bluuebunny/crossref_metadata_2025 huggingface dataset:
The role of mindfulness in lifetime history of depression: A study in Portuguese pregnant women
Authors: Azevedo J. , Bento E. , Xavier S. , Marques M. , Freitas V. , Soares M.J. , Pinto A.M. , Bajouco M. , Macedo A. , Pereira A.T.
Published: May 2016

Introduction

Despite the empirical support for the effects of mindfulness based interventions for recurrent depression (Velden et al., 2015), the literature on the relation between Mindfulness and Lifetime History of Depression/LTHD are scarce.

Objective

To compare Mindfulness levels between women with vs. without LTHD and to analyze if mindfulness dimensions are significant predictors of LTHD.

Methods

One hundred and twenty-seven pregnant women (mean age: 32.56 ± 4.785 years) in their second trimester of pregnancy (17.34 ± 4.790 weeks of gestation) completed: Facets of Mindfulness Questionnaire-10 (FMQ10; Azevedo et at. 2015) assessing the dimensions non-judgement of inner experience/NJ, ACt with awareness/AA and observe and describe/OD; a new self-report questionnaire developed to evaluate the presence of LTHD, with several “Yes/No” questions, based on DSM-5 criteria for depression.

Results

Ninety-seven (23.0%) women had LTHD. Bisserial Spearmen correlations between LTHD and FMQ scores were significant, negative and moderate (> .30, P < .01); only OD did not significantly correlated with LTHD. Independent sample T-test revealed that women with vs. without LTHD had significantly higher levels of total FMQ-10, NJ and AA (all P < .001). Logistic regression analysis showed that the model containing FMQ-10 explained 12.7–18.8% of the LTHD variance and correctly classified 77.9%; the OR was of 1.19 (95% CI .801–.886; Wald = 44.504; P < .001). The model composed by NJ and AA explained 15.5–23% and correctly classified 76.5%. NJ OR was of 1.23 (CI .734–.884; Wald = 20.806; P < .001) and AA OR was of 1.41 (CI .708–.903; Wald = 13.004; P < .001).

Conclusions

Our research discloses that less mindfulness abilities enhances the probability of having lifetime history of depression.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Psychoses of epilepsy – “Acute attacks of insanity”. What literature says and how we act
Authors: Echeverría Hernández N. , Lázaro Redondo M.D.M. , de la Torre Brasas F. , Duque Domínguez A. , Mas Villaseñor A. , García Montero C. , Martín Díaz L. , Otalora Navarro M.
Published: May 2016

Introduction

Patients with epilepsy seem particularly liable to certain major psychiatric disorders. Prevalence of schizophrenia within an epileptic population varies between 3% and 7% (1% in general population). The aetiology is possibly multifactorial (drugs and neurosurgery).

Objectives

To study comorbidity between psychoses and epilepsy and management in the literature and in our patients.

Aims

To analyze factors that might influence the onset of psychoses within an epileptic population and how this potential association could influence our practice.

Methods

PubMed search was conducted with interest in psychoses of epilepsy, pharmacology, and comorbidity. Up to 10 variables related with factors influencing psychotic episodes that required hospital admission in three patients with epilepsy were studied.

Results

Unlike published data, our patients did not have postictal psychoses. All cases had early onset temporal lobe epilepsy with no seizure activity since diagnosis (more than 20 years). No family history of either epilepsy or psychoses. Management included lamotrigine, oxcarbazepine, carbamazepine, zonisamide, and levetiracetam in conventional doses. The psychosis, which comprised affective, schizophrenic, and confusional elements, lasted longer and was more troublesome than psychosis in non-epileptic patients. Response to neuroleptics was poorer than in non-epileptic patients with psychoses. Consultation with Neurology Unit resulted in end of treatment with zonisamide and levetiracetam.

Conclusions

Less than perfect evidence suggests the association between psychosis and epilepsy. In our patients, no postictal cases were recorded. Management showed poorer effect of neuroleptics when compared with non-epileptics, and zonisamide and levetiracetam were changed for other drugs with presumably lower association with psychoses.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Clinical symptomatology and empathy in schizophrenia: Which relationship?
Authors: Trabelsi R. , Mrizak J. , Arous A. , Ben Ammar H. , Khalifa A. , El Hechmi Z.
Published: May 2016

Introduction

The impairment of cognitive and affective empathy among patients with schizophrenia (SCZ) may represent a significant feature of the illness. However, the relationship between those impairment and dimensions of psychosis remains unclear.

Objectives

To explore whether cognitive and affective empathy are associated with severety of different psychotic symptoms.

Methods

Cognitive and affective empathy were evaluated in 58 patients with stable schizophrenia with the Questionnaire of Cognitive and Affective Empathy (QCAE) comprising five subscales intended to assess cognitive and affective components of empathy. Symptomatology evaluation comprised the Positive and Negative Syndrome Scale (PANSS), the Calgary Depression Scale for Schizophrenia (CDSS) and the Clinical Global Impressions Scale Improvement and severity (CGI).

