bluuebunny/crossref_metadata_2025 huggingface dataset:
Impact of a type-D personality on clinical and psychometric properties of patients with a first myocardial infarction in a Turkish sample
Authors: Annagür B. , Demir K. , Avcı A. , Uygur Ö.
Published: May 2016

Objective

Recent studies have shown that a Type D personality is associated with an increased risk of cardiac mortality. This study aimed to examine impact of a Type D personality on clinical and psychometric properties of patients with a first myocardial infarction (MI) in a Turkish sample.

Method

The study included 131 patients who were admitted to the coronary care unit of a hospital with a first MI. All the patients underwent a psychiatric assessment within 2–6 months post-MI. Psychiatric interviews were conducted with the Structured Clinical Interview for DSM-IV (SCID-I).

Results

The first study group (Type D personality) included 50 patients, and the second study group (non-Type D personality) included 81 patients. There was a 38.2% prevalence of the Type D personality in the patients with a first MI. Those with this type of personality had a significantly higher frequency of hypertension and stressful life events. The Type D patients also had more psychiatric disorders, depressive disorders, and anxiety disorders than the non-Type D patients.

Conclusions

Our findings suggest that Type D personality traits may increase the risk of hypertension and the risk of psychiatric morbidity in patients with a first MI. Considering that a Type D personality is a stable trait; we suggest that this type of personality is a facilitator of clinical depression and anxiety disorders. These findings emphasize the importance of screening for a Type D personality as a cardiovascular risk marker and a psychiatric risk marker in MI patients.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Depression, somatic complaints and medical help-seeking in a Romanian sample
Authors: Giurgi-Oncu C. , Bredicean C. , Giurgi-Oncu F. , Romosan R. , Ienciu M.
Published: May 2016

Introduction

Depression as a disorder, with all its intensities and clinical forms, requires to be projected on the backdrop of human suffering. In evaluating a depressive episode of a somatically ill person, it is important to assess personality and social context as a whole.

Objectives

To establish the degree of somatic comorbidity/somatization in depressive patients and the correlation with their social support network.

Aims

To recommend cost-effective psycho-social interventions to offer relief and support.

Method

We evaluated 60 patients with depression of various etiologies (Recurrent depressive disorder, Paranoid-depressive disorder, Anxious-depressive disorder). Self-report and observer rating scales were used (SCL-90, Beck, Hamilton) along with a suplimentary consult (where required) by different specialists. Direct observations were made regarding the social support network, in terms of evaluating their scale and efficiency.

Results

The majority of patients included showed an obvious inconsistency in terms of objective and subjective symptoms, correlated with the lack of an adequate social support network. This resulted in more medical help-seeking, a polymorphic array of somatic symptoms, oscillations of somatic complaints, some showing lack of adherence and only mild improvement with psychotropic therapy. Most of the somatized complaints were gastro-intestinal, respiratory, pain-related and pseudo-neurological, with an increased overall evidence-based cardio-vascular comorbidity.

Conclusions

We suggest that in order to help support patients and ensure fluidization of medical services, mental health care could also be delivered effectively in primary care settings, through community-based programmes and task shifting approaches that engage and support skilled non-specialist health professionals, lay workers, affected individuals, and caregivers (Kakuma, 2011).

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Anxiety, depression, poor life-style choices, coronary event - Which causes which?
Authors: Jendricko T. , Radic K. , Vincelj J.
Published: May 2016

Introduction

Various risk factors for development of acute coronary syndrome (ACS) have been discovered. ACS has numerous consequences, including physical and mental health disturbances.

Aim

To distinguish mental health consequences and risk factors for ACS.

Objectives

To explore the interdependence between poor life-style choices (physical inactivity, cigarette smoking, unhealthy diet, alcohol consumption) and development of anxiety or depressive disorders 1 month and 6 months after ACS.

Methods

Follow-up study on 120 subjects with ACS, retested after 1 and 6 months. Existence of previous or actual mental disorders were excluded in the first phase.

Instruments

Mini International Neuropsychiatric Interview, questionnaire of general sociodemographic data and life-style factors, Acute Stress Disorder Interview and Clinician-administered PTSD Scale. Lipid levels and BMI were tracked.

Results

After 1 month 27.5% of the subjects had acute stress disorder (ASD) and 13,8% had major depressive disorder (MDD). After 6 months, 37.5% subjects had PTSD and 27.3% had MDD. Alcohol consumption showed to be predictive for development of MDD in the second phase (P = 0.002; OR = 2.48), and physical inactivity showed to be predictive for development of comorbidity of MDD and ASD in the second phase (P = 0.036; OR = 100.00).

