bluuebunny/crossref_metadata_2025_split huggingface dataset:
Burn-out indexes in mental health services employees and satisfaction in patients with a diagnosis of bipolar disorder
Authors: Harnic D. , Cardella A. , Mazza M. , Catalano V. , Bruschi A. , Janiri L. , Romano C. , Callea A. 
Published: May 2011

ObjectivesThe aim of our study is the investigation of burn-out indexes in public mental health services employees (psychiatrists, psychologists, nursing staff, care providers) working with patients affected by Bipolar Disorder in order to correlate them with patients’ indexes of satisfaction about received treatment and care.MethodsA sample of 20 employees of mental health services (psychiatrists, psychologists, nurses) and one consisting of 22 patients with a diagnosis of Bipolar Disorder have been recruited at the Bipolar Disorders Unit of the Day Hospital of Psychiatry of the A. Gemelli Hospital in Rome. Operators have been submitted the Maslach Burnout Inventory (Emotional distress, Depersonalization, Personal satisfaction/achievement/fulfilment) while patients have been submitted the Questionnaire on Satisfaction of patient (QS)ResultsBy calculating the Spearman Correlation Coefficient the Depersonalization dimension proves highly correlated with the three subscales of QS: Doctor-Patient relationship quality (-.51); Information Quality and Doctor's therapeutic competence (-.48); Efficiency of service organization (-.58)ConclusionsIn our sample high levels of Depersonalization are correlated to a low satisfaction of patients. We therefore expect low levels of Depersonalization to be correlated with a higher satisfaction of the patient. Although it is not possible to generalize these results we can hypothesize that burn out negatively influences patients’ satisfaction.
Is theory of mind impairment a trait-marker in bipolar disorder?
Authors: Ioannidi N. , Konstantakopoulos G. , Patrikelis P. , Economou A. , Sakkas D. , Ploumpidis D. , Oulis P. 
Published: May 2011

ObjectivesPrevious studies have provided evidence for Theory of Mind (ToM) impairment in bipolar disorder (BD). The aim of the study was to determine whether ToM impairment can be considered as a trait- marker or a state characteristic of BD.MethodsToM was assessed in 29 patients with bipolar-I during an episode and in remission as well as in 29 pair-matched for age, gender and education level healthy controls. Three different ToM tests were used (multilevel assessment): First Order False Belief Stories, Hinting Test, Faux Pas Recognition Test. Attention, memory, verbal learning ability, visuospatial ability, executive functions were also assessed using WAIS – Vocabulary, Block design, and Digit span, Stroop Test, Rey Auditory Verbal Learning Test, Trail Making Test, Wisconsin Card Sorting Test. Paired t-test was used to compare patients’ neuropsychological performance in episode and euthimic states and one-way ANOVA with post hoc Bonferroni corrections for the between groups comparisons.ResultsPatients showed significant impairments on ToM tasks in the acute phase compared to the control group. ToM deficits did not persist beyond mood episode, except patients’ poor performance on Faux Pas. Dysfunction in verbal learning, working memory, visospatial ability was found during both the acute and the euthymic phases in relation to the comparison group. Poorer performance in attention, immediate verbal memory and executive function tasks was observed only in the acute phase of the illness.ConclusionsImpairments in social cognition might reflect underlying general cognitive deficits and residual symptoms rather than representing a specific trait-marker in BD.
P01-216-Frontopolar cortical inefficiency underpins both “hot” and “cold” cognitive dysfunction in bipolar disorder
Authors: Jogia J. , Dima D. , Kumari V. , Frangou S. 
Published: May 2011

