bluuebunny/crossref_metadata_2025 huggingface dataset:
The Mini-Spadin, an efficient alternate to Spadin in the depression treatment
Authors: Borsotto M. , Djillani A. , Devader C. , Heurteaux C. , Mazella J.
Published: May 2016

Objectives

We previously discovered spadin as a new antidepressant drug concept. Spadin exerts its antidepressant actions on the TREK-1 potassium channel, a new antidepressant (AD) target. We have shown that spadin acts more rapidly in comparison to other ADs. We have pointed out that spadin induced neurogenesis after only 4-day treatments. We have demonstrated that spadin did not display side effects at the cardiac level and on TREK-1 controlled functions such as stroke, epilepsy or pain.

Objectives

With the final goal to make spadin a drug for human clinic, our objective was to find analogs of spadin demonstrating a better affinity or a better in vivo stability or both.

Methods

Several analogs of spadin were synthesized. Their ability to block the TREK-1 channel activity were first tested by electrophysiology on HEK293 cells stably transfected with TREK-1 channels. AD effects were measured by using the forced swim test and the novelty suppressed feeding test. Neurogenesis was investigated by measuring the expression level of the synaptic protein PSD-95 in in vitro cultured neurons.

Results

Our data allow us to identify a shortened spadin, called mini-spadin, that displayed the same AD properties as spadin and a 400 fold increase in the TREK-1 affinity. Mini-spadin increased the synaptogenesis marker PSD95 levels after only 24 hours of treatment, suggesting that like spadin, mini-spadin was able to induce neurogenesis and synaptogenesis.

Conclusions

Even if further experiments are required, the mini-spadin appears to be more efficient than spadin offering a very promising alternate to spadin as human drug.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Short-term study in patients treated with desvenlafaxine
Authors: Calvo Rivera M.P. , Aguado Bailón L. , Girela Serrano B.
Published: May 2016

Introduction

Desvenlafaxine is an antidepressant inhibitor of the reuptake of norepinephrine and serotonin (SNRI). Several publications support its efficacy in reducing depressive symptoms in the short term.

Objectives

The objective of this paper is to estimate the effect of short-term (12 weeks) of patients with depressive disorder treated with desvenlafaxine.

Methodology

This is a prospective observational study tracking a cohort of outpatients with depressive disorder treated with Desvenlafaxine for three months. To accomplish our goal we used the Montgomery-Asberg scale performing three measurements (baseline, one month and two months after initiate the treatment). The size of our sample was 24 patients.

Results

We found that in about 80% of patients the treatment was effective, no significant differences in relation to sex, age or treatment dose were reported. Regarding the severity of the symptoms, in the initial assessment 16% of the patients had a mild depressive episode, 70% a moderate episode and about 12% had a severe episode; while in the last evaluation, almost 46% of patients were in recovery, nearly 42% had mild symptoms, 8% moderate symptoms and only 4% had mild symptoms.

Conclusion

We can conclude that the treatment with Desvenlafaxine has been effective at improving in the short-term the depressive disorder, independently of gender, age and dose administered.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Dysthymia. The importance of an early diagnosis and an efficient treatment
Authors: Duque Domínguez A. , Duque Domínguez R. , García Montero C. , Martín Díaz L. , Palomo Monge M. , de la Torre Brasas F. , Echeverría Hernández N. , Lázaro Redondo M.D.M.
Published: May 2016

Introduction

Dysthymia is defined as a chronic mood disorder that persists for at least two years in adults, and one year in adolescents and children. It is important to distinguish it from other types of depression, as early as possible. The therapeutic management of dysthymia is similar to the one used in major depressive disorder.

Objectives

We report the case of a female patient aged 45, diagnosed with depressive disorder not otherwise specified since she was 20. Her psychopathological progress has gradually become aggravated, having now longer periods of depressive mood and an important tendency towards isolation.

Methodology

The patient is admitted to the Psychiatric Day Hospital presenting with important depressive symptoms. After various antidepressants were withdrawn, lithium salts were introduced. It is then that the patient starts improving her mood.

Results

– Dysthymia (F34.1).

– Mixed and other personality disorders (F61.0).

Conclusions

In spite of having an appropriate pharmacological, unfortunately, antidepressants improve dysthymia just in 50–70% of patients. Antidepressants resistant dysthymia cases have been studied. In those cases, it has been necessary to add lithium or thyroxine. This confirms that, when it comes to this disorder, there are many neurochemical mechanisms involved, given the positive response to the combination of drugs, notwithstanding the severity of the adverse effects.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Change your life with seven sheets of paper: A pilot randomized controlled trial for postnatal depression (CREATOR)
Authors: Nusrat H. , Batool F. , Tayyeba K. , Farah N. , Ann M.
Published: May 2016

Introduction

Prevalence of Common Mental Disorders (CMD) is high in low and middle-income countries. The prevalence rate of postnatal depression in Pakistani women and its effect on the growth and development of young children and child mortality is very high. Despite availability of interventions to improve maternal health, the major issue in implementation of those interventions is because of limited availability of trained health professionals.

