bluuebunny/crossref_metadata_2025 huggingface dataset:
Alexithymia and asthma
Authors: Turki M. , Naoui R. , Moussa N. , Sellami S. , Gassrara I. , Halouani N. , Hamza N. , Aloulou J. , Kammoun S. , Amami O.
Published: May 2016

Introduction

Alexithymia refers to difficulties in verbal expression of emotions, commonly observed in patients with psychosomatic symptoms. In this context, asthma is described as one of psychosomatic diseases.

Objectives

Identify clinical profile of asthmatic patients and assess the alexithymia level as well as associated factors.

Methods

We conducted a cross-sectional, descriptive and analytic study, including 30 patients followed for asthma at pulmonary outpatient department, Hedi Chaker Hospital, Sfax, Tunisia, during September and October 2015. We collected socio-demographic and clinical characteristics. Asthma control level was assessed by the Asthma Control Test (ACT). Alexithymia was measured using Toronto Alexithymia Scale (TAS 20).

Results

The mean age was 51 ans. Sex-ratio F/M was 14. The mean duration of disease was 11 years. Long-term control medicines were: inhaled corticosteroids, long-acting beta agonists and theophylline respectively in 86.7%, 33.3% and 26.7%. Two thirds of our patients had a bad therapeutic adherence. The average ACT score was 16.8 points. Asthma was uncontrolled in 1/3 and well controlled in 1/3 of cases. The average TAS 20 score was 64.8 points. Twenty percent of patients were non-alexithymic, 13.3% had a probable alexithymia and 66.7% were alexithymic. This score was positively correlated to bad asthma control (P < 0.001), long term evolution (P = 0.002) and use of inhaled corticoids (P < 0.001). It was inversely correlated to ACT score (P < 0.001).

Conclusion

Our study shows the high prevalence of alexithymia in patients with asthma and its negative impact in asthma control. Psychological support aiming specifically alexithymic dimension in these patients is indispensable.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Psychiatric comorbidity does not only depend on diagnostic thresholds: An illustration with major depressive disorder and generalized anxiety disorder
Authors: van Loo H. , Schoevers R. , Kendler K. , de Jonge P. , Romeijn J.W.
Published: May 2016

Background

High rates of psychiatric comorbidity are subject of debate: to what extent do they depend on classification choices such as diagnostic thresholds?

Aims/objectives

To investigate the influence of different thresholds on rates of comorbidity between major depressive disorder (MDD) and generalized anxiety disorder (GAD).

Methods

Point prevalence of comorbidity between MDD and GAD was measured in 74,092 subjects from the general population according to DSM-IV-TR criteria. Comorbidity rates were compared for different thresholds by varying the number of necessary criteria from ≥ 1 to all 9 symptoms for MDD, and from ≥ 1 to all 7 symptoms for GAD.

Results

According to DSM-thresholds, 0.86% had MDD only, 2.96% GAD only and 1.14% both MDD and GAD (Odds Ratio [OR] 42.6). Lower thresholds for MDD led to higher rates of comorbidity (1.44% for ≥ 4 of 9 MDD-symptoms, OR 34.4), whereas lower thresholds for GAD hardly influenced comorbidity (1.16% for ≥ 3 of 7 GAD-symptoms, OR 38.8). Specific patterns in the distribution of symptoms within the population explained this finding: 37.3% of subjects with core criteria of MDD and GAD reported subthreshold MDD symptoms, whereas only 7.6% reported subthreshold GAD symptoms.

Conclusions

Lower thresholds for MDD increased comorbidity with GAD, but not vice versa, owing to specific symptom patterns in the population. Generally, comorbidity rates result from both empirical symptom distributions and classification choices and cannot be reduced to either of these exclusively. This insight invites further research into the formation of disease concepts that allow for reliable predictions and targeted therapeutic interventions.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Surgery-first or orthognathic surgery approach: Psychosocial and physical changes
Authors: Gambaro E. , vecchi C. , Gramaglia C. , Losa A. , Giarda M. , Broccardo E. , Benech A. , Zeppegno P.
Published: May 2016

Introduction

Two surgical approaches exist for malocclusion: in the surgery-first approach the orthognathic surgery precedes the orthodontic treatment, treating facial esthetics first and then occlusion, whereas in the conventional approach (the orthodontics-first approach) the orthodontic treatment precedes the orthognathic surgery, treating occlusion first and then facial esthetics. The advantages of the surgery-first approach include the fact that patient's dental function, and facial esthetics are restored and improved soon after the beginning of treatment. Moreover, the entire treatment lasts only 1 to 1.5 years or less and orthodontic management is easier to achieve.

Aims

Our study aims to compare patients undergoing surgery-first or orthognathic surgery approach as for as self-esteem, satisfaction with their appearance in the pre- and postoperative care, quality of life and psychosocial changes, are concerned.

