bluuebunny/crossref_metadata_2025_split huggingface dataset:
Prevalence of Behavioural and Psychological Symptoms of Dementia in Nursing Homes in Berlin
Authors: Majic T. , Pluta J.-P. , Mell T. , Decker A. , Heinz A. , Rapp M.A. 
Published: March 2009

Background:Behavioral and Psychological Symptoms of Dementia (BPSD) include agitation, apathy, hallucinations, and depression. These symptoms are a challenge to professional nursing care, resulting in frequent psychiatric hospitalization, which incur high costs to the national healthcare systems.Objective:To estimate the prevalence of BPSD in nursing home residents in 16 representative nursing homes in Berlin, Germany.Methods:In a cross-sectional clustered cohort study, BPSD were assessed using the Dementia Mood Assessment Scale (DMAS), the Neuropsychiatric Inventary (NPI) and the Cohen-Mansfield Agitation Inventory (CMAI). Dementia stage severity was measured by Functional Assessment Staging (FAST) and the Mini-Mnetals State Examination (MMSE). Furthermore, the patients" history recording psychotropics and number of psychiatric hospitalizations were registered. The prevalence and incidence rates of BPSD as well the duration of hospitalization and the quantity of drug prescription were estimated.Results:BPSD are common above all in nursing home residents with dementia, exhibiting prevalence rates of above 60% of all nursing home residents suffering from dementia. The severity of BPSD was related to number of psychiatric hospitalizations, the amount of psychotropics prescribed, and caregiver burden (p < .05).Conclusion:The high prevalence rate of BPSD reflects a significant problem in nursing home care, and is related to negative health outcomes and caregiver burden. Thus, nursing home care could be improved by minimizing the severity of BPSD, as well as the amount of drugs prescribed and the frequency of demented patients" hospitalization.
Neuropsychological Performance in Both Alzheimer’s Disease and Vascular Dementia is Related to Cardiovascular Comorbidity [P01-103]
Authors: Hofrichter N. , Dick S. , Tritschler E. , Knobel A. , Heinz A. , Rapp M.A. 
Published: March 2009

Aims:Vascular pathology has been implicated in the pathogenesis of both Alzheimer's disease and vascular dementia. While performance decrements in vascular dementia are by definition thought to be related to vascular load, performance decrements in Alzheimer's disease have not yet been studied in relationship to cardiovascular comorbidity. The aim of this study was to describe neuropsychological performance in patients with mild Alzheimer's disease and vascular dementia in relationship to cardiovascular comorbidity.Method:39 patients suffering form vascular dementia and 34 patients suffering form Alzheimer's disease underwent neuropsychological testing using an extended neuropsychological battery, including tests of episodic memory, working memory, naming, verbal fluency, executive functions, and language. Cardiovascular comorbidity was assessed form medical history and chart review using the Charlson comorbidity index.Results:Patients suffering form Alzheimer's disease and vascular dementia did not differ in terms of age, education, gender distribution, or dementia severity. Cardiovascular comorbidty was more pronounced in vascular dementia patients. In both Alzheimer's disease and vascular dementia, neuropsychological performance in tests of working memory and executive functioning was related to cardiovascular comorbidity, but the relationship was stronger in vascular dementia.Conclusion:Vascular load affects neuropsychological performance in both Alzheimer's disease and vascular dementia, suggesting that cardiovascular comorbidity affects cognition across both forms of dementia.
Saccadic Eye Movements in Dementia, Major Depression and Healthy Controls - Relationship with Cognitive Functions [P01-105]
Authors: Schewe H.-J. , Vohs K. , Uebelhack R. 
Published: March 2009