Aims

The aim of this study is to deliver CBT based intervention called “change your life with 7 sheets of paper” to women with mild to moderate PND through trained Traditional Birth Attendants (TBAs).

Methods

During first stage of this rather blind feasibility randomized control trial 5 TBAs were trained to deliver CBT. Total 36 participants with PND having child between the ages 0–12 months will be recruited from community. Participants will be assessed using Edinburgh Postnatal Depression Scale, Patient Health Questionnaire (PHQ-9) and World Health Organization Quality of Life scale at baseline and then at 3 months. Eight group sessions of CBT will be delivered by trained TBAs.

Results

Outcome assessments will be done after completion of intervention of intervention i.e., 3 months after baseline. Preliminary findings will be presented in the conference.

Conclusion

Findings from this trial will help us to understand how the involvement of TBAs can help in overcoming the challenge of non-availability of trained health professionals and in attainment of millennium development goals of reducing mother and child mortality.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Characteristic distributions of CBF changes in remitted geriatric depression
Authors: Liao W. , Wang Z. , Shu H. , Zhang Z.
Published: May 2016

Background

The cerebral blood flow (CBF) is an absolute measure that superior to the relative measure of neural activity, blood oxygenation-level-dependent (BOLD). The previous studies have reported CBF abnormalities in the adult depressive patients. However, it is not clear whether the abnormal CBF could be improved in the remitted geriatric depression (RGD).

Methods

We enrolled 82 RGD patients and 90 age and education matched healthy controls. All the subjects underwent 3-T MRI with pseudo arterial spin labeling (pASL), and the pASL data were analysis voxel-by-voxel with control the gray matter volume.

Results

Compared with the healthy controls, the RGD patients demonstrated higher relative CBF value in left inferior temporal gyrus and left precuneus; while lower relative CBF value in right medial temporal and occipital cortex, right insula operculum (including parts of frontal, temporal and parietal cortex) and insula, right medial frontal cortex. When compared with the remitted early onset depression (EOD), the remitted late onset depression (LOD) showed lowed relative CBF value in right angular gyrus. While there was no significantly different relative CBF value between the RGD patients accompany with MCI and RGD patients with cognitive normal.

Conclusion

The late life depression persists with CBF abnormalities in the remitted state. And it is implicit that hyperperfusion in the left brain cortex and hypoperfusion in the right brain cortex could be the specific form to RGD patients.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Prevalence of involuntary hospitalization in patients with depressive disorders
Authors: Palma Conesa Á. , Dinamarca Cáceres F.N. , Grifell Guardia M. , Galingo Guarin L. , González Contreras L. , Campillo Sanz M.T. , Pérez Solà V.
Published: May 2016

Introduction

Depression is a disabling disorder with a high socio-economic impact. It might require hospitalization for symptom control and/or harm prevention. Other depressive disorders might as well require hospitalization in benefit of the patient. Hospitalization may be involuntary. Hospitalization willfulness in depressive patients has not been systematically studied in recent years.

Objective

The aim of this study is to explore the necessity of involuntary hospitalization in patients presenting depressive symptoms at the emergency service that were later diagnosed with a depressive disorder.

Materials and methods

From all patients visited in the psychiatric emergency service from 2012 to April 2015 those that were hospitalized in the acute mental health unit and diagnosed with a depressive disorder were studied. All those monopolar depression diagnoses were considered, excluding those within the bipolar spectrum. Diagnosis followed CIE-9 criteria. A descriptive cross-sectional study of the samples was then conducted. Statistical analysis was performed using SPSS software (SPSS Inc., Chicago, Ill.).

Results

From all 385 depressive disorders, 169 were involuntary admissions (43.9%), 196 were voluntary (50.9%) and 20 were scheduled (5.2%), difference was statistically significant (P < 0.05). Mean age, was 59.52 years for involuntary admissions, 61.7 for voluntary and 63.6 years for scheduled, with a statistically significant difference (P < 0.05). Gender differences were not significant.

Conclusions

Most depressive disorders were hospitalized voluntarily. However, a relevant percentage of patients required involuntary hospitalization. Younger patients presented a higher ratio of involuntary hospitalization. Reasons for involuntary hospitalization needs should be further studied.

Disclosure of interest

The authors have not supplied their declaration of competing interest. Liliana Galindo is a Rio Hortega fellowship (ISC-III; CM14/00111).
Efficacy Of Lurasidone In Major Depression With Mixed Features: Pattern Of Improvement In Depressive And Manic Symptoms
Authors: Nierenberg A.A. , Tsai J. , Mao Y. , Pikalov A. , Suppes T. , Loebel A.
Published: May 2016

Introduction

Evidence indicates that manic symptoms, below the threshold for hypomania (mixed features), are common in individuals with major depressive disorder (MDD).

Objectives/aims

To evaluate the effect of lurasidone on specific depressive and manic symptoms, based on Montgomery Asberg Depression Rating Scale (MADRS) and Young Mania Rating Scale (YMRS) items, in patients with MDD with mixed features.

