bluuebunny/crossref_metadata_2025 huggingface dataset:
Cretinism Muscular Hypertrophy: An Unorthodox Reflection
Authors: Mohsin H. , Channa A.
Published: May 2016

The Kocher Debre Semelaigne Syndrome (KDSS) is also known as cretinism muscular hypertrophy. It is an unusual presentation in intellectually deficit children, commonly associated with congenital or iatrogenic hypothyroidism. The incidence of KDSS is less than 10%. It is more common in males, consanguineous marriage and age range from 18 months to 10 years [4]. The creatinine phosphokinase (CPK) is usually elevated [5]. It might be misdiagnosed particularly when other classical features of hypothyroidism are not dominant at first presentation. We present a case of 15-year-old intellectually deficit female. Her epilepsy had been managed on phenytoin for a decade. She had rigidity, leg cramps, malaise, oliguria, fever, myxedema, delayed deep tendon reflexes, calf muscle hypertrophy and agitation. Her agitation was controlled by haloperidol, which worsened the condition by altering her mental status. The patient was initially managed on line of Neuroleptic Malignant Syndrome due to raised CPK of 40,680 IU/L and mixed presentation. Nevertheless, no significant change was noticed until thyroid profile was done to exclude alternative resources. Thyroid stimulating hormone (TSH) was 74.5 IU, free T3 1.22 ng/dL, and free T4 0.43 ng/dL. Thyroxine was started along with change in anti-epileptic and recovery was observed within five days. This case report highlights the inconsistent finding from previously reported cases of KDSS. The female gender, non-consanguineous marriage, slightly delayed onset with primarily neuromuscular symptoms, and raised CPK is not the frequent demonstration in KDSS. On parallel, thyroid work-up is not routinely done, which can lead to misdiagnosis and mismanagement.

References not available.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Doing More Than Act: The Dutch Fact Model, Flexible Assertive Community Treatment
Authors: Keet R.
Published: May 2016

Background/objectives

Assertive community treatment (ACT) has become the standard for integrated care for people with severe mental illnesses. Limitations of ACT are the lack of flexibility, the limited feasibility in rural areas, the limited population and the time-unlimited nature. These limitations can be overcome by flexible assertive community treatment (Flexible ACT), developed in the Netherlands and introduced in several European countries.

Methods

Three studies were done between 2006 and 2015 on the results of the introduction of Flexible ACT, two in The Netherlands and one in the UK.

Results

The outcomes in the Netherlands data show the effectiveness of Flexible ACT. Remission of schizophrenia increased form 19% to 31%. Bed use was reduced and quality of life increased. Effectiveness of FACT was also shown in the UK, where total patient time in hospital declined by half, even though the average time service providers spent with patients also declined. Collected data of the digitalized boards show that the board is used in accordance with the FACT model. Transition rate to primary care is 5–10% per year.

Discussion/conclusion

The introduction of Flexible ACT has been shown to benefit patients with severe mental illness and indicate the ability of to allocate human resources in mental health care more efficiently. Introduction to other countries will be accompanied by research on the effectiveness and feasibility within other cultures.

Disclosure of interest

The author has not supplied his/her declaration of competing interest.
Non-Attendance at Initial Appointments in an Outpatient Mental Health Centre
Authors: Perdigues S. Ramos , Llopis S. Gasque , Magaña S. Castillo , Abad Y. Suesta , Martínez M. Forner , Vera M. Gárriz
Published: May 2016

Introduction

Non-attendance at initial appointments is an important problem in outpatient settings and has consequences, such as decreased efficient use of resources and delayed attention to patients who attend their visits, and that compromises quality of care.

Objectives

To identify and describe the characteristics of patients who do not attend the first appointment in an adult outpatient mental health center, located in Barcelona.

Method

Retrospective study. The sample was made up from all patients who had a first appointment during 2014 in our outpatient mental health centre. Socio-demographic and clinical data (type of first appointment, reason for consultation, origin of derivation, priority, history of mental health problems) were described. The results were analyzed using the SPSS statistical package.

Results

A total of 272 patients were included. Twenty-six per cent did not attend their first appointment; with mean age 39.75 years and 51.4% were male. Most frequent problems were anxiety (41.7%), depression (26.4%) and psycosis and behavioural problems (11.2%). The origin was primary care (83.3%), social services (4.2%) and emergencies (2.8%). Most of them were not preferent or urgent (86.1%). The 51.4% of non-attendees had history or psychiatric problems and 13.9% nowadays are patients of our mental health centre.

Conclusions

It is important to develop mechanisms that can reduce the incidence of first non-attended appointments. In our case, most of them are attended by primary care so we can establish better communication with our colleagues and try to contact to the patients prior to the date of the appointment.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
The Onset of Psychotic Disorders and the Immigration Status – A Look Into A Growing Reality
Authors: Maia L. , Carvalho I. , Silva D. , Carneiro L.
Published: May 2016

Introduction

Recent studies point for an increased incidence of psychotic disorders among immigrants when compared to nom-immigrant population, with a substantial risk variation being observed among different ethnic minority groups and diverse host countries/societies.

