bluuebunny/crossref_metadata_2025 huggingface dataset:
Cognition in Mild and Moderate Depression
Authors: Nešović P. , Simonović M.
Published: June 2017

Introduction

It is known that there is a cognitive decline in major depressive disorder. Most studies were performed on patients whose sum on a Montgomery and Asberg depression rating scale was greater than 30.

Objectives

In our work, we concentrated on mild and moderate depression, MADRS > 30 was not criteria. Patients included were diagnosed with mild to moderate depressive episode.

Aims

To determine how depressive episodes affect cognition.

Methods

We included 30 patients diagnosed at the clinic for psychiatry in Nis. We covered the age group between 20 and 40 years, regardless of the gender and educational level. For the assessment of cognition, we used digital symbol substitution test (DSST), Rey audio verbal learning test (RAVLT), trail making test (TMT), stroop color naming test (Stroop), and patients were evaluated with Montgomery and Asberg depression rating scale (MADRS). Tests were conducted on the first visit to a psychiatrist. Patients were compared with the results of the healthy population with the same characteristics, and in the same period (August 2016). Mean values were compared and groups were compared by Student's t-test.

Results

There was a statistically significant difference in all of the tests, and all of the parts of tests conducted on the patients and the control group.

Conclusions

There is a statistically significant cognitive decline in patients with mild and moderate depression.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Lurasidone for the Treatment of Major Depressive Disorder with Mixed Features: Do Manic Symptoms Moderate Treatment Response?
Authors: Pikalov A. , Goldberg J. , Mao Y. , Siu C. , Tsai J. , Calabrese J. , Loebel A.
Published: June 2017

Background

This post-hoc analysis evaluated whether the efficacy of lurasidone in major depressive disorder (MDD) with mixed features is moderated by the number and characteristics of manic symptoms present at study baseline.

Methods

Patients meeting DSM-IV-TR criteria for MDD who presented with two or three manic symptoms (consistent with the DSM–5 mixed features specifier) were randomly assigned to 6 weeks of double-blind treatment with either lurasidone 20–60 mg/d (n = 109) or placebo (n = 100). Finite mixture models were applied to identify latent class patterns of the 10 baseline manic symptoms.

Results

Three latent class profiles were identified: 105 (50.5%) patients had manic symptom profile 1 (MIX 1) with mean MADRS 33.0, mean YMRS 9.2, mean number of manic symptoms 3.8; 63 (30.3%) patients had manic symptom profile 2 (MIX 2) with similar baseline mean MADRS (32.4) and YMRS (9.3) and lower number of manic symptoms 3.5; 40 patients had manic symptom profile 3 (MIX 3) with significantly higher severity scores in MADRS (35) and YMRS (14.9) and mean number of manic symptoms 4.6. A significant moderating effect on change in YMRS score was observed for the “decreased need for sleep” symptom, with greater lurasidone effect size (vs. Placebo) found in patients without vs. With this symptom (P < 0.05).

Conclusions

In this post-hoc analysis of a placebo-controlled trial involving MDD patients with mixed features, absence of “decreased need for sleep” was found to be significantly associated with improvement in manic and depressive symptoms and to moderate the treatment effect on manic symptoms.

Disclosure of interest

I am full time employee of Sunovion pharmaceuticals Inc.
The Major Depressive Disorder Hierarchy: Rasch Analysis of 6 Items of the Hamilton Depression Scale Covering the Continuum of Depressive Syndrome
Authors: Carvalho Alves L. Primo de , Almeida Fleck M. Pio de , Boni A. , Sica da Rocha N.
Published: June 2017

Objectives

Melancholic features of depression (MFD) seem to be a unidimensional group of signs and symptoms. However, little importance has been given to the evaluation of what features are related to a more severe disorder. That is, what are the MFD that appear only in the most depressed patients. We aim to demonstrate how each MFD is related to the severity of the major depressive disorder.

Methods

We evaluated both the Hamilton depression rating scale (HDRS-17) and its 6-item melancholic subscale (HAM-D6) in 291 depressed inpatients using Rasch analysis, which computes the severity of each MFD. Overall measures of model fit were mean ( ± SD) of items and persons residual = 0 (± 1); low χ2 value; P > 0.01.

Results

For the HDRS–17 model fit, mean (± SD) of item residuals = 0.35 (± 1.4); mean (± SD) of person residuals = –0.15 (± 1.09); χ2 = 309.74; P < 0.00001. For the HAM-D6 model fit, mean (± SD) of item residuals = 0.5 (± 0.86); mean (± SD) of person residuals = 0.15 (± 0.91); χ2 = 56.13; P = 0.196. MFD ordered by crescent severity were depressed mood, work and activities, somatic symptoms, psychic anxiety, guilt feelings, and psychomotor retardation.

Conclusions

Depressed mood is less severe, while guilt feelings and psychomotor retardation are more severe MFD in a psychiatric hospitalization. Understanding depression, as a continuum of symptoms can improve the understanding of the disorder and may improve its perspective of treatment.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Length of Admission Into Psychiatric Hospitals According to Diagnoses
Authors: Shoka A. , Lazzari C. , Gower Katherine
Published: June 2017

Introduction

In recent years, psychiatry in the United Kingdom has faced an important challenge due to the shortage of beds for patients with increased lengths of stay. Available resources have been saturated due to the reduced capability of psychiatric hospitals to provide spaces for patients needing access to psychiatric care.

