bluuebunny/crossref_metadata_2025 huggingface dataset:
Angiotensin II type 1 receptor blockade diminishes negative effect of chronic stress on memory via upregulation of brain-derived neurotrophic factor
Authors: Wincewicz D. , Juchniewicz A.
Published: May 2016

Introduction

A critical need exists for progress in the characterization of targets for pro-cognitive drug discovery. We previously demonstrated that Telmisartan (TLM), an angiotensin type 1 receptor (AT1) blocker and partial agonist of peroxisome proliferator-activated receptor gamma (PPARγ), alleviates cognitive decline in chronically stressed rats. Understanding of mechanistic background of this phenomenon is hampered by both dual binding sites of TLM and limited data on the molecular consequences of central AT1 blockade and PPARγ activation.

Objectives

To discriminate molecular effects of AT1 blockade and PPARγ activation in stress induced memory impairment.

Aims

In this study, we investigated mechanism of neuroprotection provided by TLM in chronic psychological stress.

Methods

We analyzed BDNF gene expression in the hippocampus (HIP) and medial prefrontal cortex (mPFC) in chronically restrained stressed Wistar rats (2.5 h, 21 days), repeatedly treated with TLM (1 mg/kg), GW9662 (0.5 mg/kg) – a selective PPARγ receptor antagonist, or both in combination. TATA box binding protein (Tbp) was an internal control for expression studies.

Results

Alterations of mRNA expression of BDNF are shown on Figs. 1 and 2.

Conclusions

AT1 receptor blockade restores cognitive functions in chronically stressed subjects, which is associated with changes in primarily cortical gene expression.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Neuropsychiatric consequences of deep brain stimulation surgeries in the patients affected by chronic movement disorders: A brief report
Authors: Mahdavi S. , Malakouti S.K. , Naji B. , Asadi M. , Kahani S.
Published: May 2016

The main surgical procedure for PD and other chronic movement disorders is deep brain stimulation. DBS has been reported to have specific consequences such as decline in verbal fluency and episodes of depression.

We designed an interventional study in 12 patients affected by Parkinson, dystonia and tic who underwent DBS surgery. Patient assessed before surgery, one month and one year after surgery.

The results proved a significant improvement in SF36. The Hamilton's anxiety scale showed an overall but insignificant improvement. The mean of scores of the BDI had a great drop one month after surgery but a raise at the 12th month (insignificant pattern).

Pearson's correlation test showed a significant negative correlation between age and the SF36 scores. The BDI's scores were assessed in relation with age. Although there was no actual relation between them before surgery, we detected a positive correlation between them after one year.

Conclusion

The pattern of changes can be related with the differences between perioperative expectations and real long-term outcomes. Correlations between changes seen in BDI and SF36 scores with age can be considered as a confirmatory evidence for this idea.

All cases showed an insignificant gradual decline in digit span test, which may be independent of the surgical procedure. Although the COWA test could not prove a significant deterioration in verbal fluency but a slight decline after one year was obvious, in addition to one patient who turned aphasic during this period.

The outcomes showed that the benefits of DBS outweigh the slight risk of developing depression.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Differential serum acute-phase biomarker profile in schizophrenia and bipolar disorder
Authors: Arranz B. , Sanchez M. , Garriga M. , Safont G. , Garcia-Portilla P. , Sierra P. , San L.
Published: May 2016

There is a growing interest in inflammation and immune dysfunction in severe psychiatric disorders such as schizophrenia and bipolar disorder. This dysfunction seems to consist in abnormal blood levels of cytokines and acute-phase proteins, with increased levels of C-reactive protein (CRP), fibrinogen, homocysteine and erythrocyte sedimentation rate (ESR). Higher levels can be found in acute episodes and in patients with a higher cardiovascular risk.

Acute-phase protein serum parameters were determined in a sample of 100 outpatients with schizophrenia (n = 50) or bipolar disorder (n = 50) so as to assess differences in pro-inflammatory state. Metabolic state was assessed through BMI, waist circumference, glucose, cholesterol and triglyceride levels.

The whole sample showed higher levels of fibrinogen (mean 4 ± 0.9 g/L), triglycerids (mean 2.9 ± 8.5 mmol/L), cholesterol-LDL (mean 3 ± 0.9 mmol/L), and homocysteine (mean 16.2 ± 7.3 umol/L) than our laboratory reference values from healthy individuals.

After correcting for gender and pharmacological treatment, patients with schizophrenia showed higher levels of ESR, fibrinogen, glucose and CRP, while homocysteine was not statistically different between patients with schizophrenia or bipolar disorder (see Table 1).

These results may suggest a different biomarker profile in bipolar and schizophrenic outpatients, with a more severe pro-inflammatory state in schizophrenia. Serum homocysteine levels could be a state marker in both disorders.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Lifetime antipsychotic use and brain structures in schizophrenia and other psychoses – 43-year study of the Northern Finland Birth Cohort 1966
Authors: Huhtaniska S. , Korkala I. , Heikka T. , Tohka J. , Manjon J. , Coupe P. , Remes J. , Moilanen J. , Kiviniemi V. , Björnholm L. , Isohanni M. , Veijola J. , Murray G. , Jääskeläinen E. , Miettunen J.
Published: May 2016

Introduction

The effects of long-term antipsychotic medication use on structural brain changes in psychoses are still unknown. Severity and duration of illness are key confounders when evaluating antipsychotic effects on brain morphology.

