bluuebunny/crossref_metadata_2025_split huggingface dataset:
Antenatal Stress and Anxiety, Effects on Behavioural and Cognitive Outcomes for the Child, and the Role of the HPA Axis
Authors: Glover V. 
Published: March 2009

There is now good evidence from several prospective studies that antenatal maternal stress, anxiety or depression can have long term consequences for the development of the fetus and the child. There can be a wide range of effects and both behavioural and cognitive outcomes can be altered. Such fetal programming is independent of the postnatal environment, although the nature of maternal care may have a modifying influence. The effects are clinically significant; about 15% of behavioural problems such as attention deficit/hyperactivity disorder may be attributable to prenatal stress. Not all children are affected, and those that are can be affected in different ways. Presumably there is an interaction with the genetic predisposition, but this has not yet been studied. There is little agreement about the gestational windows of vulnerability, which are probably different for different outcomes. Also we do not know the nature of the stress which is most harmful, although there is some evidence that stress due to a bad relationship with the partner is damaging, and anxiety has greater influence than depression.In animal models there is good evidence for the mediating effects of the HPA axis in both mother and fetus. In humans the evidence is less clear. Several studies have found little or no association between anxiety or depression and maternal cortisol in later pregnancy. However we have found an inverse association between amniotic fluid cortisol and child cognitive ability at 17 months, which is only apparent in insecurely attached children.
Stress Responsivity in Childhood and Adulthood: Role of the Glucocorticoid Receptor Gene
Authors: Claes S. , van West D. , Del-Favero J. , Deboutte D. 
Published: March 2009

Aims:Prenatal stress has been associated with lifelong disturbances in stress response systems and with an increased vulnerability for psychiatric disorders. However, the effect of prenatal stress is at least partially determined by individual genetic makeup. Recent data confim the potential role of the glucocorticoid receptor (GR) gene in modulating stress response and in the liability to develop mood disorders. In genetic association studies, single nucleotide polymorphisms (SNPs) in the GR gene were linked to variation in stress response systems (1). In a preliminary investigation, we studied 106 prepubertal children to estimate the impact of four GR gene polymorphisms on cortisol responses after a psychosocial stress test.Results:Carriers of the ER22/23EK mutation displayed significant lower cortisol responses to psychosocial stress compared to noncarriers. This particular polymorphism has earlier been associated to the vulnerability to develop MDD by our own research group (2) and independently by another publication (3).Conclusion:These findings support the relevance of GR gene polymorphisms in general and of the ER22/23EK polymorphism in particular in HPA axis regulation and in the vulnerability for psychiatric disorders.
Revealing the Role of Context, Experience and Individual Differences in the Assessment of Heroin Addicts’ Decision Making Abilities
Authors: Newman C.G.J. , Crome I. , Frisher M. 
Published: March 2009

The development of decision making paradigms has prompted a consideration that an underlying deficit may assist in explaining substance dependence. However, despite these advances, little progress has been made in accounting for large inter-subject variance within previous studies. This failure continues to undermine many of the previous attempts to explain individual difference.A study was undertaken to develop methods for analysing and describing individual response behaviours within a decision-making task. In addition, the effect of task manipulations such as feedback, penalties and practice were examined. Substitute medication maintained adults males were recruited for this study.Findings from this research offer new insight into a possible link between task design and the response behaviours exhibited. This study emphasised the importance of individual response behaviours, and the necessity to consider individual data as a route to understanding concepts drawn from between groups analysis. Significant issues are raised that might impact on other existing paradigms and implications are proposed in relation to the assessment and treatment of substance dependence.
Chronic Non Cancer Pain and Misuse and Dependence of Analgesic Drugs
Authors: Baldacchino A. 
Published: March 2009

As the chronic disease model is now accepted as the model to treat individuals in the community in the UK, it has become important to recognise that individuals tend to present with more than one concomittant problem (comorbidity). A increasing patient centred approach to treatment and recovery has helped to recognise the dual concept of pain and dependence within the clinical environment. There is an ever increasing prevalence of this dual presentation and this has helped to effectively manage individuals with a substance misuse history and associated chronic pain and others treated for their chronic pain with strong analgesic and subsequently experiencing substance misuse and dependence problems.This presenation aims to provide the literature overview of these populations, clinical characteristics and problems presenting in a pain and dependence clinic in Scotland. Several models of practice will also be presented.
Principles of Analgesic Effects of Opioids and Dependence of Opioids (F.E. Tramadol)
Authors: Havemann-Reinecke U. , Manouchehr S. 
Published: March 2009

