bluuebunny/crossref_metadata_2025 huggingface dataset:
Blackburn with Darwen mental health assessment and treatment team – A service evaluation report
Authors: Damle V. , Bhandary N.
Published: May 2016

Introduction

Assessment and Treatment Team (ATT) was developed to manage mental health referrals within the borough of Blackburn with Darwen (BwD). The ATT became the main point of initial referral and assessment for adults presenting with mental health needs. It acts as the gateway service for access to specialist mental health services.

Aim

To evaluate the effectiveness of ATT against the key performance indicators.

Methods

Quantitative data was collected using electronic database from June 2014–May 2015. Feedback was obtained from GPs and also from patients who attended ATT over a one-week period.

Results

The ATT received a total of 2234 referrals. A total of 73% were seen within 10 working days of the referral. Assessment outcome letters were sent to the GPs within 48 h in 47.53% cases. Referral rates to community mental health and Crisis teams were 7% each showing an overall reduction compared to the previous service. GP satisfaction – 70% were ‘moderately satisfied’ and 30% were ‘very satisfied’ with ATT. Hundred percent felt the service was easily accessible and 90% felt that the staff were friendly. Patient Satisfaction – 96% of patients rated the team as ‘friendly and polite’. Eighty-seven percent reported that they were listened to and 91% felt their concerns were understood. Eighty-three percent felt that ATT involved them in their decision making. Ninety-two percent responded that they were likely/extremely likely to recommend ATT to their friends and family.

Conclusions

The establishment of ATT has led to improved satisfaction among GPs and service users and has resulted in reduction in referrals to secondary mental health services.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Predictors and rate for one-year inpatient readmission in the psychiatric hospital of Sarajevo Canton
Authors: Kovac F. , Ahmic M. , Bilalovic P. , Tahirovic M.
Published: May 2016

Introduction

Number of patients who are again unexpectedly admitted to hospital after a previous hospitalization are used to evaluating the quality of hospital care. Readmission can be represented by the total number and by readmission rate.

Objective

Understanding the risk factors that can lead to readmission is a factor for the development of interventions that can improve the quality of care.

Aims

The purpose of this study was to examine number and predictors of psychiatric readmission within 14 days, 30 days and, 3 and 6 months.

Methods

In this retrospective study, analyses were conducted in a sample of 566 discharge adult patients who were admitted to a Psychiatric Hospital of Sarajevo Canton from 1st January to 31st December 2013.

Result

Total number of readmission was 14%. The readmission rate within 30 days was 2.8%, number of readmission quarterly was 9.1%, number of readmission within 6 months after discharge was 13%.

In the study, several factors were significantly associated with increased risk of readmission including non-compliance with drug treatment, social problems, aggressiveness, suicidality.

Conclusion

Our study suggesting that the prevention of psychiatric readmission requires continuous multidisciplinary work with patients and family members.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Comparing family members’ perceptions of the family
Authors: Kékes Szabó M.
Published: May 2016

Family organization has arguably a determinative role in our healthy social-emotional and cognitive development, although we may have different perceptions of this system. Its background is in connection with the family members’ different experience, knowledge and beliefs about the world. Furthermore, we are also prone to imagine others’ mental representations that can help us to understand them better. Sometimes these meta-representations may be more accurate, while other times they may be incorrect. Although theories of mind tasks are well-known tools to explore (meta-) representations, the use of Gehring's (2010) Family System Test (FAST) in this way is less tested. The aim of this study was to compare the family members’ perceptions of the family with one another. Children's and parents’ family images were explored. In line with Smith, Myron-Wilson and Sutton's (2010) previous findings, my results confirmed the parents’ increased ability to assess the children's perceptions. Finally, growing theory of mind abilities may also be in the background of the results above (Happe, Winner and Bownell, 1998). Subsequent studies have to broaden the focus and involve more methods, age groups in the investigations to know more about human cognitive processes.

Disclosure of interest

The author has not supplied his/her declaration of competing interest.
The evolution of emotional intelligence in schizophrenia: A comparative study of two groups at different times of the disorder
Authors: Chapela E. , Quintero J. , Morales I. , Félix-Alcántara M. , Correas J. , Gómez-Arnau J.
Published: May 2016

Introduction

People with schizophrenia show changes in the skills related to emotional intelligence, but little is known about the clinical course of these deficits. Few studies have examined the evolution of emotional intelligence in schizophrenia patients.

Objective

To increase knowledge about emotional intelligence deficits in schizophrenia and to study its clinical course and factors related, with particular interest in neurocognitive deficits.

Aims

To compare emotional intelligence and other clinical and neurocognitive data in patients with schizophrenia in a different moment of evolution.

Methods

Twenty-five patients with schizophrenia for up to 5 years of evolution were compared to 24 patients with schizophrenia for more than 5 years of evolution. The assessment protocol consisted of a questionnaire on socio-demographic and clinical-care data, and a battery of assessment scales, including MSCEIT for emotional intelligence.