Objectives

Understanding the role of antipsychotic medication on brain morphology in psychoses.

Aims

To analyze whether cumulative lifetime or current antipsychotic medication dose relates to brain morphology in schizophrenia and other psychoses at age of 43 years.

Methods

Forty-four schizophrenia cases and 35 with other psychoses from the Northern Finland Birth Cohort 1966 were scanned on a 1.5T GE Signa scanner and brain structures were extracted using volBrain automated volumetry system (http://volbrain.upv.es). Data of antipsychotic medication were collected from medical records and interviews. We used linear regression model to analyze the effect of antipsychotic medication on brain volumes and used intracranial volume and onset age as covariates. We also performed additional analyses adding psychotic symptoms (PANSS Total score) as a covariate.

Results

Higher lifetime and current dose associated to left lateral ventricle increase (b = 0.33, P = 0.033; b = 0.307, P = 0.042, respectively) and right and left accumbens decrease (b = −0.405, P = 0.013, b = −0.404, P = 0.010; b = −0.302, P = 0.027, b = −0.282, P = 0.036, respectively) in schizophrenia but not in other psychoses. When PANSS was added to the model, the findings remained regarding right and left accumbens, but not regarding left lateral ventricle.

Conclusions

It seems that antipsychotic medication affects the brain in schizophrenia, but not in the heterogeneous group of other psychoses. In schizophrenia, brain changes associated to antipsychotic medication cannot be explained by illness duration or symptom severity.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Affectivity during social behaviour in a schizophrenic-like rat
Authors: Kai L. , Gill D. , Wegener G. , Tasker A.
Published: May 2016

Introduction

Rats are social animals that produce high-frequency whistles said to reflect their underlying affective state. Injecting rats with a glutamate agonist (domoic acid) at a sensitive period of brain development, models aspects of schizophrenia. This is known as the neonatal DOM model.

Aims

We investigated whether DOM rats display altered social behaviour – as seen in patients with schizophrenia – using their high-frequency whistles as a proxy for the emotional valence of social situations.

Methods

We used 19 male Sprague Dawley rats, injected with either a low-dose of domoic acid or saline at postnatal days 8 to 14. The social behaviour of the rats was investigated at four levels:

– anticipation of social interaction;

– dyadic encounter;

– three-chamber test;

– tickling.

Tests were carried out at postnatal days 34 to 40 and 50 to 56. Rat whistles were recorded on all days of testing.

Results

In progress.

Conclusions

The interest in rat whistles as a supplement to traditional behavioural tests has increased. New software allows for detailed qualitative analysis of the whistle subtypes and thus new complexity to their interpretation. This study can help unravel information encoded in the whistles and shed light on the social behaviour of the DOM rat thus investigating it is applicability as a model of schizophrenia.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Trends of hospitalization for schizoaffective disorder (SD) in USA: A nationwide analysis
Authors: Mansuri Z. , Shambhu S. , Yadav P. , Rathod M. , Mansuri U.
Published: May 2016

Objectives

Schizoaffective disorder (SD) is an important cause of morbidity and mortality in hospitalized patients. While SD has been extensively studied in the past, the contemporary data for impact of SD on cost of hospitalization are largely lacking.

Methods

We queried the Healthcare Cost and Utilization Project's Nationwide Inpatient Sample (HCUP-NIS) dataset between 1998–2011 using the ICD-9 codes. Severity of comorbid conditions was defined by Deyo modification of Charlson comorbidity index. Primary outcome was in-hospital mortality and secondary outcome was total charges for hospitalization. Using SAS 9.2, Chi2 test, t-test and Cochran-Armitage test were used to test significance.

Results

A total of 4,66,800 patients were analyzed; 50.90% were female and 49.10% male (P < 0.0001); 61.15% were white, 25.97% black and 12.88% of other race (P < 0.0001). Rate of hospitalization increased from 13,035.05/million to 26,703.21/million from 1998–2011. Overall mortality was 0.50% and mean cost of hospitalization was 20,995.19$. The in-hospital mortality increased from 0.46% to 0.50% (P < 0.0001) and mean cost of hospitalization increased from 11,504.94$ to 31,460.67$. Total spending on SD related admissions increased from $1.2 billion/year to $6.6 billion/year.

Conclusions

While mortality has slightly increased from 1998 to 2011, the cost has significantly increased from $1.2 billion/year to $6.6 billion/year which leads to an estimated $5.4 billion/year additional burden to US health care system. In the era of cost conscious care, preventing SD related hospitalization could save billions of dollars every year. Focused efforts are needed to establish preventive measures for SD related hospitalization.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Trends of hospitalization for schizophrenia in USA: A nationwide analysis
Authors: Mansuri Z. , Rathod M. , Sutaria A. , Shambhu S. , Yadav P. , Mansuri U.
Published: May 2016

Objectives

Schizophrenia is an important cause of morbidity and mortality in hospitalized patients. While schizophrenia has been extensively studied in the past, the contemporary data for impact of schizophrenia on cost of hospitalization are largely lacking.

