bluuebunny/crossref_metadata_2025 huggingface dataset:
Facial Emotion Recognition Ability in Psychiatrists, Psychologist and Psychological Counselors
Authors: Dalkiran M. , Yuksek E. , Karamustafalioglu O.
Published: June 2017

Objectives

Although, emotional cues like facial emotion expressions seem to be important in social interaction, there is limited specific training about emotional cues for psychology professions.

Aims

Here, we aimed to evaluate psychologist’, psychological counselors’ and psychiatrists’ ability of facial emotion recognition and compare these groups.

Methods

One hundred and forty-one master degree students of clinical psychology and 105 psychiatrists who identified themselves as psychopharmacologists were asked to perform facial emotion recognition test after filling out socio-demographic questionnaire. The facial emotion recognition test was constructed by using a set of photographs (happy, sad, fearful, angry, surprised, disgusted, and neutral faces) from Ekman and Friesen's.

Results

Psychologists were significantly better in recognizing sad facial emotion than psychopharmacologists (6.23 ± 1.08 vs 5.80 ± 1.34 and P = 0.041). Psychological counselors were significantly better in recognizing sad facial emotion than psychopharmacologists (6.24 ± 1.01 vs 5.80 ± 1.34 and P = 0.054). Psychologists were significantly better in recognizing angry facial emotion than psychopharmacologists (6.54 ± 0.73 vs 6.08 ± 1.06 and P = 0.002). Psychological counselors were significantly better in recognizing angry facial emotion than psychopharmacologists (6.48 ± 0.73 vs 6.08 ± 1.06 and P = 0.14).

Conclusion

We have revealed that the pyschologist and psychological counselors were more accurate in recognizing sad and angry facial emotions than psychopharmacologists. We considered that more accurate recognition of emotional cues may have important influences on patient doctor relationship. It would be valuable to investigate how these differences or training the ability of facial emotion recognition would affect the quality of patient–clinician interaction.
Deaf Blindness and Mental Health – Prevalence of Mental Disorders of an Upper Austrian Outpatient Service
Authors: Fellinger M. , Sacherer E. , Fellinger J.
Published: June 2017

Introduction

People with deaf blindness are a vulnerable group concerning mental health problems. Due to their constraints in orientation, mobility, access to information and communication they often suffer from a lack of interpersonal relationships and accessibility to health care.

Aims

To assess the prevalence of mental disorders in patients with deaf blindness and exam associations with forms of communication.

Methods

A retrospective data evaluation of all outpatient charts of patients treated between 2000–2013 in a specialized outpatient unit that provides primary care for all deaf people for the whole catchment area of Upper Austria was conducted. Data were analysed regarding the degree of visual and hearing impairment and the presence of a mental disorder.

Results

Forty-seven of 1500 patients were identified as deaf blind including 12 suffering from Usher Syndrome. Of those 29 (61.7%) were at least once diagnosed with a mental disorder, most frequently with a mood disorder (MD) (F30–F39) in 40.4%; an anxiety, stress-related, somatoform disorders (AD) (F40–F49) in 12.8% and a schizophrenia, schizotypal and delusional disorders (F20–F29) in 10.6%. Deaf blind patients suffered compared to deaf patients more often from a MD (40.4% vs.11.3%) however less often from a AD (12.8% vs. 32.6%). No significant association between the form of communication and being diagnosed with a mental disorder could be found.

Conclusion

Patients with deaf blindness suffer to a high extend from mental disorders, especially MDs. It is of utmost importance to reduce the burden of this population and improve access to specialized services to diminish isolation as major risk factor.
Poor CYP2D6 and Ultrarapid CYP2C19 Metabolizer: Clinical Challenge in Psychiatric Treatment
Authors: Dlugauskas E. , Lengvenyte A. , Strumila R. , Utkus A.
Published: June 2017

Introduction

Finding the right medication in psychiatry can be very demanding both for the doctor and for the patient. It becomes extremely grueling when the patient has a rare type of metabolizing enzymes, and many drugs may be ineffective or cause side effects.

Objectives

To highlight the therapeutic difficulties in psychiatric treatment of the patient with complex genetic cytochrome P450 system alterations.

Aims

To provide an example on a complicated treatment course of the patient that is poor CYP2D6 and ultrarapid CYP2C19 metabolizer.

Methods

Literature review in scientific database–Pubmed–and case report presentation.

Results

We report a case of a woman in her early twenties who was repeatedly referred for psychiatric treatment. A diagnosis of paranoid schizophrenia was established, but all treatment rounds were unsuccessful, the illness kept progressing, and major depressive disorder aggravated the clinical picture. The patient became suicidal and injured herself. During the sixth hospitalization in one year the CYP2D6, CYP2C19 and CYP2C9 genotyping was done. CYP2C19 ultrarapid (*1/*17) and CYP2D6 poor metabolizer (*4/*5) profile was discovered. Drugs, that should have been avoided due to the patient's genetic profile, had been prescribed throughout five hospitalizations in a row.

