bluuebunny/crossref_metadata_2025 huggingface dataset:
Multifactorial Ethiopathogenic In Eating Disorders
Authors: Garcia E. , Leon M. , Polo F.
Published: May 2016

Eating Disorders is a heterogeneous group of syndromes which includes many factors in their develop. The three main syndromes, AN, BN and EDNOS has been defined in last DSM as independent entities. However is well known that a group of patients may change its presentation along time, so also been at first diagnosed of AN, lately will fulfil criteria for BN or EDNOS.

In the other hand, if we compare two patients with the same syndrome, as BN, or AN…

We may easily find big differences in personality, stressors…and in some cases the only common factor is the clinical presentation.

Behind all of this is the fact that syndromic classification drives to empiric treatments that are far the most validated.

But although there is a well known evolution in this disorders, with a not so bad income as one could think initially (in some cases one third could recover without treatment), what may we do with those patients that are resistant for empiric treatments?

And it is our opinion that a deeper knowledge of all the factors that contribute to the syndrome or its presentation, as well as those related to treatments results, should be taken into account.

We have reviewed all knowledge about these issues and we have completed it with our clinical practise using a 50 patients data base, here we will show our results, that are basically that even the same factors interact in different ways in each patient, so it is not just the ingredients but the recipe.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Patients With Anorexia Nervosa: Outcome Inpatient Care
Authors: Jerónimo J. , Santos J. , Castro Nunes L. , Neves S. , Sequeira F. , Neves A.
Published: May 2016

Introduction

Anorexia nervosa (AN) is characterized by self-induced starvation coupled with fear of gaining weight and a distorted body image. Its treatment is complex and challenging, and sometimes hospitalization is needed.

Santa Maria Hospital's Eating Disorders Unit (SMH-EDU) is a multidisciplinary team, formed in 1989, that provides both outpatient and inpatient treatment.

Objective

To present and discuss SMH-EDU's AN treatment and its results.

Methods

Revision and statistical analysis of all hospitalized AN’ patients’ clinical files, from 1 January 2014 to 31 December 2014. Treatment outcome was assessed by BMI variation.

Results

A total of 45 admissions (41 patients) were analysed: 75.65% had AN restricting type and 24.45% had AN purging type. All patient were females, with median age of 27 years old (range 12–57 years). Average admission BMI was 14.51 kg/m2 (ranging from 11.19 to 17.77 kg/m2). The mean lengths of stay were 39 days. Thirty-six percent of the patients had at least one previous hospitalization. Only 2 patients were readmitted at SMH-EDU: triple readmissions. The mean time between the beginning of the disorder and the admission was 111 months (ranging 2 to 408 months). Average discharged BMI was 16.32 kg/m2 (ranging from 13.24 to 19.11 kg/m2).

Conclusion

Inpatient treatment for AN at SMH-EDU is considered only for those patients whose disorder has not improved with appropriate outpatient treatment. Therefore, most inpatients at SMH-EDU have disorders of high severity, as demonstrated in our results.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Brain Changes In Anorexia Nervosa
Authors: Gkinis G. , Ortiz N. , Alberque C. , Canuto A.
Published: May 2016

Anorexia Nervosa (AN) is a serious and frequent psychiatric condition with the highest mortality rate within psychiatric diseases. It often starts during adolescence and affects young patients whose brain maturity is still incomplete but brain changes are often underconsidered although AN appears at a critical point of development.

Brain regions involved in the pathophysiology of AN are still in debate. However, the illness is often associated with enlargement of the cortical sulci and ventricles as well as with deficits in grey and white matter volumes. Functional modifications have also been evidenced: mainly global hypometabolism (PET), hypoperfusions (SPECT) and recent fMRI studies have shown that the function of the insular and cingulate cortices, in particular, differ in AN.

Neuropsychological studies have also shown neurocognitive impairments concerning executive functions, episodic and working memory as well as attentional deficits.

In 1999, Geneva University Hospitals set up a medical-psychiatric unit located in the district general hospital. This structure allows dealing with severe somatic problems as medical and nursing staffs are psychiatric and somatic specialists. AN patients are over 16, often hospitalised for the first time and have very low BMI (< 14). From the clinical observation of these patients who show significant attentional deficits, we explored whether cerebral abnormalities were present with structural MRI and Neuropsychological assessments.

We will describe the preliminary results of our clinical experience and consider their implication for the understanding of AN mechanisms. We will also discuss the links between psychopathology and brain impairments that could lead to more efficient treatments.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Revolutionary Education: Fostering Emotional Intelligence and Empathic Imagination Across The Mainstream Curriculum. Interdisciplinary Inquiry
Authors: Rozentsvit I.
Published: May 2016

If fostering emotional intelligence and empathic imagination and solving ethical dilemmas were discussed openly and taught methodically in K-12 mainstream (“typical”) classrooms, would we need metal detectors at the inner city schools’ entrances, and would we need special anti-bullying programs, which intend to correct bullying culture, rather than build a new one, based on kindness, openness, and consideration for others?

