bluuebunny/crossref_metadata_2025_split huggingface dataset:
Bipolar Disorder and Suicide: 10 Years Follow-up/retrospective Survey/
Authors: Breznoscakova D. , Palova E. , Dragasek J. , Losonciova K. , Uhrin J. 
Published: March 2009

Introduction:Bipolar disorder (BD) is chronic psychiatric disorder by mood swings, symptoms of BD are serious and life-threating. Suicide risk in patients with BD is 25-50%, more frequent during depressive episode (Compton,2000) but with adequate treatment suicide risk can be presented in nearby 50% of patients only (Goodwin, Jamison,2006). Despite these facts data about the changes of treatment habits over the longer period of time under naturalistic condition are lacking.The aim of study:To assess presence of suicidal thoughts and attempts in inpatients with BD and follow-up changes of treatment with lithium over the period of time.Patients and methods:It was retrospective survey of in-patient's files hospitalized at the 1st Dept. of Psychiatry, UPJS, Kosice (1997-2007) with typical limitations for retrospective case survey. All patients had diagnosis of BD (DSM-IV), n=125 (67% of women and 33% of men). We discovered changes in suicidal behaviour with/without treatment of lithium.Results:The first episode was depressive in 62% of patients, average number of episodes: 8,2. There was trend of decrease in use of lithium over the time (68% vs 84% in men, 29% vs 60% in women). The suicidal thoughts were more frequent during depressive episode (in 50% of women and 18% of men). Suicidal thoughts and attempts were 3 times more frequent in women vs men with BD. Suicidal attempts were 4 times more frequent in women with treatment with lithium vs without lithium.
Meta-analysis of Magnetic Resonance Imaging Studies in Bipolar Disorder and Schizophrenia [PW05-06]
Authors: Arnone D. , Cavanagh J. , Gerber D. , Lawrie S.M. , Ebmeier K.P. , Mcintosh A.M. 
Published: March 2009

Introduction:Several MRI studies have identified structural abnormalities in association with bipolar disorder. The literature is however heterogeneous and there is remaining uncertainty about the brain areas pivotal to the pathogenesis of the condition. The aim of this study was to identify, appraise and summarise volumetric MRI studies of brain regions comparing bipolar disorder with an unrelated control group and/or patients with schizophrenia.Methods:A systematic review and random-effects meta-analysis was carried out to identify key areas of structural abnormality in bipolar disorder and whether the pattern of affected areas separated bipolar disorder from schizophrenia. Excessive variability was explored using meta-regression analyses.Results:Seventy two reports met inclusion criteria. Subjects with bipolar disorder showed significant whole brain and prefrontal lobe volume reductions, and also increases in the volume of the globus pallidus. Enlargement of the lateral ventricles in bipolar disorder was confirmed, although the magnitude of enlargement was smaller than in schizophrenia. Subjects with schizophrenia, but not bipolar disorder, showed significant reductions in right amygdala volumes. Heterogeneity was statistically significant for many of the analyses and could amongst others be explained by age, duration of illness and year of publication.Conclusion:There appear to be robust changes in brain volume in bipolar disorder compared with healthy volunteers. Age and duration of illness appear to be key issues in determining the magnitude of observed effect sizes.
Depression and Cytokines: A Psychoneuroimmune Perspective [PW06-02]
Authors: Castro L.C. 
Published: March 2009

