bluuebunny/crossref_metadata_2025 huggingface dataset:
Czech gamblers view on luck as the cause of uncontrollable events
Authors: Dlhosova T. , Kundt R.
Published: June 2017

The belief in deterministic luck is considered to be one of the factors contributing to maintenance of gambling behavior. This belief was found to be stronger during the gamble situation in problematic gamblers than non-problematic. The present study deals with the difference in luck attribution between the Czech gamblers and the control group. The main goal was to find out whether the difference between belief in luck is also present in non-gamble situation. A questionnaire containing the Belief in luck and luckiness scale and 14 stories of uncontrollable events was administered to 30 pathological gamblers and 30 matched participant (by age, education, gender and nationality), who did not play any hazard games regularly. In uncontrollable events participants chose from non-material causes (luck, chance, god, destiny) one they believed to be the best fit. Results have shown a statistically significant difference between gamblers and control group in the way of attributing the causes. Control group has chosen significantly more “chance” option meanwhile gamblers opted for luck, God and destiny. There was no statistically significant difference in explicitly formulated belief in luck. It seems that the stronger casual attribution of luck, god and destiny in pathological gamblers compared to non-gamblers are not restricted only to gaming situations. Rather we can find it in other uncontrollable events as well. The absence of the difference between patients and control group in explicit belief in luck measured by questionnaire could be pointing to the stronger effect of the treatment for explicit belief than for more subtle causal attributing.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Impact of hepatitis B (HBV)/C (HCV) virus co-infection on the survival of schizophrenic patients with co-occurring substance use disorders followed for 12 years
Authors: Gimelfarb Y. , D”r Wolf A. , Ben Tzarfati M.
Published: June 2017

Introduction

There is no evidence on influence of HBV/HCV co-infection on survival characteristics in population with dual disorders.

Objective

To determine the impact of HBV/HCV co-infection on the long-term survival of schizophrenic patients with co-occurring substance use disorders.

Methods

Charts of 223 subjects admitted from January 1, 2002 to May 31, 2006 were assessed. The Kaplan–Meier survival analysis was used to estimate the cumulative survival rates. The association between HBV/HCV and mortality was estimated using the Cox proportional-hazard regression models, with adjustments for potential confounders. The main outcome was all-cause mortality. Median observation time was 10.3 years.

Results

Total all-cause 11 year, unadjusted mortality was 18.0% in population with no viral hepatitis (VH) infection (n = 185; 83.0%), 66.7% in population with HBV monoinfection (n = 3; 1.3%), 50.0% in population with HCV monoinfection (n = 28; 12.6%), and 64.3% in population with HBV/HCV co-infection (n = 7; 3.1%), P < 0.00001. In Cox regression, the adjusted hazard ratio was 4.22 (95% CI: 1.00–18.63; P < 0.05) for the HBV, 4.24 (95% CI: 2.13–8.47; P < 0.00001) for the HCV, 6.18 (95% CI: 2.01–19.01; P < 0.0015) for the HBV/HCV, all vs. no VH-infection.

Conclusions

The high mortality of schizophrenic dual disorders patients with HBV/HCV necessitates new approaches to secondary and tertiary prevention to reduce the burden of chronic liver disease and to improve survival. The strong adverse effect of HBV/HCV on survival should encourage clinical trials including schizophrenic dual disorders patients on whether patients benefit from treatment choices. It is essential that adequate resources and strategies are targeted to the schizophrenic dual disorders patients with HBV/HCV.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
European Federation of Psychiatric Trainees Exchange: Benefits to trainees and organisations
Authors: Rebowska A.
Published: June 2017

Introduction

During my time in Gothenburg, I have spent my first week with the team on the emergency inpatient ward. During my second week in Sweden, I have visited inpatient assessment unit where in depth psychological and psychiatric evaluations can be conducted. My final day was spend in a secure state institution providing accommodation and care to young people at risk of absconding or presenting with challenging behaviours.

What did I learn

Through the participation in the program I was able to gain first-hand experience of different models of healthcare delivery and I intend to implement some of the positive ideas into the services in the UK. Similarly, I hope that the host organisation may benefit from hearing how care is provided in the UK.

During my trip to Sweden, it was the first time I had an opportunity to deliver a presentation to an international audience. This highlighted new challenges such as language barrier and lack of familiarity with jargon, systems and practices that we take for granted within the NHS. I have learnt from the experience and I have now a better idea how to improve my presentations in the future. I have gained a lot of confidence in my presentation skills by speaking in front of a large audience of clinicians that I have not met before.

Disclosure of interest

The author has not supplied his/her declaration of competing interest.
Do Not be Afraid: Novel Approaches to the Treatment of Anxiety Disorders
Authors: Carvalhão Gil L. , Lázaro M. , Ponte A.
Published: June 2017

Introduction

Anxiety disorders (AD) are associated with significant morbidity and often are chronic and resistant to the treatment. A fascinating aspect of AD is the interplay of genetic and experiential factors. It is stablished that abnormal genes predispose to pathological anxiety states; however evidence clearly indicates that traumatic life events and stress are also etiologically relevant. The behavioral theories of anxiety postulates that anxiety is a conditioned response to a specific environmental stimulus. There may be two ways to neutralize fear conditioning either by facilitating a process called extinction or by blocking a process called reconsolidation.

