bluuebunny/crossref_metadata_2025 huggingface dataset:
1627 – A French Case Series Of Twenty Synthetic Cathinones Abuse
Authors: Batisse A. , Fortias M. , Sec I. , Grégoire M. , Djezzar S.
Published: July 2013

Introduction

Synthetic cathinones are becoming increasingly popular and available as legal highs on the internet smartshop. Since July 2012, all synthetic drugs from the cathinones family have been banned and listed as narcotic in France but remain used.

Objectives

To describe the clinical presentation and alert the health care community about the abuse identification and risk assessment problems of these compounds.

Methods

We retrospectively reviewed cases of cathinone derivatives abuse notified to our Parisian centre during a two-year period (2011-2012).

Results

Twenty cases of cathinones abuse were identified. Users were mostly men (19/20), with mean age of 38 years, showing occasional cathinones abuse in sexual gay party (12/20). The synthetic cathinones were most commonly administered by intravenous injection (75%): an increasingly popular practice among Parisian men who have sex with men (MSM). This practice is called “slam”. This is an especially worrisome trend since the prevalence of HIV infection in our cases were 70% (14/20) with frequent co-infection HIV/Hepatitis C (40%). Thirteen cases presented psychiatric disorders: psychotic symptoms (58%), agitation (37%), anxiety (37%), suicidal ideas (28%) or attempt (2/20), acute satyriasis (2/20). Seven patients presented a cathinones dependence with DSM 4 criteria. Two patients had forensic problems. Somatic complications were described in ten cases with various pattern of symptoms as headache or rhabdomyolysis with renal failure.

Conclusions

Cathinones cause fast dependence syndrome with strong craving and prolonged psychiatric symptoms. We discuss the relation between sex and drugs in our sample. Cathinones could have a specific effect on sexual drives.
1637 – Recall Of Previously Learned Associations And Memory Generalization In Schizophrenia, Other Psychoses, Siblings, And Controls. The Northern Finland 1966 Birth Cohort Study
Authors: Alaräisänen A. , Kukkohovi L. , Rönkkö E. , Kyllönen M. , Miettunen J. , Isohanni M. , Veijola J. , Tamminga C.
Published: July 2013

Introduction

Neurocognitive impairments are a core feature of schizophrenia. The medial temporal lobe (MTL) is a brain region associated with declarative memory important in conscious acquisition and recollection of facts and events. The basal ganglia (BG) instead are linked to non-declarative memory functions such as gradual learning of skills and habits.

Objective

Acquired equivalence (AE) is a phenomenon in which prior training to treat two stimuli as an equivalent increases generalization between them. Our objective was to study this phenomenon in birth cohort setting.

Aims

To investigate whether the recall of previously learned associations and memory generalization are declined in schizophrenia, other psychoses and siblings compared to healthy controls.

Methods

The Northern Finland Birth Cohort 1966 is based upon 12, 068 women and their 12, 058 live-born children. The modified Rutger's AE-task was performed for 35 schizophrenia patients, 26 patients suffering from other psychosis, 18 siblings of psychotic subjects and 174 controls.

Results

The behavioral data showed statistically significant impairment in both recall of learned associations and generalization in schizophrenia and other psychosis groups compared to control subjects. Siblings did not differ significantly from controls in recall of learned associations but they showed impairments in generalization.

Conclusions

Impairment in recall of learned associations and memory generalization seem to be present also in other psychotic disorders, not only in schizophrenia. Since decline in generalization was seen in addition in siblings the hypothesis that declarative memory could be one of endophenotypes of schizophrenia is supported by this study.
1638 – Prolonged Hospital Admissions Of Patients With Borderline Personality Disorder In The Context Of The New Legislation In England And Wales - Patients’ View
Authors: Clementi N. , Dobrzynska E. , Wiecko R. , Mehany S. , Fortugno F. , Eales M. , Barker D. , Rossiter S. , Britten S.
Published: July 2013

Introduction

In 2007 the Mental Health Act in England and Wales was amended and the definition of Mental Disorder was broadened. This change affected people with Personality Disorders who now can be admitted for hospital treatment without consent, often for prolonged period of time.

Objectives

This poster reviews patients’ attitudes towards the new legislation and its consequences and also presents the research on the different perspectives about the new law.

Aims

To review patients’ attitudes with regard to interfaces between Personality Disorders and the new law.

Methods

Use of the specifically designed questionnaire for patients with Borderline Personality Disorders hospitalized under Mental Health Act. MEDLINE and PsycINFO databases were also searched for all English-language articles published between 2008 and 2012 containing the keywords “Personality Disorder”, “Mental Health Act” and “patients’ view on compulsory treatment”. Additional key articles published before 2008 were reviewed. The most relevant articles were selected for review.

Results and conclusions

There is still no common consensus in regard to the benefit of compulsory hospital admission of persons with Borderline Personality Disorders. Results from questionnaires are under review.
1647 – Affordability Of Alcoho And Alcohol Dependence Prevalence In Belarus
Authors: Razvodovsky Y.E.
Published: July 2013

Introduction

Several studies evaluated the effects of changes in a price on various outcomes related to harmful alcohol consumption, including alcohol dependence, known to be specifically attributed to long-term alcohol abuse.

