bluuebunny/crossref_metadata_2025 huggingface dataset:
Chronic methiopropamine modifies preference of choice in rat gambling task
Authors: Yoon H.S. , Kim W.Y. , Ku M.J. , Cho B.R. , Kwak M.J. , Kim J.H.
Published: June 2017

Introduction and aims

Rat gambling task (rGT) is a recently developed animal model making translational research possible in psychiatric disorders related to decision-making deficits. Methiopropamine (MPA) is a structural analog to methamphetamine and a temporary controlled substance. Although increasing concerns have been raised regarding MPA's abuse, few sources of information exist regarding its psychopharmacology. Thus, we investigated whether MPA produces any changes in the choice of preference in rGT.

Methods

Rats were trained in a touch screen chamber to learn the relationships between 4 different light signals on the screen and accompanied reward outcomes and punishments set up with different schedules, for one session of 30 min each day. Once animals showed a stabilized pattern of preference, they were given a total of 5 IP injections (a single injection per day, every other day) with saline or MPA followed by 2 weeks of withdrawal. Upon MPA challenge injection, their preference of choice was re-tested in rGT chambers.

Results

Depending upon their preference of choice, rats were separated as risk-averse or risk-seeking groups. When they were pre-exposed to and challenged with MPA, rats in the risk-averse group significantly changed their preference toward more disadvantageous choices. These effects were not shown when they were pre-exposed to saline and challenged with MPA.

Conclusions

These results indicate that MPA badly influences decision-making behavior as in gambling task, implying that it may aggravate pathological symptoms of bad choices, resulting in negative consequences, observed in the patients with behavioral addictions.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Amy Winehouse Foundation young persons’ substance use survey–pilot findings
Authors: Ofori-Attah G. , Knights N. , Mazhari T.
Published: June 2017

Introduction

Government-funded research indicates the prevalence of substance use in this age group is decreasing. However, anecdotal evidence suggests otherwise.

Previous surveys have been limited by:

— difficulty recruiting schools;

— the range of substances included;

— paper surveys.

Objectives

To determine whether a secure online survey method improves substance use prevalence data collection in school age adolescents.

Method

An online survey was created following literature review, and assessment of the reliability and validity of existing surveys. A comprehensive range of substances were included. A total of 750 students (11–16 yrs) from a mainstream school in Lancashire completed the survey during a supervised classroom session. Focus groups were conducted with students and teachers.

Results

No technical problems were encountered and survey data was securely transferred to Excel allowing instant analysis.

Teachers felt the survey would be unproblematic to administer independently and found the inclusion of substances such as legal highs, and energy drinks, especially relevant.

Most students completed the survey within the session and reported a positive experience, although some difficulties understanding wording were mentioned. They felt an online survey improved confidentiality (and therefore honesty) and was easier to fill in. However, there was concern about teachers reading their responses.

Conclusions

A secure online survey may be acceptable to both teachers and students, and enables the collection of hundreds of surveys in a short time period. It also improves analysis techniques.

Further analysis of whether there is a teacher-versus-researcher supervision effect on the honesty of student responses is required.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
What are the predictors of success in smoking cessation program?
Authors: Sarikaya Varlik D. , Cenker O.C. , Ercan A.C. , Varlik C. , Uyar T.
Published: June 2017

Smoking is the most important avoidable cause of morbidity and premature mortality in the European Union and other countries. Identification of individual characteristics that predict success in smoking cessation is highly desirable. Psychological determinants of smoking cessation, especially depression and anxiety disorders are associated with a higher prevalence of smoking, a higher rate of nicotine dependence, and elevated withdrawal symptoms. In this study, we aimed to identify the determinants that effect the smoking cessation program success. We scanned 232 patient files, who attended between February 2016–June 2016 in Smoking Cessation Program in a State Hospital. The patients who have applied at least two times to unit were included to study. Phone calls were done 6 months after first admission to check the status of smoking. Then we compared sociodemographic characteristics, nicotine dependence levels and psychological symptoms of patients. Sociodemographic Data Form, Fagerstrom Nicotine Dependence Scale and Symptom Check List-90 were done with every patient. It is important to determine the predictors to quit smoking for smoking cessation program. In many studies, the level of nicotine dependence has been identified as the main predictor of successful smoking cessation. It is known that the psychiatric co-morbidity is related with low success in this program. Determining psychiatric co-morbidity and treating this will be effective for success of smoking cessation.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Big Data Market Analysis of E-health in Medical Neuroscience
Authors: Stellbrink A. , Meisenzahl E.
Published: June 2017

