bluuebunny/crossref_metadata_2025 huggingface dataset:
The Experience of Shame in Patients with Chronic Obstructive Pulmonary Disease (COPD)
Authors: Tzitzikos G. , Gourgoulianis K. , Kotrotsiou E. , Bonotis K. , Gouva M. , Kotrotsiou S. , Paralikas T.
Published: June 2017

Introduction

It is reported in global literature that Chronic Obstructive Pulmonary Disease (COPD) may cause a wide range of psychological effects, some of them not fully explored. The aim of this study is to investigate if patients with COPD experience intense feelings of shame.

Objectives

To find differences in shame experience between males and females, and if there is a correlation of shame with other socio-economic factors.

Method

Using the “Experience of Shame Scale” questionnaire (ESS) in 191 patients with COPD (104 men and 87 women) treated in Primary Health Care services in Greece.

Results

Statistical analysis showed relatively low scores (M 39.5 sd 14.9) for the experience of shame in COPD patients. There is no statistically significant difference of shame for marital status, education level or disease stage. Statistically significant difference shown between males and females (bodily shame P: 0.001, total shame P: 0.031), and between smokers and those who quit smoking. (characterological shame: P: 0.007 behavioral shame P: 0.030, total shame P: 0.009). Also statistically significant difference appears for bodily shame among Body Mass Index (BMI) groups (P: 009) and economic status of the patients (P: 0.008).

Conclusions

Patients with COPD seem to have not heavy burden with experience of shame. Any associations of shame with some patient groups are rather expected for cultural and social reasons.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Insight and Social Cognition in First Episode of Psychosis
Authors: Martínez L. , Mané A. , Cortizo R. , Cáceres I. , Treen D. , Galindo L. , Salgado P. , Berge D.
Published: June 2017

Introduction

Impairment of insight in psychotic disorder is associated with adverse impact in treatment compliance, outcome and social functioning although its underlying mechanisms are still unknown. Social cognition and more specifically Theory of mind have been proposed to be correlated to insight. However, the relationship between both factors is still not well defined.

Aims

To study the association between social cognition and insight into mental illness in individuals with early psychosis included in the first episode of psychosis program of Hospital del Mar.

Methods

From the 94 patients included in the first psychotic episode program between January 2011 and January 2016, thirty-eight patients were evaluated six months after the episode. The three initial items of SUMD (Scale Unawareness of Mental Disorder) were used to measure insight and MSCEIT (Mayer-Salovey-Caruso Emotional Intelligence Test) was used to assess social cognition. Linear correlation analysis by Pearson correlation was conducted.

Results

Insight results of SUMD six months after the first episode of psychosis were significantly associated with several subsections of MSCEIT, such as experiential area total punctuation (r = –0.574; P = 0.025), emotional facilitation section (r = –0.633; P = 0.011) and the facial emotion perception task (r = –0.572; P = 0.026).

Conclusions

Results suggest an association between insight and emotional perception and facilitation performance in first episode patients, which may suggest a role of social cognition in psychosis insight impairment. Further research to better define the participation of social cognition in insight into psychosis alteration is mandatory to understand the etiology of insight, define treatment targets and consequently improve the disorder prognosis.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Neuropsychological Profile of Specific Executive Functions in Patients with Deficit and Non-deficit Schizophrenia
Authors: Pelka-Wysiecka J. , Ernest T. , Monika M. , Jerzy S.
Published: June 2017

Although it has been shown that there are more profound deficits present in the deficit schizophrenia (DS) patients compared with their non-deficit (NDS) counterparts, there still remain a few matters that require further investigation.

Aims

(1) Comparison of executive functions between the investigated groups; (2) determining the relationship between their particular aspects within the groups; and (3) drawing up their neuropsychological profile.

Methods

One hundred and forty-eight schizophrenia patients, divided into two groups: patients with DS (n = 70) and NDS (n = 78). Patients were matched for sex, age, number of years of education and their overall cognitive functioning. For the assessment of executive function, we used the Wisconsin Card Sorting Test (WCST), the Trail Making Test (TMT), Verbal Fluency Test Phonemic (VFT P), Stroop Color Word Test (SCWT) and Go/No Go task (GNG).

Results

The DS patients compared with the NDS ones obtained lower scores in WCST and TMT (relative flexibility). We did not observe any inter-group differences in VFT P, SCWT (relative inhibition) or the GNG. In both patient groups, there appeared significant correlations between their WCST and TMT scores. The general neuropsychological profiles were similar in both groups. The DS patients exhibited slightly greater interference within concept formation and non-verbal cognitive flexibility. Such problems may therefore be specific to that particular subset of schizophrenia. Our results may be useful for the development of new rehabilitation activities, which may increase the chance of the patients’ better social functioning.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Is There an Association Between Body Uneasiness and Aberrant Salience in Anorexic Patients? A Preliminary Study
Authors: Mallardo L. , Campone B. , Tofani T. , Ciampi E. , Corsi E. , Baschirotto C. , Appignanesi C. , Lelli L. , Pietrini F. , Rotella F. , Ricca V. , Ballerini A.
Published: June 2017

The process whereby objects and representations come to be attention grabbing and capture thought and behaviour is called salience, and it is defined as aberrant when a significance is allocated to neutral stimuli. The Aberrant Salience Inventory (ASI) is a scale to measure aberrant salience, characterized by 29 dichotomic items. By now, a correlation between aberrant salience and eating disorders is unknown. Aim of this study is to evaluate an alteration of salience in patients with anorexia nervosa, to estimate the existance of a correlation between aberrant salience and the experience of body shape.