Results

Both groups show a deterioration of emotional intelligence. Schizophrenia patients over 5 years of evolution have worse performance in emotional intelligence test that schizophrenic lower evolution. In the schizophrenia group of up to 5 years of evolution, none variables correlate with emotional intelligence. In the schizophrenia group of more than 5 years of evolution, there were moderate negative correlations with the severity of symptoms and depressive symptoms, and moderate correlation of positive sign with functionality, but none of the neurocognitive assessment scales.

Conclusions

There are arguments for the existence of a progressive deterioration of emotional intelligence in schizophrenia. This deficit in emotional intelligence in schizophrenia appears to be present from the first years of the disease.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Integrated treatment in schizophrenia: A psychodynamic approach
Authors: Cianciulli M. , Ciampa L. , Gucci F.
Published: May 2016

Introduction

The severe disability of schizophrenia and its impairment in real-life functioning can improve with a treatment that stimulates personal resources such as peer-support by psychologist according to Cordiale and Montinari psychoanalytic model (2012) in a multidisciplinary team.

Objectives

Supportive and narcissistic relationships sharing real life experience, according the cohesion of Self (Kohut 1971), promotes identification processes and improves pharmacological and psychiatrist treatment.

Methods

Study participants were recruited for one year, according to diagnostic criteria of DSM V, from schizophrenic patients (n = 12) of a Mental Health Department and of a private psychiatric department (DH) in an age between 23 and 36 years, tested by SAT-P and GAF scale.

Results

All patients were treated with second generation antipsychotic and an integrated treatment with peer-support, (Galderisi et al., 2014).

Conclusions

The valiance of real-life functioning in patients with schizophrenia depends on an integrated intervention that assures a function of flexible and not coercive restraint, allowing to stable relationship with territorial agency (network) (Chiesa, 2008).

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Psychosis-related polydipsia and chronic hyponatremia – A case report
Authors: Gonçalves Godinho F. , Melo A.L. , Marques S. , Barrocas D.
Published: May 2016

Introduction

Psychogenic polydipsia has an estimated prevalence of 6–20% in psychiatric population. Although first described in the 1930s, there are few studies addressing this problem and its management. The high water intake can lead to severe hyponatremia with a mortality rate high enough to merit clinical concern.

Aims

Report a case of a schizophrenic patient with psychogenic polydipsia and hyponatremia.

Methods

Retrospective review of the clinical file and literature research on this topic.

Results

A 41-year-old man with a long-term schizophrenia presented to the emergency room (ER) with exacerbation of psychotic symptoms. In the prior 24 months, he had stopped medication and began excessive water intake (5 to 10 L/day). He presented with auditory hallucinations, passivity phenomena and persecutory and other delusional thoughts that justified this behavior – “The water will end; I have to stock it, like camels do”. Presently he had an asymptomatic hyponatremia (128 mg/dL), but 6 months before he had been admitted in the ER with vomiting, altered state of consciousness and convulsions secondary to severe hyponatremia (108 mg/dL). During the present hospitalization, organic causes of hyponatremia were excluded and he was started on behavioral measures and antipsychotics. The psychotic symptoms improved and there was no need for water restriction after the first week, with restored natremia values on discharge.

Conclusions

With this case report we intended to raise awareness on this potentially fatal condition that despite its prevalence has no defined diagnostic criteria, nor established controlled trials concerning the effectiveness of treatments.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Capgras-delusion in a female patient with schizophrenia: A case report and study of the literature
Authors: Kolarov P. , Chumpalova P. , Georgiev G. , Todorov A. , Stoimenova M.
Published: May 2016

Background

The Capgras syndrome is a rarely observed condition in patients with different psychiatric diseases, which is characterized with delusional misidentification of people, places, objects, etc.

Objective

In this case report we aim to describe the clinical characteristics and manifestation of Capgras syndrome in a female patient with schizophrenia, perform a literature search on the topic and compare our report to literature findings.

Results and discussion

A 50-year-old female patient was verbally and physically aggressive to her family members upon admission to our center. The onset of disease was marked 2 years ago when she first started feeling deserted and isolated and had a prescribed therapy for her condition which she did not follow. During the current admission a psychiatric assessment was performed. Delusional misidentification of her family members was observed and consequent food and sleep self-deprivation due to psychosis was noted. The patient denied being suicidal but was intense and psychotic, and reported different objects to have started disappearing mysteriously from her home. The patient was diagnosed with schizophrenia and was treated with haloperidol, olanzapine, chlorpromazine, and biperiden. The patient was discharged in an improved condition, without episodes of obsessive delusions and improved communication with her relatives.

