bluuebunny/crossref_metadata_2025 huggingface dataset:
Borderline personality disorder and childhood maltreatment: A genome-wide methylation analysis
Authors: Stenz L. , Prados J. , Courtet P. , Prada P. , Nicastro R. , Adouan W. , Guillaume S. , Olié E. , Aubry J.M. , Dayer A. , Perroud N.
Published: May 2016

Early life adversity plays a critical role in the emergence of borderline personality disorder (BPD) and this could occur through epigenetic programming. In this perspective, we aimed to determine whether childhood maltreatment could durably modify epigenetic processes by the means of a whole-genome methylation scan of BPD subjects. Using the Illumina Infinium® Human Methylation 450 Bead Chip, global methylation status of DNA extracted from peripheral blood leucocytes was correlated to the severity of childhood maltreatment in 96 BPD subjects suffering from a high level of child adversity and 93 subjects suffering from major depressive disorder (MDD) and reporting a low rate of child maltreatment. Several CpGs within or near the following genes (IL17RA, miR124-3, KCNQ2, EFNB1, OCA2, MFAP2, RPH3AL, WDR60, CST9L, EP400, A2ML1, NT5DC2, FAM163A and SPSB2) were found to be differently methylated, either in BPD compared with MDD or in relation to the severity of childhood maltreatment. A highly relevant biological result was observed for cg04927004 close to miR124-3 that was significantly associated with BPD and severity of childhood maltreatment. miR124-3 codes for a microRNA (miRNA) targeting several genes previously found to be associated with BPD such as NR3C1. Our results highlight the potentially important role played by miRNAs in the etiology of neuropsychiatric disorders such as BPD and the usefulness of using methylome-wide association studies to uncover such candidate genes. Moreover, they offer new understanding of the impact of maltreatments on biological processes leading to diseases and may ultimately result in the identification of relevant biomarkers.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Anticholinergic burden in inpatient psychogeriatric population – Do we care?
Authors: Lee M. , Warren A. , Zolotarev B. , Henderson J. , George M.
Published: May 2016

Background

Although recent studies have found that there is significant association between anticholinergic and cognitive impairment, especially in the elderly population, there seems to be minimal emphasis on anticholinergic burden (ACB) when prescribing medications to the inpatient psychogeriatric population.

Aim

To evaluate the prescribing patterns in Older Person Mental Health Inpatient Unit (OPMHU), whether the ACB Score on admission has been reviewed for lowest possible ACB while maintaining therapeutic effects. A protocol will be developed to ensure that ACB is reviewed for future admissions and discharges.

Methodology

Fifty patients admitted and discharged from OPMHU are recruited retrospectively from 30th September 2015, excluding outliers and deceased patients. For those who had multiple admissions during that period, only the most recent admission would be included for evaluation. Individual ACB score is calculated on admission and discharge based on pharmacist final medication summary. Their mental health records are also audited for any documented ACB review by the treating team, while making note for any pre-existing cognitive impairment.

Result

ACB has not been taken into consideration in all patients by the treating team on admission as well as when prescribing medications on discharge. Hence, it is unsurprising that the ACB score showed an increment of 30% on discharge (3.25) when compared to the admission score (2.5).

Conclusion

The study found that although ACB poses significant risks on cognitive impairment, this knowledge has not been employed pragmatically. A protocol should be developed to ensure that ACB is evaluated and managed accordingly.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Dementia severity among institutionalized elderly: Are there more unmet needs?
Authors: Ferreira A.R. , Martins S. , Dias C.C. , Fernandes L.
Published: May 2016

Introduction

The ageing population and the resulting increase in chronic diseases, including dementia, make the evaluation of their emergent needs a crucial step in psychogeriatric care. Unmet needs are found to be important clinical targets that should be followed by active management in order to improve health status and survival.

Objectives

To analyze the relation between unmet needs and cognition, and explore the nature of these needs across dementia severity stages.

Methods

A cross-sectional study was conducted in three nursing homes. Residents were excluded if they were terminally ill, unresponsive or presented delirium. All participants were assessed by Mini-Mental State Examination/MMSE (cognition) and Camberwell Assessment of Need for the Elderly/CANE (needs). Additionally, cognitive decline was staged as: absent (MMSE = 30), questionable (26–29), mild (21–25), moderate (11–20) and severe (≤ 10).

Results

The study included 175 elderly with a mean age of 80.6 (SD = 10.1) years, of which 58.7% presented cognitive decline. For these, the mean number of unmet needs was greater than for those without (4 vs 3, P < 0.001), and they differed significantly in the domains of daytime activities (P < 0.001), memory (P < 0.001) and psychotic symptoms (P = 0.005). A significant negative correlation was found between MMSE and number of unmet needs (rs = −0.369, P < 0.001). Considering the severity stages, unmet needs also differed: more needs in early stages in daytime activities (73.3%), and in advanced ones in memory (63.9%) and psychotic symptoms (23%).

