bluuebunny/crossref_metadata_2025 huggingface dataset:
P02-371 - Affects And Emotions In Women Victims Of Domestic Violence
Authors: Amann Gainotti M. , Pallini S.
Published: June 2010

Only recently has the extent and seriousness of the phenomenon of domestic violence been acknowledged, and its consequences, that are not only psychological, but also social and economical have started to be seriously investigated because of long-term consequences such as alcoholism, drug-addiction, depression, job absenteeism, incapacity to raise children, etc.The purpose of the research was to extend knowledge of the interpersonal dynamics of mistreated women by examining the characterizing emotions described by a group of women involved in violent marital relationships. Subjects were a little group of 12 women, users of a Centre for Mistreated women in Rome (Italy) that volunteered to participate in the study. Their age ranged from 24 to 50. Most had children under 18.The method included different instruments: The Adult Attachment Interview (M.Main,1998), and a free report concerning the beginning and the development of the mistreating relationship. The self report was introduced by five questions in which subjects were asked to compare their relationship to a tree, a colour, an animal, a house, a type of music.

Results

Emotions expressed by the group of mistreated women compared to those of a control group, are in a remarkable way characterized by gloominess and mournfulness and are connected to topics such as destruction, fear and death.
P02-376 - Analytic And Systemic Incest Group Psychotherapy: Five-Year Follow-Up Of A Randomized Trial
Authors: Elkjær H. , Kristensen E. , Mortensen E.L. , Poulsen S. , Lau M.
Published: June 2010

Introduction

In a previous study women with long-term sequalae of child sexual abuse (CSA) were randomly assigned to analytic (Group A) or systemic group psychotherapy (Group S). Pre-post-analysis indicated that both therapies led to significant improvement, but overall Group S had significantly better outcome than Group A. As gains tended to rise in Group A during follow-up and decline in Group S, no statistically significant difference was detected in gains between the two treatment modalities after one year.

Objectives

This study investigates if gains are maintained five year following termination, and if the groups differ in gains.

Methods

106 women started on allocated intervention. Psychological distress (GSI from SCL-90R), psycho-social functioning (GAF), and global life quality (GLQ), were assessed before and after treatment and one and five years following termination.

Results

86 patients (81%) completed group therapy, 68 (64%) completed the one-year follow-up and 64 (60%) the five-year follow-up. At five year follow-up ANOVA was performed using treatment group as a between factor and the four time points as repeated measures. Intention to treat analysis demonstrated that improvement were significant on all measures (P < 0.000). Independent samples t-test on gains was NS for all measures.

Conclusions

Women with a history of CSA who were treated with Group A or Group S treatment maintained statistical significant improvement on GSI, GAF and GLQ five years post-treatment. No significant difference was found in gains between groups.
P02-383 - Typing Mental Attitude Towards Disease Among Women After Mastectomy
Authors: Kuzhel I. , Markova M. , Martynova Y.
Published: June 2010

Object

Types of mental attitude towards disease (TMAtD) of women after mastectomy.

Methods

Cases of 104 women after mastectomy for reason of breast cancer were studied, whereof 72 - after the radical cure (primary group) and 32 - after the partial cure (control group).

PQBRI (personality questionnaire of Bekhterev Research Institute) was used for typing mental attitude towards disease.

Results

Ergopathic TMAtD was revealed with 16,7±3,7% of women from primary group and with 25±4,3% from control group; euphoric TMAtD - with 9,7±3,0% of primary group and 28,1±4,5% of control group; obsessive-phobic TMAtD - with 13,9±3,5% of primary group; vexatious TMAtD - with 20,8±4,1% of primary group and 9,4±2,9% of control group; anosognostic TMAtD - with 11,11±3,1% of primary group and 21,9±4,1% - of control group; neurasthenic TMAtD - with 6,9±2,5% of primary group; “paranoiac” TMAtD - with 11,11±3,1% of primary group; hypochondriacal TMAtD - 9,7±3,0% of primary group and 9,4±2,9% of control group; egocentric TMAtD - 6,3±2,4% of control group.

Among the patients of the primary group vexatious and hypochondriacally TMAtD have prevailed along with obsessive-phobic, paranoiac and neurasthenic TMAtD which occurred, and in the control group - euphoric, ergopathic and anosognostic type (p ≤ 0,05) occurred.

Conclusions

Disadapative TMAtD were observed among all women after mastectomy. Less disadaptative TMAtD were observed among the patients after partial mastectomy. Women after the radical surgery were diagnosed maximum pathological TMAtD. This should be considered at the elaboration of psycho-corrective measures for the given category of patients.
P02-386 - Comparison Of Life Quality Of Patients With Abnormal Uterine Bleeding Who Have Been Treated By Hysterectomy Or Hormone Therapy
Authors: Marofi M.
Published: June 2010

Introduction & objectives

Abnormal uterine bleeding (AUB) is a common problem in women that can adversely affect their quality of life.

Aim

In this survey the quality of life of the patients has been treated by hysterectomy and whom have received hormone therapy have been studied.

Method

This is a descriptive and comparative clinical study in which 54 women have been treated due to AUB by hysterectomy and 54 women received hormone therapy because of the same reason completed the WHO questionnaire for life quality. Data then analyzed by independent t test, ANCOVA and Mann-Wittnei using SPSS software.

