bluuebunny/crossref_metadata_2025 huggingface dataset:
2566 – Chronobiological Thyroid Axis Activity and Suicidal Behavior in Depressed Patients
Authors: Duval F. , Mokrani M.-C. , Gonzalez Lopera F. , Proudnikova X. , Rabia H. , Erb A.
Published: July 2013

Objectives:

The aim of this study was to investigate the relationship between suicidal behavior and chronobiological thyroid axis activity in depressed patients.

Methods:

The serum levels of TSH, were evaluated before and after 8 AM and 11 PM TRH challenges, on the same day, in 230 medication-free DSM-IV euthyroid major depressed inpatients and 50 healthy hospitalized controls.

Results:

Compared to controls: 1) patients with a recent suicide attempt (n = 71) showed lower TSH response to TRH (ΔTSH) at 11 PM, lower ΔΔTSH values (differences between 11PM-ΔTSH and 8AM-ΔTSH) (p < 0.03 and p < 0.00001, respectively), and lower free thyroxine (FT4) levels (p < 0.00001); 2) patients with a past suicide attempt (n = 52) showed no major alteration of the HPT axis activity; 3) patients without a suicide attempt history (n = 107) showed both lower 8 AM-ΔTSH and 11-PM ΔTSH (p < 0.04 and p < 0.000001), and lower ΔΔTSH values (p < 0.000001), but no alteration of circulating thyroid hormone levels.

Conclusions:

Our results suggest that in patients without a suicide attempt history increased hypothalamic TRH stimulation (as evidenced by reduced TSH responses to TRH) might be a compensatory mechanism. in patients with a suicide history this compensatory mechanism is not effective. in patients with a recent suicide attempt the evening TSH blunting, associated with reduced FT4 levels, might be indicative of a decreased central TRH activity leading to a reduction in the TSH resynthesis in the thyrotrophs during the day after the morning challenge.
2574 – Relationship of Family Caregiver Burden with Quality of Care and Psychopathology in a Sample of Arab Subjects with Schizophrenia
Authors: Zahid M.A. , Ohaeri J.U.
Published: July 2013

Introduction:

Although the family burden remains one of the most important consequences of schizophrenia, no reports have addressed this important issue in the Arab world.

Objectives:

Determine relationship of family burden with the caregiver’s/patient’s socio-demographics, clinical features and the indices of quality of care.

Method:

Consecutive family caregivers of outpatients with schizophrenia were interviewed with the Involvement Evaluation Questionnaire (IEQ-EU). Patients were interviewed with measures of needs for care, service satisfaction, quality of life and psychopathology.

Results:

Amongst the 121 caregivers, the higher burden scores were associated with caregiver lower level of education, patient’s female gender and younger age; patient’s lower subjective QOL and needs for hospital care; and not involving the patient in outdoor activities. Disruptive behavior was the greatest determinant of global ratings of burden.

Conclusion:

Despite generous national social welfare provisions, results underscore the need for the community-based programs and continued intervention with the families in order to improve the quality of care.
2585 – The Effect of Teaching Program on Body Satisfaction of Burn Women
Authors: Seyedfatemi N. , Seyedooshohadaie M. , Shekarabi R. , Haghani H.
Published: July 2013

Objectives:

Disfiguring changes in appearance secondary to illness or injury such as burn injury lead to significant body image changes in both sex but particularly in Women. Carrying out educational program about physical appearance may improve their distress and reinforce them to think positively and doing positively throughout their lives. The purpose of this study was to examine the effect of teaching program on body satisfaction of Iranian burn women.

Methods:

This quasi-experimental one-group pre-post test study investigated the impact of teaching program on Body satisfaction of Burn Women hospitalized in Mottahari Burn Hospital in Tehran. A sample of 65 burn adult women participated in this study after giving information regarding the study objectives and filling in an informed consent. Data gathering was done by the satisfaction With Appearance Scale (SWAP). Study participants completed the questionnaire before intervention. An educational workshop regarding physical appearance and the way of improving was established for the subjects. Data were collected by the questionnaire one month after intervention.

Results:

Findings revealed that the age of most of women (60 %) was 20–40 years and 61.5% were employed. Degree of burning in most of participants was 21–40%. There was significant statistical difference between Mean scores of body satisfaction before and after intervention (P = 0.001).

Conclusions:

The teaching workshop seems to promote body satisfaction of burn women. The study hypothesis was accepted. These programs should be carried out for all kind of disfigurement.
2586 – French Adaptation of Cognitive Remediation Therapy for Anorexia Nervosa: Study Design and Preliminary Findings of a Multicenter Randomized Clinical Trial in Adolescents and Young Adults
Authors: Maria A.-S. , Ringuenet D. , Courty A. , Godart N. , Duclos J. , Bignami L. , Vindreau C. , Blanchet C. , Bourdier L. , Berthoz S.
Published: July 2013

Objective:

Individual Cognitive Remediation Therapy (CRT) for AN has been found to improve patients’ neuropsychological functioning and short term outcome. No French speaking country has tested its effectiveness. Moreover, the question whether it is similarly efficient for both restrictive and binge-purging AN remains unanswered. We thus designed a randomized clinical trial on the effectiveness of individual CRT in AN adolescents or young adults.

