bluuebunny/crossref_metadata_2025 huggingface dataset:
Is empathy correlated to patients’ level of cognitive impairment in schizophrenia?
Authors: Trabelsi R. , Arous A. , Mrizak J. , Ben Ammar H. , Khalifa A. , El Hechmi Z.
Published: May 2016

Introduction

Empathy, which refers to the ability to understand and share the thoughts and feelings of others, may be compromised in schizophrenia (SCZ). Yet the relationship between empathy and neurocognitive functioning remains unclear.

Objectives

To explore whether cognitive and affective empathy are associated with the neurocognitive functioning in SCZ.

Methods

Fifty-eight outpatients with stable SCZ completed the Questionnaire of Cognitive and Affective Empathy (QCAE) comprising five subscales intended to assess cognitive and affective components of empathy. They also completed a neurocognitive battery comprising the following tests: the Hopkins Verbal Learning Test–Revised (HVLT-R), the Letter Digit Substitution Test (LDST), the Stroop Test (ST), the “Double Barrage” of Zazzo (DBZ), the Modified Card Sorting Test (MCST), Verbal Fluency (VF), the Trail Making Test-Part A (TMT-A) and the Digit Span (DS).

Results

Better affective and cognitive empathy correlated with better performance in the ST (less hesitations and less errors). Patients with better cognitive empathy performed better in the MCST (more categories achieved; P = 0.029) and in the LDST (more substitutions per minute; P = 0.031).

Conclusions

Our results bolster support for the presence of an association between NF and the decreased cognitive and affective empathy in schizophrenia.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Erotomania and mood disorder: A case report and literature review
Authors: Guillard V. , Mallet J. , Limosin F.
Published: May 2016

Introduction

Erotomania is a rare delusional disorder. De Clerambault, a French psychiatrist, was the first who advanced the concept of pure erotomania, one of the “passionate psychosis”, as a distinct disorder. However, some authors tend to consider this syndrome as related to other psychiatric disorders.

Objectives

To describe the case of a female patient with erotomanic delusion with no remission under an antipsychotic and to review the links between erotomania and other psychiatric disorders.

Methods

Literature review and a case report.

Results

We report the case of a 32 year-old epileptic woman, hospitalized for a delusional erotomanic disorder. Initially, the patient was treated with an antipsychotic, with partial effectiveness. In fact, it appeared that the conviction of being loved began while she was depressed. After one month of combined antipsychotic and antidepressive medication, she became euthymic and her erotomanic delusions disappeared. Major depressive disorder with psychotic symptoms was diagnosed. After reviewing the literature we found that erotomanic symptoms frequently appear secondarily in other psychiatric disorders. Several publications indicate a frequent association between erotomania and mood disorder, especially bipolar affective disorder and major depression, and describe the efficacy of antidepressant and mood stabilizers. Numerous theories may explain the link between erotomania and mood disorder: from narcissistic needs, to the capacity of empathy and emotional processing. Further studies are needed to clarify the nature of this link.

Conclusion

In clinical practice, a mood disorder must systematically be searched for and treated in a patient with erotomanic delusions.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Substance abuse and quality of life in chronic hepatitis C patients receiving antiviral treatment
Authors: Egmond E. , Oriolo G. , Cavero M. , Langohr K. , Solà R. , Navines R. , Martin-Santos R.
Published: May 2016

Introduction

Chronic hepatitis C virus (HCV) is one of world's most important chronic infections. HCV can be treated using interferon-alpha (IFNα) and ribavirin (RBV). HCV, IFNα and RBV are known to impair mental and physical life quality. Many HCV-infected individuals have life-prevalence of substance use disorder (SUD).

Objectives

To study life quality (SF-36) in HCV patients with SUD history during antiviral treatment.

Methods

SF-36 questionnaire was assessed in 384 HCV patients at baseline, and at 4, 12, 24, and 48 weeks of treatment. ANCOVA models were used to study the association of SF-36 scores and potential risk factors at baseline. Risk factors from baseline scores over time were studied through linear mixed models, adjusting for baseline scores.

Results

At baseline, SUD men had worse mental (P = 0.03) and physical health (P = 0.022), and younger patients had worse social functioning (P = 0.011), and mental (P = 0.001) but better physical health (P < 0.001). Figs. 1 and 2 show the results of mental and physical life quality during treatment from baseline.

Conclusions

This study emphasizes the decrease in life quality in HCV patients with SUD before and during antiviral treatment.

Grant

Instituto de Carlos III-FIS: PSICOCIT-PI110/01827,EU “One way to make Europe”, Ministerio de Economia y Competitividad (MTM2012-38067-C02-01), and support of SGR/2014/1135.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Can I have a quality seizure? A review
Authors: Ramos J. , Arriba A. , Urretavizcaya M.
Published: May 2016

Introduction

After seventy-five years of its introduction, electroconvulsive therapy (ECT) remains the most effective treatment for severe depressive disorders. It is known that the antidepressant effect is not due only to the electric current itself, but by the general seizure activity. As so, for beneficial or adverse effects of ECTs, it's mainly important to induct a well-generalized seizure. Those can be influence by several variables like, seizure duration and threshold, ECT practice factors and medication, resulting in a lack efficacy. It's advantageous to treatment if physiological markers of adequacy are established to seizure quality, because a high seizure quality has been successfully correlated with better outcome in many studies.