Conclusions

Greater cognitive decline was related with more unmet needs, which agree with previous studies. The different nature of needs across severity stages also suggests that interventions should be tailored comprising this specificity and complexity, when effective care is planned.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Attachment representations in a population of elderly subjects
Authors: Moalla M. , Feki I. , Ktata A. , Sellami R. , Triqui D. , Baati I. , Abida I. , Masmoudi J.
Published: May 2016

Introduction

According to attachment theory, attachment relationships have a lasting impact on the functioning of the individual. If this impact has been much studied in children, few studies have been conducted in the elderly.

Objectives

Explore the representations of attachment in a population of elderly subjects.

Methods

The sample consists of 90 consultants over the age of 65. Each participant filled out demographic questionnaire, Relationship Scale Questionnaire (RSQ): questionnaire of 13 items, each item rated from 1 to 5, a lower score attests a more secure attachment and Adult Attachment Questionnaire: a categorical scale of 3 statements. Statement 1 corresponds to secure attachment style, 2 to avoidant attachment style and 3 to anxious-ambivalent attachment style.

Results

The age of participants ranged from 65 to 95 years with an average of 68.14. The sex ratio M:F was 0.8. The RSQ Score ranged from 16 to 56 with an average of 37.27. Of the participants, 72.2% have secure attachment style, 24.4% have an avoidant attachment style and 3.3% have an anxious-ambivalent attachment style. The study of correlations showed strong correlation between the two scales (P = 0.00) and the RSQ score was significantly associated with poor satisfaction of married life (P = 0.025), presence of psychological trauma in childhood (P = 0.016) and a separation experience (P = 0.029).

Conclusion

Our study highlights the importance of early childhood experiences that may impact late adult life. These finding are in accordance with attachment theory.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Dementia in acutely-ill medical elderly patients
Authors: Sá Esteves P. , Loureiro D. , Albuquerque E. , Vieira F. , Lagarto L. , Neves S. , Cerejeira J.
Published: May 2016

Introduction

Dementia is one of the leading causes of disability and burden in Western countries. In Portugal, there is a lack of data regarding dementia prevalence in hospitalized elderly patients and factors associated with in-hospital adverse outcomes of these patients.

Objectives

Determine dementia prevalence in acutely-ill medical hospitalized elderly patients and its impact in health outcomes.

Methods

All male patients (> 65 years) admitted to a medical ward (> 48 h) between 1.03.2015 to 31.08.2015 were included in the study. Patients were excluded if unable to be assessed due to sensorial deficits, communication problems or severity of the acute medical condition. Baseline evaluation included socio-demographic variables, RASS, NPI, Barthel Index and Confusion Assessment Method.

Results

The final sample consisted of 270 male subjects with a mean age of 80.9 years, 116 (43%) having prior dementia. Dementia patients were significantly older (83.5 vs 78.9; P < 0.001) and had lower values of Barthel Index (dementia: 34.8 vs non-dementia: 85.8; P < 0.001). Mortality rate (9,3%) and length of hospitalization (11.2 days) were similar between groups (12.1 vs 7.1; P = 0.204 and 11.9 vs 10.6; P = 0.218, respectively). Patients with dementia had higher rates of all neuropsychiatric symptoms except depression, anxiety and mood elation. The level of consciousness (measured by RASS) was impaired in 50% of patients with dementia, which was significantly higher than in non-demented subjects (12.3%; P < 0.001). Delirium rates were 29.5% in dementia compared with 7.1% in controls (P < 0.001).

Conclusions

There is a high prevalence of dementia and an appreciable rate of delirium among these patients.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Intellectual disability among delusional disorder: A case series register
Authors: Carrillo de Albornoz Calahorro C.M. , Guerrero Jiménez M. , Porras Segovia A. , Cervilla Ballesteros J.
Published: May 2016

Introduction

The quoted prevalence of intellectual disability (ID) among adults with psychiatric illness varies widely. Some believe that these people are protected from certain intellectual and psychological stress by having ID, and therefore, are less prone to develop psychiatric illness. However, in the past decades, the more prevailing view is that people with ID are more vulnerable to psychosocial stress than people without ID, and therefore, are more likely to develop psychiatric symptomatology. According to various population surveys the probability of suffering a mental disability increase with age. Delusional disorder is as well a disease related to advanced stages of life.

Objectives/aims

The aims of the present study is to establish the prevalence of functional intellectual disability among adults who fulfil DSM 5 delusional disorder criteria.

Methods

Our data come from a case register study of delusional disorder in Andalucia (Spanish largest region). By accessing digital health data, we selected 1927 cases, which meet criteria DSM 5 for delusional disorder collecting whether in its history intellectual disability was registered by the referent psychiatrist.

Results

Of our sample, 2.6% had reflected some kind of intellectual disability in their digital clinical record.

