bluuebunny/crossref_metadata_2025 huggingface dataset:
1639 – Social Intolerance And Risk-taking Behaviors In European Adolescents
Authors: Nemes B. , Cozman D. , Wasserman D. , Carli V. , Sarchiapone M. , Wasserman C. , Hoven C. ,   The SEYLE and WESTAY Study Groups
Published: July 2013

Introduction

Social intolerance is one major topic in every modern society, but although it receives much attention in the public space, there is relatively little information related to the behavioral correlates of such attitudes.

Aim

To investigate the relation between social intolerance and risk-taking behaviors in European adolescents.

Methods

Adolescents from the SEYLE and WE-STAY cohorts were included. The questions evaluating social intolerance, sensation-seeking and delinquent behavior, alcohol, tobacco and illegal drugs use were extracted from the baseline questionnaire.

Results

Adolescents positive for at-risk tobacco, alcohol and illegal drugs use showed significantly lower levels of social intolerance. This observation might be explained by the social factors associated with substance use at this age group. No relationship was observed with sensation-seeking and delinquent behavior.

Conclusions

Social intolerance is not associated with risk-taking behaviors in adolescents.
1641 – Family Burden-focused Psychosocial Therapy With Parents And Social Functioning Of Children And Adolescents With Schizophrenic Spectrum Disorders
Authors: Koren E. , Kupriyanova T.
Published: July 2013

Introduction

Family burden is considered to be an integrated psychosocial parameter negatively impacting on symptom levels, social functioning and outcomes of children and adolescents with schizophrenic spectrum disorders, and specific measures directly aimed at lessening the burden of these families should be developed.

Objective

To assess the influence of burden-focused group therapy (BFGT) with parents on social functioning of children and adolescents with schizophrenic spectrum disorders.

Methods

Parents of 126 children with administered standard antipsychotic therapy (aged 8 - 17 years) were recruited into this study. Parents were assigned to eight 90-minutes “module” structured sessions carried out in groups (8 - 9 members) and received a systematic assessment using CGSQ and CGAS at entry and after 1, 3 and 6 month.

Results

Reciprocal effect with negative correlation (r=-0.463, P=0.005) between family burden indicators and children's total levels of functioning was established. BFGT did significantly affect family burden and correlated with positive changes in overall levels of social functioning of children using CGAS (p< 0,05). The largest decline was noted in Subjective burden (from 4.98 to 3.75).

Conclusions

BFGT aimed at managing family burden and improving children's social functioning proved to be one of key components of the psychosocial treatment and rehabilitation of children and adolescents with schizophrenic spectrum disorders in the context of increasing rehabilitation resource of their families. Further controlled studies are required to strengthen the evidence base for effective management of family burden.
1648 – What Do Adolescents Know About Depression? Efficacy And Utility Of An Information Booklet
Authors: Allgaier A.-K. , Schiller Y. , Eberle-Sejari R. , Schulte-Körne G.
Published: July 2013

Introduction

Adolescents still lack knowledge about depression and its treatment. As a result, depressed adolescents are confronted with stigmata that are barriers to treatment-seeking. Studies in adults demonstrated that depression literacy can be increased by educational material.

Objectives

We developed an information booklet on depression specifically addressing adolescents aged 13 to 17. For the first time, it was examined whether knowledge about depression in youth can be enhanced by reading an educational leaflet.

Methods

The information booklet was evaluated in 628 German ninth graders (M= 15.1 years, 58% boys) in a pre-postfollow- up design.Using study-specific questionnaires, knowledge about seven topics on depression was assessed. Key subjects were symptoms and treatment of depression as well as suicidality.In addition, students evaluated the booklet's layout, content and utility.

Results

Power-analysis of the pre-post-follow-up-comparison yielded effect sizes of knowledge enhancement between eta2 = 0.07 (medium) and 0.56 (large) for all topics of the booklet.The largest effect sizes were found for the topics “symptoms” and “antidepressants”. Sub-analysis on school types and gender showed the highest increase in knowledge in well-educated students and in girls. The participating youth assessed the booklet positively regarding all categories, with a mean overallrating of 2.15 on a scale from 1 (very good) to 6 (fail).

Conclusions

Although students’ baseline knowledge about depression was good, girls and boys of all school types significantly increased depression literacy. Thus, the booklet can help reducing stigmata and treatment barriers in adolescents.
1651 – WAVE-bd, An Ambispective Multinational Observational Study On Bipolar i And Ii Disorder (bdi, Bdii): French Cohort Clinical Outcomes (nct01062607)
Authors: Bellivier F. , Coulomb S. , Vega C. , Lukasiewicz M. , Vieta E. , Figueira M.L. , Souery D. , Langosch J.M. ,   WAVE-bd Scientific Board
Published: July 2013

Introduction

WAVE-bd provides information on the clinical management and outcomes of BDI and II patients in daily clinical practice.

Aim/objective

To describe French patients (n=480) clinical outcomes up to 18 months.

Methods

WAVE-bd included patients with ≥1 mood event (index episode) in the preceding 12 months before inclusion and followed ≥ 9 months (total participation 12 to 27 months).

Results

2896 patients were analysed worldwide, 17% in France (53% in private practice, 47% in public practice): mean age 47 years (SD: 12.51), women, 65%; BD-I, 59%; BD-II, 41%; index event depressive, 64%; hypomanic, 21%; manic, 9%; mixed, 6%.