Objectives

Against this background, it would be interesting to evaluate the relationship between alcohol affordability and alcohol dependence prevalence rates in post-Soviet Belarus.

Methods

To examine the relation between alcohol affordability and alcohol dependence prevalence in Belarus between 1990 and 2010 regression analysis was performed using the statistical package “Statistica”.

Results

In the period from 1990 to 2010 the prevalence of alcohol dependence in Belarus increased by 42,7% (from 1419,1 to 2024,4 per 10.000 of the population). The affordability of alcohol has increased significantly since the early 1990s: the average salary in 1993 could by 7.3 litres of vodka compared with 73.9 litres in 2010. The results of time series analysis suggest positive association between alcohol affordability and alcohol dependence prevalence rates: a 0.3% increase in the prevalence of alcohol dependence rate following a 1% increase in affordability of alcohol.

Conclusions

The results from this study are consistent with previous findings suggesting a significant association between alcohol affordability and alcohol-related problems. The main reason for the growth of alcohol consumption and alcohol-related problems in Belarus was the liberalization of the alcohol policy and increase in the affordability of alcohol. Hence, to prevent a further increase of alcohol affordability, increases alcohol prices seems to be one of the priority options of alcohol control policy in Belarus.
1649 – Possible Menstrual Psychosis: a Case Report
Authors: Puiu M.G. , Manea M. , Iordan A.M. , Manea M. , Patrichi B.E. , Frunza A.A.
Published: July 2013

Introduction

Described since the 19th century, menstrual psychosis is considered a forgotten disorder. Current classification systems do not include the diagnosis of menstrual psychosis, a condition comprising in psychotic episodes recurring during each menstrual or premenstrual period, but remitting the rest of the month. The world literature consists mainly of case reports. To our knowledge this is the first Romanian report of menstrual psychosis.

Objectives

To describe the course of the condition in a patient with multiple and rapid recurring psychotic episodes from onset until the most recent hospitalization.

Aims

To better understand if this case could be considered a true menstrual psychosis.

Methods

Review of the medical charts of the 57 hospitalizations the patient has had between 1977 and 2012 in the “Prof. Dr. Al. Obregia” Psychiatry Hospital.

Results

Initial diagnosis included discordant psychosis and atypical depressive state that shifted in time to schizoaffective disorder and various forms of schizophrenia. The history reveals cyclic episodes with short-term remissions and multiple hospitalizations. Treatment approaches also varied during the course of the disease, from ECT to second generation of antipsychotics without any consistent long-term remission. The frequency of episodes started to dramatically reduce only when the menopause installed.

Conclusion

Patients with a history of numerous admissions might benefit from a record review aimed at identifying temporal patterns. Clinicians should be aware of menstrual psychotic symptoms exacerbations in a minority of women with chronic mental disorders and therapeutic strategies need to be carefully considered and adjusted to each individual patient.
1656 – Experiece With Our Ambulance Of Mentaly Retarded People, With Psychiatric Disorders Since 1992 In The Christian Doppler Clinic Salzburg/austria
Authors: Sonnleitner K.
Published: July 2013

A helpfull longterm ambulant treatment of mentaly retarded outdoor-patients with multiple psychiatric disorders in a region of Salzburg, Upperaustria,Styria,Tyrol and Bavaria.

The problematic subject needs a special treatment with continue amulant contacts.

The aims are not to change the envirement of our patients and to help the professional outdoor teams to cope with the different problematics.

The Method is a team of psychiatrist and pedagogic professionalist to help the patients in contact with parents and outdoor institutions (called par example “Lebenshilfe”) to cope with their special needs.

Till now are ˜; 500 patients in our ambulant treatment and the numbers are still encreasing.

The necessity of special ambulances with a high grade of networking.

I hope for a helpfull discussion.
1657 – Component Structure Of The Positive And Negative Syndrome Scale (panss) In Patients With Schizophrenia Spectrum Disorders And Predominantly Negative Syndrome
Authors: Bobes J. , Rejas J. , Arango C.
Published: July 2013

Aim

Earlier studies have examined the symptom dimensions of the PANSS (Positive And Negative Syndrome Scale) in patients with chronic schizophrenia, regardless predominance of symptoms. The aim of this study was to examine the component structure of the PANSS in patients with schizophrenia spectrum disorders and predominantly negative syndrome.

Methods

Data of PANSS were extracted from a cross-sectional and retrospective multicenter study in 1,704 adult psychiatric outpatients meeting DSM-IV criteria for schizophrenia, schizophreniform or schizoaffective disorder. We used 5 items of the PANSS negative subscale to individually determine the presence of a negative syndrome when the score on all of the 5-items were >3, with no extrapyramidal symptoms, anxiety, or depression and dose of haloperidol, when applicable, ≤15mg/day. Exploratory factor analysis was carried out using principal component analysis to extract domains. Eigenvalues above 1 according with Kaiser K1 rule were applied to extract factors. Items with a loading of ≥ 0.4 were considered to load on a component.