Methods

Twenty-six female patients with AN (diagnosed using DSM-5) were enrolled at the Psychiatry Department of Florence. Psychopathological features were assessed at the time of enrollment using the following scales: SCL-90-R, BUT, EDE-Q. Salience alteration was assessed by the means of the ASI. Statistical analysis were realized using SPSS 20.0 with Spearman bivariate correlation.

Results

Mean age was (mean ± SD) 26.2 ± 8.72 and mean Body Mass Index (BMI) 16.1 ± 2.46. Global Severity Index (GSI), Positive Symptom Total (PST) and Positive Symptom Distress Symptom Index (PSDI) were estimated for BUT and SCL-90-R and compared to total value of ASI. Thus, we found a statistical significant (P < 0.05) direct correlation between ASI and BUTpsdi and ASI and SCL-90-Rgsi (correlation coefficient of 0.446 and 0.398, respectively).

Conclusion

In this study, we found a significant direct correlation between Aberrant Salience Inventory (ASI) values and one dimension of body uneasiness in anorexic patients. These preliminary data need further studies with a wider sample to confirm the above-mentioned data.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Anxiety, Depression and Suicidal Behavior Among Medical Students from the University of Valladolid
Authors: Alvarez Astorga A. , Red Gallego M.H. De la , Alonso Sánchez A. , Fuente Ballesteros S. De la , Delgado Santillana T. , Hernandez Anton R. , Gómez García M. , De Lorenzo Calzón M.M. , Mayor Toranzo E. , Blanco Garrote J.A.
Published: June 2017

Introduction

Suicide is a major public health problem, especially in young people. It is one of the most significant causes of mortality and potential years of life lost. Medical students are a vulnerable group presenting mental health problems.

Objectives

To study the prevalence of common mental illnesses among medical students from the university of Valladolid in order to assess the need for intervention programs.

Methods

Cross-sectional study in which, 584 students participated during the academic year 2015–2016 by completing an online self-administered questionnaire. Mental health outcomes were measured by different batteries of depression, anxiety and suicide (BDI, GAD-7 and MINI). Information about possible related risk factors was also obtained. Statistical Chi2 and Student t-tests were applied to estimate associations between socio-demographic, socioeconomic data and clinical results.

Results

We found a prevalence of 15.8% for depression, 11.6% for ideation suicide and 38.5% for anxiety, with gender differences in the latter case. Prevalence rates were higher than those described in general population. Compared to other international studies, prevalence estimates were also higher among our sample.

Conclusions

This study shows for the first time data of these three psychiatric disorders among medical students in Spain. It suggests the urge to implementing preventive activities to alleviate maladaptive behaviors, academic stress, improve the quality of life and adaptation of students to college life. Larger, prospective, multicentre studies are needed to draw conclusions about the causes and consequences of students’ stress, since evidence shows that mental health problems are perpetuated throughout professional performance.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
A Descriptive Analysis of Psychological Factors and Childhood Trauma in a Sample of Suicide Attempters
Authors: Delicato C. , Gattoni E. , Di Marco S. , Venesia A. , Vecchi C. , Bert F. , Zeppegno P. , Gramaglia C.
Published: June 2017

Introduction

Childhood trauma, especially sexual abuse, is associated with an increased risk of suicidal behavior. However, studies also show that according to the stress-vulnerability model, not all individual exposed to this kind of trauma exhibit suicidal behaviors as some protective factors could diminish the aforementioned risk, such as personality factors. Resilience might be one such a protective factor. Furthermore, there has been growing evidence to support the role of impulsive and aggressive behavior in the risk of suicide.

Objectives

To compare suicide attempters to non-suicide attempters (patients admitted for any other reason) for as far as psychological features and childhood trauma. To verify the role of resilience and coping strategies as protective factor for suicide attempt, mitigating the risk of an individual who has experienced childhood trauma.

Methods

We recruited patients referred to the inpatient and outpatient facilities of psychiatry ward of “Maggiore della Carità” hospital in Novara during the period November 2015–December 2016. We included all patients from 18 to 65 years with a psychiatric disorder that met DSM–5 diagnostic criteria. For the analysis, we divided patients into two subgroups according to the presence/absence of suicidal behaviors. The assessment included: Resilience Scale for Adult (RSA), Brief cope, Rosenberg Self-esteem Scale (RSES), childhood trauma questionnaire (CTQ), temperament and character inventory (TCI).

