bluuebunny/crossref_metadata_2025 huggingface dataset:
Elderly person's connection of family relations with quality of life and shame in the context primary healthcare
Authors: Kotrotsiou E. , Mparka I. , Xatzoglou C. , Gouva M.
Published: May 2016

Objectives

The elderly persons continue to invest substantially in emotional relationships.

Aim

The overall objective of this research study was to investigate the attitudes of elderly persons towards family relations.

Method

One hundred and ninety-seven healthy elderly individuals participated to the present study from different region in Greece. The age range was 66–93 years old. The questionnaire included: (a) the Family Environment Scale (Family Environment Scale, Form R-FES), (b) The Experience of Shame Scale (ESS), (c) the Other As Shamer Scale (OAS), (d) Quality of Life (SF-36).

Results

Univariate and multivariate analysis was applied for the statistical analysis of the data, which showed that: the elderly persons who are satisfied with their lives in past, they exhibit lower overall price external shame feelings of emptiness (empty – OAS) (P = .002), they perceived reaction of others when they make mistakes (Mistakes – OAS) (P = .000), conflict (Conflict – [Form R-FES]) (P = .000). Elderly persons who are satisfied with their life in this time show higher levels of orientation towards active recreational activity (Active-Recreational Orientation – R-FES) (P = .000). Elderly persons who declared that family relation is important for them exhibit lower levels of feeling vacuum (empty – OAS) (P = .009), and higher levels of orientation for achievements (Achievement Orientation) (R-FES) (P = .010), social role (SF – SF36) (P = .000), Mental Health summary Scale (SF_MCS-SF36) (P = .000).

Conclusion

From the findings of this study, it is apparent how important is the study of the quality of life in old age.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Implication of altered α7 nicotinic receptors and amyloid deposition in the Alzheimer's brain
Authors: Nakaizumi K. , Terada T. , Yoshikawa E. , Kakimoto A. , Takashi I. , Suzuki I. , Tomoyasu B. , Suzuki K. , Magata Y. , Mori N. , Ouchi Y.
Published: May 2016

Introduction

Brain amyloid-β protein (Aβ) deposition is a key pathology of Alzheimer's disease (AD). Cholinergic degeneration, including reductions in α7 nicotinic acetylcholine receptors (α7-nAChR), is also known as a pathophysiology of AD. Recent imaging studies have shown cognitively normal subjects with Aβ depositions, indicating a missing link between Aβ deposition and cognitive decline.

Objectives

To clarify relationships among the Aβ burden, α7-nAChR availability, and cognitive declines in AD.

Aims

To measure brain Aβ deposition and α7-nAChR availability in the same patients with AD using positron emission tomography (PET).

Methods

Twenty AD patients and age-matched 20 healthy adults were studied. The α7-nAChR availability and Aβ deposition were evaluated using PET with [11C]MeQAA and [11C]PIB, respectively. Levels of specific binding were estimated by a simplified reference tissue method (BPND) for [11C]MeQAA and a tissue ratio method (SUVR) for using [11C]PIB. The values were compared with clinical measures of various cognitive functions using regions of interest (ROIs)-based and statistical parametric mapping (SPM) analyses.

Results

[11C]MeQAA BPND levels were extensively lower in the cholinergic projection regions of AD. There was a significant negative correlation between [11C]PIB SUVR and [11C]MeQAA BPND in the nucleus basalis of Mynert (NBM). The NBM [11C]PIB SUVR was negatively correlated with the [11C]MeQAA BPND level in the anterior and posterior cingulate cortices, whereas the relation within the same region showed weak correlation. Also we found significant correlation between cognitive decline and [11C]MeQAA BPND levels in the NBM.

Conclusions

Aβ deposition-linked α7-nAChR dysfunction may account for cognitive decline in AD.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Cognitive behavioral therapy in pharmacoresistant obsessive-compulsive disorder
Authors: Vyskocilova J. , Prasko J.
Published: May 2016

Background

The aim of the study was to determine whether patients with OCD resistant to drugs may improve using intensive, systematic CBT lasting six weeks and whether it is possible to predict the therapeutic effect using demographic, clinical and psychological characteristics at baseline.

Method

There were 66 patients included in the study. Fifty-seven patients completed the program. The diagnosis was confirmed by a structured interview MINI. Patient were rated before the treatment using Y-BOCS (objective and subjective form), CGI (objective and subjective form), BAI, BDI, DES (Dissociative Experiences Scale), SDQ 20 (Somatoform Dissociation Questionnaire), and SDS (Sheehan Disability Scale), and at the end of the treatment using subjective Y-BOCS, objective and subjective CGI, BAI, and BDI. Patients were treated with antidepressants and daily intensive group cognitive behavioral therapy for the period of six weeks.

Results

During the 6-week intensive cognitive behavioral therapy program in combination with pharmacotherapy, there was a significant improvement in patients suffering from OCD formerly resistant to pharmacotherapy. There were statistically significant decreases in the scales assessing the severity of OCD symptoms, anxiety, and depressive feelings. The lower treatment effect was achieved specifically in patients who:

– showed fewer OCD themes in symptomatology;

– showed a higher level of somatoform dissociation;

– with poor insight;

– with a higher level of overall severity of the disorder in the beginning.

