bluuebunny/crossref_metadata_2025 huggingface dataset:
Forensic psychiatric expertise of patients with anti-social personality
Authors: Turki M. , Charfi N. , Maalej Bouali M. , Ben Thabet J. , Zouari N. , Zouari L. , Maalej M.
Published: June 2017

Introduction

Epidemiological studies in the general population confirm the indisputable link between criminological dangerousness and mental disorders especially anti-social personality, which increase clearly the prevalence of violent behavior.

Aim

To dress socio-demographic, clinical and medico-legal profile of offenders, with anti-social personality, in forensic psychiatric examination.

Methods

It was a retrospective study of a series of 195 patients with antisocial personality (DSM-IV). They were examined, during the period, from 2009 to 2013, on the occasion of a penal expertise in the department of psychiatry C in the Hedi Chaker university hospital, Sfax, Tunisia.

Results

The mean age of patients at the offense moment, was 29.58 years, with a sex ratio of 26.85. Among them, 66.2% were single, 49.2% had a primary school level and 41% had no profession. Between the patients, 58.5% lived in urban area and 38.5% in a high crime area. Addictive behaviors were reported in 80% of cases. Self-injury behaviors were noted in 33.8% of offenders. Psychiatric histories were reported in 66.2%, and 25.6% of patients have been already hospitalized in psychiatry department. 64.1% had already committed forensic acts, and 36% had been imprisoned at least once. The current offense was: homicide 16.9%; sexual offense 9.2%; violence 18.5%; theft 30.2%. The offense was related to impulsivity (40%) or utilitarian purpose (39%).

Conclusion

A young single man with no profession, a limited educational attainment and a history of impulsive behaviors, such is the profile most frequently encountered among offenders with anti-social personality. Interventions for reducing forensic behavior should focus on those social and clinical characteristics.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Criminal insanity and psychiatric diagnoses in Greek penal cases
Authors: Tzeferakos G. , Papaliaga M. , Papageorgiou C. , Bali P. , Douzenis A.
Published: June 2017

Introduction

To our knowledge, few studies address the issue of criminal responsibility among psychiatric offenders. In Greece, articles 34 and 36 of the penal code regulate criminal insanity and diminished responsibility, respectively.

Objectives

The objective of the present study was to provide psychiatric/legal data considering the appeal to articles 34/36 of the Greek penal code.

Methods

Legal case files of 100 adult subjects, 90 male/10 female, 88 Greeks/12 foreigners were examined.

Results

According to the first degree court, one defendant was found criminally insane, 29 with partial responsibility, while the rest were regarded as fully capable. The decisions of the court of appeal/the supreme court of appeal were 2 criminally insane, 36 partially responsible and 62, fully criminally responsible. The decisions were unanimous in 78% of the cases.

The most common diagnoses were schizophrenia spectrum psychosis (18%), antisocial/borderline/mixed personality disorder (15%) and substance use disorder (15%). Court decisions of criminal insanity/diminished responsibility were higher when the perpetrator had an Axis I diagnosis (47.5%), significantly lower in cases of personality disorder (22.2%) and even lower in cases of substance use disorder (16.7%). In patients with prior hospitalizations the percentage of criminal insanity/diminished responsibility was 55.6%, significantly higher than in cases without (24.4%).

Conclusions

Schizophrenia is the most common mental disorder correlated with offenders criminally insane/partially responsible, while a history of psychiatric hospitalization is a very strong positive predictive factor for the successful appeal of the aforementioned articles.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Evaluation of serum microRNA expression profile in panic disorder patients
Authors: Çökmüş F.P. , Özmen E. , Alkın T. , Batır M.B. , Çam F.S.
Published: June 2017

Introduction

Even though it has begun to be investigated in recent years, studies of microRNA (miRNA) in anxiety disorders are limited. Our research is the first miRNA expression study in panic disorder, which excludes of drug use and additional psychiatric disorders.

Objective

We aimed to determine the availability of miRNAs as biomarkers in the serum levels of panic disorder and to demonstrate the changing expression of miRNAs.

Methods

In the research, 35 panic disorder patients and 35 healthy controls were administered a socio-demographic and clinical information form, SCID-I, PDSS. 2 tubes of peripheral venous blood were taken from each group for genetic evaluation. miRNA expression analysis was performed in those samples by the RT-PCR method.

Results

Compared with the healthy control group, 8 miRNA expression levels were found different in panic disorder group. Five of them were up-regulated and 3 of them were down-regulated. There was no correlation between the level of miRNA expression and PDSS total score and PDSS sub-items. miR-1297 and miR-4465 expression levels were statistically significant between the two groups. Both miRNAs are also known to arrange the gene regions that affect GABAA receptor subtypes.

