bluuebunny/crossref_metadata_2025 huggingface dataset:
Anger is associated with aggressive, contamination, and sexual obsessions in severe OCD outpatients
Authors: Piacentino D. , Pasquini M. , Tarsitani L. , Berardelli I. , Roselli V. , Maraone A. , Biondi M.
Published: May 2016

Introduction

Despite the potential theoretical and clinical relevance of psychopathological dimensions in Obsessive-Compulsive Disorder (OCD), few studies to date have investigated their possible association with obsession subtypes.

Objectives/Aims

We aimed to examine whether, in OCD patients, anger and other psychopathological dimensions are associated with specific obsession subtypes.

Methods

We consecutively recruited 57 first-visit DSM-V OCD patients (females = 66.7%; age range = 18–63 years) at the Psychiatric Outpatient Clinic of our University Hospital. These patients were affected by severe OCD, as shown by a median (1st quartile–3rd quartile) Yale-Brown Obsessive-Compulsive Scale (Y-BOCS) score of 27.0 (23.0–32.5). We used the point-biserial coefficient (rpbi) to measure the correlation between psychopathological dimensions, as assessed with the Scale for the Rapid Assessment of Psychopathology (SVARAD), and obsession subtypes, as evaluated with the Y-BOCS.

Results

We found significant correlations (P-values < 0.05) between: anger/aggressiveness dimension and aggressive, contamination, and sexual obsessions; apprehension/fear dimension and contamination, religious, and somatic obsessions; sadness/demoralization dimension and contamination and somatic obsessions; obsessiveness/iterativity dimension and all obsession subtypes; impulsivity dimension and aggressive and sexual obsessions; somatic concern/somatization dimension and contamination and somatic obsessions. We also found, by using the Mann-Whitney U-test, that OCD patients with comorbid Obsessive-Compulsive Personality Disorder–but not Schizotypal or Histrionic ones–showed higher levels (P < 0.05) of obsessiveness/iterativity and anger/aggressiveness than OCD patients without the personality disorder.

Conclusions

Anger and other psychopathological dimensions seem to be linked with specific obsession subtypes in OCD patients, suggesting an association between these dimensions and OCD.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
The comorbidity of cluster C personality disorders in obsessive compulsive disorder as a marker of anxiety and depression severity
Authors: Pozza A. , Domenichetti S. , Mazzoni G.P. , Dèttore D.
Published: May 2016

Introduction

Comorbid Cluster C Personality Disorders (PDs) are the most prevalent PDs in Obsessive-Compulsive Disorder (OCD). Investigating clinical correlates associated to OCD with Cluster C PDs may allow identifying tailored treatment strategies.

Objectives

The current study examined whether OCD with comorbid cluster C PDs is associated to more severe OCD symptoms, anxiety and depression relative to OCD with comorbid cluster B PDs or OCD alone.

Methods

Two hundred thirty-nine patients with OCD were included (mean age = 35.64, SD = 11.08, 51% females). Seventeen percent had a comorbid Cluster C PD, 8% had a comorbid Cluster B PD, and 75% had OCD alone. The Structured Clinical Interview for Axis II Disorders, Yale-Brown Obsessive Compulsive Scale, Beck Anxiety Inventory, Beck Depression Inventory-II were administered.

Results

Patients with comorbid Cluster C PDs reported more severe depression and anxiety than those with comorbid Cluster B PDs (F = 10.48, P < 0.001) or with OCD alone (F = 9.10, P < 0.001). Patients with comorbid Cluster C PDs had more severe OCD symptoms than those with OCD alone but not than those with comorbid Cluster B PDs (F = 3.12, P < 0.05).

Conclusions

OCD with Cluster C PDs could be a subtype with more severe anxiety and depression. These findings could be explained with the fact that Cluster C PDs are characterized by behaviours, which can be seen as maladaptive attempts to cope with anxiety and depression. Tailored treatment strategies for OCD with comorbid Cluster C PDs are discussed to target co-occurring anxiety and depression.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Investigation of affective temperaments and chronobiology in patients with obsessive-compulsive disorder
Authors: Sakalli Kani A. , Aksoy Poyraz C. , Poyraz B.C. , Bayar M.R.
Published: May 2016

Introduction

Comorbid mood disorders affect negatively the prognosis of obsessive-compulsive disorder (OCD). Affective temperaments are assumed to be subsyndromal symptoms and precursors of mood disorders but its effects on OCD outcome remain unclear. There is a body of evidence, which supports the association between circadian rhythm disturbances and mood disorders in literature. In contrast, there is limited data concerning the effects of chronobiological preference among the patients with OCD and OCD comorbid mood disorders.

Objective

The aim of this study is to assess the clinical effects of affective temperaments and chronotype differences in patients with OCD.

Methods

The research was performed in patients with OCD which have been under treatment at least for 12 weeks (n = 76) and healthy controls (n = 55). Yale Brown Obsession Compulsion Scale, TEMPS-A, Morningness and Eveningness Questionnaire, Hamilton Anxiety Rating Scale and Hamilton Depression Rating Scale were used in the study.