Aims and methods

The aim of this work is to review the available international literature regarding to identified parameters that influence and evidence seizure quality.

Conclusion

Although throughout history ECT is embroiled in controversy, according to international bibliography, this is a technique of great therapeutic relevance and precise indications. It is noteworthy, that it has been shown to be an effective and safe treatment for many psychiatric disorders. Nevertheless, there is not a consensus regarding to the parameters to its efficacy, particularly the seizure quality. Thus, it's important to current practice, to do more studies in this field, in order to establish those parameters, have homogenise clinical practice and promote better results.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Placebo and placebo effect, variability of the clinical response according to the therapists’ behavior
Authors: Soler Iborte A. , Galiano Rus S. , López Díaz Á.
Published: May 2016

Introduction

From a historical perspective, the first data related to the placebo effect on “mental health” date to the 1950s decade, when evidence was first shown of the important percentage of people with a psychiatric pathology that benefited from the consumption of placebos. It is believed that the responses to placebos and nocebos are influenced by the content and the way of informing the patient, which influences in the quality of life and therapy adherence. Among the factors that influence the magnitude of the placebo effect, we find variables related to the patient, with the placebo itself and the therapist.

Objectives

To determine the relationship between the clinical response of a placebo and the behavior and information on the placebo contributed by the health worker.

Methodology

Systemic review of the articles published in Medline-PubMed from 2005 to the present.

Results

Being kind, friendly, interested, nice, emphatic, and considerate as well as having a positive attitude toward the patient and the treatment as well as the expectations of the therapist are variables that are associated to a beneficial effect in a placebo situation as well as in active treatment.

Conclusion

The patient's expectations, a product of selective processing of the information that she/he receives about the effect of a placebo or active treatment, and the behavior of the health worker in clinical practice, produces variability in the symptomatic response through its influence on the magnitude of the placebo effect. In the bibliography reviewed, there is a marked lack of attention dedicated to clinical studies in the addressing of this phenomenon.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Comparing gaze related anxiety in adult subjects with autism spectrum disorder (ASD) or social anxiety disorder (SAD)
Authors: Jouni A. , Amestoy A. , Bouvard M.
Published: May 2016

Social anxiety is frequently reported by individuals with ASD. If atypical eye gaze in ASD can not be fully explained by emotional models, a subgroup seems to present an active gaze avoidance associated with the report of social anxiety symptoms. The main objective of our study was to examine the gaze related anxiety in a population of adults with ASD compared with what's observed in adults with SAD. The purpose was to confirm the experience of social anxiety for some individuals with ASD and quantify its impact on gaze functioning. We included adult patients diagnosed with ASD without intellectual disability (n = 13) or SAD (n = 11) from three outpatient clinics. Patients were divided in two groups, ASD and SAD, and filled three clinical scales: Gaze Anxiety Rating Scale (GARS, Schneier et al., 2011), Liebowitz Social Anxiety Scale (LSAS, Liebowitz et al., 1999), and Social responsiveness Scale-2 (SRS-2, Constantino et al., 2003). Patients with ASD presented higher scores on SRS-2 (M [SD]: 73.5 [8.9] vs 52.4 [10.4]; P < 0.001) and lower on LSAS (M [SD]: 58.6 (32.1) vs 83.8 [22.8]; P < 0.05) but no difference on GARS scores compared to people with SAD. Furthermore, a sub-group of ASD patients, presenting with more social anxiety, reported greater gaze related anxiety and avoidance than other patients with ASD (M [SD]: 57.8 (20.5) vs 19.4 [23.5]; P < 0.05). Social anxiety can be present in ASD with an impact on gaze functioning. The SRS-2 and LSAS seem to be efficient differentiating anxiety from social ability deficits and maybe useful to guide patients toward a specialised evaluation.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
A meta-analysis on the longitudinal relationship between eating pathology and depression
Authors: Puccio F. , Fuller-Tyszkiewicz M. , Ong D. , Krug I.
Published: May 2016

Background

Despite the considerable number of studies that have assessed evidence for a longitudinal relationship between eating pathology and depression, there is no clear consensus regarding whether they are uni- or bi-directionally related.

Objective

To undertake a meta-analysis to provide a quantitative synthesis of longitudinal studies that assessed the direction of effects between eating pathology and depression. A second aim was to use meta-regression to account for heterogeneity in terms of study-level effect modifiers.

