assuming tha they reflect specif dysfunctions this raises critical questions regarding the DSM way of classifying mental disorders and to the understanding of the neurobiologic phenomena underlying them. It is the purpose of this presentation to discuss these questions and review some of the data, including our own, concerning event-related potentials endophenotypes of psychosis with special focus on the schizophrenia-bipolar dichotomy and present.
A Preliminary Study of P200 in First-episode Patients, their Relatives and Healthy Controls: Search of New Endophenotypes [PW03-04]
Authors: Silveira C. , Santos F. , Barbosa F. , Pedro A. , Palha A. , Marques-Teixeira J.
Published: March 2009

Background/Objective:

Despite the well established genetic basis of schizophrenia, the relationship between genes and the disorder itself is still elusive. Individual endophenotypes, which reduce the complexity of genetic analyses, allow statistical approaches with quantitative trait methodologies. P200 abnormalities of event-related potentials have been reported in schizophrenia with conflicting results. The present study aims to characterize the P200 in first-episode patients and to compare it with that of first-degree relatives and controls.

Methods:

ERPs were recorded at 19 sites with an auditory oddball for 21 first-episode patients with schizophrenia (mean age=25.14; SD=6.20), 41 of their first degree relatives (mean age=47.65; SD=15.53) and 19 healthy controls (mean age=26.32; SD=7.16). Potentials were averaged for frequent stimuli and P200 amplitude and latency measures were obtained.

Results:

Analysis of midline electrodes revealed significant group effects for P200 peak amplitudes (F(2, 78)=3.315, p=.042), but not for peak latencies. Post-hoc analyses revealed that patients with schizophrenia present significantly lower P200 amplitudes (M=2.466; SD=1.564) than controls (M=5.037; SD=2.500) at Pz (T(38)=3.851, p=.003). No other significant differences were found.

Conclusion:

The results obtained do not straight-forwardly support the P200 peak amplitude nor peak latency as an endophenotype of schizophrenia. However, the trends of our results may suggest that the P200 amplitudes of relatives may present intermediate values between healthy controls (with higher amplitudes) and patients (with lower amplitudes). Further statistical analyses will be required in order to disentangle the effects of possible confounding variables.
Efficacy of the Integrated Long-term Program of Management of Patients After First Psychotic Episode in 5-Year Follow-up [PW03-05]
Authors: Zaytseva Y.
Published: March 2009

The study was carried out as prospective, longitudinal investigation of first episode patients having been treated in the integrative program in first episode clinic (1st group, 114 patients) and in routine care (2nd group, 109 patients) during 5-year follow-up. The integrated program included management according to the following principles: decrease of duration of untreated psychosis; using of services with initial or early transition to day treatment and at the following outpatient treatment stages; primary use of atypical neuroleptics in combination with psychosocial interventions; long-term follow up with individualized case management; family involvement in treatment and rehabilitation process. The efficacy was evaluated according to the comparative pairwise analysis using initial demographical and clinical characteristics of patients (34 pairs).

Comparing to the routine care, patients who have been treated in first episode clinic were more adherent to therapy regimen during the follow-up period, more than half of patients maintained the condition of complete remission. Moreover, patients of the 1st group were more likely to show help-seeking behavior and referred to services during the earlier stages of the exacerbation, therefore the relapse rates were decreased and 2/3 of patients were treated in outpatient settings. Symptomatic control of the illness contributed to social recovery in patients within integrated care. By the 5th year, only 1/5 of the cases of the 1st group were formally recognized as unemployable due to psychiatric disability. Significantly better clinical and psychosocial outcomes have been shown in comparison with the group of patients, treated in routine psychiatric services.
Integral Self Therapy: A Novel Transpersonal Psychotherapeutic Method [PW04-02]
Authors: Bhat S.
Published: March 2009

This paper summarizes the results of Integral Self Therapy in the treatment of a group of 30 patients with mild anxiety and depression, and explains the steps involved in this novel psychotherapeutic method.

Integral Self Therapy (IST) is best defined as a transpersonal, nondual, psychotherapeutic method.

It is a form of transpersonal psychotherapy since practitioners of IST incorporate a spiritual understanding of the nature of the self into the therapeutic practice. IST has its theoretical foundations in the eastern paradigm of self-concept.

“Non-Dual” refers to the eastern concept of the lack of an inherent difference between the observer and observed - a personal identity is considered to be a part of a larger whole. While this has traditionally been seen as a metaphysical concept, it has powerful therapeutic implications.

For example, a person with depression and anxiety might feel a great deal of relief if they are able to experience what Maslow called “peak experiences”.

Integral Self Therapy uses meditation, and gentle confrontation to create transcendent experiences.

These experiences are then placed into context by the therapist, comparing these experiences with the patient's own sense of depression and anxiety.

In this manner, patients are moved towards a more expansive self-concept. This has a significant therapeutic benefit, with a concomitant decrease in symptoms of depression and anxiety, with results seen in 6 to 8 sessions.
Cardiovascular Risk in a Spanish Population of Bipolar Disorder Patients: Results from the BIMET Study [PW05-02]
Authors: Montes J.M. , Vieta E. , González-Pinto A. , Rejas-Gutiérrez J. , Mesa F.
Published: March 2009

Purpose:

To estimate the 10-years coronary heart disease and cardiovascular mortality risks in a Spanish population of bipolar disorder (BD) patients.

Methods:

BIMET study is a 12-month, prospective, multicentre, naturalistic study which enrolled type I or II BD patients according to DSM-IV TR criteria. A fasting blood sample was drawn to evaluate glucose, total cholesterol, HDL cholesterol, LDL cholesterol and triglycerides. Weight, height, waist circumference at the umbilicus and blood pressure were also recorded. Framinghan and SCORE functions were used to calculate the 10-year risk for coronary hearth disease or cardiovascular death respectively.