German epidemiological data (Poser and Havemann-Reinecke 2002) showed 12% of all addicted treated patients in Lower Saxony being dependent from prescribed opioid analgesics.Here we report new clinical data of 150 patients being treated because of dependence on the opioid analgesic tramadol. The documents of these patients were evaluated to social-, family-, pain- and addiction development - data, psychiatric and somatic diseases; suicidality, source of tramadol (prescription: "legal", black market: "illegal" ), withdrawl symptoms, therapy.Results:Of 140 patients (P) 123 P (88%) were "legally" dependent on tramadol (51% f, 49 m), 17 P (12.%) "illegally" dependent (54% f, 47% m). The ages of "legally" dependent P were: 20-30J: 7%; 30-40J: 16% ; 40-50J: 24%; 50-60J: 21%; 60-70J: 19%; 70-80J: 14%. In the group of "legally dependent" patients 20% were medical staff (16% nurses, 4% medical doctors), and 16% had academic professions; 19% reported an addiction disease of the parents (mostly of alcohol), 16% another psychiatric disease of the parents. 75% of the "legally" dependent patients suffered from depression, 40 % had performed suicidal trial(s), 53% have had a somatic disease before the intake of tramadol, 17% after the treatment of tramadol dependence. 69% suffered from pain before intake of tramadol (22% disc/ back, 15% megrim/ head, 5% tooth, maxillary sinus, 6% pancreas, 4% legs, 2 % abdomen, bile), 22% had no experience of pain before first intake of tramadol. 76% of the pain-patients were also ill with depression. Seizures were documented in 23% of all patients with tramadol dependence/withdrawal as cause.Conclusion:Pain, depression and pain, somatic diseases, previous addiction diseases, psychiatric family history, being a member of medical staff increase the risk to develop dependence to prescribed tramadol. Tramadol dependent patients show a high rate of suicidal trials and of seizures. Different therapies are under evaluation. Data will be discussed with respect to pathophysiological principles of analgesic and addiction effects of opioids.
Managing Co-morbid Pain and Addiction
Authors: Bannister J. 
Published: March 2009

It is important to remember that patients who misuse substances experience pain just as acutely, and probably more so, than “normal” patients. Their lives are chaotic and difficult and they often suffer from concurrent mental health problems. This in itself increases stress and distress and may make their experience of pain worse. Their coping mechanisms are heavily biased towards use of chemicals to deal with distress and they may not respond easily to non-pharmaceutical measures for pain control. Addiction is a chronically relapsing illness and we should expect our patients to respond accordingly. If a patient who has been stable and productive becomes unstable and chaotic again, this is not an indication of therapeutic failure and a signal to retreat and disengage; it means we have to change our management and try again.Addiction and chronic pain are rarely curable, just as diabetes is rarely curable. We are tasked with helping these patients to best manage their chronic diseases and we should expect setbacks as much as we enjoy success.We can use any technique we would use in pain uncomplicated by addiction. Thus we use unconventional analgesics such as tricyclic antidepressants and anticonvulsants for neuropathic pain. Regular paracetamol and short course NSAIDs have the same benefits in musculoskeletal pain. Physical approaches such as physiotherapy, TENS (transcutaneous electrical nerve stimulation) and acupuncture have their place. Behavioural modification with psychology is vital. Opioids do have analgesic effects in opioid misusers, even though popular myths have many patients believing otherwise.
A Randomized Naturalistic Open Long-term Treatment of Panic Disorder with Clonazepam or Paroxetine
Authors: Nardi A.E. , Valença A.M. , Freire R.C. , Lopes F.L. , Nascimento I. , King A.L. , Sardinha A. , Levitan M.N. , de Carvalho M.R. , de-Melo-Neto V.L. , Mezzasalma M.A. , Soares-Filho G.L. , de Cerqueira A.C. , da Costa R.T. , Versiani M. 
Published: March 2009