Objectives

This research provides a figure of length of stay linked to psychiatric pathology at discharge.

Aim

To establish the length of admission of psychiatric patients.

Methods

The sample comprised 137 discharges from a general adult psychiatric ward distributed over the first 8 months of 2016. Results were analyzed by descriptive statistics and meta-analysis.

Results

Overall, longer periods of admission were recorded for psychoses and shorter periods for adjustment disorders. Psychoses had a median length of admission of 28 days (range = 3–374); borderline personality disorders, 10 days (range = 1–249); mood disorders, 14 days (range = 2–74); drug addictions, 6 days (range = 1–222); and adjustment disorders, 5 days (range = 1–55). Meta-analysis (Fig. 1) provided a confidence interval estimate for the whole model of 24.314 days (95% CI = 13.00–35.621) with P < .001. Meta-analysis results also provided t2 = 101.061, Cochrane's Q (df = 4) = 14.327, I2 = 72.081, with P = .006.

Conclusions

Psychoses are conditions that require longer admissions, whereas adjustment disorders are more transient pathologies. Borderline personality disorder is somewhat of a hybrid condition. Overall, patients remain in hospital for about a month (24 days).

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Quality of Life and Anxious-depressive Symptoms in Cancer Patients Undergoing Mindfulness-based Interventions: Feasibility and Preliminary Outcomes on Prospective Single-centre Case-control Study (MIND4ME St.)
Authors: Pontoni G. , Maur M. , Ferrari R. , Guida A. , Poletti S. , Caggia F. , Fontana A. , Gavioli F. , Tarantino V. , Cascinu S. , Ferrari S.
Published: June 2017

Background

Mindfulness based interventions (MBIs) have shown efficacy in improving psychological symptoms including depression and anxiety in cancer patients (pts). The study aimed to explore feasibility and reproducibility of MBIs in an Italian Cancer Centre measuring biochemical and psychological parameters.

Methods

In this pilot prospective case-control study, we recruited newly diagnosed pts receiving adjuvant chemotherapy (CT). A MBIs program was designed consisting of 2.5 hours weekly for 8 weeks and, including meditation, yoga and body scan. Material for 45 minutes (mn) home daily practice was provided. Primary endpoint was to evaluate feasibility. Secondary endpoints were assessment of quality of life (QoL), psychological and biochemical outcomes of stress, tested at baseline (W0), W4, W8, W24, W48. PSS (Perceived Stress Reduction), POMS (profile of mood states scores), EuroQoL (EQ-5D-3L) were administered.

Results

Ten pts underwent MBIs program arm. We present preliminary results, while data of control arm are being collected. All pts were female, two pts (20%) dropped out. Median age was 56 years. All received adjuvant CT, 5/8 received radiotherapy and hormone therapy. Mean of sessions attending was 6.8 (76%). Median daily practice was 30 mn. EQ-5D item for depression and anxiety showed decreasing trend in mean score from moderate to light (P = 0.15) and significant improvement of auto-perceived QoL was observed comparing W0 and W8 (P = 0.02)

Conclusions

In a sensitive setting such as start CT, we found high pts compliance to MBIs. Improvement in self-perceived QoL after starting program was found and comparing anxious-depressive symptoms outcomes with control arm is still needed.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Pain Perception in Children with Autism (Prospective Study of 40 Cases)
Authors: Kachouchi A. , Said S. , Fadoua P.O.N. , Benali P.A. , Imane P.A. , Fatiha P.M. , Fatima P.A.
Published: June 2017

Introduction

Recent studies show a different mode of expression of pain associated with disorders of verbal and nonverbal communication, body schema and some cognitive impairment in autistic children.

The aim of our study was to evaluate the reactivity of an autistic child in a slightly painful stimulation in a standardized situation where there is a dual relationship with an adult.

Methods

We conducted a study, on 40 children with autism. The diagnosis of autism was established following a multidisciplinary assessment including scale ADIR (Autism Diagnostic Interview Revised) and ADOS (Autism Diagnostic Observation Schedule). Severity of autism was assessed by the CARS (Childhood Autism Rating Scale). All subjects were submitted to a pinch with a clothespin camouflaged by the palm of the hand of the examiner. The reactivity to pain was assessed by the NCCPC (Non-communicating children's pain checklist).

Results

All children have responded to pain, 57.5% had moderate to severe pain and 42.5% had mild pain. The evaluation of the expression of pain according to the items of the NCCPC showed that 95% of children responded with motor responses, 90% responded with vocal productions, only half of the children (55%) presented facial expressions and 12. 5% of the children showed physiological indices. The analysis of the type of motor and vocal reactions was not moving toward pain in almost all children (removal or protection of the area of the body affected, the precise location of the painful area are almost absent in our sample).

Conclusion

These results are in favor of a different mode of expression of pain in children with autism.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Dissociative Symptoms in Borderline Personality Disorder
Authors: Nivoli A. , Nivoli L.F. , Antonioli M. , Floris L. , Folini L. , Milia P. , Vento L.I. , Depalmas C. , Lorettu L.
Published: June 2017

Objective

To study the association of dissociative symptoms and specific psychopathological dimensions in a sample of patients with Borderline Personality Disorder (BPD).

