bluuebunny/crossref_metadata_2025_split huggingface dataset:
FC30-04 - Contributing factors in the occurrence of any mental disorders in pulmonary tuberculosis patients
Authors: Ginting T.T. 
Published: May 2011

IntroductionTuberculosis (TB) is one of world's health problems. Morbidity and mortality caused by the disease are increasing annually. Aspects involved in TB are individual, environmental, and bacterial. It is important to consider not only one's physical factor but also mental factor such as comprehension and perception.ObjectiveStigma and social isolation may occur and precipitate any psychopathology and thus co morbidity of mental disorders in tuberculosis patients.AimThe aim of this research is to identify any contributing factors in the occurrence of any mental disorders in pulmonary tuberculosis patients.MethodsQualitative method of analysis was used; begin with determining the frequency of mental disorders in pulmonary tuberculosis, followed by interview and observation of the samples that mentally disordered.ResultsThe frequency of any mental disorders in pulmonary tuberculosis was 20%. From qualitative analysis, themes such as comprehension, treatment seeking behavior, psychological impacts, stigma, financial, occupational impacts, and other stressors were obtained. Respondents’ comprehension to the disease was not satisfying; treatment seeking behavior includes visiting public health services and hospitals; psychological impacts include Kubler-Ross’ response and depression as the most prevalent; financial impact includes financial difficulties; occupational impacts include occupational problems and unemployment; and other stressors.ConclusionsRespondents’ comprehension to tuberculosis was not satisfying so thus worsen their perception of illness and of treatment seeking behavior. Their false perception will result in behavioral changes and social consequences like self-withdrawal, and together with stigma and any stressors will precipitate mental disorders.
FC30-05 - Psychiatric co-morbidities in patients with pemphigus: An issue to be considered
Authors: Arbabi M. , Mahdanian A. , Ghodsi Z. , Noormohammadi N. , Parsafar H. , Shams S. 
Published: May 2011

Background and objectivesThere exists a high prevalence of psychiatric disorders in dermatological patients. However, investigators have so far evaluated psychiatric aspects of the patients suffering from several specific skin diseases, there are a few studies concerning mental health in pemphigus patients. Our objective was to evaluate mental health status, quality of life and psychological well-being of newly diagnosed pemphigus patients.MethodsBetween April 2007 and February 2008, all newly-diagnosed pemphigus patients attending the pemphigus outpatient clinic of a dermatological hospital were given a questionnaire comprising the GHQ-28 and DLQI to fill out.ResultsOut of 283 patients, 212 complete forms were returned and analyzed. The bimodal score of GHQ ranged from 0 to 26 (Mean = 9.4) and the Likert score of GHQ ranged from 6 to 68 (Mean = 31.9). The DLQI score ranged between 0 and 30 (Mean of 13.8). A total of 157 patients (73.7%) were yielded to be possible cases of mental disorder considering GHQ-28 bimodal scores. Significant correlation between the DLQI score and bimodal and Likert scoring of GHQ-28 was detected.ConclusionOur study has depicted the prevalence of psychiatric morbidity in pemphigus patients. It underlines the fact that physicians, who are in charge of care for these patients, are in an exceptional position to distinguish the psychiatric morbidity and to take appropriate measures.
FC30-06 - Prevalence of depressive - anxiety disorders of gastroenterology outpatients in five cities cross China
Authors: Zhang L. , He Y.-L. , Ma H. , Liu Z.-N. , Jia F.-J. , Zhang M.-Y. 
Published: May 2011

IntroductionDepression and anxiety disorders are prevalent mental disorders in China. But some those patients do not seek help from psychiatrists firstly but see internists first.Objectives and aimsThis study aimed to investigate the prevalence of depressive - anxiety disorders in gastroenterology outpatients and assess the detection rate provided by physicians in China.MethodsA multicenter, hospital-based cross-sectional study was carried on in the 15 large general hospitals of five cities cross China. A total of 1995 gastroenterological outpatients were screened by Hospital Anxiety and Depression Scale (HADS). Subjects whose HADS scores ≥ 8 were interviewed by psychiatrists, using Mini International Neuropsychiatric Interview (M.I.N.I) to make further diagnoses. Physicians’ diagnoses and treatment were recorded.ResultsThe adjusted prevalence of depressive disorder and anxiety disorders was 14.39% and 9.42% respectively.ConclusionsThe prevalence of depressive-anxiety disorder is high in gastroenterology outpatients in China, which suggests the related training of detecting these mental disorders is needed to gastroenterologists.
FC31-01 - Psychiatric advance directives: From a single document to a complex and multistage intervention, realist review
Authors: Dubois V. 
Published: May 2011

