bluuebunny/crossref_metadata_2025 huggingface dataset:
Outcomes Assessment: Psychometric Properties of the Spanish Adaptation of the Outcome Questionnaire (OQ-45)
Authors: Penas P. , Iraurgi I. , Gorbeña S. , Matellanes B. , Montero M.
Published: June 2017

Introduction

The outcome questionnaire (OQ-45) has been one of the most frequently used instrument to measure clinical outcomes in psychotherapy. Probably due to its subscale structure, its applicability for a variety of disorders and life struggles, its sensitivity to change by repeated measurements and its predictive ability. Given its popularity, OQ-45 has been translated into several languages.

Objective

As the Spanish version has not been published, through this poster it is going to show the reliability and the dimensional structure of the OQ-45.

Method

One hundred and thirty-nine patients in clinical settings have completed the Spanish version. Three different confirmatory factor analysis have been calculated to analyze the construct validity.

Results

The Cronbach Alpha of the instrument was adequate .92, but also, in the three dimensions: symptoms distress (.90), interpersonal relations (.78) and social role (.66). Through the CFA was proved that the Four-factor bi-level model structure [χ2(900) = 3930.47, P < .001, AGF = .86, CFI = .91, RMSEA = .061(.049 to .073)]suited appropriately, in fact, more properly than the three-factor correlated or the three-factor with a second order factor models.

Discussion

The three-factor bi-level model structure of the OQ-45 is confirmed indicating an empirically and clinically relevant measure of client functioning. In this model each item loaded on one of the three subscales originally created. Besides, each item also captures common variance represented by the general factor of overall maladjustment, where this factor may indicate the degree to which respondents are functionally impaired. Thus, OQ-45 is an instrument that could be used for monitoring treatment efficacy and for making informed decisions about clinically significant changes.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Disability as Psychological Barrier for Employment in Russia, Implications for Rehabilitation
Authors: Kovyazina M. , Varako N. , Aziatskaya G. , Dobrushina O. , Spiridonov D. , Zarudnaya E.
Published: June 2017

Introduction

In Russia there was a misconception about employment of people with physical or cognitive disability that served as a psychological barrier for both employers and applicants. The situation has recently changed and special vacancies for invalids are open in some companies. A patient in residual period of traumatic brain injury (2010) attended our rehabilitation center with the request for employment. He grew up in orphanage and he had no experience of searching for vacancies by himself, also he had reduced communication skills. Moreover, TBI resulted in strong executive functions impairment.

Objectives and aim

Help V with employment.

Methods

Holistic rehabilitation program was developed for V. so he had a training in computer skills, CV writing and communication with employer. Cognitive-behavioral therapy methods were used while working on understanding of his limits and acceptance of his disability, and goal management training was applied to reduce frontal lobes dysfunction.

Results

After 1.5 months of counseling V. demonstrated significant improvement. He started to use e-mail and the Internet to find job openings. He was able to keep independent control of his activities. V. managed to accept his disability, so he declared it in his CV – it finally became crucial in his successful employment as clerk in a bank.

Conclusion

Holistic approach, which includes social work, neuropsychological rehabilitation and psychological support, is promising to overcome psychological barrier in employment of disabled people.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
SM-5, ICD-11, RDoC and the Future of Psychiatric Classification
Authors: Maj M.
Published: June 2017

The publication of the DSM-III in 1980 was intended to be a reaction to the evidence of the embarrassingly low reliability of psychiatric diagnoses, which was perceived as a major threat to the credibility of the psychiatric profession. The aims of the DSM-III project were actually two. First, the reliable definition of the diagnostic categories was expected to lead to the collection of research data that would validate those diagnostic entities and in particular elucidate their etiopathogenetic underpinnings. Second, there was an expectation that, by increasing reliability, communication among clinicians would be improved and clinical decisions made more rational. Today, one could say that the first aim of the project has not been achieved, while the fulfilment of the second aim has never been tested appropriately. The crisis of confidence in the DSM paradigm, clearly emerging from the debate following the publication of the DSM-5, has led on the one hand to a renewed emphasis on clinical utility, which is featuring prominently in the ongoing process of development of the ICD-11. On the other hand, it has led to a radical attempt to reform psychiatric nosology starting from neurobiological and behavioural phenotypes. This attempt does have its weaknesses, but may also represent a stimulus to reconceptualize some psychopathological constructs, especially in the area of psychoses, in order to reduce the gap between the level of neuroscience and that of clinical phenomenology.

Disclosure of interest

The author has not supplied his declaration of competing interest.
Psychological Aspects in Parents of Children with Disability and Behavior Problems
Authors: Ricci F. , Levi C. , Nardecchia E. , antonella A. , Andrea P. , Salvatore G.
Published: June 2017

Introduction

Parents of children with disabilities are at increased risk of experiencing psychological stress compared to other parents. Children's high levels of internalizing and externalizing problems have been found to contribute to this elevated level of stress. Childhood disability often imposes a social and emotional burden for children and their families.

