bluuebunny/crossref_metadata_2025 huggingface dataset:
1765 – Futher Validation Of The Children's Depression Inventory In a Portuguese Adolescents Sample
Authors: Bento C. , Pereira A.T. , Marques M. , Saraiva J. , Macedo A.
Published: July 2013

Introduction

The Children's Depression Inventory (CDI) is a 27-item, symptom-oriented scale for youths aged 7-17. In Portugal some psychometric parameters has never been analyzed before.

Objective

To analyse the reliability and construct and concurrent validity of the CDI in a Portuguese adolescents sample.

Method

969 adolescents (59.34% girls), aged 15.80 ± 1.51, answered the Portuguese versions of the CDI and of the Rosemberg Self Esteem Scale (SE). To study the temporal stability, 204 (58.74% girls) respondents answered the questionnaires again after approximately 5 weeks.

Results

CDI mean scores were difference between genders [Girls=10.84 ± 6.025 vs. Boys: 8.90 ± 6.477, p < .001]. The Cronbach's alpha (α) was .85 for the total sample, .83 for the Girls, and .87 for the Boys. Pearson correlations between the test and the re-test was r = .81 for the total sample, r = .78 for the Girls sub-sample and r = .83 for the Boys sub-sample. Based on factorial and parallel analysis, a 4-factors structure was selected for the total sample (variance explained, VE = 38.93%), the Girls (VE = 36.92%) and the Boys (VE = 41.98%). The items content were similar in the total sample and by gender, but the order of the factors was different. The four factors were: “Depression and Negative Self Esteem”, “Ineffectiveness and Somatic Symptoms”, “Anhedonia”, “Interpersonal Problems”. The SE and CDI total scores were negative and statistically (p < .001) correlated in the total sample (r = -.67), in Girls (r = -.69) and in Boys (r = -.63).

Conclusions

The Portuguese CDI has good reliability and validity, showing to be an adequate instrument for measuring depressive symptoms in Portuguese adolescents.
1767 – Electroconvulsive Therapy (ect) Convulsion Time According To Diagnosis And Treatment Phase
Authors: Barrio P. , Batalla A. , Hidalgo D. , García Acuña M. , Pons A.
Published: July 2013

Introduction

ECT remains as one of the most effective and secure psychiatric treatments for a wide variety of disorders, like depression, bipolar disorder or schizophrenia. Although not fully known, several theories hypothesize about its mechanism of action. To be effective, it has to induce a generalized convulsion of at least 15 seconds.

Objective

To analyze and compare convulsion times regarding diagnosis and treatment phase (acute, continuation or maintenance) to discern whether these factors influence convulsion time.

Methods

1675 ECT sessions were performed on 117 patients during a year at a universitary hospital. Convulsion times were analyzed comparing them according to main diagnosis (bipolar disorder, major depressive disorder, schizophrenia, schizoaffective disorder), as well as according to treatment phase (acute, continuation, maintenance).

Results

Schizophrenia mean convulsion time was 40,77 seconds (CI95% 39,25-42.28), for schizoaffective disorder it was 34,59 seconds (CI95% 32,74-36,44), for bipolar disorder 35,13 seconds (CI95% 33,83-36,43) and for major depressive disorder 34,90 seconds (CI95% 32,72- 37,07), with a statistical significance between groups of p < 0.001.

According to treatment phase, mean convulsion time in the acute phase was 34,94 seconds (CI95% 33,81-36,19), in the continuation phase it was 39,61 seconds (ICI95% 37,28-42,29), and in the maintenance phase it was 39,00 seconds (CI95% 37,92-40,18), with a statistical significance between groups of p < 0.001.

Conclusions

Although there exist statistically significant differences between groups according to diagnosis and treatment phase, they are not clinically relevant, thus concluding that neither diagnosis nor treatment phase seem to influence convulsion time to a relevant degree.
1772 – Difficulties In The Recognition Of The Wernicke-korsakoff Syndrome In a General Hospital. Three Cases And a Review
Authors: Soler-González C. , Mansilla-Sánchez S. , Balcells-Olivero M. , Gual-Solé A.
Published: July 2013

Introduction

Wernicke-Korsakoff (W-K) syndrome is a neuropsychiatric disorder resulting from thiamine deficiency, which is associated with significant morbidity and mortality. According to autopsy-based studies, it is still greatly underdiagnosed. In this case study and review, we focus on late diagnosed W-K related with alcohol misuse, and we give a short review about the topic focusing on its prompt diagnosis and adequate treatment.

Objectives and aims

We intend to underline that W-K syndrome, a preventable neurological condition and even treatable in its early phase if suspected, is underdiagnosed, with critical consequences for the patient's prognosis.

Methods

Using a case-report format, we describe three cases of W-K syndrome which were initially misdiagnosed in different general hospitals. We summarize complementary explorations, therapeutic management and evolution, and after that we shortly review the topic.

Results

The three patients were diagnosed of W-K syndrome in the psychiatry unit, weeks after being visited in the emergency facilities, where it was not suspected nor detected or prevented. All of them ended up with cognitive disabilities of a different degree, always with a remarkable impact in their functioning. One of them achieved some amelioration with thiamine in high doses, despite its late detection.