Methods

We recruited 50 patients undergoing surgery-first or orthognathic surgery approach at SC Maxillo-Facciale of Novara between October 2014 and December 2017. Assessment were performed at baseline (T0) and at follow-up (T1: 5 weeks; T2: 5–6 months), with Rosenberg Self-Esteem Scale (RSES), Temperament and Character Inventory (TCI: only at T0), Short Form Health Survey 36 (SF-36), Beck Depression Inventory (BDI-II), Resilience Scale for Adult (RSA), Psychosocial Impact of Dental Aesthetics Questionnaire (PIDAQ), Oral Health Impact Profile (OHIP-14).

Results

Data collection is still ongoing. We expect to find a better quality of life and higher self-esteem in patients undergoing surgery first approach.

Conclusion

Satisfaction is crucial for patients’ adherence to treatment and to avoid revolving door. Clinical implications will be discussed.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Liaison psychiatry: Its impact in an intrahospital treatment for a psychotic patient
Authors: Goujon D. , Chouillard D.E. , Abdullah D.B. , Dew D.B. , Beer D.L. , Grandin D.P.
Published: May 2016

Different manners of non-suicidal self-injuries are common ways to deliberately hurt oneself in order to aliviate suffering. It can be seen in various psychiatric affections. The ingestion of bizarre objects in psychotic patients is part of aggressive behaviour as a reaction to massive anxiety. We hereby present the case of a schizophrenic patient who presented to the Emergency Department for a second episode of ingestion of numerous metallic objects (screws, coins, knives, spoon, handles, …). Physical examination showed no abdominal guarding. CT scan revealed the presence of multiple metallic objects, which seemed impossible to go through the pylorus. Surgical transgastric extraction was performed. Outcome was uneventful. Patient was discharged and followed-up in a private structure. Three months later, the patient was readmitted for the same reason. Flexible endoscopy allowed this time complete extraction of the ingested objects. He recovered rapidly and was allowed to discharge from the surgical ward. The psychiatrist took decision with family to transfer him into a psychiatric hospital for the first time. His treatment was: chlorpromazine, Proton pump inhibitor, pain killers. Patient was treated by means of medication, psychotherapy, daily activities and family, preparation him for a day hospital.

Conclusion

We discuss here the beneficial multifocal treatment of a 42-year-old man suffering from schizophrenia. The life threatening ingestion of sharp and other metallic objects three times in a year was treated surgically with success. The psychiatric affection including invalidating acoustic-verbal delusions and severe negative signs were treated in pcychiatric hospital. The definite results will be discussed.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Gender differences in the manifestation of brain fag, depression and indices of anxiety among secondary school students in Nigeria
Authors: Igbokwe D. , Ola B.A. , Ndom R.J.E.
Published: May 2016

Introduction

Secondary school students in Nigeria are under intense pressure to perform well in their academics so as to have competitive advantage in advancing their studies. This pressure has been linked to western derived psycho-pathologies such as depression, anxiety and culture bound syndrome such as brain fag syndrome.

Aim

To examine gender differences in the manifestation of brain-fag syndrome, depression, and anxieties among students about to participate in Junior Secondary Certificate Examination (JSCE) and West African Senior School Certificate Examination (WASSCE) in Nigeria.

Methods

Two hundred and nine (209) students (X age = 14.27, SD = 2.18) were administered a battery of tests comprising of the Brain Fag Syndrome Scale, Brain Fag Propensity Scale, State Trait Anxiety Inventory, Patient Health Questionnaire, Mathematics Anxiety Inventory and Test Anxiety Inventory. The data was subjected to a multivariate analysis of variance (MANOVA).

Results

The result showed no significant gender differences in the manifestation of brain-fag syndrome, depression, and anxieties, F (6, 202) = 0.947, P ≥ 0.01; Pillai's Trace = 0.03, partial η2 = 0.02. In consonance with earlier studies, males reported higher brain fag mean scores than female participants (X = 5.46, SD = 2.06; X = 4.88, SD = 2.43).

Conclusions

The study has shown that adolescents who are about to take their final examinations manifest brain fag propensity and go on to manifest symptoms of the brain fag syndrome. But, there is no significant gender difference in the manifestation of brain fag syndrome among males and females.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
A brief exploratory synthesis of portrayal of mental health issues in the script and characters of TV series Wallander (Swedish Version)
Authors: Kumar S.
Published: May 2016

Introduction

The modern Swedish crime drama series Wallander by Henning Mankell presents a good portrayal of mental health issues in 21st century post modern world, including the contribution of biological, psychological and social issues in predisposing, perpetuating and maintaining them.

Aim

The aim of the exploratory synthesis is to study the characters in Wallander focusing on the portrayal of their mental health with a view on formulating biological, psychological and social factors that play a role in their development. Furthermore, mental health is reviewed in first world culture acclimatizing itself to the themes emerging from post-modern globalised world.

Method

The episodes of Wallander (Swedish Version) are reviewed focusing on the characters and the plots for each episode matching them with mental health diagnoses offered in International classification of diseases.