Results

Patients with better cognitive empathy had less total CDSS scores (P = 0.036, r = −0.449) and lower CGI-severity scale scores (P = 0.01, r = −0.536). Patients with better affective empathy had lower scores (which means a better improvement) at the CGI-improvement scale (P = 0.03, r = −0.461).

Conclusions

Our results suggest that empathy with its different component is not totally independent of the clinical state of the patient. Further studies are required to confirm whether empathy deficits are state or trait aspects of SCZ.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
An approach to neuroleptic malignant syndrome from a clinical case
Authors: Peinado A. Gomez , Ruiz P. Cano , Garcia M.D. Sanchez , Fraile S. Cañas , Cano M. Gonzalez , Fajardo G.E. Barba
Published: May 2016

Introduction

Neuroleptic malignant syndrome (NMS) takes place in patients in treatment with neuroleptics and it is potentially lethal, being important an early diagnostic and therapeutic approach.

Objectives

To analyze from a clinical case the clinical and epidemiological features, and therapeutical approach to NMS.

Method

Review of some articles in Mental Health journals and analysis of the following clinical case: 68-year-old woman with bipolar disorder, hospitalized in manic phase. Usual treatment: lithium, trazodone, quetiapine and asenapine. During the admission to hospital, the patient started presenting hyperthermia, sweating, electrolyte disturbances, limb rigidity, and elevation of CPK levels. The suspicion was NMS, so neuroleptics were stopped and fluids and dantrolene were initiated, with favorable evolution.

Results

The discharge diagnosis was NMS. Neuroleptics were gradually reintroduced under vigilance. The patient is stable and has not had new complications. NMS is an uncommon (0.02% to 3% among patients taking neuroleptic agents), but life-threatening condition. Its symptoms are hyperthermia, autonomic nervous system dysfunction, limb rigidity, altered consciousness… The attendant infections, consume of lithium, dehydration, iron deficiency and sharp changes in neuroleptic treatment are predisposing factors. The withdrawal of neuroleptics is the key of the treatment. Benzodiazepines can improve the prognosis, and electroconvulsive therapy can be necessary if there is no response to previous measures.

Conclusions

Neuroleptic malignant syndrome is a life-threatening medical complication we should try to avoid by a correct and careful use of neuroleptics. Additionally, it is important the early treatment, taking withdrawal of neuroleptics as the key starting point.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Irritable bowel syndrome (IBS) and stress; a study of international medical school students
Authors: Husain M. , Dumitrascu D.L. , Chaudhry I.
Published: May 2016

Introduction

Irritable bowel syndrome is one of the most commonly diagnosed functional gastrointestinal disorders. Irritable bowel syndrome (IBS) and its association with stress have not been researched in regards to foreign medical students in Cluj-Napoca, Romania.

Objective

To establish the prevalence of IBS in foreign medical school students and the relationship with stress.

Methods

This observational case-controlled study was carried out in “Iuliu Hatieganu” University of Medicine and Pharmacy in Cluj-Napoca, Romania. The sample size was 102, and the data was collected using an online self-report questionnaire. The ‘Rome 3 criteria’ was used to diagnose IBS and ‘Stressful Life Events Check-list’ was used to measure levels of stress.

Results

The prevalence of IBS was 24.5%, with females having higher rates (34%) compared to males (16.4%). The types of IBS were IBS-M (mixed form) 8.8%, IBS-D (diarrhoea dominant) 6.9%, IBS-C (constipation dominant) 5.9% and IBS-U (undefined) 2.9%. Students with IBS reported higher social stress compared to students without IBS.

Conclusions

More efforts should be made to combat stress that medical students experience in order to reduce the number of IBS cases. This may involve an increased role of the medical school to develop initiatives and support, with the aim of helping medical school students better cope with stress and stressful events.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
A non-smoking program in the psychiatric clinic: Eradicating tobacco from the therapeutic space
Authors: Jaber J. , Tomé A. , Reys B.
Published: May 2016

Introduction

The work describes the well-succeeded experience of the Non-Smoking Program developed in a psychiatric clinic in Rio de Janeiro city, Rio de Janeiro, Brazil.

Objective

To treat the tobacco dependence in patients with disorders for the use of substances and other psychiatric disorders. To transform the clinic therapeutic space in a free tobacco environment.

Aims

To promote the restoring of the patients’ health integrally, considering the use of tobacco is responsible for a large number of avoidable deaths, in addition to much harm to health.

Methods

In a clinic of hospitalization for diverse mental disorders treatment, especially disorders for the use of substances, in the city of Rio de Janeiro, Rio de Janeiro, Brazil, was simultaneously established a non-smoking treatment program. It was used the pharmacological therapy, associated with cognitive-behavioral therapy, occupational therapy and moderate physical activity. The average time of permanence in the non-smoking program was on average 90 days.

Results

There was significant acceptance to the proposed program. In the long-term monitoring, over 12 months, it was evidenced that most patients found themselves in tobacco abstinence.

