bluuebunny/crossref_metadata_2025_split huggingface dataset:
P02-262 - Development of Substance Abuse in Borderline Personality Disorder
Authors: Walter M. , Gunderson J. , Zanarini M. ,   CLPS Group
Published: June 2010

BackgroundHalf or more of patients with borderline personality disorder (BPD) suffer from co-occurring alcohol use disorder and/or drug use disorder. The aim of the study was to investigate the development of substance use disorders (SUD) in patients with borderline personality disorder (BPD) in the long-term course.Methods175 patients with BPD and 396 patients with other personality disorders (OPD) were assessed with semistructured interviews at baseline and at 6, 12, 24, 36, 48, 60, 72, and 84 months. They were compared on the frequency of new onsets of SUD. Kaplan-Meier analyses were used to to generate time to new onsets, and Cox regression analyses were used to examine relevant predictors for new onsets.ResultsBPD patients did show a shorter time to new onsets of SUD than the OPD group. Thirteen percent of BPD patients developed a new alcohol use disorder, and 11% developed a new drug use disorder, as compared to rates of 6% and 4% respectively for OPD. The number of antisocial personality disorder (ASPD) criteria predicted new onsets of SUD in BPD.ConclusionsPatients with BPD have a two to three times higher risk than patients with selected other personality disorders of developing a new SUD. The severity of antisocial psychopathology is related to new onsets of substance use disorder in BPD. These findings support the concept of a spectrum relationship between ASPD, BPD and SUD.
P02-266 - A True Philoshophical Aproach May Leads to a New Insight in the Research & Treatment of Psychiatry
Authors: Acharya A. 
Published: June 2010

IntroductionPhiloshophy is the ancient disciple that could answer the questions relating to human sufferings, their causes or a remedy. Doctors in dictionary meaning stands for a learned person. A psychiatrist may mean a more learned person on the matters of happyness or peace in mind or disturbances in the emotional sphere of a person, the cause of his behavioral disturbances.ObjectivesPsychiatry in future will traverse faraway from patienthood to personhood. It will be more person concenerned, well person in some transient emotional crisis or a relationship conflict in a couple or a fear in mind in a teenager before examination or a person incapable of sustaining meaninful interpersonal-relationship. It will move from the tiny clinic &will fly like a dynamic butterfly to sit besides the emotionaly upset person.AimsA noble amalgamation of past philoshopical master's teaching and the knowledge of our neuro-transmitter imbalance may come out with a suitable blend that might be sustainable to remove the misery of mind in a less costly way.MethodsTime tested some philoshopical ideas may be analysed with our objective of blending.There were Hedonistic or pleasure seeking scool or school of dispassionate.In 2500BC BUDDHA pointed, “Midle path is the best path”.(among sacrificing in totality or totalpeasureseeking sensces.)Budha's 4 noble truth, that there is misery & sufferings, there is causation for sufferings, there is way to stop sufferings, & that is possible points towards aeitiology of passion and attachment as the cause of mental disorders.ConclusionPhiloshopical amalgamation in psychiatry will open newer avenues.
P02-285 - Investigator Assessment of Clinical Parameters After Initiating Aripiprazole Therapy. Prevention Metabolic Syndrome
Authors: Marqués P. , Galicia M. , Martinez V. , Coullaut V. , Piñol C. 
Published: June 2010

IntroductionThe schizophrenia has associated traditionally with major rates of comorbilidad physics. In addition the antipsychotic ones of the second generation are causers of the so called metabolic syndrome (increase of weight, dislipemia and diabetes) that favor directly the cardiovascular disease in our patients.ObjectivesTo develop a therapeutic plan to diminish the sobremortalidad and sobremorbilidad of our schizophrenic patients (according to different studies between 25-50 % of cardiovascular risk). To detect the factors of risk, which influence the metabolic Syndrome: a high level of cholesterol HDL, IMC, smoking and hyperglycemia.To apply measures of prevention for the diabetes, for the arterial hypertension and the dislipemias.MethodsRetrospective study is realized, checking the clinical histories of the patients beginning medication with aripiprazol for symptomatology psychotic and support the treatment at least 6 months later. We realized preventive specific measures in the patients including education to the patient, careful selection of the antipsychotic with substitution if there appear signs of metabolic syndrome.Results39 patients that initiated treatment with aripiprazol, therapeutic doses. Of 39 patients 24 (61,54 %) is smoking, 18 (46,16 %) has an IMC> 25, 11 (28,39 %) hipertriglicerinemia, 5 (12,82 %) index of glycemia basal> 125 and 6 (15,38 %) with hipercolesterolemia.ConclusionThe antipsychotic atypical alter the metabolic regulation. The treatment with aripiprazol suggests minor risk of metabolic syndrome, in relation to previous similar studies, with antipsychotic others. We think it performs vital importance the prevention of the overweight orientated to patients with the first psychotic episode.
P02-289 - Alcohol Screening and Brief Interventions in Primary Health Care Facility Doboj, Republic of Srpska, Bosnia and Herzegovina
Authors: Onrust S. , Demonjic S. , Janjetovic N. , Jeremic M. , Sredic A. 
Published: June 2010