During follow-up, 77 patients (16%) reported relapses (1.25 patient-years; 95%CI = [1.04; 1.49]) and 176 patients (37%) reported recurrences (0.65 patient-years; 95%CI = [0.57; 0.74]). The most common type of reported recurrence (n; %) was depressive (114; 24%) rather than hypomanic (64; 13%), manic (14; 3%) or mixed (11; 2%). Suicide attempt was reported in 25 patients (5,2%, 0.046 patient-years; 95%CI=[0.031;0.064]). The most common type of treatment during manic and hypomanic episodes was atypical antipsychotics AAP (69% and 49%, respectively) while during depressive episodes, the most common types of treatment were antidepressants (82%).

Conclusions

These results show a high incidence of relapse and recurrence of mood events and the more frequent depressive polarity in BD patients in France. Further analyses are required to evaluate which factors influenced the severity (relapse, recurrence and suicidality) of the disease. Overall, antipsychotics and antidepressants were most commonly prescribed for manic and depressive episodes, respectively.
1653 – The Developemnt Of Adaptive And Maladaptive Patterns Of Internet Use Among European Adolescents At Risk For Internet Addictive Behaviors: a Grounded Theory Inquiry
Authors: Dreier M. , Tzavela E. , Wölfling K. , Mavromati F. , Duven E. , Karakitsou C. , Macarie G. , Veldhuis L. , Wójcik S. , Halapi E. , Sigursteinsdottir H. , Oliaga A. , Tsitsika A.
Published: July 2013

Introduction

Full findings from the European Commission funded EU-NET-ADB study (Safer Internet Programme) will be presented.

Objectives

Empirical findings that elucidate the development of an internet addictive behaviour are still incomplete. This is also related to risk as well as protective factors of internet use. Here a process oriented approach to identify underlying conditions of an internet addictive behaviour was chosen.

Aims

The aim of the study is to enhance the knowledge and understanding of underlying processes which lead to situation were internet addictive behaviour can evolve.

Methods

In total 124 in-depth interviews were conducted with adolescents with an age of 14-17 year. Adolescents from seven different European countries (Greece, Spain, Poland, Germany, Romania, Netherlands & Iceland) participated in this study. Eligibility was granted when adolescents scored more than 30 point or equal in the Internet Addiction Test (IAT; Young, 1998). Data analysis was conducted by use of a step-wise full version of Grounded Theory (Strauss & Corbin, 1990; 1998).

Results

Adolescents employed maladaptive and adaptive strategies in regard to their involvement in the internet. Thus different Digital Outcomes such as “I am addicted” (Stuck Online) ranging to more adaptive internet behaviour like (Juggling it All) and patterns of self-correcting (Coming Full Cycle) were identified. These Digital Outcomes were consequently linked to adolescent's developmental pathways and can be characterized by the core category “Navigating Adolescent Pathways”.

Conclusions

Contextual and developmental factors that mediate the development of an internet addictive behaviour could be identified and linked to multiple Digital Outcomes.
1654 – Efficacy Of Aripiprazole On Behavioural Symptoms In Three Young Patients With Severe Acquired Brain Injury
Authors: Piccoli S. , Pizzighello S. , Martinuzzi A.
Published: July 2013

The atypical antipsychotic drug aripirprazole has a partial agonist activity on the dopamine receptors. This characteristic makes aripiprazole different from other antipsychotic agents.

In this paper, we aim to describe the use of this drug in the management of three young patients with acquired brain injury: a woman with Wilsons disease, a male with a rupture of an arteriovenous malformation and a male with severe traumatic brain injury.

All patients presented behavioural symptoms. One of them presented frequent crises of psychomotor agitation with strong physical aggressive reaction, partial awareness and low frustration tolerance. The other two patients reported a prevalence of negative symptoms, as inactivity, apathy, lack of will and severe perseveration.

They were referred to our Unit and were evaluated with a full functional assessment at the moment of admission and at the discharge, depending on their clinical picture. The evaluation included: MMSE (Mini Mental State Examination), LCF (Level of Cognitive Functioning), DRS (Disability Rating Scale) and FIM (Functional Independence Measure). The behavioural assessment was made with clinical interviews.

After the introduction of aripiprazole, we found an improvement in the behavioural pattern, moreover neuropsychological and motor evaluation appeared not affected.

These results suggest that the use of aripiprazole in patients with acquired brain injury is suitable for its efficacy in reducing psychotic and behavioural symptoms but also for its potential for not affecting motor and cognitive functioning.
1655 – Suicide Attempt Prediction In a Controlled Study Of Case Management In The Prevention Of Recurrent Suicidal Behaviour
Authors: Burón P. , Al-Halabí S. , Garrido M. , Rodríguez-Revuelta J. , García-Álvarez L. , González-Blanco L. , García-Portilla P. , Sáiz P.A. , Bobes J.
Published: July 2013

Introduction

Information about the perception of suicide attempters regarding prevention of their suicide attempt may be helpful in implementing preventive strategies.

Aim

To examine:

(i)

sociodemographic profile,

(ii)

distribution of the Suicide Intent Scale, and

(iii)

differences according to the gender in the sample of participants in a controlled study to determine the effectiveness of case management programme in the prevention of recurrent suicidal behaviour.

