bluuebunny/crossref_metadata_2025_split huggingface dataset:
Subjective Cognitive Impairment: Functional MRI During Divided Attention and Measurement of Amyloid Load Using 11C-PIB PET
Authors: Rodda J. , Dannhauser T. , Cutinha D. , Okello A. , Shergill S. , Brooks D. , Walker Z. 
Published: March 2009

Background:Evidence suggests that healthy older adults with subjective memory complaints are at increased risk of dementia. Subjective Cognitive Impairment (SCI) may precede Mild Cognitive Impairment (MCI) in the clinical continuum of Alzheimer's disease (AD). Attentional deficits may be present early in AD, and associated functional changes have been reported in both MCI and AD. In the present study, activation during divided attention in SCI subjects was investigated using functional magnetic resonance imaging (fMRI). Additionally, amyloid uptake was investigated using 11C-PIB with positron emission tomography (PET).Methods:Brain activation in 11 SCI subjects and 10 controls was compared during a divided attention task using fMRI. Additionally, five SCI subjects and 14 cognitively normal healthy controls underwent 11C-PIB PET scanning. Criteria for diagnosis of SCI were:1.self-reported memory complaints,2.objectively normal cognition on detailed neurocognitive testing,3.absence of psychiatric or causative physical illness,4.normal activities of daily living and5.absence of MCI or dementia.Results:There were no differences in performance between SCI and control groups in terms of cognitive or behavioural measures. However, SCIs had increased activation in left medial temporal lobe, and bilateral thalamus, posterior cingulate and caudate. One SCI subject and one control subject had a pattern of 11C-PIB uptake similar to that seen in AD.Conclusions:The activation changes identified in SCI may relate to compensatory increased activation in the face of early AD pathology. Larger, longitudinal studies are needed to determine the extent and significance of PIB uptake in SCI.
Dissociative Disorders - Clinical Manifestation and Management
Authors: Prasko J. , Raszka M. , Pastucha P. 
Published: March 2009

Dissociative disorders are heterogeneous group of mental disorders with dissociation as dominant symptoms. Dissociation is often defined as partial or total disconnection between memories of the past, awareness of identity and of immediate sensations, and control of bodily movements, often resulting from traumatic experiences, intolerable problems, or disturbed relationships. Etiopatogenezis of dissociative disorders have not exactly known yet. The process of dissociation is independently associated with several distressing conditions such as psychiatric diagnoses, somatization, current psychological distress, and past sexual and physical victimization. The disturbance may have a sudden or gradual onset and may be temporary or chronic in its course. Dissociation has a negative impact on treatment oucome. Additionaly, dissociative patients may have an insecure attachment pattern negatively affecting the therapeutic relationship. Conceptually, the course of treatment is to improve coping, maintain reality, and establish normal integrative functions. Goals:1.improve thought processes;2.maintain a sense of reality;3.improve coping skills;4.develop stress management abilities;5.increase identity integration.The treatment is possible with psychotherapy or pharmacotherapy or both. We will introduce the CBT approach. Participants will learn:•pharmacological possibilities in the treatment of dissociative disorders;•CBT model of dissociative disorders;•motivational interviewing with dissociative patient;•how to develope therapeutic relationship with dissociative patient;•conceptualization of dissociative disorder with the patient;•Socratic questioning;•working with cognitive, emotional and behavioral avoidance;•exposure technique with dissociative problems;•problem solving.Supported by the research project IGA NR 9323-3.
The phenomenology of acute THC-psychosis
Authors: Morrison P. , Kapur S. , Murray R. 
Published: March 2009

