bluuebunny/crossref_metadata_2025 huggingface dataset:
Controversy diagnosing sex addition
Authors: Palomo Monge M. , David G.M. , Arántzazu D.D. , Sandra D.C. , María Fernanda T.G. , Silvia S.D.L.P. , Maria Fernanda A.L. , Rubén O.B.
Published: May 2016

Introduction

The sexual compulsive behavior also known as sex addition is the repetitive and intense sexual behavior of the individual. Although the few studies carried out, the prevailing rates vary between the 2% and the 20%.

Objectives

We present the case of a 46-year-old male with psychiatric treatment records since he was 17 and a personality disorder group B diagnosis and depressive reactions reactive to environmental frustrations. Several short-, medium- and long-term hospitalizations. Currently he is admitted after having expressed some autolytic ideas.

Methodology

The patient started a treatment in the Unit of Addictive Behaviors. He says he started to frequent the brothels 10 years ago to satisfy his sexual needs, but gradually increased the frequency. Later, he started to have sex online, also in fee-paying web pages. This has had a negative influence in the different aspects of his life, leading him to economic stress and endless debts.

Results

Borderline personality disorder. 301.83 (F60.3).

Other specified disruptive, impulse-control, and conduct disorder (sex). 312.89 (F91.8).

Pathological gambling. 312.31 (F63.0).

Persistent depressive disorder. 300.4 (F34.1).

Conclusions

It is clear that the compulsive sexual behavior is a disorder that includes repetitive, intrusive and distressing thoughts and leads to behaviors that affect negatively several aspects of the lives of people suffering such disorder, so that is why it is associated with other psychiatric disorders. Even though it has been described and discussed for years in literature, it is difficult to classify within psychiatric nosology and nowadays its categorization is still a challenge within the mental health.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Premature ejaculation – how to treat?
Authors: Fornelos A. , Macedo P. , Veríssimo F. , Viseu M.
Published: May 2016

Introduction

Premature ejaculation (PE) corresponds to “a persistent or recurring ejaculation pattern that occurs during sexual activity with a partner approximately 1 minute after vaginal penetration and before the person wishes to”. It affects 5–20% of men, having its origin in psychological factors and with important biological contribution. It is considered generalised, when not confined to certain patterns of stimulation, situations, or partners, or may be situational. It may occur soon after the onset of sexual activity (primary) or after a normal sexual functioning (acquired). Primary EP is associated with the hyposensitivity 5-HT2C receptors and/or hypersensitivity 5-HT1A receptors. High performance anxiety levels are related to acquired EP. Increasing this physiological knowledge has enabled significant advances in treatment.

Objective

Approach the therapeutic options of EP and its peculiarities.

Methods

Literature review of articles published in the last five years, using the PubMed and Scielo databases.

Results

At present, the approaches include psychosexual counseling, behavioral and pharmacotherapy. Among the most popular drugs, antidepressants stand out, particularly dapoxetine, the first medication specifically approved. Local anesthetics, phosphodiesterase-5 inhibitors and tramadol are also used. Acupuncture is suggested as a useful therapeutic, but needs more research.

Conclusion

The behavioral therapies are referred to as first-line treatment in the long-term, associated or not with medication. Dapoxetine is the preferred symptomatic treatment. However, a holistic approach, including psychotherapy and sex therapy, is the most beneficial modality for sexual and marital relationship.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Depression and suicide ideation in medical students
Authors: Alonso Sanchez A. , Alvarez Astorga A. , De la Red Gallego H. , Hernandez Antón R. , Gómez Sanchez S. , Noval Canga C. , Sevillano Benitez I. , Isidro García G. , Hernandez García M. , De Uribe Ladrón de Cegama F.
Published: May 2016

Background

Medical students have higher levels of depressive symptoms than the general population. Additionally, depressed students are more likely to commit suicide. Recent studies find up to 10% of medical students experiment depression and suicidal ideation, which is meaningfully higher than general population of similar age (5–8%). However, little is known about depression and suicidal ideation in medical students in Spain.

Objective

This study aims to create a self-administered questionnaire to investigate the prevalence and factors involved in depression and suicidal behaviour in medical students from a Spanish University.

Methods

We evaluated the main risk factors leaning to suicide in students. In addition, we selected an appropriate scale to assess depression among the existing ones. The evaluated items included demographic reports, academic information (academic course, unfinished subjects and accomplishment) and sanitary data (psychiatric family history, psychiatric personal history, psychotropic drug consumption, distress emotional events in the last twelve months and drugs consumption). Furthermore, we selected the 9-item Patient Health Questionnaire (PHQ-9) because of its rapidly implementation and proven efficacy.

