bluuebunny/crossref_metadata_2025 huggingface dataset:
979 – Stress Factors And Structure Of Mental Disorders In Sjögren's Syndrome
Authors: Shelomkova O. , Veltishchev D. , Lisitsyna T. , Vasiliev V. , Kovalevskaya O. , Seravina O. , Krasnov V. , Nasonov E.
Published: July 2013

Introduction

The primary Sjögren's Syndrome (SS) - a chronic, systemic autoimmune disease, characterized by lymphocytic infiltration of endocrine glands, functional impairment of the salivary and lachrymal glands, which has some common pathogenic links with stress-related mental disorders (MD).

Objectives

To evaluate the occurrence rate/severity of MD and the influence of stress factors in SS patients.

Methods

50 inpatient women (mean age 46+13.16 yrs) suffering SS were enrolled in the study. MD were diagnosed in accordance with ICD-10 criteria. The severity of depression, anxiety and stress load were measured with MADRS, HAM-A and PSS.

Results

MD were diagnosed in 42 (84%) of SS patients: depressive episode (mild/moderate; single/recurrent, n=9;18%); dysthymia (n=9;18%); generalized anxiety disorder (n=7;14%); adjustment disorder (n=8;16%); schizotypal disorder (n=9;18%). Mean severity levels of anxiety, depression and stress were 16.5+6.5; 17.2+7.9 and 16.9+6.0 accordingly. The acute stress factors and reactions were preceded the SS symptoms in most cases (n= 27, 54%). MD had the significant precipitating chronic stress factors in 36 (72%) patients. The adverse experience in childhood (parental deprivation mostly) had 32 (64%) of SS patients (recurrent events - 48%).

Conclusion

The study revealed high occurrence rate of MD, precipitating stress factors and childhood adverse experience in SS patients. The results support the stress-diathesis model of mental disorders in patients suffering rheumatic disease.
980 – Psychotropic Polypharmacy In Patients With Severe Mental Illness. a Controlled Intervention Study Aimed To Reduce The Use Of Psychotropic Medication
Authors: Hjorth P. , Jørgensen P.M. , Sørensen H.Ø.
Published: July 2013

Background

Patients with mental illness receive psychotropic medicine in high dosages and from more than one drug. Additionally the patients have high level of obesity which is a contributing factor to increased physical morbidities and premature death.

Aim

Quantify the use of psychotropic medicine in patients with severe mental illness. Measure the effect of an intervention to reduce psychotropic medicine.

Methods

Intervention study with six facilities for patients diagnosed with mental illnesses. The intervention period was one year.

Results

At index many patients had obesity and waist circumference were in average 109 cm. Mean values of antipsychotic daily doses/ defined daily doses PDD/DDD was 2.5. The rate of antipsychotic excessive dosing was 65% and 88% of the patients were treated with psychotropic poly-pharmacy. The intervention didn’t show any effect as there were no difference between the changes in the intervention group and the control group.

Conclusions

The patients were treated with antipsychotic poly-pharmacy in high dosages. The intervention did not show any effect. We must think of new ways to restrict the treatment with psychotropics to this group of patients.
987 – Burning Mouth Syndrome: Current Clinical,physiopathologic And Therapeutic Data
Authors: Ducasse D. , Olie E. , Courtet P.
Published: July 2013

Introduction

Burning mouth syndrome (BMS) is an unremitting oral burning in the absence of detectable changes of the oral mucosa, whose prevalence ranges from 3.7% to 18% in the older age groups, particularly among postmenopausal women. This condition is often under-diagnosed, and rarely treated when diagnosed.

Aims

(i)

To make a synthesis of clinical and pathophysiological data

(ii)

to provide a review on therapeutic evaluated in BMS.

Methods

We conducted a systematic review of the literature using the criteria according to the PRISMA research paradigm “glossodynia OR burning mouth syndrome OR stomatodynia OR stomadynia OR stomatopyrosis OR glossodynia OR oral dysesthesia OR persistent idiopathic orofacial pain”.

Results

(i) BMS is described as burning pain, tingling or numbness sensations in the oral mucosa, most often affecting the tongue, anterior palate and/or lips. The pain increases during the day, is relieved when the patient is eating or drinking, and is exacerbated by speeching.

BMS has a multifactorial origin, involving peripheral nerve dysfunction (peripheral small fibre neuropathy of intraoral mucosa ; subclinical lingual, mandibular, or trigeminal neuropathy) and central (striatal dopaminergic dysfunction); hormonal dysfunction (impaired production of neuroactive steroids in the skin) and psychological (neuroticiste personality with somatization).

(ii) Literature can recommend systemic alpha-lipoic acid, topical or systemic clonazepam, and psychotherapy. Efficacy data and the risk / benefit ratio of the tongue protectors allow to recommend their use.

Conclusions

We have explained current clinical, physiopathologic, and therapeutic data of BMS whose understanding is necessary to improve these patients’management.
994 – Stigmatizing Attitudes Towards Mental Ill Patients Among Medical Students And Professionals
Authors: Morgado P. , Oliveira A.M. , Machado D. , Sousa N. , Cerqueira J.J.
Published: July 2013

Introduction

Stigma of mental illness can be defined as a set of stereotypes and prejudice established in the society that leads to discriminatory behavior against people who suffer from a psychiatric condition. Mental illness stigma is widely spread in community and reaches not only general population but also health professionals. The impact of these negative attitudes in mental ill people is severe and is becoming more relevant as mental illness gets more prevalent.

