bluuebunny/crossref_metadata_2025 huggingface dataset:
Early Adversity, Symptoms of Depression and Breastfeeding
Authors: Jonas W. , Fleming A. , Steiner M. , Meaney M.J. , Atkinson L. , Mileva V. , Sokolowski M. , Kennedy J.
Published: June 2017

Backround

There is considerable variation in the prevalence of breastfeeding, which allows for investigation of factors that influence the initiation and duration of breastfeeding and its association with well being of the mother infant dyad.

Aims

To better understand factors that influence (1) maternal breastfeeding status and (2) the “effects” of breastfeeding on mothers and infants.

Methods

Participants (n = 170) derive from a longitudinal Canadian study “Maternal Adversity, Vulnerability and Neurodevelopment (MAVAN)”, a project designed to understand the pre- and postnatal influences on maternal health and child social-emotional development. Mothers provided data on breastfeeding status, early life adversity, oxytocin gene and oxytocin gene receptor polymorphisms, depression/anxiety, infant temperament and maternal sensitivity.

Results

Early life adversity associated with a shorter breastfeeding duration and higher maternal depression levels. The relation between mothers’ early adversity and the duration of breastfeeding was mediated by mothers’ depression level, but only in women carrying one variant of the oxytocin rs2740210 gene marker (CC genotype). Mothers who breastfeed at 3 months acted more sensitively towards their infants when they were 6 months old and they in turn had infants who at 18 months showed reduced negative affectivity.

Conclusion

Women who have been exposed to early adversity are “living with the past” and they are, to certain extent, protected or more vulnerable to depression, depending on their genotype. Breastfeeding associated with higher maternal sensitivity, which associated with decreased negative emotionality in the infant at 18 months. Our results help to clarify associations between early life experiences, breastfeeding, and the mother-infant relationship.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Music Orchestrating Health Feelings and Senses Given to the Music Present at the Hospital During Hemodynamic Procedures: Cardiac Catheterization and Coronary Angioplasty
Authors: Paiva S. , Rezende F. , Moreira J.
Published: June 2017

Several studies indicate that music has soothing effects and is effective for reducing stress and anxiety in coronary patients. The effects of stress on the cardiovascular system have also been proven. However, the meanings assigned to music when used during hemodynamic procedures are unknown, as are the meanings of the experience of these procedures. The aim of this research is to understand the senses and feelings of music for patients undergoing hemodynamic procedures, identify and interpret the fantasies and emotions related to, and study the possibility of deploying in hospitals the “Musical Method for Hemodynamic Procedures”, being developed by the author. This research is based on a clinical-qualitative methodology. The sampling method is the theoretical saturation. The semi-structured interview was used in order to obtain data that was submitted to content analysis. The subjects are patients undergoing hemodynamic procedures in hospital SEMPER, Brazil. We conclude that within the experience of listening to music while undergoing catheterisation 100% of the patients claimed they had overcome the experience of stress and felt calm, tranquillity, peace and happiness. Some patients described the music as a companion, as something that diverts their attention from fear, transporting them to an imaginary place, to another dimension. The episodic memory, the capacity to recognize a musical excerpt for which the spatiotemporal context surrounding its former encounter can be recalled, was also important, with surprising results in the case of patients who underwent catheterisation in the presence of music and, later, angioplasty without the presence of music.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Why do I Have to Die Twice? EMDR Treatment After Experience of Clinical Death
Authors: Softic R. , Becirovic E. , Mirkovic Hajdukov M.
Published: June 2017

Background

Clinical death is etiologically non-specific state of reversible cessation of blood circulation and breathing, the two necessary criteria to sustain life. Serious consequences in form of anxiety and/or depression can remains after recovery.

Case report

Male patient 55 y/o with no prior history of psychiatric difficulties, who experienced clinical death after cardiac infarction. Reanimation was successful and he was discharged with minimal if any cardiac consequences. During the hospitalization in Coronar unit he reacted with major depression, and aftermath with disabilitating anxiety and panic attacks followed by avoidant behavior, obsessive thoughts, social withdrawal, and consequently, very poor quality of life, regardless of the favorable outcome of somatic (cardiac) illness. The patient did not wanted psychiatric medications, so EMDR treatment was introduced. We assess negative cognition: why do I have to die twice? “Subjective unit of disturbance regarding the traumatic event (SUD) was 9”. Adhering to the EMDR protocol, the therapist helped the patient to re-process the traumatic event (the very moment when he was told that “he was died”). Complete desensitization and reprocessing were accomplished, SUD was 0, VoC was 7. Patient reached pre-morbid level of psychosocial functioning, doing his demanding job, and enjoying his social life.

