bluuebunny/crossref_metadata_2025 huggingface dataset:
Differences in Baseline Demographics, Presentation, Pathways to Care and Duration of Untreated Psychosis (DUP) in the Ethnically Diverse Population of Lancashire, UK
Authors: Damle V. , Husain D.N.
Published: June 2017

Introduction

DUP is the time from the emergence of first psychotic symptom to the commencement of adequate antipsychotic treatment. Psychopathological and sociocultural factors influence patient's treatment seeking behavior. Better understanding of DUP could help in development of improved therapeutic strategies and public health initiatives. Emphasis on early detection of psychosis and reduction of DUP has led to a huge interest in pathways to care.

Objectives

To understand the differences in baseline demographics, presentation, care-pathways and DUP in ethnically diverse population of Lancashire, UK.

Methods

Our cross-sectional study involved a subset analysis of National EDEN data for Blackburn and Preston in Lancashire.

Results

Of the 183 patients, 78% were Whites and rest belonged to BME population. Median DUP was 188 days. Whites were significantly younger at onset of both non-specific symptoms and psychosis and at acceptance into EIS. Whites were significantly less likely than non-whites to be married, more likely to be in paid work and to have used illicit drugs. There were no significant differences with respect to other demographics/delays in help seeking or DUP. Non-White group had shorter DUP of 95 days (but not statistically significant, P = 0.060).

Conclusions

Better understanding of mental illness and local services in White patients could have led to early help seeking. Having a supportive family may have promoted early help seeking and thus shorter DUP in BME group. Further studies are needed exploring socioenvironmental variables, substance misuse and knowledge of local psychiatric services amongst the BME population and the influence of these variables on DUP.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Differential Effect of Childhood Trauma Subtypes on Fatigue and Physical Functioning in Chronic Fatigue Syndrome
Authors: De Venter M. , Illegems J. , Van Royen R. , Sabbe B. , Moorkens G. , Van Den Eede F.
Published: June 2017

Objective

There is a large consensus concerning the important aetiological role of childhood trauma in chronic fatigue syndrome (CFS). In the current study, we examine the differential effect of childhood trauma subtypes on fatigue and physical functioning in patients with CFS.

Methods

One hundred and fifty-five participants receiving treatment at the outpatient clinic for CFS of the Antwerp University Hospital in Belgium were included in this study. Stepwise regression analyses were conducted with the outcomes of the total score of the Checklist Individual Strength (CIS) measuring fatigue and the physical functioning subscale of the medical outcomes short form-36 health status survey (SF-36) as the dependent variables, and the scores on the five Traumatic Experiences Checklist (TEC) subscales as the independent variables.

Results

Fatigue and physical functioning scores in CFS patients were significantly predicted by sexual harassment only. A significant effect of emotional neglect, emotional abuse and bodily threat during childhood on elevated fatigue or reduced physical functioning levels could not be found.

Conclusion

There is a differential effect of childhood trauma subtypes on fatigue and physical functioning in CFS patients. Sexual harassment emerged as the most important predictor variable. Therefore, childhood (sexual) trauma has to be taken into account in assessment and treatment of chronic fatigue syndrome.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Psychosis Induced by Interferon-α–A Limitation of Treatment
Authors: Marinho M. , Mota-Oliveira M. , Marques J. , Bragança M.
Published: June 2017

Introduction

Psychosis is an uncommon but serious complication of treatment with interferon-α, a cytokine frequently used to treat several infectious and malignant diseases.

Objectives

To provide an overview of interferon-α-induced psychosis.

Methods

Literature review based on PubMed/MEDLINE, using the keywords “interferon-α” and “psychosis”.

Results

Psychotic symptoms usually emerge between 6 to 46 weeks and on average 3 months after the start of interferon-α treatment, occurring most frequently in the form of persecutory, guilt or grandeur delusions and auditory hallucinations. Often they are accompanied by mood symptoms, anxiety, attention disturbances and insomnia. Many factors are known to increase the risk of psychiatric effects as a whole associated with interferon-α. Pathogenesis of interferon-induced psychosis remains unclear, however several theories have been discussed, namely the overlap influence of biological vulnerability and the cytokine's action on the brain. Dopaminergic, opioid, serotoninergic and glutaminergic pathways as well as hypothalamic-pituitary-adrenal axis hypersensitivity are some of the hypotheses raised about the underlying cause of that susceptibility. Psychosis management usually includes stopping interferon-α and introducing antipsychotics with minimal antidopaminergic effects and at the lowest possible dose, due to the increased risk of extrapyramidal reactions in these patients.

Conclusion

The decision to use interferon-based treatments in psychiatric patients should be highly individualized. Early recognition and adequate treatment of interferon-induced psychosis might prevent subsequent emergence of serious debilitating symptoms. Thus, it is very important that medical and psychiatric treatment teams work closely together and are familiar with this important subject.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Reasons for Acute Psychiatric Admissions and Psychological Interventions for Patients with Borderline Personality Disorder
Authors: Lekka N.P. , Carr G. , Gilpin T. , Eyo B.
Published: June 2017

Introduction

NICE guidelines advise to consider admission for patients with borderline personality disorder (BPD) for the management of crises involving significant risk to self or others. Furthermore, to consider structured psychological interventions of greater than three months’ duration and twice-weekly sessions according to patients’ needs and wishes.

