bluuebunny/crossref_metadata_2025 huggingface dataset:
2795 – Delusional Social Isolation: Criteria Attempts for Psychotic Depression and Late Paranoid Schizophrenia
Authors: Engel C. , Dugand N. , Baudu C. , Pringuey D. , Benoit M.
Published: July 2013

Introduction:

Chronic social isolation in the elderly may be related with diverse psychiatric disorders: chronic depressive episode, paranoia-type personality, and late non-schizophrenic psychosis.

Objectives:

In order to separate psychotic depression and non-schizophrenic psychosis with depressive mood, there is a need for more clearly defined criteria.

Methods:

We report the case of a 68 yrs. women living alone at home for more than twenty years, with a complete social isolation for two years. This behaviour was found associated with severe delusion: she unreasonably felt persecuted by her flat's owner and she dissimulated an extensive basocellular carcinoma on her face threatening her life. A history of a short depressive episode at the time of her divorce was only found, as she demonstrated at initial assessment many paranoia personality traits. A review of literature on this disorders’ association was therefore undertaken.

Results:

Evolution after admission revealed the lack of effectiveness of antipsychotic treatment on delusion, but some efficiency of antidepressant. Nevertheless, personality traits remained unaffected by care. Literature on the association between mood disorders and non-schizophrenic psychosis is rare, and we suggest some criteria that may account for psychotic depression and be useful to treatment choice.

Conclusions:

In the absence of a history of chronic mood or psychotic disorder, it is hypothesised that paranoia symptoms may account more for a psychotic depression than for late paranoid schizophrenia. This may have consequences for therapeutic strategy.
2796 – Resistant Depression in The Elderly: Effects of Treatment on Symptomatology, Cognitive Functioning and Functional Abilities
Authors: Gomez S. , Mazzone F. , Baudu C. , Pringuey D. , Benoit M.
Published: July 2013

Introduction:

Severe depression after mid-life has significant clinical, cognitive or functional consequences. These related dimensions may have a different evolution under treatment, and their assessment may be useful to evaluate treatment efficiency.

Objectives:

To measure differential treatment effect on clinical, cognitive and functional dimensions in elderly severe depression.

Aims:

The relation between these three dimensions has been examined from the inclusion through six weeks of treatment

Methods:

Three different treatment (antidepressant, ECT and rTMS) were proposed to ten patients aged more than 60. The clinical, cognitive and functional dimensions were compared at inclusion and J42, and their evolution was also measured. At the end, we tried to assess trends for difference between the three types of treatment. Three types of evaluation were performed: clinical (depression, anxiety and apathy), neuropsychological (memory, attentional and executive functioning) and functional (activities of daily life, autonomy).

Results:

This preliminary study put in evidence a common pre-treatment profile of depressive symptoms (mood disorder), cognitive (executive difficulties) and functional (loss of autonomy, physical problems) abilities. Clinical improvement was associated with similar cognitive and functional progression, whatever therapeutic method was proposed.

Conclusions:

Repetitive evaluation of symptomatology, cognitive performance and everyday life functioning seems to have a major importance in post midlife depressive episodes. It might be useful to determine if non-pharmacological treatment may result in a different evolution of these dimensions.
2799 – A Comparison of Depressive Symptom Manifestation: Adolescents with Low and High Level of Alexithymia
Authors: Tam B.K.H. , Wong W.S.
Published: July 2013

Introduction:

There is a dearth of literature on the effect of alexithymia on somatizing depression. Yet, the symptom manifestation of depression among people with alexithymia has not been well-investigated. The objective of this study was to examine symptom presentation in adolescents having high (HDA) or low (LDA) degrees of alexithymia.

Methods:

A total of 590 adolescents aged 11–18 years participated in this school-based study. of 269 adolescents with mild to severe depressive symptoms (Center of Epidemiological Studies—Depression Scale (CES-D)>15), 136 participants were selected and identified as either having HDA (n = 100) or LDA (n = 36). Confirmatory factor analyses (CFAs) tested the fit of a correlated two-factor structure (somatic and affective symptoms of CES-D) to the data. HDA adolescents were compared to those with LDA on somatic and affective symptoms of depression, negative affect and somatization symptoms.

Results:

Results of CFAs confirmed the two-factor model in HDA (CFI = 0.863) and LDA (CFI = 0.874) adolescents. HDA adolescents reported more somatic symptoms of depression (t = −2.97, p = 0.004) and negative affect (t = −3.53, p = 0.001) compared with LDA adolescents. No significant difference was observed between HDA and LDA adolescents on affective symptoms of depression and somatization symptoms (p > 0.05).

Conclusions:

Our findings underscore that (1) HDA adolescents reported affective symptoms of depression in a similar manner to LDA adolescents, and (2) though the tendency toward reporting somatic symptom of depression is evident, HDA adolescents did not report significantly more somatization symptoms. These findings refute the notion that patients with alexithymia articulate their emotional and psychological distress primarily through physical symptomatology.
2804 – Asenapine After Clozapine: Is Possible?
Authors: Matteo P. , Mula M. , Basaglia C. , Favaretto E. , Schwitzer J.
Published: July 2013

Bipolar disorder is a common, severe, long-term condition, characterized by manic/hypomanic, depressed, or mixed states

(1)

Lithium is the traditional treatment option, and valproate and carbamazepine have been introduced to better treat and stabilize manic/depressive cyclicity. Recently antipsychotics turned into a broader therapeutic option for bipolar disorder, as both alternative and adjunct to traditional mood stabilizers.

