bluuebunny/crossref_metadata_2025 huggingface dataset:
Cognitive impairment and its relation to predominant polarity, number of episodes and illness duration in patients with euthymic bipolar affective disorder (BAD)
Authors: Ratnatunga S.S. , Kulathilake I.C. , Kokila Medhavini K. , Dayabandara M. , Rajapakse I. , Hanwella R. , de Silva V.
Published: June 2017

Introduction

Previous optimistic assumptions about the prognosis of BAD based on the control of mood symptoms is now challenged as majority of patients continue to have cognitive deficits during the euthymic phase.

Objectives

To describe cognitive impairment in euthymic BAD and study the association with clinical characteristics.

Aims

Identify the prevalence and severity of cognitive impairment (CI); to correlate CI with the first episode, illness duration, number of episodes and predominant polarity.

Methods

Patients attending the psychiatry clinic of the National Hospital of Sri Lanka diagnosed with BAD in the remission phase were recruited. An interviewer-administered questionnaire and Montreal Cognitive Assessment test was used to ascertain clinical characteristics and cognitive functions respectively. Scores of 18–26 described as mild, 10–17 moderate and < 10 as severe cognitive impairment.

Results

Total sample size was 58. Mean age = 48.84 (SD12.5). Fifty-five percent were females. Mean duration of illness was 179.7 months (SD128.5). A mean of 6 episodes were experienced during the course of illness (min = 1, max = 18); 58.6% had depression, 37.9% had manic and 3.4% had mixed as their first episode. The predominant polarity was depressive in 65.5%. No cognitive impairment – 8.6%, mild – 63.8%, moderate – 27.6% and none with severe. There was a significant association between the presence of cognitive impairment and the predominant polarity being depressive (r = 10.886, df = 4, P = 0.028). No significant association was found between illness duration, number of episodes or the type of first episode.

Conclusions

Patients with a predominant depressive polarity are more likely to experience cognitive impairment. Cognitive impairment had no association with illness duration, type of episode or number of episodes.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Aviation mental disorders – An in-flight case of mania
Authors: Ribeirinho Marques A. , Veludo Chai M. , Cintra P. , Gonçalves V. , Esteves de Sousa D. , Albuquerque M. , Nuno Costa M.
Published: June 2017

Introduction

Due to recent aviation accidents, like German Wings flight 9525, aviation related mental health disorders have recently received much attention. Several psychological disorders have been associated with aviation ever since its beginning, both in passengers and aviation professionals. A clinical case is revised of a 33 years old air hostess, without previous psychiatric history, who was admitted twice in a manic state, and a third time abroad in Nice, France, after prolonged sleep privation due to consecutive transatlantic flights.

Objectives

Scientific revision of psychological disorders in passengers (flight related psychological stress, flight phobia, post-traumatic stress disorders after plane crashes…), aviation professionals (mood changes, sexual function disorders, jet lag, sleep disorders), ground staff, and populations living within close distance to airports (burnout, circadian rhythms disorders due to high noise levels…).

Methods

Research in Pubmed, Medscape, scientific literature and other publications, with the following research terms: aviation related mental health disorders, flight related psychological disorders, flight phobia, aerophobia, aviophobia, flight related anxiety, flight related mood disorders, flight induced mania, psychological stress and air travel; articles in English, Portuguese and Spanish.

Results

Fifty-eight articles, one book and four publications were considered relevant; the case of the patient is thoroughly described with data retrieved from the clinical file.

Conclusions

Several important issues concerning both mental and physical health are highlighted by this clinical case, yet, surprisingly, scientific knowledge has progressed at a rather slow pace and mental health professionals have not given much attention to this issue.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Mind your anger habits: For teen (group CBT for teens with anger behavioral problems)
Authors: Eraky S.
Published: June 2017

Problematic anger behaviors of children and adolescents represent a significant challenge to the clinical community. Although a number of direct and indirect factors are theorized to contribute to the etiology of aggressive behavioral problems, the cognitive-behavioral model focuses on the cognitive processes that play a significant role in the generation of anger and the aggressive responses to provocation. “Mind your anger habits: for teen” manual, is based on the cognitive-behavioral conceptualization of anger and anger management problems functions, it consists of 10 group sessions for teens and 8 group sessions for their parents.

In the “Mind your anger habits: for teen”; anger is identified as a stress reaction with three response components: cognitive, physiological, and behavioral. The cognitive component is characterized by one's perception of social stimuli and provocation cues in the social context, by one's interpretation of these stimuli, by one's attributions concerning causality and/or responsibility, and by one's evaluation of oneself and the situation. This component represents a significant area for intervention with aggressive adolescents as their perceptions and attitudes serve to prompt most behavioral responses to provocation. Research on the social and cognitive processing in aggressive youth indicates that distorted interpretations, attributional biases, and deficiencies in problem solving can all influence the selection of aggressive behavior responses. Furthermore, cognitive processing patterns are likely to become more rigid over time, and as such the maladaptive aggressive behaviors prompted by dysfunctional cognitions will be maintained.