Method:

120 female AN [16-35 years old] (60 AN-R; 60 AN-BP) from three specialized care units (P.Brousse, IMM, Cochin- MDA). Patients of each AN type are randomly allocated to one of the two treatment arms: CRT or Sham Therapy (ST). The Sham therapy (ST) has been designed to match the CRT format: an individual manualised therapist-led 10-sessions long program (2 sessions/week). ST sessions have been designed so as to avoid set-shifting and central coherence training and rather tap 3 domains: soft physical activity, emotional expression and recognition and interpersonal functioning. Primary outcomes are neurocognitive improvement at the end of therapy (TMT, WSCT performances) and better clinical status (GOAS) at the end of therapy and at follow-up (6 months, 1 year). Secondary outcomes are changes in BMI, central coherence, selfreported eating disorders symptoms and cognitive flexibility, and motivation to change.

Results:

Inclusions started in September 2012. Preliminary findings (at least 15 participants in each arm are expected by then) on short term CRT effectiveness will be presented.
2589 – Reaction Time in Schizophrenia and Mood Disorder
Authors: Krag P.J.
Published: July 2013

Introduction:

In experimental psychopathology there is a long tradition of reaction time studies. Especially in schizophrenia there has reliably been observed deficits in attention and reaction time.

Objectives:

To examine if patients with schizophrenia can be differentiated from patients with mood disorder on the basis of their reaction time patterns.

Aims:

To evaluate if reaction time measures might be useful in the diagnostic process.

Methods:

58 patients with schizophrenia, 55 patients with mood disorder, and 30 healthy controls participated in a computerbased reaction time experiment. The stimuli were short visual and auditory stimuli presented in a randomized sequence. The subjects were instructed to press a button each time they saw or heard a signal from the computer.

Results:

The reaction times of the patients with schizophrenia and mood disorder to both light and sound stimuli were significantly slower than those of the control group. Furthermore, the patient groups’ reaction times were significantly less stable than those of the control group, and they made significantly more errrors. However, no significant differences in reaction times, stability of reaction times, and number of errors were found between the two patient groups. No clear or consistent differences were observed when comparing the reaction time patterns of subgroups of schizophrenia patients with positive, mixed and negative symptoms, and mood disorder patients in manic and depressive phases.

Conclusion:

On the basis of simple reaction measures it is not possible to differentiate between patients with schizophrenia and mood disorder.
2608 – Screening For Depression in Elderly Urban Population
Authors: Raul A. , Sagare S.M.
Published: July 2013

Introduction:

žDepression is a treatable medical condition and one of the most frequent causes of emotional distress in older adults žUntreated depression can delay recovery or worsen the outcome of other medical illnesses via increased morbidity or mortality žDepression is NOT a part of normal aging.

Objectives:

žTo determine the prevalence of depression among the elderly population žTo identify the risk factors with respect to depression in elderly.

Material and methods:

žStudy design: Cross sectional study žStudy setting: Community based žSample size: 216 žStudy area: Southern part of urban Pune city žInclusion criteria: Age more than 60 yrs of age žStudy tool: Predesigned Questionnaire including WHO 5 Well being index and Mastering depression in Primary care version 2.2 was administered.

Results:

The prevalence of ndepression was 21.2% in the geriatric population. Widowed stae, financial dependancy,living in nuclear family and medical illnesses were the major stressors.

Conclusion:

The present study found that widowed state,retirement,medical illness and residing in a nuclear family system are strong predictors of depression in the elderly.

Recommendation:

žSocial support programs for the elderly must be developed to ensure their well-being. Awareness about risk factors would help in designing appropriate strategies for prevention of depressive disorders in geriatric population.
2609 – Uems Proposed Strategies to Diminish the Burden of Mental Disorder
Authors: Hermans M.H.M.
Published: July 2013

The “Union Européenne de Médecins Spécialistes” (UEMS), established in 1958, brings together general medical associations of 34 European countries. Delegates of national scientific and professional associations related to 39 different medical specialties work through specialty specific Sections and European Boards. The European principle of free movement from one country to another for all European citizens, patients and professionals, is the guiding compass.

The UEMS tries to elaborate general common criteria applicable in all countries in order to get a high level of specialist training and delivery of care all over Europe. The first European Directive concerning medical doctors was largely largely inspired by the UEMS input.

Three key issues inspire the activities of the UEMS: (1) postgraduate training, (2) continuous medical education and professional development, and (3) quality insurance in specialist practice.

The presentation will illustrate how the Section and European Board of Psychiatry try to achieve these goals within the field of mental health.

www.uems.net

www.uemspsychiatry.org

www.uems-cap.eu
2615 – Status Post Meningitis and Encephalitis? 20 Years after Infection, Psychiatry Problems
Authors: Kaludjerovic S.
Published: July 2013

Infects of CNS are very severe disorders, if not treated can lead to death. Nowadays we still noticed presence of them. in our study we traced psychiatric problems of 30 patients age 35±5, both sex, had survived meningitis and encephalitis in their early adolescence 12 to 14. 80% meningitis, other encephalitis. in day care hospital they came because of headache, depression, panic, anxiousness, compulsive behavior, emotional instability. CT of brain were observed. Before study 80% patients got drugs.

