bluuebunny/crossref_metadata_2025 huggingface dataset:
Depression and Cytokines: A Psychoneuroimmune Perspective [PW06-02]
Authors: Castro L.C.
Published: March 2009

Background:

Cytokine-induced sickness behaviour is an adaptative response to infection. Activation of the immune system, particularly the increased activity of several cytokines, has been implicated in the provocation or exacerbation of mood disorders.

Aim:

To discuss the relevance of psychoneuroimmunologic research in the understanding of the patophysiology and therapeutic targets of certain mental health disorders.

Methods:

Review of the literature. MEDLINE and PubMed databases searches for peer-reviewed studies, published between 2000 and 2008, using combinations of the Medline Subject Heading terms cytokines, sickness behaviour, immune system and depression, depressive illness.

Results:

Several lines of evidence support the relationship between cytokines and mood disorders. Cytokine elevations are more marked in severe depression and their activity may also relate with illness chronicity, neurovegetative features and high stress perception. It is argued that the activation of the inflammatory system, eliciting cytokine release and synthesis, provoke neuroendocrine and neurotransmitter changes, contributing to the development of depression. Some studies support that the brain cytokine system can become sensitized in response to non-immune stressors or to immune stressors occurring early in life.

Discussion:

The cytokines actions in the brain can help to clarify the patophysiology of certain psychiatric disorders, including depression. The research findings show an association between the activation of the brain cytokine system and depression, although the precise relationship between sickness behaviour and depression is still not clear. Further research in such a promising area of study is needed and can contribute to new therapeutical targets and a broader understanding of psychiatric disorders.
The Real Cost of Sickness-absence in Mental Health: A Cognitive Behavioural Perspective [PW06-03]
Authors: Dovey A. , Wilday S.
Published: March 2009

The number of employees experiencing psychological problems related to occupational stress has increased rapidly in Western countries and mental illness is now cited as one of the top three causes of certified sickness absence.

Worldwide economic issues are now synthesising various cultural beliefs and behaviours and should Western factors have an influence then one could presume workplace mental health problems will increase worldwide. The presentation will focus on the literature pertaining to the potential function of sickness absence for the individual as well as the known maintenance factors for anxiety and depression from a CB perspective.The presentation will highlight that the basic CB premise of emotional disorder implicates the potential for an individuals response to symptoms to have a maintenance role in the course of both anxiety and depression. The potential impact of sickness absence for anxiety and depression via the loss of the benefits of employment (e.g. structure, activity and social contact) the potential for the development of sick role behaviour (e.g. reduced activity, social isolation) as well as the reinforcement of avoidant coping are considered significant.In conclusion the presenters propose that sickness absence for individuals with anxiety and/or depression can function as a maintenance factor for both disorders. The implications for the future use of sickness absence as a standalone intervention within this group will be discussed. The audience will have an opportunity to reflect on the potential effectiveness of cognitive behavioural therapy within the workplace
Maintenance ECT in Affective Disorders [PW06-04]
Authors: Barrocas D. , Coentre R. , Chendo I. , Mendes T. , Abreu M. , Maltez J.
Published: March 2009

ECT is the most powerful therapeutic tool in the treatment of acute mood episodes. However, data on the efficacy and safety of ECT in the long term management of affective disorders is lacking, despite overwhelming rates of chronicity and/or frequent relapses among patients with unipolar and bipolar depression. In this presentation we will review the data of the ECT unit of Hospital de Santa Maria, Lisboa, on maintenace ECT (m-ECT) in these patients. We compare intra and inter-individual evolution prior and after the institution of m-ECT. Considering the number of hospital admissions, mood symptoms and other parameters, our data support the use of this technique as a prophylatic approach for patients with mood disorders and a previous good response to ECT in the acute phase of disease.
The Predictive Role of Anxiety Disorders on Depressive Phenomenology During Post-partum Period [PW06-05]
Authors: Mauri M. , Rambelli C. , Montagnani M.S. , Camilleri V. , Cortopassi S. , Ramacciotti D. , Banti S. , Borri C. , Annalisa O. , Bettini A. , Ricciardulli S. , Giunti Y. , Ciaponi B. , Di Biase S.
Published: March 2009

Aims:

To investigate the predictive role of any specific (DSM-IV) Anxiety Disorders (AD) on depressive symptoms and Major or Minor Depressive Disorder (MDD, mDD) during early postpartum period.

Method:

Women (at the 12th-15th gestational week, N=1066) were recruited in the framework of the Program ‘Perinatal Depression - Research & Screening Unit (PND-ReScU)". Depressive symptoms were assessed by the Edinburgh Postnatal Depression Scale (EPDS), and Axis-I disorders (AD, MDD, mDD) were diagnosed with the Structured Clinical Interview for Axis-I Disorders (SCID-I).

Results:

Any current AD at baseline (3rd month of pregnancy) was detected in 231 (21.7%). Having at least one current AD, was associated with a greater likelihood of having MDD or mDD during the early postpartum period, even after the adjustment for the confounding factor of having a lifetime history of MDD (RR=3.86 95%CI 1.58-9.42).

