bluuebunny/crossref_metadata_2025_split huggingface dataset:
P02-398 - There's Something Strange About My Body
Authors: Verissimo F. , Almeida S. 
Published: June 2010

This case report is about a 34 year old woman psychologist. She looked for a plastic surgeon for a breast reduction. She was feeling different, in an “obviously deformed” body, experienced as weird and far from her ideal. She was submitted to a psychological assessment witch reiterated the “low self- esteem and the surgery's benefits in order to improve the sexual self-concept”.However, something failed. The symptoms isolated her in a world of her own and started escalating. In her family there were “multiple cases of psychosis” and her past psychiatric history was suggestive of a total lack of insight leading to an extremely irregular compliance to medication.Right after the surgery, she presented with a firm belief: she had been “sexually abused during surgery” and her body had been used for “satanic rituals”. She decided to meet the plastic surgeon the day after the surgery and during the interview she wounded herself ripping the breast gauzes and by accident breaking the sutures of both nipples.Her acute distress led to a compulsive acute psychiatric inpatient admission.In summary, this case report is about a 34 year-old woman who developed a persecutory/mystical delusion after a breast reduction surgery. She was admitted to our acute inpatient ward after a mental health act psychiatric assessment.The multidisciplinary interventions planned in order to prevent new plastic surgeries in the short-term (the patient still expresses the will to submit herself to a new series) will be described.
PW01-03 - Evaluation of the Effects of Quetiapine XR Monotherapy On Sleep Disturbance In Patients With MDD
Authors: Bandelow B. , Demyttenaere K. , Papakostas G. , Trivedi M. , Szamosi J. , Earley W. , Eriksson H. 
Published: June 2010

ObjectivesEvaluate the effects of once-daily extended release quetiapine fumarate (quetiapine XR) monotherapy on sleep disturbance in patients with major depressive disorder (MDD).MethodsPooled data from four 6- or 8-week placebo-controlled quetiapine XR (50-300mg/day, administered in the evening) monotherapy studies (D1448C00001, D1448C00002, D1448C00003, D1448C00004) were analysed. Primary endpoint: change from randomisation in Montgomery-Åsberg Depression Rating Scale (MADRS) scores. Post-hoc analyses assessed changes in: MADRS item 4 (reduced sleep); Hamilton Rating Scale for Depression (HAM-D) items 4 (insomnia-early), 5 (insomnia-middle) and 6 (insomnia-late) and sleep disturbance factor (items 4+5+6); Pittsburgh Sleep Quality Index (PSQI) total and item scores. MADRS total score change was analysed for patients experiencing high (baseline HAM-D sleep disturbance factor score >=4) and low (baseline HAM-D sleep disturbance factor score < 4) sleep disturbance.ResultsIn total, 2,116 patients were randomised. At last assessment, quetiapine XR (all doses combined) significantly (p< 0.001) reduced MADRS item 4, HAM-D sleep disturbance factor and items 4, 5 and 6 and PSQI total scores from baseline versus placebo. Quetiapine XR significantly (p< 0.001) improved MADRS total score from baseline versus placebo at all time points in patients experiencing high sleep disturbance (n=865, quetiapine XR; n=514, placebo). Quetiapine XR improved MADRS total score versus placebo in patients with low sleep disturbance (n=252, quetiapine; n=121, placebo): difference significant at Weeks 2(p< 0.001), 4(p< 0.05) and 6(p< 0.05).ConclusionsQuetiapine XR monotherapy improved symptoms of sleep disturbance in MDD and was effective against depressive symptoms in patients experiencing high and low sleep disturbance levels. AstraZeneca funded.
PW01-05 - Comparative Effectiveness of Newer Antidepressants on Driving Ability and the Impact of Retest-effects
Authors: Brunnauer A. , Laux G. , Zwick S. 
Published: June 2010

