bluuebunny/crossref_metadata_2025 huggingface dataset:
FC20-04 -’Who is on my side?’ - qualitative analysis of ethnic minorities experiences of mental health related stigma and discrimination
Authors: Shefer G. , Henderson C. , Rose D. , Evans-Lacko S.
Published: May 2011

Introduction

The Time to Change (TTC) anti-stigma campaign, launched in January 2009 in England, intends to make fundamental improvements across England in: public knowledge, attitudes and discriminatory behaviour in relation to people with mental illness. To be effective and valid the campaign must reach a wide range of diverse audiences. This study explores attitudes of people from ethnic minority communities in relation to mental health.

Objectives

The study investigates:

1)

General attitudes and perceptions about mental illness in ethnic minority communities

2)

How we might increase awareness about mental wellbeing and decrease stigma in ethnic minority communities.

Methods

Ten focus groups with members of ethnic minority groups were conducted. Five groups consisted of service users and five were composed of non-service users. Two groups comprised participants from an Indian origin, two Somali origin, two Afro-Caribbean origin and the other groups were mixed.

Results

We will present findings regarding the ways in which traditional perceptions of mental health and personal experiences of ethnic minority service users affect their perceptions of sources of support such as family, friends, medical staff and religion and how this feedback could inform ant-stigma interventions.

Conclusion

The study suggests that in order to maximise the impact of anti-stigma campaigns, attention should be given to sources of discrimination and traditional perceptions of mental illness which are emphasised by ethnic minority groups. When planning anti-stigma campaigns it is important to incorporate experiences and perceptions from a wide range of audiences.
FC20-05 - Developing culturally sensitive cognitive behaviour therapy for psychosis for ethnic minority patients
Authors: Rathod S. , Phiri P. , Kingdon D.
Published: May 2011

Introduction

Studies of cognitive behaviour therapy (CBT) for psychosis demonstrate that African-Caribbean and Black African patients have higher dropout rates and poor outcomes from treatment (Rathod et al., 2005).

Aims & objectives

The main aim of the study was to produce a culturally sensitive adaption of an existing CBT manual for therapists working with patients with psychosis from specified ethinic minority communities (African-Caribbean, Black-African/Black British, and South Asian Muslims). This will be based on gaining understanding of the way members (lay and service users) of these minority communities view psychosis, its origin, and management including their cultural influences, values and attitudes.

Method

This qualitative study consisted of individual semi-structured interviews with patients with psychosis (n = 15); focus groups with lay members from selected ethnic communities (n = 52); focus groups or semi-structured interviews with CBT therapists (n = 22) and mental health practitioners who work with patients from the ethnic communities (n = 25). Data was analysed thematically using evolving themes and content analysis. NVivo 8 was used to manage and explore data.

Results

Respondent groups agreed that CBT would be an acceptable treatment if culturally adapted. This would incorporate culturally-based patient health beliefs, attributions concerning psychosis, attention to help seeking pathways and technical adjustments.

Conclusions

While individualization of therapy is generally accepted as a principle, in practice, therapists require an understanding of patient-related factors that are culturally bound and influence the way the patient perceives or responds to therapy.
FC20-06 - Cultural variation in depressive symptom burden and attribution of mental health ailments among older latinos
Authors: Ng B.
Published: May 2011

Background

The influence of acculturation and nativity on depression in Latinos remains highly contested. One potential source of ambiguity is variation in their beliefs about the causes of their mental health ailments.

Methods

We conducted cross-sectional analyses of 450 older Latinos attending a rural mental health clinic near the U.S.-Mexico border. Primary diagnosis was grouped in one of 5 categories. The Center for Epidemiological Studies of Depression (CES-D) scale was used to measure depressive symptoms. Cultural variables included nativity and a validated acculturation scale. Patients rated their level of endorsement of 13 causes of mental health ailments A one-way ANOVA was conducted to identify cultural predictors of attribution items.

Results

Latinos had a mean age of 70.9 (SD = 9.1). The most common primary diagnoses were depressive disorders (67.1%) and dementia (15.3%). The mean CES-D score was 15.08 (SD = 18.16), but higher for the more acculturated (p = 0.048), and patients with psychotic (M = 26.31, SD = 19.78) and bipolar (M = 26.05, SD = 19.54) disorders. Acculturation increased attribution of mental health ailments to significant others (ρ = 0.091; p = 0.054), difficulty with work (ρ = 0.162; p = 0.001), and hereditary factors (r = 0.202, 95% CI = 0.002, 0.403). Patients with psychotic disorders were most likely to attribute their symptoms to curses (p = 0.001) and supernatural factors (p = 0.024) compared to other diagnostic categories.

Conclusions

Acculturated Latinos attriattribute their mental health ailments to life circumstances. This may intensify depressive symptoms and partly explains the relationship between acculturation and depressive symptoms. Further, the patients’ major diagnosis must be considered when evaluating acculturative influences on depression in psychiatric populations.
FC21-01 - Physical health of residents in psychiatric and social care facilities
Authors: Hjorth P.
Published: May 2011

Background

Prevalence of physical illness among patients suffering from psychiatric illness is higher than in the average population. This is especially true for persons diagnosed with schizophrenia who mainly suffer from heart disease and metabolic disorders. Some of the second generation antipsychotics are likely to cause weight gain and metabolic syndrome associated with a two- to threefold increase in cardiovascular mortality and a twofold increase in all-cause mortality. The quality of the general health care in patients with severe mental illness and the lack of consensus about the prevention of somatic illness in this group of vulnerable patients need to be improved.