Results and discussion

Although, the recruitment is still ongoing preliminary results seem to confirm the role of resilience and coping strategies as protective factor mitigating the risk of an individual who has experienced childhood trauma from making a suicide attempt.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Acute Psychiatric Involuntary Admissions in a Gneral Hospital After Suicidal Behavior. A 2-Year Follow-Up
Authors: Fernandez Miranda J.J. , Frias Ortiz D.F. , Fernandez Diaz S.
Published: June 2017

Introduction

Patients with a plan, access to lethal means, recent social stressors and symptoms suggestive of a psychiatric disorder should be hospitalized immediately. Sometimes involuntary hospital admission is used to avoid a suicidal behavior, taking into account that after a suicide attempt 25% of people repeat attempt and 10% die by suicide.

Objectives/aims

To know hospital admission due to suicide attempts, and how many of them were involuntary.

Method

A 2-year retrospective study (2014–2015) of all cases admitted after suicidal behavior in an acute psychiatric ward in a general hospital in Gijón (Spain). Reasons for hospital admission were registered, including suicide attempts. And also if admissions were involuntary.

Results

The total number of admissions to the psychiatric unit in 2014–2015 was 2376. Admissions due to suicide attempts were 427; 300 of them were involuntary admissions. There were a total of 347 involuntary admissions these two years; among them, due to suicide attempt: 300.

Conclusions

Most of involuntary admissions in the psychiatric unit of the hospital studied followed a suicide attempt, as a prevention of repeated suicidal behavior. Obvious high risk of repeat suicide attempt generates an urgency to make an accurate assessment and create a safe treatment plan and determine to retain suicidal patients.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Clinical Features of ADHD: An Assessment of Suicide Risk and Substance Abuse
Authors: Giordano G. , Falcone G. , Nardella A. , Erbuto D. , Migliorati M. , Innamorati M. , Girardi P. , Pompili M.
Published: June 2017

Introduction

Several studies show that attention-deficit/hyperactivity disorder (ADHD) may persist into adulthood, increasing the risk of antisocial behaviour, drug abuse, psychiatric comorbidities, aggressive behaviour, social impairment and suicide risk.

Objectives

Analyze correlations among ADHD, substances abuse, alcoholism and suicide risk.

Aim

The aim of our study is to better understand the clinical features of ADHD during adulthood.

Methods

We analyzed the presence of ADHD symptoms, suicide risk and levels of hopelessness, alcoholism and substance abuse in a sample of 50 (40% males) in/outpatients of S. Andrea Hospital in Rome, between February and May 2016. We administered the following scales: Adult-Self Report Scale (ASRS), Columbia Suicide Severity Rating Scale (C-SSRS), Beck Hopelessness Scale (BHS), Michigan Alcoholism Screening Test (MAST), Drug Abuse Screening Test (DAST).

Results

In our sample of 50 adult patients, 20% had ADHD symptoms (10 subjects). We found that those with ADHD showed more frequently death desires (85.7%; χ2 = 1.31; P = 0.25) and higher levels of hopelessness (66.7%; χ2 = 0.83; P = =0.36) if compared to subjects without ADHD symptoms (respectively 63% and 45.8%). In the overall group of ADHD patients, 10% showed severe alcoholism, 20% (χ2 = 1.39; P = 0.49) had a borderline behavior, whereas 40% presented a substance abuse (χ2 = 1.75; P = 0.18).

Conclusions

ADHD may represent a psychiatric disorder with an increased suicide risk. It would be important to screen for suicidality and comorbid symptoms routinely in ADHD in order to improve the treatment of the patients.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Is There a Case for Using Social Outcomes in Self-Harm Research?
Authors: Huxley P. , Ahmed N.
Published: June 2017

Introduction

Self-harm is costly to individuals and health services and has high associated risks of further self-harm and completed suicide. Self-harm presentations to hospitals offer an opportunity to engage patients in interventions to help reduce future episodes and associated costs. This presentation reviews clinical trials for self-harm interventions conducted over the past twenty years in hospital emergency departments (1996–2016) comparing successful vs. unsuccessful trials (defined by the whole or partial achievement of trial defined outcomes) in terms of methodology, type of intervention and type of outcome measure.

Method

Databases were searched using defined keywords. Randomized trials of adult subjects presenting to emergency departments were selected.

Results

Twenty-four studies are included in the review. There was no significant difference between the type of intervention and “success”, nor were there index/control differences by sample size and follow-up length. Most trials (79%) used re-admission to hospital after a further episode as the primary outcome; only 4 (16%) of the studies reported social outcomes. As an example of social interventions and outcomes, we discuss trial results of a new social intervention for adults (many of whom do not receive a (UK-mandated) psychosocial assessment), and who are usually provided with little/no support after leaving the emergency room.

