bluuebunny/crossref_metadata_2025 huggingface dataset:
1751 – Does An Increase Of Staff Number Contribute To Changes In Physical Restraint Rates? a Longitudinal Measurement In a Geropsychiatry Unit
Authors: Voigtländer B.S. , Barth T.
Published: July 2013

Introduction

In Psychiatry there is a controversial discussion about the use of coercion in general. Against this background the question, by which factors physical restraint rates can be influenced is of foremost importance.

Objectives

In early 2008 we determined that those patients from the Geropsychiatry unit were most affected by physical restraints.

Aims

With the aim, to decrease physical restraint rates, a new concept of care was implemented in the Geropsychiatry unit. It included changes to staffing structure and staffing levels.

Methods

We performed a pre-post study (pre: 1st half of 2008, post I: 1st half of 2009, post II: 1st half of 2010, post III: 1st half of 2011). The evaluation focused on the criteria “staff number”, “physical restraint rates” and “fall rates”. The information value of the results is limited due to the used study design.

Results

There were no significant changes regarding the socio-demographic and performance data. The number of registered nurses (pre: 100%; post III: 122%) and assistant staff (pre: 100%; post III: 142) in real time increased by a total of 52 working hours per day on average. There were a significant decrease of the ratio of physically restrained patients (pre: 0.19; post III: 0.08; p < 0.0005), the total duration of restraint (pre: 3162 h; post III: 781 h; p < 0.0001), a reduction regarding further restraint criteria and insignificant changes in fall rates.

Conclusions

The results emphasize that changes to staffing levels can influence physical restraint rates. More and highquality research is needed.
1755 – Postpartum Depression, Anxiety And Marital Relationship: a Pilot Study
Authors: Di Marco S. , Gambaro E. , Zeppegno P. , Gramaglia C.
Published: July 2013

Introduction

The quality of a woman's relationship with her partner is associated with an increased risk of developing anxiety and depression in the postpartum.

Objective

To assess the prevalence of post-partum depression (PPD) and correlation between anxiety and depression in postpartum and the marital relationship in a sample of couples recruited at the Gynaecology Ward, “Maggiore della Carità” Hospital, Novara.

Aims

Evaluation of marital relationship functioning with regards to PDD onset.

Methods

This longitudinal study involved 44 couples recruited from February 2012 to March 2012. Single women, women suffering from severe chronic illnesses, drug addiction or alcoholism and with a previous diagnosis of psychiatric disorders were excluded. Mothers-to-be were assessed for depression and anxiety, during pregnancy and after delivery with the Edinburgh Postnatal Depression Scale (EPDS) and the Beck Depression Inventory-II (BDI-II). Both parents were assessed with the Relationship Satisfaction Scale (RSS); Relationship Assessment Scale (RAS); Marital Adjustment Test (MAT).

Results

The prevalence of PDD was 18% according to the EPDS and 10.5% according to the BDI-II. No gender differences emerged as far as the partner relationship is concerned. The Chi-square analysis revealed a statistically significant inverse correlation between the development of PDD assessed with EPDS after delivery and RSS score (p = 0.039) and RAS (p = 0.05). A statistically significant inverse correlation emerged between BDI-II and RAS (p = 0.005), and BDD and MAT (p = 0.006).

Conclusions

The prevalence of PDD was consistent with the literature. Satisfaction with the marital relationship and the functioning of parental relationship correlates with PDD onset. Clinical implications are discussed.
1761 – Alcohol Consumption And Cannabis Use In Young Adult Czechs
Authors: Csémy L. , Sovinova H.
Published: July 2013

Objectives

The main objective of the study is to explore associations between alcohol consumption and marijuana use in young adults and to discuss the opportunities for brief intervention.

Methods

Face to face structured interviews were carried out with 2,221 young adult Czechs (mean age 29.9, sd. 5.8 years). 51.4% were males. Alcohol consumption was calculated using beverage specific quantity frequency method. Alcohol-related problems were assessed using the Czech version of the AUDIT. Frequency of marijuana use in the last twelve months was asked as well.

Results

The overall alcohol consumption was 9.2 litres of pure alcohol per person and year. The last year prevalence of marijuana use was 21.8%. Marijuana use positively correlated with the frequency of beer drinking (r=.27), frequency of heavy episodic drinking [HED] (r = .32) and with the summary score in AUDIT (r = .39). Harmful or problem drinkers (AUDIT score >16) reported marijuana use more frequently than moderate drinkers (60% compared to 18.8%; OR = 6.54; 95% CI = 4.7; 9.1). OR for marihuana use in heavy episodic drinkers was 4.3 (95% CI = 3.3; 5.6).

Discussion

The results suggest that frequent HED and harmful drinking are closely associated with marijuana use in younger adults. Since marijuana use (including heavy use) is rather common in the Czech Republic, it would be recommendable to also extend screening and brief intervention to reduce the use of cannabis. The existing guidelines for brief intervention should be modified in order to cover marijuana consumption as well.
1762 – Defense Mechanisms, Personality Disorders And Eating Disorders: a Comparison
Authors: Pini E. , Caslini M. , Zappa L.E. , Bartoli F. , Lax A. , Clerici M.
Published: July 2013

Introduction

An analysis of the literature on eating disorders (ED) indicates that Eds are often comorbid with the diagnosis of Personality Disorder (PD). This seems to be a psychopathological feature, characteristic of this patient population. However, the double classification seems to be often insufficient when describing a very complex psychopathological picture. These observations have informed our intention to investigate these two distinct nosographic groups by means of a single construct.

