bluuebunny/crossref_metadata_2025 huggingface dataset:
630 – Escitalopram in Patients with Social Anxiety Disorder and Fear of Blushing
Authors: Pelissolo A. , Moukheiber A.
Published: July 2013

Fear of blushing (FB) is a form of social anxiety disorder (SAD) characterized by an intense and obsessive threat of blushing in front of other people. No data are available on the specific efficacy of antidepressants on FB. This open-label pilot study investigated whether the selective serotonin reuptake inhibitor escitalopram specifically improves symptoms of FB in SAD patients.

Thirty-nine patients meeting DSM-IV criteria for SAD and presenting a significant FB according to the Salpêtrière Erythrophobia Questionnaire (SEQ) were administered open-label escitalopram (10-30 mg/day) for 12 weeks. A systematic assessment, at baseline and at week 12, included the SEQ, the Liebowitz Social Anxiety Scale (LSAS) and the Hospital Anxiety and Depression (HAD) scale.

From the 39 patients included, 31 attended the week 4 visit, and 28 the week 12 visit. Significant reductions of fear of blushing were observed after 4 weeks of treatment, and were more pronounced at the end of the 12-week treatment since patients experienced a 60% decrease of their FB symptoms (p< 0.001). Nineteen (67.8%) subjects reported a 50% decrease or more of their SEQ score, and 14 (50%) met criteria for remission of fear of blushing (SEQ score < 7). The effect sizes of changes on SEQ, LSAS and HAD scales scores were high, with eta2 ranging between 0.53 and 0.86.

Results of this open study suggest that escitalopram can be a useful treatment for fear of blushing associated with SAD, even if large controlled trials are now needed to further evaluate this result.
633 – Integrative Psychotherapy Model of Anxiety Disorders
Authors: Fedak M. , Kudinova O.
Published: July 2013

At the present time in Ukraine the special priority has the problem of somatoform disorders. A prevalence of clinical somatization neurotic disturbances and necessity of differential diagnostics with somatic diseases were the precondition for studying this area.

At the same time, in Ukraine the diagnosis “Vegetative-vascular dystonia” which is ciphered G 90.8, according to ICD-10 instead of “Somatoform disoders” F40.0-F48 is used. It leads unreasonable treatment significant contingents of neurotic patients in neurological departments.

The 60 agoraphobia patients and 40 panic disorder (PD) patients were examined. The emotional disturbances of all thease patients were investigated with the clinic and pathopsychological methods. The high level of anxiety was shown. Pathopsychologically the high level of personality anxiety and low level of neurotism and depression were indentified. The system of psychotherapy correction was established, with high efficacy in 68% cases.

On that ground has been developed complex differential system of medical- psychological and psychotherapy correction of agoraphobia, PD and somatoform disorders with the - 80% high efficasy. Our experience showed the necessity of the integrative models of psychotherapy provided, parted on stage. On the first stage - sedative-adapting the receptions of cognitive and suggestive psychotherapy are used. There is groupe therapy on second-main-stage. On the third stagetupesupportive elements of the autogenic training mastered.
634 – The Psychoemotional Disturbances on Cardiovascular and Cerebrovascular Diseases and its Psychotherapy Correction
Authors: Mykhaylov B. , Fedak B. , Fedak M.
Published: July 2013

Based on the systematic approach of evaluating results of complex clinical- psychopathological, psychodiagnostical investigation cardiac infarction and cerebral stroke patients the clinical structure features, regularities in the formation, development and course of òonpsychotic psychic disorders on these patients was determined.

At patients with cardial infarction in acute period the painful syndrome was the main one, leads to severe psycho-emotional disturbances. At the background of preservation of cognitive function phobic, anxiety and depressive symptoms were prevaileted, the severity of which depends on the severity of pain. Subsequently, the primary psycho-emotional component disappeared, anxiety-depressive disorders, hypo-and anozognostical type of perception of self condition were formed.

At cerebral stroke patients disorders of level of consciousness were primary with cognitive and asthenic disturbances with subsequent formation of psycho-emotional disorders, anxiety and depressive disorders with hypohondrical elements on the basis of persistent cognitive impairments.

The multimodal principle based system of psychotherapeutical correction of nonpsychotic psychic disorders was developed. For myocardial infarction patients, system includes personaly - oriented, rational, and autogenic-training therapy for cerebral stroke patients - hypnosuggestive, cognitive - behavioral therapy, cognitive and autogenic-training therapy. The proposed system showed a significant improvement in 80% of myocardial infarction patients and 77% of patients cerebral stroke, a partial improvement - 10% of myocardial infarction patients and 13% of cerebral stroke patients.
643 – Quality Of Life, Social Support, And Severity Of Psychiatric Symptoms In Jordanain Patients With Schizophrenis
Authors: Hamaideh S.H.
Published: July 2013

Introduction:

Quality of life (QOL) has recently been recognized as an important goal of psychiatric and mental health care and has been increasingly used to evaluate health care outcomes in patients with schizophrenia.

Objectives:

The major objectives of this study were to examine levels and correlations of QOL, social support, and severity of psychiatric symptoms as well as to identify the variables that predict QOL among Jordanian patients with schizophrenia.

Methods:

Descriptive cross-sectional design was used employing structured interview method from 160 patients selected through systematic random sampling from two psychiatric outpatient clinics.

