bluuebunny/crossref_metadata_2025_split huggingface dataset:
The impact study - motivating a change in health behaviour
Authors: Smith S. , Greenwood K. , Atakan Z. , Sood P. , Ohlsen R. , Papanastasiou E. , Featherman A. , Todd G. , Eberhard J. , Ismail K. , Murray R. , Gaughran F. 
Published: May 2011

IMPaCT is a five-year project funded by the Department of Health, UK. Running in the UK and now Sweden, the IMPACT Project aims to target the poor physical health and excessive substance use seen in people with SMI. There is evidence that behavioural interventions may be associated with an improvement in physical health and substance use in this population.IMPaCT is a randomised controlled trial of a health promotion intervention which consists of a manualised modular approach to working with people with severe mental illness to empower them to improve their physical health and substance use habits. It consists of The Manual, The Reference Guide and The Better Health Handbook which make up a therapy package to support clients to become healthier.The therapy is provided by care coordinators (mental health practitioners) over a 6–9 month period and combines Cognitive Behavioural Therapy (CBT) with Motivational Interviewing (MI) principles. The aim is to work with clients to help them identify their own problem health behaviours, e.g. smoking, diet, exercise, drug and alcohol use. Realistic goals are set and revised with the client, and individual and group sessions are used to develop personal motivation to change. Information, workbooks and diaries are provided to record progress and give helpful hints, while meaningful alternative activities are introduced to replace problem health behaviours.
Physical health in schizophrenia - what's cognition got to do with it?
Authors: Gallhofer B. , Sammer G. , Hanewald B. ,   Cognitive Neuroscience Unit Giessen
Published: May 2011

Patients suffering from schizophrenia are usually treated with antipsychotic agents posing a threat both to their cognitive and physical skills. Anticholinergic and antihistaminic side effects are well known to have a negative impact on mental as well as physical health and pose a major hazard regarding progress in reintegration.Strategies changing the fate of patients have moved away from just dampening dopaminergic noise in the limbic system. Nowadays, the new focus is on cognitive remediation. The centre of these efforts is to enhance strategic and executive skills and thereby alter patients' motivation to take their life into their own hands again.The present report aims at presenting evidence from both physical treatment strategies with the power to enhance hippocampal circuit capacity as well as cognitive remediation tools with the the aim of augmenting executive skills by rewiring cognitive circuitry in the brain.Preliminary results demonstrate not only improved processing of mental load found with fMRI measured circuitry connectivity, but they also point to the improvement of physical parameters taken in a continuous clinical context.The reasons for these favourable findings are not straight forward and trivial, but they seem to be the result of complex interaction between various factors. The latter are to be pursued in a large cohort and presented at a later point in time.
Neural correlates of cognitive behavioural therapy in patients with schizophrenia
Authors: Kicher T. , Krug A. , Cabanis M. , Walter H. , Winterer G. , Müller B. , Herrlich J. , Wiedemann G. , Vogeley K. , Wittorf A. , Rapp A. , Klingberg S. 
Published: May 2011

Cognitive behavioural therapy (CBT) is an important treatment in conjunction with psychopharmacotherapy in schizophrenia. However, there is only very little research on the effects of such interventions on brain function.Recent studies have suggested that jumping to conclusions and a specific attributional bias is a predominant cognitive style in patients which might lead to the development of delusions. In this multi-centre fMRI trial, we investigated the effect of nine months of CBT on neural correlates of “jumping to conclusions” and the “attributional style” in patients with psychosis. Eighty patients and 80 control subjects were recruited in six centres and measured with 3-Tesla functional magnetic imaging (fMRI) before and after CBT.It could be shown that CBT ameliorates differences in brain activations between patients and controls after nine months.These results support the feasibility of fMRI multicenter trials and sheds further light into the mechanisms relating psychotherapy to brain function in Schizophrenia.
Social cognition in schizophrenia: Impairments and treatment approaches
Authors: Wölwer W. 
Published: May 2011