IntroductionEmotional dysregulation in Bipolar Disorder (BD) is thought to be linked with prefrontal cortex (PFC) dysfunction associated with cognitive control coupled with increased or aberrant activation within regions associated with emotional processing.ObjectivesTo determine the common and distinct patterns of functional brain abnormalities during affective and emotionally neutral cognitive processing in BD.AimsCurrent models of BD emphasise the relationship between mood dysregulation and fronto-limbic dysfunction during affective or “hot” processing. However, they do not account for deficits in emotionally neutral or “cold” tasks of memory and executive function which are also present in BD. Therefore the purpose of this study was to examine the neural correlates of affective decision making and working memory in BD.MethodsParticipants were 36 euthymic BD patients and 37 healthy controls matched for age, gender and IQ. FMRI was conducted during the Iowa Gambling Task (IGT) and the n-back working memory task as respective exemplars of “hot” and “cold” processing.ResultsThere were no group differences in performance on either task. BD patients demonstrated a pattern of inefficient engagement within the ventral frontopolar PFC in both the IGT and n-back. These abnormalities showed task-related segregation along the medial-lateral dimension for “hot” and “cold” processing respectively. Patients also showed greater activation in the anterior cingulate cortex during the IGT and in the insula during the n-back. These regions are thought to respond to markers of autonomic arousal.ConclusionsThese data demonstrate ventral frontopolar PFC inefficiency as a shared abnormality underpinning both “hot” and “cold” processing deficits in BD.
Therapeutic effect and tolerability of quetiapine XR in patients with manic episode, bipolar disorder I
Authors: Ladea M. , Grosu L.S. , Sinca M.C. , Sarpe M.C. 
Published: May 2011

IntroductionAgitation and aggressive behavior are common symptoms in patients with an acute relapse of bipolar mania.ObjectivesQuetiapine XR is an effective treatment in agitated patients with an acute relapse of bipolar disorder.AimsThe aim of this study was to assess the efficacy and tolerability of Quetiapine XR in patients with manic episode.MethodsThis naturalistic, observational study evaluated 45 patients diagnosed with manic episode, bipolar disorder I (DSM IV-TR) for a period of 4 weeks, during which the patients received Quetiapine XR, in doses between 800 mg and 1000 mg per day, using a rapid titration scheme.Efficacy of the treatment was measured using Young Mania Rating Scale (YMRS) and Clinical Global Impression Scale (CGI), performed at baseline, and then weekly. The Overt Aggression Scale-Modified (OAS-M) was used daily until day 4 and then once per week. Extrapyramidal symptoms were assessed with Barnes Akathisia Rating Scale and Abnormal Involuntary Movement Scale.ResultsImportant improvement of OAS-M total score was observed from the second day of treatment. After 4 weeks, more than a half of the patients presented a decrease of YMRS score with more than 50%. The CGI score also significantly improved. The treatment was well tolerated, mild to moderated adverse reactions being registered, without extrapyramidal symptoms.ConclusionsThese results confirm that Quetiapine XR is an effective and safe treatment for patients with an acute relapse of bipolar disorder I, the rapid titration scheme of the doses leading to a good control of aggressive behavior.
Autonomic nervous system in euthymic patients with bipolar affective disorder
Authors: Latalova K. , Diveky T. , Grambal A. , Kamaradova D. , Velartova H. , Prasko J. 
Published: May 2011

BackgroundAutonomic nervous system (ANS) dysfunction and reduced heart rate variability (HRV) have been reported in a wide variety of psychiatric disorders, but have not been well characterized in bipolar patiens in remission. We recorded cardiac activity and assessed HRV in bipolar outpatients in remission.AimsAscertain if ANS decrease with the age of the patient; ascertain relation between activity of ANS and level of dissociation, and other components (age of patients, and age of disorder, dosage of psychotropic medication)MethodsAutonomic nervous system (ANS) has been evaluated during orthostatic change in three positions (1- lie down 5 minutes, 2 – stand up 5 minutes, 3 – lie down 5 minutes). The functioning of the ANS has been measured by the diagnostic systems that are using the power spectral analysis which quantifies the heart rate variability (HRV) was assessed using time domain, frequency domain, and nonlinear analyses in 23 bipolar patients in remission.ResultsWe found highly statistically significant negative correlations between level of dissociation measured by DES and most of parameters of ANS. We found negative correlations between the age of the patient and activity of ANS, and negative correlations between activity of ANS and duration and onset of disorder.ConclusionsAutonomic dysregulation is associated with bipolar disorder in remission and has relation to level of dissociation and probably to age of patiens and age of onset and duration of disorder.Supported by grant IGA MZ ČR NT11047
P01-222-Prospective memory performance in Chinese patients with bipolar affective disorder
Authors: Lee E. , Xiang Y.T. , Au R.W.C. , Shum D. , Tang W.K. , Ungvari G.S. 
Published: May 2011

