bluuebunny/crossref_metadata_2025 huggingface dataset:
Pharmacokinetics, safety, and tolerability of four 28-day cycle intramuscular injections for risperidone-ISM 75 mg in patients with schizophrenia: A phase-2 randomized study (PRISMA-2)
Authors: Anta L. , Llaudó J. , Ayani I. , Gorostidi B. , Monreal M. , Martínez-González J. , Ochoa L. , Gutierro I.
Published: May 2016

Introduction

Risperidone-ISM is a new long acting intramuscular formulation of risperidone, for monthly administration without oral supplementation.

Objective

To characterize the pharmacokinetic of risperidone over multiple intramuscular injections in patients with schizophrenia.

Method

A multicenter, open label, two-arm, parallel design clinical trial was performed. Each patient received 4 intramuscular injections of 75 mg of risperidone-ISM in either, gluteal or deltoid muscle at 28-day intervals.

Results

A total of 70 patients were randomized, 67 received at least one dose of study medication. Preliminary data show that mean Cmax of the active moiety was achieved 24-48 hours (Tmax) after each administration and ranged over four consecutive doses from 39.6-53.2 ng/mL and 54.1-61 ng/mL, when given in gluteal or deltoid, respectively. All subjects achieved therapeutic levels (> 7.5 ng/mL for the active moiety) between 2-8 hours after drug administration. The mean concentrations were maintained above therapeutic levels throughout the 4-week dosing period. No significance changes across the study were observed, either on Positive and Negative Syndrome Scale or Extrapyramidal Symptoms Scale. Overall, 63 subjects (94%) experienced at least 1 Treatment Emergent Adverse Event (TEAE) during the study. One serious TEAE (dystonia) was related to study treatment. One death not related to study medication was informed. The most frequently reported TEAEs were hyperprolactinaemia (57.7%) and injection site pain (32.8%).

Conclusions

Risperidone-ISM achieved therapeutic levels from the first hours after drug administration and provided a sustained release throughout the 4-weeks dosing period over multiple intramuscular injections independently of the injection site. Risperidone-ISM was found to be safe and well tolerated.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
The validity of observer-based scales in the measure of drug-induced motor symptoms in a spanish sample of patients with severe mental disorders
Authors: Aznarte J. , Crespo Y. , Iglesias-Parro S. , Soriano-Peña M.F. , Ibáñez Molina A.
Published: May 2016

Background

Antipsychotic drugs are effective in schizophrenic disorders, but they are also used to treat other psychiatric conditions. Typical antipsychotics cause important extrapyramidal symptoms (EPS), which frequently result in non-compliance with antipsychotic medication. It has been stated that the second-generation antipsychotics (atypical) provoke EPS side effects less frequently than typical antipsychotics. However, there is some controversy around this statement, especially because of inefficient measures of EPS. Clinical assess of EPS normally relies upon observer-based ratings, but their reliability and validity has not been consistently established.

Objective

In the present work, we have explored the convergent and discriminant validity of the Abnormal Involuntary Movement Scale (AIMS) and the Simpson-Angus Scale (SEE), in a Spanish sample of patients with severe mental disorders. Patients could be under typical or atypical antipsychotics, antidepressants, benzodiacepines, or a combination of these.

Method

Sixty-one patients with severe mental disorders from the Mental Health Day Hospital of St. Agustín (Linares, Spain) participated in the study. Inclusion criteria were DSM-V diagnosis of schizophrenia or schizophrenic disorder, bipolar, or borderline personality disorders, and age between 18-61. In order to explore the discrimination capacity of each rating scale, Receiver Operator Characteristic (ROC) analyses were conducted.

Results

ROC curves indicated a suitable construct validity of the scales in the measurement of drug-induced motor symptoms. However, the scales were not sensitive to the number of years under treatment.

Conclusions

In line with previous research, our results question the use of rating scales as the only measure in the evaluation of EPS symptoms.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Medication and aggressiveness in real-world schizophrenia. Results from the FACE-SZ dataset
Authors: Fond G. , Favez M. , Boyer L. , Pierre-Michel L. , Pelissolo A. , Berna F.
Published: May 2016

Introduction

The primary objective of this study was to determine if second generation antipsychotic (SGA) administration was associated with lower aggressiveness scores compared to first generation (FGA) in schizophrenia (SZ). The secondary objective was to determine if antidepressants, mood stabilizers and benzodiazepines administration were respectively associated with lower aggressiveness scores compared to patients who were not administered these medications.

Methods

Three hundred and thirty-one patients with schizophrenia (n = 255) or schizoaffective disorder (n = 76) (mean age = 32.5 years, 75.5% male gender) were systematically included in the network of FondaMental Expert Center for Schizophrenia and assessed with the Structured Clinical Interview for DSM-IV Axis I Disorders and validated scales for psychotic symptomatology, insight and compliance. Aggressiveness was measured by the Buss-Perry Aggression Questionnaire (BPAQ) score. Ongoing psychotropic treatment was recorded.

