bluuebunny/crossref_metadata_2025_split huggingface dataset:
P01-80 - Elderly Mania: Throughly Revised; three (very) Difficult Clinical Cases
Authors: Cintra P. , Marques J. , Ramos A. 
Published: June 2010

ObjectivesSymptoms of mania in geriatric patients (> 65 years old) have received much recent attention, in part due to Akiskal's Bipolar Spectrum classification (Akiskal, 2000), in which subtype VI is «bipolarity in the setting of dementia». The authors present a through revision of the issue, and 3 clinical cases are presented.MethodsData was collected through Medline/Pubmed website research, literature revision and other sources. Three clinical cases are presented (identifying data and sociodemographic details, history of present illness, personal history, …), which were obtained through direct observation of the patient and consultation of hospital inpatient clinical file.ResultsWe found 11272 articles, of which 458 were reviews. We were involved in direct care to 3 elderly manic patients, in our clinical activity in 2 Psychiatric Hospitals in Lisbon.ConclusionsElderly mania is a relatively rare and ill-defined syndrome, with many possible causes (genetic, iatrogenic, metabolic, infectious, oncological, traumatic SNC injuries, epilepsy, and many other neurological disorders). Appropriated exclusion of organic pathology through a correct differential diagnosis is mandatory to obtain a suitable therapeutic approach and favorable prognosis. The growing life expectancy suggests that this neuropsychiatric syndrome should be a focus of attention for psychiatrists, internists, and other health care technicians, especially those directly involved in the care of elderly patients in settings such as state/private hospitals, private clinics, day care facilities and nursing homes.
P01-81 - The Role of Insomnia in Manic or Hypomanic Relapses of Bipolar Disorder
Authors: Pedrosa R. , Ferreira P. , Teixeira de Sousa V. , Silva A. , Viana M. 
Published: June 2010

Sleep disturbance is recognized as an essential aspect of affective illness.Multiple lines of evidence suggest that a change in sleep pattern may indicate an imminent mood change. In fact, the impaired sleep can be seen as a sign as well as a cause of manic episodes. Thus, sleep can be a predictor of mania or a marker of response and therapeutic target.This retrospective study explores the role of insomnia in patients with Affective Bipolar Disorder presenting with current mania or hypomanic episode, based on ICD-10 criteria. It was randomly selected a sample of 61 adults admitted at Psychiatry Department of Hospital de São João between 2005-2007. It was assessed the presence of insomnia before and during the treatment and compared with the duration of the hospitalization, the number of attendances to the Emergency Department and hospitalizations one year after.Given the importance of insomnia in bipolar illness, appropriate evaluation and management of sleep can be helpful in preventing relapses in this disorder. Therefore sleep improvement in mania may be clinically useful as therapeutic target.
P01-83 - Associations Between Guideline-concordant Care and Clinical Outcomes for Depression and Anxiety
Authors: Prins M. , Verhaak P. , Smolders M. , Spreeuwenberg P. , Laurant M. , van der Meer K. , van Marwijk H. , Penninx B. , Bensing J. 
Published: June 2010

AimsTo determine possible associations between guideline-concordant care and clinical outcome in general practice patients with anxiety and depression, and identification of patient characteristics associated with poor clinical outcome.MethodsData from the Netherlands Study of Anxiety and Depression (NESDA) was used. NESDA is a longitudinal cohort study to measure the long-term course and consequences of anxiety and depressive disorders. Adult patients were interviewed to measure DSM-IV diagnoses during the baseline assessment, and completed questionnaires measuring symptom severity, sociodemographic variables and social support at baseline and 12 months later. The definition of guideline adherence was based on an algorithm on care that was received.Results721 patients with a current (6-month recency) anxiety or depressive disorder participated. While patients who received guideline-concordant care (N=281) suffered from more severe symptoms than patients who received non-guideline concordant care (N=440), both groups improved equally on their depressive or anxiety symptoms after 12 months. Patients who (still) had moderate or severe symptoms at follow-up, were more often unemployed, had smaller personal networks and more severe depressive symptoms at baseline than patients with low symptoms at follow-up.ConclusionsThe added value of guideline-concordant care could not be demonstrated in this study. While patients with comorbidity of both anxiety and depressive disorders, those with smaller social networks and the unemployed were more likely to suffer from moderate or severe symptoms after 12 months, severity of depressive symptoms at baseline was most strongly associated. Findings have practical implications as well as implication for future research.
P01-87 - Evaluation of the Rate of Depression in Heart Diseases’s Patients and Dialysis Candidates Against the Healthy People
Authors: Kazemi R. , Rezaei Ghalechi E. 
Published: June 2010