It has long been known that cannabis can elicit an acute psychotic reaction. Recent work shows that, of the 60 cannabinoid molecules in the plant, delta-9-tetrahydrocannibinol is responsible for the central effects of cannabis. Here we aimed to investigate, in more detail, the psychological effects of synthetic intravenous THC in healthy subjects. Over 2 experimental sessions, participants (N=22) were administered 2.5mg IV THC or placebo under randomised, double-blind conditions. Psychological reactions were assessed using standard rating instruments and a battery of cognitive tests was completed.Following THC, there was a significant increase in self-rated and observer-rated positive psychotic symptoms which were highly correlated (r=0.62, p=0.001).Phenomena centered on de-synchronisation of self-agency (ipseity disturbance) and hypersalience/paranoia. Participants also reported a significant increase in negative symptomatology under THC conditions, which was not explained by sedation. Finally, working memory/executive functioning was markedly and consistently impaired by THC.Here we provide further evidence that THC can elicit an acute psychotic reaction in a proportion of healthy subjects. Acute THC-psychosis elicits positive, negative and cognitive symptoms. Compared with other drug models THC recreates symptomatology across 3 major dimensions of schizophrenic psychosis without sedation/clouding of consciousness. Here we also present preliminary evidence that the molecule cannabidiol (CBD) inhibits THC-elicited positive symptoms. Current work in our laboratory is exploring the underlying mechanisms.
Gender Specific and Structured Approach to Violence Risk Assessment - the Munich Prognosis Project (MPP)
Authors: Nedopil N. 
Published: March 2009

A clear structured approach to violence risk assessment that is both, evidence-based and gender specific- is high on the political and mental health agendas. The individual risk of perpetrators depends on several parameters that are incorporated into assessment instruments. Most data about risk factors included in risk assessment instruments were derived only on male offenders.This study is part of Germany's biggest risk assessment study, -the Munich Prognosis project (MPP) - and focuses on factors included in risk assessment instruments associated with criminal and violent recidivism in a sample of male and female delinquents referred for forensic-psychiatric evaluation prior sentencing. The predictive validity of four instruments (HCR 20, ILRV, VRAG and PCL-R) for violent and general repeat offenses was analyzed.When comparing the predictive validity of the four instruments for male offenders, the results were in favor of the PCL-R, i.e. PCL-R Factor 2 when focusing on violent recidivism.For female offenders ROC analysis found superior results of the HCR 20-R items (AUC .793 p< .05), the ILRV D variables (AUC .814), p< .05) and the VRAG (AUC .864, p< .05) for violent recidivism. They were in favor of the PCL-R Factor 1 (AUC .666, p< .05) when focusing on general recidivism.The importance of gender specific violence risk assessment will be discussed.
The Role of Intuition and Prognostic Risk Assessment Regarding the Leave of Offenders with Mental Disorders
Authors: Schmitt C. 
Published: March 2009

The granting of leave during terms of imprisonment plays an important part in the treatment of mentally ill offenders. According to German law, leave is to be granted in those cases where the abuse of this privilege or an attempt to flee can be negated. These regulations also, however, imply that the risk assessment of a patient's offence-related recidivism can not be the only criterion for the granting of leave.So far, there have only been few studies about the prognostic risk assessment of the general abuse of leave. This is rather astonishing, as the granting of leave outside the institutional grounds, in particular, is a decision which often leaves those responsible fraught with anxiety. Furthermore, the abuse of a granted temporary release can lead to severe consequences on various levels.As part of a study to be conducted in the German state of Rhineland-Palatinate, decisions about granting leave are to be analyzed and possible predictors of the abuse of leave are to be examined.It is assumed that the abuse of leave is likely to be motivated by the conditions of particular situations and can primarily be explained by normal psychological factors.However, it should be pointed out that, as the abuse of leave is such a rare occurrence, it poses a significant methodological problem. The criterion to be examined therefore needs to be exactly defined and particular attention must be paid to achieve an adequately high interreliability of the decision makers.
Philosophical Interpretations and Existential Effects of Hallucinations
Authors: de Haan S. 
Published: March 2009

Within philosophy, hallucinations have served as a paradigmatic test-case for epistemology in general and for theories of perception in particular. The differentiation of hallucinations from “real-life-perception” poses some interesting problems. Here, I will focus on two opposing views: first the view of hallucination as a failure of a metacognitive ability, and second a phenomenologically based view of hallucinations as a disturbance of experiential world-directedness.Our theoretical understanding of hallucinations however, should take the highly unsettling existential effects on the patients themselves into account as well. As one admits to have experienced a hallucination, this calls into question one's entire capability of perception in general. For how can one be sure not to be hallucinating again? The loss of a basic trust in one's own senses can be so stressful as to aggravate the existing symptoms. These existential effects show that perception cannot be taken as a singular faculty and strengthen the phenomenological approach to hallucinations.
Thyroid Hormones and the Psychomotor Development of the Newborn
Authors: Ares S. , Quero J. , de Escobar G. Morreale 
Published: March 2009

