bluuebunny/crossref_metadata_2025_split huggingface dataset:
Project “social point”: Partnership of sociality activities of mental health service recipients
Authors: Poggi V. , Ambrosino R. , Ciambellini M. , Ferrari S. , Melati E. , Pingani L. , Rigatelli M. 
Published: May 2011

The project “Social Point” deals in promoting integration of Mental Health Service recipients within contexts of social relationship, voluntary work and community activism. The project is still taking place in the district of Modena.AimsAssessment of the effectiveness of the project SP: production of a change in quality of life; development of purposeful relationships out of families and health services; development of Mental Health Service recipients’ awareness of being not only a user of the health service but also a resourceful person; change of method and approach within relationship between Mental Health and community and public services.MethodsAt the beginning and at the end of the integration courses (autumn/winter 2010 and after 6–8 months), both individuals and collectives, every Mental Health Service recipient was asked to fill in a form with socio-demographic characteristics and the WHOQOL-bref. A social network diagram was subsequently drawn.Expected resultsAt the end of the research (September 2010) joining courses directed to the development of social relationship is forecast to improve the quality of life of the recipients, to increment purposeful relationships and to strengthen empowerment of persons with mental disease by promoting a different project of life no more illness-based but resource-based.ConclusionThe study will provide evidences about the performance of the project with regard to the promotion of the social integration of citizens with mental disease in contexts, to the empowerment and to the promotion of processes of social.
Utilisation of psychiatric examination and counseling in senior unemployed persons
Authors: Steil C. , Meiler B. , Wiesten I. , Wiltfang J. , Kis B. 
Published: May 2011

IntroductionUnemployment is associated with various psychosocial strain factors. Previous studies show correlations between unemployment and impaired mental health. Present examinations on this set of problems mainly focused on younger unemployed, while specific psychosocial strains of senior unemployed persons were scarcely presented.ObjectivesInvestigation on psychiatric services for senior long term unemployed personsAimsTo examine the exigency and feasibility of specific mental health interventions for senior long term unemployed personsMethodsSenior long term unemployed participants in a vocational reintegration program underwent psychiatric examination and counseling. Placement officers recommended participation by choice to their clients and diagnostic examinations including clinical interviews and questionnaires were performed. Clients then received either direct treatment by the project staff, e.g. focal short-term therapy, or were placed in appropriate treatments. Numbers of clients who consented and who refused participation, dropout rates, psychiatric diagnoses and treatment placements were recorded.ResultsAttendance in the program was recommended to 161 clients to the date of this report. 136 clients consented with participation and 90 were included into examination. 21% discontinued participation in the course of examination. Of the unemployed persons surveyed, 96% received a psychiatric diagnosis and 80% multiple psychiatric diagnoses. 7% were placed to inpatient-treatment and 31% to ambulatory treatment.ConclusionPsychiatric services were highly requested and senior unemployed persons are specifically affected by mental disorders that presumably interfere with vocational reintegration. According to this, vocational reintegration programs should be flanked by psychiatric services to give consideration to the specific psychosocial strains of unemployed persons.
Relationship amongst patient and caregiver's expectations of illness to clinical diagnosis
Authors: Verma R. , Mina S. , Agarwal A. , Jiolha R.C. 
Published: May 2011

IntroductionSymptoms have a major influence on expectations to the degree to which they affect patients’ perceptions of what might be wrong (cognitive states) and reactions to illness (emotional states).ObjectivesThis study investigated the relationship of patient and caregiver's expectations of illness to the diagnosis.MethodTwo hundred new cases with their caregivers were consecutively included from the Out-Patient Department of psychiatry and assessed through a semi-structured proforma and Clinical Global Impression scale.ResultsSomatic symptoms were the predominant complaints compared to psychic complaints. Patients presenting with more psychological symptoms had more uncommon and unmet expectations compared to those with biological symptoms. Most considered their illness to be of medical nature (71% in patients; 83% in caregivers). Patients gave social causes a higher priority (23.5% in patients and 6.5% in caregivers) while caregivers give higher priority to supernatural cause (5.5% in patients and 13% in caregivers). 54.5% patients and 63.5% caregivers considered the illness to be severe which on objective assessment was for only 38%. 54% patient had co morbid psychiatric illness and 46% had only psychiatric illness and 9% had only medical illness. More was the severity of illness; more the treatment in form of medication prescription was expected.ConclusionsObjective severity of patients' disease condition, and their awareness of illness, can predict their adherence and can contribute to better targeting of health messages and treatment advice by providers.
Area-specific occupancy of the serotonin transporter by escitalopram and citalopram in major depressive disorder
Authors: Akimova E. 
Published: May 2011

