bluuebunny/crossref_metadata_2025 huggingface dataset:
The Effect of Gender on Neurocognitive Functioning in Bipolar Disorder
Authors: Tournikioti K. , Ferentinos P. , Michopoulos I. , Dikeos D. , Soldatos C. , Douzenis A.
Published: June 2017

Introduction

Bipolar disorder (BD) is frequently associated with cognitive deficits in attention, verbal memory and executive functions that have been related to various clinical characteristics of the disorder.

Objectives

However, few studies have examined the effect of gender on cognition despite its clinical relevance.

Aims

The aim of our study was to investigate potential diagnosis-specific gender effects on visual memory/learning and executive functions in BD.

Methods

Cognitive performance of 60 bipolar-I patients and 30 healthy controls was evaluated by using CANTAB battery tasks targeting spatial memory (SRM), paired associative learning (PAL), executive functions (ID/ED, SOC). A multivariate analysis of covariance (MANCOVA) of neuropsychological parameters was performed with gender and diagnosis as fixed effects and age and education as covariates. Following univariate analyses of covariance (ANCOVA) were undertaken to examine the effect of gender on each neuropsychological task.

Results

Bipolar patients showed significantly poorer performance in paired associative learning (PAL), set shifting (ID/ED) and planning (SOC). Moreover, a diagnosis specific gender effect was observed for cognitive functioning in BD (gender × diagnosis interaction P = 0.029). Specifically, male healthy controls outperformed healthy females in tasks of visual memory/learning but this pattern was not sustained (SRM) or was even reversed (PAL) in BD patients.

Conclusions

The present study is one of the few studies that have examined the effect of gender on neurocognitive function in BD. Our findings indicate that the gender-related variation observed in healthy subjects is disrupted in BD. Moreover, they suggest that gender may modulate the degree of frontotemporal dysregulation observed in BD.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Handedness in Children with Autism Spectrum Disorders
Authors: Kobylinska L. , Anghel C.G. , Mihailescu I. , Rad F. , Dobrescu I.
Published: June 2017

Children with autism spectrum disorders (ASD) have a less definitive hand preference for certain actions as opposed to neurotypical children. Moreover, left-handedness in children with ASD has been associated with more echolalia. The objective was to conduct a screening of potential risk and associated features for autism spectrum disorders, among which the hand preference of the child. The current aim is to compare the perceived handedness of children with autism spectrum disorders with that of children with other psychiatric pathologies.

Methods

Eight hundred and forty-two parents completed our risk and associated features screening questionnaire. Out of these, 494 answered the question regarding handedness (209 had children diagnosed with ASD). This asked the parents to state how they perceived their child's handedness. An ADOS assessment has been conducted for 170 of the children whose parents were included in the study, based on clinical relevance for the case. The data were analysed using Excel and SPSS 22.0. For the comparisons, Chi2 and the Kruskal–Wallis test were used.

Results

Children with ASD had more left-handedness (χ2(2) = 12.54, P = 0.002). There were no differences between boys and girls in terms of perceived handedness in any of the groups. There were no differences in the ADOS scores according to the perceived hand laterality (χ2(2) = 0.58, P = 0.74).

Conclusion

Rightward-asymmetry in regions of corpus callosum has been reported to correlate with symptoms severity in ASD. The finding of different perceived handedness in children with ASD versus children with other psychiatric pathologies is useful for designing appropriate, individualized training programs for motor therapy.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Altered Puberty Timing in Recent Decades: Implications for Adolescence-onset Conduct Disorder
Authors: Michielsen P. , Nuijten M.
Published: June 2017

Introduction

In industrialised countries, the age of puberty onset has substantially diminished over the last 150 years. Several factors, like improved nutrition and health care have contributed to this, but there are concerns about other factors, like obesity, levels of divorce and chemicals. There is an association between early puberty and externalizing disorders in both girls and boys.

Aim

To describe trends in advanced puberty timing and adolescence-onset conduct disorder (CD), analyse if an association exists between both and evaluate which measures can be taken to prevent youth from antisocial activities during adolescence.

Method

A systematic literature review using Medline, Embase and Psycinfo Databases.

Results

Family break-up and increased stress are risk factors for adolescence-onset conduct disorder. Obesity is associated with low SES families, so prevention campaigns giving advice on healthy nutrition may be beneficial. On the general level, there is no clear positive correlation between adolescence-onset CD and early puberty over the last decades as numbers of CD are decreasing.

Conclusion

Potential mental health gains can be obtained to focus on children with multiple risk factors for early puberty. More research is needed to assess, which interventions (diet, advice on body changes, social expectations, etc.) are most useful.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Paradigm Shift in the Educational System of Adolescents with Disabilities
Authors: Paulino S. , Almeida C. , Croca M. , Santos N.
Published: June 2017

Introduction

In the last years, there has been a paradigm shift in the educational system of young people with disabilities. Regular schools associated with specific support plans have become the destination of choice for these adolescents, instead of schools with special education. This integrated teaching seeks to reduce stigma and to promote tolerance but frequently these students become easy targets of psychological and physical violence or discrimination.