BackgroundThe aim of this study is the investigation of depression prevalence in heart diseases patients and dialysis candidate’s we researched depression effects on heart and renal diseases and suggested new ways to patients’ management.MethodsThis study is a descriptive and correlation study that 21 heart disease patient and dialysis candidates as the samples by questionnaire are selected we used Beck depression Anxiety test and gained results by SPSS and statistical analysis.ResultsIn this study 21 patients are selected and 67.7% of them had depression. 30% minor depression, 17.5% mild depression and 7.5% had major depression. Around the 12.5% of them needed psychiatric consultations. Most of them were middle-aged (45%),men (22%),illiterate (32.5%), citizen (92.5%),illness (52.5%) and dialysis candidates (27.5%).ConclusionOur study shows that there isn’t meaningful relation between age, academic education, type of living and disease duration of patients. We knew that there is meaningful relation between periods of heart diseases’ patients, dialysis candidates and depression against the healthy people. this research says us to notice emotional problems of patients especially patient of heart diseases and dialysis candidates,
P01-89 - Preliminary Analysis of the Functional Consequences of the CACNA1C Gene Polymorphism on Emotional Processing in Bipolar Disorder
Authors: Ruberto G. , Lelli-Chiesa G. , Vassos E. , Maierú M. , Tatarelli R. , Girardi P. , Collier D. , Kempton M.J. , Frangou S. 
Published: June 2010

ObjectivesA single nucleotide polymorphism within the CACNA1C gene (rs1006737) has been found to confer increased risk of Bipolar Disorder (BD) and has been linked to altered neuronal gating and emotional behaviour. As current models of BD suggest abnormal integration within frontolimbic networks, our aim was to explore the effect of the CACNA1C genotype on prefrontal and limbic activation.MethodsWe genotyped 90 participants from the Vulnerability to Bipolar Disorder Study comprising of 41 euthymic BD patients and 49 healthy controls. Functional magnetic resonance imaging data were obtained while participants performed a fearful versus neutral facial affect processing task.ResultsWe found a significant diagnosis by genotype interaction with BD patients homozygous for the risk allele having reduced prefrontal activation compared to the other groups.ConclusionsThe present findings support the hypothesis that the rs1006737 polymorphism in the CACNA1C gene confers increased risk of BD by modulating amygdala and PFC activation during emotional processing.
P01-91 - Management of Acute Depression in Bipolar Disorder. Formalized Recommendations from the French Society of Biological Psychiatry: Methodology and Perspectives
Authors: Samalin L. , Guillaume S. , Martin P. , Abbar M. , Meynard J.-A. , Gay C. , Courtet P. , Llorca P.-M. 
Published: June 2010

As part of a process to improve the quality of care, the French Society of Biological Psychiatry developed recommendations for clinical practice in bipolar disorder.MethodThe method chosen for these guidelines is a formalized consensus of experts. It enables, through a series of specific clinical situations proposed to the experts, to provide recommendations for the management of bipolar disorder. The situations where defined because they are not associated to evidence-based recommendations according to the lack of controlled studies.Results40 experts participate to this consensus. As in most of the guidelines for the treatment of bipolar disorder, more than 50 % of experts (51,3 to 72,9%) recommend the same therapeutic strategies to treat major depressive episode whichever the type (bipolar I or II).Unlike to other guidelines, French experts propose different therapeutic according to the presence or absence of rapid cycling. For major depressive episode without rapid cycling, 63% experts recommend a combination of an antidepressant with a mood stabilizer. In rapid cyclers, 51% experts recommend the use of a mood stabilizer in monotherapy or in combinaison, but never associated with antidepressant.ConclusionThis methodological approach enables to get closer to everyday clinical practice and integrate specificities of prescription through a national panel of experts. On the other hand, this type of methodology highlights the research perspectives: i.e. management of acute depression with rapid cycle in bipolar disorder.
P01-93 - Social, Occupational and Educational Function in a Representative Sample of Bipolar Patients Compared with the General Population
Authors: Schoeyen H. , Birkenaes A.B. , Vaaler A.E. , Auestad B.H. , Malt U.F. , Andreassen O.A. , Morken G. 
Published: June 2010

