bluuebunny/crossref_metadata_2025_split huggingface dataset:
Reduced connectivity in the uncinate fiber tract between the frontal cortex and limbic subcortical areas in social phobia
Authors: Tröstl J. , Sladky R. , Hummer A. , Kraus C. , Moser E. , Kasper S. , Lanzenberger R. , Windischberger C. 
Published: May 2011

IntroductionSeveral fMRI and resting-state connectivity studies have demonstrated alterations in the limbic system and frontal areas in social anxiety disorder (SAD).AimsHere we used high-resolution whole-brain diffusion tensor imaging (DTI) to examine differences in anatomical connectivity between patients and controls in the white matter.MethodsWe examined 14 SAD patients (age 26.3 ± 9.0y) and 15 healthy controls (age 25.6 ± 3.3y) using DTI on a 3T Trio MRI scanner (Siemens, Germany). DTI acquisition with 1.6 mm isotropic resolution was performed in 30 directions and a maximum b-value of 800. Fractional anisotropy (FA) maps were obtained using FSL. Group analysis was performed in SPM8 (two sample t-test).ResultsThe figure shows a coronal slice through the uncinate fasciculus. Arrows point to areas where SAD patients show decreased FA-values compared to controls (p < 0.05). Note that these areas are limited to the uncinate fasciculus and are found bilaterally.ConclusionReduced FA-values indicate a reduction in anatomical connectivity strength. Our study thus clearly shows reduced connectivity strength in the uncinate fasciculus connecting frontal regions with limbic areas as the amygdalae and hippocampus. This reduced structural connectivity supports functional data demonstrating alterations of brain activation in the amygdala and prefrontal regions in social phobia.
P01-183 The disgust sensitivity questionnaire [cuestionario de sensibilidad al ASCO, CSA]: A new self-report measure of disgust
Authors: Valiente R.M. , Sandín B. , Chorot P. , Santed M.A. , Campagne D. , Olmedo M. 
Published: May 2011

Introduction and aimsSome theory and empirical-driven classification systems of disgust have stimulated the creation of several self-report instruments for the assessment of disgust sensitivity [e.g., the Disgust Scale-Reviesed (DS-R,Haidt et al., 1994) and the Disgust Propensity and Sensitivity Scale-Revised (DPSS-R; van Overveld et al., 2006;Sandín et al., 2008)]. Two main problems of current self-report scales of disgust are that(a)there is not a consensus about the domains of disgust to be assessed, and(b)all self-report scales were developed in the Anglo-Saxon culture.Given the particular relationship of disgust to the individual's culture, it is desirable to construct self-report instruments based in other cultures.The aim of this work was to develop a new self-report instrument based in a Spanish-speaking population.MethodThe 11 domains (see Sandín et al.) in which Spanish people experience disgust served to define a broad range of disgust elicitors in our Cuestionario de Sensibilidad al Asco (CSA) [Disgust Sensitivity Questionnaire]. The initial questionnaire (92 items) was given to a sample of undergraduates at Universidad Nacional de Educación a Distancia. Based on factor and item analysis, sixty-two items were finally retained.ResultsExploratory factor analysis of the 62 CSA items revealed a robust eleven-factor structure, describing the following 9 dimensions of disgust: hygiene, socio-moral, sex, envelop violations/death,animals, disease,atypical food, animal decomposition, and unacceptable food. Internal consistency (alpha coeffients and corrected item-total correlations) was excellent.ConclusionsFindings suggest that the CSA is a promising new measure of disgust. The CSA demonstrated excellent factorial validity and reliability.
The role of group treatment for obsessive-compulsive disorder
Authors: Zampetaki C. , Delimpalta C. , Varouchaki E. , Zampogiannis A. 
Published: May 2011

