bluuebunny/crossref_metadata_2025 huggingface dataset:
1364 – Predictive Validity Of The Crisis Triage Rating Scale In The Disposition Of Patients Attending a Nigerian Psychiatric Emergency Unit
Authors: Adeosun I. , Adegbohun A. , Jeje O. , Omoniyi O.
Published: July 2013

Introduction

In psychiatric emergencies, there is a high premium on rapid assessment, acuity categorization and objectivity in decisions regarding the disposition of patients. The Crisis Triage Rating Scale (CTRS), a 3-item clinician-rated instrument, has demonstrated validity in determining the disposal of patients in psychiatric emergency settings. However, its utility has not been evaluated in Nigeria.

Objectives/aim

This study aimed to assess the validity of the CTRS in predicting the disposal (need for hospitalisation or out-patient treatment) of patients presenting to a psychiatric emergency unit in Nigeria.

Methods

The CTRS was administered to consecutively presenting patients (N=247) at the Emergency Unit of the Federal Neuro-Psychiatric Hospital, Yaba, Lagos. Following a comprehensive psychiatric evaluation, clinicians blinded to the CTRS scores made appropriate decisions regarding the disposal of the patients. The ability of the CTRS to predict the need for hospitalisation at different threshold scores, compared with clinical judgement as criterion, was determined statistically.

Results

The optimal threshold on the CTRS for detecting the need for hospitalisation is a cut-off score of 9 as it has the best trade-off with a sensitivity of 0.94 and specificity of 0.89. At this threshold, the overall misclassification rate is 0.09, while the area under the Receiver operating characteristics curve is 0.95. The positive predictive validity for the assessment of disposal at the optimum threshold is 0.91.

Conclusion

The CTRS is a useful tool in determining the disposition of patients presenting to psychiatric emergency service in Nigeria
1374 – Suicides And The Economic Crisis: The Icelandic Experience
Authors: Oskarsson H. , Bjarnadóttir S.
Published: July 2013

Introduction

Iceland has taken a significant economic toll following the recession starting in late 2008. Unemployment has risen sharply, personal and business bankruptcies too.

Aim

The aim of this paper to examine the possible impact of the social consequences of the economic crisis on the suicide rate.

Methods

The Icelandic Bureau of Statistics publications, Causes of Death Register, Unemployment Statistics and Purchase Power Index, were utilized. The suicide rate is based on those between 16 and 90 years, per 100.000 inhabitants. The unemployment rate includes those 16-74 years old. Due to the small population size data are presented as three-year averages from 1981-2010.

Results

The unemployment rate during this period was 0.5-3.0%, with a slightly higer rate in the mid-nineties, until mid- 2008, when it rose rapidly, peaking in 2010 at 8.1%. The suicide rate has declined, particularly during the last ten years, 13.4- 16.5/100.000, with no signs of paralleling the unemployment increase from 2008 onwards. There is one exception, the region with the highest unemployment rate in the past 10 years. The suicide rate there has been high, rising sharply in the past three years. The sample size is small, so this must be interpreted with caution.

Conclusion

The suicide rate has been relatively stable in Iceland, and not affected by the current economic crisis. There are signs, though, that that the region hardest hit by the unemployment is at a higher risk for suicides.
1380 – Association Of Polymorphism Og Genes Neuromediator System Of The Brain (drd4, Dat) With Depression In Siberia
Authors: Gafarov V. , Gromova E. , Gagulin I. , Gafarova A. , Maximov V. , Voevoda M.
Published: July 2013

As part of WHO «MONICA» in 1994, surveyed a random representative sample of men aged 25-64 years, residents of one of the areas of Novosibirsk (657 men). Depression was determined using a questionnaire of the WHO program «MONICApsychosocial ». It was genotyped the investigated polymorphisms of genes DRD4, DAT. Men in the open population of Novosibirsk, high levels of depression (29%). Since depression was significantly associated genotype 4 / 6 of the DRD4 gene and genotype 9 / 9 gene DAT. Accordingly, the depression significantly associated allele of the DRD4 gene and 6 allele of the gene 9 DAT.
1391 – Manic Episode For Consumption Of Energy Drinks
Authors: Hernandez Dorta A. , Quandt Herrera P. , Diaz Marrero G. , Suárez Benitez N. , Vera Barrios E. , Barrau Alonso V. , Gonazalez I. Gonzalez
Published: July 2013

Introduction and objectives

Description of a manic episode with psychotic symptoms in a patient by consumption of energy drinks.

Aims and methods

Literature review of the relationship between energy drink consumption and the possibility of suffering a manic episode and description of a clinical case.

Case

This case report describes a patient with no history of psychiatric interest suffers a manic episode with psychotic symptoms after consuming high amounts of energy drinks.

Results and conclusions

To my knowledge, this is one of the few cases that describe a manic episode in relation to the consumption of energy drinks, given this possibility, clinicians should consider asking about the consumption of energy drinks to young people without previous psychiatric history presenting a manic episode.
1392 – Treated Diabetes Mellitus In Institutionalized Patients With Schizophrenia
Authors: Agarwal S.K.
Published: July 2013

Introduction

Patients with schizophrenia have higher cardiovascular morbidity and mortality compared to the general population. They also have a high levels of cardiovascular mortality risk factors: hypertension, smoking, hyperglycemia, physical inactivity, obesity and dyslipidemia, However, the presence of type 2 diabetes mellitus in institutionalized patients with schizophrenia has not been well studied.

