bluuebunny/crossref_metadata_2025 huggingface dataset:
Assessment of cognitive profile (WISC-IV), autistic symptomatology and pragmatic disorders in high intellectual potential compared with autism spectrum disorder
Authors: Boschi A. , Planche P. , Philippe A. , Vaivre-douret L.
Published: May 2016

Introduction

An overlap between autism spectrum disorder (ASD), in particular Asperger Syndrome (AS), and high intellectual potential (HIP–Total IQ > 2 SD) is often discussed.

Objectives

Explore differences between homogeneous and heterogeneous Wisc-profiles among HIP children, and between HIP and ASD children, on cognitive and clinical assessments.

Methods

Forty-nine participants (mean age 11.2 years) were divided in 4 groups: High Functioning Autism (HFA), AS, Homogenous HIP and Heterogeneous HIP. Data of WISC-IV and questionnaires – Autism Quotient (AQ), Empathy Quotient (EQ), Systemizing Quotient (SQ), Children's Communication Checklist (CCC) – were compared.

(Preliminary) Results

On the WISC-IV, the Z scores curves follow similar trajectories but highlight quantitative differences between AS and heterogeneous HIP: verbal comprehension is the highest index (+1,6 SD in AS; +3,1 SD in heterogeneous HIP) followed by perceptual reasoning, working memory, and processing speed indexes (–1,2 SD in AS; +0,5 SD in heterogeneous HIP), respectively. The questionnaires show that scores of Homogenous HIP children are all in the average. Heterogeneous HIP children score 2,1 SD above average on the AQ (+1,6 SD on “Social Skills” and +1,3 SD on “Local Detail” subscales), whereas ASD children score 4 SD above average on the AQ. In addition, heterogeneous HIP children show pragmatic difficulties (–2,4 SD on the CCC, with a peak on “Area of Interest” subscale), also present in ASD children (–4 SD).

Conclusions

AS and heterogeneous HIP children show similar cognitive profiles on the WISC-IV. Furthermore, heterogeneous HIP children exhibit high scores on the AQ and have pragmatic difficulties.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
The Sedation Could Consist in a Therapeutic Strategy in Advanced Cancer Conditions
Authors: Tamarindo A. , Vogel C. , Hida G. , Malheiros D. , Ropero J. , Taniguchi S.
Published: May 2016

Introduction

The sedation could consist in a therapeutic strategy in advanced cancer conditions.

Objective

To study the drugs administered to patients under Palliative Care Sedation (PCS) audits effects on vital signs.

Methods

Our retrospective study included 101 oncological patients with mean age of 66.5 ± 13.4 years old and mean weight of 48.5 ± 3.36 kg, under PCS. The data were analysed applying the test of Wilcoxon.

Results

The drugs administered to these patients under PCS were morphine 55 mg/kg/day associated to midazolam 52.5 mg/kg/day (Morph/Midazo) or the association of morphine 55 mg/kg/day, midazolam 52.5 mg/kg/day and neuroleptics such as chlorpromazine 54.5 mg/kg/day or haloperidol 13.25 mg/kg/day (Morph/Midazo/Neurol). The values of vital signs of these patients when the sedation was initiated were: systolic blood pressure 116.55 ± 16.98 mmHg, diastolic bloodpressure73.17 ± 10.55 mmHg, heart rate 83.41 ± 16.25bpm, respiratory rate 19.39 ± 3.97 rpm and body temperature 35.91 ± 0.57 °C. No significant differences between these groups were observed. Vital signs measures were collected 48 hours before the patient's death. Significant reduction in systolic blood pressure 77.5 mmHg, diastolic blood pressure 43.3 mmHg were observed in the group (Morph/Benzo/Neurol). The Wilcoxon test for independent samples to a significance level of 5% we obtain a P-value of 0.01. The sedation period was 2.56 ± 0.23 days.

Conclusion

Neuroleptic, a central nervous system (CNS) depressant drug, when associated to other two depressants (morphine/midazolam), conducted to the patient's vital signs reduction.

Considering the short period of time between the beginning of sedation and the patients’ death; and that palliative sedation should not include the hastening of patients’ death, we suggest a better drug association criteria.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Differentiating Between Bipolar Affective Disorder (Bd) and Borderline Personality Disorder (BPD) – a Clinical Case
Authors: Ballesteros A. , Petcu A. , Cortés B. , Montes L. , Inchausti F. , Jaimes W. , Collantes J. , Zubizarreta B.
Published: May 2016

Introduction

Recent studies suggest that Borderline Personality Disorder (BPD) could be regarded as an affective disorder within the Bipolar Affective Disorder (BP) spectrum. This is supported by evidence suggesting a clinical/neurobiological overlap between these two disorders. The Temperament and Character Inventory Revised (TCI-R) may help differentiate between the two disorders and orientate the clinical approach, considering the evidence of the medium-term temporal stability of TCI-R in a clinical population.

