bluuebunny/crossref_metadata_2025 huggingface dataset:
Development of A New Activity Measure: Activity Perception in Healthy Population and in People with Chronic Illness
Authors: Martin M. , Alexeeva I.
Published: June 2017

Introduction

Self-reports provide rich information about the types of activities people engage in. Reviewing current activity measures two issues become evident. Firstly, they were developed and validated in healthy populations. Secondly, they are diverse in their applications and measured domains. Thus, to assess the construct of activity fully large numbers of measures need to be used.

Objectives

The study aimed to explore different dimensions of activity (e.g. work, physical, mental, leisure, sedentary behaviours) using a new scale assessing multiple domains of daily activities.

Methods

A new activity scale was used to investigate the types of activity and inactivity in people with chronic illness (asthma, chronic fatigue syndrome (CFS)) and in a healthy group. The types of activities measured included; leisure and sport, home and outside, social activity, work and education, and mental activity. The scale also aimed to measure the construct of inactivity, represented by sedentary behaviours, such as staying in bed during the day.

Results

The results showed a pattern of significant correlations between the new activity scale, specifically its two major domains of activity and inactivity, and other measures of functioning and activity in the illness groups, but not in the healthy group.

Conclusions

The lack of significant associations between the new activity scale and other measures of activity and functioning within the healthy group indicated the measure may be more suitable for assessing activity in people with chronic illness than in healthy people. Additionally, the results underscore the importance of measuring inactivity as a separate domain.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Approach in a mental health hospitalization unit
Authors: Rodríguez M. , Pérez V. , Linares D. , María S. Jose
Published: June 2017

Introduction

The mental health hospitalization unit of Torrecárdenas Hospital consist of a team of professional psychologists, psychiatrists, nurses and occupational therapists who perform different approaches to look after the hospitalized patient. The therapeutic Objective of this unit is the containment and implementation of intensive interventions in a crisis situation in which it has not been possible to achieve an improvement or control of the patient's symptoms in external resources.

Material and methods

We performed a descriptive cross-sectional study with patients hospitalized at the mental health hospitalization unit between September 22 and October 28, taking into account the age, sex, admitted, diagnoses, previous treatments, psychological approach and free hospital stay.

Results

(Fig. 1–3).

Conclusions

The results of this study indicate the most prevalent patient profile has a diagnosis of severe mental disorder. The 66.7% of patients had previous hospital admissions. The 81.5% of hospital admissions are involuntary. The normative psychopharmacological prescription is an atypical antipsychotic as main treatment in our study. We highlight the use of Olanzapine with an 18.52% being consolidated as the first therapeutic option. As adjunctive treatment we have a mood stabilizer such as Valproic Acid with 11.1%; or another antipsychotic such as Paliperidone with the same percentage (11.1%). Regarding hypnotic treatment, it should be pointed out the use of medium-life benzodiazepines (Lormetazepam) with a prevalence of 55.56%.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Family Burden in Caregivers of Schizophrenia Patients
Authors: Ahlem H. , Zgueb Y. , Ouali U. , Laajili Y. , Alaya S. Ben , Jomli R. , Nacef F.
Published: June 2017

Introduction

Schizophrenia is a disabling, chronic psychiatric disorder that has far-reaching consequences for both patients and their relatives. Management of schizophrenia involves family support and care. In this context, burden of care is a concept related to caregivers and family's members of patients assuming responsibility for these patients. This construct can be conceptualized as a syndrome of varying clustering affecting the general and mental health of caregivers.

Objectives

This study aims to determine the frequency and clinical correlates of family burden in schizophrenia.

Methods

We performed a transversal study in department of psychiatry A at Razi hospital. Thirty principal caregivers of schizophrenia patients were interviewed. Caregiver's burden was assessed using the Zarit scale.

Results

The mean age of caregivers was 48.7 ± 7.15 years. In our sample, 63.3% (n = 19) were parents, 23.33% (n = 7) were brothers or sisters and 13.33% (n = 4) were spouses. The mean score of Zarit was 58.75 ± 9.15. Caregivers had a severe burden in 56.66 of cases (n = 17). Levels of burden were significantly associated with history of aggressive acting out and poor treatment adherence.

Conclusion

Caregivers of schizophrenia patients experience enormous burden which is in part related to clinical features of disease. Further studies are necessary to establish the appropriate interventions in order to reduce and manage general and psychological impact of schizophrenic patients care giving.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Is it Feasible and Effective to Help Patients with Severe Mental Disorders to Quit Smoking?
Authors: Bobes J.
Published: June 2017

