bluuebunny/crossref_metadata_2025 huggingface dataset:
Further validation of the driver behaviour questionnaire – confirmatory factor analysis in a Portuguese sample
Authors: Dourado J.F. , Marques C. , Pereira A.T. , Nogueira V. , Macedo A. , Bastos Silva A.M.C. , Seco A.J.M.
Published: June 2017

Introduction

The drivers are a central component of traffic system, and their limitations, constraints, needs, motivation, level of alertness, and personality define their behaviours on the road. Understanding the determinants of the driver's behaviour is crucial to find solutions for the serious problem of road accidents.

Objective

This study aims to investigate the reliability and the construct validity of the Portuguese version of the driver behaviour questionnaire (DBQ; Reason et al., 1990; Portuguese version: Correia, 2014), using exploratory and confirmatory factor analysis (EFA and CFA) in a sample of Portuguese population.

Methods

Participants answered an online survey including socio-demographic questions and the DBQ. Inclusion criteria were: driving license and regular driving for at least three years and age lower than 75-years-old. The sample is composed of 747 participants [417 (55.8%) women; mean age = 42.13 ± 12.349 years; mean driving license years = 21.30 ± 11.338; mean years of regular driving = 20.33 ± 11.328]. The total sample was randomly divided in two sub-samples. Sample A (n = 373) was used to EFA and sample B (n = 374) was used to CFA.

Results

The most acceptable model was the three-factor model found with EFA, excluding items 1 and 24 (χ2/df = 2.01; TLI = .86; CFI = .88; RMSEA = .05, P = .315). The internal consistency analysis resulted in: infractions and aggressive driving, α = .77; non-intentional errors, α = .73; lapses, α = .71; total DBQ score, α = .84.

Conclusions

These results suggest that the Portuguese version of the DBQ is a valid and reliable measure to assess self-reported driver behaviour in the Portuguese population.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Quality of life related to the health and socio-economic resources of the elderly
Authors: Daniel F. , Ferreira A. , Espírito-Santo H. , Monteiro R. , Massano-Cardoso I. , Silva A.
Published: June 2017

Introduction

Aging is a very heterogeneous and dissimilar process, full of asymmetries. There is evidence that socio-economic differences determine disadvantages and inequalities in old ages. Older people face particular inequalities in healthiness especially with more complex and vulnerable long-term conditions, being more likely to need support from social care services.

Aim

To evaluate the quality of life (well-being) related to the health of the elderly according to socio-economic indicators.

Method

Cross-sectional quantitative study was performed. A total of 316 elderly people (M = 74.78; SD = 9.78 years of age) was interviewed with the Portuguese version of the EQ-5D-3L scale for health-related quality of life.

Results

The interaction between income and the type of residential follow-up (alone vs. accompanied) was not statistically significant [F (2.310) = .910, P < .407; Ƞp2 = .006]. Differences in health status index were statistically significant for income [F (2.310) = 5.518, P < .004; Ƞp2 = .034]. Post-hoc comparisons indicated that the mean score for those with insufficient income for their expenses (M = .39, SD = .27) was significantly different from those with income reaching their expenses (M = .50, SD = .25) as well as those with income covering their expenses sufficiently (M = .60, SD = .21). The main effect for the type of follow-up (alone vs. accompanied) did not reach statistical significance [F (2.310) = .224, P < .636, Ƞp2 = .672].

Conclusions

Income has an impact on health-related quality of life. Health in aging as a social phenomenon is not neutral to economic differences and is exposed to these structural disadvantages.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Psychosis and/or Lyme disease: There is more than meets the eye
Authors: Peixoto M.J. , Timóteo S. , Moreira I. , Cochat C. , Silva A. , Bastos-Leite A. , Silveira C.
Published: June 2017

Introduction

Lyme disease (LD) caused by the spirochete Borrelia burgdorferi (Bb) results from human contact with rural environments and is transmitted by infected ticks (Ixodes spp.)

Objectives/aims

To report a case with LD and to highlight the importance of differential diagnosis in a first psychotic episode.

Methods

Case report and systematic review of the literature.

Results

We report a case of a 19-year-old man that was admitted because of strange behaviour with alienation, perplexity and persecutory delusions. He had one previous admission to an inpatient unit two years prior and was diagnosed with psychosis not otherwise specified. After being admitted to the psychiatric ward a medical work up was completed. The patient had had a long stay in a rural environment; so anti-body specific to Bb was ordered and came positive. LD was diagnosed based on cerebral magnetic resonance imaging (MRI) findings and the presence of Bb in the cerebrospinal fluid. During treatment with anti-psychotic and antibiotic there was a noticeable clinical amelioration correlated with improvement of MRI's perfusion patterns.

