bluuebunny/crossref_metadata_2025 huggingface dataset:
Anger Expression, Impulsivity And Expressed Emotion: a Comparison Between Patients With Eating Disorder And Schizophrenia
Authors: Gambaro E. , Gramaglia C. , Cenci D. , Delicato C. , Lombardi A. , Rizza C. , Girardi L. , Binda V. , Chieppa N. , Prosperini P. , Bert F. , Siliquini R. , Zeppegno P.
Published: May 2016

Introduction

The level of express emotion (EE) is a measure of the attitude of close relatives towards a patient and include dimensions as critical comments, hostility and emotional over-involvement. Anger and impulsivity may lead to self-injurious and aggressive behaviours, and often represent an obstacle to treatment.

Aims

To compare anger expression, impulsivity and expressed emotion in ED and SCHZ, and to explore the different level of caregivers’ EE in the two groups.

Methods

Twenty-five female with ED diagnosis and 25 patients with schizophrenia, were recruited at the Psychiatry Ward and outpatient Service of AOU – Novara, during one year period. Patient's assessment included Global Assessment of Functioning (GAF), Structured Clinical Interview (SCID 1-2), Level of Expressed Emotion Scale (LEE), Paykel scale, State and Trait Anxiety Inventory (STAY 1-2), State-Trait Anger Expression Inventory (STAXY), Barratt Impulsiveness Scale (BIS-11).

Results

Levels of anxiety (both state and trait) are higher in the ED group than in SCHZ. As far as the STAXY is concerned, SCHZ patients score higher than ED ones on control over anger, while general index of anger expression was higher in ED patients. We did not find significant differences in EE between two groups, except for the patient's emotional response of the patient to the disease, which was greater among SCHZ. Both SCHZ and ED patients scored higher on the LEE, Paykel and STAY than their caregivers.

Conclusions

SCHZ and ED patients show different patterns of anxiety and anger, but similar profile as far as EE is concerned. Implications for treatment will be discussed.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Delusional of Parasitosis in Geriatric Patients
Authors: Rodriguez M. Gutierrez , Menguiano C. Moreno , Sanchez F. Garcia , Aragon R. Martin
Published: May 2016

Introduction

Delusional of parasitosis or Ekbom's syndrome (ES) is a psychiatric disorder in which the patient has a fixed and false belief that small organisms infest the body. The belief is often accompanied by hallucinations. It is an uncommon condition that was initially studied by dermatologists, more prevalent in the elderly and typically observed in women older than 50 years although isolated cases among men have been reported.

Objective

To review current knowledge about delusional of parasitosis in elderly patients through literature systematic review and the analysis of a case report.

Methodology

We performed a literature search using electronic manuscripts available in PubMed database published during the last five years, following the description and discussion of a clinical case. We report a case of an 85-year-old man who presented a delusional parasitosis as a primary disorder.

Results

The literature on ES consists mostly of case reports and limited series. In this paper, we analyze the etiology, demographic characteristics, clinical features and treatment in geriatric patients with delusional parasitosis.

Conclusion

International classifications have included this syndrome in non-schizophrenic delusions. However, it has also been reported in schizophrenia, affective disorders, and organic or induced psychosis. Treatment is based on antipsychotic agents, psychotherapy and cooperation between dermatologists and psychiatrists.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Anxiety and Depression in European Immigrants in Africa: Spaniards in South Africa
Authors: Aguado L. , Porras A. , Calvo P. , Tomita A. , Burns J. , Muñoz-Negro J.E.
Published: May 2016

Introduction

It is easy to find texts, in scientific literature, studying the adaptation of immigrants from developing countries in western countries. However, in these globalization times that we are living, few are the studies performed on members from developed countries emigrating to the third world.

Objectives/Aims

To evaluate the factors predisposing to the onset of anxiety or depression symptoms in Spanish immigrants living in South Africa.

Methods

This is an exploratory study with a sample of 51 Spanish residents in South Africa between 24 and 57 years (44% male, 56% female), 44% of which were living there for more than two years. An online survey was administered, collecting data related to reasons and conditions for their moving to the country and traumatic events living during the stay. For the screening of depression and anxiety symptoms Hopkins Symptom Scale (HSCL-25) was used. Finally, we carried about several analysis using Chi2 test. For statistical analysis SPSS was utilized.

Results

Thirty percent of the sample showed positive scores on anxiety symptoms scale, and 24% scored positive for depression. Job related items as being unemployed (P < 0.001) was associated to symptoms of depression. Insecurity/violence (P < 0.021) and race discrimination (P < 0.009) were the main factors related to anxiety symptoms.

