bluuebunny/crossref_metadata_2025_split huggingface dataset:
P01-351 - A Review of Involuntary Admissions to a Psychiatry of Old Age Specialist Unit
Authors: Davoren M. , Wrigley M. 
Published: June 2010

ObjectivesIn this review we examined the involuntary admissions to a purpose-built Psychiatry of Old Age (POA) specialist unit under the care of the North Dublin Psychiatry Of Old Age Service, Dublin, Ireland.Our objectives were to examine the source of referral, progress in hospital and outcomes of all involuntary admissions, under the Irish Mental Health Act, to this Psychiatry of Old Age specialist inpatient unit over a one year period. All patients were divided into two groups, those who were diagnosed with Dementia and those patients who had a functional mental illness. We specifically examined the characteristics of both groups to identify any differences their outcomes.MethodsA retrospective chart review of all involuntary admissions over a one year period from January 1st 2008 to December 31st 2008 was conducted.Results67% of all admissions to the Psychiatry of Old Age unit during 2008 were involuntary admissions. The detained patients were mostly male (71.4%).The most common diagnoses were Alzheimer's Dementia (38.1%), Dementia Mixed Aetiology (14.3%) and Psychotic Illness (14.3%).88.2% of Patients who had a diagnosis of Dementia required Long Term Care at the end of their admission, but only 25% of those patients who had a Functional Mental Illness were transferred for Long Term Care at discharge.ConclusionsPatients with dementia had significantly longer involuntary admissions than patients with affective or psychotic disorders. Patients with dementia were also more likely to require long-term care on discharge than those patients who did not have dementia.
P01-352 - Schizophrenia-like Alcoholic Dementia or Dementia Praecox? Case Report
Authors: Fonseca L. , Duarte J. , Simões S. 
Published: June 2010

IntroductionA clear distinction between schizophrenia and some clusters of dementia is sometimes difficult to do in clinical practice.Case reportA 38-years-old-male patient, with history of alcohol dependence, was admitted in our unit for generalized tremor, sweating, agitation, auditive, visual and cenestesic hallucinations, thought broadcasting and persecutory delusion. Agitation and the vegetative symptoms gradually subsided within 48 hours. Lab work showed no clinically significant changes. EEG and EKG were normal. MRI showed augmented cortical encephalic sulci. 5 days after the admission 10 mg of olanzapine was prescribed due to psychotic symptoms persistence. Haloperidol was stopped. A gradually improvement occurred and 26 days after the admission the patient was discharged home asymptomatic. Neuropsychological testing revealed severe fronto-temporal cognitive defect suggestive of alcoholic dementia.DiscussionThe difficulty to clearly distinct schizophrenia from some dementias may be because, as Kraepelin stated in the 19th century, schizophrenia is itself a form of early dementia. His concept of dementia praecox is supported nowadays by the knowledge acquired from several neuropsychological and neuroimaging tests that a progressive cognitive deterioration appears to occur in schizophrenic patients.
P01-354 - The Relations Between Psychosocial Factors, Care Burden and Depression on the Dementia Family Caregivers
Authors: Guerrero-Martin J. , Chaudri A. , Muñoz F. , Durán N. , Ezquerro A. , Suero P. 
Published: June 2010

ObjectivesTo describe the relation of psychosocial factors of care (phase illness, years of care, free time, extra help and symptoms of depression) influence the care burden of dementia family caregivers. To measure the relation of the level of depressive symptoms on an intense level of burden of the dementia family caregivers.MethodsIs selected a sample of 102 primary caregivers by criteria of inclusion to which a surveys do to those that the following information gathered: sociodemographic dates of the caregivers and of the dementia patients, care burden (Zarit Interview) and depressive symptoms (Beck Depression Inventory) of the family caregivers.ResultsMost of the sample experiences an intense burden level (74%) opposite to a light level (26%). Psychosocial characteristics are as per statistics significant in increasing the care burden there were free time, extra help and presence of symptoms of depression. Presence of serious symptoms of depression on the intense burden level are differently front or those who had a minor burden, 22% and 5% respectively.ConclusionsThere are most of the daughter-father/mother and spouse-spouse caregiver couples with a high percentage of caregivers of feminine sex (as in most of the studies realized on caregiver of dependent persons at European and international level). The need for free time and psychic self-care are cost-effective strategies to prevent the depressive disorders, as well as, to improve their caregiver's work. The psychoeducation programs that have being realized at European level directed to family caregiver are necessary in our country.
P01-357 - Temporal Relationship of Depression, Cognitive Impairment and Dementia in Older Persons
Authors: Ladea M. , Sinca C.M. 
Published: June 2010