Objective

This communication explores the relation between immigration and the onset of psychosis disease, namely the individual and socio-environmental factors implicated in this association.

Aims

Accessing the implications of immigration in the establishment of psychotic disorders.

Methods

The authors conducted a literary search on Medline and PsychInfo databases regarding the subject immigration and psychotic disorders, elaborating a bibliographic review of the topic.

Results

A greater incidence of psychotic disorders in immigrants (in comparison to nom-immigrant population) has been established. In actuality a range of studies carried out in different socio demographic contexts and with different ethnic groups (of immigrants) identify ethnicity, neighbourhood characteristics (namely level ethnic density), discrimination and refugee status, as some of the probable factors that modulate the rate of psychotic disorder and influence its incidence in immigrants.

Conclusions

With regard to the relationship between immigration and the development of psychosis, much is still to be understood. Future studies with focuses on different individual, social, cultural and demographic aspects need to be developed in order to better understand and addressed this phenomenon.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Keypy – An Open Source Library For EEG Microstate Analysis
Authors: Milz P.
Published: May 2016

The brain's electric field configuration reflects its momentary, global functional state. The fluctuations of these states can be analyzed at millisecond resolution by the EEG microstate analysis. This analysis reportedly allowed the detection of brain state duration, occurrence, and sequence aberrations in psychiatric disorders such as schizophrenia, dementia, and depression. Several existing software solutions implement the microstate analysis, but they all require extensive user-interaction. This represents a major obstacle to time-efficient automated analyses and parameter exploration of large EEG datasets. Scriptable programming languages such as Python provide a means to efficiently automate such analysis workflows.

For this reason, I developed the KEY EEG Python Library keypy. This library implements all steps necessary to compute the microstate analysis based on artefact free segments of EEG. It includes functions to carry out the necessary preprocessing (data loading, filtering, average referencing), modified k-means clustering based microstate identification, principal component based mean computation (across recording runs, conditions, participants, and or participant groups), and to retrieve the microstate class based statistics necessary to compare microstate parameters between groups and/or conditions. Keypy is an open source library and freely available from https://www.github.com/keyinst/keypy.

Keypy provides a platform for automated microstate analysis of large-scale EEG datasets from psychiatric patient populations and their comparison to healthy controls. It is easily applicable and allows efficient identification of deviant brain states in clinical conditions.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Agenesis of the Corpus Callosum in A Patient With Bipolar Disorder
Authors: Nogueira J. , Ribeiro R. , Vieira J. , Sousa R. , Mendes S. , Ribeiro B. , Salta M. , Barata B. , Gamito A. , Mendes R.
Published: May 2016

Background

The corpus callosum (CC) is the largest white matter structure in the brain, which plays a crucial role in interhemispheric communication. Agenesis of the CC is a rare development anomaly, with unknown cause. It could be asymptomatic or associated with mental retardation and neurologic symptoms. Some case reports, post-mortem studies and image studies have linked thickness reduction and agenesis of CC with psychotic symptoms, mainly in schizophrenia patients. Lately, anatomical abnormalities in the CC have been reported in patients with Bipolar Disorder (BD).

Case report

A 52-year-old woman was brought to the emergency room by the authorities after being physically aggressive to her 13-year-old daughter and inappropriate behavior in public. At the emergency department her mood was elevated with emotional lability, dispersible attention, slight increase of motor activity, pressured and difficult to interrupt speech, grandious and self-referent delusional ideas.

Her past history revealed hippomaniac episodes characterized by periods of excessive shopping and hyperphagia. In 2008, she had a major depressive episode.

Head CT-SCAN revealed agenesia of CC. She received the diagnosis of Manic Episode with mixed features and was treated with valproic acid, flurazepam and olanzapine.

Conclusion

This case reinforces the fact that changes in CC, probably due to deficiency in myelination, could have a crucial importance in the pathophysiology of Bipolar Disorder.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Dual Target Repetitive Transcranial Magnetic Stimulation In The Treatment Of Comorbid Obsessive-Compulsive Disorder In Patients With Anorexia Nervosa: Preliminary Results Of Two Case Reports
Authors: De Schryver N. , Lemmens G.M.D. , Baeken C. , Van den Abbeele D.
Published: May 2016

Introduction

Obsessive-compulsive disorder (OCD) is a frequently reported comorbid disorder (20–30%) in patients with anorexia nervosa (AN). Increasing evidence suggests that repetitive transcranial magnetic stimulation (r-TMS) may be effective in the treatment of refractory OCD and to a lesser extent in AN. Hereby, different target areas: supplemental motor area (SMA) and orbitofrontal cortex (OFC) and dorsolateral prefrontal cortex in AN. We report two patients with enduring AN and comorbid treatment resistant OCD treated with r-TMS.

