bluuebunny/crossref_metadata_2025 huggingface dataset:
Long Term Effect of Cognitive Behavioral Therapy in Patients with Health Anxiety
Authors: Veddegjaerde K.E.
Published: June 2017

Introduction

Cognitive-behavioral therapy (CBT) has been found to be an effective treatment of excessive health anxiety (HA), but the long-term effect over 18months has not been examined.

Objectives

Several studies have shown effect of CBT for HA-patients. However, these effects have been short or immediate after therapy. To our knowledge no studies have examined long-term effect of CBT for HA over 18 months.

Aims

To investigate the long-term effect of CBT on HA, focusing on level of HA, quality of life, subjective health complaints and general anxiety. Follow-up time was at least 10 years. Our hypothesis was that the effect was sustained.

Methods

Patients with HA received 16 sessions of CBT over a period of 12–18 months, and were followed up over at least 10 years. All patients fulfilled criteria for F45.2, hypochondriacal disorder according to ICD-10.

The patients answered several questionnaires, exploring areas such as HA, Quality of life, somatization, and mental health problems. Questionnaires were answered before CBT, after CBT and at follow up. Mixed model analysis was performed in SPSS 23.0 for all questionnaires.

Results

All scores were found to be significant in the Pre-CBT–Post-CBT and Pre-CBT–FU (0.034– < 0.001), and none were found to be significant in the Post-CBT–FU.

Conclusions

Our findings suggest that for the majority of patients with HA, CBT has a significant and lasting long-term effect. This effect lasts up to ten years post therapy.

Disclosure of interest

The author has not supplied his/her declaration of competing interest.
The Effect of Long-term Lithium Treatment on Renal Functions in Patients with Bipolar Disorder
Authors: Ayik B. , Çakır S. , Yazıcı H. , Karabulut S.
Published: June 2017

Introduction

The effect of lithium on tubular functions leading to decreased urinary concentrating ability is recognized. Although there are several studies type, severity and frequency of renal impairment and its correlation with duration of lithium therapy are not well established.

Objectives

To explore long-term effects of lithium on patients with chronic bipolar disorder.

Aims

We aimed to assess patients with bipolar disorder using lithium at least for six years in terms of renal functions, starting from mild impairments to full blown chronic renal failure.

Methods

Fifty-one patients with bipolar disorder and 38 age and sex matched healthy controls were enrolled for the study. Serum BUN, creatinine, uric acid, electrolytes, calcium (Ca), phosphorus (P), vitamin D (25-OH D3) and eGFR levels were measured. The correlations between renal function and mean lithium levels, duration of lithium treatment and GAF scores were calculated.

Results

Mean eGFR level of patients with bipolar disorder was significantly lower than that of controls. Serum creatinine, uric acid, Ca and PTH levels were higher, 25-OH D3 levels were lower in the patients than in controls. The duration of lithium treatment was positively correlated with serum creatinine and uric acid levels, negatively correlated with eGFR levels. Mean lithium levels were positively correlated with serum creatinine levels and negatively correlated with eGFR.

Conclusions

The study revealed that glomerular functioning of the patient group was significantly lower than that of the control group. The findings suggested that both duration of lithium treatment and high serum lithium levels may have a negative impact on glomerular functions.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
The Late-onset Bipolar Disorder: A Comparative Study
Authors: Derbel C. , Feki R. , Ben Nasr S. , Bouhlel S. , Ben Hadj Ali B.
Published: June 2017

Introduction

Bipolar disorders (BP) with late onset are underestimated by their frequency, their misleading presentations and therapeutic difficulties due to the high prevalence of somatic comorbidities.

Aim

To identify sociodemographic, clinical and therapeutic characteristics in subjects with a late-onset BP.

Patients and methods

Retrospective and comparative study of 101 patients followed for a BP (12 patients with BP started after 50 years and 89 patients with BP started earlier) from 2009 to 2015, in the department of psychiatry of the University Hospital Farhat Hached, Sousse, Tunisia.

Results

The mean age of subjects with late-onset TBP was 46.11 ± 12.85 years. Women were in the majority (65.3%). Ten patients had a novo mania, four patients had a late-onset mania and one patient had a secondary mania. Regarding the socio-demographic data, only the regular professional activity was more reported in the elderly (P = 0.017). Regarding clinical data, BP type 1 and secondary mania were more reported in elderly with (P = 0.050 and P = 0.000 respectively). Elderly had significantly fewer depressive episodes (P = 0.026), fewer hypomanic episodes (P = 0.000). The durations of the latest episodes and the last intervals were shorter in elderly (P = 0.045 and P = 0.000). Concerning therapeutic data, elderly had fewer hospitalizations (P = 0.045), required lower mean doses of lithium (P = 0.04) and greater mean doses of tricyclic antidepressants (P = 0.047).

