bluuebunny/crossref_metadata_2025 huggingface dataset:
Anxious Distress is Associated with Increased Immune Dysregulation in Patients with Major Depressive Disorder
Authors: Gaspersz R. , Lamers F. , Wittenberg G. , Beekman A. , van Hemert A. , Schoevers R. , Penninx B.
Published: June 2017

Introduction

Although depression with anxious distress appears to be a clinically relevant subtype of Major Depressive Disorder (MDD), whether it involves specific pathophysiology remains unclear. Inflammation has been implicated, but not comprehensively studied. We examined within a large MDD sample whether anxious distress and related anxiety features are associated with differential basal inflammation and innate cytokine production capacity.

Methods

Data are from 1078 MDD patients from the Netherlands study of depression and anxiety. Besides the DSM-5 anxious distress specifier, we studied various dimensional anxiety scales (e.g. Inventory of Depressive Symptomatology anxiety arousal subscale [IDS-AA], Beck Anxiety Inventory [BAI], Mood and Anxiety Symptoms Questionnaire Anxious Arousal scale [MASQ-AA]). Basal inflammatory markers included C-reactive protein, interleukin (IL)-6 and tumor-necrosis factor (TNF)-α. Innate production capacity was assessed by 13 lipopolysaccharide (LPS)-stimulated inflammatory markers. Basal and LPS-stimulated inflammation index scores were created.

Results

Basal inflammation was not associated with anxious distress in MDD patients (anxious distress prevalence 54.3%), except for modest positive associations for IDS-AA and BAI scores. However, anxious distress was associated with higher LPS-stimulated levels (interferon-ɣ, IL-2, IL-6, monocyte chemotactic protein (MCP)-1, macrophage inflammatory protein (MIP)-1α, MIP-1β, matrix metalloproteinase-2, TNF-α, TNF-β, LPS-stimulated index). Oher anxiety indicators (number of specifier items and anxiety diagnoses, IDS-AA, BAI, MASQ-AA) were also associated with increased innate production capacity.

Conclusions

Within a large MDD sample, the anxious distress specifier was associated with increased innate cytokine production capacity but not with basal inflammation. Results from dimensional anxiety indicators largely confirm these results. These findings provide new insight into the pathophysiology of anxious depression.
Using Quality Improvement Methodology to Achieve NICE Compliant Care for People with Intellectual Disabilities Whose Behavior Challenges
Authors: O’Kane N. , Hall I.
Published: June 2017

Background

In May 2015, NICE published guidelines for people with intellectual disabilities whose behavior challenges (NG11). Eight quality standards were subsequently developed by NICE to help service providers, health and social care practitioners and commissioners implement the necessary recommendations within the new NG11 guidelines.

Methods

We used a Quality Improvement (QI) methodology including process mapping, driver diagrams, and fortnightly QI team meetings. We conducted a baseline audit of the quality standards and used Plan-Do-Study-Act (PDSA) cycles to pilot interventions generated by the team to improve compliance with the standards.

Results

Baseline compliance with the quality standards was low. We identified four priority areas for intervention: annual physical health checks, recording the indication of medication, multidisciplinary case discussion and concurrent psychosocial interventions for those prescribed medications for challenging behavior. Using a PDSA cycle for each intervention, we have demonstrated improved compliance with the NG11 guidelines. Compliance for the recording of indication of medication for all case reviews was previously 0% and now 100%. At least one target case is discussed at each MDT team meeting. Full results for annual health checks are awaited, but intervention has already shown an improvement in the uptake from 40% to 70%. Staff and carers knowledge of psychosocial interventions for people with challenging behavior showed an improvement after training.

Conclusions

Quality Improvement methodology was successful in improving adherence to NG11 guidelines. We are currently assessing whether this is leading to reductions in challenging behavior and improvements to people's well-being.
Skin Conductance Response to Emotional Stimuli and Injury Location in Patients with Single Right Hemisphere Damage
Authors: Álvarez S. , Lahera G.
Published: June 2017

Introduction

Right hemisphere damage (RHD) has been related to alterations in emotion processing. However, results regarding physiological responses are limited and inconsistent. More research regarding specific brain areas involved in emotional physiological responses is needed.

Objectives

To examine the skin conductance response (SCR) to emotion eliciting images in patients with single RHD. To explore the relationship between SCR and brain injury location in patients with single RHD.

Aims

To examine the relationship between SCR and cortical and subcortical damage in RH regarding emotional processing.

Method

Forty-one individuals with RHD due to stroke were assessed (mean age 68.5, SD 12.2, 51.1 males). The amplitude of event-related SCR was registered through a biofeedback system while observing 54 photographs from the international affective picture system (IAPS). Emotional images were classified using two different approaches: emotional valence (pleasant, unpleasant, neutral) and social vs. non-social content. Brain damage location, determined through medical records, included cortical (frontal, parietal, temporal and occipital lobes) as well as sub-cortical (caudate nucleus, thalamus, lenticular nucleus, insular cortex, basal ganglia and limbic system) structures.

Results

Amplitude of SCR to emotional images was significantly lower in individuals with occipital cortex injury compared to those with damage in other brain locations (P < 0.05). These results were consistent through all stimuli categories but non-social pictures, which presented the same pattern though, did not reach statistical significance.