Conclusion

Cardiovascular disorders can cause anxious & depressive disorders in frequent alcohol consumers and physically inactive subjects. Since depression, anxiety, physical inactivity, and alcohol consumption cannot only be considered as risk factors for cardiovascular disorders, but also be seen as a consequence of cardiovascular disorders, strategies for primary and secondary prevention of coronary events should include a greater concern for mental health as well.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Prevention of postoperative delirium - A prospective nurse-led intervention on surgical wards in a general hospital
Authors: Kratz T. , Diefenbacher A.
Published: May 2016

Objective

Delirium is a frequent postoperative complication in older and cognitively impaired patients in general hospitals. Delirium is associated with prolonged hospital stay as well as with an increased risk of nursing home placement after discharge. We wanted to study whether the implementation of a specialized delirium nurse on a surgical ward leads to a reduction in the frequency of postoperative delirium.

Methods

In an open-label study on two surgical wards of a general hospital, first the prevalence rate of postoperative delirium in patients older than 70 years was assessed (March to August 2011). During the following intervention phase (September 2011 to June 2012), a trained geriatric nurse implemented delirium-preventative measures in accordance with the Hospital Elder Life Program (HELP). The second surgical ward provided standard treatment as usual as an in-house control.

Results

Overall 20.2%, 95% CI [14.6, 26.4] of patients on both wards without special intervention developed postoperative delirium. By implementing preoperative screening measures and specific interventions by a delirium nurse, the incidence of postoperative delirium was reduced to 4.9%, 95% CI [0.0, 11.5]. The interventions were validation, improving sleep quality, cognitive activation, early mobilisation, improving sensory perception and optimising food and fluid intake. Most important predictors of postoperative delirium were Mini Mental Status Exam results, age and preoperative infection.

Conclusion

The establishment of a specialised delirium nurse as well as the implementation of simple preoperative care measures increased postoperative attention, cognitive activation and is associated significantly with reducing risk of postoperative delirium in older and cognitively impaired inpatients.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Alternative treatment options for lithium-induced nephrogenic diabetes insipidus
Authors: López-Romeo S. , Ledesma-Iparraguirre G.
Published: May 2016

Introduction

Lithium is currently a drug of choice for treating persons with bipolar disorder and is widely used in this population. Approximately, 30% of patients taking lithium experience at least one episode of lithium toxicity. Treatment of acute toxicity involves correction of electrolyte abnormalities, volume repletion followed by forced diuresis, and dialysis in severe cases. A case report is described and it is reviewed some alternative treatment options before considering withdrawal of lithium treatment in lithium-induced nephrogenic diabetes insipidus.

Case report

A 58-year-old woman diagnosed of hypertension and bipolar disorder for 20 years. At first, she was controlled with valproic acid until she suffered a manic episode which required a mood stabilizer switch. She started a treatment with lithium 1200 mg/day and olanzapine to 10 mg/day and was completely recovered. After a year of stabilization, olanzapine was retired and she maintained stabilized with lithium 1000 mg/day during last 17 years. During last 8 months, she suffered polydipsia and polyuria (4 L/day). She was diagnosed of nephrogenic diabetes insipidus. Some measures like liquid restriction, lithium monodose and low sodium diet were carried out, obtaining a partial response. Taking into account, she was stabilised with lithium for many years, it was decided to introduce hydrochlorothiazide 25 mg/day, clinical and analytical resolution of nephrogenic diabetes insipidus was obtained. A year later, she maintains psychopathological stabilization, without any lithium secondary effects.

Conclusion

Some treatment options for lithium-induced nephrogenic diabetes insipidus could be introducing thiazides, amiloride, indomethacin, desmopressin or carbamazepine, instead of withdrawal lithium.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Affective disorders in multiple sclerosis
Authors: Said M. , Ouanes S. , Nefzi R. , Aissa A. , Maatallah H. , Ben Ammar H. , El-Hechmi Z.
Published: May 2016

Background

Psychiatric disorders have a remarquable frequency in multiple sclerosis. The leading group of these disorders consists of affective disorders. These psychiatric conditions can worsen the outcome of multiple sclerosis, thus contributing to increase the burden of the disease to both patients and relatives. Managing such a complicated situation needs a focus on the underlying links between affective disorders and multiple sclerosis.

Objective

To examine the hypotheses proposed to explain the high prevalence of affective disorders in patients with multiple sclerosis.

Methods

Literature was reviewed using the Medline database and the following keywords “bipolar disorder” “affective disorder”, “mania” and “multiple sclerosis”.

Results

PubMed research returned 13 results. After manual inspection, 10 articles were retained and examined. The cause of the high comorbidity between multiple sclerosis and mood disorders is regarded as being multifactorial: the medication used in multiple sclerosis possibly inducing/exacerbating mood disturbances, the demyelinazing brain lesions which could bring about depression or mania, genetic overlapping with affective disorders and last the psychological reactions and adjustment difficulties to the neurological handicap.