Objectives

We aimed to assess reasons for admission and access to psychological interventions in an acute inpatient BPD population.

Methods

Case notes of patients with a diagnosis of BPD (ICD-10 F60.3 and F60.31), discharged from four acute general adult wards in Sheffield during a period of twelve months were studied retrospectively, using a structured questionnaire based on BPD NICE guidance.

Results

Of the 83 identified BPD patients, seventy-eight percent were female and 82% between 16–45 years old. Eleven patients had four or more admissions. Eighty percent reported suicidal ideation at admission, with 50% having acted on it (70% by overdose, 50% cutting, 10% hanging). Of this cohort, 58% reported they intended to die. Psychosocial factors at admission were identified in 59 cases, including relationship breakdown (47.5%), alcohol/drug use (30.5%) and accommodation issues (17%). Disturbed/aggressive behaviour was documented in 27.1% of these cases. Sixty-eight percent of patients had psychology input in the 5 years preadmission: 38% (21 patients) received structured therapy, whilst 62% received only one assessment or advise to teams.

Conclusions

Patients were mainly admitted for risk management. A high proportion received unstructured psychological interventions. Services offering structured psychological interventions should be supported, as hospitalisations only temporarily address BPD patients’ suicidality and psychosocial difficulties.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Thyroid Profile and its Relationship with Response to Treatment with Lithium in Bipolar Mood Disorder Patients
Authors: Avinash P. , Pathak K.
Published: June 2017

Introduction

There is substantial evidence that even minor perturbation of thyroid function plays a significant role in clinical course and treatment outcome in depressive disorder; however the same is not yet clear in bipolar disorders.

Aims and objectives

To study the relationship between pretreatment thyroid profile and response to treatment with lithium along with other predictors of response to treatment with lithium in cases of bipolar mood disorder.

Methods

This study was conducted in the indoor facilities of a regional Institute of Mental Health, Tezpur, India in the year of 2012. Forty-five consecutive indoor patients diagnosed with bipolar mood disorder using DSM-IV-TR criteria were selected. On day 1, blood was collected for thyroid profile and BPRS 24 item scale version 4.0 was applied. They were started on lithium monotherapy and only lorazepam was used on S.O.S basis. On day 30, the BPRS was applied again to check the response to treatment, statistical analysis was done using SPSS version 16.

Results

The mean percentage fall of the BPRS score was 40%, with the maximum fall in the subscale of grandiosity and minimum for depression. Age, illness duration, substance use, family history second or later episodes were negatively correlated with treatment response. Pretreatment T4 level was positively correlated, while pretreatment TSH level was negatively correlated with the treatment response.

Conclusion

Lithium monotherapy proved to be a good agent for first episode of bipolar Mood disorder patients with manic symptoms and pretreatment T4 and TSH level were predictors of treatment response.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Impulsivity and Brain Volume in Patients with Bipolar Disorder type I and Bipolar Disorder Type II
Authors: Janiri D. , Giuseppin G. , Spinazzola E. , Maggiora M. , Sani G.
Published: June 2017

Introduction

Impulsivity is a key feature of both bipolar disorder (BD) type I (BDI) and type II (BDII).

Objective

Structural neuroimaging studies help clarifying brain mechanisms underpinning the regulation of impulsivity in BDI and BDII.

Aims

To address the question whether grey matter (GM) alterations relate differently with impulsivity in BDI and BDII.

Methods

We assessed 54 euthymic outpatients, diagnosed with BDI (n = 28) or BDII (n = 26) according to DSM-IV-TR criteria. They underwent a 3 T magnetic resonance imaging (MRI) investigation. GM brain volumes were analyzed on a voxel-by-voxel basis using Statistical Parametric Mapping 8. The Barratt Impulsiveness Scale (BIS), version 11A, was used to assess trait impulsivity.

Results

BDI and BDII patients present an inverse relationship between impulsivity and GM volume in two cerebral areas: the right cerebellum (right crus I) and the interface between the left angular gyrus and the left inferior parietal cortex (Brodmann Area 39, 7, 40). More specifically, a negative relationship for BPI and a positive relationship for BPII were found in both areas.

Conclusions

Results suggest that the different diagnosis between BDI and BDII could have a significant effect on GM changes according to impulsivity severity and point up the importance of considering the BP subtype distinction in neuroimaging studies on this topic.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Early Childcare and Trajectories of Behavioral Difficulties in Children: The EDEN Mother–Child Cohort Study
Authors: Melchior M.
Published: June 2017

Background

There is no consensus of the relationship between early childcare and later psychological development.