Results

There were higher scores in depressive, cyclothymic, irritable and anxious temperaments in patients with OCD compared to the healthy group. There were significant differences between patients with remission and not remission in depressive, cyclothymic, irritable and anxious temperaments. Compared to healthy group eveningness chronotype was more frequent in patients; however the difference was not statistically significant. The OCD patients did not differ from comorbid anxiety, depression and remission levels according to the chronotype.

Conclusion

Understanding the effects of affective temperaments and chronotype differences on the outcome of patients with OCD, may provide developing new treatment approaches in especially treatment resistant OCD patients.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
The role of coping flexibility in chronic pain adjustment: Preliminary analysis
Authors: Wong W. , Chow Y. , Wong S. , Chen P. , Lim H. , McCracken L. , Fielding R.
Published: May 2016

Introduction

While a body of research has evidenced the role of pain coping in chronic pain adjustment, the role of coping flexibility in chronic pain adjustment has received little research attention. Coping flexibility can be conceptualized with two dimensions, cognitive and behavioral. The cognitive dimension of coping flexibility (or coping appraisal flexibility) refers to one's appraisal of pain experience when changing coping strategies whereas the behavioral dimension of coping flexibility denotes the variety of coping responses individuals use in dealing with stressful demands.

Objective

The aim of this paper is to present preliminary findings on the role of coping flexibility in chronic pain adjustment by assessing 3 competing models of pain coping flexibility (see Figs. 1–3).

Methods

Patients with chronic pain (n = 300) completed a battery of questionnaire assessing pain disability, discriminative facility, need for closure, pain coping behavior, coping flexibility, and pain catastrophizing. The 3 hypothesized models were tested using structural equation modeling (SEM). In all models tested, need for closure and discriminative facility were fitted as the dispositional cognitive and motivational factors respectively underlying the coping mechanism, whereas pain catastrophizing and pain intensity were included as covariates.

Results

Results of SEM showed that the hierarchical model obtained the best data-model fit (CFI = 0.96) whereas the other two models did not attain an accept fit (CFI ranging from 0.70–0.72).

Conclusion

Our results lend tentative support for the hierarchical model of pain coping flexibility that coping variability mediated the effects of coping appraisal flexibility on disability.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
The relationship between pain coping variability and committed action in chronic pain adjustment
Authors: Wong W. , Chen P. , Chow Y. , Lim H. , Wong S. , McCracken L. , Fielding R.
Published: May 2016

Introduction

Research evidenced the association of pain coping strategies with short-term and long-term adjustments to chronic pain. Yet, previous studies mainly assessed the frequency of coping strategies when pain occurs whilst no data is available on one's flexibility/rigidity in using different pain coping strategies, i.e., pain coping variability, in dealing with different situations.

Objectives

This study aimed to examine the multivariate association between pain coping variability and committed action in predicting concurrent pain-related disability. Specifically, we examined the independent effects of pain coping variability and committed action in predicting concurrent pain-related disability in a sample of Chinese patients with chronic pain.

Methods

Chronic pain patients (n = 287) completed a test battery assessing pain intensity/disability, pain coping strategies and variability, committed action, and pain catastrophizing. Multiple regression modeling compared the association of individual pain coping strategies and pain coping variability with disability (Models 1–2), and examined the independent effects of committed action and pain coping variability on disability (Model 3).

Results

Of the 8 coping strategies assessed, only guarding (std β = 0.17) was emerged as significant independent predictor of disability (Model 1). Pain coping variability (std β = −0.10) was associated with disability after controlling for guarding and other covariates (Model 2) and was emerged as independent predictor of disability (Model 3: std β = −0.11) (all P < 0.05) (Tables 1 and 2).

Conclusions

Our data offers preliminary support for the multivariate association between pain coping variability and committed action in predicting concurrent pain-related disability, which supplements the existing pain coping data that are largely based on assessing frequency of coping.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
The relationships among psychopathy, empathy, and aggression
Authors: Lee J. , Lee H.J.
Published: May 2016

Introduction

The lack of empathy is often described as one of the core characteristics of psychopaths. However, prior studies on cognitive empathy in psychopaths have led to mixed conclusions, with some indicating that psychopaths have no impairments in cognitive empathy.

Objectives

This study set out to resolve this inconsistency by distinguishing the two factors that constitute the construct of psychopathy: Factor 1 (e.g., emotional callousness, lack of guilt) and Factor 2 (e.g., irresponsible lifestyle, poor behavioral controls).

Aims

The main aim of this study was to examine the differential relationship between these two factors and relevant variables including empathy, aggression, satisfaction with life.

Methods

Self-report questionnaires and two online experiments (facial affect recognition task, emotional scenario task) were administered to 306 undergraduate students to collect data about psychopathy, cognitive/affective empathy, aggression, satisfaction with life.