Objective:To describe with prospective methodology the therapeutic response to clonazepam or paroxetine in a 3-year treatment of panic disorder (PD).Methods:A total of 120 PD outpatients (DSM-IV) were openly treated with clonazepam or paroxetine for 8 weeks. Those who responded entered a 3-year follow-up. Demographic and clinical features were compared in the two groups.Results:Efficacy was evaluated by Intent to treat, last value carried forward. The Hamilton Scale for Anxiety (HAMA) did not differ between the groups at baseline and during the first two months. In the acute treatment phase and at the end of the long-term follow-up both groups had a significant and similar response - 86.8% of the clonazepam group and 73.0% of the paroxetine group had a complete remission of panic attacks. The mean dose for clonazepam was 1.9 ± 0.2 mg/day and for paroxetine 33.8 ± 9.8 mg/day. There was no difference in the scale scores, and the reduction in panic attacks from baseline to end-point did not differ significantly between the groups. The most common adverse events during treatment were tremor/shaking, nausea/vomiting, sexual dysfunction and appetite/weight change in the paroxetine group and drowsiness, sexual dysfunction and memory/concentration complains in the clonazepam group.Conclusion:PD patients using clonazepam or paroxetine had an equivalent response during acute and long term treatment. The patients using clonazepam had significantly less side effects than the paroxetine group.Acknowledgements: Brazilian Council for scientific and technological development (CNPq).Grant: 554411/2005-9.
Translation of Randomised Controlled Trial Findings into Clinical Practice: Comparison of Olanzapine and Valproate in the Emblem Study
Authors: Novick D. , Gonzalez-Pinto A. , Haro J.M. , Bertsch J. , Reed C. , Perrin E. , Tohen M. 
Published: March 2009

Aims:To contrast the outcomes of olanzapine- and valproate-treated patients in an observational study of acute mania with the results of a RCT assessing the same treatments (Tohen et al., 2002).Methods:EMBLEM (European Mania in Bipolar Evaluation of Medication) was a 2-year, prospective, observational study of health outcomes associated with treatment of mania. Severity of mania and depression was assessed at baseline and 6 weeks using the YMRS and 5-item version of the HAMD, respectively. The RCT was a 3-week, randomised, double-blind comparison of olanzapine (n=125) and divalproate-treated (n=123) patients hospitalised for acute manic or mixed episodes. The YMRS and HAMD were used to quantify manic and depressive symptoms, respectively.Results:621 EMBLEM patients were analysed (n=107 valproate, n=514 olanzapine). Both observed groups improved from baseline to 6 weeks in mean YMRS and HAMD-5 total scores, with significantly greater mean improvements in the olanzapine compared with the valproate group using linear regression to adjust for baseline differences. The RCT reported significantly greater mean YMRS improvement (but not HAMD) in the olanzapine-treated group. EMBLEM patients treated with olanzapine experienced significantly greater weight gain than patients treated with valproate, similar to RCT results. There was a significantly greater incidence of treatment-emergent gastrointestinal adverse events in EMBLEM patients treated with valproate.Conclusions:The EMBLEM results support those of the RCT, which suggest that olanzapine monotherapy may be more effective than valproate monotherapy in the treatment of acute mania. Contrasting observational and RCT results present methodological challenges but can provide important complementary information.
The Lundby Study - Background and Recent Findings in a 50-year Perspective
Authors: Nettelbladt P. , Mattisson C. , Bogren M. , Brådvik L. 
Published: March 2009

Aims:To describe the Lundby Study and present recent data for the period 1947-1997.Methods:The Lundby population consisting of 3563 probands was investigated by semi-structured interviews in 1947, 1957, 1972 and 1997. Sufficient information was available for 94-99%. Best estimate consensus diagnoses have been used since 1957 together with DSM-IV and ICD-10 in 1997.Results:From 1947-1972 to 1972-1997 a decrease in almost all age- and sex-specific incidences of neurotic and organic disorders was observed, whereas psychotic disorders increased consistently in males, but decreased in most age intervals in females. Women had higher first incidence depression rates than men and the average annual rate was lower for women and tended to be lower for men 1972-1997 as compared with 1947-1972. Median age at first onset of depression was around 35 years for individuals followed up for 30-49 years. The recurrence rate was about 40% and varied from 17% to 76% depending on length of follow-up. Transition to diagnoses other than depression was registered in 21% of the total sample, alcohol disorders in 7% and bipolar disorders in 2%.The overall long-term suicide risk varied from 5,6% to 6.8%. The long term suicide risk was 3.1% for medium and 13.7% for severe MDD. Severity and male sex were risk factors. After the introduction of TCAs a fall in suicide rates among depressed individuals was observed. Certain clusters of personality traits may predict functional psychosis.Conclusions:Low attrition rates over 50 years and reasonable diagnostic uniformity make comparisons over time justifiable.
Developmental Vitamin D Deficiency (DVD) and Brain Dopamine Ontogeny
Authors: Eyles D. , Cui X. , Pelekanos M. , Kesby J. , Burne T. , McGrath J. 
Published: March 2009

