bluuebunny/crossref_metadata_2025_split huggingface dataset:
P01-261 - Felt Security and Suicidality in a Clinical Sample of Adolescents
Authors: Zanussi U. , Cawthorpe D. , Wilkes T.C.R. 
Published: June 2010

IntroductionAttachment theory offers both a conceptual framework and an empirical basis for understanding the development of parent-child relationships and their contribution to individual psychosocial adaptation across the life cycle. Although no existing model adequately predicts suicide, family relationship problems are increasingly implicated in the etiology of adolescent suicidal behaviour.ObjectivesWe sought to examine the association between felt attachment security and a history of suicidal behaviour among a group of adolescents in psychiatric treatment.MethodsIn this cross-sectional study, we examined the association between felt attachment security and a history of suicidal behaviour among 122 hospitalized adolescents. Felt security (as measured by the validated Adolescent Attachment Questionnaire) has been defined as one's perception of the availability and responsiveness of an attachment figure.ResultsCompared to others, the group coded as both depressed and suicidal had significantly higher scores on the AAQ subscales of ‘perceived unavailability’ and ‘angry distress’, as well as higher comorbidity and lower self-esteem compared to non-suicidal, non-depressed adolescents. The model accounted for approximately 50% of the observed variance.ConclusionsAttachment theory integrates ethological and psychoanalytic principles in describing the origins and growth of human personality. It provides a coherent framework for understanding adolescent suicidality.
P01-410 - Stress-related, Self-inflicted Wounds During On-line Gaming: Diagnosis, Co-morbidity and Treatment
Authors: Siomos K. , Floros G. , Braimiotis D. , Lappas A. , Karagiannaki-Kastani I. 
Published: June 2010

ObjectivesThe purpose of this presentation is to describe two cases of teenage addiction to on-line gaming where the subjects required medical attention due to unintentional, self-inflicted injuries to the tongue and upper lip during the course of the game.MethodsCase study of two teenage boys, both aged 15, who attended the Specialized Outpatient Unit for Internet and PC Addiction in our Clinic, due to incessant on-line video-gaming that had a number of detrimental effects to their well-being.ResultsThe first teenager had repeatedly bitten his tongue due to stress experienced during gaming while the second had bitten his upper lip. In both cases their injuries required emergency medical assistance and thorough examinations for other possible causes (e.g spasms) for their injuries were negative. The first teenager was diagnosed with Internet Addiction Disorder and separation anxiety - pathological attachment to mother, he scored 78 on WISC-III. A behavioral intervention for separation anxiety and a CBT program for IAD was successful; his on-line gaming was limited to 2 hours/day on follow-up. The second teenager was diagnosed with IAD and co-morbid depressive disorder. Fluoxetine (30mg/day) was initiated and his mood improved while his computer usage time fell from 16 to 4 hours/day. A CBT program was initiated and he's under treatment with good progress.ConclusionsTeenagers addicted to on-line gaming can experience severe stress which they may instinctively attempt to alleviate with self-inflicted wounds. Co-morbidity with other psychiatric disorders should be carefully assessed. Treatment can be pharmaceutical or psychotherapeutic.
P01-264 - Depression, Alcohol Use Disorders and Nicotine Dependence in the General Hospital
Authors: Botega N. , Mitsuushi G.N. , Azevedo R.C.S. , Mauro M.L.F. , Fanger P.C. , Lima D.D. , Silva V.F. , Gaspar K.C. 
Published: June 2010

