bluuebunny/crossref_metadata_2025 huggingface dataset:
Depression in Geriatric Inpatients: Correlations with Nutritional State and Cognitive Functions
Authors: Bonfitto I. , Moniello G. , Ariano L. , Pascucci M. , Zanasi M.D. , Bellomo A.
Published: May 2016

Background

Although the prevalence of malnutrition is relatively low among elderly people, the risk increases significantly among inpatients and even more in those with mental deterioration.

Aims

To evaluate the possible association between the severity of depressive symptoms, the nutritional status and the cognitive decline in a sample of geriatric inpatients.

Methods

Fifty-one geriatric inpatients completed the following tests:

– Hamilton Depression Rating Scale (HAM-D), to assess the severity of depressive symptoms;

– Mini Nutritional Assessment (MNA), as a nutrition screening and assessment tool;

– Mini Mental State Examination (MMSE), to assess the cognitive impairment.

Results

There is a negative proportional relationship between HAM-D and MMSE scores (P = 0.001) and between HAM-D and MNA scores (P = 0.023). Depressed patients found to have a greater cognitive impairment and a worse nutritional status. Considering a HAM-D cut-off point of 14, distinguishing mild than moderate depression, it shows a significant correlation with the MNA scores (P = 0.008). Patients with HAM-D scores ≥ 14 have an average MNA score of 19.8, while patients with HAM-D scores < 14 have an MNA average score of 23.6. Euthymic or mildly depressed patients are not at risk of malnutrition, while those with moderate or severe depression have an increased risk of malnutrition.

Conclusions

Our study shows significant correlations between the severity of depressive symptoms and the risk of malnutrition or cognitive impairment. A mild depression state does not seem to be associated with an increased risk of malnutrition.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Neuropsychological and Motivational Factors of Cognitive Efficiency in Elderly Patients with Essential Arterial Hypertension
Authors: Pervichko E. , Zinchenko Y. , Ostroumova O.
Published: May 2016

Introduction

The diagnostics of cognitive disorders (CD) in patients with essential arterial hypertension (EAH) is often necessary for the choice of treatment strategy.

Objective

To assess the role of neuropsychological and motivational factors in cognitive efficiency of elderly EAH patients.

Materials and methods

Twenty-five patients with EAH took part in the study, stage 1–2, mean age was 67.6 ± 6.1. The assessment of cognitive functions embraced a quantitative measurement of intelligence quotient (IQ) with the Wechsler Adult Intelligence Scale (Wechsler, 1955), and investigation into qualitative features of cognitive processes with Luria's neuropsychological assessment scheme (Luria, 1980) and Zeigarnik's procedure of pathopsychological study (Zeigarnik, 1972).

Results

Within the psychological syndrome structure of CD in EAH patients the leading part is played by the neuro-dynamic factor, manifested in general lability, slowing down, and sudden exhaustion caused by reduction in energy of mental activity. The conclusion is supported by the high frequency of described symptoms among EAH patients and low dynamics of their reduction against the antihypertensive therapy (Pervichko et al., 2014, 2015). However, performance of experimental tasks makes 30% of EAH patients reveal reduced motivation. They would achieve poor results in general scoring, if compared with the group of highly motivated participants. Correlation analysis data show the interconnection between frequency disturbances in motivation and frequency in occurrence of various signs of cognitive decline, such as low efficiency in memorization and delayed recall, as well as low IQ indices.

Conclusions

The data provide a strong argument to support the hypothesis of particular importance of motivational factor of cognitive efficiency in elderly EAH patients.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
A Case of Catatonia, Klebsiella Pneumoniae Lung Infection and Intellectual Disability: Differential Diagnosis
Authors: Ballesteros A. , Montes L. , Jaimes W. , Cortés B. , Inchausti F. , Alex P. , Collantes J.
Published: May 2016

Introduction

In DSM-V, catatonia is individualized as a disease of its own. The priority is to look first for organic causes like intoxication. We present a clinical case diagnosed with intellectual disability (ID) and catatonia.

Objective

To study a case of catatonia which underwent testing using Bush-Francis Catatonia rating scale (BFCRS) prior/after clinical intervention. We therefore study catatonia's etiology in ID population.

Aims

To study the etiology of catatonia (and its clinical complications) in ID.

Method

Our patient is 48-year-old female with DI. Considering her clinical features of catatonia (using BFCRS) and clinical examination (fever and hypoxia), the case orientated towards a secondary diagnosis. Work-up tests revealed pneumonia in the lower lobe of the right lung (chest radiography showed opacities and blood tests showed Leuokocytosis with a left shift). The case further received a course oral levofloxacin (500 mg/day) and haloperidol was stopped. Valproic acid was also added to a dose of 600 mg/day, which led to clinical improvement. Remaining psychotropic treatment (duloxetine 60 mg/day, lorazepam 15 mg/day, diazepam 35 mg/day) was not modified.

