bluuebunny/crossref_metadata_2025 huggingface dataset:
Insidious: The relationship between patients and their eating disorders and its impact on ED symptoms, illness duration and self-image
Authors: Mantilla E. Forsén , Birgegård A.
Published: June 2017

Patients with eating disorders (EDs) often spontaneously talk about their disorder in terms of a symbolic other (a demon, a voice, a guardian). Further, externalizing exercises where patients are encouraged to separate their true self from their ED self are common in some treatment approaches. Yet, no previous quantitative study has investigated this phenomenon. We examined the patient-ED relationship (using the interpersonal structural analysis of social behavior methodology) and its implications for ED symptoms, illness duration and self-image. Participants were 16–25 year old female patients (N = 150) diagnosed with anorexia nervosa (N = 55), bulimia nervosa (N = 33) or eating disorder not otherwise specified (N = 62). Results suggested that patients had comprehensible and organized relationships with their EDs. EDs were primarily experienced as acting critical and controlling towards patients. Higher ED control was associated with more ED symptoms and longer illness duration, especially when coupled with patient submission. Patients reacting more negatively towards their EDs than their EDs were acting towards them had lower symptom levels and more positive self-images. Externalizing one's ED, relating to it like a symbolic other, seemed to make sense to patients and depending on its quality seemed to influence ED symptoms, illness duration and self-image. We put forward both clinical and theoretical implications based on the assumption that the patient-ED relationship may function in similar ways as real-life interpersonal relationships do.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Antipsychotic drugs in pregnancy
Authors: AlDakheel S.
Published: June 2017

Background

There has been significant increase in prescription of antipsychotic medication in the community for females in childbearing age the problem is we do not have clear guidelines because we do not have a control group.

Objectives

To evaluate maternal psychiatric, medical and perinatal outcomes associated with antipsychotic drugs in pregnancy.

Aim

To use wisdom when the risk is minimal for both mother and child.

Method

We study 3 pregnant women, one with a 6 years old, one with a 2 years old child and one still pregnant. We measure their blood sugar, blood pressure, fetal heart, movement, ultrasound using first generation antipsychotic (FGA).

Results

Patient became less psychotic then back to normal and fetal development is normal till now, no diabetes mellitus or hypertension, no malformation or abortion.

Conclusion

It is still too early to reach a clear and absolute use of safe antipsychotic drugs in pregnancy. A large sample is needed for a study and a control should be needed.

Disclosure of interest

The author has not supplied his/her declaration of competing interest.
Interpersonal sensitivity in the at-risk mental state for psychosis in Karachi, Pakistan
Authors: Mushtaq A. , Fatima B. , Fatema A.A. , Syed H. , Sohail H.
Published: June 2017

Introduction

Interpersonal sensitivity can be explained as a personality trait in which there is an excessive and expanded awareness of the behavior and emotions of others. Individuals having high interpersonal sensitivity are sensitive to interpersonal relationships and self-deficiencies in comparison to others. Studies report that high interpersonal sensitivity can cause low self-esteem and feelings of insecurity.

Objectives

The objective of this study was to examine the level of interpersonal sensitivity in individuals with an at-risk mental state (ARMS) for psychosis compared to the individuals not at risk for psychosis.

Methods

A total sample of 50 individuals was recruited from Bahria University, Karwan-e-Hayat and Karachi Psychiatric Hospital: 25 with ARMS for psychosis and 25 participants who were not ARMS, according to scores on Schizophrenia Proneness Inventory-Adult (SPI-A). All of the participants then responded to self-report questionnaire on Interpersonal Sensitivity Measure.

Results

Results showed that the group with ARMS had a significantly higher interpersonal sensitivity on average (112.5) as compared to healthy individuals (91.8). Results show significant difference in both of the groups (t = –5.049; P < .0001) indicating that interpersonal sensitivity in people with ARMS was relatively high compared to those who were not at risk.

Conclusion

This study suggests that being ‘hypersensitive’ to interpersonal interactions is a psychological feature of the potentially prodromal phase of psychosis. Addressing difficulties in interpersonal relationships and offering early psychotherapeutic interventions can be beneficial, not only in averting serious illness, but preventing loss to individual and national productivity.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Social and economical impact about problems with therapeutical adherence
Authors: Alonso Sánchez A. , Red Gallego H. De la , Álvarez Astorga A. , Noval Canga C. , Hernandez Antón R. , Gómez Sánchez S. , Medina Ojeda G.
Published: June 2017

Introduction

Psychotic spectrum diseases are one of the most expensive illnesses in our society. Being able to recover as much social and laboral activity as possible has to be the goal. Trying to achieve this objective, we face different problems, as for example therapeutic adherence.

Objectives

Show the importance of an adequate treatment and adherence in order to keep the patient as much integrated in the society as possible, and in order to reduce the economic and social cost of the psychotic spectrum diseases.

Methods

Case report and bibliography review.