ObjectivesTo identify prevalence rates and related patient characteristics associated with depression, alcohol use disorders (AUD), and nicotine dependence among individuals admitted to a university general hospital.Methods4352 consecutively admitted patients were assessed using the HAD scale and AUDIT. They were also asked on daily cigarette smoking during the previous month. Multivariate logistic regression analyses were performed.Results56.6% were male. The average age was 49.3. Prevalence rates of depressive disorder, AUD and nicotine dependence were, respectively, 14%, 9.8% and 16.9%. In the multivariate analysis depression was associated with previous suicide attempt (OR = 8.7), less schooling (3.6), prior use of psychotropic medicines (3.1), cancer (1.7) and pain (1.7). AUD were associated with male sex (OR = 6.3), smoking (3.5), admission for an external cause (2.4), mainly road accidents, and previous suicide attempt (2.3). Nicotine dependence was associated with AUD (OR = 3.4), young adulthood (2.3), widowhood (2.2) and previous suicide attempt (1.8).ConclusionsThis is the largest sample of medical and surgical inpatients surveyed by standardized screening instrument, for 13 months, in a Brazilian general hospital. High prevalence rates of psychiatric disorders and respective patient profiles highlight the need to develop more effective methods for detecting and managing these disorders. Hospital admission should be considered a milestone in a person's life from which a psychiatric disorder is detected and specific treatment strategies are implemented.
P01-266 - To assess the Impact of an Alcohol Nurse Specialist on Alcohol Related Referrals to an Irish Liaison Psychiatry Service
Authors: Clancy M. , Cotter D. , MacHale S. 
Published: June 2010

IntroductionReferrals for advice regarding treatment of alcohol related disorders form a large component of the liaison psychiatry workload. This study aims to demonstrate whether the addition of an alcohol liaison nurse specialist would decrease the number of patients needed to be seen by psychiatrists.MethodsIn-patient ward referrals were examined over 2 nine month periods. The first nine month period examined all alcohol related referrals when there was no liaison alcohol nurse. In the second period, the nurse was present. Data was analysed using SPSSv15.ResultsA total of 243 referrals were examined over the 18 month period. The number of alcohol related referrals to psychiatrists dropped from 145 to 97 after the arrival of the alcohol nurse. This represented a 33% drop in the number of referrals. The alcohol nurse saw a total of 175 referrals. The psychiatrists saw a higher percentage of delirium tremens, 13.3% increased to 27.7%, p value .009. Also of note, the percentage of female referrals increased from 28.9% of all referrals to 44.3% of all referrals after the arrival of the alcohol nurse p=.027.ConclusionThe addition of an alcohol nurse specialist led to a substantial drop in the number of alcohol related referrals to psychiatrists allowing additional time to be devoted to other aspects of the liaison psychiatry workload. More patients with delirium tremens and more women are being seen since the introduction of the alcohol nurse. Medical teams have a lower threshold of referral and more hazardous and harmful drinking was identified. Earlier intervention can help decrease longer term morbidity from alcohol.
P01-268 - The Role of Psychostress in Breast Cancer Carcinogenesis
Authors: Djordjevic M. , Sapic R. , Krivokapic Z. , Bojic M. 
Published: June 2010

Stress as a risk factor is often taken into consideration in various research studies nowadays. There seems to be an emotional background in developing different diseases.The aim of the study was to quantify psychostress through a case-control approach.MethodologyFollowing the matching in accordance with age, place of living, profession and marital status, 286 cases and 529 controls were interviewed looking for these parametres: death of the family member, an accident with severe consequences, the loss of work, a serious illness of a family member, divorce. Multifactorial logistic regression analysis was used for relative risk (RR), interval of cofidence (IC), attributive risk (AR), an estimation parametre vector, standard error, standard regressional coefficient, HI square test.ResultsThe study shows that the biggest emotional stress is death of child, death of mother, loss of work, disability, all of which were generally experienced two years prior to clinical diagnosis of the disease. RR for the cases is l.9 with the IC l.4 - 2.6 and AR 22%. RR for women in urban areas is higher than for those in rural areas and reads 2.2 with IC l.5- 3.l. It is interesting to point out that RR is the highest among the women aged 30 - 39 and reads 4.4, whereas for women aged 65 and beyond it is l.6.ConclusionAccording to the results in multifactorial etyology of the carcinogenesis we come to the conclusion that psychostress acted as a promoter two years before the illness was clinically diagnosed.
P01-272 - Study Regarding the Rehabilitation of Patients with Stroke and Associated Depression
Authors: Frunza A.A. , Laza C. , Manea M. , Nica A. , Mologhianu G. , Puiu M.G. , Popa M. , Bectas S. , Ghibusi E. 
Published: June 2010

