bluuebunny/crossref_metadata_2025 huggingface dataset:
Prevalence of Internet Addiction: A Pilot Study in a Group of Italian Students
Authors: Marazziti D. , Mucci F. , Vanelli F. , Renda N. , Baroni S. , Piccinni A.
Published: June 2017

Introduction

Internet addiction (IA) is considered part of the so-called “new technologies addictions” group, that in turn belongs to a wider, novel group of abnormal behaviors defined “no-drug addictions” or “behavioral addictions”. Similarly to substance abuse, there is the risk either to arouse symptoms like craving, tolerance and habituation either to develop a full-fledged addiction to the Internet.

Aim

The aim of this study is to examine the current pattern of Internet use and eventually of IA, as well as their main characteristics, in a group of high-school students from Calabria, a Southern Italian region.

Methods

Five hundred high-school students (42% boys, 58% girls, mean age SD ± 16.23 years) volunteered for this study. A specific questionnaire of 45 items with 5 possible answers ranging between “never” and “very often” on a Likert scale was developed.

Results

Most of the young subjects interviewed owned a smartphone with Internet, and claimed to spend more time online than at the beginning. Nearly everybody had an active account in a least one social network. A small withdrawal from social relationships and from sport activities emerged in this group.

Conclusions

Although about 10% of examined students presented IA symptoms, our findings cannot be considered representative of the total high-school population, these results underline the need of further investigation and awareness. In fact, many underestimated, vague, and other unspecific neuropsychiatric symptoms, such as alterations of sleep-wake pattern, chronic fatigue, headache, visual problems, carpal tunnel syndrome and eventually anxiety or depression may be underlying to an unrecognized condition of IA.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
The Relation Between Parent Personality Traits and Children Psychopathology: A Pilot Study
Authors: Oliveira L.A. , Cartaxo T. , Ferreira J. , Marques M. , Neiva S. , Cardoso D. , Ferreira C. , Gonçalves R. , Laureano M. , Araújo C. , Pereira A.T. , Macedo A.
Published: June 2017

Introduction

Personality plays a crucial role in a person's behavior, emotions and cognitive patterns and shows an important relationship with several variables such as marital status, mental disorders or parenting models. However, little is known about the relation between the parental Big Five personality traits (Neuroticism, Extraversion, Openness, Conscientiousness and Agreeableness) and children psychopathology regardless of the diagnostic of their offspring.

Objectives

To analyze the correlation between parents’ Big Five personality traits and their children categorical diagnosis and psychopathology score.

Methods

The authors recruited 105 children in the outpatient unit of the child and adolescent psychiatry department of the pediatric hospital of Coimbra and their 117 parents. Parents were assessed using the Portuguese version of Neo Five-Factor Inventory and children psychopathology scores were rated by child and adolescent psychiatrists using the Brief Psychiatric Rating Scale for Children.

Results

Forty-nine children (46.7%) were male and 56 (53.3%) were female, with a mean age of 12.5 ± 3.2 and 13.6 ± 2.9, respectively. Twenty parents (17.1%) were male and 97 (82.9%) were female, with a mean age of 45.8 ± 4.1 and 41.2 ± 5.4, respectively. After excluding children diagnosed with Schizophrenia, bipolar disorder, autism spectrum disorders and intellectual developmental disorder, Pearson's correlation coefficients were significant between: parents’ neuroticism and children Uncooperativeness (0.211), Manipulativeness (0.238), Hallucinations (0.257), Sleep difficulties (0.296) and Disorientation (0.204); parents’ agreeableness and children hostility (−0.228); and parent's conscientiousness and children disorientation (−0.231), all P < 0.05.

Conclusions

These preliminary results suggest that parental personality traits may influence psychopathological outcomes in their children. Data are still being collected to clarify the nature of this relationship.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Empirical Redundancy of Burnout and Depression: Evidence from Time-standardized Measures
Authors: Bianchi R. , Lichtenthäler A.
Published: June 2017

Introduction

Burnout and depression are ordinarily assessed within different time frames. Burnout is most frequently assessed on an annual or a monthly basis whereas depression is generally assessed over a one- or two-week period. This state of affairs may have partly obscured the burnout-depression relationship in past research and contributed to an underestimation of burnout-depression overlap.

Objectives

We investigated burnout-depression overlap using time-standardized measures of the two constructs. We additionally examined whether burnout and depression were differently associated with work-related effort and reward, occupational social support, and intention to quit the job.

Methods

We enrolled 257 Swiss schoolteachers (76% female; mean age: 45). Burnout was assessed with the Shirom-Melamed Burnout Measure and depression with a dedicated module of the Patient Health Questionnaire. Work-related effort and reward were measured with a short version of the Effort-Reward Imbalance Scale and occupational social support with a subscale of the Job Content Questionnaire. Intention to quit the job was assessed with 3 generic items (e.g., “I plan on leaving my job within the next year”).

Results

We observed a raw correlation of .82 and a disattenuated correlation of .91 between burnout and depression. Burnout's dimensions (physical fatigue; cognitive weariness; emotional exhaustion) did not correlate more strongly with each other (mean r = .63) than with depression (mean r = .69). Burnout and depression showed similar associations with the job-related factors under scrutiny.

