bluuebunny/crossref_metadata_2025 huggingface dataset:
Depressive and Anxiety Symptoms In Youth Mental Health Outpatients: An Observational Study
Authors: Ribeiro J. Silva , Morais S. , Mendes E. , Botelho A. , Helena G. , Luísa V. , Aida B. , Madeira N.
Published: May 2016

Introduction

There is an increased risk to develop mental disorder during adolescence and early adulthood. Given this vulnerability, and in order to facilitate the transition from child and adolescent to adult mental health services, specific services for this age group have been developed in the last years, focusing on accessibility and early referral of young mental patients. Our Psychiatry Department (Coimbra Hospital and University Centre, Portugal) created a specific unit for young adults in order to provide better care, in accordance with the specificities of this subpopulation. The team consists of psychiatrists, psychiatry residents, nurses and a clinical psychologist. Referred patients are under 20 years old, presenting clinically relevant psychopathology or behavior disturbances.

Objectives/aims

We aimed to characterize help-seeking outpatients regarding socio-demographic variables and its relation to depressive and anxiety symptoms.

Methods

Socio-demographic characterization was undertaken with young adult psychiatric outpatients observed during eleven months (1st January to 30th November 2015). Multivariate analyses were performed to identify a relationship among socio-demographic and psychopathology variables (assessed with the Portuguese version of Brief Symptom Inventory–53 itens).

Results/conclusions

One hundred and sixty-two outpatients were observed: 97 females (59,9%) and 65 males (40,1%), ages between 17 and 31 years old (average: 19,9; median: 20). We found a positive correlation between depressive and anxiety symptoms and the education level. A negative correlation was found between depressive and anxiety symptoms and male gender and presence of mental illness in the family.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Changing Pattern of Clinical Profile of First Contact Patients Attending Outpatient Services At the General Hospital Psychiatric Units In India Over the Last 50 Years
Authors: Sood M. , Ranjan R. , Chadda R.K. , Khandelwal S.
Published: May 2016

Introduction

Over the last eight decades, general hospital psychiatric units (GHPUs) have become important mental health service set-ups in India. This period has seen a large number of radical changes in the Indian society. In this background, it is important to know if it had any effects on the patients attending the GHPUs.

Methodology

A total of five hundred subjects, attending a GHPU were recruited prospectively for the study. The subjects were assessed using a semi-structured proforma. A comparison was made with similar studies conducted in GHPU settings over the last 5 decades.

Results

Neurotic, stress related and somatoform disorders was the commonest diagnostic group (33%) followed by psychotic disorders (17%) and mood disorders (15%). The finding is broadly similar to the studies done at different times in the last 5 decades. However, there were lesser number of patients with mental retardation, organic brain syndrome and seizure disorder.

Conclusion

The study highlights the strengths of GHPU set-ups like inter-speciality referrals, fewer stigmas, patients travelling from far off places to seek treatment and involvement of family in the care of mentally ill.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Mental Health Improvement Through Physical Therapy: Polish Perspective
Authors: Szczegielniak A.R. , Szczegielniak J.
Published: May 2016

Among people suffering from mental conditions increased prevalence of diabetes, cardiovascular disease, hypertension and respiratory disease is observed, with considerably higher levels of morbidity and mortality. Still, mental conditions are neglected and not treated equally to other medical states in Poland. It is commonly believed that psychiatric patients are violent and unpredictable, even though they are more likely to be a victim of violence themselves. This attitude, reinforced by media coverage and observed also among health care workers, results in unwillingness to have any relations with mental patients due to fear of them being aggressive. Connection between physical well-being and mental health is well known. Physical therapists have necessary knowledge and skills to support development of individual independence, anxiety management and lifestyle control in order to keep patients healthier. It can be done by specially designed treatment programmes consisting of exercises, manual techniques and physical medicine procedures. Lack of understanding of this valuable connection results in insufficient emphasis on the presence of physiotherapist in the multidisciplinary therapeutic team on psychiatric wards nationwide. The study focuses on summary of the current situation in Poland and starts discussion on possible areas of improvements.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
How to Relate Two Specific Concepts: Sexual Health and Sexual Minority?
Authors: Jurysta F.
Published: May 2016

Introduction

WHO defines Sexual Health as “a state of physical, emotional, mental and social well-being in relation to sexuality… and requires a positive and respectful approach to sexuality and sexual relationships, as well as the possibility of having pleasurable and safe sexual experiences, free of coercion, discrimination and violence”.

OCD-10 defines Transsexualism as “the desire to live and be accepted as a member of the opposite sex, usually accompanied by the wish to make his or her body as congruent as possible with the preferred sex through surgery and hormone treatment. The transsexual identity has been present persistently for at least two years. The disorder is not a symptom of another mental disorder or a chromosomal abnormality”.