Results

Meta-analysis results on 30 eligible studies showed that eating pathology was a risk factor for depression (rm = 0.13, 95% CI: 0.09 to 0.17, P < 0.001), and that depression was a risk factor for eating pathology (rm = 0.16, 95% CI: 0.10 to 0.22, P < 0.001). Meta-regression analyses showed that these effects were significantly stronger for studies that operationalized eating pathology as an eating disorder diagnosis versus eating pathology symptoms (P < 0.05), and for studies that operationalized the respective outcome measure as a categorical variable (e.g., a diagnosis of a disorder or where symptoms were “present”/“absent”) versus a continuous measure (P < 0.01). Results also showed that in relation to eating pathology type, the effect of an eating disorder diagnosis (b = −0.06, t = −7.304, P ≤ 0.001) and bulimic symptoms (b = −0.006, t = −2.388, P < 0.05) on depression was significantly stronger for younger participants.

Conclusions

Eating pathology and depression are concurrent risk factors for each other, suggesting that future research would benefit from identifying factors that are etiological to the development of both constructs.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Punding in Parkinson's disease: To a better understanding of a common phenomenon between Parkinson's disease and addictions
Authors: Tremey A. , de Chazeron I. , Brousse G. , Llorca P.M.
Published: May 2016

Introduction

Punding is a stereotypical motor behaviour characterized by a repetitive, excessive and non-goal oriented activity that causes an important loss of time. Since its first description in psychostimulant addicts, data on punding has only derived from studies on Parkinsonian patients treated with dopaminergic drugs. Little is known in the literature about Parkinsonian patient's characteristics who suffer from punding.

Objective

We propose to study characteristics of Parkinsonian “punders” in order to investigate the pathophysiology of this phenomenon.

Methods

In this retrospective study, we use the “Ardouin Scale of Behavior in Parkinson's disease” database. This database was initially used to design a global scale to detect changes in mood and behavior of Parkinson's disease (PD) patients. We compared different variables between Parkinsonian patients who suffer from punding with non-punder Parkinsonian patients.

Results

Eighty of the 258 patients were identified as punders. In univariate analysis, the punder and non-punder groups differed statistically with regard to the age of diagnostic of PD, hypersexuality and dopaminergic agonist treatment. In multivariate analysis, the punder and non-punder groups only differed statistically with regard to dopaminergic agonist treatment (P = 0.05).

Conclusion

Dopaminergic agonist treatments appear to be more represented among patients with punding in our sample. Impulse control disorders (ICD) are known to be more common in patients treated by dopamine agonists. Punding could be considered as the most severe form of ICD that is linked to psychomotor stimulation and reward mechanisms.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Descriptive study of hypothyroidism in an acute psychiatric unit in Barcelona
Authors: Hurtado G. , Carrió E. , Palomo A.L. , Campillo M. , Mateu G. , Farre A. , Marti J. , Sanchez R. , Fortuny J.R.
Published: May 2016

Introduction

Behavioural, psychological and cognitive disturbance have been associated with hypothyroidism, even it has been suggested that this symptoms may remain despite adequate replacement therapy with thyroxine.

Objective

To describe prevalence, sociodemographics and clinical features of patients with hypothyroidism in an acute psychiatric unit.

Aims

To know about the relation between hypothyroidism and psychiatric symptoms.

Methods

Data base collection of all patients admitted between 2010 and 2014 in the acute unit of our psychiatric hospital in Barcelona, was analyzed using SPSS program.

Results

In all 3.1% of the 4536 total patients had hypothyroidism. Among them, 46% were duplicate cases. Mean age was 53 ± 14.27 years. A total of 82.7% were woman. Patients having a TSH lower than 0.30 were 12%, TSH normal were 60.2%, TSH higher than 5 were 27.8%. Most frequent Levothyroxine dosage was: 75 μg (22.1%), 100 μg (19%), 25 μg (12.5%) and 125 μg (12.5%). Diagnosis more frequently associated with hypothyroidism was: Bipolar (26.5%), Schizophrenia (20%), Depression (15.1%), Unspecified psychosis (10%), Personality disorder (10%), Schizoaffective disorder (7.2%), Paranoia 4.3%.

Conclusion

Most of patients were stable of thyroid condition when had been admitted to our hospital. Hypothyroidism could be a relapse factor, even when treatment is adequate. Affective disorders are more frequently related with hypothyroidism (lithium has to be consider a confounding factor).

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Burnout among Portuguese oncology healthcare providers – Differences between pediatric an adult teams
Authors: Gonçalves R. , Ferreira J.M.V.D. , Araújo C. , Gonçalves M. , Pedroso S. , Pinho C.
Published: May 2016

Introduction

Burnout is characterized by emotional exhaustion, depersonalization and reduced personal accomplishment, resulting from the inability to cope with chronic job stress. The literature suggests that staffs working in adult oncology are at risk of burnout. At the same time, research found that pediatric staff experiences a different set of stressors when compared with colleagues working in adult oncology. However, no studies were identified which directly compared prevalence and sources of Burn-out on pediatric and adult oncology staff.

Objectives

To compare the differences on prevalence and sources of burnout between pediatric and adult oncology multidisciplinary teams.