Method

106 suicide attempters who attended the Emergency Room of the Hospital of Asturias from July- 2011 to October- 2012 were included in the study [33% males; mean age (SD)= 41.82 (13.16)]. Instruments: Ad hoc Sociodemographic- Questionnaire; Suicide Intent Scale (SIS); SAD-PERSON Scale; Medical Damage Scale; List of Threatening Experiences; Hamilton Depression Rating Scale.

Results

Profile: 45-54 years old (30.4%), married (34%), with bachelor's degree (42.5%), unemployed (29.2%), with children (61.3%) and living with partner (34.9%). 36.2% of the sample had the intention to repeat at the time of the suicide attempt (SA), while 22.6% actually repeated it. The intention to repeat the SA was associated with the commission of SA at 12-months follow-up (p=.002). SIS data: mean total score (SD)=15.99(4.71); mean objective score (SD)=5.69(2.48); mean subjective score (SD)=10.28(3.29). Significant differences in SIS scores were found by gender (p=.007), men scoring higher. Repetition of the SA was related with higher scores (p=.002).

Conclusions

SA severity and its repetition at 12-months follow-up was related with the intention of repetition; nevertheless we didn’t find relation between the SA severity and the repetition of SA one year later.
1660 – Prevalence And Associated Factors Of Anxiety After Deep Brain Stimulation At Subthalamic Nucleus(stn-dbs) In Patients With Parkinson's Disease
Authors: Pariwatcharakul P. , Shotbolt P. , Clough C.
Published: July 2013

Introduction

Deep brain stimulation (DBS) for Parkinson's disease (PD) has emerged as a treatment with very good motor outcomes. However, a higher prevalence of anxiety following DBS has been reported.

Objectives

To study the prevalence and associated factors of anxiety following STN-DBS

Methods

Data were retrospectively collected from medical records of PD patients who underwent STN-DBS at King's College Hospital, London from 2001 to 2010. Neuropsychiatric assessments were done pre-STN-DBS at baseline, and also approximately 6 months after the surgery.

Results

Fifty eight PD patients underwent STN-DBS. After patients with missing data (n=2), patients who were not referred for post-DBS neuropsychiatric evaluation (n=5) were excluded, 51 patients were studied. Their mean age was 61.2±7.1 years old and the mean PD duration was 12±5.2 years. Post-STN-DBS anxiety was found in 8 patients (15.7%). All of them underwent bilateral STN-DBS and had uneventful recovery. Significant associated factors were female gender (n=6; 75.0%; p=0.056) and new-onset post-DBS apathy (n=7, 87.5%, p=0.0001). However, memory impairment (n=4; 50%; p=0.076) and depression post-DBS (n=4, 50%, p=0.055) did not show statistically significant associations.

Conclusions

The prevalence of post-STN-DBS anxiety in our study (15.7%) was lower than that from the previous reports in PD patients who received medication (25-43%) and STN-DBS (40%). The associated factors were similar to those reported in medication-treated PD patients. Given relatively low prevalence of anxiety following the operation, STN-DBS is likely to be a safe treatment for PD patients with high risk for anxiety disorders.
1661 – Effects Of a Basic Protocol To Manage Patients With Personality Disorders In The General Hospital
Authors: Gonzalez-Torres M.A. , Bustamante S. , Vivanco E. , Martinez K. , Alvarez de Eulate S. , Fernandez-Rivas A.
Published: July 2013

Introduction

Patients presenting Personality Disorders and specially Borderline Personality Disorder are often admitted to Psychiatry Units in General Hospitals. Their impulsivity, affective disregulation and difficulties in interpersonal relations complicate the therapeutic atmosphere and cause problematic interactions with staff and other patients. We have developed a basic protocol to manage behavioural problems of those patients in the general hospital.

Objectives

To study the effect of the protocol on the unit's work. Aims. To know the effect of the protocol on some specific variables related to the admission and specifically the use of mechanical restraint. Methods. Prospectively, we compare data on all patients admitted during 2010 (876 total, 87 PD) before establishing the protocol and all those admitted during 2011 (870 total, 112 PD) when the protocol was in use.

Results

The proportion of patients with PD who experienced at least one mechanical restraint intervention went down from 43.7% in 2010 to only 2.7% in 2011 (p= 0.000). In the total group, figures also decreased from 17.3% in 2010 to 3.4% in 2011 (p= 0.000).

Conclusions

The use of mechanical restraints with PD patients in General Hospital Psychiatric Units can be drastically reduced using a protocol guiding the staff to better manage behavioural problems of the patients.
1662 – Clozapine Rechallenging Following Neutropenia In The Treatment Of Intellectual Disability And Comorbid Psychotic Symptoms: a Case Report
Authors: Simoni E. , Moretti V. , Pighi M. , Tedeschini E. , Mazzi F. , Ferrari S.
Published: July 2013

Clozapine has anti-aggressive effects independent of improvement of psychosis and reduce aggression, agitation and selfinjurious behavior. Among individuals with intellectual disabilities (ID) and comorbid psychiatric illness, clozapine is increasingly being prescribed to treat behavioral disturbances.

We report a case of clozapine rechallenge after neutropenia in a 30-year-old patient affected by intellectual disability and psychotic disorder with disruptive behavior.

