Suchergebnisse

The nature and scale of the global mental health challenge / Mirella Ruggeri, Graham Thornicroft, & David Goldberg -- Scaling up mental health care in resource poor settings / Shekhar Saxena, Benedetto Saraceno, and Justin Granstein -- Swings and roundabouts of community psychiatry : the UK fairground / Peter Tyrer -- Mental health services and recovery / Mike Slade [and others] -- Implementing evidence-based treatments in routine mental health services / Antonio Lasalvia and Mirella Ruggeri -- The need for new models of care for people with severe mental illness in low- and middle-income countries / Ruben Alvarado [and others] -- The role of primary care in low- and middle- income countries / David Goldberg, Graham Thornicroft and Nadja van Ginneken -- Meeting the challenge of physical co-morbidity and unhealthy lifestyles / Lorenzo Burti [and others] -- Complex interventions in mental health services research : potential, limitations and challenges / Thomas Becker and Berndt Puschner -- The feasibility of applying the clinical staging paradigm to the care of people with mental disorders / Javier Vâazquez-Bourgon [and others] -- Work, mental health, and depression / Aart Schene [and others] -- Training mental health providers in better communication with their patients / Christa Zimmermann [and others] -- Making an economic case for community mental health services / Martin Knapp -- Incorporating local information and prior expert knowledge to evidence-informed mental health system research / Luis Salvador-Carulla [and others] -- Innovative epidemiological methods / Francesco Amaddeo [and others] -- Routine outcome monitoring : a tool to improve the quality of mental health care? / Sjord Sytema and Lian van der Krieke -- Psychiatric case registers : their use in the era of global mental health / Povl Munk-Jorgensen [and others] -- Can brain imaging address psychosocial functioning and outcome in schizophrenia? / Marcella Bellani, Nicola Dusi, and Paolo Brambilla -- Statistics and the evaluation of the effects of randomised health care interventions / Graham Dunn -- Service user involvement in in mental health research / Diana Rose -- Psychotropic drug epidemiology and systematic reviews of randomised clinical trials : the roads travelled, the roads ahead / Andrea Cipriani, Michela Nosè, and Corrado Barbui -- Services for people with severe mental disorders in high-income countries : from efficacy to effectiveness / Paul Bebbington, Elizabeth Kuipers & David Fowler -- The management of mental disorders in the primary care setting -- Matteo Balestrieri -- How many wobbly planks in the platform of mental health care? / Norman Sartorius -- Treatment gaps and knowledge gaps in mental health : schizophrenia as a global challenge / Assen Jablensky.

INTRODUCTION: Although schizophrenia (SCZ) and bipolar disorder (BD) share elements of pathology, their neural underpinnings are still under investigation. Here, structural Magnetic Resonance Imaging (MRI) data collected from a large sample of BD and SCZ patients and healthy controls (HC) were analyzed in terms of gray matter volume (GMV) using both voxel based morphometry (VBM) and a region of interest (ROI) approach. METHODS: The analysis was conducted on two datasets, Dataset1 (802 subjects: 243 SCZ, 176 BD, 383 HC) and Dataset2, a homogeneous subset of Dataset1 (301 subjects: 107 HC, 85 BD and 109 SCZ). General Linear Model analyses were performed 1) at the voxel-level in the whole brain (VBM study), 2) at the regional level in the anatomical regions emerged from the VBM study (ROI study). The GMV comparison across groups was integrated with the analysis of GMV correlates of different clinical dimensions. RESULTS: The VBM results of Dataset1 showed 1) in BD compared to HC, GMV deficits in right cingulate, superior temporal and calcarine cortices, 2) in SCZ compared to HC, GMV deficits in widespread cortical and subcortical areas, 3) in SCZ compared to BD, GMV deficits in insula and thalamus (p<0.05, cluster family wise error corrected). The regions showing GMV deficits in the BD group were mostly included in the SCZ ones. The ROI analyses confirmed the VBM results at the regional level in most of the clusters from the SCZ vs. HC comparison (p<0.05, Bonferroni corrected). The VBM and ROI analyses of Dataset2 provided further evidence for the enhanced GMV deficits characterizing SCZ. Based on the clinical-neuroanatomical analyses, we cannot exclude possible confounding effects due to 1) age of onset and medication in BD patients, 2) symptoms severity in SCZ patients. CONCLUSION: Our study reported both shared and specific neuroanatomical characteristics between the two disorders, suggesting more severe and generalized GMV deficits in SCZ, with a specific role for insula and thalamus. ; Funding: PB was partially funded by grants from the Ministry of Health (RF-2011-02352308). Grant support of EM was provided by the European Union's Seventh Framework Programme for research, technological development and demonstration under grant agreement no. 602450 (IMAGEMEND Project). Part of the present study was conducted at the Hospital Universitario MarqueÂs de Valdecilla, University of Cantabria (Santander, Spain), under the following grant support: Carlos III Health Institute PI020499, PI050427, PI060507, Plan Nacional de Drugs Research Grant 2005- Orden sco/3246/2004, SENY Fundacio Research Grant CI 2005-0308007 and FundacioÂn MarqueÂs de Valdecilla API07/011. We wish to acknowledge IDIVAL Neuroimaging Unit for imaging acquirement and analysis. Part of the study was conducted at the Ospedale San Raffaele, Milano, supported by the European Union EU-FP7-HEALTH-F2-2008-222963 "MOODINFLAME" and by the Italian Ministry of Health RF-2011-02350980 projects. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.