Conclusion

These percentage has been found to concur with other epidemiological studies linking mental retardation and psychotic spectrum disease although there are no epidemiological data published to the best of our knowledge that correlate delusional disorder specifically and intellectual disability.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Overview of psychiatry in Poland, 2000–2015
Authors: Kiejna A. , Piotrowski P. , Gondek T.M.
Published: May 2016

At the beginning of the 21st century, psychiatry in Poland was functioning in the model based mostly on the network of large institutions localised outside of the main city centres. Due to Poland's accession to the European Union, it was necessary to change the mental health care system. This need was legally sanctioned when the Law on Protection of Mental Health was passed in 1994. The solutions were included in the National Programme on Mental Health Care (NPOZP). NPOZP comprised the guidelines on the mental health care system shift to community-based health services, including a roadmap for its implementation in 2011–2015. According to the evaluation of the NPOZP, including the information gathered by the Ministry of Health, the programme was implemented to a small extent. The number of large psychiatric institutions and the number of in-patient beds were reduced, the numbers of day wards as well as psychiatric wards in the multidisciplinary hospitals were increased. The training of the staff for the new system beginned. A serious challenge for the continuation of the reforms being carried out is the provision of the sufficient number of mental health professionals, particularly in the face of economic migration. A short duration of the proposed NPOZP implementation period did not allow for a full application of the new mental health care solutions, however the awareness that its implementation may be at risk led to a public and media discourse which definitely will have an impact on the improvement of the execution of the programme.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Gender and immigrant status differences in the treatment of substance use disorders among US Latinos
Authors: Alvarez K. , Cook B. , Montero Bancalero F. , Wang Y. , Rodriguez T. , Noyola N. , Villar A. , Qureshi A. , Alegria M.
Published: May 2016

US Latinos have higher rates of substance use disorders (SUDs) than Latinas, but Latinas face substantial barriers to treatment and tend to enter care with higher SUD severity. Immigrant Latinas may face greater barriers to care than native-born despite lower overall SUD prevalence. This study aimed to identify how SUD treatment needs of Latinos are addressed depending on patient gender and immigrant status within an urban healthcare system serving a diverse population.

Methods

Data from electronic health records of adult Latino/a primary care patients (n = 29,887 person-years) were used to identify rates of SUD treatment in primary and specialty care. Treatment characteristics and receipt of adequate care were compared by gender and immigrant status.

Results

Tobacco was the most frequently treated substance followed by alcohol and other drugs. Forty-six percent of SUD patients had a comorbid psychiatric condition. Treatment rates ranged from 2.52% (female non-immigrants) to 8.38% (male immigrants). Women had lower treatment rates than men, but male and female immigrants had significantly higher treatment rates than their non-immigrant counterparts. Receipt of minimally adequate outpatient care varied significantly by gender and immigrant status (female non-immigrants 12.5%, immigrants 28.57%; male non-immigrants 13.46%, immigrants 17.09%) in unadjusted and adjusted analyses.

Discussion

Results indicate overall low prevalence of SUD treatment in the healthcare system. Low rates of minimally adequate care evidence the challenge of delivering integrated behavioral healthcare for Latinos with SUD. Results also demonstrate gender and immigrant status disparities in an unexpected direction, with immigrant women receiving the highest rates of adequate care.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Clinical features of neurotic disorders in internally displaced persons
Authors: Korostiy V. , Kozhyna H. , Melamud K. , Platyniuk O.
Published: May 2016

Introduction

According to the Guiding Principles on Internal Displacement, internally displaced persons are persons who have been forced or obliged to leave their homes, in particular as a result of extreme situations, and who have not crossed an state border. As of May 21, 2015 UNHCR has information about 1,299,800 IDPs.

Aim

To study clinical features of neurotic disorders in IDPs.

Methods

We have a complex psychopathological and psychodiagnostic research 97 IDPs in volunteer center, located at the central train station in Kharkiv.

Results

In total, 75.9% of IDPs observed have violations of adaptation: long-term depressive reaction (F 43.21) and predominant disturbance of other emotions (F 43.23). The men reactive alarm indicators (average – 37.7 ± 3.0), were higher than trait anxiety (average – 32.6 ± 2.9). On the contrary, women figures trait anxiety (average – 38.6 ± 2.9) were higher than reactive anxiety (average – 34.7 ± 3.0). Severity of depressive symptoms also slightly prevailed in women. The mean score on the Hamilton scale for men was 17.0 ± 2.3 points, women – 18.0 ± 2.3 points. Test results on a scale of quality of life showed no significant differences between men and women. We have developed a medical and psychological support system to correct the neurotic disorders in IDPs.

Conclusions

The majority of people who left the ATO zone have emotional disorders of different severity and require a further correction in the specialized medical institutions.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
The inattentive and hyperactive brain: Significant links between corpus callosum features and ADHD symptoms in adulthood
Authors: Luders E. , Kurth F. , Das D. , Oyarce D. , Shaw M. , Sachdev P. , Easteal S. , Anstey K. , Cherbuin N.
Published: May 2016

Introduction

Neuroimaging studies of attention-deficit/hyperactivity disorder (ADHD) have revealed structural deviations of the corpus callosum in children and adolescents. However, little is known about the link between callosal morphology and symptoms of inattention or hyperactivity in adulthood, especially later in life.

Objective

We aimed to further expand this understudied field by analyzing a large population-based sample of 280 adults (150 males, 130 females) in their late sixties and early seventies.

