bluuebunny/crossref_metadata_2025 huggingface dataset:
Memory, attention and language deficits in major depressive disorder
Authors: Suciu B. , Paunescu R. , Miclutia I.
Published: June 2017

Objectives

For a long time, cognitive deficits were considered as part of depressive episodes and were expected to improve as other affective symptoms diminished with treatment. Because of this, cognitive impairment was rarely assessed for Major depressive disorder, but in the present time this has changed.

Methods

The study included 35 patients (age between 18 and 70) diagnosed with recurrent major depressive disorder (according to ICD-10 and DSM-V) which were evaluated during an acute depressive episode. The severity of depression was quantified clinically and with the help of Hamilton Depression Rating Scale -17 items- whereas cognitive functions were evaluated with standard cognitive tests.

Results

Out of the 35 patients included, 25 were female patients, the rest of 10 being represented by male participants. A median score of 81,5 seconds on the Trail Making Test part A showed attention focusing deficits when compared with standard scores. For semantic fluency, ten words represented the mean score; whereas for phonemic fluency the mean score was lower (seven words). A median score of 5 words resulted from the assessment of the verbal learning and memory, these are considered to be associated with memorization and retention of a list of words given.

Conclusions

These results sustain what the majority of studies revealed, that cognitive deficits are present in all cognitive domains, mostly in attention, verbal fluency and memory.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Depressive symptoms among genders
Authors: Vnukova M. , Raboch J. , Ptacek R. , Sebalo I.
Published: June 2017

Introduction

Depression is one of the most well-known psychological issues and is among the most severe ones. World Health Organisation's (WHO) report on health identifies 1.9% lifetime prevalence of depressive episode for males and almost twice as high–3.2% for females.

Methods

This study aimed to map the depressive symptoms among working population in Czech Republic.

Results

Analysis of covariance showed that there is significant effect of age F(52) = 6.58, P = 0.010 and gender F(52) = 12.53, P < .001 and t-tests showed the means of BDI II scores were significantly different for genders with females having higher mean (11.91) than males (9.80), t(1025) = −3.42, P < .001.

Conclusion

The clinical burden of depression is still an increasing one in today's society and this research helped to identify the potentially most vulnerable individuals. These seem to be working women aged 35–44.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Using digital mood monitoring technology to support the assessment, engagement and empowerment of young people presenting to mental health services with mood instability
Authors: Dubad M. , Marwaha S. , Winsper C.
Published: June 2017

Background

Digital mood-monitoring technology, such as mood-monitoring applications, is increasingly advocated within clinical research and is a potentially effective method to engage and empower youth. However, limited evidence is available on this type of technology.

Objectives

(1) To assess the evidence for the use of mobile mood-monitoring applications in youth; (2) to explore what available smartphone application would be most suitable to monitor mood from the perspective of young people; (3) to examine whether mood-monitoring applications are useful for investigating mood instability in youth; (4) to explore the utility and acceptability of using the mood-monitoring application from young people's and clinicians’ perspectives.

Aim

To investigate how mood-monitoring applications can be used to support the assessment, engagement and empowerment of young people presenting to mental health services with a range of diagnoses in which mood instability forms a key component.

Methods

A systematic review using a Cochrane methodology was conducted. After obtaining ethical approval, this study will also employ a mixed methods approach, through which quantitative findings (e.g., digital mood-monitoring data) will be furnished with an in-depth understanding of young people's views on digital mood-monitoring technology.

Results

Findings from a systematic review focusing on the evidence for the psychometric properties, usability and clinical impacts of applications in youth will be presented. Preliminary results from consultations groups and plans for future research will also be discussed.

Conclusions

Evidence acquired through this research can potentially influence mental health policies and result in more innovative (adjunct) interventions and improved outcomes for young people with mood instability.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Sex-specific issues in eating disorders: A clinical and psychopathological investigation
Authors: Di Girolamo G. , Valente S. , Cerrato F. , Scudellari P. , Atti A.R. , De Ronchi D.
Published: June 2017

Introduction

Gender is crucial in many aspects of life, including attitude towards body image perception. Although the well-known female preponderance, recent studies demonstrate an increasing Eating Disorders (EDs) incidence in males but scant literature attention.

Aims

This study aims to highlight the growing phenomenon of EDs in males and shed light on sex-related clinical features and psychiatric comorbidities.

Method

Out of 280 persons aged 18–74, consecutively referred to Bologna's outpatients EDs clinic, 267 were included in this retrospective observational study.