Results

Patients who received SGA had lower BPAQ scores than patients who did not (P = 0.01). On the contrary, patients who received benzodiazepines had higher BPAQ scores than patients who did not (P = 0.04). These results were found independently of socio-demographical variables, psychotic symptomatology, insight, compliance into treatment, daily-administered antipsychotic dose, the way of antipsychotic administration (oral vs long acting), current alcohol disorder and daily cannabis consumption.

Conclusion

The results of the present study are in favor of the choice of SGA in SZ patients with aggressiveness, but these results need further investigation in longitudinal studies. Given the potent side effects of benzodiazepines (especially dependency and cognitive impairment) and the results of the present study, their long-term prescription is not recommended in patients with schizophrenia and aggressive behavior.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Emotional recognition during the course of schizophrenia
Authors: Bošnjak D. , Makarić P. , Rojnić Kuzman M.
Published: May 2016

Introduction

Adequate emotion identification ability facilitates forming emotional relationships and effective communication. Patients suffering from schizophrenia have deficits in emotional recognition (ER), which leads to impaired social and occupational functioning.

Objectives

To compare the differences in ER between the healthy control group (HC) and two patient groups at different phases of illness: first episode psychosis (FEP) and chronic, multi-episode schizophrenia (MEP).

Aims

To investigate the pattern of emotional recognition deficit during the course of schizophrenia.

Methods

We compared three groups of participants: MEP, FEP and HC, each containing 50 participants, based on their emotional recognition abilities using the Penn Emotion Recognition Task and The I FEEL Pictures. Patients were diagnosed using Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) criteria for schizophrenia (schizophreniform disorder) with their psychopathology rated with the Positive and Negative Syndrome Scale (PANSS) scale. Besides ER tasks, patients were administered self-evaluation scales for the assessment of quality of life, depression, suicidality, impulsivity, aggression, and relationship with their parents.

Results

Our findings showed deficits in emotional recognition ability of both patient groups in comparison with HC, especially in the identification of negative emotions: sadness, fear and anger. There was no statistically significant difference between groups in the identification of happiness. First episode patients showed better results than the MEP group.

Conclusions

Although the FEP group was more successful than the ME group, our results showed that the emotional recognition impairment exists at a significant level even at the beginning of the illness.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Association between implicit motor learning and neurological soft signs in schizophrenia
Authors: Chrobak A. , Siuda-Krzywicka K. , Siwek G. , Tereszko A. , Siwek M. , Dudek D.
Published: May 2016

Introduction

Schizophrenia (SZ) patients present subtle motor deficits known as Neurological Soft Signs (NSS). Those deficits encompass impairments of motor coordination, sequencing of complex motor acts and sensory integration. It has been shown that SZ patients present also deficits of higher motor functions as implicit motor learning. Growing number of studies indicate that both NSS and implicit motor learning deficits are associated with impairments of common cortico-cerebellar pathways, however relationship between these two deficits has not been evaluated yet.

Objectives

To assess NSS and implicit motor learning in SZ patients.

Aims

To evaluate associations between NSS and implicit motor learning scores in SZ patients.

Methods

Twenty schizophrenia patients and 20 healthy controls were examined. Patients were under olanzapine, clozapine or quetiapine treatment. NSS were assessed with Neurological Evaluation Scale (NES). Implicit motor learning were assessed with a use of Serial Reaction Time Task.

Results

SZ patients presented statistically higher NSS scores than healthy controls (P < 0.001) and presented no signs of implicit motor learning. There was statistically significant negative correlation between implicit motor learning score and total score of neurological soft signs (r = −0.44), sequence of motor acts subscore (r = −0.54) and sensory integration subscore (r = −0.47) in SZ patients group (P < 0.05).

Conclusions

There is association between implicit motor learning deficits and neurological soft signs in SZ patients.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Problems in long-term treatment with atypical antipsychotics: hyperprolactinemia
Authors: Franch C. , Medina G. , Ortega M.D. , Calzada M.E. , Molina V.
Published: May 2016

Introduction

Schizophrenia and other psychotic disorders are associated with high rates of morbidity and mortality, caused by the use of specific treatments as well as health factors directly related to those processes. One of the high-frequency side effects in patients treated with classic and atypical antipsychotics is hyperprolactinemia. It causes alterations in neuroendocrine sphere (amenorrhea, galactorrhea, gynecomastia…), and other mid- and long-term effects (osteoporosis, cardiovascular risk increase and increased risk of developing cancers - specifically in breasts and endometrium).

Objectives

Check hyperprolactinemia induction by maintained treatment with atypical antipsychotics.

Methodology

A naturalistic prospective study was conducted following 75 patients on maintenance treatment with a single atypical antipsychotic during 24 months. Anthropometric and laboratory data were collected, along with the presence of different endocrine-metabolic during the 2-year study alterations.

Results

Changes in prolactin levels were found in a large number of patients, with statistically significant differences between 0 (basal) and 24 months (Basal [M = 26.27; SD = 21], 2 years [M = 38.08, SD = 34.65]; t = −2.758; P = 0.013], with hyperprolactinemia increasing from 46.6% of patients at baseline to 65.5% at 2 years, mainly with paliperidone and risperidone long acting injection (statistically significant increase in both cases) (Fig. 1).