ObjectivesAlthough the therapeutic efficacy of newer antidepressants has been demonstrated in various studies there is only little research available about patients fitness to drive under newer antidepressants.MethodsA sample of 60 depressive inpatients diagnosed according to DSM-IV criteria were randomly assigned to treatment with either mirtazapine (n=20), escitalopram (n=20) or reboxetine (n=20). To control for retest effects 15 healthy controls were examined in the same time schedule. Participants were tested before pharmacologic treatment (t0), and on days 7 (t1) and 14 (t2) with computerized tests related to car driving skills. Data were collected with the Act and React Testsystem (ART 90) and the Wiener- Testsystem (WTS) measuring visual perception, reactivity, stress tolerance, concentration and vigilance.ResultsPatients showed significant improvements in most functional domains related to driving ability skills after 14 days of treatment with newer antidepressants. Statistically significant differences between treatment groups could not be shown. However, controlling for retest-effects only in vigilance-measures significant group by time effects could be found indicating an improvement over practice effects.ConclusionsPartly remitted depressive patients treated with mirtazapine, escitalopram or reboxetine showed a better test performance in driving related skills than untreated patients. However, as most of these laboratory driving tests have a large speed component, retest effects have to be considered when interpreting results of repeated examinations.
PW01-07 - Correlates of Past Sexual and Physical Trauma in 118 Bipolar I Patients With a First Episode of Psychotic Mania
Authors: Conus P. , Cotton S. , Benno S. , Michael B. , Rothanty D. , McGorry P.D. , Lambert M. 
Published: June 2010

ObjectivesTo assess the prevalence and correlates of childhood and adolescence sexual and/or physical abuse (SPA) in bipolar I disorder (BD) patients treated for a first episode of psychotic mania.MethodsThe Early Psychosis Prevention and Intervention Centre (EPPIC) admitted 786 first episode psychosis (FEP) patients between 1998 and 2000. Data were collected from patients’ files using a standardized questionnaire. 704 files were available, 43 were excluded because of a non-psychotic diagnosis at endpoint and 3 due to missing data regarding past stressful events. Among 658 patients with available data, 118 received a final diagnosis of BD and were entered in this study.Results80% of patients had been exposed to stressful life events during childhood and adolescence and 24.9% to SPA: in particular, 29.8% of female patients had been exposed to sexual abuse. Patients who were exposed to SPA had poorer pre-morbid functioning, higher rates of forensic history, were less likely to live with family during treatment period and were more likely to disengage from treatmentConclusionsSexual and/or physical abuse is highly prevalent in BD patients presenting with a first episode of psychotic mania; exposed patients have lower pre-morbid functional levels and poorer engagement with treatment. The context in which such traumas occur must be explored in order to define if early intervention strategies may contribute to diminish their prevalence. Specific psychological interventions must also be developed.
PW01-08 - Evaluating Predictors For Remission With Placebo Using Integrated Data From Patients With Major Depressive Disorder
Authors: Deberdt W. , Nelson J.C. , Lipkovich I.A. , Marangell L.B. , Zhang Q. , Holsboer-Trachsler E. , Rihmer Z. 
Published: June 2010

ObjectivesTo identify predictors of remission with placebo treatment in double-blind randomized controlled trials (RCTs) in major depressive disorder (MDD) based on baseline characteristics.Methods989 placebo-treated MDD subjects with baseline Hamilton Depression Rating Scale total score (HAMDT17) ≥15 who completed 7-8 weeks of treatment from 8 duloxetine RCTs with placebo lead-in were included. Remission was defined as HAMDT17 endpoint score ≤7. Stepwise logistic regression and classification and regression tree (CART) methods were used to identify predictors of remission. Data were randomly split into training data (N=791, 80%) for model selection and test data (N=198, 20%) for validation. Predictive quality of models was assessed by ROC curves.ResultsIn the logistic regression analysis, out of >50 potential pre-treatment predictors, the HAMDT17 score, age, Hamilton Anxiety Scale item 14 (HAMA14: behavior at interview) and length of current MDD episode (length) were found to be most predictive for remission on placebo. These variables were also identified as top predictors by the CART method that identified 2 subgroups: “HAMA14=0 OR (HAMDT17< 22 AND length< 18 weeks)” (45% remitted), “HAMA14>0 AND (HAMDT17≥22 OR length≥18 weeks)” (21% remitted). However, the predictive power was weak for both methods with areas under the ROC curve (test data) of 67% and 56%, respectively.ConclusionsBaseline risk factors for non-remission after 7-8 weeks of placebo treatment were older age, more severe depressive symptoms, apparent anxiety, and a longer duration of current MDD episode. These results are consistent with previous findings and may aid in the design of RCTs.
PW01-09 - Assessment of Cognitive Functioning Within Different Emotional Contexts in the Group of Euthymic Bipolar Patients
Authors: Dernovsek M. , Novak T. , Sprah L. 
Published: June 2010