Depression is associated with more than 100,000 patent applications for its diagnosis and prognosis, the highest number among mental disorders. This is followed by schizophrenia with 47,000, bipolar disorder with 32,110 and hypomania with 11,377. Among diagnostic tools, magnetic resonance imaging is associated with more than 31,000 patent applications. Among recent technologies, biomarkers are associated with more than 12,000 epigenetics with about 970 metabolomics with 515 genome-wide association study (GWAS) with 486 and bionics with 497 patent applications. The patent applications related to diagnosis and prognosis of psychiatric diseases peaked in 2008 and was overall decreasing until 2016, with a local peak in 2013. This trend has been observed despite the value addition of recent technologies like machine learning, big data and internet of things. However, more conservative diagnostic tools from the last decade like magnetic resonance imaging, epigenetics, bionics and neuro-psychological testing are improved by the recent technologies. For example, bionics is improved by sensors of internet of things to collect the data from patients around the world and use the big data analytics to efficiently diagnose the psychiatric diseases. The Regents of the University of California and Human Genome Sciences Incorporation are the respective academic and non-academic institutions leading the innovations related to diagnosis and prognosis of psychiatric diseases.

Disclosure of interest

The authors declare that they have no competing interest.
Particularities in immigration amongst homeless women in Girona
Authors: Calvo F. , Giralt C. , Xavier C.
Published: June 2017

Introduction

Homelessness is a problem which affects all the areas of those who suffer it, affecting their health seriously. These risks increase when the affected person has carried out a migratory process. Another risk factor, apart from immigration, is to be woman.

Objectives

To analyse the gender demographic differences in a total cohort of homeless people in the city of Girona in 2006 and continued until the present day.

Methods

Prospective longitudinal study of the total population of homeless people in Girona. In 2006, a list was made of all the homeless people detected by both specialized and non-specialized teams which have been followed until the present day.

Results

The total number of women in the sample is lower (n = 106, 11.2%). There are fewer immigrant than autochthonous women (Chi2 = 23,1, df = 1, P < 0.001).

After following the total homeless population in 2006, we can confirm that currently we can still identify 62 people in the territory (6.7%). In this subsample there are no differences between genders (man: n = 54, 6.5% vs. woman: n = 8, 7.5%; Chi2 = 0.21, df = 2, P = 0.89). That is, men and women remain in their homeless condition in a proportional way. This fact presents great limitations, since we do not know what happened with the other 93% of the initial sample.

Conclusions

The masculinisation of the homeless people from Maghreb has tended to increase the gender differences in the homeless population, in itself more masculine. This presents a risk of increasing the invisibility of homeless women.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
The comparison of mental health and marital satisfaction of fertile and infertile women referred to infertility center of Jahad Daneshgahi In Qom
Authors: Heidari S. , Berjis K. , Ahmadi L.
Published: June 2017

Introduction

Infertility is a complex issue that affects individuals’ mental health. Also marital satisfaction can be affected by fertility status of couples. Then, it is one of the most important features of life satisfaction. So, the study of mental health and marital satisfaction of infertile and fertile women is considerable.

Objectives

This research has been done with the aim of study and comparison of marital satisfaction level and mental health of the women who have infertility problem with those who does not have this problem.

Method

In total, 180 persons (90 infertile women and 90 fertile women) were participating in this study. Participants were comprised of those referring to infertility center of Jahad Daneshgahi in Qom. They filled the general health questionnaire (GHQ) and enrich marital satisfactions questionnaire have been used. Acquired information analyzed with the independent t-tests and one-way variance analysis.

Results

Results showed infertile women have less mental health rather than fertile women and also according to results, there was significant difference in satisfaction level of the fertile and infertile women. The number of unsuccessful pregnancies whether in fertile women or infertile women didnot have considerable effect on the marital satisfaction, while, effect of this factor on marital satisfaction level of the infertile women was higher than that on the fertile women.

Conclusion

Generally, by inclusion of limitations in this plan, it is inevitable to emphasize on negative consequences of the infertility on spouses’ life and it is important to pay attention to its different dimensions.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Ulsba's Epva hospital team's first year of activity
Authors: Matos-Pires A. , Canelas P. , Coelho J. , Gaspar C. , Cavagliá R.
Published: June 2017

Domestic violence (DV) against women still lacks rigor in its identification and denouncement, which makes it an under diagnosed condition.

Physical and psychic well-being of women who are victims of DV is threatened hence it is essential to discuss this subject as a health matter. Furthermore, health professionals are usually DV victims’ first contact. In 2009, Margaret Chan from WHO stated that “Preventing violence against women requires a multi-sectoral approach, and in this context the health sector has a central role to play which includes helping to identify abuse early, providing victims with the necessary treatment, and referring women to appropriate and informed care.”

