bluuebunny/crossref_metadata_2025_split huggingface dataset:
P03-363 - Minding the Levels: About a Clinical Case with Neuropsychiatric Manifestations
Authors: Ramalho e Silva F. , Ribeiro A.E. , Serra de Lemos M. 
Published: June 2010

Introduction and aimsPsychiatry makes use of a wide range of medications, such as anti-epileptic drugs in the treatment of affective disorders, impulsive behavior or epilepsy. The authors aim to present a particular clinical presentation in order to reinforce the awareness of the side effects of our prescriptions.Case report54 year-old man, epileptic, medicated with Sodium Valproate (VPA) and Phenobarbital, admitted to our hospital due to insomnia, irritability and aggressiveness with two weeks of duration. Early evaluations showed disorientation, slow and poor speech, and prejudice ideas towards his family. Disequilibrium, asterixis and slurred speech imposed evaluation by Neurology. Analytic evaluations demonstrated high phenobarbital and ammonia levels. Both anti-epileptics were slowly withdrawn, with clinical resolution.DiscussionVPA may be associated with elevation of ammonia levels, and eventually with encephalopathy without evidence of liver failure. There is a wide range of clinical presentations of hyperammonemic encephalopathy ranging from decreased level of consciousness, irritability, agitation, focal neurological deficits, cognitive slowing, vomiting, drowsiness, and lethargy. On the other hand, high doses of phenobarbital may have similar presentations which could be potentiated by VPA.ConclusionThere was a good correlation between the fall in serum ammonia levels, clinical improvement, and anti-epileptics withdrawal, suggesting the implication of medication in this clinical picture. The case illustrates the need to check ammonia and anti-epileptic levels, and to consider this diagnosis in patients taking VPA and Phenobarbital who present with new neuropsychiatric manifestations.
P03-372 - Evolution of Patients who Underwent Electroconvulsive Therapy (ECT) in a Brazilian General Hospital from 1993 to 2007
Authors: Santos A. , Oliveira M.C. , Andrade T.S. , Freitas R.R. , Salán T.M. , Azevedo R.C.S. 
Published: June 2010

ObjectivesTo determine the outcome of patients who underwent ECT in a Brazilian General Hospital between 1993 and 2007.MethodsTelephone contact with all patients (or their relatives) who were submitted to ECT during psychiatric hospitalization in HC-Unicamp-Brazil. Data were compiled for statistical analysis at SPSS.ResultsThere were 53 successful telephone contacts (33.9% of 153 patients who underwent ECT). Losses were due to changes of telephones/addresses. No refuses occurred. The mean time between the procedure and the contact was 55.4 months (3-170). Twenty patients (37.3%) and 37 relatives (69.8%) were interviewed. Most were women (60.4% n=32), 4 were inpatients by the occasion of the call and 4 died. The mean age was 42.9±19.4. The assessments of current mental state by patients were: excellent in 5-9.4% cases, good in 12-22.6%, poor in 2-3.8%. The evaluation by family members was: excellent in 11-20.8% cases, good in 11-20.8%, poor in 7-13.2% and very poor in 5-9.4%. In 42 cases (79.2%) the patient was still under psychiatric treatment (taking psychotropic medication in 39-73.6%). In 28 cases (54%) there was need for new admission in a psychiatric inpatient ward. In 38 cases (74%) the patient reported knowing that he/she had undergone ECT, and only in 5 cases (9.4%) there was a lasting side effect of treatment reported, which was change in memory.ConclusionsData of the evolution of patients corroborate the importance of treatment with ECT for severe mental disorders, and also shows the low rate of long-term complications related to the procedure.
P03-377 - Escitalopram Induced Bradycardia, Hypotonia and Syncope
Authors: Szabo Z. , Eriksson M. , Milusic Z. 
Published: June 2010

