- Email: [email protected]
20 - Clarifying the role of neuroimaging in the diagnosis of dementia
EACLLP Abstracts / Journal of Psychosomatic Research 60 (2006) 655 – 664 OccasFAs and more frequently males. No significant differences were found in terms of psychiatric and psychosomatic morbidity, whereas medical morbidity appeared to be higher among PersistFAs. QOL perception was higher among OccasFAs. Conclusions: The majority of original FAs were still FAs at the end of the follow-up, but with a slight margin. Medical morbidity is possibly associated with persistent frequent attendance, rather than psychiatric and psychosomatic morbidity.
Reference [1] Fava GA, et al. Diagnostic criteria for use in psychosomatic research. Psychother Psychosom 1995;63:1 – 8.
16 – A 2-year follow-up study of hypochondriasis/health anxiety in primary care Fink P a, Toft T a, Ørnbøl E a, Frostholm La, Olesen F b a Research Clinic for Functional Disorders and Psychosomatics, Aarhus University Hospital, Denmark b Research Unit for General Practice, University of Aarhus, Denmark Background and aims: Studies on functional somatic symptoms and disorders and their treatment are hampered by lack of a valid and reliable diagnostic classification. Recently, an empirically founded hypochondriasis diagnosis was introduced. The aim of this 2-year follow-up study on patients with hypochondriasis was to examine the clinical importance of the diagnosis by studying the disorder’s impact on mental and physical health, health-related quality of life, disability, and use of health care services. Methods: A stratified subsample of 701 consecutive patients aged 18– 65 years consulting their family physician was assessed using the SCAN interview supplemented with questions addressing common hypochondriasis symptoms. Patients were followed up for a two-year period by means of various questionnaires (Short Form 36, Whiteley-7, SCL-som) and patient register data on health care use. Results: The 81 patients with hypochondriasis/health anxiety had a worse outcome after 2 years on all the measurements used in this study, compared to the group of patients with a well-defined medical condition according to their GP. Patients fulfilling the new diagnostic criteria had a similar or worse outcome than the patients fulfilling Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition criteria. Conclusions: This study supports the validity of the recently introduced new criteria for hypochondriasis or health anxiety. The new criteria identify a disturbing and persistent condition, which is also costly for the health care system. This indicates that the condition ought to be taken seriously, i.e., diagnosed and treated.
17 – Psychiatric syndromes hiding behind noncompliance Gazdag G a, Sebestye´n G b a Consultation-Liaison Psychiatric Service, Szt. La´szlo´ Hospital b Semmelweis University, Faculty of Medicine, Budapest, Hungary Aims: To identify those psychiatric syndromes and comorbid somatic problems, which most often lead to noncompliance. Method: Inpatient consultations between November 1999 and November 2004 of the Consultation-Liaison Psychiatric Service of Szt. Laszlo´ Hospital were retrospectively studied. Cases in which the indication of the consultation was noncompliance were selected and analyzed. Results: During the study period, 1020 consultations were done. In 23 cases (2.3%), there was an indication of consultation noncompliance. Most common psychiatric diagnoses associated to noncompliance were affective disorders (43.5%) and dementia (30.4%). Among the comorbid somatic disorders, cardiovascular (21.7%), endocrinological (diabetes) (21.7%), and gastroenterological problems (17.4%) were the most common ones.
659
Conclusions: Affective disorders and diabetes appeared more frequently in noncompliance patients than in consultations asked for other reasons. Authors try to explain how these disorders can lead to noncompliance.
18 – Psychological interventions to reduce aversive side effects from allogenic stem cell transplantation Grulke N a, Bailer H a, Larbig W b, Kaechele H a a University Hospital for Psychosomatic Medicine Ulm, Germany b Medical Psychology, University of Tu¨bingen, Germany Background and aims: Patients undergoing allogenic stem cell transplantation are suffering from nausea and emesis despite medication. We hypothesize that an additional psychotherapeutic intervention can soothe the symptoms. Methods: Patients with haematological malignancies, undergoing BMT at the units of Ulm and Tuebingen (Germany), were asked daily during their inpatient time how they suffer from nausea and emesis (6-point Likert scale; 1=no suffering, 6=severe suffering). Intervention group (IG) patients got an additional psychotherapeutic intervention programme with focus on psychoeducation, relaxation, and distraction. Results: During isolation for transplantation, patients (n=51) from the IG are suffering significantly less from nausea (P=.047) and emesis (P=.005) than controls (n=53) with treatment as usual. Conclusion: An additional supportive psychotherapeutic programme for patients can soothe the burden from nausea and emesis. The effects between the groups are small. Therefore, treating all patients must be critically reviewed with respect to the cost-benefit relationship.
