bluuebunny/crossref_metadata_2025_split huggingface dataset:
The Influence of HF-rTMS Treatment on Psychomotor Symptoms in Medication-resistant Depressed Patients of the Melancholic Subtype
Authors: Santermans L. , Vanderbruggen N. , Meers M. , Baeken C. 
Published: March 2009

Aims:Current evidence suggests that high frequency repetitive Transcranial Magnetic Stimulation (HF-rTMS) of the left dorsolateral prefrontal cortex (DLPFC) might be a promising treatment strategy for depression. However, due to rather modest clinical results, the efficacy of rTMS in depressed patients is still under debate. As melancholic depression seems to affect psychomotor activity, in this study, we wanted to evaluate whether HF-rTMS treatment affects psychomotor activity. We also wanted to examine whether the severity of psychomotor retardation could predict clinical outcome.Method:Our group consisted of twenty antidepressant-free unipolar depressed patients of the melancholic subtype. All were considered at least stage II treatment resistant. Depression severity was assessed with the Hamilton Depression Rating Scale (HDRS) and psychomotor symptoms with the Depressive Retardation Rating Scale (DRRS). All received 10 sessions of HF-rTMS delivered on the left DLPFC.Results:Forty percent of the patients showed a reduction of at least 50% on their initial HDRS score and were defined as HF-rTMS responders.The severity of psychomotor retardation, as measured with the DDRS, did not predict clinical outcome. HF-rTMS treatment resulted in significant decreases in DDRS scores for responders as well as for non-responders. However: the better the clinical outcome, the higher the observed level of psychomotor improvement.Conclusion:Our results suggest that HF-rTMS might act on the ‘psychomotor’ level and this might add some further information as to why this kind of treatment can be beneficial for severely depressed patients of the melancholic subtype.
Sociodemographic Profile and Clinical Data of Suicide Attempters from the Emergency Room of the Central Hospital of Asturias (Northern Spain)
Authors: López J.L. , Al-Halabí S. , Díaz-Mesa E.M. , Bascarán M.T. , Bousoño M. , García-Portilla M.P. , Sáiz P.A. , Bobes J. 
Published: March 2009

Objectives:i.To establish the sociodemographic profile of the subjects who attempted suicide in the Health Area IV of Asturias (Northern Spain);ii.To determinate the mental disorders more frequently associated with suicide attempts (SA);iii.To study the relationship between repetition of suicidal behaviour and severity of the SA;iv.To determinate the more commonly used methods for SA.Method:1,633 suicide attempters who attended the Emergency Room of the University Central Hospital of Asturias during the period 2003-2005 were included in the study. Evaluation of these patients was made using the WHO/Euro Multicentre Study Protocol. Psychiatric diagnoses were made following ICD-10 criteria.Results:Sociodemographic data: mean age (SD) = 38.66 (15.13); females: 62%; single: 39.8%; living with their family: 83.8%; lowest educational level: 67%; economically inactive: 33.8%. More prevalent psychiatric diagnoses were affective disorders (24.1%) and anxiety disorders (21.6%). Previous SA were present in 49.2% and 40% repeat the attempt during the monitoring period. Severity of the attempt (lethality of method and intentionality) was related with repetition of the behaviour during the monitoring period (p = 0.001). More frequent methods were overdose (74.8%) followed by cutting (18.5%).Conclusions:SA was more prevalent in a single woman with age between 30 and 50 years who suffering for affective or anxiety disorders. Many of the patients repeat the suicidal behaviour and this was related to the severity of the attempt. Individuals appear to use the methods that are available to them to attempt suicide.
Suicidal Attempts in Primary Care: Prevalence and Correlates in a Tunisian Area
Authors: El Kissi Y. , Amara G. , Bannour S. , Nasr S. Ben , Ali B. Ben Hadj 
Published: March 2009

