bluuebunny/crossref_metadata_2025_split huggingface dataset:
P01-260 - Population-based Comparison of Specialized and Community Based ADHD Service Rates: Evidence for a New Delivery Model
Authors: Wilkes C. 
Published: June 2010

IntroductionPopulation-based analysis of regional and provincial data has permitted identification of areas for modeling innovative service delivery paradigms. Attention Deficit and Hyperactivity Disorder (ADHD) serves as an example. Within the same catchment region, comparing tertiary service utilization with provincial ADHD rates, we have identified a potential service gap. Potential to improve capacity based on a fiscally neutral model is discussed.MethodAnnual data collected in the regional child and adolescent mental health program information system from 2002-2009 was used to describe characteristics of those referred with a provisional diagnosis of ADHD. Regional population-based utilization rates were compared to the region-adjusted provincial rates of ADHD.ResultsAs is typical, receiving a provisionally diagnosis of ADHD was significantly associated with longer wait for service and length of stay, being male and younger, greater comorbidity (e.g., conduct disorder), more behavioral problems and more problems at school. About half of the referrals came from community-based primary care physicians. Many children are diagnosed with ADHD by community physicians and relatively few receive specialized treatment.ConclusionsAnalysis of population-based service rates identify potentially large knowledge gap. Within this gap, the quality of service and fidelity to evidence-based practice in community-based treatment of ADHD are unknown. Community-based primary care practitioners have little specialized mental health training and may require support in delivering evidence-based care. To this end, we describe a model to address the identified service gap for ADHD.
P01-262 - Abnormal temperament in patients with morbid obesity seeking surgical treatment
Authors: Amann B. , Mergl R. , Perugi G. , El-Gjamal N. , Padberg F. , Torrent C. , Laakmann G. 
Published: June 2010

ObjectivesObesity and its related disorders are growing epidemic across the world. As some forms of abnormal temperament are considered as subtype of the soft bipolar spectrum, we aimed to evaluate abnormal temperaments in morbid obese patients.MethodsUsing a short version of the Temperament Evaluation of Memphis, Pisa, Paris and San Diego, we investigated abnormal depressive, cyclothymic, hyperthymic, irritable or anxious temperament in 213 patients with morbid obesity compared to a control group of 90 patients admitted prior to transplantation. Additionally, the Beck-Depression Inventory (BDI) and the Self-Report Manic Inventory (SRMI) were applied to assess the current mood states.ResultsThe obese group showed statistically significant more psychiatric comorbidities compared to the control group. Abnormal temperaments were significantly more often observed in patients with morbid obesity rather than in controls. Cyclothymic, irritable and anxious temperaments showed specificity to obesity. Obese patients had significantly higher scores in BDI, while no difference for SRMI scores was registered among the whole groups. All temperaments were positively correlated with BDI and SRMI in the obese group.ConclusionsOur results need replication but indicate an affective overlap in form of abnormal temperament and depressive symptoms in obese patients, whereas mood swings should be evaluated and early mood stabilization considered for patients with significant weight gain to prevent obesity or to reduce already existing overweight. Studies of mood stabilizers and prospective observations would shed further insight on this complex interface of a major clinical and public health issue.
P01-263 - Consultative psychiatry in emergency service
Authors: Arcenegui Calvo A. , de la Vega D.C. , Gutierrez Vázquez J. 
Published: June 2010

ObjectivesDescription of the patients initially attended by the medical area at Emergencies service that later required psychiatric assessment.MethodsRetrospective review of the clinical histories of the previous three months (July to September) using Hospital Ramon Cajal's history software. Data were analyzed using the SPSS software 15.0 version.Results55 patients were assessed, 25 male and 30 females, with an average age of 34 years old. Many of the patients were frequent users of our Emergencies service: almost half of the patients (45%) had already come between 2 and 5 times, and only 11 of them (20%) had never been there before. 74% of these patients were already receiving psychiatric care in their ambulatories.The most frequent cause of consulting were suicidal attempts (50’9%) and drug abuse (18’2%). Up to 56’4% needed to continue been attended by a psychiatry ambulatory, 20% required hospitalization at the psychiatric unit and only 5’5% of the patients did not need any psychiatric care.ConclusionsThe medical area in our Emergency Service is well trained in recognizing psychiatric symptons, that is the reason why around 95% of the patients of our study needed psychiatric treatment.Sucidial attempt is the typical case in which it is necessary a close collaboration between different medical areas that work in the Emergency service.
P01-275 - Depression in Diabetics-a Serious Comorbidity
Authors: Hussain A. , Shah H. , Zarger H. , Margoob M. , Wani Z. , Qureshi W. , Laway B. 
Published: June 2010

