bluuebunny/crossref_metadata_2025_split huggingface dataset:
Development of an Instrument to Measure the Level of Evidence-based Practice in Clinical Mental Health Services
Authors: Cawthorpe D. , Oliphant P. , Wilkes T.C.R. 
Published: March 2009

Introduction:While systems of care are identifying the need to employ evidence-based modes of treatment, there are to date few instruments designed to measure the degree to which clinicians apply evidence-based interventions. The interventions survey was designed to tap each clinicians’ understanding of evidence-based interventions and the degree to which they identify theory in relation to evidence-based intervention and diagnosis.Method:A literature review was conducted to identify evidence-based interventions. Search strategies included meta-analyses that focused on systematic review of a range of databases. Emphasis in the survey's design was placed on linking evidence-based interventions, diagnosis and theoretical orientations. Clinicians (n = 118) could select among a range of options including evidence-based interventions for specific diagnoses. In addition to mapping evidence to interventions by diagnosis, results include a report of index modal interventions used by staff by type (individual, group, family) and diagnosis. The higher the index reported (range 0-1) the greater the variation of interventions by diagnoses.Results:Forty percent of clinical staff favored more that one type of family therapy for different diagnoses, and 35% of staff favored more than one type of group therapy for different diagnoses, whereas about 30% of staff varied their choice of individual intervention as a function of diagnosis.Conclusions:The results indicate that the survey is able to tap a range of clinicians’ theoretical orientations and knowledge of evidence-based practices related to child and adolescent mental health interventions.
Self- perceived Health and Alzheimer Disease Incidence Risk. Data from a Population Based Cohort in Spain: NEDICES Study
Authors: Bermejo-Pareja F. , Trincado R. , Rodriguez C. , Fernandez M. , Vega S. , Morales-Gonzalez J. , Benito-Leon J. 
Published: March 2009

Background:Self-perceived health is a well-recognised predictor of later health outcomes and mortality, but its relationship to incident dementia has been scarcely explored.Objective:To analyze self- perceived health as a risk factor for dementia and Alzheimer disease (AD) in a population- based survey of the elderly (NEDICES) Study.Methods:Participants were evaluated at baseline (1994-1995) with a standardized questionnaire that included subjective and objective (chronic disorders) health status and screening questions for depression and neurologic disorders. At follow-up (a median of 3.2 years later in 1997-1998) an analogous protocol and neurological assessment were performed.Results:Of 5,278 participants evaluated at baseline there were 306 prevalent dementia cases, and 161 incident dementia cases were identified among 3,891 individuals assessed at follow-up (D: 115).Cox hazard ratio analyses showed that age, stroke and illiteracy were independent risk factors for dementia and AD. Aggregation of vascular risk factors was related to a higher risk of both dementia and AD. Good (and very good) versus less than good (fair, bad and very bad) self-perceived health was an independent risk factor for dementia (CI 95% 1.13- 2.16; p= .006) and AD (CI 95% 1.02- 2.18; p= .038) after adjusting by age, sex education and vascular risk factors.Discussion:Self-perceived health increased the risk for incident dementia and AD in the NEDICES cohort as it was previously described in the United Kindom MRC- CFA Study of dementia incidence. Global health measurements (self-perceived health, quality of life) needs farther studies as risk for dementia and AD.
My Experience in the First Female Psychiatric Intensive care unit in NHS in UK
Authors: Gintalaite K. 
Published: March 2009