The remission of the disorder was achieved more probably in patients with:

– good insight;

– the lower level of initial anxiety;

– without comorbidity with the depressive disorder.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
The risk of sleep disorders in Korean cancer patients
Authors: Lee H. , Oh S.T. , Kim D.W. , Choi W.J.
Published: May 2016

Purpose

Sleep disturbance in cancer patients is common. The aim of this study is to investigate the risk of sleep disorders in cancer patients compared to patients with other diseases using the national registry data.

Method

Using data from the Korean National Health Insurance Research Database between 2002 and 2013, the cancer group was composed of patients with an initial diagnosis of cancer in 2004 (n = 3358). The remaining people were considered as comparison group (n = 493,577) after excluding patients with any cancer or psychiatric disorder from 2002 to 2003 and from 2005 to 2013. Each sampled subject was tracked until 2013. Cox proportional hazard regressions were used to calculate the overall rate for sleep disorder development after adjusting for age, gender, and socio-economical confounders.

Results

Cancer patients were associated with an increased risk of sleep disorder in both sexes (male hazard ratio [HR]: 1.319; 95% confidence interval [CI]: 1.232–1.413; female HR: 1.289; 95% CI: 1.198–1.386) after adjusting for potential confounders. Both results were statistically significant (P < 0.001). In terms of age, the effect size of the HR was largest among elder adults, aged ≥ 70 years (male HR: 1.748; female HR: 1.820). The HR tended to increase consistently.

Conclusion

Initial diagnosis of cancer was significantly associated with sleep disorder development after adjusting for potential confounders. This result suggests that thorough screening and intervention for sleep disorders are required for the newly diagnosed cancer patients to improve their quality of life.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Interdisciplinary rehabilitation of a patient with right brain injury and recurrent depression
Authors: Varako N. , Dobrushina O. , Zinchenko Y. , Martynov S. , Kovyazina M.
Published: May 2016

Introduction

Rehabilitaton of concurrent psychiatric disorder and brain injury is a major challenge. E. underwent neurosurgery for right fronto-parietal astrocytoma. Before illness he was managing automatization of big companies, but was fired after the operation. E. felt into severe depression and anxiety with catastrofization of his illness, suicidal ideation. He resisted multiple prescriptions for SSRI, admitting a sect pretending to “treat” oncology by “psychological” methods. Half a year after operation he attended our center.

Objectives and aim

To help E. return to paid employment.

Methods

E. was evaluated by neurologists, psychiatrist, neuropsychologists. Current depressive episode appeared to be the second one with underlying schizoid and perfectionist characteristics. He had moderate text comprehension difficulties, confabulations, slight executive dysfunction. Neuropsychologist educated patient on his difficulties and developed compensatory strategies – an alternative to catastrofisation. After psychoeducational session E. agreed to receive fluvoxamine. However, he deformed the received information due to brain injury, so psychotherapy had only minor effects. Infra-low frequency neurofeedback at T4P4 and T4Fp2 sites was started to promote restoration of right brain functions. E. gradually did better, and 3 months later was able to complete CBT course along with relaxation training.

Results

Improvements in emotional status along with ability to cope with cognitive difficulties allowed E. to return to a job similar to the previous. Six month after the start of treatment medications are tapered off, E. has no signs of depression and only slight anxiety.

Conclusions

Interdisciplinary holistic rehabilitation may be effective in concurrent psychiatric disorder and brain injury.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Chronic non-malignant pain (CNMP) and substance use disorders
Authors: Herrera Duran L. , Falgas I. , Cook B. , Noyola N. , Toro M. , Alegria M.
Published: May 2016

Introduction

Chronic non-malignant pain (CNMP) is defined as pain lasting a minimum of three months. In general, chronic pain affects 20% adult worldwide population. Moreover, pain is more common in patients with depression, anxiety, and substance-use disorders and with low socioeconomic status. We aimed to better understand the influence of pain on substance use and treatment use patterns of individuals who experienced clinically recognized pain and have substance use disorder.

Methods

Patients with pain disturbances were identified in Electronic Health Records (EHR) through ICD-9 code 338*, medical written diagnoses, or diagnoses of fibromyalgia. A patient was considered to have a substance use disorder if he received treatment for illicit drug or alcohol abuse or dependence. We combined 2010–2012 (EHR) data from primary care and specialty mental health setting in a Boston healthcare system (n = 131,966 person-years) and a specialty mental health care setting in Madrid, Spain (n = 43,309 person-years).

Results

We identified that 35.3% of individuals with clinically recognized pain also report substance use disorder, compared to only 10.6% of individuals without clinically recognized pain (P < 0.01). Those with co-morbid pain and substance use disorder were significantly more likely than their specialty care counterparts without co-morbid pain and substance disorders to be seen in the emergency room (56.5% vs. 36.6%, respectively, P < 0.01).