Methods

Patients meeting DSM-IV-TR criteria for MDD, who presented with 2–3 protocol-specified manic symptoms, were randomized to 6 weeks of double-blind treatment with lurasidone monotherapy 20–60 mg/d (n = 109) or placebo (n = 100). Change from baseline in the MADRS total, MADRS-6 core depression subscale, individual MADRS items, and total and individual items of the YMRS were analyzed by MMRM, and Cohen's d effect sizes (d) were calculated for week 6 change scores.

Results

Lurasidone improved depressive symptoms at week 6 in the MADRS total score (–20.5 vs. –13.0; P < 0.0001; d = 0.8) and MADRS-6 core depression score (–13.0 vs. –8.5; P < 0.0001; d = 0.7). Significant improvement on lurasidone was observed at week 6 on all ten MADRS items (d = 0.36–0.78). Effect sizes for the MADRS-6 core depression subscale items ranged from 0.36 to 0.78 at week 6. Treatment with lurasidone was associated with significantly greater week 6 improvement on the YMRS (–7.0 vs. –4.9; P < 0.0001). Effect sizes for the 5 YMRS items with baseline item severity ≥ 2 ranged from 0.32 to 0.48.

Conclusions

In this study of MDD with mixed features, lurasidone was effective in treating the range of depressive and manic symptoms that patients presented with.

Sponsored by Sunovion Pharmaceuticals Inc.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Effect Of a Single Nights’ Wake Followed By Bright Light Therapy On Agitation
Authors: Widmark-Jensen M. , Steingrimsson S. , Szabó Z.
Published: May 2016

Introduction

Wake-therapy (or “Sleep deprivation”) has the potential of providing a fast anti-depressive response as add-on treatment to pharmaceutical intervention. Agitation in a depressive state is well known and is often associated with interrupted sleep. Although hypomanic symptoms have been reported following a single nights wake, agitation has not been examined.

Objective

To examine if agitation increases among inpatients undergoing wake-therapy compared to treatment as usual (TAU).

Methods

Admitted patients suffering from a depressive episode will be randomized to either wake-therapy combined with bright light therapy in addition to TAU, including medication, or to TAU alone. Before wake-therapy, patients are assessed using PANSS-EC, aimed at measuring only agitation. The day after a single nights wake, the assessment will be repeated. Likewise, agitation will be assessed in the control group directly after randomization as well as the day after.

Results

In this trial, 50 patients will be randomized for treatment. Results concerning agitation among patients that have undergone the trial will be presented.

Conclusions

Agitation as a side effect of wake-therapy has been scarcely investigated and this randomized trial will contribute to the knowledge of agitation following wake-therapy.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Effectiveness Of Enhanced Cognitive Behavioral Therapy (cbt-e) In The Treatment Of Anorexia Nervosa – a Prospective Multidisciplinary Study
Authors: Danielsen Y. , Rekkedal G. , Frostad S. , Kessler U.
Published: May 2016

Introduction

According to the most widely influential treatment guidelines from the National Institute for Health and Clinical Excellence and the American Psychiatric Association, existing evidence for adult AN treatment is weak, and more treatment studies are needed.

Objectives/aims

The primary objective of this project is to gain knowledge about the effectiveness of CBT-E in the treatment of Anorexia Nervosa (AN). Secondary objectives are to prospectively examine baseline predictors of treatment outcome/drop-out and to examine variables related to treatment process and patient engagement as predictors of outcome/drop-out. Thirdly, in a multidisciplinary approach, to focus on selected pathophysiological mechanisms including disturbed neuropsychological functioning, changes in the gut microbiota, immunological and genetic measures in patients with severe AN in different stages of the disease, and further to investigate to what extent they are related to treatment outcome.

Methods

The sample consists of patients aged ≥ 16 years with AN admitted to outpatient treatment (CBT-E) at Section for Eating Disorders, Haukeland University Hospital, Bergen, Norway. Outcome measures include BMI, self-reported eating disorder symptoms (EDE-Q), depression (BDI), anxiety (BAI) general psychiatric symptomatology (SCL-90-R, M.I.N.I 6.0), health related quality of life (CIA, RAND-36), physical activity (accelerometers) and neuropsychological functioning. The main measurement points are at the start of treatment, 3 months, end of treatment and one year follow-up. Baseline predictors of treatment outcome and drop-out will be examined as well as the association between early adherence, behavioral change, therapeutic alliance and treatment outcome. In addition biochemical, genetic and bacteriological assessments will be conducted.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Attachment Style And Cortisol Response To Psychosocial Stress In Eating Disorder Patients
Authors: Giugliano R. , Monteleone A.M. , De Riso F. , Nigro M. , Monaco F. , Volpe U. , Monteleone P.
Published: May 2016

Introduction

Stress exposure is a risk factor for both the onset and the maintenance of Eating Disorders (EDs). The attachment theory may provide a framework to explain the relationship between social stress and EDs, since secure attachment promotes the seeking for support in order to help people to face stressful events. The endogenous stress response system, including the hypothalamus-pituitary-adrenal (HPA) axis, is likely involved in mediating the role of attachment in the subjects’ coping with stressful situations.