Hypothesis

There is a correlation between the awareness of physical health and the physical health among patients as well as staff members.

Material and methods

The investigation is designed as a randomised controlled intervention study with follow-up after nine months.

The study population is from six facilities in the region of North Jutland in Denmark for severe chronically mental ill patients. All six facilities offer specialised social psychiatric treatment. The six facilities have 184 patients and approximately 200 staff members. A subsample of seven patients and seven staff members will be selected from the three interventions facilities and be invited to participate in separate focus groupsIn the intervention facilities, a detailed feedback of all index measures will be distributed to the patients and the staff. Individual health promotion and guidance will be carried out.
FC21-02 - Mental health and social care collaboration: A Cross-national whole network analysis of organisational partnerships in Europe
Authors: Nicaise P.
Published: May 2011

Introduction

Socially marginalised people with mental health disorders have complex needs that require integrated care. However, mental health and social care sectors are fragmented, and inter-organisational collaboration is challenging.

Aim

A cross-national whole Network Analysis was carried out to detect and interpret patterns of relations between mental health and social care services in several European cities and assess their levels of care integration, following Leutz's levels: linkage, coordination and full integration.

Method

Data on referrals and service routine meetings were collected in deprived areas of 14 European cities and processed within a Social Network Analysis approach. Structural indicators included degrees, components and overlapping cliques, betweenness centrality and centralisation and brokerage roles. Patterns of collaboration were compared across cities.

Results

Few cities had full integrated services. Whole networks had relatively low densities, including denser sub-networks of similar services. The linkage across sectors remained weaker than the linkage within sectors. Services situated in broker positions were not always integrated nor commissioned for care coordination. The centrality of these services was higher when the linkage density was lower.

Conclusions

Although differences between structural patterns of mental health and social care networks mainly depend on national care integration policies, the study revealed structural gaps in the achievement of these patterns, whatever the policy model. This could explain why different systems are basically facing the same problems in service delivery despite these differences. These gaps constitute potential weaknesses in the quality of mental health and social care integration at the system level.
FC21-03 - Health-related quality of life of women with and without a mentally ill family member
Authors: Trajanovic L. , Skakic O. , Ilic N.
Published: May 2011

Introduction

Women bear most of the burden in taking care of a chronically ill family member, thus exposing their own health and quality of life to risk. It is consider that mental health is the most vulnerable and most frequently affected health domain.

Objective

The purpose of this study was to examine the health-related quality of life (HR-QOL) in women who have and have not a mentally ill adult for a family member.

Method

MOS Short Form-36 Health Survey (SF-36) questionnaire was used in this study. A total of 118 women were questioned, 54 out of which were taking care of a schizophrenic adult family member, whereas 64 had families with no mentally ill members. The two groups were matched according to age and education level.

Results

Women with a mentally ill family member had lower scores in all quality of life domains, with the lowest scores in vitality (VT = 48,1), mental health (MH = 51,9), role emotional (RE = 53,1) and general health (GH = 53,5). Exactly the same health dimensions were estimated as the worst by women with no mentally ill family member (VT = 50,1; MH = 57,5; RE = 57,9; GH = 61). Statistically significant difference was observed only in the general health (p < 0.05).

Conclusion

Women who are taking care of a chronically mentally ill family member are not so worried about the deterioration of their own mental health, as much as they are about their general state of health. Therefore it is necessary to put an accent on this subject as well, in creating future caregivers health programs.
FC21-04 - Unmet needs differences between male and female inmate population receiving psychiatric care
Authors: Talina M. , Cardoso A.M. , Fortes F. , Morais J. , Correa B. , Xavier M.
Published: May 2011

Introduction

Inmates present higher prevalence of mental and physical disorders and are subject of some kind of social exclusion than the general population. The assessment of unmet needs is crucial for care planning.

Objectives

To assess and compare the need for care between male and female inmates undergoing psychiatric treatment.

Aims

Delivery of health and social care in prisons.

Methods

A cross-sectional, descriptive study of a non-probabilistic convenience sample of inmates referenced to a forensic psychiatric clinic in Lisbon region, during a year, was performed. The research protocol, besides a specific questionnaire, includes MINI; BPRS; GAF and Camberwell Assessment of Need, Forensic Version (CANFOR).

Results

Seventy nine males (median age 36) and 35 females (median age 32) were receiving psychiatric treatment at the time of the study. Anti-social personality disorder in men (62%) and major depression in women (62.9%) were the most frequent disorders found. Males more often present moderate to high suicide risk (36.7%) than females (28.6%). The number of unmet needs was significantly increased in males (average 6 ± 2.2) than females (4.3 ± 2.2; p< o.oo1). For males, the more frequent unmet needs concerns sexual expression (79.7%), social benefits (77.2%) and psychological distress (63.3%) and for females it was psychological distress, social benefits (62.9% each) and company (51.4%).