Objective

With this study we evaluated several parents’ psychological aspects and the emotional behavioral functioning of their children with disability.

Aim

To investigate the possible correlation between parenting stress, level of depression in parents and behavior problems in their children, taking in to account the differences between mothers and fathers.

Method

standardized forms (CBCL, PSI, BDI) were completed from 57 (28 mothers) parents of children aged from 6 to18 years, focusing on psychological well-being includes depression, parenting stress, family resilience and family adjustment.

Results

The mean age of our sample was 41.55 ± 5.4. The level of depression and stress index were higher in mothers than in fathers. Parenting stress was significantly associated with children internalizing and externalizing behavior problems in children.

Conclusion

The results of this investigation indicate the importance of examining relations between parenting stress and behavior problems in children with disabilities. Objective of ensuring the rehabilitation process aimed at the welfare of the family. These patterns have implications for both developmental theory and for service provision for individuals with disability and their families.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Preliminary Validation of the Portuguese Version of the University of Pennsylvania Computerized Neurocognitive Battery (PennCNB) in a Sample of Healthy Controls
Authors: da Motta C. , Carvalho C. Barreto , Castilho P. , Pato M.
Published: June 2017

Introduction

The advances and massification of technology have allowed new developments in effective assessment methodologies for the evaluation of cognitive functions and associated functions of several brain systems and structures. Computerized test batteries have become more robust alternatives to paper-and-pencil test batteries and useful tools for research in several scientific domains, including psychiatry, psychology, genetics and neurosciences.

Aims

To validate and disseminate the Portuguese PennCNP battery for clinical and non-clinical studies.

Objectives

To translate and provide preliminary psychometric data of the Portuguese PennCNP tests in 9 neurocognitive domains.

Method

The PennCNB (Gur et al., 2010) was translated and administered to a sample of 120 Portuguese participants from the general population.

Results

Findings on the internal consistency and performance (speed and accuracy) are presented for the 19 tasks included in the PennCNB, in addition to results of correlation analysis within tests on the same domain for criterion validity, and gender sensitivity analysis.

Conclusion

Computerized assessment provides efficient and reliable results, based on performance of abstract.

Objective and simple tasks that cover a vast range of cognitive functions

The administration requires minimal training and provides a quick and automated scoring procedure, with great utility in several research and clinical fields. The availability of a test battery suitable for a large number of Portuguese native-speakers worldwide is of added value, since the translation of measures to several languages allows creating more extensive normative samples and direct results comparability in future research, including transnational or cross-cultural studies and clinical trials.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Systemic Review: High Dose Olanzapine Treatment for Treatment Resistant Schizophrenia
Authors: Azvee Z. , Lally J.
Published: June 2017

Objectives

Schizophrenia is a major mental illness with a progressive course. Thirty percent of cases of patients with schizophrenia do not respond to adequate trials of at least 2 different groups of antipsychotics are currently classified as having treatment resistant schizophrenia (TRS). Clozapine remains the gold standard, treatment of choice for TRS. However, clozapine does not come without its own challenges. Its risk profile, particularly agranulocytosis, reported in 1% of cases, has led to the necessity of weekly blood counts within the first 18 weeks of treatment and subsequently every month with slow dose titration. Clinically, sedation, weight gain and hypersalivation may further hamper the compliance of patients. Non-compliance has been reported to cause rebound psychosis. Recent studies have raised questions as to which antipsychotic is most efficacious for TRS. Thus, we conducted a systematic review of high dose olanzapine treatment for people with TRS.

Method

A systematic review of prospective studies found through search of PubMed, Scopus and hand-searched key papers which included randomized controlled trials and open-label studies which looked at high dose of olanzapine treatment response for TRS.

Results

The study is currently ongoing and preliminary results will be presented at the conference in April 2017.

Conclusions

The gravity of burden TRS brings to patients extends itself to their families, carers and clinicians. Further evidence on which antipsychotic is more efficacious for patients with TRS would have huge implications in terms of health benefits for the patients, better informed clinical decisions and also health economics in general.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
The predictive role of insight for the evolution of the disease in Romanian patients diagnosed with schizophrenia
Authors: Crisan C.A. , Pintea S. , Miclutia I. , Macrea R.
Published: June 2017

Introduction

Schizophrenia is a serious disorder that influences all life aspects of the patients. The most important goals in schizophrenia are remission, recovery, improving psychosocial functioning and quality of life, which can be influenced by different factors, especially insight.

Objectives

To evaluate the awareness of illness in Romanian patients diagnosed with schizophrenia and to determine the predictive role of insight.