Methods

We queried the Healthcare Cost and Utilization Project's Nationwide Inpatient Sample (HCUP-NIS) dataset between 1998–2011 using the ICD-9 codes. Severity of comorbid conditions was defined by Deyo modification of Charlson comorbidity index. Primary outcome was in-hospital mortality and secondary outcome was total charges for hospitalization. Using SAS 9.2, Chi2 test, t-test and Cochran-Armitage test were used to test significance.

Results

A total of 443,659 patients were analyzed; 38.78% were female and 61.22% were male (P < 0.0001); 48.19% were white, 35.30% black and 16.51% of other race (P < 0.0001). Rate of hospitalization increased from 56,768.47/million to 79,44466/million from 1998–2011. Overall mortality was 0.70% and mean cost of hospitalization was 23,568.47$. The in-hospital mortality decreased from 0.75% to 0.73% (P < 0.0001) and mean cost of hospitalization increased from 12,775.64$ to 36,768.58$. Total spending on schizophrenia related admissions have increased from $1.75 billion/year $6.23 billion/year.

Conclusions

While mortality has slightly decreased from 1998 to 2011, the cost has significantly increased from $1.75 billion/year to $6.23 billion/year which leads to an estimated $4.48 billion/year additional burden to US health care system. In the era of cost conscious care, preventing schizophrenia related hospitalization could save billions of dollars every year. Focused efforts are needed to establish preventive measures for schizophrenia related hospitalization.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Effectiveness of long-acting injectables and clozapine in a real-world setting during the early-stages of psychotic illness
Authors: Ostinelli E.G. , Guanella E. , Cavallotti S. , Casetta C. , D’Agostino A.
Published: May 2016

Introduction

Intervention in the early-stages of psychosis may be able to shape the clinical course; critical period (CP) is best represented by the first 5 years from first admission (FA).

Objectives

To investigate the effectiveness of pharmacological intervention within and beyond the CP.

Aims

(1) To compare hospitalization rates of patients stabilized on treatment with LAIs and CLZ. (2) To determine whether treatment with LAIs and CLZ within CP can influence hospitalization rates.

Methods

Data were retrospectively collected from patients diagnosed with non-affective psychoses with FA between 2000 and 2014; 200 patients were then divided into three groups, according to stabilized treatment regimen during the final year of observation: treatment as usual (TAU), CLZ, LAIs. hospitalization duration (HSPD) and frequency (HSP) were calculated for each group.

Results

Despite a major severity before assignment to either CLZ or LAIs treatment, HSPD and HSP in both groups shifted below those observed for the TAU arm. Patients who began treatment with LAIs within the CP showed a highly significant decrease of both HSPD and HSP (respectively 17.4 ± 18 vs. 2.6 ± 8.2; Z = −2.856; P < 0.005 and 1.1 ± 0.8 vs. 0.2 ± 0.5; Z = −3.115; P < 0.005). No significant changes in hospitalization rates were observed for subjects who began treatment with LAIs after the CP.

Conclusions

Our study confirms that treatment with either CLZ or LAIs significantly impacts the course of psychotic disorders. The data seem to suggest that LAIs and CLZ should be considered more effective than conventional oral antipsychotics in the early-stages of psychotic illness. The difference among treatments tends to wane beyond the CP, especially for LAIs.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Metabolic syndrome in patients with schizophrenia receiving long-term treatment with lurasidone, quetiapine XR, or risperidone
Authors: Newcomer J. , Tocco M. , Pikalov A. , Zheng H. , Cucchiaro J. , Loebel A.
Published: May 2016

Introduction

Lurasidone has demonstrated low propensity for metabolic disturbance in adult patients with schizophrenia in short-term studies.

Objectives

To evaluate metabolic syndrome occurrence during long-term lurasidone treatment in patients with schizophrenia.

Aims

To compare metabolic syndrome rates with lurasidone versus other antipsychotic agents.

Methods

Metabolic syndrome rates (as defined by the US National Cholesterol Education Program-Adult Treatment Panel III) were evaluated in adult patients with schizophrenia treated with lurasidone in 2 long-term, active-controlled studies (quetiapine XR or risperidone). In the quetiapine XR-controlled study, patients completing a 6-week, double-blind, placebo-controlled, fixed-dose trial of lurasidone (74 mg/d or 148 mg/d) or quetiapine XR (600 mg/d) continued on double-blind, flexibly dosed lurasidone (37–148 mg/d) or quetiapine XR (200–800 mg/d) for up to 12 months. In the risperidone-controlled study, patients received double-blind, flexibly dosed lurasidone (37–111 mg/d) or risperidone (2–6 mg/d) for up to 12 months.

Results

Among patients without metabolic syndrome at baseline in the quetiapine XR-controlled study, 2.4% (2/84) of lurasidone-treated patients and 7.4% (2/27) of quetiapine XR-treated patients developed metabolic syndrome at month 12 (P = NS). Of patients without metabolic syndrome at baseline in the risperidone-controlled study, 10.3% (12/117) and 23.2% (16/69) of lurasidone- and risperidone-treated patients, respectively, developed metabolic syndrome at month 12 (P = 0.02).