Methods

We studied 1428 children participating in the French EDEN cohort. Childcare was reported prospectively between ages 4 months and 3 years: childminder, collective care, informal care. Children's behavior was assessed by mother-reported strength and difficulty questionnaire (SDQ) scores at ages 3.5, 5.5 and 8 years. Trajectories of children's behavioral difficulties (emotional difficulties, behavioral problems, peer-relations difficulties, symptoms of hyperactivity and inattention, prosocial behavior) were identified using group-based trajectory modelling (PROC TRAJ, SAS). To control for selection and confounding factors, we used propensity scores based on over 30 covariates, included in multinomial regression models as inverse probability weights of exposure.

Results

Compared to children in informal care, those who were cared for by a childminder or in collective care were less likely to have peer problems (respectively, ORs for the intermediate level trajectory = 0.67 [95% IC: 0.47–0.95] and 0.49 [95% IC: 0.34–0.72]; ORs for the high level trajectory = 0.47 [0.27–0.82] and 0.33 [0.17–0.62]). Collective care was also associated with a reduced likelihood of intermediate (OR = 0.71 [0.52–0.98]) and high trajectories of hyperactivity and inattention (OR = 0.50 [0.35–0.81]), intermediate (OR = 0.58 [0.39–0.88]) and high trajectories of emotional symptoms (OR = 0.54 [0.32–0.92]) and intermediate (OR = 0.72 [0.51–1.01]) and high behavioral problems trajectories (OR = 0.54 [0.34–0.85]).

Conclusion

Childcare attendance prior to school entry – particularly collective childcare – may have beneficial effects for children's psychological development and peer relations.

Disclosure of interest

The author has not supplied his declaration of competing interest.
The Different Effect of Childhood Trauma on Amygdala and Hippocampus in Patients with Bipolar Disorder and Healthy Controls
Authors: Janiri D. , De Rossi P. , Simonetti A. , Spalletta G. , Sani G.
Published: June 2017

Introduction

Childhood trauma (CT) is a relevant environmental stressor for bipolar disorder (BP). Amygdala and hippocampus are key areas involved both in the pathophysiology of BP and in mediating the biological response to stress.

Objectives

Structural neuroimaging studies help clarifying neural correlates of the relationship between BP diagnosis and CT.

Aims

To verify the impact of CT on amygdala and hippocampus and hippocampal subfields volumes in BP patients and healthy control (HC).

Methods

We assessed 105 outpatients, diagnosed with BPI or BPII according to DSM-IV-TR criteria, and 113 HC subjects. History of CT was obtained using the childhood trauma questionnaire (CTQ). High-resolution magnetic resonance imaging was performed on all subjects and volumes of amygdala, hippocampus, nucleus accumbens, caudate, pallidum, putamen, thalamus and hippocampal subfields were measured through FreeSurfer.

Results

All deep gray matter structures were smaller in BP than HC. CT modulated the impact of the diagnosis on bilateral amygdala and hippocampus, in particular on subiculum, presubiculum and cornu ammonis CA1. It was associated with bilateral decreased volumes in HC and increased volumes in patients with BP.

Conclusions

Childhood trauma impacts on the amygdala and hippocampus, brain areas involved in response to stress and emotion processing, and specifically on the hippocampal subfields most implicated in learning trough positive/negative reinforcement.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Psychological treatment of trihotillomania: A case study
Authors: Sarmiento Luque T. , Sanchez J.M.
Published: June 2017

This paper presents a clinical case of trichotillomania. Therefore, the aim of this study is to present in detail the procedure followed in a case of trichotillomania in a public health context, using cognitive-behavioral techniques, in order to deepen the knowledge of the efficacy of these treatment procedures and demonstrate the feasibility of implementation.

The results obtained show significant improvements in different clinical aspects: first, the hair pulling behavior disappeared completely; moreover, anxiety diminished significantly and mood normalized. All these results allow us to conclude that the intervention was successful.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Personal and pathopsychological features of patients with somatoform disorders in primary care
Authors: Tsygankov B. , Kulichenko A.
Published: June 2017

Introduction

Somatoform disorders are a therapeutic challenge for primary care physicians. Various studies show low efficacy of psychotherapy for these patients, and the need for differentiated approach to their treatment.

Objective

Explore the differences between pathopsychological, personal characteristics of patients with somatoform disorders.

Methods

It was carried out psychometric evaluation of 108 patients with different clinical variants of somatoform disorders, using SCL-90-r, Leonhard questionnaire.

Results

Patient with somatization disorder (SD) had maximum values on the “somatization”, “depression”, “hostile”, “paranoid” scales; a high level of anxiety. Singularity personality structure of these patients defining feature of exaltation, excitability, emotivity. Patients with undifferentiated somatoform disorder (USD) also showed high levels of somatization, anxiety and obsessive-compulsive, interpersonal sensitivity, phobic anxiety. Patients with stable somatoform pain disorder (SPD), had high levels of depression, obsessive-compulsive. SPD formed in individuals with features of anxiety, seizing, high emotivity. The maximum values for the scales of anxiety (ANX, PHOB) recorded in patients with somatoform dysfunction of the autonomic nervous system (SDANS). Evaluation of coping strategies showed a preferential use of the “avoidance” strategy by patients with SD, USD, a rare use of social support strategies, responsibility. Patients with somatoform pain disorder often resorted to seek social support.