Conclusions

LD is relatively rare, but physicians need to be aware of typical neuropsychiatric symptoms, given that they may occur months to years after the initial infection. Prompt diagnosis and effective treatment are crucial to avoid the possibly irreversible mental illness. In the evaluation of a first psychotic episode LD should be considered and excluded, principally if there's an epidemiological context and no psychiatric family history. MRI may be another useful asset in the diagnostic evaluation of this condition.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Adjustment of the German Prospective Payment System for Psychiatric and Psychosomatic Facilities: Does PEPP Provides a Suitable Basis? Results of a Descriptive Comparative Study
Authors: Voigtländer B.S. , Barth T.
Published: June 2017

Introduction

In Germany a consistent, performance-oriented, flat-rate remuneration system based on per-day payments for inpatient and day patient hospital services for psychiatric and psychosomatic facilities (PEPP) is developed. The Klinikum Chemnitz gGmbH decided in 2013 to participate in the optional PEPP introducing phase and acts as a PEPP cost accounting hospital.

Objectives

Due to a controversial discussion by the psychiatric experts, an adjustment of the hitherto only performance-based to a budget-oriented system based on PEPP is planned in 2017.

Aims

This paper discusses if the current PEPP remuneration system enables an appropriate recognition and measurement of services.

Methods

Descriptive analyses were performed by comparing inpatient and day patient treatment at a therapy oriented psychiatric unit and the emergency psychiatric unit in 2015. The evaluation primarily focused on the criteria of “staffing level and structure”, “imaging of services by German procedure classification (OPS) according to PEPP”, “PEPP remuneration”.

Results

Our findings (Table 1) show that in 2015 the PEPP remuneration system provided an appropriate recognition of unit-specific services in emergency psychiatry (e.g., 1 to 1 care, intensive care treatment), but services of board certified therapeutic staff were recognized inadequately in consequence of the definition of therapy by the OPS catalogue.

Conclusion

Further development of payment system should implicate changes in the definition of therapy according to scientific guidelines and the pay for performance concept.

Table 1

Disclosure of interest

Activity as a speaker, Janssen-Cilag GmbH.
Portuguese Validation of the Psychological Entitlement Scale
Authors: Araújo A.I. , Pereira A.T. , Cabaços C. , Brito M.J. , Mendonça L. , Macedo A.
Published: June 2017

Introduction

Psychological entitlement can be conceived as a disposition to believe that one deserves or is entitled to more than others. This pervasive sense has a wide impact on social behaviour, namely undesirable social outcomes. Given these theoretical implications on self-concept and interpersonal functioning, Campbell and Bonacci developed a shorter questionnaire of the Psychological Entitlement Scale (PES) to evaluate this construct by reducing from the original version from 57 to 9 items.

Objective

To investigate the psychometric properties of Psychological Entitlement Portuguese version.

Methods

A community sample composed of 286 university students (69.2% females; mean age = 21.09 ± 2.133; range: 17–33) answered the Portuguese preliminary versions of the PES, of the Dirty Dozen and of the honesty-humility dimension from the HEXACO-100.

Results

The PES Cronbach alpha was “very good” (a = 0.75). Following Kaiser and Cattel Scree Plot criteria, only one factor was extracted (explained variance = 35.46%), meaning that the scale is unidimensional. Pearson correlation coefficient of between PES and narcissism (r = 0.36), psychopathy (r = 0.21) and Machiavelism (r = 0.24) were positive, moderate and significant (P < 0.01). Pearson correlation between PES and honesty-humility was negative, moderate and significant (r = −0.43 P < 0.05).

Conclusions

The Portuguese version of PES present good internal consistency and convergent-divergent validity. Because we consider that psychological entitlement reflects a stable disposition, it is our intent to analyze PES temporal stability within the ongoing research project on the relationship between perfectionism and other personality traits. PES could be very useful both in clinical and research contexts.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Vortioxetine Efficiency in Controlling Obsessive Symptoms in Patients with Depression. A Case Report
Authors: Pardo de Santayana G. , Landera R. , Juncal M. , Porta O. , Sánchez L. , Gómez M. , Núñez N. , Pérez M.
Published: June 2017

Introduction

Obsessive symptomatology can sometimes be worsened when a patient with this personality trait suffers through a period of increased stress.

Aim

To review articles in PubMed related to how vorticoxetine affects obsessive symptoms in patients with depression.

Methods

We review the case of a 45-year-old male with obsessive personality traits diagnosed of recurrent depression. He was going through a period of stress at work that had worsened his obsessive symptoms (primarily obsessive thoughts). In a previous depressive episode, he was treated with an antidepressant that triggered sexual dysfunction as a side effect. Trying to prevent another antidepressant-induce sexual dysfunction, we decided to use voricoxetine because of its low tendency to interact with the sexual function.

