bluuebunny/crossref_metadata_2025_split huggingface dataset:
W05-01 - Rationale and Design of an RCT Comparing “EMC-Strategy” with TAU in Patients with Major Depression - the EMC Trial
Authors: Tadic A. , Gorbulev S. , Dahmen N. , Hiemke C. , Braus D.F. , Röschke J. , van Calker D. , Wachtlin D. , Kronfeld K. , Gorbauch T. , Seibert-Grafe M. , Lieb K. ,   EMC Study Group
Published: June 2010

IntroductionFor Major Depression, current guidelines recommend treatment durations of 3-8 weeks until optimisation in case of insufficient outcome. Many retrospective studies indicate that improvement (HAMD-17 decrease ≥20%) occurs usually within 10-14 days and that non-improvement after 14 days of treatment is highly predictive for poor clinical outcome.MethodsIn level 1 of the EMC trial, non-improvers after 14 days of antidepressant treatment will be randomised to “early medication change” (EMC) strategy or treatment according to current guidelines (TAU). EMC schedules treatment optimisations on day 15 and day 29 in case of non-improvement. TAU schedules a medication change after 28 days in case of non-response (HAMD-17 decrease < 50%). Both interventions will last 42 days. In levels 2 and 3, EMC strategies will be compared with TAU strategies in improvers on day 14, who experience a stagnation of improvement during the course of treatment. The EMC trial is a multi-centre, multi-step, randomised controlled trial investigating for the first time prospectively, whether non-improvers after 14 days of antidepressant treatment with EMC are more likely to attain remission on treatment day 56 compared to patients with TAU. The trial is funded by the German Federal Ministry of Education and Research (BMBF), will be conducted in cooperation with the BMBF supported Interdisciplinary Centre for Clinical Trials (IZKS) Mainz and at six trial sites in Germany.Results/conclusionsIf the EMC strategy leads to significantly more remitters, consecutive revision of guidelines, clinical practice and research settings for the treatment of MD can be expected.
Diagnosis and treatment of prepsychotic conditions
Authors: Klosterkötter Joachim 
Published: June 2010

AbstractPrevention of mental ill health has been declared a major task by the European Commission; and an early detection and intervention in psychosis in terms of an indicated (secondary) prevention in persons already seeking help for mental problems is increasingly approached across Europe both on research as well as clinical level, a mixture of both dominating. The growing interest in this field of research across Western and Western-Central Europe becomes apparent in the rapidly increasing number of publications on this topic since the turn of the century that has nearly increased by the factor of 5. The 3 leading European countries in this are Germany, the United Kingdom and Switzerland.Despite the very well reception of the ‘prevention idea’ by clinicians, researchers, relatives of patients with psychosis and clients and first promising results of early detection and/or early intervention studies, critics caution against the percentage of false-positive predictions by current prodromal criteria and the possibly unnecessary initiation of an antipsychotic psychological and/or pharmacological treatment along with its risks of unwanted side effects including early stigmatization. Supporters, however, argue that these short-comings will be overcome in the course of time and that the potential of new benign preventive interventions was just about to be discovered as well as caution against self-stigmatization by odd, eccentric behaviours and loss of functioning not recognized as part of an illness but attributed to the person him-/herself.In future, joint efforts across clinical and scientific disciplines as well as countries will be required to enhance predictive accuracy, to develop broadly applicable and risk-adapted interventions, to provide help to all in need, to extend preventive efforts to other psychiatric disorders and to possibly reach the ultimate aim, a primary prevention of mental disorders.
FC01-02 - Tanscranial Direct Current Stimulation in Depression: a Comparison Between Therapeutic Effects Obtained in Hospitalized vs Non-Hospitalized Patients
Authors: Priori A. , Ferrucci R. , Tadini L. , Vergari M. , Zanoni S. , Dobrea C. , Benatti B. , Arici C. , Bortolomasi M. , Giacopuzzi M. , Dell’Osso B. , Altamura C. 
Published: June 2010

