bluuebunny/crossref_metadata_2025 huggingface dataset:
Psychological responses to traumas of children younger than 6 years old diagnosed with posttraumatic stress disorder
Authors: Stankovic M. , Grbesa G. , Simonovic M. , Kostic J. , Ilic N.
Published: May 2016

Introduction

Criterion A2 causes many controversies in the diagnostic process of posttraumatic stress disorder (PTSD) among young children. Depending on the manner in which the trauma is indirectly experienced, clinical picture of disorder could be formed by different groups of symptoms. Profiles of symptoms groups are dependent of children ability to speak, describe or of play observation by expert.

Methods

The study included 8 children younger than 6 with PTSD diagnosis. Children were observed in a routine clinical practice.

Results

Examinees under the age of six, whose can describe traumatic event, produce symptoms that represent compaction of a traumatic event, associated with fantasies and meanings related to previous traumatic experiences. Reexperiencing symptoms associated with A2 criterion (intrusive thoughts, images, scenes of the traumatic event, recurring nightmares with oneiric sequences of the accident) were rare. Avoidance and inhibited reactions were attributable.

Discussion

Manners in which children younger than 6 experienced the trauma shows a large range from florid symptoms stated by the existing accepted classification. The results point out possible multifactorial cause of PTSD etiology.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Temperament and resilience of children of alcohol dependent individuals
Authors: Thanikachalam C. , Dhandapani A. , Choudhury S. , Sankaran A. , Subramaniam E.
Published: May 2016

Introduction

Children of alcohol dependent individuals are affected by disturbed parent-child relationship and exhibit externalizing symptoms, arrhythmicity, negative mood and low persistence.

Objectives

To assess the temperament and resilience of children of alcohol dependent individuals and to study their relationship with the father's severity and problems of alcohol intake.

Aims

To assess the psychological profile of children of alcohol dependent individuals.

Methods

Cross-sectional study conducted in a tertiary care centre from January to August 2015. Severity of alcohol dependence in father and problems related to it was assessed using ‘short alcohol dependence data’ and ‘alcohol problems questionnaire’; the temperament and resilience of their children (n = 31) was assessed using ‘temperament measurement schedule’ and ‘strengths and difficulties questionnaire’ respectively.

Results

The sample comprised of 48% boys and 52% girls with mean age (SD) of 9.32 (3.02) years. Eighty-one percent belonged to lower socioeconomic status. Their fathers’ mean age (SD) was 37.13(4.9) years and duration of alcohol dependence being 16.32 (5.7) years, average use/day being 19.19 (14.9) units with moderate (45.2%) to high (41.9%) dependence. Significant association was observed between severity of alcohol dependence and temperamental domain-threshold of responsiveness (χ2 = 17.272, P value = 0.002) (Fig. 1). The average units of alcohol consumed/day were a significant predictor for the presence of emotional problems in the child (OR = 30.12; 95%CI 1.33–677.86).

Conclusion

There's a significant association between father's alcohol use and child's psychopathology which indicates the need for preventive and curative mental health measures.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Understanding of self-harm behaviour in adolescents
Authors: Santric L. , Razic Pavicic A. , Vuk A. , Tomac A.
Published: May 2016

Introduction

The incidence and prevalence of self-harm behaviour, with or without suicidal intent, is on the rise, both in other countries as well as in Croatia. Understanding the nature of patients who show self-harm behaviour can help us to better understand the components that contribute to their morbidity and mortality.

Objectives

To expand the understanding of self-harm behaviour in adolescents as a contribution to the planning and implementation of preventive and curative programs.

Aims

To explore the psychopathological characteristics of adolescents with and without self-harm behaviour who seek psychiatric help for their mental health problems.

Methods

In this study participated 150 adolescents, aged 14–18 years, of which 52% showed some form of self-harm behaviour. During the initial examination of child and adolescent psychiatrist, participants completed self-reported questionnaires: functional assessment of self-mutilation (FASM, 1997) and the youth self report (YSR, 2001).

Results

Statistically significant difference between groups of female adolescents with and without self-harm behaviour was observed in all of eight problem scales, while in male adolescents it was observed in five of them. This indicates considerably higher level of psychopathological features in the group of patients with self-harm behaviour.

Conclusions

It is necessary to intensify monitoring of adolescents who show self-harm behaviour because of the overall level of psychopathological symptoms and the comorbidity which significantly complicates the therapeutic process. It is particularly important to continuously assess the suicide risk.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Evolution of diagnostic frequency in schizophrenia spectrum disorders in Acute Psychiatric Unit in Barcelona
Authors: Grifell M. , Galindo L. , Campillo M. , Gonzalez L. , Palomo A. , Diez-aja C. , Grau A. , San-Emeterio L. , Ibarra M. , Sanchez R. , Martín L.M. , García L. , Orejas O. , Salvador T. , Manteca H. , Pérez V.
Published: May 2016

Introduction

Several studies have suggested variations in the prevalence of schizophrenia spectrum disorders diagnosis across time. This could be due to a change in diagnostic practice motivated either for changes in DSM criteria as for local culture factors. The aim of this study is to explore the evolution of the schizophrenia spectrum disorders. We hypothesize that we would observe a transference from the schizophrenia diagnosis to psychosis not otherwise specified.