Conclusion

The project achieved its objectives, promoting the tobacco abstinence in patients with comorbidities in hospital treatment. The study proved that it is possible to remove tobacco in patients dependent on this substance during a psychiatric hospitalization.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Bobby Fischer: Chess, genius and madness at the height of the cold war
Authors: Llanes Álvarez C. , San Román Uría A. , Gómez Sánchez S. , Hernández Antón R. , Valdés Valdazo J. , Del Brio González A.M. , Martínez Sánchez J.M. , Muñoz Sánchez J.L. , Franco Martín M.Á.
Published: May 2016

Introduction

Directed by Edward Zwick “Pawn Sacrifice” is a biographical film released on September 2015. The film stars Tobey Maguire as Bobby Fischer, the American World Chess Champion, considered one of greatest player of all time. His career's peak was in 1972 when he captured the World Chess Championship from Boris Spassky of the USSR.

Aims

We tried to dig a little in the biography of Bobby Fischer who many described as mentally ill. We tried to figure out what is reality and what is just legend about Fischer. Our goal is promote chess, and also honour the great Fischer. Moreover, we wanted to explore the scientific literature published about the benefits of playing chess, especially in childhood.

Methods

We made an exhaustive review of the author's life, and also testimonies of people who knew him. Moreover, we found some articles that review the relationship between chess and IQ trying to confirm or debunk some myths about this legendary game.

Results

It was incomprehensible to everyone that the top of the career of Bobby Fischer at the same time meant an abrupt and complete fall. One possible explanation for this attitude would be a mentally unbalance not specified disorder throughout his lifespan.

Conclusions

Not all geniuses are crazy, neither all crazy are geniuses. A genius is a person with extraordinary capabilities, that focused on a topic, has the ability to enlight new ways to explain this complex world, whether it is to create a symphony, paint masterpiece or the next move on the chessboard.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Descriptive study of mechanical restraint in acute psychiatric inpatient unit of Jerez De La Frontera: Analysis of a risk profile
Authors: Pérez Revuelta J. , Carabias Contreras B. , Fernández Nicolás E. , Valverde González E. , Jiménez Espinosa A. , Guerrero Vida R. , Villagrán Moreno J.M.
Published: May 2016

Introduction

Various medical and psychiatric conditions can determine the occurrence of disruptive behavior and aggression. Mechanical restraint is part of the strategies for managing these risks. Its use implies a multidisciplinary, phased and individualized for each case strategy, with attention to the ethical and legal issues surrounding this coercive intervention.

Objective

The objective of this work is the analysis of the profile of patients who required mechanical restraint during hospitalization in a psychiatric inpatient unit.

Methodology

Retrospective descriptive analysis by collecting data of patients, who required mechanical restraint during admission, between 2007 and 2014. The data sources were medical clinical history and nursing records. Variables analyzed were sex, age, clinical diagnosis at discharge and clinical state during the episode of mechanical restraint.

Results

Of the total sample of patients requiring restraint (n = 266), 66.92% were men. The mean age of patients was 38.01 years. Distribution of clinical diagnoses based on ICD-10 coding: 30.23% F60 personality disorder (n = 289), 19.56% diagnosed with F31 bipolar disorder (n = 187) and 14.02% F20 schizophrenia. Regarding the clinical characteristics of the episode, 49.47% of patients had an agitation/violent state and in 23.11% risk of impulsive self-injury was evident, 13.47% had confusional syndrome.

Conclusion

Data analyzed shows differences in frequency distribution because of patient profile and clinical diagnosis. Otherwise, organizational factors and appropriate amendments to this level appear to play a key role in minimizing the use of such coercive measures.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Malignant catatonia and neuroleptic malignant syndrome: How different/similar are they?
Authors: Sales P. , Bernardo M. , Lopes A. , Trigo E.
Published: May 2016

Introduction

Catatonia is a neuropsychiatric syndrome that appears in medical, neurological or psychiatric conditions. There are presentation variants: “malignant catatonia” (MC) subtype shares many characteristics with the neuroleptic malignant syndrome (NMS), possibly reflecting common pathophysiology.

Objectives/methods

We present a clinical vignette and review the literature available on online databases about MC/NMS.

Results

We present a man, 41-years-old, black ethnicity, with no relevant medical history. He had two previous episodes compatible with brief psychosis, the last one in 2013, and a history of adverse reactions to low doses of antipsychotics. Since the last episode he was asymptomatic on olanzapine 2.5 mg id. He acutely presented to the Emergency Room with mutism, negativism, immobility and delusional speech, similar to the previous episodes mentioned and was admitted to a psychiatric infirmary, where his clinical condition worsened, showing muscle rigidity, hemodynamic instability, leukocytosis, rhabdomyolysis and fever. Supportive care was provided, olanzapine was suspended and electroconvulsive therapy (ECT) was initiated. After two months, he was discharged with no psychotic symptoms. He is still under ECT and no antipsychotic medication was reintroduced.

