bluuebunny/crossref_metadata_2025 huggingface dataset:
1652 – Child Pornographers: Clinical Features Of a Virtual Assault
Authors: Prat S. , Bertsch I. , Jonas C.
Published: July 2013

Introduction

The child pornography collecting process and the way the pornographer considers his collection need to be better understood. It is these psychopathological issues and the risk of the person acting out his fantasies that need to be analyzed.

Objectives

We want to understand the phenomenon of child pornography, because it is sometimes a matter of deviance without leading to actual abuse.

Aims

The aim of our study is thus to identify the characteristics of people who download child pornography.

Methods

We collected datas from forensic psychiatric assessments. The criterion for inclusion was the possession of pornographic images of minors. We studied pathological characteristics of this sample.

Results

Subjects were almost exclusively male with an average age of forty years. They have generally a good academic level. A significant difference is observed between the childhood aspects of child pornographers, sex online and offline offenders. A sense of loneliness is expressed in 32.8%.

Conclusion

Child generally fulfills a fantasy of a pedophile nature. Different profiles of child pornographers have been proposed which are not always related to pedophilia. Our study has permitted to have informations about the sexuality of child pornographers. The feel to not be well integrated could explain the use of virtual mean of telecommunication. Clinical differences can be made between child pornographers and sex online offenders.
1659 – The Development Of a Case Formulation Training Package For Probation Staff
Authors: Brown S. , Hedges L. , Patel G. , Duggan C. , Vollm B.
Published: July 2013

Introduction

A recent UK Government initiative has sought to address the management of personality disordered (PD) offenders, aiming to improve public protection by reducing reoffending whilst simultaneously improving the psychological health of offenders with PD. Case formulation (CF) is given primacy here as it enhances offender management through a psychologically informed approach and informs pathway planning through Criminal Justice System or NHS services. Probation services are given an important role in formulating cases as part of the new strategy.

Objectives

Develop a consensus amongst professionals as to what makes a good Case Formulation (CF). Investigate whether probation services can be taught CF skills, and to enhance these skills.

Aims

Develop a case formulation training package for probation staff and evaluate the training.

Method

The training package was informed by the results of a Delphi survey amongst professionals, and focus groups with probation staff, offenders and carers of individuals with PD.

Results

There was consensus that CF allows for collaboration between client and therapist, helps with complexity through organisation of case notes and has utility in treatment planning. Themes highlighted for effective CF included background, trauma, offending, risk and current lifestyle. The theoretical model gaining most support was a CBT model. The assessment of formulations was identified as challenging.

The CF training package is currently being evaluated and findings will be presented at the conference, alongside outcomes of all phases of the research.

Conclusions

CF has the potential to enhance treatment planning. Its suitability for probation staff will be discussed.
1665 – Gender Differences In Depressive Co-morbidity And Suicidal Behaviour Among Delusional Disorder Patients
Authors: González-Rodríguez A. , Molina-Andreu O. , Imaz Gurrutxaga M.L. , Bernardo Arroyo M. , Catalán Campos R.
Published: July 2013

Introduction

Although gender differences in schizophrenia are well known, this topic in delusional disorder (DD) has been poorly studied. Previous studies have shown an earlier mean age at onset in men than in women, and in those with depressive co-morbidity.

Objectives

To examine demographic and clinical differences by gender in DD.

Aims

To compare depressive co-morbidity and suicidality between men and women.

Methods

Ninety-seven patients with delusional disorder (DSM-IV-RT), attended at the Department of Psychiatry (Hospital Clinic-BCN) from 2000 to 2012, were included and followed up for one year. Demographic and clinical features at index admission, pharmacological treatment, compliance, presence of depressive co-morbidity and suicidal behaviour at follow-up were recorded. For comparisons, T, Chi-square tests and analysis of covariance (ANCOVA) were used.

Results

Seventy-six per cent were women and the most common delusional idea was delusion of persecution (74.2%). Gender differences regarding demographic features and depressive co-morbidity were not found. 22.7% of the sample presented suicidal ideation and 12.4% attempted suicide during follow-up. Women became ill later than men (50.07 vs.44.57 years), but when ANCOVA model is used with age at onset as dependent variable, sex as factor, and depressive co-morbidity and suicidal behaviour as covariates, this difference was not significant for sex effect. Women attempted suicide more often than men (13.5% vs. 8.7%) and showed less compliance during the evaluation period.

Conclusions

No gender differences in age at onset, types of DD, presence of depression and severity of global functioning were found. Women showed higher suicidal behaviour.
1666 – The Burden Of Accelerated Ageing In Schizophrenia
Authors: Cohen D. , Nugter A.
Published: July 2013

Introduction

Among patients with schizophrenia there is a significant increased prevalence of type 2 diabetes mellitus. In addition, schizophrenia is accompanied by 15–32 years reduced life-expectancy. We hypothesize a contribution from accelerated ageing.

Objectives

To compare Autofluorescence (AF) levels of patients with severe mental illness (SMI) with the general population.

Aims

To test to what extent accelerated ageing is specific for patients with schizophrenia.

Method

Outpatients with SMI were asked to participate. AF levels were measured with the AGE-reader. Patients with diabetic mellitus were excluded from the analyses.