Conclusions

Results show a relationship between occipital areas in HD and SCR to emotional eliciting stimuli, suggesting occipital right lobe involvement in physiological emotional processing.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
The use of Polygenic Risk Scores to Inform Aetiology of Mood and Psychotic Disorders
Authors: Harrison J. , Mistry S.
Published: June 2017

Introduction

Polygenic risk scores (PRS) incorporate many small genetic markers that are associated with conditions. This technique was first used to investigate mental illnesses in 2009. Since then, it has been widely used.

Objectives

We wanted to explore how PRS have been used to the study the aetiology of psychosis, schizophrenia, bipolar disorder and depression.

Aims

We aimed to conduct a systematic review, identifying studies that have examined associations between PRS for bipolar disorder, schizophrenia/psychosis and depression and psychopathology-related outcome measures.

Methods

We searched EMBASE, Medline and PsychInfo from 06/08/2009 to 14/03/2016. We hand-searched the reference lists of related papers.

Results

After removing duplicates, the search yielded 1043 publications. When irrelevant articles were excluded, 33 articles remained. We found 24 studies using schizophrenia PRS, three using bipolar PRS and nine using depression PRS. Many studies successfully used PRS to predict case/control status. Some studies showed associations between PRS and diagnostic sub-categories. A range of clinical phenotypes and symptoms has been explored. For example, specific PRS are associated with cognitive performance in schizophrenia, psychotic symptoms in bipolar disorder, and frequency of episodes of depression. PRS have also demonstrated genetic overlap between mental illnesses. It was difficult to assess the quality of some studies as not all reported sufficient methodological detail.

Conclusions

PRS have enabled us to explore the polygenic architecture of mental illness and demonstrate a genetic basis for some observed features. However, they have yet to give insights into the biology, which underpin mental illnesses.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Peripheral Levels of the Micro-RNA MiR-1202 are Correlated with Changes in Brain Activity and Connectivity During an Antidepressant Treatment
Authors: Lopez J.P. , Pereira F. , Richard-Devantoy S. , Ding Y. , Fiori L.M. , Niola P. , Turecki G. , Jollant F.
Published: June 2017

Introduction

Micro-RNAs are short non-coding sequences playing a major role in regulating gene expression. Peripheral levels of the micro-RNA miR-1202 have been shown to predict antidepressant response and to change during treatment. However, it is not clear to what extent these peripheral measures reflect central neural changes in vivo.

Objectives

We aimed at investigating a potential link between peripheral micro-RNA and neuroimaging measures.

Methods

At baseline and after 8 weeks of desvenlafaxine (50–100 mg die), twenty depressed patients were scanned with 3 T magnetic resonance imaging, first at rest then during the Go/NoGo task, a classical test of response inhibition. Blood samples were taken for RNA extraction.

Results

During resting state, baseline miR-1202 levels were predictive of decreased connectivity between the posterior cingulate and the prefrontal, occipital and parietal cortices. Changes in miR-1202 levels were correlated with changes in activity in right precuneus within the default-mode network, and with decreased connectivity between the posterior cingulate and the temporal and prefrontal cortices, and the precuneus. During the Go/NoGo task, baseline levels and changes in these levels were correlated with activity changes in different regions, including bilateral prefrontal, insular, cingulate, and temporal cortices. Finally, secondary analyses suggest an association between miR-1202 levels and glutamate levels measured by spectroscopy in dorsomedial prefrontal cortex.

Conclusions

This is the first study showing that baseline and changes in peripheral levels of one micro-RNA were associated with changes in brain activity and connectivity during an antidepressant treatment. MiR-1202 may act through the modulation of the glutamatergic system.
Concomitant 3q13.31 Microdeletion and Ring Chromosome 22 in a Patient with Severe Developmental Delay, Ventriculomegaly, and Dandy-walker Malformation
Authors: Kashevarova A. , Belyaeva E. , Skryabin N. , Vasilyev S. , Lopatkina M. , Nazarenko L. , Nikonov A. , Lebedev I.
Published: June 2017

Introduction

Over 20% of patients with developmental delay (DD) has copy number variations (CNV) of unknown significance. Some CNV may be associated with disease in a patient and also present in their apparently healthy parents. According to the two-hit model another CNV may contribute to phenotypic variation of such genomic disorders.

Objectives

DD diagnostics improvement.

Aims

Understanding the pathogenic significance of concomitant 3q13.31 and 22q13.32-q13.33 microdeletions.

Methods

Ring chromosome 22 was first detected by conventional cytogenetics. Microdeletions at 3q13.31 and 22q13.32–q13.33 were revealed by agilent technologies 60 K microarray and confirmed by qPCR. Ring chromosome was confirmed by FISH.

