bluuebunny/crossref_metadata_2025 huggingface dataset:
The global regulator LaeA controls production of citric acid and endoglucanases inAspergillus carbonarius
Authors: Linde Tore , Zoglowek Marta , Lübeck Mette , Frisvad Jens Christian , Lübeck Peter Stephensen
Published: May 2016

The global regulatory protein LaeA is known for regulating the production of many kinds of secondary metabolites in Aspergillus species, as well as sexual and asexual reproduction, and morphology. In Aspergillus carbonarius, it has been shown that LaeA regulates production of ochratoxin. We have investigated the regulatory effect of LaeA on production of citric acid and cellulolytic enzymes in A. carbonarius. Two types of A. carbonarius strains, having laeA knocked out or overexpressed, were constructed and tested in fermentation. The knockout of laeA significantly decreased the production of citric acid and endoglucanases, but did not reduce the production of beta-glucosidases or xylanases. The citric acid accumulation was reduced with 74–96 % compared to the wild type. The endoglucanase activity was reduced with 51–78 %. Overexpression of LaeA seemed not to have an effect on citric acid production or on cellulose or xylanase activity.
Minimum sampling area for the monitoring of herb diversity in riparian zone of temperate rivers, China
Authors: Kong Weijing , Xia Huijuan , Zhang Yuan
Published: May 2016

Optimal sampling area for biodiversity monitoring is a classical scientific topic for the biodiversity research in view of the cost, human resources and ecological significance. However, how much sampling area is enough for biodiversity monitoring in riparian area, the ecotone among freshwater and terrestrial system? Whether the optimal sampling areas are different among ecoregions? To explore these scientific questions, the minimum sampling area of riparian herbs was studied in Taizi river, Liaoning province, China. The species‐area relationship was modeled using average species richness in the same area (2.25, 4.5, 6.75 and 9 m2) of 55 sites distributed along riparian zone of Taizi river water course. The power model S = aAb modeled best, and was selected to fit species‐area curves. The minimum sampling areas for total species and dominant families were calculated via the selected model and corresponding estimated species richness. Results showed that the minimum sampling areas (MSAs) for herbs diversity monitoring in whole basin, highland ecoregion, midland ecoregion and lowland ecoregion of Taizi river were 12.82, 12.06, 13.46 and 13.08 m2,respectively. The MSAs of dominant families Compositae species and Graminale species were similar to that of total species. The minimum sampling area of Taizi river riparian zone was similar to other temperate riparian grassland and wet grassland, larger than dry grassland and salt meadow. So we did not need consider ecoregion difference for temperate riparian herbs diversity monitoring in watershed scale.
Maternal smoking during pregnancy and offpsring's psychiatric morbidity in early adulthood. Findings from the Finnish Family Competence Birth Cohort Study
Authors: Niemelä S. , Mikola S. , Sourander A. , Rautava P. , Sillanpää M.
Published: May 2016

Introduction

Prenatal smoking exposure is one of the most common insults during the fetal period prevalence varying from 5 to 19% in the European countries [1].

Objectives

Prenatal smoking exposure increases the risk of psychiatric morbidity in the offspring, externalizing disorders in particular. However, less is known whether maternal smoking during pregnancy increases the risk for anxiety disorders [1].

Aims

To study the associations between maternal smoking during pregnancy and offspring psychiatric morbidity in early adulthood in a Finnish birth cohort study.

Methods

A prospective data collection from 10th gestational week (GW10) to early adulthood (n = 475, 37% from the original sample). Information on self-reported smoking during pregnancy was collected using questionnaires at GW10 and GW28. Offspring psychiatric diagnoses and clinically relevant symptoms were assessed using Development and Well-being Assessment (DAWBA)-interviews at age 18 to 20 years. Information on parental alcohol use, depressive mood, anxiety, and education level, as well as offspring's gender, education level, and birth weight were used as covariates.

Results

Maternal smoking during pregnancy associated independently associated with PTSD (OR = 6.9, 95% CI 1.3–35.6, P = 0.021), and conduct disorder (OR = 2.7, 95% CI 1.02–6.9, P = 0.046) in a multivariate analysis after adjusting for other psychiatric diagnoses, offspring and parental variables (OR = 1.9, 95% CI 0.5–6.9, P = 0.359).

Conclusions

In addition to conduct problems, prenatal nicotine exposure may increase the offspring's risk for posttraumatic stress disorder (PTSD). This relationship may be explained, in part, by effects on nicotinic acetylcholine receptors and uteroplacental mechanisms [1].

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Searching for new markers of panic disorder – the examination of stem cells mobilization and levels of factors involved in their trafficking
Authors: Kucharska-Mazur Jolanta , Jabłoński Marcin , Tarnowski Maciej , Dołęgowska Barbara , Mariusz Z. Ratajczak , Samochowiec Jerzy
Published: May 2016

Introduction

Regeneration processes are the new target in looking for biological markers of psychiatric disorders.

Aims

In this study, we considered the role of stem cells and factors responsible for their trafficking in panic disorder (PD).