Methods

Both female patients (34 and 26 years respectively) were hospitalized at the Eating Disorder Unit at the Ghent University Hospital. Treatment responses were evaluated with Yale Brown Obsessive Compulsive Scale (Y-BOCS) and weight gain. Inhibitory continuous thetaburst stimulation (cTBS) of the SMA followed by cTBS of the OFC was conducted during 20 sessions, 5 sessions a week, during 4 weeks. Stimulation intensity was respectively 100% and 80% of the motor treshold.

Results

After cTBS treatment Y-BOCS score of both patients decreased (31 to 24 and 31 to 23 respectively). Only one patient showed a 10% increase of weight. The treatment was well tolerated. No significant side effects were reported.

Conclusion

Treatment resistant comorbid OCD in patients with AN may be succesfully treated with cTBS.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Exploring the Role of Dissociation Dimensions in Obsessive Compulsive Disorder
Authors: Pozza A. , Giaquinta N. , Dèttore D.
Published: May 2016

Introduction

In the last decade, accumulating evidence has been produced on the role of dissociation in Obsessive Compulsive Disorder (OCD). Understanding which dissociation dimensions are specific to OCD could suggest the integration of therapeutic strategies for dissociation in the treatment of patients with OCD.

Objectives

The current study explored the role of dissociation in a sample of patients with OCD, patients with anxiety disorders and healthy controls with the aim to understand which dissociation dimensions could be specific to OCD.

Method

One hundred seventy-one participants were included in the study (56% females, mean age = 35.96, SD = 12.61), of which 52 were patients with primary OCD, 59 were patients with Anxiety Disorders (AD), and 60 were healthy controls. The Dissociative Experiences Scale (DES), Beck Depression Inventory-II (BDI-II), Beck Anxiety Inventory (BAI), Yale-Brown Obsessive Compulsive Scale (Y-BOCS) were administered.

Results

Patients with OCD had significantly higher dissociative amnesia symptoms than patients with AD and health controls (F = 6.08, P < 0.01) and higher depersonalization/derealization symptoms than healthy controls but not than patients with AD. Patients with OCD did not report significantly higher dissociative absorption than healthy controls and patients with AD.

Conclusions

Strategies targeting dissociative amnesia and depersonalization/derealization symptoms in OCD are discussed. Future studies should examine which OCD subtypes are more strongly associated to dissociation dimensions.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Pain Management in Context of Emotionally Unstable Personality Disorder
Authors: Dobrzynska E. , Clementi N.
Published: May 2016

Introduction

Emotionally unstable personality disorder (EUPD) is characterised by Pain Paradox. The response for acute, self-induced pain seems to be attenuated while chronic, endogenous pain is usually intolerable. Pain management of this group of patients poses many difficulties, including discrepancies between subjective and objective pain assessment, patients’ demands for strong analgesics and impact on relationship with other professionals.

Objectives and aims

The purpose of the study was to review pain management options for persons diagnosed with EUPD and complaining of chronic pain.

Methods

MEDLINE and PsycINFO databases were searched for all English-language articles containing the keywords “chronic pain”, “pain management”, “borderline personality disorder”, and “emotionally unstable personality disorder”.

Results

Seventeen relevant papers were identified. Suggested first step in pain management was ongoing clarification with EUPD patients that analgesics are unlikely to fully treat their pain and support of non-pharmacological approaches to pain, including cognitive-behavioural strategies. Regarding pharmacology, liberal use of non-addicting analgesics was recommended with highly conservative use of opioid analgesics. Importance of evaluation and treatment of any underlying mood and/or anxiety syndromes was stressed as well as liaison with other professionals (e.g. psychologists, neurologists, orthopaedics, and physiotherapists).

Conclusions

Patients with EUPD often report chronic pain, which can only be managed by close collaboration of professionals from different disciplines.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
The Analgesic Efficacy of Ketamine-Magnesium Combination is Influenced by the Order of Medication Administration
Authors: Savic Vujovic K. , Vuckovic S. , Vujovic A. , Prostran M.
Published: May 2016

Introduction

Magnesium is an endogenous voltage-dependent NMDA receptor channel blocker and ketamine is a non-competitive NMDA receptor antagonist. Magnesium may potentiate the effect of ketamine in analgesia and anaesthesia, but may also interact in an opposing manner. This study aimed at evaluating type of the interaction between magnesium sulphate and ketamine administered systemically in rats with an acute nociceptive pain (tail-immersion test).

Materials and methods

Analgesic activity was assessed by tail-immersion test in male Wistar rats (200-250 g). The distal 5 cm of the tail was immersed in a warm water bath (55 ± 0.5 °C) and the time for tail-withdrawal was measured as response latency.

Results

Magnesium sulphate (2.5–30 mg/kg, s.c.) and ketamine (2.5-30 mg/kg, i.p.) administered alone did not produce any effect. However, significant antinociception (synergistic interaction) was revealed at the following doses of ketamine: magnesium sulphate of 5:5 mg/kg, 2.5:5 mg/kg and 10:5 mg/kg. The effect was not dose-dependent, and a greater response was obtained when ketamine was administered before magnesium sulphate.