Conclusion

The results indicate that male inmates have higher behavioral risk and more unmet needs than female inmates. The assessment of needs in prisons is important for the development of strategies concerning care, social integration and prevention of criminal recidivism.
FC21-05 - Clinical and economical effects one year after establishing a decentralized psychiatric outpatient service
Authors: Valdes-Stauber J. , Kilian R. , Putzhammer A.
Published: May 2011

Background

Intensification of outpatient psychiatric care may improve the care quality in community but also increase the total care costs in the first period as well as reduce in-patient cumulative length of stay over the medium term.

Objective

We investigate the economic and clinical effects of establishing of a psychiatric outpatient-service in a South-Bavarian catchment area one year before and one year after establishing.

Methods

All admitted patients in a psychiatric acute ward corresponding to the catchment area of the new outpatient- service are registered one year before establishing (2007, n = 145) and one year after (2009, n = 167). Associations between clinical, demographic and economical variables were investigated by means of multivariate regression analysis. Control variables are sex, age and psychiatric diagnostic groups.

Results

Cumulative length of stay (b = −1.72, p = 0.68) and number of admissions (b = −0.10; p = 0.28) decreased, but not significantly. In-patient as well as global care costs remains the same. Costs of prescribed psychopharmacological drugs (b = 54.4; p = 0.36) and outpatient psychiatric care (b = 67.8; p = 0.15) increase obviously, but not significantly.

Conclusions

Additional implementation of an outpatient-service is not related to increase of service use costs. We found out, that in the first year there is a demand increasing effect. The effects on in-patient parameters and diagnosis groups have to be observed for the following years.
FC21-07 - Trends in health-related quality of life and health service use associated with comorbid diabetes and major depression in South Australia, 1998–2008
Authors: Atlantis E. , Goldney R. , Eckert K. , Taylor A. , Phillips P.
Published: May 2011

Purpose

To investigate trends in health-related quality of life and health service use associated with diabetes and/or major depression in South Australia from 1998 to 2008.

Methods

Data analyzed were from 9,059 persons aged ≥15 years who participated in representative surveys of the South Australian population in 1998, 2004 and 2008. Major depression was determined using the mood module of the Primary Care Evaluation of Mental Disorders (PRIME-MD). Diagnosed diabetes and health service use was determined by self-report. Health-related quality of life was assessed using the 36-item Short-Form Health Survey (SF-36) and the 15-item Assessment of Quality of Life (AQoL) instruments. Weighted age-standardized and multiple-adjusted means of dependent measures were computed.

Results

The prevalence of diabetes only, major depression only, and comorbid diabetes and major depression increased by 74%, 36% and 53% from 1998 to 2008. Mean health-related quality of life scores were 9% to 41% lower (worse), and health service use was 49% higher for persons with comorbid diabetes and major depression than for those with diabetes only (all P-values < 0.05), consistently over the 10-year period.

Conclusions

If past trends continue, our results suggest that the population health and economic burden of comorbid diabetes and major depression will grow similarly over the next decade or so. These trends have important implications for making health policy and resource allocation decisions.
FC22-01 - Suicide risk during antiepileptic drugs treatment in bipolar disorders, unipolar depression and epilepsy
Authors: Pompili M.
Published: May 2011

Antiepileptic drugs (AEDs) are receiving growing attention for possible association with suicidal risk. Several recent studies using varied methods have yielded inconsistent findings regarding risk of suicides and other self-injurious violent acts, particularly with specific AEDs. Suicidal risk may reflect high risks of co-morbid psychiatric conditions associated with suicide that call for routine consideration in epileptic patients. However, the studies involved are limited by providing associational findings that may be confounded by several uncontrolled variables. The reported apparent suicidal risk (US-FDA, 2008) was found with highly pharmaco-dynamically heterogeneous anticonvulsants as a group, and significantly only among epileptic patients. Three AEDs appear among three highest-risk agents in at least 2/6 reported analyses: levetiracetam (5/6 studies) > lamotrigine (3/6) = topiramate (3/6), although only topiramate has been associated with new clinical depression, and the three drugs differ in pharmacodynamic mechanisms. The evidence on this point remains very limited, but some anticonvulsants may reduce risk of suicides and attempts among patients diagnosed with bipolar disorder, though perhaps less than by long-term treatment with lithium. For now, however, clinical prudence calls for routine, ongoing assessment of mood and suicidal thoughts among neurological or psychiatric patients, whether or not treated with particular drugs. This presentation reports a metanalytic investigation related to AEDs involving mood. Based on the recent research reviewed here, particular care, as well as further research, are indicated for levetiracetam and perhaps also lamotrigine and topiramate.
FC22-02 - Effect of quetiapine on functioning and quality of life in bipolar depression
Authors: Gustafsson U. , Fajutrao L.
Published: May 2011

Introduction

Depression symptoms in bipolar disorder have debilitating effects on functioning and quality of life (QoL).