(2)

Asenapine is an atypical antipsychotic indicated for the treatment of schizophrenia and of the manic or mixed episodes in bipolar I disorder (1,3). “Mrs. O.M.”, is a caucasian woman aged 55 suffering from bipolar disorder type I since she was 22 years old, with mood cycles characterized by long manic episodes with soft mixed and cognitive features. Readmitted for a manic exacerbation, the increasing of clozapine up to 250 mg/day was accompanied by hyperphagia, weight gain, cognitive impairment, sedation, fatigue, anergy, resistant chronic constipation. To that point clozapine was abruptly replaced with asenapine 20 mg/day with rapid clinical improvement within two days without major side effects. After 6 months the patient is still showing a good affective stability, without side effects. Our case report underlines the possibility of rapid switch from clozapine to asenapine in bipolar I disorder therapy resistant manic patients, presenting extrapyramidal, cognitive and metabolic side effects with atypical and typical neuroleptics.
2814 – Body Image Dissatisfaction and Eating Disorder Symptomatology: a Latent Structural Equation Modeling Examination of Moderators Among Adolescent Girls
Authors: Dakanalis A. , Favagrossa L. , Clerici M. , Volpato C. , Di Mattei V.E. , Riva G. , Madeddu F. , Zanetti A.M.
Published: July 2013

Introduction:

According to meta-analytic review, body dissatisfaction (BD) is recognized as the strongest risk factor of all forms of eating disorders (EDs).Yet, it has been found that BD is so prevalent among adolescent girls and young adult women that it is “normative”. The present study investigates why only a minority of adolescents girls report severe levels of ED symptomatology, when so many are body dissatisfied?

Aims:

Five theoretically relevant variables are investigated as potential moderators of the BD-ED symptomatology relationship (drive for thinness and bulimic behaviours).

Methods:

A sample of 401 Italian adolescent girls completed questionnaire measures of BD, drive for thinness, bulimic behaviours, as well as the proposed moderating variables of body checking, perfectionism, appearance control beliefs, internalization of socio-cultural standards of beauty, and self-esteem.

Results:

Structural equation modeling with latent factor interactions indicated that body checking, perfectionism, appearance control beliefs and internalization of socio-cultural standards of beauty intensified the primary BD-ED symptomatology, such that BD was strongly related to drive for thinness and bulimic behaviours when levels of each moderator were higher. By contrast self-esteem buffered the deleterious effects of BD, such that when levels of the moderator were higher, the relationship between BD and each criterion variable representing female's ED symptomatology was weaker.

Conclusions:

Several risk and protective factors have been found to interact with BD to influence its relation to ED symptomatology. The findings can inform the design and delivery of tailored prevention and treatments interventions for adolescent's eating disturbances.
2815 – Quality of the Assertive Community Treatment in the Avilés (Spain) Act Team
Authors: Martinez Jambrina J.J. , Gonzalez Lopez G. , Alvarez Solares J.
Published: July 2013

Introduction:

Martinez Jambrina et al. (2010) developed the first research on the quality of assertive community treatment offered by Avilés ACT team to patients who were referred to this service with psychiatric diagnoses included in the group of severe and persistent. This research focused on the study of quality standards on internal organization, assistential activity, external coordination, accessibility and quality of care considered by the users and their families.

Objectives:

To analyze the quality of the interventions of the Avilés ACT team during one year (april 2011–april 2012) and compare it with results reached in 2010.

Methods:

Descriptive Research - No experimental - Transversal.

Population:

ACT Team 11 members (2 psychiatrists, 6 nurses, 2 auxiliar nurses 1 social worker) and Users of ETAC: 110 users.

Variables- Internal Organization:- Assistential Activity- External Coordination- Accessibility- Quality of Care.

Conclusions:

The results obtained are similar to our first research (2010) The ACT team of Aviles works with quality levels that can be considered optimal if referring to USA standards of quality in this intervention
2816 – Obsessive Compulsive Symptoms and Premorbid Adjustment as Predictors of Transition to Psychosis in Ultra-High Risk Subjects
Authors: Bourgin J. , Magaud E. , Gut A. , Kazes M. , Krebs M.-O.
Published: July 2013

Introduction:

Identifying at-risk mental states of psychosis can reduce the duration of untreated psychosis and the rate of transition. Meanwhile, it may improve prevention strategies of suicide, substance abuse and anxiety disorders comorbidities.

Objectives:

We aim to investigate the clinical symptomatology differences at baseline, especially in non-specific symptoms, between UHR (Ultra High Risk) patients who did or did not make a transition to psychosis. Sharpening UHR inclusion criteria may improve prediction of transition to psychosis.

Method:

The study included 85 young help-seekers (mean age= 20 y.o.) meeting UHR CAARMS’ criteria. 46 were followed up over a period of 30 months and 27 of them were assessed in a comprehensive clinical interview. Out of 46 finally included UHR subjects, 11 (40%) made a transition to psychosis. Psychopathology was investigated with the Comprehensive Assessment of At-Risk Mental State (CAARMS), BPRS and GAF-score. To identify the most predictive variables of transition, we applied a stepwise logistic regression on CAARMS’ criteria plus other variables (premorbid adjustment scale, cannabis use, subjective experienced life events, treatment and suicide).