Conclusions

Paliperidone and risperidone long acting injectable induce increased prolactin levels in patients in long-term antipsychotic treatment.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Cortical and subcortical morphology deficits in cerebral gray matter in patients with schizophrenia and not affected siblings
Authors: Pastoriza F. , Galindo L. , Mané A. , Bergé D. , Pujol N. , Picado M. , Bulbena A. , Vilarroya O. , Pérez V.
Published: May 2016

Objective

Explore the basis of cortical morphometry in patients with schizophrenia and non-affected siblings by Magnetic Resonance Structural analyzing cortical thickness.

Methods

Twenty-nine patients with schizophrenia treated with atypical antipsychotics and clinically stable in the last 6 months were recruited. Twenty-three not affected siblings of patients with schizophrenia and 37 healthy volunteers were recruited. Magnetic Resonance Structural was performed. FreeSurfer the brain imaging software package for analysis of Cortical Thickness is used. In the analysis of group differences in cortical thickness (CT) with the general linear model (GLM), the P-value was established in 0003 following the Bonferroni correction to control for multiple comparisons (seven regions of interest a priori in each hemisphere).

Results

Significant differences in cortical thickness between patients and healthy controls. Differences between groups were calculated by general linear model (GLM) with age and sex as covairables (Table 1).

Conclusions

In applying the correction for multiple comparisons, differences in bilateral-lateral orbitofrontal, medial orbitofrontal-right and left temporal transverse frontal cortex are significant. Our study replicates previous findings and provides further evidence of abnormalities in the cerebral cortex, particularly in the frontal and temporal regions, being characteristic of schizophrenia.

Disclosure of interest

The authors have not supplied their declaration of competing interest.

Acknowledgements

L. Galindo is a Rio-Hortega-fellowship-(ISC-III; CM14/00111).
Efficacy and tolerability of switching to long-acting injectable (LAI) aripiprazole in outpatients with schizophrenia
Authors: Fernández-Abascal Puente B. , Juncal Ruiz M. , Landera Rodríguez R.
Published: May 2016

Introduction

Switching antipsychotics is a therapeutic alternative for managing side-effects, or efficacy and compliance issues.

Aim

To evaluate the efficacy and tolerability of switching to LAI-aripiprazole in patients who had insufficient response or were intolerant to the previous antipsychotic, or required a more convenient treatment regimen.

Methods

This was a prospective, observational, 6-months study carried out in 45 outpatients with schizophrenia who were clinically stabilized but a switching to another antipsychotic was clinically indicated. Patients who required hospitalization, treatment discontinuation or adding another antipsychotic (including supplementation with oral-aripiprazole) were considered treatment failures. Switching was considered successful if the side-effect/symptom/adherence/convenience improved or, if applicable, disappeared.

Results

Patients aged 38 years, 51% women, and previous antipsychotics comprised: LAI-paliperidone (42%), oral-aripiprazole (22%), oral-olanzapine (11%), oral-risperidone (7%), LAI-risperidone (4%) and others (14%). The efficacy results of the switching are presented in the table. Of the 45 patients, 7 (15%) were considered treatment failures: 3 patients were hospitalized due to recurrence of psychotic symptoms, 2 discontinued LAI-aripiprazole, and 2 required supplementation with oral-aripiprazole (Fig 1).

Conclusions

Our results suggest that switching to LAI-aripiprazole is an efficacious strategy for managing some antipsychotic-induced side-effects, persistence of negative symptoms and/or lack of treatment adherence.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Monotherapy treatment with cariprazine for the treatment of predominant negative symptoms of patients with schizophrenia: A double-blind, active comparator-controlled trial
Authors: Németh G. , Debelle M. , Laszlovszky I. , Szalai E. , Szatmári B. , Harsányi J. , Barabássy Á. , Durgam S. , Bitter I. , Galderisi S.
Published: May 2016

Objective

To examine the effect of cariprazine, a dopamine D3/D2 receptor partial agonist with preferential binding to D3 receptors, on predominant negative symptoms of schizophrenia.

Methods

Subjects with schizophrenia and PANSS factor score for negative symptoms (PANSS-FSNS) ≥ 24 and no pseudospecific factors (e.g. extrapyramidal symptoms, depression) were randomized to cariprazine 4.5 mg/d (dose range: 3-6 mg/d) or risperidone 4 mg/d (dose range: 3-6 mg/d) for 6 months.

Results

Four hundred and sixty-one patients were randomized 1:1 to double-blind risperidone (n = 231) or cariprazine (n = 230) treatment. Change from Baseline (CfB) at week 26 in the primary parameter, PANSS-FSNS, was larger in the cariprazine group than in the risperidone group (LSMD = −1.47; 95% CI: [−2.39, −0.53]; P = 0.002) significant from week 14 onwards. CfB at week 26 in the functional parameter, Personal and Social Performance (PSP) total score, showed similarly greater improvement with cariprazine than risperidone (LSMD = 4.63; 95% CI: [2.71, 6.56]; P < 0.001) significant from week 10 onward. Statistically significant differences in favor of cariprazine at week 26 were shown in the PSP areas of self-care, socially useful activities and personal and social relationships. Most patients tolerated the study treatment well, as reflected by low discontinuation rates due to adverse events (AEs). Adverse event profiles of cariprazine and risperidone were similar. The most common AEs during study treatment were insomnia (10.0%), and headache (10.4%), both in the risperidone group.

