bluuebunny/crossref_metadata_2025 huggingface dataset:
Complex Trauma, Somatoform Dissociations & Energetics Therapy
Authors: Kurz R. , Fecht S.
Published: June 2017

Introduction

Mental health professionals find it very challenging to provide counselling and therapy when confronted with disclosures of ritual, satanic and extreme abuse. Psychometric and muscle testing can facilitate diagnosis and healing in this context. Psychiatrists of renown such as David Hawkins and Colin Ross have embraced and written about energetic medicine in their practice.

Objectives

The presentation explains how somatoform dissociations are tell-tale indications of abuse and neglect of early childhood trauma and how ‘Energetics’ therapy facilitates healing.

Aims

Delegates will learn to recognise somatoform dissociation symptoms, understand advances and limitations of psychometric assessment tools, appreciate energetics approaches as an adjunct to other intervention methods and gain an insight into the origins of complex trauma.

Methods

Two case studies are used to illustrate causes, impact, diagnosis and healing of complex trauma.

Results

A set of psychometric assessments helped to unravel a chilling revictimisation crime series. ‘Twice Exceptional’ characteristics were very high IQ coupled with Dyslexia, very weak auditory memory and psychic capabilities. In another case that stemmed from extreme abuse of ancient, commercial and high-tech varieties muscle testing and energetics therapy lead to a remarkable recovery.

Conclusions

Psychometric and muscle testing can inform diagnosis, therapy and healing. Energetics can be used to bring about profound healing for those who have repressed severe trauma. This method has many advantages in that parts of it are easily learned, it is non-invasive, has no side effects, gives patients control over their reactions, eliminates triggers and offers healing.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Psychotherapies for Complex Trauma: A Combination Between EMDR and Mindfulness
Authors: Tounsi H. , Pacioselli P. , Riou L. , Gouret C. , Gross L. , Quaderi A. , Palazzolo J.
Published: June 2017

Faced with the effects of trauma, new psychotherapies are emerging in France, converging especially around awareness, experience and emotion. The hypothesis put forward here concerns the complementarities of the two following approaches: Mindfulness, part of a behavioural and cognitive context. EMDR that uses neuroscience through its ABS. The implementation of a protocol based on EMDR and mindfulness, has shown convincing results on the demented elderly person suffering from complex PTSD. The protocol begins with a session devoted to anamnesis and symptoms evaluation. The second phase consists of desensitization and cognitive restructuring. The principal foundations rely on EMDR but also include mindfulness exercises to reduce anxiety due to the effects of therapy or otherwise allow the possibility to bring new material when it seems to encounter a deadlock. The third phase is the consolidation of therapeutic benefits. For this, ABS are based on the patient's resources and meditation exercises are performed in order to amplify the restructuration. The combination of these two therapies could allow to potentiate their respective effects. The single case study that we conducted allowed us to observe encouraging results: reduction of symptoms of revival, autonomic hyper-activation and avoidance. Effects were also observed for co-morbid symptoms namely depression, anxiety and psychotic manifestations. The combination of these two approaches seems profitable and requires replication.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Prevention of Specific Learning Disorders in Early Stages
Authors: Lupu I.R. , Lupu V.
Published: June 2017

Introduction

Specific learning disorders as defined in the DSM-5 are frequently diagnosed among children – 4–9% for reading deficits – (DSM-5, 2013). As any deficit can contribute not only to a child's emotional distress, it can also result in academic failure or school abandonment. Therefore, prevention measures should be considered.

Objectives

The present study's objective was to compare the influence of a set of primary prevention measures on children's performance in reading and writing and improve their reading and writing.

Aims

We aimed to prevent specific learning disorders–dyslexia and dysgraphia in children from the second to their third year in the educational system.

Methods

Only children from the second year of school were considered (grade I). Children with clear potential for developing specific learning disorders were included in the present study. Children with any other comorbidity were excluded from the data analysis. Four experimental groups were considered – one control and three interventional – 1. Control, 2. COPS method, 3. Meixner principles, and 4. COPS method combined with Meixner principles and considering improvement of reading images, image filling, graphical schema orientation and discrimination, spatial and temporal orientation, orientation of objects, fine motor skills, temporal sequences, attention for details, perception of differences.

Results

Findings indicated that the use of the combined methods significantly improved children's performance in reading and writing. Though all interventional methods improved children's performance. Results comparison was computed.

Conclusions

Early prevention programs which that target both reading and writing can improve children's performance in reading and writing.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Pathological Gambling, Impulse Control Disorder or Behavioural Addiction: What do the Data Indicate?
Authors: Mann K. , Leménager T. , Kiefer F. , Fauth-Bühler M.
Published: June 2017

Objective

The reclassification of PG as an addictive disorder is under debate for ICD-11. Data on psychiatric comorbidity and family history might provide the basis for a well-informed decision.