ObjectivesEscitalopram is considered to be more effective than citalopram and to have less side effects. Previous studies have found that common cardiac manifestations of escitalopram overdose are QT prolongation and bradycardia. Some case reports inform about bradycardia without ECG abnormalities with therapeutic doses of escitalopram.MethodsWe report of a 29-year-old female patient diagnosed with major depression, hospitalized for 2 weeks. She had no history of any treatment with antidepressive drugs. After administration of 5 mg/day escitalopram the patient's blood pressure and pulse rate were mildly reduced and we observed presyncopal episodes daily. After 1 week of treatment the dose of escitalopram was raised to 10 mg/day and she complained about dizziness. In this case we found that presyncopal episodes lasted longer and both hypotension and bradycardia increased. These symptoms disappeared within 24 hours after escitalopram treatment was discontinuated. Results from routine laboratory tests, ECG, EEG, brain CT were normal. No other farmacologic causes were supposed to induce the above mentioned vegetativ symptoms.ConclusionBradycardia and hypotonia have been previously reported with citalopram, but there are only a few case reports about these side effects induced by a therapeutic dose of escitalopram. Both central and - by directly inhibiting the entry of Ca into vascular smooth muscles resulting in vasodilatation - periferial effects of escitalopram are supposed to be responsible for these rare phenomena. This case report supports the importance of monitoring heart rate and blood pressure when escitalopram treatment is introduced, especially in cases of previously untreated depressive patients.
P03-381 - Quality of Life Improvement Through Depression Treatment in Oncologic Patients
Authors: Vasile D. , Vasiliu O. , Vasile M.L. , Mangalagiu A.G. , Stanescu B. , Petrescu B.M. , Nastase D.M. , Bogdan V. 
Published: June 2010

ObjectiveTo evaluate the impact of depression treatment over the quality of life in oncologic patients.MethodsA group of 27 patients, 14 male and 13 female, mean age 56,3, diagnosed with lung (n=7), gastric (n=7), prostate (n=5), colon (n=4) and breast (n=4) cancer, were also diagnosed with moderate or severe depression (Hamilton Depression Rating Scale-17 items score at the inclusion was over 14). These patients received a combined, psychopharmacological (escitalopram mean daily dose 15 mg, n=15 or mirtazapine, mean daily dose 30 mg, n=12) and psychotherapeutic (cognitive behavior therapy) approach for 3 months and were monitored using monthly HAMD, Global Assessment of Functioning and Lehman Quality of Life Interview (QOLI). Patients didn’t present any significant axis I, II or III comorbid condition.ResultsPatients responded well to the combined therapy, as the final HAMD (-11.2, p< 0.01) and GAF (+12.3, p< 0.01) scores reflected, with no significant inter-group difference (p=0.23). The quality of life scales regarding health, family relations and social relations from the QOLI registered significant improvement compared to baseline (+10%, +12.2% and +12.5% respectively, p< 0.01). Patients who had the higher response rate to the treatment also had the higher rate of life quality improvement (r=0.65).ConclusionThe treatment of depression in oncologic patients is a necessity, due to the impact of depressive symptoms over the patient quality of life and is associated with a significant rate of success. The improvements are observed especially in the patient perception of health, family and social relationship and functioning.
P03-382 - Impulsive Aggression in a Patient Treated with Levetiracetam
Authors: Villegas Martinez J.L. , Blanco Garoote J.A. , Marques Cabezas P. , Cabus Piñol G. , Coullaut Garcia J. 
Published: June 2010

IntroductionComparative studies prove that levetiracetam therapy presents a major frequency of behavioral disturbances, producing problems of impulsive aggressiveness with a relative frequency. Principally if a previous psychiatric history is associated.ObjetivesReport a case of Impulsive homicide aggression in a patient treated with Levetiracetam. Extensive bibliographical review.MethodsWe describe the case of a patient admitted in our Psychiatric acute unit because a major depressive disorder and mild cognitive impairment associated with vascular factors that developed strange impulsive aggressive behavior after the initiation of treatment with levetiracetam, even to try to assassinate his wife. Follow-up visits were performed at 6 and 12 months after discharge to assess aggressive behavior and the change in the Barratt impulsivity scale and the hostility inventory of Buss-Durkee. We conducted a literature review of behavioral and aggression problems associated with treatment with levetiracetam and its possible mechanisms.ResultsAfter the phasing out of levetiracetam and replacement by oxcarbazepine, aggressive behaviors disappeared. No significant psychopathology was showed in the patient in the follow-up visits, except secondary to preexisting cognitive impairment.ConclusionsAccording to studies reviewed a 7-13% of patients treated with levetiracetam may develop behavioral disorders with impulsive aggression that usually resolve after discontinuation of drug.Comparative studies show that levetiracetam has a greater frequency of such effects, leading to problems of impulsive aggression relatively often, especially if there is a comorbid psychiatric pathology.
P03-383 - Addition of a Selective 5-HT2A/D4 Antagonist Accelerates the Antidepressant Effects of Citalopram
Authors: Wade A. , Nemeroff C. , Schatzberg A.F. , Schlaepfer T. , Haazen L. , Buntinx E. 
Published: June 2010

