bluuebunny/crossref_metadata_2025 huggingface dataset:
Efficacy of a hypericum extract (STW3-VI) – A reanalysis
Authors: Mueller J. , Kolb C.
Published: June 2017

Introduction

The course of depression during therapy in studies is usually monitored by scales like HAMD. Also the course of single items of the HAMD during therapy might be of specific interest as some symptoms are of highly predictive value. Furthermore early improvement during antidepressive therapy is a new aspect which came into the focus.

Objectives

The objectives of this study were to reanalyze clinical data regarding early improvement as well as specific symptoms or symptom cluster – like sleep disturbances.

Aims

The aim of this study was to get deeper insight into the data structure of 2 RCTs (n = 398, 42 days treatment) comparing the efficacy of a hypericum extract (STW3-VI/900 mg once daily) to Placebo.

Methods

Data structure was evaluated by comparing the total scores of the HAMD-17 to a single item analysis and by calculating the factorial structure of the end of treatment data. The treatment potential was evaluated by calculating a positive predictive value from day 7 to the end of treatment. ANCOVA, factor analysis and regression methods were used.

Results

The single item analyses were widely comparable to the highly significant treatment differences of the total scores as it were the calculated subscales. The positive predictive value of the treatment was about 75%.

Conclusions

The results underline the elsewhere proven treatment efficacy of STW3-VI regarding several new subscale aspects.

Disclosure of interest

COI: The authors are employees of Steigerwald Arzneimittelwerk GmbH, Darmstadt, Germany.
Chronic benzodiazepine use in aged patients with depressive disorder
Authors: Smaoui N. , Zouari L. , Maâlej-Bouali M. , Charfi N. , Zouari N. , Thabet J. Ben , Maâlej M.
Published: June 2017

Objective

To identify predictive variables of chronic benzodiazepine use among elderly patients with depressive disorder.

Methods

This was a cross-sectional, descriptive and analytical study, including 41 patients suffering from depressive disorders, aged 65 years or more, treated with benzodiazepine (BZD) and followed-up in outpatient psychiatry unit at Hedi Chaker university hospital in Sfax in Tunisia. We used a standardized questionnaire including socio-demographic and clinical data. Chronic BZD use was defined as BZD availability at least 50% of the days between day 181 and day 365 following initiation.

Results

The average age of patients was 69.29 ± 5.7 years. The sex ratio (M/F) was 0.5. The majority of them were married (78%), unemployed (82.9%) and living in urban area (61%). They had at most a primary degree (90.2%) and a low socioeconomic level (63.4%). The average time of BZD consumption was 4 years and 5 months.

The prevalence of chronic BZD use in our sample was 56.1%. Duration of benzodiazepine use was greater than 1 year for all chronic BZD users. The mean dose of Benzodiazepine (Lorazepam) consumed was 3.87 ± 2.8 mg per day. Chronic BZD use was correlated with low socioeconomic level (86.3% vs 36.8%; P = 0.000), psychiatric comorbidity (72.7% vs 26.3%; P = 0.004) and recent hospitalization (59% vs 15.7%; P = 0.023).

Conclusion

There is a high prevalence of chronic BZD use in our study. For the 65 years and older patients with depressive disorder, significant predictors of chronic BZD use were low socioeconomic level, psychiatric comorbidity and recent hospitalization.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
A French psychoeducational audio-visual tool for adult patients with eating disorders
Authors: Avenet L. , Ringuenet D. , Vindreau C. , Mallet J. , Avenet P.L. , Gorwood P. , Dubertret C.
Published: June 2017

Introduction

Eating disorders are pathologies with potentially serious psychic and somatic consequences, and high mortality. Lifetime prevalence in adults is about 0.6% for anorexia nervosa, 1% for bulimia, and 3% for binge eating disorder. However, the prognosis is improved if a suitable care is quickly established. Caregivers are often highly involved and helpless in facing such diseases. They often express a significant psychological distress. We must contribute to provide them answers, to strengthen their key role as a resource and support for the patient. It is found that carers themselves are poorly trained in screening, diagnosing and supporting eating disorders. There are effective therapeutic approaches, such as psychoeducation, to improve therapeutic alliance.

Objectives/aims

This work aims to realize a French psychoeducational audio-visual tool for patients with eating disorders, their caregivers, and professional carers.

Methods

We made an extensive review of literature (focus on the international practice guidelines, existing psychoeducational tools), and several consensus meetings. We decided of original directions to drive the psychoeducational approach of the movies, taking into account previous findings.

Results

This tool includes three movies approaching the symptoms and the choice of treatment setting, based on the disease course and the care's goals. They may be broadcasted on a national level through professional networks and associations involved in the treatment of eating disorders.

Conclusion

This work improves the knowledge of eating disorders in carers, patients and their families. The relevance and effectiveness of this tool on the course of the disease has to be further evaluated.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Some stay the same: Personality change after treatment for eating disorder
Authors: Levallius J. , Mu W. , Norring C. , Clinton D. , Roberts B.
Published: June 2017

Introduction

Strong evidence establishes a close relationship between personality traits and mental illness; where personality can be said to influences the likelihood, severity and longevity of a mental disorder. Personality is usually seen as fixed, yet there is a growing body of evidence for the changeability of personality, though this has rarely been studied in relation to mental disorders.