Discussion

The findings suggest that the use of repetition and re-presentation as outcome indicators may be missing the importance of social precipitants of self-harm and the need to assess social circumstances, interventions and outcomes. We discuss findings from a new social intervention trial, which addresses these limitations.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Methylation Related to Perceived Parenting in Adolescents and its Association to Depressive Symptoms Two Years Later
Authors: Van Assche E. , Vangeel E. , Freson K. , Van Leeuwen K. , Verschueren K. , Colpin H. , Van den Noortgate W. , Goossens L. , Claes S.
Published: June 2017

Introduction

Adolescents’ well being is affected by their parenting situation and can influence their well being over time. We present an exploratory study with an Illumina 450 k array, comparing methylation in adolescents, based on perceived parenting at T0, and how methylation can interact with parenting in explaining depressive symptoms two years later (T2).

Objectives

Identify differentially methylated regions (DMRs) associated with perceived parenting at T0 and investigate their association with depressive symptoms two years later.

Aims

An exploratory analysis evaluating the association between methylation and depressive symptoms longitudinally.

Methods

From two extreme parenting clusters: perceived supportive, and punishing neglecting, we randomly selected 44 adolescents (MAge = 14 at T0; 48%boys). The CES-D scale (Center for Epidemiologic Studies Depression Scale) assessed depressive symptoms. DMRs were identified based on the parenting clusters (DMRcate and comb-p) using llumina Infinium HumanMethylation 450 BeadChip data. Associations between the most significant CpG for each DMR and the depression score at T2, were calculated using linear regression analysis.

Results

We identified 17 DMRs, but only cg13306335 in PEX10 was associated with depressive symptoms at T2 (P = 0.0014, Bonferroni (17 tests): P < 0.0029). Additionally, an interaction between parenting at T0 and PEX10 methylation (T0) in explaining depressive symptoms (T2) can be suggested (P = 0.014).

Conclusions

We show that methylation at PEX10's most significant CpG is correlated with depressive symptoms at T2, these exploratory results also suggest a possible interaction between parenting and PEX10 methylation at T0 in association with depressive symptoms at T2. Validation in a larger sample is needed to support the role of methylation and its interactions in depression over time.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Development and Evaluation of a Psychosocial Model for Children Who Experience Trauma from Low and Middle-income Countries
Authors: Vostanis P.
Published: June 2017

Introduction

Despite fragmented evidence on individual interventions, good practice and child welfare programmes in low and middle-income countries (LMIC), there is no comprehensive model for early interventions, particularly for children who experience complex trauma.

Objective

The objective of the World Awareness for Children in Trauma (WACIT: www.wacit.org) is to develop an evidence-based psychosocial model for vulnerable children in low and middle-income countries with limited or no access to specialist resources.

Methods

The aim of the preliminary evaluation was to establish stakeholders’ views on the extent of need, socio-cultural context, service gaps, and recommendations for improvement and creation of working partnerships. This consisted of four studies:

– 1. Participatory workshops in six countries (Turkey, Pakistan, Indonesia, Kenya, Rwanda, Brazil) with a total 250 strategic and operational stakeholders;

– 2. Quantitative evaluation in two of these countries (Turkey, 32 participants; and Brazil, 80 participants);

– 3. Interviews with 17 stakeholders from the six countries;

– 4. Focus groups with 7 children, 7 parents, 9 teachers and 11 other professionals in one country (Kenya).

Results

Findings indicated that lack of resources (funding, facilities, training and personnel), poor collaboration (between church, families, government, schools and community), impaired parenting, socio-economic challenges and limited knowledge on child mental health as key factors that impede interventions.

Conclusions

The findings have informed the next phase of the WACIT programme in developing sustainable networks, training, and culturally appropriate interventions in the participating LMIC.

Disclosure of interest

The author has not supplied his/her declaration of competing interest.
The cannabis profile: A high-risk subtype
Authors: Landera Rodríguez R. , Gómez Revuelta M. , García Egea J.L. , Porta Olivares O. , Juncal Ruíz M. , Pérez Herrera M. , Sánchez Blanco L. , Abejas Díez D. , Santayana Jenaro G. Pardo de , Fernández Rodríguez M.
Published: June 2017

Introduction

The first phase following the diagnosis of a first psychotic episode (FEP), is crucial to determine clinical and functional long-term outcome. Cannabis exerts a mediating action on the debut of the disease and determines a poor prognosis.

Objectives

The description of a specific population profile of increased vulnerability to maintain cannabis use after a FEP could help to identify this high risk subtype of patients and speed up the implementation of specific interventions.

Materials and methods

One hundred and seventy-eight patients were recruited from PAFIP (early intervention program on FEP), obtaining detailed socio-demographic assessment. They were followed-up for a year during which cannabis consumption was assessed by Drake scale every three months. We divided the sample into two groups:

– those patients who neither smoked cannabis before the FEP nor during follow-up period (nn);

– consumers group: cannabis users before the FEP who kept on smoking during the follow-up period (ss) and those who smoked before the FEP and gave up consumption during follow-up (sn).

Results

Statistically significant differences between groups were observed. The consumers group (ss + sn) had an earlier age of onset, most were male, unemployed, single, prone to loneliness and they were concomitant users of alcohol and tobacco.

