Læknablaðið : fylgirit - 01.08.2003, Page 83

POSTERS / 27TH NORDIC PSYCHIATRIC CONGRESS I
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Mourning multiple losses in childhood: Prospective case
analysis
Kcnneth R. Kuufmnn. MD. MRCPsych., Professor of Psychiatry and Neurology,
UMDNJ-Robert Wood Johnson Medical School, 125 Paterson Street, Suite #2200,
New Brunswick, New Jersey 08901. USA. Nathaniel D. Kaufman, Diane L. Kaufman.
kaufmakr@umdnj.edu
Background: Multiple losses within short periods of time make one
question life and can exponentially influence one’s coping skills.
But what are the effects on a child and what should be done when
the next loss occurs? This unusual case addresses the multiple losses
suffered by a 7-year-old boy over an eighteen month time period.
Aims: To assess coping skills of the child and the coping strategies
of the parents with the goal of continuing this case study while the
child grows into adolescence.
Method: Prospective case analysis with literature review.
Kcsults: A 7-year-old boy experienced the deaths of three grand-
parents within 18 months (paternal grandmother 11/13/01; mater-
nal grandmother 7/31/03; and paternal grandfather 5/21/03). He was
the only grandchild who was actively involved in the eulogies of the
paternal grandparents. On the morning following his paternal
grandfather's funeral, he was informed that that his maternal uncle
had died from an “insulin reaction.” As such, this child has had to
cope with the loss of four significant relalives within 18 months in
the context of being born to older parents. At his maternal grand-
mother's unveiling he commented that „Bubby Becky will never
die ... there is a piece of her in my heart forever.“ At the eulogy to
the patemal grandfather he summarized emotions well beyond his
years - “Too many petals and thorns have fallen from the family
rose.”
Conclusions: This case report analyzes the deaths, the responses,
the parental input to assist the child through the grieving process,
and suggests steps to be taken for children faced with coping with
multiple losses.
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Psychosocial functioning and psychiatric comorbidity
among substance-abusing lcelandic adolescents
Hclga Hanncsdóttir. Psychiatrist, Landspítalinn University Hospital. Reykjavik,
Iceland. Þórarinn Tyrfingsson, Jorma Piha.
helgah@centrum. is
Our objectives were to compare behaviour problem scores (BPS)
for lcelandic adolescents admitted for detoxificalion treatment for
alcohol and narcotic abuse as compared with the general popula-
tion, in accordance with the Youth Self Report (YSR), and to de-
scribe psychosocial functioning and psychiatric comorbidity for the
treated adolescents. The case series consisted of 103 adolescents,
ages 12-18 years, who completed the YSR at the end of a 10-day
stay at the national Hospital of Addiction Medicine. The total BPS
tallied from the YSR items was compared with scores for the
general population. The psychiatric comorbidity and psychosocial
functioning of the case series were assessed through diagnostic
interviews in accordance with DSM-IV and ICD-10 criteria. The
BPS for the 36 treated girls was significantly higher than for the
general population (104 versus 36) and higher than for the 56
treated boys (82 versus 56) with 2 standard deviations above the
norm for the population. Three-quarters of the adolescents had
psychiatric comorbidity: conduct disorder (44%), depression
(28%), or posttraumatic stress disorder (11%). The findings sup-
port the discriminative validity of the YSR as part of a structured
global assessment of substance-abusing adolescents, in particular to
identify the frequently present psychiatric comorbidities.
* Adolescents, Clinical epidemiology, Comorbidity, Substance abuse, Youth Self
Report.
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Different levels of oxidative stress with typical and
atypical neuroleptics
Stefan Kropp PD Dr., Klinische Psychiatrie und Psychotherapie, Medizinische
Hochschule Hannover, OE 7117, 30623 Hannover, Germany. Kern V, Degner D,
Schneider U, Bleich S.
kropp.stefan@mh-hannover.de
Background: Toxicity of neuroleptics and potential side effects
might be mediated by lipid peroxidation.
Aims: To examine potential neurotoxic effects, a comparative study
of the potential of haloperidol and flupentixole to induce oxidative
stress in contrast to atypical neuroleptics (amisulpride, clozapine,
olanzapine, quetiapine and risperidone) was designed.
Methods: Malondialdehyde (MDA) was chosen as a marker for
lipid peroxidation. Blood samples from patients taking neuroleptic
drugs were analysed for MDA by HPLC. 92 of initially 115 enrolled
patients were completers (80%). 22 patients were in the typical, 70
in the atypical group. Mean values of MDA in patients taking atypi-
cal vs. typical antipsychotics were calculated. Variables such as smo-
king status, gender, severity of illness (BPRS) and extrapyramidal
movements (AIMS) were documented.
Results: Most MDA levels were within normal ranges (<1,0
pmol/1). Nevertheless, MDA concentrations in patients receiving
clozapine (p=0.001), quetiapine (p=0.001), amisulpride (p=0.02)
and risperidone (p=0.01) were significantly lower than within the
typical group.
Conclusions: Significant differences between MDA levels in patients
taking typical and atypical neuroleptics were found with clozapine,
quetiapine, amisulpride and nsperidone. The results indicate that lipid
peroxidation is significantly lower in most patients with atypical neuro-
leptics and higher in patients receiving flupentixole and haloperidol.
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The influence of phototherapy and fluvoxamine on
phospholipase D activity in blood platelets in anorexia
nervosa
Jan:is-Ko/ik Malgorzata. MD, PhD, Departmcnt and Clinic of Psychiatry and Psycho-
therapy, Silesian Medical University, Ziolowa 45/47, PL 40-635 Katowice, Poland.
Irena Krupka-Matuszczyk. Marek Krzystanek, Henryk I. Trzeciak, Jan Szymszal.
malgorzala.janas-kozik@psychiatria.pl
Membrane phospholipase D (PLD) is one of crucial enzymes play-
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