Objectives

To establish an association between type 2 diabetes mellitus and schizophrenia in patients living in residential homes.

Aims

To confirm a high prevalence of diabetes mellitus treatment in these patients.

Methods

Four residential institutions for patients with schizophrenia were chosen for the study. There were a total of 145 patients with schizophrenia. The first had 48 patients, males 30 and females 18, the second had 42 patients; 29 males 13 females, the third had 27 patients; 13 males and 14 females and the fourth had 28 patients; 15 males and 13 females. Computerized pharmacy print outs and records from the institutions and our office charts were reviewed.

Results

Of the 145 institutionalized schizophrenia patients, there were 87 males (60%) and 58 females (40%). The average age was 55.76 years. 39(27%) of 145 patients were on treatment for DM; 106(73%) had no diabetes mellitus; 18 (21%) of 87 males had DM and 69 (79%) had no DM; 23 (40%) of 58 females had DM and 35(60%) had no DM.

Conclusion

Type II diabetes mellitus is extremely common (27%) in institutionalized patients with schizophrenia. Due to close medical monitoring, awareness and treatment is one hundred percent.
1393 – The Study On Validity And Reliability Of Questionnaires Related To Family Environment
Authors: Fu Y. , Hou X. , Meng H. , Qin Q. , Zheng Y. , Qiu T. , Li T.
Published: July 2013

Objectives

To introduce some questionnaires related to family environment such as FAD-GFS (The General Functioning Scale of the MacMaster Family Activity Device), SLE (stressful life events), FSQ (Family Stresses Questionnaire), FLQ (Family Life Questionnaire), EFQ (Everyday Feelings Questionnaire) and evaluate their validity and reliability.

Methods

Using cross-sectional design. The general questionnaire, FAD-GFS, SLE, FSQ, FLQ, EFQ were used to collect information about family environment from 504 parents of only children FACESII-CV and Index of General Affect were used as scale of criteria related.

Results

The reliability and validity of FAD-GFS, SLE, FSQ, FLQ, EFQ is: Cronbach coefficient were 0.695 to 0.749; re-test reliability were 0.712 to 0.901; The scores of the scale in those questionnaires were correlated with each factor significantly and the coefficient of correlation is more than those between each factor of those scales. The correlation between the scores of FSQ, EFQ and the scores of Index of General Affect was-0.192, 0.539; The correlation between the scores of FAD-GFS, FLQ the score of total and three factor differently and the scores of family cohesion scores (FACESII-CV) was -0.423, 0.237, 0.514, 0.302, 0.210.

Conclusion

FAD-GFS, SLE, FSQ, FLQ, EFQ has good reliability and validity, in line with requirements of psychometric and is useful as a tool to evaluate the family environment.
1394 – Suicidal Attempts Among The Military Servants During The Adaptation Period
Authors: Mehdiyev E.S.
Published: July 2013

Introduction

The hardness of military service, the implementation of behavior of a person within the charter and the type of the personality are the important factors that led to the suicidal attempts during the adaptation period.

Methods

Current analysis were 95 militaries, who surveyed and treated at psychiatric and surgery department of Central Clinic Hospital of Armed Forces, after “unlucky” attempts of suicide (analysis for the period 2001–2011). Aged between 18–21.

Results

64.1% of the suicidal attempts of militaries during the adaptation period was observed in the first 6 months. 18.2% of them registered in the first month. In general, 77.7% of surveyed have secondary or incomplete secondary education. On time of days the greatest rating of suicides 37,8% fell at evening time. There were no complications in hereditary mental illnesses among the 93.9% of surveyed (complications only in 6.0% of them). Depending on the daytime and the season, 53.3% of suicidal attempts was observed at noon and 27.7% of suicidal attempts registered in autumn and winter. Only 24.8% of suicidal attempts made by military officers (85.1% by soldiers).

Conclusions

Main causes of suicide among the conscripts are: severities during military service adaption owing to weak preinduction training, low mental attitude and motivation of soldier caused with the omission in education, the current situation in the family, targeting and mockery from fellow servicemen; heavy moral climate in some military units, increased physical and mental stress associated with understaffing personnel of military units, and other negative factors in military sevice activities.
1420 – Patient's Language Proficiency And Inpatient Depression Treatment
Authors: Bermejo I. , Kristion L. , Härter M.
Published: July 2013

Objective

To analyze process and outcome quality of inpatient depression treatment depending on German language proficiency.

Method

Documentation of patients in 24 psychiatric hospitals in Baden-Württemberg (South Germany). The following three groups were matched according to age, gender, and education: native German speakers, non-native speakers with good German proficiency, and non-native speakers with limited German proficiency (67 in each group).

Results

Germans received more group psychotherapy than the other two groups (p = .003). No differences were found regarding pharmacotherapy. Non-native speakers with limited German proficiency were discharged an average of 19 days earlier than German speakers and 7 days earlier than non-native speakers with good German proficiency (p = .02). Compared to Germans, twice as many non-native patients with good German proficiency and nearly four times as many patients with limited German proficiency were discharged with depressive symptoms (p = .006).