Aims:

Find out are exist significance and link between infection of CNS (duration, type bacterial or viral, seizures if had happen) and psychiatric problems 20 years after?

Study-Follow up 30 patients during one year treated in day care hospital. eeg controlled. Ct brain if necessary. To measure depression used Beck, Montgomery A scales.

To measure panic used Pais 3 scales.

Results:

20 years after severe infection CNS noticed that just 20% visible eeg abnormalities. No seizures, but 10 % got AE.

50% dg as panic, felt better on clonazepam.

20%depression mild, recovered on escitalopram.

10% personae disorders on therapy.

Evaluated study showed that duration of CNS infection and seizers in anamnesis after 20 years consequence in irritability eeg as well as behavior problems so needed drugs.

Bacterial infection (pneumoccoc, enteroccoc) linked in depression. As difference, viral infection linked in anxiety, panic and personal disorders.

Beck and Montgomery A scales significant improvement after therapy. Panic scales also.
2618 – Theory of Mind and Hypomanic Personality in General Population
Authors: Terrien S. , Blondel M. , Morvan Y. , Besche-Richard C.
Published: July 2013

Introduction:

Theory of Mind (ToM) is the ability to assign a set of mental states to yourself and others. in bipolar disorders, alteration of social relationship can be explained by the impairment of the functioning of ToM. Deficit in ToM can be a trait marker of bipolar disorder and people in general population who has high score of hypomanic personality will be more likely to develop bipolar disorders.

Aims:

The goal of this study is to study abilities in a ToM task in general population with different level of hypomanic personality.

Methods:

This study examines 323 participants (23.25 ±7.74 years). Measures of hypomanic personality were evaluated by the Hypomanic Personality Scale (HPS) (Eckblad & Chapman, 1986). It is a self-report scale subdivided in 3 factors: social vitality, mood vitality and excitement. ToM was explored using Yoni task (Shamay-Tsoory & Aahron-Peretz, 2007) French adaptation. This test permits to distinguish the affective and the cognitive components of ToM.

Results:

Forward multiple regression analyses were performed to examine the effect of components of the HPS on the total score of ToM task. in women’s group, no subscales of the HPS have been included in the model. Conversely, the analyses performed on men revealed that the mood vitality subscale was a significant predictor of ToM abilities.

Conclusion:

The ToM task’s score is linked to the hypomanic score but only in men sample and only for the Mood vitality subscale. This result supports that deficits in ToM can be a trait marker of bipolar disorder in healthy men population.
2630 – Intermed Training: The Experience at the Modena Medical School
Authors: Spattini L. , Ghidoni A. , Simoni E. , Landi G. , Visentini C. , Pingani L. , Boenink A. , Ferrari S. , Mattei G.
Published: July 2013

Background:

INTERMED is a patient-centered method designed to assess bio-psycho-social case complexity in general health care. It consists in a structured interview leading to definition of 20 variables by focusing on past, present and future health needs and risks of patients. The total score supports professional decision and guides to patient-oriented care.

Aim:

To describe the training process on INTERMED interview and to assess its effectiveness.

Methods:

A training group of 4 doctors and 4 6th-year medical students attended two-hour meetings twice a month (December 2011– March 2012). After introductory sessions on theoretical aspects and inter-trainee simulations on interviewing and scoring techniques, students were assigned the task of producing recorded clinical material, which was used to comment on interviewing skills and practice on scoring. Individual and consensus scores were collected at the end of every session and compared statistically by means of Cohen’s kappa.

Results:

Agreement between individual and consensus scores was already considerable at the beginning of the training and improved during the course (Cohen’s kappa raised from 0.39 to 0.65). The participants were interested and motivated. They expressed satisfaction for the skills acquired during the training.

Conclusions:

A five months 20-hour training period is a reasonable time not only for learning how to master the instrument, but also for gaining the basic skills required to build a structured interview. These skills would be useful in the whole participants’ career and allowed the implementation of INTERMED as a clinical and research tool in the Modena General Hospital.
2640 – Exploring the Pathogenetic Association Between Schizophrenia and type 2 Diabetes Mellitus Diseases Based on Pathway Analysis
Authors: Liu Y. , Li Z. , Yi Z. , Shi T.
Published: July 2013

Accumulated studies indicate that schizophrenia patients are prone to present the type 2 diabetes symptoms, but the potential mechanisms behind their association remain unknown. Here we explored the pathogenetic association between SCZ and T2D based on pathway analysis and protein-protein interaction. To explore the pathway crosstalk, we constructed a pathway-based network including all of those significant pathways. Our results revealed that some pathways are shared by both SCZ and T2D diseases through a number of susceptibility genes. With 382 unique susceptibility proteins for SCZ and T2D, we further built a protein-protein interaction network by extracting their nearest interacting neighbours. Among 2,104 retrieved proteins, 364 of them were found simultaneously interacted with susceptibility proteins of both SCZ and T2D, and proposed as new candidate risk factors for both diseases. Moreover, some proteins were hub proteins with high connectivity and interacted with multiple proteins involved in both diseases.Some of these hub proteins are the components of our identified enriched pathways, including calcium signaling, g-secretase mediated ErbB4 signaling, adipocytokine signaling, insulin signaling, AKT signaling and type II diabetes mellitus pathways. Through the integration of multiple lines of information, we proposed that those signaling pathways, such as AKT signaling, that contain susceptibility genes for both diseases, could be the key pathways to bridge SCZ and T2D. AKT could be one of the important shared components and may play a pivotal role to link both of the pathogenetic processes. Our study provides the general pathway-based view of pathogenetic association between two diseases.
2643 – Metabolic Syndrome and Antipsychotic Treatment: How about Schizophrenia and Bipolar Disorder?
Authors: Prisco V. , Perris F. , De Santis T. , Palermito A. , Catapano F. , Fabrazzo M.
Published: July 2013

