bluuebunny/crossref_metadata_2025 huggingface dataset:
Sociocultural Factors in Mental Illness: Biopsychosocial Model
Authors: Rodríguez Vargas S. , Navarro Clemente M.J. , Ivorra Mayoral A.R.
Published: May 2016

Every human being needs to acquire by interacting with peers, learning and gradually adapted to their socio-cultural environment, attitudes, group, class, gender, provided it fits the circumstances of the environment, personal values to their They come again, a reference system which is considered to be “culture”. You cannot assess psychiatric disorders in isolation, so it is essential to study the socio-cultural context in which it occurs. It is dynamic, its historic time and not everyone integrates alike. Through a case we try to show how culture influences the expression of psychiatric pathology. Specifically, in this patient it is evident that we are beings bio-psycho-social. It is a continuation and must integrate these three areas when assessing a patient. Here we start with a family history unrelated to the Mental Health so that adherence to antipsychotic treatment is guaranteed with monthly administration depot preparation. These socio-cultural factors are the main trigger for the breakdown of the subject that cause the patient psicotización (exacerbations related to stressful situations).

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Neuroimaging Biomarker of Major Depressive Disorder
Authors: Ichikawa N. , Okamoto Y. , Okada G. , Lisi G. , Yahata N. , Morimoto J. , Kawato M. , Matsuo K. , Yamagata H. , Watanabe Y. , Yamawaki S.
Published: May 2016

Introduction

Recent studies have shown that it is important to understand the brain mechanism specifically by focusing on the common and unique functional connectivity in each disorder including depression.

Objectives

To specify the biomarker of major depressive disorder (MDD), we applied the sparse machine learning algorithm to classify several types of affective disorders using the resting state fMRI data collected in multiple sites, and this study shows the results of depression as a part of those results.

Aims

The aim of this study is to understand some specific pattern of functional connectivity in MDD, which would support diagnosis of depression and development of focused and personalized treatments in the future.

Methods

The neuroimaging data from patients with major depressive disorder (MDD, n = 100) and healthy control adults (HC: n = 100) from multiple sites were used for the training dataset. A completely separate dataset (n = 16) was kept aside for testing. After all preprocessing of fMRI data, based on one hundred and forty anatomical region of interests (ROIs), 9730 functional connectivities during resting states were prepared as the input of the sparse machine-learning algorithm.

Results

As results, 20 functional connectivities were selected with the classification performance of Accuracy: 83.0% (Sensitivity: 81.0%, Specificity: 85.0%). The test data, which was completely separate from the training data, showed the performance accuracy of 83.3%.

Conclusions

The selected functional connectivities based on the sparse machine learning algorithm included the brain regions which have been associated with depression.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
From Obsessivity to Bipolarity and Vice Versa. A Literature Review
Authors: Cano Ruiz P. , Cañas Fraile S. , Gómez Peinado A. , Sanmartin Salinas P.
Published: May 2016

Introduction

The prevalence of obsessive symptoms in bipolar patients is currently under discussion. Last years, different cases of antidepressant-induced mania and hypomania in patients with OCD have been described.

Several authors have reported that patients with OCD and bipolar disorder have more depressive episodes than patients with only OCD.

Objective

To know the relationship between OCD and other bipolar spectrum disorders.

Method

Bibliographical review on comorbidity between obsessive symptoms and bipolarity.

Results

Some longitudinal analysis have shown that patients firstly diagnosed with OCD have an increased risk for subsequent diagnosis of all other conditions, especially for bipolar and schizoaffective disorder, for those whose risk is of up to 13 times higher. The handling of a patient with bipolar disorder and OCD implies some difficulty, because of the main treatment of anxiety disorders, the antidepressants, alters the course of manic-depressive illness, accelerating cycles.

Conclusions

OCD is etiologically related to bipolar spectrum disorders and schizophrenia. Therefore, it is necessary to continue the investigation of possible involved genes and approaches for clinical practice.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Obsessive-Compulsive Disorder in Childhood and Adolescence
Authors: Freitas C. , Ferreira M.C. , Correia T. , Portinha I. , Correia Z.
Published: May 2016

Obsessive-compulsive disorder (OCD) is a severe mental illness that causes significant stress in children and adolescents. It is possible to infer three distinct etiologies – neurobiology, environment and dysfunctional interpretative patterns. Certain characteristics are attributable to OCD with onset in childhood or adolescence as higher prevalence in males, increased frequency of isolated compulsions (more cleaning, repeating and checking), higher rate of aggressive obsessions and more common accumulation behaviors. There are several psychiatric comorbidities associated with OCD like anxiety disorder and major depression. The first-line treatment in OCD is the association of a selective serotonin reuptake inhibitor (SSRI) and individual psychotherapy.

