bluuebunny/crossref_metadata_2025 huggingface dataset:
Assessing Obsessive-compulsive Symptoms: The Portuguese Version of the Padua Inventory
Authors: Galhardo A. , Pinto-Gouveia J. , Cunha M. , Massano-Cardoso I.
Published: June 2017

Introduction

Self-report instruments are useful tools for the assessment of psychopathological symptoms such as obsessive-compulsive symptoms. The Padua Inventory (PI) is a measure that has been widely used in clinical and research settings and studied in several countries.

Objectives

This study explores the psychometric properties and factor structure of the Portuguese version of the PI.

Methods

Translation and translation-back of the original version were executed. A total of 847 participants (468 women and 379 men) from the general population was recruited through a snowball procedure and completed the PI and other mental health measures. The data set was randomly split in order to conduct principal component analysis (PCA) and confirmatory factor (CFA) analysis in two different samples. Moreover, internal consistency, convergent and discriminant validity and test-retest reliability analyses were conducted.

Results

From the PCA analysis four factors emerged, comprising clusters of items related to doubting/impaired control over mental activities, contamination/washing/cleaning, checking and worries about losing control over motor behaviors. CFA results revealed that the model presented a poor fit to the data and indicated that the model would benefit from the establishment of correlations between pairs of error terms of items with identical contents. The PI exhibited excellent internal consistency, good test-retest reliability and good convergent and discriminant validity.

Conclusions

The PI Portuguese version showed a similar factor structure to the one presented in other studies and revealed good psychometric properties. Nevertheless, results from the CFA suggest that shortening the PI may be advantageous.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
HIV/AIDS “worried well”–When the “virus” leads to a significant illness, even in its absence
Authors: Marinho M. , Covelo V. , Marques J. , Bragança M.
Published: June 2017

Introduction

Management of HIV/AIDS “worried well” people is among the most complex and challenging psychiatric problems in HIV care.

Objectives

To provide an overview of HIV/AIDS “worried well”.

Methods

Literature review based on PubMed/Medline, using the keywords “HIV” and “worried well”.

Results

The HIV/AIDS “worried well” are those individuals who are intensely worried about being infected with HIV, despite overwhelming evidence to the contrary. Indeed, they will rapidly return with the renewed conviction that the physician has “got it wrong” or “missed something”. So, they tend to over-utilize health care services. Seven HIV/AIDS “worried well” sub-groups have been identified: those with past sex or drug use history; those with relationship problems; the partners/spouse of those at risk; couples in individual or family life transitions; past history of psychological problems; misunderstanding of health education material; and pseudo and factitious AIDS. These patients have several striking consistencies in their presenting phenomenology and background features and usually have psychiatric problems associated. The authors will analyze all these aspects. Currently there are no guidelines to deal with this clinical condition, however cognitive-behavioral therapy along with selective serotonin reuptake inhibitors has been an effective approach. It is also important to ensure follow-up discussion to these patients, especially where unresolved life issues may cause future vulnerability in absence of intervention.

Conclusions

Patients may express their concerns about HIV infection by several ways, directly or indirectly, and psychiatrists need to be aware of this reality, which causes much suffering as well as severe monetary loss.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Brain-derived Neurotrophic Factor (BDNF) Levels and Delirium
Authors: Adamis D. , Williams J. , Finn K. , Melvin V. , Meagher D. , McCarthy G.
Published: June 2017

Introduction

Studies of the association between blood BDNF levels and delirium are very few and have yielded mixed results.

Objectives

To investigate the blood BDNF levels in the occurrence and recovery of delirium.

Methods

Prospective, longitudinal study. Participants were assessed twice weekly with MoCA, DRS-R98, APACHE-II. BDNF levels of the same were estimated with ELISA method. Delirium has been define as per DRS-98R (cut-off > 16) and recovery of delirium as at least two consequently assessments without delirium prior to discharge.

Results

No differences in the levels of BDNF between those with delirium and those who never developed it. Excluding those who never developed delirium (n = 140), we analysed the effects of BDNF and the other variables on delirium resolution and recovery. Of the 58 remained with delirium in the subsequently observations (max = 8) some of them continue to be delirious until discharge or death (n = 39) while others recovered (n = 19). BDNF levels and MoCA scores were significantly associated with both delirium cases who became non-delirious (resolution) during the assessments and with overall recovery. BDNF (Wald χ2 = 11.652, df: 1 P = .001), for resolution. For recovery Wald χ2 = 7.155; df: 1, P = .007. No significant association was found for the other variables (APACHE-II, history of dementia, age or gender)

Conclusions

BDNF do not have a direct effect in the occurrence of delirium but for those delirious of whom the levels are increased during the hospitalisation they are more likely to recover from delirium.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Inflammation and Neurodegeneration Findings in Early Stage Bipolar Disorder
Authors: Karabulut S. , Akcan U. , Küçükali İ.C. , Tüzün E. , Çakır S.
Published: June 2017

Introduction

There is growing evidence about neuroinflammation in the aetiopathogenesis of bipolar disorder. Early diagnosis and intervention strategies are thought to be excessively important lately.