Conclusion

Despite the fact that the higher prevalence of affective disorders in multiple sclerosis is well established, these disorders still remain underdiagnosed and undertreated. A shift towards a better assessment of the psychiatric comorbidity in multiple sclerosis patients and the optimal treatment of those disorders is fundamental.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Consultation liaison psychiatry in Talavera's hospital during the year 2014
Authors: Palomo Monge M. , Sandra D.C. , Maria Fernanda A.L. , David G.M. , Maria Fernanda T.G. , Arántzazu D.D. , Silvia S.D.L.P. , Rubén O.B. , Beatriz L.D.L.
Published: May 2016

Introduction

Analyze the number of interdepartmental consultations carried out at Department of Psychiatry, Hospital Nuestra Señora del Prado from other areas of hospitalization during 2014.

Objectives

The goal is to evaluate the prevalence of psychiatric disorders in patients who are hospitalized for other reasons, and which services are needed the most.

Methods

Retrospective cross-sectional descriptive study. A record of consultations carried out by the psychiatry service in 2014 was collected. The data were analyzed according to the origin of the consultation service, the month when it was performed and the sex of the patient. The monthly percentage of interconsultations and the percentage represented by each interconsultation service were calculated. They classified according to sex.

Results

In 2014, 211 interconsultations were carried out, 104 men and 86 women. Surgery 16, 11%, pneumology 13, 74%, internal medicine 12, 32%, traumatology 8, 06%, digestive 7, 11%), I.C.U. 6, 64%, cardiology 6, 16%, hematology 5, 69%, oncology 5, 21%, pediatrics 4, 27%, gynecology 2, 84%, emergency 1, 90%, palliative1, 90%, endocrinology 1, 42%, urology 1, 42, nephrology 0, 95%, E.N.T. 0, 95%, obstetrics 0, 47%, dermatology 0%, ophthalmology 0%, rheumatology 0%. January 12, 8%, February 13%, March 9, 5%, April 6, 2%, May 5, 7%, June 8, 1%, July 6, 2%, August 4, 3%, September 8, 1%, October 12%, November 7, 6%, December 6, 2%.

Conclusions

Most of the interconsultations were carried out in January, February and October. However, August was the least busy month. The busiest service was the Surgery service, followed by the Pneumology and Internal Medicine one. There were no interconsultations of the Ophthalmology, Rheumatology and Dermatology services. The consults were in demand mainly by men rather than women.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Low-FODMAP-diet in irritable bowel syndrome offers benefits not only in terms of gastrointestinal symptoms, but also in terms of psychopathology in the medium- and long-term
Authors: Piacentino D. , Rossi S. , Piretta L. , Badiali D. , Pallotta N. , Corazziari E.S.
Published: May 2016

Introduction

Low-FODMAP (fermentable oligosaccharides, disaccharides, monosaccharides, and polyols) diets are strongly recommended to improve irritable bowel syndrome (IBS) symptoms. They are also hypothesized to improve the psychopathological status that often accompanies the syndrome. A study (Ledochowski et al., 2000) suggested that the ingestion of FODMAPs affected negatively the mood and that the elimination of dietary FODMAPs improved depressive symptoms.

Objectives/aims

We aimed to assess the levels of psychopathology pre- and post-diet in IBS patients free of any severe psychiatric disease (e.g., bipolar disorder, major depressive disorder, schizophrenia) or alcohol/substance abuse.

Methods

We consecutively recruited 75 IBS outpatients (68% females; age range = 21–68 years) at the Gastrointestinal Outpatient Center of our University Hospital. They filled out the Symptom Checklist-90-Revised (SCL-90-R), a visual analogue scale (VAS) to rate the intensity of abdominal bloating/pain, and a 2-week diary card registering the frequency of bloating/pain. Then, they were blindly assigned to a low-FODMAP diet, a low-FODMAP gluten-free diet and a control diet for 4 weeks. During the last 2 weeks they filled out a 2nd diary card and rerated the intensity of bloating/pain. Patients were reassessed after a 16-month follow-up. Independent t-test, χ2 test, and one-way ANOVA with Tukey post-hoc test were used.

Results

Baseline characteristics did not differ between the three groups. Post-diet and at follow-up, the two low-FODMAP diets, vs. the test diet, improved not only the intensity and frequency of bloating/pain, but also the SCL-90-R GSI, anxiety, and phobic anxiety scores (P-values < 0.05).

Conclusions

The low-FODMAP diet may improve psychopathology in IBS patients.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
EV435Life satisfaction and enjoyment in medication-overuse headache patients: The role of depression and insomnia
Authors: Pompili M. , Paolo G. , Martelletti P.
Published: May 2016

Introduction

Epidemiological research has documented a strong association between medication-overuse headache (MOH)and psychiatric disorders, emotional disturbances, and disordered personality traits, which are associated with worse outcomes, poorer quality of life, and higher costs to the health care system.

Objectives

Identifying risk factors for progression of headache into MOH represents one of the most relevant public health priorities and psychiatric comorbidity has been identified as a potential factor related to chronic phases.

Aims

The aim of the present study was to determine whether depression and insomnia complaints were associated with satisfaction and enjoyment with one's own life in Medication-overuse headache (MOH) patients, and whether insomnia complaints were able to explain part of the variance of QoL explained by depression.