Results

The men/women ratio was one to five. The most frequent EDs in males was Binge Eating Disorder, whereas in females Anorexia Nervosa and Bulimia Nervosa prevailed. Excessive exercising and fasting were the most common dysfunctional behaviors in men, while self-induced vomiting and laxative-diuretic abuse were more typical in women. Mood and Somatoform Disorders were more common in women, whereas Anxiety and Psychosis Disorders in males. Within personality disorders, borderline and histrionic prevailed in female, while narcissistic and anti-social in males.

Conclusions

Male compared to female EDs, show differences in clinical presentation, symptoms and comorbidities. The increased proportion of affected men should alert general practitioners, clinicians and psychologists working in non-specialized settings to be more aware of the possibilities of encountering an ED in men and of the need of exploring the eating habits in all male patients. The finding of a more pronounced physical hyperactivity in men in order to achieve an ideal body shape which is muscular and athletic suggests the need of a deeper attention to sex-different symptoms and behaviors declination.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Attachment and hypothalamus-pituitary-adrenal axis functioning in patients with eating disorders
Authors: Monaco F. , Monteleone A.M. , Pellegrino F. , Ruzzi V. , Fico G. , Volpe U. , Monteleone P.
Published: June 2017

Introduction

Attachment theory suggests that different attachment styles influence the development of individual's self-esteem and modulate the individual's ability to manage stressful events by responding with adequate affective adjustment. High levels of insecure attachment are present in adults with Eating Disorders (EDs).

Objectives

The variables that mediate the association between attachment style and EDs have not been investigated enough. The possibility exists that the endogenous stress response system is involved.

Aims

To appraise the role of the endogenous stress response system, we studied the effect of attachment styles on the hypothalamus-pituitary-adrenal (HPA) axis functioning in ED patients.

Methods

Fifty- two women with EDs and 25 healthy women completed the ECR questionnaire to assess their attachment style. Saliva samples were taken in the morning to measure the Cortisol Awakening Response (CAR). Moreover, the saliva cortisol response to the Trier-Social-Stress-Test (TSST) was measured in 30 ED patients and 15 healthy controls.

Results

Patients with avoidant attachment showed an increased CAR compared to both healthy controls and to patients with anxious and secure attachment styles. In the initial TSST phase, cortisol levels decreased in the secure attachment group but not in patients with avoidant attachment. In the TSST stress response phase, the cortisol raise was higher in insecure patients and delayed in avoidant ones.

Conclusions

In adults with EDs, attachment styles affect the HPA axis functioning and this could have a role in the pathophysiology of EDs.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
A family-based intervention of adolescents with eating disorders: The role of assertiveness
Authors: Barrios-Hernandez A.L. , Gonzalez-Cuevas G. , Graell-Berna M. , Blanco Fernandez A.
Published: June 2017

Introduction

One of the key profile features of adolescents with Eating Disorders (ED) is a difficulty with assertiveness. Indeed, current research points to the importance of these patients’ perception of excessive control exerted by their families. Because these adolescents generally live with their families of origin, family-based variables may impact the development and evolution of psychosocial risk factors associated with this psychiatric disorder.

Objective

To investigate whether adolescents with ED improve on assertive communication as a result of parental assertiveness training.

Methods

The sample was comprised of 50 female adolescents with ED receiving group therapy treatment at Niño Jesús hospital in Madrid. Out of the 77 parents participating in the study, 36 were part of the experimental group and subjected to training in assertive skills (8-week sessions for about 2 hours). In addition, 41 parents formed the control group (with no assertiveness training). Before and after this training (or the same amount of time for the control group), adolescents were administered the psychometric test known as the Rathus Assertiveness Schedule (RAS).

Results

A significant increase in RAS scores was found in adolescents whose parents were subjected to the assertiveness training. Moreover, there was a significant decrease in self-restriction scores in patients with ED after their parental assertiveness intervention. No significant changes were observed, however, in the control group.

Conclusions

Our results indicate that providing families with educational tools that aim at developing assertive communication may boost the level of assertiveness in adolescents and, thereby, presumably help in the prognosis of ED.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Run for it: Compulsive exercise in adolescents with eating disorders – a nationwide longitudinal study
Authors: Levallius J. , Collin C. , Birgegård A.
Published: June 2017

Introduction

Rigorous exercise to control weight and/or shape and to avoid negative affect has been proposed as significant in the etiology, development and maintenance of eating disorders (EDs), resulting in more severe and enduring pathology. However, few studies have investigated compulsive exercise (CE) among adolescents with EDs.

Objective

To study the longitudinal relationship between EDs and CE in adolescents.

Aims to investigate if adolescent ED patients show a similar relation between EDs and CE as previous research has found in adults.