Conclusions

This study revealed that (1) magnesium sulphate and ketamine given alone were not effective against acute nociceptive pain in rats, but (2) a combination of both drugs resulted in synergistically inhibited nociception, (3) which occurred only at selected low doses and proportions of the medications in a combination and (4) suggested the importance of the order of drug administration.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Gut Feeling
Authors: Cotta C. , Jesus G. , Vila Nova V. , Moreira C.
Published: May 2016

Introduction

There is growing evidence of the importance of nutrition in mental disorders. Gut microbiota, influenced by environmental factors such as diet and stress, has been proposed as one of the players on a dynamic called gut-brain axis, which is thought to have an influence on behaviour and mental health.

Objectives and aims

To summarize recent evidence on the topic, and its potential role in psychiatric interventions.

Methods

The authors review updated literature collected from online scientific databases.

Results

The development of the brain itself has been shown to be influenced by the gut microbiome. Research demonstrates that the composition of the microbiota has influence on behaviour through neuroendocrine and other neuroactive messengers production by the bacteria within the gut lumen. Studies in germ-free animals, animals exposed to bacterial infections, probiotic suplements or antibiotic drugs suggest a role for the gut microbiota in the regulation of anxiety, mood, cognition and pain. The gut microbiome has been implicated in brain disorders including anxiety and depression, multiple sclerosis, Alzheimer's disease, Parkinson's disease, and autism.

Conclusions

The treatment of mental disorders is usually based on pharmacological and psychotherapeutic interventions, and little attention is given to dietary interventions. The emerging field of research focused on the human microbiome suggests an important role for the gut microbiota in influencing brain development, behaviour and mood in humans, and points new strategies for developing novel therapeutics for mental disorders.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Paliperidone Palmitate Study in Patients With Personality Disorder
Authors: Gutierrez Ortega M.A. , María Dolores D.P. , Manuel M.A. , Esther M.M.
Published: May 2016

Introduction

Personality disorders are chronic affectation of mood, impulsivity, aggression and anxiety. It is thought to have biological factors related to the development of personality disorders.

Aims

To evaluate and compare the efficacy of injectable paliperidone in actual clinical practice of patients diagnosed with Personality Disorder, compared to other treatments.

Methods

We conducted a descriptive, restrospective and observational study from January 2012 to June 2015 including all the patients who are treated with paliperidone palmitate extended-release injectable suspension with a diagnosis of Personality Disorder according to DSM 5. We included patients with at least 12 months of treatment and the results were compared with respect to the 12 months prior to taking said drug. Variables studied: medical diagnosis, hospital admissions, average length of stay, total number of emergency visits or other devices, maintenance doses.

Results

We recruited 14 patients (7 women and 7 men) with a mean age of 36.2. 64.29% of patients had borderline personality disorder; 21.43% unspecified personality disorder. The mean dose of maintenance treatment is 105.357. Before the treatment, the quantity of total number of hospital admission are 1.14 versus 0.429 after treatment. The number of stay is also decreased from 13.7 to 3.5; like emergency room visits or to other devices. 78.57% of patients continue to psychopharmacological treatment. Fifty percent of patients undergoing treatment with another antipsychotic (P < 0.05).

Conclusions

The present results show that paliperidone palmitate can be an effective way to control the most characteristic symptoms of Personality Disorders, and reducing emergency visits, hospitalisations and other devices.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Organic Personality Disorder and Diogenes Symptoms: Case Report and Current Status of the Issue
Authors: Rodríguez Criado N. , Cruz Fourcade J.F. , Muñoz-Calero Franco P. , Sánchez Sánchez B. , Martín Aragón R. , Bravo Herrero S. , Manuel G.E.M. , García-Poggio Fernandez M. , Pinilla Santos B.E. , Gutiérrez Rodríguez M.
Published: May 2016

Objective

To review the current knowledge about Diogenes symptoms and organic personality disorder through systematic review of the literature and the analysis of a case.

Methods

Case report. Review. Literature sources were obtained through electronic search in PubMed.gov database of 10 last years.

Results

Background: Diogenes syndrome is a behavioral disorder characterized by severe self-neglect, hoarding, domestic dirt, and lack of shame regarding one's living state. Patients may present due to a range of reasons, few studies has been described hoarding symptoms secondary to brain injury. Early management could reduce their high-mortality condition.

Case presentation

We present a case of a 67-year-old Caucasian female known with a organic personality disorder secondary to a head trauma with obsessive hoarding symptoms. After being hospitalizated, we were authorized to explore her personal items trough photographs. Her handbag and her house were filled with rubbish and rotting food. Our patient had no insight into any self-hygiene or public health problems.

Conclusions

Information of the characteristics of Diogenes syndrome can help in earlier recognition of such persons, in order to decrease their morbidity and mortality.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Vulnerability and Psychopathology. Reviewing a Model in Theory of Psychiatry
Authors: Bone-Pina I.
Published: May 2016

Introduction

The vulnerability model is prevalent in the current Theory of Psychiatry. Systematic reflection after reviewing the historical proposition of this model can enrich its contents.