Results

The patient of this case is a 34 year old woman with a schizophrenia diagnosis given after 4 hospitalizations in psychiatry units. She had 4 years of stabilization taking an injectable antipsychotic, in which she was able to study and keep adequate familiar and sentimental relationships. After being badly recommended to retire her medication for some who identified himself as member of the “new psychiatry”, she began with new delusions and hallucinations which had to be treated at the Hospital Psychiatry Unit. She was close to get a statal job related to her architecture studies, but she was not able to go to the exam due to the exacerbation of her illness. In the review we see that the average economic cost per schizophrenic patient in developed European countries such as Germany is, at least, 14000€ per patient.

Conclusions

Adequate treatment adherence is highly important to keep an adequate control of the illness in order to sustain the better social live and job function.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Is early life environment a risk factor for psychiatric disorder?
Authors: Duarte T. , Ferreira A. , Paulino S. , Câmara Pestana L.
Published: June 2017

Introduction

Season of birth, an exogenous indicator of early life environment, has been related to higher risk of adverse psychiatric outcomes. According to literature, an excess of 5–8% of winter-spring births is found in individuals who later develop schizophrenia and bipolar disorder; this seasonal birth excess is also found in schizoaffective disorder (winter), major depression (March–May), and autism (March).

Objectives

The objective of this study was to analyze the seasonal birth patterns of in-patients with psychiatric disorders.

Aims

Understand the relation between psychiatric disorders and season of birth during a 10 year period in a Portuguese University Hospital.

Methods

Analyze the birth date distribution of 2202 in-patients between 2007 and 2016 and compare with the psychiatric diagnosis.

Results

Patients’ diseases analyzed by birthday season: 60% of patients with schizoaffective disorder were born in winter-spring, 48.4% of mental retarded patients were born in autumn, 37% of dementia patients in winter, 77% of patients with delusional disorder in winter-spring, 78% of patients with Cluster A personality disorder in spring-summer and 71% of patients with substance abuse conditions in autumn-winter. No seasonal birth excess was found for bipolar affective disorder, schizophrenia, alcohol abuse, major depressive disorder or Cluster B personality disorder.

Conclusions

Our sample data shows evidence for a potential link between season of birth and risk for schizoaffective disorder, dementia, mental retardation, Cluster A personality disorder, delusional disorder and substance abuse. The attempt to explain seasonal birth patterns in psychiatric illnesses could serve to clarify the etiological bases of such disorders.

Disclosure of Interest

The authors have not supplied their declaration of competing interest.
Identification of major depressive disorder among the long-term unemployed
Authors: Nurmela K. , Mattila A. , Heikkinen V. , Uitti J. , Ylinen A. , Virtanen P.
Published: June 2017

Introduction

Depression is a common disorder among the unemployed, but research on identification of their depression in health care (HC) is scarce.

Objectives

The present study aimed to find out if the duration of unemployment correlates to the risk for unidentified major depressive disorder (MDD) in HC.

Methods

Sample of the study consisted of long-term unemployed who were in screening project diagnosed as having MDD (n = 243). The diagnosis was found in the records of HC in 101 (42%) and not found in 142 (58%) individuals. Binary logistic regression models were used to explore the effect of the duration of unemployment to the identification of MDD in HC.

Results

The odds ratio (OR) for non-identified MDD in HC was 1.060 (95%CI 1.011–1.111, P = 0.016) per unemployment year and when unemployment had continued, for example, five years the OR for unidentified MDD was 1.336. The association remained significant throughout adjustments for the set of background factors (gender, age, occupational status, marital status, homelessness, self-reported criminal records, suicide attempts, number of HC-visits).

Conclusions

This study among depressed long-term unemployed indicates that the longer the unemployment period has lasted, the greater the risk for non-identification of MDD is. HC services should be developed with respect to sensitivity to detect signs of depression among long-term unemployed.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Decisional capacity in patients with acute delirium. A Rawlsian approach
Authors: Hostiuc S. , Negoi I. , Drima E.
Published: June 2017

Delirium is characterized by a temporary, usually reversible, cause of mental alteration; it can occur at any age, but affect most often the elderly. Delirium patients may also present acute psychotic episodes, which might make them decisionally incompetent. In order to assess decisional capacity, Fan et al developed a two-stage approach, which tries to analyse:

– the presence of delirium, using the Confusion Assessment Method;

– a proper analysis of the decisional capacity.

Often, in patients with decreased decisional capacity, physicians must assess which ethical principle should respect first – the principle of autonomy, whose practical implementation is informed consent, or beneficence – the good of the patient, irrespective of the its declared wishes. In this poster, we will look at the issue of decisional capacity in patients with acute delirium from a Rawlsian point of view, and will try to give an answer based on what is just – to respect the autonomy of the patient, or the moral duty to do good to the patient.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Serial killers: Relation between childhood maltreatment and sexual relations with the victims
Authors: De Santiago Herrero F.J. , Torres Delgado C. , García-Mateos M.
Published: June 2017

Introduction

Serial killer's (SK) familiar relations often present a disorganized adherence characterized by the paternal absence and the excessive maternal coldness or over-protection. This familiar diagram, joined to mistreatment situations, could generate different antisocial conducts in the child because of the vacancy of a significant strong figure.