Results

We present a four-year-old girl with del22q13.32-q13.33 resulted in a ring chromosome 22 and a single TUSC7 gene microdeletion at 3q13.31. The del22q13.32-q13.33 originated de novo, whereas del3q13.31 was inherited from healthy mother. The 22q13.32-q13.33 locus is associated with Phelan-McDermid syndrome (PHMDS, OMIM 606232). The patient demonstrated features both typical for the syndrome (psychomotor and speech development delay, autistic signs, aggression, sleep alteration, seizures) and atypical – attention deficit-hyperactivity disorder (ADHD), ventriculomegaly, and reduced size of cerebella hemispheres (Dandy-Walker variant). ADHD and ventriculomegaly were previously described in patients with del3q13.31 (OMIM 615433) but Dandy-Walker variant was observed in our patient for the first time. Possibly, atypical for PHMDS features, may result from trans-epistasis of microdeletions.

Conclusions

Multiple CNVs in one patient complicate genotype-phenotype correlations due to possible overlapping phenotypes and/or modifying effect of variants. This study was supported by Russian Science Foundation, grant no. 16-15-10231.
Educational level influenced the gold standard diagnosis of late-life depression in the GreatAGE study
Authors: Lozupone M. , Veneziani F. , Lofano L. , Galizia I. , Stella E. , Copetti M. , Arcuti S. , Leo A. , Sardone R. , Grasso A. , Tursi M. , Barulli M.R. , Tortelli R. , Capozzo R. , Panza F. , Seripa D. , Bonfiglio C. , Osella A.R. , Logroscino G.
Published: June 2017

Introduction

The validity of the 30-item Geriatric Depression Scale (GDS-30) in detecting late-life depression (LLD) requires a certain level of cognitive functioning. Further research is needed in population-based setting on other socio-demographic and cognitive variables that could potentially influence the accuracy of clinician rated depression.

Objective

To compare the diagnostic accuracy of two instruments used to assess depressive disorders [(GDS-30) and the Semi-structured Clinical Diagnostic Interview for DSM-IV-TR Axis I Disorders (SCID)] among three groups with different levels of cognitive functioning (normal, Mild Cognitive Impairment – MCI, Subjective Memory Complain – SMC) in a random sampling of the general population 65+ years.

Methods

The sample, collected in a population-based study (GreatAGE Study) among the older residents of Castellana Grotte, South-East Italy, included 844 subjects (54.50% males). A standardized neuropsychological battery was used to assess MCI, SMC and depressive symptoms (GDS-30). Depressive syndromes were diagnosed through the SCID IV-TR. Socio-demographic and cognitive variables were taken into account in influencing SCID performance.

Results

According to the SCID, the rate of depressive disorders was 12.56%. At the optimal cut-off score (≥ 4), GDS-30 had 65.1% sensitivity and 68.4% specificity in diagnosing depressive symptoms. Using a more conservative cut-off (≥ 10), the GDS-30 specificity reached 91.1% while sensitivity dropped to 37,7%. The three cognitive subgroups did not differ in the rate of depression diagnosis. Educational level is the only variable associated to the SCID diagnostic performance (P = 0.015).

Conclusions

At the optimal cut-off, GDS-30 identified lower levels of screening accuracy for subjects with normal cognition rather than for SMC (AUC 0.792 vs. 0.692); educational attainment possibly may modulate diagnostic clinician performance.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Psychotropic Use in Elderly with Cognitive Impairment Living in Nursing Homes
Authors: Ferreira A.R. , Martins S. , Dias C. , Simões M.R. , Fernandes L.
Published: June 2017

Introduction

Elderly patients in nursing homes (NH) are often prescribed medications for many physical and mental health problems, with polypharmacy. There is a considerable number of studies documenting this extensive prescription of psychotropic medication, despite the raised concerns about their overuse/misuse, due to serious adverse effects, including increased rate of cognitive decline associated with antipsychotics.

Aims

To characterize the prescription of psychotropics in elderly sample with cognitive impairment living in NH.

Methods

Elderly living in three Portuguese NH were included in this cross-sectional study. All residents were eligible, unless they were unwilling or unresponsive. Participants’ medication was obtained from medical records. Guidelines of ATC were used to categorize the drugs. Participants were assessed with MMSE and GDS.

Results

The sample included 172 elderly, mostly women (90%), with average of 81(sd = 10) years and median lengths of stay of 3 years. Overall, 79.1% used ≥ 1 nervous system-acting drugs. Anxiolytics (54.7%), antidepressants (29.1%) and antipsychotics (23.3%) were the most frequent. The majority (58%) presented cognitive impairment (MMSE). Among those, 46.2% presented depression (GDS) and 79.6% took at least one drug for the CNS and 41.9% ≥ 3. Antipsychotics were received by 26.5%, while 57.1% used anxiolytics, 31.6% antidepressants and 16.3% anti-dementia drugs. No significant relation between GDS and antidepressants was found.

Conclusion

This study confirms the high usage of CNS drugs in patients with cognitive impairment in NH. These rates were comparable with previous studies. Antidepressants appear to be under-used, which can be related to the under-recognition of depression. Also, potential harmful psychotropic drugs such as anxiolytics and antipsychotics are overused.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
The role of cognitive insight in reduction of positive symptoms in youth with ultra-high risk for psychosis
Authors: Rasskazova E. , Omel’chenko M. , Kaleda V.
Published: June 2017

Introduction

Cognitive insight was shown to be impaired in schizophrenia while its high level predicts improvement of psychotic symptoms. However, later studies demonstrated that in other mental disorders and healthy subjects cognitive insight might play ambiguous role being related to anxiety and lack of self-confidence.