Background:Cytokine-induced sickness behaviour is an adaptative response to infection. Activation of the immune system, particularly the increased activity of several cytokines, has been implicated in the provocation or exacerbation of mood disorders.Aim:To discuss the relevance of psychoneuroimmunologic research in the understanding of the patophysiology and therapeutic targets of certain mental health disorders.Methods:Review of the literature. MEDLINE and PubMed databases searches for peer-reviewed studies, published between 2000 and 2008, using combinations of the Medline Subject Heading terms cytokines, sickness behaviour, immune system and depression, depressive illness.Results:Several lines of evidence support the relationship between cytokines and mood disorders. Cytokine elevations are more marked in severe depression and their activity may also relate with illness chronicity, neurovegetative features and high stress perception. It is argued that the activation of the inflammatory system, eliciting cytokine release and synthesis, provoke neuroendocrine and neurotransmitter changes, contributing to the development of depression. Some studies support that the brain cytokine system can become sensitized in response to non-immune stressors or to immune stressors occurring early in life.Discussion:The cytokines actions in the brain can help to clarify the patophysiology of certain psychiatric disorders, including depression. The research findings show an association between the activation of the brain cytokine system and depression, although the precise relationship between sickness behaviour and depression is still not clear. Further research in such a promising area of study is needed and can contribute to new therapeutical targets and a broader understanding of psychiatric disorders.
The Real Cost of Sickness-absence in Mental Health: A Cognitive Behavioural Perspective [PW06-03]
Authors: Dovey A. , Wilday S. 
Published: March 2009

The number of employees experiencing psychological problems related to occupational stress has increased rapidly in Western countries and mental illness is now cited as one of the top three causes of certified sickness absence.Worldwide economic issues are now synthesising various cultural beliefs and behaviours and should Western factors have an influence then one could presume workplace mental health problems will increase worldwide. The presentation will focus on the literature pertaining to the potential function of sickness absence for the individual as well as the known maintenance factors for anxiety and depression from a CB perspective.The presentation will highlight that the basic CB premise of emotional disorder implicates the potential for an individuals response to symptoms to have a maintenance role in the course of both anxiety and depression. The potential impact of sickness absence for anxiety and depression via the loss of the benefits of employment (e.g. structure, activity and social contact) the potential for the development of sick role behaviour (e.g. reduced activity, social isolation) as well as the reinforcement of avoidant coping are considered significant.In conclusion the presenters propose that sickness absence for individuals with anxiety and/or depression can function as a maintenance factor for both disorders. The implications for the future use of sickness absence as a standalone intervention within this group will be discussed. The audience will have an opportunity to reflect on the potential effectiveness of cognitive behavioural therapy within the workplace
The Predictive Role of Anxiety Disorders on Depressive Phenomenology During Post-partum Period [PW06-05]
Authors: Mauri M. , Rambelli C. , Montagnani M.S. , Camilleri V. , Cortopassi S. , Ramacciotti D. , Banti S. , Borri C. , Annalisa O. , Bettini A. , Ricciardulli S. , Giunti Y. , Ciaponi B. , Di Biase S. 
Published: March 2009

Aims:To investigate the predictive role of any specific (DSM-IV) Anxiety Disorders (AD) on depressive symptoms and Major or Minor Depressive Disorder (MDD, mDD) during early postpartum period.Method:Women (at the 12th-15th gestational week, N=1066) were recruited in the framework of the Program ‘Perinatal Depression - Research & Screening Unit (PND-ReScU)". Depressive symptoms were assessed by the Edinburgh Postnatal Depression Scale (EPDS), and Axis-I disorders (AD, MDD, mDD) were diagnosed with the Structured Clinical Interview for Axis-I Disorders (SCID-I).Results:Any current AD at baseline (3rd month of pregnancy) was detected in 231 (21.7%). Having at least one current AD, was associated with a greater likelihood of having MDD or mDD during the early postpartum period, even after the adjustment for the confounding factor of having a lifetime history of MDD (RR=3.86 95%CI 1.58-9.42).In particular, women affected by Obsessive Compulsive Disorder (N=17; 1.6%) or Panic Disorder (N=43; 4%) had at higher risk to develop depressive symptoms (EPDS≥13) during the postpartum period than women without these AD (RR=6.9 and 6.7 respectively). As for the risk of developing PPD, the strongest association was found for women with Panic Disorder (RR=7.6 95% CI 2.62-22.0).Conclusions:AD are associated with a greater likelihood to develop depressive symptoms and MDD or mDD during the early postpartum period. Women with current PD have the strongest risk to develop both MDD or mDD and depressive symptoms during early postpartum period compared to other anxiety disorders.
Self-reported Rumination as Trait Marker for Depression: Evidence from Functional Neuroimaging [PW07-02]
Authors: Arnone D. , Pegg E. , Mckie S. , Downey D. , Elliott R. , Deakin J.F.K. , Anderson I.M. 
Published: March 2009