Conclusions

miR-1297 and miR-4465 regulate the GABAA gene that is thought to play a role in the etiology of panic disorder (Wong et al., 2014, Wang 2016). In panic disorder group, miR-1297 and miR-4465 expression levels were found to be up-regulated from the healthy control group.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
An evidenced based checklist to support anti-dementia medication withdrawal in people with down syndrome (DS), intellectual disability (Id) and dementia
Authors: Shankar R. , Ram S.
Published: June 2017

DS with aging is associated with greatly increased risk of developing dementia similar to Alzheimer's. Anti-dementia drug discontinuation is recommended when clinical benefit is not determined. In DS it is more complex as medication ill effects of stopping needs to be weighed in balance to extraneous processes such as environment changes, sensory impediments and physical ill health and natural progression of dementia.

Aim

Can identified risk factors extracted from a comprehensive literature review be developed into an evidence based check list to support risk minimized person centered withdrawal of anti-dementia drugs when considered not to be efficacious in DS?

Method

A detailed literature review using Medline, PsychInfo, Cinahl and Embase with relevant search terms in various permutations and combinations without any date limit enquiring current evidence base on anti-dementia medication withdrawal was conducted. The review also looked to extract the common risk factors in stopping medication. All risk factors were collated, reviewed by a focus group of experts, developed into a checklist.

Results

Thirty abstracts were obtained following the search. Six papers were short-listed. No papers identified a structured approach to medication reduction. An 18-factor checklist was applied prospectively to 30 cases. The checklist was sensitive to identify change to guide clinical decision-making.

Conclusions

Currently, decision to peg medication withdrawal risk is arbitrary and clinical in dementia especially in DS dementia. The evidenced based developed checklist is useful to support and structure clinical decisions. It helps clinicians and patients to focus on promoting safety, reduce harm and guide treatment.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
REMOVED: Psychiatric social work needs of families having children with mental diseases in Turkey
Authors: Arslan E. , Akgül Gök F. , Duyan V.
Published: June 2017

This has been removed as it was published accidentally. The authors listed wish it to be known that this article was not presented at the conference for which this volume is the proceedings.

The full Elsevier Policy on Article Withdrawal can be found at http://www.elsevier.com/locate/withdrawalpolicy.
Interdisciplinarity on the care of a mentally disordered person
Authors: Vasconcelos S.C. , Correia A.S.B. , Gouveia B.G. , Silva I.J. , Mendes M.S.G.C. , Moreira M.A.S.P. , Domingos E.S. , Leal A.S.L.G.
Published: June 2017

Introduction

Brazilian's humanization policy offers the extended clinic as acting tool in health services, which advocates the use of soft technologies to provide care to its clientele.

Aim

Discuss the interdisciplinary mental health residents approach to the care of the person with mental disorder.

Methods

Experience report, accomplished by experiences of mental health's multidisciplinary residency members, which is in a lato sensu postgraduate linked to the study center of collective health, of the Federal University of Paraíba, Brazil. Structured on two axes: face meetings; and singling out actions in the daily work.

Results

From the understanding of the extended clinic as a light technology interdisciplinary approach, in which different professional specialties share knowledge and co-responsible themselves for the mentally disordered patients’ care, Residents have used it as a articulation tool and insertion in the different care scenarios. When developing activities, the residents use guidelines indicated by the extended clinic in order to leverage the work done by the person with mental disorders. Among which stands out: the host, building links, qualified listening, the sensitization for the care co-responsibility, construction of the unique therapeutic project, intersectional actions and sharing care with other services that make up the health system.

Conclusion

Experiences like these made it possible to perceive the applicability of the National Policy of Humanization through its main tool, which is the extended clinic that contributes to the work process of a health team, promoting interdisciplinarity and raising the prospective to the look of transdisciplinary.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Descriptive Study of Adjustment Disorders in a Mental Health Unit.
Authors: González L. , Pecino B. , Gomez C. , Anibarro M. , Ortigosa C.
Published: June 2017

Introduction

Adjustment disorders are a common psychiatric disorder in primary care and mental health units, with point prevalence estimates ranging from 0.9% to 2.3%. These disorders have been recently defined as a stress response syndrome in the fifth edition of the DSM, causing emotional and social difficulties and also a large economic burden on society.

Objectives

The aim of this descriptional study was to analyse the socio-demographic characteristics and treatment of the patients diagnosed with adjustment disorders in the first visit in a mental health unit.

Methods

The study sample consisted of 128 patients admitted for a psychiatric consultation in a mental health unit in Alicante (Spain) from their primary care physician, between February and July 2016. Variables of gender, age, current employment status, diagnosis and treatment were measured. Data analysis was conducted using SPSS software.

Results

The data from 31 patients who were diagnosed with adjustment disorders meant a 24% of the sample. The median age was 47 years old in the adjustment disorders group. Among those with adjustment disorders, 61% were women, and 52% of them were unemployed. Almost 60% of them had at least one pychotropic prescription and only 22% were derived to psychology.