Many published studies underlined the relationship between Atypical Antipsychotic treatment and Metabolic Syndrome (MS) onset, but only few have compared the effects of Typical and Atypical Antipsychotics to this respect. The present study examined in schizophrenic and bipolar patients the impact of haloperidol (mean dose 3.37±2.28 mg and 2.51±1.48 mg, respectively) and olanzapine treatment (mean dose 12.42±6.53 mg and 9.97±5.36 mg, respectively) on glycemia, blood pressure, BMI, triglycerides and HDL cholesterol. A higher prevalence and a different time of appearance of Metabolic Syndrome was observed in Bipolar patients when treated with olanzapine. Moreover, weight increase was greater in bipolar patients treated with olanzapine (p< .000) when compared to schizophrenic treated with both Antipsychotics. These findings suggest a shared susceptibility to antipsychotic- related metabolic disregulations in both schizophrenic and bipolar patients for SGAs, but not for FGAs. Moreover, the effects of olanzapine in bipolar patients support the development and testing of interventions specifically designed for preventing and treating the metabolic syndrome and its components.
2645 – Solicitors Assaults on Psychiatrics: Tantrums at the Tribunal!
Authors: Wise M.
Published: July 2013

Introduction:

Psychiatrist write reports for a variety of judicial processes; employment law, family law, and personal injury. For a variety of reasons the commissioning agents may object to the report and seek to undermine its utility or validity. Attacks can take a range of forms from impugning an experts expertise, their competence, impartiality, the validity of the material used, the tests used, or via proxies such as another expert. After the event a refusal to pay for services provided is not unusual.

Objectives:

To familiarise psychiatrists with some of the common tactics used, illustrated by real case.

Methods:

Analysis of papers submitted to Court and in the public domain

Results, by order of frequency:

Allegations of substandard work, or even negligence are common, a feature being a lack of specifics in the assertions made in the pre-action protocols and witness statements.

Threats to report the expert to a governing body, a feature being a lack of specific details.

Threat of counter-claim for financial loss due to an unfavourable report.

Refusal to pay for the report, up to including until court proceedings for debt recovery have been issued.

Conclusions:

Outright attacks on the report are rarely successful, particularly where experts for each side meet to discuss the differences. However a refusal to pay fees is far more likely. Psychiatrists need to adopt a robust approach to Lawyers and learn which intimidatory techniques are probably hot air, and devoid of substance.
2651 – Behavioural Changes in Cocaine Dependent Patients after Group-Therapy
Authors: Di Paolo M. , Chiappini S. , Testa R. , Pettorruso M. , Di Cesare A. , Sabetta L. , Conte G.
Published: July 2013

Introduction:

Frequent and increasing relations among psychiatric and substance dependence disorders, have made, to date, more complex the treatment of this dependence, especially when the patient is facing the difficult task of maintaining abstinence, which requires a work of self-awareness, motivation to change and active modification of dysfunctional lifestyles.

Objectives:

Our study has the aim to detect patients’ changes in personality between the beginning of the rehabilitative therapy and its end, trying to get information on aspects of addiction on which the treatment affects the most.

Methods:

Our sample was formed by 153 patients, recruited at the Department of Psychiatry of Gemelli General Hospital, who were subjected to an integrated approach of treatment, both pharmacological and rehabilitative group-therapy, according to Minnesota rehabilitation model, that considers addiction as a bio-psycho-social problem.

Patients, after a first psychiatric evaluation, were asked to fill out two psychometric tests, the SymptomCheckList-90 R and the Structural Clinical Interview for DSM-IV, in two times, at the first meeting and at the last one, after 20 meetings of group therapy.

Results:

At the end of the group therapy 39 patients dropped-out, 114 patients had a significant improvement in depressive symptoms (DEP item), greater responsibility perseverance and attention in their activities and habitual contexts (GSI, DIS, W/S items), as well as better management of compulsion and impulsivity (OC item) and a lower sense of inferiority, inadequacy and discomfort in interpersonal relationships (PAR, ANX, IS, SOC. A., PSY. A. items).
2661 – Psychometric Properties of the Russian Version of the Stress Vulnerability Questionnaire - 23QVS (Serra, 2000), in a Sample of 556 Russian-Speaking Immigrants in Portugal
Authors: Monteiro A.A. , Vaz-Serra A.
Published: July 2013

Introduction:

In literature, individual vulnerability to stress is a predictive factor of a higher risk of developing stress-related disorders and mental health problems. The Stress Vulnerability Questionnaire (23QVS; Serra, 2000, 2004) is a 23-item scale, measuring vulnerability to emotional and social adverse and stressful situations, and overall life satisfaction.