Conclusions

Rates of depression and suicidal ideation are high in medical students. Currently, there is no program to detect and prevent depression neither suicide in students. For that reason, we consider that creating a new instrument to evaluate mental health in student is useful in order to offer early detection and treatment at medical school.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Multimodal validation of facial expression detection software for real-time monitoring of affect in patients with suicidal intent
Authors: Amico F. , Healy G. , Arvaneh M. , Kearney D. , Mohedano E. , Roddy D. , Yek J. , Smeaton A. , Brophy J.
Published: May 2016

Facial expression is an independent and objective marker of affect. Basic emotions (fear, sadness, joy, anger, disgust and surprise) have been shown to be universal across human cultures. Techniques such as the Facial Action Coding System can capture emotion with good reliability. Such techniques visually process the changes in different assemblies of facial muscles that produce the facial expression of affect.

Recent groundbreaking advances in computing and facial expression analysis software now allow real-time and objective measurement of emotional states. In particular, a recently developed software package and equipment, the Imotion Attention Tool™, allows capturing information on discreet emotional states based on facial expressions while a subject is participating in a behavioural task.

Extending preliminary work by further experimentation and analysis, the present findings suggests a link between facial affect data to already established peripheral arousal measures such as event related potentials (ERP), heart rate variability (HRV) and galvanic skin response (GSR) using disruptively innovative, noninvasive and clinically applicable technology in patients reporting suicidal ideation and intent compared to controls. Our results hold promise for the establishment of a computerized diagnostic battery that can be utilized by clinicians to improve the evaluation of suicide risk.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Availability and accessibility of medications and toxic substances and suicidal behavior
Authors: Arsenyan M. , Sukiasyan S. , Hovhannisyan T.
Published: May 2016

Introduction

Scientific research indicates that accessibility of suicide means has a significant influence on the choice of method. Since the choice of suicide method largely depends on availability of suicide means, the lethality of method at hand plays a crucial role in a period of suicidal crisis.

Aims

We aimed to reveal the associations between accessibility and availability of medications and toxic substances and suicidal behavior of teenage girls in Armenia.

Objective

Our objectives were to determine whether accessibility and availability of medications and toxic substances have any impact on development of suicidal behavior among teenage girls in Armenia and whether toxicity and quantity of medications and toxic substances at hand or purchased by attempters are associated with severity of outcome.

Methods

A qualitative analysis of patient histories of 26 teenage girls, hospitalized in the ICU, Toxicology Center “Muratsan”, Yerevan, RA, diagnosed as having acute deliberate self-poisoning was performed.

Results

In majority of cases, conflict situation preceded suicidal behavior and decision on attempting suicide was impulsive. Being emotionally distressed teenage girls reached for medications and toxic substances readily available in the household or bought medications from a pharmacy.

Conclusion

The vast majority of teenage girls attempted suicide by medications and toxic substances at hand. Admittedly, both, type of medication and quantity of pills or amount of toxic substances utilized, affected the severity of outcome. Hence, the availability and accessibility of medications and toxic substances played a crucial role in development of suicidal behavior and severity of outcome.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
How does someone who weighs so little feel like a burden to everyone?
Authors: Coutinho F. , Brandão I. , Pereira E.
Published: May 2016

Introduction

Anorexia nervosa (AN) is one of the most lethal psychiatric disorders, which is explained partially by starvation related health problems, but also because of high suicide rates. One of the proposed theories to explain a suicide attempt is the interpersonal theory of suicide (IPTS), with its three essential variables: feelings of thwarted belongingness, perceived burdensomeness and the acquired capacity for suicide.

Objective

To review the literature about suicidality in AN and to present a case report of a patient with restrictive AN who has committed suicide.

Methods

To review of the literature using the database Medline, through PubMed, with the keywords “anorexia nervosa”, “eating disorders” and “suicide”.

Results

Suicide attempts and completed suicide are highly prevalent among patients with AN, and some authors suggest that 20–40% of deaths in AN are due to suicide. Recently, the IPTS has been proposed as a mean to explain increased suicidality in AN patients.

Conclusion

We present a case report about a patient with a long standing AN who has committed suicide after leaving a goodbye note describing strong feelings of perceived burdensomeness directed to her family. It is of utmost importance to continue the study about the phenomenon of suicide in AN to be able to prevent this tragic outcome.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Suicide attempt in alcohol use disorder and Wernicke encephalopathy: A case report
Authors: Espinosa L. , Fortea A. , Oriolo G. , Balcells M. , Oliveras C.
Published: May 2016

Background

The relation between alcohol dependence and suicidal behavior is well known and alcohol consumption is a risk factor to take in consideration in order to prevent suicidal attempts. Wernicke encephalopathy (WE) is a common acute neurological disorder caused by thiamine deficiency frequently associated with alcohol use disorder and often infra-diagnosed. Just few cases are reported about the possible correlation between suicidal behaviour and Wernicke encephalopathy.

Objective

To describe the possible association between suicidal attempts and Wernicke encephalopathy.