Conclusion

Although according to the literature organic substrate may be found in some patients with Capgras syndrome, in the case presented here it is the dominant psychotic theme, which determined the content of the disease.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Risk-taking and self-medicating contribute to the association between psychometric risk for schizophrenia and smoking
Authors: Verwey M. , Ruzibiza C. , Linscott R.
Published: May 2016

Background

There is a robust association between positive symptoms of schizophrenia and smoking. This relationship extends to psychometric risk for schizophrenia (schizotypy). We sought to determine whether smoking in schizotypy is best understood in terms of self-medicating or risk-taking behaviour. The self-medication perspective holds that individuals with schizophrenia smoke to relieve stress. By smoking, cortisol levels increase, stimulating negative feedback circuits that reduce the hypothalamic-pituitary-adrenal (HPA) axis stress response. Increased HPA activation also stimulates dopamine release, promoting the expression of positive schizotypal experiences. In contrast, the risk-taking perspective holds that elevated dopamine promotes risk-taking behaviour, including substance misuse, by reducing reward sensitivity and increasing sensation-seeking.

Method

Undergraduates (n = 230) reported current and past nicotine use and completed the Schizotypal Personality Questionnaire and a self-report measure of stress sensitivity.

Results

Consistent with risk-taking, positive features of schizotypy predicted having ever smoked (OR = 1.02, P < 0.05) but did not distinguish current smoking from non-smoking (OR = 0.99). The self-medication hypothesis was examined in two ways. When smoking status was regressed onto positive schizotypy and stress, stress was found to predict current smoking (OR = 1.08, P < 0.05) but not having ever smoked (OR = 1.09). Secondly, stress and current smoking interacted to predict positive schizotypy (ß = 0.31, P < 0.05).

Conclusions

Risk-taking and self-medicating each contributed to the relation between smoking and schizotypy, but in different ways. Risk-taking seems to contribute to having ever smoked whereas current smoking seems to reflect self-medicating behaviour.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Treatment with intramuscular paliperidone palmitate in schizoaffective disorder
Authors: Maroto Martin L. , Hervías Higueras P.
Published: May 2016

Introduction

Injectable formulations of long acting antipsychotic are a valuable treatment option for patients with psychotic disorders. Schizoaffective Disorder (SAD) is a complex disease; the optimal treatment is not well established yet.

Objective

Answer the question about the effectiveness offered by intramuscular Paliperidone Palmitate in SAD versus other injectable antipsychotics. Keywords: schizoaffective disorder; paliperidone palmitate injection.

Methods

A case report of a 35-year-old male diagnosed with Schizoaffective Disorder six years ago and with personal history of multiple manic decompensation after treatment discontinuation. Throughout his life he has been treated with intramuscular Risperidone 87.5 mg (50 + 37.5) every 14 days, Olanzapine flas 20 mg/day, Risperidone flas 3 mg, Amisulpride 600 mg/day, Valproic acid 1500 mg/day Clonazepam 2 mg/day and Lormetazepam 1 mg. In the last admission one year ago, he started treatment with intramuscular paliperidone palmitate up to 200 mg a month. Currently he receives a monthly dose of 100 mg and concomitant lithium 800 mg/day.

Discussion

The use of intramuscular paliperidone palmitate in SAD and its effectiveness against other injectable antipsychotic is discussed.

Conclusions

The use of intramuscular paliperidone palmitate appears to constitute an employment opportunity in the treatment of intramuscular maintenance in SAD. It could be effective in stabilizing episodes of acute exacerbation and remissions of psychotic, manic and depressive symptoms.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Catatonic schizophrenia vs anti-NMDA receptor encephalitis – A video case report
Authors: Ponte A. , Gama Marques J. , Carvalhão Gil L. , Nobrega C. , Pinheiro S. , Brito A.
Published: May 2016

Introduction

Anti-N-methyl-D-aspartate receptor (anti-NMDAR) encephalitis is a treatable autoimmune disease of the CNS with prominent neuropsychiatric features that primarily affects young adults and children.

Objective

To present the diagnosis course of a case of anti-NMDAR encephalitis in a patient with previous diagnosis of Schizophrenia.

Methods

Analysis of the patient's clinical records and of a PubMed database review, using “anti-NMDAR encephalitis” as keywords.

Results

We report a single case of a 33-year-old man diagnosed with Paranoid Schizophrenia in 2009 that after 1 year of treatment abandoned follow-up. Six years later, the patient presented to the psychiatric emergency department with persistent headaches, abnormal behavior and loss of motor skill. He was admitted to the psychiatric ward with a presumptive diagnosis of “Catatonic Schizophrenia” and began to manifest fluctuating catatonic symptoms (captured in video). Neuroleptics and benzodiazepines were tried without success. There was a clinical deterioration with autonomic dysfunction, breathing instability and seizures. Complementary exams revealed: EEG with slow base activity; brain MRI with right temporal pole and right frontobasal lesions compatible with head trauma; CSF with pleocytosis; and positive anti-NMDAR antibodies. Occult neoplasm was excluded. Treatment with high-dose steroids, intravenous immunoglobulins, followed by cyclophosphamide resulted in relevant clinical improvement.