ObjectiveThere is a positive correlation between level of education and working function in the general population. Bipolar disorder (BD) is often associated with disability in social and working function. There is conflicting evidence considering educational achievements in BD patients.AimsOur aim was to investigate how education was related to social and occupational function in BD.MethodPatients with DSM-IV BD (N=257; 69.3% BD I, 25.7% BD II, 5.1% BD NOS, 51.4% females) were consecutively recruited from mental health clinics throughout Norway. The majority of patients were recruited when in-patients. About 1/2 had at least once experienced a psychotic episode. The BD sample was compared with a geographically matched reference sample from the general population (N=56.540) on levels of education, marital status, income, and disability benefits. Further analyses of association were carried out using logistic regression analyses.ResultsA significantly higher proportion of subjects in the BD group than in the reference group was single, had low income, or was disabled. No between-group difference was found in educational level. In the reference group education was inversely correlated with the risk of being disabled, but no such relationship was found in the BD group. In BD patients rapid cycling and recurring depressive episodes were the only clinical characteristics associated with low educational level.ConclusionDespite similar levels of education, BD patients had lower socio-economic status than the general population, and no association was found between education and disability for BD patients.
P01-95 - Family Psychoeducational Intervention for Depression
Authors: Shimodera S. , Fukuzawa K. , Fujita H. , Morokuma I. , Mino Y. , Inoue S. 
Published: June 2010

BackgroundWe performed family psychoeducation for depression, and investigated the association between the education and expressed emotion of patients’ families and relapse of depression.MethodsOf 103 patients diagnosed with major depressive disorder, and their primary family members, 53 patients and their primary family members gave consent. The patients were randomly allocated to an intervention or control group, consisting of 24 and 30 patients, respectively. The intervention group underwent 4 educational sessions and education in coping techniques. The relapse rate was compared between the intervention and control groups. In addition, the subjects were divided into high- and low-EE groups based on the EE judgment, and the effect of psychoeducation was compared in each group.ResultsThe relapse rate during a 9-month period was 8.3% in the intervention group, being significantly lower than that (50%) in the control group. The relapse rate in the intervention group was slightly lower than that in the control group in the high-EE group, and significantly lower in the low-EE group. Regarding the influence of EE, in the control group, the relapse rate was 70% in the high-EE group, being significantly higher than that (40%) in the low-EE group. On multiple logistic regression analysis, psychoeducation (odds ratio: 25.53, 95% CI: 2.83-229.92) and the Hamilton score at the time of entry (odds ratio: 1.16, 95% CI: 1.045-1.298) were significantly associated with relapse.ConclusionIt was suggested that the psychoeducation of families is very effective for the prevention of relapse in adult depressive patients.
P01-96 - Social Adaptation of the Patients with Depressive Disorders for the First time Admitted to the Psychiatric Hospital
Authors: Shmunk E. 
Published: June 2010