Results

With regard to the total score of the questionnaire, there was no difference between two groups (61.77±9.30 for hysterectomy group vs. 65.36±7.32 for hormone group, P=0.34).On the other hand, considering the mental dimension score of the questionnaire, a significant difference was observed between groups (50.72±16.81 for hysterectomy group vs. 80.09±10.37 for hormone group, P=0.001)

Conclusion

This study demonstrates that at least mental aspects of quality of life are significantly better in the AUB patients treated by hormone therapy, comparing to those treated by hysterectomy. Education and counseling of the patients and their families may improve life quality in more cases.
P02-389 - Mental Disorders In Dysmenorrhea
Authors: Nasyrova R.
Published: June 2010

Among somatic diseases accompanied by mental disorders, gynecological pathology occupies important positions. Study involved 100 patients with dysmenorrhea, which were divided into two clinical groups: Group 1 - 50 people aged from 14 to 18 years (period of puberty by WHO) and Group 2 - 50 people aged 18 to 23 years (early reproductive period of WHO). In conducting syndrome evaluation of mental disorders we found that structure of neurotic disorders in patients with dysmenorrhea (group 1) was determined by anxiety (36%), and then followed by prevalence of depressive and asthenic (22% and 18%, respectively) expression. Dissociative, phobic and hypochondriac syndromes were identified in 14%, 10% and 6% of the examined, respectively. The combination of syndromes occurred in 32% of examined. When considering syndrome level of neurotic disorders in women with dysmenorrhea at young reproductive age we found that prevalent in the first place is depression (in 34% of cases), followed by anxiety and asthenia (28% and 22%, respectively). Representation of hypochondriac disorders of examined group 2 increased compared with female patients included in group 1, and reached 18%. Dissociative and phobic manifestations were diagnosed in 16% and 12% women, respectively. Co-morbidity of psychopathological syndromes was diagnosed in 42% of women with dysmenorrhea in early reproductive years. Findings substantiate the need for high therapeutic and preventive strategies used in these disorders in the psychiatric and gynecological practice.

This research was done under the RF President Grant for State Support of Young Russian Scientists (№ grant MK-3743.2008.7).
P02-392 - Perinatal Psychopathology: Characterisation Of A Selected Italian Women Sample
Authors: Petrilli G. , Rizzi G. , Anniverno R. , Mencacci C. , Blom J.M.C.
Published: June 2010

Psychopathology during pregnancy and postpartum period is a clinical-medical affair, as well as a social one.

For many woman, pregnancy and postpartum may constitute a trigger, moreover if a woman is, or have been in her life, already affected by a manifest psychopathology or an asymptomatic one.

Primary-preventive approach should be considered in preconception planning with all women in childbearing age who have or are at risk for psychopathology and psychiatric illness. For them, preventive and healing standardized and evidence-based programs are needed, in particular with respect of pharmacological treatment in a so critical period; even if is not proved that any specific psychotropic drug is completely safe, due to the fact that all psychotropic medication cross the placenta barrier, there are guidelines to follow. It's as well important to highlight that even if lots have to be studied, evidence suggests that untreated depression, rather than treatment with antidepressant during pregnancy, results in adverse outcomes.

Resources, resilence, copying abilities assessment, risk and protective factors evaluation, together with pharmacological treatment costs-benefits balance, are the first steps for a personalized and effective healing program.

from a study on a high risk and selected sample recruited from PsicheDonna Center-Milan-Italy (Macedonio-Melloni, Fatebenefratelli Hospital) will be discussed.

This center is specialized in women's lifecycle mood disorders; the characterization of this peculiar sample will be presented, with respect to: - diagnosis -risk and protective factors configuration - assessment tools - pharmacological treatment planning - clinical healing activities adopted - intervention and preventive model developed.
P02-398 - There's Something Strange About My Body
Authors: Verissimo F. , Almeida S.
Published: June 2010

This case report is about a 34 year old woman psychologist. She looked for a plastic surgeon for a breast reduction. She was feeling different, in an “obviously deformed” body, experienced as weird and far from her ideal. She was submitted to a psychological assessment witch reiterated the “low self- esteem and the surgery's benefits in order to improve the sexual self-concept”.

However, something failed. The symptoms isolated her in a world of her own and started escalating. In her family there were “multiple cases of psychosis” and her past psychiatric history was suggestive of a total lack of insight leading to an extremely irregular compliance to medication.

Right after the surgery, she presented with a firm belief: she had been “sexually abused during surgery” and her body had been used for “satanic rituals”. She decided to meet the plastic surgeon the day after the surgery and during the interview she wounded herself ripping the breast gauzes and by accident breaking the sutures of both nipples.

Her acute distress led to a compulsive acute psychiatric inpatient admission.

In summary, this case report is about a 34 year-old woman who developed a persecutory/mystical delusion after a breast reduction surgery. She was admitted to our acute inpatient ward after a mental health act psychiatric assessment.

The multidisciplinary interventions planned in order to prevent new plastic surgeries in the short-term (the patient still expresses the will to submit herself to a new series) will be described.
PW01-03 - Evaluation of the Effects of Quetiapine XR Monotherapy On Sleep Disturbance In Patients With MDD
Authors: Bandelow B. , Demyttenaere K. , Papakostas G. , Trivedi M. , Szamosi J. , Earley W. , Eriksson H.
Published: June 2010

Objectives

Evaluate the effects of once-daily extended release quetiapine fumarate (quetiapine XR) monotherapy on sleep disturbance in patients with major depressive disorder (MDD).