Conclusion

26-week cariprazine treatment, given as antipsychotic monotherapy, was significantly more effective on negative symptoms and on functioning than risperidone in patients with predominant negative symptoms of schizophrenia.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
First-episode psychosis: What does it mean?
Authors: Marques S. , Godinho F. , Melo A.L. , Barrocas D.
Published: May 2016

Introduction

First-Episode Psychosis (FEP) is a variable condition, characterized by the emergence of new psychotic features for a period of at least 1 week. The majority of existing studies about FEP only address schizophrenia spectrum psychosis (SSP), which may limit the capacity to fully characterize this entity.

Objectives/Aims

Report the clinical and socio-demographic characteristics of patients with FEP in real-world setting, and compare the differences among SSP and affective FEP.

Methods

Retrospective analysis of clinical files of patients admitted to our hospital unit with FEP diagnosis from January/2012 to April/2015. Clinician-rated dimensions of psychosis symptom severity scales (DSM-5) were applied.

Results

Annual incidence of FEP was 11,3/100,000. From a total of 755 patients, 57 (7,5%) corresponded to FEP; 38 (66,7%) were diagnosed with SSP, 11 (19,3%) affective psychosis, 3 (5,2%) toxic psychosis and 5 (8,8%) organic psychosis. Most were female (61,4%), with a mean age of 49 years. The majority were unemployed (66,7%), lived with family (57,9%), and presented with moderate-severe delusions (80,1%), but without hallucinations (57,8%), disorganized speech (59,6%) or negative symptoms (85,9%). Affective FEP patients were older (61 vs 45 years), presented with less severe psychotic symptoms (7,2 vs 8,3 points), but with higher hospital admission (26,1 vs 21,1 days).

Conclusions

Regardless the growing interest concerning FEP, its conceptualization and characterization remains controversial. Our results differ from pre-existing literature data, especially concerning gender and age. By including all the possible etiologies of FEP, we aimed to obtain a more realistic characterization of this entity in a real-world setting.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Neutrophin signalling in first-episode psychosis: relationship with treatment response 1 year after the illness onset
Authors: Martinez-cengotitabengoa M. , Macdowell K. , Alberich S. , Parellada M. , Saiz P. , Rodriguez R. , Berrocoso E. , Bernardo M. , Gonzalez-pinto A. , Leza J.C.
Published: May 2016

Introduction

Pro/antiinflammatory imbalance has been found in first-episode psychotic (FEP) patients, even 12 months later. Current research is every time more focused in the need to find biomarkers to understand the underlying pathophysiological mechanisms of this severe illness.

Objectives

To assess peripherical levels of neurotrophins and their receptors and their correlation with inflammation, clinical symptomatology and response to antipsychotic treatment, over the time.

Methodology

Ninety-four FEP patients and 80 matched healthy controls were included. Blood samples were taken at baseline to measure BDNF and NGF and their receptor levels (TrkB-full, TrkB-truncated and TrkA) and pro/antiinflammatory parameters (NFkB, COX-2, iNOS, PPARgamma, 15d-PG12). Patients were followed-up during 12 months.

Results

BDNF TrkB-full receptor and NFG TrkA receptor levels increased during the follow-up whereas BDNF TrkB-truncated form receptor decreased. After adjusting for confounding variables, baseline levels of proinflamatory variables were significantly related to TrkB-full/TrkB-truncated ratio (FL/T), suggesting that a higher proinflammatory status is related to a higher FL/T ratio expression. Furthermore, baseline FL/T ratio could have a predictor role of patient's functionality 1 year after the illness onset, depending on whether patient is treated or not with antipsychotic drugs.

Conclusion

Inflammatory processes, neurotrophic pathways and functional status of FEP patients seem to be related which is of great traslational relevance. Specific, the expression of the 2 isoforms of BDNF receptor should be taken into account before starting an antipsychotic drug treatment.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Quality of Life Assessment in schizophrenia - development of a short version of the QLiS
Authors: Franz M. , Senin T. , Meyer T.
Published: May 2016

The QLiS (Quality of Life in Schizophrenia) is a disease-specific questionnaire with high content validity and sound psychometric properties. It comprises 54 items related to 12 subscales. However, its use in surveys or clinical studies is limited due to its length. Our aim was to develop and validate a short form of the QLiS.

Four steps were taken to develop the short form (QLiS-SF) using samples from the Clinical Analysis of the Treatment of Schizophrenia study. 1. A model with second order scales was developed using exploratory factor analysis. 2. The resulting model was tested in an independent sample using confirmative factor analysis (CFA). 3. Based on this model, items were selected on grounds of distributional properties, content reviews, and item loadings. 4. The resulting short form was validated independently through CFA.