Methods

A retrospective review of all psychiatric discharges in acute unit in the INAD of Parc de Salut Mar of Barcelona, between 2002 and 2014 was performed, relating each discharge to its axis I psychiatric diagnostic. An ANOVA analysis was used to calculate the differences between the months and the frequency of the diagnosis.

Conclusion

We have not been able to observe any transference between diagnoses across years. We observe a decrease of the proportion of schizophrenic spectrum disorders in its prevalence at discharge from 2012 to 2014. The proportion of not otherwise specified psychosis remains quite constant as a third of the schizophrenia diagnoses.

Disclosure of interest

The authors report no conflict of interest in this study. LG is funded by the Instituto.de.Salud.Carlos.III (CM14/00111).
Clinical and functional impact of differences between the diagnostic criteria of DSM IV-TR and DSM V for mental retardation: A case report
Authors: Navarro B. , Torres M.
Published: May 2016

Introduction

The new edition of the DSM has introduced some changes involving differences, sometimes significant, in the conceptualization and classification of mental pathology. One of the most important has been the case of mental retardation.

Objectives and aims

Discuss, with a clinical and pragmatic perspective, the relevance of those changes in the diagnosis and classification of mental retardation in DSM.

Methods

A 45-year-old woman diagnosed with mental retardation is admitted in a psychiatric rehabilitation unit for behavioral disorders and psychotic symptoms. Once controlled the symptoms and studied the patient, a disability not corresponding with the diagnosis presented (mild mental retardation according to DSM IV) is shown. Clinicians start a reevaluation of the diagnosis.

Results

A comprehensive rehabilitation program according to the pathology and deterioration of the patient is designed. With the diagnosis review is possible to find new resources and community programs, better fit for the patient needs.

Conclusions

DSM V changes in mental retardation diagnosis and classification allows a better perspective of the disease and its impact of functionality.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Are neurocognition and facial emotion recognition related in schizophrenia?
Authors: Arous A. , Mrizak J. , Trabelsi R. , Aissa A. , Ben Ammar H. , El Hechmi Z.
Published: May 2016

Introduction

Patients with schizophrenia (SCZ) show impairments in many social cognition domains including facial emotion recognition (FER). The existence of a relationship association between FER and neurcognitive functioning (NF) remains uncertain.

Objectives

To investigate the association between ToM functioning and neurocognitive functioning in SCZ.

Methods

FER was evaluated in 58 patients with stable schizophrenia with a newly validated FER task constructed from photographs of the face of a famous Tunisian actress representing the Ekman's six basic emotions. They also completed a neurocognitive battery comprising the following tests: the Hopkins Verbal Learning Test–Revised (HVLT-R), the Letter Digit Substitution Test (LDST), the Stroop Test (ST), the “Double Barrage” of Zazzo (DBZ), the Modified Card Sorting Test (MCST), Verbal Fluency (VF), the Trail Making Test-Part A (TMT-A) and the Digit Span (DS).

Results

Patients who performed better in the FER task had better performance in the VF task (P = 0.001) and in the immediate recall of the HVLT-R (P = 0.021). No correlations were found with the other neurocognitive tests.

Conclusions

Our results suggest that FER represents an autonomous cognitive function which does not necessarily require good NF.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Research assessments more important than duration of treatment? A systematic review and meta-analysis of the duration of psychosocial treatments for alcohol use disorders
Authors: Schmidt L. , Nielsen A.S. , Bojesen A.B. , Andersen K.
Published: May 2016

Background and aims

The recommendations of duration of treatment for alcohol use disorders (AUD) in clinical guidelines are based on consensus decisions. There is a risk that patients will receive too little or too much therapy. We hypothesize that there is an association between duration and effect up until a point where the effects of treatment diminish.

Methods

A systematic review and meta-analysis of randomized controlled trials of psychosocial interventions in the alcohol outpatient treatment centers. Population: adults (> 17 years) suffering from AUD treated with at least two sessions of therapy.

Statistics

Multiple linear regression analysis with outcome measured in percentage of days abstinent (PDA), percentage of heavy days drinking (PHD), drinks per drinking day (DDD) and/or proportion of participants abstinent (ABS) as a function of duration of treatment.

