bluuebunny/crossref_metadata_2025_split huggingface dataset:
Feasibility barriers and effectiveness of specific treatments for early psychosis in routine mental health care
Authors: Ruggeri M. 
Published: May 2011

IntroductionIssues of organisational structure and commitment, resource development, and clarity of roles and responsibilities must be addressed before proceeding with any attempt to implement evidence based interventions in a specific service.Evidence suggests that the management of most mental disorders and especially of psychoses is frequently suboptimal. This trend might reflect instances of inadequate resource allocation, but might also reflect the effects of stigma, discrimination, and social exclusion that people with psychosis often experience. It might also indicate poor management of available resources or deficiencies in knowledge or practice.AimsMulti-element psychosocial interventions in the first 5 years from psychosis onset have proved to facilitating recovery and reducing long-term disability. However, most studies often do not test efficacy against a control group and have been conducted in non-epidemiologically representative samples. The presentation will be focussed on process of assessment of acceptability and discrepancies between evidence and clinical practice in the treatment of schizophrenia in community care.Methods and ResultsTrials - such as the GET UP Trial (National Coordinator: Mirella Ruggeri) that is part of the Strategic Research Programs of the Italian Government - that are being conducted in the routine practice and that aim to test the feasibility and cost-effectiveness of evidence-based psychosocial interventions will be presented and discussed.ConclusionsVerify the barriers to application and situations when evidence-based interventions practice might be ineffective or inappropriate, understanding their advantages and limitations is a crucial challenge in the area of early psychosis treatment.
Needs of fathers and mothers of schizophrenia patients
Authors: Wancata J. , Matschnig T. , Freidl M. , Unger A. , Friedrich F. 
Published: May 2011

IntroductionMost studies investigating the problems and needs of schizophrenia patients’ carers include only one care-giving relative - mostly the patients’ mothers.PurposeThe compare needs of mothers and fathers of patients with schizophrenia.Methods101 sets of parents of patients suffering from schizophrenia were included in this study. They were assessed by means of the “Carers’ Needs Assessment for Schizophrenia”.ResultsCompared to fathers, mothers reported significantly more often problems concerning stress due to earlier life events and burn-out. Mothers required some interventions such as individual psychoeducation or family counselling more than twice as often than fathers. Overall, mothers reported more problems and needs than fathers. The number of mothers’ problems was predicted by not living with a partner and a shorter duration of the patients’ illness (DUPI). The number of mothers’ needs was predicted by patients’ psychiatric symptoms, not living with a partner and a shorter DUPI. Among fathers we could not identify any predictors, neither for problems nor for needs.ConclusionsParents of schizophrenic patients have various problems handling their child's illness and therefore need professional support. Overall, mothers reported more problems and needs for interventions than fathers. The differences between mothers’ and fathers’ problems and needs indicate the importance of considering the carer's gender in clinical work.
Early learning experience and adolescent anxiety: A cross-cultural comparison between Japan and England
Authors: Essau C.A. , Ishikawa S.-I. , Sasagawa S. 
Published: May 2011

Anxiety disorders are among the most common psychiatric conditions in children and adolescents. One of the most consistent findings across studies is that anxiety disorders tend to run in families. While these high prevalence rates suggest that anxiety may be “transmitted” within the family, the exact mechanism involved in this transmission is still unclear. An area that has been suggested in the transmission of anxiety from parents to children is the role of learning experiences (i.e., through modeling and information transfer). While these studies have enhanced our knowledge on the association between learning experience and anxiety symptoms, it is not known whether these findings which were based on studies conducted in Western culture could be replicated in Eastern culture.The present study compared the frequency of anxiety symptoms among adolescents in Japan and England, and examined the association between early learning experiences and anxiety symptoms. 299 adolescents (147 from England and 152 from Japan) were investigated. Adolescents in England reported significantly higher levels of anxiety symptoms than adolescents in Japan. No significant differences emerged between the two countries for parent punishment/reinforcement of anxious behavior. However, for non-anxiety symptoms, adolescents in England scored significantly higher in parent punishment and the Japanese sample scored higher in parent reinforcement. Parent verbal transmission about the danger of anxiety and cold symptoms was more common in Japan than in England. The impact of learning experience on adolescent's anxiety seemed to differ across cultures, which underscore the importance of cultural factors on adolescent's anxiety.
Self-injurious behavior and suicidal behavior in adolescents: Results from population based studies in Germany
Authors: Brunner R. , Kaess M. , Parzer P. , Haffner J. , Resch F. 
Published: May 2011