Conclusions

As ultrarapid CYP2C19 metabolizers compose around 3–4% and poor CYP2D6–6–10% of Caucasians, this case presents a rare genetic variant that only 0.18–0.4% of Caucasian population may have. These cases can be extremely clinically challenging and affect healthcare outcomes and costs. Further studies that would include clinical effectivity, drug concentration and genetic testing results are needed.
Help-seeking and psychological distress in university students: Findings from a cross-sectional online survey in the UK
Authors: Wadman R. , Webster L.A.D. , Stain H.
Published: June 2017

Introduction

With most mental health disorders emerging in the later teenage years, university students are arguably an at-risk population with increased mental health support needs. This population is characterised by important, life-changing transitions (moving away from home, friends and family) and new potential stressors (including increased academic pressures and relational challenges). Research to examine determinants of mental health help-seeking behaviours in university students is needed to ensure emotional health needs are being met at this critical time.

Objectives

To examine levels of psychological distress and mental health help-seeking behaviours in a sample of UK university students. By identifying factors associated with help seeking, we can better understand the mental health needs of this population and inform support provision.

Methods

This study draws on data from the social and emotional well-being in university students (SoWise) study, an online survey which aimed to examine risk and resilience for social and emotional well-being in young people attending a UK university.

Results

Whole sample analysis (n = 461) showed help seeking was significantly associated with psychological distress, current life stressors and anxious attachment and not associated with perceived mental health stigma. Sub-group analysis (n = 171) suggests being female and older significantly predicted help seeking in students with mild/moderate psychological distress.

Conclusions

Younger males with mild/moderate psychological distress are less likely to seek mental health support and represent an “invisible” at risk group. Results also suggest that global anti-stigma campaigns in universities may not prove effective in encouraging help seeking.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Antipsychotics and Driving Ability
Authors: De las Cuevas C.
Published: June 2017

Driving a vehicle is an important everyday life skill associated to a psychiatric patient's autonomy and identity. Nevertheless, the right to drive is not a right at all, it is a privilege granted and regulated by rules and restrictions from the States that have also the duty to pull this privilege and deny the ability to legally drive in potentially unsafe drivers. The decision about for whom and when to forbid driving is a difficult matter of judgment that must remain a clinical and professional judgment within the medical encounter. Both antipsychotics as the psychiatric disorders target of these psychoactive drugs produce changes of psychomotor performance that can interfere with the ability to drive safely. Moreover, it is really hard to distinguish between the effects of the disease itself as opposed to the effects of the medication when studying the interaction between antipsychotics and driving ability. Previous results of our research in the field indicate that psychiatric patients who improved clinically after drug treatment also showed improvements in driving ability. So, adequate psychotropic treatment causes a positive effect on driving performance that outweighs the possible deleterious effect of medication. However, it remains essential to supply mental health professionals with new information, which is quantitatively and qualitatively valid, on the role of antipsychotics in driving ability. The purpose of the present lecture is to review research undertaken to-date on the effects of antipsychotic medications on driving ability. A search of various databases, including Medline, Embase and PsycInfo, will be conducted.

Disclosure of interest

The author declares that he has no competing interest.
Extrapyramidal side effects and functional remission in schizophrenia
Authors: Ghajati B. , Leila C. , Raja L. , Majda C.
Published: June 2017

Treating patients with schizophrenia has evolved towards including, as an effective goal, their functional remission. Beyond the discrepancies in this concept definition, a plethora of studies has been conducted trying to identify predictors of functioning in schizophrenia. Among which antipsychotic prescription and related side effects.

Aim

Explore extrapyramidal side effects link with functional prognosis of patients with schizophrenia spectrum disorder.

Methods

We conducted a cross-sectional, retrospective and descriptive study in the psychiatry department “C”, in Razi hospital (Tunis), between October 2014 and March 2015. Sixty patients suffering from schizophrenia spectrum disorder (DSM IV-R) were included. Functional status was explored with the Global Assessment of Functioning Scale (GAF), the Social and Occupational Functioning Assessment Scale (SOFAS) and the Social Autonomy Scale (EAS). Extrapyramidal side effects (EPS) were evaluated using the Simpson and Angus Rating Scale (SAS).

Results

Functional remission was achieved according to GAF, SOFAS and EAS in respectively: 63,30%, 48,30% and 51,70% of the patients. SAS mean score was 0.898 ± 0.29 (0.4–2). Although SAS showed no significant association with GAF, SOFAS and EAS global scores, patient with less EPS had better autonomy in EAS’ dimension “Relationship with the outside” (P = 0.048).

Conclusion

EPS may influence functional remission at several levels starting from the neurobiological to the social stigmatization and the treatment adherence levels. Further research in this matter is required.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Functional connectivity of the ventral tegmental area and avolition in schizophrenia: A resting state functional MRI study
Authors: Giordano G.M. , Stanziano M. , Mucci A. , Papa M. , Galderisi S.
Published: June 2017

Introduction

Impaired motivation is considered a fundamental aspect of the Avolition domain of negative symptoms. The ventral tegmental area (VTA) contains the highest number of DA neurons projecting to the brain areas involved in motivation-related processes.

