bluuebunny/crossref_metadata_2025 huggingface dataset:
Kleine–Levin syndrome. A case report
Authors: Sanz Llorente S. , González Vega Z. , Bernal Romaguera P. , Ojeda Martinez A.I. , Ventura Faci T. , Marco Sanjuan J.C.
Published: June 2017

Introduction

Nowadays, 30% of the Spanish population suffers from some form of sleep disorder, occupying much of the visits to a psychiatrist. Sleep disorders are not a serious condition by itself, but have serious implications in daily life: physical exhaustion, poor performance, daytime sleepiness. Insomnia is a most common sleep disorder, however, hypersomnia must also be considered due to the limitations that it causes.

Objective

By the description of case report, we will carry out a review of the syndrome Kleine Levine.

Methods

Case report.

Results

A case of Kleine–Levin syndrome in a 23-year-old male is described. The episodic disorder was characterized by excessive sleep, voracious appetite, hyper-sexuality, irritability and memory loss. Among its history, he included a psychotic episode in childhood and an episode of behavioral disorder caused by a stressful situation. His partner refers a similar episode of hypersomnia last year that was self-limiting in 15 days and he did not go to the doctor. Patients often act normal between episodes. Remission was spontaneous. Prospects, for organic aetiology, differential diagnosis. However, arises additional tests (analytical, brain CT, EEG…) resulted no pathological. Patient fulfilled the criteria for KLS, but due to the rarity of the disorder he was previously diagnosed as psychosis not otherwise specified.

Conclusions

This case report aim to highlight that KLS though considered a rare disorder but not uncommon and lack of enough available research data is likely to be responsible for missed or erroneous diagnosis; thus we require more systematic studies regarding etiologies and treatment.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
RETRACTED: Alexithymia and alcohol use disorders: A critical review
Authors: Ghali F. , Fekih Romdhane F. , Mezghanni M. , Zghal M. , Jmii G. , Belkhiria A. , Khemiri I. , Ghazeli I. , Ridha R. , Jouini L.
Published: June 2017

This article has been retracted: please see Elsevier Policy on Article Withdrawal (https://www.elsevier.com/about/our-business/policies/article-withdrawal).

This article has been retracted at the request of the Editor-in-Chief and Author. The authors have plagiarized part of a paper that had already appeared in Addictive Behaviors 34/3 (2009), pages 237–245, http://dx.doi.org/10.1016/j.addbeh.2008.10.016. One of the conditions of submission of a paper for publication is that authors declare explicitly that their work is original and has not appeared in a publication elsewhere. Re-use of any data should be appropriately cited. As such this article represents a severe abuse of the scientific publishing system. The scientific community takes a very strong view on this matter and apologies are offered to readers of the journal that this was not detected during the submission process.
The cat and the mouse game: Is there a shift towards more dangerous substances in the cathinone illicit market?
Authors: Grifell M. , Galindo L. , Ventura M. , Ribera E. , Quintana P. , Palma A. , Carbón X. , Gonzalez L. , San-Emeterio L. , Diez-Aja C. , Caudevilla F. , Torrens M.
Published: June 2017

Introduction

After mephedrone's ban in March 2010 new cathinones proliferated widely, even a new branch of atypical derivatives was launched into the market, represented by MDPV. The cardiovascular and central nervous system toxicity draws attention to this new family of cathinones, also known as pyrovalerones. MDPV was scheduled in 2011, leading to the apparition of Alpha-PVP from which there is little information.

Objectives

The aim of the present study is to describe the evolution of different cathinones in the samples delivered for analysis to the harm reduction NGO energy control from March 2009 to March 2016 in Spain.

Methods

Energy control is a Spanish harm reduction NGO that offers to drug users the possibility of analyzing the substances they intend to consume. From March 2009 to March 2016 a total of 24,528 samples were analyzed by the NGO from which 760 contained cathinones. Substance analysis was done by gas chromatography–mass spectrometry.

Results

From 2009 to 2016, cathinones represented a 2.82% from all analyzed samples. From March 2009 to March 2010, only 5 different cathinones were detected, in this same period methylone (n = 16; 37.20%) and mephedrone (n = 17; 39.53%) represented 76% of analyzed cathinones (n = 43). From March 2015 to March 2016, 132 cathinones were detected: methylone and mephedrone represented only 19.69%, giving prominence to clephedrone (n = 25; 18.93%) and Alpha-PVP (n = 24; 18.18%).

Conclusions

The evolution of synthetic cathinones detected by energy control is consistent with the evolution described in the literature. From 2009 to 2016, the cathinones detected diversify and new substances with higher toxicity potential appear.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Does a state of alcohol hangover impair event based prospective memory?
Authors: Heffernan T.
Published: June 2017

Introduction

The alcohol hangover state (AHS) is characterized by range of symptoms (e.g., drowsiness, fatigue, gastro-intestinal problems, dry mouth, nausea, sweating) that remain after ones blood-alcohol level returns to zero following a recent bout of excessive drinking. Recent findings have revealed a range of cognitive deficits associated with an AHS, including memory deficits. It is less clear what impact the AHS has upon everyday remembering; of which prospective memory is an excellent example (PM: memory for future plans/actions; such as remembering to perform a task at a specific time).