Conclusion

Results confirm the significance of linguistic factors for the effectiveness of treatment of depressive patients and show a direct impact of linguistic factors on length of hospitalization.
1438 – Default Mode Network In Left-sided Temporal Lobe Epilepsy Patients With And Without Comorbid Affective Disorders
Authors: Shmeleva L. , Lebedev A. , Kissin M.
Published: July 2013

Affective disorders are common in patients with temporal lobe epilepsy, especially in cases of left-sided epileptic focus localization (lsTLE).

Aim

To characterize connectivity patterns of brain default mode network (DMN) in lsTLE patients with and without anxiety and depressive disorders.

Subjects and methods

28 lsTLE patients, divided into two groups: patients with (“affective” group) and without anxiety- depressive symptoms. Beck Depression Inventory (BDI), Hospital Anxiety Depressive Scale (HADS), Hamilton Anxiety Scale (HAM-A) and Montgomery-Asberg Depressive Rating Scale (MADRS) were used to assess affective symptoms. All subjects underwent 9-min resting-state fMRI scanning session. Independent component analysis (ICA) was used to isolate DMN. The resulted maps were compared in groups using two-sample t-test. The results were considered as statistically significant according to threshold of p < 0.005 with a 10-voxel extent that has recently been shown to produce an optimal balance between Types I and II error rates in fMRI studies (Lieberman, 2009). The data were processed and analyzed using SPM8 and “GIFT” toolbox for ICA “GIFT”.

Results

Mild depression and moderate-severe anxiety levels were observed in the "affective" group. Significantly increased functional connectivity was found in “affective” group in the right cerebellum (culmen), right gyrus fusiformis, dorsolateral prefrontal and midcingulate area, and in the left insula.

Conclusions

We found that brain DMN is altered by affective disorders associated with lsTLE. The observed regional pattern of difference can reflect the impaired levels of self-control often present in lsTLE patients with affective symptoms
1440 – Anterior Hippocampal Connectivity And Response To Frustration In Major Depression
Authors: Lebedev A.V. , Abritalin E.Y. , Lebedeva A.K. , Shmeleva L.M. , Korzenev A.V.
Published: July 2013

Introduction

Major depressive disorder (MDD) is associated with low frustration tolerance, which is a risk factor for suicide. Hippocampal structural and functional abnormalities have been documented to play one of the crucial roles in the pathophysiology of depression. Recent studies have revealed functional differentiation of the hippocampus. Thus, activity of the anterior part was shown to be associated with negative affect mediation.

Objectives

To investigate brain mechanisms of frustration, comparing its impact on anterior hippocampal connectivity in MDD patients and healthy controls (HCs).

Methods

14 MDD and 14 HC right-handed subjects were included in the study and underwent comprehensive clinical assessment. MDD was diagnosed during psychiatric interview according to ICD-10 criteria. The Hamilton Depression Rating Scale was additionally used to assess depressive symptoms. The original Stroop test was modified to evoke a state of frustration by administrering impossible task conditions and negative feedback during 10-min functional magnetic resonance scanning session. Psychophysiological interactions were used to analyze left and right anterior hippocampal functional connectivity changes in response to frustration. The resulted Z-maps were adjusted using Z > 2.3 threshold and a (corrected) cluster significance threshold of p = 0.05.

Results

Increased functional connectivity of the left anterior hippocampus in response to frustration was significantly higher in MDD patients compared to HCs in the pars opercularis of the right prefrontal cortex and bilateral posterior cingulate regions.

Conclusion

The results revealed that depressed patients demonstrate abnormally increased anterior hippocampal response to frustration, suggesting that hippocampal-neocortical network impairment may contribute to decreased frustration tolerance associated with MDD
1449 – A Novel Approach Of Watching Movies And Conducting Therapy For Psychiatric Inpatients
Authors: Yazici E. , Ulus F. , Selvitop R. , Yazici A.B. , Aydin N.
Published: July 2013

Objective

Using movies in psychiatric group therapy & rehabilitation classes provides ‘Entertainment, Education, Empowerment’ for the participants. We have provided such a setting where severely ill psychiatric inpatients. We aimed to describe the “Watching Cinema- Group Therapy” implementation for 500 inpatients in one year.

Method

Selected movie clips were watched in the morning and group therapy session took place in the afternoon. The patients were instructed to watch the film closely, and if required, ask for certain scenes to be replayed for a better understanding. It was followed by review of the film.

Results

We observed that these activities have encouraged the patients to talk about their beliefs, thoughts and feelings while discussing the characters and stories. We have also used as a reward for the patients who have therapeutic alliance. It motivated them to do something instead of being stayed in the room. Short movie scenes were more useful to follow up the films for the patients who have been administrated high doses of drugs.

Conclusions

It is the ingenuity and creative approaches of the educators and healers using movies in favor of behavioral health improvement. Movies are strong and important tools to be used for positive as well as productive means in treatment and teaching.
1458 – Features Of Psychomotor Development Of Children With Autistic Spectrum Disorder
Authors: Goryacheva T. , Nikitina J.
Published: July 2013

Autistic Spectrum Disorder (ASD) includes a wide range of various impairments demanding a special approach on every single stage of development.

The aim of the research was finding out the features of psychomotor development of children with ASD. Accordingly to the aim the research had following objectives:

1)

Detection of impairment mechanism of regulation of psychic process belonging to different levels, based on the analyses of

2)

normal intrauterine psychic development.