Aim

The aim of our study was to investigate by functional MRI the resting-state functional connectivity (RS-FC) of the VTA in patients with schizophrenia and its relationships with real-life motivation and avolition.

Method

The RS-FC was investigated in 22 healthy controls (HC) and in 26 schizophrenia patients (SCZ) treated with second generation antipsychotics only and divided in high (HA = 13) and low avolition (LA = 13) subgroups. We used the Quality of Life Scale and the Schedule for the Deficit Syndrome to assess real-life motivation and avolition, respectively.

Results

HA, as compared to LA and HC, showed a reduced RS-FC of VTA with the right ventrolateral prefrontal cortex (R VLPFC), right posterior insula (R pINS) and right lateral occipital cortex (R LOC). The RS-FC for these regions was positively correlated with motivation in the whole sample and negatively correlated with avolition in schizophrenia patients.

Conclusion

Our findings demonstrate that motivational deficits in schizophrenia patients are linked to reduced functional connectivity in the DA circuit involved in retrieval of the outcome values of different actions to guide behavior. Further characterization of the factors modulating the functional connectivity in this circuit might foster the development of innovative treatments for avolition.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Adverse Childhood Experiences, Personality Disorders and Addiction: Which Relationship?
Authors: Cerrato F. , Aluisio G. , Casadio P. , Di Girolamo G. , Valente S. , De Ronchi D. , Atti A.R.
Published: June 2017

Introduction

Stressful or traumatic events occurred during childhood do have a role in the genesis of personality disorders. Less is known about this remarkable association in people with addictive behaviors.

Aims

This study aims to disentangle the relationship between childhood adverse experiences, personality disorders (PDs) and substance use disorders (SUDs).

Methods

A cross-sectional naturalistic study of 320 consecutive SUDs outpatients attending an Italian addiction service. Participants were clinically evaluated by a semi-structured interview, the SCID-II (Structured Clinical Interview for DSM-IV Axis II PD), and the CECA-Q (Childhood Experience of Care and Abuse-questionnaire). Multivariate logistic regression analyses were used to estimate odds ratio (OR) and 95% confidence intervals (95% CI)

Results

The prevalence rate of PDs in our sample of patients is 62.2%. PDs were associated with a history of physical punishment in childhood (OR = 1.82; CI 95%: 1.05–3.16; P = 0.034). Being exposed to three adverse events increases the risk of Cluster B PD (OR = 5.92; CI 95%: 2.21–15.92; P < 0.001). Heroin addiction increases the risk of Cluster B PD, both as previous (OR = 2.93; CI 95%: 1.49–5.75; P = 0.003) or current (OR = 4.34; IC 95%: 1.97–11.8; P = 0.004) consumption. Childhood institutionalization increases the probability of cluster B PD (OR: 2.15; CI 95%: 1.02–4.54; P = 0.041). Whereas being employed reduces the probability of both PDs and SUDs (OR = 0.54; CI 95%: 0.31–0.93; P = 0.027).

Conclusions

PDs occurred in 62% of patients and were related to adverse childhood experiences and SUDs having detrimental effects on both social and occupational functioning. Being employed could be a protective factor on the development of PDs.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
The Concentration of the Factors Involved in Trafficking of Stem Cells in Long-Term Treated Bipolar Disorder Patients
Authors: Kucharska-Mazur J. , Reginia A. , Jabłoński M. , Dołęgowska B. , Rybakowski J. , Ratajczak M.Z. , Samochowiec J.
Published: June 2017

Introduction

After analysis of biological and pharmacological data, we formulated the hypothesis that the factors involved in trafficking of stem cells could be engaged in aetiology of bipolar disorder (BP).

Aims

In this study, we considered the role of complement cascade proteins, stromal derived factor-1 (SDF-1), and sphingosine-1-phosphate (S1P) in long-term treated BP.

Methods

A group of 30 patients with BP, without the history of lithium treatment, was examined in remission and compared with a group of 30 healthy volunteers. In peripheral blood, we have analysed the concentration of stromal derived factor-1 (SDF-1), sphingosine-1-phosphate (S1P), and some proteins of the complement cascade (C3a, C5a, C5b-9).

Results

Peripheral blood concentration of C3a, C5a, C5b-9 and SDF-1 was significantly higher in BP group compared to control group. The concentration of S1P does not distinguish BP patients from controls.

Conclusion

Our results suggest the possible role of the regeneration system in aetiology of BP.