Methods

An observational analytic study was conducted. Patients with BPD were administered the Diagnostic Interview for Borderline (DIB-R) and Dissociative Experience Scale (DES–II).

Results

Participants were 34 adult patients with BPD. The majority presented with dissociative symptoms (65.6%; n = 21). A statistical significant correlation was found between DES total score and DIB-R subscales: depression (P = 0.04), feeling of loneliness and emptiness (P = 0.005), sexual deviation (P = 0.002) and intolerance to loneliness (P = 0.01). Furthermore, depersonalization was statistically correlated with the severity of borderline psychopathology (DIB-R total score- P = 0.04), suicidal behavior (P = 0.001) and interpersonal problems (P = 0.04). Derealization was significantly correlated with cognition (P = 0.02), psychotic thought (P = 0.004) and intolerance to loneliness (P = 0.02).

Conclusions

Dissociative symptoms are not easy to detect in the clinical daily work. More than a half of patients with BPD presented with dissociative symptoms detected with a specific rating scale. Particularly, only some specific psychopathological dimensions are correlated with dissociation and need to be assessed in patients with BPD.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Overweight/obese Patient Referrals to Plastic Surgery: Temperamental and Personality Traits
Authors: Pavan C. , Bassetto F. , Vindigni V.
Published: June 2017

Introduction

Correlations between psychiatric disorders and overweight/obesity are reported in the literature. The study aimed at detecting correlations between psychiatric disorders, temperamental traits and body image perception in overweight and obese patients who seek surgical lipostructuring treatments.

Methods

28 overweight/obese patients (age 18–60 yrs, BMI 25 to 34.9 at recruitment) were enrolled in the period March 2008–June 2011 between those referring to the outpatient service for Obesity-related lipodystrophisms of the Institute of Plastic Surgery. Presence of psychiatric disorders, temperamental traits and body image perception were evaluated, and compared to a control group (n = 25) from general population sharing clinical/demographic features. Psychiatric evaluation was based on acquisition of clinical history, Mini-International Neuropsychiatric Interview, Beck Depression Inventory, Yale Brown Scale (YBOCS), Paykel Life Events Scale, NEO Five Factory Inventory, Tridimensional Personality Questionnaire (TPQ), Body Shape Questionnaire (BSQ).

Results

The patients group presented higher scoring in lifetime depression and BSQ with moderate/mild concern with body shapes. With regard to personality traits, TPQ revealed higher score in subscale RD4 (dependence/independence) in the patients, while controls scored higher in “openness to experience” NEO-FFI sub-scale. At YBOCS obese patients presented higher prevalence of obsessive characters.

Conclusion

The affective sphere is a relevant feature in obese patients, but also obsessive traits, as negative body shape perception and temperamental and personality characteristics appear to be involved in leading patients to seek surgical consultation. These aspects are implicated in medical/surgical outcome and compliance to treatments.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Relationship Between Childhood Trauma and Psychotic Symptoms in Patients with Schizophrenia
Authors: Kılıçaslan E.E. , Esen A. , Izci Kasal M. , Ozelci E. , Murat B. , Gulec M.
Published: June 2017

Introduction

The association between childhood trauma and psychotic symptoms is still not clearly understood. Findings for positive and negative symptoms are confounding. This symptomatic response may differ according to the type of childhood trauma, for example childhood abuse was associated with positive symptoms while childhood neglect was associated with negative symptoms.

Objectives

This study examined the relationship between childhood trauma and psychotic symptoms in schizophrenic patients after controlling for the possible confounding factors, such as clinical features, depression, and sleep quality.

Methods

The childhood trauma questionnaire – short form, Positive and Negative Syndrome Scale (PANSS), Calgary Depression Scale for Schizophrenia, Pittsburgh sleep quality index, and the suicidality subscale of mini-international neuropsychiatric interview were administered to 199 patients with schizophrenia. We used sequential multiple stepwise regression analyses in which positive symptoms, negative symptoms, overall psychopathology and total symptoms of schizophrenia were dependent variables.

Results

Depressive symptomatology and childhood physical abuse (CPA) significantly contributed to positive, negative, general psychopathology and global schizophrenia symptomatology. Stepwise regression analysis results are presented in Table 1.

Conclusions

Our findings suggest that CPA during childhood could have an impact on psychopathology in schizophrenia.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Day-to-day and Social Functioning of Patients with Negative Symptoms of Schizophrenia: Post-hoc Analyses of a Phase 3 Clinical Trial with Cariprazine Monotherapy and Risperidone
Authors: Barabássy Á. , Laszlovszky I. , Szatmári B. , Szalai E. , Harsányi J. , Németh G.
Published: June 2017

Introduction

Negative symptoms have substantial impact on day-to-day functioning of patients with schizophrenia affecting their ability to perform activities of daily living and to maintain personal relationships.

Objective

To present post hoc data on day-to-day and social functioning of patients with predominant negative symptom (PNS) of schizophrenia, treated with cariprazine versus risperidone.