Objectives and aims

We explored cortisol responses to the Trier Social Stress Test (TSST) of patients with EDs in order to evaluate possible associations between subjects’ attachment styles and HPA axis functioning.

Methods

Twenty-one adult patients with EDs (7 with secure attachment and 14 with insecure attachment) filled in the Experience in Close Relationship (ECR) questionnaire, which assesses the adult attachment style, and were exposed to the TSST. Saliva samples were collected before and after the stress in order to measure cortisol levels.

Results

As compared to ED patients with secure attachment, those with insecure attachment showed a significant different pattern of the HPA response to the stress test.

Discussion

Present findings suggest that attachment style may influence the HPA response to stress in patients with EDs and this effect may have relevant implications for the pathophysiology of EDs.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
‘Dar Kenn Ghal Sahhtek’ – An Effective Therapeutic Intervention
Authors: Falzon Aquilina F. , Grech A. , Zerafa D. , Agius M. , Voon V.
Published: May 2016

Introduction

‘Dar Kenn Ghal Sahhtek’ is a residential service for patients suffering from eating disorders, namely Bulimia Nervosa, Anorexia Nervosa and Obesity (Binge Eating and Non Binge Eating type). The focus will be made on the obesity services.

Objectives

1. To show that Dar Kenn Ghal Sahhtek has proved to be an effective therapeutic intervention towards obesity (with or without binge eating). 2. To show that from a recruitment of 30 obese subjects a substantial proportion met the DSM-5 criteria for Binge Eating Disorder.

Aims

1. To show that by means of questionnaires and physical testing a marked improvement was made following the therapeutic interventions offered at DKGS. 2. To highlight the high incidence of binge eating disorder in a sample of 30 obese subjects recruited via DKGS.

Methods

1. Interviewing the patient for the DSM-5 criteria of binge eating. 2. Comparing scores of questionnaires before admission and prior to discharge. 3. Evaluating the response to various treatment modalities.

Results

On interviewing the group of 30 patients, 47.6% of the patients were found to be the diagnostic criteria of Binge Eating Disorder according to DSM-5 (Table 1).

Conclusion

Firstly, a considerable proportions of obese subjects proved to meet the DSM-5 criteria for binge eating while Dar Kenn Ghall Sahhtek has proved to be an effective therapeutic intervention towards obesity (with and without binge eating).

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Eating Disorders. Review Of Current Treatment Options For Anorexia Nervosa, Focused On Psychotherapy And Pharmacological Treatment
Authors: Sánchez Sánchez B. , Muñoz-Calero Franco P. , Rodriguez Criado N. , Cruz Fourcade J.F. , Martín Aragón R. , Bravo Herrero S. , García-Poggio Fernández M. , Gil-Eliche Moreno M. , De Cos Milas A. , Chinchurreta de Lora N.
Published: May 2016

Introduction

Anorexia nervosa is a disorder of eating behavior that is a major health problem on our society. It is characterized by three main criteria: self-induced starvation, desire for thinness or fear of obesity, and the presence of medical signs and symptoms due to improper feeding. This work is focused on its treatment. The biopsychosocial approach allows the design and application of effective therapeutic strategies and a multidisciplinary team collaboration is essential.

Objectives

Research of current pharmacological and psychotherapy treatments options of the disease.

Material and methods

Literature review based on articles and publications on this topic.

Results

In anorexia nervosa, it is necessary to establish a therapeutic alliance between doctor and patient. Patient usually feels no motivation to improve. The different treatments options to combine, in terms of the patient status, are: nutritional rehabilitation, cognitive-behavioral, family and interpersonal psychotherapies and pharmacological treatment. It can be carried out at the ambulatory, at the day-hospital or by medical stay, even beyond patient will.

Conclusions

Nowadays, the nutritional rehabilitation is the best treatment established and it is the core treatment. About the psychotherapies, the cognitive-behavioral is the most used because it has exposed better results in all different studies proved and in clinical practices, followed by the family therapy which is the responsible of the patient family's treatment. Pharmacological treatment should not be used systematically and its exclusive use is not enough to resolve anorexia nervosa as there are needed also other treatments combined.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Differences In The Attitudes Of Clinical And Pre-clinical Medical Students To Mental Illness
Authors: Adekunte O. , Oliver C. , Owen B.
Published: May 2016

Background

The quality of care provided to psychiatry patients by doctors can be influenced by attitudes towards mental illness. Equally important is the attitude of medical students as future treating doctors towards mental illness. This survey compares the differences in the attitudes of pre-clinical and clinical years student to mental illness.

Aims

To compare attitudes of pre-clinical and clinical medical students’ to mental illness.