Results

[Mean AF values in study-population (N=122)]

Age-cohortsGeneral PopulationSMI-populationt-valueSize Study Population20–29 years1.532.175.95***N=1130–39 years1.732.2110.20***N=3040–49 years1.812.317.85***N=4350–59 years2.092.857.03***N=2460–69 years2.462.8252.44*N=14*

p< .05

***

p< .001

Of the 154 patients who were asked to participate 70,8% were male, 74,3% suffered from schizophrenia, 15,3% from diabetes mellitus and of 3% the skin was too dark for a reliable assessment. Only 5 patients refused to participate.

A regression analysis with age as single predictor, confirmed the predictive value of age. Compared to the general population (R2 = .60), the explained variance of R2=.23, p< .001 in the study population is low. Addition of duration of treatment or psychiatric diagnosis as predictors did not change the outcome.

Conclusion

AF-values indicate that accelerated ageing is present in patients with SMI.
1667 – Explaining Job Satisfaction And Job Control: a Survey Among Finnish Psychiatrists
Authors: Korkeila J. , Svirskis T. , Mäki P. , Melartin T. , Valkonen-Korhonen M.
Published: July 2013

Background

Job satisfaction has major impact on mental health and job performance. Expected work satisfaction may influence choice of specialization within medicine.

Methods

A postal survey was conducted in 2009 among the members (N=1398) of Finnish Psychiatric Association. Out of these respondents 1132 were still working-aged. All in all 64.8% (N=738) of the working-aged members returned the survey. Only psychiatrists and residents were included in the final cohort of the study (665). Factors associated to work satisfaction were studied and a principal component analysis was conducted on factors reported to disturb working. The correlations of factors scores with job satisfaction and job control were analyzed. Spearman correlation coefficients were calculated between factor scores and work satisfaction.

Results

Most respondents (73.8%) were satisfied with their work. Job satisfaction showed a negative correlation with increase in pace of work (rho= -0.24, p< 0.001). Job control correlated positively with job satisfaction (rho = 0.46, p< 0.001). “Working conditions” factor explained 28.6%, “leadership” 8.8%, “failure without support” 7.8%, fear at work 6.5% and “patient records” factors 5.9% of the variation of perceived harmful factors at work. “Working conditions” and “leadership” factors showed the strongest and most significant negative correlations with job satisfaction (rho = -0.45, p< 0.001, rho= -0.32, p< 0.001, respectively. “Working conditions” associated strongly and significantly with and job control (rho=-0.57, p< 0.001).

Conclusion

Job satisfaction may be better than expected among psychiatrists. However, employers should put emphasis on good fit between person and job to promote well-being of their employees.
1668 – Prevalance Of Ptsd, Depression And Anxiety Symptoms Among Adolescents 6 Months After Van-erciş Earthquake 2011
Authors: Kadak M.T. , Nasıroğ lu S. , Aydın A.
Published: July 2013

Introduction

Earthquakes, one of the major natural disasters, tend to be unpredictable, uncontrollable, and highly destructive. They lead to strong initial trauma and significant long-term effects such as posttraumatic stress disorder, depression, anxiety, or other symptoms.

Objectives

In this research, posttraumatic stress, anxiety and depressive symptoms were studied among adolescents 6 months after Van-Erciş Earthquake 2011.

Method

In the present study a total of 738 Turkish high school students, aged 13-17 years, participated in the study in Van city affected severely by the earthquake. Participants completed a set of questionnaires including the demographic measures, posttraumatic stress reactions, depression, anxiety and dissociation.

Results

The results of the present study showed the presence of probable diagnosis of PTSD in 295 (40.69%), of anxiety in 384 (53.04%) and of depression in 245 (33.70%) of the adolescent examined. Multiple logistic and linear regression analyses were conducted to explore the predictive values of independent variables on development of posttraumatic, anxiety, depressive, and dissociative psychopathology among adolescents experienced Van earthquake.

Conclusions

Our results show high rates of PTSD, anxiety and depression symptoms in adolescents who survived the October 2011 Van-Erciş earthquake. Further, our results highlight the relevance of gender differences, previous psychopathology, trait anxiety, anxiety sensitivity in the response to mass trauma that should be taken into account when facing such events. Our results confirm the pervasive effects of a disaster and risk factors, such as an earthquake, for mental health in adolescents.
1671 – Use Of Transcranial Magnetic Stimuaiation (tms And Rtms) In Adhd
Authors: Logan Ellis H. , Zaman R.
Published: July 2013

Introduction

We reviewed current state of research involving the applications of TMS and rTMS in understanding of pathophysiology as well as the treatment of ADHD.

Objectives

To assess how TMS has furthered our knowledge of neurobiological models of ADHD and to consider further research. To look at possible applications of rTMS in the management of ADHD and to evaluate the current state of research.

Methods

Literature review using an online search.

Results

The investigative studies are small in numbers, but show some promising results. TMS adds weight to the theory of a hypofunctional dopaminergic circuit involved in ADHD pathophysiology. Treatment studies (only 2) using rTMS shows some use in treatment of ADHD, such as brief improvement in attention. These studies, however, are very preliminary, small in numbers and suffer from methodological difficulties.

