bluuebunny/crossref_metadata_2025 huggingface dataset:
Abnormal connectivity in dorsolateral prefrontal cortex in schizophrenia patients and unaffected relatives
Authors: Galindo L. , Pastoriza F. , Bergé D. , Mané A. , Roé N. , Pujol N. , Picado M. , Bulbena A. , Perez V. , Vilarroya O.
Published: May 2016

Objectives

The aim of this study is to explore connectivity of the left dorsolateral prefrontal cortex (LDLPC) by functional magnetic resonance imaging during resting state, in subjects affected by schizophrenia and unaffected relatives.

Methods

We recruited a group of 29 patients diagnosed with schizophrenia, who were treated with atypical antipsychotics, who are and were clinically stable in the last 6 months and had an illness duration range from 5 up to 15 years. We also recruited a group of 23 unaffected relatives, without history of other mental, neurological or somatic disease and a group of 37 healthy volunteers. No subject in any of the three groups met criteria for substance use disorders.

All three groups were clinically evaluated, and a functional magnetic resonance during Resting State was performed.

Functional images were reoriented to the first scan, normalized to the MNI EPI template and smoothed with an 8 mm Gaussian kernel, with SPM. The CONN-FMRI Toolbox v1.2 was used to create individual subject seed-to-voxel connectivity maps, to the corresponding seeds of the default mode network.

Results

Fig. 1.

Conclusions

Our results show a significant increase in connectivity between LDLPC and anterior prefrontal cortex, dorsolateral prefrontal cortex and somatosensory association areas, especially between patients and controls. It is noteworthy to mention that we found a significant decrease in connectivity between LDLPC and supramarginal gyrus, superior temporal gyrus and somatosensory association areas between unaffected relatives and controls.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
An interventional, multi-center, randomized, double-blind, placebo-controlled, active reference, flexible dose study of brexpiprazole in adults with acute schizophrenia
Authors: Marder S.R. , Hakala M. , Gislum M. , Skuban A. , Weiller E. , Weiss C.
Published: May 2016

Introduction

Brexpiprazole is a serotonin-dopamine activity modulator that is a partial agonist at 5-HT1A and dopamine D2 receptors at similar potency, and an antagonist at 5-HT2A and noradrenaline alpha1B/2C receptors.

Objectives

Evaluating the efficacy, safety, and tolerability of flexible doses of brexpiprazole compared with placebo in patients with acute schizophrenia.

Aim

Primary endpoint was change from baseline to week 6 in PANSS total score and key secondary endpoint was change from baseline to week 6 in CGI-S score.

Methods

Phase 3, multi-center, randomized, double-blind, placebo-controlled, active reference, trial (NCT01810380). Hospitalized patients were randomized to brexpiprazole (2 to 4 mg/day), placebo, or quetiapine extended release (400 to 800 mg/day) for 6 weeks. Quetiapine was included as an active reference. Changes from baseline were analyzed using an MMRM approach.

Results

Mean change in PANSS total score was −20.0 and −15.9 in the brexpiprazole (n = 150) and placebo (n = 159) groups, respectively (P = 0.056). Sensitivity analyses suggested treatment effect (e.g., ANCOVA, LOCF: P = 0.025; ANCOVA, OC: P = 0.026). Mean change in PANSS total score (−24.0) with quetiapine (n = 150) was significantly greater than that with placebo (P < 0.001), demonstrating sensitivity of the assay. Brexpiprazole separated from placebo on the mean change in CGI-S score (−1.2 vs. −0.9, P = 0.014). The proportion of patients reporting TEAEs were similar between the brexpiprazole and placebo treatment groups (54% versus 54.7%).

Conclusion

Treatment with brexpiprazole showed a clinically meaningful improvement in patients with acute schizophrenia. While the difference between brexpiprazole and placebo only approached statistical significance, sensitivity analyses and secondary endpoints supported a treatment effect of brexpiprazole.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
An observational study of clozapine-induced sedation and its pharmacological management
Authors: Ramos Perdigues S. , Mane Santacana A. , Sauras Quetcuti R.B. , Fernandez-Egea E.
Published: May 2016

Introduction

Clozapine is the only drug approved for resistant schizophrenia, but remains underused because of its side effects. Sedation is common, but its management is unclear.

Objectives

To analyze factors associated with clozapine-induced sedation and the efficacy of common treatment strategies.

Aims

To determine clozapine-induced sedation factors and possible therapeutic strategies.

Methods

Using two years’ electronic records of a community cohort of resistant schizophrenia spectrum disorder cases on clozapine, we performed three analyses: a cross-sectional analysis of which factors were associated with number of hours slept (objective proxy of sedation), and two prospective analyses: which factors were associated with changes in hours slept, and the efficacy of the main pharmacological strategies for improving sedation.

Results

One hundred and thirty-three patients were included; 64.7% slept at least 9 hours/daily. Among monotherapy patients (n = 30), only norclozapine levels (r = .367, P = .033) correlated with sleeping hours. Multiple regression analyses confirmed the findings (r = .865, P < .00001). Using the cohort prospectively assessed (n = 107), 42 patients decreased the number of hours slept between two consecutive appointments. Decreasing clozapine (40%) or augmenting with aripiprazole (36%) were the most common factors. In the efficacy analysis, these two strategies were recommended to 22 (20.6%) and 23 (21.5%) subjects, respectively. The majority (81.8% and 73.9%) did not report differences in the hours slept.