ObjectiveThere is a growing appreciation that depression may be a presenting syndrome of dementia.This study intends to show that the presence of cognitive impairment in a depressive episode in older people may have important prognostic implications in developing dementia.MethodsIn this study a first group of 17 depressed patients with mild cognitive impairment (MMSE over 26) was compared with a second group of 18 depressed patients with mild to moderate cognitive impairment (MMSE bellow 26). The mean age for both groups was 68. The depression was measured using the MADRS scale. All the patients included were severely depressed at the inclusion. Both groups showed important improvement of the depressive episode, following the treatment with antidepressants (escitalopramum, sertralinum, venlafaxinum).Both groups were followed for 2 years after the depression resolution.ResultsIn the first group of patients the MMSE was 26 at baseline and 26 or over at discharge.In the second group of patients the score of MMSE had a value of minimum 17 at baseline and a maximum of 26 at discharge.Five patients (three in the first group and two into second group) did not complete the 2 years follow up period.Over the period of 2 years, 37% of patients from the second group developed a dementia, comparing with only 14% of the patients from the first group.ConclusionsAfter 2 years, the patients with depression and significant cognitive impairment had twice the risk of developing dementia as those who had only depression.
P01-359 - Overall Quality of Life Among Spanish Patients with Mild Cognitive Impairment and Dementia
Authors: Lucas Carrasco R. , March J. 
Published: June 2010

ObjectivesDoing there is no consensus for a multidimensional definition of Quality of Life (QoL) in dementia, and that informant- and self-perceptions of QoL differed substantially, lately it has been proposed to analyze Overall QoL using a simple item. Our objective was to investigate Overall QoL and how this perception among people with Cognitive Impairment and Dementia is associated with other variables. Thus, obtained predictor variables of QoL will act as confirmatory indexes to corroborate the self-reported QoL in clinical setting.MethodsWe conducted a cross-sectional survey where 106 participants with Cognitive Impairment (CI) and Dementia completed a face to face interview including diagnosis of dementia (DSM-III-R / DSM-IV), sociodemographic information, health perception and a list of chronic medical conditions, depressive symptoms (GDS-15) and functional ability (Barthel Index). Quality of life was measured with the self-assessment of overall QoL item from WHOQOL-BREF.ResultsMean age was 78.7 y.o. (SD: 7.1, range 55-91); 64.8% were female and 50% had primary school or more. Ordinal Logistic Regression analysis showed four factors correlated with a better QoL: (1) patients rating their health as good or more than good, (2) patients considering themselves healthy, (3) patients reporting not having depression, and (4) patients having less depressive symptoms (lower GDS scores).ConclusionsA single-item global rating of patient QoL could prove useful in assessing QoL of most mild-to-moderate-stage CI and dementia patients. Affective states should be considered when assessing QoL in patients with CI and dementia; consistently, negative mood have a detrimental impact on QoL.
P01-360 - Training in Cognitive Reasoning for Elders: is More Better?
Authors: Hohaus L. , Weekes A. 
Published: June 2010