Conclusions

TMS has provided some useful information about the likely pathophysiology of ADHD, and results show that it is a safe an effective way to investigate and treat this condition. Much more research is needed to investigate the potential applications of this technology.
1676 – What Is The Relationship Between Coping Styles And Depression In Adolescents? We-stay Project
Authors: Burón P. , Al-Halabí S. , García-Álvarez L. , Díaz-Mesa E. , Garrido M. , Galván G. , Rancaño J.L. , Casero M. , García-Portilla P. , Sáiz P.A. , Bobes J.
Published: July 2013

Introduction

Some coping strategies might serve as protective functions by regulating the negative emotions associated with stress, whereas others may exacerbate the effects of stress and contribute to maladaptation.

Aim

To examine the distribution of the Beck Depression Inventory II (BDI-II) scores in the Spanish sample of adolescents from the “Working in Europe to Stop Truancy among Youth” Project (WE-STAY) and study the differences according to the coping style.

Method

Sample: 1409 pupils from 23 schools sited in Asturias (Spain) [48.55% males; mean age(SD) = 15.16(1.22)]. Instruments:

(1)

Coping Across Situations Questionnaire (CASQ);

(2)

BDI-II.

Results

7.3% of the sample scored in mild depression, while 4.9% did so in moderate (BDI-II criteria). Significant differences were found by gender in BDI-II scores, females scoring higher in severe, moderate and mild depression (p< .005). Regarding to the coping style, 65.4% of the sample showed internal style. The least representative was the withdrawal style (13.9%). Significant differences were found in the coping style by gender, females scoring higher in both active and withdrawal styles (p< .050). Regarding to the relation between BDI-II scores and coping style, pupils with withdrawal style score higher in severe, moderate and mild depression (p< .000).

Conclusions

Although ideally would be an active style, pupils showed mainly an internal coping style (which includes assessing a situation and looking for a compromise). Coping style was related with the severity of depression. Withdrawal style (which includes denial) is related to a worsening of depression. Thereby, training coping skills may be important.
1678 – Do Vitamin d Levels In Bipolar And Schizophenia Outpatients Differ? Outcome Of a Dutch Cross-sectional Study
Authors: Boerman R. , Cohen D. , Schulte P.F.
Published: July 2013

Introduction

Itzhaky (2012) found significantly lower vitamin D level in patients with schizophrenia than in healthy controls.

Objective

Measurement of vitamine-D in bipolar and schizophrenia/schizoaffective outpatients.

Aims

Determining the prevalence of vitamin D deficiency in outpatients with bipolar disorder, schizophrenia or schizoaffective disorder in the Netherlands.

Method

Outpatients in the Alkmaar region aged 18w65 years with a bipolar disorder, Schizophrenia/schizoaffective disorder were asked to add vitamin D levels determination to the annual standard blood sample taking.

Results

111 patients, 54 with schizophrenia/schizoaffective disorder and 57 with bipolar disorder, participated. 58 (53%) was male, mean age 47 (SD 9.9) years. 64 (58%) showed vitamin-D insufficiency (< 50 nmol/L), 32 (29%) vitamin-D deficiency (< 30 nmol/L). 7 (6.3%) female patients aged >50 had a serum level between 30–50 nmol/l. No significant differences were found between bipolar disorder and schizophrenia/schizoaffective disorder.

Conclusion

To prevent osteoporosis, vitamin D supplementation is advised with vitamin D-levels below 30nmol/l or below 50 in women >50 years and men >70 years, (Dutch Health Council). Using to this criterion 39 patients (35%) of the study-population needed vitamine-D supplement. If confirmed, addition of vitamine-D levels to the annual somatic screening of patients with bipolar disorder, schizophrenia/schizoaffective disorder is indicated. Limitation: the impact of the season on vitamine-D levels was not corrected for in either population.
1679 – Group Psychotherapy With Mentally Ill Inpatients In a Psychiatric Unit Of a University Hospital
Authors: Scherer E.A. , Giraldi I.M.E. , Scherer Z.A.P. , Scaduto A.A.
Published: July 2013

Introduction

Assistance for mentally-ill patients can be performed in psychiatric units of general hospitals. At the Psychiatric Ward at Ribeirão Preto Medical School Hospital of the University of São Paulo, Brazil, the assistance offered follows the therapeutic ambient model. Group psychotherapy with clients is one of the approaches provided. The group meetings occur every day, are 1-hour long, and follow theoretical principles of group therapy with inpatients, emphasizing “here-and-now” interventions. They are coordinated by psychiatry residents and observed directly by a group therapist preceptor.

Objective

To present a framework of group psychotherapy interventions with inpatients in a psychiatric unit of a university general hospital based on the analysis of one group meeting.

Aims

To characterize a group psychotherapy intervention with inpatients in a psychiatric unit as a model for assistance and teaching.

Method

Exploratory and descriptive qualitative research. It was performed a content analysis of an in loco transcription of a group meeting with 11 patients and 4 staff members.

Results

The following themes were discussed: illness-, self- and other perceptions; respect and relationships within the unit; discharge. Patients had participated freely and interacted among themselves. The group’s coordinator guaranteed the meeting’s structure and facilitated discussion and exchanges among patients.