Conclusions

Factor related to employment, security and discrimination, has been significantly associated to the onset of anxiety and depression symptoms. Other factors related to the moving to the country or social relationships have shown no relations. More studies are needed to provide information about adaptation and factors related to mental health in Occidental immigrants in developing countries.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Peculiarities of Depressive Disorders in Emigrants and Re-Emigrants
Authors: Maruta N.O. , Venger O.P. , Panko T.V. , Yavdak I.O.
Published: May 2016

Introduction

Emigration and remigration are one of the greatest modern problems and considered as a factor provoking manifestation and exacerbation of mental disorders as well as pathocharacterological personality changes. In emigrants and re-emigrants peculiarities of course of depressive disorders with different genesis are not investigated, that impedes a development of adequate therapeutic methods.

Aim

To study clinical-psychopathological peculiarities of depressive disorders in emigrants and re-emigrants patients with psychogenic (F43.21, F43.22) (69 non-emigrants, 68 emigrants, 67 re-emigrants), endogenous (F31.3, F31.4, F32.1, F32.2, F33.1, F33.2) (65, 66 and 63 patients, respectively) and organic depressive disorders (F06.3) (64, 62 and 61 patients, respectively) were examined.

Methods

A clinical-psychopathological investigation, Standardized Personality Examination Method, Lusher's Method of Color Choices, HDRS, HARS, MADRS, and SCL-90-R.

Results

The highest level of severity of depressive disorders in re-emigrants and the lowest level in non-emigrants were registered. Re-emigrants had predominantly depressive, asthenic-depressive and apathic-depressive forms, whereas emigrants had mainly anxious-depressive ones. According to SCL-90-R data, emigrants had higher indexes of somatization, obsessive-compulsive disorders, anxiety, whereas re-emigrants had higher indexes of depression and interpersonal sensitivity as well as an index of distress expression. In patients examined it was determined a predomination of dysthymic personality traits manifested in the frameworks of the leading depressive of anxious-depressive syndromes. An influence of emigration and remigration factors was the greatest in psychogenic depressions and the lowest in organic depressive disorders.

Conclusions

The abovementioned regularities should be taken into account in pharmacotherapy and a social-psychological support for such patients.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Skin Picking – A Case Report
Authors: Fonseca A. , Poças A. , Batista A. , Araújo R.
Published: May 2016

Introduction

Compulsive skin picking and trichotillomania are both impulse control disorders, characterized by the need or urge to touch, scratch, scrub, friction, rub, bite, press or dig in the skin; it is often an answer to minimum skin defects or to mild acne. The resulting tissue damage can be moderate to severe.

Objective

Case report of a woman with Skin picking resistant to treatment.

Methods

Clinical observation.

Results

43-year-old woman who was admitted in emergency in June 2014 because of her skin lesions. After observation by Dermatologist she was sent to the Psychiatric due to injuries caused by her. She referring compulsion to scratch, bite and tear the skin since she was 3 years old. After introduction of psychotropic drugs, the patient was referred to the Psychiatric consultations. After 1 year consultation there is some clinical improvement.

Conclusion

Despite clinical advances in psychiatry, the Skin Picking disease is still little known today, requiring more research and knowledgement in terms of phenomenology and of treatment.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
An Approach to Comorbidity Between Obsessive-Compulsive Disorder and Schizophrenia
Authors: Gomez Peinado A. , Cañas Fraile S. , Cano Ruiz P.
Published: May 2016

Introduction

An association has been observed between obsessive symptoms in Obsessive Compulsive Disorder (OCD) and psychotic symptoms in schizophrenia, being sometimes difficult to establish a clear limit between them. The term “schizo-obsessive disorder” was proposed to describe the resulting disorder of comorbidity of OCD and schizophrenia, although it has not been definitely settled.

Objective

To analyze the incidence of coexistence of OCD and schizophrenia symptoms and the way it modifies the treatment and prognosis of the illness.

Method

Review of some articles published in Mental Health journals such as “Salud Mental” and “Actas Españolas de Psiquiatría”.

Results

Some studies about psychotic patients have determined 15% as the average of comorbidity of OCD and schizophrenia. The probability of having OCD is six times bigger if there is psychotic pathology associated.

The fact that obsessive and psychotic symptoms get together in some patients shades the prognosis bringing more negative symptoms, more depressive humor, a larger cognitive impairment, more resistance to treatment and more relapses than we can observe in OCD and schizophrenia isolated.

The pharmacological treatment usually consists in neuroleptic plus anti-obsessive drugs, together with cognitive-behavioral therapy. Sometimes, when there is a very bad evolution, it is required to consider psychosurgery as one necessary option, even though its use in this context is not much widespread.

Conclusions

The simultaneous presence of OCD and schizophrenia is more common than we could expect only by chance and makes the prognosis worse, being difficult to find a truly effective treatment.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Personality Disorders and Suicide Attempts
Authors: Muquebil Ali Al Shaban Rodriguez O.W. , López Fernández J.R. , Huergo Lora C. , Ocio León S. , Hernández González M.J. , Alonso Huerta A. , Gómez Simón M. , Abad Acevedo I. , Rubio Rodríguez L. , García Álvarez G. , González Suárez A.
Published: May 2016

Introduction

The personality disorders are defined according to the DSM-5 like “an enduring maladaptive patterns of behavior, cognition and inner experience, exhibited across many contexts and deviating markedly from those accepted by the individual's cultures. These patterns develop in adolescence and the beginning of adulthood, and are associated with significant distress or disability”. The personality disorders can be a risk factor for different processes of the psychiatric pathology like suicide. The personality disorders are classified in 3 groups according to the DSM-5:

– cluster A (strange subjects): paranoid, schizoid and schizotypal;

– cluster B (immature subjects): antisocial, bordeline, histrionic and narcissistic;

– cluster C (frightened subjects): avoidant, dependent and obsessive-compulsive.