Methods

A total of 3116 girls and 139 boys from a nationwide clinical EDs database were investigated on CE prevalence and frequency in relation to ED diagnosis, psychiatric symptoms, associated features and outcome. Denial of illness in self-ratings was adjusted for.

Results

Adjusted CE prevalence in girls was 44%; with highest prevalence in bulimia nervosa. Average CE frequency was 3.9 times/week (SD = 2.6). Those with CE scored significantly higher than non-CE on total ED severity, dietary restriction and negative perfectionism (P < 0.001). There were only minor differences between CE and non-CE patients on emotional distress, hyperactivity, suicidality and self-esteem. Among boys, adjusted CE prevalence was 38%, and only total ED severity was significantly related to CE (P < 0.05). Initial CE did not impact prognosis, yet cessation of CE during 1-year follow-up was associated with ED remission.

Conclusions

CE is a common clinical feature in adolescents with EDs, as previously found in adults. CE had less detrimental impact on EDs than predicted and cessation was associated with better outcome.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Overweight and obesity's prevalence, identification of risk factors in children and teenagers in two schools of Monteria
Authors: Romero Otalvaro A.M. , Perez-Vargas M. , Pena V. , Martha M.
Published: June 2017

The research has the intention to determinate the prevalence, risky factors of overweight and obesity in a sample of six hundred people between seven (7) and eighteen (18) years old, chosen by a simple random sampling with exclusion criteria, pathologies that affect the weight and size (diabetes paralysis; malformation or physic limitations). The data was collected through national poll of the nutritional situation and Colombia ENSIN, in the demographic and anthropometric information register and poll identification of food habits and physical activity questionnaire for children PAQ-C. The comparative analysis was made through SPSS in two determined populations by the low and medium social status criteria in the overweight and obesity variables, risky factors related with physical activity food habits and gender. It can be concluded that the population presents normal weight, prone to obesity. Based on the medium socioeconomic status, the percent of male obese teenagers is higher than the female one. Children independent of the socioeconomic status, present a higher percentage of obesity than teenagers. A high percent of population do not do physical exercise. There is no evidence of the relation between socioeconomic level and the presence of unhealthy food habits.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Self-admission to in-patient treatment: Patient experiences of a novel approach in the treatment of severe eating disorders
Authors: Strand M. , Bulik C.M. , von Hausswolff-Juhlin Y. , Gustafsson S.A.
Published: June 2017

Introduction

The course of an eating disorder is often prolonged and can lead to enduring disability for many years, with some patients requiring lengthy periods of in-patient care. Unfortunately, there is still little evidence concerning the optimal model of in-patient care for these patients.

Objectives

Self-admission is a novel treatment tool, whereby patients who have high health care utilization are offered the possibility to self-admit to an inpatient ward for up to seven days, because of deteriorating mental health or any other reason. Purposes behind the model are to increase the availability of in-patient care, to promote autonomy and agency, and to decrease total inpatient care utilization.

Aims

To investigate whether self-admission can be beneficial for patients with severe eating disorders.

Methods

Two beds out of eleven at a specialist eating disorders inpatient unit were reserved for self-admission of well-known patients. All participants were interviewed about their experiences in the program at 6 months.

Results

Participants described an increased sense of agency and safety in their everyday lives. Suggestions were also made, such as a more active outreach approach in promoting admission, providing a continual staff contact during the brief admission episode, and offering a similar self-admission model for day treatment.

Conclusions

Self-admission is a viable tool in the treatment of severe eating disorders and can increase quality of life by providing a safety net and promoting agency. However, logistical obstacles must be addressed in order to promote a constructive use.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
An explorative look at Jerusalem syndrome and its validity?
Authors: Kumar S.
Published: June 2017

Introduction

The aim of the explorative study poster is to look into the phenomenon of psychotic disorder/manifestations collectively termed as Jerusalem syndrome – a psychotheological condition characterized by temporary psychosis like symptoms upon visiting Jerusalem.

Aim

The primary aim is to explore the theories pertaining to the possible causes and psychopathology involved in Jerusalem syndrome with a view to contextualize their credibility and weightage against the extant evidence in neurological science. It would also look at the possible treatments used.

Method

A detailed literature search has been undertaken to identify variety of case reviews and publications about Jerusalem syndrome and case interviews of psychiatrists in Jerusalem: dealing with neurological, psychological explanations of the condition; have been proposed by psychiatrist or psychologist and neurologists as a possible psychopathological manifestation.

Discussion

The results are synthesized and presented in a tabular form. The discussion expands on the various theories and their relevance with a view to establish the nosological validity of the condition and the viable treatment models available.