Discussion/conclusion

Many studies suggest that clinical or laboratory tests do not distinguish MC from NMS and that they are the same entity. These two conditions are life-threatening and key to treatment is a high suspicion level. There is no specific treatment; supportive care and stopping involved medications are the most widely used measures. ECT is a useful alternative to medication.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Internalization of stigma and self-esteem as it affects the capacity for intimacy among patients with schizophrenia, comparison between Jews and Arabs
Authors: Segalovich J. , Stolovi T. , Behrbalk P. , Romem P.
Published: May 2016

In addition to the physical and psychological signs and symptoms of their disorder, people who have schizophrenia also experience severe repercussions associated with social isolation [1]. Internalization of social stigma was found to be a statistically significant core factor that affects self-esteem and the ability to create intimacy among Jewish patients with schizophrenia. Significantly more Muslim patients were married in comparison to Jewish patients. There was statistically significantly less internalization of stigma of mental illness among hospitalized patients than among individuals with schizophrenia who live in the community [2]. The current study examines the relationship between internalization of stigma, self-esteem, and the ability of people diagnosed with schizophrenia to form intimate attachments with loved ones, in Arab patients compare to the existing sample of 24 patients from the Jewish sector 2. Data is gathered for 27 Muslim patients with schizophrenia who live in the community, ages 18–60, men and women from the following four questionnaires: Demographics Questionnaire, Self-Esteem Scale, Internalized Stigma of Mental Illness Scale and the Intimacy Attitude Scale-Revised. The study received the approval of the Ethics Committee. There was statistically significantly less internalization of stigma of mental illness, high self-esteem and high capacity for intimacy among Jewish patients than among Muslim patients. Knowledge of how these variables affect the capacity for intimacy provides a therapeutic window for advanced nursing interventions that will eventually provide support and guidance cultural adapted, for people with schizophrenia in creating intimate relationships.

References not available.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Body image and eating disorders are common in professional and amateur athletes using performance and image-enhancing drugs (pieds). A cross-sectional study
Authors: Piacentino D. , Longo L. , Pavan A. , Ferracuti S. , Brugnoli R. , Girardi P. , Sani G.
Published: May 2016

Introduction

The use of Performance and Image-Enhancing Drugs (PIEDs) is on the increase and appears to be associated with several psychopathological disorders, whose prevalence in unclear.

Objectives/Aims

We aimed to evaluate the differences–if any–in the prevalence of body image disorders (BIDs) and eating disorders (EDs) in PIEDs users athletes vs. PIEDs nonusers ones.

Methods

We enrolled 84 consecutive professional and amateur athletes (35.8% females; age range = 18–50), training in several sports centers in Italy. They underwent structured interviews (SCID I/SCID II) and completed the Body Image Concern Inventory (BICI) and the Sick, Control, One, Fat, Food Eating Disorder Screening Test (SCOFF). Mann-Whitney U test and Fisher's exact test were used for comparisons.

Results

Of the 84 athletes, 18 (21.4%) used PIEDs. The most common PIEDs were anabolic androgenic steroids, amphetamine-like substances, cathinones, ephedrine, and caffeine derivatives (e.g. guarana). The two groups did not differ in socio-demographic characteristics, but differed in anamnestic and psychopathological ones, with PIEDs users athletes being characterized by significantly (P-values < 0.05) higher physical activity levels, consuming more coffee, cigarettes, and psychotropic medications (e.g. benzodiazepines) per day, presenting more SCID diagnoses of psychiatric disorders, especially Substance Use Disorders, Eating Disorders, Body Dysmorphic Disorder (BDD), and General Anxiety Disorders, showing higher BICI scores, which indicate a higher risk of BDD, and higher SCOFF scores, which suggest a higher risk of BIDs and EDs.

Conclusions

In PIEDs users athletes body image and eating disorders, and more in general psychopathological disorders, are more common than in PIEDs nonusers athletes.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Familial multiple cavernomatosis and neuropsychiatric symptoms: Is there any relation?
Authors: Espirito Santo V. , Almendra R. , Figueiredo A.R. , Almeida A. , Rego I. , Guimaraes P. , Velon A.G.
Published: May 2016

Introduction

Cavernomas are clusters of abnormal blood vessels found in the brain and spinal cord. The familiar form is an autosomal dominant disorder associated with the presence of multiple cavernomas in both locations.

Clinical Case

A 84-year-old man was admitted in our neurologic department for a sudden onset of difficulty in walking associated with loss of urinary sphincter control. Past history included a major depressive disorder with psychotic features since youth, epilepsy since 33 years old and, at 77 years old, he had a hemorrhagic stroke resulting from cavernous malformation haemorrhage. Medication consisted of clopidogrel 75 mg id, risperidone 3 mg id, venlafaxine 37.5 mg bid and clobazam 10 mg id. On neurological examination, he showed psychomotor slowing, dysexecutive syndrome, paraparesis and hypoesthesia with sensitive level by D10. Blood test was normal. Dorsolumbar spine-TC showed intradural hyperdensity by D12-L1, probably because of a hemorrhage lesion, that MRI revelled to be a cavernoma. Brain-MRI demonstrated 3 massive cavernomas in cortical-subcortical right occipital lobe, left lenticular nucleus and left pre-central gyrus and countless small infratentorial and supratentorial cavernomas. We inquired his family and we found out that one of his daughters also had multiple brain cavernomas, diagnosed after a hemorrhagic stroke when she was 55 years old.

