bluuebunny/crossref_metadata_2025 huggingface dataset:
A case for considering differences between organic and psychogenic amnesia
Authors: García López R. , Gota Garcés J.M. , García Jiménez J. , Muñoz Negro J.E. , Gutiérrez-Rojas L.
Published: June 2017

Introduction

Medical record, general examination, laboratory findings, neuropsychological interview and multidisciplinary consideration are essential to establish differencial diagnosis and correct approach in amnesic episodes.

Aim

To describe differences between organic and psychogenic anterograde amnesia.

Methods

Single case report and literature review.

Results

A 51-year-old man with only diagnosis of DM I, single, a good relationship with his family, without any personal or familiar psychiatric or neurological history, came to the hospital emergency department brought by his sisters referring disorientation, acute memory loss and mood changes, prevailing indifference to the situation for the last three days. After general exploration, including psychopatological examination and higher brain functions study, we arrived to the conclusion that the patient suffered from anterograde short-term severe amnesia as the only symptom, with evident conservation of autobiographic memory. The family referred as a possible stressor factor his mother's recent transfer to a different city, which had caused constant repeated questions about her location. Given the questionable presentation and trigger we shared the case with the neurologist, who ordered an array of tests to rule out any organic cause (LP, CT, MRI…), obtaining as a final result a diagnosis of limbic encephalitis, treated and effectively solved in two weeks with high-dose glucocorticoids.

Conclusion

Certain features of the symptoms exploration in amnesic episodes such as reiterative questioning about a specific topic, a non-modified autobiography or the absence of a clear traumatic precipitant factor, are essential for a correct approach and may lead the clinic to an organic evaluation.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Profile lipid and obesity in patients with Tms to treatment with antipsychotis
Authors: Suaréz A. Gonzále. , García L. Lago , Huerta A. Alonso , León S. Ocio , Simon M. Gómez , González M.J. Hernández , Al Shaban Rodriguez O. Walid Muquebil Ali , Suarez M.P. Estebanez , Salas I. Barreda , Fernandez J. Lopéz , Ortiz D. Frias , Ojea E. Torio
Published: June 2017

Introduction

Psychiatric patients tend to have severe metabolic alterations of multifactorial causes, lifestyle, diet, drug use and psychopharmacological treatment, especially antipsychotic drugs which act as risk factors for cardiovascular disease, strokes, infections and complications of diseases basal negatively influencing its evolution and prognosis.

Objectives

Rating the profile lipid and the prevalence of obesity in patients registered as disorder mental severe in treatment with antipsychotics.

Aims/methods

A descriptive study was performed taking as variables to take into account levels of cholesterol, triglycerides, weight and size.

Results

Of the 28 patients included in the study 7 refused to perform the corresponding measurements. Of the 21 remaining, 3 showed values higher than 150 mg/dl triglycerides and cholesterol figures higher than 200 mg/dl. Other 3 patients presented hypercholesterolemia without alteration of triglycerides and 2 hypertriglyceridemia without elevation of the cholesterol. Concerning the IMC, found that 7 patients presented overweight (BMI > 25 and < 30) and 5 patients obesity (BMI > 30). Of the 8 patients with lipid disorders, 2 had prescribed treatment with risperidone (oral or injectable) more quetiapine, 2 oral risperidone as monotherapy, risperidone1 more amisulpride, 1 quetiapine more aripiprazole, quetiapine 1 in monotherapyand 1 injection invega more oxcarbamacepina.

Conclusions

We found lipid alterations in a 38.1% of patients and a BMI greater than 25 in a 57.14% of 21 patients who agreed to the study. The most prescribed antipsychoticamong these patients were risperidone (5 patients) followed closely by quetiapine (4 patients).

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Waiting for the child cleft lip and/or palate surgery: Differences between mothers and fathers’ experiences
Authors: Guerriero V. , Gnazzo A. , de Campora G. , Vegni E. , Zavattini G.C.
Published: June 2017

Introduction

Literature on parents of children affected from cleft lip and/or palate has described the risk of higher levels of stress and anxiety during the pre-surgery period. To the best of our knowledge, just one study has empirically investigated the differences in the psychosocial adjustment of both mothers and fathers, but information on the pre-surgery period were not given. Given that, the aim of the current study is to evaluate the psychological functioning of both parents waiting for the child operation.

Method

Data from 34 Italian parents (F = 18; M = 16; Mean age = 36.62, SD = 6.07) of children affected by cleft lip and/or palate (Mean age = 12 months; SD. = 13.75 months) were collected during the pre-hospitalization visits. The following questionnaires were administered, respectively to mothers and fathers: PSI-SF, MSPSS, PACQ, DAS and FACES-IV.

Results

Data shows no significant differences between fathers and mothers on the total score of each variable taken into account. Differently, significant differences emerge on the “Self Blame” PACQ subscales.