Results:

At baseline, premorbid adjustment and severity of CAARMS’ Obesssive-Compulsive Symptoms (OCS) were found to significantly influence the transition: poor premorbid adjustment, associated with moderate level of OCS increased the sensitivity (72.7%) and the specificity (92.8%) of the prediction.

Conclusions:

Premorbid adjustment and level of OCS were predictive of transition in subjects at UHR. These characteristics could increase the level of prediction of psychosis.
2818 – Syndrome of Childhood Ataxia with Cerebral Hypomyelination (Cach) Revealed by Treatment-Resistant Depression
Authors: Stroescu A. , Cohen M. , Bayreuther-Giordana C. , Thomas P. , Pringuey D. , Benoit M.
Published: July 2013

Introduction:

White-matter abnormalities are sometimes associated with mood disorders, and atypical depression may be related with a leukodystrophy.

Aims:

A case report of a treatment-resistant depression with cognitive deficits and extensive white-matter hyperintensities suggested a literature review on this unattended association.

Methods:

A 33 yrs. woman was recovered in our psychiatric ward with a recurrent depressive disorder, partially resistant to antidepressant for eleven years. MADRS score was 26 at admission, without significant anxiety or psychotic symptoms. After 12 days, she presented delirium with neurological localisation symptoms. MRI examination put in evidence confluent hypersignal of white matter with demyelinisation, without grey-matter lesion. No biological or enzymatic abnormalities were detected. A severe executive dysfunction with information slowing was detected on neuropsychological assessment. We performed a literature review on the association of depression and leukodystrophy.

Results:

The presented case is a probable Childhood Ataxia with Cerebral Hypomyelination (CACH) syndrome lately revealed by treatment-resistant depression. It represents 30% of all causes of leukodystrophy, and as it is described typically in a childhood form, an onset at adulthood has also been reported, sometimes with foreground behavioural and affective disorders. in that form, it may present with a treatment-resistant and atypical depression.

Conclusions:

Treatment-resistant depression in young people with an atypical presentation may be related with an extensive white-matter disease, and a complete evaluation including MRI, biological, enzymatic, neuropsychological assessments, is therefore recommended.
2823 – Stress-Related Psychological Symptoms Among Health Care Professionals in a Greek Hospital
Authors: Lyrakos G.N. , Aslani H. , Catopodi A. , Papastavrou D. , Kouvari S. , Batistaki C. , Spinaris V.
Published: July 2013

Introduction:

Healthcare professionals (HCP) suffer from work-related or occupational stress often resulting from high expectations, coupled with insufficient time, skills and/or social support at work, but stress also resolves from everyday life.

Aims:

The aim of the present study was to measure the stress-related psychological symptoms in HCP and to assess significant differences among different specialties.

Methods:

Stress as a syndrome that is factorially distinct from depression and anxiety, characterized by nervous tension, difficulty relaxing and irritability, was measured with the stress scale of the Depression Anxiety Stress Scale (DASS). Statistical analysis was performed with SPSS-19.

Results:

196 HCP from a public hospital in Greece participated in the study. of them, 33 (16.6%) were males and 166(83.4%) females. 49(24.6%) were nursing staff, 59(29.6%) medical staff (MS) and 91(45.7%) administrative personnel (AP). in stress, Nursing Aid (NA) (M = 14.8 ± 8.4), Paramedics (P) (M = 17.8 ± 10.5) and MS (M = 13.7 ± 10.7) had higher scores from the general population (M = 12.4 ± 9.8). Statistical significant differences were found with Mann Whitney U, in stress between Register Nurses (RN) (M = 8.1 ± 6.4) and MS (M = 13.7 ± 10.7) (z = −2.458 p < .05) and between RN and NA (M = 14.8 ± 8.4) (z = −2.058 p < .05). After ANOVA, MS were found more easily upset, impatient and irritable/over reactive than RN(z = −1.952 −2.034 and −2.408 p < .05 respectively), NA more easily upset and irritable than RN(z = −2.875 and −2.160 p < .05 respectively) and paramedics were more impatient than RN (z = −2.713).

Conclusions:

Health care staff experiences stress with significant differences among different specialties that are correlated with the profession and the demands of the job description.
2828 – Comparison of Clinical and Sociodemographic Features of Bipolar Disorder According To Gender
Authors: Erdem M. , Akarsu S. , Bolu A. , Günay H. , Garip B. , Ak M. , Zincir S.
Published: July 2013

Introduction:

Although the lifetime prevalence of bipolar disorder is not different between men and women, some of the features of the disease vary between the genders.

Aim:

To compare the clinical and sociodemographic features of bipolar disorder according to gender.

Methods:

In this study the data of 125 bipolar disorder tip I patients who had been admitted to Department of Psychiatry of Gulhane Military Medical Faculty between 2009–2011 were examined. Data of these patients were obtained by examining the patients files.

Results:

95 of 125 patients (%76.0) were male, and 30 (%24.0) were female. Age of disease onset in bipolar male patients was 22,5 ± 6,9; %6.3 had a history of suicid attempt and %11.6 had a history of substance abuse. Age of disease onset in bipolar female patients was 28,7 ± 9.7. %23.3 had a history of suicide attempt. There was no history of substance abuse in female patients. Psychotic features and history of substance abuse were more prominent in men. The later age of disease onset and longer duration of hospitalization were determined in women.