Conclusion

The use of the questionnaire SCL-90-r has identified a number of clinical features of patients with different variants of the SFD. Typologically in all samples of patients revealed moderate accentuation on emotivity trait.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
A broken heart
Authors: Gordillo Montaño M.J. , Ramos Perdigues S. , Latorre S. , de Amuedo Rincon M. , Torres Llorens P. , Boned Torres S.V. , Segura Valencia M. , Guisado Rico M. , Merino del Villar C.
Published: June 2017

Introduction

Within the various cultures and throughout the centuries has observed the relationship between emotional states and heart function, colloquially calling him “heartbroken”. Also in the medical literature are references to cardiac alterations induced by stress.

Objective

Takotsubo is a rare cardiac syndrome that occurs most frequently in postmenopausal women after an acute episode of severe physical or emotional stress. In the text that concerns us, we describe a case related to an exacerbation of psychiatric illness, an episode maniform.

Method

Woman 71 years old with a history of bipolar I disorder diagnosed at age 20. Throughout her life, she suffered several depressive episodes as both manic episodes with psychotic symptoms. Carbamazepine treatment performed and venlafaxine. He previously performed treatment with lithium, which had to be suspended due to the impact on thyroid hormones and renal function, and is currently in pre-dialysis situation.

She requires significant adjustment treatment, not only removal of antidepressants, but introduction of high doses of antipsychotic and mood stabilizer change of partial responders. In the transcurso income, abrupt change in the physical condition of the patient suffers loss of consciousness, respiratory distress, drop in blood pressure, confusion, making involving several specialists. EEG was performed with abnormal activity, cranial CT, where no changes were observed, and after finally being Echocardiography and coronary angiography performed when diagnosed Takotsubo.

Results/conclusions

In this case and with the available literature, we can conclude that the state of acute mania should be added to the list of psychosocial/stressors that can trigger this condition.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Bipolar versus schizoaffective disorder: Clinical profiles
Authors: Romosan A.M. , Dehelean L. , Romosan R.S. , Papava I. , Drut I.
Published: June 2017

Introduction

Differentiating between bipolar (BD) and schizoaffective disorder (SAD) can be challenging, especially during early stages of the illness.

Objectives

Comparing clinical profiles and socio-demographic characteristics of patients diagnosed with BD and SAD.

Methods

The study, conducted between 2014–2016, included 67 inpatients from the Timisoara Psychiatric Clinic, diagnosed with either BD (n = 35) or SAD (n = 32), according to ICD-10 criteria. The following parameters were analyzed: number of episodes, number of times hospitalized, onset age, frequency and nature of psychotic symptoms, family history of psychiatric disorders and socio-demographic characteristics (age, sex, marital status). Data were obtained by direct interview and patient files. Symptom severity was measured with Brief Psychiatric Rating Scale (BPRS).

Results

There were no significant differences between the two samples regarding age or sex distribution. Schizoaffective patients were more frequent unmarried (P = 0.007). Onset age was significantly lower in SAD patients (22.41 years for SAD, 28.36 years for BD). SAD patients had the highest number of episodes and needed more frequent hospitalization. Bipolar patients had higher percentage of family history of affective disorders when compared to schizoaffective patients (41% versus 36%). Hallucinations were more frequently found in schizoaffective patients than in bipolar patients (P = 0.004). We found no significant differences between the two samples regarding the presence or the type of delusions. The SAD sample had significantly higher BPRS total scores than bipolar patients (P = 0.035).

Conclusions

Although this study revealed numerous similarities between BD and SAD, it also identified differences that may be helpful in establishing the correct diagnosis.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Temporality in mania: Phenomenological, neurobiological and therapeutic consequences
Authors: Schwartz M. , Moskalewicz M. , Schwartz E. , Wiggins O.
Published: June 2017

Manic disturbances of temporality are underemphasized in present-day accounts. For example, they are not included among criteria for manic episodes in DSM or ICD. Nonetheless, as already claimed by Binswanger (1964), aberrant temporality is core to the disorder. Persons with mania live almost exclusively in the present and hardly into the future. Especially in the larger scheme of things, their future is already here. There is no “advancing, developing or maturing,” anticipations have been achieved, all that I strive for is present – if you will just get out of my way! A half century ago, Binswanger spelled out this temporal foundation for mania and summed up consequences. The manic self, not living into the future, “is not, to borrow a word, an existential self.”