Iodine is a trace element which is essential for the synthesis of thyroid hormones. If maternal iodine deficiency in pregnancy is severe, fetal brain damage will occur. This damage is irreversible after birth. Mild/moderate iodine deficiency during pregnancy and early postnatal life is associated with neuro/psycho-intellectual deficits in infants and children. The severity is not only related to the degree of iodine deficiency, but also to the developmental phase during which it is suffered, the most severe being the consequence of iodine deficiency during the first two trimesters of pregnancy. The close involvement between human brain development and thyroid hormones is widely accepted. The effects of T3 on the central nervous system are mediated by the regulation of the expression of genes that synthesize proteins implicated in cerebral neurogenesis, neuronal migration and differentiation, axonal outgrowth, dendritic ontogeny, and synaptogenesis. They are also necessary for cerebellar neurogenesis (predominantly during early postnatal life), gliogenesis (predominantly during late fetal life to 6 months postnatally), and myelogenesis (during the second trimester of gestation to 2 years of postnatal life). From clinical studies on the effect of iodine deficiency of both mother and fetus it becomes clear that T4 is required for brain development during gestation.Low T4 levels during neonatal life could be a negative factor contributing to the neurodevelopmental problems of very preterm infants. Indeed, retrospective studies have shown a relationship between hypothyroxinemia and developmental delay and an increased risk of disabling cerebral palsy.
Markers of Oxidative Stress in Bipolar Disorder and in Schizophrenia
Authors: Gama C. 
Published: March 2009

There has been strong evidence in recent years that oxygen free radicals may play an important role in the pathophysiology of schizophrenia and bipolar disorder. More recent evidence of altered antioxidant defenses in major mental illnesses has been accumulating. Much of the focus on antioxidant defense mechanism has been on the key scavenging antioxidant enzymes: Superoxide dismutase (SOD), Catalase (CAT) and Glutathione peroxidase (GSH-Px). Of these, SOD activity has been the most frequently examined.The imbalance between antioxidant and oxidant mechanisms increases what is called oxidative stress, when the oxygen free species react and could damage lipids, proteins, carbohydrates and DNA. Lipids are the main compound of cellular membrane and the oxygen free radicals reaction to them is called lipid peroxidation. Several plasma lipid peroxides, like MDA, are measured by Thiobarbituric acid reactive substances (TBARS). Increased levels of TBARS have been reported in the plasma of drug-free and medicated bipolar disorder and schizophrenic patients. It is hypothesized that psychotic symptoms seen in both disorders might be a consequence of peroxidative injury to membrane phospholipids. Moreover, neuronal functioning is affected by this injury either by changes in membrane fluidity or by alterations in membrane receptors, which can cause neurotransmitter uptake and release impairment and even cell death.
New World of Mental Health Legislation England and Wales David Jolley and Reinhard Heun
Authors: Jolley D. , Heun R. 
Published: March 2009

After eight years of tortured negotiations between government, professional psychiatrists and lay pressure groups, England and Wales will begin to use new Mental Health Legislation November 2008. This will not be a new Mental Health Act, but a substantial modification of the 1983 act. There are nine key changes:1.A single definition of mental disorder: ‘any disorder of mind or brain’.2.Criteria for compulsion: ‘appropriate medical treatment’ test.3.Age-appropriate services: special arrangements for under 18 years.4.Professional roles: approved clinicians and responsible clinicians (non-medical).5.Nearest relative: recognises Civil Partnerships, allows displacement.6.Supervised Community Treatment Orders.7.Mental health Review Tribunal: unified.8.Advocacy: Independent Mental Health Advocates.9.ECT: new safeguards.The Code of Practice identifies five key principles:1.Purpose - to minimise adverse effects of Mental Disorder.2.Least Restriction.3.Respect - diverse needs, values and circumstances.4.Participation - involving patient in planning, developing and reviewing treatment and care.5.Effectiveness, efficiency and equity - optimal use of resources.Earlier drafts had been described as: ‘little more than a Public Oder Bill dressed up as Mental Health legislation’; ‘ethically unworkable and practically unworkable’. Much of the dissent related to suggestions that people with Personality Disorder behaving in a dangerous or antisocial way should be subject to compulsory detention. Fears included breach of liberties and Human Rights and transformation of Mental Health Services disadvantaging people with major mental illnesses.
Depressive Disorders in Portugal: EAAD and the Depanx Project Regional Baseline Data and the WMH Survey National Data
Authors: Gusmão R. , de Almeida J.M. Caldas 
Published: March 2009