Methods

Participants were 187 consecutive adult outpatients admitted to the outpatient headache clinic. Patients were administered the Quality of Life Enjoyment and Satisfaction Questionnaire (Q-LES-Q), the Beck Depression Inventory–II (BDI-II), and the Athens Insomnia Scale (AIS).

Results

The BDI was associated with all the dimensions of the Q-LES-Q, with more severe depression being associated independently with lower satisfaction and enjoyment with one's own life. The AIS was independently and significantly associated only with physical health, such that patients with more insomnia complaints were 3.1 times (P < 0.001) more likely to report lower physical health satisfaction.

Conclusions

Our findings confirmed that MOH has a negative impact on quality of life, and suggested that depression and insomnia were independently associated with satisfaction and enjoyment of life in MOH patients.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
The impact of traditional healers on the treatment of psychotic patents in Alexandria, Egypt
Authors: Darwish S.
Published: May 2016

Introduction

Psychotic symptoms in the Egyptian community have always been mixed up with supernatural phenomena. This makes patients and their families seek help from traditional healers who can abuse them physically, financially and sexually.

Aim

The aim of the study was to assess the impact of the traditional healers on the psychotic patients in the Egyptian community.

Objectives

To measure the percentage of patients going to traditional healers and how much they pay and for how long.

Methods

The study was conducted on a total of 555 psychotic patients. Four hundred and fifty-five psychotic patients from the Mamoura Mental state Hospital and 100 psychotic patients from a private hospital in Alexandria in duration of three months in 2006. A special questionnaire was designed and was run for all patients and their families.

Results

A total of 67.4% of male patients consulted healers while 88.4% of the females consulted healers. Only 9.4% of the females who went to the healers were highly educated compared to 19.7% of the male patients. The majority of the patients who improved were illiterate or can only read and write. Lower socioeconomic groups tend to have a higher percentage in consulting healers and a longer duration of staying in treatment with them. Although therapy at the first session tended to be for free, from the second session forward patients pay more than they would pay seeing a psychiatrist.

Conclusions

Traditional healers have a negative impact on the psychiatry practice and are sources of patient's abuse in Egypt.

Disclosure of interest

The author has not supplied their declaration of competing interest.
EV466Characterization of the refugee population in a psychiatry clinic in Lisbon
Authors: Prata-Ribeiro H. , Bento A. , Ponte A. , Neves B. Costa , Gil L.
Published: May 2016

The refugee population has been a growing concern to the developed countries in general and to Europe in particular. The recent mass migrations are changing the population that is getting to the psychiatric hospitals, not only culturally but also pathologically. The aim of this study is to characterize the refugee population that contacts with the clinic of transcultural psychiatry in Centro Hospitalar Psiquiátrico de Lisboa, understanding the most frequent pathologies and nationalities. The methods used consisted in analyzing the refugee population that attended a psychotherapeutic group and consultation in the Transcultural clinic of Centro Hospitalar Psiquiátrico de Lisboa during the past year. Analyzing the population, 66 refugees were in contact with the transcultural clinic, 44 of which were men, being the other 22 women, representing a total of 23 countries. The more frequent nationality was Iranian (20) and the most frequent diagnosis was “adjustment disorder and anxiety” (38). We can reach the conclusion that more refugee men contact with our psychiatric hospital than women, accounting for 66, 6% of the total; 30, 3% of the refugees were from Iran, followed by Pakistan with 10, 6%. The fact that the most frequent diagnosis is adjustment disorder and anxiety, accounting for 57, 6% of the sample, seems to point out the extreme stress refugees undergo.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
The sense of community in times of secularization and modernism
Authors: Rosa D.
Published: May 2016

Based on theoretical studies we approach the secularization process and the introduction of the Modern ideas effects over the community sense. The object's removal from the religious institutions’ domain or its signification from the sacred and the exaltation of the rational and the urbanization unveil how both phenomena affect social relations regarding its interference over social symbols, meanings and, therefore, over the identity that underlies the community sense. What is shown are the deep social transformations that inflict over the still recent structures of urbanization, not enough assimilated or well understood in concerning of the forces that act over the relationships and daily life of whom integrates them. Religion is conceived as a human projection and, therefore, as a result of a necessary unconscious signification process that occurs through a mechanism of self-defense for inner conflict, with the intention of externalize it. Thereby, the Modern ideas can’t provide a tolerable interpretation of reality to fulfill the emotional void resulted from secularization. In this context, the solidarity, responsible for the community identity, decline while happened the decrease of common representations. Nonetheless, the necessity of signification doesn’t decrease. Thus, against modernist predictions, community's members tend to redirect its projections, qualifying new symbols. What is noticed is that no process can remove representation's meaning without offer a substitute or witness the redirection of it to other object. Nonetheless, it is possible to provide tools that will help community to detach of projections when the necessity of them be surpassed conceiving the reality.