Objectives

To assess effects of 8 weeks of quetiapine monotherapy on functioning and QoL in patients with bipolar depression (BPD).

Aims

To evaluate functioning and QoL using patient-reported outcomes.

Methods

Data from 4 trials (BOLDER I and II; EMBOLDEN I and II) of quetiapine (300 and 600 mg/day) in BPD were combined (n = 2593). The Sheehan Disability Scale (SDS) measured functioning (BOLDER II; EMBOLDEN I and II) and the QoL Enjoyment and Satisfaction Questionnaire (Q-LES-Q)-Short Form measured QoL (BOLDER I and II; EMBOLDEN II).

Results

Quetiapine improved overall functioning (mean change [SE] in SDS total score: -7.23 [0.49], -7.49 [0.49], with quetiapine 300 mg/day and quetiapine 600 mg/day, respectively vs placebo (-5.91 [0.54]); P < 0.01 for both). Both doses improved functioning in SDS domains of work/school, social life, and family life/home responsibilities vs placebo (P < 0.05). Quetiapine 600 mg/day reduced days missed from work/school and productivity losses vs placebo (P < 0.01). QoL was improved with both quetiapine doses vs placebo (P < 0.001; least squares mean changes (SE) in Q-LES-Q total score from baseline to Day 57: 9.69 (0.51), 9.95 (0.50), and 6.81 (0.54) with quetiapine 300 mg/day, quetiapine 600 mg/day, and placebo, respectively). Tolerability was consistent with the known safety profile of quetiapine.

Conclusions

Quetiapine treatment (300 and 600 mg/day) for 8 weeks significantly improved functioning and QoL vs placebo in patients with BPD.

Supported by funding from AstraZeneca Pharmaceuticals LP.
FC22-03 - Annual periodicity and personality: Season of birth is associated with affective temperaments
Authors: Gonda X. , Rihmer Z. , Fountoulakis K.N. , Pompili M. , Erdös P. , Ormos M.
Published: May 2011

Objectives

Periodicity, cyclicity, and annual rhythms are inherent characteristics of living organisms, and have also been reported for diverse physiological and pathological conditions and phenomena. Season of birth was also associated with central monoamine and monoamine metabolite levels in several studies. Furthermore, several studies indicate a significant effect of season of birth on personality traits and characteristics. A relationship between birth season and novelty seeking has been described and confirmed in several studies. However, affective temperaments have not so far been studied with respect to their association with birth season.

Aims

The aim of our present study was to investigate the possible association between affective temperaments and season of birth in a nonclinical sample.

Methods

366 university students completed the standardized Hungarian version of the TEMPS-A. Ordinary Least Squares regression was applied to explain the relationship between TEMPS-A subscales and birth season of the respondents.

Results

We found a significant association between temperament scores and birth season in case of the Hyperthymic, Cyclothymic, Irritable and Depressive temperaments, while no significant results emerged for the Anxious temperament.

Conclusions

Our results provide further evidence for an association between season of birth and personality, extending the results to affective temperaments as well. Furthermore, our results can be related to clinical observations concerning the seasonal variation of onset and hospitalization due to affective episodes, thus our results also have clinical significance.
Fc22-04 Effect of folic acid add-on treatment in patients with acute mania on clinical symptoms and urinary 6-sulfatoxymelatonin: double blind placebo-controlled trial
Authors: Modabbernia A. , Ashrafi M. , Rahiminejad F. , Akhondzadeh S.
Published: May 2011

Introduction

Cyclic changes in symptomatology, sleep disorders and changes in body temperature in bipolar disorder suggest a circadian rhythm disorder and its most important regulator, melatonin. Folate is both a melatonin enhancer and has been shown to be lower in manic patients.

Objectives

To investigate the association between melatonin level (by its most important metabolite, urinary 6-sulfatoxymelatonin) and clinical score of bipolar patients after folate supplementation of their medication.

Methods

Forty eight patients (who had at least one manic episode based on DSM-IV) were included in the study and out of these patients 8 patients dropped out during the study due to changes in diagnosis and 40 were randomized to group A (21 patients, folic acid+lithium+resperidone) and group B (19 patient, placebo +lithium+resperidone). Also 8 controls were selected for comparison of urinary 6 sulfatoxymelatonin levels. Morning Urinary 6 sulfatoxy melatonin and Young Mania Rating Scale were measured in the beginning and at the end of the first month.

Results

There were significant differences between group A and B in the alteration of level of urinary 6-sulfatoxymelatonin measured during the study period(11.7 ± 13.4 Vs -6 ± 16.2 p< 0.001)both groups had significantly lower 6MT than controls and this persisted till the end of the first month in both groups. Significant difference was seen between alteration of YMRS in two groups(34.5 ± 3.9 Vs 30.1 ± 3.8 p < 0.001).

Conclusion

Our findings showed that folic acid may be effective as an adjunct to main mania treatment, and it may exert its effect partially due to changes in melatonin profile.
FC23-01 - Affective temperament and and attachment - also a study about depression and anxiety in a young adult population
Authors: Cordeiro R.C.
Published: May 2011

Introduction

The transition from adolescence into adulthood is a stage of human development characterized by a broad change of physical and psychological dimensions.