Methods

We compared 515 male pathological gamblers from inpatient treatment units with 269 matched controls. Patients were diagnosed by experienced clinicians. In a random sample of 58 patients clinical diagnoses were validated through SKID 1 interviews [1].

Results

88% had a comorbid diagnosis of substance dependence (nicotine dependence 80%, alcohol dependence 28%). Only 1% of the gamblers had an impulse control disorder diagnosis. Compared with controls first degree relatives were more likely to suffer from alcohol dependence (27.0% vs. 7.4%), PG (8.3% vs. 0.7%) and suicide attempts (2.7% vs. 0.4%).

Conclusions

In addition to recent papers on the neurobiology (Fauth-Bühler et al., 2016) and genetics of gambling [2,3], our findings support the classification of PG as behavioural addiction in the ICD-11 [4].

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Citalopram–induced delusions in an older adult
Authors: Fennema J. , Petrykiv S. , De Jonge L. , Arts M.
Published: June 2017

Introduction

Selective serotonin reuptake inhibitors (SSRIs) are the most prescribed antidepressants worldwide. In older adults, citalopram is generally well tolerated and safe in the therapeutic dose range of 20 to 40 mg/day. In literature, there are cases of SSRI-induced psychosis, but mainly with fluoxetine. There are only three reported cases of citalopram-induced delusions, however, these case-reports did not involve an older adult.

Objectives and aims

To provide a case of citalopram–induced psychosis in an older adult, followed by the review of available literature.

Methods

A case report is presented and discussed followed by a literature review.

Results

A 64-year-old woman without somatic illnesses was referred by a general practitioner with depressive symptoms. One week after initiation of citalopram 10 mg/day she suddenly developed delusions, predominantly in the early morning. No other medical evidence was found that could explain her delusions. After discontinuation of citalopram her delusions quickly resolved.

Conclusion

This is the first case report of a SSRI-induced delusion in an older adult. Citalopram has been reported to be one of the safest SSRIs. Although most SSRI's have a mild side-effect profile, care should be taken when initiating SSRIs since unpredictable adverse effects may occur.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Protection of proteins and lipids of blood plasma by different lithium salts under ethanol-induced oxidative damage
Authors: Prokopieva V. , Yarygina E. , Plotnikov E.
Published: June 2017

Introduction

The creation of new lithium compounds with antioxidant activity is relevant problem for psychiatry. The aim of this work was study of the protective effect of lithium salts against ethanol-induced oxidative damage to proteins and lipids of human blood plasma in vitro.

Methods

We used lithium ascorbate and lithium carbonate 0.6 mmol/L which correspond to the therapeutic dose (in terms of lithium ions). Antioxidant carnosine (β-Ala-L-His) was used as comparison drug. We used the blood of 12 healthy donors. The heparinized blood samples were incubated in presence of tested preparations for one hour at 37 °C. The final ethanol concentration in samples was 0.5%. Oxidative modification of proteins was determined as the level of carbonylated proteins with 2.4–dinitrophenilhydrazine, lipid peroxidation products–as the level of TBA-reactive products by spectrometry. Statistical analysis was performed with “Statistika 10” program.

Results

The addition of ethanol in the blood led to a significant increase in carbonylated proteins and TBA-reactive products in the plasma (carbonylated proteins: without ethanol 0.26 ± 0.01 nmol/mg of protein; with ethanol 0.33 ± 0.02 nmol/mg; TBA-reactive products: without–3.2 ± 0.1 nmol/mL; with–4.0 ± 0.2 nmol/mL, P < 0.05). In the presence of carnosine such increase of oxidized products of biomolecules is not observed, i.e. carnosine had a protective effect against ethanol-induced oxidative damage. Lithium ascorbate showed a protective effect like carnosine. Lithium carbonate revealed no detectable influence on biomolecules in the conditions of our experiment.

Conclusion

Lithium ascorbate has a protective effect on blood plasma proteins and lipids under ethanol-induced oxidative damage of biomolecules.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Childhood Trauma and Structural and Functional Brain Mechanisms Linked to Psychopathology
Authors: Aas M.
Published: June 2017

Background

Childhood trauma increases the risk of a range of mental disorders including psychosis. Whereas the mechanisms are unclear, previous evidence has implicated atypical processing of emotions among the core cognitive models, in particular suggesting altered attentional allocation towards negative stimuli and an increased negativity bias. Here we tested if childhood trauma was associated with differentiation in brain responses to negative and positive stimuli. We also tested if trauma was associated with emotional ratings of negative and positive faces.

Methods

We included 101 patients with a DSM schizophrenia spectrum or bipolar spectrum diagnosis. History of childhood trauma was obtained using the Childhood Trauma Questionnaire (CTQ). Brain activation was measured with functional MRI during presentation of faces with negative or positive emotional expressions. After the scanner session, patients performed emotional ratings of the same faces. Structural MRI was also measured.