Methods

We report the case of a 57 year old man, with past diagnosis of disthymia and amphetamine abuse disorder, and a history of bariatric surgery, who was hospitalized in the intensive care unit (ICU) of hospital clinic for a suicidal attempt by mean of metro railway precipitation. He presented two episodes of psychomotor agitation in the context of an abstinence syndrome that reverted with midazolam continuous perfusion and clonazepam 8 mg per day. Consequently to medical improvement, he was moved to Psychiatry Unit of Addictive Behavior and finally diagnosed with alcohol use disorder.

Results

In the physical exam, bilateral nystagmus and cerebellar ataxia were observed. Signs of malnutrition were detected in the blood analysis. In a brain magnetic resonance image, volume deficits in the mammillary bodies, thalamus, cortex and corpus callosum, as well as peri-aqueductal altered signal were observed, all signs compatible with Wernicke encephalopathy diagnoses.

Conclusions

Wernicke encephalopathy is a frequent concomitant condition in patients with alcohol use disorder. The consequent cognitive decline could represent an independent added risk factor for suicidal behavior.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Suicide risk assessment and prevention interventions in military veterans
Authors: Teo A.
Published: May 2016

Introduction

Concerns over suicide among military veterans has been as issue of major public and policy concern, particularly by the Veterans Health Administration (VHA), which is the largest integrated health care system in the United States.

Objectives and aims

The reasons for suicide risk and means to reduce risk in this population have been under active investigation and implementation. The aim of this presentation is to review recent trends in suicide risk assessment and suicide prevention interventions within the VHA in the United States.

Methods

A literature review consisting of an electronic database search of PubMed, “gray literature” search, and manual search for articles related to suicide in military personnel and veterans was conducted.

Results

In recent years, annual VHA rates of completed suicide have ranged from approximately 34 to 40 suicides per 100,000 person-years, rates significantly higher than the general US population. Risk assessment methods examined in military veteran populations have primarily included self-report instruments, scales, and checklists. Recently, “big data” approaches to analysis of electronic medical records have shown promise in stratifying veterans into high- and low-risk groups. VHA suicide prevention initiatives have included extensive staff hiring, development of research centers and data-sharing agreements focused on suicide, a national telephone crisis line, routine suicide risk assessment and screening, and suicide safety plans.

Conclusions

Military veterans in the US receiving care in the VHA have a variety of risk factors for suicide and continue to be at elevated risk despite implementation of numerous suicide prevention initiatives.

Disclosure of interest

The author has not supplied his declaration of competing interest.
A salivary biochemical analysis of certain recruits associated with suicidal ideation
Authors: Xiaomei W.
Published: May 2016

Objective

To explore the biochemical indicators of the persons at high risk of suicide.

Aims

To achieve early screening of the persons at high risk of suicide.

Methods

Suicide ideation of new recruits was generally investigated with self-rating idea of suicide scale (SIOSS). Twenty-five recruits whose scores were more than 12 were recognized as the suicide ideation group. Another 25 recruits without suicide ideation were randomly selected as the control group. Saliva samples of each group were collected for biochemical analysis after one month and three months. The SIOSS was used again for evaluation of suicide ideation.

Results

After one month, the concentrations of Ca, Mg, Amy and SA in saliva were demonstrated to be statistically different between the two groups. After three months, the concentrations of Ca, Mg, Amy and SA in saliva between the two groups showed no significantly difference. According to SIOSS results, only 7 persons of the original suicidal ideation group were recognized as suicidal ideation group, the other 18 people's SIOSS scores were less than 12. And the SIOSS scores of the control group (without suicidal ideation group) were also less than 12. There was no statistical difference in the three groups for comparison of salivary Ca, Mg, Amy and SA.

Conclusion

The biochemical indicators l of saliva lack specificity for suicidal ideation screening.

Disclosure of interest

The author has not supplied his declaration of competing interest.
Telepsychiatry in the opinion of Polish patients and psychiatrists
Authors: Wojtuszek M. , Kachnic J. , Wutke J. , Krysta K.
Published: May 2016

Background

Telepsychiatry takes advantage of modern communication technologies and new forms of patient–doctor and doctor–patient contact.

Objective

This research focuses on the knowledge of telepsychiatry and the attitude to it among patients and psychiatrists in Poland.

Subject and methods

An anonymous survey was conducted among 105 psychiatrists aged 26–74, including 74 women and 31 men and 102 patients aged 21–79, including 61 women and 41 men.

Results

Research reveals that the majority of patients never met with the concept of “epsychiatry” and do not know what it means. However, more than 50% of respondents answered positively to every question considering the utility of telepsychiatry. Furthermore according to 18%, it is possible to replace an eye-to-eye conversation by videoconferencing. Only 15% of doctors claim to have an extensive knowledge on telepsychiatry, and 10% do not know what it means. The vast majority of physicians perceive positive aspects of this method of medical care, but 63% would not want any general insertion of telepsychiatry. Doctors are apprehensive of losing personal data and medical confidentiality, and of the necessity of legal changes.