Objective

We developed an integrative model in 4 axes to approach Sexual Health concept and Transsexualism.

Aims

Holistic and integrative model of transsexualism gives a better understanding of this disorder and ameliorates global treatment. Moreover, this model should be applied to each sexual minority.

Results

1. Etiology integrates psychological, biological and neuro-developmental aspects. 2. Clinical features for treatment imply large and multidisciplinary approach. 3. Scientific literature includes more than thousand papers on Transsexualism and numerous expertises as endocrinology, psychiatry, cardiology, sleep… 4. Social networks are developed in hospitals, associations… as well as between patients themselves.

Conclusions

Holistic and integrative approach of Sexual Minority as Transsexualism could reach Sexual Health concept defined by WHO.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
The Portuguese Mental Health Law –the Criteria for Compulsory Internment
Authors: Prata-Ribeiro H.
Published: May 2016

The Portuguese Mental Health Law is complex, aiming to ensure patients liberties and basic civil rights are respected. A specific part of this law regards the compulsory internment and its criteria, being as protective as possible, in order to prevent wrongful internments for people against their will.

The aim of this study is to analyze the mechanisms available to ensure liberty, in a law apparently about coercion.

The methods used consisted in analyzing the law and interpreting its most important details, mentioning them so they can be read and used as examples.

It can be concluded that the Portuguese law has a very strict list of mandatory criteria for the possibility of the compulsory internment, as a way of ensuring no people suffer it wrongfully. The most important being that no person can be interned compulsory if not considered to suffer from a severe mental disease, not being that enough and having to at least present risk for themselves or others, or to juridical goods of high value. Thus, revaluation of the patient is mandatory only five days after the internment by two different doctors, being the same process assured from then on every two months. Only possible flaw lays on the fact that there is no maximum amount of time predicted for internment, being that always dependent of the revaluations made. Although, the law is considered to be good and prevent abusive use of the compulsory internments.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Childhood Ocd: The Importance of an Integrated Approach
Authors: Molina López M.F. , Hernández Sánchez J.M. , Cancino Botello M.C. , Peña Serrano A.
Published: May 2016

Introduction

OCD is one of the most frequently diagnosed disorders during childhood. A prevalence of 1% is estimated, but according to the literature is an underdiagnosed pathology.

Aims

To differentiate pathological rituals from those that children can have as normal behavior during their natural development. To perform a differential diagnosis and a current review of the literature.

Methods

Descriptive analysis of a patient's medical record diagnosed of OCD and Tourette syndrome.

Case report

Eight years old male diagnosed of Tourette syndrome (vocal and motor tics). Obsessive thoughts cancer related, self-examinations with compulsive pattern and anxiety with social and academic interference. Family history of tics in both parents during childhood. Currently, father with order rituals and mother with an Anxiety Disorder in treatment. Treatment with Sertraline 25 mg/day was tested with poor tolerance. Currently, the patient is being treated with Aripiprazole 1 mg/day with an important improvement of his symptoms and quality of life. OCD has comorbidity with affective and anxiety disorders, as well as Tourette syndrome. It's essential to differentiate pathology from certain behaviors considered normal during a child's development. For example, some children can have certain level of meticulousness, insecurity or a lucky object, but these behaviors shouldn’t be confused with OCD symptoms. The treatment of choice is a combination of CBT with pharmacological therapy.

Conclusions

An early diagnosis during childhood together with an appropriate comorbidity detection can reduce the tendency towards chronicity of this disorder leading to a better quality of life in these patients.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Psycho-Oncology in Portugal: It is Different from the Rest of the World?
Authors: Da Ponte G. , Lobo M. , Neves T. , Paiva A.
Published: May 2016

Introduction

Psycho-Oncology (PO) is a specific psychiatric approach to cancer patients. The main psychiatric disorders observed are delirium and adjustment disorders (AD) and the most frequent treatments used are pharmacologic and psychotherapeutic.

With regard to the type of cancer, the most frequent in Portugal are breast, digestive and prostate.

Objective

Analyze the activity of PO in a district general hospital in Portugal.

Aims

Demonstrate that the main core in PO is similar in the world.

Methods

Prospective longitudinal study, during one year.

Results

The sample had 130 patients (369 evaluations), mainly male, with the mean age of 64.22 years. The most frequent psychiatric diagnoses were delirium (56 cases; 43%) and AD (44; 34%) and the main interventions used were pharmacologic and psycho-education. The most common frequent cancers were digestive (54; 42%), urologic (16; 12%) and breast (15; 11%). This high frequency of urologic cancer was interpreted as a consequence of the sample and its geographic location, but it was also a reflection of the large number of requests made by this specialty. The majority of cancers had an advanced stage (84% vs 16%) that can be explained by the sample but also by health culture in Portugal, which is reflected in the inpatient services: Oncology (51; 39%) and Palliative Care (25; 19%).