Objective

To study the longitudinal interplay between personality and eating disorders (EDs), particularly the associations between personality, recovery and treatment modality.

Aims

To investigate changes in the five domains and thirty lower-level facets of personality in non-underweight EDs, and its associations to intervention and outcome.

Methods

Two hundred and nine adults with EDs enrolled either in a four-month multimodal psychodynamic group-therapy (DAY) or four-six month internet-based supported cognitive behavioural therapy (iCBT). ED diagnosis and personality (by the five-factor model) were assessed at baseline, termination and 6-month follow up. Structural equation modeling was used to analyze domain-level development, and reliable change (RCI) for facet-level development.

Results

Remission rate at end of treatment was 71% in DAY and 55% in iCBT. Over time, Neuroticism decreased significantly while Extraversion, Openness and Conscientiousness increased (P < 0.01). Treatment and outcome had little influence on domain-level change. At the facet-level, 28% of patients reliably changed in any given facet, and there were several differences in pattern based on treatment and outcome.

Conclusions

This study lends support for the possibility of personality change and its relevance for recovery from EDs.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Are coping strategies really different among family members of patients with eating disorders?
Authors: Sampogna G. , Fiorillo A. , Luciano M. , Del Vecchio V. , Volpe U. , Monteleone A. , Bruni A. , Segura-Garcìa C. , Catapano F. , Monteleone P. , Maj M.
Published: June 2017

Introduction

Family members of patients with Eating Disorders(EDs)–in dealing with the relatives’ disease–report negative feelings such as self-blame and criticism, but little is known regarding their coping strategies.

Objectives

To describe coping strategies in a sample of relatives of patients with EDs using the Family Coping Questionnaire–Eating Disorder version (FCQ-ED).

Aims (1) To evaluate coping strategies in relatives of patients with EDs; (2) to describe differences in coping strategies according to type of kinship with the patient; (3) to identify correlations among socio-demographic characteristics, patients’ clinical characteristic, and type of coping strategies.

Methods

Relatives’ coping strategies were evaluated using the FCQ-ED, a self-administered questionnaire, consisting of 32 items, grouped in 5 subscales: coercion; positive communication; collusion; seeking for information; avoidance, plus one item on seeking for spiritual help.

Results

Seventy-two patients and 127 relatives were recruited. The most frequently adopted coping strategies were seeking for information, positive communication, seeking for spiritual help; the former were positively correlated with the level of education of both patients and relatives. Mothers avoided the patients less frequently than other relatives.

Discussion

This is one of the first studies focused on coping strategies in families of patients with EDs showing that problem-oriented ones are used quite often. Socio-demographic characteristics and type of kinship can have an impact on the adoption of coping strategies, but further longitudinal studies are needed in order to identify other possible factors implied in their development.

Conclusions

This represents an initial attempt to understand how clinical, social and personal variables can have an impact on the development of coping strategies.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Turkish version of body attitude test: Its reliability and validity
Authors: Huri M. , Sahin S. , Akel S. , Slepecky M. , Kotianova A.
Published: June 2017

Introduction

Breast cancer (BC) may cause problems on body perception and awareness which can be perceived as a threat on body attitude among women with breast cancer.

Objectives

The Body Attitude Test (BAT) assesses subjective attitude toward women's own body.

Aim

The aim of the present study was to develop the Turkish version of the BAT and examine its reliability and validity.

Methods

The study group (SD) consisted of 72 women diagnosed with BC while 100 healthy women (HW). The women evaluated by BAT, Eating Disorder Inventory (EDI) and Self Esteem Inventory (SEI) in 7–10 days intervals. Internal consistency was determined with Cronbach's alpha coefficient. Factor analysis was conducted on BAT ratings given by control group.

Results

The mean age was 43.7 ± 8.76 of women with BC while 46.4 ± 10.84 in HW. Mean duration of cancer was 2.4 ± 0.7 years. Factor analysis showed BAT was composed of two factors as body dissatisfaction and lack of familiarity with one's body. The BAT demonstrates satisfactory level of internal reliability (α = 0.932). BAT was related with EDI subscales: drive for thinness (r = 0.741, P < 0.001), ineffectiveness (r = 0.736, P < 0.001) and body dissatisfaction (P = 0.718, P < 0.001) and SEI subscale: familial self-esteem (r = -0.629, P < 0.001).

Conclusion

The results support the validity and reliability of BAT which is able to differentiate the clinical and non-clinical form of subjective attitude toward women's own body. Turkish version of BAT could be used as an appropriate measure for assessing subjective attitude towards own body in women with and without breast cancer in Turkey.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Eating disorders symptoms related to gestational BMI in breastfeeding mothers
Authors: Volpe F. , Giliberti L. , Soldera G. , Straface G. , Zanardo V.
Published: June 2017

Background and aims

Research has shown that maternal obesity and underweight are major risk factors for reduced initiation, duration, and exclusivity of breastfeeding. This prospective, cohort study analysed the association between gestational body mass index (BMI) and symptoms of eating disorders (ED) in breastfeeding women.