Aims:This study aimed to determine prevalence and correlates of suicidal attempts in an adult primary care population in Sousse (Tunisia).Method:Sampling followed a stratified multistage probability cluster design from witch a representative sample of adult primary care population of Sousse was obtained. The sample was composed of 1249 subjects aged 18 years or more. Subjects were interviewed by trained clinicians using the Tunisian version of Composite International Diagnostic Interview 2.1.General and clinical characteristics of subjects who had reported previous suicidal attempts were compared with those of the remainder using t test and Chi-2 test.Results:Mean age in our sample was 43.4 ± 17.62 years, with female gender (70.9%) and urban residency (67.8%) predominance. 62.3% of participants were married, 27.3% celibates and 10.4% divorced or widowed. 68.4% of them had low educational level and 70% were out of work during the last 12 months. Suicidal attempts were found in 2.9% of participants. They were correlated to less than 40 years age (p=0.036) and to the diagnosis of major depressive episodes (p< 10-3), recurrent major depressive disorder (p=0.005) and dysthymic disorder (p< 10-3). Among major depressive episodes, only severe ones were associated to higher prevalence of suicidal attempts (p< 10-3).Conclusion:Prevalence of suicidal attempts in Sousse primary care population was 2.9%. It was correlated to low age and to depressive disorders.
Depression, Cognitive Impairment, Somatic Complaints and Disability. Data from the “Faenza Community Aging Study”
Authors: Forlani C. , Atti A.R. , Ferrari B. , Dalmonte E. , De Ronchi D. 
Published: March 2009

Aim:To evaluate the relationship between depression, somatic symptoms, cognitive impairment and disability in an elderly population.Methods:216 subjects (65-84 years) were clinically examined for somatic symptoms, and underwent a mental health examination. Depression was defined by Geriatric Depression Scale scores >11/30; cognitive impairment by Mini-Mental State Examination scores < 24/30; functional status by Instrumental Activities of Daily Living Scale. Associations between depression, cognitive impairment or somatic symptoms and disability were evaluated by logistic regression analyses, estimating Odds Ratios (ORs) and 95% confidence intervals (95%CI) adjusted by sex, age, education.Results:Disability was common among depressed individuals (OR(95%CI)=3.60(1.63-7.96)) and among cognitively impaired subjects (OR(95%CI)=7.35(3.07-17.60)). An increasing number of somatic complaints increased the probability of functional impairment: compared with presence of 1-2 somatic symptoms, complaint of 3-6 and 7-12 symptoms were related to disability with OR(95%CI)=3.30(1.11-9.80) and OR (95%CI)=4.20 (1.17-15.09) respectively. Distinguishing pain, gastrointestinal, pseudo-neurological and general symptoms, only general somatic symptoms (palpitations, fatigue, sleep disturbances) were associated with disability (OR(95%CI)=1.81(1.25-2.62), independently by medical conditions (OR(95%CI)=1.57(0.98-2.52)). An additive effect toward disability was observed when general somatic complaints and cognitive impairment were co-existing (OR(95%CI)=23.68(5.50-101.86)). Including simultaneously cognitive impairment, somatic complaints and depression in the model, only cognitive impairment was still significantly related (OR(95%CI)=5.87(2.66-12.96)).Conclusions:Among many possible causes of disability in the elderly, an important role could be attributed to cognitive deficits.
The Use of Drugs for Mood Disorders in Italy: Preliminary Results [P02-95]
Authors: Carta M. , Aguglia E. , Balestrieri M. , Bocchetta A. , Drago F. , Faravelli C. , Morosini P.L. , Nardini M. , Hardoy M.C. 
Published: March 2009

Background:Some community surveys in Italy have shown that a proportion of subjects without lifetime psychiatric diagnosis (anxiety/depression) used antidepressants. The prescription of AD in bipolar depression appears to be another largely underestimated problem in the clinical practice and is difficult to recognise by means of traditional epidemiological methods (lay interview and structured diagnostic tools).Objectives:The purpose is to use defined and validated international semi-structured interview as diagnostic instrument administered by expert clinicians to evaluate appropriateness and amount of over and under prescription of psychotropic drugs in different Italian community areas. The focus is on general antidepressant use and use in subjects with bipolar disorder and in subsyndromal depression.Methods:Study design: Community survey. Study population: sample randomly drawn, after stratification by sex and age, from the adult population of Municipal records in 6 Italian Regions: about 4000 persons will be interviewed. Tools: Questionnaire on psychotropic drugs consumption, prescription, health services utilisation;diagnostic Structured Clinical Interview np version;Mood Disorders Questionnaire; Short Form Health Survey. Ethical aspects: a signed informed consent for each candidate. The study was approved by the ethical committee of theItalain National Health Institute.Expected results:The study aims to identify the frequency of over and under prescription of psychotropic drugs in different Italian regions and the determinants of prescription related to physicians, patients, comorbidity and symptoms and to establish the basis for a cohort prospective study to assess the future changes.
Evidence Supporting the Historical Context for Current Views on Unmet Need in Child and Adolescent Mental Health [P02-96]
Authors: Wilkes T.C.R. , Cawthorpe D. 
Published: March 2009