Will we learn lessons from the Columbine High School and the Sandy Hook Elementary School massacres, and radically change educational system, to incorporate empathic imagination and emotional intelligence into mainstream K-12 curriculum – as a mandatory discipline – instead of leaving this important part of learning and character formatting only to the special education sphere?

This symposium represents a collaborative effort of four educators from various disciplines who crossed boundaries to emphasize and foster emotional intelligence and empathic imagination throughout the K-12 curriculum.

The following are the parts of the proposed multidisciplinary panel:

– multidisciplinary approach to revolutionary education, or paradigm shift towards fostering emotional intelligence and empathic imagination across the mainstream curriculum;

– Descartes’ error, the triune brain, and neurobiology of emotional intelligence;

– changing our consciousness: imagining the emotional experience of the other;

– teaching social skills and play therapy in schools: report from the trenches of special education;

– examining cultural artifacts, tools for personal, emotional, and academic development;

– growing kind kids: mindfulness and the whole-brained child;

– Emotional Imprint™ at the street squash: ‘If you talk, you don’t kill.’

Disclosure of interest

The author has not supplied his declaration of competing interest.
Gender Difference among Psychiatric Patient's Profile in Emergency Department
Authors: Gonçalves M. , Teixeira J. , Diana R. , Craveiro a.
Published: May 2016

Introduction

Over the past 40 years, services for psychiatric patients have become increasingly deinstitutionalized, shifting away from inpatient facilities. as a result, patients seek other avenues for treatment, including outpatient facilities and community resources. Unfortunately, those resources have also become increasingly constrained by widespread budget cuts, leaving patients with the health care system's last remaining safety net—the emergency department (ED).

Because EDs are seeing increasing numbers of patients, hospital administrators have recognized the importance of improving throughput and the quality of care delivered in EDs.

The aim of this report is to investigate the gender difference among patient's profile in psychiatric emergency room, assessing the socio-demographic and clinical characteristics, reasons for attendance and practices.

Methods

Retrospective and observational study, conducted at Centro Hospitalar e Universitário de Coimbra, during a three month period. Statistical analysis of data with “SPSS 21”.

Results

During the three months period, a total of 2309 patients were admitted in Psychiatric ED, 1485 female and 824 male.

Regarding clinical data, the authors are expecting to find different psychopathology among male and female, as well as psychiatric comorbidities, diagnoses after discharge, treatment conducts, social support and different rates of psychiatric comorbidities.

Conclusions

Factors such as patient's vulnerability, defined by socio-demographic elements, characteristic as the type and severity of their mental illness, social support, treatment adherence, with significant implications of prognosis, costs and care. The conducted study enabled us to outline a profile of male and female psychiatric patients in ED.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Psychiatric Emergency Prehospital: Incidence and Management of Agitation in Valladolid (Spain)
Authors: Rodriguez Calzada R. , Siesto Marcos M. , Roset  arisso P. , Suarez Fuentes M. a. , Delgado  alonso L. , Rodriguez Calzada M. , Rodriguez Calzada R. , Calzada  amorrortu E.
Published: May 2016

Introduction

agitation is a frequent and complex emergency. Prehospital management of agitation requires appropriate measures to preserve patients’ safety, stabilize the patient and alleviate suffering, and transfer to the hospital psychiatric services, including involuntary admission if needed.

Objectives

To describe the incidence and management of agitation by the emergency medical service of Castilla y León (S aCyL) in an area of Valladolid.

Methods

Retrospective study of all psychiatric emergencies attended by a prehospital emergency medical service in 2014.

Results

one hundred and twenty-one emergencies were attended over a catchment area that covered 170,000 inhabitants (1.4/1000 inhab.). Overall, 55% were men, mean age was 45 years, 60% were considered psychiatric, 29% organic and 11% mixed. However, men had a higher frequency of organic (39%) compared to psychiatric (48%) agitation than women (16% and 75%, respectively), and most of them were related to alcohol or drug use. among patients with psychiatric or mixed agitation 81% had psychiatric history and the pharmacologic treatment most frequently used was intramuscular midazolam.

Conclusions

The incidence of acute agitation accounts for almost half of the total psychiatric emergencies in the prehospital setting. Since there are different healthcare providers in charge, specific protocols as well as treatment procedures are needed to provide the most adequate management, in order to ensure the best psychiatric emergency chain.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Psychological Well-being Among Social Network Users of King Saud University Students
Authors: Alateeq D. , Alhadi A. , AlAteeq F. , Alsubie A. , AlEesa D. , AlShareef S. , Omair A.
Published: May 2016

Introduction

Social networks allow individuals to express themselves, and establish or maintain connections with others. Using social networks like Facebook may be associated with a sense of self-worth and may play an important role in psychological development of university students who are in emerging adulthood phase.