Aims

This study wants to highlight the importance of the evaluation of insight in psychotic patients, taking into account that awareness leads to compliance with treatment, decreased rate of relapses and rehospitalization and a better prognosis.

Material and methods

Overall, 80 patients (44 males and 36 females) recruited from first and second psychiatric clinic Cluj-Napoca, diagnosed according to ICD-10 and DSM-V criteria with schizophrenia and acute psychotic disorder participated in this study. A semi-structured interview collected demographical data. Psychotic symptoms were evaluated using PANSS, severity of the disease using CGI and insight using SUMD.

Results

Our results showed that the most important predictive factors for the evolution were: level of insight (r = −0.41 P < 0.01), presence of family history (r = 0.24 P < 0.05) and belonging to urban areas (r = 0.23 P < 0.05). The level of insight explained 16% of variance of improving psychotic symptoms during hospitalization.

Conclusions

The awareness of illness is one of the predictive factors for long-term schizophrenia and the best predictive model of disease progression is composed of variables SUMD total and PANSS total on admission.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Validation of the Portuguese version of the consumer experiences of stigma questionnaire (CESQ)
Authors: Mendonça L. , Azeredo-Lopes S. , Landeiro I. , Grácio J. , Gonçalves-Pereira M.
Published: June 2017

Introduction

Tackling stigma and discrimination is a major concern worldwide as demonstrated e.g. in the European Mental Health Action Plan. We need valid and feasible indicators to assess the stigma of mental illness. In Portugal, validated scales focused on mental health consumers’ personal experiences of stigma are scarce. The consumer experiences of stigma questionnaire (CESQ) (Wahl, 1999), developed in collaboration with the National Alliance for the Mentally Ill, focuses on users’ real life experiences. Although it was validated in different countries, some psychometric properties (e.g. test-retest reliability) are to be tested.

Objectives

To further assess CESQ psychometric properties and to validate its Portuguese translation.

Methods

The CESQ Portuguese translation was developed in collaboration with the author (Otto Wahl), using standard translation and back-translation procedures. The acceptability of items was assessed in pilot studies and discussed in groups also involving health professionals. The measure was then used in a convenience sample of 122 persons with severe mental illness. Assessments included test-retest reliability (n = 48). A factor analysis was also conducted.

Results

Overall, the CESQ translation proved acceptable and missing items were few, not compromising the analysis. The intraclass correlation coefficient (ICC) for test-retest reliability was 0.83 [95% CI 0.71–0.90] and Cronbach's alpha for internal consistency was 0.80 [95% CI 0.75–0.85]. In the principal component analysis, factor loadings confirmed the two originally reported domains: stigma and discrimination.

Conclusions

The CESQ Portuguese version demonstrated good validity and reliability, replicating research using the original version and adding to the documentation of its psychometric properties.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Gynecological consultations during the period of untreated psychosis
Authors: Calahorro C.M. Carrillo de Albornoz , Jiménez M. Guerrero , Negro J.E. Muñoz
Published: June 2017

Background

Twenty-one percent of women with first episode of psychosis in the south Granada between 2008 and 2014 went to hospital emergency during the duration of untreated psychosis (DUP) aiming a gynecological consultation caused by psychotic symptoms. Only one in five was referred to mental health services.

Aims

To improve difficulties detecting cases during the prodromal phase, we aim to analyze the patient's profile and reasons for consultation and study whether there are variables that facilitate referral to specialist intervention.

Methods

A retrospective clinical–cases review of medical histories was made searching for sociodemographic variables, drug consumption, emergency services consultations and psychotic prodromal outcomes.

Results

They were single women between 18–32 years. Sixty percent reported cannabis consumption. All of them live with family. Eighty percent were studying or unemployed. Three types of emergency consultations were reported with a similar incidences: order the emergency-contraception-pill, a pregnancy test or “a scan to check virginity/a nonconsensual relationship”. During the initial exploration, about 40% were under the influence of drugs. Most of them had nonspecific symptoms of anxiety, emotional lability, irritability, etc. In half of the cases were reported weight loss, insomnia and several variations of the usual behavior in recent days.

Discussion

The most important variable is to analyze the reason for consultation. Moreover, substance abuse and a combination of prodromal symptoms including positive and other nonspecific are detected. Furthermore, at the profile with possible demands, we believe it is appropriate not to delay mental health assessment after making the appropriate intervention.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Subjective well-being under clozapine measured with the Serbian version of GASS-C: Preliminary results
Authors: Ristic D. Ignjatovic , Dan C. , Hinic D. , Jovic J.
Published: June 2017

Introduction

Clinical benefits of antipsychotic treatment depend on the efficacy and on the patients’ tolerability and compliance. To reduce patient initiated treatment discontinuation, timely detection of treatment emergent side effects is essential. The Glasgow Antipsychotic Side-effects scale for clozapine (GASS-C) is a recently developed instrument to measure subjectively experienced clozapine side effects.