After several failed trials of other antipsychotics, the patient required an inpatient stabilization. Clozapine was prescribed to manage his severe set of psychotic symptoms and behavioral disturbances. At baseline the full blood count was normal. The patient responded to clozapine and the dose was rapidly increased until it was 300 mg/day. After ten days, a white blood cell (WBC) count of 3.50 migl/mmc and a neutrophil count of 1.56 migl/mmc were revealed. Clozapine was withdrawn. During the following three months the patient had been treated with several combinations of antipsychotics, mood stabilizers and benzodiazepines, but he continued to exhibit bizarre behavior, severe paranoid delusions, and an inability to conduct activities of daily living. Therefore, after a brief period of washout, clozapine was reinstated (25 mg/day) and it was slowly increased by 25 mg every week until it was 100 mg/day. The patient improved and his WBC count and absolute neutrophil count remained within normal limits. Clozapine might be an effective treatment option for individuals with ID and psychotic disorder whose symptoms are not adequately controlled. Furthermore, we assume that a slow titration might help in preventing neutropenia during clozapine rechallenging.
1670 – Prevalence Of Apathy And Depression In a Population Of Elderly Subjects Using Specific Diagnostic Criteria: Preliminary Results From a Multicenter Cross-sectional Study (adep Study)
Authors: Bensamoun D. , Derreumaux A. , Aguera Ortiz L.F. , Lopez J. , Karsten K. , Dechamps A. , Dachesky D. , Bianchini S. , Robert P. , David R.
Published: July 2013

Introduction

Apathy and depression are the two most frequent neuropsychiatric symptoms in Alzheimer's disease (AD) and related disorders. Whereas neuroimaging studies have shown different neural pathways for these two symptoms, a clinical overlap between apathy and depression is frequently described.

Objective

To describe the prevalence of apathy and depression among elderly subjects with or without dementia criteria using specific diagnostic criteria for apathy and depression.

Method

Subjects from an ongoing cross-sectional study were recruited in 4 centers (France, Indonesia, Spain, Argentina). Apathy and depression were assessed using the diagnostic criteria for apathy and for depression. Additionally, the apathy and dysphoria domains of the NPI-C (Neuropsychiatric Inventory-Clinician), as well as the 12 domains of the original NPI (Neuropsychiatric Inventory) were assessed.

Results

431 subjects (mean age=74.6 ± 10.4 ; gender=♂ 29%) were recruited (France=100, Spain=90, Indonesia=182, Argentina=79). Among them, 25% were healthy elderly subjects, 9% had a diagnosis of MCI (Mild Cognitive Impairment), 46% had a diagnosis of dementia (including AD, Lewy body, vascular, mixed and fronto-temporal dementia). In the overall population, the prevalence of apathy and depression were respectively 41% and 25%. More specifically, the prevalence of apathy and depression in the AD sample were 67% and 25%.

Conclusion

Diagnostic criteria for apathy and depression, as well as the NPI-C, are recent assessment methods in the field of dementia, developed to increase the accuracy of the clinical evaluation of BPSD. It is therefore critical to propose multicenter observational studies comparing these new tools with classical assessment methods.
1672 – Pathological Internet Use Among European Adolescents: Psychopathology And Self-destructive Behaviors
Authors: Durkee T. , Kaess M. , Carli V. , Sarchiapone M. , Wasserman C. , Hoven C. , Wasserman D. ,   SEYLE Consortium
Published: July 2013

Aims

To investigate the association of psychopathology and self-destructive behaviors with maladaptive Internet use (MIU) and pathological Internet use (PIU) among European adolescents.

Design

A cross-sectional analysis.

Setting

The study was performed within the context of an on-going epidemiological study conducted in Europe entitled Saving and Empowering Young Lives in Europe (SEYLE). Schools were randomly selected in catchment areas across eleven countries: Austria, Estonia, France, Germany, Hungary, Ireland, Israel, Italy, Romania, Slovenia and Spain, with Sweden as the coordinating center.

Participants

The study sample comprised 11,357 school-based adolescents (M/F: 4,856/6,501; Mean Age: 14.9).

Measurements

MIU and PIU was measured by the Young's Diagnostic Questionnaire for Internet Addiction (YDQ). Psychopathology was measured using the Beck Depression Inventory-II (BDI-II), Zung Self-Rating Anxiety Scale (Z-SAS) and Strengths and Difficulties Questionnaire (SDQ); self-destructive behaviors were assessed by the Deliberate Self-Harm Inventory (DSHI) and Paykel Suicide Scale (PSS).

Findings

MIU and PIU prevalence was 13.4% and 4.2%, respectively; significant gender and country differences were found. A stepwise regression showed that suicidal behavior (RRR=9.8), depression (RRR=5.4), conduct problems (RRR=1.9) and symptoms of ADHD (RRR=1.7) were independently associated with PIU. Anxiety, peer relationship problems and NSSI were not independent factors in the model explaining PIU. Gender and country interactions influenced the association between psychopathology, suicidal behaviors and the YDQ score.

Conclusion

Among adolescents, certain forms of psychopathology and self-destructive behaviors appeared to be highly interrelated with MIU and PIU. These associations are influenced by both gender and country.
1673 – Evaluation Of Sleep And Pain In Newly Diagnosed Patients With Generalised Anxiety Disorder (gad): The Espiga Study
Authors: Allgulander C. , Baldwin D.S. , Gastó C. , Pirkola S. , Wittchen H.-U. , Atkinson G. , Haswell H. , Prieto R.
Published: July 2013

Introduction

In the general population the 12-month prevalence of GAD is estimated to be about 2%. Higher prevalences have been found in primary care settings, with estimates of well over 6%. The role of sleep problems and pain in GAD remains understudied.

Objectives

To evaluate the frequency of sleep problems and pain in newly diagnosed GAD patients in 5 European countries.