Objectives

To characterize and evaluate attitudes and prejudicial reactions adopted by a population of medical students and doctors from psychiatry, internal medicine and surgery that study/work in Braga's region (North of Portugal).

Methods

Students and professionals were surveyed using a socio-demographic questionnaire and AQ27 questionnaire - Portuguese version, a validated questionnaire to measure stigmatizing attitudes and reactions. A total of 353 questionnaires were collected. Response rate was 68,8% among doctors (n=150) and 32,6% among medical students (n=203). Scores between groups and contributes of age, sex and past experience were analyzed with linear regression modeling.

Results

High scores in several stigmatizing attitudes were found in both medical students and professionals. Psychiatrists displayed lower levels of stigmatizing attitudes in all categories analyzed, except “pity” which was dependent on age of responders. Interestingly, students showed significantly lower stigmatizing attitudes in help, pity and avoidance. No differences were found between groups among coercion and segregation.

Conclusions

The results show that both medical students and professionals, including psychiatrists, exhibit stigmatizing attitudes, which should be specifically addressed in order to improve care.
995 – Reconceptualization Of The Relationship Between Experience With Trauma And Posttraumatic Stress Symptoms
Authors: Rosenthal B.S. , Wilson W.C.
Published: July 2013

Introduction

The conventional two-class psychiatric conceptualization of PTSD has been criticized for ignoring the existence of “trauma without symptoms” and “symptoms without trauma”.

Objective

To present and test a new four-class conceptualization of the relationship between trauma and symptoms that responds to the above criticism. The proposed four classes are: PTSD (high trauma and high symptoms); Resilient (high trauma but low symptoms); Stress Prone (low trauma but high symptoms); and Ideal Norm (low trauma and low symptoms).

Aim

To demonstrate fit between new conceptualization and empirical data.

Method

Sample: 673 adults age 18-19. Measures: a trauma index incorporating five types of frequently experienced potentially traumatic events; a standardized 16 item measure of posttraumatic stress symptoms; multi-item scales of two protective factors (social support and self efficacy). Statistical procedures: cluster analysis and ANOVA.

Results

Statistical cluster analysis produced four classes of individuals: 19% of sample had high trauma and high symptoms (PTSD); 23% had high trauma and low symptoms (Resilient); 21% had low trauma and high symptoms (Stress Prone); and 36% had low trauma and low symptoms (Ideal Norm). “Resilient” and “Norm” groups also had high “protection”. Four-class model was a better fit to data than two-class model.

Conclusions

The proposed re-conceptualization, using four classes and incorporating protective factors, better describes the empirical trauma-symptom relationship than the conventional two-class psychiatric conceptualization of PTSD; and begins to clarify the psycho-social dynamics of the trauma-psychopathology relationship.
997 – The Relation Between Instrumental Musical Activity And Internet Addiction Among High School Students
Authors: Canan F. , Yildirim O. , Sinani G. , Ozturk O. , Ustunel T.Y.
Published: July 2013

Introduction

Musicians are a population often stereotypically linked to a wide range of substance use behaviors. A number of convenience studies provide support for the perception of disproportionately high substance use rates by musicians.

Objectives

An association between alcohol and substance abuse and musical activity has been reported previously. However, up until now, no study has been carried out on the relationship between Internet overuse and musical activity.

Aims

The aim of this study was to evaluate Internet addiction among adolescents and to examine the correlation between problematic Internet use and musical activity.

Methods

The study was conducted among 1905 students, aged between 14 and 18 years. Internet Addiction Test (IAT) and a sociodemographic query form were used in the collection of data. Students were also asked if they were regularly engaging in a musical activity.

Results

The students with problematic Internet use and Internet addiction were more likely to engage in musical activity than students with avarage Internet use (p<0.001). Adolescents who regularly engage in a musical activity scored higher on IAT than adolescents who do not (36.3±17.5, 28.9±14.9, respectively; p<0.001). Additionally, students who regularly engage in a musical activity were found to spend more time on Internet when compared to those who do not (p<0.001).

Conclusions

These results indicate an association between the Internet addiction and musical activity. We hope that future studies will fruitfully draw upon our exploratory findings in order to generate a more nuanced understanding of the nature and implications of Internet addiction among musicians.
999 – The Self-image Of Adolescents And Its Relationship To Internet Addiction
Authors: Canan F. , Yildirim O. , Sinani G. , Ustunel T.Y. , Yildirim M. , Ozturk O. , Ataoglu A.
Published: July 2013

Introduction

Self-image is developed by the way in which adolescents think, feel and behave and it arises from the person's body image during preadolescence. problematic A considerable amount of literature published so far on Internet addiction reveals that it is a worldwide phenomenon.

Objectives

Internet use involves an individual's inability to control his or her use of the Internet, negative consequences (e.g., failing in school, decreased productivity), and marked distress and/or functional impairment Until now, no studies were performed to investigate the relationship between Internet addiction and self-image.

Aims

The aim of this study was to evaluate Internet addiction among adolescents and to examine the correlation between problematic Internet use and self-image.

Methods

We assessed 1912 high school students, aged between 14 and 18 years. Internet Addiction Test (IAT), Offer Self- Image Questionnaire (OSIQ), and a sociodemographic query form were used in the collection of data.