Objectives and aims

To examine the associations between affective temperaments (depressive, cyclothymic, hyperthymic, irritable and anxious) and attachment styles in a population of adolescents and young adults.

Method

Sample: 760 nursing students from 4 Higher Schools. Data was collected by a self-report questionnaire, with several measures: Temperament Evaluation of Memphis, Pisa, Paris and San Diego (TEMPS-A), (Akiskal & Akiskal, 2005a, Figueira et al., 2008), the Intimate Friendship Scale (Sharabany, 1994; Cordeiro, 2007), Father/Mother Attachment Questionnaire - QVPM, Version IV (Matos & Costa, 2001a), Love Attachment Questionnaire - QVA, Version III (Matos & Costa, 2001b), Beck Depression Inventory (Beck, 1967; Vaz Serra & Pio de Abreu, 1973ab) and the State-Trait Anxiety Inventory - STAI - Forms Y-1 and Y-2 (Spielberger, Gorsuch & Lushene, 1997, Silva & Campos, 1998, Santos & Silva, 1997).

Results

The participants are mostly female (83.3%) with an average age of 21.3 years.

The dominant affective temperament for the total of the studied population was the depressive temperament but the results suggested a balance between anxious and irritable temperaments and also between depressive and cyclothymic temperaments.

Conclusion

The attachment to a best friend has shown to be associated with anxious temperament. All temperaments were associated with several factors of attachment to the mother, the father or to love peers.

A correlation between temperament and anxiety and between temperament and depressive symptoms were also found.
FC23-02 - Gender and genotype modulation of the association between lipid levels and depressive symptomatology in community-dwelling elderly
Authors: Ancelin M.-L. , Carrière I. , Boulenger J.-P. , Malafosse A. , Stewart R. , Cristol J.-P. , Ritchie K. , Chaudieu I. , Dupuy A.-M. ,   The Esprit Study
Published: May 2011

Background

Lipids appear to mediate depressive vulnerability in the elderly, however, sex differences and genetic vulnerability have not been taken into account in previous prospective studies.

Methods

Depression was assessed in a population of 1040 women and 752 men aged 65 years and over at baseline and after 7-year follow-up. Clinical level of depression (DEP) was defined as having either a score of 16 and above on the Centre for Epidemiology Studies Depression scale or a diagnosis of current major depression on the Mini International Neuropsychiatric Interview. Lipid levels, apolipoprotein E and serotonin transporter linked promoter region (5-HTTLPR) genotypes were evaluated at baseline.

Results

Multivariate analyses adjusted by socio-demographic and behavioral variables, measures of physical health including ischemic pathologies, and genetic vulnerability indicated gender-specific associations between dyslipidemia and DEP, independent of the use of lipid lowering agents or apolipoprotein E status. Men with low LDL-cholesterol levels had twice the risk of prevalent and incident DEP whereas in women low HDL-cholesterol levels were found to be significantly associated with increased prevalent DEP (OR = 1.5) only. A significant interaction was observed between low LDL-cholesterol and 5-HTTLPR genotype, men with s/s or s/l genotype being at increased risk of DEP (OR = 6.0 and 2.7, respectively). No significant gene-environment interaction was observed for women.

Conclusions

DEP is associated with higher atherogenic risk in women (low HDL-cholesterol), whereas the reverse is observed in men (low LDL-cholesterol). Late-life depression may have a complex gender-specific etiology involving genetic vulnerability in men.
FC23-03 - Estrogen receptor polymorphisms and late-life depression
Authors: Ryan J. , Scali J. , Carriere I. , Peres K. , Rouaud O. , Scarabin P.-Y. , Ritchie K. , Ancelin M.-L.
Published: May 2011

Introduction

Despite a putative role for estrogen in depression, studies on the association between depression and estrogen receptor (ER) polymorphisms are surprisingly lacking.

Objectives

To determine the association between ER polymorphisms and late-life depression in 6809 men and women and to investigate factors which could modify this association.

Method

Community-dwelling elderly aged 65 years and older were recruited in France as part of the Three City Study. Depression was assessed using the Centre for Epidemiological Studies Depression Scale and the Mini-International Neuropsychiatric Interview, according to DSM-IV criteria. The association between five polymorphisms of the ER-α and ER-β with depression was determined using multi-adjusted logistic regression models.

Results

Men with the AA genotype of the ER-β rs4986938 polymorphism had an increased risk of depression, while in women, carriers of the A allele for the ER-β rs1256049 had an increased risk. Subsequent analysis indicated that the increased risk in women occurred only in those not using hormone treatment. In women the CC and GG genotypes of the ER-α PvuII and XbaI, respectively were associated with a decreased risk of depression. A significant interaction between the ER-α PvuII and ER-β rs4986938 polymorphisms suggests they may act together to modify the depression risk.