Conclusion

Near death experience has high traumatic potential with serious psychological consequences. EMDR is efficious treatment for variety of anxiety disorders caused by psychologic trauma due to physical illness.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
ICD-11: Example of Psychotic Disorders
Authors: Gaebel W.
Published: June 2017

The revision of the current classification criteria for disorders issued by the World Health Organization (WHO) (International Classification of Disorders, ICD-10) is underway and will also include a revision of the classification criteria of the mental and behavioural disorders. Working groups for specific groups of mental disorders had produced suggestions for revised diagnostic criteria and included a working group on schizophrenia and other primary psychotic disorders. This presentation will focus on this group of mental disorders. Major changes suggested were an introduction of symptom and course specifiers, the inclusion of cognitive symptoms and a de-emphasising of the so-called first rank symptoms of schizophrenia, a cross-sectional approach towards the classification of schizoaffective disorder and a reorganization of the acute psychotic disorders. Initial internet-based field trials showed some incremental improvements of diagnostic reliability, but more crucial for an adjustment of the revised classification criteria will be the expected results of the upcoming clinic-based field trials.

Disclosure of interest

Unterstützung bei Symposien/Symposia Support.

– Janssen-Cilag GmbH, Neuss

– Aristo Pharma GmbH, Berlin

– Lilly Deutschland GmbH, Bad Homburg

– Servier Deutschland GmbH, München

– Fakultätsmitglied/Faculty Member

– Lundbeck International Neuroscience Foundation (LINF), Dänemark
The Effects of Animal-Assisted Therapy on Happiness of Chronic Psychiatric Patients in a Nursing Home in Tehran: A Randomized Controlled Study
Authors: Tobeh F. , Sahebalzamani M. , Fattah Moghaddam L. , Farahani H.
Published: June 2017

Background

Psychiatric patients who live in nursing homes may often feel a loss of autonomy, decision-making, and participation in social activities. They usually had little or no visitors and also they do not have any purpose for living. Pets may decrease this problem and improve their happiness.

Objectives

The aim of this study is to evaluate the effects of animal-assisted therapy (AAT) on happiness of chronic psychiatric patients in nursing home.

Method

The study design was a randomized controlled trial (RCT) with pre and post-test. Seventy males with chronic mental health disorder who were patients of the nursing homes were randomly divided into a pet therapy intervention group and control group. Patients in the experimental group received pet-therapy with bird as 6 weeks therapy comprising 6 sessions per week. All patients were evaluated by the Oxford happiness questionnaire before and after 6 weeks.

Results

Analysis of covariance (ANCOVA) was conducted and pretest was considered as a covariate variable. The result demonstrated that the patients in the experimental group had significantly increased (P < 0.001) happiness in posttest scores.

Conclusion

It is important to consider ways of enhancing happiness in psychiatric patients who live in the nursing homes. Also, it is appearing that AAT can be helpful for them.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Relationship Between Brain Structural Abnormalities and Early Onset Psychotic Disorder–case Presentation
Authors: Allkoja B. , Mitro E. , Zenelaj B. , Alikaj V.
Published: June 2017

Introduction

Contemporary structural models of several psychiatric disorders propose abnormalities in the structure and function of distinct neural networks. Clinical observations of affective and cognitive changes arising from cerebellar lesions and stimulation permit the hypothesis that the cerebellum may not be irrelevant in some neuropsychiatric states. There is evidence that patients with schizophrenia have altered corticocerebellar connectivity.

Objectives

To evidence a case with early onset psychosis accompanied with brain structural abnormalities.

Method

Case description.

Results

The patient is 15 years old girl with an acute psychotic episode. For more than two months she had demonstrated odd behavior, getting around all the time purposelessly, abandoned school etc. She presented with disorders of perceptions, disorganized speech, insomnia and fluctuations in her mood and behavior. In her brain, MRI was found vermian atrophy, and CT was found hypocampal glyosis and dilatation of temporal corn.

Conclusions

Although the structural mapping studies have been equivocal, the weight of evidence supports extending the study of cerebellar activity in schizophrenia. For example, the finding that unaffected first-degree relatives of probands with schizophrenia have reduced cerebellar volumes, along with the observation of reduced cerebellar volumes in neurolepticnaïve patients with schizophrenia, suggests that cerebellar atrophy may be a hereditary trait rather than a psychotropic associated epiphenomenon.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Brain Metabolic Abnormalities in Schizophrenia Patients
Authors: Amorim M. , Moreira A. , Marques A. , Summavielle T.
Published: June 2017

Introduction

Main schizophrenia symptoms result from abnormalities in brain function, such as hypofrontality and structural deficits on the prefrontal-thalamic-cerebellar circuit, as shown in brain imaging studies in first-episode SCZ patients. Whether metabolic alterations may be underlying these events is being studied thoroughly.

Objectives/aims

To assess brain metabolic disturbances in first episode and/or drug-naïve SCZ patients.

Methods

We conducted a literature review through Pubmed search for MeSH: schizophrenia, metabolism, glucose, insulin, brain. Controlled studies on first episode and/or drug-naïve SCZ patients were included.