Results

According to the IAT, 201 students (10.5%) were found to be a ‘problematic Internet user’ or an ‘Internet addict’. The students with Internet addiction scored lower on all subscales of OSIQ (impulse control, emotional tone, body image, social Relations, vocational and educational goals, family relations, mastery of the external world, emotional health and superior adjustment), except sexual attitudes. A significant negative correlation between daily OSIQ subscales and IAT and weekly Internet use was found.

Conclusions

The results of this study showed that Internet addiction was related to the development of the self-image, which is a crucial psychological structure gained in adolescence.
1001 – Delusional Themes In Paranoid Schizophrenia And Persistent Delusional Disorder
Authors: Papava I. , Lazarescu M. , Bredicean C. , Ienciu M. , Dehelean L. , Enatescu V.R. , Romosan R.
Published: July 2013

Introduction

Delusion is one of the most characteristic features of all psychotic disorders. It is an essential symptom for both paranoid schizophrenia and persistent delusional disorder. Although delusion in schizophrenia is described as unorganized and organized in persistent delusional disorder, the delusional themes within these psychosis are relatively similar, with the exception of bizarre delusion which is considered as belonging to schizophrenia.

Objectives

Identifying the types of delusions in long-term evolution of patients with paranoid schizophrenia and persistent delusional disorder and comparing the frequency of their occurrence in the two groups.

Aims

Highlighting significant differences in the frequency of delusional themes in long-term evolution of the two groups of subjects with the diagnosis we mentioned above.

Methods

We formed a sample of 60 subjects with persistent delusional disorder and a sample of 34 subjects with paranoid schizophrenia. Patients from both groups had an average course of illness of 10 years. We have quantified for each patient the number of hospital admissions during which they tested positive for a certain type of delusion.

Results

Within the persistent delusional disorder group the most frequent type of delusion was of persecution, followed by delusions of reference. Delusions of persecution and delusions of being followed found to be the most common delusional themes in the paranoid schizophrenia group.

Conclusions

We have not found significant differences between the two groups regarding the type of delusions, with the exception of bizarre delusions. The paranoid theme is the most common theme for both types of pathologies.
1006 – Basic Emotion Recognition And Psychopathology In Schizophrenia
Authors: Laroi F. , Fonteneau B. , Mourad H. , Raballo A.
Published: July 2013

Socio-emotional competence is a key aspect of schizophrenia, both in terms of psychopathological vulnerability and outcome. In this respect, current research increasingly emphasizes the importance of deficits in facial expression recognition. The focus of the present study is the performance in recognizing six basic emotions (sadness, anger, happiness, fear, disgust, surprise), which play an essential role in shaping daily function and interpersonal interactions. A group of 20 patients diagnosed with DSM-IV schizophrenia were compared with a group of 20 matched controls on a facial expression recognition task, derived from the Karolinska Directed Emotional Faces (KDEF; Lundqvist et al., 1998), and were subsequently assessed with the Positive and Negative Syndrome Scale (PANSS). Facial expression recognition performance was significantly more impaired in patients, and was selectively correlated with the Positive and Cognitive dimensions of the PANSS. Furthermore, significant group differences were found with respect to joy and surprise.
1008 – Recurrent Hyponatremia Induced By Antidepressants: Purposely a Case
Authors: Martínez Cortés M. , Ogando Portilla N. , Torio Palmero I. , Del Nido Varo L. , Ortega Bernardo M.C. , Jimenez Arriero M.A.
Published: July 2013

Introduction

Hyponatremia is an antidepressants known adverse effect, ADH secretion has been postulated in its etiology.

Objectives

To identify risk factors for hyponatremia induced by antidepressants and psychopharmacologic alternatives.

Methods

Literature search was performed in PubMed. We report of a case of recurrent hyponatremia treated in our center: woman, 57years old, HIV, HCV; performing 4 episodes of severe hyponatremia in 5 months of treatment involving thiazide, venlafaxine, citalopram, olanzapine,haloperidol, enalapril, escitalopram.

Results

Risk of hyponatremia is higher in patients treated with antidepressants (OR = 2.97), especially serotoninergic antidepressants (OR = 3.96). Elderly and thiazide increment that risk (OR = 6.31 and OR = 8.4 respectively), specially age, thiazide and SSRIs (OR = 148). Higher prevalence in females, lower limit levels of sodium and low body weight. All SSRIs are likely to produce hyponatremia. The effect appears in the first month, it's not dose-dependent and recovers by interrupting treatment. Some cases have been reported following re-exposure to the same or different antidepressant: fluvoxamine and paroxetine (Arizon, 2002), duloxetine and escitalopram (Stovalle, 2009), sertraline and fluoxetine (Raphael, 2010), sertraline and citalopram (Pure, 2011).

Conclusion

Early detection is important, as well as the evaluation of concomitant risk factors in all patients starting antidepressant. Some asymtomatic cases can be unnoticed by clinicians, so risk patients it seems necessary to control ion pretreatment periodically, and to chose safer treatments (bupropion, agomelatine, mirtazapine and reboxetine). In our case, age, sex, concomitant diseases, low sodium and low weight were determinants for the recurrence of the disorder.
1009 – Outcome Of Hospital Treatment For Opioid Dependence In Slovenia - Preliminary Results
Authors: Delic M. , Pregelj P.
Published: July 2013

Introduction

In the field of drug abuse treatment, noncompletion and negative outcome is a general problem.

Objectives

Outcome of hospital treatment of opioid dependence was examined.

Aims

The purpose of the present study was examination of a cohort of patients treated at Centre for treatment of drug addiction at the beginning of the treatment, after three and six months.

