bluuebunny/crossref_metadata_2025_split huggingface dataset:
PW01-14 - Lithium Placental Passage and Perinatal Outcome: Clinical Management During Late Pregnancy
Authors: Imaz M.L. , Torra M. , Santos-Lozano C.C. , Torres A. , Marqueta C. , Hernández J.M. , Pérez J.M. , Teixido I. , Martín-Santos R. , García-Esteve L. 
Published: June 2010

IntroductionDespite lithium has been used for the last 50 years as a maintenance treatment for bipolar disorder during pregnancy, there is limited information about perinatal clinical outcomes from fetal exposure to lithium.Objectives1.To quantify the rate of lithium placental passage2.To assess any association between plasma concentration of lithium at delivery and perinatal outcome.MethodsObservational and prospective study. Subjects: Women in maintenance treatment with lithium, being attended during pregnancy at the Perinatal Psychiatry Programme of Hospital Clínic (Barcelona, Spain) between 2007 and 2009. Procedure: We assessed sociodemographical data; dose/day of lithium carbonate; other drugs doses; plasmatic concentration of lithium carbonate in maternal blood intrapartum and in the umbilical cord; obstetrical maternal complications; gestational age at delivery; weight at delivery; Apgar scores; congenital malformations; hospital stays, infant serum concetrations of thyroid-stimulating hormone.ResultsEight mother-child diads. Mean age of the mother (SD): 32.1 (4,7); 100% caucasian and married. Mean dose of maternal lithium (SD): 675mg (237,5mg). Premature rupture of membranes (%):25. Gestational mean age (in weeks) (SD): 39,9 (1). Birth weight (SD) : 3625gr (451,2gr); Mean Apgar1min (SD): 8,38 (1,1); Mean Apgar5min (SD): 9,75 (0,4). Loss of fetal intrapartum wellness (%): 12,5. Days of hospitalization (mean) (SD):9,5(16,6). Lithium plasmatic concentration (mEq/L), mean (SD): maternal 0,45(0,1), umbilical cord 0,33(0,1), lithium ratio uc/m 0,93 (0,3); infant TSH μU/mL mean (SD): 4,9(4,6).ConclusionsLithium placental passsage was 0,93 (0,63-1,07). ≤At umbilical cord lithium levels ≤ 0.60 mEq/L, we didn't have any preterm deliveries, low birth weight newborns, nor neonatal complications.
PW01-19 - Rumination is Influenced by a Genetic Interaction Between GIRK2 Receptor and CREB in Two Independent European Samples
Authors: Lazary J. , Juhasz G. , Anderson I. , Deakin J.F. , Bagdy G. 
Published: June 2010

ObjectivesRumination is a significant cognitive symptom of depression. As rumination is strongly related to altered memory function we selected two genes previously described as important candidates for both depression and memory processing to assess their contribution to rumination. Based on a possible functional role for cAMP-dependent protein kinase in the mechanism of action antidepressants, we studied the association between G protein-activated K+ channel 2 (GIRK2) and cAMP-response element binding (CREB) protein genes and rumination in two independent European samples.MethodsWe genotyped an exonic SNP (rs2070995) in GIRK2 gene and a promoter SNP (rs2253206) in CREB gene of 611 individuals from Budapest and 1174 individuals from Manchester. Rumination was measured by Ruminative Response Scale (RRS) of Response Style Questionnaire. Generalized linear models (GLMs) were performed for single marker associations. Likelihood ratio tests were used for interactions between genetic markers on RRS.ResultsSingle marker associations did not provide any significant individual effect of the two SNPs on rumination. However, interaction analyses revealed a strongly significant interaction between the rs2070995 and rs2253206 on RRS in both European samples (pBudapest=0.00099; pManchester=0.0027). Homozygous TT individuals for rs2070995 in interaction with homozygous GG for rs2253206 scored significantly higher on RRS compared with other genotypes.ConclusionOur results suggest that two key post-receptor signalling proteins, GIRK2 and CREB, interact with each other in regulating the process of rumination which may have relevance for depression and its treatment.These studies were supported by the Sixth Framework Programme of the EU, LSHM-CT-2004-503474, HRF T03298/2000.
PW01-24 - Evaluation of the Effects of Quetiapine XR Monotherapy According to MDD Severity: Pooled Data From 4 Placebo-controlled Trials
Authors: Montgomery S. , Thase M. , Papakostas G. , Bauer M. , Trivedi M. , Svedsäter H. , Udd M. , Gustafsson U. , Eriksson H. 
Published: June 2010

