bluuebunny/crossref_metadata_2025 huggingface dataset:
Needs assessment of people with severe mental illnesses and their families in Azerbaijan
Authors: Ismayilova J.
Published: June 2017

Needs assessment of people with severe mental health problems and their family members provides important information necessary for developing effective interventions at both population and individual level. The study aimed to determine various needs perceived by patients with SMI and their family members, as well as to find out possible relations between the needs and socio-demographic and clinical variables. Similarly the study was intended to evaluate family burden and users’ satisfaction with services.

Fifty dyads of a patient and family members applying for outpatient services were participated in the study. Sociodemographic questionnaire, Brief Psychiatric Rating Scale, Camberwell assessment of needs, involvement evaluation questionnaire and verona service satisfaction scale were used as assessment tools.

The most unmet needs reported by people with SMI and their relatives were psychological distress, social activities and welfare benefits. The study showed significant burden in families caring for people with SMI, which correlated with their views about patients’ needs and had a negative impact on the psychological well-being. Evaluation of satisfaction with services pointed out the gap between provided and desired services reported by patients and their relatives. Most of study participants wished to have sheltered work, or receive help in finding employment.

The study results suggest that in order to achieve better outcomes, services for persons with SMI should be developed in accordance with patients’ most prominent needs. With this regard needs assessment should become an integral part of routine clinical practice. The results may be used for mental health service planning, development and evaluation.

Disclosure of interest

The author has not supplied his/her declaration of competing interest.
Internet addiction in adolescents and staying at a dormitory: A controlled study
Authors: Kıvrak Y. , Kıvrak İ.C.
Published: June 2017

Introduction

Internet addiction can have important consequences in adolescents. Many adolescents have to live apart from their families for their education during high school. Some of these students stay in dormitories. Despite the many studies on Internet addiction, none of them clarify the Internet addiction status and quality of life of dormitory residents.

Aims

Our aim in this study was to determine the internet addiction scores of dormitory residents and evaluate whether a difference was present with students who lived at home.

Methods

The subject group consisted of randomly chosen dormitory students. The control group consisted of another randomly chosen student at the same class who was staying at home. The sociodemographic data forms the pediatric quality of life inventory (PedsQL), children's depression inventory (CDI) and internet addiction test (IAT) were administered.

Results

We found lower Internet addiction scores and total psychosocial scores in dormitory students compared to students who lived at home. There was no difference between the groups regarding depression score, physical health total score and quality of life total score.

Conclusions

Our results indicate that dormitory students suffer less from Internet addiction than those staying at home while the quality of life is similar. Staying at a dormitory may be protective against and therapeutic for Internet addiction without decreasing the quality of life and missing school for internet addict adolescents as it makes it more difficult for them to access the internet.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Results of the Implementation of a Spanish Computerized Guideline for Depression in Primary Care
Authors: Vidal D. Palao , Cavero M. , Monreal J.A. , Bonet J.M. , Moreno M.D. , -Solà V. Peréz
Published: June 2017

A new computerized CPG for Major Depression (e-CPG-MD) was integrated in electronic medical records of primary care in a 7 million population in Catalonia (Spain). An integrated design allows precise access in each patient visit, improving diagnosis, treatment and follow-up. It facilitates an evaluation of suicide risk in depressed patients.

Objective

To evaluate the effects of a multifactor process of implementation of the e-CPG MD, analyzing its use and the key clinical outcomes.

Methods

A cluster randomized clinical trial was performed in 10 primary care centers (PCC) in Barcelona. In five of ten centers a multifaceted implementation process of the e-CPG-MD was developed during 6 month. The others five PCCs received only an usual diffusion. The multifaceted process includes an establishment of local implementation teams, an interactive training program, regular feedback audits, educational outreach visits and periodic reminders.

Results

At six month, a greater proportion of new MD patients from active PCCs were included in the e- CPG-DEP (4.1% + 3.1% vs. 52.7% + 7.3%, p < 0.001); the incidence of MD diagnostics of Major Depression increased significantly (rate quotient = 1.56, p < 0.001) and the proportion of cases with moderate and severe MD too (13.6% vs 41.1%, p = 0.002).

