bluuebunny/crossref_metadata_2025_split huggingface dataset:
SS05-02 - Management of depression with agomelatine: A different perception
Authors: Hajak G. 
Published: May 2011

Agomelatine is a completely new approach to the treatment of depression thanks to its innovative mode of action. Acting as melatonergic agonist and 5-HT2C antagonist, it provides depressed patients with a distinctive antidepressant efficacy that perfectly suits patients’ needs and addresses all symptoms at each step of depression. Two years after the first launch in Europe, now is the time for an update from doctors and patients alike.The patient/doctor relation is key when initiating depression treatment, because patients are reluctant to start, fearing withdrawal symptoms, serious unwanted side effects, and “addiction”. It is important therefore that they understand that agomelatine has none of these effects.The benefits perceived by patients right from the first days of treatment are influential, because patients are reluctant to continue with classic antidepressants (delayed onset of perceived benefit, early side effects). The early improvement reported by patients on agomelatine supplements data on clinical benefits seen in clinical trials from the first week versus venlafaxine (CGI-I, rate of response, daytime alertness, feeling good) and after two weeks versus sertraline (twice as many HAM-D responders to agomelatine as to sertraline).Finally, patients are reluctant to maintain antidepressant treatment because of later side effects (weight gain, sexual dysfunction, emotional blunting). Patients on agomelatine confirm the absence of the classic side effects of antidepressants and are more likely to continue treatment than they are with other drugs. Both the antidepressant efficacy and the tolerability were confirmed in a large non-interventional study in a real-life setting in daily practice.
SS05-03 - Proven antidepressant efficacy of agomelatine against the full range of symptoms
Authors: Kasper S. 
Published: May 2011

Most antidepressants acting through monoaminergic systems have limitations in efficacy and tolerability and this has led to other approaches to provide patients with adequate treatment.Agomelatine is an innovative approach to depression as it resynchronizes circadian rhythms, which are disturbed in depressed patients, thanks to its action on the melatonergic MT1 and MT2 receptors, and the 5-HT2C receptors.The efficacy of agomelatine in depressed patients has been shown in several multicenter, randomized, double-blind parallel-group studies either in comparison with placebo or in 4 head-to-head studies vs an SSRI (sertraline, escitalopram, or fluoxetine in patients with more severe depression) or vs an SNRI (venlafaxine) after 6-8 weeks of treatment.Agomelatine produced a continuous improvement by significantly reducing all core symptoms of depression. Agomelatine significantly reduced the incidence of relapse in acute responders over a 6-month period (21.7% for agomelatine versus 46.6% for placebo, P = 0.0001), even in the severely depressed patients. Agomelatine was well tolerated in the short and long term.The pooled analysis of 4 head-to-head comparison studies showed after 6-8 weeks a significant difference in favor of agomelatine vs SSRIs/SNRIs in the HAM-D total score 1.37 (P < 0.001) and for responders (7.21%, P = 0.005). In addition, fewer patients withdrew due to emergent adverse events with agomelatine (6.3%) than with SSRIs/SNRIs (10.5%, P = 0.0058).Taken together these data indicate that agomelatine is an effective treatment of depression in the short and long term, with a distinctive efficacy and better tolerability than the main current treatments.
SS05-04 - Overcoming the challenges of the anxiety spectrum
Authors: Stein D. 
Published: May 2011