Despite the proven association between smoking and high rates of medical morbidity and reduced life expectancy in people with severe mental disorders (SMD), their smoking rates do not decline as they do in the general population. We carried out a non-randomized, open-label, prospective, 9-month follow-up multicentre trial to investigate the clinical efficacy, safety and tolerability of a smoking cessation programme designed for the treatment of patients with SMD in the community under real-world clinical conditions. A total of 82 patients were enrolled. Short-term efficacy: The 12-week 7-day smoking cessation (self-reported cigarettes per day =0 and breath CO levels ≤9 ppm) prevalence was 49.3%, with no statistically significant differences between medications (transdermal nicotine patches 50.0% vs. varenicline 48.6%, chi-square =0.015, P = 1.000). Long-term efficacy: At weeks, 24 and 36, 41.3 and 37.3% of patients were abstinent, with no statistically significant differences between treatments. Safety and tolerability: No patients made suicide attempts or required hospitalization. There was no worsening of the scores on the psychometric scales. In both groups, patients significantly increased weight, without significant changes in vital signs or laboratory results, with the exception of significant decreases in ALP y LDL-cholesterol levels in the varenicline group. Patients under varenicline more frequently presented nausea/vomiting (P < 0.0005), patients under TNP experienced skin reactions more frequently (P = 0.002). Three patients under varenicline had elevated liver enzymes. In conclusion, we have demonstrated that in real-world clinical settings it is feasible and safe to help patients with stabilized severe mental disorders to quit smoking.

Disclosure of interest

This work was partly supported by the Spanish Ministry of Science and Innovation, Instituto de Salud Carlos III (FIS PI10/01758) and Fondos Europeos de Desarrollo Regional (FEDER). The Health Services of the Principado de Asturias, Spain, donated part of the medication used in this study.
Normalization of mortality rate and life expectancy in schizophrenia: Challenges and options
Authors: Cohen D.
Published: June 2017

Studies of mortality-rates and life expectancy in schizophrenia have consistently shown that the standardized mortality rate (SMR) are raised compared to the general population. In a meta-analysis (2007) of 38 studies with 22,296 deaths, all cause SMR was 2.98. SMR in a French cohort study (2009) in 3470 patients with schizophrenia, were 3.6 for men and 4.3 for women. A recent epidemiological study (2015) of a US-cohort of 1,138,853 individuals with schizophrenia, 4,807,121 million years of follow-up and 74,003 deaths, all cause SMR was 3.7 for the total population: 3.3 for men and 4.3 for women. Life expectancy, the other side of the coin of increased SMR, in this study was reduced with 28.5 years. Studies in life expectancy, the other side of the coin of increased SMR, show a substantial, if not alarming reduced life expectancy. Israel with 12.5 years and Denmark–15 years for women and 20 years for men – reported the lowest reduction in life expectancy, while Arizona reported the highest reduction of 32 years. Progress in such diverse fields as genetics, neuro-imaging, early diagnosis of (ultra) high-risk populations, CBT and rehabilitation treatment, has not improved schizophrenia SMR or life expectancy. On the contrary, in far a trend is visible, the situation tends to worsen, not to improve. After going through the barriers for optimal somatic care, both patient and health care related, we will discuss options for improvement of the level of somatic health care, at the preventive and therapeutic level.

Disclosure of interest

The author has not supplied his/her declaration of competing interest.
Does Transcranial Electrical Stimulation Induce Changes in Peripheral Physiology?
Authors: Lehto S.
Published: June 2017

Transcranial electrical stimulation (tES) is a non-invasive brain stimulation method that has evoked increasing interest during the past years. The most common form of tES, transcranial direct current stimulation (tDCS), is considered to modulate neuronal resting potentials. For example, anodal stimulation over motor cortex appears to lead to increased neuronal excitability under the stimulation electrodes. However, some recent findings suggest that the effects of tDCS extend beyond the cortical areas under the electrodes, to deeper brain structures such as the midbrain. The brain also actively regulates peripheral physiology. Thus, changes in brain activity following tES may lead to modulation of peripheral physiology. For example, tDCS targeting primary motor cortex has been observed to induce changes in peripheral glucose metabolism. Furthermore, stimulation of dorsolateral prefrontal cortex has been shown to lead to alterations in cortisol secretion and the activity of the autonomic nervous system. Unpublished findings from our group corroborate with the above observations. Nevertheless, the evidence regarding peripheral effects of tES remains limited. Investigating such possible effects may be relevant especially from the point of view of tES safety and potential therapeutic discoveries.

Disclosure of interest

The author has not supplied his declaration of competing interest.
Validation of the Czech version of the community assessment of psychic experiences (CAPE)
Authors: Keřková B. , Martínková Z.
Published: June 2017

Introduction

In the Czech Republic, research of the schizophrenia spectrum suffers from a lack of standardized measuring instruments. The community assessment of psychic experiences (CAPE) has been used internationally to quantify positive, negative and affective symptoms associated with the spectrum and to screen individuals who may be in risk of developing a spectrum disorder.

Aims and objectives

This study aimed to develop a Czech version of the CAPE and to examine its psychometric properties in a nonclinical population.

Methods

An author with an expertise in the field and a subject-naïve author translated the CAPE into the Czech language. After a professional back-translation, the instrument's most suitable version was agreed upon. Lie-scale items were added to allow for an online circulation. The CAPE was administered to a large sample of participants alongside the Beck depression inventory (BDI-II).