Results:

Results showed that the highest QOL domain was social relationship and the highest source of social support was from significant others. Severity of affective symptoms was the highest and the severity of positive symptoms was the lowest. QOL correlated positively with social support, patients’ educational and income level, and employment; and negatively with severity of psychiatric symptoms, duration of untreated illness, and duration of treatment. Support from friends, duration of untreated illness, income level, and severity of affective symptoms predicted QOL and accounting for 47.3% of the variance.

Conclusions:

This study confirms poor QOL in schizophrenia despite significant improvement in various methods of treatment. Enhancing social support, decreasing the duration of untreated illness, encouraging working and employment, and controlling affective symptoms will improve QOL of patients with schizophrenia.
682 – Age and Adverse Effects of Psychopharmacological Treatment. Data from the Drug Surveillance Program AMSP in Switzerland
Authors: Greil W. , Haeberle A. , Schuhmann T. , Grohmann R. , Baumann P.
Published: July 2013

Objectives and aims:

The frequency of severe adverse drug reactions (ADR) of psychotropic drugs in relation to age is investigated and especially the incidence in hospitalized patients aged up to 60 years is compared with patients aged above 60 years.

Methods:

The data - prescription rates of psychotropic drugs, reports of severe ADR - are taken from psychiatric hospitals in Switzerland between 2001 to 2010 and stem from the drug surveillance program AMSP.

Results:

699 patients exhibited severe ADR: 517 out of 28282 patients up to 60 years (1.8%); 182 out of 11446 elderly patients (1.6%, ns). Linear regression analyses show a significantly decreasing relationship between the incidence of ADR and patients’ age in general and in particular for weight gain, EPMS symptoms, increased liver enzymes and galactorrhoea. Delirium increases with age. A significantly decreasing relationship was observed for age and the dosages of olanzapine, quetiapine, risperidone, valproic acid and lamotrigine. Comparing age groups, lower frequency of ADR in general was found for antipsychotic drugs and anticonvulsants, in particular also for valproic acid in the elderly. Weight gain was found to be lower in the eldery for antipsychotic drugs, in particular also for olanzapine. For the group of mood stabilizing anticonvulsants (carbamazepine, lamotrigine and valproic acid) the elderly exhibited a lower incidence of reported allergic skin reactions.

Conclusion:

The results suggest that in hospitalized patients the incidence of common severe adverse effects such as weight gain and EPMS symptoms as a consequence to psychotropic medication decreases with age.
687 – Bifactor Models Support ICD-10 Construct of ADHD Against DSM-IV, Both in Children Rated by Teachers and Self-rated in Adults
Authors: Caci H.M. , Morin A.J.S. , Bouchez J. , Baylé F.J.
Published: July 2013

Introduction:

Attention Deficit-Hyperactivity Disorder (ADHD) is present in both DSM-IV and ICD-10, with slight differences. For instance, one item is allocated to hyperactivity in DSM-IV and to impulsivity in ICD-10. ADHD is best conceived as a set of core symptoms with some specificity in phenotypal symptomatology. Regarding the specific components, their number remains an open question, the answer oscillating between two (Attention and Hyperactivity-Impulsivity) and three (Attention, Hyperactivity, and Impulsivity).

Aims:

The aim of this study is to contrast alternative measurement models of instruments assessing ADHD symptoms (2 versus 3 specific factors, hierarchical versus bifactor models) across instruments, and age groups.

Methods:

We analysed data from the new ChiP-ARD study. Youths (n = 892) aged 5 to 18 years-old were randomly selected and rated by their teachers (ADHD-Rating Scale, and SWAN). Parents (n = 1,171) of these youths rated their own behaviour using the Adult ADHD Symptom Rating Scale (ASRS). The fit of alternative models for ordered-categorical items was tested using the robust Weighted Least Square Estimator (WLSMV).

Results:

Results support a bifactor model including one global ADHD factor and two specific Inattention and Hyperactivity- Impulsivity factors. The results also show that the Hyperactivity-Impulsivity factor is improperly defined, and unreliable, calling into question the existence of this subtype. Furthermore, the fit improved when Impulsivity was measured by 4 (ICD-10) versus 3 (DSM-IV) items.

Conclusion:

ADHD is a continuous condition from childhood to adulthood, and the “Talk too much” item is best conceived as a measure of Impulsivity than Hyperactivity.
688 – High Society - An Integrated Approach To Care
Authors: Ofori-Attah G.
Published: July 2013

Introduction:

Gamma-Butyrolactone (GBL) is a recreational drug, whose use has increased in recent years. However, it is highly addictive and when consumed in excessive amounts, physical and psychological dependence can develop.

High profile deaths, including the death of a young medical student, have increased the public's awareness of GBL. However, in spite of this and a change in UK law (2009) to make the once legal high a class C drug, the number of patients presenting to emergency departments with GBL overdose has continued to rise. There is significant anxiety amongst professionals working in acute medicine and psychiatry when it comes to managing these difficult presentations, which combine symptoms of a frightening psychosis with marked physical compromise, which can ultimately lead to coma and death. There is also a lack of medical literature concerning GBL.

Aim:

To discuss a case that presented at Chelsea and Westminster Hospital, highlighting:

The signs and symptoms of GBL intoxication and withdrawal.