Results

A total of 307 [61% men, mean age: 41 (SD:12) years] fulfilled criteria for inclusion in the analysis. Principal component analysis of the PANSS revealed four components: positive, negative (all negative items of the original PANSS plus items 15 and 16 of the general psychopathology subscale), mood and disorganization, explained 58% of the total variance. Internal consistency (Cronbach-alpha) of these 4 domains was high: 0.897, 0.874, 0.819 and 0.833, respectively.

Conclusions

This analysis suggest a four component structure of the PANSS in patients with schizophrenia spectrum disorders and predominantly negative syndrome.
1663 – Alcohol And Tobacco Usage And Depressive Symptoms Among University Students
Authors: Salminen T. , Saukkosaari J. , Hakko H. , Räsänen P. , Jääskeläinen E.
Published: July 2013

Introduction

Substance abuse and mental health problems have been increasing among young population.

Aims

To find out the prevalence of alcohol and tobacco usage and their association with depressive symptoms among university students.

Methods

Web-based questionnaire was sent to all 13397 university students of Oulu University, Finland in November 2011. 2167 (16,2%) replied, 31,5% were males and 68,5% females. The questionnaire included Alcohol Use Disorders Identification Test (AUDIT-C), questions concerning tobacco, and Symptom Check List-90 (SCL-90). We analyzed the prevalence of alcohol and tobacco usage and their association with depressive symptoms by gender.

Results

Among males 46,0% had hazardous drinking habits (AUDIT-C score 4-7) and 21,3% had very hazardous drinking habits (AUDIT-C score 8-12). Among females 63,2% had hazardous drinking habits (AUDIT-C score 3-7) and 4,8% had very hazardous drinking habits (AUDIT-C score 8-12). 14,8% of males and 12,1% of females were smoking tobacco irregularly and 4,8% of males and 4,4% of females smoked regularly. There was no statistically significant association between usage of alcohol and symptoms of depression among males or females. Among males, but not among females, there was statistically significant positive association between tobacco smoking and depressive symptoms (p=0,001).

Conclusions

The prevalence of hazardous drinking habits in our sample was very high compared to earlier studies conducted among university students. Contrary to earlier studies there was no association between hazardous drinking habits and depressive symptoms. In the future factors associating to hazardous drinking and the prevention of this phenomenon should be studied in more detail.
1664 – Evaluation Of The Effectiveness Of Treatment Response Applying Panss, Gaf And Moca In Patients With Schizophrenia
Authors: Fisekovic S. , Memic A. , Burnazovic-Ristic L.
Published: July 2013

Introduction

Schizophrenia (SCH) is considered the most serious psychiatric disorder with complex pathogenetic and pathophysiological mechanisms and inadequate treatments.

Objectives

Given the association of psychotropic medication and cognitive, functional, and neuropsychiatric symptoms (NPS), the use of certain measuring instruments among patients who suffer from schizophrenia is important because the quantification of treatment effects is crucial for optimizing the management of patients with schizophrenia.

Aims

To assess the efficacy of antipsychotic therapy in schizophrenic patients with predominantly negative and positive symptoms, cognitive impairment and social, occupational and psychological dysfunction.

Methods

Two main groups were selected for analysis: (N=34) included patients taking first-generation antipsychotics (FGAs) and (N=16) included patients taking second generation antipsychotics (SGAs). We used the Positive and Negative Syndrome Scale (PANNS), Global Assessment Functioning (GAF) and Montreal Cognitive Assessment Scale (MOCA).

Results

Out of the total number of examinees (n=50), 15/50 (30%) were males and 35/50 (70%) were females; the age of onset was 38.4±1.77; duration of illness (mean±SD) 32.5±5.00; SANS-Total (mean±SD) (23.82±9.962); SAPS-Total (mean ±SD) (28.6±9.74). Analysis of the PANSS scale bipolar index shows that patients on SGA, on average, had lower scores (2.37±12.5) compared to patients on FGA (5.91 ±9.61).

Conclusions

Preliminary evidence showed that there are no significant advantages in the use of atypical antipsychotics compared with typical ones in a group of patients suffering from schizophrenia. It is important to realize what role the advancement of antipsychotics has played and what still needs to be accomplished to further improve the outcome of sch patients.
1669 – Correlates Of Postpartum Anxiety
Authors: Pereira A.T. , Marques M. , Soares M.J. , Maia B.R. , Bos S.C. , Azevedo M.H. , Valente J. , Nogueira V. , Madeira N. , Roque C. , Macedo A.
Published: July 2013

Introduction

Factors associated with postpartum/PPT anxiety have been insufficiently investigated.

Objective

To identify correlates of PPT anxiety.

Methods

201 3-months postpartum women completed the Portuguese versions of Postpartum Depression Screening Scale (PDSS), Beck Depression Inventory/BDI-II, Profile of Mood States, Difficult Infant Temperament Questionnaire/DITQ, Multidimensional Perfectionism Scale and questions on sociodemographic variables, Lifetime history of insomnia/LTHD, Lifetime history of depressive symptomatology/LTHDS, Current insomnia, Health perception/HP, Stress perception/SP, Perceived social support/PSS, Quality of life/QOL, Health problem/complication postpartum, Sensibility to hormonal fluctuations, Type of delivery and Type of feeding. Postpartum anxiety was measured with the Anxiety/Insecurity (AI) subscale of the PDSS.