IntroductionSelf-harming and suicidal behaviour are both well-recognized problems during adolescence. While prevalence rates are very high and still rising in most western countries, there is an extensive need for understanding childhood developmental aspects, personality factors and psychological correlates of self-harm and suicidality. Additionally, specific and effective prevention should be established regarding self-harming and suicidal behaviour as one of the largest concerns of public health during this period of life.ObjectivesTo investigate the prevalence and the associated psychological and social factors of self-harming behaviour in adolescents. To evaluate a school-based intervention aimed at reducing self-harming behaviour in adolescents.MethodsIn the years 2005 and 2010 we performed one population-based, cross-sectional study including a sample of 5,759 ninth-grade students and one randomized-controlled, school-based prevention study within the large EU-consortium (SEYLE) comprising a sample-size of 1,387 students on self-harming and suicidal behaviour in Heidelberg.ResultsThe data suggest that there is a strong link between social factors and occasional self-injurious behavior and, especially in repetitive self-injurious behaviour, that there is a strong association between self-injurious behaviour and suicidal behaviour as well as self-injurious behaviour and emotional and behavioural problems. Preliminary results of the randomized-controlled prevention study could reveal a decrease of self-harming behaviour in adolescents in the short-term as well as long-term-follow-up.ConclusionsThe results support a need to investigate the possible neurobiological underpinnings as well as social factors of self-harming behaviour within a longitudinal model.
Evidence-based training in treatment treatments: The case of pediatric psychopharmacology
Authors: Jensen P.S. 
Published: May 2011

IntroductionDespite major research advances in pediatric psychopharmacology and psychotherapy over the last 20 years, the lack of well-trained specialists has posed almost insurmountable barriers to many children and families from receiving high-quality, evidence-based assessment and treatments. The REACH Institute, an international non-profit organization dedicated to disseminating evidence-based treatments, has developed portable, effective methods to train primary care and specialty health providers in pediatric psychopharmacology and psychotherapies.ObjectivesTo develop effective, scientifically-proven methods for teaching and disseminating evidence-based treatments.AimsTo develop, disseminate, and evaluate high quality approaches for teaching primary care and specialty mental health practitioners in pediatric psychopharmacology.MethodsUsing novel approaches grounded in scientific behavioral change technologies, over 700 health care providers have been trained in evidence-based pediatric psychopharmacology in sites across multiple countries, including the US, Canada, and Norway. All trainings are rigorously evaluated for changes in health care practitioners' behaviors and clinical practices, including within an NIH-funded randomized controlled trial (RCT).ResultsTrainings have been very well-received across multiple countries, requiring only minor adaptations. These trainings have been effective in yielding changes in health care practitioners abilities and actual clinical practices, enabling more children to access appropriate pediatric psychopharmacology.ConclusionsEffective and disseminable methods for changing health care practitioners behaviors in applying pediatric psychopharmacology treatments are possible, and can be adapted to different countries, languages, and cultural contexts.
Is there a biological basis to the Bipolar spectrum?
Authors: Agius M. , Lee J. , Wotherspoon D. 
Published: May 2011