IntroductionThe serotonin transporter (SERT) occupancy after long-term antidepressant treatment (steady-state) at minimum clinical doses has been reported to be approximately 80% (e.g., Meyer 2007, J.Psychiatry Neurosci;32(2):86-102, review). However, this value is mostly calculated in the striatum, therefore the occupancy values in other brain areas might be better associated to clinical parameters.ObjectivesTo compare the SERT occupancy of the striatum to occupancy values in six other brain areas.Methods18 patients with major depressive disorder (MDD) received either escitalpram (10mg/d) or citalopram (20mg/d) in a double-blind, longitudinal study. They underwent three PET scans using the radioligand [11C]DASB: PET1 baseline, PET2 six hours after the first drug intake and PET3 after three weeks of treatment. Occupancy of SERT at PET3 was analyzed in seven regions partly associated with alterations in MDD: striatum, subgenual part of the anterior cingulate cortex (sgACC), ACC, amygdala, inferior frontal cortex (IFC), superior frontal cortex (SFC), superior parietal cortex (SPC). ROI-based quantification was performed in PMOD.ResultsThere was a huge range in occupancy values of different areas: amygdala (93.5% ± 6.9%, mean ± SD), SPC (90.8% ± 8.0%), ACC (86.0% ± 13.2%), sgACC (79.1% ± 23.6%), striatum (78.8% ± 4.9%), SPF (64.0% ± 26.4%), IFC (54.4% ± 21.7%). We found significant differences in occupancy values between striatum and the ACC, amygdala, IFC, SFC, SPC (t-test, p < 0.05).ConclusionsIn this study we show significant differences in SERT occupancy between brain areas ranging between 54.4% and 93.5%. According to the area-specific effects of changes in serotonergic neurotransmission, regional occupancy values, especially in limbic areas, might be considered in the association to clinical response.
Which is the optimal depression rating scale for psychiatrists? a diagnostic validity comparison of hospital anxiety and depression scale (HADS) and psychiatric judgement against the MINI
Authors: Al-Salihy Z. , Rahim T. , Mitchell A. , Mahmud M. , Muhyaldin A. 
Published: May 2011

IntroductionUstun et al estimated that depression is the fourth leading cause of global disease burden. The burden of depression on the healthcare system is equally significant with an estimated US annual cost of approximately $26 billion (1990). In a European epidemiologic study of mental disorders involving six countries, major depression was the single most common disorder assessed, with a 12-month prevalence of 3.9%.ObjectivesOur aim was to find the optimal tool with the highest accuracy in comparison to the (MINI) for depression.AimsWe aimed to find the depression rating scale with the highest accuracy when applied by psychiatrists in Iraq.MethodsWe recruited 400 subjects; The (MINI) was used as a gold standard to define the presence of major depression according to DSMIV criteria stratified into 200 patients with primary depression and 200 non-depressed subjects in Kurdistan region of Iraq. We examined the symptoms of depression using the Hospital Anxiety and Depression Scale (HADS) and Clinical Global Impression (CGI). Interviews were performed by three psychiatrists who were blinded to the group allocations. ROC curve analysis was used.ResultsBoth HADS and CGI performed with high accuracy compared with the MINI interview for DSMIV major depression. Clinicians using the CGI were accurate in their clinical judgement with sensitivity of 97% and specificity of 99%.ConclusionsWe found the psychiatrist's opinion alone was very accurate with higher sensitivity and specificity than the HADS and therefore it is unclear from our sample if questionnaires would help clinicians in their diagnoses.
Effects of once-daily adjunct quetiapine XR on sleep disturbance in patients with mdd: a pooled analysis from two acute studies
Authors: Bauer M. , McIntyre R.S. , Szamosi J. , Eriksson H. 
Published: May 2011