In particular, women affected by Obsessive Compulsive Disorder (N=17; 1.6%) or Panic Disorder (N=43; 4%) had at higher risk to develop depressive symptoms (EPDS≥13) during the postpartum period than women without these AD (RR=6.9 and 6.7 respectively). As for the risk of developing PPD, the strongest association was found for women with Panic Disorder (RR=7.6 95% CI 2.62-22.0).

Conclusions:

AD are associated with a greater likelihood to develop depressive symptoms and MDD or mDD during the early postpartum period. Women with current PD have the strongest risk to develop both MDD or mDD and depressive symptoms during early postpartum period compared to other anxiety disorders.
Self-reported Rumination as Trait Marker for Depression: Evidence from Functional Neuroimaging [PW07-02]
Authors: Arnone D. , Pegg E. , Mckie S. , Downey D. , Elliott R. , Deakin J.F.K. , Anderson I.M.
Published: March 2009

Background:

Research using fMRI indicates that sustained limbic activity is linked to processing negative words and self-reported rumination in currently depressed individuals. It is unknown whether this is also present in remitted depressed individuals. We tested the hypothesis that a tendency to ruminate constitutes a trait for depression by using a standard covert fMRI emotional task face in previously and never depressed volunteers and postulated that high rumination scores would correlate with activity in brain areas previously associated with depression.

Methods:

37 controls (25 female) and 30 remitted depressed (RD, 22 female) were enrolled. Volunteers completed the Ruminative Responses Scale (RRS) and underwent fMRI scanning using a standard covert fMRI emotional task faces. Significance level was set at p < 0.05 (FWE).

Results:

With RRS score controlled for RD showed reduced subcortical and limbic activity to sad and fearful faces compared to controls. Correlations between RRS scores and neural activity in all participants and control participants alone were very limited. However, in RD, RRS score was negatively correlated with neural response to happy faces and positively correlated with neural response to sad and fearful faces, in cortical and limbic regions associated with depression (hippocampus, thalamus, caudate, insula and cingulate gyrus).

Conclusion:

The results suggest that reduced limbic activity is associated with remission, possibly as a maintenance mechanism. However, within the remitted group the more ruminative participants show greater response in these areas to negative stimuli, and less to positive stimuli. This could be a neurobiological marker for risk of relapse
The Risk of using Antidepressants During Pregnancy: Serious Concern or much ado about Little? [PW07-03]
Authors: Steiner M. , Shea A. , Soares C.N.
Published: March 2009

Perinatal psychiatric disorders are a leading cause of maternal morbidity, they transmit across generations and may pose the first adverse life event for a child. The myth that pregnancy is “protective” in terms of mental health has long been refuted and it is now well established that the incidence of depression during pregnancy is at least as high when compared to other phases in a woman's lifetime. Moreover, depression during pregnancy has been associated with a number of adverse outcomes both for the mother and the baby. Untreated depression during pregnancy is also one of the strongest predictors of a subsequent postpartum depression.

Data on the “relative safety” of antidepressants during pregnancy are accumulating but at the same time sporadic, at times inconsistent reports on potential risks associated with their use are cause for concern. Recognizing the limitations of our knowledge regarding the “relative safety” of antidepressants during pregnancy it is paramount to weigh the risk of not treating vs. the benefit of treating in each case.

We report here on more than 400 pregnant women at risk for depression seen at our clinic. One third of these women received antidepressants during different phases of their pregnancies and the outcome/well-being of their babies assessed. There were no significant increases in long-term untoward outcomes in these babies.

We also demonstrated in a smaller subpopulation that the use of antidepressants has a “positive” effect on both neuroendocrine and neurophysiological parameters, using the cortisol awakening response and heart rate variability as biological markers.
A web Based Education Program in Adolescent Depression and Suicide for Primary Care Physicians [PW07-04]
Authors: Kutcher S.
Published: March 2009

Adolescent depression and suicide are two important and related issues that can be effectively addressed by primary care physicians who have received appropriate training which includes the use of simple clinical tools that can be applied in usual primary care settings. This presentation reviews the evidence pertaining to primary care intervention for adolescent depression and suicide and provides a detailed description of a new Canadian web-based educational program for primary care physicians in the domain of adolescent depression and suicide.
Saccadic Eye Movements in Dementia, Major Depression and Healthy Controls - Relationship with Cognitive Functions [PW08-01]
Authors: Schewe H.-J. , Vohs K. , Uebelhack R.
Published: March 2009

We compared horizontal saccadic eye movements in patients with dementia (n=18), and age-matched patients with major depression (n=18) or healthy controls (n=18). Cognitive functions were evaluated using Mini-Mental-State-Examination (MMSE) and ADAS-cog.

Results:

Saccadic latency and number of saccadic intrusions were significantly (p< 0.001) higher in patients with dementia relative to healthy controls and depressed patients. There were significant correlations between MMSE total score and latency (r = -0.78, p< 0.01) or number of saccadic intrusions (r = -0.80, p< 0.001) in the demential group. In addition, both saccadic parameters were significantly associated with ADAS-cog total score of patients with dementia, whereas the subscale “orientation” showed the strongest correlation with latency (r = 0.71, p< 0.01) and intrusions (r = 0.74, p< 0.01).