ObjectivesEvaluate the effects of once-daily extended release quetiapine fumarate (quetiapine XR) monotherapy in patients with major depressive disorder (MDD) according to disease severity.MethodsPooled data (quetiapine XR 50, 150 and 300mg/day doses combined) from four 6- or 8-week placebo-controlled quetiapine XR monotherapy studies (D1448C00001, D1448C00002, D1448C00003, D1448C00004) were analysed. Key inclusion criterion for all 4 studies: HAM-D total score ≥22. Primary endpoint: change from randomisation in Montgomery-Åsberg Depression Rating Scale (MADRS) total score. A post-hoc analysis assessed change from randomisation in MADRS total score and MADRS response (≥ 50% reduction in MADRS total score) at endpoint (Week 6 or Week 8) in 6 severity cohorts (defined by a MADRS total score at randomisation ≥24, ≥26, ≥28, ≥30, ≥32 or ≥34).Results1752 patients (comprising the l’ all patients’ group) were evaluated (MADRS score ≥24 at randomisation, n=1601; ≥26, n=1467; ≥28, n=1269; ≥30, n=1038; ≥32, n=745; ≥34, n=500). Quetiapine XR significantly reduced mean MADRS total score at endpoint in lrsquo;all patients’ (p< 0.001 vs placebo) and in all 6 severity cohorts (≥24, ≥26, ≥28, ≥30 and ≥32, p< 0.001 vs placebo; ≥34, p< 0.01 vs placebo). MADRS response rates were significantly higher in the quetiapine XR group vs placebo in the ‘all patients’ group (p< 0.001 vs placebo) and in all 6 severity cohorts (≥24, ≥26, ≥28, ≥30 and ≥32, p< 0.001 vs placebo; ≥34, p=0.001 vs placebo).ConclusionsQuetiapine XR monotherapy significantly improved depressive symptoms in patients with MDD irrespective of disease severity, including the most severe levels of depression.AstraZeneca funded
PW01-25 - Extended Release Quetiapine Fumarate (quetiapine XR) In Patients With MDD: Results From 8 Placebo-controlled Studies
Authors: Montgomery S. , Kalali A. , Earley W. , Szamosi J. , Eriksson H. 
Published: June 2010

ObjectivesTo evaluate once-daily extended release quetiapine fumarate (quetiapine XR) as monotherapy (50, 150 and 300mg/day) (acute and maintenance treatment) or adjunct treatment (150 and 300mg/day) in patients with MDD.MethodsEight (7 acute, 1 maintenance) placebo-controlled studies were analysed. Primary endpoints: change from randomisation in Montgomery-Åsberg Depression Rating Scale (MADRS) scores (acute); time from randomisation to depressed event (maintenance). Statistical analyses: ANCOVA for difference between quetiapine XR and placebo in LSM change in MADRS total score from randomisation to study end (LOCF; acute); hazard ratio (HR) for time to recurrence of a depressed event (maintenance).ResultsFigure 1 shows treatment differences (95% CIs) for primary efficacy variable for the seven acute studies. Four monotherapy studies (D1448C00001, D1448C00002, D1448C00003, D1448C00014) were significant in favour of quetiapine XR; Study D1448C00004 (monotherapy) was not. Studies D1448C00006 and D1448C00007 were significant in favour of adjunct quetiapine XR. Time from randomisation to depressed event (Study D1448C00005) significantly increased with quetiapine XR; HR (95% CI): 0.34(0.25, 0.46); p< 0.001; number of depressed events: 55, quetiapine XR; 132, placebo. Safety findings were consistent with the known tolerability profile of quetiapine.ConclusionsQuetiapine XR consistently demonstrated antidepressant efficacy, with 6/7 acute studies positive in favour of quetiapine XR (monotherapy or adjunct). Quetiapine XR maintenance therapy significantly reduced risk of a depressed event, demonstrating relapse prevention. AstraZeneca funded
PW01-28 - Asenapine as Adjunctive Treatment For Bipolar Mania: A Placebo-controlled 12-week Study and 40-week Extension
Authors: Calabrese J. , Stet L. , Kotari H. , Zhao J. , Kouassi A. , Szegedi A. , Panagides J. 
Published: June 2010