We compared horizontal saccadic eye movements in patients with dementia (n=18), and age-matched patients with major depression (n=18) or healthy controls (n=18). Cognitive functions were evaluated using Mini-Mental-State-Examination (MMSE) and ADAS-cog.Results:Saccadic latency and number of saccadic intrusions were significantly (p< 0.001) higher in patients with dementia relative to healthy controls and depressed patients. There were significant correlations between MMSE total score and latency (r = -0.78, p< 0.01) or number of saccadic intrusions (r = -0.80, p< 0.001) in the demential group. In addition, both saccadic parameters were significantly associated with ADAS-cog total score of patients with dementia, whereas the subscale “orientation” showed the strongest correlation with latency (r = 0.71, p< 0.01) and intrusions (r = 0.74, p< 0.01).There were no significant differences in saccadic eye movements between healthy controls and patients with major depression as a whole, or a subgroup of depressed patients with the worst cognitive performance (n=9).Conclusions:It seems that disturbances in horizontal saccadic eye movements in patients with dementia are related to the degree of cognitive deficits in these patients. On the other hand, the lack of alterations in horizontal saccadic eye movements in depressed patients despite poor cognitive performance indicates different mechanism.
New Diagnostic Approaches: To Enable Care Home Staff Understand and work Effectively with Behaviours that Challenge in Dementia
Authors: Scott A. 
Published: March 2009

Background:Behaviours that challenge in dementia exceed the capability of care home staff. Evidence shows medication, traditionally the first line treatment has limited benefit, may hasten cognitive decline and is associated with vascular and cardiac problems in older people. Alternatively, admission to hospital occurs despite 90% of behaviours occurring as a response to care practices or environmental factors. Instead, the reasons should be addressed focusing on when, where, why and with whom these behaviours manifest themselves.AIMS In 2006, a five-month pilot study within the Northern Health and Social Services Board (NHSSB) (Antrim and Ballymena, Northern Ireland), using the Newcastle Model, a bio-psycho-social intervention received 20 referrals involving 11 care homes.Method:This new diagnostic approach formulatesbehaviours in terms of peoples’ needs, which are assumed to drive behaviours. The model is a hybrid of well-established ideas from various psychological models,but its distinguishing feature lies in the unique integration of teaching, supervision and intense support provided to care home staff. The NeuroPsychiatric Inventory Caregiver Distress (NPI-D) measures frequency and severity of behaviours and level of distress this causes staff. This was administered pre and post intervention.Results:Four hospital admissions were averted which, based on the average length of stay, would have cost an estimated £81,500. NPI-D scores decreased following interventions.Conclusion:The potential of this pilot study was noted by the Institute of Healthcare Management Quality Awards prompting the NHSSB to fund a Behaviour Sciences Nursing Service. A clinical effectiveness and full cost effectiveness analysis is now planned.
Hypochondrial Symptoms as the First Sign of Frontotemporal Dementia (FTD)
Authors: Simões S. , Machado Á. 
Published: March 2009

Introduction:Psychiatric symptoms are very prevalent in FTD, in particular in its behavioural variant. Among these, hypochondrial symptoms can be found, usually along the course of the disease.Clinical case:A 70-year-old previously healthy woman was seen for progressive behavioural disturbances. Nine years before she started complaining of having almost all possible diseases. Every time that she saw a documentary or any news describing a disease, she said she had all its symptoms, so she must have the disease. The family started to find this strange, as every time she sake medical help, everything was fine. Even more strange was when she feared having completely inadequate diseases, like the “blue baby syndrome”. Several months after, she started having incomprehensible fears, refused to be left alone, locked all dors and windows and did not want to go outside because she was afraid that someone would harm her. Over the next years the full-blown FTD picture developed, with reduction of speech output, verbal and sexual disinhibition, impulsivity, hyperphagia and aggressivity, with total lack of insight. Upon examination she was coprolalic, inadequate, perseverant and had frontal release signs. MRI showed bilateral frontotemporal atrophy and PET revealed frontotemporal hypometabolism.Conclusion:Although hypochondrial symptoms are one of the affective classical symptoms in FTD, they are unusual in first stages of disease, and has not been, to our knowledge, reported as a presenting sign. These findings highlight the need to bear in mind this diagnosis in all patients presenting with novel psychiatric symptoms in late life.
The Social Intervention for People with Alzheimer Disease in Transylvania Region
Authors: Stoica L. 
Published: March 2009