Methods

Pediatric and adult oncology professionals, including medical and nursing from a Portuguese oncology center completed the Portuguese version of the Copenhagen Burnout Inventory. Data was analyzed using SPSS.

Results

Since the study is currently ongoing the authors will only be able to provide final results and conclusions by the time of submission of our work presentation, in March 2016. However, according to the literature available, we are expecting to found symptoms of Burnout in the superior limit of normality, with differences in the major sources of stress between adult and pediatric professionals.

Conclusion

The differences in the challenges experienced by adult and pediatric teams highlight the importance of adequate prevention strategies to specific needs of each unit. Further investigation of stress across a wider range of professional disciplines is required in order to explore this gap.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
The syndrome of irreversible lithium-effectuated neurotoxicity: Clinical case and review
Authors: Leite F. , Salgado H. , Viveiros S. , Coya P.
Published: May 2016

Introduction

Lithium is a mood stabilizer used in the treatment of bipolar disorder. Lithium has recently been associated to permanent neurological damage namely persistent cerebelar dysfunction as well as peripheral and central neuropathies.

Objectives

To present a clinical case of a probable Syndrome of Irreversible Lithium-effectuated Neurotoxicity (SILENT) and a review of the literature concerning this rare syndrome.

Aims

Increase awareness and knowledge of SILENT.

Methods

Psychiatric and psychological evaluation of a probable clinical case of SILENT and review of the literature using the key words “lithium neurotoxicity” and “Syndrome of Irreversible Lithium-effectuated Neurotoxicity”.

Results

A 54-year-old female patient was admitted in our hospital due to involuntary lithium intoxication, with acute renal and cardiovascular failure, neurological, metabolic and electrolytic dysfunction in an acute confusional state and in need of dialysis. The patient clinical picture rapidly improved although, when she achieved normal lithium seric levels, it was observed a worsening of the preexisting confusional state followed by two consecutive generalized tonic-clonic convulsions and a partial convulsion. A short time after, it was recognized the development of a persistent catatonic state. It was detected urinary incontinence and repetitive, monosyllabic, incoherent, short phrased speech featuring echolalia, together with emotional lability and incongruous affect. The patient slightly improved with the introduction of anti-Parkinson's pharmacotherapy.

Conclusions

This clinical case raises several differential diagnoses due to its psychiatric and neurologic characteristics. We conclude that the most probable diagnosis is SILENT.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Living with Parkinson disease – the central role of primary care physicians and a multidisciplinary approach
Authors: Oliveira M. , Marinho M. , Santos C.
Published: May 2016

Introduction

Parkinson disease is a frequent neurodegenerative disorder. Presence of psychopathology is well described in this illness, nevertheless the etiology is still unknown.

Methods and aims

The authors present a clinical case of a patient with idiopathic Parkinson disease with depressive symptoms after the decline of his functioning. We aim to emphasize the importance of a multidisciplinary approach and the central role of general physicians in screening these situations.

Results

The patient is a male with 64 years old, reformed with a personal history of hypertension. With 62 years old he started with mild motor complaints that got worse over time, culminating after a year and half on him being almost dependant for most of his daily activities. He also started to express feelings of sadness, despair, and recurrent thoughts of death. He refused to seek out medical help, but was convinced by his wife to consult his general physician that observed the patient and referenced him to Neurology and Psychiatry consultations. He also started sertraline 50 mg/day. He was diagnosed with Parkinson disease and started medication with ropinirole, levodopa and carbidopa with a good response. In Psychiatry consultation the dose of sertraline was increased to 100 mg/day with improvement, and it was provided information on the disease to the patient and family and also supportive psychotherapy.

Conclusions

General physicians have a privileged position on screening patients with psychopathology when other physical conditions or illnesses are present. The fast and correct referencing of these patients can improve the prognosis.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
How do obese people eat?
Authors: Felix-Alcantara M.P. , Perez-Templado J. , Banzo-Arguis C. , Martínez de Velasco R. , Ruiz-Velasco E. , Quintero J.
Published: May 2016

Introduction

The recently published DSM-5 defines Eating Disorders (ED) as “a persistent alteration in the food supply or food-related behavior leading to an alteration in the consumption or absorption of food and cause a significant deterioration in health or psychosocial functioning” and, nevertheless, it does not include obesity as an ED due to the lack of enough evidence to include it. However, everyday more evidence supports that disordered eating could be a significant factor, at least, in development and maintenance of obesity.

Objectives

Describe the eating behavior of a 180 obese sample.

Methods

One hundred and eighty patients with obesity that went to the endocrinology service in order to lose weight are referred to the Psychiatry department to be assessed. To explore the eating behavior it was administered the Bulimic Investigatory Test of Edinburgh, BITE.

Results

A total of 68.7% of patients showed a disordered eating pattern, 71.6% tend to eat a lot when feeling anxious, 63.8% eat rapidly large amounts of food, 72.8% worry about not to have control over how much eat, 40.5% consider that their pattern of eating severely disrupt their life, 40.7% eat sensibly in front of others and make up in private, 59.1% cannot stop eating when they want to and 58.3% admit binges of large amounts of food.