Objective

We present a clinical case diagnosed with BD which underwent testing using TCI-R. TCI-R orientated towards a secondary diagnosis of BPD and the case further received a course of Dialectical Behavior Therapy (DBT) which led to clinical improvement. We therefore study the usefulness of TCI-R in this clinical setting.

Aims

To study whether TCI-R may help differentiate between BD and BPD in mood stabilized patients.

Method

Our patient is a 52-year-old married male diagnosed with BD. Considering his clinical features of impulsivity/instability of behaviors and pathological interpersonal relationships, patient was started on individual DBT (fortnightly, 4 months). Psychotropic treatment (paroxetine 30 mg/day, lithium 1000 mg/day, aripiprazole 15 mg/day) was not modified.

Results

TCI-R scores: harm avoidance (100%), novelty seeking (53%), reward dependence (20%), persistence (18%), self-directedness (1%), cooperativeness (2%) and self-transcendence (48%). After 4 months of therapy, the patient improved in distress tolerance, acceptance, behavioral activation and assertiveness.

Conclusions

TCI-R is an inventory for personality traits in which character scores differ markedly between PD and non-PD patients. It is a useful tool in BPD patients orientating the clinician in the differential diagnosis and the treatment approach.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Influence of Temperamental and Character Traits on Antidepressant Response in Patients Affected by Major Depressive Disorder
Authors: Prisco V. , Di Puorto C. , Fabrazzo M.
Published: May 2016

Several studies have been conducted to evaluate personality characteristics in patients affected by major depressive disorder. Temperamental and character traits may help clinicians to identify responders to antidepressive therapy. The aim of our study was to evaluate these characteristics as possible predictive indices of response to SSRIs or SNRIs. A cohort of 41 patients was included (30 F and 11 M), whose diagnosis was made according to DSM-IV criteria. Subjects were interviewed using the HAM-D and the HAM-A scale in basal condition (T0) and after 4 weeks (T1) of antidepressive treatment. Patients with a ≥ 50% reduction of HAM-D and HAM-A score, have been considered as responders, when compared to basal conditions. All subjects were in monotherapy and evaluated using the TCI-R scale. In patients affected by major depressive disorder, personality assessment was characterised, from a temperamental point of view, by high levels of Persistence and Reward Dependence and, from a character one, by high levels of Self Directiveness and Cooperativity. After 4 weeks of antidepressive treatment, responders to HAM-D had higher levels of Responsibility versus Guilt, which could be considered as a predictor of positive response to SSRIs or SNRIs. Conversely, responders to HAM-A showed higher values of Responsibility versus Guilt and of Safety versus Fear of uncertainty. These values were predictive of a recovery of anxious sintomatology associated with depressive disorder. Our results are in line with those reported in the literature, indicating that character dimensions “Self Directiveness” and “Cooperativity” could be important predictors of response to antidepressants.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
On The Carlos Castilla Del Pino “Axiom of Behavioral Significance” and Its Relevance in Philosophy of Psychiatry: The Unification of Clinical Neuroscience
Authors: Vargas M.
Published: May 2016

Carlos Castilla del Pino (1922-2009) was a Spanish psychiatrist and essayist with a wide work ranging from neuropsychiatry to social psychiatry. His essays include interesting psychopathological, anthropological and semiotic ideas.

The “axiom of behavioural significance” proposes that human behaviour is not an objective event but a meaningful act. As the objective of human behaviour is relation between human beings, it must be studied only under this communicative perspective.

Based in this axiomatic approach of Castilla del Pino, some arguments of interest to philosophy of psychiatry will be exposed:

– Mind is based in language and language is a communicative acts system in need of a dialogic community, namely, in need of a group of interacting brains. So, referring to the “brains-mind problem” is proposed to be preferred instead of referring to the “brain-mind problem”. Mind is a language-based emergent property of the social group, not a property of a single brain.

– The intention of human behaviour and the content of mental subjective phenomena should not be taken as a sign of any brain disease. Human behavior and mental representations always refers to a social group and a social context, not to a single brain. The only disease indicators we can take as disease signs are the formal aspects of behaviour and mind contents, as disexecutive syndrome or mental automatism are.

– As a corollary, it is proposed that neurology and psychiatry do not have any epistemic difference, leading to defence the unification of clinical neuroscience.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Metamorphosing Histories: The Narrative as a Tool for Psychological Trauma's Recovery
Authors: Becker J.
Published: May 2016

Considering psychological traumatism as a subject in constant discussion, this study approaches the recovery of the patients that suffered violent events. Based on studies about the reflection of disasters and wars, we present trauma as a consequence of the unexpected event from where is originated intense fear. Trauma is a violation, an abruption, which disorganizes and incapacitates the victim. When a violence situation is experienced, the physical and verbal abuses are not alone as the elements that interfere in the trauma's establishment, but also their representations. Thereby, the event that produces trauma is imposed, although its meaning depends of the history and beliefs of the subject. Understanding that the accident's representation is the cause of the trauma's establishment, we introduce the narrative as tool for psychological trauma's recovery, because it allows the victims relive their past and reframe their feelings. Regarding it, we highlight the relevance of the sociocultural context – before, during and after the trauma –, once it has direct influence over the way the person deals with adversities, as it can stimulate or stop a resilience process. This study takes in consideration that resilience is not something static, a faculty that the subject has or not, but a process that can be developed, improved or reduced. Thus, the narrative is presented as essential to initiate a resilience process, empowering the victims to confront the trauma and to rewrite their history and their return to life.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Image of Psychiatric Hospitals Among General Population in 2015, Views From Four Countries
Authors: Fontaine A.
Published: May 2016