There were no significant differences in saccadic eye movements between healthy controls and patients with major depression as a whole, or a subgroup of depressed patients with the worst cognitive performance (n=9).

Conclusions:

It seems that disturbances in horizontal saccadic eye movements in patients with dementia are related to the degree of cognitive deficits in these patients. On the other hand, the lack of alterations in horizontal saccadic eye movements in depressed patients despite poor cognitive performance indicates different mechanism.
Neuropsychological Performance in both Alzheimer’s Disease and Vascular Dementia is Related to Cardiovascular Comorbidity [PW08-02]
Authors: Hofrichter N. , Dick S. , Tritschler E. , Knobel A. , Heinz A. , Rapp M.A.
Published: March 2009

Aims:

Vascular pathology has been implicated in the pathogenesis of both Alzheimer's disease and vascular dementia. While performance decrements in vascular dementia are by definition thought to be related to vascular load, performance decrements in Alzheimer's disease have not yet been studied in relationship to cardiovascular comorbidity. The aim of this study was to describe neuropsychological performance in patients with mild Alzheimer's disease and vascular dementia in relationship to cardiovascular comorbidity.

Method:

39 patients suffering form vascular dementia and 34 patients suffering form Alzheimer's disease underwent neuropsychological testing using an extended neuropsychological battery, including tests of episodic memory, working memory, naming, verbal fluency, executive functions, and language. Cardiovascular comorbidity was assessed form medical history and chart review using the Charlson comorbidity index.

Results:

Patients suffering form Alzheimer's disease and vascular dementia did not differ in terms of age, education, gender distribution, or dementia severity. Cardiovascular comorbidty was more pronounced in vascular dementia patients. In both Alzheimer's disease and vascular dementia, neuropsychological performance in tests of working memory and executive functioning was related to cardiovascular comorbidity, but the relationship was stronger in vascular dementia.

Conclusion:

Vascular load affects neuropsychological performance in both Alzheimer's disease and vascular dementia, suggesting that cardiovascular comorbidity affects cognition across both forms of dementia.
The use of Drugs for Mood Disorders in Italy: Preliminary Results [PW08-03]
Authors: Carta M. , Aguglia E. , Balestrieri M. , Bocchetta A. , Drago F. , Faravelli C. , Morosini P.L. , Nardini M. , Hardoy M.C.
Published: March 2009

Background:

Some community surveys in Italy have shown that a proportion of subjects without lifetime psychiatric diagnosis (anxiety/depression) used antidepressants. The prescription of AD in bipolar depression appears to be another largely underestimated problem in the clinical practice and is difficult to recognise by means of traditional epidemiological methods (lay interview and structured diagnostic tools).

Objectives:

The purpose is to use defined and validated international semi-structured interview as diagnostic instrument administered by expert clinicians to evaluate appropriateness and amount of over and under prescription of psychotropic drugs in different Italian community areas. The focus is on general antidepressant use and use in subjects with bipolar disorder and in subsyndromal depression.

Methods:

Study design: Community survey. Study population: sample randomly drawn, after stratification by sex and age, from the adult population of Municipal records in 6 Italian Regions: about 4000 persons will be interviewed. Tools: Questionnaire on psychotropic drugs consumption, prescription, health services utilisation;diagnostic Structured Clinical Interview np version;Mood Disorders Questionnaire; Short Form Health Survey. Ethical aspects: a signed informed consent for each candidate. The study was approved by the ethical committee of theItalain National Health Institute.

Expected results:

The study aims to identify the frequency of over and under prescription of psychotropic drugs in different Italian regions and the determinants of prescription related to physicians, patients, comorbidity and symptoms and to establish the basis for a cohort prospective study to assess the future changes.
Eating Behaviour and Perfectionism in Students: A Prospective Study [PW09-02]
Authors: Soares M.J. , Maia B. , Pereira A.T. , Gomes A. , Marques M. , Valente J. , Pato M. , Azevedo M.H. , Macedo A.
Published: March 2009

Aim:

To investigate the role of perfectionism in the development of disordered eating behaviours.

Method:

382 female university students completed the Hewitt & Flett MPS and the EAT-40 at baseline, one year after (T1) and two years later (T2).

Results:

Perfectionism at baseline was significantly associated with long-term abnormal eating attitudes/behaviours. Self-Oriented Perfectionism (SOP) and Socially Prescribed Perfectionism (SPP) were significant predictors of disordered eating behaviours. SOP at baseline was predictive of diet concerns, at T1 and T2. Baseline SPP was correlated with overall eating disturbance at T1 and T2. Regression analysis revealed that only SPP was a significant predictor of bulimic behaviours and social pressure to eat at T1, but not at T2.

Conclusion:

Our findings contribute to a more clear understanding of the association between perfectionism and eating disorders. SOP and SPP were prospectively associated with abnormal eating attitudes/behaviours and SOP was found to be predictive of diet concerns.
Do Stressful Life Events Predict Eating Disorder Relapse?: Six-year Outcomes from the Collaborative Personality Disorders Study [PW09-04]
Authors: Grilo C. , Pagano M. , Stout R.
Published: March 2009

Aims:

To examine the natural course of eating disorders (ED) prospectively over 6 years and to examine link between stressful life events (SLEs) and ED relapse among women with personality-disorders (PDs).