Conclusions

The use of cannabis has a detrimental effect on the outcome of schizophrenia. A specific and early intervention could contribute to prognostic improvements. Identifying cannabis consumption subtypes could be useful for this purpose.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
A violation of emotion regulation as a central link in pathogenesis of stress-induced hypertension
Authors: Pervichko E. , Zinchenko Y. , Ostroumova O.
Published: June 2017

Introduction

Essential hypertension (EH) is one of the most common diseases of the cardiovascular system. Today, scientists discover more and more patients whose BP values during work appear to be higher than those values during free time. This form of EH is called “hypertension at work”.

Objective

To study the role emotion dysregulation in the pathogenesis of EH.

Materials and methods

A projective study of emotion regulation was undertaken with our modified version of Rosenzweig Picture-Frustration Test (Zinchernko, Pervichko). At the second stage of the study, the simulation of emotional stress with the aspiration level modelling was carried out. The level of state anxiety, BP values and levels of catecholamines, renin and angiotonin I were taken before and after the experiment. Eighty-five patients with “hypertension at work” (mean age: 45.9 ± 2.8), 85 patients with “classical” EH (mean age: 47.4 ± 4.5 years) and 82 healthy subjects (mean age: 44.9 ± 3.1) took part in the study.

Results

“Hypertension at work” patients significantly more frequently than patients from the second group and healthy subjects are more prone to rumination, disasterization and repression of their emotions. They will seldom employ the strategy of subjective-objective interactive transformations; their edibility to actualize new meanings in traumatic situations is diminished. We showed that emotion regulation strategies in “hypertension in the work” patients were ineffective in overcoming the emotional tension and created the conditions for chronization of high blood pressure, and could be considerded as the central link in pathogenesis of stress-induced hypertension.

Conclusion

The results contributes to enrich our understanding of etiology and pathogenesis of EH.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Prevalence, incidence and comparative meta-analysis of all-cause and specific-cause cardiovascular disease in patients with serious mental illness
Authors: Solmi M. , Veronese N. , Beatrice B. , Stella R. , Paolo S. , Davide G. , Collantoni E. , Pigato G. , Favaro A. , Stubbs B. , Carvalho A.F. , Vacampfort D. , Correll C.U.
Published: June 2017

Patients with severe mental illness (SMI) have been described at higher risk of cardiovascular disease (CVD). The aim of this systematic review and meta-analysis was to quantify prevalence, incidence, cross-sectional association and longitudinal increased risk of coronary heart disease (CHD), stroke, transient ischemic attack and cerebrovascular disease (CBVD), heart failure (HF), peripheral vascular disease (PVD), death due to CVD, and any CVD in patients with SMI. We included 92 studies, with a total population of 3,371,461 patients (BD = 241,226, MDD = 476,102, SCZ = 1,721,586, SMI = 932,547) and 113,925,577 controls. Pooled prevalence of any CVD in SMI was 9.9% (95% CI = 7.4–13.3) (33 studies, 360,144 patients). Compared to controls, after adjusting for a median of 7 confounders, SMI was associated with higher risk of CVD in cross-sectional studies, OR:1.53 (95% CI = 1.27–1.83) (11 studies), with CHD OR: 1.51 (95% CI = 1.47–1.55) (5 studies), with CBVD OR: 1.42 (95% CI = 1.21–1.66) (6 studies), and tended to be associated with HF OR: 1.28 (95% CI = 0.99–1.65) (4 studies). Cumulative incidence was 3.6 CVD events in a median follow-up period of 8.4 years (range: 1.76–30). After considering a median of 6 confounders, SMI was associated with higher longitudinal risk of CVD in longitudinal studies HR: 1.78 (95% CI = 1.6, 1.98) (31 studies), of CHD: HR: 1.54 (95% CI 1.30–1.82) (18 studies), of CBVD HR: 1.64 (95% CI 1.26–2.14) (11 studies), of HF HR:2.10 (95% CI 1.64–2.70) (2 studies), of PVD, unadjusted RR: 3.11 (95% CI 2.46–3.91) (3 studies), of death due to CVD, HR 1.85 (95% CI 1.53–2.24) (16 studies). In this meta-analysis, the association between SMI and CVD has been quantified in a world representative sample; we suggest prevention of CVD should be warranted as standard care in SMI.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Psychological and clinical factors associated with emotional distress related to type 2 diabetes mellitus
Authors: Stankovic Z. , Lalic K. , Jasovic M.
Published: June 2017

Introduction

Stress and coping with diabetes can affect the severity of disease directly, through pathophysiological processes or indirectly, through the patient's own perception of disease by deteriorating adherence to therapy and daily functioning.

Objectives

To investigate emotional distress related to T2DM according to demographic, clinical, psychological, metabolic and anthropometric characteristics.