Conclusions

The type of psychiatric disorders and treatments offered in PO is preserved around the world. The authors propose to do more studies, namely if the relation with others specialties affects psychiatric treatment of the patient.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Caregiving Experience of Multiple Myeloma Patients
Authors: Gonçalves M. , Teixeira Silva J. , Cabral A. , Santos Z.
Published: May 2016

Introduction

Multiple Myeloma (MM) is a cancer formed by malignant plasma cells. On a worldwide scale, it is estimated that about 86,000 incident cases occur annually. The aim of this report is to investigate the experience among multiple myeloma caregivers, assessing the mental adjustment to cancer diagnosis and the most prevalent psychopathology in the caregivers. This paper also attempts to establish the influence of the symptoms has in the caregiving experience.

Methods

All eligible caregivers will be approached during a regularly scheduled patient clinic visit and informed consent will be obtained prior to study participation. Data will be collected using the Mental Adjustment Scale to the Cancer Scale Partner (EAMC-F), Memorial Symptom Assessment Scale – Short Form, and Depression, Anxiety and Stress Scale (DASS-21).

Results

According to the literature caring for patients with MM can be different comparing with another form of cancer. It is an incurable form of cancer, although treatments improve life expectancy and quality of life. The authors are expecting to find high rates of depression, anxiety, unmet needs, and burden of care. The symptoms of the patients will probably influence the caregiving experience.

Conclusion

MM accounts for about 14% of all newly diagnosed hematological cancer, and it is estimated that its incidence will rise. The importance of psychiatric intervention in the multidimensional approach is becoming a recognized reality. This is essential in the treatment of psychiatric disorders, to improve prognosis and quality of life but also to reduce side effects of treatments and symptoms related to cancer.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Portugal's History of Psycho-Oncology
Authors: Fonseca A. , Batista A. , Malheiro F. , Poças A. , Araújo R.
Published: May 2016

The psycho-oncology represents an interface between psychology and oncology. In Portugal, the creation of Psycho-oncology was due to the collaboration between oncologists with psychiatrists and psychologists. This partnership led to the creation of first Portuguese research works in Psycho-oncology, contributing to the enrichment of this discipline.

Objective

Describe the history of psycho-oncology in Portugal. Research articles and theses related to Psycho-oncology in Portugal and do his description statistics.

Material and methods

Literature review of articles and theses on Psycho-oncology made in Portugal, using the following search engines: “Pubmed”, “Medline”, “ScieloPortugal” and scientific repositories of Portuguese universities.

Results

Until 1997, psycho-oncology did not arouse the interest of researchers; however, since then, the Psycho-oncology has grown exponentially, with regard to the investigation. There was a period of increase in publications between 2005 and 2012 as well as, increase in the number of undergraduate theses, master's and doctorate. Disclosure of publications within the Psycho-oncology lies spread by various magazines in different specialties, demonstrating that this area arouses the interest not only of psychiatrists and psychologists, but also of other health professionals.

Conclusion

Despite growing research in Psycho-oncology and growing interest among clinicians and researchers, there is still some shortcomings, warning that the psychological support is also scarce in some Portuguese institutions.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Prevalence of Different Pain Categories Based on Pain Spreading in Older Adults in Sweden: A Multilevel Association With Socio-Demographic Characteristics, Comorbidities and Drug Consumption (Pain S65+)
Authors: Dragioti E. , Larsson B. , Bernfort L. , Levin L.Å. , Gerdle B.
Published: May 2016

Introduction

Understanding of factors related to chronic pain in elderly is limited.

Objectives and aims

To estimate the prevalence of pain categories based on spreading of pain on the body and to investigate how such spreading is related to demographic variables, pain intensity, comorbidities and medication in an elderly general population in southeastern Sweden.

Methods

A total of 6611 adults aged ≥ 65 years participated (mean age = 76.2; SD = 7.4). Pain categories were assessed by a self-reported postal questionnaire covering 45 anatomical predefined pain regions along with demographics, pain intensity during previous seven days, comorbidities and medication. Poisson regression models with robust error variance were used for data analyzing.

Results

The prevalence of pain spreading categories was: chronic local pain (CLP) 16%; chronic regional pain medium (CRP-Medium) 17%; chronic regional pain heavy (CRP-Heavy) 5% and chronic widespread pain (CWSP) 2%. Overall, increased prevalence for CRP-Heavy and CWSP in subjects 75–79 years old compared to those 65–69, 70–74, 80–84 and ≥ 85 years were revealed. In men, 75–79 years old, CRP-Heavy was more common than in the other pain categories. In women, 75–79 years old CWSP, was more common than in the other pain categories. Pain intensity was strongly associated with all pain categories (P < 0.001). CLP was associated with trauma, rheumatoid arthritis, cancer, prescribed and non-prescribed analgesics. CRP-Medium was associated with rheumatoid arthritis, CRP-Heavy with rheumatoid arthritis and lung diseases and CWSP with rheumatoid arthritis and prescribed analgesics (P < 0.001).