Methods

Pooled data from four 6- or 8-week placebo-controlled quetiapine XR (50-300mg/day, administered in the evening) monotherapy studies (D1448C00001, D1448C00002, D1448C00003, D1448C00004) were analysed. Primary endpoint: change from randomisation in Montgomery-Åsberg Depression Rating Scale (MADRS) scores. Post-hoc analyses assessed changes in: MADRS item 4 (reduced sleep); Hamilton Rating Scale for Depression (HAM-D) items 4 (insomnia-early), 5 (insomnia-middle) and 6 (insomnia-late) and sleep disturbance factor (items 4+5+6); Pittsburgh Sleep Quality Index (PSQI) total and item scores. MADRS total score change was analysed for patients experiencing high (baseline HAM-D sleep disturbance factor score >=4) and low (baseline HAM-D sleep disturbance factor score < 4) sleep disturbance.

Results

In total, 2,116 patients were randomised. At last assessment, quetiapine XR (all doses combined) significantly (p< 0.001) reduced MADRS item 4, HAM-D sleep disturbance factor and items 4, 5 and 6 and PSQI total scores from baseline versus placebo. Quetiapine XR significantly (p< 0.001) improved MADRS total score from baseline versus placebo at all time points in patients experiencing high sleep disturbance (n=865, quetiapine XR; n=514, placebo). Quetiapine XR improved MADRS total score versus placebo in patients with low sleep disturbance (n=252, quetiapine; n=121, placebo): difference significant at Weeks 2(p< 0.001), 4(p< 0.05) and 6(p< 0.05).

Conclusions

Quetiapine XR monotherapy improved symptoms of sleep disturbance in MDD and was effective against depressive symptoms in patients experiencing high and low sleep disturbance levels. AstraZeneca funded.
PW01-05 - Comparative Effectiveness of Newer Antidepressants on Driving Ability and the Impact of Retest-effects
Authors: Brunnauer A. , Laux G. , Zwick S.
Published: June 2010

Objectives

Although the therapeutic efficacy of newer antidepressants has been demonstrated in various studies there is only little research available about patients fitness to drive under newer antidepressants.

Methods

A sample of 60 depressive inpatients diagnosed according to DSM-IV criteria were randomly assigned to treatment with either mirtazapine (n=20), escitalopram (n=20) or reboxetine (n=20). To control for retest effects 15 healthy controls were examined in the same time schedule. Participants were tested before pharmacologic treatment (t0), and on days 7 (t1) and 14 (t2) with computerized tests related to car driving skills. Data were collected with the Act and React Testsystem (ART 90) and the Wiener- Testsystem (WTS) measuring visual perception, reactivity, stress tolerance, concentration and vigilance.

Results

Patients showed significant improvements in most functional domains related to driving ability skills after 14 days of treatment with newer antidepressants. Statistically significant differences between treatment groups could not be shown. However, controlling for retest-effects only in vigilance-measures significant group by time effects could be found indicating an improvement over practice effects.

Conclusions

Partly remitted depressive patients treated with mirtazapine, escitalopram or reboxetine showed a better test performance in driving related skills than untreated patients. However, as most of these laboratory driving tests have a large speed component, retest effects have to be considered when interpreting results of repeated examinations.
PW01-07 - Correlates of Past Sexual and Physical Trauma in 118 Bipolar I Patients With a First Episode of Psychotic Mania
Authors: Conus P. , Cotton S. , Benno S. , Michael B. , Rothanty D. , McGorry P.D. , Lambert M.
Published: June 2010

Objectives

To assess the prevalence and correlates of childhood and adolescence sexual and/or physical abuse (SPA) in bipolar I disorder (BD) patients treated for a first episode of psychotic mania.

Methods

The Early Psychosis Prevention and Intervention Centre (EPPIC) admitted 786 first episode psychosis (FEP) patients between 1998 and 2000. Data were collected from patients’ files using a standardized questionnaire. 704 files were available, 43 were excluded because of a non-psychotic diagnosis at endpoint and 3 due to missing data regarding past stressful events. Among 658 patients with available data, 118 received a final diagnosis of BD and were entered in this study.

Results

80% of patients had been exposed to stressful life events during childhood and adolescence and 24.9% to SPA: in particular, 29.8% of female patients had been exposed to sexual abuse. Patients who were exposed to SPA had poorer pre-morbid functioning, higher rates of forensic history, were less likely to live with family during treatment period and were more likely to disengage from treatment

Conclusions

Sexual and/or physical abuse is highly prevalent in BD patients presenting with a first episode of psychotic mania; exposed patients have lower pre-morbid functional levels and poorer engagement with treatment. The context in which such traumas occur must be explored in order to define if early intervention strategies may contribute to diminish their prevalence. Specific psychological interventions must also be developed.
PW01-08 - Evaluating Predictors For Remission With Placebo Using Integrated Data From Patients With Major Depressive Disorder
Authors: Deberdt W. , Nelson J.C. , Lipkovich I.A. , Marangell L.B. , Zhang Q. , Holsboer-Trachsler E. , Rihmer Z.
Published: June 2010

Objectives

To identify predictors of remission with placebo treatment in double-blind randomized controlled trials (RCTs) in major depressive disorder (MDD) based on baseline characteristics.

Methods

989 placebo-treated MDD subjects with baseline Hamilton Depression Rating Scale total score (HAMDT17) ≥15 who completed 7-8 weeks of treatment from 8 duloxetine RCTs with placebo lead-in were included. Remission was defined as HAMDT17 endpoint score ≤7. Stepwise logistic regression and classification and regression tree (CART) methods were used to identify predictors of remission. Data were randomly split into training data (N=791, 80%) for model selection and test data (N=198, 20%) for validation. Predictive quality of models was assessed by ROC curves.