Conclusion

It is always necessary to look for an organic cause in manic syndrome in late-onset BP. Doses of lithium should be lower. However, doses of TAD should be higher.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Information to Improve Awareness, Contribution to Evidence-based Practice – What Does the Brazilian population Knows About Autism
Authors: Amato C. , Varanda C. , Fernandes F. , Molini-Avejonas D.
Published: June 2017

The present prevalence of autism spectrum disorders (ASD) demands changes in health policies highlights barriers that are inherent to the national diversity and therefore poses great challenges to the planning and delivering specialized services. Systematic data regarding the level of knowledge and information about autism in the general population may help in building a set of evidences to support decision-making processes about intervention proposals directed towards this population. Aiming to contribute to evidence-based practice, this study used a digital-delivered questionnaire to assess the knowledge by the general population about autism in Brazil. A self-explanatory questionnaire was made available on-line. It was comprised by 57 questions divided in five domains: data about the answerer; information about how the person had access to the issue of autism; information about the concept of autism (signs, symptoms and etiology); information about the characteristics of persons with autism and what are the professionals that are essential in the team that assists these individuals. Participants were contacted via e-mail and given full information on the nature of the research. They were 4282 persons living in the five large regions of Brazil. Results indicate that most of the participants were mothers, followed by teachers. The analysis of the answers demands consideration of the hypothesis that although most of the participants have answered that they knew what is Autism, this knowledge is based on lay beliefs and not on scientific-based information. This reality must be taken into account when proposing intervention programs directed to persons with ASD.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
The Association Between Problem Behaviors and Yin-Yang Temperament in Korean Middle School Students
Authors: Lee S.J. , Chae H.
Published: June 2017

Objectives

The Yin-Yang represents two opposing and complementary traits of nature such as introvert-extrovert and passive-active, and has been primary framework of medicine for thousands of years in the East. The purpose of this study was to examine the problem behaviors of the middle school students, which is a major social and psychopathological issue in Korea, from the Yin-Yang temperaments.

Methods

Subjects of 670 middle school students (365 boys and 305 girls) finished Korean version of youth self-report (YSR) for describing the problem behaviors and Sasang personality questionnaire (SPQ) for measuring Yin-Yang temperament. The high (30%) and low (30%) SPQ score groups were shown to represent Yin and Yang temperament groups with acceptable reliability and validity. We examined the correlation between YSR and SPQ, and YSR subscale differences between high and low SPQ score groups.

Results

The SPQ significantly (P < 0.01) correlated positively with YSR externalizing problem (r = 0.148, r = 0.182) and negatively with YSR Internalizing Problem (r = −0.212, r = −0.177) in boys and girls, respectively. The Yang temperament group (8.42 ± 6.24, 8.36 ± 6.59) is significantly (P < 0.01) higher than Yin group (6.17 ± 4.82, 5.83 ± 5.32) in Externalizing Problem, and the Yin temperament group (9.55 ± 7.72, 11.38 ± 8.18) is significantly (P < 0.01) higher than Yang group (6.01 ± 5.95, 8.28 ± 7.49) in Internalizing Problem with boys and girls, respectively.

Conclusion

These results showed that the Yin-Yang temperament of traditional eastern medicine might be clinically useful for screening psychopathological problems in adolescents. Implications and suggestions for cross-cultural psychological study of the East and West are also suggested.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
The Relationship Between Physical and Mental Disorders in a Pediatric Population
Authors: Chartier G. , Cawthorpe D.
Published: June 2017

Introduction

Few studies examine comorbidity in a pediatric population. This poster presents results that extend our understanding of the relationship between mental disorder and physical disorders using a population-based study approach.

Objectives and aims

To review the evidence behind comorbidity of psychiatric disorders and other medical disorders. To propose an informatic approach that evaluates those comorbidity on a population-scale.

Methods

Using an informatics approach, a dataset containing physician billing data for 235,968 (51% male) individuals up to 18 years old spanning sixteen fiscal years (1994–2009) in Calgary, Alberta, was compiled permitting examination of the relationship between physical disorders and mental disorders, based on the International classification of diseases (ICD).

Results

All major classes of ICD physical disorders had odds ratios with confidence intervals above the value of 1.0, ranging from 1.08 (Perinatal Conditions in 4–6 year olds) to 4.95 (Respiratory Conditions in 0-3 year olds). Distinct major class ICD disorder patterns arise in comparing all children with adults and specific age strata for those under 19 years of age.

Conclusions

This study represents the first evidence reported in a population-based data set of the effect of mental disorders on each major class of ICD diagnoses related to a physical disorder. The focus on the early intertwinements between physical and mental disorders in a pediatric population may help to target strategic areas for future research and investment.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Subtypes of Psychosis Among Difficult-to-treat Patients – A Cluster Analytical Replication Study Among Chronically Psychotic, Institutionalized Dual Diagnosis Patients
Authors: Dost-Otter R. , Timmerman L. , Van Veen M. , Diekman W.
Published: June 2017

Background

Research is lacking on possible subtypes of psychosis in difficult-to-treat patients that require long-term institutionalisation due to a combination of psychosis, substance abuse and problem behaviours after multiple failed treatments.