Results

Lower metabolic activity in the frontal regions of the brain is associated to an increase in norepinephrine transmission and decrease in dopaminergic transmission with reduced dopamine efflux in the frontal cortex. This seems to lead to cellular changes resulting in resulting lower blood flow and glucose demand. Molecular analysis of postmortem SCZ patients’ brains has indicated alterations in glucose metabolism and insulin signalling pathways, showing evidence for prefrontal cortex decreased expression of glucose metabolism, namely glycolytic enzymes such as glyceraldehyde 3-phosphate dehydrogenase, hexokinase, phosphoglycerate mutase, enolase and pyruvate kinase and decreased levels and phosphorylation of the insulin receptor and insulin signalling proteins AKT1 and GSK3β. Significantly elevated glucose concentrations in cerebrospinal fluid were observed in SCZ patients, but with no serum levels differences. A SCZ brain specific increased glucose could be explained by preferential utilization of lactate, predominantly produced by astrocytes, over glucose as an energy substrate.

Conclusions

Abnormalities in brain glucose metabolism and insulin signalling seem to appear in early stages of SCZ, suggesting a role in SCZ onset and pathophysiology.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Association between GRM3 gene polymorphisms and response to treatment in Moroccan schizophrenic patients
Authors: Lagouaiti H. , Zairy G. , Charoute H. , Somali R. , Atouche N. , Elalaoui A. , Battas O. , Agoub M.
Published: June 2017

Objective

The aim of this study is to evaluate the association between response to treatment in Moroccan schizophrenic patients and GRM3 gene polymorphisms.

Method

We have genotyped three SNPs of GRM3 gene (rs1989796, rs1468412, rs1476455) in 33 Moroccan schizophrenic patients. We assessed the severity of symptoms using Positive and Negative Symptoms Scale (PANSS) and Brief Psychiatric Rating Scale (BPRS) during two months of antipsychotics treatment.

Results

The result revealed a positive change in PANSS negative symptoms in patients with rs1468412SNP and a difference in allele frequency of rs1989796SNP between responders and nonresponders to treatment.

Conclusion

Our data indicate that rs1468412 and rs1989796 GRM3 gene polymorphisms play a role in response to schizophrenia treatment.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Remission and recovery from first-episode psychosis in adults: A systematic review and meta-analysis of long-term outcome studies
Authors: Lally J. , Ajnakina O. , Stubbs B. , Cullinane M. , Murphy K.C. , Gaughran F. , Murray R.M.
Published: June 2017

Introduction

Remission and recovery rates for people who have had a first episode psychosis (FEP) remain uncertain.

Objectives

We conducted a systematic review and meta-analysis to assess pooled prevalence rates of remission and recovery in FEP in longitudinal studies and conducted meta regression analyses to investigate potential moderators.

Methods

A systematic literature search of major electronic databases without language restrictions was conducted from database inception until July 1, 2016. Longitudinal studies with follow up greater than 1 year reporting data on remission or recovery rates in FEP were included.

Results

Seventy-nine studies were included representing 19,072 FEP patients (mean age = 26.9 years, male = 59.5%). The pooled rate of remission among 12,301 individuals with FEP was 57.9% (95%CI: 52.7–62.9, Q = 1536.3, P< 0.001, n = 60 studies, mean follow up = 5.5 years). Restricting the analysis to studies, which used the remission in schizophrenia working group (RSWG) criteria (n = 25 studies, n = 6909 patients), the pooled remission rate was 56.9% (95%CI: 48.9–64.5, Q = 656.9). Higher remission rates were moderated by studies from more recent years. The pooled prevalence of recovery among 9642 individuals with FEP was 37.9% (95%CI: 30.0–46.5, Q = 1450.8, studies = 35, P = 0.006, average follow up = 7.2 years). Recovery rates were higher (P< 0.05) in North America compared to other regions.

Conclusions

Our data suggest that remission and recovery rates in FEP may be more favorable than previously thought. We observed stability of recovery rates after the first two years, suggesting that a progressive deteriorating course of illness is not typical. While remission rates have improved over time, recovery rates have not, raising questions about the effectiveness of specialist early intervention services in achieving improved recovery.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Treatment of drug-resistant schizoaffective disorder with aripiprazol depot off-label: A case report
Authors: Galmés L. Niell , Mures R.A. Baena , Páramo Í. Alberdi , Guadalupe M.M. Tenorio , Hernández G. Montero , Quijano J. Rodríguez , Deike L. Gallego , Gómez A. Carrillo
Published: June 2017

Introduction

We expose a woman diagnosed with schizoaffective disorder 2 years ago, before she received several diagnostics. She was admitted to the psychiatry unit with hyperactivity, pressured speech without taking an appropriate turn, flight-of-ideas, irritability, expansiveness, emotional liability, ideas of reference and insomnia without diurnal tiredness. In addition, she admitted having abandoned the medication one month ago. She was diagnosed with maniac episode with psychotic symptoms and the medication was reintroduced. After two weeks, no response was observed so we decided to introduce ability depot 600 mg/3 weeks.