Conclusion

Familiar multiple cavernomatosis is associated with neuropsychiatric disorders. We enhance the impact that such a diffuse form of the disease has on the brain network causing atypical psychocognitive symptoms. In all cases a detailed neuropsychiatric family history should be sought and all should be followed regularly clinically and by MRI.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Innapropriate sinus tachycardia – cardiac syndrome or anxiety-related disorder?
Authors: Rasmus P. , Kozłowska E. , Sobow T.
Published: May 2016

Introduction

Relation between psychology, psychiatry and cardiology are multidimensional and begin to have growing importance in the diagnosis and treatment of patients of cardiosurgery, electrocardiology and cardiac rehabilitation. Inappropriate sinus tachycardia (IST) is a rarely diagnosed clinical syndrome characterized by excessive resting heart rate (HR) or disproportional increasing HR during exercise. The mechanisms of IST are not well understood. It is speculated that psychological factors might be of importance.

Aims

The purpose of the study was to evaluate possible relation between the level of anxiety, personality traits and control of emotions, emotional intelligence, coping with stress strategies and manifestation of IST.

Methods

The participants were 23 women with a diagnosis of IST (age range 31.8 ± 8.72) and 23 women (28.7 ± 4.4) without cardiac diseases. The research applied psychological tools including: State–Trait Anxiety Inventory, NEO-Five Factor Inventory, Courtauld Emotional Control Scale, Emotional Intelligence Questionnaire, Coping Inventory for Stressful Situations and an originally developed sociodemographic questionnaire.

Results

It has been found that that the group of women with IST received higher results in Trait Anxiety Inventory compared to the group of healthy women and the relation was highly statistically significant (P = 0,009). No other differences were found.

Conclusions

Inappropriate sinus tachycardia can be considered as an anxiety related disorder. However, its pathogenesis and classification position remains elusive.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Social skills training group with Turkish immigrants: Results of a pilot study
Authors: Altunoz U. , Bozkurt S. , Bannasch V. , Castro-Nunez S. , Graeff-Calliess I.T.
Published: May 2016

Introduction

Social skills training (SST) is an element of cognitive-behavioral therapy, which focuses to improve verbal-nonverbal behaviors involved in social interactions.

Aims-objectives

To assess the effectiveness of a standardised 8–sessions-SST-group therapy (Hinsch&Pfingsten) in Türkish Immigrants who have anxiety/depressive disorders.

Method

German-Turkish transations-backtranslations of contents and materials of the standardised 8–sessions-SST-group therapy were performed. These weekly eight group sessions applied by two Turkish-psychotherapists to 8 voluntary Turkish-Immigrants (F/M = 4/4, age = 50 ± 5.4), who were in treatment for anxiety/depressive disorders in our transcultural outpatient-clinic in Hannover, Germany. Symtom-Checklist-90 (SCL-90) and Insecurity Questionnaire (I-Q) administered before and after the treatment programm. Seven patients completed pre-post scales.

Results

Table 1 presents the scale scores. There was no significant improvement in global-symptom-severity and insecurity-profiles after the SST. One of the psychotherapists and one of the patients were interviewed to discuss qualitatively possible reasons of that.

Psychoherapist

I think patients were not comfortable with many pencil-paper homeworks. Daily-life-examples were too close to German culture. Therefore it's crucial to culturally modify the sessions.

Patient

I found the sessions-homeworks strict and different from my thinking style and culture.

Conclusions

Qualitative data of this study stated that no improvement may be caused by eurocentristic nature of the psychotherapeutic approach. Berry (2006) suggested that such interventions may generate/exacerbate acculturative-stress and may not be beneficial for the patient. Further studies should investigate effectiveness of culturally-modified SST in Turkish immigrants.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Immigrants in emergency rooms: The role of culture in the diagnostic process and diagnostic certainty
Authors: Collazossp F. , Gutierrez C. , ruth P.D.R. , Carmen V.M. , William L.
Published: May 2016

Introduction

Transnationalism provides a serious challenge in mental health care, especially due to the crucial role of communication. Emergency room interactions offer an opportunity to analyze the role of cultural competency among providers and how they relate to immigrants in the clinical encounter.

Objectives

This study addresses three aims: to assess the level of provider-perceived accuracy of diagnoses; to evaluate the use of restraints; and to compare diagnoses rates between patients of diverse racial/ethnic groups.

Methods

We examined patients’ race/ethnicity and their relation to service use and perceived certainty of mental health diagnoses. Three hundred and forty-seven migrants and 67 natives as well as their providers were interviewed in psychiatry emergency rooms in Barcelona (Spain).