Results

Correlation analysis revealed that both Factor 1 and Factor 2 had negative correlations with self-reported measures of cognitive/affective empathy, and only Factor 1 emerged as a significant predictor of both kinds of empathy. Aggression also showed a stronger positive correlation with Factor 1 than with Factor 2, regardless of subtypes (instrumental, reactive, relational, overt aggression). On the other hand, satisfaction with life was more negatively correlated with Factor 2 than Factor 1, and regression analysis revealed that only Factor 2 was a significant predictor.

Conclusions

This study showed Factor 1 is more important than Factor 2 in explaining both empathy and aggression in psychopath, while satisfaction with life is better explained by Factor 2 than by Factor 1.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Russian–Georgian war crimes and its outcomes
Authors: Jishkariani M.
Published: May 2016

Introduction

Georgia is the Country located in Caucasian Region with two occupied territories: Abkhazia and South Ossetia. Since 1993 as a result of military actions 500,000 civilians became victims of ethnic cleansing. In October 13, 2015 the Prosecutor of the International Criminal Court, requests judges for authorization to open an investigation into the Situation in Georgia that clearly shows importance of the problem addressed by this study.

Objectives of the study includes

Observation of outcomes of traumatic stress among three categories of victims: IDPs, population living in the military conflict zone and civilians living in the so called “Buffer Zone”. Aim of the study was to provide comparative analysis between trauma affected different groups.

Methods

The clinical and paraclinical methods using the semi–structured clinical interview, psychological test battery and paraclinical diagnostic tests were used, analysis were provided by using the SPSS.

Results

Based on observation in 2014–2015 n = 150 victims of war crimes were observed. Also additional stressors for all target groups were identified. Differences and similarities of psychological and somatic after effects of trauma revealed.

Conclusions

We can conclude that prolonged stress situation with unsecured environment and daily life under unexpected circumstances caused prolongation of PTSD alongside of behavioral changes and with damages in social adaptation. On the other hand completed trauma with leaving of native living areas and significant changes in social life in most of cases caused emotional disturbances with prolonged chronic depression and persistent fillings of grief.

Disclosure of interest

The author has not supplied his/her declaration of competing interest.
Post-traumatic stress disorder: Women – Ecuador
Authors: Valdez V. , Veloz J. , Rueda D. , Santana C.
Published: May 2016

Objectives

To determine the incidence of traumatic events in Ecuadorian women exposed to domestic violence and other complex social situations and their relationship with PTSD.

Methods

We applied a transversal descriptive study accomplished by the INEC (National Institute of Statistics and Census). The INEC recruited Ecuadorian women from 15 years old and more, the surveys were focused on this population. In total, 18,800 rural and urban housings were selected all over the country, 24 provinces. Date of the survey: November 16–December 15 of 2011. A, D and G were taken as references for guidelines following the criteria diagnosis of DSM V (Diagnostic and Statistical Manual of Mental Disorders) to determine a Traumatic Event.

Results

The average age of the sample was 28 years old. The standard deviation was 21, ages: 15–25 years old: 14.265 (21.6%), 25–35 years old: 9.324 (14.1%), 35–45 years old: 8.132 (12.3%), 45–55 years old: 6.283 (9.5%), 55–65 years old: 4.302 (6.5%), > 65 years old: 23.745 (35.9%). Prevalence of the traumatic event (DSM-V) 4.6%. Women experienced any kind of violence 60.6%: 61.4% urban, 58.% rural. Types of abuse: psychological: 53.9%, physical: 38.0; sexual, patrimonial: 35.3%. Domestic violence 76.0% y other types of violence 24.0%.

Conclusion

Domestic violence rate is high, also, in this study, we determined that women face an important index of violence during their daily activities. Psychological abuse is the highest abuse, higher in the urban areas. These results based on acute traumatic events may predispose women to develop PTSD. The prevalence of traumatic events must be an alert to the Mental Health Organizations, not only in Ecuador but also in Latin American.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Early detection and treatment of mental illness in the workplace – an intervention study
Authors: Sørensen H. , Valentin J. , Bording M.K. , Larsen J.I. , Larsen A. , Omland Ø.
Published: May 2016

Introduction

Conditions of depression and anxiety among employees’ leads to increased absenteeism and decreased social and professional function.

Objectives

To test a collaborative model for contributing to mental health at work at the lowest interference and highest possible availability among Danish workers.

Aims

To investigate the effect of early detection and treatment in order to interrupt and improve conditions of clinical and sub-clinical levels of mental illness.

Methods

Self-reporting questionnaires were used for identification of clinical and sub-clinical cases of mental illness and for follow-up. Four questionnaires were distributed to all employees in six medium-large companies in Denmark (n = 1292) during a period of 16 months. Employees meeting the screening criteria were assessed diagnostically. Outpatient psychiatric treatment was offered to employees diagnosed with mental illness and preventive CBT-session to those assessed with sub-clinical conditions. Follow-up questionnaires were filled out after 6 and 12 months. Data were analysed using repeated measure mixed effects linear regression.

Results

Of the 587 (55%) employees that returned the questionnaires, 58 were referred to either outpatient psychiatric treatment (n = 38) or preventive treatment (n = 20). Levels of psychopathology decreased significantly in both treated groups. Comparing with the pre-treatment period, a significant positive difference in change in psychopathology was detected for employees in psychiatric treatment. Measured up to healthy controls, the self-perceived level of stress also decreased significantly among employees in psychiatric treatment.