Objectives:

The purpose of this study was to assess the psychometric properties of a Russian version of the 23QVS in a sample of Russian-speaking immigrants residing in Portugal.

Methods:

The 23QVS was administered to Russian-speaking immigrants in 12 Local Immigrant Support Centers in Portugal, along with a number of other self-report tests as part of a larger mental health status immigrants' study.

Results:

The Russian version of the 23QVS has an internally consistent measure Cronbach's α, 710 for the total scale (Item 7 was excluded). PCA was carried out in order to re-examine the factor structure of the scale. Seven factors were identified, overall matching the ones foreseen by the author of the scale.

Conclusions:

The findings suggest that the Russian version of the 23 QVS addressed adequately the original concepts and dimensions, and demonstrated a high level of equivalence with the original version.
2679 – A Mixed Methods Approach: Perception and Practice in Managing Schizophrenia in Malaysia Among Levels of Service Provider in Hospital
Authors: Wan Husin W.A.I. , Rashid R. , Amer Nordin A. , Hasan S.I. , Ramli N. , Ahmad Zahari M.M. , Habil H.
Published: July 2013

Objectives:

The aim of this study is to investigate the “Hospital Service providers” perception, attitude and actual practice in managing schizophrenia in Malaysia.

Method:

In this study, it was designed as a mixed -methods study. in the first phase, quantitative surveys have been implemented among 42 service providers. in the second phase, the descriptive qualitative study method was also used.

Result:

The questionnaires designed to gather the data relating to the respondent satisfied in managing Schizophrenia in Malaysia. Thirty five (or 83.3%) of the respondents are satisfied with the current Schizophrenic overall management, but twenty one (or 50.1%) of the respondents does not satisfy with current psychosocial interventions available in Malaysia. The qualitative found that, the psychiatrists responded that they are satisfied with current use of atypical antipsychotic in the hospitals but they are concerned with the lack of community services particularly in the university hospitals. The medical officers and general practitioners responded that they received many patients who were brought by their families to see them in outpatient clinic. However, many doctors failed to diagnose the disorder as they have a lack of training in diagnosing mental illness diseases. This is mainly due to misperception about mental illness particularly in rural areas among the Malay population.

Conclusion:

The study concluded that more community awareness program needs to be done which emphasis on mental illness to reduce the duration of untreated illness and ensure active roles of family members in supervision of treatment.
2705 – Cultural Issues in the Prevention and Treatment of Perinatal Disorders
Authors: Bassi M.
Published: July 2013

The birth of a child is a crucial event in the woman life, generally is a moment of joy and fulfillment, but instead often experienced by new mother with concern, fear and anxiety. The psychological vulnerability of women during the postnatal period is commonly referred to a “postpartum depression”, a term that is actually referred to a cluster of symptoms with a very different clinical level, severity and duration. If a network of family and social support, which is active in caring for new mothers and newborns, is usual for the European women, for the migrant woman in most cases this support is totally lacking. The absence of a social support, with economic and housing precariousness, frequently brings foreign women into a particular vulnerability situation, with an increased risk for the development of postnatal depression. Many studies clearly show an increased postpartum depression risk for migrant women than for women living in their country of origin.
2711 – Trajectory of Comorbidity in Obsessive-Compulsive Disorder
Authors: de Mathis A. , Diniz J. , Shavitt R. , do Rosário M.C. , Miguel E.
Published: July 2013

Introduction:

Obsessive-compulsive (OC) symptoms may begin at any point of the life span. Comorbid psychiatric disorders in OCD is more a rule than an exception and can contribute to the OCD-related burden.

Objectives:

The goal of this study is to understand the trajectory of comorbid disorders in OCD according to the first manifested psychiatric disorder and their impact in the clinical manifestation of OCD and.

Methods:

1001 consecutive OCD outpatients from the Brazilian Obsessive-Compulsive Disorder Consortium were evaluated. Inclusion criterion: OCD as the main psychiatric diagnosis (DSM-IV). Exclusion criteria: comorbid schizophrenia and mental retardation. The instruments applied were: SCID-I; Y-BOCS; DY-BOCS, YGTSS (significant level =5%). To investigate the age at comorbidities onset Bayesian approach was performed. Those distributions contain all the information obtained by the data for the mean age at onset.

Results:

OCD patients that presented separation anxiety disorder (N=175, age of onset SAD 5.35) as first diagnosis had higher frequency of social phobia, simples phobia, generalized anxiety disorder and panic disorder (78.3%; p=0.05), somatoform disorders (13.1%; p=0.05) and post-traumatic stress disorder (30.3% p=0.003). OCD patients that presented ADHD (N=50, age of onset ADHD 6.42; age of onset OCD 13.08) as first diagnosis had higher frequency of substance abuse (16.0%; p=0.00001). OCD patients that presented tic disorders (N=44, age of onset tic disorder 6.86; age of onset OCD 16.18) as first diagnosis had higher frequency of OC spectrum disorders (50.0%; p=0.03).