ObjectivesAlthough numerous studies agree that bipolar patients demonstrate extensive cognitive deficits, it is still unclear to which extent these impairments persist across different mood states, including euthymia. Given that the emotional and cognitive processes are closely intertwined, we aimed to examine selective attention, cognitive inhibition, and social cognition within different emotional context in the group of remitted bipolar outpatients.Methods80 euthymic bipolar outpatients and 66 healthy volunteers matched for sex, age and education participated in the study. Internal State Scale and Barratt Impulsiveness Scale were used to assess self-reported affective states and trait impulsivity. Computerised versions of Colour-Word Stroop, Emotional Stroop, Affective Go/NoGo and Ekman Recognition of Facial Expression task were administered to assess selective attention, inhibition of cognitive control and social cognition.ResultsSeveral cognitive deficits in selective attention, inhibition of cognitive control and social cognition tasks have been identified in the group of euthymic bipolar outpatients. They revealed worse recognition of negative, positive and neutral affect than controls. Besides cognitive disruptions which were reflected in longer reaction times and more erroneous performance to different emotional stimuli and in different emotional contexts, also trait impulsivity was considerably elevated in the group of bipolar euthymic outpatients.ConclusionsBipolar outpatients in our study demonstrated relatively marked impairments in cognitive functioning within different emotional contexts also during the euthymia. Applied neuropsychological inventory proved as useful tool for assessing specific cognitive impairments in bipolar mood disorder, and could contribute to more effective diagnosing and treatment of patients.
PW01-12 - Two or Three Age-of-Onset Groups in Bipolar I Disorder? Findings of Commingling Analysis in Romanian and German Bipolar I Patients
Authors: Grigoroiu-Serbanescu M. , Rietschel M. , Paul T. , Schulze T.G. , Noethen M.M. , Cichon S. , Elston R.C. 
Published: June 2010

BackgroundAge-of-onset (AO) seems to be a phenotypic variable with a strong genetic component and therefore useful in molecular analysis of bipolar disorder (BP). A debate about the cut-off point for defining early AO has developed over the last few years. Using an Expectation-Maximization algorithm Bellivier et al. (2001) found the best fit for a model with three onset-groups, proposing the age 20-21 as cut-off for early onset, while using the same algorithm Kennedy et al. (2005) found the best fit for a two onset-group model with age 40 as cut-off with an incidence peak for mania in the age-band 21-25. Based on segregation analysis, we proposed a two AO-group model with cut-off age 25 for early onset (Grigoroiu-Serbanescu et al. 2001). The present study aimed at investigating the best AO-model in 500 Romanian BPI and 1458 German BPI patients using commingling analysis (SAGEv6.01-software) (Elston et al, 2009). The best model was selected according to Akaike's Information Criterion (AIC).ResultsThe two AO-group and three AO-group models provided similar AIC-values both in the Romanian and the German sample. The Romanian early-onset group (40% cases) had means around 18 years, SDs=6-7, while in the German early-onset group the mean AO was around 20 years (SDs=9-11) (50% cases). Thus the cut-off for early-onset (X +1SD) was different.ConclusionOur results overlapped with the findings of Kennedy et al (2005) showing that two-curve and three-curve AO mixtures similarly fit the AO-distribution in BPI disorder and the cut-offs for early-onset differ by sample.
PW01-21 - Poor Sleep is Related to Parenting Stress and Impaired Postpartum Bonding in Depressed Mothers
Authors: Mikoteit T. , Keller N. , Brand S. , Sievers E. , Riecher-Rössler A. , Holsboer-Trachsler E. , Hatzinger M. 
Published: June 2010