Conclusions

Long-term treatment with lurasidone was associated with lower rates of metabolic syndrome in patients with schizophrenia compared to treatment with quetiapine XR or risperidone.

Support

Sunovion Pharmaceuticals Inc.

ClinicalTrials.gov identifiers

NCT00789698, NCT00641745.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Trends of hospitalization for schizophreniform disorder in USA: A nationwide analysis
Authors: Rathod M. , Mansuri Z. , Shambhu S. , Karnik K. , Sutaria A. , Mansuri U.
Published: May 2016

Objectives

Schizophreniform disorder (SD) is an important cause of morbidity and mortality in hospitalized patients. While SD has been extensively studied in the past, the contemporary data for impact of SD on cost of hospitalization are largely lacking.

Methods

We queried the Healthcare Cost and Utilization Project's Nationwide Inpatient Sample (HCUP-NIS) dataset between 1998–2011 using the ICD-9 codes. Severity of comorbid conditions was defined by Deyo modification of Charlson comorbidity index. Primary outcome was in-hospital mortality and secondary outcome was total charges for hospitalization. Using SAS 9.2, Chi2 test, t-test and Cochran-Armitage test were used to test significance.

Results

A total of 8645 patients were analyzed; 36.21% were female and 63.79% were male (P < 0.0001); 49.04% were white, 39.06% black and 19.9% of other race (P < 0.0001). Rate of hospitalization decreased from 599.22/million to 394.47/million from 1998–2011. Overall mortality was 0.23% and mean cost of hospitalization was 17930.23. The in-hospital mortality reduced from 0.21% to 0.15% (P < 0.0001) and mean cost of hospitalization increased from 9662.88$ to 27,749.68$ from 1998–2011. Total spending on SD related admissions have increased from $47.59 million/year to $853.83 million/year.

Conclusions

While mortality has slightly decreased from 1998 to 2011, the cost has significantly increased from $47.59 million/year to $853.83 million/year, which leads to an estimated $806.24 million/year additional burden to US health care system from 1998 to 2011. In the era of cost conscious care, preventing SD related hospitalization could save billions of dollars every year. Focused efforts are needed to establish preventive measures for SD related hospitalization.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Does family history of schizophrenia affect the severity of disease?
Authors: Sisek-Šprem M. , Herceg M. , Jukić V.
Published: May 2016

Introduction

Previous studies have demonstrated that family history is associated with earlier age at onset, severity of positive and negative symptoms, and the duration of untreated illness. Hereditary factors may contribute a vulnerability for antisocial and/or violent behaviour per se, and for other stable characteristics such as aggressive behaviour.

Aim

To analyze the impact of family history of schizophrenia and aggressive behavior among members of family on severity of disease and aggressive behavior of patients.

Method

The study population consisted of 120 male schizophrenic patients classified into non-aggressive (n = 60) and aggressive (n = 60) groups, based on indication for admission in hospital (aggression/anything else but aggression). For severity of disease, we assessed psychopathology using the Positive and Negative Syndrome Scale (PANSS), the number of hospitalizations and the total equivalent dose of therapy (collected from medical record). The presence of a family history and aggression in family was assessed using a semi-structured interview of patients and, when available, family members.

Results

Twenty-seven (22.5%) participants were determined to have at least one family member with schizophrenia or another psychotic disorder, with no difference between aggressive (10%) and non-aggressive (12.5%) group. There was no significant interaction between family history and severity of disease (PANSS, number of hospitalizations, total equivalent dose of therapy). Aggressive behaviour in first-degree family member had no influence on aggressive behaviour of patients with schizophrenia.

Conclusion

Family history of schizophrenia does not affect the severity of disease nor aggressive behaviour.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
The role of modified states of consciousness in drug use
Authors: Freitas C. , Mendes A.M. , Queirós S.
Published: May 2016

Modified state of consciousness (MSC) is defined as a mental state that can be subjectively recognized by an individual or by an objective observer of the individual, as representing a difference in the psychological functioning of the “normal” state, alert and awake of the individual. Drugs are products with definitions and conceptual boundaries, historically defined. The use of psychoactive drugs is related to the increased plasticity of human subjectivity which is reflected in various technical means to change the perception, cognition, affect and mood. The authors propose to conduct a literature review on the types of MSC, the way to achieve them and their implications in drug consumption pattern.

A MSC consists of dimensions such as self-oceanic limitlessness, agonizing self-dissolution and visionary restructuring.

Normal MSC includes dreams, hypnagogic state and sleep. Others may be induced by hypnosis, meditation or psychoactive substances. Those achieved by drugs allow the subject to access feelings and sensations which go beyond the everyday reality or, on the other hand, leakage of reality.

Anthropological studies show that in almost all civilizations, man sought ways to induce MSC.

