bluuebunny/crossref_metadata_2025_split huggingface dataset:
Telepsychiatry - When Resources are Short
Authors: Mucic D. 
Published: March 2009

“Telepsychiatry” refers to video conferencing (interactive audio-video link in real-time where patient and doctor can both see and hear each other at the same time). Limited access to clinicians that have similar cultural and ethnic background decrease speed and accuracy of diagnosis and treatment (especially psychotherapeutic intervention). One solution to this problem is to give refugees, migrants and asylum seekers access to ethnic specialists by using Telepsychiatry.4 stations have been established in Denmark during pilot project in periode 2005-2007. The equipment has been installed in two hospitals, one asylum seekers centre and one social rehabilitation institution.Participants were mentally ill refugees, migrants and asylum seekers. 61 participants were involved in the assessment and/or treatment through 318 telepsychiatry provided remote consultations. They received mental health care by video-conferencing from providers who spoke participants ‘own language, i.e. without the assistance of interpreters.All participants were asked to fulfil 10-items satisfaction questionnaire after the end of Telepsychiatry contact. The most of participants would prefer treatment via Telepsychiatry than via interpreter.Aside from cross cultural patient population, Telepsychiatry can be used in order to provide mental health care towards domestic population in rural and remote areas with resource shortage.
Cannabis and Psychosis
Authors: Crome I.B. 
Published: March 2009

Aim:This contribution will explore UK-based research developments in substance misuse and mental illness over the last 20 years.Methods:The main body of work revolves around research largely, but not only, funded by the Department of Health from the late 1990s. Early research revolved around alcohol, especially alcoholic hallucinosis: the relationship with schizophrenia-like illness was examined and the conclusion at that time on the basis of twin, family and clinical studies, was that very few cases did develop into schizophrenia. More recently, large general population epidemiological, and medium or small scale clinical studies, have been undertaken on the relationship between substance misuse (sometime specifically on cannabis) and the later development of mental illness especially psychosis.Results:The presentation will aim to draw parallels with the current debate around the link between cannabis and psychosis and urges caution in too rapid an assertion that cannabis is necessarily ‘causal’ and the clinical and policy implications of the misinterpretation of evidence. A proposal will be put forward that the genesis of psychotic illness in alcohol misuse is revisited using more sophisticated research methodologies.Conclusions:Given the changing landscape of substance use in the UK, particularly the fashion of polysubstance use and the recognition that this may be associated with psychotic illness, other drugs that are associated with psychotic illness should be similarly investigated to determine whether there is a common mechanism that might throw light on understanding the relationship between substance use and psychotic illness or schizophrenia.
Comorbidity and Comortality
Authors: Baldacchino A. , Crome I. 
Published: March 2009

Aims:To analyse the nature and extent of data extracted from case files of deceased individuals in contact with health, social care and criminal justice services six months prior to their drug deaths in Scotland during 2003.Methods:A cross-sectional descriptive analysis of 317 case notes of 237 individuals who had drug related deaths, using a data linkage process, was undertaken. All contacts made with services in the six months prior to death were identified. Information on clinical and social circumstances obtained from case records of social care services, specialist drug treatment, mental health and non-statutory services and the Scottish Prison Service and Criminal Records Office were collated using the Centre for Addiction Research and Education Scotland (CARES) Clinical and Social Circumstances Data Collection Form.Findings:More than 50% (n=237) were seen six months prior to their drug death. Sociodemographic details were reported much more frequently than medical problems. While there was information available on ethnicity (49%), living accommodation (66%), education and income (52%), and dependent children (73%), medical and psychiatric history was recorded in only 12%, blood-borne viral status in 17%, and life events in 26%. This paucity of information was also a feature of the treatment plans and progress recorded for these individuals.Conclusions:The 237 drug deaths were not a population unknown to services. Highly relevant data about the six-month period prior to death were missing. Improved training to promote in-depth recording, and effective monitoring may result in better understanding and reduction of drug deaths.
Cocaine Use and Liability to Psychotic Symptoms
Authors: Franzek E.J. 
Published: March 2009