Results

Internal consistency was assessed using the Cronbach's alpha. Internal structure was evaluated using confirmatory factor analysis and compared to the structure of the original. Criterion validity was examined through correlation analyses of the BDI-II scores and the total and subtotal CAPE scores.

Conclusions

It is determined whether the Czech version of the CAPE has sufficient reliability and validity to be recommended for research purposes. It is expected that further study of the CAPE as well as the introduction of additional tools will motivate the standardization of research, diagnosis and prevention of schizophrenia spectrum disorders in the Czech Republic.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Comparison of cortisol levels in patients with schizophrenia and in healthy controls
Authors: Wilczyński K.M. , Tobolska D. , Lorek M. , Mazgaj E. , Gawlik A. , Krysta K.
Published: June 2017

Introduction

The hypothalamus-pituitary-adrenal axis (HPAA) plays a pivotal role in response to a range of external and internal factors often described as “stress”. Growing evidence in a literature, suggest various dysregulations of HPAA, in course of numerous mental disorders. Patients with schizophrenia and bipolar disorder seem to have elevated basal cortisol secretion, what might be caused by the diminution of glucocorticoid receptors’ amount. It was of the interest if the cortisol concentration in patients, with diagnosed schizophrenia, differs from healthy individuals.

Materials and methods

Two groups of participants were included into the study. First group (study) consisted of 10 patients with diagnosed schizophrenia and control group which included 38 healthy individuals. Study was divided into two stages, first one (pilot) included only control group, and utilized cortisol concentrations measurement from saliva, blood and 24 h urine sample. Second part (main study) involved both groups although focused on a salivary cortisol concentrations.

Results

A mean salivary cortisol concentration in patients with schizophrenia who underwent treatment was significantly lower in comparison with healthy individuals.

Conclusions

Obtained results indicate that patients who underwent a treatment, and does not present notable clinical signs of schizophrenia, may have moderately lowered levels of salivary cortisol. This may be a reflection of relenting psychotic symptoms as well as a direct effect of atypical antipsychotic drugs on a HPA axis activity.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Reasons to choose a long acting antipsychotic and tolerability
Authors: Molina I. Martínez , Venegas N. Gómez-Coronado Suárez de , Ramón P. Blanco
Published: June 2017

Introduction

Aripiprazole depot is an atypical antipshycotic used to treat positive and negative symptoms of psychosis or acute mania.

Aim

Describe the reason why psychiatrists switch the current antipsychotic treatment on to aripiprazol depot, its tolerability and the reasons to stop aripiprazol depot treatment.

Methods

Descriptive analysis based on a sample of 37 patients, aged 18–65 years, treated during one year with antipsychotics at two community mental health units.

Results

Switching on to aripiprazole depot principal reasons: promote adherence (25%), persistence of symptoms (25%) and high levels of prolactin or sexual dysfunction (16.66%):

– side effects of aripiprazole depot: insomnia (11.11%), inquietude (8.33%), sexual dysfunction (2.77%) and hypertensive crisis during administration (2.77%);

– 83.33% of the patients are still taking it after one year. The most common reasons to stop or change it were the presence of secondaries (11.11%) and clinical exacerbation (5.55%).

Conclusions

Aripiprazole depot is well tolerated (even better than other antipsychotics). Common side effects are not severe and appear in a small percent of patients.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Corticospinal Excitability Predicts Antidepressant Response to RTMS
Authors: Oliveira-Maia A. , Press D. , Pascual-Leone A.
Published: June 2017

Repetitive transcranial magnetic stimulation (rTMS) targeting the left dorsolateral prefrontal cortex (DLPFC) is a treatment option for patients with medication-resistant major depressive disorder (MDD). However, antidepressant response is variable and there are currently no response predictors with sufficient accuracy for clinical use. Here we report on results of an observational open-label study to determine whether the modulatory effect of 10 Hz motor cortex (MC) rTMS is predictive of the antidepressant effect of 10 Hz DLPFC rTMS. Fifty-one medication-resistant MDD patients were enrolled for a 10-day treatment course of DLPFC rTMS and antidepressant response was assessed according to post-treatment reduction of the 17-item Hamilton Rating Scale for Depression score. Prior to treatment, we assessed the modulation of motor evoked potential (MEP) amplitude by MC rTMS. We measured MEP's to single pulse TMS using surface electromyography, before and after MC rTMS, and calculated MEP modulation as the change of mean MEP amplitude after MC rTMS. MEP modulation proved to be a robust predictor of reduction of clinician-rated depression severity following the course of DLPFC rTMS: larger MC rTMS-induced increase of corticospinal excitability anticipated a better antidepressant response. These findings suggest that MC rTMS-induced modulation of corticospinal excitability warrants further evaluation as a potential predictive biomarker of antidepressant response to left DLPFC 10 Hz rTMS, and could inform future developments of rTMS to treat depression.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Stressors in patients with schizoaffective disorder
Authors: Reula L. Montes , García H. Saiz , Fernández A. Portilla
Published: June 2017