Conclusions

An integrated collaborative model for early detection and treatment was beneficial in order to interrupt and improve the course of mental health problems among Danish employees.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Health-seeking attitudes and existing support services for psychiatric trainees
Authors: Conde E. , Lomax A. , Santos T. , Pattyn T. , Skjødt C. ,   E.R.G. HELP Project
Published: May 2016

Introduction

Concern for medical doctors’ health has been widely recognized over the past ten years. EFPT is aware of the heterogeneity of support set up for doctors in distress, recognizing the need for further cross-Europe research.

Aims

The EFPT “HELP Project” was designed to investigate psychiatry trainees’ perceptions of and attitudes towards health seeking at a Europe-wide scale. Furthermore, it aims to determine what services are available in Europe specifically to support physicians’ health.

Methods

Multinational, cross-sectional survey conducted in 14 European countries between 2013 and 2014. Data collection was accomplished by an anonymous online or hard copy questionnaire. Completion implied consent to participate. Data was analysed using SPSS v20.0.

Results

Of the respondent trainees, 57.7% were from developed economies; 46.2% under 30 years; 26.9% males. Ninety-eight per cent said they would have surgery in the public sector, versus 42.3% who agree to get treatment there for an eating disorder, depression (28.8%) or addiction (17.3%). Trainees from developing economies were significantly less confident in using public sector help for mental health difficulties. When asked for advice regarding the same problems in their fellow trainees, they said they would recommend public sector help. Specific services for doctors exist in the UK, Spain, The Netherlands and Switzerland, but most trainees said there were no services locally.

Conclusion

The EFPT believes specialised physician health services are needed to ensure doctors seek help when necessary, while avoiding feeling stigmatised or punished in doing so. The authors plan to create a ‘survival guide’ for European trainees in distress, with collated information about local services for doctors.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Psychosis among HIV-infected patients –a serious and complex association
Authors: Marinho M. , Marques J. , Bragança M.
Published: May 2016

Introduction

Psychosis represents an uncommon but serious complication in the course of HIV infection, and always requires a careful differential diagnosis.

Objectives

To provide an overview of psychosis in HIV-infected patients.

Methods

Literature review based on PubMed/MEDLINE, using the keywords “HIV” and “psychosis”.

Results

Psychosis in HIV-positive individuals can be divided into psychotic disorders predating HIV infection and new-onset psychotic disorders in HIV-seropositive patients. The pathophysiology of psychosis in this population is complex and a multifactorial etiology is likely in most instances. The authors will analyze them and describe the differences of psychopathological pattern in first-episode psychosis between HIV-positive and HIV-negative patients. Antipsychotic agents are the treatments of choice regardless of the underlying diagnosis. However, they should always be used at the lowest possible dose for the shortest possible duration. Increased sensitivity to extrapyramidal reactions, high risk for dyslipidemia and hyperglycemia, potential interactions between HAART and some antipsychotic agents are also important considerations. Importantly, psychosis may be a harbinger of dementia. Cross-sectional studies have also suggested that psychosis may adversely impact the morbidity and mortality associated with HIV-infection.

Conclusions

Psychosis disorders may arise before or at any time during the course of HIV infection. A solid understanding of the complex relationship between psychosis and HIV allows for better evaluation and more effective treatment for psychotic individuals at risk for or infected with HIV. Thus, both HIV care programs and psychiatric care clinics should be made familiar with this important subject.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Neuroleptic effect in aggressive mice after the transplantation of immune cells treated in vitro with chlorpromazine
Authors: Markova E. , Knyazheva M. , Shushpanova T.
Published: May 2016

Introduction

Existence of integration, mutual relations of nervous and immune systems, which cellular elements are characterized by expressed phenotype and functional similarity, means the possibility of immune cells participation in the regulation of higher nervous activity.

Objectives

Previously, we demonstrated the possibility of targeted regulation of animal's behavior by the transplantation of immune cells with definite functional characteristics. Based on the our previous research results in the present study, we investigated the modulating effect of the immune cells, treated in vitro with chlorpromazine on the nervous and immune systems functional activity in aggressive mice.

Methods

(CBA × C57Bl/6) F1 aggressive mice, exposed to 10-days chronic social stress, were undergoing the transplantation of immune cells in vitro treated with chlorpromazine. Animal's behavioral parameters, cytokines synthesis in the brain and immune cells before and after transplantation were estimated.

Results

It was shown that aggression is associated with the increased production of spleen T-helper 1 cell-derived cytokines IL-2 and IFNγ, as well as decreased TNFα production by the spleen mononuclear phagocyte cells. These alterations were more pronounced following mitogen stimulation. Spleen cells, obtaining from aggressive mice, were treated in vitro with chlorpromazine and then injected intravenously into syngeneic aggressive recipients. The cell's transplantation led to the reduction of the recipient's motor activity in the “open field” and Porsolt swimming tests and normalized cytokines synthesis in the brain and immune cells.