This work was supported by grant POIG.01.01.02-00-109/09.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Prevention of Conduct Disorders at the Community Level
Authors: Kostić J. , Stanković M. , Milosavljević L.
Published: June 2017

Introduction

Epidemiological data indicate that 30% to 50% of young people contact the child psychiatrist for behavioral disorders problems. Protective factors research that reduce the risk of conduct disorders are just as important as the research of risk factors. The aim of this work is to introduce the preventive factors in the reduction of conduct disorders, including 4 domains: individual, family, school and community. The emphasis is placed on preventive factors at the community level, which are covered by the national, state and local policies that support programs oriented towards children and young people. Good infrastructural community support enable young people to participate in activities where they have opportunities to make choices, make decisions and share responsibility. These experiences help young people to develop new skills, increase their self-confidence and make the difference, while such programs help adults to create a basis for understanding and working together with young and engaged people.

Conclusion

The interest in the behavior of young people and their perspective creates a culture of care for young people instead of a culture of ignoring or even marking behavior among young people as deviant and antagonistic, which has a significant preventive effect on the development of behavior disorder.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Relationship Between Early Maladaptive Schemes and Traumatic Childhood Experiences with Suicidal Behavior in Adults
Authors: Montes Reula L. , Saiz García H. , Portilla Fernández A.
Published: June 2017

Exposure to traumatic events in childhood is associated with suicidal behavior in adulthood, in the form of ideas, attempted or completed suicide. The abuse causes impaired cognitive schemes in the attachment figure, abandonment, mistrust and vulnerability to damage. The literature has demonstrated the dose–response relationship between a traumatic event in childhood and the development of mental disorders and the possibility of suicidal behavior. In addition, abuse is transmitted through the generations along with another factor of suicidal vulnerability (family history of suicide). Abuse in childhood is associated with depression, anxiety, antisocial behavior or substance. In fact, in investigations is suggested the vulnerability to any psychopathological disease. A history of suicidal behavior increases the risk for these children. Since child abuse increases suicidal behavior, we can find families in which coexists history of suicidal behavior and child abuse. The high prevalence of abuse and vulnerability neurodevelopmental leads us to consider a plan of action for this population. Rejection and/or contempt suffered in a developing brain might be related to subsequent alterations in emotional regulation or impulsivity. For these associations should conduct a more thorough screening in children's consultations to address this issue. It is very important to approach about cognitive schemes that subsequently repeated dysfunctional acts. Impulsive o unstable behavior could be reduced. This would decrease the consequences that these children have in adulthood.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Genetics and Neurophysiological Characterization of First Episode and Deficit Schizophrenia
Authors: Samochowiec J. , Bienkowski P. , Frydecka D. , Misiak B. , Kucharska-Mazur J. , Wysiecka J. Pelka
Published: June 2017

The deficit subtype of schizophrenia (DS) is hypothesized to constitute a pathophysiologically distinct subgroup of schizophrenia patients suffering from enduring, idiopathic negative symptoms. The aim of the present study was to assess a relationship between the deficit/non-deficit dichotomy and various markers. We tested a hypothesis that stem cells and factors that modulate their trafficking may be biological markers of acute psychosis.

Methods

The DS was identified using the SDS. The MMP-9, BDNF, and COMT gene polymorphisms were genotyped. DNA methylation of the human endogeneous retrovirus type K (HERV-K) sequences was determined. Smell identification test was performed using the Sniffin’ Sticks test. For the assessment of executive function we used the Wisconsin Card Sorting Test, the Trail Making Test, Verbal Fluency Test Phonemic, Stroop Color Word Test and Go/No Go task.

Results and Discussion

There was no association between the examined functional gene polymorphisms, methylation levels and DS. Similarly, there was no relationship between overall odor identification abilities and the deficit/non-deficit dichotomy. The results tended to indicate specific problems in the identification of few odors in DS. DS, compared with the non-deficit group, obtained lower scores in the WCST and TMT and exhibited greater interference within concept formation and non-verbal cognitive flexibility. Furthermore, in patients with the first schizophrenia-like episode, the number of circulating Lin (-)/CD45 (-)/CD34 (+) very small embryionic like stem cells (VSELs) and the S1P plasma level were the best predictors of risk and are proposed as novel markers for the first “schizophrenic” episode of psychosis.

Disclosure of interest

The authors declare that they have no competing interest.
Executive Functioning Impairments in Adolescents with Early Diagnosis of Obsessive Compulsive Disorder
Authors: Nazarboland N.
Published: June 2017

Despite the neuropsychology literature provide reliable evidence of impaired executive functions in obsessive-compulsive disorder (OCD), it has not been determined whether these deficits are prior to onset of the disorder or they begin to appear as consequence. To investigate whether recent onset of OCD in adolescence is characterized by executive functioning difficulties in behavioral inhibition, attentional flexibility, and decision-making. Executive functions were compared in adolescents with recent (past year) appearance of OCD symptoms (n = 40) and control group (n = 40). Three computerized tests within the CANTAB battery were completed by all subjects (the Affective Go/No Go task, the Intra-Dimensional, Extra-Dimensional Set-Shifting task, and the Decision-Making task). Using one-way ANOVA showed that compared with control group, the OCD adolescents displayed a bias towards negative stimuli with less errors on sad and hopeless words on the Affective Go/No Go task. They also made faster decisions while they bet more of their available points compared to controls, in the Decision-Making task. Adolescents with recent OCD diagnosis (less than one year) showed greater attention towards sad and hopeless stimuli and more impulsive behavior when making decisions. However, they were able to switch attentional set to neutral stimuli. These findings suggest that executive functioning impairments can characterize adolescence OCD from early beginning of the disorder.