Methods

The study involved 1318 consecutive, at term, healthy mothers, who delivered at the division of Perinatal Medicine of Policlinico Abano Terme, located in a North-Eastern Italy industrialized area, supporting advanced educational levels, good socio-economic status and low and late fertility. The day of discharge mothers completed the completed the eating disorder examination-questionnaire (Fairburn and Beglin, 2008), including four subscales, restraint (R), shape concerns (SC), weight concerns (WC), eating concerns (EC) and a global score (GS). Mothers’ BMI groups were categorized as underweight, normal weight, overweight and obese, according to 2009 IOM guidelines.

Results

EDE-Q mean values ( ± SD) significantly increased with BMI increasing categories. Compared to normal weight mothers (n = 290, 22.0%), obese women (n = 273, 20.7%) had higher significant GS (0.6 ± 0.7 vs. 0.2 ± 0.3; P = 0.006), R (0.6 ± 0.9 vs. 0.3 ± 0.6; P < 0.0001), EC (0.4 ± 0.6 vs. 0.3 ± 0.5; P < 0.0001), SC (0.9 ± 1.0 vs. 0.3 ± 0.5; P < 0.0001) and WC (0.7 ± 0.8 vs. 0.1 ± 0.3; P < 0.0001). In addition, formula-feeding adoption at discharge significantly increased with BMI increasing categories (P per trend = 0.01).

Conclusions

We present evidence that gestational obesity is associated with reduced breastfeeding rates at discharge and higher ED symptomatology. Women need information and support to gain adequate weight during pregnancy.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Anxiety disorder on acting people in emergencies
Authors: Oller Canet S. , Madariaga Garcia D. , Castillo Magaña S. , Gasque Llopis S. , Adell Anglés V.
Published: June 2017

Introduction

Disasters and emergencies generate a psychological impact on both survivors and response teams. Traumatic events and his memory would be a risk factor for anxiety disorders.

Objectives

Describe the most common post emergency anxiety signs in a sample of Spanish people who responded directly to emergencies.

Methods

Study carried out by survey filled through Google Forms application; in this survey, we retrospectively value anxiety using the screening scale for generalized anxiety disorder of Carroll and Davidson.

Results

The survey was answered by 20 people, of whom 60% were women 68.20% age range between 18–6 years and with university studies in the 70% of the interviewees. Four nurses, 2 doctors, 4 emergency assistants workers, 2 civil protection workers, 1 ambulance worker, 1 military, 3 policemen, 1 fire-fighter and 2 others. Sixty percent of cases did not received specific aid. The anxiety scale items that are most affected are musculoskeletal stress and sleep, with lower prevalence of psychological anxiety (Fig. 1). Women showed higher prevalence of psychological anxiety, muscle tension, and sleep disturbance.

Conclusions

The data reveals that the staff responding to emergencies recalled experienced musculoskeletal problems or sleeping disturbance better than psychological anxiety which was relegated to the background. Post-emergency treatment should be provided to all participants in emergencies including specific interventions for musculoskeletal stress and insomnia.

Disclosure of interest

The authors have not supplied their declaration of competing interest.

Fig. 1

Scale for generalized anxiety disorder of Carrol and Davidson results.
Algorithm-based protocol for the identification, management and treatment of psychiatric patients with acute psychomotor agitation
Authors: Vieta E. , Garriga M. , Cardete L. , Bernardo M. , Lombraña M. , Blanch J. , Catalán R. , Vázquez M. , Soler V. , Ortuño N. , Martínez-Arán A.
Published: June 2017

Introduction

Psychomotor agitation is the most common behavioural disorder observed in emergency and psychiatry departments. This syndrome is characterized by excessive or inappropriate motor or verbal activity and important emotional tension. Psychomotor agitation may be associated with medical conditions, substance intoxication/withdrawal and in a significant number of cases with schizophrenia or bipolar I disorder.

Objectives

The objective of this protocol was to provide up-to-date guidance to identify, manage and treat patients with an episode of acute agitation, considering the consensus clinical knowledge, current ethical standards and available therapies. This protocol is aimed to be a patient-centric tool helping to anticipate and prevent the escalation of agitation symptoms.

Methods

The method followed to elaborate this document was through a combination of comprehensive bibliographical review (complied in the article “Assessment and management of agitation in psychiatry: expert consensus” by Garriga M. et al. (World J Biol Psychiatry, 2016), interaction with patients, and the clinical experience in our centre.

Results

The elaboration of this protocol resulted in a document that contains guidelines to identify, manage and treat patients efficiently, ethically and safely. One of the novelties of the protocol is the addition of dichotomies based on the patients’ willingness to cooperate. The information is summarized in easy-to-use algorithms for non-specialized healthcare professionals.