Conclusion

The findings suggest that CNMP is associated with an increase risk of substance abuse disorder.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Unraveling pathways to depression in fibromyalgia, the role of perseverative negative thinking and negative affect
Authors: Pinto A.M. , Costa C. , Pereira A.T. , Marques M. , Pereira da Silva J.A. , Macedo A.
Published: May 2016

Introduction

Several studies have demonstrated a strong link between fibromyalgia, negative affect (NA) and depression. However, it remains unclear why some fibromyalgia patients get depressed while others do not and, primarily, which mechanisms account for this difference. We hypothesize that, besides clinical features, the engagement in dysfunctional strategies like perseverative negative thinking (PNT) followed by an amplification of NA levels may increase the risk of fibromyalgia patients experiencing depressive symptoms.

Objective/Aims

To explore the serial mediator effect of PNT and NA on the relationship between fibromyalgia symptoms and depressive symptoms.

Methods

Hundred and three women with fibromyalgia (mean age 47.32 ± 10.63) completed the Portuguese version of the Revised-Fibromyalgia Impact Questionnaire, Perseverative Thinking Questionnaire, Profile of Mood States and Beck Depression Inventory-II. The association between the variables was investigated via Pearson correlations and serial multiple mediation.

Results

The estimated model was significant [F (3.86) = 57.318, P < .001] explaining 66.66% of depressive symptoms variance. The total effect of fibromyalgia symptoms on depressive symptoms was of .4998 (SE = 0.0795, P < 0.001; CI > 0.3417 and < 0.6578), with a significant direct effect of 0.1911 (SE = 0.0653; CI > 0.0614 and < 0.3209). The total indirect effects were of 0.3086 (SE = 0.0619; CI > 0.2033 < 0.4458). Three significant specific indirect effects were found.

Conclusion

The effect of fibromyalgia symptoms on depressive symptoms is partially operated through cognitive interference/unproductiveness, which in turn influences NA levels. Such findings highlight the crucial role of these constructs in the relationship between fibromyalgia symptoms and depressive symptoms and the urge to address them when treating individuals reporting greater fibromyalgia symptoms.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
The Big Five Inventory (BFI): Reliability and validity of its Arabic translation in non clinical sample
Authors: Alansari B.
Published: May 2016

Introduction

One of the most researched theories of personality is the Five Factor Model, frequently evaluated through the Big Five Inventory 44-item BFI. Although there is an Arabic version, its psychometrical properties in Kuwaiti population are yet unknown.

Objectives

The objective of this study was to evaluate the psychometric properties of the BFI and its factorial structure in an Arabic non-clinical sample.

Methods

The participants were 685 first year undergraduate Kuwaitis: 305 males mean age = 22.77 ± 4.57 and 380 females; mean age = 19.61 ± 2.59). The Arabic version of BFI (John and Srivastava, 1999) was administered to participants. The internal consistency reliability, factor structure, and convergent validity of the BFI with PFQ-C (Barbaranelli, Caprara, Robasca, and Pastorelli, 2003) were assessed.

Results

Internal consistency was satisfactory for the Neuroticism, Extraversion, and Openness to Experience, Agreeableness, and Conscientiousness subscales respectively (Cronbach's alpha = 0.83, 0.82, 0.79, 0.82, 0.90) for males and (Cronbach's alpha = 0.74, 0.83, 0.85, 0.81, 0.92) for females. The results revealed significant gender differences where the males obtained a higher score than females on extraversion and conscientiousness, while females obtained a higher score than males on neuroticism. Principal component analyses (PCA) showed that a five-component solution explains 42.27% of the total variance for males and 41.47% for females. The convergent correlations in sample between the BFI and PFQ-C (mean r = 54) for validity coefficients.

Conclusion

These findings suggest that the BFI is a brief measure of the Big Five personality traits and it provides satisfactory reliable and valid data.

Disclosure of interest

The author has not supplied his/her declaration of competing interest.
Perseverative negative thinking prospectively mediates the relationship between perfectionism and psychological distress
Authors: Casimiro P. , Pinto A.M. , Pereira A.T. , Quaresma V. , Soares M.J. , Amaral A.P. , Maia B. , Marques M. , Nogueira V. , Roque C. , Madeira N. , Bajouco M. , Morais S. , Macedo A.
Published: May 2016

Introduction

We have recently found that Perfectionism and Perseverative Negative are both correlates of psychological distress/PD and that PNT mediates the relationship between perfectionism and PD (Macedo et al., 2015).

Objectives

To investigate if perfectionism and PNT are prospectively associated to PD and if PNT is a longitudinal mediator between perfectionism and PD, controlling for perceived stress and gender.

Methods

A total of 227 university students (80.1% girls) filled in the Portuguese validated versions of Perseverative Thinking Questionnaire (PTQ), Multidimensional Perfectionism Cognitions Inventory (MPCI), Profile of Mood States and Perceived Stress Scale, with an additional item to evaluate perceived social support/PSS at T0 and after approximately one year (T1) (Mean months = 12.77 ± 1.137). Only variables significantly correlated with the outcomes (Tension/Anxiety at T1 and Depression at T1) were entered in the conditional process analysis. The moderating role of perceived support on the link between Concern over Mistakes (MPCI) and psychological distress and between PTQ total score and psychological distress (anxiety and depression separately) was examined via conditional process analyses.

Results

The estimated models were significant (F = 4.257, P = .002; F = 6.476, P < .001) explaining 15.9% of tension-anxiety and 25.5% of depression variance. A significant conditional indirect effect of PTQ total score on psychological distress at average and higher levels of perceived support was found, in both models (anxiety and depression). On the contrary, the two models showed a non-significant conditional direct effect of Concern over Mistakes on psychological distress only at any level of perceived support.