Discussion

The results are collated and a general commentary is offered on the observations and motifs revealed in the portrayal. The focus will be on individual character formulations (both recurring main characters as well other side characters). In addition, there is a commentary on contributing to mental health problems in a post-modern industrial society.

Disclosure of interest

The author has not supplied his declaration of competing interest.
The relationship between anxiety, depression and hopelessness among nonclinical sample
Authors: Alali T.
Published: May 2016

Introduction

This research aims at examining the relationship between anxiety, depression, and hopelessness among nonclinical Kuwaiti sample using Beck Anxiety Inventory, Beck Depression, and hopelessness inventories.

Objectives

highlighting the relationship between anxiety, depression, and hopelessness among nonclinical sample of females and males and the common factor/s.

Methods

The participants were 616 (308 females & 308 males), Kuwait University students. The two genders were matched in age (18.15 ± 0.36 & 18.18 ± 0.38, t = 0.94, P > .05) and BMI (24.12 ± 3.27 & 23.50 ± 4.85, t = 0.54, P > 0.5). The Arabic versions of the Beck Anxiety Inventory (BAI), Beck Depression Inventory-II (BDI-II), the Beck Hopelessness Scale (BHS), and demographic surveys were administered to participants during classes. All participants read and signed a consent form before participating. The correlation matrices, exploratory factor analysis, and reliability analysis are used in this study.

Results

Internal consistency of scores were satisfactory for the BAI, BDI-II, & BHS inventories respectively (Cronbach's alpha (M) = 0.88, 0.75, 0.74 & (F) = 0.89, 0.84, 0.88). A correlation of (r = 0.53) between the BAI and BDI-II and (r = 0.43) with BHS. Meanwhile a correlation of (r = 0.58) between BDI-II & BHS. A principal-axis factor analysis with oblique rotation suggested one factor accounting for 67.73% of the common variance.

Conclusion

The results indicate that there is a strong relationship between anxiety, depression and hopelessness. This highlights the important of examining common factors between anxiety, depression and hopelessness among nonclinical sample.

Disclosure of interest

The author has not supplied his/her declaration of competing interest.
Decentering and avoidance: Mechanisms between external shame and depression symptomatology
Authors: Ferreira C. , Mendes A.L. , Marta-Simões J. , Trindade I.A.
Published: May 2016

It is widely accepted that shame plays a significant role in the development and maintenance psychopathology, namely depressive symptoms. In fact, the experience of shame is highly associated with the adoption of maladaptive strategies to cope with negative feelings, such as experiential avoidance (i.e., the unavailability to accept one's private experiences), and the inability of decenter oneself from unwanted internal events. The present study aims to explore a mediation model that examines whether external shame's effect on depressive symptomatology is mediated through the mechanisms of decentering and experimental avoidance, while controlling for age. Participants were 358 adults of both genders from the general population that completed a battery of self-report scales measuring external shame, decentering, experimental avoidance and depression. The final model explained 33% of depression and revealed excellent model fit indices. Results showed that external shame has a direct effect on depressive symptomatology and simultaneously an indirect effect mediated by the mechanisms of decentering and experiential avoidance. These data seem to support the association between shame and depressive symptomatology. Nevertheless, these findings add to literature by suggesting that when the individual presents higher levels of shame he or she may present lower decentering abilities and tends to engage in experiential avoidance, which amplify the impact of external shame and depression. Furthermore, our findings seem to have important clinical implications, stressing the importance of developing intervention programs in the community that target shame and experimental avoidance and that promote adaptive emotion regulation strategies (e.g., decentering) to deal with adverse experiences.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Escitalopram orally-disintegrating tablets (ODT) in major depression treatment
Authors: Polikowska M. , Łoza B.
Published: May 2016

Introduction

The growing rate of depressive disorders causes needs for more effective and more innovative solutions. The modern patients’ challenges make them fail mostly in the treatment compliance. Some reports have described that escitalopram orally disintegrating tablets (ODT) induce faster response and lower dropout rate than oral standard tablets (OST), although both forms have equal bioavailability.

Aim

We tried to clarify effectiveness rates between escitalopram ODT and OST treatments in depressive patients.

Method

An open-label, 6-month, randomized, flexible-dose study was conducted for direct comparison of the effects of escitalopram ODT (N16) and OST (N15) on dropout rate and clinical outcomes in patients with major depression.

Results

Outcome measures included Hamilton Depression Rating Scale (HDRS), Drug Attitude Inventory-10 (DAI), Clinical Global Improvement Scale (CGI), and Psychological General Well-Being Scale (PGWB). The tolerability was assessed by the UKU scale. No significant difference was found in HDRS, CGI, PGWB and GAF between the two forms of tablets. No significant difference was found in any tolerability rates. However, dropout rate favored escitalopram ODT group (N5, 31.3%) vs escitalopram OST (N7, 47.0%). DAI-10 outcomes, both in patients’ general attitude and subjective feelings, were significantly improved in ODT group (P = 0.000), comparing with OST.