Conclusions

As early detection of antibodies may allow for earlier treatment of anti-NMDAR encephalitis, which is associated with better outcomes, we believe the present case underscores the importance of clinicians maintaining vigilance for neuropsychiatric symptoms that have not adequately responded to therapy.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Awareness of illness and psychosis
Authors: Remesal Cobreros R. , Alonso Díaz R. , Cortázar Alonso E. , Andrés Villa M.
Published: May 2016

Introduction

One of the characteristics of Karl Jaspers approach to clinical practice was the importance he gave to the subjective experience by the patient. Patient's self-observation is one of the most important sources of knowledge of the psychic life of the patient. The lack of awareness of illness is quite common in psychotic spectrum.

Aim

The aim of this paper was to examine and compare a group of patients diagnosed with psychosis disorder with another group with other mental disorders, in relation to their mental and emotional suffering,

Sample

The sample was composed by 118 subjects with both sexes. It was divided into two groups: patients with a diagnosis of psychotic disorder and another one with other mental disorders.

Instrument

Inventory SCL-90-R, which evaluating a wide range of psychological and psychopathological symptoms was used.

Statistics analysis

Two groups were compared with respect to perceived psychopathological symptoms.

Results

Statistically significant differences were observed between both groups. Patients with psychotic disorders showed lower scores in most clinical scales. It reflects less emotional suffering and psychological distress perceived in this group against the other. It could be related to the lack of awareness of illness by psychotic patient.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
The aetiology of schizophrenia as outlined in a treatment-resistant case
Authors: Vella Fondacaro D. , Falzon Aquilina F.
Published: May 2016

Introduction

The development of treatment-resistant schizophrenia in a 16-year-old Maltese girl was analyzed in terms of its biopsychosocial model of disease.

Objectives

To highlight the presentation of treatment-resistant schizophrenia.

To investigate the etiology of treatment-resistant schizophrenia.

Aims

To utilize the biopsychosocial model of disease in order to investigate the aetiology of treatment-resistant schizophrenia.

To highlight the treatment modalities utilized in this case of treatment-resistant schizophrenia.

Methods

Interviewing the patient.

Analyzing all investigations and documentation made during her admission in an acute psychiatric hospital.

Evaluating the response to various treatment modalities.

Carrying out literature reviews.

Results

Image attached.

Conclusions

Although the aetiology of treatment-resistant schizophrenia remains somewhat unclear even after many years of study, the biopsychosocial model is nevertheless useful in understanding the development of this condition. The treatment modalities to which the patient was resistant were also identified.

Figure not available.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Sexuality in mental health: Brazilian science production review (2001–2014)
Authors: Boaes R. , Silva M.B.B. , Russi J.A.
Published: May 2016

Aiming at analyzing mental health and sexuality studies, specifically in papers published in Brazil, this dissertation brings a review of the literature carried out in two databases. It can be noticed that studies on sex, gender and sexuality show the complexity of the understanding of human sexual life going from essentialist to constructivist perspectives, conceiving sexuality in several manners. However, studies on madness, mental health and psychosocial care point to different conceptions of mental sickening process, mental health being at the same time a science field and a psychological well-being value to be achieved. Surveys in nursery homes show that institution agents represent the sexuality of a mentally suffering person (MSP) as abnormal or non-existing. The review of academic production on the subject, has put together 685 publications, 43 of them in both, with only 109 from Brazil, these ones having been systematized by title and abstract, only eleven were selected and studied thoroughly. Results show that the analyzed science production is scarce, being the theme just at its beginning in collective health, with the predominance of biomedical approaches focusing in on sexual behavior, with special attention to the vulnerability to IST/HIV/AIDS, the absence of sexual education and gaps in the training to work with sexuality. The conclusion is that the studied Brazilian science production on sexuality in the field of mental health is not centered on sexual and reproductive rights of MSP, while user sexual practices and the representations of professionals come to the fore in the analyses.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Radiotherapy and treatment of cervical cancer – sexuality implications
Authors: Fornelos A. , Macedo P. , Nunes S. , Figueiredo A. , Silva M. , Viseu M.
Published: May 2016

Introduction

Cancer of the uterine cervix represents 10% of malignant tumors affecting women. Despite occupying fifth place in the global mortality rate it is described with the highest healing potential. One of the most used treatments is radiotherapy, which has a particularly significant impact on women's quality of life, especially in their sexuality. Biological and psychic factors are suggested as possible etiologies for sexual dysfunction situations. Changes in body image may arouse feelings of shame and low self-esteem. In what concerns biology, vaginal stenosis is referred as a cause of vaginism and vaginal bleeding, with consequent decrease in libido and pleasure.