Objective:In over 60 years little has changed in children's mental health and the flag waving continues: It is time for action in the trenches. It is imperative to focus health policy on the need to provide basic mental health succor to children and their families. A failure to alter the situation related to children's mental health will no doubt have catastrophic consequences for our society. We review the level of progress made in reforming regional mental health services since 2002.Methods:Using population-based representation of regional service utilization capacity permits comparison of regional, provincial and national rates of child and adolescent mental disorder.Results:Regional services in the last 6 years have served at most approximately 1% of the 0-18 year old population annually. This rate represents an increase from about 0.6% in 2002.Conclusions:Rationing the scant professional resources that exist to serve children's mental health will become increasingly difficult. For example, it is estimated that three percent of 0-18 year-olds are estimated to suffer a debilitating mental problem. Implication for policy are that our results point to service gaps in need of immediate policy development to meet basic needs of children. Several strategies are considered.
Monitoring of the Metabolic Syndrome in Psychiatric Inpatients
Authors: Cordes J. , Regenbrecht G. , Agelink M.W. , Zielasek J. , Kahl K.G. 
Published: March 2009

In this naturalistic observational study carried out in an inpatient treatment setting we as yet surveyed the parameters of the metabolic syndrome. A weekly monitoring procedure was implemented. The analysis included data of 350 patients over a time of 12 weeks. The last observation carried forward method was applied. Additionally we are evaluating the informative value of visceral body fat percentage as measured by a body composition analyzer. The patients showed a weight increase over the first 12 weeks (mean increase: 0.87 kg, p < .001) as well as an increase of the body mass index (mean increase: 0.45 kg/m2, p < .001). Accordingly, waist circumference (mean increase: 1.06 cm, p = .007) and visceral fat index (mean increase: 0.19, p = .007) increased. No worsening of fasting glucose and blood lipid concentrations was detected. Spearmens coefficient indicated correlations between visceral fat index and body mass index (ρ = .77; p < .001), waist circumference (ρ = .70; p < .001), and triglyceride concentrations (ρ = .39; p < .001). Correlations between visceral fat index and fasting glucose (ρ = .18; p = .019), and visceral fat index and total cholesterol (ρ = .16; p = .049) were weak but also significant. In contrast, the HDL cholesterol showed a negative relation with ρ < -.39 at each point in time (p < .001).We conclude that psychiatric patients are at increased risk for the development of metabolic alterations during inpatient treatment. The possible underlying mechanisms of this interaction are discussed.
Psychiatric Inpatient Readmission in a General Hospital: Preliminary Report of a Two Years Observational Study
Authors: Guerreiro D. , Navarro R. , Telles D. , Martins P. , Trigo E. , Silva M. , Carvalho M. , Gois C. 
Published: March 2009

Introduction:Studying inpatient clinical population's features allows a better understanding of readmissions. Factors associated with higher levels of readmission may give clues concerning better treatment planning and follow-up.Objectives:To detect psychosocial and clinic factors associated with readmissions in an inpatient general psychiatric population.Method:107 patients consecutively admitted to an inpatient unit were characterized in terms of psychosocial, clinical, treatment and discharge plan features. Readmission was defined as the number of previous admittances in the last two years.Results:Patients characteristics: Average age 44 (SD: 16); 58% female; 10 (SD:5) years of education; average disease duration of 128 (SD:115) months. Main diagnosis: 30,8% schizophrenia; 14% bipolar I disorder; 13,1% major depression; 11,2% recurrent major depression; 5,6% cluster B personality; 3,8% bipolar II disorder and 2,9% schizoaffective disorder. From more to less frequent diagnosis implicated in readmissions were schizophrenia, schizoaffective disorder, recurrent major depression, bipolar I, bipolar II and major depression episode. Readmissions were not associated with inpatient treatment or disease duration, nor toxics or axis II diagnosis. Nonetheless, beginning a depot antipsychotic medication was related to an increase in previous admissions.Conclusion:These are preliminary results of a small sample, but they point towards the usefulness of a systematic evaluation of inpatient populations, mainly in what concerns complex clinical situations like major pathology readmissions.
Psychiatric Comorbidity in Children and Adolescents with High Functioning Autism
Authors: Herguner S. , Motavalli N. 
Published: March 2009