This presentation will describe phenomenological characteristics of such a manic self and then present correlating findings from contemporary neuroscience. Importantly, such findings clarify present and future therapeutic interventions. Of critical importance is manic chronobiology: clocks in our brains afford receptor sites for the lithium ion. At these sites, lithium potently inhibits the circadian rhythm regulator glycogen synthase kinase 3 and alters the biological cascade that follows. By taking a close look, we can comprehend implications for mania as well as for treatment with lithium: Neurobiologically, lithium disrupts manic rhythm dysregulation and restores a more “normalized” temporality. The consequence is no less than the return of the existential self.

A receptor mechanism of action for lithium additionally portends future specific and safer treatment options “after lithium.”

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Drawing in autistic spectrum disorder children
Authors: Cepedello S. , Adrian A.S. , LAura G.B. , Eduardo M.T. , Nieves D.U.V. , Henar D.L.R. , Aldara Á.A.
Published: June 2017

Introduction

Drawing can be a tool to complete the psychodiagnose process, especially in children with expression and verbal problems.

The autistic spectrum disorder (ASD) children have problems to describe their feelings and emotions, they can provide us many information drawing their own world.

Objective

The purpose of this study was to discover the psychopathology of children with ASD through their drawings.

Methods

A4-sized booklets were given for ASD children from 6 to 16 years to draw an imaginary family (L. Corman), a human figure (Buck) or a free drawing.

Results

In most of the drawings of ASD children, we could find at least one of the three criteria of ASD: social deficits, communication difficulties and restricted interests.

Conclusions

A projective technique as drawing could help us to discover additional information about our patients, specially children and mainly the ones who had problems with the expression of feelings like ASD children.

The act of drawing can be used to understand children's struggles, their internal world. Moreover, it could also help the children gain insight and review progress through drawing records.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Adolescence and self-injuries
Authors: Dörr A. , Viani S. , Yamil Q.
Published: June 2017

This article is a reflection on the current affairs and an invitation to think about worrying phenomena in youngsters: self-injuries or cuts in the arms in eight young adolescent patients. We try to figure out the underlying cause of such behavior, which is more common every day and reveals some characteristics of society. Sociocultural, individual and family changes are analyzed, showing possible connections among these instances, identity and self-injuries. We suggest that the difficulties in identity development may be related to practices such as self-injury or others, which are related to mentalization problems. In the sociocultural level we find a way to socialize in which subjective discomfort has increased, there is overabundance, mass consumption, and the traditional social institutions (family, school and religion) have failed. Youngsters do not know themselves nor their projects. This difficulty is accompanied by an individual's failure in mentalization capacities (name one's feelings), leading the suffering youngster to practices such as self-injuries, which become permanent. Finally, the particulars of family relationships are described: distance between parents and their offspring, with the life experiences of the former being less appreciated by their offspring while forming their own identity, this is, they are responsible of becoming the architects of their own identities. They are orphans without traditions, which are sources of identity and innovation; to know who we are we must know where we come from.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
The psychological profile and the counter attitudes of encopretic children's mothers: A Tunisian study
Authors: Kammoun W. , Walha A. , Hadjkacem I. , Baccouche K. , Chaari H. , Ayadi H. , Moalla Y. , Ghribi F.
Published: June 2017

Introduction

Persistent encopresis is part of a fairly specific pathologic complex including personality, and familial factors. To a very large extent, interest in encopresis issues has revolved around the mother–child relationship.

Objectives

In this study, we aimed to assess the psychological profile and the counter attitudes of encopretic children's mothers.

Methods

We led a retrospective and descriptive study carrying on 91 medical records of children with encopresis, followed in the outpatient child psychiatry department of the Hédi Chaker university hospital of Sfax over a period of seven years, going from January 1st, 2000 till December 31st, 2006.

Results

In our study, emotional deprivation was noted in 62.2% of cases. Besides, repeated separations from mothers were noted in 26.4% of cases with 2.2% cases of prolonged separations. Our study also revealed that 19.8% of mothers have obsessive personality traits while 14% have rather anxious traits. Furthermore, 6.6% of encopretic children's mothers were found to have anxio-depressive spectrum disorders according to the DSM-IV-TR. Mothers’ intolerance towards encopresis was estimated at 53.3%. This intolerance was mainly reflected in physical punishment, depreciation, blame and humiliation. Toilet training was rigid in more than half of cases (62.2%).

Conclusion

Childhood encopresis can be viewed as a result of a maternal-child conflict. In fact, the mother–child relationship appears to be directly involved in the genesis of encopresis. Nevertheless, the role of the own child neurodevelopmental state in response to the family system should not be ignored.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Visual delayed memory in ADHD children
Authors: Kiselev S.
Published: June 2017

It was shown that children with ADHD have deficit in cognitive abilities. Particularly, in our previous research we have revealed that children with ADHD have weakness have deficit in memory for faces and for names in delayed recall condition.

The goal of this research was to examine the hypothesis that children with ADHD have weakness in visual memory in delayed recall condition.

The experimental group included 19 children with ADHD at age 6–7 years. The control group included 19 typically developing children. The children from experimental and control group were matched for IQ, gender and age.