Objectives

To check neuroinflammation levels in early stage bipolar disorder and explore the associations with clinical variables.

Aims

We aimed to evaluate inflammation and neurodegeneration findings in early stage bipolar disorder.

Methods

Serum interleukin 1-receptor antagonist (IL-1Ra), interleukin 6 (IL-6), tumor necrosis factor-alpha (TNF-α), high sensitive C reactive protein (hs-CRP), S100B and neuron specific enolase (NSE) levels were assessed by enzyme-linked immunosorbent assays in a total of 30 patients with bipolar disorder in the early stage and compared with 30 matched healthy controls. The clinical symptoms were rated using Montgomery Asberg Depression Scale, Young Mania Rating Scale, Positive and Negative Syndrome Scale and Clinical Global Impression Scale.

Results

Among the patients with bipolar disorder, 14 (% 46.6) were in a manic/hypomanic state and 12 (% 40) were in a euthymic state. Serum IL-6 levels were significantly higher (P = 0.018), TNF-α and S100B levels were significantly lower in the early stage group (P < 0.001 and P = 0.03, respectively). After repeated analysis with only drug-naive patients, the results showed no difference. There was a positive and significant correlation between TNF-α levels and CGI, MADRS scores (all P < 0.05); NSE levels and MADRS scores (P < 0.05).

Conclusions

This study supported the association of early stage bipolar disorder with inflammation and neurodegeneration. IL-6 may be a potential biomarker. Thus, early diagnosis and intervention may be crucial to prevent progressive neuroinflammation and neurodegeneration in early stages of disorder.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Predicting Secondary Mental Health Care Use in Adolescence using Self-, Parent- and Teacher-reported Problem Behavior in a Community-based Record-linkage Study
Authors: Raven D. , Jörg F. , Visser E. , Schoevers R.A. , Oldehinkel A.J.
Published: June 2017

Introduction

In adolescence, help-seeking is affected by different actors. The influence of each actor on help-seeking is often studied in isolation, or, if multiple informants are included, using only few assessments of adolescents’ mental health.

Objectives

The aim of this study is to determine the extent to which self-, parent- and teacher-reported problem behavior predict secondary care in adolescence and to what extent the informants’ relative importance changes over time.

Methods

Data from the Dutch community-based cohort study tracking adolescents’ individual lives survey (TRAILS) were linked to administrative records of secondary care from 2000 (age 9) to 2011 (age 21). Internalizing and externalizing problems were assessed using the youth self-report, child behavior checklist and teacher checklist of psychopathology at ages 11, 13 and 16, and the adult self-report at age 19.

Results

The annual incidence of secondary care fluctuated between 1.3% and 2.4%. In Cox regression analyses that adjusted for sociodemographic covariates and problem behavior, internalizing problems but not externalizing problems predicted secondary care. Secondary care between the ages 11 to 13 years was predicted best by teachers, between the ages 13 to 16 by parents, and between the ages 16 to 21 by adolescents.

Conclusions

The relative importance of informants for predicting secondary care shifts over time, which suggests that each informant is the driving force behind secondary care at a different phase of adolescence. The treatment gap may be reduced by improving problem recognition of teachers in secondary education and by educating young adults about mental health problems.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Basic Symptoms in the Community and their Association with Age
Authors: Schultze-Lutter F. , Michel C. , Schimmelmann B.G. , Ruhrmann S. , Kindler J. , Schmidt S.J.
Published: June 2017

Introduction

Limited clinical relevance of attenuated psychotic symptoms before the turn from early to late adolescence, i.e., age 15/16, was reported.

Objective

This emphasizes the potentially important role of neurodevelopmental aspects in the early detection of psychoses.

Aims

We examined the age effect on prevalence and clinical relevance of 14 cognitive and perceptive basic symptoms (BS) included in risk criteria of psychosis in a random representative 8–40-year-old community sample (n = 689).

Methods

Participants underwent clinical interviews for BS, psychosocial functioning and current mental disorder on the telephone.

Results

BS were reported by 18% of participants, mainly cognitive BS (15%). Age seemed to affect perceptive and cognitive BS differently, indicating an age threshold for perceptive BS in late adolescence (around age 18) and for cognitive BS in young adulthood (early twenties) – with higher prevalence, but a lesser association with functional deficits and the presence of mental disorder in the below-threshold groups. Thereby, effects of the interaction between age and BS on functioning and mental disorder were commonly stronger than individual effects of age and BS.