IntroductionPsychiatric Advance Directives (PADs) are documents that allow severe and chronic mentally ill users notifying preferences of treatment and appointing a surrogate decision-maker for crisis relapses. Despite many expected benefits at the intrapersonal, interpersonal and organisational levels of the mental health system, PADs take-up rate remains low and many barriers to their use were identified. Moreover, a recent Cochrane systematic review provided little evidence on these benefits.AimA realist review was carried out to clarify the theoretical frameworks underlying PADs, examine data evidencing these frameworks and determine the conditions in which PADs may have an effect, on what issues, and how.MethodAfter a selection process, 38 references were retrieved from health and social sciences databases containing empirical data on PADs. Papers were thematically coded along identified theoretical frameworks and levels of effects, and populated with empirical data. Results were reported within a multistage process including the PAD definition, completion, registration, access, and honouring.ResultsThree theoretical frameworks were identified: users' autonomy, therapeutic alliance and health providers' networking. Although PADs were set up in a user's autonomy approach, they produce better results within a therapeutic alliance framework. Networking is determining on access and honouring stages. However, the literature mainly focused on definition and completion stages. Very little is known about their actual honouring.ConclusionPAD is a complex intervention with effects and barriers at each step of the process and levels of action. Their take-up rate and evaluation could be improved assessing these levels and stages separately.
FC31-02 - Is it ethical not to prescribe placebo? the patient's perspective on the usage of placebo for the treatment of depression - a comparative study
Authors: Feffer K. , Nitzan U. , Lichtenberg P. , Lev-Ran S. , Fennig S. 
Published: May 2011

IntroductionThe current stands of the medical establishment exclude usage of placebo in the clinical setting on ethical grounds. No attempt has been made to clarify the viewpoint of the psychiatric patient regarding the matter.ObjectiveTo compare the viewpoint of healthy subjects to that of patients who suffered from depressive episode.Aims1)Investigate the willingness of subjects in both groups to receive placebo for the treatment of depression, and2)compare both groups’ views regarding the ethical aspect of placebo usage (e.g. doctor-patient relationship, patient's autonomy, etc).MethodWe enrolled 81 patients and 107 healthy subjects. Patients were recruited from an out-patient clinic and were diagnosed, in the past or present, as suffering from a depressive episode. All subjects were briefed thoroughly about the efficacy, potential benefits and limitations of placebo in treating depression and then completed a self-report questionnaire.Results64% of the patients (N = 50) expressed consent to use placebo in case they suffer again from depressive symptoms, compared to 79% (N = 85) of healthy subjects (p< 0.05). In both groups over 70% of the subjects do not perceive prescribing placebo as a deceit or as an act that diminishes the patients' autonomy (p>0.05).ConclusionsThe majority of patients agreed to receive placebo medication as a first line treatment, and do not feel that it will negatively affect their sense of autonomy or doctor-patient relationship. These findings question some of the ethical justification of excluding placebo from the clinical practice and call for further discussion in the subject.
FC31-04 - Outside the questionnaire a preliminary of the essence of differential diagnostics in ethical psychiatric practice: The conners as paradigm
Authors: Brand Flu R.L. 
Published: May 2011