Objectives

Development of clinical criteria for high and ultra-high risk for psychosis allows to study the role of cognitive insight in these patients.

Aims

The aim was to examine the role of cognitive insight in different clinical groups of youth with ultra-high risk for psychosis.

Methods

Seventy-six male patients 16–25 years old with non-psychotic mental disorders (with preliminary diagnoses of mood disorders – 30, personality disorders – 25, schizotypal disorder – 21 patients) meeting criteria of ultra-high risk for psychosis and 55 healthy male controls filled Beck Cognitive Insight Scale, Symptom Checklist 90-R. The Scale of Prodromal Symptoms was used twice upon hospitalization and after 1-month period.

Results

Moderation analysis reveals that in patients with preliminary diagnoses of mood disorders and schizotypal disorder cognitive insight is related to higher anxiety and obsessiveness and to poorer improvement on SOPS and positive symptoms. In patients with symptoms of personality disorders, it predicts better symptoms improvement.

Conclusions

Results demonstrate importance of differentiation of the functions of cognitive insight in different patients with ultra-high risk for psychosis both in clinical psychological assessments and CBT.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
The split version of Global Assessment of Functioning scale – application and utility in remitted psychotic patients
Authors: Andric S. , Mihaljevic M. , Mirjanic T. , Maric N.
Published: June 2017

Introduction

Current knowledge about the advantages of using split version of GAF scale – having separate Symptom (GAF-S) and Functioning (GAF-F) subscales is insufficient and has number of gaps. Present study analyzed the manner in which young adult remitted psychotic patients with different functional levels vary in their symptom severity and how GAF-F reflects presence/absence of well-known psychosis risk factors.

Methods

Sample comprised 37 remitted psychotic patients (56.8% male, 29.4 ± 6.1 years), categorized based on GAF-F scores into groups: ‘Moderate remission’ (GAF-F 41–60, n = 19) and “Good remission” (GAF-F > 61, n = 18). Participants were assessed using the GAF-S, WAIS-R, Nottingham Onset Schedule, Premorbid Adjustment and Brief Core Schema scales, childhood trauma and bullying questionnaires. Mann–Whitney and Student's t-tests were used to assess between-group differences.

Results

Groups did not differ in age, sex and education. When compared to “Good remission” group, “Moderate remission” group exhibited earlier illness’ onset (P = 0.01), greater symptom severity (P = 0.00), negative self-evaluation (P = 0.02), more childhood physical abuse (P = 0.01) and bullying (P = 0.01). Moreover, trend-like significances (P = 0.08) were observed for poorer adolescence adjustment and negative evaluation of others. There were no between-group differences regarding IQ and duration of untreated/treated illness.

Conclusions

GAF scale is in the continual use since early 1990, however, evidence of further development of the instrument itself is sparse. Present research is demonstrating that GAF-F scores reflect diverse factors related to psychosis risk, the illness’ course and quality of remission. Moreover, the results contribute to surmount some of the gaps in knowledge about the split version of GAF scale.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Neurocognitive status in different stages of psychosis: Changes from the first episode psychosis to remission
Authors: Bošnjak D. , Makarić P. , Kekin I. , Sabo T. , Živković M. , Savić A. , Silić A. , Čulo I. , Ostojić D. , Jukić V. , Rojnić Kuzman M.
Published: June 2017

Introduction

Neurocognitive impairment in schizophrenia is associated with functional disability and poorer quality of life, and is the most resistant of all schizophrenia symptoms to current psychopharmacotherapy.

Objectives

To compare the differences in neurocognitive status during the acute phase of first psychotic episode and stable symptomatic remission.

Aims

To investigate the pattern of neurocognitive impairment in patients with first episode psychosis during acute phase and stable remission phase.

Methods

We performed a longitudinal study, including 150 patients with first episode of psychosis at two time points: during their hospitalization at Zagreb university hospital centre or university psychiatric hospital Vrapče, at acute phase of illness and after 12–18 months, during stable remission. Assessment included detailed clinical interview, clinical rating of neuropsychiatric symptoms using standardized psychiatric scales, self-assessment scales and comprehensive neurocognitive testing.

Results

While our preliminary results (n = 40) showed statistically significant improvement in various neurocognitive domains, including visuo-learning abilities, verbal learning, executive functions, attention and processing speed, initial impairment in semantic and phonetic fluency observed in acute psychosis remained unchanged in remission as well.

Conclusions

Although our results showed improvement in most of cognitive domains during time, language abilities remained unchanged. This further confirms the hypothesis that language impairment is a trait marker of psychotic disorder.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
The relationship between theory of mind and social functioning within the schizophrenia spectrum
Authors: Bredicean C. , Papava I. , Giurgi-Oncu C. , Cristanovici M. , Popescu A. , Tuculanu O.
Published: June 2017

Introduction

Current research shows that subjects with disorders belonging to the schizophrenia spectrum have a poor social functioning. There are several factors that can influence social functioning, social cognition being one of them.

Objectives

Assessing the ability to identify emotions and its role in the social functioning of subjects with a schizophrenia spectrum diagnosis.

