bluuebunny/crossref_metadata_2025 huggingface dataset:
Mindfulness, Self-compassion And Depressive Symptoms In Pregnant Women
Authors: Pereira A.T. , Xavier S. , Bento E. , Azevedo J. , Marques M. , Soares M.J. , Freitas V. , Pinto A.M. , Roque C. , Macedo A.
Published: May 2016

Introduction

Depressive symptoms in pregnancy are risk factors for postpartum depression and associated to adverse child outcomes (Glover, 2014). Depressive symptoms decreases after participation in mindfulness and self-compassion based interventions for pregnant women (e.g. Goodman et al., 2014). However, apart from intervention trials, there are not studies on the relationship between mindfulness, self-compassion and depressive symptoms in pregnancy (Zoeterman, 2014).

Objective

To explore the association between mindfulness, self-compassion and depressive symptoms in pregnant women.

Methods

Four hundred and twenty-seven pregnant women (mean age: 32.56 ± 4.785 years) in their second trimester of pregnancy completed a set of self-report questionnaires validated for pregnancy: Facets of Mindfulness Questionnaire-10 ([FMQ-10]; Azevedo et al., 2015; to evaluate Nonjudging of experience/NJ, acting with awareness (AA) and observing and describing (OD), Self-Compassion Scale ([SCS]; Bento et al., 2015; to evaluate self-kindness, self-judgment, common humanity [CH], isolation, mindfulness and over-identification [OD]) and Postpartum Depression Screening Scale-24 (PDSS-24; Pereira et al., 2013). Only variables significantly correlated with the outcomes were entered in the multiple regression models.

Results

FMQ-10 and SCS Total scores were both significant predictors of PDSS-24 (B = –0.294,–0.272). Derealization and failure predictors were NJ and Isolation (B = –0.234; 0.384); Suicidal ideation predictor was NJ, OD and isolation (B = –0.152;–0.115; 0.334); concentration difficulties and anxiety predictors were isolation and CH (B = 0.296;–0.201); Sleep difficulties predictors were AA and isolation (B = –0.199; 0.248) (all P < 0.05).

Conclusions

Mindfulness and self-Ccompassion dimensions, particularly nonjudging of experience, acting with awareness, observing and describing are protective correlates of antenatal depressive symptoms. Isolation is a correlate of PD in pregnancy.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
First Evidence For Glial Pathology In Late Life Minor Depression: s100b Is Increased In Males With Minor Depression
Authors: Polyakova M. , Sander C. , Arelin K. , Lampe L. , Luck T. , Kratzsch J. , Hoffman K.T. , Riedel-Heller S. , Villringer A. , Schoenknecht P. , Schroeter M.
Published: May 2016

Minor depression is diagnosed when a patient suffers from two to four depressive symptoms for at least two weeks. Though minor depression is a widespread phenomenon, its pathophysiology has hardly been studied. To get a first insight into the pathophysiological mechanisms underlying this disorder we assessed serum levels of biomarkers for plasticity, glial and neuronal function: brain-derived neurotrophic factor (BDNF), S100B and neuron specific enolase (NSE). Twenty-seven subjects with minor depressive episode and 82 healthy subjects over 60 years of age were selected from the database of the Leipzig population-based study of civilization diseases (LIFE). Serum levels of BDNF, S100B and NSE were compared between groups, and correlated with age, body-mass index, and degree of white matter hyperintensities (score on Fazekas scale). S100B was significantly increased in males with minor depression in comparison to healthy males, whereas other biomarkers did not differ between groups (P = 0.10–0.66). NSE correlated with Fazekas score in patients with minor depression (rs = 0.436, P = 0.048) and in the whole sample (rs = 0.252, P = 0.019). S100B correlated with body mass index (rs = 0.246, P = 0.031) and with age in healthy subjects (rs = 0.345, P = 0.002). Increased S100B in males with minor depression, without alterations in BDNF and NSE, supports the glial hypothesis of depression. Correlation between white matter hyperintensities and NSE underscores the vascular hypothesis of late life depression.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Aspects Of Quality Of Life In Depression
Authors: Puiu M.G. , Manea M.C. , Andrei I.A. , Cristache A.M. , Frunza A.A. , Boer M.C. , Patrichi B.E. , Parfene Banu M.E. , Manea M.
Published: May 2016

Introduction

The quality of life in patients with depression may be a measure of the efficiency of its management. Although quality of life is a subjective concept, difficult to assess, it may be reflected by the degree of social adaptation and the individual's level of functioning.

Objective

The study evaluates the time evolution of depressive symptoms and of some parameters attesting the quality of life in patients diagnosed with depression who are on antidepressant treatment.

Aims

Highlighting the evolution in time of depressive symptoms and patients’ perceptions on some aspects of quality of life.

Methods

There were included 23 patients who met the criteria of depressive episode, single or within recurrent depressive disorder, according to the International Classification of Diseases (ICD-10-AM), requiring antidepressant treatment. Subjects were evaluated at baseline and after 12 weeks of treatment using the Hamilton Rating Scale for Depression (HAMD), Sheehan disability scale (SDS), Social Adjustment Scale – Self-report (SASS).