19 – Perceived changes of personality after stem cell transplantation Grulke N, Bailer H University Hospital for Psychosomatic Medicine Ulm, Germany Background and aims: Having survived allogenic hematopoietic stem cell transplantation (HSCT), do patients believe that they have changed as a person? Methods: One to three years after HSCT, we asked patients from the units of Ulm and Tuebingen (Germany) on a 6-point Likert scale (1=not at all, 6=very intense) if they have changed in general, physically, and psychologically. Results: Data from 50 surviving patients could be evaluated. Less than 20% of the patients reported no or only slight general, physical, or psychological changes. However, more than a third of the patients reported intense or very intense changes. Data show a decrease over time for physical changes, and an increase over time for general and psychological changes. Conclusion: Changes in personality after HSCT seem to be common. To date, this topic is neglected in the literature. Further research is needed for a better understanding of the quality of changes and, if necessary, for the development of prevention strategies.
20 – Clarifying the role of neuroimaging in the diagnosis of dementia Gutie´rrez LB, Saz P, Larraga L, Lopez, Gonzalez-Torrecillas JL, Lobo A, Gracia A, Campayo A Unidad de Psicosomatica y Psiquiatria de Enlace, Hospital Clinico Universitario, Zaragoza, Spain Background and aims: The memory clinic (MC) was developed to manage cognitive problems and dementias in the context of the psychosomatic and liaison psychiatry unit in a university hospital. The main objective of MC is to give support to the primary care physician in diagnosis and clinical care. Also, it develops other functions such as training and research. The aim of this presentation is to study the weight of neuroimaging findings on dementia diagnosis.
660
EACLLP Abstracts / Journal of Psychosomatic Research 60 (2006) 655 – 664
Methods: A series of 126 consecutive patients attending our MC (mean= 75.42, range=48 – 97) was assessed using the study protocol clinical and neuropsychological, and when appropriated, neuroimaging and lab test. CT head scan were performed on 102 subjects and single photon emission computed tomography (SPECT) on 81 subjects. Both International Statistical Classification of Diseases, 10th Revision and Diagnostic and Statistical Manual for Mental Disorders, Fourth Edition diagnostic criteria were used for dementia. Analysis was performed using cross tables to assess the level of observed concordance between clinical diagnoses and neuroimaging and also CT and SPECT findings. Results: Of patients, 62.7% had dementia [34% Alzheimer disease (AD); 26.2% vascular or mixed dementia (VMD)], but in CT, 84.3% of subjects showed atrophy, and 70.1% of findings suggested vascular lesions. SPECT showed reduced perfusion in 72.4%. Observed correlations between diagnosis and neuroimaging were: AD–CT=57.6%; VMD–CT=74.1%; AD–SPECT=58.1%; VMD–SPECT=58.1%. With regard to CT and SPECT, higher correlation was detected in basal ganglia lesions (71.4%) and poorer in both frontal lobes (37.5% and 43%). Conclusions: The agreement and accuracy presented is modest. It is important to emphasize in clinical observations that daily life activities seem to be better predictors than other complementary tests.
21 – What stresses parents most after the loss of an extremely preterm child? A qualitative study Jenewein J a, Fauche`re JC b, Glaser A a, Mo¨rgeli H a, Bu¨chi S a a Department of Psychiatry, University Hospital, Zurich, Switzerland b Department of Neonatology, University Hospital, Zurich, Switzerland Background and aims: The aim of this study was first to analyse the most stressful factors for parents; secondly, to determine whether there are differences between parents’ estimation of stressful factors and that of staff. Participants and methods: Fifty-two parents and 14 members of staff were asked, bWhat was the most stressful factor in the period of delivery, treatment on the NICU, and death of the child?Q Their responses were analysed by qualitative content analysis. Results: Content analysis showed five stressful factors overall: about one third of parents’ statements (30%) applied to the death of the child, whereas about two thirds referred to stressful circumstances or emotions like helplessness (30.7%), treatment in hospital (16.5%), behaviour of the environment (13.4%), and guilt (9.5%). Statements referring to treatment in hospital and guilt were significantly higher in mothers than in fathers. Analysis of the answers of staff showed helplessness (40%), death (28.9%), and guilt (25.5%) to be the most stressful factors. Treatment in hospital per se was not rated as a stressful factor. Conclusions: There is evidence that, after the death of an extremely preterm child, parents not only suffer from the loss of their baby but also from traumatic circumstances of the loss. These parents are at risk of developing long-lasting psychiatric disorders. Special attention should be paid to the high burden of the treatment itself. General practitioners and other caregivers should be informed in order to be sensitised to potential sequelae like anxiety disorders or depression.