Conclusion

Differential age effects of perceptual and cognitive BS seem to follow normal brain maturation processes, in which they might occur as infrequent and temporary nonpathological disturbances. Their persistence or occurrence after the conclusion of main brain maturation processes, however, might signify aberrant maturation processes. Thus, BS might provide important insight into the pathogenesis of psychosis and into potential neuroprotective targets.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Interaction Between Previous Attempts and Diagnosed Psychiatric Disorder as a Risk Marker of Repeated Suicide Attempts among Adolescents: Results from a Prospective Hospital-based Study
Authors: Martinez-Ales G. , Jimenez E. , Roman E. , Sánchez P. , Louzao I. , Cano A. , Orosa A. , Rubio I. , Fraga A. , De Diego A. , Coll M. , Nocete L. , Baena V. , Gallego R. , Rodríguez B. , Bravo M.F.
Published: June 2017

Suicide is the second most frequent cause of death among the youth and its rates among adolescents have recently risen. Up to 30% of adolescents who attempt suicide will try it again within a year. Our objective is to analyze how previous attempts and diagnosed psychiatric disorder behave as markers of risk of reattempts and their statistical interaction. We include every underage patient treated by an emergency room psychiatrist after a suicide attempt in a General Hospital between years 2010 and 2015. Patients free of relapse after 1000 days are censored. We obtain Kaplan–Meier estimates for the risk of a new attempt as a time-dependant variable, dividing them by the presence of previous suicide attempts, diagnosed psychiatric disorder or both at a time, checking the differences by using log-rank tests. Then, we perform Cox proportional risk models including both variables and a factor of their interaction and adjust them by sex and age in a non-automatically driven multivariate analysis, thus obtaining HR estimates. We present 150 cases (118 female; mean[SD] age in years: 15.8 [1.6]). Overall, 22.6% of them relapse during follow-up time. Multivariate models show interaction of previous attempts and diagnosed psychiatric disorder is associated with relapse with an HR of 1.27 × 108 (95% CI: 5.51 × 107 – 2.9 × 108). Interaction of both factors is an outstanding risk marker of relapse after an attempted suicide and should thus be given clinical importance in tertiary prevention.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Personality and Spirituality as Predictors of Suicidality in Depressed Patients
Authors: Mihaljevic S. , Aukst-Margetic B. , Karnicnik S. , Vuksan-Cusa B.
Published: June 2017

Introduction

Some studies show that more expressed spirituality and some dimensions of personality have protective role from suicidality.

Aim

The aim of our study is to examine the influence of the spiritual quality of life (QoL) and dimensions of personality on course of suicidality in patients with depression.

Methods

Ninety-nine patients were assessed with self-report measures of suicidality (BHS), personality (TCI), spirituality (WHOQOL-SRPB) during a yearlong follow-up.

Results

Spirituality was inversely linked with suicidality at baseline and during follow-up and more expressed spirituality influenced faster recovery from suicidality. Dimensions of temperament harm avoidance and self-directedeness show as significant predictors of recovery from suicidality.

Conclusion

In our sample, spirituality, harm avoidance and self directedeness are significant predictors of recovery from suicidality. This finding is stimulus for further researching of protective factors from suicidality.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Psychoeducational Family Intervention: Benefits and Obstacles Reported by Mental Health Professionals
Authors: Pocai B. , Savorani M. , Borriello G. , Del Vecchio V. , Sampogna G. , De Rosa C. , Malangone C. , Luciano M. , Giallonardo V. , Fiorillo A.
Published: June 2017

Introduction

Despite several guidelines recommend the use of psychoeducational family interventions (PFIs) as add-on in the treatment of patients with bipolar I disorder (a), their implementation on a large scale remains limited (b).

Objectives

To identify benefits and obstacles in implementing a PFI in the clinical routine care.

Methods

This was a multicentre, real-world, controlled, outpatient trial, carried out in 11 randomly recruited Italian mental health centres. Mental health professionals received a training on PFI and provided the intervention to patients with bipolar I disorder and their relatives. Difficulties and benefits in performing PFI were collected through an ad-hoc schedule, which was administered at baseline and 5 times during the different stages of the intervention.

Results

Mental health professionals report significant improvements in the intervention-related benefits over time (T0 = 5.3 ± 2.0 vs. T5 = 7.9 ± 0.9; P < .0001), in particular in their professional skills (T0 = 6.5 ± 2.3 vs. T5 = 8.0 ± 0.8; P < .01). They also report to be more satisfied with their own work (T0 = 6.6 ± 2.3 vs. T5 = 8.0 ± 1.3; P < .05). The most relevant difficulties were related to the need to integrate the PFI with other work responsibilities and to the lack of time, which did not decrease overtime.

Conclusions

PFIs are feasible in routine care for the treatment of patients with bipolar I disorder and their relatives, and main obstacles are related to the organization of mental health centres, and not to the characteristics of the intervention itself.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Efficacy and Safety of Clozapine in Patients with Intellectual Disability
Authors: Ifteni P. , Teodorescu A.
Published: June 2017

Introduction

Aggression is common and a major behavioral problem in patients with intellectual disability (ID). Antipsychotics are frequently used for psychosis or challenging behavior. There is little literature regarding utilization of clozapine in patients with ID for aggressive behavior.

Aims and objectives

The aims of the study were the evaluation of efficacy and safety of clozapine in treatment of aggression in patients with ID.

Methods

A longitudinal naturalistic study including a cohort of 225 consecutive patients with intellectual disability admitted to an acute psychiatric unit between 1 January 2014 and 31 December 2015. Severity of symptoms was assessed at admission with Modified Overt Aggression Scale (MOAS) and Global Assessment of Functioning Scale (GAFS). The data included: demographics, main psychiatric diagnosis, IQ, alcohol/smoking, institutionalization, antipsychotics and another psychotropics, restraint, readiness to discharge (RDQ), side-effects and length of stay.

