bluuebunny/crossref_metadata_2025_split huggingface dataset:
PW01-50 - Broadening Of Generalized Anxiety Disorders Definition Does Not Affect The Response To Therapy: Findings From The Adan Study
Authors: Álvarez E. , Carrasco J.L. , Olivares J.M. , Perez M. , Pérez-Gómez V. , Vilardaga I. , Rejas J. 
Published: June 2010

PurposeTo elucidate the consequences of broadening DSM-IV criteria for generalized anxiety disorder (GAD), we examined the evolution of GAD symptoms in two groups of newly diagnosed patients; one group according to DSM-IV criteria and the other, according to broader criteria.MethodsMulticentre, prospective and observational study conducted in outpatient psychiatric clinics. Patients with GAD according to DSM-IV criteria and subjects with anxiety symptoms fulfilling broader criteria were compared. Broadening criteria was considered 1-month of excessive or non-excessive worry and only 2 associated symptoms listed on DSM-IV for GAD. Socio-demographic data, medical history and functional outcome measures were collected three times during a 6-month period.Results3,549 patients were systematically recruited; 12.8% excluded because not fulfilling inclusion criteria, 1,815 patients in DSM-IV group (DG) and 1,264 in broad group (BG). Both groups were similar on their sociodemographic characteristics at baseline and most patients (about 80%), even newly diagnosed were exposed previously to pharmacological therapies (mainly benzodiazepines) of their anxiety symptoms. As a result of treatment at psychiatric clinics, the percentage of patients without symptoms of anxiety as per HAM-A scale were 49.0% and 58.0%, respectively at the 6 month visit (p=0.261). Similarly, responder rate (≥ 50% reduction of baseline scoring) were, respectively, 59.7% and 67.7% (p=0.103). Improvement in MADRS scores were observed in both group to a similar extent; 12.1 and 12.5 points average reduction respectively (p=0.264).ConclusionBroadening of GAD criteria could lead to earlier diagnosis that will benefit patients by starting appropriate treatment sooner.
PW01-60 - Similar Short- And Long-Term Efficacy Results Of Aripiprazole In Post-Pubertal Adolescents (Ages 15-17) And Adults With Schizophrenia
Authors: Loze J.-Y. , Correll C. , Landsberg W. , Forbes R.A. , Nyilas M. , Jin N. , Carson W.H. 
Published: June 2010

IntroductionAvailable data suggest that sex hormone levels during puberty may affect symptom onset and expression, treatment responsiveness and outcomes in schizophrenia, whereas post-pubertal adolescents may have a similar clinical presentation and treatment response compared to adults with schizophrenia.ObjectivesPost-hoc analyses were conducted to assess the similarity of short- and long-term efficacy between post-pubertal adolescents and adults with schizophrenia treated with aripiprazole.MethodsBased on available European epidemiologic data, a cut-off age of 15 years was used to isolate a subgroup of mostly post-pubertal adolescents with schizophrenia in aripiprazole clinical studies. Outcome measures from this subgroup (ages 15-17; n=147) were then compared to outcomes from one adult study (n=853) on short and long-term measures of efficacy, including PANSS scores, response rates, and remission rates.ResultsComparable short and long-term treatment effects were observed on the PANSS total and subscale scores, demonstrated by overlapping 95% confidence intervals (mean change from baseline in PANSS total score (OC dataset): at week 6 in adults: -27,7; in adolescents 15-17 yr: -29,6; at week 30 in adults: -39,2; in adolescents 15-17 yr: -36). Percent of adolescents achieving response (defined as ≥ 30% decrease in PANSS total score from baseline) at 32 weeks (80,2%) on open label treatment was similar to that in adult studies at week 34 (80%) on double blind treatment (OC dataset).ConclusionsAdolescents with schizophrenia (ages 15-17, mostly post-pubertal) demonstrate a positive treatment response in short-term and long-term studies which is similar to that observed in the adult patient population.
PW01-64 - Treatment Motivation In Adolescent Patients With Anorexia Nervosa
Authors: Pauli D. , Winkler Metzke C. , Steinhausen H.-C. 
Published: June 2010

