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A study of turbulent impurity transport by means of quasilinear and nonlinear gyrokinetic simulations is presented for Wendelstein 7-X (W7-X). The calculations have been carried out with the recently developed gyrokinetic code stella. Different impurity species are considered in the presence of various types of background instabilities: ion temperature gradient (ITG), trapped electron mode (TEM) and electron temperature gradient (ETG) modes for the quasilinear part of the work; ITG and TEM for the nonlinear results. While the quasilinear approach allows one to draw qualitative conclusions about the sign or relative importance of the various contributions to the flux, the nonlinear simulations quantitatively determine the size of the turbulent flux and check the extent to which the quasilinear conclusions hold. Although the bulk of the nonlinear simulations are performed at trace impurity concentration, nonlinear simulations are also carried out at realistic effective charge values, in order to know to what degree the conclusions based on the simulations performed for trace impurities can be extrapolated to realistic impurity concentrations. The presented results conclude that the turbulent radial impurity transport in W7-X is mainly dominated by ordinary diffusion, which is close to that measured during the recent W7-X experimental campaigns. It is also confirmed that thermodiffusion adds a weak inward flux contribution and that, in the absence of impurity temperature and density gradients, ITG- and TEM-driven turbulence push the impurities inwards and outwards, respectively.
Schizophrenia is a chronic disease. Several etiopathogenic aetiologies have been posed, among them the existence of cerebral inflammation. S100B is a calcium-binding protein, mainly produced and secreted by astrocytes, that mediates the interaction among glial cells and between glial cells and neurons. Serum S100B levels have been proposed as a peripheral marker of brain inflammation.
The aim of this research is to study if the serum level of the protein S100B has relationship with positive psychopathology.
31 paranoid schizophrenic inpatients (22 male and 9 female, 36.7±10.3 years) meeting DSM-IV criteria participated in the study. Blood was sampled by venipuncture at 12:00 and 24:00 hours. Blood extractions were carried out during the first 48 hours after hospital admission. Psychopathology was assessed by the Positive and Negative Syndrome Scale (PANSS). Serum S100B levels were measured by sandwich ELISA techniques.
Correlations between serum levels of S100B protein and PANSS positive scores are shown in the following table. The first figure corresponds to the Pearson's correlation coefficient, while the figure in brackets corresponds to its statistical significance.
Total Positive Score
Serum levels of S100B protein may be used as a biological marker of positive psychopathology in paranoid schizophrenia.Acknowledgement
Mixed Bipolar patients are those who have co-existing depressive symptoms during mania. These patients are supposed to have a worse evolution.
The objective of this study was to compare the long-term outcomes of patients who had at least one mixed episode with those who experienced only pure manic episodes.
169 outpatients diagnosed of Bipolar I disorder and treated at least during two years were included. 120 patients (71%) complited the follow-up over 10 years. Baseline demographic and clinical variables were included.
The patients with mixed episodes (37%) had a significantly younger mean age at onset comparing with those with manic episodes (25.3 years vs. 30.8 years; p=0.025) they also had more previous mood- incongruent psychotic symptoms χ2= 6.77, p=0.034), more number of hospitalizations (OR= 1.36, 95% CI = 1.14; -1.63; p< 0.001), and more number of episodes (OR= 1.21, 95% CI = 1.10-1.31; p< 0.001). There were no significant differences relating to depressive episodes, alcohol use, drug abuse, suicidal behaviour and suicide attempts.
Age at onset differed significantly between the mixed episode and pure mania groups, with mixed episode patients having a younger age of onset. This is interesting as one of the major results of the study we have found that age at onset mediates some of the factors classically related to outcome in mixed episodes like alcohol abuse and suicide attempts. However, independently of age at onset, these patients represent a especially severe type of bipolar disorder.
In our work we propose to use the adult developmental eye movement test (A-DEM) of Gene Sampedro et al, for the study of saccadic movements in schizophrenia.
To study the importance of saccades and attention in a sample of institutionalized patients with schizophrenia in a Unit of Psychosocial Rehabilitation.