Results

Forty-four studies with 8485 participants were included. Mean duration: 18 (8–82) weeks and 15 (2–36) sessions. Mean follow-up time: 43 (8–104) weeks with a mean of 5 (2–18) research assessments. Only ABS was significantly associated with duration of treatment; ABS increased with 1.6%-point (P < 0.01) with each additional week in treatment. Surprisingly the analysis showed that each research assessment increased PDA with 11%-point (P < 0.001), decreased PHD with 4%-point (P < 0.05) and decreased DDD with 8%-point (P < 0.001).

Conclusion

Duration of treatment was associated positively with proportion of participants abstinent but not percentage of days abstinent drinks per drinking day or percentage of heavy drinking days. The three latter outcomes were affected positively by number of research assessments.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Alterations in retinal processing in regular cannabis users
Authors: Schwan R. , Schwitzer T. , Giersch A. , Laprevote V.
Published: May 2016

Introduction

Cannabis is one of the most prevalent drugs used worldwide. However, the neural consequences of cannabis remain poorly understood. There is a need for a rapid improvement of the scientific knowledge on the cerebral impact of cannabis use. Since the retina is an easy-to-access part of the central nervous system, it can reflect the neurochemistry of the brain.

Objectives

Considering the anatomical and functional distribution of the cannabinoid system in the retinal ganglion cells, the objective of this study was to assess whether the regular use of cannabis could affect the ganglion cells functioning.

Aims

Assessment of the ganglion cells function in regular cannabis users compared to healthy controls.

Methods

Recordings of pattern electroretinogram (PERG) were performed in regular cannabis users and healthy controls using standard of the International Society for Clinical Electrophysiology of Vision (ISCEV). The amplitude and implicit time of the PERG N95 were assessed.

Results

The N95 implicit time of PERG was significantly decreased in regular cannabis users compared to healthy controls.

Conclusions

We found alterations in the ganglion cells function in regular cannabis users, as showed by the increase in N95 implicit time. The ganglion cells represent the ultimate retinal relay before the visual information is relayed to the brain and, according to these results, we suppose that the signal elicited by these cells and transferred through the visual pathways is altered in cannabis users. A direct action of exogenous cannabinoids in the retinal glutamatergic transmission is discussed.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Prevalence of alcohol consumption in psychiatric consultations and drug addiction consultations by application the cage questionnaire camouflaged
Authors: Zamora Rodríguez F.J. , González Martínez I. , Tolosa Gutiérrez L. , Zoido Ramos J.M.
Published: May 2016

Introduction

Alcohol consumption associated with other psychiatric disorders in outpatient psychiatric comorbidity is a common, yet often underdiagnosed and undertreated, resulting in a worse prognosis of both diseases.

Objective

To evaluate the prevalence of alcohol consumption in psychiatric outpatient consultations and compared to drug addiction consultations.

Methods

A total of 25 outpatient psychiatrists of Extremadura and 10 doctors of substance abuse centers of Extremadura (CEDEX) participated in the study. They were included in the study a total of 373 patients, 244 who were in treatment at mental health center and 129 as a center of drugs.

Results

The mean age of patients in psychiatric consultations was 50.05 years and 42.60 years of CEDEX. The percentage of women was 54% of cases in psychiatric consultations and 18.6% in the CEDEX. Diagnoses included in psychiatric consultations were: anxiety disorders (17.2%), depressive disorders (46.3%); personality disorders (7.8%); mild mental retardation (2.5%); psychotic disorders (12.3%); dementia (2.5%); bipolar disorder (6.1%); and ADHD (1.2%). In the consultations of drugs they were: 45.4% alcohol dependent; 15.7% to cannabis; 13.3% cocaine; 10.9% heroin; 8.1% more heroin to cocaine; and 6.6% to other addictions. A total of 18.9% of patients in psychiatric consultations had a score of 2 or more in the CAGE and 62.8% of the CEDEX.

Conclusions

We found nearly a fifth of the patients attending psychiatric outpatient clinics which have a hazardous drinking, harmful or alcohol dependence, for almost two thirds of drug queries.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Cannabis psychosis, gender matters
Authors: Hamilton I. , Galdas P. , Essex H.
Published: May 2016

Introduction

Despite recent findings pointing toward cannabis psychosis as one area where gender differences may exist, there has been a widespread lack of attention paid to gender as a determinant of health in both psychiatric services and within the field of addiction.

Objectives

To explore gender differences in treatment presentations for people with cannabis psychosis.

Aims

To use national data sets to investigate gender differences.

Methods

Analysis of British Crime Survey data and a Hospital Episode Statistics data set were used in combination with data from previously published epidemiological studies to compare gender differences.

Results

Male cannabis users outnumber female users by 2:1, a similar gender ratio is found for those admitted to hospital with a diagnosis of schizophrenia or psychosis. However this ratio increases significantly for those admitted to hospital with a diagnosis of cannabis psychosis, with males outnumbering females by 4:1.