Aims

The aim of this study is to identify and describe (through tests that evaluate defense mechanisms) the defensive styles that characterize the two groups of patients, in order to outline a defensive profile that can assimilate or differentiate the psychopathological groups.

Materials and methods

The study was carried at the Department of Psichiatry of the San Gerardo Hospital in Monza. The Defence Style Questionnaire-40 (Farma Cortinovis, 2000) was administered and analysed. The sample consisted of 40 participants with eating disorders, recruited among the outpatients for eating disorders, and 40 patients with personality disorders recruited from two Psychiatric Outpatient Services.

Results and conclusions

The data analysis showed a statistical significance in the use of Immature defense mechanisms and Neurotic defence mechanisms in both clinical samples.The patients with PD used a significantly higher number of psychotic defense mechanisms than patients with ED. These results may suggest that in ED patients, the symptoms can be themselves considered as defense mechanisms, or a defensive style that characterizes and makes specific the psychopathological picture.
1764 – Case Report: Antidepressant Withdrawal Mania
Authors: Nascimento M. , Graça J. , Palma D. , Trancas B. , Ribeiro R. , Luis A.
Published: July 2013

Introduction

Antidepressant withdrawal mania is a rare paradoxical event. It was initially reported in unipolar patients but it can also occur in bipolar patients, despite adequate mood-stabilizing treatment. It has been described with all antidepressant classes and may be self-limited or require medical hospitalization. Tapered withdrawal doesn’t seem to prevent the condition, though most reported cases developed after abrupt antidepressant discontinuation. Chronic antidepressant therapy enhances dopaminergic neurotransmission in the mesolimbic system. Noradrenergic hyperactivity and cholinergic overdrive secondary to antidepressant cessation are the most accepted theoretical mechanisms proposed.

Objectives

Case report, discussion and literature review.

Aims

We report a case of fluoxetine withdrawal mania and discuss its implications on clinical practice.

Methods

Case report and non systematic literature review.

Results

We present a case of a divorced 59-year-old woman who developed a manic episode shortly after antidepressant discontinuation. She was under antidepressant therapy since 2001, due to an unipolar chronic depressive disorder. She was put on fluoxetine 20 mg q.d. since 2005. On May 2012, she discontinued the antidepressant therapy upon misunderstanding medical advice. Few weeks later, she was involuntarily admitted to our inpatient unit presenting a manic episode with psychotic features. She started valproic acid 1000 mg q.d. and risperidone 4 mg q.d. and a complete remission was quickly obtained.

Conclusions

This case illustrates the potential for mania related to antidepressant discontinuation. Differential diagnosis includes spontaneous mania, antidepressant withdrawal syndrome and antidepressant induced mania. Finally, the authors discuss the adequacy of categorizing this entity in bipolar spectrum disorders.
1776 – Clinical And Cognitive Correlates Of Suicide Attempts In Bipolar Disorder
Authors: Seyller M. , Olié E. , Chaib L. , Henry C. , Courtet P. ,   the BIPADD Group of Face
Published: July 2013

Introduction

Bipolar disorder (BD) is strongly associated with suicidal behaviors. Suicidal behavior is based on a stress/vulnerability model. Several factors have been identified, including clinical features (such as impulsivity) and cognitive deficits (such as impaired decision making or problem solving). Identifying specific factors in BD patients is needed to better prevent suicidal behaviors.

Objectives

1)

To identify clinical and cognitive characteristics associated with suicidal behaviors in euthymic BD patients.

2)

To determine a correlation between neuropsychological variables and the number and characteristics of suicidal attempts.

Methods

214 euthymic BD patients from the national network of “Centres Experts Bipolaires” were included and divided into two groups based on the personal history of suicide attempts. Socio-demographic and clinical variables were collected and neuropsychological functions were assessed (attention, memory and executive functions).

Results

We found an association between suicidal behavior and gender, employment status. Suicidal attempters had significantly more mixed episodes and hospitalizations. There was no difference between the two groups concerning neuropsychological measures. The number of suicide attempts and verbal fluency scores were negatively correlated.

Conclusions

The lack of significant differences in neuropsychological scores may be due to a common vulnerability between suicidal behaviors and BD. Further studies, especially prospective ones, are needed in order to characterize high risk BD patients in order to develop effective specific preventive strategies.
1791 – A Case Of Psychosis In a Patient Affected By Beta Thalassemia Major: a Genetic Link?
Authors: Ranieri R. , Demartini B. , Mormandi G. , Scarone S.
Published: July 2013

A 35-year-old man affected by betathalessemia major was treated at the age of 10 years old by allogeneic bone marrow transplant and then he had a one-year treatment with cyclosporine. In March 2012 he was admitted to our psychiatric department because of delusional thoughts, hallucinations, anxiety and behavioral abnormalities. The insight was absent. His parents reported a progressive social retirement from the age of 16 years old and hallucinations even in the last few years. Furthermore the familial history was positive for psychotic symptoms (brother).