Objective

(1)

Assess the psychological well-being of Saudi university students using social networks (Facebook).

(2)

Explore whether the relationship between Facebook use and bridging social capital is different for individuals with varying degrees of self-esteem and satisfaction with life.

Aim

To study the psychological well-being of Saudi university students using social networks (Facebook).

Method

An electronic survey was published in the community site for all students of King Saud University. in addition to the demographic information, the survey evaluates Facebook use intensity, bridging social capital and psychological well-being: self-esteem and satisfaction with life.

Results

A total of 1005 students completed the survey, of which 50.5% were female. Majority of them were members in Facebook (92.1%).

Conclusions

Results showed no significant correlation between the use of Facebook and psychological well-being. It could be due to the fundamental difference between Arabs and other cultures or due to the use of other social networks. There was a positive relationship between bridging social capital and psychological well-being with being in preparatory year, which is most likely because advanced years has more workload preventing students from participating in King Saud University community. A longitudinal study over a series of years and addressing other popular social networks would be the next step.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Towards a redefinition of dissociative spectrum dimensions inside Capgras and misidentification syndromes in bipolar disorder: Case series and literature review
Authors: Preve M. , Salvatore P. , Mula M. , Favaretto E. , Godio M. , Traber R. , Colombo R.A.
Published: May 2016

Introduction

Misidentification phenomena and Capgras Syndrome (CS) occur in different psychiatric (psychotic or major affective illnesses) and neurological (traumatic brain injury, epilepsy, neurosyphilis, etc.) disorders [1,2]. The aim of this report is to redefine dissociative spectrum dimensions inside CS and misidentification syndromes in patients with Bipolar Disorder (BD).

Method

Five inpatients were assessed with the SCID-P, SCID-DER, DSS, HRSD, YMRS, a neurological and general medicine review, a first-level brain imaging examination (CT and/or MRI). We conducted a systematic literature review (PubMed, Embase, PsychInfo) using the key terms “Capgras Syndrome” and “Misidentificaition”.

Results

All patients were diagnosed with type-I BD and had concomitant CS that presented with misidentification phenomena in the context of psychotic mixed state. They reported high scores for autopsychic and affective depersonalization symptoms as well as high SCI-DER (mean = 24.4) and DSS (mean = 13) total scores.

Discussion and conclusion

To our knowledge in literature, there are not studies that evaluated dissociative spectrum symptoms in CS in BD. This condition of identity and self fragmentation could be the key to shedding light on the interconnection between affective and non-affective psychotic disorders from schizophrenia to BD, and may underscore the possible validity of the concept of the unitary psychosis proposed by Griesinger [3–5]. Further research is warranted to replicate our clinical and qualitative observations and, in general, quantitative studies in large samples followed up over time are needed. Methodological limitations are considered.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
The Assessment of Social Disability in Persons With a Diagnosis of Mental Disorder. Preliminary Data
Authors: Gondek T.M. , Królicka A. , Misiak B. , Kiejna A.
Published: May 2016

Social disability in persons diagnosed with mental disorder is one of the factors preventing them from achieving the broadly defined well-being, even when appropriate and effective treatment is applied. Improvement in the field of social disability is therefore one of the main challenges for the mental health and social welfare policy makers. The second version of the Groningen Social Disabilities Schedule (GSDS-II) is widely used in the assessment of social disability, however the relationship between its degree and many of the clinical and demographic factors have not been investigated thoroughly enough.

The objective of the study is to assess the degree of social disability using GSDS-II as well as to analyze the relationship between the degree of social disability and clinical, social and demographic factors, in patients with a mental disorder diagnosis of F20–F48 according to ICD-10, aged 18–65, in a day ward and an inpatient ward settings.

The paper presents the data gathered from a preliminary sample of 20 patients of both genders diagnosed with mental disorders who gave their informed consent to participate in the study, thus comprising 10% of the targeted total study sample.

Our study, performed on a larger, targeted sample, will provide a better insight into the social functioning of persons with a burden of mental disorder. A precise presentation of the social disability shall improve the model of care offered to these persons. Any possible parallel studies in other countries, employing analogical methodology, could allow for a cross-national and cross-cultural comparison of the received outcomes.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Most Common Diagnoses in First Consultations On Mental Health Centers
Authors: Manso Bazús C. , Valdes Valdazo J. , Garcia Fernandez E. , Velilla Diez L.T. , Min Kim J. , Martinez Martinez C. , Heredero Sanz M.Á.
Published: May 2016

Introduction

It often happens that primary care teams sends to specialized care any type of demand without discriminating on many times.

Objective

Study of diagnoses that get to the consultations.

Methodology

Retrospective observational study with data gathered during 3 months of diagnosis carried out in the first consultations.

Results

The study guides that there is much minor pathology in the first consultation.