Method:

Subjects were 132 female patients with bulimia nervosa (N=40) or EDNOS (N=92) in the Collaborative Longitudinal Personality Disorders Study. EDs were assessed with the Structured Clinical Interview for DSM-IV Axis-I, and monitored with the Longitudinal Interval Follow-up Evaluation during follow-up. PDs were assessed with the Diagnostic Interview for DSM-IV PD (DIPD-IV), and monitored with the Follow-Along version of the DIPD-IV during follow-up. SLEs were assessed with the Life Events Assessment (LEA). Follow-up assessments were conducted at 6- and 12-months and then yearly through 72 months. Proportional hazard regression analyses were performed to examine the link between time-varying levels of SLEs and ED relapse. Cox regressions controlled for the same covariates used in prior work: duration of ED, number of co-morbid psychiatric disorders, and time-varying status of PDs.

Results:

Of the 132 patients, 59% had remissions from ED, 68% of whom subsequently relapsed over the course of 6 years (BN and EDNOS did not differ in relapse). Total number of negative SLEs reported by ED patients significantly predicted subsequent ED relapse (HazardRatio=1.5, p< .05). The types of SLEs that predicted ED relapse were elevated work stressors (HazardRatio=3.0, p< .01) and elevated recreation stressors (HazardRatio=3.1, p< .05).

Conclusion:

Higher work stress and higher recreation stress represent significant warning signs for triggering relapse for women in remission from BN and EDNOS.
A Model for the Management of Suicidal Behaviour in Primary Care [PW10-03]
Authors: Voros V. , Osvath P. , Fekete S.
Published: March 2009

Introduction:

Although suicide rates are decreasing in most European countries, suicide is still a major health concern. Despite of the fact, that the vast majority of suicidal patients contacted with health care services before the suicidal act, the doctor-patient meeting is a necessary, but sometimes not sufficient way enough to prevent suicide. Most patients, who commit or attempt suicide, are not regarded as being at high immediate risk at their final contact with health care services.

Aims and methods:

Based on reviewing the relevant literature and on our previous studies we developed a brief, practical, clinical guideline, which may aid general practitioners and primary care professionals to assess suicide risk and also to manage these patients.

Results:

We introduce a model for an integrated, regional suicide prevention strategy, which includes recognition, risk assessment and also intervention. The main steps of our model are to recognize warning signs, explore crisis situation and/or psychopathologic symptoms, assess protective and risk factors, estimate suicide risk, plan intervention strategies, and finally manage suicidal patients through the different levels of intervention.

Conclusion:

In the management of suicidal behaviour the complex stress-diathesis model has to be adjusted by considering biological markers (mental disorders, personality traits) and psycho-social factors (crisis, negative life events, interpersonal conflicts). Only after the assessment of these factors primary care professionals, as ‘gatekeepers’ can manage suicidal patients effectively by using adequate psychopharmacotherapeutic and psychotherapeutic facilities in the recognition, treatment and prevention of suicidal behaviour.
Effects of Somatopsychic Comorbidity on Lagtime and Length of Stay in Patients Referred to a Psychiatric Consultation Service in Germany [PW10-04]
Authors: Diefenbacher A. , Strain J.J.
Published: March 2009

It is not clear whether psychiatric comorbidity in medically ill patients contributes to longer lengths of hospital stay (LOS), and whether interventions carried out by psychiatric consultation-liaison (c-l) services lead to a reduction of LOS. Furthermore, the lagtime paradigm, i.e. the notion that the earlier a psychiatric consultation takes place, the shorter LOS of the resp. patients are, has been questioned. To study if different degrees of somatopsychic comorbidity have effects upon Lagtime and LOS of patients seen by a c-l-psychiatric service. Patients consecutively referred to a c-l-service in Berlin during a one year study period were categorized into six groups of different somatopsychic comorbidity using a count-approach based upon ICD-10 psychiatric, and ICD-9 somatic diagnoses. The groups with more psychiatric than somatic diagnoses show shorter LOS and shorter Lagtimes. Patients with only psychiatric diagnoses overall show the shortest average LOS and Lagtime. For the groups, however, with more somatic than psychiatric diagnoses, LOS and lagtimes are longer. In the groups with equal numbers of psychiatric and somatic diagnoses, there is a trend with higher numbers of somatic diagnoses showing longer LOS and Lagtimes. On the other hand, in both groups with 2 and more somatic diagnoses, a trend can be seen toward shorter LOS and Lagtimes in such patients with more than 1 psychiatric diagnosis. Psychiatric comorbidity in medically ill patients does not sufficiently explain differences in LOS and Lagtime of patients seen in psychiatric c-l-services, but a complex interplay of somatopsychic comorbidity has to be taken into account.
Guardianship Consultations in the Psychiatric Consultation Service in a General Hospital [PW10-05]
Authors: Diefenbacher A. , Rottbeck R. , Burian R.
Published: March 2009

Objective:

Due to the implementation of the DRGs (Diagnosis Related Groups) in the somatic departments of general hospitals, an elevated demand for psychiatric consultations can be anticipated. It is a moot question whether psychiatric consultation services are adequate for such a surplus load. We investigated whether the proportion of psychiatric consultation requests for patient's capacity to consent and for guardianship is rising.