Disclosure of interest

The author has not supplied his declaration of competing interest.
Guide for adults in the children's therapeutic tale: “I conquered my fears”
Authors: Lima C. , Cunha G. , Figueiredo M. , Moreira F.
Published: June 2017

The book “I conquered my fears” was created as a result of the clinical experience of the author. It is a therapeutic tale, which is valid as a resource to be used by health workers and parents so as to help children overcome their fears at bedtime.

Because experience is important for an adult so as to better reflect on the theme, the book also includes an appendix to help accordingly.

The adult is invited to express what he/she likes to hear the most and the least, when waking from a sleepless night, and is also invited to dynamically interact with the book, give answers and create hypothesis, with no fear of making mistakes.

The parents, after reading the book, refer a better stress management capacity at critical moments experienced with the children at bedtime.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
A descriptive study of a sample of 42 male diagnosed psychotic disorder
Authors: Martí Garnica V. , Ortega Garcia M.D. , López Bernal M.A. , Russo De Leom J.R. , Marin Garcia S.
Published: June 2017

The aim of this study is the approach to mental illness and specifically in serious mood disorders, long-term treatments that improve adhesion as continuous treatments ensure compliance are needed, they minimize the risk of relapse and readmission and therefore increase the chances to have a good fit and social, relational and even occupational functioning. We analyzed a sample of 42 male diagnosed with schizophrenia, schizoaffective disorder, chronic delusional disorder that starts treatment with paliperidone palmitate in outpatients. It is analyzed the dose of paliperidone palmitate employed for stabilization and family satisfaction at the time of stabilization is analyzed in the study. Our results are that the mean dose of paliperidone palmitate is 138 mg. The patient diagnosed with schizophrenia are 47.6% and the average dose is 132.5 mg. Chronic delusional disorder is 2.3% and the mean dose 50 mg. Other comorbidity mood disorders are 21.4% and the mean dose is183 mg. Other disorders (F70, F72…) are 28.5% and mean dose 133 mg. The average family satisfaction (minimum 1 up to 5) is 4, with the highest score among patients diagnosed with F20. Schizophrenia. To conclude, long lasting injectable achieves important adherence and high percentage of antipsychotic monotherapy, thus reducing the side effects although our sample 4.7% which has occurred removed therefore.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Attempted suicide in people with co-occurring bipolar and substance use disorders
Authors: Mustapha S. Ben , Homri W. , Jouini L. , Labbane R.
Published: June 2017

Aims Study the impact of SUD co-morbidity on suicide risk in patients with BD.

Methods

Case-control study during a period of six months from July 2015 to December 2015. One hundred euthymic patients with BD (type I, II or unspecified) were recruited in the department of psychiatry C Razi Hospital, during their follow-up. Two groups were individualized by the presence or not of a SUD co-morbidity.

Results

The average age of patients with SUD was 44.02 years that of the patients without SUD was 44.12 years.

The sex ratio of patients with SUD was 5.25 and that of patients without SUD were 0.61.

Twenty-six percent of patients with SUD comorbidity had a history of suicide attempts. Fourteen percent of patients without SUD had a history of suicide attempts.

The association between SUD and history of suicide attempts was not significant (P = 0.134).

The average suicide attempts were 3.08 for patients with addictive behaviors and 2.00 for patients without SUD.

The association between SUD and the number of suicide attempts was not significant (P = 0.375).

The means of suicide attempts used were drugs in 12% of cases, 3% of cases by phlebotomy, 3% of cases by hanging, 3% of cases immolation, 2% of cases of organophosphate ingestion, 3% of cases by defenestration, 3% of cases by the precipitation front of a vehicle and 1% of cases by drowning.

Conclusions

Co-morbid SUD in individuals with BD is significantly associated with suicide attempts. Individuals with this co-morbidity should be targeted for intensive suicide prevention efforts.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Improving dual diagnosis care in acute psychiatric inpatient settings through education
Authors: Bonnie K.
Published: June 2017

Background

Patients with co-existing substance use and mental disorder (dual diagnosis) have complex and challenging care needs. Acute psychiatric care settings play a vital role in providing services for patients with dual diagnosis as they often do not voluntarily seek treatment. This is significant in that recent data reveals that 57% of the psychiatric inpatients at an inner city hospital in Vancouver, Canada are characterized as dual diagnosis.

Purpose

To develop an educational module which will equip nurses/practitioners with the skills and knowledge required to deliver evidence-based dual diagnosis care in acute psychiatric settings.