Aim

The aim of this study is to increase our knowledge of this group of patients in order to apply more targeted interventions.

Objective

To identify subtypes of psychosis among this group by cluster analysis and compare these subtypes on different clinical variables.

Methods

PANSS data was acquired for 117 patients. Separate clusters were identified by using Ward's method of hierarchical cluster analysis, replicating Dolffus et al., 1996 [1], who used this method in a cohort of schizophrenia patients. Subtypes of psychosis were identified using PANSS items. Clusters were compared on several clinical variables, f.e. course of admission.

Results

Four distinct clusters were identified (Fig. 1): (1) a ‘positive cluster’, (2) a ‘mild cluster’, (3) a ‘negative cluster’, and (4) a ‘mixed group’. These clusters are similar to those found by Dolffus et al.

There was a significant association between cluster and co-morbid personality disorder, P < 0.05. No significant association was found between clusters and other clinical variables.

Conclusions

Among difficult-to-treat institutionalised patients four distinct subtypes of psychosis could be identified, comparable to those found in a cohort of schizophrenia patients.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Explanatory and Confirmatory Factor Structure of Beck Scale for Suicide Ideation in Non-clinical Sample
Authors: Alsalman R. , Alansari B.
Published: June 2017

Introduction

The Beck Scale for Suicidal Ideation (BSS) is a self-report 19-item scale preceded by five screening items. The BSS and its screening items are intended to assess a patient's thoughts, plans and intent to commit suicide. All 24 items are rated on a three-point scale (0 to 2). In this study, scores from the five screening items were included in the overall score. Therefore, total scores could range from 0 to 48.There is no study until this date that examines the factor structure of BSS among Kuwaitis.

Objectives

The current study investigated the original three-factor model of the (BSS) in non-clinical sample.

Methods

Sample one consisted of 285 males and 300 female students from Kuwait University while sample two consisted of 201 males and 302 females from Kuwait University. The Arabic version of BSS was administered to participants. Explanatory factor based on sample 1 and conformity factor analysis based on sample 2 of BSS were used in this study.

Results

The explanatory and confirmatory factor analysis of (BSS) extracts three factors and three structures of BSS. Factor I = active suicidal desire; Factor II = preparation; Factor III = passive suicidal desire. In addition, the results revealed no significant gender differences in the factor structure of BSS.

Conclusions

The results of both confirmatory and exploratory factor analysis indicated that the original three-factor model provided the best fit for the two genders.
Mood Disorders in Elderly Patients Hospitalized for Acute Exacerbation of COPD
Authors: Bonfitto I. , Moniello G. , Pascucci M. , Bellomo A.
Published: June 2017

Introduction

Chronic obstructive pulmonary disease (COPD) represents the most common cause of chronic respiratory failure and it's associated with several comorbidities such as depression. Depression is about four times more frequent in elderly patients with COPD compared to peers who are not affected and its prevalence increases with the degree of disease severity.

Objective

To assess mood and perception of the quality of life in elderly patients hospitalized for acute exacerbation of COPD.

Methods

Thirty-five elderly patients hospitalized for reactivation of COPD were examined; they were subjected to spirometry test for the calculation of FEV1 and to COPD Assessment Test (CAT) and Hamilton Rating Scale for Depression (HAM-D) to evaluate impact of COPD on patients’ quality of life and depressive symptomatology, respectively. The number of COPD exacerbations in the last year prior to hospitalization and the number of recovery days required for the stabilization of patients were also recorded.

Results

There were strongly significative correlations (P < 0.001), positive between HAM-D scores, CAT scores, number of exacerbation in the last year and hospital length of stay and negative between HAM-D scores and FEV1 values. Furthermore, females were more depressed, with lower FEV 1 (P = 0.043) and with a longer length of stay (P = 0.039) as compared to males.

Conclusions

A greater severity of depressive symptoms is related to a greater severity of COPD exacerbations, disability associated with it and perceived by the patient, as well as a higher number of recovery days and annual acute exacerbations, particularly in female gender.
A Residential Psychiatric Approach for Forensic Patients: The Experience of “Tiziano” Facility
Authors: Cargioli C. , Polese L. , Macchia G.
Published: June 2017

Introduction

Italian forensic mental hospitals closed on March 31st, 2014 and offenders sentenced to need a psychiatric care are restrained in facilities. Since 2002, the residential psychiatric facility “Tiziano” (Aulla, Massa-Carrara) hosts forensic patients, on appointment with national health system and compulsorily admitted by the justice system.

Methods

This descriptional and prospective study provides a thorough report on the main epidemiological, clinical, and criminological features of 60 mentally ill offenders hosted in the “Tiziano” facility between 2002 and June 2016.