ObjectiveThis study aimed to detect and quantify depressive disorders following strokes and to follow the evolution of such patients after administering anti-depressive medication in association with the rehabilitation program.Materials and methodThis is a prospective study on 36 patients suffering from post stroke hemiplegia, situated in an interval of two to twelve months after the stroke. The patients have been randomly divided into two groups, the study group consisting of 21 patients who received anti-depressive medication in addition to the rehabilitation program, and the control group (15 patients) who only received the rehabilitation therapy. All patients were evaluated for depression using the Hamilton depression scale (HAM-D) at the beginning of the study and after two months of anti-depressive medication. Their clinical and functional evolution was evaluated using standardized scales and quality of life scales (FIM). Other parameters were noted such as age, sex, level of education and family support.ResultsAs expected, both the depression and the functional scores improved significantly after two months of rehabilitation treatment associated with anti-depressive medication in the study group compared to the initial evaluation. Also, improvement was noted when compared to the results of the control group.Conclusions.in accordance with others published studies, this analysis shows the importance of early detection and treatment of post stroke depression.A multi disciplinary team that includes a psychiatrist must be assembled for the treatment of stroke patients, as such a team brings the most benefit to the patients.
P01-276 - Depression and Heart Failure Outcomes
Authors: Ibishi N.F. , Kola V. , Musliu N. 
Published: June 2010

Chronic illnesses such as HF may precipitate depression. In either case, there are both behavioral and pathophysiologic mechanisms by which depressive symptoms may lead to adverse outcomes in patients with HF.Depressive symptoms are common in patients with HF, and are associated with markedly worse baseline health status, and are a strong predictor of worsening of HF symptoms, functional status, and quality of life over time and leads to increased hospitalization and rate of mortality.Depression is an independent risk factor for HF mortality, either through direct pathophysiological mechanisms of neurohormonal activation, arrhythmia, inflammation and hypercoagulation or through behavioral mechanisms.A meta-analysis has demonstrated that patients with depression were three times more likely to be nonadherent with treatment recommendations. As for the treatment of obesity, poor nutritional habits, smoking, and sedentary lifestyles, patient non-adherence can complicate physician attempts to modify psychosocial risk factorsIn this article we review and synthesizes the research assessing the effects of depression as mental disorder in HF treatment and prognosis and can arise many unresearched issues regarding the future managment difficulties in untreated and undiagnosed depressive disorder and his outcomes.Clinicians should be aware of the strong link between depressive symptoms and adverse health status outcomes in patients with HF and the treatment of non-physical aspects of chronic disease should be considered as part of the management of HF, in order to reduce anxiety, depression, and disturbances of social function.
P01-281 - Psychopathological Features in Somatic Asymptomatic HIV Positive Patients
Authors: Latas M. , Kostic M. , Glomazic O. 
Published: June 2010

BackgroundMany studies on samples of HIV-positive patient's shows correlation of psychiatric symptoms and medical and immunological symptoms of HIV infection. Also, presence of psychiatric distress was showed in some somatic diseases, especially the ones which lead to chronic.AimThe aim was to examine presence of psychopathological symptoms among HIV-1 infected patients which haven’t developed AIDS, in comparison to hepatitis B or C infected patients.MethodsSample for consisted of 60 patients: a) 30 somatic asymptomatic HIV-1 seropositive patients who constituted study group, and b) 30 patients infected with hepatitis B or C which constituted control group. All of them have been assessed on the presence of psychiatric symptoms by the SCL-90 (The Symptom Checklist 90). After the assessment those two groups were compared by student's t test on every subscale and total score.ResultsResults of the study showed that patients in both groups exhibited moderate presence of psychopathological symptoms, especially symptoms of depression, anxiety and interpersonal sensitivity. Moreover, patients with HIV exhibited obsessive-compulsive symptoms. Results showed that there are no statistically significant differences in presence psychopathological symptoms between somatic asymptomatic HIV-positive patients and patients infected with hepatitis B or C.ConclusionBased on the results of this study it could be concluded that, beside the moderate presence of psychopathological symptoms in the samples of somatic asymptomatic HIV-positive patients and hepatitis B or C infected patients, there is no statistically significant difference in those samples of patients.
P01-287 - Psychiatric and Neuropsychologic Changes in Growth Hormone Deficient Subjects After Traumatic Brain Injury and Response to Growth Hormone Replacement Therapy
Authors: Maric N. , Doknic M. , Pavlovic D. , Pekic S. , Stojanovic M. , Jasovic-Gasic M. , Popovic V. 
Published: June 2010

