Abstracts of the XII World Congress of Psychiatry of the World Association
of Psychiatry in Yokohama, Japan

Chosen by Drs. John E. Mezzich and Miguel R. Jorge

 

Profile of cytokines in MDD subtypes F. Lotufo-Neto, A. Marques, W. Domingues, E. Prado
Institute and Department of Psychiatry, University of São Paulo. PO Box 3671, CEP 05403-010 São Paulo, Brazil.

Introduction:
Major depressive disorder (MDD) may be associated with alterations of cytokines.
Hypothesis:
. The different cytokine profiles should discriminate subtypes of major depressive disorder
METHODS:
Twenty-seven outpatient depressed patients, without intake of
antidepressants, they were diagnosed and evaluated according to the criteria
of severe combined immunodeficiency Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV-SCID) Rating Scale and Hamilton Depression.
Patients were classified into different subtypes (melancholic, not melancholy, acute, chronic , severe and moderate). Cytokines (concentration were measured
in plasma IL 1 and IL 6 e INFgama) both before and
. after treatment
Results:
. significant increase in cytokine IL 1beta in patients with non melancholic, acute severe and MDD was observed
after treatment, IL 6 increased significantly in all groups (except non-melancholic). INFgama signifi-cantly increased in patients with MDD gloomy, severe and acute.
basal metabolic rate in anorexia nervosa
prior to treatment
AR Knight, Cervantes PL
Clinic Eating Disorders, National Institute of Psychiatry “Ramon de la Fuente”. Mexico City, Mexico.

Previously it has been reported after prolonged semiham-Bruna, the basal metabolic rate (BMR acronym) decreased markedly due to weight loss and hypometabolism. In patients with anorexia nervosa (AN), the evaluation of traditional formulas BMR has shown overestimate. In this study we compared the Harris-Benedict formulas, Mifflin St. Jeor, Owen and FAO / WHO / UNO against resting energy expenditure (REE acronym), obtained through indirect calorimetry (gold standard) in three Mexican patients with AN. We also performed a joint-pométrica evaluation of these patients and observe the BMR concerning these anthropometric indicators.
We conclude that the different formulas were not effective in assessing the BMR in AN patients at the start of
treatment. The use of indirect calorimetry may be more suitable for the design of an initial plan of nutrition for these patients.
Bibliography:
1. Scalfi L, Marra F, De Filippo E, et al. The prediction of basal metabolic rate in female patients With anorexia nervosa. Int J Obes Relat Metab Disord. 2001; 25: 359-364.
2. Russell J, Baur LA, Beumont PJ, et al. Altered energy metabolism in anorexia nervosa. Psychoneuroendocrinology. 2001; 26: 51-63.
3. Pauly RP, Lear SA, Hastings FC, Birmingham CL. Resting energy expenditure and plasma leptin levels in acute anorexia nervosa During refeeding. Int J Eat Disord. 2000; 28: 231-234.
4. Polito A, Fabbri A, Ferro-Luzzi A, et al. Basal metabolic rate in anorexia nervosa: relation to body composition and leptin Concentrations. Am J Clin Nutr. 2000; 71: 1495-1502.
5. Schebendach JE, Golden NH, Jacobson MS, et al. The metabolic respon-
ses to starvation and refeeding With anorexia nervosa in adolescents.
Ann NY Acad Sci 1997; 817:. 110-109.
6. Schebendach J, Golden NH, MS Jacobson, et al. Indirect calorimetry
in the nutritional management of eating disorders. Int J Eat Disord.
1995; 17: 59-66.
Use of antidepressants in schizophrenia
AT Ruiz, E. Miranda
Department. Psychiatry and Mental Health, Faculty of Medicine, University of Chile. . Santiago, Chile
Objective:
Schizophrenia patients are often treated with anti-psychotic and antidepressant. This study analyzed the prescription of antidepressants in schizophrenia.
Method:
A sample of 400 schizophrenic patients, according to the criteria of the Diagnostic and Statistical Manual studied
of Mental Disorders, third revised edition (Diagnostic and Statistic Manual of Mental Disorders, 3rd edition revised [DSM-III-R]). Information on prescription drugs, age at manifestation of the dis-ease, symptoms and course of mood symptoms was obtained. Studen test was used in data analysis.
Results:
Eighty-two schizophrenic patients (20.5%) they received antidepressants (69.5% male; 30.5% women). Compared
tion with the total sample, the age at onset of the disease (16.5 years DS 9.15%) was significantly lower (p <0.05). Sixty-eight patients (83%) reported depressive symptoms and 33 cases (40%) showed a high risk of injury (suicide attempts). In 62 patients (76%) a tendency toward chronic course was observed.
Conclusions:
antidepressants to patients more men than women were prescribed. major depressive symptomatology was observed both in the course of the disease as when manifesta-tion thereof. This suggests that patients with schizophrenia have a poor prognosis.
Bibliography:
1. Lam RW, Peters R, Sladen- Dew N, S. Altman clinic A community-based survey of antidepressant use in persons With schizophrenia. Can J Psychiatry 1998; 43: 513-516.
2. Levinson DF, Umapathy C, Musthaq M. Treatment of schizoaffective
disorder and schizophrenia With mood symptoms. Am J Psychiatry. 1999; 156:. 1138-1148
epilepsy and schizophrenia
EB Tornese, MS Hermida
Hospital and Dr. Braulio Moyone Gallego Center.
Buenos Aires, Argentina.