Conclusions

This research brings into focus the marked gender differences in cannabis psychosis. Attending to gender is important for research and treatment with the aim of improving understanding and providing gender sensitive services.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Temporal epilepsy and psychosis - Comorbidities
Authors: Klaric V. , Klaric D.
Published: May 2016

Introduction

The simultaneous presence of temporal epilepsy and psychosis includes a careful approach to diagnosis and titration of medication.

Aim

To achieve remission of comorbid diseases resistant to therapy.

Methods

Psychotherapy interview and support, laboratory measurements, EEG, cerebral CT and MRI scan, psychological testing.

Results

The patient was a girl 16 years of age. In 2011, she started experiencing auditory hallucinations of disturbing content, ideas of persecution, and she feared that people were going to kill her, all of which were bothering her deeply. In the family anamnesis, her grandmother and aunt both suffer from schizophrenia. In the first neurological assessment, there were no abberations. The patient was treated with high doses of various antipsychotics, but the hallucinations became unbearable to the extent that she was about to commit suicide. Anticonvulsive therapy was planned, and in the meantime, a second neurological assessment was performed, which confirmed the coexistence of temporal epilepsy. Combined therapy consisting of anticonvulsive and antipsychotic medication markedly abated the hallucinations. However, the patient began to feel cramping of the right arm, as well as experiencing the negative symptoms of psychosis. She wasn’t functioning normally anymore, she was distinctly adynamic, depressive, with a lack of initiative, and poor memory and concentration. Psychological testing confirmed significant cognitive, emotional and personality disorders (of organic source).

Conclusion

Treatment of the overlapping symptoms of temporal epilepsy and psychosis is complex, along with the presence of intellectual deterioration.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Clinical aspects of depression in Parkinson's disease
Authors: Leite F. , Salgado H. , Campos O. , Carvalho P. , Pinto da Costa M. , Queirós P. , Cochat C.
Published: May 2016

Introduction

Parkinson's disease is the most common neurodegenerative movement disorder in the elderly population. The disease is clinically characterized by major motor symptoms that include bradykinesia, rigidity, tremor and postural instability. In addition to the motor symptoms, Parkinson‘s disease is characterized by emotional and cognitive deficits, which reduce quality of life independently from motor manifestations.

Objectives/Aims

To discuss the clinical manifestations of depression in Parkinson's disease according to the most recent scientific literature.

Methods

Online search/review of the literature has been carried out, using Medline/Pubmed, concerning, “Parkinson's disease” and “depression”.

Results

Depression is the most frequent psychiatric disorder in Parkinson's disease. In up to 30% of the cases, the depressive symptoms precede the development of motor symptoms. Independently of the age of appearance, duration and severity of the motor symptoms, depression is generally an integral part of the disease. Depression in Parkinson's disease is generally mild or moderate, with premature loss of self-esteem and volition. Although the high rates of suicidal ideation, suicide is rare. There is also a high prevalence of panic attacks and anxiety.

Conclusions

It is difficult to correctly identify depression in Parkinson's disease as some symptoms assigned to Parkinson's disease itself can in fact be the clinical manifestation of a depressive disorder. On the other hand, depressive symptoms may not be recognized as such, but considered manifestations of Parkinson's disease.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
ADHD “Symptomatic contamination” in dual pathology (I): general analysis of the “Sym_Con” sample
Authors: Zoido Ramos J.M. , Pino Calderon F.J. , Gutierrez Casares J.R.
Published: May 2016

Introduction

The links between ADHD and SUD are demonstrated in the scientific literature. The existence of dual diagnosis affects both prognosis and clinical-therapeutic assessment.

Objective and aims

Describe the general characteristics of a sample of patients with SUD (n = 162) who seek treatment for their addiction, based on the presence of symptomatic contamination by ADHD, compared to a sample of adults (n = 246) without addictive pathology (parents of children with different risk for ADHD).

Methods

We assessed using different scales the properties of the sample (visual analogical [general state of health, sadness, anxiety, irritability, suspiciousness], WURS, BDI and Exploratory List of ADHD symptoms).

Results

The average age in the group of parents was 40.59 versus 35.88 on the SUD group, with 42% and 87% males respectively. SUD group presented worse general state, with higher average of sadness, anxiety, irritability and suspicioness, as well as WURS and exploratory symptoms of ADHD, as shown in Fig. 1 and 2.

Conclusions

The SUD group had higher ADHD symptomatic contamination respect to Parents group. These results are preliminary and are pending more thorough analysis as part of a more extensive and complex study, requiring further confirmation in future studies.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Dual diagnosis (Depression and addictions): Special considerations
Authors: Prieto Sánchez I. , Ramírez Domínguez M.D.L.C. , Rodríguez Martínez A. , Garrido Torres N. , Reina Domínguez M. , Biedma Martín A.S. , González Macías C.
Published: May 2016

Introduction

Dual diagnosis is a growing problem in Western society, despite which there are no large studies examining this issue, nor specific protocols to address them.