Aim:The present study aimed to investigate psychiatric comorbidity rates and patterns in a sample of clinically referred school-aged children with High Functioning Autism (HFA).Method:All cases were taken from children and adolescents who consecutively referred to Istanbul Faculty of Medicine, Department Child and Adolescent Psychiatry, Autism Unit. Participants were 30 children and adolescents (29 male, 1 female), aged 6-15 (10y 2m ± 2y 2m) year-old, who met DSM-IV criteria for Autistic Disorder and had a Performance IQ over 70 on WISC-R. Psychiatric comorbidity was assessed using the Schedule for Affective Disorders and Schizophrenia for School Age Children-Present and Lifetime Version (K-SADS-PL).Results:90% (n=27) of the children had at least one comorbid psychiatric disorder, and 76.6% (n=23) had two or more. In 76.6% (n=23) of the cases at least one Anxiety Disorder was present, and in 63% (n=19) of the children criteria for at least one Disruptive Behavior Disorder was met. The most frequent Axis I psychiatric diagnoses were ADHD (60%), SP (53.3%), Oppositional Defiant Disorder (30%) and OCD (20%).Conclusion:A very high rate of psychiatric disorders was detected in a small group of clinically referred children and adolescents with HFA. These results underscore the importance of detailed assessment of behavioral and emotional problems in ASDs.
Children of Psychiatric in-Patients - Prevalence, Psychiatric Symptoms and Obstacles for Professional Support
Authors: Koelch M. , Schmid M. , Fegert J.M. 
Published: March 2009

Aims:Children of mentally ill parents are at high risk to develop psychiatric disorders. Psychiatric disorders often limit parenting skills and there are obstacles to accept professional help for the children. The study aimed to explore the prevalence of mentally ill parents in inpatient treatment, emotional and behavioural problems of their children, access to support for their children and obstacles for receiving support.Method:Inpatients of psychiatric hospitals of a county were examined by questionnaires (amongst other scales the Strengths and Difficulties Questionnaire (SDQ).Results:104 patients with children were detected, 81 patients with 165 children were enrolled. Most of the patients had more than one child and most of them had more than 3 prior inpatient treatments. Results in the SDQ indicated an up to fife fold increased number of children with emotional/behavioural problems compared to non-psychiatric samples. Even it 40% of the patients were dissatisfied with the care of their children during treatment, they seek seldom professional help. 51% have strong resentments against the youth welfare custodies. 55% quote that they cancelled or missed former inpatient treatments because of the inadequate nurturance of their children.Conclusion:Identification of children with need for professional support can be improved by using standardized questionnaires. Study results imply that psychiatrist should focus on parenthood of their patients and specialised offers of support are needed.
Is There Social Markers for Depression? Analysing the Portuguese Example
Authors: Mateus M. , Silva C. , Nogueiro O. , Redondo J. 
Published: March 2009

Sociologists and anthropologists have long been engaged to study the changes in society, over time. This is particularly true since the end of the nineteenth century and beginning of the twentieth century, heights of history, that caused profound changes in the forms of relationships between men, in family scale and in the society itself. The industrial revolution, the exodus to the city, the emancipation of women, the world wars, the creation of the European economic community, the mass media and consumerism, have profoundly altered the social networks and engagement in which man lived since ancient times. The authors aim to address this issue, by trying to understand the behavioral changes that were needed to adapt to this new structure of society and in what way they were responsible for the loss of mechanisms of cooping, with the anti - social behaviour, with stress and depression.The Portuguese example is finally exploited, given the most significant changes in the last century, as the fall of the monarchy, the instability of the early republic, the dictatorship, the colonial war, the April 25, the entry into the EEC.
Day Hospital and Then…follow-up Two and a Half Years After the Hospitalization
Authors: Pedrosa R. , de Sousa V. Teixeira , Marques J. , Martins A. , Domingues I. , Moura L. , Curral R. , Torres A. Roma 
Published: March 2009