Conclusions

Our findings elucidate heterogeneity of pain in elderly which has to be further investigated.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Psychosemantics of Pain in Patients With Coronary Artery Disease
Authors: Pervichko E. , Zinchenko Y. , Pak L.
Published: May 2016

Introduction

It is known for a fact that a number of psychological factors may affect heart pain perception in patients with coronary artery disease (CAD). However, psychosemantics of pain in CAD patients was hardly ever explored.

Objective

To study the features of pain psychosemantics in CAD patients.

Methods

There were applied McGill Pain Questionnaire (Melzack, 1975); the psychosemantic technique “Classification of sensations” (Tkhostov, Efremova, 1989); the 20-item Toronto Alexithymia Scale (Bagby, Taylor, Parker, 1994); and State-Trait Anxiety Inventory (Spielberger et al., 1983). Fifty-four CAD patients took part in the study, the mean age was 55.9 ± 7.6 years. CAD duration was 5.8 ± 2.6 years.

Results

CAD patients with the high level of trait anxiety (28%) choose greater variety of descriptors for pain definition, revealing an impaired ability to differentiate between emotional states and physical sensations. They show higher scale values for McGill Pain Questionnaire. Patients with high indices of alexithymia (31%) require significantly fewer words for description of painful and dangerous perceptions within the “Classification of sensations”. This may testify to a certain bafflement in verbal description of the pain. With that, intensity of alexithymia does not correlate significantly with the high level of state and trait anxiety (P > 0.05). The method of “Classification of sensations” revealed that patients with trait anxiety, as well as those with alexithymia, define the pain with significantly more numerous metaphorical and affective descriptors (Pervichko, Zinchenko, 2013).

Conclusions

Received results prove an important role of psychological factors in etiology of chest pain in CAD patients with the high level of trait anxiety and alexithymia, which supports the urgency of psychotherapy for them.

References not available.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Labor Pain Management: Effect of Pelvic Tilt by Birth Ball, Sacrum- Perinea Heat Therapy, and Combined Use of them, a Randomized Controlled Trial
Authors: Taavoni S. , Abdolahian S. , Neisani L. , Hamid H.
Published: May 2016

There are various safe non-pharmacologic methods for labor pain management, which mostly decrees suffering of mother and some of them significantly decrease pain too.

Aim

To assess effect of pelvic tilt by birth ball, sacrum-perinea heat therapy and combination use of them on active phase of physiologic labor.

Method

In this randomized control trial, 120 primiparous volunteer with age 18-35 years, gestational age of 38–40 weeks, in one of hospitals of Iran university of medical sciences were randomly selected and divided in four groups: Pelvic tilt by using birth ball, sacrum perinea heat therapy, combined use of two mentioned methods and control group. Tools had 3 main parts of personal characteristic, client examination form and pain visual analogue scale (VAS). All ethical points were considered.

Results

Equality of four groups had been checked before intervention. Lowest pain score first belong to pelvic tilt by birth ball then combined group and finally in heat therapy, which all were significantly less than control group. Significant decrease of pain had been seen in birth ball group and combined group during after 30 minutes intervention, but in the heat therapy group, it was seen after 60 minutes intervention (P-value < 0.05).

Conclusion

All three interventions of this study had significant effect and decreased labor pain during active phase, but highest decrease was in pelvic tilt by birth ball group and its effect started after 30 minutes intervention. It is suggested that that Obstetrics and Midwives consider these safe methods for labor pain management.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
The Concept of Time Perspective Within a Psychiatric Context
Authors: Stefanatou P. , Giannouli E. , Antonopoulou Z. , Tsellos P. , Vaslamatzis G. , Typaldou M.
Published: May 2016

Introduction

According to time perspective (TP), theory behaviour is influenced by the individual's perception of his/her past, present and future. Boyd and Zimbardo postulate that a healthy balance between orientation to the past, present and future exists.

Objectives

Investigation of TP in the context of psychopathology.

Aims

To investigate and compare TP in Obsessive Compulsive (OCD) and Borderline Personality Disorder (BPD).

Method

Twenty-eight OCD and 28 BPD patients (36% of men), matched for age and education, completed the Greek version of the Zimbardo Time Perspective Inventory (ZTPI); a 56-item self-administered questionnaire measuring individuals’ orientations to the past, present, and future. ZTPI consists of five factors: Past Negative (PN), Past Positive (PP), Present Hedonistic (PH), Present Fatalistic (PF) and Future (F).

Results

BPD patients scored significantly higher in PH and PF and significantly lower in PP factors than OCD patients. No significant gender differences emerged for either group. In the BPD group, age correlated significantly negatively with PH, while education correlated positively with F.