Results

Three second order scales were constructed: illness-related quality of life, social life, and global subjective well-being. CFA of the new theoretical model resulted in a CFI of 0.67 and absolute fit indices of CMIN/df = 2.55, RMSEA = 0.08, SRMR = 0.09. We selected 13 items that showed good statistical properties and good fit of content to subscale. Fit of the underlying theoretical model with the 13 items was satisfactory (CFI = 0.95, CMIN/df = 2.23, RMSEA = 0.06, SRMR = 0.04). Composite reliability scores for the three subscales were above 0.70.

The QLiS-SF showed adequate model fit and reliability. It offers a novel, well-founded opportunity to assess quality of life in persons with schizophrenia in situations in which the application of the long version is not considered possible.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
The relationship between childhood trauma and theory of mind in schizophrenia
Authors: Mrizak J. , Trabelsi R. , Arous A. , Aissa A. , Ben Ammar H. , El Hechmi Z.
Published: May 2016

Introduction

A history of childhood trauma is reportedly more prevalent in people suffering from psychosis than in the general population. Previous studies linked childhood trauma (CT) to neurocognitive impairments in schizophrenia (SCZ), but rarely to theory of mind (TOM) deficits.

Objectives

To investigate the relationship between TOM deficits and CT in SCZ.

Methods

Fifty-eight outpatients with stable SCZ completed the Childhood Trauma Questionnaire retrospectively assessing five types of childhood trauma (emotional, physical and sexual abuse, and emotional and physical neglect). They also completed an intention-inferencing task, in which the ability to infer a character's intentions from information in a short story is assessed.

Results

Our results suggest a relationship between specific kinds of CT and TOM deficits. A history of childhood physical neglect was significantly correlated to a worse performance in the intention-inferencing task (P = 0,001). Patients with higher scores of CT denial also had less correct answers (P = 0,035) and more false answers (P = 0,013).

Conclusions

Our results need replication but underline the necessity of investigating psychosocial mechanisms underlying the development of social cognition deficits, including deficits in TOM.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Self-criticism and self-compassion role in the occurrence of insomnia on college students
Authors: Teixeira I. , Simões S. , Marques M. , Espírito-Santo H. , Lemos L.
Published: May 2016

Introduction

To our knowledge there are no research about the influence of self-criticism and self-compassion in the occurrence of insomnia.

Objectives

To study the association between self-criticism, self-compassion and insomnia on university students; to explore differences in these associations on two moments of student's lives–examination and no examination period.

Aims

We anticipate that the stress and pressure of the examination period have an impact on student's sleep and there are, also, differences by age and gender.

Method

Self-Criticism and Self-Reassurance Scale, Self-Compassion Scale, Pre-Activation Sleep Scale, Insomnia Assessment Scale and Anxiety and Depression and Stress Scales were answered by 160 college students (M = 26.45, SD = 7.98; range = 19–54 years) during an examination period and by 108 college students during a no examination period (M = 26.34; SD = 0.43; range = 19–54 years).

Results

In both periods (examination and no examination period) older students (30–54 years) tended to be more self-compassionate and tolerant, such as less self-critical and punitive. During the examination period, younger students (19–29 years) showed higher levels of self-criticism, cognitive, and somatic activation before falling asleep. There was also a higher proportion of younger students in the insomniac and insomnia symptomatic groups. Moreover, significant correlations were found between cognitive and somatic activation and depression, anxiety, and stress in both moments.

Conclusions

In the examination period, the youngest students are more critical and less compassionate, what might lead to greater cognitive and somatic activation before sleep and, consequently, to insomnia symptoms and insomnia itself.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Spousal abuse in married women with suicidal attempt in Shiraz, Iran
Authors: Sahraian A. , Bahreini S. , Mani A.
Published: May 2016

Introduction

Epidemiological studies revealed that 21 to 34 percent of women around the world have been victim of physical assault by their spouse and spouse abuse have been more prevalent in developing countries.

Objectives

The most common form of violence against women is spousal abuse which is a dangerous factor and leads to serious psychological damages while it is one of the most important causes of suicide in married women.

Aims

The study of factors related to spousal abuse in the population where they attempt to suicide is important for recognizing it and preventing spousal abuse, consequently, preventing suicide.

Methods

The study was conducted cross-sectional on 360 married women who attempted suicide and referred to Shoshtari Hospital in Shiraz. Instruments for data collection comprised of about spousal abuse questionnaire and demographic cases questionnaire which were filled through interview.

Results

A total of 43.9% of domestic violence prevalence, 61.7% of economic violence, 45.3% of psychological violence, 38.1% of social violence, 38.1% physical violence, 35.9% of sexual violence was reported. There was a relation between spousal abuse and some factors such as: age difference between spouses, wife and husband's education, husband's substance abuse, husband's medical illness, wife's psychiatry disorder, spouses’ obligatory marriage, polygamy and husband's job.