Objectives

To raise awareness of the importance of dual diagnosis both its prevalence and special features that presents need a different performance plan from them separately.

Methods

Comprehensive literature review of all published in the last 2 years, as well as the specific features.

Conclusion

Dual diagnosis has very specific characteristics that we must know in order to develop therapeutic strategies adapted to the present conditions.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Casting wider diagnostic nets for anxiety and depression: Disability-driven cross-diagnostic subtypes in a large population study
Authors: Wanders R. , van Loo H.M. , Wardenaar K.J. , Vermunt J.K. , Meijer R.R. , De Jonge P.
Published: May 2016

Introduction

Data-driven techniques are frequently applied to identify subtypes of depression and anxiety. Although they are highly comorbid and often grouped under a single internalizing banner, most subtyping studies have focused on either depression or anxiety. Furthermore, most previous subtyping studies have not taken into account experienced disability.

Objectives

To incorporate disability into a data-driven cross-diagnostic subtyping model.

Aims

To capture heterogeneity of depression and anxiety symptomatology and investigate the importance of domain-specific disability-levels to distinguish between homogeneous subtypes.

Methods

Sixteen symptoms were assessed without skips using the MINI-interview in a population sample (LifeLines; n = 73403). Disability was measured with the RAND-36. To identify the best-fitting subtyping model, different nested latent variable models (latent class analysis, factor analysis and mixed-measurement item response theory [MM-IRT]) with and without disability covariates were compared. External variables were compared between the best model's classes.

Results

A five-class MM-IRT model incorporating disability showed the best fit (Fig. 1). Accounting for disability improved the differentiation between classes reporting isolated non-specific symptoms (“Somatic” [13.0%], and “Worried” [14.0%]) and those reporting more psychopathological symptoms (“Subclinical” [8.8%], and “Clinical” [3.3%]). A “Subclinical” class reported symptomatology at subthreshold levels. No pure depression or anxiety, but only mixed classes were observed.

Conclusions

An overarching subtyping model incorporating both symptoms and disability identified distinct cross-diagnostic subtypes. Diagnostic nets should be cast wider than current phenomenology-based categorical systems.

Figure not available.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Paliperidone palmitate could reduce the consumption of drugs of abuse in psychotic patients?
Authors: Zangrando A. , Babici F. , Pascolo-Fabrici E. , Riolo A.
Published: May 2016

Introduction

It's not easy to choose between different antipsychotics in the treatment of patients with schizophrenia that use drugs of abuse both legal (alcohol, benzodiazepine, anticholinergics) and illicit (heroin, cannabis, cocaine). The use of substances is a powerful risk factor for poor outcome. From CATIE study, we know that the discontinuity is lower with Olanzapine but psychotic patients continue to take drugs of abuse despite medication. Probably, an important aspect is the anhedonia secondarily produced by neuroleptics.

Objective

We want to evaluate if Paliperidone Palmitate reduces addictive behaviors in a small group of psychotic patient who have agreed to recived injection after the switch from other antipsychotics.

Method

We have identified four individual with chronic use of drugs of abuse in a Mental Health Center. These subjects were abusing alcohol, cannabis, spice and benzodiazepine. We administered before new treatment and after 2 months the Snaith-Hamilton Pleasure Scale of Snaith et al. (1995) and the Leeds Dependence Questionaire of Raistrick et al. (1994).

Results

The hedonic tone tends to improve and the addictive behavior decreased.

Conclusion

The therapy with Paliperidone Palmitato is associated with a reduction of the addictive behaviors but we need studies with a larger number of patients.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Depression and quality of life in hospitalised patients with congestive heart failure (CHF): A cross-sectional study from Karachi, Pakistan
Authors: Husain M. , Tayyeba K. , Husain M. , Fatima B. , Ansari S.U.H. , Rahman R. , Chaudhry I.B. , Husain N.
Published: May 2016

Introduction

There is strong association between depression and mortality rates among patients with CHF. Despite the massive burden of cardiac disease as well as that of depression in Pakistan, there is limited data regarding the prevalence of depression in patients suffering from CHF. The aim of this study was to assess prevalence of depression in patients with CHF and to compare the health related quality of life of depressed and non-depressed patients with CHF.

Methods

A total of 1009 patients diagnosed with CHF were recruited from different public hospitals in Karachi, Pakistan. Depression was assessed at baseline using the Beck Depression Inventory (BDI) and health related quality of life was assessed using Euro Qol (EQ-5D).