Objectives

Complete and deepen the meaning of the concept “vulnerability” in Psychiatry.

Aims

Review historical approaches to the concept of vulnerability in Psychopathology. The study starts with Zubin & Spring and reaches contemporary approaches especially in the writings of Giovanni Stanghellini.

Seek sources to deepen its meaning looking back to Karl Jaspers and Ludwig Binswanger's classical Psychiatry. They offer psychopathological notions that can be used to enrich a model of vulnerability.

Methods

This is research in the context of Theory of Psychiatry, its method implies a historical literature review and a systematic philosophical reflection.

Results

Vulnerability is still revealed to be the best concept to organize a model of mental illness. This study proposes to avoid any simple identification of vulnerability with statistical or genetic risk. Vulnerability in psychopathology should always be confronted with the horizon of human subjectivity. To keep in view this horizon – a limit impossible to grasp – is indispensable for clinicians and researchers if they want to understand patients who suffer mental illness. This process is helpful to avoid any reductionism about the image of mental illness and about the human being who suffers that illness.

Conclusion

“Vulnerability” is shown as a concept that needs to be thought over thoroughly and to be present in psychopathology to overcome reductionism and to understand the very possibility of psychiatric illness.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Relationship Between Attitude Toward Spirituality and Attitude and Performance of Spiritual Care Among Nurse
Authors: Farahaninia M. , seyedfatemi N. , Abbasi M.
Published: May 2016

Introduction

Although spiritual care is commonly regarded as a nursing task, in practice, it is often provided inadequately.

Objective

The purpose of this study was to examine relationship between attitude toward spirituality and the attitude and performance of spiritual care among nurses who working in hospitals of Iran university of medical sciences.

Methods

This was a correlative-descriptive study. Spiritual Perspective Scale (SPS) and Nursing Spiritual Care Perspective Scale (NSCPS) were used to gather the data. A number of 166 nurses participated in this study.

Results

Findings showed that of nurses’ spirituality attitude score was 4.98 ± 1.1 which indicated high attitude toward spirituality. The total average of nurses’ attitude about spiritual practices was 3.67 ± 0.51, which signified the positive attitude of nurses about spiritual practices. Findings revealed that positive spiritual attitude had a significant correlation with 6 out of 12 expressed spiritual interventions. In addition, spiritual attitude generally had a significant positive correlation with spiritual interventions. The positive spiritual attitude had a significant correlation with only 3 items out of 11 for the attitude toward spiritual practices. There was no correlation between spiritual attitude and the attitude toward spiritual practices.

Conclusion

In spite of the positive attitude, nurses did not perform half of the spiritual interventions which most of them were in line with fulfilling the patients’ religious needs. Establishment of in-service education program regarding spiritual care practice by role play and modeling methods are recommended.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
The stigma of mental illness in children and adolescents: A systematic review
Authors: Kaushik A. , Kostaki E. , Fewings S. , Thomas G. , Kyriakopoulos M.
Published: May 2016

Introduction

One in ten children and adolescents experience mental health difficulties at any given time, yet only one third of those suffering access treatment. Untreated mental illness predisposes to longstanding individual difficulties, and presents a great public health burden. Large scale initiatives to reduce stigmatization of mental illness in children and adolescents, identified as a key deterrent to treatment, have had limited success, and research is scarce.

Aims

To gain a better understanding of the stigma experienced by children and adolescents with mental health difficulties.

Objectives

We conducted a systematic review of the literature examining stigma and self-stigma towards children and adolescents with mental health difficulties, in order to better understand the extent and type of discrimination directed towards this particularly vulnerable group.

Methods

Following PRISMA guidelines, the databases Pubmed, PsychINFO and Cochrane were searched for original research published between 1980 and 2014, assessing public stigma (i.e. the reaction of the general public) and self-stigma (i.e. internalized public stigma) towards children and adolescents with mental health difficulties.

Results

Thirty-seven studies were identified, confirming that stigmatization towards children and young people suffering mental health difficulties is a universal and disabling problem. There was some variation by diagnosis and gender, and stigmatization was for the most part unaffected by labelling. Self-stigmatization led to more secrecy and avoidance of interventions.

Conclusions

The findings confirm that stigmatization of mental illness is poorly understood due to a lack of evidence and methodological discrepancies. Implications of the findings are discussed, and suggestions made for future research.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Mental Health, Self-Compassion, Organizational Virtuosity and Commitment in Workers From Local Administration
Authors: Simões D. , Simões S. , Espírito-Santo H. , Simões D. , Marques M. , Lemos L.
Published: May 2016

Introduction

Positive and organizational psychology can offer an important contribution to strengthen human virtues that protects intra- and interpersonal functioning, which, in turn, might enhance worker's well-being and the success of organizations.