Objectives

Review novel approaches to the treatment of AD.

Aims

To update on treatment for AD.

Methods

A literature search was performed on PubMed database.

Results

Cognitive behavioral therapies use exposure techniques, in which the patient has to confront the fear-inducing stimuli in a safe environment in order to facilitate the fear extinction. The therapy is often context-specific, so one way of strengthen extinction learning is by boosting NMDA receptor activation, either with direct acting agonists (D-cycloserine) or with indirect glycine enhancing agents (selective glycine reuptake inhibitors). Memory reconsolidation is based on the notion that memories are dynamic rather than stable. Reactivation of a memory can return it to a labile state from which it must be reconsolidated. Blocking reconsolidation is a therapeutic opportunity of update and alter the memory, weakening traumatic memories. Beta-blockers and opioids may disrupt this process.

Conclusions

Psychotherapy and psychopharmacology may have a synergistic role in AD treatment.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Prefrontal Theta Cordance in the Prediction of Antidepressant Response to Various Classes of Antidepressants in Patients with Depressive Disorder
Authors: Bares M. , Novak T. , Brunovsky M. , Hejzlar M.
Published: June 2017

Introduction and objectives

Previous studies demonstrated efficacy of reduction of QEEG prefrontal theta cordance (RC) after the first week of treatment in the prediction of antidepressant response.

Aims

The study aimed to compare the ability of RC in the prediction of response to various antidepressant classes.

Methods

All patients (n = 142) were treated with antidepressants (SSRI-58, SNRI-47, NDRI-22, NaSSA-15) for ≥ 4 weeks. Response was defined as MADRS reduction ≥ 50%. EEG were performed at baseline and week 1 of treatment and cordance was calculated for 3 prefrontal electrodes (Fp1, Fp2, Fz).

Results

Logistic regression identified RC as a predictor of response to SSRI, SNRI and NDRI but not for NaSSA. Predictive parameters of RC for response to mentioned antidepressant classes are displayed in the Table 1.

Areas under curves of ROC analysis (AUC) of RC for response prediction were not significantly different among antidepressant classes.

Conclusion

The predictive efficacy of RC for response to SSRI, SNRI and NDRI was comparable.

This study was supported by the grants of MH CZ nr.15-29900A, MH CZ – DRO (NIMH-CZ, 00023752) and by the project Nr. LO1611 from the MEYS under the NPU I program.
Maternal Depressive Symptom Trajectories and Psychosocial Functioning in Young Adults: A 27-year Longitudinal Study
Authors: Luoma I. , Korhonen M. , Salmelin R.
Published: June 2017

Introduction

Maternal depression is a well-known risk factor for child development. Longitudinal studies extending from pregnancy to adulthood, however, are rare.

Objectives

The aim of the study was to investigate whether maternal high depressive symptom trajectories (chronic or intermittent depressive symptom patterns) from pregnancy to the adolescence of the children predict lower adaptive functioning or higher levels of emotional or behavioural symptoms in young adults.

Methods

The sample comprised 329 first-time mothers from maternity centres in Tampere, Finland. Maternal depressive symptoms were assessed with the Edinburgh Postnatal Depression Scale (EPDS) antenatally and at two months, six months, 4–5 years, 8–9 years and 16–17 years after delivery. A model including four symptom trajectories (very low, low-stable, high-stable and intermittent) was selected to describe the symptom patterns over time. Adaptive functioning and problems of the children (n = 144) were assessed by the Adult Self Report forms (Achenbach & Rescorla) at the age of 27 years.

Results

High maternal depressive symptom trajectories did not predict self-reported lower adaptive functioning of the children in adulthood. However, children of mothers with chronic or intermittent depressive symptom patterns reported higher levels of internalising problems as well as symptoms of depression and anxiety in young adulthood than the children of mothers with very low or low stable symptom patterns.

Conclusions

High maternal depressive symptom trajectories predict higher levels of emotional symptoms of children in young adulthood. The mechanisms of intergenerational transmission are important topics for further research.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Structured risk Assessment: Aggression and Safety in Ambulatory Emergency Service
Authors: Arts M. , Sanderse-Besselink P. , Terburg H. , Van De Sande R.
Published: June 2017

Introduction

Discussing the threat of aggression is not always at the forefront in ambulatory care providers. A structured risk analysis model for ambulatory emergency psychiatry is currently not available, while aggression does occur regularly.

Objectives and aims

The aim of this study is to evaluate the added value of a risk analysis model and implement the best available model in emergency outpatient practice.