During the hospitalization, an antipsychotic therapy based on paliperidone was started. After two weeks at the dosage of 9 mg per day his psychopatological condition slowly improved. He was discharged after one month: delusions, hallucinations and behavioral abnormalities disappeared, anxiety decreased. During the following months the patient was evaluated: no relapse of positive symptoms was observed but his personal, social and working functioning remained significantly impaired. A diagnosis of schizophrenia has not been formulated yet because of the temporalcriterion.

Cases where schizophrenia and betathalassemia occurred simultaneously were reported in literature, mostly when psychotic symptoms affected more than one family member. The association maybe suggests a genetic link between these two disorders. Previous studies showed that genetic abnormalities in the short arm of chromosome 11, responsible of betathalassemia, are also known as crucial regions for the genetic susceptibility of schizophrenia.Further studies are needed to better clarify this genetic association in order to verify which abnormalities of chromosome 11 are more associated with the onset of schizophrenia.
1792 – Inpatient Suicide Risk Association With Depression, Anxiety Disorders And Pharmacogenetic Testing
Authors: Lineberry T. , Parsaik A. , Moore K. , Bryan C.
Published: July 2013

Introduction

National and international research has shown the association between depression and anxiety disorders with the risk of planned and impulsive suicidal behavior. Patients with depression may have severe anxiety or agitation associated with their depression with or without comorbid additional anxiety disorder diagnoses.

Objectives

1.

Evaluate differences between self rated overall suicide risk of inpatients on a treatment resistant depression unit based on presence or absence of comorbid anxiety disorder.

2.

Evaluate association of pharmacogenetic testing results with self-ratings of suicide risk.

Aims

1.

To determine if suicide risk of psychiatric inpatients is higher in patients with depression and comorbid anxiety disorder.

2.

To determine utility of pharmacogenetic testing with suicide risk assessment and patterns of use in patients with treatment resistant depression at a large academic medical center.

Methods

This is a retrospective records review study of a sample of over 700 inpatients on a treatment resistant depression unit at the Mayo Clinic. Patients overall suicide risk self-assessments will be analyzed for differences in suicide risk assessment controlling for diagnoses, age, and sex. Pharmacogenetic testing results, including serotonin transporter and p450 2D6 testing results, will be analyzed for their association with suicide risk.

Results

Statistical analyses results are pending at time of abstract submission.

Conclusions

At a population level, the interplay between anxiety disorders and depressive symptoms is felt to be key to understanding the progression from suicidal ideation to suicidal behavior. Factors complicating this at an individual patient level along with results of research study will be discussed.
1796 – Social Phobia In Non-demented 75- And 85-year Olds. Associated Factors
Authors: Karlsson B. , Skoog I.
Published: July 2013

Introduction

Social phobia is one of the most common psychiatric disorders. There is a lack of knowledge on the relationship between social phobia and cognitive functioning among older adults.

Aim

To examine cognitive functioning, prevalence and psychiatric comorbidity of social phobia in an elderly population.

Methods

A general population sample of non-demented 75-year olds (N = 768) and 85-year olds (N = 432) was investigated in 2005-2006 (75-year olds) and 2009-2010 (85-year olds) by psychiatric nurses. The procedure was identical with semistructured psychiatric examinations including the Comprehensive Psychopathological Rating Scale, and the Mini International Neuropsychiatric Interview. Social phobia was diagnosed according to the DSM-IV criteria. Cognitive function was measured with the Mini-Mental State Examination, and eight different psychometric tests measuring short- and long-term memory, nonverbal memory, logical reasoning, visuospatial and executive ability.

Results

The one-month prevalence of social phobia was 2.5% (N = 30), this was more common among women than among men (3.2% vs. 1.3%). Individuals with social phobia more often had major depression compared to individuals without symptoms of social phobia (33.3% vs. 4.3%). MMSE-score did not differ between individuals with and without social phobia. Individuals with social phobia had worse visuospatial and executive ability measured with Clock Test, compared to individuals with no symptoms of social phobia.

Conclusions

Our results indicate that social phobia is not unusual in old age and that comorbidity with depression is common. Social phobia does not have an impact on global cognitive functioning. Social phobia influenced visuospatial and executive ability but not performance on several other cognitive tests.
1800 – Improvement Of Attention Deficit Hyperactivity Disorder Management In The Primary Medical Home Through Psychiatrist-taught Psychopharmacology
Authors: Wegner L. , Humble C. , Domino M. , Stiles A. , Wegner S. , Kratochvil C. , Jensen P.
Published: July 2013

Introduction

US primary care clinicians (PCCs) are increasingly assuming the medical management for psychiatric disorders. Clinical practice guidelines (PCGs) remain gold standard for professional care, yet physician adoption is not universal. We sought identification of methods to increase evidence-based mental health practices for the most commonly diagnosed pediatric behavioral condition, attention deficit hyperactivity disorder (ADHD).

Objective

Test two psychiatric interventions of different intensity levels, both designed to increase primary care clinicians’ use of PCGs for managing ADHD.