Results

Higher levels of childhood trauma were associated with stronger differentiation in brain responses to negative compared to positive faces in clusters comprising the right angular gyrus, supramarginal gyrus, middle temporal gyrus, and the lateral occipital cortex (Cohen's d = 0.72-0.77). In patients with schizophrenia, childhood trauma was associated with reporting negative faces as more negative, and positive faces as less positive (Cohen's d > 0.8).

Conclusions

Along with the observed negativity bias in the assessment of emotional valence of faces, our data suggest stronger differentiation in brain responses between negative and positive faces in patients with childhood trauma.

Disclosure of interest

The author has not supplied his declaration of competing interest.
Effect of Cognitive-Behavioral Therapy and Spiritual-Religious Intervention on Improving Coping Responses and Quality of Life Among Women Surviving from Breast Cancer
Authors: Ghahari Shahrbanoo , Fallah Rahele , Bolhari Jafar , Mousavi Mahdi , Akbari Mohammad Esmaeel
Published: June 2017

Objective.

The present study aims to evaluate the effectiveness of cognitive behavioral therapy (CBT) and spiritual-religious intervention in improvement coping responses and quality of life among women surviving from breast cancer.

Methods.

This was a semi-experimental study. Forty-five breast cancer survivor referred to cancer research center at Shahid Beheshti university of medical Sciences in Tehran, assigned in 3 groups randomly (CBT group, spiritual-religious group and control group). The interventions were eight sessions cognitive-behavioral therapy and spiritual-religious intervention. The participants were evaluated through quality of life questionnaire published by european organization for research and treatment of cancer (QLQ-30C-ver3) and coping responses inventory (CRI). The data were analyzed using covariance.

Finding.

Although both intervention groups improved in coping and quality of life, it was not statistically significant(P < 0.08).

Conclusion.

Although both intervention groups improved in coping and quality of life but there is no differences between two groups.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Basic Principles of Supervision and Its Ethics in Cognitive Behavioral Therapy
Authors: Vyskocilova J. , Prasko J. , Slepecky M. , Kotianova A.
Published: June 2017

Background

Supervision is the systematic guidance of a therapist by a supervisor. It is a basic part of training and ongoing education in cognitive behavioral therapy (CBT). Self-reflection and ethical reflection are an important part of supervision.

Method

The Pubmed database was searched for articles using the keywords supervision in CBT, therapeutic relations, ethics, transference, counter transference, schema therapy, dialectical behavioral therapy, acceptance and commitment therapy.

Results

We discuss conceptual aspects related to supervision and the role of self-reflection and ethical reflection. The task of supervision is to increase the value of the therapeutic process in the client's best interest. Establishing the supervisor-supervisee relationship is based on principles similar to those in the therapeutic relationship. Additionally, supervision is oriented towards increasing the therapist's competencies. The CBT therapist's core competencies involve good theoretical knowledge, professional behavior towards clients, ability to use specific therapeutic strategies for maintaining the therapeutic relationship, sensitivity to parallel processes and accomplishment of changes, and adherence to ethical norms. Given the fact that during supervision, the supervisee may be at any stage of his/her training, supervision must take into consideration where the therapist is in his/her training and development and what he/she has or has not learnt.

Conclusions

Both the literature and our experience underscore the importance of careful supervision of cognitive behavioral therapy. Numerous approaches are used in supervision, which is associated with the abilities to self-reflect and to realize transference and counter transference mechanisms.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Perinatal Stress, Anxiety, and Depression: Effects of a MBCP Intervention on Mother-infant Interaction
Authors: Setterberg S.E. , Nissen E. , Jonas W. , Niemi M.
Published: June 2017

Introduction

Transition into parenthood is a demanding phase in life and exposes the becoming parents to vulnerability for depression, anxiety and stress. Perinatal mental health problems are a major public health issue and many women suffering from depression during their first year after delivery. High levels of stress during pregnancy are associated with adverse psychological and physiological outcomes for the infant and parents. There seems to be an intergenerational transmission of mental health from parent to infant. The current study evaluated the effectiveness of mindfulness intervention during pregnancy in reducing depression symptoms, anxiety and perceived stress in parents-to-be.

Objectives

Assess whether the mindfulness will improve interaction between mother-infant at 12 months.

Methods

Perceived stress scale and Edinburgh postnatal depression scale used to measure stress and depression during pregnancy. Parent child early relational assessment assessed mother-infant interaction.

Results

Inhibited parent-infant relationships were more common in the control group comparing to the mindfulness intervention group. This is in line with previous research on periantal depression, anxiety, and stress, showing more dysfunctional dyads. A depressed mother has reduced capability to be alert to her baby's signals, which is necessary for appropriate parent-infant relationship to occur. The cumulative effect of impaired parent-infant relationship is a “depressed dyad” of mother and infant.