Conclusions

A multifaceted implementation method of an e-CPG-MD increased significantly its uses, the registered incidence of MD and improved the capacity of recognizing severity. Further analysis is necessary in order to determine the impact on clinical outcomes.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Effectiveness of the structural approach components on the marital quality, and problem solving of couples
Authors: Nafian Dehkord M. , Kimiaee S.A. , Zandipour T. , Hassanabadi H.
Published: June 2017

The aim of this research is investigating the effect of training structural-systematic approach components on marital quality and problem solving of couples. General plan of research is a quasi-experimental with pre-post test and control group. Statistic population includes all clients of psychology and counselling clinic of Ferdowsi Mashhad University couples with marital conflicts and issue in problem solving in 2014. Sample size includes 10 couples in each control and examination group. Examination group has received 10 couple-therapy structural-systematic group meetings. Research tools were two questionnaires; revised marital quality scale and family problem solving (2010). To analyse data ANCOVA method has been used. For analysing data SPSS software has been used. Results have indicated that structural-systematic approach results in significance increment of marital quality and couple problem solving in comparison to control group. It can be said that structural-systematic approach may has a significant effect on family structure having a systematic and comprehensive approach and tries to solve happened problems and defects changing family structure. It is hoped that can progress in couple-therapy and family therapy using this approach.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Antipsychotic-induced hyperprolactinemia
Authors: Khouadja S. , Soussia R. Ben , Bouallagui A. , Marrag I. , Younes S. , Nasr M.
Published: June 2017

Introduction

As antipsychotic agents are increasingly used, many patients are at risk for antipsychotic-induced hyperprolactinemia.

Aims of the study

Estimate the prevalence of hyperprolactinemia in patients treated by a single antipsychotic and identify the risk factors for its occurrence.

Methods

This is a prospective study carried out at the psychiatric department of psychiatry of university hospital of Mahdia during 24 months. We have included all patients with a follow up and treated by single antipsychotic for at least 12 weeks. A pituitary MRI has been requested for patients with a prolactin level higher than 100 ng/ml.

Results

We have collected 92 patients. Hyperprolactinemia was found in 34.8% of patients among which 7.6% have had prolactin level greater than 150 ng/ml. Pituitary MRI have revealed 2 cases of macro-adenoma. The decrease of the antipsychotic doses has significantly improved prolactin levels. The switch of antipsychotic with another less inducing hyperprolactnimea has significantly decreased prolactin levels. 7 factors were correlated significantly to hyperprolactinemia: sex (female), substance use, presence of side effects, combination of psychotropic drugs, atypical antipsychotics, type of antipsychotic: Haloperidol and amisulpride, antipsychotic dose greater than 1000 mg Chlorpromazine equivalent.

Conclusion

Hyperprolactinemia must be carefully identified, through a pre-therapeutic assessment and monitoring of patients.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Clinical profile of patients hospitalized for delirium
Authors: Smaoui F. , Frikha M. , Bouchhima I. , Hdiji O. , Farhat N. , Kacem H. Haj , Dammak M. , Mhiri C.
Published: June 2017

Introduction

Delirium is a common clinical syndrome characterized by acute disruption of all cognitive and behavioural functions.

Objectives

– Draw up an epidemiological and clinical profile of patients hospitalised for delirium;

– Assess different pathologies involved.

Methods

We conducted a retrospective and descriptive study, in the neurology department at Habib Bourguiba university hospital, Sfax, Tunisia, at the period from 2009 to 2013. We included 52 patients hospitalised for delirium. Socio-demographic and clinical data were collected from patient files.

Results

The mean age was 66.5 years. The majority (73.1%) were elderly patients (> = 60 years). Sex-ratio (M/F) was 1.73. It was the first episode in 96.2%.

Medical histories were cardiovascular in 55.8%, endocrinal in 25%, neurological in 11.5% and psychiatric in 13.5%. The beginning of the signs was brutal in 55.8% of cases. The reported symptoms were: disorientation in time and space (76.9%) and behaviour disturbance (63.5%), memory disorder (23.1%), headaches (26.9%) and hallucinations (17.3%). Organic etiologies were noted in 75% of cases: vascular 42.30%, metabolic 11.50%, infectious 11.5%, tumoral 3.9% and iatrogenic 3.8%. Delirium grafted on dementia was retained in 5.8% of cases.

Conclusion

Delirium is associated with increased mortality. Its prevention is essential and requires recognition of risk situations.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Cross-national Trainee Collaboration-The EFPT Research Experience in Psychiatry
Authors: Tomori S. , Mogren T. , Asztalos M. , Sampognia G. , Borovcanin M. , Erzin G. , Veiera J. , Tipa R. , Gurcan A. , Naughton S. ,   E.F.O.P.T. EFPT
Published: June 2017

Introduction

The interest for academic background and investigational activities are essential in psychiatry. Several European-wide, early career psychiatrists-driven studies have been carried out completely independently, leading to high quality publications, where all the co-authors are junior researchers.

Objectives

To further elaborate the European federation of psychiatric trainees (EFPT) platform of promoting the experience of collaborative work and research lead by psychiatric trainees in different countries all over Europe.

Methods

A review of EFPT collaborative trainee-led research initiatives since the beginning with the focus on published articles and their impact on psychiatric community in Europe.