IntroductionDisrupted sleep is common in depression.ObjectivesInvestigate effects of adjunct extended release quetiapine fumarate (QTP-XR) on sleep disturbance and quality in patients with MDD and inadequate response to antidepressant (AD) therapy.MethodsData were pooled from two (D1448C00006/D1448C00007) 6-week, double-blind, randomised, placebo (placebo+AD)-controlled studies of adjunct QTP-XR (15 0 mg/day and 300 mg/day). Primary endpoint: MADRS total score change versus placebo+AD. Secondary endpoints (post hoc): change from randomisation in MADRS item 4 (reduced sleep), HAM-D items 4, 5 and 6 (early-, middle- and late-insomnia), sleep disturbance factor (HAM-D items 4+5+6) and sleep quality (PSQI global score). MADRS total score change in patients with baseline HAM-D sleep disturbance factor score > = 4 or < 4 (high and low sleep disturbance, respectively) was evaluated.Results919 patients received adjunct QTP-XR: 150 mg/day (n = 309), 300 mg/day (n = 307), placebo+AD (n = 303). At Week 6, adjunct QTP-XR (both doses) reduced MADRS item 4, HAM-D sleep disturbance factor, HAM-D items 4, 5 and 6 and PSQI global scores from baseline versus placebo+AD (p < 0.001). In patients with baseline HAM-D>=4 (n = 226, 215 and 210, respectively) adjunct QTP-XR (both doses) improved (p< 0.01) MADRS total score versus placebo+AD from Week 1 onward. In patients with baseline HAM-D< 4 (n = 83, 92, 93, respectively) adjunct QTP-XR (both doses) improved (not statistically significantly) MADRS total score versus placebo+AD at Week 6.ConclusionsAdjunct QTP-XR significantly restored sleep and improved sleep quality in patients with MDD and inadequate response to AD. Significant improvement in depressive symptoms was demonstrated with adjunct QTP-XR in patients with MDD and high baseline sleep disturbance. AstraZeneca funded.
An audit to identify factors that are more commonly associated with depressed patients on augmentation therapy under the befordshire east community mental health team (BECMHT)
Authors: Butler S. , Holt C. , Agius M. , Zaman R. 
Published: May 2011

BackgroundWhilst it is important that we treat patients with depression in primary care if possible there are many patients with depression who will need the more expert support provided in secondary care.Aims and methodsAn Anonymised Database held by the Bedford East Community Mental Health Team was studied to assess what factors were related to the use of Augmentation Strategies to treat resistant depression.ResultsOf the total 282 patients 109 (38.7%) were on augmentation therapy. In the F32 and F33 group just over a third of the patients (35.8% and 37.1%) were on augmentation therapy and in the F41.2 group over a half of patients (56.7%) were on augmentation therapy.DiscussionThere does seem to be a relationship between the number of risk factors a patient has and the likelihood that they are on augmentation. Particularly strong factors are another psychiatric diagnosis and ‘other suicide risk factors’.ConclusionGenerally the patients coming to secondary care with more of the specified risk factors are more likely to need augmentation.
Effectiveness of a psychoeducational group intervention in patients with mild/moderate depression in primary care (PC): randomized controlled trial
Authors: Casañas R. , Catalan R. , Casas M. , Raya A. , Fernandez E.M. , Escudero E. , Romero M.T. , Lalucat L. 
Published: May 2011