22 – Anxiety and depressive symptoms among women with metabolic syndrome: comparative study with hypothyroid and hyperthyroid patients KaramustafalVoglu KO, Ozcelik B, Guven T, BakVm B Psychiatry Clinic/Sisli Etfal Research and Education Hospital, Istanbul, Turkey Aim: The aim of this study is to determine the anxiety and depressive symptoms among women with metabolic syndrome and to compare them with patients with thyroid dysfunction. Methods: Fifty-two metabolic syndrome, 47 hypothyroid, and 49 hyperthyroid outpatients aged between 18 and 65 years, who were consecutively
admitted to endocrinology outpatient unit at a general hospital, were included to the study. Being illiterate, cognitive impairment, pregnancy, psychiatric history in the last 6 months, and having an operation in the last 3 months were exclusion criteria. Subjects were evaluated with sociodemographic form and The Hospital Anxiety and Depression (HAD) Scale. Scores N10 were considered as positive for depression and anxiety. Data were analized using chi-square and one-way analysis of variance tests with SPSS 11.5 program (SPSS, Chicago, IL, USA). Results: Anxiety was found in 19 % of metabolic syndrome, 34 % of hypothyroid, and 45 % of hyperthyroid patients. The difference between these 3 groups was statistically significant (P=.02). Depression was found in 21 % of metabolic syndrome, 34 % of hypothyroid, and 37 % hyperthyroid patients (PN.05). However, HAD items 6 and 12 (depressive mood and looking forward with enjoyment) were significantly higher among patients with thyroid dysfunctions (Pb.05). HAD items related to anxiety such as 1, 5, 11, and 13 were significantly higher among patients with thyroid dysfunctions (Pb.05). Conclusion: Anxiety and depression are very common psychiatric disorders, which should be screened cautiously in patients with endocrinologic dysfunctions. Different aspects of HAD items could represent different psychiatric disturbances among patients with endocrinologic dysfunctions.
23 – Prevalence of stalking and its emotional impacts on psychiatrists, psychotherapists, and psychologists Krammer A, Stepan A, Baranyi A, Kapfhammer HP, Rothenha¨usler HB Universita¨tsklinik fu¨r Psychiatrie, Medizinische Universita¨t Graz, Austria Background: Stalking, in the psychiatric context, describes pathological behaviour, which is characterized by repeated persecution, harassment, menace, or assault of a person. Although the term is not new, it gains more and more attention in the psychiatric field. Because of the association of stalking and mental disorders, in particular, psychiatrists, psychologists, and psychotherapists belong to the exposed professions. If they fall victim to stalking during their career, this can have a disruptive impact, sometimes leading to posttraumatic stress disorder. Methods: One hundred seventeen psychiatrists, psychologists, or psychotherapists in Graz, working in a clinical or extramural setting, participated in an anonymous interview. To register possible experiences with stalkingdefining behaviour, a modified version of the questionnaire by Kamleiter was used. Prevalence and severity of a posttraumatic stress disorder were determined with the bImpact of Event ScaleQ by Horowitz. Results/Conclusions: The study showed an incidence of stalking of 38.5%. The rate of female stalkers (60%) was extraordinary high. Most victims (68.9%) experienced nonviolent threats. Regarding the diagnosis of the offenders, most of them (41.9%) suffered from schizophrenia, schizotypal, and delusional disorders (F2), followed by disorders of adult personality and behaviour (F6) (30.2%). Of the victims, 44.4% developed a PTSD. The analyses suggest that stalking, in the psychiatric field of activity, is a common and serious phenomenon, and that strategies for prevention and protection of potentially affected professions will have to be developed.