Results

After 1 month, the patient improved according to BFCSR score.

Conclusions

We presented a case of presence of catatonia in other psychiatric conditions and undiagnosed general medical conditions. Haloperidol is contraindicated those circumstances and it may have worsened her clinical state (it should be used cautiously in DI). Other medications (gabaergic drugs) should be considered in such settings and rare causes related to hypoxia cannot be ruled out (Table 1).

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Challenging Behaviour in People with Intellectual Disabilities: The Assessment and Intervention Team
Authors: Courtenay K. , Jaydeokar S.
Published: May 2016

Objectives

People with intellectual disabilities (ID) present with behaviours that challenge community services. Community models of care as alternatives to hospital care exist but are often vary in their function. Certain strategies have been developed to manage challenging behaviour in people with ID. Data from a three-year period on a community-based service for people with ID and challenging behaviour that uses an objective, multi-disciplinary approach is presented.

Methods

A case note survey of adults with ID under the care of the Assessment and Intervention Team (AIT), a challenging behaviour service in the London Borough of Haringey.

Results

Over the three-year period, 65 adults were managed by AIT. Forty-four were male and 21 were female. The age range was 21–64 years of age. The level of ID was mild ID 61%, moderate 39%. Diagnoses included psychotic disorder (25%); mood disorder (20%); developmental disorder (40%); dementia (10%); challenging behaviour (45%). Six people (11%) were admitted to hospital during their time with AIT. The length of care under AIT ranged from four to fourteen months.

Conclusions

AIT managed effectively people with ID living in the community who presented with complex problems putting their placement at risk. The rate of hospital admission was reduced in this period compared with the previous three years. The length of stay in in-patient services was reduced. The most common reasons for the behaviours included mental illness and ‘challenging behaviour’. People with developmental disorders were a large proportion. Community alternatives are effective with positive benefits to the person.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Comparison of treatment response of typical and atypical antipsychotics in acute mania
Authors: Medici C.R. , Kai L.M. , Kirkedal C. , Straszek S.P.V.
Published: May 2016

Introduction

The medical treatment of acute mania today mainly includes atypical and typical antipsychotics, lithium or valproat. Atypical antipsychotics are often used as first-line treatment, while typical antipsychotics come with the risk of severe long-term side effects and less used today. However, typical antipsychotics may lead to a faster reduction in the severity of mania or a faster remission of symptoms.

Objective

To investigate whether the acute effect of typical antipsychotics differs from atypical antipsychotics measured by a daily mania rating-scale (MAS-M) and duration of treatment in a real-life clinical setting.

Aim

To help determine if short-term treatment with typical antipsychotics may still be of benefit in the acute treatment of mania.

Methods

This is a retrospective case record study. Patients admitted to an acute hospital ward with acute mania between 2012 and 2015 were included (n = 100). The daily use of atypical and typical antipsychotics will be compared by daily change in Bech-Rafaelsen Modified Mania Scale (Mas-M) score and time to discharge. The change in mania over time is presented visually using graph curves.

Results

The data extraction and data handling will be executed in the winter 2015–2016.

Conclusions

Any preliminary findings will be presented at EPA 2016.
A Three-Month Follow-Up Study Evaluating Changes in Clinical Profile and Attitudes Towards Involuntary Admission
Authors: Bainbridge E. , Hallahan B. , McGuinness D. , Higgins A. , Murphy K. , Gunning P. , Newell J. , McDonald C.
Published: May 2016

Introduction

Involuntary admission and treatment is often a traumatic experience for patients and there is a wide variation in attitudes towards care even when patients are recovered.

Objectives/aims

The purpose of this large prospective study was to identify clinical predictors of attitudes towards care during involuntary admission.

Methods

Three hundred and ninety-one consecutively admitted involuntarily patients to three psychiatric inpatient units over a 30-month period were invited to participate in the study. Comprehensive assessments at admission and 3 months after discharge were attained including measures of symptoms, insight, functioning, attitudes towards involuntary admission and coercive experiences. Multiple linear regression modelling was used to determine the optimal explanatory variables for attitudes towards care.

Results

Two hundred and sixty-three individuals participated at baseline and 156 (59%) successfully completed follow-up assessments. Individuals improved significantly over time clinically and in their attitudes towards their care. At baseline greater insight (P < 0.001) and less symptoms (P = 0.02) were associated with more positive attitudes towards care as was older age (P = 0.001). At follow-up, greater insight (P < 0.001), less symptoms (P = 0.02) and being older (P = 0.04) were associated with more positive attitudes towards care. More positive attitudes towards care at follow-up were associated with greater improvements in insight over time (P < 0.001) and having a diagnosis of an affective psychosis (P = 0.0009).