The importance of managing the psychosis alongside the physical symptoms.

Where these patients should be managed.

Case:

24-year-old patient, brought to A+E after police received reports about a gentleman in an underground station exhibiting ‘erratic, unusual behaviour’.

Conclusion:

This case highlights the need for an integrated approach to the management of substance misuse in acute hospital settings. GBL is a substance that most practising doctors have not been taught about. Education on the topic, and other emerging recreational drugs, should be an important part of our continuing professional development.
690 – Depressive and Anxiety Disorders and Functioning in Clinical High-Risk Patients. Results of the EPOS Project
Authors: Salokangas R.K.R. , Luutonen S. , Ruhrmann S. , Graf von Reventlow H. , Heinimaa M. , Juckel G. , Linszen D. , Dingemans P. , Birchwood M. , Patterson P. , Klosterkötter J.
Published: July 2013

Introduction:

Depressive and anxiety disorders are the most common clinical diagnoses in patients at clinical high-risk (CHR) of psychosis (1).

Objectives:

Clinical disorders and functioning in CHR patients.

Aims:

To study how depressive and anxiety disorders associate with patients’ functioning at baseline and follow-ups in CHR patients.

Methods:

In the EPOS project, 245 young help-seeking CHR patients were examined, and their baseline diagnoses were assessed by the SCID-I. The patients were interviewed with the SIPS/SOPS, including assessments of positive and negative symptoms and the Global Assessment of Function (GAF), at baseline and at 9 and 18 months follow-ups.

Results:

At baseline and follow-ups, the patients without depressive or anxiety disorders had highest GAF scores. At baseline, the patients with depressive disorders had lower GAF scores than the patients with anxiety disorders. At follow-ups, there were no differences in GAF scores between the patients with depressive or anxiety disorders. In modelling, negative symptoms associated with low GAF scores at baseline and follow-ups, positive symptoms only at baseline and anxiety disorders at 18 months follow-up.

Conclusions:

Depressive and anxiety disorders associate with poor functional outcome, and require thus special attention when intervention for the CHR patients is carried out. Positive symptoms predict transition to psychosis (2), but their role in predicting functional outcome is not as great. Instead, negative symptoms associate with poor functional outcome and require intensive intervention.

(1) Salokangas RKR et al. Schizophr Res 2012, doi:10.1016/j.schres.2012.03.008.

(2) Ruhrmann S et al. Arch Gen Psychiatry 2010;67:241-251.
695 – Associations between Symptoms, Functional Status and All-Cause Mortality in People with Schizophrenia
Authors: Hayes R. , Chang C.-K. , Fernandes A. , Begum A. , To D. , Broadbent M. , Hotopf M. , Stewart R.
Published: July 2013

Background:

Compared to the general population, people with schizophrenia have a substantially higher risk of premature mortality which translates into a 10–15 year reduction in life expectancy. The aim of this investigation was to determine if symptoms (including aggression, hallucinations or delusions, and depression) or the environmental and functional status of people with schizophrenia contribute to the high mortality risk observed in this patient group.

Methods:

We identified cases of schizophrenia, aged ≥15 years in a large secondary mental healthcare case register linked to national mortality tracing. We modelled the effect of specific symptoms, activities of daily living (ADLs), living conditions, occupational and recreational activities (Health of the Nation Outcome Scale [HoNOS] subscales) on all-cause mortality over a 4-year observation period (2007-10) using Cox regression.

Results:

We identified 4270 schizophrenia cases (170 deaths) in the observation period. After controlling for a broad range of covariates, mortality was not significantly associated with hallucinations and delusions or overactive-aggressive behaviour, but was associated with subclinical depression (adjusted HR 1.5; 95% CI 1.1-2.2) and ADL impairment (adjusted HR 1.8; 95% CI 1.2-2.9).

Conclusions:

Severity of symptoms, such as delusions and hallucinations, was less important in predicting mortality than subclinical depression and difficulties carrying out activities of daily living. The overall picture appears to be one where the highest all-cause mortality risk is in service users who are least visible to clinical teams.
698 – Urinary Tract Infection and Mental Illness
Authors: Stantiford E.M. , Echeverría Hernández N. , Brasas F. De la Torre , Pecero García O. , Duque Domínguez A. , Lázaro Redondo M.M. , Bango Suárez J.I.
Published: July 2013

Introduction:

It is well known that mental illneses are associated with higher prevalence of somatic disorders when compared to the general population. We observed that, at the time of admission to the Acute Psychiatric Unit (APU) at our Hospital, many patients have associated urinary tract infection.

Objectives:

To determine the characteristics of patients that present with urinary tract infection on admission to the APU

Methods:

From all admissions to the APU during 2011, patients with urinalysis, sediment and culture suggesting urinary tract infection were recruited for this study.

Results:

83 out of the 229 patients admitted to the APU had urinary tract infection at the moment of admission. Most common psychiatric diagnoses in patients with urinary tract infection were: mood disorders (37.35%), psychotic disorders (22.89%) and personality disorders (14.46%) Of these 83 patients, 72.29% had a history of previous psychiatric admissions and 91.67% had a new admission with an associated urinary tract infection.