Conclusions

Considering relatively high prevalence of spousal abuse in people who attempted suicide and the relation between some demographic factors with violence, besides regarding spousal abuse as one causes of suicide, the women's screening, particularly those who attempt suicide in regard to spousal abuse and its related factors seems necessary.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Therapist-guided internet-based cognitive-behavioural therapy for adult obsessive-compulsive disorder: A meta-analysis
Authors: Pozza A. , Andersson G. , Dèttore D.
Published: May 2016

Introduction

Cognitive-behavioural therapy (CBT) is the first-line psychological treatment for obsessive-compulsive disorder (OCD). However, most individuals suffering from OCD do not receive CBT. An innovative approach to improve access to evidence-based care is the use of the Internet to deliver effective treatments. Therapist-guided Internet-based cognitive-behavioural therapy (iCBT) involves the administration of structured online lessons that provide the same information and skills typically taught in clinician-administered CBT, often with email support from a therapist. Accumulating evidence on iCBT for OCD has been produced, but a meta-analysis has not been conducted.

Objectives

Through meta-analytic methods, the present study summarized evidence on iCBT for OCD.

Aims

Efficacy on OCD symptoms and comorbid depression versus control conditions at post-treatment and follow-up was evaluated.

Methods

A PRISMA meta-analysis was performed on randomized controlled trials. Treatments were classified as iCBT if they included CBT components for OCD (eg, exposure and response prevention) delivered through the Internet with or without email/phone support from a therapist.

Results

Four trials were included (n = 238), which were classified at low bias risk. At post-treatment iCBT outperformed control conditions with a high effect size on OCD symptoms (d = 0.85, P<.05) and a medium on comorbid depression (d = 0.52, P<.05). Treatment effects were stable at 4-month follow-up with a high effect size on OCD (d = 1.45, P<.05), but not on comorbid depression (d = 0.33, P<.05).

Conclusions

iCBT seems a promising treatment modality for OCD. Further trials should assess log-term outcomes and effects on quality of life.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
DECIDE study: Effectiveness of shared decision making in treatment planning at discharge of inpatient with schizophrenia: Half sample interim analysis, preliminary conclusions
Authors: Pérez Revuelta J. , Lara Ruiz-Granados I. , Gonzalez Saiz F. , Pascual Paño J.M. , VIllagran Moreno J.M.
Published: May 2016

DECIDE Study

Effectiveness of shared decision making in treatment planning at discharge of inpatient with schizophrenia: interim analysis.

Introduction

Shared decision-making denotes a structured process that encourages full participation by patient and provider in making complex medical decisions. Hamann et al. conducted a few years ago a randomized controlled trial with schizophrenic inpatients and found increased knowledge and perceived involvement in decisions about antipsychotic treatment at discharge by the experimental group, but not clear beneficial effects on long term outcomes. The present communication introduces the DECIDE study.

Aims and objectives

Of the study: to demonstrate the effectiveness, measured as treatment adherence and readmissions at 3, 6 and 12 months, of shared decision making in the choice of antipsychotic treatment at discharge in a simple of schizophrenics hospitalized after an acute episode of their disorder. Of the oral presentation: to present preliminary conclusions with more of the half of the sample.

Methods

Randomized controlled trial, prospective, two parallel groups, not masked, comparing two interventions (shared decision making and treatment as usual). Study population: inpatients diagnosed of schizophrenia and schizoaffective disorders (ICD-10/DSM-IV-R: F20 y F25) at Adult Acute Hospitalization Unit at Jerez General Hospital.

Results

At discharge, increased scale score COMRADE, both subscales (Satisfacción in communication and trust in the decision) statistically significant. At 3 months follow-up, intensification of these differences in effect size and statistical significance and shows trends in health outcomes. We will present results for 6 and 12 months.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Gender differences in benzodiazepines prescription in old age patients
Authors: Martinez-Cengotitabengoa M. , Besga A. , Bermudez-Ampudia C. , Garcia-Alocen A. , Gonzalez-Ortega I. , Lopez M.P. , Diaz M.J. , Chicote N. , Enriquez J. , Abrain A. , Olles R. , Esnal S. , Salem H. , Cuesta E. , Duenas M. , Gonzalez-Pinto A.
Published: May 2016

Objectives

To assess the prescription of benzodiazepines (BZD) in elderly patients, and to explore any gender differences.

Methods

Six hundred and fifty-four patients (≥ 65) admitted in an emergency service of a general hospital due to a fall. BZD use information was collected (dose, half-life profile).

Results

BZD are significantly more prescribed to women (47.6%) than men (36.1%) (X2 = 8.097, P = 0.004). We conducted a logistic regression analysis using as dependent variable taking or not BZD and sex as the independent one, covariating the model by age. We noted that sex remains significant despite enter the age variable in the model (OR = 1.5, P = 0.013). A total of 21.6% of patients consumed intermediate or long half-life BZDs, appearing a greater tendency to prescribe such BZD to women (X2 = 3.606, P = 0.058). In the 58.0% of prescriptions, prescribed dose was higher than the recommended for the elderly. The percentage is significantly higher for men (70.0%) than women (53.1%). Furthermore, a total of 54 prescriptions (15.8%) were even higher than the recommended adult dose, with no significant differences between men and women.

Conclusions

We found evidence of a higher prescription of BZD in women independently of age. Despite not being recommended, prescription of intermediate or long half-life BZD continues, in a slightly higher manner in women. BZD are prescribed above the recommended dose for elderly in a large number of patients, especially in men. A considerable proportion of elderly patients (15.8%) consume BZD doses even higher than the recommended for adults.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Evaluation of suicide risk in psychiatric patients after discharge. A follow-up study
Authors: Giordano G. , Federica R. , Denise E. , Monica M. , Marco I. , Maurizio P.
Published: May 2016

Introduction

Several studies show that the first period after discharge has an higher suicide risk.