Patients with schizoaffective disorder have recurrent episodes of a mood disorder with severe psychotic symptoms. In many cases, patients have toxic abuse in some situations that could cause confusion in symptoms and ranking it. It is about a patient diagnosed 5 years ago of schizoaffective disorder with decompensation caused by leaving medication and drug consumption. A year ago, the treatment was changed to intramuscular formulation with abilify maintena to ensure compliance and adherence. The patient continues to consume toxic in weekends, with symptoms of self-referentiality and suspicion towards their environment. Two weeks ago, he was with the girlfriend of a friend and after this event, the friend has been threatening him. The patient has a state of anxiety rising, with interpretations and associations delirious about this friend. He sleeps with a knife in bed if the friend entered his home. It is a very overwhelmed situation, magnifying and causing severe impact on their underlying disorder. When the patient is evaluated, it is decided to add treatment with olanzapine a few days to reduce symptoms and anxiety. Patients with mental disorders have stressors that cause anxiety like a healthy patient. It is true that the impact it has on the patients tend to be older and to overvalue the signs and real situations. In these cases should not be considered a decompensation and attribute symptoms to lack of efficacy of treatment. In many cases, if we associate a more sedating antipsychotic profile, they shall reduce symptoms.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
A descriptive study of a sample of 42 male outpatients diagnosed psychotic disorder
Authors: Ortega Garcia M.D. , Marti Garnica M.V. , Garcia Marin S. , Martinez Martinez C. , Blanco del Valle P. , Gomez Martinez R. , Lopez Bernal M.A.
Published: June 2017

Aims

The approach to mental illness and specifically in serious mood disorders, long-term treatments that improve adhesion as continuous treatments ensure compliance are needed, they minimize the risk of relapse and readmission and therefore increase the chances to have a good fit and social, relational and even occupational functioning.

Method

We analysed a sample of 42 male diagnosed with schizophrenia, schizoaffective disorder, chronic delusional disorder that starts treatment with Paliperidone Palmitate in outpatients. It is analysed the dose of paliperidone palmitate employed for stabilization and family satisfaction at the time of stabilization is analysed in the study.

Results

The mean dose of Paliperidone Palmitate is 138 mg. The patient diagnosed with schizophrenia are 47.6% and the average dose is 132.5 mg. Chronic delusional disorder is 2.3% and the mean dose 50 mg. Other comorbility mood disorders are 21.4% and the mean dose is 183 mg. Other disorders (F70, F72…) are 28.5% and mean dose 133 mg. The average family satisfaction (minimum 1 up to 5) is 4, with the highest score among patients diagnosed with F20 Schizophrenia.

Conclusions

Long lasting injectable medications achieve important adherence and a high percentage of antipsychotic monotherapy, thus reducing the side effects, although in our sample 8% which has occurred was removed therefrom.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Staging in Bipolar Disorder: Clinical, Biochemical, and Functional Correlates
Authors: Grande I.
Published: June 2017

In the field of bipolar disorder, some proposals of a staging model have been suggested considering the progressive features of the disorder. The staging model regards special features of the patients and further draws a route to define the prognosis and treatment as well as the neurobiological background of the disorder. The aim of this model is to identify rational therapeutic targets and provide the most effective and less toxic intervention in a time-sensitive manner. Advocating for a model of staging in bipolar disorder that can group the patients according to quantitative cut-offs of common practice clinical variables as well as defining a biochemical correlation seems to be a further step towards an operative and valid model of staging in bipolar disorder.

Disclosure of interest

Dr. I. Grande has received a Juan Rodés Contract (JR15/00012), Instituto de Salud Carlos III, Spanish Ministry of Economy and Competiveness, Barcelona, Spain and has served as a consultant for Ferrer and as a speaker for AstraZeneca, Ferrer and Janssen-Cilag.
Sexual-dimorphism of the planum temporale in schizophrenia: An MRI study
Authors: Pigoni A. , Delvecchio G. , Perlini C. , Barillari M. , Ruggeri M. , Altamura C. , Bellani M. , Brambilla P.
Published: June 2017

Introduction

Anatomical alterations in the Superior Temporal Gyrus (STG) have been reported in schizophrenia. The STG is one of the most asymmetric and lateralized structure of the brain, and the process of lateralization seems to vary according to gender. Although it has been suggested that patients with schizophrenia do not show normal brain lateralization, only few studies investigated it in the STG considering the effects of sex.

Objectives

The objective of this study is to evaluate sexual dimorphism in STG volumes in a sample of patients with schizophrenia compared to age-and sex-matched healthy controls.

Methods

Seventy-two right-hander males (40 schizophrenia patients and 32 controls) and 45 right-hander females (18 schizophrenia patients and 27 controls) underwent clinical evaluation and a 1.5 T MRI scan. Gray and white matter volumes of regions of interests within the STG were detected, including the Heschl's Gyrus (HG) and the planum temporale (PT).