Methods

Data from 26 weeks, phase 3, randomized, double-blind, active-controlled study in PNS patients were analyzed (EudraCT 2012-005485-36). Subjects with PNS (PANSS factor score for negative symptoms ≥24) were randomized to cariprazine 4.5 mg/d or risperidone 4 mg/d. Change from baseline to end of treatment on the personal and social performance scale (PSP) and PANSS prosocial subscale (P3, P6, N2, N4, N7, G16) was analyzed.

Results

Significantly greater improvements were seen with cariprazine compared to risperidone in the change from baseline to end of treatment on the PSP (LSMD + 4.632 [2.71, 6.56]; P < 0.001) from week 10 onwards (effect size 0.48); in the PSP subdomains of self-care (LSMD −0.2 [−0.3; −0.1]; P = 0.004), personal and social relationships (LSMD −0.2 [−0.4;−0.1]; P < 0.001) and socially useful activities (LSMD −0.4 [−0.5; −0.2]; P < 0.001); in the number of patients who improved at least 10 points on the PSP (OR 2.1; P = 0.001) or shifted to a higher category (OR 2.2; P = 0.001); and on the PANSS prosocial subscale (LSMD −0.8 [−1.41, −0.16]; P = 0.014).

Conclusion

Post hoc evaluation of this study showed that cariprazine treatment is associated with a clinically relevant improvement in patient functioning and social competence compared to risperidone.

Disclosure of interest

Employee of Gedeon Richter Plc.
The Relationship Between Negative Symptoms and Cognitive Functioning in Patients with an at Risk Mental State for Psychosis
Authors: Leanza L. , Egloff L. , Studerus E. , Andreou C. , Heitz U. , Beck K. , Menghini-Müller S. , Ittig S. , Riecher-Rössler A.
Published: June 2017

Introduction

Negative symptoms and cognitive impairments are both present in patients with an at risk mental state (ARMS) for psychosis and negatively affect functioning and outcome. According to previous studies in patients with first-episode psychosis, negative symptoms are negatively associated with cognitive functioning while positive symptoms do not seem to be associated. Yet, little is known about the specific relationship of negative symptoms and cognitive functioning in ARMS patients.

Objective

To evaluate, the relationship between negative symptoms and cognitive functioning in ARMS patients.

Methods

Data of 154 ARMS patients were collected within the prospective Basel early detection of psychosis (FePsy) study. Negative symptoms were assessed with the SANS, positive psychotic symptoms with the BPRS, cognitive functioning with an extensive neuropsychological test battery. Multiple regressions were applied and results were controlled for age and gender.

Results

Regression analyses showed a significant, negative association between negative but not positive psychotic symptoms and cognitive functioning, showing the strongest association with verbal fluency (see Fig. 1). However, results mainly did not withstand correction for multiple testing.

Conclusions

The association found between verbal fluency and negative symptoms may be indicative of an overlap between those constructs. Finally, verbal fluency might have a strong influence on the clinical impression of negative symptoms, especially on alogia.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
The Management of Insomnia by Tunisian General Practitioners
Authors: Yaich K. , Maalej Bouali M. , Charfi N. , Sellami W. , Nasr Z. , Zouari L. , Ben Thebet J. , Maalej M.
Published: June 2017

Introduction

Sleep disorders are common in clinical practice. However, they are relatively poorly understood by doctors. The aim of our study was to describe the management of insomnia by general practitioners (GPs).

Methods

A cross-sectional survey was carried out during the month of Mai 2016. Among the 193 GPs randomly selected from different areas of Sfax, in Tunisia, 127 completed a questionnaire about the management of insomnia.

Results

Among our participants, 46.5% stated that they often discuss the quality of sleep with their patients even when it is not their chief complaint. Forty-three percent reported that they are often consulted by insomniac patients. Twelve percent of GPs declared they know the “sleep diary”. Homeopathic treatment was the most prescribed first line medication (45.3%). Sleep hygiene measures were commonly recommended by 82.7% of the GPs. Relaxation therapy was known by 46.7% of the GPs and used by 26.7%. Sleep-restriction therapy was known and used by respectively 15.8% and 9.2% of participants. Discussing the quality of sleep with patients was correlated to: the frequency of solicitation for insomnia (P = 0.00), the knowledge of sleep diary (P = 0.031), and the recommendation of sleep hygiene measures (P = 0.032).

Conclusion

Continuous medical education, especially concerning non-pharmacological treatment measures, could drastically improve the management of insomnia by Tunisian GPs.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
The Spatial Pattern of Suicides in Europe
Authors: Kandrychyn S. , Yury R.
Published: June 2017

Introduction

The regularity in suicide rates in Europe was one of the essential challenges facing social scholars at the end of XIX century.

Aims

The present study aims to assess the continuation of this phenomenon in XXI century.

Methods

To explore this phenomenon, suicide rates were obtained from WHO official publications for 1990, 2000, 2010 and 2012 across 41 European nations. In order to examine the regularity of spatial suicide pattern, the data sets were subjected to Spearman's rank order correlation analysis.