Conclusions

This protocol may provide the basis of a new standardized treatment paradigm for psychomotor agitation which may help improve the patient's experience and therapeutic alliance with the healthcare professional and optimize resources in healthcare centres.

Disclosure of interest

COI: The preparation of the protocol was funded by an unrestricted grant from Ferrer International. The company had no say on protocol content. Dr Vieta has received funding for research projects and/or honoraria as a consultant or speaker for from the following companies and institutions: AB-Biotics, Allergan, AstraZeneca, Bial, Bristol-Myers Squibb, Dainippon Sumitomo Pharma, Elan, Eli Lilly, Farmaindustria, Ferrer, Forest Research Institute, Gedeon Richter, Glaxo-Smith-Kline, Janssen, Lundbeck, Otsuka, Pfizer, Roche, Sanofi-Aventis, Servier, Shire, Solvay, Sunovion, Takeda, Telefónica, Institute of Health Carlos III [Instituto de Salud Carlos III], Séptimo Programa Marco (ENBREC), Brain and Behaviour Foundation (NARSAD) and Stanley Medical Research Institute.
Risk factors of self-injury behavior among psychiatric inpatients
Authors: Charfi N. , Hentati S. , Maâlej Bouali M. , Zoauri L. , Zouari N. , Thabet J. Ben , Maâlej M.
Published: June 2017

Background

Self-injury behavior among mental patients has been recognized for several years, yet our understanding of its mechanisms and its risk factors remains limited.

Objectives

This study aimed to assess the prevalence of deliberate self-harm (DSH) among psychiatric inpatients and to identify its association with personal and clinical factors.

Methods

It was a descriptive and analytic study. It included 87 psychiatric inpatients followed in the psychiatry department “C” at the Hedi Chaker University Hospital of Sfax in Tunisia. Barratt Impulsivity Scale (Bis11) and the 28-items Childhood Trauma Questionnaire (CTQ) were used to assess respectively impulsivity and child maltreatment.

Results

The average age of patients was 29.32 ± 8 years. Most of them were male (75%) and single. Fifty-nine percent of patients had previously attempted suicide. A history of DSH was found in 60.9% of cases. The most frequent trauma types were emotional abuse and physical neglect with respectively 58.7% and 69.8%. Factors positively correlated with DSH were: male gender (P = 0.026), father alcoholism (P = 0.024), history of suicide attempts (P = 0.017), borderline personality (P = 0.00) and history of emotional abuse (P = 0.008) or physical abuse (P = 0.04) or neglect (P = 0.004). Score “Bis11” was significantly correlated with suicide attempts (P = 0.00) and presence of childhood abuse (P = 0.00) or neglect (P = 0.01).

Conclusion

DSH seems to be a prevalent problem among psychiatric inpatients. It concerns mainly patients with a history of child abuse and impulsive behavior such as suicidal attempts underlying borderline personality disorder. Patients with these risk factors warrant specific attention in mental health services.

Disclosure of Interest

The authors have not supplied their declaration of competing interest.
Public beliefs and attitudes towards schizophrenia and major depression: Findings from a representative population-based study
Authors: Lien Y.J. , Kao Y.C.
Published: June 2017

Introduction

Previous studies have suggested that public beliefs and attitudes toward mental illness may be influenced by country-specific social and cultural factors.

Objectives

This study aimed to carry out a national survey to assess people's beliefs and stigmatizing attitudes toward schizophrenia and major depression in Taiwan.

Methods

We randomly recruited participants aged 20–65 (n = 1600) in Taiwan, using a computer-assisted telephone interviewing. Participants were presented with a case vignette for major depression and schizophrenia. Questions were asked about causal attributions, emotional reactions, and social distance of individuals afflicted by psychosis or depression.

Results

In respect of causal attributions, respondents were more concerned with the likelihood of biogenetic explanations for schizophrenia as compared with depression. The same applied to other explanations such as god's willingness and being possessed or haunted. In contrast, psychosocial factors were more likely to be endorsed as a cause of depression than as a cause of schizophrenia. For perceived dangerousness, significantly more respondents considered schizophrenia likely to be violent toward others and to be unpredictable. In terms of emotional reactions, respondents were significantly more likely to express anger or fear for schizophrenia vignette. A similar pattern was shown for the social distance, where respondents were also significantly less likely to express a willingness to contact people suffering from schizophrenia within different social relationships.

Conclusions

The findings from this study may enhance our knowledge of community beliefs and stigmatizing attitudes towards people with mental disorders in Taiwan and highlight the importance of understanding these issues in context.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Specifics of the implementation of the security measures of medical nature in the Republic of Serbia
Authors: Misic P.
Published: June 2017

The medical security measures in the Republic of Serbia include:

– mandatory psychiatric treatment and confinement in a medical institution;

– mandatory psychiatric treatment at liberty;

– mandatory treatment of alcoholics and;

– compulsory Drug Addiction Treatment.