Discussion

Escitalopram in its classical form (OST) has become a leader in a group of antidepressants, thanks to safety of use, efficacy and tolerability. In the ODT form, escitalopram can meet additional needs, both clinical and lifestyle. ODT may reduce dropout rate and costs of long-term treatment improving the patients’ compliance.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Randomized controlled trial testing behavioral weight loss versus multi-modal stepped-care treatment for binge eating disorder
Authors: Grilo C.
Published: May 2016

Introduction

Binge eating disorder (BED) is prevalent, associated with obesity and elevated psychiatric co-morbidity, and represents a treatment challenge.

Objective and aims

A controlled comparison of multi-modal, stepped-care versus behavioral-weight-loss (BWL) for BED.

Methods

One hundred and ninety-one patients (71% female, 79% white) with BED and co-morbid obesity (mean BMI 39) were randomly assigned to 6 months of BWL (n = 39) or stepped-care (n = 152). Within stepped-care, patients started BWL for one month; treatment-responders continued BWL while non-responders switched to cognitive-behavioral-therapy (CBT) and all stepped-care patients were additionally randomized to anti-obesity medication or placebo (double-blind) for five months. Independent assessments were performed by research-clinicians at baseline, throughout treatment, and post-treatment (90% assessed) with reliably-administered structured interviews.

Results

Intent-to-treat analyses of remission rates (0 binges/month) revealed BWL and stepped-care did not differ significantly overall (74% vs 64%); within stepped-care, remission rates differed (range 40% - 79%) with medication significantly superior to placebo (P < 0.005) and among initial non-responders switched to CBT (P < 0.002). Mixed-models analyses of binge eating frequency revealed significant time effects but BWL and stepped-care did not differ overall; within stepped-care, medication was significantly superior to placebo overall and among initial non-responders switched to CBT. Mixed models revealed significant weight-loss but BWL and stepped-care did not differ overall; within stepped-care, medication was significantly superior to placebo overall and among both initial responders continued on BWL and non-responders switched to CBT.

Conclusions

Overall, BWL and stepped-care treatments produced improvements in binge-eating and weight loss in obese BED patients. Anti-obesity medication enhanced outcomes within a stepped-care model.

Disclosure of interest

The author has not supplied his/her declaration of competing interest.
Binge-eating disorder and major depressive disorder co-morbidity: Sequence and clinical significance
Authors: Grilo C. , Becker D.
Published: May 2016

Introduction

Binge-eating disorder (BED) is associated with obesity and with elevated rates of co-occurring major depressive disorder (MDD) but the significance of the diagnostic comorbidity is ambiguous—as is the significance of the onset sequence for MDD and BED.

Objective and aims

We compared eating-disorder psychopathology and psychiatric comorbidity in three subgroups of BED patients: those in whom onset of BED preceded onset of MDD, those with onset of MDD prior to onset of BED, and those without MDD or any psychiatric comorbidity.

Methods

A consecutive series of 731 treatment-seeking patients meeting DSM-IV-TR research criteria for BED were assessed reliably by doctoral-clinicians with semi-structured interviews to evaluate lifetime psychiatric disorders (SCID-I/P) and ED psychopathology (EDE Interview).

Results

Based on SCID-I/P, 191 (26%) patients had onset of BED preceding onset of MDD, 114 (16%) had onset of MDD preceding onset of BED, and 426 (58%) had BED without co-occurring disorders. Three groups did not differ with respect to age, ethnicity, or education, but a greater proportion of the group without MDD was male. Three groups did not differ in body-mass-index or binge-eating frequency, but groups differed significantly with respect to eating-disorder psychopathology, with both MDD groups having significantly higher levels than the group without co-occurring disorders. The group having earlier onset of MDD had elevated rates of anxiety disorders compared to the group having earlier onset of BED.

Conclusions

MDD in combination with BED—with either order of onset—has a meaningful adverse effect on ED psychopathology and overall psychiatric co-morbidity.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Emotional neglect as the colossus among traumas in patients with eating disorders. A case-control study
Authors: Piacentino D. , Loriedo C. , Biondi M. , Girardi P. , Vanderlinden J. , Pignatelli A.M.
Published: May 2016

Introduction

Individuals with eating disorders (EDs) often report a history of early traumatization. Although a great attention has been paid to sexual and physical trauma, less is known about emotional one, especially neglect.

Objectives/aims

We aimed to estimate the prevalence of sexual, physical, and emotional trauma–occurring under 18 years of age–in ED patients vs. healthy controls, focusing on emotional abuse and neglect.

Methods

We consecutively recruited 57 DSM-V ED outpatients (91.2% females; age range = 18–42 years) at the Psychiatric Outpatient Clinic of our University Hospital and 90 healthy controls (78.9% females; age range = 20–39 years). Among ED patients, 43.9% had restrictive anorexia nervosa (AN), 29.8% binge/purging AN, 26.3% bulimia nervosa. Individuals completed the Eating Disorder Inventory-2 (EDI-2) and the Traumatic Experiences Checklist (TEC). We used Mann-Whitney U test and χ2 test for comparisons.