Results

Female patients with schizophrenia presented a reduction in left PT gray matter volumes (F = 4.58, P = 0.03) and a lack of the normal PT asymmetry index (t = 0.27; P = 0.79) compared to female controls (t = 5.47; P < 0.001). No differences were found between males for volumes or laterality. Also, in patients with schizophrenia STG gray and white volumes negatively correlated with positive symptoms (r = −0.33, P = 0.02 and r = −0.29, P = 0.03 respectively), whereas left PT gray matter volumes were negatively associated to duration of illness (r = −0.27, P = 0.04).

Conclusions

Sexual dimorphism plays a key role on PT in schizophrenia, underlying the importance of gender as a modulator of brain morphology and lateralization of schizophrenia.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Clinical Staging of Psychotic Disorders: From Dimensions to Neurobiology
Authors: Batalla A.
Published: June 2017

The clinical staging model is an approach used in medicine to define the extent of disease. In psychiatry, this model has recently been applied to psychotic disorders to distinguish the earlier, non-specific features of illness (e.g. ultra-high risk [UHR]; at-risk mental state [ARMS]), from later, more severe features associated with chronic illness. A key element of the staging model is to identify and classify the neurobiological processes underlying the disorder and to define potential interventions in the different stages. With the premise that dysfunctional neural mechanisms underlie symptomatology, the integration of categorical phenotypic classifications (class of disorder) with dimensional criteria (domains of dysfunction) becomes crucial. This approach aims to better classify trans-diagnostic dimensions of disease and discrete symptom-specific subgroup populations within biological frameworks, which may lead to the detection of new biomarkers and the development of more effective treatment and prevention strategies.

Disclosure of interest

The author has not supplied his declaration of competing interest.
Enjoying expression: Exploring the benefits of music therapy on patients diagnosed with schizophrenia and using metaphor games/improvisations for increasing emotional awareness level
Authors: Salur Ö. , Ala-Ruona E. , Uçar S. , Eren N.
Published: June 2017

Although music therapy is an evidence-based and effective therapy method in clinical psychiatric settings all around the world, the literature on music therapy's effect specifically on emotional awareness is very limited. This study, which has been conducted as a part of presenter's music therapy master's thesis aims to examine the clinical benefits of music therapy in a Turkish university hospital, to enable further research and promote the recognition of music therapy as a valid clinical method in psychiatry in this country. A study was conducted in Istanbul university psychiatry clinic with 6 patients currently under standard care due to diagnoses of schizophrenia or schizophrenia-like disorders by the hospital staff. The participants attended 20 music therapy sessions with pre-post clinical psychological tests applied around the sessions. The results reveal that group music therapy supports the well being of outpatients diagnosed with schizophrenia. Significant changes on general functionality, personal and social performance, depression levels, increase in the level of ways of coping with stress and decrease in difficulties in emotion regulation concerning emotional awareness and are reported. Music therapy games/improvisations using animals as metaphors were played to reach emotional content of patients that normally have very limited verbal sharing in sessions, which possibly effected the change on emotional awareness. Session notes consisting of the therapy crew's observations support the statistical analysis of these benefits. These findings show that music therapy can be beneficial on multiple dimensions, including emotional awareness, in a Turkish university hospital; and therefore, more implication opportunities are suggested.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
When schizophrenia leads to terrorism: A case report
Authors: Staali N.
Published: June 2017

Background

Some have suggested that terrorists are mentally ill and have used labels such as psychopathic or sociopathic, narcissistic, paranoid, are schizophrenic types, or passive–aggressive. Others have argued that although terrorist actions may seem irrational or delusional to society in general, terrorists in fact, act rationally, and there is no evidence to indicate that they are mentally ill/disordered, psychopathic or otherwise psychologically abnormal.

Objective and method

Here we present the case of Mr. A, a 32 year old man diagnosed with schizophrenia, who travelled to Egypt and Syria in attempt to join the ISIS terrorist organization, and discuss the clinical features, treatment processes and two years follow-up of this particular case.

Conclusion

As described in some studies, most terrorists do not demonstrate serious psychopathology and there is no single personality type. Thus, the relationship between terrorism and mental illness mostly refers to the question about pathological travel as part of a religious and messianic delirium.

Disclosure of interest

The author has not supplied his/her declaration of competing interest.
The emergence of psychosis in a patient with severe hypothyroidism: A case report and literature review
Authors: Turk M.L. , Rosen J.
Published: June 2017

Hypothyroidism is associated with changes in mental state that can range from mild cognitive impairment to depression to florid myxedema coma. A few cases have linked the occurence of psychotic symptoms in the context of severe hypothyroidism, an event referred in the literature as “myxedema madness”. We describe the case of a 48-year-old male with no past psychiatric history and a past medical history of hypertension and hypothyroidism who presented to the psychiatric unit for management of new-onset psychosis, particularly paranoid delusions. On basic medical screening, the patient was found to have severe hypothyroidism manifested by a TSH level of 51.85 and a free T4 level less than 0.4. The patient was treated with both an antipsychotic and thyroid hormone replacement, after which his hypothyroid symptoms and his psychosis improved. Liothyronine was also prescribed to speed up the recovery course, as his delusions were thought to be due to his hypothyroidism. The aim of this poster is to shed light on the possibility of development of psychosis concomitantly with severe hypothyroidism, given the rarity of such events, as well as to illustrate the importance of treating the underlying medical cause rather than only focusing on the treatment of the psychiatric symptoms. The use of Liothyronine proved to be beneficial in this case, as the patient's symptoms drastically improved after its administration. This could potentially illustrate the importance of using Liothyronine particularly in the treatment of delusional disorder in severe hypothyroidism.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Schizophrenia and obsessive compulsive disorder
Authors: Vrbova K. , Prasko J. , Cinculova A. , Krnacova B. , Talova B. , Tichackova A. , Latalova K.
Published: June 2017