Conclusion

PNT prospectively mediates the relationship between negative perfectionism and PD.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Effects of different types of instruction on the Scores of PID-5 profile
Authors: Riegel K. , Preiss M. , Harsa P.
Published: May 2016

Introduction

Section III of 5th edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) includes a hybrid model of personality pathology, in which dimensional personality traits (PTs) are used to derive one of six categorical Personality Disorder (PD) diagnoses. The Personality Inventory for DSM-5 (PID-5) has been developed to assess PTs within this new system.

Objectives

PT is a tendency to feel, perceive, behave, and think in relatively consistent ways across time and situations. PD diagnosis is generally stated if a pattern of maladaptive PTs persists at least 5 years. Nevertheless, the PID-5 instruction does not cover duration of symptoms.

Aims

We have explored the effect of two different types of instructions, in which duration of symptoms is or is not explicitly mentioned, on the PID-5 scores. Moreover, we have asked whether the scores differ in psychiatric patients and healthy individuals.

Methods

Differences between original and modified instructions of the Czech PID-5 version have been evaluated in a group of 62 psychiatric patients and 38 healthy controls; each respondent has been administered both instruction types in random sequence. ANOVA mixed design has been used to test the relation between groups and different sequence of administration.

Results

We have found no consistent differences in PID-5 scores using the different types of instruction described above.

Conclusions

In our sample, PID-5 seems to reflect strong beliefs of a subject regardless of symptoms’ duration and could be reliably used with both types of instruction. The PID-5 represents an appropriate instrument for the assessment of maladaptive PTs.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Psychotic experiences, alcohol–cannabis abuse, stressful events and familial risk is associated with onset of clinical psychosis: Evidence from a 6-year longitudinal population-based cohort
Authors: Kirli U. , Binbay T. , Elbi H. , Kayahan B. , van Os J. , Onay H. , Ozkınay F. , Gokcelli D.K. , Alptekin K.
Published: May 2016

Introduction

Both clinical and subclinical psychosis is probably a consequence of underlying genetic and environmental interactions.

Objectives

Defining differential impact of environmental/familial risk factors and psychotic experiences across the onset of clinical psychosis.

Aims

To assess mental health outcomes in a 6-year follow-up of a representative general population sample with a special focus on extended psychosis phenotype.

Methods

Addresses were contacted in multistage clustered area probability sampling frame covering 9 districts and 302 neighbourhoods (n: 4011) at baseline (T1) and 6 years after (n: 2142) (T2). Psychotic experiences were screened with Composite International Diagnostic Interview and probable cases were re-interviewed with SCID-I. Relations were tested using logistic regression models.

Results

Of subclinical psychotic symptoms at baseline, 6.4% transitioned to clinical psychosis; 44.4% persisted, 90.2% transitioned to any DSM disorder. Of newly onset clinical psychosis at T2, 62.8% had subclinical psychotic expressions at baseline. The risk of developing clinical psychosis was greater in those with baseline subclinical psychotic experiences, alcohol–cannabis abuse, stressful-forensic event history and family history of mental disorders. Most of risk factors associated with psychosis proneness at T1 were also associated with clinical psychotic outcome at T2 (Table 1).

Conclusions

Psychotic experiences takes attention for the risk to develop psychosis due to underlying genetic and environmental interactions; also may be an important risk factor to develop any mental disorder.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
The frequency, type and impact of appearance comparisons on body dissatisfaction and disordered eating behaviours in women's daily lives
Authors: Drutschinin K. , Fuller-Tyszkiewicz M. , De Paoli T. , Lewis V. , Krug I.
Published: May 2016

Objective

To examine the impact of appearance comparison behaviours, trait body dissatisfaction and eating pathology on women's state body dissatisfaction and engagement in disordered eating behaviours in daily life.

Method

Using ecological sampling method (ESM), 116 women residing in Australia, completed a baseline questionnaire containing the trait-based measures, before being signalled by an iPhone app six times daily, for seven days, to self-report on their recent appearance comparison behaviours, current state body dissatisfaction and recent disordered eating behaviours.

Results

Multi-level modelling revealed that upward comparisons (comparisons against more attractive individuals) elicited increases in state body dissatisfaction (β = 0.89, P < .001) and disordered eating behaviours (β = 0.29, P = .002). Contrastingly, downward comparisons (comparisons against less attractive individuals) elicited decreases in state body dissatisfaction (β = –0.31, P = .048) and, unexpectedly, increases in disordered eating behaviours (β = 0.46, P < .01). The frequency of appearance comparison engagement, regardless of whether it was upward or downward comparisons, was also predictive of increased disordered eating behaviours (β = 0.12, P < .001). In addition, eating pathology and trait body dissatisfaction were directly associated with higher state body dissatisfaction, and increased in disordered eating behaviours (all P < .001).

