ABSTRACTS - World Psychiatric Association

also shown. The optimal cut-off point was estimated as 5/6, and the
sensitivity and specificity were 0.94 and 0.93, respectively. The ROC
curve analysis indicated that the diagnostic efficiency of MIS-K was
comparable with that of MMSE-KC. We conclude that the MIS-K has
not only high reliability and validity, but is also useful as a screening
instrument for dementia.
PO3.104.
PATTERN OF CEREBRAL ANOMALIES IN OLDER
PERSONS WITH SCHIZOPHRENIA OR ALZHEIMER’S
DISEASE
M. Boccardi, D. Paternicò, A. Prestia, C. Geroldi, A. Adorni,
G.B. Frisoni
IRCCS S.Giovanni di Dio, Fatebenefratelli, Brescia, and AFaR
(Associazione Fatebenefratelli per la Ricerca), Rome, Italy
Different cognitive impairment is described for people with Alzheimer’s
disease (AD) and for elderly people with schizophrenia, but the differences
in the patterns of cerebral anomalies at direct comparison of the
two conditions is unknown. The study aimed to identify the differences
in the grey (GM) and white matter (WM) of people with geriatric schizophrenia
and AD with voxel-based morphometry (VBM). Twenty elderly
subjects with schizophrenia (age: 67.7±6.2; sex: 10 females) from a
psychogeriatric ward, 19 consecutive outpatients with AD (73.2±9.0; 12
females) and 19 controls (73.1±7.3; 14 females) underwent high resolution
3D magnetic resonance imaging. VBM was performed with SPM2,
(optimized protocol). P was set at 0.05-FDR corrected for the comparisons
with controls and at 0.005 uncorrected for direct comparisons of
patient groups. Subjects with schizophrenia compared to controls had
smaller GM in the thalamus, parahippocampal gyrus and putamen.
Smaller clusters of atrophy were located in the cingulate, insular, frontal
and occipital gyri. AD patients vs. controls had atrophy in the thalamus,
medial frontal gyrus, and parietal lobe, extending to the cuneus and precuneus.
On the direct comparison of schizophrenia vs. AD, a cluster of
atrophy could be observed in the precuneus of AD patients. The WM
experiment showed atrophy along the whole corpus callosum in schizophrenics
vs. controls and, although to a lesser extent, in the AD sample
vs. controls. On the direct comparison the schizophrenia sample
exhibited smaller WM volume in the right cerebellum. Thus, the patterns
of GM and WM anomalies were largely overlapping in schizophrenia
and AD patients, but the two samples showed an opposite
trend, with greater GM involvement in the AD sample, and more WM
anomalies in the schizophrenia sample. This may reflect the different
pathogenesis of the two conditions: degenerative in AD and developmental
in schizophrenia.
PO3.105.
TREATMENT OF LATE LIFE DEPRESSION
ASSOCIATED WITH MILD COGNITIVE IMPAIRMENT
R.M. Chenderes, C. Mila, D.M. Podea, P.D. Nanu
Departments of Psychiatry and Neurology, University of Arad,
Romania
The aim of this study was to determine the influence of mild cognitive
impairment (MCI) on the outcome of late life depression. We recruited
60 patients diagnosed with late life depression (ICD-10 and DSM-
IV criteria, age over 65 years) and MCI (score between 21 and 28 on
the Mini Mental State Examination, MMSE). The patients were divided
into two groups: group A (30 patients treated with mirtazapine, 15-
30 mg/day, and piracetamum, 1600 mg/day) and group B (30 patients
treated with mirtazapine only) The evaluation was done at recruitment,
after 6 weeks and after 6 months of treatment. Cognitive impairment
was evaluated with the MMSE and depressive symptoms with
the Montgomery-Asberg Depression Rating Scale (MADRS). The
average of MMSE scores for group A were 26.3 at recruitment, 27.9
after 6 weeks and 28.6 after 6 months. Group B improved by only 1.5
points after 6 weeks (from 25.7 to 27.2) and by only 1.8 points after 6
months (from 25.7 to 27.5). The improvement on the total MADRS
score was 7.6 points for group A vs. 4.9 points for group B after 6
weeks and 11.2 and 7.3 points, respectively, after 6 months. These
data suggest that MCI has a better outcome in patients treated with
antidepressants and nootropics than in those treated only with antidepressants.
This work was supported by the Romanian Ministry of Education and
Research.
PO3.106.
ANTIOXIDANTS ASSOCIATED WITH NOOTROPICS
IMPROVE MILD COGNITIVE IMPAIRMENT
IN A POPULATION OVER 65 YEARS OLD
D.M. Podea, P.D. Nanu
Departments of Psychiatry and Neurology, University of Arad,
Romania
With aging, oxidative stress may cause mild cognitive impairment
(MCI). We evaluated the improvement of cognitive functions using
nootropics alone or nootropics associated with antioxidants in a late
life population with MCI. We included 60 patients with MCI (Mini
Mental State Examination, MMSE score between 21 and 28), over 65
years of age. They were divided into two groups: group A (n=30) treated
with piracetam (1600 mg/day); group B (n=30) treated with coenzyme
Q10 (30 mg/day) plus piracetam (1600 mg/day). They were evaluated
using MMSE at admission, and after 1, 3 and 6 months of treatment.
After 1 month of treatment, the mean MMSE score improved by
0.2 points in group A and 0.4 points in group B. After 6 months of
treatment, those treated with piracetamum+CoQ10 had an increase in
the MMSE median score of 3.3 points, vs. 1.3 points in group A. The
association of piracetam and CoQ10 may improve the cognitive functioning
by several mechanisms: the reduction of inflammation, excitotoxicity
and oxidative stress, or the triggering of axonal/dendritic
sprouting.
The work was supported by the Romanian Ministry of Education and
Research.
PO3.107.
CONCEPT OF DEPRESSION-DEMENTIA
INTERMEDIATE ZONE
T. Kobayashi, S. Kato
Department of Psychiatry, Jichi Medical University, Tochigi, Japan
In this rapidly aging society, clinicians are faced with more and more
mentally disordered elderly people. Among mental disorders in the
elderly, depression and dementia are the most common in clinical
practice. However, both sometimes coexist, succeed each other, and
confuse clinicians. It has been argued that depression can be distinguished
from apathy in dementia by its emotional responses expressed
as negative thought about self, present, and future, despair, helplessness,
and pessimism. It has been pointed out that depressive symptoms
such as sadness, diurnal variation in mood, early and late insomnia
allow to differentiate major depression from Alzheimer’s disease.
However, the distinction is not always so clear in clinical situations.
Our clinical experience with patients who develop dementia after the
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