Introduction

In recent years, numerous studies about the image of psychiatry have been conducted. However, to our knowledge, a significant part of psychiatry has been very little explored: the vision of psychiatric hospitals (PsH). For instance, “PsH” on google images reveals a long list of frightening pictures of ravaged places.

Objectives/Aims

With such an image spread by the medias, we wanted to evaluate the vision of PsH and treatment modalities among general population in 2015, in 4 countries: France, Spain, England, and Brazil.

Methods

An online survey in 4 languages has been sent via facebook and emails. Two hundred and fifteen responses were collected during September 2015: 178 French, 11 Spanish, 17 Brazilians, 9 English.

Results

Thirty-nine percent of participants consider PsH as a place of care, and 16% as an asylum. There were differences among countries: for example, asylum is more represented in France than Spain. Regarding patients admitted in PsH, they are not all dangerous (90%), nor all irresponsible (94%) and have specifics rights (66%). Concerning diseases: delirium, bipolar disorders, and perversity are to be treated in PsH, while depression, addiction, and autism are to be cured in psychiatric structures other than hospital. Moreover, 2% of participants believe abuses are common practice, whereas a majority consider therapeutic activities instead.

Conclusions

These results are quite different from the studies based on the perception of mental illness and patients. Here, on the overall, they are quite encouraging. So, PsH could lead the path on the improvement of the image of psychiatry.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Acceptability and Feasibility of the Mindfulness Based Program for Infertility (PBMI)
Authors: Galhardo A. , Cunha M. , Pinto-Gouveia J.
Published: May 2016

Introduction

Infertility is described as a low-control stressor that may induce psychopathological symptoms. The Mindfulness Based Program for Infertility (MBPI) is a structured intervention targeting infertile women that aims to cultivate mindfulness and acceptance skills. The MBPI efficacy was tested in 55 infertile women who completed the program and 37 women in a control group. By the end of the MBPI, women who attended the program revealed a significant decrease in depressive symptoms, internal and external shame, entrapment and defeat. Inversely, they showed significant improvement in mindfulness skills and self-efficacy to deal with infertility.

Aims

Determine the MBPI feasibility and acceptability.

Methods

The MBPI includes 10 weekly sessions, in a group format, with the duration of about 2 hours each. Participants’ recruitment was supported by the Portuguese Fertility Association. Fifty-five female participants with an infertility diagnosis who were pursuing medical treatment for infertility completed a questionnaire specifically developed to address the acceptability and satisfaction with the MBPI at the end of the 10th session.

Results

Participants scored as “very useful” most of the MBPI components (mindfulness practice, acceptance skills, values clarification, psychoeducation on stress and fertility-related lifestyle factors), except for the yoga component. The same pattern was found for the utility information, group support, small group exercises, contact with the therapist, progress notes and MBPI materials. The mean score for satisfaction with the therapist knowledge/competence was 9.55 (maximum: 10), the MBPI quality 8.91 and the MBPI global utility 8.95.

Conclusions

The MBPI showed to be feasible and well accepted by participants.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
The Development of Headucate in Mental Health Awareness
Authors: Patel A. , Soundararajan V. , Beezhold J.
Published: May 2016

Introduction

Headucate is a pioneering student-led society at the University of East Anglia (UEA), founded in 2012. Mental health stigma exists widely and is a well-known barrier to accessing support. This presents a need for education and raising awareness about mental illness.

Objectives

The goal is to spread mental health awareness locally, measured by school outreach and events organised. This is achievable through Headucate's collaboration with the university and schools to convey the message each year.

Aims

Headucate aims to raise mental health awareness and tackle stigma, with the intention of reaching the university, schools locally and communities nationally.

Methods

Headucate delivers workshops for secondary schools. This involves interactive sessions to stimulate discussions about mental health and illness, and where to find help. Additionally, there are university-held talks from a variety of guest speakers who are experts in this field.

Results

It has expanded beyond medical students to involve the whole university, with a shared interest in mental health awareness. Research conducted by Headucate in 2014-2015 has indicated there is a statistically significant (P < 0.001) increase in the knowledge about mental illness and knowing where to get help following school workshops.