Conclusions

Adjustment disorders are considered as an intermediate category between no mental disorder and affective disorders. Most authors recommend to start with a psychotherapeutic intervention. Despite starting with medication has not proved effectiveness in the studies, most of the patients had at least one psychotropic prescription before the psychiatric evaluation.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Correlation Between Resilience with Aggression and Hostility in University Students
Authors: Mojrian F. , Homayouni A. , Rahmedani Z. , Alizadeh M.
Published: June 2017

Resilience as a capacity to withstand stress and calamity is one of the important components of mental health and aggressive is a negative behaviour that can threaten human health. So, the purpose of this study was to investigate the correlation between resilience with aggression and hostility in university students. The research method is correlation, 155 university students were selected by convenience sampling method and responded to Corner & Davidson resilience questionnaires and Boos & Perry aggression and hostility questionnaire. The data were analysed by correlation formula. The results showed that there is a significant and negative correlation between resilience with aggression and hostility, which means when the score of resilience is high, people's aggression and hostility decreases. Therefore, it is recommended to increase the resilience of people by specific teaching programs to reduce the basis of aggression and hostility.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
IECs, Drug Trials and Regulators–the Hounds Barking up the Wrong Tree
Authors: Nagpal R. , Jhanwar V.G. , Mital A.K. , Warrier E.M.D.
Published: June 2017

As India hurtles on into the 21st century with dizzying speed, the constantly evolving ethics, law and its interpretations fall behind. The cut and paste policy makers constantly impose regulations out of sync with the geopolitical realities. The Mental Health Care Bill now awaiting approval arose because we signed first on a global body convention and now are forced to comply. The family, a ubiquitous feature of our patient support system is slowly being derecognized. Instead, NGOs are the new approved caregivers. Our patriarchal society, earlier a repository of warmth and security is now jeered at. The mental health professional, the last mile delivery of mental health is in a quixotic position and some of the tantalizing issues of surreptitious drug administration, informed consent, the newer laws enacted or being enacted, narcoanalysis and drug trials will be discussed with pragmatic solutions offered to a disinterested regulator.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
When it's the Time to Switch the Therapeutic Approach on Electroconvulsive Therapy for Residual Positive Symptoms in Schizophrenia?
Authors: Nechifor I. , Nita N. , Buzut M.
Published: June 2017

Introduction

Schizophrenia is clearly one of the most debilitating diseases. Luckily, in the past 20 years, there has been a wide and good change in symptomatology due to the new atypical antipsychotics. Still, there are patients who are treatment resistant after different adjustments like switching or adding antipsychotics. Most of the clinicians consider Clozapine the “last resort”. But what if it doesn’t work so well on some patients?

Objective

To determine the point when it's time to try electroconvulsive therapy in schizophrenia treatment-resistant patients or remain on conventional approach.

Aims

The aim of this work is to determine whether it's better for those patients who have residual positive symptoms to use oral/depot antipsychotics or to switch on electroconvulsive therapy.

Methods

This work presents the case of the patient C.D., 35 years, diagnosed with paranoid schizophrenia since 2008. Risperidone, Olanzapine, Aripiprazole were introduced during time, with some improvement on the positive symptomatology, but the patient developed several side-effects. At his last admission in our hospital, he came after a suicidal attempt caused by high anxiety and depression due to his false beliefs. Clozapine was introduced, but after one month of treatment, the patient still had the belief that his neighbours want to harm him somehow.

Results

The patient and his mother definitively refused electroconvulsive therapy because of their personal beliefs. He affirmed that he can live with this “low-dose” of suspiciousness which, unfortunately, had a negative impact on his social life.

Conclusions

We still recommend electroconvulsive therapy in these situations, even though, there are many misconceptions regarding this approach.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Linguistic Validation of a Battery for Measurement of Affirming Attitudes about Mental Illness
Authors: Saguem B. , Romdhane A. Ben , Ali B. Ben Hadj
Published: June 2017

Introduction

Stigma restrains the life opportunities of individuals with serious mental illness. This study aimed at performing a linguistic validation of a battery for measurement of affirming attitudes; a battery that might be used to test the impact of anti-stigma and socially inclusive programs.

Methods

Three measures were considered: the Recovery Scale, Empowerment Scale and Self-Determination Scale. Two native Arabic speakers, bilingual in English, independently translated the original measures into Arabic. A collaborative pooled version of the questionnaires was then obtained from the two translations. The pooled version was back-translated into English by a professional translator. A draft Arabic version of the battery was obtained from the comparison between the original questionnaires and the back-translation and was tested on 30 Arabic-speaking medical students. We also discussed the existence of other wording that enables the meaning of statements to be expressed clearly.

Results

The test of the different items allowed the detection of three typing errors. It also highlighted mistranslating two terms to one term that does not distinguish between them in term of the meaning: “Goal” and “Purpose”. Comments were reported on the wording of certain items in the questionnaire. These comments referred to the problems related to the grammatical and syntactical construction of certain expressions. The translation from English into Tunisian dialect is different from our dialect.