Results

ED patients scored significantly higher than controls on all EDI-2 subscales (P-values < 0.05). On the TEC, emotional trauma was more frequent than sexual/physical ones in both ED patients and controls. Emotional trauma, and to a lesser extent physical one, were significantly more frequent in ED patients than controls. Distinguishing between emotional abuse and neglect, the latter had a higher prevalence than the former in both groups. Additionally, ED patients reported significantly more neglect, but not emotional abuse, than controls.

Conclusions

Our findings show a high prevalence of emotional trauma in EDs, mainly neglect, i.e., a lack of care and attention potentially contributing to EDs. Thus, it is crucial to investigate emotional neglect in ED patients.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Professional stress among psychiatrists–a Delphi study
Authors: Dhandapani A. , Armugam S.S. , Chaturvedi S.K.
Published: May 2016

Introduction

Professional stress is a misfit between a person's skills and demands of the job. It has been found to be common among psychiatrists and affects their personal and professional life.

Objectives

To rank order the factors and manifestations of professional stress among Indian psychiatrists.

Aims

To determine the factors and manifestations associated with professional stress among Indian psychiatrists.

Methods

A qualitative ranking type Delphi study was conducted at National Institute of Mental Health & Neurosciences, Bangalore. The Delphi team comprised of 43 randomly selected Indian psychiatrists with at least 10 years of clinical experience in psychiatry. Questionnaires were mailed & the replies were analyzed and a consolidated list was sent back to rank order them. Agreeability was assessed & the final list of factors and manifestations was shared with the experts.

Results

Forty-eight percent of the experts completed all 3 stages of the study, 53% opined that age & gender were not a factor; however 58% & 44% opined that personality attributes & relationship status were significant factors contributing to professional stress (Table 1).

Conclusion

Professional stress in Indian psychiatrists is largely secondary to increased workload and inadequate support system. System level changes, like increase in manpower and handling stigma regarding psychiatry, is required.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
A new psychiatric society is born: Spanish Society of Psychiatry Residents (SERP)
Authors: Llanes Álvarez C. , San Román Uría A. , Núñez Morales N. , Sevillano Benito I. , Hervías Higueras P. , Gómez-Coronado Suárez de Venegas N. , Puerta Rodríguez S. , Valdés Valdazo J. , Prieto Lorenzo V. , Pimenta V. , Pinto da Costa M.
Published: May 2016

Introduction

The European Federation of Psychiatric Trainees (EFPT) is an independent Federation of Psychiatric Trainees and represents the consensus of psychiatric trainee's organizations across European countries and advocates for what training should look like, regardless of the country. Spain was one of the last countries to be part of the Association. Finally, and after months of hard work and networking, on September 2015 the Spanish Society of Psychiatry Trainees(SERP), was founded and Spain became a observer member of the EFPT.

Objectives

One of the main goals of the SERP, is creating a program of clerkships, in both directions, from other trainees to come to Spain, and for Spanish Trainees to go abroad.

Methods

Our idea in this poster is to explain a first look of which Hospitals/Units would be appropriate to make a rotation, and to explain the first steps in order to create a database with information about the nightshifts, possible accommodation and other aspects related to the organization. We want to use this poster to present to Europe our new Association.

Results

On September 25 at the National Congress of Psychiatry in Santiago de Compostela, a Group of Spanish trainees founded the SERP, organized the first Board and signed the Founding Amendments.

Conclusions

After two previous failed attempts, finally on 25th September 201; the Spanish Society of Psychiatry Residents (SERP) was founded, an important part of the activity of this company is promoting exchanges between residents of member countries in Spain.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Psychiatric disorders in mass media and social networks: A media impact study
Authors: Álvarez de mon M.Á. , Sánchez R. , Molero P.
Published: May 2016

Introduction

Every year, 1 million people commit suicide in the world. Major Depressive Disorder is the first cause of loss of Disability-Adjusted Life Years (DALYs) in developed countries.

Objective

To study the references to psychiatric disorders in the media and to measure their media impact compared with other topics such as politics, sports and tabloids.

Methods

We focused on the top-six journals in terms number of readers in the USA. Our research strategy included the introduction of several terms of interest (ex: “anxiety”) on each journal's Twitter account. The search was restricted to 2014, and yielded a database of 6296 news, which was categorized in four areas: health, politics, sports and tabloids.

Results

Six hundred and eighty-one (10.8%) news dealt with psychiatric disorders. The term with the highest impact in mass media was “suicide”, present in 1 of every 3 Psychiatrics-related news. Anorexia was the psychiatric disorder with the lowest impact (just 1 tweet). We noticed certain peaks-patterns in the number of tweets coincidentally with the suicide of any famous person. Within the total of terms included in our study, suicide ranked the 8th position regarding media impact.