Methods

We applied a well-validated approach capturing the thickness of the corpus callosum with a high regional specificity at 100 equidistant points. In addition to correlating point-wise callosal thickness with ADHD symptom measures within the whole sample, we tested for sex interactions.

Results

There were significant sex interactions with respect to measures of inattention and hyperactivity, with follow-up analyses revealing significant negative correlations in males (see Fig. 1 – Top). In contrast, there were positive correlations with respect to hyperactivity only in females (see Fig. 1 – Bottom).

Conclusion

A thinner corpus callosum may be associated with fewer fibers or less myelination. Thus, the negative correlations, as observed in males, suggest an impaired inter-hemispheric communication necessary to sustain motor control and attention, which may contribute to symptoms of hyperactivity, impulsivity and/or inattention. The functional relevance and underlying mechanisms of the positive correlations, as detected in females, remain to be resolved.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Differential effects of coping strategies on autogenous and reactive obsessions
Authors: Lee M.S. , Kwon S.M.
Published: May 2016

Introduction

Obsessive thoughts can be categorized into two subtypes, autogenous obsessions and reactive obsessions. Although it has been investigated that each subtype associates with different maladaptive coping strategies, no studies have yet empirically compared the effectiveness of adaptive coping strategies on autogenous and reactive obsessions.

Objectives

It is hypothesized that acceptance, which is a core therapeutic principle of acceptance-based cognitive therapy (ACT), is more effective on autogenous obsessions, whereas response suppression as a principle of exposure and response prevention (ERP) has a stronger effect on reactive obsessions.

Aims

To compare the effectiveness of two coping strategies (acceptance and response suppression) on autogenous and reactive obsessions.

Methods

A total of 164 undergraduate students completed questionnaires for obsessional thoughts and coping strategies. According to the most distressing thought, sixty subjects (n = 30 with autogenous obsession, n = 30 with reactive obsession) were randomly assigned to two groups differing in treatment conditions. Individual psychoeducation and practice were performed for four different groups (2 obsessional subtypes × 2 coping strategies).

Results

Repeated measure ANOVA demonstrated that the autogenous obsessional group showed greater distress reduction after acceptance treatment than response suppression treatment, although its effect was not statistically significant. However, the reactive obsessional group did not show the interaction effect between distress reduction and the two coping strategies.

Conclusions

The results suggest that coping strategies have differential effects on distress reduction of obsessional subtypes. Different therapeutic approaches may need to be offered to individuals with autogenous and reactive obsessions.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Group cognitive behavioural therapy for outpatients with obsessive-compulsive disorder in a psychiatric service in Italy
Authors: Pozza A. , Domenichetti S. , Tanini A. , Ruggieri E. , Dèttore D.
Published: May 2016

Introduction

Group Cognitive Behavioural Therapy (GCBT) is a cost-effective modality of treatment alternative to individual Cognitive Behavioural Therapy (CBT). Despite several well-controlled trials demonstrated the efficacy of GCBT for Obsessive Compulsive Disorder (OCD), few studies evaluated the effectiveness of GCBT on outpatients attending routinary psychiatric services, and in Italy this topic appears understudied.

Objectives

The current study evaluated the effectiveness of a GCBT protocol on OCD symptoms and comorbid depression and anxiety in a group of outpatients attending a psychiatric service in Italy.

Method

Twenty outpatients with a diagnosis of OCD were included in the study and received 20 sessions of GCBT, consisting of psychoeducation on anxiety and OCD, relaxation training, in vivo/imaginal exposure and response prevention, cognitive restructuring for obsessive beliefs, cognitive defusion, and assertiveness training. The Yale-Brown Obsessive Compulsive Scale (Y-BOCS), Beck Depression Inventory (BDI-II), Beck Anxiety Inventory (BAI) were administered at pre- and post-treatment.

Results

Two outpatients had a comorbid bipolar disorder, eight had a concurrent personality disorder. Ten outpatients were on concurrent antidepressants, five on antipsychotics. Three outpatients prematurely dropped out from treatment. Among completers, GCBT produced significant changes on OCD symptoms, anxiety and depression from pre- to post-treatment. The GCBT protocol was feasible and the outpatients reported high satisfaction judgements.

Conclusions

Future studies should investigate clinical predictors of best response after GCBT and assess maintenance of symptom changes at long-term follow-up.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Defence mechanisms and coping skills in oncology patients
Authors: Bredicean C. , Giurgi-Oncu C. , Papava I. , Romosan R. , Jurma A. , Cristanovici M. , Hurmuz M. , Popescu A.
Published: May 2016

Introduction

Oncology-related illnesses have become quite frequent in our lives. Lately, medical progress in the field of oncology has led to an increase in the survival rates of people diagnosed with cancer. The minimisation of disturbances in the lives of these people is done by each on their own, by using defence mechanisms and coping skills.

Objectives

To identify the coping and defence mechanisms of subjects diagnosed with cancer compared with non-clinical subjects.

Aims

To increase quality of life of subjects diagnosed with cancer through psychotherapy interventions.