Methods

A cross-sectional survey of 212 clinical students (CS) and pre-clinical students (PS) at Newcastle University. Each responded anonymously to an electronic questionnaire. The responses take the form of: Yes/No, free text, order of preference, and Likert scale. Results were analysed based on basic statistical analysis.

Results

Little differences exist between the 2 groups in their beliefs that psychiatric patients are not difficult to like, mental illness can be a result of social adversity, psychiatry patients often recover and that people with mental illness should be offered a job with responsibility. However, 54% PS disagreed that mental illness often leads to violence, compared to 66% CS and 87% of PS identified that mental illness can be genetic in origin compared with CS of 91%.

Conclusion

This survey did not identify any significant difference between the attitudes of pre-clinical and clinical students in most of the domains. However, a higher percentage of clinical students associate violence with mental illness and are unwilling to consider an elective period in psychiatry.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Simulation Training - Pilot: Psychiatry Higher Trainees’ Mental Health Tribunal Report Writing, Oral Presentation And Cross-examination By Tribunal Panel
Authors: Adekunte O. , Owen B. , Burrell C.
Published: May 2016

Introduction

Simulation provides a non-judgemental environment where trainees learn skills without compromising patients’ safety or dignity. It also provides safe environment where anxiety-provoking, real-life clinical situations can be recreated and repeatedly practiced. Mental health review tribunal is an anxiety-provoking experience for higher trainees and use of simulation can alleviate this anxiety.

Aims

To develop trainees’ skills in writing of tribunal reports and giving oral evidence using simulation technique (ST).

Objective

To facilitate trainees’ familiarisation with the process of Mental Health tribunal and improve their skills in completing report and giving oral evidence using ST.

Methods

There are 2 sessions: one half-day session of interactive teaching providing fundamental details on essential elements of the tribunal process, duties and report. This is followed by 4-weeks gap to allow participants to prepare and submit anonymised patients’ reports to the panel. Finally, a second full day of presentation and cross-examination by (real) tribunal panel with 25-minutes of formative feedback.

Results

Six trainees participated in the pilot: A high percentage of participants strongly agreed or agreed that ST is an effective learning experience for tribunal report writing and cross-examination by the panel. Similar proportion agreed that ST helped to facilitate familiarisation with the tribunal process and that it is a satisfactory teaching method. Finally, all participants agreed that ST helped to achieve personal objectives for attending the seminar.

Conclusions

Simulation in psychiatry is becoming an effective learning experience. The outcome of this pilot on report writing and cross-examination by tribunal panels how its increasing effectiveness and relevance in psychiatry.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
The Attitudes Towards Depression Of General Practitioners Can Be Improved By An Educational Program
Authors: Álvarez de Mon M.Á. , Manzanera R. , Lahera G. , Saiz-Ruiz J. , Alvarez de Mon M.
Published: May 2016

Background

Continuous education of physicians is critical for the quality of medical care.

Objectives

To investigate the attitudes of general practitioners towards depression and to evaluate the short- and long-term impact of a specific designed postgraduate university program in depression.

Method

In this prospective, interventional study participated 1322-certificated Family Practice specialist. They filled out the Depression Attitude Questionnaire (DAQ) Spanish validated version before starting the educational intervention; an official approved 12 ECTS postgraduate university program. The participant refilled the questionnaires at the end of the course and 6 months later.

Results

A total of 885 females and 420 males (mean 48 years) and with a mean clinical experience of 25 years participated in this study. Short-term after training, PGs positively significant (P < 0.05) changed their attitudes in the management of depression in 18 out 20 items of the DAQ. There were not significant changes in only item 1 related to the number of patients presenting depressive symptoms seen in the last 5 years and the knowledge of the underlying biochemical abnormality. In the long-term, the positive effects observed in the short-term did not significantly change. However, in item 1 a significantly increase was observed. The effectiveness of the intervention was related nor to the to the age and sex of the physician nor to the years of medical practice.

Conclusions

A specific designed educational program can improve the attitudes in depression of GPs. Years of clinical practice are not a limitation for improving the medical attitudes of General practitioners in mental health.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Educational Project: Learning From The Patient
Authors: Flores P. , Soro M. , Orejas O. , Masferrer C. , Fernandez A. , Renom J. , Negredo M.
Published: May 2016

Introduction

Learning from the patient presents a pedagogical experience where patients expert in mental health participate as teachers in the teaching-learning processes.

This training activity is a pilot aimed to assess the impact and integration in the study plan of the students following the training course in auxiliary nursing care, Barcelona.

Objectives

To offer a global vision on mental health problems in order to break the stigma, being the persons affected the main actors.

Stress the value of the patient voice and its particular way of living and suffering the illness in order to offer a suitable attention.

Promote the integration of expert patients as teachers in the education programs.

Methodology

The training activity starts with the evaluation of the previous mental health knowledge and believes of the students.

Round table with the participation of:

– 2 expert patients explain their history of life and how the illness affects their day-to-day life;

– 2 mental health professionals explain how they help patients to recover and empower them.

Four groups about the impact of illness on a personal, educational, working and social level.