ObjectiveDiabetes mellitus is a syndrome with disordered metabolism and inappropriate hyperglycaemia due to either the deficiency of insulin secretion or to a combination of insulin resistance and inadequate insulin secretion to compensate. Depressive disorders have been found to occur at increased prevalence rates among patients with Type 1 and Type 2 Diabetes Mellitus 9. Depression has the additional importance in diabetes because of its association with poor compliance with diabetic treatment, poor glycemic control and an increased risk of micro and macro vascular complications. An accurate estimate of depression prevalence is needed to keep and gauge the potential impact of depression management in patients with co-morbid diabetes 22. Better recognition and better treatment of depression are important in themselves but they could also improve medical outcome by substantial portion in patients of diabetesMethodsTotal of 527 cases of Diabetes were screened for major depressive disorder (MDD) by using DSMIV based criteria system. Montgomeny Asberg Depression rating scale (MADRS) and Clinical Global Impression (Severity) (CGI) scale to access severity.Conclusion:1.Major depressive disorder is inordinately high among the sample of adult diabetic patients occurring at the rates of 2 - 6 times greater than those observed in general population.2.Majority of patients with diabetes who have major depressive disorder have depression of moderate severity and not just mild depressive symptomatology.3.The presence of major depressive disorder is significantly associated with poorer glycemic control.
P01-277 - Evaluation of Efficacy of Fluoxetine in the Management of Major Depression and Arthritis in Patients Suffering from Rheumatoid Arthritis
Authors: Jain A. , Bhadauria D. 
Published: June 2010

ObjectivePatients with chronic pain suffer dramatic reductions in physical, psychological, and social well being, and their health related quality of life is lower. Anxiety and depressive disorders occur in 20%-25% of patients with rheumatoid arthritis.The effectiveness of antidepressants for the treatment of major depression is well documented; however, the analgesic properties of this class of medication are under-appreciated.This study aims to prove magnitude of association between RA and Depression along with independent effect of Fluoxetine on depression and arthritis.Method100 socio-demographically matched woman attending a rheumatology clinic with a diagnosis of rheumatoid arthritis as defined by American Rheumatism Association criteria, were approached for the study along with homogenous group of controls. HADS, MADRS and CGI were applied. Both the groups were treated with anti RA drugs along with added antidepressant in depressed RA group.ResultsStrong association between RA and depression was established. Treatment out come of RA was better and earlier in the depressed RA patients who were given antidepressant than non-depressed RA.ConclusionAll chronic pain conditions warrant psychiatric evaluation to unmask the associated psychiatric disorders as treatment of psychiatric disorders prove to expedite the recovery of physical symptoms as well, thus improving productive life span of an individual with chronic painful conditions.
P01-278 - Analysis of correlation between intensity of anxiety, depression and cognitive functions - before and after coronary artery bypass surgery
Authors: Krysta K. , Woznica A. , Krzych L. , Pawlak A. , Skarysz J. , Eysmontt Z. , Krupka-Matuszczyk I. , Bochenek A. , Cisowski M. , Janas-Kozik M. 
Published: June 2010