Anxiety disorders are considered to be the most prevalent of the psychiatric disorders, with generalized anxiety disorder (GAD) being one of the most common in primary care practice. GAD is a chronic and disabling disorder, which is frequently underdiagnosed and undertreated. It is characterized by both psychic symptoms (particularly worry) and somatic symptoms, and often complicated by comorbid conditions such as depression.Agomelatine, the first melatonergic antidepressant, has been shown to be effective and well tolerated, not only in treating major depressive disorder, but also in treating the anxiety symptoms of depression. These findings give impetus to investigation of its potential anxiolytic properties in GAD.Two randomized, double-blind, placebo-controlled studies assessed the efficacy of agomelatine in GAD. The first, a 12-week study, used the HAM-A total score as the primary outcome measure. In the second, a relapse prevention study, the responders to a 16-week open treatment period with agomelatine were randomized to maintenance treatment with either agomelatine or placebo for a 26-week period.In the short-term treatment of GAD,1 agomelatine was superior to placebo with a HAM-A total score difference of 3.28 (P = 0.04). In the maintenance treatment of GAD, the incidence of relapse was significantly lower with agomelatine than with placebo. Agomelatine was well tolerated in both trials.In summary, these studies showed that the novel antidepressant agomelatine is also efficacious in the treatment of GAD.
Update on pharmacological treatment of anxiety disorders: Where is the greatest room for imrpovement?
Authors: Baldwin D. , Meron D. , Tiwari N. 
Published: May 2011

The ideal anxiolytic drug would be effective in all anxiety disorders, with a rapid onset of action, across all symptom domains and the spectrum of severity, in achieving remission and minimising disability, in preventing relapse, and in treating comorbid depression. Ideally, the drug would be suitable for once-daily dosage, would have minimal adverse effects or cause minimal interference with everyday life, not lead to the development of tolerance, have no discontinuation symptoms, be suitable in physically ill patients and free from interactions, and be safe in overdose.But there are no ideal anxiolytic drugs. Response rates to initial treatment can be disappointing, it is not possible to reliably predict likelihood of response; a substantial proportion of patients experience unwanted effects; many will relapse despite treatment adherence; comparatively little is known about further management after initial non-response; and discontinuation symptoms can be troublesome.Hence there is much room for improvement in identifying those patients who are most likely to benefit from treatment; in choosing between drug and psychological treatments; in choosing the right drug for the right patient groups; in optimising medication dosage to achieve maximum effectiveness whilst minimising adverse effects; in combining drug treatments to enhance efficacy; and in treating over the long term to prevent relapse and recurrence.
Sociodemographic and clinical characteristics of depressive disorder in Kirkuk county
Authors: Al-Jiboori S.D.A. 
Published: May 2011

BackgroundDepression has been recognized as a major public health evidenced by its ranking of fourth position among the global burden of diseases. Many believe it will occupy second position by the year 2020. Studies have been done in Iraq and neighboring countries in the Arabic area. This is the first study in Kirkuk.Aims of the studyTo determine the clinical and sociodemographic characteristic of depressive disorders in Kirkuk county. To compare it with previous studies in Iraq and other countries. To try to draw some inferences from the study, in order to develop psychiatric services to meet the demand of this challenging disorder.Methods231 depressed patients were included, 78 men, 153 women. Outpatients attendees were included after they consented to participate. DSM IV TR criteria were used to identify cases.ResultsWomen outnumbered men (66%), unemployed were a majority (61%), rural areas were over represented (61.5%). Widowed came at the top (30%) followed by divorced (28%). The lowest rate was in Married (17%). Major depression was the most common subtype (61%) followed by dysthymia(15%), while the lowest subtype is bipolar depression 14(6%). Loss of energy or fatigue was the most frequent symptom (77%), while the lowest was suicidal idea (25%). The highest comorbidity was anxiety disorders (male14%, female46%). Alcohol and drug abuse were nonexistent in women and very low in men (3%, 5%).ConclusionThe frequency of depression subtypes among patients were as follows, major depression 61%, dysthymia 15%, psychotic depression 9.5%, postpartum depression 8.6%, bipolar depression 6%. The sociodemographic characteristic factors are consistent with some previous findings. The high comorbidity of anxiety disorders among depressed patients may be due to situational factors nowadays.
Sociodemographic and clinical features of patients with depressive disorder in Khartoum, Sudan
Authors: Omer A. 
Published: May 2011