What characterizes the problematic or abusive use of certain substances is not necessarily the amount and frequency of drug use, but the disharmony in the socio-cultural, family and psychosocial contexts of the individual.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Sensory hypersensitivity predicts reduced sleeping quality in patients with major affective disorders
Authors: Serafini G. , Engel-Yeger B. , Gonda X. , Pompili M. , Rihmer Z. , Amore M.
Published: May 2016

Introduction

Major affective disorders ranging from subthreshold affective temperaments to severe affective diseases and anxiety, are frequently associated with sleep–wake dysregulation. Interestingly, recent studies suggested an active role of Sensory Processing Disorders (SPD) in the emergence of sleep disturbances.

Objectives

The objective of this study was to investigate the relationship between SPD and sleep quality in subjects with major affective disorders and specific affective temperaments.

Aims

This study aimed to examine the sensory profile (expressed in hypersensitivity or hyposensitivity) of patients with major affective disorders and its relative contribution to the prediction of sleep quality while also considering affective temperaments and depression, known as factors that may impact sleep quality.

Methods

We recruited 176 participants (mean age = 47.3) of which 56.8% have unipolar depression and 43.2% bipolar disorder. Reduced sleep quality was evaluated using the Pittsburgh Sleep Quality Index (PSQI) whereas affective temperaments were assessed using the Temperament Evaluation of Memphis, Pisa, Paris and San Diego (TEMPS).

Results

Sensory hypersensitivity, assessed using Adolescent/Adult Sensory Profile (AASP), significantly distinguished between poor and good sleepers. Sleep quality was mainly predicted by the Beck Depression Inventory-II total score and anxious temperament. Yet, sensory hypersensitivity contributed to this prediction mainly in regard to sleep efficiency and related daytime dysfunctions.

Conclusions

The careful assessment of the unique sensory profile and its behavioral/functional influence on patients’ quality of life may help clinicians and health providers in developing targeted treatment interventions.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Relation between substance of abuse and demographic characteristics, medical and psychiatric history in patients with substance related disorders
Authors: Herrera S. , Riquelme A. , León T. , Babul M.
Published: May 2016

Introduction

Substance related disorders is a problem of global concern because of the high prevalence and costs for patients and society. In one of the latest surveys, 52% of the American population reported being current alcohol drinkers and 6.3% admitted being heavy drinkers. In addition, 9.4% are illicit drug users, being marijuana the most commonly used.

Objectives

To determine whether there is a relation between the substance of abuse and the demographic characteristics, medical and psychiatric comorbidities of patients with substance use disorder.

Patients and methods

This correlational study examined data of 218 patients with substance use disorder (DSM-5), that consulted at the Addiction Unit of “Red de Salud, Pontificia Universidad Católica de Chile”, between April 2012 and September 2015. Data included: demographics, medical and psychiatric history, laboratory and imaging tests.

Results

Out of all the patients, 57% suffered from alcohol use disorder, whereas 21% abused of marijuana, 20% of cocaine and 8% of benzodiazepines. There was a correlation between alcohol use disorder and being over 40 years of age, being separated and having higher educational studies. For marijuana, being under 40 years of age, being single and having no medical comorbidities. For cocaine, not being single. For benzodiazepines, being over 40 years of age, being separated and having medical comorbidities. All of these correlations were statistically significant.

Conclusion

These results emphasize on the complexity of these patients and on the important contrast created between age, marital status, level of education and prevalence of comorbidity depending on the abused substance.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Treatment of patients with opioid addiction with different disease duration
Authors: Khodjaeva N. , Sultanov S.
Published: May 2016

To study the characteristics of medical and rehabilitation care for patients with opioid dependence we have investigated 50 patients. All patients on long-term use of opioids were divided into 2 groups. The duration of drug abuse in group 1 ranged from 4 months up to 5 years. In the second group, the duration of dependence was more than 5 years. Patients in the second group of somatic-neurological symptoms were having somatic disorders and organic brain damage. Systematic observation in drug treatment clinics at the place of and maintenance treatment of at least one year was achieved in 8.48% of patients of group 1 and 3.85% of the second group. Consequently, the role of the therapeutic factor in trying to achieve regression syndrome pathological attraction in early stages of the disease, we recognize more productive. Patients of the second group with a large weighting of disease duration was noted clinical abstinence syndrome both by somatic and neurological disorders, as well as by more severe anxiety, dysphoric disorders. These disorders require the inclusion in the scheme of treatment techniques aimed at more effective detoxification and immune reactivity of the organism. Patients of the second group was added to the treatment nootropics and immunomodulators. Analysis of the results of treatment in patients with drug addiction with different disease duration showed significant differences in the effectiveness. In the second group with a duration of more than 5 years of addiction, it is advisable to the treatment nootropics, immunomodulators.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
The Internet addiction and the correlation with the socio-economic crisis in students of University of applied sciences of Thessaly (TEI of Thessaly)
Authors: Kotrotsiou S. , Katsavria V. , Kotrotsiou E. , Gourgoulianis K. , Gouva M. , Paralikas T. , Hatzoglou C.
Published: May 2016

Introduction

Use of the Internet lately has significantly been increased worldwide. The time users spend browsing the Internet is constantly increased resulting to serious consequences incurred in personal, professional and social life.

Aim

The purpose was to explore whether the economic crisis is affecting the use and addiction to Internet, whether the economic crisis is a risk factor in the appearance of addiction to the Internet and if the occupation and the existence of extra-curricular activities act as barriers to the development of addiction to the Internet on students.