The authors reviewed the clinical records of patients diagnosed with OCD observed in a child and adolescence psychiatry liaison consultation between April and September 2015, inclusive, aiming to characterize the sample, to describe the typical clinical picture and to evaluate the existence of physical and/or psychiatric comorbidities, comparing the results with those expected in literature.

The typical patient profile found was a 12-year-old male, living with relatives, with no neonatal complications, with stable home environment, without family psychiatric history, with associated medical comorbidities, with age of onset symptoms at 10.5 years-old, with only an obsession (contamination), with only a compulsion (cleaning or checking), with psychiatric comorbidities, treated with SSRI and without psychologyaccompaniment.

There are some limitations that must be taken into account because the sample was taken from a liaison psychiatry consultation, but in general terms, the results were similar to those described in the literature.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Disorganized attachment and psychological symptoms in children with somatic symptoms disorders
Authors: Bizzi F. , Charpentier Mora S. , Cavanna D.
Published: May 2016

Introduction

Somatic symptoms disorders (SSD) are one of the most neglected areas in child and adolescent psychiatry (Mohapatra et al., 2014). SSD are characterized by multiple and variable physical symptoms without demonstrable pathophysiological processes. Literature has investigated the role of several psychological variables in SSD, with inconclusive data. Moreover, there is a paucity of studies on middle-childhood and early adolescence in this clinical condition.

Objectives

We focus on the role of attachment and on psychological aspects in children with SSD.

Aims

The aims are to verify the presence of:

– an overrepresentation of attachment disorganization in these children;

– an overrepresentation of psychological symptoms.

Methods

Fifty-six consecutive Italian patients with SSD, aged from 8 to 15, were administered Child Behavior Checklist (Achenbach, 1991) and Child Attachment Interview (Shmueli-Goetz et al., 2000).

Results

Findings showed:

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

– high levels of anxiety and depression.

Conclusion

This study extended previous research in middle-childhood and early adolescence in SSD. The findings support the influence of the disorganization aspects and the psychological problems surrounding the SSD. The clinical implications for future research directions are discussed.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
What do we share during a meal? Exploratory study of shared stories in ADHD children
Authors: Boulard A. , Leclercq C.
Published: May 2016

Introduction

Many research focus on the study of language in ADHD children. However, the discourse is beyond the language and provides access to child representations of the world, to its own history. The aim of our study was to compare and analyze the self-narratives during a family meal.

Method

Speeches of 5 children (6–10 years) were recorded, analyzed and then compared to a strictly matched control group. Once transcribed, the data were morphosyntactically annotated and processed using multivariate exploratory techniques. A thematic analysis was also realized to understand how ADHD children moved from one conversation topic to another.

Results

Our first results showed that ADHD children have more difficulty in producing self-narratives while they are doing something else (eat). Moments of sharing common stories are less frequent compared to the control group. The transition from one topic to another is made by direct associations (e.g. the child talks about what he is eating, and this leads him to think about the next day's dinner). The construction of the self-narratives is poorer compared to the control group, both in content and in length of utterances.

Conclusion

Interestingly, concerning ADHD children, it appears:

– That these self-narratives exist;

– but also that they are poorer;

– that they allow, less frequently than in the control group, projections into the future or recollection of past events.

If ADHD children cannot access to these moments, special attention should be paid to this sharing of family history outside of daily activities.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
A New Look at Personality Disorders Treatments
Authors: Neves S. , Tudela J.
Published: May 2016

Introduction

Mental illness develops and is inseparable from the sociocultural context. The Disturbances may exhibit different symptoms in different cultures. In personality disorders, there is a pathological expansion of normal traits that often demonstrate a sociocultural change. The quality of life of these patients can improve with certain treatments, which appears to be relevant to be achieved.

Method

Search on Pubmed and Medline for original research or review articles published in English or Portuguese in the last 10 years. It used a combination of terms: “personality”, “treatment”, “personality disorder”, “borderline”, “antissocial”, “pharmacotherapy”, and other named personality disorders.

Objectives/Aim

Search the evidence base and the new perspectives for the effective treatment of personality disorders.

Results

The same personality traits may be adaptive or non-adaptive in different contexts. So, without changing these characteristics, patients can learn to use them more effectively. In other words, although the therapy did not change the personality traits, it can be modified in the way they affect the behavioral expression.

Conclusions

Psychological or psychosocial intervention is recommended as the primary treatment for borderline personality disorder and pharmacotherapy is only advised as an adjunctive treatment. The amount of research about the underlying, abnormal, psychological or biological processes leading to the manifestation of a disordered personality is increasing, which could lead to more effective interventions.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Family and Professional Functioning in Patients With Personality Disorders
Authors: Zioła A. , Wypiór M. , Sobieraj A. , Krysta K.
Published: May 2016

Introduction

Personality disorders (PD) are weight group of conditions. As possible causes of PD, literatures indicates being victim/witness of domestic violent. There is valid suspicion that PDs may have influence on marital status, education level and professional activity.