In a pilot study with 55 inpatients, primarily admitted for cocaine addiction, the following hypotheses were found: Patients with cocaine addiction and comorbide core schizophrenia (according to Kreapelin, n=17) respond completely different on cocaine use than all other groups of patients including a schizophrenia spectrum group (without core schizophrenia according to Kraepelin). When using cocaine the schizophrenic patients do not experience new psychotic symptoms and existing symptoms do not get worse. Most of them are less bothered of negative symptoms and some of them are, even more, less bothered of positive symptoms. In all other patients with various comorbidity (n=28) and without comorbide psychiatric disorders (n=10) positive psychotic symptoms occur dependent on the dosage of cocaine. In some of them the positive symptoms are also triggered by stress alone. The symptoms occurred in a dosage dependent hierarchical structure: mistrust - delusions of reference with fear - delusions of persecution and illusions with anxiety or panic - threatening voices and noises - disorganized and catatonic behavior.The psychopathology induced by cocaine prooved to be similar to one of the core symptoms of cycloid psychoses.The hypothesis is raised that there is an individual genetically and/or environmentally caused liability to the developing of positive psychotic symptoms under various stress factors including drugs. These reactive psychoses have to be distinguished from schizophrenia. Their relationship to the spectrum of cycloid psychoses is discussed.
Controversy Over the Diagnosis of ‘Cannabis-Induced Psychosis’
Authors: Arendt M. 
Published: March 2009

Background:Both the ICD-10 and the DSM-IV operate with a diagnosis of cannabis-induced psychotic disorder. Despite this, the diagnosis is controversial.A number of studies have shown that cannabis can induce short-lived psychotic symptoms, and that this could depend on factors such as genetic predisposition. To qualify for a diagnosis of ‘cannabis-induced psychosis’, however, the symptoms must last for at least 48 hours according to the ICD-10. This diagnosis has traditionally been regarded as benign, but this is based on a very limited number of studies.Methods:We have conducted two studies based on Danish treatment registers. Firstly, all patients who had received psychiatric treatment for cannabis-induced psychosis were followed for at least 3 years to determine the rate of subsequent treatment for schizophrenia-spectrum disorders. Secondly, familial predisposition for psychiatric disorders among subjects treated for cannabis-induced psychosis and schizophrenia was compared using competing risk analyses.Results:Schizophrenia spectrum disorders were diagnosed in 44.5% of the 535 subjects included in the first study. New psychotic episodes of any type were diagnosed in 77.2% and 47.1% received a diagnosis of schizophrenia spectrum disorders more than a year after the cannabis-induced psychosis.Those who develop cannabis-induced psychosis and schizophrenia spectrum disorders both show elevated levels of predisposition for schizophrenia, other psychotic conditions, and other psychiatric disorders in first-degree relatives. In general, the level of predisposition is of similar magnitude in individuals treated for cannabis-induced psychosis and schizophrenia.Conclusion:Cannabis-induced psychosis could be an early sign of schizophrenia rather than a distinct clinical entity.
Skunk and psychosis in South East London
Authors: Di Forti M. , Morgan C. , Mondelli V. , Gittens L. , Handley R. , Hepgul N. , Luzi S. , Marques T. , Aas M. , Masson S. , Prescott C. , Russo M. , Sood P. , Wiffen B. , Papili P. , Dazzan P. , Pariante C. , Aitchison K. , Powell J. , Murray R. 
Published: March 2009

Background: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).Hypothesis:We predicted that first episode psychosis patients are more likely to use higher potency cannabis and more frequently than controls.Methods: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. All were recruited as part of the Genetic and Psychosis (GAP) study which studied all patients who presented to the South London and Maudsley Trust.Results:There was no significant difference in the life-time prevalence of cannabis use or age at first use between cases and controls. However, 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. 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).Conclusions:Patients with first episode psychosis have smoked higher potency cannabis, for longer and with greater frequency, than healthy controls.
Clinical and Epidemiological Data on Eating Disorders NOS
Authors: Machado P. 
Published: March 2009

Eating Disorders Not Otherwise Specified (EDNOS) represent the most common eating disorder diagnosed in specialized treatment settings. The purpose of the current presentation is to review epidemiological data on this residual diagnostic category. Namely we will present data on the prevalence of EDNOS in a nationwide community sample. In this study, participants were 2028 female students, aged 12 to 23, attending public schools in the 9th to 12th grades in Portugal. Participants completed the Eating Disorder Examination Questionnaire in Stage 1 of the study. In Stage 2, we selected all the participants who met any of these criteria:1.BMI ≤17.5,2.scores ≥4 on any of the four EDE-Q Subscales,3.a total EDE-Q score ≥4, or,4.the presence of dysfunctional eating behaviors.In Stage 2, eating disorder experts interviewed 901 participants using the Eating Disorder Examination. The prevalence of all eating disorders was 3.06% among young females. Prevalence for anorexia nervosa was 0.39%, for bulimia nervosa 0.30%, EDNOS 2.37%. EDNOS was a very common eating disorder and accounts for three-quarters of all community cases with eating disorders. Implications for research and treatment will be presented.
Psychiatric Comorbidity in Eating Disorders Not Otherwise Specified (EDNOS)
Authors: Milos G. 
Published: March 2009