Results

Statistically significant decrease in mean HAMD scores was observed in the second administration. There were registered statistically significant differences of scores obtained in the two administrations for the 17 items of the SASS scale. Correlations with statistical significance between HAMD scores and some of the SDS areas were observed.

Conclusions

Results showed a favorable course of depressive symptoms while under treatment and differences in time of subjects’ perception on several aspects evaluated on SASS for the group studied. Correlations with statistical significance between HAMD scores and some SDS areas were observed.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Subthreshold symptoms in bipolar disorder: Impact on quality of life
Authors: Khemakhem R. , Homri W. , Karoui D. , Belhadj H. , Mouelhi L. , Bram N. , Ben Romdhane I. , Labbene R.
Published: May 2016

Introduction

Several studies have analyzed the influence of bipolar disorder (BD) related to many kinds of functioning. Even if it is obvious that patients in relapse have poor quality of live (QoL), what's about it in interictal phases with subthreshold symptoms?

Aims

To study the potential relationship between QoL and subthreshold symptoms in bipolar I patients in remission.

Objective

To evaluate the above relationship, we hypothesized that subsyndromic BD phases can be related to worse subjectively QoL.

Methods

This was a cross-sectional study. Forty-four BD patients were enrolled. The subthreshold symptoms were evaluated by Hamilton Depression Rating Scale (HDRS) and Young Mania Rating Scale (YMRS). Patients with HDRS lower than 7 and YMSR lower than 6 were the successful applicants. Then, we run the Tunisian version of SF-36 to measure the QoL.

Results

Twenty-seven men and seventeen women with an average age of 39.3 years were selected. Age of beginning of BD was 31.5 years and patients were in relapse since 1.56 years. The HDRS's average score was 2.73. Twenty patients (45.5%) have an HDRS upper than 4. The YMRS's average score was 2.25 and twenty-nine BD's patients have a score between 1 and 6. The overall average score at SF-36 scale were 64.2 and 25% of BD patient with subthreshold symptoms had a poor QoL.

Conclusions

Subsyndromic interictal phases affect the QoL of BD patients and it's necessary to introduce therapy adapted according to troubles in order to improve patient's quality of life and functioning.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Perfectionism, a Transdiagnostic Construct In Eating Disorders
Authors: Rodriguez Cano T. , Beato Fernandez L. , Mata Saenz B. , Rojo Moreno L. , Vaz Leal F.J.
Published: May 2016

Introduction

Perfectionism is considered a multidimensional key risk factor for Eating Disorders (EDs). There are discrepancies regarding if it is mainly associated to Anorexia nervosa (AN) but not to other EDs.

Objectives

To study if Perfectionism is not only related with AN, but it is present in all EDs and associated with more transdiagnostic attitudes and behaviors.

Aims

To see if there were significant differences among EDs subgroups concerning Perfectionism and to study which abnormal eating attitudes were more associated with this trait.

Methods

Participants were 151 outpatients with EDs. DSM-IVTR diagnoses were: 44 (29.1%) Anorexia Nervosa (AN), 55 (36.4%) Bulimia Nervosa (BN) and 52 (34.4%) Eating Disorders not Otherwise Specified (EDNOS). Perfectionism was assessed with the Edinburg Investigatory Test (EDI-2) subscale; general psychopathology with the Beck Depression Inventory (BDI), State and Trait Anxiety Inventory (STAI), Rosenberg Self-Esteem Questionnaire (RSE). Eating psychopathology was measured with the Bulimic Investigatory Test (BITE), Eating Attitude Test (EAT-40), EDI-2 and the Body Shape Questionnaire (BSQ).

Results

No significant differences were found regarding Perfectionism among the three groups. Body dissatisfaction was the variable most associated with Perfectionism (β = 0.330, F = 14.2, P < 0.001, 10.9% of the variance) adjusting for general and eating psychopathology. Ascetism and Interoceptive awareness were the EDI-2 subscales most associated with Perfectionism.

Conclusions

The findings confirm that Perfectionism is present in all EDs and there is a relationship between body dissatisfaction and Perfectionism. Interplay has been suggested between these two factors for the development of EDs.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Impulsivity And Traumas In The Eating Disorder
Authors: Soto Laguna M. , Pérez López M.D.L.D. , Diaz Marsá M.F. , Aida N.F.
Published: May 2016

Introduction

The eating disorder are not only isolated power problems. They interweave issues and pathologies in patients often difficult to approach and have crimping going to reach a solution and get to the real problem of the patient. As it has been observed in studies if they have established relationships between patients with an impulsive nature and traumatized regarding the presentation of eating disorders.

Objectives

Our study aims to establish the relationship between eating disorder such as anorexia and bulimia with factors such as impulsivity and suffered traumas.