Results

In the logistic regression analysis, out of >50 potential pre-treatment predictors, the HAMDT17 score, age, Hamilton Anxiety Scale item 14 (HAMA14: behavior at interview) and length of current MDD episode (length) were found to be most predictive for remission on placebo. These variables were also identified as top predictors by the CART method that identified 2 subgroups: “HAMA14=0 OR (HAMDT17< 22 AND length< 18 weeks)” (45% remitted), “HAMA14>0 AND (HAMDT17≥22 OR length≥18 weeks)” (21% remitted). However, the predictive power was weak for both methods with areas under the ROC curve (test data) of 67% and 56%, respectively.

Conclusions

Baseline risk factors for non-remission after 7-8 weeks of placebo treatment were older age, more severe depressive symptoms, apparent anxiety, and a longer duration of current MDD episode. These results are consistent with previous findings and may aid in the design of RCTs.
PW01-09 - Assessment of Cognitive Functioning Within Different Emotional Contexts in the Group of Euthymic Bipolar Patients
Authors: Dernovsek M. , Novak T. , Sprah L.
Published: June 2010

Objectives

Although numerous studies agree that bipolar patients demonstrate extensive cognitive deficits, it is still unclear to which extent these impairments persist across different mood states, including euthymia. Given that the emotional and cognitive processes are closely intertwined, we aimed to examine selective attention, cognitive inhibition, and social cognition within different emotional context in the group of remitted bipolar outpatients.

Methods

80 euthymic bipolar outpatients and 66 healthy volunteers matched for sex, age and education participated in the study. Internal State Scale and Barratt Impulsiveness Scale were used to assess self-reported affective states and trait impulsivity. Computerised versions of Colour-Word Stroop, Emotional Stroop, Affective Go/NoGo and Ekman Recognition of Facial Expression task were administered to assess selective attention, inhibition of cognitive control and social cognition.

Results

Several cognitive deficits in selective attention, inhibition of cognitive control and social cognition tasks have been identified in the group of euthymic bipolar outpatients. They revealed worse recognition of negative, positive and neutral affect than controls. Besides cognitive disruptions which were reflected in longer reaction times and more erroneous performance to different emotional stimuli and in different emotional contexts, also trait impulsivity was considerably elevated in the group of bipolar euthymic outpatients.

Conclusions

Bipolar outpatients in our study demonstrated relatively marked impairments in cognitive functioning within different emotional contexts also during the euthymia. Applied neuropsychological inventory proved as useful tool for assessing specific cognitive impairments in bipolar mood disorder, and could contribute to more effective diagnosing and treatment of patients.
PW01-12 - Two or Three Age-of-Onset Groups in Bipolar I Disorder? Findings of Commingling Analysis in Romanian and German Bipolar I Patients
Authors: Grigoroiu-Serbanescu M. , Rietschel M. , Paul T. , Schulze T.G. , Noethen M.M. , Cichon S. , Elston R.C.
Published: June 2010

Background

Age-of-onset (AO) seems to be a phenotypic variable with a strong genetic component and therefore useful in molecular analysis of bipolar disorder (BP). A debate about the cut-off point for defining early AO has developed over the last few years. Using an Expectation-Maximization algorithm Bellivier et al. (2001) found the best fit for a model with three onset-groups, proposing the age 20-21 as cut-off for early onset, while using the same algorithm Kennedy et al. (2005) found the best fit for a two onset-group model with age 40 as cut-off with an incidence peak for mania in the age-band 21-25. Based on segregation analysis, we proposed a two AO-group model with cut-off age 25 for early onset (Grigoroiu-Serbanescu et al. 2001). The present study aimed at investigating the best AO-model in 500 Romanian BPI and 1458 German BPI patients using commingling analysis (SAGEv6.01-software) (Elston et al, 2009). The best model was selected according to Akaike's Information Criterion (AIC).

Results

The two AO-group and three AO-group models provided similar AIC-values both in the Romanian and the German sample. The Romanian early-onset group (40% cases) had means around 18 years, SDs=6-7, while in the German early-onset group the mean AO was around 20 years (SDs=9-11) (50% cases). Thus the cut-off for early-onset (X +1SD) was different.

Conclusion

Our results overlapped with the findings of Kennedy et al (2005) showing that two-curve and three-curve AO mixtures similarly fit the AO-distribution in BPI disorder and the cut-offs for early-onset differ by sample.
PW01-21 - Poor Sleep is Related to Parenting Stress and Impaired Postpartum Bonding in Depressed Mothers
Authors: Mikoteit T. , Keller N. , Brand S. , Sievers E. , Riecher-Rössler A. , Holsboer-Trachsler E. , Hatzinger M.
Published: June 2010

Objectives

Poor sleep is a common complaint in postpartum depression (PPD). Depression as well as sleep disturbances may affect parenting functions and mother-infant relationship. The purpose of this study was to examine the relationship between objective sleep data, parenting stress and bonding in PPD.

Methods

Forty-five mothers (age: 34.5 ± 5.4 years SD) suffering from PPD were examined 212 ± 156 days (SD) after parturition. Depression was measured by Hamilton Depression Rating Scale (HDRS-ADS) and Beck Depression Inventory (BDI). Parenting stress and bonding were assessed by self report scales, i.e. Parenting Stress Index (PSI) and Postpartum Bonding Questionnaire (PBQ). In a subsample of 10 participants sleep parameters were assessed by actigraphy and sleep logs during seven consecutive days. Actigraphic sleep parameters were put in relation to severity of depression, PSI and PBQ scores.