ObjectivesAsenapine is indicated in adults for acute treatment of schizophrenia and bipolar I disorder. We describe the efficacy and tolerability of adjunctive asenapine in bipolar patients showing incomplete response to lithium or valproate monotherapy.MethodsIn a 12-week core study, patients were randomized to flexible-dose asenapine (5 or 10 mg BID) or placebo as an adjunct to continued mood stabilizer therapy. Patients completing the core study without protocol violations could enter a 40-week extension. Changes from core study baseline on the Young Mania Rating Scale (YMRS) and Montgomery-Asberg Depression Rating Scale (MADRS) total scores were assessed at week 3 of the core study and at week 52 in the extension. Efficacy in the core study was assessed using ANCOVA with LOCF to impute missing data. The extension was not powered for statistical comparisons; descriptive statistics were employed.ResultsThe intent-to-treat population comprised 318 patients (asenapine, 155; placebo, 163) in the core study and 71 (38; 33) in the extension. Mean±SD changes at week 3 with asenapine and placebo, respectively, were -9.7±10.1 versus -7.7±9.6 (P=0.0257) on YMRS and -2.8±7.2 versus -2.2±6.8 (P=0.3684) on MADRS. Mean±SD changes at week 52 with asenapine and placebo were -17.2±13.7 versus -19.7±11.8 on YMRS and -3.3±9.8 versus -3.9±7.7 on MADRS. The incidence of treatment-emergent AEs with asenapine and placebo was 73% and 69% in the core study, 78% and 69% in the extension.ConclusionsAsenapine was effective as an adjunct to mood stabilizer in bipolar I disorder and was well tolerated.
PW01-35 - A Prospective Study of Mixed Bipolar Patients: Ten Years of Follow Up
Authors: Ugarte A. , García J. , Ruiz de Azúa S. , González I. , Sáenz M. , Gutierrez M. , Valcarcel C. , Zuhaitz E. , de la Rosa I. , Alonso R. , González-Pinto A. 
Published: June 2010

IntroductionMixed Bipolar patients are those who have co-existing depressive symptoms during mania. These patients are supposed to have a worse evolution.ObjectiveThe objective of this study was to compare the long-term outcomes of patients who had at least one mixed episode with those who experienced only pure manic episodes.Methods169 outpatients diagnosed of Bipolar I disorder and treated at least during two years were included. 120 patients (71%) complited the follow-up over 10 years. Baseline demographic and clinical variables were included.ResultsThe patients with mixed episodes (37%) had a significantly younger mean age at onset comparing with those with manic episodes (25.3 years vs. 30.8 years; p=0.025) they also had more previous mood- incongruent psychotic symptoms χ2= 6.77, p=0.034), more number of hospitalizations (OR= 1.36, 95% CI = 1.14; -1.63; p< 0.001), and more number of episodes (OR= 1.21, 95% CI = 1.10-1.31; p< 0.001). There were no significant differences relating to depressive episodes, alcohol use, drug abuse, suicidal behaviour and suicide attempts.DiscussionAge at onset differed significantly between the mixed episode and pure mania groups, with mixed episode patients having a younger age of onset. This is interesting as one of the major results of the study we have found that age at onset mediates some of the factors classically related to outcome in mixed episodes like alcohol abuse and suicide attempts. However, independently of age at onset, these patients represent a especially severe type of bipolar disorder.
PW01-36 - The Long-term Safety, Tolerability And Effectiveness Of Adjunctive Aripiprazole To Lithium/valproate In Bipolar i Patients Partially Non-responsive To Mood Stabilisers
Authors: Vieta E. , Owen R. , Baudelet C. , McQuade R. , Sanchez R. , Fyans P. , Loze J.-Y. , Marcus R. 
Published: June 2010