Conclusions

The success has transformed from starting as an idea into one of UEA's largest student societies which will continue to expand. Future goals include a mental health awareness campaign and collaborating with student groups at the university, to host events that link mental health to other causes. Furthermore, Headucate is hoping to expand outreach to the elderly community.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Hospitalization Durations and Remission Rates of Patients in a Psychiatry Clinic
Authors: Tutuncu R. , Kullakçı H. , Hakan B. , Algul A. , Ates A. , Basoglu C.
Published: May 2016

Objective

The duration of hospitalization is related to many well-documented factors in literature. However, little is known about psychiatric patients and psychiatric service delivery in non-Western developing countries. It is supposed that major contributing factors in discharge are remission rates and functional levels. Therefore, this naturalistic preliminary study aimed at analyzing and describing the hospitalization duration and remission rates of a psychiatric population treated in the mental health inpatient facility.

Methods

A total of 88 male patients, who were hospitalized in a psychiatry clinic were included in the study. They were evaluated at admission and before discharge using the Brief Psychiatric Rating Scale (BPRS) and the Clinic Global Impression Scale (CGI). Other variables, including length of stay, number of previous admissions, demographic characteristics, and diagnosis were also assessed.

Results

Mean of the total scores on BPRS were declined from 24.95 to 13, and the mean CGI scores were declined from 3.85 to 2.04 during hospitalization period. Mean length of hospitalization was 7.91 days.

Conclusion

Our study shows that patients are discharged from the hospital with approximately 50% decrease in symptom severity. Such research can contribute to understand better, the needs of psychiatric patients, and help to develop continuously improved service delivery and optimize therapeutic options.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Depression Among HIV-Infected Patients–A Reality that Must Not be Forgotten
Authors: Marinho M. , Mota-Oliveira M. , Peixoto M.J. , Marques J. , Bragança M.
Published: May 2016

Introduction

HIV-infection is a very stigmatized, chronic disease with increased rates of psychiatric disorders, being major depression the most common.

Objective

To review the recent research related to depression in HIV-infected patients.

Methods

Literature review based on PubMed/Medline, using the keywords “HIV” and “depression”.

Results

HIV-infected patients have a chance 2-7 times higher of developing major depression, around the time of diagnosis or during the course of their illness. However, only fewer than 50% of the cases are recognized clinically. Several factors contribute to its under-recognition and under-treatment, such as the overlap between the neurovegetative symptoms of depression, the somatic symptoms of HIV disease, and the effects of comorbid diseases; the mistaken belief that depressive symptoms are expected in this group; the neuropsychiatric side effects associated with some antiretrovirals. Besides, major depression presents important diagnostic challenges due to biological, psychological, and social components associated with the infection. The authors will analyze the clinical presentation.

Depression has been associated with a negative impact on quality of life, poorer HAART adherence, faster HIV disease progression and increased mortality risk. Importantly, however, appropriate psychiatric intervention can do it over. In fact, studies suggest that patients receiving SSRI treatments for depression have rates of adherence and CD4+ T-cell counts similar to non-depressed patients receiving HAART.

Conclusions

The high prevalence of major depression in HIV-positive individuals and its serious consequences if untreated, increase even further the importance of its effective identification and subsequent treatment in this group of patients.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Neurocognitive deficits underlying attention-deficit/hyperactivity disorder (ADHD): A clustering/subgrouping analysis
Authors: Leung P. , Chan F.
Published: May 2016

Introduction

Neurocognitive deficits are assumed to be underlying the behavioral symptoms of ADHD. Research over the years has identified a host of these neurocognitive deficits, but no single one deficit appears to be dominant or pervasive in all ADHD children. This raises the query whether there can be further subgrouping of ADHD children at the neurocognitive level.

Objectives and aims

This study aims at disentangling the heterogeneous neurocognitive deficits underlying ADHD. To achieve this, we explore if there are separable neurocognitive subgroups in ADHD children.

Methods

One hundred and sixty-four Chinese ADHD boys and 163 typically developing controls, aged 6 to 12, were recruited in Hong Kong. A neurocognitive battery of executive function (EF) measures was administered. Cluster analysis was first conducted to identify subgroups of ADHD children based on their neurocognitive functioning. MANOVA was then employed to further explore the differences between subgroups.

Results

Two ADHD subgroups were identified. One subgroup showed multiple EF deficits, including disinhibition, impaired interference control, distorted temporal information processing, slow processing speed, and delay aversion. The other subgroup, on the contrary, had intact EF but increased response variability. Both subgroups had comparable ADHD phenotypic severity and comorbidity pattern. However, ADHD children in the EF deficits subgroup were more responsive to medication (i.e., methylphenidate).

Conclusion

Results support the neurocognitive heterogeneity of ADHD. EF deficits and response variability are two separable neurocognitive profiles underlying and subgrouping ADHD children of comparable severity. This subgrouping has implication for medication response and offers candidate endophenotypes for neuroimaging and genetic study.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Which Type Of Management Is Most Suited For Patients With A Diagnosis Of False Self Personality (FSP) Within A Psychodynamically-Oriented Institutional Day Hospital? A Study
Authors: Giorgio G. , Marmo F.
Published: May 2016

Introduction

Our work team have already found that our Institutional Psychiatric Open Light Treatment (IPOLT) model allows the patient affected by severe mental illness (SMI) to more easily express her/his personal coping skills rather than behaving passively thanks to the “real free spaces” separating a structured intervention from another. Our work consisted in evaluating how patients with FSP respond to IPOLT.