Aims

To describe the influence of personality disorders in suicide attempts.

Methodology

Exhibition of clinical cases.

Results

In this case report, we exhibit three clinical cases of suicide attempts which correspond to a type of personality disorder belonging to each of the three big groups of the DSM-5 classification, specifically the paranoid disorder of the cluster A, the disorder borderline of cluster B and the obsessive compulsive of cluster C.

Conclusions

The personality disorders have a clear relation with the suicide attempts, increasing this influence in some of them, especially the borderline personality disorder.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Occurrence of Addictions, Self-Harm Behaviours, Suicidal Attempts in Patients With Personality Disorder (Pd)
Authors: Wypiór M. , Zioła A. , Sobieraj A. , Krysta K.
Published: May 2016

Introduction

According to previous researches, the risk of addictions and self-harm or suicidal behaviours seems to be higher in patients with personality disorders (PD) than in general population.

Objective

To prove that patients with the diagnosis of PD are in the group of risk of addictions, self-harm behaviours and suicidal attempts.

Aims

Analysis the occurrence of addictions, autoagressive behaviours and suicidal attempts in patients with PD.

Methods

Retrospective analysis of 123 patients diagnosed with PD and hospitalized over the years 2012-2015 in the Department of psychiatry and psychotherapy, medical university of Silesia, Katowice. Statistic analysis of variables and comparing with previous studies.

Results

Three quaters of hospitalized patients were females.

Average age in analysed population was about 48.5 years old.

The frequency of suicidal attempts history was 38% among these patients.

Most popular method of suicidal attempts was drugs overuse.

Nineteen percent of PD patients has revealed self-harm behaviours history.

PD's population have 46% risk of addictions.

Conclusion

Hospitalized patients with personality disorders are in the group of risk of addictions, self-harming behaviours and suicidal attempts.

Care should be taken with patients revealing any risk of autoregressive behaviours and they should be advised accordingly. Preventive actions should be taken with these patients when any life-threatening behaviours suspecting.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Childhood Physical Punishment as Risk Factor for Combat-Related PTSD
Authors: Becirovic E. , Softic R. , Mirkovic Hajdukov M. , Becirovic A.
Published: May 2016

Introduction

Risk and protective factors for PTSD can be grouped into pretraumatic, peritraumatic, and posttraumatic. Reported childhood abuse has predictive risk effects for PTSD than most other pretraumatic risk factors.

Objective

To examine childhood physical abuse history in war veterans.

Aims

To determine whether childhood physical abuse is risk factor for PTSD in war veterans.

Methods

Cross-sectional study of 205 war veterans tested by Harvard Trauma Questionnaire and sociobiographic Questionnaire (with data of childhood physical punishment).

Results

A significant difference in reported childhood physical punishment between war veterans with and without PTSD was found. Veterans with PTSD were identified as recipients of childhood physical punishment.

Conclusions

Childhood physical punishment has positive correlation with development of PTSD in war veterans.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Psychiatric Re-Hospitalization in Mental Disorders
Authors: Hervías Higueras P. , Maroto Martín L. , Jimenez de los Galanes Marchán P. , San Román Uría A. , Nuñez Morales N.
Published: May 2016

Many patients with severe mental illness are admission in hospital; but little is known about psychiatric re-hospitalization in this population. Our objective was to identify motives of psychiatric re-hospitalization in Dr. Rodriguez Lafora hospital. It is an observational, descriptive and retrospective study. We collected information about patients aged 18 to 64 who were hospitalized during the month of January of 2015 in the acute psychiatric hospitalization by Selene software. We reviewed psychiatric re-hospitalization for 6 months later and the results were analyzed by SPSS software. The percentage of inpatients with a diagnosis of schizophrenia spectrum and other psychotic disorders was 29.4%, 13.7% bipolar disorders, 13.7% personality disorders, 11.8% depressive disorders, 9.8% alcohol use disorders, 3.9% schizoaffective disorders, 3.9% intellectual disabilities, 3.9% adjustment disorders with depressed mood, 3.9% obsessive-compulsive and related disorders, 2% substance-related and addictive disorders, 2% feeding and eating disorders and 2% adjustment disorders with mixed anxiety and depressed mood. The percentage of psychiatric re-hospitalization in patients with alcohol use disorders was 60%, 57.1% personality disorders, 50% obsessive-compulsive and related disorders, 50% schizoaffective disorders, 28.6% bipolar disorders, 26.7% schizophrenia spectrum and other psychotic disorders and 0% in the other inpatients. Why the percentage of psychiatric re-hospitalization is higher in patients diagnosed with personality disorder and alcohol use disorders? It would be important to establish an approach through more appropriate units as alcoholic detoxification unit and personality disorders unit.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Psychoneuroimmunology Alternations As A Comorbidity of Post-Traumatic Stress Disorder In Veterans – Case Report
Authors: Đerke F. , Filipovic-Grcic L. , Braš M. , Djordjevic V.
Published: May 2016