Objectives

Following up psychiatric inpatients after discharge may be important in order to better understand the risk and the protective factors of suicide.

Aim

The aim of our follow-up study is to evaluate the predictive factors of suicide in a sample of psychiatric inpatients after discharge.

Methods

We analyzed the temperament and the levels of hopelessness, depression, suicide risk in a sample of 87 (54% males) inpatients at time T0 (during the hospitalization), T1 (12 months after discharge) and T2 (8 months after T1). We administered the following scales: BHS, MINI, TEMPS, GMDS, CGI.

Results

A statistically significant difference on the risk of suicide with substance abuse was found among patients who were followed up and who refused to participate, respectively at T1 (χ24 = 2.61; P < 0.05) and T2 (χ24 = 1.57; P = 0.05). At T1, 4 patients attempted suicide and 18 showed suicidal ideation. In the second follow-up, 1 patient successful committed suicide, 1 subject attempted suicide and 10 patients showed suicidal ideation. Patients with suicidal ideation at T1 showed higher levels of hopelessness and a diagnosis of bipolar disorder type I (χ24 = 10.28; P = 0.05). Sixty-seven percent of subjects with suicidal ideation showed higher scores in the BHS at T1. Significant differences were found on the anxious temperament at T2 between two groups.

Conclusions

The follow-up could represent a significant strategy to prevent suicide in psychiatric patients.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Capturing depression with your smartphone: Validity and utilization of iHOPE for depressed patients in Taiwan
Authors: Chin-Lun Hung G. , Li M.S. , Chen Y.L. , Chiang J.H.
Published: May 2016

Introduction

Clinical assessment for depression, to date, has relied heavily on patients’ retrospective report, which is liable to recall bias.

Objectives

A number of mobile applications for ecological momentary assessment (EMA) of depressive disorder have been piloted, however, evidence regarding their validity and acceptance is limited.

Aims

In this study, we examined the association between Hamilton Rating Scale for Depression (HAM-D) and EMA of depressive symptoms via a smartphone application and demonstrated the level and determinants of utilization.

Methods

Our mobile phone application, iHOPE, would perform EMA of depression, anxiety, sleep and cognitive ability. Outpatients with depressive disorder were invited to use iHOPE for 8 weeks. Smartphone usage patterns and clinical characteristics were assessed.

Results

We enrolled 59 outpatients with depression (38 [64.4%] women; mean [SD] age = 37.3 [13.9] years). In 8 weeks, participants interacted with iHOPE for an average of 10.8 (SD = 12.3) days; a trend of decreased frequency of use (P = 0.03) was observed. Scores of HAM-D at baseline was associated with, of the first 14 days, scores of PHQ-9 (P = 0.005), visual analogue scale of depression (P = 0.003) and anxiety.

Conclusions

EMA via mobile technology appears to be valid and feasible for Asian patients with depression. Mobile health has a potential for the assessment of depressive disorder in areas with limited awareness and resource for mental health conditions.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
The impact of anxiety and depression on academic performance in undergraduate medical students
Authors: Mihăilescu A.I. , Diaconescu L.V. , Ciobanu A.M. , Donisan T. , Mihailescu C.
Published: May 2016

Introduction

Stress associated with medical education, correlated with symptoms of depression and anxiety, has been involved in generating academic performance problems and thus, long-term consequences, such as poor quality of medical care. If anxiety and depression are proved to influence quality of academic achievement, their prevention could lead to better outcomes also in the quality of medical care.

Objective

The objective of the study was to analyze if anxiety and depression decrease academic performance in first and second year medical students.

Methods

As a measure of anxiety and depression symptoms we used Zung Self-rating Anxiety score > 36, respectively Zung Self-rating Depression Scale score > 40, in the periods before the examination session, in the first semester (in no-stress conditions). As a measure of academic performance, we have obtained the average grade at the end of the academic year from 254 of the total population of 356 first and second year medical students. Statistical analyses were carried out with SPSS version 16 (Spearman correlations and logistic regression).

Results

Academic performance decreases inversely in rapport of anxiety (rho = –0.144, P < 0.05) and depression (rho = –0.192, P < 0.05) scores in the period before the examination session. Also, depression in this period predicts low levels of academic performance with average grade in the inferior quarter (grades lower than 7.52) particularly in first year students, irrespective of gender (χ2 = 8.922, P < 0.01, OR = 0.928; IC 95% = 0.864–0.997).

Conclusion

These findings suggest the necessity of coming up with prophylactic methods to prevent anxiety and depression especially in first year medical students, as these prove to be factors that impend academic performance.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Grief cognitions and cognitive-emotional regulation associated with romantic breakup distress among college students
Authors: Mirsu-Paun A.
Published: May 2016

Introduction

Individuals manage differently the experience of a romantic breakup [RB]. These differences may in part be related to the use of different cognitive-emotional regulation strategies [CERS]. Also, global negative beliefs and catastrophic misinterpretations regarding the RB may contribute to the emotional distress (Boelen and Reijntjes, 2009).