Conclusions

The obtained results allow us to conclude that Polish patients and doctors, regardless of their knowledge, age, gender or disease, perceive advantages of telepsychiatry. In connection with this, implementing this method into the Polish medical market makes sense and is in accordance with both patients’ and doctors’ opinion. Based on our research, we confirmed that there is a necessity of wider popularisation of telepsychiatry among Polish therapists.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Light as an aid for inpatient recovery: A systematic review
Authors: Henriksen J. , Okkels N.
Published: May 2016

Introduction

The indoor light environment of hospital wards may affect functions and symptoms that are central to the process of inpatient recovery, including sleep, anxiety, well-being, and mood.

Objective

To assess whether interventions in light improves recovery in hospitalized patients across all medical specialties.

Methods

We systematically searched and reviewed the literature for RCT's on adult inpatients where any light intervention were compared to standard care or placebo. We reviewed effects of light on various outcomes, and compared differences in administration, timing, color, and intensity of the light.

Results

We identified 2330 titles, of which 32 met our predefined selection criteria. Choice of administration, timing, wavelengths, and intensity varied. However, most studies investigated bright light therapy with high intensity and short exposure time, others low-intensity light at night filtered of wavelengths in the blue spectrum, and yet others the use of dawn simulation. Comparators were either placebo lamps with low intensity or regular indoor light. Most studies were performed on psychiatric inpatients, showing that bright light therapy is an effective aid in recovery of major depression. Across medical specialties, several studies reported improved sleep quality during the light intervention. Other studies found a lower rate of delirium. In elderly patients with dementia, studies found light interventions to relieve agitation and confusion.

Conclusions

Light may ease a broad range of symptoms and behaviors across inpatient categories. The intervention is inexpensive, well tolerated, and non-invasive. This study underlines intelligent lighting design as an interesting, yet under-explored, non-pharmaceutical treatment.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Adherence to treatment and number of relapses in patients treated with atypical antipsychotic prolonged release
Authors: Dominguez M.D.L.C. Ramirez , Sánchez I. Prieto , Caro M. Nuñez , Torres N. Garrido , Martn A.S. Biedma
Published: May 2016

Introduction

The extended release injectable offers a good alternative for those patients with no or poor adherence to treatment. Numerous studies indicate that decrease the number of relapses in such individuals. Our aim is to check whether a group of our patients diagnosed with dual pathology coincide with these data.

Methods

We followed a group of 5 patients diagnosed with paranoid schizophrenia or delusional disorder with drug consumption in the last year. We measured the number of relapses, understood as the number of visits to emergency and outpatient devices Mental Health Hospitals and hospitalizations six months before the start of treatment with aripiprazole injectable extended release and six months after.

Results

The preliminary results point to a significant reduction in the number of emergency room visits and hospitalizations after starting sustained release injectable treatment.

Conclusions

Our preliminary results are consistent with the literature, we found also reduced consumption of toxic and better adherence to drug addiction devices. The new antipsychotics extended release is a good alternative for patients with dual diagnosis.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Electroconvulsive therapy: Brief versus ultrabrief pulse right unilateral electroconvulsive therapy
Authors: Raposo M.R. , Medina M.L. , González A.L. , Martínez I. , Gil A. , Belmar A. , Piqueras M.D. , Murcia J.B. , Ivanov V. , Manzur P. , Busaileh A.
Published: May 2016

Introduction

Electroconvulsive therapy (ECT) is an effective depression treatment, but it has potential cognitive side effects. Bitemporal ECT has been traditionally used, but in recent decades, right unilateral (RUL) electrode placement has been proposed to decrease the cognitive side effects of ECT. Ultrabrief pulse (UBP) right unilateral (RUL) ECT is an increasingly used treatment option that can potentially combine efficacy with lesser cognitive side effects.

Objectives

To evaluate whether ultrabrief pulse (UBP) right unilateral (RUL) electroconvulsive therapy (ECT) is as effective as brief pulse (BP) RUL ECT in addition to cause lesser cognitive side effects.

Material and methods

A search is performed in the available scientific literature on systematic review and meta-analysis of the subject under study, through the database PubMed.

Results

– Current evidence supports the efficacy of right unilateral (RUL) electroconvulsive therapy (ECT) given with an ultrabrief pulse width in the treatment of depression;

– ultrabrief pulse RUL ECT leads to lesser cognitive side effects than traditional forms of ECT;

– ultrabrief pulse RUL ECT may be slightly less effective than traditional forms of ECT.

Conclusions

BP compared with UBP RUL ECT was slightly more efficacious in treating depression and required fewer treatment sessions, but led to greater cognitive side effects. The decision of whether to use BP or UBP RUL ECT should be made on an individual patient basis and should be based on a careful weighing of the relative priorities of efficacy versus minimization of cognitive impairment.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
A “Newly Discovered in Romania” atypical antipsychotic prolonged release treatment for patient with schizophrenia. First results of a naturalistic study with recently approved paliperidone palmitate
Authors: Sarpe M. , Ladea M. , Bran M.
Published: May 2016

Introduction

Intramuscular paliperidone palmitate is a long-acting atypical antipsychotic, which has only been marketed in Romania from march 2015 as a free of charge medication/subsidized for the acute and maintenance treatment of schizophrenia in adults.