The Alzheimer disease affects mostly old people but sometimes even adults; it manifests itself as a series of brain modifications which determine several perturbations: thinking, memory, language, mood disturbances. All these disturbances take place gradually and strengthens as the illness advances. The exact causes that determine the Alzheimer disease are still unknown, that is why it can not be prevented or cured. Although, a diagnostic in the first stages and treatment as soon as possible is absolutely necessary for slowing it's evolution.Unfortunately, the number of persons affected by Alzheimer is rising in Transylvania region. I estimated that only 12-15% of the cases are discovered in the early stages. The effect of the illness doesn't just affect the ill one, but all his family. Taking care of someone who suffers from Alzheimer means a lot of effort, because he needs permanently supervision and help in any kind of activity. Moreover, most of the times, the family is notable to take care of the sick person at home, and it has to take him to a residential center. Although, this is not always the best solution, especially that after being institutionalized, they are often having a nervous breakdown and the disease has a bad evolution. The social worker plays a very important role in helping the person who suffers from Alzheimer. The social intervention has to consider not only the specific needs of the ill, but also the family needs and it has to take place in both directions.
Assessing the Relationship Between Compliance with Antidepressant Therapy and Costs Among Employees in the United States
Authors: Birnbaum H. , Ben-Hamadi R. , Kelley D. , Hsieh M. , Seal B. , Cremieux P. , Greenberg P. 
Published: March 2009

Objective:Assess effects of antidepressant compliance on healthcare and workplace costs.Methods:Using workplace survey data for 2 large employers’ healthcare claims (2004-2006), patient selection criteria considered depression diagnosis and antidepressant claims history. Employed respondents working in the past month were categorized by Medication Possession Ratio into compliance groups by quartiles; bottom/top quartiles were defined as compliant/non-compliant. Direct (medical/drug) costs were measured as insurer payments to providers; indirect (absenteeism/presenteeism) costs were based on one-month recall of workplace performance (hours worked/missed, self-rated performance), estimated as (hours missed x self-reported hourly income). Annualized, inflation-adjusted (2006) costs were compared between compliant/non-compliant groups using multivariate models controlling for baseline characteristics. Analyses were conducted for all patients and a subsample of diagnosed depression patients.Results:Among all patients (n=1,224), medical costs were numerically lower for compliant vs. non-compliant patients ($4,857 vs. $5,926, p=0.221); drug costs were significantly higher for compliant patients ($2,329 vs. $1,570, p=0.001). Indirect costs were not statistically different between compliant/non-compliant patients ($22,278 vs. $20,714, p=0.237). Among the depression subgroup (N=488), medical costs were numerically lower for compliant vs. non-compliant patients ($5,005 vs. $7,630, p=0.152) while drug costs were numerically higher for compliant patients ($2,550 vs. $1,829, p=0.153). Absenteeism costs were 30% lower for compliant patients ($7,725 vs. $11,040, p=0.038); presenteeism costs were not significantly different ($19,079 vs. $17,457, p=0.441).Conclusions:Absenteeism costs decrease significantly with compliance among depressed patients as do medical costs (not significantly). Further research is warranted regarding reason for poor antidepressant compliance and influence of compliance on costs.
Treatment Emergent Sexual Dysfunction Related to Antidepressants: A Meta-analysis
Authors: Chiesa A. , Serretti A. , Calati R. , de Ronchi D. 
Published: March 2009