Objective

To study the associations between a psychological construct, self-compassion, and some organizational constructs, organizational commitment and organizational virtuosity and to explore differences in each construct by gender, age, working time (in the organization), type of employment bond and professional group.

Aims

Positive actions inside organizations promote positive emotional states.

Method

One hundred and thirty workers from local administration (men, n = 78; 60%; age, M = 44,22; SD = 8,67; range = 19-63 years old) filled in the Self-Compassion Scale, the Organizational Commitment Questionnaire, the Organizational Virtuosity Questionnaire and the Depression, Anxiety and Stress Scales.

Results

There was a positive association between organizational commitment and organizational virtuosity. Optimism and integrity (organizational virtuosity dimensions) positively correlated with the self-criticism dimension and with self-compassion total score. Some dimensions of mental health (depression and stress) were negatively associated with organizational virtuosity. Employees with less education, belonging to a professional group less qualified or with an unfavourable employment bond perceived the organization as less virtuous, and were less committed.

Conclusion

Promoting positive actions inside organizations seem to encourage positive emotional states in individuals. The development of a compassionate capacity, by self-compassion and mindfulness, humanize both individuals and organizations. These workers, with their leaders, can promote affective and normatively committed workforces, presenting positive perceptions about organizational virtues.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Tests Get Me Nervous: A Case of Pharmacological Enhancement
Authors: Muquebil Ali Al Shaban Rodriguez O.W. , Ocio León S. , Gómez Simón M. , Hernández González M.J. , Álvarez de Morales Gómez-Moreno E. , López Fernández J.R. , Frías Ortiz D.F. , Barrio Nespereira A. , Gutiérrez Vázquez G. , Pérez Gómez L. , Tuñón Gorgojo L.
Published: May 2016

Introduction

The use of drugs to improve cognitive performance (pharmacological enhancement) is a practice that increases in frequency, especially in individuals with a high degree of academic education, university students, and workforce with high responsibilities. Legal substances such as alcohol and caffeine, prescription drugs such as modafinil or methylphenidate and some illegal drugs such as amphetamines or cannabis are utilized to improve cognitive performance, maintain wakefulness, or induce sleep. Perception of risk is low in many cases. Internet has facilitated the illicit access to prescription drugs with astonishing ease.

Objective and methods

We want to exemplify through a clinical case, how the access to some of these substances through internet is very easy, and how, in this case, the use of Modafinil (drug indicated for narcolepsy) with the objective of maintaining academic performance aggravates symptoms of anxiety in a 22-year universitary patient.

Results

Exposition of clinical case in the poster.

Conclusions

The use of substances (“smart drugs”) presents risks for both physical and psychological health that sometimes are not perceived by the user. It is surprising that a highly educated individual has taken Modafinil without researching for a deep understanding of the side effects of the drug.

Internet access of regulated substances that should only be prescribed by a physician to be used on very concrete symptoms is extremely easy. In the case of the Modafinil, it is possible to access its purchase by simply searching the words “purchase/buy Modafinil” in any internet browser.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Isolated Psychiatric Presentation of Anti N-Methyl-D-Aspartate Receptor Encephalitis: A Case Report
Authors: Azevedo P. , Monteiro F. , Correia A.P. , Norton A. , Moreira A.M.
Published: May 2016

Introduction

Anti N-Methyl-D-Aspartate receptor (NMDAR) encephalitis is an autoimmune disorder with a presentation that includes acute behavioral changes, psychosis, cognitive impairment and autonomic instability. In some cases, there are isolated psychiatric symptoms without neurological involvement.

Aims

To raise awareness of the disorder among psychiatrists, considering it a differential diagnosis in a first psychotic episode since a prompt diagnosis and treatment can dramatically affect the outcome.

Objectives

To summarize the latest literature about this field and to present a case report.

Methods

A brief review of the latest literature was performed on PubMed using the keywords “anti N-methyl-D-aspartate receptor encephalitis”, “anti-NMDA encephalitis”, “psychiatric symptoms”.

Results

A 20-year-old male was admitted to our inpatient unit with bizarre delusions of grandious and religious content, somatic hallucinations, sleep cycle inversion and strange behaviour. These symptoms had been present for 1 week and remitted after 10 days of treatment with risperidone. On follow-up, he developed anhedonia, apathy and blunt affect. Brain MRI showed multiple hyperintense changes in T2 and T2-FLAIR, highly suggestive of demyelinating lesions. The cerebrospinal fluid showed mild lymphocytic pleocytosis, mildly increased proteins, oligoclonal bands and anti-NMDAR antibodies of intrathecal production. He was treated with corticoids and the antipsychotic was discontinued. No neurologic symptoms were ever present.

Conclusion

This is an atypical case of anti-NMDAR encephalitis because of its isolated psychiatric presentation. Most patients develop neurological symptoms 2 to 3 weeks after onset of psychiatric symptoms. Monosymptomatic syndromes arise in less than 5% of patients.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Deficit in executive abilities as a risk factor for emerging weakness in grammar understanding in Russian-speaking children
Authors: Kiselev S.
Published: May 2016

Introduction

Weakness in grammar understanding is key future of specific language impairment (SLI) in children. There has been a considerable amount of work on the language abilities of children with SLI, but we still know relatively little about their other cognitive abilities –in particular their non-linguistic cognitive strengths and weaknesses.