Methods

A group of 113 patients consecutively admitted to a closed detoxification unit between October 2011 and September 2012 were assessed. Positive outcome of the treatment is defined as complete abstinence in the 28 days before review. Baseline data were obtained using The Treatment Outcomes Profile (TOP), The Drug Addiction Treatment Efficacy Scale (DATES), and a semistructured research interview for obtaining information on patient's sociodemographic characteristics. Follow up scores of TOP and DATES have been recorded after three and six months.

Results

Fifty-two patients completed 6 weeks of detoxification program. After 3 months 45 of 84 evaluated subjects (53%) had a positive outcome, 14 patients (12%) abused heroin and 36 patients (32%) abused other drugs. After 6 months 14 of 52 evaluated patients (27%) had a positive outcome and 9 patients (8%) used heroin.

Conclusion

The share of patients with positive outcome peaked at 3 months, however the decreased use of heroin was sustained throughout the observation period.
1011 – Psychiatry In Poland: Toward Development
Authors: Samochowiec J. , Heitzman J. , Rajewski A.
Published: July 2013

Since collapse of communism in 1989, the Polish mental health system has moved through the long deinstitutionalization process, reducing number of beds in psychiatric hospitals. The system of occupational and rehabilitation psychiatry was virtually collapsed. Some psychiatric hospitals received EU financing programs and improved their standards. The morbidity of affective disorders, increased ten times in Poland same as non-alcohol dependencies. The current economic crisis did not mobilize professionals. Because of that, the Polish Psychiatric Association engaged in introducing the looking-forward National Program of Mental Health Care, which is currently underway in Poland (planned for 2011-2015). The Program is multi-focused, mainly creating basic psychiatric system of care, dispersed throughout the whole country, for residual psychotic patients, disabled people, alcohol dependents and dementia patients. However the plan does not constitute other parts of the system, like highly-specialized and expensive centers for patients with more complex diagnostic and therapeutic needs. Meantime, the Polish total spendings for psychiatry did not raise for the second year in a row. That's one of the lowest European levels of the financing psychiatry (3,3-3,5% of whole Healthcare spend). The number of psychiatrists in Poland (2500), clinical psychologists and psychotherapeutists is still low.

1.

Bilikiewicz A. Psychiatry at the turn of the 20th and 21st centuries Psychiatr Pol. 1998; 32:547-55

2.

Heitzman J. From the president of the Polish Psychiatric Association]. Psychiatr Pol. 2011;45:5-8.
1013 – Mild Cognitive Impairment - Pharmacotherapeutic Opportunities
Authors: Podea D.M. , Mila C. , Blaj M.M.
Published: July 2013

Introduction

Mild cognitive impairment (MCI) is considered today to be a prodromal stage of Alzheimer's dementia, but without standardized pharmacotherapy.

Objectives

To follow the outcome of patients diagnosed with MCI treated with nootropics, alternative herbal agents, cholinesterase inhibitors.

Aims

To assess the efficacy of early treatment in MCI.

Methods

200 patients (over 60 years) diagnosed with MCI were evaluated using the MMSE (Mini Mental State Examination) scale at screening, after 1 and 2 years of treatment. They were divided in four groups:

A -50 patients treated with Piracetamum 1600mg/day

B -50 patients treated with Rhodiola-rosea, 2capsules/day

C -50 patients treated with Galantamine, 16mg/day

D -50 patients not treated

Results

The improvement of the MMSE score was as following:

[Results].

MMSE scoreScreeningImprovement after 1 yearImprovement after 2 yearsGroup A23.962.121.88Group B24.161.972.28Group C23.962.142.88Group D24.5No improvement-2.86 (worsening)

Conclusions

Comparing the outcome of treated and non-treated groups, we observed that the early treatment of MCI delays the transition to dementia. The outcome of the treated groups after 1 year of treatment was approximately the same. Longtime treatment shows a better improvement in the group treated with cholinesterase inhibitors (Galantamine) compared to the other treated groups, but not statistically significant. Galantamine improves cognitive function. This study proves the necessity of early treatment for MCI to delay the transition to dementia.
1015 – Suicides In The Greek Island Of Crete During The Economic Crisis: Reality Vs Myth
Authors: Vgontzas A.N. , Kastanaki A. , Michalodimitrakis E. , Basta M. , Koutentaki E. , Michalas N.
Published: July 2013

Introduction

Recently, suicides in Greece, have drawn national and international interest due to the current economic crisis. According to published reports, suicides in Greece have increased up to 40%. Specifically, lay press has highlighted Crete as an area with the sharpest increase of suicides in Greece.

Objectives

To explore whether the economic crisis is associated with increased suicide rates in Crete.

Aim

To investigate the suicide rates in Crete between 1999-2011.

Methods

Data on suicides were selected from the Department of Forensic Medicine files of the University Hospital of Heraklion/Crete, as well as from the Forensic Medicine Files of Crete.

Results

Our analysis showed that during the period examined (1) Crete, although has the highest suicide rate in Greece, there is no significant increase between 1999-2011, (2)Deaths due to suicide are four times more frequent in men compared to women, (3) In women there is a significant decrease of suicides, (4) There is a decreasing trend for suicides in Western Crete whereas, there is an increasing trend in Eastern Crete.