Aims

The present study explored whether the AHS impairs everyday PM.

Methods

Twenty-one AHS participants were compared with 28 non-AHS controls using a between-groups design. All completed a prospective remembering video procedure (prvp), which measured event-based pm. the prvp required the participant first to memorise a series of specific action-locations combinations and then to recall these combinations whilst viewing a CD clip of a busy shopping high street. Drug use (alcohol, smoking, etc.) and mood (anxiety and depression) were also measured, as these have been shown to have a deleterious impact upon PM.

Results

The AHS group recalled significantly fewer event-based PM combinations on the PRVP compared with the non-AHS control group (P < 0.05). There were no significant differences between the groups on age, smoking, alcohol use or mood.

Conclusion

These results confirm that a state of alcohol hangover impedes everyday prospective memory. The wider implications will be discussed at conference.

Disclosure of interest

The author has not supplied his/her declaration of competing interest.
Dutch Intervention Programmes for Children of Mentally Ill Parents
Authors: Van Amelsvoort T.
Published: June 2017

This presentation reports on the outcomes of a practice-based and science-based enterprise in the Netherlands to develop a comprehensive national prevention program focused on children of parents with a mental illness. An outline of the multicomponent program is presented which includes a wide set of interventions that address evidence-based risk factors and protective factors in multiple domains, including children in different age groups, parents and families, social networks, professionals and the community as a whole.

The 20-year history of this program illustrates the importance of long-term collaborative investments that are required of practitioners, policymakers and scientists to develop and implement a nationwide, comprehensive approach for addressing the prevalent transmission of psychiatric problems from parent to child. The results of recently undertaken controlled efficacy studies of various preventive interventions are presented, as well as findings from process evaluations. Also, strengths and weaknesses of the current program are discussed and recommendations will be offered for the main challenges ahead in terms of program innovation, implementation and research.

Disclosure of interest

The author has not supplied his declaration of competing interest.
An unusual case of ‘laughing gas’ addiction in Singapore
Authors: Selvaraj A. , Wong K.E.
Published: June 2017

Objective

Recreational use of nitrous oxide (N20) or ‘laughing gas’ inhalation is a common phenomenon in countries like UK and US where it is associated with music festivals and parties. However, as far as we know, recreational N20 use in Singapore has hitherto not been reported in the press or scientific journals. We report the first case of N20 use and addiction in a young Singaporean male who was introduced to it by a friend from a Western country where its use is prevalent.

Methods

A 20-year-old Singaporean male with an existing psychiatric diagnosis of major depression, presented with a 3 year history of solitary regular N20 inhalation that escalated from infrequent low dose use to the current daily high-dose use which he was unable to control. He exhibited symptoms of dependence — including preoccupation, tolerance, withdrawal and difficulty in cutting down. No major adverse medical complications were noted so far.

Results

The patient was assessed to have Nitrous Oxide Dependence; and is currently undergoing regular counselling sessions in an attempt to motivate him to cut down or stop his N20 use.

Conclusion

This case is unique for 2 reasons:

– extant literature suggests that only anectodal evidence exists for psychological dependence of N20 in Singapore; yet our patient clearly demonstrates psychological dependence;

– this is the first reported case of N20 use disorder in Singapore; and perhaps ASEAN, with the unusual presentation in a young male whose use is solitary and private.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
A comparative research of therapy regimens related to patients with alcohol addiction syndrome for the period 2000–2009 in narcological clinical hospital No. 17 of Moscow
Authors: Tsygankov B. , Shamov S. , Zemskov M.
Published: June 2017

The incidence rate of alcohol addiction syndrome continues to increase worldwide. In the Russian Federation, there is a priority of the patient's rights for an effective and safe treatment of narcological disease. This is achieved using standardised, reproducible, statutory narcological patients diagnosis and management standards.

Research purpose

Identify efficient algorithms for alcohol addiction syndrome treatment in a Narcological Clinical Hospital No. 17 of Moscow (NCH№17), allowed Narcological patients Diagnosis and Management Standards for the period 2000–2009.

Research objectives

(1) Identify the key therapeutic treatment algorithms that were used in NCH№17 of Moscow in the period 2000–2009. (2) Compare the effectiveness of therapeutic regimens identified.

Data for study – hospital sheets of patients treated from 2000 to 2009 in NCH№17 of Moscow. Analyzed 520, included in the research: 401 hospital sheets of 118 patients.

Methods

(1) Continuous sampling. (2) Statistical, Fisher's exact test, Microsoft Excel software (version 13.1.) and Statistica 5.1.