Methods

A survey of 74 nurses working in acute psychiatric settings was completed to identify their learning needs and challenges. This was followed by a comprehensive review of evidence from literature to identify competencies, knowledge and skills needed to deliver dual diagnosis care. Content for the educational module was then validated by a panel of leading international experts on dual diagnosis. Two focus groups of acute psychiatric nurses were then conducted to discuss content. An 8 hour educational session was then developed and piloted using the content that was reviewed and validated.

Results

Thirteen content areas were identified and validated by experts. Evaluations from participants of the educational session suggest improved knowledge, skills and competencies in dual diagnosis care.

Conclusions

This project translates evidence into practice, contributes to the body of knowledge on dual diagnosis care and improves practitioners’ confidence and competency in delivering evidence-based care which also will improve patient care outcomes and experiences.

Disclosure of interest

The author has not supplied his declaration of competing interest.
Comparative study of psychiatric comorbidity differences in patients with ADHD and cocaine substance use disorders and patients ADHD and cannabis use disorders
Authors: Martínez-Luna N. , Rodriguez-Cintas L. , Daigre C. , Grau-Lopez L. , Palma-Alvarez R.F. , Esojo A. , Roncero C.
Published: June 2017

Substance Use Disorders (SUD) and Attention Deficit Hyperactive Disorder (ADHD) are frequent conditions in out drug treatment centers. There are evidences about the high prevalence of ADHD in SUD patients (20%) compared with just ADHD in general population (1–7.3%). Both disorders and psychiatric comorbidity are important in the diagnosis proceeding. The objective of this study is search the difference in psychiatric comorbidity conditions between patients with ADHD and Cocaine SUD and ADHD and Cannabis SUD. ADHD was present in 158 patients of a total sample in which 46,8% used cocaine, 17.1% cannabis and 36.1% used both. Mood disorders were 26.8% in cocaine users, 21.7% in cannabis and 18.9% in both. Anxiety disorders were 20.3% in cocaine users, 37.5 in cannabis and 13% in both users. Primary psychotic disorders were 2.9% in cocaine users, none in cannabis and 11,1% in both drug users. Personality disorders by cluster were, Cluster A: 11.3% in cocaine group, 36% in cannabis group and 24.5 in cannabis and cocaine group. Cluster B: 33.8% in cocaine group, 44% in cannabis group and 51.9% in cannabis and cocaine group. Cluster C: 9.9% in cocaine group, 28% in cannabis group and 19.2% in cannabis and cocaine group. There could be common pathways of neuronal damage related to psychiatric comorbidity depending of used drug, the differences in comorbidity found in this study could explain a little part of it. It is important to manage SUD-ADHD and other psychiatric comorbidity in order to improve the outcomes of these patients.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Other ways for the treatment of alcohol dependence: A patient treated with nalmefene
Authors: Olivares O. Porta , Ruiz M. Juncal , Revuelta M. Gómez , Santayana Jenaro G. Pardo de , Blanco L. Sánchez , Rodriguez R. Landera , Santos A.B. Pérez , Las Revillas Almajano F. Arnaiz de
Published: June 2017

Introduction

Alcohol dependence belongs to one of the major risk factors to health worldwide. Alcohol consumption is a significant factor for mortality in the world: 6.3% in men and 1.1% in women. The alcohol use disorder is also very common: 5.4% in men, 1.5% in women. Despite its high frequency and severity of this disorder, only 8% of all alcohol dependents are treated once.

Aims

An interesting treatment option is geared toward reducing alcohol intake. Some patients in treatment for alcohol use disorder prefer an initial target of reducing consumption. Nalmefene, an antagonist naltrexone associated with opioid receptors, has been authorized in the European Union to help alcohol-dependent patients reduce their consumption. Antagonists’ opiate receptors are associated with reduced reward in relation to alcohol consumption, thus helping patients in reducing energy consumption.

Methods

A man of 39 years old, with a diagnosis of alcohol use disorder and depressive disorder and poor outcome despite different types of treatment (as aversive agents) was treated with nalmefene.

Results

After a few months, nalmefene had a beneficial effect on the patient, with a significant reduction in the number of days of excessive alcohol consumption and total consumption in the sixth month. In addition, treatment was well tolerated, with no observed secondary effects.

Conclusions

Nalmefene appears to be effective and safe in reducing heavy drinking. Drugs such as nalmefene have demonstrated efficacy in association with a biopsychosocial approach to help patients achieve their personal objectives for this disorder.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
The sofa is better than Freud
Authors: Buffardi G.
Published: June 2017

When it comes to the therapeutic dialog between doctor and patient, psychiatrist or psychotherapist and user, there are several factors that are taken into consideration, though some of these aren’t of a specific psychological model, they fulfill an important role both in the management of the relationship itself as well as in the care.

Their importance in the therapeutic relationship is such that a doctor or a therapist cannot simply manage them by “common sense”, or follow his own propensity for dialogue: he must know them well and he needs a training on their own management with the same precision that is needed for the specific psychological model training.