Disclosure of interest

The author has not supplied his/her declaration of competing interest.
Untreated Remission of Adolescents’ Mental Health Problems: Challenging the Treatment Gap?
Authors: Raven D. , Jörg F. , Schoevers R.A. , Oldehinkel A.J.
Published: June 2017

Introduction

Mental health problems are highly prevalent and are associated with a high burden, but such problems are often left untreated. This is referred to as the “treatment gap”. The question of who is most likely to remit from their mental health problems without treatment has received surprisingly little attention. A few studies do suggest that untreated remission is common in the general population, but these are in particular limited by short follow-up times.

Objectives

The aims of this study are to describe untreated remission of mental health problems in adolescence, and to assess the extent to which mental health problems recur after untreated remission.

Methods

Data from the Dutch community-based cohort study TRacking Adolescents’ Individual Lives Survey (TRAILS) were used. Depressive and anxiety problems were assessed using the Youth Self-Report at ages 11, 13, and 16, and the Adult Self-Report at ages 19 and 22.

Results

Preliminary analyses show high rates of untreated remission (approximately 80% over all waves). However, a substantial proportion of remitted cases still report sub clinical levels of mental health problems at follow-up. More elaborate analyses are ongoing, and will be presented at the conference.

Conclusions

First results suggest that untreated remission is common in adolescents. The presence of residual symptoms may point towards an elevated risk of recurrence in adolescents who remit without treatment. Further knowledge about untreated remission is of vital importance for an accurate assessment of the treatment gap, and for prevention and early intervention programmes.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
School Violence: Characterization of Occurrence's Records of a Public High School Institution
Authors: Scherer E. , Scherer Z. , Cavalin L. , Rodrigues J.
Published: June 2017

Introduction

Acts of indiscipline, incivility and violence are common in the school environment and reflect on physical and mental health of those involved.

Objective

To characterize conflict records made by students, teachers/others and parents/guardians in a Brazilian high school institution.

Method

Qualitative research, exploratory documental. Studied 113 records from 2014 to 2016.

Results

“Indiscipline and Incivility”–75 records (66 by teachers/others and 9 by students) of students: improper use of clothes and accessories, cell phone use in class, not bringing material, dating in school, conversations during class, do not respect the timetables, inappropriate jokes, disrupting activities, theft of materials and disrespect toward authority figures. “School violence”–22 records (12 by students, 9 by teachers/others and 1 by parent/guardian) of school violence: physical violence between students, psychological/verbal between students/teachers/others, and a match of sexual abuse. Three records (by teachers/others) of violence against the school: students destroyed teaching and cleaning materials and caused damage to the patrimony. Fifteen records (12 by students, 2 by parents/guardians and 1 by teacher) of school's violence: teachers’ harassment (excessive rigor in regard to school performance, clutter in the ratings, refusal to clarify doubts and inappropriate criticism on student's behavior) and institutional negligence (teachers’ delay, lack of clarification on teaching organization and supervision in practical activities).

Conclusion

Some students’ acts of indiscipline and incivility can be protests against the social control of the school. Assistance in case of conflicts and violence as well as preventive measures must be based on interdisciplinary and inter-sectorial articulation practice.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Pediatric Mania: The Controversy Between Euphoria and Irritability
Authors: Serra G. , Uchida M. , Battaglia C. , Casini M.P. , De Chiara L. , Biederman J. , Vicari S. , Wozniak J.
Published: June 2017

Introduction

Pediatric bipolar disorder (BD) is a highly morbid pediatric psychiatric disease, consistently associated with family psychiatric history of mood disorders, with high levels of morbidity and disability and with a great risk of suicide.

Objectives

While there is a general consensus on the symptomatology of depression in childhood, the phenomenology of pediatric mania is still highly debated and the course and long-term outcome of pediatric BD still need to be clarified.

Aims

To assess the prevalence, demographics, clinical correlates and course of these euphoric versus irritable pediatric mania.

Methods

Systematic review of the available studies assessing the phenomenology, course and outcome of pediatric mania.

Results

Eighteen studies reported the number of subjects presenting with either irritable or elated mood during mania. Irritability has been reported to be the most frequent clinical feature of pediatric mania reaching a sensitivity of 95–100% in several samples. Only half the studies reviewed reported on number of episodes or cycling patterns and the described course was mostly chronic and ultra-rapid whereas the classical episodic presentation was less common. Few long-term outcome studies have reported a diagnostic stability of mania from childhood to young adult age.