Results

From 2000 to 2009 (1998, 2003 and 2005) have changed three times: legislative framework, focus, narcological patients’ treatment regulation (Fig. 1).

Fig. 1

Periods of application of different regimens are outlined: 2000–2002, 2003–2005, 2006–2009.

Therapeutic algorithm was considered successful if the stage-by-stage approach was complied with. Algorithm inefficiency is designated as “failure of treatment stage-by-stage approach”. Disadvantages of therapeutic regimens lead to complications. Polypragmasy influenced the development of complications. From the analyzed 118 hospital sheets (pursuant to Fisher's exact test), 72 patients had polypragmasy, 40% cases – proven cause was delirium, 20% – refusal of treatment (Fig. 2).

Fig. 2

Surrogate variable of complications is refused treatment.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Psychological distress and alcohol use among adolescents
Authors: Charfi N. , Turki M. , Smaoui N. , Maalej Bouali M. , Zouari L. , Zouari N. , Ben Thabet J. , Maalej M.
Published: June 2017

Introduction

Anxiety and depression, as well as alcohol use are widespread among teenagers, and constitute a huge public health burden worldwide.

Objective

To study the link between alcohol consumption and emotional distress (anxiety and depression) among adolescents.

Methods

We conducted a cross-sectional study in May and June 2016. The sample consisted of 314 pupils from 4 colleges and schools in Sfax (Tunisia). Alcohol Use Disorders Test (AUDIT) was used to evaluate alcohol dependence. Anxiety and depression levels were evaluated using the “Hospital Anxiety and Depression Scale” (HADS).

Results

The mean age was 16 years with a sex ratio of 1.08. Among the participants, 18.9% reported having drunk alcohol at least once and 42.37% of them still consume. The main reasons for alcohol initiation were the search of new experiences (78%) or pleasure and well-being (39%) and the curiosity (49.15%). According to AUDIT, 1.7% of alcohol users presented an alcohol misuse and 20% presented dependence.

The prevalence of anxiety and depression were respectively 56.1% and 23.7%. Anxiety was correlated to alcohol experimentation (P = 0.03) and non-supportive environment (P = 0.003). Depression was correlated to alcohol experimentation (P = 0.001), AUDIT score (P = 0.009), somatic histories (P = 0.02), physical abuse (P = 0.02), non-supportive environment (P = 0.016) and graduating class level (P = 0.005).

Conclusion

Our study highlights the close association between alcohol consumption and emotional distress in adolescence, which seems to be bi-directional. When attempting to reduce the risk of alcohol consumption, we should focus a particular attention on adolescents studying in graduating class, reinforce adolescents’ family support and prevent physical abuse.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Anti-epileptic drugs in opiate addictions
Authors: Vucetic-Arsic S. , Alcaz S.
Published: June 2017

Introduction

Mood dysregulation came to be a hallmark in addiction diseases.

Objectives

Antiepileptic drugs (AEDs) are used extensively to treat non-epilepsy disorders, such as mood disorder. Addiction disease may be triggered by bipolar disorder. Contemporary theories of addiction focus on pathophysiological mechanisms that imply a misbalance in the area of motivational behaviour, cognitive control, inhibitory function and decision-making processes.

The aim of the study was to confirm the clinical significance of AEDs use in the treatment of opiate addicts during hospital detoxification and in stabilizing period.

Methods

The prospective study comprised 70 medical histories of the patients treated in hospital setting over a period August 2015–2016. The study included patients with diagnosis of an opiate dependence and related mood disorders based on the ICD-10 classification. The rate of opiate withdrawal syndrome was measured by Objective Withdrawal Scale (OWS).

Results

Our data uncovered a significant correlation between addiction and bipolar disorders, since 21% of inpatients treatment have co-morbidity. According to a survey, 74% of patients were treated with AEDs during detoxification period and in outpatients setting 1 month later. According to OWS in 65% cases AEDs improved the mood and affect, numbness, sensitivity.

Conclusion

AEDs role in opiate withdrawal syndrome was to normalize the affect, applied as an adjuvant therapy and also used during the recovery, in order to correct mood fluctuations. The high rate of co-morbid mental illnesses between addiction and other mental disorders argues for a comprehensive approach to evaluate each disorder concurrently, providing treatment as needed.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Observational study of suicide attempts in a community mental health unit
Authors: Guerrero Jiménez M. , Albornoz Calahorro C.M. Carrillo de , Gota Garcés J.M.
Published: June 2017

Introduction

Concurrent with the recent global economic crisis there is a rising concern about the effect of recession on suicide mortality rates.

Aim

To record patients treated urgently in community mental health unit of Motril, Granada (Spain) by attempted suicide.

Methods

Descriptive study recording patients treated urgently in Motril community mental health unit who have done any suicide gesture from February 2015 until December of that year.

Results

In total, 39 urgent assessments were recorded during the observational period.

The month of highest incidence was November, with 6 visits followed by August and October (5).

The most common method was voluntary drug intake.