Methods

Eighty-two in- and outpatients of both sexes (<65 years) with endocrinologist-diagnosed T2DM, duration ≥5 years, treated with either oral therapy, insulin or both, were included in this cross-sectional study. The Beck Depression Inventory (BDI) was employed for assessment of severity of depressive symptoms. The Mini Mental State Examination (MMSE) was used for assessment of cognitive status. The Problem Areas in Diabetes (PAID) (subscale related to emotional problems associated with T2DM) was applied for assessment of emotional distress. Clinical characteristics of the illness were obtained from medical records. Laboratory and anthropometric measures (Body mass index, Waist circumference) were also performed. The level of significance in statistical analyses (Student's t-test, Pearson's correlation) was P = 0.05.

Results

The PAID (emotional distress) subscore was significantly higher in patients with psychiatric heredity (P = 0.028) in relation to these without (Student's t-test). Considerable positive correlation between PAID subscore and BDI score (r = 0.588) (P = 0.000), and negative correlation between PAID subscore and MMSE score (r = −0.201) (P = 0.050) were also found (Pearson's correlation).

Conclusions

Psychological factors: psychiatric heredity, higher intensity of depression and poor cognitive functioning were significantly associated with emotional distress related to the illness in patients with type 2 diabetes mellitus.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Who did it? Exploring gaze agency in obsessive-compulsive (OC) checkers
Authors: Giuliani M. , Gregori Grigc R. , Martoni R.M. , Cavallini M.C. , Crespi S.A. , de'Sperati C.
Published: June 2017

Introduction

Clinically, OC-checkers often report staring compulsions and “lack of action completion” sensations, which have been linked to self-agency alterations. Belayachi and Van der Linden (2009) theoretically proposed that “abnormal” checkers self-agency could be due to an over-reliability on environmental cues and to a tendency to specify actions in a procedural and inflexible way, conceiving them as “low-level” agents. Currently, no studies have experimentally address this issue.

Objectives

To investigate self-agency in OC-checkers subtype, measuring gaze agency (the ability to understand that we can cause events through our eye movements) and taking into account both agency beliefs and agency feelings.

Methods

13 OC-checkers and 13 healthy controls underwent two tasks. “Discovery” task, a completely novel task used to examine causal learning abilities. Subjects watched bouncing balls on a computer screen with the aim of discovering the cause of concurrently presented acoustical beeps. “Detection” task, a two-alternative forced choice task that required subjects to tell whether or not the beeps were generated by their own eye movements.

Results

Checkers exhibit:

– lower performance scores and confidence ratings when they have to self-attribute the beep cause, but not eye behavioral differences, during discovery task;

– lower confidence ratings, but a level of accuracy similar to that of controls, during detection task.

Conclusions

Checkers do not show an altered self-agency per se, but what we have called a “doubtful” self-agency: indeed, we argue that agency beliefs alterations found during Discovery task can be due to pathological doubt, rather than to altered agency feelings.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Outcomes of involuntary hospital admission. Satisfaction with treatment and the effect of involuntary admissions on patients
Authors: Reshetukha T. , Alavi N. , Prost E. , Groll D. , Cardy R. , Mofidi N. , Wang P. , Patel C. , Sajid S.
Published: June 2017

Introduction

Involuntary hospitalization in those presumed to be mentally ill has been a common practice. Although some patients are hospitalized for aggression, two-thirds of the patients are hospitalized because of the threat they pose to themselves. Although these patients require risk assessment and evaluation for possible presence of mental illness, the question is how much these patients will benefit from involuntary admission and what the long-term outcome would be.

Method

All patients admitted involuntary to the psychiatric ward in Kingston, Canada, and psychiatrists involved in their care were interviewed to see whether they think the involuntary admission was helpful. All patients were asked to fill-out MacArthur AES to assess their satisfaction with hospitalization.

Results

Although psychiatrists frequently reported that the admission was justified, only 29 out of 81 patients reported being explained to why they had been admitted involuntarily. Also, there was a significant difference in AES scores between those who were and were not given an explanation for admission. In addition, psychiatrists more often reported that the involuntary admission worsened the therapeutic relationship which was significantly associated with involuntary admission that was not explained to patients.

Discussion

The results of our study shows that patients admitted involuntarily often feel disappointed with staff and mental health system. It could lead to feeling of hopelessness, frustration and low self-esteem. If explained, some patients who present with risk to self might accept voluntary admissions, that will improve therapeutic alliance with psychiatrists and increase satisfaction from hospitalization. Result of this study could improve the decision making process for involuntary admissions.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Evaluation of a nonsmoking program in psychiatric clinic
Authors: Jaber J. , Tomé A. , Castro F. , Hollanda A. , Reys B.
Published: June 2017

Introduction

The work evaluates the nonsmoking program successful experience, carried out between the years of 2008 and 2015 in a psychiatric clinic in the city of Rio de Janeiro, Rio de Janeiro, Brazil.

Objectives

The program has as objectives to evaluate the treatment of tobacco dependence in patients with disorders for the use of substances and other psychiatric disorders and the experience of transforming the therapeutic space of the clinic in a tobacco-free environment, considering that the use of tobacco is responsible for a large number of avoidable deaths and other aggravations to health.