Results

Main topics of trainee research are related to postgraduate psychiatric training schemes in Europe raising awareness on enhancing and harmonizing standards of psychiatric education and training across Europe. Other research topics are related to treatment strategies while being a psychiatric in Europe, to migration and “brain drain” phenomenon of psychiatric trainees in Europe, to access to information in psychiatric training.

Conclusions

International cooperation's in research should be promoted since the training. Joining professional associations provides opportunities for participating in research activities and establishing networks with other colleagues. Collaboration between psychiatric trainees ensures a more effective use of individual talents and a quick way of accessing and transferring new knowledge and research expertise. Moreover it provides a supportive framework for multi-center research.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Shame & Guilt: Definitions, Antecedents and Structure of Experience
Authors: Oyebode F.
Published: June 2017

Aims In this lecture I will define and distinguish between shame and guilt. I will then discuss the potential causes of shame and guilt and how these emotions manifest in behavioral and phenomenal terms. I will conclude by introducing a classification that deals with the varieties and nature of the pathologies of shame and guilt that are evident in clinical practice. I will rely on concepts developed by Karl Jaspers, Hans Jonas and Bernhard Schlink. In doing this I will be exploring the role of moral and juridical principles upon the experience of shame and guilt including the place of the imperatives of responsibility upon the experience of shame and guilt. I will argue further that shame and guilt are as important as other secondary emotions such as envy and jealousy but are not as examined and studied in clinical practice. I will make a case for the centrality of these emotions to an understanding of and response to particular clinical conditions in daily practice.

Methods

N/A.

Results

N/A.

Conclusions

Shame and Guilt are both important emotions that are central to our understanding of and response to particular conditions in daily practice. Their antecedents and structure provide a basis for distinguishing between them.

Disclosure of interest

The author has not supplied his declaration of competing interest.
Depression Among Chronic Pain Patients
Authors: Berrahal I. , Ayadi B. , Haddad M.
Published: June 2017

Introduction

Patients with chronic pain are more likely to develop depression, which is associated with decreased function, poorer treatment response and poor quality of life.

Objective

This study aimed to determine the prevalence of depression in patients with chronic pain.

Methods

This descriptive cross-sectional study was conducted among clinically diagnosed chronic pain patients from the pain management ward of La Rabta hospital in Tunisia over a period of six months.

Sociodemographic and clinical data were obtained from patients’ interviews and medical records.

The Beck depression inventory (BDI) was used for screening depression diagnoses and the Visual analogue scale (VAS) to assess the severity of pain.

Results

The sample included 102 patients with a mean age of 46.4 ± 10.4 years. The majority of the patients were females (72.5%, n = 74), married (83.3%, n = 85) and being employed (58.8%, n = 60). The prevalence of depression was (40.1%, n = 41). The mean duration of pain was 3.6 ± 1.5 years. The severity of pain was mild in 28 cases (19.3%), moderate in 36 cases (31.3%) and severe in 38 cases (49.4%). Depression was significantly associated with the duration of pain (P < 0.01). A positive correlation was observed between pain severity assessed by VAS and BDI (r = 0.521, P = 001). Depression was significantly associated with the duration of pain (P < 0.01).

Conclusions

Depression is frequent in patients who suffer from chronic pain and it was significantly associated with the duration and the severity of pain. Antidepressants and psychological therapies can be effective and should be delivered as part of a multidisciplinary pain management plan.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Study of the Interactions Between Magnesium, Ketamine and Morphine on Acute Nociception in Rats
Authors: Vujovic K. Savic , Vujovic A. , Vuckovic S. , Medic B. , Prostran M.
Published: June 2017

Objectives

Study is aimed at evaluating the effects of ketamine and magnesium sulphate on acute nociceptive pain in rats and examination whether magnesium sulfate added to ketamine or morphine-ketamine combination produces higher level of analgesia.

Methods

Analgesic activity was assessed by tail-immersion test in male Wistar rats (200–250 g).

Results

Magnesium sulfate (2.5–60 mg/kg, s.c.) and ketamine (2.5-30 mg/kg, i.p.) given alone did not produce any effect on antinociception. However, there is a synergistic interaction between ketamine (2.5, 5 and 10 mg/kg) and magnesium sulfate (5 mg/kg). Both ketamine and magnesium sulfate, as well as their combination potentiated the antinociceptive effect of morphine (2.6 mg/kg, i.p.).

Conclusion

This study revealed potentiation of ketamine and morphine-ketamine combination by magnesium sulphate in tail-immersion test in rats with higher activity when ketamine is given before magnesium sulfate. It is first time to demonstrate the synergistic interaction between magnesium sulphate and ketamine in lowering body temperature and in antinociception with statistical confirmation.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Client Versus Patient – The Clinical. Economical, Moral, Legal and Other Implications of a Choice
Authors: Latecki B.
Published: June 2017

The presentation discusses the overt and hidden meaning of the terms between “patient” or “client” regarding persons undergoing psychotherapy and implications of using these terms. Some historical and recent opinions and points of view are presented. As the outcome of the discussion, it is concluded that to weigh pros and cons and to decide on which name would be more appropriate, one must resort to taking into consideration the definitions of therapy, suffering, and healing. It is suggested that the criterium should be the level and nature of suffering experienced by the “taker” and the level and nature of care performed by the “giver” (provider). The relations between both parties are also discussed in terms of existential phenomenology–as opposed to dualistic approach – and holism versus atomism. It is the intention of the author to deliver some practical and not only theoretical contribution to clinical practice.