Method

Nineteen subjects diagnosed with cancer who were receiving chemotherapy were recruited to the study. For comparison, a control group of non-clinical participants were also recruited. Participants were included into the study according to particular inclusion/exclusion criteria. The evaluation was conducted during 2014 and consisted of the analysis of the following parameters: socio-demographic data, clinical data, defence mechanisms (DSQ-60) and coping mechanisms (COPE scale).

Results

The group of subjects diagnosed with cancer demonstrated the presence of defence mechanisms of the following type: passive aggressiveness, projection and coping mechanisms that were characterised by an emphasis on social support. The control group had defence mechanisms of the following types: repression, denial and coping mechanisms that focused on emotions.

Conclusions

There are differences in defence and coping mechanisms between subjects with cancer compared to the non-clinical group. It may be that defence and coping mechanisms can be optimized through psychotherapy interventions to increase quality of life.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Emotional agility – a new language and paradigm for psychiatry
Authors: Kurz R.
Published: May 2016

Introduction

Emotional Agility constitutes an alternative to the DSM-5 personality trait model.

Objective

The presentation outlines how Emotional Agility is conceptualised and measured through self-report and multi-rater questionnaires.

Aims

The paper highlights the development of a short Emotional Agility trait questionnaire and a corresponding behavioural measure with 18 items.

Method

Data (n = 929) from a substantial personality questionnaire with 161 questions was utilised to create a 54 question ‘short form’ that measures the Big 5 personality factor plus Need for Achievement through 18 facet scales of 3 items each. Data on the same subjects from a 50-item criterion measure was reduced to 18 items that are structurally aligned to the 18-predictor facets.

Results

Predictor reliabilities averaged 0.752 at Factor as well as Facet level. The unit weight sum of the 54 questions achieved an uncorrected validity of 0.28 (n = 929) against external ratings of effectiveness. Joint factor analysis showed good discrimination between the six factors. A ‘positive manifold’ of Emotional Agility scales emerged as expected which could be conceptualised as the opposite of the MMPI2 ‘Demoralisation Factor’.

Conclusion

The Emotional Agility approach could ground mental health assessments firmly in positive approaches that use every-day terminology. It seems preferable to vague scales claiming to measure obscure ‘clinical’ constructs through hugely overlapping items that are often not fit for purpose.

Disclosure of interest

The author has not supplied his/her declaration of competing interest.
Self-Concealment Scale: Validation of two Portuguese versions
Authors: Costa M. , Pereira A.T. , Soares M.J. , Azevedo J. , Macedo A.
Published: May 2016

Introduction

Self-Concealment Scale (SCS) is composed of ten items to measure self-concealment, defined as a tendency to conceal from others personal information that one perceives as distressing or negative (Larson and Chastain, 1990).

Objective

To investigate the psychometric properties of the SCS-10 Portuguese version and of an adapted version containing two additional items specifically focused on self-concealment related do health problems (physical and psychological)–SCS-12.

Methods

The Portuguese version of the SCS-12 and other validated questionnaires designed to evaluate self-reported health, perfectionism and optimism-pessimism were administered to a convenience sample of 555 adults from the community (60.5% females; mean age = 43.49 ± 10.565).

Results

The SCS-10 and SCS-12 Cronbach's alphas were α < 0.80. In both versions, all the items contribute to the internal consistency. The factor analysis, following the Kaiser and the Cattel's Scree Plot criteria, revealed that SCS-10 is unidimensional and that SCS-12 reliably and validly evaluates two dimensions: F1 Keeping secrets (Explained variance = 48.60%; α = 0.816), F2 Personal concealment including health problems (9.65%; α = 0.797). The pattern of correlations of the SCS dimensional and total scores was as follow: negative low correlations with physical health (@−0.20), negative moderate correlations with psychological health (@–.30), moderate correlations with self-oriented perfectionism, social-prescribed perfectionism, pessimism (@0.25) and optimism (@−0.20).

Conclusions

The Portuguese versions of SCS have good reliability and validity (construct and convergent-divergent). The factorial structure partially overlaps with the original. SCS could be useful for research proposes, namely in an ongoing project on the role of the mentioned personality traits on illness and health behavior.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Effects of implicit affect on emotional coping and school adjustment: A short-term longitudinal study with a school-based universal prevention program for enhancing emotional abilities
Authors: Uchida K. , Yokoshima T. , Yamasaki K.
Published: May 2016

In recent years, affect and emotions are hot research topics in the domains of psychology and brain science. Moreover, an increasing number of studies have started to investigate the effects of implicit affect on health and adjustment. The purpose of this study was to examine the effects of implicit affect on explicit emotional coping with others’ emotions and school adjustment in children.

Methods

Participants were 5th- and 6th-grade children in two public elementary schools in Japan. The final samples were fifty-six children (25 boys and 31 girls). Participants completed a battery of three questionnaires just before (T1) and after (T2) an school-based universal prevention program for enhancing emotional coping abilities with others’ emotions, which was implemented in eight classes during one month. The questionnaires were utilized for assessing implicit positive and negative affect (IPA and INA), explicit emotional coping abilities to identify, understand, and regulate others’ emotions, and the adaptive status of children at school.