Disclosure of interest

The author has not supplied his/her declaration of competing interest.
Emotional decision for accepting patients in the ICU in Greece – where are the guidelines?
Authors: Christodoulou I. , Dounias G. , Tsakiridis I. , Peitsidis N. , Lahana C. , Gonezou D.
Published: June 2017

Introduction

It is not a rare phenomenon to ask a bed in the ICU in a basis of emergency. Then, the answer coming from the intensivists may be more than surprising. Objective of our study is to highlight the fact that emotional reasons and not medical criteria are the dominant ones for accepting a patient in the ICU.

Methods

We present 4 cases of interest.

Results

A poor Russian 75-year-old man with gastric cancer, anemia and haemodynamic instability was not accepted in the ICU with the oral and not written rejecting answer that he suffers from advanced cancer. A 35-year-old transplanted patient with bone marrow, fever, severe lactic acidosis, was not accepted in the ICU for hours because the intensivist would give her consent only if the patient would undergo a cholecystectomy first! The intensivist was a pneumonologist! In the end multiple liver abscesses were discovered, so an operation would not help. An 80-year-old man operated for colon cancer with haemodynamic instability was accepted in the ICU without delay. A 72-year-old with colon cancer, cachexia, thrombopenia and severe dementia, coming from the Psychiatric Hospital where he remained for months, was accepted in the ICU without delay.

Conclusions

If there is not an Ethics Commitee to examine these unexpectability matters concerning patients needing a place in ICU, then a psychiatric evaluation of Intensive Unit physicians might help, for the good of patients. Would a member of the Parliament or a celebrity receive a “No” from the ICU?

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Fitness to practice and fitness to regulate
Authors: Kurz R.
Published: June 2017

Introduction

In 2012, forensic psychology Professor Jane Ireland published initial research claiming that two third of psychological assessment reports sampled from UK family courts were ‘poor’ or ‘very poor’. ‘Fitness to practice’ concerns were raised by vested interest and dismissed after a 1-week hearing – four years later.

Objectives

The presentation outlines the nature of various UK institutions, such as family courts, HCPC and GMC as well as their practices which raise questions about their fitness to regulate.

Aims

Delegates will start to learn how institutions that purport to serve public interest yet can be easily exploited by vested interests.

Methods

Case studies are used to illustrate how extremely serious concerns were ignored but persecution concerns upheld.

Results

In one case, four courts appointed experts ignored an obvious child trafficking process where a toddler was raped to cover up birth and disappearance of a newborn baby that succeeded from incestuous rape. In spite of a clinical psychologist failing to cover the two index incidents, the concerns did not meet the HCPC ‘Standard of Acceptance’. A ‘revenge concern’ was raised by vested interests. In another case, the GMC refused to investigate a psychiatrist who had lied and rather absurdly claimed that repeatedly seeking return of her children was evidence for a mother's personality disorder. In a widely publicized case Psychiatrist Dr Hibbert accused of unnecessarily, breaking up families was investigated but cleared of misconduct by the GMC.

Conclusions

Institutions tasked with protecting public safety and fairness appear to be unduly biased towards shielding inadequate professionals and persecuting whistle-blowers.

Disclosure of interest

The author has not supplied his/her declaration of competing interest.
Head banging as a form of self-harm among inpatients within forensic mental health and intellectual disability services
Authors: Chester V. , Alexander R.
Published: June 2017

Introduction

“Head banging” is a common form of self-harm, linked to numerous negative outcomes including significant brain damage. However, little research has investigated the prevalence and correlates of head banging behaviour in clinical populations.

Method

Head banging episodes were identified from the incident records (n = 5417) of two inpatient forensic services (one intellectual disability and one mental health), using relevant search terms. Rates were compared between individual patients, by gender, diagnosis and level of security. Incident accounts were analysed qualitatively using thematic analysis.

Results

Two hundred and twenty nine incidents of head banging were recorded, occurring approximately every three days in each service. The prevalence of the behaviour between individual patients varied widely, ranging from one to 38 incidents within one year. Women and patients with intellectual disability appeared more likely to engage in head banging. Qualitative incident reports indicated that head banging was associated with mental distress, anger, and psychotic experiences.