ObjectivesIncreasing evidence suggests that training in complex reasoning skills may delay the onset of cognitive impairment. A key challenge is to develop cost effective brief interventions which lead to optimal performance.AimsHence the major aims of this research were to examine the benefits of a brief intervention for elders, and to compare any improvements with those achieved after more training is provided.MethodsA fully randomised controlled trial was conducted with 30 healthy older adults (M = 64 years) Participants completed measures of the WASI Matrix Reasoning subtest before and after the brief intervention, and again after the extended intervention. Those allocated to training were asked to complete a two week program of sudoku problems of increasing difficulty using tactics demonstrated in guidelines provided. This was followed by an advanced suduko program with harder problems and more sophisticated tactics.ResultsA 2 × 3 (Training × Time) mixed ANOVA on WASI scores was conducted. This showed a significant interaction between Training and Time (F(2,56) = 4.18, p< .05, partial eta squared = .13). Further ANOVAs were conducted to examine this interaction. These showed that the training group improved over time but that the control group did not. Furthermore the training group improved significantly after the brief intervention, and improved more after the extended intervention.ConclusionsA brief two week training program in suduko enhanced cognitive reasoning in older adults as assessed by the WASI reasoning subtest. A further two week advanced program in suduko further improved cognitive reasoning.
P01-367 - Vitamin D Deficiency in Elderly Psychiatric Patients: First Results
Authors: Gaasbeek B. , Marijnissen R. , Havers H. , Kaassenbrood A. 
Published: June 2010

BackgroundElderly people are likely to have inadequate storage of vitamin D. Physical consequences may include pain, loss of bone tissue, decrease of muscle power, increase of fall risk and fractures. Also, among women an association of low vitamin D levels and a higher incidence of mood disorders has been reported.Prevalence of vitamin D deficiency is highest among institutionalized elderly. Elderly psychiatric patients could be at increased risk because of inadequate diet, polypharmacy, diseases that interfere with vitamin D metabolism and less exposure to sunlight due to homeboundness.In July 2008 we started a study on a clinical department of geriatricpsychiatry ward with the aim to establish the nutritional and vitamin status (including vitamin D) at and during admission.MethodsAll patients admitted to the clinical department of geriatric psychiatry of De Gelderse Roos Mental Health Care Institute (Arnhem, The Netherlands) were included.ResultsDuring six months (July 2008-January 2009) the vitamin D level was established in 50 patients. At admission a vitamin D deficiency was found in 40 patients (80%).Conclusion and discussionBecause vitamin D deficiency could have serious implications, both physical and psychiatric, we recommend routine assessment of vitamin D levels at psychiatric admission. If found too low, supplementation needs to be considered. In further research we will establish whether there is an association between vitamin D deficiency and the occurrence of psychiatric disorders. Also we will investigate if non-deficient patients at admission develop deficiency during admission.
P01-374 - Needs of the Elderly in Polish and German Rehabilitation Centers
Authors: Rymaszewska J. , Mazurek J. , von Renteln-Kruse W. 
Published: June 2010

AimNeeds of the elderly are complex and difficult to identify since connected with many different dimensions. The aim was to identify met and unmet needs of patients referred to old age rehabilitation services in Poland (Wroclaw-Wr) and Germany (Hamburg-Ha).MethodsPatients (n=80) over the age of 60 were assessed using the Camberwell Assessment of Need for the Elderly (CANE), Mini Mental State Examination (MMSE), Global Deterioration Scale (GDS), Good Milieu Index (GMI) and Activities of Daily Living Scale (ADL). Patients were at least 2 weeks under rehabilitation due to orthopedic or neurologic reasons.ResultsBoth groups were similar concerning age, gender, education and marital status. Satisfaction of the ward was the same. Wr-patients were significantly more demented (25.1 vs.26.8; p=0.011), depressed (4.12 vs 3.0; p=0.033) and disabled (24.88 vs 76.62; p< 0.0001).The mean number of total, unmet and met needs before rehabilitation was similar in both centers. However, significantly more needs in accommodation, eyesight /hearing /communication and benefits were reported in Wr, whereas psychological distress and food in Ha.During rehabilitation program over twice more unmet needs were reported in Wr vs. Ha (1.38 vs. 0.57; p =0,0029) in the areas of eyesight /hearing /communication and benefits, continence, money.Ha received twice more formal assistance than Wr before (0,0027), but Wr twice more during rehabilitation (p< 0,0001).Assessing individuals needs may help in creating individual complete rehabilitation program within continuing care post discharge and improve quality of life.
P01-376 - Screening for Dementia in Very Old Age in Primary Care
Authors: Stoppe G. , Buss K. , Wolf S. , Stiens G. , Maeck L. 
Published: June 2010