IntroductionTranscranial direct current stimulation (tDCS) is a novel somatic treatment proposed for depressive illness.AimsWe aimed to assess the efficacy of tDCS in patients with severe, depression and whether hospitalized patients respond differently from non-hospitalized subjects.Methods28 patients (aged 36-79 year) with drug-resistant Major Depressive Episode in major Depressive Disorder or in Bipolar Disorder, according to DSM IV-TR, were enrolled. Patients were divided into two groups: ‘outpatients’ (N=14) and ‘hospitalized patients’ (N=14).HAM-D (21 items) were administered as outcome measure, before and after tDCS, to assess treatment response. tDCS delivered by a Newronika stimulator (Milano, Italy) was delivered over the dorsolateral prefrontal cortex (anodal electrode was placed on the left DLPC and cathode electrode on the contralateral area) at the intensity of 2mA, for twenty minutes, twice a day for 5 consecutive days.ResultsAll the patients well tolerated the treatment with no side effects. Despite the different severity at the baseline between the two groups (p=0.03), after five days of tDCS the mood scores improved in both groups, by 22% in outpatients group ([baseline vs post stimulation: mean± SE] HDRS: 20.3± 1.3 vs 15.9±1.8, p= 0.009) and by 32% in hospitalized patients (HDRS: 28.7± 2.7 vs 19.7±2.8, p= 0.0006). The improvement after tDCS did not differ between the two groups (p=0,3).ConclusionstDCS significantly improves patients with severe major depression after five days of treatment without significantly different effects in hospitalized and non hospitalized patients. Hence, tDCS treatment could be suitable also for non hospitalized patients at low suicidal risk.
FC01-04 - Differential Effects of Depressive Symptoms on Mortality in Middle-Aged Adults with and without CHD
Authors: Nabi H. , Shipley M. , Vahtera J. , Hall M. , Korkeila J. , Marmot M.G. , Kivimäki M. , Singh-Manoux A. 
Published: June 2010

ObjectivesDepression and mortality have been studied separately in patients with coronary heart disease (CHD) and in populations healthy at study inception. This does not allow comparisons across risk-factor groups based on the cross-classification of depression and CHD status. We prospectively examined the effects of depressive symptoms, assessed in 2002-2004, on all-cause and cardiovascular -mortality in a large sample of 5936 middle-aged participants, with and without established CHD, followed over 5.6 yearsMethods-resultsWe created 4-risk-factor groups based on the cross classification of depressive symptoms and CHD status. The age-and-sex-adjusted hazard ratios for all causes death were 1.67-fold (p< 0.05) higher for participants with only CHD, 2.10-fold (p< 0.001) higher for those with only depressive symptoms and 4.99-fold (p< 0.001) higher for those with both CHD and depressive symptoms when compared to participants without either condition. The two latter risk-factor groups remained at increased risk after adjustments for relevant confounders. Further comparisons indicated that the risks of all-cause death were also higher, but to a lesser extent, for participants with both depressive-symptoms and CHD when compared to those with only one of these conditions. These associations were also observed for cardiovascular mortalityConclusionsThis study provides evidence that depressive symptoms are associated with an increased risk of all-cause and CVD death and that this risk is particularly marked in depressive participants with co-morbid CHD. Several clinical guidelines have recommended screening, referral, and treatment of depression in primary and cardiovascular care units. These findings suggest that these recommendations need further consideration.
FC02-01 - Trait Aggression in Adult Psychiatry is Predicted by Childhood Hyperactivity, Conduct Disorder, Adult Substance Abuse, and Low Cooperativeness
Authors: Hofvander B. , Ståhlberg O. , Nydén A. , Wentz E. , degl’Innocenti A. , Billstedt E. , Forsman A. , Gillberg C. , Nilsson T. , Råstam M. , Anckarsäter H. 
Published: June 2010