Conclusions

Social networks can be a useful tool for the divulgation of mental disorders and their awareness among the general population. Despite psychiatric disorders are very prevalent and cause high morbidity, they have a relatively low media impact. Despite the WHO recommendation of avoiding specific information regarding the suicide of famous people, for preventive reasons, suicide is the psychiatric disorder with the highest media impact.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
The evaluation of the effects of daytime sleepiness, anxiety and depression on the quality of life in 112 emergency medical staff
Authors: Cankaya S. , Topbas M. , Beyhun N.E. , Can G. , Kizilay Cankaya P.
Published: May 2016

Introduction

One hundred and twelve emergency medical staff are faced with many physical and mental problems due to the deterioration of their sleep-wake cycle and getting out of their usual work and social life.

Objectives

The aim of this study was to examine the effects of anxiety, depression, day time sleepiness on the quality of life in 112 emergency medical staff.

Methods

Target population of this cross-sectional study was the 112 emergency medical staff in the province of Rize. We tried to obtain all the universe (n = 154), so the sample was not selected. One hundred and four people (67%) participated in the study. In the data form, Epworth sleepiness scale, Beck Anxiety Inventory, Beck Depression Inventory and the SF-36 quality of life questionnaire were applied.

Results

The prevalence of pathological sleepiness was 14.4% (n = 15), the prevalence of anxiety was 39,8% (n = 41), the prevalence depression was 20,2% (n = 21), respectively (Table 1).

Conclusion

Based on high levels of anxiety and depression that reduces quality of life compared to the general population in 112 emergency services workers, motivational programs, coping strategies, psychological counseling services are required. Also, against the psychosocial risk factors forming anxiety and depression in the working life, organizational measures must be taken.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Long-stay in high and medium secure forensic psychiatric care – Prevalence, patient characteristics and pathways in England
Authors: Edworthy R. , Vollm B.
Published: May 2016

Introduction

Forensic psychiatric services are costly and highly restrictive for patients. Clinical experience and the limited research available indicate some patients stay for too long in these settings. A proportion of patients may, however, require long-term (potentially life-long) secure forensic psychiatric care but their needs may not be met by existing service provision designed for faster throughput.

Objectives

We conducted a national, multi-centre, cross sectional study exploring the prevalence of long-stay and characteristics of long-stayers in high and medium secure forensic psychiatric care in England.

Aims

(1) Estimate the prevalence of long-stay in secure settings in England (length of stay over 5 years in medium secure care or 10 years in high secure care); (2) describe the characteristics, needs and care pathways of long-stay patients. Develop recommendations following the exploration of international models for this patient group.

Methods

We employed a mixed-methods approach including the analysis of administrative data, case file reviews, patient interviews, consultant questionnaires, interviews with clinicians and commissioners and a Delphi survey.

Results

Twenty-five percent (n = 401) of our sample were experiencing long-stay. This patient group has a heterogeneous set of characteristics and needs relating to their diagnosis, offending history, risk and therapeutic need and have experienced a variety of care pathways through secure care.

Conclusions

We found a greater number of long-stay patients than originally estimated with a set of characteristics and needs that are arguably different to that of the general forensic population, therefore calling for a specific care pathway and service provision for this patient group with a greater focus on autonomy and quality of life.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Abnormal amygdala functional connectivity during an fMRI expectancy task in pedophilia
Authors: Ristow I. , Li S. , Demenescu L.R. , Walter H. , Beier K. , Kruger T. , Schiffer B. , Ponseti J. , Walter M.
Published: May 2016

Introduction

Pedophilia is a disorder where sexual preferences of adults are directed towards children. This disorder impacts society with 1–2 out of every 10 children being sexually approached by an adult, often resulting in prolonged negative psychological effects. Prior research reported structural and functional amygdala alterations in pedophilia. As the neurophenomenological model of sexual arousal suggests the importance of the amygdala in the emotional component, we focused on amygdala functional connectivity in pedophilia.

Aims

To investigate amygdala functional connectivity (FC) modulated by expectancy and salient stimuli in pedophilic patients.

Methods

Thirteen pedophilic patients and 13 matched healthy controls underwent a salience expectancy task in a 7T ultra high fMRI study. Subjects perceived pictures of naked adults and children. Half of the pictures were preceded by an expectancy cue. Participants were instructed to actively expect the picture depending on the cue. We conducted psychophysiological analysis (PPI) to examine amygdala FC changes in two amygdala sub-regions for child/adult stimuli during the expectancy period and the visual stimuli consummation period using as seed regions the basolateral (BLA) and central nucleus of the amygdala (CeA).

Results

Healthy controls, relative to patients showed significant stronger left CeA to right post-central gyrus FC during expectancy of adult > child picture. For picture condition (adult > child picture) we found significant stronger left CeA to left dorsolateral prefrontal cortex FC in patients compared to healthy controls.