BackgroundThe Bipolar Spectrum is usually presented as a Clinical Spectrum. We attempt to demonstrate that there is a neurobiological basis to this spectrum.MethodWe carried out a review of the literature.ResultsThere is evidence, at a neuroimaging level, at a genetic level, and also at an intracellular level for a biological basis to the bipolar spectrum.DiscussionWhat arises from this review is that the bipolar spectrum may be wider than previously thought. It is of interest that similar neuroimaging findings may be found in PTSD, Unipolar Depression, Bipolar Illness, and Borderline Personality Disorder.ConclusionThe key biological issue regarding the bipolar spectrum is the mechanism by which unipolar depression evolves over time into bipolar illness. At present we can only speculate about this mechanism, but its elucidation will clarify how these illnesses are related in the bipolar spectrum.
Do neurons have mood and how can it be stabilised?
Authors: Hranov L.G. 
Published: May 2011

Polarity of affective tone has taken the role of the core defining feature of bipolar affective disorder (BAD) eclipsing Falret's and Kraepelin's emphasis on cyclicity and recurrence. Yet in many clinical cases polarity is lost in the course of time while cyclic recurrence persists for decades, completely disrupting patients’ lives. That's why true “mood stabilisation” aims not as much at reducing episode severity as at reducing episode number to a minimum.On the neuronal level polarity could be envisaged as interplay between arousal and inhibition due to trans-membrane ion currents, either brief and adaptive or pathologically sustained. Cyclicity and recurrence could arise from permanent deficits in neuronal plasticity and resilience which are to a large extent under genetic control. The “mood stabilising” properties of different pharmacological agents are due to multi-level actions on the intracellular signal transduction pathways affecting the function of Gi and Go proteins, of some intracellular messengers (mioinositol, Bcl-2, ER stress proteins, MARKS, the complex calmodulin-synapsin1-synaptotagmin), and of some crucially important enzymes: adenilyl cyclase, various protein kinases (ά, ε, C, MAP, Akt), mitochondrial respiratory chain enzyme complexes, histone deacetylase and acetyltransferase, GSK-3. Thus, in the long run “mood-stabilising agents” exert blockade of excitotoxic/apoptotic pathways, phosphorilation of microtubular proteins, and regulation of the expression of genes implicated in processes involved in neuroplasticity, neuroprotection, even neurogenesis, and hamper the long-term neuronal (and by extension, mental) deterioration. Lithium displays the broadest spectrum of such actions and provides, by far, the best control over the chronic protean symptoms of BAD.
Genetics of schizophrenia and bipolar disorder
Authors: Pregelj P. 
Published: May 2011

According to recent knowledge there are probably multiple susceptibility genes involved in patophysiology of schizophrenia and bipolar disorder, each of small effect, which act in conjunction with environmental factors. These genes could influence synaptic plasticity, neurodevelopment and neurotransmission. There are an estimated 4,000 genes involved in the complicated communication between brain cells. However, overlapping of candidate genes between both disorders was reported.Recent studies revealed that random mutations not inherited from either parent play a role in schizophrenia. The relation between psychopathological events, the phenomenology of the trauma and neurobiological changes related to schizophrenia and bipolar disorder is not totally understood.The symptoms of schizophrenia are believed to be triggered by stress-induced changes in neurobiological systems representing an inadequate adaptation of neurobiological systems to exposure to stressors. Recent studies suggest that epigenetic mechanisms may play an important role in the interplay between stress exposure and genetic vulnerability also in humans. In preclinical studies it was first suggested that epigenetic mechanisms may be involved in the modulation of gene expression in response to stressful stimuli. Recently, epigenetic differences in a neuron-specific glucocorticoid receptor (NR3C1) promoter between postmortem hippocampus obtained from suicide victims with a history of childhood abuse and those from either suicide victims with no childhood abuse or controls were found, indicating the involvement of these mechanisms in human adaptation to stress. Future research could lead to prenatal screening for both disorders, and for new, more personalized approaches to treating people depending upon their genetic profile.
Variation in oxytocin receptor gene and psychiatric illness
Authors: Brüne M. 
Published: May 2011