IntroductionMisdiagnoses can have profound implications on treatment outcome; in children also risks of continuation in adulthood, including forensic repercussions.The Conners questionnaire, an international tool to rule in ADHD poses like any structured assessment tool a ceiling effect of optimum sensitivity/specificity. This gap in certainty of diagnosis can be bridged by clinical astuteness on applicable differential diagnoses, an exercise which resulted in transformational treatments in complex ‘ADHD’. This instigated an analysis of the Conners parent questionnaire in relation to common differential diagnoses or problems.AimsTo explore alternative explanations and differential diagnoses in the abbreviated Parent - Conners questionnaire.ObjectiveTo establish common ADHD differential explanations and diagnoses from this questionnaire to inform on more comprehensive diagnostic schedules and algorithms.MethodEvery item of the questionnaire is appraised in relation to its assigned index i.e. ‘oppositional, cognitive problems/inattention, hyperactivity’ and ‘ADHD’. Differential explanations of ADHD symptoms are explored in terms of diagnoses or specific significant impairment according to established psychiatric diagnostic and neurocognitive criteria.ResultsHyperarousal i.e. anxiety symptoms i.e. correlate with all indices of the questionnaire. The oppositional index can be indicative of anger or social and communication problems. Hyperactivity can also be explained by sensory processing difficulties. The Cognitive/inattention index may reflect (specific) learning difficulties. The ADHD index can reflect learning and communication problems.ConclusionAbove named alternative explanations for an ADHD diagnosis using the Conners questionnaire need to be further studied to inform on enhanced clinically effective medication and non-medication interventions.
JS02-04 - The organisation of emergency psychiatry in The Netherlands
Authors: Mulder C. , de Leeuw R. 
Published: May 2011

IntroductionThe organisation of emergency psychiatry varies between European countries. Our aim is to describe the organisation of emergency psychiatry in the Netherlands, including relevant epidemiological data.MethodsThe organisation of emergency psychiatry in the Netherlands was assessed using written material, official statistics and a recent study about the organisation of outpatient crisis services.ResultsIn the Netherlands, most psychiatric emergency services are being delivered by three levels of care: primary care physicians, outpatient crisis services and inpatient admission units. The outpatient psychiatric crisis services constitute the key factor in the emergency psychiatric care, as they do most assessments (triage), short term crisis interventions and referral. Outpatient crisis services are available 24/7, and are mainly staffed by physicians (including psychiatrists) and psychiatric nurses. Usually, patients first consult a primary care physician in case of a psychiatric crisis situation, which can be followed by a referral to an outpatient emergency crisis service in the local region. Patients can also be referred by mental health clinicians (for example for triage for involuntary admission), the police or emergency departments of general hospitals. The outpatient crisis services perform diagnostic and risk assessments (triage), short term crisis interventions, and decide on referral to other services. These can be specialized outpatient programs or (in)voluntary admission to a psychiatric hospital. The number of crisis contacts per 100.000 inhabitants varies between regions, depending e.g. on population density. For example 400 crisis contacts per 100.000 inhabitants were registered in 2003 in the urban region of The Hague, versus 200 per 100.000 in a surrounding rural area. As a mean 20% of patients are being referred to a psychiatric hospital, half of them involuntarily. The number of crisis contacts, voluntary admissions, as well as involuntary admissions rises steadily in The Netherlands. In 1978, 17 per 100.000 inhabitants were admitted involuntarily, as compared to 50 in 2009. Reasons for involuntary admission include self harm, harm to others and severe self neglect. Involuntary admission for reason of severe self neglect is increasing over the last ten years. As a seperate phenomenon, ethnic minority groups, especially from Antillean, Surinam and Moroccan descent, are over-representated in outpatient as well as inpatient emergency services in the urban areas.ConclusionOutpatient crisis services constitute the key factor in the organisation of emergency psychiatric services in The Netherlands. The last decade, the number of crisiscontacts, as well as the number of (in)voluntary admissions did rise.
JS03-03 - Prevalence and Impact of Common Mental Disorders: International Similarities & Differences. Results of the Who World Mental Health (WMH) Surveys Initiative
Authors: Alonso J. ,   on behalf of WHO World Mental Health (WMH) Consortium
Published: May 2011