Methods

The study design is a mixed method model. Semi-structured questionnaires were administered by nurses and psychiatrists. A benchmark study took place at an outpatient emergency service in South Netherlands. A literature search was performed using PubMed and CINAHL for the period 2000–2014.

Results

From this research, we found a discrepancy between the perception and the actual occurred aggression. Care workers often do not discuss aggression related issues, however, case studies show that aggression does occur frequently. In literature studies we have found several risk assessment models, most of which are used within the inpatient psychiatry.

Conclusion

To avert aggression incidents and prevent recurrence, it is important to maintain a solid risk analysis model. Introducing a checklist risk crisis service (CRC) can promote a critical reflection on the threat of aggression and bring awareness on the theme of aggression. Implementation of a CRC in daily practice can be of great value.
Incidence of Gamma-Hydroxybutyrate (GHB) Abuse and Dependence in a Rural Crisis Resolution Team in the Netherlands
Authors: Michielsen P. , Propadalo L. , Arts M.
Published: June 2017

Introduction

GHB abuse and dependence are common in the Western region of Northern Brabant, a rural region in the south of the Netherlands.

Aim

The main goal is to look at the incidence and management of GHB abuse and dependence seen by the CRT in a rural area.

Method

This is a retrospective data analysis based on patient files of all assessments of the Western Northern Brabant crisis resolution team (CRT) from 2013 till 2015. Inclusion criterion was current or recent (<24 hours) use of GHB with or without alcohol and other drugs. Several parameters were studied: frequency, duration and dose of GHB use, reason for referral and treatment/policy, which is used (admission, prescribed medication).

Results

On a total of 4093 cases 50 persons were included. It shows that the percentage over the years has remained about the same (resp. 1.13%, 1.54% and 1.02%). Of all cases 41.5% used GHB only, 39.6% also used other drugs, and 9.4% GHB with alcohol and other drugs. During the assessment in the emergency department 37.7% was treated with a benzodiazepine, while 43.4% received no psychotropic medication.

Conclusion

GHB abuse and dependence are not commonly seen in the CRT, but the withdrawal symptoms can be challenging and GHB withdrawal is often accompanied by aggressive outbursts. Therefore, it is very important to make a decision whether outpatient or inpatient treatment is necessary and if psychotropic medication is needed.
Addiction and Violence Among People with Severe Mental Illnesses: An Updated Literature Review
Authors: Khemiri I. , Fekih Romdhane F. , Belkhiria A. , Lamia J. , Trabelsi R. , Ghazeli I. , Ridha R.
Published: June 2017

Introduction

Violence has important relevance for the criminal justice and health care systems especially forensic psychiatry. Previous studies reported the relation between violence, mental illness and substance abuse. We purpose to investigate the association between addiction and violence among people with severe mental illness through a review of literature.

Method

we conducted a Medline and Pubmed literature search of studies published between “2000 and 2015”, combining the terms “psychotic disorders”, “addiction” “substance use disorder”.

Results

The studies published showed that much of the excessive violence observed in patients with severe psychiatric disorders is due to co-morbid substance use. Increasing violence associated with substance use disorders in these patients had same level than that observed among subjects without severe psychiatric disorders. Increasing violence in subjects with substance use disorder but without severe mental disorders was higher than in patients with only severe mental disorders. In fact, mental disorders could increase the risk of installing on substance use disorders, and therefore increase the risk of partner violence. Among the substances used, if alcohol is frequently identified as a consumer risk for the emergence of violence among subjects with severe psychiatric disorders, stimulants could be causing more violence than alcohol.

Conclusions

Severe mental illnesses are associated with violence. However, most of the excess risk appears to be mediated by substance abuse co-morbidity. This finding improves the need of prevention of substance use disorders and emphasizes the fact that patients with severe mental disorders are more often victims than perpetrators of violence.
Do Mood Stabilizers Help in Borderline Personality Disorder?
Authors: Völlm B. , Stoffers-Winterling J. , Mattivi J. , Simonson E. , Storebø O.J. , Nielsen S. , Kielsholm M.L. , Lieb K.
Published: June 2017

Background

Despite the relatively weak evidence base, individuals with borderline personality disorder are often treated with pharmacological interventions. Amongst the drugs, which have shown most promise, are mood stabilizers, which were one of the two drug classes with the most beneficial effects in a previous cochrane review though the robustness of findings was described as low (Stoffers et al., 2010). Here we present data on the latest evidence for mood stabilizers based on an updated cochrane review currently underway.

Methods

A systematic review and meta-analysis of randomized controlled trials was conducted. All randomized comparisons of drug vs. placebo, drug vs. drug, or drug vs. a combination of drugs in adult BPD patients were eligible for inclusion. Outcomes comprised BPD core pathology as depicted by DSM criteria, associated pathology, i.e., depression and anxiety, general measures of overall psychopathology severity, tolerability, and adverse effects. Two researchers selected trials, assessed quality and extracted data independently.