Results

The perceived certainty of clinical diagnosis is lower for Asians (OR = 0.2, 95% CI [0.07–0.63]), and higher when the clinician feels comfortable with the patient (OR = 5.41, 95% CI [2.53–11.58]). The probability of restraints is higher for Maghreb patients compared to native born (OR = 3.56, 95% CI [1.03–12.26]). The probability of compulsory admission is lower for Latinos compared to native born (OR = 0.26, 95% CI [0.08–0.88]). The probability of receiving a diagnosis of psychosis is lower when the clinician can communicate in the patient's language (OR = 0.37, CI 95% [0.16–0.83]).

Conclusions

Cultural factors such as level of comfort and communication in the patient's language play a central role in diagnosis and treatment. This study highlights the importance of culture in psychiatric diagnosis and the role of cultural competency for mental health providers.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Religious and spiritual implication in the assessment and management of bipolar disorder
Authors: Maia L. , Coutinho A. , Carvalho I. , Baptista B. , Carneiro L.
Published: May 2016

Introduction

Religion/spirituality and medicine have been related in one way or another sense the beginning of our know History. Patients’ beliefs, values and practices influence the way disease is perceived and managed. In order to provide adequate care the physician must have proper knowledge of the patients’ spiritual/religious context, otherwise it may fall prey to errors of diagnostic, inappropriate management and subsequent poor compliance.

Objectives

To present the case of an adult male (a preacher whose beliefs include mediunity) with delusional ideation of mystical content and mood elation, identified during a religious ceremony.

Aims

Questioning the frontier between spiritual/religious beliefs and psychopathology.

Methods

A case report is presented and a literature review of the theme is shortly surveyed.

Results

The case reports to a 53 years old man, who during a religious ceremony presented himself with agitation and disinhibition, removing all his cloths and living the church naked. Additionally it was identified the presence of insomnia, heteroaggressiveness, accelerated speech, mood elation and delusional ideation of mystical and megalomaniac content. Several studies demonstrate the importance of acknowledging the religious/spiritual beliefs of patients. This knowledge allows the psychiatry to correctly identify the existing psychopathology and organize an appropriate intervention plan for the patient.

Conclusions

Spiritual and religious beliefs’ influence the way disease is perceiver and managed. Physician should collect a brief spiritual story of the patient and learn about the different religious/spiritual beliefs and practices of their community, in order to understand the full dimension of the individual illness.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Chronic illness-related shame and experiential avoidance mediate the impact of IBD symptomatology on depression
Authors: Trindade I.A. , Ferreira C. , Pinto-Gouveia J.
Published: May 2016

Inflammatory bowel disease (IBD) is group of chronic diseases that cause symptoms such as abdominal pain, urgent diarrhoea and fatigue, as well as associated complications (e.g., arthritis). Literature has pointed that IBD may cause depressive symptomatology, which seems to aggravate physical symptoms in a cycle of depression and inflammation. This study's aims to examine the mediator roles of chronic illness-related shame and experiential avoidance in the relationship between IBD symptomatology and depression, while controlling for associated medical complications. The sample comprised 161 adult IBD patients (52 males and 109 females), with a mean age of 36.73 (SD = 10.93), that completed validated measures. The hypothesised model was tested through path analyses. Results (see Fig. 1) showed that although IBD symptomatology presented a direct effect of .13 on depression, the majority of its impact was mediated through chronic illness-related shame and experiential avoidance with an indirect effect of 0.22. Indeed, IBD symptomatology seemed to lead to higher chronic illness-related shame, which presented a direct effect on depression of .15 and an indirect effect mediated by experiential avoidance of 0.37. This model presented excellent goodness-of-fit indices. These findings suggest that targeting shame and experiential avoidance in IBD patients would have beneficial outcomes for patients’ well-being. It thus seems that compassion and acceptance-based psychotherapies should be included in treatment programs for IBD.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Maladaptive emotion regulation mediating the link between the recall of early affiliative memories and depressive symptomatology
Authors: Marta-Simões J. , Ferreira C. , Mendes A.L. , Trindade I.A.
Published: May 2016

The inability of recalling warm and safe memories with parents and close relatives has been often associated in literature with a negative and judgmental sense of self, and a higher proneness to experience feelings of inferiority, inadequacy, and defectiveness. Thus, intending to deal with self-judgment and inferiority, individuals may become submissive as a way of compensating one's negative emotional states with other's positive attention and desirability. However, both early negative affiliative memories and submissiveness are associated with higher vulnerability to psychopathology, namely depression. Using a sample of 338 young women, the present study intended to examine the association between early affiliative memories and depressive symptomatology, and the mediator roles of self-judgment and submissive attitudes and behaviours on this association, through a path analysis. The tested model provided an excellent fit to the data, accounting for 41% of the depressive symptomatology's variance. Results revealed a direct effect of early affiliative memories on depressive symptomatology; and also on self-judgement and submissiveness, explaining 28% and 23% of their variances, respectively. Moreover, part of these memories’ effect on depressive symptomatology was explained by self-judgment and submissiveness, which seems to suggest that submissiveness, although used to compensate feelings of inferiority and a judging attitude towards the self, may be a maladaptive strategy due to its positive association with depressive symptoms. This study's findings appear to emphasize the relevance of targeting submissiveness, especially in the context of a scarce recall of early affiliative experiences, when approaching women's depressive symptomatology on mental health promotion programs.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Monitoring of liver function in major depressive disorder treated with SSRI
Authors: Ifteni P. , Teodorescu A.
Published: May 2016