Conclusions

W-K can be prevented and treated if early detected, but it is underdiagnosed, with severe consequences for the patients. We suggest some measures that could enhance its detection and prevention, like modifying emergency room protocols, both diagnostic and therapeutic.
1774 – Female Perspective Of Borderline Personality Disorder And Depression
Authors: di Giacomo E. , Alamia A. , Manzutto S. , Aspesi F. , Lazzari M. , Riboldi G. , Clerici M.
Published: July 2013

Daily clinical practice shows that most admissions due to depressive symptoms are established more by personality (PD) - in particular borderline - than mood disorders (even if the prevalence of unipolar depression is assessed as 10 times higher than borderline PD). Both have a higher incidence in the female populace.

Methods

During the 6 months of recruitment, the patients admitted for depressive symptom complaints were screened with a medical history and socio-demographic inventory, the SCID II, the Hamilton Depression Rating Scale (HAM-D), the Beck Anxiety Interview (BAI), and the Beck Depression Interview (BDI). The patients will be retested through a follow-up after 3 and 6 months with HAM-D, BDI and BAI. Only the feminine part of the sample was considered (n = 60) and divided by SCID II results in Borderline Personality Disorder [B] (n = 33), Other PD [O] (n = 14) and negative [N](n = 9); 4 patients refused to complete the tests [R].

Results

Statistically, there were no significant differences among the groups, if the same test is compared at the same moment; however, during follow-up B improves in a statistically significant way compared to others. Moreover, those of B who underwent psychotherapy statistically had significantly lower scores than those of B who did not.

Conclusion

Research clearly demonstrates the importance of PD, and in particular borderline, in determining admissions due to depressive symptomathology. Moreover, Borderline PD patients improve more than other patients after an admission, particularly if they underwent psychotherapy.
1781 – High Prevalence Of Sexual Dissatisfaction In Hemodialysis Patients
Authors: Martins J.P. , Biavo B.M.M. , Martins C.T.B. , Rocha J.C. , Caramello S.R. , Ribeiro E.
Published: July 2013

Background

Sexual dysfunction is the inability to perform satisfactory sexual activity. It is estimated that 80% of men have erectile dysfunction in dialysis and 55% of women, difficulty in sexual arousal. Men may have decreased libido, erectile dysfunction and difficulty reaching orgasm. Women have difficulty in sexual arousal, decreased vaginal lubrication, dyspareunia, and difficulty achieving orgasm.

Objective

Assess sexual dysfunction in hemodialysis patients.

Methods

A Cross-sectional analysis conducted with a randomized sample of 100 subjects from a total of 521 hemodialysis patients (20%) of both genders. Data were collected through Kidney Disease Quality of Life - Short Form (KDQOL-SF).

Results

Most patients were female (52%), mean age 55 ± 14 years. After KDQOL-SF, the most common complaint was lack of sexual activity (82.81%). Most patients are dissatisfied with sexual performance (59%). Among them, the more dissatisfied were women, 61% (36/59), p < 0.02, and patients under 65 years, 61% (36/59) p < 0.007. Among those who report being sexually satisfied, the majority were male (58.33%). We found that sexual dissatisfaction is more common in women. Among 52 female patients, 37 were dissatisfied (71.15%), whereas among men, we have 56.25% (27/48) of sexual dissatisfaction.

Conclusion

There is evidence of high prevalence of dissatisfaction in the hemodialysis patients sexual performances. Further studies are needed on their sexual function, as well as therapeutic interventions that may offer improvement in this negative scenario.
1799 – Deep Transcranial Magnet Stimulation Improves Depression And Fatigue In Multiple Sclerosis
Authors: Gaede G. , Tiede M. , Lorenz I. , Pfueller C.F. , Doerr J. , Bellmann-Strobl J. , Zangen A. , Schippling S. , Paul F.
Published: July 2013

Introduction

Fatigue and depression are among the most frequent symptoms in multiple sclerosis (MS), affecting up to 90% of patients at onset or during the course of the disease. Repetitive transcranial magnetic stimulation (rTMS) has proven safe and efficacious for treating depression.

Objective

To perform a randomized, sham-controlled pilot study to evaluate effects of deep rTMS on fatigue and depression in patients with multiple sclerosis.

Methods

28 MS-patients underwent 18 sessions of deep rTMS over 6 weeks. 10 patients underwent sham stimulation, 9 patients stimulation of the left prefrontal cortex (PFC) (18 Hz, 120% motor threshold (MT)) and 9 patients of the motor cortex (MC) (5 Hz, 90% MT). Following the treatment, patients were observed for further 6 weeks. Effects on fatigue were evaluated with the Fatigue Severity Scale (FSS) Depression was assessed by Becks Depression Inventory (BDI).

Results

There was no significant change of BDI or FSS in sham group, as well as in PFC group over all time points. However BDI in MC group showed a significant decrease already in early treatment phase (-25.74% ± 24.36%, p = 0.013) and continued decrease over treatment period with maximum in follow up phase (-39.23% ± 21.57, p = 0.001). In FSS, MC group showed a trend to decrease during treatment period and the effect becomes significant in follow up phase (-26,72% ± 16.30%, p = 0.001).

Conclusion

Our data suggests that deep rTMS may have positive influence on depression and fatigue. Intrestingly, comparable effects on both symptoms were observed in MC group but not in PFC or in sham group.
1802 – The Age Interference On Quality Of Life Of Patients Undergoing Chronic Hemodialysis
Authors: Martins J.P. , Rocha J.C. , Caramello S.R. , Clesca P. , Ribeiro Junior E. , Martins- Tzanno C.T.B.
Published: July 2013

Objective

To assess quality of life through self-administered KDQOL-sf (Kidney Disease Quality of Life - short form) by patients on hemodialysis (HD) classified according to age.