ObjectivesDetermine whether and how primary health care workers (PHCW) provide alcohol screening and brief interventions (SBI) and assess their interest in improving.MethodsA questionnaire built built on WHO recommendations for alcohol prevention and harm reduction in primary health care was distributed to 130 primary health care workers (26.9% doctors, 73.1% nurses) in family medicine and emergency medicine departments in the Primary Health Care Facility Doboj.ResultsThe participation rate was 61% (79/130), of which 28 (35%) doctors and 51 (65%) nurses answered the questionnaire. 3 (10.7%) doctors and 3 (5.9%) nurses provide alcohol screening always, 15 (53.6%) doctors and 22 (43.1%) nurses sometimes, while 10 (35.7%) doctors and 25 (49%) nurses never do alcohol screening. None of the PHCW uses AUDIT, 1 uses CAGE, and others use clinical screening procedures. 12 (42.9%) doctors and 40 (78%) nurses never provide brief interventions. 22 (28%) PHCW are interested in providing alcohol screening, while 20 (71.4%) doctors and 15 (29.4%) nurses are interested in improving their SBI skills.ConclusionsPrimary health care workers do not provide routinely alcohol screening and brief interventions aimed at prevention and reduction of alcohol related problems. Those who do provide SBI do not follow WHO recommendations. There is a certain interest to improve, but the fact that 39% PHCW did not even answer the questionnaire is indicative. Motivation, training on SBI and follow-up of PHCW are needed.
P03-323 - Antipsychotics and Readmission in a Population of Psychotic Patients in a Psychiatric Unit of a General Hospital
Authors: Câmara Pestana L. , Carmo A.L. , Sequeira Mendes R. , Zuzarte P. 
Published: June 2010

IntroductionThe poor compliance to antipsychotic medication is a major problem in ambulatory treatment of patients with psychotic symptoms, leading to an increased risk of exacerbation and inpatient readmission.ObjectivesOur objective is to clarify if the administration of prolonged release antipsychotics (PRAP) is a relevant factor in the decrease of inpatients readmissions.MethodsThrough a retrospective study, we assessed the socio-demographic and psychopathological features of a sample of patients with diagnostic of Schizophrenia and Schizoaffective disorder (DSM-IVTR), who were admitted to a psychiatric inpatient unit, in the period of two years (January 2007 to December 2008). This sample was divided in two groups (with readmissions/without readmissions), considering as having readmissions the patients that were readmitted in the nine months after the first medical discharge. We compared the use of PRAP versus oral antipsychotics (OAP) at the time of the first medical discharge, assessing if these differences had any impact in the readmissions.ResultsSample of 88 patients, 55,68% (n=49) male, 53,41% (n=47) unemployed, 64,77% (n=57) single. The most frequent diagnostic was Paranoid schizophrenia (73,86%, n= 65), followed by Schizoaffective disorder (17.05%, n= 15). Of the patients that had readmissions (n=15; 17,05%), 40,00% were medicated with PRAP (n=6) compared with 49,32% (n=36) of the patients with no readmissions (n=73). These differences had no statistic significance.ConclusionsTaking in consideration the small sample of patients, the frequency of readmissions was low. About 50% of the patients were medicated with PRAP+OAP, with no evidence that this decision had reduced the readmissions.
P03-326 - Treatment-Emergent Sexual Dysfunction Related to Antidepressants: a Meta-Analysis
Authors: Chiesa A. , Serretti A. 
Published: June 2010