Background

Major depressive disorder is one of the most prevalent psychiatric illnesses in the world affecting more than 12% of men and more than 21% of women in their lifetime. Selective serotonin reuptake inhibitors (SSRIs) are worldwide prescribed to treat depression. SSRIs drugs can cause drug-induced liver injury (DILI).

Aims

The aim of the study was to evaluate the liver function in patients treated with SSRI in order to detect DILI.

Methods

All the patients with first major depressive episode treated with the same SSRI antidepressant for at least 3 months between September 2013 and September 2015 were entered into the study. The hepatic function panel included aminotransferases, total and direct bilirubin, albumin, total protein, gamma glutamyl transferase (GGT), LDH cholesterol, hepatitis B virus (HBV), and hepatitis C virus (HCV).

Results

Of 134 subjects with MDD according to The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) who met inclusion criteria, 98 patients entered into study. Seventy-seven (76.5%) were treated with SSRI for at least 3 months with mean age were 45.4 (SD = 6.3), 65 women (66.3%). Five patients (5.1%) were newly diagnosed with hepatitis, and 10 (10.2%) presented elevated values of ALT, AST. The mean duration of depressive symptoms was 9.2 months (SD = 6.9).

Conclusions

The treatment with SSRI seems to be effective and safe in our sample. A relative small number of patients with MDD were diagnosed with viral hepatitis during this cross-sectional study. Further randomized and controlled trials are needed.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
The impact of neuroinflammation and inflammatory cytokines in depression and suicidal behavior
Authors: Serafini G. , Pompili M. , Girardi P. , Amore M.
Published: May 2016

Introduction

It has been suggested that neuroinflammation and inflammatory mediators may play a crucial role in the pathophysiology of both major depression and suicidal behavior. Immunological differences have been reported between both subjects with major affective disorders and suicidal behavior.

Objectives

The main objective of this review was to deeply investigate the nature of the association between inflammatory cytokines in depression and suicidal behavior. Aims: The study aimed to conduct a systematic review of the current literature to investigate the association between inflammatory cytokines, depression, and suicidal behavior.

Results

Generally, an imbalance between pro-inflammatory and anti-inflammatory cytokines has been documented in both major depression and suicidal behavior. The presence of major depressive disorder (MDD) with suicidal ideation/attempts was associated with differences in inflammatory cytokine profile when compared to that without suicidal ideation/attempts. However, not all studies demonstrated a positive correlation between inflammatory cytokines and suicidal behavior.

Conclusions

The mentioned association between inflammatory cytokines, depression, and suicidal behavior does not imply the existence of a causal relationship. Further additional studies should clarify the molecular mechanisms of the immune activation pathways underlying depression and suicidality.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Obesity: The influence of expressed emotion, anxiety and life events
Authors: Di Tullio E. , Gattoni E. , Gramaglia C. , Ruggiero V. , Biroli G. , D’andrea F. , Gili S. , Gualano M.R. , Siliquini R. , Zeppegno P.
Published: May 2016

Background

Expressed Emotion (EE) can be described as a measure of the emotional temperature of the family climate and plays a role in disease course and outcome, especially in chronic illnesses. Overweight and obesity are severe problems with serious implications as far as health risks are concerned. The literature suggests having a high EE caregiver correlates with a worse treatment compliance in obese patients.

Objectives

To measure level of EE, stressful events and anxiety in obese patients and their caregivers; to investigate the possible correlations between treatment compliance and EE.

Methods

We recruited 190 obese patients and 125 caregivers. Socio-demographic features were recorded. Assessment included: Level of Expressed Emotion Scale (LEE), one version for patients and one for relatives in order to evaluate 4 dimensions: Intrusiveness, Emotional Response, Attitude toward Disease, Tolerance and Expectation; the Paykel's Interview for Recent Life Events; STAI Y1 concerning state anxiety and STAI Y2 concerning trait anxiety; BMI (Body Mass Index) was measured at T0 and after 3,6 and 9 months.

Results

We have found a correlation between gender and trait anxiety, and an inverse correlation between age and trait anxiety both in patients and caregivers. The decrease of BMI during follow-up is statistically significant and this reduction seems to be affected by tolerance and expectation perceived by patients and the emotional response on behalf of caregivers.