Results

Most forensic patients were male (90%, n = 54; average age: 33 years). Sixty percent of subjects (n = 36) had a clinical diagnosis of psychosis (19.4% affective psychosis, 72.2% non-affective psychosis, 8.4% organic psychosis), and about one third of them (31.6%, n = 19) had a personality disorder (63.1%, n = 12, antisocial personality disorder, 42.1%, n = 8, borderline personality disorder, 21.0%, n = 4 other personality disorders). Mental insufficiency was diagnosed in 11.6% (n = 7) of subjects, while substance use disorder affected 35.0% (n = 21) and alcohol use disorder 26.6% (n = 16). Forty-nine patients (81.7%) had committed serious crimes against people; 15% (n = 9) were murderers or attempted murderers, and 46.7% (n = 28) had committed more crimes. The average length of stay is 22 months.

Conclusions

To date, there are no data about long-term follow-up and clinical outcome of mentally ill offenders restrained in Italian psychiatric facilities. Additional studies are needed to assess psychopathology and differentiate treatment according to diagnosis, and to identify risk factors of relapse for criminal behavior relapse.
Experiences of Young Offenders and Health-care Professionals Involved in Transitions from Forensic Adolescent Mental Health Services: A Qualitative Study
Authors: Livanou M. , Furtado V. , Singh S.
Published: June 2017

Introduction

Transitions from child and adolescent mental health services to adult mental health services have been quite troublesome for young people in the UK. There is strong evidence throughout the literature that long waiting lists and rigid adult services criteria hamper dramatically transitions across services. Little knowledge exists about transitions from forensic adolescent services to adult services.

Objectives

To interview health-care professionals and young offenders in transition of care from forensic child and adolescent mental health services in England.

Aims

This study aimed to bridge the current literature gap in regards to transitions across forensic services and the complexities resulting from disruptive care.

Methods

This study adopted a prospective design to identify young offenders referred to adult services over a six-month period. We utilized semi-structured interviews. Health-care professionals were interviewed about their transition views and perspectives. Young offenders were followed-up within a month of their transition and were interviewed.

Results

The numbers of transitions within forensic settings are much lower compared to those of general transitions across mental health services in England. Transition delays were a repetitive theme across interviews due to lack of bed availability, especially in medium secure hospitals, and poor multi-agency communication. Commissioning determines age boundaries along with transfer destination for each service.

Conclusions

Ineffective liaison among different sectors might impact adversely young people and hallmark their long-stay in the system. Therefore, continuity of care within forensic services should be looked warily along with the role of policy shaped by commissioning. Multiple transitions can repeatedly traumatize young people moving across services.
Antidepressant use During Pregnancy and the Risk of Major Congenital Malformations in a Cohort of Depressed Pregnant Women: A Re-analysis of the Quebec Pregnancy Cohort
Authors: Bérard A. , Zhao J.P. , Sheehy O.
Published: June 2017

Objective

To quantify the association between first-trimester antidepressant exposure and the risk of major congenital malformations (MCM) in a cohort of depressed women.

Method

Data were obtained from the Quebec pregnancy cohort. All pregnancies with a diagnosis of depression or anxiety, or exposed to antidepressants in the 12 months before pregnancy, and ending with a live-born singleton were included. Antidepressant classes (selective serotonin reuptake inhibitors (SSRI), serotonin norepinephrine reuptake inhibitors (SNRI), tricyclic antidepressants (TCA), and other antidepressants), and types were individually compared to non-exposure during the first-trimester (depressed untreated). MCM overall and organ-specific malformations in the first year of life were identified.

Result

Eighteen thousand four hundred and eighty-seven depressed pregnant women were included. Citalopram use during the first-trimester was increasing the risk of MCM (aOR 1.36, 95%CI 1.08, 1.73; 88 exposed cases). Antidepressants with serotonin reuptake inhibition effect (SSRI, SNRI, amitriptyline (the most used TCA)) were increasing the risk of certain organ specific defects: paroxetine was increasing the risk of cardiac defects (aOR 1.45, 95%CI 1.12, 1.88), and ventricular/atrial septal defects (aOR 1.39, 95%CI 1.00. 1.93); citalopram was increasing the risk of musculoskeletal defects (aOR 1.92, 95%CI 1.40. 2.62), and cranyosynostosis (aOR 3.95, 95%CI 2.08, 7.52); TCA was associated with eye, ear, face and neck defects (aOR 2.45, 95%CI 1.05, 5.72), and digestive defects (aOR 2.55, 95%CI 1.40. 4.66); and venlafaxine was associated with respiratory defects (aOR 2.17, 95%CI 1.07, 4.38).

Conclusion

Antidepressants with effects on serotonin reuptake during embryogenesis are increasing the risk of some organ specific malformations in a cohort of pregnant women with depression.

Disclosure of interest

COI: Disclosures and acknowledgments: AB is a consultant for plaintiffs in litigations involving antidepressants and birth defects. All other authors report no financial relationships with commercial interests. All authors have completed the ICMJE uniform disclosure form.
Predictors of the use of Psychosocial Interventions in Portugal: Results from the SMAILE Project
Authors: Cardoso G. , Antunes A. , Loureiro A. , Santana P. , Caldas-de-Almeida J. , Silva M.
Published: June 2017

Introduction

The treatment of psychiatric disorders depends on a combination of different types of care, such as psychiatric treatment and psychosocial interventions. However, there is little research on the factors that determine access to care, particularly to psychosocial interventions.