Objective

To evaluate the integration of adolescents with disabilities in mainstream education compared to special teaching.

Methods

Analysis of 32 patients with disabilities from the adolescence consultation of the psychiatry service of hospital de Santa Maria, between January 2015 and September 2016.

Results

About 30% of the adolescents with disabilities who attend regular schools with special support complains of poor adjustment associated with some kind of mistreatment by peers.

Conclusion

Violence among students in school is a current problem very difficult to fight. Young people with disabilities often find themselves in a significant minority presenting less efficient defense mechanisms. If unprotected, they may easily develop school phobia or refusal. These situations must be identified and avoided to prevent the associated suffering.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Correlations Between the Parents’ ADHD Score and the Child's ADOS Score in Parents of Children with Comorbid ADHD–Autism Spectrum Disorder
Authors: Rad F. , Kobylinska L. , Mihailescu I. , Buica A. , Dobrescu I.
Published: June 2017

From assortative mating theory to genetic background, several ethipathogenic hypotheses in ASD deal with the traits of parents.

Background

several ethipathogenic hypotheses in ASD deal with the traits of parents. The objectives of our study were to measure the ADHD and autism spectrum disorder quotients in parents of children diagnosed with ASD comorbid with ADHD and to correlate the measurements for the tests in parents with those in their children. The specific aim was to identify whether any significant correlations exist.

Method

Fifty-two pairs of parents of children with autism spectrum disorders and ADHD were included in this study, based on informed consent and the ethical committee's approval. The child's diagnosis was established by a specialist in child and adolescent psychiatry, based on the child's clinical symptoms and on specific diagnostic scales, such as the ADOS and ADHD-rating scale. The parents completed an Autism Spectrum Quotient Scale (ASQS) and an adult ADHD scale. The data were analyzed using SPSS 22.0 and Excel. The correlations were verified using Spearman's non-parametric correlation test.

Results

There was a strong correlation between the parents’ ADHD scores (r = 0.5, P < 0.001), and a reverse medium correlation between the mother's ADHD score and the child's ADOS score (r = –0.32, P = 0.02). The father's ASQS and ADHD scores correlated between each other (r = 0.31, P = 0.02). There were no correlations between the parents’ and the child's ADHD score, nor between the child's ADOS score and the parents’ ASQS scores.

Conclusion

Our results suggest that ADHD symptoms in parents of children with autism spectrum disorders comorbid with ADHD might be predictors for the child's prognosis.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Reward Learning and Dopamine Release in Adults with 22q11DS
Authors: Van Duin E. , Kasanova Z. , Beck M. , Hernaus D. , Myin-Germeys I. , van Amelsvoort T.
Published: June 2017

Background

22q11.2 deletion syndrome (22q11DS) is a genetic disorder caused by a microdeletion on chromosome 22q11.2 and associated with an increased risk for psychosis. A dysfunctional motivational reward system is thought to be one of the salient features in psychosis caused by abnormal dopamine functioning. It is unknown whether patients with 22q11DS have a dysfunctional reward system.

Methods

This study aims to investigate reward learning in 22q11DS. The study included 10 adults with 22q11DS (age: 33.1 years, 60% female) and 10 age-gender-matched healthy controls (HC, age: 39.7 years, 60% female). A single infusion 18F-fallypride PET scan was acquired during which all subjects performed a version of the learning phase of the Probabilistic Stimulus Selection Task for reward learning (RL), modified to deliver social feedback.

Results

IQ-scores were significantly lower in the 22q11DS group (P < .001) compared to HC. The 22q11DS group both earned significantly less money (P < .05) and performed worse during the RL-task (P < .05) than HC. However, the learning curve for the RL-task was the same for both groups. IQ-scores were a significant positive predictor for earnings (P < .05) and performance (P < .05), but not for the learning curve.

Conclusions

These preliminary results indicate that people with 22q11DS are capable of learning at the same speed as HC, however they are less susceptible for reward than HC because their overall performance during RL is worse than HC. This lower reward sensitivity could be a result of haplo-insufficiency of COMT in 22q11DS and consequently abnormal prefrontal dopamine functioning.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Early maladaptive schema domains in the first day of menses and 15 days after the menses in healthy volunteers
Authors: Ünsalver B.Ö. , Ulu A. , Hızlı Sayar G.
Published: June 2017

Introduction

Premenstrual syndrome (PMS) symptoms may affect the physical, psychological and social lives of many women of the reproductive age group. Most women report being extra-sensitive and have difficulties with emotional regulation and some patients report worsening of their psychiatric symptoms during the premenstrual period. Early maladaptive schemas (EMS) are developed early in childhood and may remain dormant until they are activated by situations relevant to the particular schema.

Objective

We hypothesized that some of the psychological symptoms of PMS may be related to EMS activation and that this activation is due to the hormonal changes of the menstrual cycle.