Conclusion

We proposed an Arabic version of a battery of measures that reflect affirming attitudes. This is a step for reliable measures that assess stigma in Arabic countries.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Analysis of Hospital Admissions for Psychiatric Care in Portugal: Results from the SMAILE Study
Authors: Silva M. , Antunes A. , Loureiro A. , Santana P. , Caldas-de-Almeida J. , Cardoso G.
Published: June 2017

Introduction

Evidence shows that the prevalence and severity of mental disorders and the need for psychiatric admission is influenced by socio-demographic and contextual factors.

Objectives

To characterize the severity of hospital admissions for psychiatric care due to common mental disorders and psychosis in Portugal.

Aims

This retrospective study analyses all acute psychiatric admissions for common mental disorders and psychosis in four Portuguese departments of psychiatry in the metropolitan areas of Lisbon and Porto, and investigates the association of their severity with socio-demographic and clinical factors.

Methods

Socio-demographic and clinical variables were obtained from the clinical charts of psychiatric admissions in 2002, 2007 and 2012 (n = 2621). The number of hospital admissions per year (>1) and the length of hospital stay (31 days) were defined as measures of hospital admission severity. Logistic regression analysis was used to assess which socio-demographic and clinical factors were associated with both hospital admission severity outcomes.

Results

Results showed different predictors for each outcome. Being widowed, low level of education, being retired, having psychiatric co-morbidity, and a compulsory admission were statistically associated (P < 0.05) with a higher number of hospital admissions. Being single or widowed, being retired, a diagnosis of psychosis, and a compulsory admission were associated with higher length of hospital stay, while having suicidal ideation was associated with a lower length of hospital stay.

Conclusions

Socio-demographic and clinical characteristics of the patients are determinants of hospital admissions for psychiatric care and of their severity.

Funding Fundação para a Ciência e Tecnologia (FCT), Portugal.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Psychosocial Interventions to Improve the Quality of Life for Men with Prostate Cancer: A Network Meta-analysis of 31 Randomized Controlled Trials
Authors: Qiu S. , Linghui D.
Published: June 2017

Background

The treatment of prostate cancer (PCa) can trigger a sequence of life-altering decisions that can induce depression and effects on health-related quality of life. We aimed to simultaneously compare all available psychosocial interventions using both direct and indirect data.

Methods

In this systematic review and network meta-analysis, we searched the Embase, Medline, PsycINFO, and the Cochrane central register of controlled trials for randomized controlled trials (RCT) published before Oct, 2016, that compared active treatments dealing with psychosocial problems in PCa patients after treatment. The primary outcome was health-related quality of life improvement as measured by the 36-Item Short-Form Health Survey (SF-36). Psychological morbidity was assessed with the Hospital Anxiety and Depression Scale (HADS). This study is registered with PROSPERO, number CRD42016049621.

Results

We screened 113 potentially eligible studies and identified 31 RCTs, that examined 7 psychosocial interventions in 3643 PCa participants. In terms of SF-36, cognitive behavioral therapy [standard mean difference (SMD) 2·48, credible interval [CrI] 0.23 to 4.46], group based counseling (SMD 1·36, CrI 0·40 to 3·17) had significantly greater effects than usual care. Participants assigned to all assessed interventions had a significantly improvement in depression compared with usual care, except for those assigned to psychoeducational therapy (SMD 0.02, 95% CrI -0.11 to 0.15).

Conclusion

This review shows that cognitive behavioral therapy, group based counseling and exercise may have significant beneficial effects considering SF-36 and HADS when compared with usual care. However, additional well-done research studies are necessary to establish the role of psychosocial interventions in men with PCa.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Confirmatory Factor Analysis of NEO-FFI-20 in a Portuguese Sample
Authors: Dourado J.F. , Pereira A.T. , Marques C. , Azevedo J. , Nogueira V. , Macedo A. , Bastos Silva A.M.C. , Seco A.J.M.
Published: June 2017

Introduction

The Five-Factor Model organizes human personality traits under a comprehensive framework of five dimensions–neuroticism, extraversion, openness to experience, agreeableness and conscientiousness. The dimensions are empirical generalizations of enduring differences in behavioural, emotional and cognitive patterns between individuals. The Portuguese version of the NEO-Five Factor Inventory (NEO-FFI-20) is increasingly used as it is the shortest version to evaluate the “Big 5”.

Objective

To investigate the reliability and the validity of the Portuguese version of NEO-FFI-20-item (Bertoquini & Pais Ribeiro) in a Portuguese sample, using exploratory and confirmatory factor analysis (EFA and CFA).

Methods

747 participants [417 (55.8%) women; mean age = 42.13 ± 12.349 years] answered an online survey which included the NEO-FFI-20 and socio-demographic questions. The total sample was randomly divided in two sub-samples (sample A, n = 373; sample B, n = 374). Sample A was used to EFA and sample B was used to CFA.

Results

The Portuguese version of NEO-FFI-20, excluding items 14 and 16, had an acceptable fit to the data (χ2/df = 2.28; TLI = .88; CFI = .90; RMSEA = .06; P = .059). The internal consistency analysis resulted in: Neuroticism, α = .68; Extraversion, α = .62; Openness to Experience, α = .74; Agreeableness, α = .70; and Conscientiousness, α = .74.