Methods

A group of 30 patients with panic disorder was examined and compared with a group of 30 healthy volunteers. In peripheral blood we have analysed: the number of hematopoetic stem cells – HSC (Lin−/CD45+/CD34+) and HSC (Lin−/CD45+/AC133+), the number of very small embryonic – like stem cells – VSEL (Lin−/CD45−/CD34+) and VSEL (Lin−/CD45−/CD133+) and concentration of stromal derived factor-1 (SDF-1), sphingosine-1-phosphate (S1P), and some proteins of the complement cascade.

Results

Peripheral blood concentration of HSCs (Lin−/CD45+/AC133+) was significantly lower in PD group compared to control group, before and after antidepressant treatment. Peripheral blood concentration of VSEL (Lin−/CD45−/CD133+) was significantly lower in PD group before treatment compared to concentration after treatment. In PD group concentrations of factors involved in stem cell trafficking were statistically significant lower in PD group (before and after treatment) compared to control group.

Conclusion

Examination of regeneration system seems to be useful in PD diagnostics.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Delays to diagnosis and treatment in patients presenting to mental health services with bipolar disorder
Authors: Patel R. , Shetty H. , Jackson R. , Broadbent M. , Stewart R. , Boydell J. , McGuire P. , Taylor M.
Published: May 2016

Introduction

There are often substantial delays before diagnosis and initiation of treatment in people bipolar disorder. Increased delays are a source of considerable morbidity among affected individuals.

Aims

To investigate the factors associated with delays to diagnosis and treatment in people with bipolar disorder.

Methods

Retrospective cohort study using electronic health record data from the South London and Maudsley NHS Foundation Trust (SLaM) from 1364 adults diagnosed with bipolar disorder. The following predictor variables were analysed in a multivariable Cox regression analysis on diagnostic delay and treatment delay from first presentation to SLaM: age, gender, ethnicity, compulsory admission to hospital under the UK Mental Health Act, marital status and other diagnoses prior to bipolar disorder.

Results

The median diagnostic delay was 62 days (interquartile range: 17–243) and median treatment delay was 31 days (4–122). Compulsory hospital admission was associated with a significant reduction in both diagnostic delay (hazard ratio 2.58, 95% CI 2.18–3.06) and treatment delay (4.40, 3.63–5.62). Prior diagnoses of other psychiatric disorders were associated with increased diagnostic delay, particularly alcohol (0.48, 0.33–0.41) and substance misuse disorders (0.44, 0.31–0.61). Prior diagnosis of schizophrenia and psychotic depression were associated with reduced treatment delay.

Conclusions

Some individuals experience a significant delay in diagnosis and treatment of bipolar disorder, particularly those with alcohol/substance misuse disorders. These findings highlight a need to better identify the symptoms of bipolar disorder and offer appropriate treatment sooner in order to facilitate improved clinical outcomes. This may include the development of specialist early intervention services.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Trends of hospitalization for major bipolar unspecified in USA: A nationwide analysis
Authors: Sutaria A. , Mansuri Z. , Rathod M. , Shambhu S. , Mansuri U.
Published: May 2016

Objectives

Bipolar unspecified (BP-U) is an important cause of morbidity and mortality in hospitalized patients. While BP-U has been extensively studied in the past, the contemporary data for impact of BP-U on cost of hospitalization are largely lacking.

Methods

We queried the Healthcare Cost and Utilization Project's Nationwide Inpatient Sample (HCUP-NIS) dataset between 1998–2011 using the ICD-9 codes. Severity of comorbid conditions was defined by Deyo modification of Charlson comorbidity index. Primary outcome was in-hospital mortality and secondary outcome was total charges for hospitalization. Using SAS 9.2, Chi2 test, t-test and Cochran-Armitage test were used to test significance.

Results

A total of 711,147 patients were analyzed; 61.33% were female and 38.67% were male (P < 0.0001); 77.63% were white, 13.17% black and 9.2% of other race (P < 0.0001). Rate of hospitalization increased from 2,310.28/million to 74,908.88/million from 1998–2011. Overall mortality was 0.81% and mean cost of hospitalization was $25,152.02. The in-hospital mortality reduced from 1.24% to 0.97% (P < 0.0001) and mean cost of hospitalization increased from 11,308.05$ to 32,211.67$. Total yearly spending on BP-U related admissions have increased from $207 million/year to $19.15 billion/year.

Conclusions

While mortality has slightly decreased from 1998 to 2011, the cost has significantly increased from $0.21 billion/year $19.15 billion/year, which leads to an estimated $18.94 billion/year additional burden to US health care system. In the era of cost conscious care, preventing BP-U related hospitalization could save billions of dollars every year. Focused efforts are needed to establish preventive measures for BP-U related hospitalization.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Suicidality and psychiatric comorbidities among adults with childhood identified ADHD: Gender differences – a population-based longitudinal study
Authors: Yoshimasu K. , Barbaresi W.J. , Colligan R.C. , Voigt R.G. , Killian J.M. , Weaver A.L. , Katusic S.K.
Published: May 2016

Objective

To evaluate the effect of comorbid psychiatric disorders (PD) on the association between childhood ADHD and suicidality and the effect of gender on the association between PDs and suicidality among adults with childhood ADHD.

Method

Subjects were recruited from a birth cohort of all children born 1976–1982 remaining in Rochester, MN after five years of age. Participating subjects with research-identified childhood ADHD (n = 232; mean age 27.0 years; 72% men) and non-ADHD controls (n = 335; mean age 28.6 years; 63% men) were administered a structured psychiatric interview (MINI International Neuropsychiatric Interview) to assess suicidality and psychiatric comorbidities.