Introduction:A new PICU for women was opened in January 2007, and was the first Unit of its kind in the NHS. It provides an inpatient care for women detained under Mental Health Act 1983 with serious mental illness. The main group of service users comprises women with borderline personality disorder. Median length of stay is 6-12 weeks.The team is multidisciplinary and works closely to ensure that effective gender sensitive care is delivered. As a very new team we experienced powerful internal dynamics for the first year. Lots of support groups, supervisions and psycho educational activities are provided for our staff members by different experts.The therapeutic model is in the process of development and is based on mentalisation theory. An audit on “Care after Intramuscular Rapid Tranquilization” was undertaken on the ward.Objective:To present a very new service for women including powerful dynamics within the team, a model of care provided for our client group and audit results.Method:Descriptive.Conclusions:1.It illustrates the powerful feelings of the staff during treatment of female service users (the results of analysis of the questionnaire will be provided) within PICU and the way we managed to deal effectively with it.2.It clarifies the amount of resources demanded for treatment of this client group.3.Audit results reveal the progress made in care after service users are given rapid tranquilisation in 06-08/2007-2008.4.It illustrates that the process of agreeing a model of care, as well as the model itself, in a PICU setting is very useful activity.
Sculpture of the Schyzophrenia
Authors: Kalkan H.S. 
Published: March 2009

This project is a documantary about a schyzophrenia patient whose name is Sewusen. Sewusen has got popularity in Tunceli around East region of Turkey. After his death in 1994, the people in Tunceli have established his sculpture at the center of the city. Most of the schyzophrenia patients live around the people at Tunceli and the people behaves well towards them. The difference of Sewusen is that, he has lived about 40 years at the street and he had no relationship between money and goods. When he gets hungry, he eats in any restaurant and nobody demands any money from him. The people look to the situation as normal. With the effect of the religious aspect of the community, they see Sewusen as Holy but not mad.In that project, I made a documentary which defines in general the point of view about mental disorders of the community of Tunceli but at custom it gives information about Sewusen.As a result, this project is about cultural psychiatry and it is made against Stigma. It takes 30 minutes to present and it is English subtitled.
Attempted Suicide and HPA Axis Dysregulation as Suicide Predictors in Elderly Mood Disorder Inpatients
Authors: Jokinen J. , Nordström P. 
Published: March 2009

Dysregulation of the hypothalamic-pituitary-adrenal (HPA) axis function is associated with suicidal behaviour and age-associated alterations in HPA axis functioning may render elderly individuals more susceptible to HPA dysregulation related to mood disorders. Research on the role HPA axis function in suicidal behaviour in elderly mood disorder patients is sparse.The study sample consisted of 99 depressed elderly inpatients 65 years of age or older admitted to the department of Psychiatry at the Karolinska University Hospital between 1980 and 2000. 24 % of patients had attempted suicide just before admission. The hypothesis was that elderly mood disorder inpatients who fail to suppress cortisol in the dexamethasone suppression test (DST) are at higher risk of suicide.During a mean follow-up time of 17 years (range 6-25.5 years), six suicides were identified from the death certificates. The DST non-suppression distinguished between suicides and survivors in elderly depressed inpatients and the suicide attempt at the index episode was a strong predictor for suicide. Additionally, the DST non-suppression showed higher specificity and predictive value in the suicide attempter group. Due to age associated alterations in HPA axis functioning, the optimal cut-off for DST non-suppression in suicide prediction may be higher in elderly mood disorder inpatients.
Interpersonal Psychoterapy in Portugal
Authors: Gago J. 
Published: March 2009

In December of 2007 we create the Portuguese Interpersonal Psychoterapy Society in order to continue the development of this psychotherapy in our country. Before in 2003 it took place two courses of 20 hours each in two hospitals in Lisbon (Hospital S. Francisco Xavier and Hospital Sta Maria) with the partnership of Spanish Interpersonal Psychoterapy Association and colleagues from Madrid (Francisco Aguado and Maria Dièguez) and Barcelona (Sole Puig and Lecina Fernandez). After those courses a group of psychologists and psychiatrists start to use this psychotherapy in clinical practice in Portugal with the supervision of the colleagues from Spain. This psychoterapy was applied in public and private clinic, for depression, anxiety, grief and cronic physical diseases like diabetes.We will describe the developments of this psychoterapy in Portugal, the future plans for it spread and the ongoing research studies.Note: This presentation was included in the proposal we did before for the simposium "Developments in Psychoterapy: Interpersonal Psychoetrapy" propose by Dr. Carlos Góis.
IPT in Physical Diseases. The Diabetes Mellitus Case
Authors: Gois C. 
Published: March 2009