Conclusion

Mindfulness intervention reduced depressive symptoms, anxiety, and perceived stress in pregnant women. At 12 months mother-infant relationship assessment, the mindfulness intervention group dyads showed a more attuned mother-infant interaction.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Quality of Life of Children and Youngsters who Attended the Psycho-Educational Program “+ Familia” (+family)
Authors: Lima C. , Cunha G. , Brandão F.
Published: June 2017

The program “+ Família” part of the activities promoted by CLDS + from Paredes de Coura in 2015, has enabled to act at the level of strategy development for qualifying families. The perceived quality of life of children and youngsters was evaluated in 2 moments: at the beginning (n = 23) and in the end (n = 11). We used the scale kidscreen-10, translated and measured for the Portuguese population. At the first moment, the sample consisted of 65% of women and 35% man; 87% aged between 6 and 10 years old and 13% aged between 11 and 15 years old; 74% attended the 1st cycle of studies and 13% had some type of disability. Based on 4 of the questions, the perception of quality of life has improved, between the beginning and the end of the program implementation. So for the remaining 6 questions, quality of life was perceived in a more negative way in the same period. An intra subject analysis would have to be made in order to measure the results’ bias due to the absence of 12 subjects in the final evaluation.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Confirmatory Factor Analysis of the Frost et al Multidimensional Perfectionism Scale-24 (F-MPS 24)
Authors: Soares M.J. , Azevedo J. , Pereira A.T. , Araújo A.I. , Castro J. , Chaves B. , Roque C. , Bajouco M. , Macedo A.
Published: June 2017

Introduction

The F-Multidimensional Perfectionism Scale is a widely used instrument to assess perfectionism trait. The original scale comprises 35-items that measure the six dimensions of Frost et al (1990) conceptualization of perfectionism: personal standards (PS), concern over mistakes (CM), doubts about actions (DA), parental criticism (PC), Parental expectations (PE) and Organization (O).

Objective

To examine the factor structure of the 24-items short form of the F-MPS using confirmatory factor analysis (CFA), in a sample of Portuguese university students.

Methods

The sample comprises 344 university students (68.4% females), with an average age of 20.69 years (SD = 1.59; range = 17–24). They completed a version of F-MPS with 24 items that results from the selection of the four items with highest loadings in the respective six dimensions of the original Portuguese version (Amaral et al., 2013).

Results

After correlated errors, we obtained a good fit for the FMPS with six factors (X2/df = 2.125; CFI = .936; GFI = .891, RMSEA = .057; P[rmsea≤ .05] = .043). The 24-item F-MPS short form revealed good internal consistency (α = .825). The six dimensions showed acceptable or good internal consistency, as revealed by Cronbach's alpha (α: PS = .80; CM = .76; DA = .82; PC = .84; PE = .89, O = .85).

Conclusions

The F-MPS 24 items short form CFA confirmed the six factor model as a reliable and valid measure to assess multidimensional perfectionism in Portuguese university students.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
“Neurodevelopment in a dish” Elucidates the Mechanisms of Autism Spectrum Disorder
Authors: Ilieva M. , Kamand M. , Kolev K. , Forsberg S.L. , Svenningsen Å.F. , Sheldrick-Michel T.
Published: June 2017

Introduction

Autism spectrum disorders (ASD) is a group of neurodevelopmental disorders characterized by deficits in social cognition, communication, and behavioral flexibility. Most of the cases appear to be caused by the combination of autism risk genes and environmental factors affecting early embryonal brain development. The current animal and 2D cellular models are not able to recapitulate the complex integrity of the developing brain. Therefore a model of the brain that can cast a light on the pathological processes during brain development is of a high need.

Aim and objectives

The aim of our research is to develop a three-dimensional brain organotypic system (brain organoids) for culturing patient's derived induced pluripotent stem cells (iPSC).

Methodology

We propose a multidisciplinary approach, involving the generation of patient specific iPSC from somatic cells (fibroblasts) and 3D culturing techniques to build a complex “humanized” in vitro platform for ASD research. Further we will investigate differences in gene expression of potential disease related markers and cellular phenotype between autistic patients and controls.

Results

Brain organoids have the ability to recreate the right complexity of the brain. On the cellular and gene expression level, organoids demonstrate a high similarity to the neurodevelopment in vivo and can therefore recapitulate early stages of the neurogenesis.

Conclusion

To date organoids are the most relevant cellular in vitro platform for the understanding the mechanisms behind ADS pathology. Organoids are a good modeling system for elucidating the role of epigenetic and environmental factors for development of ASD.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Confirmatory Factor Analysis of a Portuguese Short Version of the Cognitive Emotional Regulation Scale
Authors: Martins M.J. , Pereira A.T. , Soares M.J. , Amaral A.P. , Madeira N. , Araújo A. , Macedo A.
Published: June 2017

Introduction

The cognitive emotions regulation questionnaire (CERQ) is a 36-item questionnaire to measures specific cognitive emotion regulation strategies used in response to the experience of threatening or stressful life events. The Portuguese version of CERQ proved to be a reliable and valid measure to evaluate eight dimensions: Positive reappraisal and planning, positive refocusing, rumination, blaming others, putting into perspective and self-blame.

