bluuebunny/crossref_metadata_2025_split huggingface dataset:
P01-32 - The Effect of Valproat Versus Lithium in the Long-term Treatment of Subtypes of Bipolar Disorders (BD)
Authors: Elezi F. , Sotiri E. , Braho A. , Dobi F. , Dyrma A. , Tomori S. 
Published: June 2010

BackgroundBipolar disorder begins during adolescence but often escapes diagnosis at this time because episodes are misinterpreted with other psychiatric disorders. Lithium, carbamazepine, valproate, and other drugs are used for the treatment of acute episodes and maintain treatment of bipolar disorders.AimsTo compare the efficacy of Valproate vs. Lithium in the long-term treatment of patients with subtypes of bipolar disorders.Method120 patients with more than two episodes of BD (according to DSM-IV) in a longitudinal, comparative and randomized clinical trial, for 2 years (104 weeks) divided in two equal parallel-groups with open label pre-randomized phase. Primary outcome measure was time to relapse/recurrence of any mood episodes. Survival analyses (Kaplan-Mayer and Cox Proportional Hazard) were used for statistical analysis.ResultsCumulative survival for valproate's group was S(104)=0.3570, (35.70% and lithium's group S(104)=0.3136, (31,36%). Valporate is superior to lithium for the treatment of non classic BD I (Log Rank 0.0309, p=0.0100). Valproate prolongs median survival time with 11±9 and mean survival time to 7±4 weeks more than lithium. Treatment with lithium has 20.4% higher relative risk for relapse/recurrence than treatment with valproate Vp (β = 0.186, p = 0.434). Valproate is superior for the treatment of BD with psychiatric comorbidity (Log Rank =0.0007. p=0.0026).ConclusionsWe found that valproate is significantly more effective than lithium in prophylactic treatment of bipolar I disorders in non-classic subtype and in bipolar disorder with psychiatric comorbidity.
P01-38 - Efficacy of Adjunctive Aripiprazole in Patients with Major Depressive Disorder: Pooled Analysis of Subgroup Data from Three Clinical Trials
Authors: Gismondi R. , McQuade R. , Loze J.-Y. , Owen R. , Berman R. 
Published: June 2010

AimsTo conduct a subgroup analysis of the efficacy of adjunctive aripiprazole as treatment in patients with major depressive disorder (MDD) who demonstrated an inadequate response to standard antidepressant therapy (ADT).MethodsData were pooled from three identical, short-term, double-blind, placebo-controlled studies (CN138-139, CN138-163, CN138-165) with an 8-week phase of placebo plus ADT and a 6-week double-blind phase with ADT plus adjunctive placebo or aripiprazole. Only MDD patients without psychotic features were eligible for entry. The primary efficacy endpoint was the mean change in the Montgomery Asberg Depression Rating Scale (MADRS) total score in the double-blind phase. Subgroup analyses of the primary efficacy endpoint were performed for age, race, ethnicity, MADRS response, number and choice of previous ADTs, episode duration, and use of selective serotonin re-uptake inhibitors (SSRI).ResultsCompared with the adjunctive placebo group, adjunctive aripiprazole was associated with greater reductions in MADRS total score in all subgroups. Mean change in MADRS total score ranged from -10.71 to -5.89 with adjunctive aripiprazole and -7.57 to -4.10 with adjunctive placebo. No statistically significant treatment-by-subgroup interaction effects were observed for any subgroup except gender (p=0.039). This difference is, however, primarily because of results from study CN138-139 results; consistent results between men and women were reported in CN138-163 and CN138-165.ConclusionsPooled data indicate that in patient populations with similar baseline characteristics, treatment with adjunctive aripiprazole and ADT is efficacious in improving the symptoms of MDD in subgroups of patients having an inadequate response to ADT.
P01-39 - Adjunctive Aripiprazole in Patients with Major Depressive Disorder: Efficacy Data from three Short-term Studies
Authors: Gismondi R. , McQuade R. , Loze J.-Y. , Owen R. , Marcus R. 
Published: June 2010