Conclusion

The study's findings suggest that BPD patients have a hedonistic orientation towards time and life and a helpless/hopeless attitude towards the future to a significantly greater degree than OCD patients, whereas OCD patients seem to have a more positive and nostalgic attitude towards the past than BPD patients. Further research would provide additional information concerning the role of TP in OCD and BPD patients.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Veiling Existence With Clothing
Authors: Molina-Andreu O. , González-Rodríguez A. , Pelegrina Cetrán H.
Published: May 2016

Our aim is to discuss the notion of freedom in severe depression. We will address it considering several phenomenological conceptions of the matter, from Binswanger's nicht können to more recent Ratcliffe's loss of existential feelings and also by clinging to our own clinical experience, in particular a case of melancholic depression in a 67-year-old woman.

Our patient suffered a clear melancholic syndrome, with an intense psychomotor inhibition, she felt uncapable of doing anything, spent hours brooding over menial tasks and thought much about dying, because she sensed the world as being devoid of possibilities and the future closed, experiences she considered “not related to disease” but to her own “incurable moral failure”.

In order to discuss the notion of freedom in depression, we will particularly focus on one of her psychopathologic phenomena, the empoverishment delusion-like experience of having run-out of proper clothing, which we consider was based on a inhibited “perception” of reality, an unreflective experience of corporeal “not being able”, a loss of the motivational force of intentionality. However, we will argue that this unreflective, pre-given experience showed striking connections to the patient's sub-depressive personhood, a classical Tellenbach's typus melancholicus.

An hermeneutical analysis of her existence will be performed using the anthropologic person-centered dialectic model developed by one of the authors, and building on it, we will introduce the distinction between lived experience (Erlebnis) and factual experience (Erfahrung) which we consider it is essential to enlighten the nature of the loss of freedom that severe depression entails.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Justice In Psychotherapy
Authors: Vyskocilova J. , Prasko J. , Slepecky M. , Hruby R. , Latalova K. , Holubova M. , Marackova M.
Published: May 2016

Introduction

Justice is one of the fundamental concepts of right ordering of human relationships. Justice is a regulative idea for the arrangement of society preceding the law and already seen in animals; the sense of justice is observed as early as in young children. The ability to altruistic behavior, sense of fairness, reciprocity and mutual help are probably genetically determined as a disposition, which may further develop or be deformed by education. Although justice issues are common in psychotherapy, they may not be reflected and processed in the course of therapy.

Method

Review of psychotherapeutic text and reflection of experiences of the authors.

Results

In psychotherapy, justice issues appear directly in what the client says (mostly about injustice), but more frequently, the issues are implicitly contained in complaints and stories against a background of conflicts and problems. They may be related to the client's story, his or her problems with other people, and the therapeutic process itself, including client's selection of therapy, therapeutic relationship, and therapeutic change strategies. Problems with justice between the therapist and the client may be revealed by honest therapist self-reflection or high-quality supervision.

Conclusions

Although justice issues are common in psychotherapy, they may not be reflected and processed in therapy. By increasing receptiveness to the issue of justice, the therapist may improve the therapeutic process.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
The Mechanistic Property Cluster View of Mental Disorder: A Tenable Form of Non-Reductionist Realism?
Authors: Strijbos D.
Published: May 2016

Introduction

The question what mental disorders are lies at the heart of the philosophy of psychiatry. In search of a valid taxonomy of mental disorders, it is a question that needs a proper answer. In recent work, Kenneth Kendler et al. (2011) have put forward the “mechanistic property cluster” (MPC) model of mental disorder. On this view, mental disorders are mechanistically mediated clusters of multi-level (bio-psycho-social) properties. Kendler et al. present the MPC-model as a non-reductionist form of realism – realist because it tries to account for mental disorders in terms of the causal structure of the natural world, non-reductionist because it views mental disorders as clusters of multi-level properties. For the project of psychiatric nosology, such non-reductionist realism would be a great step forward and indeed preferable to pragmatist and constructionist models of mental disorder.

Objective

To critically assess the MPC-model in light of arguments against realism about mental disorders presented in the philosophical literature.

Aims

To achieve a proper understanding of the ontology of mental disorders that can inform future psychiatric nosology.

Methods

Literature study and conceptual analysis.

Results

Despite appearances, the MPC-view fails to take into account the various (societal, practical, scientific) values that determine the delineation of mental disorders. It ultimately faces philosophical problems similar to those of more reductionist forms of realism.

