bluuebunny/crossref_metadata_2025 huggingface dataset:
Loxapine for agitation in Psychiatric Patients Who Consult in Emergency Medical Services
Authors: Carrillo M.Á. , Martínez M.J. , Botías P. , Imbernón I. , Martínez-Carlón M. , Fueyo M. , Calero C. , Megias N. , Pina S. , Gavilan M. , Sanchez M.P. , Sanchez J. , Chacon P.
Published: May 2016

Introduction

The DSM-5 defines psychomotor agitation as excessive motor activity associated with a feeling of inner tension. The activity is usually nonproductive and repetitious and consists of behaviors such as pacing, fidgeting, wringing of the hands, pulling of clothes, and inability to sit still. This kind of behavoir occurs in up to 25% of psychiatrics patients who consult in emergency medical services.

Objective

The main objective was to determine the efficacy of loxapine inhalation powder in acute agitation.

Methods

Ten agitated psychiatric patients scored Positive and Negative Syndrome Scale – Excited Component (P aNSS-EC) baseline and ten minutes after the administration of aD aSUVE®.

Results

The efficacy of loxapine 10 mg in the acute treatment of agitation was established in a short-term (10 minutes).

Conclusions

Loxapine is the first and only orally inhaled medication for the acute treatment of agitation associated with psychiatrics disorders, which is a tool easy-to-use in emergency medical services.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Do we Know Why we indicate a Mechanical Restraint?
Authors: Pérez E.J. , Galindo L. , Grifell M. , Dinamarca F.N. , Chavarria V. , Salgado P. , Pérez V.
Published: May 2016

Introduction and objectives

Mechanical restraint is a therapeutic procedure commonly applied in acute units in response to psychomotor agitation. Its frequency is between 21 and 59% of patients admitted. These patients represent a risk to both themselves and for health workers. There are not clinical studies that compared if there are differences of the frequency of the specific indication for the mechanical restraint.

The aim of this study is to explore the differences of frequency of each indication of mechanical restraint on patients on the psychiatry acute and dual pathology units.

Material and methods

we reviewed retrospectively the informatics record of all the mechanical restraints made and the total discharges of the three acute care units and dual disorders of Neuropsychiatry and addictions institute of the Parc de Salut Mar de Barcelona, between January 2012 and January 2015. The episodes of mechanical restraint, the specific indications for them and the DSM-IV diagnostic were coded. Then, was calculated the frequency and proportion of mechanical retrains in the most common diagnostic groups. An ANOV a was performed:

– risk of self-aggressiveness;

– state of self-aggressiveness;

– risk of hetero- aggressiveness;

– state of aggressiveness;

– risk of psychomotor agitation;

– state of psychomotor agitation;

– acute confusional state;

– fall risk;

– risk reduction on therapeutic interventions;

– avoid pulling out of life support systems;

– facilitate administration of drug treatment;

– patient voluntarily requests it;

– high-risk of escape.

Results

The number of discharges analyzed was 4659 from which 838 had an episode of mechanical restraint associated.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Psychiatric Emergencies and admissions in Ciudad Real area. Statistic Study. a Reflection on use of Emergency Resources and admission Criteria
Authors: Martínez  arnaiz J. , García Blanco C. , Vallejo-Sánchez B.
Published: May 2016

Introduction

Ciudad Real is an area of approximately 500,000 inhabitants, with a University Hospital and several district hospitals. Psychiatric services and emergencies are centralized in the University Hospital. we analysed the totality of area admissions during 2014, establishing different categories according to ICD 10 diagnosis.

Objective

we want to compare different categories of patients who are admitted to hospital (severe mental illness versus non-severe mental illness), morbidity in different areas and readmission rates according to diagnosis.

aims

To establish a correspondence between attention and severity of psychiatric pathology, diagnostic criteria and how we manage both severe and non-severe mental illness and the repercussion in terms of assistance and pressure in psychiatric emergencies.

Methodology

initially, we made a simple statistic analysis of all admission (400 approximately) in 2014 based on ICD-10 diagnosis, socio-demographic parameters, area, admission stay, number of admissions. we compare both groups: severe and non-severe mental illness according to international criteria. we apply a Pearson correlation searching for relation between severity and attendance to psychiatric emergencies.

Results

around a 60% of admissions are not due to severe mental illness, these conditions have twice the readmission rate than severe mental illness. we did not find a correlation between attendance to psychiatric emergencies and severity of the condition. Other factors seem to have an important role in re-admissions.