Results

Compared to controls, ADHD cases were significantly more likely to meet criteria for suicidality [odds ratio (OR) = 2.7, 95% CI 1.7–4.5]. Although this association was not moderated by the presence of PDs (P = 0.63 for interaction effect), the association between ADHD and suicidality was partially mediated by the presence of PDs [OR decreased from 2.7 to 2.1 (95% CI 1.2–3.5)]. Among adults with childhood ADHD, there was no significant moderating effect of gender on the association between suicidality and PD (P = 0.26 for interaction effect). However, the odds of suicidality was 6.1 (95% CI, 2.3–15.9) times higher among males with both externalizing and internalizing PDs compared to males with no disorders; among females the corresponding odds ratio was 3.4 (95% CI, 0.7–16.6).

Conclusion

Childhood ADHD is significantly associated with adult suicidal risk. Among those with ADHD, associations between suicidality and comorbid psychiatric disorders are more apparent in men among those with comorbid externalizing and internalizing disorders.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Loneliness is adversely associated with lifestyle and physical and mental health
Authors: Richard A. , Rohrmann S. , Vandeleur C.L. , Schmid M. , Eichholzer M.
Published: May 2016

Introduction

Loneliness is a common emotional distress experience and there is increasing evidence of associations with unhealthy lifestyle and adverse health-related factors. Little is known about age and sex as potential effect modifiers, and about the prevalence of loneliness.

Objective/aims

To assess the associations of loneliness with behavioral, physical and mental health factors, taking sex and age into account and to examine the prevalence of loneliness in individuals aged 15+ years.

Methods

Data from 20,007 participants of the cross-sectional population-based Swiss Health Survey 2012 were analyzed. The association of loneliness with lifestyle and health-related factors were assessed with logistic regression analyses. Wald tests were used to test for age and sex differences.

Results

Loneliness was reported by 64.1% of individuals, and was associated with smoking (OR 1.13, 95% CI 1.05–1.23), physical inactivity (1.20, 1.10–1.31), non-adherence to the 5-a-day recommendation for fruit and vegetable consumption (1.21, 1.07–1.37), and more visits to a physician within the last year (1.29, 1.17–1.42). Loneliness was also associated with high cholesterol levels (1.31, 1.18–1.45), diabetes (1.40, 1.16–1.67), self-reported chronic diseases (1.41, 1.30–1.54), impaired self-perceived health (1.94, 1.74–2.16), moderate and high psychological distress (3.74, 3.37–4.16), and depression (2.78, 2.22–3.48). Age modulated the associations in BMI, smoking, visiting a physician within the past year, and self-perceived health. Sex did generally not modulate the associations.

Conclusion

Loneliness is associated with unhealthy lifestyle, and poorer physical and mental health. Associations were modulated by age, but not sex. Further longitudinal studies are needed to elucidate the causal relationships of these associations.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Parkinsonism and basal ganglia volumes in first-episode psychosis
Authors: Cuesta M.J. , Sánchez-Torres A.M. , Cabada T. , Lecumberri P. , Lorente-Omeñaca R. , López-Ilundain J.M. , Ribeiro M. , Moreno-Izco L. , Gómez M.
Published: May 2016

Introduction

Parkinsonian motor signs are the most frequent of the genuine motor abnormalities present in drug-naïve patients with schizophrenia, and are also present in patients with a first-episode of psychosis (FEP).

Objective

To study whether there are differences in basal ganglia volumes depending on the presence of Parkinsonism in FEP.

Methods

Forty-six patients with a FEP were included in the study. Twenty-three controls were included to normalise patients’ brain volume data. Parkinsonism was assessed with the UKU scale. Brain volumes were obtained with MRI (1.5 Tesla Siemens Avanto). Reconstruction and volumetric segmentation was made with the Freesurfer© software (http://surfer.nmr.mgh.harvard.edu/). Patients were divided into two groups, considering the presence/absence of Parkinsonism (UKU total score cutoff point = 4). Patients have been treated with antipsychotics a mean of less than 2 months. There were not significant differences in the total exposure to antipsychotics between both groups. ANCOVAS were performed including gender as covariate.

Results

Patients with Parkinsonism showed a trend towards significance to exhibit reduced volumes in the left caudate and right putamen (Fig. 1).

Conclusions

FEP patients who exhibit Parkinsonian signs tend to show reduced left caudate and right putamen volumes in the early phases of psychotic illness, after correcting by gender.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Detection of CYP2D6 polymorphism using Luminex xTAG technology in autism spectrum disorder: CYP2D6 activity score and its association with risperidone levels
Authors: Sukasem C. , Santon S.
Published: May 2016

Introduction

The determination of the accurate CYP2D6 genotyping is essential in the clinical setting and individualization of drug therapy.

Objectives

In this study, was to apply the Luminex xTAG technology to detect significant CYP2D6 polymorphisms and copy number variation, including assessment the relationship of CYP2D6 polymorphisms and risperidone plasma concentration in autism spectrum disorder children (ASD) treated with risperidone.