Children from both groups were assessed with visual memory subtest from Luria's neuropsychological assessment battery. This subtest is designed to assess the ability to perform the visual memory for objects in immediate and delayed conditions. Two-way ANOVA was used to reveal group differences in reproducing the objects in two conditions.

We have not revealed significant differences between children from experimental and control group in the reproducing the objects in immediate condition. However, the interaction of condition type and group was significant (P ≤ 0.05). ADHD children were less successful in reproducing the objects in delayed condition.

In view of the obtained results, it can be assumed that children with ADHD have specific deficit in memory domain – weakness in delayed memory.

Disclosure of interest

The author has not supplied his declaration of competing interest.
Autism, psychosis and marfan: The Lujan–Fryns syndrome
Authors: Montero G. , Alberdi I.
Published: June 2017

Objectives

We report the case of a 19-year-old male who was brought to our psychiatry consultation by his family for behavioural disorders and poor school performance of years of evolution.

Results

We found ourselves before a tall, thin, childish, suspicious, perplex, inhibited and minimizer patient, so we sent him to our hospital for psychiatric admission, where he showed a flowery delirium of mystic, religious and megalomaniac content; complex visual and auditory hallucinatory phenomena; and where he was diagnosed of acute polymorphic psychotic disorder and autism spectrum disorder with marfanoid habit. Therefore, we suspected a Lujan–Fryns syndrome and requested genetic confirmation. Risperidone was prescribed as solo treatment, with a rapid control of the symptoms.

Conclusions

Lujan–Fryns syndrome, first described in 1984, corresponds to a sequence mutation in exon 22 of med12 gene of chromosome X. It is hard to suspect and diagnose before puberty. Those affected have marfanoid habit and also other psychiatric manifestations such as autistic behaviour, mild-moderate mental retardation (there are some reported cases with normal intelligence), language disorders, emotional instability, aggressiveness, hyperactivity, shyness which can be extreme, obsessive-compulsive disorder, isolation, delusions, visual and auditory hallucinations, and there are cases that describe schizophrenia. Its diagnosis requires adequate physical and psychopathological examination, and it is established with clinical suspicion and genetic confirmation. There are very few cases described and there is little bibliography available about Lujan–Fryns syndrome [1].

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Non-suicidal self-injury in adolescents: A diagnostic and psychopathological approach. A case presentation
Authors: Ortega Garcia M.D. , Marti Garnica V. , Garcia Marin S. , Martinez Martinez C. , Gomez Martinez R. , Blanco del Valle P.
Published: June 2017

Self-injurious behavior is a major public health problem. An increase in the number of self-injuring adolescents has been observed since the mid-1960s.

Description of clinical case

C. is a 14 teenager who comes to a mental health center for the first time a year ago for having numerous self-injuries in the forearm. She says that she cannot avoid doing so in moments of anxiety and that, in addition, when she is hurt she calms down. Throughout the interviews, C. relates that after the death of her best friend in a traffic accident she is alone and with episodes of anxiety.

Exploration and complementary tests

It is important to analyze the risk factors of self-injurious behaviors in adolescence such as:

– personal characteristic;

– psychiatric disorders;

– family characteristics;

– mass media.

Diagnosis

Depressive episode (F32).

Differential diagnosis

In general, self-injury is considered as a symptom or characteristic of a specific psychiatric disorder. Stereotyped self-injury is characteristic of processes of cognitive deficit of the level of severe and profound mental retardation. Compulsive self-harm involves symptomatic habits such as severe scratching of the skin or already differentiated psychiatric entities, such as trichotillomania, onicofagia or delusional parasitosis… Important psychotic disorder.

Conclusions

Following the Task Force's criteria, in relation to probably effective therapies, it can be concluded that the therapy based on mentation for adolescents (MBT-A) is the first effective treatment for the treatment of self-harm in adolescents.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Must we fear antidepressants in adolescents?
Authors: Paulino S. , Santos N. , Almeida A.C.
Published: June 2017

Introduction

Epidemiological studies have established that teenager's prevalence rates of major depression are significant (10%). The media has given a good deal of attention to the potential risks of antidepressants and their connection to increased suicidality (especially in children and adolescents). These concerns have had a significant impact on both the prescribing of antidepressants and the parental fears about their use. It is interesting to note that in large groups’ studies of adolescents treated with selective serotonin reuptake inhibitors there have been no evidence of increased suicidal risk.

Objective

Understand if there is a significant association between antidepressant treatment and suicidality in a 3-months follow-up study of the adolescent's consultation of Centro Hospitalar Lisboa Norte.

Methods

Analysis of 81 adolescents with an initial diagnosis of major depression treated with an antidepressant for at least 3 months.

Results

After the follow-up period there has been an improvement in sadness in 92.6% of the adolescents, a remission of death thoughts in 98.8% and an absence of suicides attempts. In 61.7%, it was necessary to introduce also an antipsychotic in a low dose and in 12.3% another antidepressant with a hypnotic effect.