Conclusions

Most of our patients showed a pattern of disordered eating, and then our findings support the idea of disordered eating as a significant factor in the development and maintenance of obesity. Therefore, obesity requires a multidisciplinary approach that goes beyond the traditional nutritional guidance.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
The relationship of perfectionism with changes in body dissatisfaction in eating disorders treatment outcome
Authors: Rodriguez Cano T. , Beato Fernandez L. , Mata Saenz B. , Rojo Moreno L. , Vaz Leal F.J.
Published: May 2016

Introduction

Body dissatisfaction is one of the core psychopathological components in Eating Disorders (EDs) and it tends to persist over time regardless treatment interventions. Perfectionism is considered as a mediator and moderator between body dissatisfaction and disordered eating.

Objectives

To study the influence of Perfectionism in EDs outcome.

Aims

To analyze changes in body dissatisfaction at one year follow-up in patients with eating disorders and the effect of perfectionism over these changes.

Methods

Participants were 151 patients with eating disorders. DSM-IVTR diagnoses were as follows: 44 (29.1%) Anorexia Nervosa (AN), 55 (36.4%) Bulimia Nervosa (BN) and 52 (34.4%) Eating Disorders no Otherwise Specified (EDNOS). Perfectionism was assessed with the Edinburg Investigatory Test (EDI-2). The Body Shape Questionnaire (BSQ) was also distributed. One year after the beginning of their treatment, patients were reassessed.

Results

Patients with BN showed significantly higher scores on BSQ than those with AN. There was a significant improvement in BSQ after one year of treatment regardless the diagnostic (repeated measures ANOVA: F 8.4, P<.01). Perfectionism was a co-variable that influenced in those changes.

Conclusions

The results confirm the interaction between perfectionism and body dissatisfaction in the treatment outcome of EDs. It has been described an interplay between Perfectionism, body dissatisfaction and disordered eating attitudes and behaviours, being Perfectionism a moderator factor. The results highlight the need of dealing not only with the core symptoms of EDs, but also with the moderator factors such as Perfectionism to enhance the outcome.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Eating disorders: What has the society to do with it?
Authors: Wimmer-Puchinger B. , Blahout S. , Waldherr K.
Published: May 2016

The prevention of eating disorders is a main concern of the Vienna Women's Health Programme, which was adopted by the Vienna City Council in 1998. Eating disorders are very serious mental health problems in adolescence. There is evidence that media exposure of the thin ideal body image leads to uncertainty, low self-esteem and dieting. To examine the current state of body (dis-)satisfaction and the risk of eating disorders among Viennese adolescents, we surveyed 1427 participants at the age of 12 to 17, using a self-assessment questionnaire that included the Eating Disorder Inventory (EDI-2), the SCOFF-questionnaire and the Rosenberg self-esteem scale. Results support our hypothesis. The highest concern among adolescents is about their weight and body shape. 76% of the girls surveyed wanted a skinny body, 31% were afraid of gaining weight, and 32% have already been dieting - 13% took appetite suppressants, 5% used vomiting, 3% took laxatives. According to the SCOFF-questionnaire, 30% of the girls were at risk of having eating disorders. Trends were evaluated via regression analysis. In 2012 girls used less dieting and had lower scores in the EDI-2 subscales ‘body dissatisfaction’, ‘drive for thinness’ and ‘bulimia’ than in 2001. Boys had less conspicuous scores than girls in total, but have shown an alarming increase in body dissatisfaction. School prevention programmes are indicated to enhance media literacy and encourage self-esteem among adolescents. To be successful, an interdisciplinary approach has to be established. The City of Vienna has already launched several awareness campaigns to counter unhealthy body ideals.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Lessons from a Balint group scheme led by psychiatry trainees for year 3 bristol medical students on their medicine/surgery placements
Authors: Wood K. , Kothari A. , Malone J.
Published: May 2016

Background

The UK General Medical Council highlights the centrality of effective communication, reflective practice and the doctor-patient relationship in medical practice. A decline in empathy has been documented as occurring within clinical and early postgraduate years, potentially affecting diagnostic processes and patient engagement. Access to Balint groups can enhance awareness of the patient beyond the medical model, but remains limited at many UK medical schools. This scheme offered Balint groups to Bristol medical students in their first clinical year, demonstrating that this method is relevant beyond psychiatry.

Methods

Initial focus groups with medical students indicated that many felt unable to discuss distressing aspects of clinical encounters. During 2013-2014, a Balint scheme run by psychiatry trainees was started for 150 students in their psychiatry placements. During 2014-15, the scheme was introduced to all third-year medical students on their medicine/surgery placement. Balint leaders have group supervision with a psychoanalytic psychotherapist. Evaluation of the scheme was based on pre-and post-group questionnaires and leaders’ process notes.