Contrary to widespread belief we think that education on non-specific factors has to be desirable and that the ability to manage them can be implemented both by a deeper understanding as well as by dedicated training tools.

Disclosure of interest

The author has not supplied his/her declaration of competing interest.
A rare type primary central nervous system lymphoma with primarily psychiatric diagnosis- a case report
Authors: Cikrikcili U. , Saydam B. , Aktan M.
Published: June 2017

Primary central nervous system lymphoma (PCNSL) is a high-grade malignant B-cell non-Hodgkin neoplasm that is an infrequent variant of all intracranial neoplasms (1%) and all lymphomas (< 1%)

PCNSL is documented mainly in immunocompromised patient groups, although it may also be diagnosed in immunocompetent patients. It affects mainly the eyes, supratentorial areas, or the spinal cord. The lesions are typically localized in frontal lobes, corpus callosum and basal ganglia. Additionally, lesions might rarely be detected at infratentorial areas and in medulla spinalis. Even though a wide spectrum of treatment options are available, such as chemotherapy, radiotherapy, or surgery; response rates are low and prognosis is poor in spite of appropriate treatment.

The case we reported here is 57-year-old male presented with symptoms of aggresivity, impulsivity, depressive mood and personality changes. Histopathological diagnosis was CD5 positive diffuse large B cell lymphoma, which is very rare in high-grade lymphomas. There were no neurological signs related to CNS tumor and the clinical manifestations responded very well to chemotherapy consisting of high dose methotrexate, vincristine and procarbazine. The significance of such neuropsychiatric symptoms in the course of treatment for PCNSL has been previously documented as well. These behavioral and emotional symptoms might manifest themselves based on where the neoplasm is localized. Therefore, psychiatrists should be more aware of the uncommon manifestation of the disorder as reported in this case. Consultation for differential diagnosis might also be necessary in such cases.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Lithium toxicity after bariatric surgery
Authors: De Jonge L. , Petrykiv S. , Fennema J. , Arts M.
Published: June 2017

Introduction

Bariatric surgery is globally increasingly being applied in patients with morbid obesity to achieve permanent weight reduction. More than fifty percent of these patients have a psychiatric disorder in their history and over thirty percent take psychotropic medication. The prevalence of bipolar disorder in patients who undergo bariatric surgery is around four percent, and most of them are treated with lithium.

Objectives & aims

To report and discuss the effect of bariatric surgery on changes in lithium absorption.

Methods

We present all published case studies and literature review on lithium toxicity after bariatric surgery.

Results

To date; only two case-reports were published with dramatic changes in lithium level after vertical sleeve gastrectomy and Roux-en-Y bariatric surgery. Within a period of two to five weeks, the patients were presented to the emergency department with signs of dehydration and acute kidney failure.

Conclusion

Clinicians should be aware of dramatic and possibly even life-threatening pharmacokinetic changes in drug absorption that may occur after bariatric surgery. Careful monitoring and even reduction of lithium dosage before and after surgery could potentially prevent serious complications.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Depression in people with multiple sclerosis
Authors: Ellouze F. , Bouali W. , Hidouri B. , Younes S. , Nasr M.
Published: June 2017

Introduction

Depression is the most common syndrome associated with Multiple Sclerosis (MS) with a high prevalence during a lifetime.

Objectives

To assess the prevalence of depression in patients treated in neurology for MS.

Methods

We performed a retrospective study on 17 patients diagnosed with MS and confirmed with the criteria of Mac Donalds 2010 with a follow-up in the neurology department of the EPS Mahdia for a period of nine years (2006–2014), then addressed to a psychiatric consultation for depression.

Results

In total 17 patients were hospitalised in the neurology department during the study. Ages ranged from 20 to 39 years with an average of 33 years. The average course of the disorder is 5 years. We objectified a female predominance with 82%, a professional activity was found in 76% of patients. The comorbidities found are mainly hypertension, diabetes and asthma, respectively in 11%, 5% and 5%. Depression was clinically confirmed in 9 patients, that to say, 52% of our sample addressed in the psychiatric consultation, whose 6 received an antidepressant (fluoxetine) and 3 received paroxetine. An anxiolytic was given to the half of these patients.

Conclusion

The association between MS and depression would, therefore, be neither fortuitous nor only related to non-specific factors of any chronic disease. Specifying the relative share of these explanatory factors is probably one of the challenges for future researches in this area.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
The development of a brief 5-minute mindful breathing therapy for the reduction of distress in palliative cancer patients
Authors: Ng C.G. , Tan S.B. , Lai K.T. , Zainal N.Z. , Sulaiman A.H. , Chong J.C.
Published: June 2017

Introduction

Although psychological distress is highly prevalent, palliative cancer patients are mostly too lethargic to undergo many sessions of the conventional psychotherapy.