AimsTo evaluate the efficacy of aripiprazole as adjunctive treatment in patients with major depressive disorder (MDD) without psychotic features and an inadequate response to standard antidepressant therapy (ADT).MethodsData were collected from three identical, short-term, double-blind, placebo-controlled studies (CN138-139, CN138-163, CN138-165). After a single-blind prospective phase with placebo plus ADT, patients with inadequate response were randomized to 6-weeks’ treatment with adjunctive aripiprazole or placebo. The primary efficacy endpoint was the mean change in the Montgomery Asberg Depression Rating Scale (MADRS) total score during the double-blind phase. Secondary endpoints were response (≥50% reduction in MADRS total score), remission (MADRS total score ≤10 and ≥50% reduction in MADRS total score), and mean change in Hamilton Depression Rating Scale (HAM-D17) total score.ResultsIn all three studies, adjunctive aripiprazole was associated with a significantly greater reduction in MADRS total score than adjunctive placebo, with a treatment difference ranging between -3.73 and -2.84 (p≤0.001 in each study). Response and remission rates with adjunctive aripiprazole (32.4-46.6% and 25.4-36.8%, respectively) were also significantly higher than with adjunctive placebo (17.4-26.6% [p< 0.05 in each study] and 15.2-18.9% [p< 0.05 in each study]). Mean change in HAM-D17 total score ranged from -7.64 to -6.77 with adjunctive aripiprazole and from -5.12 to -4.41 with adjunctive placebo (p< 0.001 for each study).ConclusionsResults of the three studies indicate that treatment with adjunctive aripiprazole and ADT is effective in improving the symptoms of MDD in patients who have had an inadequate response to ADT.
P01-42 - G72/G30 Candidate Gene for Bipolar I Disorder is not Associated with Psychosis in the Romanian Population
Authors: Grigoroiu-Serbanescu M. , Herms S. , Diaconu C.C. , Bleotu C. , Neagu A.I. , Abou Jamra R. , Gherghel M. , Sima D. , Dan I.A. , Prelipceanu D. , Nöthen M.M. , Cichon S. 
Published: June 2010

BackgroundThe G72/G30 gene is one of the common loci shared both by schizophrenia and bipolar disorder. Studies accumulating since the discovery of this gene complex in 2002 produced controversial results in both disorders in different populations.ObjectiveWe investigated the association between G72/G30 gene and bipolar I disorder (BPI) in the Romanian population paying special attention to the association of G72/G30 locus with lifetime psychosis in BPI patients.MethodFourteen G72-SNPs were genotyped in a Romanian sample of 198 BPI patients and 180 controls screened for psychiatric disorders in the Institute of Human Genetics, Life & Brain Center of the University of Bonn, Germany. Statistical analysis was performed with FAMHAP and Haploview-v3.32. The significance level of the results was corrected for multiple testing through permutations in 100,000 Monte Carlo simulations.ResultsNone of the fourteen SNPs was associated with the global diagnosis of BPI in our total patient sample or with the psychotic BPI subtype. But four SNPs reached nominal significance in the non-psychotic BPI subgroup [rs3916965 (M12) (P=0.044), rs1935057 (P=0.037), rs3916967 (M14) (P=0.043), rs2391191 (M15, non-synonymous) (P=0.043)]. In the non-psychotic subgroup, the haploblock including M14 and M15 (GA) remained significantly associated with BPI after correction through permutations (P=0.0524; OR=1.82).ConclusionOur results are the first replication of the study by Williams et al. (2006) reporting the same G72-SNPs [M12(A) and the functional SNP M15(A)], with the same alleles, to be associated with non-psychotic BPI disorder.
P01-50 - Hormonal Study of Depression with co Morbid Erectile Dysfunction
Authors: Khan M. , Sana N. , Gull M. , Mukhtar Z. , Chaudhry H. 
Published: June 2010

BackgroundErectile dysfunction is twice common in patient with depression. Testosterone plays vital role in erectile function. Low testosterone level is found in patients of depression. High level of prolactin has depressive effect on libido function. Hypogonadism and hyperprolactinemia can be the causative factor for depression. Hormonal changes can be both cause and effect of depression with ED.MethodIn sample of 76 patients having depression with co morbid ED blood levels of prolactin, and free testosterone were determined.Half of patients were treated with sex friendly antidepressants while in other half mesterolone and piribedil were used as adjunct medicines.ResultsIn 9.2% free testosterone level was below than reference value. In 28.9% prolactin level was high .51 .31% were found having border line free testosterone level.In younger age group free testosterone level was lower than older age group. There exist inverse relation between prolactin level and free testosterone level. Patients who were given adjunct medication showed rapid improvement both for depression and erectile dysfunction.DiscussionReduced level of free testosterone and high level of prolactin has bilateral relation with depression with co morbid ED. Although prevalence of hypogonadism and hyperprolactinemia is low in the study yet high numbers of borderline cases are of great significance. It is postulated that fall in sexual function is directly proportional to change in levels of these hormones from the base line that are reversed by adjunct medicines.ConclusionIn patients with concomitant major depression and erectile dysfunction hormonal changes plays important role.
P01-59 - A Multistage Chronobiologic Intervention for the Treatment of Depression: a Pilot Study
Authors: Lucian M. 
Published: June 2010