Conclusions

Crete has the highest suicide rates in Greece, which however, has not increased during the last 13 yrs. There is a relative increase of suicides in Eastern compared to Western Crete during this period. Our findings do not support the popular belief of increased suicides due to the current economic crisis. The relative increase of suicides in Eastern Crete may be explained by other factors, i.e the lack of community psychiatric services in the area.
1024 – Prospective Analysis Of Stn Dbs In Parkinson's Disease: Motor And Non-motor Symptoms Evolution Link To Electrodes Localization
Authors: de Chazeron I. , Pereira B. , Durif F. , Llorca P.-M. , Chéreau-Boudet I.
Published: July 2013

Even if evidence suggests that Deep Brain Stimulation (DBS) of the Subthalamic Nucleus (STN) provides a beneficial clinical effect in Parkinson's disease (PD) for up to 10 years there are also several potential risks among them psychiatrics complications.

The aim of this study was to identify the patient-related, medicosurgical, and psychosocial factors that influence PD patient's evolution in STN DBS.

Method

We investigate, in 36 STN DBS PD patients, depression, anxiety and mania at baseline, 3-mounth post-surgery and 6-mounth post-surgery. At baseline, demographic data and clinical characteristics (duration of disease, PD medication, past psychiatric history were also collected. Scores at motor section of the unified Parkinson disease rating scale and PD medication were evaluated at baseline, 3-mounth post-surgery and 6-mounth post-surgery. A multivariate analysis and a factorial discriminant analysis (FDA) were considered to study differences between surgical outcomes considering an adjustment on disease duration.

Results

Thirty six patients with Parkinson's disease treated with STN-DBS were analyzed considering stimulating electrodes localization (‘in’, ‘frontier’, ‘out’ of STN).

Concerning the pre-surgical parameters, no configuration was found.

Considering only 3-mounth post-surgery parameters (electrodes localization, motor scores, psychiatric data, PD medication) patients differ according to surgical positioning: ‘frontier’/’out’ and ‘in’ but the best separation between the 3 groups of localization was obtain including pre-surgical post-surgery parameters. This segregation was maintained at 6-mounth postsurgery.

Conclusions

Our work provides preliminary answer to the question of impact of the exact electrode position on neuropsychological side effects of STN-DBS and enhances the importance of combining pychiatrico-neuro-surgical data.
1028 – Cognitive Impairment And Mortality In Older Clients Of a Secondary Mental Healthcare Case Register In London, Uk
Authors: Chang C.-K.
Published: July 2013

Cognitive impairment was found related to higher mortality among the elders. However, study results about cognitive malfunction at earlier stages of specialist assessment or treatment to mortality for the ones without dementia were still in debate. An anonymised electronic database in South London and Maudsley NHS Foundation Trust (SLAM) covering 1.2 million population was utilised to assess the influence of cognitive impairment measured by Mini-Mental State Examination (MMSE) to survival among the clients 65+ years old when firstly assessed during 2007-2010. They were followed up for survival till the end of July, 2011 by the linkage to National Health Services in UK. Overall and subgroup analyses for specific diagnoses were done by Cox regressions. Age, gender, psychiatric diagnosis, ethnicity, marital status, primary care trust, and deprivation score were considered as potential confounders. A total of 7,196 subjects were identified, including 3,674 subjects diagnosed as dementia, 1,435 as depression and 492 as delirium. The adjusted hazard ratios of MMSE score in quintiles (30- 28, 37-25, 24-21, 20-16 and 15-0) when firstly assessed in SLAM were 1.19, 1.36, 1.69 and 2.13 (95% CIs: 0.99-1.42, 1.15- 1.62, 1.42-2.01 and 1.79-2.55) with 1st quintile as reference group (p-value of test for trend < 0.01). Except the delirium group, analyses for all the ones but dementia excluded, the depression group, and depression group with dementia excluded revealed similar outcomes. In current study, we identified a universal effect of cognitive impairment to mortality. Declining cognition function might reflect underlying physical conditions leading to death.
1029 – Relationship Between Aberrant Salience Processing And Psychotic Symptoms In a Clinical Trans-diagnostic Sample: Preliminary Data
Authors: Lelli L. , Godini L. , Spadafora M. , Pietrini F. , Lo Sauro C. , Ballerini A.
Published: July 2013

Introduction

Aberrant salience consists of the unusual or incorrect assignment of salience, significance or value to different innocuous stimuli. It has been hypothesized that subjects with an aberrant salience could be proneness to develop psychosis. Despite the importance of this concept in psychosis, only few instruments assess aberrant salience.

Objectives and aims

To evaluate aberrant salience processing in a clinical trans-diagnostic sample and its relationship with psychotic symptoms.

Methods

Thirty-six outpatient subjects attending the Psychiatric Unit of the University of Florence were recruited: 9 with Major Depression Disease (MDD), 8 with Schizophrenia (SC), 19 with Bipolar Disorder (BD). Patients were assessed by means of a clinical interview (SCID-I/P) and several questionnaires, including the Aberrant Salience Inventory (ASI).

Results

The three groups showed significant differences in the lifetime presence of psychotic symptoms, with higher frequency in BD and SC patients (p< 0.01). Significant differences in ASI scores were found between MDD and BD (p< 0.01), and SC and BD (p< 0.01), while any difference between BD and SC was observed. Subjects with positive ASI (cut-off>14) reported more frequently past and lifetime psychotic symptoms (p< 0.01) and constituted a distinct cluster from patients with ASI score < 14.