Conclusions

Non-severe mental illness is consuming an important part of emergency psychiatric resources. Criteria of admission need to be reviewed or apply rationally.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Access To Mental Health And Immigration
Authors: Fuentes Márquez S. , Alonso Díaz R. , Cortázar Alonso E.
Published: May 2016

in the present study, we certain demographic variables of immigrants accessing specialized mental health care at two points in time: 2013 and 2014. According to the National institute of Statistics, the number of foreigners fell by 4% in 2013 and 3% in 2014 due to emigration and the acquisition of Spanish nationality. Among the objectives of the department of health is collected to ensure the right to health protection to immigrants through effective access to the health system and improve management capacity and performance of health centers in diverse contexts.

Results

Despite the overall decline in foreign an increase in first consultations requested for immigrants was observed. At both time points, higher demand for foreign women is observed. With respect to age greater demand seen in middle adulthood, however in 2014 there is a greater homogeneity with respect to this variable. The greatest demand comes from Morocco, Romania and Poland, although most Latin American countries are increasingly observed.

Conclusions

Better access and better quality health care to both the immigrant population and of citizens in amount from acceptance and commitment to this complex and diverse and its approach will be achieved.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Victimization of The Mentally Ill
Authors: El-Missiry A.
Published: May 2016

Background

Persons with mental disorders living in the community are liable for victimization and are considered as a high-risk group.

Objective

To explore the socio-demographic variables and clinical characteristics related to victimization of patients with schizophrenia in comparison to their non-victimized counterparts.

Subjects and methods

One hundred patients were recruited from the inpatient wards and outpatient clinics of the institute of Psychiatry, Ain Shams University. They were subjected to Structured Clinical interview for DSM-IV Axis I diagnosis (clinical version); Positive and Negative Syndrome Scale (PANSS); Global Assessment of Functioning (GAF); Clinical Global Impression (CGI); designed extensive questionnaire to elicit demographic data; inquiry about drug compliance and Victimization Questionnaire.

Results

Seventy patients of the studied sample were non-victimized and 30 patients were victimized. Victimized patients were significantly younger, living mainly in urban areas, had less frequent history of bullying at school. There were exposed significantly to higher frequency of family domestic violence and childhood abuse. They scored higher for all subscales and in total PANSS scores and they were less compliant on medication than did their non-victimized counterparts.

Conclusion

Studies of victimization of mentally ill did not draw the attention of researchers and clinicians in Arab world. This study proves that victimization is not uncommon among patients with schizophrenia; clinicians should include assessment for victimization of their patients as a routine work. The current study provides preliminary data for clinicians and policy makers to consider strategies to protect patients with various mental illnesses from being victimized.

Disclosure of interest

The author has not supplied his declaration of competing interest.
Study of Self-perceived Health in a Clinical Sample
Authors: Fernandez-Quintana A. , García-Mahía M.D.C.
Published: May 2016

Introduction

The assessment of self-perceived health provides an insightful clinical tool when it comes to addressing the subjective perception of social functioning, mental and physical health.

Objective

To analyze self-perceived health in patients treated in a primary care clinic and its relationship with other clinical and socio-demographic variables.

Methods

A randomized sample of 130 patients, aged 18 years or over, undergoing treatment in a primary care clinic was evaluated. Patients were interviewed following a self-perceived health scale as well as a scale for other clinical and socio-demographic variables. Clinical records were reviewed for prior psychiatric and somatic diagnoses.

Results

Overall, the prevalence of somatic disorders in our simple was 92.3%, whilst psychiatric disorders were present in 23% of patients. Only 6% of the sample reported their mental health to be affected to some degree, while 67% declared their physical health to be damaged. Forty-three percent of the sample follows prescribed psychopharmacological treatment. Women showed lower self-perceived health and reported more psychiatric symptoms in accordance with higher actual prevalences of psychiatric disorders. Among those patients with a psychiatric illness, only two reported the will to search for mental health care, whilst most would prefer consulting their general practitioner.

Conclusions

Less than half of the patients who have been diagnosed with a psychiatric disorder consider their mental health to be affected. Among those who do report a self-perceived mental health concern, the majority would prefer consulting their general practitioner rather than a psychiatrist.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Social-stress Disorder. What Does it Mean for the people?
Authors: Pityk O. , Pityk M. , Kuzhda I.
Published: May 2016

In 90th of 20 Russian psychiatrist Y.A. Alexandrovsky expressed opinion of presence the group of so-called social-stress disorders that was determined like psychogenic-actual for most people in definite social, economic and political situation.

Used the method of clinic-psychopathological interview with patients who applied outpatient psychological consultation on the chair of psychiatry.

The main changes in psychic state include following behaviors and clinical implications: loss of the value of human life, which is manifested in indifference to death in lowering caution when hazardous situations, willingness to sacrifice lives without any ideals. There is unrestrained lost for pleasure and moral promiscuity, exacerbation of personality typological traits, development of hyperstenic reactions (to self-destructive non-expedient behavior), hypostenic disorders, panic reactions, depression, dissociative and conversive irregularities, loss of communicational plasticity, loss of the ability to adapt to what happens with the preservation prospects of targeted actions, manifestations of cynicism, the tendency to antisocial actions. Patients had complaints on increase anxiety, pessimistic attitudes, existential vacuum, sense of uselessness and loss of perspectives, tendency to irrational perception of reality with including mechanisms of autistic and archaic thinking.