Disclosure of interest

The author has not supplied his declaration of competing interest.
Longitudinal effect of depression on glycemic control in patients with type 2 diabetes: A 3-years prospective study
Authors: abuhegazy H. , Elkeshishi H. , Kamel A. , Ismail A. , Sherra K. , Saleh N. , Azim K.A. , Mokhtar D.
Published: May 2016

Objective

to examine the longitudinal effect of depression on glycemic control in a sample of patients with type 2 diabetes.

Methods

the patients were recruited from diabetes clinic in Saudi airlines medical center, in Jeddah, the base line study community consisted from 172 patients with type 2 diabetes. They were assessed for depression using BDI II, and diagnostic interview, and for diabetic control using HbA1c. We created a person-period data set for each patient to cover 6 months intervals up to 3 years. We used generalized estimation equation (GEE) for analysis of longitudinal data. HbA1C was the response variable while depression and time were the main covariates. Variables were included in GEE models based on clinical importance and preliminary analysis. Other variables included as covariates were gender, education, duration of diabetes, co-morbidity and LDL. All statistical analysis used α = 0.05 level of significance and were performed using SPSS software version 21.

Results

Unadjusted HbA1c means were significantly higher in depressed vs. non-depressed subjects at all time points. The adjusted HbA1c means in final GEE model were significantly higher in depressed vs. non-depressed subjects. In all adjusted models depression was a predictor of glycemic control weather it was BDI score (estimate = .049, P = .002), diagnoses of MDD (estimate = 2.038, P = .000), or other depressive diagnosis (estimate = 1.245, P = .000).

Conclusion

This study on clinical sample of type 2 diabetic patients demonstrates that there is a significant longitudinal relationship between depression and glycemic control and that depression is associated with persistently higher HbA1c over time.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Late-onset bipolar disorder: What else?
Authors: Ferreira C.P. , Alves S. , Oliveira C. , Avelino M.J.
Published: May 2016

Introduction

Geriatric-onset of a first-episode mania is a rare psychiatric condition, which may be caused by a heterogeneous group of non-psychiatric conditions. To confirm late-onset bipolar disorder (LOBD) diagnosis, secondary-mania causes should be ruled out.

Objectives

To provide a comprehensive review reporting prevalence, features, differential diagnosis, comorbidity and treatment of LOBD.

Methods

The literature was systematically reviewed by online searching using PubMed®. The authors selected review papers with the words “Late-onset mania” and/or “Late-onset bipolar” in the title and/or abstract published in the last 10 years.

Results and discussion

With population ageing, LOBD is becoming a more prevalent disorder. Clinical presentation may be atypical and confounding, making the diagnosis not always obvious. Several non-psychiatric conditions must be considered in an elderly patient presenting with new-onset mania, namely stroke, dementia, hyperthyroidism or infection causing delirium. Only then LOBD diagnosis may be done, making that an exclusion diagnosis. Comorbidities, such as hypertension or renal insufficiency are often present in the elderly and must be taken into account when choosing a mood stabilizer.

Conclusions

LOBD remains a complex and relatively understudied disorder with important diagnostic and therapeutic implications. This diagnosis must be kept in mind for every elderly patient presenting with new-onset mania. Further investigations could contribute to a better understanding of LOBD etiopathogenesis and to set out better treatment guidelines.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Impact and importance of anhedonia as a mediating variable in amelioration of social functioning in depressed patients
Authors: Gourion D. , Vinckier F. , Mouchabac S.
Published: May 2016

Background

Anhedonia is a core dimension of major depressive disorder (MDD). Paradoxically, the association between anhedonia and social impairment is poorly known.

Objective

To determine the longitudinal relationships between depressive symptoms, anhedonia, and social functioning in depressed patients treated with agomelatine.

Material and method

One thousand five hundred and seventy patients with MDD starting treatment with agomelatine prescribed by their GPs were included in a prospective study (follow-up: 10 to 14 weeks). Patients were assessed at baseline and at the end point of the study, using the MADRS to assess antidepressant efficacy, the SHAPS scale and an original visual analog scale exploring the subjective pleasure felt by patients in their main leisure activity to measure anhedonia, and the QFS to measure social functioning in its qualitative and quantitative dimensions. In addition to the univariate analyses, a mediation path analysis was performed using the Sobel test.

Results

The results showed a robust and significant improvement in symptoms of depression, anhedonia, and social functioning. The correlations between the SHAPS and QFS scores were high and significant. Subsequent analyses showed that amelioration of anhedonia is a significant mediating variable between the progression of depressive symptoms and social functioning (Δ QFS G = –14.3, P < 0.0001) and explains around one third of the variance of the model (35.37%).

Conclusion

Anhedonia, a major dimension of depression, provides specific insights into the understanding of the complex links between residual symptoms of MDD and social functioning. In conclusion, improving the evaluation of anhedonia is a fundamental issue in primary care.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Childhood abuse in adult women with unipolar depression seeking treatment at a tertiary care centre in India, compared to healthy women
Authors: Devasthali G. , Jangam K. , Ka T. , Raj A. , Kesavan M.
Published: May 2016

Introduction

Childhood abuse has been reported as a precursor and maintaining factors for adult psychiatric disorders. Childhood physical abuse, neglect and sexual abuse have been independently reported in women with depression. There is a serious dearth of literature on the incidence of childhood abuse among women with depression from India.