Conclusion

Aberrant salience is significantly associated to lifetime psychotic symptoms. Thus it represents a relevant psychopathologic dimension that requires a careful investigation in patients with an history of psychotic events. The ASI could represent an useful instrument to evaluate the proneness of clinical and pre-clinical samples to develop psychotic symptoms.
1030 – Ocular Pigmentation And Cataract In Therapy With Phenothiazine
Authors: Celona D. , Panarello S. , Zangrando A. , Carlino D. , De Vanna M.
Published: July 2013

Introduction

Since 1960, a decade after the introduction of phenothiazine drugs, there were reports of drug related ocular opacities and pigmentation in patients who had been receiving continuous high dose therapy, particularly with chlorpromazine. These ocular effects seem to be related to high doses of phenothiazines and are potentially irreversible. The purpose of our study is to evaluate the pathophysiology of ocular damage, risk factors, treatment and any potential reversibility.

Material and methods

Bibliographic research used PubMed and PsychINFO and conduced to 12 papers.

Results

Analysis of papers has shown that the main pathophysiological mechanism is related to an alteration of excretion of catecholamines, that exposure to sunlight presents a risk factor for the development of corneal deposits and cataract while, as regards the reversibility of these effects, the data are still controversial.

Conclusions

It is necessary, for psychiatrists, the information of the various ocular adverse effects of therapy with phenothiazine so that can be arranged to create a closer and more effective collaboration with an ophthalmologist to prevent and treat this disease.

Moreover, other studies are necessary to lead to an appropriate treatment plan.
1031 – Risk Of Psychiatric Disorders In Hypospadias - a Nationwide Swedish Cohort Study
Authors: Butwicka A. , Lichtenstein P. , Landén M. , Nordenström A. , Nordenskjöld A. , Frisén L.
Published: July 2013

Introduction

Even though 0.3-0.8% percent of the male population are born with hypospadias, it is not known if this is associated with an increased risk for psychiatric morbidity later in life.

Aims

The aim of this study was to assess the association between hypospadias and risk of psychiatric disorders in affected individuals.

Methods

The association between hypospadias and psychiatric disorders was examined in a population-based cohort study using Swedish registers. Individuals born in Sweden between 1973 and 2009 were included in the study. Among them, 11,156 patients with hypospadias were identified and matched with 1,098,714 distinct controls by year of birth and county. The following outcomes were evaluated: 1- suicide attempt, 2- psychotic, 3- mood, 4-anxiety, 5- eating, 6- personality disorders, 7- disorders due to psychoactive substance use, 8- ADHD, 9- pervasive developmental disorders, 10- intellectual disabilities, and 11- other childhood emotional disorders.

Results

After adjusting for socio-economic and perinatal factors, malformations and/or genetic syndromes, patients with hypospadias were more likely to be diagnosed with pervasive developmental disorders (OR 1.4; 95% CI 1.1-1.6), intellectual disabilities (OR 1.8; 95% CI 1.6-2.1), ADHD (OR 1.2; 95% CI 1.0-1.4) and other childhood emotional disorders (OR 1.3; 95% CI 1.1-1.4) compared to the controls. No relation between other psychiatric diagnosis and hypospadias was found.

Conclusion

Hypospadias is associated with an increased risk of neurodevelopmental disorders.
1034 – The Metabolic Syndrome And Late-life Depression
Authors: Marijnissen R. , Smits J. , Schoevers R. , van den Brink R. , Holewijn S. , Franke B. , de Graaf J. , Oude Voshaar R.
Published: July 2013

Objectives

The association between depression and metabolic syndrome is becoming more obvious.

Aims

We examined the relationship between the number and individual components of metabolic syndrome and late-life depressive symptom clusters.

Methods

In 1279 individuals aged 50 through 70 participating in the Nijmegen Biomedical Study (Cross-sectional populationbased survey), we measured all metabolic syndrome components and depressive symptoms using the Beck Depression Inventory (BDI). Principal components analysis of BDI-items yielded two factors, representing a cognitive-affective and a somatic-affective symptom-cluster. Multiple regression analyses adjusted for confounders were conducted with BDI sum score and both depression symptom-clusters as dependent variables, respectively. We explored the differences in this association between men and women.

Results

In fully adjusted models, both presence of the metabolic syndrome as well as number of components was associated with the BDI sumscore(resp. β=0.063;p=0.022 vs. β=0.112;p< 0.001), the latter showing the strongest association. These associations were primarily driven by the somatic-affective symptom-cluster. Testing individual components of the metabolic syndrome, showed that in men waist circumference, triglycerides and HDL cholesterol were significantly associated with depression, whereas in women only the waist circumference.

Conclusions

The specific association somatic-affective symptoms suggest confounding by a (subclinical) somatic condition in stead of a real association with classical depression. The identified sex-differences suggest different pathways between depression and metabolic perturbations in men only. However, as vascular disease develops at higher ages in women and findings were in the same direction but non-significant in women, future research in older women sample should confirm our findings.
1036 – Characteristics Of Patients And Factors Associated To Discharge From Residential Facilities: a Prospective Cohort Study In Italy
Authors: de Girolamo G. , Candini V. , Buizza C. , Ferrari C. , Boero M.E. , Giobbio G.M. , Goldschmidt N. , Greppo S. , Iozzino L. , Maggi P. , Melegari A.L. , Pasqualetti P. , Rossi G.
Published: July 2013

Introduction

PERDOVE study is a prospective observational cohort study, which providing follow-up at one year, aims to investigate the socio-demographic and clinical characteristics of patients in in the 23 medium-long term RFs of the St John of God Order.