BackgroundSeveral chronobiologic techniques were proposed as an alternative to antidepressant medications. The current article reports the design and the initial outcome results of a new chronobiologic multistage intervention (CMI) that is comprised of the following techniques:(i)partial sleep deprivation during the second half of the night(wake therapy),(ii)medium (green) wavelength light in combination with dawn simulation (DS),(iii)bright light therapy (BLT), and (iv) sleep phase advance (SPA).MethodsThe study was conducted as a set of 12 single-case designs with moderate-to-severe depressive volunteering patients. Depression, anxiety and tension measurements were taken on a daily basis beginning with a baseline measurement (T0), followed by a set of four consecutive morning measurements during the therapeutic intervention (T1-T4),and with a final measurement carried out at the end of 4 weeks of follow-up (T5).ResultsA clinically significant rapid improvement of the depressive symptoms was demonstrated and maintained for at least 4 weeks after the end of the intervention. No dropouts or compliance difficulties were observed. Sleepiness in the late afternoon hours was reported by several of the participants, but did not reach a level that interfered with their ability to function.ConclusionsThese initial findings showed the procedure to be effective and well tolerated. It affords many advantages, such as the achievement of a rapid response, no extinction of the therapeutic effect after 4weeks of follow-up, safety, high patient compliance and cost effectiveness.
P01-71 - Are Treatment Preferences Relevant for Response to Serotonergic Antidepressants and Cognitive-behavioural Therapy in Depressed Primary Care Patients?
Authors: Mergl R. , Henkel V. , Allgaier A.-K. , Kramer D. , Hautzinger M. , Kohnen R. , Coyne J. , Hegerl U. 
Published: June 2010

ObjectivesLittle is known about the influence of patients’ preferences and expectations about offered treatments for depression on treatment outcome. Therefore, we investigated whether in primary care patients with depressive disorders receiving a preferred treatment is associated with a better clinical outcome.MethodsWithin a randomized, placebo-controlled, single-centre, 10-week trial with five arms (sertraline; placebo; cognitive-behavioural group therapy (CBT-G); moderated self-help group control; treatment with sertraline or CBT-G according to patients’ choice), 145 primary care patients with mild-to-moderate depressive disorders according to DSM-IV criteria were investigated. Preference for medication versus psychotherapy was assessed at the time of patients’ screening using a single item. To assess therapy outcome, the post-baseline sum scores of the Hamilton Depression Rating Scale (HAMD-17) were used.ResultsDepressed patients receiving their preferred treatment (sertraline or CBT-G) (N=63) responded significantly better than those who did not receive their preferred therapy (N=54) (p = 0.001). The difference in outcome between both groups was 8.0 points on HAMD-17 for psychotherapy and 2.9 points on HAMD-17 for treatment with antidepressants. This result is not explained by differences in depression severity or drop-out rates.ConclusionsPatients’ preference for pharmaco- versus psychotherapy should be considered when offering a treatment because receiving the preferred treatment conveys an additional and clinically relevant benefit (HAMD-17: +2.9 points for drugs; +8.0 points for CBT-G) in outcome.
P01-75 - Quetiapine XR or Lithium Combination with Antidepressants in Treatment Resistant Depression
Authors: Montgomery S. , Dell’Osso L. , Kasper S. , Pitchot W. , Dencker-Vansvik E. , Köhler J. , Jörgensen L. , Bauer M. 
Published: June 2010