This study aimed to analyse the course of eating disorders (ED) over thirty months emphasizing comorbidity and stability of the ED diagnoses. Particularly attention was given to the eating disorders not otherwise specified (EDNOS) subjects in comparison with anorexia nervosa (AN) and bulimia nervosa (BN) patients.192 women with a DSM IV eating disorder diagnosis - 55 AN, 108 BN, 29 EDNOS - was assessed with the structured interview (SCID I) at the baseline, one year and thirty months after the first assessment.83.3% of the total sample had in addition to the ED diagnosis one or more lifetime axis I diagnoses. We found no significant differences between the most common axis diagnoses - anxiety and affective disorders, or dependence disorders - in the three diagnostic groups, excepted for social phobia, in fact this disorder was significantly often present in AN. The distribution of the lifetime suicidal attempt was very similar in the three diagnostic groups.The stability of the ED diagnoses was low, but EDNOS was the most instable ED diagnosis with a tendency to remission.The axis I comorbidity of ED was very high, and the EDNOS subjects showed a very similar axis I comorbidity compared with subjects with AN and BN. The stability of the ED diagnoses was low and the EDNOS group showed the highest ED diagnosis instability and tendency to remission. The relationship between axis I comorbidity, and ED instability is unclear, further studies in these fields are needed.
Progress in the Development of ICD-11 and DSM-V Classifications of Mental Disorders
Authors: Sartorius N. 
Published: March 2009

The International classification of diseases - which includes a chapter dealing with mental disorders - will be revised and its 11th Revision will be published in 2014.A special unit within the World Health Organization coordinates the process of revision and the numerous tasks that have to be undertaken to ensure full participation of the WHO member states in the process of revision as well as the consideration of evidence on which the classification is to be based.The Department of Mental Health and Substance Abuse Control of the WHO has created a special advisory group that should help it in considering the evidence and proposals made by scientists, governments, organizations and interested individuals and in producing the draft of the classification of mental disorders for inclusion into the 11th Revision of the ICD: This group has, in turn, developed several structures that will deal with the tasks that will arise in the revision process. At the same time the American Psychiatric Association has created a DSM 5 Task Force that should develop proposals for the 5th Revision of the Diagnostic and Statistical Manual that will be published in 2012.The lecture will describe the processes and structures that have been put in place by the two organizations and refer to the issues that have arisen or are likely to arise in the course of work that should lead to the proposals for the ICD 11 and the DSM 5.
State of the Art “Personality Disorders”
Authors: Herpertz S. 
Published: March 2009

Personality disorders have high prevalence rates of approx. 8% in the general population and up to 40% among psychiatric patients. The increasing amount of empirical and experimental research within the last ten years challenges our concept of personality disorders (PDs) with the following most prominent findings:•Longitudinal studies indicate much less stability than expected.•The DSM classification system hypothesis of a fundamental difference between axis I and axis II disorders has not been empirically affirmed.•Some of the current categories of disorders cover highly heterogeneous individuals and have low therapeutic implications.•The detection of neurobiological underpinnings of personality dysfunctioning points to a close interaction between nature and nurture in etiology.•Psychotherapeutic approaches developed for specific disorders have been proven to be efficacious; they rather favour a limited focus on maladaptive behaviors and attitudes instead of targeting a fundamental change of personality structure.•There is no empirical basis for polypharmacy; classes of psychotropic agents act on a rather broad spectrum of symptoms with no convincing database to suggest the combination of several drugs with respect to different targets.
Unjustly Neglected: Siblings of People with a Schizophrenic Psychosis
Authors: Schrank B. , Sibitz I. , Schaffer M. , Amering M. 
Published: March 2009

