bluuebunny/crossref_metadata_2025 huggingface dataset:
Anxiety, depression and perceived health status in patients with epilepsy
Authors: Smaoui F. , Turki E. , Halouani N. , Turki M. , Bouchhima I. , Bouzidi N. , Ben Amar M. , Amami O. , Mhiri C.
Published: May 2016

Introduction

Epilepsy is a chronic disease often disabling, source of stigma and poor quality of life.

Objectives

Determine the prevalence of anxiety and depression in patients with epilepsy and the associated factors.

Methods

We conducted a prospective, descriptive and analytical study among 20 patients followed for epilepsy in our department of neurology. The study was conducted from February to April 2015. We used a preestablished form to collect the socio-demographic and clinic profile of the patients. The assessment of anxiety and depression was made via the HADS “Hospital Anxiety and Depression Scale” and the perceived health status via GHQ scale “General Health Questionnaire”.

Results

The average age of our patients was 35.9 years. The average GHQ score was 27.7. It was higher in women without a statistically significant difference. It was positively correlated with the number of attacks during the last 12 months (P = 0.042), poor treatment adherence (P = 0.007), the feeling of disability (P = 0.021) and the feeling of stigma (P = 0.008). Anxiety was estimated in 35% of cases and 45% were depressed. Depression was significantly associated to the celibacy (P = 0.012), the feeling of stigma (P = 0.038) and the GHQ score (P = 0.016). Anxiety was correlated with the absence of hobbies (P = 0.02) and the GHQ score (P = 0.008).

Conclusion

It is important to detect these psychiatric disorders and to manage generators factors to ensure a better quality of life and social integration for these patients with epilepsy.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Debate: Can suicide be prevented?
Authors: Wasserman D.
Published: May 2016

Suicidal behaviour is the most common life-threatening psychiatric emergency. Reliable and precise tools to predict suicidal behaviours and to get support in the clinical practice are frequently requested.

Several measurement tools for suicide risk assessment, both psychometric and biological have been studied. However, the low precision of the predictions make these tools insufficient from the clinical perspective. To date, the same applies to the search of genetic predictors. The best information is gained in a standard clinical evaluation, which puts focus on the need of acquiring the best possible knowledge and skills by practicing clinicians.

The European Psychiatric Association (EPA) issued a guidance paper on suicide treatment and prevention, which was published in the European Psychiatry in 2012 [1]. This guidance paper elucidates the process of systematic evaluation of suicidal risks in the clinical interview, an overview of the best treatment possibilities and strategies for follow-up. As psychiatric patients constitute the majority of people who commit suicide, the adequate treatment of depression, substance use disorders, schizophrenia and other psychiatric diseases is a must.

We will probably never be able to have perfect measurements to predict if an individual will or will not commit suicide, due to the complexities of human behaviour. However, with a good clinical praxis, suicide is an unnecessary death [2].

Disclosure of interest

The author has not supplied his declaration of competing interest.
The psychological impact of melasma. A report of 30 Tunisian women
Authors: Fatma F. , Baati I. , Mseddi M. , Sallemi R. , Turki H. , Masmoudi J.
Published: May 2016

Introduction

Melasma is a common disorder of acquired hyperpigmentation characterized by tan or brown macules and patches localized to photo-exposed areas of the face.

Objective

To study the psychological impact of melasma on Tunisian women.

Methods

We conducted a cross-sectional study on thirty patients with melasma who attended the dermatology department of the University Hospital in Sfax (Tunisia).

The questionnaire included socio-demographic and clinical data. We used four measurement scales:

– MELASQOL questionnaire;

– Rosenberg Self-Esteem Scale;

– Hospital Anxiety and Depression Scale;

– Body Image Questionnaire.

Results

The mean age was 34.6 years. The majority was living in urban areas (90%), was married (56.7%) and had a profession (80%).

Sixty percent of patients were anxious and 16.7% were depressed. Both self-esteem and body image were respectively altered in 43.3% and 36.6%. The average score of MELASQOL was 31.77%. It was higher in single woman (36.8 vs. 28.4), younger than 40 years old (31.5 vs. 21.7), having a low socioeconomic status (45.2 vs. 29) and working in private sector (40 vs. 24).

The quality of life was more damaged in patients with disease duration less than five years (P = 0.024).

Anxious patients had higher MELASQOL scores than non-anxious (38.17 vs. 22.17; P = 0.008), as well as depressed patients (49 vs. 28.32; P = 0.009).

High MELASQOL scores were correlated with low self-esteem (P = 0.05) and altered body image (P = 0.04).