BackgroundThere are many screening instruments available for the detection of dementia. However, they were not tested in very old age and often not in the primary care setting for which they are developed.MethodWe condensed a screening battery of all elements of common tests (MMSE, TFDD, DEMTECT, Clock Test…). Nine primary care practices took part in the study. The practice assistants were trained to approach all patients over 75y visiting the practice. Only patients with already diagnosed dementia, severe hearing or vision disability or communication deficits were excluded. After informed consent they applied the screening. Within the next days a second independent neuropsychological examination was arranged in the memory clinic of the University of Goettingen. This included established neuropsychological tests (CERAD-NP, WMS-R, TMT.) and further scales were applied (NPI, CDR..). All patients with CDR=0.5 were approached 1.5y later for a follow-up by phone.ResultsN=90 patients (25M, 65F) took part in the initial evaluation. From N=54 with CDR=0.5 only N=14 could be reached for follow-up. None of them returned to CDR=0, most progressed up to CDR=4. There were some correlations to education and dementia severity. All available screenings showed a good effect size of >0.70 (MMSE, DEMTECT, TFDD, RDST).ConclusionElements for an optimal screening of the oldest old are discussed.
P01-377 - Separated Wards for the Elderly in Psychiatric Hospitals: the Patient View
Authors: Stoppe G. , Sutter M. , Maeck L. , Krebs-Roubicek E. 
Published: June 2010

BackgroundAt least at the larger hospitals specialised gero-psychiatric units have been introduced, usually taking care of those at age 65y and higher. The advantages of this approach have been discussed and examined. The patients’ view has only rarely been investigated and mostly only from a single perspective (e.g. patient satisfaction on gero-psychiatric wards).MethodsWe performed semistructured qualitative interviews in our hospital in a balanced sample of (n=14) patients at 18-40y, (n=10) patients at 41-60y, (n=16) patients at 61-75y, (n=8) patients over 75y. There were (n=) 24 male and (n=) 24 female patients. 12 patients hat been treated exclusively in old age psychiatry, and 10 patients had been treated in old age psychiatry after their 65th birthday.ResultsThe majorities of the patients saw advantages in mixed sex and age care for the younger and for the older patients. Disadvantages where not seen for younger patients, however for the elderly the view was ambivalent (26 yes versus 22 no). Female and higher age patients and those with multiple hospitalisations tended to expect more disadvantages. While a mixed ward would be regarded as more (stimulating), disadvantages could be the combination of aggressive young and frail elderly patients as well as the overburdening of the staff.ConclusionThis is the first investigation on patient view on the segregation of old age psychiatric patients. Further studies should lead to a consumer guided care provision allowing specialisation as well as defending ageism.
P01-387 - Bipolar Affective Disease and AIDS - Concerning a Clinical Case
Authors: Ferreira M. , Matos G. , Tavares A. , Cunha J. 
Published: June 2010