Objectives and aims

To determine the efficacy and tolerability of paliperidone palmitate in 12 patients with schizophrenia in an outpatient care unit, taking into account the limited clinical experience with this product in Romania.

Methods

The study was performed in an outpatient care unit. Data was collected from medical records of patients started on paliperidone palmitate between March and June 2015. This time period was selected because we wanted to have at least a 6-month period of evaluating these patients. Some of the patients were previously on risperidone long-acting injection (in Romania the advantages of a 1-month injection instead of 2 and the fact that the medication does not need to be held in a refrigerator are 2 important factors that can increase the compliance of the patients). Others were treated with other long-acting antipsychotics (flupentixol). The rest were patients treated before with risperidone, with good response, but with problems of non-compliance.

Results

None of the patients treated with paliperidone palmitate relapsed. Some of them had, at maximum dose, minor extrapyramidal symptoms that disappeared when we lowered the dose. Taking into account the lack of insight and the non-compliance of patients with schizophrenia, this treatment seems to be extremely valuable, maybe more in this kind of cases, in outpatient care units.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Do patients with better neuro-cognition have better theory of mind?
Authors: Mrizak J. , Arous A. , Trabelsi R. , Aissa A. , Ben Ammar H. , El Hechmi Z.
Published: May 2016

Introduction

Theory of mind (ToM) has repeatedly been shown to be compromised in many patients with schizophrenia (SCZ). By contrast, the association between ToM deficits and neuro-cognitive functioning (NF) remains uncertain.

Objectives

To investigate the association between ToM functioning and neuro-cognitive functioning in SCZ.

Methods

Fifty-eight outpatients with stable SCZ completed the intention-inferencing task (IIT), in which the ability to infer a character's intentions from 28 short comic strip stories is assessed. They also completed a neuro-cognitive battery comprising the following tests: the Hopkins Verbal Learning Test–Revised (HVLT-R), the Letter Digit Substitution Test (LDST), the Stroop Test (ST), the “Double Barrage” of Zazzo (DBZ), the Modified Card Sorting Test (MCST), Verbal Fluency (VF), the Trail Making Test-Part A (TMT-A) and the Digit Span (DS).

Results

The performance in the IIT significantly correlated with performance in some neuro-cognitive tests including efficiency in DBZ, number of uncorrected mistakes in ST, number of correct categories in MCST and the time needed to succeed the TMT-A. No correlations were found between performance in the ITT and in memory tasks (HVLT-R and DS).

Conclusions

ToM may rely on some neuro-cognitive functions (mainly attention and executive functioning). Elucidating the exact relationship between ToM and NF may be useful as both are targeted in specific psychotherapeutic interventions.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Epidemiological and clinical profiles of hospitalized female patients in the psychiatric hospital “Nuestra Señora Del Pilar” between 1912 and 1915
Authors: Abad C. , Bouzán M.L. , Martín A. , Lanzán M.T. , Ortega O. , Bosqued L.
Published: May 2016

Introduction

Hospitalization is fundamental in the treatment of severe psychiatric disorders, at present and in the past. The Psychiatric Hospital “Ntra. Sra. Del Pilar de Zaragoza”, established in 1425, is one of the most ancient hospitals and with longest history of the country, one of the first centers to start considering as demented persons as another sick patient. This paper describes the sociodemographic and clinical characteristics of the patients admitted to the psychiatric hospital between 1912 and 1915.

Method

We developed a descriptive research, using secondary information sources (clinical histories) of patients hospitalized between 1912 and 1915. For data analysis was used software SPSS 10.

Results

We reviewed 110 files and the most common diagnoses were senile dementia and manic-depressive psychosis. The mean of age was 42 years, and the predominant marital status was the single status (47%). We documented that in more than 60% of the cases, the precedence of the patients was from rural zone. El 75% of the patients had remained hospitalized during several years until their death. Only the 10% were discharged for improvement.

Conclusion

It is important to understand the socio-economic variables of the female patients from a century ago to be aware of the evolution of psychiatry and psychiatric treatment and consequently of the profile of current patients.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Motherhood – a disturbed beginning: A review of a case series
Authors: Andrade M. , Rodrigues C. , Cardoso C. , Palma V.
Published: May 2016

Introduction

Perinatal mental illness is one of the most frequent complications of pregnancy and the postpartum period. During the puerperium, the risk of developing a mental disease, such as a psychotic episode, is higher than in any other time in a woman's life.

Objectives

The two main objectives are to describe a case series of 4 patients diagnosed with pospartum psychosis, and to synthesize the most important facets of this mental illness based on a literature review.

Aims

The aim is to provide an overview of the clinical and epidemiological aspects of postpartum psychosis.

Methods

The four clinical cases are presented by describing the similar as opposed to the differential aspects between all patients, using the information obtained through successive clinical interviews and the case file. Research was accomplished through Clinical Key and PubMed (2005-2015) using the keywords: postpartum psychosis.