Results

Poor sleep, i.e. low total sleep time (TST) was negatively correlated to depression (HRDS-ADS) (r = -.63; p < .05). Low TST was associated with poor bonding (r = -.82; p = .02), especially attitudes of “rejection and anger”. Severity of depression (BDI) was correlated with parenting stress (r =.50; p =.005). Mothers with high parenting stress tended to have more difficulties in bonding (r =.65; p =.016). Neither sleep parameters nor parenting stress and bonding were correlated with the infant's age.

Conclusions

In PPD poor sleep should be recognized and treated early, because it is associated to parenting stress and disturbed bonding, which might have a detrimental impact on mother-infant relationship.
PW01-27 - Translational Pharmacology of Quetiapine and Norquetiapine: Preclinical Findings Support Multifunctional Psychotropic Properties
Authors: Nyberg S. , Widzowski D.
Published: June 2010

Objectives

Clinical studies demonstrate that quetiapine is efficacious in schizophrenia, bipolar mania, bipolar depression, major depressive disorder, and generalized anxiety disorder. The pharmacological basis for this broad range of clinical effects is not completely understood. The current experiments evaluated pharmacological assays investigating the receptor-binding characteristics of quetiapine and norquetiapine (the major human metabolite) and compared these with other atypical antipsychotics and standard antidepressants.

Methods

In vitro receptor-binding assays utilized cloned human targets including norepinephrine transporter (NET), dopamine D2 receptor, and serotonin 5-HT1A, 5-HT2A, and 5-HT2C receptors stably expressed in CHO or HEK cell lines. In vitro functional studies included uptake-inhibition assays for NET and GTPgammaS assays for D2/D3 antagonist and 5-HT1A agonist activity.

Results

Norquetiapine demonstrated high affinity at 5-HT2A receptors (5 nM) and moderate/high affinity at NET (29 nM) and 5-HT2C receptors (76 nM), while quetiapine had moderate affinity at 5-HT2A receptors (29 nM), weak affinity at 5-HT2C receptors (2800 nM), and lacked appreciable affinity at NET. Both quetiapine and norquetiapine showed moderate affinity at D2 receptors (56 nM and 59 nM, respectively) with moderate/low-potency antagonist activity. Both quetiapine and norquetiapine exhibited low affinity at 5-HT1A receptors (1800 nM and 570 nM, respectively) with low-potency agonist activity.

Conclusions

These experiments confirm that quetiapine-norquetiapine have multiple pharmacological effects at targets associated with psychotropic drug action. This combination of effects by quetiapine-norquetiapine at dopaminergic, serotonergic, and noradrenergic targets may explain the antipsychotic, antidepressant, and anxiolytic properties of quetiapine.

Supported by funding from AstraZeneca Pharmaceuticals LP.
PW01-30 - Increased Scores on the Hypomania Check List-32 and on the Mood Disorder Questionnaire In Treatment-resistant Depression: Polish Tres-dep Study
Authors: Rybakowski J. , Kiejna A. , Angst J. , Pawlowski T. , Siwek M. , Lojko D. , Dudek D.
Published: June 2010

Objective

An undiagnosed bipolarity may be one of the reasons connected with treatment resistance in major depressive disorder. In recent years, the tools have been introduced helping to assess the bipolarity such as the Hypomania Checklist (HCL-32) and the Mood Disorder Questionnaire (MDQ). The objective of the study was to compare scores of bipolarity measured with these scales between patients with treatment-resistant and treatment non-resistant depression within the framework of all-Poland multi-center study TRES-DEP.

Methods

One-thousand and fifty-one patients recruited from 150 outpatient psychiatric clinics in Poland and fulfilling DSM-IV criteria for single or recurrent major depressive episode were studied. Five-hundred and sixty-nine patients were identified as having treatment-resistant depression on account of non-obtaining remission in recent depressive episode after minimum of two courses of adequate treatment with antidepressant drugs. They were compared with 482 patients with non-treatment-resistant depression. All patients were assessed using the structured demographic and clinical data interview, as well as the Polish version of HCL-32 and MDQ

Results

Patients with treatment-resistant depression scored significantly higher compared with non-resistant depression both on HCL-32 and MDQ (11.9+8.3 vs 8.5±7.7 and 4.3±3.5 vs 2.7±2.9, respectively). Independent risk factors of treatment resistance were scoring of14 or higher on HCL-32, and 6 or higher on MDQ.

Conclusions

Higher scoring by patients with treatment-resistant depression on both HCL-32 and MDQ may suggest a possible association between bipolarity and worse response to antidepressant drugs in patients with major depressive disorder.
PW01-33 - Onset of Depression Inventory (ODI) - Comparison of the Onset Speed of Unipolar and Bipolar Depressive Episodes
Authors: Strauss M. , Mergl R. , Sander C. , Merz C. , Schönknecht P. , Hegerl U.
Published: June 2010

Introduction

The rate of manifestation of depressive episodes can vary appreciably. The complete development of a depressive episode may be very rapid, taking less than one hour or be very slow, taking up to one month. Altough this clinical observation suggests different neurobiological pathomechanisms, the onset speed of depressive episodes in different affective disorders has not been investigated systematically up to now. The objective of this study was to establish the onset speed of depressive episodes in patients with a history of at least one depressive episode and to compare the onset speed in unipolar with that in bipolar affective disorders.