Objectives

Timely detection of unreported clozapine related side-effects.

Aim

Documenting the prevalence of side-effects in schizophrenia or chronic psychotic disorder with the Serbian version of the GASS-C.

Methods

The sample included 95 in and outpatients with schizophrenia or chronic psychotic disorder. All subjects filled out the Serbian version of the GASS-C and a sociodemographic questionnaire.

Results

The median age was 46.1 years; 53.7% of subjects were male. Clozapine doses ranged from 25 to 423 mg. Drowsiness (78%) was the most commonly reported side-effect. Overall, 16.8% of the patients added other complaints, such as headache, pain, hand or leg numbing or nightmares. According to GASS-C total score categorization [2], only 4.2. % of subjects were rated with severe side-effects, while 14% of themselves rated their symptoms as severe or distressing. More side effects were reported by female patients and by inpatients. Only a weak positive correlation was found between the severity of the side effects and clozapine dosage.

Conclusions

We found the GASS-C to be a useful instrument that elicits both unknown side-effects and patients rating of their severity. Side effects did not clearly relate to the prescribed dose. Future research should include the relation of clozapine plasma levels with side effects assessed with GASS-C.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Mortality in people with psychotic disorders in Finland: A population-based 13-year follow-up study
Authors: Keinänen J. , Mantere O. , Markkula N. , Partti K. , Perälä J. , Saarni S.I. , Härkänen T. , Suvisaari J.
Published: June 2017

Introduction

People with psychotic disorders have increased mortality compared to the general population. The mortality is mostly due to natural causes and it is disproportionately high compared to the somatic morbidity of people with psychotic disorders.

Objectives

We aimed to find predictors of mortality in psychotic disorders and to evaluate the extent to which sociodemographic and health-related factors explain the excess mortality.

Methods

In a nationally representative sample of Finns aged 30–70 years (n = 5642), psychotic disorders were diagnosed in 2000–2001. Information on mortality and causes of death was obtained of those who died by the end of year 2013. Cox proportional hazards models were used to investigate the mortality risk.

Results

Adjusting for age and sex, diagnosis of nonaffective psychotic disorder (NAP) (n = 106) was statistically significantly associated with all-cause mortality (HR 2.99, 95% CI 2.03–4.41) and natural-cause mortality (HR 2.81, 95% CI 1.85–4.28). After adjusting for sociodemographic factors, health status, inflammation and smoking, the HR dropped to 2.11 (95% CI 1.10–4.05) for all-cause and to 1.98 (95% CI 0.94–4.16) for natural-cause mortality. Within the NAP group, antipsychotic use at baseline was associated with reduced HR for natural-cause mortality (HR 0.25, 95% CI 0.07–0.96), and smoking with increased HR (HR 3.54, 95% CI 1.07–11.69).

Conclusions

The elevated mortality risk associated with NAP is only partly explained by socioeconomic factors, lifestyle, cardiometabolic comorbidities and inflammation. Smoking cessation should be prioritized in treatment of psychotic disorders. More research is needed on the quality of treatment of somatic conditions in people with psychotic disorders.

Disclosure of interest

Jaakko Keinänen owns shares in pharmaceutical company Orion.
Social and nonsocial cognitive functions in patients with schizophrenia: A comparative neuropsychological and neurophysiological study
Authors: Khalil M.A. , Saleh A.A. , El-Fayoumy N.M. , Gohar S.M.
Published: June 2017

Background

Patients with schizophrenia suffer from cognitive deficits in seven domains in addition to social cognition. P300 latency and amplitude have been linked in these patients to the basic cognitive deficits.

Objectives

Comparing patients suffering from schizophrenia with matched healthy subjects as regards auditory event related potential tests as measured by P300.

Subjects and methods

Fifty-two subjects were divided into 2 groups: group (A): 27 patients with schizophrenia according to the diagnostic and statistical manual of mental disorders-text revised (DSM-IV TR). Those with current substance use, psychiatric disorders or organic disorders were excluded. Group (B): 25 healthy control subjects with negative history of substance and psychiatric disorders. Patients were assessed using Positive and Negative Symptom Scale (PANSS) for severity of psychotic symptoms, Addenbrook's Cognitive Examination Revised (ACE-R) for basic cognitive, reading the mind in the eye test for social cognition, P300 and electro-encephalography (EEG)

Results

The two groups were different significantly in ACE total and its subtests measuring attention-orientation, memory, language, visuospatial and reading the mind in the eye test for social cognition scores with patients showing lower scores (P = 0.000, 0.012, 0.000, 0.038, 0.041 and 0.001 respectively). Control group had higher amplitude of P300 and shorter latency than patients (P = 0.003 and 0.005 respectively). P300 amplitude correlated positively with visuospatial memory (P = 0.015). PANSS general pathology scale correlated positively with duration of untreated psychosis (P = 0.029) and with fluency (P = 0.047).