Objectives

To study, in the SK, the relation between having suffered childhood mistreatment and the sexual aggression to the victims before killing them.

Method

A study is realized between the variables of childhood mistreatment and sexual aggression to the victims. The data has been extracted from 100 protocols of SK with different nationalities elaborated by the unit of analysis of criminal behavioral (University of Salamanca, Spain).

Results

The results show a significant relation between both variables.

Conclusions

It can be confirmed that the SK who have suffered childhood mistreatment sexually attack their victims before killing them while those who did not experiment it during their childhood do not realize that conduct.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Paranoia: When criminology predicts vocational prognosis
Authors: Ghajati B. , Sahar G. , Imen B. , Rim R.
Published: June 2017

Patients with paranoia have always been a group of exiting but daunting patients for mental health professionals. Indeed, the risk of a violent acting out with important aggressive discharges confers to these patients an elevated dangerosity potential. If various criminological aspects of violence in paranoia have been described, their link to functional prognosis of patients have been seldom addressed.

Aim

To determine if criminological details of violence acts in paranoia patients predict their functional prognosis.

Methods

A retrospective, descriptive and analytic study have been conducted, based on a chart consult. Twenty-three patients with paranoia (i.e. Chronic delusional disorder type jealousy or erotomania in DSM IV) patients have been included. These patients have been hospitalized in the forensic psychiatry department of Razi hospital of Tunis (Tunisia), between 1995 and 2015, after not being held by reason of insanity, according to article 38 of the Tunisian Criminal Code.

Results

Delusional disorder types were: jealousy (17), persecution (4), erotomania (1) and claim (1). The majority were married (18), undereducated (17), with irregular work (13). Forensic acts were uxoricide (15), attempted murder (5), violence against people (2) and destruction of public properties (1). Patients used bladed weapon in most of the cases (13), in the victim's residence (19), with premeditation in (17) of the crimes. Only 5 patients worked regularly after discharge.

Conclusion

If our results expose further data concerning potential dangerosity of patients with delusional disorders, they also highlight the marginalized situation of these patients when released back into society.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Mental health care practice in transgender persons deprived of liberty
Authors: Jemar G.N. , Mariana Edith S. , Maria Mercedes D.
Published: June 2017

Gender diversity set a new paradigm in terms of challenge and study for mental health. The analysis includes everything from basic parameters such as shed prejudices and preconceptions, to question old concepts rooted yet even from the proposed DSM, understanding gender diversity not just in terms of behaviour, choices or sexual conditions but from the integration of this in cognition and social inclusion, and finally understand that the nosological processes become in fact they do not have their origins in the diversity of gender, and that this per se does not constitute a pathology. The main issues addressed are the social marginalization, the problems of co-existence, discrimination, external and internal positioning for their conduct, election or sexual and gender perceptions and ways of adaptation are implemented, in addition to nosological processes current mental health, which are influenced but not because of the above. The population Trans in penitentiary system frequently mental health care for problems such as substance abuse, convivial and adaptive circumstances, being achieved in most cases a specific record of the particular problems and behavioral system that allows the convivencial adaptation, with the limiting variables that negatively influence (discrimination, marginalization, etc). The binary logic in the current psychopathology as well as society and culture in general prevents nosological analyze processes of these patients regardless of their behavior, sexual choice or self-perception of gender. They should consolidate new paradigms of psychopathological analysis to achieve a more comprehensive understanding of the nosological processes in these patients to achieve effective therapeutic targets.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Incest in the Schizophrenic patient: Case report
Authors: Mezghani M. , Fekih-Romdhane F. , Ghali F. El , Zghal M. , Jmii G. , Jouini L. , Ghazeli I. , Ridha R.
Published: June 2017

Introduction

Incest may be defined as sexual relations between close blood relatives. Legally, incest and sexual aggression toward minors are classified as a criminal behaviour. Tunisia is among the countries from which incest cases are rarely reported.

Objectives and method

The aim of this study is to investigate the relationship between the psychotic structure and incest, and to describe the individual, clinical, and criminal traits of the incestuous father through clinical observation.

Case report

Mr T.G is 46 years old. He is married and has six daughters. His wife appears to be passive, and largely dependent on her husband. Mr T.G has had incestuous relationships, initially, with his two eldest daughters. The acts were followed by the mother's complicit silence and the non-denunciation of the daughters. Two years later, he starts an incestuous behavior with his third daughter. Incest took place in the context of delusion. The patient was convinced that he is responsible of his daughters’ sexuality education. He develops an incoherent theory of purification with a tendency towards morbid rationalism. It is only after four years of insufferable paternal incestuous relationships that the third daughter filed a complaint to the police. A psychiatric expertise concluded that the accused is exempt from criminal responsibility.