ObjectiveIn patients undergoing coronary-artery bypass surgery (CABG) the presence of cognitive functions deficits is frequently observed. This procedure is also associated with a danger of appearance of depression and anxiety. As the above symptoms may coexist, the purpose of this study was to observe the presence of depression and anxiety symptoms before and after the operation, and their impact on the cognitive functioning of operated patients.MethodsIt included 50 subjects in whom the intensity of depression was assessed with the use of the Beck Scale (BDI), and the anxiety as state and trait was assessed with the use of STAI scale on 1 day before the operation and on 5-7 days after the operation. At the some time cognitive functions were assessed with the use of Vienna Test System (VTS).ResultsThe change of intensity of anxiety and depression and most of the analysed cognitive functions, except learning ability, was statistically significant. However the correlation of depressive and anxiety symptoms with the cognitive deficits achieved the level of significance only with the reference to attention disorders.ConclusionThe achieved results show a considerable independence of the cognitive functions examination from the present emotional state in examined patients.
P01-279 - Hypersexuality Following Traumatic Brain Injury (TBI) and Neurosurgery: Case Analysis With Literature Review
Authors: Kaufman K. , Gallagher T. , Schneider J. , Tobia A. 
Published: June 2010

IntroductionHypersexuality is an uncommon behavioral complication associated with traumatic brain injury (TBI) involving lesions to frontal basal, temporal, or diencephalic structures. Experimental brain injury in animals has produced hypersexual behaviors; however, there is comparative paucity of knowledge in humans. TBI with hypersexuality offers insights into neurological basis of aberrant sexual behaviors as well as potential treatments. This case report describes social/sexual disinhibition in a patient following neurosurgery for self-inflicted TBI.MethodCase analysis with literature review.Results32-year-old male was admitted with TBI following an unsuccessful suicide attempt, self-inflicted nail gun injury to the occiput. CT scan revealed 6.5cm nail that had entered the skull in right occiput, right parasagittal location with nail head right of vein of Galen, coursing through splenium of corpus callosum, right thalamus-hypothalamus-midbrain, with its tip at the suprasellar cistern. Occipital craniotomy with retrieval of foreign body was performed eleven days after admission. From post-operative day eight through twenty-seven, patient made inappropriate sexual comments to female medical student: asking her out repetitively, describing her physical appearance, enquiring about her suitors, and requesting her to call him upon his discharge. Prior psychiatric history was pertinent for major depression and social anxiety (especially women) with psychotropic noncompliance. During admission, patient was diagnosed with recurrent major depression, social anxiety by history, and impulse control disorder nos. On sertraline titrated to 100mg qhs, depression resolved with increased control over newly acquired sexual/social disinhibition noted.ConclusionTBI can lead to social disinhibition and hypersexuality. Sertraline may be a beneficial treatment.
P01-280 - Depression, anxiety and vital exhaustion are associated in outpatients with bronchial asthma
Authors: Kostaras T. , Moussas G. , Tselebis A. , Bratis D. , Christodoulaki A. , Kleftogianni D. , Gouma P. , Anagnostopoulou M. , Moulou A. , Karkanias A. 
Published: June 2010

ObjectivesMany studies have attempted to delineate the positive relationship between anxiety and depressive symptomatology in outpatients with bronchial asthma. However, do not exist reports on the relation between the depression, anxiety and vital exhaustion in these patients.Aim of the study is to investigate the levels and the associations between anxiety, depression and vital exhaustion in outpatients with bronchial asthma.MethodsThe study was performed in one of the largest hospitals of chest diseases in Greece. Forty (14 men και 26 women) outpatients with bronchial asthma participated in the study. Using the BDI (Beck Depression Inventory), the STAI (Spielberger Anxiety Trait Inventory) and the Maastricht Questionnaire (MQ) we assessed depression, anxiety and vital exhaustion, respectively. Age and duration of the disease were also recorded.ResultsMeans of age and of duration of the disease were 43.22±13.05 and 9.24±6.01 years, respectively. The mean STAI score was 42.47±9.9, mean BDI score was 14,16±7,54, and the mean MQ score was 21.02±11.05. Percentages of 29% and 60% of the sample were presented with significant anxiety and depressive symptoms, respectively. No correlation was observed between the demographics (age and duration of disease) and the STAI's and MQ's scores. In contrary, a positive correlation was observed between the levels of depression, anxiety and vital exhaustion (pearson correlation p< 0.001).ConclusionsThe study confirms the coexistence of the depressive symptomatology with anxiety and vital exhaustion in outpatients with bronchial asthma. Therefore, this comorbidity should be taken into account in order to develop specific supportive psychological interventions.
P01-284 - Cognitive Impairments in Refractory Hypertension
Authors: Lougon M. , Verri V. , Rangel Tura B. , Cordovil Oliveira I.L. , Mazzaronne R. 
Published: June 2010