Conclusions

Severe irritability is the most common presentation of abnormal mood described in children with bipolar disorder. Longitudinal studies of samples with irritable versus elated mood presentation and chronic versus episodic course may help clarify whether these are factors predicting different long-term course, treatment-response and outcome of pediatric onset bipolar disorder.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Two-step Cluster Analysis Application to a Sample of Psychiatric Inpatients at Psychiatric Service of Diagnosis and Care
Authors: Ambrosini F. , Benassi M. , Sant’Angelo R.P. , Raggini R. , Mandolesi L. , Piraccini G.
Published: June 2017

Introduction

Recent findings demonstrated significant overlaps among major psychiatric disorders on multiple neurocognitive domains. However, it is not clear which are the cognitive functions that contribute to this phenomenon.

Objectives

To find the optimal clustering solution using the two-step cluster analysis on a sample of psychiatric patients.

Aims

To classify into subgroups a cross-diagnostic sample of psychiatric inpatients on the basis of their neurocognitive profiles.

Methods

Seventy-one patients with psychotic, bipolar, depressive and personality disorders hospitalised at Psychiatric Diagnosis and Care Service of Bufalini Hospital of Cesena participated in the study. The symptomatology was assessed using Health of the Nation Outcome Scales-Roma and Brief Psychiatric Rating Scale. Cognitive functions were evaluated using Tower of London, Modified Wisconsin Card Sorting Test, Judgment and Verbal Abstract Tasks test, Raven matrices, Attentional Matrices, Stroop Test and Mini Mental State Examination. Two-step cluster analysis was conducted using the standardized scores of each neurocognitive test.

Results

Two groups were obtained:– group 1, with good cognitive performances;– group 2, with almost all subjects having impaired cognitive performances.

Executive functions and attention are the major determinants of the cluster solution. The clusters did not differ on socio-demographic correlates. Different diagnoses were equally distributed amongst the clusters.

Conclusions

Two-step cluster analysis was useful in identifying subgroups of psychiatric inpatients with different cognitive functioning, overcoming other cluster techniques limitations. According to former literature, these results confirm a continuum of severity in cognitive impairment across different psychiatric disorders.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Attention, Vigilance and Visuospatial Functioning in Hospitalised Elderly Medical Inpatients – Relationship to Delirium Syndromal Status and Motor Subtype Profile
Authors: Daly C.
Published: June 2017

Objective

The early and efficacious detection of neurocognitive disorders poses a key diagnostic challenge. We examined how bedside cognitive tests perform across the spectrum of delirium and motor subtypes.

Methods

The performance on a battery of bedside cognitive tests were compared in elderly medical inpatients with DSM-IV delirium, subsyndromal delirium, and no neuro cognitive disorder and in motor subtypes.

Results

One hundred and ninety-eight patients (mean age 79.14 ± 8.26) were assessed with no delirium (n = 43), subsyndromal delirium (n = 45), and full syndromal delirium (n = 110). The ability to meaningfully engage with the tests varied from 59% for vigilance B test to 85% for Spatial Span forward test and was found to be least in the full syndromal delirium group. The no delirium group was distinguished from the delirium groups for all the tests and from the full syndromal delirium group for the vigilance B test and global visuospatial function test. The subsyndromal delirium group differed from the full syndromal delirium group in respect of global visuospatial function test, spatial span backwards and vigilance A tests. Patients with full syndromal delirium were best identified using the interlocking pentagons test and clock drawing test whereas those with subsyndromal delirium were best identified using interlocking pentagons test and months backwards test. Those with subsyndromal delirium were significantly better in their ability to engage than those with full syndromal delirium.

Conclusions

Simple bedside tests of attention, vigilance, and visuospatial ability are useful to help to distinguish neurocognitive disorders namely subsyndromal delirium from other presentations.

Disclosure of interest

The author haS not supplied his/her declaration of competing interest.
The Effects of Bariatric Surgery on Pharmacokinetics of Antidepressants: A Systematic Review
Authors: de Jonge L. , Petrykiv S. , Fennema J. , Arts M.
Published: June 2017

Introduction

Morbid obesity (BMI ≥ 35) has been associated with mood and anxiety disorders. Regular use of antidepressants is common among patients who are candidate for bariatric surgery. The Roux-en-Y gastric bypass (RYGB) is one of the most common techniques used in bariatric surgery for reducing nutrient absorption. This type of surgery may however result in major changes in drug absorption.

Objectives and aims

To report and discuss the consequences of bariatric surgery on changes in antidepressant drug absorption.

Methods

We present all published in vitro and in vivo studies on antidepressant drug absorption after bariatric surgery.

Results

In vitro studies showed that only bupropion had a significantly increased dissolution in a post-RYGB environment; venlafaxine and citalopram showed no alteration of dissolution; fluoxetine, paroxetine, sertraline, and amitryptiline had an significantly decreased dissolution in a post RYGB environment. Some in-vivo studies reported that only citalopram and escitalopram had an increased dissolution.