Portuguese Health Ministry has created, through the legal dispatch No. 6378/2013 of may 16, an integrated intervention model on interpersonal violence throughout life, entitled Ação de Saúde sobre Género, Violência e Ciclo de Vida (ASGVCV), made operational by Equipas para a Prevenção da Violência em Adultos (EPVA) teams.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
A Single Dose of Oxytocin on Music Performance Anxiety: Results Involving a Situation of Simulated Performance
Authors: Osório F.L. , Barbar A.E. M. , Donadon M.F. , Crippa J.A.S.
Published: June 2017

Introduction

Music performance anxiety (MPA) is a persistent and distressing experience that involves apprehension linked with musical performance in public (individual or collective). Anxious individuals concentrate their anxiety in situations that involve social scrutiny, favoring distorted, dysfunctional, and negative interpretations of that situation followed by experiences of physiological symptoms associated with the exposure. The most commonly used substances in the pharmacological management of MPA are beta-blockers and benzodiazepines. However, these options are not fully efficient and cause relevant side effects that interfere mainly with performance. Therefore, investigations on alternative substances to treat MPA are highly opportune.

Objective

To assess the acute effects of oxytocin (OT) on physiological and cognitive variables during an experimental model of simulated performance.

Methods

We assessed 12 musicians with MPA pre-treated with intranasal OT (24 UI) or placebo in a crossover trial involving an experimental situation of public performance. Cognitive and physiological measures (heart rate, blood pressure, salivary cortisol) were recorded before/during performance (anticipatory performance anxiety). Statistical analyses were made using Stata Direct.

Results

The results showed no effects of OT on physiological symptoms (P > 0.190). In respect to anticipatory anxiety, however, we found a tendency for OT to reduce negative cognitions associated with music performance (P = 0.06). No side effects were reported by musicians throughout the trial.

Conclusion

These tendencies, if confirmed through the expansion of the sample, have important implications for the practice of amateur and professional musicians who could benefit from interventions as the one described, possibly with a lesser impact of side effects.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Switching Bipolar Disorder Patients Treated with Clozapine to Another Antipsychotic Medication: A Mirror Image Study
Authors: Ifteni P. , Teodorescu A.
Published: June 2017

Introduction

Bipolar disorder (BD) is associated with periodic symptoms’ exacerbations, leading to functional impairment, substance abuse, and increased risk of suicide and accidents. Clozapine has never been approved for the treatment of BD but it is used in severe episodes.

Aims

The aim of the study is to evaluate the risks and benefits of switching remitted BD patients treated with clozapine to another antipsychotic medication.

Objectives

We assessed the proportion of relapsed patients after switching clozapine, time until relapse, type of relapse and the number of admissions.

Methods

This was an observational, mirror image study of 62 remitted BD outpatients treated with clozapine. Following a change in drug reimbursement rules by which clozapine was no longer reimbursable for patients with BD, 25 patients were switched to another antipsychotic and the rest of 37 continued on clozapine agreeing to pay treatment.

Results

The mean score of CGI-BP at admission in study was in on both groups almost similar (2.3 vs. 2.4). After switching, a significant proportion of patients relapsed (77%), in 100% cases with a manic episode requiring hospitalisation. The mean YMRS score at relapse was significantly higher compared with the evaluation at the time prior to switching (31.78 (SD = 9.72) vs. 11.99 (SD = 7.29), P < 0.01).

Conclusions

Despite the limitations of this naturalistic study, the results suggest that switching from clozapine to another antipsychotic may increase the risk of relapses in remitted patients with BD. The risks, costs and consequences of symptoms exacerbation should be weighed against the quest to control pharmacy costs.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
A Comparison Between Manic Patients With or Without Antipsychotic Continuation Treatment: Data from a 12-months Follow-up Study at Mood Disorder Unit of San Raffaele–Turro Hospital
Authors: Brioschi S. , Delmonte D. , Locatelli C. , Franchini L. , Barbini B. , Colombo C.
Published: June 2017

Introduction

Several studies suggest that in severe bipolars there is a long-term benefit in continuing antipsychotic therapy plus a mood stabilizer also after remission from a manic episode. Nevertheless, the long-term use of antipsychotics is associated with significant side effects which can interfere with patient global functioning. In this sense, antipsychotics should not be continued unless the benefits outweight the risks.

Objectives

The present study describes the course of illness between bipolar patients remitted from a manic episode, in continuation treatment with or without antipsychotic therapy during a 12-months follow-up period.

Methods

Cinquante-six bipolars (22 male and 44 female) remitted (Young < 12) from a severe manic episode were observed during a 12-months follow-up. According to clinical judge, as continuation treatment, 21/56 (37.5%) took antipsychotic plus mood stabilizer (AP + MS); 35/56 (62.5%) took mood stabilizers monotherapy (MS). During follow-up period YMRS and HAM-D were administered at 6th and 12th month to verify remission.

Results

At the end of follow-up up, 33/56 patients (58.9%) maintained remission, 23/56 (41.1%) relapsed (56.5% depressive, 31.4% manic). The greater number of relapses occurred within 6th month: 16/56 (28.8%). In AP + MS group 12/21 patients relapsed (57.14%); in MS group 11/35 patients relapsed (31.4%). No statistical difference between the two continuation treatment strategies was observed (Chi-square = 3.586; P = 0.06).