Conclusion:

Our results were appeared to be in line with the results of the studies about gender differences in bipolar disorder. Making prospective studies about this subject is considered to be useful to determine the epidemiological characteristics of mood disorders.
2829 – Clinical Features in Hospitalized Bipolar Patients
Authors: Erdem M. , Akarsu S. , Ak M. , Bozkurt A. , Özşahin A.
Published: July 2013

Introduction:

Bipolar disorder usually begin at an early age and often need hospitalization. in this study, we aimed to investigate the clinical characteristics of patients with bipolar disorder

Methods:

The data of 108 bipolar type I patients who were admitted to psychiatry clinic of a university hospital due to manic episode between 2007–2009 were examined.

Results:

45 of 108 bipolar patients (41.6%) episodes of mania was just across diseases. 18 of these 45 patients were diagnosed with first-episode mania. Percentage of these patients according to their diagnosis index episode, mania was 65.7%; hypomania was 15.7%; hypomania and depressive episode was 18.5%. The number of entrants as a manic episode was approximately 3 times as depression disease beginners. Maximum rate of admission to clinic was in November and December (14.8% and 10.1%). The distribution of hospitalization rate was 21.2% in winter, 25.9 and 24% in spring and summer, 28.7% in autumn. The mean length of hospitalization was 22.4 ± 16.0 days and patients were hospitalized 2.75 ± 2.34 times during their diseases. Patients had manic episodes average of 3.1 ± 4.4 times and depresif episodes average of 1.4 ± 2.5 times during their diseases.

Conclusions:

There is no consensus regarding the types of seizures in first episode bipolar disorder. The first period of mania or depression is likely close to each other. in our study, the most prominent was mania with 65.7%. Major depressive periods usually begin in winter and autumn and improves in summer.
2833 – A Six Year Follow-Up Study of Cognitive Change in First Onset Depressive Patients
Authors: Su H. , Xu Y.F. , Jiang K.D. , Li F. , Zhang X.H. , Fang Y.R.
Published: July 2013

Introduction:

The debates about depressive disorder and cognition impairment are supported by controversial data.

Objective:

We launched the study to investigate cognitive change in first onset depressive patients over a 6 year period.

Methods:

A prospective cohort was performed. Participants included 206 cases of first onset depressive Chinese outpatient aged from 17 to 60 year old and followed from Apr. 2003-Feb. 2004 to Apr. 2009-Feb. 2010 in Shanghai. During the first 48 weeks, case management service was delivered. Participants were assessed by 17-HAMD and HAMA scale at baseline, week 12, week 32, week 48, and year 6. Cognitive changes were assessed using the WMS-RC, WAIS-RC, and WCST at baseline (n = 116), week 12 (n = 80) and year 6 (n = 24), 41 normal participants as control.

Results:

(1)

During the first depressive onset, cognitive performance deteriorated comparing with those of control group (P < 0.01).

(2)

At week 12,effective medication could relieve symptom and improve cognition function (P < 0.05), cognitive performance compared between patient and control with no obvious difference (P > 0.05). While patient group had a significantly larger proportion (whose Memory Quotient below 85) than control group did (χ2 = 5.66, P < 0.05).

(3)

Using a general linear mixed model to estimate cognitive change,patients with more severe depressive retardation and lower education had a worse short-term memory over 6 years (estimate = -1.65, SE = 0.80, P < 0.05;estimate=1.63, SE = 0.30, P < 0.01), adjusting for demographics and medical status.

Conclusion:

The first onset depressive patient has cognitive defects. Memory does not full recovery after symptom relief. Short-term memory impairment persists over 6 years with relative factors.
2835 – French Version of the Hypomanic Personality Scale (HPS): Factorial Structure in a Non-Clinical Student Sample
Authors: Morvan Y. , Terrien S. , Blondel M. , Carré A. , Besche-Richard C.
Published: July 2013

Introduction:

Hypomanic Personality Scale (HPS) is a self-report questionnaire designed to identify high risk and vulnerable subjects to bipolar disorders in non-clinical samples.

Objectives:

To identify HPS factorial structure in a French non-clinical sample and to compare for different factors solutions described in the literature.

Methods:

We carried out a survey within a student population with a French version of HPS. The factorial structure of HPS was tested first by a scree plot with simulation (using R “psy” library) in an Exploratory Factorial Analysis (EFA) with promax rotation. Secondly the number of factor was fixed for a Confirmatory Factorial Analysis (CFA) performed with AMOS.

Results:

A total of 347 students (mean age 23 years, 80% of women) were included in PCA (incomplete questionnaires were not included). Scree Plot with simulation revealed a 5 factors solution which accounted for 33% of the total variance. We also tested the 3 and 4 factors solution to compare respectively with factors solution obtained by Rawling et al. (2000) and more recently by Schalet et al. (2011). Our 4 factors solution was identical to Rawling et al. (2000) but the 3 factors solution was different from Schalet et al. (2011). Goodness of fit indices showed that the 5 factors solution “fits” our data better compared to other factorial solutions.