Materials and methods

It has used a sample (n = 57) and patients spent three scales “Barratt Impulsiveness Scale” (BIS-11), “Questionnaire traumatic experiences” (TQ) and the BSQ, scale measuring dissatisfaction disorders eating behavior. The aim is to see the relationship between anorexia and bulimia regarding trauma and impulsivity.

Results

It is intended to check if having character traits of impulsivity or miss having lived or suffered traumatic experiences such as the unexpected death of a family member, rape, kidnapping… establishes a relationship in patients who develop conduct disorders food.

Conclusion

This study aims to see if there is a correlation between eating disorder and factors such as traumatic experiences and an influential feature in this pathology such as the impulsivity through a sample of patients (n = 57) over 18 years.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Comparison Of Attitudes Of Pre-clinical And Clinical Medical Students To Psychiatry As a Career Choice: a Cross Sectional Study
Authors: Oliver C. , Adekunte O. , Bruce O.
Published: May 2016

Background

Psychiatry recruitment is currently insufficient to meet the targeted mental health service needs in the UK. Psychiatry is unpopular amongst medical students and in 2011, only 61% of junior training posts were filled by the first recruitment. RCPsych is currently working to promote psychiatry as a career choice for medical students.

Aims

To compare preclinical and clinical medical students’ attitudes towards psychiatry as a career choice.

Methods

A cross-sectional survey of 212 clinical students (CS) and pre-clinical students (PS) at Newcastle University. Each student responded anonymously to an electronic questionnaire. The responses take the form of: Yes/No, free text, order of preference, and Likert scale. Results were analysed based on basic statistical analysis.

Results

A total of 29% PS rated psychiatry in their top 3 career choices compared with 16% CS. Fifty-seven percent PS believe that psychiatry is a respected branch of medicine and 70% believes it makes good use of medical training, while CS rated these at 50% and 52% respectively. Sixty-nine percent PS believe that psychiatry is scientific evidence based compared with 63% CS. Eighty-one percent PS disagreed with the statement that they feel negative about psychiatry compared with 61% CS.

Conclusions

The outcome shows increase in negative attitude to psychiatry between pre-clinical and clinical years at the medical school. This makes psychiatry an unpopular speciality among final year students. Further research is required to ascertain the reason for this decline in interest and negative attitude.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Supervision Of International Medical Graduates
Authors: Casanova Dias M. , Andlauer O. , Dave S.
Published: May 2016

Introduction

Doctors qualified outside the UK constitute > 40% workforce in psychiatry. Differential examinations’ attainment and poor career progression are key issues for International Medical Graduates (IMGs). Due to increased migration, this is transversal to many countries. Varying ethical standards and values in different countries can create difficulties in the workplace and impact quality of patient-care.

Objectives

To understand current support available for IMGs across countries; identify areas of best practice.

Methods

We ran a preliminary open consultation to establish which initiatives were available across Europe and worldwide to address IMGs’ training abroad impact on their training/work in the host country and if any support exists for supervisors of IMGs. Representatives of European trainees were contacted through European Federation of Psychiatric Trainees network and early career psychiatrists through World Psychiatric Association network. Emphasis was given to identified host countries of IMGs.

Results

No specific initiatives were identified in Europe. Out of the six main host countries – Denmark, Finland, Norway, Sweden, Switzerland, UK – one did not provide information. Many countries reported specific requirements for a doctor to be accepted to work. There are courses on language and medicolegal processes. Some support is available for doctors doing short clinical placements. However, once an IMG has been accepted to work in the host country, there is no special support given by way of supervision.

Conclusions

Reports suggest IMGs welcome initiatives to help them gain skills related to the system, its culture, and appreciate feedback on their performance. There is a need to help host countries better support IMGs.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
An Audit to Improve Prescription Writing on Inpatient Medication Cards
Authors: Parvathaiah H. , Osman F.M. , Daly C.
Published: May 2016

Background

The most common intervention performed by physicians is the writing of a prescription. All elements in the complex process of prescribing and administering drugs are susceptible to error.

Aims

To measure the extent to which information recorded on prescription cards conforms to basic standards of prescription writing.

To improve prescribing, recording and staff knowledge.

To identify common prescribing errors and focus on the same to improve our standard of practice.

Methods

An audit tool was designed to collect data and standard was set 100%.

Results

In the initial audit, there was significant deficiency in prescription writing, which was presented at the internal teaching to all doctors and recommendations were made. This audit was repeated after a month, which showed improvement in prescription writing and recording.

Recommendations

Write all drugs in CAPITALS ensuring correct spelling, dose, route of administration and frequency.

Complete all fields on front of the prescription card legibly.

Document any change in prescription card in clinical notes.

All doctors to go through their current clients medication cards and ensure any gaps filled and errors corrected.

Audit report will be kept in audit folder as a reference for any rotating doctor to repeat the audit every six months in the services.