24 – Cerebral response pattern to pain and anticipation of pain in patients with multisymptomatic functional disorder Kuzminskyte R a,b, Kupers R c, Fink P a a The Research Clinic for Functional Disorders and Psychosomatics and CFIN, Aarhus University, Aarhus, Denmark b PET center, Aarhus University Hospital, Aarhus, Denmark c PET center, Rigshospitalet, Copenhagen, Denmark Multisymptomatic functional disorder (MFD) is characterised by pain and many physical complaints from various organ systems that cannot adequately be explained by known pathophysiological mechanisms. The aim of this study was to examine cerebral response patterns to painful and
Reference [1] Fava GA, et al. Diagnostic criteria for use in psychosomatic research. Psychother Psychosom 1995;63:1 – 8.
16 – A 2-year follow-up study of hypochondriasis/health anxiety in primary care Fink P a, Toft T a, Ørnbøl E a, Frostholm La, Olesen F b a Research Clinic for Functional Disorders and Psychosomatics, Aarhus University Hospital, Denmark b Research Unit for General Practice, University of Aarhus, Denmark Background and aims: Studies on functional somatic symptoms and disorders and their treatment are hampered by lack of a valid and reliable diagnostic classification. Recently, an empirically founded hypochondriasis diagnosis was introduced. The aim of this 2-year follow-up study on patients with hypochondriasis was to examine the clinical importance of the diagnosis by studying the disorder’s impact on mental and physical health, health-related quality of life, disability, and use of health care services. Methods: A stratified subsample of 701 consecutive patients aged 18– 65 years consulting their family physician was assessed using the SCAN interview supplemented with questions addressing common hypochondriasis symptoms. Patients were followed up for a two-year period by means of various questionnaires (Short Form 36, Whiteley-7, SCL-som) and patient register data on health care use. Results: The 81 patients with hypochondriasis/health anxiety had a worse outcome after 2 years on all the measurements used in this study, compared to the group of patients with a well-defined medical condition according to their GP. Patients fulfilling the new diagnostic criteria had a similar or worse outcome than the patients fulfilling Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition criteria. Conclusions: This study supports the validity of the recently introduced new criteria for hypochondriasis or health anxiety. The new criteria identify a disturbing and persistent condition, which is also costly for the health care system. This indicates that the condition ought to be taken seriously, i.e., diagnosed and treated.
17 – Psychiatric syndromes hiding behind noncompliance Gazdag G a, Sebestye´n G b a Consultation-Liaison Psychiatric Service, Szt. La´szlo´ Hospital b Semmelweis University, Faculty of Medicine, Budapest, Hungary Aims: To identify those psychiatric syndromes and comorbid somatic problems, which most often lead to noncompliance. Method: Inpatient consultations between November 1999 and November 2004 of the Consultation-Liaison Psychiatric Service of Szt. Laszlo´ Hospital were retrospectively studied. Cases in which the indication of the consultation was noncompliance were selected and analyzed. Results: During the study period, 1020 consultations were done. In 23 cases (2.3%), there was an indication of consultation noncompliance. Most common psychiatric diagnoses associated to noncompliance were affective disorders (43.5%) and dementia (30.4%). Among the comorbid somatic disorders, cardiovascular (21.7%), endocrinological (diabetes) (21.7%), and gastroenterological problems (17.4%) were the most common ones.
659
Conclusions: Affective disorders and diabetes appeared more frequently in noncompliance patients than in consultations asked for other reasons. Authors try to explain how these disorders can lead to noncompliance.
18 – Psychological interventions to reduce aversive side effects from allogenic stem cell transplantation Grulke N a, Bailer H a, Larbig W b, Kaechele H a a University Hospital for Psychosomatic Medicine Ulm, Germany b Medical Psychology, University of Tu¨bingen, Germany Background and aims: Patients undergoing allogenic stem cell transplantation are suffering from nausea and emesis despite medication. We hypothesize that an additional psychotherapeutic intervention can soothe the symptoms. Methods: Patients with haematological malignancies, undergoing BMT at the units of Ulm and Tuebingen (Germany), were asked daily during their inpatient time how they suffer from nausea and emesis (6-point Likert scale; 1=no suffering, 6=severe suffering). Intervention group (IG) patients got an additional psychotherapeutic intervention programme with focus on psychoeducation, relaxation, and distraction. Results: During isolation for transplantation, patients (n=51) from the IG are suffering significantly less from nausea (P=.047) and emesis (P=.005) than controls (n=53) with treatment as usual. Conclusion: An additional supportive psychotherapeutic programme for patients can soothe the burden from nausea and emesis. The effects between the groups are small. Therefore, treating all patients must be critically reviewed with respect to the cost-benefit relationship.