Conclusions

Levels of EE should be considered when planning treatment interventions to enhance compliance in obese patients and to support change in their life-style.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Developing simulated training in old age psychiatry to recognise and assess medical problems in a psychiatric setting (RAMPPS)
Authors: Narayana U. , Corrado O.J. , Rowlands P. , Kaur S.
Published: May 2016

Introduction

Older people with mental ill health are more likely to receive lower quality of health care, inappropriate prescriptions and reduced access to services, leading to increased rates of mortality [1–3]. There is increase focus on supporting people with multiple long-term physical and mental health conditions, particularly by embracing opportunities created by technology [4] (references are not available for this abstract).

Objectives

To identify the common medical comorbidities on the Old Age Psychiatry Wards.

Aims

To develop simulation training from the medical scenarios.

Method

We audited all patients referred to the Liaison Geriatrician from 2008 to October 2015 from the Mount Hospital Leeds, which consists of 4 Old Age Psychiatry wards. Data was collected in October 2015 and included referral date, patients’ age and sex, number of referrals, reason for referral and the outcome.

Results

We assessed 339 (142 F, 197 M) patients with a mean age of 77 (range: 56-94). The cardiovascular problems constituted the majority (34%) of the referrals, central nervous system (11%), respiratory (8%), gastrointestinal (8%), infection (8%), musculoskeletal (7%), renal (3%), others (19%) and the reasons were unknown in (2%) of the 440 referrals. Some unusual problems were diagnosed including a spontaneous pneumothorax, primary biliary cirrhosis.

Conclusion

The audit highlights the essence for more training in recognising and assessing medical problems in psychiatric settings - the simulation programme (RAMPPS) in Old Age Psychiatry. As a result of the service model, we are developing a simulation-training course tailored to the mental and physical health needs of the elderly.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Presence of 2,5-dimethoxy-4-bromoamphetamine (DOB) among samples brought for drug checking in Spain
Authors: Quintana-Mathé P. , Grifell-Guardia M. , Palma-Conesa Á. , Gil-Lladanosa C. , Fornís-Espinosa I. , Caudevilla-Galligo F. , Gallindo-Guarin L. , Farre-Albaladeo M. , Ventura-Vilamala M. , Torrens-Melich M.
Published: May 2016

Introduction

New Psychoactive Substances (NPS) appear to be increasing in popularity because they mimic the effect of traditional drugs. DOB is a world-wide controlled phenethylamine, with agonist activity in 5HT2A receptors. Its effects are comparable to those of LSD, with dosage range 1.0–3.0 mg and duration 18–30 h.

Objective

To assess the presence of DOB in the substances submitted to, and analyzed by, energy control.

Materials and methods

All samples presented to Energy Control (EC) from August 2009 to August 2015 were analyzed. EC is a spanish harm-reduction non governmental organization that offers to users the possibility of analyzing the substances they intend to consume. Samples in which DOB was detected using gas chromatography-mass spectrometry were selected for this study.

Results

From a total of 20,062 samples, 13 contained DOB (0,06%), with no clear variations among the years studied. The samples were mostly sold as DOC(8), DOB(2) and LSD(2). Nine out of total 13 samples presented as blotter.

Conclusion

Results suggest that availability of DOB in the Spanish drug market is anecdotic. Nonetheless, a number of the samples containing DOB were not sold as such, increasing the possibility of side effects, as users may ignore which substance they are actually using. When a patient presents at an Emergency Department with persistent hallucinogenic symptomatology after ingesting a blotter, psychiatrist should be aware of long-lasting psychedelics such as DOB.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Does psyche pain manifest as agitation in the emergency setting?
Authors: Zun L. , Downey L.
Published: May 2016

Objectives

The objective was to determine a patient's level of psyche pain when they present to an emergency department (ED) and whether there was a relationship between this psyche pain and the patient's level of agitation.

Methods

This was a prospective study using a convenience sample of 300 patients presenting to an ED with a psychiatric complaint. This study was conducted in an urban, inner-city trauma center with 60,000 ED visits a year. After obtaining consent, a research fellow administered validated tools for assessing agitation, BAM, PANSS-EC, ACES, assessment of psyche pain, MBPPAS and a self-assessment of agitation at admission. SPSS version 22 was used for statistical analysis and the study was IRB approved.

Results

A total of 74 patients were enrolled at this time. The most common ED diagnoses were depression, schizophrenia, or bipolar disorder. Majority of patients were African-American (59%), falling in the 25–44-year-old age range (56%). Fifty-two percent male and 48% female. Psyche pain was rated by MBPPAS as marked (18.9%) or moderate (67.6%). The self-reported tool demonstrated 20% none, 16% mild, 21% moderate and 42% marked level of agitation. The agitation rating varied by the tool with self-reported level of agitation having the highest correlation with level of psyche pain (P < 0.05).

Conclusions

Psychiatric patients frequently present to the emergency department with a high level of psyche pain and high level of self-reported agitation. This correlation may signal the need to address a patients’ level of agitation early in evaluation process.

Disclosure of interest

The authors have not supplied their declaration of competing interest.