bluuebunny/crossref_metadata_2025_split huggingface dataset:
Comparison of the Hypomania Check List-32 scale with the Mood Disorder Questionnaire on Spanish Sample
Authors: Vieta E. , Martinez-Aran A. , Sanchez-Moreno J. 
Published: March 2009

Hypomania is perhaps the most difficult psychiatric syndrome to rule out retrospectively. However, the retrospective detection of hypomania is crucial for a correct diagnosis of bipolar disorder, and particularly bipolar II, and for the implementation of the right pharmacological treatment. Unfortunatelly, still nowadays, the misdiagnosis of bipolar II disorder as unipolar depression is very frequent, and may carry serious consequences for the patients. The availability of a good screening tool for past hypomania episodes would be extremely helpful.The psychometric study of the development of the HCL-32 scale in Spain exhibits high internal consistency and similar stability over time, in comparison with other instruments such as the MDQ and suggests that this scale may be very useful for the detection of bipolar disorder and past hypomania.The results of our study suggest the usefulness of the HCL-32 to screen out previous hypomanic symptoms in psychiatric patients, thus leading to better detection results than with the MDQ, although with the possibility of obtaining more false positives. HCL-32 has been shown to be a useful instrument for the detection of hypomania in patients with an affective disorder. The Spanish version exhibits good psychometric properties in relation to sensitivity and specificity. Given the difficulties involved in both the retrospective and cross-sectional diagnosis of hypomania, a key aspect of appropriate management of bipolar disorders, this questionnaire represents a potential improvement in clinicians’ ability to detect and correctly treat bipolar disorder, and in some aspects such as internal consistency, obtains better results than the MDQ.
Updateon Recent Research with the Hypomania Checklist HCL-32
Authors: Angst J. , Gamma A. , Meyer T.D. 
Published: March 2009

Background:The Hypomania Checklist HCL-32 (Angst et al. 2005) is still in development as a screening instrument for hypomania in depressed patients and as a research tool.Update:The original HCL-32 was slightly modified, omitting one tricky question on consequences (HCL-32 R1) and recently (HCL-32 R2) by adding two new symptoms (gambling and overeating). It is currently available in 27 languages.New investigations include a Europe-wide GAMIAN study, individual studies in Brazil, Tunisia, Lebanon, Turkey, Korea, Taiwan and China, and the ongoing worldwide multicentre BRIDGE study.Results:1.new data have been collected on the re-test reliability in China and Sweden and correlations with the Mood Disorder Questionnaire in Brazil;2.exploratory and confirmatory factor analysis re-confirmed a two-factor structure (elated/overactive vs. irritable/risk taking) of the self-assessed hypomanic syndrome, replicable in over 1500 subjects from the community and patients with mood disorders across all cultures so far analysed;3.total item scores have repeatedly been shown to be independent of the current mood state (normal, low, high);4.adolescents/young adults in love feel high, and score comparably to bipolar-II patients on the HCL-32 (Brand et al 2007);5.89% of bariatric patients were also found to be high scorers on the HCL-32 (Alciati et al. 2007);6.studies with the HCL-32 in subjects with alcohol use disorders (AUD) (previously shown to be strongly associated with bipolarity) are ongoing.Future goals:Trans-cultural comparisons and evaluation of the questions on the consequences of hypomania for case-definition.
Is there a Role for Antipsychotics in OCD?
Authors: Zohar J. 
Published: March 2009