ObjectivesImprovement in symptoms of depression is typically delayed with antidepressant treatment. Pipamperone (PIP) at low doses acts as a highly selective 5HT2A/D4 receptor antagonist. The purpose of this study was to investigate whether the addition of PIP to the SSRI citalopram (CIT) would increase the rate of resolution of depressive symptoms.MethodsThis was an 8-week, double-blind, parallel-group, single-dummy study in patients with MDD who received either CIT 40 mg daily or PIP 5 mg bid plus CIT 40 mg daily (PIPCIT).ResultsThe mean total MADRS score (±SD) of the 165 patients (81% women; mean age, 40 y) was 32.6±5.5. More CIT than PIPCIT patients discontinued treatment in the first 4 weeks [15 (18%) vs 3 (4%); P=0.003]. Reductions in mean total MADRS scores were significantly (ITT LOCF) larger in patients receiving PIPCIT after 1 week [-6.42±6.18 vs -3.99±5.15; P=0.007] and 4 weeks [-15.06±8.48 vs - 12.11±8.30; P=0.025] compared with those receiving CIT alone. Significant differences in favor of PIPCIT were observed in MADRS items “reduced sleep,” “reduced appetite,” “concentration difficulties,” and “pessimistic thoughts.” Mean CGI-I scores were also improved after 1 week of PIPCIT [3.09±0.85 vs. 3.47±0.72; P=0.002]. There were no significant differences observed at 8 weeks. No additional, clinically significant adverse events were noted in the PIPCIT group.ConclusionsA low dose of PIP added to CIT provided superior antidepressant effects and less discontinuations compared with CIT alone during the first 4 weeks of treatment, and especially in the first week, at apparently no tolerability/safety cost.
P02-300 - Severe Non-Adherence to Treatment Phenomena in Russian Patients with Advanced Atherosclerosis
Authors: Drapkina O. , Ashikhmin Y. , Smirnova V. 
Published: June 2010

ObjectiveTo assess the prevalence and structure of non-adherence in Russian population of patients with advanced atherosclerosis.MethodsSixty patients (mean age was 69±11 yrs, 30 males) with advanced cerebral arteriosclerosis and ischemic heart disease were randomly selected from cardiovascular department and enrolled in the study for subsequent psychiatric counseling, questionnaires and MRI procedures. Patients with stoke, focal neurological deficit and any psychiatric disorders in anamnesis were excluded.ResultsWe have shown that 80% of patients have decreased or completely absent adherence to medical care. This patients were subsequently divided into three subgroups. First subgroup (30%) was characterized by partial denial of illness, where 3 (5%) patients suggest that they understanding somatic disease clinical course better than doctors. Significantly decreased compliance was most apparent in secound subgroup (30%), manifesting in self-changing drug and dosage regimen (for instance, skipping the medication without the doctor advise. In this subgroup 6 patients (10%) showed denial of treatment pattern underscored that conventional treatment for atherosclerosis as a whole is harmful for them and prefer to avoid all medications after discharge. Third subgroup included patients with vascular dementia (20%), where MRI analysis revealed white matter lesions with preferable localisation in emotional areas of cerebral (sub)cortex. There was a strong and significant correlation between the MRI white matter leasions score and treatment non-adherence level (r = 0.75).ConclusionNon-adherence is very prevalent in patients with advanced atherosclerosis estimating for up to 80%, while severe non-adherence is observed in 35% of patients.
P02-302 - The Impact of Binge Eating Symptomatology in the Quality of Life of Obese Patients Suffering From A Mood Disorder
Authors: Gonidakis F. , Ginieri-Coccosis M. , Rali E. , Spilioti E. , Varsou E. , Papadimitriou G. 
Published: June 2010