Results

The expert patients were very optimistic and reinforced their own self-esteem. The students show a more positive attitude towards mental illness and express that patients’ are first PEOPLE, then patients’

Conclusions

The expert patients collaborating with professionals are ready to become teachers in the health care academic programs and, specifically, in mental health.

Taking into account the patient voice and vision improves the technical, personal and social competences of professionals.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Young Psychiatrists’ Network. Between Past and Future
Authors: Kanellopoulos A. , Psaras R. , Kokras N.
Published: May 2016

The Young Psychiatrists’ Network (YPN) is a rapidly growing network of Early Career Psychiatrists (till 40 years of age or 5 years since completion of specialty – unless otherwise specified in home country) and Psychiatric trainees.

Its aims include, global development of psychiatry through close collaboration of YPs worldwide, expanding knowledge and sharing experiences, and facilitating the evolution of YPs from different parts of the world and improvement of their knowledge, skills and abilities.

From 30th September – 4th October the 5th YPN Meeting was held in Porto Heli in Greece. It was the biggest Young Psychiatrists Meeting ever held with more than 150 participants from 42 world countries and it was an absolute success. The state of the art scientific program included plenary lectures by renowned psychiatrists such as Prof. Nik. Bouras and Prof. Martin Prince, symposiums and workshops.

In conjunction with the 5th YPN Meeting from 27–30 September, a leadership course directed by Prof. N. Sartorius and Prof. K.H. Wittchen was held in Athens with the participation of 16 participants from 11 world countries.

The next meeting will be in Italy on September 2016.

Future plans include research collaboration, regional meetings and promoting the best possible work and educational conditions for young psychiatrists from all over the world.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
A Brief Survey Of The Impact Of Restructuring Of Clinical Placement And Education Delivery For Medical Students In 5 Boroughs Partnership Nhs Foundation Trust
Authors: Kumar S. , Baldwin A.
Published: May 2016

Introduction

In the United Kingdom, a drive has been initiated to duly attract and recruit medical student into career psychiatry. However, most medical students attending university find the psychiatry lacks structure and organised model in teaching delivery.

As a result, many medical students put off earlier on in their studies by psychiatry.

Aim

We wanted to test the above hypothesis with the introduction of structure by allocating de-centralised teaching and hands on clinical experience for medical students.

Method

The collective survey tool is devised to reflect the needs of medical students with de-centralised teaching separate but to complement university studies. This included introduction of induction package, set out syllabus, structured learning sessions. The results of the feedback from the medical students were collated and the results are discussed.

Discussion

The results indicate the success of the decentralized and borough based teaching, with improved interest in psychiatry and higher attendance rate. The feedback has been positive, and efforts of the tutors have been appreciated. Whether this will translate into higher recruitment rate number is to be seen.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
The Japanese Society of Psychiatry and Neurology Fellowship – Reflections of Participation from European Early Career Psychiatrists
Authors: Ryland H. , Scheeres K.
Published: May 2016

Introduction

The Japanese Society of Psychiatry and Neurology (JSPN) fellowship is a long-running programme to support early career psychiatrists from around the world to attend the society's annual conference in Japan.

Objectives

To inform early career psychiatrists of the nature of the fellowship, disseminate learning from the experience and to encourage applications to the scheme.

Methods

Each member organisation of the World Psychiatric Association can nominate up to two early career psychiatrists for consideration by the fellowship committee. Applicants must submit an abstract in one of two themes, describing how services are designed in their country. Twelve early career psychiatrists are selected to participate in the programme each year.

Results

In 2015, fellows were drawn from ten countries across three continents. The fellowship programme involved several components, including the opportunity to present the nature of psychiatric services in our home nations in dedicated seminars with other international fellows. This provided an excellent platform to compare and contrast different national approaches in key areas. Each seminar was co-chaired by an eminent psychiatrist and an early career psychiatrist from Japan, increasing the possibilities for professional exchange and mentoring.

The Japanese Young Psychiatrists’ Organisation arranged a number of activities for the fellows including a guided tour of a local psychiatric facility. This enabled fellows to gain a deeper understanding of psychiatric practice in Japan, through informal discussions and interaction with clinicians.

Conclusions

The JSPN fellowship is an effective mechanism for fostering improved relations and understanding between early career psychiatrists across the world.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Educating To Legality. a Tool To Prevent Crimes of Psychiatric Patients
Authors: Zangrando A. , Babici F. , Pascolo-Fabrici E. , Riolo A.
Published: May 2016

Introduction

Be a citizen means having rights but also duties and be subject to laws. Educating to legality is essential for mutual respect in the community, for the rules of social life and to exercise own rights of citizenship. A psychiatric patient can commit crimes because of mental disorders but also in absence of psycopathological problem. When a patient commits an offence, it is correct to know whether he was due and if he is actually a danger to society. The law do not allow ignorance but what patients really know about the law is not clear.

Objective

In this study, we want to investigate the legal knowledge in citizens with mental disorders. Moreover, we want to build pathways to increase compliance with the law.