Objectives

This paper describes observations of psychotic patients operating from the position of FSP in order to evaluate how they respond to IPOLT compared with other patients according to three standards (day hospital attendance, psychotic episodes and hospital admissions).

Aims

Identify the core factors for management of patients with FSP in the context of IPOLT.

Methods

We isolated a sample including patients affected by severe mental illness (SMI); within this sample, we selected a small group of patients with FSP. During the last three years, we have been evaluating patients with FSP in terms of day hospital attendance, number of psychotic episodes and number of hospital admissions compared with data obtained from other patients with SMI without diagnosis of FSP.

Results

The two data sets revealed no statistically significant differences in terms of the three standards.

Conclusions

Our preliminary study showed a good effect for IPOLT treatment on patients with SMI. We expected that patients affected by SMI with FSP would have a different response to IPOLT, but it was not. We do not know whether such results depend on a too small sample of patients or inappropriate descriptors.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Major Depressive Disorder With Psychotic Symptoms in Elderly. A Case Report
Authors: Hernández Sánchez J.M. , Cancino Botello M.C. , Molina Lopez M.F. , Canseco Navarro M.Á. , Arnés González S. , Muñoz Carril M. , Monzó J.A.
Published: May 2016

Introduction

The proportion of elderly people and affective syndromes are more and more common in developed countries. Elderly people have physiological conditions that may limit our intervention.

Objectives

To present a case of a major depressive disorder with psychotic symptoms in a 72-year-old woman.

Methods

Medline search and review of the clinical history and the related literature.

Results

We present the case of a 72-year-old woman with psychiatric history of a major depressive disorder 14 years ago with ad integrum restitution after pharmacological treatment. In 2015, our patient was admitted to the psychiatry ward due to major depressive symptomatology (apathy, anhedonia, global insomnia, weight loss) that associated mood-congruent delusions (nihilistic, ruin, guilt, catastrophic) with deregulated behaviour. The patient was resistant to combined pharmacological treatment with aripiprazole, desvenlafaxine, mirtazapine and lorazepam, therefore, we decided to administer ECT, with successful results after 5 sessions. Brain tomography, blood and urine tests were normal. Clinical signs of dementia were not present.

Conclusions

Inpatients with deregulated behaviour; it is important to rule out organic causes, especially in elderly, in whom dementia, brain tumors or metabolic disturbances may simulate psychiatric syndromes.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Differential Diagnosis Between Schizophrenia and in Major Depression: The Importance of Abnormal Bodily Phenomena
Authors: Mancini M. , Stanghellini G.
Published: May 2016

Introduction

Anomalies of bodily experience have for long been described as relevant features of schizophrenia and major depression, yet such experiences are usually neglected in clinical examination. Bodily experience is the implicit background of our experiences against which we develop a coherent sense of self as a unified, bounded entity, naturally immersed in a social world of meaningful others. Such tacit experiential background is often perturbed in schizophrenia and major depression. Empirical research shows that patients with schizophrenia and major depression frequently present many different kinds of anomalies of bodily experience in the course of their illness.

Objective

To characterize the abnormal bodily phenomena in both schizophrenia and major depression.

Aim

To improve differential diagnosis based on the identification of typical features of abnormal bodily experiences in persons affected by schizophrenia and major depression and to provide supplementary diagnostic criteria.

Method

Analysis of empirical and theoretical research published in the last 25 years.

Result

Ongoing bodily feelings of disintegration/violation and nothingness/mechanization (e.g. one's body experienced as a object-like mechanism) are the most typical experiences in people with schizophrenia whereas major depressives are not able to detach themselves from the experience of bodily failure or chrematization (from chrema = corpse, i.e., feeling like a corpse) and therefore, feel worthless, guilty, or decaying. They feel chrematized in their very self.

Conclusion

These experiences might be considered as specific and they can contribute to differential diagnosis of somatic complaints in schizophrenia and in major depression.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Role of music and non-musical techniques in self-guided emotional regulation
Authors: Mohan R. , Anand N.
Published: May 2016

Introduction

Studies on relationships between music, visual imagery or therapeutic techniques, like mindfulness and emotions have been undertaken with varying success in predominantly adult populations. Their role in the child and adolescent population remains unclear.

Aims and objectives

We undertook a systematic literature review to assess current evidence in the use of music, guided imagery with/without therapeutic techniques for emotional processing in adults, children and adolescents.

Methods

We identified 87 relevant papers (JSTOR, OVID Medline, Cochrane, PubMed, Science Direct, Taylor & Francis and Wiley). We excluded non-English papers and qualitative analyses. Nine studies used quantitative techniques (Neuroimaging) for assessing emotional change using musical and non-musical stimuli (n = 77). Of these, four studies used fMRI and two used PET scans.