BackgroundDue to the high prevalence of depressive symptoms in PC (Ayuso, 2001) is relevant to know the impact of the psychoeducation in the management of these symptoms to decrease the prevalence in the PC population.ObjectiveTo compare the effectiveness of a psychoeducational group intervention in patients with mild/moderate depression in PC.Methods242 participants older than 20 years with ICD-10 mild/moderate depression were recruited through nurse/general practice in 12 urban primary health care centers in Barcelona city. Randomization was realised by means of a computer program. Exclusion criteria: severe mental disorder, major depressive disorder, use of secondary mental health services and acute medical illness. The intervention group (IG) received a psycoeducational group program (12 weekly 1,5h sessions) leads by two nurses. The program was an adaptation of Coping With Depression (CWD) (Lewinsohn, 1989). The control group (CG) received TAU. Outcome measures: Sociodemographic, BDI and EuroQol-5D questionnaires pre-post intervention.Results232 patients were included, IG (n = 121) and CG (n = 112), of whom 86 patients had mild depression (BDI≤ 18) and 146 moderate depression (BDI≥ 19). The sample characteristics were as follow: 90% women with mean age of 53,27 (SD = 12,72)The intervention was associated with significant improvements in BDI (t(230) =-2.25; p = 0.025). Separately analyze the sample: Patients with mild depression: (t(83) =-2.52; p = 0.014).Patients with moderate depression: (t(141) =-2.62; p = 0.010). Posttest results show that this intervention has statistically significant effect on depressive symptoms in overall sample and in mild/moderate depression separately.ConclusionsThe psychoeducational intervention is effective treatment in both mild and moderate depressive symptoms in primary care.
The prevalence of depression in patients with cushing’s syndrome
Authors: Danciulescu Miulescu R. , Calarasu M.E. , Rosca R.I. , Danoiu S. 
Published: May 2011

Background and aimsCushing's patients demonstrate major depression more than any other medical condition. Major depression is a common, complication of Cushing’s syndrome, with no significant differences between pituitary -dependent and -independent forms. The aims of the study is to estimate the prevalence of depression in patients with Cushing’s syndrome.Materials and methods23 patients with Cushing’s syndrome (14 with pituitary-dependent and 9 with pititary-independent forms) were recruited for this study. The subjects were between 52 and 67 years. Patients were screened initially with a questionnaire detailing their age, medical history, concomitant medications. The Zung self-rating depression scale was used to assess depressive symptomatology. It contains 20 items: index scores below 50 reflect no depression, 50–59 reflect mild depression, 60–69 reflect marked to moderate depression and scores of ≥ 70 reflect severe to extreme depression. Results were compared with measurements in 21 subjects without Cushing’s syndrome.ResultsThe prevalence of depression in patients with Cushing’s syndrome was 52.17% (12 patients). 2 patients (2 women) present mild depression and 10 patients (9 women and 1 men) present moderate or severe depression. Moderate or severe depression was significantly associated with older age, female sex, relatively more severe clinical condition. The prevalence of depression in 21 subjects without Cushing’s syndrome was 4.76% (1 women with mild depression).ConclusionThis study showed that patients with Cushing’s syndrome have a greater a risk of depression than people without Cushing’s syndrome. Patients with Cushing’s syndrome should be routinely screened and adequately treated for depression.
Therapeutic strategies used on treatment of depression. Dria study
Authors: Salvador R. , Galan J. , Garcia-Toro M. 
Published: May 2011

IntroductionThere are few clinical studies about strategies used in depression in clinical practice.ObjectivesDescribe therapeutic strategies used in psychiatric care in patients with depression who had a suboptimal response to standard antidepressants under real-life conditions.MethodsNon-interventional study that included a prospective cohort of outpatients diagnosed with Major Depressive Disorder (MDD) who needed a change on the treatment. Strategies were group as: switch of antidepressant, combination of antidepressants, augmentation or a combination of previous strategies. Follow-up period was 22-26 weeks.Results364 patients were included by 58 psychiatrists, 336 were analyzed (92.3%) and 315 (86.5%) completed the follow-up.[Strategies selected in each change][Relationship between no. changes and no. strategie]ConclusionsStrategies more used were: switch to another antidepressant, combination of antidepressant, augmentation and multiple strategies.Although a change of treatment was decided, frequently it was selected a strategy used in the past.This study has been sponsored by AstraZeneca Farmaceutica Spain, SA.
Biological alterations during remission of major depressive disorder
Authors: Hartinger B. , Scharinger C. , Diers K. , Kasess C. , Huf W. , Kalcher K. , Boubela R. , Pail G. , Brocke B. , Kasper S. , Moser E. , Pezawas L. 
Published: May 2011