Objective

Studying the PD influence on patients quality of life concerning both personal and professional areas of life.

Aim

Analysis of the exposition to the violence in relation to PD diagnosis. Evaluation of the education level and professional activity in studied group, furthermore marital status.

Methods

Retrospective analysis of 123 patients diagnosed with PD hospitalized over the years 2012-2015 in the Department of psychiatry and psychotherapy, medical university of Silesia hospital. Statistic analysis of variables and comparing with previous researches.

Results

Three quarters of hospitalized patients were females.

Average age was about 50 years old.

Proximal martial status: 40% single, 60% formalized relationship (about 20% were divorced).

Among participants, 50% were employed, and 80% have completed at least 12 years of education.

About 40% had been victim/witness of domestic violence.

Conclusions

The patients with PD had often experienced the domestic violence in childhood. Higher risk of impaired personality development with patients, who had been violence victim or witness is possible and they need to be advised accordingly. Research did not reveal PDs’ influence on the education level. To define correlation between employment or marital status and PD further researches are needed.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Phenomenology of ADHD
Authors: Sanahuja C. , Suarez A. , Fernandez C.
Published: May 2016

Introduction

Phenomenology is a term borrowed from philosophy which refers to the study of the structures of experience and consciousness. Founded as a school by Edmund Husserl in the early 20th century, it was later expanded and modified by many others, including Martin Heidegger, to include the analysis of existence and hermeneutics.

Objectives and aims

To explain the clinic phenomenology of ADHD based on the historical bibliography regarding this term, making references to the heterogeneity of its phenomenological presentation depending on social context, age and gender.

Methods

To go over the historical considerations of phenomenology and its evolution, as well as its clinical applications, in order to use this knowledge in a clinical context based on the observation of different cases in clinical practice.

Results

We try to apply the phenomenological method as first inaugurated by Karl Jaspers’ General Psychopathology (1913) to analyse the different clinical phenomena that can be observed in patients diagnosed with ADHD.

Conclusions

We think that watching the psychiatric conditions, in this case ADHD, through the phenomenological lens can lead to a better understanding of the heterogeneity of their appearance in the clinical practice.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
The Other, Role Theory, Key Elements on the Development of One-Self and Psychopathology
Authors: F.I.Z.  , C.Z.  , J.V.
Published: May 2016

We plan to analyze the psychological and sociological concepts of the other and the role theory. We would describe the roles in psychopathology differentiating between the identity of the role and the identity of oneself and its entailment with the other, with respect to the development of the individual and its difficulties in the acquisition of roles, leading to different clinical entities. These pathologies show phenomenological differences observed in clinical situations such as schizophrenia, depression, bipolar disease, personality disorders and in psychopathological manifestations of epilepsy. We analyze the difficulties schizophrenic patients have in assuming roles, as well as in the recognition of “the other”, depressive patients and their over identification of roles, the link to manic states, and a poor identity observed in patients with hysteria. Special considerations are made in the social interactions of epileptic patients with “the other” which takes the form of “being with”, and the dynamics established by epileptics in their social roles. These characteristics are also found in epileptic psychoses. When a psychotic state ends, and patients recover from a clear or lucid epileptic psychoses, they return to work recovering their social roles and interaction with others. In the case of cognitive impairment and organic dementia, there is a difficult adaptation due to this disability. Experiences lived under the psychotic episode are maintained, even reinforced and influence how they consider themselves and the others, in particular in terms of moral and religious ideas.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Dimensions of DSM-5 Posttraumatic Stress Disorder (PTSD) Symptoms
Authors: Soberón C. , Crespo M. , Gómez-Gutiérrez M. , Fernández-Lansac V.
Published: May 2016

Introduction

Despite the four factor model of PTSD proposed in the DSM-5 (APA, 2013) has received a better empirical support than three factor model of DSM-IV (APA, 1994), some alternative models proposed can provide a better representation of PTSD's latent structure.

Objective

The current study tested the fit of seven models, including the 3-factor DSM-IV model (APA, 1994), the 4-factor DSM-5 model (APA, 2000), the 4-factor dysphoria model (Simms, Watson & Doebbeling, 2002), the 5-factor dysphoric arousal model (Elhai et al., 2012), the 6-factor anhedonia model (Liu et al., 2014), the 6-factor externalizing behaviors model (Tsai et al., 2014) and the 7-factor hybrid model (Armour et al., 2015) that combines key features of the anhedonia and externalizing behaviors models.

Aim

It expected that the 7-factor hybrid model (Armour et al., 2015) would be the best fitting model.

Methods

PTSD symptoms were assessed using the Global Assessment of Posttraumatic Stress Disorder (EGEP-5; Crespo, Gómez & Soberón, 2016) in a sample of 165 victims of different traumatic events. Confirmatory Factor Analysis (CFAs) were conducted on each of the seven models using Maximum Likelihood (ML) estimation method.