Introduction and objectiveIt's known worldwide that depression is becoming a major health problem and its prevalence is increasing. Unfortunately very few studies were done in our country to verify this. The main objective of this study is to find out the prevalence of depression among patients attending a general psychiatric clinic, and demonstrate their Sociodemographic and clinical features.Type of studyThis is a descriptive retrospective study carried in Khartoum, Sudan.MethodFiles of patients attending a private psychiatric clinical in Khartoum in the period June 2005- June 2010 was reviewed. Only those with diagnosis of depression were chosen, socio demographic date and clinical features were documented, results were shown below.Result and discussionTotal numbers of patients with depression were 137 (11.4%) those with schizophrenia are (13%), meaning that patients with schizophrenia are brought with relatives more than patients with depression. Females are more than males (56.2%), the majority are between ages 41---60 (40.9%), married (65%), (14.9%) has got family history of psychiatric disorders, (52%) has previous history of psychiatric treatment. Regarding clinical features, depressed mood is the commonest symptom (98.5%), loss of interest (91.9%), reduced energy (57%), guilt feelings (17.9%) and (35.8%) of our samples expressed suicidal ideations. The commonest type of somatic symptoms is generalized aches and pain (30.7%). (8%) presented with nihilistic delusions. The most common prescribed antidepressants are SSRI.
Sociodemographic and clinical characteristics of depressive disorder in Saada in Yemen
Authors: Shuwail A.Y. 
Published: May 2011

BackgroundDepression has been recognized as a major public health evidenced by its ranking of fourth position among the global burden of diseases. Many believe it will occupy second position by the year 2020. This is the first study in Saada and Yemen.Aims of the studyTo determine the clinical and sociodemographic characteristic of depressive disorders in Saada country.MethodsPatients who attended the medical OPD in general hospital during six month and consented to participate in this were screened with Hospital Anxiety and Depressive Scale (HAD). Identified depressed patients were studied and results were analysis.Results714 patients attended, 20 refused to participate. 694 patients were screened by HAD Scale. 438(63%) were men. 21% were borderline and only 16% fulfilled the score for depression.72.3 suffer from loss of appetite, 50% from fatigue, 50% from loss of interest, 21% from suicidal ideas, 41% sleep disturbance and 12% of guilt feeling. 28% suffered from dizziness, 23% of gasterointestinal symptoms, and 16% from aches and pains. There was statistically significant difference between major depressive disorder and mixed anxiety and depressive disorder in that women were more. There was a trend towards statistical significance (P = 0.054) between delusions and qat chewing. There was no statistical significance with hallucination and qat chewing. Results were analysed and compared with other local and international studies.ConclusionMild depressive illness is more common in women, there was no impact of qat on depression, loss of appetite was the most common symptom. These finding are consistent with other local studies.
Telemental health in treatment of ethnic minorities in EU
Authors: Mucic D. 
Published: May 2011

Access to adequate mental health care services is one of the identified problems within EU mental health services. Increased migration into and within EU cause the increased demands for clinicians with selected skills.TeleMental Health applications could improve access to mental health care in rural, remote and under-served as well as in metropolitan areas all around EU. Telepsychiatry is the most common telemental health application. Furthermore, there are various internet based approaches to treatment of mental conditions on distance. Transcultural telepsychiatry model, developed in Denmark during last decade was aimed to treat ethnic minorities via their own mothertongue(s) by use of telepsychiatry. Patient satisfaction rapported within telepsychiatry service in Denmark is very high. The restricted physical contact and non-verbal communication of telepsychiatry compensates by the fact that the doctor and patient spoke the same language and had similar cultural and/or national references.Ongoing international telepsychiatry collaboration established between Sweden and Denmark is a success that may be exported to other european countries. The experiences from this pioneer international transcultural telepsychiatry service may contribute to further development an European Telepsychiatry Network. However, this model may be used as an inspiration for conducting of larger international telepsychiatry service capable to provide mental health care toward diversity of patient populations underserved on their mother tongue within EU.
Depression and internet addiction: Correlation and treatment approaches
Authors: Stojakovic M. 
Published: May 2011