Conclusions

The best predictors of positive attitudes towards care during and after involuntary admission are illness related factors, such as levels of insight and improvement in insight, rather than service or legislation related factors, such as the use of coercive measures, seclusion and restraint.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
An Empirical Study of the Working Conditions in the Drug Prevention Centers of Attika, Greece: New Prospects And Possibilities In An Era Of Uncertainty
Authors: Dritsas I. , Theodoratou M. , Margaris T. , Christodoulidis S. , Valsami O.
Published: May 2016

Introduction

Studies have documented that drug prevention centers in Greece have been through an era of turmoil and uncertainty (EKTEPN, 2015, Tsounis, 2012, Kiritsi and Tsiotra, 2004) underlining the staff's hard work all over Greece.

Purpose

The aim of this study was to investigate the effects of the current fiscal crisis on the operating conditions as described by the staff of the Attica substance prevention centers with the emphasis on main problem areas and solutions.

Material

Statistically reliable questionnaires were used by the research team investigating participants views on the aforementioned areas of enquiry.

Method

Two Questionnaires were administered to 59 psychologists and social workers working at the centers of Attica, Greece during the summer of 2015.

Results

The majority (85%) of those working at the centers mentioned the main problems as following:

– issues concerning the institutional role of the centers, the education and supervision of the staff;

– fiscal issues as a result of the economic austerity, which undermine the operation of the centers and the morale of the staff.

Conclusions

Our empirical study is actually the first one which delves into the inner workings of the drug prevention centers in Attica, Greece:

– the extent the phenomenon of drug dependence in Greece, examining the epidemiology and the influence of the financial crisis, as well as the strategies and action plans developed in a national and EU level;

– the most significant innovative and standard European and Greek prevention programs.

Finally, research methodological issues are discussed in the light of the main findings of the empirical research.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Review of Outcome Domains in European Mental Healthcare
Authors: Großimlinghaus I.
Published: May 2016

Introduction

Quality in mental healthcare is a complex, multifaceted construct. It can be categorized into structures, processes and outcomes. In the past decade, there have been many initiatives on the assurance and improvement of process quality through the development, evaluation and implementation of process indicators for several important process domains including, for example, continuity and coordination of care. Moreover, outcome measurement, focusing on the extend to which intended outcomes of mental health service provision are achieved, is receiving growing interest and should be pursued through a systematic approach.

Objectives

Systematic compilation of outcome domains in mental healthcare.

Aims

Identification of the full range of outcome domains in mental healthcare.

Methods

Systematic literature review on outcome domains in mental healthcare.

Results

A whole range of outcome domains can be identified and categorized onto a continuum ranging from ‘traditional’, objective outcome domains, such as mortality and symptomatology, to more subjective outcome domains, such as quality of life and well-being. Moreover, outcome measures in different outcome domains can be assessed taking different perspectives into account, including either the provider or the patient.

Conclusions

In order to develop and implement systematic outcome measurement in mental healthcare, a first step is the identification and systematization of outcome domains in mental healthcare. This will provide a basis for identifying important outcome domains from the perspectives of both, patients and professionals. In a next step, appropriate and important outcome measures can be identified.

Disclosure of interest

The author has not supplied his/her declaration of competing interest.
Collaborative Space Using the Andalousian Integrated Care Process of Anxiety, Depression and Somatization
Authors: Guerrero Jiménez M. , Rodrigo Manzano J.A. , Carrillo de Albornoz Calahorro C.M. , Girela Serrano B.M.
Published: May 2016

Introduction/objectives

The Integrated Care Process of Anxiety, Depression and Somatization (ICP-ADS) lays out the cooperation between primary care (PC) and mental health (MH) as basic premises. Showing this model improves patient detection, inadequate patient referrals, adherence and response to medical treatment.

Aims

The Therapeutic Program (TP) established in PC includes low intensity psychological and psychosocial interventions, pharmacological treatment, and use of collaborative space with MH combining consultations, case tracking and educational activities. Our rotation as MH residents in the Community Mental Health Unit (CMHU) has focused on this framework, encouraging the use of a collaborative space.

Methods

Three training sessions were used to deal with the process as a whole. PC professionals were given self-help handbooks for low intensity interventions and clinical practice handbooks for psychopharmacological treatment. The referral space was established afterwards, where we took part in the TP founded by the PC doctor. In case the demand would continue, we opened consultation one day a week for co-therapy. With brief interventions of 3–4 sessions we continued the work with self-help guides, which also optimized psychopharmacotherapy.

Results

Referrals were sufficient in many cases. Sixteen procedures were completed in co-therapy, half of which required referrals to encourage adherence. Only a referral to MH had to be done. Three months later, a follow-up showed that no patient in co-therapy had to be referred to specialized care.

Conclusions

The amount of referrals was reduced in comparison to previous months, adherence to interventions of low intensity was improved and was useful in both detection and prevention of new cases.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Fifteen-Month Follow-Up of an Assertive Community Treatment Program for Chronic Patients With Mental Illness
Authors: Jeong J.H. , Lee K.H. , Jon D.I.
Published: May 2016

Objective

This study was to evaluate the effect of an assertive community treatment (ACT) program on psychiatric symptoms, global functioning, life satisfaction, and recovery-promoting relationships among individuals with mental illness.