Objectives & aims

We investigated and compared the incidence of childhood abuse (overall) – physical, emotional and sexual (individual components)- among women seeking treatment for unipolar depression (UD) compared to healthy women (HW).

Methods

We compared the data of women diagnosed with UD (n = 134) from a larger pool of women seeking treatment for psychiatric disorders from our hospital (n = 609) with HW (n = 100) for the purpose of this study. The participants were screened using the MINI International Neuropsychiatric Interview (MINI) and for childhood abuse using the ISPCAN Child Abuse Screening Tool - Retrospective (ICAST)-R. The incidence of childhood abuse between the two groups was compared using the Chi-squared test.

Results

The UD women have significantly more childhood emotional abuse than HW (69.5% vs 30.5%; χ2 = 4.819, P < 0.05). There was no statistically significant difference between the two groups on overall abuse, physical or sexual abuse (all P > 0.16).

Conclusions

Consistent with world literature, significantly more childhood emotional abuse was seen among Indian women with UD compared to HW. It is likely that that repeated emotional abuse in childhood leads to negative attributions among children, later getting generalised to life events resulting in depression in adulthood.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Relation between major depressive disorder as regards severity in a sample of Egyptian population and serum level of tumor necrosis factor alpha
Authors: Harby S. , Molokhia T. , Aboelwafa H. , Elneely D.
Published: May 2016

Introduction

Depression is a life threatening psychiatric disorder. STAR-D study stated that remission rates decrease, and relapse rates increase. It produces chronic diseases and worsens mean health when co-morbid with these diseases. The depressive symptoms in humans are analogous to the ‘sickness behavior’ syndrome seen in animals when injected by pro-inflammatory cytokines.

Objective

This study was done to clarify the relation between the severity of depression and serum level of tumor necrosis factor alpha (TNF), so improving the quality of pharmacological management.

Aim

This study was done to prove that inflammatory process is involved in the pathogenesis of depression by assessing the serum level tumor necrosis factor alpha (TNF alpha)

Methods

Our study is comparing between 60 patients with major depressive disorder and 30 healthy controls regarding the serum level of tumor necrosis factor alpha. Patients were diagnosed by a semi-structured interview using Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition. Patients were subdivided into mild, moderate and severe depression according to Hamilton Rating Scale for Depression (17 items). Assessment of serum level of tumor necrosis factor alpha was done using enzyme- linked immunoassay technique.

Results

Serum level of TNF alpha was significantly higher among patients than among controls (Z = 4.710*P ≤ 0.001*) regardless the severity of depression.

Conclusions

Serum TNF alpha can be used as a biomarker of depression but not for the disorder severity. However, further study is needed to detect if there is a relation between major depressive disorder and serum level of other inflammatory markers as C-reactive protein.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
The meaning of loss in the context of elderly homes
Authors: Laranjeira C.
Published: May 2016

Introduction

Family plays a pivotal function in life of all human being and their significance even increases with the age. However, living in a elderly home may result in a multitude of losses which must be addressed by individual through the process of grief.

Aim

The purpose of this study was to explore situations of loss and grief among institutionalizes elders.

Methods

It is a qualitative, descriptive and exploratory research. Data was collected from two Portuguese elderly homes in the municipality of Viseu, Portugal. A purposeful sample of 7 elders was recruited, and audiotaped face-to-face semi-structured interviews were conducted.

Results

Three dimensions of emotional loss were created: loss by death, loss by separation and other losses. Loss by separation was further divided into three subcategories: marriage separation, family separation and separation of peers living in the elderly home. The death of a loved one reminds the elderly individual of his/her own mortality, complicating the process of mourning. Separation, however is much more difficult to overcome because there is a loss among the living, with the possibility to lose the meaning of life with the other one.

Conclusions

Understanding loss and grief among elderly people is fundamental for nursing care, in order to help them with the process of coping and to prevent institutionalization to become an unpleasant experience. This will also offer health care facilities suggested ways to reduce or combat loneliness and depression among the elderly people.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Mindfulness, self-compassion and spiritual well-being in chronic depression
Authors: Silva E. , Simões S. , Espírito-Santo H. , Marques M. , Lemos L.
Published: May 2016

Introduction

Depression is one of the main causes of incapacity worldwide. Research has shown that mindfulness practice, self-compassion promotion, and spiritual well-being are beneficial for depressed individuals.

Objective

Analyze the associations between compassion, mindfulness, and spiritual well-being, during and after a therapeutic intervention (concluded less than a year ago).

Aims

To determine if mindfulness, self-compassion, and spiritual well-being are predictors of depression.