Methods

The program achieved the objectives, assessing the promotion of the tobacco abstinence in a large number of patients, through the utilization of pharmacological treatment, cognitive behavioral psychotherapy, occupational therapy, art therapy and moderate physical activity.

Results

In a 12-month period, after carrying out the program, 48% of the assessed patients kept in tobacco abstinence.

Conclusions

The study showed the percentage of patients who were discharged on tobacco abstinence and the percentage of those who kept abstemious after 12 months, demonstrating that the nonsmoking program is an efficient tool in the tobacco dependence treatment and can be used over a psychiatric hospitalization with promising results.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Beyond the crisis: Ongoing psychiatric treatment and service utilization after initial symptom stabilization following first-episode psychosis for adolescents
Authors: Gearing R. , Brewer K. , Mian I. , Moore K. , Fisher P. , Hamilton J. , Mandiberg J.
Published: June 2017

Introduction

The importance of timely identification and treatment of psychosis are increasingly the focus of early interventions, with research targeting the initial high-risk period in the months following first-episode hospitalization. However, ongoing psychiatric treatment and service utilization after the symptoms have been stabilized over the initial years following first-episode has received less research attention.

Objectives

To model the variables predicting continued service utilization with psychiatrists for adolescents following their first-episode psychosis; examine associated temporal patterns in continued psychiatric service utilization.

Methods

This study utilized a cohort design to assess adolescents (age 14.4 ± 2.5 years) discharged following their index hospitalization for first-episode psychosis. Bivariate analyses were conducted on predictor variables associated with psychiatric service utilization. All significant predictor variables were included in a logistic regression model.

Results

Variables that were significantly associated with psychiatric service utilization included: diagnosis with a schizophrenia spectrum disorder rather than major mood disorder with psychotic features (OR = 24.0; P = 0.02), a first degree relative with depression (OR = 0.12; P = 0.05), and months since last psychiatric inpatient discharge (OR = 0.92; P = 0.02). Further examination of time since last hospitalization found that all adolescents continued service utilization up to 18 months post-discharge.

Conclusions

Key findings highlight the importance of early diagnosis, that a first degree relative with depression may negatively influence the adolescent's ongoing service utilization, and that 18 months post-discharge may a critical time to review current treatment strategies and collaborate with youth and families to ensure that services continue to meet their needs.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Impact of socioeconomic position and distance on mental health care utilization by incident users of antidepressants. A Danish nationwide follow-up study
Authors: Packness A. , Waldorff F. , Hastrup L. , Simonsen E. , Vestergaard M. , Halling A.
Published: June 2017

Introduction

Equal access to health care treatment is a highly prioritized goal in most OECD countries. Timely access has become a priority too; in Denmark now with a 4-week deadline from referral to diagnosis. When mental health services become more centralized and allocation of patients to treatment further away from home become more common, it could have a negative impact on the goal of equal access.

Objective

To determine the impact of socioeconomic position (SEP) and distance to provider on outpatient mental health care utilization among incident users of antidepressants.

Method

A nationwide, Danish, register based, follow-up study on frequencies of contacts to out-patient psychiatric services, psychologist consultations supported by public funding and therapeutic talks by general practice.

Preliminary results

Outpatient-psychiatric services were reached more often by patients in low SEP measured by income, but their frequencies of visits were less. Contacts to psychologists were less than half for patients in low SEP and less frequent too. Mental health service by GP showed low SEP associated with low contact. No difference in use of emergency or inpatient psychiatric services was found. Distance to provider showed interaction with SEP and contact to psychologist and frequencies of contact to outpatient psychiatrists. When distance increased by 5 km, contact to psychologist fell by 11% among lowest income group and frequencies of visits to outpatient psychiatrist fell by 5%.

Preliminary conclusion

Lower SEP is associated with lower mental health care utilization. Increased distance to provider increases inequity in mental health service utilization.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Cultivating the compassionate self against depression: An exploration of processes of change
Authors: Matos M. , Duarte J. , Duarte C. , Pinto-Gouveia J. , Gilbert P.
Published: June 2017

Introduction

Compassion and self-compassion can be protective factors against mental health difficulties, in particular depression. The cultivation of the compassionate self, associated with a range of practices such as slow and deeper breathing, compassionate voice tones and facial expressions, and compassionate focusing, is central to compassion focused therapy (Gilbert, 2010). However, no study has examined the processes of change that mediate the impact of compassionate self-cultivation practices on depressive symptoms.

Aims

The aim of this study is to investigate the impact of a brief compassionate self training (CST) intervention on depressive symptoms, and explore the psychological processes that mediate the change at post intervention.

Methods

Using a longitudinal design, participants (general population and college students) were randomly assigned to one of two conditions: Compassionate self training (n = 56) and wait-list control (n = 37). Participants in the CST condition were instructed to practice CST exercises for 15 minutes everyday or in moments of stress during two weeks. Self-report measures of depression, self-criticism, shame and compassion, were completed at pre and post in both conditions.