Conclusions

Sex-specific associations between ER polymorphisms and depression have been identified, with HT appearing to be beneficial for genetically vulnerable women. These findings of distinct genetic susceptibility to late-life depression may be important for designing novel hormone-based therapies that would have optimal effectiveness in sub-groups of depressed women and men.
FC23-04 - Anti-neuropeptide y plasma immunoglobulins are distinctly associated with altered mood and appetite in depressive disorder
Authors: Garcia F.D. , Coquerel Q. , do Rego J.-C. , Cravezic A. , Kiive E. , Déchelotte P. , Harro J. , Fetissov S.
Published: May 2011

Introduction

Neuropeptide Y(NPY) has potent antidepressant and orexigenic properties suggesting that altered NPY signaling can be relevant to etiology of altered mood and appetite commonly co-occurring in depressive disorder.

Objective

Study if plasma levels and affinities of anti-NPY immunoglobulins(autoAbs) are affected in depression.

Methods

Plasma levels of NPY-reactive total/free IgG, IgM and IgA autoAbs were measured by ELISA in 14 patients with mild and in 9 patients with moderate depression and 20 controls. Affinity of autoAbs was assayed by the plasmon resonance. Depressant-like effect of human autoAbs was studied in mice using forced-swim test(FST) after IV injections of patients’ and controls’ IgG. Effects of affinity anti-NPY to antagonize NPY-induced antidepressant and orexigenic effects were studied in mice.

Results

Plasma levels of NPY total IgG autoAbs were lower in patients with moderate depression than in patients with mild depression and healthy controls. MADRS scores correlated negatively with levels of NPY free autoAbs but not with their affinity values were not significantly among study groups. Body mass index(BMI) correlated negatively with affinities of NPY IgG autoAbs. Immobility time in FST was increased by I.V. injection of IgG of patients and controls and correlated negatively with levels of NPY total IgG autoAbs. Low and high affinity NPY IgG autoAbs antagonized NPY-induced anti-immobility effect. Higher affinity autoAbs antagonized more NPY-induced food intake.

Conclusion

These data suggest that changes of plasma levels of anti-NPY autoAbs are relevant to altered mood while changes of their affinity may be involved in altered appetite in depressive disorder.
FC23-05 - Pregnancy and post-partum depression and anxiety in a longitudinal general population cohort: the effect of eating disorders and past depression
Authors: Micali N. , Simonoff E. , Stahl D. , Treasure J.
Published: May 2011

Aims

To investigate the effect of past depression, past and current eating disorders (ED) on perinatal anxiety and depression in a large general population cohort of pregnant women, the Avon Longitudinal Study of Parents And Children (ALSPAC).

Methods

Anxiety and depression were measured during and after pregnancy in 10,887 women, using the Crown-Crisp Experiential Inventory and Edinburgh Postnatal Depression Scale. Women were grouped according to depression and ED history: past ED with (n = 123) and without past depression (n = 50), pregnancy ED symptoms with (n = 77) and without past depression (n = 159), past depression only (n = 818) and controls (n = 9,660). We compared the course of depression and anxiety with linear mixed-effect regression models; and probable depressive and anxiety disorders using logistic regression.

Results

Women with both past depression and past/current ED had high anxiety and depression across time perinatally; this was most marked in the group with pregnancy ED symptoms and past depression (b coefficient:5.1 (95% CI 4.1-6.1), p < 0.0001), especially at 8 months post-partum. At 18 weeks in pregnancy all women (apart from those with past ED only) had a higher risk for a probable depressive and anxiety disorder compared to controls. At 8 months post-partum pregnancy ED symptoms and/or past depression conferred the highest risk for a probable depressive and anxiety disorder.

Conclusions

Pregnancy ED symptoms and past depression have an additive effect in increasing the risk for depression and anxiety perinatally. Screening at risk women for anxiety and depression in the perinatal period might be beneficial.
Fc24-01 - Ego defense mechanisms in pakistani medical students: a cross sectional analysis
Authors: Parekh M. , Majeed H. , Khan T. , Khan A. , Khalid S. , Khwaja N. , Khalid R. , Khan M. , Rizqui I. , Jehan I.
Published: May 2011

Background

Ego defense mechanisms, defined by Freud as unconscious resources used by the ego to reduce conflict between the id and superego, are a reflection of how an individual deals with conflict and stress. Vaillants’ proposed Hierarchy of Defenses states that mature defenses are associated with better adaptive functioning and health, as opposed to immature defense which are correlated negatively with measures of adaptive adult functioning.

Objectives

This study assesses the prevalence of various ego defense mechanisms employed by medical students of Karachi, which is a group with higher stress levels than the general population.

Methods

A questionnaire based cross-sectional study was conducted on 682 students from five major medical colleges of Karachi in November 2006. Ego defense mechanisms were assessed using the Defense Style Questionnaire(DSQ-40) individually and as grouped under Mature, Immature, and Neurotic factors.

Results

Neurotic defenses had a higher mean score(5.62) than Mature(5.60) and Immature(4.78) mechanisms. Immature mechanisms were more commonly employed by males whereas females employed more Neurotic mechanisms than males. Neurotic and Immature defenses were significantly more prevalent in first and second year students. Mature mechanisms were significantly higher in students enrolled in Government colleges than Private institutions (p< 0.05).

