bluuebunny/crossref_metadata_2025_split huggingface dataset:
CS06-01 - New insights into the cellular and molecular mechanisms underlying the etiology of schizophrenia
Authors: Marin O. 
Published: May 2011

Growing evidence suggest that disruption of cortical interneuron function is common to several psychiatric conditions, such as schizophrenia. Cortical interneurons play major roles in the function of the cerebral cortex. Through mostly inhibitory mechanisms, interneurons regulate the activity of pyramidal cells, prevent hyperexcitability, and synchronize the rhythmic output of cortical activity. In particular, the function of some classes of interneurons has been shown to be crucial for the generation and maintenance of gamma rhythms, a pattern of brain waves that is associated with perception and memory.Work in my laboratory aims at elucidating the mechanisms controlling the development of cortical interneurons. We have recently found that several genes associated with schizophrenia, such as Nrg1 and ErbB4, control several aspects of the development of cortical interneurons. In this talk, I will summarize our current view on the biological mechanisms that may underlie the etiology of schizophrenia, linking susceptibility genes, cortical inhibitory function and brain development.
CS06-04 - Short and long-term treatment outcomes in schizophrenia
Authors: Moeller H.-J. 
Published: May 2011

Schizophrenia is a chronic disorder with a high risk of poor outcome in terms of symptoms and social functioning and possibly also progressive brain alterations. The relapse rate is high and each relapse can induce further aggravations, both in psychosocial as well as in neurobiological terms. Thus, acute and long-term treatment with the highest degree of effectiveness should be provided to the patients in acute and long-term treatment.Neuroleptic medication is the most important part of the treatment regimen for schizophrenic patients. The efficacy of neuroleptics in the acute and long-term treatment of schizophrenia is very well proven and the effect size is comparatively high. The second-generation antipsychotics (SGAs) have advantages over the neuroleptics of the first-generation (FGAs), and high expectations have therefore been put into them for the treatment of schizophrenia. Their better extrapyramidal-motor tolerability and efficacy in treating negative, depressive and cognitive symptoms, in addition to positive symptoms, supposedly result in a more favourable influencing of the overall course of the disease and in a higher quality of life for the patients, thus improving their acceptance by patients and leading to increased compliance. Differences in the pharmacological profile can be identified among others by receptor imaging approaches.
DB01-01 - Is EBM killing the art of treatment in psychiatry?
Authors: Gaebel W. 
Published: May 2011

Evidence based medicine (EBM) is the conscientious, explicit, and judicious use of current best evidence in making decisions about the care of individual patients. The practice of EBM means integrating individual clinical expertise with the best available external clinical evidence from systematic research. Applied to treatment in psychiatry, somatic, pharmacological and psychotherapeutic therapy as well as prevention and rehabilitation are to be assessed systematically. Evidence-based practice guidelines for the treatment of mental disorders are available in many countries and were developed based on the principles of EBM. This includes literature reviews, which are time-consuming and beyond the scope of everyday clinical psychiatrists' work capacity. Thus, evidence-based guidelines support the art of treatment in psychiatry by providing expertise.Treatment algorithms published in treatment guidelines are often misunderstood as strict rules. In fact, guidelines cannot provide non-exceptional regulations. They imply the option to deviate from guideline recommendations. Guidelines and EBM will only be able to support clinical decision making. The “art” of making therapeutic decisions remains an essential competence of the practising psychiatrist.Adhering to guideline recommendations in psychiatric treatment leads to optimized patient outcomes. EBM thus provides a firm basis for often complicated treatment decisions in psychiatry and critically supports the art of treatment in psychiatry. It will never kill this art but rather help it to survive as a highly specialized, scientifically based medical competence.
DB02-01 - Drug treatment is not necessary for maintenance treatment of depression
Authors: Fava G.A. 
Published: May 2011

Prolongation or lifelong pharmacotherapy has emerged as the main therapeutic tool for preventing relapse in depression. However, outcome after discontinuation of antidepressants is unfavourably affected by the duration of their administration. Loss of clinical effects, despite adequate compliance, has also emerged as a vexing clinical problem. Use of intermittent pharmacotherapy with follow-up visits is another therapeutic option, that, however, entails the problems of resistance and of discontinuation syndromes.In recent years, several controlled trials have suggested that a sequential use of pharmacotherapy in the treatment of the acute episode and psychotherapy in its residual phase may improve long-term outcome. Antidepressant drugs may be tapered and discontinued during the course of psychotherapy. The sequential treatment of depression not fall within the realm of maintenance strategies. It is an intensive, two-stage approach, which is based on the fact that one course of treatment with a specific tool (whether pharmacotherapy or psychotherapy) is unlikely to provide solution to the complex array of symptoms of patients with mood disorders.
DB02-02 - Drug treatment is not necessary for maintenance treatment of depression - con
Authors: Möller H.-J. 
Published: May 2011