Results

Hierarchical regression analyses showed that higher IPA at T1 was associated with higher explicit emotional coping and motivation for learning at T2. Also, higher INA at T1 was related to better peer relationship at T2. Moreover, higher IPA and INA at T1 were concerned with higher scores of classroom climate and approval at T2.

Conclusion

This study suggested that higher IPA leads to higher explicit emotional coping with others’ emotions. Also, it suggested that higher implicit affectivity (i.e., both higher IPA and INA) causes more adaptive status of children at school.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Interleukin-receptor antagonist (IL1-RA) with respect to schizophrenia psychopathology
Authors: Frydecka D. , Misiak B. , Sedlaczek P. , Pawlak-Adamska E.
Published: May 2016

Introduction

The influence of the immune deregulation on the risk and psychopathology of schizophrenia is increasingly recognized in the literature.

Aim

To assess the association between serum IL-1RA on schizophrenia psychopathology.

Methods

We recruited 88 schizophrenia patients (38 males and 49 females, mean age 38.12 ± 12.67 years) and 88 healthy adult control subjects (68 males, 20 females, mean age 40.63 ± 7.99 years). Lifetime psychopathology was evaluated using Operational Criteria for Psychotic Illness (OPCRIT) checklist, while current psychopathology was assessed using Positive and Negative Syndrome Scale (PANSS). Serum samples were stored in aliquots at –80 °C. Serum levels of IL1-RA were measured using Immunoassay (ELISA).

Results

There were statistically significant differences between schizophrenia patients and healthy controls (median ± interquartile range: 350,81 ± 227.04 and 888.74 ± 762.63, respectively [pg/ml]) (U Mann–Whitney test, Z = –7.99, P < 0.0001). There were no differences in serum IL1-RA levels between male and female among patients with schizophrenia (U Mann–Whitney test, Z = –0.22, P = 0.82) nor among healthy control subjects (U Mann–Whitney test, Z = –0.17, P = 0.86). Among schizophrenia patients, there was a trend-level association between IL-1RA serum level with negative symptoms (Spearman correlation coefficient, r = –0.23, P = 0.056), positive symptoms (Spearman correlation coefficient r = –0.22, P = 0.066), and on a statistically significant level with general symptoms (Spearman correlation coefficient r = –0.28, P = 0.018).

Conclusion

Serum IL1-RA level is higher in schizophrenia patients in comparison to healthy controls and it is associated with schizophrenia psychopathology.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
The novel antipsychotic cariprazine (RGH-188): State-of-the-art in the treatment of psychiatric disorders
Authors: Orsolini L. , Valchera A. , De Berardis D. , Vecchiotti R. , Iasevoli F.
Published: May 2016

Introduction

Cariprazine (RGH-188) is a novel antipsychotic drug that exerts partial agonism of dopamine D2/D3 receptors with preferential binding to D3 receptor, antagonism of 5HT2B receptors and partial agonism of 5HT1A. Currently, cariprazine is in late-stage clinical development (phase III clinical trials) in patients with schizophrenia (S) and in patients with bipolar disorder (BD), as well as an adjunctive treatment in patients with Major Depressive Disorder (MDD) and drug-resistant MDD.

Objectives

Cariprazine has completed phase III trials for the acute treatment of schizophrenia and bipolar mania, phase II trials for the bipolar depression and MDD whilst it is undergoing phase III trials as an adjunct to antidepressants.

Aims

The present review aims at proving a comprehensive summary of the current evidence on the safety, tolerability and efficacy of cariprazine in the treatment of schizophrenia, BD (manic/mixed/depressive episode) and MDD.

Methods

A systematic search was conducted on PubMed/Medline/Scopus and the database on Clinical Trials from inception until April 2015 by typing a set of specified keywords.

Results

Available evidence seems to support cariprazine efficacy in the treatment of cognitive and negative symptoms of schizophrenia. Preliminary findings suggest its antimanic activity whilst it is still under investigation its efficacy in the treatment of bipolar depression and MDD. Furthermore, the available data seems not to allow judgements about its antipsychotic potential in comparison with currently prescribed antipsychotics.

Conclusions

Further studies should be carried out to better investigate its pharmacodynamic and clinical potential, particularly as alternative to current antipsychotic drugs.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Use of inhaled loxapine in acute psychiatric agitation
Authors: Ovejero S. , Iza M. , Vallejo S. , Vera C. , Sedano A. , Álvarez R. , Mata L. , Sánchez-Alonso S.
Published: May 2016

Objectives

The aim of this work is to study the efficacy of loxapine inhalation powder on agitated patients in a psychiatric inpatient unit.

Methods

Nineteen patients sample, with an average age of 39.4 years old, diagnosed with schizophrenia, bipolar disorder or schizoaffective disorder. Patients inhaled loxapine 10 mg, using the staccato system, when they suffered a psychomotor agitation. The clinical efficacy was measured as a change from baseline in the Positive and Negative Syndrome Scale-Excited Component (PANSS-EC) and in the Young Mania Rating Scale (YMRS) one hour after the administration of loxapine.