Results

fMRI demonstrates a significant relation between amygdalar activation and emotional response to visual imagery (P < 0.05, n = 45). Early information using PET scanning shows a significant association between activation of different parts of brain with varied visual imagery (one study, n = 5) and varied music (one study, n = 10). There is similarity in the activation of specific cortical areas using musical and non-musical stimuli. Two separate studies of patients with damaged amygdala due to disease (n = 6) showed significant impairment of emotional processing and response.

Conclusions

There is early encouraging data providing evidence of possible relationships between music and visual imagery in emotional processing. Further studies are needed to examine these in detail, especially in children/adolescents. Music with visual imagery may be a useful adjunct in the self-guided processing of milder emotional disorders with components of anxiety, depression, adjustment and emotional dysregulation.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Erotomania – A Review of De CléRambault's Syndrome
Authors: Oliveira C. , Alves S. , Ferreira C. , Agostinho C. , Avelino M.J.
Published: May 2016

Introduction

Erotomania (also known as De Clerambault's syndrome) is usually described as a rare delusional syndrome characteristically involving an individual who believes that another person, typically of higher social, economic or political status, is in love with the individual. De Clerambault's syndrome remains a ubiquitous nosological psychiatric entity with uncertain prognosis that remains recognised as a subtype of delusional disorder in DSM 5.

Objectives and aims

To review the history of Erotomania as a nosological psychiatric entity, its clinical characteristics and course. Also to report some selected clinical cases.

Methods

The authors have conducted an online search on PubMed with MeSH words“erotomania”, “erotomaniac delusion” and “Clerambault” and systematically reviewed some case reports.

Results

Erotomania is a relatively uncommon and misunderstood disorder characterised by the presence of a persistent erotic delusion. The individual (usually described as a woman) has had little or no contact with the other person who is perceived as watching over, protecting or following the individual. Despite various authors have described and named this syndrome, it was Clérambault who first classed the symptoms into the disorder he referred to as “psychose Passionelli” (1942). There are numerous theories as to the aetiology of this illness that is not uniquely associated with any specific disorder. We reviewed some clinical cases.

Conclusions

Erotomania is a relatively uncommon psychiatric disorder. An increased awareness and understanding of this illness will assist in the recognition of patients affected, opening doors for future progress on its aetiology and, therefore, the development of new treatment options.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
The delusion of aurora (a structural and dynamic analysis)
Authors: Porta Pelayo D. , López Alonso L.
Published: May 2016

Introduction

The classical authors associate the insanity with delusions, without delusions there was not insanity. This axiom has changed nowadays, and it's also accepted that insanity can exist without delusions.

Aim

We aim to know and describe which factors are involved in the development of the delusion. Use these conclusions to drive the patient to the comprehension and acceptance of the reality.

Objective

(a) Unravel the mechanism of delusion, (b) seek the causes, (c) find out an explanation about the origin and development of the delusional thematic.

Method

Clinical biographic review, carried on in 2 steps: (a) review the delusions store in the Hermanas Hospitalarias Spanish hospitals (17 centres), (b) choose one of them, (c) use the inductive method for analyzing the details and for making conclusions in order to be apply in the delusional process.

Results

(a) Understand the internal dynamic of delusion and how the delusion becomes the main axis of the patient life. (b) The patient finds on the delusion a life motive, which did not exist before.

Conclusion

Paraphrasing Dr.Castilla del Pino, “the delusion is a necessary mistake”. From the emotional point of view, it can be said “the delusion is a cry of a captured heart”.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Kraepelin's ghost: Late onset schizophrenia, dementia (non)praecox, or paraphrenia? (case report)
Authors: Vukovic V. , Nikolić Lalić S. , Voskresenski T. , Jokić S.
Published: May 2016

Introduction

It is difficult to establish whether a patient has late onset schizophrenia or frontotemporal dementia. The object of the following case report is to point out the difficulty of making a differential diagnosis between these two entities.

Case summary

A 49-year-old female patient was admitted to our hospital after presenting with auditory and visual hallucinations, formal thought disorder, persecutory delusions, ideas of reference, insomnia. Memory, executive function and attentional tasks were severely compromised. Computerized tomography showed incipient frontal lobe atrophy. There were no significant abnormalities found in blood and urine samples or physical and neurological examinations. After showing no response to olanzapine, and extrapyramidal side effects to fluphenazine, risperidone was initiated which subsequently led to complete withdrawal of positive symptoms.

Discussion

Patients presenting with psychotic symptoms after the age of 40 presented a diagnostic quandary, as they were less likely to present with negative symptoms, formal thought disorder or affective blunting, and more likely to have systematised delusions and visual hallucinations. Frontotemporal dementia is a disorder that can present itself with cognitive decline and a large range of psychiatric symptoms. The risk of late onset schizophrenia is greater in women, possibly implicating a causative role of female sex hormones. Atypical antipsychotics risperidone and olanzapine seem to be an adequate treatment.