Thus, psychological status of the population of Ukraine is a model of social-stress disorder and can be considered like a basis, which leads to the decreasing of the individual barrier of mental adaptation with the next manifestation of different forms of psychological maladjustment.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Patients’ Needs as an Outcome Measure in Schizophrenia
Authors: Stefanatou P. , Konstantakopoulos G. , Giannouli E. , Ioannidi N. , Mavreas V.
Published: May 2016

Introduction

Outcome assessment has been highlighted as a crucial factor in the evaluation and transformation of mental health services, providing evidences for the improvement of clinical practice.

Objective

This is the first clinical study in Greece to investigate the relationship between the crucial outcome measures of needs, quality of life, disability and psychopathology for patients suffering from schizophrenia. Furthermore, service evaluation based on the assessment of the above outcome measures has never taken place in the country.

Aims

To examine the associations between the patients’ needs and other treatment outcome indicators:

– quality of life;

– disability;

– dimensions of schizophrenia symptomatology.

Method

The CAN-R, WHOQOL-BREF, WHODAS 2.0 and PANSS scales were administered to a sample of fifty-three schizophrenia patients and the correlations between the above outcome measures were computed.

Results

(1) Significant negative correlations emerged between the total number of needs and unmet needs and subjectively assessed quality of life. (2) Significant positive correlations emerged between the total number of needs and unmet needs and subjectively assessed disability. (3) Significant positive correlations were found between the dimensions of schizophrenia symptomatology (positive/negative/general) and the total number of needs in our sample.

Conclusion

According to our findings:

– as the number of unmet needs increases patients’ quality of life is lowered;

– a possible relationship exists between unmet needs and subjectively assessed disability;

– a possible relationship exists between needs and all the dimensions of schizophrenia symptomatology.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Values and Values Work in Cognitive Behavioral Therapy
Authors: Vyskocilova J. , Prasko J. , Ociskova M. , Sedlackova Z. , Marackova M. , Holubova M. , Hruby R. , Slepecky M.
Published: May 2016

Background

Values influence our thought patterns, emotions, wishes, and needs. Although individuals may be fully aware of their value systems, these often lie more or less outside the area of full consciousness. At least occasional awareness of one's priorities and set of values may be an effective means of self-regulation.

Method

Literature review and description of cases.

Results

Cognitive behavioral therapy is aimed at dealing with practical problems and goals in life through changes in cognitive processes, behavior, and emotional reactions. Changes to some values naturally accompany changes to these processes. Life values also underlie motivation to achieve therapeutic changes. For this reason, clarification of patients’ life values is important to therapists as focusing on values aids in connecting therapeutic goals with important areas of life. In addition to a better understanding of patients’ life stories and difficulties that have brought them to a psychotherapist, the identified value system may become a part of everyday CBT strategies such as time management, cognitive restructuring or accommodation of conditional assumptions.

Conclusion

Identification and assessment of life values and their use in the course of therapy is a process that increases patients’ motivation to face unpleasant emotions and make careful steps in CBT in order to achieve therapeutic goals. Knowing the patient's life values may help the therapist set therapeutic goals that are associated with significant areas of the patient's life. Together with other CBT techniques, this value-oriented approach increases the effectiveness of therapy and durability of its outcomes after its completion.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Euthymia is not always euthymia: Clinical status of bipolar patients after 6 months of clinical remission
Authors: Samalin L. , De chazeron I. , Reinares M. , Torrent C. , Bonnin C.D.M. , Hidalgo D. , Murru A. , Pacchiarotti I. , Bellivier F. , Llorca P.M. , Vieta E.
Published: May 2016

Introduction

Most studies selected euthymic patients with bipolar disorder in inter-episodic phase according to clinical remission criteria at least between 1 and 6 months. However, possible differences can exist in the course of clinical symptoms in bipolar patients related to the duration of clinical remission.

Objectives

The main aim of this study was to evaluate the clinical status of bipolar patients after 6 months of clinical remission.

Methods

We performed a cross-sectional study of bipolar outpatients in clinical remission for at least 6 months. Bipolar Depression Rating Scale (BDRS), Young Mania Rating scale, Pittsburgh Sleep Quality Index (PSQI) scale, Visual Analogic Scales (VAS) evaluated cognitive impairment were used to assess residual symptomatology of patients. Multivariate analysis (MANCOVA) was conducted for analysing possible differences between 3 groups of patients according to their duration of clinical remission (< 6 months–1 year, < 1 year–3 years, < 3 years–5 years).