Results

Of 225 potentially eligible individuals, 205 (92.7%) were treated with antypschotics and 110 male (53.56%) with mean age 32.37 (SD = 9.9). Thirty-seven patients (18%), 18 male (48.65%) were treated with clozapine, mean dose 309.45 mg/day (range 100–450 mg/day). Clozapine reduced need for restraint and duration of hospitalization compared with haloperidol (P < 0.05).

Conclusions

Clozapine was efficient and safety for treating persistent aggression in patients with intellectual disability. There were no seizures, myocarditis or agranulocytosis during study. Larger and randomized trials are needed to fully explore the anti-aggressive benefit of clozapine.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
L-dopa Modulates Striatal Functional Connectivity in Adults with Psychotic-like Experiences: A Randomized Double-blind Placebo-controlled Study
Authors: Rössler J. , Unterrassner L. , Wyss T. , Haker H. , Brugger P. , Rössler W. , Wotruba D.
Published: June 2017

Introduction

According to the dopamine hypothesis functional brain abnormalities and neurochemical alterations may converge to cause psychosis through aberrant salience attribution. Indeed, resting-state functional magnetic resonance imaging (rs-fMRI) has revealed widespread brain disconnectivity across the psychotic spectrum.

Objectives

To advance the understanding of the dopaminergic involvement in intrinsic functional connectivity (iFC) and its putative relationship to the development of psychotic disorders we aimed to investigate the link between L-Dopa, a dopamine precursor, and its modulation of striatal iFC in subthreshold psychosis, i.e. non-clinical psychosis.

Methods

We used a randomized, double-blind placebo controlled study design including in our sample 56 healthy, male, right-handed, subjects with no familiar risk factors for psychosis who were assessed with the Schizotypal Personality Questionnaire (SPQ) and underwent 10 minutes of rs-fMRI scanning. All subjects received either 250 mg of Madopar DR®(200 mg L-Dopa plus 50 mg benserazid, dual release form) or a placebo. We analysed resting-state iFC of 6 striatal seeds, known to evoke dopamine related networks.

Results

The main effect of L-Dopa presented itself (FWE-corrected) as a significant decrease in iFC from the right ventral striatum to the cerebellum and the precuneus cortex, and an increase in iFC to the occipital cortex. Subjects with high SPQ positive symptom sub-scores showed a significant increase of L-Dopa induced connectivity.

Conclusion

We identified striatal functional connectivity being modulated by augmented dopamine availability, and in support of the dopamine hypothesis, we found that those iFC patterns are associated to high scores of psychotic like experiences.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Epigenetics in the Remission of Anorexia Nervosa: A Follow-up Study of Whole-genome Methylation Profiles
Authors: Ramoz N. , Guillaume S. , Courtet P. , Gorwood P.
Published: June 2017

Introduction

Anorexia nervosa (AN) is a severe psychiatric disorder. The epigenetic regulations are strongly suggested in AN. We and other groups have performed a whole-genome methylation study (methylome) in AN. We found that the differentially methylated CpG sites are located around genes involved in biological processes in link with embryonic morphogenesis, brain development and its plasticity, in particular adhesion and axon guidance. Here, we study an independent group of 40 AN patients. Furthermore, we have done a follow-up during more than one year, to compare the methylation profiles in subjects that evolve to the remission.

Objectives

Our work is to replicate the methylome study in an independent AN cohort and to characterize profiles of methylation at two times for the same subjects to compare the AN patients that convert to remitters.

Aims

Our goal is to identify diagnostic and prognostic epigenetic signatures for AN.

Methods

Of the 40 AN patients, 18 evolved to remission. Furthermore, the blood samples of the subjects from the 2 times will be investigated, like this, each subject is its own control. Methylation of DNA is measured by using the Infinium HumanMethylation450 BeadChip technology.

Results

Comparisons of AN to controls showed similar profiles of methylation involving the same biological processes as previously identified. We are comparing now the difference of methylation between the 18 remitters and the 18 actual AN, taking into account of the two times of samples.

Conclusions

We expect to characterize specific methylation signature of the prognostic of the AN remission.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Relationship between personality traits with language anxiety among bilinguals
Authors: Bialayesh S. , Homayouni A. , Nasiri Kenari M. , Shafian Z.
Published: June 2017

Language anxiety is a distinct complex of self-perception, beliefs, feelings, and behaviors related to classroom language learning arising from the uniqueness of the language learning process. Effects of foreign language anxiety are particularly evident in the foreign language classroom, and this anxiety is a strong indicator of academic performance. So, the study aimed to investigate relationships between personality traits with language anxiety among bilinguals. The research method was correlation. The population was included all upper intermediate language learners and higher levels in language institutes, that 250 learners were selected by cluster sampling method, and responded to McCare & Costa's NEO personality traits (neuroticism, openness to new experience, extroversion, agreeableness, and conscientiousness) and Horwitz's language anxiety inventory. The data were analysed by Pearson correlation formula. The results showed that there is positive and significant relationship between neuroticism and openness to new experience with language anxiety, and positive and significant relationship between extroversion, agreeableness, and conscientiousness with language anxiety. Thus, it can be concluded that personality traits have important impact on language anxiety.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Related factors of anxiety in elderly assisted in nursing consultation
Authors: Carvalho C.M. , Cardoso Vernaglia T.V. , Correa Soria D. de Assis , da Silva T.D.J. Espirito Santo , de Souza S.R. , Mello R. , Ribeiro Bitencourt G. , Gripp M. , Guimaraes M. , Goncalves A. , Felippe I.
Published: June 2017