Conclusions

The MPC-model fails as a realist model of mental disorders. Its non-reductionism, however, is an important contribution to theories of explanation in psychiatry.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Posttraumatic Stress Disorder, Violence and War
Authors: Dos Santos M.A.
Published: May 2016

Introduction

In a globalized world, violence, present in all forms and in all places, is a public health problem with serious early or late consequences for the mental health of those who are direct or indirect victims. Violence is avoidable and preventable and is not evenly distributed by population groups or regions being among the top 20 causes worldwide of years lost due to disability and with a projected increase by 2030 according to the World Health Organization (Mathers, Fat & Boerma, 2008).

Methodology

The search was made on ScienceDirect database, using the following keywords: posttraumatic stress disorder; violence and war. It was included documents in English published between 2004 and 2015; as well as textbooks and documents officers.

Discussion

Violence is a risk factor for the disorder of post-traumatic stress disorder (PTSD) which, in turn, is also a risk factor for perpetrating violence. The PTSD can occur when a person faces or faces an unexpected traumatic stressor, such as war, violent personal assault, have been held hostage or kidnapped confinement as a prisoner of war, torture, terrorist attack, or serious car accidents (Javidi & Yadollahie, 2012). The costs of violence are high and its routinization for a living have important effects on mental health.

Considerations

Studies in relation to PTSD and violence are necessary for us to have a better understanding of the phenomenon and its consequences for public health, as well as to promote the mental health of all.

References not available.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Challenging MCMI-III Results With In-Depth Psychometric Assessment and Lacter & Lehmann (2008) Complex Trauma Guidelines
Authors: Kurz R.
Published: May 2016

Introduction

Complex trauma resulting from neglect and abuse in early childhood is frequently misdiagnosed.

Objective

This presentation shares emerging “best assessment practices” that help to differentiate complex trauma from Schizophrenia.

Aims

The case study demonstrates that a wide-ranging psychometric assessment and the application of Lacter & Lehmann (2008) guidelines provide accurate results while MCMI-III results can be spurious.

Method

“Unbelievable” disclosures of an adult survivor prompted a search for scientific references, experiences in the survivor scene and historical examples. Work-related personality questionnaires, in-depth ability tests and Lacter & Lehmann (2008) guidelines were deployed to differentiate complex trauma from an erroneous diagnosis based largely on MCMI-III results.

Results

The research identified measurement issues with the MCMI-III clinical personality questionnaire that generated spurious elevations on Narcissistic, Delusional and Paranoid scales. Work-related personality questionnaires provided much more useful information showing no “personality disorder” risks at all. WAIS results confirmed an earlier “Twice Exceptional” ability pattern with very high verbal IQ (95%ile) and extraordinarily poor auditory working memory (2nd%ile) i.e. a “Dyslexia” performance pattern. Lacter & Lehmann (2008) guidelines showed that none of the 42 schizophrenia indicators applied and only 1/3 of the complex trauma indicators.

Conclusion

Mental health professionals must remain cognizant to the chilling notion that extreme abusers may “frame” victims in order to make them “appear” schizophrenic. As MCMI-III was developed originally for those seeking therapy, its use in forensic settings with the general population should be avoided. Tests do not diagnose people – people do!

Disclosure of interest

The authors have not supplied their declaration of competing interest.
PTSD And Quality of Life Among Firefighters and Municipal Police Forces
Authors: Lima C. , Maia Â. , Ferreira R. , Magalhães A. , Nunes H. , Pinheiro S. , Ribeiro L. , Rodrigues C. , Santos P. , Santos V. , Teles R.
Published: May 2016

Research has shown that PTSD is prevalent among firefighters and police forces and that Quality of Life (QoL) is seriously compromised in individuals suffering from PTSD. However, QoL studies with these professionals are scarce. This study results from a screening program held by the Portuguese Red Cross (PRC) aiming to analyze predictors of QoL. Participants were 95 firefighters and municipal police officers. They answered the Posttraumatic Stress Disorder Checklist (PCL-5) in order to evaluate the prevalence of PTSD symptoms, as well as measures of social support (3-Item Oslo Social Support Scale) and QoL (EUROHIS-QOL-8). From the results, there were no group differences regarding total PTSD, social support or QoL and 10% of participants reported enough symptoms to PTSD diagnostic. Social Support and PTSD explained 25% of QoL variance, PTSD symptoms explaining 10% (negative beta) and, in the second step, social support explained 15%. The results suggest that it would be important to include QoL as an outcome measure in clinical and research work in these populations, with special attention to PTSD and social support.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Differences in Psychiatrists’ and Psychologists’ Classification of Trauma-Related Changes of Consciousness in PTSD
Authors: Schmidt T. , Uldall S.W. , Carlsson J. , Munk-Jørgensen P. , Andersen K.
Published: May 2016

Introduction

Mental trauma may precede persistent changes in a person's mental health in the form of psychosis and dissociation. Presently, there are no subtypes to the diagnosis of PTSD. A psychotic subtype of PTSD has been proposed, and studies show that these patients differ as well in symptoms as biologically from patients with non-psychotic PTSD. Dissociation and psychosis are generally viewed as different phenomena. Where dissociation is understood as a disintegration of the mind, psychosis is viewed as a neurodegenerative disorder on a mainly biological/genetic basis. The delineation of psychotic and dissociative symptoms is not clear however.