ObjectivesCompare quetiapine+antidepressant (AD) with lithium+AD, and quetiapine monotherapy with lithium+AD in open, rater-blinded treatment.MethodsPatients with treatment resistant depression (Thase et al 1997 stage 1 and 2) with severity of MADRS ≥25 received: quetiapine XR 300mg/day plus AD (SSRIs or venlafaxine) (n=229), lithium (monitored to between 0.6 to 1.0 meq/l) plus AD (n=221) or quetiapine XR alone (300mg/day) (n=225) for 6 weeks. Primary efficacy measure was change from baseline in MADRS total score. The pre-specified non-inferiority limit was 3 points on the MADRS.ResultsFewer patients discontinued on quetiapine+AD (15.2%) than lithium+AD (20.5%) and quetiapine monotherapy (21.5%). Quetiapine+AD and quetiapine monotherapy, were not inferior to lithium+AD in the primary (per protocol) analysis with a mean difference (97.5%CI) on the MADRS of -2.32 (-4.6 to -0.05) favouring add-on quetiapine and -0.97 (-3.24 to 1.31) favouring quetiapine monotherapy. This mandated superiority testing on the modified ITT population showing no significant difference at endpoint.In a post hoc analysis discounting multiplicity, quetiapine+AD was significantly more effective than lithium+AD on the MADRS change from baseline, p=0.046. The advantage was observed at day 4 (p=0.007) and persisted throughout. Efficacy was supported by CGI-I (p=0.07). Quetiapine+AD showed a numerically greater advantage over lithium+AD in those with two failed treatments (Stage 2) rather than one (Stage 1).ConclusionsQuetiapine+AD and quetiapine monotherapy, were non-inferior to lithium+AD in treatment resistant depression. There was an early significant and persistent efficacy advantage on MADRS for quetiapine augmentation compared with lithium augmentation of SSRI or venlafaxine treatment.
P01-78 - Cognitive Impairment and Altered Vigilance in Treatment Resistant Major Depression
Authors: Neu D. , Kornreich C. , Montana X. , Hoffmann G. , Sentissi O. , Verbanck P. 
Published: June 2010

IntroductionMajor depression (MDD) presents among other symptoms with cognitive impairment and diurnal fatigue. Residual fatigue in non-remitted patients often shows neuropharmacological treatment resistance. The relationships between cognitive dysfunction, vigilance, fatigue and affective symptom intensity is poorly described in treatment-resistant MDD (TRD).MethodsDuring a prospective study protocol, 17 in-patients hospitalized for TRD were compared to a healthy control group (n=17). Patients were under SNRI or SSRI and free from diurnal benzodiazepines. All subjects underwent structured psychometry (HAMD, HAD), cognitive assessment and vigilance measurements (behavioral sleep résistance task, BSRT; psychomotor vigilance test, PVT; Auditory Verbal Learning, AVLT; trail making test, TMT). Subjective fatigue and sleepiness were assessed by the Fatigue Severity and the Epworth Sleepiness Scales respectively. All measures have been performed at two time points (T1 and T2) with a 10-day interval.ResultsT1 and T2 showed higher fatigue and sleepiness in MDD (p< 0.05). With exception for the BSRT, between group comparisons showed significant differences for all variables.Comparison for repeated measures (T1 and T2) showed improvement in depressive symptom intensity (HAMD, p< 0.0005) but cognitive and psychomotor performances only improved for the TMT (TMT-B, p=.001).ConclusionsTRD presents here with psychomotor slowing, with impaired mental flexibility (executive function) and declarative memory dysfunction. Interestingly, despite subjective complaints (ESS), objective sleepiness (BSRT) had not been revealed. Furthermore affective symptom improvement was not associated to an increase in declarative memory or psychomotor performances.
P01-82 - Heterogeneity of DSM-IV Major Depressive Disorder as a Consequence of Subthreshold Bipolarity
Authors: Zimmermann P. , Brueckl T. , Nocon A. , Pfister H. , Lieb R. , Wittchen H.-U. , Holsboer F. , Angst J. 
Published: June 2010

ContextThere is growing evidence that major depressive disorder (MDD) might be overdiagnosed at the expense of bipolar disorders (BPD).AimTo identify a subgroup of subthreshold BPD among DSM-IV MDD, which is distinct from pure MDD regarding validators of bipolarity.MethodData come from the ten-year prospective-longitudinal EDSP-Study, a community survey from Munich, and were assessed with the DSM-IV/M-CIDI. Subthreshold BPD was defined as fulfilling criteria for MDD plus presence of manic symptoms, but never having met criteria for hypomania.ResultsAmong 488 respondents with MDD, about 60% had pure MDD and 40% subthreshold BPD. Compared to pure MDD, the subthreshold BPD group was found to have(a)an increased family history of mania,(b)considerably higher rates of nicotine dependence and alcohol use disorders,(c)twice as high rates of panic disorder, and(d)a tendency towards higher rates of criminal acts.(e)In prospective analyses, subthreshold BPD converted more often into BPD during follow-up with the criterion D (symptoms are observable by others) being of critical predictive relevance.ConclusionData suggest that MDD is a heterogeneous concept including a large group of subthreshold BPD, which is clinically significant and shares similarities with BPD. Findings might support the need for a broader concept and a more comprehensive screening of bipolarity.
P01-86 - The Evaluation of Relation between the Rate of Marital Satisfaction and Depression in Tekab, Iran
Authors: Rezaei Ghalechi E. , Kazemi R. , Taghavi N. 
Published: June 2010