Origin:

– 59% were remitted from the general hospital emergency department;

– critical care and emergency ambulatory devices: 1;

– primary care: 10;

– another specialist: 2;

– own initiative: 2.

Discharge diagnosis:

– 35.8% individuals did not meet criteria for any mental disorder, although some of them were classified with V or Z diagnosis according to ICD-10 for making a reactive gesture to a emotional crisis, couple breakups or economic problems;

– 11 of them meet criteria for various anxiety disorders, obsessive compulsive and adaptative crisis.

Discussion

Knowing some peculiar characteristics in suicidal populations as well as the most prevalent pathologies, it could be adapted both the profile of nurse attendance and the type of resources needed to ensure effective patient care.

Conclusion

Profile of patients attended for suicide attempt in an outpatient setting in a semi-rural coastal area is variated. It is worth to mention that one-third of this population did not meet criteria for any mental disorder.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
The emotional stroop test for screening of suicide risk
Authors: Pereira H. , Esgalhado G.
Published: June 2017

Introduction

Suicide is problematic today, being one of the most potentially fatal psychological phenomena, so it is important to assess thinking about suicide or suicidal ideation.

Objectives

In this study we aim to develop methodological procedures, in order to understand if the emotional stroop test for screening of suicide risk is a good measure of suicidal ideation.

Methods

A cross-sectional study was carried-out among a convenience sample of 100 subjects. The data collection was done using a socio-demographic questionnaire, the emotional stroop test for screening of suicide risk, the suicidal ideation questionnaire and the beck depression inventory.

Results

Regarding the degree of association between the score of interference of the emotional stroop test and level of suicidal ideation there is a strong negative correlation and statistically significant. There are statistically significant differences in the scores on the three sheets of emotional stroop test between subjects with high suicidal ideation and low suicidal ideation. Attention is impaired in the group with suicidal ideation.

Conclusions

The emotional stroop test for screening of suicide risk is a useful, rapid and simple assessment tool that can to be used to detect symptoms of suicidal ideation.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Neurocognitive Predictors of Social Cognition in Subjects with Schizophrenia and their First-degree Relatives
Authors: Mucci A. , Galderisi S. , Rocca P. , Rossi A. , Bertolino A. , Maj M.
Published: June 2017

Introduction

Social cognition is a complex construct that refers to the functions required to understand other people's mental states and behavior. In people with schizophrenia, social cognition deficits account for a proportion of variance in functional outcome, independent of symptomatology. However, the relationships among social cognition, neurocognitive functioning and functional outcome are still unclear. Previous investigations had several limitations including small sample size, heterogeneous and limited measures of social cognition and neurocognitive functions.

Aims

Within the study of the Italian Network for Research on Psychoses, we investigated factors influencing outcome in patients with schizophrenia and their unaffected relatives. Psychopathology, including depression, neurocognition, social cognition and outcome were assessed using instruments designed to overcome some of the previous limitations.

Methods

Structural equation modeling was used to test direct and indirect effects of neurocognition, social cognition and functional capacity on vocational and interpersonal functioning. Tests of facial emotion recognition, emotional intelligence and theory of mind were included to assess social cognition. The MATRICS Consensus Cognitive Battery (MCCB) was used to investigate neurocognition.

Results

In both subjects with schizophrenia and their first-degree relatives, social cognition was found to be independent of negative symptoms and to have a direct impact on outcome. Neurocognition was a predictor of functional capacity and social cognition, which both mediated its impact on outcome. Social cognition was independent of functional capacity and negative symptoms.

Conclusions

Better understanding of how neurocognitive dysfunction and social cognition deficits relate to one another may guide efforts toward targeted treatment approaches.

Disclosure of interest

AM received honoraria or advisory board/consulting fees from the following companies: Janssen Pharmaceuticals, Otsuka, Pfizer and Pierre Fabre SG received honoraria or advisory board/consulting fees from the following companies: Lundbeck, Janssen Pharmaceuticals, Hoffman-La Roche, Angelini-Acraf, Otsuka, Pierre Fabre and Gedeon-Richter.

All other Authors declare no potential conflict of interest.
Risk factors for suicide in the transgender community
Authors: Williams A.
Published: June 2017

Introduction

Approximately 41% of transgender people attempt suicide at least once in their lives compared to the rate of 5% in the general population Transgender patients who have attempted suicide once have a nearly 40% chance for making a third attempt in their lifetime. Addressing the high rate of suicidality among transgender people must be an important clinical concern during treatment. Screening for suicidal ideation is important when working with the transgender community. Knowing the risk factors that affect the transgender community and creating interventions to ameliorate these risk factors can decrease the negative outcomes.

Method

A literature review of articles pertaining to the transgender community and suicide was performed. Of 20 articles reviewed, 14 were pertinent.

Results

The literature review showed several unique risk factors contribute to the high rate of suicide in this population: lack of family and social supports, gender-based discrimination, transgender-based abuse and violence, gender dysphoria and body-related shame, difficulty while undergoing gender reassignment, and being a member of another or multiple minority groups.