Method:

The DRGs were implemented in the somatic departments of the Ev. Krankenhaus Königin Elisabeth Herzberge (KEH) at the end of 2003. We compared consultation requests with the keywords “capacity to consent”, “capacity to enter contracts” and “need for guardianship” in the year 2002 with 2004.

Results:

Significantly more consultations with the keyword “guardianship” were requested in 2004 compared to 2002 (p=0.019). 56% concerned medical questions regarding capacity of consent. There was a slight, but increase in the requests social reasons.

The confirmation of the indication for the appointment of a guardian decreased inversely without statistical significance (80% in 2002 and 64% in 2004; Chi-Square p=0.058).

Conclusion:

The increasing demand of the consiliary-liason-service was confirmed in our investigation. It is possible that the implementation of the DRGs plays a role in the increase of psychiatric consultation request. As a trial to ease the growing burden, we developed a form which also enables colleagues from the somatic departments to apply for guardianship of their patients without psychiatric assistance.
The Poster of Posters: Evaluation of the 20th ECNP Congress [PW10-06]
Authors: Versonnen F.
Published: March 2009

Basic and clinical research are both of importance for psychiatry. In psychiatric care, both neurobiological and psychosocial underpinnings of clinical diagnosis and treatment. To come to a meaningful intervention, one is in need of different levels of explanation. Moreover, in a clinical setting, an integration of the so called Evidence Based Medicine (EBM) and Narrative Based Medicine (NBM) seems to be most appropriate. Basic research is sometimes seen as ‘more scientific’ and this may be reflected by granting more awards for these posters. A simple quantitative analysis is done by comparing the basic and clinical posters at the 20th ECNP Congress in Vienna. The total of submissions, the basic versus clinical ‘awards"- and Odds-ratio are calculated. Some corrections are needed. First, 10 psychology posters, were classified as basic and were reattributed to the clinical category. Second, after a qualitative analysis and correction for preclinical narratives or basic research methods for 7 awarded clinical posters, they were reclassified to the basic science category. All awarded basic posters were labeled correctly. After this double correction the Odds ratio was calculated. A total of 725 posters were submitted, 426 clinical and 299 basic. Fifty posters were awarded. The Odds ratio of getting an award was 5, 8 in favor of basic science posters. This is an expression of the current undervaluation of clinical research.
The Prevalence of Attention Deficit Hyperactivity Symptoms in School Children: A Highly Consanguineous Community
Authors: Bener A.
Published: March 2009

Objective:

The objective of the present study was to find the prevalence of attention deficit hyperactivity (ADH) symptoms in a highly consanguineous community.

Design:

A cross sectional study was conducted during October 2006 - January 2007.

Subjects and methods:

A total of 2500 primary school students, aged 6-12 years were randomly selected from the government primary schools and 1869 students (74.8%) gave consent to participate in this study.

Results:

Of the students surveyed, 50.7% were boys and 49.3% girls. The data revealed that 158 boys [16.7%; 95%CI (14.4-19.2] and 50 girls [5.4%;95%CI (4.1-7.1)] scored above the cut-off (≥15) for ADH symptoms, thus giving an overall prevalence of [11.1%; 95%CI (9.7-12.6)]. The Children who had higher score for ADH symptoms were in the age group 6-9 years. Children who had higher score for ADH symptoms had school performance poorer than those with lower scores (P=0.002). 200 children (96.2%) with ADH were disobedient, 60.6% noisy and hyperactive, 36.5% very cranky, 37.5% troublesome and 37.9% nervous. The logistic regression identified in our study that socio-economic condition, number of children, school performance and poor relationship between parents were the main contributors for ADH. This shows that the consanguinity has no impact on ADH children.

Conclusion:

The study revealed that ADH symptoms are found to be a common problem among the school children in Qatar. A significant difference was found between children with and without ADHD for their behaviour.
A Longitudinal Study of Children Diagnosed with Attention Deficit Hyperactivity Disorder: Child Psychiatry, Neurological and Psychoanalytic Viewpoints
Authors: de Lara A. Cohen , Guinard M. , Lacaze E. , Pinton F. , Chambry J. , Billard C.
Published: March 2009

We shall present the development of a cohort of 40 children aged from 6 to 11 who were initially diagnosed with ADHD (T0) and then reassessed after two years of treatment with multimodal treatment in addition to stimulant medication. At the outset of the study (T0) the children underwent a complete assessment which included a child psychiatric examination, a neuropsychological evaluation of attention skills and a psychodynamic psychological assessment using the T.A.T. and Rorschach projective tests interpreted from a psychoanalytic viewpoint. An identical protocol was used for the reassessment of the children two years later (T2).

Clinically, and from a strictly behavioral point of view, it is clear that there was a calming down of the symptoms associated with the ADHD. Can the same be said for the results of the neuro-psychological and projective tests as well as for the overall psychic functioning of the children?