Conclusions:

French version of the HPS showed a factorial structure composed of 5 factors in a non-clinical student population. However, this result needs to be confirmed with a more important and representative sample.
2839 – Ziprasidone Augmentation of Lamotrigine in Treatment Depersonalization in Bipolar Disorder
Authors: Preve M. , Mula M. , Favaretto E. , Basaglia C. , Schwitzer J.
Published: July 2013

Dissociative symptoms in mood and anxiety disorders are still under-diagnosed and undertreated. Growing evidence suggest that dissociative symptoms are highly present in mood disorders. We hereby describe the case of a 35-year-old Caucasian young lady affected by bipolar disorder (BD), panic disorder (PD) and dissociative symptoms, referred to our clinic for depressive episode accompained by reoccurrence of PD and severe affective and autopsychic depersonalization (scoring at DES 45 and at CDS 80). with paroxetine 40 mg and lamotrigine 50 mg, daily, depressive and panic symptoms progressively improved until remission while depersonalization symptoms remained unchanged causing significant distress. Therefore, ziprasidone 40 mg was introduced with significant improvement in dissociative symptoms at six months (more than 50% at DES and CDS scale). To our knowledge there is no report on the use of ziprasidone augmentation to lamotrigine in treating dissociative symptoms in BD. It's interesting to note that ziprasidone has a relatively high affinity for 5-HT2C serotonin receptors, is a potent 5-HT2C inverse agonist and has a high affinity to 5-HT1A receptors where displays a partial agonist pharmacological profile (4). This is important because partial agonism at the 5-HT1A receptor has been postulated as a potential therapeutic mechanism in the alleviation of depression and anxiety symptoms (5). It is, thus, possible to speculate that the serotoninergic potentiation correlated to ziprasidone introduction, resulted in an improvement of dissociative symptoms, due to the blockade of postsynaptic 5-HT1A receptors (5). Obviously, further research in this area is warranted to replicate our clinical observation.
2840 – Quality of Life and the Levels of Depression and Anxiety at Polycystic Ovary Syndrome
Authors: Erdem M. , Balıkcı A. , Öznur T. , Akarsu S. , Keskin U.
Published: July 2013

Introduction:

Polycystic ovary syndrome (PCOS) is a common disease in women during the reproductive period. Studies have shown a reduction in the quality of life in patients with PCOS. But there is no consensus on which symptoms of PCOS influence the quality of life more.

Aim:

In this study, we aimed to compare the quality of life, depression and anxiety levels of patients with PCOS to healthy controls.

Methods:

53 reproductive-age women with PCOS and 53 healthy women who admitted to obstetrics and gynecology outpatient clinic of a university hospital were included in the study. For the evaluation of the quality of life of all patients, Polycystic ovary syndrome quality of life scale (PCOS-Q), Beck depression and anxiety levels of depression (BDI) and Beck Anxiety Inventory (BAI) was used.

Results:

While mean BDI scores were higher in patients with PCOS compared with control group, no significant difference was observed between the two groups in terms of BAI score. At the PCOS group; the total score of quality of life scale and the subscale scores of emotional deterioration, weight problems, infertility and menstrual disorders were significantly lower than the control group, but no significant difference was detected at the hirsutism subscale between the two groups.

Conclusions:

PCOS has a negative impact on patients’ quality of life. To improve the quality of life of patients it should be taken into account the symptoms which are affecting the current state and the treatment should be planned toward this direction.
2844 – Idea Inpatient Discharge Project: Experiences and Analysis
Authors: Roventa C. , Banjac V. , Brecic P. , Cavajda Z. , Dujmovic J. , Ergovic-Novotny D. , Gasparovic M. , Giurgi C. , Grahovac T. , Kekin I. , Knez R. , Nawka A. , Peharda T. , Razic A. , Roata L. , Rojnic M. , Smoljanic D. , Tomicevic M. , Vidovic D. , Zhabenko O. , Zivkovic M. , Thornicroft G. , Sartorius N.
Published: July 2013

Introduction:

IDEA project is the outcome of Association for the Improvement of Mental Health programme and coordinated at Institute of Psychiatry, King's College London.

Aims:

Are to explore experience of people treated in a mental health setting across nations, determine how inpatient experiences can be improved. Experience gained from interviews will be used to propose questionnaire for routine use, develop versions of interview for other services, inform a possible follow-up study.

Methods:

30 consecutive patients are interviewed on day of discharge in own language. Semi-structured interview covers physical condition in institutions, experiences of treatments like medication, satisfaction with staff, privacy, dignity and whether rights were respected. Responses are summarized on several visual analogue scales and quantitative analysis will be performed. The scale will also be analysed by demographic indices within centres to see whether different groups have different experiences.

Qualitative responses will be analysed thematically, both within and between centres, identifying core themes for each domain and core themes for the protocol as a whole.

Results:

10 countries are participating, 577 interviews are completed. It is noticed a large disparity between institutions in regards to the amount of contact patients have with family, access to phone, quality of food, surroundings and view of medication and therapy.