Psychiatry Day Hospitals deal with a wide spectrum of disorders, being responsible for a psychosocial intervention that intends to improve patient's quality of life. The Psychiatry Day Hospital Department of Hospital de São João has thirty-eight years of activity, and has been one of the first in Portugal. The aim of this Psychiatry Unit, composed by a multidisciplinary team, is to prevent relapses and rehospitalisations, promoting the patients’ social rehabilitation, building a bridge between inpatient hospitalization and their re-entry into the community.The primary objective of this cross-sectional study was to evaluate important aspects of service's quality, such as the use of health resources and results in functional terms. The authors made the follow-up of the patients that had been admitted in 2005 (Jan 2005 - Dez 2005; n= 77). For this purpose, it was assessed the number of attendances to the Emergency Department and hospitalizations two and a half years before and after the treatment in Day Hospital. It was also compared their current employment situation to that which preceded the Day Hospital care.This study was performed in clinical setting among a reduced sample, with the inherent limitations. It would be appealing to replicate this investigation in a larger population and including some other variables.
Choice of Psychotropic Drugs Used for Intentional Drug Overdose
Authors: Tournier M. , Grolleau A. , Cougnard A. , Molimard M. , Verdoux H. 
Published: March 2009

Objectives:To assess with which frequency subjects with intentional overdose of psychotropic drugs ingest their own psychotropic drug treatment, and whether prescription of a drug may be a factor influencing the choice of drugs used for the IDO.Methods:Demographic characteristics, psychiatric history, and currently prescribed psychotropic drug treatment were collected for all the patients (n=1654) admitted to an emergency department (ED) for IDO with psychotropic drugs (anxiolytics, hypnotics, antidepressants, antipsychotics and mood stabilizers) over a period of 18 months.Results:Two-thirds of the patients ingested during the IDO at least one of their own prescribed psychotropic drugs. Compared with the subjects who had ingested psychotropic drugs not prescribed for them, they were more likely to have a history of psychiatric hospitalization (OR 4.2; 95%CI 3.1-5.5), of parasuicide (OR 2.5; 95%CI 1.9-3.3), to be a psychiatric outpatient (OR 3.9; 95%CI 3.0-5.1), and to present with a serious IDO (OR 2; 95%CI 1.4-2.9). Independently from age and psychiatric hospitalization history (i.e. the seriousness of psychiatric disorder), they ingested during the IDO more often antidepressants (OR 4.4; 95%CI 3.0-6.4), antipsychotics (OR 2.9; 95%CI 1.7-4.8) and mood stabilizers (OR 4.1; 95%CI 1.6-10.7). No association was found with prescription for overdose of benzodiazepine or paracetamol.Conclusion:Prescription of the psychotropic drugs plays an important role in the choice of the drugs ingested for the IDO. It might make potentially “dangerous” drugs available for the patient. Physicians have always to balance the benefit of the treatment against the risk of drug overdose.
Expert Evaluation of «Another Unhealthy Conditions»
Authors: Danilova S. 
Published: March 2009

Patients who have had chronic mental disorders, another unhealthy conditions, mental retardation are considered to be irresponsible. Special interest represent is disorders, which expect as “another unhealthy conditions”. Mental disorders consider without process basis (pathokinesis have has chronic or acute psychosis), dementia. Another unhealthy conditions is quality differences from mental standard, but it does happen expressive that does irresponsible.56 men have been examined in the department of Personality Disorders and psyhogenias. Age: 20-60 years old. Disorders experts as “another unhealthy conditions” includes of the Classification ICD-10: Personality Disorders (F 60 - F 61), organic Personality Disorders (F 06.3 - F 07.9), mentally retardness of slight degree with breach of behaviour (F 70.1). Diagnosis of Paranoid Personality Disorder and Schizoid Personality Disorder were most common.Analysis of expert evaluation is show that it is necessary to estimate psychological criteria of irresponsibility. Analysis of pathological symptoms, structure of personality and cognitive disorders, disposition of crime, situational and motivational factors are show that it is necessary to estimate a depth of mental pathology, disturbance of critical abless and defects of personality and intellectual functions to expects conclusions of irresponsibility.