Results

Of the 1009 participants recruited to the study, 66.4% (n = 670) met the threshold for depression using the BDI measure. Of the depressed patients, 66.7% (n = 447) were male. Preliminary results indicate that participants who were depressed at baseline had poorer health related quality of life on EQ-5D measures as compared to those who were non-depressed (mean EQ-5D descriptive score 10.45 in depressed patients vs 7.37 in non-depressed patients and mean EQ-5D visual scale score 35.09 in depressed patients vs 52.19 in non-depressed patients).

Conclusion

Considering the high prevalence of depression and its serious negative impact on quality of life of patients suffering from chronic physical illness, it is important to design and test culturally adapted psychosocial interventions to reduce depression and improve quality of life for these patients.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Prevention, early detection and effective treatment of the psychological disorders in asthma and chronic obstructive lung disease
Authors: Zawada K. , Koźmin-Burzyńska A. , Krzysztof K.
Published: May 2016

Background

Chronic respiratory diseases which embrace asthma and chronic obstructive pulmonary disease (COPD) are common conditions in the population. In a large number of cases, they are diagnosed very late. Statistics of deaths, especially in the case of COPD, are underestimated because morbidity and mortality can be affected by other comorbid conditions, for example cardiovascular disease.

Objective

The objective of this analysis was to find out the corelation between the psychological distress and social factors in patients with asthma and chronic obstructive lung disease.

Methods

A literature analysis on this topic was performed. Asthma and COPD impair not only physical functioning of patients but also affect their psychological state. Mood disorders and cognitive function impairment are more often observed in this group than in the general population. It has been proven that the coexistence of psychological dysfunction significantly worsens the functioning of patients (affects, among others, their work, family and social lives) and has an impact on the course of the treatment of the somatic illness. First of all, patients with cognitive deficits have greater problems in applying treatment recommendations. Accordingly, it seems to be important to pay more attention to the problem of mental disorders in patients with obstructive lung diseases.

Conclusions

There is a clear need for a multidisciplinary approach that will enable prevention, early detection and effective treatment of the psychological disorders in that group of patients.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
The resource utilisation associated with medically unexplained physical symptoms
Authors: Sundram F. , Lee K. , Johnson M.
Published: May 2016

Introduction

Patients with medically unexplained physical symptoms (MUPS) may present frequently to hospital settings and receive potentially unnecessary investigations and treatments.

Objective

A sample of 49 patients was drawn and their handwritten and electronic clinical records were examined in detail to extricate all MUPS-related secondary care activity within six months of the MUPS presentation (emergency department, inpatient stays, outpatient appointments, and all associated investigations, procedures and medications).

Aims

We aimed to assess the frequency and type of MUPS presentations to clinical services and estimate the associated direct healthcare costs.

Method

This study was undertaken at Waitemata District Health Board (WDHB), the largest DHB in New Zealand. All patients with a diagnosed presentation of MUPS in 2013 were identified using the WDHB clinical coding system. Their clinical records were screened to select all patients who matched the study inclusion and exclusion criteria. Standardised national costing methodology was used to calculate the associated healthcare costs.

Results

Forty-five percent of patients presented to hospital settings at least twice over the one-year timeframe. The most common diagnoses were non-epileptic seizures (31%) and hyperventilation syndrome (30%). The total cost for the sample was NZ$179, 271 (mean NZ$3659). Costs were most significant in the areas of inpatient admissions and emergency care.

Conclusion

MUPS can result in frequent presentations to hospital settings. The costs incurred are substantial and comparable to the costs of chronic medical conditions with identifiable pathology. Improving the recognition and management of MUPS has the potential to offer more appropriate and cost-effective healthcare nationally and internationally.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
psychological experiences reported in regarding hepatitis C and use of interferon: A clinical-qualitative study in a Brazilian university outpatient service considering its possible side effects
Authors: Fahl I.D. , Costa F.D. , Stucchi R.S.B. , Turato E.R.
Published: May 2016

Relevant emotional and behavioural reactions are associated with diagnosis and treatment of hepatitis C that can impair adherence to medical management. Hepatitis C accounts for significant number of both – liver transplants and deaths. Treatment has as major component the interferon alpha, and many of patients can experience side effects that often lead to non-adherence to drug treatment and dose modification.

Objective

To discuss psychological meanings attributed to IFN alpha treatment's side effects and its symbolic relation with adherence or not to treatment, on viewpoint of interviewed outpatients at a Hepatitis Service.

Method

Data collection was conducted using the Clinical-Qualitative Method, utilizing semi-directed interviews with open-ended questions in depth, fully transcribed. Qualitative Content Analysis employed for processing data, emerging meaning cores, with categorization into discussion topics. Sample closed by information saturation.

Results

Nine interviews. The analysis revealed:

– coping attitude - handling the disease to have willpower; a moral feeling regarding the need to overcome the disease and treatment side effects to demonstrate “strength”, as well as to deny psychologically the occurrence of side effects;

– disruptive attitude: reports of anxiety regarding to patients presenting neuropsychiatric symptoms by medication;

– realistic attitude: speeches show perception of natural evolution and treatment real function.