Disclosure of interest

The author has not supplied his/her declaration of competing interest.
Post-traumatic Stress Spectrum and Adult Autism Subthreshold Spectrum in Parents of Children with Epilepsy: Correlations and Gender Differences
Authors: Carmassi C. , Corsi M. , Gesi C. , Bertelloni C.A. , Pedrinelli V. , Massimetti G. , Bonuccelli A. , Orsini A. , Dell’Osso L.
Published: June 2017

Introduction

Data that assess the co-morbidity between post-traumatic stress symptoms and autism spectrum are scarce. Nevertheless, some authors suggested that subjects with autism spectrum disorder (ASD), due to their difficulty in understanding the codes of communication, empathy, expression, are lower resilience to traumas.

Objectives

The aim of this study was to explore in a sample of parents of children with epilepsy, the presence of correlations between the symptoms of post-traumatic stress and adult autism subthreshold spectrum.

Methods

Seventy-seven parents completed the Trauma and Loss Spectrum Self-Report (TALS-SR), specifically modified for one's son epileptic disease, and 72 parents completed the AdAS Spectrum (Adult Autism subthreshold Spectrum).

Results

Eight subjects (11.1%) presented a total score ≥45 at the AdAS Spectrum, corresponding to the satisfaction of a symptomatic ASD criteria and indicative of the Adult Autism Spectrum subthreshold. More specifically, a total score ≥45 was found in 7 (15.9%) of mothers and 1 (3.6%) of the fathers, with no statistically significant differences between the two groups (P = 0.139).

Noteworthy correlations between TALS and AdAS, emerged only in the subgroup of the fathers. In particular, a relevant number of moderate to good correlations emerged between the Domain II (reactions to the events of loss) of the TALS-SR and the AdAS Domain III (non verbal communication), Domain VI (restricted interests and ruminations) and total score.

Conclusions

Results indicate that this peculiar psychopathological model could lead to increased vulnerability to effects of the trauma, in particular in male.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Flourishing: Factors associated with positive mental health among young adults with neuropsychiatric disorders
Authors: Appelqvist-Schmidlechner K. , Lämsä R. , Annamari T.H.
Published: June 2017

Young people with Asperger's syndrome and/or ADHD face major challenges in their lives affecting their quality of life and general well-being.

The aim of this study was to investigate factors that associate with positive mental health (flourishing) among young adults with neuropsychiatric disorders.

The sample consisted of 188 young adults with diagnosis of Asperger's syndrome (AS) (F84.5) and/or ADHD/ADD (F90). They participated in the one-year “My Way” rehabilitation programme organized and funded by the social insurance institution of Finland. Baseline questionnaires included measures on positive mental health (SWEMWBS), provisions of social relationships (SPS), social competence (MASC) and questions about functional capacity and leisure time activities. Information on diagnosis was received from doctors’ statements.

Of the study participants, 35% had a comorbid mood, anxiety or stress-related disorder (F30-F40). Among those, 14% had low, 79% moderate and 7% high positive mental health (flourishing). Higher rate of physical activity was associated with flourishing. Furthermore, flourishing was associated with high level of provisions of social relationships, social competence as well as good general functional capacity. No association was found with engagement in employment or education, or having the diagnosis of AS, ADHD/ADD or a comorbid psychiatric disorder (F30–F40).

People with psychiatric disorders experience high positive mental health, too. Social relations, social competence and general functional capacity play an important role in mental well-being of young adults with neuropsychiatric disorders. Supporting them may help in reaching also other goals set for the rehabilitation, such as capacity to work or study.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Neurobiological Mechanisms of Problem Gambling and Treatment
Authors: Goudriaan A. , van Holst R. , van Timmeren T.
Published: June 2017

Background and aims

In the past decade, neurobiological research on pathological gambling has flourished. Based on neurobiological similarities between pathological gambling and substance use disorders and similarities in genetics, diagnostic criteria, and effective treatments, pathological gambling was the first behavioral addiction to be included in the DSM-5 within the revised category Substance-related and addictive disorders.