Results

We started treatment with vorticoxetine reaching a dose of 10 mg/day. Three weeks later the patient reported a decrease in his levels of anxiety, a slight upturn of his mood and a relieve of his obsessive symptoms.

Conclusions

Vorticoxetine can be considered a good therapeutic option in the treatment of obsessive symptoms in a depressive episode with patients with a history of antidepressant-induce sexual dysfunction.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Use of Memantine in Organic Personality Disorder: A Case Study
Authors: Petrikis P. , Argitis P. , Karabas A. , Platari P. , Paschalidis K. , Karalis G. , Mavreas V.
Published: June 2017

This is a case study of a 27-year-old man with co-morbid congenital communicating hydrocephalus and epilepsy. The patient had multiple hospitalizations in psychiatric clinics due to serious domestic violence caused by compulsive buying demands. Impaired social interaction skills, diminished judgment, planning, insight and temporal organization difficulties were also present and the diagnosis of organic personality disorder was given.

The patient was treated with 1.5 g valproc acid for epilepsy and for the behavioural difficulties multiple antipsychotics, benzodiazepines, SSRI's and beta-blockers were administrated, without major benefits. Due to serious aggression and impulsive behaviour, it was administrated memantine 20 mg/day according to NMDA receptor antagonist hypothesis and gradually reduced the benzodiazepines and SSRI's.

A significant decrease in the average score of the Barratt Impulsiveness Scale (BIS-11) and to violence incidences was observed. Also, social interaction skills were improved and a slight improvement at patient's judgment was observed.

The patient had good tolerance during the treatment and no side effect was reported. It is the first scientific report on memantine effectiveness in this patient group. Further research is needed.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Shame: An Overlooked Factor in Conceptualizing and Treating Borderline Personality Disorder: Its’ Powerful Role in the Lives and Suicides of People with BPD
Authors: Porr V.
Published: June 2017

Shame, a central emotion in borderline personality disorder (BPD), has been overlooked despite its’ relationship to self-injurious behaviour, chronic suicidality, self-esteem, quality of life, and angry-hostile feelings. Patients describe shame when explaining acute feelings of emotional pain. There is a paucity of research exploring the impact of shame on the person with BPD's sense of self and behaviors. BPD symptoms may be the expression of and defenses against this painful emotion. Shame-proneness is related to anger arousal and the tendency to externalize attributions for one's own behavior by blaming others or not taking responsibility for one's behavior. The relationship between shame-proneness and BPD has important implications for treatment. TARA for BPD, an educational and advocacy organization, developed a Family Psycho-education program teaching how shame is often the common denominator of BPD responses, triggering escalations, emotional shifts, volatile reactions, anger and misperceptions. Shame is the response to perceived negative evaluations (judgment, criticism, or blame) and general misinterpretation of social situations. Shame is an impediment to thinking clearly, exaggerates ambiguity and overwhelms cognitive ability in the moment. As shame is often confused with guilt, raising awareness of shame responses is essential for improving family relationships. Families can learn to recognize shame responses and implement evidence based techniques from dialectic behavior therapy (DBT) and mentalization based therapy (MBT) to decrease its’ impact on their loved one with BPD. Demonstration of methodology to address shame in family interactions and data from a TARA Internet survey of The Experience of Shame will be presented.

Disclosure of interest

The author has not supplied his/her declaration of competing interest.
The Experience of Time in Habitual Teenage Marijuana Smokers
Authors: Dörr A.
Published: June 2017

The research is qualitative; it studies the experience of time in young people who smoke marijuana in excess, given the high rate of smoking in the teenage years, a delicate stage regarding the planning of the future. Our objective is to see how the relationship between past and future plans is manifested in their biography, through goals and actions, in light of their ability to anticipate themselves. Our guiding principle is the ability to “anticipate oneself”, proposed by Sutter, a phenomenological psychiatrist. The information was obtained from the analysis of autobiographies of young persons through the hermeneutical phenomenological method developed by Lindseth, based on Ricoeur. The results reveal that in the biographies the past temporal dimension is characterized by poor descriptions, the present is where they extend themselves most, describing tastes, how they visualize themselves, but showing a lack of clarity in their interests. In the future, we see the absence of reference, giving the impression of no progression from the past, and without awareness of the fact that the future possibilities or lack thereof are heavily dependent on present actions.

Disclosure of interest

The author has not supplied his/her declaration of competing interest.
Relationship between affective temperaments, traits of schizotypal Personality and early diagnosis in a sample of Italian healthy subjects
Authors: Ricci F. , Ventriglio A. , Pascucci M. , Bellomo A.
Published: June 2017

Introduction

Akiskal et al. [1] examined the relationship between affective temperaments and characteristics of schizotypal personality disorder. Schizotypal personality disorder is becoming increasingly important both in itself as a significant personality disorder and as a condition that can provide important insights into the origins of schizophrenia. Perceptual and interpersonal cognitive disorders, behavior and disorganized speech do the schizotypal personality disorder a kind of mild form of schizophrenia, a premorbid or prodromal phase of this serious disorder.