Objectives

The study aims to develop a brief, quick and easy to administer psychological intervention for rapid reduction of distress in palliative care patients.

Methods

In phase I, an expert panel of multidisciplinary team was formed. The theory of mindfulness-based intervention was simplified into a 5-minute mindful breathing technique that can be learnt and practiced by palliative care patients.

In phase II, the efficacy of 5-minute mindful breathing was investigated in a pilot test that comprised of nine palliative cancer patients and eleven care takers.

In Phase III, the efficacy of 5-minute mindful breathing was further examined in a non-blinded, randomized controlled trial (RCT) that included 60 cancer patients under palliative care. Apart from perceived distress, physiological measures were assessed.

Results

The effect of 5-minute mindful breathing in rapidly reducing distress among palliative care patients was confirmed in both the pilot test (Tan et al., 2015) and RCT (Ng et al., 2016). The finding was further supported by the significant physiological changes associated with distress reduction such as decreased breathing rate, blood pressure, pulse rate, galvanic skin and increased skin surface temperature (Ng et al., 2016) with the 5-minute mindful breathing.

Conclusion

The 5-minute mindful breathing is a quick and easy to administer intervention that is useful for reducing acute suffering or distress in palliative care patients.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Morgellon disease: A case report
Authors: Stoimenova-Popova M. , Valtchev V. , Chumpalova P. , Tumbev L. , Veleva I. , Todorov A. , Stoichev K. , Popov P.
Published: June 2017

Background

Morgellons disease is a delusional disorder that leads to the belief that one has parasites or foreign material moving in, or coming out of, the skin. The name was coined in 2002 by Mary Leitao; a mother who rejected the medical diagnosis of her son's delusional parasitosis. She revived it from a letter written by a physician in the mid-1600s.

Objective

In this case report, we aim to describe the clinical characteristics and manifestation of morgellon disease in 26 years man.

Results and discussion

Bulgarian athlete of 26 years stopped to be actively involved with the sport after a severe contusion to the right knee during the race. Had a joint surgery in the Netherlands and of course when that will not be able to compete more professional sports began to use cannabinoids daily. After three months patient went to dermatologist because of skin rashes and intense itching, crawling sensation on and under the skin. The patient reported that pull out threads from his skin. Dermatologist Initiated treatment with antibiotic creams and corticosteroids. The symptoms persist and the patient has consulted a psychiatrist regarding appeared complaints of fatigue, poor concentration and increased anxiety. Psychiatrist based on clinical and medical history was diagnosed morgellon disease. We started treatment with risperidone in increasing doses up to 2 mg/day. After a month the patient has a significant reduction of symptoms.

Conclusion

Morgellons disease is a little-known disorder that is often associated with non-specific skin, nerve, and psychiatric symptoms.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Understanding the cultural concept of “highly sensitive person” among bipolar patients
Authors: Ioannou M. , Dellepiane M. , Olsson S. , Steingrimsson S.
Published: June 2017

Introduction

The concept of “highly sensitive person” is a cultural concept, which has become popular in western societies including Sweden. A highly sensitive person (HSP) is usually described as having hypersensitivity to external stimuli, different cognitive processing and high emotional reactivity. Although the concept lacks diagnostic validity, psychiatric patients may refer to this concept.

Aims

To examine the feasibility of the Cultural Formulation Interview (CFI) and the clinical relevance of cultural concepts of distress among patients with bipolar disorder that report being a HSP.

Methods

A case series of three patients with a diagnosis of bipolar disorder that report HSP. The CFI was conducted with all patients and the applicability of the DSM-5 cultural concepts of distress tested.

Results

In all three cases, the CFI facilitated the clinical consultation as reported from the patients and in one of the cases also increased the treatment engagement. The HSP-concept could be conceptualized as a cultural syndrome, idiom of distress and as an explanatory model.

Conclusion

The CFI and the cultural concepts of distress proved to be useful for understanding the concept of HSP as also they increased the cultural validity of the diagnostic interview. The three cases illustrate the challenges when encountering patients with other cultural references than clinicians. This highlights the necessity to integrate anthropological thinking in our current diagnostic work in order to reduce the “category fallacy” and promote a more person-centered approach in psychiatry.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Impact of illness course perception on desire for social distance towards people suffering from schizophrenia in Hanoi, Vietnam
Authors: Martensen L.K. , Hahn E. , Cao T.D. , Schomerus G. , Dettling M. , Nguyen M.H. , Angermeyer M.C. , Diefenbacher A. , Ta T.M.T.
Published: June 2017

Introduction

In Vietnam, as well as in other low and middle-income countries, stigmatization and discrimination of mentally ill patients is highly prevalent.

Objectives

It is important to identify determinants of stigmatization in a socio-cultural context as they may reveal anchor points for anti-stigma efforts.