Results

A mean of 9.8 points reduction (22.6 at baseline and 12.7 one hour after the administration) was found on the PANSS-EC (t-test, P < .001) and 68.4% of the patients were considered responders as they obtained a reduction of at least 40% of the basal score. On 10 of the total of the agitated patients showed an improvement of the psychomotor excitement, and this allowed the clinicians to remove the physical restraint; on 6 of the agitated patients the physical restraint could be avoided during the whole treatment; and 3 of the patients experienced a reduction of the excitement. The reduction on PANNS-EC on the latest group was not statistically significant (t-test, P = .121).

Conclusions

Inhaled loxapine was a non-invasive, rapid and effective alternative treatment for acute agitation in a psychiatric inpatient unit. It resulted more effective on mild and moderate cases; not been significantly effective on the severe cases of agitation.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Which antidepressants are associated with increased risk of developing mania? A retrospective electronic case register cohort study
Authors: Patel R. , Reiss P. , Shetty H. , Broadbent M. , Stewart R. , McGuire P. , Taylor M.
Published: May 2016

Introduction

The symptoms of bipolar disorder are sometimes misrecognised for unipolar depression and inappropriately treated with antidepressants. This may be associated with increased risk of developing mania. However, the extent to which this depends on what type of antidepressant is prescribed remains unclear.

Aims

To investigate the association between different classes of antidepressants and subsequent onset of mania/bipolar disorder in a real-world clinical setting.

Methods

Data on prior antidepressant therapy were extracted from 21,012 adults with unipolar depression receiving care from the South London and Maudsley NHS Foundation Trust (SLaM). multivariable Cox regression analysis (with age and gender as covariates) was used to investigate the association of antidepressant therapy with risk of developing mania/bipolar disorder.

Results

In total, 91,110 person-years of follow-up data were analysed (mean follow-up: 4.3 years). The overall incidence rate of mania/bipolar disorder was 10.9 per 1000 person-years. The peak incidence of mania/bipolar disorder was seen in patients aged between 26 and 35 years (12.3 per 1000 person-years). The most frequently prescribed antidepressants were SSRIs (35.5%), mirtazapine (9.4%), venlafaxine (5.6%) and TCAs (4.7%). Prior antidepressant treatment was associated with an increased incidence of mania/bipolar disorder ranging from 13.1 to 19.1 per 1000 person-years. Multivariable analysis indicated a significant association with SSRIs (hazard ratio 1.34, 95% CI 1.18–1.52) and venlafaxine (1.35, 1.07–1.70).

Conclusions

In people with unipolar depression, antidepressant treatment is associated with an increased risk of subsequent mania/bipolar disorder. These findings highlight the importance of considering risk factors for mania when treating people with depression.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Efficacy and safety of long-term cabergoline treatment of antipsychotic-induced hyperprolactinemia (naturalistic study)
Authors: Yunilaynen O. , Starostina E. , Dzeranova L. , Baranov P. , Dedov I.
Published: May 2016

Introduction

Antipsychotic-induced hyperpolactinemia (AIH) is associated with disturbing clinical symptoms, such as sexual dysfunctions, menstrual disorders and galactorrhea. Long-term studies of dopamine agonists in AIH are scarce.

Objectives

To assess efficacy and safety of cabergoline use in psychiatric patients with AIH, including impact on sexual function and quality of life(QoL).

Methods

It was an open-labeled non-randomized naturalistic prospective comparison of cabergoline vs nо treatment in 84 chronic psychiatric patients (F/M = 77/7) with AIH. Cabergoline treatment was started in 44 patients, the сontrol group included 40 patients who rejected the treatment with cabergoline. For assessment of QoL, sexual dysfunction and other hyperprolactinemia symptoms, UKU side effects rating scale (UKU) and SF-36 were used.

Results

The main and control groups were comparable on all main clinical and psychiatric characteristics. The effective cabergoline dose was 0,25-3 (median-0,5) mg weekly; total cabergoline exposure–534 patient-weeks. Normal prolactin levels were achieved after 4-44 (median-14) weeks in 95% of patients. At 3 months after cabergoline discontinuation, prolactin remained normal in 71%, and AIH recurred in 29% of patients. Prolactin normalization was associated with significant reduction of menstrual disorders, galactorrhea, improvement of UKU scores on sexual desire, orgastic dysfunction, total UKU score and SF-36 scores on subscales of social functioning (P = 0,006), role-emotional (P = 0,042), and mental health (P = 0,049). The rate of psychosis exacerbation in control group was higher than in the treatment group (37,5% vs 0%; P < 0,001).

Conclusions

Cabergoline is effective and safe in majority of AIH patients. Long-term cabergoline treatment is not associated with psychosis exacerbation. Beyond reversal of typical AIH symptoms, treatment with cabergolin improves sexual function and QoL.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Electroconvulsive therapy in elderly - a preliminary study
Authors: Agostinho C. , Duarte M. , Alves R. , Cunha I. , Batista A.M.
Published: May 2016

Introduction

Studies with electroconvulsive therapy (ECT) in elderly focus mainly on the assessment of possible side effects on the cognitive functioning; there are few studies that evaluate the effectiveness.