Aims

Increase PCCs’ use of PCGs for managing ADHD.

Methods

Participants: 70 North Carolina (NC) PCCs ; 70 case managers; 35 to 40 pediatric resident physicians; 420 pediatric government-insured patients ages 6-18 years (chart abstraction only).

Procedures: PCCs were randomized to:

(1)

PCC training and follow-up support only; or

(2)

PCC, case manager, and office staff training (collaborative) and follow-up support interventions.

Differences in knowledge, skills, attitudes, and ADHD assessment and treatment practices assessed by participant selfcompleted surveys at baseline, 6, and 12 months. Six of their patient charts were abstracted to determine the extent they followed American Academy of Pediatrics (AAP) treatment guidelines. NC Medicaid (government insurance) claims for children and adolescents of participating practices and a group of control practices were reviewed for diagnostic documentation.

Results

For collaborative trained PCCs:

(1)

increased use of ADHD symptom screeners and greater frequency of F/U visits;

(2)

greater identification of children with ADHD, but decrease in the probability of receiving an ADHD medication

(3)

lower rate of prescribing above dosing guidelines.
1820 – Suicide In The Us Army
Authors: Lineberry T.
Published: July 2013

Introduction

Suicide rates in the United States Army have steadily risen over the past eight years to record levels and continue to rise. The suicide rate now is greater than the general US population even after controlling for sex and age. This change is even more concerning based on the previous steady decreased rate compared to the US general population in the thirty years prior to 2004. In 2012, suicide deaths have outpaced combat deaths year to date.

Objectives

1. Using epidemiologic surveillance data and new scientific data, describe factors associated with the increase in suicide deaths and potential targets for interventions.

Aims

Provide overview of factors associated with suicide in military populations and effects of combat on suicide rates.

Methods

Information provided will be based on current published and ongoing research synthesizing the larger suicide research literature.

Results

Suicide in the Army has steadily increased since 2004 along with other surrogate markers of increased psychiatric illness including post deployment surveillance, anonymous surveillance, clinical utilization rates and rates of drug misuse and abuse.

Conclusions

Integrating media and scientific reports on the increased rates of miltary suicide is challenging. However, clinically relevant targets to impact rates along with strategies to research factors associated with suicide and larger prevention efforts hold promise.
1823 – Addiction To High Dose Buprenorphine And Sexually Transmitted Diseases In Tunisia
Authors: Belarbi A. , Ben Ammar H. , Moula O. , Bouasker A. , Ghachem R.
Published: July 2013

Introduction

High dosage buprenorphine (Subutex) is actually the principal treatment for substitution medication. Some misappropriations and wrong uses have been seen; the most frequent and sever being using tablets for injections. Since the introduction in different countries, the high dose buprenorphine as a substitition treatment for opioid drug dependence, the number of overdose deaths and heroin users are significantly declined. But the existence of non-use replacement of this processing, mainly intravenously, was born a new scourge of addiction, especially in Tunisia. Besides the risk of overdose, there is a risk of viral contamination.

Objectives

To study the sexually transmitted diseases among patients addicted to high dose buprenorphine in Tunisia and followed in the outpatient hospital Razi.

Materials and methods

It is a retrospective study of twenty-three (23) patients (23 men), injection of high dose buprenorphine, having consulted the outpatient clinic of Razi Hospital between January and July of 2012.

Results

8 patients had a communicable disease: 1HIV, 5 Hepatitis C, 1Hepatitis B, 1 syphilis. 4 patients had infectious complications: 3 cases of skin infections and 1 case of endocarditis. 9 had never been screened. 8 recognized using a used needle.

Conclusion

The addiction to high dose buprenorphine is a widespread phenomenon in Tunisia. Lack of information and awareness of companion in Tunisia is at the origin of serious infectious complications. Health professionals have to play an important role in drug addict patients’ education and supervision, to prevent addiction to buprenorphine and related infectious complications.
1826 – State And Trait Anxiety In Young Women With Vasovagal Syncope
Authors: Szewczuk-Boguslawska M. , Zysko D. , Kaczmarek M. , Agrawal A.K. , Rudnicki J. , Gajek J. , Fedorowski A.
Published: July 2013

Objectives

The aim of the study was to assess the state and trait anxiety in women with vasovagal syncope.

Methods

The study group consisted of 50 women referred to tilt testing with finally diagnosis of vasovagal syncope and 166 women from general population: 115 women who have never experienced faints (control negative group), 51 women who reported at least one faint episode (control positive group). All women were aged 21-40 years old. Women filled State and Trait Anxiety Inventory (STAI), the women from study group just before tilt testing after the whole procedure explanation. No one asked woman refused STAI completion or tilt testing. The STAI results were presented as raw results and trichotomized into lower than average, average and higher than average.

Results

The raw result of STAI as a state was significantly higher in the study group (41.6 ± 9.8) than in the both control groups (37.6 ± 10.6 and 39.8 ± 10.5) p< 0.05. The raw results of STAI as a trait did not differ among groups (respectively 41.3 ± 8.7 vs 40.4 ± 9.4 vs 42.3 ± 8.8 p=NS). The occurrence of lower than average trait anxiety was significantly lower in study (36.0%) and control positive group (37.3%) than in the control negative group (56.5%) p< 0.05. The percentage of women with higher than average trait anxiety did not differ.