Objectives

We want to show that is possible the use of ability depot off-label in patients with a special difficulty in handling. Also, we want to show that higher doses are not dangerous and it's possible to study new treatment guidelines for ability depot.

Methods

We use the Positive and Negative Syndrome Scale (PANSS) pre (the day of the introduction) and post (at two weeks) treatment with aripiprazol depot; the Clinical Global Impression rating scale (CGI), also pre and post.

Results

We have obtained a punctuation of 180 in PANSS the day of the introduction of the aripiprazol depot and 45 at two weeks. In addition, we obtained 6 in CGI the day of the introduction and 3 at two weeks.

Conclusions

In this case, aripiprazol depot has shown good tolerability and efficacy for the acute phase of schizoaffective disorder at higher doses than recommended in clinical guidelines. The efficacy and safety data are consistent with short-term, placebo-controlled studies of aripiprazol depot conducted in similar populations.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Organic psychosis: Much more than dopamine
Authors: Gutierrez R. Martín , Ruiz M. Juncal , Olivares O. Porta , Rodríguez R. Landera , Blanco L. Sánchez , Díez D. Abejas , Jenaro G. Pardo de Santayana , Revuelta M. Gómez , Requena C. Marín , Galán V. Gajardo
Published: June 2017

Introduction

Most of elderly onset psychosis present as a consequence of one or more organic processes. We present the case of an 81-year-old patient with diagnosis of a posterior fossa meningioma. It emerged with abrupt positive symptoms of psychosis with important family and social disruption. The interest of the case lies in the low frequency of psychiatric symptoms associated to this type of tumor, given its location. Thus, these symptoms may be explained, by normal pressure hydrocephalus (NPH) secondary to the tumor.

Objectives

To highlight the importance of performing a complete organic screening in elderly onset psycotic patients.

Material and method

From the mentioned case, we performed a literature review of psychopathology associated with NPH.

Results

Psychiatric examination demonstrated parasitization delusions and delusional misinterpretations; tactile and visual zoomorphic hallucinations were also present. They were compatible with Ekbom syndrome; anxiety and behavioral disorganization were prominent. We introduced treatment with risperidone 0.5 mg/12 h with important decrease of positive psychotic symptoms. Currently, the patient is waiting for a ventricular-peritoneal shunt.

Conclusions

The NPH usually presents with memory failures, psychomotor slowing, problems in calculating and writing. It may progress to a neurological impairment so intense that may be indistinguishable from Alzheimer's disease. From a psychopathological point of view, affective or psychotic symptoms and/or behavioral disorganization may also appear. In few cases, HNT onset shows with prominent psychiatric symptoms instead of neurological impairment. These symptoms may improve with pharmacological and surgical treatment. Thus, it is important to get an accurate diagnosis.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
A case of delusional disorder
Authors: Porta Olivares O. , Juncal Ruiz M. , Fernández Abascal Puente B. , Gómez Revuelta M. , Pérez Herrera M. , Garcia Egea J.L. , Garcia Ayala L. , Nuñez Morales N.I. , Landera Rodríguez R. , Santayana Jenaro G. Pardo de , Sánchez Blanco L.
Published: June 2017

Introduction

Functioning of patients with delusional disorder may be impaired, particularly if the delusional thinking is chronic rather than episodic. They refuse to characterize their beliefs as false and view opposing views with surprise, if not hostility and disdain, dismissing or ignoring them, and continuing their struggle to find resolution or restitution for the wrongs they have endured or the illnesses from which they suffer. They typically reject and often resent the suggestion that they are mentally compromised. They are a difficult group to engage clinically, often refusing to meet with a clinician about their delusions and/or to take medication. The first-line treatment of delusional disorder is antipsychotic medication rather than other clinical interventions. Patients with the disorder often reject psychiatric treatment, it is particularly important that medication be prescribed in the context of a therapeutic relationship that includes support, education, encouragement of healthier pursuits, and discouragement of damaging, delusion-inspired actions.

Methods

We describe a case of a 55-year-old woman with a delusional disorder that was diagnosed 4 years before. The supervision of the right take of the treatment was not possible and the intensity of behavioral disturbances increased. Then we started the treatment with long-acting injectable aripiprazole.

Results

Within the 4 months following the start of treatment, her mental state improved by attenuation of psychotic symptoms.

Conclusions

Long-acting aripiprazole could be an effective tool for treatment of psychotic symptoms in patients with no insight and difficulties to check the proper treatment take.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
When the term “schizophrenia” is enough to modify the way you interact with others: Evidence for a motor synchrony task
Authors: Rainteau N. , Salesse R. , Raffard S. , Capdevielle D.
Published: June 2017

Introduction

Most individuals with schizophrenia will be confronted with some forms of stigmatization. In recent years, the term “schizophrenia” has been increasingly contested by clinicians and family members and many of them argue for a change of name. Surprisingly, most of the research has been explored though self-reports but behavioural research is still lacking. The aim of our study was to assess through an experimental design if the term “schizophrenia” was enough to modify social behaviours.