Results

AI significantly correlated with LTHDS (rS=.32), LHI (rS=.18), Current insomnia (rS=.32), BDI-II (r=.76), SP (rS=.38), PSS (rS=.25), Perceived QOL (rS=.37), Health perception (rS=.29), Health problem in the postpartum (rS=.26), Negative Affect/NA (r=.66), Positive Affect/PA (r=.58), Conditional Acceptance/CA (r=.29) and DIT (r=.38) (all p< .01). Mean comparisons revealed that women with vs. without LHDS, with vs. without LTHI, good sleepers vs. with insomnia syndrome, high vs. low SP, low vs. high PSS, bad/very bad vs. good/very good QOL, bad/very bad vs. good/very good HP, high (< M+1DP) vs. low (>M-1DP) DIT, CA, NA and low vs. high PA had significantly higher mean scores in AI (all p< .01). Linear regression model composed of all correlated variables explained 53.7% of AI variance and showed that NA, PA and DIT are significant (p< .05) predictors of AI.

Conclusion

Our findings are in accordance with previous research and contribute to the progress on this topic.
1674 – Phenomenology Of Combat-related Ptsd
Authors: Kolov S.
Published: July 2013

Objectives

Many researchers point out that combatants demonstrate various additional symptoms that do not fit into the PTSD classical clinical picture. Unfortunately, until present moment there has been a great need for a conception that will unite all the approaches.

Method

To achieve our goal we used traditional clinical-anamnestic and clinical-psychological methods which included clinical-psychological scales of multidimensional anger assessment, aggressive behaviour scale, depersonalization scale, the Mississippi PTSD scale. We examined 557 combatants, 109 of which had the full range of PTSD symptoms, whereas the rest demonstrated subclinical manifestations of the disorder in question.

Results

It was discovered that compulsory PTSD symptoms in combatants have specific peculiarities. Anger, being part of PTSD hyperreactive cluster, here is associated with impulsive-hostile aggression. This explosive syndrome displays features characteristic only of combatants, also it negatively influences every aspect of a combatant's life (namely, physical and mental health, vital functions, social relationships). The mentioned above syndrome is closely related with personal relations and accompanied by such pathological coping mechanisms as social avoidance/restrictions, redirection of aggression onto self and others. The noted emotional violations of basic emotions of anger and anxiety, that are compensated by depression and depersonalization and that have protective-coping character, can be termed a syndrome of affective-stressed dysfunction. This explains high comorbidity in PTSD combatants with depressive disorders.

Conclusions

The revealed additional symptoms and syndromes function as a whole complex of combat-related post-stress disorders and single out combatants into a peculiar group among patients with other stress disorders.
1675 – Co-occurring Substance Misuse In Clients Presenting To a Psychiatric Unit In a General Hospital In Jamaica
Authors: Iballaboh H. , De La Haye W.
Published: July 2013

Introduction

Co-Occurring Substance Misuse is associated with negative effects on psychiatric illnesses with implications for medication compliance, relapse and treatment outcome.

Aims

To contribute to research in the area of Co-occurring Substance Misuse in the Caribbean in general and Jamaica in particular.

Objectives

To determine the prevalence of Co-occurring Substance Misuse, associated demographic characteristics and reports of interpersonal violence.

Method

A cross-sectional study design was used with consenting patients admitted to the Psychiatric Unit at the University Hospital of the West Indies, Kingston over the period March 2011 to September 2011. Data collection utilized a researcher administered Background Questionnaire. Data analysis was done using the Statistical Package for the Social Sciences Version 18.0 (SPSS 18.0).

Results

Of 100 consenting patients, 36 (36%) were diagnosed as having Co-occurring Substance Misuse, 31 (83.8%) males and 5 (13.5%) females, mean age 27.17 ± 9.6 years, range 14-59 years. Past year alcohol (86.5%), tobacco (86.5%), marijuana (89.2%) and cocaine (13.9%) use were reported, with the majority of patients (94.4%) reporting polysubstance use. The mean age of onset for alcohol was 14.3 yrs, tobacco, 14.8 yrs, cannabis, 16.5 yrs and cocaine 21.4 years. 70% were diagnosed with a Psychotic Disorder and 30% had a Mood Disorder. A high prevalence of interpersonal violence (77.8%) was reported.

Conclusion

There is a high prevalence of Co- morbid Substance Misuse in this sample of patients. Patients should be screened on admission for Co-morbid Substance Misuse and a combined, integrated approach to the management of these patients should be established.
1677 – A Basic Protocol To Manage Patients With Personality Disorders In The General Hospital
Authors: Gonzalez-Torres M.A. , Bustamante S. , Vivanco E. , Trojaola B. , Fernandez-Rivas A.
Published: July 2013

Introduction

Patients presenting Personality Disorders and specially Borderline Personality Disorder are often admitted to Psychiatry Units in General Hospitals. Their impulsivity, affective disregulation and difficulties in interpersonal relations complicate the therapeutic atmosphere and cause problematic interactions with staff and other patients.