Conclusion

Patients with schizophrenia differ from controls in P300.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
The Effect of Prefrontal Transcranial Direct Current Stimulation on Resting State Functional Connectivity
Authors: Keeser D.
Published: June 2017

Transcranial direct current stimulation (tDCS) of the prefrontal cortex (PFC) is currently investigated as therapeutic non-invasive brain stimulation (NIBS) approach in major depressive (MDD) and other neuropsychiatric disorders. In both conditions, different sub regions of the PFC (e.g. the dorsolateral prefrontal cortex, the dorsomedial prefrontal cortex and others) are critically involved in their respective pathophysiology. Although the neurophysiological properties of tDCS have been extensively investigated at the motor cortex level, the action of PFC tDCS on resting state and functional MRI connectivity of neural networks is largely unexplored. Beyond motor cortex paradigms, we aim to establish a model for PFC tDCS modulating functional connectivity in different conditions to provide tailored tDCS protocols for clinical efficacy studies in major psychiatric disorders such as MDD and schizophrenia. One major obstacle in brain research is that patients represent themselves as individuals not as groups. Recent research has shown that the individual human brain functional MRI connectivity shows different within-variability than the variability found between subjects. Several neuroimaging methods may be useful to find a classifier that can be reliable used to predict NIBS effects. These neuroimaging methods include individual brain properties as well as the evaluation of state-dependency. Anatomical targeted analyses of rTMS and tDCS in neuropsychiatric patients and healthy subjects have found promising results.

By combining neuroimaging and NIBS new functional models can be developed and compared in different health and pathology states, e.g. in the development of any given psychiatric disorder.

Disclosure of interest

Supported by the Federal Ministry of Research and Education (“Forschungsnetz für psychische Erkrankungen”, German Center for Brain Stimulation–GCBS–WP5).
A thalamo-cortical genetic co-expression network is associated with thalamic functional connectivity linked with familial risk for schizophrenia
Authors: Passiatore R. , Antonucci L.A. , Di Carlo P. , Papalino M. , Monda A. , Taurisano P. , Bertolino A. , Pergola G. , Blasi G.
Published: June 2017

Introduction

The genetic architecture of schizophrenia is based on polygenic trajectories. Indeed, genes converge on molecular co-expression pathways, which may be associated with heritable characteristics of patients and their siblings, called intermediate phenotypes, such as prefrontal anomalies and thalamic dysconnectivity during attentional control [2].

Objectives

Here, we investigated in healthy humans association between co-expression of genes with coordinated thalamo-prefrontal (THA-PFC) expression and functional connectivity during attentional control.

Methods

We used Brainspan dataset to characterize a coordinated THA-PFC expression gene list by correlating post-mortem gene expression in both areas (Kendall's Tau>.76, Bonferroni P < .05). Then, we identified a PFC co-expression network1 and tested all gene sets for THA-PFC and PGC loci [3] enrichments (P < .05). SNPs associated with the first principal component of the resulting enriched gene set were combined in a Polygenic Co-Expression Index (PCI) [1]. We conducted Independent Component Analysis (ICA) on attentional control fMRI data (n = 265) and selected Independent Components (ICs) including the thalamus and being highly correlated with an attentional control network2. Multiple regressions were conducted (predictor: PCI) using a thalamic cluster previously associated with familial risk for schizophrenia [2] as ROI (FWE P < .05).

Results

In one of the 8 ICs of interest there was a positive effect of PCI on thalamic connectivity strength in a cluster overlapping with our ROI (Z = 4.3).

Conclusion

Decreased co-expression of genes included in PCI predicts thalamic dysconnectivity during attentional control, suggesting a novel co-regulated molecular pathway potentially implicated in genetic risk for schizophrenia.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Hyperthermia and neuroleptic malignant syndrome-Case report
Authors: Puljić K. , Herceg M. , Jukić V.
Published: June 2017

Neuroleptic malignant syndrome (NMS) is a rare, but life-threatening, idiosyncratic reaction to neuroleptic medications that is characterized by fever, muscular rigidity, altered mental status, and autonomic dysfunction. NMS often occurs shortly after the initiation of neuroleptic treatment, or after dose increases. Malignant hyperthermia (MH) or malignant hyperpyrexia is a rare life-threatening condition that is usually triggered by exposure to certain drugs. The 46-years-old female patient was diagnosed schizophrenia at the age of 22. Currently, she is hospitalized due to psychotic decompensation. The patient was admitted with following daily dose therapy of: haloperidol 15 mg, biperiden 4 mg and diazepam 15 mg. During this hospitalization she developes muscle rigidity, tremor, hyperthermia, and laboratory results showed increase of enzimes CPK and LDH, so we started treatment of suspected malignant neuroleptic syndrome. After a treatment and recovery with complete withdrawal of all presented symptoms, our patient developed a malignant hypertermia that was resistant to all applicated medications. Our dilemma is whether presented symptoms of malignant hyperthermia are related to malignant neuroleptic syndrome or not?