Purpose

Increasing the social functioning of subjects with a schizophrenia spectrum diagnosis.

Method

We evaluated 31 subjects who were at their first admission to the Timisoara psychiatric clinic and who met the diagnostic criteria for a schizophrenia spectrum disorder (a diagnosis of F20, F22 or F25 according to ICD 10). The following parameters were monitored: sociodemographic (gender, age of onset, educational level, marital and professional status), theory of mind (Reading the Mind in the Eyes Test) and social functioning (GAF Scale). The subjects were evaluated during periods of remission. The acquired data was statistically processed.

Results

The results of the sociodemographic parameters analysis were similar to those in international literature. Most subjects showed a lack of theory of mind (a mean score of 18, standard deviation 5.84). All subjects experienced a decrease in social functioning (a mean score of 64.7 on the GAF Scale). There is a direct correlation between the ability to identify emotions and social functioning (Spearman R = 0.386, P < 0.05).

Conclusions

A decreased ability to identify emotions is directly correlated with decreased social functioning in subjects with schizophrenia spectrum disorders.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Patients with severe schizophrenia. functioning improvement after 7-year of comprehensive treatment
Authors: Fernandez-Miranda J.J. , Díaz-Fernández S. , Frías-Ortiz D.F.
Published: June 2017

Introduction

To reach not only clinical but also rehabilitation (especially to improve psychosocial functioning) goals in people with schizophrenia is a need.

Objective

To know the retention in treatment and functional outcomes of patients with severe schizophrenia enrolled in a specific and comprehensive programme for 7 years.

Method

A 7-year prospective, observational study of patients with severe schizophrenia (CGI-S of 5 or over) undergoing comprehensive programme (n = 200). Assessment included at the beginning and after 3, 6, 12, 24, 36 and 84 months: the CGI-S, the Camberwell Assessment of Needs (CAN) and the WHO-DAS. Time in treatment, reasons for discharge, laboratory tests, weight, medications, adverse effects and hospital admissions in the previous six years and during the follow-up were registered.

Results

CGI at baseline was 5.9 (0.7). After seven years, 44% of patients continued under treatment (CGI = 4.3 (0.8); P < 0.01); 36% were medical discharged (CGI = 3.4 (1.5); P < 0.001); WHO-DAS decreased in the four areas (P < 0.005) and also CAN (P < 0.01); 8% were voluntary discharges. Ten patients dead; three of them committed suicide (1.5%). Hospital admission decreased significantly (P < 0.001), and also antipsychotic combinations and antiparkinsonian medications. Fifty-five percent of all of them were treated with atypical long-acting antipsychotics, with good tolerability and few side effects (among them, only 4% were voluntary discharges).

Conclusion

Retention of patients with schizophrenia with severe symptoms and impairment in a specific and comprehensive programme was really high. Such good treatment adherence helped to get remarkable clinical and functional improvement. Long-acting medication seemed to be useful in improving treatment adherence.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Comorbidities in Patients with an At-risk Mental State and First Episode Psychosis
Authors: Heitz U. , Cherbuin J. , Menghini-Müller S. , Egloff L. , Ittig S. , Beck K. , Andreou C. , Studerus E. , Riecher-Rössler A.
Published: June 2017

Introduction

Non-psychotic axis I diagnoses are highly prevalent in at-risk mental state (ARMS) and first episode psychosis (FEP) patients, the most common being affective and anxiety disorders. Few studies have examined differences between ARMS and FEP patients or gender effects regarding such diagnoses.

Objective

To examine current and lifetime comorbidities in ARMS and FEP patients. Furthermore, to examine gender differences, and differences between patients with (ARMS-T) and without later transition to psychosis (ARMS-NT).

Methods

This study was part of the Früherkennung von Psychosen (FePsy) study. Current and lifetime axis I comorbidities were assessed using the Structured Clinical Interview for DSM-IV (SCID-I).

Results

One hundred and thirty-two ARMS and 98 FEP patients were included. Current comorbidities were present in 53.1% of FEP and 64.4% of ARMS patients, the most common being affective, anxiety and substance use disorders. Current affective disorders were significantly more common in ARMS than FEP. Lifetime comorbidities were diagnosed in 58.2% of FEP and 69.7% of ARMS patients, with significantly more affective and anxiety disorders in ARMS than FEP. Male FEP patients had more current and lifetime substance use disorders (across all substances) compared to female FEP. No differences emerged between ARMS-T and ARMS-NT.

Conclusions

As expected ARMS patients have many comorbidities, while clearly diagnosed FEP have less comorbidities. There were few gender differences in axis I comorbidities. Moreover, no differences between ARMS-T and NT emerged, suggesting that axis I comorbidities do not improve prediction of transition. Nevertheless, the high comorbidity prevalence is relevant for global functioning and clinical treatment.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Clinical Features and Diagnosis of Alcoholic Hallucinosis
Authors: De Uribe-viloria N. , Alonso Sanchez A. , De Lorenzo Calzon M. , Gomez Garcia M. , Alvarez Astorga A. , Red Gallego H. De La , Hernandez Anton R. , Gomez Sanchez S. , Noval Canga C. , Medina Ojeda G. , Ladron De Cegama F. De Uribe
Published: June 2017

Introduction

Alcoholic hallucinosis is a rare complication of chronic alcohol abuse, characterized by acoustic verbal hallucinations and delusions, mainly of a menacing content, arising in clear consciousness, that appear during or shortly after a period of heavy alcohol consumption.