At this point in our research, and taking into account that T 2 just ended, we can affirm that the children who were assessed with neurotic disorders (according to the classification of psychopathological disorders in childhood) were those who showed the clearest signs of improvement. We shall then study in depth the majority of the population who were assessed with borderline personality disorders (BPD). As these children received a multimodal treatment over the two years time of the study which involved either individual, group or family psychotherapy, we shall use brief clinical case studies for a comparative approach to our research results.
Disorder-specific Right Inferior Prefrontal Dysfunction During Two Tasks of Inhibitory Control in Pediatric Attention-deficit/hyperactivity Disorder Compared to Pediatric Obsessive-compulsive Disorder
Authors: Rubia K. , Cubillo A. , Woolley J. , Halari R. , Smith A. , Brammer M.
Published: March 2009

Inhibitory dysfunction is the key behavioural and cognitive phenotype of Attention Deficit Hyperactivity Disorder (ADHD) and of obsessive-compulsive-disorder (OCD). Both disorders show deficits in tasks of response inhibition and cognitive flexibility as well as fronto-striatal brain dysfunctions during task performance. The goal of this research was to investigate differences and commonalities in functional neural networks mediating inhibitory control between adolescents with ADHD and those with OCD to identify disorder-specific neurofunctional biomarkers.

Event-related functional magnetic resonance imaging (fMRI) was used to compare brain activation of 18/12 boys (Stop/Switch task) with clinical ADHD, 10 boys with clinical OCD and 20 healthy comparison boys during a tracking Stop task measuring motor response inhibition and its failure and a switching task measuring cognitive flexibility. Non-parametric permutation analyses were used for fMRI analysis (XBAM). Functional connectivity analyses investigating group differences in fronto-striatal connections will be presented at the conference.

Both patient groups shared brain dysfunction compared to controls in right orbitofrontal, left dorsolateral (Stop task) and left inferior prefrontal cortices (Switch task). Right inferior prefrontal under-activation, however, was specific to ADHD during both tasks. Under-activation in left caudate and anterior cingulate was also specific to ADHD during the Switch task.

Patients with ADHD appear to have both common and distinct dysfunctions during inhibitory control compared to OCD patients. The most consistent fMRI finding in ADHD of a dysfunction in right inferior prefrontal cortex during inhibitory control appears to be disorder-specific when compared to OCD, and may be a specific neurofunctional biomarker of ADHD.
Fronto-striatal Brain Dysfunction in Adults with Hyperactive/inattentive Behaviours Followed up from Childhood During Interference Inhibition and Attention Allocation
Authors: Cubillo A. , Halari R. , Taylor E. , Rubia K. , Giampietro V.
Published: March 2009

Functional magnetic resonance imaging studies (fMRI) in children with Attention Deficit Hyperactivity Disorder (ADHD) have observed functional abnormalities in fronto-striatal and temporo-parietal brain regions during tasks of inhibitory and attention control. However, hardly any modern functional imaging studies have investigated functions of interference inhibition or attention control in adult ADHD.

We used fMRI combined with a variant of the Simon task that measures interference inhibition as well as attention allocation to compare 11 medication-naïve adults (26-30 yrs) with inattentive/hyperactive behaviours and 15 age-matched healthy controls. Patients were followed up from childhood ADHD, recruited from a 20-year prospective longitudinal epidemiological study. All met criteria for inattentive/hyperactive behaviours on an Adult Hyperactive Interview, but only 8 met clinical diagnostic criteria for ADHD. Correlation analyses were furthermore conducted within patients to correlate symptoms with brain activation. Functional connectivity analyses for group differences in fronto-striatal connectivity will be presented at the conference.

No differences were observed in task performance. During interference inhibition, adults with persistent inattentive/hyperactive compared to controls showed reduced activation in predominantly left orbitofrontal and medial cortex, caudate and putamen. During attention allocation adults with hyperactive behaviours showed dysfunction in left inferior/dorsolateral prefrontal cortex and in right inferior and superior parietal areas. Correlation analysis showed a significant negative correlation between inattentive/hyperactive behaviours and the parietal activation cluster during interference inhibition. The study demonstrates the continuity of the pattern of fronto-striatal and parietal neurofunctional abnormalities during tasks of interference inhibition and attention allocation from childhood to adult ADHD even with symptomatic improvement.
Fronto-striatal Brain Dysfunction in Adults with Hyperactive/inattentive Behaviours Followed up from Childhood in Tasks of Motor Inhibition and Cognitive Flexibility
Authors: Cubillo A. , Halari R. , Taylor E. , Rubia K. , Giampietro V.
Published: March 2009

Attention Deficit Hyperactivity Disorder (ADHD) in children has been associated with functional abnormalities in fronto-striatal brain regions during tasks of inhibitory control. In adults with ADHD, however, no functional magnetic resonance imaging (fMRI) study has investigated the neurofunctional correlates of the most compromised cognitive functions of motor response inhibition or cognitive flexibility.

fMRI was used combined with a tracking Stop task of motor response inhibition and a cognitive Switch task to compare brain function between 11 medication-naïve adults (26-30 yrs) with inattentive/hyperactive behaviours and 14 age-matched healthy controls. Patients were followed up from childhood ADHD, recruited from a 20-year prospective longitudinal epidemiological study. All met criteria for inattentive/hyperactive behaviours on an Adult Hyperactive Interview, but only 8 met clinical diagnostic criteria for ADHD. Whole brain regression MR analyses were furthermore conducted within patients to correlate symptoms with brain activation. Functional connectivity analyses for group differences in fronto-striatal connectivity will be presented at the conference.