Conclusion

Being concerned with the group’s structure in a therapeutic ambient model is essential for its development. However, it has been noticed that the coordinator’s flexibility tends to favor patients to transpose their experiences along group meetings and the therapeutic ambient to their lives outside the hospital.
1681 – Psychological Symptoms And Habitual Smoking In Greek Health Professionals
Authors: Giotakis K. , Pachi A. , Ilias I. , Zafeiropoulos G. , Vouraki G. , Drylli O. , Bratis D. , Tselebis A. , Douzenis A. , Moussas G.
Published: July 2013

Introduction

Greece presents the highest prevalence of smokers among Western European countries with a percentage of 37.6%. Studies investigating the psychological parameters associated with habitual smoking, both among the general population as well as among health professionals are focused on anxious and depressive symptoms, without taking into account other possible psychological parameters.

Aims

To assess the implication of psychological parameters in the preservation and termination of habitual smoking.

Methods

One hundred and four health professionals were randomly selected and asked to fill out the Symptom Check List - 90 - R (SCL-90R) [1]. Participant demographics, smoking habits, amount of daily cigarette consumption, and whether or not participants displayed an intention or effort to quit smoking were all taken into account.

Results

Among smokers, 50% displayed an intention to quit smoking. Smokers who intended to quit displayed the highest levels in subscales of somatization, anxiety, depression and anger. Daily cigarette consumption, among smokers, showed a positive correlation to subscales of obsessive-compulsive symptoms, interpersonal sensitivity, depression, anxiety as well as of anger, paranoid ideation and psychoticism.

Conclusions

The fact that one in two smokers indicates an intention to quit smoking is both interesting and optimistic regarding possible termination of the smoking habit. Habitual smoking is positively correlated to psychological parameters that should be taken into account when drafting a smoking intervention programme.
1693 – A Pilot Project Of Cinemeducation For Medical Students: Focus On Psychiatry, Stigma, And Empathy
Authors: Feggi A. , Lombardi A. , Gramaglia C. , Zeppegno P.
Published: July 2013

Introduction

Stigma on psychiatric patients is frequent not only among common people but also in healthcare professionals. Cinema might be useful tool for medical educational purposes and might help reduce negative attitudes towards mental illness.

Objectives

In the first place, to develop a pilot project of cinemeducation aimed at enhancing awareness and thinking over about psychiatry and stigma in medical students; secondly, to investigate students’ stigmatizing attitudes, empathy, personality and self-esteem and the impact of the cinemeducation intervention on some of these variables.

Methods

From October 2012 to January 2013, students will attend six cinemeducation lectures focused on helping relationships. Sociodemographic data will be collected at baseline only, and so will the Temperament and Character Inventory. In order to investigate attitudes towards psychiatry, self-esteem, alexithtymia and empathy, students will be asked to fill in some self-administered scales, both at baseline and at the end of the six lectures. These scales will include: Attitudes Towards Psychiatry Scale, Social Distance Scale, Dangerousness Scale, Mental Illness: Clinicians’ Attitudes Scale, Interpersonal Reactivity Index, Rosenberg Self-Esteem Scale, Toronto Alexithymia Scale.

Results/conclusions

The correlation among the variables assessed will be investigated in order to understand whether certain personality traits, self-esteem and empathic attitude influence students’ beliefs about psychiatry. The impact of the cinemeducation lectures on stigmatizing attitudes will be investigated as well.
1700 – Group Therapy With Chronic Mental Patients And Their Families
Authors: Scherer E.A. , Scherer Z.A.P.
Published: July 2013

Introduction

The meeting of families who share the same problem enables the creation of a new therapeutic space that allows a rich exchange regarding solidarity and mutual aid. The presence of others allows reviewing each family’s beliefs, questioning the secrets, incomplete information and taboos, and raises questions about assumptions maintained over time.

Objectives

To characterize group meetings of chronic mental patients and their families regarding thematic and interaction of participants.

Aims

Understand the interaction between chronic mental patients and their families.

Method

This is a qualitative participant observation study. Five weekly outpatient groups with 15 patients and their families were analyzed.

Results

The subjects discussed were related to symptoms of mental illness, treatment options and cures, expectations of patients and families facing the reintegration of those in work and other activities, and the group concern with the difficulty of expressing feelings. Emotions had resonance in these meetings and, among them, feelings of gratitude, recognition and reconciliation, as well as anger, boredom, disappointment or discomfort. The possibilities of group contention expanded, and each person was accompanied and stimulated the expression of his/her own feelings, for being a witness and co-participant of expression of affection from others. When psychotic patient gather with their families, deep and unwieldy anxieties are mobilized.

Conclusion

The importance of including the family is in the fact that we can confront patients with the real objects of their family history and make corrective emotional experiences of primitive distorted object relations.
1702 – Impairments In Episodic-autobiographical Memory, Social Information And Emotional Processing In Cadasil During Mid-adulthood
Authors: Markowitsch H.J. , Staniloiu A.
Published: July 2013

Introduction

Cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy (CADASIL) is a small-vessel disease of the brain that is genetically transmitted and often is diagnosed in middle adulthood. It can lead to progressive cognitive deterioration, emotional and personality changes. The disorder is often erroneously diagnosed as it may mimic other neurological or neuropsychiatric conditions (such as multiple sclerosis).

Objectives

This work’s objectives are establishing greater recognition among health care providers of this relatively common, but yet underestimated cause of cognitive and emotional changes.

Aims

We present a middle aged patient with genetically confirmed Cadasil.