Conclusion

Research results demonstrated the neuroleptic effect in aggressive mice, obtained by the transplantation of immune cells treated in vitro with chlorpromazine.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Family functioning and individual psychopathology in a non-clinical general population
Authors: Adamis D. , Petmeza I. , McCarthy G. , Tsamparli A.
Published: May 2016

Introduction

A family “constructs” an identity of its own derived from their assumptions about relationships and the social environment they live in. This identity transcends the individual while at the same time encourages individual differentiation. Family functioning is influenced from different factors like social context, qualitative characteristics, and from individual's medical or psychiatric condition.

Aims and objectives

To examined the effects of sociodemographic factors and individual psychopathology on the function of family in a non-clinical sample.

Methods

Cross-sectional study of participants and their families. The follow data collected:

–demographics (age, gender, occupation, education);

–description of the family (number of members, single parents family, adoption);

–history of mental or physical illnesses;

–Family Assessment Device (FAD);

–Symptom Checklist-90 (SCL-90).

Results

The sample constituted of 151 families, (453 individuals), in 48 families, 2 family members participated, in 56 families, 3 members participated, in 46 families 4 members participated and 1 family had 5 members participating. One hundred ninety-four (42.8%) were children and 259 (57.2%) were parents. The mean age of the children was 23.62 (SD: 6.35) and 68 (35%) were males. Mean age of the parents was 51.4 (SD: 8.2) and 117 (45.2%) were males. SCL-90 identified 183 participants as caseness. Multilevel analysis showed that individual psychopathology (caseness) was the only statistical significant factor for family dysfunctioning.

Conclusion

There is strong association between family dysfunction and psychopathology of a member. Dysfunctional families need further psychiatric evaluation of the members. Cause-effect cannot be concluded from this cross-sectional study.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Psychometric evaluation of a 33-item subset of MOODS-SR for distinguishing bipolar disorder
Authors: Ioannou M. , Dellepiane M. , Benvenuti A. , Feloukatzis K. , Skondra N. , Steingrimsson S.
Published: May 2016

Introduction

The MOODS-SR is a self-report instrument consisting of 161 dichotomous items. It is designed to assess lifetime presence of mood spectrum psychopathology. Recently, it has been proposed that a subset of 33 items can be used to distinguishing bipolar disorder.

Aim

To evaluate psychometric properties of a 33-item subset and to propose a clinically relevant cut-off for screening for bipolar disorder.

Methods

Patients with mood disorders were recruited from outpatient services at Sahlgrenska University Hospital. Patients and a convenience sample of healthy controls were offered to fill in the MOODS-SR. A post-hoc analysis was conducted for the 33-items subset of the MOODS-SR.

Results

The subset showed high internal consistency (Cronbach α = 0.95). The mean scores of patients with bipolar disorder (22.7 ± 6.4) were significantly higher than those of the unipolar (11.3 ± 4.9) and control group (7.0 ± 7.0, P < 0.005). A significant correlation was found between YMRS (r = 0.50, P < 0.005) and the 33-item subset, but not with MADRS (r = –0.22, P = 0.223).

Conclusion

The 33-item subset of MOODS-SR showed promising psychometric properties, including good known-group validity. It discriminated bipolar patients from unipolar patients and healthy subjects. The clinical usefulness of these finding needs further investigation.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Mood instability and clinical outcomes in mental health disorders: A natural language processing (NLP) study
Authors: Patel R. , Lloyd T. , Jackson R. , Ball M. , Shetty H. , Broadbent M. , Geddes J.R. , Stewart R. , McGuire P. , Taylor M.
Published: May 2016

Introduction

Mood instability is an important problem but has received relatively little research attention. Natural language processing (NLP) is a novel method, which can used to automatically extract clinical data from electronic health records (EHRs).

Aims

To extract mood instability data from EHRs and investigate its impact on people with mental health disorders.

Methods

Data on mood instability were extracted using NLP from 27,704 adults receiving care from the South London and Maudsley NHS Foundation Trust (SLaM) for affective, personality or psychotic disorders. These data were used to investigate the association of mood instability with different mental disorders and with hospitalisation and treatment outcomes.

Results

Mood instability was documented in 12.1% of people included in the study. It was most frequently documented in people with bipolar disorder (22.6%), but was also common in personality disorder (17.8%) and schizophrenia (15.5%). It was associated with a greater number of days spent in hospital (B coefficient 18.5, 95% CI 12.1–24.8), greater frequency of hospitalisation (incidence rate ratio 1.95, 1.75–2.17), and an increased likelihood of prescription of antipsychotics (2.03, 1.75–2.35).