In this presentation novel findings from gambling research in our research group focusing on the role of impulsivity, anticipation towards monetary outcomes, and the interaction between stress and cue reactivity will be presented, with a focus on new functional MRI results. An overview will be given on the concepts of impulsivity and compulsivity in pathological gambling and relevant neurocognitive and neuroimaging findings. Implications of neurobiological research for novel intervention research, such as in neuromodulation studies and personalized medicine will be highlighted.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Differences in empathy in Italian university students: Are medical students more or less empathetic?
Authors: Pascucci M. , Di Sabatino D. , Stella E. , La Montagna M. , Nicastro R. , Grandinetti P. , Testa R. , Parente P. , Pozzi G. , Janiri L. , Ventriglio A. , Bellomo A.
Published: June 2017

Introduction

Empathy is the capacity to understand or feel what another person is experiencing. It is an important quality in the medical profession, since it is fundamental in interpersonal relationships with patients. Nevertheless, many studies have found that over time medical students (MS) become less empathic and more detached from patients.

Objectives and aims

To determine MS loss of empathy and to study the differences in empathy between MS and other university students who are not involved in healthcare.

Methods

We enrolled 244 MS (120 of the 1st year and 124 of the last year) and 125 other university students not involved in healthcare, in different universities in Rome and Foggia (Italy). They anonymously and voluntarily completed a socio-demographic questionnaire and Baron Cohen's empathy quotient test (EQ).

Results

We found no differences regarding EQ total score between MS and other students, however there are few differences considering individual EQ items. In particular, MS really like taking care of others (P = 0.005) and they are sometimes considered to be rude, even if only they are only blunt (P = 0.006). We found no differences in empathy between first year and last year MS.

Conclusions

In our sample of Italian students, we have not found MS to be more or less empathetic than other university students, but there are some peculiar differences in empathy that make them better suited to the chosen course of study. Moreover, we found no differences between the different years of medical school.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Training occupational therapists in how to use cognitive behavioral therapy in their practice
Authors: Slepecky M. , Huri M. , Sahin S. , Kayihan H. , Prasko J. , Kotianova A. , Popelkova M. , Zatkova M.
Published: June 2017

Introduction

Cognitive behavior therapy (CBT), which is used by mental health professionals including occupational therapists (OT) is a time-sensitive, structured, present-oriented therapy directed toward solving current problems and teaching clients skills to modify dysfunctional thinking and behavior.

Objectives

Supporting the development of CBT theory and efficient use by mental health professionals are vital.

Aim

To present the results of CBT training for OTs, which was funded by “European Union technical assistance for increasing the employability of people with disabilities” project (Europe Aid/136449/IH/SER/TR).

Methods

Using a basic CBT theoretical framework the participants attended 96 hour face to face training modules with written materials including fundamental features, preconditions and methods used in CBT. A Turkish CBT book was published for course. Participants trained their skills under supervision and send the results to educators. Pre-post of training CBT knowledge and quality of training (plan-contents, educators, and environment) were evaluated by 5-Likert scale.

Results

Thirty OTs (f = 23, m = 7) mostly 43.3% PhD; 20–25 (30%) and 45–50 (26.7%) years age period were included. Total mean score for quality of education was 109.4 ± 29.4 with 23.63 ± 4.34, 47.36 ± 6.41, 38.40 ± 21.61 for plan-contents, educators, and environment subscores, respectively. CBT knowledge was increased from 15.70 ± 6.08 to 45.06 ± 4.59 (P < 0.001).

Conclusion

Training increased CBT awareness and practice skills of OTs. Teaching OTs CBT may increase their understanding of person-environment-occupation approach, psychological problem solving, occupational engagement and participation of individuals. Our result supports that mental health professionals should collaborate to share ideas, develop guidelines and promote good practice examples in client-centered and holistic rehabilitation care.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Mobile Phone Addiction: Evidence from Empirical Research
Authors: Kuss D.
Published: June 2017

Introduction

Recent technological innovations have led to a proliferation of mobile and smartphones, which have become the cornerstone of modern societies in the 21st Century in terms of communication, notifications and entertainment. Latest research however suggests that with the advantages offered by mobile technologies, smartphone use today may have a significant impact on mental health and well being. Overuse has been associated with stress, anxiety, depression and addiction.

Objectives

This talk aims to highlight results of current mobile phone addiction research.

Aims

To replicate and extend earlier research with regards to psychopathology (depression, anxiety and stress), mobile phone use and age on problematic mobile phone use and addiction.

Methods

Individuals aged 16 and above participated in an online study that contained a pool of validated psychometric measures. Data were analyzed using Structural Equation Modeling.

Results

Calls per day, time spent on the phone and using social media significantly predicted prohibited and dependent mobile phone use, whereas stress predicted dependent use only. Anxiety and depression did not significantly predict problematic mobile phone use. Findings also revealed that problematic mobile phone use is prevalent across all ages and both genders.

Conclusions

The current results have implications for addiction to using mobile phones, and suggest teachers, parents and affected individuals may benefit from awareness and prevention efforts, respectively.