Method

A group of 96 inpatients was investigated consecutively using the structured patient interview “Onset of Depression Inventory” (ODI). In 76 patients, there was a unipolar depressive disorder and 20 patients suffered from a bipolar depressive disorder.

Results

The onset speed of the current depressive episode in patients with effective disorders correlated significantly with the onset speed of the previous depressive episodes (p < 0.001). Furthermore, there was a significant difference in the onset of the depressive episodes between unipolar and bipolar affective disorders (p < 0.001). In 55% of patients with a bipolar disorder, the depressive episode was manifested within one week whereas this was the case in only 22,37% of the patients with a unipolar affective disorder.

Conclusion

The rate of manifestation of depressive episodes differs between unipolar and bipolar disorders. The clinical observation reported here can support the diagnostic appraisal of depressive episodes.
PW01-37 - Long-term Efficacy of Quetiapine In Combination With Lithium or Divalproex on Mixed Symptoms In Bipolar I Disorder
Authors: Vieta E. , Suppes T. , Gustafsson U. , Paulsson B.
Published: June 2010

Objective

To determine the efficacy of QTP in patients with bipolar I disorder with mixed symptoms.

Method

Data from 2 phase III studies (D1447C00126 and D1447C00127) were pooled. Unlike previous analyses of these studies, mixed events were analyzed separately. Patients received QTP (400-800 mg/d)+Li/DVP to achieve ≥12 weeks of clinical stability followed by double-blind treatment with QTP (400-800 mg/d)+Li/DVP or PBO+Li/DVP for up to 104 weeks. Primary endpoint was time to first mood event post-randomization.

Results

1326 patients were included in the ITT population. Relative to PBO, QTP significantly increased time to recurrence of mixed events (P< 0.0001). 445 ITT patients had a most recent mixed episode at study entry. In these patients, mood events were reported by fewer patients on QTP+Li/DVP (21.0%) than on PBO+Li/DVP (53.9%). These events included mixed (6.4% vs 22.1%), pure manic (5.0% vs 13.3%), and pure depressed events (9.6% vs 18.6%). Time to recurrence of mood events was significantly longer for patients on QTP+Li/DVP than for those on PBO+Li/DVP for mixed (HR, 0.23, 95% CI, 0.13-0.42, P< 0.0001), pure manic (HR, 0.30, 95% CI, 0.15-0.60, P=0.0007), and pure depressed events (HR, 0.38, 95% CI, 0.22-0.64, P=0.0003). No new safety concerns were noted.

Conclusions

In stable patients with bipolar I disorder, QTP+Li/DVP significantly increased: a) time to recurrence of mood events compared with PBO in patients with mixed symptoms at study entry; and b) time to occurrence of mixed mood events in patients with any mood episode at study entry.

Supported by funding from AstraZeneca Pharmaceuticals.
PW01-38 - Maintenance Treatment With Quetiapine Added To Either Lithium or Divalproex In Bipolar I Disorder
Authors: Suppes T. , Vieta E. , Gustafsson U. , Paulsson B.
Published: June 2010

Objective

Combined data are presented from 2 long-term studies (D1447C00126; D1447C00127) of QTP in combination with Li or DVP in the prevention of mood events in bipolar I disorder. Data from Li and DVP treatment groups are analyzed separately to determine the added benefit of QTP.

Methods

Patients received QTP (400-800 mg/d)+Li/DVP to achieve ≥12 weeks of clinical stability followed by double-blind treatment with QTP (400-800 mg/d)+Li/DVP or PBO+Li/DVP for up to 104 weeks. Li or DVP treatment was openly assigned at the discretion of the investigator. Primary endpoint was time to first mood event post-randomization.

Results

1326 patients were included in the ITT population. In both Li and DVP groups, the risk of recurrence of any mood event was significantly reduced following treatment with QTP relative to placebo (HR, 0.32, 95% CI, 0.24-0.44 and HR, 0.28, 95% CI, 0.21-0.37; for Li and DVP, respectively; P< 0.0001 for both). This trend was repeated for risk of recurrence of mania and depression events (P< 0.0001 vs placebo). Comparison of QTP+Li versus QTP+DVP groups revealed no differences in the risk of recurrence of mood, mania, or depression events. Safety data were generally consistent with the recognized safety profiles of QTP, Li, and DVP.

Conclusions

In stable patients with bipolar I disorder, treatment with QTP, in combination with either Li or DVP, resulted in similar significant increases in the time to recurrence of a mood event (mania or depression) compared with placebo, regardless of Li or DVP co-treatment.

Supported funding from AstraZeneca Pharmaceuticals.
PW01-49 - Depersonalization In Patients With Panic Disorder: Role Of Personality
Authors: Mendoza L. , López H. , Rodriguez A. , Navinés R. , Imaz M.L. , Gutierrez F. , Crippa J.A. , Martín-Santos R.
Published: June 2010

Introduction

Depersonalization (DP) is a common and complex clinical phenomenon in neurology and psychiatry. It is defined as an experience in which the individual feels a sense of unreality and detachment from him/herself. Prevalence and clinical correlates of dissociative symptoms in general, and DP in particular have been associated to panic disorder (Hunter et al., 2004). Moreover, DP has been associated with certain personality traits, specifically “harm-avoidant” temperament dimension, immature defenses, and overconnection and disconnection cognitive schemata (Simeon et al., 2002).

Objectives

To investigate the prevalence of DP syndrome in panic disorder and its relationship with personality.