Impairments in cognitive processes underlying social interaction (i.e. “social cognition”) have increasingly attracted interest in schizophrenia research during the last years. These impairments concern various components of social cognition, exist relatively independent from impairments in basic cognition and from clinical psychopathology, are already present at the onset of the disorder, and can even be detected in persons at high risk of developing schizophrenia. As social cognitive impairments are closely related to poor functional outcome, and because longitudinal studies have proven the stability of social cognitive impairments across the course of the disorder despite clinically efficacious traditional treatment, various specialized treatment and rehabilitation programs targeting social cognitive impairments have been developed during the last years. These programs differ significantly with regard to the conceptualization of the impairments and the required treatment strategies, i.e. whether the impairments are suggested to be represent cognitive “deficits” or cognitive “biases” requiring remediation vs. debiasing approaches. Moreover the programs differ with regard to the scope of cognitive subcomponents addressed, i.e. whether the program focuses on only one social cognitive subcomponent like affect recognition or whether several subcomponents are addressed in parallel. As the evaluation of such programs is still in an infant stage there is still debate about the most efficacious approach.This presentation will give an overview on social cognitive impairments and on respective treatment strategies, before the subsequent presentations will exemplify three treatment programs, which may help schizophrenia patients to overcome their impairments in social cognition and social functioning.
A targeted remediation approach: The training of affect recognition (TAR)
Authors: Sachs G. , Winklbaur B. , Jagsch R. , Frommann N. , Kryspin-Exner I. , Wölwer W. 
Published: May 2011

IntroductionAn increasing number of studies is focusing on general deficits in patients with schizophrenia in identifying, differentiating and recalling facial emotions which significantly impairs the patient's psychosocial functioning and quality of life.ObjectivesThese impairments seem not to be affected by conventional treatment. According to preliminary results antipsychotics alone show only little effects on social cognition.AimsThe present study investigated the efficacy of a computer based training focussing on facial affect recognition (Training of Affect recognition TAR, Wölwer et al. 2005) for the remediation of social cognitive dysfunctions.MethodsEffects on social cognition were tested with the Vienna Emotion Recognition Task (VERT-K, Pawelak 2004). Neurocognitive performance was assessed by the Wisconsin Card Sorting Test (WCST Heaton et al. 1993). Additional assessments were tests of alertness, vigilance and working memory (TAP Zimmermann and Fimm 2002), positive and negative symptoms (PANSS Kay et al. 1987), Beck Depression Scale (BDI Beck 1964) and Quality of Life (WHOQOL-Bref WHOQOL Group 1998).ResultsIn comparison to the TAU group, the TAR group achieved significant improvements in affect recognition in general as well as in recognizing sad faces (p < 0.01) (Fig.2). In addition, we found significant improvements for the TAR group in regard to vigilance and Quality of Life (p < 0.05).ConclusionsTreatment with new antipsychotics alone leads only to limited effects on social cognition and functioning. A specific combined treatment of new antipsychotics and TAR leads to improved cognition and emotional performance with additional positive effects on functional outcome.
A broad-based remediation approach: The integrated neurocognitive therapy (INT)
Authors: Roder V. , Mueller D.R. , Schmidt S.J. 
Published: May 2011