Conclusion

After bariatric surgery, special caution is required in patients using antidepressant medication because of the expected changes in drug absorption, nutritional status, and electrolyte balance.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
The Relationship Between Coping Strategies and Sociodemographic Characteristics, Shame and Anxiety in Families of Children or Adolescences with Inflammatory Bowel Diseases: A Cross Sectional Study
Authors: Gouva M. , Katsanos K. , Tsoutsi A. , Dragioti E. , Kotrotsiou E.
Published: June 2017

Introduction

Ulcerative colitis and Crohn's disease is characterized from a complicated therapeutic management, with bodily and psychological impact to the family.

Objectives

This study examined the coping strategies among families with a child or adolescent with IBD.

Aim

The aim was to investigate possible sex differences with respect to coping strategies of the parents would correlated to overall coping strategies.

Method

The participants were biological parents of patients diagnosed with IBD. The total sample included 61 parents with a mean age 46.2 (SD = 7.4). The parents completed:

– the Family Crisis Oriented Personal Scales;

– the Other As Shamer Scale;

– the Experiences of Shame Scale (ESS);

– questionnaire concerning socio-demographic information.

Results

Mother reported higher levels of social support, accept help, passive appraisal, and overall strategies compared to fathers. The strongest difference was found in accept help (P < 0.001). The feelings of shame of the mothers and fathers of the IBD families were very similar, without statistically significant differences between the groups. The results of the MLR, after controlling for adolescents age, sex and illness duration, revealed that the older age, being a mother, being married and being employment had direct positive associations with the overall coping strategies, while ESS had direct negative associations with the overall coping strategies. The model with all seven predictors explained 68% of the total variance (R2 = 0.68, F = 6.409, P < 0.001).

Conclusions

Our findings provide more detailed information on the coping strategies of Greek families with a child or adolescence with IBD.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Whose insight is it anyway?
Authors: Sewell M. , Mondello V. , Styles T. , Paul D. , Vecchio D.
Published: June 2017

Introduction

There is little research comparing patients’ views with those of their treating psychiatrists. In a survey of patients’ views conducted in 1993 for MIND (UK) by Rogers, Pilgrim and Lacey only 10% saw their problems in terms of mental illness. This highlights the tension between psychiatric codifications of mental abnormalities and explanations provided by patients themselves.

Aims

This pilot project explores the perceptions of mental health issues in patients and their psychiatrists in a regional Western Australian setting.

Methods

A mixed methods approach including semi-structured interviews of patients and their treating psychiatrists. Recruiting 5 consecutive people in the categories of involuntary in-patients, voluntary in-patients, patients on CTO, community patients and their psychiatrists.

Questions asked of the patients were:

– Why are you here?

– What problems do you have?

– What can be done?

– What control do you have?

– What control do other people have?

Psychiatrists were asked similar questions. Responses were recorded, transcribed and thematically analyzed to reveal key themes. Quotations are used to illustrate points participants wished to make.

Results

We report on differences in understanding in both groups. This study reveals areas for further enquiry.

Conclusions

Considerable diversity is revealed. A key conclusion is that insight is a concept relevant both for treated and treating.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Assessment of Serum IL-4, 15d-PGJ2, PPAR Gamma Levels in Patients with Bipolar Disorder
Authors: Erzin G. , aydemir Ç. , yüksel R. , tatlıdil E. , Çakır B. , sezer S. , göka E.
Published: June 2017

Introduction

Many hypotheses have been proposed about development of bipolar disorder including inflammatory processes due to the external and endogenous factors. There are strong evidences that immunological dysfunction is present in bipolar disorder. In the pathophysiology of bipolar disorder, there are many data that support the inflammatory hypothesis.

Objectives

In this study, to clarify the etiology of bipolar disorder, based on the inflammatory process hypothesis, it is aimed to measure and evaluate serum 15d-PGJ2 and PPARγ, anti-inflammatory cytokine IL-4 levels in patients with bipolar disorder.

Methods

This study was performed at Ankara Numune Training and Research Hospital. Ninety-five patients are included in the study that were in their mania or remission periods and meet the DSM-V criteria for bipolar disorder. Forty-four healthy volunteers are included in the study as well. Serum IL-4, 15d-PGJ2, PPARγ levels are measured in both groups. Young Mania Scale, Hamilton Depression Scale, demographic data form were given to patient group.

Results

In our study, 15d-PGJ2, PPARγ levels were found statistically significantly lower in patients with bipolar disorder compared to healthy controls.

Conclusion

There are differences in anti-inflammatory prostaglandin levels in patients with bipolar disorder who are in their mania period when compared to healthy controls and patients in their remission period. This does not show any significance according to smoking and gender. This implies that inflammation markers could be a good candidate to determine trait markers, which will provide an insight for preventing patient from mania period or prognosis after the diagnosis of bipolar disorder.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
A Case Control and Follow-up Study of “Hard to Reach” Young People Who also Suffered from Multiple Complex Mental Disorders
Authors: Camilleri N. , McArdle P. , Newbury-Birch D. , Stocken D. , LeCouteur A.
Published: June 2017

Aims

To describe the mental disorders and social function of the hard to reach young people (HTRYP) from the innovations project (IP) and compare to a matched sample from a community mental health team (CMHT).