Sample formed by 30 people.15 patients and 15 controls. 15 patients were corresponding to all the schizophrenic patients admitted in January, 2009 in a Unit of Psycosocial Rehabilitation of Conxo's Psychiatric Hospital. The 15 of the group control were selected of random form between sanitary personnel without psychiatric pathology, homogenizing the variables chronological age and sex with regard to the group of investigation.
The A-DEM vertical half to 44.37 seconds in the control group versus 59.54 seconds in the sample of patients. Regarding the results of the horizontal A-DEM obtained an average score of 47.07 seconds compared to control group obtained 60.68 seconds in the group of patients. The schizophrenic patients are characterized for having an attention diminished in 87 %, opposite to 47 % of the group control that they have a normal attention and 40 % increased. These differences of saccadic movements and of the attention are statistically significant.
Schizophrenic patients have few saccades both horizontally and vertically slower than normal people.
Schizophrenic patients show a marked deficit of attention to the normal population.
The use of psychiatric services has been associated with a wide range of clinical variables. However, information about the impact of adolescent personality pathology related to hospital admissions is limited.
To analyze the different combination of personality pathology associated to variables of psychiatric hospital admissions (number of admissions, total of days spent as psychiatric inpatient, average of days for admission, and number of admissions in a day care hospital).
The ICD-10 and DSM-IV modules of the semi-structured interview IPDE (International Personality Disorders Examination) were administered, in a sample of 107 adolescent psychiatric patients (M=15.8, SD=0.8 years old; age rank 15-17; 79% female).
Personality pathology group identified by the IPDE showed significantly higher number (p< .001) of psychiatric admissions (M=1.48) than no personality pathology group (M=0.57), but not significant higher number of admissions in a day care hospital. Psychotic patients showed the highest rate of admissions (M=2.88). In present sample, between 30% and 38% of all hospital admitted patients showed a Cluster B personality disorder (PD).The users of psychiatric inpatient services with a complex PD (two o more PD from different clusters) presents in average: 2-2.5 admissions, 34-53 total days spent as psychiatric inpatient, and 11-16 days on each admission.
Patients with psychotic disorders or complex PD were the highest users of inpatients services, but not of day care hospital admissions.
To find out the frequency of medical conditions presented by a population of institutionalized chronic schizophrenic patients.
The target population is a total of 220 schizophrenic patients, 48 men and 172 women, diagnosed following the ICD-10 criteria, institutionalized at least during 5 years in a 76,8% of the patients. The average age was of 64,64 years.
Specific survey applied by the group of investigators aiming to collect socio-demographical data and the medical conditions, using the following psychometric scales: Cumulative Index of Illnesses (CII), Global Assessment Scale (GAS), and Clinical Global Impression (CGI).
Statistical analysis was performed with SPSS v 15.0, including descriptive statistics and correlation analysis.
Diabetes was found in 15% of cases, obesity in 31,7%, overweight in 39%, high blood pressure in 24,5%, high cholesterol serum levels in 21%, high triglyceride serum levels in 8,7%. A 26% of the patients were smokers.
The average number of categories at the CII scale was 4,84 and the average total score was 11,96.
Our patients predominantly are of an advanced age, female sex, and long-term inpatients. The presence of comorbid physical illness is high. The relatively low number of smokers could be explained by the demographic characteristics of our sample.
Interdigital 2D:4D ratio has been considered as an indicator of prenatal exposure to androgens, entailing then a smaller ratio more androgenisation. Although it has been related to systemizing and empathy dimensions in the general population, it has never been studied in parents of people with Autism Spectrum Disorders (ASDs).
Objectives and aims
To analyse the relationship between the 2D:4D ratio and these psychological variables in this population.
The sample was composed by parents of both genders of people with (n = 46) or without (n = 42) ASDs. The ratio was calculated as the mean of 3 measurements of each hand evaluated by 3 different researchers. Psychological dimensions were evaluated by means of the Systemizing and Empathy Quotients (SQ and EQ, respectively).
Parents of ASDs persons showed lower scores in the EQ than controls, being these differences replicated only in men. No differences between groups for the 2D:4D ratio were found. Nevertheless, regression analyses indicated that in parents of ASDs a higher 2D:4D left ratio predicted a higher EQ. This result was also observed in men but not in women. In any case, the model was not significant in the control group.