Conclusion

Doctors should continue to improve prescription writing and reduce any adverse events or errors.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Parasomnias and Panic attacks: a Case Report
Authors: Benavente López S. , Salgado Borrego N. , Hernández Durán C. , Muro Fernández de Pinedo E. , García Marín a.P. , Pérez Ordoño L. , Sainz Herrero a. , Sanz Paloma a.M. , Barbosa Requena R. , Vázquez Rodríguez L.T. , Rodrigo Borja G. , Vila Santos J. , Jiménez Morillas F. , Bermejo Lorero S. , Castro  arias M.L.
Published: May 2016

Introduction

Parasomnias are a category of sleep disorders in which abnormal events occur during sleep, due to inappropriately timed activation of physiological systems.

Case report

we report the case of a 41-year-old female who has no psychiatric history. The patient went to emergency department because when she was starting to sleep, in the first state of sleep, she felts a sensation of paralysis in all her body, with incapacity for breathing, chest oppression and tactile hallucinations like something or someone was touching her entire body. Due to that, the patient awoke frightened, with high levels of anxiety, with heart palpitations, shortness of breath, trembling, choking feeling, sweating, nausea and fear of dying. When the patient arrived to the emergency department, she was suffering a panic attack, thinking that she could have some kind of neurological disease or she was suffering a heart attack. after treating the panic attack with 1 mg of lorazepam, all the symptoms subsided gradually.

Discussion

in this case report, we present a patient with a new-onset parasomnia, with hypnagogic hallucinations and a panic attack at the awakening. It is known that stress factors are closely associated with parasomnias, as we can see in this case because the patient was moving and she was sleeping in a new place.

Conclusions

Parasomnias are very frequently present in general population and they can trigger intense anxiety status that can lead to panic attacks.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Socio-demographic Factors Among Delusional Disorder: a Case Series Register
Authors: Carrillo de Albornoz Calahorro C.M. , Guerrero Jiménez M. , Porras Segovia A. , Cervilla Ballesteros J.
Published: May 2016

Introduction

Delusional disorder has reached an entity of growing interest with a prevalence in developed countries between 1 and 4% of the psychiatric consultations.

Objective

To describe various socio-demographic and clinical variables that characterize patients diagnosed with delusional disorder in Andalucía according to DSM-5 criteria.

Methods

Reviewing common medical history digital records. First, it has been proved whether it complies DSM-5 criteria for the diagnosis of delusional disorder. Then, there have been different epidemiological variables collected: age, sex, family psychiatric history, and marital status, and employment status, age of onset of illness, number of years of follow-up by specialized care, the number of visits to your computer, and number of hospitalizations in a psychiatric inpatient unit among others.

of the 1927 patients studied, 1452 met the criteria for diagnosis of delusional disorder. These patients live in Andalusia and come to different mental health care units, with an average follow-up period of 9 years and 1 month.

Results

About half of the sample were women and half men (49% versus 51%).

Forty-seven percent of the sample are married or have a couple, and 19% are in active employment.

Thirty-two percent have a family history of psychiatric mental disorder written in his digital clinical record.

Seventy-five percent of the sample meets criteria F22, while 25% are diagnosed as other psychoses.

Conclusion

This is the largest record of cases registered with delusional disorder to date, in which we describe the biopsychosocial characteristics of this group of patients in the largest Spanish region.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Socio-demographic Analysis of An Early Psychosis intervention Programme
Authors: Carrillo de Albornoz Calahorro C.M. , Rodrigo Manzano J.A. , Girela Serrano B.
Published: May 2016

Introduction

During the first 5 years of the onset of schizophrenia, the majority of the clinical and psychosocial deterioration takes place.

This period of time is critical in terms of diagnosing the illness and providing effective psychosocial and pharmacological treatment.

Objectives/aims

Knowing the demographic profile of users of an Early Psychosis intervention Programmeto adapt the intervention to their specific needs.

Methods

A descriptive statistical analysis of the records of every patient on admission program during year 2014 was carried out. There have been various socio-demographic variables collected such as: sex, age, initial diagnosis, drug consumption, educational level, labor situation, referral source and origin.

Results

We found an average age of 26, near the normal curve between 15 and 35 years distribution.

Eighty percent of our simple were men.

Eighty percent were non-affective psychosis as their initial diagnosis.

Abuse toxic in 70%, in all cases cannabis or derivatives.

Education level: 56% primary studies. Thirty percent reached secondary studies. Fourteen percent higher educational level.

in terms of job-training situation: 30% were working, 40% unemployed and 30% studying.

Sixty-five percent were referred from primary care centers, 20% from drug abuse centers and 15% from hospitalization units.

Main nationalities were Spanish 65%, 30% were Moroccan, and 5% other came from other nationalities.

Conclusion

It stresses the importance of intervening on dual diagnosis, the need for greater coordination with primary care to improve the detection of cases and the development of the training-labor area in the recovery process.

It is also necessary to evaluate the different characteristics of immigrants included in the program.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Psychotic Symptoms in General Population: Correlates in The Andalusian Province of Granada
Authors: Guerrero Jiménez M. , Carrillo de Albornoz Calahorro C.M. , Girela Serrano B.M. , Cervilla Ballesteros J.A.
Published: May 2016

Introduction

Several recent epidemiological studies have reported during the last few years that the prevalence of psychotic symptoms in the community is bigger than the previously thought.