Results

Only a limited number of additional trials using mood stabilizers was identified since the publication of the last cochrane review, mainly utilizing Sodium Valproate. This added to the evidence base for mood stabilizers though the overall evidence remains very limited.

Conclusion

Mood stabilizers show some initial evidence for their effectiveness in borderline personality disorder. However, these have to be replicated before wider conclusions can be drawn for clinical practice.

Disclosure of interest

The authors declare that they have no competing interest.
Psychiatric Symptomatology as the Initial Presentation of Brain Cancer
Authors: Fornelos A. , Macedo P. , Figueiredo A. , Roque M.
Published: June 2017

Glioblastoma multiforme is the most common primary adult brain tumor. Clinically, non-specific psychiatric symptoms may arise as their first and only manifestation, prior to any neurological deficits. The most form of psychiatric presentation of neurological diseases are depressive complaints, although these may also be accompanied by behavioral and/or cognitive, anxious and psychotic symptoms. By explaining this case report we aim to emphasize the importance of considering the diagnosis of an organic brain disease, even when only primary psychiatric symptoms are evident. The bibliographic research was made using PubMed and Scielo, and analysis of the electronic patient process. Man of 68 years with a history of hypertension, nephrectomy, splenectomy and left brachial plegia after a car accident. He had been previously seen by a psychiatrist for a 6-month history of depressive symptoms, which had been successfully treated. He later developed new behavioral changes such as heteroaggressiveness, social maladjustment and disfasia, for which he was sent to the emergency room. Brain-CT scan displayed a left front temporal expansive injury. Admitted to the Neurology Department for further diagnostic investigation. Subsequent MRI, detected massive infiltrative lesion with significant mass effect and cystic/necrotic area. The anatomopathology disclosed a glioblastoma grade IV. This case reinforces the importance of carrying a imagiologic workup in cases like this, especially on patients with atypical presentation of psychiatric symptoms.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Differential Effects of MGluR5 Receptor Blockade on Behavior, Schizophrenia-relevant Gene Expression and Neuronal Activation Patterns from Development to Aging Mice
Authors: Gass P. , Inta D. , Luoni A. , Riva M.A.
Published: June 2017

Introduction

The glutamate system is implicated both in mood disorders and schizophrenia. Mice lacking metabotropic mGlu5 receptors (mGluR5 KO) display schizophrenia-like abnormalities. Additionally, mGluR5 antagonists represent promising alternative anxiolytics/antidepressants. However, the underlying age-specific molecular/cellular mechanisms are only partially understood.

Objectives

We aimed at identifying molecular alterations associated with a genetically induced mGluR5 deletion, which results in a schizophrenia-like phenotype. Additionally, we investigated age-specific effects of mGluR5 antagonists on emotional behaviour and c-fos activation.

Methods

For analysis of mRNA and protein levels we performed Real-time RT-PCR and Western blot investigations of brains from mGluR5 KO and wild-type mice. Additionally we used classical behavioral tests for determining anxiety- and depression-like changes triggered by the mGluR5 antagonist 2-Methyl-6-(phenylethynyl)pyridine (MPEP). Finally, we used profiling of c-Fos expression, as marker of neuronal activity, induced by MPEP from postnatal day 16 (P16) to adulthood (P90).

Results

We found reduced expression levels of reelin, GAD65, GAD67, parvalbumin, as well as NMDA and AMPA receptor subunits in mGluR5 KO mice, especially in the prefrontal cortex (PFC). We measured age-specific alterations in emotional behaviour of mGluR5 KO mice, with marked increase of anxiety during aging. There was a remarkably conserved activation of the paraventricular nucleus of the hypothalamus, implicated in stress regulation, by MPEP at all investigated ages, whereas the extended amygdala was specifically activated in adulthood only.

Conclusions

Our animal data provide new insights into the potential role of mGluR5 in neurochemical and behavioural changes associated with schizophrenia and mood disorders during the lifespan.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
True and variable response inconsistency as indicators of psychological distress in the normative sample and mental disorders
Authors: Rasskazova E. , Spivakovskaya A. , Tkhostov A.
Published: June 2017

Introduction

Despite a long psychological discussion on the inconsistency and fragmentation in self-appraisals as factors of neuroses and personality disorders (Horney, 1991, Lynch, 2014) classical psychodiagnostic considers response inconsistency as an indicator of protocol invalidity only.

Objectives

Using MMPI-2 True and Variable Response Inconsistency scales (TRIN, VRIN), we suggest that the inconsistency (within normative range) is related to poorer psychological well-being in the normative sample and is higher in affective disorders.

Aim

To study the relationship between response inconsistency and psychological well-being.

Methods

In total, 1443 healthy controls and 190 patients with mental illnesses (50 with affective disorders, 21 with addictions, 73 with schizophrenia and schizotypal disorder, 46 with adjustment disorder) who scored within normative range on all the validity scales of the Russian version of MMPI-2 participated in the study.