Conclusions

Currently, attention on mental health is overcrowded because there is an excess of derivation from minor pathologies. So, an adequate coordination and communication with primary care could improve patients’ care.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Percussions of Different Types of Media on Children's Behavior
Authors: Zaky E.
Published: May 2016

Background

The media has been around for ages, but what we experienced growing up is worlds away from what our children are growing up with today. Media is a double ended weapon that not only can be of priceless value for children if used in moderation but also it could have a tremendous negative impact on their lives.

Objectives

Highlighting the positive and negative percussions of media on children's behavior.

The first 2 years of life are considered a critical time for brain development. TV and other electronic media can get in the way of exploring, playing, and interacting with parents and others, which encourages learning and healthy physical and social development. As kids get older, too much media time can interfere with their activities such as being physically active, reading, doing homework, playing with friends, and spending time with family. So, while using media in moderation could be very beneficial for education, entertainment, and communication with others of different cultures, it could be very dangerous in encouraging risky behavior as substance abuse, violence, and unhealthy eating habits.

Conclusion

Because it is always a matter of quality time and not the quantity of time spent by our children using different types of media, it is so important for caregivers to monitor media content and set viewing and interacting limits for their children and share them in their healthy interests to ensure that our children will not be left on their own in an unknown and potentially risky media world.

Disclosure of interest

The author has not supplied his declaration of competing interest.
A Systematic Review of the Prevalence and Incidence of Neuropsychiatric Conditions in Populations With Traumatic Brain Injury
Authors: Zaman N. , Faruqui D.R.
Published: May 2016

Introduction

The relationship between traumatic brain injury and neuropsychiatric conditions has a strong clinical link. Despite significant clinical presentations, there has been a limited focus on quantifying the association between traumatic brain injury and psychiatric disorders.

Objectives

To conduct a systematic review to determine the prevalence and incidence of neuropsychiatric conditions in patients with traumatic brain injury.

Aims

To determine the association between traumatic brain injury and psychiatric illness.

Methods

A systematic search was made of Medline, PsycINFO, EMBASE and article bibliographies. Search terms for rates of psychosis, mood disorders, anxiety conditions, organic personality disorder, neuropsychiatric disorders, neuro-behavioural disorders, aggression, dementia and frontal lobe disorder were utilised. We followed MOOSE criteria and did not apply temporal limits.

Results

There were 845 relevant searches in total. After exclusion of duplicates, case reports, case series reports, letters, reviews, commentaries, systematic reviews, and editorials there were 143 relevant abstracts identified. This was further reduced to a review of 48 full text papers. We identified prevalence rates of depression between 6.9–62.5%, mania of 9–12.5%, PTSD 1.9–50%, aggression 28.4–57%, anxiety disorders 6–63% (including GAD 8–9%, agoraphobia 2–6%, panic disorder 9%, social phobia 1%) insomnia 11–29%, personality change of 33.3%, dementia 8.16% and substance use 3–8%.

Conclusions

We have identified significant rates of neuropsychiatric morbidity in patients with traumatic brain injury. We have particularly identified limited research studies into psychosis, mania, dementia and personality disorders in this patient group. The review further emphasises the importance of identifying neuropsychiatric comorbidities in post-traumatic brain injury and the importance of addressing these comorbidities.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
One Risk Factor of Depression Disorder in Chinese Women
Authors: Zhang Y. , Feihu L. , Zunxiao D. , Jianguo S. , Qiangju W.
Published: May 2016

Background

The prevalence of major depressive disorder (MDD) is higher in those with the unemployed and those with low social status. Most of the available data comes from studies in developed countries, and these findings may not extrapolate to developing countries. However, the extent of unemployed status cause MDD is unclear. This study seeks to determine whether depressive disorder is associated with unemployment and to further investigate the relationship between occupation, and social class in Han Chinese women with MDD.

Method

Data came from Oxford and VCU Experimental Research on Genetic Epidemiology (CONVERGE) study of MDD (6017 cases, age between 30 and 60; 5983 controls, age between 40 and 60). DSM-IV depressive and anxiety disorders were assessed using the World Mental Health Composite International Diagnostic Interview. All subjects were interviewed using a computerized assessment system. All interviewers were trained by the CONVERGE team for a minimum of one week. The interview includes assessment of psychopathology, demographic and personal characteristics, and psychosocial functioning.

Results

The odds ratio (OR) between employment and MDD is 0.69. An OR of less than one is protective. Lower social class is not associated with an increase in the number of episodes, or with increased rates of comorbidity with anxiety disorders.