The prevention of aggressive behaviours is a core priority for psychiatric clinical work, but the association between the diagnostic concepts used in psychiatry and aggression remains largely unknown.ObjectiveWe aimed to describe aggression according to the subscales formed in the Life History of Aggression (LHA) in relation to life-time psychiatric diagnoses.Methods178 adults referred for psychiatric evaluations of childhood-onset neuropsychiatric disorders (outpatients) and 92 perpetrators of violent crimes referred to pre-trial forensic psychiatric investigations had comprehensive, instrument-based, psychiatric assessments, including the LHA scales. Total and subscale LHA scores were compared to the categorical and dimensional diagnoses of childhood and adult DSM-IV axis I and II mental disorders, general intelligence, GAF, and personality traits according to Cloninger's biopsychosocial model.ResultsThe two groups had similar LHA scores (despite higher scores on the Antisocial scale in the offender group). Higher total LHA scores were independently associated with the hyperactivity facet of attention-deficit/hyperactivity disorder (AD/HD), childhood conduct disorder, substance-related disorders, and low scores on the Cooperativeness character dimension according to the Temperament and Character Inventory. IQ and GAF-scores were negatively correlated with the LHA subscale Self-directed aggression. Autistic traits were inversely correlated with aggression among outpatients, while the opposite pattern was noted in the forensic group.ConclusionIn these study groups, aggression was predicted by childhood behaviour aberrations, adult substance-related problems, and character immaturity rather than by symptoms associated with the major mental disorders. AD/HD in combined or hyperactive, but not inattentive, forms, was associated with high scores on aggressive behaviours.
FC03-04 - The Importance of Measuring Functional Impairment with the Composite International Diagnostic Interview in Depression Research. A PredictD-Spain Study
Authors: Moreno-Kustner B. , Motrico E. , Bellón J. , Gil-de-Gómez-Barragán M.J. , Díaz-Barreiros M.A. , Martínez-Cañavate M.T. , Vázquez-Medrano A. , March S. , Torres-González F. ,   Predict Spain Group
Published: June 2010

ObjectiveTo determine the association between functional impairment, as reported in a lay-administered structured interview (CIDI), and severity of depression, depressive symptoms and risk factors for depression.MethodsWe undertook a cross-sectional study of 5442 consecutive attendees at general practices in seven Spanish provinces participating in the PredictD-Spain study on predictors of depression. Participants were administered the depression section of the Composite International Diagnostic Interview (WHO-CIDI 2.1), allowing diagnoses by the ICD-10 and DSM-IV classifications for depressive episodes. Impairment was measured using the CIDI question about whether symptoms seriously interfered with important areas of functioning, such as work or looking after the house and family. We measured a set of 39 known risk factors for depression.ResultsFirstly, the 6-month prevalence of a depressive episode according to ICD-10 was 28.7% (1563) and of major depression according to DSM-IV it was 13.6% (742). Secondly, out of the 1563 patients with a depressive episode according to ICD-10, nearly half (47.9%; n=749) had no impairment in important areas of functioning.ConclusionsAs the ICD-10 criteria for depressive diagnoses do not include the criteria that symptoms cause impairment in social, occupational or other important areas of functioning, a large number of false positive cases are included in reported prevalence rates; and secondly, the measurement of functional impairment, at least operationalized using a lay-administered structured interview such as CIDI, is not enough, in epidemiological research studies, to assess the clinical importance of depressive symptoms.
YSFC01-06 - Perspectives of Using Neuroimaging Methods in Differential Diagnosis of Depression
Authors: Lebedev A. , Korzenev A. , Abritalin E. , Tarumov D. , Fokin V. , Sokolov A. 
Published: June 2010

IntroductionDepression is one of the most common mental health problem and it grows greater every year around the world.AimsThe main aims were to analyze the possibility of using functional and structural neuroimaging methods in diagnosis of different depression types and to find the predictors of pharmacological resistance.Materials & methods46 patients with depression syndrome were distributed into 3 groups: 1) Neurotic Depression (Diagnosis: Adjustment disorders) - ND group; 2) Endogenous Depression (Diagnosis: Recurrent Depression, Bipolar Affective Disorder - current depressive episode, Schizoaffective disorder, depressive type) - PD group, 3) Depression due to organic pathology (Diagnosis: Organic depressive disorder, Organic mixed affective disorder) - OD group. Controls were 18 years old- and gender-matched healthy participants. We used several methods of functional (positron-emission tomography, functional magnetic resonance imaging) and structural (voxel-based morphometry, diffusion-tensor imaging) neuroimaging.ResultsWe found several functional and structural abnormalities in limbic structures within all three groups. Some of them were the same, some were different. Also we found several functional and structural predictors of pharmacological resistance.ConclusionsWe found several functional and structural abnormalities in all three depressive groups. Almost all of them were parts of so-called frontal-subcortical circuits, dysfunction of which, according to the present knowledge, could play crucial role in depression pathogenesis.Summarizing our own results and analyzing the data of our colleagues, we complement a theory of depression pathogenesis and propose an original point of view for neurobiological basis of different types of depressive disorders and its pharmacological resistance.
P01-03 - Biomarkers for Changes in Self-regulation Through Cognitive Behavioral Therapy for Depression
Authors: Nocon A. , Keck K. , Pfister H. , Heldmann B. , Rosenhagen M. , Uhr M. , Lucae S. , Ising M. 
Published: June 2010