Conclusions

Burnout and depression may be empirically-redundant constructs. Measurement artifacts probably contributed to an underestimation of burnout-depression overlap in many studies.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Adult Attention-deficit Hyperactivity Disorder(ADHD) in Parents of ADHD Children
Authors: Kolat E. , Kolat U.
Published: June 2017

Objective

ADHD is one of the most common mental disorders of childhood and adolescence, and characterized by inattention, hyperactivity, and impulsivity symptomatology. The objective of this study is to find out the difference between ADHD prevalence in parents of children with or without ADHD.

Method

A total of 132 parents of 90 ADHD children; aged between 6 and 12, and 67 parents of 45 non-ADHD children were recruited in the study. Control parents were matched to ADHD children parents according to age, gender and educational status.

Results

Rate of childhood ADHD were significantly higher among parents of ADHD children compared to the parents of control group (P = 0.039). Rate of adult ADHD (P = 0.076) was not significantly but higher among parents of ADHD children compared to the parents of control group.

Conclusion

In our study, we found the prevelance of childhood ADHD in parents of children with ADHD, similar to those reported by published studies but the prevelance of adult ADHD is lower than most of the previous studies. There may be several reasons for us to find a relatively low rate of adult ADHD. Firstly, in our study only parents of ADHD children are investigated, but in the previous studies not only parents but also siblings of ADHD children are investigated. Secondly, in the previous studies adult ADHD is diagnosed according to DSM-III; not DSM-IV. Under the highlight of our findings, assessing adult ADHD in patients with having a child with ADHD is important for treatment and prognosis.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Paliperidone Palmitate and Quality of Life in Schizophrenia
Authors: Juan Carlos N.B. , Girela B. , Maria Angeles A.
Published: June 2017

There is growing interest in the study of the quality of life of mental disorders in general, and particularly in schizophrenia. The quality of life is defined by the world health organization as the perception that an individual has of his place in existence, in the context of culture and value system in which they live and in relation to its objectives, their expectations, their rules, their concerns. Paliperidone palmitate is a depot anti-psychotic treatment monthly application is indicated for maintenance treatment of schizophrenia in adult patients. In this work the quality of life in 5 subjects with a diagnosis of paranoid schizophrenia (less than 10 years of diagnosis) is evaluated, all males, aged between 42 and 45 years and with poor adherence to oral treatment. The patients received an average of paliperidone palmitate 100 mg/month. We evaluate the quality of life at baseline and after 3 months – BREF quality of life (WHOQOL – BREF) Scale Quality of Life (QOLS) and WHO was used. The results showed significant improvements in major QOLS scale in all subjects. There were no significant differences in total score WHOQL – BREF scale, but if there was improvement in the scores of some subscales. They no side effects evaluated in the UKU scale. The quality of life in schizophrenic patients can be affected by the presence of, particularly cognitive and negative clinical symptoms. New treatments as paliperidone palmitate improve adherence and have fewer side effects can improve the perceived quality of life. However, they need more extensive studies double-blind evaluation.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Antidepressants-Induced Sexual Troubles
Authors: Ben Ammar H. , Hamdi G. , Zalila H. , El Hechmi Z.
Published: June 2017

Introduction

For a long time, antidepressants sexual side effects have been neglected. Currently, no reliable scientific data is available regarding the nature and frequency of sexual dysfunction induced by antidepressants. The aim of our study was to evaluate the prevalence and type of sexual dysfunction induced by antidepressants, and to identify factors associated with the occurrence of these disorders.

Methodology

A descriptive and analytical cross-sectional study extending over a period of two week. For the purpose of this research, a socio-demographic card, the Arizona Sexual Experiences Scale (ASEX) and the Psychotropic-Related Sexual Dysfunction Questionnaire (SALSEX) were used.

Results

Fifty-five patients were recruited. The diagnosis of major depressive episodes was dominant (49.1%). Moreover, fluoxetine and tricyclic were in top of the list of antidepressants with respective proportions of 41.8% and 38.2% and respective dose 20.86 mg/24 h and 72.38 mg/24 h. The score using the ASEX scale was 14.63 ± 5.23. Using the SALSEX scale, 47.3% of patients claimed to have had sexual disorders secondary to antidepressants with a moderate score of 9.19 ± 2.56. Furthermore, sexual disorders were more common in the elderly aged of 45 (66.66%) as well as in patients started on paroxetine (66.66%) and on sertraline (66.66%) (P ≤ 0.05).

Conclusion

The sexual side effects of antidepressants have a major impact on the quality of life and adherence to treatment. They also represent an important risk factor for relapse and recurrence in major depression, in this context, the prescription of an antidepressant.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Treatment in Anorexia Nervosa: The Role of Neuropsychological Features in Predicting Response
Authors: Meneguzzo P. , Collantoni E. , Tenconi E. , Bonello E. , Croatto G. , Degortes D. , Santonastaso P. , Favaro A.
Published: June 2017

Introduction

Neuropsychological impairments in anorexia nervosa (AN) have been considered both as putative risk factors and as a target for treatment. However, the role of neuropsychological variables as predictors of outcome is not clear.