Conclusion:

First psychopathological manifestation in OCD patients is associated with distinct long-term trajectory of comorbid psychiatric disorders.
2712 – Boufée délirante in the Contemporary Psychiatric Nosology: A Case Control
Authors: Teixeira B. , Venâncio Â. , Araújo M.
Published: July 2013

Introduction:

The French nosological concept of bouffée délirante (literally “delusional flush or rush”) may define a subgroup of non-affective, acute remitting psychoses with an especially favourable prognosis. To date, relatively little published literature is available about this entity.

Objectives:

To discuss the concept, nosological status, diagnostic features and associated clinical characteristics of bouffée délirante.

Aims:

A case report of bouffée délirante is described. The concept and clinical features of the condition are reviewed.

Methods:

A case report is presented in detail and a literature review of the theme is surveyed.

Results:

The authors report a case of a 48-year-old woman with no psychiatric background until November 2011 when she developed a sudden onset of persecutory delusions concerning her colleagues and boss. She believed computers and televisions were under their control and that her daughter and husband were in danger. This information was given by the voices she believed to hear. During one week, she developed behavior disturbance that motivated her urgent evaluation. As she was admitted to our department, she showed herself defensive and hostile. During the first day in our ward she described a delusion of Capgras, but the symptoms were rapidly overtook with low doses of antipsychotic.

Conclusions:

Bouffée délirante is a historic French diagnostic term used in the past to describe a short-lived psychosis. The term was substituted differently in ICD-10 (described as acute and transient psychotic disorders) and DSM-IV-TR (brief psychotic disorder). The key diagnostic features are acute, floridly psychotic symptoms with complete remission.
2720 – Before and after Acceding to a&e Departments by Migrants: Data from a 1-Year Observation
Authors: Gazzoletti E. , Reggianini C. , Ferrari S. , Mattei G.
Published: July 2013

Introduction:

Hospital A&E departments are the most frequent access to healthcare among migrants, often accounting for improper admissions. This also impacts massively on delivery of psychiatric care and prevention, making it hard to provide a health program, and not just solving an acute situation.

Objective:

To analyze admissions to the A&E by migrants, focusing on previous medical/psychiatric history and health program after discharge.

Methods:

Electronic databases were searched for all migrants accessing the A&E departments of the two general hospitals in Modena, Italy, during 2010.

Results:

Of the patients evaluated in the A&E, 10.24% were migrants. For 5% of these, the reason for admission was psychiatric, for 36% non-psychiatric (mostly traumatic); for the remaining 56%, admission was due to mild somatic symptoms, possibly medically unexplained symptoms suggestive of somatization (i.e. 16.59% gastro-intestinal symptoms, 10.92% joint pains).

Only 32% of the migrants accessing because of explicit psychiatric reasons (attempted suicide, alcohol abuse, aggressiveness) were investigated by a psychiatrist. After the psychiatric consultation, 35% of patients were referred to community mental health centers, 20% to psychiatric wards, 22% to primary care, 6% to services for substance abuse.

Conclusions:

Migrants in the A&E are referred to psychiatry only for severe psychopathology and disturbances, very rarely for symptoms suggestive of somatization, which are particularly difficult to recognize in the A&E: this may result in delay in diagnosis and chronicization.
2721 – Effect of Some Meteorological Factors on Suicidal Behavior in Daejon, Korea
Authors: Kim P.S. , Lee C.H.
Published: July 2013

Introduction:

In many cultures, weather and season have been thought to influence our physical and mental health. However studies of the effect of meteorological factors on suicidal behavior have yielded inconclusive and often contradictory results. Furthermore, little attention has been paid to weather is associated with suicide in Asian countries as shown in Western countries, even though suicide rates in Korea have increased steadily.

Objectives:

To study the effect of weather condition on suicidal behavior in Daejon, Korea. in this study, suicidal attempters who had visited the Eulji Medical Center were included.

Aims:

The aim of this study is to further explore the differential effect of certain climatic factors on suicidal attempt probabilities in Daejon, Korea between 2009 and 2011.

Methods:

Three-year data of suicidal attempts within Daejon, Korea were analysed in relation to meteorological data, which were measured at the Daejon Meteorological Administration. Data on suicidal attempt and weather were matched.

Results:

Our study indicates that temperature and duration of sunshine are significant associated with the suicidal attempts (p < 0.05). These correlation were independent of age and sex.

Conclusions:

Within the interaction of biological and environmental influences in the development of suicidal ideation and behavior, some weather conditions may additionally contribute to the risk of suicidal attempt.
2722 – Training in Preventive Psychiatry: A Survey of Early Career Psychiatrists from 36 Countries
Authors: Sampogna G. , De Rosa C. , Del Gaudio L. , Del Vecchio V. , Luciano M. , Fiorillo A.
Published: July 2013

Introduction:

The practice of early interventions in psychiatry has became one of the most prevalent paradigms in modern psychiatry. in the routine care the dissemination remains frustratingly slow. However, little is known about the characteristics of training curricula.

Aims:

To describe:

1)

characteristics of training on prevention and early intervention in psychiatry;

2)

organizational and clinical differences of early intervention services in the different countries;

3)

trainees’ satisfaction and management of patients with mental disorders.