There are actually four types of situations where intervention with antipsychotics might be considered for the treatment of Obsessive compulsive disorder. Obsessive compulsive patients with poor insight (what was previously called ‘psychotic obsession’), schizophrenic patients with OCD, obsessive compulsive patients with tic disorder, and obsessive compulsive patients who did not respond to intervention with an adequate treatment of antiobsessive medication.The data supporting the role of antipsychotic medication in obsessive compulsives with poor insight are not convincing. However, at times the treatment dilemma (antipsychotic or antiobsessive) actually derives from diagnostic ambiguity; many of the very severe ego-syntonic obsessive compulsive patients may be erroneously diagnosed as schizophrenic, while they are actually severe OCD that should be treated with antiobsessive medication and not antipsychotic.The prevalence of OCD amongst schizophrenic patients ranges from 10-25% and has a negative effect on the prognosis for those substantial proportion of schizophrenic patients. Preliminary data implies that for this subset of patient (the schizo-obsessive patients) a combination of antipsychotic and antiobsessive medication might be useful.It is crucial to screen for tic disorder in patients with, OCD as this subset of patients responds (both in terms of obsession and tics) to a combination of typical antipsychotic and antiobsessive medication.Data in regard to augmentation of OCD patients who did not respond to treatment with SSRI suggest that risperidone might have a specific therapeutic potential in this subset of patients. The role of antipsychotics with 5HT1D properties like ziprasidone need to be studied.
The Role of Arts and Humanities in undergraduate Medical Curricula
Authors: Sukhanova E. 
Published: March 2009

This paper will explore possible ways of integrating humanities disciplines in medical education.In today's world, medical students have to learn to understand the social and cultural environment in which medicine is practiced. The humanities have long since have been the principal site of diversity in the academy. Now they can help medical students come to terms with diversity that is the context ot today's medicine.Studies in arts and humanities help recognize the limitations of purely biotechnical approach to patient care, in complex and paradigm-changing ways. Such studies also pave the way for understanding how social assumptions and values play out in healthcare policies. In sum, the humanities provide an additional insight into the human condition, allowing students “to consider human beings in their totality,” in the words of Jean Delay, a pioneer of psychopharmacology who also maintained a literary career throughout his life.Furthermore, humanities contribute to the development of complex interpretive skills, embracing affective aspects of intelligence as much as they embrace conventional rationalist forms of inquiry such as logic, analysis, deconstruction and critique. There is some evidence that medical students who have an additional background in the humanities are less vulnerable to burnout while studying and go on to perform better in important areas of practice. Approaches to developing specific learning outcomes and curricular guidelines will be discussed.
Genome-wide Search for Genes Associated with Memory-related Brain Activation Patterns
Authors: Papassotiropoulos A. , de Quervain D.J.-F. 
Published: March 2009

Background:Human memory is a polygenic trait. Heritability estimates of ~50% suggest that genetic factors have an important impact on this fundamental brain function.Objectives:1.To identify genes and gene-clusters related to memory capacity and to brain activation during memory tasks;2.To translate the findings to memory-related disorders.Methods:A combination of genome-wide association studies (GWAS), candidate gene studies (gene clustering) and functional MRI (fMRI) in independent populations which were carefully tested for episodic memory performance and for the presence or absence of Alzheimer’s disease.Conclusions:Variability of human memory performance is related to variability in genes encoding proteins of important signaling cascades, including NMDA receptor, metabotrobic glutamate receptor, adenylyl cyclase, CAMKII, PKA and PKC. Functional magnetic resonance imaging reveals that this genetic profile correlates with activations in memory-related brain regions. GWAS reveal the existence of novel genes significantly related to human memory performance, brain activation and to the risk for developing Alzheimer’s disease.
Patients with First Episode Psychosis Take More and Stronger Cannabis than Controls
Authors: Di Forti M. 
Published: March 2009