IntroductionObsessive-Compulsive Disorder (OCD) is characterized by recurrent intrusive thoughts and/or repetitive behaviors carried out in a ritualistic fashion. Both obsessions and compulsions are ego-alien and produce anxiety if resisted. Cognitive behavioural therapy (CBT) based on exposure and response prevention (ERP) and pharmacotherapy are currently the most popular choices of treatment.ObjectiveIndividual CBT/ERP with or without psychopharmacological treatment has been established as the treatment of choice for OCD, but group CBT/ERP has received little attention although it has been proposed as a cost-effective alternative. The aim of this paper is to explore its pros and cons.MethodReview of the current literature.ResultsGroup CBT/ERP appears to be equally effective as individual, although the latter has been associated with a more rapid rate of improvement. Both achieve similar reductions in anxiety and depressive symptoms and have similar dropout rates. Group theray is also acceptable to most patients and saves time and money to both patients and doctors. It is not documented whether it achieves change of the same magnitude as the individual format of the respective treatment. Patients with more severe global symptoms are less likely to respond to the group format, therefore an attempt to reduce these symptoms prior to the treatment of OCD may be necessary.ConclusionGroup treatment is an effective treatment for OCD in the long term, but more research needs to be done to compare the effectiveness of group and individual treatment formats.
Efficacy of adjunctive aripiprazole to lithium or valproate in the long-term treatment of mania in subjects with bipolar i disorder (CN138–189)
Authors: Abbar M. , Khan A. , Rollin L. , Sanchez R. , Carson W. , Morris B. , Timko K. , Marcus R. 
Published: May 2011

ObjectivesTo evaluate the long-term safety and efficacy of adjunctive aripiprazole (ARI) to lithium (LI) or valproate (VAL) in delaying time to relapse in bipolar I disorder.MethodsBipolar I disorder subjects with a current manic or mixed episode received LI or VAL for at least 2 weeks; inadequate responders (YMRS score ≥ 16 and ≤35% decrease from baseline at 2 weeks) received adjunctive ARI. Subjects maintaining mood stability (YMRS and MADRS ≤ 12 for 12 consecutive weeks) were randomised 1:1 to double-blind ARI (10 to 30 mg/day) or placebo (PBO) plus LI or VAL. Relapse was monitored up to 52 weeks.Results337 subjects were randomised to continuation of mood stabiliser plus adjunctive ARI or PBO; 61.3% and 52.7%, respectively, completed the study. Adjunctive ARI significantly delayed the time to any relapse, hazard ratio = 0.544 (95% CI: 0.33, 0.89, log-rank p = 0.014). Overall relapse rates at 52 weeks were 14.9% and 25.4% in ARI vs PBO subjects. A superior reduction in CGI-BP Mania Severity of Illness from baseline at 52 weeks was also observed (0.3 vs. 0.0, respectively, p = 0.01). Adverse events generally were as expected per known drug and illness profiles with no significant difference in mean change in body weight between adjunctive PBO (0.60 kg) and adjunctive ARI (1.07 kg) (p = 0.49 Week 52, LOCF).ConclusionContinuation of aripiprazole treatment increased time to relapse to any mood episode compared with placebo plus LI/VAL over 1 year, indicating a long-term benefit in continuing adjunctive aripiprazole to a mood stabiliser after sustained remission is achieved.
Strong scalability indexes for a new self-rating scale for mania and depression
Authors: Adler M. 
Published: May 2011

The Affective Self Rating Scale (AS-18) was developed in response to clinical need for a user friendly self-rating scale for simultaneous assessment of depression, mania and mixed affective states in outpatient settings. The two subscales of AS-18 have nine items each (AS-18-M and AS-18-D). There are five levels of response categories graded from 0 to 4. AS-18 has been evaluated in two samples of bipolar 1 patients, using the non-parametric Mokken method. The Mokken method was especially developed for analysis of scales of ordinal type and gives scalability indexes that are measures of the ability of items and a full scale to rank persons according to their total score on a common dimension (unidimensionality).The AS-18 have in two samples shown scalability indexes above the generally accepted cut-offs of ≥ 0.3 for items and ≥ 0.5 for a strong full scale.ConclusionAS-18 has good basic psychometric properties. It takes only a few minutes for patients to perform and is suitable for routine use in outpatients with bipolar 1 disorder.
Mixed affective states; a study within a community mental health team with treatment recommendations
Authors: Agius M. , Singh S. , Ho J. , Zaman R. 
Published: May 2011