Firstly, recent data on depressive disorders and suicidality burden in Portugal is presented and treatment gap is stressed as well as the insufficient information until recent years (1).At the national level, the first epidemiological study on psychiatric disorders embedded within the World Mental Initiative Survey is ongoing and prevalence and needs for care data will be presented.Implementation process of the EAAD 4-level intervention in Portugal is ongoing along with restructuring of both liaison and specialized mental health care on a regional sector of 350.000 inhabitants with a mental health specialised care department and four large primary care health centres, where liaison between 4 mental health teams and 200 GP was taking place accordingly with varying models (substitute care in most) and different clinical criteria for admission and follow-up.The restructuring of mental health teams and their missions implied that while a set of sub-teams stood responsible for severe mental disorders, another subgroup was deemed to comply exclusively with common mental disorders and primary care liaison aided by standardisation of clinical criteria for referrals evaluation and reply, specialised therapeutic interventions, as well as collaborative stepped care.Baseline and some outcome data on suicide and depression will be presented such as rates, psychopharmacological prescriptions, general population knowledge and beliefs, media reporting, and pre and post training evaluation of primary care professionals.
Promoting Recovery for People with Long-term Mental Illness in Institutional care: An International Delphi Study of Stakeholder Views
Authors: Turton P. , Wright C. , White S. , Killaspy H. 
Published: March 2009

Aims:To identify the specific components of care that key stakeholders in ten European countries at different stages of de-institutionalization regard as most important in promoting recovery in this group; to measure consensus between and across stakeholder groups and countries; and to develop a conceptual framework of ‘domains’ of care.Method:Each participating country completed a series of conventional three-round Delphi exercises with four separate panels of experts; service users, mental health professionals, carers and advocates. In Round 1 an initial open question asked respondents to identify up to 10 components of care they considered most important in promoting recovery. In Round 2 these ideas were fed back to the group and rated on a 5-point scale. In Round 3 the group re-rated the components in the light of information about the whole group's response. Components achieving high importance rankings and high consensus were grouped into domains.Results:The 40 participating panels generated around 4,000 separate items of care. From these, eleven broad domains of recovery practice were identified. Results will be presented descriptively to show the domains and components of care considered to be most important to recovery, and to show consensus within and across countries, and between stakeholder groups. It will be seen that there was generally high consensus between groups and countries but some modest differences in priorities.Conclusions:Delphi methodology is useful in eliciting and evaluating different perspectives on recovery-based practice. Strengths and weaknesses of the approach will be discussed.
The Development of the DEMoBinc. Toolkit and the Results of Reliability Testing
Authors: Taylor T. , Killaspy H. , King M. , White S. 
Published: March 2009