ObjectivesAim of the study was assessing motivation to change in a clinical sample of adolescents with anorexia nervosa and its relation to specific cognitions and behaviours.MethodsN= 77 patients with anorexia nervosa (75 female, 2 males, mean age = 15.8, SD = 1.3) were evaluated with Anorexia Nervosa Stage of Change Questionnaire (ANSOCQ) measuring motivation to recover and further questionnaires evaluating treatment and course of the disorder. The latter included Eating Disorder Inventory (EDI-2), the Eating Attitude Test (EAT), the Pros and Cons of Anorexia nervosa questionnaire (PCAN), and the Body Image Questionnaire (FKAN). Data were collected at treatment onset (T1), follow-up was after 12 months (T2).ResultsAt T1 motivation to change was significantly related to the EDI subscale measuring drive for thinness (p < .001) and body dissatisfaction (p< .01), to the PCAN pros scales measuring appearance (p< .01) and safe/structure (p< .01), to the EAT scale measuring dieting (p< .001) and the FKAN subscale measuring the feeling of body massivity (p< .001).The stage of motivation to change at treatment onset was very low in the sample (67% in stage 1 = precontemplation or 2 = contemplation). There was no relation between motivation at T1 and BMI at T2 but the increase of motivation between T1 and T2 predicted a better outcome (BMI at T2).ConclusionsMotivation to change is related to specific cognitions and behaviours in adolescent patients with anorexia nervosa. Increase of treatment motivation during the first months of treatment seems to be predictive for outcome.
PW01-67 - Eating Disorders And Problems In Adolescence
Authors: Winkler Metzke C. , Pauli D. , Steinhausen H.-C. 
Published: June 2010

ObjectivesThe aim of the study was assessing differences in selected psychosocial and behavioural variables between a referred sample of patients with an eating disorder, a non-referred risk sample with eating problems, and a healthy control group.MethodsThere were N=100 patients (95 females and 5 males, Mean age = 15.8, SD = 1.3) in the referred sample. The two matched non-referred groups of each N=215 participants (95% females, 5% males; Mean age =16.1, SD = 1.5) stem from the Zurich Adolescent Psychology- and Psychopathology-Study (ZAPPS). Emotional and behavioural problems were assessed using the Youth Self Report (YSR) and a depression scale. In addition, the participants responded to questionnaires covering life events, self-related cognitions, coping capacities, perceived parental behaviour, and family climate.ResultsCompared to both non-referred groups, the referred sample had significantly higher scores on the social withdrawn, anxious/depressed and thought problems scale of the YSR, on the depression and the life events scales, and significantly lower scores on the self esteem scale. Compared to the referred sample, the non-referred risk sample had significantly higher scores on the YSR-scale measuring externalizing problems and the perceived parental rejection scale, but lower scores on the family climate scales measuring cohesion and adaptability.ConclusionsThe three groups were differentiated by various psychosocial and behavioural variables. Externalizing problems and indicators of a poor family climate were more common in a non-referred high-risk group with eating problems than in a referred sample with clinical eating disorders.
PW01-68 - Psychiatric And Familial Factors In Pediatric Diabetic Patients And Their Relation To Quality Of Life And Metabolic Control
Authors: Butwicka A. , Zalepa A. , Fendler W. , Szadkowska A. , Zawodniak-Szalapska M. , Młynarski W. , Gmitrowicz A. 
Published: June 2010

ObjectivesTo determine the influence of parent and child depressive and anxiety symptoms, family functioning and its influence on child quality of life and diabetes control among children and adolescents.Methods149 Children and adolescents (aged 8-18 years) with duration of diabetes longer than 1 year were enrolled to the study. Participants and their parents were evaluated by self-report measures (BDI, STAI, CDI, MASC, FACE-IV).ResultsThere were 83 males and 66 females in the group. Mean age at the time of evaluation was 13,4±2,7 years. Median duration of diabetes was 4,0 (Interquartile Range 2,4-5,1) years. Mean HbA1c level was 8,0±1,5%. Child depression (beta= -0.41; p< 0.001), child (beta=-0.28; p< 0.01) and parent anxiety (beta=-0.17; p< 0.05) were all associated with lower quality of life. Family communication, flexibility, cohesion and satisfactions scores, despite being significant in univariate correlations were excluded during stepwise regression model building. HbA1c correlated with CDI rating (beta=-0.17; p< 0.05).ConclusionsPresence of anxiety and depressive symptoms among children and their parents significantly worsens the quality of life among individuals with diabetes. Family-based communication trainings could contribute to improved metabolic control.
PW01-70 - Socio-Demographic And Clinical Analysis Of Psychiatric Interconsultations In A Pediatric Ward Of A Brazilian University Hospital
Authors: Jacintho A.C.d.Á. , Santos A. , Salán T.M. , Celeri E.H.R.V. , Dalgalarrondo P. , Botega N.J. ,   Child and Adolescent Psychiatry Study Group
Published: June 2010