Results

A total of 525 patients were included into the study. The multivariate analysis indicated a significant effect of the duration of clinical remission on the different residual symptoms (Pillai's trace: F 4.48, P < 0.001). The duration of clinical remission was associated with the significant improvement of the BDRS total score (P = 0.013), the PSQI total score (P < 0.001) and the cognitive VAS total score (P < 0.001)

Conclusion

These results support a possible improvement of residual symptoms according to the duration of clinical remission in bipolar patients. Any definition of euthymia should specify the duration criteria.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Effectiveness of Paliperidone Depot in Seriously Violent Men With Comorbid Schizophrenia and Dissocial Personality Disorder in a Uk High-Security Hospital
Authors: Mortlock A.M. , Larkin F. , Ross C. , Sengupta S. , Das M.
Published: May 2016

Introduction

High-security hospital patients are often complex in presentation characterised by treatment resistance, medication non-concordance and history of violence. Paliperidone is licensed as both an oral and depot antipsychotic for the treatment of schizophrenia. Whilst there is data for the effectiveness of paliperidone palmitate (PP), there are no studies involving patients in forensic settings or those with comorbid personality disorder.

Objective

To determine the effects of PP on violence, aggression and personality pathology.

Aim

To evaluate the clinical effectiveness of PP.

Methods

This was a retrospective service evaluation involving 11 patients. Medical records and interviews with the treating psychiatrist were used to formulate clinical global impression (CGI) and to identify incidents of violence. The effect on personality symptom domains; cognitive-perceptual, impulsive-behavioural dyscontrol and affective dysregulation was ascertained, as well as engagement with occupational and psychological therapies.

Results

Six patients were being prescribed PP. All 6 showed improvement in the CGI score with benefits in the symptom domains. Two patients demonstrated a reduction in violence risk and 2 remained incident-free. There was improvement in engagement with therapies. Benefits were also seen in aspects of personality for those who had discontinued PP.

Conclusions

This pragmatic study of a small but complex patient group demonstrated that PP was effective in reducing symptoms of schizophrenia. Additionally and for the first time, it was shown that PP was also effective in reducing violence as well as improving personality pathology dimensions in a comorbid patient. This could have significant implications for management of high-security patients.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
When a Man Loves a Woman: a Case of Erotomania in the 21st Century
Authors: Rodrigues C. , Andrade M. , Palma V. , Cardoso C.
Published: May 2016

Introduction

Erotomania, or De Clerambault's Syndrome, was first described in 1921. However, cases of Insane Love were long known before. Presently, this condition is classified as a delusional disorder typically affecting women. However, in forensic samples, most of these reports relate to men with violent behaviour, associated to harassing or stalking of a woman.

Objective

To present the case of a man, diagnosed with Erotomania and literature review of similar cases.

Aim

To bring awareness to the infrequent diagnosis of this condition in males and the legal implications this condition may have.

Methods

Consultation of the patient's clinical process and published articles focusing on Erotomania in men.

Results

A 50-year-old man was referred from Court for persistently stalking a woman on the past few years. He revealed erotomanic and persecutory delusions, believing these accusations were all part of a scheme to restrain his alleged relationship.

There was a clinical improvement during hospitalization and treatment with antipsychotics. Due to the legal process in court, a forensic examination was also performed.

Conclusions

On the follow-up, the patient remained stabilized. He would not verbalize any delusional content, and calmly deny any inadequate behaviour. However, some of his stalking attitude remains. As many of these patients, we believe his delusion is still present, although his behaviour is more controlled with treatment. Recognizing the characteristics and course of this disorder in our patients, grants a better chance of intervention and attentiveness towards the legal implications that may arise.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Continuities and Discontinuities Between Psychopathy and Narcissism Among Male Offenders
Authors: Velotti P. , Garofalo C. , D’Aguanno M. , Rogier G.
Published: May 2016

Introduction

A heated and longstanding debate exists as to whether psychopathy and narcissism represent two distinct, albeit overlapping, constructs, or two different labels for the same concept. However, relatively scant attention has been dedicated to this issue in offender populations, which are likely to present elevated levels of both psychopathy and narcissism. Furthermore, the picture is complicated by the multidimensional nature of both constructs.

Objective

We sought to explore the associations among psychopathy facets and pathological narcissism dimensions, comparing an offender sample with community participants.

Aims

To highlight similarities and differences in clinically relevant and sub-clinical levels of psychopathy and narcissism dimensions, as well as in pattern of associations between them.

Methods

A sample of male offenders incarcerated in Italian jails, and a sample of community-dwelling men, were administered the Self-Report Psychopathy Scale (SRP-4; Paulhus et al., 2015) and the Pathological Narcissism Inventory (PNI; Pincus et al., 2009).