IntroductionAgitated Unipolar Depression and Bipolar mixed states combine depressive and manic symptoms, reflecting severe forms of affective disorders with an increased suicide risk. These states have not been defined with adequate consensus and hence present a diagnostic and therapeutic challenge.MethodWe searched the records of patients with Affective Mixed States in a community Mental Health Team to identify patients with affective mixed states.We assessed the treatments prescribed and the time it took to treat the Mixed states so that they then suffered from depression or were euthymic.ResultsTen out of 17 patients were suicidal when experiencing a mixed state. Of the 6 patients that were agitated, 5 were suicidal. Best results were achieved with a combination of -Reducing antidepressant -Increasing mood stabilisers (Depakote, Lithium) -Increasing/adding atypical antipsychotics. With such treatment, the average duration to resolution was 2.5 weeks. The worse results were achieved by adding antidepressants to a patient experiencing low mood with a mixed state such treatment led to resolution in 10 weeksDiscussionAgitation is a strong predictor of suicide risk. Reducing antidepressants is important thus Increasing/adding antipsychotics and mood stabilisers without changing antidepressants led to an 8.5 weeks duration of treatment.ConclusionPatients with mixed states should be reviewed regularly and risk-assessed -We suggest weekly due to increased suicide risk. With very high-risk patients, referral should be made to the Crisis Team. Care coordinators should be involved for regular contact with services.
Bipolar depression symptoms across the lifespan
Authors: Al Jurdi R.K. , Gyulai L. , Sajatovic M. , Nguyen C.X. 
Published: May 2011

IntroductionA paucity of evidence describes the presentation of depression across age groups among patients with bipolar disorder.ObjectivesWe explored the symptoms and the severity of acute bipolar depression in a multicenter, naturalistic follow-up study for treating bipolar disorder.AimsTo investigate whether specific depression symptoms are more frequent and/or severe in the elderly with bipolar disorder compared to a younger cohort.MethodsThe Systematic Treatment Enhancement Program for Bipolar Disorder is a National Institute of Mental Health-funded project to evaluate the longitudinal outcome of patients with bipolar disorder. Patients were categorized with “depression” if they experienced at least two consecutive weeks of five clinically significant depression symptoms (change in sleep or appetite; decreased energy; low mood, guilt or low self-esteem; anhedonia; decreased concentration or increased distractibility; psychomotor agitation or retardation; and presence of suicidal thoughts, intent or plans). Patients were stratified by age, (20-59 and >60), and data of all diagnosed with depression were analyzed.ResultsOf 3,615 participants with bipolar subtype-I or II, 1,564 were diagnosed with depression. Ninety-eight (6.3%) were at least 60 years of age. The most common symptoms in both groups were anhedonia and decreased energy. Younger adults were more likely to have low self-esteem, distractibility, and psychomotor agitation. Except for decreased sleep in the younger cohort, the severity of symptoms was comparable between groups. The two cohorts had a Clinical Global Impression score of 3.99 (p = .887).[Step BD- Depression Rating Guidelines][STEP-BD Bipolar Depression Symptoms by Age][STEP BD Bipolar Depression Symptom Severity]ConclusionsPresenting symptoms and severity of depression in patients with bipolar disorder are comparable across age groups.
Theory of mind and neurocognitive functioning in patients with bipolar disorder
Authors: Assion H.-J. , Wolf F. , Brüne M. 
Published: May 2011

ObjectivesStudies into social cognition in psychiatric disorders have recently been expanded to address the questions whether or not “theory of mind” (ToM), that is, the ability to represent own and others’ mental states, is impaired in bipolar affective disorder (BPD).Results have been mixed so far, mainly due to possible confounding effects of neurocognition, as well as, clinical factors such as acuity and current mood. Here, we explored ToM and its associations with neurocognitive functioning in BPD.Methods33 patients with bipolar I disorder (of which 12 were currently depressed, 10 manic, and 11 remitted) and 29 healthy controls were assessed using a test battery that was identical to the one that was used in previous studies into schizophrenia, comprising diverse neurocognitive tasks, including measures of intelligence, executive functioning, and ToM tasks.ResultsThe bipolar patient group as a whole, as well as all three clinical subgroups, were impaired on all measures of ToM relative to controls, but did not differ from each other in most ToM scores. Patients’ poorer performance on executive tasks did not fully explain ToM differences between patients and controls, suggesting a partially selective ToM deficit in BPD.ConclusionsPatients with BPD are impaired in ToM, partially independent of other cognitive dysfunctions and current mood.
Biological support to distinguish between congruent and incongruent symptoms in psychotic bipolar i patients
Authors: Basterreche N. , Zumárraga M. , Dávila W. , Dávila R. , Guimón J. , Arrue A. , Gordo E. 
Published: May 2011