ObjectivesTo analyze the clinical and demographic profile of psychiatric interconsultations in a pediatric ward of a Brazilian university hospital in 2008.MethodsReview and statistical analysis, using SPSS, of the medical records of the 31 children/adolescents admitted to the Hospital from the University of Campinas-Brazil who required psychiatric assessment.Results1,072 children/adolescents were hospitalized, with a total of 1,933 admissions. Psychiatric consultation was requested for 31(16 girls and 15 boys), 4(12.9%) were hospitalized more than once in 2008. Ages: 2 months-18 years old (mean: 9.9 ± 4.5). 19(61.3%) were white, 5(16.1%) mixed and 3(9.7%) black. Mothers were responsible for the children/adolescents in 23(74.5%) cases. 2(6.5%) children attended kindergarten and 19(61.3%), primary school. The permanence time varied between 1-199 days (mean: 24 ± 38.1). 8(25.8%) patients had psychiatric diagnoses at admission and were taking psychotropic drugs. 26(83.9%) had a positive clinical pediatric history. In 25(80.6%) patients the psychiatry diagnosed at least one mental disorder (more than one in 15-48.4% patients). Depressive mood disorders were the most prevalent. Psychiatric pharmacotherapy was used for 20(64.5%) patients and 17(54.8%) continued taking medication after discharge. Only 1 patient did not need referral after discharge. 1 patient died 7 months after the assessment.ConclusionsThe experience of being ill can have great emotional significance for children/adolescents and their families. The presence of a psychiatrist on staff can help the pediatrician in dealing with these situations, influencing therapy and prognosis.
PW01-71 - A Common Comorbidity: How To Deal With Depression In Chronic Heart Failure?
Authors: Norra C. 
Published: June 2010

ObjectivesDepressive syndromes in chronic heart failure (CHF) are highly prevalent with 20-40% and are associated with various aspects of increased cardiac mortality and impact on health system. Likewise, CHF may increase the risk of developing depression or vice-versa via bidirectional interactions of possible shared pathophysiology.MethodsWhile at current only a minority of comorbid patients with CHF receives adequate diagnosis and treatment, identification, treatment, and prevention by optimizing cardiological and psychiatric strategies appears essential. - An introductory overview on the occurrence, atypical presentation of symptoms, and risk factors of depression and CHF will be given (Norra et al. 2008) with main regard on the recent work.ResultsConcerning depression profiles, conventional cut-off-scores of rating instruments were analysed and have to be newly discussed in cardiologic patients (Forkmann et al. 2009). Further, depressed inpatients versus cardiologic inpatients with depression (Norra et al. in prep) showed differences on the cognitive-emotional aspects of depression (e.g. self-accusation, crying, social withdrawal) as opposed to great similarities (e.g. anergy, sleep disturbances). Here, sleep-related breathing disorders may also contribute to the depressive phenotype in CHF (Skobel, Norra et al. 2005). Interestingly, poor subjective sleep quality significantly predicts increased depressive symptoms in cardiac disease (Norra et al. in prep).ConclusionsOnly early screening, diagnosis and treatment of subclinical/modified depression in CHF may prevent further deteriorating effects of this comorbid disease on the heart and brain. A multicenter trial ‘MyHeart’ (EU 6th framework, IST 507816) is ongoing with a special focus on potential cardiac markers and depressive symptoms.
PW01-72 - The Ethnic Distribution Of Personality Disorder In An Inpatient Sample
Authors: Raffi A. , Malik A. 
Published: June 2010