Conclusions

The NEO-FFI-20 can be used to reliably and validly evaluate the BIG FIVE in an ongoing research project on traffic psychology to better understand and respond to risky behaviours on the road.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Psychological Defense Mechanisms in Patients with Different Forms of Essential Hypertension
Authors: Pervichko E. , Zinchenko Y.
Published: June 2017

Introduction

Essential hypertension (EH) is one of the most common diseases of the cardiovascular system. Today scientists discover more and more patients whose blood pressure values during work appear to be higher than those values during free time. This form of EH is called “hypertension at work”.

Objectives

To indicate psychological defense mechanisms in patients with “hypertension at work”, as compared with ‘classical’ EH and healthy individuals.

Materials and methods

Defense mechanisms were evaluated by the survey “The Life Style Index”. Eighty-five patients with ‘Hypertension at work’ (mean age was 45.9 ± 2.8) and 85 patients with ‘classical’ EH (mean age was 47.4 ± 4.5 years) took part in the study.

Results

The results showed the dominance of low level psychological defences. The most common mechanisms were denial, projection and regression. More mature defense processes included reaction formation and rationalization. The patients with ‘Hypertension at work’ significantly (P < 0.05) differs from second group by more frequent representation of displacement, denial, projection and reaction formation. Comprehensive interpretation of our findings suggested that affection of EH patients (specifically ‘Hypertension at work’) can be characterized by dominance of negative emotions and aggressive tendencies which would be projected, denied or suppressed. Such a complex of defense mechanisms is typical for those, who knows, based on own experience, that uncontrolled negative emotional reactions could be unsafe in social environment.

Conclusions

Our findings can be considered as a basis to define a “risk group” amongst EH patients by an attribute of “emotional well-being” disorder and to develop psychological recommendations for them.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Evaluation of Sleeping Profile in Schizophrenia Patients Treated with Paliperidone-Extended Release: Result From an Open Labeled Perspective Study in South East Asia (Perfect Study)
Authors: Kongsakon R.
Published: June 2017

Objective

To evaluate the impact of treatment with paliperidone extended release for 6 months on sleeping profile in schizophrenia patients.

Methods

A total of 984 patients meeting the DSM-IV criteria for schizophrenia who switched their antipsychotics to be paliperidone ER were recruited from 61 sites in five countries in Southeast Asia. We assessed patients in terms of demographic profile, sleep quality and daytime drowsiness as visual analog scale.

Results

Patients in our studies received paliperidone ER treatment for 6 months. About 70% completed the treatment. Sleep quality and also daytime drowsiness were significantly increased in patients compared with their baseline. The predictive factors that have effect on sleep profile improvement were completion of the study and baseline PANSS score.

Conclusion

Patients receiving paliperidone ER were found to have improvement in sleep quality and also improvement in daytime drowsiness, especially in patients within completion group and the higher baseline PANSS score.

Disclosure of interest

The author has not supplied his/her declaration of competing interest.
The Role of Cannabinoids in Schizophrenia: Where Have we Been and Where are we Going?
Authors: Reis J. , Pereira G.
Published: June 2017

Introduction

Several studies have shown that both endocannabinoid system (ECS) and synthetic cannabinoids (SC) might be involved in schizophrenia.

Objectives

To review recent literature on the role of cannabinoids in schizophrenia. The review includes the evidence of cannabis use as a risk factor for the development of schizophrenia, but also the preliminary evidence for the use of cannabinoid-based compounds in the treatment of psychosis.

Methods

The authors made an online search on PubMed for clinical trials and reviews published in the last 12 months, using the keywords: “cannabinoids”, “endocannabinoids”, “phytocannabinoids” and “schizophrenia”.

Results

The use of Cannabis sativa is associated with increased risk of developing psychotic disorders, including schizophrenia, and earlier age at onset of psychosis. Δ9-Tetrahydrocannabinol (THC) has multiple actions in the brain development, including impairment of neuroplasticity, dysregulation of dopamine and glutamate signaling, and, possibly, neurotoxicity. The ECS has been implicated in psychosis both related and unrelated to cannabis exposure. Cannabinoid receptors type 1 (CB1 R) and type 2 (CB2 R), as well as the endogenous ligand N-arachidonoylethanolamine (AEA) and 2-arachidonylglycerol (2-AG) levels, are most likely to be involved in the pathophysiology of this disorder. On the other hand, the antipsychotic effects of some cannabinoids have been investigated in recent studies. Cannabidiol (CBD) and Δ9-tetrahydrocannabivarin (THCV) may have therapeutic potential for the treatment of psychosis.