Objective:Siblings of individuals suffering from schizophrenia are often overseen as relatives in need in clinical practice and they are an underrepresented group in research focussing on the needs of carers and relatives of psychiatric patients. We investigated differences between siblings and parents as well as spouses, in regards to help seeking, utilisation of an open group for relatives, their subjective burden and quality of life.Methods:147 relatives of in-patients and patients attending a day hospital where assessed using the General Health Questionnaire (GHQ), Family Problem Questionnaire (FPQ), WHO Quality of Life-BREF (WHOQOL-BREF) and a questionnaire inquiring about their utilisation of various sources of information and help throughout the course of the illness.Results:Siblings had less contact with patients compared to both parents and spouses, and their quality of life showed less impairment than that of the other groups. However, siblings’ subjective burden was comparable to that of spouses. Still, compared to the other groups, they reported significantly less utilisation of any source of information and help and were far less likely to be invited to support offers specifically aimed at relatives.Conclusions:Siblings of patients with schizophrenia are a particularly neglected group regarding support aimed at relatives. They are heavily distressed, yet there is little offer of professional support for them.
Family Needs, Children and Parenthood in People with Mental Illness
Authors: Becker T. , Kilian S. , Kilian R. , Lahmeyer C. , Krumm S. 
Published: March 2009

Objective:Given that parental mental diseases affect the whole family system, a family centered support and help system seems appropriate for families with a mentally ill mother/father. However, the majority of mental health services do not integrate interventions for the family system into psychiatric treatment programs.Aims:To introduce a counselling and support service for families with a mentally ill parent (FIPS) that has been established at a psychiatric hospital serving a large catchments area. Preliminary results of a qualitative study that focused on the clients’ family background as well as on their reasons for utilising the service and service satisfaction will be presented.Methods:Factors that impact the family system are considered and brought to a concept for counselling and support service for families with a mentally ill parent. Problem-focused interviews with 14 clients (mentally ill parents and relatives) of the counselling service for families were subjected to content analysis.Results:Most clients came to the counselling centre because of worries that the parent's mental illness might negatively affect children's well-being. Mentally ill mothers described their daily lives as utterly burdensome and also reported strong feelings of guilt towards their children. The concept of FIPS includes psychoeducation, social therapy, case management and family therapy. Clients assessed the counselling service as helpful and reported some significant changes.
Family Cohesion, Psychoeducation, and Insight in Schizophrenia
Authors: Aldebot S. 
Published: March 2009

The speaker will describe the first two modules of the culturally informed family therapy for schizophrenia, as well as some of her own research on insight in severe mental illness. The first module of the treatment is Family Collectivism. This module is based on strong research linking perceptions of family cohesion to decreased psychiatric symptoms and less general emotional distress (Weisman, Rosales, Kymalainen, & Armesto,2005). This module is aimed at fortifying a strong sense of family unity and helping members to view themselves as a team working towards a mutual goal with the objective of tapping into the protective effects of experiencing a cohesive family unit. A demonstration of this module will beconducted using volunteers from the audience.The second module, Education, is based on earlier psycho-educational programs of Falloonet al. (1984) and Miklowitz and Goldstein (1997). The Education module discusses the known causes of schizophrenia, the exacerbating factors, and ways in which family might influence the patient's mood, thoughts, and behaviors. This speaker will discuss patients' insight into having a mental illness, which is an important variable when conducting psychoeducational programs. Many individuals suffering from schizophrenia have limited or no insight into the fact that they have a mental illness. This speaker will explore possible mediators and moderators of the relationship between insight and distress and discuss how these factors may be important during treatment, particularly in the psychoeducation module.
Diagnosis, Classification and Treament of Psychopathology in Infants and Toddlers: Incorporating an Infant Mental Health Approach
Authors: Shah P. , Almeida M.C. 
Published: March 2009

Aims:This workshop will present a theoretical framework to conceptualize early childhood behavior problems in the context of the early parent-child relationship, and will demonstrate how this relational framework can be used to diagnose, classify, and treat child behavior concerns in children under the age of five.Background:There is increasing evidence to suggest that a significant number of very young children manifest signs of early psychopathology, and that behavioral problems that emerge early are likely to persist, and warrant further assessment and intervention. One of the challenges to identifying early psychopathology in young children is how to diagnose and classify early behavioral disturbances using a developmental and relational framework.Methods:This presentation will describe an “infant mental health approach” to diagnose and intervene with young children with behavioral concerns. This comprehensive model of behavioral assessment incorporates an assessment of the parent's perceptions of the child, observations of dyadic interactions, and utilizes a developmental context to diagnose, classify and treat early behavioral concerns in children under the age of five. Using the DC 0-3R, this model will highlight how an understanding of child behavior in the context of the parent-child relationship can be a helpful framework to diagnose and treat early behavioral disturbances in children under the age of 5. Participants will learn how to identify vulnerabilities in the parent-child relationship, how to diagnose and conceptualize early psychopathology in young children, and how to formulate interventions to support dyads at risk.