Discussion

Head banging occurs frequently in forensic services, and has documented associations with traumatic brain injury in affected individuals, thus negatively impacting progress through the care pathway and treatment outcomes. Further research should investigate short and long term management strategies and treatment approaches, in order to minimise harm.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Intergenerational transmission of antisocial personality disorder: Maternal role and its declination
Authors: Di Giacomo E. , Clerici M.
Published: June 2017

Antisocial personality disorder is a well-established disease which features space from cruelty to lack of empathy and remorse. Its etiology has been deeply analyzed both for genetic and environmental implications. The role of family context has been underlined throughout the whole psychopathology as an explanation to the etiological conflict between nature and nurture. Even if this conflict seems to be apparently solved, it is still possible to ponder about family implications in terms of causes and consequences. In the antisocial field, maternal role may offer interesting and surprising food for thought. Even if it is commonly believed an intergenerational transmission of aberrant behaviors, particularly in terms of learning behaviors and lack of empathy assimilation, it exists a side part of maternal pathological expression that may play a role in the intergenerational transmission and it is extremely difficult to be detected. Female declination of this disorder may be expressed also through somatic implications and complaints, leading to the hypothesis of a self-reflection of the lack of consideration for other's needs, which is distinctive. It is of extreme importance, particularly in terms of prevention, to consider and identify these connotations of the disorder to be able to try to interrupt the cycle of transmission through generations.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
A study of the impact of child and adolescent abuse on personality disorders in adult women
Authors: Kachaeva M. , Shport S. , Nuckova E. , Afzaletdinova D. , Satianova L.
Published: June 2017

Introduction

Researches on female offenders have indicated a high degree of psychiatric morbidity amongst women. Since the rates of female criminality are rising it would appear important to conduct the study of the relationship between criminal behaviour and psychiatric diagnoses in female offenders.

Objectives

The main purpose of this investigation is to find out origins of crimes in women and to reveal the influence of child and adolescent maltreatment on personality disorders in adult women.

Methods

Clinical psychopathological, psychological, statistical.

Results

A cohort of 24 females with diagnosis of personality disorders was examined. All of them had committed crimes of violence. In the majority of the sample women had a previous history of psychiatric admissions (child psychiatric hospitals, adolescent units). The retrospective review revealed that the majority of women in their childhood were exposed to emotional, physical and sexual abuse in their families. Our results point that maltreatment may distort personality formation and social adjustment and contribute to behavior problems, negative relation to socialization and criminal behavior in adulthood.

Conclusion

The study revealed that psychiatric disorders in childhood and adolescence are predictive of adult criminality in females. This findings may be used as prognostic indicators of development of aggression in female forensic patients.

The study is supported by the Russian Fund of Fundamental Investigations 6-06-00314

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Differences in current psychological and physiological subclinical stress levels in forensic patients with psychopathic personality traits
Authors: Nigel S. , Streb J. , Leichauer K. , Hennig B. , Otte S. , Dudeck M.
Published: June 2017

Stress and its associations with psychopathic traits have been widely studied. However, recent research suggests the distinction between psychological and physiological symptoms of subclinical stress experience. Possible differences regarding these two dimensions of stress and their relations to psychopathy factors have not been investigated yet. Hence, this is the first study on psychological and physiological subclinical stress levels of forensic patients with psychopathic personality traits. We expected to find distinct associations between stress dimensions and psychopathy factors. Therefore, we examined 164 forensic patients with a substance use disorder regarding their psychopathy scores and current stress levels, using the Psychopathy Personality Inventory (PPI) and the Subclinical Stress Questionnaire (SSQ). Our results indicate that only the experience of psychological stress and not physiological stress is predicted by psychopathy. More precisely, the psychopathy factor “Impulsive Antisociality” is a positive predictor of subclinical psychological stress symptoms, while the factor “Fearless Dominance” is a negative predictor. Thereby, gender has an influence as females are more likely to experience psychological and physiological stress. In conclusion, these results imply that forensic patients scoring high on the psychopathy factor “Impulsive Antisociality” experience high levels of psychological distress. This is in line with previous findings describing Impulsive Antisociality as a generally maladaptive trait manifesting in low adaptability and insufficient coping strategies.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Evaluation of a court liaison and diversion service in London over a quarter of a century
Authors: Ryland H. , Exworthy T. , Shaun G. , Khan A. , Lynne R.
Published: June 2017

Introduction

Oxleas NHS Foundation Trust has run a Court Diversion Service in South East London since 1991. It provides services for people within the earlier stages of the Criminal Justice System.

Objectives

This evaluation aims to combine data from across the 25-year period since the introduction of the diversion scheme. It seeks to provide a longitudinal picture to elucidate the impact of service changes during this time.

Methods

The evaluation uses data obtained from a variety of sources for four points in time: 2015/2016, 2011, 1999 and 1991. Data across domains was collated to allow longitudinal analysis.

Results

After the initial introduction of the scheme in 1991, the total mean time on remand was noted to drop from 67.1 days to 49.5 days (P < 0.001). There were 280 referrals over 18 months in 1991, 210 per year in 1999, 190 in 2011 and 174 between April 2015 and March 2016. Violent crimes increased from 29% in 1991 to 47% in 2011. The proportion with schizophrenia decreased from 31% in 1991 to 18% in 1999, before increasing again to 25% in 2011. The use of Section 37 hospital order disposal decreased from 15% in 1991 to just 4% in 2011.