Aims

Our aim is to investigate the role of neuropsychological variables as predictors of response to treatment in a group of individuals affected by AN.

Methods

The study sample consisted of 144 patients diagnosed with acute AN, according to the DSM-5 criteria, referred to the Eating Unit of the Hospital of Padova, Italy. All participants were assessed by means of a neuropsychological and clinical test battery at intake and followed during outpatient treatment for an average of 531 days. Eighty-three percent of the patients underwent cognitive behavioral therapy, the families of 75% of the patients were included in the treatment and 48% of the patients took antidepressants (SSRI).

Results

Both body mass index at assessment and illness duration appeared to be independent factors significantly affecting the outcome. The role of neuropsychological variables was explored including cognitive performance in a multivariate analysis including BMI at intake, duration of illness and diagnostic subtype. The inclusion in the model of the Wisconsin Sorting Card Task performance and the central coherence index (calculated by the Rey Figure Test) significantly increased the prediction ability of the model for full remission at the end of treatment.

Conclusions

This is the first study to show that neuropsychological characteristics may predict treatment response in AN. These data support the implementation of cognitive remediation techniques in the treatment of AN.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Longitudinal Changes in Sleep Disturbances, Mental Toughness, and Physical Activity in Patients with Multiple Sclerosis
Authors: Sadeghi Bahmani D. , Esmaeili L. , Gerber M. , Lemola S. , Clough P.J. , Holsboer-Trachsler E. , Brand S.
Published: June 2017

Background

Multiple sclerosis (MS) is a chronic progressive autoimmune disease. Fatigue, depression and cognitive impairments are the most common symptoms of patients with MS. Whereas there is extant research on fatigue, depression, and cognitive impairment of patients with MS during the clinical course, no research focused on the long term changes of psychological functioning, sleep problems, and physical activity on these patients. The aims of the present study were therefore to examine changes in physical activity, sleep disturbances, and mental toughness over a 1.5-year period of time in people with multiple sclerosis after the onset their MS.

Methods

A total of 18 patients with diagnosed MS (mean age: M = 33.61 years) took part in this study. They completed a booklet of questionnaires covering socio-demographic data, mental toughness, sleep disturbances, and physical activity, at the onset of disease and 1.5 years later.

Results

In total, 1.5 years after the onset of MS, patients had lower levels of vigorous physical activity, but not statistically significant change in moderate physical activity. Patients with sleep disturbances at the onset of disease had statistically significant sleep disturbances also 1.5 years later.

Conclusions

Compared to the onset of disease, 1.5 years later, patients with MS reported similar mental toughness traits, sleep disturbances and levels of moderate physical activity. The pattern of results of the present pilot study suggests that the onset of MS is not an obstacle for doing moderate physical activity. Based on the result of this study, sleep disturbances remains stable by time.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Profile Socio-Demographic and Clinical of Suicide Victims in Brusque County, Santa Catarina, Brazil, Between 2012 and 2015
Authors: Cigognini M.
Published: June 2017

Introduction

Among the main causes of mortality in the world stands out approximately 1 million deaths due to suicide. In Brazil, this is the third cause of death due to external factors, being 5.3 the average rate per 100,000 inhabitants. The state of Santa Catarina ranks second in the national ranking with an index of 8.6. According to WHO, it is necessary to detect probable suicide risk factors once information can prevent deaths.

Aim

Identify socio-demographic and clinical profile of suicide victims in Brusque County, State of Santa Catarina, Brazil, between 2012 and 2015.

Methods

Observational, descriptive and quantitative study, with analysis of 60 police investigations with suicide records, occurred from January 2012 to December 2015, in Brusque County.

Results

The suicide was 15.29 per 100,000 inhabitants. The victims had an average age of 46.51, and ±2.12 (SD). Among them, 67.5% suffered from depression and 88% received pharmacological treatment. Regarding marital status, 59% were married or living in a stable union. Men accounted for 78% of the sample. Death by hanging occurred in 65% of cases and 22% previous attempts were recorded, and in 15%, it was mentioned suicidal intent. Among the reasons for the act, it was highlighted family member's death. Given the underreporting, such data may be even more significant.

Conclusions

The observed rates were significantly higher than the state and national rates. Prevention strategies can be focused on early diagnosis and treatment of depression in middle-aged men, and who had recent loss of a family member.

Disclosure of interest

The author has not supplied his/her declaration of competing interest.
Victimization in Childhood as a Suicide Risk Factor in Adults
Authors: Dedic G.
Published: June 2017

Objective

Little is known about the predictive association between victimization among children and adolescents with depression and suicidal ideation in adults. The aim of our study was to examine whether victimization in childhood and early adolescence increases the likelihood of self-harming in adults.