This talk is based on Kuss, D.J. et al. (2016). Problematic mobile phone use and addiction: The roles of psychopathology, mobile phone use and age. Under review, and was funded by the British Academy and NTU.

Disclosure of interest

The author has not supplied his declaration of competing interest.
Autoimmune limbic encephalitis: When psychiatric symptoms are not what they seem
Authors: Samico A. , Venâncio Â.
Published: June 2017

Introduction

The autoimmune (AI) limbic encephalitis (LE) can manifests as changes in neuropsychiatric functions and can even occur with isolated psychiatric symptoms. Many times it is a manifestation of paraneoplastic syndromes and it is lately diagnosed.

Objectives

Our objective is to increase awareness to this pathology, since initial contact with these patients is often performed by a psychiatrist and its early detection and treatment greatly improve the prognosis of the patients.

Aims

The aim of this presentation is to address the AI LE as a differential diagnosis in patients with psychiatric symptoms.

Methods

Presentation of a clinical case of AI LE and syndrome revision.

Results

The clinical case involves a 62-year-old man, with no psychiatric history, who begun to present depressive symptoms, emotional lability, aggressiveness and amnesic deficits with 4 months of evolution. After realize an exhaustive clinical evaluation, a cerebral MRI and LCR analysis, the results were consistent with seronegative AI LE. The patient was treated with corticoid therapy and presented a favorable evolution, with remission of the symptoms.

Conclusions

Even though it is a rare pathology, AI LE is an important differential diagnosis to consider in patients with psychiatric symptoms and it is essential to enhance the early detection and treatment of this pathology. This condition also reinforces the role of AI diseases in psychiatric disorders in general, an area, which requires further investigation. With this clinical case, we expect medical professionals to be able to recognize the importance of this diagnosis.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Cotard syndrome: Pathology review
Authors: Samico A. , Perestrelo J. , Venâncio Â.
Published: June 2017

Introduction

Cotard syndrome (CS) is a rare neuropsychiatric condition characterized by nihilistic delusions, which may range from negation of existence of parts of the body to delusion of being dead or negation of self-existence, and it requires an urgent and appropriate therapy.

Objectives

Our objective is to highlight the importance of CS, reinforcing that medical professionals should be aware of this pathology to prompt clinical description, diagnostic and treatment.

Aims

The aim of this presentation is to alert psychiatrists to this remaining syndrome.

Methods

Review of phenomenological and theoretical issues regarding SC.

Results

CS can be found in numerous psychiatric or neurologic pathologies but it is most seen in patients with severe depression. It is typically divided in three subtypes: psychotic depression, Cotard type I, with nihilistic delusions without mood symptoms, and Cotard type II, with mood symptoms and auditory hallucinations. There are numerous etiological hypothesis mechanisms, including unusual perceptual experiences, which can similarly be involved in Capgras delusion, disconnection from emotional or limbic processes, an impaired belief evaluation or a tendency to excessive self-attribution. Frontotemporoparietal circuitry also seems to have an important role in its pathology. Treatment usually involves electroconvulsive therapy, antidepressants and anti-psychotics and the prognosis depends on the underlying disorders.

Conclusions

CS is a rare pathology with self-defeating risk and its clinical recognition and proper treatment are essential to improve the prognosis of these patients. Diagnostic criteria or clinical instruments for assessment of this syndrome should be encouraged, since its lack is a limitation for systematic studies and consequent management advances.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Polycystic ovarian syndrome in patients with schizophrenia treated with atypical anti-psychotics: A case control study
Authors: De Silva V. , Senanayake A. , Ratnatunga S.S. , Dissanayake S. , Gamage S. , De Silva S. , Hanwella R. , Wijeyaratne C.
Published: June 2017

Objective

Objective was to compare the prevalence of probable polycystic ovarian syndrome (PCOS) in females treated with atypical anti-psychotics with normal controls.

Aims

To compare the prevalence of PCOS in patients treated with atypical anti-psychotics and normal controls. To study the hormone profiles in these two groups.

Methods

Cases consisted of 102 reproductive age females with schizophrenia treated with atypical anti-psychotics for ≥6 months and had gained ≥10% body weight. Control group was 123 age and BMI matched females. Menstrual history, physical examination for hirsuitism, acne, androgenic alopecia, anthropometrics measures, Ultrasound abdomen and hormone analysis were done.

Results

Mean age of cases = 33.17 years (SD 8.9) and controls = 33.08 years (SD 5.6). Mean BMI of cases = 25.92 (SD 5.2) and controls = 25.03 (SD 4.3). Polycystic ovarian morphology of ovaries on ultra sound scan was significantly more in cases 49 (48%) than controls 16 (13.%) (P < 0.001). Probable PCOS was significantly more in atypical anti-psychotic treated females (n = 22, 21.56%) than in normal controls (n = 10, 8.13%) (P = 0.04). Atypical anti-psychotic treated patients with PCOS had significantly lower mean LH levels 6.69 mIU/L than those without PCOS 10.30 (P = 0.35). There was no significant difference in testosterone, FSH, prolactin, TSH and free T4 levels.