ObjectivesPoor sleep is a common complaint in postpartum depression (PPD). Depression as well as sleep disturbances may affect parenting functions and mother-infant relationship. The purpose of this study was to examine the relationship between objective sleep data, parenting stress and bonding in PPD.MethodsForty-five mothers (age: 34.5 ± 5.4 years SD) suffering from PPD were examined 212 ± 156 days (SD) after parturition. Depression was measured by Hamilton Depression Rating Scale (HDRS-ADS) and Beck Depression Inventory (BDI). Parenting stress and bonding were assessed by self report scales, i.e. Parenting Stress Index (PSI) and Postpartum Bonding Questionnaire (PBQ). In a subsample of 10 participants sleep parameters were assessed by actigraphy and sleep logs during seven consecutive days. Actigraphic sleep parameters were put in relation to severity of depression, PSI and PBQ scores.ResultsPoor sleep, i.e. low total sleep time (TST) was negatively correlated to depression (HRDS-ADS) (r = -.63; p < .05). Low TST was associated with poor bonding (r = -.82; p = .02), especially attitudes of “rejection and anger”. Severity of depression (BDI) was correlated with parenting stress (r =.50; p =.005). Mothers with high parenting stress tended to have more difficulties in bonding (r =.65; p =.016). Neither sleep parameters nor parenting stress and bonding were correlated with the infant's age.ConclusionsIn PPD poor sleep should be recognized and treated early, because it is associated to parenting stress and disturbed bonding, which might have a detrimental impact on mother-infant relationship.
PW01-27 - Translational Pharmacology of Quetiapine and Norquetiapine: Preclinical Findings Support Multifunctional Psychotropic Properties
Authors: Nyberg S. , Widzowski D. 
Published: June 2010

ObjectivesClinical studies demonstrate that quetiapine is efficacious in schizophrenia, bipolar mania, bipolar depression, major depressive disorder, and generalized anxiety disorder. The pharmacological basis for this broad range of clinical effects is not completely understood. The current experiments evaluated pharmacological assays investigating the receptor-binding characteristics of quetiapine and norquetiapine (the major human metabolite) and compared these with other atypical antipsychotics and standard antidepressants.MethodsIn vitro receptor-binding assays utilized cloned human targets including norepinephrine transporter (NET), dopamine D2 receptor, and serotonin 5-HT1A, 5-HT2A, and 5-HT2C receptors stably expressed in CHO or HEK cell lines. In vitro functional studies included uptake-inhibition assays for NET and GTPgammaS assays for D2/D3 antagonist and 5-HT1A agonist activity.ResultsNorquetiapine demonstrated high affinity at 5-HT2A receptors (5 nM) and moderate/high affinity at NET (29 nM) and 5-HT2C receptors (76 nM), while quetiapine had moderate affinity at 5-HT2A receptors (29 nM), weak affinity at 5-HT2C receptors (2800 nM), and lacked appreciable affinity at NET. Both quetiapine and norquetiapine showed moderate affinity at D2 receptors (56 nM and 59 nM, respectively) with moderate/low-potency antagonist activity. Both quetiapine and norquetiapine exhibited low affinity at 5-HT1A receptors (1800 nM and 570 nM, respectively) with low-potency agonist activity.ConclusionsThese experiments confirm that quetiapine-norquetiapine have multiple pharmacological effects at targets associated with psychotropic drug action. This combination of effects by quetiapine-norquetiapine at dopaminergic, serotonergic, and noradrenergic targets may explain the antipsychotic, antidepressant, and anxiolytic properties of quetiapine.Supported by funding from AstraZeneca Pharmaceuticals LP.
PW01-30 - Increased Scores on the Hypomania Check List-32 and on the Mood Disorder Questionnaire In Treatment-resistant Depression: Polish Tres-dep Study
Authors: Rybakowski J. , Kiejna A. , Angst J. , Pawlowski T. , Siwek M. , Lojko D. , Dudek D. 
Published: June 2010