Introduction:Prevalence of Major Depression in populations with physical diseases as Diabetes Mellitus is twice or more than in general population. As IPT framework concerns relationships, communication skills and problem solving, all significant in adjustment to chronic disease, it is a potential treatment indication in such a clinical situation. Some IPT work has been done in HIV populations.Objectives:Treatment results with IPT or antidepressants in Major Depression in Diabetes Mellitus Type 2. Secondary outcomes are differences in attachment, diabetes psychological adjustment and metabolic control.Method:20 adult outpatients with type 2 Diabetes and Major Depression with no other comorbidity (except chronic diabetes complications) randomized to usual treatment (SSRI and consultation or IPT. Combined treatment added if patient wasn't 25% better from basal MADRS score at 6th week. Metabolic control obtained with HbA1c.Results:Patients distribution:IPT-7; Usual-7; Combo-2; Dropouts: Usual-3; Combo-1. Patients characteristics: 54,55±6,75 years aged, 85% female gender, 6,25±2,99 years education, HbA1c 8,94%±2,31. Paired samples test comparing basal values and at 6 months: usual treatment and IPT both efficacious in reducing MADRS scores by 50% (p< .01); usual treatment patients with better diabetes psychological adjustment and anxious attachment lowering (both p< .05); metabolic control better with IPT, but not significant (p=0,1).Conclusion:These are preliminary results with a small sample, but pointing towards the usefulness of IPT in depressive type 2 diabetic patients. Discussion will pay particular attention on benefits of psychological change related to Diabetes and to personal life with aid from clinical examples.
Back to Basics: Challenges in Classification of Depression
Authors: Küey L. 
Published: March 2009

Depressive disorders constitute a major health problem worldwide. From feelings of grief of daily human life to psychotic melancholic states, many different forms of depression are recognized. This fact also raises problems of classification in depressive disorders.This presentation aims to review issues of “threshold level”, “comorbidity”, “the importance of patients’ narrative”, and “identification of core symptoms” in depression.It is widely accepted that a common core shared in depression is anhedonia; thus, vitality of the person is lost. Mortality and vitality are the two key phenomena to consider in understanding depression.The reality of mortality has always been a task to overcome emotionally. Human sciences and belief systems have accumulated a huge amount of theory on this issue. But, it is a crucial inevitable challenge for every human being, and this confrontation may also lead to face some sort of depressive way of being. The degree of psychological awareness and of working through the reality of mortality may determine the odds and the forms of depressive state that a person may develop. The phenomenology of depressive disorders will also be discussed in the context of mortality vs. vitality using clinical vignettes from the authors’ clinical practice to broaden the scope of discussion.
Role of Tryptophan-kynurenine Pathway in Depression: Psychopathological Aspect
Authors: Myint A.-M. 
Published: March 2009

It was reported that cytokines such as IFN-γ reduce the synthesis of 5-HT by stimulating the activity of indoleamine 2,3 dioxygenase (IDO) enzyme which degrades tryptophan to kynurenine. Kynurenine is further metabolized to kynurenic acid (KYNA), 3-hydroxykynurenine (3OHK) and quinolinic acid (QA) by kynurenine aminotransferase (KAT), kynurenine 3-monooxygenase (KMO) and kynureninase. Both KMO and kynureninase are also shown to be activated by IFNγ. The 3OHK is neurotoxic apoptotic while QA is the excitotoxic N-methyl-D-aspartate (NMDA) receptor agonist. Conversely KYNA is an antagonist of all three ionotropic excitatory amino acid receptors and considered neuroprotective. In the brain, tryptophan catabolism occurs in the astrocytes and. The astrocytes are shown to produce mainly KYNA whereas microglia and macrophages produced mainly 3OHK and QA. The astrocytes have been demonstrated to metabolise the QA produced by the neighbouring microglia.Tryptophan breakdown has been found to be increased but KYNA, the neuroprotective metabolite is decreased in both blood and cerebrospinal fluid of the patients with major depression compared to healthy controls. Moreover, the ratio between KYNA and 3OHK showed significant correlation with response to treatment. These findings lead to the hypothesis an imbalance neuroprotection-neurodegener-ation in terms of kynurenine metabolites and their immunological and biochemical interactions in the brain might further induce the apoptosis of the neuroprotective astrocytes and the vulnerability to stress is thereby enhanced.
The Sayle Research Project
Authors: Carli V. 
Published: March 2009