The aim of this presentation is to explain how the medical security measures are implemented in the Republic of Serbia. The methods used in this study are analysis and synthesis of the implementation of security measures in the Republic of Serbia based on many years of practical work in forensic centre for the implementation of security measures. By duration of medical security, measures may be twofold:

– of unlimited duration, when the offender is undergoing medical treatment and keeping in a medical institution, while there is a need for treatment, or until there is no threat to the environment (the length of time is difficult to determine, however, that the most common word on the permanent indefinite treatment and storage required special caution and detailed analysis of all the elements relevant for this decision).

– limited duration, where the duration of treatment is determined by the court and to no longer than three years as provided in the current The Criminal Code of the Republic of Serbia.

The basis of every civilized society make the legal and moral norms governing the relations within the community, and thus regulate and protect their most essential element – the man – his physical and psychological integrity.

Disclosure of interest

The author has not supplied his/her declaration of competing interest.
Personality type of homicide offenders based on psychiatrist expert reviews
Authors: Szilágyi P.
Published: June 2017

Despite the relatively prudent regulations and dissuasive punishments worldwide, the number of homicide offenses are not decreasing. In my study those psychiatrist expert opinions were reviewed, which were created in closed homicide cases in the institute of forensic medicine of Debrecen over five years from 2007.

The subject of my study was that what kinds of personalities these crime offenders have, and whether they were in a pathological mental state while committing the crime. The majority of the offenders were from the most active age group between 20 and 40, for the victims, however, the opposite can be said, as the most common homicide acts were committed against the older age group, because due to their age they are less able to defend themselves than the truly active age group. Out of 25 committers, 9 had psychiatric treatment in its antecedents – mostly suicidal intentions or attempts, alcohol dependence or depressive episode. Among the cases examined, antisocial personality disorder was only made probable in 42% of the perpetrators; however, it was not qualified as restrictive factor in neither case.43.5% of the offenders were under the influence of alcohol at the time of committing the act, and 58.3% had no criminal record before.

The public believes about the homicide offenders that only people with abnormal mental condition can commit them – however, based on the reviewed psychiatrist expert opinions, the limitation of imputation ability can rarely be established professionally. Milder or more severe limiting factor were established in only 12% of the offenders.

Disclosure of interest

The author has not supplied his declaration of competing interest.
The Effects of a Brief Educational Programme Added to Community Mental Health Treatment to Improve Patient Activation and Attendance: A Randomized Controlled Trial
Authors: Lara-Cabrera M. , Nesset M.B.
Published: June 2017

Introduction

Though interest grows in improving patient activation in general medical health services, there is little evidence from randomised controlled trials in mental health settings of how to achieve this.

Objective

We aimed to evaluate the effects of a brief pre-treatment peer-co-led educational intervention added to mental health treatment. The intervention was developed and carried out in cooperation with user representatives, peer educators and health professionals, and aimed at activating and preparing patients to participate in own treatment.

Aims

To assess the 4 months and 12 months effects on patient activation measure-13 (PAM-13) and attendance.

Methods

Patients from two community mental health centres were randomised to a control group (CG, n = 26) receiving treatment as usual, or an intervention group (IG, n = 26), consisting of four-hour group pre-treatment educational seminar (peer-support and encouragement to adopt an active role) followed by treatment as usual.

Results

At 4 months follow-up only the IG improved significant on PAM-13. Preliminary results at 12 months on PAM-13 and attendance will be presented.

Conclusion

Brief pre-treatment education improves patient activation at 4 months and could potentially have an effect on attendance at 12 months follow-up.

Practice implications

Pre-treatment education co-led in cooperation with user representatives, peer educators and health professionals is a rational and easy way to activate and engage outpatients in their own health care process.

Clinicaltrials.gov Identifier: NCT01601587

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Specialist Clinic Dedicated to Chronic Mental Illness and Metabolic Monitoring
Authors: McCafferty B.
Published: June 2017

Introduction

People with serious mental illness exhibit higher morbidity and mortality rates of chronic disease than the general population. A significant proportion of premature deaths has been related to modifiable cardiovascular risk factors and may be related to medications taken for mental illness.

Objectives

Establish a clinic for a cohort of patients with chronic mental illness dedicated to monitoring physical health focusing on modifiable risk factors.

Methods

Patients with chronic mental illness taking psychotropic medications long term were invited to attend clinic.

The following areas were examined: History focusing on current mental state, cardiovascular history assessing diet, exercise, personal and family history of cardiovascular disease, Exam including waist circumference, BP, pulse, ECG and calculation of BMI. Laboratory tests including HbA1c, Lipid profile, and other tests as appropriate such as serum lithium. Examination for tardive dyskinesia (Abnormal Involuntary Movement Scale (AIMS)), outcomes, (Health of the Nation outcome scale (HoNos)) and quality of life (WHOQOL-Bref) were performed also performed as additional indicators of global health.

Results

Sample consisting of 47 patients. Mean age 56.1 (SD: 13.6) males 27 (60%). Mean years of illness 23.1(SD:12.2). Mean HoNos 2.7 (SD 2.5). Four cases prolonged QTc, 5 HbA1c > 6% (2 no prior record of elevation); 18 abnormal lipid profiles, (12 no prior record of elevation); 4 blood pressure readings ≥ 140/90, 3 no prior diagnosis of hypertension; 18 BMI > 25.