Results

In all four cases, the patients developed symptoms of sleep disturbance, mood fluctuation, altered thinking process with delusions or obsessions, and bizarre behaviours. This occurred within the first four weeks after labour, which was in all cases an obstrutced labour. The data suggests that postpartum psychosis is a presentation of bipolar disorder. Clinical aspects and risk factors related to this perinatal complication all coincide with the cases presented.

Conclusions

Postpartum psychosis is a rare presentation of perinatal mental illness. However, it presents itself, as a psychiatric emergency, and the early and correct assessment are crucial to reset the development of the mother–child bond.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Risk factors of anxiety and depressive symptoms in female patients experiencing intimate partner violence in Poland
Authors: Karakula-Juchnowicz H. , Lukasik P. , Morylowska-Topolska J. , Juchnowicz D. , Krukow P. , Flis M.
Published: May 2016

Introduction

There is an evidence indicating that women experiencing intimate partner violence (IPV) quite common suffer from anxiety and depression, but predictors and protective factors are not well known in this group of patients.

Aim

The aim of the study was to try to find factor that are connected with higher rates of anxiety and depressive symptoms in the group of female patients experiencing IPV.

Method

The study was conducted in six randomly selected centers of primary health care (PHCs) in Lublin province. One hundred and two female patients experiencing IPV were administered a structured questionnaire and the Hospital Anxiety and Depression Scale (HADS). The sequential models were created with using backward stepwise multiple regression to investigate potential risk and protective factors connected with higher rates of anxiety and depression symptom in the group.

Results

In a study group, 68% in Anxiety Subscale(A) and 56% in Depression Subscale of HADS (D) had positive scores. Living in the country (P = 0.003) was connected with higher scores in HADS-A (P = 0.003) but not in HADS-D. Experiencing physical violence was connected with higher score in HADS-D (P = 0.005), but not in HADS-A. Chronic physical illness (A P = 0.013; D P = 0.015), being unemployed (A P = 0.024; B P = 0.008), and experiencing economic violence (A P < 0.001; D P = 0.001) were connected with higher stores in both Subscales of HADS. Taking financial support (A P = 0.002, D P = 0.003) was the protective factor for both kinds of symptoms.

Conclusions

Socio-economic factors have stronger influence on anxiety and depressive symptoms in women experiencing IPV than demographic factors.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Pregnant patients admitted to an inpatient psychiatric unit: An 18-months’ experience
Authors: Ozdemir A. , Bulanik D. , Aksoy-Poyraz C. , Cirakoglu E. , Enginkaya S. , Tomruk N.B.
Published: May 2016

Objective

Our aim was to describe demographic data of pregnant patients admitted to an inpatient psychiatric unit and analyze treatment preferences for acutely ill pregnant patients.

Methods

A prospective chart review was carried out to identify pregnant patients who admitted to the inpatient unit during the period April 2014–September 2015. Details regarding their sociodemographic, clinical, and treatment data were obtained from these records for the study.

Results

The total number of pregnant patients, admitted to our psychiatry inpatient clinic during the survey period was 15. The mean age of the patients was 30.33 (with a range of 21–38 years). Two thirds of the patients were hospitalized in the 1st trimester. Bipolar disorder (46.6%) was the most common diagnosis, followed by psychotic disorder (33%), and unipolar severe depression (20%). Eleven patients (67%) out of 15 had a psychiatric illness before getting pregnant. It was found that premenstrual syndrome was reported by 60% of patients. Haloperidol was the most frequently used psychotropic drug for the treatment of psychotic disorders and bipolar manic episodes.

Conclusion

The information regarding the course of bipolar disorder in pregnancy is controversial. While some studies support the opinion that pregnancy appeared to have a protective effect against an increase in symptoms, others stress that the risk for relapse in the pregnancy period is high. It is noteworthy that the majority of our patients are bipolar patients in the 1st trimester. The abrupt cease of mood stabilizer use may lead to recurrence in bipolar disorder.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Predictors of aggressive behavior among acute psychiatric patients: 5 years clinical study
Authors: Aparicio Reinoso T. , Gonzalez Parra S.
Published: May 2016

Introduction

The problem of violence and aggressive behaviour among patients with psychiatric disorders need careful assessment to improve the quality of psychiatric care.

Objective

The aim of this paper is to describe the characteristics of repeated episodes of violence among patients admitted to a Psychiatric Ward, which is a total of 66 beds at Doctor Rodriguez Lafora Hospital from January 2009 to December 2014.

Methods

We designed a retrospective, longitudinal and observational study over a 5-year period in two brief hospitalization units of Doctor Rodriguez Lafora Hospital in Madrid. The main variables studied were: type of admission, diagnosis, age, trigger and shift.