Conclusions

Our data confirm the efficacy of mood stabilizers monotherapy in long-term treatment of our severe (psychotic features, revolving-doors) bipolar patients. In fact, once the remission was obtained, the clinical choice of discontinuing antipsychotic therapy did not worsen the course of illness without a higher risk of relapse.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
A psychometric Evaluation of the Parents as Social Context Questionnaire (PASCQ), Swedish version
Authors: Addo R. , Åslund C. , Nilsson K.
Published: June 2017

To understand parent and child relations researchers have used three bipolar dimensions (warmth and rejection, structure and chaos, autonomy support, and coercion). These dimensions are not necessarily bipolar but could work as unipolar dimensions. The Parents as Social Context Questionnaire (PASCQ) has been used in parenting studies but needs to be further investigated in different populations to ensure the validity and reliability of the scale. The present study explored the structures of and provided evidence regarding validity and reliability of the PASCQ. This study aimed to examine whether the Swedish version of the PASCQ is a reliable questionnaire when measuring the six dimension of parenting. The participants consisted of 1634 adolescents (58.6% females) born in 1997 (52%) and 1999. Factor analyses were conducted to investigate whether the Swedish scale generated six dimensions. Regression analyses were conducted to measure the different factors and spearman correlations between dimensions were conducted. The analysis indicates that the PASCQ consists of five dimensions, however rejection (negative) and warmth (positive) loaded on the same dimension and are referred to as two separate factors, making the questionnaire consistent of six dimensions. All items had a factor score >0.4 and loaded in a coherent manner. Therefore, the PASCQ can be used to assess six dimensions of parenting styles. The PASCQ Swedish version can be used as a measure of parenting styles in a Swedish population. Further research is necessary to evaluate the validity and reliability in other samples as well.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Childhood Sexual Abuse Among New Psychiatric Outpatients in a City in Northern Alberta-prevalence Rate and Demographic/Clinical Predictors
Authors: Agyapong V. , Juhás M. , Ritchie A. , Ogunsina O. , Ambrosano L. , Corbett S.
Published: June 2017

Child sexual abuse (CSA) is a major global health problem with serious adverse effects at later ages. Our paper examines the prevalence rates and the demographic and clinical predictors of CSA among adult psychiatric outpatients. A data assessment tool was used to compile information on the demographic and clinical characteristics of all new patients assessed in four psychiatric outpatient clinics between 1st January 2014 and 31st December 2015. The 12-month prevalence rate for CSA among new psychiatric outpatients in Fort McMurray was 20.7% (10.7% for males and 26.9% in females). With an odds ratio for sex of 3.30 (CI = 2.06–5.29), female patients are about three times more likely to report a history of CSA compared to male patients when controlling for other factors. Similarly patients with at most high school education (OR = 1.8, CI = 1.145–2.871) and those with previous contact with psychiatric services (OR = 1.7, CI = 1.124–2.616) were about two times more likely to report a history of CSA compared to the patients with college/university education or those with no previous contact with psychiatric services respectively. Similarly, patients with histories of substance abuse (OR = 1.5, CI = 1.179–2.642) and patients with family histories of mental illness (OR = 1.8, CI = 1.032–2.308) had higher likelihoods of reporting histories of CSA compared to patients without histories of substance abuse or family histories of mental illness respectively. Our findings suggest that victims of CSA are an at-risk population in need of ongoing mental health and educational support.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Pregnancy and Cord Vitamin D Status and Symptoms of Autism Spectrum Disorders in Toddlers: An Odense Child Cohort Study
Authors: Clausen S.S.B. , Christesen H.T. , Dalgård C. , Lykkedegn S. , Munk-Jørgensen P. , Bilenberg N.
Published: June 2017

Introduction

Vitamin D deficiency is widespread globally in pregnant women and is suggested to contribute to offspring risk of symptoms of autism spectrum disorders (ASD), but findings are inconsistent.

Objectives

To investigate whether low prenatal 25OHD exposure and 25OHD status in early life increase risk of early symptoms of ASD.

Aims

To investigate early signs of ASD.

Methods

From the prospective birth cohort, Odense child cohort (n = 2.549), Denmark, we included singletons with their mothers with available serum concentrations of 25OHD at early pregnancy (n = 1.231), late pregnancy (n = 1.361), and birth (n = 2.082). ASD symptoms were rated by parents on the pervasive developmental problem (PDP) scale of the Child behavior checklist for ages 1½-5 (CBCL 1½-5). Associations between 25OHD and PDP score were analyzed by multiple linear and logistic regression models. A priori included covariates were gestational age, child gender, birth weight, season of birth, parity, parental psychiatric diagnoses, maternal age, smoking habits, alcohol consumption, education level, vitamin D supplementation, and pre-gestational BMI.

Results

Means (SD) of 25OHD for early pregnancy, late pregnancy, and cord were 65.5 (21.5), 78.7 (27.0), and 47.0 (21.7) nmol/L, respectively. PDP data were obtained at a mean (SD) of 2.7 (0.6) years of age. Data from the regression analyses are pending.