Results

Sixteen groups led by 12 trainees were run twice over the year to serve 246 medical students. Two example cases are discussed here. Students appreciated the chance to discuss complex encounters with patients in a supportive peer environment, and work through a range of emotionally challenging issues.

Conclusions

Novel aspects of this work include the implementation of Balint groups within medicine and surgery placements; the enrolment of psychiatry trainees as leaders with group supervision and leadership training workshops from the UK Balint Society; and the scale of the scheme.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Survivors of gender-based violence and role of official psychiatry in recovery process
Authors: Molchanova E.
Published: May 2016

Consequences of events in the Southern region of the Kyrgyz Republic continue to have impact on communities to the present day. One of the most significant is a number of undiagnosed cases of rapes and other types of gender-based violence (GBV), which happened during the events of 2010. Accurate prevalence rates of GBV cases is still unknown. According to official data of Ministry of Internal Affairs, there were only seven cases of rape, however, according to the crisis center reports, there were 325. Even more alarming, witnesses of the Osh events suggest one out of three women in Osh and Jalal-Abad were either raped or suffered from other types of GBV. Those acts included undressing and unveiling, and cutting women's hair to a shamelessly short length. Cultural stereotypes dictate women hide their ‘shame’, which is why only a small percentage of victims with PTSD symptoms that developed after GBV sought out services from professionals, such as from crisis centers, psychologists and psychiatrists and, of course, police. Author analyzed several cases of women raped during the Osh massacre and suffered from PTSD signs afterwards. The previous painful experience of GBV was uncovered during treatment. The problem is that mental heath care specialists are the last stop for applying for help. This paper analyses several ways of solving the problem, including creating a number of normative documents in collaboration with Ministry of Internal Affairs and Ministry of Health of the Kyrgyz Republic.

Disclosure of interest

The author has not supplied his/her declaration of competing interest.
Type A personality and its association with mortality: Considering different analysis approaches of the Bortner Scale
Authors: Lohse T. , Faeh D. , Bopp M. , Rohrmann S.
Published: May 2016

Introduction

Type A behaviour pattern (TABP) is defined as the combination of competitive need for achievement, sense of time urgency, aggressiveness, and hostility. Studies raised evidence for an association between TABP and cardiovascular disease. Recent studies on its association with mortality showed contradicting results and used different methods to measure TABP.

Objectives/aims

Investigating the association between TABP and all-cause, CVD, and all-cancer mortality.

Methods

We used data of the MONICA and the NRP1A studies that were linked with the Swiss National Cohort (SNC) (n = 7997). Essentially, the SNC is an anonymous record linkage of census, migration and mortality data. TABP was measured by the Bortner Scale. To determine the all-cause, CVD, and cancer mortality risk a Cox regression was performed. Following Edwards et al. (1990), we analysed the Bortner Scale in two different ways: all items and its two dimensions (speed and competitiveness) separately.

Results

We found a significant association of the Bortner Scale with all-cause mortality in women (adjusted for sociodemographic factors HR 1.02, 95% CI 1.00–1.03, additionally adjusted for lifestyle factors–smoking, alcohol intake, physical activity, BMI category–1.01, 1.00–1.03). The subscale of competitiveness was associated with all-cause and CVD mortality in women. Interestingly, stratifying for lifestyle variables revealed that the association was only present in those having a healthy lifestyle, e.g. non-smoking or non-hazardous alcohol intake.

Conclusions

The Bortner Scale and its subscale of competitiveness were associated with mortality in women. In those having great health awareness, this might offer potential for further reduction of mortality risk.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Descriptive epidemiology of depressive and anxiety disorders, cognitive impairment and dementia in a sample of elderly patients in the geriatric unity of a general hospital
Authors: Pater A. , Espolio Desbaillet Y. , Peris D.
Published: May 2016

Introduction

Studies have demonstrated the high prevalence of depressive disorders amongst elderly people and their underestimation and mistreatment.

Objective

The aim of this study is to describe epidemiological issues in a sample of elderly hospitalized patients, giving special attention on the prevalence of depressive and anxiety disorders and the detection of potential risk factors.

Material and methods

The sample included 168 elderly patients referred for the geriatric unit of a general hospital. Epidemiological and clinical data were collected. Geriatric Depression Scale (GDS), Mini Mental State Examination (MMSE) and Functional Independence Measure (FIM™) were used. Data were analyzed with XLSTAT program.

Results

The 39% of the sample were men and the 61% women, with an age range between 65 and 95 years. Nine percent of patients aged 65–84 had a diagnosis of depressive or anxious-depressive disorder, compared to 13% within the age range 85–95. However, 14% of patients aged 65–85 had a GDS higher than 5 and 19% for the patients aged 85–95, which could confirm the underestimated rate of depression diagnosed in elderly patients. Item “feeling loneliness” was pointed out in 75% and item “feeling bored” in 64% of all GDS higher than 5. Prevalence of dementia was 8% in the whole sample.