Methods

The patient underwent extensive neuropsychological testing. In addition, he underwent comprehensive medical, neurological, neuroradiological and genetic investigations.

Results

Neuroimaging data showed significant changes in both white and gray matter. Neuropsychological investigations revealed variable degrees of impairments in executive functions, emotional and social information processing and conscious mnemonic processing (episodic-autobiographical memory).

Conclusions

Impairments in episodic-autobiographical memory, executive functions and social and emotional processing may represent early neuropsychological changes in Cadasil. Identifying both the early neurological and neuropsychological features of this condition, in order to enable early accurate diagnosis is a crucial task for future research.
1706 – Atrial Fibrillation And Panic Disorder: Differential Diagnosis In General Medical Settings
Authors: Olazabal Eizaguirre N. , González-Torres M.A. , Gaviria M.
Published: July 2013

This paper studies the relationship between atrial fibrillation and panic disorder. Doubts about differential diagnosis are usual in emergency services and general medical settings. Panic disorder prevalence rates have been found high in patients suffering from atrial fibrillation. Besides, different studies have observed that frequently, patients diagnosed with anxiety disordes have higher cardiovascular disease rates comparing general population.

Anxiety disorders are very common in general population, and related economic costs are huge. The overutilization of medical services is also present in this patients, and misdiagnosis leads to unnecessary medical evaluations. Usually, patients suffering form panic disorder exhibit somatic complaints suggesting coronary disease such as chest pain or palpitations. Then, correct practiser uses screening test (arteriography, effort test...) to reject cardiovascular disease.

We suggest an algorithm to optimize the differential diagnosis using clinical interview and asking for some aspects that have been demonstrated as highly specific. It is based in five general factors: age, sex, refered anxiety level, typical /atypical chest pain and complementary test. The aim is the correct diagnosis and treatment for such different illnesses and to decrease the costs due to misdiagnosis.
1711 – Addiction Among Young Moroccan Students Of a Vocational Training Institute
Authors: Jouahir I. , Azzaoui F.-Z. , Ahami A. , Elhessni A. , Faid M.
Published: July 2013

Introduction

The internship system of some institutes and adolescence period could constitute a favorable medium to develop addiction behaviors among students.

Objectives

The objective of this study is to determine the prevalence of addicted students of an Institute of the vocational training in city of Mohammedia (North-West of Morocco) and the kind of substances used in this addiction.

Methods

An epidemiological study is conducted among 460 students of this institute. These students aged from 18 to 26 years, are individually questioned about their consumption of different kinds of drugs.

Results

The obtained results show that only 100 boys speak freely of their consumption of drugs and/or alcohol and only 6 girls confess to be smokers (tobacco) including 2 consumers of drugs. Indeed, the drug most commonly used is cannabis rolled into cigarettes (Hashish). These drugs are used regularly at least once a day and especially at night before bed to facilitate sleep. The kinds of substances used depend also on socio-economic level of students; the students from rich families consume up to 12 joints a day against some puffs of joint shared by many consumers for poor students. In addition, the poor students consume some local preparation called “maajoune” or “cala”. Alcohol consumption is casual during weekends or ceremonies.

Conclusion

This study is an preliminary investigation that lighted the problem of addiction among students in this vocational training institute. So, deeper researches must be done in order to determine the factors causing and/or influencing this kind of pathologic behavior.
1717 – Cognitive Rehabilitation As Part Of The Treatment Of Patients With Dual Diagnosis
Authors: Krysta K. , May-Majewski A. , Krupka-Matuszczyk I.
Published: July 2013

Introduction

Cognitive deficits belong to the most common symptoms of schizophrenia as well as of disorders related to substance abuse. It is then important to cope with those deficits effectively during the treatment of rehabilitation process of patients with dual diagnosis.

Objectives

To analyze cognitive changes in patients with dual diagnosis participating in a cognitive rehabilitation program.

Methods

120 patients suffering from schizophrenia with a comorbid drug addiction were recruited to the study. All of them participated in a treatment program in a modified therapeutic community (TC) for patients with dual diagnosis. During their treatment they also took part in a program of rehabilitation of cognitive functions with a use of a computerized training battery. The cognitive functions were assessed twice: first time at the beginning of the treatment and second time after six weeks of cognitive rehabilitation. The applied neuropsychological tests were TMT, part A and B, Stroop Test and Verbal Fluency Test. The intensity of schizophrenic symptoms were measured by the PANSS scale. All participants of the study were treated with second generation antipsychotics.

Results

After six weeks of cognitive rehabilitation all patient improved significantly in all applied neuropsychological tests. There were no significant changes in the PANSS scale results.

Conclusions

The above results confirm the necessity of introducing cognitive rehabilitation in therapeutic programs for patients with dual diagnosis. The above results may also be an effect of other therapeutic interventions used in the TC rehabilitation model, antipsychotic treatment or other factors, which need further investigation.
1718 – Depression And Risk Development Of Acute Cardiovascular Diseases In Female Population Aged 25–64 In Russia
Authors: Gafarov V. , Panov D. , Gromova E. , Gagulin I. , Gafarova A.
Published: July 2013

The aim

To explore the effect of depression (D) on relative risk of myocardial infarction (MI) and stroke and its relation with awareness and attitude towards the health in female population of 25–64 years in Russia.