Aims

Our aim was to measure any changes regarding the EMS domains between the first day of menses and 15 days later.

Methods

One hundred and ten women from an architectural and engineering firm were enrolled in the study. After ruling-out psychopathology with Symptom check-list-90-R, remaining women (n = 65) filled out young schema scale short form (YSS-SF) on the first day of menses and 15 days after menses. The time of probable ovulation was defined as 15 days after the first day of menses.

Results

YSS-SF scores regarding the schemas of defectiveness, insufficient self-control, failure to achieve, vulnerability to harm or illness were significantly decreased by the 15th day of menses (P < 0.05). Abandonment, social isolation, dependency, enmeshment and self-sacrifice schema scores remained similar on the first and 15th days.

Conclusions

EMS activation may contribute to the PMS symptoms, therefore schema therapy may be an option for those women suffering from PMS.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Obesity and Obstetric Complications are Associated with Rapid-cycling in Italian Patients with Bipolar Disorder
Authors: Caldiroli A. , Buoli M. , Dell’Osso B. , Carnevali G.S. , Serati M. , Suppes T. , Ketter T.A. , Altamura A.C.
Published: June 2017

Introduction

Rapid cycling (RC) worsens the course of bipolar disorder (BD) being associated with poor response to pharmacotherapy. Previous results about clinical variables potentially associated with RCBD were discordant or unreplicated.

Objectives

An early diagnosis should be the goal to properly treat RCBD patients.

Aims

To compare clinical variables between RC and non-RC bipolar patients and to identify related risk factors.

Methods

A sample of 238 bipolar patients was enrolled from three different community mental health centers. Descriptive analyses were performed on total sample and patients were compared in terms of sociodemographic and clinical variables according to the presence of RC by multivariate analyses of variance (MANOVAs, continuous variables) or χ2 tests (qualitative variables). Binary logistic regression was performed to calculate odds ratios.

Results

Overall, 28 patients (11.8%) had RC. The two groups were not different in terms of age, age at onset, gender distribution, type of family history, type of substance use disorder, history of antidepressant therapy, main antidepressant, psychotic symptoms, comorbid anxiety disorders, suicide attempts, thyroid diseases, diabetes, type of BD, duration of untreated illness, illness duration, duration of antidepressant treatment and GAF scores. In contrast, RC patients had more often a history of obstetric complications (P < 0.05), obesity (P < 0.05) and a trend to hypercholesterolemia (P = 0.08). In addition, RC bipolar patients presented more frequently lifetime MDMA misuse (P < 0.05) than patients without RC.

Conclusions

Obesity and obstetric complications are risk factors for the development of RC in BD. Lifetime MDMA misuse may be more frequent in RC bipolar patients.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Cortical Inhibition in Symptomatic and Remitted Mania Compared to Healthy Subjects: A Paired-pulse TMS Study
Authors: Sanjay N. , Basavaraju R. , Biradar S. , Mehta U. , Kesavan M. , Thirthalli J. , Ganesan V.
Published: June 2017

Introduction

Cortical inhibition (CI) is a neurophysiological outcome of the interaction between GABA inhibitory interneurons and other excitatory neurons. Transcranial magnetic stimulation (TMS) measures of CI deficits have been documented in both symptomatic and remitted bipolar disorder (BD) suggesting it could be a trait marker. The effects of medications and duration of illness may contribute to these findings.

Objective

To study CI in BD.

Aims

To compare CI across early-course medication-naive BD-mania, remitted first episode mania (FEM) and healthy subjects (HS).

Methods

Symptomatic BD subjects having < 3 episodes, currently in mania and medication-naive (n = 27), remitted FEM (n = 27; YMRS < 12 and HDRS < 8) and 45 HS, matched for age and gender, were investigated. Resting motor threshold (RMT) and 1-millivolt motor threshold (MT1) were estimated from the right first dorsal interosseous muscle. Paired-pulse TMS measures of short (SICI; 3ms) and long interval intracortical inhibition (LICI; 100ms) were acquired. Group differences in measures of CI were examined using ANOVA.

Results

Table 1.

Conclusions

Symptomatic mania patients had the highest motor thresholds and the maximum LICI indicating a state of an excessive GABA-B neurotransmitter tone. Remitted mania patients had deficits in SICI indicating reduced GABA-A neurotransmitter tone. Putative changes in GABA-A neurotransmitter system activity with treatment may be investigated in future studies. CI has received less attention in BD as compared to schizophrenia and is a potential avenue for future research in this area.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Effectiveness of Psychoeducational Family Intervention on Coping Strategies of Relatives of Patients with Bipolar I Disorder
Authors: Savorani M. , Borriello G. , Del Vecchio V. , Sampogna G. , De Rosa C. , Malangone C. , Luciano M. , Pocai B. , Giallonardo V. , Fiorillo A.
Published: June 2017

Background

Relatives’ coping strategies – an essential element for the recovery of patients with severe mental disorders – are grouped in problem-oriented and emotion-focused. The former include practical strategies to deal with the stressful situation and are associated with a better long-term outcome of patients and relatives; the latter are psychologically driven and are associated with a worse outcome. It has been reported that psychoeducational family intervention (PFI) can improve problem-oriented coping strategies, while few data are available on relatives of patients with bipolar disorder.