Conclusion

These findings highlight the general negative impact that appearance comparisons have on fluctuating states of body dissatisfaction and eating pathology, as well as illustrating how trait characteristics partially account for this volatility. These findings provide further information that may be used to inform eating disorder prevention and intervention efforts.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Sensory processing disorders, duration of current episode, and severity of side effects in major affective and anxiety disorders
Authors: Serafini G. , Engel-Yeger B. , Vazquez G.H. , Pompili M. , Amore M.
Published: May 2016

Introduction

Longer duration of untreated illness, longer duration of current episode, and severity of medication side effects may negatively influence the psychosocial functioning in major affective and anxiety disorders. Studies also suggested the involvement of sensory perception in emotional and psychopathological processes.

Objective

The objective of this study is to investigate the nature of the association between duration of untreated illness, duration of current episode, and severity of medication side effects.

Aims

The study is aimed to examine the relationship between sensory processing disorders (SPD), duration of untreated illness, duration of current illness episode, and the severity of side effects related to psychoactive medications.

Methods

The sample included 178 participants with an age ranging from 17 to 85 years (mean = 53.84 ± 15.55); psychiatric diagnoses were as follow: unipolar major depressive disorder (MDD) (50%), bipolar disorder (BD) (33.7%), and anxiety disorders (16.3%). subjects completed a socio-demographic questionnaire, the Udvalg for Kliniske Undersøgelser (UKU), and Adolescent/Adult Sensory Profile (AASP) questionnaire.

Results

Longer duration of current episode correlated with greater registration of sensory input and lower avoidance from sensory input among unipolar patients, lower registration of sensory input, and higher tendency for sensory sensitivity/sensation avoidance among bipolar participants. In addition? longer duration of current episode correlated with lower sensory sensitivity/avoidance among anxiety participants, respectively. Mean UKU total scores were associated with lower sensory sensitivity among bipolar individuals as well.

Conclusions

SPD expressed in either hypo-/hypersensitivity may be used to clinically characterize subjects with major affective and anxiety disorders.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Hematological safety of olanzapine
Authors: Alageel A. , Gaffas E.
Published: May 2016

Introduction

Olanzapine is an atypical antipsychotic medication, previously expected to be safe in terms of hematological side effects and an alternative choice to clozapine in patients who develop hematotoxicities. However, since olanzapine was introduced to the market, a lot of cases reports have been published revealing it could cause hematoxicity. Some of them indicate that olanzapine induces agranulocytosis. Because of that, it raises the concerns about hematological safety of olanzapine.

Objective

To date, no review discusses this topic specifically, so we conducted a systemic review to explore and address this issue.

Methods

We searched Pubmed, Google Scholar, Ovid and Medline databases for articles between 1998 and 2015 that include keywords olanzapine, leukopenia, neutropenia, and agranulocytosis.

Results

A total of 38 publications were identified. The case reports included patients aged 16 to 83 years. Doses ranged from 2.5 to 30 mg. After starting treatment, onset of hematotoxicity varied from the first day to 2–3 years, but most commonly within the first month. Also, olanzapine could induce leukopenia in patients who have never developed drug-related leukopenia.

Conclusion

Among antipsychotic medications, olanzapine is the third leading cause of neutropenia and the second leading cause of atypical antipsychotic medication. Because of the small body of literature regarding the hematotoxic side effects of olanzapine, we encourage further research to understand the mechanism by which olanzapine causes granulocytopenia. The identification of risk factors could facilitate the development of new surveillance guidelines in patients taking olanzapine. We recommend that the guidelines of using and monitoring olanzapine need to be reconsidered.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Nicotinic acetylcholine receptor antagonists for treatment-resistant depression: A meta-analysis
Authors: Bahk W.M. , Woo Y.S. , Seo H.J. , Yoon B.H. , Jon D.I. , Kwon Y.J. , Lee K.H. , Min K.J. , Lee S.Y. , Wang H.R.
Published: May 2016

Objective

Emerging preclinical and clinical evidence suggests a potential role of nicotinic acetylcholine receptors in the pathophysiology of depression. Several clinical trials have investigated the efficacy of nicotinic acetylcholine receptor antagonists in treatment-resistant depression. We performed this meta-analysis to investigate whether nicotinic acetylcholine receptor antagonists significantly improve symptoms in patients with major depressive disorder who have an inadequate response to standard antidepressant therapy.

Methods

A comprehensive literature search identified 6 randomized controlled trials. These 6 trials, which included 2067 participants, were pooled for this meta-analysis using a random-effects model.

Results

Nicotinic acetylcholine receptor antagonists failed to show superior efficacy compared to placebo in terms of the mean change in the Montgomery-Asberg Depression Rating Scale (MADRS) score [mean difference = –0.12 (95% CI = –0.96 to 0.71); response rate (risk ratio [RR] = 0.92 (95% CI = 0.83 to 1.02)); and remission rate [RR] = 1.01 (95% CI= 0.83 to 1.23)].

Conclusion

This meta-analysis failed to confirm preliminary positive evidence for the efficacy of nicotinic acetylcholine receptor antagonists in treatment-resistant depression. Further studies investigating the efficacy of various alternative treatment strategies for treatment-resistant depression will help clinicians to better understand and choose better treatment options for these populations.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Sexual side effects in patients treated with desvenlafaxine: An observational study in daily practice
Authors: Navarro B. , Perez L. , Erkoreka L. , Arroita A. , Perez I.
Published: May 2016

Introduction

Sexual function is important for patients’ well-being but it is a common side effect of SSRI and SNRI, included desvenlafaxine.