Background:Research using fMRI indicates that sustained limbic activity is linked to processing negative words and self-reported rumination in currently depressed individuals. It is unknown whether this is also present in remitted depressed individuals. We tested the hypothesis that a tendency to ruminate constitutes a trait for depression by using a standard covert fMRI emotional task face in previously and never depressed volunteers and postulated that high rumination scores would correlate with activity in brain areas previously associated with depression.Methods:37 controls (25 female) and 30 remitted depressed (RD, 22 female) were enrolled. Volunteers completed the Ruminative Responses Scale (RRS) and underwent fMRI scanning using a standard covert fMRI emotional task faces. Significance level was set at p < 0.05 (FWE).Results:With RRS score controlled for RD showed reduced subcortical and limbic activity to sad and fearful faces compared to controls. Correlations between RRS scores and neural activity in all participants and control participants alone were very limited. However, in RD, RRS score was negatively correlated with neural response to happy faces and positively correlated with neural response to sad and fearful faces, in cortical and limbic regions associated with depression (hippocampus, thalamus, caudate, insula and cingulate gyrus).Conclusion:The results suggest that reduced limbic activity is associated with remission, possibly as a maintenance mechanism. However, within the remitted group the more ruminative participants show greater response in these areas to negative stimuli, and less to positive stimuli. This could be a neurobiological marker for risk of relapse
The Risk of using Antidepressants During Pregnancy: Serious Concern or much ado about Little? [PW07-03]
Authors: Steiner M. , Shea A. , Soares C.N. 
Published: March 2009

Perinatal psychiatric disorders are a leading cause of maternal morbidity, they transmit across generations and may pose the first adverse life event for a child. The myth that pregnancy is “protective” in terms of mental health has long been refuted and it is now well established that the incidence of depression during pregnancy is at least as high when compared to other phases in a woman's lifetime. Moreover, depression during pregnancy has been associated with a number of adverse outcomes both for the mother and the baby. Untreated depression during pregnancy is also one of the strongest predictors of a subsequent postpartum depression.Data on the “relative safety” of antidepressants during pregnancy are accumulating but at the same time sporadic, at times inconsistent reports on potential risks associated with their use are cause for concern. Recognizing the limitations of our knowledge regarding the “relative safety” of antidepressants during pregnancy it is paramount to weigh the risk of not treating vs. the benefit of treating in each case.We report here on more than 400 pregnant women at risk for depression seen at our clinic. One third of these women received antidepressants during different phases of their pregnancies and the outcome/well-being of their babies assessed. There were no significant increases in long-term untoward outcomes in these babies.We also demonstrated in a smaller subpopulation that the use of antidepressants has a “positive” effect on both neuroendocrine and neurophysiological parameters, using the cortisol awakening response and heart rate variability as biological markers.
Saccadic Eye Movements in Dementia, Major Depression and Healthy Controls - Relationship with Cognitive Functions [PW08-01]
Authors: Schewe H.-J. , Vohs K. , Uebelhack R. 
Published: March 2009

We compared horizontal saccadic eye movements in patients with dementia (n=18), and age-matched patients with major depression (n=18) or healthy controls (n=18). Cognitive functions were evaluated using Mini-Mental-State-Examination (MMSE) and ADAS-cog.Results:Saccadic latency and number of saccadic intrusions were significantly (p< 0.001) higher in patients with dementia relative to healthy controls and depressed patients. There were significant correlations between MMSE total score and latency (r = -0.78, p< 0.01) or number of saccadic intrusions (r = -0.80, p< 0.001) in the demential group. In addition, both saccadic parameters were significantly associated with ADAS-cog total score of patients with dementia, whereas the subscale “orientation” showed the strongest correlation with latency (r = 0.71, p< 0.01) and intrusions (r = 0.74, p< 0.01).There were no significant differences in saccadic eye movements between healthy controls and patients with major depression as a whole, or a subgroup of depressed patients with the worst cognitive performance (n=9).Conclusions:It seems that disturbances in horizontal saccadic eye movements in patients with dementia are related to the degree of cognitive deficits in these patients. On the other hand, the lack of alterations in horizontal saccadic eye movements in depressed patients despite poor cognitive performance indicates different mechanism.
Neuropsychological Performance in both Alzheimer’s Disease and Vascular Dementia is Related to Cardiovascular Comorbidity [PW08-02]
Authors: Hofrichter N. , Dick S. , Tritschler E. , Knobel A. , Heinz A. , Rapp M.A. 
Published: March 2009