Objectives

To assess the impact of the PFI on promotion of problem-oriented coping strategies adopted by relatives of patients with bipolar I disorder.

Methods

This study was conducted in 11 Italian mental health centers. Patients and their relatives were allocated to the experimental group receiving PFI or to the control group (waiting list). Before starting the intervention and at the end of the PFI, coping strategies were assessed using the family coping questionnaire.

Results

Of the 139 recruited families, 72 families were allocated to the experimental group and 67 to the control group. Relatives from the experimental group reported a significant improvement in problem-oriented coping strategies, such as positive communication (P < .01) and searching for information (P < .05). On the other hand, a reduction in collusion (P < .0001), avoidance (P < .01) and resignation (P < .001) were found at the end of the intervention.

Conclusions

PFI is effective in promoting the coping strategies in relatives of patients with bipolar I disorder and it should be given routinely in mental health centers.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Implications of COMT and Subclinical Psychiatric Symptoms on the Phenotypic Variability of 22q11.2 Deletion Syndrome: A Transversal and Longitudinal Approach
Authors: Guerrera S. , Armando M. , Pontillo M. , Papaleo F. , Vicari S.
Published: June 2017

Introduction

22q11.2 deletion syndrome (22q11.2DS) results from a hemizygous microdeletion on chromosome 22 and is characterized by phenotypic variability. Several studies have been conducted on the impact of COMT functional polymorphism in 22q11DS, suggesting that attenuated psychotic manifestations are frequent in children and adolescents and represent one of the strongest predictors for the onset of psychotic disorder.

Objectives

We explored possible interaction between COMT polymorphism and subclinical psychiatric symptoms in a 22q11.2DS cohort of 42 participants aged 6 to 26 years: 17 hemizygosity for COMT-Met and 25 hemizygosity for COMT-Val.

Aims

To analyse impact of COMT gene in 22q11DS and its related psychiatric correlates.

Method

Each participant, genotyped for the catechol O-methyltransferase (COMT) Met/Val polymorphism, underwent structured psychiatric and cognitive assessment. Analysis of positive and negative symptoms was performed by the structured interview for prodromal syndromes (SIPS). Finally, longitudinal data available in a subsample of 24 individuals were used to explore the developmental trajectories of psychotic symptoms one year later.

Results

There was a significant positive correlation between COMT Val polymorphism and positive symptoms; at follow-up, no significant correlation were found between COMT polymorphism and psychiatric symptoms. No other significant differences were found between groups (Comt/Met-Comt/Val) on any other CBCL or QI score.

Conclusions

COMT and additional genes microdeleted might interact in the susceptibility to schizophrenia in 22q11.2DS: psychotic symptoms might result from an epistatic interaction with other genes. Moreover, gene-environment, in presence of genetic vulnerability could increase the risk of schizophrenia in 22q11DS.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Clinical Characteristics Associated with Suicide Attempt in Patients with Bipolar Disorder
Authors: Vismara M.-E.-M. , Dell’Osso B. , Dobrea C. , Cremaschi L. , Benedetta G. , Arici C. , Benatti B. , Oldani L. , Altamura A.-C.
Published: June 2017

Introduction

Bipolar disorder (BD) is a chronic, highly disabling condition, associated with a high burden of morbidity and mortality, often secondary to suicidal behaviors. In previous reports, different variables have been associated with a higher risk of suicidal acts, with variable effect.

Objectives

To evaluate which socio-demographic and clinical variables correlate with suicide attempts in bipolar patients.

Aims

To enrich literature data about suicidal behaviour in BD.

Methods

A sample of 362 BD patients (DSM IV-TR) was retrospectively collected and divided in two subgroups, in relation to the presence of a previous suicide attempt. Socio-demographic and clinical variables were compared between attempters and non-attempters using Corrected multivariate analysis of covariance (MANCOVA).

Results

A total of 26,2% of analyzed patients attempted suicide in their lifespan, and approximately one third of them had multiple suicide attempts (i.e. ≥ 2; 31%). Depressive polarity at index mood episode, higher number of psychiatric hospitalizations, comorbidity with alcohol abuse, eating disorders and psychiatric poly-comorbidity were significantly associated with suicide attempt. Additionally, treatment with lithium, poly-pharmacotherapy (≥ 4 current drugs) and higher recurrence of psychosocial rehabilitation were significantly more frequent in patients who attempted suicide.