Aims

This population based study conducted in urban and rural Hanoi aims to explore whether public perception of prognosis and course of illness concerning people with symptoms indicating schizophrenia have an impact on the desire for social distance, an important factor of stigmatization.

Methods

Based on a population survey using unlabelled vignettes for schizophrenia carried out in the greater Hanoi area in 2013, a sum score of the Social Distance Scale was calculated. A regression analysis was carried out to examine the impact perception of prognostic factors on the desire for social distance. The stratification of the sample (n = 455) was representative in terms of gender, age, urbanity and household size to the Hanoi population according to the 2013 census.

Results

Factor analysis revealed three independent factors of prognosis perception:

– 1. lifelong dependency on others;

– 2. loss of social integration and functioning;

– 3. positive expectations towards treatment outcome.

Both negative prognostic ideas (1,2) were significantly correlated with more desire for social distance in schizophrenia.

Conclusion

Stronger desire for social distance was observed among people with negative expectations about the prognosis of persons suffering from psychotic symptoms. Thus, our study indicates a link between social acceptance and ability to maintain a social role in the Vietnamese society.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Ethno-cultural predictors, which determine features of cognitive behavioral therapy of persons with PTSD
Authors: Sulaimanova M. , Sulaimanov R.
Published: June 2017

Objective

Study of the predictors of ethno-cultural adaptation among male population with PTSD.

Materials and methods

We examined 72 males (age: 18–52) with PTSD (F43.1), acquired in interethnic Kyrgyz-Uzbek conflict. In the process of CBT 3 psychotherapeutic groups were formed: 1st (2 homogenous subgroups) included 24 ethnic Kyrgyz, 2nd (2 homogenous subgroups): 24 ethnic Uzbeks, 3rd (2 heterogeneous subgroups): 12 Uzbeks, 12 Kyrgyz.

Methods

Semi-formalized interview, standardized scales for evaluating PTSD, anxiety, depression, aggression, loneliness.

Results

High levels of aggressiveness among Kyrgyz: 52.4, among Uzbeks: 51.7 (P < 0.05), loneliness among Kyrgyz: 38.9, among Uzbeks: 46.2 (P < 0.05), anxiety among Kyrgyz: 48.8, among Uzbeks: 52.4 (P < 0.05), depression among Kyrgyz: 57.5, among Uzbeks: 61.1 (P < 0.05) are mutually conditioning factors. In the CBT process, the values decreased: in 1st group anxiety level to 44.4 (P < 0.05), depression: 54.2 (P < 0.05); aggressiveness: 48.2 (P < 0.05), loneliness: 38.4 (P < 0.05); in 2nd: anxiety: 49.4 (P < 0.05), depression: 59.8 (P < 0.05), aggressiveness: 47.3 (P < 0.05), loneliness: 42.4 (P < 0.05); in 3rd: anxiety: 41,1 (P < 0.05), depression: 52.2 (P < 0.05), aggressiveness: 46.5 (P < 0.05), loneliness: 35.5 (P < 0.05).

Conclusions

High levels of aggressiveness and loneliness among the respondents of both ethnic groups are the predictors of PTSD. Emphasized anxiety-phobic (group 1) and anxiety-depressive (group 2) disorders are the activating mechanisms of adaptation processes in micro-society (psychotherapeutic group). Dominating anxiety-phobic disorders (group 1), anxiety-depressive disorders (group 2), and their entanglement with values of aggressiveness and loneliness determine development and stability of clinical-psychopathologic manifestations as dysthymic disorders, which is an indicator for biological treatment. Heterogeneous group, as a result of CBT, has shown activation of psychological adaptation mechanism by the dissociative type, which is one of the mechanisms of ethno-cultural adaptation and requires subsequent research.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Prevalence of depression in Tunisian general population
Authors: Belhadj H. , Jomli R.
Published: June 2017

Introduction

Depression is a major burden for the health-care system worldwide.

Objective

To identify prevalence and severity of depression in Tunisian general population and define socoiodemographic characteristics of screened positive to depression participants.

Method

We undertook a cross-sectional and descriptive study. A total of 134 participants, representative of the Tunisian general population, were enrolled. Age, gender, and educational level were the major criteria for representativeness. Depression was assessed with the Patient Health Questionnaire (PHQ-9).

Results

The cut-off score was 10. The prevalence of depression was 13.4%. There were no statistical difference in gender, education and age for the prevalence of depression.

Conclusion

The World Health Organization ranks depression as the fourth leading cause of disability worldwide. Thus, the detection of depression and the dissemination of treatment in the general population are very important to reduce the burden of the disease.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Anxiety and depression at the medical students in post-examination
Authors: Saadi S. Ben , Moula O. , Oueslati J. , Jelalia I. , Ghachem R.
Published: June 2017

Introduction

The course of medical studies is a long route asking for a lot of breath. It is enclosed by the national examination for specialisation, which allows to access professional training. This examination requires a diligent preparation over several months in difficult conditions for the most part of the candidates who are in practical training.