Aims

To analyze, in an Italian sample of healthy subjects, the correlation between affective temperaments and schizotypal traits.

Methods

We recruited 173 healthy subjects aged between 18 and 65 years who have completed the following tests:

– BIS-11;

– SPQ;

– SDS;

– SAS;

– HCL-32;

– TEMPS-A.

Results

At linear regression analysis between TEMPS-A scores and other rating scales are observed highly significant associations between increasing scores of cyclothymic and depressive temperament, subjective anxiety and depression with scores pertaining to the schizotypal personality disorder.

Conclusions

Clinically, a better understanding of the mechanisms that lead to a schizotypal personality could lead to the development of effective preventive and curative treatments in an early stage of symptoms in addition to the identification of subgroups at risk for the development of schizophrenic pathology.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Resilience, pain and quality of life in people with physical disabilities: A systematic review
Authors: Aranguren P.
Published: June 2017

Introduction

More than a thousand million people live with a certain type of disability over the world (more than a 15% of the population worldwide). In Spain, 2.5 millions of people suffer from a physical disability. Disability can be understood as an interaction of the individual's health condition (disease, illness…) and his/her environmental and personal factors. Resilience could be included as a powerful personal factor, which would play a major role in the individual's quality of life. Resilience can be defined as a universal basic capacity to prevent, minimize or overcome life's adversities, even reaching a change in the life of the individual.

Aim

To determine the association among resilience, pain and quality of life in people with physical disabilities.

Materials and methods

An electronic search of several databases (Psycinfo, Medline, Pubmed…) was performed using the terms resilience, physical disability, and physical illness among others.

Results

– Pain and resilience show an important relationship. Factors as acceptance, pain beliefs and self-efficacy are directly related with a lower pain interference.

– Resilience and quality of life show a strong positive relationship.

Conclusion

Several factors are related to resilience in people with physical disabilities. Resilience seems to be an important capacity that helps individual with physical disabilities overcome adversities. Further analyses are required.

Disclosure of interest

The author has not supplied his/her declaration of competing interest.
Mental health care of the family – Reality and innovative projects in the Russian practice
Authors: Gutkevich E. , Lebedeva V. , Vladimirova S. , Semke A.
Published: June 2017

Introduction

Psychosocial functional deficiency of persons with mental disorders covers the most important kinds of activity: work, education, independent living, and interactions with people, family interactions. Important aspect of rehabilitation practice is work with the family, relatives, and the nearest environment of patients due to decrease in the field of marriage or stable cohabitation.

Objective

To determine adaptive-preventive potential of the family in the area of mental health.

Material and methods

The analysis of multilevel characteristics of adaptation of 414 adult persons (patients with mental disorders and members of their families) with use of system approach and the methodical complex (“The Passport of Health of the Family”) has been carried out.

Results

We define the adaptive-preventive potential of the family of mental patient as biological (genetic) and social-psychological opportunities of family system of the individual to compensate the limits of ontogenetic (life) cycle of the family of several generations caused by the illness of the family member. Novelty of the “Clinical-psychological model of anti-relapse behaviour based on interaction of mental patients, their families, persons from the general population and experts in the field of mental health” project consists of scientific justification of development of multilevel (individual, family, society) model of anti-relapse behavior.

Conclusion

This multidisciplinary project is aimed at the persons entering into risk groups for development of mental disorder (for example, persons with sub-syndrome symptoms or with biological, and psychological or social risk factors) and the persons entering into risk groups for relapse of the existing mental disorder.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
The effects of support interventions on anxiety and depression in women with preterm labor during hospitalization
Authors: Kao M.H. , Chie-Pein Chen C.P.
Published: June 2017

Aim

To examine the effects of support interventions on anxiety, depression in women hospitalized with preterm labour at admission and 2 weeks.

Background

Hospitalized pregnant women with preterm labour have significantly higher anxiety and depression levels. Few studies have explored the effects of support interventions on anxiety, depression in such women.

Methods

A randomized, single-blind experimental design was used. The control group (n = 103) and intervention group (n = 140) were recruited from the maternity wards of one medical centre in northern Taiwan between January 2013 and April 2015. The control group received routine nursing care. The experimental group received support interventions, which included an interview, distraction methods and assistance with daily living needs. Groups were evaluated with the Beck anxiety inventory, Edinburgh Postnatal Depression Scale and at admission and 2 weeks of hospitalization.

Results

There were no significant differences between groups for demographics, obstetric characteristics, or birth outcomes. For the control group, anxiety and depression scores increased significantly decreased 2 weeks after hospitalization. The intervention group had a small, but significant, increase in anxiety and no significant change in depression at 2 weeks. Participants who received 2 weeks of support intervention had significantly lower anxiety and depression scores than the control group.