Conclusions

The present paper reported a correlation with some specific clinical variables and the lifetime presence of suicide attempt in patients with BD. Although these retrospective findings did not address the causality issue, they may be of clinical relevance in order to better understand suicidal behavior in BD and to adopt proper strategies to prevent suicide in higher risk patients.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Risk of Mental Disorders and Difficulties or Conflict in Relationships in Young Adults
Authors: Gorbeña S. , Penas P. , Calvete E. , Crespo I. , Iraurgi I.
Published: June 2017

Introduction

Higher risk of mental health problems has been linked with problems in relationships, including the experience of relational conflict with significant others and peers. Conversely, positive relations with others have been established as a key factor of psychological well being.

Objectives

We hypothesized that psychological maladjustment will be related to the number, nature and severity of relational stressors. Furthermore, there would be a higher likelihood of risk of mental disorders for those who experience more relational hardships and of greater severity. Positive relations with others will protect from risk of mental health problems.

Method

A total of 4461 university students completed a health and well-being survey, including the GHQ-12 (centesimal and 3-point cut-off scores), Ryff psychological well-being scale and a scale of 25 life stressors. Indexes of number and severity of difficulties in relationships were calculated with 10 items including romantic partners, friends, family, and classmates.

Results

Correlations were significant. Logistic regression showed a risk effect for all stressors with OR values above 1.32. Overall perceived severity had the highest value (OR = 2.38, 95% CI = 2.16–2.61) and amongst the 10 stressors, gender related abuse/violence was also the highest (OR = 1.90, 95% CI = 1.73–2.09). Positive relations showed a protective effect (OR = 0.60, 95% CI = 0.56–0.54).

Conclusions

Findings can inform health promotion, prevention and therapeutic interventions so as to improve the quality of personal relationship and conflict management skills, and to strengthen well-being associated with positive relations with others. Academic institutions committed to student welfare and the promotion of healthy environments should play a major role in young adults’ mental health.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
A Hybrid Effectiveness-implementation Trial of Wellness Self-management Program for Patients with Severe Mental Illness in an Italian Day Hospital Setting
Authors: Palumbo D. , Landi S. , Margolies P. , Salerno A.-J. , Cleek A. , Castaldo E. , Mucci A.
Published: June 2017

Introduction

Wellness self-management is an adaptation and expansion of the illness management and recovery, an internationally recognized best practice. WSM is a recovery-oriented, curriculum-based practice designed to help adults with severe mental health problems make decisions and take action to manage symptoms and improve their quality of life.

Objectives

In the present study, the Italian translation of the WSM was implemented and validated. Moreover, the impact of its application in a day hospital setting on cognitive functions, psychopathology, personal resources and real-life functioning with respect to treatment as usual (TAU) was investigated.

Aims

The study was aimed at assessing the effectiveness of a semi-structured version of WSM in a day hospital setting in patients with severe mental illness.

Methods

Fourteen patients with a diagnosis of severe mental illness were recruited and randomly assigned to either WSM or TAU. WSM participants attended four 2-hour sessions per week for 1 month, including lessons selected on the basis of the goals of participants. Both groups received weekly planned treatment in the day-hospital setting and continued their pharmacotherapy.

Results

The two groups of patients were comparable for age, education, cognitive functioning and psychopathological severity. WSM produced a significantly greater improvement in neurocognition, psychopathology, personal resources and real-life functioning with respect to TAU.

Conclusions

Our results offer promising preliminary evidence that the use of WSM provides an effective complement to current mental health treatment.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Autistic Traits in Patients with Anorexia Nervosa, Bulimia Nervosa or Binge Eating Disorder: A Pilot Study
Authors: Gesi C. , Carmassi C. , Luciano M. , Bossini L. , Ricca V. , Fagiolini A. , Maj M. , Dell’Osso L.
Published: June 2017

Introduction

Previous data showed higher autistic traits in individuals with anorexia nervosa (AN) compared to healthy controls (CTL). It is not known, however, whether this characteristic is shared by other feeding and eating disorders (FEDs) or it is uniquely associated to AN.

Objectives

To compare autistic traits among individuals with AN, bulimia nervosa (BN), binge eating disorder (BED) and CTL and to investigate which specific dimensions differentiate one group from another.

Methods

A total of 241 FED patients (53 AN, 41 BN, 42 BED) and 105 CTL were administered the autism-spectrum quotient (AQ), the adult autism subthreshold spectrum (AdAS Spectrum), the Ritvo autism and Asperger diagnostic scale 14-item (RAADS-14 Screen).

Results

FED subjects reported higher AQ, AdAS spectrum and RAADS-14 total and subscales scores compared to CTL (all P < .001). No differences were found amongst AN, BN and BED subjects in questionnaires’ total scores. BN group scored higher than AN in the hyper-/hyporeactivity to sensory input domain of the AdAS spectrum (P < .001); AN group scored higher than BED in the attention switching domain of the AQ (P < .001), and BED group scored lower than both AN and BN in the mentalizing deficit domain of the RAADS-14 (all P < .001).