Post Traumatic Stress Disorder (PTSD) is defined as an extensive response to a major traumatic event. Psychoneuroimmunology represents an integrative approach in tackling and understanding various human diseases and disorders such as cardiovascular, autoimmune and physical complaints/chronic pain. Psychosocial context influences brain stress response pathways and modifies stress-related behavior. In this case report, we observed 5 patients, veterans from Croatian War of Independence (1990-1995), who suffer from PTSD. They have altered stress reactivity, as well as distinct expression for genes involved in immune activation. Those patients have been found to exhibit a number of immune changes including increased circulating inflammatory markers, increased reactivity to antigen skin tests, lower natural killer cell activity, and lower total T lymphocyte counts. The traumatic event (Croatian War of Independence) generates downstream alterations in immune function. This case report imply that immune dysfunction caused by PTSD may mediate or facilitate somatic conditions.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Anxiety Among Hiv-Infected Patients – When Anxiety Is A Disorder and not Simply A Natural Reaction to a Life-Threatening IIIness
Authors: Marinho M. , Amaral A. , Pereira E. , Marques J. , Bragança M.
Published: May 2016

Introduction

HIV infection is a chronic disease characterized by a great deal of uncertainty and unpredictability, being anxiety disorders a frequent psychiatric problem.

Objective

To provide an overview of anxiety in HIV-infected patients.

Methods

Literature review based on PubMed/Medline, using the keywords “HIV” and “anxiety disorders”.

Results

HIV-infected individuals can experience symptoms of anxiety across the spectrum of anxiety disorders. Adjustment disorder with anxious mood is the most common diagnosis, followed by generalized anxiety disorder and panic disorder. Some patients present with these disorders prior to notification, others develop them during the course of their illness, mainly at key moments. In HIV-infected patients, anxiety can be a manifestation of side effects of medication; a symptom of an illness associated with HIV disease; or, most commonly, the psychological response to the stressors of the illness. In fact, many issues are responsible for the anxiety experienced by people living with HIV. The authors will analyze them. Besides the distress of anxiety disorders, these lead to a decrease in adherence to antiretroviral treatments, resulting in adverse progression of HIV disease and increased risk of mortality. Importantly, however, appropriate psychiatric intervention can do it over.

Conclusions

Careful diagnosis and treatment of anxiety disorders in the context of HIV disease is even important, given the serious effects if untreated. Thus, anxiety should never be seen simply as a natural reaction to a life-threatening illness.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Choosing an antipsychotic on a case of late-onset psychosis – A challenge on everyday practice
Authors: Oliveira M. , Peixoto M.J. , Novais C. , Santos C.
Published: May 2016

Introduction

Psychosis with onset in late adulthood already constitutes a challenge on the differential diagnosis and treatment, especially in polypharmacy patients.

Methods and aims

We present a case report of a 61-year old woman with a late-onset psychosis and discuss the clinical evolution and the pharmacological treatment.

Results

The patient suffered from obesity, type II diabetes mellitus with poor glycemic control, and hypertension. She had a first psychotic episode at the age of 56, having persecutory delusional ideas and auditory hallucinations with psychomotor agitation and insomnia. She was first medicated with an atypical antipsychotic (olanzapine) with little response and worsening of the glycemic control. A switch was performed to haloperidol with remission of symptomatology with low doses (4 mg/day). Through follow-up the doses of haloperidol was decreased and eventually suspended, but having a relapse a few months later. Haloperidol was again introduced and the symptoms remitted. Stability was maintained, but the patient started to show lower limbs symmetrical rigidity and psychomotor retardation. It was decided to switch haloperidol to risperidone, but the patient reported side effects with its use, and had to stop it. Haloperidol was again introduced, but had to be discontinued after motor symptoms got worse. Again the patient had another recurrence of psychotic symptoms and it was decided to introduce paliperidone (6 mg/day) with good response and tolerability.

Conclusions

The safety and tolerability of antipsychotic medication is variable. When choosing a treatment in a patient with comorbid medical conditions, it can severely influence the desirable outcome.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Obsessive symptoms in schizophrenia: A case report
Authors: Benavente López S. , Salgado Borrego N. , de la Hera Cabero M.I. , Oñoro Carrascal I. , Flores L. , Jiménez Rico R.
Published: May 2016

Introduction

Schizophrenia could be presented with obsessive thoughts or an obsessive-compulsive disorder. It is known that some antipsychotics like clozapine could cause obsessive symptoms or worsen them.