Conclusion

Although benign, melasma causes an important psychological impact such as anxiety, depression, low self-esteem and poor body image. These effects should be considered in the care plan.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Burnout and neurotic symptoms among medical students
Authors: Tereszko A. , Drozdowicz K. , Szymura M. , Tuleja A. , Korzeniowski W. , Kozłowska A. , Siwek M. , Dudek D.
Published: May 2016

Introduction

Medical studies are considered one of the most stressful majors and the medical profession is one of the most at risk of burnout. Some studies indicate the presence of symptoms of burnout already in the early stages of career, or even before it started, i.e. during studies preparing for the profession. Medical studies may be such a case and it can affect the mental health deterioration and cause the occurrence of both burnout and neurotic symptoms.

Objectives

Assessment of the impact of the course of studies on mental health of students and the risk of rapid burnout.

Aim

Estimation of the prevalence and severity of burnout and neurotic symptoms among medical student depending on the year of study.

Methods

Seven hundred and eighty-one medical students participated in the study. We used translated version of Maslach Burnout Inventory-Student Survey and Polish questionnaire – Symptom checklist S-III – for neurotic symptoms assessment.

Results

There was no significant difference in MBI-SS subscales and symptoms checklist between first and last year of studies. Difference turned out to be significant when 1st and 6th year students with 3rd year – in Symptom checklist (P < 0.01 and P < 0.05, respectively), MBI-SS emotional exhaustion subscale (P < 0.01 for both) and depersonalization subscale (P < 0.01, significant only when compared with 1st year students).

Conclusions

Study revealed interesting pattern of burnout and neurotic symptoms, with theirs greatest severity at the beginning and the end of studies.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Severe behavioral disturbances in bipolar disorder: A case report
Authors: Benavente López S. , Salgado Borrego N. , de la Hera Cabero M.I. , Oñoro Carrascal I. , Flores L. , Jiménez Rico R.
Published: May 2016

Introduction

Behavioral disturbances are common in psychiatric patients. This symptom may be caused by several disorders and clinical status.

Case report

We report the case of a 40 year-old male who was diagnosed of nonspecific psychotic disorder, alcohol dependence, cannabis abuse and intellectual disability. The patient was admitted into a long-stay psychiatric unit because of behavioral disturbances consisted in aggressive in the context of a chronic psychosis consisted in delusions of reference and auditory pseudohallucinations. During his admission the patient received the diagnosis of bipolar disorder type 1, presenting more severe behavioral disturbances during these mood episodes. It was necessary to make diverse pharmacological changes to stabilize the mood of the patient. Finally, the treatment was modified and it was prescribed clozapine (25 mg/24 h), clotiapine (40 mg/8 h), levomepromazine (200 mg/24 h), topiramate (125 mg/12 h), clomipramine (150 mg/24 h) and clorazepate dipotassium (50 mg/24 h). With this treatment, the patient showed a considerable improvement of symptoms, presenting euthymic and without behavioral disturbances.

Discussion

In this case report, we present a patient with severe behavioral disturbances. The inclusion of bipolar disorder in the diagnosis of the patient was very important for the correct treatment and management, because of depressive and manic mood episodes the behavioral disturbances were exacerbated.

Conclusions

Patients with behavioral disturbances could present psychotic and affective symptoms as cause of them. It is necessary to explore these symptoms and try different treatments to improve them.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
The influence of treatment modality on long-term neurocognitive functioning in treatment resistant bipolar depressed inpatients treated with pharmacotherapy or electroconvulsive therapy
Authors: Bjorke-Bertheussen J. , Auestad B. , Kessler U. , Schoyen H.
Published: May 2016

Introduction

Bipolar depression is difficult to manage, and causes considerable disability and distress for patients and their surroundings. Electroconvulsive therapy (ECT) is an effective treatment, but there are concerns regarding long-term neurocognitive impairment, and in particular autobiographical memory.

Objectives

To compare the long-term effects of algorithm-based pharmacologic treatment (APT) and ECT in treatment-resistant bipolar depression as measured with standard neurocognitive tests and autobiographical memory interview.

Aims

To examine the long-term neurocognitive effects of ECT.

Methods

In this multicenter randomized controlled trial 73 in-patients with treatment resistant bipolar depression were randomized to either APT or unilateral ECT. Patients were assessed at baseline and at 6 months. Neurocognitive functions were assessed with the MATRICS Consensus Cognitive Battery (MCCB), Wechsler Abbreviated Scale of Intelligence (WASI) and the Autobiographical Memory Inventory - Short form (AMI-SF). At 6 months, neurocognitive data were available for 26 patients (APT n = 11, ECT n = 15).

Results

There were no group-differences at baseline.

At 6 months, there was no group-difference in MCCB-score (APT 44.9 vs. ECT 46.0, P-value: 0.707), or WASI total IQ-score (APT 103.9 vs. ECT 107.2, P-value: 0.535). There were indications of (P-value: 0.109) poorer AMI-SF consistency score in the ECT group (APT 72.3% vs. ECT 64.3%).