Methods

We randomly 159 hemodialysis patients and applied the KDQOL-sf between February/10 and March/11. We evaluated the quality of life based on scores below or above 50, on all scales, according to age < 60 years (n = 85) and ≥ 60 years (n = 74).

Results

In patients < 60 years, the scales in which they had poorer quality of life were: physical function 47/85 (55.3%), Chronic Kidney Disease (CKD) burden 46/85 (54.1%), professional role 57/85 (67.1%) and sexual function 47/85 (55.3%). In patients ≥ 60 years, the scales with poorer quality of life were: physical functioning 47/74 (62.2%), physical function 51/74 (68.9%), general health 38/74 (51.3%), energy / fatigue 45/74 (60.8%), CKD burden 56/74 (75.7%), professional role 49/74 (66.2%) and sexual function 60/74 (81.1%).

Conclusion

While patients younger than 60 years have a quality of life decrease in 4 scales, patients with more than 60 years have worsened in 7 scales, with significant worsening of sexual function. We conclude that the quality of life is more impaired in the elderly undergoing HD.
1805 – Child Bipolar Disorder: a Case Report
Authors: Zappitelli M.C. , Pereira M.L. , Gonçalves E.C. , Bordin I.A.
Published: July 2013

Background

The diagnosis of bipolar disorder in children and adolescents has increased in clinical settings throughout the last two decades. Its prevalence is around 1.8% being similar in different countries. However, how it is diagnosed is still a challenge due to its variability of clinical presentations, overlapping with other more commonly psychiatric disorders and high rates of comorbidities. Therefore, it is still important to report cases in order to enhance our knowledge about this complex field of the mental health in childhood and adolescence.

Objective

To present clinical characteristics and follow-up of a 12 year-old adolescent who met DSM-IV criteria for bipolar disorder NOS.

Method

To describe the clinical trajectory from the diagnosis to the outcomes of the mentioned case, focusing on the main symptoms and family functioning.

Results

The combination of mood stabilizers, family interventions and individual psychodynamic therapy resulted in an improvement of the global functioning.

Conclusion

Even in a complex case of child bipolar disorder with early onset the treatment based on pharmacotherapy, individual psychodynamic therapy and systemic family therapy was able to provide satisfactory results.
1807 – Influence Of Childhood Trauma In The Cognitive Biases Implicated In Pathogenesis Of Delusional Disorder
Authors: Vicente I. , Laorden A.T. , Sánchez M.J. , Del Amo V. , Olmeda M.S. , De Portugal E. , García I.
Published: July 2013

Introduction

There exists evidence about the presence of Childhood Trauma (CT) being implicated in pathogenesis of Delusional Disorder (DD).

Objectives

Investigate de influence of CT in the cognitive biases (attentional bias, jumping-to-conclusions, personalizing attributional bias, need-for-closure and “self” discrepancies) and in the social cognition alterations (theory-of-mind and facial emotion recognition deficits) which have been postulated to be implicated in formation and maintenance of DD.

Methods

Childhood Trauma was measured using the “Childhood Trauma Questionaire” in 64 patients (n=64) diagnosed with DD by the SCID-I (DSM-IV-TR). The cognitive biases were evaluated using specific scales (“Emotional Stroop”, “Experimental Beads Task”, “Need-for-Closure Scale”, “Internal, Personal and Situational Attributions Questionnaire” and “Personal Qualities Questionnaire”). Social Cognition was evaluated using a theory-of-mind task (“Faux-Pas”) and a facial recognizing task (“Eyes Test”). The relationship between CT and those anomalies were examined using lineal regression models controlled by sociodemographic characteristics, premorbid IQ (“National Adult Reading Test”), delusion intensity (“Maudsley Assessment of Delusion Schedule”), depression intensity (“Beck Depression Inventory”) and neuropsychological function (attention, verbal learning, working memory and executive function; measured by a extensive neuropsychological assesment).

Results

High scores in CT were significantly associated with low scores in Faux-Pas task after being adjusted by the delusion and depression intensity, executive function and antipsycothic medication dose.

Conclusions

The severity of Childhood Trauma in patients with DD is related to theory-of-mind deficits, a social cognitive function which has been implicated in the pathogenesis of the Delusional Disorder.
1808 – The Use Of Antipsychotic Drugs In Elderly Patients With Dementia
Authors: Ben Ammar H. , Bel Arbi A. , Robbana L. , Moula O. , Bouasker A. , Ghachem R.
Published: July 2013

Introduction

Delusions, hallucinations, aggression, and agitation affect more than half of patients with dementia. Antipsychotic drugs are used to treat these behaviors and symptoms. They are among the most frequently used psychotropic drugs in this disease, but their benefits are uncertain and concerns about safety have emerged. We assessed the current practice in use of antipsychotics medication in outpatients with dementia.

Method

We conducted a retrospective cohort study involving patients older than 65 years who began outpatient treatment with antipsychotic drugs following a dementia diagnosis.

Results

22 patients were included (16 female, 6 male) with mean age of 78.6 years. All patients consulted for behavioral problems. Most received typical aantipsychotic drugs (72,8%), while 36,4% received atypical antipsychotic drugs. 13 patients (59,1%) were receiving haloperidol. Improvement was observed in 54,5% of patients.