Objectives and aims

To outline the key clinical features of alcoholic hallucinosis in order to improve differential diagnosis with other entities.

Methods

We studied the evolution of an outpatient followed in a Mental Health Centre of Valladolid and compared it with present data about the condition, found in a bibliographic search of articles no older than 10 years about the topic.

Results

Partial insight about the experience, along with clear consciousness, was key to discard other psychiatric diagnosis that also present acoustic hallucinations. Neuroimagining and functional tests in our patient showed moderate cognitive impairment and cortical atrophy, which contradicts other studies which claim that an acceptable level of cognition must be present in order to gain the necessary insight to meet the diagnostic criteria.

Conclusions

Alcoholic hallucinosis is a rare form of subacute encephalopathy, secondary to an abrupt stop in a previously chronic and heavy alcohol consumption. Its diagnosis is mainly clinical, and neuroleptics are the most used drug, being abstinence essential for an adequate evolution. The course is usually benign, although the acoustic phenomena may not disappear completely.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Ethics in Transcultural Psychiatry
Authors: Schouler-Ocak M.
Published: June 2017

Global migration and the increasing number of minority groups, including immigrants, asylum seekers, refugees and ethnic minorities, mean that increasingly, psychiatrists and patients may come from different cultural backgrounds. Therefore, cultural differences between patients and clinicians have become a matter of growing importance to mental health care as western societies have become increasingly diverse. This talk will attempt to illustrate how attention to these cultural differences enriches the discussion of ethics in mental health care. This talk will also attempt to underline that cultural competence is able to enhance the ethical treatment of mental health of patients from different cultural backgrounds. Consequently, to be culturally competent, a clinician must be sensitive, knowledgeable, and empathetic about cultural differences. Therefore, cultural competence is a concrete, practical expression of bioethics ideals. According to Hoop et al. in 2008, it is a practical, concrete demonstration of the ethical principles of respect for persons, beneficence (doing good), nonmaleficence (not doing harm), and justice (treating people fairly), the cornerstones of ethical codes for the health professions.

In this talk the complex relationship between culture, values, and ethics in mental health care will be analyzed and discussed.

Disclosure of interest

The author declares that he has no competing interest.
Early and Late Onset Bipolar Disorders in Older Adults
Authors: Smaoui N. , Zouari L. , Charfi N. , Maâlej-Bouali M. , Zouari N. , Thabet J. Ben , Maâlej M.
Published: June 2017

Introduction

Age of onset of illness may be useful in explaining the heterogeneity among older bipolar patients.

Objective

To examine the relationship of age of onset with clinical, demographic and behavioral variables, in older patients with bipolar disorder.

Methods

This was a cross-sectional, descriptive and analytical study, including 24 patients suffering from bipolar disorders, aged 65 years or more and followed-up in outpatient psychiatry unit at Hedi Chaker university hospital in Sfax in Tunisia. We used a standardized questionnaire including socio-demographic, behavioral and clinical data. Age of onset was split at age 40 years into early-onset (< 40 years; n = 12) and late-onset (≥ 40 years; n = 12) groups.

Results

The mean age for the entire sample was 68.95 years. The mean age of onset was 39.95 years. The majority (60%) of patients were diagnosed with bipolar I. Few meaningful differences emerged between early-onset and late-onset groups, except that tobacco use was significantly higher in the late-onset group (66.6% vs. 16.6%; P = 0.027). No significant differences between the early-onset and late-onset groups were seen on demographic variables, family history and number of medical diagnoses or presence of psychotic features.

Conclusion

Our study found few meaningful behavioral differences between early versus late age at onset in older adults with bipolar disorder.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Cultural Variations in Bipolar Disorders in Non-clinical Samples
Authors: Aldos H. , Merey H. , Soliman A.
Published: June 2017

Introduction

The prevalence of bipolar disorder (BD) is continuously increasing worldwide. Based on pathophysiological prospective, BD is related to the change in neural circuitry involved in the regulation of emotion. Since there is a cultural variation in emotion expression, it is expected that BD is subject to cultural differences. The literature suggests that the prevalence of BD is influenced by gender, region and ethnicity.

Objectives

Exploring the pervasiveness of BD in the Arab cultures.

Aims – exploring the pervasiveness of BD in six different but related Arab cultures;

– examining the gender differences in BD in the Arab cultural context.

Methods

This study used 327 freshmen university students (42% males and 58% females) from six different Arab universities and administered the Mood Disorder Questionnaire (MDQ). The validity and reliability of the MDQ was measured on 220 Qatari university students.

Results

The results showed that BD was positively related to age and that males exhibited greater BD symptoms than females. The MDQ scores varied between the Arab subcultures. Sudanese subjects scored the highest on the MDQ, and therefore showed the highest numbers of BD characteristics, followed by Palestinians, Egyptians, Yemenis, Qataris, Jordanians and Tunisians. The Tunisians exhibited the lowest BD symptoms among six Arab cultures.