Conclusions

In this well-off cohort with relatively high levels of cord 25OHD, power calculations allows us to detect a true change of 0.02 PDP scores per 10 nmol/L change in 25OHD. Further studies will clarify whether early PDP scores track later ASD diagnosis.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Evaluation of Anxiety in Children with Acute Leukemia: A Prospective Study of 20 Cases
Authors: Baccouche K. , Walha A. , Medhaffar M. , Kammoun W. , Ayadi H. , Moalla Y. , Elloumi M. , Ghribi F.
Published: June 2017

Introduction

The occurrence of acute leukemia (AL) in childhood causes a profound upheaval in the child itself and also within his family. Exposure to this test could contribute to the emergence of anxiety.

Objective

Our work aims to describe the characteristics of anxiety in this population during the management of the AL.

Patients and methods

Our study, still in progress, is prospective and conducted among 20 children hospitalised in hematology department of UMC Hedi Chaker Sfax (Tunisia) during the year 2015–2016. It is performed in two times. The anxiety was assessed using the STAI scale.

Preliminary results

The average age of our population is 7 years (minimum age = 4 years, maximum age = 11 years). The majority of our patients come from urban areas (76.9% of cases). About their sibling rank, they are mostly the youngest in 53.8% of cases, the oldest in 30.8% of cases and juniors in 7.7% of cases. The most common diagnosis is the lymphoblastic B AL (46.2% of cases).

Referring to the STAI scale, 30% of our patients were anxious and had high scores during the first evaluation. Then, the anxiety level attenuates gradually during management period and only 15% were anxious at the 2nd evaluation time.

Conclusion

Several factors such as hospitalisation, diagnosis announcement and cancer treatment contribute to the triggering and maintaining of anxiety. Early detection of anxiety and the good listening between the care team and the parents could appease the high level of anxiety and ensure better management.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Mobile Health Program to Reduce Psychological Treatment Gap in Mental Healthcare in Alberta Through Daily Supportive Text Messages – Cross-sectional Survey Evaluating Text4Mood
Authors: Agyapong V. , Mrklas K. , Juhás M. , Omeje J. , Ohinmaa A. , Dursun S. , Greenshaw A.
Published: June 2017

Background

To complement the oversubscribed counselling services in Alberta, the Text4Mood program which delivers daily supportive text messages to subscribers was launched on the 18th of January, 2016. This report presents an evaluation of self-reports of the impact of the program on the mental wellbeing of subscribers.

Methods

An online link to a survey questionnaire was created by an expert group and delivered via text messages to mobile phones of all 4111 active subscribers of the Text4Mood program as of April 11, 2016.

Results

Overall, 894 subscribers answered the survey (overall response rate 21.7%). The response rate for individual questions varied and is reported alongside the results. Most respondents were female (83%, n = 668), Caucasian (83%, n = 679), and diagnosed with a psychiatric disorder (38%, n = 307), including Depression (25.4%, n = 227) and Anxiety (20%, n = 177). Overall, 52% (n = 461) signed up for Text4Mood to help elevate their mood and 24.5% (n = 219) signed up to help them worry less. Most respondents felt the text messages made them more hopeful about managing issues in their lives (81.7%, n = 588), feel in charge of managing depression and anxiety (76.7%, n = 552), and feel connected to a support system (75.2%, n = 542). The majority of respondents felt Text4Mood improved their overall mental well-being (83.1%, n = 598).

Conclusion

Supportive text messages are a feasible and acceptable way of delivering adjunctive psychological interventions. Given that text messages are affordable, readily available, and can be delivered to thousands of people simultaneously, they present an opportunity to help close the psychological treatment gap for mental health patients.
The Clinical Course of Depression: Chronicity is the Rule Rather than the Exception
Authors: Verhoeven J. , Verduijn J. , Milaneschi Y. , Beekman A. , Penninx B.
Published: June 2017

Introduction

Major depressive disorder (MDD) is often considered an episodic disorder. However, literature might underestimate the chronicity of MDD since results depend on follow-up duration and the extent to which psychiatric co-morbidity is taken into account.

Aim

To determine, whether MDD should be considered an episodic or chronic disorder.

Objective

To examine the 6 year course of MDD, incorporating data of multiple time points and taking common psychiatric comorbidities into account.

Methods

Data were from 903 patients with current MDD at baseline in the Netherlands study of depression and anxiety, with subsequent data from 2 year, 4 year and 6 year follow-up. Four course trajectories were created taking all information during follow-up into account classifying patients as (1) recovered, (2) recurrent without chronic episodes, (3) recurrent with chronic episodes or (4) consistently chronic. A chronic episode was defined as having symptoms consistently over 2 years.

Results

The recovery rate of MDD was 58% at 2 year follow-up but looking at 6 year follow-up and taking into account co-morbid dysthymia, (hypo) mania and anxiety disorders reduced this recovery rate to 17%. Moreover, more than half of the patients experienced chronic episodes.