Results

All the models tested (except for DSM-IV model) yielded an adequate fit to the data. However, 7-factor hybrid model (Armour et al., 2015) provided a better fit than other competing models.

Conclusions

The current findings suggest that the dimensional structure of DSM-5 PTSD symptoms may be best represented by the 7 factors proposed in the hybrid model instead of 4 factors of DSM-5.

References not available.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
The Impact of Early Affiliative Memories on Psychological Health: The Mediator Role of External Shame and Cognitive Fusion
Authors: Ferreira C. , Mendes A.L. , Marta-Simões J. , Trindade I.A.
Published: May 2016

Early positive interactions have been positively associated with positive mental health outcomes. In contrast, the lack of these early affiliative experiences of warmth and safeness can have negative consequences on the individual's physical, emotional and social development.

The current study tests a mediation model that examines the mediator effect of external shame and cognitive fusion on the association between early affiliative memories with attachment figures and with peers, and psychological quality of life. These analyses were conducted using a sample of 453 participants from the community.

The final model explained 47% of psychological quality of life and presented excellent model fit indices. Results from path analysis showed that both early affiliative memories of warmth and safeness with peers and attachment figures present a significant impact on psychological quality of life through the indirect effect of external shame and cognitive fusion. In fact, although early affiliative memories with peers also presented a direct effect on psychological quality of life, the impact of early affiliative memories with attachment figures on this outcome was totally mediated through the mechanisms of external shame and cognitive fusion.

These findings seem to provide an important contribution to the field of early affiliative memories of warmth and safeness with attachment figures and with peers by uncovering the mediating role of external shame and cognitive fusion. Furthermore, these data highlighted the relevance of developing intervention programs in the community, especially in a context of early adverse experiences, for the promotion of mental health well-being.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Mental Health and Empathy: Do Nursing Students Have Better Attitudes to Psychiatric Patients?
Authors: Pascucci M. , Capobianco F. , La Montagna M. , Stella E. , Ventriglio A. , Rubini G. , De Angelis A. , Parente P. , Janiri L. , Pozzi G. , Di Nunzio V. , Piemontese G. , Bellomo A.
Published: May 2016

Background

Stigma towards mental illness has a major impact on the quality of life and the health care of psychiatric patients. Several studies have reported that health professionals have more negative attitudes than general population.

Aims

To explore empathy and attitudes towards mental illness in nursing students (NS) and non-health university students. Our purpose is to see how NS have more empathic and less stigmatizing attitudes towards psychiatric patients, compared to other university students.

Methods

We tested 96 university students (50 NS and 46 non-health university students), with the following questionnaires anonymously filled out:

– Community attitudes towards mental ill (CAMI), to evaluate the different students’ attitudes towards mental illness;

– Empathy quotient (EQ), to assess empathy.

Results

NS differs from the other group in 5 items of CAMI (P < 0.05 in 3 items and P < 0.01 in 2 items), and Authoritarianism subscale (P = 0.023). This shows that NS have a greater general awareness and less stigmatizing attitudes about the need to hospitalize the mentally ill, the difference between psychiatric patients and general population, the wrong need of segregation and the real causes of mental illness. There is also a significant difference in EQ (items 6, 21, 25, 44, 59): future nurses seem to have a slightly higher empathy, even though the EQ total score does not differ in the two groups.

Conclusions

These results suggest that there is a difference with respect to the attitudes towards psychiatric patients in NS and students who do not follow health-care courses: NS have more empathetic and less stigmatizing attitudes.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Obsessive Versus Delusional Jealousy: Destruction in a Form of Creation – A Review
Authors: Almeida Leite R. , Conde E. , Queirós Santos T. , Almeida M. , Azevedo Santos T. , Mesquita Figueiredo A.
Published: May 2016

Introduction

Jealousy is a complex emotional state and some degree is considered normal in mature love, but when does it become destructive in a relationship? There's a thin line between what is normal and what is pathologic. Pathological jealousy differs from normal by its intensity and irrationality. Obsessive and delusional jealousies are different types of pathological jealousy, difficult to distinguish, which is important, since they have different treatment. Despite the differences, both result in significant distress and carry the risk of homicide/suicide, so it's a matter deserving the psychiatrists’ attention.

Objective

Explore the psychopathological differences between obsessive and delusional jealousy and list the characteristics and difficulties in the approach to pathological jealousy.

Methods

The results were obtained searching literature included on the PubMed and Google Scholar platforms.

Results

Delusional jealousy is characterized by strong and false beliefs that the partner is unfaithful. Individuals with obsessive jealousy suffer from unpleasant and irrational jealous ruminations that the partner could be unfaithful, accompanied by compulsive checking of partners’ behavior. This jealousy resembles obsessive-compulsive phenomenology and should be treated with SSRIs and cognitive-behavioral therapy. Delusional jealousy is a psychotic disorder and should be treated with antipsychotics.