Conclusions

High prevalence of depressive and anxious disorders amongst the elderly is to be taken in account. Potential risk factors could be loneliness and lack of daily activity. The development of social primary prevention interventions in order to decrease the prevalence of these pathologies amongst elderly is needed.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Making sense of economic deprivation as a predictor of suicide and homicide: A nationwide register-study
Authors: Pompili M. , Vichi M.
Published: May 2016

Introduction

Classical work on lethal aggression often viewed suicide and homicide as sharing a common source.

Objective

The present investigation explores the association between measures of social deprivation on the relative incidence of suicide over homicide in Italian provinces.

Methods

Data refer to official government sources on lethal violence rates and measures of social deprivation. The central dependent variable is termed SHR or the suicide rate expressed as a proportion of the sum of the suicide and homicide rates Data were available for the 103 Italian provinces.

Results

The SHR had three significant predictors. The greater the percentage of the population with low education, the lesser the tendency towards suicide. The tendency towards suicide was also predicted by rental housing, the greater the percentage of the population living in rental housing the less the tendency towards suicide. The inverse of the unemployment rate also predicted the SHR. Given that the measure follows an inverse function, the greater the unemployment rate the lesser the tendency towards suicide relative to homicide (SHR). We can interpret the results relative to a homicidal tendency in the SHR: the greater the low education percentage of the population, the greater the homicidal tendency, and the greater the rental housing percentage, the greater the homicidal tendency in the SHR.

Conclusion

The results are consistent with a stream of previous research that connects deprivation with a relatively high probability for disadvantaged populations to direct aggression outwardly in the form of homicide rather than inwardly in the form of suicide.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Structure and function of social networks, loneliness, and their association with mental disorders among older men and women in Ireland: A prospective community-based study
Authors: Santini Z. , Fiori K.L. , Tyrovolas S. , Haro J.M. , Feeney J. , Koyanagi A.
Published: May 2016

Introduction

Interpersonal stressors and social isolation are detrimental for emotional health, but how these factors are related to loneliness and altogether influence risk for mental disorders is not well understood.

Objectives

To examine the mediating role of loneliness in the associations of relationship quality and social networks with depressive symptoms, anxiety, and worry among a sample of Irish men and women in late-life.

Aims

To determine the gender-specific risk for mental disorder associated with poor social relationships and loneliness among older adults.

Methods

Data came from the Irish Longitudinal Study on Ageing (TILDA). Nationally representative data on 6105 community-dwelling adults aged > 50 years were analyzed. Follow-up data was obtained two years after cohort inception. Multivariable linear regressions and mediation analyses were used to assess the associations. Analyses were stratified by gender.

Results

Better spousal relationship quality was protective against depressive symptoms and worry for men. For both genders, support from friends was protective against depressive symptoms, and better relationship quality with children was protective against depressive symptoms and worry. Social network integration was inversely related to depressive symptoms for men. Loneliness significantly mediated most associations (Tables 1–3).

Conclusions

High quality spousal relationships and social integration appear to play a more central role for mental health among men than for women. For both genders, poor social relationships increase feelings of loneliness, which in turn worsens mental health. Interventions to improve relationship quality and social networks, with a focus on reducing loneliness, may be beneficial for the prevention of mental disorders among older adults.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Burden of care among relatives of people with dementia attending tertiary care in Oman
Authors: Al Maqbali M. , A-Sinawi H.
Published: May 2016

Introduction

Providing care to people with dementia is a stressful experience and has been associated with high burden of care. Such issue has been under-researched in Arabic/Islamic parts of the world.

Aims and objectives

The aim of this study is to determine the degree of burden of care among caregivers of people with dementia attending the Old-Age clinic, Sultan Qaboos University Hospital, Oman.

Methods

Fifty patients with dementia and their primary care caregivers were included in the study. The diagnosis of dementia was based on DSM 5 criteria and the severity was rated according to the Global Deterioration Scale for Assessment of Primary Degenerative Dementia and Clinical Dementia Rating. Level of dependency was measured using the Katz Index of Independence in Activities of Daily Living (ADL) and Lawton Instrumental Activities of Daily Living (IADL) Scale. For the caregivers, burden of care was determined by Zarit Burden Interview (ZBI).

Results

The majority of caregivers were adult children (90%) who are supported by other relatives. Overall, 70% of caregivers demonstrated high degree of burden as quantified by ZBI. Factors such as patient's age, duration and severity of dementia, level of dependency and female gender of the caregiver were associated with higher burden.

Conclusion

Burden is common among dementia caregivers and several factors interplay to influence the perceived stress. As increased burden was evidenced to be associated with higher incidence of mental disorders, screening and early intervention will impact positively on the caregiver as well as the patient.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Cognitive deterioration and depressive symptoms in elderly people living in the community
Authors: García Mahía M.D.C. , Fernández Quintana Á. , Vidal Millares M.
Published: May 2016

Introduction

Depression is a prevalent illness in elderly people. Cognitive deterioration associated to depressive symptoms is frequently considered as Dementia, especially in primary care. The study of the relation between both pathologies is necessary to correct treatment of mental illness in elderly people.