Parents of ASDs persons showed lower EQ than controls, being this quotient predicted by the left 2D:4D ratio only in the former. When analysing in each gender, these results are only obtained in men. Among other parameters, the D2:D4 ratio (especially the left hand one) could be considered a valid indicator of the ASDs parent's idiosyncrasy.
The introduction of the first atypical antipsychotic with a long acting formulation has open new therapeutic options for the treatment of schizophrenic patients. Our objective consists of comparing psychopathology levels and global functioning in patients with paranoid schizophrenia treated in monotherapy either with long-acting injectable risperidone (LAIR) or conventional depot antipsychotics (DA).
Patients attending at the community mental health center during the six-month recruitment period were eligible to enter the study. Scores achieved in positive and negative subscales of PANNS and EEAG scale of (Global Activity Evaluating Scale) were evaluated at baseline and 6 months later. Six patients treated with RLAI and six patients treated with DA were recruited. Data were analyzed both with the real sample (N=6 per group) and extrapoling the same results to a bigger sample size (N=24 per group).
Mean increase in scores for both PANNS positive and negative subscales were lower in patients treated with RLAI that in those treated with DA (positive subscale: 0.018±0.06 vs. 0.048±0.03, RLAI and DA, respectively, p=0.387; negative subscale: 0.232±0.076 vs. 0.3095±0.123, RLAI and DA, respectively, p=0.579). EEAG scores were higher for patients treated with RLAI than those treated with DA (1.250±0.56 vs. 0.333±0.225, p=0.144). When these results are extrapolated to a sample of 24 patients per group, differences in EEAG reach statistical significance (p=0.034).
After 6 months of treatment, patients treated with RLAI tend to show a greater improvement in their global activity than those treated with DA.
High prolactin blood levels is an adverse effect of neuroleptic treatment. Typical antipsychotics seem to produce it more frequently than atypical ones.
To know hyperprolactinemia prevalence in our patients related with the type of antipsychotic drug used.
171 individuals, 31 male patients and 140 female ones, with a mean age of 61,67 years old and a mean hospital stay of 18,20 years.
The sample was divided in three groups:
– Typical antipsychotics group: 37 patients.
– Atypical antipsychotics group: 92 patients.
– Typical and atypical antipsychotics group: 42 patients.
Prolactin serum levels were determined (normal values: 1.5-25 ng/ml for fertile age women, 0.7-20 ng/ml for post-menopause women and 0-20 ng/ml for men).
Prevalence of hyperprolactinemia for every group, for single antipsychotic drugs, for age groups, for gender and for diagnosis were obtained.
Prevalence of hyperprolactinemia was 66.1% for the global sample. Results for the different groups were the following:
– Typical antipsychotics group: 73.0%
– Atypical antipsychotics group: 60.9%
– Typical and atypical antipsychotics group: 71.4%
Statistical analysis according to concrete antipsychotic drug showed the following hyperprolactinemia percentages:
– Risperidone: 90.0%
– Haloperidol: 69.2%
– Olanzapine: 44.4%
– Quetiapine: 33%
– Aripiprazol: 14.3%
– Clozapine: 11.1%
Our study finds lower hyperprolactinemia blood levels in patients on atypical antipsychotic treatment than on typical antipsychotic one. Haloperidol and risperidone got the worst results in this matter while clozapine and aripiprazol showed the best ones.
Caregiving of offspring with a chronic illness is a highly stressful vital experience. Previous studies with parents of schizophrenic persons revealed that these situations increase health complaints (González-Bono et al., 2009), with the duration of caring being a relevant variable (Contell-Montaña et al., 2010). The higher age of the caregivers of schizophrenia can contribute to this health unbalance, but little is known in younger samples.
To test whether middle-aged caregivers (parents of autistic persons) present higher health disturbances than controls and to investigate the moderating role of duration of caring
Health complaints and resting levels of immunoglobulin A (IgA) were measured in a sample of 38 middle-aged caregivers of autistic offspring (24 mothers/14 fathers) and 35 parents of healthy persons (17 women/18 men) of similar characteristics.
