bluuebunny/crossref_metadata_2025_split huggingface dataset:
The online discussion forum depression: Chances and risks
Authors: Hegerl U. , Blume A. , Rummel-Kluge C. 
Published: May 2011

IntroductionWe evaluated participation effects and motives of people participating in an online discussion forum for depressive patients.Objectives/AimsCharacteristics of participants, diagnoses and treatment status were analysed. In addition, the effects of participation in the forum on the individual handling of the illness and their motivation to use the online forum were examined.Methods55 active users were interviewed by telephone using a computer-assisted version of a fully structured psychiatric interview (DIA-X) and online with the Beck Depression Inventory (BDI).Results52 study participants (94.5%) received the diagnosis depression. Currently, 36.5% of the respondents suffer from a depressive episode. 90.2% received outpatient treatment before, 64.7% inpatient treatment. The respondents stated that their trust in medical treatment was raised (63.3%) and that they were encouraged to seek professional help (61.2%).ConclusionThe forum reaches its targets, namely to provide an information platform for depressive patients and their relatives to encourage patients to seek professional help and the users do not see it as an alternative, but rather as a supplement to professional and psychological care. By participating in the forum, aspects of self-help, especially a strengthened sense of community and acceptance of coping with the own illness-related situation can be accomplished.The results of this study as well as first results of a current research project, an evaluation of the content by analyzing word counts in psychological and linguistic categories, will be presented in the context of chances and risks of this E-mental health tool.
The effect of family psychoeducational interventions on patients with depression
Authors: Fiorillo A. , Malangone C. , Del Vecchio V. , De Rosa C. , Luciano M. , Giacco D. , Sampogna G. , Del Gaudio L. , Maj M. 
Published: May 2011

While the efficacy of family psychoeducational interventions in the treatment of schizophrenia is now well documented, few data are available on its efficacy in major depression. This study aimed to verify the effectiveness of a family psychoeducational intervention according to the Falloon model on patients’ clinical status, social functioning and lifestyle and on relatives’ burden and social network.The study was coordinated by the Department of Psychiatry of the University of Naples SUN and carried out in 7 Italian mental health centres. In each centre, 8 patients with major depression and their relatives were recruited if they fulfilled the following criteria: a) diagnosis of unipolar major depression according to the DSM-IV; b) aged between 18 and 65 years; c) in charge to the local mental health centre for at least 6 months; d) at least one depressive episode in the last two years; e) living with at least one relative aged between 18 and 70 years.Recruited families have been randomly allocated to the experimental group, which received the psychoducational intervention for 6 months, or to the control group, which received the treatment as usual plus an informative brief intervention.22 families have been treated with the experimental intervention and 22 with the control one. At the end of the intervention, patients’ clinical status and life-style significantly improved in the treated group, as well as family objective burden and social contacts.Family psychoeducational intervention are useful in reducing personal and family difficulties caused by depression and in improving patients’ lifestyles.
European Network of Bipolar Research Expert Centres (ENBREC): an overview of the project
Authors: Henry C. 
Published: May 2011

ENBREC (European Network of Bipolar Research Expert Centres) is a disease-oriented network designed to set up a EU-wide network of expert centres, specialized in research and care in bipolar disorders. The European added value is to share expertise in the different fields of research and to have access to large cohorts of patient. It is an FP7 project whith 6 countries involved.ENBREC will provide an EU-integrated facility for research on epidemiology, diagnosis, treatment and on the mechanisms of bipolar disorders.A preliminary step was to develop a computerized medical file to collect in a same manner a minimum set of clinical data to perform observational studies. We also include a common cognitive battery. Patients will be re-assessed every 6 months. This systematic assessment is the minimum required to be involved as an expert centre of the network. In parallel, we will collect DNA samples to perform genetic studies on well-characterized patients. Moreover, data from scanners performed for diagnostic purpose will be pooled to provide a large sample of structural brain pictures.Other modules are proposed in the framework of the expert centres for observational studies with a high frequency of assessment to be able to capture more detailed description in psychopathological variables and in treatment response.This cohort will allow selecting and recruiting patients for interventional studies or in specific programmes of research. Large cohorts of well-characterized patients are needed to improve the knowledge of this heterogeneous disease and to translate research outcomes into health improvements.
Effective strategies for health information, self-help and psychoeducation in bipolar disorder
Authors: Barbato A. ,   European Network of Bipolar Research Expert Centers
Published: May 2011