Methods

All 84 ASD patients included in this study had been receiving risperidone at least for 1 month. The CYP2D6 genotypes were determined by luminex assay. Plasma concentrations of risperidone and 9-hydroxyrisperidone were measured using LC/MS/MS.

Results

Among the 84 patients, the most common genotype was CYP2D6*1/*10 (26.19%). The most common allele was CYP2D6*10 (51.79%) and the second most allele was CYP2D6*1 (27.98%). There were 46 (55.42%) classified as EM, 33 (39.76%) as IM, and 4 (4.82%) as UM. The plasma concentration of risperidone and risperidone/9-hydroxyrisperidone ratio in the patients were significant differences among the CYP2D6 predicted phenotype group (P = 0.001 and P < 0.0001, respectively). Moreover, the plasma concentration of risperidone and risperidone/9-hydroxyrisperidone ratio in the patients with CYP2D6 activity score 0.5 were significantly higher than those with the CYP2D6 activity score 2.0 (P = 0.004 and P = 0.002, respectively).

Discussions

The present study suggests that it would be ideal to identify the CYP2D6 genotype of patients before prescribing and administering risperidone. Furthermore, the use of CYP2D6 gene scoring system to determine an individual's metabolic capacity may become an essential tool for a more rational and safer drug administration.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Birth by cesarean section and schizophrenia. Results from the multi-center FACE-SZ dataset
Authors: Fond G. , Boyer L. , Llorca P.M. , Leboyer M.
Published: May 2016

Objectives

Children born by cesarean section (“c-birth”) are known to have different microbiota and a natural history of different disorders including allergy, asthma and overweight compared to vaginally born (“v-birth”) children. C-birth is not known to increase the risk of schizophrenia (SZ), but to be associated with an earlier age at onset. To further explore possible links between c-birth and SZ, we compared clinical and biological characteristics of c-born SZ patients compared to v-born ones.

Method

Four hundred and fifty-four stable community-dwelling SZ patients (mean age = 32.4 years, 75.8% male gender) were systematically included in the multicentre network of FondaMental Expert Center for schizophrenia (FACE-SZ).

Results

Overall, 49 patients (10.8%) were c-born. These patients had a mean age at schizophrenia onset of 21.9 ± 6.7 years, a mean duration of illness of 10.5 ± 8.7 years and a mean PANSS total score of 70.9 ± 18.7. None of these variables was significantly associated with c-birth. Multivariate analysis showed that c-birth remained associated with lower peripheral inflammation (aOR = 0.07; 95% CI 0.009–0.555, P = 0.012) and lower premorbid ability (aOR = 0.945; 95% CI 0.898–0.994, P = 0.03) independently of age, age at illness onset, sex, education level, psychotic and mood symptomatology, antipsychotic treatment, tobacco consumption, birth weight and mothers suffering from schizophrenia or bipolar disorder.

Conclusion

Altogether, literature data as well as our results suggest that c-birth is associated with lower weight gain and lower inflammation in schizophrenia, which could be explained by microbiota differences. Further studies should take into account c-birth when exploring the role of microbiota in SZ patients.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Disrupted thalamo-orbitofrontal but not fronto-temporal white matter connectivity in people with schizotypal personality disorder
Authors: Lee T.Y. , Kim S.N. , Kwon J.S.
Published: May 2016

Introduction

Despite patients with schizophrenia showed the deficits in the fronto-temporal and thalamo-frontal connectivity, the white matter connectivity in patients with schizotypal personality disorder had not been systemically investigated.

Methods

This study involved 40 neuroleptic-naïve patients with schizotypal personality disorder (SPD), 60 patients with schizophrenia (SCZ), and 100 healthy controls (HC), and scanned on the 3T MRI scanner. Probablistic tractography was performed using the FATCAT software in AFNI. The target brain regions (bilateral lateral frontal, medial frontal, orbitofrontal, temporal and thalamus) were extracted from the automated segmentation and cortical parcellation. Cross-sectional comparisons in mean fractional anisotropy (FA) performed on the thalamo-lateral frontal, thalamo-medial frontal, thalamo-orbitofrontal, lateral frontal-temporal and orbitofrontal-temporal pathway. We also analyzed the relationship between the white matter pathway and the Positive and Negative Syndrome Scale and GAF.

Results

The diffusion tensor imaging showed that SCZ and SPD had decreased FA in the left thalamo-orbitofrontal pathway. However, SPD showed no alteration in the fronto-temporal pathway, despite SCZ showed decreased FA in the left temporo-orbitofrontal pathway. In SCZ, there were significant correlations between FA value in the left temporo-orbitofrontal pathway and negative symptoms score in PANSS and GAF score. However, SPD showed the trend level relationship between the GAF score and FA value in the left temporo-orbitofrontal pathway.

Conclusion

These results suggest that the deficits in thalamo-frontal connectivity may be a trait marker of schizophrenia spectrum disorder, and the deficits in fronto-temporal connectivity may play a key role towards the vulnerability of psychosis.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Neurochemical and behavioral sensitization to d-amphetamine in healthy subjects measured with [11C]-(+)-PHNO-PET
Authors: Popovic A. , Bauer M. , Bartova L. , Sauerzopf U. , Praschak-Rieder N. , Rami-Mark C. , Nics L. , Philippe C. , Mitterhauser M. , Wadsak W. , Kasper S. , Willeit M.
Published: May 2016

Introduction

It has been shown that patients with schizophrenia are super-sensitive towards dopamine-releasing agents such as amphetamine. Here, we studied the effects of amphetamine sensitization on amphetamine-induced dopamine release in healthy subjects.