Conclusions

This study does not find that ECT causes long-term impairment in neurocognitive function as measured with standard neuropsychological tests. We find a trend towards poorer autobiographical memory in the ECT-group, and there needs to be further research regarding this.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Mixed-effects models: Family burden and functionality in patients with bipolar disorder
Authors: Bermúdez-Ampudia C. , García-Alocén A. , Martínez-Cengotitabengoa M. , Alberich S. , González-Ortega I. , Barbeito Resa S. , González-Pinto A.
Published: May 2016

Introduction

The bipolar disorder (BD) has an important effect over the lives of patients and families. The attitude of the family is a modifiable factor through specific interventions and it has been related with BD prognosis.

Objectives

Study a sample of families and patients with BD.

Aims

Compare between two groups its course of burden of caring for family members with BD. Also, we will see the course of the functionality in patients.

Methods

Sample of 148 individuals who caring a familiar with BD. Seventy-six of these followed psychoeducation session are going to be experimental group (EG), and the others 72 did not followed any session are going to be control group (CG). There is a follow-up at 6 months and one year. To see the course of the burden and the functionality it will be used mixed models.

Results

At baseline, there were not significant differences between CG and EG in objective and subjective burden and functionality. But over time there were significant results in the three cases. For objective burden (b = −0.016; P = 0.0001) EG presented a drop (b = −0.014; P = 0.0062), while CG did not show changes (b = 0.002; P = 0.4691). For subjective burden (b = −0.014; P = 0.0058) without significant results for CG (b = −0.352; P = 0.3203) and a significant decrease in EG (b = −0.017; P = 0.003). For the functionality (b = 1.474; P = 0.000) there was a significant increase in EG (b = 1.349; P = 0.000) but not for CG (b = −0.125; P = 0.3828).

Conclusions

Two groups did not differ at baseline however after the psychoeducation sessions appear clear differences, decreasing the burden for EG group and the functionality also improved for EG.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Human rights and mental health care – Can we find a common ground?
Authors: Pūras D.
Published: May 2016

Future of psychiatry is discussed in the context of modern human rights principles, evidence-based policies and sustainable development goals.

After international community agreed on sustainable development goals to be reached by 2030, there is a good opportunity to address mental health as a priority and to substantially invest in promotion of mental health and emotional well-being.

Psychiatry, as an influential specialty, needs to reconsider its strategy in this context, and to rethink strengths and weaknesses of its role and image.

Protection of dignity and human rights of persons with psychosocial disabilities, in the post-CRPD framework, should become a priority for psychiatry. Common ground for search of a new consensus between different views on non-consensual treatment in psychiatry could be equilibrium within the principles of “first, do no harm”, “right to treatment” and “no hierarchy within human rights”. For mental healthcare practice, this would mean that good intentions to provide evidence-based interventions do not justify the use of force and deprivation of liberty which threatens dignity and universal human rights principles.

Psychiatry, while rethinking future directions, should critically reconsider its current focus on neurobiological paradigm and tradition of using force in the name of medicine and social control. These two paradigms, traditionally perceived as strengths of psychiatry and sources of its power, are now too often misused and increasingly discussed as lacking evidence, ignoring human rights and thus threatening image of psychiatry. Instead, psychiatry could consider accepting post-CRPD challenge as a unique opportunity for change, through strengthening strategic alliance with human rights mechanisms, social sciences, general and community medicine, modern public health approach and users’ perspective.

Disclosure of interest

The author has not supplied his declaration of competing interest.
Social functioning and social cognition in bipolar disorder: Is there a connection?
Authors: Maria Iulia V. , Delphine R.C. , Audrey H. , Arthur K.
Published: May 2016

Introduction

The research interest in social cognition in bipolar disorder has increased in a significant way in the last decade showing major impairments, especially in mental state reasoning, even during euthymia (Samamé et al., 2012; Samamé et al., 2015). Social cognitive processes in humans describe the ways individuals draw inferences about other people's beliefs and the ways they weigh social situational factors in making these inferences (Green et al., 2008). A causal relationship between social cognition deficits and global functioning has been already established in schizophrenic populations (Green et al., 2015). But there is still little information regarding the relation between social cognition and social functioning in bipolar disorder.

Aims

To review the relationship between general/social functioning and social cognitive impairments in bipolar patients.

Methods

A systematic review of literature was conducted. Relevant articles were identified through literature searches in PubMed/Medline, EBSCOHost and Google Scholar databases dating from 2000 to 2015 using the keywords “bipolar”, “social cognition”, “theory of mind”, “mentalizing”, “emotion recognition”, “emotion processing”, “functioning” and “quality of life”.

Results

The findings of the review will be discussed, regarding the specificity of the thymic state of the patients and the social cognition instruments used.

Conclusions

To the best of our knowledge, the present review is the first to explore specifically the relation between the social cognition deficits and the general/social functioning of bipolar patients. This exploration is of interest for a better comprehension of this disorder to improve the outcome of the patients.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
First manic episode in a patient with a frontal meningioma
Authors: Queirós M. , Caseiro J.
Published: May 2016

Introduction

Psychiatric symptoms are common among brain tumor patients. Meningiomas are the most common benign brain tumors accounting for 13 to 26% of all intracranial tumors and might present exclusively with psychiatric symptoms. To diagnose a manic episode according to DSM-5 criteria the episode must not be attributable to the physiological effects of a substance or to another medical condition.