ObjectiveThe main purpose of this study is to measure the prevalence of cognitive impairments among hypertensive outpatients in the Hypertension Department of Cardiology National Institute.MethodsA sample of 90 consecutive hypertensive outpatients was evaluated from the cohort of 217 hypertensive patients population in treatment. They were assessed by the same PhD psychiatrist using the Mini Mental State Examination.MethodsProspective study of a sample of 90 consecutive hypertensive outpatients was evaluated from the cohort of 217 hypertensive patients population in treatment. They were assessed by the same psychiatrist, using the Mini Mental State Examination (MMSE).ResultsThe main question, proposed by this study, if arterial hypertension causes cognitive impairment, has a negative answer, for it was observed that for each mercury millimeter increased in the Diastolic Blood Pressure (DBP), occurs a downfall of only 0.02 in the MMSE, but when adjusted according to the age of subjects, the association among DBP and the MMSE score disappears. Statistical analysis included the t test of Student or Mann-Whitney, qui-square test or Fisher's exact test and linear regression.ConclusionsThis study did not show any causal correlation between hypertension and cognitive impairment. According to numberless articles, the MMEE instrument demonstrated in this study, great bias associated with illiteracy and formal education.
P01-289 - Use of the PHQ-9 as a Screening Tool for Post-stroke Depression
Authors: Ulhaq S. , Symeon C. , Agius M. 
Published: June 2010

IntroductionFollowing a previous audit conducted at Bedford Hospital we found no formal screening tool for depression was used in post-stroke patients. The prevalence of depression in the sample of 63 patients was 28%. We recommended the implementation of the PHQ-9 questionnaire as a screening tool for depression in these patients.Objectives/AimsTo assess the effectiveness of the PHQ-9 as a screening tool for depression in stroke patients. To review whether implementing this screening tool has increased the prevalence of depression within this patient population.MethodAll patients admitted to the stroke ward in Bedford Hospital between 10/09/09 and 13/12/09 were included in the audit. Patients were screened two weeks after admission. Exclusion criteria were met if patients lacked mental capacity to be screened; the patient declined or was discharged or deceased within 2 weeks.ResultsOf 83 patients admitted, 18 (23%) were screened. Of these, 10 patients (53%) scored 5 or above, indicative of depression. One patient scored 10 indicative of moderate depression, and one patient scored 19 indicative of severe depression.ConclusionThe PHQ-9 questionnaire is useful as it clearly increased the prevalence of post-stroke depression. However noticeably there are a significant proportion of patients who could not be screened using this tool as it is a self report assessment. This includes those who lack capacity or have communicative difficulties as is common after a stroke.
P01-291 - Prevalence of Differnt Somatoform Disorders in Psychiatric Consultations of a General Hospital: a 10-year Study in Farabi Hospital
Authors: Shakeri J. , Rahimnia M. , Ebrahimzadeh M. , Abdoli N. , Kalantary S. , Naseri S. 
Published: June 2010

AimTo find the prevalence of different Somatoform Disorders (SDs) in psychiatric consultations to inpatients and outpatients of Farabi General Hospital(Kermanshah-Iran) in 10 years (from 1994 to 2004) and to define their demographic variables.MethodsAny patient, who received an SD diagnosis by the consultants, was further assessed, using a two-phase design, for DSM-IV SD criteria.ResultsA total of 801 patients fulfilled diagnostic criteria for a DSM-IV SD. Among these 493(61.5%) had Conversion Disorder, 127(15.9%) Somatization Disorder, 117(14.6%) Hypochondriasis, 41(5.1%) a Body Dysmorphic Disorder and 23(2.9%) a Pain Disorder).Most of the patients were young, female, married and not educated more than primary school.ConclusionSomatoform Disorders are common in psychiatric consultations of General Hospitals. Internists, surgeons and other specialists need to be aware of these disorders.
P01-298 - Effects of Written Emotional Expression on General Health of Patients with Multiple Sclerosis
Authors: Ranjbar F. , Herizchi S. , Talebi M. , Pourafkary N. 
Published: June 2010