The comparisons of haloperidol with risperidone suggest no difference in efficacy for the treatment of global behaviour disturbance. On the other hand, use of haloperidol is, however, associated with a higher incidence of extrapyramidal and other side effects.

Conclusion

The treatment of elderly patients requires daily careful management and monitoring because of their polypathology, polymedication and of their greater sensitivity to the toxic effects of drugs. Overall, the study findings suggest that there is a need to monitor antipsychotic drug use by elderly patients in light of recent efficacy and safety data on atypical agents.
1817 – Child And Adolescent Mood Disorders Program (proacth)
Authors: Pereira M.L. , Zappitelli M.C. , Daniel C. , Admoni D.H. , Gonçalves E.C. , Trovão M.M. , Mello R.A. , Bordin I.A.
Published: July 2013

Background

Mood disorders have a multifactorial etiology comprising genetics and environmental aspects in a complex interplay between them. Depression and bipolar disorder have been increasingly diagnosed in children and adolescents in the recent years. A meta-analysis about the epidemiology of bipolar disorder in youth showed that the overall rate was 1.8%. Concerning depression in youth the lifetime prevalence varies from 3% in children to almost 20% in adolescents.

Objective

To describe a treatment and research program (PROACTH) for children and adolescents with mood disorders (depressive and bipolar disorder).

Method

The program operates from Monday through Friday. Patients are referred to the program from primary care health services. On admission, patients were screened with standardized instruments. After that, the patients were submitted to pharmacological and psychosocial interventions. Finally, the follow-up period depends on each patient illness evolution. Also, the team encompasses child psychiatrists, systemic family therapists, psychologists and social workers.

Results

The combination of pharmacotherapy and psychosocial interventions (individual psychotherapy and family therapy) led to a decrease of symptoms and a better psychosocial functioning.

Conclusion

In spite of the complex interplay between genetic and environmental factors usually found in children with mood disorders, timely and appropriate interventions are efficacious to achieve a favourable outcome.
1832 – Factors Of Dysontogenesis Of Mental Development Of Children With Sensoneural Hearing Disorders
Authors: Kupriyanova I. , Karaush I.
Published: July 2013

We studied mental health of pupils of Tomsk Specialized Boarding School for children with hearing disorder (100 hard of hearing (sensoneural hearing loss) and 30 deaf (sensoneural deafness), of 8-18 years old). We have revealed pathology of pregnancy and labor of mother and neurological and/or somatic pathology. Almost 90% of children were characterized by retardation in early development. Almost 8% are brought up by deaf/deaf-mute parents. In the investigated group 80% of families are characterized by pathological types of upbringing - under conditions of hypo- and hyper-care 30,5% and 18,1% of children, respectively are brought up, Contradictory upbringing has been noticed in 13,3% of cases, systematic conflicts in the family - 18,1%.

Urban inhabitants prevail (63%), under adverse living conditions 29,5% of children live, the same number lives under conditions of boarding school. In one-parent families, 30,5% are brought up, with guardians - 10,5%. One third of fathers and 16,7% of mothers abuse alcohol, 61,9% of families have low material level.

Structure of neuropsychiatric disorders in children of the examined group - disturbances of psychological development - F83 (78 pers. - 60%), mental retardation (F70, F78, F79) - 20% (26 children), disturbances of behavior with onset in childhood (hyper-dynamic syndrome) - F90 (11 persons - 8,5%). Only 8,5% (11 pers.) have normal intellectual development. In 90% of children, we have revealed disorders of speech development F80.8, conditioned by basic disease.

In ontogenesis of these children we some adverse characteristics and conditions affecting negatively further development of child.
1835 – Antipsychotics For Schizophrenia: Too Little Progress After 50 Years?
Authors: Hunter R. , Barry S. , Gaughan T.
Published: July 2013

Introduction

ll antipsychotics act via dopaminergic receptor antagonism. This pharmacology is shared by all first (FGA) & second (SGA) generation antipsychotics. We reviewed the efficacy & safety of all antipsychotics in clinical use for BMJ Clinical Evidence (Barry et al 2012).

Methods & questions

Our paper summarises key results from this systematic review based on comprehensive literature search of the Medline, Embase, Cochrane Library, and other databases including safety information from the FDA and MHRA in UK. The main clinical questions of interest were: What is the efficacy of drug treatments for positive, negative, or cognitive symptoms of schizophrenia? How effective are treatments for people with schizophrenia resistant to standard antipsychotic drugs?

Results

We found 51 systematic reviews, RCTs, or observational studies that met our inclusion/quality criteria and performed GRADE analysis to assess quality of evidence. Key results are presented for efficacy & safety for: amisulpiride, chlorpromazine, clozapine, depot haloperidol, haloperidol, olanzapine, pimozide, quetiapine, risperidone, sulpiride, ziprasidone, zotepine, aripiprazole, sertindole, paliperidone, flupentixol, depot flupentixol, zuclopenthixol, depot zuclopenthixol, and clozapine.