Conclusions

Providing interventional support could reduce anxiety and depression for women with preterm labour during hospitalization.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Promotion mental health: Healthy habits program in patients with severe mental illness in the north Almeria mental health unit (Activarte)
Authors: Marin Olalla M. , Vidal Lopez A. , Perez Ramirez B. , Maldonado Lozano R. , loret Lopez A.L.
Published: June 2017

Introduction

Promoting healthy lifestyles in patients with severe mental illness (balance diet, physical activity, smoking withdraw, adequate oral hygiene, optimal self-esteem and healthy sexuality) help patients to rely on their recovery.

Aims

– avoid social isolation and stigma.

– encourage the recovery process, considering as well as the manage of symptoms together the functioning and quality of life of the patients.

– improve the progress and illness prognosis.

Methods

– The program is introduced in the North Health Area of Almeria (Hospital Huercal–Overa) and FAISEM–Andalusia foundation to the social inclusion of mental illness patients;

– patients included in the program has been previously assess and informed-therapeutical contract;

– the program started in January 2013, with 10 sessions in the community, and groups sessions.

Results

– fifty patients included between a total of 300–initial target 16%;

– the initial target considered was at least 60–75% of participation rate—being the result of 80–95%;

– physical assessment detected 10% of metabolic syndrome being the patients referred to primary medical care to the adequate management.

Program:

– twenty group sessions scheduled being performed 19: 95%;

– ten active sessions in community scheduled being performed 9: 90%–one sessions (beach trip) was cancelled due to budget problem;

– patients level of satisfaction: under assessment;

– broadcasting: 2 press articles, scientific communications, and shared the experience through FAISEM to all the Andalusia Areas.

– research: expecting spreading the experience and improve the results.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Stigma and attitudes towards mental illness: Gender differences in a sample of Italian medical students
Authors: Pascucci M. , La Montagna M. , Di Sabatino D. , Stella E. , Nicastro R. , Grandinetti P. , Testa R. , Parente P. , Janiri L. , Pozzi G. , Piemontese G. , Ventriglio A. , Bellomo A.
Published: June 2017

Introduction

stigma in mental illness is characterized by discrimination towards people affected by mental disorder. Consequence of the paradigm “stigma-injury-discrimination” is the social exclusion of these patients and the denial of their rights. Medical students, those who should be important reference points for psychiatric patients, are instead one of the categories that contribute to their stigmatization.

Objectives

To study the attitudes of medical students towards psychiatric patients.

Aims

The present study analyzes gender differences in a sample of Italian medical students towards mental illness.

Methods

A total of 339 Italian medical students completed a cross-sectional survey, in Rome and Foggia (Italy). We used the Italian version of Community Attitude towards the Mentally Ill test (CAMI) to analyze the students’ attitudes.

Results

There is a substantial difference among the attitudes towards mental disorders in female and male students. Female students have obtained less stigmatizing results in 9 of the CAMI test items (P < 0.05), in Benevolence (P = 0.001) and Social Restrictiveness subscales (P = 0.043) and in the total score (P = 0.013).

Conclusions

These results are in line with those achieved in scientific literature, confirming that women tend to show more humanitarian attitude towards the mentally ill. Even in the original article of the validation of the CAMI test, the authors found better attitudes in women in all subscales, with the exception of Social Restrictiveness subscale (that in our analysis also correlates with the female gender).

Disclosure of interest

The authors have not supplied their declaration of competing interest.
The importance of early detection of child neurodevelopment in primary care in Colombia
Authors: Romero Otalvaro A.M. , Munoz-Argel M.
Published: June 2017

Introduction

The systematic assessment of child development for the first 30 months of age is essential in the monitoring of health outcomes; this requires to have a structured protocol to systematically observe the milestones that have to be achieved at each stage of child development, and prevent deficiencies related to risk factors, reduce and prevent special needs arising from a deficit of the neurodevelopment.

Objective

Describe the results of the evaluation of early detection of neurodevelopment problems in subjects from 0–30 months of age who assist to child developmental centers in municipalities located in the Colombian Caribbean region; the main need for intervention was characterized with different neurodevelopment problems.

Methods

A cross-sectional study was developed. Childs from 0–30 months of age who attended to the child development centers were tested. Exclusion criteria were not stipulated. The ASQ-3 and a demographic survey (Graffar's survey) were administrated, in order to correlate the social level and the overall results.

Results

The study included 750 boy/girl. The maturational development for each age group was determined, an analysis of each neurodevelopment area was conducted and the results were correlated with the demographic survey.