Objectives

Our objective is to clarify, whether psychologists and psychiatrists describe trauma-related changes of consciousness (TCC) differently as dissociative or psychotic. Furthermore, we wish to compare scientific journals, and look for differences in how psychiatrists’ and psychologists’ make use of the terms dissociation and psychosis in relation to TCC.

Aims

We aim to investigate whether TCC are interpreted differently among psychiatrists and psychologists.

Methods

This study is a systematic critical review of the literature. The databases PubMed, Embase and PsychInfo will be used. Articles involving PTSD with TCC will be included. Studies will be classified as viewing TCC's as either psychotic or dissociative, based on the terms the authors use to describe the observed phenomena.

Results

The results will be presented at the EPA in March 2016 in Madrid.

Conclusion

The study will reveal differences in how psychiatrists and psychologists classify TCC's in PTSD.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Clinical-Psychopathological Peculiarities of the Prodromal Stage of Psychosis
Authors: Maruta N.O. , Kutikov O.Y. , Bilous V.S. , Zakal K.Y. , Yaroslavtsev S.O.
Published: May 2016

Introduction

Under conditions of growing of mental pathology in population, the European Psychiatric Association proposes an early detection of such pathology and timely medical interventions as the main strategy. First of all, this concerns psychoses at whole, and schizophrenia particularly, as the most disabling mental disorders. Here, a special role belongs to early interventions in the prodromal stage of psychosis (PSP). Such interventions might prevent development of the pathological process, promote solving of everyday and financial problems of patients, an early restoring of cognitive deficits and social functioning.

Aim

To investigate clinical-psychopathological peculiarities and quality of life (QoL) of patients with PSP 72 patients (first hospitalization) with acute polymorph psychotic disorder (F23.0, F23.1) were examined both in the format of real time and retrospectively.

Methods

A clinical-psychopathological and psychometric (PANSS, Scale of Suicidal Risk, SOPS, Scale for Detection of Clinical-Dynamic Variant of Course of Prodromal Period, PAS-SI) methods; the Method for Assessment of Integrative QoL Index.

Results

In the patients clinical-psychopathological impairments in the PSP period manifested in form of a lowered stress tolerability (80.5%), agitation (40.2%), anxious conditions (72.2%), tension, concentration and attention problems (68.0%), sleep disorders (93.0%), contents of thoughts (56.9%). The patients had low QoL indexes on scales of personality realization (81.9%), psychological well-being (87.5%), and a general QoL impression (95.8%).

Conclusions

The abovementioned clinical manifestations should be considered as PSP diagnostic criteria, which open possibilities for an early interventions and prevention of consequences of this pathology.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
A Creative Experience in the Treatment of Patients in Mental Health
Authors: Jaber J. , Humel S. , Reys B.
Published: May 2016

Introduction

The work describes a well-succeeded experience in the utilization of art therapy in a psychiatric clinic in the city of Rio de Janeiro, Rio de Janeiro, Brazil. The clinic is concentrated on the treatment of diverse mental disorders, in special, the disorder due to the use of psychoactive substances.

Objective

To present new and creative therapeutic ways inside the hospital for the treatment of patients having diverse psychiatric disorders, especially disorders due to the use of psychoactive substances.

Aims

Demonstrate the decrease of resistance to the treatment under the hospital system, the strengthening of the therapeutic alliance, the appreciation of the therapeutic space and the well-being promotion during the treatment.

Methods

One hundred and twenty patients, in a clinic for psychiatric treatment, participated in this therapeutic project, which offered psychological treatment through artistic and creative processes, promoting the possibility of experiencing their recovery through the realization of a Carnival programming inside the therapeutic setting.

Results

All patients showed good acceptance to the workshops and participated in the presentations. Over the workshops, the patients also received therapeutic approaches and worked personal difficulties, which came up along the therapeutic process.

Conclusions

Through the project development, the patients showed excellent investment and appreciation of the alliance and therapeutic space, demonstrating the great potential of the psychological treatment, through the creative processes of art therapy.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Different Attitudes Toward Psychiatry and Psychiatric Patients in Nursing Students: Can Personal Experiences Reduce Stigma?
Authors: Pascucci M. , Rubini G. , Stella E. , La Montagna M. , Capobianco F. , Ventriglio A. , De Angelis A. , Parente P. , Janiri L. , Pozzi G. , Di Nunzio V. , Piemontese G. , Bellomo A.
Published: May 2016

Background

Psychiatric patients often do not receive the same health treatment reserved for patients with no mental disorders. Stigma in mental-health nurses can worsen the patients’ healing time and quality of care.