Conclusions

Mothers and fathers seem to share the same psychological experience during their child pre-surgery period. To note, our preliminary data highlight the maternal perception as featured by a greater sense of guilty for the child's disease. The feeling of guilt may be a risk factor for the parental ability to cope with the experiences of the child's illness, influencing parental care giving and parent-child relationship.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Couple satisfaction and parenting stress in parents of children with ASD
Authors: Guerriero V. , Fioravanti I. , Petrillo M. , Di Renzo M. , Zavattini G.C.
Published: June 2017

Introduction

Literature on parents’ adjustment in families with autism spectrum disorder (ASD) children highlights on one hand that raising a child with ASD represent a higher stressful experience comparing to families of children with other disabilities and families of children with typical development. On the other hand, a recent systematic review on relationship satisfaction of these parents stressed the very lower levels of couple satisfaction in parents raising a child with ASD. Give that, the aim of this study is to investigate the association between relationship satisfaction and parental stress in a sample of parents of ASD children.

Method

70 parents were recruited (34 = M and 36 = F) to sign the following self-reports: Parenting stress index-short-form (PSI-SF), to assess stress relative to parental role, and dyadic adjustment scale (DAS), to assess couple satisfaction.

Results

The analysis showed no differences between mothers and fathers respect to investigated variables. Negative correlations between almost all subscales of the PSI-SF and the subscales of DAS emerged. Moreover, from the regression analysis performed, it can be concluded that the values of the total score of the DAS predicts the PSI-SF total score.

Conclusions

In accordance with and building on the achievements of previous studies, these data illustrate a positive influence of couple adjustment on parental stress in parents of ASD children, supporting the hypothesis that relationship satisfaction emerge as a protective variables in the process of parental adaptation.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Psychiatric causes of unfitness for military service
Authors: Kefi H. E. , Medeb M.A. , Brahim C. Bechikh , Bouzouita I. , Krir W. , Eddif S. , Oumaya A.
Published: June 2017

Introduction

The national service is a duty for every Tunisian citizen. The knowledge of psychiatric causes of unfitness for military service would enable developing standardized procedures for selecting and psychiatric assessment of young candidates.

Objectives

Determination of the diagnostic categories, frequency and factors associated with psychiatric causes of unfitness for military service.

Method

This was a retrospective, descriptive study, performed on medical files of candidates examined between the 1st of January and the 31st of December 2015 at the military hospital of Tunis.

Results

Eight hundred and seventy-two subjects were examined as a part of an assessment for mental fitness for military service. They were male, single, with an average age of 23.73 ± 3.5 years. Alcohol was consumed by 17.9% of subjects, cannabis by 12.8% and psychotropic by 4.7%. Fourteen percent had self-mutilation, 8.5% had criminal record and 5.3% had tattoos. Military unfitness was found in 80.8% of cases. The main causes of unfitness were anti-social personality disorder (40.6%), hysterical neurosis (14.9%), adjustment disorders (14.5%) and limited intellectual level (7.5%). The average length of service before found unfit was 9.14 months for anti-social personality, 5.94 months for adjustment disorders and 1.78 months for psychotic disorders. This period was significantly longer for the personality disorders (8.62 months) compared to psychotic disorders (P = 0.013) or to non-psychotic disorders (5.05 months, P < 0.001).

Conclusion

The evaluation on the mental ability of military personnel must be performed at an early date, given the financial, material and human consequences that would result from a delayed diagnosis.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
The relationship between parent perfectionism and childhood anxiety of their children in female Refah bank employees in Tehran
Authors: Heidari S.
Published: June 2017

Although many studies have investigated the relationship between perfectionism and anxiety among the adults, little is known about the manifestations of the effects of parent perfectionism on anxiety of children in Iran. This study was conducted to examine the relationship between positive and negative perfectionism of mothers whit anxiety of their children in an Iranian sample. Besides the study of effects of mother's perfectionism and how can make serious problems for their children is another aim of this research. The study was consisted of 150 women of Refah Bank employees and their 8–15 years old children, which were selected by a multi-stage random cluster sampling. In order to evaluation, the positive and negative perfectionism scale and the revised children's manifest anxiety were assessed. After data collection, Pearson correlation and stepwise regression, using SPSS were conducted. Results showed that positive perfectionism of mothers was not correlated significantly with their child's anxiety. However, mothers’ negative perfectionism was associated positively with children anxiety which was significant at 0.01 probability level. Analysis of stepwise regression showed that mothers’ perfectionism predicted anxiety of their child. It can be concluded that negative perfectionism of mothers can directly and indirectly have negative effects on children and provide serious problems for them. Our findings indicate that although we must take care of unhealthy and neurotic consequences of negative perfectionism but positive striving for perfection can help us to improve in some aspects.

Disclosure of interest

The author has not supplied his/her declaration of competing interest.
The investigation of nurses’ burnout levels in the context of emotional habitus
Authors: Akgün B. Mala. , Öz F.
Published: June 2017

Introduction

The concept of Bourdieu's habitus effects nurses’ approach to patients. Habitus is the site of nurses’ internalizations of the rules in the field of care work, where nurses acquire emotional habitus that corresponds to ethical values and feeling rules of care work. If nurses do not manage their emotions in accordance with the moral disposition, social suffering will be occur. Determining social suffering helps to understand how a tension between the field of care work and emotional habitus can violate nurses’ well-being and cause burnout.