Results

The suicide rates rank order distribution between European nations in 1990 was associated with suicide rates in 2000, 2010 and 2012 (rs = .91, .81, and .80, respectively, P < .001). The national suicide death indices show the significant positive correlation over the studied period, what means the definite regularity of suicide mortality pattern and absence of essential changes or fluctuations between the regions. The highest indices have the countries situated on the Northern and Eastern part of the European continent (Lithuania, Russia, Belarus and Hungary). On the opposite pole are the nations settled the Mediterranean and British islands. Thus, the fixed gradient in suicide distribution with the growing to the north and northeast of European continent is visible. The same stable vector in suicide spatial distribution is duplicated on the vast territories on the east part of Europe.

Conclusions

The data presented support the idea that spatial regularity in suicide distribution in Europe is not generally connected with social and cultural changes occurred during the centuries.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Association between ADHD and psychopathy among inmates in a high-security prison in Portugal
Authors: Loureiro D. , Machado A. , Silva T. , Veigas T. , Cerejeira J.
Published: June 2017

Introduction

ADHD is associated with psychopathic traits, both in the general population and in perpetrators, due to the impulsivity, but not the affective component of psychopathy.

Objectives

To analyze this relationship among a sample of inmates from a high-security male prison, using an instrument that further divides the callous-unemotional factor of psychopathy into boldness and cruelty, and see if they relate to ADHD independently from the impulsivity/disinhibition.

Methods

One hundred and one subjects aged 18–65, with at least 4 years of formal education, were interviewed for socio-demographic data and completed the ASRS-v1.1 (Adult ADHD Self-Report Scale) and the TriPM (Triarchic Psychopathy Measure). Subjects were divided into ADHD positive or negative according to their score in the ASRS-v1.1, and then compared regarding TriPM score (total, disinhibition, boldness and cruelty) using Student's t-test. Linear regression was used to assess independency between the subscales of TriPM.

Results

Seventeen subjects scored positive for ADHD. They significantly differed from the non-ADHD group regarding all psychopathy scores (total, t = −5.03, P < 0.0001; disinhibition, t = −3.53, P = 0.0006; and cruelty, t = −4.96, P < 0.0001), except for boldness (t = 1.97, P = 0.005). The cruelty score is independent from boldness (R2 = 0.03) but not from the disinhibition score (R2 = 0.24). Disinhibition and boldness are also unrelated (R2 = 0.01).

Conclusions

In line with previous work, our study shows a strong association between ADHD and psychopathy, with both conditions sharing the disinhibition/impulsivity factor. Although ADHD subjects score higher for cruelty, this isn’t independent from disinhibition, and may be a result of them being more prone to admit to cruel behaviours, due to deficient response inhibition.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Cannabinoid hyperemesis syndrome, a treatment discussion
Authors: Ramos-perdigues S. , Gordillo M.J. , Caballero C. , Latorre S. , Boned S.V. , Guisado M. , De Almuedo M. , Torres P. , Sanchez M.T. , Contreras E. , Fernandez A. , Esmeralda G. , Sanchez E. , Segura M. , Torres C. , Herrero G. , Tur M. , Merino C.
Published: June 2017

Introduction

Cannabinoid hyperemesis syndrome (CHS), is characterized by recurrent episodes of severe nausea and intractable vomiting, preceded by chronic use of cannabis. A pathognomonic characteristic is compulsive bathing in hot water. The resolution of the problem occurs when cannabis use is stopped. However, patients are often reluctant to discontinue cannabis. Treatment with anti-emetic medication is ineffective. Case series suggested haloperidol as a potential treatment. Other antipsychotics as olanzapine has been used as anti-emetic treatment in chemotherapy.

Objectives

To describe three cases of patients with CHS whom showed a successful response to olanzapine, even when, haloperidol had failed.

Aims

To present an alternative treatment for CHS which can offer benefits over haloperidol.

Methods

We present three cases of patients who suffered from CHS and were admitted to emergency department. All patients were treated with olanzapine after conventional anti-hemetic treatment failure. One patient was also unsuccessfully treated with haloperidol.

Results

All three patients showed a good response to olanzapine treatment. Different presentations were effective: velotab and intramuscular. Their nausea, vomits and agitation were ameliorated. They could be discharge after maintained remission of symptoms.

Conclusions

Olanzapine should be considered as an adequate treatment for CHS. Its suitable receptorial profile, its availability in different routes of administration and its side effects profile could offer some benefits over haloperidol.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Sensitivity and specificity of the Italian version of the bipolar spectrum diagnostic scale. Different scores in distinct populations with unipolar depression
Authors: Piacentino D. , Girardi P. , Md K.G.D. , Sanna L. , Pacchiarotti I. , Rossi D.P. , Girardi N. , Rizzato S. , Callovini G. , Sani G. , Manfredi G. , Brugnoli R. , Pompili M. , Pies R. , Ghaemi S.N. , Mazzarini L.
Published: June 2017

Introduction

To date, the proposition of recurrence as a subclinical bipolar disorder feature has not received adequate testing.

Objectives/Aims

We used the Italian version of the bipolar spectrum diagnostic scale (BSDS), a self-rated questionnaire of bipolar risk, in a sample of patients with mood disorders to test its specificity and sensitivity in identifying cases and discriminating between high risk for bipolar disorder major depressive patients (HRU) and low risk (LRU) adopting as a high recurrence cut-off five or more lifetime major depressive episodes.