3)

Marking out several groups of children having different levels of psychomotor development.

4)

Working out the directions of intervention and evaluation their efficiency.

Results

The analyses of normal intrauterine psychic development, based on principle of reconfiguration of cross-functional connections, system organization and construction of psychic functions hierarchy, allowed marking out four groups.

1)

Sensory level of psychic development, serving for keeping the internal homeostasis.

2)

Perception level of psychic development, working out a certain range of automatisms.

3)

Level of bodily-spatial analyses, helping to master either inner or outer space.

4)

Voluntary level of psychic development, building not vertical but horizontal inter-hemispheric connections.

For every group of children we have marked out the diagnostic indications and stated the correction tasks. We propose the whole structure of sessions: sequence, periodicity, evaluation criteria for psychomotor correction. The correction method does not have a hard fixed structure, its application to children having Autistic Spectrum Disorder demands individual approach. It also has a range of contra-indications
1460 – Translation And Validation Study Of The Subjective Happiness Scale (shs) In Greek General Population, Diabetes Mellitus And Patients With Emotional Disorders
Authors: Lyrakos G.N. , Dragioti H. , Batistaki C. , Spinaris V.
Published: July 2013

Introduction

The SHS is a brief four-item measure of global subjective happiness rated on a Likert scale from 1 (strongly disagree) to 7 (strongly agree). SHS is suited for different age, occupational, linguistic, and cultural groups, is easy to implement and its short form possesses measurement accuracy.

Objectives

To test the psychometric properties of SHS.

Aims

To validate an easy to use and valid measurement, for primary care and during treatment assessment in psychiatric patients with emotional disorder(PPED) and general population (GP) in Greece.

Methods

Translation was performed using the multiple forward and backward translation protocol. Life orientation test (GrLOT-R), Depression anxiety stress scale (DASS) and Satisfaction with life Scale (SWLS), was also administered to check construct validity of SWLS.

Results

856 adults participated, 218 (25.5%) males, 638 (74.5%) females. The total scale of the SWLS had a coefficient alpha of .756. Item - total correlations where from .223-.735. Factor analysis has supported a unidimensional model with 1 factor explaining 59.4% of the total variance. Mean scores differed significantly between GP (M=18.4±4.4) and PPED (M=15.2±4.2) (Mean differences=4.622 p< .001). There was significant negative correlation with stress (r=-.443 p< .001) anxiety (r=-.350 p< .001) and depression (-.416 p< .001) and positive with GrLOT-R (r=.574 p< .001) and SWLS (r=.678 p< .001).

Conclusions

The results of the current validation study suggest that the Greek translation of the SHS is both reliable and valid, with good construct and discriminant validity and psychometric properties close to those reported in the international literature.
1465 – Osmotic-release Oral System Methylphenidate (oros-mph) Treatment Of Adult Prison Inmates With Adhd: a Randomised Controlled Trial With Open-label Extension
Authors: Ginsberg Y. , Hirvikoski T. , Grann M. , Lindefors N.
Published: July 2013

Introduction

ADHD is associated with pervasive cognitive, emotional and functional impairments and increased rates of coexisting disorders. Epidemiological studies indicate 25-45% of prison inmates to have ADHD. However, ADHD is often unrecognised in prison inmates and stimulant treatment was not previously evaluated in this group.

Objectives

Provide effective treatment for prison inmates established with ADHD.

Aims

Evaluate efficacy and long-term effectiveness of osmotic-release oral system methylphenidate (OROS-MPH) in adult male long-term prison inmates with ADHD.

Methods

A 5-week randomised, double-blind, placebo-controlled, fixed-dose (72 mg/d) trial was conducted in 30 prison inmates with ADHD and coexisting disorders. In a following 47-week open-label extension (OLE), flexible-dosing OROS-MPH was provided alongside psychosocial interventions within a high-security Swedish prison. Primary outcome was change in ADHD symptoms after 5 weeks (CAARS: O-SV). Secondary outcomes included self-reported ADHD symptoms, global severity, global functioning, cognition, motor activity, institutional behaviour and quality of life.

Results

OROS-MPH was highly effective and overall safe, both in the short-term relative to placebo (Cohen’s d=2.17; NNT=1.1), and in the long-term when provided alongside psychosocial interventions. Treatment continued to improve ADHD symptoms, global functioning, motor activity, cognition, quality of life, and behaviour control over the 47-week OLE. No drug misuse was reported and a majority of participants completed rehabilitation programs.

Conclusions

OROS-MPH effectively improved symptoms and functional impairments of ADHD in prison inmates with ADHD. We suggest that OROS-MPH provided alongside rehabilitation programs could be a feasible and effective multimodal intervention for adults with ADHD and coexisting disorders within a prison setting
1473 – Seasonal Pattern In Bipolar Disorder: Prevalence, Clinical Characteristics And Gender Influence
Authors: Geoffroy P.A. , Etain B. , Scott J. , Boudebesse C. , Lajnef M. , Leboyer M. , Bellivier F.
Published: July 2013

Introduction

Circadian rhythm pathways are highlighted in a number of etiological models of bipolar disorder (BD). More than 25% of bipolar patients may present seasonal pattern (SP). However, there is very limited scientific data on the prevalence of SP, its clinical manifestations and any gender influence.