Conclusion

Treatment with atypical anti-psychotics is associated with higher prevalence of PCOS. This has not been reported previously. The hormonal profile in these patients may be different with low testosterone and LH levels.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Long acting injectable aripiprazole: An observational study
Authors: Garcia N. , Brotons J. , Genoves R. , Martinez-Raga J. , Saez C. , Calabuig R.
Published: June 2017

Introduction

Several trials have shown the efficacy of long acting injectable (LAI) second-generation anti-psychotics compared with other anti-psychotics. LAI aripiprazole is a novel therapeutic tool in the management of patients with schizophrenia.

Aims

The present study aimed to evaluate the clinical outcomes of patients who initiated treatment with LAI aripiprazole, by comparing their clinical outcomes prior and after initiating treatment with LAI aripiprazole.

Methods

This observational, retrospective, mirror study assessed a series of socio-demographic and clinical variables during the 12 months prior to commencing LAI aripiprazole, while on another anti-psychotic medication, and the first 12 months of LAI aripiprazole. The sample included a series of consecutive patients receiving LAI aripiprazole at the Doctor Peset university hospital health area, in Valencia (Spain). The variables analyzed in the study included: emergency room visits, number and average length of hospitalizations, relapse, rate of abandonment of treatment and number of anti-psychotics needed as maintenance treatment.

Results

The preliminary analysis showed a reduction in the rate of emergency room visits and the number of relapse and total hospitalizations while on LAI aripiprazole; however, there is no a reduction of the average length of hospitalizations. A reduction in the number of anti-psychotics as maintenance treatment was not appreciated, however, there was an improvement in treatment adherence.

Conclusions

The preliminary results showed that LAI aripiprazole is an useful option that could suppose a benefit concerning treatment adherence, a decreased in number of relapses and hospitalizations and use of health resources.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Sexual dysfunction associated with antidepressants and how to prevent it. Is vortioxetine effective?
Authors: Saiz Garcia H. , Montes Reula L. , Portilla Fernandez A. , Pereira Sanchez V. , Olmo Lopez N. , Mancha Heredero E. , Rosero Enriquez A.S. , Martinez Parreño M.E.
Published: June 2017

Introduction

One of the most common, and many times hidden, secondary effects of antidepressants drugs use is sexual dysfunction (SD). It has been noted that as many as 20% of patients will discontinue treatment with an SSRI, with one-third of these patients doing so due to adverse reactions.

Methodology

A review was conducted aiming to clarify the pathogenesis of sexual dysfunction in depressed patients or taking antidepressants and how to prevent and manage it. The literature search was conducted in PubMed data reviewing articles dating between 2015 and 2016.

Results

(1) the sexual response cycle is negatively affected in individuals suffering from major depressive disorder, even before initiation of any psychotropic medication. The serotonergic system plays a largely inhibitory role on sexual desire, orgasm, and ejaculation with involvement of the hippocampus and amygdala. Tricyclic antidepressants increase the level of prolactin and indirectly suppress the level of testosterone. (2) Bupropion and vortioxetine are the only antidepressants that have level 1 evidence supporting that they either have a more favorable SD profile. (3) SD with vortioxetine was not statistically higher when compared with placebo, and was statistically lower compared with other SSRIs or SNRIs. (4) There is evidence that antidepressants that are also 5–HT1A receptor agonists (e.g. vortioxetine and vilazodone) may facilitate sexual performance.

Conclusions

In case of SD pharmacologic and non-pharmacologic options are available. Vortioxetine seems to be a good pharmacologic option, with better NNH than SNRI and less SD.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Clinical vignette – Aripiprazol long acting injection monotherapy as long-term treatment for bipolar disease
Authors: Solana C. , Nascimento S. , Duarte M. , Mendes M.
Published: June 2017

Introduction

Over the last decade a number of effective maintenance treatments for bipolar disorder (BPD) have been developed. Lithium remains the best-established option, but valproic acid, lamotrigine, olanzapine, and quetiapine are also effective maintenance drugs. However, oral administration contributes to lower adherence rates with these drugs. In the United States and Europe, aripiprazole is approved for the acute management of manic and mixed episodes and maintenance in BPD. It presents the advantage of a low risk of metabolic side effects, sexual dysfunction, and sedation, which can facilitate treatment adherence and help improve clinical outcomes.

Objectives

The authors present an illustrative case on which aripiprazol long acting injection monotherapy was effective as maintenance treatment in a patient with long history of BPD with several hospital inpatient admissions and very poor therapeutic adherence.