Aims:Vascular pathology has been implicated in the pathogenesis of both Alzheimer's disease and vascular dementia. While performance decrements in vascular dementia are by definition thought to be related to vascular load, performance decrements in Alzheimer's disease have not yet been studied in relationship to cardiovascular comorbidity. The aim of this study was to describe neuropsychological performance in patients with mild Alzheimer's disease and vascular dementia in relationship to cardiovascular comorbidity.Method:39 patients suffering form vascular dementia and 34 patients suffering form Alzheimer's disease underwent neuropsychological testing using an extended neuropsychological battery, including tests of episodic memory, working memory, naming, verbal fluency, executive functions, and language. Cardiovascular comorbidity was assessed form medical history and chart review using the Charlson comorbidity index.Results:Patients suffering form Alzheimer's disease and vascular dementia did not differ in terms of age, education, gender distribution, or dementia severity. Cardiovascular comorbidty was more pronounced in vascular dementia patients. In both Alzheimer's disease and vascular dementia, neuropsychological performance in tests of working memory and executive functioning was related to cardiovascular comorbidity, but the relationship was stronger in vascular dementia.Conclusion:Vascular load affects neuropsychological performance in both Alzheimer's disease and vascular dementia, suggesting that cardiovascular comorbidity affects cognition across both forms of dementia.
The use of Drugs for Mood Disorders in Italy: Preliminary Results [PW08-03]
Authors: Carta M. , Aguglia E. , Balestrieri M. , Bocchetta A. , Drago F. , Faravelli C. , Morosini P.L. , Nardini M. , Hardoy M.C. 
Published: March 2009

Background:Some community surveys in Italy have shown that a proportion of subjects without lifetime psychiatric diagnosis (anxiety/depression) used antidepressants. The prescription of AD in bipolar depression appears to be another largely underestimated problem in the clinical practice and is difficult to recognise by means of traditional epidemiological methods (lay interview and structured diagnostic tools).Objectives:The purpose is to use defined and validated international semi-structured interview as diagnostic instrument administered by expert clinicians to evaluate appropriateness and amount of over and under prescription of psychotropic drugs in different Italian community areas. The focus is on general antidepressant use and use in subjects with bipolar disorder and in subsyndromal depression.Methods:Study design: Community survey. Study population: sample randomly drawn, after stratification by sex and age, from the adult population of Municipal records in 6 Italian Regions: about 4000 persons will be interviewed. Tools: Questionnaire on psychotropic drugs consumption, prescription, health services utilisation;diagnostic Structured Clinical Interview np version;Mood Disorders Questionnaire; Short Form Health Survey. Ethical aspects: a signed informed consent for each candidate. The study was approved by the ethical committee of theItalain National Health Institute.Expected results:The study aims to identify the frequency of over and under prescription of psychotropic drugs in different Italian regions and the determinants of prescription related to physicians, patients, comorbidity and symptoms and to establish the basis for a cohort prospective study to assess the future changes.
Eating Behaviour and Perfectionism in Students: A Prospective Study [PW09-02]
Authors: Soares M.J. , Maia B. , Pereira A.T. , Gomes A. , Marques M. , Valente J. , Pato M. , Azevedo M.H. , Macedo A. 
Published: March 2009