Methods

We collected a cohort of 10 offenders and asked them if they were interested in an educational course on legality. We interviewed a sample of patients at risk of breaking the Penal code to assess their basic knowledge.

Results

The reasons to undertake an educational program on compliance with the law were higher for offenders, maybe for fear of damaging sanctions. Those at risk of being sued for their behavior seemed to have more background than other group.

Conclusions

It is essential to develop educational programs about crime prevention within the psychiatric field through training courses that increase the knowledge and awareness of effects of the Penal code. Moreover, citizens with mental disorders at risk of crimes should be supported by specific interventions aimed to social ethics.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
“Flakka”: an Emerging Trend Or a Mass Media Phenomenon? Presence of alpha-pvp in Samples Submitted To a Drug Checking Facility
Authors: Grifell M. , Quintana P. , Torrens M. , Palma a. , Galindo L. , Ventura M. , fornís I. , Gil C. , Caudevilla F. , Farré M.
Published: May 2016

Introduction

New psychoactive substances (NPS) are drugs that have recently become available, are not worldwide regulated, and often intend to mimic the effect of controlled drugs. α-Pyrrolidinopentiophenone ( alpha-PVP) is a potent stimulant cathinone that is thought to act inhibiting dopamine and noradrenaline reuptake. It has been associated with hallucinations, psychosis and death.

Objectives

To explore the presence of alpha-PVP from the samples handled to, and analyzed by energy control.

To determine whether it is a new trend in recreational settings.

Methods

all samples presented to energy control were analyzed.

Samples in which alpha-PVP was detected using Gas Chromatography-Mass Spectrometry were selected for study.

a Google trend analysis was also performed to asses the media impact of alpha-PVP.

Results

From a total of 20,062 samples, 33 contained alpha-PVP (0.16%). The samples containing alpha-PVP were mostly sold as such (40%) despite a significant proportion being sold as MDM a (15%). Google trend analysis showed an abrupt increase of alpha-PVP searches in 2015 reaching 50% of the MDM a-ones.

Conclusion

Our results suggest presence of alpha-PVP in the drug market may be increasing, especially as adulterant of other drugs. Severe side effects might be even more serious considering that a significant proportion of users may ignore which substance they are actually using. However, the total amount of alpha-PVP analyzed remains small, and does not support the alarming reports published in media.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Frequent attendance: a Clinical and Epidemiological Study
Authors: López-Romeo S. , Ledesma-Iparraguirre G.
Published: May 2016

Background

Frequent attenders (F a) are patients who attend a health care facility repeatedly. The frequency of frequent attendance at emergencies department has been defined as 4 or more attendances/annum. F a are few in number but they produce a high number of attendances.

aims

To determine prevalence of F a, mean attendances/year generated by F a and frequency of visits by months.

Methods

a retrospective study was performed on psychiatry's emergency department database from January until December 2013. F a was defined as those with ≥ 4 attendances at emergency services in a year.

Prevalence of F a, attendances’ prevalence, diagnosis’ prevalence, Mean attendances generated by F a and frequency of visits by months were analysed.

Results

among 4824 attendances we found 181 F as (5.98%). Men represented 50.80% and women 49.20%. F a presented a mean of 6.33 attendances/year, while non-F a presented a mean of 1.29 attendances/year.

in accordance with frequency of visits by months, it was observed that number of attendances was increased in april and May, in both F a and non-F a.

Conclusion

Prevalence of F a was 5.98%, F a generated a 23.74% of attendances. Most prevalent F a’ diagnoses were: anxiety disorder, personality disorder non-specified and schizophrenia.

F a at emergency department contributes to overcrowd them. for this reason, it is important to take into account these results to develop new strategies to improve F a’ attention and prevent its occurrence.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Patients’ Characteristics Related with Risk of Being Restrained in acute Psychiatric Hospital in Romania
Authors: Mihai a. , Crainic M. , Mocan M. , alexiev I. , Sărmăan a.P. , Mihai a.
Published: May 2016

Seclusion and restraining in acute psychiatry wards is used when patients tend to harm themselves, other patients or staff members. Seclusion and restraining decision-making is a complex process based on risk of aggressivity, patient's diagnosis, history of violent incidents, staff experience, hospital internal regulations and national mental health law.

The aim of this study is to evidentiate the patients’ characteristics, which could be predisposed to restraining procedure in acute psychiatric setting in Romania.

Material and method

This is a two years retrospective study conducted on a total of 1000 patients (56.9 females, 43.1 males) randomly selected, admitted in acute psychiatric hospital. From these on 100 patients restraining techniques were applied.

Results and discussions

Out of the restrained patients male, younger usually suffering of personality disorder were more frequent restrained. Statistical analysis of restrained group characteristics comparing with larger group of the total patients admitted showed no significant differences between these two groups. Regressive analysis on different clusters found a higher risk to be restrained for patients with agitation and recurrent depressive disorder, male, from urban area. This study draws attention to the importance of a good study design and proper methodology.