Objectives

To determine the emotional habitus of nurses’ with the high level of burnout.

Methods

Clinic nurses of Hacettepe university hospitals constituted the population of this study. Firstly, Nursing Information Form, Maslach Burnout Scale were applied to participating 350 nurses. Secondly, semi-structured thorough individual interviews were made with 39 nurses of 201 with the high level of burnout.

Results

With content analysis emotional habitus, problem areas for emotional habitus, results of these problem areas, optimal behavior in expressing feelings of nurses and related to suggestions to gain these statements total twenty themes were reached. Nurses suggested proposals to gain optimal behavior in expressing feelings. These are individual development, obtaining professional knowledge, role modeling, experiencing. Also, nurses wanted to see value by patients and hospital administration and respect patients.

Conclusions

To prevent and cope with burnout; it has been proposed that awareness training programmes and course contents about emotional habitus, management emotions should be arranged.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Steroid-induced psychiatric syndromes: A case report and a review of the literature
Authors: Martín Gutierrez R. , Suarez Pinilla P. , Medina Blanco R. , Landera Rodriguez R. , Juncal Ruiz M. , Gómez Revuelta M. , Río Hortega I. Madrazo del , Porta Olivares O. , González Gómez J. , Hernando Fernández R.
Published: June 2017

Introduction

Glucocorticoids are widely prescribed for a variety of diseases and are known to cause neuropsychiatric as well as somatic side effects.

Objective

To review the incidence, clinical characteristics, course and treatment of neuropsychiatric effects of glucocorticoids.

Aim

We have described the case of a 86-year-old woman. She had no personal and no psychiatric medical history in her family. She presented wrist arthritis requiring high doses of an oral corticoid treatment (prednisona 20 mg/d). After a week, she started with symptoms characterised by persecutory and surveillance delusions. Organicity was ruled out. The patient got a progressive recovery after starting anti-psychotic medication and progressive reduction of the steroid drugs.

Methods

We have performed a literature review of the neuropsychiatric complications of glucocorticoids using the PubMed database.

Results

Neuropsychiatric effects of glucocorticoids involve affective, behavioural, and cognitive manifestations. The incidence is variable, between 2 and 60% of patients who receive steroids. Although the effects of glucocorticoids are unpredictable, the administered dose is the most significant risk factor for the development of neuropsychiatric symptoms. Dosage reduction typically results in clinical recovery. Although the limited data on this subject, it is a problem that clinicians face on their regular basis. The administration of anti-psychotics or mood stabilizers may be beneficial in the prevention and treatment of this syndrome.

Conclusion

The neuropsychiatric effects of glucocorticoids are unpredictable and non-specific. More controlled trials are needed in order to perform evidence-based clinical guidelines for the treatment with glucocorticoids and for the prevention of neuropsychiatric manifestations.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Violence as object of interdisciplinary research: Characterization of a Brazilian group of studies
Authors: Scherer E. , Scherer Z. , Rodrigues J. , Cavalin L. , Silva D. , Camargo N. , Scherer N.P.
Published: June 2017

Introduction

The interdisciplinary group of studies on violence (GREIVI), created in 2006, develops teaching, research and community extension activities related to violence and its impact on individuals’ mental health (victims or perpetrators).

Objective

To describe the subjects studied, the participants and the activities developed in the GREIVI in the period of 8 years.

Aims

Knowing the GREIVI's activities.

Method

Qualitative exploratory documentary study. Analysed 90 group monitoring reports from 2009 to 2016. The records were subjected to content analysis.

Results

Production: completed 11 research projects of undergraduate and postgraduate students; 7 in progress; presented 9 works in international scientific events; published 9 articles; 1 extension project in elementary school (2009 to 2016). Established partnership with international research and education institution to articulate and implement new projects. Topics discussed: definition, types and nature of violence; ecological model of violence; violence against women; and school violence. Activities: directed reading; discussions and exchange of experiences between the participants; presentation, discussion and advice on research and community extension projects; production and dissemination of scientific papers; technical visits and activities’ structuring and planning. Participants: professionals and undergraduate and graduate students from different areas (nursing, psychiatry, psychology, social work, education, biology and political advisor who works with the theme of violence).

Conclusion

The GREIVI have provided interdisciplinary space for discussion of different aspects of violence and the construction of research and extension projects to the community.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Protective Effect of Saikosaponin B2 on Damage of Cultured SH-SY5Y Cells in Vitro Introduced by Hydrogen Peroxide
Authors: Zhang Y. , Liu F. , Dai Z. , Wu Q.
Published: June 2017

Objective

To investigate the effect of saikosaponin B2 on the damage of cultured SH-SY5Y cells.

Methods

10% calf serum including volume fraction 0.05, 0.10, 0.20 saikosaponin B2 (10−4mol·L−1) were added respectively into the SH-SY5Y cells, which were then treated with 140 μmol· L−1 hydrogen peroxide(H2O2). 10% calf serum group and blank serum without H2O2-treated group were as the model group and the control group. The effect of saikosaponin B2 was observed by morphological identification, colorimetric MTT assay.