IntroductionMany authors support the idea that Mood Incongruent Psychosis is a subtype of affective illness, although no clear definition or etiopathogenic basis of the congruent or incongruent subtype has been found.AimsIn this study we intend to evaluate clinical and biological differences between Psychotic Bipolar I patients who have mood congruent or mood incongruent psychotic symptoms.MethodsThe study has been carried out in 80 Psychotic Bipolar I Patients before, and after, four weeks of treatment with Olanzapine plus Lithium. We studied the correlation between the plasma concentration, before treatment, of the dopamine metabolite 3,4 Dihydroxyphenylacetic acid (DOPAC) and the clinical response to treatment.ResultsThe most remarkable result found was that Clinical Improvement after 28 days of treatment correlated positively with the initial concentration of DOPAC, but ONLY in the subgroup of patients with congruent psychotic symptoms.ConclusionsFrom our results it seems that the Congruence and Incongruence of psychosis in bipolar I patients can provide a basis to objectively divide these patients. Both groups can be distinguished based on the relationship established between their concentration of DOPAC before treatment and their clinical response to the pharmacological treatment.Supported byUniversidad del País Vasco Grant N° EHU 09/21 and Fondo de Investigación Sanitaria and Feder Founds Grant N° 09/01760.
Change in mood instability (MI) with time and treatment
Authors: Bowen R. , Mahmood Y. , Milani A. , Baetz M. 
Published: May 2011

IntroductionThe literature indicates that most patients with Major Depression mention sudden short “mood swings” (MI) when asked. MI is known to be distressing but little is known about the treatment.ObjectivesTo determine whether MI changes with community treatment of depression.AimTo study changes in MI with 3-6 months of treatment for depression in patients with Major Depression and complaints of MI.Methods34 patients with Major Depression and complaints of “mood swings” were recruited from 4 psychiatric practices. They were interviewed with the MINI diagnostic interview and the Mood Disorders Questionnaire. They completed the Beck Depression Inventory (BDI), the State-Trait Anxiety Inventory Trait Form (STAI-T), and Visual Analogue Scales for Depressed Mood (VAS) and Anxious Mood twice a day for a week. The Mean Square Successive Difference Statistic (MSSD) was calculated from the VAS readings. The BDI, STAI-T, and VAS were repeated after 6 months of treatment.Results25/34 patients reported past hypomania. Most patients were treated with a combination of antidepressants and mood stabilizers. The BDI and STAI-T scores improved with treatment. There was no overall change in depressed and anxious MI. Change in Depressed MI and Anxiety MI correlates with change in BDI from T1 to T2ConclusionsAnxiety and depression improved with treatment as expected. Change in MI is inconsistent. Research into medications and psychosocial treatments that improve MI is needed and this will probably improve depression treatment outcome.
Driving ability in bipolar patients receiving lithium or lamotrigine
Authors: Brunnauer A. , Segmiller F. , Hermisson I. , Seemüller F. , Riedel M. , Laux G. , Engel R. , Möller H.-J. 
Published: May 2011

ObjectivesDriving is a daily activity for most people in developed countries and is important in maintaining independence. Bipolar patients may have an impaired driving behavior because of the pathology itself, with psychomotor and cognitive disturbances. Additionally, adverse effects of pharmacologic treatment may be detrimental.Methods24 remitted bipolar outpatients diagnosed according to ICD-10 criteria were enrolled in the study, receiving either lithium (n = 12) or lamotrigine (n = 12). Participants were investigated under steady state plasma level conditions. According to the German Guidelines for road and traffic safety data were collected with the Wiener Testsystem (WTS) measuring visual perception, reactivity, stress tolerance, concentration and vigilance.Psychopathologic symptoms were rated with the Montgomery-Asberg Depression Rating Scale (MADRS) and the Young Mania Rating Scale - Clinician rated (YMRS-C).ResultsAbout 40% of patients were without clinically relevant psychomotor disturbances. In 40% of cases mild to moderate impairments could be seen, and 20% of the patients were considered as severely impaired. Data show that patients under lamotrigine had an altogether better test performance than patients treated with lithium. Especially in visual perception and stress tolerance differences were most pronounced.ConclusionsAbout 20% of remitted bipolar outpatients treated with lithium or lamotrigine must be considered unfit to drive. In 40% of the cases it seems justified to counsel patients individually, taking into account compensational factors. Analysis of our data point to an advantage for bipolar patients treated with lamotrigine when compared with lithium. However causal relationships can not be drawn from our data.
The two faces of the blade: Stigmatization and internalized stigmatization
Authors: Cam M.O. , Cuhadar D. 
Published: May 2011