Conclusions

Using NLP, it was possible to identify mood instability in a large number of people, which would otherwise not have been possible by manually reading clinical records. Mood instability occurs in a wide range of mental disorders. It is generally associated with poor clinical outcomes. These findings suggest that clinicians should screen for mood instability across all common mental health disorders. The data also highlight the utility of NLP for clinical research.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Blonanserin augmentation in patients with schizophrenia – who is benefited from blonanserin augmentation?: An open-label, prospective, multicenter study
Authors: Woo Y.S. , Park J.E. , Kim D.H. , Sohn I.K. , Hwang T.Y. , Park Y.M. , Jon D.I. , Jeong J.H. , Yoon B.H. , Bahk W.M.
Published: May 2016

Introduction

Evidences for antipsychotics augmentation for schizophrenic patients with suboptimal efficacy have been lacking although it has been widespread therapeutic strategy in clinical practice.

Objectives

The purpose of this study was to investigate the efficacy and tolerability of blonanserin augmentation with an atypical antipsychotics (AAPs) in schizophrenic patients.

Methods

A total of 100 patients with schizophrenia partially or completely unresponsive to treatment with an AAP recruited in this 12-week, open-label, non-comparative, multicenter study. Blonanserin was added to existing AAPs which were maintained during the study period. Efficacy was primarily evaluated using Positive and Negative Syndrome Scale (PANSS) at baseline, week 2, 4, 8, and 12. Predictors for PANSS response (≥ 20% reduction) was investigated.

Results

The PANSS total score was significantly decreased at 12 weeks after blonanserin augmentation (–21.0 ± 18.1, F = 105.849, P < 0.001). Response rate on PANSS at week 12 was 51.0%. Premature discontinuation was occurred in 17 patients (17.0%) and 4 patients among them discontinued the study due to adverse events. Nine patients experienced significant weight gain during the study. Response to blonanserin augmentation was associated with severe (PANSS > 85) baseline symptom (OR = 10.298, P = 0.007) and higher dose (> 600 mg/day of chlorpromazine equivalent dose) of existing AAPs (OR = 4.594, P = 0.014).

Conclusions

Blonanserin augmentation improved psychiatric symptoms of schizophrenic patients in cases of partial or non-responsive to an AAP treatment with favorable tolerability. Patients with severe symptom despite treatment with higher dose of AAP were benefited from this augmentation. These results suggested that blonanserin augmentation could be an effective strategy for specific patients with schizophrenia.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Superficial neurostimulation application, alpha rhythm and clinical effects
Authors: Rico P. , Aranguren P.
Published: May 2016

Introduction

The alpha rhythm (EEG) in prefrontal regions has been related with the emotional equilibrium, predisposition for a positive mood (Urry et al., 2004) and the activation of the approximation system (Davidson and Irwin, 1999). Superficial neurostimulation application (SNSA) provokes an increase of such rhythm in prefrontal and temporal areas (Bardasano et al., 2010).

Aims

To demonstrate that the increase of alpha synchronization is a common factor in the satisfactory evolution of patients with different pathologies.

Methods

Thirty patients with different symptoms (hostility, anxiety, bruxism and obsessive symptoms) received 20 weekly sessions of 45 minutes long using the SNSA.

Materials

–SNSA topology system: it is a machine for superficial stimulation that uses electricity through superficial electrodes which are placed on feet and hands and an electrode over the 7th cervical vertebra;

–digital encephalogram;

–Faraday cage.

Results

The alpha rhythm was incremented in 85% of the cases in anterior regions of the brain, related with the improvement of scale's punctuation.

Conclusion

The alpha rhythm has been showed to be presented in all individuals that improved their symptoms after the application of SNSA (Fig. 1).

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Effect of an acceptance and commitment group therapy in the treatment of panic disorder and agoraphobia. A preliminary study
Authors: Leon-quismondo L. , Lopez-rios F. , Rodriguez-pedraza E. , Fernandez-liria A. , Lahera G.
Published: May 2016

Introduction

Acceptance and commitment therapy for the treatment of panic disorder and agoraphobia has been a big boost in last years, and there are preliminary studies about its efficacy. However, most studies have used individual interventions.

Objectives

Evaluate the effect of an acceptance and commitment group therapy in patients with panic disorder and agoraphobia.

Methods

The sample consisted of 24 patients, aged between 18 and 55 years old, who were referred to groups by psychologists and psychiatrists of Mental Health Center. The intervention in each group consisted of 12 treatment sessions of 1 h 30 m duration, weekly. One pretest and posttest evaluation was conducted. The variables studied were: severity of panic disorder (Panic Disorder Severity Scale [PDSS]), fear of physical sensations (Body Sensations Questionnaire [BSQ]), frequency of catastrophic thoughts (Agoraphobic Cognitions Questionnaire [ACQ]) and level of experiential avoidance (Acceptance and Action Questionnaire-II [AAQ-II]).

Results

The mean scores for all variables studied decreased in the post-evaluation. Means in post-evaluation were significantly lower (t Student, a = 0.10) in three of the four variables studied: severity of the condition (P = 0.001), frequency of catastrophic thoughts (P = 0.038) and level experiential avoidance (P = 0.073). In other words, patients had fewer panic attacks after treatment, and those who had were less intense, they had less catastrophic thoughts about consequences of anxiety, and they were better to accept their feelings and thoughts.