IntroductionThe natural course of Major Depressive Disorder (MDD) encompasses the occurrence of alternating intervals of major depressive episodes and remission. While several abnormalities in neural circuits related to acute MDD have been identified, the neural mechanisms underlying stable remission remain obscure.ObjectivesAcute MDD is characterized by increased amygdala and subgenual anterior cingulate cortex (sACC) activation and decreased connectivity between the amygdala and the sACC. Consequently, we expect those regions to be affected during remission.AimsTo determine whether active counter-regulatory mechanisms are implicated in the maintenance of full remission once antidepressant treatment has been discontinued.MethodsFunctional and structural magnetic resonance imaging was used to measure brain activation and volume of the amygdala and the sACC. Images were obtained from 38 healthy subjects without any psychiatric life-time diagnosis and 38 gender-matched drug-free remitted MDD patients. Furthermore, correlation analyses were performed with clinical variables.ResultsPatients with rMDD exhibited lower activation in the amygdala and the sACC and increased functional coupling between the amygdala and sACC compared to controls. This connectivity was particularly pronounced in patients characterized by a long cumulated time of depressive episodes. Similarly, structural connectivity results showed increased association between the amygdala and sACC volume in rMDD patients compared to controls.ConclusionsRemitted MDD is related to neural alterations within a neural circuit encompassing the amygdala and the sACC compared to controls. These findings suggest active counter-regulatory mechanisms likely contributing to the maintenance of remission once treatment has been discontinued.
Antidepressant treatment and advanced oxidation protein products in depressed patients
Authors: Heymann-Szlachcinska A. , Wykretowicz A. , Rybakowski J. 
Published: May 2011

IntroductionOxidative stress plays a role in producing advanced oxidation protein products (AOPP). High level of AOPP was observed in patients with such pathological conditions as ischemic heart disease, diabetes, cancer or neurodegenerative diseases.ObjectivesA role of oxidative stress in depression and in antidepressant treatment has been implicated. There have been no studies so far on AOPP in psychiatric diseases.Aim: An assessment of AOPP concentration, as a marker of oxidative stress, in patients with depression and the effect of antidepressant treatment.MethodsThirty-one patients hospitalized at Department of Adult Psychiatry, Poznan University of Medical Sciences, were studied. The first depressive episode was diagnosed in 5 patients, recurrent depressive disorder in 6 patients, and depression in the course of bipolar affective disorder in 20 patients. Patients were treated with venlafaxine (10), paroxetine (7), fluoxetine (5), clomipramine (4), citalopram (3), sertraline (1) and mianserine (1). Advanced oxidation protein products (AOPP) levels were measured twice: before treatment and in remission on maintenance doses of drugs. Control group consisted of 18 healthy volunteers, age- and gender matched.ResultsThere was no significant difference between depressed patients and healthy controls in the AOPP concentration before treatment. There was no correlation between AOPP levels and diagnosis, duration of illness, duration of the current episode and the age of illness’ onset. After antidepressant treatment, a significant decrease of AOPP concentration was found.ConclusionsThe results of the study may confirm previous data suggesting a decrease of some markers of oxidative stress after antidepressant treatment.
An audit to identify factors affecting response to treatment among depressed patients who have documented suicidal ideation/attempts in a bedfordshire community mental health team
Authors: Holt C. , Butler S. , Agius M. , Zaman R. 
Published: May 2011

IntroductionIn recent years there has been a move towards treating depressed patients in the community.One factor that may reduce the likelihood of discharge from secondary care is suicidality. The aim of this audit was to identify factors associated with continued suicidality among Community patients.Subjects and methodsWe searched an anonymised database of patients and identified all those with previously documented suicidal thoughts or attempts. We also noted the presence of factors such as alcohol problems, drug problems, augmentation therapy and ‘other risk’ factors (e.g. financial problems or homelessness). We assessed the latest clinic letter, to see if patients were still reporting suicidality. We compared the aforementioned factors between the group of patients in which suicidality was still present (group N) and the group of patients in which suicidality was no longer a feature (group Y).ResultsOf the 56 patients with suicidal thoughts or attempts there were 44 in group N (79%) and 12 in group Y (21%). Alcohol problems, drug problems and ‘other’ risk factors were more common among group Y than group N. Conversely, the percentage of patients on augmentation therapy was greater in group N than group Y.DiscussionThe audit provides an insight into the factors that might influence outcomes among depressed patients.ConclusionsAlthough the results are suggestive, it is difficult to make firm conclusions about patient outcomes on the present data. The audit provides a useful starting point, especially in considering the treatment of patients within the CMHT.