Objectives and aims

Evaluate incidence and characteristics of sexual dysfunction caused by desvenlafaxine in the clinical practice.

Methods

One hundred and thirty-three patients with recently introduced desvenlafaxine treatment are recruited from Barakldo and Uribe-Kosta Mental Health Centres in Biscay, Spain. UKU scale is administered to measure sexual side effects. Statistical analysis is performed using SPSS v.22.

Results

Sexual dysfunction is observed in 5 patients (3.7%) at 50 and 100 mg/d (2 and 3 patients, respectively) desvenlafaxine doses. Two patients (1.5%) have experimented more than one sexual side effect. Regarding gender differences, the most frequent sexual dysfunctions are diminished sexual desire (5.5%) and erectile dysfunction (5.5%) in men and orgasmic dysfunction (1.2%) in women (P-values are 0.034; 0.034 and 0.408, respectively). Discontinuation is decided in 60% of patients.

Conclusions

Desvenlafaxine has a well-tolerated sexual side effect profile in general population. There are some gender-related differences both in presentation and perception, as it has been described with other drugs, and this should be taken into account by prescriptors.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Validation of the Depression, Anxiety and Stress Scale–DASS-21 in a community sample of Portuguese pregnant women
Authors: Xavier S. , Bento E. , Azevedo J. , Marques M. , Soares M.J. , Freitas V. , Mota D. , Macedo A. , Pereira A.T.
Published: May 2016

Introduction

The Depressive Anxiety and Stress Scale (DASS-21; Antony et al., 1998) had been widely used to measure psychological distress among clinical and non-clinical populations, including in Portugal (Pais-Ribeiro et al., 2004). Although DASS-21 has been considered useful to evaluate psychological distress in the perinatal period, studies reporting on its psychometrics are scarce (Brunton et al., 2015).

Objective

To investigate the psychometric properties of the DASS-21 in a Portuguese sample of pregnant women.

Methods

Four hundred and twenty-seven pregnant women (mean age: 32.56 ± 4.785 years) in their second trimester of pregnancy (17.34 ± 4.790 weeks of gestation) completed the Portuguese versions of DASS-21 and of Postpartum Depression Screening Scale (PDSS-24; Pereira et al., 2013).

Results

The DASS-21 Cronbach's alpha was “very good” (a = 0.92). Following the Kaiser and the Cattel Scree Plot criteria, two factorial structures were explored. Three factors structure (explained variance/EV = 57.18%): F1-stress (included 8 items; α = 0.89); F2-Anxiety (7 items; α = 0.79); F3-Depression (6 items; α = 0.82). In the two factors structure (EV = 50.96), the Stress and Anxiety items load in the same factor (F1: 15 items; α = 0.91) and the F2 is composed of the Depression items (F2: 6 items; α = 0.82). Pearson correlations between DASS-21 total and dimensional scores and the PDSS-24 scores were all significant, positive and moderate to high (@.50).

Conclusions

The Portuguese version of DASS-21 has good reliability, construct and concurrent validity when used with pregnant women. Its factorial structure significantly overlaps with the original, with only one item loading in another factor. DASS-21 could be very useful in diverse settings in the perinatal period.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
First-generation versus second-generation antipsychotic drugs for depression in schizophrenia
Authors: Corbo M. , Acciavatti T. , Marini S. , Cinosi E. , Di Tizio L. , Di Caprio L. , Viceconte D. , Matteo L. , Giuseppe D.I. , Martinotti G. , Di Giannantonio M.
Published: May 2016

Introduction

A certain degree of depressive symptoms is common in schizophrenic patients. The assessment and treatment of depressive symptoms in schizophrenia is clinically challenging.

Objectives

We conducted a cross-sectional study to investigate the depressive dimension of schizophrenic patients.

Aims

The aim was to evaluate the effect of pharmacotherapy on depressive symptomatology.

Methods

Thirty-four outpatients (18-65 years old) with stable schizophrenia in monotherapy with FGAs or SGAs. We evaluated: depressive symptoms with Calgary Depression Scale for Schizophrenia; positive and negative symptoms (with Positive and Negative Symptom Scale); neurocognition (with Matrics Cognitive Consensus Battery); social cognition (with Facial Emotional Identification Test); social functioning (with Personal and Social Performance Scale and with UCSD Performance-based Skills Assessment). Collected data underwent statistical analyses.

Results

A SGAs therapy was associated with: lower depressive symptoms (mean SGAs group = 4.0; mean FGAs group = 7.86, P < 0.05); lower mean positive symptoms (mean SGAs group = 12.65; mean FGAs group = 17.43, P < 0.05); lower negative symptoms (mean SGAs group = 21.35; mean FGAs group = 29.07, P < 0.05); lower scores on the PANSS-total (mean SGAs group = 71.05; mean FGAs group = 91.86, P < 0.01). After correction for multiple variables, the SGAs group still had significantly lower values towards the FGAs group (P < 0.05).