Objectives

To improve staff response to behavioural problems of patients presenting Personality Disorder in psychiatric units in the general hospital.

Aims

To develop a protocol to guide staff interventions with these patients.

Methods

After analyzing the patients flow from the emergency room to discharge and the current proposals in the literature on the subject, we create a protocol addressing more frequent problems using a task group composed of psychiatrists, psychologists and nurses involved in the daily care of these patients.

Results

A protocol is delineated guiding clinicians and staff on how to deal with assistance at the emergency room, entrance to the ward, initial contract and agreement, responses to specific problems during treatment and final discharge.

Conclusions

A protocol to guide the staff dealing with behavioural problem of patients with PD in the general hospital can be developed and provides clinicians with a therapeutic frame that structures the different treatment interventions.
1687 – Social Cognition In Patients With Dissociative Amnesia
Authors: Markowitsch H.J. , Staniloiu A.
Published: July 2013

Introduction

Dissociative amnesia is triggered by psychological stress or trauma. Its hallmark is a severe (usually retrograde) memory impairment within episodic-autobiographical domain, occurring without evidence of significant brain damage on conventional structural brain imaging.

Objectives

This work’s objectives are establishing greater recognition of possible relations between memory performance and social cognition in patients with dissociative amnesia.

Aims

We review data on social cognition (affective and cognitive theory of mind, simulation, empathy, social judgment, moral judgment) from our own patients with dissociative amnesia.

Methods

Patients were investigated medically, psychiatrically and with neuropsychological and neuroimaging methods.

Results

Patients with dissociative amnesia show variable degrees of impairments of components of social cognition, based on their comorbid conditions (e.g. concurrent clinical or subclinical depression), types of memory impairments (e.g. extent of retrograde amnesia, presence of autobiographical semantic deficits), pattern of brain metabolic changes, personality characteristics, neuropsychological profile (performance on executive functions or emotional processing) and testing paradigms.

Conclusions

The impairment in dissociative amnesia seems to go beyond the conscious mnemonic deficit, encompassing various aspects of social information processing. Knowledge about the pattern of metabolic and micro-structural brain changes in patients with dissociative amnesia as well as a fine-grained analysis of the neural correlates of various aspects of social cognition might provide an understanding of when and how episodic-autobiographical memory contributes to social cognition. As several studies emphasized, some structures involved in mnemonic processing may also play a role in social perception, cognition and behavioural regulation, including future-minded choice behaviour.
1692 – Obsessive-compulsive-bipolar Disorder Comorbidity: a Case Report
Authors: Ribeiro J.P. , Ribeiro Â. , Ribeiro B. , Silva J.C.
Published: July 2013

Introduction

Anxiety disorders have been historically described as a feature of Bipolar Disorder (BD), and Obsessive-compulsive-bipolar disorder (OCBD) comorbidity has been referred in literature. A survey reports that 55,8% of obsessive-compulsive patients may develop BD in their lifetime. Another survey estimates it at 21%. Mania in Obsessive-Compulsive Disorder (OCD) can occur either as an independent comorbidity or as a result of an antidepressant-induced switch in a patient in anti-OCD drugs.

Objectives/aims

The aim of this poster is to describe and discuss some aspects of this psychiatric comorbidity, with emphasis on its diagnosis and management, based on a case report.

Methods

This case report describes a 38-years-old married male with 5 years history of OCD treated with an antidepressant, admitted at our psychiatric ward due to a manic episode. Its management and therapeutic approach are described.

Discussion/conclusion

A baseline of “neurosis” (versus “psychosis”) in some BD presentations has emerged from recent scientific evidence, which prompts its better understanding. As a complex comorbidity, OCBD represents a diagnostic and therapeutic challenge implying further systematic exploration.
1696 – Postictal Psychoses - The Importance Of Seizures Control a Case Report
Authors: Ribeiro Â. , Ribeiro B. , Ribeiro J.P. , von Doellinger O.
Published: July 2013

Introduction

Psychiatric symptoms occur quite often in epilepsy and are an important prognostic factor in quality of life of patients with this neurological condition. The psychotic disorders occurring in epilepsy are classified according to their chronological relationship with the seizures. The peri-ictal psychoses occur before (pre-ictal), during (ictal) or after (postictal) the emergence of a seizure. Inter-ictal psychoses occur independently of seizures. Postictal psychosis (PP) episodes are typically of short duration.

Objectives/aims

Our aim is to show the great importance of seizures control as a way to prevent the onset of psychotic symptoms, thereby improving patient’s prognosis and quality of life.

Methods

In this paper we describe a case of a 44-year-old man, with post-traumatic epilepsy and postictal psychotic symptoms.

Results/conclusion

The search and the recognition of psychiatric symptoms in epilepsy allow a better understanding of the overall clinical case and, therefore, a more effective treatment.
1698 – Testing Routine Outcome Measurement In Outpatient Care In Satakunta Hospital District, Finland
Authors: Korkeila J. , Nevalainen M. , Horjamo K.
Published: July 2013

Background

Health-Related Quality of Life has been considered suitable for outcome measurements in chronic illnesses.