Conclusion

The common issue in pathological jealousy is the problem of adherence to treatment and bad prognosis. In order to achieve better treatment outcomes, we should follow-up the patient regularly. One key factor is to explore the psychopathology and motivate the sufferer for the proper pharmacological and psychotherapeutic interventions, trying to reduce the suffering caused by ideas of unfaithfulness.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Comparisons of psychological characteristics between schizophrenia, bipolar disorder and depressive disorder patients
Authors: Shin M.S.
Published: May 2016

Introduction and objectives

This study was conducted to examine the psychological characteristics of the schizophrenia (n = 20), bipolar disorder (n = 20) and depressive disorder (n = 13) patients on MMPI-2 and Rorschach responses.

Methods

MMPI-2 and Rorschach was individually administered to all patients, and their Rorschach responses were scored by Exner's comprehensive scoring system. The means of T scores of MMPI-2 subscales and Rorschach scores were compared among the three groups.

Results

The schizophrenic and bipolar disorder groups showed significantly higher scores on the MMPI-2 K scale than the depressive group, while the depressive group showed significantly higher score on MMPI-2 Si scale than the schizophrenic and bipolar groups. In Rorschach responses, the bipolar and depressive groups obtained significantly higher scores on two variables (FM + m, m) than the schizophrenic group. The bipolar group obtained significantly higher scores on three variables (es, CP, a), suggesting hyperactivity and mood dysregulation.

Conclusions

These results suggested that patients with depressive disorder might subjectively suffer from more severe emotional and social discomfort than patients with the schizophrenia and bipolar disorder, while patients with bipolar disorder and schizophrenia would be more defensive than the depressive patients.

Disclosure of interest

The author has not supplied his/her declaration of competing interest.
A case report: Sanchís-Banús syndrome
Authors: Valdés Valdazo J. , Franch Pato C.M. , Martínez Martínez C. , Serrano García A. , De Santiago Sastre J. , Ugidos Fernández A. , Min Kim J.
Published: May 2016

Introduction

There are few reported cases relating visual acuity and psychosis. The Spanish psychiatrist Sanchís-Banús focused on two patients who became blind and who, due to stress developed paranoid and jealousy delusional ideas. He called it “Sanchís-Banús syndrome” (SBS) that is mentioned in the psychiatry literature.

Methodology

A case report. We present a case of “paranoid delusion of the blind” (SBS), quite similar in its clinical characteristics to those of the original patients of the valencian psychiatrist Sanchís-Banús. In our case, we met a 46-years-old woman, who worked as a lottery seller because she had a visual problem: retinitis pigmentosa. She had had her first psychotic decompensation when the blindness started. In spite of having achieved good social and work performance with quetiapine 400 mg/daily, laboral conflicts and stress caused her delusional ideas again. She began to think that her mother was not her real mother (Capgras syndrome) and that she was being persecuted. She also did not eat the meal and did not drink water because she thought that they were contaminated.

Results

We started treatment with clozapine at doses of 300 mg every day (50-50-200) combined with aripiprazole15 mg/day tolerating the medication without notable effects. After this adjustment of medication, remission and good criticism of hallucinatory and delusional clinical course. The nosological, clinical, and prognostic features of SBS are discussed in light of the current literature.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Do I need treatment? Insight and therapy adherence in a group of patients in treatment with aripiprazole long acting injectable
Authors: Berta S. , Víctor C. , Ivan T. , Julia M. , Silvia O. , Sandra C. , Estanislao M. , Miguel M. Luis , Noelia B.
Published: May 2016

Introduction

Relapse prevention is one of the major goals in psychiatry because it will mark the prognosis and quality of life in patients. In this aspect, plays a very important role insight and adherence to treatment. Some studies show that long acting injectable treatments improve adherence as compared with oral medications.

Objective

The objective of this study is to analyse the degree of insight and adherence to treatment of a group of patients with aripiprazole long acting injectable ALAI treatment.

Methodology

Descriptive study in a group of patients treated with ALAI. Three months of follow-up. To assess the insight we had use the 3 first items of the Unawareness of Mental Disorder SUMD. Adherence to treatment is evaluated by monitoring if patients come to administrate ALAI.

Results

n = 6, 2 women (33.3%) and 4 men (66.7%). The mean age of the sample was 37 years. Diagnoses were 4 patients with psychotic disorder (66.7%;) 2 with bipolar disorder (33.3%). At the SUMD, mean score for the items consciousness of having a disorder and awareness of the effects of medication was 3, and for the item awareness of the social consequences of mental disorder 4. The mean score for the total punctuation was 10. Five (83.3%) had a 100% of adherence, just 1 patient discontinued de treatment on the third month.