Conclusions

Emerging evidence suggests an important role of ECB system and SC on schizophrenia. On the other hand, recent studies have shown some phytocannabinoids might represent therapeutic promises in this disorder.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Interaction of Symptoms and Cognitive Dysfunction in Remitted Schizophrenic Patients With and Without Residua – Important Sign of Heterogeneity for Design of Cognitive Enhancer Studies
Authors: Rupchev G. , Morozova M. , Burminskiy D.
Published: June 2017

Introduction

It is well-known fact that cognitive dysfunction (CD) determines the quality of remission in patients with schizophrenia. However many attempts to demonstrate the link between symptoms and CD failed. The reason for this fact is unclear.

Objectives

Heterogeneity on basis of the important sign jeopardizes the signal detection.

Aims

Assessment of interaction between clinical symptoms and CD in schizophrenic patients in remission with and without residual psychotic symptoms (RPS).

Methods

Adult schizophrenic patients in remission with and without RPS (DSM 295.30) on stable treatment not less than 6 months were assessed with PANSS, CGI, BACS. The indices of the testing were compared between groups. The correlation analysis was performed. The correlation was considered significant if R > 0.60.

Results

Ten females and 34 males were divided into two groups according to presence (27 patients) or absence (17 patients) of RPS (PANSS items P1 and P3 > 2 but < 5). The severity of symptoms and CD were equal in both groups, excluding P6 (P = 0.0005), P20 (P = 0.007), P23 (P = 0.0004), and positive subscale PANSS (P = 0.00001). In the group without RPS, we found that CGI score, scores of 10 items of PANSS, scores of PANSS subscales, excluding negative subscale, and total PANSS score highly negatively correlated with total BACS score (average R = –0.70 ± 10). In the group of patients with RPS, no correlations were found.

Conclusions

Patients with RPS has clinical significant dissociation of psychic and cognitive functioning that should be considered in planning, and assessing of results of cognitive enhancers studies.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Devaluation Towards People With Schizophrenia in Italian Medical, Nursing, and Psychology Students
Authors: Sideli L. , Verdina A.U. , Seminerio F. , Barone M.V. , La Cascia C. , Sartorio C. , Mule A. , Guccione C. , La Barbera D.
Published: June 2017

Introduction

Discrimination towards people with schizophrenia (PWS) by healthcare professionals is responsible of underdiagnosis and undertreatment of these patients. Negative attitudes toward PSW in health care professionals tend to be present since their university studies and are related to their knowledge and experience about the disease.

Objectives and aims

To assess opinion towards PSW in medical, nursing and psychology students and to investigate the relation with their knowledge of schizophrenia and its causes.

Methods

The study involved 133 medical, 200 nursing and 296 psychology undergraduate students. The opinion on mental illness questionnaire, the Devaluation Consumers Scale, and the Devaluation of Consumer Families Scale were administered to the sample. ANOVA and ANCOVA were used to test differences between groups and the relation between causal explanation of schizophrenia and discrimination towards PWS.

Results

Psychology students were more aware than the other student of public stigma towards PWS and their families (F 12.57, P < 0.001; F 32.69, P < 0.001) and expressed a more positive view on treatments’ effectiveness (F 30.74, P < 0.001). Psychology (OR 0.48, 95% CI 0.26–0.88) and nursing (OR 0.29, 95% CI 0.15–0.55) students were more likely to identify psychological and social risk factors as more frequent causes of schizophrenia (vs. biogenetics) and these, in turn, were related to a better opinion towards social equality of PWS.

Conclusions

These preliminary findings underline the relevance of biopsychosocial model of schizophrenia within stigma-reduction programs for health science students.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Structural Covariance Networks in Anorexia Nervosa (AN): A Multimodal Graph Theoretical Analysis
Authors: Collantoni E. , Meneguzzo P. , Tenconi E. , Manara R. , Santonastaso P. , Favaro A.
Published: June 2017

Introduction

The possibility of evaluating cortical morphological and structural features on the basis of their covariance patterns is becoming increasingly important in clinical neuroscience, because their organizational principles reveal an inter-regional structural dependence which derive from a complex mixture of developmental, genetic and environmental factors.

Objectives

In this study, we describe cortical network organization in anorexia nervosa using a MRI morpho-structural covariance analysis based on cortical thickness, gyrification and fractal dimension.

Aim

Aim of the research is to evaluate any alterations in structural network properties measured with graph theory from multi-modal imaging data in AN.

Methods

Thirty-eight patients with acute AN, 38 healthy controls and 20 patients in full remission from AN underwent MRI scanning. Surface extraction was completed using FreeSurfer package. Graph analysis was performed using graph analysis toolbox.

Results

In acute patients, the covariance analysis among cortical thickness values showed a more segregated pattern and a reduction of global integration indexes. In the recovered patients group, we noticed a similar global trend without statistically significant differences for any single parameter. According to gyrification indexes, the covariance network showed a trend towards high segregation both in acute and recovered patients. We did not observe any significant difference in the covariance networks in the analysis of fractal dimension.