Conclusions

The findings suggested that it is arguable that BD is sensitive to cultural variations in the Arab world, with males showing a higher number of bipolar symptoms. It is arguable that BD is influenced by cultural openness and socioeconomic status.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Prenatal and Perinatal Factors in Autism Spectrum Disorders–a Case Control Study of a Serbian Sample
Authors: Mandic-Maravic V. , Pejovic-Milovancevic M. , Mitkovic-Voncina M. , Lecic-Tosevski D.
Published: June 2017

Introduction

Autism spectrum disorders (ASD) are complex psychiatric disorders, with both genetic and environmental factors implicated in their etiology. Recent studies suggest the prenatal and early postnatal genesis of ASD, therefore, understanding the effect of environmental risk factors could be important for prevention and treatment of ASD.

Aims

The aim of this study was to determine the association of prenatal factors and perinatal complications with ASD.

Methods

Our study included 102 subjects with ASD (80% boys) aged 9.35 ± 5.85, and 107 age and sex matched healthy controls (77% boys). For the diagnosis of ASD, we used the ICD-10 criteria and Autism Diagnostic Interview-Revised (ADI-R). A questionnaire regarding prenatal and perinatal factors/complications was administered to all subjects.

Results

Logistic regression model of having autism vs. being a control subject included gender, age, maternal and paternal age at birth, pregnancy order, smoking in pregnancy, number of medication during pregnancy (mostly tocolytics, antihypertensives, antiarrhythmics), and early postnatal complications (mostly prematurity, low birth weight, hyperbilirubinaemia). The model was significant, explaining about the third of variance, with number of medication during pregnancy and having an early postnatal complication as significant predictors.

Conclusions

Our study has shown a significant association of specific prenatal and perinatal factors and ASD, even after controlling for other potential confounding variables. Identifying specific risk factors is important for prevention of ASD. It is also the first step in defining basis of the gene–environment interaction mechanism, which might enable development of an individualised therapeutic approach for this group of disorders.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Comparison of Learning Disabilities in Reading, Math, Spelling and Academic Progress of Children with Attention Deficit Disorder with Hyperactivity and Normal Children at Elementary Schools
Authors: Nazer M. , Hamid O.
Published: June 2017

Learning disabilities and attention deficit disorder with hyperactivity of important issues should be considered in elementary school students. The aim of this study was comparison learning disorders, reading, spelling, math and achievement among students in elementary school grades in Bandar Abbas. For this purpose, 384 students were randomly selected. Instruments for gathering data were:

– k-Math test;

– test spelling disorder (Fallahchai test);

– reading test (Baezat test);

– CSI-4.

Factor analysis of variance test was used to analyze of data. The results showed that in the scale of dyslexia, there were more disorders in the children with attention deficit disorder in reading errors, comprehension and reading speed than normal group. In mathematical disorder scale, there were significant difference between the two groups of children with attention deficit disorder with hyperactivity and normal children. Then, the children with attention deficit disorder had higher disorders in operations math, mathematical concepts, mathematical applications, and general score math. The scale of the problem dictates there were significant difference between the two groups of children with attention deficit disorder with hyperactivity and normal children. Then, the children with attention deficit disorder had higher disorders in problem dictates. In academic achievement, the children with attention deficit disorder had lower mean in academic achievement. Finally, the results showed that age, gender, and their interaction had no significant impact on learning disorders, based on attention deficit disorder and normal groups.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Paternal Smoking During Early Developmental Period and Risk of Offspring's Attention Deficit Hyperactivity Disorder
Authors: Kim H.S. , Yang W.S. , Lee C.H. , Bang Y.R. , Yoo J.H. , Kim S.H. , Park J.H.
Published: June 2017

Introduction

Although prenatal maternal smoking is an established risk factor for offspring's attention deficit hyperactivity disorder (ADHD), the studies of association between paternal smoking and childhood ADHD have produced inconsistent results.

Objective

The objective of the present study was to determine whether paternal smoking during early developmental period is associated with an increased risk of offspring's ADHD.

Methods

We conducted hospital-based case-control study with 107 medically diagnosed ADHD cases and 205 controls (aged 6–12 years). The diagnoses of ADHD were assessed with DSM-IV based semi-structured diagnostic interviews. Paternal smoking behavior was assessed with spouse-report questionnaire. The association between exposure to paternal smoking and ADHD were analyzed using multivariate logistic regression analysis. The primary outcome of interest was an odds ratio (ORs) reflecting the risk of offspring's ADHD incidence associated with father's smoking during the index pregnancy, up to one year after birth, and current smoking status. Control variables in our regression model were age, sex, financial status, parents’ education levels, low birth weight, and premature birth.

Results

Our final regression model revealed that paternal smoking during pregnancy (OR = 1.68, 95% CI = 1.03–2.76) and up to one year after birth (OR = 1.69, 95% CI = 1.04–2.77) were significantly related to their offspring's ADHD.