Conclusions

On our sample adherence, it was almost complete in all patients. To highlight the scores for SUMD which means low insight. A large sample is required to increase the reliability of the study.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Analysis of the diagnoses of patients treated with palmitate paliperidone
Authors: Diago Labrador C. , Álvarez Montoya A.M. , Ruano Hernández T.
Published: May 2016

Objectives

Review of the diagnoses of the treated patients with palmitate paliperidone for one year in a mental health unit, as well as some of their key sociodemographic characteristics, the length of the hospital stay and the average treatment according to clinical diagnosis.

Methods

Descriptive epidemiological study including patients admitted to our hospital. It covers the period from January 2014 to December 2014.

Results

For the period between January and December, a total of 315 patients were admitted in our mental health hospital unit, of which 45 were treated with paliperidone palmitate. The diagnosis were: schizophrenia (25 patients; 55.56%), schizoaffective disorder (7 patients; 15.56%), delusional disorder (5 patients; 11.11%), bipolar disorder (1 patient; 2.22%), personality disorder (2 patients; 4.44%), obsessive-compulsive disorder (1 patient; 2.22%), organic brain disorder (1 patient; 2.22%), schizophreniform disorder (1 patient; 2.22%) and mental retardation (1 patient; 2.22%). The mean age of patients was 35.7 years old. The most common marital status was unmarried state (30 patients; 66.6%). The average stay per hospital admission was 19.33 days. The most abused drugs were tobacco (31 patients; 68.8%). The mean dose of paliperidone palmitate was 137.5 mg. Schizophrenic patients need higher doses of treatment.

Conclusions

A significant improvement in functionality was observed in our patients. What's proven efficacy and good tolerability and adherence, so we consider paliperidone palmitate as a drug of first choice in the treatment of schizophrenia.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Nalmefene and alcohol use disorder
Authors: Díaz Piñeiro M.D. , Gutiérrez Ortega M.A. , Mateos Agut M. , Martín Martínez E. , Sanz Cid B.
Published: May 2016

Introduction

Psychopharmacology study.

Objective

To evaluate Nalmefene effectiveness in clinical practice in patients diagnosed with alcohol use disorder.

Method

Descriptive, prospective and observational study with patients diagnosed with alcohol use disorder, treated with Nalmefene during 6 months.

Results

Twenty-seven patients (9 women and 18 men); average age: 47.92. A total of 64.28% with F10 as an exclusive main diagnosis. Drink urge perception at the beginning: 6.37 points over 10.6 months later, 3.25 points. Loss of alcohol drinking control perception at the beginning: 6.03 points over 10. Six months later, it is reduced down to 2.37 points. GGT reduction (from 107.18 to 36.5 U.I./L) and Mean Corpuscular Volume reduction (from 90.2 to 88.9 fl). The average of days/month with binge drinking at the beginning was 16.18 SD (standard drinks); and monthly total of alcohol consumption is 182.75 SD. After a month: 4.6 days and 66.52 SD. After 6 months, it decreases to 4 days/month and 63.3 SD. The results of the Rhode Island Change Assessment scale are: 7.4% in pre-contemplation stage, 70.37% contemplation stage, 3.7% action stage and 18.5% in maintenance stage. Six months later: 75% contemplation, 12.5% action and 12.5% maintenance stage. The main side effects were: nausea and vomiting, 22.22% at the beginning and 12.5% that persist with intakes; sexual side effects in 22.22% throughout the treatment; the 14.8% report increased sleeping and dreaming, 14.8% report restlessness, after six months drowsiness prevails with a 18%. At first, orthostatic dizziness appears in a 14.8%, disappearing 4 weeks later.

Conclusion

Nalmefene is effective in reducing alcohol consumption, with few side effects and good acceptance.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Tropicamide eye drops reduce clozapine-induced hypersalivation: A case report
Authors: Kilic O. , Ozturk H.M. , Ata E.
Published: May 2016

Introduction

Clozapine-induced sialorrhea (CIS) is a common, treatment-limiting and stigmatizing side effect. All systemic agents that are used for hypersalivation may increase clozapine side effects such as blood pressure changes, constipation, or arrythmias. Oral application of topical anti-muscarinic agents may be a low side effect option for treatment of CIS.

Objective

The aim of this case report was to propose an off-label treatment of tropicamide drops to CIS and to stimulate further investigation.

Case report

A 33-year-old male inpatient with schizophrenia has been on clozapine 800 mg and amisulpride 600 mg/day. His drooling was occasional and severe as drool drips off his chin during the day and night. Wet area over the pillow, visual analog scale (VAS), the short form of health survey (SF-36), UKU side effect rating scale, scale for the assessment of negative symptoms (SANS), scale for the assessment of positive symptoms (SAPS) were applied at baseline and in one-week intervals. Oral application of one drop of tropicamide % 0.5 (5 mg/mL) to left and one drop to right side before going to bed in the first week and two drops to each side were administered subsequently. Informed consent was given by the patient.

Results

No psychological, neurological, autonomic and other side effects were observed associated with tropicamide. On VAS, the patient rated hypersalivation 5/7 at baseline, 4/7 after one drop each, 3/7 after two drops each.