Conclusions

High levels of suspicion of possible neurodevelopment problems and the referral to diagnostic evaluation were observed for access to appropriate treatments. Early detection is highlighted as a tool in primary care that optimizes health sector resources and act in the appropriate periods of plasticity of child development.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Patient education for behavior change: Harm reduction and hypertation control
Authors: Soria D. , Schincariol G.M. , Chan G.T. , Pontes De S. Linda Beatriz , Domingos E.J. , Souza S.R.D. , Silva C.M.C.D. , Vernaglia T.V.C.
Published: June 2017

Background

Chronic non-communicable diseases (NCD) are a public health problem in Brazil. In addition, NCDs is more strongly associated with common mental disorders than was each NCD individually. This study is about the implementation and execution through the university extension project “harm reduction and mental health: hypertation control and health education” developed at Images of the Unconscious Museum, Brazil.

Aims

Measure the prevalence of hypertation, verify the association with chronic NCDs, educate about risk behavior and improve to psychosocial rehabilitation.

Methods

A socio-demographic and blood pressure profile was constructed. We identify hypertation on 33 patients. After the diagnosis, the family health unit was contact to construct a clinical care plan. We distribute health educational material about clinical diseases.

Results

Thirty-six percent patients was identify with hypertation; once had high blood pleasure and rejected any intervention; 68% have family rates of hypertation and 100% referred low salt on diet. A book storytelling was constructed to give orientations about health lifestyle. We conducted therapeutic workshop to highlighting the creative, imaginative and expressive potential of the users on health behavior.

Conclusion

We identify low blood pressure after the activities and a new health style after the orientation process.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Cognitive dysfunction in acute psychosis
Authors: Mulligan O. , Tan W.T. , Lowry G. , Adamis D.
Published: June 2017

Introduction

Patients with psychosis often present with cognitive dysfunction during the course of their illness. Inflammatory markers such as cytokines and neurotrophins have been investigated, as they are relevant to the change in cognitive function.

Objectives

To evaluate the cognitive function between patients with acute psychosis and those without. Moreover, this study also investigates cytokines and neurotrophins levels in acute psychosis and their relation with cognition, severity of psychosis and trajectory of their levels across time and under treatment.

Methods

Longitudinal, observational, pilot study, of psychiatric inpatients. Participants were assessed on the first day using brief psychiatric rating scale, CAGE, trail making test B and Wisconsin card sorting test. These assessments were repeated weekly until patients were discharged. Blood samples were also collected on the same day for cytokines and neurotrophins analysis. However, the result on cytokines and neurotrophins levels is still pending, therefore only clinical findings will be presented.

Results

Thirty-one patients (mean age: 43.7, SD: 18.9, 14 females and 17 males) were recruited. Eleven were acutely psychotic. Generalized estimating equations modelling were used to compare these two groups based on cognitive and demographic variables. Patients with psychosis are more likely to have significantly lower scores for CAGE (Wald-x2 = 6.268, df = 1, P = 0.012), significantly more abnormal scores in Trail Making Test B (Wald–x2 = 7.338, df = 1, P = 0.007), failure to maintain set (Wald–x2 = 8.323, df = 1, P = 0.004) and perseveratives errors (Wald-x2 = 4.385, df = 1, P = 0.036) although they have more years of education than those without psychosis.

Conclusions

These data show individuals with acute psychosis have impaired cognitive function compared to others.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Assessment of empathy and psychological characteristics of smokers
Authors: Iatrou G. , Gourgoulianis K. , Kotrotsiou E. , Gouva M. , Kotrotsiou S. , Paralikas T.
Published: June 2017

Introduction

Smoking causes many life-threatening diseases and is a major risk factor for several main causes of death. Damage by smoking is also caused to those called “passive smokers”. Passive smoking has been implicated in many adverse effects on health. Very few studies deal with empathy in smokers while smoking in the presence of non-smokers.

Purpose

Estimation of empathy and psychological characteristics of Greek smokers.

Methodology

For research purposes we used questionnaires Toronto empathy questionnaire (TEQ), symptom check list 90-R, experience of shame scale (EES) and other as Shamer scale – OAS.

Results

A statistically significant difference has been observed in the TEQ to gender (2.436, 0.02), with women showing the highest value (3.4 ± 0.4), as well as in the mean in behavioral shame 2. Another statistically significant difference has been observed in behavioral shame between educational level (3.419, 0.026) and the price of characterological shame among those who reported smoking in the workplace and those who did not.

Conclusions

The sample consisted of 27 subjects with average age 24 years and standard deviation of 4 years. Smokers accounted for 48.1%, of whom 69.2% stated that smoke in their living space. Respectively, the percentage of smokers in the workplace was equivalent. The largest percentage of smokers, (13 people, 69.2%) think that non-smokers are very annoyed when surrounded by people smoking close to them. The proportion of those who said they are very much bothered when in places where smoking is prohibited but somebody smokes, is large (47.1%).