Objectives

and aims We suggest estimating the degree of anxiety and depression at the candidates in the week following the national examination for specialization of 2016.

Methods

We have put online on the pages of the various Tunisian Faculties of Medicine an anonymous questionnaire intended for the candidates who took the national examination for specialization of 2016. We used the scale HAD (Hospital Anxiety and depression scale).

Results

We recruited 220 participants. More or less half of the participants declare to be rather often in a good mood, that they take little only of the pleasure in the same things as before, that they laugh and see the highly-rated voucher of things really less than before, that they are made of the concern very often and that they sometimes experience sensations of fear. A third of the participants feel tense or irritated most of the time feel sudden sensations of panic rather often and have the impression to work in slow motion rather often.

Conclusion

Taking the national examination of specialization rhymes with stress and anxiety. It leads us to question: is it necessary to assure a psychological coverage during the preparation and upstream of the competition?

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Management of treatment resistant depression: A comparison between French expert consensus guidelines and international evidence based guidelines
Authors: Charpeaud T. , Yrondi A. , El-Hage W. , Leboyer M. , Haffen E. , Llorca P.M. , Courtet P. , Aouizerate B.
Published: June 2017

Expert consensus guidelines rely on a relevant methodological procedure complementary to based-evidence recommendations. They aim at offering support strategies derived from expert consensus for clinical situations where the levels of evidence are either absent or insufficient. Recommendations for resistant depressive disorders proposed by french association for biological psychiatry and fondamental foundation, were based on responses from 36 highly specialized experts in this field. They were invited to complete a comprehensive questionnaire with 118 issues. The questions raised covered a wide range of aspects from the evaluation of therapeutic resistance and clinical conditions increasing the risk for treatment failure to the adopted therapeutic strategies organized according the effects of previous treatment lines. Specific populations/situations especially including elderly, comorbidities (anxiety disorders, personality disorders and addictions) were also been studied through specific questions. Such recommendations are intended to substantially help the decision and therapeutic choice of clinician implied in the management of resistant depressive disorders in everyday clinical practice. We propose in this communication to compare the results of these recommendations with the various data from the evidence-based guidelines in order to demonstrate their complementarity for the management of resistant depressive disorders.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
The effect of subjective well being method on depression in high school students
Authors: Pourshahriari M. , Abrishami Z.
Published: June 2017

Introduction

Depression has a large impact on individual, family and society. This disorder can start early in life and often go untreated. The aim of current research was to investigate the effectiveness of subjective well being method in reduction of depression in high school students by using a cluster random sampling four hundreds students were selected from five different areas. All subjects answered the Kovaks Depression Questionnaire and hundred (fifty boys and fifty girls) had been selected who were under the mean score. The subjects were randomly assigned to four groups, two excremental, two controls. The intervention was used in an hour and a half each week for twelve weeks fifteen.

Methods

The data was analysed using manova that showed significant difference among experiment pan control groups on depression scores. But there were no difference between sexes.

The study suggest further study with longer intervention.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Theory of mind in binge eating disorder: an exploratory study
Authors: Legnani A. , Martoni R.M. , Brombin C. , Cugnata F. , Porta R. , de Filippis R. , Erzegovesi S. , Caputi M.
Published: June 2017

Introduction

to date, studies on the relationship between Theory of Mind (ToM) and eating disorders (ED) have never considered binge eating disorder (BED).

Aims a) to assess ToM abilities in a sample of patients suffering from BED comparing them with healthy controls; b) to evaluate the influence of several variables (demographic, clinical and neuropsychological dimensions, attachment styles, traumatic events, comorbid Axis I and II disorders) on ToM abilities.

Methods

we assessed ToM in a sample of 20 BED patients and 22 women from the general population using the Reading the Mind in the Eyes Test (RMET) and the Faux Pas Test (FPT).

Results

regarding the first aim, the comparison between groups showed that the clinical group scored significantly lower than the control group on the RMET as well as on FPT. Regarding the second aim, two different multiple regression models were performed: one for the RMET and one for the FPT. Both of them led to significant results. When modeling RMET score, it emerged that age and Binge Eating Scale significantly reduce the score, while vocabulary and drive for thinness have a positive effect (r2 = 0.62). When modeling FPT score, we found that central coherence and binge eating significantly reduce the total score (r2 = 0.33).

Conclusions

our study begins to shed light on the relationship between ToM and BED; in particular, it suggests that BED patients have lower mentalization skills than healthy controls and ToM abilities are partially influenced by clinical variables related to eating pathology.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Association between eating disorders and 5-HTTLPR polymorphism: The experience of an Italian eating disorders unit
Authors: Oriani M.G. , Barchiesi M. , Sabbatini L. , Nardi B.
Published: June 2017

Introduction

Eating Disorders (ED) as Anorexia Nervosa (AN), Bulimia Nervosa (BN) and Binge Eating Disorder (BED) are severe and debilitating psychiatric diseases whose etiology is complex and still largely unknown. Several studies seem to suggest that serotonin could be involved and notably there are several associations with 5-HTTLPR polymorphism, especially with the S allele and the S/S genotype.