Material and methods

Under the third screening of the WHO “MONICA-psychosocial” (MOPSY) program random representative sample of women aged 25–64 years (n=870) were surveyed in Novosibirsk. D was measured at the baseline examination by means of test “MOPSY”. From 1995 to 2010 women were followed for 16 years for the incidence of MI and stroke.

Results

The prevalence of D in women aged 25–64 years was 55.2%. With growth of D levels positive self-rated health reduced and almost 100% of those women have health complaints. Women with major D significantly extended negative behavioral habits: smoking and unsuccessful attempts to give it up, low physical activity, they are less likely to follow a diet. Major D associated with high job strain and family stress. Risk of MI development in women with D during 16 years of study was higher in 2.53 times (95%CI=1.26-24.34; p< 0.05), risk of stroke was higher in 4.63 times (95%CI=1.03-20.89; p< 0.05 MI and stroke rates were more likely in married women having D with average educational level who being in both “managers” and “physical labor” social classes.

Conclusions

The prevalence of D in women aged 25–64 years more than 50%. Women with D had 2.53-fold risk of MI and 4.63-fold risk of stroke over 16 years of follow-up.
1720 – From Psychosis To Remission Through Artistic Expression
Authors: Derganc M. , Savs A.P. , Care K.
Published: July 2013

Introduction

Group music/art therapy in patients with schizophrenia may not contribute to the treatment outcome but it certainly offers an opportunity to monitor patient's progress during psychiatric treatment. In our case we followed the patient's improvement through ten drawings.

Case report

A 24-year-old female psychology student was admitted to our hospital for the first time. She presented with unusual posturing, mannerisms, disorganized speech, auditory hallucinations, and paranoid delusions. According to her mother, the symptoms started about two years prior to the hospitalization. She was unsuccessfully treated with olanzapine at maximum dose. Additional treatment with a maximum dose of amisulpride also proved unsuccessful. After switching her to clozapine and aripiprazole her behavior normalized and the psychotic symptoms subsided. Because of epileptic seizures as a side effect of clozapine treatment she was given valproic acid. She achieved solid remission and was transferred to the day hospital. As an inpatient she attended group music/art therapy sessions once a week. At the beginning her drawings were abstract, disorganized and perseverative. As her mental status improved, her drawings became more and more realistic.

Conclusion

While it is difficult to imagine the way someone with a mental illness perceives the world, drawings produced by the mentally ill offer a hint of this experience. In itself, realistic expression is not ’better’ than abstraction; moreover, it could be ventured that in her early drawings our patient was more responsive to musical stimuli than later when her regaining control produced more organized but also more schematic and stereotypical drawings.
1721 – Expressed Emotion In a Mixed Sample Of Psychiatric, Oncological And Obese Patients
Authors: Gili S. , Gattoni E. , Porro M. , Zeppegno P. , Gramaglia C.
Published: July 2013

Introduction

Expressed Emotion (EE) reflects the “emotional temperature” of a family. High EE and low EE families can be identified. The degree of family EE correlates with patients’ outcome, being a high family EE predictive of a greater likelihood of relapse, an increased need for care and inpatient treatment.

Objectives

Firstly, to evaluate EE, life events and anxiety in a mixed sample of psychiatric, oncological and obese patients recruited from the Psychiatry, Oncology and Nutrition Wards of the “Maggiore della Carità” General Hospital, Novara (Italy). Secondly, to compare these parameters among the three subgroups of patients. Furthermore, we also recruited a cohabiting relative for each patient and compared the relative's EE and EE as perceived by patients.

Methods

112 patients attending the Psychiatry (n=34), Nutrition (n=56) and Oncology (n=21) Wards were involved. Patients were assessed by means of the following scales: Level of Expressed Emotion (LEE) scale, Paykel Life Events scale, State Trait Anxiety Inventory 1 and 2.

Results

Data collection is ongoing. Anyway, preliminary results suggest that psychiatric patients are more likely to have a longstanding diagnosis, to have received inpatient care but they are less likely to suffer from comorbid organic disorders. Consistently with current literature, obese patients get higher scores than the other subgroups of patients at EE.

Conclusions

Clinical implications are discussed, focusing on the need to carefully address the issue of high EE families in order to reduce the need for inpatient treatment, increase compliance and improve patients’ and relatives’ quality of life.
1728 – Association Between Duration Of Untreated Psychosis And Progression Of Brain Volume Change In Schizophrenia - The Northern Finland 1966 Birth Cohort
Authors: Jääskeläinen E. , Penttilä M. , Haapea M. , Isohanni M. , Murray G. , Jones P. , Guo J. , Nikkinen J. , Kiviniemi V. , Veijola J. , Miettunen J.
Published: July 2013

Introduction

Long duration of untreated psychosis (DUP) has been associated to brain morphological changes in schizophrenia in cross sectional analyses. It is unclear DUP relates to brain volume change over time.

Aims

Our aim was to analyze the association between length of DUP and total brain volume change in schizophrenia in a general population based sample.

Methods

All members of the Northern Finland 1966 Birth Cohort (NFBC1966) known to have had psychotic illness were invited for a field study at the age 34-years (in average 10 year after onset of psychosis) and follow up nine years later at the age 43-years. DUP was assessed from medical records. The total brain volume scan interval change and the DUP information were available for 32 subjects with DSM III R schizophrenia. We analysed the correlation between length of DUP and the mean annual whole brain reduction, adjusted for age of illness onset and sex.