Results

In the normative sample, TRIN and VRIN correlated with social and emotional alienation as well as conative lack of ego mastery (r = .27–.33) and were higher in affective disorders (P < .05) and in patients having symptoms of personality disorders (as appraised by their doctors). In patients with affective disorders and adjustment disorders, they were related to higher likelihood of invalidity due to mental illness.

Conclusions

Response incoherence within normative range is a sign of poorer well-being in the normative sample (in the form of fatigue, apathy, feelings of excessive strain, lack of understanding from others and injustice). In line with psychological theories of self-fragmentation, incoherence is related to affective disorders (and poorer adjustment to them) and symptoms of personality disorders.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Internal and external responsiveness of the personal and social performance scale in patients with schizophrenia
Authors: Chiu E.C. , Hsieh C.L.
Published: June 2017

Introduction

The Personal and Social Performance scale (PSP) is widely used to assess social functioning with 4-domain scores and a global score in patients with schizophrenia. However, internal and external responsiveness of the PSP is largely unknown limiting its use as an outcome measure.

Objectives

The purpose of this study was to examine internal and external responsiveness of the PSP in inpatients with schizophrenia receiving treatments in the acute phase.

Methods

Eighty patients were conducted the PSP and the Clinical Global Impression-Severity (CGI-S) at admission and at discharge. The standardized effect size (ES), the standardized response mean (SRM), and paired t-test were used for examining internal responsiveness. We estimated correlations between the changes in scores of the PSP and those of the CGI-S using Pearson's r for investigated external responsiveness.

Results

For internal responsiveness, the ESs and the SRMs of the domains were 0.74–1.74 and 0.68–1.72, respectively. The values of the ES and the SRM in the global score were 1.72 and 1.74, respectively. The paired t-tests showed statistically significant difference (P < 0.001) for the score changes of the four domains and the global score. Regarding external responsiveness, fair and moderate to good correlations (r = 0.35–0.74) were found among the changes in the 4-domain scores and the global score with the those of the CGI-S.

Conclusions

The PSP has sufficient internal responsiveness and substantial external responsiveness in inpatients with schizophrenia receiving treatments at the acute wards. The PSP is useful as an outcome measure for detecting changes of social functioning over time.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Classification of first-episode schizophrenia spectrum disorders and controls from whole brain white matter fractional anisotropy using machine learning
Authors: Mikolas P. , Hlinka J. , Pitra Z. , Skoch A. , Frodl T. , Spaniel F. , Hajek T.
Published: June 2017

Background

Schizophrenia is a chronic disorder with an early onset and high disease burden in terms of life disability. Its early recognition may delay the resulting brain structural/functional alterations and improve treatment outcomes. Unlike conventional group-statistics, machine-learning techniques made it possible to classify patients and controls based on the disease patterns on an individual level. Diagnostic classification in first-episode schizophrenia to date was mostly performed on sMRI or fMRI data. DTI modalities have not gained comparable attention.

Methods

We performed the classification of 77 FES patients and 77 healthy controls matched by age and sex from fractional anisotropy data from using linear support-vector machine (SVM). We further analyzed the effect of medication and symptoms on the classification performance using standard statistical measures (t-test, linear regression) and machine learning (Kernel–Ridge regression).

Results

The SVM distinguished between patients and controls with significant accuracy of 62.34% (P = 0.005). There was no association between the classification performance and medication nor symptoms. Group level statistical analysis yielded brain-wide significant differences in FA.

Conclusion

The SVM in combination with brain white-matter fractional anisotropy might help differentiate FES from HC. The performance of our classification model was not associated with symptoms or medications and therefore reflects trait markers in the early course of the disease.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Driving Ability and Psychotropic Drugs: Legal Framework, Forensic Aspects
Authors: Graf M.
Published: June 2017

Although the rate of victims of road traffic accidents is already relatively low in Switzerland compared to other western countries, still 253 people died in 2015. The Swiss parliament therefore issued in 2012 already a program called “Via secura” to increase road traffic security by means of a package of measures, ranging from immobilizing systems for the car in case of drunken drivers to stricter rules for medical assessment of ability to drive a car and better training for doctors in such assessment to finally stricter laws regarding lower tolerance for alcohol levels and zero tolerance for drug consumption when driving a car. The presentation will focus on changes in legal regulation for both medical assessment as well as rules for alcohol or drug consumption when driving a car. Positive and negative consequences for the field of forensic psychiatry are discussed.