Background

IP was a new multidisciplinary team based within an inner city, walk-in health centre, North East England (throughout 2011).

Methods

Phase 1 and 2: retrospective review of clinical case notes of YP who attended the IP and CMHT. Phase 3: 24-months follow-up evaluation of the mental state and social function, using Health of the Nation Outcome Scales for Child and Adolescent Mental Health (HoNOSCA) and Children's Global Assessment Scale (CGAS).

Results

Overall, 36 referrals accepted by the IP, 31 met criteria for HTRYP, 15 were offered individually tailored therapy. IP group experienced more deprivation compared to the CMHT matched sample (n = 115). At baseline, the HTRYP had more mental disorders, higher severity scores and lower levels of social function (HTRYP HoNOSCA mean: 19.1 and CMHT mean: 11.2 P = < 0.001 and HTRYP CGAS mean: 51.0, CMHT mean: 58.9, P = 0.05). The HTRYP made significantly greater improvement compared to CMHTYP; (HoNOSCA P = < 0.001 and CGAS P = < 0.002). Thirteen HTRYP attended the follow-up review at 24 months compared with nine of CMHTYP. There was great variability in terms of social function between the YP within each sample.

Conclusion

The term “HTR” describes a state, which the YP may be at a particular point their lives. A service, which utilises a developmental theoretical framework, offers regular reviews and an individualised care plan, could reduce longer-term morbidity and mortality suffered by HTRYP.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
The Role of Maladaptive Psychological Strategies in the Association between Shame and Psychological Quality of Life
Authors: Ferreira C. , Mendes A.L. , Marta-Simões J.
Published: June 2017

Shame experiences have been highly associated with the engagement in maladaptive strategies (such as experiential avoidance and cognitive fusion) to cope with unwanted thoughts and feelings. Furthermore, these maladaptive processes have been linked to different psychopathological conditions.

The current study aimed to test the mediational effect of two different emotional regulation processes, cognitive fusion (i.e., the entanglement with unwanted inner events) and experiential avoidance (i.e., the unwillingness to be in contact with these inner experiences and the tendency to avoid and control them), on the association between external shame and psychological quality of life.

Participants were 421 (131 males and 290 females), aged between 18 and 34 years old.

The tested path model explained 40% of the variance of psychological quality of life and showed excellent model fit indices. Results demonstrated that external shame presented a significant direct effect on psychological quality of life and, in turn, an indirect effect, through the mechanisms of cognitive fusion and experiential avoidance. In fact, these findings seem to suggest that higher levels of external shame are linked to a higher tendency to engage in cognitive fusion and to lower acceptance abilities, which appear to explain decreased levels of psychological quality of life.

The present findings seem to offer significant clinical implications, emphasizing the importance of targeting maladaptive emotion strategies through the development of acceptance and decentering abilities.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Suicidal Ideation Amongst Adolescent Suffering from Disordered Eating: The Young-HUNT Study
Authors: Saeedzadeh Sardahaee F. , Lingaas Holmen T. , Micali N. , Kvaløy K.
Published: June 2017

Introduction

Suicide takes a great toll on both individuals and societies. Successful preventive measures would require a careful understanding of the scope of suicidal ideation as well as its associated factors. Amongst mental disorders, anorexia nervosa has the highest mortality rate due to suicide.

Objective and aims

Studying the prevalence of suicidal ideation and its associated factors in adolescents (13–19 years old) affected by disordered eating (DE).

Methods

Logistic regression was employed to study associations between suicidal ideation and age, gender and disordered eating in adolescents from a population-based prospective study, The Young-HUNT 3 cohort, 2006-8. DE cases were defined using the self-reported questionnaire (Eating Attitude Test-7) and then grouped into two subscales, poor appetite/under-eating and uncontrolled appetite/overeating.

Results

A total of 3933(boys 49% and 51% girls) were included. In total, 177 poor appetite/under-eating and 365 uncontrolled appetite/overeating cases were identified. Prevalence of suicidal ideation was 24.5% in total sample with girls being more affected (27.1%). Prevalence of suicidal ideation amongst poor appetite/under-eating case group and uncontrolled appetite/overeating cases was respectively 43.5 and 39.2%. The odds-ratio of suicidal ideation amongst poor appetite/under-eating cases compared to control group was 2.56 (95% CI, 1.85 to 3.42, P-value < 0.001) whilst the odds-ratio of suicidal ideation amongst uncontrolled appetite/overeating cases compared to control group was 2.19 (95% CI, 1.75 to 2.74, P-value < 0.001). Results remained significant after adjusting for anxiety and depression symptoms.

Conclusion

Focus on high risk groups such as DE seems important in taking suicide preventive measures.

Disclosure of interest

The authors have not supplied their declaration of competing interest.