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Can drug interaction be useful? Case report of a schizophrenic patient treated with paliperidone long-acting injection
Authors: Sarpe M. , Bran M. , Maria L.
Published: June 2017

Introduction

Intramuscular paliperidone palmitate (PLAI) is a long-acting atypical anti-psychotic approved in Romania for the maintenance treatment of adults with schizophrenia.

Objectives

To determine the efficacy and tolerability of PLAI in a non-compliant patient with previously very low tolerability to oral anti-psychotics. The patient had been on risperidone long acting injection (RLAI) and had significant adverse events (i.e. tremor, akatisia) which persisted even when treated with the lowest dose of PLAI: 50 mg.

Aims

Since the efficacy of PLAI was good, and since a lower dose (than 50 mg of PLAI) is not available in Romania, we tried different ways to lower plasma concentration (PC) of the anti-psychotic because the patient presented clinically significant adverse effects (AE).

Methods

Initially the time between the injections was extended at maximum recommended (35 days), with a slight effect, then an off label treatment was associated in order to lower the PC of PLAI. We used 300 mg of carbamazepine long acting, that may lower the PC of PLAI up to 30%. For the evaluation of the efficacy and tolerability, we applied: the clinical evaluation, the positive and negative syndrome scale, the Barnes Akathisia rating scale, the Simpson-Angus Scale and the abnormal involuntary movement scale.

Results

After using the above mentioned, strategies, the one that had indeed good results on reducing AE, with no alteration of the psychic status of the patient, was the association of carbamazepine.

Conclusions

In clinical practice, some off label medication associations may be salutary!

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Antipsychotics in chronic schizoaffective disorder: A naturalistic study
Authors: Tsygankov B. , Ryzhukhinskaya A. , Evgeny K. , Pavlichenko A.
Published: June 2017

In spite of the beneficial effects of antipsychotics (AP) on the course of schizoaffective disorder (SAD) in general, there is an evidence for some negative aspects of their application. The objective of the study was to investigate the clinical manifestations and the course of resistant SAD while treated by the different AP. At present, the research includes 63 patients with SAD and duration of psychotic and/or affective symptoms more than six months. The research was naturalistic follow-up. The first group of patients (n = 18) were treated with SGA. An average duration of hospitalization was 61.2 days. After a reduction of acute psychotic condition, subthreshold psychotic and anxiety symptoms were still remaining. The total PANSS score was 71 ± 8. The second group (n = 24) was treated with a combination of FGA and SGA. An average duration of hospitalization was 53.8 days, the total PANSS score was 79 ± 6. It has been prevailed subthreshold bipolar symptoms. The third group of patients (n = 21) were treated with FGA. An average duration of hospitalization was 45.5 days; the total PANSS score was 63 ± 10. The negative symptoms and subthreshold depressions have been prevailed among the patients.

To conclude, the treatment of SAD by the SGA and combination of SGA and FGA are more likely associated with persistence of subthreshold psychotic and/or bipolar disorder and the longer duration of hospitalizations. On the other hand, application of FGA in SAD is more likely associated with negative symptoms and depressions after a reduction of acute psychotic condition.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
EEG spectral power changes in solving spatial logical task in schizophrenia patients in the first episode and in remission
Authors: Zaytseva Y. , Garakh Z. , Morozova A.
Published: June 2017

Introduction

Despite the assumption that the EEG parameters in schizophrenia may be predictive for the treatment outcome, there are only a small number of such studies present. We hypothesised that the characteristics of the changes in EEG rhythms during cognitive load might differ in the first episode of psychosis and remission being dependent on the stage of the illness.

Methods

The EEG rhyths spectral power (SP) in the resting state and their changes during the performance of spatial logical task in 25 first-episode psychosis patients (FEP) and same patients in remission (REM) after 6–18 months were analysed. Control group included healthy subjects matched with patient group by gender, age and years of education.

Results

The resting state SP values did not differ in FEP and REM. When performing a task, FEP theta SP was decreased compared to the resting state values in F7, F8, P3, T6 sites (P < 0.05), while gamma2 SP was increased in Fz (P < 0.001) and Pz (P < 0.01). REM theta, alpha, and beta1 SP was decreased in the same way as in norm in all sites (P < 0.05). Gamma2 SP increase was found in sites Fp1, F8, Fz (P < 0.05). FEP theta and beta1 SP changes during cognitive load positively correlated with the PANSS scales (delusions, thought disorders, hallucinations). REM did not have significant correlations between SP and PANSS parameters.