19 – Perceived changes of personality after stem cell transplantation Grulke N, Bailer H University Hospital for Psychosomatic Medicine Ulm, Germany Background and aims: Having survived allogenic hematopoietic stem cell transplantation (HSCT), do patients believe that they have changed as a person? Methods: One to three years after HSCT, we asked patients from the units of Ulm and Tuebingen (Germany) on a 6-point Likert scale (1=not at all, 6=very intense) if they have changed in general, physically, and psychologically. Results: Data from 50 surviving patients could be evaluated. Less than 20% of the patients reported no or only slight general, physical, or psychological changes. However, more than a third of the patients reported intense or very intense changes. Data show a decrease over time for physical changes, and an increase over time for general and psychological changes. Conclusion: Changes in personality after HSCT seem to be common. To date, this topic is neglected in the literature. Further research is needed for a better understanding of the quality of changes and, if necessary, for the development of prevention strategies.
20 – Clarifying the role of neuroimaging in the diagnosis of dementia Gutie´rrez LB, Saz P, Larraga L, Lopez, Gonzalez-Torrecillas JL, Lobo A, Gracia A, Campayo A Unidad de Psicosomatica y Psiquiatria de Enlace, Hospital Clinico Universitario, Zaragoza, Spain Background and aims: The memory clinic (MC) was developed to manage cognitive problems and dementias in the context of the psychosomatic and liaison psychiatry unit in a university hospital. The main objective of MC is to give support to the primary care physician in diagnosis and clinical care. Also, it develops other functions such as training and research. The aim of this presentation is to study the weight of neuroimaging findings on dementia diagnosis.
660
EACLLP Abstracts / Journal of Psychosomatic Research 60 (2006) 655 – 664
Methods: A series of 126 consecutive patients attending our MC (mean= 75.42, range=48 – 97) was assessed using the study protocol clinical and neuropsychological, and when appropriated, neuroimaging and lab test. CT head scan were performed on 102 subjects and single photon emission computed tomography (SPECT) on 81 subjects. Both International Statistical Classification of Diseases, 10th Revision and Diagnostic and Statistical Manual for Mental Disorders, Fourth Edition diagnostic criteria were used for dementia. Analysis was performed using cross tables to assess the level of observed concordance between clinical diagnoses and neuroimaging and also CT and SPECT findings. Results: Of patients, 62.7% had dementia [34% Alzheimer disease (AD); 26.2% vascular or mixed dementia (VMD)], but in CT, 84.3% of subjects showed atrophy, and 70.1% of findings suggested vascular lesions. SPECT showed reduced perfusion in 72.4%. Observed correlations between diagnosis and neuroimaging were: AD–CT=57.6%; VMD–CT=74.1%; AD–SPECT=58.1%; VMD–SPECT=58.1%. With regard to CT and SPECT, higher correlation was detected in basal ganglia lesions (71.4%) and poorer in both frontal lobes (37.5% and 43%). Conclusions: The agreement and accuracy presented is modest. It is important to emphasize in clinical observations that daily life activities seem to be better predictors than other complementary tests.
21 – What stresses parents most after the loss of an extremely preterm child? A qualitative study Jenewein J a, Fauche`re JC b, Glaser A a, Mo¨rgeli H a, Bu¨chi S a a Department of Psychiatry, University Hospital, Zurich, Switzerland b Department of Neonatology, University Hospital, Zurich, Switzerland Background and aims: The aim of this study was first to analyse the most stressful factors for parents; secondly, to determine whether there are differences between parents’ estimation of stressful factors and that of staff. Participants and methods: Fifty-two parents and 14 members of staff were asked, bWhat was the most stressful factor in the period of delivery, treatment on the NICU, and death of the child?Q Their responses were analysed by qualitative content analysis. Results: Content analysis showed five stressful factors overall: about one third of parents’ statements (30%) applied to the death of the child, whereas about two thirds referred to stressful circumstances or emotions like helplessness (30.7%), treatment in hospital (16.5%), behaviour of the environment (13.4%), and guilt (9.5%). Statements referring to treatment in hospital and guilt were significantly higher in mothers than in fathers. Analysis of the answers of staff showed helplessness (40%), death (28.9%), and guilt (25.5%) to be the most stressful factors. Treatment in hospital per se was not rated as a stressful factor. Conclusions: There is evidence that, after the death of an extremely preterm child, parents not only suffer from the loss of their baby but also from traumatic circumstances of the loss. These parents are at risk of developing long-lasting psychiatric disorders. Special attention should be paid to the high burden of the treatment itself. General practitioners and other caregivers should be informed in order to be sensitised to potential sequelae like anxiety disorders or depression.