Conclusions

Our study support the notion that switch from a FGA to a SGA could be a relatively simple first-step for the treatment of this condition. Atypical antipsychotics might exercise antidepressant effects with different potential mechanism including: remission of a FGA-induced depression and action on of 5-hydroxytryptamine, dopamine [other than postsynaptic D2], and α1-noradrenergic receptor sites.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Clinical and functioning outcomes of second-generation long-acting antipsychotics in a sample of schizophrenia patients during a follow-up period of 6 months
Authors: Corigliano V. , Mancinelli I. , De Carolis A. , Tamorri S.M. , Di Pietro S. , Pazzelli F. , Ciccaglione I. , Girardi P. , Comparelli A.
Published: May 2016

Introduction

Second-generation long-acting injectable antipsychotics (LAIs) constitute a valuable alternative for the treatment of schizophrenia and combine advantages of both long-acting injectable drugs and atypical antipsychotics. Realistic, naturalistic studies are necessary to evaluate the impact of LAIs on specific cluster of symptoms.

Objectives

To collect clinical and functioning outcomes in outpatients with schizophrenia treated with LAIs during a follow-up period of 6 months.

Aims

To determine the impact on symptoms and functioning of second-generation LAIs.

Methods

It is a 6-month naturalistic, observational, prospective, non-interventional study of patients diagnosed with DSM-V schizophrenia disorder. Clinical data were assessed by the Positive and Negative Syndrome Scale (PANSS) and the Global Assessment of Functioning (GAF). For statistical analysis, we used the Wallwork's five-factor model of the PANSS.

Results

A total of 50 schizophrenia patients (70% male; mean age: 36.2 ± 10.4) referred to the Depot Clinic at Sant’Andrea Hospital in Rome was included. Eight patients received treatment with risperidone LAI (RLAI), 20 with paliperidone-palmitate LAI (PLAI), 10 with olanzapine-pamoate LAI (OLAI) and 12 with aripiprazole LAI (ALAI). LAIs were overall associated with improved functioning and positive symptoms; OLAI, ALAI e PLAI correlated with improved negative symptoms, RLAI, OLAI e PLAI with improved disorganised/concrete symptoms, OLAI e PLAI with improved excited symptoms; ALAI improved depressive symptoms.

Conclusion

Over the 6-month period, LAIs were associated with improved functioning and illness severity in schizophrenia patients with different symptoms profile. Treatment with PLAI and OLAI showed the major clinical advantages, whereas only ALAI correlated with improved depressive symptoms.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Anti-DNA antibodies in the blood of patients with schizophrenia possess DNA-hydrolyzing activity
Authors: Ermakov E. , Smirnova L. , Sinyanskii L. , Dobrygina D. , Semke A. , Nevinsky G. , Buneva V. , Ivanova S.
Published: May 2016

Introduction

Autoantibodies (Abs) to different neuronal receptors and DNA were detected in the blood of patients with schizophrenia. Abs hydrolyzing DNA were detected in pool of polyclonal autoantibodies in autoimmune and infectious diseases, such catalytic Abs were named abzymes.

Objectives

To investigate the level of anti-DNA antibodies and DNA-hydrolyzing activity of IgG from the serum of patients with schizophrenia depending on leading clinical symptoms.

Aims

– To measure the concentration of anti-DNA Abs in serum of patients with leading positive and negative symptoms;

– to determine DNA-hydrolyzing activity of IgG.

Methods

In our study, 51 patients were included. The levels of antiDNA Abs were determined using ELISA. DNA-hydrolyzing activity was detected as the level(%) of supercoiled pBluescript DNA transition in circular and linear forms. Statistical analysis was performed in “Statistica 9.0”.

Results

Anti-DNA Abs of patients with schizophrenia not only bind DNA, but quite efficiently hydrolyze the substrate. IgG of patient with schizophrenia were shown to possess DNA hydrolyzing activity. It should be noted that DNAase activity of IgG in patients with schizophrenia with a negative symptoms was significantly higher, than in patients with positive symptoms (Table 1).

Conclusions

The data show a correlation with the level of DNase activity and leading symptoms of patients with schizophrenia.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Reducing cardiovascular risk in non-selected outpatients with schizophrenia: A 2.5-year programme conducted in a real-life setting
Authors: Hjorth P. , Jørgensen P.M. , Kynde A.
Published: May 2016

Introduction

Patients with schizophrenia have increased somatic morbidity and increased mortality. Knowledge of how to integrate prevention and care of somatic illnesses into the treatment of psychiatric patients is required.

Objectives

Forty-seven patients diagnosed with schizophrenia participated in the programme (mean age: 33.3 years, SD: 11.9).

Aims

To investigate whether a 2.5-year interventional programme to improve physical health is effective.

Method

The intervention consisted of health promotion activities focusing on the patients’ health, not their diseases. The patients’ physical health parameters were intensely monitored and each patient received individual guidance on healthy food and on how to live a physically active life.

Results

Extensive problems with obesity, especially among the women, were observed, and low level of physical activity among the patients was demonstrated. The included patients were in a high risk of developing cardio vascular diseases and diabetes type 2. The main outcomes were reduction in waist circumferences and in consumption of soft drinks and an increase in coffee drinking. Furthermore, an increase in time spent on moderate and light physical activities was observed. The patients showed great interest in the programme, and it was unproblematic getting the patients to participate in the entire programme. Moreover, they willingly followed the health guidance and achieved a healthier life.