Introduction

A recent reviews of published researchers suggest, that up to 25% of schizophrenia patients suffer from obsessive-compulsive symptoms (OCs) and about 12% fulfill the diagnostic criteria for obsessive-compulsive disorder (OCD). Recently, the interest in this issue has significantly increased, probably due to the finding, that second generation antipsychotics, especially clozapine, might induce or aggravate OCs.

Objective

The aim of our study was to investigate and clarify the literature data about the extent to which comorbid OCs affects the severity and course of schizophrenia.

Methods

The articles were identified by the keywords “schizophrenia comorbidity” and “obsessive compulsive disorder”, using the medline and web of science search. Additional information was obtained by studying the references of summaries of relevant articles.

Results

Obsessive-compulsive symptoms or fully expressed obsessive-compulsive disorder leads to more severe overall psychopathology and poorer treatment outcomes in patients with schizophrenia. This comorbidity is accompanied by increased neurocognitive impairment, high levels of anxiety, depression, and suicidality, less favorable levels of social and vocational functioning, and greater social and health service utilization.

Conclusions

In clinical practice, schizophrenia patients should be carefully monitored for OCs, which may occur at any time during the schizophrenia disease. Early recognition and targeted treatment of this comorbidity reduce patient's distress; positively influence the course of illness and overall treatment outcome.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Regional features of prevalence of cannabinoid dependence in children in Siberia
Authors: Artemyev I. , Vladimirova S.
Published: June 2017

Aim

To distinguish socio-cultural predictors of cannabinoid dependence of child population in Siberia.

Methods

Clinical verification of dependence, due to cannabinoid use in the age group “0–14 years” across 22 administrative territories of Siberia and the far east. Review, of statistical materials of regional narcological institutions.

Results

Cannabinoid dependency in children has been revealed in 8 of 22 territories–intensive indices per 10,000 of the population of the matched age were in two territories–0.2, one territory–0.4, in two–0.7, and in three–2.1, 3.2, 14.0, respectively. In the related territories, the specific weight of cannabinoid dependence in total structure of substance dependence for population as a whole (children, adolescents, and adults) was as follows: 0.7%, 0.8%, 2.7%, 3.5%, 27.2%, 67.6% and 76.9%. Therefore, for those territories where ill children are under observation their number per 10,000 of the population is closely associated with structural size of addictions: high level of cannabinoid dependence, formed in the territory, is interrelated with greater number of children, dependent on cannabinoids in this territory. With account for made corrections it should be recognized that “saturation level” of the territories, in particular, with cannabinoids results in higher indices of substance dependence among child population.

Conclusions

It should be considered that calculation of intensive indices is conducted for the age group “0–14 years” while diagnosed age range includes children aged 9–14 years, therefore, real indices of dependence, with account for this hypothetical correction, are three times higher as a minimum.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Oxytocin as a Treatment Enhancer in Anorexia Nervosa
Authors: Russell J. , Maguire S. , Kesby A. , McGregor I. , O’Dell A. , Treasure J.
Published: June 2017

Introduction

Nutritional rehabilitation in anorexia nervosa (AN) is impeded by fear of food, eating and change leading to treatment resistance. Oxytocin exerts prosocial effects on anxiolysis, fear modulation, trust and brain plasticity.

Objective

A placebo-controlled RCT examined the effects of self-administered intranasal oxytocin (IN-OT) in AN patients.

Aim

To ascertain whether single and repeated doses of IN-OT enhance treatment in AN.

Methods

Female AN patients self-administered twice daily 18IU IN-OT (n = 21) or placebo (n = 21) for 4–6 weeks during hospital treatment. Weight and BMI were measured at baseline and after treatment. The Eating Disorders Examination (EDE) was the primary outcome measure. Cognitive rigidity was compared between groups after four weeks repeated dosing. The effects of the first and last doses of IN-OT versus placebo, on salivary cortisol before a high-energy afternoon snack, were compared.