Discussion

Aiding the transgender patient to develop coping mechanisms for dealing with negative societal pressures and skills in widening their social supports may help to reduce risk factors and increase well-being for transgender patients. Assessing suicidal ideation in transgender patients, connecting them with contacts in the transgender community and utilizing CBT based techniques to reduce dysphoria and to aid in coping may reduce risk of suicide attempts. More research is needed in specific interventions in the transgender community.

Disclosure of interest

The author has not supplied his/her declaration of competing interest.
Improving medical student empathy: Initial findings on the use of a book club and an old age simulation suit
Authors: Barry T. , Chester L. , Fernando M. , Jebreel A. , Devine M. , Bhat M.
Published: June 2017

Introduction

Empathy is critical to the development of professionalism in medical students, but evidence suggests that empathy actually declines over the course of undergraduate medical education.

Objectives

Improving medical student empathy by encouraging students to think about the person behind the illness.

Methods

Two interventions were studied. From December 2015 until November 2016, a fourth year psychiatry medical student book club was conducted. Students were asked to read an autobiography of a lived experience of psychosis. The old age simulation suit aims to simulate the sensory and physical impairments faced by older adults with age related illnesses. A training session provided a transient experience of old age for the students.

Results

Forty-four students completed the feedback on the book club. Twenty-eight (64%) stated that they strongly agreed with the statement ‘the book club encouraged me to consider the person behind the illness’. Thirty-nine (89%) stated that after attending the book club their empathy towards people with mental health problems had increased. Eleven students completed full feedback following the old age simulation session. Empathy statements relating to living in an ageing body improved from the pre-test median score of 4 (range 1–7) to a median score of 6 (range 2–8) post-teaching session. Empathy statements focusing on sensory and physical impairments had pre-test score median of 3 (range 1–7) and post-test median 8 (range 3–9).

Conclusions

Feedback from these sessions has demonstrated that with a little creativity, empathy training can be delivered to medical students with a positive impact.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
A quality improvement project focused on assessment of risk level of outpatient psychiatry patients
Authors: Tuvia T. , Kats M. , Aloezos C. , To M. , Ozdoba A. , Gallo L.
Published: June 2017

Since the implementation of the Clinical Learning Environment Review by the Accreditation Council for Graduate Medical Education, there has been an emphasis on training residents in health care quality as well as patient safety. As such, psychiatry residency training programs have had to incorporate quality improvement (QI) projects into their training. We developed a QI curriculum, which not only included resident and faculty participation, but also encouraged other staff in our department to focus on patient safety as well as improving their performance and the quality of care provided to the patients.

In this poster, we present the development of our curriculum and will include a successful QI project to highlight this. This project focused on creating an algorithm to help assign patient risk level, which is based on evidence based risk factors. This project was created due to a survey conducted in our clinic which demonstrated that clinicians, and in residency training in particular, identifying and managing high risk patients can be anxiety provoking for trainees. We will present the specifics of this QI project, and additionally outline the steps that were taken to develop and integrate the QI project into clinical practice.

Objectives

(1) Learn how to successfully incorporate a QI project and curriculum into a psychiatry residency training program.

(2) Understand both resident and faculty perspectives on what resources facilitated participation in QI.

(3) Present the development of a quality improvement project focused on risk assessment of outpatient psychiatric patients.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Associations between gender and outcome of acute psychiatric admission, looking specifically at length of stay and type of admission
Authors: Beezhold J. , Farooq U. , Isaac J. , Shepherd A.
Published: June 2017

Introduction

There is little published data regarding the association between gender and outcomes in acute inpatient psychiatry. We present outcomes from a study of 5601 acute psychiatric admissions.

Objective

The objective of this study was to identify associations between gender and outcome of acute psychiatric admission, looking specifically at length of stay and at whether they were detained in hospital.

Methods

The relationship between gender and acute psychiatric inpatient length of stay and detention status was analyzed for all admissions over 90 months from Sept 2002 to Feb 2010. There were 5601 consecutive admissions included in this study, 2862 of which were male and 2739 were female. There were no exclusions. Data was complete for more than 99% of subjects, and was extracted from part of routine service data on an anonymous- basis. The subjects were admitted into two acute inpatient wards in central Norfolk. Data was analyzed using SPSS. Ethics consent was granted by the research ethics committee.

Results

The study showed no significant difference in average length of stay (female = 32.98, male = 32.11; P = 0.595). Additionally, no significant difference was found linking gender to detention status (26% female, 25% male; P = 0.517) as opposed to informal or voluntary admission.

Conclusion

The study found no evidence of a gender bias regarding overall length of stay and legal status in acute admissions. Further research should be conducted in this area to examine whether there is any gender bias in outcomes relating to diagnosis.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
The psychological effects of unmarried women “a field study on a sample of unmarried women in Algeria”
Authors: Fekih L. , Mounis B.
Published: June 2017

Background

The present research was designed to determine the psychological stress as experienced by unmarried women in the education sector, and how to help them to discover the meaning of their presence in the framework, innovation and achievement, art, science, comprehension, love and adaptation in life.