Introduction A number of studies have shown that there is international variation in the prevalence of common mental disorders. Several factors have been suggested to explain such differences. Methodological challenges to comparability include: differences in settings, samples, assessment methods, and reporting practices. Also, cultural differences have been pointed out as possible cause of differential recognition and reporting of mental health issues. There is still uncertainty about the degree of international variation in the prevalence of mental disorders, and the lack of comparability of results is still an issue.Objectives We assessed the prevalence and impact of mental disorders in the WHO World Mental Health (WMH) Survey Initiative, using common survey, assessment and reporting methods.Methods The WMH surveys were completed in 24 countries from Africa, the Americas, Asia, Europe, the Middle-East and the Pacific. Representative samples of the adult, non-institutionalizes population were interviewed face-to-face, with the aim of estimating the prevalence, burden and unmet need for treatment of common mental disorders. The Composite International Diagnostic Interview (CIDI, 3.0) was used in all surveys to assess mental health status. Common mental disorders assessed included: anxiety, mood, disruptive behaviour, and substance disorders. Several standard measures of disability, both generic and disorder-specific, and role impairment were administered.Results Results show that the mental disorders are commonly occurring in all participating countries. The inter-quartile range (IQR: 25th–75th percentiles) of lifetime DSM-IV disorder prevalence estimates (combining anxiety, mood, disruptive behaviour, and substance disorders) is 18.1–31.1%. The IQR of 12 month prevalence estimates is 9.8–19.1%. Prevalence estimates of 12-month Serious Mental Illness (SMI) are 4–6.8% in half of the countries, 2.3–3.6% in one-fourth and 0.8–1.9% in one-fourth. Possible causes of international variation will be addressed. Analysis of age-of-onset reports shows that many mental disorders begin in childhood-adolescence and have significant adverse effects on subsequent role transitions. Mental disorders are found in the WMH data to be associated with high levels of role impairment.Conclusions Despite this burden, the majority of mental disorders go untreated. Although these results suggest that expansion of treatment could be cost-effective form both the employer perspective and the societal perspective, treatment effectiveness trials are needed to confirm this suspicion. The WMH results regarding impairments are being used to target several of these interventions.Additional information about the WMH Surveys Initiative and the funing of the project can be found at: http://www.hcp.med.harvard.edu/wmh/
PL02-01 - Why are there so Few New Drug Treatments in European Psychiatry?
Authors: Montgomery S. 
Published: May 2011

Those with psychiatric disorders have long suffered from prejudice, their illnesses and suffering often trivialised by journalists in their columns and by government agencies. Tougher regulations appear to be imposed on the licensing of new treatments in psychiatry and harsher criteria for their reimbursement by government agencies compared with other therapeutic areas despite clear evidence that these disorders are associated with the highest levels of suffering and disability according to the WHO.For a new treatment for a psychiatric disorder to be licensed in the EU more studies meeting stricter conditions are required than is the case with equivalent licensing authorities such as the FDA. For example, in the EU a comparator arm is required in clinical trials in addition to the more scientific placebo control. There is no adequate justification for this demand which appears to confound the demonstration of efficacy and safety versus placebo with pricing issues. A further hurdle in the EU is the requirement that long term efficacy compared to placebo is established before a treatment can be licensed which causes delay in bringing the drug to the market and adds to the cost of development. The process might be eased if access to specialist advice by the licensing agencies, strictly limited in the CHMP in contrast to other agencies, were improved.Difficulties in the licensing process and delays following the granting of a licence inevitably have a negative effect on the viability of developing new treatments. Even when a licence is granted transparency/pricing commissions are the source of serious delays before clinicians are allowed to prescribe the treatment. Delays in allowing access to treatment by EU citizens can be so long that medications become available only after they have come off patent. These issues have led some pharmaceutical companies to withdraw from the development of treatments in psychiatry for the EU market and to close their neuroscience laboratories. The resulting loss of expertise in neuroscience will not be easily reversed. Psychiatric patients in the EU will find that the options for new treatments of their serious disorders are declining compared with other countries.
Early Detection in Psychosis: 5 year Outcome in the Scandinavian Tips-Study
Authors: Larsen T.K. , Melle I. , Auestad B. , Haahr U. , Joa I. , Johannessen J.O. , Opjordsmoen S. , Rishovd-Rund B. , Rossberg J.I. , Simonsen E. , Vaglum P. , Friis S. , McGlashan T. 
Published: May 2011