Conclusion

This study suggests that in Han Chinese women, employment is positive protect factor to MDD. Lower social status and unemployment increases the risk and severity of MDD. In China, lower socioeconomic position is associated with increased rates of MDD, as it is elsewhere in the world.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Critical Analysis on Legal Capacity of The Mentally Retarded: the Portuguese Reality in the European Context
Authors: Cajão R. , Pereira C.A. , Silva J.R. , Lourenço J.P. , Gil N.P. , Colón M.F.
Published: May 2016

Introduction

Almost 50 years after the mental health reform in Europe and the deinstitutionalization of the mentally ill, there seems to be a slow change in the social concept of mental disorder. However, in the case of mental retardation, little progress has been made, since the social approach to these patients does not seem to involve the promotion of their autonomy. This is a reality with implications in medical, social and forensic psychiatry settings.

Objective

We will present a statistical analysis on interdiction/inhabilitation processes in two districts of Portugal followed by a comparative analysis between Portuguese and other European countries’ civil law concerning the regulation of legal capacity.

Aims

Critical analysis of the means by which the concept of legal incapacity has been applied in the Portuguese social setting.

Methods

Descriptive and retrospective analyses of 500 expert reports in the districts of Coimbra and Viseu regarding interdiction/disqualification processes. Research on Pubmed and legal databases; keywords used: mental disability, mental retardation, civil law, mental incapacity, legal incapacity, legal capacity, interdiction, curator.

Results

The number of forensic psychiatric examinations has suffered a significant increase in the last years. The majority of these expertise concern interdiction/inhabilitation processes. Mental retardation is the more prevalent diagnosis, and the great majority of the cases were interdicted.

Conclusions

In Portugal, the law has been applied in order to safeguard the economic assets of mentally retarded individuals, but not in order to promote their social integration and autonomy.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Mentally ill Patients Who Committed Sexual and Physical Assaults: A Study About 37 Cases of Expertise Reports
Authors: Hajji K. , Marrag I. , Ben Soussia R. , Fathallah S. , Nasr M.
Published: May 2016

Introduction

Several studies suggest the existence of a relationship between major mental disorders and crime. However, it is important to emphasize that violent behaviors do not affect all patients and that issues of criminality among mentally ill persons only represents a small proportion.

Aims

The objective of this study is to establish the general and clinical profile of perpetrators of sexual and physical assaults.

Methods

This is a retrospective study of the records of forensic psychiatric expertise, conducted in the psychiatry department of the University Hospital of Mahdia during the period from May 1st 2000 to May 31st 2013.

Results

The general profile of the population the study was characterized by a mean age of 39 years, a sex ratio of 8.25, unemployment in 73% of cases and by the presence of a psychiatric personal history 54% of cases. Sexual and physical assaults accounted for 54.5% of cases. It was essentially in descending order: assault and battery (65%), rape (16.2%) and incest (5.4%). As for the clinical profile, schizophrenia and epilepsy were recorded each in 13.5% of cases, major depressive disorder in 8.1% of cases, bipolar disorder in 5.4% and substance abuse in 5.4% of cases. A personality disorder was observed in 48.6% cases, essentially antisocial personality (55%). Comorbidity with addictive behavior was observed in 56.7% of cases.

Conclusion

It is necessary to characterize a subgroup of patients with mental disorders, likely to commit violent crimes, in order to prevent acting out behaviors and adapt their management.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Acute Psychotic Disorder and Forensic Acts: About 25 Cases
Authors: Younes S. , Ben Soussia R. , Hajji K. , Marrag I. , Zarrouk L. , Nasr M.
Published: May 2016

Background

The aim of this study was to identify the socio-demographic status and clinical features of patients with acute psychotic disorder and who committed a medicolegal act, seek acute psychosis implicated and raise the characteristics of this medicolegal acts.

Methods

We performed a retrospective study of 25 male patients with acute psychotic disorder. They were involuntary hospitalized in the medicolegal department of Razi, according to Article 29 of Law after committing a medicolegal act because of dementia within the meaning of article 38 of the Tunisian Penal Code.

Results

It was about a young person, average age of 27.32 years, family cohesion was often present (80%), with forensic history (20%), violence history (20%) and substance abuse (40%), having a personality disorder (25%), having a precipitating factor (32%), having an acute psychotic episode (72%), repetitive acute psychotic episode (16%), a first manic episode (8%) and drug-related psychotic disorder (4%). They had committed by order of frequency serious physical assault (43.5%), attempted murder, assault and injury followed by attacks against property (40%). The victim was mostly a family member (40%), without determination, under the influence of toxic substances (16%) and motivated by delusions of persecution (51%). The acting out was recognized (68%). The majority was indifferent (92%) and does nothing (68%).

Conclusion

The first-episode psychosis have a high-risk of acting out, early treatment may prevent some medicolegal acts. Preventing of acting out in the psychotic involves the identification of risk factors and an early treatment of mental disease.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Poor Quality of Mental Health Assessment Reports in UK Family Courts: A ‘call to Action’
Authors: Kurz R.
Published: May 2016

Introduction

Prof. Jane Ireland found that 65% of assessment reports sampled from UK family courts were ‘poor’ or ‘very poor’.