Conclusion:

It will be a better understanding of the size, structure and staffing of the institutions included in the study, which will help us with our observations about inpatient experiences by putting them in context and make recommendations to institutions.
2846 – A Multicentre Study on Adult Attention-Deficit/Hyperactivity Disorder in Subjects with Affective Disorders: Role of Personality Traits and Clinical Implications
Authors: Di Nicola M. , Sala L. , Romo L. , Catalano V. , Tedeschi D. , Even C. , Dubertret C. , Mazza M. , Martinotti G. , Callea A. , Guelfi J.D. , Rouillon F. , Janiri L. , Gorwood P.
Published: July 2013

Background:

A significant comorbidity between attention-deficit/hyperactivity disorder (ADHD) and affective disorders has been consistently reported in adults. Less data regarding the role of personality traits, and the influence of ADHD co-occurrence on clinical characteristics and outcome of mood disorders are currently available.

Methods:

The sample consisted of 296 subjects, divided into three homogeneous groups according to demographic characteristics: 106 subjects diagnosed with major depressive disorder, 92 with bipolar disorders and 98 healthy controls. ADHD diagnosis was based on DSM-IV-TR criteria. Childhood and adult ADHD features were measured with the Wender Utah Rating Scale (WURS), the Adult ADHD Self-rating Scale (ASRS) and the Brown Attention Deficit Disorder Scale (ADD). The Hospital Anxiety and Depression Scale (HAD) and the Revised NEO Personality Inventory (NEO-PI-R) were also administered to the clinical groups, in order to investigate depressive/anxious symptoms and personality dimensions.

Results:

The prevalence of adult ADHD in subjects with bipolar disorders or major depressive disorder was 22.0% and 8.5% respectively (p < .001), compared to 3.1% in healthy controls. Significant associations between personality traits, depressive/anxious symptoms and ADHD features were found.

Discussion:

The present study emphasises the close relationship between affective disorders, especially bipolar disorders, and ADHD in adults. Our findings support the need to assess subjects with mood disorders in the clinical setting for possible co-existing ADHD and to further investigate personality traits to better understand the etiology of affective disorders and ADHD co-occurrence.
2847 – The Role of Family/Caregivers in Management of Delirium
Authors: Martins S. , Simões M. , Fernandes L.
Published: July 2013

Delirium is a prevalent neuropsychiatric syndrome in elderly patients hospitalized, associated with negative clinical outcomes. in this context, the early identification, timely and optimal management of people with delirium are fundamental in the treatment. According to the current recommendations from NICE, once delirium occurs, non-pharmacological interventions should be considered as the first-line, with identification of any possible underlying causes, providing supportive care and preventing complications and treating behavioural problems.

Family and caregivers involvement by health professionals is also recommend, for an effective management of this clinical condition.

The present study aims to present an update about the role of family in the management of delirium.

Its presence becomes beneficial to the patient, helping protect against emotions of fear, anxiety, loneliness or isolation. They can also facilitate effective communication, using some strategies such as verbal reorientation, clear instructions, eye contact, making the patient feel more secure.

On the other hand, the education of families and caregivers by health professionals about delirium symptoms, fluctuating course, possible causes, as well as treatment options, becomes also crucial to the management of this syndrome.

The present work is supported by FCT (Foundation for Science and Technology) PhD fellowships (SFRH/BD/63154/2009 - S. Martins).
2849 – A Classical View of The “Error Processing Effect”
Authors: Welcome M.O. , Pereverzev V.A.
Published: July 2013

Recent literature data suggests that the system that is necessary for the monitoring and processing of error is a dynamic one. Importantly, the number of brain regions involved in error monitoring and processing varies with age [for review, see Pontifex et al., 2010]. Two major reasons are possible: maturation of the neural systems that identifies different errors (see Stevens et al., 2009); and neural plasticity. While, the other factors might determine the capacity of the brain's error monitoring and processing, present research does not provide adequate evidence for this relationship. Frankly, the vast aspect of brain error monitoring and processing research is still barren and much is needed to be unraveled. Here, we only focus on a recent study we conducted on university students as regards to error processing dynamics relationship with glycemia. The involved determination of cognitive abilities based on a model we had earlier designed revealed important results in this area of research. Conducted correlation and regression analyses reveal important findings. The phenomenon of increased error commission following decrease in blood glucose level, we refer to the “error processing effect”. We also suggest a mechanism (of complex systems) for this phenomenon.
2850 – Outcomes of 11509 Assessments for Possible Detention Under the Mental Health Act in Norfolk, United Kingdom 2001–2011
Authors: Beezhold J. , Pandey A. , Pandey S. , Parker J.
Published: July 2013

Introduction:

Compulsory admission to psychiatric hospital in the United Kingdom (UK) is governed by the Mental Health Act (MHA). There have been concerns that the application of this legislation may be discriminatory, and that there is a trend towards increasing use of coercion.

Aims and objectives:

To evaluate data on MHA assessments in order to determine overall outcomes; and whether there is evidence for a difference in outcomes based on variables such as age, gender, or ethnic group.

Methods:

A database including around 99% of all such assessments was compiled from information recorded routinely at the time of the assessments by senior social workers who lead the assessments. This was analysed using SPSS statistical software.

Results:

There were clear statistical correlations with a number of variables including marital status, living alone and age. There was a slight but significant bias towards using shorter detention periods of up to 28 days for women, rather than longer up to six-month periods. However, despite this there was no overall evidence of gender bias.