Objective

Describe the implications in the sexuality of women with cancer of the uterine cervix after radiotherapy.

Methods

A literature search using the PubMed and Scielo databases of scientific articles published in the last 10 years.

Results

In the literature, there are significant changes in sexual behavior in women with cervical cancer in the period after radiotherapy. A large percentage reveals sexual abstinence and an equally significant part presents sexual dysfunction caused by lack of lubrication, arousal and orgasm. Moreover, it is reported decreased libido and sexual pleasure, vaginal bleeding and vaginism. On the other hand, there is a small account of cases in which it is mentioned increase libido and pleasure.

Conclusion

Despite the high probability of healing this disease, the patients’ quality of life after advanced stages of radiotherapy, should be a source of concern, especially with regard to sexuality.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Autolytic behavior in acute psychiatric hospitalization
Authors: Hervías Higueras P. , Maroto Martín L. , Raffo Moncloa S. , Jiménez de los Galanes Marchán P.
Published: May 2016

The aim of the study was to identify inpatients due to autolytic behavior in the acute psychiatric hospitalization of Dr. R. 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. The results were analyzed by SPSS software; 53.3% of patients diagnosed with schizophrenia spectrum and other psychotic disorders were hospitalized for acute exacerbation of paranoid schizophrenia; 57.1% of personality disorders for suicide attempts, 28.6% autolytic ideation; 28.6% of bipolar disorders due to mania, 28.6% depression, 28.6% mixed clinical and 14.29% suicide attempts; 60% of alcohol use disorders for autolytic ideation, 20% intoxication; 100% of substance-related and addictive disorders due to autolytic ideation; 100% of feeding and eating disorders for autolytic ideation; 50% of obsessive-compulsive and related disorders due to autolytic ideation; 100% of adjustment disorders with depressed mood due to drug over-eating; 100% of adjustment disorders with mixed anxiety and depressed mood for mixed clinic; 16.7% of depressive disorders due to dysthymia, 16.7% due to major depressive episode, 16.7% for moderate depressive episode, 16.7% for mild depressive episode with mixed nature, 16.7% for drug over-eating, 16.7% for autolytic ideation. It would be important to focus on patients with a diagnosis of adjustment disorders, personality disorders, alcohol use disorders, obsessive-compulsive and related disorders and bipolar disorders, providing community care and avoiding the risks associated psychiatric hospitalization.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Economic impact of suicidality in manic patients with depressive features
Authors: Ösby U. , Jonas E. , Hällgren J. , Pompili M.
Published: May 2016

Introduction

There is limited information published on the specific financial costs of completed and/or attempted suicide in bipolar patients. In the last 15 years, only 6 studies were published. Their results vary considerably due to differences in methods used. Also, information on cost for pure manic versus mixed episodes is lacking. This is surprising, since studies have shown that suicidal behaviour is more common among patients with depressive symptoms than with pure mania, and this difference increases considerably when the mixed-features specifier is applied.

Objectives

We conducted a registry study with the aim to expand the epidemiological information on suicidal behaviour by episode type in bipolar disorder, and its associated costs.

Methods

Health data were retrieved from the Swedish Patient Register. Data covered the period 1990–2014 and included the number of discharged patients with bipolar diagnosis, hospital re-admissions, and attempted and/or completed suicides. Moreover, we retrieved data on suicide and cause of death from the Swedish Cause of Death register. Analyses were done for the whole sample and stratified by subtypes (mania, depression and mixed forms).

Results

First results will be presented at the EPA meeting.

Conclusions

This is a nation-wide Swedish study of completed and attempted suicide in bipolar patients. The hypothesis we will test is that there is a substantial variation between different bipolar disorder subtypes, and that most of the expenditures due to suicidal behaviour in bipolar disorder are linked to mixed forms, mania in combination with depression.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Suicidal behavior in old age: Special considerations
Authors: Ramirez Dominguez M.D.L.C. , Ramirez Dominguez A. , Prieto Sánchez I. , Gonzalez Macias C.
Published: May 2016

Introduction

Suicide in the elderly is a growing problem in Western society, despite which there are no large studies examining this issue, nor specific protocols to address them.

Objective

To raise awareness of the importance of suicidal behavior in elderly both its prevalence and special features that presents need a different performance plan from other fractions old.

Methods

Comprehensive literature review of all published in the last two years, as well as the specific features.