Conclusions

This is a newly established clinic. Preliminary results have highlighted modifiable risk factors some of which may represent new diagnoses. Close liaison with General Practice is of importance.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Could Promoting Happiness Mental Health Policy Prevention Against Suicide?
Authors: Chaouqi A. , Mamouni Y. Alaoui , Hammani Z. , Yassari M.
Published: June 2017

What do we know about happiness? What is the essence of happiness? What are the causes of happiness? Is there a difference between individual happiness and collective happiness? Can we measure happiness? Let us see if there is a correlation between suicide and happiness?

Disclosure of interest

The authors have not supplied their declaration of competing interest.
From Pilot Project to RCT – Music Intervention to Improve Sleep Quality in Depressed Patients: A Mixed Methods Study
Authors: Lund H.N. , Heyman-Shlaczinska A. , Pedersen I.N.
Published: June 2017

Introduction

Insomnia is a common sleep disorder for patients with depression. This has a major impact on the quality of life for the individual. A randomized controlled trial (RCT) will address the use of music as a non-pharmacological treatment to reduce insomnia in depression.

Objectives and method

The aim is to investigate, whether music listening is effective to:

– improve sleep quality;

– reduce symptoms of depression;

– improve quality of life;

– limit or replace medication.

A RCT will address the use of music as a treatment modality in depression using an explanatory mixed methods design. In the first phase of the study, patient data is collected from 3D accelerometer, log files from a new app for iPad called ‘the music star’ and questionnaires (MDI, HAM, PSQI and WHO-QOL). ‘The music star’ is an app for iPad used to select music from special designed playlists developed by Danish music therapists in psychiatry. An exploratory follow-up (semi-structured interviews) aims to explain quantitative results from accelerometer and ‘the music star’ log files. Participants enrolled are registered at the clinic for unipolar and bipolar affective disorders at Aalborg University Hospital – Psychiatry. The participants test whether a sound pillow and special designed playlists is effective to reduce insomnia in depression in a 4 week period.

Results and conclusions

A feasibility study has been conducted on 11 participants showing positive results in terms of participation and sleep quality.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Cancer Survivor – What Comes Next?
Authors: Alves M. , Tavares A.
Published: June 2017

Introduction

The number of long term cancer survivors (more than 5 years after diagnosis) are nowadays increasing because of advances in cancer screening, early detection, treatment strategies and management of acute treatment toxicities.

Objectives

We aim to highlight the long-term psychological responses or late effect of cancer diagnosis and treatment.

Methods

Non systematic literature review through the Medline and clinical key databases, with time constraints.

Results

There are physical and functional difficulties that may not be solved with the conclusion of treatment or can become problematic in survivors of cancer.

Long-term refers to psychological or emotional responses that emerge after cancer diagnosis and treatment and persist for at least 5 years. Late effects of cancer refer to psychological or emotional responses that emerge after treatment completion. Risk factors to its development depends on the diagnosis, type of treatment, age at treatment, time since treatment, genetic vulnerability, psychological, social and environmental factors.

Specific deficits are more prevalent in survivors than in healthy adults of the same age. Fatigue, sexual dysfunction, cognitive impairment and musculoskeletal symptoms are common. Functional limitations that induce restricted physical and social activities may happen in survivors. Physical function and late complications can be influenced by lifestyle, socio-economic and biologic factors.

Conclusions

Cancer survivors face short-term and long-term challenges to physical and mental health and they need to be addressed in the active treatment and throughout the continuum of survivorship care. Screening for mental health morbidity should be better integrated into active cancer treatment and survivorship and it should be provided mental health later interventions.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Executive Functions in Delusion-prone Individuals – Preliminary Studies
Authors: Tereszko A. , Janeczko W. , Słowik J. , Brzezicka K. , Prochwicz K. , Siwek M. , Dudek D.
Published: June 2017

Introduction

Executive dysfunctions in psychotic disorders, mainly schizophrenia are well-known phenomenon, however the information about executive functioning in subclinical psychotic states are still scarce. The rationale for focusing on the delusion-proneness (delusion-like states) is suggested role of executive dysfunction in the process of developing delusions.

Aims

Our aim is to assess the relationship between delusion-proneness and executive functions.

Objectives

We would like to assess two cognitive functions: shifting and inhibition and updating, depending on the severity of delusion-like symptoms. We expect that higher delusion-proneness is associated with more pronounced executive dysfunctions, as it is observed in clinical population with existing delusions.

Methods

In order to assess delusion-proneness, we used Polish version of Peters et al. Delusions Inventory (PDI). To evaluate shifting and inhibition, two test were conducted–Berg's Card Sorting Task (BCST) and Stroop task respectively. Correlation analysis were performed.

Results

Sixty-four participants (41 women and 23 men) were recruited in this study. Mean age was 28.8, SD = 10.37. Statistical analysis revealed significant negative correlation of PDI distress subscale and BCST non-perseverative errors. The overall score, as well as all PDI subscales correlated negatively also with the Stroop task's total number of errors and positively with the accuracy in incongruent variant.