Methods

Feasibility of collecting routinely data on health gains during treatment was assessed during a outpatient service development project in Satakunta hospital district. Finland. Patients contacting the outpatient services for the first time were asked to fill in scales during their first visit. The sacles were sent by mail three months, one year and two years after the first visit. The instruments used were AUDIT-5, BDI-21 and 15D. 15D is a scale developed for purposes of estimating QALY’s in health economic research. It has been widely used in Finland in general population and patient populations including psychiatric patients. Previous studies have defined a population standard (0.9402 out of a score of 1) for 15D assessments and a universal cut-point (change of 0.03) for clinically significant change.

Results

The use of routine-based outcome measurement has been well feasible in outpatient care. So far 949 patients have undergone the first measurement point, 590 the second assessment point and 312 the third assessment point. The data collection is still on-going and numbers of responses at later intervals are likely to increase. At the first assessment the mean 15D score was 0.7616, at three months 0.7857 and at one year 0.7995. Scores increased especially concerning anxiety and depression, but considerably less regarding sleep.

Conclusion

Routine measurement of health gains is feasible within the context of public psychiatric services. Measurement implied also need for development of insomnia treatment.
1699 – Long Lasting Personality Changes After The Onset Of Dissociative Amnesia
Authors: Staniloiu A. , Markowitsch H.J.
Published: July 2013

Introduction

Across various cultures, dissociative amnesia is triggered by psychological stress or trauma. Its hallmark is a severe (usually retrograde) memory impairment, occurring without evidence of significant brain damage (as detected by conventional structural brain imaging). In a substantial number of cases, the memory impairment follows a chronic course. Sometimes dissociative amnesia occurs on a background of a personality disorder (narcissistic or borderline). Other times, amnesia itself triggers long lasting personality changes.

Objectives

This work’s objectives are establishing greater recognition among health care providers of the spectrum of the personality changes that may accompany chronic forms of dissociative amnesia.

Aims

We review data from own patients with chronic forms of dissociative amnesia.

Methods

Patients were investigated medically, psychiatrically, neuropsychologically and and neuroradiologically.

Results

Changes in personality dimensions occur after the onset of amnesia. These may involve affectivity, perception (e.g. impaired self face or face-emotion processing), cognition (e.g. social cognition) and behaviour (e.g. changing in eating, smoking, drinking or working habits).

Conclusions

The observed personality changes may represent a consequence of amnesia. Functional imaging studies show metabolic changes in dissociative amnesia in brain areas involved in conscious mnemonic processing. Several structures engaged in processing within episodic-autobiographical memory system were also implicated in self and reward-related processing. Alternatively, the personality changes may be viewed as being pivotal in the development and maintenance of dissociative amnesia; this personality shift may subsequently lead to enduring changes in ways of cognitive processing, self-processing, perception and affect.
1703 – Activities Group With Young Students: Conflicts Identification
Authors: Scherer E.A. , Scherer Z.A.P. , Cocenas S.A. , Guazzelli M.S. , Censi F. ,   Interdisciplinary Study Group about Violence(GREIVI)
Published: July 2013

Introduction

In a public elementary and secondary education school, in the interior of São Paulo state, an Extension Project of the University of São Paulo that aims to invest in the promotion of physical, mental and social health of a group of students is developed. Structured activities, including games, group activities and experiences are offered, coordinated by nursing students and supervised by a faculty member responsible for the project.

Objectives

To verify the opinion of a group of students about the school and the roles of significant people; to identify existing conflicts, according to the type of violent acts.

Aims

To know the circumstances of the interaction of a group of young students with the school and family.

Method

This qualitative study with participant observation analyzed 3 group meetings conducted with twenty 6th grade students of the elementary school.

Results

Students’ perceptions about the school and its professionals were different. They considered family members as important people, who take care, place limits, scold and beat. They struggled to establish their role and that of colleagues at school. Colleagues are friends to play with. The following types of violence were identified: physical, psychological and negligence.

Conclusion

To work on self-esteem, tolerance and cooperation; alleviate conflicts with affective attitudes that express respect; offer educational spaces where young people can take positions, facilitate their interaction and exercise their creativity and reflection preventively collaborate to decrease violence at school. Thus, it may be easier to build models of peaceful coexistence in other social environments.
1709 – Parents’ Perceptions Of Adolescents With Attention Deficit Hyperactivity Disorder
Authors: Scherer Z.A.P. , Stefanini J.R. , Scherer E.A. ,   Interdisciplinary Study Group about Violence (GREIVI)
Published: July 2013

Introduction

Attention Deficit Hyperactivity Disorder (ADHD) is characterized by symptoms of inattention, hyperactivity and impulsivity. Arises in childhood and can persist throughout adulthood, and may cause difficulties in personal, academic, familiar, social and professional life areas of the individual.

Objective

To know and describe the parents’ perceptions of teenagers with ADHD about this disorder.

Aims

To assist in the understanding of ADHD in adolescence.