Aims

Estimate the prevalence in our influence area, as there are no previous studies focused on this measure and its correlated factors in Andalusia population.

Methods

Literature review was made about the prevalence reported in all continents as well as the found correlation. Then, a cross-sectional epidemiological study was designed (Granada). We present data from 809 Andalusian individuals taken from the Unified Data Base of the Andalusian Health System.

Results

This poster presents a brief but updated systematic literature review of psychotic symptoms in the general population (i.e. delusions and hallucinations). We present also data from 809 individuals from our clinical catchment area. Prevalence of psychotic symptoms in Granada was of 10.3%. Hallucinations were reported in 6.1% and 7.4% reported delusions.

Conclusions

The prevalence found was similar to other studies in the Spanish population such as the EsEMED Study performed in Catalonia where 11.2% of psychotic symptoms were reported, and similar to European studies like the BNS in Great Britain with a 10.9% of psychotic symptoms. Differences obtained in percentages could be due to different measure scales (PSQ, MINI, CIDI…) used in other studies made in the North American population such as the National Comorbidity Survey with a 28% of prevalence reported. inter-interviewer differences and the potential risk factors for psychotic symptoms in each population seem to be the causes of such differences and similarities.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Mental and Behavior Disorders Among Combatants in Ukraine
Authors: Mykhaylov B.
Published: May 2016

in Ukraine, the significant participants of the “anti-terroristic operation” (ATO) need to provide a system of psychiatric, psychotherapeutic assistance.

The 6 groups of disorders:

– non-pathological reaction (Z65.5);

– pathological reactions (F43.0);

– neurotic disturbances (F45);

– psychotic disturbances (F44);

– PTSD (F43.1);

– chronic personality changes (F62.0).

The system of complex assistant was provided. Step 1: emergency psychological assistance. It is carried out on the basis of crisis intervention, that is defined as the emergency and urgent medical and psychological first aid, aimed at the return of the victim to the adaptive level of functioning, preventing progredient development of mental disorders, reducing the negative impact of a traumatic event.

Step 2: medical and psychological support. The purpose is the relief of mental and behavioral disorders, prevention (secondary and tertiary), psychological maladjustment, progressive course of mental disorders, with the purpose, rational, suggestive, cognitive behavioral (CBT), and others. The aim of psychotherapy is to support the patient's assistance, processing traumatic material revaluation of the crisis, a change of attitude, increased self-esteem, develop realistic perspectives and active life position. It is important to restore a sense of competence and design future in which you can use a good past experiences. Step 3: the primary goal of treatment is relief of anxiety and fear, stress, adaptation to the human life and activity in conditions of continuing psychogenic. The most effective method of psychotherapy in these cases is CBT. Step 4: supportive. All steps developed by multimodal model of psychotherapy.

Disclosure of interest

The author has not supplied his declaration of competing interest.
Evolution of bipolar disorder over 12 years in a psychiatric hospital
Authors: Ribera E. , Grifell M. , Campillo M.T. , Ezquiaga I. , Martínez L. , González L. , Palomo A. , Pérez V. , Galindo L.
Published: May 2016

Introduction

Bipolar disorder is a leading cause of hospitalization in psychiatric hospitals. It is known that early detection of bipolar disorder is associated with a better prognosis.

Objectives

The aim of this study is to conduct a demographic analysis of patients hospitalized for bipolar disorder in a single center between 2003 to 2014.

Methods

Retrospective cohort study of 1230 patients admitted with bipolar disorder diagnosis from 2003 to 2014 at Centre Assistencial Emili Mira i López of Parc Salut Mar of Barcelona. We divided the study in two periods: 2003–2008 and 2009–2014. We analyzed the following variables: frequency of admissions, age, sex and days of hospital stay, comparing both periods. Chi-square test for categorical variables and Student t test for quantitative variables were applied.

Results

The mean ages at the first and second period are 52 and 47, respectively (P < 0.001). There are no significant differences in sex and days of hospitalization. The frequency of admissions on the first and third trimesters is higher than in the second and fourth, although the differences are not statistically significant.

Conclusions

Despite the large number of patients in the study, there are limitations, such as being a retrospective study and not being adjusted for confounding factors. The average age of patients in the second period is lower than in the first. This could suggest an improvement in early detection of bipolar disorder in the last years. Further research is needed to confirm this hypothesis.

Disclosure of interest

LG is funded by the Instituto de Salud Carlos III(CM14/00111).
Issues Regarding Compulsory Treatment in Compulsory Admitted Mentally ill Patients
Authors: Tsopelas C.
Published: May 2016

Introduction

In psychiatric clinical practice compulsory admission to hospital is the last option of the overall care provided to mentally ill patients, justified in terms of civil and human rights because of issues of protection for patients’ and society members’ life and health. Usually treating psychiatrists believe that issues of compulsory admission are without doubt associated with the permission, or even obligation, to apply compulsory treatment in a routine daily base.