Conclusion

Incest is a multi-faceted phenomenon, which makes its approach, comprehension, and treatment quite complex. For a psychotic patient incest is a means to deny alterity by crushing other. It also allows him to find, in this complete power, control over his annihilation anxiety.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Predicting offense recidivism in Schizophrenia patients
Authors: Oueslati B. , Ridha R. , Mrabet A.
Published: June 2017

Introduction

Schizophrenia increases the risk of offending. Recidivism rates are significant.

Aim

Identifying general and violent recidivism risk factors in schizophrenia patients.

Methods

We conducted a case control study. All included patients were admitted, at least once, to the forensic psychiatry department in Razi Hospital between January 1st, 1985 and December 31st, 2014 after a decision of irresponsibility by reason of insanity. All those who reoffended during this period were considered as cases. A draw was performed to create the control group. Both groups were matched according to their first offenses’ types as well as to their ages. A multivariate analysis was performed.

Results

We included 25 cases and 38 controls. Eight recidivism risk factors were identified. Living in urban poor neighbourhoods (P = 0.023; OR = 4.86), having been unemployed (P = 0.042; OR = 2.18) and not having lived with the family (P = 0.039; OR = 1.36) after discharge were considered as risk factors. The same applied to alcohol (P = 0.026; OR = 4.89) and cannabis use disorders (P = 0.018; OR = 6.01). A hospitalization shorter than 6 months increased the risk by 1.79 (P = 0.046). A combination of conventional antipsychotics (P = 0.023;OR = 4.81) and a poor adherence (P = 0.001; OR = 10.42) were considered as recidivism risk factors too.

Conclusions

All eight recidivism risk factors are dynamic. This makes recidivism prevention conceivable. Measures involving the patient, the health care system, patients’ families, society and the government should be taken.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
German mental health care in people with intellectual and developmental disabilities (idd) in comparison to other European countries
Authors: Elstner S.
Published: June 2017

Introduction

In Germany, mental health care in people with IDD is mostly determined by experts’ opinions. Particularities of the psychiatric assessment and treatment of people with IDD and a co-morbid psychiatric disorder are taught neither at medical schools nor in the scope of the medical training of psychiatrists.

Objectives

The present study examined the influence of socio-political aspects of health care on quality and organisation of mental health care in people with IDD.

Methods

Various aspects of health care systems in Germany and three other European countries were explored and juxtaposed subsequently with a special developed questionnaire.

Results

The health care systems of four different European countries differ in socio-economical, educational and system-financed aspects.

Conclusions

Differing organisational levels of national health care systems and socio-economical aspects within these countries contribute to the organisation of the mental health care system in people with IDD. Suggestions for a better harmonisation of European mental health care in people with IDD are offered.

Disclosure of interest

The author has not supplied his declaration of competing interest.
Adapting the assertive community treatment (ACT) for the needs of different communities: A comparative case study of KUINA ACT Japan and Mt. Sinai ACT Canada
Authors: Chow W. , Shiida M. , Andermann L.
Published: June 2017

In this e-poster, we will present the assertive community treatment (ACT) model in both Japan and Toronto, Canada. We will compare the adaptations of ACT models in both teams in order to serve their target populations efficiently and effectively.

We will also compare the demographic data, clinical data and the outcomes of both ACT teams by analysing the hospitalisation days, number of emergency admission and the number of admissions into hospitals.

We will also highlight differences in the mental health systems in Japan and Canada.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Long-acting injectable antipsychotics and global functioning in north western italian public health service
Authors: Probo M. , Dalo’ V. , Facchini F. , Rudoni M. , Preziosi V. , Nano D.
Published: June 2017

Introduction

Long-acting injectable antipsychotics (LAI-APs) should be the first choice therapy in the treatment of schizophrenia, however their use in outpatient's psychiatric services remains limited.

Objective

Observational study in schizophrenic patients of the northwestern public health service.

Aim

To assess demographic and psychopathological features in patients treated with LAI haloperidol (H-LAI) and second-generation LAI antipsychotics (SG-LAI).

Methods

We recruited 105 schizophrenic patients upon LAI-APs treatment, and we assessed socio-demographic data, medical comorbidity, substances use, time from admission, treatment length, and per os augmentation therapies. All participants were assessed for global functioning and severity of illness by CGI-SCH and PSP, respectively.

Results

Of all patients, 52% were treated by H-LAI, 48% by SG-LAI. No statistical differences (P > 0.05) were found between the 2 groups for age, gender, other demographic variables, substances use, somatic comorbidities. Both groups were homogeneous for severity of illness (CGI-SCH score = 4.20 in H-LAI vs. 4.38 in SG-LAI) and global functioning (PSP score = 49.1 in H-LAI vs. 54.4 in SG-LAI). Compared with the H-LAI group, SG-LAI-treated patients were characterized by shorter time from admission (>10 yrs) and treatment length (>1 yr), and less frequent anticholinergic drug co-prescription. We counted only 6 LAI-APs treatments started in the last year.