Results

The mean annual whole brain volume reduction was 0.66%. The reduction was 0.76% among those with shortest DUP, 0.58% among those with median DUP, and 0.63% among those with longest DUP. There was no statistically significant correlation between DUP and annual brain volume change when adjusted for onset age and/or sex.

Conclusions

We did not find an association between long DUP and brain volume decrease in schizophrenia in 9 years follow up. Although long DUP has been associated with differences in brain volume in cross sectional analyses, the significance of DUP on brain morphology in long term is unclear.
1742 – Mood Disorder, Psychotic Symptoms And Overlooked Skin Lesions. Mrs. o.: a Single Case
Authors: Pini E. , Tremolizzo L. , Tremolizzo S. , Cerri C.G. , Bartoli F. , Apollonio I. , Ferrarese C. , Cornaggia C.M.
Published: July 2013

Mrs. O. is a 57 years old secretary. Her past medical history is unremarkable relative to psychiatric disorders or other diseases. She came to the ER because of sudden and severe depressive symptoms, including thoughts of death. Moreover, at times she had brief episodes of confusion during which she displayed depersonalization and short periods of spatial and temporal disorientation.

She was hospitalized in the psychiatric ward and underwent routine blood tests, neurological exams and a MR brain scan, without showing any significant abnormalities. Notably, she presented a maculopapular rash compatible with herpes zoster. Thirteen days later, she was feeling much better and was sent home, with an indication of a psychiatric follow-up. A week later Mrs. O. returned to the ER, since she presented a mixed episode, again with psychotic symptoms. During this second period of hospitalization, Mrs. O. presented persistent mild fever, and more apparent brief moments of spatio-temporal disorientation were noted, accompanied by psychomotor slowness. The impression of an underlying process was further confirmed and a neurological consultation was asked for again. Suspecting viral encephalitis, the patient was admitted to the neurological department and started on acyclovir, demonstrating an initial improvement of the psychiatric symptoms. The follow-up MR brain scan was normal. A suspicion of acute inflammatory demyelinating polyradiculoneuropathy (AIDP) was formulated. Thirty days later Mrs. O.’s deficits in strength were improving steadily and she was transferred to the rehabilitation ward. The psychiatric symptoms had completely receded.
1748 – Electroconvulsive Treatment In Schizophrenia: a Systematic Review
Authors: Dominici G. , Longo L. , Marconi G. , Lester D. , Serafini G. , Girardi P. , Pompili M.
Published: July 2013

Introduction

Electroconvulsive therapy (ECT) is a medical treatment that is most effective for mood disorders.It has also been shown to be an effective form of treatment for schizophrenia. However, many unanswered questions remain regarding its role in the management of people with schizophrenia.

Objectives

Evaluate the main indications of ECT in schizophrenia patients.

Aims

To investigate the efficacy of ECT in the treatment of schizophrenic patients, evaluating its effects in the short-term and the long-term, comparing ECT with pharmacotherapy, and assessing the effects of treatment and the main indications for use in patients with schizophrenia.

Methods

A systematic review of the literature was conducted for ECT and schizophrenia. Forty-nine articles from peerreviewed journals were identified.

Results

The most common indication for using ECT for schizophrenia patients was to augment pharmacotherapy, while the most common accompanying symptoms were, in order, catatonia, aggression and suicide. Catatonic patients responded significantly better to ECT than patients with any other subtype of schizophrenia. The combination of ECT with pharmacotherapy can be useful for drug-resistant patients. The use of an ECT-risperidone combination or ECT-clozapine combination in patients non-responsive to prior pharmacotherapy was found to be most effective.

Conclusions

ECT, combined with pharmacotherapy, may be a viable option for a selected group of people with schizophrenia. In particular, the use of ECT is recommended for drug-resistant patients, for schizophrenic patients with catatonia, aggression or suicidal behavior, and when rapid global improvement and reduction of acute symptomatology is desired.
1750 – Affect Dysregulation And Eating Disorders: a Preliminary Study On The Construct Of Alexithymia
Authors: Caslini M. , Pini E. , Bartoli F. , Bertelli S. , Zappa L.E. , Clerici M.
Published: July 2013

Introduction

Alexithymia correlates with fundamental psychological traits of eating disorders in a complex causal model and high relapse rates which may be due to a lack of affect regulation. The literature does not reach definitive conclusions about the usefulness of this construct in the clinical field.

Aims

The purpose of this preliminary study was to evaluate the presence of alexithymia and its correlation with epidemiological variables, psychological characteristics, symptom severity, and general psychopathological dimensions.

Materials and methods

A sample of 125 patients with eating disorders was recruited from outpatient care for eating disorders at the San Paolo Hospital in Milan. Patients were administered the following scales: the TAS20, SCL-90 and EDI-2.