Methods

Thirty-two patients were part of the ACT program and 32 patients matched for age, sex, and mental illness were in a standard case-management program and served as a control group. Follow-up with patients occurred every 3 months during the 15 months after a baseline interview. Participants completed the Brief Psychiatric Rating Scale (BPRS), Global Assessment of Functioning (GAF) Scale, Life Satisfaction Scale, and Recovery-Promoting Relationship Scale (RPRS).

Results

According to the BPRS, the ACT group showed a significant reduction in symptom severity, but the ACT program was not significantly more effective at reducing psychiatric symptoms from baseline to the 15-month follow-up compared to the case-management approach. The ACT group showed more significant improvement than the control group in terms of the GAF Scale. Both groups showed no significant differences in the change of life satisfaction and in the change of recovery-promoting relationships. We observed a significant increase in recovery-promoting relationships in the control group, but the group × time interactions between groups were not statistically significant.

Conclusions

In this study, we observed that ACT was significantly better at improving the GAF than case management. However, ACT did not demonstrate an absolute superiority over the standard case-management approach in terms of the BPRS and the measures of life satisfaction and recovery-promoting relationships. ACT, however, may have some advantages over a standard-case management approach.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
The Social Representations of Aggravating Factors Living Conditions and Their Connection to Their Psychological Profile
Authors: Kotrotsiou E. , Gouva M. , Briseniou E. , Dragioti E. , Skenteris N.
Published: May 2016

Objective

To investigated the Greek social representations towards harmful factors of health.

Design

Cross-sectional questionnaire survey.

Method

Two hundred and eighty healthy individuals participated to the present study from different region in Greece. The age range was 19–65 years old. The questionnaire included:

– question for the recording of social representations based on free association methods;

– The Greek version of the Revised Experiences in Close Relationships (ECRI);

– The Symptom Checklist 90-revised (SCL-90);

– question for the social-demographic parameters.

Results

One factor and multifactor analysis was used for statistical analysis. Results showed significant differences in social representation of diet in terms of age and marital status. Place of region and chronic disease were found to affect the development social representations, such as exercise and disease, respectively. Exercise, night out and health were found like positive social representations, smoking and disease were characterized as negatives, whereas diet, alcohol and lifestyle were found controversial enough. Moreover, the results highlight the significant relationship between social representations towards harmful factors of health, psychopathology and attachment style (P < .05).

Conclusion

The results of the current study highlighted the importance of studying on social representations and provided more support to the representations theory context. But more crucially, our study highlighted functional domains of them related to psychopathology.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
How Are You?: A Culturally Sensitive Group Therapy Program for Latinos
Authors: Paris M. , Lopez M. , León-Quismondo L. , Silva M. , Añez L.
Published: May 2016

Introduction

An ongoing challenge for the behavioral health field in the United States is ensuring access to culturally and linguistically responsive treatments for the growing number of monolingual Spanish speakers. The limited availability of services further compromises mental health outcomes given the unique psychosocial stressors often experienced in this population, such as language barriers, family separation and inadequate social support, unemployment, trauma, and poverty.

Objective

In response to the local demand for services, the authors describe a specialized group program for monolingual Spanish speaking adults with chronic and persistent mental illness.

Aims

The program aims are two-fold:

– to reduce exacerbation of psychiatric symptoms for individuals presenting in an acute state of distress through the provision of recovery-oriented mental health services in a familiar setting and preferred language;

– to offer a specialized behavioral health training experience for bilingual psychology doctoral students.

Methods

The group is led by the psychology fellow and is offered twice per week for a total of six hours, and includes elements of interpersonal and cognitive behavioral therapy; motivational interviewing; spirituality; coping skills training; and art/music.

Results

The described mental health group program is the only one available in Spanish in the local community and has reduced utilization of the hospital emergency room. Consequently, it fills an important gap in the service system and offers care that would otherwise be unavailable for individuals in need.

Conclusions

The program is a cost-effective alternative to hospitalization for Spanish speaking Latinos and a unique professional experience for psychologists in-training interested in a career in the public sector.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Preserving Control: Understanding People's Experiences Before, During and After Detention Under the Irish Mental Health Act 2001
Authors: McGuinness D. , Higgins A. , Hallahan B. , Bainbridge E. , McDonald C. , Murphy K.
Published: May 2016

Introduction

The Mental Health Act 2001 provides a legal framework for the involuntary admission and treatment of individuals deemed to have a mental disorder to psychiatric units. The perspectives of people who have been detained are relatively poorly understood.

Objective

To develop a theoretical understanding of individual's experiences throughout the trajectory of their detention and to understand the psychological and social processes that individuals use to cope before, during and after detention.

Methods

Fifty individuals subject to detention across three psychiatric units consented to be interviewed three months after their detention. Using a semi-structured interview people recounted their experiences. Interviews were analysed using the principles underpinning Grounded Theory.