Despite comparable task performance, adults with persistent inattentive/hyperactive behaviours showed reduced activation compared to controls in inferior prefrontal cortex, caudate and thalamus during both tasks, as well as in parietal lobes during the Switch task. Regression analyses furthermore showed a linear negative correlation between behavioural symptoms and overlapping, but more extensive fronto-striatal, parietal and cerebellar brain dysfunction. The findings demonstrate for the first time the persistence of the typical childhood ADHD pattern of fronto-striatal dysfunction during tasks of cognitive control in adults with persisting behavioural symptoms, suggesting stability/continuity of neurofunctional abnormalities between childhood and early adulthood.
School Children with ADHD - Effects of Once-dealy OROS Methylphenidate Treatment ADHD Symptoms Included Improvement Academic Functioning
Authors: Djurkovic-Lazic J. , Lazic B. , Milojevic N. , Djuric D.
Published: March 2009

Objective:

Many well known studies have defined results and tolerability of stimulants used in school children with ADHD in last period. In our follow-up study from August 2007 to January 2009. will present results of once-daily OROS Methylphenidate therapy including break it for holiday.

Method:

We are enrolling 32 children in study, 7-14 years old, and all of them were team-diagnosed according DSM IV/psychiatrist, psychologist, neurologist. Children with ADHD symptoms are treating with OROSMPH (18-54mg), with adjustments based on clinical symptoms, and all ADHD symptoms measures, vital signs, EEG and laboratory results also will be included through our study period.

Results:

Effects of OROS MPH therapy will be presented only in children who completed the study, looking for adverse events, clinically significant effects on vital sings, EEG, laboratory test parameters, and also, improvement academic functions, before and after breaking therapy.

Conclusions:

Besides our expecting on reduction of ADHD symptoms with minimal effects on vital sings,values on growth, tick, laboratory test, it considers too, better academic functioning, social relationship with continual therapy.
Behavioral and Emotional Problems of Children with ADHD
Authors: Mojs E. , Gajewska E. , Głowacka M.D. , Samborski W.
Published: March 2009

ADHD as long term disease is diagnosed in first years of life. Ill children need complex psychotherapy and pharmacotherapy and effects sometimes are minor. The aim of the study was to estimate possible emotional disturbances, control of emotions, impulsivity, behavioral problems or psychosomatic disturbances in children with ADHD.

40 mothers of children fulfilled the questionnaire of Achenbach and questionnaire of authors' concept. Children aged 6-18 yrs of age were estimated by mothers. The results show the most often problems underlined were low control of emotions 50%, impulsivity 25%, aggressiveness - 10%. Parents also show tendency of appearance of psychosomatic problems as headaches, sleep disturbances, eating disturbances. They connected these problems to school adaptations problems.

There was correlation between level of intelligence (IQ) and frequency of appearance of sleep disturbances. The lower level of IQ the sleep disturbances reveal more often.

In conclusion: Children with ADHD need also complex care, also psychotherapy and there is a need of psychological counseling for the families.
The Development of an Adult ADHD Transitional Service
Authors: Naidoo K. , Willis C. , Bohra M. , Bhat H.
Published: March 2009

Aim:

To describe the development of a service addressing the needs of adults with ADHD, and to survey the caseload of this service.

Method:

This review describes the process of setting up a new service for adults with ADHD. This includes drawing up a service plan to look at the resources required, and arranging shared-care agreements with general practitioners. The service was developed in two phases, with the initial phase accepting transitional patients with an established diagnosis of ADHD, and phase two looking at the assessment of individuals without a previous diagnosis. All referrals to the service were surveyed, and information was collated on age, gender, diagnosis, co-morbidity, medication and employment.

Results:

The service was set up in November 2007, and over a period of 10 months, 32 referrals were accepted, having met the criteria for assessment. Cases were accepted on the basis that they had a previous diagnosis of ADHD, the majority originating from Child and Adolescent services.

The caseload review revealed high levels of comorbidity. The majority of patients were treated with stimulant medication. The ratio of male to females was higher, as expected. The incidence of substance misuse and conduct disorder was consistent with other studies.

Conclusion:

The demand for a service addressing the needs of adults with ADHD has been high, as evidenced by the volume of referrals received. ADHD persists into adulthood in approximately 50% of children with the diagnosis so follow up into adulthood is crucial.
Study of the Home Environment and Symptoms of Inattention and Hyperactivity in a Clinic Based Sample
Authors: O'Mahony M. , Lai W.W. , Mulligan A.
Published: March 2009

The HOME (Caldwell and Bradley) is a well recognised 59 item tool used for assessing the home environment and especially how supportive the home environment is for the child's developmental needs. It is applied in the home and is scored according to rater observations and parent interview answers.