IntroductionNo figures exist for the prevalence of personality disorder in ethnic minorities, compared to the general UK population, where prevalence figures range between 13% for general practitioner patients to 40-50% of psychiatric in-patients. Differences in diagnosis indicate that Black patients more likely to be diagnosed with Schizophrenia and less likely to be diagnosed with personality disorder. There is underuse of psychotherapy services by ethnic groups and less likelihood of receiving psychological therapies.ObjectivesA cross-sectional survey of inpatient data collected over 2 years(2007-2009), examined the prevalence of personality disorder, with regards to ethnic distribution, among 6531 psychiatric inpatients. The survey was conducted in Mersey Care NHS Trust, a mental health care provider in the North West of England. Ethnicity was divided into 2 broad categories, White British and Black and Minority Ethnic group (BME).Results273(4.2%) patients were diagnosed with personality disorder. 91(33.3%) males and 177(64.8%) females had personality disorder diagnosis. 23(8.4%) BME patients compared to 250(91.6%) White British patients were diagnosed with personality disorder. The most common diagnosis was Emotionally Unstable personality disorder (184 cases). Personality disorder is under-diagnosed in this inpatient population compared to the evidence base. Results support the research evidence base, that personality disorder in BME is under-diagnosed.ConclusionPersonality disorder is a stigmatizing label and is fraught with diagnostic uncertainty. Pre-existing attitudes in these communities regard mental illness as a non-entity, a stigma or taboo. It is not only the patient population that needs educating but also the professionals responsible for detection and management of personality disorder.
PW01-73 - The Impact Of Ethnicity And Language Needs On Duration Of Admission To A Psychiatric Inpatient Unit
Authors: Raffi A. , Mahmood J. , Tavernor S. 
Published: June 2010

IntroductionLanguage is the main investigative and communicative tool in psychiatry and adequate understanding of language is essential for thorough assessment by the clinician, and for patient satisfaction. Interference with communication impairs our ability to assess a patient comprehensively. In a Department of Health survey of British Asians in hospital, more than half had experienced difficulties in communication and reported dissatisfaction with existing interpretation services.Aims/objectivesAudit whether language needs and Ethnicity are addressed in an adult inpatient sample and evaluate consequent impact on hospital admission duration.MethodCasenotes of patients, who were identified as having language needs, were audited against National Institute for Mental Health in England(NIMHE) standards for the provision of an interpreter at every medical review(standard=100%). Electronic patient data was analysed for recording of ethnicity, language, admission duration and demographic data.ResultsSample size 3028. 3028(100%) had ethnicity recorded and 1434(47%) had spoken language recorded. Of 23 case notes audited, an interpreter was present on 28.3% of occasions. White British patients had average admission durations of 39.8 days compared to 53.7 days in Black/minority ethnic groups(BME). English speaking patients spent 43.4 days in hospital compared to 74.9 days for non-English speaking patients. BME/Non-English speaking patients spent 78.8 days in hospital compared to 42.1 days for English speaking/White British patients.ConclusionsThe study highlights an immediate need for addressing language/interpretation services within the trust. The implications of longer hospital admission duration on service user experience/dissatisfaction with services and financial implications for the Trust are evident. Further training for staff in cultural awareness and documentation of needs has been recommended.
PW01-74 - Cerebral Blood Hypoperfusion In Mild Cognitive Impairment And Mild Dementia In Alzheimer'S Disease Measured With Pulsed Arterial Spin Labeling Mri
Authors: Alexopoulos P. , Förschler A. , Wohlschläger A. , Sorg C. , Grimmer T. , Förstl H. , Kurz A. , Zimmer C. , Preibisch C. 
Published: June 2010

Pulsed arterial spin labeling (PASL) perfusion imaging is an MRI technique,relying on the detection of magnetically labelled water. The aim of the present study was to determine regional CBF abnormalities in patients with Alzheimer's Disease (AD) and Mild Cognitive Impairment (MCI), the transitional clinical stage between normal cognition and dementia, as compared with cognitively normal elderly controls using PASL.MRI was performed on a 3 T MR scanner. A multislice STAR sequence with WET presaturation and thin slice periodic saturation pulses was used for PASL: readout single-shot EPI; TR/TE/a = 2500ms/17ms/90°; TI1/TI1S/TI2 = 700ms/ 1200ms/1500ms; 11 slices ; 80 pairs of labeled-control; scan time 7min 18sec. For coregistration a single shot EPI and a T1-weighted TFE sequence were acquired. Resting CBF maps were obtained from 15 elderly cognitively normal controls, 13 MCI patients and 7 patients with AD. Analysis of variance was performed across groups using SPM5. Results were thresholded at p< 0.05, corrected for FWE.Lower perfusion was found in the left and right inferior parietal cortex and angular gyrus, in the left middle temporal and posterior cingulate cortex in patients. A small reduction of perfusion was detected in the left caudate in patients as compared with cognitively normal controls.These results confirm previous findings of hypoperfusion in parietal and temporal areas of patients with MCI and AD as compared to age matched controls. In addition, lower perfusion was detected in the left caudate. PASL may be a valuable tool for investigating the transition from normal ageing to dementia.
PW01-75 - Predictors For Cognitive Decline In Major Depression Associated With Cardiovascular Diseases
Authors: Chenderes R.M. , Podea D.M. , Nanu P.D. , Mila C. 
Published: June 2010