Aims

In this review, we are exploring issues around the implementation of compulsory treatment.

Methods

Thorough research of the main databases and web search engines for relevant studies, agencies and organizations, interested in compulsory treatment issues.

Results

Research shows ambiguous views. Conservatives argue that delay of any substantial, even enforced, and well documented treatment, would result in delay of treatment and excess use of other potentially more enforced methods. Using laws and legislation patients’ rights are guarded but we also have the obligation to treat patients. On the other hand, liberals express totally opposite views. Capacity (or incapacity) is not ‘all or nothing’ but specific to decision and should be respected, with the exception to emergency treatment need.

Conclusions

The capacity of decision-making of the mentally ill patient, whether or not being compulsory admitted, should be assessed in a more holistic and systematic approach and become part of the standard practice, followed by dissemination of these decisions to all relevant parties. Restore decisional autonomy should be one of the main goals of any therapeutic intervention.

Disclosure of interest

The author has not supplied his declaration of competing interest.
When Patients With Paranoia Commit Medicolegal Acts: A Descriptive Study
Authors: Ghajati B. , Ghezaiel S. , Chebbi R. , Berrahal I. , Ridha R.
Published: May 2016

Patients with paranoia have always been an attractive and redoubtable group of mentally ill to mental health professionals. In fact, beyond complex psychopathology and relatively better functioning, these patients do represent a real threat to themselves and their presumed persecutors.

Objectives

To explore criminological aspects of medicolegal acts committed by patients with paranoia.

Methods

We conducted a retrospective and descriptive study, based on medical charts consult. Were included, patients suffering from paranoia (persistent delusional disorder: jealous/persecutory/erotomania type, DSM-IV), hospitalized in the forensic psychiatry department of Razi hospital between 1995 and 2015. This psychiatry department provides medical care for male patients not held by reason of insanity, according to article 38 of the Tunisian Criminal Code. Patients’ socio-demographic characteristics were collected as well as criminological details of their acts of violence (victim, weapon type, crime scene, premeditation…).

Results

We collected 23 patients. Delusional disorder types were: jealousy (17), persecution (4), erotomania (1) and claim (1). The majority was married (18), undereducated (17), with irregular work (13). Forensic acts were uxoricide (15), attempted murder (5), violence against people (2) and destruction of public properties (1). Patients used bladed weapon in most of the cases (13), in the victim's residence (19), with premeditation in (17) of the crimes. Nine patients reported their act of violence to the authorities.

Conclusion

Our results do expose further data concerning potential dangerosity of patients with delusional disorders, and by that invites mental health professionals to prevent these acts with screening for violence predictors and risk factors.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Stalking and its Forensic Psychiatric Assessment
Authors: Izáková L. , André I.
Published: May 2016

Introduction

Stalking, a dangerous persecution, gained attention because of persecution of celebrities by fans suffering by mental disorders. In psychiatry, there is no consensus about the exact definition of stalking, because it can result from many different motivations and constellations of psychopathological symptoms.

Objective

The authors provide an overview of the current state of stalking, i.e. dangerous persecution as a new crime in Slovakia. They describe the characteristics of stalkers (persecutors), victims and their interaction in their forensic psychiatric practice.

Method

Search in author's expert reports were conducted on stalking. Analysis of motivations, mechanisms of persecutions and analysis of psychopathological symptoms and mental disorders in stalkers and their victims were made.

Results

Stalkers and their victims are a heterogeneous group with different psychopathology and mental disorders including personality disorders and psychosis. The authors document general principles of forensic psychiatric assessment of stalkers as crime offenders.

Conclusion

Stalking is problem also in forensic psychiatric practice also in Slovakia. Stalkers who suffer from mental disorders require adequate diagnostic and psychiatric treatment also in forced setting.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Explorations of Cooperation and Recalcitrance in Secure Mental Health Hospitals
Authors: McKeown M. , Chandley M. , Jones F. , Wright K. , Duxbury J. , Foy P.
Published: May 2016

This paper reports on the findings of three qualitative research studies undertaken within, respectively, medium and low secure units in one UK region, and a high secure mental health hospital in England (UK). The first study investigated alliance based involvement practices. The second explored service user and staff views and sense making of the notion of recovery. The third study is ongoing into service user and staff experiences of extreme coercive measures, such as forms of restraint and long-term seclusion or segregation. All studies utilised either semi-structured interviews or focus groups. All data was subject to thematic analysis.

Selected and emergent themes include:

– the importance of relationships and communication; security first; involvement as pacification;

– different understandings of recovery; the importance of meaningful occupation; staff-service user relationships; recovery journeys and dialogue with the past; and recovery as personal responsibility;

– good and bad coercion; cooperation, resistance and recalcitrance; and alternatives to coercion.