Objectives/aims

Describe a case of first manic episode with a frontal meningioma along with a brief review of available literature.

Methods

The case we report is based on information collected from interviews with the patient and the family members as well as from the clinical files. The literature review was performed using the PubMed database.

Results

We describe the case of a 58-year-old woman presenting with symptoms of a first manic episode with psychotic features. There were no previous hypomanic or major depressive episodes. In order to exclude organic causes a brain CT scan was performed that revealed a possible frontal lesion. A brain MRI confirmed the presence of a frontal meningioma with an approximate diameter of 1.4 cm.

Conclusions

The majority of the cases described in the literature refer to large tumors presenting with major depressive symptoms. Given the absence of similar cases in the literature, it seems unlikely that such a small benign lesion may cause a manic episode with psychotic features. Nevertheless, we cannot exclude that possibility.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Early interventions practices in ASD – Maternal behavior in spontaneous interaction with their children
Authors: Amato C. , D’Antino M.E. , Rocha M. , Fernandes F.
Published: May 2016

Recent studies point out that the occurrence of Autism Spectrum Disorders (ASD) is up to 1%. In Brazil, providing services of medical diagnosis for children with ASD takes precious time. The time spent waiting for the conclusion of the diagnostic process would be extremely important to the child's development. In this context, the parent–children interaction is an important aspect to be considered as a factor that has a positive impact in this process. The aim of this study was to explore maternal behavior during a spontaneous play situation with their children. All subjects were filmed for 30 minutes during a spontaneous play situation with their mothers that did not receive any special instructions. The subjects were 30 normal children, 3 of each age (respectively 9, 12, 15, 18, 21, 24, 27, 30, 33 and 36 months) and 20 autistic children with ages varying from 2:10 to 10:6 (not expected any chronological association). The whole corpus was analyzed considering of each subject, of each group and the possible associations between the groups. The analysis of the maternal behavior provides data about the importance of mother–child interaction and how everyday life activities and routines can be used to increase the opportunities to improve the ASD child's communicative abilities and their creative use as an important part of the whole development. These findings provide further evidence that families should be included in any plan for intervention designed towards ASD children.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Disruptive behavior disorders and somatic symptoms disorders: Which strategies of emotion regulation children and their parent's use?
Authors: Bizzi F. , Castellano R. , Cavanna D.
Published: May 2016

Introduction

Emotion regulation (ER) is defined as the processes through which emotional awareness and experience are monitored, evaluated, maintained, and modified (Thompson, 1994). Difficulties with these processes have been proposed to increase risk for psychopathology. Disruptive behavior disorders (DBD) and somatic symptoms disorders (SSD) are characterized by an inability to express and modulate emotional states. Research aims to understand how ER influences mental health.

Objectives

We focus on two strategy of ER: Cognitive Reappraisal, involves changing the way one thinks about a situation in order to change its emotional impact; Expressive Suppression involves suppressing or hiding external expressions of emotion from others (John and Gross, 2004)

Aims

We assess ER in order to examine the relation with SSD and DBD in childhood and with their parents.

Methods

The sample consists of 188 subjects divided in four groups: n = 41 children with DBD (M = 10.78 years, SD = 2.11); n = 50 parents (36 mothers and 14 fathers) of children with DBD; n = 44 children with SSD (M = 11.98 years, SD = 2.04); n = 53 parents (40 mothers and 11 fathers) of children with SSD. Were administered the ERQ (Balzarotti et al., 2010) for parents and ERQ-CA (Gullone and Taffe, 2012) for children.

Results

DBD children reported higher levels of Suppression than SSD subjects; high levels of Suppression were reported in mother SSD and in father DBD.

Conclusion

This study extended previous research in childhood, including both mothers and fathers. The findings contribute to a greater understanding of the development of ER, which has important implications for psychological wellbeing.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
ADHD and bipolar disorder challenge in diagnosis in children and adolescents
Authors: Cano Ruiz P. , Gómez Peinado A. , Cañas Fraile S. , Sanmartin Salinas P.
Published: May 2016

Introduction

The professionals in charge of children and adolescents with attention deficit disorder and hyperactivity disorder (ADHD) should be prepared to treat a wide variety of psychiatric symptoms, as most have at least one comorbid psychiatric disorder.

Sometimes the differential diagnosis between ADHD and bipolar disease is difficult because of overlapping symptoms between the two disorders (Geller et al., 1997; Biederman et al., 2000; Singh et al., 2006).

Methodology

A literature review about the comorbidity between ADHD and bipolar disorder in children and adolescents was performed.