Our group has pioneered research indicating that Developmental vitamin D (DVD) deficiency (a candidate risk factor for schizophrenia) alters both brain development and function. We have convergent evidence indicating a disturbance in dopamine signalling in this model. 1stly the superior colliculus (the proto-basal ganglia) is the initial site where the vitamin D receptor is expressed in foetal brain; 2ndly we show a reduction in Catechol-O-methyl transferase (a major metabolic enzyme for dopamine) in these foetal brains; 3rdly dopamine metabolites in the DVD deplete neonatal brain reflect this enzymatic change. When we allow these animals to mature under vitamin D normal conditions we repeatedly observe alterations in both spontaneous and psychomimetic enhanced locomotion. Consistent with the theme of persistent changes in dopamine signalling in this model we now present new data showing that dopamine transporter density and/or affinity are altered in DVD deplete female offspring whilst DA 1 receptor density and dopamine cell number are reduced in DVD deplete male offspring (all P< 0.05 n>8).Our most recent studies indicate that Nurr-1, a nuclear transcription regulator important in both bone and dopamine neuron development and survival may be a molecular mediator of these processes. Nurr-1 is upregulated by parathyroid hormone (PTH). PTH levels are 2-3 fold greater in vitamin D deficient Dams across gestation. Most importantly we have just shown that Nurr-1 is dose-dependently upregulated by parathyroid hormone (PTH) in a neuroblastoma cell line.Conclusions:Our findings strongly suggest that vitamin D directly (or indirectly via PTH) mediates dopamine neuron development.
Double Blind Randomised Clinical Trial of Bright Light Therapy in Elderly Subjects with Nonseaonal Major Depressive Disorder
Authors: Lieverse R. , Nielen M. , Uitdehaag B. , van Someren E. , Smit J. , Hoogendijk W. 
Published: March 2009

Background:The cause of depression is largely unknown, but several studies point to disturbances of biological rhythmicity. The functioning of the suprachiasmatic nucleus (SCN) is impaired, as evidenced by an increased prevalence of day-night rhythm perturbations, such as sleeping disorders. Moreover, the inhibitory SCN neurons on the hypothalamus-pituitary adrenocortical axis (HPA-axis) have decreased activity and HPA-activity is enhanced, when compared to non-depressed elderly. Using bright light therapy (BLT) the SCN can be stimulated. In addition, the beneficial effects of BLT on seasonal depression are well accepted. BLT is a potentially safe, nonexpensive and well accepted treatment option. But the current literature on BLT for depression is inconclusive.Methods/design:RCT (ClinicalTrials.gov identifier: NCT00332670) in 89 subjects, of 60 years and older with a diagnosis of major depressive disorder. After inclusion subjects were randomly allocated to the active (BLT) vs. placebo (dim red light) condition. just before the start of light therapy, after completion of three weeks therapy period, and three weeks thereafter several endocrinological, psychophysiological, psychometrically, neuropsychological measures are performed:Results:Main effect analyses on HADRS-17 scores revealed significant antidepressant effects from BLT. Primary results will be presented.Discussion:BLT reduces nonseasonal depression in elderly patients. Additional lightning may easily be implemented in the homes of patients to serve as add-on treatment to antidepressants or as a stand-alone treatment in elderly depressed patients. Our data support the role of a dysfunctional biological clock in depressed elderly subjects, such a finding may guide further development of novel chronobiological oriented treatment strategies.
The Involvement of BDNF in Pathogenesis and Treatment of Depression
Authors: Joubert A. 
Published: March 2009