Aim

This research aims to identify the various problems and mental disorders that unmarried women suffering from, and to determine the differences between unmarried women in terms of the psychological problems resulting from “unmarried” in: ages, kind and professional status.

Method

The method used in this research is purely descriptive following the collected data from the sample of 200 unmarried women. The tools that were used in this research as follow: Self-Confidence Scale, Psychological Stress Scale, “List of Information Collection for unmarried women”; we proceeded with some statistical techniques.

Results

The findings of this research were:

– emotional problems are the most common problems experienced by unmarried women;

– the present study indicates the presence of depressive symptoms in 17%, which can evolve toward psychotic depression as dysthymia (loss of interest in daily activities, hopelessness, low self-esteem, self-criticism, trouble concentrating and trouble making decisions, effectiveness and productivity, avoidance of social activities, feelings of guilt and worries over the past, insomnia…);

– the impact of unmarried on late stages have more negative impact, and psychological effect on them was more severe and the greatest harm.

Conclusion

The advancement of women in the age without marriage or “unmarried women” is origin of psychological stress and low self-confidence.

Dissclosure of interest

The authors have not supplied their declaration of competing interest.
Gender differences on mental health distress: Findings from the economic recession in Portugal
Authors: Frasquilho D. , Cardoso G. , Ana A. , Silva M. , Caldas-de-Almeida J.M.
Published: June 2017

Introduction

Evidence from past economic recessions shows that increased risk of mental distress is likely to occur. Until now, little is known whether distress levels differ by gender in countries highly hit by the economic recession.

Objectives

The aim of the study was to characterize and analyze the differences in mental health distress in men and women during the current economic recession in Portugal.

Methods

A subsample of 911 participants from the 2008 national mental health survey, were re-interviewed in 2014/2015. Sociodemographic data was collected and mental health distress was evaluated using the 10-item Kessler's Psychological Distress Scale (K10). Chi-square statistics were used to investigate differences between men and women in mental distress as a categorical variable.

Results

Mean mental distress differed significantly according to gender, Chi2 (1) = 13.716, P = 0.001. The results showed that a much higher proportion of women (18.5%) revealed to be under psychological distress compared to men (9.9%).

Conclusions

Distress levels during the economic crisis in Portugal differ significantly by gender. More women reported to be distressed compared to men. There are several hypotheses for a differential expression of psychological distress between women and men during the recession, such as different gender roles which asserts that differences are due to gender and country based coping resources but also due to several determinants of mental health such as income, employment and social status. Further research is needed to better predict a variety of characteristics that are important for this outcome.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Gender differences in external factors affecting psychiatric visits in a Greek hospital
Authors: Lyrakos G. , Kornarou E. , Menti D. , Spinaris V. , Spyropoulos I.
Published: June 2017

Introduction

According to previous literature, there are important differences, based on gender, on the external factors that affect psychiatric visits of individuals. Females are, in general, more likely to report being affected by family and emotional issues whilst men are less likely to do so.

Objectives

To examine gender differences in external factors affecting psychiatric visits.

Aims

To investigate whether females report different external factors, which impact on the decision to visit a psychiatrist, compared to males.

Methods

In this study, there were 1205 participants, out of them 685 were males (56.8%) and 520 females (43.2%). The mean age was 45.54. Convenience sampling method was used and participants were recruited from the general hospital of Nikaia, “Ag. Panteleimon”, in Athens, Greece, from 01/01/2012 to 31/12/2015. The data were analysed through the SPSS software.

Results

There were significant gender differences in external factors reported for psychiatric visits, as Chi2 (8): 185.608, P < 0.001. More specifically, more women reported being affected by family problems (5.5%) compared to men (2.6%). Additionally, more females reported being affected by emotional issues (7%) compared to men (5.6%) and psychological issues were more important for women (13.9%) compared to men (7.5%), as well. However, more men reported addictions as the external factors impacting on psychiatric visits (23.1%) compared to women (6.6%).

Conclusions

There are significant differences in the external factors affecting psychiatric visits between men and women. Further investigating such differences could help us better understand the reasons affecting the individuals’ decision to seek psychiatric help.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
The treatment of premenstrual syndrome with preparations of Vitex Agnus Castus (Chaste-berry): A systematic review and meta-analysis
Authors: Schulte P. , Verkaik A. , Kamperman A. , Van Westrhenen R.
Published: June 2017

Introduction

Five to 8% of women of reproductive age suffer from moderate to severe symptoms of premenstrual syndrome associated with substantial distress or functional impairment.

Objective

To determine the efficacy, tolerability and acceptability of Vitex agnus castus (VAC, chaste-berry) preparations for treatment of premenstrual syndrome (PMS).