Epidemiological studies have reported that the increased risk of developing psychosis in cannabis users is dose related. In addition, experimental research has shown that the active constituent of cannabis responsible for its psychotogenic effect is Delta-9-Tetrahydrocannabinol (THC) (Murray et al, 2007). Recent evidence has suggested an increased in potency (% TCH) in the cannabis seized in the UK (Potter et al, 2007). We predicted that first episode psychosis patients are more likely to use higher potency cannabis and more frequently than controls.We collected information concerning socio-demographic, clinical characteristics and cannabis use (age at first use, frequency, length of use, type of cannabis used) from a sample of 191 first-episode psychosis patients and 120 matched healthy volunteers. Cases were more likely to be regular users (p=0.05), to be current users (p=0.04) and to have smoked cannabis for longer (p=0.01). Among cannabis users, 86.8% of 1st Episode Psychosis Patients preferentially used Skunk/Sinsemilla compared to 27.7% of Controls. Only 13.2 % of 1st Episode psychosis Patients chose to use Resin/Hash compared to 76.3% of controls (OR*= 7.4 95% CI 3.4- 17.2, Adjusted for age, gender, ethnicity, level of Education and employment status).The concentration of TCH in these in South East London, ranges between 8.5 and 14 % (Potter et al, 2007). Controls (47%) were more likely to use Hash (Resin) whose average TCH concentration is 3.4% (Potter et al, 2007).Patients with first episode psychosis have smoked higher potency cannabis, for longer and with greater frequency, than healthy controls.
Cannabis Abuse at First Episode Psychosis (FEP): Data from Mental Health Centres in Modena and Bologna, Italy
Authors: Tarricone I. , Rossi E. , Pecile D. , Castellani A. , Paparelli A. , Bandieri V. , Ferrari S. , Pingani L. , Di Lorenzo R. , Rigatelli M. , Berardi D. 
Published: March 2009

Aims:To evaluate the clinical and functional effects of cannabis abuse in patients at First Episode Psychosis (FEP) referring to Community Mental Health Centre (CMHC) “Bologna Ovest” and in patients admitted with a diagnosis of psychosis at the Modena Emergency Psychiatry Ward (EPW).Method:All FEP patients, aged 18-35, referring to CMCH “Bologna Ovest” in a 6-years period were evaluated and followed-up at 3 and 12 months. Of the 1559 psychiatric admissions at the Modena EPW in a 3-year period, those with a positive history for substance abuse were selected.Results:Among the 88 Bologna Ovest FEPs, 32% were cannabis abusers (FEP-c). In Bologna, FEP-c were more frequently natives (23.39% vs 31.13%; c sq=5.1; p=0.02) single (26.38% vs 0,0% c sq=7.3, p=0.007) and unemployed (13.50% vs 18.32%, c sq=2.4, p=0.1). Non FEP-c did not use any other drug (0.0% vs 26.1%, c sq=77.5; p< 0.001). A trend towards higher prevalence of hospital admission at follow-up was found for FEP-c (4.20% vs 2.4%, c sq=3.8, p=0.07). 22.0% of patients admitted at the Modena EPW had a positive history for substance abuse: of these, 7% were diagnosed with paranoid schizophrenia, which significantly correlated with the use of cannabinoids (alone or in association).Discussion:Our results enlighten that cannabis use is frequent among psychotic patients admitted to hospital and worsens clinical course of FEP patients, consistently with previous evidence (Hambrecht & Hafner, 1996; Hafner et al., 2004).
Sex-specific Long-term Behavioral and Neuroendocrine Consequences Oftransient Peripubertal Metabolic Challenges
Authors: Patchev A. , Sousa N. , Almeida O. 
Published: March 2009

Interaction between neuroendocrine stress and metabolic signals has become increasingly linked to the pathogenesis of affective and cognitive disorders. Independent evidence shows that nuclear receptors represent an essential interface of communication between these signals and the central nervous system.On the premise that lifelong brain functions are subject to programming by stressful and metabolic signals during early life, we induced voluntary hyperphagia in prepubertal male and female rats by providing them with a cafeteria-like choice between normal chow and foods with high motivational value (palatable, high fat/high energy). The cafeteria diet was withdrawn from one subset of animals during early adulthood (postnatal day, PND 80), and several endpoints of interest were monitored until PND 200. While both sexes displayed similar metabolic outcomes during exposure to the cafeteria diet, there were substantial sex differences in the metabolic, behavioral and endocrine consequences of withdrawal of palatable food. Consistently increased food consumption and body mass gain were recorded in males, whereas females that were pre-exposed to the cafeteria diet showed clear signs of adrenocortical hyperactivity. Thus, besides verification of sex-specific mal-programming of appetitive behavior and metabolic set-points by early life events, we also demonstrate evidence for differential translation of metabolic challenges during peripubertal development into aberrations suggestive of altered neuroendocrine responsiveness to stress.
How Hormones Influence Gene Expression: Implications to the Pathophysiology of Schizophrenia
Authors: Brentani H. , Carraro D. , Mota L.D. , Maschietto M. , Mello H.B. , Torres C.H. , Gama C.S. , Goodman A.B. , Belmonte-de-Abreu P. , Palha J.A. 
Published: March 2009