Methods

Eleven participants from the community were asked to engage in three coordination tasks with a simple dot displayed on a screen and moved by another person. Participants had to synchronize their movements with either a schizophrenia patient, a patient with neuro-emotional integration disorder (NEID) or a healthy subject, situated in different rooms. Each condition was counterbalanced between participants. In reality, the movements of the dot were pre-recorded (five trajectories) and were therefore identical for all three conditions.

Results

Measuring the error between the displayed and performed trajectories, participants coordinate worse when they though interacting with a schizophrenia or NEID patient in comparison to the “healthy” (F(2.20) = 4.02; P = .034; n2P = 0.29) condition. Post-hoc analysis revealed an even higher difference between “schizophrenia” and “healthy” conditions (P = 0.01).

Conclusion

Our study is the first to demonstrate that the label “schizophrenia” directly impacts our behaviour, with negative consequences on social interactions. However, our results cannot confirm yet a positive effect induced by changing the name.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
The awareness of social inference task (TASIT) updated: Signal detection theory (SDT) in emotion recognition and its link to psychotic symptoms
Authors: Rossi R. , Santarelli V. , Carmela M. , Gianfelice D. , Cicciarelli R. , Pacitti F. , Rossi A.
Published: June 2017

Introduction

Social cognition (SC) is an impaired domain in schizophrenia. However, little is known on the Signal Detection properties of SC deficits.

We analyzed the relationship between emotion perception and psychotic symptoms in a sample of schizophrenic patients. For this scope, we extended the scoring system of the awareness of social inference task-emotion recognition (TASIT-ER) according to signal detection theory (SDT).

Methods

Sample:

– one hundred and nineteen inpatients from L’Aquila Inpatient unit diagnosed with schizophrenia.

Dependent variable:

– Positive and Negative Syndrome Scale (PANSS)’s Positive, Negative, Disorganized, Excited and Depressed dimensions, and total score.

Independent variable:

– a modified version of TASIT-ER. The original scoring system, including only “HITs”, was extended with “False Alarm” (FA), defined as a detection of an emotion when not present.

Statistical analysis:

– multivariable linear regression models for each sub-group of emotions to assess the effect of FAs on psychotic symptoms compared to HITs.

Results

FAs on positive emotions were associated with disorganized (b = 31.95), excited dimensions (b = 41.84) and PANSS Total (b = 152.46); FAs on negative emotions were associated with Excited dimension (b = −57.97) and PANSS Total (b = −243.70). HITs on Negative emotions were associated with Negative (b = −13.37), Disorganized (b = −8.64) Excited (b = −8.74) dimensions and with PANSS total (b = −45.30).

Discussion

FA rates were more strongly associated with total PANSS score than HIT rate, suggesting a prominent role of false recognition in defining psychotic symptoms, especially disorganized and excited ones, consistently with computational models of psychosis that rationalize false recognition as failures of active inference systems in updating their predictive model of sensory information.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Corticosteroid-induced psychosis: Case report and review of the literature
Authors: Tenorio Guadalupe M. , Alberdi Páramo I.
Published: June 2017

Introduction

Steroid psychosis still presents many unsettled clinical aspects. Despite several reviews and case reports are available, modes of onset and recovery need a more accurate description. We will focus on a 53-year-old woman who was hospitalized against her will because of her agitated psychotic state. Her symptoms were indicative of an acute psychotic disorder resulting from the use of corticosteroids. We considered it important to report this case because corticosteroids have been widely prescribed since about 1950 to treat a broad spectrum of somatic illnesses and to emphasize the relevance of the dose of steroids in this case.

Objectives

We describe a case of substance-induced psychotic disorder resulting from corticosteroids administration and we review the scientific literature about this topic.

Aims

To obtain more information about the incidence of steroid-induced psychotic symptoms, the relation between the type of steroids, its dose and the clinical presentation, the most important risk factors and how to prevent psychotic episodes during steroids-treatment.

Methods

After discussing the case, we studied the literature systematically using official medical browsers.

Results

Very little reliable evidence has been available relating to steroid-induced psychosis.

Conclusions

There is much to learn about adverse psychiatric reactions to corticosteroid treatment. It should be improved awareness of the limited available knowledge and to stimulate research aimed at improved methods of prevention, recognition and treatment.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Adjunctive minocycline in clozapine and amisulpride treated schizophrenia patients with persistent symptoms
Authors: Tzavellas E. , Karaiskos D. , Konstantinou J. , Oikonomou E. , Soldatos R. , Paparrigopoulos T.
Published: June 2017

Objective

Clozapine and amisulpride are two effective antipsychotic and their combination often is used for treatment refractory people with schizophrenia, yet many patients partially respond. Clinical data and the recent literature suggest benefits with minocycline. in our study we adjunct minocycline in five schizophrenic patients and we observed them for a period of 6 months.

Methods

Our patients received adjunct minocycline (100 mg oral capsule twice daily).