Objectives

(1)

To describe the sociodemographic, clinical, and treatment-related characteristics of RF-patients during an index period in 2010;

(2)

to identify predictors and characteristics associated with discharge at 1-year follow-up;

(3)

to evaluate clinicians’ predictions about each patient's likelihood of Home Discharge (HD).

Methods

All patients staying in September 2010 with a primary psychiatric diagnosis received a set of standardized assessment instruments, including a “Patient Schedule”, BPRS, HONOS, PSP, PHI, and SLOF. Detailed socio-demographic and clinical data were also collected. Logistic regression analyses were run to identify independent discharge predictors.

Results

The study involved 403 patients. 66,7% is male, mean age is 49 (±10). 70.7% is unmarried. The average duration of illness of these patients is 23 years. Primary diagnosis is represented by schizophrenic spectrum disorders (67.5%). At 1 year follow-up, 104 patients (25.8%) were discharged: 13.6% to home, 8.2% to other RFs, 2.2% to supported housing, and 1.5% to prison.

Conclusions

The main variables associated with a higher likelihood of being discharge to home were: to have an illness duration of less than 15 years and to have an available and effective social support in the last year. Lower severity of psychopathology, and higher working skills were also associated with a significantly higher likelihood to be discharged to home.
1039 – Predictors Of Quality Of Life In a Sample Of Inpatients With Schizophrenia In 23 Residential Facilities In Northern Italy
Authors: Lanfredi M. , de Girolamo G. , Candini V. , Buizza C. , Ferrari C. , Boero M.E. , Giobbio G.M. , Goldschmidt N. , Greppo S. , Iozzino L. , Maggi P. , Melegari A.L. , Pasqualetti P. , Rossi G.
Published: July 2013

Introduction

Many cross-sectional studies have explored the relationship between subjective QOL of people with schizophrenia and different socio-demographic characteristics, clinical and psychosocial factors. Only few studies tried to identify factors that influence the QOL of these patients using a longitudinal design.

Objectives

Aim of the present study was to determine influence of clinical factors, socio-demographic variables, spirituality and satisfaction with services on QOL, to identify clinical predictors associated with quality of life at one year follow-up.

Material and methods

Measures at baseline included: demographics, BPRS, PHI, RBANS, FPS, HoNOS, SWBS, VSSS, and the Italian version of the WHOQoL-Brief. Measures at follow up included: HONOS, BPRS, FPS, WHOQoL-Brief. Logistic regression models were adopted to evaluate the association between WHOQoL-Brief scores and patient's sociodemographics, clinical characteristics, spirituality and services’ satisfaction.

Results

The study included 171 patients: 64% males; mean age 48.7 (sd=8.9) with primary diagnosis of schizophrenia. Different domains of QOL were predicted by different indicators at baseline. Younger age, more time spending doing nothing, lower BPRS, lower satisfaction with services were explanatory variables for low quality of life in psychological facet. Spirituality and religiousness were associated with Environmental domain and VSSS was associated to all QOL domains.

Conclusions

Rehabilitation plans for people with schizophrenia living in RFs should pay attention to mediators of change in subjective QOL such as level of activities, social support, spirituality and satisfaction with mental health services. In particular, anxiety and depressive symptoms remain as long-term outcomes of QOL at one year follow up.
1046 – Switching To Lurasidone In Patients With Schizophrenia: Tolerability And Effectiveness At 6 Weeks And 6 Months
Authors: McEvoy J. , Citrome L. , Hsu J. , Werner P. , Pikalov A. , Cucchiaro J. , Loebel A.
Published: July 2013

Introduction

Effectiveness studies of therapeutic switching of antipsychotics provide valuable clinical information.

Objectives

Assess effectiveness of switching patients to lurasidone.

Aims

To evaluate 3 dosing strategies when switching patients to lurasidone.

Methods

Patients were randomized to three open-label lurasidone dosing strategies: 40mg/day for 14 days (n=74); 40mg/day for 7 days then 80mg/day for 7 days (n=88); and 80mg/day for 14 days (n=82) and stratified by their previous treatment (sedating vs non-sedating). Prior antipsychotic was tapered (50% step-down, day 8, discontinued day 14), followed by 4 weeks of flexible dose treatment (40-120 mg/day). Primary outcome was time to treatment failure (TTF). Of the 198 subjects completing core 6-week study, 149 (75.3%) enrolled in a 6-month extension study.

Results

Switching to lurasidone was well tolerated; 198 (81.1%) of subjects completed core study, 19 (7.9%) subjects experienced treatment failure of which 16 (6.7%) discontinued due to an AE. No clinically relevant differences were noted among the 3 dosing strategies. TTF was earlier in patients previously receiving sedating antipsychotics vs. non-sedating (log rank p=0.101). Core study yielded LS mean (SE) within-group improvement on PANSS total score -5.3 (±0.7), LOCF with further improvement of -1.5 (±0.9), LOCF, at Month 6 from extension baseline. Ninety-eight subjects (65.8%) completed extension phase. Premature discontinuation causes included consent withdrawal (12.1%) and AEs (11.4%). Weight and lipid changes at 6 months were minimal.

Conclusion

Switching to lurasidone was safe and well tolerated regardless of initial dosing strategy. Switched patients maintained or improved symptom control during core and extension treatment.
1052 – Assessment Of The Degree Of Dependence According To The Principles Of The Icf Concerning People Suffering From Mental And Behavioural Disorders
Authors: Čeledová L. , Čevela R. , Ptáček R. , Kuželová H.
Published: July 2013

Introduction

Since 2007, there has been a gradual increase in the total number of the institutionally approved dependency regarding mental disorders (21 596 cases in 2007, 24 317 cases in 2011). The newly proposed criteria of the assessment of the degree of dependence from January 1, 2012 are set according to the principles of the International Classification of Functioning, Disability and Health (ICF). The aim was to take into account the social needs of patients suffering from mental disorders.