IntroductionPersons suffering from bipolar affective disorder have a wide range of cognitive deficits, but there have been limited understanding of prospective memory performance. Time-based prospective memory is remembering to perform an action at a specific time, whereas event-based prospective memory is remembering to perform an action when an external cue appears.ObjectivesAssess the time-based and event-based prospective memory performance in Chinese persons diagnosed with bipolar affective disorder.AimsIdentify factors associated with prospective memory performance.MethodsA sample of 40 persons diagnosed with bipolar affective disorder were recruited from a psychiatric outpatient clinic. All participants completed the Cambridge Prospective Memory Test, Rivermead Behavioral Memory Test, Test of Nonverbal Intelligence - Third Edition, the Young Mania Rating Scale and Hamilton Rating Scale for Depression.ResultsThe mean total score of the Cambridge Prospective Memory Test of persons diagnosed with bipolar affective disorder was 24.4 ± 7.0. Time-based prospective memory performance was worse than event-based PM task. The Cambridge Prospective Memory Test total score was associated with the Hamilton Rating Scale for Depression score and Rivermead Behavioral Memory Test score. The performance of time-based prospective memory tasks was associated with the Hamilton Rating Scale for Depression score, and the performance of event-based prospective memory tasks was associated with the Rivermead Behavioral Memory Test total score.ConclusionsPersons diagnosed with bipolar affective disorder are found to have worse time-based than event-based prospective memory performance. The importance for everyday functioning and independent living needs to be explored in future studies.
P01-224-Diagnosis and misdiagnosis of bipolar disorder: decision making of Austrian psychiatrists
Authors: Lex C. , Rados C. , Meyer T.D. 
Published: May 2011

IntroductionStudies show that bipolar disorder is often misdiagnosed. One reason for misdiagnosis may be that psychiatrists do not rely strictly on ICD or DSM criteria but consider some symptoms, e.g., „decreased need for sleep”, as more critical than others. Another reason could be that the diagnosis of bipolar disorder is associated with the total number of reported symptoms.ObjectivesFirstly, we investigate if an individual is more likely to be diagnosed with bipolar disorder if he/she reports a „decreased need for sleep”. Secondly, we explore if a high number of reported relevant symptoms increases the likelihood of a bipolar diagnosis.MethodFive case vignettes that varied in respect to the relevant information were sent to 400 randomly selected Austrian psychiatrists. The vignettes contained all information that is required to diagnose a bipolar disorder according to ICD-10 or DSM-IV. The psychiatrists were asked to return a questionnaire that collected data on their diagnostic decision making.ResultsPreliminary data will be reported and discussed.
P01-225-A case of unipolar mania
Authors: Lopes R. , Azevedo J. , Curral R. , Esteves M. , Coelho R. , Roma-Torres A. 
Published: May 2011

IntroductionThe concept of unipolar mania has been raised, rejected and resurrected by a number of authors, and its true position within bipolar affective disorders is still a subject of debate.Clinical caseA 52-year-old Caucasian woman was presented to the emergency room accompanied by family members because she had seven days without sleeping, exaggerated self-confidence and was engaged in multiple activities.DiscussionAt the mental examination she presented irritability, agitation, elation of mood, verbiage, sexual disinhibition, delusional activity of persecutory content, absence of insight. She had three manic episodes earlier and she didn’t have therapeutic adherence. The patient maintained an optimal level of performance functioning between maniac episodes, and also had no earlier depressive episodes. She described herself as a very creative, original, friendly, outgoing, sociable, responsible person. She had no family history of bipolar disease or other psychiatric disorder. An hemogram, basic biochemical investigations, cerebral TC, ilicits drugs screen and EEG were preformed showing no relevant alterations. She was admitted at an acute care psychiatric unit for 16 days. She had a good response to risperidone 2 mg and 1000 mg of divalproex sodium and to cognitive behavioural treatment.ConclusionDue to her previous 3 and her current manic episodes, without history of depressive symptoms, we concluded by the diagnosis of unipolar mania. Although there are certain sociodemographic and clinical variables that overlap, there does seem to be recent evidence concerning clinical, psychopathological and treatment features indicating a nosological separation of unipolar mania from bipolar mania.
P01-226-Line item analysis in paediatric patients with bipolar I disorder treated with aripiprazole
Authors: Loze J.-Y. , Mankoski R. , Zhao J. , Carson W. , Youngstrom E. , Findling R. , Forbes R. , Landsberg W. 
Published: May 2011