Conclusions

The court diversion scheme has produced significant benefits since it was introduced in 1991, despite a rise in the proportion of violent alleged offences. Changes to the service have seen decreased use of hospital orders.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Pregabalin use in adults with intellectual disabilities
Authors: Courtenay K. , Jaydeokar S. , Perera B.
Published: June 2017

Introduction

Pregabalin is a well-established anti-epileptic drug in the treatment of epilepsy. It is also indicated for the treatment of generalised anxiety disorder and neuropathic pain. In addition, it has mood modulating properties. In people with intellectual disabilities it is used to treat epilepsy. There is little evidence of the use of pregabalin in managing mental health difficulties in people with intellectual disabilities.

Objectives

To describe the use of pregabalin in adults with intellectual disabilities.

Method

A descriptive case series of adults with intellectual disabilities living in the community, under the care of a community psychiatrist, who are prescribed Pregabalin. Outcomes of treatment were measured using the health of the nation outcome scale for people with intellectual disabilities (HoNOS-LD).

Results

Fourteen cases were identified in the community service of adults with Intellectual Disabilities. Twelve were men and two were women. The average age of the sample was 29 years. The range in duration of using pregabalin was from 3 to 72 months. Thirteen adults had a diagnosis of Autism of which three also had ADHD. The indications for using pregabalin and numbers were : anxiety (12); liability of mood (2); generalised anxiety disorder (1); epilepsy (1). The daily dose range was from 150 mg to 300 mg The mean change in HoNOS-LD scores was 32%.

Conclusions

Pregabalin is a useful treatment in people with intellectual disabilities who experience anxiety. It is especially effective among adults with ID and autism to modulate mood and anxiety symptoms.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Nursing practice in mental health at family health strategy
Authors: Mussumeci P. Amaral , Rodrigues N. De Almeida Nassif , Aguiar B. Gerbassi Costa , Chaves S. Maria do Amaral , Ramos W. Maria Antunes , Louro T. Quinellato , Ribeiro Y. Cristiane , Conrad D. , Pinto C. Baptista
Published: June 2017

The nurse practice model at the family health strategy is characterized by direct involvement in the patient's health-disease recovery process, deconstruction of social stigma involving mental health disorders, and the restoration of patient autonomy their social ties. This descriptive study follows a qualitative approach to document and analyse practices performed by mental health nurses at the family health strategy (FHS) in Rio das Ostras, Brazil. The study identifies practices implemented by Mental Health Nurses at FHS and the nurses’ own reflection and analysis on these mental health practices. Data was collected through semi-structured interviews. All interviewed nurses had worked in the primary mental health care for at least one year at the FHS units in Rio das Ostras. Data was analysed, grouped, and coded according to two categories: 1) The nurses’ professional practices in mental health at the FHS, and 2) The nurses’ view on mental health practices at the FHS. Results show that the main activities in mental health at FHS involve working with the matricial team, continuing education, reception, home visits, referrals, therapeutic workshops and community therapy. Nurse perspectives on professional practices involve prevention, establishment of bonds with patient, and nurses’ training to deliver care to patients who are suffering. The bond with and care for the patient, family and community, is one of the FHS differentiators. In that vein, the study looks at the link between health care delivery, territory and population attended. The health care based on territoriality, allows increased patient and family confidence.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Community mental health services in the eyes of community mental health centers staff
Authors: Attepe Ozden S. , Icagasioglu Coban A.
Published: June 2017

Introduction

Community mental health centers (CMHC) are established for providing services to individuals with serious mental illness. In these centers, individual's need of treatment and care are expected to be met with a mental illness in the community as possible. The process of community mental health service creation in Turkey is relatively new and gaining popularity in last 7–8 years. First CMHC was established in 2008. After this date CMHCs’ have been opened and the target of 2016 is reaching across 236 CMHC in Turkey.

Objectives

In this context, this study aims to provide views of psychiatrists, nurses, social workers, psychologists and occupational therapists who work in CMHC for the services that provided to individuals in these CMHC's and learn how to define their professional roles and responsibilities in CMHC.

Methods

This paper used qualitative research design. Data was collected from 7 CMHC in Ankara through in-depth interviews with a total of 30 people consisting of psychiatrists, nurses, social workers, psychologists and occupational therapists.

Results

The participants look positively about given services, however, financial pressure in the creation process of services, problems in employee personal rights and lack of policies and services related to mental health forced employee and reduce the quality of services provided.

