Læknablaðið : fylgirit - 01.08.2003, Blaðsíða 20

■ ABSTRACTS / 27TH NORDIC PSYCHIATRIC CONGRESS
Objective: Severe cognitive impairment is common in elderly
patients with schizophrenia. Alzheimer’s disease (AD) is the main
cause of dementia among the elderly. Biochemical and genetic
studies suggest that amyloid beta-peptide (Ab) is central in AD. We
examined the possible involvement of Ab in cognitive impairment
in schizophrenia.
Method: Specific antibodies against two major forms of Ab, Ab40
and Ab42, were used in ELISA assays to determine the levels of Ab
in postmortem brains from AD patients (N=10), controls (N=ll),
and schizophrenia patients with (N=7) or without (N=26) AD.
Kesults: The levels of amyloid b-peptide were highest in the AD,
followed by the patients with schizophrenia and controls. The mean
Ab42 level in the schizophrenia patients without AD was similar to
that in the controls, but the level in the schizophrenia patients with
AD was significantly higher than in those without AD or controls.
The Ab42 level in the schizophrenia patients with AD was
significantly lower than the level in the AD.
Conclusions: In contrast to elderly schizophrenia patients with AD
pathology, those without AD had Ab levels that were not signifi-
cantly different from those of normal subjects; hence Ab does not
account for the cognitive deficits in this group. Tliese results suggest
that the causes of cognitive impairment in “pure” schizophrenia are
different from those in AD. The decrease of Ab in schizophrenia
patients with AD as compared to patients only with AD may be
due to the neuroleptic treatment or the heavy smoking, as haloperi-
dol and nicotine decrease the Ab levels.
F-6/3 Friday 15/8,15:00-16:00
Simvastatin treatment lowers both alpha- and beta-
cleaved app in Alzheimer’s disease
Magnus Sjögren, Associate Professor, Institute of Clinical Neuroscience, SE413 45
Goteborg, Sweden. K Gustafsson, S Syversen, A Olsson, A Wallin, K Blennow.
magnus.sjogren@medfak.gu.se
We investigated the clinical and biological effects of cholesterol-
lowering treatment with a statin in 19 patients with Alzheimer’s
disease. All patients received simvastatin 20 mg/day for 12 weeks in
an open trial. Primary efficacy parameters were the changes after
12 weeks in the cerebrospinal fluid (CSF) levels of beta-amyIoid42
(AB42), alpha-secretase-cleaved APP (alpha-sAPP), beta-secre-
tase-cleaved APP (beta-sAPP), tau, phospho-tau and the plasma
levels of beta-amyloid (AB). A secondary efficacy parameter was
the change in ADAS-cog score. After 12 weeks, CSF alpha-sAPP
and CSF beta-sAPP were significantly reduced (p<0.001), but the
CSF levels of tau, phospho-tau, AB42 and the plasma levels of AB
were unchanged. The ADAS-cog score was slightly increased
(p<0.05). Furthermore, a decrease in total-cholesterol levels was
found at 12 weeks although all patients had normal levels at base-
line. The results suggest that simvastatin acts directly on the proces-
sing of APP by inhibiting both the alpha- and the beta-secretase
pathways. Results of 12-month follow-up and comparison with the
effects of statin treatment in vascular dementia will also be pre-
sented.
F-6/4 Friday 15/8,15:00-16:00
Co-occurrence of anxiety, depression and alcholism
Halldór Kolbeinssun, MD, Psychiatrist, Landspítali University Hospital, Reykjavík,
Dept. Psychiatry at Kleppur, Iceland. H Óskarsson, JG Stefánsson, Þ Þorgeirsson, K
Stefánsson.
halldork@landspitali. is
Aims: To investigate the co-occurrence of depressive disorders and
alcoholism among subjects diagnosed with anxiety disorders.
Method: The study is based on the screening for anxiety and de-
pression in a population sample, followed by diagnostic work-up
with the computerized version of the Composite International
Diagnostic Interview (CIDI). ICs have to meet criteria for either an
ICD-10 or a DSM 3-R anxiety diagnosis.
Results: 1.136 cases were diagnosed with a lifetime diagnosis of
anxiety disorders. Thereof 67% had a depressive disorder. Co-morbid
alcoholism was found in 31.8% of those with anxiety; 19.8% of the
females and in 48,5% of the males. The presence of depression with
anxiety would increase the number of those with alcoholism. The
mean Age of Onset (AGO) of alcoholism in this group is 24.8 years;
the AGO of all the anxiety disorders, except Generalized Anxiety
Disorder, have an earlier onset. AGO of depression is 25.3 years.
Conclusion: The prevalence of alcoholism is high in our cohort of
individuals with anxiety disorders, much higher than expected when
compared with prevalence studies of alcoholism in the Icelandic
population. The co-morbidity of alcoholism was still higher when
there was co-occurrence of depression and anxiety disorders. It is
noteworthy from an etiological point of view that alcoholism rarely
precedes the onset of most affective disorders.
F - 7 / 1 Friday 15/8,15:00-16:00
Patterns of antipsychotic use and side-effects in a lst
episode psychosis service
Páll Multhíusson, Dr., Section of Early Psychosis, Institute Of Psychiatry, Institute Of
Psychiatry, PO BOX 67, DeCresigny Park, London SE4 1AR, UK. P Power, P McGuire.
p. matthiasson @iop. kcl. ac. uk
Background: Lambeth, an inner city area in South London has a
very high incidence of psychosis. Patients are managed by The
Lambeth Early Onset (LEO) service, a specialised community team,
those with severe symptoms are admitted to a 18-bed inpatient unit.
Aims: This audit looked at patterns of antipsychotic use in the LEO
service.
Methods: We reviewed patterns to care, diagnoses, antipsychotic
medication and side-effects in patients with lst episode of psychosis
presenting over a 12-month period. This was a retrospective case
note review over the first 3-6 months of each individual’s treatment.
Results: Fifty-two patients (28 males, 24 females) were enrolled,
just over half of admissions. The majority presented with non-
affective psychosis. The most commonly used antipsychotics were
risperidone, olanzapine and quetiapine. The doses prescribed were
low and there was a good clinical response in the majority of cases.
Side-effects occurred in 39% of patients. In 13.5% they led to with-
drawal of medication. One patient had repeated urinary retention,
one developed diabetes mellitus.
20 LÆKNABLADIÐ / FYLGIRIT 48 2003/89