Results

In our study, we analyzed the prototypical person who carries out these episodes of aggression: a male between 31–40 years, diagnosed with psychotic disorder or personality disorder, involuntary admitted. This episode is associated as a main trigger to mood disturbances, lack of acceptance of standards and psychotic symptoms. These episodes occur more frequently in the afternoon shift one business day and often processed without injuries or minor bruises to other patients and/or nursing assistants. In our practice, we have observed that in most cases adequate verbal restraint in the beginning is sufficient to prevent the episode of aggression.

Conclusions

Understand the aggressive factors can influence the production of violent behavior and the use of appropriate containment techniques may be considered a therapeutic option to prevent and address violent behavior in psychiatric patients hospitalized in brief hospitalization units.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Leganés Psychiatric Hospital in the early twentieth century (1900–1931): An approach to healthcare activity
Authors: Candela Ramírez R. , Conseglieri Gámez A. , Vázquez de la Torre Escalera P.
Published: May 2016

Introduction

Leganés Psychiatric Hospital has been the subject of several studies about its institutional history and clinical activity. The first decades of the twentieth century are the less explored years; however, important events for the development and establishment of the discipline of psychiatry happened in Spain during this period.

Objectives/aims

To describe the clinical and therapeutic management of inpatients admitted to Leganés National Asylum between 1900 and 1931.

Material and methods

This is a retrospective case series study. We reviewed medical records found in the Historical Archives of Psychiatric Institute, Germany (n = 1043) of inpatients admitted between 1900 and 1931. We analyzed clinical care variables, mainly related to diagnosis and treatment, of the patients who were admitted during this period (n = 1043) with SPSS v21. We consulted bibliography, such as asylum documents and diverse primary and secondary literature.

Results

The diagnosis of mania was very common in the early twentieth century. Lypemania nearly disappeared after 1910 and monomania was not observed in any patient. Delusions decreased after 1905. The first patient diagnosed with schizophrenia was admitted on 19th November 1921. From that moment, the use of this term increased significantly. Only 4.4% of patients admitted underwent treatment.

Conclusions

We confirmed the predominance of French nosology in the early twentieth century. From 1920, an increase in German nosography was observed. The application of treatments was rare.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Description of the activity of a psychiatric day hospital from its opening up to the present day
Authors: Duque Domínguez A. , Duque Domínguez R. , Martín Díaz L. , García Montero C. , Palomo Monge M. , Vaquero López M.D.L.N. , Pérez Arévalo E.
Published: May 2016

Introduction

Description of the most relevant data found in a Psychiatric Day Hospital opened ten months ago in the hospital complex of Ávila.

Objectives

The goal is to evaluate clinical and management data in patients of the Psychiatric Day Hospital.

Methods

Retrospective cross-sectional descriptive study. A data collection form where each patient is classified into: sex, age, average stay, first admission or readmission, origin, reason for discharge, destination on discharge and diagnoses (classification ICD-10) was used.

Results

From the opening of the Psychiatric Day Hospital ten months ago, 58 patients have been admitted: 70.7% women and 29.3% men. Readmissions: 1.7%. Their origin was: psychiatric hospitalization (53.5%), outpatient department (31%), emergency room (13.8%) and Centre for Psychosocial Rehabilitation (1.7%). 41 out of 58 patients have been discharged. Reasons for discharge: improvement (78%), referral to other units (7.4%), voluntary discharge (4.8%) and others (9.8%). The destination on discharge was: outpatient department (90.4%), Centre for Psychosocial Rehabilitation (4.8%), and Inpatient Rehabilitation Unit (4.8%). The most frequent diagnoses on discharge were: bipolar affective disorder, adaptation, emotionally unstable personality disorder, dysthymia, persistent delusional disorders, specific personality disorders and severe depressive episode with psychotic symptoms.

Conclusions

The Psychiatric Day Hospital is an intensive treatment unit with a partial hospitalization system, which is distinguished by the variety of patients it is able to admit, as well as the clinical and management benefits the dynamic of these units can provide.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Criteria and concurrent validity of DIVA 2.0: A semi-structured diagnostic interview for adult ADHD
Authors: Fadeuilhe Grau C. , Palma-Álvarez R.F. , Nasillo V. , Palomar G. , Corrales M. , Richarte V. , Van de Glind G. , Casas M. , Kooij J.J.S. , Ramos-Quiroga J.A.
Published: May 2016

Introduction

Attention Deficit Hyperactivity Disorder (ADHD) prevalence in the general adult population is estimated to be between 2–4%. Despite the high prevalence, until recently there was only one validated semi-structured interview available for the accurate diagnostic assessment of ADHD within the adult population: the Conners Adult ADHD Diagnostic Interview for DSM-IV (CAADID).

Objectives

To examine the concurrent validity of the DIVA 2.0 interview comparing the diagnostic rate with the CAADID interview. To analyse the criterion validity of the DIVA 2.0 in the Spanish language in an adult sample.

Aims

The aim of this is to study was to evaluate criterion validity of the DIVA 2.0 in an adult sample comparing with the CAADID and other ADHD severity scales.