Figure

[readmissions]

Conclusions:

A high percentage of patients admitted to our APU have recurrent urinary tract infections. Urinary tract infections may play a negative impact on their psychopathological evolution and may be associated with the need for hospital admission.
704 – Thought Disorders - Evolution of Historical Concepts
Authors: Telles-Correia D. , Moreira A.L.
Published: July 2013

Introduction:

Several authors made important contributions to the evolution of psychopathological concepts that we now often gather under the topic of formal thought disorders (FTD).

Objectives:

Our objectives were to describe the interpretation of concepts - including FTD and related concepts - by authors that had a major impact in the field and in defining trends nowadays.

Aims:

In general we aimed to reach a comprehensive understanding of the evolution of the above mentioned.

Methods:

We reviewed the literature by searching PUBMED and a library database using the terms thought and language and association and schizophrenia and course interchangeably. We used article and book references to increase our search.

Results:

Throughout the years - from the first observations suggesting a primary pathology of the ability to coordinate ideas of Esquirol and Guislain to the current DSM-IV Schizophrenia criteria - and considering authors from all over the world - including Fish (UK), Kurt Goldstein, Carl Schneider, Emil Kraepelin (Germany), Eugen Bleuler (Switzerland), Jules Séglas (France), Nancy C. Andreasen (USA), Pio de Abreu (Portugal), Elie Cheniaux (Brazil), among others - terms have been given approximate meanings and different symptoms/signs have been considered to that purpose.

Conclusions:

Using precise concepts of formal thought and related disorders is crucial when considering diagnostic hypothesis and passing information on to colleagues. Thus, it is of utmost importance having a better understanding of the above.
705 – Psychotropic Drugs and HIV
Authors: Moreira A.L. , Godinho Pereira M. , Telles-Correia D.
Published: July 2013

Introduction:

VIH/AIDS infection is frequently associated with psychiatric disorders. Psychiatric comorbidities may interfere in adherence to antiretroviral treatment. Therefore, diagnosis and treatment of these conditions are essential. However, the administration of a new drug to the HAART therapy can result in drug interactions.

Objectives:

Our objectives were to describe the relationship between mental disorders and HIV and to analyze the interactions and adverse reactions when combining psychotropic drugs and antiretrovirals.

Aims:

We aimed to review the literature of the association of mental disorders and HIV focusing mainly on the pharmacological aspects.

Methods:

We reviewed the English literature from 1993 until 2011 searching MEDLINE using interchangeably the key-words HIV, AIDS, psychosis, depression, anxiety, secondary mania, antidepressive agents, antipsychotics, benzodiazepines, and HAART.

Results:

Patients with mental illnesses may be more prone to acquire infectious diseases by taking risk behaviors. Also, HIVinfected patients are more likely to present with psychiatric symptoms than the general population. Adding pharmacotherapy may improve adhesion to the antiretroviral treatment. We highlight the use of antipsychotics, antidepressants, benzodiazepines and mood stabilizers in patients diagnosed with HIV. We include interactions between pharmacotherapy and antiretroviraltherapy. Some of these drugs (e.g. Ritonavir) have shown important interactions, while others have shown any or no information was found available.

Conclusions:

Choosing the best therapeutic intervention in each case, particularly considering those drugs with the least interactions and adverse effects, is crucial for a therapeutic success and in the combat to infection.
710 – Risperidone-associated Deep Venous Thrombosis: Case Report and Review
Authors: Ouanes S. , Abdelghaffar W. , Rafrafi R. , Jomli R. , Melki W. , Nacef F. , El-Hechmi Z.
Published: July 2013

Deep venous thrombosis (DVT) is a rare but potentially life-threatening adverse effect of antipsychotic medication. In this paper, we present a case of DVT that occurred during the first month of risperidone use. The patient Mr. M., aged 33, presented with a delusion of persecution based on a purely interpretative mechanism.

The diagnosis of a delusional disorder of the persecution type was made and the patient was started on risperidone 2mg bid. Two weeks later, the patient was admitted to the internal medicine department for femoro-iliac DVT.

Etiological investigation ruled out common congenital as well as acquired causes for thrombophilia, and DVT was hence attributed to risperidone use. The patient quickly responded to heparin then warfarin treatment. Risperidone was switched to amisulpride.

Although antipsychotics have been widely used for more than fifty years, their association with DVT has not been discovered until recently.

DVT usually occurs during the first three months of antipsychotic use and is more common with atypical and low-potency typical drugs than with high-potency conventional antipsychotics. Amisulpride appears to be the antipsychotic drug least associated with DVT.

This case highlights a scarce yet serious side effect associated with antipsychotic use. Caution should be applied when initiating such a treatment in patients with a high risk of thrombosis. Occurrence of DVT in a patient on antipsychotic medication should lead to the current treatment being stopped, and if necessary, switched to either amisulpride or a highpotency conventional drug.
711 – Non-Psychotic Mental Disorders in Female Patients with Climacteric Hysteria
Authors: Lukiyanova E. , Semke V.
Published: July 2013

Objective:

Identify spectrum of non-psychotic mental disorders in climacteric hysteria in women.