Results

According to different studies, between 60 and 90% of children and adolescents with ADHD have comorbid bipolar disorder. However, the percentage of children and adolescents with ADHD that has comorbid bipolar disorder varied from 10 to 22% (puedes poner from 60 to 90% si no quieres repetir el and).

Conclusions

The prevalence of bipolar disease, particularly among adolescents, is between 1 and 7%. This percentage is higher if all forms of bipolar spectrum are included. Some personal and family factors increase the probability of a patient having ADHD present bipolar disease: decreased IQ, delayed development, family history of ADHD or bipolar disease, and the combined subtype.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
When Ockham razor's principle is not applicable: Differential diagnosis of a rare case of child and adolescent psychosis
Authors: Dinamarca F. , Palma A. , Grifell M. , Galindo L. , Gonzalez L. , Campillo M.T. , Perez V.
Published: May 2016

Introduction

The diagnosis of schizophrenia in children is rare. Less than 4% of schizophrenic patients begin before age 15 being much less stable than in adults as an entity in time. It is estimated that only 50% of diagnoses of schizophrenia in patients under 15 years are maintained over time. The most frequent differential diagnoses are bipolar disorder, post-traumatic stress disorder and dissociative disorder.

Objective and methods

A case of a patient of 18 years old admitted in our service with diagnosis of paranoid schizophrenia due to the presence of delusional symptoms at age of 14 and due his evolution with impaired overall performance is presented. Upon arrival he presented delusions, self-referentiality and a strange phenotype with a pitched voice. Clinical history included presence of sexual abuse prior to debut of psychotic symptoms and rare medical comorbidity (diagnosed at age 15 of hypertension and paroxysmal sinus tachycardia). A kariotipe was done in a previous admission with normal results.

Results

During hospitalization symptomatic remission was achieved in just two days by decreasing antipsychotic potency of the treatment, he also presented elevated metanephrines and also elevated plasma aldosterone and renin in blood tests.

Conclusions

We discuss the differential diagnosis including schizophrenia, post-traumatic stress disorder with dissociative symptoms and endocrine pathology (pheochromocytoma and hyperaldosteronism).

L. Galindo is a Rio Hortega fellowship (ISC III; CM14/00111).

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Exercise addiction: Identification and prevalence in physically active adolescents and young eating disordered patients
Authors: Lichtenstein M. , Støving R.K.
Published: May 2016

Introduction

Exercise addiction is characterized by increasing exercise amounts, withdrawal symptoms and lack of control. Eating disorders and exercise addiction often appear together, but only eating disorders are recognized as diagnoses. However, exercise addiction can exist independently from eating disorders and can be as harmful as any other addictive behavior.

Objectives

The Exercise Addiction Inventory (EAI) is useful to identify exercise addiction symptoms in adults and prevalence rates of 3–10% have been found. But a scale for adolescents does not yet exist even though behavioral addictions seem to be more prevalent among young people.

Aims

To develop an instrument for identification of exercise addiction in adolescents and to estimate the prevalence and negative consequences.

Methods

We developed a Youth version of the EAI and screened 383 adolescents in sport settings and 69 patients from an eating disorder department (age range 11–20 years).

Results

The psychometric properties of the scale were good (Cronbachs alpha 0.71). The prevalence of exercise addiction was 5.5% in adolescents in sport settings and 21.2% in eating disorder patients. We found a positive linear relationship between EAI-score and “high weekly exercise amounts” (r = 0.4, P = 0.00), “the tendency to exercise in spite of injury” (r = 0.4, P = 0.00), “feelings of guilt when not exercising” (r = 0.5, P = 0.00), “reduced sport performance related to overtraining” (r = 0.2, P = 0.00), and “food dominating life” (r = 0.2, P = 0.00).

Conclusions

On basis of this study, we recommend the EAI-Y for identification of exercise addiction in adolescents. Early identification is important since it can prevent excessive and obsessive exercise, injuries, reduced sport performance and eating disorder pathology.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Feasibility of the stress and anger management program on children with high functioning autism spectrum disorder in a sample population from Karachi
Authors: Tauseef B. , Zadeh Z. , Fatima B.
Published: May 2016

Introduction

Research shows that individuals with Autism Spectrum Disorder, struggle with emotional competence as compared to their typically developing counterparts. This leads to internalizing (stress) and externalizing (anger management) problems in the affected population. The stress and anger management program (STAMP) designed by Scarpa et al. is a manualized treatment protocol with good clinical efficacy.

Objective

The objective of the present study is to test the feasibility and suitability of STAMP as a systematized treatment protocol in Karachi and to enable the sample population, to become emotionally competent.

Aim

The aim is to evaluate the effectiveness of STAMP on the reduction of symptoms in the sample population.

Method

Ten children with high functioning autism spectrum disorder will be selected from various institutes in Karachi, and randomized to experimental and waitlist control group after pre-intervention assessment. Upon completion of the intervention with the experimental group, the waitlist control group will be offered the intervention. Both the groups will be assessed, immediately after the intervention, followed by a one-month follow up assessment.