Method

The sample consisted of 82 patients, 65 females and 17 males, aged 38.02 ± 11.05 years on average, hospitalized in Daily hospital. The juvenile victimization questionnaire (JVQ), defense style questionnaire (DSQ) and Beck depression inventory were applied in 48 patients following suicide attempt and in 34 patients who were on psychotherapeutic treatment due to various life crises not resulting in suicide attempt. According to indication, we excluded patients with psychosis, substances abuse and dementia. The examinees of both groups were matched by age, education, professional and marital status. Comparison of the patient groups was done by t-test.

Results

The suicide attempters were depressed (Beck depression inventory 19.13 ± 10.20), using immature defense mechanisms (P < 0.005). The JVQ established statistically differences in two general areas: Peer and Sibling Victimization (P < 0.001) and sexual victimization (P < 0.05).

Conclusion

Even after controlling for lifetime factors known to increase the risk of suicidal behavior, adults who reported peer and sibling and sexual victimization in childhood were still more likely than other adults to attempt suicide later in life. Psychotherapists must understand that history of childhood victimization is important to put suicide attempt in a psychodynamic context which can help them in their work with patients’ psychotherapeutic crisis intervention following suicide attempt.

Disclosure of interest

The author has not supplied his/her declaration of competing interest.
Decision Making Under Ambiguity and Under Risk in Depressed Suicide Attempters, Depressed Non-Attempters and Healthy Controls
Authors: Deisenhammer E.A. , Schmid S.K. , Kemmler G. , Moser B. , Delazer M.
Published: June 2017

Introduction

Study results on decision-making (DM) abilities in suicidal individuals are conflicting. Most studies have focused on DM under ambiguity and included patients with a lifetime history of suicide attempts.

Objective

To assess DM abilities with two different instruments in recent suicide attempters.

Methods

The study sample consisted of three groups. Group 1 (SA) were currently depressed inpatients having attempted suicide within the previous six months. Group 2 (NSA) consisted of depressed inpatients without a lifetime history of suicide attempts. Group 3 (CG) was a healthy control group. Besides depression severity, impulsiveness and suicidal intent (SA group only) DM was assessed using the Iowa gambling task (IGT) for DM under ambiguity and the game of dice task (GDT) for DM under risk.

Results

A total of 78 participants (SA group, n = 21; NSA group, n = 31; CG, n = 26) were included into the study. Significant between group differences were found regarding marital status, current partnership, smoking status, depression score, impulsiveness score and family history of psychiatric disorders (all discriminating controls from patients but not between SA and NSA groups). The three groups did not differ with regard to IGT scores. Concerning GDT, the SA group showed significantly lower scores compared to the two other groups, implying a readiness for more risky decisions in suicide attempters versus non-attempters and controls.

Conclusion

Suicide attempters appear to make more risky decisions compared to depressed non-attempters as well as healthy controls even if the DM under ambiguity patterns do not differ.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Understanding the Role of Bereavement in the Pathway to Suicide
Authors: Galway K. , Mallon S. , Leavey G. , Rondon-Sulbaran J.
Published: June 2017

Introduction

Bereavement is considered to be a common precursor of death by suicide. Studies suggest those bereaved by suicide may be particularly vulnerable to suicide themselves. Recently, there has been a concern over the number of deaths by suicide across UK and Europe. As a result, an increasing number have been exposed to bereavement by suicide. It remains unclear how these deaths might impact on future suicide rates.

Objectives

To examine a two-year cohort of all suicides in Northern Ireland, in order to report on bereavements recorded in the records of those who died by suicide. To assess the bearing of these deaths on those left behind.

Aims

To provide an estimate of the prevalence and types of bereavements that may have contributed towards the suicide.

Methods

Following the sociological autopsy approach to studying death by suicide, data was collected from a range of sources, including GP records and Coroner records and interviews with bereaved relatives. The analyses draw on relatives’ accounts in order to increase our understanding of the impact of suicide bereavement. Interviews took place between 18 months and 5 years after the death by suicide.

Results

Of the 403 deaths by suicide, 15% of the individuals experienced bereavement and 9% bereavement by suicide. The results support the assertion in the literature that bereavement by suicide increases the risk of suicide through a process of suicide contagion.

Conclusions

The conclusion explains how the findings will be fed into knowledge translation processes, to provide future programs of suicide prevention research and changes to practice.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Socio-Demographic and Clinical Features of Patients Referred to Emergency Room Psychiatric Consultation Between 2006 and 2015. A Comparison Between Migrants and Natives
Authors: Gambaro E. , Vecchi C. , Gramaglia C. , Bert F. , Delicato C. , Avanzi G. , Castello L.M. , Zeppegno P.
Published: June 2017

In recent decades, Italy has become a desirable destination for immigrants. It should be noted that the organization of mental health services in Italy strongly relies on outpatient services, while the psychiatric wards usually accommodate patients in acute phases of their disorder. Nonetheless, migrants’ first contact often happen in a psychiatry ward when they are in a severe and acute psychopathological condition. The research was performed in the Emergency Department (ED) of the Maggiore della Carità Hospital, Novara, Italy. We collected data about 3781 consecutive patients, 3247 Italian natives and 421 migrants, assessed in the ER of the Maggiore della Carità Hospital, and referred to psychiatric assessment after ER triage. From 1st January 2006 to 31st December 2007, only data for migrant patients were available. From 1st January 2008 to 31st December 2015, data were available for all consecutive patients assessed in the ER. An experienced psychiatrist assessed patients with a clinical interview, including the assessment of suicidal intent, suicidal behaviors and attempts. The psychiatrist filled in for each patient a data sheet, reporting demographic data and clinical features. The high frequency of substance use disorders was higher in the migrant population than in the native one. The request for psychiatric consultation for self-injury behaviors was more frequent in migrants and also suicide attempts were more common. Nonetheless, being a migrant was not a predictor of suicide attempt in our sample.