Conclusions

The presence of increased segregation properties in cortical covariance networks in AN may be determined by a retardation of neurodevelopmental trajectories or by an energy saving adaptive response. The differences between the analyzed parameters likely depend on their different morpho-functional meanings.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Tracking Insomnia Seasonal Variations Through Consumption of Hypnotics
Authors: Gradiški I.P. , Bilić P. , Sabo T. , Vilibić M.
Published: June 2017

Introduction

Light-stimulated release of melanopsin suppresses the nocturnal production of melatonin and is sending signals to multiple brain areas, including hypothalamic suprachiasmatic nuclei and thus controlling the release of the pineal hormone melatonin and therefore control the circadian rhythm. Consumption of sedatives and hypnotics was used as an indirect measure of seasonal variations in sleep disturbances among inpatients at University Psychiatric Hospital Vrapče.

Methods

Retrograde record analysis was performed from 1st January to 31st December 2012 on commonly used hypnotics and sedatives: zolpidem, nitrazepam, flurazepam, and midazolam.

Results

The lowest consumption of hypnotics was recorded in the months of November, August and September while the highest consumption was recorded in January, December and March which can be seen in Fig. 1. Although there were differences in the monthly prescription of hypnotics, when it comes to seasonal patterns, there are no statistically significant differences.

Conclusions

There is no significant difference between the consumption of hypnotics in the observed seasons although the consumption of hypnotics is higher in the months with shorter daylight. This study attempted to correlate exposure to light and insomnia through the prescription of hypnotics and it is possible there are other important variables not included in this study.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Association between Internet addiction and depression in medical students, faculty of medicine in Thailand
Authors: Kuladee S. , Boonvisudhi T.
Published: June 2017

Introduction

Internet addiction has become a harmful behavioral problem found to be highly prevalent in high school and college students. Many studies demonstrated significantly association between Internet addiction and depression.

Aims

To study the prevalence of Internet addiction and the association between internet addiction and depression in medical students, faculty of medicine, Ramathibodi hospital.

Methods

A cross-sectional study was conducted. Participants were the first to fifth-year medical students who agreed to participate in this study. Demographic characteristics were derived from self-rated questionnaire and were analyzed by descriptive statistics. Thai version of Young's Internet Addiction Diagnostic Questionnaire and Thai version of Patient Health Questionnaire (PHQ-9) were used to assess internet addiction and depression, then Chi2 test and logistic regression were used to analyze the associations between internet addiction, depression and associated factors.

Results

From 705 participants, 24.5% had internet addiction and 29.0% had depression. There was statistically significant association between Internet addiction and depression (odd ratio: 1.92; 95% confidence interval [CI]: 1.34–2.77, P-value < 0.000). Logistic regression analysis illustrated that the Internet addiction group had risk of depression 1.58 times higher than the group without Internet addiction (95% CI: 1.04-2.38; P-value < 0.031). Academic problem was found to be a significant predictor of both Internet addiction and depression. Furthermore, Internet addiction, relationship problems with friend and lover, and health problem were also significant predictors of depression.

Conclusions

Internet addiction was common psychiatric problem which associated with depression among medical students. We suggest that surveillance of Internet addiction should be considered in medical schools.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Evaluation of the cardiovascular disease risk of the psychiatric inpatients of a university hospital by using Framingham risk score
Authors: Tas Durmus P. , Kose Cınar R. , Sonmez M.B. , Gorgulu Y. , Ozkan N.
Published: June 2017

Introduction

According to literature, the patients with severe mental disorder have higher cardiovascular disease risk than the normal population.

Objectives

The current study based on the assumption that elevated inflammatory markers may be related to cardiovascular disease risk in psychiatric patient population.

Aims

This study is aimed to define the relation between the inflammatory reactant, C-reactive protein levels and 10-year risk of coronary heart disease according to Framingham risk score (FRS).

Methods

A total of 204 patients (106 female–98 male) who admitted to the psychiatric service between March and November 2015 and diagnosed with major depression, bipolar disorder and psychotic disorder were included in the study. Participants were evaluated by their gender, age, body mass index, waist circumference, high density lipoprotein levels, total cholesterol levels, systolic and diastolic blood pressures, diabetes comorbidity and CRP levels.

Results

Ten-year risk of cardiovascular disease was found significantly higher at males than females (P < 0.001). There was no correlation between the FRS and the CRP levels which is an acute phase reactant and a contributer of atherogenesis (P = 0.763). However, mean values of CRP levels were determined as 0.59 ± 0.07 mg/dL for females and 0.56 ± 0.07 mg/dL for males. These levels are both high compared to the normal value which is up to 0.34 mg/dL. There was also a remarkable correlation between FRS scores and waist circumference (P = 0.012).

Conclusions

Framingham risk score can be used to detect cardiovascular disease risk and can be helpful in management of pharmacotherapy of the high-risk population.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
The eating disorders iceberg: Emotional deregulation and impulsivity lay below
Authors: Valente S. , Di Girolamo G. , Cerrato F. , Vannucci L. , De Ronchi D. , Atti A.R.
Published: June 2017

Introduction

Eating disorders (ED) and personality disorders (PD) are often interplayed in every-day clinical practice. Less is known on patient's emotional deregulation and impulsivity.