Conclusion

Guilt feelings emerged regarding to difficulties of being loyal to treatment, a strongly valorative speech on being ill what must lead to “overcome the evils of life”. Health teams must understand these meanings to talk openly about human feelings on illness and treatment, promoting an adequate adherence.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Does depression conciliate in marital adjustment?
Authors: Channa A.
Published: May 2016

Marriage is one of the principal facets when it comes to interpersonal context of depression. There is evidence supporting bidirectional casual effect between depression and marital satisfaction. However the phenomenon of marital adjustment and its related variable has not been given much attention in the Pakistan.

Objective

To determine the frequency of marital adjustment in patients with depression.

Method

Depressed patients, who were aged between 15–65 were included. Patients who had documented co morbid of substance use or any unstable serious general medical condition were excluded. The severity of depression was evaluated by using Urdu validated Hamilton Depression Rating Scale. Marital adjustment is determined by using Urdu validated version of Kansas Marital Satisfaction Scale.

Result

Only 8.6% were well adjusted in their marital life, and all were females. The association of marital adjustment and severity of depression and difference in both genders on KANSAS was insignificant. The longer duration of illness was positively interrelated to the marital adjustment with odd ratio of 7.6. Being employed and above 30 years of age were inversely related to marital satisfaction with odd ratio of 6.1 and 5.4 respectively. However, the correlation between other independent variables and marital adjustment were insignificant in both genders.

Conclusion

This study confirms the presence of high frequency i.e. 91.4% of marital dissatisfaction in depression in both male and females, irrespective of their severity of depression.

Disclosure of interest

The author has not supplied their declaration of competing interest.
Perceptual symptoms in the latino psychiatric patients attending inner city outpatient clinic
Authors: Gonzalez L. , Khadivi A. , Gu W. , Korenis P.
Published: May 2016

Introduction

Psychotic symptoms occur in a variety of psychiatric disorders and medical conditions. In addition, a significant proportion of the general population reports history of psychotic symptoms in the apparent absence of a psychiatric disorder. Reviewed literature suggests that Latino patients report certain forms of visual and auditory hallucinations without other indications of psychotic illness. In addition, it is common that some individuals with diverse religious or cultural backgrounds may present with psychotic transient experiences, which can be culturally normative.

Objective

To determine the prevalence of hallucinations and describe the nature of hallucinatory experiences in relation to cultural belief in Latino and non-Latino psychiatric outpatients.

Methods

We conducted a retrospective case control study of 146 patients who were admitted to the outpatient psychiatric clinic for a period of ten months. We assessed clinical characteristics of these patients and reviewed the extended mental status examination, which contained questions about various form of hallucinations and spiritual experiences. This poster will explore the prevalence of hallucinations in the Latino population and determine the percentage of patients with a diagnosis of psychotic illness. A discussion of the phenomenological hallucinatory experiences and its relationship to cultural beliefs in the Latino psychiatric patients will also be presented.

Conclusions

Psychotic symptoms present differently across cultures. The Latino population is most likely to have psychotic like symptoms related to their cultural beliefs. Clinicians must understand the diverse cultural experiences and beliefs of the patients they work with to prevent misdiagnosis of culturally normative experiences.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Challenges to employment among latino population with severe mental illness
Authors: O’Connell M. , Costa M. , Gonzalez A. , Damio G. , Ruiz K. , León-Quismondo L. , Davidson L.
Published: May 2016

Introduction

Unemployment is common in persons with severe mental illness (SMI) and more in Latino population. Department of Mental Health and Addiction Services (DMHAS) of Connecticut offers a supported employment (SE) Program to help clients get competitive work in integrated settings with nondisabled workers in the community.

Objective

Capture perspectives of key informant groups to describe barriers for linking Latinos with SMI to employment and adapt SE Services for subpopulations.

Method

Four focus groups were conducted (employment specialists, case managers and peer support counselors/employers/two with clients-one in Spanish and other in English). They were conducted during January-February 2015, 70–90 minutes each one. A question guide was developed for each group. Participants per focus group ranged from 3–10, voluntarily. Two new questionnaires to the baseline pack were developed: challenges to Employment Assessment–provider and client version.

Results

Thirty individuals participated. Several barriers to employment were reported. Clients and staff reported criminal record, lack of employment history and lack of motivation. Staff described client hygiene, mental status, physical health, substance abuse and discrimination. Clients, staff and employers reported language barrier for Latinos who don’t speak English. Non-adherence to medication was reported by clients and employers. About Spanish-Speaking Latinos with mental illness, medication, discrimination, previous abuse by employers, inappropriate employment, difficulties of the job interview and computer skills appeared as challenges. English-Speaking Latinos with mental illness identified transport, stability, support, keeping apartment and financial needs.