Several differences were found between migrants and natives in socio-demographic, clinical and treatment variables. Clinical implications will be discussed.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Integrated Regional Autism Program: The IRAP Multidisciplinary Model
Authors: Varrucciu N. , Manfredini M. , Di Santantonio A. , Roversi P. , Di Sarro R.
Published: June 2017

Introduction

Receiving an autism spectrum disorder (ASD) diagnosis often is daunting for individuals and families because of the life-long difficulties with functioning, health and quality of life [1]. “Casa del Giardiniere” is the reference facility for ASD at the Local health authority. The multidisciplinary team is composed by child psychiatrist, psychiatrist, psychologist, behavior analyst, educator, speech therapists, neuropsychomotor therapist, and social worker. Following the international guidelines for the neurodevelopmental disorders, patients’ age changed from 0–18-year-old to lifespan.

Objectives

This work aims to illustrate our model, resulting from the integration of family, social and health services, and school.

Methods

Data on demographic, family, and clinical factors were gathered among subjects admitted to our ASD unit along 2015. All participants underwent to the following process: diagnostic assessment, Functional assessment of speech, communication, cognitive and adjustment skills, treatment, and parent training.

Results

Data showed a general improvement of skills. The best results were achieved when a full sharing of methods and strategies in all areas of life were possible. Results will be discussed in details.

Conclusions

This model allows to realize efficient individualized treatment programs and to benefit of specific training both on intervention programs and approach with families. Furthermore, parents learn to “see” their child not only within its limits.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
A Neuro-developmentally Sensitive and Trauma Informed Service Delivery Approach for Child and Youth Mental Health and Psychiatry
Authors: Wilkes T. , Wang E. , Perry B.
Published: June 2017

This presentation will introduce the innovative approach to child and youth mental health and psychiatry using the neurosequential model of therapeutics (NMT). This is a neuro-developmentally sensitive and trauma informed approach and acknowledges the importance of early experiences shaping the organization of the brain. An outline of the stress response and its relevance to hyper-arousal and dissociative responses will be discussed as this impacts attachment and the reward neuro-biology. The hierarchy of brain development will be emphasized in the clinical approaches to child psychiatry especially in reference to child maltreatment and neglect. The critical role of sensory integration, self regulation, relational health and cognitive development in treatment planning will be discussed versus the categorical diagnosis of ADHD, autism, bipolar disorder and depression. This has profound economic and psychopharm practice implications in child and youth mental health treatments. Consequently the importance of these concepts in informing public policy for early child development and school mental health literacy will be emphasized. Additionally the outcome of these approaches on the reduction of staff turnover, critical incidents in schools and residential placements will be shared.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Comorbid depressive symptoms in persistent delusional disorder: A retrospective study from India
Authors: Kulkarni K. , Arasappa R. , Prasad K. , Zutshi A. , Chand P. , Murthy P. , Kesavan M.
Published: June 2017

Background

Previous studies have reported depressive symptoms in patients with persistent delusional disorder (PDD). Patients with PDD and depression may need antidepressants for treatment.

Aim

The aim of the study was to compare the sociodemographic profile, clinical presentation and treatment response in patients with PDD with and without comorbid depressive symptoms.

Methods

We conducted a retrospective chart review of patients diagnosed with PDD (ICD-10) from 2000 to 2014 (n = 455). We divided the patients into PDD + depression (n = 187) and PDD only (n = 268) for analysis.

Results

Of the 187 patients with PDD + D, only eighteen (3.9%) were diagnosed with syndromal depression. There were no significant differences in sociodemographic profile including sex, marital and socioeconomic status (all P > 0.05). PDD + D group had a significantly younger age at onset ([PDD + D: 30.6 9.2 years vs. PDD: 33.5 11.1 years]; t = 2.9, P < 0.05). There was no significant difference between the clinical presentation including mode of onset, the main theme of their delusion and secondary delusions (all P > 0.3). However, comorbid substance dependence was significantly higher in patients with PDD only. (χ2 = 5.3, P = 0.02). In terms of treatment, response to antipsychotics was also comparable ([> 75% response: PDD + D = 77/142 vs. PDD = 106/179); χ2 = 1.9, P = 0.3). There was a significant difference between the two groups in terms of antidepressant treatment ([PDD + D = 32/187; 17% vs PDD: 17/268; 6%), χ2 = 12.9, P = 0.001).