Conclusions

The intervention seems relevant and manageable in an outpatient setting. The results are promising in the ongoing process of improving physical health among patients with schizophrenia. We recommend implementation of the programme in daily practice.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
A mirror image study of the utility of long acting aripiprazole
Authors: Hodgson R. , Aladakatti C. , Kataria N. , Saravanappa T. , Brittany D.
Published: May 2016

Aims and background

Ablify Maintena (AM) is a long acting injection of aripiprazole that received marketing authorisation in the UK in January 2014. It is costly compared to first generation antipsychotics (FGAs) LAIs and there are no robust trials comparing AM with FGAs. We examined the effectiveness and use of AM in a mental health trust.

Methods

We identified all patients prescribed AM in North Staffordshire (population: 470,000) since launch and examined records for demography, diagnosis, bed and medication use. We examined the effectiveness of AM using a mirror image design.

Results

Thirty patients received AM in a time frame allowing a 1-year follow-up. Sixty-nine percent were male and the mean age was 39 years. Over half were detained under the 1983 Mental Health Act and 30% were inpatients on a psychiatric intensive care unit when AM was started. Twenty-eight patients had a psychotic diagnosis. There was a significant reduction in bed occupancy (63 v 6 days, P = 0.0001) and admissions (1.6 v 0.5, P = 0.0001). The median dose was 400 mg. Lack of effectiveness/poor adherence with prior treatments were the main reason for starting AM in 84%. Eighty-six percent of patients clinically improved on AM. Blood parameters were in the normal range.

Discussion

Within the limitations of the methodology, our results show a reduction in psychiatric bed use in the year following AM initiation on an intention to treat basis. The reduction in bed use equates to a minimum annual saving of £14,250 per patient. AM at the median study dose costs £2645 per year.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Perceived and anticipating stigma in schizophrenia in relationship with depressive symptoms and functionality degree
Authors: López-Micó C. , Reneses B. , Gallego L. , Maria Sagrario G. , Fernandez R. , Huidobro Á. , Reyes L. , Gómez P.
Published: May 2016

Introduction

Perceived and anticipated stigma is relevant issues in patients with schizophrenia. Stigma has negative consequences both in quality of life and in the course of illness.

Objectives

To analyze the degree of perceived and anticipated stigma and discrimination in patients with schizophrenia and their relationship with clinical and socio-demographic variables.

Methods

A cross-sectional study was carried out in a sample of 100 patients with diagnosis of schizophrenia, 18 or more years old, clinically stabilized, without axis I DSM-IV comorbidity. Patients received treatment in the outpatient services of a catchment area in Madrid. Perceived and anticipated discrimination was evaluated trough the DISC-12 (Discrimination and Stigma scale). Other study variables were: socio-demographic characteristics, symptoms of depression (Calgary Scale) and functionality degree measured by Global Assessment of Function (GAF).

Results

The presence of symptoms of depression evaluated by the Calgary Scale and low degree of functionality measured by GAF are associated with greater feelings of discrimination and stigma, especially in the sub-scales of experienced and anticipated discrimination of the DISC 12. Anticipated stigma is higher in men than in women while the rest sub scales of the DISC-12 do not correlate with gender or other sociodemographic variables.

Conclusions

Preventive strategies to avoid the stigma in schizophrenia should consider some characteristics associated with disease, especially the degree of functionality and presence of depressive symptoms.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Odors hedonic judgment in patients with schizophrenia. Influence of negative symptoms and β-endorphin levels
Authors: Urban-Kowalczyk M.
Published: May 2016

Introduction

The relationship between olfactory and emotional processing is an area of increasing interest in schizophrenia research.

Objectives

Olfactory identification deficits are well described in schizophrenia while the results for pleasantness ratings remain unclear.

Aims

Evaluation of odor identification and hedonic judgment related to severity of negative symptoms and β-endorphin concentration.

Methods

Fifty outpatients with schizophrenia were included in the study: 25 with negative symptoms (PN) and 25 without predominant negative symptoms (P). They were compared with 23 healthy individuals. In all study groups University of Pennsylvania Smell Identification Test (UPSIT) and odor hedonic evaluation were performed. Clinical symptoms severity was evaluated using PANSS. Plasma concentrations of β-endorphin were assayed in all participants.

Results

PN made more odor identification errors than controls (P = 0.000) and P sample (P = 0.001). Hedonic judgments of unpleasant odors were significantly more pleasant in PN sample than in P (P = 0.03) and controls (P = 0.041). PN had significantly higher concentration of β-endorphin than P sample (P = 0.014) and controls (P = 0.009). No relationship between β-endorphin concentration and odors identification and odor hedonic judgment was found in both patient samples and controls.

Conclusions

Increased level of β-endorphin is related to predominance of negative symptoms but probably it is not involved in olfactory identification performance and hedonic judgment in schizophrenia. Patients with predominant negative symptoms revealed different pattern of pleasantness rating – they experience unpleasant odors as more pleasant. Alterations in smell identification and hedonic judgment could be differentially expressed in some subtypes of schizophrenia.

Disclosure of interest

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