Methods

We included 115 patients with DSM-5 bipolar disorder (69 type I, 41 type II, and 5 NOS) and 58 with major depressive disorder (29 HRU and 29 LRU, based on the recurrence criterion). Patients filled-out the Italian version of the BSDS, which is currently undergoing a validation process.

Results

The BSDS, adopting a threshold of 14, had 84% sensitivity and 76% specificity. HRU, as predicted, scored on the BSDS intermediate between LRU and bipolar disorder. Clinical characteristics of HRU were more similar to bipolar disorder than to LRU; HRU, like bipolar disorder patients, had more lifetime hospitalizations, higher suicidal ideation and attempt numbers, and higher rates of family history of suicide.

Conclusions

The BSDS showed satisfactory sensitivity and sensitivity. Splitting the unipolar sample into HRU and LRU, on the basis of the at least 5 lifetime major depressive episodes criterion, yielded distinct unipolar subpopulations that differ on outcome measures and BSDS scores.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Relationship between migration-stressors and self-reported symptoms of depression in an outpatient sample of Vietnamese migrants in Germany
Authors: Ta T.M.T. , Wolf S. , Nguyen M.H. , Dettling M. , Hahn E.
Published: June 2017

Introduction

Vietnamese migrants under the influence of migration-related stressors (MRS) represent a vulnerable group within the mental health care system in Germany.

Aims

First study examining the relationship between the quantity of experienced MRS and the severity of self-reported symptoms of depression in a Vietnamese outpatient-sample.

Methods

137 first-generation Vietnamese migrants diagnosed with depression were asked to complete the BDI-II and 24 questions about stressful experiences related to the migration process. Linear regression models was performed to examine the influence of the MRS-quantity on BDI-II total score and on BDI-II subscales (Buckley et al., 2001).

Results

A higher number of experienced MRS was found to be related to a higher BDI-II total score, as well as to a higher score on the cognitive subscale in particular. Regarding the cognitive depression-dimension the BDI-II items pessimism, past failure, guilt feelings, punishment feelings and suicidal thoughts were positively related to the MRS-quantity.

Discussion and conclusion

A dose-response-relationship was found, with a higher number of MRS being related to a higher severity level of self-reported depressiveness as well as to a higher level of cognitive depression-symptoms in particular. The increase in suicidal ideations in the light of MRS-exposure is in line with findings from other migrant populations. Therapeutic interventions may focus (more) on depressive cognitions as a result of recurring MRS-experiences. Special attention should be placed on suicidal thoughts being boosted by MRS.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
The Italian admission experience survey: A factor analytic study on a sample of 156 acutely hospitalized psychiatric patients
Authors: Trobia F. , Mandarelli G. , Tarsitani L. , De Pisa E. , Pompili M. , Girardi P. , Biondi M. , Ferracuti S.
Published: June 2017

Introduction

The admission experience survey (AES) is a reliable tool for measuring perceived coercion in mental hospital admission. We developed the Italian AES through translation back-translation and administered it to acutely hospitalized psychiatric patients.

Objectives/Aims

To verify psychometric characteristics of the Italian AES. To Examine the AES factor structure.

Methods

n = 156 acutely hospitalized patients (48% women, 69% voluntary) were recruited in two university hospitals in Rome (Umberto I Policlinic, Sant’Andrea Hospital) and were administered the Italian AES. We conducted a principal component analysis (PCA) with equamax rotation.

Results

Socio-demographic and clinical characteristics of the sample are reported in Table 1. The Italian AES had good internal consistency (Cronbach's alpha = 0.90); Guttmann split-half reliability coefficient was 0.90. AES total score significantly differed between voluntary and involuntary patients (5.08 ± 4.1 vs. 8.1 ± 4.9, P < 0.05). PCA disclosed a three-factor solution explaining 59.3 of the variance. Significant correlations emerged between AES total score and clinical variables (Table 2). Pearson's correlation coefficient disclosed a significant correlation between perceived coercion and psychiatric symptoms severity (BPRS total score).

Conclusions

The Italian version of AES and proposed new factor structure proved reliable.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Dissociative symptoms are associated with neurocognitive dysfunction in patients with MDD
Authors: Berdzenishvili E. , Tcheishvili G. , Sinitsa M.
Published: June 2017

Introduction

It is widely reported that persons with major depressive disorder (MDD) show impaired performance on cognitive functioning, including frontotemporally mediated cognitive functions. The presence of cognitive dysfunction among patients with dissociative symptoms in trauma-related disorders may contribute to poorer treatment outcomes. Patients with major depressive disorder (MDD) frequently report dissociative symptoms. Here we investigate association of dissociative symptoms and neurocognitive dysfunction in patients with depression. We predicted that higher levels of dissociative symptoms among persons with MDD would be associated with lower scores on objective measures of frontotemporally mediated neurocognitive functions.