Oxytocin (OT) is an evolutionarily conserved nonapeptide that is produced in the magnocellular neurons of hypothalamic paraventricular and supraoptic nuclei. The widespread intracerebral projections of OT-producing neurons subserve its role as a neurotransmitter and neuromodulator. OT is well known for its functions in reproduction, including parturition and lactation. In recent years, the effects of OT on social interaction have become a focus in both normal and abnormal psychology research. OT attenuates fear responses, improves empathy and also exerts major effects on pair-bonding and attachment.Studies have revealed that polymorphic variation of the oxytocin receptor gene (OXTR) also influences stress reactivity and empathetic responses in humans, as well as temperament, and even amygdala volume. This clearly implies that OXTR variation interacts with environmental contingencies, such that it can be regarded an interesting target in psychopathology research.OT has the potential to ameliorate symptom severity in psychiatric conditions such as social anxiety disorder, autism and schizophrenia. Accordingly, future research into the interaction between OXTR variation and environment may contribute to clarify the role of OT in psychopathology.
Gene environmental interaction in psychiatry: The 5-HTTLPR and COMT story from an evolutionary point of view
Authors: Sanjuan J. , Costas J. , Molto M.D. 
Published: May 2011

The general medical model explains that there are genetic and environmental risks and protective factors in the aetiology of any complex disease. The main idea supported by this model is the existence of good and bad polymorphisms. We present a review of the literature and some examples of our own empirical studies about this issue in psychiatry; with special focus on the methodological problems of this medical model.In relation with 5-HTTLPR we present the results of a longitudinal study of 1804 women. In this study the “LL” genotype seems to be a risk factor for post-partum depression, probably due to gene-hormone interaction after delivery. But the same genotype might be a protective factor of emotional disorder in other life-time and environmental condition.In relation with COMT gene, we present a meta-analysis (including our own data) of 51 studies comprising 13,894 schizophrenic patients and 16,087. We found a small but significant protective effect for heterozygosis at rs4680 (pooled OR ¼ 0.947, P¼ 0.023; pooled OR ¼ 0.813, P¼ 0.0009). Thus, the COMT functional polymorphism rs4680 contributes to schizophrenia genetic susceptibility under an over-dominant model, indicating that both too high and too low levels of dopamine (DA) signalling maybe risk factors.In summary, both examples suggested that there are no ‘bad’ or ‘good’ genotypes in relation to common variants. The controversial results of many genetics associations’ studies in psychiatry might become comprehensive under an evolutionary approach.
S12-03 Individual differences in social affiliation: The role of the A118G polymorphism of the mu-opioid receptor gene (OPRM1)
Authors: Troisi A. 
Published: May 2011

IntroductionMost of us find social encounters rewarding, especially when we encounter those with whom we are familiar and have built up a relationship. From an evolutionary point of view, this is not surprising considering that human beings are fundamentally social organisms. Considering that endogenous opioids mediate hedonic responses to a variety of natural rewards, the common A118G polymorphism in the mu-opioid receptor gene (OPRM1) might also modulate individual differences in the capacity to experience social reward.AimsIn the present study, we hypothesized that, compared to individuals with the A118A genotype, individuals expressing the minor 118G allele had an increased need for affiliation and an increased capacity to experience social reward.MethodsIn a mixed sample (N = 214) of adult healthy volunteers and psychiatric patients, we analyzed the association between the A118G polymorphism of the OPRM1 and two different psychological constructs reflecting individual differences in the capacity to experience social reward.ResultsCompared to individuals expressing only the major allele (A) of the A118G polymorphism, subjects expressing the minor allele (G) had an increased tendency to become engaged in affectionate relationships, as indicated by lower scores on a self-report measure of avoidant attachment, and experienced more pleasure in social situations, as indicated by lower scores on a self-report measure of social anhedonia.ConclusionsThe results reported here are in agreement with the brain opioid hypothesis of social attachment and raise several questions about the maintenance of the A118G polymorphism in the evolution of human social behavior.
Dialogue and challenge among different specialities
Authors: Atti A.R. 
Published: May 2011