Results

Using the PANSS, we identified a statistically significant (P < 0.05) clinical improvement from the fourth week of treatment for positive mainly, and less for negative symptoms in all our patients. Global cognitive function did not differ, although there was a significant improvement in working memory favoring minocycline. Moreover there was a marked reduction of anxiety and depressive symptoms.

Minocycline was well tolerated and no patient presented side effects.

Conclusion

Minocycline seems to help significantly schizophrenic patients who do not respond fully to their medication consisted of clozapine and amisulpride. Larger studies are needed to validate these findings.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Attitude of person living with psychosis towards MH professionals: A qualitative study
Authors: Vaiphei K. , Sreedaran P. , Sathyanarayanan V.
Published: June 2017

Aims

Studies investigating attitudes of people with mental illness are scarce. The aim of the present study was to investigate person living with psychosis on their attitudes and perception towards the mental health professionals in contact with mental health services.

Methods

An in-depth interview was used to explore their lived experiences and attitude towards mental health professionals.

Results

Both negative and positive attitudes were prevalent among the patients. Most negative attitudes concerned on not giving time, the MHPs are most interested in financial gains. They felt attitude changes according to diagnosis, psychosis perceived as diagnosis with violence; they are more interested in protecting themselves, perception that treating symptoms and not cause of illness. On the contrary, they felt positive on the relationship and time given to them.

Discussion and conclusions The PLWI's attitude to MHPs could be a product of the type of admission (forced upon), symptoms related or on the type of service settings. The present study is purely qualitative, single settings, could not be generalised. However it points on the need for sensitization of MHPs and relationship building oriented intervention.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Trazodone a good start key for normal sleep in two cases of somnambulism
Authors: Marinescu G.C. , Popa S. , Zarioiu I.C.
Published: June 2017

Introduction

In our current practice, we do not see many cases of somnambulism in adults. We do not have much information about their treatment and outcome. In difficult cases, some clinicians try to use benzodiazepines, which decrease slow-wave sleep. More recent reports suggest the use of zolpidem.

Objectives

Sleepwalking disorder consists of a sequence of complex behaviours that are initiated in the first third of the night during deep NREM (stage III and IV) sleep. The architecture of normal sleep is impaired. In important cases - with dangerous behaviour – we need treatment.

Aims

Trazodone is an antidepressant with sedative effect due to H1 and α1 receptors blockade. Trazodone can rewrite the bad sleep architecture of depressive patients with insomnia and improve sleep in such cases. For these reasons, we try to use trazodone in somnambulism.

Method

We had two case studies (males, 24 and 22 old), diagnosed with NREM arousal disorder, sleepwalking type, according to DSM-5. Both patients were treated with trazodone 50 mg/day, up-titrated with 50 mg/day every three days. The target used dose was 150 mg/day because this is the most sedative.

Results

Somnambulism disappeared in both cases after the first dose of trazodone. We treated three month both patients and then down-titrated and stopped the treatment. After one year from stopping the treatment, the patients had not new episodes of somnambulism.

Conclusions

Trazodone has the power to rewrite, in those cases, the sleep architecture of somnambulism. This action is due to blockade the brain's arousal histamine and adrenaline systems.

Disclosure of interest

Speaker honoraria from Angelini Pharmaceuticals Romania.
The perception and attitudes of nursing staff in state psychiatric hospitals regarding the causes and treatment of substance abuse and effecting factors
Authors: Baysan Arabacı L. , Engin E. , Yetmiş N. , Şen G. , Ozturk T.
Published: June 2017

Objective

This study was performed with the aims of determining the perceptions of nursing staff in psychiatric hospitals regarding the causes and treatment of substance addiction as well as their attitudes towards people with substance abuse problems.

Method

This study was carried out with 389 nurses working at 5 state psychiatry hospitals in Turkey. In this study, demographic questionnaire, the causes of drug abuse scale (CADAS), drug abuse scale (CUDAS), attitudes scale (AS), and a demographic questionnaire were used. Independent sample t-test, variance, correlation, and linear regression analyses were used.

Results

In this study, 82.8% of the nurses were female, and the mean age was 33.79 ± 7.58. We found that the demographic characteristics of the nurses did not affect their perception regarding the causes of addiction and treatment (P > 0.05); but it did have an effect upon their attitude towards people with substance use problem (P < 0.05). Also, it was established that there was a negative relationship between their perception regarding causes of substance misuse and their attitude towards a person with substance use problem; and a positive relationship between their perception regarding substance misuse treatment and their attitude towards the person with substance use problem (P < 0.05).

Conclusion

Nursing staff working in psychiatric hospitals in Turkey have the perception that a person takes substances in order to “cope with problems”and for reasons pertaining to his/her “social environment”. Nursing staff tends to indicate a negative attitude towards persons with substance abuse problems, such distancing themselves socially from the patients.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Ethylone: A synthetic cathinone emerging in Barcelona
Authors: de Dios M. , Monteagudo E. , Trabsa A. , Grifell M. , Galindo L. , Quintana P. , Palma A. , Ventura M. , Sanagustin D. , Pérez S. , Torrens M.
Published: June 2017

Introduction

Synthetic cathinones, the active component in “bath salts”, have surfaced as a popular alternative to other illicit drugs of abuse, such as cocaine, MDMA (ecstasy), and methamphetamine, due to their potent psychostimulant and empathogenic effects.