ObjectiveCognitive functions have a decisive influence and prognostic value for functional recovery. The NIMH MATRICS initiative established a consensus on neuro-cognitive and social cognitive domains relevant for the treatment of schizophrenia. Against this background we developed the Integrated Neurocognitive Therapy (INT) covering all MATRICS domains. INT is strongly based on therapeutic principles of the Integrated Psychological Therapy (IPT) designed by our research team several years ago. INT is partly computer based and intends to restitute and compensate neuro-cognitive and social cognitive functions.MethodsINT was evaluated in an international multi-cite RCT with centers in Switzerland, Germany, and Austria. The Swiss National Science Foundation supported this study. INT was compared with a treatment as usual control condition (TAU). INT patients received 30 therapy sessions twice a week. 169 schizophrenia outpatients participated in the study.ResultsUsing an ANOVA model, INT groups show superior effects after therapy and 1-year follow-up in proximal outcomes of neuro- and social cognition. Significant effects are evident in most of the MATRICS-domains. Additionally, significant effects in more distal outcomes are evident for INT patients in psychosocial functioning and negative symptoms after therapy and at follow-up. A low drop-out rate of 12% of the INT patients indicates a high acceptance by the patients.ConclusionsResults support evidence for the efficacy of INT in proximal and distal outcome dimensions. Further evaluations on INT have to investigate its relevance for different psychotic populations such as young early psychotics and more chronic older patients.
Childhood abuse and the genetic variants of the HPA and serotonin systems
Authors: Wasserman D. 
Published: May 2011

According to a stress diathesis model, genes and environment, as well as possible interactions in-between (GxE), may result in vulnerability towards suicidal behaviors (SB), characterized by behavioral trigger endophenotypes such as increased depression-intensity and aggression/anger/impulsivity.Excessive stress has the potential to induce unfavorable effects in a variety of higher brain-functions, incurred as side effects to maladaptive responses in the genetically controlled stress-responsive neurosystems eg. in the hypo- thalamic-pituitary-adrenal(HPA) axis. Childhood traumatic experiences are particularly relevant as stressful experiences are they frequently occur in the early childhood, when susceptibility to external stressors is higher. Childhood abuse has been found in several study as directly associated with suicidal behavior, independently from other psychological or psychopathological risk factors.HPA-axis dysregulation is regarded as an endo- phenotype of depression-, anxiety- and alcohol abuse disorders, commonly found also in suicide behaviors. Various neurobiological alterations, suggesting abnormal HPA-axis activity and reactivity, have also been demonstrated to occur in suicidal behaviors including completed suicides.The HPA axis is a major systemic stress-modulator being mainly controlled by the regulatory corticotropin releasing hormone receptor 1 (CRHR1) gene. An overview will be presented of the role of the HPA axis in suicidal behaviors with a focus on CRHR1 gene. and on interactions with childhood traumatic experiences.
Stressful life events in early life and suicidal behaviour
Authors: Saiz P.A. 
Published: May 2011

There is robust evidence that stressful life events (SLE) are associated with an increase in risk of developing depression. However, humans display wide variation in response to adversity. Caspi et al (2003) reported that a functional length polymorphism (5-HTTLPR) in the promoter of the serotonin transporter gene moderated the influence of SLE on depressive symptoms, major depression, and suicidality, suggesting evidences of a gene-by-environment interaction.Neuroimage data from healthy, non-depressed, s allele carriers of the 5-HTTLPR show an exaggerated amygdale response to threatening visual stimuli as well as reduced gray matter volume in limbic regions critical for processing of negative emotion compared with individuals with the LL genotype. These data suggest a potent modulatory effect of the 5-HTTLPR on amygdala reactivity to environmental threat.In recent years, a growing number of molecular genetic studies have focused on the serotonin system, suggesting that this system may be involved in the pathogenesis of suicidal behaviour. Meta-analytic evidences support a link between the s allele of the 5-HTTLPR and the risk of suicidal behaviour. However, several case-control association studies show an association between the short allele and the violence, the number, and the medical lethality of the attempts.On the other hand, recent data suggest that biological stress reactivity, mediated by the hypothalamic-pituitary-adrenocortical axis, might be a plausible mechanism underlying the association between the 5-HTTLPR genotype and exposure to life stress in predicting psychopathology.In this presentation we discuss data regarding the complex relationship between the above mentioned systems, stress, and suicidal behaviour.
Neural, cognitive and behavioral correlates of CBASP- effects
Authors: Schnell K. 
Published: May 2011