The entrance of the afferent information to the neocortex hi-pocampo contributes to the understanding of the functional changes in neuronal connectivity. The fun-tions of the entorhinal cortex and morphological alterations and Hippocampus-pales connections may be the substrate of psychosis in temporal lobe epilepsy and schizophrenia.
The purpose of this paper is to test the correlation between psychopathology and structural alterations and temporal lobe epilepsy schizophrenia.
As a basis for the study 56 patients with Epilepsy-sia temporal lobe and 76 schizophrenic individuals, between 25 and 65 years of age were used. The following tests were administered: Mini-mental state examination (. Folstein et al), com-scale behavior for overall dementia (. Blessed et al), Barcelona Test adapted scale for assessing positive and negative symptoms ( Andreasen). Psychopathological neurobiology correlations were analyzed.
In 100% of epileptic patients recorded a temporary disfunction-ing, which correlates with positive symptoms represented by sensory and emotional disturbances and cognitive impairment. In 100% of individuals we recorded schizo-phrenic frontal dysfunction, according to the severity of psychopathology and cognitive impairment.
The central atrophy in the temporal lobe epilepsy and schizophrenia prevail in the temporal lobe area in mediobá-music the most severe stage of both conditions.
Bibliography:
1. P. Gloor The Temporal Lobe and Limbic System. Oxford University Press. 1997.
2. Joseph, R. Neuropsychiatry, Neuropsychology, and Clinical Neuroscience, 2nd ed. Williams
and Wilkins, USA, 1996.
Association between galantamine and Venlafaxine XR
in patients with cognitive impairment and depression
JC Zarra
Department of Psychiatry, Hospital Italiano of La Plata.
La Plata, Buenos Aires, Argentina.
Objective:
To evaluate and develop treatment pharmacological and therapeutic RESPONSE-ta association between antidepressant and a new nootropic agent in patients with comorbidity of depression and cognitive impairment.
Recognize the relationship between cerebral oxygen deficiency and depressive disorder.
To evaluate the therapeutic response in patients with comorbidity between cognitive disorder and depression treated with Ga-lantamina, Venlafaxine XR and both drugs combined.
Method:
A group of 150 patients with symptoms of cognitive impairment and depression (criteria according to Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition [DSM IV]) were separated into groups of 50. For 12 months, each group was given a lie-is different.