Objectives

To describe the presence of Ethylone in samples delivered to energy control from 2014 to 2015 in Spain.

Methods

The total number of samples analyzed from 2014 to 2015 was 8324. Only those samples containing ethylone were studied. They were analyzed by energy control, a Spanish harm reduction NGO that offers the possibility of analysing the substances that users report. Analysis was done by gas chromatography-mass spectrometry.

Results

From June 2014 to December 2015, 8324 samples were delivered to EC. From this samples 28 (0.336%) contained ethylone. Twelve (0.144%) were delivered as MDMA, representing a 0.783% of the samples delivered as such, and only one sample (0.012%) delivered as MDMA presented ethylene as an adulterant along with MDMA. Other 6 samples (0.072%) were delivered as ethylone and 10 samples (0.120%) were delivered as unknown pills.

Discussion

Ethylone consumption is found to be an emerging issue according to the results of our samples, an increase of such is found during 2015. This might be traduced as an increase of ethylone in the drug market, but a sample selection bias should be considered as samples were voluntary delivered by consumers. An alarming phenomenon is that in some occasions ethylone is sold as MDMA, but effects take longer to occur and last longer, which may lead to an overdose if used as MDMA.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Efficacy of vortioxetine for patients with dual pathology
Authors: Fernández Mayo L. , Barbero García E. , Baño Rodrigo D. , Agujetas Rodríguez M. , García Sanchez A. , De Antonio Pérez V.
Published: June 2017

Introduction

Patients with dual pathology have worse clinical evolution and worse therapeutic response. Drugs modify the functioning of certain neurocerebral transmission systems, producing cognitive, emotional and behavioral changes. Vortioxetine (Brintellix®) is used as a treatment for major depressive disorder (MDD) and it is considered a new multimodal antidepressant. Preclinical data suggest that the effects on numerous serotonin receptors result in regional increases in noradrenaline and dopamine as well as glutamatergic transmission.

Objectives

This analysis assessed the efficacy of vortioxetine (Brintellix®) in patients with affective disorders and abuse drugs (dual pathology).

Methods

Efficacy was assessed with a study of patients who were recruited in a qualitative and observational study. They were treated with vortioxetine (Brintellix®). Outcome measures included changes from baseline to endpoint in Hamilton Depresion Rating Scale (HDRS). They were also interviewed weekly about craving and substance use. Urine test controls were done to corroborate results.

Results

A total of 11 vortioxetine-treated patients improved their depressive and anxiety symptomatology. Seven of them (64%) were males and four of them (36%) were women. Cocaine was the main drug of abuse (n = 9, 82%). The doses were between 5 and 20 mg/day. After the clinical evaluation and 12 weeks of treatment, they achieved to reduce significantly the drug use and verbalized a decrease in craving. Two patients dropped out of the study.

Conclusions

Vortioxetine (Brintellix®) was shown as efficacious in reducing depressive and anxiety symptoms in patients with dual pathology.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Sexual dysfunctions in injectable drug users in Tunisia
Authors: Jihene J. , olfa M. , Haifa Z.
Published: June 2017

Introduction

The drug addiction in the buprenorphin with high dosage (BHD) by injectable way, represents a real plague in Tunisia, consequently, we are confronted with diverse complications including the sexual dysfunctions.

Objectives

Identify and determine prevalence of the sexual dysfunctions among this population.

Methods

It is a transverse, descriptive study. We looked for sexual dysfunctions by using the international index of the erectile function (IIEF 15), among a population of 52 male users of BHD by injectable way.

Results

The average score in the IIEF-15 was 36.65 with a standard deviation of 20.87, a negative correlation with duration and the quantity of consumption was noted.

The average erectile function (EF) was 15.63 ± 9.26, which corresponds to a mild to moderate erectile dysfunction, whereas 31% had a severe dysfunction.

The average score of the orgasmic function (OF) was 6.35 ± 3.52.

The average score of the sexual desire (SD) was 4.27 ± 2.90.

The average score of the satisfaction with sexual intercourses (IS) was 5.77 ± 4.54, an alteration was noted in 96% of the cases, which was correlated with the severity of the consumption.

The average score of the global satisfaction (OS) was altered at 92% of the subjects.

The majority of the subjects brought back the chronology of their disorders in after the consumption of BHD. No patient consulted in sexology.