Objective

The presentation raises international awareness of the problem and explains the contextual factors that contribute to malpractice.

Aims

The paper highlights typical deficiencies in family court assessments and forensic processes in order to reduce the risk of unsafe custody rulings.

Method

Due to the paucity of published academic literature ‘ad hoc’ Internet searches were utilised to collect source material and identify advocates. A range of conferences, seminars and continued professional development (CPD) events revealed the background for some of the persistent problems.

Results

The suppression of the trauma-centric approach to mental health issues and its re-emergence are central to understanding the trajectory and how to improve professional practice.

Organised Ritualised Crime Abuse Networks (ORCANs) seem to be at work infiltrating institutions that are supposed to uphold law and order.

Inadequate psychometric instruments appear to beguile some mental health professionals into wrong diagnosis and testimony.

Conclusion

The standard of UK family court assessments must improve. Scrapping ‘forced adoption’ legislation that drives the ‘child snatching’ culture in UK social services department would benefit society including citizens from abroad whose governments vocally criticise the removal of their children through clandestine UK ‘child protection’ procedures.

Disclosure of interest

The author has not supplied his declaration of competing interest.
Prevalence and Nature of Mental Disorders Among Young Offenders in Custody and Community: A Meta-Analysis
Authors: Livanou M. , Furtado V. , Singh S.
Published: May 2016

Introduction

Prevalence studies show that nearly 80% of young offenders present psychiatric comorbidity. Juvenile offenders are at 3 times higher risk of being diagnosed with a psychiatric disorder. Recent systematic reviews have mainly focused on youth in detention neglecting youth in the community. Females and ethnic minorities have been overlooked in the literature in spite of the increasing rates of psychiatric disorders striking these groups.

Objective

To perform a meta-analysis on the prevalence rates of various mental disorders including depression, psychosis, PTSD, conduct disorder, ADHD, learning disabilities and personality disorders among young offenders. Self-harm and suicidal behaviour are examined too.

Aims

To compare the prevalence of psychiatric disorders among young offenders across custody and community and to emphasise on gender, age, and ethnic variations.

Methods

Relevant studies have been identified with computer-assisted searching and scanning of reference lists. Prevalence of mental disorders based on gender, age and ethnicity along with potential moderating factors are extracted from the included studies. Meta-regression is performed to test covariates that might have contributed to differences in prevalence rates across studies.

Results

After searching the relevant literature, 99 studies were determined to be eligible for data extraction.

Conclusions

Young offenders with ongoing mental health problems comprise a vulnerable group within forensic psychiatric services that needs special attention. More prevalence studies should be conducted to improve mental health provision. Ethnic, gender, and age variations across young offenders should be addressed and turn interventions into a tailored process that responds to the young person's particular treatment needs.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Results of Forensic Assertive Community Treatment in Belgium After 33 Months
Authors: Marquant T. , Goethals K.
Published: May 2016

Introduction

Forensic adaptations of assertive community treatment (ACT) remain understudied in Europe, whereas promising results emerge from the United States. There is a need for research into the effectiveness of ForACT outside the United States, as Europe differs greatly in terms of organisation of mental health and judicial system.

Objective

Investigating effectiveness of forensic adaptations of ACT in the area of Flanders, Belgium. Outcome measures are divided into forensic, like arrests or incarcerations, and non-forensic, like admissions and length of stay.

Aims

Investigating effectiveness of ForACT on forensic and non-forensic outcome measures as well as factors related to outcome. A third outcome is community tenure, which is the actual number of days divided by the potential number of days spent in the community.

Methods

A controlled cohort study was designed over with first results at 33 months. The experimental group consists of a new ForACT team in the area of Flanders, Belgium (n = 70). Patients are admitted from prison, psychiatric hospitals or other community-based care. The control group consists of mentally ill offenders in community-based treatment after release from prison (n = 56).

Results

Results on forensic measures and community tenure are promising in favour of the ForACT team. In contrast, clients are often, though shortly, readmitted into psychiatric residential care. Substance use emerges as the main reason for admissions.

Conclusions

A local forensic adaptation of ACT reveals promising results on forensic outcome measures, yet suffers a large number of admissions.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Matricide Versus Patricide in One Croatian Psychiatric Forensic Inpatient Unit
Authors: Pedisic I. , Radic K. , Buzina N. , Jukic V.
Published: May 2016

Introduction

Parricide (referring as parental homicide) is a rare event among homicides, yet challenging and intriguing from psychiatric point of view. Still, literature concerning parricide is sparse and most studies concern small or heterogenous samples or anecdotal cases.

Objective

To analyze differences in parricide offenders among forensic psychiatric inpatients at the university psychiatric hospital Vrapče's centre for forensic psychiatry.

Aims

To test some differences between parricide offenders with regard to specific type of parricide.

Methods

Available retrograde data of 50 years forensic inpatients (n = 430). We identified parricide cases of matricide and patricide included.