ObjectiveTraumatic brain injury (TBI) is recently recognized as a risk factor for hypopituitarism, presented most frequently with growth hormone deficiency (GHD). GHD is associated not only with changes in body composition, but also with impaired quality of life, cognitive dysfunctions and some psychiatric sequelae, usually classified as “depression” or “atypical depression”. The impact of GH therapy on mental status is still unknown.DesignPsychiatric and cognitive functions were tested in six adult GHD subjects at baseline (minimum three years after TBI), reassessed after six months of GH replacement therapy as well as twelve months after discontinuation of GH therapy. Psychiatric and cognitive examinations included semi-structured interviews and three instruments: Symptom-checklist (SCL-90-R), Zung Depression Inventory and standard composite neuropsychological battery.ResultsSix months of GH therapy in GHD TBI patients improved cognitive abilities (particularly verbal and nonverbal memory) and improved psychiatric functioning. Severity of depression decreased, as well as intensity of interpersonal sensitivity, hostility, paranoid ideation, anxiety and psychoticism. In three GHD patients who stopped GH therapy for twelve months we registered worsening of the verbal and nonverbal memory, as well as increase in Zung score and three SCL dimensions: inter-personal sensitivity, anxiety and paranoid ideation.ConclusionThis preliminary data suggest that GH therapy induced reduction of depression, social dysfunction and improvement in certain cognitive domains in GHD patients after TBI. Our data support the necessity of conducting randomized placebo-controlled trials on the effects of GH therapy on neuropsychological and psychiatric status in GHD TBI patients.
P01-296 - “I don’t Want to be a Patient”: Case Report on Munchausen's Syndrome
Authors: Pires Z. , Ribeiro A. , do Vale C. , Monteiro L. 
Published: June 2010

ObjectivesThe Munchausen's Syndrome, first described by the English doctor Richard Asher in 1951, refers to a factitious disorder present in patients who are repeatedly admitted in medical emergencies for apparent serious diseases and are looking forward to intensive medical care. The authors present a challenging case report, highlighting the importance of a thorough medical investigation before setting into Munchausen's Syndrome stigmatizing diagnosis.MethodsThe authors present a case studied in an Oncological Center, with emphasis on the medical data, diagnostic process, multidisciplinary approach, family-social-occupational implications and outcome. A review on Munchausen's Syndrome, using Medline database, focusing on the last decade publications on the subject, was carried out.ResultsThe clinical presentation initially led to strong suspicion towards Munchausen's Syndrome, since it was an young adult, single, health related profession (doctor), with life event triggers (family and social isolation; affective rupture).With the on going diagnostic process, it ended out on an atypical presentation of Crohn's Disease. However, the stigmatizing label had already been set, adding psychological damage to the patient (adjustment depressive disorder).ConclusionFrom the Munchausen's Syndrome review in recent literature, the authors conclude that this rare diagnosis is even rarer on oncologic settings. It should always be an exclusion diagnosis, made after a careful medical screening carried on by an expert and multi-disciplinary team, which should include a liaison psychiatrist. The patient presented classical Munchausen's clinical profile, which can be misleading by it self, incurring into a misdiagnosis.
P01-299 - Effect of preoperative information and reassurance in decreasing anxiety in patients who are candidate for coronary artery bypass graft surgery
Authors: Ranjbar F. , Akbarzadeh F. 
Published: June 2010