Methods

Caucasian individuals who met DSM-IV criteria for BD I or II were recruited from three university-affiliated psychiatric departments in France (Paris, Bordeaux, Nancy). SP was defined according to DSM-IV criteria. Clinical and socio- demographic variables were obtained from structured interviews with the patients and their relatives.

Results

Four hundred and fifty-two bipolar patients (n=452) in euthymic state were included in the study, 102 of them (23%) were considered as having SP according to DSM-IV criteria. Multivariate analysis showed a significant association of BD patients with SP for bipolar II subtype (OR=1.99, p=0.013), rapid cycling (OR=2.04, p=0.02), eating disorder (OR=2.93, p=0.003) and the total number of depressive episodes (OR=1.12, p=0.002). 71% of cases were correctly classified by this analysis. However, when stratifying the analyses by gender, SP was associated with BD II subtype (OR=2.89, p=0.02) and total number of depressive episodes (OR=1.21, p=0.002) in males but with rapid cycling (OR=3.02, p=0.003) and eating disorders (OR=2.60, p=0.02) in females.

Conclusions

The high prevalence of SP in BD, its associated clinical characteristics and the observed differences between genders, suggest that SP represents a potentially important specifier of BD.
1476 – Factors Associated With Lifetime Antidepressant-induced Mania In Bipolar Disorder Patients
Authors: Brichant-Petitjean C. , Sportiche S. , Etain B. , Henry C. , Kahn J.-P. , Azorin J.-M. , Marion L. , Bellivier F.
Published: July 2013

Introduction

Antidepressants may induce manic or hypomanic episodes. The identification of predictors of antidepressant- induced mania (AIM) is essential to improve the management of bipolar disorder (BD). However, the rare studies on AIM are generally characterized by small sample sizes, varying definitions of AIM and heterogeneous groups of patients, thus leading to conflicting results.

Objectives

To compare a population of AIM(+) to AIM(-) patients in order to identify specific clinical factors associated with AIM.

Methods

All 252 participants met the DSM-IV criteria for BD. Only patients who reported AIM in the 90 days after the beginning of an antidepressant (with or without a mood stabilizer) were diagnosed as AIM (+) and those without any lifetime history of AIM despite lifetime antidepressant prescription were considered AIM (-). Sociodemographic and clinical factors were collected using the DIGS, ALS, AIS BIS and WURS.

Results

AIM(+) (N=74) and AIM(-) (N=178) patients did not differ significantly in terms of age, gender distribution, bipolar disorder duration and age of onset, ALS, BIS and WURS score. However, the rates of rapid cyclers, lifetime history of suicidal acts, alcohol use disorder and AIS score were significantly higher in the AIM(+)group. The type of polarity of onset was significantly different in both groups.

Conclusions

A history of rapid cycling, of suicidal acts and of alcohol use disorder could be considered as risk factors of AIM in BD. Patients with these factors could therefore be identified as a vulnerable subgroup prone to manic switch with antidepressant.
1478 – Role Of Hyperthermia In Neurologic Sequelae Of The Neuroleptics-lithium Combination
Authors: Lakhal N. , El Kefi H. , Souissi S. , Jouini F. , Edhif S. , Oumaya A. , Gallali S.
Published: July 2013

Introduction

The combination of lithium and neuroleptic is frequently used in the treatment of bipolar disorder. After a febrile episode, some patients exhibited neurological sequelae including cerebellar, pyramidal and extra-pyramidal signs. Lithium may be the main factor of neurotoxicity but hyperthermic states are probably involved in determining brain damage.

Case description

58 year-old Tunisian women with a medical history of bipolar disorder treated by combination of lithium carbonate (700 mg/day) and levomepromazine (50 mg/day), was presented to the hospital with complaint of fever, cough, walking instability, choreic and dystonic abnormal movements. Physical examination found a temperature of 39 C°, rhino- bronchial, cerebellar, pyramidal, and extra-pyramidal syndrome. The additional diagnostic tests such as brain scan, MRI brain and lumbar puncture were normal. Desperate the corticoid treatment the cerebellar syndrome persisted.

Discussion

This case and some literature reviews illustrate the role of hyperthermic states in brain damage of the neuroleptics-lithium combination. Neuropathological findings showed selective degeneration of cerebellar purkinje cells. Research on this topic is recommended.
1479 – Schizophrenialike Psychosis - a Case Of a Hidden Neurosyphilis
Authors: Rio C. , Pinto H.C.
Published: July 2013

Background

Recent studies have shown an increase in the prevalence of infectious syphilis. If not treated, 30% of patients may develop tertiary syphilis, where neurosyphilis is included. Neurosyphilis can present a variety of psychiatry symptoms, including mania, depression, psychosis and dementia.

Methodology

The authors present a case of a persistent psychosis (similar to late schizofrenia) with 3 years of evolution in a 42-years old man. In the first hospitalization, the patient was clinically studied, namely with Venereal Disease Research Laboratories (VDRL) that was negative. Other possible causes for psychosis were excluded. His clinical state never improved significantly despite the high doses of antipsychotics.

The hypothesis of syphilis was deeply studied with Fluorescent Treponemal Antibody-Absorption (FTA-ABS) and Treponema Pallidum Hemaglutination Assay (TPHA) which revealed positive results.