Results

Both saikosaponin B2 of 10−6mol·L−1 and 2 × 10−6mol·L−1 can relieve the damage of SH-SY5Y cells and increase the survival of the cells.

Conclusion

saikosaponin B2 can protect the cultured SH-SY5Y cells from damage induced by H2O2.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
A Serious Case of Hysteria
Authors: Adrián A. , Noval Canga C. , Eduardo M. , Sofía G. , Henar D.L.R. , Gema M. , Sandra C. , Nieves D.U.
Published: June 2017

Introduction

Histrionic personality disorder (HPD) is one of the most common personality disorders diagnosed in Psychiatry. This disorder, although not thoroughly researched, has been known to be present in more than 40 percent of patients. There is also a high tendency for those diagnosed with this disorder to be female.

Objectives

The purpose of this case is to show all the difficulties caused by this pathology, since differential diagnosis with other personality disorders, groups of characteristics from different clusters and also, complications produced in daily routine.

Methods

The purpose is to study a clinical case of a 27-years-old woman, with a degree in journalism, who began with a depressive episode after a failed relationship. After being diagnosed of infertility, she debuted with dissociative episodes and somatization symptoms. She did not remember what she had done during the dissociative episode. After that, she suffered several depressive episodes, and a pseudo hipomaniac episode, making the diagnosis of bipolar disorder, with no pharmacological response to lithium or lamotrigine.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Prevalence Study of Mental Disorders in Georgian Military Personnel Participating in Peace-keeping Missions
Authors: Giorgi S. , Oniani T. , Nino G. , Giorgi K. , Estate L.
Published: June 2017

Introduction

Due to the professional activities acute stress disorder and PTSD are most diffuse disorders among military servants. Number of studies revealed relationships between post-traumatic stress and depression, anxiety or somatic complaints.

Objective

Though Georgian military personnel actively take part in the international peacekeeping missions since 2004 and no research was conducted to investigate the prevalence of abovementioned disorders.

Aims

Thus, this study aims to investigate the prevalence of PTSD, depression, anxiety and somatic complaints in the cohort of Georgian military servants.

Method

The research participants were 2799 military servicemen who had been deployed on the 6 month long period to the peace-keeping missions and were screened for psychological problems after deployment. All of them were Caucasian males, with average age of 29.3 years. All participants were asked to complete a PTSD Checklist for DSM-5 (PCL-5), as well as a 15-item somatic subscale of the Patient History Questionnaire (PHQ-15), a 9-item depression subscale of the Patient History Questionnaire (PHQ-9), a 7-item anxiety subscale of the Patient History Questionnaire (GAD-7).

Results

Prevalence rate of probable PTSD screened by the PCL-5 was 2.7%. Further investigation showed that depressive, anxiety and somatic symptoms among them was 21.6%, 8.7% and 21.7% respectively.

Conclusion

Appreciable positive relationship was found (r = 0.65–0.70; P < 0.001) between these variables in the deployed military servants. Therefore, it is recommended that military servants should be screened on all above mentioned conditions along with PTSD, in order to see full picture of co-morbid problems.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Post-traumatic Mania Symptoms: About One Case
Authors: El Kefi H. , Beldi I. , Krir W. , Benchikh Brahim C. , Eddif S. , Oumaya A.
Published: June 2017

Introduction

Psychotraumatism can constitute for some people a real existential fracture, a real upheaval of the psychic organization.

Immediate psychological reactions can vary from one-off and temporary reactions to far more severe and sometimes enduring reactions.

Material and methods

We collected the case of a patient who was hospitalised in April 2015 for manic symptoms in the immediate aftermath of a terrorist attack, with a review of the literature.

Clinical case

This is Mr. A. F., aged 38, with a personal history of AVP and a shooting wound following a terrorist attack. He had presented a psychomotor instability and an exaltation of the mood in the immediate aftermath of an ambush.

Behavioural problems were identified by the psychiatric team during the group debriefing conducted at the HMPIT emergency room. During his hospitalisation, a chemotherapy based on thymoregulators, neuroleptics and anxiolytics was introduced.

The evolution was marked by a significant regression of the manic syndrome after ten days, and the installation of a post-traumatic stress condition (PTSD). At the end of eight months, the patient was able to resume his work with long-term thymoregulatory treatment, a ban on weapons and safety posts.

Conclusion

Manic episodes are rarely observed as an immediate post-traumatic reaction. Their occurrence does not prevent the subsequent installation of PTSD. Has psychic trauma revealed a latent psychosis? Is it a trauma-induced mood disorder?