Anxiety in elderly can be diagnosed based on a detailed history and cognitive examination using various instruments. These instruments aim to obtain information that supports both the syndromic and etiological diagnosis and the planning and execution of therapeutic and rehabilitation measures to be used in each case. During the nursing consultation with elderly people in the Federal University of State of Rio de Janeiro (UNIRIO), many patients with cognitive impairment showed anxious behavior. The study objectives to describe the factors related to the nursing diagnose anxiety in elderly patients attended in the nursing consultation. The consultations are based in the application of the nursing process. After the symptoms analysis, the nursing diagnosis anxiety is complemented with the related factors. The principals are death threat (64%), stressors (19%) and not needs met (17%). The data found are associated with cognitive impairment. Cognitive impairment in the elderly can lead to anxiety, depression and hopelessness, according to many studies.

Conclusions

Working the cognitive needs, and reducing stressors are appropriate strategies to reduce the anxiety. The care with the health professionals is important to notice the related factors early and improve the strategies.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
The effectiveness of mindfulness-based stress reduction (MBSR) in anxiety and depression in patients with multiple sclerosis (MS)
Authors: Alisaleh E. , Ghahari S.
Published: June 2017

Objective

The main objective of the present study is to investigate effectiveness of mindfulness-based stress reduction in anxiety and depression in patients with multiple sclerosis.

Methods

This study is in kind of semi-experimental research in form of pretest–posttest pattern with control group. Statistical population of the study consists of all patients with multiple sclerosis referred to Iran MS Association by 2016. Sampling method in this study is available sampling and based on having inclusion criteria. Among depressed and anxiety patients 30 individuals were selected randomly and were classified in two groups with 15 people in each group. Experimental group was under mindfulness-based training on stress reduction for 8 sessions. Control group was also in waiting list. All patients in experimental and control groups fulfilled depression and anxiety inventories before and after intervention. Obtained data was analyzed using MANCOVA and in SPSS22 software.

Finding

Obtained results show that there is significant difference between the two groups in terms of anxiety and depression after intervention (P < 0.001).

Conclusion

Mindfulness-based stress reduction can help reduction of symptoms of anxiety and depression in patients with MS.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Conversion disorder: Unexplained symptoms of silenced emotions?
Authors: Martins C.P. , Carvalho S. , Silva F. , Almeida H.S.
Published: June 2017

Introduction

Conversion disorder is a condition defined by the presence of symptoms of altered voluntary motor or sensory function, not intentionally produced or feigned, presumed to be the expression of a psychological conflict or stressor, but mimicking neurological diseases or other medical conditions, that must be excluded before this diagnosis is made. The suspicion of conversion disorder arises when clinical findings are incompatible with the suggested neurological or medical conditions and there is a temporal relation between the onset of the symptoms and a psychological stressor. However, when these hints are absent, diagnosis may not be clear and require wider workup.

Objectives/aims

To make a brief review on conversion disorder and present an illustrative clinical-vignette.

Methods

We collected information from medical records and interview with the patient and made a research on PubMed with the MeSH terms “conversion disorder”.

Results

We present a 51-years-old female outpatient with episodes of paralysis of left upper and lower limbs. Some months before the onset of these symptoms, her daughter came to live with her. Their relationship became very conflictual. Electroencephalogram, laboratory and imaging studies were normal. She did not tolerate the antidepressants tried (SSRI, SNRI and trazodone), but reported to feel better with amisulpride and alprazolam.

Conclusions

Widely discussed in the past as “hysteria”, conversion disorder is still intriguing, because little is known about the link between body and mind, making the management of patients with this disorder challenging and highlighting the need for more studies on the topic.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Is there a difference in prevalence of anxiety and depression symptoms among patients with different stages of hypertension?
Authors: Mermerelis A. , Kyvelou S.M. , Akke V. , Papageorgiou C. , Stefanadis C. , Douzenis A.
Published: June 2017

Introduction

Whether anxiety and depression are associated with hypertension and to what extent is not clear.

Aims

The aim of the present study was to assess any differences in the prevalence of anxiety and depression among different groups of hypertensive patients.

Methods

The study cohort comprised of 127 patients (75 male, mean age 54 ± 14) who underwent assessment of their blood pressure levels and were divided in four groups: group I (normotensives, n = 34), group II (stage 1 HTN, n = 33), group III (stage 2 HTN, n = 30) and group IV (stage 3 HTN, n = 30). The evaluation of anxiety disorder was made by means of Hospital Anxiety Depression Scale (HADS), while the evaluation of depression was made with the Beck Depression Inventory (BDI). Statistical analysis was done with SPSS for windows. P-value was set at 0.05 for differences to be considered significant.