IntroductionMany patients with bipolar disorders do not achieve clinical and functional recovery, even with good pharmacotherapy compliance. The influence of patients’ attitudes, behavior, subjective state and interpersonal environment on course of the disorder points out the importance of psychosocial interventions and patients’ active role to improve outcome.MethodsA survey of recent guidelines, systematic reviews and clinical trials of psychosocial interventions for bipolar disorders was performed.ResultsResearch evidence supports the efficacy and likely effectiveness of a number of psychosocial treatments: Individual and group psychoeducation, family-focused therapy, interpersonal and social rhythm therapy, cognitive behavior therapy. The lower cost and potential ease of dissemination of group psychoeducation suggest that this should be the first-line approach, with more complex interventions reserved to selected subgroups of patients. The following elements should be included in a basic psychoeducation package: information about the disorder and available treatment options, identification of early warning signs, encouragement of structured routines and healthy lifestyles, use of a mood diary and life-event charting to monitor mood patterns and effectiveness of intervention, improvement of communication skills, emotional self-regulation and social skills, reduction of self-stigmatization, stabilization of sleep/wake cycles, awareness of medication effects and improvement of decision-making skills on drug treatment in a collaborative way, acquisition of balanced attitudes towards the self in relation to the illness.ConclusionThe introduction of psychoeducation interventions with a focus on self-help strategies and patients empowerment and the adaptation of research models to everyday practice, can improve the outcome of bipolar disorders in real world.
Neuroimaging findings in bipolar disorder - opportunities for network projects
Authors: Andreassen O. ,   ENBREC
Published: May 2011

The overall aim of the Imaging work package in ENBREC is to develop a common magnetic resonance imaging (MRI) protocol which allows pooling of data acquired from different MRI scanners, that can be used in multi-site studies of bipolar disorders.Structural MRI studies usually provide global estimates of gray or white matter volume changes, or a small number of regions of interest (ROIs). Recent advances in structural imaging now allow for a more comprehensive evaluation of brain changes by providing continuous maps of cortical thickness and surface area, subcortical volumes, and measures of white matter microstructure throughout the brain. Such high-resolution structural MRI for morphometric analyses is now being used for automatic quantification of brain structures. There are recent reports of cortical abnormalities in bipolar disorder, which will be reviewed.White matter can now be quantified using diffusion tensor imaging (DTI). This MRI variant for quantifying the integrity of white matter structure throughout the brain measures water diffusion and its directionality. The degree of anisotropy of overall motion in a voxel is expressed as an index of the directionality of diffusion (fractional anisotropy; FA). Lower FA values are thought to reflect factors such as demyelination and axonal injury, and has been used to show white matter abnormalities in bipolar disorder.A suggestion for protocol for multi-site brain imaging study in bipolar disorder will be presented.
Treatment optimization: The long-term perspective in bipolar disorder
Authors: Bauer M. , Ritter P. , Pfennig A. 
Published: May 2011

Bipolar disorder is for most patients a life-long illness, associated with a recurrent, chronic course, and functional disability. Primary treatment goals are to stabilize the patient and prevent recurrence of episodes and suicide.Although bipolar disorder has traditionally been regarded as an illness with good prognosis and most patients returning to normal functioning when a mood episode is over, several longitudinal studies suggest that the long-term outcome is less favorable than previously thought. Combinations of drugs are frequently used in clinical practice for mood stabilization, especially for those who have not responded to monotherapy. Although combination treatments are commonly administered, full interepisode recovery is not achieved in all patients, and as a consequence, bipolar disorder is one of the leading causes of disability.Among clinicians and in international guidelines, lithium is widely considered as the ‘gold standard’ for long-term treatment. The choice of treatments is undergoing considerable change as new treatments are available, anticonvulsants and atypical antipsychotics are taking a more prominent position. However, the evidence available for the newer treatment options including the various combination treatments varies greatly.The episodic nature of bipolar disorder requires prophylactic long-term treatment. Many previous worthwhile treatment effects of available mood stabilizing agents and psychotherapeutic interventions on major outcomes in bipolar disorder are only of moderate size and therefore require large-scale studies. Such trials to investigate longer-term outcomes are logistically challenging and expensive, and therefore only feasible within a multisite and multinational approach based on a common documentation system of the illness course.
Epidemiology of depression and distress in patients with inflammatory bowel disease (IBD) and validation of an indicator scale of perceived stress for psychosocial impairments
Authors: Hardt J. , Conrad S. , Muche-Borowski C. , Raspe H. 
Published: May 2011