Case Report

We report the case of a 53-year-old male who was diagnosed of schizophrenia. The patient was admitted into a long-stay psychiatric unit due to the impossibility of outpatient treatment. He presented a chronic psychosis consisted in delusions of reference, grandiose religious delusions, and auditory pseudohallucinations. He often presented behavioral disturbances consisted in auto and heteroaggressive behavior, being needed the physical restraint. Various treatments were used, including clozapine, but obsessive and ruminative thoughts went worse. Because of that, clozapine dose was lowed, and it was prescribed sertraline and clomipramine. With this treatment the patient presented a considerable improvement of his symptoms, ceasing the auto and heteroaggressive behavior, presenting a better mood state, and being possible the coexistence with other patients. Psychotic symptoms did not disappeared, but the emotional and behavioral impact caused by them was lower.

Discussion

This case report shows how a patient with schizophrenia could present severe behavioral disturbances due to obsessive symptoms. If obsessive symptoms are presented, clozapine must be at the minimum effective dose and antidepressants with a good antiobsessive profile.

Conclusions

Obsessive symptoms could be presented as a part of schizophrenia. Clozapine could worsen this symptoms and it is necessary to adjust its dose to the minimum effective dose.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Internalized stigma, negative symptoms and global functioning in schizophrenia
Authors: Capatina O.O. , Miclutia I.V.
Published: May 2016

Introduction

Negative symptoms (NS) of schizophrenia were usually described as a unitary construct and as a separable domain of pathology; however recent studies suggest, that they encompass 2 separable domains: Diminished Expression (DE) and Avolition-Apathy (AA). Research into the relationship between internalized stigma and NS have yielded mixed results up to present.

Objective

The objectives of this study was to assess the factor structure of NS and to examine the relationship between these factors and internalized stigma, global functioning and sociodemographic characteristics.

Aims

The broad aim of this study was to gather greater understanding of the relationship between internalized stigma, NS and global functioning.

Methods

A sample of 50 consecutive subjects were recruited from outpatient psychiatric hospitals meeting the criteria for schizophrenia according to ICD-10. The patients were evaluated using the Positive and Negative Symptoms Scale (PANSS), Negative Symptoms Assessment-16 items (NSA-16), Global Assessment of Functioning (GAF), Clinical Global Impression-Severity Scale (CGI-s), Internalized Stigma of Mental Illness Scale (ISMI) and were interviewed to assess sociodemographic characteristics.

Results

A two-factor structure for the domain of NS was found: an AA and DE profile group. AA and DE subgroups significantly differed on clinically relevant external validators and greater resistance to stigma is related to both fewer AA and DE symptoms in people with schizophrenia.

Conclusions

Our findings suggest that the different subdomains of NS can be identified within the broader diagnosis of schizophrenia and that they should be analyzed as distinct domains and that stigma resistance can be a possible intervention target to ameliorate NS.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Treatment with antipsychotics and sexual dysfunction in a sample of schizophrenic inpatients
Authors: García Mahía M.D.C. , Fernández Quintana Á. , Vidal Millares M. , Castro Calvo R.
Published: May 2016

Introduction

Previous studies show association between sexual dysfunction and antipsychotic treatment.

Objectives

To study the prevalence and clinical correlates of sexual dysfunction in schizophrenic inpatients treated with antipsychotics. To analyze the influence of sexual complaints in treatment adherence.

Methods

Retrospective descriptive study of psychiatric inpatients diagnosed of schizophrenia following DSM-IV-TR) criteria and treated in an acute care unit of Psychiatry in an university hospital in a 12-month period. Patients treated with combination of antipsychotics (typical and atypical) were excluded from the analysis (n = 60). Sexual side effects were evaluated with Udvalg for Kliniske Undersogelser (UKU) Side Effect Rating Scale and evaluated in two treatment groups: conventional antipsychotics, and atypical antipsychotics. Patients were asked about subjective experience with other treatments.

Results

The mean age of subjects was 32.4 (SD = 8.7). From the whole sample 38 (63.3%) were men and 22 (36.7%) women. Sexual dysfunction related to treatment was present in 78% of patients. Men were more affected than women and 69% of them related that sexual dysfunction had influenced the decision of treatment withdrawal previous to income. Amenorrhea was more common on risperidone and amisulpride. Analysis of different antipsychotics and its relationship with sexual dysfunction are presented.

Conclusions

Sexual dysfunction is a frequent side effect associated with antipsychotics in schizophrenic patients. The sexual side effects may reduce the quality of life and may increase non-compliance that is usually associated to readmissions and worse prognosis of severe mental illness.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Analysis of the duration of untreated illness (DUI) in the first episode psychosis Program (FEP) in AGS South Granada
Authors: Girela Serrano B. , Guerrero Jiménez M. , Carrillo de Albornoz Calahorro C.M. , Rodrigo Manzano J.A. , Martínez García O.B.
Published: May 2016

Introduction

Duration of untreated illness (DUI) has been considered as a relevant variable used to measure the degree of disabilities that are associated with psychotic disorders. In this paper we describe a cluster of patients with a DUI superior to 1 year according to their symptoms and sociofamiliar functioning.