Results

It is expected that STAMP will significantly reduce the incidence of problem behaviours as measured by the standardized assessment questionnaires from the manual; as well as significantly reduce the severity of scores on the internalizing and externalizing components of the strength and difficulties questionnaire, in the experimental group as compared to the control group.

Conclusion

It is expected that the results of the present study could be utilized to train mental health professionals in Karachi for systematized treatment of ASD and related problems.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Potential neurobiological ADHD biomarkers
Authors: Uzbekov M. , Misionzhnik E.
Published: May 2016

Objectives

Pathogenetic mechanisms of hyperkinetic syndrome (HKS) or attention deficit hyperactivity disorder (ADHD) are not clear.

Aim

To elucidate some aspects of monoamine involvement in pathogenesis of disorder and response of monoaminergic systems to psychostimulant medication.

Methods

Levels of different monoamines, their metabolites and N-methylnicotinamide (end product of kynurenine pathway) were measured in daily samples of urine from children (7–11 years old) with mild and severe HKS using fluorimetric and chromatographic methods as well as platelet monoamine oxidase (MAO) activity. Thirty children with mild HKS received psychostimulant Sydnocarb 5–15 mg daily for 1–1.5 months (for ethical reasons children with severe HKS were not included in study).

Results

HKS was accompanied by activation of dopaminergic and inhibition of noradrenergic systems. There were found metabolic differences between two forms of HKS. Compared with mild HKS, severe HKS was characterized by significant 2-fold increase of MAO activity and L-dopa, dopamine and adrenaline excretion. After sydnocarb treatment children's clinical status improved along with decrease of excretion of homovanillic, vanillylmandelic and 5-hydroxyindoleacetic acids and increase of N-methylnicotinamide.

Conclusions

Results indicate that dopaminergic and noradrenergic systems play important role in pathogenesis of HKS. Clinical improvement of HKS children was accompanied by significant increase of N-methylnicotinamide excretion. It is proposed that increased urine excretion of kynurenine metabolite–N-methylnicotinamide and N-methylnicotinamide/5-hydroxyindoleacetic acid ratio can serve as potential biomarkers for evaluation of efficacy of psychostimulant medication. We hypothesize that kynurenine system plays significant role in pathogenesis of HKS/ADHD.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Anxiety and undiagnosed pheochromocitoma
Authors: Santalla C. Cocho , Sanahuja C.
Published: May 2016

Introduction

Pheochromocytomas are rare catecholamine-secreting tumours from the adrenal medulla. The clinical presentations may mimic other disorders due to nonspecific symptoms produced by catecholamines in blood.

Objectives

We report a case of undiagnosed pheochromocytoma in a 29-year-old woman with a two year history of anxiety. We undertook a literature review.

Methods

PubMed search using “pheochromocytoma”, “anxiety” as key words. Follow by a manual review of identified publication. We report a case of a 29-year-old with a two-year history of anxiety pharmacologically treated without success. She presents episodes of acute anxiety accompanied, sometimes, by nausea or headache, without high blood pressure. She presented a previous medical history of thyroid carcinoma. The patient was referred to the endocrinology service for thyroid review, postulated as potential source for drug resistance. High catecholamine levels were found and pheochromocytoma diagnosis was confirmed histopathologically.

Results

The releasing catecholamine in blood can lead to a number of symptoms that can include paroxysmal hypertension, headache, palpitations, anxiety, chest/abdominal pain, nausea. Hypertension may not be the main symptom. These symptoms can be misinterpreted as psychiatric disorders, in particularly anxiety disorders. Elevated urinary catecholamine suggested the diagnosis of pheochromocytoma.

Conclusions

Pheochromocytoma should be included in the differential diagnosis of anxiety disorders, especially if pharmacological treatment is not effective. The suspected cases should be investigated, even in the absence of hypertension, due to the potential morbidity of untreated pheochromocytoma.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Disruptive mood dysregulation disorder in adults: A case report
Authors: Kilic O. , Demirbas Cakir E. , Tufan A.E.
Published: May 2016

Introduction

Disruptive mood dysregulation disorder (DMDD) defined by DSM-V is characterized by severe and recurrent temper outbursts and persistently irritable or angry mood.

Objectives

Our aim is to attract attention to an adult case with DMDD since the literature is lacking adult manifestations.

Case report

A 18-year-old boy have been on follow-up in our outpatient clinic since he was 12 with complaints of being increasingly irritable and angry during most of the day. He had temper tantrums six or seven times per week involving verbal rages, physical aggression and throwing things to friends and family members. There had never been a distinct period lasting more than one day during which the full symptom criteria, for a manic, hypomanic or a depressive episode had been met. He was also reported to be hyperactive, impulsive, and had difficulty concentrating and focusing since he was seven. Laboratory evaluations were within normal limits. Results of screening forms provided by parents and teachers supported the presence of attention deficit and hyperactivity disorder (ADHD). ASRS, YMRS, STAXI, SCID-I, Diagnostic Interview for Adult ADHD (DIVA) were the psychometric evaluations carried out in order better to characterize the clinical situation.