BackgroundDuring the last decades we have seen a new focus on early treatment of psychosis. Several reviews have shown that duration of untreated psychosis (DUP) is correlated to better outcome. However, it is still unknown whether early treatment will lead to a better long term outcome. This study reports the effects of reducing DUP on 5-year course and outcome.MethodsDuring 1997-2000 a total of 281 consecutive patients aged > 17 years with first episode non-affective psychosis were recruited of which 192 participated in the 5-year follow-up. A comprehensive early detection (ED) program with public information campaigns and low-threshold psychosis detection teams was established in one health-care area (ED-area), but not in a comparable area (No-ED area). Both areas ran equivalent treatment programs during the first 2 years and need-adapted treatment thereafter.ResultsAt the start of treatment ED-patients had shorter DUP and less symptoms than No-ED-patients. There were no significant differences in treatment (psychotherapy and medication) for the 5 years. Mixed-effects modeling showed better scores for the ED-group on PANSS negative, depressive and cognitive factors and for GAF social functioning at 5 year follow-up. The ED-group also had more contacts with friends. Regression analysis did not find that these differences could be explained by confounders.ConclusionsEarly treatment had positive effects on clinical and functional status at 5 year follow-up in first episode psychosis.
Individualised Pharmacotherapy of Alcoholism
Authors: Mann K. 
Published: May 2011

Treatment of alcoholism is successful but effect sizes are in the low to moderate range. Heterogeneity of patients entering treatment trials could be one potential explanation. Several attempts have been made to subgroup patient for specific treatment approaches (“matching”). A new approach includes biological data such as pharmacogenetics and neuroimaging for treatment-patient matching.In the PREDICT study (Mann et al., 2009) 426 alcohol-dependent patients were randomized either to placebo, naltrexone or acamprosate. Design and questionnaires were similar to the US COMBINE Study (Anton et al., 2006). Extending Project MATCH and the COMBINE Study we used biological and psychopathological characteristics of patients in order to test their response to naltrexone or acamprosate. In pharmacogenetics 14 SNPs from an own genome-wide association and follow-up study (Treutlein et al., 2009) were tested for differential treatment outcome. Indeed, one SNP showed a significant gene dose effect under acamprosate. Using neuroimaging we confirmed that an increase in brain activity in the ventral striatum is related to time to relapse. We also found support for our hypothesis concerning the rewarding characteristics of alcohol in a certain subgroup of patients. Here f-MRI BOLD response in the ventral striatum predicted a positive naltrexone response. Furthermore, new opioid receptors in alcoholics and normal controls were assessed using carfentanil PET.Analyses are still underway.In conclusion the treatment of alcoholism is moving towards a personalised approach. This holds the potential for a significant increase in effect sizes of our treatment trials and thus for better treatment options for our patients.
Ressource-Oriented Treatment of Addiction - the Orpheus Programme
Authors: Musalek M. 
Published: May 2011

Major problems in treating patients suffering from addictions derive from the fact that the diagnostic category dependence syndrome covers a highly inhomogeneous patient group. Therefore uniform therapeutic approaches inflexibly following treatment guidelines have not fulfilled prognostic expectations. This was the starting point for developing a new modular resource-oriented treatment program in the Anton Proksch Institute Vienna.Changing paradigms in the treatment of addiction, the Orpheus Programme offers a host of different modules designed to help patients to discover their own aims, objectives, values, and resources. The main task of the Orpheus modules is an increasing autonomous and joyful life. Abstinence represents no longer the only final goal of therapy, but is an important step to offer space and possibilities for the patients’ new life. When life becomes once again beautiful and filled with joy and meaning, addictive substances lose their seductive power: The more beautiful and attractive the patient's life, the less the drugs attractiveness. As illustrated by Orpheus, who defeated the sirens (as a symbol for addictive agents) by making the better, louder, and more attractive music, it becomes the patients’ main task to make a better “music of life”; the Orpheus modules are not training programs telling the patients how the better life looks like (as in former moral therapy); they intend to provide places, spaces and atmospheres encouraging and promoting the patients to make possible the possible.