Results

Weight gain was similar in IN-OT and placebo groups. Only the EDE eating concern subscale score was significantly lower after 4–6 weeks (mean 35 days) of IN-OT (p = 0.006). Anticipatory levels of salivary cortisol fell from baseline after the initial dose in contrast to the placebo group where levels increased. After four weeks IN-OT, salivary cortisol was significantly lower (p = 0.023) overall with little anticipatory increase compared to placebo. There were no differences in anxiety scores. Cognitive rigidity was significantly lower in the IN-OT group (p= 0.043)

Conclusions

Self-administered IN-OT might enhance nutritional rehabilitation in AN by reducing eating concern and cognitive rigidity. Lower salivary cortisol before a high-energy snack, suggests reduction of fear rather than anxiety.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
The singular therapeutic project as an interdisciplinary care strategy to the alcohol and/or other drugs user
Authors: Vasconcelos S.C. , Correia A.S.B. , Gouveia B.G. , Silva I.J. , Mendes M.S.G.C. , Neves M.J.S. , Ribeiro E.C.O. , Castro A.L.G.
Published: June 2017

Introduction

Among the psychosocial care network services and devices, highlights the Center of Psycho-Social Attention (CPSAad) aimed at building a comprehensive, regionalized care, based on the extended clinic and from Singular Therapeutic Project (STP).

Aims

Report a successful experience of building a Singular Therapeutic Project in Center of Psycho-Social Attention.

Methods

This is a descriptive/reflective study type experience report, held in CPSAad from experiences of Mental Health's Multidisciplinary Residency members linked to the Center for Studies in Public Health, João Pessoa, Paraíba, Brazil.

Results

It was noted that the STP assists practitioners in the planning of interventions from the needs highlighted by the user and it promotes the knowledge exchange and the co-responsibility of those involved in the care. Therefore, was built a STP of a homeless alcoholic user who initially attended the service as its basic needs refuge (food, hygiene and rest) without showing any interest in participating of activities, little interaction with professionals and other users, difficulties in expressing himself, besides often arriving at the service under alcohol influence. The residents planned the STP from the user's admission through the qualified hearing and construction of bonds.

Conclusions

The Singular Therapeutic Project operationalization allowed the user to feel cared, attended in his needs and recognized by the staff; favoured its treatment co-responsibility, leading him to participate in the proposed activities, medical appointments and examinations, and consequently the improvement of his interpersonal relationships.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Increased intake of monosaccharides and disaccharides in opioid-addicts
Authors: Gorzelańczyk E.J. , Szponar A. , Walecki P.
Published: June 2017

Introduction

Persons dependent on opioids often characterized by the coexistence of a whole range of dysfunctional behaviors, which may also lead to eating disorders.

Objectives

Impulsive and risky behavior, conducive to the formation of polysubstance dependence, including food addiction, which manifests itself in the uncontrollable craving substances, that are quickly metabolized and turned into sugar in the bloodstream.

Aims

Aim of the study was to assess the nutritional status and carbohydrates consumption in opioid-dependent individuals treated with methadone substitution therapy.

Methods

Fourteen opioid addicts during methadone maintenance treatment were examined. Eighteen healthy individuals matched for age and gender were included to the control group. The 24 hour hour diet recalls interview was used. After the dietary recall, a special questionnaire was administered to ascertain frequency of refined carbohydrates consumptions during the past 30 days.

Results

It was found the nutritional deficiencies in the diet and poor nutritional status in opioid-addicts compared to healthy ones. Opioid-dependent individuals significantly more often snack between meals. It was found increased consumption monosaccharides and disaccharides in foods and beverages in opioid-addicts compared to healthy ones (P < 0.05).

Conclusions

Investigation of dietary behaviors may facilitate understanding of dynamics of addiction, so that we can use more effective methods of treatment.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Impact of childhood trauma on co-morbidity among alcohol dependent patients: Controlled study
Authors: Gulec Oyekcin D. , Gurgen A.
Published: June 2017

Introduction

Childhood trauma has been found to be prevalent in treatment-seeking alcoholics.

Objectives

We aimed to investigate the childhood trauma prevalence among alcohol dependent patients and the prevalence of psychiatric co-morbidity.

Methods

A total of 61 participants were assessed; 35 treatment-seeking alcohol dependent patients and 26 age-gender matched controls in the addiction division of psychiatry department of Çanakkale Onsekiz Mart University. After describing the study and obtaining informed consent, participants were assessed with demographic questionnaires, followed by the structured clinical interview for the DSM-IV-TR and childhood trauma questionnaire (CTQ-28).

Result

The 91.4% of the patients were male, mean age was 42.03 ± 12.9. The overall prevalence of CTE of the alcohol dependent patients was (88.6%) higher than the control (42.3%) group. Respectively the prevalence of physical neglect was 80%, emotional neglect 74.3%, emotional abuse was 51.4%, physical abuse 40% and sexual abuse 28.6%. For psychiatric disorders 96.8% of the alcohol dependent patients with childhood trauma reported any of the psychiatric disorders, 64.5% ever having a mood disorder with 25.8% ever having any anxiety disorders, and 16.1% ever having attention and hyperactivity disorder. The most common psychiatric co-morbidity was found to be as depression (58.1%).