Results

The theory ‘Preserving Control’ encapsulates individuals’ experiences and consists of three related themes: ‘Losing Control’, ‘Regaining Control’ and ‘Maintaining Control’. ‘Losing Control’ describes individuals’ experiences of losing their autonomy and liberty thought the process of detention and hospitalisation. ‘Regaining Control describes, the strategies individuals used in an attempted to restore their loss of autonomy and control. ‘Maintaining Control’ describes how individuals lived with the consequences of detention and contended with impact on discharge.

Conclusions

Whilst a large variation existed in relation to the subjective experience of being detained, the characteristic process that individuals tend to experience related to identifiable phases of preserving control in the face of this loss of autonomy. Findings from this study highlight the importance of more sensitive interactions support and information during and after the detention process.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Mindfulness, Self-Compassion and Psychological Distress in Pregnant Women
Authors: Xavier S. , Azevedo J. , Bento E. , Marques M. , Soares M. , Martins M.J. , Castilho P. , Nogueira V. , Macedo A. , Pereira A.T.
Published: May 2016

Introduction

Anxiety, depression, and stress in pregnancy are risk factors for adverse outcomes for mothers and children (Glover, 2014). There is good evidence showing a decrease in psychological distress when pregnant women participate in interventions comprising mindfulness and self-compassion practices (Dunn et al., 2012). However, there are few studies on the relationship between mindfulness, self-compassion and psychological distress variables in pregnancy, without being within the scope of intervention trials (Cohen, 2010; Zoeterman, 2014).

Objective

To explore the association between mindfulness, self-compassion and psychological distress/PD in pregnant women.

Methods

Four hundred and twenty-seven pregnant women (mean age: 32.56 ± 4.785 years) in their second trimester of pregnancy (17.34 ± 4.790 weeks of gestation) completed the Facets of Mindfulness Questionnaire-10 (FMQ-10; Azevedo et al., 2015; to evaluate Non-udging of experience/NJ, acting with awareness/AA and observing and describing), Self-Compassion Scale (SCS; Bento et al., 2015; to evaluate self-kindness/SK, self-judgment, common humanity, isolation, mindfulness and over-identification) and Depression Anxiety and Stress Scale-21 (DASS-21; Xavier et al., 2015). Only variables significantly correlated with the outcomes (Total DASS-21, Stress, Anxiety and Depression) were entered in the multiple regression models.

Results

FMQ-10 and SCS Total scores were both significant predictors of DASS-21 (B = –.335,–.296). Stress predictors were NJ, AA, SK and isolation (B = –.164;–.196;–.087; .353); Anxiety predictors were NJ, SK and isolation (B = –.198;–.124; .268); depression predictors were NJ, SK and Isolation (B = –.277;–.128; .232) (all P < .01).

Conclusions

Mindfulness and self-compassion dimensions, particularly non-udging of experience and self-Kindness are protective for PD in pregnancy. Isolation is a correlate of PD in pregnancy.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Experience of Burnout Syndrome In Resident Physicians
Authors: Cigarroa-Vázquez P. , Vargas-Huicochea I.
Published: May 2016

Medical residents, as a population that is in formation and that represents the workforce in public hospitals, are in a particularly vulnerable situation for the development of burnout syndrome (BOS), defined as a psychosocial disease in response to chronic stress in the work environment. This study analyzed the impact of BOS on a personal level, residents’ ways of coping, and the perceived needs to prevent it.

Objectives

To analyze the experience of BOS in medical residents of Mexico City.

Methods

Qualitative design with a phenomenological approach. Semi-structured interviews were conducted. Participants were medical residents in training who agreed to participate. Data analysis was based meaning categorization and condensation, as well as some elements of discourse analysis.

Results

We had interviews with residents of gynaecology, otorhinolaryngology, family medicine and psychiatry. We have found that there are some specific aspects that contribute to the development BOS:

– the hidden curriculum that has become evident through unnecessary punishments;

– various roles to be met simultaneously by residents;

– the basic needs like sleeping and eating right are not being met due to excessive workload.

– impact in general health.

Conclusions

It is necessary to make visible the complexity of the BOS and its impact on trainees to prevent deterioration in the quality of life and overall health status. It would be to achieve the satisfaction of basic needs as essential conditions for physical and mental well-being of all human beings, and more so for those whose task is to contribute to the health of others.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Anticipating the unknown: A mixed method study assessing French psychiatrists opinions towards prognosis in adolescent and young adult psychiatry
Authors: Benoit L.
Published: May 2016

The early treatment of psychiatric disorders has become a central goal of mental health policies worldwide. Yet little is known about the attitudes of psychiatrists regarding prognosis in their daily work. When treating young patients with acute psychotic symptoms, how do psychiatrists manage diagnostic uncertainty? Do they anticipate the risk of schizophrenia or avoid making prognostications? To what extent do they communicate their expectations to patients and their families?