Discussion

Patients with PDD + D had significantly earlier onset of illness. These patients may require antidepressants for treatment.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Addiction co-morbidity in bipolar disorder
Authors: Baatout A. , Ouali U. , Jomli R. , Elkefi H. , Oumaya A. , Nacef F.
Published: June 2017

Introduction

Addiction is often underdiagnosed in bipolar disorder (BD), although it is frequent and known to complicate its clinical course.

Objectives

The aim of our study was to study socio-demographic and clinical factors associated with addiction in BD patients.

Methods

This is a retrospective, cross-sectional, descriptive and comparative study on 100 patients followed in our department and diagnosed with BD type I according to DSM 5. Demographic and clinical data was compared across the groups: Addiction + (A + ) and Addiction–(A − ).

Results

Nighteen patients had an addiction co-morbidity (A + ), whereas 81 had not (A − ). The mean age of the (A + ) group was 39.47 years whereas it was 42.52 years in the (A − ) group. Males represented 68.4% of the (A + ) group and 48.1% of the (A − ) group. Age of illness onset was lower in the (A + ) group (mean = 23.16, median = 21) compared to the (A − ) group (mean = 26.04, median = 27). Addiction co-morbidity was significantly associated with predominant manic polarity (P = 0.03). All (A + ) patients presented mood episodes with psychotic features, whereas psychotic features were only found in 86.6% of (A − ) patients. Co-morbid addiction was significantly associated with a higher number of mood episodes (P = 0.04), a higher number and duration of hospitalisations (P = 0.02, P = 0.015), and a poorer compliance (P = 0.07). All A+ subjects received antipsychotics, and they were significantly more to receive long-acting antipsychotics (P = 0.06).

Conclusions

Addictions worsen the prognosis of bipolar disorder and require specific therapeutic strategies. They deserve therefore the particular attention of clinicians.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Co-morbidity of psychiatric/physical disorders with alcohol abuse/dependence in a sample of clients of the emergency department of the psychiatric hospital of Attica–Greece
Authors: Tsaklakidou D. , Rizavas I. , Efstathiou V. , Christodoulou C. , Papadopoulou A. , Douzenis A.
Published: June 2017

Introduction

Increased coexistence of psychiatric symptoms in patients with alcohol abuse/addiction is highlighted in the literature. Equally high is the coexistence of physical illnesses due to the harmful effects of alcohol.

Aims

To record the profile and the characteristics of individuals with psychiatric/somatic co-morbidity who attend the psychiatric emergency department/(PED) of the largest psychiatric hospital in Greece.

Methods/Results

A total of 1058 individuals, with a mean age of 44.4 years, were identified having alcohol problems in a five-year time period (2010–2015) in the context of the PED, while the majority of them was found to have psychiatric co-morbidity. The most common diagnosis was psychotic syndromes (24.2%), followed by affective (23.8%), personality (12.5%), and somatoform and anxiety disorders (6.3%). About 3% of the sample presented acute alcohol poisoning or severe withdrawal symptoms, coexistence with severe somatic disease and organic mental disorders. More than a third (37%) of them had to be hospitalized, while the involuntary hospitalization rates (21%) were higher than the voluntary ones (16%). Finally, 13.65% suffered from co-morbid somatic diseases with need of immediate emergency and hospital care.

Conclusions

The abuse and/or dependence of alcohol are largely associated with the coexistence of psychiatric and physical diseases. The psychiatric and physical co-morbidity, as regards attendance and hospitalization–involuntary and voluntary–, present a higher rate in men (86%) and mainly affects people of productive age. Additional data are needed to explore detailed factors that could contribute to a better design of more appropriate services for patients with alcohol use disorders.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Psychopathological aspects of appearance dissatisfaction in aesthetic medicine
Authors: Medvedev V. , Frolova V. , Vissarionov V.
Published: June 2017

Introduction

The pathogenesis of dissatisfaction of the own appearance in patients without obvious abnormalities is still unexplored. The aim of the study was to investigate the structure of psychopathological disorders in patients without evident appearance abnormalities seeking for surgical or cosmetological correction.

Methods

Study sample has included 227 women (average age: 35.8 ± 4.9 years) and 54 men (average age: 30.9 ± 5.7 years)–patients of plastic surgery and cosmetology clinic. The study used clinical psychopathological and follow-up methods of examination.

Results

We have found the heterogeneous spectrum of mental disorders in this group of patients: overvalued dysmorphophobia was diagnosed in 26%, anxiety-phobic disorders–23.1%, obsessive-compulsive disorders–in 11%, depression–in 32%, delusional disorders–in 7.5% of patients.

Conclusions

The results of our study show that the phenomenon of dissatisfaction with the appearance without obvious cosmetic defects manifests in the course of wide spectrum of mental disorders. The follow-up shows no improvement and even worsening of patients’ mental state after cosmetological or surgical treatment. Decision about possibility and extent of the operation should be based on the analysis of patient's mental state and motive for reference to aesthetic medicine specialist.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Second generation direct-acting antiviral (DAAs) Treatment on HCV+ patients: Patient reported outcomes (PROs) and psychiatric symptoms in a real world setting sample
Authors: Moneglia M. , Santangelo A. , Burian I. , Gragnani L. , Elisa F. , Quargnolo M. , Pallanti S. , Zignego A.L.
Published: June 2017

Introduction

Anti-HCV treatments are moving away from interferon-alpha towards DAAs, associated with fewer side effects, better tolerability, and better PROs.