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Prejudice towards people with mental illness
Authors: Radović J. , Roncevic-Grzeta I. , Rebic J.
Published: June 2017

This paper reports the results of a medical research that measured prejudice and attitudes towards mentally ill people and towards the mental illness. Three groups of respondents were studied: medical students, psychology students and the general population. Medical students and psychology students represented a population that is educated in regards to mental illness, and the general population was not trained so much about mental illness. The hypothesis was that the respondents who have been working with mentally ill people and had lots of knowledge about mental illnesses were the persons with less prejudice towards people with mental illness. The main objective of research was to examine the differences in prejudice and attitudes between respondents who had experience and knowledge related to mental illness and people with mental illness compared to those without such knowledge and experience. Testing was conducted using an anonymous online survey consisting of thirteen questions. The research confirmed the hypothesis and it could be an incentive for education aimed at specific groups.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
The Current European Status
Authors: Maric N. , Andric S. , Raballo A. , Kuzman M. Rojnic , Klosterkötter J. , Riecher-Rössler A.
Published: June 2017

In the last two decades, both early detection (ED) and early intervention (EI) programs and services have gradually become important and innovative components of contemporary mental health care. However, it is unclear whether ED/EI programs have consistently been implemented throughout Europe.

Here, we report results of the EPA Survey on ED/EI Programs in Europe in 2016.

A 16 item questionnaire was sent to representatives (presidents and secretariats) of 40 EPA National Societies/Associations (NPAs), representing 37 countries. The representatives were also invited to recommend a person for additional information about ED/EI services/programs in the country.

The response rate was 59.4% (22 NPAs). Fifteen out of 28 NPAs were from developed, and 7 out of 8 from economies in transition. ED/EI services have been implemented in 54.5% of the included countries, mean duration 10.0 ± 4.9 yrs. Mostly, neither ED were separated from EI, not the adults from adolescents. National plans to develop ED/EI were reported in four countries. Although national guidelines for schizophrenia exist in most of the countries (73.9%), specific chapters focusing on ED/EI and/or at-risk mental states were not included in the majority of them. Duration of untreated psychosis was unknown in 63.6%. In those who gave the estimation it was 12–100 weeks (median in weeks: 33 developed economies; 44 economies in transition).

The fields of ED/EI have been unequally developed across Europe. Still, many NPAs are without the development plans. EPA and its Sections should address the identified gaps and suggest how to harmonize services for the full range of assessments and interventions.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Trazodone in treatment of interferon-induced anxiety in persons with viral hepatitis C
Authors: Miljatovic A.
Published: June 2017

Introduction

The interferon therapy is associated with numerous adverse psychiatric effects, such as tension, irritability, insomnia, etc.

Goal

The goal of this study was to examine the severity and the frequency of anxiety in persons with chronic hepatitis C receiving pegylated interferon alpha combined with ribavirin. We have also tried to assess the efficiency of trazodone in treatment of symptoms of anxiety in patients receiving pegylated interferon.

Method

The total of 36 patients whose diagnosis of chronic hepatitis C has been confirmed both serologically and patohistologically, receiving interferon therapy, ages 22 to 60, participated in this study. The control group consisted of 32 patients, all with same diagnosis, corresponding with those in the study group in terms of gender, age duration of the illness and the level of education. All patients received pegylated interferon alpha 2a, administered subcutaneously once per week, along with oral ribavirin. The research used the following instruments of clinical assessment: structural clinical interview–SCID, ICD–10; Hamilton anxiety rating scale–HAM-A, and the self-report scale for assessment of anxiety–state-trait anxiety inventory–STAI-Form Y. The testing using these instruments was conducted four weeks after the start of the treatment, then after eight weeks, after 12, 24 and 48 weeks, i.e. at the end of the treatment. The patients in the study group received 150–300 mg of trazodone per day, starting at the week 6 of interferon treatment.

Results

The research showed that in the beginning of the interferon treatment approximately one quarter of the patients exhibited symptoms of anxiety in both groups. The administration of trazodone showed beneficial effects in reduction of anxiety induced by the treatment with pegylated interferon.

Disclosure of interest

The author has not supplied his/her declaration of competing interest.
Effectiveness of long-acting aripiprazole in schizoaffective disorders: A naturalistic longitudinal study
Authors: Nivoli A. , Antonioli M. , Folini L. , Floris L. , Meli G. , Paolo M. , Lorettu L.
Published: June 2017

Introduction

Intramuscular paliperidone palmitate (PP) is a long-acting, atypical anti-psychotic for once monthly intramuscular (IM) administration in the treatment of patients with schizophrenia.

Objective

To study the effectiveness (efficacy and quality of life) of ARP in the maintenance treatment of schizoaffective disorder.

Methods

A non-randomized, prospective naturalistic study was performed in out-patients with schizoaffective disorder unsuccessfully treated with oral anti-psychotics. Efficacy of ARP over time was evaluated by using brief psychiatric rating scale (BPRS 24-items), quality of life was evaluated by using QL-Index, both at T0 and at most recent visit (T1). Data were analyzed with Student's t-tests and Pearson correlations (α value, two tailed). Paired t-test was applied for BPRS and for Ql-Index total scores (T0–T1).