Methods

We compare a group with a DUI superior to 1 year (n = 7) against a group with a DUI inferior to 1 year (n = 17).

Results

The group with a DUI superior to 1 year showed an average age of 4 years younger (21) as the duration of untreated psychosis (DUP) of 1 to 3 months in the 80% of cases and higher percentage of unemployed or without occupation. The 60% were derived from primary care, compared to the 17% of the other group. Although the consumption of toxic substances was similar in both groups, no toxic psychosis were found in comparison with the 35% present in the group with a DUI inferior to 1 year. PANSS’ profile scored more positive and less negative symptoms. Both have similar general psychopathology. There were group differences in the Social Functioning Scale (SFS) with lower scores in the superior to 1 year DUI, in the following scales: Prosocial, Autonomy, Execution and Employment. The Global Assessment of Functioning (GAF) gives an average of almost 8 points higher.

Discussion

While the SFS shows significant differences in several areas of social functioning, both PANSS’ profile and the family questionnaire do not support greater deterioration, as evidenced in the GAF's average score.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Institutionalization of patients with schizophrenia in the modern era
Authors: Ifteni P. , Szalontay A. , Teodorescu A.
Published: May 2016

Introduction

Patients with schizophrenia requiring long-term institutionalization represent cases with poor outcome, often leading to high costs for patients and family and constituting a huge economical burden for society if patients are young.

Aims

The aims were the evaluation of patient hospitalized for long period in a psychiatric hospital for chronic patients.

Objectives

The objectives of the study were identification of characteristics and predictors of institutionalization in schizophrenia.

Methods

Retrospective study of all institutionalized patients with schizophrenia in Brasov County, Romania, with a DSM-IV-TR lifetime diagnosis of schizophrenia institutionalized between 1995 and 2014.

Results

Institutionalized patients between 2005 and 2014 (n = 172) had lower age (51.15 vs. 57.08, P < 0.05) and lower age at institutionalization compared with patients admitted between 1995 and 2004. Lower education level (8.23 vs. 13.22, P < 0.05), only one parent, multiple antipsychotics treatments and suboptimal response under first generation long acting antipsychotics are predictors for institutionalization. Haloperidol is the main treatment option (42.54%) followed by olanzapine 17.1% and clozapine 10.24%.

Conclusions

Our study showed a tendency to institutionalize patients with schizophrenia at the younger age compared with past decades. Early intervention in psychosis, controlled treatment with SGAs should be solutions to avoid institutionalization of young patients with schizophrenia.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Psychogenic polydipsia and schizophrenia
Authors: Maroto Martín L. , Hervías Higueras P.
Published: May 2016

Introduction

Psychogenic Polydipsia is defined as the desire to drink liquid in big quantities with an inappropriate activation of the mechanisms of thirst without loss of liquid for urine. This disorder is frequent enough and can derive in a water poisoning, a clinical presentation of high mortality.

Objective

Review of the Psychogenic Polydipsia in patients with schizophrenia and theoretical discussion of a case report.

Methods

A case report of a 58-year-old male, admitted in hospital with a clinical presentation of hyponatremia with severe low serum osmolarity secondary to Psychogenic Polydipsia. As psychiatric history he has a diagnosis of Paranoid Schizophrenia for forty years in treatment with Paliperidone 6 mg: 1-0-0, Haloperidol 10 mg: 0-0-0.5, Quetiapina 300 mg: 0-0-1, Trazodona 100 mg: 0-0-1, Ketazolam 30 mg: 0-0-1, Diazepam 10 mg: 0-0-1.

Discussion

Psychogenic Polydipsia is not included in any section of current psychiatric classifications as specific diagnosis. There are several psychiatric disorders that may present with psychogenic polydipsia; however, the most common cause appears to be schizophrenia.

Conclusions

Mechanisms of hyponatremia in patients with schizophrenia are not well clarified; nevertheless, dopamine seems to be the common link between psychogenic polydipsia and schizophrenia.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Clinical correlates of comorbid chronic tics and Tourette syndrome in a National Inpatient Children's Unit
Authors: Zinna S. , Kyriakopoulos M.
Published: May 2016

Introduction

Chronic tics and Tourette syndrome (TS) can be comorbid with several neuropsychiatric conditions and may add to the complexity of children's clinical presentation and need for inpatient input.

Objectives

To review the clinical notes of all children admitted to a National Children's Inpatient Unit (aged up to 12 years) over a 5-year period and analyse their demographic and clinical characteristics including the presence of chronic tics/TS.

Aims

To assess the clinical correlates of comorbid chronic tics/TS in an inpatient preadolescent population.