IntroductionThanks to social, technological, and medical advances occurred during the last century, the aging of the population has become a worldwide phenomenon (Kinsella, 2002). The high socio-economic impact of this demographic transition has recently stimulated a growing interest for the aging process (Lunenfeld, 2008) and elderly mental health has been receiving increasing attention (Mental Health in Older People. Consensus, 2008).ObjectiveOld age psychiatry, or psychogeriatric, deals with psychiatric conditions that predate the ageing process such as schizophrenia or depression, and with diseases occurring later in life like dementia and other cognitive disorders. To cope with the increased workload due to older people, Psychiatric Services are required to provide multidisciplinary, comprehensive and integrated care.AimsTo investigate the attitude of Bologna's Psychiatric Services in the care of elderly affected by psychiatric disorders.MethodsSelf-completed questionnaires administered to psychiatrists.ResultsPsychogeriatric is the second main priority of psychiatry for the new millennium. Psychiatrists working in liason-consultation settings take care of around 20 elderly patients per weeek. Sedation, insomnia and resistant-depression treatment are the most frequent interventions required to psychiatrists by colleagues of other specialities. Psychiatrists report feelings of un-satisfaction and worries for potential drugs side-effects. They “don't like much” dealing with elderly people especially with patients affected by un-treatable conditions such as dementia (narcissistic wound?).ConclusionAccessible and responsive services working in liason with other medical specialists, gero-psychiatric nurses, case manager and social workers might be a good response to the increasing needs of elderly with mental health disorders.
Routine Outcome Monitoring (ROM) in Belgian and Dutch forensic patients
Authors: Goethals K. 
Published: May 2011

IntroductionBy means of ROM, the efficacy of forensic psychiatric treatment can be measured in domains of risk of recidivism, level of psychopathology, and quality of life. Although, research of the efficacy of this treatment has several methodological pitfalls.ObjectivesTo review the literature of ROM in forensic psychiatry; to consider the way of implementing ROM; to present relevant instruments in the domains as mentioned above.AimsTo investigate whether forensic psychiatric treatment leads to less symptoms, and a decrease of reoffending; to investigate the correlation between degrees of psychopathology and quality of life.MethodsPatients are recruited from the University Forensic Center (UFC), Antwerp, Belgium, which is a outpatient facility for treatment of sex offenders. In the future patients from other facilities will be included. Several instruments are used to measure the degree of psychopathology, risk of recidivism, and quality of life.ResultsPreliminary results are presented and discussed in this paper.
Definitions of reality
Authors: Oyebode F. 
Published: May 2011

IntroductionThe nature of reality is an age-old problem. The distinction to be drawn between the external world and our subjective experience raises questions about how far our experience of the phenomenal world corresponds to the objective external world.AimsIn this talk I will describe Plato's simile of the cave, and use this to examine the nature of reality and of illusion. I will then turn to how reality and illusion are dealt with in literature, drawing examples from Cervantes' Don Quixote, Jose Samarago's Blindness, Sophocles' Oedipus The King, and the works of Borges' & Kafka. I will also critically examining Baudrillard's simulacrum.MethodThis will involve conceptual analysis of the ideas and notions in the texts described above.ResultsWe can never be sure of the accuracy and validity of our experiences. This problem is even more acute in the modern world because of the difficulty that consciousness has in distinguishing reality from fantasy.ConclusionThe philosophical and literary ideas and concepts about reality are of great importance to psychiatrists, not least because of the distortions of reality that many patients experience. I will conclude by emphasizing the implications of these notions for psychiatrists.
Reality in depression
Authors: Cutting J. 
Published: May 2011

The presentation will cover 3 aspects of reality:
1)Reality as resistance;2)Reality as actuality;3)Reality as correct insight.A brief consideration of the nature of these in normals will be given.
A descriptive account of the psychopathology of each aspect will be then discussed, with particular emphasis on:
a)undue resistance in depressive illness;b)qualitative differences in actuality, i.e experience of external world and body in schizophrenia;c)so-called “depressive realism” as a more correct insight into ones owen actions than is possessed in normals.