Methods

Non-interventional, cross-sectional survey of 1650 adult patients newly diagnosed with GAD in primary care settings. Assessment included clinical interview rating and self report data.

Results

Mean age of the sample was 49.2 years (SD; 14.5). Mean GAD-7 score was 14.8 (SD; 3.1) and the median duration of symptoms was 12.0 months. The proportion with sleep disturbance and pain were 85.9% and 75.9%, respectively. Disturbed sleep had persisted for a median of 9.0 months and was mainly classified as “difficulty in falling asleep” (76.1%) or “nocturnal awakening” (58.8%). The median duration of pain was 6.0 months, and located mainly in the cervical region (47.0%) and upper back/limbs (40.1%). The mean number of days that patients were unable to work because of GAD-related health problems during the preceding 3 month period was 10.8 (95%CI; 9.6-12.0). The proportion of patients that visited the primary care physician and specialist during the preceding 3 months was 93.8% and 40.3%, respectively.

Conclusions

Sleep problems and pain are extremely frequent characteristics of GAD, contributing to the disability and work productivity profile associated with GAD as well as the patients’ use of health care resources.
1683 – Social Behavior And Ultrasonic Vocalizations In Adult Mice β2-ko: Pertinence Of An Animal Model For Schizophrenia
Authors: Gankpé F.G. , Mésenge C. , Granon S.
Published: July 2013

Introduction

In patients suffering from neuropsychiatric disorders such as schizophrenia and depression, the neurobiological processes of decision-making are severely compromised. Some recent studies showed that social behavior and the ultrasonic vocalizations parameters in mice, expressed their emotional mood and could be used to analyze the process of decisionmaking. But, remains to highlight the modulation of these parameters under the effect of drugs, used in the treatment of these pathologies.

Objectives

The aim was to find out the neuropharmacological modulators of decision-making in β2-ko adult male mice, suggested as animal model for schizophrenia, in order to test the pertinence of that model.

Methods

We first, administered clozapine used in the treatment of schizophrenia in human. Then, we analysed the social behavior as well as ultrasonic vocalizations parameters by Avisoft® in social interaction condition.

Results

Our results show that adult male mice β2-ko emit ultrasonic vocalizations. Under the effect of clozapine, the emission of ultrasonic vocalizations are regulated by the balance between cholinergic and dopaminergic pathways. The activation of the cholinergic together with the inhibition of the dopaminergic pathways induces a negative emotional state, showed by vocalizations with low frequency of about 50 kHz. The activation of the dopaminergic with the inhibition of the cholinergic system induces a positive emotional state, showed by vocalizations with high frequency of about 60 to 80 kHz.

Conclusions

The administration of clozapine allowed re-establishing the social behavior parameters in β2-ko mice as well as the level of wild type mice but not about vocalization.
1685 – Monitoring Clinical Observation On Acute Psychiatric Wards
Authors: Najim H. , Saleem K. , Alshibiny B. , Ezeasor N.
Published: July 2013

Background

Clinical observation is very important to manage risk of people who are acutely ill on psychiatric wards. It is always an area of dispute between different specialities and disciplines in serious untoward incidents(SUI). Three levels of observations have been applied on acute psychiatric words. Assessing practice is important to help identifying positive and negative aspects of clinical practice.

Methods

A questionnaire was developed by HN to collect demographic. Medical notes on Westley and Grangewater wards were reviewed. Excel Microsoft Office World Computer Programme was used to analyse the results.

Results

57% were men.

62% were above 41 years of age.

Majority were suffering from schizophrenia and schizoaffective disorders 61%.

64.28 % were admitted as formal patients.

31.42 % were on level I observation.62.53 were informal.

54.76% were risk to themselves, 28.57 % risk to others.

82.3% were on level II observation, 31.42% formal and 68.50% informal.

21.32% were on level III observation. 66.66% were formal and 66.66% had an incident before this level.

Conclusion

This study have shown that patients are assessed properly before they go on any level of care. Some patients need to go on level III as they pose a risk mainly to other people. Regular reviews of patients, especially on high level of observation should be done more promptly, as being on observation is not a comfortable experience to go through and applying the least restrictive practice should always be sought and adopted.
1686 – Teamwork In The Multidisciplinary Melanoma Group
Authors: Scherer E.A. , Scherer Z.A.P.
Published: July 2013

Introduction

In the Multidisciplinary Melanoma Group (MMG) of Ribeirão Preto Medical School Hospital of the University of São Paulo, Brazil, physicians of different specialties (plastic surgery, dermatology, oncology, pathology and psychiatry) work in an integrated way and weekly provide care to outpatients with melanoma. They hold monthly meetings to: discuss administrative issues; update diagnoses, therapies and treatment protocols; discuss research projects, and bring members together.

Objectives

To present, based on a clinical case report, a reflection about the MMG’s teamwork.

Aims

To understand the teamwork of different specialties physicians in providing care to people with melanoma.

Methods

Case report and reflection.

Results

Woman, 35 years-old, white, divorced, two sons (11 and 7 year-old). Primary melanoma operated 5 years before and inguinal metastases resected one month prior to the follow up at MMG. Psychiatric approach: tense, dissociated, with no knowledge about the illness’ meaning, worried about the children. Adjuvant oncologic treatment and support psychotherapy were implemented. After few months, she complained of mild fever and fatigue that interfered in relationship with her children. With change in the adjuvant treatment protocol, patient’s situation was discussed and, after risks and benefits evaluation, it was chosen to discontinue her treatment. Patient got closer to her children and more involved in psychotherapy and outpatient treatment.