Conclusions

Sedationis common and involves pharmacological and non-pharmacological factors. The only correlation was a weak correlation between norclozapine plasma levels and total sleeping hours. Reducing clozapine and aripiprazole augmentation were the most successful strategies to ameliorate sedation, although both strategies were effective only in a limited numbers of subjects.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Psychometric properties of the Turkish version of the UPPS Impulsive Behavior Scale Sensation Seeking Subscale in a sample of inpatients with alcohol use disorder
Authors: Evren C. , Umut G. , Evren B. , Bozkurt M. , Can Y.
Published: May 2016

Objective

Turkish version of the UPPS Impulsive Behavior Scale was previously validated in a sample of psychiatric inpatients. The aim of the present study was to evaluate psychometric properties of the sensation seeking subscale of this scale in a sample of inpatients with alcohol use disorder.

Method

Participants (n = 190) were evaluated with the sensation seeking subscale of UPPS Impulsive Behavior Scale.

Results

Sensation seeking subscale had two factors, which together accounted for 63.80% of total variance. As similar with original subscale internal consistency for the sensation seeking (coefficient α=0.859), factor 1 (α=0.862) and factor 2 (α=0.755) examined by Cronbach's alpa, were high. Factor 1 (r = 0.894) and factor 2 (r = 0.863) were highly correlated with total score, whereas moderately correlated (r = 0.544) with each other. Test-retest correlation for sensation seeking (n = 120) was mild (r = 0.460). Test-retest correlation for factor 1 was moderate (r = 0.518) and for factor 2 was mild (r = 0.431).

Conclusion

These findings support the Turkish versions of the sensation seeking subscale of the UPPS has good psychometric properties among inpatients with alcohol use disorder.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Relationship of impulsivity with severity of ADHD symptoms while controlling the effects of anxiety and depression in a sample of inpatients with alcohol use disorder
Authors: Evren C. , Umut G. , Evren B. , Bozkurt M. , Can Y.
Published: May 2016

Objective

The aim of the present study was to evaluate relationship of impulsivity with severity of ADHD symptoms while controlling the effects of anxiety and depression in a sample of inpatients with alcohol use disorder.

Method

Participants included 190 inpatients with alcohol use disorder. Participants were evaluated with the State-Trait Anxiety Inventory (STAI), the Beck Depression Inventory (BDI), the Short Form Barratt Impulsiveness Scale (BIS-11-SF) and the Adult ADHD Self-Report Scale (ASRS).

Results

Impulsivity predicted both severity of ADHD symptoms and inattentive and hyperactive/impulsive dimensions, even after controlling the effects of depression and anxiety in linear regression models. Types of negative affect that predicted dimensions of ADHD differed; similar with severity of ADHD symptoms, depression and trait anxiety also predicted inattentive dimension, whereas trait and state anxiety predicted hyperactive/impulsive dimension.

Conclusion

Impulsivity is related with severity of ADHD symptoms and dimensions of ADHD although negative affect that is related with dimensions may differ.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Personality dimensions and drug of choice: A descriptive study using Cloninger's temperament and character inventory revised
Authors: Hurtado G. , Mateu G. , Martinez R. , Farre A. , Marti J. , Sanchez R. , Diaz L. , Campillo M.
Published: May 2016

Personality dimensions related with drug use are novelty seeking, impulsivity and harm avoidance. Studies predicting drug of choice over personality variables are controversial.

Objective

To describe personality profile of drug users in relation to substance of choice.

Aims

To know personality dimension differences according to drug used.

Methods

Cloninger's TCI-R was administered to 218 patients in a dual diagnosis unit.

SPSS was applied.

Results

Of the patients, 33.94% had personality disorder. Principal substances used were alcohol, cocaine and cannabis.

Most of drug users had normal scores in each dimension. No high scores were found in reward dependence, self-directedness and cooperativeness with any drug.

High scores were observed for novelty seeking in 42.9% of timulants users; for arm avoidance in a quarter of cocaine, alcohol and methadone users and for persistence in 18.2% of hypnotics users.

Low scores were observed for reward dependence in 45% of heroine and hypnotics users; for persistence in 50% of methadone and 32% of cocaine users; for self-directedness in most of types of drug users and for cooperativeness in up to 50% in heroine, hypnotics, stimulants and cocaine users.

Statistical significant differences were observed for cocaine use and high novelty seeking and low cooperation; for non cannabis use and high harm avoidance; for non anfetamine use and low scores in reward dependence; for opiate use and low self-directedness.

Conclusions

Most of patients had normal scores in the different dimensions.

Presence of comorbid personality disorder led us to consider the results with caution.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Clinical implications of codependency as a model of health disorders associated with stress, in wives of men with alcohol dependence
Authors: Korostiy V. , Kozhyna H. , Markova M. , Yaruj V.
Published: May 2016

Introduction

The potential adverse consequences, personal distress, shame and guilt presented by patients who suffer from codependency require a more in-depth understanding of the phenomenology of this disorder.