Aims:

A recent cross sectional study has shown an association between the HOME score and the severity of ADHD symptoms, especially hyperactivity, in children with ADHD. This study will ascertain if the association between symptoms of hyperactivity and the HOME score is present in children with non-ADHD clinical disorders as well as children with ADHD.

Method:

Parents of children aged < 10 years attending the Child Guidance Unit, Mater Misericordiae Hospital from 2006 onwards were invited to partake in the study. The HOME was administered to 100 participants and the child's symptoms of inattention and hyperactivity were assessed by administering the Conners’ Parent Rating scale.

Results:

A correlational bivariate analysis was performed on parent ratings of inattention and hyperactivity with the total Home score and each subscale. For each set of symptoms, there was a significant and negative correlation with total HOME score: Pearsons's r = -.22, p = .028 for hyperactivity and Pearson's r = -.33, p = .001 for inattention.

Conclusion:

Higher scores of hyperactivity and inattention are associated with a lower total HOME score; therefore there is an association between symptoms of hyperactivity and the home environment in children with non-ADHD clinical disorders as well as children with ADHD.
Empirical Analysis of the Association between given Names and Attention-deficit Hyperactivity Disorder in Children
Authors: Shoval G. , Manor I. , Zalsman G.
Published: March 2009

Names may carry unconscious personal significance, thus making them a possible important aspect of identity, which may play a pivotal role in the development of personality and psychopathology. Several empirical studies have shown an association between rarity of names and psychopathology. The main aim of our study was to investigate the association between the first names of children with ADHD and the trait of hyperactivity from various aspects. A total of 134 names of children with ADHD were compared to an age and sex- matched general population control name list.

The names of ADHD patients were rated as expressing more hyperactivity linguistically than those of the general population controls. Names of ADHD patients had a lower number of syllables than control names (1.84±0.55 vs. 2.22±0.74, p< 0.0001) and their prevalence in the general population was significantly lower (0.0051±0.0046 vs. 0.0079±0.0076, p=0.0003). All findings remained significant following Bonferroni adjustment.

Our findings strongly supported our hypothesis that the “nature” of names (i.e. linguistic meaning) of ADHD patients differed significantly from matched controls of the general population. Possible mechanisms that may explain this intriguing relationship are discussed as well as clinical implications in the field of psychotherapy.
Nicotinic Acetylcholine Receptor α4 Subunit Gene Variation Associated with Chinese Han Patients with Attention Deficit Hyperactivity Disorder
Authors: Weidong J. , Xuezhu H. , Tianyou G. , Chuang Y. , Qianqian L. , Yong X. , Lanting G.
Published: March 2009

Previous pharmacological, human genetical, and animal models have implicated the nicotinic acetylcholine receptor α4 subunit (CHRNA4) gene in the pathogenesis of ADHD. The objective of this study is to examine genetic association between single nucleotide polymorphisms (SNPs) in the CHRNA4 gene (rs2273502, rs1044396, rs1044397 and rs3827020 loci) and ADHD. Both case-control and family-based design were used in this study. Children aged 6 to 16 years were interviewed and assessed with the CBCL and CPRS-R to identify probands. No significant differences in frequency distribution of genotypes or alleles between the case and control groups were found. However, further haplotype analyses showed CCGG haplotype on risk for ADHD in 164 case-control sample and TDT analysis suggested that the allele C of rs2273502 over-transferred in 98 ADHD parent-offspring trios. Our findings suggest that CHRNA4 gene may play a role in the pathogenesis of ADHD, and further work is necessary to replicate and confirm what role the CHRNA4 gene may play in the etiology and pathogenesis of ADHD in large independent samples.
The Prevalence of Substance Induced Psychosis & Substance Induced Mood Disorders in Adolescent Population
Authors: Aldandashi S. , Blackman M.
Published: March 2009

Introduction:

Drug and alcohol addiction is a leading cause of raising health care cost and has adverse effect on peoples health, social and occupational functioning.

The purpose of this study was to investigate the prevalence of substance induced psychosis and mood disorders in adolescent population, and to determine what type of substance causing the presentation.

Methods:

Child psychiatry consults in the emergency department at Royal Alexandra Hospital, Edmonton, Canada during October, November, and December, 2007.

Age was 12 to 17 years both sexes. Presenting complaints were either psychosis or mood symptoms. The diagnosis of substance induced disorder was made according to the DSM IV TR. Urine toxicology screen were obtained before discharge from Emergency department for cannabis, amphetamine, and cocaine. Blood test for ETOH was performed.

Results:

Total number of subjects was 27 patients. 70.37% presented with substance induced mood disorder, 29.62% with substance induced psychosis. For patients with psychosis (8, one was excluded, untested urine) 28.57% the urine test was positive for amphetamine, 42.85% marijuana, 14.28% cocaine, 14.28% negative test. For patients with mood disorder (19, 6 was excluded, untested urine) 76.92% urine was negative for substances, 15.30% blood was positive for ETOH, 7.69% urine was positive for cannabis.

Discussion:

In this preliminary data, a trend that substance induced mood disorder is more prevalent than substance induced psychosis. Substance is more to cause psychosis than mood disorder. Cannabis use is more than amphetamine and cocaine to produce psychosis. ETOH use is more than Cannabis to produce mood symptoms.