Caregivers report more immunological, muscular, genital-urinary and general health complaints than controls. Additionally, the scores of all scales and total score of Goldberg Health Questionnaire were higher in caregivers than in non caregivers. No significant differences were found in IgA levels. Among caregivers, fewer years of caring were associated with more anxiety and lower IgA levels.
Chronic stress of caregiving of autistic offspring is associated with more health complaints. The number of years after unequivocal diagnosis of autism has a moderating effect on immunological disturbances and anxiety in care givers. Further research is needed to clarify whether the interventions focused on anxiety can influence the low antibodies levels and decrease future health complaints.
Analysing reactivity to laboratory stressor in lab is a valid model for understanding how people act in real-life situations. Electrodermal activity is a good index of emotionality, which has not been analysed in caregivers of persons with Autism Spectrum Disorders (ASDs).
Objectives and aims
This work aims to compare the response of electrodermal activity to mental stress between caregivers of ASDs people and controls, as the former could show a different response due to their particular situation characterised by a state of continuous alert.
Parents of both genders of people with (n = 44) or without (n = 42) ASDs carried out a set of different mental tasks. Skin Conductance Level (SCL) was continuously registered before, during, and after the tasks. Skin Conductance Responses (SCR) were obtained from SCL levels using Acqknowledge software.
For SCL, a significant effect of “gender” and of “period x group” and “period x group x gender” interactions was observed. SCL was higher in men than in women and in controls when compared to caregivers. Controls presented more SCL Reactivity than caregivers, being these results were replicated in men (who also showed worse recovery in controls) but not in women. In caregivers, men showed lower SCR Reactivity than women.
Caregivers of ASDs showed a lower electrodermal reactivity to mental stress than controls, and this effect was stronger in men. These results could reflect a lower reactivity to stressful situations in caregivers and, consequently, a loss of the adaptative potential of the stress response in this population.
Andalusia is the most highly populated (7,849,799 hab.) region of the Spanish State. It has all the sanitary domains under its own Health Service (Consejería de Salud), and it has undertaken a deep reorganization of the psychiatric services, establishing a new model based on the mental health communitarian alternative that is already completely implanted. Rates of readmission are a method to assess the quality of care and an important tool in the planning of services of mental health.
The aim of this study is to establish if readmission rates are influenced by Human Resources in Psychiatric Community Devices.
Part of FIS Project PI05/90061 ‘Patterns of General Hospital Psychiatric Units Overuse’.
MBDS is a system of hospital register that gathers all the discharges produced in the andalusian hospitals. It is totally trustworthy from 1995, and we have processed data up to 2004.
Our Data Set register 101234 hospital admissions of psychiatric patients.
The number of admissions from patients who enter three times or more throughout the year has been: 22.66%(1995); 24.66% (1996); 31.01%(1997); 30.72%(1998); 34.07%(1999); 35.35%(2000); 36.92%(2001); 32.93%(2002); 31.20%(2003) and 29.36%(2004).
On the other hand, it has been an increase in Mental Health Human Resources Rates: 24.23-100.000 inhab-(1998); 24.19 (1999); 26.01(2000); 28.04(2001); 29.83(2002); 29.16(2003); 29.34(2004) and 29.90(2005).
Increasing human resources in psychiatric community devices do not change revolving-door rates in general hospital acute psychiatric units in a community mental health system.
Adoption, twin and family studies suggest that suicide behavior is familial and heritable. Both completed and attempted suicide appear to be transmitted in a familial form. Genetics and environment influences had been detected in various studies. But suicidal behavior suggests to be inherited independently from the mental disorders usually associated with it. While traditional statistics emphasizes inference and estimations, data mining emphasizes the fulfillment of a task such as classification, estimation, or knowledge discovery.
The goal of this study was to determine in a large sample of suicide attempts which variables are associated with family history of attempted suicide.
In an emergency room, 539 adult suicide attempters were recruited. The two dichotomous dependent variables were family history of suicide attempt (10%) and of completed suicide (4%). Independent variables were 101 clinical variables explored with two data mining techniques: Random Forest and Forward Selection.