Conclusion

Suicidal behavior in the elderly has very specific characteristics that we must know in order to develop therapeutic strategies adapted to the present conditions.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Over, but not out-recognition and preventing aircraft-assisted murder-suicide by Aircrew
Authors: Saxena A. , Sharma V. , Walia A. , Sharma P.
Published: May 2016

Context and introduction

The recent crash of Germanwings Flight 4U9525 appears to be the latest act of aircraft-assisted murder-suicide. The psychiatric preventive aspects of the murder-suicide need to be discussed, and effective measures for recognition and prevention of this murder-suicide are needed. Aircrew health is biased towards the physical ailments, and evaluation manuals have not discussed the mental health aspects, especially preventive strategies. These strategies involve multifactorial interventions, their applicability and usefulness are not globally validated.

Objectives and methods

Thanatology has since long, focused on early detection of mental distress and elucidating behavioural and psychological factors that predispose towards attempts at self-harm. Aircrew forms a different group from the general population. The recognition and preventive strategies in this special group, must, therefore, be tailored to this group with its special characteristics.

Data sources, study selection and data synthesis publications were identified via electronic searches using multiple search terms related to suicide prevention. The available effective preventive measures were juxtaposed on the current concepts in aerospace psychiatry.

Conclusions

Murder-suicide by aircrew is an event that is the culmination of undetected, ignored or even condoned discrete events that gradually progress and insidiously escalate. The importance of psychological factors in this catastrophic event needs to be disseminated amongst psychiatrists, and aircrew medical examiners. Ascertaining which components of suicide prevention programmes are effective in early recognition of aircrew who may attempt or complete the murder-suicide and putting into practice these to optimize the use of limited resources, is therefore essential and necessary.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
A new evidence-based neuropsychological model of suicidal propensity and suicide based in depression
Authors: Thorell L.-H.
Published: May 2016

Introduction

Objectively validated models of the depressed suicide are lacking. Early observations that electrodermal hyporeactivity was strongly related to suicide in depression required an untraditional statistical approach that was applied on materials from published materials with between themselves totally confirming results.

Objectives

A plausible explanation model of the relationship had to be developed.

Aims

The aims were to investigate the nature of electrodermal hyporeactivity and its possible causes and connections to other suicide relevant factors and to formulate a coherent model of the depressed suicide.

Methods

Published materials with in- and outpatients (in total > 900 patients) comprising follow-up of suicide and tests of habituation of the electrodermal response were analysed. Symptomatology, gender, age and other variables were considered and so were knowledge and theories from other scientists.

Results

The apparent loss of or considerably reduced specific electrodermal orienting (curiosity) responses in future depressed suicide victims showed clear relationships to and clear independence of considered important suicidal factors.

Conclusions

Loss of specific orienting responses indicates loss of hippocampal CA3 plasticity. CA3 areas are early and centrally positioned in the information processing of neocortical sensory input supporting the hypothesis of a particular neuropsychological dysfunction disabling normal cognitive and emotional curiosity reactions to everyday events. It is proposed that this dysfunction may make the depressed person ready to leave the everyday life and fearless of imminent pain – a loss of two important barriers against suicide.

It seems righteous to propose this basically objectively validated model as a plausible explanation of the depressed suicide.

Disclosure of interest

The author has not supplied his declaration of competing interest.
ApTiC: A feasibility trial of a communication method using mobile technology to improve assessment within an early intervention service
Authors: Riley M. , Lovell M. , Gire N. , Lane S. , Taylor P.J. , Fitzsimmons M. , Chaudhry I.B. , Bee P. , Lovell K. , Husain N.
Published: May 2016

Introduction

The early intervention service (EIS) approach is based on therapeutic interactions, which promote service user recovery from first episode psychosis. Collaborative therapeutic work between the service user and case manager depends on good communication. This can be a challenge for people with psychosis as the process of thought can be disrupted or stimulus misinterpreted leading to communication errors.

Objective

The objective is to develop an interactive tool that can assist service user's communication of distress, whilst employing a psychoeducational approach to the use of an informal therapeutic measurement scale; subjective units of distress (SUDs) and early warning signs (EWS). The ApTiC mobile intervention will include ten numerically graded emoticons from low to extreme distress. Each emoticon is associated with specific individualised service user descriptors and linked to an individually agreed action plan and level of response to be offered by a staff member.

Aim

The aim of the present study will be to examine the feasibility and acceptability of the ApTic mobile intervention in preparation for a larger randomised controlled trial.

Methods

Phase one: qualitative research to inform the development of the complimentary tool and mobile app (qualitative). Phase two: a 12-week rater-blinded randomized control trial of ApTiC compared to routine EIS case management (quantitative).

Results

The qualitative data will be presented.