Aims

The aim of this study is to investigate whether depressive symptoms are related to certain areas of cognitive decline in elderly people.

Methods

The sample included community people older than 65 years (n = 927), mean age 72.9; 55.1% were women and 44,9% men. Instruments used were Beck Depression Inventory (BDI), Blessed Dementia Scale (BDS), Mini Mental State Examination (MMSE), verbal fluency test, clock drawing task, Wechsler digit substitution test and Wechsler similarity test.

Results

Of the sample, 15,2% presented cognitive deterioration in Blessed Dementia Scale, with statistical significance in relation between growing age, female sex and cognitive deterioration (P < 0.005). Twenty-eight percent of the sample present cognitive decline, finding the same relation between sex, age and cognitive condition. Of the sample, 33.5% presented mild depression, 9.1% moderate depression and 1.4% presented severe depression using BDI. Correlations between depression and cognitive tests were analyzed. In demographic factors, social support was significantly correlated with depression but marital status, occupation and education were not correlated.

Conclusions

There is a high prevalence of depressive symptoms and cognitive deterioration in elderly people. High levels of depressive symptoms are associated with cognitive deterioration, especially in comprehension and judgment, delayed recall, verbal memory and visuospacial coordination in elderly people.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Efficacy of memantine for elderly patients in the mild stage of Alzheimer's and vascular dementia in Ukraine
Authors: Kholin V. , Bachinskaya N. , Rozhelijuk I.
Published: May 2016

The aim of our research was to investigate the effectiveness of memantine treatment of Ukrainian patients with Alzheimer's (AD) and vascular dementia (VaD) depending on existing ApoE genotype.

Methods

It was a complex examination of 60 elderly persons (72.40 ± 1.35 years) with mild stage of AD and VD. The effectiveness of response to (20 mg/day) memantine intake was studied during the first 3 months of treatment. Efficacy of short-term treatment was determined by MMSE and the numbers of positive statistically significant changes ADAS-cog subtests. Genetic ApoE polymorphism was investigated too (using the of the PCR technique). Statistical Anova analysis was done.

Results

After 3 months of treatment significant changes in the overall score of Adas-cog was observed in both groups with some differences in subscale profiles. For AD patients, statistically positive changes (P < 0.05) were found in comprehension of spoken language, naming objects, commands, ideational praxis and delayed recall subtests. For VaD patients, statistically positive changes (P < 0.05) were found in comprehension of spoken language, naming objects, word finding difficulty and delayed recall subtests. There was established a significant prevalence of individuals with genotype ɛ4/ɛ4 among patients with AD compared with patients with VD. The main differences, according to the memantine efficacy treatment in carriers ApoE3 and ApoE4 genotypes, were in remembering test instructions subtest.

Conclusions

The memantine treatment efficacy in AD and VaD patients in mild stage of dementia was not significantly associated with an existing of Apo-E genotype polymorphism.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Effectiveness and cost-effectiveness of a cardiovascular risk prediction algorithm for people with severe mental illness
Authors: Zomer E. , Osborn D. , Nazareth I. , Blackburn R. , Burton A. , Hardoon S. , Holt R.I.G. , King M. , Marston L. , Morris S. , Omar R. , Petersen I. , Walters K. , Hunter R.M.
Published: May 2016

Introduction

Cardiovascular risk prediction tools are important for cardiovascular disease (CVD) prevention, however, which algorithms are appropriate for people with severe mental illness (SMI) is unclear.

Objectives/aims

To determine the cost-effectiveness using the net monetary benefit (NMB) approach of two bespoke SMI-specific risk algorithms compared to standard risk algorithms for primary CVD prevention in those with SMI, from an NHS perspective.

Methods

A microsimulation model was populated with 1000 individuals with SMI from The Health Improvement Network Database, aged 30–74 years without CVD. Four cardiovascular risk algorithms were assessed; (1) general population lipid, (2) general population BMI, (3) SMI-specific lipid and (4) SMI-specific BMI, compared against no algorithm. At baseline, each cardiovascular risk algorithm was applied and those high-risk (> 10%) were assumed to be prescribed statin therapy, others received usual care. Individuals entered the model in a ‘healthy’ free of CVD health state and with each year could retain their current health state, have cardiovascular events (non-fatal/fatal) or die from other causes according to transition probabilities.

Results

The SMI-specific BMI and general population lipid algorithms had the highest NMB of the four algorithms resulting in 12 additional QALYs and a cost saving of approximately £37,000 (US$ 58,000) per 1000 patients with SMI over 10 years.

Conclusions

The general population lipid and SMI-specific BMI algorithms performed equally well. The ease and acceptability of use of a SMI-specific BMI algorithm (blood tests not required) makes it an attractive algorithm to implement in clinical settings.

Disclosure of interest

The authors have not supplied their declaration of competing interest.