Objectives

To characterize the use of psychosocial interventions (psychotherapy, day hospital, and psychosocial rehabilitation) in users of outpatient psychiatric services in Portugal.

Aims

This retrospective study analyses all outpatient psychiatric visits in four Portuguese departments of psychiatry in the metropolitan areas of Lisbon and Porto, and aims to evaluate the socio-demographic and clinical determinants of psychosocial interventions.

Methods

Socio-demographic and clinical variables were obtained from clinical charts of outpatients’ visits in 2002, 2007 and 2012 (n = 2621). All patients were characterized regarding the use of any psychosocial intervention beyond psychiatric consultations. Logistic regression analysis was performed to evaluate the predictors of psychosocial interventions use.

Results

Being followed in 2012, being single, having no professional activity, and having a diagnosis of psychosis or common mental disorder were significantly associated (P < 0.05) with higher odds of accessing psychosocial interventions. On the other hand, a lower level of education was associated with less use of this type of care.

Conclusions

Socio-demographic and clinical characteristics of psychiatric services, outpatients are determinants of the use of psychosocial interventions. Evidence suggests that social inequalities may influence the access to psychosocial interventions in Portugal.

Funding

Fundação para a Ciência e Tecnologia (FCT), Portugal.
Effectiveness of Antipsychotic Medication in the Treatment of BPD
Authors: Stoffers-Winterling J. , Storebø O.J. , Völlm B. , Mattivi J. , Nielsen S. , Kielsholm M.L. , Simonsen E. , Lieb K.
Published: June 2017

Introduction

Though prescription is off-lable, “atypical” or “second-generation” antipsychotics (SGAs) are prevalently given to borderline personality disorder (BPD) patients. They have also been the focus of research on pharmacological agents in BPD in recent years, as the previous version of the relating cochrane systematic review shows.

Objectives

We are currently updating this cochrane systematic review on pharmacological interventions for BPD. First findings on the up-to-date evidence relating to SGAs will be presented.

Methods

We conducted a systematic review and meta-analysis of randomized controlled trials (RCTs) according to cochrane collaboration standards. Any randomized comparisons of drug vs. placebo, drug vs. drug, or drug vs. a combination of drugs in adult BPD patients were eligible. Primary outcomes were BPD core pathology as depicted by DSM criteria. Secondary outcomes included associated pathology, i.e., depression and anxiety, general psychopathology severity and functioning as well as tolerability and safety. Two researchers selected trials, assessed quality and extracted data independently.

Results

The current RCT evidence on SGAs in BPD will be presented, and their use in everyday clinical care settings will critically be discussed.

Disclosure of interest

The authors declare that they have no competing interest.
Prevalence of the CYP2D6*10 (C100 T) Polymorphism in psycho-neurological patients in North-Western and Siberian regions of the Russia
Authors: Shnayder N.A. , Nasyrova R.F. , Lipatova L.V. , Teplyashina V.V. , Sosina K.A. , Sivakova N.A. , Bochanova E.N. , Dmitrenko D.V. , Artyuhov I.P. , Neznanov N.G.
Published: June 2017

Introduction

The gene CYP2D6 is of great interest also due to its highly polymorphic nature, and involvement in a high number of medication metabolisms. The presence of polymorphisms in the CYP2D6 gene may modulate enzyme level and activity, thereby affecting individual responses to pharmacological treatment.

Materials and methods

Allele and genotype frequency distributions of CYP2D6*10 variants and predicted phenotypes were analyzed in blood samples of 123 patients (53 patients from north-western region and 69 patients from Siberian region) using polymerase chain reaction (PCR)-restriction fragment length polymorphism, PCR-single-strand conformation polymorphism.

Results

The T/T, C/T, and C/C genotype frequencies of the CYP2D6*10 allele were significantly different (P < 0.01) in regional groups. The frequency of the wild homozygous variant C/C of the CYP2D6*10 allele (extensive metabolizers) in the Siberian region was the highest, while the north-western region of Russia had the lowest frequency (P < 0.001), which are 82.6% and 64.2%, respectively. The frequency of the heterozygous variant C/T of the CYP2D6*10 allele (intermediate metabolizers) was significantly a bit high in the north-western region, while the Siberian region of Russia had the lowest frequency (P < 0.001), which are 35.8% and 17.4%, respectively. The homozygous variant T/T of theCYP2D6*10 allele (poor metabolizers) was not identified.

Conclusion

The C100T polymorphism of the CYP2D6 gene may be associated with several drug-induced reactions in patients with depression, schizophrenia, epilepsy etc. The differences in the prevalence of intermediate metabolizers in north-western and Siberian regions of Russia may be due to genetic drift and accumulation of alleles typical of European and Asian populations.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Symptoms of Anxiety During Pregnancy and Metabolism: A Pilot Metabolomics Study
Authors: Toffol E. , Elomaa A.P. , Glover V. , Kivimäki P. , Pasanen M. , Keski-Nisula L. , Huuskonen P. , Voutilainen S. , Velagapudi V. , Lehto S.
Published: June 2017

Introduction

Anxiety symptoms are frequent during pregnancy, and they adversely affect pregnancy outcomes and offspring development. The underlying biological mechanisms are not known, but may in part be explained by alterations in certain maternal metabolic pathways. No metabolomic studies have investigated possible metabolic alterations in anxious pregnant women.