ObjectiveAn undiagnosed bipolarity may be one of the reasons connected with treatment resistance in major depressive disorder. In recent years, the tools have been introduced helping to assess the bipolarity such as the Hypomania Checklist (HCL-32) and the Mood Disorder Questionnaire (MDQ). The objective of the study was to compare scores of bipolarity measured with these scales between patients with treatment-resistant and treatment non-resistant depression within the framework of all-Poland multi-center study TRES-DEP.MethodsOne-thousand and fifty-one patients recruited from 150 outpatient psychiatric clinics in Poland and fulfilling DSM-IV criteria for single or recurrent major depressive episode were studied. Five-hundred and sixty-nine patients were identified as having treatment-resistant depression on account of non-obtaining remission in recent depressive episode after minimum of two courses of adequate treatment with antidepressant drugs. They were compared with 482 patients with non-treatment-resistant depression. All patients were assessed using the structured demographic and clinical data interview, as well as the Polish version of HCL-32 and MDQResultsPatients with treatment-resistant depression scored significantly higher compared with non-resistant depression both on HCL-32 and MDQ (11.9+8.3 vs 8.5±7.7 and 4.3±3.5 vs 2.7±2.9, respectively). Independent risk factors of treatment resistance were scoring of14 or higher on HCL-32, and 6 or higher on MDQ.ConclusionsHigher scoring by patients with treatment-resistant depression on both HCL-32 and MDQ may suggest a possible association between bipolarity and worse response to antidepressant drugs in patients with major depressive disorder.
PW01-33 - Onset of Depression Inventory (ODI) - Comparison of the Onset Speed of Unipolar and Bipolar Depressive Episodes
Authors: Strauss M. , Mergl R. , Sander C. , Merz C. , Schönknecht P. , Hegerl U. 
Published: June 2010

IntroductionThe rate of manifestation of depressive episodes can vary appreciably. The complete development of a depressive episode may be very rapid, taking less than one hour or be very slow, taking up to one month. Altough this clinical observation suggests different neurobiological pathomechanisms, the onset speed of depressive episodes in different affective disorders has not been investigated systematically up to now. The objective of this study was to establish the onset speed of depressive episodes in patients with a history of at least one depressive episode and to compare the onset speed in unipolar with that in bipolar affective disorders.MethodA group of 96 inpatients was investigated consecutively using the structured patient interview “Onset of Depression Inventory” (ODI). In 76 patients, there was a unipolar depressive disorder and 20 patients suffered from a bipolar depressive disorder.ResultsThe onset speed of the current depressive episode in patients with effective disorders correlated significantly with the onset speed of the previous depressive episodes (p < 0.001). Furthermore, there was a significant difference in the onset of the depressive episodes between unipolar and bipolar affective disorders (p < 0.001). In 55% of patients with a bipolar disorder, the depressive episode was manifested within one week whereas this was the case in only 22,37% of the patients with a unipolar affective disorder.ConclusionThe rate of manifestation of depressive episodes differs between unipolar and bipolar disorders. The clinical observation reported here can support the diagnostic appraisal of depressive episodes.
PW01-37 - Long-term Efficacy of Quetiapine In Combination With Lithium or Divalproex on Mixed Symptoms In Bipolar I Disorder
Authors: Vieta E. , Suppes T. , Gustafsson U. , Paulsson B. 
Published: June 2010

ObjectiveTo determine the efficacy of QTP in patients with bipolar I disorder with mixed symptoms.MethodData from 2 phase III studies (D1447C00126 and D1447C00127) were pooled. Unlike previous analyses of these studies, mixed events were analyzed separately. Patients received QTP (400-800 mg/d)+Li/DVP to achieve ≥12 weeks of clinical stability followed by double-blind treatment with QTP (400-800 mg/d)+Li/DVP or PBO+Li/DVP for up to 104 weeks. Primary endpoint was time to first mood event post-randomization.Results1326 patients were included in the ITT population. Relative to PBO, QTP significantly increased time to recurrence of mixed events (P< 0.0001). 445 ITT patients had a most recent mixed episode at study entry. In these patients, mood events were reported by fewer patients on QTP+Li/DVP (21.0%) than on PBO+Li/DVP (53.9%). These events included mixed (6.4% vs 22.1%), pure manic (5.0% vs 13.3%), and pure depressed events (9.6% vs 18.6%). Time to recurrence of mood events was significantly longer for patients on QTP+Li/DVP than for those on PBO+Li/DVP for mixed (HR, 0.23, 95% CI, 0.13-0.42, P< 0.0001), pure manic (HR, 0.30, 95% CI, 0.15-0.60, P=0.0007), and pure depressed events (HR, 0.38, 95% CI, 0.22-0.64, P=0.0003). No new safety concerns were noted.ConclusionsIn stable patients with bipolar I disorder, QTP+Li/DVP significantly increased: a) time to recurrence of mood events compared with PBO in patients with mixed symptoms at study entry; and b) time to occurrence of mixed mood events in patients with any mood episode at study entry.Supported by funding from AstraZeneca Pharmaceuticals.