Conclusions

Longitudinal data of this psychiatric cohort study showed that full recovery is the exception rather than the rule. MDD follows a chronic course and, moreover, persons are prone to switch to other psychiatric disorders.
The Impact of Endurance Training on Brain Structure and Function in Multi-episode Schizophrenia
Authors: Malchow B.
Published: June 2017

Structural and functional brain alterations as well as cognitive deficits are well-documented findings in schizophrenia patients. Cognitive impairments affect the long-term outcome of schizophrenia and are the main contributors to disability. Despite their clinical impact, however, no effective options are available to treat them sufficiently. Aerobic endurance training has been shown to have effects on brain plasticity, gray and white matter volume as well as functional connectivity measures and on cognitive functioning in animal models and healthy humans. However, effects of physical exercise in combination in combination with cognitive remediation are unknown in Schizophrenia. 21 chronic schizophrenia patients and 21 age and gender–matched healthy controls underwent 3 months of aerobic exercise (endurance training, 30 min, 3 times per week). 21 additionally recruited schizophrenia patients played table soccer (known as “foosball” in the USA) over the same period. After 6 weeks of endurance training or table soccer, all participants commenced standardized cognitive training with a computer-assisted training program. We could show that a 3-month endurance-training program combined with CR therapy had positive effects on everyday functioning in multi-episode Schizophrenia patients. Deficits improved from medium to mild as assessed with the GAF. Negative symptoms, short and long-term verbal memory and cognitive flexibility also improved with training. We could demonstrate grey matter volume increase in the left temporal lobe in schizophrenia patients undergoing endurance training. A non-endurance and coordinative training stimulus like playing table soccer led to a clearly distinct pattern of grey matter alterations in Schizophrenia patients.

Disclosure of interest

The author declares that he has no competing interest.
Mthfr Allele Distribution in Romanian Schizophrenia Patients
Authors: Nemes B. , Cozman D.
Published: June 2017

Introduction

Currently available data on the aetiology of schizophrenia suggests a major involvement of epigenetic mechanisms. One such mechanism could be the alteration of activation and silencing of genes, which involves DNA methylation and de-methylation. The main limiting enzyme involved in the methyl-donor cycle is methylene-tetra-hydro-folate-reductase (MTHFR), and the most frequently observed mutation in the MTHFR gene, altering its activity, is the C677 T mutation.

Aim

In the present study, we investigated the frequency of MTHFR C677 T mutation and total plasma homocysteine (tHcy) concentrations in a sample of Romanian schizophrenia patients as compared to healthy controls.

Methods

Seventy schizophrenia patients (35% females) with a mean age of 38.8 ± 20.5 years and 50 healthy controls (50% females) with a mean age of 36.3 ± 11.6 years were included. MTHFR genotype was determined through polymerase chain reaction and tHcy levels were determined through reversed phase high-pressure liquid chromatography.

Results

Schizophrenia patients, registered higher frequency of the T allele, with the CC genotype observed in 39.4% of them, as compared to a frequency of 60.6% in the control group (P = 0.002–Fisher's exact test). tHcy concentrations did not differ between the two groups (10.7 ± 4.2 vs. 11.2 ± 4.1, P > 0.005–Mann–Whitney U test).

Conclusions

Romanian schizophrenia patients have a significantly higher frequency of the MTHFR C677 T mutation, but without significant effect on tHcy concentrations.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Swallowing Disturbances and Psychiatric Profile in Older Adults: The GreatAGE Study
Authors: Lozupone M. , Leo A. , Sardone R. , Veneziani F. , Bonfiglio C. , Galizia I. , Lofano L. , Grasso A. , Tursi M. , Barulli M.R. , Capozzo R. , Tortelli R. , Panza F. , Seripa D. , Osella A.R. , Logroscino G.
Published: June 2017

Introduction

Several studies have reported controversial links between swallowing disturbances (SD) and psychiatric disorders in older age. The available data on the epidemiology of SD in the general population are scarce and often conflicting, because of numerous methodological factors source of possible counfounders.

Objectives

We aimed to screen the presence of psychiatric and cognitive disorders associated with SD in a random sampling of the general population ≥ 65.

Methods

A sample of 1127 elderly individuals collected in a population-based study (GreatAGE) in Castellana Grotte (53,50% males, mean age 74.1 ± 6.3 years), South-East Italy, were mailed a validated self-report questionnaire to assess SD (Eating Assessment Tool-EAT10). Psychiatric disorders and symptoms [assessed with Semi-structured Clinical Diagnostic Interview for DSM-IV-TR Axis I Disorders, Geriatric Depression Scale-30 (GDS-30) and Symptom Checklist Revised-90 (SCL-90R)], cognitive functions were assessed with a comprehensive neuropsychological battery, neurological exam, and demographics were compared in participants with and without SD using t-tests and Mann–Whitney U-test.