Aims:Data suggest the involvement of monoaminergic and neurotrophic systems in the pathogenesis and treatment major depressive disorder (MDD). We are particularly interested in their interaction, and therefore studied monoaminergic mechanisms in a series of functional imaging studies using positron emission tomography (PET).Methods:Patients with a history of severe trauma and a diagnosis of posttraumatic stress disorder (PTSD) with and without a co-morbid diagnosis of MDD, patients with a diagnosis of MDD and PTSD alone and healthy control with and without a history of severe trauma were studied. Selective radiotracers for the serotonin 1B receptor subtype, the serotonin transporter and the norepinephrine transporter were synthesized using GE's FXC module and/or Bioscan's AutoLoop by methylation with C-11 methyl triflate or C-11 methyl iodide, respectively. Following a transmission scan, the radiotracers were injected by pump over one min and high resolution research tomography (HRRT) list mode data were acquired for 120 min on a HRRT. A summed image was created and registered to the subject's T1-weighted MR images, which, in turn, were registered to an MR template.Results:We found evidence for distinctly different neurobiological mechanisms in patients with MDD and PTSD relative to patients with only one diagnosis.Conclusions:Our data suggest biological endophentotypes for co-morbid PTSD and MDD which will not only support further research on the neurobiological systems that implement the psychopathology, but may stimulate translational research to develop preventive or treatment interventions for co-morbid patients.
A Different DNA Methylation Profile is Obtained from a Recently Published MZ Study of Psychiatry
Authors: Liang M. , Hu Y. , Chen D. 
Published: March 2009

Aim:To get a more robust DNA methylation profile from the data given by a published article of a MZ study of psychiatry.Method:Considering the relevance of birth weight with DNA methylation profiles, we reanalyzed the data from the paper of Mill etc. (DOI: 10.1002/ajmg.b.30316) with rearrangement of the group order within twin pair, prior if lighter in birth weight. Statistical methods used are including mean, correlation and paired-samples t-test (considering twins’ particularity).Results:We calculated twin difference by lighter twin's methylation percentage minus that of heavier twin. The mean of CpG1 methylation differences is -7.08% while -7.17% for CpG2. The two means have no statistical significant difference in a paired-samples t-test (t=0.027, p=0.979, 2-tailed). These results are different from the original paper: 10.3% for CpG1 and 16.1% for CpG2, which are statistical significantly different (t=-2.792, p=0.018, 2-tailed). Besides, we found that in the lighter twin group, the methylation percentage are statistical significantly different between CpG1 and CpG2 (t=2.627, p=0.024, 2-tailed). As to correlation analysis, we got a slightly different result: correlation between MZ differences in two sites is weaker after rearrangement (r=0.875, while r=0.913 before arrangement, both p< 0.001).Conclusion:According to our study, the results imply that twin differences may not be the only thing worthy of investigation. Different patterns among CpGs in certain kinds of subgroups should also need attention. We need conduct a robust data analysis strategy in our researches on the epigenetic aspects of psychiatry, where monozygotic twins have a favorable utility.
Conditional Acceptance as a Distinct Feature of Socially-prescribed Perfectionism: A Study in Portuguese Pregnant Women
Authors: Macedo A. , Bos S. Carvalho , Maia B. , Soares M.J. , Marques M. , Pereira A.T. , Gomes A. Allen , Valente J. , Azevedo M.H. 
Published: March 2009

Aim:To investigate associations between perfectionism dimensions and psychological distress 421 pregnant women (M=29.8, SD=4.48 years) completed measures of Self-Oriented Perfectionism (SOP), Socially-Prescribed Perfectionism (SPP) (MPS; Hewitt & Flett, 1991; Soares et al., 2003), mood (POMS; McNair et al., 1971; Azevedo et al., 1991) and depressive symptomatology (BDI-II; Beck et al., 1996; Coelho et al., 2002).Methods:A 2-factor model of Perfectionism with SOP and SPP dimensions and a 3-factor model with SOP, SPP-Others’ High Standards and SPP-Conditional Acceptance factors were explored. Correlations and Linear Regressions were calculated between perfectionism factors and mood variables/depressive symptoms.Results:Higher levels of SPP factors were in general associated with increased Anxiety, Depression, Anger, Fatigue and Confusion, with decreased Vigour and with more severe depressive symptomatology. SPP dimension and both SPP sub-scales explained depressive symptoms.Conclusion:Our results, in contrast with those from the study of Campbell and DiPaula (2002) did not confirm a preferential association between SPP-Conditional Acceptance and psychological distress (PD), revealing that both components of SPP were associated with PD.