Objective

To confirm the dimensional structure of a Portuguese short version of the CERQ using Confirmatory Factor Analysis (CFA).

Method

Items selection was based on the previous results of the exploratory factor analysis of the 36-items version. Items presenting the highest loading (≥ 70) in their respective factor were selected. A preliminary short version composed of 22 items were answered by a sample of 480 university students (81.9% females), with a mean age of 19.49 years (SD = 2.047; range = 17–30). CFA (using Mplus software) was used to test if the eight dimensions’ model suggested by prior exploratory factor analyses fitted the data.

Results

The eight dimensions’ model has a good fit (χ2 = 424.015, P < .01; RMSEA = 0.056, 90%CI = 0.049–0.063; CFI = 0.930; TLI = 0.910; SRMR = 0.051). Although composed of fewer numbers of items, all subscales presented good reliability (Cronbach alpha< 70).

Conclusions

The CERQ-22 is a reliable and valid measure to evaluate cognitive emotion regulation strategies in young adults. Being a shorter version it is particularly useful for multivariate and prospective studies. In the near future we will test this structure in a clinical sample.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Mild Depressive Symptoms Mediate the Impact of Childhood Trauma on Long-Term Functional Outcome in Early Psychosis Patients
Authors: Alameda L. , Philippe G. , Philipp B. , Q. D. Kim , Philippe C.
Published: June 2017

Introduction

The mechanism linking childhood trauma (CT) to the functional deficits observed in early psychosis (EP) patients is as yet unknown.

Objectives

To examine the potential mediating effect of depressive symptoms in this well-established association.

Methods

Two hundred nine EP subjects aged 18-35 were assessed for functioning and psychopathology after 2, 6, 12, 18, 24, 30, and 36 months of treatment. Patients were classified into early-trauma if they had faced at least one experience of abuse (physical, sexual, or emotional) or neglect (physical or emotional) before age 12, and late-trauma if the exposure had occurred between ages 12 and 16. Psychopathology was assessed with the Positive and Negative Syndrome Scale and the Montgomery-Asberg Depression Rating Scale. Functioning was measured with the Global Assessment of Functioning (GAF) and the Social and Occupational Functioning Assessment Scale (SOFAS). Mediation analyses were performed in order to study whether the relationship between CT and functioning was mediated by depressive symptoms.

Results

When compared with nonexposed patients, early but not late trauma patients showed lower levels of GAF and SOFAS scores over all the time points, excepting after the first assessment. After 30 and 36 months, the effect of early trauma on functioning was completely mediated by depressive symptoms. No mediating effect of positive or negative symptoms was highlighted at those time points.

Conclusion

Mild depressive symptoms mediated the impact of early trauma on long-term functional outcome. Intensifying pharmacologic and/or psychotherapeutic treatment, focused on the depressive dimension, may help traumatized EP patients to improve their functioning.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Systemic Review: High Dose Olanzapine Treatment for Treatment Resistant Schizophrenia
Authors: Azvee Z. , Lally J.
Published: June 2017

Objectives

Schizophrenia is a major mental illness with a progressive course. Thirty percent of cases of patients with schizophrenia do not respond to adequate trials of at least 2 different groups of antipsychotics,are currently classified as having treatment resistant schizophrenia (TRS). Clozapine remains the gold standard, treatment of choice for TRS. However, clozapine does not come without its own challenges. Its risk profile, particularly agranulocytosis, reported in 1% of cases, has led to the necessity of weekly blood counts within the first 18 weeks of treatment and subsequently every month with slow dose titration. Clinically, sedation, weight gain and hypersalivation may further hamper the compliance of patients. Non-compliance has been reported to cause rebound psychosis. Recent studies have raised questions as to which antipsychotic is most efficacious for TRS. Thus, we conducted a systematic review of high dose olanzapine treatment for people with TRS.

Method

A systematic review of prospective studies found through search of PubMed, Scopus and hand-searched key papers which included randomized controlled trials and open-label studies which looked at high dose of olanzapine treatment response for TRS.

Results

The study is currently ongoing and preliminary results will be presented at the conference in April 2017.

Conclusions

The gravity of burden TRS brings to patients extends itself to their families, carers and clinicians. Further evidence on which antipsychotic is more efficacious for patients with TRS would have huge implications in terms of health benefits for the patients, better informed clinical decisions and also health economics in general.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Characteristics and duration of untreated illness in correlation with insight level of first time diagnosed schizophrenia patients in rural region of Latvia
Authors: Berze L. , Pavlovs K. , Slikova K. , Bodins V. , Samule I. , Kurakina N. , Smonins I. , Rancans E.
Published: June 2017

Introduction

Improved insight level among schizophrenia patients is predictive for better illness prognosis.

Objective

Explore factors connected to insight.

Aim

Evaluate the insight level and clinical characteristics of first time hospitalized schizophrenia spectrum patients.