Methods

A retrospective naturalistic study of all patients admitted to our unit from 2009 to 2014 was conducted. Children with and without chronic tics/TS were compared in terms of age, gender, family history of mental illness, history of neurodevelopmental problems in siblings, medication on admission and at discharge, length of admission and functional outcomes using Chi2 and t-tests for categorical and continuous data respectively.

Results

A total of 133 children (mean age = 11.2 years) were included. Twenty-five (18.8%) were diagnosed with chronic tics/TS. Autism spectrum disorder was the most commonly comorbid diagnosis (84%), with the second most common being an anxiety disorder/OCD (52%). Statistically significant higher percentages of learning disability, neurodevelopmental problems in siblings, medication at discharge and longer inpatient admissions were identified in children with tics compared with the rest of the sample. No other differences were found.

Conclusions

The prevalence of chronic tics/TS in children needing inpatient treatment is significant. In our sample, chronic tics/TS seem to represent a marker of increased neurodevelopmental deviance and overall symptom severity.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Sexology population characterization – a two years’ experience at a Lisbon specialized centre
Authors: Varregoso M.I. , Borges G. , Xavier R.
Published: May 2016

Introduction

Within psychiatry, sexology is a very particular area of expertise both by the nature and specificity of its diagnosis, as by the various difficulties and challenges their patients place. Sexology is a sub-specialty niche, but also a vast universe that covers such diverse conditions as paraphilia, gender dysphoria or sexual dysfunction. The sexology consultation of Santa Maria Hospital (HSM) is one of the biggest centers specialized in sexual disorders in the country. Consultations depend on the collaboration of a sexologist psychiatrist and psychiatry residents in close connection with endocrinology, urology and plastic surgery services.

Objective

We intend to conduct a characterization of the population observed in the HSM sexology consultation, in a period of 2 years, from the analyses of different general and diagnosis-specific relevant variables.

Methods

We intent to make a descriptive analysis of the population that attended the sexology consultation over the last 2 years. The sample study refers to all patients who have been specifically referred to sexology department or that directly requested access to this consultation. Data will be collected from medical computer records.

Results

Through systematic evaluation of different variables we can possibly conclude by some putative associations. A comprehensive characterization of this particular population is a possible method for a better and deeper insight on the diagnosis itself.

Conclusions

The purpose of this work is to increase peers’ sensitivity both to sexology and to the patients sexology serves.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Human factors in driving accidents: A cognitive investigation in the Gulf context
Authors: Alotaibi Y.
Published: May 2016

Introduction

Human factors have been reported as the reason behind the majority of car accidents. However, to date, no studies at least in the Arab world generally and Gulf area specifically, conducted a comprehensive examination of cognitive functioning as potential predictors of car accidents and driving violations.

Objectives

Examining the role of cognitive functions e.g., verbal working memory, attentional control as predictors of traffic accidents and driving violations.

Aims

Examining the predictability of individual's cognition of occurrence of driving violations and accidents.

Methods

The study was carried on a sample of hundred and thirty two participants whose age ranged between 24 and 31 years. They were classified into groups of violators and non-violators, accident free and accident involved as well. Cognitive functioning were measured using self-reports and task performance, and a series of ANOVAS as well as stepwise multiple regressions were conducted to test the research hypothesis.

Results

Findings showed significant differences between violators and non-violators and between the accident free and accident involved groups in almost all of the considered factors, except for the decision making factor. Moreover, Pearson product-moment correlations showed that there were significant negative correlations between age, driving violations, and cognitive performance and the accidents.

Conclusions

Human cognition such as executive functioning and mental planning are key factors for predicting driving behavior and traffic accidents. The study results have many implications in diagnosing and preventing or at least reducing driving violations and road accidents.

Disclosure of interest

The author has not supplied his/her declaration of competing interest.
DECIDE Study: Effectiveness of shared decision-making in treatment planning at discharge of inpatient with schizophrenia. Experience after 20 months of the study
Authors: Revuelta J. Pérez , Paño J.M. Pascual , Ruiz-Granados I. Lara , Saiz F. Gonzalez , Gomez C. Rodriguez , Juan J.M. Mongil San , Celis M. Ayerbe de , Garcia M. Pavon , Morales J. Mestre , Rio M.J. Garcia del , Vida R. Guerrero , Moreno J.M. Villagran
Published: May 2016

Introduction

Shared decision-making denotes a structured process that encourages full participation by patient and provider in making complex medical decisions. There has been extensive and growing interest in its application to long-term illnesses but surprisingly not in severe psychiatric disorders, such as schizophrenia. However, the great majority of schizophrenics are capable of understanding treatment choices and making rational decisions. Although the main justification for shared decision-making is ethical, several randomized controlled trials support its effectiveness in improving the quality of decisions, but robust evidence in objective health outcomes is needed.

Aims and objectives

Of the study: to demonstrate the effectiveness, measured as treatment adherence and readmissions at 3, 6 and 12 months, of shared decision making in the choice of antipsychotic treatment at discharge.