The efficacy of antidepressants is clinically relevant. The highest effect size was demonstrated for severe depression. Based on responder rates and based on double-blind placebo-controlled studies, the number needed to treat (NNT) is 5–7 for acute treatment and 4 for maintenance treatment. Monotherapy with one drug is often not sufficient but has to be followed by other antidepressants or by comedication/augmentation therapy approaches.Generally, antidepressants reduce suicidality, but under special conditions like young age or personality disorder, they can also increase suicidality. However, under the conditions of good clinical practice, the risk-benefit relationship of treatment with antidepressants can be judged as favourable also in this respect.The capacity of psychiatrists to individualise and optimise treatment decisions in terms ofthe right drug/treatment for the right patient’ is still restricted since currently there are no sufficient powerful clinical or biological predictors which could help to achieve this goal. There is hope that in future pharmacogenetics will contribute significantly to a personalised treatment. With regard to plasma concentration, therapeutic drug monitoring (TDM) is a useful tool to optimize plasma levels therapeutic outcome.
DB03-01 - We still need benzodiazepines in the treatment of mental disorders: The case against (invited debate)
Authors: Lader M. 
Published: May 2011

Benzodiazepines have anxiolytic, hypnotic, muscle-relaxant and anticonvulsant properties. They also lessen agitation in the psychotic patient. They are much safer than previously available drugs such as the barbiturates. All sedative drugs have characteristic pharmacodynamic effects, causing sedation, psychomotor slowing and memory impairment.The widespread use of benzodiazepines long-term is problematic. Even though some tolerance develops, long-term users are impaired in cognitive and psychomotor function compared to non-users. Tapering the drugs, even after several years of use, results in improvement in functioning. Newer anxiolytics such as SSRIs and pregabalin cause less impairment. Benzodiazepines are associated with dependence on prescribed doses with a clear-defined withdrawal syndrome lasting a few weeks; this is evident in 20–30% patients on benzodiazepines, and is severe in 10%. Benzodiazepines should never be withdrawn abruptly because fits paranoid or confusional psychoses may ensue. Secondary abuse of all sedative drugs is common and contributes to specific drug-related harms in abusers.Few longterm studies have been performed so the longterm risk/benefit ratio is imprecise. The paucity of “gold standard” clinical trials means that the benzodiazepines seem no more effective than placebo in the longterm as anxiety-- and insomnia-reducing agents.Alternative medications for the Anxiety Disorders have been developed and evaluated, principally SSRIs and pregabalin. Similarly, newer drugs are available for treating Sleep Disorders. Longterm use can be avoided by using non-pharmacological or non-dependence inducing medications. The fundamental problem which precludes routine longterm use is that it is impossible to identify those users who will develop dependence beyond 1–3 months prescription.
DB03-02 - We still need benzodiazepines in the treatment of mental disorders: The case against (invited debate)
Authors: Lader M. 
Published: May 2011

Benzodiazepines have anxiolytic, hypnotic, muscle-relaxant and anticonvulsant properties. They also lessen agitation in the psychotic patient. They are much safer than previously available drugs such as the barbiturates. All sedative drugs have characteristic pharmacodynamic effects, causing sedation, psychomotor slowing and memory impairment.The widespread use of benzodiazepines long-term is problematic. Even though some tolerance develops, long-term users are impaired in cognitive and psychomotor function compared to non-users. Tapering the drugs, even after several years of use, results in improvement in functioning. Newer anxiolytics such as SSRIs and pregabalin cause less impairment. Benzodiazepines are associated with dependence on prescribed doses with a clear-defined withdrawal syndrome lasting a few weeks; this is evident in 20–30% patients on benzodiazepines, and is severe in 10%. Benzodiazepines should never be withdrawn abruptly because fits paranoid or confusional psychoses may ensue. Secondary abuse of all sedative drugs is common and contributes to specific drug-related harms in abusers.Few longterm studies have been performed so the longterm risk/benefit ratio is imprecise. The paucity of “gold standard” clinical trials means that the benzodiazepines seem no more effective than placebo in the longterm as anxiety-- and insomnia-reducing agents.Alternative medications for the Anxiety Disorders have been developed and evaluated, principally SSRIs and pregabalin. Similarly, newer drugs are available for treating Sleep Disorders. Longterm use can be avoided by using non-pharmacological or non-dependence inducing medications. The fundamental problem which precludes routine longterm use is that it is impossible to identify those users who will develop dependence beyond 1–3 months prescription.
ECP02-01 - Globalisation and the impact of economic factors on psychiatric disorders
Authors: Bhugra D. 
Published: May 2011