Methods

All consecutive first time hospitalized schizophrenia spectrum patients in a psychiatric hospital from 01.01.2016–26.09.2016. Patients were interviewed upon hospitalization and at the discharge with Scale for the assessment of positive symptoms (SAPS) and negative symptoms (SANS), Schedule of assessment of insight-extended (SAI-E), The Calgary depression scale for schizophrenia (C-sch), sociodemographic and clinical data were collected. All participants signed written informed consent and the study was approved by the Riga Stradins University Ethics committee.

Results

From 45 first episode patients, 38 met the inclusion criteria. Mean age was 37.66 years (SD: 11.48 years), the average duration of untreated illness (DUI) was 40.5 months (SD: 57.35 months). Psychopathologic symptoms and insight levels evaluated in scores in the 1st and 2nd interviews were as follows: SAPS 69.11 (SD: 20.78) and 33.61 (SD: 18.04), SANS 63.21 (SD: 25.30) and 40.95 (SD: 24.47), SAI-E 15.50 and 27.24 (SD: 13.24), P < 0.001, C-sch 8.50 (SD: 5.31) and 4.27 (SD: 2.86), P < 0.05. There was no statistically significant correlation between DUI and insight level. A higher level of insight at hospitalization correlated with higher levels of depression: r = 0.569, P < 0.001.

Conclusions

We noticed a tendency that lower insight levels might correlate with longer periods of untreated illness. We found that higher insight levels correlated with higher symptoms of depression.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
A novel methodology to evaluate the molecular validity of preclinical psychosis models compared to schizophrenia brain pathology
Authors: Cox D. , Gottschalk M. , Wesseling H. , Ernst A. , Cooper J. , Bahn S.
Published: June 2017

Rodent models of schizophrenia (SCZ) are indispensable when screening for novel treatments, but quantifying their translational relevance with the underlying human pathophysiology has proved difficult. A novel systems methodology (shown in Figure 1) was developed integrating and comparing proteomic data of anterior prefrontal cortex tissue from SCZ post-mortem brains and matched controls with data obtained from four established glutamatergic rodent models, with the aim of evaluating which of these models represent SCZ most closely. Liquid chromatography coupled tandem mass spectrometry (LC-MSE) proteomic profiling was applied comparing healthy and “disease state” in human post-mortem samples and rodent brain tissue samples. Protein-protein interaction networks were constructed from significant abundance changes and enrichment analyses enabled the identification of pathophysiological characteristics of the disorder, which were represented across all four rodent models. Subsequently, these functional domains were used for cross-species comparisons. Five functional domains such as “development and differentiation” represented across all four rodent models, were identified. It was quantified that the chronic phencyclidine (cPCP) model represented SCZ brain changes most closely for four of these functional domains, by using machine-learning techniques. This is the first study aiming to quantify which rodent model recapitulates the neuropathological features of SCZ most closely. The methodology and findings presented here support recent efforts to overcome translational hurdles of preclinical psychiatric research by associating behavioural endophenotypes with distinct biological processes.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
A systematic review of the pharmacological treatment of delusional disorder
Authors: Negro J.E. Muñoz , Cervilla J.
Published: June 2017

Introduction

Pharmacological treatment is the gold standard in delusional disorder (DD), moreover the second generation antipsychotics (SGA) are widely used in the treatment of DD, in spite of this, none SGA is authorized for the treatment of DD.

Objectives

To evaluate the evidence available for pharmacological treatment in adults with DD. Especially, that concerning SGA.

Methods

A systematic review on pharmacological treatment of DD was conducted. We selected the best evidence available. Then, we analysed them critically, assessing its biases and quality, finally performed a narrative and quantitative synthesis.

Results

The quality of the evidence was very low. There were not randomized clinical trials. n = 385, 177 SGA. Antipsychotics achieved a good response in a 33.6% of the patients. First generation antipsychotics (FGA) did show superiority compared to SGA (39% good response vs. 28%, respectively. P ≤ 0.02). We could not find data about superiority of any drug over other. Pimozide, traditionally considered the most effective drug, did not confirm to be a superior treatment compared to others. Reasons for superiority of FGA were analyzed. The role of another treatments were testimonial, but antidepressants can be a promising treatment.

Conclusions

There is no evidence to make strong recommendations, although antipsychotics in general appear to be an effective treatment for DD. Superiority of FGA against SGA was shown. We need to develop clinical trials in DD and SGA, since their better tolerance profile might be the best candidates to do.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
A scale of autonomy for patients with schizophrenia – new instrument for clinical assessment of the level of independency: Description and validation
Authors: Rupchev G. , Morozova M.
Published: June 2017

Introduction

Today the scales for measurement of functional status and life satisfaction (GAF, PSP, EQ-5D, SQLS) gain more importance in assessing schizophrenic patients. Autonomy of living is to the great extent the basis of patient well-being. Each of these scales has the criteria, testing ability for independent life, but none of it tests autonomy as a separate object.