IntroductionA significant number of patients suffering from a mood disorder gain weight either due to the medication side effect and/or the lack of exercise. Binge Eating disorder has a high comorbidity with mood disorders. Both disorders have been found separately to have a high negative impact ob the patients quality of lifeAimThe aim of the study was to investigate the possible impact of binge eating symptomatology in the quality of life of obese patients suffering from a mood disorder.MethodWe approached 117 obese patients treated for mood disorder (unipolar and/or bipolar). All patients were recruited from a free of charge anti-obesity program specifically designed for mental patients that have gained weight. Each participant filled in the WHO Quality of Life Brief Scale (WHOQOL-Bref), a questionnaire on Binge Eating symptomatology based on DSM-IV research criteria, the General Health Questionnaire (GHQ) and the Social Physique Anxiety Scale (SPAS).ResultsAccording to DSM-IV criteria 40 patients were suffering from Binge Eating Disorder. The comparison between Binge Eating and non Binge Eating group (t-test) showed that the former group had higher SPAS measurements (p=0.007) and lower WHOQOL-Bref measurements in the psychological (p=0.01) and physical (p=0.006) domains. All other measurements as well as age, body mass index and gender did not show any statistical significant difference between the two groups.ConclusionThe presence of Binge Eating symptomatology might worsen patients quality of life especially when they are already carrying the burden of a mood disorder and obesity.
P02-305 - Clinical Features of the Phenomenon of the Somatization
Authors: Kim A. , Sulimanova M. 
Published: June 2010

The frequency of organ somatization in multimedical network was the object of study.MaterialsThe results of clinical and epidemiological study of 2181 patients (average age-54 ± 0.8) are presented.MethodsInventory for clinical-anamnestic behavior sign of adaptation form of disease of patients with comorbid phenomenon and standard scales for value of anxiety and depressions were used.ResultsPatients with somatoform pain more complicated in pharmacologic treatment, have complex diagnostic procedures, sometimes surgical interventions, were are often cases of analgesic dependence 5,8 (P< 0,05). The patient with idiopathic pain (antidepressant therapy's reply 4,2 (P< 0,05) and cognitive therapy's 2,8(P< 0,05)) and organ somatizations (analgesic dependence 3,5 (P< 0,05), antidepressant therapy's effect 4,3 (P< 0,05) and the cognitive therapy's reply 3,4(P< 0,05)) almost never has decided the idea about the mental nature of agonizing somatic sensations, seldom collaborate with psychiatrists.ConclusionThe phenomenon of somatization is a group of disorders in the base of which mechanisms of the psychical adaptation and behavior are. The admission of axial somatization's symptoms as mechanisms of the psychical adaptation and behavior and additional, forming by the purposeful interview of the patient, is appearing to be reasons, that is making actual questions of the effective competent communication for the optimization of therapeutic interventions. Thereby, the phenomenon of the somatization as mechanisms of the psychical adaptation and behavior is axial symptoms and cultural dependent features forming in the structure of the purposeful interview and the doctor's clinical estimation of the patient - are additional.
P02-314 - Temperament and Character in Outpatients with Anorexia and Bulimia Nervosa
Authors: Martínez-Gómez P. , Ramos-Ríos R. , Tajes-Alonso M. , Gastañaduy-Tilve M.J. , González-Lado I. , Martínez-Formoso S. , Arrojo-Romero M. 
Published: June 2010

ObjectivesThe aim of this study is to assess the personality traits in a sample of Spanish anorexic and bulimic outpatients.MethodThe revised version of the Temperament and Character Inventory was administered to 76 women attended in an Eating Disorders Unit and to 46 healthy controls. Both groups were matched by gender, age and instruction.ResultsDiagnoses in the sample were distributed as follows: bulimia nervosa (BN) 33, binging-purging type anorexia nervosa (BPAN) 23 and restricting anorexia nervosa (RAN) 18. RAN patients were significantly younger (21.6 vs. 26.3 p < 0.01). Differences in the harm avoidance, persistence and selfdirectedness subscales of the TCI were found (see table). RANBPANBNCp Novelty seeking89.397.399.697.40.15n. s.Harm avoidance116.1118.3118104.40.002BPAN, BN > CReward dependence112.5111.7103.7110.50.12n. s.Persistence120.7113.7108.4102.90.005RAN > CSelfdirectedness125.5120.8117149.5< 0.001C > RAN, BPAN, BNCooperativeness141.4145.9138.3142.90.34n. s.Selftranscendence63.867.266.959.50.17n. s.[Results]ConclusionsIn concordance with previous reports, compared with healthy controls, patients show lower scores in self-directedness. Persistence seems to be associated with restricting behaviours, whereas harm avoidance with binging and purging. RAN trends to have low scores in novelty seeking items and BN shows lower reward dependence, but this differences are not statistically significant, perhaps because of sample size.
P02-318 - Stress, Mental Disorders & IBS”
Authors: Solati K. , Adibi P. , Palahang H. 
Published: June 2010