Objectives

To measure d-amphetamine-induced dopamine release as measured with the D2,3 agonist radioligand [11C]-(+)-PHNO-PET via change in non-displacable binding potential (BPND) and behavioral measures of d-amphetamine effects with drug effects questionnaire (DEQ) and subjective states questionnaire (SSQ).

Aims

To study d-amphetamine-induced sensitization in healthy subjects on a behavioral and neurochemical level with [11C]-(+)-PHNO-PET in order to gain more knowledge on sensitization-induced changes in the dopaminergic system.

Methods

Twelve stimulant-naïve healthy male subjects underwent three 90-min [11C]-(+)-PHNO-PET-scans and four oral administrations of d-amphetamine. After a naïve baseline scan, subjects underwent a PET scan with previous ingestion of 0.4 mg/kg bodyweight of d-amphetamine 90–120 minutes before scanning. Subsequently, subjects were sensitized to d-amphetamine with the same dose on two separate days. Thereafter, they underwent another PET scan with previous d-amphetamine ingestion. DEQ and SSQ were administered before, 60 min, 90–120 min, and 210 min after amphetamine ingestion.

Results

We found significant sensitization effects on a behavioral level and on a neurochemical level after four administrations of amphetamine. Items of the SSQ, which showed significant sensitization effects were “outgoing”, “energetic”, “lively”, “alert” and “focused”.

Conclusions

We were able to induce significant behavioral and neurochemical sensitization in healthy humans, which were measured with [11C]-(+)-PHNO-PET for the first time. This sensitization model will be useful for studying the neurobiology of schizophrenia.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Assessment of cognitive impairment with the cognitive assessment interview (CAI) was useful for identifying poor psychosocial functioning outcome in patients with psychosis
Authors: Sánchez-Torres A. , Elosúa M.R. , Lorente-Omeñaca R. , Moreno-Izco L. , Peralta V. , Ventura J. , Cuesta M.J.
Published: May 2016

Introduction

Cognitive impairments clearly impact the daily functioning of patients with psychosis.

Objectives

To assess cross-sectionally whether there are differences in the cognitive domains assessed with the CAI, for considering the real-world functioning of a sample of patients with psychosis.

Methods

The sample consisted of 76 patients with a DSM-IV psychotic disorder. Patients were assessed with the cognitive assessment interview (CAI), which is an interview-based measure of cognitive functioning that is intermediate between cognitive functioning and daily functioning, and three subscales of the specific levels of functioning (SLOF), an informant-rated measure of functioning. The CAI was used to assess the patient and an informant, and these scores were integrated into a rater composite score. We divided the sample by a median-split procedure for each of the three functional domains, and then applied ANOVAs to compare the two groups (impaired/not impaired) in the six cognitive domains of the CAI: working memory, attention, verbal memory, problem solving, processing speed, and social cognition.

Results

We found significant differences between the impaired vs. non-impaired groups in most of the cognitive domains assessed with the CAI (Fig. 1).

Conclusions

Interview-based assessment of cognition with the CAI allows for the prediction of everyday functioning in patients with psychosis. Impairment in almost all CAI cognitive domains, except for social cognition, was associated with poorer psychosocial functioning.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Adjunctive memantine in clozapine-treated refractory schizophrenia: A one-year extension study
Authors: Veerman S. , Schulte P. , Deijen J.B. , de Haan L.
Published: May 2016

Introduction

In a recent 26-week placebo-controlled, crossover trial (n = 52) we found significant positive effects on verbal and visual memory, and negative symptoms in clozapine-treated patients with refractory schizophrenia.

Objectives

In this 1-year extension study, we report the long-term effects and tolerability of memantine add-on therapy to clozapine.

Aims

To evaluate the persistence of improvements in cognitive functioning and symptoms of memantine add-on therapy to clozapine in schizophrenia.

Methods

Completers of the first trial who experienced a beneficial effect of memantine after 12 weeks continued memantine for one year. Primary endpoints were change from baseline to 26 weeks treatment and 26 weeks to 52 weeks treatment on memory and executive function using the Cambridge Neuropsychological Test Automated Battery (CANTAB), Positive and Negative Syndrome Scale (PANSS), and Clinical Global Impression Severity Scale (CGI-S). Secondary endpoints were change on the Health of the Nation Outcome Scales (HoNOS) and Liverpool University Neuroleptic Side Effect Rating Scale (LUNSERS).

Results

Of 32 completers who experienced a beneficial effect of memantine 23 patients continued memantine for one year. Memory improvement was sustained, verbal recognition memory improved even further between t = 26 weeks and t = 52 weeks. Continued treatment with memantine add-on to clozapine was associated with significantly improved PANSS positive, negative and overall score, CGI-S and HoNOS scores.