Results

The analysis included a total of 22 parricide offenders. All parricide offenders were male adults. Matricide was more prevalent then patricide (13 vs. 9). Matricide offenders were in average younger when committed crime, had more prevalence of psychotic disorders and earlier onset of symptoms in comparison with patricide group.

Conclusion

We identified differences and similarities between these two parricide offenders groups. It is important to expand research further including different types of motives and family dynamics regarding the type of parricide victim.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
The Biopsychosocial Paradigm in the Assessment of Mental Health of Older Persons
Authors: Pishchikova L.
Published: May 2016

The vulnerability of patients of late age in psychiatry increases the professional and ethical requirements to the quality of psychiatric and forensic psychiatric help. It must account for the clinical and dynamic features of mental disorders in old age, biopsychosocial determinants of their formation, be based on a conceptual approach and a comprehensive understanding of the involution processes. To identify biopsychosocial determinants of mental disorders in old age and (or) involving patients to the forensic psychiatric examination, we examined 235 late age patients in criminal and civil cases. Revealed: «non-dement» mental disorders – with 45.5%, psychosis – with 7.7%, dementia – with 46,8%. The results of biopsychosocial determinants of involution are determined as follows: biological: sensory and motor deprivation, multicomorbid somatic neurological pathology, specific syndromes and disorders if late age, dementia; socio-psychological: termination of labor activity, living alone and loneliness, problematic relationship with children because of housing disputes and alcohol; legal: conclusion and contestation of legal civil acts, participation in criminal proceedings as victims and defendants, legal illiteracy, legal controversy, lack of legal protection; victimological: physical (assault, abuse), psychological (threats of commitment into social security institutions, involuntary commitment to a psychiatric hospital and examination by a psychiatrist, hold in the psychiatric hospital), financial violence (fraud with housing for older people and deception, manipulation during conclusion of civil-legal acts), violation of rights of older person (unlawful deprivation of legal capacity).

Disclosure of interest

The author has not supplied his/her declaration of competing interest.
Emotion processing and social functioning in euthymic bipolar disorder
Authors: Aparicio A. , Sánchez-Morla E.M. , Santos J.L. , Mateo J.
Published: May 2016

Introduction

A large number of studies have found that patients with bipolar disorders have a poor performance in tasks assessing social cognition.

Objectives and aims

The present study aimed to investigate whether euthymic bipolar patients (EBP) have a dysfunction in emotion processing when compared to controls. An additional objective was to determine whether there is association between emotion processing and psychosocial functioning.

Methods

A sample of 53 EBP and 53 healthy controls matched for age, gender, education level and premorbid intelligence were studied. All subjects were assessed using the MATRICS Consensus Cognitive Battery (MCCB) and two additional executive function measures: the Trail Making Test–Part B and the Stroop Test. Emotion processing was examined using the Mayer-Salovey-Caruso Emotional Intelligence Test (MSCEIT). Psychosocial functioning was assessed using the Global Assessment of Functioning (GAF) scale and the Functional Assessment Short Test (FAST).

Results

For the MSCEIT, EBP obtained lower total scores (P = 0.001), experiential area scores (P = 0.012), strategic area scores (P = 0.000), perceiving emotions branch scores (P = 0.008), understanding emotions branch scores (P = 0.014) and managing emotions branch scores (P = 0.000) than controls. There were no significant differences between groups for the using emotions branch (P = 0.113). In addition, partial correlations controlling for sub-clinical psychopathology in EBP showed the existence of a significant correlation of MSCEIT total score and MSCEIT strategic area score with FAST total score.

Conclusions

EBP exhibit deficits in several areas of emotion processing. Performance in emotion processing tasks is associated with social functioning in these patients.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Delirium, Hallucinations and Criminal Liability
Authors: Turki M. , Halouani N. , Naoui R. , Gassara I. , Hamza N. , Aloulou J. , Amami O.
Published: May 2016

Introduction

The relationship between psychotic motivation and the genesis of medico-legal acts is well documented in the literature. Delirium and hallucinations, in particular, have been widely reported in this context.

Objective

The aim was to identify socio-demographic, clinical, and criminological profile of patients hospitalized for forensic acts committed in psychotic context.

Methods

We conducted a descriptive retrospective study, including 7 patients committing a forensic act in psychotic context, selected among all patients hospitalized after a judgement of dismissal (Tunisian law), in psychiatry department, Hedi Chaker university hospital, Sfax, Tunisia. Socio-demographic and clinical data were collected through patients’ observations.

Results

The mean age was 37.7 years. Sex-ratio (M/F) was 6. The criminological act was an attack in 57.1% and homicide in 42.9% of cases. It was committed on the outside in 42.9% of cases. The tool was a bladed weapon in all cases. The victim was a family member in 71.4% of cases. The context was a delirium in 71.4% (theme: 80% persecution, 20% jealousy; mechanism: 40% hallucinatory, 60% interpretative) and hallucinations in 42.9% of cases. Among our patients, 57.1% were indifferent and 28.6% regretted the act. Psychiatric diagnosis was: schizophrenia 57.1%; delusional disorder 28.5% and brief psychotic disorder 14.2%. Personality disorder was reported in 28.6% of patients.