Methods

Patients who met DSM-V diagnostic criteria for a primary diagnosis of recurrent MDD were recruited. The Hamilton Rating Scale for Depression (HAM-D) was administered to assess the severity of depressive symptoms. To assess dissociative symptoms participants completed the Multiscale Dissociation Inventory (MDI). Two groups of patients were selected and matched. One group consisted of 13 patients having MDD and dissociative symptoms and second group consisted of 12 patients having MDD only. To measure frontotemporally mediated cognitive functioning following tests were administered: Color Trails Test; Wisconsin Card Sorting Test; Conners’ Continuous Performance Test (CPT). To examine group differences on clinical and neuropsychological scores, two-tailed independent samples t-tests was performed.

Results

Group comparisons of performance on neuropsychological tests showed that participants with depression and dissociative symptoms performed worse on Color Trails Test Part 2 completion time, a measure of mental flexibility and processing speed. MDI depersonalization scores were correlated with measures of processing speed, mental flexibility and sustained attention. Specifically, Color Trails Test Part 2 scores were negatively correlated with depersonalization symptoms, where lower scores indicate slower completion time. Depersonalization symptoms on the MDI were also related to the CPT Hit Reaction Time Interstimulus Interval Change (a measure of vigilance), such that higher levels of depersonalization were related to better performance in a less active environment.

Conclusions

Our results suggest that dissociation is related to specific subtle impairments in neurocognitive functioning. Dissociative symptoms should ideally be assessed before treatment, as they may influence MDD treatment response. The findings point towards the need to further examine the impact of dissociation on functioning in patients with depression.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Birth order and psychiatric morbidity
Authors: Hussain J.
Published: June 2017

Objectives:

– to determine the frequency of sociodemographic factors (birth order)among subjects attending a psychiatric clinic;

– to establish psychiatric diagnosis of subjects;

– to bring out dominating frequencies of birth orders of the patient in relation with related diagnosis.

Methodology

This cross-sectional study was conducted at outpatient clinic of Liquate university hospital Hyderabad during 1st January 2012 to 31st January 2012. One hundred consecutive subjects attending a psychiatric OPD with psychiatric symptoms, were assessed for the total siblings, birth order among siblings and their psychiatric diagnosis. The socio-demographic data was recorded through a designed semi-structured proforma, and diagnosis was established by diagnostic and statistical manual-IV text revised criteria (DSM-IV TR).

Results

The age range remained 9-60 years and numbers of siblings were in the range of 1–12 siblings and fourth birth order was found to be dominant in this study to have psychiatric morbidity (38%). While, frequency of first order birth was 18%. Generalized anxiety disorder and depressive (GAD) disorders were dominant diagnosis (55%), while GAD was more in the male gender.

Conclusion

This study shows that psychiatric morbidity was more common in the lower birth order. This study may be carried out at different centers of psychiatry for the better assessment of psychiatric morbidity.

Disclosure of interest

The author has not supplied his declaration of competing interest.
Benefits of EMDR therapy on the memory in the treatment of PTSD
Authors: Sassi Andrade Vieira S. , Di Giorgio M. , Cohen E. , Caurand M. , Manchon A. , Quaderi A. , Palazzolo J.
Published: June 2017

According to some studies, 80% of subjects suffering from post-traumatic stress disorder (PTSD) present twice the risk of developing an insanity as they age because of the high level of stress that has been induced. Indeed, the triggered trauma has a deleterious effect on the establishment of the stress’ axis (the hypothalamic pituitary adrenal axis) which is then not able to regulate itself. As a consequence, the hippocampal neurons will be attacked by an excess of cortisol. Memory's dysfunction is central in the symptomatology of PTSD, particularly in respect to encoding and recall. The hippocampus is able to transfer information to the prefrontal cortex. Actually, subjects with PTSD present less activity in the prefrontal cortex triggered by a decrease of encoding and recall capacities. EMDR therapy (eye movement desensitization and recruitment) allow for a fast relief of symptoms by a bilateral alternate stimulation (SBA). Indeed, saccadic eye movements stem affect related to the traumatic event and process the associated cognitions. During the desensitization phase in EMDR, we noticed an increase in activity of the brain's prefrontal, ventromedial, amygdala and thalamic regions. Indeed, the recall of traumatic memories goes through implicit emotional valence regions and associative areas for which the experience is already deeply integrated. After comparing cerebral activity before and after the therapy, researches on EMDR shows that a reduction of stress’ symptoms has some sensitive link to PTSD (in prevention to dementia).

Disclosure of interest

The authors have not supplied their declaration of competing interest.
The effect of Qing Huan Ling on the hypoglutamatergic schizophrenia model in mice
Authors: Zhang Y. , Liu F. , Dai Z. , Wu Q.
Published: June 2017

Objective

To investigate the effect of Qing Huan Ling and (or) risperidone on activity and preferences behavior of the hypoglutamatergic schizophrenia model in mice.

Methods

Seventy kunming mice were randomly divided into 5 groups, one group as placebo group. The rest groups intraperitoneal injection MK-801 continuously 14 day, then randomly numbered: model group, Qing Huan Ling group, risperidone groupand Qing Huan Ling combined risperidone group. Intragastric administration give corresponding drugs for each group one month, at the same time observe high activities and changes in the preferences of five groups.

Results

Compared with the blank group, activity of the rest model groups induced by MK-801 was increased (P < 0.05). After intragastric administration one month, model groups of high activity was decreased, especially risperidone combined Qing Huan Ling group. There was no statistical meaning in inquiry activity of five groups (P > 0.05). Compared with model group, latent period of step-through test was prolonged 35.5 s (P < 0.05), of step-down test was prolonged 11.4 s in risperidone combined Qing Huan Ling group.