Material and methods:

127 female patients of climacteric age. Clinical-psychopathologic, clinical-dynamic, mathematicstatistical methods were used. Diagnoses have been verified according to ICD-10 (have been introduced in order of lessening number of female patients): adjustment disorders - 47; organic emotional-labile (asthenic) disorder - 30; personality disorders - 11; anxiety disorders - 9; somatoform disorders - 7; organic anxiety disorder - 7; combined organic emotional-labile (asthenic) disorder and adjustment disorder - 6; agoraphobia - 3; organic affective disorder - 2; organic dissociative disorder - 2; dissociative disorders - 2; affective disorders (depressive episode of mild degree of severity, dysthymia) - 1. Large range of non-psychotic mental disorders defines climacteric hysteria as a psychopathologic complex.

Results:

Clinical examination was added by analysis of archive medical records and retrospective assessment of dynamic of the disease. Study of clinical typology, dynamic of non-psychotic mental disorders in women with climacteric hysteria has allowed distinguishing 3 variants. Somatized-hypochondriac (72 - 55,69%) - with persistent hypochondriac fixation on body sensations, somatovegetative disorders, nosophobias (cardio-, stroke-, infarction-, cancer-, lissophobia). Anxiety-depressive (44 - 34,65%) - with decreased mood, irritability, tearfulness in the period of hormonal changes of body in climax, accompanying severity of heart, mediastinum, epigastrium, fluctuating arterial pressure, sleep disorders. Psychopath-like (11 - 8,66%) - with explosiveness, increased emotional excitability, stormy affective manifestation of emotions.

Conclusions:

Based on distinguished variants we have defined algorithms of therapy of non-psychotic mental disorders in women with climacteric hysteria.
721 – European Psychiatric Trainees and their Interactions with the Pharmaceutical Industry: Results from the EFPT-PRIRS Study
Authors: Riese F. , Guloksuz S. , Roventa C. , Fair J.D. , Haravuori H. , Rolko T. , Flynn D. , Giacco D. , Banjac V. , Jovanovic N. , Bayat N. , Palumbo C. , Rusaka M. , Kilic O. , Augėnaitė J. , Nawka A. , Zenger M. , Kekin I. , Wuyts P. , Barrett E. , Bausch-Becker N. , Mikaliunas J. , del Valle E. , Feffer K. , Lomax G.A. , Gama Marques J. , Jauhar S.
Published: July 2013

The influence of pharmaceutical industry (PI) on clinical practice and research in psychiatry has been considered a serious problem. Strict rules and guidelines were developed to regulate the interactions between doctors and PI. However, there is an ongoing debate whether these were thoroughly implemented in practice and internalized by physicians. The objective of our study was to assess the attitudes and behaviors of trainees in psychiatry and child & adolescent psychiatry toward PI across Europe. Methodologically, a validated questionnaire with additional items was administered to1444 trainees in 20 European countries. The minimum response rate was set at 60%. We found a high variation across countries in number of interactions between trainees and PI representatives; Portugal and Turkey had the highest number of interactions. The majority (59.76%) agreed that interactions with PI representatives have an impact on physicians’ prescribing behavior; whereas only 29.26% and 19.79% agreed interactions with PI representatives and gifts from PI have impact on their own prescribing behavior, respectively. Most of the gifts were considered appropriate by the majority, except tickets to vacation spot and social dinner at a restaurant. Of the sample, 70.76% think they have not been given sufficient training regarding how to interact with PI representatives. Only less than 20% indicated they have guidelines at institutional or national level. In conclusion, there is substantial interaction between trainees and PI across countries. The majority feel inadequately trained regarding professional interaction with PI, and believes they are immune to the influence of PI.
741 – Re-audit: Are Inpatients Routinely Assessed for Venous Thromboembolism on Admission. Oxford, UK, 2012
Authors: Al-Taiar H.
Published: July 2013

Aims:

The audit aims to investigate whether physical health assessment and VTE risk assessment were routinely completed and documented. The results will be used to develop plans around the prevention and management of VTE in inpatients.

Background:

An estimated 25000 people in England die from preventable hospital-acquired Venous Thromboembolism (VTE) every year. The recently issued NICE guidelines give a framework for assessment and management of VTE risk. This is a re-audit followed by an initial audit carried out in Sep 2011.

Methodology:

The audit was completed in May 2012 using the electronic patient information system (RiO) and where needed paper notes available on the wards were also reviewed. Data collection focussed on assessing evidence that the physical health proforma has been completed and VTE risk identified.

The sample included 144 adult and 65 older adult inpatients (cross sectional sample in May 2012).

Conclusions:

Completion of physical health assessment is improved (94%) compared to initial audit (92%).

Where completed, 100% of the physical health assessments were documented.

Recording of physical health assessment on RiO was improved.

VTE risk assessment has improved (83%) as compare to the initial audit (79%).

Recommendations:

Physical health assessment completion needs to improve until 100% is achieved.

After completion, physical health assessment for every patient needs to be recorded on RiO.

To ensure that VTE risk assessment is completed for every patient on the ward.

Repeating the audit in 6 months to see if these changes have been implemented.
750 – Clinical Experience on the Application of Transference Focused Psychotherapy in the Supervision of a Case after a Year of Observation
Authors: Morales Puig L. , Ignacio M. ,   Grup-TLP Barcelona
Published: July 2013

Introduction:

In 2011 Several institutions of the Catalan network of Mental Public Health initiated a project to improve the attention of patients with borderline personality disorder (BPD), following Prof. Otto Kernberg model: The Transference Focused Psychotherapy (TFP).