Results:

A total of 320 and 417 patients, mean age 46.3 (13.0) years, were included for the Framingham and SCORE calculations respectively. The overall mean (standard deviation) risk for coronary heart disease was 7.3% (7.8) according to Framingham algorithm, with 6.3% of patients classified as having a high risk of coronary disease (Framingham higher than 10%). The mean overall risk for cardiovascular mortality was 1.2% (2.4) according to SCORE algorithm, with 6.5% of patients falling within the high cardiovascular mortality risk segment; SCORE higher than 5%. No statistically significant differences were observed between type I and II patients.

Conclusion:

This study reflects a substantial risk for cardiovascular events or mortality in a Spanish cohort of bipolar disorder patients. Results were comparable to those seen in subject with schizophrenia spectrum disorders. Therefore, an effort for controlling all cardiovascular risk factors in bipolar disorder patients should be carried out by clinicians and health decision makers.
Bipolar Disorder (BD) and Obsessive Compulsive Disorder (OCD) Comorbidty or Varied Episodes in the Same Disorder [PW05-03]
Authors: Oral E. , Ozan E. , Deveci E. , Aydın N. , Kirpinar I.
Published: March 2009

Previous studies have suggested that OCD has comorbidity with bipolar disorder (BD) (1,2). We evaluated the three bipolar OCD cases.

C1: Because of the OCD symptoms Chlomipramine was started. Her OCD symptoms improved in several days but manic symptoms was apeeared, switched to Lithium Carbonate. In her out patient exams, manic and obsessive compulsive symptoms were almost never observed simultaneously at the course.

C2: In 2003, her complaints started as combined OCD and Manic symptoms, Risperidon and Lithium carbonate were started, manic and OCD symptoms improved. In 2005, OCD and Depressive symptoms appeared together. She got improved with Lithium Carbonate and Chlomipramine. She had one episode with obsessive and manic symptoms or obsessive and depressive symptoms every year till now. Her uncle had Depression and her aunt had Bipolar disorder.

C3: Because of his OCD symptoms we prescribed SSRI and lower dose antipsychotic. At that time he hospitalized for his manic symptoms, his OCD was partially remitted. His manic symptoms improved with Lithium carbonate1200p/d. He had resistant obsessive compulsive symptoms and episodic manic symptoms. His father had M. Depressive episodes.

Conclusion:

Our cases suggest that bipolar OCD has episodic course, treatment resistant symtomatology, high family loading and high frequency of recurrence.
Does Gender have any Effect on the Neurophycological Damage in Cocaine Addicts? [PW06-01]
Authors: Mangado E. Ochoa , Madoz-Gúrpide A. , Vadillo E. Salvador
Published: March 2009

Records:

Taking into account the differences on the basal cognitive performance, pattern of drug use, and the influence of menstrual cycle on cerebral blood flow and neuronal lost, it is expected to find differences on the neuropsychological damage resulting of chronic cocaine use according to the patient's gender.

Objetive:

To know about the influence of the gender factor on the neurophycological damage as a result of chronic use of cocaine.

Experiment and method:

Using a neurophicological assessment battrery (digit (WAIS-III), Trail Making, Card's, Zoo's (BADS), and Wisconsin Card test), we compare the performance between males (N= 19) and females (N= 5). This assessment is part of a wider observatory prospective study with a control group, to study neurophycology damage caused by the cronic consumption of cocaine (Proyect MSC-2005/465 (DGPNSD).

Results:

The mean age on our sample is 36.0 years (ds: 6.3); mean of schooling time was 8.4 years. 83.3% consume cocaine daily, but only 12.5% injected intravenously. The average of daily cocaine consumption is 1.5 gr (ds: 1.3). 87.5% use also other illegal substances.

No statistically significant differences were found between the two groups in any of the tests applied. The adjustment was made considering different patterns of drug use, schooling time and other variables. In the others analysis of the same tests in the group control neither did no find any different evidence in gender factor.

Conclusions:

Differences according to gender could not be found. On the statistical adjustment, pattern of cocaine use and previous cognitive function were considered.
F2695: A New Therapeutic Potential for Major Depression. A Phase II Double-blind Randomised Trial Results
Authors: Mansuy L.
Published: March 2009

F2695 is a novel antidepressant exerts simultaneous noradrenergic and serotoninergic neurotransmitter effects.

F2695 SR was administered in patients with Major Depression in a randomized, multinational, double-blind, placebo-controlled 10-week study, assessing the efficacy and safety of F2695 SR progressive titration safety adapted doses from 75 mg to 100 mg od, in out-patients with Major Depressive Disorders. The 563 randomized patients fulfilled the diagnostic criteria for Major Depressive Disorders and presented moderate or severe Major Depressive Disorders. Efficacy analysis found a significant difference between F2695 and placebo in favour of the active treatment in term of a significantly greater improvement in MADRS total score with F2695 compared with placebo (p< 0.0001). In addition, significantly more patients achieved MADRS response (a decrease in total score equal or superior to 50%) and MADRS remission (defined as a total score inferiorior to10) in the F2695 group than in the placebo group such an effect being usually not seen on this measure in the relatively short time span of a ten-week study. At the doses tested, F2695 was effective from early in the treatment (week 2) and the difference in efficacy compared with placebo increased steadily throughout the study.

The severity to entry in this study was relatively high and the mean MADRS entry score was 31, about 40% of patients were in the severe category of depression.

This study: provided evidence of the efficacy of F2695 in major depression population. Therapeutic effect was sustained in term of effect-size, responders and remissions rate, in front of placebo.