Depressed patients show a disturbed hypothalamic-pituitary-adrenal (HPA) axis regulation, resulting in increased cortisol levels, inadequate cortisol suppression following a low dose of dexamethasone, increased concentrations of corticotropin releasing hormone (CRH) in the cerebrospinal fluid, and a blunted adrenocorticotropic hormone (ACTH) response following CRH administration. Treatment with antidepressants, but seemingly also cognitive behavioral therapy (CBT), is associated with an improvement of a disturbed HPA-axis regulation, which can be most sensitively evaluated with the combined dexamethasone (dex)/CRH test. Favorable response to antidepressant treatment can be predicted at an early stage by determining the degree of normalization of HPA-axis function under treatment in a second dex/CRH test.We report about the predictive validity of HPA-axis normalization on the favorable response of CBT in medicated depressed patients.Medicated depressed patients receiving CBT at the Max-Planck-Institute of Psychiatry in Munich are studied using the State-Trait-Angstinventar (STAI), Beck Depression Inventory (BDI), Volitional-Components-Questionnaire (VCQ-3), Emotion-Regulation Questionnaire (EPQ) and the Self-Control and Self-Management Scale (SCMS). Neuroendocrine parameters including measures of HPA-axis regulation are measured before and after therapy via dex/CRH test.Up to the present moment data for N=38 depressed patients have been collected (N=21 male, 25-78 years; N=17 female, 21-80 years). The mean level of depression and anxiety showed a significant decrease between pre- and post-treatment measurement. Measures of perceived self-regulation and self-estimation increased and measures of perceived self-inhibition and inhibition of will decreased.The expected changes in depression, anxiety and self-regulation after treatment with antidepressants and CBT were observed. Endocrine data are currently under analysis.
P01-106 - Verbal Working Memory Capacity in Patients with Chronic Schizophrenia, Chronic Depression, and Healthy Participants
Authors: van den Noort M. , Bosch P. , Kueppenbender N. , Mondt K. , van de Craen P. , Yeo S. , Lim S. 
Published: June 2010

ObjectivesThe new standard computerized reading span test (RST), which is a complex verbal working memory test, was used for the first time in the assessment of verbal working memory capacity (Van den Noort et al., 2008) in two clinical populations.MethodsSixty participants, divided over three different groups; 20 patients with chronic schizophrenia, 20 patients with chronic depression, and 20 healthy participants, entered the study. The selection of the participants was based on strict inclusion and exclusion criteria. There was no comorbid depression in the patients with schizophrenia, as measured by the BDI-II. A comparison was made between the 3 different groups with respect to their verbal working memory capacity. The new standard computerized RST (Van den Noort et al., 2008) was used.ResultsIn this study, in line with previous studies, a significant decrease in verbal working memory capacity and a general slowing down was found in chronic patients with schizophrenia and chronic patients with depression in comparison with healthy participants. In addition, patients with schizophrenia showed a nearly significant higher reading span score but were significantly slower than the chronic patients with depression.ConclusionsThe new standard computerized RST (Van den Noort et al., 2008) is a suitable complex verbal working memory test that could be used for clinical applications, for instance, for the assessment of verbal working memory capacity in patients with chronic schizophrenia and chronic depression.
P01-111 - Study of the Factors that Contributes to the Relapse of the Major Depression
Authors: Kyloudis P. , Georgiadis M. , Rekliti M. , Wozniak G. , Mouzas O. , Roupa Z. 
Published: June 2010