Methodology:

In every telematic meeting, the transcription of the clinical session with its video recording is presented to Dr. P. Foelsch and the rest of professionals from the supervision group.

Results:

From the different techniques of the TFP, the following were of great usefulness for the observed case: the therapeutic contract, which facilitated working the impulsiveness of the patient, the techniques of clarification, confrontation and interpretation that allowed the patient to understand what was happening to her and to integrate separated aspects of herself, and the recognition of the non verbal language that in numerous occasions was the best way to understand what was happening to the patient.

Conclusions:

The advantages of the TFP on the observed case, and generally, in BPD patients are many, but I would highlight: First, as these patients manifest their primitive conflicts in dissociated behaviour rather than in the content of free association, the more systematized interventions of the TFP makes easier to work with them. Secondly, the therapeutic contract at the beginning, permits to maintain the treatment frame under even sever acting-out conditions.
751 – Characterizing Psychopathology, Neuropsychology and Functioning in Delusional Disorder as Opposed to Other Psychosis
Authors: Muñoz Negro J.E. , Ibáñez Casas I. , Ballesteros Ramos J.L. , Busaileh Salas A. , Cervilla Ballesteros J.A.
Published: July 2013

Introduction:

Delusional disorder is traditionally considered a less severe clinical entity than schizophrenia or schizoaffective disorder. From the dimensional approach to psychiatric diagnostic classification it might be necessary redefine the diagnostic classification of psychosis.

Aim:

To assess differences found in psychopathology, neuropsychology and functioning among schizophrenia, schizoaffective disorder and delusional disorder.

Methods:

59 patients were included in this study. 30 out of them presented a diagnostic of schizophrenia, 15 patients delusional disorder and 14 schizoaffective disorder. All of them were assessed through different scales including PANSS, GAF, SIX, SCIP and DKEFS Stroop. To compare the different groups ANOVA, Post hoc Bonferroni analysis and X2 test were carried out.

Results:

We found statistically significant differences regarding negative symptoms between patients with schizophrenia and delusional disorder, being those less intense and severe in the last ones. In that way, a inversely proportional trend regarding negative and positive PANNS subtypes between schizophrenia and delusional disorder was observed.

Conclusions:

In spite of the fact that the delusional disorder is considered less severe disease than other psychosis we only found a less degree of severity for negative symptoms. Further studies with greater sample size must be conducted.
752 – Immature Psychological Defense Mechanisms: Association with Personal Importance of Junk Food, Alcohol and Television Viewing
Authors: Brody S. , Costa R.M.
Published: July 2013

Introduction:

Immature psychological defense mechanisms are psychological processes that play an important role in suppressing emotional awareness and contribute to psychopathology, including personality disorder. In addition, unhealthy food, television viewing, and alcohol consumption can be among the means to escape self-awareness. In contrast, engaging in, and responding fully to specifically penile-vaginal intercourse (PVI) is associated with indices of better emotional regulation, including less use of immature defense mechanisms.

Objective:

To research the association of immature defense mechanisms with personal importance of junk food, alcohol, television, PVI, and noncoital sex.

Method:

In an online survey, 334 primarily Scottish women completed the Defense Style Questionnaire (DSQ-40), and rated the personal importance of junk food, alcohol, television, PVI, and noncoital sex.

Results:

Immature defense mechanisms correlated with personal importance of junk food, alcohol, and television. Importance of PVI correlated with mature defenses, and less use of some component immature defenses. Importance of alcohol correlated with importance of junk food, television, and noncoital sex. Importance of junk food was correlated with importance of television and noncoital sex.

Conclusions:

The findings are discussed in terms of persons with poorer self-regulatory abilities having more interest in junk food, television, and alcohol, and less interest in PVI.
753 – Female Adolescents'needs: the Importance of Health Promoting Schools
Authors: Shahhosseini Z. , Simbar M. , Ramezankhani A.
Published: July 2013

Background & purpose:

In contemporary society, schools play an increasingly important role in preparing young people for adulthood. This role is more prominent especially in female adolescents because of synchronization of puberty years and girls attendance in schools. the purpose of this paper is to explore adolescents and key informants' perception and experiences regarding to importance of schools in female adolescents' health needs.

Material and methods:

This qualitative study was conducted in Sari in the North of Iran. Sixty-seven urban and rural female adolescents between 12-19 years of old participated in 8 focus group discussions. in addition, semi structured interviews were done with 11 key informants. Participants were selected based on purposeful sampling and with maximum variety. All taperecorded data was fully transcribed and thematic analysis was done to identify key themes.

Results:

Two main categories emerged from data: Optimal performance of teachers and administrators and Educational reform. Conscious teachers, Promotion counseling in schools and optimal management were the main subcategories of the first theme and reform of teaching patterns and reducing test anxiety were the main subcategories of the second.

Conclusion:

The school is responsible for changing and modifying maladaptive behaviors, and providing emotional and mental health of students. So reform in educational system, improvement of teaching patterns and promotion of teachers, counselors and administrators performances are necessary.
756 – Fear and Discomfort as Possible Response to a Distress Test in Smokers Under Nicotine Withdrawal Conditions
Authors: Bertoli G. , Amendola B. , Cosci F.
Published: July 2013

Introduction:

Some studies showed that nicotine withdrawal may increase the likelihood to develop anxiety or distress.