Methods

This is a mixed method study. Firstly, a series of in depth interviews addressed French youth psychiatrists’ opinions towards prognosis. Participants worked in a variety of settings, public institutions, private practice, and student help. Secondly, an online survey investigated French psychiatrists’ opinion toward prognosis. The survey consisted of the presentation of a clinical vignette in which a psychiatrist communicates on prognosis to a young patient with acute psychotic symptoms. The vignette was randomly shown in four versions with different predictions and outcomes. Respondents were then asked questions regarding prognosis communication.

Results

Qualitative analysis stresses psychiatrists’ uncertainty in their daily work with teenagers presenting unclear symptoms that might be the sign of a beginning psychotic process or might as well reflect adolescent unease. Psychiatrists are reluctant to commit into prognosticating or using standardized tools. The contradiction between the expectations that psychiatrists be able to predict what will happen to a young patient and their impossibility to do so, raises an ambivalence that is only managed through a deep emotional involvement. The survey received more than 400 answers, and statistical analysis is in progress.

Disclosure of interest

The author has not supplied his/her declaration of competing interest.
Koro Syndrome in an Obsessive-Compulsive Disorder Patient
Authors: Silva L. , Raposo-Lima C. , Soares C. , Cerqueira J.J. , Morgado P.
Published: May 2016

Introduction

Koro syndrome is a culturally related disorder characterized by intense anxiety that the penis (vulva or nipples in females) is shrinking or retracting and will recede into the body. Usually it occurs in epidemics in Southeastern Asia, being extremely rare in western countries. The condition is more common in males and is classified within Obsessive Compulsive and Related Disorders.

Case report

A 27-year-old single man was referred to the psychiatric department. By the age of 23, he began worrying that his penis was shrinking and retracting into the abdomen. He described these thoughts as intrusive, ridiculous and repetitive. During the first months the thoughts were not very disturbing but he progressively developed an urge to verify the length of his penis several times a day. To diminish the anxiety provoked by the obsessive doubts on penis length, he started to have repetitive thoughts and mental images about sexual acts, to consume pornography compulsively and to increase his masturbatory behaviors (from some times a week to several times a day). He described those thoughts and behaviors as unpleasant and uniquely driven to reduce anxiety provoked by obsessions.

He was prescribed fluvoxamine 200 mg/day and initiated cognitive behavioral therapy with good response. Y-BOCS score decreased from 30 at initial evaluation to 18 after 3 months of treatment.

Conclusions

Koro syndrome is a very rare condition in psychiatry in western countries, usually presenting secondarily to other psychiatric disorders. Awareness of this diagnosis and knowledge on its management are critical to provide optimal care to patients.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Obsessive-Compulsive Disorder With Comorbid Schizotypal Personality Disorder: a Novel Clinical Form?
Authors: Perris F. , Fabrazzo M. , Prisco V. , Giacco D. , Catapano F.
Published: May 2016

Different studies have identified specific clinical characteristics of patients with obsessive-compulsive disorder (OCD) in comorbidity with schizotypal personality disorder (SPD), although no perspective evaluations of prognosis and response to treatment have been conducted so far. The aims of the present study were to evaluate: (1) the clinical and demographic correlates of OCD patients with comorbid SPD (OCD-SPD) using standardized instruments; (2) the response of OCD-SPD patients to long-term naturalistic pharmacological treatment. Socio-demographic and clinical characteristics of patients with OCD-SPD were compared to patients with “pure OCD”. OCD-SPD patients were characterized by a greater severity of obsessive-compulsive symptomatology, earlier age at onset, a higher rate of schizophrenia spectrum disorders in their first-degree relatives and a poorer insight. During the observational period, OCD-SPD patients were less likely to achieve remission of their symptomatology and required a greater number of trials with different antipsychotic drugs or received more frequently augmentation with antipsychotics. Our findings suggested that comorbidity with SPD is correlated to a poor treatment response in OCD patients and a reduced likelihood to recover from OCD symptoms, following standard pharmacological treatments. Further research is needed to identify alternative strategies for the management of this cohort of patients.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
The Comorbidity of Traumatic Life Events in Childhood Age With Adult Obsessive-Compulsive Disorder
Authors: Kıvılcım S. , Erensoy H. , Tonguç D.B. , Sarıdogan G. , Ebru K.
Published: May 2016

Purpose

Obsessive-Compulsive Disorder (OCD) is a mental disorder characterized by obsessions and/or compulsions. Although some epidemiological studies take part in literature, which claim that traumatic life events in childhood ages are observed more in patients with OCD compared to healthy population, the number of these studies is limited. In this study, it is aimed to compare OCD patients with healthy volunteers in terms of traumatic life events in childhood ages.

Method

With 25 consecutive patients who are diagnosed as OCD and whose treatment continues, 25 healthy controls equivalent in terms of sociodemographic features are included in the study. Sociodemographic Data Form, Childhood Age Trauma Quarter (CTQ) and Maudley Obsessive Compulsive Question List (MOCQL) are applied to the participants. Significance Value in statistical level is accepted as P < 0.05.