Group 1: galantamine 16 mg / day
Group 2: Venlafaxine XR 75 mg / day
Group 3: Both drugs, the same dose
Results:
The results of therapeutic response evaluated over 12 months, according to the Rating Scale for Depression Hamilton-17 items (HDRS-17) Rating Scale of Depression Montgomery and Asberg (MADRS), the Mini-Mental State Examination (MMSE), the Clinical Dementia Rating (CDR) and the Clinical Global Impression ( GCI) showed that the third group, which received the combined drugs, had a much more satisfying than the other two response.
Conclusions:
The group receiving the combination of nootropic agent Galantamine with antidepressant Venlafaxine XR had a res-start therapy relevant successful (the best), so that there is a possible relationship between cerebral oxygen deficiency and depression. The deficit of cerebral oxygenation may be a generator of depressive disorder.
Literature:
1. Kaplan HI, BJ Saddock. Synopsis of Psychiatry, 8th ed. Baltimore, MD:
Williams & Wilkins; 1998.
2. American Psychiatric Association. Statiscal and Diagnostic Manual of Mental Disorders, 4th ed. Washington, DC: American Psychiatric Association; 1994.
Study on Health and Aging
in Bambui (BHAS): prevalence and factors
associated with insomnia in Brazil
FL Rocha, E. Ochoa, HL War, et al.
Department of Psychiatry, Brazilian Association of Psychiatry. Belo Horizonte, Matto Grosso, Brazil.
Objective:
The objectives of this study were to determine the prevalence and factors associated with insomnia among older adults, Habi-tives of a small Brazilian town (Bambui, Matto Grosso).
Method:
Within the group old, 1,742 residents were selected for a structured interview. Participants 1,516 (87%).
Results:
The prevalence of insomnia was 38.9%. 25.1% of par-ticipants reported on the use of sleeping pills; 49%
of this total complained of insomnia, suggesting that treatment should be reassessed. Regardless, factors associated with insomnia were female dissatisfaction with plans for leisure, individual classification of health as fair or poor / very poor, previous medical diagnosis of a condition, inability to perform routine ac-tivities ( two weeks earlier), and stay in bed (2-weeks earlier).
Conclusion:
The prevalence of insomnia was high, indicating that it is a pro-public health problem. Additional investigations are required insomnia in elderly populations in Brazil and other developing countries.
: Bibliography
1. Lima e Costa MFF, Uchoa E, War HL, et al. The Bambui Health and Ageing Study (BHAS): methodological approach and preliminary results of a
population-based cohort study of the elderly in Brazil. Rev Saude Publica. 2000; 34: 126-135.
2. Maggi S; Langlois JA, Minicuci N, et al. Sleep complaints in community-dwelling older persons: prevalence, Associated factors, and Reported causes.
J Am Geriatr Soc 1998; 46:. 161-168.
3. Newman AB, PL Enright, Manolio TA, et al. Sleep disturbance, psychosocial correlates, and cardiovascular disease in 5,201 older adults: the Cardiovascular Health Study. J Am Geriatr Soc 1997; 45: 1-7..
4. Pollak CP, Perlick D. Sleep problems and institutionalization of the elderly.
J Geriatr Psychiatry Neurol. 1991; 4: 204-210.
5. Pollak CP, Perlick D, Linsner JP, et al. Sleep problems in the community elderly as predictors of death and nursing home placement. J Community Health. 1990; 15: 123-135.
June. Vitiello MV. Sleep disorders and aging: understanding the causes. J Gerontol A Biol Sci Med 1997; 52A:.. 189-191
Does old age reduces the risk
of mental distress?
Blay SL, SB Andreoli, FL Gastal
Federal University of São Paulo. São Paulo, Brazil.
OBJECTIVE:
This study was designed to determine the prevalence of mental distress among elderly vivendo community in Brazil, and to compare rates in different age groups.
Method:
A representative sample of the community, 7,860 subjects older than 60 years old, underwent initial evaluation by a validated version of the Assessment Questionnaire OARS Mental Health. One cross-sectional design was used.
Results:
In the total sample, the prevalence of mental distress was 22%. The correlation between age and psychiatric morbidity was significant (Spearman r = 0.067 p <0.01). There was a higher pro-portion of distress among the elderly (43%,> 80 years), compared with less elderly (38%, 60-80 years) (chi-square 9.6 df = 1 p <0.02). There was a higher proportion of female subjects with greater psychiatric morbidity. The frequency of highest scores in women in the age group of 91 and older was nearly three times higher than among men (46% and 17% respec-tively). For men, psychiatric scores are generally lower when compared with women in all age groups.
Conclusion:
The overall prevalence of mental distress increases with age, with prevalence estimates more prominent in women .
Bibliography:
1. Regier DA, Farmer ME, Raer DS, et al. One-month prevalence of Mental diorders in the United States and Sociodemographic Characteristics: the Epidemiologic Catchment Area study. Acta Psychiatr Scand. 1993; 88: 35-47
2. Australian Bureau of Statistics. Profile Mental Health and Wellbeing of Adults 1997. Australia’s Health. Canberra, Australia: 1998.
The dopamine transporter gene
and response to methylphenidate in ADHD
LAP Rohde, T. Roman, Szobot C., et al.
Department of Psychiatry, Federal University of Rio Grande do Sul Porto Alegre, Rio Grande. do Sul, Brazil.
OBJECTIVE:
To assess whether an association between homozygosity for the