Conclusion

It is clear that untreated major depression carries significant suffering and disability. Although treatment with antidepressants may take several weeks before clinical improvement appear and depression may worsen in the first days, its therapeutic effect should not be underestimated even if becomes necessary to add another medication in the first days. In evaluating these kinds of concerns, we must always differentiate between media hype and scientific data.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Emotion dysregulation and sex working belief in sample of adolescents
Authors: Petrocchi C. , Velotti P.
Published: June 2017

Introduction

In the last decade, international study attention to the problem of risk of sexual behavior in adolescents has grown. Some research has shown emotion dysregulation to be an important predictors of forbidding outcomes for example alcohol and drugs abuse or risky sexual behavior.

Objectives

The aims of this study are analyze emotion dysregulation in adolescents and their belief regarding sex working of adolescents.

Methods

The sample is composed by 123 participants (58 male adolescents, and 65 female adolescents, they is 14–15 years). All participants completed a self-report questionnaire, Difficulties in Emotion Regulation Scale. Them, participants responded to questions on prostitution.

Results

Frequency analysis showed that 78% of participants believe that prostitution is wrong; 1.4% of adolescents believe that the voluntary prostitution is not wrong; 2.4% believe that prostitution is not wrong if it can economically help their parents; and 4.9% believe that prostitution is wrong only if the customer is an adult. Regarding emotion dysregulation, test t analysis highlights some differences between male and female. The female presents difficulties (P = 0.025) to strategies respect male adolescents and they manifest a tendency to significative difference in impulse (P = 0.061) and goals (P = 0.067).

Conclusions

These preliminary results show that females may experience greater difficulties to take functional strategies to regulate emotions and could risk adopting risky sexual behavior such as prostitution.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Psychopathological approach of unsafe games among teenagers: A case report
Authors: Ben Hamouda A. , Bourgou S. , Ben Rejeb S. , Hamza M. , Saguem B.N. , Charfi F. , Belhadj A.
Published: June 2017

Introduction

Voluntary asphyxiation by practicing unsafe games such as choking, hanging, strangulation or other means of inducing hypoxia/anoxia is not uncommun among adolescents and can lead to unintended death but it stills not very well-known so underestimated by parents and underdiagnosed by health professionals.

Objectives

Study of clinical, psychological and psychopathological features in adolescent practicing unsafe games through a case report and a literature review.

Methods

We will present the case of a 14-year-old boy followed up in the Child and Adolescent Psychiatry Department of Mongi Slim Hospital (La Marsa, Tunisia) for behavioral disorders and recurrent syncope. This case report will be supported by a literature review.

Case report

S.B., 14-year-old boy, unique child of two divorced parents, with precarious family socio-economic conditions, no apparent medical problems and no known history of drug or alcohol abuse, suicidal ideation or suicide attempts, consulted first time in the department for behavioral disorders. The diagnostic of dysthymia was made. Seven months later, he was hospitalized in the medical intensive care unit for postictal coma. All medical investigations were normal. In the following, S.B. revealed that he used to practice voluntary asphyxiation by compressing the two carotids using his fingers until loss of consciousness. The diagnosis of paraphilia (DSM-5) was established.

Conclusions

Early recognition of such cases and awareness of psychological and psychopathological motivations might prevent serious complications and lethal outcome for these “unsafe-young-players”.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Quality of life in parents of children with attention-deficit-hyperactivity disorder
Authors: Khemakhem K. , Sahnoun C. , Ayadi H. , Boudabbous J. , Cherif L. , Walha A. , Moalla Y. , Hadjkacem I. , Ghribi F.
Published: June 2017

Aim

The aim of our study was to investigate and compare the quality of life of parents of children with ADHD and parents of children within psychiatric troubles.

Methods

We conducted a cross sectional and comparative study, on 20 families of children with ADHD, followed in child and adolescent psychiatry department of Sfax, Tunisia, and 20 control families. We used the Short Form Health Survey (SF 36) translated and validated in Arabic to evaluate the quality of life of the parents of the two groups.

Results

The average age of the patients of our survey was 9 years 8 months with a predominance of boys. We objectified a significant difference between the overall scores of the quality of life of parents of children with ADHD and the control sample. A highly significant difference was noted in the following areas: mental health, bodily pain and social functioning. The difference was significant in vitality score. The difference was not significant in 4 scores: general health, physical functioning, role physical, and role emotional.

Conclusion

Families with a child with ADHD have many challenges which impact certainly in their quality of life. As a child and adolescent's psychiatrics, we should be aware of these consequences in order to help the parents to improve their quality of life.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
The WHO ICD-11 classification and diagnosis of mental disorder in people with disorders of intellectual development (PWDID): An international study on clinical utility
Authors: Cooray S.E. , Alexander R. , Weber G. , Bhaumik S. , Roy A. , Roy M. , Bakheet A. , Devapriam J. , Mendis J. , Javed A.
Published: June 2017

Introduction

Constituting 2% of the population, PWDID are a vulnerable group with a higher prevalence of mental disorders than the general population. ICD diagnostic criteria often rely on adequate cognitive functioning and hence diagnosis of mental disorders in PWDID can be difficult, consequently leading to inequity of treatment, prognosis and stigma. Our study critically analysed the available evidence base and explored the feasibility of applying modified diagnostic criteria within the context of cumulative iterative iteration. We present the outcome using diagnosis of DID and anxiety disorder as examples.