Results

He was considered as fulfilling DSM-5 criteria for ADHD and DMDD, and started on sertraline 50 mg/day and OROS methylphenidate 36 mg/day. At the following visits, temper tantrums were much reduced and there were moderate improvement in ADHD symptoms.

Conclusions

By defining the adult manifestations of DMDD accurately, clinicians will be able to improve diagnosis and care.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Gender differences in acute and transient psychotic disorder
Authors: López Díaz Á. , Galiano Rus S. , Soler Iborte A. , Fernández González J.L. , Aznarte López J.I.
Published: May 2016

Introduction

In the recent decades, there is a growing interest in gender differences in psychotic disorders. Also, in the field of acute and transient psychosis, according to various studies, women seem to have higher prevalence and long-term diagnostic stability.

Objectives

To determine whether there are gender differences in clinical features of acute and transient psychotic disorders (ATPD).

Methods

Descriptive cross-sectional study in the adult patients with ATPD were admitted between 2011 and 2015 in our acute psychiatric ward. Diagnostic criteria was according to the International Classification of Diseases (ICD-10). Descriptive and inferential statistic procedures for clinical symptoms and diagnostic subcategories were performed, using the MedCalc software, version 15.8.

Results

Thirty-nine patients met the inclusion criteria. Males were (MG) 41%, females (FG) 59%. There were some statistically significant differences between gender in the polymorphic features group (>FG, P = 0.048), and in the presence of acute stress (>FG, P = 0.0277). Length of stay was also different, but without statistical significance (>MG, P = 0.0607). In contrast, symptomatic sets, family history of psychosis, and type of onset (sudden or acute) were similar for both groups.

Conclusions

The gender differences seem to be in favour of a higher prevalence of polymorphic psychotic symptoms, in relation to stressful events in women. Somehow, these factors could be a condition, which would determine a greater diagnostic stability in female patients, even in cases of recurrences.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Neuropsychological characteristics of individuals with mild cognitive impairment
Authors: Wang Q. , Sheng Y.
Published: May 2016

Introduction

As the population ages, cognitive impairment is prevalent among older adults and this may cause a huge burden to society. In order to take precautions effectively, we need to understand the characteristics of cognitive function of older adults, especially the individuals with mild cognitive impairment (MCI).

Objectives

To explore the characteristics of cognitive function changes in individuals with mild cognitive impairment.

Methods

A total of 108 individuals with MCI as MCI group and 108 volunteers as control group were recruited in the study. The age, gender and years of schooling were matched between the two groups. The cognitive function was evaluated with the Montreal Cognitive Assessment (MoCA).

Results

Individuals of MCI group performed poorer than those of control group on executive function, attention, calculation, language and delayed memory. The difference between the two groups was statistically significant (P < 0.05). The cognitive impairment in participants with MCI were delayed memory (100%), language (75%), executive function (66.7%), attention (44%) and calculation (20.4%).

Conclusions

The impairment of memory, language and executive function is the primary characteristics in individuals with MCI. Individuals with MCI have similar characteristics with early stage Alzheimer's disease (AD). We should take preventive measures to improve or delay AD.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Are we able to influence cognitive dysfunction in multiple sclerosis?
Authors: Davidescu E.I. , Nicolae S.A. , Buraga I. , Tudose C. , Popa N.
Published: May 2016

Introduction

Multiple sclerosis (MS) is the most common chronic neurologic disease affecting young people. Cognitive dysfunction is an important part of disability, interfering with quality of life (QoL). Disease modifying therapies (DMT) are gold standard of long-term treatment in MS.

Objectives

Assessment of DMT impact on evolution of cognitive dysfunction.

Aims

To analyze the cognitive status in a lot of 74 patients with MS, with a mean age of 40.4 years, treated with different DMT in the National Health Program.

Methods

Testing patients during 2014–2015 for cognitive dysfunction, by applying MMSE, Sunderland Clock Test, Beck Depression Inventory, Fatigue Impact Scale and QoL Short form-36 scores every 6 months; analyzing demographic, clinical and magnetic resonance imagery (MRI) data.

Results

Thirty-six percent of lot showed memory and concentration changes (12 patients with secondary progressive MS, 15 with relapsing-remitting MS); mean age of these patients was 46.29 years, with a mean period of evolution of the disease of 9.8 years before starting DMT; cortical atrophy was present on MRI in 37% of these patients. Mean age of those who didn’t present cognitive disturbances was 37.01 years, with a mean period of evolution of 6.2 years before starting DMT. Disturbances appeared independently of the presence of cortical atrophy, as this marker appeared in 5% of patients with no cognitive dysfunction.