A model for family history of completed suicide could not be developed. A classificatory model for family history of attempted suicide included the use of alcohol in the intent and family history of completed suicide, provide a sensitivity of 78.4%, a specificity of 98.7% and accuracy of 96.6%.
A classificatory model for family history of completed suicide could not be developed using data mining techniques. But it suggested that the use of alcohol in the intent and family history of completed suicide may be associated with familial attempted suicide.
Our study aimed to compare the mental illness awareness in institutionalized schizophrenics when compared to non institutionalized schizophrenics.
Diagnoses of Schizophrenia was done following the ICD-10 dignosis criteria. We chose a convenience sample of our patients: 74 patients, 69.9% of institutionalized inpatients and a 31.1% of outpatients.
Specific survey applied by the group of investigators aiming to collect socio-demographical data and clinical data, using the following psychometric scales: Scale to Assess Unawareness of Mental Disorder (SUMD), Global Assessment Scale (GAS), and Clinical Global Impression (CGI).
Statistical analysis was performed with SPSS v 15.0, including descriptive statistics and correlation analysis.
Differences found among awareness of response to medication and the awareness of social consequences of mental disorders are statistically significant, being higher in the institutionalized group of schizophrenics.
Caregivers of relatives with chronic diseases has shown lower rest levels of immunoglobulin A than non-caregivers (Gallagher et al., 2008). In response to mental stress, IgA levels used to be increased in healthy population (Okamura et al. 2010). Scarce studies have been focused on immunological effects of caregiving in response to stress, and the results are controversial. To our knowledge, there are no studies stressing this field in chronically stressed populations such as caregivers of autistic offspring.
Objectives and aims
Evaluate whether caregivers present different psychosocial and immunological responses to acute stress than non-caregivers, as well as what is the role of gender in these responses.
38 caregivers of persons with autism and 35 non-caregivers were exposed to a psychosocial laboratory stress. IgA levels were measured before, during and after a set of several mental tasks, while the state of mood was evaluated before and after the stressors.
Caregivers showed blunted IgA response to stress in men and women compared with non-caregivers, although the response pattern was different for each gender. Moreover, caregivers presented worse mood (depression, anger, fatigue, vigor and total score) than non-caregivers. Moreover, psychological effects of stress are inversely associated with levels of IgA, fundamentally during the task.
Caregiving reduces IgA secretion in response to psychosocial stress, although differently in men and women. Further studies are necessary to explore other neuroendocrine factors, together with mood, that could be involved in this buffered response.
Comorbidity has been defined as the coexistence of somatic and psychiatric diseases with diferent physiopatology in the same person, and it can appear simultaneously to the schizophrenia or during the patient's lifetime. There are two types of comorbidity: episodical or taking place during the lifetime of the patient. We can diffferenciate between comorbidity itself (in cluster, dependent or associated) to the so-called pseudo-comorbidity. Besides, comorbidity has been classified as a co-syndrome and it is considered a prognosis indicator of this disease, which can determine an increase in the rates related to relapses, worse response to treatment, less capacity to cope with social situations, and suicide in patients suffering from schizophrenia.
177 schizophrenic patients were assessed for affective symptoms and suicide behaviour. 24.3% were suffered for depression. 35% had a previous record of autolytic attempts. The rate of suicide history were higher among depressed schizophrenics (50%) than non-depressed schizophrenics (20%) (p<0,05).
We point out the clinic importance of suicide in schizophrenic patients suffering from depression. Moreover, the study shows the necessity to carry out longitudinal studies to recognize indicators of depression in advance and establish the diagnosis of depression, and, also, to acknowledge the importance of the gender factor in the depression of schizophrenic patients.
Early onset forms of bipolar disorder may be difficult to distinguish from schizophrenia. Although operational criteria have become more precise, and there are more diagnostic systems to catalogue a psychotic adolescent, the clinicians continue having difficulties.
To know the stability of the diagnosis of definitively bipolar patients with psychotic symptoms during the episodes, and factors that can influence other psychotic diagnoses in the first episode of the illness.
140 bipolar patients of Araba, (Basque country) were included during 2 years. Patients were divided into two groups: unstable diagnoses (UD)(bipolar patients with an initial diagnosis of other psychosis) and stable diagnoses (SD) of bipolar disorder. Clinical and sociodemographic data were obtained.