Conclusions

Despite of the literature support, LAI-APs treatment for schizophrenia is still limited in our service. Our data suggest that SG-LAI-APs are used as first choice of LAI-APs treatment, although maintained for short time, while H-LAI are reserved to long-standing patients and are burdened by side effects needing anticholinergic treatment.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Developing Community Mental Healthcare: Kosovo Case
Authors: Halilaj G.
Published: June 2017

Background

Community mental healthcare in Kosovo is still in its developmental stage and thus pose an ongoing challenge for the health system and population.

Objectives

The purpose of this study is to describe the processes of preparation, implementation, challenges and future of community mental health service in Kosovo as an economically struggling society with underdeveloped health care system.

Methods

Review of the current state of community services provision for mentally ill peoples in Kosovo in the light of the objectives and targets of the WHO comprehensive mental health action plan 2013–2020.

Results

The implementation of a new community mental health service in Kosovo still is characterized by considerable shortages, beside substantial effort on various levels. On the policy and financial level, it was made possible by a clear intent/initialization of international bodies and coordinated commitment of all responsible national stakeholders and authorities. Obstacles remain regarding improvements of service development indicators: financial and human resources; capacity building; stakeholder involvement and service availability. Lack of strategies for promotion and prevention in mental health and lack of information systems, evidences and research for mental health is vital need.

Conclusions

Community mental healthcare in Kosovo despite struggles faced is successfully installed and represents one of Kosovo health system achievements. Comprehensive, integrated and responsive mental health services in community-based settings in line with international and regional human rights instruments is goal to be addressed.

Disclosure of interest

The author has not supplied his/her declaration of competing interest.
Mental Health of Management Staff in the Closed Environment of Construction
Authors: Kornetov N. , Pushpusheva O.
Published: June 2017

Introduction

it is difficult to overestimate the role of social, cultural and environmental conditions in evaluation of psychological health in hard intellectual work.

Objectives

Research of construction staff in far taiga conditions using PHQ и GAD-7.

Aims

to investigate the correlation between major depressive disorder, anxiety and somatoform disorders and gender and marital status.

Methods

we studied 119 people who live in concentrated social environment and in conditions of hard work and lack of relaxation. In order to study depression, anxiety, and somatoform disorders we used PHQ и GAD-7 rating scale.

Results

we noted that distribution of depression according to gender has statistically significant differences. In the men group the number of depressive individuals is 5 (11.1%; P < 0.01). In the women group the number is 28 (37.8%; P < 0.01). Also it was stated, that marital status does not influence the distribution of depressive symptomatology level (P > 0.05). Distribution of anxiety symptoms significantly differs by gender. In the group of men anxiety observed in 1 patients (2.2%; P < 0.05), whilst in the group of women – in 13 patients (17.6%; P < 0.05). Gender proved to be irrelevant in the occurrence of somatoform disorders (P > 0.05); it is also not dependent on marital status (P > 0.05).

Conclusion

Staff employed into hard working social environment experience a range of negative psychological effects such as depressed mood, fatigue, and insomnia. Lack of leisure and lack of time for walking cause dissatisfaction with life, which contributes to the development of depression, anxiety and somatoform disorders.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Quality of Life in People with Chronic Mental Illness
Authors: McCafferty B.
Published: June 2017

Introduction

An association between chronic mental illness and significantly reduced quality of life in relation to the general population is speculated in the literature internationally.

Objectives

To investigate the quality of life of people with chronic mental illness taking psychotropic medication living in the community and attending the Mental Health Services of Sligo town.

Methods

Review of data including demographics, diagnoses and World Health Organisation Quality of Life Bref scale (WHOQOL-Bref) scores from consecutive patients attending specialist outpatient clinics dedicated to the care of people with chronic mental illness. Raw scores for each WHOQOL-Bref domain were converted to transforme scores in the range 0–100 for ease of comparison with other validated instruments tools.

Results

Total number of patients: 47. Mean age: 56.1 (SD: 13.6), males: 27 (60%). Mean years of illness: 23.1 (SD: 12.2). Primary psychiatric diagnosis: psychotic disorders 26 (57.8%), mood disorders 16 (35.6%), others 3 (6.6%). WHOQOL-BREF Domain transformed scores: physical health mean: 68.1, SD: 19.92, psychological health mean: 68.2, SD: 19.62, social relationships: 66.2, SD: 21.44, environment: 76.8, SD: 19.5.