Conclusions

Through understanding perspectives of the professional staff toward community-based services will help to determine current problems in CMHC for policy makers.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Expanding the Role of Primary Health Care in the Provision of Mental Health Services to the Population of the Kyrgyz Republic
Authors: Galako T.
Published: June 2017

Providing comprehensive, integrated services in the field of mental health in primary health care (PHC) is a component of the state mental health program for the population of the Kyrgyz republic (KR) in the 2017–2030 biennium. In order to develop an action plan in this area a situational analysis of resources of psychiatric care at PHC level was carried out. There was revealed a significant deficit of specialists, such as family doctors, mental health care professionals. In spite of the need for 3,300 family doctors, only 1706 work, and 80% of them are of retirement age.

The results of a research showed a low level of knowledge and skills of family physicians for the early detection of mental disorders and provision of appropriate medical care. There are also a limited number of psychiatrists, especially in rural regions (77% of the required quantity).

During recent years, there have been implemented significant changes in the system of mental health services, aimed at improving its quality, the approach to the place of residence of the patient and the prevalence of psychosocial services.

Since 2016 in 8 southern regions in the Kyrgyz Republic has been introduced a new model for the provision of comprehensive health care services. Piloting this model involves psychosocial rehabilitation of patients with mental disorders, the help of mobile teams at the place of patient residence, as well as psychoeducation, training, and support to family doctors. These and other measures will help to optimise mental health care at PHC level.

Disclosure of interest

The author has not supplied his/her declaration of competing interest.
Mental Health of College Students: Five-year Experience of the University Psychiatric Outpatient Clinic of São João Hospital Centre
Authors: Guedes R. , Mota-Oliveira M. , Pereira E. , Peixoto M.J. , Ferraz I. , Oliveira M. , Silveira C.
Published: June 2017

Introduction

The clinic of psychiatry and mental health of São João hospital centre (Oporto, Portugal) has implemented a psychiatric consultation to support college students since 2007. This consultation is open to all of the universities in the metropolitan area of Oporto.

Aims/objectives

This specific consultation aims to detect and intervene early in the treatment of psychiatric illness and to promote mental health in this specific population.

Methods

Retrospective study conducted in the São João hospital centre, Oporto, Portugal. Patients attending university student's specific consultation between January 1st 2011 and March 31st 2016 were included. Data collection included sociodemographic variables, clinical diagnosis (ICD-10, WHO, 1992) and psychological scales (WAIS-III, BSI, HADS, SF-36 and NEO-PI-R). SPSS® software (v. 20.0, 2011) was used for statistical analysis.

Results

In this study, 139 patients were included (66.2% female, medium age 23.1 years old). The majority of patients were medical, engineering or nursing students (respectively 20.9%, 18.0% and 17.9%). The most frequent diagnosis was adjustment disorders, anxiety disorders, mood disorders and personality disorders. 54.6% completed all the psychological scales.

Conclusions

The number of students with mental health issues is increasing. Early detection and treatment of these pathologies may allow improvements on the educational, economic and social levels, as well as in the quality of life.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
The Relationship between Happiness, General Health and Life Expectancy of Cancer Patients
Authors: Heydari S.
Published: June 2017

Introduction

Cancer is a disease that all human beings are afraid of it and anyone, of any age may be affected.

Objective

The objectives of this research are relationship between well-being and life expectancy in patients with cancer in Noshahr Shahid Beheshti hospital is the general purpose of this research.

Aim

Studying the relationship between happiness, general health and life expectancy of cancer patients.

Method

The method used in this research is descriptive and correlation. Statistical population contains all the patients who were diagnosed with cancer in Shahid Beheshti hospital Noshahr. The panel sampling used as sampling method and the sample size was limited to 50 people.

In order to collect the data, we used Oxford's happiness questionnaire containing 29 multiple-choice phrases, Life expectancy questionnaire by Schneider (1991) and general health questionnaire (GHQ-28). In descriptive review of the collected data the mean, standard deviation and frequency tables were used and in inferentially section in order to determine and compare the obtained scores in these 3 tests, according to the findings, parametric methods were used.

Result

The results show that the correlation between mental health, happiness and life expectancy was significant.

Conclusion

As life expectancy increases accountability; Happiness and mental health in patients with cancer increases by the same amount.

Disclosure of interest

The author has not supplied his/her declaration of competing interest.
Aspects of Recovery and Resilience–factors Enabling an Independent and Fulfilling Life
Authors: Krieger J. , Rößner-Ruff V. , Hoins D. , Graef-Calliess I.T.
Published: June 2017

Introduction

The concept “recovery” takes the position that individuals with severe chronic psychiatric disorders can recover and establish a certain degree of mental stability that can enable an independent and fulfilling life. To sustain recovery different variables and interdependent factors are needed, f.e. psychological resilience and empowerment. Actually, there are few studies focusing on the interdependency of recovery and resilience in patients with severe chronic psychiatric disorders, especially with an emphasis on overall psychiatric diagnosis and a longitudinal section.