Objectives:

Nicotine withdrawal symptoms (NWS) may specifically provide an opportunity to learn that physical sensations can be aversive, thus anxiety or distress-provoking.

Aims:

We evaluated whether NWS predict the responding to a test inducing distress, the so called Breath Holding (BH) test, in regular smokers evaluated under nicotine withdrawal conditions or under non withdrawal conditions. Specifically, we studied if fear or discomfort are felt as a response to the test inducing distress.

Methods:

We run a cross-over design study on current smokers. Each subject received either nicotine and placebo in two different test days according to a randomized, double-blind order. Four hours after the administration of nicotine or placebo, each subject underwent the BH test. Fear and Discomfort were evaluated by means of a Visual Analogue Scale (VAS-F for Fear and VAS-D for Discomfort).

Results:

20 subjects (10 females and 10 males) with a mean age of 32,05 ± 10,13 years were studied. At baseline the two conditions did not differ. No statistically significant results were found for VAS-F and VAS-D in terms of response to the BH test.

Conclusions:

NWS seem not to affect the response to a distress test in current smokers at least when fear or discomfort are taken into account.
758 – 3-alkyl Fentanyl Analogues: Structure-activity-relationship Study
Authors: Vuckovic S. , Savic Vujovic K. , Srebro D. , Vujovic A. , Medic B. , Prostran M.
Published: July 2013

Fentanyl, the prototype of the 4-anilidopiperidine class of a synthetic opioid analgesics, is widely used to supplement general anesthesia or to treat postoperative and cancer pain. in order to discover an analgesic with the improved pharmacodynamic and pharmacokinetic profile, extensive efforts during last five decades have been devoted to synthesis of a large number of fentanyl analogues and establishing the structure-activity-relationship (SAR) of the 4-anilido-piperidine class of analgesics. This study is aimed to examine the analgesic activity of some newly synthesized 3-alkyl fentanyl analogues and compared with fentanyl. Antinociception is measured by using tail-immersion test in male Wistar rats.The relative potency was: (±)cis-3-methyl fentanyl (8)>(±)trans-3-methyl fentanyl (2)≥(±)cis-3-ethyl fentanyl (1.5)>fentanyl (1)≥(±)trans-3-ethyl fentanyl (0.9)>(±)cis-3- butyl fentanyl (0.064)≥(±)trans-3-butyl fentanyl (0.035)>(±)cis-3-benzyl fentanyl (0.008)≥(±)trans-3-benzyl fentanyl (0.0055). the duration of action (ED99) was: (±)cis-3-methyl fentanyl (90min)>(±)trans-3-methyl fentanyl (40min)≤(±)cis-3-ethyl fentanyl (60min)≥(±)trans-3-ethyl fentanyl (40min)≤fentanyl (50min)=(±)cis-3-butyl fentanyl (50min)=(±)trans-3-butyl fentanyl (50min)=(±)cis-3-benzyl fentanyl (50min)=(±)trans-3-benzyl fentanyl (50min). Pharmacological results show that groups in position 3 of the piperidine ring, which are larger than methyl, severely reduce the analgesic potency compared to fentanyl. It is likely that the steric factor (i.e. voluminosity of the group and cis/trans isomerism) plays a crucial role in the analgesic potency of this series. Although the duration of action, in general, does not depend on the stereochemistry, longer action of the most potent 3-alkyl fentanyl analogues such as cis-3-methyl- and cis-3-ethyl fentanyl, is more likely influenced by pharmacodynamic, rather than pharmacokinetic variables.
760 – Cognitive and Affective Impairments of a Novel SCA/MND Crossroad Mutation Asidan
Authors: Abe K. , Ikeda Y. , Kurata T. , Ohta Y. , Manabe Y. , Okamoto M. , Takamatsu K. , Ota T. , Takao Y. , Shiro Y. , Shoji M. , Kamiya T. , Kobayashi H. , Koizumi A.
Published: July 2013

Background:

A variety of hereditary spinocerebellar ataxia (SCA) develops a broad spectrum of both ataxia and non-ataxia symptoms. Cognitive and affective changes are one such non-ataxia symptoms, but have been described only in hereditary SCAs with exonic CAG gene expansion.

Methods:

We newly found intronic hexanucleotide GGCCTG gene expansion in NOP56 gene as the causative mutation (=SCA36) in nine unrelated Japanese familial SCA originating from Asida river area in the western part of Japan, thus nicknamed Asidan for this mutation. These patients show unique clinical balance of cerebellar ataxia and motor neuron disease (MND), locating on the crossroad of these two diseases. We examined cognitive and affective analyses on 12 Asidan patients who agreed to join the examination.

Results:

The 12 Asidan patients demonstrated a significant decrease in their frontal executive functions measured by frontal assessment battery (FAB) and Montreal cognitive assessment (MoCA) compared with age- and gender-matched controls, whilst mini-mental state examination (MMSE) and Hasegawa dementia score-revised (HDS-R) were within normal range. the decline of frontal executive function was related to their disease duration and scale for the assessment and rating of ataxias (SARA). They also demonstrated mild depression and apathy. Single-photon emission tomography (SPECT) analysis showed that these Asidan patients showed decline of regional cerebral blood flow (rCBF) in a particular areas of cerebral cortices such as Brodmann areas 24 and 44-46.