Objective:Sexual dysfunction is an important under-estimated side effect of antidepressant drugs. Patients, in fact, if not directly questioned, tend to scarcely report them. Thus, the aim of the present meta-analysis is to quantify sexual dysfunction caused by antidepressants on the basis of studies where sexual functioning was purposely investigated through direct inquiry and specific questionnaires.Methods:A literature search was conducted using Medline, Isi web of Knowledge and references of selected articles. Selected studies performed on patients without previous sexual dysfunction were entered in the Cochrane Collaboration Review Manager Software (RevMan version 4.2). Our primary outcome measure was the rate of total treatment emergent sexual dysfunction. Our secondary outcome measures were the rates of treatment emergent desire, arousal and orgasm dysfunction.Results:Our analyses indicated significantly higher rates of treatment emergent sexual dysfunction as well as specific phases dysfunction compared to placebo for the following drugs: citalopram, escitalopram, fluoxetine, fluvoxamine, paroxetine, sertraline, duloxetine, venlafaxine, clomipramine, imipramine and phenelzine, whereas no significant difference with placebo was found for the following antidepressants: amineptine, bupropion, moclobemide, mirtazapine and nefazodone. Nonetheless sufficient evidences (>100 subjects) are available only for bupropion, citalopram, fluoxetine, paroxetine, sertraline and venlafaxine.Discussion:Present evidence on treatment emergent sexual dysfunction caused by antidepressant is sufficiently studied only for few drugs. Furthermore some statistical limiting assumptions, as the inclusion of open label or small studies and the presence of an evident publication bias, could reduce the significativity of our findings. Thus, treatment emergent sexual dysfunction should be more deeply investigated.
Effectiveness and Tolerability of Escitalopram in the Treatment of Depression with or Without Mental and/or Somatic Comorbidities
Authors: Yfantis A. , Giailoglou D. , Chourdaki E. , Sotiriadou K. , Laggis N. , Markoula S. , Sotiriou M. 
Published: March 2009

Purpose:To evaluate the effectiveness and tolerability of escitalopram in patients suffering from depression with or without comorbid mental and/or physical disorders in a naturalistic setting.Methods:Open-label 3-month study, conducted in 186 investigational sites in Greece. Efficacy assessment was based on CGI-S, MADRS and CGI-I scales. Tolerability was evaluated by spontaneously reported adverse events and treatment discontinuation rates. Statistical analysis was based on a modified intent-to-treat dataset (at least one valid post-baseline CGI-S measurement) and the per protocol dataset (valid CGI-S measurements at all 3 visits).Results:The analysis dataset of the study included 3,931 patients (mean age 45.5±10.8, 65.8% women, 37.4% with any comorbidity, and baseline mean MADRS 26.7±8.4). Patients with comorbid mental disorders were more severely ill at baseline (p< 0.001, both MADRS and CGI-S). Patients showed significant improvement (p< 0.001) during the treatment period based on both MADRS and CGI-S scores. There was no significant difference between the four groups (no comorbidity, comorbid mental disorder, comorbid physical disorders, comorbid mental and physical disorders). However, for both scales, the change from baseline increased with the severity of illness. Patients in the comorbidity groups had slightly higher overall discontinuation rates (8.2% to 10%) than patients without comorbidity (6.9%), with a total of 7.8% (n=308) Discontinuation due to adverse events was 2.3% (n=92).Conclusion:Escitalopram was comparably effective and well tolerated in depressed patients with and without mental and/or somatic comorbidity.
A Randomized and Double- blind Clinical Trial of Venlafaxine Hydrochloride Sustained Release Capsules for Treating Juvenile Depression
Authors: Hongfen C. , Weidong J. , Guoquan Z. , Chuang Y. , Tianyou G. 
Published: March 2009

Object:To evaluate the efficacy and safety of venlafaxine hydrochloride(HCL) sustained release capsules in treating juvenile with depressive disorder.Methods:A randomized, double blind dummy clinical trial enrolled 60 adolescent patients with depression, who were randomizedly designed to administer venlafaxine HCL sustained release capsules 150 mg or fluoxetine 20 mg daily for 8 weeks. The efficacies of both treatment groups was evaluated based on the Hamilton Depression Scale and Clinical General impression Scale pre and post-treatment.Results:The scores of Hamilton Depression Scale at the end of therapy were significantly reduced compared with the baseline in both gtnups (P< 0.O1). The effective rate of venlafaxine HCL sustained release capsules versus fluoxetine treatmlent was 70.0% and 65.5%, respectively, the P value showed no statistical difference (P>0. OS). The common adverse reactions included dry mouth, insomnia, dizziness, and loss of appetite.Conclusion:Venlafaxine HCl sustained release capsules is an effective agent for juvenile with major depression.
The Most Severe Somatic Disorders Treated with Excitaloprim
Authors: Kaludjerovic S. 
Published: March 2009