Findings suggest that cooperation is largely framed by services in terms of compliance with a bio-medical model. The impact of the secure environment, whilst ever-present, is not an absolute constraint on the realisation of recovery or involvement objectives. The availability of extreme coercive measures raises some seemingly paradoxical understandings from both service user and staff perspectives. Critical social theory is drawn on to illuminate the tensions between cooperation and recalcitrance and suggest further exploration of their respective legitimacy.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Differential Binding of Creb, Usf, and c-myc to the Calreticulin Human Specific –220c May Be Linked with the Evolution of Higher Brain Functions in Human
Authors: Farashi S.
Published: May 2016

Introduction

We have previously reported a human-specific nucleotide in the promoter sequence of the calreticulin (CALR) gene at position –220C, which is the site of action of valproic acid.

Objectives

Reversion of this nucleotide to the ancestral type, –220A, co-occurs with severe deficit in higher brain cognitive functions.

Aims

In the current study, we compare the pattern of protein binding between –220C and –220A.

Methods

Antibodies reactive against transcription factors CREB, USF, and c-Myc were used to identify the specific proteins involved in complexes with DNA using electrophoretic mobility shift assay (EMSA).

Results

Significant increase was observed in the overall protein complexes binding to the –220 C allele vs. –220A. The transcription factors, CREB, USF, and c-Myc, were differentially bound to –220C, represented by supershifts.

Conclusions

We propose that differential binding of CREB, USF, and c-Myc to CALR nucleotide –220C may be linked with the evolution of higher brain functions in human.

Disclosure of interest

The author has not supplied his/her declaration of competing interest.
Psychiatric Disturbances in a Patient with Melas Syndrome: a Case Report
Authors: Rizza M.C. , Di Marco S. , Delicato C. , Vecchi C. , Gramaglia C. , Prosperini P. , Cantello R. , Zeppegno P.
Published: May 2016

Introduction

Mitochondrial disorders of energetic metabolism (MD) represent a heterogeneous group of diseases manifesting at any age and its one of a number of mitochondria syndromes that share the common characteristics of encephalopathy and myopathy. The clinical expression of MELAS (Mitochondrial Myopathy, Encephalopathy, Lactic Acidosis and Stroke-like episodes) is highly variable and ppsychiatric symptoms are rarely reported in literature even if are more common in MELAS syndrome than in the general population.

Objective

The first aim of the study is describing the clinically observed primary psychiatric symptoms in a patient affected by MELAS syndrome admitted to the Psychiatric ward. The second aim is to go back over the diagnostic process, which led, from the uncommon psychiatric symptoms and signs to the final genetic diagnosis of MD.

Methods and results

We report the case of a 44-year-old male with MELAS in whom psychiatric symptoms preceded the establishment of the clinical diagnosis for several months. Diagnosis was initially based on the neuroimaging and metabolic findings and subsequently confirmed with genetic analysis.

Conclusions

In case of aggressive and paranoid behaviour with delusions of persecution and disorganised behaviour mmitochondrial disorders deserve consideration as part of the differential diagnosis, especially if there is suspected involvement of other organ groups or positive family history of MD. There is no specific consensus approach for treating MELAS syndrome. Management is largely symptomatic and should involve a multidisciplinary team.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Prepulse inhibition in euthymic bipolar disorder patients in comparison with control subjects
Authors: Santos J.L. , Mateo J. , Aparicio A. , Sánchez-Morla E.M.
Published: May 2016

Introduction

Deficient prepulse inhibition (PPI) of the startle response, indicating sensorimotor gating deficits, has been reported in schizophrenia and other neuropsychiatric disorders.

Objectives and aims

The present study aimed to assess sensorimotor gating deficits in euthymic bipolar patients. Furthermore, we analysed the relationships between PPI and clinical and cognitive measures.

Method

PPI was measured in 64 euthymic bipolar patients and in 64 control subjects matched for age, gender, education level and smoking status. Clinical characteristics and level of functioning were assessed in all participants using the Hamilton Depression Rating Scale (HDRS), Young Mania Rating Scale (YMRS) and Functioning Assessment Short Test (FAST). Cognition was evaluated using the MATRICS Consensus Cognitive Battery (MCCB) and the Stroop Test as an additional measure of executive function.

Results

Compared with controls, patients with bipolar disorder exhibited PPI deficits at 60- and 120-milliseconds prepulse-pulse intervals. Among patients with bipolar disorder, PPI was correlated with the social cognition domain of the MCCB. PPI was not significantly correlated with other clinical or neurocognitive variables in either group.

Conclusions

Our data suggest that PPI deficit is a neurobiological marker in euthymic bipolar disorder, which is associated with social cognition but not with other clinical, functional or cognitive measures.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Mini-Mental State (MMS) Evaluation of Dementia in Psychiatric Patients Admitted to a Long Stay Ward
Authors: Amel N. , Isabelle L.P. , Aurelie G. , Marc H. , Mohammed A. , Ziad I.
Published: May 2016

Normal 0 21 false false false FR X-NONE X-NONE MicrosoftInternetExplorer4.

MMS scores for 41 psychiatric patients were analyzed at admission and regularly throughout their stay.