Conclusions:

These data suggest the patients with Asidan mutation show unique cognitive and affective characteristics different from other hereditary SCAs with exonal CAG expansion or MND.
764 – The Quality of Life Enhancement Program for Persons with Mental Illness
Authors: Pan A.-W. , Chen Y.-L. , Hsiung P.-C. , Chen T.-J.
Published: July 2013

Introduction and aims:

Previous studies showed that persons with mental illness had poorer quality of life than persons with the other medical conditions. We developed a manualized treatment - Quality of Life Enhancement Program (QOLEP) based on literature review and clinical experiences. the contents of the program include 4 sessions of ‘occupational life scheduling’ and 4 sessions of ‘coping skills’ provided by an occupational therapist during a 4-week period (2 times/week) which each session lasts for one to two hours.

Methods:

Twenty-one subjects were recruited from community mental health rehabilitation centers in northern Taiwan. They were randomly assigned to either treatment group (N=11) or control group (N=10). the subjects in the control group received general supportive therapy over the phone twice a week for 4 weeks. Both groups were evaluated at baseline and posttreatment. the mixed-effects linear model was applied to analyze the efficacy of the treatment.

Results:

The results showed that the subjects who participated in the QOLEP had significantly better physical QOL than that of control group (-9.66+4.24, p< .05). the suicidal ideation of the subjects for both groups decreased over time (2.64+3.16, p< .05). Most of the participants indicated that the activities were easily understood, helpful to them, and are willing to participate in the program again.

Discussion:

With the program developed based on concept of occupational engagement, we were able to demonstrate the efficacy of specific treatment on quality of life and used it as evidence to support future development in mental health area.
770 – Psychiatric co Morbidity and Stress in Primary Caregivers of HIV Patients
Authors: Sinha V. , Paswan R.K. , Sharma I.
Published: July 2013

Introduction:

HIV like other chronic illnesses is an important contributing factor for psychiatric co-morbidity in not only HIV sufferers as well as their caregivers. Few studies show that a significant proportion of caregivers of HIV positive patients had psychiatric illness which is otherwise neglected but in turn hampers the quality of care provided to the HIV positive patient as well as the caregiver himself. This chunk of population if identified at a earlier stage, steps to teach them healthy coping strategies as well as timely initiation of management of psychiatric illness can decrease the burden of disease.

Aims and objectives:

To assess and compare the presence of psychiatric morbidity, stress and quality of life in primary caregivers of HIV patients.

Methodology:

All primary caregivers of HIV positive patient attending the Anti Retroviral Therapy(ART) center during six month period were assessed using a semi-structured Performa, International neuropsychiatric interview English version 5.0.0 (MINI PLUS) scale, PSLES, WHO QOL brief scale,. Data was segregated and analysed using appropriate statistical test.

Result:

Out of total 125 respondents 24(19.2%) were found to be depressive. Anxiety disorders were significantly prevalent (8.4%). other psychiatric disorders were somatisation, adjustment disorder etc. PSLES was fairly high and WHO QOL scoring was low in caregivers as compared to control group.

Conclusion:

Significantly high number of caregivers was positively screened for psychiatric morbidity, most of them were stress related neurotic disorders. the stress level was more in caregivers and quality of life was compromised as compared to control group.
785 – Attributional Retraining Group Therapy Versus Selective Serotonin Reuptake Inhibitors: Neurobiological Effects
Authors: Wang C. , Zhang N. , Zhang Y.
Published: July 2013

Objective:

The aim of this study was to compare the effectiveness of attribution retraining group therapy (ARGT) versus selective serotonin reuptake inhibitors (SSRI) in the treatment of major depressive disorder (MDD), generalized anxiety disorder (GAD) and obsessive-compulsive disorder (OCD).

Methods:

109 patients with MDD, GAD and OCD were recruited from the outpatient department of a tertiary referral hospital between 2007 and 2008. Subjects were sequentially recruited and randomized into ARGT group (n=63) and SSRI group (n=66) for an 8-week treatment period. 54 outpatients in ARGT group and 55 outpatients in SSRI group completed the study. All subjects were assessed using Hamilton Depression Scale, Hamilton Anxiety Scale before and after treatment. Yale-Brown Obsessive Compulsive Scale was employed only for OCD subjects. Plasma hormone levels of serotonin, norepinephrine, cortisol, adrenocorticotropic hormone, and brain-derived neurotrophic factor (BDNF) were measured at baseline and at 8 weeks.

Results:

Symptom scores were reduced significantly in both ARGT and SSRI treatment groups (p< 0.001) at the end of the treatment course. However the patients in the ARGT group had significantly lower plasma cortisol concentrations compared to baseline (p< 0.05). on the other hand, patients receiving the SSRIs showed significantly increased plasma levels of serotonin (p< 0.05) and BDNF (p< 0.01).

Conclusions:

Our findings suggest that ARGT may modulate plasma cortisol levels and take effect to the HPA axis as opposed to SSRIs which may up-regulate plasma serotonin and BDNF levels via a different pathway to produce an overall improvement in the clinical condition of patients.