Conclusions

In conclusion alcohol use disorders are thought to be associated with childhood trauma. Patients with alcohol use disorders are exposed to have more childhood trauma. Childhood trauma is associated with psychiatric co-morbidity especially depression. We have to ask for childhood trauma in alcohol dependent patients with psychiatric co-morbidity.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Tobacco cessation failure: Predictive value of BDI score
Authors: El kefi H. , Guetary Y. , Bouzouita I. , Bechikh Brahim C. , Krir W. , Eddif S. , Oumaya A.
Published: June 2017

Background

Smoking is a major healthcare issue. Evidence shows considerable comorbidity between nicotine dependence and depressive disorders.

Objectives

We are interested in the correlation between Beck's depression inventory (BDI) scores and smoking cessation outcomes.

Methods

Retrospective, transversal and analytical study. Data were collected from 95 patients followed in the smoking cessation consultation of The military hospital of Tunis. The BDI was used to assess depressive symptoms and nicotine dependence evaluated by Fagerstrom test for nicotine dependence (FTND).

Results

Population was composed of men (92%), married in 65% of cases, with a mean age of 45 ± 13 years. The mean age of smoking initiation was 18 ± 4.5 years. Regular smoking average was 37 ± 20 Packs/Year. The mean cigarette consumption was 30 ± 15 per day. Forty-two percent patients reported at least one attempt to quit smoking, with an average of 37.26 days of abstinence. The mean score of FTND test was 7 ± 2.31. The BDI score was higher than 3 in 86% of cases. Patients with severe depression (BDI > 15) had never attempted a withdrawal in 71% of cases (P = 0.009), had a high or very high dependence in 85.7% of cases (P = 0.016). The average of cigarettes per day was 40 (P = 0.035) and they had failed withdrawal in 79% of cases (P = 0.53).

Conclusion

There was a fairly consistent association between presence of depression and smoking severity. This suggests that for individuals with nicotine dependence who are interested in quitting smoking, assessment and treatment of depressive symptoms may improve smoking cessation outcomes.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Addictology consultations: Experience of the outpatient department of the Razi hospital
Authors: Jihene J. , Olfa M. , Haifa Z.
Published: June 2017

Introduction

The addiction is a social and universal phenomenon. Its coverage is quite recent in Tunisia. It requires a facilitation of the access to healthcare, with broadcasting of the policy of reduction of risks.

Objectives

Raise a current situation of the addicting conducts of our patients.

Methods

Retrospective descriptive study, concerned the patients having an addiction in psychoactive substances followed in the external consultation of the hospital Razi between November 2014 and September 2016.

Results

The average age was 34 ± 10.23 years.

Among the patients, 93.7% was of sex male.

Almost half immigrated in secret in Europe.

Seventy-five percent had criminal record.

The most used product was tobacco followed by alcohol, cannabis, benzodiazepines, Trihexyphenidyl and the opiates.

The buprenorphin is the most consummate opiate in misuse.

Target substances of the request of weaning are respectively: the buprenorphin (58.87%), benzodiazepines (12.63%), the trihexyphenidyl (7.71%), the alcohol (5.61%), the cannabis (5.26%).

A pathological personality was raised in 17.5%.

A psychiatric comorbidity was found to 8% of the patients.

The coverage is made on 3 shutters: biological by the symptomatic treatment of the weaning and the comorbidities, psychological and social by the social and occupational reintegration thanks to non-governmental organizations.

Conclusion

Addictology is a stigmatized speciality in Tunisia, by the peculiarity of the patients and the slowness of the results. Nevertheless the number of consultants does not stop increasing where from the interest to create more specialized services and structures of rehabilitation.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Therapy workshop: Experience of the senses
Authors: Lira E.M.B. , Vasconcelos S.C. , Piagge C.S.L.D. , Luna S.O. , Silva Nascimento V. , Silva F.P. , Oliveira A.G.M. , Ribeiro E.C.O. , Frazão I.S.
Published: June 2017

Introduction

The psychoactive substances consumption modifies the users’ sense-perception.

Objectives

Discuss the therapeutic workshop as a stimulation strategy of the sense organs.

Methodology

The activities were developed at a Center of Psycho-Social Attention for alcohol and other drugs – CPSAad, located in north-eastern Brazil. The therapeutic workshop was divided into six sessions; being worked a sense organ in each meeting. Initially, the sessions were explained and they entered the room in silence. At first, vision and lastly, taste. The taste dynamic session was initiated by the pool where users experienced different flavours and made distinctions between them, including a food without flavour, experiencing feelings of pleasure and displeasure. This dynamic was finalized in the institute's kitchen with different ice cream flavours. The participants freely served themselves, being led to reflections on their choices of pleasure. The sixth session was constituted by listening about all Therapy Workshop Experience of the Senses, on which participants reported emotions and feelings experienced during the sessions, such as: fear, anxiety, craving, denial, pleasure and displeasure.

Results

It was identified a universe of sensations that can be translated into a sense-perception reframing about themselves and their surroundings.

Conclusion

The participants presented a sensory dullness, relating the experienced stimuli to the consumption of psychoactive substances, demonstrating a strong equivalence between the proposed activity and substance dependence. This activity enabled an interdisciplinary approach, through knowledge and interventions exchange.

Disclosure of interest

The authors have not supplied their declaration of competing interest.