Method

Patients diagnosed with chronic depression were treated in a residential therapeutic community for a period of six to eight months. The 63 participants (M = 32.84, SD = 10.24, range = 15–50 years old; 32 during treatment; 31 after treatment) were assessed with the Beck Depression Inventory, the Questionnaire of the Five Facets of Mindfulness, the Self-Compassion Scale, and the Spiritual Well-Being Questionnaire.

Results

There were differences in mindfulness, self-compassion, spiritual well-being and depression by sex, existence of previous psychiatric treatment, moment of the study (during versus after intervention), and depression levels. After intervention the group had higher levels of mindfulness and self-compassion (common humanity) and lower levels of over-identification, compared with group during treatment. The predictors of depression were the self-judgment dimension of the self-compassion scale and, negatively, the mindfulness dimensions of non-reactivity and non-judging, and the spiritual well-being dimension of personal well-being.

Conclusion

Results confirm the relationship between the study variables and depression. This reinforces the importance of intervention based on positive psychology enhancing positive areas of human experience, rather than focusing on psychological pain, weaknesses, and disabilities.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Treatment of mild to moderate major depressive disorder with agomelatine in patients with cardiovascular disorders (national observational multicenter study “pulse”)
Authors: Medvedev V.
Published: May 2016

Introduction

The urgency of depression treatment in patients with cardiovascular diseases (CVD) is determined by the increasing prevalence of affective disorders. For these patients, tolerance and safety of antidepressants are of great importance.

Objective

To obtain additional data on therapeutic efficacy and tolerance of agomelatine in the treatment of mild to moderate depressive disorders in cardiologic practice in Russia.

Methods

Eight hundred and ninety-six adult patients with CVD (86.5% arterial hypertension, 29.5% stable angina, 16% myocardial infarction, 23.6% conduction disturbances, 17.6% chronic heartfailure) were treated with agomelatine 25-50 mg for 12 weeks. Depression and anxiety symptoms were evaluated via Hospital Anxiety and Depression Scale (HADS), Clinical Global Impression (CGI-S and CGI-I), Visual Analog Scale (VAS), Spielberger Anxiety Scale (SAS), Whitely Hypochondria Index (WHI) and quality of life questionnaire (SF-36). Safety and tolerance were also monitored according to the summary of product characteristics recommendations.

Results

HADS scores decreased throughout the study and severe anxiety rate decreased from 95.9% to 15%. After 12 weeks of treatment, remission (HADS < 7) rate was 84.6%. Subjective assessment of patient health significantly improved (P < 0.00001). WHI decreased significantly (P < 0.00001). Physical and mental health significantly improved (P < 0.00001). Heart rate and blood pressure decreased. Treatment acceptability was considered “excellent” by 82% of doctors and 75% of patients.

Conclusion

Agomelatine significantly improved depressive symptoms, anxiety and hypochondria in depressed patients with CVD and demonstrated good tolerance. This suggests the possibility of wide and safe use of agomelatine for treatment of depression in patients with CVD.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Depression In Pregnancy Associated With Lower Consumption Of Salads
Authors: Papakosta V. , Papaliagka M. , Mpakouras S. , Garas A.
Published: May 2016

Introduction

A considerable amount of studies support the association of depression with nutritional factors, especially fruit and vegetables. Little evidence exists concerning mood and nutritional habits of pregnant women in Greece.

Objective

Our specific objective was to examine potential relationships between fruit and vegetable consumption and depression in pregnant women.

Aims

The overall aim of this study was to investigate the nutritional habits and the depression level of healthy pregnant women in Greece.

Method

Eighty-eight healthy pregnant women, aged 25–44 years (mean± standard deviation: 32.41 ± 3.9), were studied with the aid of a questionnaire addressing eating habits and the Beck Depression Inventory (BDI).

Results

Twenty-four women were found having mild to moderate depression (score 20–24, according to BDI) associated with lower consumption of salads (P < 0.05). No association was found between depression and consumption of fruit or fruit juices, or prescribed supplements (Ca, Fe, Mg, folic acid).

Conclusion

Interestingly, in our sample an association of depression in pregnancy was found with the consumption of salads but not fruit or fruit juices. The presence of vitamin B in vegetables is one of the factors differentiating them from fruit. So it might be a crucial element for further research.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Consensus Statements On Cognitive Dysfunction In Depression In The Uk: Rationale And Process For Gaining Consensus
Authors: Young A.H. , Bones K. , Goodwin G. , Harrison J. , Katona C. , McAllister-Williams H. , Rasmussen J. , Strong S.
Published: May 2016

Introduction

Cognitive dysfunction is an important aspect of depression that includes problems with thinking, concentration and memory. Research suggests that the cognitive aspect of depression is highly prevalent and has a significant impact on patient functioning. Currently, cognitive dysfunction in depression is largely unrecognised, unmonitored and untreated.

Aims

We aim to define cognitive dysfunction in clinical depression (major depressive disorder) and explore its detection and management in the UK, highlighting priority areas to be addressed.