BackgroundPrevious studies showed associations of stress and episodes of active disease [1,2]. We reported survey data on psychosocial problems of IBD patients [3]. This study investigates associations of stress with health impairments and analyses a scale of perceived stress as an indicator for psychosocial impairments (construct/criterion validity) [4].MethodsIn a multiregional German survey in 2005, 1083 patients with Crohn's disease (CD) and ulcerative colitis were recruited (gastroenterological practices, university outpatient clinics, patient organization). The questionnaire incorporated WHO's ICF [5] and established items and scales (i.a. HADS [6]). Scale construction followed item response theory analysing psychometric properties.ResultsOf the survey responders (58% CD, 65% female, mean age 42yrs), ⅓ reported severe fatigue. Clinically relevant anxiety was observed in 24%, depression in 29% of men and 21% of women. With three items we constructed a scale with good psychometric properties. Three groups (low, moderate, high perceived stress) were identified, differing substantially in reported anxiety/depression and the GIBDI disease activity score.ConclusionsIBD patients report multiple psychosocial impairments. The scale of perceived stress may identify IBD patients with high demand for psychosocial attendance, if confirmed in independent samples. For enhanced secondary prevention [7] we propose integration of this psychosocial indicator into the diagnostic process.
The role of psychological distress, somatization and personality traits in the formation of IBD patients' health-related quality of life (HRQOL) and smoking habits
Authors: Hyphantis T. 
Published: May 2011

IntroductionClinical parameters predict HRQoL in inflammatory bowel disease (IBD), however some patients have impaired HRQoL despite clinical remission; furthermore, Crohn's disease (CD) is associated with smoking, while ulcerative colitis (UC) is largely a nonsmokers’ disease, indicating that psychological distress and personality variables might mediate the relationship of clinical variables with HRQoL and smoking.AimsTo assess psychological distress and personality traits in IBD and their contribution to the formation of HRQoL and smoking habits.MethodsIn 76 IBD outpatients we compared psychological distress symptoms and defensive profile between CD and UC. In another study of 185 IBD patients, we tested the relation of psychological distress, defense mechanisms and personality traits with HRQoL, smoking, and nicotine dependence.ResultsCD patients presented a more immature defensive profile. The more psychologically mature IBD patients had lower relapses and surgical operations’ rates. Psychological distress was associated with impaired HRQoL in a dose-response fashion. Somatization was independently associated with impaired HRQoL and mediated the relationships of anxiety and depression with HRQoL. In CD, the relationship of the smoking-linked personality characteristic “impulsive sensation seeking” with current smoking and nicotine dependence was stronger.ConclusionsIBD patients exhibit several specific psychological difficulties in adaptation to stressors. Apart from addressing timely psychological distress and somatization symptoms, clinicians and consultation-liaison psychiatrists should consider the patients’ defensive profile, since such personality traits, although usually underestimated, are strongly independently associated with the disease's outcome. Our findings might be also relevant to more effective interventions targeting smoking cessation in CD patients.
Associations of affective disorder in patients with inflammatory bowel disease
Authors: Baig B.J. , Lees C.W. , Johnstone E.C. , James V. , Satsangi J. , Lawrie S.M. 
Published: May 2011

IntroductionInflammatory Bowel Disease (IBD) is associated with co morbid depression and anxiety of up to 42%. Corticosteroids, used commonly in IBD, are known to cause psychiatric side-effects and could be an independent risk factor for affective illness. Recent studies show that depression is also associated with raised CRP and IL6.AimsThis study aims to show which demographic, clinical, medication and immunological factors are predictors of anxiety and depression in IBD.MethodsThe IBD, Steroids and Affective Disorder (ISA) study is a cross-sectional study of IBD patients in Edinburgh, UK. Out patients underwent assessment including Hospital Anxiety Depression Scale (HADS) past psychiatric history, steroid medication history, inflammatory markers, the Medication Adherence Rating Scale (MARS) and Altman Self Rated Mania Scale (ARSM).Results326 patients with Crohns and 256 with Colitis (72% of clinic attendees) were recruited. 251 (43%) patients scored 12 or above on the HADS questionnaire. 45% of patients had previously suffered from affective illness. Patients on Prednisolone and Budesonide scored significantly higher on HADS Depression (p = 0.03 and p = 0.002) as did those who had been on Prednisolone for more than 8 weeks (p = 0.041). Being on prednisolone was not associated with increased Colitis and Crohns activity indices (p = 0.2). HADS scores were measured against other disease and demographic variables.ConclusionAffective illness is common in the IBD population and the prescription and duration of systemic corticosteroids are associated with depression. Biological and disease variables may play an important role in co morbid affective illness in IBD
Socioeconomic and psychological factors associated with non-adherence to treatment in IBD patients: Results of the isseo survey
Authors: Nahon S. 
Published: May 2011