Conclusions

In the extension phase the positive effect of memantine add-on therapy on verbal memory sustained and positive, negative and overall symptoms of schizophrenia, clinical global status and psychosocial functioning significantly improved. Memantine was well tolerated without serious adverse effects.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Decreased interhemispheric resting state functional connection in schizophrenic patients with auditory hallucinations
Authors: Wang H. , Wang G.
Published: May 2016

Introduction

Auditory hallucination (AH) has been always concerned as a main core symptom of schizophrenia. However, the mechanisms of AH are still unclear.

Objectives

The aim of this study is to further explore the complicated neuroimaging mechanism of AHs from a new insight by using voxel-mirrored homotopic connectivity (VMHC).

Methods

Forty-two patients with AH (APG), 26 without AHs (NPG) and 82 normal controls (NC) participated in resting state fMRI scan. Correlation analyses were used to assess the relationships between VMHC and Hoffman scores. Additionally, ROI analysis was used to further know about the functional connectivity between the brain areas with changed interhemispheric FC and the whole brain.

Results

APG showed reduced VMHC in the parahippocapus, fusiform gyrus, rolandic operculum, insula, heschl's gyrus and superior temporal gyrus (STG). Hoffman score of APG group had negative correlation with VMHC in these regions. Besides, ROI analysis supported decreased interhemispheric FC in schizophrenia with AH and verified functional connectivity abnormalities in schizophrenia.

Conclusions

These findings suggest impairment of interhemispheric coordination and whole brain FC in schizophrenia with AH, which may be implicated to the neuroimaging mechanism of auditory hallucination. Furthermore, this research highly support dysconnectivity hypothesis that schizophrenia related to abnormalities in neuronal connectivity.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
The structure of mental disorders in HIV-infected patients with syphilis
Authors: Chumakov E. , Petrova N. , Smirnova I.
Published: May 2016

Introduction

There are no data in literature on mental disorders in HIV-infected patients with syphilis.

The objective of the study was to determine the structure of mental disorders in HIV-infected patients with syphilis.

Method

Sixty-five HIV-infected patients with syphilis were examined by a clinical method.

Results

The sample included 45 men (average age 32.09 ± 9.83) and 20 women (average age 31.7 ± 5.97). We divided the sample into three comparison groups (according to the importance of risk factors): women, men who have sex with men (MSM), and men who have sex with women (MSW).

Mental disorders were identified in most patients (83%). Opiate dependence (F11, ICD-10) was established in 55% of women (7.7% for MSW, 0% in MSM; P < 0.001). The dependence on multiple drug use (F19) was revealed with nearly the same frequency in women (25.0%) and in MSW (23.1%); but far less frequently in MSM (3.2%; P = 0.047). The dependence on stimulants (F15) was found in women (5.0%) and MSM (6.3%). The dependence on alcohol (F10) was more common among MSW (61.5%) and women (50.0%) (9.4% in MSM; P < 0.001). 20% of women had Depressive episode (F32). Adjustment disorders (F43) were found much more often in men (43.8% for MSM; 38.5% for MSW; 10% for women; P = 0.035). Personality disorders (F60) were found in all the groups.

Conclusions

We revealed a high incidence of addictions among women and MSW. Affective disorders were represented by depressive episode in women and adjustment disorders in men.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Sleep disturbances and substance use disorders: An international study of primary care and mental health specialty care patients
Authors: Fortuna L. , Noyola N. , Cook B. , Amaris A.
Published: May 2016

Introduction

There is no comprehensive evidence on the influence of sleep disturbances (SD) on substance use disorders (SUD) or treatment use patterns of individuals with comorbid disturbances.

Objective/aim

To better understand comorbidities and treatment use patterns of individuals with SD and SUD.

Methods

We combine 2010–2012 electronic health record (EHR) data from healthcare system in Boston (n = 131,966 person-years) and Madrid, Spain (n = 43,309 person-years). Patients with sleep disturbances (SD) were identified in the EHR through ICD-9 codes and medical records and substance use disorders (SUD) identified by documented treatment for drug or alcohol abuse or dependence. Rates of SUD are compared between individuals with and without SD. Among those with both, adequacy of mental health treatment (defined as eight or more outpatient visits or four or more outpatient visits with a psychotropic prescription) and ER use is compared.

Results

Among the individuals, 21.1% with SD also report SUD, compared to only 10.6% of individuals without SD (P < .01). Those with comorbidities were more likely than their specialty care counterparts without comorbidities to be seen in the ER (57.1% vs. 36.6%, respectively, P < .05). Limiting the sample to only those with both SD and SUD in specialty mental health care (n = 268 in Boston and n = 28 in Madrid), 49.2% of Boston patients received adequate care compared to 38.5% of Madrid patients, and 57.8% of Boston patients had any ER use in the last year vs. 50% of Madrid patients.

Conclusions

SD is correlated with SUD and comorbid patients are more likely to use emergency services.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Demographic characteristics, medical and psychiatric history of patients with prescription opioid use disorder
Authors: Herrera S. , Riquelme A. , León T. , Babul M.
Published: May 2016

Introduction

Over the past two decades the prescription of opioid analgesics has increased with a subsequent escalating in prescription opioid misuse. It is estimated that 4.5 million (2.5%) of the United States of America population abuse of pain relievers; opioids are among the most commonly.

In Chile there are few reports about the prevalence of opioid use disorder.

Objectives

The aim of this study is to describe the demographic characteristics, medical and psychiatric comorbidity of patients that suffer from opioid addiction.