Disclosure of interest

The author declares that he has no competing interest.
Psychiatry and Primary Care: A Global Medical Care
Authors: Gelas-Ample B. , Fau L. , Bailly A. , Pillot-meunier F.
Published: June 2017

Patients suffering from psychiatric disorders have a decrease in life expectancy of 15 years compared to the general population. This excess mortality is not related predominantly to suicide but mostly to a higher frequency of somatic diseases, such as cardiovascular, neoplastic, metabolic diseases. Their high prevalence and their low diagnoses are related to a poorer access to screening, prevention and somatic care than in the general population. Indeed, we estimated that more than 60% of patients treated in public psychiatry do not have a general practitioner (GP) in France. The GP has a role in the coordination, prevention and management of patient health care circuit. To allow a better access to general practitioner, a consultation and a somatic network have been created in Lyon. The purpose is to bring the user back into the primary care system, to ensure a durable monitoring, and a better prevention of avoidable diseases. Patients without GP are oriented to the consultation by their referent psychiatry team. During three consultations with a doctor and a nurse, an assessment of the patient's overall health is realized as well as a synthesis and a redirection to the city network. This reinstatement also allows a better communication between somatic and psychiatric care, to insure a more global view of the patient. A work around the re-empowerment and social rehabilitation is carried out to re-anchor the person in the city and in the care, which every citizen is entitled.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
An Investigation of the Coupling of Temperament Traits with Major Depression
Authors: Sulis W. , Trofimova I.
Published: June 2017

A diversity of neurochemical hypotheses related to major depression (MD) suggests that further investigation is needed for uncovering the neurophysiological nature of MD. Since both temperament and mental illness have been linked to varying degrees of the same neurotransmitter imbalances in neurophysiological systems of behavioral regulation, the analysis of temperament traits as weak forms of neurochemical imbalances might give new insights into symptoms and nature of MD. This study analyzed the predictions of the opioid receptor hypothesis within the neurochemical model of functional ensemble of temperament proposing that a dysregulation of the opioid receptors acting on monoaminergic systems gives rise to the symptoms of major depression (MD). The study investigated the coupling of sex, age and temperament traits with MD across four age groups (17–24, 25–45, 46–65, 66–85) by reviewing the records of testing in 423 patients and volunteers with (210) and without (213) the MD. The records included testing with the personality assessment inventory, structure of temperament questionnaire, structured clinical interview and other diagnostic measures. In line with the hypothesis, patients with MD had significantly lower physical endurance, social-verbal endurance, mental endurance, plasticity, physical tempo, sensation seeking and self-confidence, and higher impulsivity and neuroticism than non-depressed individuals. Other sex- and age-related effects are reported. The results suggest that new versions of the DSM should consider an increase of impulsivity and a decrease in plasticity of behavior as criteria symptoms of MD.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Predictors of Remission at 1-year Follow-up among ocd Patients: Findings from The Netherlands Obsessive-compulsive Disorder Association (NOCDA) Study
Authors: Tibi L. , van Oppen P. , van Balkom A. , Eikelenboom M. , Anholt G.
Published: June 2017

Introduction

Obsessive-compulsive disorder (OCD) is described as a chronic condition. However, relatively little is known about predictors affecting its long-term outcome.

Objective

To examine the contribution of clinical and interpersonal determinants in predicting remission status of 254 OCD patients at one-year follow-up (FU1).

Methods

We used the baseline and FU1 data of The Netherlands obsessive-compulsive disorder association (NOCDA) study. Clinical predictors were chronicity level, depressive and obsessive-compulsive symptom severity. Suspected interpersonal factors included attachment style, social support and expressed emotion. Remission status was defined using the Yale-Brown obsessive-compulsive symptom (Y-BOCS) scale. χ2 tests and ANOVAs were used for bivariate analyses, followed by multivariate multinomial logistic regression analyses to assess main effects and interactions in predicting remission status at FU1.

Results

Bivariate tests demonstrated significant differences in remission status as a function of chronicity level, depressive and obsessive-compulsive symptom severity and social support. Regression analyses revealed that increased baseline OCD severity reduced the odds for both partial and full remission at FU1 (OR = .87, 95%CI = .82–93, P < 0.001). Increased depressive severity at baseline reduced the odds for partial remission at FU1 (OR = .95, 95%CI = .91–.98, P < 0.01). Interactions analyses demonstrated that the adverse effects of OCD severity on partial remission disappeared at the presence of secure attachment (IOR = 1.11, 95%CI = 1.05–1.24, P < 0.05) and high social support (IOR = .88, 95%CI = .78–98, P < 0.05).

Conclusions

The contribution of clinical severity is critical for understanding the prognosis of OCD. The interpersonal context of OCD patients may mitigate the unfavorable effect of severity on outcome, thus should be addressed in treatment.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Determinants of Functioning in Euthymic Patients with Bipolar Disorder: A Structural Equation Modelling Approach
Authors: Samalin L. , Boyer L. , Murru A. , Pacchiarotti I. , Reinares M. , Bonnin C.M. , Torrent C. , Norma V. , Corinna P. , de Chazeron I. , Boucekine M. , Geoffroy P.A. , Bellivier F. , Llorca P.M. , Vieta E.
Published: June 2017

Background

Euthymic patients with bipolar disorder (BD) experience residual symptoms. Interestingly, residual symptoms appear to impact the natural course of BD and represent potential predictors of recurrence and functional impairment.