Results

Data were available for 8 outpatients consecutively prescribed ARP and naturalistically treated attending at the psychiatric clinic, university of Sassari. Mean time on ARP treatment was 207.14 days (sd 137.2). BPRS mean total score at T0 was 57 (sd 13.2) and at T1 was 39.7 (sd 10.8). QL-Index mean total score was at T0 5.43 (sd 1.6) and at T1 7.14 (sd 2.7). Paired sample test showed a statistically significant difference in decreasing symptoms at BPRS over time (P = 0.001) and QL-Index total score (P = 0.023). The analyses showed a significant improving at the following BPRS sub-items: anxiety (P = 0.005), mood elevation (P = 0.014) conceptual disorganization (P = 0.048), emotional withdrawal (P = 0.05), tension (P = 0.02) and distractibility (P = 0.03).

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Changes in the trend of anti-psychotics prescription in elderly patients in a general hospital in Singapore 2005–2013
Authors: Tan L. , Kinson R.
Published: June 2017

Objectives

This was a descriptive study of the prescription trend of anti-psychotics for elderly patients in a general hospital in Singapore.

Methods

Elderly patients aged >65 who received at least 1 prescription of anti-psychotics during 2005, 2007, 2009, 2011 and 2013 in Tan Tock Seng Hospital, Singapore, were selected. Data was obtained from the hospital computerized prescription records.

Results

The total number of elderly patients who received anti-psychotics increased from 865 in 2005 to 1990 in 2013. Following the official warning issued by the health sciences authority in 2004 regarding the increased risks of cerebrovascular events in elderly patients taking olanzapine and risperidone, prescriptions for risperidone reduced between 2005 to 2013 (20.74% vs. 11.79%, 95% CI: 0.07–0.10, P < 0.0001). However, the percentage of prescriptions of other atypical anti-psychotics such as quetiapine increased from 27.47% to 58.48% (95% CI: 0.29–0.33, P < 0.0001), in 2005 and 2013 respectively, and prescriptions for olanzapine remained relatively stable at 6.65% in 2005 and 8.94% in 2013 (P > 0.05). With the black box warnings extended to typical anti-psychotics 3 years later, the percentage of prescriptions of typical anti-psychotics decreased between 2005 to 2013, e.g. haloperidol (33.19% vs. 13.39%, 95% CI: 0.17–0.22; P < 0.0001), sulpiride (6.58% vs. 2.83%, 95% CI: 0.03–0.05, P < 0.0001) and chlorpromazine (3.85% vs. 1.85%, 95% CI: 0.01–0.03, P < 0.0001).

Conclusions

After the first safety warning the percentage of prescriptions for risperidone dropped significantly, and there was a significant increase for quetiapine. The percentage of haloperidol, sulpiride and chlorpromazine prescriptions declined after both warnings. Anti-psychotics use in the elderly continues to be prevalent.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Hyperprolactinemia and anti-psychotics: Prevalence and risk factors
Authors: Walid B. , Marrag I. , Ben Soussia R. , Ellouze F. , Nasr M.
Published: June 2017

Introduction

Hyperprolactinemia is a frequent side effect observed in patients treated with anti-psychotic drugs. The frequency of clinical signs usually correlates with elevated serum prolactin levels.

Objectives

To estimate the prevalence of hyperprolactinemia among patients treated with a single anti-psychotic and specify the risk factors for its occurrence.

Methods

Cross-sectional study performed in a period of 6 months in the psychiatric department of Mahdia's hospital, for all patients seen in the consultation and treated with a single anti-psychotic for 12 weeks, with a stable dose, and meeting the inclusion and exclusion criteria of the study. Prolactin blood tests have been performed and confirmed by a second one in case of abnormality objectified in the first lab test results. A magnetic resonance imaging (MRI) was intended for patients with prolactin levels greater than 150 ng/mL.

Results

Ninety-two patients were gathered. Prevalence of hyperprolactinemia was 34.8% of which 7.6% had prolactin levels greater than 150 ng/mL. Two macroadenomas’ cases were detected. The analytical study found 7 factors significantly correlated with hyperprolactinemia, which are: female sex, substance use, the presence of side effects, prescription of atypical anti-psychotics, the anti-psychotic treatment prescribed: haloperidol/amisulpride, doses of anti-psychotic greater than 1000 mg equivalent to chlorpromazine and the combination of psychotropic drugs.

Conclusion

Prolactin blood test should be a systematical analysis for all patients treated with anti-psychotics, to prevent the short and long term side effects.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Self-transcendence and excessive TV commercial viewing in senior pupils
Authors: Vasilchenko A. , Tukaiev S. , Havrylets Y. , Rizun V. , Kashpur D. , Pogorilska N. , Radchuk O. , Zyma I. , Abbasova G. , Derevinskaya L.
Published: June 2017

Self-transcendence is an important component of mental health and emotional well-being, and associates with everyday stress. The aim of this study was to reveal the relationships between excessive TV commercial viewing and self-transcendence. Forty-two healthy senior pupils aged 14–17 years participated in the study. We used the temperament and character inventory by cloninger, cloninger tridimensional personality questionnaire, the school anxiety test by Philips, Maddi Hardiness survey, and the emotional intelligence self-evaluation by Hall. We found that excessive TV commercial viewing has been linked to self-transcendence, which directly correlates with empathy and school anxiety. There was an inverse correlation between self-transcendence and self-directedness. We also found interrelations between self-transcendence and reward dependence, mediated by the noradrenergic brain system. We argue that the propensity for watching TV commercials and self-transcendence may determine the activity of monoaminergic brain systems along with the constitutional traits and personality characteristics.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
A systematic review of transcranial magnetic stimulation use for treating autistic spectrum disorders: Preliminary results
Authors: Barahona-Corrêa B. , Chainho A. , Lopes R.
Published: June 2017