Results

Their average age at admission was 65.7. Thirty-six patients had a diagnosis of chronic psychosis, two with bipolar disorders, one with frontotemportal dementia, two with Korsakoff syndrome.

At admission, 21 (51%) patientsshowed mild cognitive deterioration (score = 18–26), 12 (29%) moderate deterioration (12–17), 6 severe deterioration (0–11), 2 had normal scores (27–30). Over the following years, 28 patients were reassessed:

– 12 (42%) were stable, 7 (25%) had a fluctuating score, 5 (18%) improved;

– 4 (14%) deteriorated over their successive MMS evaluations;

– age, socio-cultural level and psychiatric diagnosis were not associated with change in MMS scores;

– average change between initial and final assessment was +6.0 points for patients with improved score, –7.75 for those showing deterioration;

– 1.28 for those with fluctuating scores, –1.0 for stable patients.

Analysis

Unstable psychiatric disorders associated with somatic pathologies influenced MMS scores for all patients, particularly for those with MMS deterioration or fluctuation even if this phenomenon could also be observed to a lesser extent in stable patients. By contrast, patients whose MMS scores improved over time were more mentally stable and had no current somatic problems. Multidisciplinary teamwork is important for patients with deteriorating MMS scores.

Conclusion

By illustrating the impact of somatic and psychiatric factors on dementia, the present study underlines the value of multidisciplinary professional care, the role of the family and the importance of long-stay wards.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Comparative Efficacy and Safety of Antidepressive Mono- and Multimodal Therapy with Citicoline in Elderly Patients with Depression in Psychogeriatric Unit
Authors: Kalyn Y. , Gavrilova S. , Safarova T. , Shipilova E.
Published: May 2016

Introduction

Citicoline is a choline donor involved in the biosynthesis of brain phospholipids and acetylcholine, used for treating neurodegenerative disorders. Several studies have shown its beneficial effects both in degenerative and vascular cognitive decline. Due to its effects on the adrenergic and dopaminergic CNS activity, citicoline can also be used as an adjuvant in depression treatment.

Objectives and aims

Comparative evaluation of efficacy and safety of a multimodal antidepressive therapy with ceraxone (citicoline) plus one of the antidepressants (venlafaxine, agomelatine, or fluvoxamine) and monotherapy with the same antidepressant for the treatment of depression in the elderly. Two groups of patients were included in the study (21 patients in each group) aged from 60 to 79 years old, comparable to the main clinical characteristics.

Methods

First group patients were treated with a single antidepressant, patients of the second group – with the same antidepressant and intravenous infusions of ceraxone: 10 infusions (500 mg in 100 mL isotonic sodium chloride solution) during 2 weeks, followed by transfer to the drug in solution at 3 mL per os two times a day for six weeks.

Results

A multimodal therapy with ceraxone leads to more rapid and significant therapeutic response along with the reduction of adverse events compared to antidepressant monotherapy.

Conclusion

Obtained data allows to recommend a multimodal antidepressive therapy with ceraxone (citicoline) for the treatment of elderly depressive patients to reduce the risk of adverse effects of antidepressants and to shorten hospitalization period.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Very Late-onset Schizophrenia-Like Psychosis: Case Report and Current Status of the Issue
Authors: Aragón R. Martín , Rodríguez M. Gutiérrez , Herrero S. Bravo , Menguian C. Moreno , Criado N. Rodríguez , Fourcade J.F. Cruz , Franco P. Muñoz-Calero , Sánchez B. Sánchez
Published: May 2016

Introduction

Schizophrenia has traditionally been considered to strictly be an early-onset disorder. Current nosologies, including DSMV, are not restrictive with age of onset in schizophrenia and all patients that satisfy diagnostic criteria fall into the same category. Since 1998, International Late-Onset Schizophrenia Group consensus, patients after 60 are classified as very-late onset schizophrenia-like psychosis. Female overrepresentation, low prevalence of formal thought disorder, and a higher prevalence of visual hallucinations are associated with later age at onset. Atypical antipsychotics represent the election treatment because of the reduced likelihood of EPS and tardive dyskinesias, and should be started at very low doses, with slow increases.

Objective

To review the current knowledge about very late-onset schizophrenia through systematic review of the literature and the analysis of a case.

Methods

Case Report. Review. Literature sources were obtained through electronic search in PubMed database of last fifteen years.

Results

We present a case of a 86-year-old woman suffering from delusions and hallucinations, diagnosed with very late-onset schizophrenia-like psychosis, after differential diagnosis with other disorders. We analyze ethiology, epidemiology, clinical features and treatment in geriatric patients with schizophrenia.

Conclusions

Reluctance to diagnose schizophrenia in old people is still present today, probably in relation with the inconsistency in diagnostic systems and nomenclature, and consideration of medical conditions in the diagnosis. Identification of these patients is really important in order to start an appropriate treatment, which can lead to patient clinical stability.

Disclosure of interest

The authors have not supplied their declaration of competing interest.