Conclusions

1.

High trait anxiety seems not be related to the occurrence of vasovagal syncope.

2.

Lower than average trait anxiety may play protective function of vasovagal syncope occurrence.
1827 – Prevalence Of Risk Behaviours Among European Young. Preliminary Data From An Italian Sample We-stay Project
Authors: D’Aulerio M. , Carli V. , Iosue M. , Basilico F. , Recchia L. , Apter A. , Balazs J. , Bobes J. , Brunner R. , Cosman D. , Kahn J.P. , Postuvan V. , Saiz P. , Varnik A. , Wasserman C. , Hoven C. , Sarchiapone M. , Wasserman D.
Published: July 2013

Introduction

Truancy negatively affects almost every aspect in the life, including physical, mental health, social and economical conditions.

Objectives

To implement and evaluate outcomes of three different kinds of intervention against truancy. A mechanistic intervention to stop truancy will be used as control.

Aims

To reduce truancy among European adolescents improving mental health in European high schools.

Methods

The WE- STAY intervention carried out in 6 different European Countries. In Italy a sample of 2265 High school students (mean age 15.6 ± 0,6; 64,4% females) was selected. The students were randomized into one of four different intervention arms. Baseline evaluation of students' lifestyle, coping styles, at-risk truancy, self-harm behaviours and mental health issues was collected using a structured questionnaire.

Results

6% has been absent from school for 7 days or more without a valid excuse during the past year. 55,0% of the sample has smoked cigarettes; 7,2% drank alcohol 4 or more time during the week (13,9% male and 3,4% female). About the use of drugs, 17,4% of them used drugs at least once in a lifetime. 16% of the students started a fight at least once in a lifetime.

Conclusions

Truancy is often related to mental health problems and at-risk behaviours. The truancy has been the focus of a different policy initiatives, often ended in failure. Through the implementation of WE-STAY is possible to acquire more data on truancy prevalence and its correlated psycho-social and psychiatric aspects, as well as information on school and parents attitudes toward this phenomenon.
1830 – The Particularities Of The Long-term Evolution Of Functional Psychoses (the Timisoara Project Of Typology And Evolution Of Functional Psychosis)
Authors: Lazarescu M. , Blajovan J. , Giurgi-Oncu C. , Baranescu R. , Milin M. , Mihalcea R. , Suflea C. , Rosu M.
Published: July 2013

This study discusses 597 cases of functional psychosis with an average evolution of over 10 years and a stable diagnostic over the last 5 years, found in the outpatient service of Timisoara.

The cases are part of the project entitled The Timisoara Project of Typology and Evolution of Functional Psychosis, initiated with a Case Register since 1985 to date.

The research team has since remained unaltered and for all the cases there was a permanent record of psychopathological episodes upon admissions, clinical evolution and treatment between episodes, socio-demographic dynamics, as well as other types of evaluation.

The assessments were made at 1 year after onset, and respectively after 5, 10 and 15 years. The stability or metamorphosis along time of these diagnostics was evaluated, as well as other clinical parameters from onset to present days. The approach has allowed for the parallel study of the following casuistry (understood both as episode and constant disorder): schizophrenia, persistent delusional disorder, bipolar disorder with or without delusional ideation, major depressive disorder with or without delusional ideation, schizoaffective disorder (with various subtypes). The casuistry has evidenced delusional disorder as being distinct from schizophrenia, both in terms of independent evolution, as well as in association with affective pathology.
1831 – Dnase And Protease Activity Of Immunoglobulins g Of Patients With Schizophrenia
Authors: Smirnova L. , Fattakhov N. , Parshukova D. , Buneva V. , Kornetova E. , Semke A. , Ivanova S.
Published: July 2013

Introduction

Phenomenon of presence of catalytic properties in immunoglobulins has been actively investigated. Research of catalytic properties of antibodies in schizophrenic patients with various clinical manifestations of the illness has not been carried out previously.

Objectives

To study DNase and proteolytic activity of immunoglobulins G isolated from serum of blood of patients with schizophrenia.

Methods

IgG have been isolated from serum of blood of 34 persons with affine chromatography. DNase activity of antibodies was identified according to degree of hydrolysis of supercoiled form of DNA of plasmid pBluescript per unit of time. Proteolytic activity was assessed according to degree of hydrolysis of basic protein myelin and its peptides. IgG were electrophoretic homogeneity.

Results

We have identified that IgG of schizophrenic patients possess a higher (0,392 ± 0,19 nM DNA /mgAB/h), than in healthy persons (0,029 ± 0,06 nM DNA /mgAB/h) specific DNAse activity. It has been shown that DNase activity is an own property of antibodies. It has been found that proteolytic hydrolysis of serum of blood of schizophrenic patients is 5 times as high as indices of hydrolysis in healthy persons. It has been revealed that patients with predominant negative symptoms show maximum high percent of protease hydrolysis 66,9%, different from patients with leading positive symptoms (13,9%).