BackgroundSexual dysfunction (SD) is an important underestimated adverse effect of antidepressant drugs. Patients, in fact, if not directly questioned, tend to scarcely report them. The aim of the present meta-analysis was to quantify SD caused by antidepressants on the basis of studies where sexual functioning was purposely investigated through direct inquiry and specific questionnaires.MethodsA literature search was conducted using MEDLINE, ISI Web of Knowledge, and references of selected articles. Selected studies performed on patients without previous SD were entered in the Cochrane Collaboration Review Manager (RevMan version 4.2). Our primary outcome measure was the rate of total treatment-emergent SD. Our secondary outcome measures were the rates of treatment-emergent desire, arousal, and orgasm dysfunction.ResultsOur analyses indicated a significantly higher rate of total and phase-specific treatment-emergent SD compared with placebo for the following drugs in decreasing order of impact: sertraline, venlafaxine, citalopram, paroxetine, fluoxetine, imipramine, phenelzine, duloxetine, escitalopram, and fluvoxamine, with SD ranging from 25.8% to 80.3% of patients. No significant difference with placebo was found for the following antidepressants: agomelatine, amineptine, bupropion, moclobemide, mirtazapine, and nefazodone.DiscussionTreatment-emergent SD caused by antidepressants is a considerable issue with a large variation across compounds. Some assumptions, such as the inclusion of open-label studies or differences in scales used to assess SD, could reduce the significance of our findings. However, treatment-emergent SD is a frequent adverse effect that should be considered in clinical activity for the choice of the prescribed drug.
P03-330 Case Report: Serotonin Syndrome vs Neuroleptic Malignant Syndrom
Authors: García-Murillo L. , Calero-Fernandez R. , Jimenez Fernandez S. , Rojas Estape M. , Serrano E. , Sanchez E. , Iglesias C. 
Published: June 2010

BackgroundSerotonin Syndrome (SS) is an adverse drug reaction that drives mental-status changes, autonomic hyperactivity and neuromuscular abnormalities.Neuroleptic Malignant Syndrome (NMS) is an idiopathic reaction to dopamine-antagonist that consists of extra-pyramidal symptoms, autonomic dysfunction, hyperthermia, diaphoresis and fluctuating consciousness.Differential diagnosis is sometimes difficult for their overlapping clinical features. Potentially lethal, both require heightened clinical awareness for prevention, recognition and prompt treatment.Case reportCaucasian 59 years-old woman with Catatonic profile (Scored: severity-17points/ 5 screening in Bush-Francis Catatonia-Rating-Scale).Past Medical History-Hypothyroidism-Bipolar Disorder type-2 (25 years of evolution)15 days before hospitalization, anafranil and fluoxetine treatment was replaced by Trazodone 200 mg/day and venlafaxine 150mg/day. She was also on valpromida and lorazepam 15 mg/day.Current historyMutism, negativism. No reaction to painful stimuli, stuporous. Diaphoresis, pallor, tremor, axial rigidity without pyramidalism (>lower limbs), high fever (40°C), tachycardia (>100lpm), rhabdomyolysis (CPK reached 17.000, 48 hours after the admission), leukocytosis, upper transaminasas, hiponatremia with hiperpotasemia.Differential diagnosis-NMS: Intensity, duration and high CPK are suggestive (Sternbach). This syndrome has been described due to Venlafaxine.-SS: Combination of Venlafaxine and Trazodone favors but she doesn't have acatisia, hiperreflexia, diarrhea and it wasn't resolved after 96 hours.Drugs were removed and Lorazepam on high doses (5mg/day) was prescribed. One month later the patient was totally recovered of the episode.ConclusionsIf unsure diagnoses it's priority to remove the causing drugs and supportive care. Afterwards, it can be used benzodiacepines, also dantroleno in SNM.
P03-339 - Accuracy of Psychotropic Medication in Adults with Intellectual Disabilities
Authors: Hove O. , Biringer E. , Havik O.E. 
Published: June 2010

ObjectivesIt is generally acknowledged that individuals with intellectual disabilities (ID) benefits from psychotropic treatment for mental disorders (MD) in the same way as people in the general population. It has also been shown that problem behavior (PB) does not respond to psychotropic treatment. Thus, we hypothesized that the presence of MD was assocated with psychotropic treatment, whereas PB (not MD) was not.MethodIn a community sample of adults with ID (N=593), the presence of dementia, psychoses, depression, mania, obsessive-compulsive disorders, five anxiety disorders and eight problem behaviors were screened using the Psychopathology Checklists for Adults with Intellectual Disability (P-AID). Information regarding the use of psychotropic medicine (ACT-N) was collected. Staff members in group homes served as informants both for the screening and the use of drug.ResultsPsychotropic medication was reported in 40% of the sample. Of the 23% that presented with MD only, 44% received psychotropic medication (p=.310). Of the 12% that presented with both MD and PB, 51% received such medication (p=.032). The strongest association was found between psychotropic treatment and having PB only. Among the 8% that showed PB only, 52% received psychotropic medication (p=.022).ConclusionContrary to our expectations, the presence of PB rather than MD were associated with the use of psychotropic treatment. The present findings suggest that people with ID often receives no psychotropic treatment for MD, or they receives such treatment for the wrong reason, leaving the accuracy of psychotropic treatment to a minimum.
P03-341 - Metabolic and Neuroendocrinologic Effects of Long-Acting Injectable Risperidone Under Real-Life Conditions
Authors: Jasovic-Gasic M. , Maric N. , Doknic M. , Britvic D. , Pekic S. , Stojiljkovic D. , Damjanovic A. , Popovic V. 
Published: June 2010