Conclusions

Neurotic mechanisms are more commonly encountered than Mature or Immature mechanisms among medical students of Karachi, and this could reflect greater stress levels than the general population. Employment of these mechanisms was associated with female gender, enrollment in a private medical college, and students enrolled in the first 2 years of medical school.
FC24-02 - Psychiatric literacy and the personality disorders
Authors: Winceslaus J. , Furnham A.
Published: May 2011

Introduction

This study explored the unknown psychiatric literacy of the public with regard to the Personality Disorders (PDs).

Objectives

To find out -

i)

Whether a lay person recognises the presence of a psychological problem in a person with a PD.

ii)

What labels lay people give to people living with PDs.

iii)

How lay people rate the quality of life of people living with PDs.

iv)

Whether a history of psychological education or illness improves a lay person's ability to identify a PD.

Aims

To assess how much work is needed to be done in order to increase public psychiatric literacy to a satisfactory level with regard to the PDs.

Methods

A vignette identification methodology was employed. 223 participants responded to the questionnaire Eccentric people’. Results: Lay people recognise people with PDs as being unhappy, unsuccessful at work and as having poor personal relationships, but do not associate these problems with psychological causes. Rates of correct labelling were low; under 7% for 7/10 PDs. History of psychological education and illness were positively correlated with the correct recognition of 70% and 60% of the personality disorders respectively.

Conclusions

The psychiatric literacy of the public with regard to the PDs is low. This raises concerns about the health seeking behaviour and correct diagnosis of sufferers, as well as the stigma attached to them and their social neglect by others. Psychiatric literacy needs to be increased, psychological education achieves this. The media could be an effective tool to increase psychiatric literacy.
FC24-03 - Lack of cortisol response during exposure therapy in patients with obsessive-compulsive disorder
Authors: Kellner M. , Muhtz C. , Yassouridis A. , Wiedemann K.
Published: May 2011

Introduction

Exposure therapy with response prevention (ERP) is the most effective treatment for patients with obsessive-compulsive disorder (OCD), but associated with considerable temporary stress during initial sessions.

Objectives

Amazingly, only scant information is available about stress hormone release during exposure therapy and its implication on therapy outcome in OCD.

Aims

To characterize hypothalamic-pituitary-adrenocortical activation during ERP treatment in OCD.

Methods

15 patients with OCD were studied twice from 13:00 to 16:00 - on the day before and of their first ERP therapy session (14:00 to 15:00). Subjective units of distress (SUD, 100 mm visual analogue scale) and salivary cortisol concentrations were assessed every 20 minutes.

Results

Before and during (but not after) ERP SUD were significantly increased versus the control day (mean SUD before ERP: 49.8 vs. 31.4, mean peak vaules during ERP: 72.6 vs. 34.0). Salivary cortisol decresed significantly during the study period (as expected according to the regular diurnal rhythm), but no significant differences between ERP and the control day were detected at any time point.

Conclusions

Despite clear-cut psychological stress before and during ERP, no increased release of cortisol was observed. Our findings resemble respective results in panic disorder. Possible neurobiological underpinnings of this unexpected regulatory pattern will be discussed. Furthermore, we will speculate on the impact of lacking cortisol response on extinction learning during ERP.
FC24-04 - Authoritarian personality traits in Iranian medical students
Authors: Firoozabadi A. ,   Psychiatric Research Center
Published: May 2011

Introduction

Adorno and his colleagues made an attempt to describe the behavior of people in the pre-war era in Germany. Their research led to the introduction of F-scale which is used as a measurement for conservative and authoritarian attitudes.

Objective

By the use of F-scale, we tried to evaluate authoritarian traits in a group of Iranian medical students in Shiraz University of Medical Sciences. Socio-economic status of the present-day Iran is comparable to pre-war era in Germany.

Method

80 medical students (40 men and 40 women) in different years of education were randomly selected and evaluated by the questionnaire. By statistical analysis, authoritarian traits were compared between male and female students and also in different years of education (First year, 3rd year and internship).

Results

Female students showed a higher score than the male students. Also, we found a trend for male students to become more authoritarian over time. For the female students an opposite trends was found.

Conclusion

These results could be representative of different attitudes of male and female students toward authority related issues. Also, it could be in favor of different effects of education on authoritarian traits among the male and female.
FC24-05 - Maternal transmission of borderline personality disorder (BPD): a prospective community-based cohort study
Authors: Barnow S. , Arens E.
Published: May 2011

Objective

This longitudinal, community based cohort study assessed the mother-offspring transmission of BPD and examined whether maternal parenting styles and offspring temperament are associated risk factors.

Methods

At baseline 315 mothers and 414 offspring of the general population were investigated. Five years later the offspring were followed up and diagnostic interviews were carried out. BPD risk in children of BPD-mothers was compared to the BPD risk in children of healthy mothers. The contribution of an anxious-impulsive temperament in offspring and invalidating maternal parenting style to the prediction of BPD features was analyzed.

Results

Offspring of mothers with BPD were 8.5 times more likely to exhibit the diagnosis of BPD than offspring of healthy mothers. Prediction analyses suggest that mother-offspring transmission of BPD may be partially mediated by reciprocal transactions between a vulnerable temperament and an overprotective maternal parenting style.