Objective

This pilot study compared the metabolic profiles of anxious and non-anxious pregnant women using a mass spectrometry-based quantitative metabolomics system.

Methods

Cases were 20 participants of the Kuopio birth cohort study (www.kubico.fi) with first and third trimester symptoms of anxiety (Edinburgh postnatal depression scale, anxiety subscale – EPDS-3A ≥ 4), but no depression (EPDS ≤ 12). Controls were 20 participants with low anxiety (EPDS–3A ≤ 3) and depression (total EPDS ≤ 9) in both the first and third trimester. Maternal metabolic profiles were analyzed from serum samples drawn when the mothers arrived at the delivery hospital.

Results

Metabolic pathway analyses revealed significant enrichment in the glycine, serine and threonine metabolism (P = 0.046), as well as in the betaine (P = 0.048) metabolism pathways. Homocysteine was the only metabolite to significantly differentiate between cases and controls (VIP score 3.3), with lower concentrations in cases (P = 0.003) even when excluding non-users of folic acid supplementation (n = 5; P = 0.002), C-sections (n = 5; P = 0.013), or samples taken immediately postpartum (n = 2; P = 0.004). No other metabolites significantly differed between the groups.

Conclusions

Physiological adaptation induced by pregnancy, which may have homogenized the study populations, could explain the only minor metabolic differences between the two groups. Further research in larger samples, comparing metabolic alterations in umbilical cord blood and maternal blood is warranted.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
The utilization of a creative strategy in the prevention of the use of psychoactive substances with children and adolescents
Authors: Jaber J. , Humel S. , Leite S. , Tomé A. , Hollanda A. , Reys B.
Published: June 2017

Introduction

The work describes a successful experience in the utilization of art as a tool to work the prevention of the use of drugs. The experience was developed with children and adolescents between the ages of 3 and 17 who reside in a risky area near Latin America's biggest dump, located in the city of Taguatinga, FD, Brazil.

Objectives

Create a therapeutic space to make possible the dialog with the children and adolescents, promoting the prevention and the consciousness about the harm of the use of psychoactive substances, providing clarification on the theme, through art, being the use of formal language and terms, like “illicit drugs”, unnecessary.

Methods

The children, who participated in the project, used, as expression tool, several painting items. The public was divided by age in two groups: the children received ludic approach, allowing the team nearness and interaction with them, in such a way that the former transmitted information and guidance about the harm on the use of psychoactive substances.

Results

The results were satisfactory. All the children and adolescents involved in the project demonstrated adhesion to the use of the offered tools and established a communication link, which allowed the receptivity of information about prevention in the use of psychoactive substances.

Conclusions

Through the developed activities, it was observed that the strategy utilization of art as a language had better effiency than a formal approach since the children and adolescents could have a learning space in a spontaneous way, demonstrating interest.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Fatigue and return-to-work in cancer patients: Association with work ability and quality of life
Authors: Monteiro S. , Bártolo A. , Andrea A. , Diana S. , Pereira A.
Published: June 2017

Introduction

Fatigue is a common and debilitating problem in cancer survivors. Research show that this symptom endures even in disease-free patients affecting quality of life. Returning to work is physically and emotionally demanding for this population and fatigue levels seems to predict the time taken to return to work and the ability of the worker.

Objective

Our main objective was to explore the direct effect of the fatigue on work ability and quality of life of professionally active cancer survivors. Aims Fatigue levels, work ability and overall quality of life of survivors group were compared with a sample of individuals without cancer history. Relationship between fatigue symptoms and work ability and quality of life were examined within of the survivors group.

Methods

This cross-sectional study included 57 cancer survivors and 57 controls (n = 114) and data was collected from two Central Hospitals of Portugal. Participants completed the Functional Assessment of Chronic Illness Therapy-Fatigue, the Work Ability Index and the Functional Assessment of Cancer Therapy-General.

Results

Cancer survivors reported higher levels of fatigue than controls and worse work ability and quality of life (P < .001). Controlling the effect of the age and gender, fatigue of the cancer survivors group influenced negatively their overall quality of life (β= –.315, P= .013, R2= .143) but not their work ability.

Conclusions

Although the fatigue has not affected directly the work ability of the cancer survivors, two years or more after the conclusion of the treatments, this symptom has a significant effect on the quality of life.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Illness representation as a factor of quality of life in youth with mental illnesses
Authors: Rasskazova E. , Spivakovskaya A. , Tkhostov A.
Published: June 2017

Introduction

Cognitive perspective considers beliefs as key factors of compliance and adjustment in mental disorders (Beck, 2011) that are especially important in youth. In psychosis illness, representation is related to CBT efficacy.