Conclusion

These findings add to the recent literature by indicating that amygdala dysfunctional connectivity is involved in development of deviant sexual behavior.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Not just ‘callous-unemotional’: Psychopathic traits are associated with emotion dysregulation dimensions
Authors: Velotti P. , D’aguanno M. , Garofalo C. , Rogier G.
Published: May 2016

Introduction

Historically, psychopathic individuals have mainly been described as characterized by pervasive callous-unemotional traits, with dramatic implications for clinical and forensic practices – such as the tendency to deem psychopathic individuals as untreatable. However, recent evidence with community samples have highlighted that psychopathic traits may be in fact related to emotion dysregulation rather than being the mere reflection of an underlying ‘unemotionality’. Yet, it is no clear if this association extends to populations with more severe forms of psychopathy (i.e., offenders).

Objectives

We wanted to replicate previous evidence of an association between emotion dysregulation and psychopathic traits in a sample of incarcerated offenders.

Aims

To investigate the associations among emotion dysregulation dimensions and psychopathic traits, exploring similarities and differences between the Interpersonal-Affective and the Antisocial-Lifestyle facets of psychopathy.

Methods

A sample of male offenders incarcerated in Italian jails completed the Self-Report Psychopathy Scale (SRP-4; Paulhus, Neumann, & Hare, 2015) and the Difficulties in Emotion Regulation Scale (DERS; Gratz & Roemer, 2004).

Results

In line with the expectations, emotion dysregulation dimensions did predict higher levels of psychopathic traits. Structural Equation Modelling revealed that selected dimensions of emotion dysregulation were associated with different facets of psychopathy.

Conclusions

Based on our findings, we argue that psychopathic traits may be associated to a certain extent with emotion dysregulation, and thus a focus on improving emotion regulation skills may hold the promise to dampen the therapeutic pessimism when dealing with psychopathic offenders.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Polymorphism neuropeptide receptor gene S (NPSR1) and sleep disturbances
Authors: Gafarov V. , Voevoda M. , Gromova E. , Maximov V. , Panov D. , Gagulin I. , Gafarova A.
Published: May 2016

Objective

To study the association gene of candidate NPSR1 rs324981 with sleep disorders in the open population of men 45–64 years of Novosibirsk.

Materials and methods

The study of the association candidate gene polymorphisms with sleep disorders was carried out during the examination of a random representative sample of men 45–69 years (n = 1770). The response rate was 61%. The median age is 56.5 year. Every 12 a man was selected for genotyping (n = 147). To assess the level of sleep was used a questionnaire which was filled with self-test. Statistical analysis was performed using SPSS-11.5.

Results

The level of sleep disorders in the male population of 45–64 years was 79.9%. The frequency of homozygous C/C genotype of neuropeptide S (gene NPSR1 rs324981) was 19.4%, T/T genotype occurs in 27.8%, C/T genotype −52.8%. Men dominated the T allele of −54.2%, and the C allele −45.8% growth trend Fnd dissatisfaction with the quality of their sleep among men. Men T-allele carriers, most evaluated their sleep as “satisfactory” in 69% of cases, (χ2 = 15,713 df = 8, P < 0.05).

Conclusion

Association found men carrier T-allele of neuropeptide S (gene NPSR1 rs324981), a sleep disorder.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Effect of Disrupted-in-Schizophrenia 1 gene on treatment response in patients with a first episode of psychosis
Authors: Vázquez Bourgon J. , Ayesa Arriola R. , Suarez Pinilla P. , Roiz Santiañez R. , Tordesillas Gutierrez D. , Ortiz-García de la Foz V. , Crespo-Facorro B.
Published: May 2016

Introduction

There is substantial evidence suggesting that individual variability in antipsychotic treatment response could be genetically determined. Disrupted-in-Schizophrenia 1 (DISC1) gene has been previously associated to the illness and to treatment response in a sample of patients suffering from psychosis. However, there is a lack of studies on the effect of DISC1 on treatment response in samples of first episode psychosis.

Objectives

The aim of this study was to explore the relation between variations in DISC1 gene and treatment response to antipsychotics in a sample of drug-naïve patients with a first episode of psychosis.

Methods

Two hundred and twenty Caucasian drug-naive patients experiencing a first episode of non-affective psychosis were genotyped for rs821616 (Ser704Cys), rs6675281 (Leu607Phe) and rs1000731. Early (6 weeks) response to antipsychotic treatment was assessed with the Brief Psychiatric Rating Scale, the Scale for the Assessment of Positive Symptoms, and the Scale for the Assessment of Negative Symptoms. Other clinical and socio-demographic variables were recorded to eliminate potential confounding effects.

Results

We found a significant association between rs1000731 and treatment response. Thus, those patients homozygous for the G allele of rs1000731 were more frequently non-responders, measured with SANS, after 6 weeks of treatment, than those carrying the A allele (X2 = 4.019; P = 0.032). Moreover, when analysing the clinical improvement longitudinally, we observed that those patients carrying the A allele for the rs1000731 presented a greater improvement in positive symptoms dimension (F = 8.905; P = 0.003).