Methods

A modified Delphi method was used as the process to gain consensus. A multi-stakeholder steering committee of depression experts (including psychiatrists, psychologists, primary care physicians, and representatives from occupational therapy and a depression charity) provided the key themes and, through round-table discussion, developed draft statements. The main areas of focus were burden, detection and management of cognitive dysfunction in depression. These statements formed a questionnaire to be reviewed by 150–200 health-care professionals with an involvement in the management of depression, with level of agreement noted as ‘strongly disagree’, ‘disagree’, ‘don’t know/uncertain’, ‘agree’ or ‘strongly agree’. Responses to the questionnaire will be analysed (very high agreement [> 66%] or very low agreement [< 33%]) and the steering committee will revise and finalise the consensus statements, and identify priority areas for future consideration. The steering committee was initiated and supported by the pharmaceutical company Lundbeck Ltd, through an educational grant. Lundbeck Ltd did not influence content.

Results

Results of the questionnaire and the evolution of the final consensus statements will be presented.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Full Of Nothing
Authors: Cortazar Alonso E. , Guillen Rodrigo H. , Fuentes Marquez S.
Published: May 2016

The eating disorders like anorexia, bulimia nervosa, and obesity are known and described from the principles of Western civilization. Eating disorders affect a large number of people, which about the 90–95% of them are women. Not to forget is their multicausality. Though their etiology is not exactly known yet, being on a diet is the most important predictor of having an eating disorders.

We summarize here a case of R. a 30-year-old woman, who visited the Infant Mental Health Institut for the first time at the age of 13 referred by her pediatrician and suspected to have an eating disorder. R. lived with her parents and an older sister. The patient suffered an underweight below the healthy and a distorted perception of her body among other symptoms. She has gone through several specialists and treatments including day hospital since her first entrance at the hospital.

The flexibility and cooperation between the different therapists involved in the treatment is essential for a good outcome of the patient. There are many factors that can have an influence in the treatment, like the reluctance to the treatment, the counter transference feelings that the therapy can cause and the way of relationship. These factors can often cause situations of confusion and misunderstandings between the different professionals who attend the patient, who have to be well coordinated. Not to forget is that the biggest loser of all is the patient itself.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Anxiety, Stress And Depression: a Comparison Between Anorexic, Obese And Healthy Control Women
Authors: Botteon G.
Published: May 2016

Introduction

Several studies have proved that people who suffer from Anorexia Nervosa (AN) experience higher levels of anxiety, stress and depression than general population; while controversial results have been found among obese people (OB); the purpose of this study is to compare levels of anxiety, stress, and depression in AN sample, in OB sample and in Healthy Control Group (HC).

Methods

AN sample: 27 anorexic inpatient women in an eating disorder unit. OB sample: 27 obese women evaluated for elegibility of bariatric surgery intervention. HC group: 27 women from different countries had been recruited. DASS 21 and STAI-Y questionnaires had been subministred to evaluate anxiety, stress and depression. The questionnaires had been scores and statistical analysis had been held to determine whether the differences founded in the 3 populations were significant or not (P-value < 0.05).

Results

Table 1. The differences founded were significant.

Conclusion

Anxiety and stress (DASS21, STAI): AN have reported higher levels than OB and HC that present similar levels. Depression (DASS21): AN have reported higher levels than OB and HC; OB higher levels than HC.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Aspects of sexuality in bipolar women
Authors: Damian L. , Miclutia I.
Published: May 2016

Introduction

In spite of more studies dedicated to the topic of sexual disorders among schizophrenic patients or to the sexual effects of antipsychotics and antidepressants, few studies entangle broadly the issue of sexual attitudes and behaviors of bipolar patients, due partly to the heterogeneity of the disorder and the variety of episodes, and treatments.

Objectives

To establish if special sexual patterns are specific to depressive or manic episodes and if the sexual disorders are related to the severity of the mood episodes.

Aims

To compare depressive, manic, and matched controls regarding their sexuality.

Methods

The current study is an observational cross sectional study, carried out on 173 women, among them 112 bipolar, diagnosed according to ICD-10 criteria (81 depressive, and 31 manic), and 61 controls. All subjects fulfilled the Sexual Disorders Interview (SDI), Female Sexual Function Index (FSFI) and to bipolar patients BDI, YMRS have been administered.

Results

Female bipolar patients were significant less sexual active than controls, depressive women being less interested in sexuality than manic patients; there were not significant differences between the two patients’ samples regarding the frequency of sexual intercourse, degree of psychopathology. Sexual problems on FSFI were detected in 75% of bipolar patients, both bipolar groups emphasizing difficulties in arousal, lubrication and sexual satisfaction.

Conclusions

The issue of sexual problems in bipolar female patients is delicate to investigate and often neglected, being difficult to ascertain to the mood disorder itself or to different treatments the patients have been exposed to, or to stigma.

Disclosure of interest

The authors have not supplied their declaration of competing interest.