Method

Oral thematic research with parents of adolescent assisted in a Child and Adolescent Psychiatric Clinic of Ribeirão Preto Medical School Hospital of the University of São Paulo, Brazil. The semi-structured interviews were performed with 5 families at their residences.

Results

The analysis of parents’ narratives identified two categories: “living with a teenager with ADHD” and “adolescent with ADHD in school context”. Parents realize that they, as well as, school professionals have difficulties in dealing with the adolescent with ADHD. Recognize that since childhood their children manifest different behaviors. They mentioned lack of knowledge, information and guidance related to this disorder. They were concerned about the future of these young people and the discrimination they suffer.

Conclusion

Social and family relations established with the adolescents with ADHD can be characterized by constant conflicts. It is necessary to offer support and guidance to parents, with the joint participation of health care and education professionals. The approaches must be constantly evaluated to its improvement and adequacy, following the different phases of young people's development.
1713 – Early Recognition And Treatment Of Youth And Young Adults At-risk For The Development Of Severe Mental Disorders
Authors: Pfennig A. , Bauer M. , Leopold K.
Published: July 2013

Introduction

Despite improvements in treatment for patients with severe mental disorders, such as bipolar disorder and schizophrenia, there is still a long delay from first symptoms to correct diagnosis and treatment. Since these illnesses usually manifest themselves within adolescence and young adulthood, this time lag impacts chances for an adequate individual development.

Objectives

With rather unspecific symptomatology in early stages of the development of the disorders and the still existing stigmatisation, a broad and low-threshold strategy is needed. In November 2008 an early recognition and prevention centre for mental disorders was opened at the University Hospital in Dresden.

Aims

The aim of this service is to shorten the delay to correct diagnosis and treatment in severe mental disorders. In parallel, early detection instruments are developed and early intervention strategies studied in research projects.

Methods

In this specialized centre diagnostics, counselling and treatment are provided for subjects aged 12 to 40 by a multidisciplinary team in a low-threshold setting.

Results

250 youth and young adults were offered diagnostics and, if appropriate, treatment. In about 2/3 of clients, mental disorders had already manifested themselves, in some cases an additional risk for even more severe developments was ascertained. Counselling and transfer to appropriate treatment is offered to all clients, all are followed up on a regular basis to validate the process and assess the prognostic value of our service.

Conclusions

A broad, low-threshold and multidisciplinary approach for early recognition and treatment of severe mental disorders holds the chance of earlier appropriate care.
1719 – Group Therapy With Burned Patients
Authors: Scherer Z.A.P. , Scherer E.A.
Published: July 2013

Introduction

The literature mentions that being burned is one of the most traumatic situations that an individual can experience physically and emotionally. The burned patient has to fight the physical discomfort and the pain, as well as with early and late psychological problems, as delirium, regression, depression and altered body image.

Objective

To understand the physical and emotional pain of a group of people who suffered burns.

Aims

To understand the suffering of people who have burn injuries.

Method

This is a qualitative participant observation study. 11 groups conducted with 10 patients in a burn unit of a public university hospital were analyzed. Meetings occurred weekly and were 30 minutes to 1 and a half hours long.

Results

The themes related to feelings, fears and doubts resulting from the burn and its treatment were frequent. Patients could only speak of internal pain when they had space to report physical pain. In those moments, some of them could expose themselves to reveal that the burn had been an attempt of suicide. They realized that their problems, fears and fantasies related to recovery, consequences and social isolation were not unique; and they had the opportunity to share them, feeling so relieved.

Conclusion

The experience with the studied group identified some goals for groups with burned patients: to inform about the procedures and questions that cause anxiety; decrease the sense of isolation, stimulating exchanges, instilling hope in recovery; encourage the sharing of concerns about the consequences and social isolation; and identify destructive behaviors.
1722 – The Itinad Study: Preliminary Results Of a Psychoeducation Progam For Caregivers Of Alzheimer Patients
Authors: Negri A. , Colmegna F. , Clerici M.
Published: July 2013

Introduction

Alzheimer's Disease (AD) surges as a major issue in public health, and so does quality of life of patient's informal caregivers, who are exposed to negative outcomes such as increasing psychological distress and burden, depression and anxiety, which are also often associated to a poor knowledge of the disease, of its symptoms and of patient's needs.

Objectives

The purpose of the ITINAD project is to demonstrate the effectiveness of a psychoeducational program in reducing the negative impact of caregivers’ coping with an AD patient and in increasing the knowledge.

Methods

The study involved 185 caregivers from 10 Italian centers: 89 of them were assigned to the control group, while 96 belonged to the experimental group, which was submitted to a 12 sessions psychoeducational program that developed themes such as clinical aspects of the illness, relatives’ roles and coping strategies. Socio-demographic data for the caregivers were analyzed, while the Hamilton Rating Scales were used to assess the symptoms of anxiety (HRSA) and depression (HRSD); the Psychological General Well-Being Index (PGWBI) measured psychological distress; the QPF (Familiar Issues Questionnaire) was used to evaluate caregivers’ burden and their consciousness towards AD.

Results

Caregivers belonging to experimental group showed a significant decrease in anxiety (p=0,00) and depression (p=0,00); the program led also to a better self control in caregivers as shown by the PGWBI (p=0,04). The QPF demonstrated an improvement in AD's symptoms’ management (p=0,00).