A lumbar puncture was performed and cerebrospinal fluid analysis resulted in the diagnosis of neurosyphilis. The Computerized Axial Tomography (CAT) had no abnormalities. The patient started the course of treatment for neurosyphilis with endovenous penicillin G.

Results

After the treatment of neurosyphilis, steady improvements were noted in psychotic and cognitive symptoms. After his discharge from the hospital he was medicated only with Lorazepam S.O.S.

Conclusions

This case emphasizes that neurosyphilis still has to be considered in the differential diagnosis within the context of psychiatric disorders even with no other signals suggesting this diagnosis. Psychiatric symptoms and cognitive dysfunction intensely respond to the correct treatment of neurosyphilis. Furthermore, this case shows that we should be alert for the VDRL false negatives
1480 – Psychopathological Disease And Emotion Regulation
Authors: Velotti P. , Garofalo C. , Zavattini G.C.
Published: July 2013

Introduction

Research aims to understand how psychological mechanisms influence mental health. Accordingly, much of the studies in this field has been dedicated to clarifying how emotion regulatory strategies may be associated with increased psychopathology (Gross & John, 2003). Individuals regulate their emotions in a wide variety of ways.

Objectives

We focus on two commonly used emotion regulation strategies: reappraisal (changing the way one thinks about a potentially emotion-eliciting event) and suppression (changing the way one responds behaviorally to an emotion-eliciting event).

Aims

We analyze emotion regulation strategies (Gross & John, 2003) in order to examine their relation with a broad range of psychological problems and symptoms of psychopathology.

Methods

Emotion regulation was assessed by means of the Emotion Regulation Questionnaire (ERQ, Gross & John, 2003), which taps two regulatory strategies, suppression and reappraisal. The psychopathological distress was assessed by the 90- item Symptom Checklist-90-Revised (SCL-90-R; Derogatis, 1994) by indicating the degree of distress on a scale of 0 (not at all) to 4 (extremely) caused by a list of problems during the past 7 days. The sample consisted of 548 individuals (age: M=32.97; DS=3.55 for male; M=31.29; DS=3.64 for female).

Results

Individuals who reported low levels of suppression reported the lowest levels of psychopathological symptoms.

Conclusions

Our findings highlight that the capacity to regulate emotions may be associated with reduced psychopathology and more adaptive functioning
1487 – Affective Temperament And Psoriasis: a Report Of 65 Adult Cases
Authors: El Kefi H. , Youssef Zaara S. , Souissi S. , Jouini F. , Edhif S. , Oumaya A. , Lakhal N. , Gallali S.
Published: July 2013

Introduction

Psychosocial stressors are found in 40 to 80% of patients with psoriasis. The inability to cope with a stressful situation can induce a flare up of psoriasis. Several factors modulate our adaptive response to stress such as affective temperament (AT).

Objectives

The objective of this study is to determine the dominant AT in patients with psoriasis and the correlation between AT and clinical features of the disease.

Methods

It was a descriptive cross-sectional study. A total of sixty five subjects and two examiners were recruited. The evaluation of temperament was made thanks the Tunisian version of TEMPS-A.

Results

Hyperthymic temperament (HT) was the dominant temperament in patients with psoriasis (70%). Patients with poor response to treatment had a higher prevalence of cyclothymic (CT), depressive (DT), irritable (IT) and anxious (AT) temperament. The prevalence of CT (p=0.039), DT and AT (p=0.032) was higher in patient with joint pain and pruritus. The stressful situations induce more flare up of psoriasis in patient with AT (p=0.006) and DT (p=0.06). A patient with HT reported minimal discomfort, the patient with IT, CT, DT and AT had daily to major discomfort.

Conclusion

Patients with psoriasis have the same dominant temperament than general population. However, the patients with AT, CT, DT and IT have more poor response to treatment and more functionally disabling symptoms (pruritus, joint pain). The impact on quality of life and expressed discomfort would be greater.
1491 – Psychogenic Mental Disorders In Women - Mothers Of Dead Military Man: a New Version Of a Depressive Syndrome
Authors: Pudikov I. , Romanov D.
Published: July 2013

Modern war, more sophisticated methods of destruction act not only on the psychic of the military, but also on the civilian population, creating new clinical material, relatively unknown in the era of conventional wars. Prolonged reactive depression in mothers and wives of killed military personnel is one of them. The originality and the protracted course of mental state are associated with certain features of trauma. Inability to identify the body of the deceased is a key element of opportunistic situations in further defining the specificity of the clinical picture in patients of this group. The inability to fulfill the prescribed public burial ritual, the potential probability of erroneous report of son's death, the lack of time for lamentation with the body of the deceased, lack of rituals deprives women of important defense mechanisms of grief recovery. According to anamnesis, the inability to implement the ritual of lamentation with the victims caused the onset of anxiety, guilt feelings, burdensome feelings of mental anguish. Later (1-2 years) the status of women was characterized by contradictory combination of anxiety- melancholic background mood, guilt, feeling of internal strain, vague expectations, discomfort feeling of depersonalization.

There are epistemological basis for allocating disorders in separate diagnostic categories:

1.

Phantom feelings are quite easily recognized, so that they can be recognized well with high level of consistency between clinicians.

2.