Introduction and objectivesMultiple Sclerosis (MS) is an acquired chronic neurological disorder. Studies have shown that prevalence of MS is more in some areas of Iran like as Azarbaijan(Tabriz) and Isfahan. General health problems are prevalent in MS patients. Written Emotional Expression (WEE) is one of the cost-effective self helpers' methods that its efficacy has been studied on mental health, but this method has never been studied on MS patients in Iran.AimsAim of this study was to evaluate efficacy of WEE on general health of MS patients.MethodsWith experimental study, 40 (8 male, 32 female) MS patients who had completed informed written consent and filled General Health Questionnaire (GHQ-28) were asked to write their negative feeling for 30 minutes daily for 4 consecutive days. After 15 days they filled GHQ again. Finally the Statistical analysis was done.ResultsAfter intervention of Written Emotional Expression, general health score in patients with multiple sclerosis decreased significantly. (p< 0.01)ConclusionsWritten Emotional Expression may be effective on general health of multiple sclerosis patients.
P01-300 - The study on Anxiety Disorders in Implantable Cardioverter Defibrillator (ICD) Patients
Authors: Ranjbar F. , Akbarzadeh F. , Ghaemian N. 
Published: June 2010

Introduction and objectivesSudden cardiac death (SCD) is responsible for 300,000 deaths annually. The use of ICD has improved survival rates following SCD episodes. However ICD may causes anxiety in patients. ICD shock is suspected as cause of enhanced anxiety.AimsThe aim of present study was to evaluate the prevalence of anxiety disorders in patients with ICD.MethodsIn a case- control study with random sampling of 57 patients with ICD (at least 6 month after ICD implantation) they were compared with 57 patients without ICD as control group. In this study the SADS questionnaire and DSM- IV structured interview were used. The relation of gender, age, marital status and shock with anxiety was determined. The analysis was done using descriptive and qualitative statistics.ResultsFrequency of anxiety disorders in ICD patients was 47.4%. 19.3% panic disorder, 47.4% GAD, 12.3% phobia and 5.3% OCD. PTSD was not seen in ICD patients in this study. There was a significant difference in frequency of anxiety disorders between ICD patients and control group (P= 0.001). The most frequent disorders in patients with ICD were GAD. The incidence of anxiety disorders in patients with and without ICD discharge was 84% and 18% respectively. Anxiety disorder was significantly related to the ICD discharge (P< 0.0001).ConclusionsAmong the anxiety disorders GAD was observed to be the most frequent in the patients with ICD discharge rather than patients without ICD.
P01-317 - Opposition to the Jewish Rite of Circumcision in Modern Israeli Society as Expression of Motherhood and Feminism
Authors: Bankirer Y. , Abramovich Y. , Gooldin S. , Kotler M. 
Published: June 2010

ObjectiveUp until recently, Jewish circumcision was a taboo Jewish rite, with the upmost importance to Jewish identity. Lately, voices began to rise in Israel that questions the rite. It is a growing community of parents that did not circumcise their sons, and stood oppose to the status quo of circumcision.We will examine Jewish circumcision in non religious society in Israel through the voices of mothers who did not circumcise their sons.MethodQualitative constructivist research based on depth interviews of mothers who did not circumcise their sons and cross cultural literature review.ResultsIn most cases the mother initiated an emotional decision not to circumcise. The characteristics of these women were atheist, older than usual, very educated, Most of which grew up with high expectations to be successful financially and professionally, but chose to live a more “homey” lives with their main goal children upbringing.ConclusionsWe have found that the opposition to Jewish circumcision in Israel is a statement that goes against the devaluation of the primary dyad between a mother and her child. It is not an isolated event but a part of a broader conceptual believes that emphasizes more “feminine” values such as motherhood, breastfeeding, nature and ecology, as opposed to “muscular” values as culture, ritual ceremonies, financial wealth and militarism. The social change that is represented by the opposition to Jewish circumcision is a part of the individualism of society which emphasizes the importance of the processes within the family unit.