The Human Immunodificiency Virus infects primarily the immune system. However, the infection may also affect the central nervous system, materialising itself, in this particular case, in neurological and neuropsychiatric disturbances.The authors describe the case of a 48 year-old female patient with bipolar affective disease, identified since she was 21. She has a long history of regular examination in speciality consultations, including several psychiatric hospital stays. More recently, she is conducted to the psychiatric emergency department, being admitted for a maniform state. During the stay her general condition deteriorates progressively, being often taken to the regular emergency department. The serious weight-loss associates itself to altered states of consciousness, ataxia and disartry, as well as diahrrea, fever syndromes and breathing difficulty. As a consequence, the patient stays in bed. Despite several diagnosed infections and the histologic result of the cervical cancer biopsy, requested in an ambulatory regime (“lymphoproliferative disease involving the cervix”), she is always conducted to the psychiatric ward. She is admitted in the medicine ward only a month later and is, afterwards, transferred to the infectious diseases ward, with the aim of studying the neuropsychiatric condition in connection with the HIV/AIDS infection.The authors come to the conclusion that, it is rather important that the anti-HIV antibodies research is included in the routines of complementary diagnosis examinations requested by psychiatrists.They also reflect about the little relevance that other medicine areas give to the physical diseases of the psychiatric patients, weakening them even more.
P01-389 - Psychogenic Non-epileptic Seizures: Clinical Classification Based on the Video-EEG Analysis of 145 Seizures
Authors: Hubsch C. , Baumann C. , Maillard L. 
Published: June 2010

The “psychogenic non-epileptic seizures (PNES), paroxysmal behavioral changes that resemble an epileptic seizure but are not associated with electrophysiological epileptic changes seem to be caused by a psychological process. They still are misdiagnosed. The video-EEG allows their direct observation.After studying the characteristics of the affected population, we have studied the semiological aspect of PNES and have sought to demonstrate inter and intra-individuals reproducibility who attest to common “laws” and would look a neurological substrate for these events.We analyzed the symptomatology of 145 PNES, recorded by video-EEG in 52 patients. Statistical analysis of data consisted first, to describe the characteristics of seizures and patients. Secondly, we conducted a multiple correspondence analysis and hierarchical clustering. The SAS ® v9.1 was used.Results5 subtypes of PNES emerged from the statistical analysis showing reproducibility of seizures in 61.54% of patients:-brief crisis with automatisms and dystonia-“pauci-kinetic”, sensitive crisis with preserved contact-brief and brutal crisis with break contact and clonic jerks-“major crisis” with extended axial spasms-prolonged, fluctuating with hyperventilation preceded by prodrome.The identification of a typology can move from a clinical based diagnosis to a real positive diagnosis. The reproducibility of the crisis allow to make common pathophysiological hypotheses. The history of psychological trauma query on a relationship between the management of neuro-psychological affects and PNES “dysfunction” of connections between the frontal lobe, the limbic system and the basal ganglia. Beyond the positive diagnosis, the fundamental and therapeutic perspectives are many.
P01-391 - The Diagnosis of Melancholic and Atypical Depression During Pregnancy
Authors: Kammerer M. , Glover V. , Pinard C. , Künzli H. , Taylor A. , von Castelberg B. , Marks M. 
Published: June 2010

IntroductionAtypical and melancholic subtypes of depression based on the Diagnostic and Statistical Manual (DSM) IV are important concepts, especially for biological psychiatry. The aim of this study was to determine whether the symptoms used for the diagnoses of atypical and melancholic depression can distinguish these subtypes during pregnancy.MethodA modified version of the Structured Clinical Interview for DSM IV (SCID interview) was used that allowed assessment of all DSM IV symptoms of melancholic and atypical depression with depressed and non depressed women in pregnancy. A Swiss cohort of 449 women was interviewed. Four diagnostic groups were compared: women with melancholic, atypical, or non specified depression, and those without depression.ResultsSeventeen per cent of the cohort met SCID criteria for a depressive episode of depression at least once in pregnancy, with melancholic depression 2.4%, atypical depression 4.4%, and non specified depression 10.2%. Many of the symptoms used to distinguish atypical and melancholic depression did not discriminate between these groups during pregnancy. However some, such as mood reactivity, distinct quality of mood and sleep pattern, did discriminate.ConclusionsDifferential diagnosis between melancholic and atypical depression in pregnancy needs to be based on pregnancy specific definitions. The possible therapeutic consequences and the neurobiological basis for these findings warrant further research.