Methods

After an extensive literature search all randomized controlled trials of VAC in women with PMS and/or premenstrual dysphoric disorder were included.

Results

We found 17 randomized controlled trials of VAC in the treatment of PMS of which 14 studies could be included in the quantitative analysis. All trials, except one, found the Vitex agnus castus preparation to be more efficacious than placebo, pyridoxine and magnesium for either total symptom score or individual symptoms or symptom clusters. Unfortunately, the majority of trials is hampered by a high risk of bias. The pooled effect of VAC in placebo-controlled trials was large (Hedge's g: −1.21; 95% CI: −1.53 to −0.88), but heterogeneity extremely high (I2 = 91%). We could not single out distinct factors that could explain this heterogeneity. The funnel plot and Egger's tests suggest the presence of bias over the full set of studies and effect sizes.

Conclusion

Although meta-analysis shows a large pooled effect of VAC in placebo-controlled trials the high risk of bias, high heterogeneity and risk of publication bias of the included studies preclude a definitive conclusion. The pooled treatment effects should be viewed as merely explorative and, at best, overestimating the real treatment effect of VAC for PMS symptomatology.

Disclosure of interest

P.S. reports personal fees from H. Lundbeck A/S, outside the submitted work. The other authors have not supplied their declaration of competing interest.
High Cognitive Reserve in Bipolar Disorders as a Moderator of Neurocognitive Impairment
Authors: Grande I. , Sanchez-Moreno J. , Solé B. , Jimenez E. , Torrent C. , Bonnin C.D.M. , Varo C. , Tabarés-Seisdedos R. , Balanza-Martínez V. , Valls E. , Morilla I. , Carvalho A.F. , Ayuso-Mateos J.L. , Vieta E. , Martinez-Aran A.
Published: June 2017

Background

Cognitive reserve (CR) reflects the capacity of the brain to endure neuropathology, minimize clinical manifestations and successfully complete cognitive tasks. The present study aims to determine whether high CR may constitute a moderator of cognitive functioning in bipolar disorder (BD).

Methods

One hundred and two patients with BD and 32 healthy controls were enrolled. All patients met DSM-IV criteria for I or II BD and were euthymic (YMRS ≤ 6 and HDRS ≤ 8) during a 6-month period. All participants were tested with a comprehensive neuropsychological battery, and a Cerebral Reserve Score (CRS) was estimated. Subjects with a CRS below the group median were classified as having low CR, whereas participants with a CRS above the median value were considered to have high CR.

Results

Participants with BD with high CR displayed a better performance in measures of attention (digits forward: F = 4.554, P = 0.039); phonemic and semantic verbal fluency (FAS: F = 9.328, P = 0.004; and Animal Naming: F = 8.532, P = 0.006); and verbal memory (short cued recall of California Verbal Learning Test: F = 4.236, P = 0.046), after multivariable adjustment for potential confounders, including number of admissions and prior psychotic symptoms.

Conclusions

High cognitive reserve may therefore be a valuable construct to explore for predicting neurocognitive performance in patients with BD regarding premorbid status.

Disclosure of interest

Dr. I. Grande has received a Juan Rodés Contract (JR15/00012), Instituto de Salud Carlos III, Spanish Ministry of Economy and Competiveness, Barcelona, Spain and has served as a consultant for Ferrer and as a speaker for AstraZeneca, Ferrer and Janssen-Cilag.

Disclosure of interest

Dr. I. Grande has received a Juan Rodés Contract (JR15/00012), Instituto de Salud Carlos III, Spanish Ministry of Economy and Competiveness, Barcelona, Spain and has served as a consultant for Ferrer and as a speaker for AstraZeneca, Ferrer and Janssen-Cilag.
Prevalence of Attention Deficit Hyperactivity Disorder Among Primary School Children in Riyadh, Saudi Arabia; 2015–2016
Authors: Albatti T. , ALHedyan Z.
Published: June 2017

Introduction

ADHD is one of the most common neurodevelopmental disorder among children. It is described as a chronic impairing disorder that negatively affects the academic attainment and social skills of the child. Furthermore, ADHD symptoms continue into adulthood in 30–60% of affected children. Consequently, they will most likely be missed from employment many times.

Aims

Determine the prevalence of attention deficit hyperactivity disorder among children in Saudi Arabia.

Objectives

Determine the prevalence of attention deficit hyperactivity disorder among both governmental and private primary Saudi school children aged 6–9-year-old. And to measure the gender difference of ADHD prevalence. Also, to determine any association between the socio-demographic characteristic of parents of children with ADHD.

Methods

An observational cross-sectional study of 1000 primary school children belonging to 1st, 2nd and 3rd grade. The selected students were screened by the ADHD rating scale using multistage sampling technique. The first stage was selection of 20 schools from all Riyadh regions by simple randomization. The second stage was choosing children whom serial numbers were multiplies of five in each class. The ADHD rating scale was filled by both parents and teachers along with a socio-demographic questionnaire for the parents.