Conclusions

The analysed REM EEG characteristics differ less from the norm than the FEP. Based on the results, the performance of the task is related to the stage of the illness.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Multidisciplinary approach about contraception in a day hospital of mental health
Authors: Calahorro C.M. , Guerrero Jiménez M. , Girela Serrano B.M.
Published: June 2017

Background

Women with mental illness are a disadvantaged group both in terms of their gender and because of their mental disorders, and they experience serious problems related to reproductive health.

The high rates of unplanned and unwanted pregnancies among women with schizophrenia underscore the importance of understanding their attitudes and practices related to family planning. Different studies reveal that even though many sexually active women with serious mental illnesses do not want to become pregnant, they do not use birth control.

Objectives

Release last data about contraception methods among patients with severe mental illness after doing a bibliographical review. Also reflect present setup in Motril day hospital women patients and their relationship with sexuality and contraception. At the same time we intend to clarify and unify the proceedings on ethical problems respecting subject's autonomy, beneficence, qualification and minors’ protection.

Methods

Data were collected through face-to-face interviews and a questionnaire based on the literature and prepared by the researchers which was designed to determine the kinds of reproductive health issues the patients were experiencing.

Results

It was found that female patients with psychiatric disorders had more negative attributes with regard to contraception approach and sexuality compared with a corresponding healthy population.

Conclusions

We reached an agreement about future contraception approaches in Motril day hospital users as part of the global treatment offered in our section.

Motril

Hospital gynaecology service has facilitated the proceedings for contraceptive subcutaneous implants insertion in those indicated women.

Day hospital patients were instructed individually and through group work about healthy sexuality.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Sperm donation and surrogacy from a male perspective
Authors: Carolino N. , Galhardo A. , Moura-Ramos M. , Cunha M. , Monteiro B.
Published: June 2017

Introduction

Societal changes in the last decades led to the arise of new paradigms on gender equity. Studies addressing fertility/infertility issues have been conducted mainly in women and in this research area, male partners have deserved less attention. More recently there has been a major focus on the idea that fertility/infertility aspects have to be conceptualized from a couples’ perspective.

Goals

The current study sought to explore attitudes towards gamete donation and surrogacy in a sample of young men in reproductive age.

Methods

A total of 111 males with ages ranging from 18 to 40 years old and without children completed an online questionnaire addressing attitudes towards gamete donation and surrogacy.

Results

The majority of participants (77.3%) would be willing to donate their sperm, and their main motivation for doing that would be to feel “happy to help a couple struggling to have a child”. Participants stated that the likelihood of donating would increase if they were able to attend counseling, to complete the procedure in an IVF center located in their residence area, and being provided with more information about infertility. Regarding surrogacy 82% are in favor of this procedure legalization and 49.5% would be willing to use it if they needed.

Conclusion

Men showed a positive attitude towards sperm donation and surrogacy, emphasizing the importance of counseling and information availability on these topics. This may suggest that they are willing to get involved when fertility issues are addressed.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Sexual excitation, sexual inhibition and a prevalence of sexual disorders among msm and heterosexual men
Authors: Kowalczyk R. , Kaluga M. , Jacek K. , Nowosielski K.
Published: June 2017

Introduction

Dual control model of the sexual response (DCM) indicates, that there are two separate, but cooperating systems of sexual excitation and inhibition. Previous studies using DCM concept have shown, that MSM (men having sex with men) had higher excitation (SES) and one of the types of inhibition (SIS1) levels, in comparison to the exclusively heterosexual men. MSM also reported more frequent occurrence of sexual disorders (erectile disorders, premature ejaculation and decreased sexual desire).

Objectives

Comparison of the MSM and heterosexual men groups in order to verify erenow observed differences in sexual excitation/inhibition propensity and prevalence of sexual problems.

Methods

The sample consisted of two groups: 47 heterosexual men and 60 MSM. The participants have anonymously filled up questionnaires (Polish version of the Sexual Inhibition/Sexual Excitation Scales SIS/SES and the author's survey) via internet. Then statistical analysis was executed.

Results

Our findings have shown, that both groups were similar in their propensities for sexual excitation (SES) and inhibition due to the risks of failure in sexual performance (SIS1), while MSM scored higher on the inhibition scale, related to the threat of negative consequences of sexual response (SIS2). Heterosexual men more frequently suffered from premature ejaculation and less commonly reported decreased desire. There were no differences in the erectile disorders report between MSM and heterosexual men.