Results

Comparing the four groups of patients there was a significant difference both in BDI (8.6 ± 7.0 vs. 11.6 ± 10.4 vs. 27.1 ± 5.8 vs. 32.4 ± 3.9, P < 0.0001) and HADS (10.2 ± 7.2 vs. 9.7 ± 7.0 vs. 16 ± 4.7 vs. 27 ± 5.1, P < 0.0001). We proceeded to comparison among the 4 groups and there was a significant rise in the BDI and HADS in three of the four groups group II > group III > group IV, P < 0.0001.

Conclusion

These data suggest that there is a clear burden of anxiety and depression as the levels of BP increase. This finding is of important clinical significance as it could contribute to a different approach of hypertensive patients. A larger cohort study could enlightened the mechanisms involved.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
The risk of hypertension in general population with anxiety traits in Russia/Siberia: Gender disparities. WHO survey MONICA-psychosocial
Authors: Gafarov V. , Gromova E. , Panov D. , Gagulin I. , Gafarova A.
Published: June 2017

Objective

To determine gender differences in prevalence of anxiety traits in general population and to evaluate its impact on the risk of hypertension in men and women aged 25–64 years in the open population in Russia/Siberia.

Methods

Under the third screening of WHO program “MONICA-psychosocial” a random representative sample of the population aged 25–64 were surveyed in Novosibirsk in 1994 (n = 657 men, n = 870 women). Anxiety levels were measured by means Spielberger test. Over the 16-year period were identified 229 cases of AH in women and 46 for men. Cox-proportional regression model was used for an estimation of hazard ratio (HR).

Results

In general population aged 25–64 years at 99.5% of women and 97.5% of men had moderate and high levels of anxiety traits. In univariate Cox regression analysis model the risk incidence of arterial hypertension in women and men with high level of anxiety was 2.383-fold and 5.18-fold higher, respectively, over 5 years of follow-up. It was 1.853-fold and 5.75-fold higher over 10 years and 1.45 and 3.82 times higher over 16 years after baseline. In the multivariate Cox regression model HR of hypertension was 1648 in women with high level of anxiety; and it was 4.568-fold higher in men.

Conclusion

Despite the higher prevalence of HLA in women, the risk of developing hypertension is much higher in males.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Mental health literacy in bipolar disorder: A cross-sectional survey in Saudi Arabia
Authors: Alosaimi F. , Alateeq D. , AlHenaki R. , Bin Hussain S. , Bin Salamah A. , Al-Muhanna A. , AlAngari M.
Published: June 2017

Introduction

Stigmatization of individuals with mental illnesses is widespread and serves as a major barrier to treatment. Specific alterations in mental health literacy about a disorder and its perceived treatability can change this social attitude. Assessing awareness of bipolar disorder is important as the WHO ranked bipolar disorder as the sixth cause of disability.

Objectives

To assess mental health literacy (knowledge, attitudes and beliefs) in bipolar disorder among Saudi population.

Methods

Cross sectional study is currently conducted. We are using valid reliable questionnaire assessing the level of awareness, knowledge, attitude and behavior toward bipolar disorder. It is distributed to adult Saudi citizen (> 17 years of age) in malls, university and hospitals in Riyadh. People who are known to have psychiatric disorder and their caregivers or who works as psychiatrists and psychologists are excluded.

Results

There are 200 samples collected, and 14 were excluded according to exclusion criteria. Fifty-two percent of our preliminary sample has heard about bipolar disorder, and more than half of them believe that neurotransmitter disturbances, substance use and psychological trauma are more likely to be causes of bipolar. In contrast, 49% of the sample did not choose psychiatric medication as effective treatment for bipolar, whereas more than half of them chose praying.

Conclusions

It is a first-of-its-kind research study in Saudi Arabia determining the current mental health literacy of bipolar disorder in Saudi Arabia. We are aiming to increase the sample size to reach 1000 participants. Further study will be needed to investigate possible interventions to improve such problem.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Determination of p11 multifunctional protein in human body fluids by enzyme-linked immunosorbent assay
Authors: Jiang H. , Quan R. , Yuan Y.
Published: June 2017

Objectives

The diagnosis of major depressive disorder (MDD) is symptom based due to the lack of biological biomarker. p11 protein was recently found to be an important factor mediating depression-like states and antidepressant responses. The aim of the study was to assess whether p11 protein in urine can serve as a potential biomarker for major depression, and the relationship of its levels among urine, serum and cerebrospinal fluid (CSF).

Methods

We obtained urine samples from 13 drug-free MDD patients and 13 age- and gender-matched healthy controls. We also collected urine, serum and cerebrospinal fluid samples from 13 of fracture patients or cesarean section patients in the spinal anesthesia. The concentrations of p11 protein were measured using ELISA.