IntroductionWith the process of globalisation in full flow, the movement of people and products across the globe has brought a series of difficulties. With migration the socio-economic status of the individuals may change with the likelihood that this status will be lower rather than higher, although depending upon the reasons for migration this may change too.ObjectivesLiterature shows that low socio-economic status is associated with a higher level of psychiatric morbidity.AimsWhether migration acts as a mediator needs to be investigated further.MethodsVarious studies have shown that rates of psychosis are elevated in migrants though these rates are differentially increased in different groups indicating that factors other than migration may be at play.ResultsIn this presentation the literature and link the acculturation and cultural identity with post-migration experiences will be reviewed.ConclusionA link exists between the perceptions within cultures and level of economic development of what constitutes mental health. The state of advancement of mental health services of a country will certainly have a large impact on prevalence rates. Further investigation should be carried out to examine in greater depth the relationship between social inequality and disorder prevalence, as distinct from income inequality.
ECP02-03 - Research perspectives in transcultural psychiatry for young psychiatrists?
Authors: Tarricone I. , Braca M. , Mencacci E. , Marseglia M.V. , De Gregorio M. , Colonna N. , Panigada S. , Stivanello E. , Berardi D. ,   Bologna Devereux Research and Study Group
Published: May 2011

IntroductionMigration is a growing phenomenon in western countries. Several studies report a greater prevalence of psychiatric disorders among migrants. Some studies indicate a interesting relation between such disorders in migrants and their migration history, particularly the process of integration in the host country (Bhugra and Jhons 2005; Morgan et al 2010).AimsTo present the Bologna Migration History Questionnaire, that is a research tool to study the migration history and identify the related determinants of psychiatric disorders.MethodsWe conducted a literature review on questionnaires used to study the determinants of psychiatric disorders in migrants and on etiopathogenetic hypotheses. We identified the main determinants to be investigated and expanded a research tool already used in a Mental Health Centre (MHC) of Bologna accordingly. A first version of this tool was discussed during a workshop with fieldworkers from different MHCs in Italy and with international experts on migration and mental health.ResultsThe developed tool includes three sections: 1) Pre-migration phase; 2) Migration phase; 3) Post-migration phase. Through the tool, information is gathered on: socio-economic factors that precede and follow the migration, reasons and organization of the migration, relations and social support in the host country, detected changes and satisfaction achieved within different fields of experience. Information can be retrieved either from medical records or through semi-structured interviews with the patients within a month from the first contact.ConclusionsCurrently the tool has been distributed to different Italian MHC to assess its feasibility with regard to data collection and the appropriateness of questions. Young psychiatrists and trainees show great interest in this study. We discuss discuss research perspectives for young psychiatrists within international research projects to better investigate the relation between migration and mental health in western countries.
ECP05-02 - Coercive measures and legal aspects
Authors: Kallert T.W. 
Published: May 2011

In detail two issues will be addressedThe analysis of standardized reports on the national legal situations on involuntary admission to psychiatric hospitals. This work revealed major cross-national differences, e.g. for basic conditions as well as for additional criteria for involuntary admission, time periods for making decisions, the association between involuntary placement and treatment, patients’ rights to register complaints, roles of relatives, and safeguard procedures of these processes.One of the clinical results (established by the assessment of 2326 legally involuntary patients) was that in the different countries, between 39% and 71% of the patients found the admission right after one month, and between 46% and 86% after three months. Female patients, those living alone and those with a diagnosis of schizophrenia had more negative views. Adjusting for confounding factors, differences between countries were significant. The presentation will outline that a potential explanation of these differences is the extent to which national mental health legislation protects the rights and interests of the patients concerned.Thus, the important, but complex link between coercive measures and legal aspects will be demonstrated. Further, the discussion section of this presentation will focus on legal issues which could be (cross-nationally) harmonized in the sensitive field of coercive treatment.
ECP05-03 - Treatment of suicidal patients: Legal and ethical aspects
Authors: Wasserman D. 
Published: May 2011

According to WHO estimates, 1.5 million people worldwide will complete suicide in the year 2020 and approximately 10-20 times this number will attempt suicide. Given that suicide still remains the most serious outcome of mental disease, it is essential that psychiatrists are specifically trained regarding legal and ethical aspects related to the treatment of suicidal psychiatric patients.Clinical decisions guided by evidence based knowledge and ethical judgments according to the principles of beneficence, non-maleficence and autonomy intimately interact when a psychiatrist performs suicide risk assessment, recommends treatment and follow- up rehabilitation measures. Ethical dilemmas of respecting acute suicidal or chronic suicidal patient's autonomy when she/he is unable to control self-destructive impulses, confidentiality, Do Not Resuscitate (DNR) orders and involuntary confinement for the institutional ward will be discussed.Existing research indicates that suicide risk is higher in the immediate aftermath of discharge from the hospital and when patients are transferred to outpatient care without securing the follow- up visit. Psychiatrists are sometimes under considerable pressure, due to economical downsizing of the psychiatric care, to discharge suicidal patients from inpatient care, which can lead to serious legal and ethical repercussions. Following evidence-based procedures is crucial, as well as maintaining a high standard of documentation for all processes and decisions taken.Continuous education of health care staff, scrutiny of existing routines and knowledge about own attitudes towards suicidal patients are needed in order to prevent suicide.
ECP05-04 - Malpractice - An issue for all psychiatrists
Authors: Beezhold J. , Maughan N. 
Published: May 2011