Results

The estimated prevalence of ADHD was 3.4%. ADHD manifestations affect boys more than girls. In addition, ADHD was more frequent among children of illiterate mothers. Finally, ADHD was significantly more prevalent among first grade children.

Conclusion

This epidemiological study filled the data gap of ADHD prevalence in Riyadh. The study's findings go in line with many nearby and global studies.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Children with Somatic Symptoms Disorders and Disruptive Behavior Disorder: Which is the Role of Anger to Caregivers?
Authors: Bizzi F.
Published: June 2017

Introduction

The quality of adult-infant interactions represents a critical context in which child adaptation problems could evolve, and child psychopathology could develop. Literature has investigated the role of attachment to caregivers, nevertheless, there is a paucity of studies on middle-childhood and early adolescence in patients with somatic symptoms disorders and disruptive behavior disorders.

Objective

This study investigates the attachment to caregivers in children with somatic symptoms disorders and disruptive behavior disorders, focusing on the role of Anger to mothers and fathers.

Aims

The aims are to verify the presence of: – high frequency of insecure attachment;

– an overrepresentation of attachment disorganization;

– high levels of Anger to caregivers.

Method

Fifty-six patients with somatic symptoms disorders, and 42 patients with disruptive behavior disorders, aged from 8 to 15, are administered the child attachment interview.

Results

Findings show: – Insecure attachment in more than half of the patients;

– a significant presence of disorganized attachment with respect to both parents;

– higher levels of anger to father in children with somatic symptoms disorders.

Conclusion

Considering the attachment to have a regulatory function, the knowledge of the different attachment strategies in middle-childhood and early adolescence may enhance our understanding and improve the management and the treatment of patients with somatic symptoms disorders and disruptive behavior disorders.

Disclosure of interest

The author has not supplied his/her declaration of competing interest.
Psychiatric Vulnerability in Adults with Intellectual Disability and Autism: A Literature Review
Authors: Coli S. , Scuticchio D. , Bertelli M.
Published: June 2017

Introduction

Adults with Intellectual disability (ID) and Autism Spectrum Disorder (ASD) are more vulnerable to mental health problems than the general population.

Objectives/aims

This study investigates presence and rate of psychiatric disorders in comparison with ID or ASD alone, and appropriateness of assessment and diagnostic procedures or tools.

Methods

A systematic mapping of the literature was carried out on the basis of the above mentioned issues. The search was conducted using PubMed and ScienceDirect, according to the following keywords: psychiatric comorbidity, psychiatric disorders, autism, ASD, intellectual disability, mental health problems, adults, assessment tools, diagnosis. Twenty-eight papers were selected for pertinence to mapping issues among more than 500.

Results

Many studies show that ASD is an important vulnerability factor for psychiatric co-morbidity and for challenging behaviors (CBs) in adults with ID. Highest rates were reported for psychotic, mood, anxiety, and obsessive-compulsive disorders. Few studies show that the difference between adults with ID plus ASD and adults with only ID are not statistically significant, but for the presence of CBs in those with ID plus ASD. The disagreement of results is based on a variety of factors such as diagnostic over-shadowing, scarcity of specific assessment tools, consideration of the introspective and communication difficulties, incompleteness of medical records, and low reliability of information sources.

Conclusions

Although low studies concordance, the literature mapping suggests the presence of ASD in ID to be associated with higher rates of psychopathology. Since the relevant implications for prevention and clinical management, further research with high-level evidence is hoped.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Mirtazapine and Trazodone Efficacy on Major Depressive Disorder (MDD) is Moderated by Patients’ Age and Sex: A Randomized, Controlled Trial
Authors: Vilibić M. , Šurina Osmak Ž. , Tomljenović M. , Kolarić B. , Jukić V.
Published: June 2017

Introduction

NaSSA antidepressant mirtazapine and SARI trazodone has proven efficacy on MDD.

Aim

To compare differences in mirtazapine and trazodone efficacy on MDD in different age and sex groups.

Methods

A consecutive sample of 60 MDD outpatients were randomized to mirtazapine 30 mg/day or trazodone 150 mg/day for a 3 months stable dosing period at the department of biological psychiatry and psychogeriatrics of the university psychiatric hospital Vrapče, Croatia. Outcome was relative lowering of HAMD-17 scale result. The study was single blind: rater was blinded, while patients informed regarding prescribed medication.

Results

Overall efficacy of mirtazapine and trazodone was comparable (84% lowering of HAMD–17 in both cases; difference P = 0.754). After adjustment for MDD baseline severity (CGI–S), education, marital and working status, interaction of age and sex significantly moderated two drugs’ efficacies. In patients older than 47 years, in male patients trazodone was significantly more effective, and in female patients significantly less effective than mirtazapine. This effect was increasing by aging.

Conclusion

Mirtazapine and trazodone efficacy on MDD is moderated by patients’ age and sex.