Results

As expected, levels of both narcissism and psychopathy were significantly higher in the offender sample. Narcissism and psychopathy were only partly related, with correlations ranging from low to moderate in size, and differential pattern of associations between selected dimensions emerged consistently with theoretical models and in line with prior studies.

Conclusions

Psychopathy and narcissism are two separate syndromes, which share similar aspects but also present distinct features and this is likely to explain their partial overlap. Future studies should take a closer look at how facets of psychopathy and narcissism relate across different samples (e.g., also examining female offender samples).

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Dealing With Shame – the ‘psychopathic Way’: Preliminary Investigation for a New Developmental Framework of Psychopathic Traits
Authors: Velotti P. , D’aguanno M. , Garofalo C. , Rogier G.
Published: May 2016

Although individuals with psychopathic traits are deemed as immune to emotional experiences, in recent year, some authors have advanced the hypothesis that a pervasive pattern of emotion dysregulation may characterize the developmental trajectories leading to a psychopathic personality structure. Shame has been proposed as crucial emotions to understand psychopathy. It has been argued that people, who often experience shame feelings during their childhood, may develop adaptive strategies to cope with them, which lead to maladaptive strategies to regulate shame feelings in adulthood. These maladaptive strategies may explain the increased likelihood for these individuals to violence when feeling ashamed. Whether these mechanisms may also explain the presence of high psychopathic traits remains a clinically valid theoretical hypothesis, which lacks empirical support.

Objective

To investigate whether maladaptive strategies to cope with shame feelings were associated with psychopathic traits.

Aims

To examine the association between four maladaptive shame coping were positively related with psychopathic traits.

Methods

A sample of male offenders incarcerated in Italian jails completed the Self-Report Psychopathy Scale (Paulhus et al., 2015) and the Compass of Shame Scale (Elison et al., 2006).

Results

As hypothesized, maladaptive shame regulation strategies did predict psychopathic traits in the offender sample examined. Specifically, significant and meaningful associations occurred between avoidance and attack other coping styles and psychopathic traits.

Conclusions

The present study is among the first in providing evidence of a possible relationship between maladaptive strategies to cope with shame feelings and psychopathic traits, and such link can be informative to tailor treatment programs for these hard-to-treat patients.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Catatonia and Dementia
Authors: Almeida M. , Gama Pereira C.
Published: May 2016

Introduction

Catatonia, described by Kahlbaum in 1874, is usually seen as a type of schizophrenia, but it can also occur in a wide range of other psychiatric/organic disturbances. There is a documented association between dementia and catatonia, in all phases of cognitive impairment.

Aims

Literature review and discussion about Catatonia, regarding a case report.

Methods

Clinical interviews and literature review in PUBMED database.

Results (case report)

Female patient, 89 years old, without psychiatric history, was diagnosed with dementia 5 months prior to episode. On admission, she presents with prostration, mutism and refusal to eat/drink. Laboratory studies were normal and TC-CE shows signs of an old stroke in left temporo-parietal region and diffuse signs of ischemic leucoencephalopathy. At psychiatric evaluation, she was stuporous, unreactive to pain, mute, not following verbal commands, keeping her eyes closed and resisting attempts to open her eyelids. She had global rigidity, axial and limbs, and maintains the postures the examiner puts her into for long periods. She was already given chlorpromazine, without improvement. Then she takes diazepam 10 mg iv, with remission of the state.

Conclusions

Although catatonia usually presents with drama, clinicians often forget to consider it in differential diagnosis, probably because of its traditional association with schizophrenia. A promptly diagnostic is crucial to provide adequate treatment, avoiding drugs that can worsen/perpetuate the clinical state. Some authors even support the idea that motor features associated with end-line dementias may correspond to lorazepam-responsive catatonia, in which treatment may have a tremendous impact worldwide.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Syndrome of Inappropriate Antidiuretic Hormone Secretion Associated with Desvenlafaxine
Authors: García Fernández E. , Ramos García D.M.I.
Published: May 2016

Introduction

Desvenlafaxine is a prescription medication approved for the treatment of major depressive disorder in adults. Hyponatremia secondary to inappropriate secretion of antidiuretic hormone (SIADH) is a possible side effect in patients receiving serotonin-norepinephrine reuptake inhibitors (SNRIS)

Method

To report a case of SIADH associated with desvenlafaxine.

Results

We present a 80-year-old female patient who required hospitalization due to an episode of psychotic depression. During the hospitalization, the patient developed hyponatremia after commencing treatment with desvenlafaxine. The serum sodium at this time was 117 mmol/L, serum osmolality was 249 mosmol/kg, urine osmolality 395 mosmol/kg and urine sodium 160 mmol/L, consistent with a diagnosis of SIADH. Desvenlafaxine was ceased and fluid restriction implemented. The mental status improved, and electrolyte studies 6 days later revealed serum sodium and osmolality values of 135 mEq/L during treatment with duoxetine.