ObjectivePresent study focuses on metabolic and neuroendocrinologic effects of long-acting injectable risperidone (LAIR) treatment in a naturalistic sample of patients with schizophrenia spectrum disorders.MethodTwenty three outpatients with schizophrenia or schizoaffective disorder (ICD X) (age 32.3±6.5years, illness duration 8.7±5.1 years, PANSS 78.1±14.7) were included. At the time of evaluation the patients were treated with LAIR for 1.4±0.7 years, average dose 38.6±9.9mg. Total duration of antipsychotic therapy was 8.0±4.8 years. Control group (n=23) were healthy volunteers matched by age, sex and education.In the morning serum we measured leptin, prolactin, cortizol, IGF1, T4, FSH, LH, HbA1c, total cholesterol, HDL, LDL and triglicerides. Both groups were tested by oral glucose load (OGTT), with measuring insulin levels and anthropometric parameters.ResultsIn comparison to control group, the patients had higher BMI (p< .001), waist circumference (WC, p=.004), increased leptin (p=.013), prolactin (p< .001), triglycerides (p=.029) and fasting glucose (p=.004). After controlling for BMI, WC and sex, only prolactin (p< .001, ηp2= .50) and leptin (p=.040, ηp2=.13) were significantly increased in the patient group.ConclusionThis is the first study of LRAI effects on metabolic and neuroendocrine parameters. Our cross-sectional study has shown that the most consistent side effects of LAIR were increased prolactin and leptin, while other deviations might be attributed to confounding covariates. Whether pharmacokinetic and pharmacodynamic advantages of LAIR over oral drug formulation are accompanied with favorable metabolic and neuroendocrine profile remains to be assessed by head to head studies.FundingThis study was supported by a grant from the Ministry of Science, Republic of Serbia (Project 145019).
P03-345 Levels of Plasma Serum Dehydroisoandrosterone-Sulfate and Cortisol in Combat Veterans
Authors: Kolov S. 
Published: June 2010

ObjectivesRecent studies suggest that such neuroactive steroids as dehydroepiandrosterone-sulfate (DHEAS) and cortisol play an important part in conditioning psychiatric disorders in combatants. Cortisol may have a neurotoxic effect whereas DHEAS can produce a neuroprotective impact.MethodWe have investigated the morning plasma level of DHEAS and cortisol as well as DHEAS/cortisol ratio in the group of forty combat veterans in the remote period of combat stress and the same parameters - in the control group consisting of 30 healthy males (N=30).ResultsIn comparison with the control group, the combatants reliably showed considerably higher level of cortisol (p< 0,05), lower level of DHEAS (p< 0,001) and lower DHEAS/cortisol ratio (p< 0,001). Then the veterans were divided into two groups with the help of the “Mississippi Scale for Combat-Related Posttraumatic Stress Disorder”: those having post-traumatic stress disorder (PTSD) and those without this diagnosis. As a result, no trustworthy difference between levels of DHEAS, cortisol and their proportion was found in PTSD-positive and PTSD-negative veterans. Each of these groups displayed the reliable reduction of DHEAS level as compared to the control group.ConclusionsThe results of our investigation demonstrate that the veterans differed significantly from the control group in the level of neurosteroids. This fact apparently cannot be linked to PTSD symptoms. Thus there is an urgent need for further examination of clinical and psychological components correlated with altered levels of DHEAS and cortisol in combat veterans.
P03-355 Antidepressants Risks Adverse Hematological Effects
Authors: Marqués P. , Ladrón de Cegama U. , Martinez V. , Valera C. , Piñol C. 
Published: June 2010