Discussion

The evidence for some ‘standard’ treatments is surprisingly weak. Up to 1/3 -1/2 of patients fail to respond to currently available antipsychotics, and all antipsychotics cause side effects in most people. This downbeat conclusion is not surprising, given clinical experience and the common mechanism of action of all antipsychotics. More efficacious antipsychotic medication will only be developed from understanding the biological pathogenesis of schizophrenia.Barry S, Gaughin T, and Hunter R. Schizophrenia. BMJ Clinical Evidence 13 July 2012.

http://clinicalevidence.bmj.com/x/systematic-review/1007/overview.html.
1844 – Predictors Of Use Of Long Acting Antipsychotics In Patients With Schizophrenia
Authors: Albayrak Y. , Beyazyüz M. , Öztürk N. , Kuloğ lu M.
Published: July 2013

Introduction

Schizophrenia is a chronic illness with a worldwide lifetime prevalence of about 1% [1]. Non-adherence and partial adherence to antipsychotic medication treatment is common and long-acting injectable “depot” preparations of antipsychotic medications have been used as an alternative to oral medication therapy for patients for whom adherence is a clinically significant problem [2].

Methods

In present study,we collected the sociodemographic and clinical data of 252 patients who were diagnosed as schizophrenia according to DSM-IV-TR and who were followed up by our outpatient clinic at least two years. The data obtained from medical records and interviews; patients were grouped according to using of long acting antipsychotics.

Results

The long acting antipsychotics were prescribed to 96 patients of 252 patients. The rates of history of suicide attempt, family history of schizophrenia and violent bahaviour were significantly more in long acting antipsychotic group (p≤ 0.05). In regression analyze, history of suicidal and violent behaviour and family history of schizophrenia were found to be significant for predicting the use of long acting antipsychotics (p≤ 0.05).

Discussion

Considering the commonness of poor adherence to treatment in schizophrenia, we suggest that predicting the sociodemographical and clinical factors associated with using of long acting antipsychotics is important for treating effectively schizophrenic patients with poor treatment adherence in early stages.
1846 – The Effect Of Borrowing On Mental Health
Authors: Mazetas D. , Gouva M. , Kotrotsiou E. , Chletsos M.
Published: July 2013

Introduction

Considering the current Greek economic crisis, it is reasonable to discuss the potential and expected effects of the crisis in mental health.

Objective

This study examined the effect of borrowing on mental health.

Aim

This study aimed at detecting the interaction of borrowing on the bio-psycho-social health.

Materials and methods

273 community individuals participated in the present study. The measures used were: Family Environment Scale, the Hostility and Direction of Hostility Questionnaire, the Symtom Checklist 90-R, State - Trait Anxiety Inventory, Family Crisis Oriented Personal Evaluation Scales, Other As Shamer Scale, Experience of Shame Scale, Cardiac Anxiety Questionnaire.

Results

The borrowers have statistically higher average than non-borrowers parents at the scales of paranoid-ideation 6,55 ± 4,03, guilt (SCL - 90) 0,93 ± 1,14, orientation of the family for achievements 6,44 ± 1,54, moral emphasis of the family environment 4,67± 2,21, and at family mobilization to accept help in the periods when the family is in crisis 11,13 ± 4,65. Particularly interesting result of this study was the finding that borrowers with heavy debt from mortgages and personal loans and credit cards have higher levels of paranoid-ideation (8,38), more stress for their heart function (1,395) and avoiding activities for heart function (1,809), higher levels of internal shame (21,38), feeling empty (4,52), higher levels of behavioral shame (20,62) and higher levels of thoughts of death (1.05).

Conclusion

The heavy debt has not only economic consequences but also, is associated with serious psychological distress. The factors of personality, of postponement of satisfaction, of impulsivity are correlated with the borrowing.
1854 – Building The Foundation Of Effective Community Practice In Austere Times: Urban, Rural And Blended Challenges To Evidence-based Practice Sustainability
Authors: Reid M. , Ragg D.M. , Mills C.
Published: July 2013

Introduction

While evidence-based psychiatric practices (EBPs) are assumed to be more efficient, savings and sustainability are elusive during times of economic instability. This presentation uses two-years of penetration and cost-related data from46 community mental health providers to document EBP penetration and sustainability during a period of serious funding contraction.

Objectives

This study sought to identify specific elements that contribute to EBP-related savings and sustainability in urban, rural and blended environments.

Aims

This study identifies critical organizational practices that sustain EBPs during difficult economic times.

Methods

Using existing claims data on the State of Michigan website, researchers used a stratified regression analysis to identify critical variables contributing to increased use of EBPs and decreased use of high-cost services. Follow-up qualitative data were collected from administrators of high and low penetration organizations to provide insight into within-agency strategies that contribute to EBP implementation and sustainability.

Results

Findings identify direct and indirect contributors to sustainability and efficiency when implementing evidence-based practices. Direct contributors include unit-cost funding and the number of EBPs implemented. Indirect contributors include organizational promotion activities that create an atmosphere of excellence. Findings vary across urban, rural and blended environments.