Aims

The aim of this research was to examine the hypothesis that Russian-speaking children at the age of 4 with deficit in executive abilities have a risk for emerging weakness in grammar understanding at the age of 6.

Methods

One hundred and twenty-five children at the age of 4 were assessed with the NEPSY to reveal children with different level of executive abilities. We have revealed 21 children with deficit in executive abilities. The control group included 21 children with typical level of executive abilities. The children from experimental and control group were matched for IQ and gender. In the framework of longitudinal research, children at the age of 6 from both groups were assessed by Grammar Understanding Test from Luria's neuropsychological assessment technique.

Results

Two-way ANOVAs with repeated measures revealed significant differences between groups for scores in the Grammar Understanding Test. Children from experimental group had weakness in grammar understanding.

Conclusions

We have revealed that children at the age of 4 with weakness in executive abilities have a risk for emerging weakness in grammar understanding at the age of 6. In view of the obtained results, it can be assumed that executive abilities have influence on the development of grammar understanding in preschool children.

Disclosure of interest

The author has not supplied his/her declaration of competing interest.
“Yo Soy La DesintegracióN”: Helplessness and Sublimation Through Frida Kahlo's History
Authors: Becker J.
Published: May 2016

Considering the relevance of studying the pathologies of emptiness for contemporaneous clinic, this work approaches the correlation between helplessness and sublimation concepts. Helplessness is considered a new theory, developed by David Maldavsky that uses the term desvalimiento to define a clinical condition described by the feeling of emptiness. To understand this concept, it is necessary to return to a primitive period, when the baby is beginning to qualify his affections. Thus, using historical construction, we start at Freud's works (focusing in the primitive period and the affections qualification), explore the “good-enough mother” importance, from Winnicott, and reaching the helplessness from the present-days Maldavsky's studies. The Frida Kahlo's history illustrates this work as much because of her toxic current as because of her talent to sublimate. The maternal failure, the toxic relationships, the trauma's imposition, the abuse of alcohol and drugs and the viscosity denounce her helplessness. Nevertheless, the art expresses her fight for life. The Frida Kahlo's works represent her suffering, but they also are her attempts to understand her feelings and to reframe her traumatic events. Therefore, we introduce the sublimation as an alternative to the helplessness. Although helplessness is the lack of the symbolic life, we present the art as an opportunity to confront experiences, which can allow the representation of the traumas and the qualification of affections. Through the sublimation, Frida Kahlo recreated her inner world and returned to life.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Psychopathology and Spiritual Experiences: Criteria for Differential Assessment
Authors: Bone-Pina I.
Published: May 2016

Introduction

There is a plurality of differing opinions defining borders between mental disorders and spiritual experiences. This research proposes criteria for clarifying those boundaries.

Objectives

Summarize practical criteria for clinicians to assess psychopathological symptoms with spiritual content and to attain a differential diagnosis from healthy spiritual experiences.

Aims

Merge different approaches from psychopathology, psychology of religion and religious studies to attain practical criteria.

Methods

Literature review using a phenomenological and critical approach.

Results

1. Severe psychiatric symptoms with religious content: (1) are usually in the context of personal impoverishment; (2) appear odd in cultural environments and within a person's biography; (3) do not enhance action or, in the phenomenological tradition, (4) these symptoms come from a weakening of the “intentional arc”. 2. A guiding map is suggested to evaluate spiritual expressions and their relationships with mild or moderate mental disorders and with mental health and personal growth. This map is developed by combining different traditions from the psychology of religion. 3. Psychiatric and psychological judgment of religious/spiritual experiences should be self-limited. There is a judgment about its content and about its validity or truth, which is only possible within the different spiritual traditions.

Conclusions

Psychopathology establishes principles to discriminate some psychotic symptoms from healthy spiritual experiences. Psychology of religion offers some general rules to guide the psychological evaluation of spiritual beliefs and their influence on mental well-being and personal growth. This review opens fields for future research in relating psychopathology and the study of religious experience.

Disclosure of interest

The author has not supplied his/her declaration of competing interest.
Paraphrenia: Evolution of the Concept
Authors: Freitas C. , Figueiredo A.R. , Abreu T. , Queirós S.
Published: May 2016