IntroductionNumerous reports have pointed out the risks adverse hematological effects associated with psychotropic drugs. We report a severe case of thrombocytopenia in a healthy 79 year-old patient happened after mirtazapine administration. Suggesting an immune mechanism.ObjetivesReport a case of mirtazapina-induced inmuno tromnbocitopenia, review of bibliography and to propose monitoring and management strategies.Aims and methods:Care report: PPD (n°HC 16996) treatment with mirtazapina 15 mg/d.Clinical: equimosis cutaneous multiple. Without focalidad. From the point of view etiológico discards organicity (aplasia megacariocítica, processes linfoproliferativos and infectious). An analytical previous examination supports normal platelets until April, 2009, in February the dose doubles from 15 to 30 mg (of mirtazapina). Fatal conclusion: exitus for hemorrhage intracraneal in September, 2009. Clinical judgment: Several Trombopenia, uncertain origin.Literature review: The first well-documented case of mirtazapine-induced immune thrombocytopenia is “Glycoprotein IIb/IIIa complex is the target in mirtazapine-induced immune thrombocytopenia” (Blood Cells, Molecules, and Diseases, 2003).The analysis “Proportion of drug-related serious rare blood dyscrasias” (American Journal of Hematology, 2004) suggests that a substantial fraction of blood dyscrasias may be attributable to drug therapy.ResultsHematologic side effects from psychotropics may present as serious or even fatal consequences of treatment. Incidences of hematological changes for antidepressants were much lower (about 0.01%).ConclusionsBefore initiating therapy with antidepressants, a carefully case history, with special attention to heart disease, family record and medical treatments, should be obtained. Clinical best practice regarding the safe and effective use of psychotropic medications is based on appropriate monitoring of drug-related problems.
P03-368 - Paliperidone in Patients with Psychotic Disorders and HIV/AIDS
Authors: Fernández J.L. , Rojo Á. , Miralles C. , Ocampo A. 
Published: June 2010

ObjectivesTo assess how effective paliperidone is for psychotic symptoms of patients with HIV/AIDS and to assess neuropsychiatric, liver and metabolic side effects associated with paliperidone.MethodThe participants were 9 patients with HIV/AIDS who had psychotic symptoms. These patients were assessed with the brief psychiatric rating scale (BPRS), and the cut-off point was 21. Neurocognitive impairment was assessed with the mini-mental state examination (MMSE), using a cut-off point of 28. Hemathological tests serum transaminases were performed to determine liver function and metabolic syndrome study was implemented as defined by the National Cholesterol Education Program. All patients started taking medication with paliperidone up to 3-9 mg/kg. After a one, three and six-month period of treatment, the patients were reassessed using UKU side-effect rating scale, BPRS, hemathological tests and a full metabolic symdrome study.ResultsPaliperidone is an effective antipsychotic drug: only one patient had psychotic symptoms. Paliperidone didn’t cause any side-effect in none of the nine patients, had a good profile of tolerance regarding liver function, any patient suffered changes in hemathological tests serum transaminases and there wasn’t any significant change in metabolic parameters of the nine patients. Any patient suffered cognitive impairment using MMSE.ConclusionsPaliperidone can be considered a highly effective treatment for patients with psychotic symptoms and HIV/AIDS. This drug has a good antipsychotic profile, doesn’t affect liver function, doesn’t cause neuropsychiatric side-effects and doesn’t cause metabolic syndrome after a six-month treatment. These findings support this drug as first choice treatment of this kind of patients.
P03-369 - Compliance to Treatment with Quetiapine vs Quetiapine XR of 24 Patients with Diagnosis of First Episode of Psychosis in SPDC
Authors: Russo A. , Pirone S. , Passione N.M. , D’Amato F. , Pirarella F. , Fiore F. 
Published: June 2010

ObjectiveTo value medication adherence and discontinuation of treatment among first episode psychosis patients (FEP) treated with quetiapine or extended release of quetiapine (XR).MethodPatients with a first episode of psychosis, age 26+/- 2(N=24) were randomly assigned to treatment with quetiapine 300 mg for twice daily(n=12), or quetiapine rp 300mg/day in one administration daily(n=12),for a 6 months periodResultsThe drop-out of patients for any cause thought the 6-months study was:2 for quetiapine and 6 for quetiapine XR. However, symptom reduction were the same in both groups.To conclude: According to a interview conducted with patients, there is more compliance to therapy for patients treated with quetiapine XR, they prefer to be given a day instead of twice daily administration. Fewest drop-out with quetiapine XR is probably also due to steady-state quetiapiana rp is reached more quickly and better maintained, resulting in greater clinical control.