Conclusions

Our results suggest a minor contribution to antipsychotic drug response of genetic alterations in the DISC1 gene.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Understanding adverse health effects of widowhood in old age – A cross-countries mixed methods study
Authors: Kristiansen C.B. , Munk-Jørgensen P. , Mattisson C. , Andersen K.
Published: May 2016

Introduction

Widowhood in old age increases mortality and adverse health effects, particularly depression and need for psychiatric care. The causes of this are poorly understood. To study risk factors and mechanisms, theories about what to study are needed. A qualitatively approach to widowhood from the widow/widower's perspective may uncover important knowledge.

Objectives

To investigate risk factors of the adverse health effects associated with widowhood in old age from the perspective of the widower/widowers and to test the generalisability of the theories quantitatively.

Methods

This is a cross-country mixed methods study combining narrative interviews with Danish widows/widowers and a 50-year follow-up study from Sweden – The Lundby Study. Widows/widowers above 65 years of age referred to in- or outpatient treatment at the Department of Psychiatry at Odense or Aarhus University Hospital are included. Narrative interviews are conducted and analysed according to grounded theory. The qualitatively developed theories will then be tested quantitatively through the Lundby Study by comparing widows/widowers above 65 years with age-matched controls, who are still married.

Results

In the Lundby Study, 597 persons above 65 years were identified in the latest follow-up: 176 (29.5%) were widow/widowers, 421 (70.5%) were married/cohabitating. Depending on the theories developed a total of 384 possible variables regarding physical health, mental health and general living circumstances are tested. Further results will be presented.

Conclusions

The causes of adverse health effects in widowhood are poorly understood. This study will potentially contribute to unravelling these by identifying possible risk factors.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
The weight of borderline intellectual functioning on the capacity of integration and social adaptation of patients with borderline personality disorder
Authors: Galletta D. , Califano A.I. , Vangone N. , De Simone S. , Mastrola A.M. , Suarato V.
Published: May 2016

From the analysis of current scientific literature are still few studies on the relationship between personality disorders and borderline intellectual functioning, since the latter, without its own specificity, has always been considered as a kind of undefined zone between intellectual functioning medium and intellectual disabilities. Several studies have shown the presence of comorbidity of the personality disorders with BIF, emphasizing a higher frequency of Borderline Personality Disorder. BIF is considered a significant risk factor for the development of a broad spectrum of neuropsychiatric disorders, in particular in our observations ongoing since 2003, it assumes an important weight on the global functioning of patients with personality disorder as we have stated in the intervention SOPSI 2012. In detail, this study focuses on the relationship between BPD and BIF, noting the weight the latter on the social adaptability, job placement and creation of bonds of individuals with Borderline Personality Disorder. Patients included in this study were 52 (40 F and 12 M), of which 27 belonging to the first group had a borderline intellectual functioning in comorbidity with BPD and 25 individuals belonging to the second group with BPD without BIF. The results show that 33% of individuals included in the first group did not find a job working compared to 16% of the second group, showing further falls in attention and concentration, therefore, in the ability to anticipate and generalization, impacting strongly on the degree of adaptation to social life, while there are not significant differences in the ability to create emotional ties between the two groups.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Sweet and bitter taste perception in anorexia nervosa: A functional MRI study
Authors: Monteleone A.M. , Esposito F. , Prinster A. , Cantone E. , Canna A. , Pellegrino F. , Nigro M. , Amodio R. , Volpe U. , Di Salle F. , Monteleone P.
Published: May 2016

Introduction

Taste perception is a complex phenomenon modulated by different factors, such as taste receptors and memory brain circuits. The palatability of the food, that activates the central reward pathways, also plays an important role in taste perception. It means that taste is able to influence the choice of food and then eating behaviour.

Objectives

It is well known that people with anorexia nervosa (AN) have a lower sensitivity to reward stimuli and recent studies suggested that altered function of taste neural circuitry may contribute to restricted eating in AN.

Aims

The aim of this study was to evaluate, in patients suffering from AN, the activation of brain areas involved in taste perception and in central reward mechanisms to both pleasant and aversive taste stimuli and to correlate gustatory neurocircuitry activity with eating behaviours, temperament measures and/or sensitivity to reward and to punishment.

Methods

Fifteen underweight female AN patients and sixteen normal-weight healthy women underwent a functional MRI to measure brain areas activation to repeated stimuli of a pleasant taste (sucrose solution), alternated with an aversive taste (bitter solution), and water taste.

Results

Compared to healthy controls, patients with AN showed a significantly reduced activation of left insula and left dorsolateral prefrontal cortex to sweet stimulus and reduced activation of right parietal cortex to bitter stimulus.

Conclusions

These results, if confirmed in future studies, may improve our knowledge about the pathophysiological mechanisms of AN.

Disclosure of interest

The authors have not supplied their declaration of competing interest.