Of the oral presentation: to present the study design; to make an interim report of the data obtained at the moment of the congress.

Methods

Randomized controlled trial, prospective, two parallel groups, not masked, comparing two interventions (shared decision making and treatment as usual). Study population: Inpatients diagnosed of schizophrenia and schizoaffective disorders (ICD-10/DSM-IV-R: F20 y F25) at Adult Acute Hospitalization Unit at Jerez General Hospital.

Results

Currently in the recruiting phase with 55 patients included in the study. An interim analysis of at least half of the target sample size.

Conclusions

We will show the study design and decision tools employed. Conclusions in relation to the effectiveness (adherence and readmissions) and subjective perception.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
The psychotic patient at the General Hospital
Authors: Monforte Porto J.Á. , San Román Uría A. , Llanes Álvarez C. , Humada Álvarez G. , Sevillano Benito I. , Cepedello Pérez S. , Hernández Antón R. , Gómez Sánchez S.
Published: May 2016

Background

Patients with schizophrenia have a higher prevalence of physical illness and a higher mortality from natural causes than the general population, which is a reason why they can be hospitalized for medical and surgical pathologies.

Aims

To determine the demand, the reason for consultation and the sociodemographic characteristics of the psychotic patient admitted at the general hospital.

Methods

Sociodemographic variables (age, sex, marital status, education, place of residence, residential housing, with who they live, work status) and health care (service of origin, type of request and its relevance, complaints, days of delay between the request and assistance, number of visits, average length of stay).

Study design

Prospective epidemiological study of 80 psychotic patients (F.2 ICD-10), from the total of 906 consults solicited from 1 January 2012 until 31 December 2014. Bioethical considerations: compliance with these principles justice, non-maleficence, autonomy and beneficence.

Results

The average age is 58.34 years old, 60% were male, 73.8% single, 81.3% with primary education, 52.5% living in urban areas; and the 88.8% of cases were pensioners. The Departments that generate a greater demand are Internal Medicine (53.8%), Orthopaedic Surgery (10%), Pneumology (8.8%) and ICU (8.8%). The most frequent reasons for consultation are assessment/treatment setting (77.5%), abnormal behavior (30%), disorientation (18.8%) and psychotic symptoms (18.8%).

Conclusions

The typical profile of psychotic patients hospitalized for medical-surgical diseases is a male, middle-aged, single, with primary education and pensioner; from whom it's sued consultation for adjusting of treatment, and secondly for abnormal behavior.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
The cultural products analysis in medicine and psychiatry
Authors: Pavez F. , Alcántara A. , Saura E. , Pérez G. , Marset P.
Published: May 2016

Introduction

As the psychopathological constructs have been influenced by scientific and cultural paradigms of its time, culture reflects and determines the way of understanding health and disease. The knowledge generated is integrated to the cultural wealth and it continues its development by interacting with culture, thus the ideas of mental illness and its treatment vary according to culture and beliefs of a given population in a given time.

Objectives

To propose a framework for analysis through the examination of cultural products. We argue that this strategy can give us some clues about how the general population understands mental illness and the psychiatric work.

Methods

A review of the literature available about social representations of science, medicine, illness and psychiatry, through cultural products analysis.

Results

There are many works that address the presence of these issues in the social imaginary by analyzing cultural products. In the field of psychiatry, the analysis of films, literature and music (the last, in a lesser extent) are the most frequent.

Conclusions

The analysis of cultural products can be a source of additional knowledge that connects us with the social representations of our profession and its scope of practice, favoring a better understanding about what psychiatry and mental illness means for our patients and general population.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Government employees and depressive and anxiety disorders: A systematic review
Authors: Dos Santos M.A.
Published: May 2016

Introduction

Depressive and anxiety disorders are common among working adults and costly to employers and individuals and their prevalence is high. Public sector employees are also vulnerable to poor mental health, mainly where have been occurring organisational changes similar to private sector concepts.

Objective

To highlight the unmet mental needs for new vulnerable working population, government employees.

Methods

The search was conducted using PubMed, Medline, Web of Science, Scopus, B-on, Science Direct with the terms “government employees”, “federal employees”, “depressive disorders”, “anxiety disorders”. Using the PRISMA methodology, 1374 articles were considered with the search terms and if were published in the last 10 years; after a review of the title and summary, 5 eligible studies in english were included.

Discussion

Mental disorders are growing public health problem, and creating an enormous toll of suffering, disability and economic loss. There are few studies about depressive and anxiety disorders in public sector and those confirm that it would be to examine to what extent national characteristics can explain why individual and organizational characteristics are more related to them in some countries than in others, especially not including military or police officers who usually are submitted to high psychological distress.

Conclusions

Workplace health promotion in addressing job stress is crucial to fight against to a range of mental health outcomes. Mental health screening in the public sector may contribute for changes to the traditional roles of government and its management structures and must be encouraged to find out the underlying mechanisms of developing depressive and anxiety disorders.

Disclosure of interest

The author has not supplied his/her declaration of competing interest.