Conclusion

The proper use of a uniform language, the definition of roles, clear communication and concern with the aim of taking care of people with melanoma in their clinical and emotional needs facilitate the adjustment and cohesion in the MMG.
1704 – Suicide Attempts Before And During The Financial Crisis In Greece
Authors: Stavrianakos K. , Pachi A. , Paplos K. , Nikoviotis D. , Fanouraki E. , Tselebis A. , Lekka D. , Karakasidou E. , Kontaxakis V. , Moussas G.
Published: July 2013

Objective

Periods of financial crises have been associated with impairment of mental health and increased suicidality. The purpose of this research is to study the potential impact of the consequences of the financial crisis, such as unemployment, job insecurity, debts, poverty, social exclusion on the suicidality in the Greek population.

Method

The records of patients who were hospitalized in the Internal Medicine Clinics of a general hospital after attempting suicide in the years 2007 and 2011, before and during the financial crisis respectively, were studied. Demographic data, methods of suicide attempt, psychiatric history and severity of psychopathology at the time of suicide attempt, were recorded for each patient.

Results

The statistical analysis showed that during the financial crisis there is an increase in the number of suicide attempts. Most affected are those who are unemployed, married, who are reaching the age of retirement or are already retired and have no history of psychiatric disorder or suicide attempt. Furthermore, there was evidence suggesting that a decreased threshold of psychopathology was adequate for individuals to exhibit suicidal behavior.

Conclusions

It seems that the economic crisis in Greece has a negative impact on the mental health of its population and causes an increase in suicidal behavior. Consequently, mental health promotion and suicidality prevention programs are essential for the accurate and timely identification and the immediate and effective management of high risk individuals.
1705 – Prevalence Of Personality Type d In Greece
Authors: Kokras N. , Kouzoupis A.V. , Papadimitriou G.N.
Published: July 2013

Introduction

The type D personality (negative affectivity and social inhibition) has been associated with increased risk for adverse cardiovascular outcomes. The prevalence however of type D personality appears to vary significantly among different societies and cultures.

Objectives

The objective of the present study was to verify the prevalence of type D personality in Greece.

Aims

To identify the prevalence of social inhibition, negative affectivity and personality type D, as measured by the DS-14 scale, in Greek patients.

Methods

A randomly selected sample of 100 patients with acute myocardial infarction and 100 patients with hyperparathyroidism were recruited. All patients were asked to complete the Hospital Anxiety and Depression Scale, the Athens Insomnia Scale and the DS-14 scale.

Results

Social inhibition was present in 43% of patients suffering from hyperparathyroidism and in 55% of patients suffering from acute myocardial infarction. Negative affectivity was present in 51% of patients with hyperparathyroidism and in 68% of patients with myocardial infarction. As a result, type D personality was found to be present in 29% of patients with hyperparathyroidism and in 46% of patients with acute myocardial infarction.

Conclusions

Prevalence of personality type D was found higher in Greek patients when using the translated DS-14 scale and in comparison to other european studies. Interestingly, Greek patients with acute myocardial infarction had a higher type D personality prevalence than those suffering from hyperparathyroidism, confirming that the construct of type D, however variable, might play a role in the development of cardiovascular events.
1716 – Abnormal Resting-state Functional Connectivity In Euthymic Bipolar Patients
Authors: Favre P. , Polosan M. , Pichat C. , Bougerol T. , Baciu M.
Published: July 2013

Objectives

Bipolar disorders (BD) are characterized by emotional and cognitive impairment reflected in functional MRI studies. Although the default mode network (DMN) would be also impaired, resting-state activity was much less explored in these patients. Our current study aims to assess the DMN functional connectivity in euthymic bipolar patients (EBP) in order to identify potential trait abnormalities of this disease.

Methods

Fifteen EBP and 15 matched healthy controls (HC) underwent fMRI exam during 6 min resting state (rest while keeping attention focused on a visual cross on a projection screen). The Independent Component Analysis (ICA) was used to identify DMN network and functional connectivity in each subject. The DMN group maps of EBP and of HS were compared statistically. Additionally, within-group analysis was performed in EBP group to explore the effect of disease duration on functional connectivity.

Results

Compared to HC, EBP showed reduced DMN connectivity within medial prefrontal cortex, right angular gyrus and left occipital lobe as well as abnormal recruitment of right insula and right middle cingulate gyrus. For the EBP group, significant positive correlation between disease duration and functional connectivity has been observed within left amygdala and right middle cingulate cortex.

Conclusions

Our results revealed decreased DMN functional connectivity within frontal and parietal regions in EBP and suggest abnormal internally-focused activity in these patients. Furthermore, the abnormal recruitment of limbic regions such as right insula, middle cingulate gyrus and amygdala may reflect emotional instability and hyperreactivity of EBP, which might be amplified with the disease evolution.
1723 – Female Prisoners And Gender Violence
Authors: Scherer Z.A.P. , Scherer E.A. ,   Interdisciplinary Study Group about Violence (GREIVI)
Published: July 2013

Introduction

Violence is one of the most serious forms of discrimination on account of sex /gender. It is a phenomenon that affects women of different social classes, ethnic and professional groups. Some of these women end up involved with situations that leads them to imprisonment.