Results

In MDD patients, urine levels of p11 protein were all less than the minimum detectable concentration of the ELISA kit. The urine levels of p11 were detectable only in one healthy control. In the spinal anesthesia patients, we can detect p11 concentrations in both serum and urine in only two patients. Besides, levels of p11 were detectable in the serum of one patient and urine of another patient. We were unable to measure CSF levels of p11 in all patients.

Conclusions

Concentrations of p11 protein in the body fluids are very low and unstable. The sensitivity of the current p11 ELISA kit is currently unsatisfactory, requiring the development of an ELISA kit of higher sensitivity to determine whether p11 in body fluids can serve as biomarker for depression.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Social cognition and bipolar disorder: A preliminary study
Authors: Ponte F.D.R. , Cardoso T.D.A. , Lima F.M. , Kunz M. , Rosa A.R.
Published: June 2017

Aim

To assess the clinical outcomes associated with social cognition impairment in euthymic patients with bipolar disorder.

Method

It was a cross-sectional study with convenience sample. The diagnose of bipolar disorder was performed by psychiatrist, using DSM-IV criteria, at bipolar disorder program – Hospital de Clinicas de Porto Alegre (Brazil), where the sample was recruited. The social cognition was assessed by psychologists using the Reading the Mind in the Eyes Test.

Results

We included 46 euthymic BD patients: BD I (n = 39), women (n = 32), age (49.11 ± 13.17), and years of education (10.56 ± 3.80). Patients with social cognition impairment were not different of patients without social cognition impairment regarding socio demographic factors (gender, age, educational level, marital status, and employment status). Patients with social cognitive impairment showed higher rates of BD I patients (P = 0.036) and higher proportion of hospitalization in the first episode (P = 0.033), as compared to patients without social cognition impairment.

Conclusion

This is a preliminary study demonstrating that BD patients with social cognition impairment show worse clinical outcomes. Severe BD onset seems to be an important predictor of social cognition impairment. However, more studies are needed investigating social cognition impairment in subjects with bipolar disorder.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Clinical case: Gynecological side effects caused by methylphenidate
Authors: Ballesteros A. , Rosero Á.S. , Inchausti F. , Manrique E. , Sáiz H. , Carrión C.
Published: June 2017

Introduction

Methylphenidate drugs is prescribed in attention deficit disorder and hyperactivity. Among its rare side effects, include alterations in the gynecological. We report a clinical case and review current evidence regarding the tolerability this drug in this area.

Methods

We performed a PubMed search of articles published in English of different types (case reports or case/controls studies). We collected the clinical practice guidelines conclusions regarding adverse drug reactions.

Case presentation

Our patient is a 14-year-old male diagnosed of ADHD treated with methylphenidate (0.8–1 mg\kg). He developed bilateral and asymmetric gynecomastia under this treatment plan so a referral was made to rule out other causes of this event. After performing several work up tests, it was concluded that this clinical presentation was caused by methylphenidate. Hence, we initiated crossed titration swapping this drug to atomoxetine. Four months later, he was mentally stable and he experimented a volumetric decrease as concerns his gynecomastia.

As regards methylphenidate, in 2009 a couple of cases in which alterations in the sexual sphere presented with the oros presentation were reported. There are series of reported pharmacological side effects (gynecomastia) and also denoted an improvement of the same months after drug discontinuation.

Conclusions

Gynecological clinic secondary to the use of psychotropic drugs in ADHD is uncommon. In line with our case, the current evidence suggests a drug suspension as adverse effects are usually reversible (although it may take several months to complete recovery). Further studies are needed to understand the mechanisms underlying these tolerability issues.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Lifestyle factors and internet addiction among school children
Authors: Bener A.
Published: June 2017

Aim

The aim was to determine the association between internet addition [IA] and fatigue, sleep disturbance, depression, and life style factors among school children.

Subjects and methods

A cross-sectional survey based on multistage stratified random sampling and 1188 students (73.3%) gave consent during October 2011 to December 2012. Data including socio-demographic details, lifestyle and dietary habits Internet Addiction Test (IAT), Fatigue Scale, Epworth Sleepiness Scale [ESS] and Beck Depression Inventory (BDI) test. Univariate and multiple logistic regression analysis were performed.

Results

The overall prevalence of IA among school children was 19.8%. The proportion of IA was significantly more among males (56.4%) as compare to females (43.6%; P = 0.035), school performance (P < 0.001) and family income (P = 0.032). Those with IA had significantly less number of sleep hours (6.16 ± 0.80 vs. 6.58 ± 1.29; P < 0.001) as compared to normal. Those with IA had significantly high number of hours internet use (3.82 ± 1.64 vs. 3.03 ± 1.64; P < 0.001) as compared to normal. A significantly larger proportion of IA than normal subjects reported having headaches (P = 0.010), double vision (P = 0.037), eye hurt (P = 0.021), eye tired (P = 0.005), dizziness (34.4% vs. 27.3%; P = 0.002), fatigue, and hearing problem (P = 0.048). A significantly larger proportion of students with IA most frequently gratifying site (19.9% vs. 11.6%; P < 0.001), browsed games (38.6% vs. 29.9%; P = 0.010), chat sites (29.7% vs. 22%; P = 0.013), email (54.2% vs. 63.1%; P = 0.36), and research (61.0% vs. 69.2%; P = 0.017).