According to catamnesis, phantom experiences, welded with a specific, anxiety-melancholic affect tend to protracted, chronic course, maintaining their clinical identity and anguish, torturous content for the person
1494 – Mindfulness-based Cognitive Therapy Reduces Depression Symptoms In People Who Have a Traumatic Brain Injury: Results From a Randomized Controlled Trial
Authors: Bedard M. , Felteau M. , Marshall S. , Cullen N. , Gibbons C. , Dubois S. , Maxwell H. , Weaver B. , Rees L. , Gainer R. , Mazmanian D.
Published: July 2013

Introduction

Traumatic brain injuries (TBI) may lead to persistent depression symptoms. We conducted several pilot studies to examine the efficacy of mindfulness-based interventions to deal with this issue; all showed strong effect sizes. The logical next step was to conduct a randomized controlled trial (RCT).

Objective

We sought to determine the efficacy of mindfulness-based cognitive therapy for people with depression symptoms post-TBI (MBCT-TBI).

Methods

Using a multi-site RCT design, participants (mean age = 47) were randomized to intervention or control arms. Treatment participants received a group-based, 10-week intervention; control participants waited. Outcome measures, administered pre- and post-intervention, and after three months, included: Beck Depression Inventory-II (BDI-II), Patient Health Questionnaire-9 (PHQ-9), and Symptom Checklist-90-Revised (SCL-90-R). The Philadelphia Mindfulness Scale (PHLMS) captured present moment awareness and acceptance.

Results

BDI-II scores decreased from 25.47 to 18.84 in treatment groups while they stayed relatively stable in control groups (respectively 27.13 to 25.00; p = .029). We did not find statistically significant differences on the PHQ-9 and SCL-90R post- treatment. However, after three months, all scores were statistically significantly lower than at baseline (ps < .01). Increases in mindfulness were associated with decreases in BDI-II scores (r[29] = -.401, p = .025).

Conclusions

MBCT-TBI may alleviate depression symptoms up to three months post-intervention. Greater mindfulness may have contributed to the reduction in depression symptoms although the association does not confirm causality. More work is required to replicate these findings, identify subgroups that may better respond to the intervention, and refine the intervention to maximize its effectiveness.
1514 – Barahona Fernandes: a Helmsman In The 20th Century Portuguese Psychiatry
Authors: Canha J. , Rio C. , Rodrigues-Silva N.
Published: July 2013

Introduction

Barahona Fernandes (1907-1992) is considered one of the most distinguished portuguese psychiatrists and perhaps the most known outside the country. He did part of his studies in Germany, under orientation of prominent professors such as Carl Kleist and Kurt Schneider, and got contact with the philosophic theories of Karl Jaspers and Nicolai Hartmann. In Portugal, he leaded the Lisbon University Clinic where he developed his countless studies on mental health.

Objectives

The authors shortly revisit the biography and some aspects of Barahona Fernandes’ works.

Aims

This communication points out the singularities of his personality and work, and draws attention to the importance of his contributions on mental health.

Methods

Review of the literature concerning the author’s publications and biography.

Results

Through his whole work emerges the effort in a “converging view” that tries to integrate different influences and perspectives, in order to better achieve a coherent explanation of the human being. One of his theoretical models discusses the Personality - “Personalidade em Situaao” - in which he describes a complex organization based on comunicating hierarchical layers (from a biological foundation to a more noologic apex), subject to the interaction with the environmental features, in a homeostatic balance that can be disturbed.

Conclusions

The unique work of Barahona Fernandes constitutes an important material to apprehend the psychic experience. His “converging” theories try to capture a multi-dimensional structure of the human being and help clinicians to get a deeper understanding on the process of getting mentally ill
1516 – Effect Of Four Weeks Of Rtms On Brain Activity In Obsessive-compulsive Disorders During An Flanker Task: a Randomized Double Blind Study
Authors: Gaudeau-Bosma C. , Januel D. , Jaafari N. , Mallet L. , Pelissolo A.
Published: July 2013

Currently, 25-30% of Obsessive-compulsive disorder (OCD) patients are considered to be resistant to conventional therapies (cognitive-behavioral therapy and medications including selective inhibitors of reuptake of serotonin and clomipramine). Among alternative therapeutic strategies for theses refractory patients, repetitive Transcranial Magnetic Stimulation (rTMS) has been proposed (Greenberg et al., 1997). Few regions were choice for OCD patients and one of them could be a promising target: the Supplementary Motor Area (SMA). The aim of this project focuses on evaluate the SMA as a promising region to treat OCD patients. Forty patients were include in this double blind study, each received 20 session of rTMS (1 session / day) for 4 weeks with active or sham coil. rTMS parameters consisted of 1500 pulses/d, at 1 Hz, 5 trains of 5 min with an interval inter- stimulus of 2 min and 100% of motor threshold. To localize the SMA, neuronavigation was based on anatomical Magnetic Resonance Imaging (MRI) using Brainsight software. The therapeutic effect of rTMS will be assessed through a psychological evaluation and a task performed in functional MRI, before and after therapeutic: The Eriksen’s task. Its objective is to evaluate cerebral metabolism’s modifications during a simple task likely to recruit the error detection system implicating the Anterior Cingulate Cortex without inducing obsessive-compulsive symptoms. This modification were correlated with clinical and cognitive assessment and behavioral results of the Eriksen task
1519 – Significance Of Support Of World Psychiatric Association And European Psychiatric Association To Congresses Of National Psychiatric Associations - Case Of Bosnia-herzegovina
Authors: Pajević I. , Hasanović M. , Avdibegović E. , Račetović G.
Published: July 2013