Aims

To describe neuropsychiatric symptoms and PROs during DAAs treatment in a group of HCV+ patients.

Methods

Forty outpatients, scheduled for DAAs treatment, were assessed at enrolment (T0), 4 weeks (T1), at the end of treatment (EOT) and after 12 weeks of follow up (F-UP), by means of MDRS, HAM-D, HAM-A, MRS, Y-BOCS and SF-36. Afterwards the sample was divided into two groups as a function of a positive psychiatric history (19) and compared with each other.

Results

Total sample mean scores between W0 and F-UP were compared and an improving trend was observed in all administered scales. An SF-36 items analysis showed a statistically significant difference in emotional role functioning between W0 vs EOT and EOT vs F-UP, in change in overall health status between W0 vs EOT and W0 vs F-UP.A multivariate logistic regression analysis showed that a positive psychiatric history was not associated with an improvement in vitality of 4.3 (minimal clinically important difference). Comparing the two groups, no significant fluctuations in SF-36 scores were founded and major deviations score increases were recorded in patients with a psychiatric history in all scales.

Conclusions

Our real world data shows that new regimens do not seem to be associated with psychiatric side effects and conversely a clinical improvement compared to baseline was found, suggesting an immediate gain in PROs over the treatment period, particularly the psychiatric subgroup.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Exact psychiatry: Six axioms
Authors: Vargas M.L.
Published: June 2017

Psychiatry is a clinical technological practice where the rational fundaments, methods and knowledge “corpus” have a scientific nature. The science philosopher Mario Bunge proposes that philosophy, as well as science, may tend to be exact. Philosophy of science is the rational setting where any scientific discipline can ascribe sense to its theoretical models and factual sentences. Axiomatization is the method to exactify a discipline. By axiomatization, we can exactify psychiatry as “medicine of the soma”, therefore avoiding fallacies in the theoretical models we use.

Objective

To describe six axioms for the definition of “exact psychiatry” as “medicine of the soma”. Six axioms will be defined and explained. They are ordered attending to hierarchical and historical priority:

–axiom of the cultural universal of social cohesion: since the antiquity all cultures have cultural universals which promote social cohesion;

–axiom of healing as a form of “isonomia”: health-related cultural constructs are related with help receiving due to body vulnerability. It appears with Hippocratic medicine;

–axiom of nosological realism: diseases really exist. They are biological regularities that accelerate death. It appears in the 17th century;

–axiom of illness subjectivity: the personal impact of disease is subjective. There exist diseases in patients. It appears in the 20th century;

–axiom of the unification of neuroscience: psychiatry and neurology have the same ontological reference, brain diseases. It consolidates in the 21st century;

–axiom of clinical phenomenology as the epistemological specificity of psychiatry: clinical phenomenology characterizes “soma” as the referring of psychiatry. The future.

Disclosure of interest

The author has not supplied his declaration of competing interest.
A crossroad in ADHD – adult-onset ADHD
Authors: Ponte A. , Prata Ribeiro H. , Carvalhão Gil L. , Pereira D.
Published: June 2017

Introduction

Attention-deficit/hyperactivity disorder (ADHD) is a common disorder characterized by inattention or hyperactivity–impulsivity, or both. For a long time, ADHD was thought of as a disorder of children which would sometimes persist into adulthood. DSM 5 uses as a criterion that several symptoms have to be present prior to age 12 years.

Objectives

To discuss the findings of 3 recent cohorts that show the onset of ADHD in adulthood.

Methods

A review of selected articles of interest using PubMed database.

Results

3 large, longitudinal, population studies from Brazil, New Zealand (NZ) and the United Kingdom (UK) show that we are at a crossroads in our understanding of ADHD. In each study, the prevalence of adult-onset ADHD (Brazil, 10.3%; UK, 5.5%; and NZ, 2.7%) was much larger than the prevalence of childhood-onset adult ADHD (UK, 2.6%; Brazil, 1.5%; and NZ, 0.3%). They all propose different conclusions that would result in a paradigmatic shift in ADHD: in Brazil, that child and adult ADHD are “distinct syndromes”; in the UK, “that adult ADHD is more complex than a straightforward continuation of the childhood disorder” and in NZ, that adult ADHD is “not a neurodevelopmental disorder”. Faraone et al., in an editorial in JAMA Psychiatry, propose that these findings might correlate to subthreshold child ADHD before it emerges as adolescent- or adult-onset ADHD.

Conclusions

It's an exciting time in ADHD research. These new data work as an incentive to study adult-onset ADHD and how it emerges. Future research will shape our understanding of adult ADHD.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Investigation of internet dependent and depressive symptoms among secondary school students
Authors: Karaca S. , Uyanık E. , Kenç M. , İşlek M. , Aksu R. , Ongun E. , Unsal Barlas G.
Published: June 2017

Introduction

Internet use and depression is a significant problem regardless of social status and in almost all age groups. Internet addiction in adolescents is considered to be the most important risk groups.