Methods

A transversal study was performed to check the criteria and concurrent validity of the DIVA 2.0 compared to the CAADID.

Results

Forty patients were recruited in an adult ADHD program at a university hospital. The DIVA 2.0 interview showed a diagnostic accuracy of 100% when compared with the diagnoses obtained with the CAADID interview and goods correlations with three self-reported rating scales: the WURS, the ADHD Rating Scale and Sheehan's’ Dysfunction Inventory.

Conclusions

The DIVA 2.0 has good psychometric properties and is a reliable tool for the assessment of ADHD in adults.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Group therapy for university students with autism spectrum disorders
Authors: Furuhashi Y. , Shusuke F.
Published: May 2016

Introduction

Autism spectrum disorders (ASD) are a group of neurodevelopmental syndromes characterized by deficits in communication, social interaction and imagination. These symptoms are present in the early developmental period, but may not be fully obvious until social demands exceed the child's limited capacities. In spite of its early presenting, this condition is not diagnosed until adult stage. In Japan, many patients with ASD were diagnosed after entering university, however, few treatment options are available. The aim of this study is to investigate the effectiveness of group therapy in university students with ASD.

Methods

A one-group, pre-intervention-post-intervention design was adapted for this study. All patients with ASD were recruited from Shizuoka University. The group therapy programs consisted of cognitive behavioral therapy and recreational activity. Outcome measures were Beck Depression Inventory-Second Edition, Quality of Life Inventory, State Trait Anxiety Inventory and Rosenberg Self-Esteem Scale.

Results

There were 14 participants, 7 males and 7 females. Their ages were from 19-years-old to 23-years-old. All participants had over 80% of attendance in the six-month group therapy.

Conclusions

These preliminary results suggest that the group therapy can improve symptoms of depression and anxiety for some students with ASD. More research is needed to draw more sturdy conclusions, especially with respect to improvements in quality of life.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Practical teaching of behavioral sciences to medical students
Authors: Hammouda M.
Published: May 2016

Introduction

The teaching of behavioral sciences was in form of lectures to the medical students in the 2nd year of the college, because the lecture is the least beneficial method of teaching. As I have noticed also that students were more interested to practice behavioral skills. So I suggested to the authority of the faculty to teach part of the behavioral sciences in a practical way and proposal of that was introduced and accepted to teach in that way and to give 20% of marks to this practical part, this in addition to the same theoretical lectures.

Method

The students were divided into groups of 30, every group present one day only through their 2nd year. This day divided into two parts each is 2 hours and in between have an hour break. The 1st part includes group discussion about communication, group dynamics, group leading and scientific way of problem solving. The 2nd part is dividing students into small groups of 10 students, to practice the previous skills in group interaction to solve one problem in a scientific way. All groups collected again to see what they have done.

Results

The results revealed more interest and more enthusiasm to learn in that way and make it easy to practice in their daily life.

Conclusion

We have to change into more practice in our teaching of medical students especially skills of human communication, group leading group dynamics as well as problem solving.

Disclosure of interest

The author has not supplied his/her declaration of competing interest.
Depressive symptoms in patients with schizophrenia
Authors: Aladashvili T.
Published: May 2016

Introduction

Depression is common among patients with schizophrenia and is associated with a wide range of poor outcomes, including psychotic relapse and suicide. The aim of the study is to evaluate the presence of depressive symptoms in patients with schizophrenia and to compare depression intensity in schizophrenic patients and patients with depressive disorder.

Methods

In this cross sectional study were included 40 patients from both genders. Patients were divided in 2 groups: (1) examined group: 20 schizophrenic patients who presented depressive symptomatology. Depressive symptoms-evaluated with the 17-item Hamilton Rating Scale for Depression. Inclusion criteria: schizophrenic disorder by ICD-10 (F20.0-F20.9), total score higher than 7 on the HRSD-17 and age between 25 and 65; (2) control group: 20 patients with depressive disorder. Inclusion criteria: recurrent depressive disorder by ICD-10 (F33.0-F33.9), total score higher than 7 on the HRSD-17 and age between 25 and 65. Psychiatric rating scales for clinical evaluation of prominence of symptomatology: 17-item Hamilton Rating Scale for Depression (HRSD-17) and PANSS (Positive And Negative Syndrome Scale).

Results

The prevalence of patients with depressive symptoms among the schizophrenic patients was 45% i.e. out of 20 evaluated patients with schizophrenia, 9 showed depressive symptoms. The total score in the remaining 11 patients on the HRSD-17 was lower than 7 and they were excluded. Difference between the two groups for gender difference was not statistically significant.

Conclusions

The percentage of patients with depressive symptoms among the patients with schizophrenic disorder was 45%. Schizophrenic patients more frequently presented mild and moderate depression in comparison to the control group. In the majority of subjects with schizophrenia and depressive symptoms positive schizophrenic symptomatology was predominant.

Disclosure of interest

The author has not supplied his/her declaration of competing interest.