Conclusions

These findings suggest the utility of a psychoeducational group in preventing negative outcomes in AD's caregiver.
1726 – Eating Disorders In Male Patients: Medical And Psychiatric Co-morbidity
Authors: Moscara M. , Bolondi M. , Cuoghi G. , Cameli M. , Miselli M. , Visentini C. , Ferrari S. , Rigatelli M. , Mattei G.
Published: July 2013

Introduction

Men make up approximately 10% of the diagnoses of specified Eating Disorders (ED), with Bulimia Nervosa more common in men than Anorexia. However, Eating Disorder Not Otherwise Specified (EDNOS) are more prevalent in men than Anorexia and Bulimia combined. Rates of concurrent depression and personality disorders are also high in men with EDNOS, as well as rates of medical co-morbidity.

Objectives

To describe a sample of male patients attending a Psychiatric Day Hospital.

Aims

To understand possible links between the diagnosis of ED and medical and psychiatric co-morbidity among male subjects.

Methods

Clinical data about male patients attending the Psychiatric Day Hospital of Modena from 05/01/2009 to 13/06/2012 were collected and analyzed. Psychiatric diagnoses were defined according to DSM IV criteria, medical comorbidities according to ICD10 criteria.

Results

Male patients with ED were on the whole 11 (7.9% of total patients). Nine of them (81.8%) were diagnosed with EDNOS; 7 had medical co-morbidity, namely gastrointestinal (36.4%), respiratory (9.1%), renal (9.1%), rheumatologic (18.2%), cardiac (9.1%) and hypertension (16.6%); 9 had psychiatric co-morbidity, namely personality disorders (46.2%), major depression (30.8%), substance abuse (15.4%) and anxiety disorders (7.7%). Only 1 male patient (9.1%) was suffering from the ED, with no medical or psychiatric co-morbidity.

Conclusions

Male patients suffering from ED are increasing and knowledge on their clinical features are less clear than for female subjects, resulting in a more difficult and less effective clinical management. Despite the small sample size, this study attempts to increase the understanding of this clinical population.
1729 – Standardised Treatment For Anxiety Disorders: An Evaluation Of Implementation And Treatment Outcomes
Authors: Tranberg H.D. , Lau M.E. , Mortensen E.L.
Published: July 2013

Introduction

Standardised and timely restricted care for anxiety disorders has replaced former treatment in the Mental Health Services in the Capital Region of Denmark. Currently, there is no documentation regarding the impact of treatment standardisation on patient outcome and on service delivery.

Objective

The aim is to investigate

i)

the effect of standardised treatment on patient outcome, and

ii)

the implementation outcomes of standardised treatment programs for anxiety disorders in clinical practice.

Methods

The study is conducted as a quasi-experimental prospective pre-post study in a naturalistic setting in which patients are referred randomly to the two mental health centres. Patients included in the study are aged above18 years and referred to standardised treatment for anxiety disorders (F40-41). The Conceptual Model of Implementation Research [1] distinguishes between outcomes at three different levels: implementation, service and client (patient), and argues that client outcomes depend on outcomes of the previous levels. This study includes outcomes at all levels. The clinical outcome data include the Symptom Check List-90R, Beck Anxiety Inventory, Global Assessment of Functioning and WHO Wellbeing Index.

Results

The first patient was included in October 2012. The study design will be described in details and preliminary results presented.

Perspectives

From January 2013 standardised and timely restricted care for anxiety disorders are introduced at a national level in Denmark, which further increase the relevance of the present study.
1732 – Characteristics Associated With Lithium Response In Bipolar i And Ii Disorders
Authors: Sportiche S. , Brichant-Petitjean C. , Etain B. , Henry C. , Kahn J.-P. , Gard S. , Bellivier F.
Published: July 2013

Introduction

Lithium remains the gold standard of prophylactic treatment in bipolar disorder. However 10–40% of patients are not responder to lithium and there is still no operational predictive markers of lithium response. Moreover, previous studies relate some conflicting results due to the absence of an unanimous definition and evaluation of prophylactic lithium response. Our objective was to identify clinical factors associated with prophylactic lithium response assessed by Alda questionnaire that includes 6 categories of prophylactic response from no response for at least two years of treatment to no relapse for three years.

Aims

To study characteristics associated with lithium response.

Methods

All 516 participants met the DSM-IV criteria for bipolar disorder. They all received at least once in their life lithium (for at least two years) and all completed the Alda questionnaire. They were compared on several sociodemographic and clinical factors which were collected using the DIGS. Psychological dimensions were assessed with the ALS and AIS (for affective lability and instability), the BIS (for impulsivity) and the WURS (for ADHD screening) and history of childhood trauma.

Results

Among the 516 subjects, 132 (25,6%) were lithium responders with no relapse during at least two years of treatment; 106 (20,5%) were poor lithium responders. These groups were compared for clinical, dimensional and childhood trauma characteristics, using both univariate and multivariate analyses.

Conclusions

Characteristics associated with lithium response may help to define personalized strategies.