To test the validity of two different social cognitive mechanisms as mediators of CBASP-treatment effects, we conducted fMRI-studies ini) healthy andii) healthy compared to chronically depressed subjects.The first fMRI experiment included in these studies explored the neural representations and behavioral correlates of causal contingencies between action and response in social interaction and the regulatory effect of successful/erroneous affective response prediction on the limbic system. In the second experiment we examined the ability to infer on the affective states of another person and the correlated activation of the neural “Theory of Mind” (ToM)-Network comprising superior temporal and dorsomedial prefrontal cortices.In the first experiment we demonstrated for the first time, that the probability of an interaction partner's contingent response to an action is inversely correlated with the activation of a network of medial, ventrolateral prefrontal and inferior-parietal cortices in healthy controls. The congruence of predicted and actual responses modulated activations of amygdala (aversive responses) and ventral striatum (positive responses). The Second experiment actually replicated previous observations, that mentalizing of affective states predominantly activates anterior parts of the ToM-network.Preliminary results of the comparison between healthy and chronically depressed individuals indicate dysfunctional differentiation of social partners’ predictability in chronic depression as well as altered neural representations of contingencies. For the second experiment we found altered activation within the Theory of Mind network in the patient group.Finally we will demonstrate pre-post measurements of neural and behavioral changes in both systems of social cognition after 12 CBASP sessions.
Theoretical considerations and clinical implementations of the somatoform disorders concept
Authors: Bobrova M.A. , Bobrov A.E. 
Published: May 2011

The existing ICD-10 typology of somatoform disorders is often criticized. The alternative approach to pseudo-somatic complaints as an expression of anxiety-affective disorders still deserves much recognition among practicing psychiatrists.To evaluate the validity of these views a group of 53 patients (24 men and 29 women) was studied with the help of clinical interview, symptomatic scales, personality and neuropsychological tests. Results of statistical analysis demonstrate that there are four relatively independent "core" variants of somatoform syndromes, which closely resemble ICD disorders: anxiety-depressive, psychovegenative, dissociative, and paranoid hypochondriac. These variants differ in symptomatology, levels of disturbance and prognosis.The obtained data evidence that differences in clinical features of somatoform disorders are determined by specificity of cognitive styles, changes in sensory levels, dysfunction of brain antinociceptive system, higher integrative brain functions and personality/behavioral patterns. It also means that contradiction between empirically and operationally based approaches to somatoform disorders reflects the consecutive transition from phenomenological to descriptive and then - to bio-psycho-social paradigm in modern psychiatry.
Chronic stress and anxiety-depressive spectrum disorders in patients of phoniatric practice
Authors: Veltishchev D. , Stukalo A. , Romanenko S. , Kovalevskaya O. , Seravina O. 
Published: May 2011

ObjectivesTo research the influence of stress factors on the development and circuit of voice disorders in their relation to anxiety and depressive spectrum.AimesTo analyze the extent to which the anxiety and depressive disorders are spreading among the patients with voice dysfunctions, to determine the variety of factors for psychological traumatic experience, and to distinguish the variety of anxiety and depressive disorders.MethodsThe Hospital Anxiety and Depression Rating Scale (HADS), the projective psychological tests.Preliminary HADS screening was conducted among 180 patients. More than half of the patients (57.5%) had high risk of anxiety and depressive disorders. 55 patients (44 women, 13 men, age of 18–70) with voice disorders and the positive results of screening were included to the study. Patients underwent a complete otolaryngologic examination and were grouped into organic voice pathology (34.5%) and non-organic voice pathology (65.5%). In accordance with ICD-10, anxiety and depressive disorders were diagnosed in 48 (87%) patients. In most cases (98.7%) the phoniatric pathology developed in chronic stress conditions. The prevailed chronic stress factors that provoked both anxiety-depressive spectrum disorders and voice pathology were inability to reach pre-set social goal (65.4%), ethical conflict (18.2%) and lack of external control factors (16.4%). Professional factor was also important as 38.2% of the group claimed heavy voice load at work.Chronic stress factors play significant provoking role in the development of voice and anxiety-depressive spectrum disorders, which should be taken into account to design diagnostic and therapeutic tactics for patients with voice pathology.
Objective versus subjective sleep in patients with insomnia related to generalized anxiety disorder and apnea as compared with normals
Authors: Saletu B. , Anderer P. , Gruber G. , Parapatics S. , Dorffner G. , Saletu-Zyhlarz G.M. 
Published: May 2011