Methods

One-hundred-four consecutive adult patients with panic disorder were assessed with the Semi- Structured Clinical Interview for DSM-IV-Axis I and II. All participants were evaluated with the Cambridge Depersonalization Scale (Sierra and Berrios, 2000) and the Cloninger Temperament and Character Inventory. The severity of panic disorder was measured with the Panic and Agoraphobia Scale.

Results

Seventeen patients (16.3%) had a DP syndrome. There were not socio-demographic differences between both groups with and without DP syndrome. Patients with DP syndrome showed a higher score in “self-transcendence” character dimension (p< .001), higher prevalence of personality disorders (p=.007) and greater severity of panic disorder (p=.007). A logistic regression analysis showed that severity of panic disorder (p=.031) and higher “self-transcendence” personality dimension (p=.019) predicts DP syndrome in panic disorder patients. The Hosmer-Lemeshow test showed the goodness-of-fit of the model.

Conclusions

The study confirms the association of DP syndrome with panic disorder and their relationship with “self-transcendence” personality dimension.
PW01-52 - Post-Traumatic Stress Disorder (Ptsd) Among Emergency Medicine Staff
Authors: Saberi H.
Published: June 2010

Objectives

Emergency department staff and emergency medicine personnel in particular are at risk of various types of occupational stresses such as mental traumas. Little information is available about possibility and rate of PTSD among emergency medicine staff in Iran and the world as well. This study is to cover the prevalence of and affecting factors on the PTSD among the EM personnel in Iran.

Methods

In an analytic-descriptive study in 2009, 150 emergency medicine personnel of Kashan and Arak city were investigated to estimate both the PTSD rate and severity of mental traumas. Standard questionnaires of IES 15 and PTSS 10 along with DSM- IV criteria were utilized in this regard.

Results

121 out of 150 subjects answered the questionnaires. All the clients were examined in terms of DSM- IV criteria in which 44 (36.4%) ones met the PTSD diagnostic criteria. In the IES scale, one third of the EM staff belonged to the event severely affected group. 11 (9%) subjects received a 5 or more PTSD score demonstrating a relatively severe reaction in them. Marital status had a meaningful correlation with PTSD condition, so that the single were more likely to meet the PTSD criteria.

Conclusions

According to the study, rate of PTSD and severity of the traumas resulted among the emergency medicine personnel were both high to a great extent. It seems that these individuals are severely exposed to occupational stress and the pertinent complications, and further attention should be given to their psychological condition then.
PW01-56 - Peculiarities Of Teenagers’ Suicidal Behavior
Authors: Adomaitienė V. , Jaras A. , Lauciūtė E. , Dambrauskienė K. , Taranda V. , Vilkas V.
Published: June 2010

Objective

Suicide is one of predominant causes of death among young Europeans. Recent statistical data on suicide proves that Lithuania is one of the leading countries in this domain. The goal of this study is to define and compare the peculiarities of suicidal behavior among teenage boys and girls.

Methods

109 teenagers of the age 14 to 17 years old (52 boys and 57 girls), who were treated in Kaunas University of Medicine Psychiatry Clinic Children - Teenagers’ Department after suicide attempts, took part in the study. Medical documentation and structured questionnaire designed by the authors were used.

Results

The incidence of suicidal thoughts among teenagers who attempted suicide was compared according to gender. It was determined that almost one fourth of the boys (23,1%) and one sixth of the girls (17,5%) have never thought about committing suicide before they attempted to do that. Almost every other boy (48,1%) and 40,4% of the girls have had suicidal thoughts a few times a year. One fourth of the boys (28,8%) and one third of the girls (36,8%) have had suicidal thoughts a few times per month or per week. And only a few girls (5,3%) still had suicidal thoughts after a suicidal attempt (X2=4,04, df=3, p=0,3).

Conclusions

No statistical gender differences were found in estimating the incidence of suicidal thoughts among teenagers who attempted suicide.
PW01-58 - Association Between Depressive Symptoms And Pubertal Status In Boys And Girls From A Uk Cohort
Authors: Joinson C. , Heron J. , Araya R. , Lewis G.
Published: June 2010

Objectives

To examine the association between advancing pubertal status and the emergence of depressive symptoms in boys and girls from a UK cohort.

Methods

Self-reported depressive symptoms were assessed using the Short Mood and Feelings Questionnaire at three time-points (10.5, 13 and 14 years). We derived trait measures of depressive symptom level at each time-point using confirmatory factor analysis and compared the 3 depressive symptom factors with pubertal status (using regular self-reported Tanner assessments from 8-14 years) separately in boys (n=2902) and girls (n=2886). Main effects were estimated, adjusted for time lag between assessment of pubertal status and depressive symptoms, and then further adjusted for confounders (social class, maternal education, parental separation, financial problems, housing tenure).

Results

For girls at age 10.5 years, there was little evidence of a relationship between pubertal status and depressive symptoms, with an increase in symptoms of 0.025 SD's for each additional pubertal stage (indicated by Tanner stages 1 through 5) for breast development and 0.023 SD's for each additional stage for pubic-hair development. With increasing age, the association between pubertal stage and depressive symptoms in girls strengthened. At age 14 years, advancement of each pubertal stage represented an increase in 0.13 SD's of depressive symptoms for breast development and 0.10 SD's for pubic hair development. For boys, there was no clear relationship between pubertal development and depressive symptoms at any time-point.