Conclusion

The current study confirmed the of evidence linking problematic internet use with negative fatigue, greater numbers of symptoms, anxiety, sleeping disturbances, depressive and lifestyle risk factors, among vulnerable young children.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Association of adolescent symptoms of depression and anxiety with daily smoking and nicotine dependence in a sample of Tunisian teenagers
Authors: Ghanmi L. , Elleuch S. , Daoud M. , Zitoun K. , Zouari L. , Maalej M.
Published: June 2017

Aims

To examine the association of adolescent depression and anxiety symptoms with daily smoking and nicotine dependence in Tunisians teenagers.

Design

A cross-sectional study including teenagers (n = 162) from two colleges located in Gabes (south of Tunisia) and used a self-administered anonymous questionnaire. Adolescent depression and anxiety symptoms were assessed using the Hospital Anxiety and Depression scale translated and validated in Tunisia. adolescent tobacco use was defined as: daily use (6 or 7 days per week) and the loss of autonomy over tobacco use was evaluated with the Hooked on Nicotine Checklist (HONC).

Findings

The prevalence of smoking was 61.7%. It was 92% for boys and 8% for girls. In our sample, 30.7% of teenagers used manufactured cigarettes and chicha; 93.8% of daily smokers had already lost control of their smoking. Their average score the HONC was 5.5 (gap deviation 2.4). Of these, 61.3% had a score greater than or equal to 5. Rates of anxiety and depression were respectively 43% and 20%. Nicotine-dependent adolescents were significantly more anxious than non-dependent: 68.3% vs. 48.7% (P = 0.04). We do not note significant differences between depressed teenagers and adolescents without depression, regarding nicotine dependence.

Conclusions

Smoking is frequent among teenagers in Gabes. Adolescent smokers with anxiety symptoms are at increased risk for nicotine dependence. These results incite to pursue work that takes account of the specific diagnosis and treatment of tobacco dependence among adolescents, especially when psychiatric comorbidity makes smoking cessation more difficult.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Efficacy of romantic and sexual psycho-educational training for adolescent with high-functioning autism spectrum disorder: A pilot study
Authors: Giovagnoli G. , Mossolani G. , Napoli E. , Pontillo M. , Vicari S. , Mazzone L.
Published: June 2017

Introduction

Romantic and sexual functioning in individuals with autism spectrum disorder (ASD) are understudied. Recent findings evidenced that adolescents and adults with present romantic and sexual behaviors comparable with their neurotypical peers. However, it is worth to note that dysfunctional and inappropriate romantic and sexual behaviors are often described in this population.

Objectives

To investigate efficacy of a psycho-educational training in a small group of adolescent with high-functioning ASD (HFA, QI > 70).

Methods

Six adolescents (all males, range age 14–16 years) have been evaluated before (T0) and after (T1) a 10-session sexual and romantic psycho-educational structured group training, of 90′ each session. Clinical evaluation included parent-report questionnaires, as SBS for sexual behaviors and CBCL for behavioral problems, and a self-report questionnaire for sexual behaviors, called SESAMO. Moreover, autistic symptoms were investigated with ADOS-2 at T0.

Results

Preliminary analysis revealed a statistically significant differences between T0 and T1 in sexual education (P = 0.02) and frequency of dysfunctional sexual behaviors (P = 0.02) of SBS and in sexual expectations about the partner in SESAMO (P = 0.04). No differences were found in CBCL.

Conclusion

Preliminary results showed an improvement of romantic and sexual functioning in adolescent boys with HFA, as reported by either parents and adolescents, after participating to a structured psycho-educational training. More sexual education and information, less inappropriate sexual behaviors and more-appropriate expectations about potential partner were reported at the end of the training. These results should be confirmed in studies including larger ASD and control sample.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
The neurocognitive development of premature infants at 5 months corrected age
Authors: Kiselev S. , Lvova O. , Suleimanova E.
Published: June 2017

It is known that prematurity is a risk for neurodevelopmental disorders, particularly for ADHD and autism. However, the impact of prematurity on neurocognitive functions in the early stages of development is not investigated thoroughly.

The aim of research was to reveal the differences in neurocognitive development in premature infants and full-term infants at 5 months age.

The participants were 26 premature infants and 26 gender matched healthy full-term infants. The gestational age of preterm infants was between 29 and 35 weeks.

The Bayley Scales of Infant Development were used to evaluate the neurocognitive abilities in infants.

The one-way ANOVA has revealed that premature infants performed significantly (P ≤ 0.05) more poorly than the full-term infants on cognitive scale, receptive language and gross motor. No significant differences were found between preterm and full-term infants on expressive language and fine motor.

Two-way ANOVA has revealed no significant (P ≤ 0.05) differences between female premature infants and full-term female infants on gross motor in comparison to male infants.

It was proposed that the prematurity has specific (not global) negative effect on neurocognitive development at 5 months age with gender effect on development of gross motor.

Disclosure of interest

The authors have not supplied their declaration of competing interest.