ObjectiveTo evaluate the long-term tolerability and effectiveness of aripiprazole adjunctive to lithium or valproate in bipolar mania.MethodsCompleters of a 6-week double-blind comparison of adjunctive aripiprazole versus placebo in bipolar mania partially responsive to monotherapy were followed up over 46-weeks on open-label aripiprazole plus lithium (ARI+LI) or valproate (ARI+VAL).Results283 (ARI+LI n=108; ARI+VAL n=175) patients entered and 146 (ARI+LI n=55; ARI+VAL n=91) completed the 46-week extension. Safety results for both combinations were consistent with the known tolerability profile of aripiprazole, lithium and valproate. No clinically significant changes in lipids or glucose were observed with either ARI+LI or ARI+VAL. Mean (SE) weight change from double-blind endpoint to Week 46 (LOCF) was 2.3 (0.6) kg with ARI+LI and 2.0 (0.4) kg with ARI+VAL. Temporal analysis of the time of first onset of adverse events showed that akathisia and insomnia tended to occur early in treatment, with few new cases in patients previously treated with aripiprazole during the 6-week study.Significant improvements from baseline in YMRS total score and MADRS total score were sustained over the 52 weeks with both ARI+LI and ARI+VAL treatment.Mean reduction from baseline at Week 52 LOCF[95%CI], p value vs baselineARI+LIARI+VALYMRS total score-16.5 [-18.1; -14.8], p<0.001-17.6 [-18.9; -16.3] p<0.001MADRS total score-1.7 [-3.3; -0.1] p<0.05-2.7 [-4.0; -1.4] p<0.001ConclusionsLong-term aripiprazole adjunctive to lithium/valproate in bipolar mania was safe and well-tolerated. Improvements in manic and depressive symptoms observed during the first 6 weeks of treatment were maintained.
PW01-39 - Characteristics of Patients With Hypomanic Symptoms Presenting a Current Major Depressive Episode Identified With The Hcl-32 Patient Questionnaire
Authors: Vieta E. , Angst J. , Azorin J.-M. , Bowden C.L. , Perugi G. , Young A.H. ,   for the BRIDGE Study Group
Published: June 2010

ObjectivesTo evaluate the extent of hypomanic symptoms in patients presenting with a current major depressive episode (MDE) and to identify characteristics differentiating patients with hypomanic symptoms from those with pure unipolar depression, using the HCL-32 self-assessment tool.MethodsThis cross-sectional diagnostic study was performed in eighteen countries. Community- and hospital- based psychiatrists included consecutively all consulting adult patients with a diagnosis of MDE and completed a questionnaire on sociodemographic variables, diagnosis, medical history, treatment and comorbid psychiatric disorders. Each patient completed the Hypomania Self-Rating Scale (HCL-32 R2), and those scoring ≥14 were assigned a diagnosis of bipolar disorder. The frequency of study variables in the bipolar disorder (BD) and unipolar depression subgroups were compared.ResultsA total of 5635 patients were included. Overall, 1645(39%) had received a diagnosis of BD, 703(16%) fulfilled DSM-IV-TR criteria for BD and 2942(54%) scored ≥14 on the HCL-32. Patients scoring ≥14 on the HCL-32 were significantly more likely to have experienced a mood switch in response to antidepressants (OR:3.4), a family history of bipolarity (OR:2.4), comorbid substance abuse (OR:2.1) or borderline personality disorder (OR:1.7) and current mixed-state symptoms (OR:1.5).ConclusionsIn patients with DSM-IV MDE self-assessed, hypomanic symptoms were present in 54% of patients, whereas only 16% fulfilled DSM-IV criteria for bipolar disorder. However, these patients presented features recognised to be associated with bipolar disorder. The presence of bipolarity in patients presenting with a major depressive disorder may be frequent and use of this questionnaire would contribute to improve awareness and prompt better diagnosis.
PW01-40 - Reward Learning and Processing In Euthymic Bipolar Patients: Insights From Behavioural and Neuroimaging Studies
Authors: Wessa M. , King A.V. , Bongers A. , Hennerici M.G. , Gass A. , Linke J. 
Published: June 2010