Objectives

This study was conducted to determine correlation of Internet addiction and depressive symptoms among secondary school students.

Method

This research was conducted at two secondary public schools in İstanbul during 2015-2016 academic year. Ethics committee approval and permission was obtained from the Directorate of National Education Institutions. The population of the study was 2121 students. The sample group was 1312 students who completely filled in measuring instruments. The measuring instruments consisted of a personal information form, Internet Dependency Scale (IDS) and Children's Depression Inventory (CDI). The data were analyzed with the descriptive statistical analysis and Pearson correlation test.

Results

The average of students’ age was 12.44 ± 1.20. 50.2% of the sample were women. 53.8% of the sample spent 1–2 hours per day in Internet. Mean IDS point was 38.942 ± 12.90 and mean CDI point was 12.52 ± 7.13. According to the IDS cutpoint; 80.9% of students were normal users, 18,4% of them were high-risk users and 0.6% of them were Internet dependents. According to the CDI cutpoint, 16.8% of the students had depressive symptoms. A statistically significant moderate correlation was found between mean scores of CDI and IDS (r = 0.414; P < 0.01).

Conclusions

There is a relation between Internet dependent and depressive symptoms. This finding supports the outcomes of previously performed studies.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Brain pathway differences between Parkinson's disease patients with and without depressive symptoms
Authors: Mohammadi Jooyandeh S. , Baghai T.C. , Aarabi M.H. , Dolatshahi M. , Langguth B.
Published: June 2017

Introduction

Depression occurs frequently in patients suffering from Parkinson's disease (PD). However, the neural basis of depression in PD remains unclear. Diffusion magnetic resonance imaging (DMRI) connectometry is based on the spin distribution function (SDF), which quantifies the density of diffusing water.

Aim

The aim of this study was to assess the microstructural changes in the brain connectivity of PD patients with and without depressive symptoms.

Methods

DMRI was used to assess microstructural abnormalities in the brains of 16 PD patients with depressive symptoms compared to 11 PD patients without depressive symptoms. Data used in the preparation of this paper were obtained from the Parkinson's progression markers initiative (PPMI) database (http://www.ppmi-info.org/data/). This dataset was acquired on a 3-Tesla scanner (Siemens), producing 64 DWI at b = 1000 s/mm2 and one b0 image. Diffusion MRI data were corrected for subject motion, eddy current distortions, and susceptibility artefacts due to magnetic field inhomogeneity. DMRI connectometry was conducted in a total of 27 patients using percentage measurement.

Results

PD Patients with depressive symptoms showed decreased anisotropy (FDR < 0.05) in the fornix bilaterally, left inferior longitudinal fasciculus (ILF) and corticospinal tract bilaterally compared to PD patients without depressive symptoms.

Conclusions

Lesser WM integrity of the left ILF fibers, which connect visual face recognition areas to the amygdala and hippocampus, seems to be associated with depressive symptoms in PD patients. Our study supports the hypothesis that neurodegenerative processes in projections from the somatosensory, cingulate, and insular cortices may be related to depression in PD.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Meta-analysis of aberrant brain activity in psychopathy
Authors: Poeppl T. , Donges M. , Rupprecht R. , Fox P. , Laird A. , Bzdok D. , Langguth B. , Eickhoff S.
Published: June 2017

Introduction

Psychopathy is characterized by superficial charm, untruthfulness, lack of remorse, antisocial behavior, egocentricity as well as poverty in major affective reactions. This clinical profile has been empirically conceptualized and validated. Recent brain imaging studies suggest abnormal brain activity underlying psychopathic behavior. However, no reliable pattern of altered neural activity has been disclosed so far.

Objective

To identify consistent changes of brain activity in psychopaths and to investigate whether these could explain known psychopathology.

Methods

First, we used activation likelihood estimation to meta-analyze brain activation changes in psychopaths across 28 functional magnetic resonance imaging studies reporting 753 foci from 155 analyses (P < 0.05, corrected). Second, we functionally characterized the ensuing regions employing meta-data of a large-scale neuroimaging database (P < 0.05, corrected).

Results

Psychopathy was consistently associated with decreased brain activity in the right amygdala, the dorsomedial prefrontal cortex (DMPFC), and bilaterally in the lateral prefrontal cortex (LPFC). Consistently increased activity was observed bilaterally in the fronto-insular cortex (FIC) (Fig. 1). Moreover, we found that the physiological functional role of the candidate regions related to social cognition (DMFPC), cognitive speech and semantic processing (left FIC/LPFC), emotional and cognitive reward processing (right amygdala/FIC) as well as somesthesis and executive functions (RLPFC).

Conclusion

Psychopathy is characterized by abnormal brain activity of bilateral prefrontal cortices and the right amygdala, which mediate psychological functions known to be impaired in psychopaths. Hence, aberrant neural activity can account for pertinent psychopathology in psychopathy.

Disclosure of interest

The authors have not supplied their declaration of competing interest.