Aims

To investigate whether clinical features of ED and PD correspond to a specific impulsivity and emotional background pattern.

Objective

ED, PD, impulsivity and emotional regulation.

Methods

A group of outpatients with ED (n = 39) was compared to a group of healthy controls (n = 40) by means of semi-structured interviews and standardized questionnaires (BIS-11, DERS, Eat-26, SCID-II and STAI), in order to evaluate association between clinical features (ED and PD) and altered impulsivity or/and emotion regulation.

Results

Seventy-five percent of ED cases matched also diagnostic criteria for PD. Cluster B diagnoses occurred more frequently in Bulimia Nervosa (BN) and Binge eating disorders (BED) whereas Cluster C PD was strongly associated with restrictive anorexia (AN-R) (P < 0.001). BIS-11 scores were significantly higher in cluster B as compared to cluster C PD (P = 0.019). People with PD have a significantly higher DERS score compared to people without (P < 0.001). Mean DERS scores were similar in BN, BED and AN Binge purging (AN-BP) but lower in AN-R (P < 0.001).

Conclusions

ED is an iceberg top, of a three-step ladder. The intermediate step is built of personality traits and disorders forging the variety of ED clinical expressions. The hidden base of iceberg is represented by both the emotional (de)regulation and the level of impulsivity. Therapies focused on the base of this iceberg are needed for a clinical resolution of eating symptoms.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Benefits of antidepressant treatment after a stroke
Authors: Zerriaa O. , Moula O. , Ben Saadi S. , Jelalia I. , Ghachem R.
Published: June 2017

Introduction

Stroke is an important cause of morbidity and is responsible for 9% of all deaths worldwide. The most frequent neuropsychiatric consequence of stroke is post-stroke depression (PSD). It has been shown to be associated with both impaired recovery and increased mortality. The aim of our study is to determine the benefits of antidepressant prescription after a stroke.

Method

The databases from Medline and PubMed were reviewed for articles related to post-stroke depression (PSD), antidepressant treatment and stroke, post-stroke depression and functional recovery, stroke related impairment.

Results

Antidepressant drugs have been shown to be effective in treating PSD in six double blind randomized studies. Patients treated with antidepressants had better recovery from disability than patients who did not receive antidepressant therapy: it was proved that antidepressant drugs cause an improvement in cognitive skills and functional recovery in PSD patients. In patients with ischemic stroke and moderate to severe motor deficit, the early prescription of fluoxetine with physiotherapy enhanced motor recovery after 3 months. Some studies showed that PSD can be effectively prevented: nortriptyline, fluoxetine, milnacipran and sertraline appeared to be efficacious in preventing depression after stroke and are to use without significant adverse effects in stroke patients.

Conclusion

Antidepressant treatment plays an increasing role in the management of patients with acute stroke. Therefore, early initiation of antidepressant therapy, in non-depressed stroke patients, may reduce the odds for development of PSD, and improve cognitive and functional recovery.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
The development of an abbreviated version of the Cornell scale for depression in dementia (CSDD) for the assessment of depression in palliative care inpatients
Authors: Mohamad M. , Davis B. , Twomey F. , Lucey M. , Conroy M. , Adamis D. , Meagher D.
Published: June 2017

Introduction

In the palliative care setting, accurate identification of depression is important to allow delivery of appropriate treatments.

Aims:

– 1. To assess rates of depression in palliative care inpatients using the CSDD, comparing with formal clinical diagnosis based on diagnostic and statistical manual of mental disorders (DSM-IV) criteria;

– 2. To identify items of the CSDD that most distinguish depressive illness in a palliative care setting.

Methods

We measured rates of depression in patients admitted into a palliative care inpatient unit with the CSDD. DSM-IV clinical diagnosis of major depressive disorder (MDD) was achieved using all available clinical information by an experienced independent rater. We calculated Cohen's Kappa to measure concordance between the CSDD and DSM-IV diagnosis.

Results

We assessed 142 patients (56.3% male; mean age: 69.6 years), the majority of which had a cancer diagnosis (93.7%). 18.3% (n = 26) met DSM-IV criteria for MDD, while 12% scored ≥6 on the CSDD with 15 cases of depression common to these two methods (K = 0.65). Discriminant analysis identified five CSDD items that were especially distinguishing of MDD; sadness, loss of interest, pessimism, lack of reactivity to pleasant events and appetite loss. An abbreviated version of the CSDD, based on these 5 items, proved highly accurate in identifying DSM-IV MDD (AUC = 0.94), with sensitivity of 89% and specificity of 84% at a cut-off score ≥2.

Conclusions

There was good level of concordance between the CSDD and DSM-IV diagnosis of MDD. We identified five depressive symptoms that are especially discriminating for depression in palliative care patients.

Disclosure of interest

The authors have not supplied their declaration of competing interest.