Stigmatization is a serious problem that felt by 54.6% of bipolar patients. The most dramatic deterministic about attidues of bipolar patients towards their illness is decreased self esteem that occur result of illness. Stigma and internalized stigma experiences of a patient with bipolar disorder will be transferred in this case report.Case31 years old, married, female patient. She is having bipolar disorder treatment for three years. About her diseases she said that “ıt is the worst illness among all of the illness, because mind is the organizatör of the human body, if you loss your mind you can not move your hand or arm”.About public stigma she told that “people afraid because of harming by us, when they see us on street they enter their home, they don’t give permission to touch their child and run away from us. My brothers wife saying me afraid from me and don’t want to be alone with me.” Also patient said that “I’m not having a talk with my neighbour because I feel they won’t take seriously me. I stayed in hospital for 28 day because illness after discharged I didn’t told anyone about staying in psychiatry clinic. In the past I done eveything but now I’m doing nothing. I feel all of the weight of the world on me. I feel myself weak both as physical and mental”ConclusionStigmatized people believe that others will devalue and reject the people with mental illness and experiencing negative outcomes such as demoralization, decreased self esteem, impaired social adaptaion, unemployment, decreased psychiatric treatment adherence.
Case report: Scream of the mother whose daughter is bipolar
Authors: Cam M.O. , Cuhadar D. 
Published: May 2011

50-90% percent of patients with mentall ilness live with their relatives after the acute treatment. Giving care brings important burden to family. Experinence of a mother whose daughter is bipolar will be transferred in this case.Case46 years old, housewife. Her daughter disease occured seven years ago in pospartum period. Mother said “three months after birth my daughter came to me with her child. she gave up the child on my arms and said “look after this baby, I want to be free and I’m going”, I didn’t understand what is happening and felt afraid. At the same time her self care was very bad, also there was only a diaper on baby. Before ilness my daughter was working in a factory because of the illness she gave up working. Now she wants to work but if she has an episod when working and says again “I want to go”, what can I do. When she is with me I can control her but out I can’t.When she is good or when she is worse isn’t clear, if something happen to her. My daughter is pure, if someone around her want to utilieze from her what will be happen. I often follow her, she knows this and get angry to me, but it is beyond my power. She have to use drug for a long time, drugs are expensive and although using drugs her illness show recurrence. It is a very difficult condition, knowing ever will be fully recovered thouth me every efforts are unnecessarily”.
Identify of family caregiver needs of patients with bipolar disorder
Authors: Cheraghi F. , Shamsaei F. 
Published: May 2011

IntroductionToday's, families of individuals with bipolar disorders are actively participating in the care of their relative. Successful management of bipolar disorder in the community relies significantly on family caregivers. The need and experiences of such caregivers have been little studies with respect to bipolar disorder.ObjectiveThe aim of the study was to identify of family caregivers needs of patients with bipolar disorder.MethodsIn a qualitative research of phenomenological methodology, the family member’s caregivers of bipolar disorder in farshian psychiatric hospital in Hamedanl were selected by purposive sampling in the year 2010. By reaching data saturation the number of participant was 12. Data were gathered through in-depth interviews and analyzed by “Van manen” method.ResultsFive main themes were identified in this study analysis: educational needs, consult needs, economical needs, care and nursing needs and supports needs.ConclusionIdentified the need of family member caregiver with bipolar disorder patient for mental health services to be helped and to identify the specific caring interventions that are effective in helping to sustain family caregiving.