High prevalence of self-destructive behaviours during adolescence - both as expression of early psychopathology and as “paraphysiological” developmental behaviors - challenges the implementation of health promotion strategies specifically addressed to an age bracket in which plasticity of psychical structure can favour an overall successful outcome.SAYLE is a European research project with the aim of promoting healthy behaviours in adolescents, at a high school level of intervention. During the presentation targets and structure of the prevention program will be described. The projects has been designed in order to compare the efficacy of different prevention strategies for adolescents: a general health promotion program targeting students’ awareness on healthy/unhealthy behaviours and students" self-efficacy in diminishing unhealthy behaviours; a screening by professionals of at-risk students through a questionnaire (TeenScreen) - for adolescents identified as high risk (screen positives) the program includes referral to mental health treatment and ensuring compliance; a gatekeepers’ program, training all adult staff at schools (teachers, counselors, nurses etc.) and parents on how to recognize & refer a student with risk-taking behaviours or suffering from mental illness to mental-health help resources (QPR -Question, Persuade & Refer).
Suicidology and Substance abuse in Adolescence
Authors: Werner N. , Kahn J.-P. 
Published: March 2009

Adolescence is a critical period for suicidal risk. Suicide currently ranks as the second or third leading cause of mortality among adolescents in developped countries. It has been shown that a history of suicidal act, of depressive disorder and of a substance use disorder (SUD), alcohol and drugs, are the most prominent risk factors for suicidal behaviour among adolescents.Data on alcohol and drug use disorders and suicide consisted primarily of reports on alcohol use disorders and, to a lesser extent, opioid use disorder. The magnitude of the association with other drugs is still unclear.The relationships between substance use disorder and suicidal behaviour are multiple: In the long term, SUD may be associated with increases in stress and co-occuring psychopathology (poor self esteem, feeling of worthlessness, isolation).These elements may reach a level where a suicide attempt is viewed as a means to cope with perceived unsolvable difficulties. During life crises, SUD can also be responsible for inhibiting adaptative coping and desinhibiting suicidal behaviour. Finally, SUD and suicidal behaviour share common vulnerability factors: history of childhood abuse, genetically determined dimensions such as impulsivity or psychiatric disorders, particularly unipolar depressive and bipolar disorder.Given the comorbidity between SUD and suicide, it is essential for treatment and prevention that all suicidal adolescents be screened for SUD and vice versa. Ideally, adolescents who receive diagnosis of SUD and co-occuring suicidality should follow an integrated treatment protocol that addresses both conditions.
Follow up of Adolescent Suicide Attempters
Authors: Apter A. 
Published: March 2009

Objectives:To follow adolescent suicide attempters attending an emergency room in southern Israel through their induction examination for military service and then for the duration of this service.Methods:117 attempters were evaluated after a suicide attempt, and then followed up for up to five years. Outcome was assessed by their achievements on pre-induction psychometric and psychological testing at the induction center and by the quality of their service. Repeated suicidal behavior was also assessed.Results:In general boys had a worse prognosis than girls and suicidal behavior associated with poor educational achievements was particularly associated with a poor psychosocial outcome.Conclusions:Adolescent suicidal behavior in general has a good prognosis but boys with educational difficulties who attempt suicide are at great risk for adjustment problems.
Gender Differences in Suicidal Behaviour and Self-injurious Behaviour in Adolescents: Results from a German school survey
Authors: Brunner R. , Parzer P. , Haffner J. , Resch F. 
Published: March 2009