Autistic spectrum disorders (ASD) are a group of neurodevelopmental disorders that manifest as deficits in social communication and interaction, and restricted, repetitive behaviors and interests. ASD affect at least 1% of the population and are associated with lifelong disability and early death. There are no effective biological treatments for ASD, although non-invasive neuromodulation has sparked great interest as a possibly useful therapeutic approach. Here, we present preliminary results of a systematic review on the effectiveness of transcranial magnetic stimulation (TMS) in ASD treatment. Using appropriate syntax we searched Pubmed, Web of Science, Science Direct, and Educational Resources Information Clearinghouse. Following standard PRISMA statement (Preferred Reporting Items for Systematic Reviews and Meta-analyses) procedures, we selected 12 eligible studies, comprising four controlled and four uncontrolled trials on the effects of TMS on ASD core symptoms, and 9 controlled and three uncontrolled trials on TMS effects on cognitive performance in ASD. The 12 studies totaled 233 subjects. Although combined effect sizes favor TMS in all fours groups of studies, conclusions are limited by the high study heterogeneity. Furthermore, only three of the controlled studies used sham TMS as the control intervention, and only two studies followed up the therapeutic effects after the last TMS session. Side effects, none of them serious, occurred in 6.4% of treated subjects. Our main conclusion is that there is currently little evidence that sustains the commercial offer of TMS for treating ASD. Better-designed studies are badly needed to fully elucidate the role of TMS in the treatment of ASD.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
ECT in major recurrent depressive syndrome with Parkinsonism syndrome
Authors: Gómez Alemany T. , Soler Vidal J. , Targa I. , Garcia Alarcon B. , Santoro A. , Alcoverro O. , Sendra Lopez J.
Published: June 2017

A 71-year-old woman with history of major recurrent depressive syndrome responsive to clomipramine (last episode at 50-year-old) with the following medical records: ischaemic stroke with progressive cognitive impairment to the extent of requiring wheelchair.

Current episode

Depressive symptoms, with suicidal thoughts, anxiety, tremor and low food intake in the last month (due to choke phobia) with up to 10 kg of weight loss.

Diagnosis

Major recurrent depressive syndrome resistant to treatment with Parkinson syndrome.

Treatment

Lorazepam 10 mg/day levodopa 150/carbidopa 37.5 mg/day, LART Electroconvulsive therapy (Thymatron SYSTEM IV) was also carried out 3 times a week until 15 sessions were reached.

Discussion

This case illustrates the successful response with LART ECT towards major recurrent depression syndrome associated with a pharmacological parkinsonism maintained over the long-term (one year with ECT). There are sufficient evidences showing that the ECT has an effect in the dopaminergic system at different levels: dopamine release, dopamine neurotransmission and linkage with its receptor, and these effects differ between an acute stimulation and when repeated stimulation is carried out. It must be taken into consideration the fact that concomitant existence of depression and parkinsonism could represent another indication for ECT, since the pharmacological management of these patients is highly complex and could even more if we bear in mind that one of the therapeutical options towards the antidepressant potentiation (atypical anti-psychotics) can worsen the symptomatology.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Electroconvulsive Therapy Management in Benzodiazepine-Resistant Catatonic Syndrome: A Case Report
Authors: Louzao Rojas I.I. , Orosa Duarte Á. , Martínez-Alés García G. , Rubio Zavala I. , Fraga Domingo A. , Sánchez Castro P. , Bonán M.V. , Román Mazuecos E. , Flores Martínez A. , Rodriguez Vega B. , Bravo Ortiz M.F. , Jiménez Sola E.
Published: June 2017

Catatonia is a rare but potentially lethal neuropsychiatric syndrome. Despite its historical association with schizophrenic disorders, it is more frequent in affective ones, and is currently considered an independent pathological entity. The basis of the treatment, regardless of the cause, is the use of benzodiazepines and electroconvulsive therapy (ECT), without a clear consensus on the combined treatment. Regarding ECT, the frequency and number of effective sessions has not been clearly established. Therefore, clinical evolution is the main factor to be considered in order to determinate the appropriate treatment regimen, although the daily application of ECT is preferred, at least for the first week. We report the case of a 41-year-old patient with paranoid schizophrenia, who presented with a benzodiazepine resistant catatonic syndrome. The clinical picture included stupor, mutism, negativism, severe stiffness, catalepsy, waxy flexibility and diaphoresis, with slight CPK increase but with no other extrapyramidal symptoms, fever more than 39 and hemodynamic instability, which allowed to exclude a neuroleptic malignant syndrome. A blood analysis, lumbar puncture, CT, EEG and viral serologies were performed with inconclusive results. The patient required ICU admission and ECT treatment and we used the Bush-Francis Catatonia Rating Scale to evaluate the evolution of symptoms. Six daily treatments with ECT led to an almost full recovery of the patient. Further case series regarding the clinical management of this syndrome are needed, in order to reach consensus on an effective ECT regimen.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Therapeutic Approach to Complicated Grief–An Example of Group Psychotherapy in Psychiatric Patients
Authors: Soares J. , Azevedo Pinto S.L. , Pinheiro A.C. , Pacheco S. , Curral R.
Published: June 2017

Introduction.