Conclusions

It is expected that once validated, the SUDs based ApTiC will enhance rapport and understanding thus improving the recovery approach to well-being and hopefully preventing relapse or the involvement of the crisis team or hospital admissions.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
mHealth in mental health: What do the users think about it?
Authors: Sengelen J.M. , Banea I.C.
Published: May 2016

There is currently a major trend for e-health and the first mental health applications for smartphones are now released. Patients and health care professionals are still struggling to position themselves in relation to these new approaches. So, we wanted to know more about the involvement of mental health users and their care providers in mobile health (mHealth) technologies. We needed to understand their expectations and their reluctances. For achieving this purpose, we carried out an online survey for mental health users (n = 108). It turns out that people who responded to this survey are well equipped with smartphones and are experienced in using mobile apps. They expect from professionals an advisory role in relation to e-health. The major interest lies in practical, concrete applications and the main reluctance is about management, transit and storage of data. It is necessary to involve mental health users and health care professionals together in order to develop these new tools. To achieve this, health care professionals must continue to invest themselves in the use and understanding of m-Health tools.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
It is possible to change clozapine by another neuroleptic
Authors: Fluvia F.X. , Pastor R.
Published: May 2016

It is well known that when we have a schizophrenic patient who do not respond to two batches of neuroleptics at full dosage for more than six month, it may be wise to try with clozpine which is believed to be one of the best neuroleptics we have but with two main handicaps: it can produce leucopenia which can be fatal and epileptic seizures as well. We do think that in many cases, clozapine has been used too soon in the treatment of the schizophrenic patient, before we can really talk of a resistant patient. To prove that we have changed the clozapine treatment of four chronically ill schizophrenic patients admitted to a home for the chronically mentally ill. Two patients were changed from clozapine 400 mg/day to paliperidone 15 mg/day along two months time. They both improved in mental clarity and ability of thinking. Another patient were changed from 600 mg/day to 27 mg/day of paliperidone. That patient worsened a little bit mainly with hostility and social avoidance but it was mandatory to change neuroleptic because he had had two seizures and had low levels of platelets and therefore he was at risk of developing leukopenia. The fourth one was taking 300 mg of clozapine and was changed to 12 mg of paliperidone. We got no change in the clinical outcome.

Discussion

We discuss the different explanations for the results we got.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Antipsychotic combination strategies in patients with bipolar disorder
Authors: Ruiz R. Molina , Oller M. de Castro , Macías V. Gomez , Rodriguez M. Roncero , Rada F. Montañes
Published: May 2016

Introduction

Treatment strategies in bipolar disorder (BPD) has changed in the last decades and polypharmacy including antipsychotics has become extremely common compared to monotherapy with mood stabilisers. Clinicians tend to use 2 or more atypical antipsychotics despite the lack of evidence to support safety, tolerability and efficacy of this practice.

Objective

To determine most frequently used treatment strategies in a sample of bipolar disorder patients and review of the literature.

Methodology

Analysis of a sample of 35 patients with BPD from Madrid and review of recent literature for evidence arising from international guidelines recommendations and meta-analyses.

Results

Most frequently used treatment approach in our sample was polytherapy, including at least 1 atypical antipsychotic (31%) and polytherapy, including at least 2 antipsychotics (47%) together with mood stabilisers. Only 11% were in monotherapy with mood stabilisers and another 11%were in monotherapy with one atypical antipsychotic but without mood stabilisers. Aripiprazol and olanzapine were among the most preferred atypical antipsychotics. Efficacy and safety of such combinations have not been systematically compared with monotherapy in the literature. Previous data indicate that polytherapy in BPD may incur in important disadvantages [1].

Conclusions

Treatment of BPD remains challenging. Polytherapy seem to have replaced monotherapy due to less relapses and better results in treatment of affective symptoms. However, compliance and secondary long-term effects should be taken into account. Superiority in terms of efficacy in polytherapy needs to be balanced with tolerability issues. More studies on combination therapy, long-term efficacy and safety are needed.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Antipsychotic injectable extended release: A case report
Authors: Dominguez M.D.L.C. Ramirez , Gonzalez L. Hernandez , Sánchez I. Prieto , Martinez A. Rodriguez , Leon S. Fernandez
Published: May 2016

Objective

To demonstrate the therapeutic efficacy of aripiprazole LP by a case of difficult clinical management and that we often find in our daily practice.

Methods

Description of a clinical case of a 21-year-old man, recently diagnosed with paranoid schizophrenia with no awareness of disease neither treatment adherence and harmful use of THC and cocaine that are identified as precipitating factors for multiple hospital admissions.

Results

Injectable medication with objective clinical improvement is significant, cessation of readmissions, achieving improvement in all parameters measured functionality and proper adherence to treatment as well as outpatient mental health of both devices as of drug dependence.