Schizophrenia is a complex genetic disorder. The lack of concordance on disease manifestation in monozygotic twins provides clear evidence that environmental factors are key determinants in disease aetiology. In accordance, various environmental modulators such as hormones and vitamins may well contribute to the altered expression pattern of several genes identified in post-mortem brain tissue of patients. We constructed a microarray platform containing 1,808 human genes, where 142 belong to vitamin A, thyroid hormone and estrogens’ metabolic pathways, to specifically address whether these could contribute to a molecular signature of schizophrenia in peripheral lymphocytes. We found that the genes encoding for PLP1, UGT1A6, NTRK1, THRAP1, ESR2, TRIP13, MAPK8, TGFB2, IGFBP4 are differentially expressed in lymphocytes of patients under treatment with clozapine, risperdal or haloperidol. Some of these genes have been previously reported by others to be altered in brain regions of schizophrenic patients, and all are implicated in pathways suggested to be involved in the disease. These observations further support that:1.studies in peripheral blood lymphocytes may contribute to reveal candidate genes in schizophrenia;2.transcription modulation of several genes may occur through the mediation of vitamin and hormones, therefore linking genes and environment in schizophrenia.In order to understand the involvement of these genes in schizophrenia, future studies should investigate whether some of the observed changes are replicated in animal models of the disease, and how antipsychotic treatment interferes with their expression.
Geriatric Psychiatry and Human Rights in Romania - Involuntary Treatment
Authors: Tataru N. , Dicker A. 
Published: March 2009

The protection of human rights and the dignity of persons with mental disorders has not a relatively short history in Romania. We have a short review of legislation and of conditions of hospitalization concerning involuntary commitment of the mentally ill people during our history before and after 1989, having more than 30 years experience in the field. Since 1989 it has been necessary to create committees to investigate abuse during involuntary commitment. On the other hand, before 1989 some persons with (or even without) mental disorders were committed to a psychiatry department to protect them. Generally, Romania's legislation is in keeping with principles set out by the World Health Organisation, United Nations and so on, concerning the protection of people with mental illnesses. The legislation calls for adequate treatment and respect for the human rights of the persons with mental disorders.Standards and practice regarding involuntary commitment in a psychiatric department and also involuntary ambulatory treatment of person with mental disorders have been improved since the introduction of the new mental health law in 2002. We discuss about the assessment of competence in the elderly and ethical aspect of care and research, and about involuntary commitment of incompetent elderly patients. We also refer to the complications and difficulties when trying to apply the civil commitments compulsive hospital admission measure. Involuntary commitment of incompetent patients took in the consideration the best interest of the patient, but also the well-being of the family and the potential risk for others.
The European Alliance Against Depression (EAAD): An Evidence Based Cost-effective Approach to Improve Depressed Patients Care and Prevent Suicidality
Authors: Hegerl U. , Network E.A.A.D. 
Published: March 2009

The European Alliance Against Depression (EAAD) is a 4-level, community-based intervention programme to improve the care of depressed patients and prevent suicidality in Europe (1).In 2001, a pilot project, the ‘Nuremberg Alliance Against Depression’, was initiated. This community based intervention program comprised a 4-level action programme, implemented in the city of Nuremberg (500,000 inhabitants) (2). Careful evaluation has provided evidence that this program is effective: the number of suicidal acts was reduced by 24% during the two year intervention compared to a baseline year and a control region (2).Based on these positive results 18 international partners representing 16 different European countries established the ‘European Alliance Against Depression’ in 2004. The EAAD partners initiated respective regional intervention programmes addressing depression and suicidality. Evaluation of the activities takes place on regional and international level.The European Commission listed EAAD as a ‘best practice’ model in its Green Paper (European Commission 2005).
Religion and Spiritual Advice as Surrogate Care Provision for Mental Health Problems in the ESEMED Survey
Authors: Kovess V. , de Graaf R. , Haro J.M. , Bruffaerts R. , Gilbert F. , Briffault X. , Coldony J. , Alonso J. 
Published: March 2009