Objective

Evaluate the effectiveness of this treatment in the population over 65 years.

Aims

Perform a preliminary study to evaluate the response to ECT of ≥ 65 years patients with depression.

Methods

We carry out a descriptive study based on patients treated in the last 10 years in the ECT Unit of Centro Hospitalar Psiquiátrico de Lisboa.

Results

Our initial sample consisted of 457 patients. We select patients aged ≥ 65 years with depression, and with complete data, including electroconvulsive parameters, and initial and final Hamilton Rating Scale for Depression (HRSD) scores (n = 59). Of this, 81.36% (n = 48) had unipolar depression, and 18.64% (n = 11) had bipolar depression. In the first group, the mean variation between the initial and final scores in HRSD was 13.88 points, and 27.10% (n = 13) of the patients ended the treatment in the normal range of HRSD score. In the second group, the mean variation was 12.82, and 63.60% (n = 7) ended the treatment in the normal range of HRSD. Considering the initial and final HRSD scores, it appears that unipolar depression group presents higher values (severe depression) (P < 0.05). When we compare the mean variation between the initial and final HRSD scores, we didn’t observe a statistically significant difference between the two groups. There was a clinical improvement in both.

Conclusions

The acute treatment with ECT appears to improve depressive symptoms in bipolar and unipolar depression, when considering an elderly population.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Repetitive transcranial magnetic stimulation (rTMS) for the management of treatment-resistant depression in schizophrenia
Authors: Mosolov S. , Maslenikov N. , Tsukarzi E.
Published: May 2016

Introduction

Depression is the most common co-occurring syndrome in schizophrenia, which affects up to 60% of patients. Depression aggravates negative symptoms and cognitive deficit and can deteriorate social functioning, quality of life and outcome of the disease. Insufficient clinical response to adequate pharmacotherapy determines rising interest to brain stimulation techniques such as rTMS.

Objectives

The primary goal was to evaluate safety and efficacy of rTMS in treatment-resistant schizophrenia patients with dominant depressive and negative symptoms in open non-controlled trial.

Aims and patients

Thirty-one schizophrenia (ICD-10) patients with evident depression (CDSS ≥ 6) and negative symptoms and with stable low rate positive symptoms on combined adequate pharmacotherapy (antipsychotic + antidepressant), which have not been changed for at least 6 weeks, were included to the study.

Methods

All patients received 15-Hz rTMS on the left dorsolateral prefrontal cortex (100% intensity, 1800 pulses per session, 5 sessions per week, 15 sessions per course) with 8-shaped coil of Neuro-MS/D stimulator (Neurosoft). The primary efficacy measure was 50% CDSS score reduction after the 3rd week of treatment. The secondary measures were weekly reduction rates for CDSS and for PANSS negative syndrome scale.

Results

Twenty (64,5%) patients respond to rTMS. Final mean CDSS score reduction was 55,2% (P = 0,000004), and mean PANSS negative scale score reduction was 21,3% (P = 0,000012). Two patients (6,5%) were excluded due to persistent headaches, no serious adverse events were observed.

Conclusions

rTMS is safe and effective strategy for the management of treatment-resistant depression in schizophrenia and can alleviate negative symptoms. Further sham-controlled studies are needed.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
What makes for good outcomes in solution-focused brief therapy? A follow-up study
Authors: Cortes B. , Ballesteros A. , Collantes J. , Aguilar M.L.
Published: May 2016

Introduction

Solution-focused brief therapy (SFBT) is a strength-based and a social constructivist approach that assumes that individuals have the ability to develop creative solutions that enhance their lives to develop a new self, modify worldviews, and implement behaviour changes.

Objectives

To develop a quantitative research to determine which clinical variables and process variables are measured using the technique of judges and determine its statistical association with the outcome at termination of therapy and follow-up, using the videos of SFBT psychotherapy sessions, and a follow-up call.

Aims

To identify variables associated with outcome at termination and follow-up and to evaluate the success applying SFBT.

Methods

Sample was composed by 74 cases.

Criteria of inclusion

A telephone number available to make the follow follow-up call and at least 6 months since termination (6 months to 39 months, mean 15.6 months). Three questionnaire were used, The First-Session Rating Questionnaire, The Last-Session Ration Questionnaire and The Follow-up Questionnaire.

Results

Goals were reached 88% of the cases, patients said that complaint was totally resolved were 17% and 26% when the dropouts were excluded, and that complaint was partially resolved were 76% and 65% when the dropouts were excluded. According to the judges, the successful at termination was the 86%, and the successful at follow-up was 67% according to the Follow-Up Questionnaire. No variables were statistically associated to the successful at termination or the follow-up.

Conclusions

SFBT reaches the “minimum efficacy permitted” according to the general consensus of experts. Clinical of process variables was not associated to success.

Disclosure of interest

The authors have not supplied their declaration of competing interest.