IntroductionDysregulation of motivation and altered processing of reward represent important diagnostic criteria of bipolar disorder and have been proposed as a trait marker of the disorder. Until now, only few studies investigated the processing of reward and learning through reward and punishment in euthymic bipolar patients (BP).Objectives/aimsTwo studies were conducted to investigate mechanisms of reward learning and processing in euthymic BP and healthy individuals (HC).MethodsIn the first study, 23 euthymic BP, 15 remitted patients with Major depression (MD) and 16 HC participated in an associative learning task, assessing the efficiency of contingency learning as well as the preference to learn through positive or negative feedback. In the second study, a probabilistic reversal learning task was conducted during functional magnetic resonance imaging. Here, the neural correlates of reward and punishment were assessed in 22 euthymic BP and 21 HC.ResultsWe observed no group differences for the efficiency of contingency learning. However, euthymic BP with a manic episode prior to remission learned better from positive feedback whereas euthymic BP with a depressed episode prior to remission and remitted MD patients learned better from negative feedback. HC did not show such preferences in learning. In addition, bipolar patients exhibited increased orbitofrontal and parahippocampal activity in response to reward but no differences in response to punishment.ConclusionsInterestingly, the last episode seems to differentially affect emotional and learning processes during euthymia. On a neural level, euthymic BP seem to be more sensitive to reward than healthy individuals.
PW01-41 - Mania Induced By Mefloquine Prophylaxis: Case Description And Literature Review
Authors: Yelmo S. , Morera A. , Henry M. , Renshaw A. , 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 resultsThe case describes a 26-year-old Spanish woman who 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.
PW01-43 - White Matter Integrity In Social Anxiety Disorder - a Diffusion Tensor Imaging Study
Authors: Baur V. , Hänggi J. , Rufer M. , Jäncke L. , Herwig U. , Brühl A. 
Published: June 2010

ObjectivesSocial anxiety disorder (SAD) is characterized by anxiety in situations in which one may be evaluated or be in focus of attention by others. Functional neuroimaging studies revealed hyperactivity of the amygdala in response to social cues like faces in patients with SAD. To date, little is known about the neuroarchitecture of SAD. We hypothesized structural alterations in white matter regions projecting to or from the amygdala such as the uncinate fasciculus.MethodsDiffusion tensor imaging (DTI) was applied in 26 patients with SAD and 24 healthy controls (HC). White matter integrity was assessed by fractional anisotropy (FA), a measure of fiber coherence and integrity. In addition, individual scores of trait anxiety were correlated voxel-wise with FA values.ResultsPatients with SAD showed reduced global mean FA across the whole brain and locally in regions near the left amygdala, thalamus, cerebellum, cingulate cortex/corpus callosum, and in the corticospinal tract. Furthermore, trait anxiety correlated negatively with FA in a similar region as in the group comparison near the left amygdala, probably representing the left uncinate fasciculus.ConclusionsReduced white matter integrity in patients with SAD was found globally as well as locally in different brain regions. The region near the left amygdala/uncinate fasciculus was the only one yielding significance in both the FA group comparison and voxel-wise correlation with trait anxiety. This points to a functional role of this fiber tract in anxiety and emotion regulation, for instance in top-down inhibition of the amygdala by the frontal cortex.
PW01-44 - Impact of Glyoxalase-1 Mrna Expression On Cck-4 Induced Anxiety
Authors: Eser D. , Leicht G. , Laenger A. , Schuele C. , Baghai T. , Mulert C. , Uhr M. , Rupprecht R. 
Published: June 2010

ObjectivesThere is evidence that the antioxidant enzyme glyoxalase-1 (Glx-1) may play a role in anxiety-related behaviour. However, discordant findings between Glx-1 expression and anxiety-related behaviour have been observed in animal models. Because no data are available on the relation between Glx-1 mRNA expression and human anxiety so far, we investigated the expression of Glx-1 mRNA in peripheral red blood cells in relation to cholecystokinin-tetrapeptide (CCK-4) induced anxiety in healthy subjects.MethodsTwenty-three healthy subjects underwent challenge with CCK-4. Glx-1 mRNA expression was assessed by quantitative real-time polymerase chain reaction prior to CCK-4 injection. Baseline anxiety was assessed with the State-Trait-Anxiety-Inventory (STAI) and panic response was measured with the Panic Symptom Scale (PSS).ResultsCCK-4 elicited a marked anxiety response accompanied by a significant increase in heart rate. Glx-1 mRNA expression correlated significantly with severity of CCK-4 induced anxiety. In contrast, Glx-1 activity did not correlate with state or trait anxiety.ConclusionsThe positive correlation between Glx-1 mRNA expression and CCK-4 induced panic severity suggests that Glx-1 is involved into the acute anxiety response to CCK-4. Our preliminary findings support preclinical findings and point towards a role of Glx-1 for human anxiety.