IntroductionWith increasing use of Internet in everyday life there is the risk of developing Internet dependency that can be correlated with depression. Is the internet an antidepressant or Internet addiction often causes mood-altering side effects?ObjectivesThe focus is to examine correlation between depression and Internet addiction, as well as potential treatment approaches.AimsThe aim of the study was to evaluate treatment approaches and the correlation between depression and Internet addiction(IA) by use of Telepsychiatric service.MethodsA total of 100 Bosnian clients were studied. Internet Addiction Test (IAT), Beck Depression Inventory (BDI), and the Zung Depression Inventory (ZDI) was used, by Telepsychiatric service, to assess state measures of symptom severity. First, they were evaluated for their severity of Internet addiction with consideration of their behavioral characteristics and their primary purpose for computer use by IAT. Second, we investigated Depression by Telepsychiatry service with BDI and ZDI scale. Third, we investigated correlations between depression and Internet addiction.ResultsThe symptoms of IA had been founded at 59% and 41% of patients had no IA. Symptoms of depression had been found at 45% patients. Internet addiction was significantly associated with depressive symptoms; IA and depression had been found at 41% patients (P < 0.01).ConclusionsThis study reveals a significant association between Internet addiction and depressive symptoms.
Treatment of opioid dependence using a Tele-Psychiatry Model
Authors: Schwager H.A. ,   TeleMental Health: From Research to Clinical Practice
Published: May 2011

IntroductionOpioid dependence has increased greater that 150% from 1965–2008. Almost 2 Million Americans are currnetly opioid depndent. Approxmately 4.4 million teenagers and adults have used opioid prescription painkillers for nonmedical purposes. Greater than 75% of opioid dependnet patients in the U.S. go untreated. Greater than 60% of opioid dependent patients don't seek reatment due to lack of accessibility of treatment centers or programs.Method100 opioid dependent patients (illicit street and iatrognenic) volunteered and entered a “TELE-PSYCIATRY MODEL” for treatment of their depencence (age range 19,- 61. 58 males,42 females). Utilizing the Bupernorphen protocol, all patients were intrviewed, examined, induced, and regularly followed, ALL utilizing SECURE VIDEOCONFERENCNG interactive treatment methodologies. No in-person contact was made with any patients.Results2 patients dropped out, 98 remain in treatment, and opioid free after a 7 month average. All patients found the Tele Psychiaty model to be acceptable, effective and prefeable.
EPA Guidance on Prevention of Mental Illness and Promotion of Mental Health
Authors: Bhugra D. 
Published: May 2011

Prevention of mental illness and promotion of mental health are a significant component of any clinician's clinical work load. However, often this aspect is omitted from training and service delivery due to insufficient resources and the sheer volume of clinical load. Considerable evidence confirms that prevention can significantly reduce the onset of and subsequent related burdens to mental illness, and associated personal, social and economic costs. Often prevention and promotion get confused, and further mental illness and mental health are related but distinct dimensions. Acute mental illness usually prevents positive mental health or wellbeing, yet similarly someone without mental illness can have poor mental health and poor well being. Prevention of mental illness relates closely to and can result from promotion of mental health and associated resilience.Prevention can be categorised in multiple ways and most clinicians regularly utilise secondary and tertiary prevention. Primary prevention addresses wider determinants across whole populations. Selective prevention targets groups at higher risk of developing disorder. Secondary prevention involves early detection and intervention and corresponds to indicated prevention. This lecture summarises these challenges and the impact of mental illness, and develops the case for prevention. The risk and protective factors for mental illness and various ages of onset are presented. Interventions at different life stages are also outlined. The lecture relies on the EPA Guidance on prevention of mental ill health and promotion of mental well being using the development of UK policy as structure. Future steps will be presented within European and global context.
Position Statement of the European Psychiatric Association (EPA) on the Value of Antidepressants in the Treatment of Unipolar Depression
Authors: Möller H.-J. 
Published: May 2011