Methods:

Sixty early career psychiatrists have been invited to participate in the survey, recruited from the early career psychiatrists’ network of the World Psychiatric Association (WPA). Respondents were asked to provide the collective input of their trainees’ associations, and not the individual feedback of any officer of the association.

Results:

36 out of 60 invited countries compiled the questionnaire. University training programs in early intervention for mental disorders are provided in 21 out of 36 countries (58%). Half of early career psychiatrists feel completely or enough confident to provide specialistic interventions to patients during early stages or at the onset of the disorder. Fifty-three percent of respondents are not satisfied with training on preventive psychiatry. Early intervention services most frequently available are those for schizophrenia (76%). Informative campaigns on mental disorders are usually conducted in 33 countries (87%).

Conclusions:

A huge variability exists as regards early intervention training and practice. Further efforts are needed in order to establish training programs according to the educational needs of trainees and early career psychiatrists.
2725 – The Impact of Perceived Insecurity on Patients' Well-being: A Study in 24 Mental Health Centres
Authors: De Rosa C. , Sampogna G. , Del Gaudio L. , Del Vecchio V. , Luciano M. , Fiorillo A.
Published: July 2013

Introduction:

The recent global crisis as well as the increasing crimes’ rates have been claimed to be a factor of mental distress and disturbance.

Objectives:

To describe the levels of insecurity and the fear of crime in a sample of patients with mental disorders with a sample of mental health professionals.

Methods:

The study has been carried out in 24 Italian mental health centres. in each centre 20 patients and 20 mental health professionals have been recruited. Clinical status and social functioning have been evaluated with the Global Assessment of Functioning (GAF), the Hamilton Anxiety scale (HAM-A) and the Hamilton Depression scale (HAM-D). Fear of crime and insecurity have been assessed by Perceived Insecurity Questionnaire (PIQ).

Results:

The final sample consists of 426 patients. They are mostly female (70%), employed and married, with a diagnosis of mood disorder (52%). High levels of worries/insecurity at the PIQ are reported by 42% of patients. Perceived insecurity is associated with higher levels of HAM-A and HAM-D. Nearly all respondents report to have worries or fears about the future (93%), in particular as regards bereavement or loss (41%), economic difficulties (28%), mental or physical illness (26%). in multiple regression model, worries about the economic situation are more frequent in person who are male, young, married and with more than two children.

Conclusions:

The results suggest an association between perceived insecurity with anxiety and depression. Further studies are needed to better understand this association and to develop educational programs on stress and mental disorders.
2733 – Quetiapine for the Treatment of Cocaine Dependence
Authors: Tapp A. , Wood A. , Sylvers P. , Kilzieh N. , Saxon A.
Published: July 2013

Background:

Cocaine abuse continues to be epidemic, and yet there are no FDA approved medications for the treatment of cocaine use disorders within the United States.

Methods:

This 12-week, prospective, double-blind, randomized, placebo-controlled study examined the effectiveness of quetiapine (Seroquel XRTM) versus matched placebo for the treatment of cocaine dependence in non-psychotic individuals. Sixty Individuals with a diagnosis of cocaine dependence were randomized in this study. Those who were randomized to quetiapine (N=29) were titrated up to a target dose of 400 mg/day of quetiapine, while those in the placebo arm (N=31) were given a matched placebo. All subjects had weekly clinic visits and a cognitive-behavioral therapy group session. Outcome measures included questionnaires of cocaine use, money spent on cocaine, and urine drug screens (UDS).

Results:

The drop-out rate was substantial at 68%, however there were no group differences between the two arms of the study. Using a repeat measures ANCOVA, as a whole, the subjects in this study improved by reducing their self-reported use of cocaine (p=.018) and self reported money spent on cocaine (p=.041) over the course of the study. However, the quetiapine group was not significantly different from the placebo group. in addition, cox regression analyses yielded non-significant differences (p = .65) between groups in predicting sobriety, as defined as three weeks negative UDS.

Conclusions:

This study did not find group differences between the quetiapine and placebo arms, indicating that quetiapine does not appear to be beneficial in the treatment of cocaine dependence.
2735 – Suicide in Physicians: An Overview
Authors: Paraschakis A. , Michopoulos I.
Published: July 2013

Introduction:

Physicians have an increased risk of dying by suicide in comparison with the general population.

Objectives:

This difference has been studied in the literature.

Aims:

To present the characteristics of this phenomenon.

Methods:

Literature review using Medline and hand search of relevant articles.

Results:

The suicide risk is slightly higher for male and substantially higher for female physicians in comparison with the general population (relative risk 1.1-3.4 and 2.5-5.7 respectively). It also varies from 1.5-3.8 in males and 3.7-4.5 in females as compared with other professionals. Depression, drug & alcohol abuse problems, history of prior attempts, availability of method (drugs), physical illness, burn-out syndrome, interpersonal difficulties and loneliness constitute risk factors. Physicians rarely do “unsuccessful” attempts and most commonly die by drug poisoning. This may be due to the fact that they have easy access to drugs, knowing better their lethal doses. Anesthesiologists, Psychiatrists and General Practitioners have the highest risk. The increased risk in female physicians is concerning given the rising number of women in the medical profession. However, as poor status integration has been proposed as an explanation, their increasing proportion in the medical workforce could hopefully help reverse this trend.