Conclusion

It is thus important to educate stakeholders, on the frequency of sexual dysfunctions and the importance of their screening to improve the management of this problem.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Clock genes SNP array identifies a key role of the PER1/HES7 gene in the risk of cannabis addiction and psychiatric comorbidities
Authors: Lafaye G. , Benyamina A.
Published: June 2017

The existence of biological rhythms disruption in addicted subjects has been described including disturbances in their sleep-wake pattern, rest-activity rhythms, and feeding schedules. Circadian rhythms have also been related to psychiatric diseases, including mood and anxiety disorders and the regulation of dopaminergic transmission, especially in reward circuitry in substance abusers. The relationship between them remained enigmatic and no data on the role of clock genes variants on cannabis dependence have been documented. We aimed at exploring the role of clock gene genotypes as potential predisposing factor to cannabis addiction, using a high throughput mass spectrometry methodology that enables the large-scale analysis of all the known clinically-relevant polymorphisms of the core human clock genes. We have conducted a case-control study on 177 Caucasians categorizing between cannabis-addicted subjects (n = 83) and casual cannabis consumers (n = 94). We report here a strong association between the TT* genotype RS1442849 in PER1/HES7 gene and a significantly higher risk of vulnerability to be dependent to cannabis. Moreover, this SNP was overrepresented in the subsets of cannabis users with more severe characteristics like personal psychiatric history, unemployed status, and beginning of cannabis use early in lifetime as well as large weekly consumption. HES7 gene is a newly described gene with a circadian expression regulated by reactive oxygen species in many cell types including neural stem cells. The HES7 TT* genotype RS1442849 gene could intervene on the dopamine reward systems. This genotype thus represents the first potential biomarker for stratification of cannabis consumers for the risk to develop a true dependence.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
The neural basis of cognitive control in gambling disorder: A systematic review of fMRI studies
Authors: Moccia L. , Pettorruso M. , De Risio L. , De Crescenzo F. , Di Nuzzo L. , Conte E. , Leone B. , Ferri V.R. , Martinotti G. , Di Nicola M. , Janiri L.
Published: June 2017

Introduction

Decreased cognitive control over the urge to be involved in gambling activities is a core feature of gambling disorder (GD). Cognitive control can be conceptualized as the sum of high-order cognitive faculties interacting in the achievement of goal-oriented behaviors. As such, cognitive control can be differentiated into several cognitive sub-processes, such as response inhibition, conflict monitoring, decision-making and cognitive flexibility, all of which prove to be pivotal in GD clinical phenomenology.

Objectives

Over the past few years, several studies and reviews have indicated a lack of cognitive control in GD through self-report questionnaires and neurocognitive tasks. Conversely, there are only a limited number of neuroimaging studies, which investigate the neural mechanisms underlying diminished cognitive control in GD.

Aims

This research aims to systematically review functional magnetic resonance imaging (fMRI) studies that target cognitive control in GD.

Methods

A literature search was conducted in order to find appropriate published articles on fMRI studies in GD.

Results

Fourteen fMRI studies were included. Depending on which neurocognitive task was employed, the studies were divided into five different sections: conflict monitoring, response inhibition, delay discounting, cognitive flexibility and decision-making.

Conclusions

Impaired activity in prefrontal cortex may account for decreased cognitive control in GD, contributing to the progressive loss of control over gambling behaviors. However, the way in which cognitive control interacts with affective and motivational processes in GD is still matter of investigation. Among prefrontal areas, orbitofrontal cortex has been indicated as a possible nexus for sensory integration, value-based decision-making and emotional processing, thus contributing to both motivational and affective aspects of cognitive control.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Nalmefene effectiveness in reducing alcohol consumption and prevention of craving: A case report
Authors: Pardo de Santayana G. , Landera R. , Juncal M. , Porta O. , Sánchez L. , Gómez M. , Nuria N.
Published: June 2017

Introduction

Alcohol use disorder is a pressing problem in our society. However, only a small percentage of patients with alcohol use disorder are ever treated. Nalmefene acts as an antagonist of mu opioid receptors preventing the pleasurable sensation that often accompanies alcohol consumption, while its modulation of kappa opioid receptors can decrease the dysphoria associated with alcohol withdrawal.

Aim

Studying the effect of nalmefene on patients with alcohol use disorder who are trying to reduce their daily alcohol consumption.

Methods

This is a descriptive study that pretends to assess the effect of nalmefene 18 mg/day on alcohol intake in a sample of five patients (3 men and 2 women) that came to our psychiatric consultation from March to September 2016. They all had tried in the past to stop or reduce their alcohol consumption but were unable to do so. We initiate follow-up with the patients in psychiatric consultation for the next three months with a monthly frequency.

Results

Out of the 5 patients, 4 reported to have reduced their alcohol consumption over the observation time, going from 32 drinks per week to 18 drinks per week on average. The fifth patient abandoned prematurely the treatment due to the appearance of side effects (nausea). No other relevant side effects were detected.

Conclusions

Nalmefene appears to be effective and safe reducing abusive alcohol intake and avoiding alcohol withdrawal syndrome. Therefore, nalmefene can be considered a good therapeutic option helping reduce alcohol consumption in patients with alcohol use disorder.

Disclosure of interest

The authors have not supplied their declaration of competing interest.