Conclusions

Increase of DNA-hydrolyzing properties of Ig G is likely to be associated with great number of extracellular DNA. Detection of high values of proteolytic activity may be associated with occurring in serum of blood of patients of large number of destructed or damaged proteins.
1833 – Incest: a Traumatic Experience: a Case Report
Authors: Belarbi A. , Ben Ammar H. , Moula O. , Bouasker A. , Ghachem R.
Published: July 2013

Introduction

Incest may be defined as sexual relations between close blood relatives. It is found in all walks of life and all cultures. Incest is a taboo in all populations. This “secret” lived in childhood raises questions about the future of such a psychological trauma. Father-daughter incest is the most common. It has psychological, social, medical, and legal ramifications. Recently, it was reported that being the victim of paternal incest during childhood might be a significant predictor of a borderline personality disorder and complex posttraumatic stress in adults. Tunisia is among the countries from which incest cases are rarely reported.

Objectives

Browse the impact of this early trauma on victims to become adult and difficulties the therapeutic approach.

Clinical case

We propose from a clinical case of a family, in which five girls were victims of father-daughter incest.

Conclusion

This would suggest that father-daughter incest is the most traumatic experiences which deserves attention and that we cannot afford to ignore. In-depth knowledge of the dynamics and effects of father-daughter incest suggest specific treatment strategies are indeed necessary.
1840 – Pharmacokinetics Of Lithium During Delivery And In The Neonatal Period. a Preliminary Data
Authors: Guitart M. , Imaz M.L. , Soy D. , Torra M. , González-Rodríguez A. , Hernández S. , Hernández Rambla C. , Soler C. , Torres A. , Garcia-Esteve L.
Published: July 2013

Introduction

Lithium has been used in the treatment of bipolar disorder in pregnant women. However, information on the pharmacokinetics of lithium during perinatal period is scarce.

Objectives

To study pharmacokinetics of lithium during delivery and in the neonatal period.

Methods

A prospective, observational and naturalistic study was conducted at the PERINATAL PSYCHIATRY PROGRAM CLÍNIC-BARCELONA, from 2005 to 2012. We included all consecutive cases of pregnant women with bipolar disorder I or II (n = 22), and on maintenance treatment with lithium monotherapy (n = 13) or polytherapy (n = 9) during pregnancy who elected artificial feeding. Lithium plasma concentrations in maternal blood and umbilical cord were detected. Lithium plasma concentrations in infants (n = 16) at delivery and in the neonatal period were obtained to calculate elimination half-life, which was estimated by lineal regression. Technique: AVL 9180 electrolyte analyser using a lithium-selective electrode (detection limit =0.10 mEq/L).

Results

Women did not fulfil diabetes criteria pre-pregnancy and during pregnancy. Attending to neonatal outcomes, infants exposed to polytherapy had a higher weight at birth (percentils) than those exposed to lithium alone [53.38 (33.40) vs. 70.22 (26.25)]. No statistically significant differences were found in umbilical cord:maternal plasma concentration ratio between those treated with lithium monotherapy and women treated with polytherapy (1.05 vs. 1.08). The lithium mean elimination half-life (SD) in infants was 6.73 (9.12) days.

Conclusions

Lithium crosses placental barrier almost completely. Elimination half-life in neonates exposed to lithium in utero was 6.73 days. Moreover, lithium treatment during pregnancy requires therapeutics monitoring in exposed dyads.
1841 – Increased Mortality In Young Women With Personality Disorder
Authors: Holm H. , Ekselius L. , Björkenstam E. , Björkenstam C.
Published: July 2013

Introduction

Young women with personality disorders (PD) are common in psychiatric inpatient care. The clinical impression is that there is a considerably increased incidence the last decade.

Objectives and aim

To show changes in frequency and extent of inpatient care for PD, and the relation to suicide.

Method

All admissions for inpatient care given a primary diagnosis of PD in compulsory or voluntary care years 1990 to 2010 were extracted from the National Patient Register. Subsequently, data from the Cause of Death Register were extracted and linked for the same time period.

Results

There were more than 60,000 admissions for PD in Sweden 1990–2010. During the last ten years there was a doubling of the number of yearly admissions for young women in the ages 18 to 24 years, and inpatient care hospitalization for PD are currently six times more common for women than for men in this age group. The same is true for compulsory care. Every fifth woman in this age group who had committed suicide had been treated for PD within the last five year period prior to the suicide.

Conclusions

The incidence of inpatient care in young women with PD did show a sharp rise during the last decade. There was a corresponding increase in suicide with a diagnosis of PD. Guidelines for treatment and care exist but more knowledge and action plans directed both to health care and the society are urgently needed.
1842 – Severe Mental Illness And Metabolic Syndrome: a Meta-analysis
Authors: Bartoli F. , Carrà G. , Carretta D. , Lax A. , Pini E. , Clerici M.
Published: July 2013

Introduction

People suffering from Severe Mental Illness (SMI) have a shorter life expectancy than general population. The excess of mortality may be primarily due to premature cardiovascular diseases. Subjects with a diagnosis of SMI may have an high prevalence of Metabolic Syndrome (MetS).

Aim

To estimate the risk of MetS among subjects with SMI compared to their counterpart without SMI.