Conclusions

Quality of life is a complex multidimensional entity and its assessment relies on subjective reporting and analysis as supported by validated instrument tools. Our results suggest that quality of life is reasonably high among this cohort of patients, contrasting much of the current literature in similar populations. The mean score for social relationships was lower than other domains. This may suggest that a lack of socialisation may be associated with chronic mental illness and identifies a clinical focus for improvement of quality of life.

Disclosure of interest

The author has not supplied his/her declaration of competing interest.
The Effects of Personality Traits of University Students in their Romantic Relationships
Authors: Ongun E. , Barlas G. Unsal
Published: June 2017

Introduction

Most people will have romantic relationship in different periods of their life and sometimes this relationship can contain abuse. The abuse which is perceived in romantic relationships can be an important problem for university students.

Objective

This study was conducted to determine the effects of personality traits of university students in the abuse which is perceived in their romantic relationships.

Methods

The study was descriptive and analytical. The students of Marmara University Faculties of Law, Pharmacy, Nursing and Midwifery, Cinema and Television department comprised the sample. The measuring instruments consisted of a personal information form, the Basic Personality Traits Instrument (BPTI) and Romantic Relationship Assessment Inventory (RRAI). The data were analyzed with the SPSS 11.5 programme, using the “Mann–Whitney U Test”, “Kruskal–Wallis Test”, “Spearmans Correlation Test”.

Results

RRAI mean score was 102.41 ± 33.79; subscale of BPTI's mean scores were; extraversion 28.60 ± 5.97; conscientiousness 28.30 ± 5.91; agreeableness 33.73 ± 4.29; neuroticism 26.09 ± 6.48; openness to experience 21.91 ± 3.83; negative valence 9.82 ± 3.36. There was a low level negative significant relation was obtained between subscale of conscientiousness (r = −0.196, P = 0.000), agreeableness (r = −0.168, P = 0.000), a low level positive significant relation was found between subdimensions of neuroticism (r = 0.168, P = 0.000), negative valence (r = 0.255, P = 0.000) and abuse.

Conclusion

In conclusion, there is a relation between personality traits and perceived abuse. Therefore, education programmes should be prepared about abusive behaviour and its risk factors and consequences.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Sociodemographic Profile of Psychiatric Inpatients at a Center of Mental Health Care in Brazil
Authors: Soria D. , Vernaglia T.V.C. , Santiago N.R. , Ramos E.C.F. , Leitão D.R.D. , Marcellini P.S.
Published: June 2017

Background

The most prevalent disorders between the chronic diseases are the mental health disorders. Almost 650 million of people in the world suffer of some mental health disorders, which cause serious impact on individual abilities, family relationship and social rehabilitation.

Aims

We describe and study the sociodemographic characteristics and the diagnosis of a sample of male and female psychiatric inpatients undergoing treatment in a mental health care center in Brazil.

Methods

It is a descriptive cross-sectional study, carried out with 517 psychiatric inpatients from a Brazilian health institution – IMAS Nise da Silveira. Data was collected from January to December 2014 and occurred through consultation of the patients’ hospital notes. Univariate analysis was used for the data collection and analysis.

Results

Our sample was composed by 52.6% (n = 272) of men and 47.4% of women (n = 245); 50.5% were over 40 years old and have a long time of hospitalization. Overall, 64.6% had schizophrenia; 27.2% mood [affect] disorders; 3.7% mental and behavioural disorders due to psychoactive substance use; 1.4% mental retartation; 0.4% personality disorders; 0.2% disorders of psychological development.

Conclusion

The profile could advance the mental health care and rehabilitation of these people. Although could improve public policies.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Assessing Sustainability of an Intensive Primary Care Training for Children and Adolescents with Attention Deficit Hyperactivity Disorder
Authors: Wegner L. , Stiles A. , Jacobson Vann J. , Rasmussen E. , Wegner S.
Published: June 2017

Introduction

Adherence to practice guidelines for diagnosing and treating attention-deficit/hyperactivity disorder (ADHD) by primary care providers (PCPs) is important for optimizing care for many children and youth. However, adherence is often low. To address this problem, we implemented an intensive intervention in 2009 aimed at improving diagnosis and management of ADHD among PCPs.

Objectives

The study objective is to assess the sustainability of intervention-attributable outcomes.

Aims

The study aims are to assess the sustained effect of the intervention on PCP intentions to implement, attitudes toward, and obstacles to implement ADHD practice guidelines.

Methods

During November 2009, 48 PCPs from 31 clinical practices completed a 3-day training, 6 months of biweekly telephone peer group reinforcement, and baseline questionnaires; follow-up questionnaires were completed at 12 months. To assess sustainability, we tracked PCPs and administered the questionnaire in 2016.

Results

Intentions to implement ADHD guidelines remained stable over seven years, with all mean values ranging from “probably will” to “definitely will” implement guidelines.