ObjectiveThe aim of this study was to find relationship between life events stress, mental disorders and irritable bowel syndrome.MethodsThis descriptive and cross sectional study was performed during six months on the 76 patients IBS. The life events stress or Paykel, GHQ-28 and Rome III criteriaand clinical interview was used assessment.ResultsThe differences were statistically significant between life events stress and mental disorders with IBS (P< 0/05).ConclusionPsychology distress and life events stressor is important component of the IBS symptom experience and shoud be considered when treatment strategies are designed.
P02-322 - Integrative Approaches in the Therapy of the Comorbid Conditions
Authors: Kim A. , Sulaimanova M. 
Published: June 2010

ObjectivesStudy of the clinical features in the group of somatoform and psychosomatic disorders.MaterialsThe results of clinical and epidemiological study of 2181 patients (average age-54 ± 0.8) are presented.Methodsinventory for clinical-anamnestic behavior sign of adaptation form of disease of patients with comorbid phenomenon and standard scales for value of anxiety and depressions were used.ResultsThe homogeneous group of disorders in which somatic as well as psychical symptoms are equivalent 6,7 (P< 0,05).The phenomenon of comorbidity as the independent clinical adaptive mechanism was revealed 8,3 (P< 0,05). In the research group the positive response for the psychotropic therapy was registered 5,3 (P< 0,05).ConclusionThe phenomenon of comorbidity in practice area reduces to new understanding of the coexistence of the psychic and somatic register, illustrates the possibility of the valuation of indicator of quality of manifestation of symptom and syndrome in context of social functioning. The social functioning is the indicator of quality and optimization of the diagnostic and therapeutic processes, which are demanding independent culturally dependent diagnostic directives from existing classifications (ICD-10, DSM-IV). The somatic symptom is the integral part of psychopathologic syndromes.
P02-323 - The Prevalence of Disorders Eating in Patients with Diabetes Mellitus
Authors: Danoiu M. , Danoiu S. , Danciulescu Miulescu R. , Poiana C. , Cristescu V. 
Published: June 2010

ObjectivesThe aim of this study was to estimate the prevalence of disorders eating among patients with diabetes mellitus.MethodStudies have shown that The Eating Attitudes Test (EAT-26) can be an efficient screening instrument as part of a two-stage screening process in which those who score at or above a cut-off score of 20 are referred for a diagnostic interview. 44 patients with diabetes mellitus (28 women and 16 men) were recruited for this study. Height, current weight, body mass index (BMI) were determined. The EAT- 26 for Eating Disorders was completed. Results were compared with measurements in 32 nondiabetic subjects (22 women and 10 men).Results and conclusionsThe prevalence of disorders eating among patients with diabetes mellitus was 18.18%. Of the 44 patients with diabetes mellitus, 8 scored higher on EAT (average score 32.01, BMI 31.36 kg/m2) than the remaining 36 patients with diabetes mellitus, whose score averaged 14.22 (BMI 26.32 kg/m2). In this study we found significant differences for the recorded parameters between diabetic patients with and without disorders eating. Age were similar in both groups, but BMI were higher, and scored on EAT were higher in diabetic patients with disorders eating. The prevalence of disorders eating among nondiabetic subjects was 6.25%. Two patients with diabetes mellitus develop a clinical eating disorder and needs cognitive-behavioral, interpersonal psychotherapy and pharmacologic treatment. The EAT-26 score at or above of 20 needs expertise in eating disorders, and nutrition.
P02-326 - Impact of IBS-like Symptoms on Quality of Life in Patients with Crohn's Disease in Remission
Authors: Trikos L. , Bojic D. 
Published: June 2010

ObjectivesIrritable bowel syndrome (IBS) is one of the most prevalent functional gastrointestinal disorder. The aim of our study was to assess the prevalence of irritable bowel syndrome (IBS)-like symptoms in Crohn's disease (CD) patients in remission. Furthermore, the possible relation of IBS-like symptoms with quality of life was studied.MethodsSixty-four patients with known Crohn's disease were invited to complete the SF-36 (to assess quality of life) while in clinical remission and were studied for the possibility of IBS-like symptoms. Diagnosis of IBS was made according to ROME III Criteria. Physical health summary score (PCS) and mental health summary scores (MCS) of CD patients with IBS-like symptoms were compared with PCS and MCS of CD patients without IBS-like symptoms.ResultsIBS-like symptoms were found in 55% of Crohn's disease patients in remission. CD patients with IBS-like symptoms had lower well-being scores than those without IBS-like symptoms.ConclusionThe presence of irritable bowel syndrome-like symtoms impaired the quality of life of patients with Crohn's disease.