Methods

A questionnaire was prepared based on the diagnostic tool IAT (Internet Addiction Test). The survey was conducted in June of 2014 on 632 students.

Result

It was found that 6.2% of the sample population has moderately addictive behavior and 0.5% has a serious addiction. Addiction levels to the Internet are affected by someone working while studying and his monthly income, by daily time spent by the student in activities besides school, by the time spent daily on the Internet and by the operations mostly used. Also found that the risk of developing Internet addiction is higher among students who said they had difficulty paying their bills and Internet subscription and to those who due to economic crisis would stop all their activities in order to obtain money.

Conclusions

The economic crisis is a factor that affects on Internet addiction and occupation and activities may act as a deterrent to the emergence of the phenomenon.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Delusional symptoms with alcohol
Authors: Montes Reula L. , Ballesteros Prados A.
Published: May 2016

A patient is twenty-eight years old who comes to the emergency services because he has visual hallucinations related to alcohol consumption. He only consumes alcohol sporadically in leisure time. Since he began drinking at 18 years he has presented these symptoms in only four occasions. He does not relate with a more quantity of alcohol or another stressors. After a few minutes, these symptoms disappear and so he criticizes.

It is about of study through a clinical case the alcoholic hallucinosis, their characteristics and to see the differences in the patient. The patient in the acute phase presents a view of reality altered that later he recovers. There is no loss of consciousness or behavioral disorders. There are similarities with a pathological intoxication but there is not a regular relationship between consumption and symptoms.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Exercise addicts with injuries are in risk of depression
Authors: Lichtenstein M. , Andersen K. , Jørgensen U.
Published: May 2016

Introduction

Exercise addiction is characterized by increasing exercise amounts, withdrawal symptoms and lack of control. Exercisers with addiction continue to exercise in spite of pain and injury because they use exercise to regulate emotions, identity and self-esteem. How do they react to injuries?

Objectives

It is hypothesized that exercise addiction is a risk factor for emotional distress when an injury occur due to withdrawal symptoms and lack of identity.

Aims

To estimate the prevalence of exercise addiction in exercisers with injuries at the musculoskeletal system and to test the relationship between addiction and emotional distress (depression and stress).

Methods

The Exercise Addiction Inventory was used to identify exercise addiction. To measure depression and stress we used the Major Depression Inventory (MDI) and the Perceived Stress Scale (PSS). Participants (n = 694) were regular exercisers with injuries at foot, knee or shoulder at an orthopedic hospital department.

Results

The prevalence of exercise addiction was 7.6%. We found that exercisers with addiction reported more emotional distress in terms of higher MDI-scores 18.0 (SD = 11.0) versus 11.7 (SD = 9.1); P = 0.00 and in total PSS-score 17.6 (SD = 7.2) versus 13.9 (SD = 6.8); P = 0.00. Chi2 analyses showed that 25% of the addicted exercisers met the criteria for clinical depression, while only 11% of the non-addicted exercisers were depressed; P = 0.00.

Conclusions

Exercisers with addiction appear at somatic departments treating musculoskeletal injuries. It is a vulnerable group characterized by elevated levels of depressive symptoms and clinical stress. We recommend to offer psychological interventions focusing on emotional distress and prevention of re-injury by reducing excessive and obsessive exercise patterns.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Personality disorders: Which personality features lead to a comorbid substance use disorder?
Authors: Lombardi A. , Rossi A. , Gramaglia C. , Girardi L. , Zeppegno P.
Published: May 2016

Introduction

Dual Diagnosis (DD) refers to coexistence of a psychiatric disorder, which is often a Personality Disorder (PD), and a Substance Use Disorder (SUD). Despite DD is a topic of interest in recent years, few studies have focused on the temperament and character traits of PD patients with or without a comorbid SUD. Anyhow, the assessment of personality traits may be helpful to understand the relation among psychiatric disorder, drug use and environment in patients with addictive behaviors.

Aims

The aim of this study is to compare two subgroups of PD patients, with and without a comorbid SUD. Sociodemographic, clinical and personality profile, as assessed with the Temperament and Character Inventory, will be compared.

Methods

We are recruiting patients with a PD diagnosis referring either the psychiatry ward or outpatient service of the AOU “Maggiore della Carità”, Novara, Italy; secondly, we will group them according to the presence/absence of SUD. Cloninger's TCI-R will be administered together with a structured interview to gather sociodemographic and clinical information.

Results

Data collection is ongoing; we expect to find a different personality profile in PD and DD Patients.

Conclusions

Temperament, which is the biological part of the personality, seems to have an important role in addictive behavior; therefore assessing the personality traits of DD patients can help to improve the differential diagnosis and to establish strategies for treatment and prevention. In particular, sensation seeking and impulsivity are temperamental characteristics that may favor SUD in patients with psychiatric disorders.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Childhood trauma in suicide attempters: Case-control study
Authors: Jimenez-Trevino L. , Gonzalez-Blanco L. , Garcia-Portilla M.P. , Blasco Fontecilla H. , Lopez Castroman J. , Courtet P. , Carli V. , Sarchiapone M. , Baca-Garcia E. , Saiz Martinez P. , Bobes Garcia J.
Published: May 2016

Introduction

An expanding body of research suggests that childhood trauma and adverse experiences can lead to a variety of negative health outcomes, including substance abuse, depressive disorders, and attempted suicide among adolescents and adults. Alcoholism, depressed affect, and illicit drug use, which are strongly associated with such experiences, appear to partially mediate this relationship as observed in population studies.