Conclusions

Evidence-based practices require a strong organizational commitment to remain viable during difficult financial times.
1855 – Preliminary Data Of a Working Group For The Treatment Of Ed In Eastern Piedmont
Authors: Prosperini P. , Ferraris S. , De Bernardi C. , Damonti A. , Stramba D. , Olivetto L. , Costa L. , Casagrande G. , Omezzolli T.
Published: July 2013

A group of intercompany job is constituted from the DSMs of the ASLs of Biella (BI), Novara (NO), VCO, Vercelli (VC) and of the Psychiatric Clinic of the AOU of Novara (NO) finalized to the definition of relief runs for the patients with Eating Disorders (ED). Currently they result active 2 ambulatory devoted to the ED near NO and VCO. In the AOU NO a collaboration is active with the dietology and a daily DH with activity of group for patient with different diagnoses. To Borgosesia (VC) a project of promotion and prevention it is active in the secondary (course of formation for teachers, job with the students) schools. In the DSM NO it is active a program of food education in the schools. Patients affections from ED currently in load: AOU NO 47 (2 AN Purging, 5 AN Restrictive, 2 BED, 20 Bulimia, 18 EDNOS); DSM NO 15 (7 AN, 5 Bulimia, 3 EDNOS); DSM VCO 27 (10 AN, 5 Bulimia, 12 EDNOS); DSM VC 21 (5 AN Purging, 1 AN Restrictive, 6 Bulimia, 9 EDNOS); DSM Arona (NO) 13 (4 AN, 9 Bulimia); DSM BI 20 (8 AN, 8 Bulimia, 4 EDNOS). In the last two years the followings have been effected refuges in Therapeutics Community specific (CT) for ED: 3 near the CT to Moncrivello (VC) and 1 near the CT to Cuasso al Monte (VA). Besides the structures of the DSM they are present associations of relatives and volunteers (informative counter).
1867 – Motor Procedural Learning In Individuals With Mild And Moderate Alzheimer's Disease Compared To Healthy Subjects
Authors: Pasgreta K. , Feit J. , Nowińska E. , Walecki P. , Gorzelańczyk E.J.
Published: July 2013

Introduction

There are cognitive and motor impairments in individuals with Alzheimer's disease, which are related to their ability to learn the new procedures, skills and activities.

Objectives and aims

The aim of the study is to compare motor procedural learning in individuals with mild and moderate Alzheimer's disease with motor procedural learning in older subjects without dementia.

Methods

32 individuals with mild and moderate Alzheimer's dementia (AD) (F.00.0, F.00.1, F.00.2) (MMSE> 15) (25 women, mean age 76.8 ± 6.41 and 7 men, mean age 79.1 ± 5.21), and 32 individuals without symptoms of dementia (healthy controls- HC) matched for sex, age and education level were examined. Motor procedural learning was assessed by the Pursuit Rotor Task (PRT). The time [ms] of keeping cursor within the moving round object-dot during every 4 trials was measured (after training session).

Results

The average time [ms] of keeping cursor within object in particular trials is as follows:

-

AD: 857, 1035, 1060, 1098

-

HC: 1014, 1068, 1316, 1681

Statistically significant difference was found in parameters from fourth trial between examined groups (U Manna-Whitneya: Z=- 1,962; p=0,05).

Conclusions

It was found that mild and moderate AD patients are able to procedural learn motor task although they achieve worse scores than older persons without dementia.
1876 – Mechanisms Of Adaptation To Adjust To The Situations Of Life
Authors: Sava N.I. , Cozaru G.C. , Papari A.C. , Papari A.
Published: July 2013

The human being is the product of continuous remodelabil of confluence of modelable and of a multitude of factors. In view of the many factors that can influence the way that the adjustment of the individual we are introducing in study groups of turkishtatar to reveal whether membership of an ethnic group or religion affects whether or not the adaptive model.

In this connection, we started from the idea that the defence as develops earlier with so they will have a decisive role for the future, so therapeutic approach should take account of the depth of defense, its counterparts which are behavioural adjustment in close relation with personality and not least by biological variables such as gender, the age, duration, number of children, ethnicity, religion, etc.

Comparative study will aim to highlight where there are significant differences in the statistical relationship between personality and coping mechanisms (viewed from a broader perspective, the adjustment of the map) in the ethnically and religiously. The role of membership in an ethnic group and religion will be studied in the context of the life of the couple on the steps of its stability, this research brings attention to ways and means of adjustment of the partners in a mixed couple.

We believe that we can achieve a comprehensive evaluation model to bring attention to a map of adjustment on the unconscious-conscious, with personality and role in the determination of the role that it can have variables on ethnicity and religion that relationship.
1877 – Discrimination Of Family Environment Among Parents Of Children With Diabetes And Parents Of Children With Autism
Authors: Kotrotsiou E. , Dragioti E. , Kitta M. , Bakou E. , Albani E. , Mantzoukas S. , Gouva M.
Published: July 2013

Introduction

Living with a child with a chronic disease can affect family life in various domains.

Objectives

To investigate the relationships of family systems in two different populations: parents of children with autism and parents of children with diabetes.

Aim

To examine whether there is a meaningful differentiation on family functioning between families of diabetic and of autistic children.

Methods

This cross-sectional study included 105 parents of autistic children (36 men - 69 women, mean 41 years, SD = 6,5) and 83 parents of children with diabetes (18 men - 65 women, age 41 years, SD = 7). The measuring tools used were: a) Family Environment Scale (FES). A discriminant analysis (DA) was performed. Predictor variables were age and environmental characteristics of families.

Results

Significant mean differences were observed for all the predictors on the DA. While the log determinants were quite similar, Box's M (202, 558) indicated that the assumption of equality of covariance matrices was violated (p=.000). However, given the large sample, this problem is not regarded as serious. The DA revealed a significant association between groups and all predictors, accounting for 72, 3% of between group variability. Closer analysis of the structure matrix found only three significant predictors, namely conflict (-.507), achievement orientation (.618) and active-recreational orientation (.418). The cross validated classification showed that overall 77, 0% were correctly classified.