Objective:To complete missing information on the influence of spiritual and religious advisors as informal providers for mental health problems in Europe.Methods:Recourse to religious practice or belief when coping with mental health problems was evaluated using data from the ESEMED survey. This was a stratified, multistage, clustered-area probability sample survey of mental health carried out in six European countries which included 8796 subjects. Between countries differences in sociodemographic characteristics, religious affiliation, and prevalence of mental disorders and management of mental disorders were evaluated.Results:Religion appears to play a limited role in coping with mental health problems in Europe. Only 7.9% of individuals seeking help for such problems turned to a religious advisor. This proportion differed between countries from 13% in Italy, 12.5% in Germany, 10.5% in the Netherlands, 5.8% in France, 4.7% in Belgium to 4% in Spain. In addition, seeking help exclusively from religion was reported by only 1.3% of subjects. Practicing religion at least once a week and considering religion as important in daily life were predictors of using religion versus conventional health care only. Use of religion was not influenced by gender and age. Non-Christian respondents and individuals with alcohol disorders were more likely to use religion. In Spain, the use of religion is much lower than average.Conclusions:Unlike the situation in the United States, organised religion does not provide alternative informal mental health care in Europe. At best, it could be considered as an adjunct to conventional care.
Development of a European Measure of Best Practice for People with Long Term Mental Illness in Institutional Care (DEMoBinc)
Authors: Killaspy H. 
Published: March 2009

This presentation will give an overview of the aims and progress of the DEMoBinc study. The project aims to develop a toolkit for assessing the living conditions, care and human rights of people with long term mental illness in psychiatric and social care institutions in European countries. The study has been funded for 36 months by the European Commission and started in March 2007. It involves eleven centres across ten countries: UK; Germany; Spain; Czech Republic; Bulgaria; Italy; Netherlands; Poland; Greece; Portugal.The toolkit will assess domains considered most important for service users’ recovery and is designed for use in a face to face interview with the institution manager. The domains have been identified through an international literature review and Delphi exercises in each country with mental health professionals, clients, carers and advocates and agreed by the research partners and an international panel of experts in rehabilitation and recovery. The toolkit will be refined through the course of the study to maximise:a.its reliability;b.its usability;c.its abilityto deliver assessments that can be used within each country's established systems of change at local, regional and national level. The toolkit assessment will also be compared against clients’ quality of life, autonomy and markers of recovery to test whether it can deliver a proxy-measure of the promotion of individuals’ human rights and recovery. In addition, a health economic component will assess the institution's “value for money”.
The DEMoBinc Study in Portugal: Development and First Results
Authors: Cardoso G. , Coelho C. , Caldas de Almeida J. 
Published: March 2009

The DEMoBinc study's main objective is to develop an instrument for assessing the living conditions, the quality of care, and the human rights of long-term mentally ill patients in psychiatric and social residential care. It started on March 2007, with 11 centres and 10 countries participating.The Portuguese centre has carried out a national literature review of mental health legislation, standards of care related with residential care for mental patients, and mandatory procedures for physical restraint and seclusion.A three-round Delphi exercise with four groups of experts - advocates, mental health professionals, service users, and carers - was also developed. In the first round the participants were asked to state the ten more important components of care helping recovery in institutional care for the long-term mentally ill. The results were sent back to be rated for their importance on a 5-point scale. Finally, the participants were asked to confirm or change their own scores in comparison with the calculated group median. Between twelve and 18 participants by group were contacted, and the overall rate of participation was 73%.A pilot study using the first draft of the DEMoBinc instrument was done, and refinement of the instrument is being carried out in twenty institutions and will be completed during the next months.The results of the Portuguese centre on the national literature review, the Delphi exercise, and the first phase refinement of the DEMoBinc instrument will be presented and discussed.