Aims:To develop a toolkit to assess the quality of institutionalised care, in both hospital and community settings, for individuals with long-term mental illness.Methods:The toolkit was developed by the UK research teams. Items were included to assess the six domains (Living Environment; Therapeutic Environment; Treatments and Interventions; Self-management and Autonomy; Social Policy, Citizenship and Advocacy; Clinical Governance) and three cross-cutting themes (Social Inclusion; Human Rights; Recovery-based Model) which emerged from the international literature review, Delphi exercises and cross-country care standards. Following translation and piloting in each country, the toolkit was refined and tested for reliability in 20 units in each country (a total of 200 units).Results:Test-retest reliability was assessed using intra-class correlations and Cohen's Kappa coefficients. Factors with low reliability or extreme response biases were dropped. Remaining items were subjected to an exploratory factor analysis to test the allocation of items to domains and cross-cutting themes and improve their internal consistency. Correlations between domains were explored to determine whether or not domains could be combined.In the next phase of the study,the toolkit domain ratings will be analysed for associations with standardised assessments of service users' quality of life, autonomy and markers of recovery to investigate whether the toolkit can provide a proxy measurement of the institution's promotion of human rights and recovery.
Neurobiology of Affective Disorders - Insights from Pet Imaging
Authors: Hietala J. 
Published: March 2009

Recent brain imaging studies indicate subtle functional and also structural brain changes in affective disorders. We report specific neurotransmitter receptor findings in vivo in major depression testing directly the ‘old’ monoamine and also newer peptide neurotransmitter hypotheses of unipolar major depression.Positron Emission tomography imaging demonstrates relatively consistently a widespread reduction of brain serotonin 5-HT-1A receptors in drug-free or never-treated patients with clinical depression. The reduction of 5-HT-1A receptors is not confined to frontal or temporal cortex but seem to be widespread including multiple brain regions. Our data shows that the 5-HT-1A receptor finding seems to be robust even in primary care patients with mild/moderate depression. Pilot findings in our laboratory suggest that this alteration can be ‘normalized’ with a psychotherapeutic intervention. Substance P NK1 receptors appear not to be altered in never-medicated MDD patients. However, HAM-D total scores correlated positively with NK1 receptor binding in neocortical as well as limbic brain areas suggesting a modulatory role for NK1 receptors in major depression.Our results indicate specific neurotransmitter changes in clinical depression that could also represent therapeutic targets but the specificity of these findings e.g. in relation to anxiety disorders (or comorbid conditions) needs to be explored further.
Imaging Usual Addictions: Tobacco, Canabis and Alcohol
Authors: Leroy C. , Chanraud S. , Artiges E. , Martelli C. , Cachia A. , Andoh J. , Kostogianni N. , Berlin Y. , Reynaud M. , Aubin H.J. , Trichard C. , Martinot J.-L. 
Published: March 2009

Background:Brain models of drug addiction are being tackled in humans, using PET and MRI.Results:1.Whereas tobacco and cannabis do not interact directly with dopamine sites, positron emission tomography detected lower availability in sites regulating the catecholamines homeostasis, notably in dopamine transporter sites in striatal and in extrastriatal regions. This further supports repeated and long term substance use progress towards an adaptative diminished basal dopamine level that would contribute to the switch to an addicted brain.2.Alcohol: abnormalities in brain macro- and micro- structure were searched in detoxified alcohol-dependents with preserved psychosocial functioning:-Brain function (fMRI): fronto-cerebellar overactivation detected during an auditory language task in alcohol-dependents may reflect the compensatory effort required for patients to maintain the same level of performance as controls.-Brain macrostructure (MRI). Widespread lower white matter volumes, and lower grey matter volumes in the frontal lobe, insula, hippocampus, thalami and cerebellum, were detected. Poorer neuropsychological performance correlated with smaller grey matter volumes in these regions and with lower white matter volume in the brainstem.-Brain microstructure (DTI): tractography of white matter fiber bundles revealed that brainstem bundles alteration may contribute to cognitive flexibility impairment. Regression analyses showed memory scores were related to brain microstructure in parahippocampal areas, frontal cortex, and left temporal cortex. This suggest diffusion imaging (DTI) is a useful probe to early alcohol-induced brain alterations.Conclusion:While indices of dopamine down-regulation are consistency detected in several drug addictions, even “socially-adapted” alcohol dependence may induce change in brain structure.Psychol Med. 1998 28:1039-48.Neuropsychopharmacology. 2007 32:429-38.IEEE Trans Med Imaging. 2007 26:553-65J Nucl Med. 2007 48:538-46.Neuropsychopharmacology (Chanraud S et al., 2008 Jul 9. [Epub ahead of print]).J Clin Psychopharmacol (Leroy C et al, in press).