Objectives

The purpose of this study is to evaluate if an association between ED and 5-HTTLPR (especially the S allele frequency) can be shown.

Material and methods

A group of about 100 subjects attending the eating disorders unit of Ancona will be tested. Their DNA will be taken and the frequency of the S allele will be compared with a control subjects group negative for ED. Then, the ED group will be divided, according to the DSM-5 criteria, in 3 subgroups (AN, BN, BED) and potential differences will be evaluated.

Results

At the moment, we are still collecting patients. According to other studies involving 5-HTTLPR, the S allele frequency in Italy is comparable with the European one, so there is reason to believe that an association could be found.

Conclusions

Serotonin involvement in ED in literature is shown, but it still has to be completely expounded. Studies as this one could help in describing the etiology and the development of this disease.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Visuo-Haptic information processing in patients suffering of anorexia nervosa
Authors: Risso G. , Martoni R.M. , Cavallini M.C. , Erzegovesi S. , Baud-Bovy G.
Published: June 2017

Introduction

Several studies recently investigated how Anorexia Nervosa patients (ANp) process multimodal information. Longo (2015) hypothesized that ANp might be less reliant on visual perception of bodies than healthy controls (HC). Case et al. showed that processing of multimodal information might be disrupted in ANp. Literature lacks of studies that measure precisely and compare directly the contributions of each sensory input.

Objective

To investigate the integration of visual and haptic inputs in ANp compared with HC and measure the weight of each input.

Method

We used a visuo-haptic integration task with a setup adapted from Gori et al. (2008) to measure each sensory input's when judging the size of a cube according to Maximum Likelihood Estimation theory which describes the optimal multimodal integration behaviour (Ernst and Banks, 2002). Fifteen ANp and 16 HCs were recruited.

Results

Regardless the group, we found considerable individual variability about the integration processes; moreover, many participants did not integrate optimally. Correlation analysis suggested that ANp rely less on visual information then HC.

Conclusions

Despite using a setup previously validated with children, the observation that many HC did not integrate optimally is not in line with the results of previous studies, making it difficult the comparison with the AN group. The setup might not be adapted to adults and it needs to be improved. Our study shows for the first time how it might be possible to measure and compare directly the contribution of two different sensory modalities. This could provide precious information to deeply investigate the pathology.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Evaluation of experts’ clinical practice in crisis unit and psychiatric emergency technical and therapeutic principles to better intervene
Authors: Denis J. , Hendrick S.
Published: June 2017

Introduction

Clinical practice in emergency room and crisis unit is often fraught with pitfalls (Immediate demands, accelerated temporality, difficulties working with family and care network). This practice contains specific clinical therapeutic interventions based on recognized theoretical frameworks. These theoretical frameworks constitute “formal knowledge”. They help to diagnose but have got limitations. In fact, clinical competence requires also technical and interpersonal skills (“know-how”) as well as reasoning skills and clinical intuition (“Informal knowledge”). All these knowledge and skills are built over clinical experience based on trainings and supervisions, continued clinical reasoning and exchanges with colleagues.

Objectives

Our research aims to capture therapeutic processes in clinical crisis intervention by illustrating what experts really do in their clinical practice and above all, how they do.

Aims

Our study illustrates several crisis situations, moment-by-moment, by analyzed experts’ voices.

Method

Our method is grounded in a first person epistemology and used a qualitative methodology focused on explicitation interview. Ten crisis interviews were analyzed in a micro and macro perception.

Results

Our research based on experts’ voices has identified a series of therapeutic techniques and principles who are essential to better intervene in clinical crisis intervention. A model of intervention was developed to train debutant clinician.

Conclusion

We believe that reflexivity is a powerful attitude to understand and transform practices in a lasting way.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Relation of stress coping strategies and depressive symptoms in university students
Authors: Kara D. , Gulmez H. , Sayar G. Hizli
Published: June 2017

Relationships between students’ coping strategies with stress and effects on depressive tendencies of negative automatic thoughts are examined in the poster. A group of 153 (126 female and 27 male) university students attending the University of Üsküdar were examined using the Coping Strategy with Stress Indicator (CSSI) to measure the styles of coping with stress; the Beck Depression Inventory (BDI) to measure the level of depression and the Revised Automatic Thoughts Scale (ATS-R) to measure the negative automatic thoughts. Significant relationships were established among CSSI, BDI and ATS-R.

Disclosure of interest

The authors have not supplied their declaration of competing interest.