Conclusions

Although it is necessary to continue the study with a larger sample, these preliminary results support the use of ACT in group format in the treatment of panic disorder and agoraphobia.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Canadian psychiatry utilization trends
Authors: Radu G. , Harris N. , Hessen J. , Fowler K. , Pickett S. , Wenhui Ren K. , Harris G.E.
Published: May 2016

Introduction

The number of psychiatrists continues to grow in Canada. Patient psychiatry utilization statistics, including reasons for termination of such services, are important factors that have the potential to impact future Canadian and international psychiatry service policies and practices. In addition, understanding the reasons for psychiatry service termination is necessary to improve service quality and effectiveness.

Aims

This study focused on utilization trends, perceived effectiveness of psychiatry services, and reasons for termination of psychiatry services in Canada.

Method

Prevalence of psychiatry service use, perceived effectiveness, and reasons for termination of such services were investigated in a Canadian sample (n = 25,113). Prevalence rates were investigated by geography, sex, and age. Data were self-reported and collected through a national Canadian phone survey focused on mental and physical health.

Results

Results highlight that a small percentage of participants reported utilizing psychiatry services. The majority of participants using such services perceived them as useful. Across geographical regions, reasons for discontinuing services were most often related to completing treatment, feeling better, or not seeing the treatment as helpful.

Conclusions

This study explored psychiatry utilization trends, perceived psychiatry effectiveness, and reasons for patient termination of such services. Results are explored through a geographical region breakdown, sex differences, and age stratification. Implications for policy, practice, and training are discussed from a Canadian and international perspective.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
How we can enhance treatment adherence? Perspective of patients and clinicians
Authors: Cardoso A. , Aguiar P. , Byrne M. , Xavier M.
Published: May 2016

Introduction

Non-adherence to antipsychotic medication is commonly found in mental health disorders (MHD), thus forming a major obstacle to long-term maintenance treatment and contributing to high relapse rates and also can influence the attitudes and beliefs of mental health professionals (MHP).

Objectives

–assess the beliefs of MHP;

–assess perception of illness in patients with MHD.

Aims

Contribute to treatment adherence of patients with MHD, through developing adequate strategies to their needs.

Methods

In this cross-sectional study, we use a convenience sample of patients with MHD attending in the mental health departments of three general hospitals in Lisbon great area. Data is being collected through individual interviews. We have applied clinical and socio-demographic questionnaire and additional measures to assess symptom severity, treatment adherence and attitudes towards medication. For MHP, we used a optimism scale (ETOS), Difficulty Implementing Adherence Strategies (DIAS); Medication Alliance Beliefs Questionnaire (MABQ).

Results

Two convenience samples were composed by 150 patients with MHD (mean age: 39.7; SD ± 9.8) and 65 MHP (mean age: 37.0; sd 8.3) working in a variety of settings is being collected. From the perspective of patients, the most important reason for adherence is to accept the illness (54,7%, n = 82). 50.8% (n = 33) of MHP believes that if patients are unmotivated for treatment, adherence strategies are unlikely to be effective. 43.1 (n = 28) of MHP agrees that if patients do not accept their illness, any adherence strategies that result.

Conclusion

With this study, we expect to gain further knowledge on the factors related patients and MHP that might influence compliance and, therefore, contribute to the development of effective strategies to promote treatment adherence in MHD.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Cognitive training using a web-based tailor-made program for first-episode psychosis patients: An exploratory trial
Authors: Moura B. , Mendes T. , Antunes F. , Barandas R. , Croca M. , Frade P. , Linhares L. , Vian J. , Levy P. , Figueira M.L.
Published: May 2016

Introduction

Cognitive deficits are a core feature of the first psychotic episode patients and could be an obstacle to functional ability. Cognitive stimulation could be a promising method to surpass neuropsychological deficits.

Objectives

–to implement an online training protocol to stable first psychotic episode outpatients;

–to assess adherence to the intervention;

–to measure neurocognitive, psychopathological and functional outcomes pre- and post-training.

Aims

To investigate the feasibility of an online-based resource for cognitive stimulation (COGWEB®) and explore possible benefits in different domains.

Methods

Fifteen patients were enrolled from the Early Psychosis Intervention Program (PROFIP) at the Department of Psychiatry of Santa Maria Hospital, Lisbon. The training consisted on 30-40-minute online sessions performed every weekday during 6 months at home. Assessments were performed at baseline and after program completion and included: psychopathological scores; personal and social functioning scores; Clinical Global Impression and a neuropsychological battery.

Results

Every participant had some kind of impairment on baseline. Mean training time was 36 h. Six patients left the program before completion (half of them because they got employed). The program showed overall good feasibility and safety with no reported significant psychiatric occurrences or hospitalizations. Results regarding final neuropsychological, psychopathological and functioning showed a tendency for stability or improvement on an individual case analysis.

Conclusions

Our results show that cognitive training using an online-based stimulation software is a feasible intervention for first-episode psychosis patients with possible benefits for this population. However, results should be analyzed very carefully because of different participant trajectories and of study limitations.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Psychometric evaluation of the Greek version of Mc Master Family Assessment Device (FAD)
Authors: Adamis D. , Petmeza I. , McCarthy G. , Tsamparli A.
Published: May 2016

Introduction

The Family Assessment Device (FAD) is a self-report questionnaire, developed to assess the six dimensions of the McMaster Model of family functioning. It has been translated to the Greek language but never validated.