Conclusion

The combination of Qing Huan Ling and risperidone can suppress the high activity; also can protect harmed memory of the preference behavior in the hypoglutamatergic schizophrenia model in mice.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Personal experiences of recovery facilitated by participation in an individual placement and support intervention
Authors: Gammelgaard I. , Stenager E. , Eplov L.F. , Petersen K.S.
Published: June 2017

Introduction

Individual placement and support (IPS) is an evidence-based intervention where IPS consultants support people with severe mental illness in achieving competitive employment. IPS is a recovery-oriented intervention, but vast evidence regarding its ability to influence recovery-oriented outcomes challenges this position.

Aim

To investigate how an IPS-intervention influences the personal recovery process in people with severe mental illness.

Method

A qualitative phenomenological study including interview of 12 participants in an IPS-intervention. Analysis was made using a four-step phenomenological analysis method.

Results

IPS contributed to personal recovery in a number of ways: The IPS consultants’ ability to create an equal, acknowledging and safe relationship where participants’ needs were taking into consideration in the search and support for job or education was found valuable. In combination with employment, the role of the IPS consultant contributed to normalization and stabilisation of participants’ daily lives, changed their behaviours and beliefs about maintaining new achievements, personal goals and dreams.

Conclusion

Individual placement and support provides opportunities to gain personal goals and contributes to stabilisation and normalization of participants’ daily lives. This study supports the notion that the individual placement and support positively influences personal recovery in people with severe mental illness.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Effectiveness study of “occupational connections” – A short-term, in-patient intervention for promotion functioning and participation in daily life of people with mental health conditions
Authors: Lipskaya-Velikovsky L. , Krupa T. , Kotler M.
Published: June 2017

Objectives

Mental health conditions (MHC) have been associated with restrictions in daily life participation and functioning affecting health and well-being. Substantial numbers of people with MHC experience hospitalizations, however, there is limited evidence supporting functional interventions in the in-patient setting to promote recovery. The OC is an intervention implemented during sub-acute hospitalization, which attempts to promote activity and participation of people with MHC, both during the in-patient stay and upon return to the community, with a view to enabling recovery. To facilitate its implementation, we investigate the OC effectiveness.

Aims

Investigate the OC contribution to cognition, symptoms and functional capacity among inpatients with schizophrenia.

Methods

This is a quasi-experimental, prospective, pre/post-designed study with convenience sampling. Inpatients with schizophrenia were enrolled into the study group participating in the OC intervention (n = 16); or the control group participating in hospital treatment as usual (n = 17). The study participants completed evaluations at baseline and at discharge or after 10 weeks with: Neurocognitive State Examination, Trail Making Test, Ray Complex Figure, and Category Fluency Test for aspects of cognition; Positive and Negative Syndrome Scale for symptoms severity, and Observed Tasks of Daily Living-Revised for functional capacity.

Results

Statistically significant improvement in cognitive functioning, symptoms severity and functional capacity was found in the study group after the intervention. These changes were not observed in the control group.

Conclusion

The results support the OC effectiveness for cognitive and functional capacity improvement and symptomology relief. The findings advance the body of evidence for functional interventions in hospital settings.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Awareness of and satisfaction with available treatment options in schizophrenia: Results from a survey of patients and caregivers in Europe
Authors: Cherubin P. , Maria C. , Hargarter L. , Wooller A.
Published: June 2017

Introduction

Understanding beliefs and concerns of patients with schizophrenia and their caregivers, regarding treatment options, is key to improving their care. Perceived fears can impact adherence to therapy and represent a barrier to prescribers when discussing treatment decisions.

Objectives

Explore patient and caregiver awareness of and satisfaction with available treatment options.

Methods

Independent market research agency commissioned by Janssen, performed an online European survey in 2016 to capture demographics, awareness of available therapies, current treatment satisfaction and adherence from patients with schizophrenia and caregivers.

Results

Results from 166 patients with schizophrenia and 468 caregivers from 12 European countries (France, Germany, UK, Italy, Spain, Denmark, Russia, Sweden, Austria, Belgium, Switzerland, and the Netherlands). One-fifth of patients reported they have not discussed alternative treatment options with their healthcare professional (HCP) despite 37% of patients being dissatisfied or very dissatisfied with their current therapy. HCPs were considered as the primary information source for the majority of patients (73%), although 27% of patients and 25% of caregivers believed that HCPs were not fully aware of all available treatment options. Moreover, 68% of patients treated with oral antipsychotics confirmed they would consider switching to a long-acting antipsychotic treatment, though 32% reported they have not been made aware of it as an option. Many caregivers (46%) reported dissatisfaction with their level of involvement in treatment decisions.

Conclusions

This survey underlines the critical role HCPs play in providing relevant information on treatment alternatives and emphasize the need for an open dialogue on available treatment options between HCPs, patients and caregivers.

Disclosure of interest

Pierre Cherubin is a full-time Janssen employee working within the Medical Affairs Department.

The other authors have not supplied their declaration of competing interest.