Objectives

We have tested the association between early trauma and suicide attempts in a sample of suicide attempters from the Eureca International Project and a matched healthy control sample.

Methods

We have studied the prevalence of childhood stressful events compared with healthy controls in a multicentre sample of 791 suicide attempters (SA) and 630 healthy controls (C), we have measured childhood parental neglect, physical abuse, sexual abuse, and emotional abuse, using the Childhood Trauma Questionnaire (CTQ). Chi2 tests were performed using SPSS v15.0.

Results

A significant increase in prevalence of childhood trauma was found in the suicide attempters sample for all types of trauma: childhood physical abuse: 25.3% (SA) vs. 11.1% (C) (Chi2 test: 120,108 P = 0.000); childhood sexual abuse: 18.2% (SA) vs. 2.4% (C) (Chi2 test: 88,212 P = 0.000); parental neglect 25.3% (SA) vs. 1.1% (C) (Chi2 test: 164,910 P = 0.000); childhood emotional abuse: 34.9% (SA) vs. 5.6% (C) (Chi2 test: 176,546 P = 0.000).

Suicide attempters were increasingly overrepresented compared with controls if experiencing more than 1 trauma: represented 77% of the sample who suffered 1 type of childhood trauma vs. more than 90% of the sample with 2 or more types of trauma.

Conclusions

A powerful graded relationship exists between adverse childhood experiences and risk of attempted suicide.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Epidemiological profile of drug users in Tunisia
Authors: Sellami R. , Messedi N. , Feki I. , Trigui D. , Zahaf A. , Masmoudi J.
Published: May 2016

Introduction

Changing cultural values and increasing economic stress are leading to initiation into substance use. Despite religious and legal constraints on Muslims against the consumption of drugs, drug addiction is a widespread problem and is destroying the lives of many individuals and families, in Tunisia.

Objectives

To examine the socio-demographic characteristics of Tunisian addicts and to identify the drugs commonly used.

Methods

This was a cross-sectional study, which included 200 patients at the addiction treatment center “Aide et Ecoute” in Sfax (Tunisia). The survey was conducted during the month of January to September 2014.

Results

Only males were found to get treatment in the addiction center for various addictions. The mean age was 33.32 years and the mean age for starting substance use was 17.30 years. More than half (65.9%) were not married and 59.5% had involvement with criminal justice. Substance dependence was commonly seen in poor and middle socioeconomic class. The most common substance used was buprenorphine (34.8%). There was a significant relation between buprenorphine consumption and immigration (P= 0.013). Peer pressure was one of the most important factors for trial of substance in our study.

Conclusion

As the mean age of initiation of substance abuse was early twenties, in liaison with schools and colleges, some recreational activities can be generated to prevent diversion of youth towards the devil of drug abuse.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Misuse of pregabalin: Case series and literature review
Authors: Suardi N.E. , Preve M. , Godio M. , Bolla E. , Colombo R.A. , Traber R.
Published: May 2016

Introduction

Pregabalin is widely used in neurology, psychiatry and primary healthcare, and recently in literature different studies explain the possible misuse [1,2]. Pregabalin has shown greater potency in preclinical models of epilepsy, pain and anxiety, and may have potential in the treatment of cocaine addiction [3]. The purpose of this report is to review the clinical evidence for the potential of abuse and misuse of pregabalin. We propose ten different cases and literature review.

Method

Ten inpatients with misuse of pregabalin were assessed with: the SCID-P, Anamnestic Folio, HAM-A and DAST. We conducted a systematic review of the literature (PubMed, Embase, PsychInfo), using the terms “pregabalin”, “misuse”.

Results

All our patients present: cocaine, alcohol and/heroin positive in drugs urine screening at admission; a significant high level of total anxiety at the HAM-A Tot (P < .001), and especially at the item 7 (P < .001); the misuse of pregabalin is made for sniffing; the predominant symptoms assessed were euphoria, psychomotor activation and sedation.

Discussion and conclusion

Schifano F et al., [1,2] suggest that pregabalin should carefully prescribe in patients with a possible previous history of drug abuse. Our result identifies a particular population the misuse pregabalin that are abuser of cocaine, alcohol and/or heroin. Further research is warranted to replicate our clinical and qualitative observations and, in general, quantitative studies in large samples followed up over time are needed. Methodological limitations, clinical implications and suggestions for future research directions are considered.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
A randomized controlled trial of an internet-delivered treatment: Its potential as a low-intensity community intervention for adults with symptoms of depression
Authors: Richards D. , Timulak L. , Vigano N. , O’Brien E. , Doherty G. , Sharry J. , Hayes C.
Published: May 2016

Introduction

Internet-delivered treatments for depression have proved successful, with supported programs offering the potential for improved adherence and outcomes. Internet interventions are particularly interesting in the context of increasing access to interventions, and delivering interventions population-wide.