Objectives

The study aimed to analyse the relationship between residual depressive symptoms, sleep disturbances and cognitive impairment as determinants of psychosocial functioning in a large sample of euthymic BD patients.

Methods

We performed a cross-sectional study of 468 BD outpatients in clinical remission for at least 6 months. Bipolar Depression Rating Scale (BDRS), Pittsburgh Sleep Quality Index (PSQI) scale, Visual Analogic Scales (VAS) evaluated cognitive impairment and functioning assessment short test were used to assess residual symptomatology and functioning of patients. We evaluated functioning with. Structural equation modelling (SEM) was used to describe the relationships among the residual depressive symptoms, sleep disturbances, perceived cognitive performance and functioning.

Results

SEM showed good fit. This model revealed that residual depressive symptoms (path coefficient = 0.37) and perceived cognitive performance (path coefficient = 0.27) were the most important features significantly related to psychosocial functioning. Sleep disturbances were indirectly associated with functioning via residual depressive symptoms and perceived cognitive performance (path coefficient = 0.23).

Conclusions

This study contributes to a better understanding of the determinants of psychosocial functioning during the interepisodic periods of BD patients. These findings should have implications for the improvement of functioning of BD patients in a personalized approach to treatment.

Disclosure of interest

COI: Dr. Samalin reports personal fees and nonfinancial support from Astra-Zeneca, Bristol Myers Squibb, Janssen, Lundbeck, and Otsuka.

The authors L. Boyer, A. Murru, I. Pacchiarotti, M. Reinares, C.M. Bonnin, C. Torrent, V. Norma, P. Corinna, I. de Chazeron, M. Boucekine, P.A. Geoffroy, F. Bellivier, P.M. Llorca, E. Vieta have have not supplied their declaration of competing interest.
Integrating the Findings from Boundary Sciences for Development of the DSM/ICD Classifications
Authors: Trofimova I.
Published: June 2017

Introduction

Temperament and mental illnesses are considered to be varying degrees along the same continuum of imbalance in the neurophysiological regulation of behavior. Mental disorders are linked to specific patterns in the relationships between neurotransmitters and between brain structures. Similar links were found for temperament traits. Development of DSM and ICD classifications might benefit therefore from an integration between psychiatry, functional neurochemistry and differential psychology.

Objectives

To describe the neurochemical systems underlying mental disorders and temperament traits in healthy adults.

Methods

Findings in neurochemistry, neuropsychology, differential psychology and psychopathology are compared to the traits described in various temperament models. This analysis is summarized in the perspective of the neurochemical functional ensemble of temperament (FET) model.

Results

Neurochemical correlates for 12 main dynamical aspects of behavior are presented as a systemic framework that follows a universal functional structure of human actions described in kinesiology, neuroanatomy, neurochemistry and clinical neuropsychology. The role of monoamine systems (serotonin, dopamine, noradrenalin), acetylcholine, GABA/glutamate, neuropeptide and opioid receptor systems are linked to regulation of specific dynamical properties of behavior in a systematic way. Several insights for the structure of the classification of mental disorders from the perspective of the FET model are proposed.

Conclusions

An integration of research in neurochemistry and psychopathology of behavior with differential psychology based on healthy samples can bring new insights for future versions of DSM and ICD classifications of mental disorders. Such integration does not follow either dimensionality or categorical approach but instead is based on functional ecology of human behavior.

Disclosure of interest

The author has not supplied his declaration of competing interest.
Needs of People with Schizophrenia/Psychosis and their Caregivers: A Large Scale Survey
Authors: Lahera G. , Cid J. , González-Pinto A. , Cabrera A. , González I. , Vieta E. , Arango C. , Crespo-Facorro B.
Published: June 2017

For the first time in Spain, a large scale survey (5205 people) was carried out to establish the real needs of those directly affected by the illness. Patients and caregivers responded to a 9-question survey concerning dimensions: personal, social, medical treatment, psychotherapy and rehabilitation. For patients, the most important need (an average score of 3.5 on a scale of importance from 1 to 4) was to feel their emotional needs covered. The following average scores were also obtained: feel well physically (3.42), improve autonomy (3.41), have leisure activities (3.21) and work/study (3.1). A total of 42% of patients indicated having little or no freedom over their lives. Thirty-six percent indicated that medical treatment did not start soon enough, 35% that psychotherapy started too late and 13% saying they had received no psychotherapy at all. The help from professionals most valued was provide information about the illness (3.4), dedicating more time (3.4) investigating new treatments (3.3) paying attention to secondary effects (3.3) and incorporating the patient in decision making (3.3). Most patients reported a state of health “regular to good” but 10% indicated not being understood at all in their social environment since onset of illness and 25% being little understood. The anti-stigma initiative most valued was to increase investment in schizophrenia in health planning. Integral health planning should incorporate patient insights concerning basic needs and treatment preferences.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
How Could Affect Stress, PEP and Sex in Working Memory?
Authors: Maria Isabel C.-R. , Manuel C.-R. , Andrea M. , Miguel R.-V.
Published: June 2017

Background

The first episode of psychosis is a crucial period when early intervention can alter the trajectory of the young person's ongoing mental health and general functioning. Cognitive abilities are nuclear for the social recovery. Stress impairs higher cognitive processes, dependent on the prefrontal cortex (PFC) and that involve maintenance and integration of information over extended periods, including working memory and attention. Different mechanism are involved such as HPA-Axis hyperactivity, affecting PFC. Recently, investigations show the different evolution of cognitive abilities between different sex in WM.