Conclusion

The factors which influence the risk of being restrained in acute psychiatric setting are more related with behavior characteristics than diagnosis or demographical items.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
The Prevalence of The Burnout Syndrome among Population Examined at The Psychiatric Emergency Department for attempted Suicide
Authors: Perju E. , Gallois E.
Published: May 2016

Introduction

The intention of this study is to show the frequency of the burnout syndrome among the population seen at psychiatric ER for the most severe complication of the burnout, the suicide attempt.

Objective

(a) To demonstrate the frequency of burnout among the population examined at psychiatric ER for suicide attempt.

(b) To establish a correlation between the frequency of burnout and:

– the socio-demographic characteristics;

– the psychiatric follow-up;

– the type of personality found.

Methods

Descriptive study on a sample of 92 patients examined at psychiatric ER between 01/02/2014 and 01/06/2014 after a suicide attempt, seen by a single doctor. The patients received the Maslach Burnout inventory (MBI).

Results

The frequency of burnout among the population consulted for suicide attempts is 8.7%. The limitations of this study were: the use of MBI questionnaire only by one doctor and a collection of data carried on a certain period of time.

I managed to characterize the population seen after the suicide attempt induced by the burnout: 88% women; 25% foreign population working in a context with many responsibilities; the predominance of obsessive personality – 50%, followed by anxious personality type – 25%; the suicide attempt was done by a population without psychiatric history and without psychiatric follow-up – 75%; the studied population is divided between patients working in a high responsibility environment – 36% and patients working in the social or the public environment – 63%.

Eighty-eight percent of patients were brought in after their first suicide attempt.

Conclusion

Despite the fact that until now a unanimous definition has not been formulated on the CIM-10, the burnout syndrome is one of the most popular disorders.

The problematic is real, considering that this syndrome, which starts with a psychological distress, can escalade to a self-aggressive behaviour.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Case Report of Autointoxication with Nutmeg Committed By a Suicide attempter
Authors: Petrykiv S. , de Jonge L. , Michielsen P. , arts M.
Published: May 2016

Introduction

autointoxication with nutmeg in an emergency setting is a rare, but potentially a life-threatening event. Despite the low incidence of ‘tentamen suicidii’ (TS) with nutmeg, this substance is cheap and readily available. Early recognition of a suicide attempt with nutmeg poisoning can be extremely difficult, especially when nobody witnessed the nutmeg intake. Worldwide there are only a few cases reporting TS with nutmeg.

Objectives

To present a case of TS with nutmeg committed by a suicide attempter.

aims

To review available literature on TS with nutmeg.

Methods

a case report is presented and discussed, followed by a literature review.

Results

Five published cases of suicide attempts with nutmeg were found while searching through PUBMED and Embase. Our case describes a 57-year-old female, diagnosed with borderline personality disorder, who has been admitted to the emergency department in a state of agitation, diminished cognition, respiratory difficulties and hemodynamic instability. Electrocardiography showed a fast sinus arrhythmia with no uschemic or hypertropic changes. Blood sampling, serum and urine toxicology did not reveal any abnormalities. in view of the complexity of her condition, she admitted to have taken a large dose of nutmeg. The patient was kept for observation, offered reassurance, and rehydratation.

Conclusion

The presentation of inexplicable clinical state accomplished by disturbances of central nervous, respiratory and hemodynamic systems in the population of patients with attempting suicide should alert the physician to the rare but probably underreported possibility of nutmeg autointoxication.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Inhaled Loxapine for The Treatment of agitation in Borderline Personality Disorder
Authors: Puente R. , Rabito  alcon M.F. , Garcìa Jorge S. , Dolengevich Segal H. , Benítez  alonso M. , Gómez- arnau Ramírez J. , Garrido Beltrán a. , Rodríguez Quirós J. , Unzeta Conde B. , Pecero García O. , Correas Lauffer J.
Published: May 2016

Introduction

inhaled loxapine has shown efficiency in the treatment of the mild-moderate agitation syndrome of schyzophrenia and mania patients. Its rapid response and calming effect non-sedative allow to hypothesize reasonable efficiency and tolerability in borderline personality disorder diagnosed patients.

aims

analyze the efficiency and tolerability of inhaled loxapine as a pharmacological approach in the treatment of agitation in borderline personality disorder (BPD) clinical diagnosed patients.

Materials and method

an application was administered for every agitation episode in BPD patients treated with inhaled loxapine in the emergency room or the psychiatric ward, which included B aRS and CGI-S scales for the evaluation of each episode and its severity, before and after its use. Other secondary measures of efficiency were taken into account, such as requirement of physical restrain.

Results

in the majority of evaluated episodes inhaled loxapine decreased notably initial B aRS and CGI-S values and no serious clinical side effects attributable to this medication were observed.

Conclusion

in our sample, inhaled loxapine was efficiency and well tolerated pharmacological intervention for agitation in BPD patients.

Disclosure of interest

The authors have not supplied their declaration of competing interest.