Objective

Investigate the potential feasibility and effectiveness of an online intervention for depression in the community.

Aims

Establish the effectiveness of a supported online delivered cognitive behavioural intervention for symptoms of depression in adults in the community.

Methods

The study was a randomized controlled trial of an 8-module internet-delivered cognitive behavioral therapy (iCBT) program for adults with depressive symptoms (n = 96) compared to a waiting-list control group (n = 92). Participants received weekly support from a trained supporter. The primary outcome was depressive symptoms as measured by the Beck Depression Inventory (BDI-II). The program was made available nationwide from an established and recognized charity for depression.

Results

For the treatment group, post-treatment effect sizes reported were large for the primary outcome measure (d = 0.91). The between-group effects were moderate to large and statistically significant for the primary outcomes (d = 0.50) favoring the treatment group. Gains were maintained at 6-month follow-up.

Conclusion

The study has demonstrated the efficacy of the online delivered space from depression treatment. Participants demonstrated reliable and statistically significant changes in symptoms from pre- to post-intervention. The study supports a model for delivering online depression interventions population-wide using trained supporters.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Disrupted homeostasis during chronic ethanol consumption associated with specific mechanism of endogenous neurosteroids activity
Authors: Shushpanova T. , Bokhan N. , Mandel A. , Solonsky A. , Novozheeva T. , Semke A. , Lebedeva V. , Kazennykh T. , Udut V. , Arbit G. , Philimonov V. , Markova E.
Published: May 2016

Introduction

Neurobiological research describes one of mechanisms overlap in the Cortico-Striatal-Limbic Circuit (CSLC), which can be disrupted due to chronic stress and alcohol abuse that primarily modulated by the hypothalamic-pituitary-adrenal (HPA) axis, from which cortisol is an end-product.

Objectives

To investigate the effects of chronic stimulant abuse on the CSLC. This was examined by relating cortisol levels with grey matter volume in brain structures associated with addiction and stress.

Aims

We hypothesized that stimulant-dependent individuals show increased cortisol levels and abnormalities in the CSLC. We further hypothesized relationships between altered grey matter volume and increased cortisol levels in the patients.

Methods

Twenty-two alcohol-dependent individuals, men only and 21 healthy volunteers (matched for age and gender) underwent an assessment session. Cortisol, DHEA and DHEA-S was assessed in blood plasma. Mood, impulsivity and compulsivity were measured by clinical instruments.

Results

Alcohol-dependent individuals showed higher levels of cortisol in blood plasma, and decreased levels of progesterone and its metabolites DHEA and DHEA-S, which were associated with distinct expression in impulsivity and compulsivity in alcoholic patients. Indices of these steroids were changed compared with healthy persons. Plasma cortisol was positively correlated with the duration of alcohol use. The relationships observed between cortisol, progesterone and its metabolites: DHEA and DHEA-S may be explained by abnormal functioning of HPA axis.

Conclusions

Optimizing of disrupted homeostasis during chronic ethanol consumption being provided with specific mechanism by manipulation of endogenous neurosteroids activity may prove a beneficial pharmacotherapeutic strategy in the intervention of alcohol abuse.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Therapeutic efficacy of original anticonvulsant meta-chloro-benzhydrylurea (m-ch-BHU) in the treatment of patients with a compulsive craving for alcohol
Authors: Shushpanova T. , Bokhan N. , Mandel A. , Lebedeva V.
Published: May 2016

Introduction

The problem of the treatment of alcohol addiction is very difficult due to the reoccurrence of relapses. One of the major concepts of the formation of alcohol addiction is the concept of epileptic origin of compulsive craving for alcohol.

Objective

We investigated therapeutic efficacy of long-term dosing of original anticonvulsant (m-ch-BHU) on symptoms of alcohol withdrawal syndrome (AWS) in patients with a compulsive craving for alcohol.

Methods

Sixty-eight male alcoholic patients aged from 24 to 53 years with different levels of alcohol abuse were examined. Type of course of alcoholism in examined patients was of middle-progressing character. Clinical evaluation of state of patients was carried out with traditional clinical description. Quantitative characterization was conducted according to Hamilton Anxiety Scale and Hamilton Depression Scale. m-ch-BHU was administered to alcoholic patients at dose from 300 mg a day during 21 days against the background of conventional medication as well as in post-withdrawal period under various degrees of severity of affective disorders.

Results

Among affective disorders dysphoric symptoms have a marked tropism for m-ch-BHU. Of the other clinical manifestations in the structure of AWS cerebral diencephalic paroxysms, cardiovascular and myofascial symptoms have the most pronounced sensitivity to the drug. In patients with complicated forms of alcoholism application of m-ch-BHU is effective also in phase of remission in spontaneously arising symptom complex of neurovegetative manifestations of primary pathological craving for ethanol called “dry abstinence”.

Conclusions

Our data allows recommending the use of m-ch-BHU under outpatient conditions as an anti-recurrent and preventive agent.

Disclosure of interest

The authors have not supplied their declaration of competing interest.