Aims and objectives

To evaluate the psychometric properties of the Greek version of FAD in a non-clinical sample.

Methods

In a sample of Greek families, FAD was administered together with the already validated Family Adaptability and Cohesion Evaluation Scale (FACES-III). In a subsample of 96 participants, the scales were administered again after 1 month.

Results

A sample of 453 participants (194 children and 259 parents) had completed both questionnaires (151 families). Mean age of children was 23.62 (SD: 6.35), 68 (35%) were males. Mean age of parents was 51.4 (SD: 8.2), 117 (45.2%) males. All subscales of FAD had significant correlation (concurrent validity) with FACES-III (n = 453, P < 0.001). Test-retest reliability range from 0.58 to 0.82 (n = 96, P < 0.001). Internal consistency (Cronbach's alpha) range from 0.47 to 0.94. A model with the 6 factors had a good statistical fit but not all the items were loading in the same components as from the theory assumed.

Conclusions

The Greek FAD has good psychometric properties, although its factor structure might differ from the original version. Further evaluation of the Greek version of FAD in other settings and in different samples especially clinical remains a task for future research.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Pool-data of clinical cases of inhaled loxapine (Adasuve)
Authors: Gil Luna E. , Morato Parcerisa J. , Roset Arisso P. , Boldeanu A.
Published: May 2016

Introduction

Agitation is a psychiatric emergency that requires immediate assistance. Inhaled loxapine is a new option for achieving rapid tranquillisation avoiding coercive measures and over-sedation, which fits with patient's preferences and increases their satisfaction with treatment.

Objective

Review the experience of use of inhaled loxapine in clinical practice.

Methods

We included data from all reports of case series with 10 or more patients published by European prescribers.

Results

Ten posters were included that reported data on 116 patients, mostly diagnosed with psychotic or bipolar diseases. Among the 60 patients that were evaluated using PANSS-EC, baseline agitation intensity was above 20 in 45 of them (75%) and between 15 and 32 in 15 (25%). Regarding patients evaluated with the CGI-S scale, 17 patients had a score between 6 and 7 points and 4 had scores between 4 and 5. All patients were able to properly inhalate the drug. In some patients agitation receded as early as 2 minutes, and almost all of them were controlled within 10 minutes. Only 6 patients required the 2nd dose of loxapine within 24 hours. When patients were asked for, they showed a preference for inhaled administration instead of intramuscular one, manifested high levels of satisfaction with inhaled treatment, and in one report inhaled loxapine was stated to contribute to avoid mechanical restraint. Inhaled loxapine was well tolerated and no over-sedation was reported or any EPS, just a case of mild orthostatic hypotension.

Conclusion

This pool-data review of inhaled loxapine in real world clinical practice shows that it is an effective treatment, with a very rapid response, easy to administer and well tolerated, with a good acceptance from patients.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Bedtime Counterfactual Processing Questionnaire (BCPQ): Validation of the Portuguese version
Authors: Borges J. , Borges D. , Pereira A.T. , Cabral A.S. , Azevedo J. , Macedo A.
Published: May 2016

Introduction

Counterfactual thinking is a set of mental representations of alternatives to the past actions. When it focuses on personal decisions, the emotion that results is regret, which has important implications for psychological distress (Borges et al., 2015). The Bedtime Counterfactual Processing Questionnaire (BCPQ; Schmidt and Linden, 2009) was developed to assess the frequency of regret-related counterfactual thoughts during the pre-sleep period.

Objective

To investigate the psychometric properties of the BCPQ (extended version) Portuguese version.

Methods

A community sample composed of 108 university students and 79 employees (78.1% females; mean age = 33.16 ± 13.175; range: 17-62) answered the Portuguese preliminary versions of the BCPQ and Regret Scale (Schwartz et al., 2002). To study the temporal stability, 31 participants (83.9% females; mean age = 26.54 ± 18.761) answered the BCPQ again after 6 weeks.

Results

The BCPQ2 Cronbach alpha was “very good” (a = 0.81). All the items contributed to the internal consistency. The test-retest correlation coefficient was high, positive and significant (0.78; P = 0.05); there was not significant difference between test and re-test scores [29.87 ± 5.309 vs. 30.13 ± 5.353, t (30) = −0.204, P = 0.840]. Following the Kaiser and the Cattel's Scree Plot criteria, two meaningful factors were extracted which explained variance (EV) was of 65.06%: F1 Regret (EV 43.17%; a = 0.88), F2 low pride (21.88%; a = 0.88). Pearson correlations of EA total score with BCPQ2 and F1 were significant and moderate (r@.50) and with F2 was non-significant.

Conclusions

Although the Portuguese version of the extended version of BCPQ has good reliability and validity, the low pride-related dimension seems to be relatively independent of regret.

Disclosure of interest

The authors have not supplied their declaration of competing interest.