IntroductionPsychiatrists practice in a world of ever increasing scrutiny of their daily practice. Premiums for malpractice insurance are increasing year after year. Yet there are common themes that emerge from complaints and malpractice litigation that may be usefully elucidated in order to contribute towards improvements in psychiatric practice.ObjectivesBy the end of this presentation the audience will have a good practical and theoretical understanding of the common causes of malpractice complaints and litigation, and will be well placed to improve their practice accordingly.AimsThis presentation aims to examine and discuss malpractice issues in psychiatry. The focus will be on learning the lessons from the experience of other psychiatrists in order to improve the standard of our own practice, and improve our ability to deal appropriately with any future concerns and complaints.MethodsData and experience from medical malpractice insurers, research findings, perspectives from cognitive neuroscience and stories from the popular media will be reviewed. The presentation will highlight key issues and themes in order to draw out the lessons for all psychiatrists.ResultsCertain simple principles are fundamental to safeguarding psychiatric practice from malpractice complaints and litigation.ConclusionsAll psychiatrists are potentially vulnerable to malpractice complaints and litigation. There is much media attention paid to certain cases. This may in turn contribute to the public perception of psychiatry and psychiatrists. Yet there are also a number of straightforward steps that many psychiatrists can take in their day to day practice that will protect both themselves and their patients now and in the future. Improving our practice can not only benefit our patients and ourselves personally, but can also contribute to combating stigma and enhancing the image of psychiatry.
ECP06-01 - Genomewide - asscociation studies of psychiatric phenotypes: What they have told us and what to do next
Authors: Schulze T.G. 
Published: May 2011

Genome-wide association studies of psychiatric disorders have highlighted several novel susceptibility genes and taught us several importnat lessons.1)Psychiatric disorders are polygenic disorders. The contribution of each locus to risk of disease is modest and disease risk increases substantially with the total burden of risk alleles carried.2)The best findings from GWAS do not necessarily fall within those genes that have previously been widely studied.3)Pursuing a “top-hits-only” strategy may prevent us from understanding the genetic complexity of psychiatric disorders and polygenic disorders in general. A detailed consideration of the wider distribution of association signals across studies may prove to be a valuable strategy in complex genetics.4)Allelic heterogeneity may be an important factor in psychiatric disorders. Allelic heterogeneity means that a phenotype can be caused by different alleles within a gene; this phenomenon has been extensively observed in monogenic disorders such as cystic fibrosis as well as in BRCA1/2-associated breast cancer.5)Finally, as with other complex phenotypes, GWAS in psychiatric disorders demonstrate that the variants identified so far only account for a small fraction of genetic variability.Future research will need to embark on several complementary approaches in order to fill the yet “unexplained” part of the variance. These will among others include sequencing projects, pharmacogenetic studies, detailed genotype-phenotype dissection approaches, and the study of prospectively assessed phenotypes.
ECP07-01 - Cbasp workshop - introduction into the cognitive - behavioral analysis system of psychotherapy (cbasp) to treat depression
Authors: Brakemeier E.-L. , Berger M. 
Published: May 2011

The Cognitive Behavioral Analysis of Psychotherapy (CBASP) by James McCullough is the only psychotherapeutic intervention specifically designed for chronic forms of depression. CBASP integrates behavioural, cognitive, interpersonal, and psychodynamic theories and strategies.The approach focuses on problems resulting from maltreatment and inhibition of maturation in early childhood by using the therapeutic relationship in a personal disciplined way. In addition, other interpersonal strategies such as the Significant Other History, the proactive Transference Hypothesis, and the Interpersonal Discrimination Exercise are used to overcome preoperational thinking. By means of another specific technique, the Situation Analysis, patients learn to focus on the negative consequences of their usual behaviour and to use efficient social problem-solving strategies.In a large study involving over 600 patients with chronic Major Depression, CBASP proved to be effective. The combination of an antidepressant and CBASP was the most beneficial treatment condition. Particularly effective was CBASP for the subgroup of chronically depressives with an early childhood trauma.In the workshop the theoretical basis will be taught, the specific techniques will be shown by live and video demonstrations, and they will be practised.