Introduction and objectivesPsychological problems like anxiety in patients who are candidate for coronary artery bypass graft (CABGs) may increase mortality and morbidity. The effect of reassurance and preoperative information in decreasing anxiety is uncertain.AimsThis study was designed to address the effect of preoperative information and reassurance in decreasing anxiety patients who are candidate for CABGs.MethodsWith experimental study and random sampling 85 (55male and 30 female) of 238 patients who were candidate for CABGs were included and completed spilberger anxiety test on the day of admission. Preoperative information and reassurance was done and test was completed again a day before the surgery. At last the Statistical analysis was done.ResultsThe Mean score of anxiety in patients with mild anxiety disorder (21 patients) was 34± 4.2 before and 39±5.8 after intervention. In patients with moderate anxiety disorder (39 patients) the score decreased from 52.61±3.8 to 50.76±56. Twenty five patients had severe anxiety disorder formerly with score of 63.88±2.8 which decreased to 53.88±7.6. All of differences were significant statistically.ConclusionsIn patients with mild anxiety intervention of preoperative information and reassurance resulted in increasing of anxiety but in patients with moderate or severe anxiety disorder such intervention decreased the level of anxiety significantly.
P01-305 - Differences in the Treatment Response to Antithyroid Drugs Versus Electroconvulsive Therapy in a Case of Recurrent Catatonia With Graves’ Disease
Authors: Saito T. , Saito R. , Suwa H. , Yakushiji F. , Takezawa K. , Nakamura M. 
Published: June 2010

ObjectivesTreatment of medical catatonia sometimes requires management of presenting psychiatric syndrome as well as treatment of causative medical illnesses. Treatment response to these approaches may, however, differ even in the same patient suffering a relapse of a similar clinical picture, and this presents a therapeutic challenge for physicians. We therefore report a case of medical catatonia due to Graves’ disease which responded to antithyroid therapy in the first episode but required electroconvulsive therapy (ECT) when relapsed, then discuss the possible mechanism which caused different treatment response.MethodsWe describe the clinical course with the laboratory findings of recurrent catatonic episodes of a patient with Graves’ disease.ResultsA 25-year-old woman manifested stupor, catalepsy and echolalia accompanying goiter, proptosis and tachycardia. Laboratory findings on thyroid function were consistent with Graves’ disease. Treated with thyamazole (TMZ), her psychiatric and physical symptoms gradually subsided. She had remained euthyroid and symptom free for 10 years on TMZ 5 mg every other day. However, at age 35, she exhibited stupor with mannerism and stereotypy. Laboratory findings revealed mild exercerbation of thyroid function. Though antithyroid therapy regained euthyroid, her psychiatric symptoms persisted. Further treatment with neuroleptics did not ameliorate her symptoms. She was thus administered bitemporal ECT and recovered after 7th trial.ConclusionsAggravation of thyroid function associated with catatonic symptoms when relapsed was milder compared to the first episode. This suggested that dysregulation of thyroid homeostasis in the central nervous system might have persisted despite the peripheral euthyroid and could affect the treatment response.
P01-309 - The Life Quality of the Receivers a Year After Renal Transplantation
Authors: Tel H. , Tel H. , Dogan S. 
Published: June 2010

ObjectivesEnd stage renal disease (ESRD) is a chronic disease that shortens the life span of individuals. Renal transplantation is accepted as good choice in the treatment of patients with ESRD. Many physical, psychological and social problems have been observed for many years in receivers after renal transplantation. The problems encountered after renal transplantation may adversely affect the life quality of the individuals. This study is carried out to define the life quality of the receivers after a year of renal transplantation.Methods54 patients that were followed in a transplantation centre of a university hospital between January 2007 and January 2009 were included into the study. The data is obtained through personal data forms and SF-36 life quality scale.ResultsIt was defined meaningful negative relation between the age and life quality of the receivers was found (p< 0.00), as the age increases the life quality of the receivers decreased, the life quality of women receivers and the ones living in large families was found to be lower.ConclusionsThe life quality of the receivers after a year of transplantation was good in low level. It is necessary that the receivers be cared with holistic approach and supported them to have quality life considering life quality of the individuals.