Aims:The primary aim of our study was to determine gender differences of the prevalence rates of suicidal behaviour (suicidal ideation, plans and attempts) and self-injurious behaviour (intentional self-mutilative acts like cutting and burning).Method:Self-report cross-sectional survey. A representative sample of school students of the 9th grade (n = 5759, mean age = 14.98 (SD=0.73), 49,8% female adolescents) from the Rhein-Neckar-District in Germany has been investigated.Results:Moderate forms of intentional self-mutilative acts in the previous year was reported by 630 of 5759 (10.9%) school students. Additional 229 (4.0%) students reported repetitive forms of self-mutilation. In comparison with the male students the risk of moderate forms of self-mutilative acts (relative risk ratio: RRR=1.60) was significantly increased for female students, for repetitive acts (RRR=2.64), respectively. With regard to suicidal behaviour 14.4% of the adolescents reported suicidal ideas and 7.9% one or more suicidal attempts during their life time. Adolescent girls who smoked demonstrated a high rate of risk for DSH; there was no significant association between smoking and DSH in adolescent boys. Compared with participants without a history of DSH, adolescents with DSH scored significantly higher on the YSR-subscales of somatic complaints, anxiety and depressive symptoms and delinquent behaviour.Conclusion:Moderate forms of intentional self-mutilative acts and severe forms as well as suicidal behaviour were found to be associated with pronounced emotional and behavioral problems. In particular female adolescents are at higher risk for DSH in comparison to male adolescents.
Deficit in Theory of Mind is a Risk Factor for Relapse of Major Depression
Authors: Kanba S. 
Published: March 2009

Background:Recently, we reported that patients with depression have theory of mind (ToM) deficit during remission from acute episodes. ToM deficit means difficulty in social adjustment and thus may indicate a poorer prognosis.Methods:We evaluated ToM ability of 50 patients during remission from major depressive episodes. The patients were followed for 1 year and their outcome observed.Results:After 1 year, patients who had ToM deficit in a second order false question relapsed significantly more frequently as compared with patients who did not have a deficit (Fisher"s exact test pb0.0001; relative risk (RR)=8.105; CI 2.020, 32.524).Significant differences were shown in scores of the Global Assessment of Functioning Scale (p< 0.0001) between the two groups.Conclusions:Patients with ToM deficit in second order false belief during remission may be a high risk group for recurrence and lower social function 1 year after recovering from a major depressive episode.
Alcohol Misuse in People with Schizophrenia: Findings from the Paddi (psychiatric and Addictive Dual Diagnosis in Italy) Study
Authors: Carrà G. , Lusignani G. Segagni , Sciarini P. , Borrelli P. , Popa I. , Montomoli C. , Clerici M. 
Published: March 2009

Background:Comorbid alcohol misuse in schizophrenia and severe mental illness is associated with significant clinical, social and legal problems. An epidemiologically informed approach to planning service delivery requires an understanding of which clinical populations are at particularly high risk for alcohol misuse. Most evidence about the prevalence of this comorbidity comes from the USA, Canada and Australia, and, though at a different pace, also from Europe.Method:A cross-sectional survey design has been used to determine the prevalence In Italy of comorbid drug and alcohol and any - even minor - mental disorders. Staff ratings was used to assess comorbid substance use.Results:Though overall dual diagnosis prevalence is around 2%, significantly higher rates were found in inner cities. Furthermore significant differences were found between different geographical areas (Northern vs. Centre vs. Southern Italy). Peculiar diagnostic subgroups showed higher risk to develop such comorbid condition, whilst a number of clinical and sociodemographic variables, including area of residence, were associated with the risk to develop a dependence syndrome.Conclusions:Sampling and assessment procedures are major limitations which might explain the lower rates as compared with the current Anglo-Saxon literature. However, such variability emphasizes also that high comorbid alcohol misuse rates are not necessarily the direct result of biological features inherent in schizophrenia, but that social factors play an important role. Finally, a number of risk factors associated with dual diagnosis could build up an evidence base about the nature of their substance use, providing targeted service planning and policy making.