Almost all of patients treated for cancers, experience episodes of persistent depression. Which moment is the most terrible? The moment patients hear their diagnosis,or time suffer while getting chemotherapy?The time on controls tumor markers or when their relatives give up on them? When mirror reflects damaged body and face. Or felt useless in the presence of their children?•diagnosis of cancers C00,E05 are difficult to accept, and go hand in hand with major depression F33/ according to ICD-10.•why excitaloprim as choice?Patients age 27 to 37 need antidepressant with pharmacokinetic superiority. Excitaloprim works faster than any other antidepressant, and it is strong, thanks to its dual serotonergic bonding on primar part as well as alosteric part bonding. It is weak inhibitor of the well defined liver cytochrome P450 isoenzym, CYP2D6., EEg .EKG is ok, so its safe drug/.In this study, I followed the results of excitaloprim treatment on 30 patients (20 females, 10 males).During 2 months, 20 patients were diagnosed with cancer (mostly colon and breast). All this patients have already been operated. Some have anus praeternaturalis.Other patients have AIDSinitial phase, and autoimmune dg/On Hamilton scale, 45, points, MADRS on 10 items, 40, on Becks scale 65.Zung self rating index o,6. In this project, patients without children were much more suicidal.Cancer patients got 20 mg excitaloprim pro die, other 10 mg pro die. After 2 mothsscales showed statistically important improvements despite severity.
The Comparison Between Therapeutic Effects of Different Classes of Antidepressant Drugs in Treatment of Genetical and Reactional Depression
Authors: Molavi P. , Karimollahi M. , Faridi M. 
Published: March 2009

Background:Depression as a common psychiatric disorder can occur in two types: Endogenous or genetic and exogenous or Reactional. These two types of depression, from the point of view of response speed to treatment and type of appropriate drug for treatment are different. This study has been executed to compare therapeutic effects of different classes of anti-depressant drugs in treatment of genetic and Reactional depression.Materials and methods:Present survey is a clinical-trial study, a completely randomly block type, that has performed on 30 patients (male and female). Selection of study sample accomplished randomly among unipolar depressed patients that has referred to Ardabil’s psychiatry clinic diagnosed based on DSM-IV criteria. Researcher - Made questionnaire, Beck, and Catelle depression test were used to collect data. To analyze data, for completely randomly blocked designs, two-factor variance analysis method and F test were used.Results:This study showed that Genetical depression does not response treatment Rapidly and its response type is not good and persistent. From the point of view of time, Reactional depression has a delaying response but its response type is good and persistent. In addition, no difference was observed in efficacy of different classes of drugs for treatment of these two types of depression. The results of this research showed that there is no difference between treatment response of two types of depression (Genetical and Reactional).Conclusions:There is no preference in efficacy of different classes of drugs in treatment of these two types of depression.
Hepatitis C and Depression - the Effects of Tianeptine
Authors: Martinovic J. 
Published: March 2009

Objective:Infection with the hepatitis C virus is a global problem with the prevalence of around 3%and a tendency of becoming chronic with 75% of the infected people.The latest research indicates that chronic hepatitis C is connected with a higher risk of the beginning of depression.It also indicates that depression is more common with patients who have a chronic HCV infegtion as compared with other liver diseases.Aim:The aim of this study was to evaluate the efficiency of tianeptine in depression treatment of people with chronic hepatitis C.Method:A total of 3o patients with serologically affirmed diagnosis of hepatitis C,aged 30 to 55 years,were included in this study.The level of depression with these patients was measured using MADRS scale.The minimal score value on the MADRS scale during the initial rounds was 25.The patients received 37.5 mg of tianeptine for 8 weeks without the concomitant therapy.Rounds were organized at the beginning of the treatment, after 3 weeks,and after 8 weeks of treatment for all patients.Results:There is a significant improvement in terms of reduction in depression on the MADRS scale with patients treated with tianeptine after 3 and 8 weeks of treatment as compared with the initial rounds.70% of patients treated with tianeptine reduced the score on the MADRS scale, to 15 and lower after 8 weeks of treatment.Conclusion:Tianeptine shows considerably useful effects in reduction of depression symptoms with patients with chronic hepatitis C infection.