Complicated Grief (CG) affects 7–10% of the grieving individuals in the general population. However, the incidence is much higher in psychiatric patients, reaching 70% in most samples. These individuals present many risk factors for such condition, demanding a particular attention and treatment approach. Most studies have shown that pharmacological treatment may help relieving depressive and anxiety symptoms, although they do not promote a consistent improvement of the grieving scenario. Several meta-analyses have recognized different psychological interventions as effective in dealing with the loss, decreasing psychological suffering and promoting adaptation. It is accepted that the benefits of the intervention overcome any possible harm.

Objectives.

To evaluate the impact of a group intervention (12 sessions) in pharmacologically stabilized psychiatric patients presenting with CG.

Methods.

Patient selection was performed through a clinical interview and the fulfilment of the following psychometric tests: Complicated Grief Inventory; the Impact of Events Scale; Beck Depression Inventory; Social Support Scale. These assessment tools were also used to evaluate the impact of the intervention performed.

Results.

After the psychotherapeutic intervention, there were significant differences in the levels of depressive and post-traumatic stress symptoms.

Conclusion.

Group intervention in CG has proven effective in this population, specially regarding depression and post-traumatic stress levels.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
The Evolution of Cognitive Behavioural Therapy – The Third Generation and Its Effectiveness
Authors: Carvalho S. , Martins C.P. , Almeida H.S. , Silva F.
Published: June 2017

Introduction.

First wave cognitive behavioural therapy (CBT) focuses essentially on classical conditioning and operant learning and second wave on information processing. They are based on the premise that certain cognitions, emotions and physiological states lead to dysfunctional behaviour and so, by eliminating the first ones, changes in behaviour will take place. Third wave CBT appeared in an attempt to increase the effectiveness of first and second wave by emphasizing contextual and experiential change strategies.

Objectives/Aims.

To make a review on the actual state of the art of third wave CBT, focusing on MBSR (Mindfulness-Based Stress Reduction), MCBT (Mindfulness-based Cognitive Behavioural Therapy), DBT (Dialectical Behaviour Therapy), ACT (Acceptance and Commitment Therapy) and CFT (Compassion Focused Therapy).

Methods.

Research on PubMed using the terms “third wave cognitive behavioural therapy”.

Results.

Methods and targets differ between MBSR, MCBT, DBT, ACT and CFT. Depression, anxiety and borderline personality disorders are some of those targets. However, a transdiagnostic approach is the hallmark of all third wave therapies: mental processes or emotions transversal to many psychiatric disorders such as shame, self-criticism, experiential avoidance or cognitive fusion are the main focus, emphasizing the context and human experience over any categorical diagnosis.

Conclusions.

Third wave cognitive behavioural therapy is an emerging approach born from the need to improve and complement first and second waves. Although very promising, it is still a recent approach and data to support its superiority over the conventional therapies is missing.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Object Relations and Self-Esteem in young Adults with Schizophrenia in Long-Term Psychodynamic Group Psychotherapy
Authors: Grah M. , Restek-Petrović B. , Bogović A. , Mayer N. , Handl H. , Filipčić I.
Published: June 2017

Introduction

Psychodynamic concepts describe object relations deficits in patients with schizophrenia originating from their earliest developmental stage, which is due to reduced ability of direct caregivers to adequately stimulate the child, as well as genetic factors. During psychodynamic group psychotherapy, members through psychotherapy gradually release the old family roles and experiment with new models of behaviour and thus change internalized object representations.

Aim

The aim of this study was to investigate changes in object relationships and self-esteem in the psychodynamic group psychotherapy in young patients suffering from schizophrenia.

Subjects and methods

The study included a total of 41 patients diagnosed with schizophrenia. Before joining the psychodynamic group therapy and after two years of participation in the treatment, all patients completed a test of object relations and the Rosenberg self-esteem scale.

Results

Comparison of the results in two time periods showed downward trend results in all tested dimensions of object relations, a statistically significant difference was found for dimension symbiotic fusion: after two years of participation in the psychodynamic group psychotherapy, patients had significantly expressed less need for symbiotic relationships. Self-esteem was higher in the second period of testing, but without statistical significance.

Conclusion

Taking into account the limitations of this study, we can conclude that the results are encouraging. During psychodynamic group processes in young patients with schizophrenia there is a trend of positive changes in terms of object relations and self-esteem and a significant reduction in the need for symbiotic merging.

Disclosure of interest

The authors have not supplied their declaration of competing interest.