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Unconventional side effects of antidepressants: Focus on emotional blunting
Authors: Falaschi V. , Baroni S. , Mucci F. , Akiskal H. , Marazziti D.
Published: June 2017

Objectives

The aim of this study was to investigate the unconventional side-effects of selective serotonin reuptake inhibitors (SSRIs) and tricyclics (TCAs) antidepressants during long-term treatment of depression, with a special focus on emotional blunting and, in particular, on the possible changes of some features of loving relationships.

Methods

Two hundred outpatients (130 women and 70 men, mean age ± SD: 43.4 ± 11.1 years) were enrolled. They were suffering from mild or moderate depression, according to DSM–5 criteria, treated with one antidepressant for at least six months and involved in a long-term loving relationship. A specifically designed test, the so-called “sex, attachment, love” (SALT) questionnaire was built to assess the possible changes of the loving relationship.

Results

The results showed differences between the two genders, in particular women taking TCAs reported more sexual side effects than men, whereas men taking SSRIs complained a reduction of the feelings of love and attachment towards the partner.

Conclusions

Antidepressants seem to have a dimorphic effect on some elements of loving relationships, however these results need to be further explored.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Advantages of second-generation long-acting injectable anti-psychotics: Focus on hospital admission rates in southeast Tuscany
Authors: Iazzetta P. , Forte A. , Cesari G. , Lucii C. , Magnani N. , Cardamone G.
Published: June 2017

Introduction

Several studies suggested that second-generation long-acting injectable anti-psychotics (SGA-LAIs) might be effective on preventing relapse and admission/readmission rates among patients affected by schizophrenic and bipolar disorders. Moreover, studies highlighted that SGA-LAIs may reduce costs and healthcare resource utilization (HRU) among community psychiatric settings.

Objectives

The objective of the present study was to evaluate whether the increased use of SGA-LAIs among community psychiatric services in southern Tuscany was related to:

– reduced costs and HRU;

– reduced hospital admission/readmission.

Methods

Data consisted of both regional registry and data prospectively collected at admission and/or follow up assessments. Patients included were: patients affected by schizophrenia/schizoaffective or bipolar disorders, treated with SGA-LAIs.

Results

The increased use of SGA-LAIs was related to a significant reduction of admission and/or readmission rates, as long as a significant reduction in costs and HRU among the community services included in the study.

Conclusions

The present findings suggest that SGA-LAIs might have a positive cost/effectiveness profile and could reduce hospitalizations, costs and HRU among a community sample. This could be related to a better tolerability of SGA-LAIs compared to FGA-LAIs, and less adverse effects. More studies on community samples should focus on the cost/effectiveness profile of SGA-LAIs.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Intervention in Early Psychosis - Current Status and Future Perspectives
Authors: Galderisi S. , Pietrafesa D. , Palumbo D.
Published: June 2017

Introduction

The delay between psychosis onset and initiation of treatment (duration of untreated psychosis, DUP) is associated with a poorer treatment response and overall functional outcome. In Europe several early detection and intervention programs have been developed to reduce the DUP and promote Phase-specific Treatments (PsTs).

Aims

To review the evidence of a) the effectiveness of European Early Interventions (EEIs) in reducing DUP; b) an impact of PsTs on clinical and social outcomes; and c) EEIs cost-effectiveness.

Methods

A literature search in PubMed, PsychInfo, Cochrane and individual journals through cross-referencing was performed. All European Randomized Controlled Trials (RCTs) designed to reduce DUP and/or to implement PsTs for people with first-episode psychosis were included in the review.

Results

Studies examining early detection programs compared with Standard Care (SC) reported discrepant findings as to their impact on the DUP. PsTs generally reduce hospitalizations and improve service engagement when compared with SC; their impact on other clinical variables, e.g. symptomatology and social functioning, is unclear. Studies assessing EEIs cost-effectiveness in comparison with SC consistently report an advantage for EEIs in the long run.

Conclusions

EEIs, as compared to SC, show several advantages that seem to result in an overall reduction in the cost of care. Therefore, the development of EEI is recommended.

On the other hand, some inconsistencies in the reported results suggest that EEIs should include psychosocial interventions targeting unmet needs of schizophrenia patients, such as cognitive dysfunction and negative symptoms.

Disclosure of interest

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 have declared.
Successful treatment of OCD-bipolar co-morbidity with clozapine – aripiprazole combination
Authors: Ouali U. , Zgueb Y. , Ouertani A. , Nacef F.
Published: June 2017

Introduction

Co-morbid obsessive-compulsive disorder (OCD) in bipolar disorder (BD) negatively affects clinical course and outcome, and considerably complicates its treatment.

Objective

To show a therapeutic approach still rarely used in case of resistant bipolar disorder associated with OCD.