Conclusions

We reported for the first time that not only AN but also BN and BED patients show greater autistic traits compared to CTL. Longitudinal studies are needed to confirm this preliminary report and to elucidate whether autistic traits either precede, co-occur or follow FEDs.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Exploring Lithium Impact on Glomerular Function in Bipolar Patients Through Pharmacogenomics
Authors: Tsermpini E.E. , Zhang Y. , Niola P. , Chillotti C. , Ardau R. , Severino G. , Bocchetta A. , Patrinos G.P. , Lee M.T.M. , Squassina A.
Published: June 2017

Introduction

Bipolar disorder (BD) is characterized by unusual shifts in mood and energy and affects 1 to 3% of the general population. Lithium (Li) can prevent patients from depression and mania, as well as reduce the risk of suicide. Unfortunately, a high rate of patients do not respond positively to Li treatment. In line with various studies, Li treatment is also associated with potentially severe adverse reactions, including renal dysfunctions. Specifically, it has been reported that Li may induce reduction of glomerular filtration rate (GFR) in long-term treated BD patients.

Aims

The aim of our study was to evaluate the contribution of genetic variants in Li-induced reduction of the estimated GFR (eGFR) in bipolar patients, under long term Li therapy.

Objectives

We screened the literature to identify genes previously shown to be associated with kidney function or Li mechanism of action and genotyped tag SNPs covering these genes.

Methods

The sample comprised 70 Sardinian bipolar patients genotyped for 46 SNPs, located in 33 genes, with Invader assay and Sanger sequencing.

Results

Our results showed that a SNP (rs378448) located in Acid Sensing Ion Channel Neurona-1 (ACCN1) gene, significantly interacted with years of Li treatment in reducing eGFR (F = 4.166, P = 0.046).

Conclusions

Our preliminary findings suggest that ACCN1 (ASIC2) gene could be involved in modulating the susceptibility of BD patients to develop renal dysfunctions induced by chronic Li treatment.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Treatment of maternal antenatal depression
Authors: Arsova S. , Manuseva N.
Published: June 2017

Introduction

World statistical data show that a large number of mothers suffer from antenatal or postnatal depression and that it is linked with difficulties in personal and emotional development in child.

Aim

To present the importance of treatment of antenatal depression.

Material and methods

We present is a 32-year-old woman man, with completed high level of education, married, mother of one child, pregnant in first trimester, who suffered of depression several years ago. Diagnosis was made in line with the ICD 10 (F33), and the following diagnostic instruments were used: HAMA, HAMD, clinical interview.

We present is a 32-year-old woman man, with completed high level of education, married, mother of one child, pregnant in first trimester, severe depression with depressive mood, weight lost, insomnia, agitation, suicidal thoughts.

She was treated in the day hospital of our clinic with SSRI antidepressants, individual and group psychotherapy.

Results

During the day hospital stay patient was treated with pharmacologic agents (SSRI anti-depressants – tbl. Sertralline), which showed a great success, that is reduction in the depression, sleep improvement, normal gain weight and regular pregnancy and baby birth with APGAR score 9/9.

Discussion

Literature shows that antenatal depression is associated with poor mother self-care during pregnancy including poor visit of antenatal clinics, substance misuse, low birth weight, preterm delivery and significant intellectual and emotional deficits in children whose mothers were suffered of antenatal or postnatal depression.

Conclusion

Treatment of antenatal or postnatal depression is very important for mothers’ mental health and for the normal develops of child also.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Demyelination in rat model of mania-like behavior
Authors: Andrabi M. , Subbiah V. , Sagar R. , Mathur R.
Published: June 2017

Introduction

Ample amount of data suggests role of REM sleep deprivation as the cause and effect of mania. In the present model, we have tried to implement behavioral sensitization to sleep deprivation, conditions mimicking natural circumstances, so as to produce an animal model with symptomatology resembling very close to human mania. Pre-clinical and clinical studies have shown that mania is often co-morbid with multiple sclerosis, therefore we sought to find out whether myelin integrity is disrupted and if lithium could protect against such damage.

Objectives

(1) To analyse mania-like behavior after REM sleep deprivation. (2) To analyse any damage to myelin under TEM.

Aims

We wanted to see if there could be any damage to myelin after behavioral sensitization to stress.

Methods

Rats were sleep deprived by classical flowerpot or platform method. OFT was performed to assess behavior of rats. The analysis was performed over 5 min, separated into 5 bins of 1 min each. Behavioral scores included total square entries, inner square entries, time spent in center, rearing frequency, time spent rearing, number of grooming bouts, time spent grooming defecation and time spent still. TEM was performed to study changes in myelination in two distinct regions of brain, DG and VTA.

Results

It was observed that the REM sleep deprived rats had mania like symptoms. REM sleep deprivation lead to demyelination in DG and VTA. Lithium treatment restored myelination per se.