Ten basic needs

The assessment of the degree of dependence includes the evaluation of the functional impact of the longterm unfavourable state of health on the ability to manage the 10 basic needs. The basic needs are further specified by the ICF principles and activities. Prior to the adoption of this method, assessing the degree of dependence had been tested in terms of its functionality, reliability and impact on disabled people. The tests have demonstrated moderate benefits of this method for people suffering from mental disorders.

[The 10 basic needs in the ICF classification].

MobilityChapter 4 Mobility, such as d 450 Walking, d 460, d 410OrientationChapter 1 Learning and applying knowledge, such as codes d 110 - 129CommunicationChapter 3 Communication, d 310 - d 360Self-feedingChapter 5 Self-care, eating and drinking, d 550 - 560Putting on clothes and footwearChapter 5 Self-care, d 540Washing oneselfChapter 5 Self-care, d 510 - 520ToiletingChapter 5 Self-care, d 530Looking after one's healthChapter 5 Self-care, d 570, Chapter 2 General tasks and demands, such as d 230Personal activitiesChapter 8 Major life areas, such as d 810 - 820, Chapter 9 Community, social and civic life, such as d 910 - 920Household tasksChapter 6 Domestic life, such as d 630 - 640

Conclusion

The method in question provides an efficient interconnection within the ICF application in both healthcare and dependence degree assessment. Thus, the reflection of ICF in new medical assessment criteria used to assess the degree of dependence will contribute to a change in how healthcare professionals perceive disabilities, and it will ensure that the areas of healthcare, aftercare or long-term care, and the social area are combined more effectively.
1054 – Assessment Of Health And Working Capacity Of People With Dementia For Purposes Of The Social Security System
Authors: Čevela R. , Čeledová L. , Ptáček R. , Kuželová H.
Published: July 2013

Introduction

A new approach to health assessment and the rate of working capacity decline of patients suffering from dementia, is based on the results (as of January 1, 2010) of a project entitled: Advances in medical science reflected in functional health state assessment and working incapacity in relation to International Classification of Diseases and International Classification of Functioning, Disability and Health.

Disability due to dementia

The total number of hospitalizations due to dementia (F01, F03, G30) increased by more than one fifth (from 6549 to 7981 hospitalizations) between 2006 and 2010. However, the overall number of disabilities between 2006 and 2009 decreased by one half (from 2998 to 1571), and between 2010 and 2011 dropped to 5% of its original number (190 and 144 cases respectively). Nevertheless, between 2007 and 2011, there was a 50% increase in the number of patients with institutionally confirmed disabilities (from 6270 to 9504).

Conclusion The new approach to incapacity assessment is in accordance with medical experts' opinions and advances in medical science, related to function ability, activity and participation.

The new way of incapacity assessment could be the reason for the dramatic decrease in the number of institutionally confirmed disabilities in 2010 and 2011, despite the growing number of patients suffering from dementia.

Such discrepancy may also be explained by early diagnostics and more effective treatment, which prevent patients with dementia from becoming disabled.

Moreover, this hypothesis corresponds to the increasing number of patients with a certain degree of dependence due to dementia.
1057 – Evaluation Of Quality Of Life, Psychosocial Functioning, And Medication Adherence Among Patients Switched To Lurasidone From Other Antipsychotics
Authors: Awad G. , Hassan M. , Loebel A. , Hsu J. , Pikalov A. , Rajagopalan K.
Published: July 2013

Introduction

Patient reported outcomes (PROs), i.e. quality of life (QoL), psychosocial functioning and medication adherence are vital assessments of results in schizophrenia treatment.

Objectives

Quality of life, psychosocial functioning and adherence attitude were evaluated among adult patients with schizophrenia switched from current antipsychotics to lurasidone, using the Personal Evaluation of Transitions in Treatment (PETiT) scale, a PRO measure.

Aims

Evaluate PROs after switching to lurasidone.

Methods

Stable but symptomatic adult outpatients with schizophrenia were switched from their previous antipsychotics to lurasidone, in a 6-week, open-label trial. Subjective responses to antipsychotic therapy were evaluated at baseline and study endpoint using PETiT (Higher scores=better outcomes). Score change was obtained for all patients and those switched from “sedating” (olanzapine, quetiapine) or “non-sedating” (risperidone, aripriprazole, ziprasidone, others) agents. Change from baseline to endpoint in total (overall QoL) and subscale scores (psychosocial functioning, adherence attitude) were compared using ANCOVA.

Results

Of the 244 patients switched to lurasidone, 213 had available data. Changes from baseline in mean total PETiT score (3.2, P< 0.0001) and subscale scores of psychosocial functioning (2.5) and adherence attitude (0.7) were reported in all patient groups (p< 0.001). Improvement in mean total PETiT score was observed in patients switched from non-sedating (3.5, n=139) and sedating (2.7, n=74) antipsychotics and was statistically significant (P< 0.0001) in the non-sedating group. Differences in statistical significance (sedating vs non-sedating) may arise from smaller changes, not sample size.

Conclusions

In this study, patients switching to lurasidone experienced improvement in QoL, psychosocial functioning and adherence attitude.