Paraphrenia was identified as a psychopathological entity characterized by chronic delirium, described next to schizophrenia, but with rich and fanciful elaborations, without social and cognitive impairment associated. Despite having been extensively described, paraphrenia fell into disuse. With this work, the authors intend to carry out a literature review on the concept of paraphrenia, since its first report to the extinction from the current practice of psychiatry. The term paraphrenia (para “near” phrenia “pathological mental state”) was first noted by Kahlbaum in 1863, who identified dementia and subdivided it into three types: “neofrenia”, “paraphrenia hebetica” and “senilis paraphrenia”). Magnan and Manager suggested the concept of “chronic hallucinatory psychosis” in 1963, while Kraepelin started jobs with similar characteristics, defining the concept of paraphrenia. Kraepelin distinguished dementia praecox from the later onset dementia, despite considering them closer to one another than any of them to paranoia. Paraphrenia would be characterized by less formal disturbances of thought and greater preservation of affection. In 1911, with “schizophrenia” expression, Bleuler broke with Kraepelin concept, as Mayer, who reviewed Kraepelin patients, concluding that more than half had progressed to a diagnosis of schizophrenia. At this time, paraphrenia was virtually abolished from the practice of psychiatry. Despite the observations made over the years, the concept of paraphrenia have revealed that the description proposal does not correspond to an isolated and distinct psychiatric condition, several times, in clinical practice we have encountered with patients presenting diagnostic criteria for schizophrenia but with the evolution of the disease showing no significant deterioration in several areas.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
“Bouffée Délirante” Induced by Meditation
Authors: Baena Mures R.A. , Niell Galmes L. , Lázaro Pascual Y. , Saiz Gonzalez M.D.
Published: May 2016

Introduction

Meditation is frequently applied in Western as well as non-Western countries for different purposes; we know little about adverse events. The symptomatology of a meditation-related psychosis appears to show similarities with that we call “bouffée delirante”.

Methods

A female patient is described who developed an acute and transient psychosis with polymorphic symptomatology after meditating (Bikram-yoga). We made a literature search for psychotic states related to meditation.

Results

There are some case reports of psychosis disorder induced by meditation. Some cultural syndromes like Qi-gong appear on DSM-IV as psychotic reaction. In this case, the syndrome is not culture bound.

Conclusions

Meditation can act as a stressor in vulnerable patients who may develop a transient psychosis with polymorphic symptomatology (confusion, pananxiety, mood swings and mood dystonic psychotic symptoms) with a short duration.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Soft neurological signs in schizoaffective disorder – Indicator of psychotic spectrum or diagnostic bias (case report)
Authors: Vukovic V. , Nikolic Lalic S. , Mitic J. , Stojanovic M.
Published: May 2016

Introduction

Neurological soft signs (NSS) refer to a group of neurological deficits with no apparent pathognomonic supstrate and comprise phenomena such as disorders of simple motor coordination, sensory integration, as well as disinhibition sings. Schizophrenia and other neuropsychiatric disorders are associated with a higher prevalence of NSS.

Case summary

A 21-year-old male presented to our hospital with symptoms including anxiety, delusions, mood alterations, insomnia, and hypomania. Neurological assessment revealed presence of soft neurological signs. Personal history was positive for hypoxic birth injury and psychiatric heredity. During his stay, the patient showed not only partial response to treatment during several months, but also extrapyramidal symptomatology (limb hypertonia, decreased associated movements during walking, arm dropping, and rigidity of the neck, as well as elevated blood levels of CK, CRP, and high body temperature). There was no progression of NSS. The addition of valproate to antipsychotic treatment led to mild improvement. An MRI exam indicated presence of lesions in the white mass.

Discussion

Although NSS have been more frequently associated with schizophrenia, especially in patients with dominant negative symptoms, there are findings, which suggest their presence in schizoaffective and bipolar disorders. Their presence is often an indicator of poor outcome, they can resemble EPS, and their association with frequency and severity of EPS is unclear.

Conclusion

The presence of NSS is not enough to discriminate schizoaffective disorder, a “vague” diagnosis from others in what is considered the psychotic spectrum.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Treating ADHD in people with intellectual disabilities
Authors: Courtenay K.
Published: May 2016

Objectives

Attention Deficit Hyperactivity Disorder (ADHD) is more prevalent in people with intellectual disabilities (ID). Drug therapy is the primary treatment for ADHD targeting the core signs of inattention, impulsivity, and hyperactivity (NICE 2013). Knowledge on ADHD has been gleaned from studies in children and children with ID. People with ID have comorbid disorders for example, autism and epilepsy that can complicate the management of ADHD. Knowledge of the effects of treatment is essential in managing ADHD in people with ID. The current evidence on the application of drug therapy for ADHD in ID is described.

Method

A literature review of publications in English language was undertaken.

Results

Using medication to treat ADHD is effective in treating the signs of ADHD in people with ID. The response rates in ID to drug therapy for ADHD approximates to 55% that is lower than in the general population. People with ID experience more side effects from medication that can lead to withdrawal from treatment. Guidelines exist internationally on the appropriate prescribing of medication. Methylphenidate, a psycho-stimulant drug is the drug of first choice. Atomxetine, a non-stimulant drug, is effective in people with ID.

Conclusions

ADHD in people with ID is treatable but clinicians need to be knowledgeable and skilled in managing the disorder in people with ID. Newer drugs could offer more because of their different profile of more tolerable side effects.

Disclosure of interest

The author has not supplied his/her declaration of competing interest.