BackgroundOur main goal is evaluation of marital satisfaction in depressed patients and researches of the rate of depression between men and women.MethodsThis investigation is descriptive and correlation study that 93 people (48M, 45F) as the accidental samples by GRIMS and Beck depression questionnaire are collected. Results of this study by Mann Whitney Test, Kruskal-wallis Tests, Chi-square Tests and Spearman’s rho are achieved.ResultsOur study shows that 50.06% of people had relative marital satisfaction and 47.64% had minor depression. The marital satisfaction of women were more than men 49.23% the rate of women depression was high too 47.5%.DiscussionIn this study there is no meaningful relation between age, duration of marriage, sex, educations, occupational situation and marital satisfaction and depression too but there is meaningful relation between marital dissatisfaction and depression. We advise to go to psychiatrists when spouses have several problems in their sexual relation ship.
P01-97 - Mania Induced by Mefloquine Prophylaxis: Case Description and Literature Review
Authors: Yelmo S. , Morera-Fumero A. , Renshaw A. , Henry M. , Gracia R. 
Published: June 2010

ObjectivesMefloquine is being used as malaria prevention by Plasmodium Falciparum in chloroquine-resistant zones. We describe a woman who developed a manic episode with psychotic symptoms during mefloquine treatment.Methods and resultsA 26-year-old Spanish woman had been working in Mali for the last six months and had started antimalarial prevention with mefloquine. In Mali, the clinical picture had a sudden debut and she related: excessive happiness, incapacity to sleep, and megalomania (she believed to have special powers and to be the mother of all the children). She was admitted in a hospital in Mali for seven days and received treatment with haloperidol and chlorpromazine. Then, she was repatriated to Spain without treatment and she continued suffering the same symptoms. After 15 days, she went to our hospital and she was admitted. Treatment started with risperidone (up to 6 mg/day) and clonazepam (up to 1.5 mg/day). At admission Young Mania Rating Scale (YMRS) was 25 points. Physical examination and complementary tests were normal, and was orientated as a manic episode with psychotic symptoms secondary to mefloquine. She had a quick symptomatic improvement (after 7 days of treatment YMRS was 5 points) and was discharged after 15 days.ConclusionMefloquine more frequent adverse neuropsychiatric effects are: dizziness, vivid dreams and insomnia. Others are confusion, and auditory hallucinations. Side effects are dose dependent. Psychotic symptoms are frequently auto-limited when mefloquine is suppressed but treatment with atypical antipsychotics is often needed. MDR1/ABCB1 polymorphisms may play a role in neuropsychiatric side effects
P01-115 - Analysis & Follow up Study of 120 Teen Agers Those were Presented with Examination Phobia in a Clinic in India
Authors: Acharya A. 
Published: June 2010

IntroductionPhobias & fearfulness shortly before examination are a common presenting feature in a section of teen aged students, ausing a stress in their own aswellas in their anxious parents. On a longitudinal evaluation of such 120 cases in a remote district clinic in the age group of 15-23 with a median age of 18 years will show their varied underlying morbidity ultimately.ObjectivesIs it a normal phenomenon or much sressed those may shows some psychological disorders is ascertained here.AimsHere is a search for their such varient stress prior to examination & an attempt to identify their etiology so that some remedy is seen.Methods120 cases in those age group who complained of phobia 1-90 days before exam in the rural clinic in Midnapore 126k.m away from capital city of Kolkata & stayed for a follow up for 24 months were analysed. They constite 72 female & 48 males. They were followed up at 2 monthly interval & their pshychological assesment was done by psychologist. Their final diagonosis at the end of 2 year were tabulised asper criteria of ICD-10.ResultsMild mental retardation & lower side IQ< 80 were found in majority of cases (Apprxm.25%).Acute anxiety disorder was next (15%), followed by generalised anxiety disorders (10%),obsessive compulsive disorder is also revealed in about 5% cases, more in females. Other less common disorders were depressive disorders, conduct & personality disorders, & other bevavioral disorders. No pshycotic ilness like schizophrenia was revealed.ConclusionsAnxiety Disorders in varient & obscured form may be a common presenting feature of teenagers as examination phobia in first & may yields to therapy with family.