Conclusions

The reduction of CIS by oral use of tropicamide eye drops is promising and should be explored with randomized controlled trials.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
California rocket fuel: And what about being a first line treatment?
Authors: Silva J. , Mota J. , Azevedo P.
Published: May 2016

Introduction

The association venlafaxine-mirtazapine is currently known as California Rocket Fuel (CRF). Studies show advantage in terms of efficacy and rapid control of depressive symptoms compared to other associations. Venlafaxine is a selective serotonin-noradrenalin reuptake inhibitor and mirtazapine is a noradrenergic-specific serotonergic antidepressant: the result is a potent noradrenergic and serotonergic effect. Studies say that CRF should be performed only for drug-resistant depression; however, there are case reports of its use as a first line treatment, in selected patients.

Objectives

To summarize the latest literature about this field and to present a case report.

Aim

To explore and critically review the controversies of venlafaxine-mirtazapine association as a first line antidepressants strategy.

Methods

A brief review of the latest literature was performed, using PubMed and the keywords “venlafaxine-mirtazapine association”. A case report about a depressed woman is presented.

Results

Despite most studies are referent to its utility in drug-resistant depression, there are recent pilot studies that recommend CRF as a first line option.

M., a 64-year-old woman, had her first psychiatric consultation. She had been depressed for 2 years, she lost 10 kg, had total insomnia and suicidal thoughts. CRF was started up to 150/15 mg, daily. An improvement was noticed after two weeks of treatment and the stabilization of depressive symptoms were achieved by the fourth month.

Conclusions

CRF seems to be effective and useful. Patients with insomnia and weight loss may benefit from CRF as a first line option. However, more studies are needed.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Use of cannabis components in the treatment of mental disorders
Authors: Tsopelas C. , Dimitraka M. , Ntounas P. , Gatos-Gatopoulos A. , Karadima D. , Charalampos T.
Published: May 2016

Introduction

There is evidence that supports the increased risk of developing psychosis or psychotic like symptoms in vulnerable populations after use of cannabis. Cannabis’ main psychoactive component, Δ9-tetrahydrocannabinol (THC), induces acute psychotic effects and cognitive impairment. But there is also evidence to suggest that molecules in the cannabis plant could have an antipsychotic affect.

Aims

In this review we are trying to explore the possibilities of cannabis use as a therapeutic agent in mental disorders.

Methods

Thorough research of the main databases, and web search engines for relevant studies, using appropriate keywords. We scrutinize them independently, before reaching consensus about appropriateness.

Results

In animal models repeated treatment with cannabis constituent cannabidiol CBD or the atypical antipsychotic clozapine attenuates or reverses the schizophrenia-like behavioral disruption.

In humans there are data that CBD counteracts psychotic symptoms and cognitive impairment associated with cannabis use. Also CBD may lower the risk for developing cannabis use associated psychosis. There are opposite effects of CBD and THC on brain activity patterns in key regions implicated in the pathophysiology of schizophrenia, such as the striatum, hippocampus and prefrontal cortex.

Conclusions

The possible mechanism of action of GBD is not fully clarified, as it may involve anti-inflammatory or neuroprotective properties. These initial clinical studies with CBD treatment of psychotic symptoms argument the potential of CBD as an effective antipsychotic compound. Mechanisms responsible for these effects need to be further investigated.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Safeguarding foster care youth from overmedication
Authors: Pataki C. , Thompson C. , Crecelius G. , Tesoro J. , Polsky G. , Kambam P.
Published: May 2016

Introduction

There are increasing concerns regarding long-term psychotropic polypharmacy prescribed for foster care youth 3.5 to 5 times more often than in at-home youth (Kreider et al., 2014). Polypharmacy risks include weight gain, glucose intolerance and type 2 diabetes. (De Hert et al., 2011). In view of these risks, novel interventions are essential to safeguard foster care youth from overmedication.

Objectives

To present guidelines for identification and management of polypharmacy in foster care youth.

Aims

To demonstrate a novel intervention to monitor and diminish polypharmacy and enhance psychiatric care in foster care children.

Methods

Polypharmacy is identified using LA County Juvenile Court Mental Health Service (JCMHS) Psychotropic Parameters* to review medication consent forms from treating psychiatrists. Polypharmacy triggers an in-person JCHMS consultation. *(Parameters 3.9 for JCMHS PMAF Review, Revised May 2015).

JCMHS Psychotropic Parameters (summary):

– age 0–5 years:

– 2 or > psychotropic medications,

– Any antipsychotic (*except Risperidone in ASD);

– age 6–8 years:

– 3 or > psychotropic medications;

– age 9–17 years:

– 4 or > psychotropic medications;

– All age youth:

– 2 or > psychotropic medications in the same class (antipsychotics, antidepressants, stimulants, mood stabilizers, alpha agonists).