Bosnia-Herzegovina (BH) appeared as very complex geopolitical and demographical country after tragic 1992-1995 war and Daytona Peace Agreement. Besides all national professional medical associations, the Psychiatric Association of Bosnia- Herzegovina (PABH) is only one which is successfully established on the whole geopolitical space of BH. This Association organized the first national Congress which is the third Congress of psychiatrists after BH established trough Daytona Peace Agreement. In very humble financial occasions with world economic crisis it was very difficult to organize professional and scientific meeting with high level of realization. After communication with the leaders of World Psychiatric Association (WPA) and European Psychiatric Association (EPA) considering mutual collaboration, realization of this Congress was possible on very high level of scientific and professional achievements and performances.

The Third Congress was Co-sponsored by WPA and under the patronage of EPA. WPA helped in engagement of ten distinguished university professors and researchers from USA, Australia, UK, South Africa, Pakistan, Germany, Italy and Austria but also with the workshop: “Partnership for mental health improvement in world: WPA recommendations for good practice in work with users of mental health services and their families”. EPA helped with two EPA academia CME courses: “Complexity of posttraumatic reactions” and “Psychoses-proneness: Clinical assessments of vulnerability”. All 30 university professors of psychiatry from Slovenia, Croatia, Serbia and Bosnia-Herzegovina (region of former Yugoslavia) together with about 260 participants had opportunity to be informed about the most novel achievements in theory and practice of psychiatry and mental health care in the World.
1526 – Attenuation Of The Hypothalamic-pituitary-adrenal Axis As a Consequence Of Childhood Adversity - a Possible Mechanism Of Sex-specific Vulnerability For Psychiatric Disorders In Adolescence?
Authors: Kaess M. , Simmons J.G. , Whittle S. , Allen N.
Published: July 2013

Introduction

Alterations of the Hypothalamic-Pituitary-Adrenal Axis (HPAA) may be related to the development of psychiatric disorders, especially in the context of childhood adversity. The “attenuation hypothesis” postulates that chronic childhood adversity leads to initial hyperactivation of the HPAA, which subsequently may turn into hypoactivation during adolescence, and support the development of emotional and behavioural problems. However, studies investigating this hypothesis during the course of adolescence are rare.

Methods

The sample comprised 49 adolescents (f/m 19/30), subsampled from a larger longitudinal study on adolescent development. Assessments were performed at three points in time (T1-T3). Pituitary Gland Volume (PGV) as an estimate of chronic HPAA activity was measured by MRI at T1 (mean age 12.5) and T3 (mean age 16.5). HPAA functioning was assessed via multiple salivary cortisol measures at T2 (mean age 15.5). The Cortisol Awakening Response (CAR) was calculated as a measure of HPAA activity. Additionally, childhood adversity was assessed at T2 using the Childhood Trauma Questionnaire (CTQ).

Results

There was a significant sex-specific association of PGV at T1 and HPAA activity at T2. While PGV was positively predicting HPAA activity in boys, girls showed a reverse pattern (attenuation of the HPAA). A blunted CAR in girls was significantly related to their report of childhood adversity.

Conclusions

The results show that girls may have a higher tendency of attenuation of the HPAA in the context of childhood adversity and initial hyperactivation of the HPAA. This may contribute to their higher risk for diverse psychiatric disorders during adolescence.
1533 – A Naturalistic Study Of The Diagnostic Evolution Of Schizophrenia
Authors: Serrano-Drozdowskyj E. , Lopez-Castroman J. , Leiva-Murillo J.M. , Blasco-Fontecilla H. , Garcia-ieto R. , Artes-Rodriguez A. , Morant-Ginestar C. , Blanco C. , Courtet P. , Baca-Garcia E.
Published: July 2013

Introduction

In the absence of biological measures, diagnostic long-term stability provides the best evidence of diagnostic validity.Therefore,the study of diagnostic stability in naturalistic conditions may reflect clinical validity and utility of current schizophrenia diagnostic criteria.

Objectives

Describe the diagnostic evolution of schizophrenia in clinical settings.

Methods

We examined the stability of schizophrenia first diagnoses (n=26,163) in public mental health centers of Madrid (Spain).Probability of maintaining the diagnosis of schizophrenia was calculated considering the cumulative percentage of each diagnosis per month during 48 months after the initial diagnosis of schizophrenia.

Results

65% of the subjects kept the diagnosis of schizophrenia in subsequent assessments (Figure 1). Patients who changed (35%) did so in the first 4-8 months. After that time gap the rates of each diagnostic category remained stable. Diagnostic shift from schizophrenia was more commonly toward the following diagnoses: personality disorders (F60), delusional disorders (F22), bipolar disorder (F31), persistent mood disorders (F34), acute and transient psychotic disorders (F23) or schizoaffective disorder (F25).

Conclusions

Once it is confirmed, clinical assessment repeatedly maintains the diagnosis of schizophrenia.The time lapse for its confirmation agrees with the current diagnostic criteria in DSM-IV. We will discuss the implications of these findings for the categorical versus dimensional debate in the diagnosis of schizophrenia.