Objective

To identify histories of gender violence in a feminine jail population; to analyze the relation of this violence with the imprisonment.

Aims

Understand the circumstances of gender violence that imprisoned women were exposed.

Method

Thematic oral history research, carried out at the Female Penitentiary in Ribeirão Preto (SP) - Brazil. A semistructured interview was applied to 15 female prisoners.

Results

The analysis of the prisoners’ narratives allowed the identification of two categories: “involvement with criminal partners” and “victimization and violence cycle”. In both, the interviewed women understood that they were dominated by men and considered the violence against them deep-rooted in human culture. They claimed that their involvement in criminal activities, mainly drug trafficking, was under the influence or enticement by companions. Some of them were arrested because they carried drugs to their partners inside male penitentiaries. They said that they had no alternative to the criminal activity as there were no social support and opportunities.

Conclusion

The complexity of violence against women makes necessary the implementation of health, social assistance and education public policies that comprise combat, prevention, assistance and assurance of women’s rights.
1731 – The Relationship Between Pain Symptoms, Anxiety And Perceived Family Support In Lung Cancer Patients
Authors: Lekka D. , Tselebis A. , Bratis D. , Zafeiropoulos G. , Nikoviotis D. , Karkanias A. , Syrigos K. , Moussas G.
Published: July 2013

Introduction

Lung cancer is a stressful condition for both patient and family. The anxiety and pain accompanying cancer and its treatment have a significant negative influence on the patient’s life quality.

Aims

To investigate the correlation between anxiety, pain and perceived family support in a sample of lung cancer patients.

Methods

The sample consists of a total of 101 lung cancer patients hospitalized at the oncology department of a general hospital. Anxiety, pain (severity and interference) and perceived family support were assessed using Spielberger’s State - Trait Anxiety Inventory (SSTAI), the Brief Pain Inventory (BPI) and the Family Support Scale (FSS) respectively.

Results

Analysis showed that there is a correlation between anxiety, pain and family support as perceived by the patients. Pain intensity (severity and interference) has a positive correlation to both state and trait anxiety and a negative correlation to family support. The effects of pain in everyday life also exhibit a positive correlation to state and trait anxiety and a negative correlation to family support. Anxiety (state and trait) has a significant negative correlation to family support.

Conclusions

Pain intensity in lung cancer patients seems to have an effect on patient anxiety and perceived family support. Treating patients’ pain could lead to a decrease in anxiety symptoms as well as an increase in perceived family support.
1738 – The Lethal Potential Of Lamotrigine - Dress Syndrome
Authors: Vila Nova V. , Cotta C. , da Ponte G. , Mendes S.
Published: July 2013

Introduction

The Drug Reaction with Eosinophilia and Systemic Symptom (DRESS) is a severe adverse drug-induced reaction of delayed onset. It is characterized by a severe skin eruption, fever, hematologic abnormalities, and internal organ involvement, potentially life-threatening. His incidence ranges from 1 in 1000 to 1 in 10,000 drug exposures. More than 50 drugs have been reported to induce DRESS, however anticonvulsants account for one third of the drugs causing DRESS.

Objective

To Highlight to the knowledge of potential adverse effects of psychiatric drugs.

Methods

To describe and discuss a case report of DRESS Syndrome induced by Lamotrigine in a patient with bipolar disorder, using medline database.

Results

The pathogenesis of DRESS syndrome is not fully understood. However, his death rate is up to 10%, what makes his recognition very important. From all the drugs that can cause DRESS, lamotrigine, used in psychiatry as mood stabilizer, is the second principal drug related to it, next to carbamazepine.

Conclusion

Although, this syndrome is mainly managed in non-psychiatric units, a psychiatrist must know the potential reactions to the drugs he uses. The psychiatrist must be able to warn the patient and to suspect of this clinical identity, in to order to a quicker and better managing of these cases. This subject is an example how psychiatry and medicine are linked and how important is a multidisciplinary approach of a psychiatric patient.
1739 – Obsessive Symptoms Onset Ay Childbirth
Authors: di Giacomo E. , Colmegna F. , Vergani P. , Pucci B. , Tabacchi T. , Clerici M.
Published: July 2013

Aims

Obsessive compulsive disorder (OCD) is relatively more frequent in pregnancy (third trimester) -3,5%- and post partum - 4 to 9%. Puerperium is at risk for onset of OC disorder and OC personality disorder. Most common obsession are contamination (75%), aggressive (33.3%), and symmetry/exactness (33.3%), and the most common compulsions are cleaning/ washing (66.7%) and checking (58.3%). OC personality disorder is a risk factor for post partum onset of OCD.

Methods

We selected women during their admission for delivery (n = 61) and analyzed: sociodemographically and through administration of EPDS, BDI, BAI, WHOQOL and SCID II (comparing Obsessive-Compulsive patients [OC=32] with negative patients [NEG=11]). Time of recruitment: 2 weeks

Results

Labor: Emergency cesarian OC (21,4%) vn NEG (10,3%)

Previous treatment: OC (outpatient department+ private psychiatrist+ psychologist) 11,1% vs NEG 0%; only Psychologist OC 16,7% vs NEG 6,3%

Past drug intake: Antidepressant OC 11,1% vs NEG 0%

Miscarriage: OC (22,2%) vs NEG (31,3%)

Previous Oestroprogestinic intake : OC (66,7%) vs NEG (81,3%)

Complication during pregnancy: OC (38,9%) vs NEG (21,9%)