Objectives

To explore the associations between CERS, grief cognitions related to RBs, and depression and suicidal ideation/behaviors in a sample of college students.

Aims

To conduct regression analyses to predict depression, anxiety, hostility, and suicide behaviors from CERS and grief cognitions (as independent variables).

Methods

Cross-sectional, self-report data was collected from 359 college students who experienced a RB. The assessments used were: Cognitive-Emotional Regulation Questionnaire- Short Form (Garnefski et al., 2002); the Grief Cognitions Questionnaire adjusted to grief after RBs (Boelen et al., 2003); the subscales of Depression, Anxiety, and Hostility of the Counseling Center Assessment of Psychological Symptoms-62; and the Suicide Behaviors Questionnaire-Revised, Osman et al., 2001).

Results

Past suicide thoughts or attempts were predicted by Other-Blame; self-reported likelihood of future suicide attempt was predicted by Self-Blame, Other-Blame, and Positive Reappraisal, Grief Cognitions-Future, and Grief Cognitions-Appropriateness. Depression was predicted by all cognitive-emotional regulation subscales except Acceptance and Perspective, and by RB grief cognitions (self, future, self-blame, others, and perceived appropriateness of own grief reaction).

Conclusions

Clinical assessment to evaluate at-risk young adults after RBs could incorporate evaluations of cognitions regarding the RB and self-blaming, appropriateness of one's own grief reaction, and thoughts about the future.

Disclosure of interest

The author has not supplied his/her declaration of competing interest.
SOMA Score, cardiovascular risk screening tool for psychiatric patients
Authors: Páv M. , Hollý M. , Cendelínová M. , Gojda J. , Polák J.
Published: May 2016

Introduction

Life expectancy of patients with severe mental illness (SMI) is two decades shorter than that of general population. The most important cause of death are cardiovascular diseases (CVD).

Objectives

There is a need for CVD risk screening tools development and validation in the context of the Czech Republic.

Aims

Methodological approach to a CVD risk screening, risk stratification and specific life-style interventions development is presented. In a context of the psychiatric hospital with c. 7000 admissions per year.

Methods

There are no concise data on CVD risk of psychiatric patients in the Czech Republic so cross-sectional analysis of one day hospitalized patients was performed.

Results

A sample of 1056 pts. was obtained. Database allowed extraction data on CVD risk factors (RF): diagnosis, age, sex, BMI and blood pressure (BP). The most common diagnosis were F20 and F10. Multicriterial analysis according to diagnosis (frequency of highest BMI and BP) showed the worst results in the F20 followed by F10 group. Would we define the CVD RF as BMI ≥ 30, age ≥ 65, sBP ≥ 140, dBP ≥ 90, then no RF is present in 368, one in 238, two in 191, three in 92 and four RF in 33 pts. Two step screening protocol was developed – SOMA score. Variables and cut-offs for positivity were set based on the results.

Conclusion

Methodological process of SOMA score screening is presented as well as consecutive health care interventions.

Disclosure of interest

The authors have not supplied their declaration of competing interest.

Acknowledgement

The study was realized in a framework of SOMA project, Program CZ11 Initiatives in public health care, Norway grants, NF-CZ11-OV-2-030-2015.
Impact of psychotic symptoms in functionality and quality of life of major depression patients in maintenance/continuation eletroconvulsive therapy (M/C ECT)
Authors: Tarelho A. , De Arriba Arnau A. , Robles Martínez M. , Sarachaga Urretavizcaya M. , Soria Tomás V. , Menchón Magriñá J.M. , Salvat Pujol N.
Published: May 2016

Introduction

Psychotic depression has a higher rate of disability and relapse than non psychotic depression, however the optimal maintenance treatment after an acute response to either the antidepressant/antipsychotic combination or an ECT course is unclear (Rothschild, 2013). Although ECT is an effective therapy in affective disorders and M/C ECT is used to achieve and maintain patient's stability (Brown, 2014), very little is known about its implications in functionality or quality of life.

Objectives

To study the relation between psychotic symptoms and functionality and quality of life in patients with Major Depressive Disorder (MDD) undergoing M/C ECT.

Methodology

Transversal descriptive study of a sample of 17 MDD patients in M/C ECT. Administration of SF-36 (quality of life related to health), FAQ (functionality), Family APGAR, MMSE, GAF, HDRS. Informed consent. Statistical analysis with SPSS18.

Results

The mean age of the sample was 72.47 years, 58.8% presented with psychotic symptoms and 41.2% with melancholic symptoms. We only found a statistically significant negative correlation between the Family APGAR and the presence of psychotic symptoms (U = –2.291, P = 0.025), without other differences in terms of functionality or quality of life.

Conclusions

This study supports that there is no implication in the presence of psychotic symptoms regarding functionality or quality of life among the patients undergoing M/C ECT. We emphasize the need for randomized control trials to disentangle the effects of multiple variables on the functionality and quality of life of patients in M/C ECT.

Disclosure of interest

The authors have not supplied their declaration of competing interest.