BackgroundMajor depression is often associated with cardiovascular diseases, due to the common ethiopathogenic mechanism: increased sympathetic activity. Mild cognitive impairment is associated with major depression and cardiovascular diseases are a predisposing factor leading to cognitive decline.The objectiveof this study is to determine the association of biological markers of sympathetic hyperactivity with cognitive decline in the context of a major depression associated with cardiovascular diseases.Material and methods60patients with major depression and cardiovascular pathology were included (16 over 65years and 44 under65). The intensity of depression was evaluated with MADRS and the intensity of cognitive decline was evaluated with MMSE. Paraclinical tests (cortisolemia, fibrinogen,CRP) were also performed.Results and discussionsIncreased systolic blood pressure is significantly associated with high MADRSscores and low MMSEscores in the elderly(p=0.004, p=0,035, CI=95%) and in adults(p< 0.05,p=0.034,CI=95%). Increased diastolic blood pressure is significantly associated only with MADRSscores in adults(p=0.019,CI=95%) and it is not correlated with MMSE, neither in adults nor in the elderly.Increased cortisolemia is significantly associated with the intensity of cognitive decline (p=0.027,CI=95%) and with the intensity of depression (p< 0.05,CI=95%) in adults but the correlation in the elderly is not significant (p>0.05,CI=95%, in both cases). Fibrinogen is not carelated with cognitive decline and with depression but CRP is associated more strongly with the adults (p=0.003,CI=95%) than with the elderly (p=0.041,CI=95%).ConclusionsIncreased systolic blood pressure and CRP are associated with cognitive decline in adults and in the elderly. Hypercortisolemia is significantly associated with mild cognitive impairment only in adults.
PW01-76 - Serotonin System Gene Polymorphisms In Alzheimer'S Disease
Authors: Fehér Á. , Juhász A. , Rimanóczy Á. , Kálmán J. , Janka Z. 
Published: June 2010

Alzheimer's disease (AD) is a neurodegenerative disorder with complex aetiology and strong genetic determinants. Depression occurs in a large proportion of AD patients, and history of depression represents risk for developing AD. Possible links between AD and depression may be the involvement of serotoninergic disturbances. Present study was undertaken to evaluate the possible role of the 22bp tandem repeat polymorphism of the serotonin transporter gene (5HTTLPR) and the T102C polymorphism of the serotonin receptor2A gene (HTR2A) in AD.The study included 247 AD and 206 healthy control (HC) probands. The diagnosis of probable AD was based on NINCDS-ADRDA criteria. The genetic analyses were performed by PCR amplifications. The two 5HTTLPR alleles were denoted as short (S) and long (L) alleles.The HTR2A genotype distribution did not differ significantly between the AD and HC groups (p=0.108). The analysis was also performed by investigating T- (C/C) and T+ (C/T and T/T) genotypic categories, and a statistically significant difference was found (T-: AD:38.0%, HC:28.6%; T+: AD:62.0%, HC:71.4%; p=0.037). The frequency of the 5HTTLPR genotypes was similar in AD as compared to HC group (p=0.883). Logistic regression analysis revealed an interaction between the 5HTTLPR and HTR2A polymorphisms (p=0.032); the L/L and C/C genotype carriers had an increased risk for AD (OR=2.50; 95%CI:1.19-5.25; p=0.016).There was no significant correlation between AD and the 5HTTLPR polymorphism in itself. Our findings indicate however, that the HTR2A T102C polymorphism is associated with AD either alone or in interaction with 5HTTLPR.This work was supported by OTKA K 60589/2006.