Conclusions

When starting DMT, age and time of evolution of the disease are essential for further developing of cognitive dysfunction. Mood and anxiety disturbances can be a prodromal marker of neurocognitive troubles. DMT have neuroprotective outcome in MS.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
The effect of interpersonal multisensory stimulation on the self-face recognition in adults with autistic syndrome disorder
Authors: Deltort N. , Cazalets J.R. , Amestoy A. , Bouvard M.
Published: May 2016

Studies on individuals without developmental disorder show that mental representation of self-face is subject to a multimodal process in the same way that the representation of the self-body is. People with autistic spectrum disorder (ASD) have a particular pattern of face processing and a multimodal integration deficit.

The objectives of our study were to evaluate the self-face recognition and the effect of interpersonal multisensory stimulation (IMS) in individuals with ASD. We aimed to show a self-face recognition deficit and a lack of multimodal integration among this population.

IMS consisted of the presentation of a movie displaying an unfamiliar face being touched intermittently, while the examiner applied the same stimulation synchronously or asynchronously on the participant. The effect resulting from IMS was measured on two groups with or without ASD by a self-face recognition task on morphing movies made from self-face and unfamiliar-face pictures.

There was a significant difference between groups on self-recognition before stimulation. This result shows a self-face recognition deficit in individuals with ASD. Results for the control group showed a significant effect of IMS on self-face recognition in synchronous condition. This suggests the existence of an update of self-face mental representation by multimodal process. In contrast, there was no significant effect of IMS demonstrated in ASD group, suggesting a multimodal integration deficit for the constitution of self-representation in this population.

Our results show the existence of a self-face recognition deficit in individuals with ASD, which may be linked to a lack of multimodal integration in the development of the self-face representation.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Sex differences in the neural basis of theory of mind during development
Authors: Frank C.
Published: May 2016

Introduction

Theory of mind (ToM) is the ability to predict behaviors of others in terms of their underlying mental states. It is carried out in order to make sense of and predict behavior. Impairments in ToM have been found in many psychiatric/neurological disorders including schizophrenia and autism spectrum disorders. Previous research has indicated sex difference in ToM development. Previous research has also found some differences in the neural basis of ToM.

Objectives/aims

An objective/aim of the present study was to examine possible sex differences in the neural mechanism associated with ToM development. Another objective was to examine the neural basis of ToM that is shared by both sexes throughout development.

Methods

Thirty-two adults (16 women) and 24 children (12 girls) were assessed with fMRI while performing a false belief (FB) task.

Results

During the ToM relative to non-ToM condition, adults and children of both sexes showed increased activity in the medial prefrontal cortex (mPFC) and the temporo-parietal junction (TPJ). Both boys and girls recruited more brain regions than adults. Moreover, children employed structures involved in the human mirror neuron system (hMNS) more than adults. More specifically, boys recruited the inferior frontal gyrus (IFG) more than men, while girls recruited the precentral gyrus more than women.

Conclusions

These results suggest that boys/men and girls/women employ different brain regions for ToM during development.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Relationship between executive functions and adherence to antiretroviral therapy in HIV-infected patients
Authors: Hernández Huerta D. , Parro Torres C. , Madoz Gúrpide A. , Ochoa Mangado E. , Pérez Elias M.J.
Published: May 2016

Introduction

HIV-related damage of the central nervous system is manifested in varying severity of neurocognitive disturbances. Research on measures of executive functioning has confirmed that HIV infection is associated with progressive difficulties in these abilities. Moreover, several studies in recent years have shown that an impaired cognitive function confers a higher risk of poor adherence to antiretroviral therapy.

Objectives/Aims

The aim of this study is to analyze the relationship between executive functions and ART compliance.

Methods

We designed a cross-sectional case-control survey. Cases were defined as HIV-infected patients who missing at least 10% intakes in the last year (reported by hospital pharmacy) and self-reported non-adherence by Simplified Medication Adherence Questionnaire (SMAQ). Controls were defined as HIV-infected patients who accomplishing at least last 95% intakes in the last year (reported by hospital pharmacy), and self-reported adherence by SMAQ. Patients with adherences between 90–95% were not included. Executive functions were evaluated with Wisconsin Sorting Card Test. Linear regression was employed as statistical analysis. Results were adjusted for follow-up years. Wisconsin score was already adjusted for gender, age and education level when data were corrected.

Results

Our sample was compound by 63 patients: 37 controls and 26 cases. A statistical signification (P < 0.05) was found for total correct, total errors, perseverative responses, perseverative errors, conceptual level responses and trials to complete first category score between adherence and non-adherence treatment patients.

Conclusions

In our sample worse executive function score, measured by Wisconsin Card Sorting Test, was linked to poor adherence to antiretroviral treatment in HIV patients.

Disclosure of interest

The authors have not supplied their declaration of competing interest.