IntroductionAripiprazole has demonstrated efficacy for the treatment of paediatric patients (10–17 years) with a manic or mixed episode associated with bipolar I disorder in a clinical trial that utilised the Young Mania Rating Scale (YMRS) Total score as the primary outcome measure.Objectives/aimThis analysis evaluated the profile of discrete symptom response using the YMRS and other measures.MethodsPost-hoc analysis of individual items of the YMRS and the parent or subject version of the General Behaviour Inventory (GBI) Mania and Depression scales using data from a 4-week, double-blind, randomised trial that compared aripiprazole (10 or 30 mg/day, n = 197) with placebo (n = 99).ResultsIn total, 296 patients were randomised; 80% completed the study. Significant decreases at Week 4 (p < 0.05) were seen in eight YMRS items: elevated mood, increased motor activity/energy, need for sleep, irritability, speech (rate and amount), language/thought disorder, abnormal thought content and disruptive/aggressive behaviour. For the GBI, effect sizes for parent-reported mania items were medium to large (for example, 0.41 for ‘depressed but high energy’ to 0.78 for ‘rage combined with unusually happy’) but were consistently small on subject self-reported items of mania and depression and, for the overall scale, had the poorest agreement with clinician ratings.ConclusionsAripiprazole demonstrated improvements in some of the more troublesome symptoms of paediatric patients with bipolar I disorder experiencing an acute manic or mixed episode. Of note, irritability and aggression showed large treatment effects on both clinician and parent-reported measures, but less so for subject-reported measures.
P01-227-Implementing family psychoeducational intervention in bipolar i disorder: a randomized controlled trial
Authors: Luciano M. , Del Vecchio V. , Malangone C. , Giacco D. , De Rosa C. , Fiorillo A. , Maj M. 
Published: May 2011

IntroductionBipolar disorder is associated with high personal and social burden, impaired social functioning and high levels of disability. The psychoeducational family intervention, found to be effective in the treatment of schizophrenia, may be particularly useful for patients with bipolar disorder and their relatives.Aims & methodsThis study, funded by the Italian Ministry of Health, coordinated by the Department of Psychiatry of the University of Naples SUN and carried out in 11 randomly selected mental health centres, included the following phases1) development of informative materials;2) training of 2 mental health workers per center;3) random selection of 16 families of patients with bipolar disorder for each center: 8 being randomly allocated to the experimental group and 8 to the control group.Results62 families have been recruited. Mental health workers reported several advantages in conducting the intervention, in particular in the relationship with patients and families. Significant improvements have been reported in professional skills and relationships with colleagues. The advantages tend to increase over time. The main reported difficulties are lack of time to run the intervention, identification of appropriate families, excessive workload and the need to integrate this intervention with other work commitments.ConclusionsIt is possible to provide psychoeducational family intervention for patients with bipolar I disorder and their families, after a relatively short period of training. In order to facilitate the dissemination of this intervention in routine conditions, a better planning of the activities of the mental health centers may be useful.
P01-228-Behcet's syndrome comorbid with bipolar disorder: A case report
Authors: Maner F. , Şahmelikoğlu Ö. , Hısım Ö. , Özhan H. , Sarıahmetoğlu H. , Tümay N. , Emin Ceylan M. 
Published: May 2011