Results and conclusions

The results indicate that 38% of the sample were alexithymic, an underestimation when compared to literature; different types of ED did not differ in alexithymia scores. The TAS20 did not correlate with the epidemiological variables. Diagnoses of Axis II disorders predicted the presence of alexithymia, suggesting that it may contribute to affective dysregulation found in personality disorders. The TAS20 further correlated with EDI-2, in particular with the subscales relating to the body and the relational aspects, and with the level of general psychopathology on the SCL-90, indicating that alexithymia may be a dimension that extends across nosographies in disorders of affective dysregulation.
1753 – Capacity To Exercise Civil Rights: Serial Cases Study 5 Case Reports
Authors: Barros I. , Felix Junior S.P.
Published: July 2013

Introduction

In Brazil there is a great demand for evaluation of the capacity to exercise civil rights of mentally ill patients, aiming their judicial interdiction as a protective measure. In Rio de Janeiro, the Public Attorney Office counts with a seven psychiatrists team, that among other functions, will evaluate the civil capacity of individuals, giving the district attorneys a technical psychiatric background to decide whether, or not, to demand a judicial interdiction.

Objective

Analyze five case reports in which district attorneys have demanded a civil capacity evaluation.

Method

This is a serial cases study of five patients, where each individual was assessed. The final psychiatric diagnosis was obtained with a psychiatric evaluation of the patients, the examination of their records or relatives interview.

Discussion

The five patients, each with a different diagnosis, were assessed individually. The civil incapacity is not an absolute state, but a relative situation, and the reasons and circumstances are important elements in forensic evaluation.

Conclusions

Interdiction is not always the best, or even the most convenient solution to social, economic and legal problems occasioned by the absence or loss of insight or self-determination caused by disability or mental illness. It is vital to characterize the absence or loss of sense of judgment, self-determination or volition, and it is necessary to determine that such damage would be significant to the specific conditions of the familiar and socio-economic profile of each citizen.
1754 – Psychiatric Symptoms In Patients On Methadone Maintenance Treatment
Authors: Moussas G. , Fanouraki E. , Asomatou A. , Dermatis G. , Pachi A. , Nikoviotis D. , Evmolpidi A. , Zafeiropoulos G. , Bratis D. , Tselebis A. , Giotakis K. , Malliori M.
Published: July 2013

Introduction

The high prevalence of psychiatric comorbidity in drug dependent individuals is well known. However, there is limited literature available regarding the comorbidity of psychiatric disorders in drug addicts on methadone maintenance treatment (MMT).

Aims

To determine the comorbidity of mental disorders in patients on MMT.

Methods

The Symptom Checklist 90-Revised (SCL-90R) [1] was completed by 85 drug addicts (65 male and 20 female) on MMT. We recorded demographic data, duration of addiction, and duration of MMT.

Results

The mean age of the sample was 42.0 ± 8.8 years old, the mean duration of substance use was 24.3 ± 8.2 years and the mean duration of MMT was 6.8 ± 4.1. The majority of participants (78.8%) were unemployed and 58.3% of them had no children. Participants scored higher on the depression, paranoid ideation, anxiety, hostility, somatization, interpersonal sensitivity and psychoticism SCL-90R sub-scales, with average scores >1 [2]. On the contrary, lower scores were recorded in the obsessive-compulsive and phobic anxiety sub-scales. The percentage of participants that reported abnormal scores for each sub-scale was as follows: 89.3% for depression, 83.3% for paranoid ideation, 74.7% for anxiety, 66.7% for hostility, 64.7% for somatization, 51.2% for psychoticism and 35.7% for phobic anxiety. No abnormal scores were recorded regarding obsessive-compulsive symptoms. Only 8.4% of participants did not score abnormally on any sub-scale.

Conclusions

Drug-addicted patients on MMT show a high comorbidity of psychiatric disorders. In particular, the likely presence of depressive and paranoid symptoms should be taken into serious account when deciding on a therapeutic strategy.
1758 – Comparison Of The Patterns Of Antidepressant Use Among Young And Older Adults In France
Authors: Etchepare F. , Verdoux H. , Sanglier T. , André M. , Tournier M.
Published: July 2013

Introduction

Antidepressant drugs have been found underused in the older population relative to younger adults, particularly in the USA before Medicare part D. No study assessed the antidepressant use according to age in France.

Objective

To compare the patterns of antidepressant use among young and older adults: treatment duration, switches, association of antidepressants, coprescription of psychotropic drugs and adherence to treatment.

Methods

A historical cohort study included 27,306 young adults and 7,747 older adults, who were beneficiaries of the French national health care insurance and initiated a new antidepressant treatment over the study period. They were followed for atleast six months.

Results

Most patients received only one type of antidepressant (91.81% of young adults and 91.73% of older). The coprescription of psychotropic drugs was frequent in both groups (62.91% in young adults and 62.36% in older). The associations of antidepressant drugs were rare (1.42% in young adults and 1.50% in older). Elderly patients had a significantly longer duration of treatment than young adults (m = 135.4 days, SD = 198.6 vs m = 104.3 days, SD = 159.6; HR = 0.9; 95%CI=[0.88–0.93]; p < 0,0001). Furthermore, they had a higher probability of good adherence than young adults when treatment was initiated by a general practitioner (23.28% vs 16.02%; OR = 1.3 [1.22–1.41]), a hospital practitioner (OR = 1.76 [1.35–2.30]) or a specialist other than psychiatrist (OR = 1.85 [1.26–2.70]).

Conclusions

The use of antidepressant drugs was similar in both age groups, except for the treatment duration and adherence that were better in the older patients. This result may be attributed to the French healthcare system.