Findings

In OCD patient group, CTQ scores are found high in statistical level compared to healthy controls. It has been determined that there is a significant relationship between total score of MOCQL slowness subscale scores, subscale scores of sexual and emotional abuse, MOCQL rumination subscale scores and CTQ sexual abuse scores.

Result

Compared to healthy controls, more findings of traumatic life event in childhood age are observed within OCD patients.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Lack of Occupation and Depression Onset in Oncology Patient – Case Report
Authors: Filipovic-Grcic L. , Đerke F. , Braš M. , Djordjevic V.
Published: May 2016

Being able to live an active and meaningful life is important for mental health of every individual. In this case report we examine the life of an oncology patient who developed depression six years ago. The patient is a fifty seven year old woman who has been suffering from Von Hippel-Lindau syndrome for the last forty years. Her father and two uncles died from the same disease. She had her first operation when she was seventeen years old and has had numerous operations since then. During this time she has undergone four neurosurgical operations, nephrectomy, spine and pancreas operation and eye enucleation. Despite the fact that by being a chronic oncology patient she was prone to depression, she did not develop depressive symptoms. It did not happen even as her husband went to war and left her to take care of their child. It did not come afterwards as they struggled financially. Only after they moved to a new apartment and as she finished decorating it, did depression finally occur. During entire life she was an active, outgoing person, who took pleasure in socialising and various hobbies. She only developed depression after she was pensioned, left with the responsibility to care for her old mother. Following the psychiatric treatment she regained interest in people and become active in different cancer support groups. This example accentuates the importance of every-day pleasurable activities as a defence mechanism against depression.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Pancreatic Cancer Associated With Psychotic Depression – A Case Report
Authors: Perfene-Banu M.E. , Cristache A.M. , Andrei I.A. , Tudorache M.C. , Popa R.E. , Manea M.
Published: May 2016

Pancreatic cancer is an aggressive form of cancer with increasing incidence and a 5-year survival rate of 4% for all stages. Depression and anxiety have a higher prevalence than the general population in all cancer types. Also, rates of depression in patients with pancreatic cancer are higher than in patients with other types of gastrointestinal neoplasms. Depression in pancreatic cancer has also been shown to impair quality of life, so early and adequate antidepressant treatment is an essential component of comprehensive supportive care.

We would like to report the case of a 67-year-old female patient, with no previous psychiatric history, brought to the psychiatry emergency unit by her husband for psycho-motor agitation, persecutory delusions, delusional jealousy and bizarre behavior. According to her husband, the symptoms started insidiously over the last few weeks and that she attempted suicide by drug overdose three days before admission to our clinic, which she denies. Three years prior to her hospitalization the patient received surgical, radiotherapy and chemotherapy treatment for a base of tongue tumor and 6 months prior to her psychiatric admission, the was diagnosed with cephalic pancreatic neoplasm for which she received seven cycles of chemotherapy. Treatment with mirtazapine, risperidone, and lorazepam was initiated. The evolution was favorable and the patient was discharged one week later.

Early recognition and treatment of mood disorders associated with cancer are important because, left untreated, they may lead to difficulty in managing symptoms, increased demand for health services and low adherence to treatment.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Characterization of a Referral to Psycho-Oncology Liaison Consults in a General Hospital
Authors: Ramos J. , Oliveira A.
Published: May 2016

Introduction

Liaison psychiatry is based on a practice that lies on the interface between psychological, sociological and biological factors of illness. Cancer is a devastating disease. For many patients the occurrence of it is synonymous of chronic, severe or lethal outcome. It is important for health professionals to be aware of the psychological suffering of these patients and promote a proper use of specialized consultations in order to increase and improve adherence to treatment.

Aims

To make known the reality of referral to a Psycho-Oncology Liaison consult and its context in literature.

Methods

Data collection on applications for the 1st request to Psycho-Oncology liaison consults occurred between 2010–2012 in the variables, gender, age, reason for referral, psychiatric history, cancer diagnosis, knowledge of the referral and who does (patient/family/service) and psychiatric diagnosis. Statistical analysis with Microsoft Excel 2010®.

Results

It was found that there were 83 applications during the three years, 24 men and 59 women. The most prevalent cancer diagnoses were breast cancer (29.89%) and colorectal carcinoma (19.28%). Most patients had knowledge of the request (75.9%). The reason was mostly for Anxiety and Depression (33.73%).

Conclusion

Cancer disease coupled with feelings of loss of autonomy, hopelessness and pain can lead the patient to develop psychopathology of anxious-depressive disorders. This condition may hamper the normal recovery of the patient. The promotion of mental well-being in cancer patients is critical to recovery and leads to a better adherence to treatment, inclusive can influence survival.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Psychiatric Disorders in Patients With Atypical Facial Pain
Authors: Medvedev V. , Frolova V. , Fofanova Y. , Drobyshev A.
Published: May 2016

Objective

Maxillofacial surgeons and dentists often (up to 10%) deal with the phenomenon of atypical facial pain (AFP) – painful condition of maxillofacial area without clear organic pathology. Psychiatric studies of this disorder are almost lacking.