IntroductionEarlier studies reported that subjective sleep quality correlates with objective polysomnographically measured sleep initiation and continuity, but less with sleep architecture.AimsThis study aimed to investigate relations between subjective and objective sleep in normals (N), insomnia comorbid with generalized anxiety disorder (G) and apnea (A).MethodsOne hundred and seventy-seven normals (50.9±19.6a), 100 insomniac G patients (37.9±10.6a) and 51 A patients (51.3±9.7a) completed the self-rating scale for sleep and awakening quality (Saletu et al. 1997) regarding two polysomnographic nights analyzed by the Somnolyzer (Anderer et al. 2005). Correlations were calculated based on changes between the first (adaptation) and second polysomnographic night to diminish inter-individual variances of sleep perception.ResultsIn N, subjective sleep quality (S-QUA) demonstrated correlations (p < 0.01) with sleep efficiency (EFF), wake after sleep onset (WASO), S2, S1%, REM, S1, frequency of awakenings (FW), latency to continuous sleep (L-CONT), sleep latency (S-LAT) and slow-wave sleep, while awakening quality (A-QUA) showed weak (p < 0.05) correlations with EFF and WASO. Somatic complaints (S-COM) correlated (p < 0.05) with WASO and REM. In G, correlations (p < 0.01) were obtained between S-QUA and EFF, WASO, S2, L-CONT and S-LAT (p < 0.05), while A-QUA correlated with S2, WASO and EFF. In A, S-QUA correlated (p < 0.01) with EFF, S2, S1%, S2%, L-CONT, WASO and less (p < 0.05) with S-LAT and S1. A-QUA correlated with S2, S2% (p < 0.01), L-CONT and EFF (p < 0.05). S-COM correlated with S-CONT (p < 0.01) and S-LAT (p < 0.05).ConclusionEFF, WASO, S2 and less S-LAT determine good S-QUA in all groups.
SS05-01 - The place of agomelatine in the antidepressant armamentarium
Authors: Boyer P. 
Published: May 2011

The choice of an antidepressant is tailored according to patient factors (age, sex, severity, diagnostic subtype, comorbid disorders, past response) and to drug characteristics (efficacy, tolerability, safety, simplicity of use, discontinuation syndrome).A wide range of antidepressants are available nowadays, with mode of action mainly based on the monoamine hypothesis of depression, but all have limitations: still too many nonresponding patients, late onset of action, and poor tolerability profile, resulting in low adherence. The challenges for a new antidepressant are first to provide all patients with rapid and sustained antidepressant efficacy in relieving all symptoms, second to lead patients out of depression by achieving complete remission, and third to ensure that patients are compliant throughout treatment.Agomelatine is a new antidepressant with an innovative mode of action acting as an agonist of melatonergic MT1 and MT2 receptors as well as an antagonist of serotonergic 5-HT2C receptors. These receptors play a major role in circadian rhythms, which are dysregulated in depression. Recent data suggest that the distinctive antidepressant efficacy of agomelatine results from the potential synergy between these receptors.Agomelatine rapidly improves depressive symptoms in most subtypes of depression, particularly in patients with anxiety symptoms, known as factor of resistance. Moreover, agomelatine shows greater antidepressant efficacy than fluoxetine in severely depressed patients (HAM-D total score difference over 8 weeks: 1.49; P = 0.024).Thanks to its unique impact on mechanisms at the core of depressive dysregulation, agomelatine provides doctors and patients with an innovative approach to depression treatment.