Conclusion:

This is the largest such study in the published literature and provides clear evidence of outcomes and trends in the use of coercive powers under the Mental Health Act in Norfolk, United Kingdom.
2852 – Comparative Analysis of Diagnosing of Delirium in Elderly Inpatients of General Hospital
Authors: Merkin A. , Borisov I. , Shushkevitch A. , Cheremushkin E.
Published: July 2013

Introduction:

Confusional state is a common disorder in geriatric inpatients in general hospital. The diagnosis of this disease in the elderly is especially difficult due to imprecision of clinical. It is a hard challenge both to specialists non psychiatrists and even psychiatrists. Delirium often is misdiagnosed in 30–50% inpatients and on admission.

Aim:

To compare the rate of misdiagnosis of delirium in the elderly by a psychiatrist and general medical personnel.

Methods:

Interview of physicians and nurses of the general medicine and traumatology units to identify inpatients 65 years old and older with delirium diagnosed by the respondents. Subsequent screening of all the inpatients of 65 years old and older by a psychiatrist for delirium detecting.

Results:

The rate of delirium misdiagnosis in the traumatology unit was 28.6%. Overdiagnosis of delirium in the general medicine unit was 22.2%. Incorrect diagnoses of delirium by specialist psychiatrist was 8.7%.

Conclusions:

Satisfactory results of diagnosis of delirium provided by specialist psychiatrist are caused by combination of clinical assessment of anamnesis and present state by skilled psychiatrical survey and usage of standard psychometric scales. The results of diagnosis by specialists non-psychiatrists primarily are caused by their insufficient in-depth knowledge in delirium. It confirms high demand in comprehensible and rational diagnostic schemas for general medical staff, for providing basic psychiatry knowledge for them and more active usage of standard psychometric scales by specialists non-psychiatrists and especially nurses to improve their recognition of mental disorders.
2853 – Arachnoid Cyst and Psychosis: A Case Report
Authors: Cargaleiro I. , Oliveira-Maia A. , Duarte P. , Barahona-Corrêa B.
Published: July 2013

Introduction:

Arachnoid cysts (ACs) are intra-arachnoidal space occupying lesions, typically of a benign and congenital nature. They reportedly occur in more than 1% of the population, and are usually considered incidental when found in people with psychiatric symptoms. However, some authors argue for a putative causal relationship, based mainly on reports of improvement of a co-existing mental condition after surgical decompression of a cyst.

Objectives:

We describe a patient with schizophrenia-like psychosis and a temporal AC.

Aims:

We will argue for the possibility of an association between the AC and psychotic symptoms.

Methods:

We used a multidisciplinary approach to the patient, with emphasis given to diagnosis and treatment. We also reviewed the literature on the association between AC and psychosis.

Results:

We describe a 46-year-old woman with schizophrenia-like psychotic symptoms and visual hallucinations, refractory to antipsychotic treatment (including clozapine). Magnetic resonance imaging revealed a volumous AC with mass effect on temporal parenchyma. The patient was considered eligible for possible removal of the cyst, but refused to consult with a neurosurgeon.

Conclusions:

The meaning of ACs found in patients with psychosis remains controversial. in our case, the lesion's volume and mass effect, the involvement of a region with a central role in the pathophysiology of psychosis, and the refractoriness to clozapine treatment, all argue for a causal role in the patient's psychosis. Surgical decompression might have improved the patient's outcome. Yet, the lack of a solid evidence-base made it ethically unacceptable to advocate for this option in a reluctant patient.
2855 – Evaluating the Headucate Educational Intervention to Raise Mental Health Awareness Among School Children in the Uk
Authors: Parker S. , Robertson C. , Allen N. , Beezhold J. , Bhutto A. , Laverack R. , Parry L. , Piper L. , Smith R. , Wade T.
Published: July 2013

Introduction:

The symptoms of many mental illnesses often begin during high school. Interventions to improve mental health awareness amongst adolescents may lead to improved outcomes. in the UK unfortunately many schools do not fulfil this need and mental health education is not a compulsory part of the curriculum.

Aim:

To develop and measure the effectiveness of and educational intervention designed to raise awareness and empower adolescents to recognise signs of poor mental health and access services appropriately.

Objectives:

Evaluate the effectiveness of the intervention through baseline and follow up surveys.

Methods:

Students at Norwich Medical School collaborated with teachers, psychiatrists and general practitioners to design an educational intervention that aims to tackle stigma and raise awareness of mental health conditions among 13-14 year olds in the hope that they can access services when needed, support those around them and look after their mental health. To evaluate effectiveness of the intervention, a knowledge, attitudes and practices survey that utilises a social distance scale that has been adapted for this age group and will be used to gather baseline and follow up data after six months.

Results:

We have developed a one-hour educational intervention delivered by medical students, that uses a variety of teaching techniques to raise awareness of mental health issues. We will start implementation in January 2013 so will have baseline effectiveness results shortly after.

Conclusions:

Headucate has the potential to fill an important gap in effectively raising awareness of mental health issues in schools.
2857 – Alexithymia in Patients with Schizophrenia and in Patients with Asthma
Authors: Abdelghaffar W. , Rafrafi R. , Lakhal H. , Ouanes S. , Jomli R. , Nacef F. , Hechmi Z.
Published: July 2013

Introduction:

The pathogenesis of schizophrenia is still unclear. Genetic, biological and environmental factors are thought to intervene. It is known that schizophrenia is characterized by a difficulty to express one's feelings and identify other persons’ feelings (theory of mind) and so does alexithymia which is a psychosomatic concept.