Patients and methods

This transversal study examined data of 7 patients with opioid use disorder (OUD; DSM-5) that consulted at the addiction unit of “Red de Salud, Pontificia Universidad Católica de Chile”, between November 2013 and October 2015. Data included: demographics, medical and psychiatric history, laboratory and imaging tests.

Results

Of all the patients, 57% were men, 25 to 67 years of age, 43% between 35-40 years; 57% were married; 57% had completed studies at university. 43% had also alcohol use disorder, 28% marijuana, 28% cocaine and 28% benzodiazepines than in most cases began before OUD. In addition; 57% had medical comorbidity among which stand out obesity (17%), osteoarthritis (17%) and chronic low back pain (17%). Eighty-three percent require hospitalization. Twenty-eight percent had abnormal liver tests and one patient had positive hepatitis B core antibody. Opioids used were: morphine(14%), codeine (43%), tramadol (42%).

Conclusion

These results emphasize on the misuse of prescription opioids analgesics, the complexity of patients with OUD and the prevalence of other substance use disorder that precedes and accompany OUD.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Psychosis and polydrug abuse in a patient with Dandy-Walker variant
Authors: Orsolini L. , Valchera A. , Vecchiotti R. , Panichi M. , De Berardis D.
Published: May 2016

Background and purpose

Dandy Walker “syndrome” (DWS) was firstly defined by Dandy and Blackfan, and then described by Hart et al. [1] as a series of neurodevelopmental anomalies in the posterior fossa, including Dandy-Walker (DW) malformation, DW variant (cerebellar hypoplasia/aplasia of the cerebellar vermis and cystic dilatation of the fourth ventricle), mega-cisterna magna and posterior fossa arachnoid cyst. Mental symptoms have been associated with DWS in previous reports, but the spectrum of mental symptomatology widely varies between clinical cases, ranging from psychotic/schizophrenia-like to mood/cognitive symptoms [2].

Methods

Here we describe a case of psychosis and polydrug abuse in a 27-year-old man with DW variant a 4-year history of polydrug abuse, sporadic alcohol abuse, epilepsy and psychotic symptoms including delusions of reference/persecution, suspiciousness, associated with obsessive thoughts, mood lability and persistent anxiety.

Results

He was recovered for a 28-day program of detoxification from drug addiction/stabilization of psychiatric symptoms. Family history of Bipolar Disorder, gambling disorder (father) and depression (mother). The mental status examination at baseline revealed slowness of thought, psychomotor retardation, aboulia/anhedonia/apathy/hypomimic facies/asthenia/social withdrawal/deflected mood/poor thought content/blunted affect/self-neglect/poor insight, cognitive impairment and oppositive and partially collaborative attitude and behaviour. Borderline intelligence activity was found on WAIS-R (IQ = 79). At the baseline, he was taking carbamazepine 400 mg BID (baseline serum level: 6.720 μg/ml), gabapentin (400 mg BID), paroxetine (20 mg/d), olanzapine (10 mg/d) and methadone (70 ml/d), with a poor response/control both on psychotic and seeking drug symptomatology.

References not available.

Conclusions

Further DWS clinical cases should be evaluated in order to better investigate the role of this variant to addictive and psychotic symptoms.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Improved drug-use patterns at six months post discharge from inpatient substance use disorder treatment; results from compulsory and voluntary admitted patients
Authors: Pasareanu A. , Vederhus J.K. , Kristensen O. , Clausen T. , Opsal A.
Published: May 2016

Background

The Norwegian Municipal Health Care Act opens for mandated treatment for persons with severe and life-threatening substance use disorder. This study aims to examine substance use related outcomes at six-month following in-patient treatment and to analyse factors associated with improved outcomes and abstinence.

Method

This prospective study followed 202 hospitalised patients with SUD that were admitted voluntarily (n = 137) or compulsorily (n = 65). The European Addiction Severity Index was used at baseline and at follow-up to assess socio-demographics and substance use variables. Regression analysis was conducted to investigate factors associated with abstinence at six-month follow-up.

Results

The frequency of use of preferred substance showed markedly improvement for both voluntary admitted (VA) and compulsory admitted (CA) patients (61% and 37% respectively) at follow-up. Seventy-five percent of VA patients using amphetamine reported improvement compared to 53% of CA patients. At follow-up, the CA group continued to have a higher rate of injection use. The CA group had experienced higher rates of overdose the past six months and lower abstinence rates (24% versus 50%) at follow-up. Lower severity of drug use at intake (non-injection drug use), voluntary treatment modality and higher treatment involvement during follow-up all were significant factors associated with abstinence at follow-up.

Conclusion

Voluntary treatment for SUD generally yielded better outcomes; nevertheless we found improved outcomes also for CA patients. It is important to keep in mind that the alternative to CA treatment in reality is no treatment at all and instead a continuation of life-threatening drug use behaviours.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
The role of buprenorphine maintenance therapy in opioide recidive prevention: Experiences from Croatia
Authors: Radic K. , Bosnjak D. , Korpar A. , Puljic A. , Bagaric A.
Published: May 2016

Introduction

Buprenorphine, a partial agonist of mu opioid receptors and an antagonist at kappa opioid receptors, is widely used in the treatment of the opioid addiction, as it reduces cravings and effects of opioid withdrawal, decreases opioid consumption and diminishes rewarding effects of it. In University Psychiatric Hospital Vrapče, the oldest psychiatric hospital in Croatia, buprenorphine maintenance therapy is a standard and important part of integrative psychiatric treatment offered to opioid drug users.