Conclusions

The result suggests the involvement of myelin damage in the pathogenesis of mania, Li offers protection against such damage.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Reversible cognitive impairment associated with a high free fraction but subtherapeutic total blood level of valproic acid due to hypoalbuminemia in a bipolar patient
Authors: Dautzenberg G. , Nederlof M. , Heerdink E. , Beekman A.
Published: June 2017

Valproic acid (VPA) is widely used in the treatment of epilepsy and bipolar disorder. It is largely bound to serum proteins (80–95%) in particular albumin, with a saturable binding capacity. Under conditions of hypoalbuminemia, protein binding of VPA will decrease and its pharmacologically-active free fraction will rise, even to toxic levels while measuring subtherapeutic VPA total blood levels [1].

We present an elderly bipolar patient with (sub)clinical total levels of VPA and a high free fraction of VPA due to hypoalbuminemia (14–24 g/L) leading to severe reversible cognitive impairment.

VPA and the free fraction in particular, was the most likely cause of the cognitive impairment [2]. There was a time-correlation with increasing blood levels of total VPA (68 mg/L, reference 80–120 mg/L [3]), notably the free fraction (37.5 mg/L, reference 5–15 mg/L), and the intoxication.

For therapeutic drug monitoring in laboratories, generally, total VPA concentrations (free + protein-bound) are measured instead of free fractions, due to technical difficulties, a lack of established reference ranges [4] and (inter)national guidelines [5,6] not requiring it. This presentation and literature points out that it is clinically relevant to measure the free fraction [7,8], especially in patients with hypoalbuminemia [9–11] to prevent unnecessary side effects and toxicity.

We recommend measuring albumin during VPA use; particularly in patients with nephrotic syndrome, liver disease [12] or older adults [13–15]. Hypoalbuminemia demands a free fraction measurement.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Correlation between alterations of inflammatory markers and treatment with atypical antipsychotics in patients diagnosed with bipolar affective disorder
Authors: Godio M. , Marino F. , Preve M.
Published: June 2017

Introduction

Clinical evidences suggests that cerebral inflammatory processes are involved in the development of major affective disorders [1].

Obvious correlations exist between changes of inflammatory markers such as acute-phase protein C (PCR) and VES, in patients with bipolar spectrum diagnosis [2].

Objectives

Our aim is demonstrating the correlations between changes of PCR and VES and pharmacological treatment with atypical antipsychotics in patients with acute bipolar disorder, highlighting a trend.

Method

Twenty patients with bipolar disorder were assessed at the entrance (T0), after three weeks (T1) and after six weeks (T2) of hospitalization using specific rating scales and blood tests routines include PCR and VES.

Results

Is possible to appreciate a correlation between the affective phase of bipolar disorder and inflammatory markers with a proportional trend (Table 1).

Discussion and conclusion

The scores obtained seem to confirm the effect of antipsychotic in both sense of psychiatric symptomatology reduction and in anti-inflammatory action.

A confirmation of a correlation between the resolution of affective disorders and normalization of inflammatory markers confirm the intrinsic anti-inflammatory activity of such drug compounds [3].

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Posttraumatic stress disorder symptoms and related factors after circumcision operation performed with general or local anesthesia
Authors: Kozanhan B. , Kocaoğlu C. , Gunduz M. , Akca O.F.
Published: June 2017

Objective

Elective circumcision operation for male children can affect their psychological status.

Aim

We aimed to investigate the traumatic effect of the circumcision procedure and the predictive factors that could contribute to this effect.

Method

One hundred and thirty-four children who admitted to urology and child surgery clinics to perform a circumcision procedure were included in the study. The whole group was divided into two groups including general anesthesia (GA) (n = 71) and local anesthesia (LA) (n = 63) groups. The procedure was performed under general and local anesthesia in the relevant groups. All of the participants filled the Child Depression invenTory (CDI), State (SA), and Trait (TA) Anxiety and Childhood Anxiety Sensitivity index (CASI) before the operation, and the Child Posttraumatic Stress Reaction index (CPSRI) 1 month after the operation.

Results

CDI, CASI and TA scores of the children were similar in both groups, however, SA scores of the LA group were higher than GA group (P < 0.001), and CPSRI scores of the GA group were higher than LA group (P = 0.04). When the other parameters were controlled in regression analysis, only CDI scores predicted CPSRI scores in LA group (P = 0.02), and TA scores predicted CPSRI scores in the GA group (P = 0.03).

Conclusion

Children who witness the surgical procedure of the circumcision do not develop serious PTSD symptoms. In contrast, children who experience general anesthesia procedure during circumcision develop more serious PTSD symptoms than children operated with local anesthesia. Trait anxiety and depressive symptom severity may be important in developing PTSD symptoms after circumcision operation.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Children with opsoclonus myoclonus syndrome: Types of psychological development
Authors: Burlakova N. , Mikadze Y. , Fedorova Y. , Bembeeva R. , Ilyina E. , Zavadenko N.
Published: June 2017

Introduction

Opsoclonus myoclonus syndrome (OMS) in childhood still remains unexplored from the perspective of clinical psychology.

Objectives and aims

The research was aimed at defining types of psychological development in the group of children with OMS. The study included 18 children between ages 2 years 4 months and 9 years with OMS (8 boys, 10 girls).