Conclusion

These findings indicate that these groups were not characterized by unique underlying factors and that may inform the development of a common family support system.
1886 – Natural History Of Bipolar Disorder: Implications For The Duration Of Untreated Illness
Authors: Rogers J.P. , Agius M. , Zaman R.
Published: July 2013

Introduction

Bipolar disorder is widely acknowledged to be underdiagnosed, resulting in a huge unnecessary global impact of the disease. Two schools of thought explain this poor recognition: the first considers that bipolar is simply missed; the second proposes that the underdiagnosis is due to unnoticed conversion from unipolar depression.

Aims

We examined how the natural history of bipolar disorder should affect our understanding of its underdiagnosis.

Objectives

We endeavoured to find the points in the patient's history where they first experienced depressive and manic (or hypomanic) symptoms and to follow the progress of their diagnoses through primary and secondary care.

Methods

We analysed patient records in a database held by a community mental health trust, finding 128 patients with confirmed bipolar disorder. We then conducted a retrospective audit on the patients’ notes to find the relevant data.

Results

Only 29.5% of the patients had been given a diagnosis of bipolar disorder in primary care, while only 59.3% were diagnosed as such initially by secondary psychiatric services, the majority of the remainders having been diagnosed with major depressive disorder. In general, manic or hypomanic symptoms followed depressive symptoms with a delay of several years (μ=7.3, σ=7.9), but even after manic symptoms were manifested, there was still a considerable delay before a diagnosis of bipolar was made (μ=7.6, σ=8.3).

Conclusion

Our study demonstrates that there is some evidence for both theories of the underdiagnosis of bipolar. Psychiatrists must be aware both of missing manic symptoms and of conversion from unipolar depression.
1888 – Is Cardiophobia Key Factor Of Hypertensive Patient's Quality Of Life?
Authors: Tsartsalis D. , Dragioti E. , Kyriazopoulos G. , Halkias T. , Kotrotsiou E. , Gouva M.
Published: July 2013

Introduction

A series of studies have shown an association between symptoms of psychological distress and hypertension.

Objectives

To quantify the link between cardiac anxiety functioning (commonly referred to as cardiophobia), depression and quality of life in hypertensive patients.

Aim

To test the hypothesis whether these symptoms of distress are meditated on hypertensive patient's quality of life.

Methods

A cross-sectional design was performed. A sample of 160 hypertensive patients (81 men - 79 women, mean age 51 years, SD = 12 ranged 25-77) participated to the present study. The questionnaire included:

a)

question for the recording of social-demographic characteristics and clinical features,

b)

The SF-36 Health Survey,

c)

the Beck Depression Inventory -II, and

d)

The Cardiac Anxiety Questionnaire.

Both SPSS for Windows 14.0 and STATA 10 were used for statistical analysis.

Results

Age was differ significantly among the two sexes (t = -2789, p =.006). Linear regression models found that for psychical health cardiac anxiety and depression were fully mediate on levels of quality of life in hypertensive patients after controlling for age, gender and other socio-demographic variables (Beta= -0,36, p=.000, Beta= 0,133, p=.007 respectively). Cardiophobia was the only independent variable that impacts on mental health (Beta= 0, 40, p=.001) after adjustments.

Conclusion

Quality of life is associated with depression and cardiophobia in the case of hypertension. Therefore health care providers should consider the close linear association between psychological distress and quality of life in their continuing care of their patients.
1891 – Apply Eye-tracking Research In Diagnosing The Level Of Executive Functions In Preschool And Early-school Age Children
Authors: Orylska A. , Racicka E. , Brzezicka A. , Wolańczy T. , Karwowska D. , Sypień E. , Sędek G.
Published: July 2013

The aim of research is to examine the level of executive function in children of preschool and early school age. In the present study we examined 100 children at aged 4 - 6 years. Studied attention, working memory and inhibition functions with using eye movements tests. The results were compared to study with using the Behavior Rating Inventory of Executive Function- Preschool (BRIEF-P) questionnaires. Examined whether the results obtained from studies questionnaires completed by parents and teachers are consistent with the results of eye movements tests conducted directly to children. Compared that assessment, parents or teachers in BRIEF-P questionnaires, is closer the results obtain with using eye movements examination. The results were used to determine the profile of the development of executive functions in the early childhood. The study precede checking the usefulness of eye-tracking research as an objective tool to support the diagnosis of mental disorders which are accompanied by deficits of executive functions.

We anticipate the eye-tracking study will show diversity profiles eye movements trajectories which map the different levels of development of executive functions, depending on the developmental age of children and risk groups predisposed to mental disorders.
1906 – Mental Disorders In Leprosy: High Prevalence And Low Psychiatric Care
Authors: Rocha-Leite C.I. , Borges-de-Oliveira R. , Machado P.R.L. , Pettersen K.M. , Trinchão M. , Morais-de-Jesus M. , Andrade-Nascimento M. , Daltro-Oliveira R. , Quarantini L.C.
Published: July 2013

Introduction

Leprosy is an infectious disease with high physical disability and is strongly associated with chronic pain, since there may be significant impairment of the peripheral nervous system. Additionally, the stigma associated with the label of leprosy persists and imposes a high social commitment of the disease.

Objective/aims

Describe the frequency of psychiatric comorbidities in leprosy patients and check if they had been previously diagnosed and were in psychiatric care.