Psychotropic medication doses in excess of recommended (*LA County Department of Mental Health Parameters 3.8 for use of Psychotropic Medications for Children and Adolescents).

Results

Approximately 25% of JCMHS annual psychiatric consultations were initiated by JCMHS parameters for polypharmacy. Corresponding consultations included education and recommendations discussed with treating psychiatrists regarding polypharmacy and optimal psychiatric management.

Conclusions

JCMHS Psychotropic Parameters is a useful tool to identify polypharmacy and enhance psychiatric care of foster care youth.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
The use of electroconvulsive therapy (ECT) in the Czech Republic
Authors: Kalisova L. , Madlova K. , Albrecht J. , Michalec J.
Published: May 2016

Aim

The aim of this study was to monitor the use of electroconvulsive therapy (ECT) in the Czech Republic for the purpose of harmonizing national practice.

Method

A 13-item questionnaire was sent to all Czech inpatient psychiatric facilities. This questionnaire assessed technical background of ECT, indications for the treatment, procedure in detail, way of documentation and monitoring of side effects.

Results

ECT is used 23 centers (10 psychiatric hospitals, 5 university psychiatric departments and 8 psychiatric wards) across the Czech Republic. There is no special legal act regulating the use of ECT in the CR, but there are guidelines issued by the Czech Psychiatric Society available. All centers use instruments delivering brief pulse stimuli. All patients have to be indicated for this treatment and have to sign inform consent form/excluding situation when patient's life is endangered/. Somatic state is assessed/EKG, blood tests, eye check-up regularly and other examinations in individual cases/. Thiopenthal and succinylcholine are used most often for anesthesia and myorelaxation. Bitemporal electrode placement is the preferred option in all centers. The ECT is provided 2–4 times a week in special ECT rooms in the presence of staff team/psychiatrist, anesthetist, psychiatric and anesthesiological nurses/. Continuation ECT and outpatient ECT is not used. The procedure including side effects is documented in individual patient's documentation, but summarizing documentation is conducted only in some centers.

Conclusion

ECT is widely used in the Czech Republic. Procedures in all centers follow national guidelines. There is need to improve documentation system to harmonize national practice.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Assessment of adopted minors admitted to the inpatient unit in Hospital Clínico Universitario of Valladolid during the last 8 years
Authors: Rodríguez Andrés L. , Otálora Navarro M.E. , Geijo Uribe M.S. , Mongil Lopez B. , Imaz Roncero C.
Published: May 2016

Research about adjustment of adopted children indicates that they have more emotional and behavioral problems than non-adopted children. We have examined 28 adopted minors that have been admitted to the inpatient unit in Hospital Clínico Universitario of Valladolid. We examine the gender, age, diagnose and the number of hospital admissions. In the sample of 28 patients, there are 15 males (53.57%) and 13 females (46.42%). The most common diagnosis is attention deficit hyperactivity disorder (57.57%), followed by reactive attachment disorder of infancy or early childhood (46.42%). Readmission rate is 44.2%. Male patients have higher rates of readmission (60.86%) than females (39.1%). Males have higher rates of readmission (60.86%) than females (39.1%).

Discussion

Results indicate a higher rate of admissions in adopted males than females, being attention deficit hyperactivity disorder and reactive attachment disorder of infancy or early childhood the most common diagnosis. Rate of readmission is higher in males.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Cognitive behavioral approaches to coping with suffering and hardship
Authors: Vyskocilova J. , Prasko J. , Ociskova M. , Sedlackova Z. , Slepecky M. , Hruby R. , Holubova M. , Marketa M.
Published: May 2016

Introduction

Low level of ability to endure discomfort, hardship and distress, which are integral parts of adverse life events, may lead to loss of mental stability and maintenance of psychological disorder.

Method

Review of literature and case descriptions.

Results

The patient often tries to cope with their suffering through avoidance and compensatory behavior which may relieve his suffering immediately; however, in the long term, it leads to the deterioration in the quality of his life and the persistence of suffering. Cognitive behavioral approaches focused on increasing the ability to endure unpleasant and distressful life experiences, allow the patient to better bear the inevitable losses in life, which he is exposed to, endure his anxiety, sadness, and the urge to impulsive action or escape; so the patient have more possibilities to act more freely, functionally and purposefully. Modern cognitive behavioral approaches, such as Dialectic Behavioral Therapy, Mindfulness Based Cognitive Therapy, Acceptance and Commitment Therapy and Compassion Focused Therapy developed and applied therapeutic methods designed to increase the patient's resistance to suffering and his ability to cope it better. These approaches are applied not only in patients with chronic psychiatric disorders, but also in patients with chronic physical illnesses and permanent disability.

Conclusions

The modern CBT strategies can help patients to increase his/her resistance to the distress, discomfort and suffering.

Disclosure of interest

The authors have not supplied their declaration of competing interest.