Aims

To show potential benefits of buprenorphine maintenance therapy as a pharmacological agent in psychiatric care for opioid drug users.

Objectives

To describe series of clinical cases in which the introduction of buprenorphine in therapy of opioid drug users lead to reduced number of their hospitalizations.

Methods

Clinical cases from University Psychiatric Hospital Vrapče Addictions Treatment Department were identified and the course of patients’ treatment was analyzed. Summaries of cases, with the emphasis on protective factors for stabile maintenance, are presented.

Results

After switching patients from various opiates to buprenorphine in a controlled in-patient environment, our patients became more functional and their integrative psychiatric treatment could then start. After discharge, an improvement was visible in different dimensions of their lives, and the re-admittance was the exception, since recidives were rare. They continued their treatment actively, in outpatient programmes of our clinic.

Conclusions

Drug-seeking behaviour of presented opioid users was avoided by buprenorphine maintenance therapy provided with intermittent psychotherapeutic interventions or usual psychiatric support in aftercare. In our experience, such integrative psychiatric care prevents re-admittances and recidives.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
New drugs: Use of everyday substances as substances of abuse
Authors: Ramirez Dominguez M.D.L.C. , Prieto Sánchez I. , Nuñez Caro M. , Hernandez Gonzalez L.
Published: May 2016

Introduction

Emerging drugs are a growing problem, of which we have little information and clinical experience and pose a challenge in everyday clinical practice because many are not detectable with the test at our disposal and its effect on cognition and behavior are not well known.

Methods

Conduct a thorough literature review of all the material in this regard has been published both in high impact journals and in the last International Congress of Dual Pathology.

Results

There are many and varied new substances used for harmful/abuse consumption mainly for their sedative effects and/or hallucinogens, easily accessible since many are easily purchased online or can even be easily obtained at any pharmacy without a prescription.

Conclusion

There are more and more often consumed new substances with high harmful potential and very easy to obtain. It is therefore essential knowledge to identify, treat and educate not only our patients but to the general population.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Addictive behaviours: Cocaine and cannabis use
Authors: Raposo M.R. , Ivanov V. , Martínez I. , Murcia J.B. , González A.L. , Piqueras M.D. , Manzur P. , Gil A. , Belmar A. , Bravo S. , Bello I. , Rodríguez A.
Published: May 2016

Introduction

The most common psychiatric disorders associated with substance use in patients with dual diagnosis, personality disorders are followed by schizophrenic disorder. Among the substances used in patients with dual diagnosis, stands cocaine, followed by cannabis and alcohol.

Objectives

Evaluate the differences in the frequency of sex for cocaine and cannabis consumed in a sample of patients undergoing follow Mental-Health Center for Drug Dependency Unit.

Material and method

We conducted a cross-sectional study and analyze the differences by gender for the frequency and pattern of cocaine and cannabis, in a sample of patients in treatment at the Mental-Health Center for a year to present dual pathology.

Results

There are significant differences in the frequency of cocaine use among men and women. Eight percent of men use cocaine compared to 0% of women. This monthly cocaine use is more common in women than in men at 45.5% versus 21.8%. Of women, 27.3% use cocaine fortnightly, which is not typical for men (0% of men in the sample). The weekly use of cocaine represents 55.2% among men compared to 27.3% of women.

There are no significant differences in the frequency of cannabis use among men and women. Both sexes consume cannabis daily.

Conclusions

The monthly cocaine use is more common in women. In men the most common is the use of cocaine weekly.

In both sexes cannabis use is more common daily.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Cocaine use and employment
Authors: Raposo M.R. , Ivanov V. , Murcia J.B. , Piqueras M.D. , Martínez I. , González A.L. , Busaileh A. , Manzur P. , Belmar A. , Bello I. , Bravo S. , Gil A. , Rodríguez A.
Published: May 2016

Introduction

Cocaine use is prevalent in mental health consultations in both sexes. However, in men and women there are differences in the frequency of use of substances and on the employment situation.

Objectives

Show the differences for the use of cocaine and employment status of men and women, in a sample of patients followed at the Mental Health Center in Drug Dependency Unit.

Material and methods

We conducted a cross-sectional study and analyze the differences according to sex for cocaine use and the employment situation, in a sample of patients who are undergoing treatment at the Mental Health Center for a year diagnosed with dual pathology.

Results

In men in active employment status, the percentage of cocaine use is 19.5% and if we compare with women in the same job situation, the percentage of cocaine use is 0%.

Men who are unemployed use more cocaine than women in the same job situation. For retirees, the highest percentage of cocaine is found in women.

Hundred percent of women use cocaine by sniffing. Men use different ways of cocaine consume.

Snorted way 67.7%, 14.9% smoked and snorted, smoked 8% and 2.3% intravenous.

Conclusion

Men use cocaine more frequently unemployed while women do more it often being retired.

The route most used cocaine consume in both sexes is snorted.

Disclosure of interest

The authors have not supplied their declaration of competing interest.