10 repeat allele of the dopamine transporter gene (10/10) and
poor response to methylphenidate (MPH), re-cover above, could be replicated in a sample children of Brazilians
us with ADHD.
Methods:
In a blind naturalist, 50 young men with ADHD study were treated with MPH. Drug efficacy was measured by the Abbreviated Classification Scale 10-item Conners (ABRS) and Global Assessment Scale for Children (CGAS).
Results:
While 75% (15/20) of young people without 10/10 showed an improvement over the 50% in the ABRS scores
with MPD, only 47% (14/30) of subjects with 10/10 reached the same level of improvement with medications (unilateral p <0.04). Moreover, the increase in the group without 10/10 was significantly higher scores than the other group CGAS (unilateral p <0.01).
Conclusions:
Our findings confirm an association between homozi-gosidad for allele 10 repeated in the DAT1 locus and poor response to MPH.
Bibliography:
1. Winsberg BG, Comings DE. Association of the Dopamine Transporter
Gene (DAT1) methylphenidate with poor response. J Am Acad Child Adolesc Psychiatry. 1999; 38: 1474-1477.
2. Cook EH, MA Stein, Krasowski MD, et al. Association of attention-deficit disorder and the dopamine transporter gene. Am J Hum Gen 1995; 56: 993-998
Prevalence of postpartum depression
in the city of Porto Alegre
L. Tannous
Federal University of Rio Grande do Sul.
Porto Alegre, Rio Grande do Sul, Brazil
Objective:
To identify women with depression six weeks of giving birth, using the scale of Edinburgh, in the city of Porto Alegre.
Method:
was carried conduct a cross-sectional study of a representative sample of women living in Porto Alegre and who had given birth between 5 and 16 June 2001, in order to determine the prevalence of postpartum depression at six
weeks of delivery . Postnatal Depression Scale Edinburgh was used, considering individuals with depression rating equivalent to or greater than 13.
The calculation of sample size took into consideration estimated postpartum depression previous studies -12%, with a standard deviation of 4 % coefficient of variation of
95% to 80%, with a prevalence rate of 3.0, and pre-valence of unexposed subjects of 7%. Out of a total number of 1,650 births / month in Porto Alegre, a sample of 220 subjects was investigated. In order to ensure the stratification and per-measures, 35% was added, totaling 300 subjects.
Results:
it was located and interviewed a group of 271 mothers, 2 refused to participate and 27 were not found. An esti-mately the prevalence of postpartum depression of 20.7 was obtained
. (95% CI 15.7-25.7)
Conclusions:
In Porto Alegre prevalence of postpartum depression was found in 20.7%, which is higher than that described in the literature.
Psychiatric comorbidity in type 2 diabetes mellitus
Pinto JS Alberte, MA Cabral
Department. Medical Psychology and Psychiatry, Norberto de Souza Pinto Filho. . Campinas, São Paulo, Brazil
Objective:
An evaluation of mood disorders in patients with dia-betes mellitus type 2.
Method:
This is a qualitative and quantitative study comprised 2 gru-pos: a group of 50 patients with diabetes mellitus 2 (DM2) and a comparison group of 30 patients with essential hypertension (EAH, acronym in English), under treatment at the Outpatient Diabetes Unit, Unicamp.
Instruments:
A semistructured interview about life history and Depression Inventory Scholarship (BDI, in English).
Results:
In the study group of 50 patients, 25.1% had depression and 37.5% had anxiety, while in the
comparison group, 33% had depression and 25% anxiety.
Conclusion :
These monitoring results point to the importance of investigating the overall dynamics of treatment, including care provided by the doctor patient relationship, behavior within the family, proper diagnosis, psychopharmacological psicotera-tic and support.
Bibliography:
1. Beck AT, Ward CH. Mendelson M, et al. An Inventory for Measuring
Depression. Arch Gen Psychiatry. 1961: 4, 53-63.
Survey on subjective well-being
in the general population of Brazil
B Passos, G. Solymos, CT Miranda, Andreoli SB
Department of Psychiatry, Federal University of São Paulo. São Paulo, Brazil.
OBJECTIVE:
The purpose of this report is to assess subjective well com-stopping two independent samples of adults from different socioeconomic strata.
Method:
cross-sectional survey, which analyzes two Brazilian random samples: in a neighborhood of upper class ( n = 225) and one poor (slum, n = 375), totaling 605 subjects.
In this research the inventory of Subjective Well-Being (SUB) and the Adult Psychiatric Morbidity Questionnaire (QMPA) were used. Explore factor analysis and we extracted six factors wellness: social support, general welfare, inadequate mental mastery, confidence, deficiency in social con-tacts and concern for the primary group.
Results:
Considering the total of subjects had greater confidence preva-lence (69%), as opposed to all other factors being that scored about 40%. The subjects of the slums, or shantytowns, are affected nega-tively regarding trust, social support and mental control, although not affected their feelings of well-being, social contacts, or concern for your partner. There is an asso-ciation important between a low level of well-being and symptoms of anxiety or depression.
Bibliography:
1. Almeida-Filho N, Mari JJ Coutinho E et al. Brazilian multicentric study of
psychiatric morbidity: methodological feature and prevalence estimates.
Br J Psychiatry. 1997; 171: 524-529.