Whoqol psychological: OC (22,05) vs NEG (23,66) p = 0,46; environment: OC (28,32) vs NEG (31,09) p=0,015; physical: OC (23,37) vs NEG (26,72) p=0,011

BAI: OC (14,58) vs NEG (5,75) p=0,0005

BDI: OC (5,63) vs NEG (1,72) p< 0,0001

Conclusions

The groups clearly differ. From a test analysis we can underline that OC feels less confident in their environment and perceives less Physical wellness. BAI and BDI are statistically different, even if OC scores small level of anxiety or depression.
1741 – Social Cognition In a Case Of Amnesia With Neurodevelopmental Mechanisms
Authors: Markowitsch H.J. , Borsutzky S. , Staniloiu A.
Published: July 2013

Introduction

Co-occurring impairments of episodic-autobiographical memory and theory of mind were described in several psychiatric and neuropsychiatric disorders. Despite sophisticated elaborations in theoretical domains, the relationship between episodic-autobiographical memory and social cognition remains unelucidated.

Objectives

This work’s objectives are establishing greater recognition of the possible contribution of episodic - autobiographical memory to social cognition, by resorting to data from developmental amnesia (a condition with onset in early childhood, caused by relatively selective bilateral damage to hippocampi).

Aims

We describe a young adult with amnesia with neurodevelopmental mechanisms.

Methods

The patient was investigated medically, psychiatrically, with extensive neuropsychological methods and with neuroimaging.

Results

Neuroimaging revealed grossly reduced hippocampi volumes bilaterally. There was no evidence of pathology in the underlying parahippocampal region or other areas. Performance on tasks that tapped on various aspects of social cognition was non-uniform, ranging from within normal limits to moderate impairment.

Conclusions

According to our knowledge, this is among the first case reports about a comprehensive evaluation of social information processing in a patient with amnesia with neurodevelopmental mechanisms. This patient showed impairments in performance in some laboratory tasks for social cognition, but not in others. This suggests that various components of social cognition may have different neural correlates; their unraveling may aid understanding of when and how episodicautobiographical memory contributes to social cognition. This study also emphasizes the need to employ various tasks to assess social cognition in patients with amnesia, which go beyond traditional laboratory paradigms.
1756 – Child Sexual Abuse Andnarcissism: a Case Report
Authors: di Giacomo E. , Aspesi F. , Clerici M.
Published: July 2013

Child Sexual Abuse has a wide range of connotations. Psychiatric implications often include depression, post-traumatic stress disorder, and also self-harming behavior. Moreover it often determines personality correlates (in particular Borderline Personality Disorder).

In this contribution we report an explicative case of the consequences linked to child sexual abuse.

Patient: Male, 40 ys, divorced, one son (11 ys). He reports child sexual abuse by both parents (7 to 12 ys). Abuses ended when he fight with his father using a knife. He worked for an airline company, but was fired for an excess of work absence due to pathology. Since adolescence he presented obsessive-compulsive behavior, anxiety, mood instability, impulsiveness, flash backs, nightmares, attention difficulties and sleep disorder (linked to the idea of his own death during sleeping).

Clinical diagnoses: Post Traumatic Stress Disorder and Obsessive Compulsive Disorder (Axis I), and Personality Disorder NAS with obsessive compulsive and narcissistic traits (Axis II). He complains about side effects due to many drugs (different antidepressants, antipsychotics and mood stabilizers), but shows small responsiveness.

Test:

WAIS-R: I.Q.=105

RORCHACH: a personality organized with narcissistic defenses due to relational defects linked to self and identity definition.

SCID-II: Personality Disorder NAS with obsessive compulsive and narcissistic traits.
1763 – Effectiveness And Safety Of Rapid Clozapine Dose Titration
Authors: Ifteni P. , Manu P.
Published: July 2013

Background

Clinical guidelines recommend slow clozapine dose titration, a procedure introduced in the 1980's to decrease the risk of drug-induced seizures and hypotension. The procedure is considered safe, but may delay adequate control of symptoms.

Objective

To evaluate the effectiveness and safety of rapid clozapine dose titration in schizophrenia patients at high risk of harming themselves or others.

Methods

The rapid clozapine dose titration was used for a consecutive cohort of schizophrenia patients (N = 111, mean age 42.1%, 52% males) admitted to a single psychiatric hospital. Clozapine was started with a dose of 12.5–25 mg and additional doses of 25–50 mg where given as needed every 6 hours. The clozapine treatment was intiated on admission for 73 patients who had been treated with clozapine in the past (Group 1). Thirty-eight patients received clozapine after failing to respond to other antipsychotics (Group 2).

Results

Admission PANSS scores were similar in the 2 groups (104.3 ± 2.9 vs. 103.8 ± 5.1, p = 0.48). Symptom control was obtained after 4.1 ± 3.1 days with a maximum dose of 352.7 ± 176.1 mg clozapine/day in group 1 and after 7.1 ± 4.8 days (p < 0.001) with a maximum dose of 408.6 ± 187.5 mg clozapine/day (p = 0.12) in Group 2. The PANSS scores at discharge indicated similar reduction in symptom severity (60.5 ± 5.4 vs. 59.8 ± 7.4, p = 0.539). None of the patients treated had seizures, syncope, neutropenia or other significant adverse events.

Conclusions

Rapid clozapine dose titration appears safe and effective when used in schizophrenia patients with or without prior exposure to the drug.