Objectives:

To compared patients with schizophrenia with patients presenting a disease that is classically considered as a psycho-somatic disease: asthma.

Methods:

Thirty-nine patients with schizophrenia (group S) and thirty nine sex and age matched patients with asthma (group A) were assessed by the same psychiatrist using the 20 items-Toronto Alexithymia Scale validated in Arabic.

Results:

The mean alexithymia score in group A was 70, 45 versus 68,44 in group S, with no statistically significant difference.

The prevalence of moderate alexithymia (score superior to 60) was 22, 6% in group A and 37, 5% in group S, with no statistically significant difference.

The prevalence of severe alexithymia (score superior to 70) was 57% in group A and 26% in group S. Difference was statistically significant (p = 0,003).

Conclusion:

This study showed that severe alexithymia was significantly higher in patients with asthma compared to patients with schizophrenia. Nevertheless, the high prevalence of moderate alexithymia in patients with schizophrenia shows that alexithymia should be taken into account when treating a patient with schizophrenia, and a psychotherapy addressing this issue would be helpful.
2860 – Reappraisal Mediates the Link Between 5-HTTLPR and Social Anxiety Symptoms
Authors: Miu A.C. , Vulturar R. , Chis A.
Published: July 2013

Mounting evidence suggests that social anxiety symptoms are related to

(1)

polymorphisms in the serotonin transporter gene promoter region (5-HTTLPR) and

(2)

reduced use of adaptive forms of emotion regulation such as reappraisal.

It is not known, however, whether reappraisal mediates the link between 5-HTTLPR and social anxiety. Participants to this study were unselected community volunteers, all Caucasians from a circumscribed geographical area. They were genetically tested for 5-HTTLPR status, and self-report measures of social anxiety symptoms and reappraisal use were obtained. The results indicated that participants with one or two low-expressing alleles displayed increased social anxiety symptoms and reduced levels of cognitive reappraisal. Cognitive reappraisal significantly mediated the influence of 5-HTTLPR on social anxiety symptoms, and this effect was evident on two different measures of reappraisal. Therefore, this study shows that cognitive reappraisal is a major intermediate phenotype of the social anxiety spectrum. Our correlational results suggest that individuals with low-expressing 5-HTTLPR genotypes may benefit the most from cognitive-behavioral psychotherapy because they do not appear to engage as frequently as others in reappraisal.
2862 – Reason for Psychiatric Consultation in the Elderly
Authors: Ennaoui R. , Jomli R. , Ouertani A. , Zgueb Y. , Nacef F.
Published: July 2013

Introduction:

Aging is a natural and inevitable process leading organizations live to change over time after the phase of maturity. His progress is highly variable from one individual to another. So that the old population is very heterogeneous. But this heterogeneity is also and especially due to the very high frequency and diversity of chronic diseases in this population.

Objectives:

The aim of our study was to evaluate the different patterns of psychiatric consultations in the elderly.

Patients and methods:

This is a retrospective study conducted in the outpatient hospital razi, involving 90 patients aged consultant during 2011.

Results:

In total, 90 cases were recorded. The average age of patients was 77.5 years.

The sex ratio (M / F) was 1.04. The majority of consultants had an iron status of married (51.1%) and widowed (41.1%). 77.8% of patients were illiterate. 63% of patients were retired and 49% of cases were low socioeconomic level. Personal psychiatric histories were found in 12% of consultants. The two reasons for consultation were the most common symptoms of depression (sleep problems, headaches, food refusal, sad mood, psychomotor retardation, somatic complaints) and behavioral disorders with 50 and 42.2% of cases.

Conclusions:

The prevalence of psychiatric disorders is important in the elderly because half of those over age 65 suffer from a psychiatric disorder.
2871 – Capgras Syndrome and Mignon Delusion - Delusional Misidentification Syndromes
Authors: Juretić Pešćica M. , Knez R. , Pavešić Radonja A.
Published: July 2013

Introdaction:

Delusional misidentification syndromes are specific groups of psychopathological symptoms. in rare cases, can occur independently but are often part of the other psychopathology in psychiatric disorders of organic or endogenous origin. Capgras syndrome indicates that the patient misrecognizes close relative, claims to have acquaintances replaced with someone who look-alike, that someone has entered the body of their relative and therefore he/she only physically resembles. in Mignon delusion patient believes that parents were not his/hers, but that real parents are from noble origin.

Objective:

To show the course of the disease and the clinical manifestation in schizophrenic patient, who during several annual treatment developed symptoms of Capgras syndrome and Mignon delusion.

Method:

72 year old female patient was admitted to the hospital due to deterioration of mental state.On admission in mental status dominated: accelerated opinion in form and in content with plenty paranoid ideas she also said: This is not my husband. Sometimes I know that this man wears a mask, so he looks like him, but my husband is not here he is in the U.S. Insight into previous medical records,showed that in the previous hospitalization she amounted symptoms of Mignon delusion and was saying that her parents were not hers and that she is a descendant of a noble family. It is Significant that those symptoms were followed after minor head injury.

Conclusion:

Dynamics of changes in symptoms indicates the importance of further processing in order to determine whether these symptoms were result of underlying disease or may be caused by an organic lesion that is very often in the same substrate.