ObjectivesTo investigate characteristics of prehospital period of patients with depressive disorders and their influence on the level of social functioning.MethodsAfter informed agreement 102 patients with depressive disorders (DD) for the first time admitted to the psychiatric hospital were examined with RDC of ICD-10. For the assesment of the level of social functioning Social Adaptation Self-evaluation Scale (Bosc M. et al., 1997) was used.ResultsThe average duration of DD before psychiatric examination was 19,1 months (up to 312 months). The average age was 43,8±11,5 years. Most patient had first depressive episode (61,8%), second 8,9%, third 2,9% and 4,9% had «double depression». The most part of the patients (61,8%) with DD saw their primary care (PC) doctors, 47,1% of them did it more than twice. The average number of visits to PC was 3,6 (up to 49), the average number of investigations was 2,4 (up to 8). The most part of visits to primary care (PC) fell at patients with heart complaints (р=0,02), the less part to patients with loss of energy (р=0,0007). More visits to PC were associated with low level of social functioning (r>-0,2, р<0,05). Low level of social functioning correlated with older age, duration and severity of depression, number of previous episodes and PC attendance.ConclusionsIn ddition to some clinical characteristics of depressive disorders the level of social functioning depends on PC visiting.
P01-122 - Experiential Avoidance in Subjects with Social Anxiety
Authors: Berrocal C. , Bernini O. , Cosci F. 
Published: June 2010

ObjectivesExperiential Avoidance (EA) has been conceptualised as one of the main vulnerability processes for psychopathology, including social anxiety, in the so-called ACT (Acceptance and Commitment Therapy) model - one of the “new wave” behavioral-cognitive approaches. EA refers to the degree to which an individual fuses with thoughts, avoids negative feelings, and is unable to act in the presence of difficult private events.This study is aimed at exploring the role of EA in subjects with social anxiety.MethodsParticipants were 113 subjects recruited from the general population and with high levels of social anxiety as measured by means of the Liebowitz Social Anxiety Scale. Participants were classified into high and low experiential avoiders according to results from the Italian version of the Acceptance and Action Questionnaire.ResultsThe two groups did not differ in gender, marital status, educational level, or age distributions. Between-groups differences on several psychological measures, including depression, general psychopathology, quality of life and well-being were explored. Results indicated that individuals with social anxiety reporting higher levels of EA showed higher levels of depression and psychopathology, and lower levels of quality of life and well-being than low-EA participants.ConclusionsConsistent with theoretical predictions in the ACT model, these findings suggest that EA may play a significant role in moderating negative psychological outcomes in subjects with social anxiety.
P01-128 - A Comparative Study on Brain-behavioral Systems Action in Patients with Obsessive-compulsive and Phobia Disorders
Authors: Didehdar Ardebil M. , Fekri Y. , Hasani Goleyakh M. 
Published: June 2010

ObjectiveThis study aims at scrutinizing the action of Behavior-Brain systems in patients with obsessive-compulsive disorder and patients with Phobia by comparing them. The study is based on Jeffry Gary personality Theory.Method20 patients with obsessive-compulsive disorder and 20 patients with Phobia that matched together by age, education level and gender were selected from patients referred to consulting clinics in Ardebil in 2008. Gary & Wilson personality questionnaire administered for assessing the Behavior-Brain systems action. The collected data were analyzed using descriptive and independent T-test to test the hypothesis generated in the study.ResultsAnalyzing the collected data shows that there is no significant difference between Phobic and obsessive patients in behavior activating systems and behavior inhabitation systems; but there is significant difference between two groups in fight -flight system.ConclusionThe results of this study are in agreement with basic hypothesis of Gary's Reinforcement Sensitivity Theory and neuro-psychological status of patients with disorders. The reason of no significant difference between two behavior activating systems and behavior inhabitation systems in phobic and obsessive patients might be due to the similarity of behavior roots in these two disorders.
P01-133 - Modifying Respiratory Functionality in Healthy Subjects: Towards Development of Anti-panic Breathing Therapy
Authors: Fadda E. , Catenazzi U. , Cammino S. , Ozino S. , Galimberti E. , Bellodi L. 
Published: June 2010