Objectives

We suggest that in different mental disorders different illness-related beliefs are important for quality of life domains.

Aim

To reveal relationships between illness representation and quality of life in mental disorders controlling for psychopathological symptoms.

Methods

One hundred and eighteen male patients 17 – 27 years old : 33 with mood disorders, 26 with personality disorders, 27 with schizotypal disorder and 32 with schizophrenia recovering after first episode of psychosis filled Illness Perception Questionnaire, Symptom Checklist 90-R, Quality of Life and Enjoyment Questionnaire (version for mental illnesses).

Results

After statistical control for psychopathological symptoms, in personality disorders feeling of personal and treatment control (β = .43–.52, P < .01) as well as belief in longer (β = .42, P < .05) but not cyclic (β = –.65, P < .05) illness duration predicted satisfaction with health while belief in longer duration and less consequences correlated with better satisfaction with leisure time (β = .87, P < .01). In mood disorders, feeling of treatment control (β = .32, P < .05) and belief in shorter illness duration (β = –.37, P < .05) were related to better satisfaction in emotional sphere.

Conclusions

Beliefs about illness duration, consequences and control could be important in assessment and CBT for youth with personality disorders while treatment control and illness duration are important in work with youth with mood disorders.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
The impact of emotional intelligence on the emotional state of nurses in public hospitals in Cyprus
Authors: Symeou M. , Evstathiou A. , Charalambous G. , Jelastopulu E.
Published: June 2017

Introduction

The term emotional intelligence (EI) has gained more and more popularity in the last two decades and has been studied in various workplace settings.

Objectives/aims

The purpose of the present study was to estimate the EI in nursing personnel, to examine which factors are associated with EI and how EI correlates with their emotional state.

Methods

A cross-sectional study was conducted from April to May 2016 in a representative sample of nursing personnel from seven public hospitals of Cyprus. A total of 585 nurses completed the Greek Emotional Intelligence Scale (GEIS), consisting of 52 items measuring four basic emotional skills and scored on a 5-point Likert scale (from low (52) to high (260) EI). Furthermore, the Depression, Anxiety, and Stress Scale (DASS 21) was applied. Statistical analyses were performed using the SPSS v.20.0.

Results

Overall mean EI scores were 184.11 for males and 184.82 for females. Being married and having children as well as having leading position was associated with higher EI (P = 0.024, P = 0.002, P = 0.012, respectively). The highest EI scores were identified between the middle aged nurses (36–50 years, EI = 191.5, P = 0.000) and nurses with more years of work (> 12 years, EI = 189.59, P = 0.000). The overall EI scores have moderate negative correlation with the emotional state of the nurses (P = 0.000).

Conclusions

The present study reveals under-optimal EI scores and confirms the negative relationship with the emotional state of nurses. Based on the literature, the EI can be developed, thus suitable programs could substantially improve the emotional skills in nursing personnel.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
C-reactive protein and parathyroid hormone in acute severe psychotic disorders (schizophrenia, bipolar disorder and methamphetamine-induced psychotic disorder)
Authors: Arya S. , Ahmadkhaniha H. , Alavi K. , Arya B. , Zarei Z.
Published: June 2017

Introduction

and objectives Schizophrenia accompanies with elevated C-reactive protein (CRP) and vitamin D deficiency. However, there are scarce documentations regarding bipolar disorder and methamphetamine-induced psychotic disorder.

Aim

To compare serum levels of vitamin D, parathyroid hormone (PTH), calcium, phosphorus and CRP levels in psychotic disorder patients and control group.

Methods

A case-control study was conducted on four groups: acute phase of schizophrenia, acute manic episode of bipolar disorder, methamphetamine-induced psychotic disorder and healthy control subjects. Sample size was 45 in each group. Weekly duration of sun exposure, monthly vitamin D intake and serum levels of vitamin D, calcium, phosphorus, PTH and CRP were assessed. Brief Psychiatric Rating Scale (BPRS) was used to evaluate psychotic symptoms.

Results

Duration of sun exposure and monthly vitamin D intake were comparable among groups. Serum levels of vitamin D, calcium and phosphorus were not statistically different between groups (P = 0.463, P = 0.086 and P = 0.339, respectively). Serum levels of PTH were significantly higher in control group (P < 0.001). CRP levels were significantly lower in control subjects (P < 0.001). The levels of serum vitamin D and CRP did not show statistically significant difference among three groups of patients.

Conclusion

Acute psychotic disorders seem to be associated with higher CRP and lower PTH levels. Clinical importance of the findings and relation of these differences to the metabolic and inflammatory bases of psychosis are not clear yet.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Assessing suicide risk with the Clinical Interview for Psychotic Disorders (CIPD): Preliminary reliability and validity of the Suicide Risk Scale for Psychosis (SRS-P)
Authors: Martins M.J. , Castilho P. , Carvalho C. , Pereira T. , Gonçalves J. , Guiomar R. , Marques C. , Pinto A. , Carreiras D. , Bajouco M. , Macedo A.
Published: June 2017

Background

Suicide risk is an important variable to consider both in assessment and throughout the therapeutic process in psychotic disorders. The SRS-P is an 18-item scale computed from the patient and clinician-rated scores obtained in the CIPD. The scale comprises lifetime assessment of depressed mood, anhedonia and its current interference and severity, current and past feelings of hopelessness, suicidal ideation, ‘voices’ about suicide, and suicide-related behaviors.