Conclusions

Our findings are mostly in conflict with previous DCM studies results. Several issues, just like method of sexual orientation assessment or cultural differences may had its impact on such results. More detailed studies on these issues are required.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
The importance of psychosexual variables in the sexual functioning in sexually active adults
Authors: Pereira H.
Published: June 2017

Introduction

Sexuality is a very important human dimension which contributes to psychosocial well-being and psychosexual variables, such as sexual self-esteem, sexual anxiety and sexual depression, can affect sexual functioning; however, there are few studies that demonstrate this relationship.

Objectives

To assess the psychosexual variables and sexual performance levels in a sample of adults, and verify and determine the degree of association between sexual functioning and self-esteem, anxiety and sexual depression.

Methods

The study included 422 adults that were sexually active (who had sex in the previous month); 265 (62.8%) were women and 149 (35.3%) were men, who filled out a sociodemographic questionnaire and scales related to sexuality and sexual functioning, Sexuality Scale and Sexual Functioning Questionnaire Short Form (CSFQ 14), broadcast over the internet.

Results

The results obtained allowed to know the relationships between the variables and psychosexual sexual functioning, and was statistically significant correlation between the two dimensions and significant differences between the correlation when comparing gender and sexual orientation.

Discussion and conclusions

This study allows us to highlight the importance of psychosexual variables in sexual functionality expression, in the sense that those working in the area of sexuality should be aware of how the human psyche interferes with sexual manifestation.

Disclosure of interest

The author has not supplied his/her declaration of competing interest.
Rethinking classification of zoophilia
Authors: Sendler D. , Lew-Starowicz M.
Published: June 2017

Introduction

In 2011, Anil Aggrawal proposed ten-point classification system of zoophilia, based on forensic literature review.

Objectives

(1) Allow for conceptualization and improved management of zoophilic patients in clinical practice or forensic examinations, (2) describe identity of modern-day zoophiles, including demographics and psycho-social profile, and (3) determine normative and pathologic traits and behaviours.

Methods

A qualitative observational study of user activity (n = 958) on discussion forums, combined with brief demographic survey. Data were analyzed according to principles of grounded theory. Surveys of own design (demographic, discreet + open ended questions) were answered by 350 participants. Presented data show aggregate conclusions from mixed methods qualitative and quantitative analysis.

Results

Proposed classification system categorizes zoos as either classic, sexual, romantic, or platonic. Relationship goals of classic and romantic zoos are reminiscent of those typical of human partnership, differentiated by the commitment and psychological distress level (romantic zoos, affectionate relationship goals outweigh sexual pursuit; classic zoos, romantic and sexual urges cause distress rather than pleasure). Sexual zoos show high prevalence of hypersexuality traits. Platonic zoos are typically confused about the roots of their sexuality. Contrary to common perceptions, prevalence of sexual sadism is extremely low (<1% in our study). Sociopathic traits determine propensity for animal cruelty, which is not synonymous with typical zoophilia. Half of respondents were in committed relationship with human partner, whom they frequently attempted to “convert” into practicing zoophile.

Conclusions

We can categorize zoophiles into four sub-types. Emotional attachment and sexual urges play equal role in bonding with animal partner.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Treatment of alcoholism – New targets?
Authors: Carvalhão Gil L. , Lázaro M. , Ponte A. , Teixeira J. , Prata Ribeiro H. , Mota T.
Published: June 2017

Introduction

Alcohol use disorders (AUD) is a preventable cause of significant morbidity and mortality worldwide. AUD is a heterogeneous disorder stemming from a complex interaction of neurobiological, genetic, and environmental factors. To achieve treatment effectiveness this heterogenity should be considered, as well as safety.

Objectives

Review mechanisms underlying alcohol addiction in order to work out new, more effective treatment strategies.

Aim

To update on treatment for alcoholism.

Methods

A literature search was performed on PubMed database.

Results

Alcohol dependence is a chronic, relapsing condition in which there is evidence of significant change in the motivation and control systems in the brain. Increasingly drug therapy is focused not just on the treatment of the acute withdrawal syndrome, but on modifying these other dysregulated brain systems. Of the numerous neurotransmitter systems that have been identified for the development of new medicines, the most promising compounds appear to be those that modulate the function of opioids, glutamate with or without gamma-aminobutyric acid, and serotonin. Other putative therapeutic medications including direct modulators of dopamine function and enzyme inhibitors also shall be discussed. At present, only four medications are approved for the treatment of alcohol dependence in Europe, that is naltrexone, acamprosate, disulfiram and the most recent nalmefene. Among other promising strategies the following drugs are mentioned: baclofen, topiramate, ondansetron, aripiprazole, rimonabant and varenicline.

Conclusions

Pharmacological development remains a high priority in the alcoholism field. Drugs have different safety profiles that need to be balanced with the treatment objective, individual patient preferences and comorbid conditions.

Disclosure of interest

The authors have not supplied their declaration of competing interest.