Læknablaðið : fylgirit - 01.08.2003, Page 36

■ ABSTRACTS / 27TH NORDIC PSYCHIATRIC CONGRESS
sodes explained the overall results. In palients not having those
clinical features, the effect size of PSST the treatment corresponded
to the PSST-active drug combination. Furthermore, the effect of
PSST and placebo corresponded to the results reported in other
studies of cognitive behavioural therapy for depression conducted
by clinical psychiatrists or psychologists.
These results strongly indicate that the current debate of the effi-
cacy of antidepressant per se is ridiculous. The key questions is to
identify those needing drugs in addition to psychological intervention.
S-XI/4 Friday 15/8, 11:00-12:30
Are psychotropic medications over-prescribed in children
and adolescents? Discussion of recent data
Bcrtrand Lauth, Child and Adolescent Psychiatrist, National University Hospital, Dept.
of Child and Adolescent Psychiatry, Dalbraut 12,105 Reykjavík, Iceland
bertrand@landspitali. is
Background: The growing use of psychotropic drugs in children and
adolescents and increasing knowledge in that field represent major
progress in child psychiatry, both in the areas of treatment and
prevention, especially if medications are used in combination with
other treatment methods. But today, in many cases, the clinical use
of psychotropic treatments of child and adolescent psychiatric
disorders outstrips its demonstrated scientific validity.
Aims: To study prescribing practices and prescription rates in
different countries. To raise questions and discuss important practi-
cal and theoretical issues in that field.
Method: Use of national statistics, central guidelines and medical
articles searched on Medline.
Kesults: Prescribing practices are very different from one European
country to another, from one “school” to another, and from one
physician to another. However, today there is a growing consensus
that the benefit/ risk ratio of drugs use for non-FDA-approved
indications is often preferable to that of currently approved older
medications. Moreover, dramatic changes in child psychiatric clini-
cal everyday practices have substantially modified both identity and
role of child psychiatrists inside multidisciplinary teams.
Conclusions: Beyond many important practical issues regarding
indications and rules of prescription at that age, clinicians have now
to think about the role and redefine the part that psychopharmaco-
logic approaches should play among all other treatment methods
used for children and adolescents.
S-XII/1 Friday 15/8,11:00-12:30
Haplotypes are not found in excess within dysbindin, G72
or DAAO among schizophrenic patients in lceland
Hrcinn Slefúnsson1. Engilbert Sigurðsson2, Valgerdur Steinþórsdóttiri, Pórdur Sig-
mundsson-, Jón Brynjólfsson2, Steinunn Gunnarsdóttiri, Ómar ívarssonZ, Ómar Hjalta-
son2, Helgi Jónsson-, Vala G. Guðnadóttir>, Andrés Ingasoni, Hrönn Harðardóttir?,
Jeffrey R. Gulchert, Einar Guðfinnsson, Hannes Pétursson2, Kári Stefánsson>
hreinn@decode.is
'DcCODE Genetics, Sturlugötu 8, 101 Rcykjavík, Iceland. 2Division of Psychiatry,
Landspítali University Hospital, Reykjavík, Iceland
Although many genes have been investigated using the candidate
gene approach, only a few schizophrenia susceptibility genes have
been identified by positional cloning. This involves a genome-wide
scan for linkage followed by the fine mapping of a susceptibility
locus and subsequent haplotype analysis. Last year three schizo-
phrenia candidate genes were identified with this approach, NRGl,
G72 and dysbindin. Interestingly, all three genes are involved in the
glutamatergic system. Application of the yeast two-hybrid system
has also lead to the identification of molecular partners for some of
these genes. This will aid in the search for epistatic interactions to
get clearer picture of how each gene might contribute to the disease
etiology. In this manner the D-amino acid oxidase (DAAO) was
found to interact with G72, and haplotype analysis in both genes
suggested a possible epistatic interaction. It is thus possible that
variants of both genes confer increased risk of schizophrenia
through the same pathway.
Replication studies are underway for all four genes, i.e. NRGl,
dysbindin, G72 and DAAO. The NRGl at-risk haplotype, seven
markers, found in excess in Icelandic schizophrenia patients was
also found in excess in a large Scottish sample of patients and
controls. For the dysbindin gene the initial haplotype described has
not been found in significant excess in other schizophrenia cohorts.
The follow-up studies have either identified other at-risk haplo-
types within the same gene or find no significant association. We
have estimated haplotype frequencies within boundaries of dys-
bindin, G72 and DAAO in Icelandic schizophrenia patients and
controls but failed to find significant association.
S-XII/2 Friday 15/8,11:00-12:30
Genetics of bipolar disorder: The role of the G72 gene in
lceland
Þorgdr E. Þorgeirsson. Engilbert Sigurösson-, Andrés Ingason', Þórdur Sigmundsson2,
Jón Brynjólfsson?, Ómar ívarsson2, Ómar Hjaltason2, Helgi Jónsson2, Vala G.
Guðnadóttiri, Hrönn Harðardóttir2. Jeffrey R. GulcherL Einar Guðfinnsson, Hreinn
Stefánssoni, Hannes Pétursson2, Kári Stefánsson>
>DeCODE Genetics, Sturlugata 8, 101 Reykjavík, Iceland. 2Division of Psychiatry,
Landspitali University Hospital, Reykjavfk Iceland.
Last year, three schizophrenia candidate genes were identified
based on positional cloning, or NRGl, G72, and dysbindin (1-3). D-
amino acid oxidase (DAAO) has been found to interact with G72,
and genetic analysis suggests epistatic interaction (3). Bipolar
disorder (BPD) links to 13q32-33, the region containing the G72
gene (4), and association to BPD has been suggested in or near the
G72 gene (5). These findings are independent of the association
found for schizophrenia as the results are based on a positional
cloning approach, i.e. linkage analysis followed by fine mapping,
TDT and haplotype analysis. The reported associations to variants
of the same gene for both disorders in independent studies consti-
tute genetic evidence for the widely held belief that schizophrenia
and bipolar disorder share a common genetic basis. Although the
associated haplotypes are in both cases within the G72 gene, they
are not identical for the two disorders. Thus it is possible that the
increased susceptibilities to bipolar disorder and schizophrenia are
due to different variants of the G72 gene.
As part of our ongoing study of the genetics of bipolar disorder
we have estimated haplotype frequencies within boundaries of the
G72 gene in Icelandic bipolar patients and controls, and the results
of these sludies will be reported.
36 L/EKNABLAÐIÐ / FYLGIRIT 48 2003/89