Conclusions

Contrary to our expectation, results have shown that delusion-proneness is associated with better results in executive functions test, especially in terms of accuracy. These results suggest that executive functions may play a role in the development and maintenance of delusional ideation, however, its relationship may be a bit more complex.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Effect of Long-acting Injectable Aripiprazole in Glucose and Lipids: A 1 Year Study
Authors: Juncal Ruiz M. , Porta Olivares O. , Fernández-Abascal Puente B. , Gómez Revuelta M. , Landera Rodríguez R. , Santayana Jenaro G. Pardo de , Sánchez Blanco L. , Pérez Herrera M. , Abejas Díez D. , García Egea J.L.
Published: June 2017

Introduction

Atypical anti-psychotics are associated with an impaired in glucose and lipids homeostasis.

Aims

To evaluate, the effect in lipids and glucose levels after switching to long-acting injectable (LAI) aripiprazole.

Methods

This was a prospective, observational, 1 year study carried out in 125 outpatients with schizophrenia who were clinically stabilized but a switching to another anti-psychotic was indicated. We measured basal levels of glucose and lipids at the time to start the study and 1 year after switching to LAI-aripiprazole.

Results

In basal analytic we observed these abnormalities: hyperglycemia (16.7%), high-levels of LDL-cholesterol (33.3%), low-levels of HDL-cholesterol (39%) and hypertrygliceridemia (22.2%). One year after switching to LAI-aripiprazole we found: glucose levels were normalized in all patients; levels of LDL-cholesterol were lower in 66.7% (in 33.3% levels were normalized) and they were higher in 16.7% (in 11% marked a change from normal to abnormal parameters); levels of HDL-cholesterol were lower in 23.3% and higher in 32.2% (in 11% levels were normalized); and finally, levels of tryglicerides were higher in 66.7% (in 8% marked a change from normal to abnormal parameters) and in 16.7% they were lower (in 7.3% levels were normalized).

Conclusions

LAI-aripiprazole has a beneficial effect in glucose and cholesterol levels. Although, it usually increases tryglicerides levels, only in seven cases there was a change from normal to abnormal parameters. Our study suggests that LAI-aripiprazol could be an alternative in patients with schizophrenia who have high levels of glucose and lipids related with atypical anti-psychotics treatment.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Quality of Lfe in Healthy Siblings of Patients with First Episode of Psychotic Illness and its Predictors
Authors: Knytl P. , Vorackova V. , Mohr P.
Published: June 2017

Families of patients with first episode of psychotic illness are exposed to numerous distress factors related to the care of their relative. It has been shown that these families experience higher levels of anxiety, depression, economic strain, and helplessness. According to the prior studies, long-term psychotic illness can also have negative impact on quality of life (QoL) in healthy siblings [1]. The aim of our study was to assess QoL in siblings of patients with first episode of psychosis and to examine effects of sibling-related and illness-related variables on QoL. Study sample consisted of first-episode psychosis patients (n = 20) and their healthy siblings (n = 20). All subjects were administered World Health Organisation Quality of Life Questionnaire Scale Brief (WHOQOL-Brief). Duration of untreated psychosis, medication adherence (Hayward scale) and severity of positive psychotic symptomatology (evaluated by Positive and Negative Symptom Scale) were used as illness-related variables, birth order served as a sibling–related variable. QoL has been accepted as a valuable outcome measure in many psychiatric conditions; thus, identification of contributing factors may help to improve overall outcome. Moreover, close monitoring of adverse effects of illness on QoL in healthy siblings may become a part of larger prevention strategies.

Supported by the grant projects MH CR AZV 15-28998A, MEYS NPU4NUDZ: LO1611.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Schizophrenia and Pregnancy: The Tactics of Management
Authors: Lukmonov S. , Ruzieva G. , Nazarova I.
Published: June 2017

Purpose

The study of literature data of the treatment of pregnant women with schizophrenia and making recommendations on the management of this category of patients.

Methods

Theoretical analysis of a number of scientific works of foreign researchers, which studied questions of application of psychotropic drugs in patients with schizophrenia during pregnancy.

Discussion

The important source of problems for patients with schizophrenia is a protection against pregnancy. The number of children born in mentally ill mothers has increased at least three times. Hereditary factors in children born from two parents with schizophrenia plays, an important role: approximately 46–68% of these children may develop schizophrenia. In studies on psychotic means, there were no increase in number of anatomical anomalies or deviations in the development associated with this treatment. Low doses do not have a deleterious effect on fetal body weight, duration of pregnancy, fetal or neonatal mortality, as well as the frequency of malformations and deformities. Neither oral nor deposited anti-psychotic drugs are not associated with malformations and malformations of the fetus.