Methods

Case report based on the patient's file. Narrative review of articles available in PubMed about the use of aripiprazol in BPD.

Results

For this patient, aripiprazol long acting injection has proved to be an excellent choice for long-term treatment of BPD. The once-a-month injection promotes therapeutic adherence, which in this case was combined with involuntary outpatient treatment, ensuring therapeutic compliance.

Conclusions

Aripiprazol has been shown to be safe and effective in the maintenance treatment in BPD. It shows similar efficacy and a superior tolerability profile when compared with other well-established treatments. Further studies are needed, warranted by its potential advantages, particularly on patients with poor insight and adherence.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Place of electroconvulsive therapy in the treatment of depression in France: A comparative study between clinical practice and international recommendations
Authors: Charpeaud T. , Tremey A. , Courtet P. , Aouizerate B. , Llorca P.M.
Published: June 2017

Objectives

To study the place of electroconvulsive therapy (ECT) in the treatment of major depressive disorder in France and compare it with international recommendations and algorithms.

Method

Multicenter, retrospective study in 12 French university hospitals. Diagnosis, delay between the onset of the episode and the first day of ECT, previous treatments have been identified. Only patients treated for major depressive disorder between 1 January 2009 and 1 January 2014 were included.

Results

A total of 754 patients were included (middle age 61.07 years, sex ratio 0.53). The diagnoses listed were: first major depressive episode (14.95%), bipolar depression (38.85%) and unipolar recurrent depression (46.19%). The delay before ECT, was 11.01 months (13,98), and was significantly longer for first episodes (16.45 months, P < 0.001) and shorter in case of psychotic symptoms (8.76 months, P < 0.03) and catatonic symptoms (6.70, P < 0.01).

Conclusions

The delay before ECT appears on average, four times longer than recommended by treatment algorithms for the management of major depressive disorder. This long delay could be explained by a very heterogeneous access to this treatment in French territory.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
The Effectiveness of Three Psychotherapies of Different type and Length in the Treatment of Patients Suffering from Anxiety Disorder
Authors: Knekt P. , Lindfors O. , Maljanen T.
Published: June 2017

Introduction

Data on the comparative effect of short and long-term psychotherapy in anxiety disorder is scarce.

Aim

To compare the effectiveness of two short-term therapies and one long-term psychotherapy in the treatment of patients with anxiety disorder.

Methods

Altogether 50 outpatients with anxiety disorder as the only axis I diagnosis, were randomly assigned to long-term psychodynamic psychotherapy (LPP), short-term psychodynamic psychotherapy (SPP), and solution-focused therapy (SFT) and were followed for 5 years. The outcome measures were psychiatric symptoms, working ability, need for psychiatric treatment, remission, and cost-effectiveness.

Results

During the first year of follow-up, no significant differences in the effectiveness between the therapies were noted. During the following 3 years, LPP and SFT more effectively reduced symptoms, improved work ability, and elevated the remission rate than SPP. No significant differences between LPP and SFT were seen. At the end of the follow-up, the use of auxiliary treatment was lowest in the SFT group whereas remission rates or changes in psychiatric symptom or work ability did not differ between the groups. The average total direct costs were about three times higher in the LPP group than in the short-term therapy groups.

Conclusions

The difference in effectiveness of LPP and SFT was negligible, whereas SPP appeared less effective. Thus, the resource-oriented SFT may be a cost-effective option in this selected patient group, while unconsidered allocation of patients to LPP does not appear to be cost-effective. Given the small number of patients, no firm conclusions should, however be drawn based on this study.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Contribution of EMDR Therapy in the Management of Personality Borderline: About A Clinical Case
Authors: Nafiaa H. , Ouanass A. , Benchikhi L.
Published: June 2017

EMDR therapy is a new approach to psychotherapy that uses alternating bilateral stimulation, either through the movement of the eyes or through auditory or cutaneous stimuli, to induce rapid resolution of symptoms related to past events. The protocol of EMDR therapy is based on a set of principles that are essential to a humanistic and integrative approach to medicine and health: confidence in the self-healing capacity of each individual, the importance of history personal approach, a person-centered approach, restored power, the importance of mind-body bonding, well-being and performance improvement. Several controlled studies have demonstrated the remarkable effectiveness of EMDR therapy for post-traumatic stress disorder resolution. Indeed, to date, EMDR therapy is one of the best documented methods of treating post-traumatic stress disorder in the scientific literature. We report here the clinical case of a young lady with post-traumatic stress disorder complicated by depressive disorder, on borderline personality, and as comorbidity a polyaddition to tobacco, alcohol and cannabis, and in whom EMDR therapy proved its efficacy in the management of her disease, enabling her to return to a better life.

Disclosure of interest

The authors have not supplied their declaration of competing interest.