Aims

To assess reliability and convergent validity of the SRS-P in a sample of participants with psychosis.

Methods

The sample comprised 22 participants (68.2% male), single (72.7%), between 19 and 47 years old (M = 31.05; SD = 7.088), with 4–17 years of education (M = 11.77; SD = 3.176), employed (50%). The most prevalent diagnosis was schizophrenia (68.2%) and the participants had a mean of 1.90 hospitalizations (SD = 2.548). The mean age of illness onset was 23.57 years (SD = 5.555). The participants were assessed with the CIPD, Depression, Anxiety and Stress Scales-21, Forms of Self-Criticism and Reassurance Scale, Self-Compassion Scale, Other as Shamer Scale and the Empowerment with Psychotic Symptoms Scales.

Results

The SRS-P has shown good reliability (α = .87) and validity in relation to depressive symptoms (r = .67; P = .001), anxiety (r = .74; P < .001), stress (r = .59; P = .004), inadequate self (r = .43; P = .046), hated self (r = .54; P = .009), reassured self (r = –.65; P = .001), self-compassion (r = –.63; P = .002), shame (r = .46; P = .033) and empowerment regarding positive symptoms (r = –.54; P = .015).

Conclusions

The SRS-P presented adequate reliability and convergent-divergent validity. Further studies are planned in order to test the factorial structure of the scale and confirm the presented results in a larger sample.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Testing decision-making competency of schizophrenia participants in clinical trials. A meta-analysis and meta-regression
Authors: Sorin H. , Rusu M.C. , Ionut N. , Drima E.
Published: June 2017

Aim

The primary purpose of this study is to evaluate the degree of impairment of decision-making capacity in schizophrenia patients compared to non-mentally-ill controls, as determined by the MacCAT-CR instrument.

Materials and methods

We analyzed the results obtained from three databases: ISI Web of Science, Pubmed, and Scopus. Each database was scrutinized using the following keywords: “MacCAT-CR + schizophrenia”, “decision-making capacity + schizophrenia”, and “informed consent + schizophrenia.”

Results and discussions

We included ten studies in the analysis. Even if schizophrenia patients have a significantly decreased decision-making competence compared to non-mentally-ill controls, they should be considered as competent unless very severe changes are identified during the clinical examination. Using enhanced informed consent techniques significantly decreased the difference between schizophrenia patients and non-mentally-ill controls (except for the reasoning dimension), and should be employed whenever the investigators want to include more severe patients in their clinical trials. Older age, an increased percentage of men gender or inpatient status tend to escalate the score difference of decision-making competence compared to non-mentally-ill subjects in various dimensions of the decision-making capacity. The main limitations of the study are: (1) a decreased number of studies included in the analysis is small (2) only three studies included data about enhanced ways of informing potential subjects.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Side Effects of Clozapine and Their Relationship with Clinical Variables in Patients with Schizophrenia
Authors: Gürcan G. , Hun Şenol Ş. , Anıl Yağcıoğlu A.E. , Ertuğrul A.
Published: June 2017

Introduction

The side effects of clozapine may affect the treatment process negatively, and increase the disability.

Aims

We aimed to assess the side effects of clozapine, and their relationship with the clinical variables in schizophrenia patients, and study the predictors of disability.

Methods

Consecutive 122 outpatients who met DSM-IV criteria for schizophrenia, and were on clozapine treatment were included in the study. Information about sociodemographic characteristics, past and current clinical status were gathered through a clinical interview and review of the medical records, and physical measures and laboratory tests, including clozapine plasma levels, were recorded. The patients were assessed with SCID-I, Positive and Negative Syndrome Scale, UKU-Side Effect Rating Scale, WHO-Disability Assessment Schedule-II.

Results

Hypersalivation, weight gain, sedation and constipation were the most common side effects of clozapine. Although the mean plasma clozapine levels were high (828.11 ± 445.5 ng/mL), no significant effect of clozapine dose and plasma levels were detected on the severity of side effects, except for constipation. Metabolic syndrome prevalence was found to be 50% according to ATP IIIA criteria. Duration of clozapine treatment, clozapine dose and plasma levels were not significantly different between patients with and without metabolic syndrome. Regression analysis showed that the severity of schizophrenia psychopathology and the number of side effects predicted the severity of disability.

Conclusions

Side effects of clozapine increase the disability of patients with schizophrenia and should be monitored regularly. On the other hand, clozapine dose and plasma levels do not determine the severity of most of the common side effects.

Disclosure of interest

The authors have not supplied their declaration of competing interest.