Method

The study was conducted with a sample of 120 leprosy patients treated at two hospitals for leprosy: Hospital Dom Rodrigo de Menezes and University Hospital of Federal University of Bahia, in Salvador, Bahia, Brazil. Survey participants were older than 18 years of age, had confirmed the diagnosis of leprosy and were in antimicrobial treatment. Patients were evaluated face to face with a socio-demographic questionnaire and the Mini-International Neuropsychiatric Interview (MINIPlus) in Portuguese. The period of data collection was limited from October 2009 to June 2012.

Results

The assessment using the MINI-Plus showed that 34 (28.33%) patients did not have any psychiatric diagnosis and 86 (71.66%) had at least one. Of these 86 patients, 25(20.83%), met the criteria for one diagnosis, 26 (21.66%) had two diagnoses and the rest, 35 (29.16%), had three or more psychiatric diagnoses. All patients with moderate or high risk for suicide had one or more psychiatric comorbidities.

Conclusion

Leprosy patients have a high prevalence of psychiatric comorbidities. Beyond that, most of them had no previous psychiatric diagnosis and the absolute majority were not in treatment.
1909 – General Anxiety Disorder - Gender Differences In Responce To Antidepressant Treatment
Authors: Vavrusova L.
Published: July 2013

Anxiety disorders are highly prevalent clinical conditions (25%) causing high number of hospital admissions and utilization of health care. Recent clinical trials indicate that gender differences in responsiveness to drug therapy also occur. Several lines of inquiry have focused on explaining this gender-related difference due to the higher prevalence of these disorders in women. There is a pile of evidence of a physiologic component is based on gender differences in gastrointestinal transit time, visceral sensitivity, central nervous system pain processing, and specific effects of estrogen and progesterone on gut function as well as on hypothalamic-pituitary-adrenal (HPA) circuitry in adult women., differences in autonomic nervous system, and reactivity. Decreased activity of HPA was observed in trait anxiety and anxiety disorders like panic disoerder or posttraumatic stress disorder. Twenty four patients high level of anxiety in general anxiety disorder participated in the study. ACTH and cortisol plasma concentrations were followed in regular intervals in patients who did not respond to 8 weeks of antidepressant treatment. Our findings show that highly anxious females exhibited lower cortisol release than highly anxious males, suggesting that high-anxiety in females may be associated with inability to respond to antidepressant treatment.
1920 – Pain Anxiety Symptoms And Chronic Low Back Pain: Differences Between Greek Men And Women Patients
Authors: Baliotis K. , Korakakis V. , Katri F. , Dragioti E. , Kotrotsiou E. , Gouva M.
Published: July 2013

Introduction

Anxiety of pain plays a very important role in pain persistence and disability in patients with musculoskeletal pain.

Objective

This study examined the effect of pain anxiety symptoms on chronic pain.

Aim

The aim of the present study was the evaluation of pain anxiety symptoms in patients with chronic low back pain (CLBP) and the differences between genders.

Materials and methods

Two-hundred and one patients with CLBP participated in the present study (53 men - 148 women, mean age±SD 37,4±13,7). The measures used were: Pain Anxiety Symptoms Scale-PASS-20 (McCracken & Dhingra, 2002) and another questionnaire with socio-demographics and attitudes and self-reported questions data on the impact of the chronic pain in their life.

Results

The mean scores (±SD) for men and women with CLBP and the p values from the T-tests were respectively: PASS- 20 total score, 22,19±9,09 and 30,11±14,15, (P=0,000), for avoidance, 8,15±3,02 and 9,65±4,46, (P=0,025), for fearfull thinking, 6,64±2,99 and 8,33±3,91, (P=0,002), for cognitive anxiety 3,98 ±2,72 and 5,90 ± 4,20, (P=0,005) and for Physiological Responses 3,42 ±2,53 and 6,21 ± 3,67, (P=0,000).

Conclusion

The results of the present study revealed the high levels of pain anxiety symptoms in patients with CLBP. Furthermore, women were found to be affected of pain anxiety symptoms more than men.
1924 – Psychological Characteristic Of Atypical Chest Pain Patients Versus Coronary Patients
Authors: Nikolic G.M. , Zikic O.V.
Published: July 2013

Introduction

Near 25% of chest pain patients who refer to cardiologist do not have coronary disease or any other organic cause. Psychogenesis of their symptoms is often unrecognized so, they are treated neither cardiologic, nor psychiatric.

Method

We have evaluated 30 nonorganic chest pain patients and compare with 30 coronary patients in regard their socio demographic characteristic, stressful life events, level of anxiety and depression and presence of psychiatric disorder. We have used SCL- 90 R, M.I.N.I, Hamilton Anxiety and Hamilton Depression Scale, Holms -Rache Scale of life events.

Results

Non organic patients were predominant women, age under 40, who have had their job lost or death in the family. Panic disorder was present at 8 patients, General Anxiety disorder at 5, and Somatoform disorder at 10 patients in these groop. Coronary patients had Minor depression disorder at 4 patients, and General Anxiety disorder at 2 patients. Level of anxiety (Hamilton Scale, SCL-90 R) somatization (SCL-90 R) and global distress (SCL-90 R) was significant higher in nonorganic chest pain patients compared with coronary patients.

Conclusion

Cardiologists should consider psychogenesis of unexplained chest and recomended psychiatric evaluation and treatment in the early phase of disorder. Careful cardiologic follow up is also recomended for these distressed patients.