Results

Results showed that, at post-intervention, participants in the CST condition decreased depression, self-criticism and shame, and increased self-compassion and openness to receive compassion from others. Mediation analyses revealed that changes in depression from pre to post intervention were mediated by decreases in self-criticism and shame, and increases in self-compassion and openness to the compassion from others.

Conclusions

These findings support the efficacy of compassionate self training components on lessening depressive symptoms and promoting mental health.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Gender differences and temperaments affective, impulsivity, sensation seeking and traits of schizotypal personality
Authors: Ricci F. , Ventriglio A. , Pascucci M. , Bellomo A.
Published: June 2017

Background

In the literature, the growing interest to the gender such as variable expression and treatment of psychiatric disorders, it is emerged in a considerable number of fields. Gender differences have become the subject of numerous investigations, in order to verify how the sex variable might affect the psychopathology.

Aims

We propose to evaluate the role of gender differences in the development of traits of schizotypal personality, impulsivity, SS and their influence in the definition of temperamental component.

Materials

We recruited 173 healthy subjects, between 18 and 65 years, who completed the following tests: BIS-11; SPQ; SDS; SAS; HCL-32; TEMPS-A; SSS.

Results

The bivariate analysis by gender shows scores for the hyperthymic temperament significantly higher among males compared to the scores for the female sex, which, in turn, presents higher scores for cyclothymic. The levels of anxiety and depression are higher among women while levels of sensation seeking are higher among men. Although the male gender is associated with a greater sensation seeking, compared to women, it is not showed a higher correlation with the different types of impulsivity. We can find significant differences to the subscales for the SPQ between the two genders.

Conclusions

The examination of these data may suggest the existence of differential specific features of gender that, in the presence of psychopathology, become more easily detectable; particularly in the male gender, it seems to emerge more impulsive behavior and activation compared to the female gender in which instead it seems to prevail a tendency to emotionality and introversion.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Systematic risk assessment in a mother-baby unit (MBU)–Importance for maternal and infant safety
Authors: Saraf G. , Chandra P. , Desai G. , Thippeswamy H.
Published: June 2017

Introduction

Systematic assessment of risks is an essential component of care in psychiatric mother baby units. Self-harm, infant neglect and harm or the vulnerable physical health of both mother and infant may all pose risks.

Aim

Development of a risk assessment tool and risk assessment among mother-infant dyads at a MBU in Bangalore, India.

Methods

Based on data from 200 admissions, doctors and nurses of the unit developed a 15-item tool for risk assessment. Risk was assessed by both nurses and doctors among 58 consecutive mothers admitted to the unit. Risk domains included risks to self, to infant, related to infant health and feeding and violence faced by mother. Frequencies of various risks were calculated. Nurses’ risk assessments were compared to the residents’ risk assessments.

Results

The mean age of the mothers was 25 (±4) years, age of infant 4 (±4) months and duration of episode was 4 (±14) months. Diagnoses included acute polymorphic psychosis (30%), BPAD (27%) and depression (21%). 47% had high suicidal risk and 28% had made an attempt in the current episode. 22% had expressed ideas of infant harm and 24% had physically harmed the infant. 48% of mothers had been physically violent. Multiple risks were seen in 47%. Doctors were able to identify risks more often than nurses.

Conclusion

Risks for self-harm, infant harm and related to infant health were high. Systematic risk assessment by both nurses and doctors is important in an MBU to ensure adequate care for the mother infant dyad.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Effectiveness and tolerance of treatment with Aripiprazole LAI in a group of schizophrenics patients
Authors: Olmo López N. , García Nicolás M. , Núñez Domínguez L.A.
Published: June 2017

Introduction

In the pharmacological treatment of schizophrenia, more and more authors suggesting the use of injectable antipsychotics long-term these patients, since it increases adherence to treatment, one of the risk factors for relapse that argues most often to explain the failure of the treatment of these patients.

In the present study, it is to observe the evolution of a group of such patients to assess efficacy and tolerability of treatment with Aripiprazole LAI.

Material and method

Data from 17 patients treated at a mental health center in Navarra (Spain), diagnosed with schizophrenic disorder, followed over a year after beginning treatment with Aripiprazol LAI are collected.

The data collected are:

– date of treatment change (month and year);

– antipsychotic previous;

– reason for change;

– aripiprazole LAI dose;

– number of income before and after the start of Aripiprazole LAI (mirror);

– effects adverse pre and post start of treatment with Aripiprazole LAI: metabolic, endocrine, extrapyramidal;

– treatment antipsychotic concomitant pre and post start Aripiprazole LAI.

Results

The results show a decrease in the number of income after the start with Aripiprazole LAI, with very good retention of treatment, and a low number of side effects, which were mild.

Conclusions

Treatment with Aripiprazole LAI is a good therapeutic alternative to the use of antipsychotic drugs by mouth, with good adherence, tolerability and efficacy.

Disclosure of interest

The authors have not supplied their declaration of competing interest.