IntroductionTreatment is a key condition in preventing relapses in inflammatory bowel disease. The aims of the ISSEO study were specifically to study socioeconomic and psychological factors and adherence to treatment in a large cohort of IBD patients.MethodsA questionnaire concerning demographic, clinical and psychosocial characteristics was mailed to 6000 IBD patients belonging to the French association of IBD patients (AFA). The questionnaire was also available on the website of the AFA for non-member patients to answer. Good adherence to treatment was defined as taking ≥80% of prescribed medication. Socioeconomic deprivation was assessed using the specific EPICES score (http://www.cetaf.asso.fr) developed in France. Anxiety and depression were assessed using the HAD scale.Results1069 women and 594 men (43.6 ± 15.4 yrs) completed the questionnaire, 1450 (87%) of them belonged to the AFA. 1044 had Crohn's disease, 36 indeterminate colitis and 583 ulcerative colitis. Adherence ≥80% was reported by 90% of patients. Logistic regression identified the following factors for good adherence: anti-TNF alpha therapy (OR 2.3, 95% CI 1.46–3.63) and membership of the AFA (OR 1.67, 95% CI 1.05–2.64), while anxiety (OR 0.62, 95% CI 0.42–0.90), and constraints related to treatment (OR 0.32, 95% CI 0.23–0.47) were associated with non-adherence.ConclusionIn this large cohort of IBD patients, psychological distress and constraints related to treatment decrease adherence to treatment, while membership of a patients’ association improves it.
Methodology of mapping in integrative molecular biology
Authors: Iris F. 
Published: May 2011

Psychiatric illnesses remain of unclear etiopathogenesis and a variety of them can coexist, partly mimicking each other while contributing to and distorting symptomatic expressions. To understand the processes involved, it is necessary to unravel signalling pathways, complex interaction networks and metabolic alterations involving a plethora of anatomical components. Hence, whatever the nature of the alterations convincingly detected, these must be associated with their most-likely cellular contexts to then have a chance to reverse engineer the events that could have given rise to the observed alterations and predict their most plausible functional consequences. This requires the utilisation of analytical approaches collectively known as “Systems Biology”.Systems biology explores how parts of biological entities function and interact to give rise to the behaviour of the system as a whole. But having said that, what can we actually do?Two broad approaches to systems biology currently exist: the frequently followed mathematical (Bayesian) procedures and the more rarely encountered heuristic approaches.Heuristic modelling plays the role of an architect (defines the nature, the structure, the functionalities and the contextual constrains of a process) while mathematical modelling plays the role of an engineer (reveals the dynamics and robustness of this process while defining the set of parameters sufficient to give rise to similar or very different phenotypes).This talk will explain, through concrete examples, the approaches whereby one can harness heuristic frameworks to produce multi-level models of complex neurobiological processes that can then be independently tested and biologically validated or refuted.
Transcultural telepsychiatry and its impact on patient satisfaction
Authors: Mucic D. 
Published: May 2011

IntroductionNational and International telepsychiatry service was established between Denmark and Sweden in order to increase access to cross-cultural expertise. Patient acceptability study was conducted to assess the patients’ attitudes toward the quality, advantages and disadvantages of telepsychiatry service.MethodsOver a period January 2005-December 2007, 61 patients were treated via telepsychiatry by clinicians that speak patientsrespective mother tongues. Video-conferencing equipment connected the Little Prince Psychiatric Centre in Copenhagen with two hospitals, one asylum seekers’ centre and one social institution in Denmark. These stations were also connected to the Swedish department of the Centre. Number of languages spoken was 9 while the number of nationalities treated was 11. No interpreter assistance has been used.After the end of the telepsychiatry contact all patients were asked to complete a satisfaction questionnaire.ResultsPatients reported a high level of acceptance and satisfaction with telepsychiatry. They expressed a wish to use telepsychiatry via their mother tongue, rather than interpreter-assisted mental health care in the future.DiscussionThe restricted physical contact and non-verbal communication of telepsychiatry was compensated by the fact that the doctor and patient spoke the same language and had similar cultural and/or national references. The results of the survey may contribute to further development of, primarily, European Telepsychiatry Network. However, this model may be used for conducting of larger international telepsychiatry service capable to provide mental health care toward diversity of patient populations underserved on their mother tongue worldwide.
Culturally competent mental health care
Authors: van Loon P.J. 
Published: May 2011

A dynamic view of culture defines it as the semiotic system that people use to interpret their inner and outer worlds and that shapes their responses to it.Culture is more than the fixed patterns of behaviour acquired and transmitted through symbols and related to a particular cultural group.Cross cultural psychiatry makes use of both universalistic and relativistic concepts.It is important to make use of these concepts as clinician in the diagnostic and therapeutic process with patients.Attention will be paid to the concept of idioms of distress, how does the patient elaborate his suffering?Clearly elucidation of the idioms of distress is essential in formulating an accurate diagnosis.Another factor as emphasised in the Cultural Formulation which is highly relevant to this subject is the therapist patient relationship. Transference and countertransference issues related to the necessity of reconciling the meaning of verbal and nonverbal expressions of the patient along with contextual information about the patient and his environment with diagnostic critieria are relevant here.Some research particularly related to how symptoms are expressed and carried out in the department in Rotterdam will be discussed in this workshop.