Conclusion

The acting out in a psychotic moment in patients with mental illness remains the most formidable event, causing sometimes the problem of criminal liability. Control of attendance at psychotherapy and psychotropic treatment are preventive and curative necessary measures to avoid crossing the dangerous acts.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Neurofarmagen® Testing and Drug Side Effects: An Evaluation of its Use Among a Real-world Case Series
Authors: Oliva F. , Pomeri A. Portigliatti , Nibbio G. , Giuseppe M.
Published: May 2016

Introduction

Various pharmacokinetic and pharmacodynamics features have proven to be involved in the development of drug-induced side effects in psychiatry and thus pharmacogenetic profiling should be considered during drug selection to avoid the onset of side effects.

Aim

To explore the usefulness of Neurofarmagen® testing in clinical practice by evaluating whether the genetic profile given by the tool could properly explain the onset of side effects during antipsychotic treatment.

Methods

The pharmacogenetic profile of ten patients having a history of side effect appeared during to specific a psychopharmacologic treatment was determined by Neurofarmagen® testing tool. The relationship between genetic profile and side effects was evaluated and classified.

Results

Sixty percent of the sample showed a genomic alteration related to a increased likelihood of having any side effects, one half of which presented pharmacokinetic alteration (slow or intermediate phenotype for the implicated cytochrome) whereas the other half had a pharmacodynamic gene variant (related to dopamine or serotonin pathway).

Conclusion

the Neurofarmagen® testing tool may be useful in the clinical practice in order to avoid drug-induced side effects.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
A Case Report of Charles Bonnet Syndrome – The Silent Doubt: Am i Crazy?
Authors: Lopes A. , Sales P.
Published: May 2016

Introduction

The Charles Bonnet syndrome refers to symptoms of visual hallucinations that occur in patients with visual acuity or visual field loss. These are often called release hallucinations, reflecting the most widely accepted theory about their pathogenesis. The syndrome is most found in elderly patients, 70–85 years, and this probably reflect the mean age at which the most common underlying conditions are seen. It is probably more common than is thought and because either it is misdiagnosed as psychosis and/or dementia or it is not reported by patients because they fear that the hallucinations represent psychiatric disease.

Objective and method

The authors present the clinical case of a 89-year-old woman, with no previous psychiatric disease, admitted to hospital because of visual hallucinations in form of children and animals. She experienced them during months until she told someone. No psychiatric symptoms were found. The lady had a serious cataract on the left eye with total loss of the visual acuity, as documented by ophthalmologic examination.

Results

The patient initiated quetiapine 300 mg and will have period appointments with a neurologist. Further future information will be presented.

Conclusions

A correct diagnosis is essential to treat these patients and explaining them the meaning of the hallucinations is generally relieving. Many author disagree with antipsychotic agents, while others report benefit.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Paliperidone Palmitate in Psychogeriatric Patients and New Criteria Stopp-start
Authors: Martinez Perez I. , García Sánchez F. , Raposo Hernandez M.R. , Gil Sánchez A. , Gonzalez Galdamez A.L. , Piqueras Acevedo M.D. , Lujan Rico J.M. , Belmar Simo A. , Garcia Briñol C.J.
Published: May 2016

The treatment of psychosis in the elderly should ensure effectiveness and avoid side effects from combination therapy. Long acting antipsychotic as paliperidone palmitate facilitates this work. Furthermore, STOPP-START criteria, first published in 2008 (in Spanish in 2009), are being adopted as reference criteria throughout Europe. The Spanish version of the new 2014 edition is also recently published [1]. A descriptive study of a total of 53 institutionalized patients in psychogeriatric residence (> 60 to 97 years) with psychotic disorder diagnosis and treatment with various neuroleptics is done. In total, 26.4% of the sample admitted to treatment with three different antipsychotics, and 47.1% with combination of two antipsychotics. Only 26.4% worked with antipsychotic monotherapy. In these patients, treatment with paliperidone palmitate starts or sets the previous dose. A CGI scale is applied after six months of treatment. Antipsychotic monotherapy in 66.66% of patients on neuroleptic combination therapy was achieved, so that 75% of the sample currently maintains monotherapy with paliperidone palmitate. The paliperidone palmitate has shown effectiveness in the symptomatic control and reducing the risk of inapropiate prescribing in older patients with psicosis. The paliperidone palmitate allows antipsychotic monotherapy in the psychogeriatric patient with severe mental illness polymedicated as the STOPP-START criteria recommends.

Reference not available.

Disclosure of interest

The authors have not supplied their declaration of competing interest.