The mean age at onset was significantly lower in the UD group (p = 0.004). It was rare to have an unstable diagnosis when the first psychotic episode occurred after age 38 (p = 0.008). There were more singles in the UD group (p = 0.010).
The presence of mood incongruent psychotic symptoms was more frequent in the UD group (p < 0.001).
Mood incongruent psychotic symptoms variable was the only independent factor significantly associated with an unstable diagnosis in the multivariate analysis (p = 0.036).
One third of the patients have been previously diagnosed with other psychotic illness.
This study suggests that the most important factor is the clinical picture, especially the presence of mood-incongruent psychotic symptoms. A correct diagnosis is important because patients who are prescribed mood stabilizers have lower rates of rehospitalisation than those who are not treated with mood stabilizers.
Schizophrenia is not only a mental disorder but also has other components affecting the physical part of the body. Several studies have suggested that neuroinflammatory processes may play a role in schizophrenia pathogenesis, at least in a subgroup of patients.
This poster reported the preliminary results of a project aiming to find schizophrenia biomarkers. We present biological parameters and clinical variables of patients with schizophrenia according to the lab results and the clinical assessments.
Cross-sectional, naturalistic study. Inclusion criteria: DSM-IV diagnosis of schizophrenia; age >17 years; and written informed consent given.
123 patients with schizophrenia. Mean age 40.75 (10.37), 67.5% males. There is relationship between homocysteine(oxidative stress) and psychopathology: PANSS [negative subscale 0.27 (p=0.003), general subscale 0.21 (p=0.028) and Marder factor 0.28 (p=0.003)], NSA [global score 0.24 (p=0.010), and some factors: communication 0.26 (p=0.005), affect 0.28 (p=0.002), motivation 0.30 (p=0.001) and motor retardation 0.27 (p=0.004)]; Functioning [(PSP total score -0.24 (p=0.011) and some PSP factors: work 0.30 (p=0.001), self-care 0.21 (p=0.022)]. However, there is no relationship between C-reactive protein(inflammation) and any clinical variable. On the other hand, there is relationship between: glucose and cognitive impairment; cholesterol and NSA motivation score, cognitive impairment and PSP (total score, self-care and work); triglycerides and HDRS (total score, melancholia factor and vitality factor), NSA motivation score and cognitive impairment.
The negative dimension of schizophrenia is associated with high homocysteine levels, which means an oxidative stress state. As well, a worse functioning level is associated with high homocysteine level.
Tapentadol is a centrally-acting synthetic analgesic which acts as a mu-opioid receptor agonist as well as a norepinephrine re-uptake inhibitor. It is use to treat cronic pain. Most prevalence adverse effects are gastrointestinal and nervous symptoms. Furthermore, it has objectified, with less frequency, psychiatric disturbances.
To analyse the relationship between a maniac episode and tapentadol.
Forty-nine-year-old female, with personal history of dyslipidemia and lumbar herniated discs in L4-L5, L5-S1, in treatment with tapentadol 200 mg/day for 20 days and no past psychiatric history. She was admitted to the Psychiatry Department due to a maniac episode, with desinhibition, pressure and loud speech, euphoria, megalomaniac delusion and sleep disturbance for the last 10 days. Young Mania Rating Scale (YMRS) was 36 points. Olanzapina 15 mg/day was introduced and tapentadol was removed. Symptoms remitted quickly and 6 days later, at discharge, YMRS was 4 points. One year later, the patient continued to be asymptomatic.
Opioids can produce psychiatric disorders like hallucination, sleep disorders, depressed mood, disorientation, agitation, nervousness, restlessness, euphoric mood. Secondary mania to tapentadol mechanism is unknown, but having opiate cases described, it is possible to attribute this episode to tapentadol.
– Secondary mania is associated with various medical conditions, including vitamin B12 deficiency, brain injury, HIV infection and drugs such as alcohol, caffeine, sympathomimetics, steroids, bupropion, isoniazid, clarithromycin and opioids.
– Further research is required to determine if the maniac episode was only isolated by the tapentadol or it is the beginning of a bipolar disorder.