Conclusion

Psychiatry is facing the great challenge of modifying the natural history to the deterioration of schizophrenia, a disease considered one of the leading causes of years lived with disability. The objectives medium and long-term treatment of this disease are centered on the delay-avoidance disability and improving the functioning and quality of life of people with this disease.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Psychiatry heal thyself: a lifestyle intervention targeting mental health staff to enhance uptake of lifestyle interventions for people prescribed antipsychotic medication
Authors: Rosenbaum S. , Watkins A. , Ward P.B. , Pearce D. , Fitzpatrick K. , Curtis J.
Published: May 2016

Introduction

People experiencing severe mental illness (SMI) face a shortened life expectancy of up to 20 years, primarily due to preventable cardiovascular (CV) diseases. Lifestyle interventions are effective in reducing CV risk, yet examples of service-wide interventions are lacking. Staff culture remains a barrier to the successful implementation of lifestyle interventions. The Keeping the Body in Mind (KBIM) program, established by SESLHD (Australia), aims to close the gap in life expectancy through multidisciplinary teams, including clinical nurse consultants, dieticians, exercise physiologists, and peer support workers. Prior to the KBIM rollout, an individualized lifestyle intervention called Keeping Our Staff In Mind (KoSiM) was offered to all district mental health staff.

Objective

KoSiM examined the effectiveness of a staff intervention to improve physical health, confidence, knowledge and attitudes of mental health staff.

Methods

Mental health staffs were invited to participate in an online survey and a 4-week individualized intervention including personalised health screening and lifestyle advice, with a 16-week follow-up. Outcomes assessed included: attitudes, confidence and knowledge regarding metabolic health, weight, waist circumference (WC), blood pressure, sleep, diet, physical activity and exercise capacity.

Results

Of a total of 702 staff, 204 completed the survey (29%). Among those completing the survey, 154 staff (75%) participated in the intervention. A mean decrease in waist circumference of 2 ± 2.7 cm, (P < 0.001) was achieved. Among staffs that were overweight or obese at baseline, 75% achieved a decrease in WC.

Conclusion

Improving staff culture regarding physical health interventions is an important step in integrating lifestyle interventions into routine care.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
The effectiveness of first-time-mother parent education for infant interaction and sense of parenting competence in Taiwan
Authors: Chung F.F. , Liu H.E.
Published: May 2016

Background

This study is designed to investigate the relationship between first-time-mother postpartum parenting education and its effectiveness on the quality of mother–infant interaction and in turn, sense changes of parenting competence.

Methods

Eighty-one healthy first-time-mother infant dyads were recruited. The control group (n = 40) received normal postpartum care, being the medical and cultural norms practiced in Taiwan. The experimental group (n = 41) received extra education by way of a 40-minute videotape on infant states, behaviors, communication cues, and a handout about play practices. Data was collected at five time periods: around first week, followed by the first, second, third and sixth month after birth. Assessment scales used for this study were the Chinese Version of the Parenting Sense of Competence Scale (C-PSOC), the Edinburgh Perinatal Depression Scale (EPDS), and the Nursing Child Assessment Teaching Scale (NCATS), in order to score videotaped mother-infant interactions.

Results

The results of the study between these two groups showed that there was an increase in the quality of mother–infant interaction within the experiential group. In addition, it was found that at the five points of assessment, there were no significant sense changes of parenting competency and no significant differences in postpartum depression. For all subjects, there was a correlation between postpartum depressions, competency in parenting, and quality of mother–infant interaction.

Conclusions

Study results prove that first-time-mothers in Taiwan who are provided extra educations about infant abilities, as well as how to effectively play with babies, are likely to witness an improvement in interactional quality.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Effects of depressive mood of female high school students on dysmenorrhea and sleep quality
Authors: Kim S. , Kim H. , Kim M.J. , Min Y. , Lim J. , Lee Y. , Kim S. , Kim C.H.
Published: May 2016

Background

This research aimed to identify the effects of depressive mood of female high school students on dysmenorrhea and sleep quality.

Methods

This research was conducted for 2 months from September 2015 to October 2015. A total of 3 types of self-reported questionnaire were adopted for the research. Control group was separated by Zung Self-rating Depression Scale (ZSDS). Each group adopted a self-made questionnaire for research on menstruation and Pittsburgh Sleep Quality Index (PSQI) for research on sleep. Chi2 test and AVOVA analysis through SPSS-21 were used as statistics methods.

Results

Analysis was made on 72 female students who submitted clear answers to the questionnaire. There were 34 students from normal mood group and 38 from depressive mood group. Depressive group presented meaningful results on regularity, pain severity, and drug treatment history of menstruation. Particularly, depressive group had 51.4% among subjects having severe menstrual pain of grade 3 by VMS (verbal multidimensional scoring system), way higher than 27.6% among subjects in the normal group. PSQI for sleep showed a meaningful result that 20.8% of those in the normal group were diagnosed with sleep disorder compared to 86.8% for the depressive group. A meaningful difference was seen in sleep latency, sleep duration, sleep disturbance, use of sleep medication, daytime functional disturbance among 7 items of PSQI.

Conclusion

This research showed that female high school students with depressive mood had high frequency and severity in dysmenorrhea and sleep quality disturbance.

Disclosure of interest

The authors have not supplied their declaration of competing interest.