Conclusion

(1) The drugs should be administered at the lowest effective dose for the shortest possible time and decrease in the dose during the last days before the birth. (2) Pregnant women with acute psychotic disorders are dangerous, both for herself and for the child. (3) After the birth due to high risk of recurrence or exacerbation of schizophrenia taking anti-psychotic drugs should be in full dose.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Cannabis Use in a First Onset Psychosis Sample: Prevalence and Clinical Differences in Relation to Age of Onset
Authors: Pardo M. , Matalí J. , Butjosa A. , Regina V. , Dolz M. , Usall J.
Published: June 2017

Introduction

There is a wide range of studies focusing on the use of cannabis in first episode psychosis (PEP). Literature using child and adolescent samples is scarce.

Objectives and aims

To determine the prevalence and clinical differences between cannabis users and non-cannabis users of early onset first episode psychosis (EOP), and adult onset first episode psychosis (AOP).

Method

One hundred and forty patients were recruited in adult (AOP subsample, n = 69) and child and adolescent (EOP subsample, n = 71) mental health services. The Positive and Negative Syndrome Scale was used for psychotic symptoms and the Calgary Scale for affective symptoms. The Chi2 test analysed clinical differences between users and nonusers within subsamples, and in the total sample a Pearson correlation was used for the relationship between age at cannabis use and PEP.

Results

The prevalence of lifetime use of cannabis and the average age at first use were 48% and 13.82 years (± 1.15) in the EOP subsample, and 58% and 17.78 years (± 3.93) in the AOP subsample. Within EOP, cannabis users were older (P = .001), had fewer negative symptoms (P = .045) and less depressive symptoms (P = .005). Within AOP, cannabis users were younger (P = .018) and had greater severity of positive symptoms (P = .021). Age at first cannabis use and age at PEP were positively correlated.

Conclusions

Cannabis use is prevalent in adult and early onset psychosis. Cannabis users differ clinically from non-users, and the earlier the use of cannabis, the earlier the onset of psychosis.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Efficacy and Tolerability of Aripiprazole Intramuscular as Maintenance Treatment in Patients with Paranoid Schizophrenia
Authors: Serván B. , Montes A. , Machín M. , Gómez P. , García-Albea J. , González S. , Ibáñez J. , Morón M.D.
Published: June 2017

Introduction

Patients suffering from paranoid schizophrenia, require long-term anti-psychotic treatment, which provide, in addition to adequate efficacy both positive and negative symptoms, a good safety and tolerability profile that would ensure adequate adherence to prevent relapse.

Objectives

To analyze the efficacy, tolerability and therapeutic adherence over a year after the introduction of aripiprazole depot in patients diagnosed with paranoid schizophrenia previously treated with other oral or depot anti-psychotics [1,2,3].

Methods

One-year prospective longitudinal study with a sample size of 23 patients diagnosed with schizophrenia in outpatient treatment. Study variables (baseline, 6 and 12 months): Brief Psychiatric Rating Scale (BPRS), clinical global impression (CGI), mean dose of aripiprazole depot, previous treatments, adherence, relapse rate, prolactin levels, sexual dysfunction, BMIs.

Results

Twenty-three patients (71% men, 29% women) diagnosed with paranoid schizophrenia were identified. Improvement was obtained in the different study variables with statistically significant difference (P ≤ 0.05).

Conclusions

Following the introduction of aripiprazole depot in patients diagnosed with schizophrenia previously treated with other oral or depot anti-psychotics in our study, we conclude that maintaining therapeutic efficacy a better tolerability and safety profile, better therapeutic adherence and consequently lower relapse rate were achieved.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Investigation of Salivary Cortisol Response to Awakening in Underweight and Weight-Restored Patients with Anorexia Nervosa
Authors: Pellegrino F. , Monteleone A.M. , Nigro M. , Ruzzi V. , Cimino M. , Volpe U. , Monteleone P.
Published: June 2017

Introduction

Anorexia nervosa (AN) is characterized by dysregulated eating that leads to chronic malnutrition, which may be responsible for several physical complications, including endocrine alterations, such as hyperactivity of the hypothalamus-pituitary-adrenal (HPA) axis.

Objectives

Several studies have shown a dysregulation of the cortisol awakening response (CAR) in symptomatic AN patients. However, it has not been established if the deranged CAR of underweight AN patients is a primary phenomenon or an alteration secondary to malnutrition.

Aims

The aim of this study was to explore the salivary CAR in both underweight and weight-restored patients with AN.

Methods

We recruited 59 women: 18 undernourished AN patients, 15 weight-restored AN women and 26 normal-weight healthy controls. Saliva samples were collected in the morning, immediately after awakening and after 15, 30 and 60 minutes, in order to measure saliva levels of cortisol. Participants filled in the state-trait anxiety inventory (STAI) to test their anxiety levels in the morning of the test.

Results

Compared to healthy controls, underweight AN patients showed an enhanced CAR whereas the weight recovered patients had a normal CAR. These results were not correlated with levels of anxiety.

Conclusions

For the first time, our results demonstrate that the deranged CAR found in acute AN patients is not present in weight-restored ones, suggesting that altered activity of the HPA axis of symptomatic AN patients is a state-dependent phenomenon.

Disclosure of interest

The authors have not supplied their declaration of competing interest.