Conclusions

SIADH has been reported with a range of antidepressants in elderly patients. This case report suggests that desvenlafaxine might cause clinically significant hyponatremia. Close monitoring is recommended in patients starting therapy with antidepressant treatment to study and prevent possible adverse effects.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Sensory processing patterns, coping strategies, and quality of life among patients with major affective disorders
Authors: Engel-Yeger B. , Serafini G. , Gonda X. , Pompili M. , Amore M.
Published: May 2016

Introduction

Several studies suggested the involvement of sensory perception in emotional processes and major affective disorders. Similarly, cognitive capacities and coping strategies are reported to influence quality of life of patients with unipolar and bipolar disorders.

Objectives

The main objective of this study was to investigate the nature of the association between sensory processing patterns, coping strategies, and quality of life among patients with major affective disorders.

Aims

The study aimed to compare unipolar/bipolar patients concerning sensory processing, coping strategies and quality of life (QOL); examine correlations between sensory processing and QOL; investigate the relative contribution of socio-demographic characteristics, sensory processing, and coping strategies to the prediction of QOL.

Methods

Two hundred and sixty-seven participants, aged 16–85 years (mean = 53.6 ± 15.7), 157 diagnosed with unipolar major depressive disorder and 110 with bipolar disorder type I and type II completed the Adolescent/Adult Sensory Profile, Coping Orientations to Problems Experienced, and Short Form 12 Health Survey 2.

Results

The unipolar and bipolar groups did not differ concerning sensory processing, coping strategies, and QOL. Sensory processing patterns correlated with QOL independently of the mediation by coping strategies. Correlations between low registration, sensory sensitivity, sensation avoidance, and reduced QOL were found more frequently in unipolar patients than bipolar patients. Elevated physical QOL was mainly predicted by lower age and lower sensory sensitivity whereas elevated mental QOL was mainly predicted by coping strategies.

Conclusions

Future studies should further investigate the impact of sensory processing and coping strategies on patients’ QOL to enhance adaptive and functional behaviors related to affective disturbances.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Psychotherapy for Adhd in People with Idd
Authors: Elstner S.
Published: May 2016

Introduction

Psychopharmacology and psychotherapy in children with ADHD is still well established and has been studied for many years. There has been a growing interest in treatment of ADHD in adults for some years. Whereas meanwhile the psychopharmacological treatment is well studied, the psychotherapeutic interventions are still to optimize.

Objective

Since the acceptance of the diagnosis of “ADHD” in adults, there has been a growing interest in using medication as the first-line therapy. There is an established evidence base for psychopharmacological treatment in ADHD. The current therapeutic recommendations for the general population apply to people with ADHD and IDD. The study is a review of psychotherapeutic interventions in the treatment of ADHD in adults with and without IDD supported by a case study.

Methods

A literature search was conducted in “Pubmed” and “PsycInfo” using the keywords “Psychotherapy”, “ADHD”, “Adults” and further “Psychotherapy”, “ADHD”, “Adults”, “intellectual”, “disabilities”. Exclusion criterion was ADHD as a sub-syndrome in the presence of other syndromes.

Results

Only 2–3 publications on psychotherapy in adults with ADHD were found. Very little was found on people with IDD, and these were especially combined with the Fragile X Syndrome.

Conclusion

Psychotherapy in adults with ADHD is not yet well elaborated in the scientific literature. There are some common used intervention strategies like psycho-education, cognitive behavioural therapy, and attention focusing interventions such as mindfulness-strategies. Using the principles of Easy-to-Read language and modifying the general therapeutic settings as recommended by NICE, an adaptation of these interventions in the treatment of adults with ADHD and IDD has potential.

Disclosure of interest

The author has not supplied his/her declaration of competing interest.
Can Physician Incentives Improve Continuity of Care For Patients Receiving Depression Treatment in the Primary Care Setting?
Authors: Joseph P. , Kazanjian A.
Published: May 2016

Introduction

In 2008, the province of British Columbia, Canada introduced financial incentives to encourage general practitioners (GPs) to assume the role of major source of care for patients seeking mental health treatment in primary care. If successful, this intervention could strengthen GP–patient attachment and consequently improve continuity of care. The impact of this intervention, however, has never been investigated.

Aim

To estimate the population level impact of physician incentives on continuity of care (COC).