Results

The prevalence rates of SD amounted at 5.97%. Psychiatric diagnosis (24.22% of the sample) was statistically significant associated with SD (EAT ≥ 3, P = 0.038), and a trend was found for major depressive disorder and generalized anxiety disorder. Among SCL-90R domains, only anxiety showed a significant association with EAT ≥ 3 (P = 0.006). GDS-30 score was found to be higher in subjects with SD (P = 0.008). Cognitive functions did not differ between the two groups except for an increasing trend for Clinical Dementia Rating Scale in EAT ≥ 3 (P = 0.058).

Conclusions

These preliminary results showed an association between SD in older age and late-life major depression and anxiety disorders.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Long-term rates of remission and late psychotic transition of individuals at risk for psychosis
Authors: Beck K. , Andreou C. , Studerus E. , Egloff L. , Heitz U. , Menghini-Müller S. , Ittig S. , Leanza L. , Uttinger M. , Simon A. , Borgwardt S. , Riecher-Rössler A.
Published: June 2017

Introduction

In the growing research field of early psychosis detection in patients with an at risk mental state (ARMS), most studies focus on the transition to frank psychosis. However, the majority of ARMS patients do not go on to develop frank psychosis and reported transition rates are declining. Little is known about the long-term outcome of these non-transitioned patients (ARMS-NT).

Objectives

To investigate in preliminary analyses the long-term outcome of ARMS-NT patients with respect to persistence of ARMS signs and symptoms and the rates of late psychotic transition.

Methods

The ongoing study “FePsy-BHS-NT” follows up ARMS-NT without transition during at least the first two years for up to 15 years after their initial assessment. ARMS status is ascertained with the Basel Screening Instrument for Psychosis (BSIP). ARMS remission is defined as the absence of attenuated psychotic symptoms or brief limited intermittent psychotic symptoms for at least 12 consecutive months.

Results

In this preliminary sample of 51 ARMS-NT, the majority of patients (70.6%) have remitted from their at risk mental state, 13.7% remain at risk and 15.7% have made a late psychotic transition during the course of long-term follow up (median = 5.75, range 4–11 years after initial assessment).

Conclusions

The considerable rates of ARMS persistence and late psychotic transition indicate that longer follow-up durations than commonly recommended should be contemplated in ARMS patients. Potential predictors of favorable long-term clinical outcome, as well as psychosocial, neurocognitive and other outcomes of ARMS-NT patients will be further evaluated in the present study.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
How is Evaluated Mental Health Recovery?
Authors: Penas P. , Moreno M.C. , Uriarte J.J. , Ridgway P. , Iraurgi I.
Published: June 2017

Introduction

There is an increasingly recognition of the concept of recovery in the treatment of mental illness. Recovery defined as living a fulfilling, rewarding life, even in the ongoing presence of a mental illness. Consequently, a number of instruments have been designed to assess recovery-oriented outcomes.

Objective

The objective of the study was to conduct a systematic revision of the instruments used to assess recovery with appropriate psychometric properties.

Method

A systematic review of the literature has been realized. The adequacy of the instruments utilization, the content validity and psychometrics properties were gathered and analyzed.

Results/discussion

After a systematic review, it has been obtained 25 different instruments for measuring personal recovery and 17 for assessing the orientation of recovery in mental health services. As a consequence of the lack of consensus that exists in the conceptualization of recovery; several instruments have been developed and used to assess the different recovery domains. But it is essential to select scales that match with the recovery model and assess adequately the individual's recovery, and also, the recovery orientation of services. Moreover, those instruments should have appropriate psychometric properties and should be suitable to be introduced in routinely clinical settings.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Ethics and Aesthetics–Philosophical Perspectives
Authors: Poltrum M.
Published: June 2017

European intellectual history teaches us that beauty is not just an adornment to life but is also a major source of strength for our life. Moreover, the positive aesthetic experience also has healing power. That beauty is a highly effective antidote to life's suffering, i.e. acts as an anti-depressant, has been documented in the tradition of philosophical aesthetics from Plato to Bloch. Beauty reveals truth and goodness (Plato), it shows the harmonious order and the glory of things (Pseudo-Dionysius the Areopagite), it is one of the transcendental names of God (Thomas of Aquinas), in beauty the world appears in its perfection (Baumgarten), beauty is the daughter of freedom (Schiller), it offers a temporary escape from the suffering of existence (Schopenhauer), aesthetic values are the only values that withstand nihilism and the meaninglessness of existence and are thus the actual stimulus of life (Nietzsche), the beautiful is the sensual appearance of the idea (Hegel), beauty is an anti-depressant and Weckamin of being, it tears people out of their forgetfulness of Being (Heidegger), there is a close relationship between the shining forth of the Beautiful and the evidentness of the Understandable (Gadamer), in an artwork and through the aesthetic attitude the Other, foreign, the non-identical that is mangled and mutilated in the administered world is preserved and saved (Adorno). Many more positive affirmative descriptions from the tradition of philosophical aesthetics demonstrate that beauty and the aesthetic have a therapeutic dimension.