ObjectivesSeveral studies showed respiratory irregularities in patients with Panic Disorder (PD). This led to the development of the Breathing Therapy, a therapeutic strategy aimed to modify dysfunctional respiratory patterns. However, it remains unclear whether and how BT regularize respiration. The aim of this study was to evaluate whether and how a single performance of a specific respiratory technique could modify respiration at rest.MethodsTwenty-eight healthy subjects were randomly assigned to two groups, performing either a slowed 9-breaths-per-minute respiration (group 1) or a “combined” respiration (group 2) so as to evaluate the most effective respiration able to produce respiratory modifications. Respiratory recording took 40 minutes including basal respiration (T1), breathing technique (T2), natural breathing (T3). We evaluated Tidal Volume (VT), respiratory frequency (RF) and end-tidal PCO2 (PetCO2) standard deviations (SD), Approximate Entropy (ApEn).ResultsIn both groups ApEn values significantly decreased from T1 to T3. However, we observed an increase of ApEn values from T2 to T3 and of VT'SD from T1 to T2. In group 2 RF'SD decreased and PetCO2'SD increased from T1 to T3. RF'SD increase in both groups from T2 to T3.ConclusionBoth techniques could modify respiratory physiology, leading to reduced ApEn values and increased respiration variability. The repeated practice of such respiratory techniques could modify respiratory functioning. Further studies are needed to determine which technique has the highest likelihood to reduce breathing irregularities and its possible use for the treatment of PD.
P01-135 - Anxiogenic Properties of a Virtual Reality Simulation for Panic Disorder with Agoraphobia
Authors: Freire R. , De Carvalho M. , Joffily M. , Zin W. , Nardi A. 
Published: June 2010

ObjectivesThere are several useful methods to induce anxiety in patients with panic disorder with agoraphobia (PDA). Our aim was to ascertain if a virtual reality simulation could induce anxiety and physiologic alterations in PDA patients.Methods10 healthy controls (HC) and 10 patients who fulfilled DSM-IV criteria for PDA were recruited for this study. Before and after the experiment the anxiety level was measured with the Subjective Units of Distress Scale (SUDS), the Diagnostic Symptom Questionnaire (DSQ) was used to ascertain panic attack symptoms. The heart rate, skin conductance and respiration parameters were monitored during the exposure to the VR. The virtual reality simulation was a 3D computer animation of a short bus trip, from a first person perspective. The Igroup Presence Questionnaire (IPQ) was used to measure the sense of presence.ResultsPDA patients had higher familial history of panic disorder. From the 10 PDA patients only 3 were not taking medications. In PDA patients the VR exposure increased anxiety levels, they also had higher scores in the DSQ and two of them had panic attacks. Compared to the HC, the PDA patients had higher skin conductance levels, electrodermal response magnitude, respiratory rate, tidal volume, and respiratory rate irregularities. The heart rates were higher for patients who had panic attacks, followed by the HC and the non-panicking patients. Regarding the sense of presence the two groups were similar.ConclusionThis study indicated that VR exposure may induce anxiety, electrodermal and respiratory alterations in patients with PDA.
P01-141 - Vasomotor Symptoms are Associated with Anxiety in Perimenopausal Women
Authors: Karaoulanis S.E. , Rizoulis A.A. , Lialios G. , Xiromeritis A. , Nasika Z. , Angelopoulos N.V. 
Published: June 2010

ObjectivesMenopausal symptoms of hot flushes and night sweats are defined as vasomotor symptoms. They are markers of declining serum estradiol, are not universal in menopausal women and may occur in women who are sensitive to the effects of estradiol on thermoregulatory centers and serotonergic, adrenergic, and norepinephrine neurotransmitters. The aim of this research was to find out if vasomotor symptoms were associated with anxiety in perimenopausal women.Materials and methodsWe examined perimenopausal women with anxiety and a comparison group of asymptomatic perimenopausal women. One hundred and two (102) women participated in the study, 44 suffering from anxiety and 58 normal controls. All women were between the ages 40 and 58 and presented with a history of menstrual cycle irregularity of at least six months duration but not longer than one year of amenorrhea. The diagnosis of anxiety was determined by an interview and the Hamilton Anxiety Rating Scale (HAM-A). Vasomotor symptoms were assessed with the Menopause Rating Scale (MRS). The association between vasomotor symptoms and anxiety in perimenopausal women was made using Wilcoxon-Mann-Whitney test.ResultsA significant relationship between vasomototor symptoms and anxiety was found in perimenopausal women. The severity of vasomotor symptoms was strongly associated with the severity of anxiety (p< 0.001).ConclusionsIt appears that hot flushes and night sweats are associated with anxiety in perimenopausal women.