This position statement will address in an evidence-based approach some of the important issues and controversies of current drug treatment of depression such as the efficacy of antidepressants, their effect on suicidality, their place in a complex psychiatric treatment strategy including psychotherapy.The efficacy of antidepressants is clinically relevant. The highest effect size was demonstrated for severe depression. Based on responder rates and based on double-blind placebo-controlled studies, the number needed to treat (NNT) is 5–7 for acute treatment and 4 for maintenance treatment. Monotherapy with one drug is often not sufficient but has to be followed by other antidepressants or by comedication/augmentation therapy approaches.Generally antidepressants reduce suicidality, but under special conditions like young age or personality disorder, they can also increase suicidality. However, under the conditions of good clinical practice, the risk-benefit relationship of treatment with antidepressants can be judged as favourable also in this respect.The capacity of psychiatrists to individualise and optimise treatment decisions in terms of ‘the right drug/treatment for the right patient’ is still restricted since currently there are no sufficient powerful clinical or biological predictors which could help to achieve this goal. There is hope that in future pharmacogenetics will contribute significantly to a personalised treatment. With regard to plasma concentration, therapeutic drug monitoring (TDM) is a useful tool to optimize plasma levels therapeutic outcome.The ideal that all steps of clinical decision making can be based on evidence-based medicine is far away from reality. Clinical experience still has a great impact.
EPA Guidance on Conflicts of Interest
Authors: Hoschl C. , Fialova L. 
Published: May 2011

Conflict of interest (COI) is a set of circumstances that creates a risk that professional judgments or actions regarding a primary interest will be unduly influenced and compromised by a secondary interest. It might arise in clinical practice, research, and education, and might include individuals and institutions.Primary interests include the pursuit of well-being of patients, ensuring the independence of medical education, and protecting the objectivity and integrity of medical research.Secondary interests might involve financial interests, pursuit of recognition and professional career advancement. COI might result from the multiple roles of physicians in patient care, research, administration, provision of expert opinion and policy advice, and consultancy to commercial organizations. The purpose of the COI policy is to protect the interests of the patients, strengthen the integrity of the profession, and preserve public trust in medicine and psychiatry. The aim of the guidance is to eventually prevent these conflicts from arising rather than remediate them ex post. It is desirable to identify factors that might lead to their occurrence, offer a framework for their recognition and assessment, introduce the principles and standards of their disclosure, and provide recommendations for their transparent resolution.
A Multi-Centre Pragmatic Trial of Antipsychotic Drug Treatment
Authors: Kilian R. , Steinert T. , Weiser P. , Bayer W. , Jaeger S. , Pfiffner C. , Frasch K. , Eschweiler G. , Messer T. , Croissant D. , Becker T. , Längle G. 
Published: May 2011

The ELAN study is a prospective multi centre observational trial on the effectiveness and safety of long-term antipsychotic treatment of people with schizophrenia or schizoaffective disorders with quetiapine in comparison to olanzapine and risperidone under real world treatment conditions.374 adult persons with schizophrenia or schizoaffective disorder prescribed antipsychotic maintenance therapy with quetiapine, olanzapine or risperidone were included at discharge from inpatient treatment. Psychotropic regimen, psychopathological symptoms, general and cognitive functioning, negative side-effects and quality of life were assessed before discharge and at 6, 12, 18 and 24 month follow-up assessments. Intention-to-treat analyses and crossover analyses were conducted by mixed-effects regression models including random linear time effects and time x treatment effects, controlling for baseline differences and additional psychotropic medication and using propensity scores to control for selection bias.As indicated by significant linear time effects the patients improved with regard to psychopathological symptoms, general functioning, subjective quality of life and cognitive processing speed. No change of extrapyramidal motor side-effects, body mass index or waist circumference was obtained. The lack of any significant time x treatment interaction effects indicated no differences in the safety or effectiveness between the three antipsychotics. Nevertheless, the average hospital admission rate of patients receiving olanzapine was lower in comparison to patients receiving quetiapine or risperidone.