Objective

Development of a new scale.

Aims

Description and validation of a scale for evaluation of autonomy of living in schizophrenic patients.

Methods

Forty patients diagnosed with schizophrenia according to ICD−10 (F 20.хх), 13 males and 27 females, aged 49.8 ± 9, disease duration is 22 ± 8.6 years. New scale and PANSS, CGI-S, NSA, BACS, GAF, PSP was administered.

Results

The scale comprises five points (activity, intentional behavior, range of social interaction, specificity of interaction with the doctor (medical conventionality) and autonomy), and total score. The internal consistency of the scale was high – cronbach's alpha 0.83. The construct validity with GAF and PSP was moderate (R varied from 0.36 to 0.55). The total score of the new scale correlated with the PANSS negative subscale score (R = −0.51), with CGI-S score (R = −0.57), and with the BACS total score (R = −0.57).

Conclusion

The scale of autonomy corresponds to the major psycho-diagnostic requirements: internal consistency, construct and discriminative validities. It can be considered a new instrument for assessing the integrative target of treatment and rehabilitation of patients with schizophrenia.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Persistent genital arousal: Differential diagnosis and management in the emergency room of psychiatry
Authors: Calahorro C.M. , Jiménez M. Guerrero , Serrano B.M. Girela
Published: June 2017

Background

We describe the case of a 50 years old woman who attended the emergency room for complaints that involves continuous orgasms in the last two months that she describes “as waves”. The woman is a widow and claims not to have had sexual relationships since her husband died four years ago.

Main objective

Persistent genital arousal disorder (PGAD) is a relatively unknown clinical condition affecting several women. Moral standards, as well as conservative beliefs regarding sexuality, are believed to be involved in the etiology and maintenance of this syndrome. Nevertheless, there are no consistent data on the content of the beliefs system presented by these women.

PGAD It has been identified as a condition of often unprovoked genital arousal associated with a significant level of distress.

PGAD is not well understood, and no definitive cause has been determined.

Our main objective was to review the literature on PGAD, identify possible causes of the disorder, and provide approaches to the assessment and treatment of the disorder based on the authors’ experience and recent literature.

Comments

PGAD is a potentially debilitating disorder of unwanted genital sensation and arousal that is generally spontaneous and unrelenting. Since its first description in 2001, many potential etiologies and management strategies have been suggested. PGAD likely represents a range of conditions manifesting in unwanted genital sensations. Successful treatment requires a multidisciplinary approach and consideration of all reversible causes as well as cognitive therapy.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Evaluation of depression and anxiety, and their relationship with insomnia, nightmare and demographic variables in medical students
Authors: Haji Seyed Javadi S.A.
Published: June 2017

Introduction

Researches showed comorbidity of sleep disorders and mental disorders.

Objectives and aims

The current study aimed to evaluate depression and anxiety and their relationship with insomnia, nightmare and demographic variables in the medical students of Qazvin University of Medical Sciences in 2015.

Method

The study population included 253 medical students with the age range of 18–35 years. Data were gathered using Beck depression inventory, Kettle anxiety, and insomnia and nightmare questionnaires and were analyzed by proper statistical methods.

Results

Among the participants, 126 (49.6%) subjects had depression and 108 (42.5%) anxiety. The prevalence of depression and anxiety among the subjects with lower family income was significantly higher (Chi2 = 6.75, P = 0.03 for depression and Х2 = 27.99, P < 0.05 for anxiety). There was a close relationship between depression with sleep-onset difficulty, difficulty in awakening and daily sleep attacks, and also between anxiety with sleep-onset difficulty and daily tiredness (P < 0.05). In addition, there was a close relationship between depression and anxiety with nightmare; 16.2% of the subjects with depression and 26.5% of the ones with anxiety experienced nightmares.

Conclusion

Results showed a relationship between nightmare, insomnia and level of family income with increasing depression and anxiety in the medical students; hence, due to the importance of medicine in human life, it is necessary to evaluate the mental health of medical students, identify and solve the relative problems such as anxiety, depression and related symptoms such as insomnia and nightmare in them.

Disclosure of interest

The author has not supplied his/her declaration of competing interest.
Example of alert and reporting system of scopolamine poisoning among Parisian cocaine users at regional, national and European levels
Authors: Batisse A. , Chevallier C. , Azevedo Correia J. , Martinez M. , Hoizey G. , Chèze M. , Buscail S. , Deveaux M. , Djezzar S. , Sandrine B. , Samira D.
Published: June 2017

Introduction

In the literature, few intoxications are related to scopolamine due to its presence in cocaine, heroin or even in counterfeit rohypnol tablets. Nonetheless, during summer 2016, several cases of non-fatal intoxication appeared in the region of Paris.

Objectives

Demonstrate how clinical detection of rare toxic events are fostered by exchanges in close collaboration with different territorial level.