Conclusions

Generally, favorable self-reported intentions (see Exhibits 1 & 2), attitudes and obstacles to implementing ADHD guidelines were sustained seven years after the intensive training and follow-up intervention.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Case Report: Three Years of Refractory Atypical Depression Successfully Treated With“Old School” Moclobemide (maoi-r)
Authors: Latorre S. , Moreno I. , Gordillo M.J.
Published: June 2017

Background

Atypical depression is linked to bipolarity and specific response to mono amino oxidase inhibitors (MAOI), treatments not commonly used due to their complex handling. We describe a successfully treated case.

Methodology

Clinical description. Depression severity is assessed with Montgomery Asberg depression rating scale (MADRS).

Clinical case

Female, 54-year-old. Major depression, since 2011, refractory to venlafaxine/aripiprazol and escitalopram 20 mg/day. Manic episode with psychotic symptoms after potentiation with duloxetine. Diagnose of schizoaffective disorder was made, treated with aripiprazol 10 mg/day, with established chronical depressive symptoms, despite addition of valproate and venlafaxine, and partial response to pramipexole up to 1 mg/day.

– Decision of cleaning up aripiprazol during 8 days and switch to moclobemide monotherapy was made due to atypical features. Baseline MADRS: 31. At week 2, there is change in mood, expression, psychomotor features and speech formal and content alterations. At week 4, activity increases, and biorythms normalize. At week 8 (with 600 mg/day increased dose), full response is obtained, including drive, and anxiety, with MADRS 12.

– After one year of treatment, she has kept stability with no manic or psychotic symptoms emergence. Reduction in dose are linked to depression relapses. She still struggles with psychosocial recovery.

– Tolerance has been good in all moment, except for headache crisis, not linked to high blood pressure or diet.

Conclusions

MAOI still has a role in affective disorders treatment, given its effectiveness, unique mechanism of action and good tolerability. Targeted psychopharmacological and phenomenology knowledge can be the key to a recovery.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Attention Deficit Hyperactivity Disorder and Scientific School Performances Among Moroccan Children
Authors: Rouim F.Z. , Azzaoui F.Z. , Ahami A.O.T.
Published: June 2017

Background and aim

Attention deficit hyperactivity disorder (ADHD) is classified as neurodevelopmental disorders. ADHD is one of the major problems in childhood encountered most often in schools. A study realized by Platt in 2011 show that children with ADHD often experience difficulties in mathematics. The aim of this study is to assess whether there is a relationship between school performance in scientific subjects (mathematics and natural science) and attention deficit hyperactivity disorder.

Methods

The study was realized among 239 children studying in a urban school in Kenitra city (North-West of Morocco), and aged from 6 to 16 years. To evaluate the relationship between ADHD and the average class results of mathematics and natural science, Conners rating scale (parent and teacher short version) and the academic transcripts are used.

Results

The results show that there is a significant correlation (P < 0.05, P < 0.01) between the average class results in each natural science and mathematics and three components of Conners rating scales (parent's version), which are behavioral difficulties, learning difficulties and hyperactivity/impulsivity. Furthermore, the Conners rating scale (teacher's version) show, also, that there is a significant correlation (P < 0.05, P < 0.01) between behavioral difficulties, hyperactivity/impulsivity and Inattention passivity and the average class results in natural science and in mathematics.

Conclusion

As known, children with ADHD are not less intelligent than other children, although our study show that children with ADHD represent low marks in natural science and in mathematics. In fact, deeper investigations are needed to study the possible factors that could affect ADHD children's school performance.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
The Impact of the Type of Surgical Treatment on the Quality of Life of Portuguese Women with Breast Cancer
Authors: Pereira H. , Castelo R.
Published: June 2017

Introduction

Breast cancer significantly impacts dimensions of quality of life such as mental health, one's level of activity, family well-being, physical concerns (symptoms and pain), treatment satisfaction, emotional well-being, sexual intimacy, and social functioning.

Aim

The aim of this study is to evaluate the impact of the type of surgery on the quality of life of women being treated for breast cancer, based on the comparison of samples of women who have undergone different types of surgery.

Method

Our sample consists of 90 Portuguese women divided into three groups of 30 participants each. The first group underwent radical surgery in order to treat their breast cancer. The second group of women had conservative surgery as a breast cancer treatment. Finally, the last group of women did not have any type of surgical intervention. We use a socio-demographic questionnaire and the Portuguese version of the EORTC QLQ-30 as measurement instruments. The sample consists of patients from a central hospital in Lisbon, Portugal, and the data were collected anonymously.

Results

We find that in all dimensions of quality of life measured, including general health, physical functioning, social roles, and all emotional, cognitive, and social dimensions, the group of women who underwent radical surgery shows lower scores when compared to the other two groups. This indicates that this group has lower levels of quality of life.

Conclusion

The use of surgery for the treatment of breast cancer leads to a diminished quality of life following surgical intervention.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Sham-neurofeedback as an Intervention: Placebo or Nocebo?
Authors: Arina G. , Osina E. , Dobrushina O. , Aziatskaya G.
Published: June 2017

Introduction

Sham-controlled studies of neurofeedback are aimed to provide evidence-based data regarding its efficacy. However, a sophisticated sham procedure may turn out to be an intervention rather that a neutral control.