Aims

Address current shortcomings in ICD classification regarding PWDID by contributing effectively to the WHO ICD-11 consultation process in collaboration with international stakeholders.

Objectives

Facilitate accessibility of ICD-11 criteria for diagnosis of mental disorders capable of engendering robust evidence based epidemiological data and healthcare in PWDID.

Methods

We evaluated current evidence via a systematic literature search utilising PRISMA guidelines and developed pragmatic guidelines to adapt ICD diagnostic criteria in PWDID. A brief screener [Glasgow Level of Ability and Development Scale (GLADs)] for detecting DID was also studied internationally within the context of clinical utility (n = 136).

Results

The evidence base relating to mental disorders in PWDID is poor, significantly hampered by difficulties in applicability of diagnostic criteria. The GLADs appears to be a promising screening tool with good clinical utility for detecting disorders of intellectual development (DID) particularly where resources are scarce.

Conclusions

Pragmatic modifications to ICD-11 diagnostic criteria and the GLADS tool facilitates its clinical utility for PWDID and contributes significantly to enhancing research based evidence, and, ultimately their health access and well-being.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Translational inhibitors as potential therapeutic tool of human neuroblastoma through mitochondrial gene expression
Authors: Hina S.
Published: June 2017

Neuroblastoma is a solid neuroendocrine tumour and most common type of cancer of infancy. It is a complex heterogeneous disease and many factors such as molecular, cellular and genetic features are involved in its development. Mitochondria play a pivotal role in neuronal cell survival or death. Neurons are highly reliant on aerobic oxidative phosphorylation (OXPHOS) for their energy needs. Defective activities of mitochondrial complexes I, II, III and IV have been identified in many neurological and neurodegenerative diseases. Human mitochondria with its own genetic material meet the needs required for the assembly of subunits of the oxidative phosphorylation (OXPHOS) complexes. A number of translational inhibitors are known that could potentially effect translation of mitochondrial protein synthesis. Among these puromycin, homoharringtonine and cyclohexamide were selected for the present study. The effect of these translational inhibitors on mitochondrial gene expression for the treatment of neuroblastoma are not well established. Therefore, in this study, we have investigated the effects of these translational inhibitors on the expression of human mitochondrial gene expression in SH-SY5Y neuroblastoma cells.

We observed a significant effect on the level of mitochondrial transcripts upon exposure to these translation inhibitors in SH-SY5Y cells, however, the effects on expression of mitochondrial proteins were minimal. This suggests that translational inhibitors might not directly affect the abundance of mitochondrial proteins. Translational inhibitors induce significant effect on mitochondrial gene expression that can be lead to the new-targeted therapy for treating neuroblastoma.
Prevalence of psychiatric comorbidities in epilepsy
Authors: Charfi N. , Daoud S. , Farhat N. , Bouali M. Maâlej , Zouari L. , Zouari N. , Thabet J. Ben , Damak M. , Mhiri C. , Maalej M.
Published: June 2017

Introduction

Epilepsy is a chronic disease defined as a brain disorder, characterized by a predisposition to present seizures, generating cognitive, psychological, and social consequences.

Objective

To determine the prevalence of psychiatric comorbid disorders in patients with epilepsy (PWEs) and its associated factors.

Methods

We conducted a cross-sectional study involving 30 PWEs who were treated in the neurology department of Habib Bourguiba Hospital in Sfax, Tunisia. We used the Mini International Neuropsychiatric Interview for the diagnosis of Axis I psychiatric disorders.

Results

The half of patients had psychiatric comorbidities: 4 had major depressive disorder (MDD), 2 had MDD with generalized anxiety disorder, 4 had MDD with social phobia, 1 had bipolar disorder type I, 1 had panic disorder, 1 had agoraphobia and 2 had generalized anxiety disorder.

Twenty-five PWEs had seizure-onset below 30 years old and among them, 40% had psychiatric comorbidities. Among patients who had seizure-onset above 30 years old, none had psychiatric comorbidities. Psychiatric comorbidities were found in 71.5% of patients with seizure frequency >2 per year. Psychiatric comorbidities were more common in patients with generalized seizures compared to whom with partial seizures (53% versus 45%). It was also more common in patients treated with polytherapy compared to whom with monotherapy (64% versus 37.5%).

Conclusion

The prevalence of psychiatric comorbidities is relatively high among PWEs. The most frequent diagnoses found were mood and anxiety disorders. It is very important to identify them and treat them to enhance seizure control.

Disclosure of interest

The authors have not supplied their declaration of competing interest.