Objective

To explore the different attitudes towards mental illness and psychiatry in nursing students (NS) of the first and the final year of university, and the importance of having visited a psychiatric ward and having known a psychiatric patient.

Methods

Fifty NS completed the following tests:

– Community attitudes towards mental ill (CAMI);

– Attitudes towards psychiatry (ATP-30);

– Empathy quotient (EQ).

Results

NS of the final year differ significantly from those of the first year in 4 CAMI items, in Authoritarianism subscale (P = 0.041), Social Restrictiveness (P = 0.029) and Community Mental Health Ideology (P = 0.045), indicating a more mature and responsible approach to psychiatric patients, without considering them a threat to be secluded. EQ does not show a significant difference in empathy, not even considering the individual items. Final year NS also have more positive attitudes toward Psychiatry in 3 ATP-30 items and total score (P = 0.01). Those who visited a psychiatric ward have more positive attitudes towards mental illness and Psychiatry, in 6 CAMI items and 3 ATP-30 items. Having personally known a psychiatric patient leads to positive attitudes in only a few CAMI items.

Conclusions

Last-year NS, who have had more direct relationships with patients through practical training, have more empathetic and less stigmatizing attitudes. It is also very useful to attend a psychiatric ward during the nursing training.

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Disclosure of interest

The authors have not supplied their declaration of competing interest.
Management And Psychiatric Manifestations Of Anti-NMDA Receptor Encephalitis, A Case Report
Authors: Gallego R. , Flores A.
Published: May 2016

Introduction

Anti-NMDA receptor (NMDAR) encephalitis, formally recognized in 2007 by Dalmau et al, is an autoimmune disorder with a complex presentation that includes psychiatric symptoms, memory deficits, and autonomic instability. The exact incidence is unknown but age, gender, and ethnicity may all play a role. Presence of antibodies against the GluN1 subunit of the NMDAR in the CSF and serum confirm the diagnosis of NMDAR encephalitis.

Case report

We report the case of a previously healthy, 19-year-old woman, 6 weeks pregnant. She had a generalized tonic-clonic seizure followed by psychiatric symptoms, including insomnia, emotional lability, delusions, and disorganized behavior. During the course of the disease, she demonstrated speech impairments and catatonic features associated with abnormal movements.

She was provided lorazepam 1 mg twice a day to treat her catatonic symptoms, her insomnia and her speech improved. Olanzapine was introduced, reaching a dose of 20 mg/day for managing psychosis and agitation.

Discussion

NMDA-R encephalitis is a novel disorder with prominent psychiatric manifestations that is widely underdiagnosed. Neuroleptics may be helpful for managing psychosis and agitation, but may exacerbate movement abnormalities. Benzodiazepines are helpful for agitation, insomnia and catatonia associated with this condition.

Conclusion

Earlier recognition of this illness is crucial as prompt diagnosis and multidisciplinary treatment, can potentially improve prognosis. There is an increasing need for psychiatrists to become aware of the disorder and consider it in their differential diagnosis, specially in patients with new onset psychosis, history of encephalitis or subtle neurological symptoms. Careful selection of psychopharmacological interventions may reduce suffering.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Aids Mania – Is It A Potential Indicator to Initiate HAART?
Authors: Marinho M. , Marques J. , Bragança M.
Published: May 2016

Introduction

Mania occurs in higher rates among individuals with HIV/AIDS, especially with the progression of HIV infection, and constitutes an additional risk factor for facilitate the HIV spread.

Objective

To provide an overview of secondary mania in HIV-infected patients.

Methods

Literature review based on PubMed/Medline, using the keywords “HIV”, “AIDS” and “mania”.

Results

Secondary mania or AIDS mania may be due to illicit or prescribed drugs, CNS infection with HIV, medical illness, including opportunistic infections. Of these, HIV neurotoxicity has been proposed to be the most important factor in its pathogenesis. Mania AIDS differs from primary mania with regard to clinical presentation, course, management and prognosis. The authors will analyze them. Besides decrease to treatment adherence, maniac symptoms also predispose to HIV risk behaviors, which may lead to further HIV transmission. Importantly, the occurrence of HIV mania may announce the transition from HIV infection to AIDS perhaps before other clinical signs are evident. Early recognition and treatment of manic symptoms with mood stabilisers, antipsychotics and HAART improve quality of life, protect from further cognitive deterioration and decrease mortality. In these patients, medication side-effects toxicity, drug interactions, and adherence require special attention.

Conclusions

Mania has been associated with HIV/AIDS and in many instances acts as a barrier to achieving best treatment outcomes. Thus, psychiatrists need to be aware of the complexities involved in the emergence of manic episodes in HIV-infected patients in order to deal with them in the most appropriate and effective manner.

Disclosure of interest

The authors have not supplied their declaration of competing interest.