Conclusions

Given that offspring of mothers with BPD are not only at heightened familial risk of BPD but also other mental disorders, specificity of factors that are shared between mothers and their offspring is questioned. Early prevention needs to be provided to this high-risk group, especially if there are additional risk factors, as the transaction between vulnerable temperament and maladaptive parenting.
Fc24-06 - Exploration of personality factors and the predictive impact on therapy utilization: The externalizing mode of functioning
Authors: Loeffler-Stastka H. ,   Section for Psychotherapy
Published: May 2011

Introduction

In recent years more attention has been paid to non-responders, i.e. patients who do not benefit from therapy, do not engage in treatment or terminate therapy prematurely.

Study 1/objectives

It was to identify personality factors predicting psychotherapy utilization on the basis of personality pathology, affect regulation and interpersonal functioning.

Methods

Affectivity (AREQ), the interpersonal context (QORS) and character pathology (SWAP-200) were assessed.

Results

Combination of instruments showed one stable factor predictive for non-engagement in psychotherapy, revealing an externalizing personality dimension, dominated by externalizing defenses, acting out, deficient super-ego functions, impairment in reflective functioning and in relating to others (n sample 1 = 129). Stability of the predictive power of this personality factor for therapy engagement could be shown and a replication in two other samples (n sample 2 = 95, n sample 3 = 94) confirmed the findings.

Study 2/objectives

Further we examined the question if the externalizing mode of functioning is relevant for the course of psychoanalytic treatments.

Methods

In 38 psychoanalytic treatments, severity of symptoms (SCL-90-R), interpersonal problems (IIP), character traits and psychostructural functioning (SWAP-200) were investigated half-yearly.

Results

For the first year denial of needs for closeness, and fears of an impulsive breakthrough of negative affects predicted dropout of therapy. During the second year externalizing defence, projection/projective identification, somatisation, hypochondria and dismissive interpersonal behaviour predicted break-ups.

Conclusion

The studies point at the necessity of interpreting affect-regulatory parameters, such as the externalizing parameter, from the very beginning and during the course of the treatment.
FC24-07 - Identity exploration of borderline personality disorder
Authors: Mac Farlane D.
Published: May 2011

Introduction

Adolescents with confused identity are a highly challenging client group. They respond to their adverse psychosocial environment with a variety of life-threatening behaviours.

Identity Exploration (IDEX) is a new approach which can be readily integrated into treatment modalities such as IPT (interpersonal), CAT (cognitive-analytic), DBT (dialectical) and SFT (solution-focussed) which are used for such cases.

Objectives

To identify identity states, their clinical manifestations and presentations by type.

To provide clinical illustrations of each type, highlight where treatment interventions are possible within this paradigm, and report outcomes.

Aims

To set out the details of a twelve week group treatment programme. Elements of the programme are - knowing the origins of problems; getting to know self; enhancement of self-concept and self-esteem; discovering self confidence; being satisfied; dealing with rejection and disappointment; taking time out; cooperating and sharing; being kind to self.

Methods

Completion of IDEX instrument; qualitative assessment, using the Alston grid, to differentiate comorbid conditions which include ADD, juvenile bipolar disorder, reactive attachment disorder, developmental traumatic disorder and complex PTSD; process notes of group therapy sessions; CORE evaluation of outcomes.

Results

The summary scores for the main parameters - empathetic identification, identity diffusion, conflicted identification and contaridentification - together with how they relate to the four identity states - Achieved, Foreclosed, Diffused and Moratorium - and outcomes will all be reported.

Conclusion

Identity Exploration is an easily administered tool which requires minimal training and which can be integrated into whichever treatment modality a therapist is trained in.
FC25-01 - Effects of additional exposure to psychoeducation and relaxation in acute stress disorder
Authors: Sartory G.
Published: May 2011

Introduction

Meta-analytic studies found exposure to be the most effective treatment in PTSD. Results are less clear with regard to acute stress disorder.

Objectives

To evaluate the additional effect of exposure therapy to supportive counseling.

Aims

The assessment of subjective measures and the heart-rate (HR) response to trauma reminders in the two treatment conditions.

Methods

Forty recent trauma victims with acute stress disorder were randomly assigned to three sessions of either prolonged exposure (PE) or supportive counseling (SC) with both groups also receiving psychoeducation and progressive relaxation. PE was administered imaginal and in vivo, both being therapist-assisted. Assessments were carried out before and after treatment and again after three months. Patients were shown ideosyncratic trauma-related pictures and autonomic responses assessed. Four years later, patients were asked by telephone whether they had required further treatment.

Results

There were no significant group differences with regard to symptomatic improvement at the end of treatment. Before treatment both groups showed HR acceleration to trauma-related pictures. After treatment the PE group showed attenuation of the HR-response and a reduction of spontaneous skin conductance fluctuations (SF) whereas the SC group showed a decelerative (orienting) HR response and an increase in SF. Over the next four years 43% of the SC group and and 9% of the PE group required further treatment.

Conclusion

The data show that SC, unlike PE, fails to attenuate autonomic responses to trauma-related stimuli suggesting that the former treatment fails to reorganize the trauma network.