Conclusion

Schizophrenia is a heterogeneous disease with a large variety of clinical manifestations. Special care should be given to patients with age over 40, including neurocognitive assessment, laboratory and hormone tests, and a long-term follow-up.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Assessing quality of life following long-acting injection treatment: 4 cases register
Authors: Calahorro C.M. , Guerrero Jiménez M. , Navarro Barrios J.C.
Published: May 2016

Introduction

Quality of life is defined by the World Health Organization as “Individuals’ perceptions of their position in life in the context of the culture and value systems in which they live, and in relation to their goals, expectations, standards, and concerns.” Schizophrenia is a severe, disabling, lifelong disorder, associated with severe social and occupational dysfunction. Aripiprazole Long Acting Injection (LAI) is indicated for maintenance schizophrenia treatment in adult patients stabilised with oral aripiprazole. It is the fourth second-generation antipsychotic depot formulation approved for treating schizophrenia.

Objectives

Assessing quality of life in 4 patients treated with aripiprazole LAI.

Methods

In this paper, we evaluate of quality of life in 4 subjects with diagnosis of paranoid schizophrenia (less 10 years of diagnostic), male, age between 42 and 50 years, with poor adherence to oral treatment. These patients received aripirazol LAI 400 mg/month. We evaluate quality of life at baseline and after 3 months. We used the Quality of Life Scale (QOLS) and WHO-Quality of Life-Bref (WHOQOL-BREF).

Results

Results demonstrated significant greater improvements in all QLS scores. No significant changes in the WHOQOL-BREF total, but improvement in subscale scores.

Conclusion

Quality of life in schizophrenia is adversely influenced by the presence of clinical symptoms, especially negative and depressive. Depot medications can improve treatment adherence, however, long-term antipsychotic use can lead to irreversible adverse effects (dyskinesias), which in some cases were reduced by using newer antipsychotics (risperidone, paliperidone, aripiprazole). Aripiprazole LAI can be useful to improve quality of life. Further methodologically robust studies are needed to generate evidence-based conclusions.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Antipsychotic medications and cardiometabolic risk – A review of current literature
Authors: Gunturu S. , Shah K. , Korenis P. , Lawler S. , Kucheria M.
Published: May 2016

In the USA, 68% of adults and 31% of children are overweight or obese. Obesity doubles mortality rates and has significant associated medical costs with an average obese person spending $1500 or more per year. In addition, 10% of all adults and 23% of adults over 60 years have type 2 diabetes, with an average person spending $2257 or more per year. In 2009, 1 out of every 10 healthcare dollars was spent on type 2 diabetes, totalling $174 billion. People with serious and persistent mental illness die on average 25 years earlier than the general population. Cardiovascular disease is the primary cause of death in persons with mental illness and accounts for 60% of the increased mortality. Furthermore, 46.24% of individuals with cardiometabolic risk factors who are also on antipsychotic medications take high- to moderate-risk antipsychotics. The cluster of cardiometabolic syndrome includes: type 2 diabetes, hypertension, dyslipidemia, obesity and pre-existing cardiovascular disease. There are, however, modifiable risk factors including smoking cessation, diet change, physical activity, medical care and choice of antipsychotic medication (on which the physician has direct control). More information is therefore needed on various antipsychotic medications and their associated cardiometabolic risk factors in order to educate physicians. In this review article, we examined 10 articles on antipsychotic medications, and their effect on the 5 domains, including type 2 diabetes, hypertension, dyslipidemia, obesity and pre-existing cardiovascular disease. Overall, there was a clear trend, which found a significant difference in the associated risk factors amongst various antipsychotic medications.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
New models for research and development in the treatment of mental illness
Authors: Kjær J.N.
Published: May 2016

The pharmaceutical industry's investments in research and development of novel treatments for mental illness have heavily declined in the past decade. Major private investments are, by most experts, seen as necessary to develop new treatments. However, psychiatry is not the only area overlooked by the industry. For decades infectious diseases have also lacked investments in research and development.

Aims

The aims of this study were to investigate the new models of research and development in infectious diseases that emerged after the pharmaceutical industry ceased their investments and to model how these can be used in psychiatry.

Method

A systematic review. We searched PubMed, EMBASE and Web of Science for the keywords “infectious diseases”, “research and development” and “pharmaceutical industry”.

Preliminary results

The searches gave a total of 248 references. Among the findings, we want to highlight the Drugs for Neglected Diseases initiative (DNDi) and the WHO Research and Development Treaty (R&D Treaty). DNDi is a non-profit organization that has developed six new drugs since 2003. The development costs were €150 millions per drug, which is considerably below the costs for drug development claimed by the pharmaceutical industry. The R&D Treaty will commit member states of the WHO to fund development for neglected health needs using alternative incentives like milestone prizes, patent pools and direct grants. The treaty has not yet been agreed upon.

Conclusions

Though a low priority from the pharmaceutical industry, other funding models have proven able to deliver new treatments. This could also lead to more development of non-patentable treatments, e.g. psychotherapy.