Objective

The study examines residential patients with severe chronic psychiatric disorders who lived in a long-term care institution for psychiatric rehabilitation (SGB XII) in Lower Saxony and who were able to move out and live by themselves in 2016. Persons with mental retardation and patients who have spent more than 30 years in a long-term care institution will be excluded.

Methods

Randomised controlled trial based on a mixed-methods-design and a longitudinal course (5 follow-ups within 24 months after the first interview).

Aims

Investigate factors for independent living on different levels (like micro, meso, macro) with focus on recovery and resilience by patients with severe chronic psychiatric disorders.

Results

First results of a pilot study and focus groups will be presented.

Conclusion

Results of investigation should be used in different subject areas like identification of factors enabling independent living and creation of effective therapy interventions for patients with severe chronic psychiatric disorders who have lived in a long-term care institution.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Health Education in Caring for an Individual with Psychic Suffering: An Experience Report
Authors: Lira E.M.B. , Silva A.O. , Santos L.J.M. , Vasconcellos Y.L. , Paiva E.E.L. , Bittencourt G.K.G.D. , Silva F.P. , Teófilo T.J.S. , Vasconcelos S.C.
Published: June 2017

Introduction

Integral nursing for an individual with a mental disorder requires care, management and educational skills to improve the quality of life of the patient.

Objectives

Describes a health education experience in caring for an individual with psychic suffering.

Methods

Activities were developed at a psychosocial care center in the city of João Pessoa, Brazil, with students in the third year of nursing school. Three sessions were held on the topic “self-efficacy in the use of psychoactive drugs”. Related factors, such as motivation, self-esteem and support, were chosen by the participants and discussed at each weekly session.

Results

In the discussion groups, the students were able to exercise care based on the exchange of knowledge with the patients who use the service. The ties established in each session enabled the identification of the specific needs of each individual, such as the desire to learn how to improve one's self-esteem, and the active participation of the patients.

Conclusions

The experiences assisted the students in developing the role of the nurse as an educator. The group actions underscored the importance of the skill of health education among nurses.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Community Based Mental Health Care in Bosnia and Herzegovina – an Overview of the Last Six Years
Authors: Racetovic G. , Slavica P. , Rosic B. , Grujic-Timarac S.
Published: June 2017

Introduction

Mental health care in Bosnia and Herzegovina (BH) is changing and shows the new trends more than 20 years. In last 6 years is established strong network of community mental health centers (CMHC) as a most important service in the prevention, treatment and rehabilitation of mental illnesses.

Objectives

Project of mental health in BH (PMH) is the largest reform project, supported by the Swiss Government and it is planned to be implemented in whole BH emphasizing importance of community mental health care and putting patients in the focus of the reform.

Aims and method

To show positive trends and practices in BH as well as obstacles in some fields of the reform.

Results

For the last six years are made positive national mental health policies, established case management model in work with people with severe mental disorders, broad spectrum of services recognized by health insurance (validation of the work for all team members), user initiatives (organization), active role of primary mental health care, reduction of hospitalization, etc. On the other way, yet are not established protected housing, early interventions services and universal methodology or team structure in all CMHC.

Conclusions

Community based mental health care shown as a good choice in the reform of the mental health in BH, confirming positive results from other countries. That is a reason to continue with improvements based on daily practices of the teams in CMHC.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Taking Care of People Suffering from Neuropsychiatric Illness Living at Home
Authors: Sæterstrand T.M.
Published: June 2017

Content background

People suffering from neuropsychiatric illness are often in need of caring and nursing over a long period of time. Research shows that patients suffering from such illness do not very often get enough care in practice.

Aim

To gain knowledge about nurses experiences from taking care of older people living at home and suffering from chronic and neuropsychiatric illness.

Method

Qualitative analysis: fieldwork and qualitative interviews with 11 nurses who worked in four units in two different municipalities in Norway.

Results

Challenges in clinical nursing explain the process nurses work in when they take care of people with neuropsychiatric illnesses living at home. This is caring for patients, taking care of family members, managing complex patient situations and the need for coaching and cooperation.

Conclusion

To gain a good cooperation with other health personnel to strengthen the competence is important, especially when the goal is caring. Nurses with education in neuropsychiatric care can strengthen the competence maybe and reach a better patient care. The organization of the community health system needs to be studied.

Disclosure of interest

The authors have not supplied their declaration of competing interest.