Aim:To investigate the role of perfectionism in the development of disordered eating behaviours.Method:382 female university students completed the Hewitt & Flett MPS and the EAT-40 at baseline, one year after (T1) and two years later (T2).Results:Perfectionism at baseline was significantly associated with long-term abnormal eating attitudes/behaviours. Self-Oriented Perfectionism (SOP) and Socially Prescribed Perfectionism (SPP) were significant predictors of disordered eating behaviours. SOP at baseline was predictive of diet concerns, at T1 and T2. Baseline SPP was correlated with overall eating disturbance at T1 and T2. Regression analysis revealed that only SPP was a significant predictor of bulimic behaviours and social pressure to eat at T1, but not at T2.Conclusion:Our findings contribute to a more clear understanding of the association between perfectionism and eating disorders. SOP and SPP were prospectively associated with abnormal eating attitudes/behaviours and SOP was found to be predictive of diet concerns.
Do Stressful Life Events Predict Eating Disorder Relapse?: Six-year Outcomes from the Collaborative Personality Disorders Study [PW09-04]
Authors: Grilo C. , Pagano M. , Stout R. 
Published: March 2009

Aims:To examine the natural course of eating disorders (ED) prospectively over 6 years and to examine link between stressful life events (SLEs) and ED relapse among women with personality-disorders (PDs).Method:Subjects were 132 female patients with bulimia nervosa (N=40) or EDNOS (N=92) in the Collaborative Longitudinal Personality Disorders Study. EDs were assessed with the Structured Clinical Interview for DSM-IV Axis-I, and monitored with the Longitudinal Interval Follow-up Evaluation during follow-up. PDs were assessed with the Diagnostic Interview for DSM-IV PD (DIPD-IV), and monitored with the Follow-Along version of the DIPD-IV during follow-up. SLEs were assessed with the Life Events Assessment (LEA). Follow-up assessments were conducted at 6- and 12-months and then yearly through 72 months. Proportional hazard regression analyses were performed to examine the link between time-varying levels of SLEs and ED relapse. Cox regressions controlled for the same covariates used in prior work: duration of ED, number of co-morbid psychiatric disorders, and time-varying status of PDs.Results:Of the 132 patients, 59% had remissions from ED, 68% of whom subsequently relapsed over the course of 6 years (BN and EDNOS did not differ in relapse). Total number of negative SLEs reported by ED patients significantly predicted subsequent ED relapse (HazardRatio=1.5, p< .05). The types of SLEs that predicted ED relapse were elevated work stressors (HazardRatio=3.0, p< .01) and elevated recreation stressors (HazardRatio=3.1, p< .05).Conclusion:Higher work stress and higher recreation stress represent significant warning signs for triggering relapse for women in remission from BN and EDNOS.
A Model for the Management of Suicidal Behaviour in Primary Care [PW10-03]
Authors: Voros V. , Osvath P. , Fekete S. 
Published: March 2009

Introduction:Although suicide rates are decreasing in most European countries, suicide is still a major health concern. Despite of the fact, that the vast majority of suicidal patients contacted with health care services before the suicidal act, the doctor-patient meeting is a necessary, but sometimes not sufficient way enough to prevent suicide. Most patients, who commit or attempt suicide, are not regarded as being at high immediate risk at their final contact with health care services.Aims and methods:Based on reviewing the relevant literature and on our previous studies we developed a brief, practical, clinical guideline, which may aid general practitioners and primary care professionals to assess suicide risk and also to manage these patients.Results:We introduce a model for an integrated, regional suicide prevention strategy, which includes recognition, risk assessment and also intervention. The main steps of our model are to recognize warning signs, explore crisis situation and/or psychopathologic symptoms, assess protective and risk factors, estimate suicide risk, plan intervention strategies, and finally manage suicidal patients through the different levels of intervention.Conclusion:In the management of suicidal behaviour the complex stress-diathesis model has to be adjusted by considering biological markers (mental disorders, personality traits) and psycho-social factors (crisis, negative life events, interpersonal conflicts). Only after the assessment of these factors primary care professionals, as ‘gatekeepers’ can manage suicidal patients effectively by using adequate psychopharmacotherapeutic and psychotherapeutic facilities in the recognition, treatment and prevention of suicidal behaviour.