Aims

Improve the detection of short toxic epidemic.

Methods

Suspected cases of scopolamine poisoning notified to Parisian Addictovigilance centre were reported. Information shared through different levels of the alert process contributed to strengthen their assessment.

Results

Seventeen cases of probable scopolamine poisoning among cocaine users were registered between the 6 and 24 of July. In the first 4 cases, toxicological analysis, of blood samples were scopolamine positive, with high concentration between 7 ng/mL and 25 ng/mL (usual therapeutic range: 0.1 to 1.1 ng/mL). A collected sample of this cocaine powder had a purity of 23.2%, with 15.2% of scopolamine. Half time of scopolamine is longer than half time of cocaine (3–8 hours versus 1–2 hours): this could explain why the observed effects lasted over 24 hours (8/17). Main clinical features were mydriasis (15/17), high blood pressure (12/17), tachycardia (13/17), behavioural disorder with agitation (13/17), hallucinations (5/17), and coma (8/17). Practitioner's responsiveness and the extensive information sharing [MM1] between regional and European level were congruent.

Conclusions

Adulterated street drugs can lead to short toxic epidemic which could be unnoticed. Emerging event should require careful assessment with linkage between risk assessors and risk managers.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Substance use among youth psychiatric outpatients
Authors: Morais S. , Silva Ribeiro J. , Oliveira P. , Mendes E. , Botelho A. , Godinho H. , Vale L. , Bessa A. , Renca P. , Santos V. , Madeira N.
Published: June 2017

Introduction

Portuguese young adults (15–34 years old) were more frequent engaged in substance abuse (1.2%) than the general population, according to the Portuguese substance use annual report (2014). Alcohol was the most frequent substance use on youth adults. Cannabis was the most frequent illicit substance used (23.9% of users were considered dependent), with higher prevalence than previously reported. LSD (0.4%) use was also higher among young adults than in previous studies. Cocaine (0.4%), heroine/opiates (0.4%), ecstasy (0.3%), and hallucinogenic mushrooms (1.1%) had their consumption lowered among young adults.

Objectives/aims

To characterize a population of young adult psychiatric outpatients, regarding substance use and associated risk.

Methods

Socio-demographic characterization of our young adult unit outpatient users between 1st January 2015–31st July 2016. Substance use was assessed with the Portuguese version of Alcohol, Smoking and Substance Involvement Screening Test (ASSIST).

Results

A total of 255 outpatients were observed during the timeframe; 58 outpatients were assessed with ASSIST: 44 females (75.9%) and 14 males (24.1%), aged between 16–33 years old (average: 20.95; median: 19.50). For tobacco, 3.5% had high risk, 37.9% moderate risk and 58.6% low risk; 22.4% had moderate risk of alcohol, 13.8% moderate risk of cannabis, and 20.7% moderate risk of tranquilizers. For others substances (cocaine, stimulants, inhalants, hallucinogens, and opiates) the risk was low.

Conclusions

In our sample, alcohol and cannabis use had the highest risk, as reported in the National Annual Report; however, we observed a moderate risk for tranquilizers use. In future care planning, youth mental health should address tobacco and alcohol abstinence, and preventive measures regarding anxiolytics should be undertaken, such as banning sale without medical prescription.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Retrospective analysis of a novel community opiate detoxification programme within Bristol specialist drug & alcohol service (BSDAS)
Authors: Paklet L. , Radu I. , Watson B.
Published: June 2017

Introduction

Until recently community opiate detoxification strategies have largely been limited to gradual dose reductions in opiate substitute treatment (OST). These detoxes are often lengthy leading to “windows of opportunities” in patients’ motivation to detox being missed. Furthermore, many patients remain on sub-optimal OST doses for long periods of time, during which they are more vulnerable to relapse to illicit opiate use.

Within our community service, we adapted and implemented a novel two-week community opiate detoxification programme using buprenorphine front-loading and lofexidine. We worked in partnership with Bristol drugs project (BDP) to offer an 8-week psychosocial intervention alongside the medically assisted detoxification.

Objectives

Assessing the completion rates and clinical safety of this intervention.

Methods

Data collection was performed through retrospective review of patients’ case notes over a 9-month period.

Results

Seventy-five percent of the patients starting an opiate detox successfully completed the intervention.

Lofexidine improved the mean opiate withdrawal scores by 28% at 45 min after the first dose and this was a sustained effect throughout the detox. Mean systolic blood pressure dropped by 6.2 mmHg at 45 min after the first dose of lofexidine and by 16.5 mmHg two days later however this was asymptomatic in all patients. There was no significant change in the heart rate and no adverse events.

Conclusion

Our team innovatively adapted and tailored a cost-effective community opiate detoxification programme using a multi-agency strategy in a climate of limited funding and staff resources. Our data clearly indicates positive outcomes in terms of completion rates and clinical safety.

Disclosure of interest

The authors have not supplied their declaration of competing interest.