Methods

The following methods were used: analysis of patient's development and medical record, psychological interview with parents, neurological state assessment and pathopsychological assessment.

Results

Patients were divided into three groups according to cognitive development level:

– group with normal intelligence level (n = 4);

– group with developmental delay (n = 11);

– group with intellectual disability in different forms (n = 3).

Several children in group 1 (n = 3) and in group 2 (n = 4) expressed neurotic behavior with increased levels of anxiety and fear of trying unusual actions during psychological assessment. Children with delay in psychoverbal development (n = 7) and with developmental delay (n = 1) expressed psychopathy-like states with verbal aggression and had difficulties controlling their emotions. In some cases (n = 2), the psychological state of the patient was defined as borderline state with emotional instability, especially in mother–child interaction.

Conclusion

Psychological features of children with OMS indicate heterogeneity of their development types that implies different prognosis and developmental dynamics for each type. The results point out the necessity of detailed psychological examination aimed at correlation of psychological help to children with OMS and their families with their psychological state.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Sixteen-year population-based cohort study of main class International Classification of Diseases associated with psychiatric disorders in a sample under the age of two years
Authors: Cawthorpe D.
Published: June 2017

Introduction

This paper illustrates the use of cohort data from a population to describe the early life prevalence and odds ratios (ORs) of the main classes of International Classification of Diseases (ICD) associated with any mental disorder arising at any time during the 16 year study period.

Objectives

The main ICD disorder classes were examined in relation to psychiatric disorders over 16 years in a cohort under the age of two years between April 1st, 1993, and January 1st, 1995.

Aims

To demonstrate the utility of studying the complete profile of associated diagnoses over time in a population cohort.

Methods

The total number of individuals under the age of two years before 1995 (n = 17,603) were tallied within each main class of ICD disorder by year and expressed as ORs of those with and without any 16-year psychiatric disorder.

Results

The greatest annual rates observed in the early years of life were for the following main ICD classes of disease: respiratory system, sense organs, symptoms signs ill-defined conditions, no diagnosis, injury poisoning, and skin subcutaneous tissue disorders. These disorders also had the highest ORs in early life given the presence of a mental disorder at any time during the study period.

Discussion

Knowing the early life main class diagnoses associated with psychiatric disorders could guide both basic science research as well as early intervention social and health investment policies.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Determining the influence of game treatment on decreasing divorce children's’ stress
Authors: Ebrahimi F.
Published: June 2017

Introduction

One of the main challenges facing the fact that every society has always called divorce. Phenomenon in modern societies is growing at a rapid rate and adverse effects of economic, social and especially psychological, parents and children.

Aim

This study pays to determining the influence of game treatment on decreasing divorce children's’ stress.

Methods

The method of study is of testing in which statistical society of study includes all children (girl and boy) of divorced parents. From all statistical society, we have selected a sample about 26 persons by randomly sampling. The instrument for gathering information in this study includes children stress test (SCARED) in which has been studied sample after measuring its narration and stability.

Result

The result of dependent t-test and covariance analysis showed game treatment has meaningful and positive influence on children stress.

Conclusions

The amount of its interference on decreasing divorce children stress is about 83%. It means 83% of the whole remained scores variance is related to game treatment interference.

Disclosure of interest

The author has not supplied his declaration of competing interest.
Child and adolescent service and community mental health center: HoNOS findings in a joint take in charge model in Trieste
Authors: Bignotto A. , Celona D. , Pascolo Fabrici E. , Garino D.
Published: June 2017

Introduction

A collaboration between the Child and Adolescent Unit 2 (Badof-2) and Community Mental Health 2 (CMHC-2) started several years ago in order to have a joint take in charge of under 25 people presenting needs to either one of the services. A major focus has been put, in this period, on early psychotic onset.

Objectives

The impact of schizophrenia and other psychotic disorders on daily life has been very well studied in clinical populations and in general ones, leaving some gaps on which are more heavily involved in the resulting disability. In this study, we have used the HoNOS scale, in the Italian validated version, in order to evaluate the single items.

Methods

We have enrolled all the under-30 people taken in charge by the two aforementioned services in the period 2013–2016 with a ICD-10 F20–F29 diagnosis, dividing them in two subgroups (′13–′14 and ′15–′16) in order to find if there was an impact of the prolonged time of take in charge. A HoNOS evaluation has been submitted to all the 21 people found.

Results

HoNOS scores of the first subgroup are generally lower than the ones of the second subgroup (median: 6 vs. 16.5). Self-harmness, cognitive disorders and post-psychotic depression have a heavier impact in daily life than the classic positive and negative symptomatology. Focusing on psychosocial recovery programs, this area has been partly marginally affected.

Conclusions

The two subgroups show different HoNOS scores, with lower ones in the ′13–′14 group. More studies on general population and covariates should be conducted.

Disclosure of interest

The authors have not supplied their declaration of competing interest.