Conclusions

Focus groups can help in knowledge about the diversity of Latino communities to improve SE Services and outcomes for Latinos.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Newer substances and their effects: A case report
Authors: Peñuelas Calvo I. , Sevilla Llewellyn-Jones J. , Sareen A. , Cervesi C. , González Moreno A.
Published: May 2016

Introduction

Due to constant flow of people in and out of Europe several drugs are now days appearing in European markets that were previously unknown. There is a need to gain awareness and knowledge about these new substances and to recognize their use and learn about their effects and management.

Aims/objectives

Ayahuascais commonly called yagé is a traditional spiritual medicine in ceremonies among the Indigenous peoples of Amazonian Peru. It is undetected in urine or blood and therefore it is important to understand and ask about its usage during clinical assessment.

Methods/results

Thirty-six years old woman immigrant from South America came to us with auditory hallucinations. About three years ago she was introduced who introduced her to a community of Euto poeple that performed daily rituals of spiritual awareness involving the use of Ayahuasca. She became a part of it and started consuming Ayahuasca daily. She started becoming socially isolated accompanied by delusional and mystical religious ideations. She later began having persecutory delusions and auditory hallucinations that Archangels speak to her about how to create music. Patient was involuntary admitted in a mental health unit and started on risperidone. Gradually her condition improved and she stopped having auditory hallucinations. After being discharged from the hospital, patient was followed on an outpatient basis with injectable risperidone.

Conclusions

Due to the blend of different cultures in Europe, it is necessary to have a better understanding about the cultures, rituals and the substances that are relatively new and are currently been used.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
The characteristic of auditory hallucinations in patients with schizophrenia, schizoaffective and bipolar disorder with psychotic features in Iran
Authors: Zamir S.M. , Haji Seyed Javadi S.A. , Majidi M.
Published: May 2016

Introduction

Auditory hallucinations are perceptional experiments that occur in schizophrenia, schizoaffective disorder and bipolar disorder with psychotic features. Characteristic of these hallucinations may have relation with cultural factors.

Aim

We have done this study to understand more about content and characteristic of auditory hallucinations in Schizophrenia, schizoaffective and bipolar disorder with psychotic features in Qazvin, a state in north-center of Iran.

Methods

We used the questionnaire that prof. Romme and Escher developed in 1987 for research purposes. Sixty patients diagnosed with schizophrenia, schizoaffective and bipolar disorder with psychotic features that admitted or attended at clinic of Qazvin medical science university hospital, psychiatry ward, were interviewed.

Results

The 45 men and 15 women in three groups were interviewed. The most were men, single, and in fourth decade of their life. Most patients mentioned that they heard one voice. Mean age of appearing voices in patients were 19 to 29 years old. Most patients in the schizoaffective and bipolar group heard male voices and in schizophrenia were both sexes. Eighty-five percent of bipolar patients, 65% of patients with schizoaffective disorder heard friendly voices. It was 30% in patients with schizophrenia. Fifteen percent of bipolar patients, 75% of schizophrenia and 45% of schizoaffective stated that voice was hostile.

Conclusion

Our study has revealed that culture affected content and characteristic of auditory hallucinations. We suggested that some complementary studies will be done in future from different Iranian cultures not just people of Qazvin.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
The effectiveness of various potential predictors of response to treatment with SSRIs in patients with depressive disorder
Authors: Bares M. , Novak T. , Brunovsky M.
Published: May 2016

Introduction

The substantial non-response rate in depressive patients indicates a need to identify predictors of treatment outcome.

Objective and aims

The aim of the open-label, 6-week study was:

– to compare efficacy of a priori defined predictors: ≥ 20% reduction in MADRS score at week 1, ≥ 20% reduction in MADRS score at week 2 (RM ≥ 20% W2), decrease of prefrontal theta cordance value (RC) and increase of serum/plasma brain-derived neurotrophic factor (BDNF) at week 1;

– to assess whether the combination of these factors yield more robust predictive power than when used singly.

Methods

All patients (n = 38) were hospitalized and treated with various SSRIs. Areas under curve (AUC) as well as predictive values were calculated to compare predictive effect of single and combined predictor model.

Results

Twenty-one patients (55%) achieved response. The RM ≥ 20% W2 (AUC-0.83) showed better predictive efficacy compared to all other predictors with exception of RC. Other significant differences were not detected. The identified (logistic regression) combined predictive model (RM ≥ 20% W2 + RC) predicted response with accuracy of 82% (AUC-0.92) and was significantly better than other predictors but not RM ≥ 20% W2 and RC.

Conclusions

Our findings indicate that the RM ≥ 20% W2 alone and in combination with RC may be useful in the prediction of response to SSRIs. Serum/plasma BDNF did not show strong predictive potential.

Disclosure of interest

The authors have not supplied their declaration of competing interest.