Methods

Data from a single-case cross-over sham-controlled study of NF in migraine were analyzed to access the effects of sham-NF. The study included 5 females with chronic migraine and was divided into 4 phases: pre-evaluation (≥ 2 weeks), treatment 1 (5 weeks), treatment 2 (5 weeks), post-evaluation (≥ 2 weeks), where treatment 1 and 2 included 10 infra-low frequency NF and 10 sham-NF sessions at T3T4 site in randomized order. Participants filled out a computerized diary about headache and emotions.

Results

Sham-NF resulted in some reduction of the level of tension (0.8 ± 0.7 vs. 1.1 ± 0.5, P = 0.1) and anxiety (0.56 ± 0.5 vs. 0.95 ± 0.4, P = 0.07) as measured by the mean value in the diary (rating from 0 - no emotion, to 3 - very intense). While the total frequency of headache was not influenced by sham-NF (40 ± 11% vs. 40 ± 7% days, P = 1), a tendency towards an increase in quantity of severe headaches (42 ± 18% vs. 20 ± 18% days, P = 0.07) and in the need for drug intake (74 ± 27% vs. 44 ± 30% days, P = 0.07) was observed. We supposed that expectation of feedback and failure to receive it during sham sessions may have possible negative effects, while frequent visits to the clinic and contact with the therapist may explain reduction in anxiety.

Conclusion

Sham-NF seems to have both placebo and nocebo effects, which should be considered during interpretation of results of the studies.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Are Patients with Emotionally Unstable Personality Disorder Overmedicated?
Authors: Dobrzynska E.
Published: June 2017

Emotionally Unstable Personality Disorder (EUPD) is often considered as treatment resistant clinical challenge. While effectiveness of psychological therapies for EUPD is widely acknowledged, there is less supportive evidence for pharmacotherapy use and patients with EUPD are perceived as overmedicated.

Objectives and aims

The purpose of the study was to review prescribing guidelines and clinical practices for EUPD.

Methods

MEDLINE and PsycINFO were searched for all English-language articles published 2000-2016 and containing the keywords “emotionally unstable personality disorder”, “borderline personality disorder”, “pharmacotherapy”, “drug treatment” and “treatment guidelines”.

Results

NICE guidelines (2009) recommend pharmacotherapy should not be used for EUPD but for comorbid conditions only. In line with the American Psychiatric Association practice guideline, the Dutch and German guidelines recommend antipsychotics for cognitive-perceptual symptoms. However, in contrary to mood stabilisers they question the efficacy of antidepressants on impulsivity and affective dysregulation.

Studies on clinical practice showed 68% of borderline patients without comorbid disorder in UK were using antidepressants, 59% antipsychotics, 59% sedatives and 23% mood stabilizers. Similar results reported Paolini et al with polypharmacy in 83.5% of cases.

Conclusions

All international guidelines recommend psychological therapies as the first-choice in EUPD treatment but diverge with respect to pharmacotherapy use. NICE and Australian guidelines abstain from psychotropics what may prevent to some degree counterproductive polypharmacy, but also can refrain from temporary pharmacological support when needed. More RCTs for pharmacotherapy use in EUPD are needed but meanwhile using pharmacotherapeutic algorithms for specific symptom domains might be the way forward.

Disclosure of interest

The author has not supplied his/her declaration of competing interest.
Associations Between Chronotype and Schizotypy in Healthy Adults
Authors: Chrobak A. , Tereszko A. , Arciszewska A. , Siwek M. , Dudek D.
Published: June 2017

Chronotype is defined as individual circadian preference, most often represented on the continuum between two extremes: morningness and eveningness. Growing number of studies show associations between circadian preference and various psychopathological symptoms. Eveningness has been shown to be related with depressiveness in non-clinical population, while mornigness has been presented as protective factor. Schizotypy is a schizophrenic-spectrum personality trait linked with a tendency to eccentricity, magical thinking and unusual experiences. Features of schizotypy has been identified in patients with mood disorders i.e bipolar disorder. While there is growing number of studies evaluating associations between chronotype and affective symptons, to our best knowledge there are no studies adressing the issue of association between schizotypy and circadian preferences. A total of 887 healthy individuals took part in the web-based study. Chronotype has been assessed with the use of Composite Scale of Morningness. Schizotypy has been measured with the use of the enlarged version of The Oxford-Liverpool Inventory of Feelings and Experiences (O-LIFE). Analysis revealed significant positive correlations between cognitive disorganization, introvertive/anhedonia, implusiveness/nonconformity and eveningness. To our best knowledge, results indicate for the first time relationship between eveningness and schizotypy, measured by O-LIFE.

Disclosure of interest

The authors have not supplied their declaration of competing interest.