ObjectivesTo probe the factors that contributes to the relapse of the major depression after being hospitalized for a period of three consecutive months in a psychiatric clinic.Material & methods22 patients (8 men) who were in the clinic were examined (average age 49.2, SD=7.2) suffering from major depression and who fully recovered between episodes. The criteria for their participation in the sample were according to DSM-IV®, and the >2 relapses/year.ResultsBy the stepwise multiple regression analysis it was found that by hierarchy the factors that cause the relapse are, the fact that the patient does not respond to the first antidepressant treatment (parameter estimate p< 0.002), child or teenage depression background (p< 0.002), the presence of stressful facts (diseases, financial problems, loss of 1st degree relatives, p< 0.004) and the co morbidity with character disorders in the II (p< 0.01) axis.ConclusionsThe importance of a negative outcome of the major depression should be co estimated with the danger of self-destruction as a result of the illness, the difficulties of the interpersonal relationships, the professional activities, the impact on the family, alcoholism, drug abuse etc. and mainly the empirical impact on the patient.
P01-15 - Neural Correlates of Cognitive Control in Major Depressive Disorder
Authors: Brühl A. , Rufer M. , Baur V. , Kaffenberger T. , Herwig U. 
Published: June 2010

ObjectivesCognitive control of emotions by reappraisal strategies is a psychotherapeutic technique reducing emotional load and anxiety in stressful situations. A previous study in healthy subjects resulted in a top-down regulatory effect by reappraisal during the anticipation of negative and unknown cued emotional stimuli as expressed by increased medial prefrontal cortical activation and accordingly reduced amygdalar activity. We were now interested in neurobiological changes in patients with major depressive disorder (MDD) compared to healthy controls during the application of cognitive control.Methods20 patients suffering from a depressive episode in the course of MDD and 20 healthy subjects underwent functional magnetic resonance imaging. All subjects were instructed and trained to apply a ‘reality check’ as cognitive control strategy during the cued anticipation of known negative and possibly negative, thus unknown (50% positive/negative) emotional stimuli.ResultsApplying cognitive control during the anticipation of negative and unknown cued stimuli, depressed patients had lower brain activity compared to healthy controls in thalamic and occipital regions as well as in the right extended amygdala, in the anterior cingulate cortex and the right anterior insula. Brain activity was increased in depressed patients in the right precentral gyrus and the left superior temporal gyrus/posterior insular region (close to Wernicke region).ConclusionWe found several areas with reduced and also increased activations in MDD compared to healthy controls. We found no obvious deficits in this preliminary analysis in regions as the amygdala and the MPFC, corresponding to the hypothesized deficits in cognitive control mechanisms in MDD.
P01-16 - Similarity of the Neural Correlates of Neuroticism and Affective Measures, but not with Extraversion
Authors: Brühl A. , Viebke M.-C. , Kaffenberger T. , Herwig U. 
Published: June 2010

ObjectivesExtraversion and neuroticism are differentially correlated with affective disorders: Neuroticism is strongly correlated with depression and anxiety disorders, whereas extraversion is rather negatively correlated with anxiety disorders. Theories have implicated a common biological basis of neuroticism and affective disorders.MethodsThis study examined neural correlates of neuroticism and extraversion as well as of affective measures with functional magnetic resonance imaging using a task addressing pessimistic emotion processing during the cued anticipation of emotional stimuli in 14 healthy subjects. The measures of personality and affectivity were used as primary covariates for the correlation with brain activity during the anticipation of emotional versus neutral stimuli to identify brain regions in which individual brain activity was strongly correlated with psychometric measures.ResultsNeuroticism, depression and anxiety were correlated with brain activity in parieto-temporo-occipital regions, functionally involved in visual-perceptual processing and attentional modulation, and also in caudate regions. Extraversion was correlated with brain activity particularly in prefrontal regions.ConclusionsOur results point to possible common neural correlates of neuroticism and the affective measures, whereas extraversion seems to have a differential neurobiological basis. Particularly, the correlation with caudate regions, involved in implicit patterns of reaction, points to possible “automatized” biases in neuroticism and depression.