Methods

A sample of 41 FEPs and 39 healthy subjects were evaluated. The variables assessed were verbal and visual memory, attention, working memory, processing speed, mental flexibility, verbal fluency, motor coordination, planning ability and intelligence.

Results

We found an interaction between age (< 16 years and > 16 years) and group (psychosis vs. controls) in working memory (P = 0.04). There were no difference in men < 16 years old control group and men with same age plus psychosis (5.87 ± 1.57 vs. 5.83 ± 1; P = 0.1) in WM. However, this work was found to be significantly different in the univariant analysis of working memory in the group < 16 years old women control (7.30 ± 1.56) and women psychosis group (5.61 ± 1.91).

Conclusion

Social cognition and stress seem to be directly relation. Some studies show that stress enhance cognition performance in men while impairing it in women. Stress affect a variety of cognitive processes such attention and working memory. Deficit in social cognition are present in the prodromal phases of psychosis.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Cross cultural aspects of OCD in Islam and clinical practice
Authors: Abouhendy W.I.
Published: June 2017

Introduction

Religious obsessions and compulsive acts compromise approximately two thirds of all obsessive compulsive disorder symptomatology in Muslim patients. Imam's mosque is consulted before a psychiatrist.

Objectives

To explore the Islamic jurist's views and methods in dealing with obsessions and compulsions.

Aims

Introduction of guidelines for managing OCD in some Muslim patients.

Methods

We began studying the different opinions of scholars in defining obsessive compulsive behaviour focusing on the tight criteria required by the Maliki Jurists to consider the individual being obsessed. This was followed by a thorough review of other Islamic doctrines.

Results

The jurisprudential therapeutic approach includes:

– obsessions are satanic whispers not originating from the self, which is equivalent to “It is not me but my OCD” in modern cognitive behavioural approach;

– diverting attention from the obsessive thought rather than engaging with it;

– not to respond to the obsessional thought (response prevention);

– listing of religious permits;

– focusing attention on acts of worship;

– thought stopping.

At the end we added various jurisprudential rules to be remembered by patients such as certainty does not fade with scepticism, no defiles by doubt, there are no doubts for a man with excessive doubts.

Conclusion

Exposure and response prevention techniques are deeply rooted in Islamic jurisprudence and are practised with conviction by OCD Muslim patients. We produced specific guidelines that could be used by clinical psychologists and other mental health professionals in dealing with OCD patients top ensure their engagement in therapy.

Disclosure of interest

The author has not supplied his declaration of competing interest.
Neurotic personality dysfunctions as factors predisposing for reacting with suicidal ideation to intensive psychotherapy
Authors: Rodzinski P. , Ostachowska A. , Cyranka K. , Rutkowski K. , Dembinska E. , Sobanski J. , Citkowska-Kisielewska A. , Mielimaka M.
Published: June 2017

Introduction

Identifying patients’ risk of reacting with suicidal ideation (SI) to psychotherapy is an important clinical problem that calls for empirical verification.

Objectives

Analysis of associations between patients’ initial neurotic personality dysfunctions not accompanied by SI and emergence of SI at the end of a course of intensive psychotherapy conducted in integrative approach with predominance of psychodynamic approach in a day hospital.

Methods

Neurotic Personality Questionnaire KON-2006 and Life Inventory were completed by 680 patients at the time of admission to a psychotherapeutic day hospital due to neurotic, behavioral or personality disorders. Symptom Checklist KO “O” as a source of information about emergence of SI was completed both at the admission and at the end of the treatment. Among 466 patients without SI at the admission, in 4% SI occurred at the end of the treatment.

Results

A number of neurotic personality dysfunctions (demeanors declared) that significantly predisposed to SI emergence at the end of the treatment were found: physical aggression against close ones (P < 0.001), grandiose fantasies (P = 0.043), tendencies to resignation (P = 0.022) and resignation-related feeling of loss of life opportunities (P = 0.037), tendency to follow predominantly ones intuition (P = 0.035).

Conclusions

In patients who declared the above-mentioned demeanors increased risk of SI emergence than in others (10–30% vs. 4%) indicate that there are particular vulnerable areas of neurotic personality that require especially careful approach during intensive psychotherapy–dealing with those areas may result in distress or anxiety that may lead to SI.

Disclosure of interest

The authors have not supplied their declaration of competing interest.