22 – Anxiety and depressive symptoms among women with metabolic syndrome: comparative study with hypothyroid and hyperthyroid patients KaramustafalVoglu KO, Ozcelik B, Guven T, BakVm B Psychiatry Clinic/Sisli Etfal Research and Education Hospital, Istanbul, Turkey Aim: The aim of this study is to determine the anxiety and depressive symptoms among women with metabolic syndrome and to compare them with patients with thyroid dysfunction. Methods: Fifty-two metabolic syndrome, 47 hypothyroid, and 49 hyperthyroid outpatients aged between 18 and 65 years, who were consecutively
admitted to endocrinology outpatient unit at a general hospital, were included to the study. Being illiterate, cognitive impairment, pregnancy, psychiatric history in the last 6 months, and having an operation in the last 3 months were exclusion criteria. Subjects were evaluated with sociodemographic form and The Hospital Anxiety and Depression (HAD) Scale. Scores N10 were considered as positive for depression and anxiety. Data were analized using chi-square and one-way analysis of variance tests with SPSS 11.5 program (SPSS, Chicago, IL, USA). Results: Anxiety was found in 19 % of metabolic syndrome, 34 % of hypothyroid, and 45 % of hyperthyroid patients. The difference between these 3 groups was statistically significant (P=.02). Depression was found in 21 % of metabolic syndrome, 34 % of hypothyroid, and 37 % hyperthyroid patients (PN.05). However, HAD items 6 and 12 (depressive mood and looking forward with enjoyment) were significantly higher among patients with thyroid dysfunctions (Pb.05). HAD items related to anxiety such as 1, 5, 11, and 13 were significantly higher among patients with thyroid dysfunctions (Pb.05). Conclusion: Anxiety and depression are very common psychiatric disorders, which should be screened cautiously in patients with endocrinologic dysfunctions. Different aspects of HAD items could represent different psychiatric disturbances among patients with endocrinologic dysfunctions.
23 – Prevalence of stalking and its emotional impacts on psychiatrists, psychotherapists, and psychologists Krammer A, Stepan A, Baranyi A, Kapfhammer HP, Rothenha¨usler HB Universita¨tsklinik fu¨r Psychiatrie, Medizinische Universita¨t Graz, Austria Background: Stalking, in the psychiatric context, describes pathological behaviour, which is characterized by repeated persecution, harassment, menace, or assault of a person. Although the term is not new, it gains more and more attention in the psychiatric field. Because of the association of stalking and mental disorders, in particular, psychiatrists, psychologists, and psychotherapists belong to the exposed professions. If they fall victim to stalking during their career, this can have a disruptive impact, sometimes leading to posttraumatic stress disorder. Methods: One hundred seventeen psychiatrists, psychologists, or psychotherapists in Graz, working in a clinical or extramural setting, participated in an anonymous interview. To register possible experiences with stalkingdefining behaviour, a modified version of the questionnaire by Kamleiter was used. Prevalence and severity of a posttraumatic stress disorder were determined with the bImpact of Event ScaleQ by Horowitz. Results/Conclusions: The study showed an incidence of stalking of 38.5%. The rate of female stalkers (60%) was extraordinary high. Most victims (68.9%) experienced nonviolent threats. Regarding the diagnosis of the offenders, most of them (41.9%) suffered from schizophrenia, schizotypal, and delusional disorders (F2), followed by disorders of adult personality and behaviour (F6) (30.2%). Of the victims, 44.4% developed a PTSD. The analyses suggest that stalking, in the psychiatric field of activity, is a common and serious phenomenon, and that strategies for prevention and protection of potentially affected professions will have to be developed.
24 – Cerebral response pattern to pain and anticipation of pain in patients with multisymptomatic functional disorder Kuzminskyte R a,b, Kupers R c, Fink P a a The Research Clinic for Functional Disorders and Psychosomatics and CFIN, Aarhus University, Aarhus, Denmark b PET center, Aarhus University Hospital, Aarhus, Denmark c PET center, Rigshospitalet, Copenhagen, Denmark Multisymptomatic functional disorder (MFD) is characterised by pain and many physical complaints from various organ systems that cannot adequately be explained by known pathophysiological mechanisms. The aim of this study was to examine cerebral response patterns to painful and