Conclusions:

Physicians -particularly female- present high risk of suicide. Adequate services of counseling, support and care that provide anonymity and confidentiality should be the cornerstones of preventive efforts. The last are complicated by the fact that restriction in the main suicide method (drugs) seems a hardly applicable preventive measure in this population.
2740 – Diminished Responsibility in England and Wales: Historical and Current Perspectives
Authors: Patil P. , Rasquinha N.
Published: July 2013

Introduction:

Diminished Responsibility has formed an important aspect of the law of homicide in England and Wales since 1957. It acts as a partial defence to murder and if successful, reduces the charge to manslaughter. Despite operating for over fifty years in England and Wales, it was subjected to regular criticism leading to the enactment of a revised plea.

Aims and objectives:

This paper examines diminished responsibility, the elements of the revised plea and its legal/ clinical impact.

The core components of the old plea involved abnormality of mind substantially impairing mental responsibility. However, the obscure wording, the lack of psychiatrically recognized concepts and expert-jury role confusion led to a number of proposed reforms to the plea. The revised plea which came into force in 2010 consists of four limbs- abnormality of mental functioning, recognized medical condition, substantial impairment of mental ability and an explanation/causation requirement.

Conclusions:

Although the new plea has intended to accommodate medical advances and modernize and clarify the law, its scope has been largely narrowed. Academics have criticized the explanation/causation requirement for being too complex to prove and so restrictive that satisfying an insanity plea might be easier. Concern has been expressed that more contested cases and murder convictions would result from this restriction in the plea's scope. Cases such as mercy-killing and battered spouses which previously could be dealt with ‘sympathetically’, might now be excluded. Interestingly, role confusion continues to be present with medical experts treading onto the jury's territory, opining on legal issues.
2742 – A Prospective Comparative Study of Risperidone Long-Acting Injection For Treatment-Resistant Schizophrenia with Dopamine Supersensitivity Psychosis
Authors: Kimura H. , Kanahara N. , Komatsu N. , Ishige M. , Muneoka K. , Yoshimura M. , Yamanaka H. , Suzuki T. , Komatsu H. , Sekine Y. , Watanabe H. , Iyo M.
Published: July 2013

Backgrounds:

Although treatment-resistant schizophrenia (TRS) is a highly heterogeneous disorder, an established and efficacious treatment for those patients to date is pharmacotherapy with clozapine. Dopamine supersensitivity psychosis (DSP) is characterized by profound unstable positive symptoms and tardive dyskinesia, and its mechanism is related to up-regulation of dopamine D2 receptors (DRD2) which can be induced by long-term treatment with antipsychotics. Patients with DSP take generally excessive high dosages of neuroleptics and thus meet easily the criteria of TRS. A drug with secure and stable pharmacokinetic, which can keep an appropriate blockade of DRD2, may contribute to amelioration and prevention of the dopamine supersensitivity state. Risperidone long-acting injection (RLAI) is a candidate agent which meets this hypothesis.

Methods:

For 115 patients with TRS, we divided them into two groups; the one is those with a history of DSP and the other is without DSP, and treatment with RLAI was conducted for 12-month duration. This is an observational study which did not control concomitant medications or dosage of RLAI.

Results:

Clinical symptomatology and medications at baseline did not differ between the two groups. The results from the final analysis for remaining 95 patients revealed that the group with DSP showed greater improvements in the change of BPRS total score than the group without DSP.

Conclusions:

These results suggested strongly that the dopamine supersensitivity state could be related partly with the etiology of TRS. An atypical agent with long half-life time such as RLAI, can provide beneficial effect for patients with DSP.
2755 – The Metabolic Syndrome in Untreated Schizophrenia Patients: Prevalence and Suggested Mechanisms
Authors: Reddy S. , Goudie C. , Agius M.
Published: July 2013

The Metabolic Syndrome (MetS) is a constellation of markers which often coexist in patients, each representing an increased risk of developing cardiovascular disease. It is established that the prevalence of MetS among schizophrenic patients is greatly increased compared to the general population. This effect is mostly attributed to use of atypical antipsychotic medications, however questions also exist over whether schizophrenia itself can contribute more directly to metabolic dysfunction. Indeed metabolic disturbances were common in mental illness as early as 1879, many years before the implementation of antipsychotic medications.

We evaluated the link between MetS and schizophrenia which is independent of antipsychotics, by conducting a systematic literature search of Pubmed (2002-2012) for studies of drug-naive and first episode patients. 12 papers met our criteria, from which 893 patients were evaluated. An average prevalence of MetS across these studies was 10.8%. We found that there are very few data to suggest that the incidence of MetS is increased in first episode and drug naive adult patients with schizophrenia. It appears, however, that schizophrenia does increase some components of MetS, such as diabetes.

Many contributory mechanisms have been proposed for the observed metabolic dysregulation in schizophrenic patients. There include hypothalamic-pituitary axis dysfunction, sympathetic nervous system dysfunction, proinflammatory states and several genetic mutations, however much controversy exists in this area.

There is a huge cardiovascular burden on schizophrenic patients, accounting for 50% of natural excess deaths. It is crucial, therefore, to establish the causes and optimal management of MetS in schizophrenia.