Disclosure of interest

The author has not supplied his/her declaration of competing interest.
Aripiprazole is effective for the improvement of psychotic symptoms in patients with dementia with lewy bodies
Authors: Kikuchi Y. , Kanbayashi T. , Shimizu T.
Published: May 2016

Objective

Dementia with lewy bodies (DLB) is commonly considered the second most common form of dementia. The purpose of this study is to investigate the treatment effects of aripiprazole in patients with DLB.

Methods

Eleven patients who had meet the criteria for DLB participated in this study. The presence of psychotic symptoms was confirmed by scores of either the delusions or hallucinations items of the Neuropsychiatric Inventory (NPI) score. Patients who had 25 or more on the Mini-mental State Examination Scale (MMSE) at the entry or having brain damage were excluded. Aripiprazole was initiated at a low dose (3 or 6 mg/day) and titrated to higher doses at 2-weeks intervals or more rapidly based on investigator's judgment. Previous medications prior to aripiprazole administration were not changed through this trial. Patient's clinical status was assessed at baseline, then 2 weeks during the study by using NPI, Clinical Global Impression (CGI) and Brief Psychiatric Rating Scale (BPRS) to measure psychotic behavioral symptoms, and Simpson-Angus Scale (SAS) to measure parkinsonism symptoms. Clinical Dementia Rating (CDR) and MMSE were carried out at screening and end point to evaluate cognitive function.

Results

The mean scores of the SAS and CDR were significantly decreased at the study endpoint compared to baseline. The mean scores of the NPI and BPRS improved up until 4 weeks after having started aripiprazole. After 4 weeks, improvements slowed. The mean score of the CGI-S was decreased up until 8 weeks.

Conclusion

This study shows that aripiprazole may be effective for the treatment of psychotic symptoms in patients with DLB.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
The therapeutic potential of natural compounds against Alzheimer's disease: A preclinical pharmacological study in both sexes
Authors: Kokras N. , Dimitriadou M. , Sotiropoulos I. , Skaltsounis A.L. , Tsarbopoulos A. , Dalla C.
Published: May 2016

Alzheimer's disease (AD), a neurodegenerative neuropsychiatric disorder, is often comorbid with depression and anxiety. Neuropsychiatric disorders are also characterized by sex differences. However, most preclinical pharmacological studies are conducted using only males. Herein, we used male and female twelve-month-old mice (3xTg) expressing mutated forms of human proteins Tau, APP and Presenilin1. These mice are considered a valid animal model of AD. We investigated the effects of the natural compound trans-crocin-4 (TC-4), which is derived from Crocus sativus and the olive compound oleuropein on the cognitive, depressive and anxious profile of 3xTg mice. We found that male and female 3xTg mice exhibited reduced locomotor activity and oleuropeine treatment (100 mg/kg i.p., for 21 days) did not reverse this phenotype. In addition, anxiety- and depressive-like behaviors were not affected by genotype, sex or oleuropeine treatment. Interestingly, oleuropeine exhibited a tendency to enhance cognitive performance in male 3xTg mice. Treatment with TC-4 (50 and 150 mg/kg, i.p., acutely or chronically for 10 days) affected locomotor activity in a sex-differentiated manner. Interestingly, acute TC-4 clearly enhanced cognitive performance in all groups although it reduced center entries in the open field. Additionally, chronic TC-4 treatment enhanced novel object discrimination mainly in male 3xTg mice. Our findings highlight the potential of those natural compounds, which warrant further investigation but also emphasize the benefits of including both males and females in preclinical pharmacological studies.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Metabolic syndrome and its association with psychotropic medications in psychiatric patients from CAISM–IGSS (Center for Comprehensive Care Mental Health/Guatemalan Institute of Social Security)
Authors: Lopez J.
Published: May 2016

Introduction

The use of antipsychotics represents an integral part of the psychiatric practice, unfortunately the use seems to be associated with an elevated frequency of metabolic alterations causing an important weight disorder and glucose and lipid homeostasis, diminishing life expectations for these patients, likely to develop metabolic syndrome without proper control.

Objectives

This study intended to find the association between metabolic syndrome in patients with psychotropic treatments used in the Guatemalan Institute of Social Security (IGSS).

Methodology

Cohort Study (n = 43 patients) who were treated combined with antipsychotics and mood stabilizers or antidepressants, conducting checkups at the beginning, then two to four months after, evaluating diagnosis of metabolic syndrome according to the criteria stated by the International Diabetes Federation (IDF).

Results

Risk factor with the use of clozapine and valproic acid was revealed after four months of exposure (RR = 2.32). With the use of clozapine and mood stabilizers a risk factor was prevalent with exposure after four months (RR = 2.67), and with the use of antidepressants a protective factor for the development of metabolic syndrome was revealed at four months of exposure (RR = 0.3741).

Conclusions

the use of antipsychotics in combination with mood stabilizers represents a risk factor for developing metabolic syndrome, especially the association with valproic acid.

Disclosure of interest

The author has not supplied his declaration of competing interest.