Methods

Presentation of the clinical case of Mr. M.H., who is treated in our department since 2008 for OCD-bipolar co-morbidity, followed by a literature review.

Results

Mr. M.H. is a 29-year-old male patient. He developed BD associated to OCD at age 20. In order to control bipolar symptoms, the patient received several trials of anti-psychotics combined with mood stabilizers with little improvement. Resistant BD was diagnosed, and clozapine 300 mg daily introduced, leading to significant improvement in bipolar symptoms but worsening in OC symptoms. Treatment of OCD with fluoxetine and with cognitive-behavioral therapy (CBT) was unsuccessful. Introduction of aripiprazole 20 mg daily led to decided improvement of OC-symptoms. After one year, clozapine was gradually tapered down to 150 mg daily without reappearance of bipolar symptoms but further improvement of OC-symptoms.

Conclusion

Treatment of OCD-bipolar co-morbidity is difficult given the risk of manic switch with antidepressants and the risk of benzodiazepine dependence. CBT could represent an alternative, however, it did not show any efficacy in our patient. Worsening of OCD under clozapine is described in the literature. Adjunction of aripiprazole to clozapine seems an interesting therapeutic option: it diminishes OC symptoms without destabilizing the patient's mood state.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Interactions between SSRI's and statins: Clinical relevance versus statistical significance
Authors: Petrykiv S. , De Jonge L. , Arts M.
Published: June 2017

Introduction

Depression and hypercholesterolemia are two of the most commonly treated conditions in the developed countries, while the lipid–lowering agents and antidepressants are among the most widely prescribed drugs in the world. There is a common concern that selective serotonin reuptake inhibitors (SSRIs) can trigger statin adverse effects, especially myopathy. However, the supporting evidence originates from studies in-vitro and big epidemiological studies. Recent pharmacokinetic insights indicate that the magnitude of pharmacokinetic interaction between SSRIs and statins is likely to be below the threshold for clinical significance.

Objectives and aims

Explorative study on pharmacokinetic effects of SSRIs on statin drugs.

Methods

We performed a detailed literature review through PubMed, EMBASE and Cochran's Library to assess the clinical relevance of combined SSRIs and statin use. To address pharmacokinetic interactions between two drug groups, we focused on:

– cytochrome P450 enzyme metabolism of statins;

– CYP enzyme inhibition by SSRIs;

– SSRIs–statin drug interactions;

– non-CYP pharmacokinetic pathways.

Results

With regard to pharmacokinetic drug interactions and the risk of statin related myopathy, escitalopram, citalopram, and paroxetine are to be safe in co-therapy with all statins. Rosuvastatin and pravastatin are almost certain to be safe in co-therapy with all SSRIs. Fluoxetine and sertraline are also likely to be safe, even when combined with atorvastatin, simvastatin, and lovastatin.

Conclusion

Though the absolute risk of concomitant use of SSRIs with statins seems to be negligible, even this risk can be minimized by using lower statin doses and monitoring the patient.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Coping, schemas and cardiovascular risks – Study protocol
Authors: Slepecky M. , Prasko J. , Majercak I. , Gyorgyova E. , Kotianova A. , Zatkova M. , Chupacova M. , Tonhajzerova I. , Popelkova M. , Kotian M.
Published: June 2017

Introduction

According indicators from the OECD in 2015, cardiovascular diseases remain the main cause of mortality in most OECD countries. But main risk factor, as smoking, obesity, hypertension or physical activity do not explain that Slovak republic was the worst from OECD countries with number 404 age-standardized rates per 100,000 population.

Objectives

Determine which psychological, psycho-physiological and anthropometrics factors are at risk of cardiovascular diseases:

Aim

The aim is to determine, which risk psychological, psycho-physiological and anthropometrics markers are remarkable in time, when individual subjectively perceives himself as health. Based on the analysis of these correlates will be identified predictors, mediators and moderators of the cardiovascular diseases from the area of psychological variables, which accentuates the clinical picture of a patient with cardiovascular disease. Another aim is to identify specific risk factors for target advice on a lifestyle modification and creation of an interdisciplinary methodology for the prevention of cardiovascular diseases.

Methods

Project is aimed to clarify the relation between psychological factors (measuring by personal inventories as temperament predispositions, maladaptive schemes, coping, personality characteristics), balance of autonomic nervous system (by measuring HRV, skin conductance, muscle tension, respiration, and surface temperature), anthropometrics characteristics (BMI, weight, height) with potential symptoms of cardiovascular diseases confirmed in cardiac evaluation (12-lead ECG), blood pressure, examination of pulse wave, and data of arteriographic examination.

Conclusions

The results of the study can help to the better understanding of the interface between psychological factors and cardiovascular problems, which help to find new diagnostic, preventive and treatment approaches.

Disclosure of interest

The authors have not supplied their declaration of competing interest.