Method

This retrospective study examined linked health administrative data from physician claims, hospital separations, vital statistics, and insurance plan registries. Monthly cohorts of individuals with depression were identified and their GP visits tracked for 12 months, following receipt of initial diagnosis. COC indices were created, one for any visits (AV) and another for mental health visits (MHV) only. COC (range: 0–100) was calculated using published formula that accounts for the number of visits and number of GPs visited. Interrupted time series analysis was used to estimate the changes in COC before (01/2005–12/2007) and after (01/2008–12/2012) the introduction of physician incentives.

Results

The monthly number of people diagnosed with depression ranged from 7497 to 10,575; yearly rates remained stable throughout the study period. At the start of the study period, mean COC for AV and MHV were 75.6 and 82.2 respectively, with slopes of –0.11 and –0.06. Post-intervention, the downward trend was disrupted but did not reverse.

Conclusions

Physician incentives failed to enhance COC. However, results suggest that COC could have been worse without the incentives.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Preliminary Evaluation of the Italian Version of the Inspire Measure of Staff Support for Personal Recovery
Authors: Ratti N. , Mattioli B. , Mellini L. , Negri I. , Mastrocola A.
Published: May 2016

Introduction

Supporting personal recovery has become the main aim for mental health services in many countries nowadays. In particular, the relationship between individual service users and staff members can be the key issue in supporting recovery and this requires specific measures in order to identify and evaluate the orientation of services in this process of change. INSPIRE is a standardized questionnaire developed by King's College, London that represents a service user-rated measure of staff support for personal recovery in the UK.

Objective

Although there is a number of instruments aimed at monitoring recovery in the clinical and functional features, there is still lack of measures for personal recovery and recovery orientation of services in the Italian background.

Aims

The aim of this study is to evaluate the psychometric properties of the Italian version of INSPIRE as it is applied in the Italian mental health services.

Methods

Two rounds of data were collected from a sample of 79 inpatients and outpatients of rehabilitation centers and consultant service of the municipality of Ravenna. Analysis was undertaken using SPSS. The main issues investigated were internal consistency, test-retest reliability and exploratory factor analysis.

Results

The results in the present studies indicate that the Italian version of the INSPIRE measure had a very good internal consistency and a satisfactory test-retest reliability.

Conclusions

While further studies testing the instrument in larger and more diverse clinical contexts are needed, INSPIRE can be considered a relevant and feasible instrument to use in supporting the development of a recovery-oriented system in Italy.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Prevalence and determinants of common fears in children and their socio-demographic characteristic
Authors: Bener A.
Published: May 2016

Objective

Most children experience some degree of fear during their development. Excessive fears can create serious obstacles to children. The aim of this study was to identify the most common fears in a sample of children and adolescents and examine the socio-demographic correlates of fears.

Subjects and methods

This cross-sectional study was conducted during the period July 2010 to February 2012 at Public and Private Schools of the Ministry of Education and Higher Education, in Qatar. Out of 2188 students approached, 1703 students agreed to participate in this study, with a response rate of 77.8%. The questionnaire includes socio-demographic information, academic performance, behaviour at home and various fears.

Results

More than half of the children experienced fears (56.7%). Most of them were in the intermediate level, 12–15 years old (46.1%). Overall, reported fears were significantly more frequent in girls (62.6%) than boys (37.4%) (P < 0.001). A significant difference was observed between girls and boys who experienced fears in their age group (P < 0.001), education of mother (P = 0.04), household income (P = 0.008) and academic performance (P < 0.001). The most frequent reported fears were fear of someone dying in the family (85.2%), parents getting divorced (84.5%), breaking religious law (82%), being kidnapped (78.2%), family members ill (78%) and dying (76.7%).

Conclusions

The study findings revealed that fears were highly prevalent in Arab children and adolescents in Qatar. Girls reported more fears than boys. There was a significant difference observed between girls and boys in their age group and academic performance for the reported fears.

Disclosure of interest

The author has not supplied his/her declaration of competing interest.
Early Intervention In Psychosis In Hospital Santa Ana AGS. A Transcultural Vision
Authors: Girela Serrano B. , Guerreron Jiménez M. , Carrillo de Albornoz Calahorro C.M. , Rodrigo Manzano J.A. , Martínez García O.B.
Published: May 2016

Introduction

The aim of this paper is to study the profile of Moroccan users to contextualize interventions and to identify if specific requirements are observed.

Methods

A descriptive statistical analysis of sociodemographic and clinical variables are performed to acknowledge the differences between Moroccan users (n = 6) compared to the group of Spanish users (n = 12).

Results

The following was found in the Moroccan users: the average age was 7 years higher. The percentage of Toxic abuse was slightly higher (83% vs 75%), although in comparison to the Spanish users the Moroccan users had double the percentage of patients treated in the Addictions center.

There were no significant differences in the duration of untreated psychosis (DUP) and in the duration of untreated illness (DUI). According to the referral, the Moroccan users were better detected in Primary care (50%/8%).