Disclosure of interest

The author declares that he has no competing interest.
Self-harm and Attachment in Adolescents: What is the Role of Emotion Dysregulation?
Authors: Rogier G. , Petrocchi C. , D’aguanno M. , Velotti P.
Published: June 2017

Introduction

Self-harm typically occurs in adolescence and has been conceptualized as a dysfunctional strategy to regulate intense negative emotions. Furthermore, empirical literature outlines that self-harmers are more prone to have an insecure attachment style. Moreover, the link between quality of attachment and capacity to regulate emotions has been theoretically and empirically supported.

Objective

To examine the associations between attachment style, self-harm behaviors and emotion dysregulation among a sample of adolescents. The sample consisted of 740 adolescents aged between 13 and 19 years (mean age = 16.70, SD = 0.91).

Aims

To explore the nature of different pathways by which insecure attachment leads to self-harm behaviors.

Results

As expected, insecure attachment and emotion dysregulation were positively associated with self-harm behaviors. Moreover, emotion dysregulation mediated the link between attachment styles and self-harm. Specific pathways between types of insecure attachment dimension of emotion dysregulation and self-harm behaviors emerged.

Conclusions

Such results confirm the theorization of self-harm behaviors as a dysfunctional strategy to regulate emotions. Moreover, such emotion dysregulation in self-harmers seem to be connected to insecure attachment. Depending on the subtype of insecure attachment, specific dimensions of emotion dysregulation seem to be involved in self-harm behavior, suggesting interesting clinical implications.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
A Systematic Review and Case Report of the Koro Syndrome in an Intellectually Disabled Caucasian Patient
Authors: Pastor Romero A. , Guillot de Mergelina E. , Borredá Belda L. , Pérez Prieto J.F.
Published: June 2017

Introduction

Koro syndrome has traditionally been considered a culturally bound syndrome, characterized by the delusional belief that one's genitalia are retracting and the anxiety caused by the perception of imminent death. Although it is widely regarded as an epidemic in South-east Asia, there are some isolated cases in other cultures as well.

Objectives

We present a Koro case study and a systematic review, focusing on the presentation and its treatment, in order to make visible this syndrome to Western culture and provide the tools to identify it.

Aims

To provide an overview of Koro's presentation, phenomenology and treatment. We also want to clarify the nosology classification of this syndrome and its influence in the reported cases.

Methods

We begin describing a new case of Koro syndrome: a Spanish male presented an acute psychosis, the patient had an intellectual disability and a family history of mental illness. A systematic review was done based on articles published in Pubmed following the PRISMA guidelines.

Results

From 117 studies, only 29 met the inclusion criteria. Data were analyzed on several epidemiological and clinical characteristics. We found that Koro syndrome is more often presented as a result of intoxication or as a part of a previous known psychotic disorder. Cases involving patients sharing their delusion have been only reported in Asia.

Conclusion

No specific data could be obtained about epidemiology and pathogenesis, as our conclusion about Koro syndrome was based mainly on few case studies. Pharmacotherapy and social support may be effective in ameliorating the symptoms.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Joint Hypermobility Syndrome and Anxiety Disorder: Structural Brain Correlates
Authors: Eccles J. , Tung J. , Harrison N. , Mathias C. , Critchley H.
Published: June 2017

Introduction

Joint hypermobility syndrome/Ehlers Danlos III (JHS/EDS III) is a common, connective tissue condition. This group is over-represented in panic/anxiety disorders and exhibits autonomic abnormalities and heightened interoceptive sensibility. Previous neuroimaging in healthy volunteers with hypermobility has observed differences in key emotional brain regions, notably amygdala and insula.

Aims and objective To explore, in a clinical population, the structural brain correlates underpinning the association between JHS/EDS III and anxiety.

Method

Seventy participants were divided into four experimental groups: (2 × 2 factor design: presence/absence of hypermobility; presence/absence of anxiety). Hypermobility was assessed using Brighton Criteria. All participants underwent brief tests of autonomic function and interoception. Structural images were obtained using a 1.5 T MRI scanner. Results are reported at whole brain uncorrected significance threshold of P < 0.001.

Results

Comparison of grey matter volume revealed increased insular volume in anxious patients with JHS/EDS-III compared to anxious patients without (Fig. 1A, B), correlating with initial peak heart rate on standing. Additionally, amygdala volume correlated with hypermobility score in anxious patients, but not in non-anxious individuals (Fig. 1C, D). Amygdala volume correlated with interoceptive accuracy.

Conclusions

This data implicates amygdala and insula as likely neural substrates mediating clinical relationships between hypermobility syndrome and anxiety, demonstrating the relevance of autonomic and interoceptive influences on this relationship. Further work hopes to explore functional and structural connectivity between these regions in JHS/EDS-III.

Disclosure of interest

The authors have not supplied their declaration of competing interest.