IntroductionBehcet's Syndrome is a chronic inflammatory disorder of unknown etiology, characterized by aphthous lesions and recurrent ulceration of the mouth, genitals and uveitis.ObjectivesThe central nervous system is involved in about 20% of cases.AimsOnly few reports deal with affective symptoms associated with Behcet's syndrome.MethodsWe report a case of a 43 year old male with Neuro-Behcet's Syndrome that presents with a psychotic manic attack. He developed Behcet's Syndrome at the age of 23, with recurrent uveitis and aphthous lesions in the mouth, painful ulcers in the genitalia and erythema nodosum. HLA-B 5 was positive.ResultsHe was treated with azothioprine 150 mg/day for 13 years and prednole 100 mg/day during uveitis attacts for a week. At the age of 37 a sudden occurrence of right hemiparesia due to cerebrovascular accidence salicylic acid 100mg/day, siclosporine 150 mg/day, piracetame 1600mg/day were administered. He presented to psychiatry clinic in manic episode with euphoric mood, psychomotor agitation, talkativeness, decreased need for sleep, excessive buying and he had an unrealistical thought that he was a player of a famous soccer team. He was diagnosed as bipolar I disorder, according to DSM-IV. This was the patient's first admission and the symptoms which were continuing for 6 years exaggerated during uveitis attacks.Psychiatric examination releaved that increaced psychomotor activity, hypomaniac affect, amount and affect speed of speech affect, increased associations, grandiose delusions.ConclusionThere are a few reports dealing with bipolar disorder as an entity related to Behcet's syndrome.
P01-229-Emotional incontinence or bipolar disorder?about a case report
Authors: Mnif L. , Masmoudi J. , Charfi N. , Baâti I. , Kolsi S. , Jaoua A. 
Published: May 2011

IntroductionPost-stroke emotional incontinence and bipolar disorder are two disorders that involve the dysfunction of brain structures responsible of emotional regulation.The objective of this work is to study the links between these disorders through a clinical case.Case reportIt was a 43 year old patient who consulted for an emotional incontinence appeared after an ischemic stroke with lenticulocapsular and right semioval center lesions.Treatment with antidepressant was marked by the appearance of hypomania.Discussion and conclusionThe appearance of a pharmacologically induced hypomania in this patient could suggest a link between emotional incontinence and bipolar disorder.Especially that periventricular areas and deep subcortical structures, involved in emotional regulation, are affected in these disorders.More attentiveness against antidepressant treatment is required, because of the potential risk of a pharmacological hypomania.
Quality of life in bipolar disorders compared to schizophrenia
Authors: Zouari L. , Abida I. , Walha M. , Masmoudi J. , Ben Thabet J. , Zouari N. , Maalej M. 
Published: May 2011

IntroductionThe classic opinion of a favorable prognosis of bipolar disorders, compared to schizophrenia, is refuted by modern conceptions.ObjectivesThe aim of this study was to assess the quality of life (QOL) in bipolar patients compared to schizophrenic patients’, and to identify clinical and sociodemographic variables statistically associated to a poor QOL in bipolar disorder patients.MethodsOne hundred and twenty outpatients, 50 with bipolar disorder and 70 with schizophrenia, according to DSM-IV-TR criteria, were included in the study. The QOL has been assessed, in all patients, using the «36 item Short-Form Health Survey» (SF-36).ResultsThirty-six percent of the bipolar patients had a poor QOL, versus 37% among the schizophrenic patients. The bipolar patients had the score of the standardized vitality subscale significantly lower than schizophrenic patients’ (p = 0.036); the latter had the standardized general health subscale score significantly lower (p = 0.03). There were no other statistically significant differences. The multivariate analyses showed three variables significantly correlated to a poor QOL in bipolar patients: age at the time of the study ≥ 40 years (p = 0.01), professional irregularity or inactivity (p = 0.005), age at onset ≥ 25 years (p = 0.004).ConclusionOur survey of the QOL in bipolar patients showed that it did not differ globally from the schizophrenic patients’, with the SF-36 scale. Results reported in the literature are not in agreement. Further longitudinal studies on several months, with other assessments, would permit to verify the validity of our results.