Aim

The aim of this study was to define psychopathological disorders in patients with AFP and to set up psychopharmacological treatment strategies.

Methods

The study used clinical psychopathological and psychometric (Pain measurement scales: Brief Pain Inventory, VAS, Pain Catastrophizing Scale) methods. We included patients with AFP examined in the clinic in December 2014 - September 2015.

Results

Study sample consists of 54 patients with AFP: 45 women (83.3%), 9 men (16.7%), 18-70 years old (39.5 ± 14.7 years). In 67.8% of patients (33 women, 4 men), AFP was associated with affective disorders; among them, recurrent major depressive disorder was verified in 9.2% (4 women, 1 men), single depressive episode – in 33.6% (15 women, 3 man), bipolar II depression – in 3.6% (2 women), cyclothymic disorder – in 7.1% (4 women), dysthymia – in 14.3% (8 women). In 10.8% of patients (6 women), AFP was considered as a symptom of somatoform pain disorder. In 21.4% (6 women, 5 men), AFP was related with schizotypal personality disorder. Psychopharmacological agents used were SSRIs (fluvoxamine, escitalopram), SNRIs (venlafaxine, duloxetine), agomelatine and antipsychotics (quetiapine, amisulpride, alimemazine). The pain subsides in 87,04% of patients and the severity of pain decreased in 12.96% of patients.

Conclusion

Patients with AFP should be examined by psychiatrist in order to determine psychopathological disorders and to elaborate psychopharmacological treatment strategies.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Gender Differences in Hofstede's Cultural Dimensions Among a Kuwaiti Sample
Authors: AlAnezi A. , Alansari B.
Published: May 2016

Introduction

Hofstede's model of cultural dimensions has become the most widely accepted and most frequently cited model for cross-cultural research. His cultural dimensions included power distance index (PDI), individualism vs. collectivism (IDV), masculinity vs. femininity (MAS), uncertainty avoidance index (UAI), and long-term vs. short-term orientation (LTO).

Objective

The objective of this study is to explore gender related differences in the Hofstede's five dimensions of national culture for work-related values among a sample from Kuwait.

Methods

The participants were 540 first year secondary school Kuwaiti teachers (270 males: mean age = 28.95 ± 2.47; 270 females: mean age = 28.20 ± 2.04). The Arabic version of the Values Survey Module, VSM 08 was administered to participants. Data analysis include independent sample t-test was used to examine gender differences in Hofstede's five dimensions of national culture.

Results

Internal consistency was satisfactory for the Power Distance, Individualism vs. Collectivism, Masculinity vs. Femininity, Uncertainty Avoidance, and Long-term vs. Short-term Orientation subscales respectively (Cronbach's alpha = 0.82, 0.84, 0.90, 0.74, 0.87) for males and (Cronbach's alpha = 0.77, 0.90, 0.83, 0.80, 0.88) for females. The results revealed significant gender differences where the males obtained a higher score than females on individualism (t = 2.95, P < 0.002), and masculinity (t = 2.77, P < 0.005), while females obtained a higher score than males on power distance (t = 4.48, P < 0.000), and long-term orientation (t = 4.13, P < 0.000).

Conclusion

These findings suggest that the gender differences exist for cultural dimensions, and provide insight on leadership characteristics.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
A Life Tiptoeing: Being a Significant other to Persons With Borderline Personality Disorder
Authors: Ekdahl S. , Ewa I. , Kent-Inge P. , Mats S.
Published: May 2016

Introduction

Borderline Personality Disorder (BPD) is a severe psychiatric health problem with a reputation of being difficult to deal with and to treat. Significant Others (SOs) of patients with BPD show higher levels of psychological distress compared with the general population. Strengthening the coping strategies of SOs has been shown to play an important role in the recovery of the person with psychiatric health problems. Research around SOs of persons with BPD is, to our knowledge, scarce, especially qualitative research exploring their experiences.

Objective

We believe that if the personnel working in health care and psychiatric care are able to better understand SOs experiences and life situation, it could be an important step toward improved care.

Aim

The aim of this study was to describe SOs experiences of living close to a person with BPD and their experience of encounter with psychiatric care.

Methods

Data were collected by free-text questionnaires and group interviews and were analyzed by qualitative content analysis.

Results and conclusion

The results revealed four categories: a life tiptoeing; powerlessness, guilt, and lifelong grief; feeling left out and abandoned; and lost trust. The first two categories describe the experience of living close to a person with BPD, and the last two categories describe encounter with psychiatric care.

Disclosure of interest

The authors have not supplied their declaration of competing interest.