Conclusions

The current results suggest that exposure to paternal smoking during the fetal and newborn period is associated with increased risk of ADHD. This study warrants public health policies to reduce children's exposure to secondhand smoke and their risk of ADHD.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Pretreatment Predictors of Early Response Revealed by Quantitative Cerebral Blood Flow in Major Depressive Disorder
Authors: Hou Z. , Wang Z. , Jiang W. , Yin Y. , Yue Y. , Zhang Y. , Yuan Y.
Published: June 2017

Objective

The potential pattern of regional cerebral blood flow (rCBF) in major depressive disorder (MDD) underlies different response to antidepressants medication remain unclear. This study aimed to investigate the differences of rCBF between patients with different treatment response.

Methods

Eighty MDD patients [(44 treatment-responsive depression (RD) and 36 non-responding depression (NRD)] and 42 healthy controls (HC) underwent pulsed arterial spin labeling (PASL) scans in magnetic resonance imaging and clinical estimates. The exact rCBF values of each groups were obtained via quantification evaluation.

Results

Compared to NRD, the RD patients showed decreased rCBF values in frontal sensorimotor network (i.e. left paracentral lobule, left medial frontal gyrus, right superior frontal gyrus and right middle frontal gyrus), and further receiver operating curve (ROC) analyses demonstrated that the altered rCBF in these four regions exhibited outstanding performance on distinguishing NRD from RD. The NRD also exhibited reduced rCBF in bilateral cerebellum posterior lobe and right middle occipital gyrus and elevated rCBF in right postcentral gyrus and right middle frontal gyrus as compared to HC.

Conclusions

The decreased rCBF in frontal sensorimotor network appeared to be distinct characteristics for NRD, and might be severed as promising neuroimaging markers to differentiate depressed patients with weak early response to antidepressant medication. These findings expand our understanding of neural substrate underlying the antidepressant efficacy.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Alexithymia and Coping Strategies: Predictors of Hopelessness?
Authors: Serafini G. , Capobianco L. , Pompili M. , Girardi P. , Amore M.
Published: June 2017

Introduction

Alexithymic traits and coping strategies may affect the onset and course of many psychiatric conditions. However, their role in determining hopelessness and suicide risk has been not still elucidated.

Objectives

The present study analyzed the correlations between alexithymia, coping strategies, and hopelessness.

Aims

We aimed to evaluate whether specific coping strategies and alexithymia may predict hopelessness which is widely considered an independent risk factor for suicide.

Methods

This is a cross-sectional study conducted on 276 patients (19.9% men, 81.1% women; mean age: 48.1 years, SD: 16.9), of which most with major affective disorders, who were admitted at the Psychiatric Unit of the University of Genoa (Italy). All participants were assessed using the Beck Hopelessness Scale (BHS), Coping Orientations to Problems Experienced (COPE), and Toronto Alexithymia Scale (TAS-20).

Results

Alexythimic subjects significantly differ from non-alexythimic individuals in terms of substance abuse (χ2 = 23.1; P = .027). According to bivariate analyses, we found a significant correlation between hopelessness and suicidal thoughts/wishes (r = .34; P = .01), humor (r = –.24; P = .05), and behavioural disengagement (r = .205; P = .05). Behavioural disengagement is also a positive predictor of hopelessness (OR = 1.25; 95% CI: 1.03–1.52) while humour is a negative predictor of hopelessness (OR = 0.85; 95% CI: 0.73–0.99).

Conclusions

Behavioural disengagement needs to be considered a risk factor while humor is a protective factor for suicide. Surprisingly, we found no significant association between alexithymia and hopelessness. Further additional studies are requested to test these exploratory findings in order to more deeply elucidate the role of both alexithymia and coping strategies in suicidal behaviour.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Validation and Test-retest Reliability of Facial Expressions Basic Emotions of Baby Stimulus
Authors: Donadon M. , Martin Santos R. , De Lima Osório F.
Published: June 2017

Introduction

Emotional facial expression paradigms of adults have been very used in the literature; however, studies with baby's emotional faces are very few.

Objectives

To study the psychometric validity and reliability of a series of basic emotions faces of babies stimuli.

Methods

We used 72 photographs of 12 baby faces (6–12 months), both sex and different ethnic groups, expressing basic emotions (happiness, sadness, fear, anger, surprise and neutral) elicited in the laboratory by pre-task defined. A total of 119 subjects of both sexes (63% women) in different age groups (18–65 years) and ethnicities, were invited to evaluate the facial emotional stimuli presented by the computer program SuperLab. They should choose the emotion represented by the photograph. Furthermore, 31 subjects were randomly selected to perform a test-retest assessment after an interval of 20 days.

Results

It was observed that 35 stimuli presented hit rate exceeding 70% and 11 between 60% and 50%. The facial emotion of happiness was the most easily recognized, while fear was associated with the lower success rates. Only seven stimuli presented a hit rate lower than 20% (fear). All stimuli, except for one, showed a good reliability test/retest (McNemar test > 0.05).

Conclusion

The study offers a series of baby emotional facial stimuli with good validity and reliability for research setting. However, the 30% of stimuli without satisfactory success rate may be problems with stimuli or stimulating task, as it becomes difficult to distinguish the emotion face on the baby.

Disclosure of interest

The authors have not supplied their declaration of competing interest.