Regarding the PANSS negative symptoms predominated in Moroccan (45/20 percentile) and general psychopathology (65/35 percentile).

In the Social Functioning Scale (SFS), there are only differences in Autonomy Execution (T score = 104/T = 92).

The Family Questionnaire (FQ) shows that families reported greater frequency and discomfort of symptoms and the user as less capable of controlling themselves. Finally, the Global Assessment of Functioning (GAF) offers an average of nearly 15 points lower.

Discussion

The training area stands out as a handicap in the rehabilitation process. Clinically negative symptoms and general discomfort are factors that limit the overall functioning. More specific interventions are also required for the families of these users.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Portuguese Junior Doctors Exchanging in the Uk – Reflections From the Experience
Authors: Salgado H. , Pinto da Costa M. , Walker H. , Powell J. , Potter L. , Ryland H. , Kjellstenius A. , Feteanu C.
Published: May 2016

Introduction

The interest in experiencing training abroad has grown and its benefits have been progressively recognized. For these reasons, several psychiatric trainees seek to extend their competencies, skills and knowledge through these exchange opportunities, such as the European Federation of Psychiatric Trainees (EFPT) Exchange Programme.

Objectives

With this work we intend to describe these international experiences of being acquainted with a different health system and psychiatry training programme.

Aims

Reflect on the impact of these experiences, considering on how these can be used to benefit the patient care provided across countries, further to the professional and personal individual benefits that colleagues gain.

Methods

Presenting the testimonials of junior doctors from abroad that have had the opportunity to observe and collaborate in the current system of the United Kingdom.

Results

The EFPT Exchange Programme is an excellent opportunity for psychiatry trainees to share experiences, knowledge and good practices. The cultural and social framework of psychiatry certainly has an impact on the approach to mental health problems, and being knowledgeable of these differences can provide benefits not only to the junior doctors who complete these exchanges abroad, but also to their colleagues working at their hosting institutions that become acquainted with different realities through their presence and feedback.

Conclusions

The benefits of these exchange mobility experiences are unequivocal. Therefore, it is fundamental to share these experiences and promote these opportunities.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Where to Be in 5 Years? Brain Drain of Psychiatric Trainees – Case of Albania
Authors: Tomori S. , Pinto da Costa M. ,   European Federation of Psychiatric Trainees
Published: May 2016

Introduction

The brain drain of psychiatrists is considered as a mental health care damaging phenomenon in low- and middle-income countries. Albania currently has one of the world's highest emigration rates, relative to its population and a total emigrant population of more than 1.25 millions in 2014. More than 50% of the lecturers and researchers in Albania left the country during 1991–2005. Nevertheless, the data on healthcare workers migration is very limited.

Objectives

Assessing the migration profile and migratory trends of psychiatry trainees in Albania as part of EFPT Brain Drain study in Europe.

Methods

Data collection was accomplished by an anonymous online survey and hard-copy questionnaire in University Hospital Center “Mother Teresa”, to all psychiatric residents in Psychiatric Clinic in Tirana, during May–October 2013.

Results

More than 2/3 respondents are very dissatisfied with their income but the main reasons for leaving the country are personal and family composition. A minority did have a short term or long term experience abroad respectively 8,3% and 16.7% during which 50% of them considered to have the same opportunities as the locals. A total of 66% of residents consider leaving the country after the residency training.

Conclusions

Losing large numbers of skilled psychiatrists contributes to decreasing of quality of mental health services. Since it can be considered “brain waste” in terms of a loss of investment into human resource development, Albania needs to establish policies to promote returnees.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
A Brief Exploration of the Psychological Support Available for Cancer Victims/Survivors and Relatives in Health System in Riga, Latvia
Authors: Kumar S. , Stengrevica E.
Published: May 2016

Introduction

In Riga, Latvia, people who have been diagnosed with cancer at various stages, are not offered any group or individual psychological intervention. This applies for the immediate relatives as well.

Aim

The aim of the study was to collate a homogenous understanding of the resources and standards of extant practice in psychological needs of patients and their family diagnosed with cancer. Further aims include to identify any deficiencies in the service delivery and make appropriate recommendations.

Method

The collective survey tool is devised to reflect the psychological needs of the aforementioned patients were devised by the authors, one a practicing psychiatrist in UK and the other with background in group work and support in Riga. The tool extended to ask coping skills, understanding, impact on relationship, work and general well-being of patients and carers and their family members alike. The collated survey was distributed and results collated.

Discussion

The results of the survey indicate number of deficiencies in the organization and service delivery. There is also a huge lack of psychological support to family members who have been affected by a diagnosis of cancer or loss to cancer in the family. We also discuss means of improving service delivery in groups for this sample.

Disclosure of interest

The authors have not supplied their declaration of competing interest.