Methods

A systematic review and meta-analysis of English and non-English articles using PubMed, Embase and PsycINFO was performed. ORs with related confidence intervals were used as association measures. All pooled analyses were based on random-effects models.

Results

The pooled analysis showed a statistically significant association for MetS in people suffering from SMI. However, we found a consistent level of heterogeneity between the included studies. Subanalyses showed that both SCZ and BD had higher risk than general population without SMI. No statistical differences were found comparing SCZ and BD subjects.

Conclusions

People with SMI have significantly higher risk to having MetS than general population. Despite some limitations, the results of present meta-analysis emphasize the relevance of a continuous cardio-metabolic assessment in the SMI population. Longitudinal researches are needed in order to assess the impact of a regular cardiovascular screening, prevention and treatment on the improvement of health status and life expectancy among people suffering from SMI.
1848 – From Gene Expression Variation To Definition Of Biomarkers In Depression
Authors: Belzeaux R. , Ibrahim E.C.
Published: July 2013

Several studies examined gene expression variations in depressive patients compared to control subjects in post-mortem samples as well as in fresh peripheral tissues.

Our aim has been investigate gene expression variations during Major Depressive Episode (MDE) in peripheral blood mononuclear cells (PBMCs). We collected PBMCs from two different cohorts of severe MDE patients (n=11 and n=13) and compared gene expression between patients and matched-control subjects. Moreover, in a 64 weeks prospective study, we had the opportunity to investigate what happens when a healthy subject gets his first MDE. We analysed gene expression variations accross time in both patients and controls and used both pan-genomic microarray and RT-qPCR strategies for RNA quantification. Finally, to compare gene expression variations in blood tissue and in post-mortem, we benefited from transcriptome databases to reanalyze, with uniform filtering and quantification procedures, gene expression in a large set of samples collected from other groups.

We found several genes whose expression vary significantly between patient and control subjects as well as between the severe acute MDE phase and the following therapeutic response or remission phases occuring several weeks and months later, respectively. Beyond then, both well-known candidate genes, such as 5HTT, TPH1 or NRG1, and new genes (HIST1E1, PPT1) could be proposed for biomarkers development in MDE.

Our results demonstrate that gene expression variation in PBMCs could be relevant as biomarkers for depression. The convergence of our data and other studies will be discussed as well as the comparability between brain and blood gene expression.
1857 – Peer Relationships And Adolescents Mental Health: Finding From The Seyle Project In Italy
Authors: Iosue M. , Carli V. , D’Aulerio M. , Basilico F. , Recchia L. , Apter A. , Balazs J. , Bobes J. , Brunner R. , Corcoran P. , Cosman D. , Durkee T. , Haring C. , Kahn J.P. , Keeley H. , Marusic D. , Postuvan V. , Resch F. , Saiz P. , Varnik A. , Varnik P. , Wasserman C. , Hoven C. , Sarchiapone M. , Wasserman D.
Published: July 2013

Introduction

Peer relationships play a critical role in the development of adolescents, not only for the acquisition of social skills but also for the sense of personal identity and competence. Thus the quality of peer relationships influences actual and future mental health of the adolescent.

Objectives

SEYLE (Saving and Empowering Young Lives in Europe) is a randomized controlled trial, funded by the EU, evaluating interventions for mental health promotion and suicide prevention. The study comprised 12,395 high-school students from 11 European countries.

Aims

We investigated the differences on psychological problems between students with poor and good peer relationships.

Methods

1,195 adolescents (mean age 15.3 ± 0.6; 68% females) from the Molise region constituted the Italian sample. Adolescents were identified as with poor peer relationships if they never or just sometimes get along with people of their age, feel that peers like having them in the group and feel that peers were kind and helpful. Psychometric measures were used to assess mental health problems such as depression (Beck Depression Inventory II), anxiety (Zung Self-Assessment Anxiety Scale), well-being (WHO-5) and suicidal ideation (Paykel Suicide Scale).

Results

Adolescents who reported poor peer relationships scored significantly higher (p < .005) on the scales assessing depression, anxiety and suicidal ideation and significantly lower (p < .001) on the WHO-5.

Conclusions

Particularly in adolescence peer relationships may influence psychological well-being and vice versa mental health influences the openness to the others. So promoting mental health and contemporary improve social skills could lead adolescents to a better life.
1859 – The Effect Of Unemployment On Mental Health
Authors: Chletsos M. , Mazetas D. , Kotrotsiou E. , Gouva M.
Published: July 2013

Introduction

Considering the current Greek economic crisis, it is reasonable to discuss the potential and expected effects of the crisis in mental health.

Objective

This study examined the effect of unemployment on mental health.

Aim

This study aimed at detecting the interaction of unemployment on the bio-psycho-social health.

Materials and methods

273 community individuals participated in the present study (122 men - 151 women, mean age 49,2± 6,9). The measures used were: a) Family Environment Scale (FES), b) the Hostility and Direction of Hostility Questionnaire (HDHQ), c) the Symtom Checklist 90-R (SCL-90), and d) State - Trait Anxiety Inventory (STAI), e) Short Form Health Survey (SF-36), f) Other As Shamer Scale (OAS), g) Experience of Shame Scale (ESS).