Conclusions

More advanced pubertal status was associated with an increased level of depressive symptoms in girls in early/mid adolescence but not boys.
PW01-63 - Functionality And Quality Of Life In Children And Adolescents With Adhd Transitioning To Oros Mph - Correlations Of Outcomes
Authors: Niederkirchner K. , Mattejat F. , Dichter S. , Schaeuble B.
Published: June 2010

Objective

To explore correlations of outcomes in children and adolescents with ADHD transitioning from IR MPH onto OROS MPH.

Methods

Post hoc analyses of a 12 week open label trial in patients (6-18 yrs) with a diagnosis of ADHD (ICD-10) transitioning from IR MPH onto OROS MPH. Assessments included Conners parents rating scale, children's global assessment scale and quality of life (ILC; LK0-28) of patients, including self rating and parent's rating. A regression model on difference in CPRS at endpoint from baseline as dependent variable and sex, age, baseline CPRS and diagnosis as explanatory variables was performed. Relationships between ILC, CPRS and C-GAS scores were assessed by Spearman's rank correlation coefficients.

Results

598 patients (ITT population; 84.8% boys; median 10 yrs) received a median starting and final dose of PR OROS MPH of 36 mg/day. Scores on C-GAS, CPRS, ILC (parents and patients) improved (p< 0.001). Burden of disease in care givers and children decreased (p< 0.001). Older age, poor baseline score, diagnosis of F.90.0 (hyperkinetic disorder) were associated with greater improvements on CPRS. The difference between endpoint versus baseline scores of patient's and parent's rating of patient's ILC, C-GAS and ILC (patients'rating) correlated. ILC (parents'rating) and CPRS correlated inversely (a decrease in CAARS was associated with higher scores on ILC).

Conclusion

Transitioning to OROS MPH was associated with improvement in daily functioning, quality of life and decreased burden of disease. Improvement in symptoms was associated with improved quality of life aspects and better social functioning.
PW01-81 - Deficits of Spatial Memory and Oxidative Stress Damage Following Exposure to Lipopolysaccharide in a Rat Model of Parkinson's Disease
Authors: Hritcu L. , Ciobica A. , Stefan M. , Nabeshima T.
Published: June 2010

Objectives

The present work was undertaken in order to investigate the effects of systemic lipopolysaccharide endotoxin administration (250 μg/kg) on spatial memory formation and oxidative stress in rats subjected to right-unilateral lesion of the dopaminergic neurons of the substantia nigra by means of 6- hydroxydopamine (6-OHDA) compared to normal and lipopolysaccharide alone treated rats.

Methods

Thirty male Wistar rats weighing 200 ± 50 at the start of the experiment were used. The substantia nigra was right-unilateral lesioned by stereotaxic microinjections of 8 micrograms (free base) 6-OHDA. The rats were pretreated 30 min before the 6-OHDA infusion with 25 mg/kg desipramine to protect noradrenergic projections. Sham-operated rats received only an injection of desipramine, followed by vehicle in the substantia nigra. Lipopolysaccharide (LPS from Escherichia coli serotype 0111:B4, Sigma) was dissolved in pyrogen-free 0.9% NaCl at the concentration of 250 μg/kg and intraperitonealy injected in normal and 6-OHDA-lesioned rats for a period of 7 continuous days. 7 days after continuous LPS administration we assessed memory formation by means of Y-maze and radial arm-maze task, and the endogenous antioxidants activity in rat temporal cortical area.

Results

Systemic lipopolysaccharide administration significantly decreased spontaneous alternation in Y-maze task, working memory and reference memory in radial arm-maze task, suggesting impairment of both short-term memory and long term-memory, respectively. Furthermore, lipopolysaccharide administration significantly decreased activity of the biochemical markers of endogenous antioxidants in rat temporal cortical area.

Conclusions

Our results further validate that lipopolysaccharide may exacerbate the development of neurological dysfunctions associated with Parkinson's disease.
PW01-83 - Co-Morbidity And Mortality In Vascular Dementia: A Naturalistic Follow-Up 2000 To 2007
Authors: Malik A. , Potlori R. , Natalwala A. , Heun R.
Published: June 2010

Introduction

Vascular Dementia (VD) patients have increased co-morbidity and higher mortality in comparison to other patients. Neuro-degeneration, cognitive deficits and underlying medical conditions may influence the pattern of co-morbid disorders and their possible effects on mortality in VD.

Aim

To investigate whether the pattern of co-morbidity and its relevance for later death differed between hospitalised VD and elderly controls.

Method

Diseases with a prevalence of more than 1% at hospital admission were compared between 341 hospitalised VD and 72244 control subjects aged above 70 years referred to the University of Birmingham Hospital, UK. Risk factors i.e. co-morbidities that were predictors of mortality within the seven year follow-up were identified using logistic regression and cox regression analyses. Confidence intervals of relative risks were used to compare the relevance of risk factors for later mortality between groups.

Results

Subjects with VD suffer more with peripheral vascular disease, atrial fibrillation, type 2 diabetes mellitus, pneumonia, ischemic stroke and urinary tract infections than other hospitalised elderly patients. In contrast, myocardial infarction was less prevalent in VD subjects in comparison with hospitalised controls. The prevalence of hypertension, ischemic heart disease, angina and heart failure was not statistically different in the two groups.

Conclusion

Patients with Vascular Dementia have a different pattern of co-morbidity, but die from the same diseases as other hospitalised patients. Infections including pneumonia may need special attention in patients with vascular dementia who might not be able to identify or report the early symptoms.