Results

Multivariate analysis was applied for the statistical analysis of data, and the results was: a) the unemployed have the highest level (6.82) of feelings of inferiority, the total price (47.30) of internal shame, State Anxiety (47,58), Obsessive- Compulsive (11,42), interpersonal sensitivity (8,30), depression (13,64), phobic anxiety (3,79), and intropunitiveness hostility (7,45). Still have the lowest levels of the scales of Intellectual - Cultural Orientation (4,97), family orientation for active recreational activity (3,61), mental health (58,00), physical role (62,12) and summary scale of physical health (266,64).

Conclusion

It was found that the unemployed suffer more than all social groups at periods of economic crisis and this has impacts on psychosomatic health, on state stress, as much as on the feelings of inferiority and shame which they feel.
1878 – The Relationship Between Life Satisfaction And Levels Of Social Functioning In Elderly
Authors: Senyurt M. , Gun H. , Demiralp M.
Published: July 2013

Purpose

This descriptive study aims to determine the relationship between life satisfaction and levels of social functioning in elderly.

Method

The sample of the study is consisted of 115 individuals who lives in a district of Aydın between January-March 2012 and who are volunteer to participate the study. The data were obtained from Sociodemographic Data Collection Form, Social Functioning Scale (SFS) and the Life Satisfaction Scale (LSS). Chi-quare, Correlation, Mann-Whitney and Kruskal-Wallis tests were used in data analyzes.

Findings

57.4% of the participants were women, 58.3% of elderly participants were married and 93% used auxiliary device. The mean LS total score of men were higher than women (X=10.1 ±3.7). There was a statistically significant relationship between total score of Life Satisfaction Scale and the subscales of Social Functioning. A statistically significant difference were found between age and interpersonal functioning, independence-competence, independence-performance subscales of SFS (X2= 11.584, p= 0.003, X2= 14.988, p= 0.001 and X2= 20.190, p= 0.00 respectively).

Unlike the male, life satisfaction scores were increased in females if leisure time activities were increased (z=3.445, p= 0.001). There was a positive correlation between interpersonal functionality and life satisfaction score (r= 0.188, p= 0.045) in elderly. Interpersonal functioning and business-professional scores were lower in the individulas who were using the auxiliary devices (respectively X2=12.405, p= 0.03 and X2=25.674, p= 0.00). The individuals who live alone were more socially withdrawn than the others (X2= 41 289, p = 0.00).

Results

Life satisfaction and social functioning in elderly were affected from each other in high levels.
1890 – Creative Agency: The Autobiography Of Mental Illness: An Exploratory Review Of Practice Of Writing As a Tool During Mental Illness
Authors: Kumar S. , Gent M.
Published: July 2013

Introduction

Mental Illness is a very unique and intimate experience. Over the ages various art forms, particularly writing have been used to document experiences of mental illness. Though the history of Psychiatry is a feature of mainstream Psychiatric training, complementary study of literature and its relevance to mental illness is underused.

Objectives

To undertake an exploratory search of writing as tool to reflect the phenomenology of mental illness and to evaluate the role of medical humanities in understanding and coping mental illness.

Aims

To present an explorative review of a selection of poems and prose by authors with mental illness who have written in English Language.

Methods

We conducted a comprehensive search of online databases including the Madness and Literature Network (UK), Medical Humanities Resource Database (UK), the Arts Literature and Medicine Database (US) and other popular books.

Results

We compare various extracts by well known authors along with the lesser known contemporary accounts of writers to evaluate the role of writing.

Conclusions

There is a long tradition of writing about depression mental illness in the canon of English literature. Compared to autobiographical writing about depression, it is difficult to identify many autobiographical accounts of severe mental illness. Examples of writing projects illustrate that people with severe mental illness, and with dementia, may use the support of others to produce creative writing. It may be useful to Psychiatrists in training, and to wider society, to reflect on the creative agency inherent in their writing.
1901 – Child And Adolescent Psychiatry In Light Of National Programme Of Mental Health In Poland
Authors: Cialkowska-Kuzminska M. , Kasprzak M. , Kiejna A.
Published: July 2013

Introduction

National Programme of Mental Health was established by the government in 28.12.2010. It specifies direction of health care development. The main goals of National Programme of Mental Health are: 1. Promotion mental health and prevention of mental disorders 2. Provision of support and easy access to psychiatric health care and other forms of care necessary for living in families and society.3. Development of research and information about mental health. Nevertheless there is still lack of the separate, coherent programme on promoting and preventing mental health among children and adolescents.

Objectives

To indicate the main barriers in current development of child and adolescent psychiatry in Poland.

Methods

Quality and quantity assessment of national programmes, analyses of distribution of child and adolescent mental heath services.

Results

However a significant improvement in area of child and adolescent psychiatry took place, some barriers are still noticeable: the insufficient number of child and adolescents psychiatrists, low numbers of programmes related to early intervention, low availability of psychotherapy and sociotherapy, insufficient number of centres to help dysfunctional families and families in crises, low number of programmes on mental health promotion implemented as regular activities in schools.

Conclusions

There are needs of coordination in service planning and regular evaluation of child and adolescent mental heath services.