Objective

To determine targets of psychotherapy work with the codependency wives of men with alcohol dependence (AD).

Aim

To determine the features of clinical manifestations of codependency as a model of health disorders associated with stress.

Methods

Integrated clinical-psychopathological and psychodiagnostic research, using anxiety and depression scales M. Hamilton, scale of psychosocial stress L. Reeder and methods for determining stress and social adaptation of Holmes and Rahe.

Results

One hundred and sixty wives of men with AD, depending on the type of AD (TF Babor's classification), were divided into two groups: group A, 80 patients with AD type A and 80 their wives, and group B, 80 men with AD by type B TF Babor, and 80 wives. Comparison group consisted of 50 married women whose husbands are not suffering from AD.

All the wives of men with AD distortions emotional state of the prevalence of pathological manifestations of depression and anxiety clinically delineated levels and high levels of psychosocial stress and low stress, unlike women men without alcohol problems. It was found that the more severe psychopathological manifestations occurring in the wives of men with a family history, burdened alcohol and drug abuse (group B).

Conclusions

Available data suggest that a single mechanism of family experiences a stressful situation, we were put in the basis for developing a comprehensive treatment measures and psychotherapeutic support codependent wives patients with AD.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Internet-use related addiction: The state of the art of clinical research
Authors: Kuss D. , Lopez-Fernandez O.
Published: May 2016

Introduction

In 2013, the American Psychiatric Association included Internet Gaming Disorder in the appendix of the 5th edition of the DSM-5, suggesting more research is necessary for the condition to be officially accepted as mental disorder. Criticisms have emerged as to the viability, validity and reliability of the proposed condition, and researchers have pointed out that the subsuming of Internet addiction under the umbrella term of Internet Gaming Disorder (as is the case in the DSM-5) is highly problematic.

Objectives and aims

The objective of this talk is to provide a comprehensive and inclusive analysis of clinical research of Internet-use related addictions from a holistic perspective, given the ambiguity of previous research in the field.

Methods

A systematic literature review was conducted using the database Web of Science, and a total of 44 empirical and clinically relevant studies were identified.

Results

Results indicated that the published clinical research studies can be categorized into four areas, including (i) treatment seeker characteristics, (ii) psychopharmacotherapy, (iii), psychological therapy, and (iv) combined treatment, each of which will be discussed.

Conclusions

At the present day, both diagnosis and research of Internet-use disorders appears rather broad. Furthermore, there appears a need for developing a gold standard of clinical assessment. This will support the establishment of efficacious and effective treatments which need to be tailored to the individual help seekers’ needs.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Do medical students use cognitive enhancers to study? Prevalence and correlates from lithuanian medical students sample
Authors: Lengvenytė A. , Strumila R.
Published: May 2016

Introduction

Use of prescription psychostimulants and nootropics for non-medical purpose is a growing trend, especially in academic environment. Seeing the risks of neuroenhancement we decided to investigate situation in Lithuania.

Objective

Analyze the use of cognitive enhancers among medical students in Lithuania.

Aims

1. Determine the prevalence of cognitive enhancement. 2. Figure out what drugs are mostly used and reasons for the usage. 3. Evaluate the contributing factors.

Methods

A cross-sectional survey study was performed in Vilnius University and Lithuanian University of Health Sciences. Students were asked to fill anonymous paper questionnaires consisting of 13 items concerning prevalence of substance use to enhance cognitive performance, reasons, and correlates during lecture time.

Results

Results are summarized in Table 1. A total of 8.1% of responders indicated that they had used cognitive enhancers. Nootropics were the most frequently mentioned: 59.6%, while psychostimulants were mentioned less frequently: 38.3% (including modafinil, methylphenidate and amphetamine derived drugs), and 23.4% indicated other substances. Improvement of concentration and increased studying time were predominant purposes (55.3% and 48.9% of users). Male students reported 3 times higher prevalence rates than females (14.6% vs. 5.1%, P < 0.05). Prevalence were also higher in students, who knew someone using these substances as compared to those who did not (17.3% vs. 5.1%, P < 0.05); it was the most associated factor with cognitive-enhancing drug taking behavior (Table 1).

Conclusions

In Lithuania, 1 of 12 medical students admits to having used neuroenhancing drugs. Nootropics were the most used drugs. Knowing user was the most important factor for usage.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Early alcohol use as prognostic factor for severity in dually diagnosed patients
Authors: Martinez-Riera R. , Mateu-Codina G. , Farre-Martinez A. , Perez de Heredia J.L. , Marti-Bonany J. , Hurtado-Ruiz M.G. , Campillo-Saenz M.T. , Sanchez-Gonzalez R. , Ribas-Muñoz N. , Castillo-Buenaventura C. , Torrens-Melich M.
Published: May 2016

Objectives

Describe the distinguishing characteristics between patients with early onset of alcohol use (EARLY, age < 15) and late onset of alcohol use (LATE, age > 16), both affected of acute non-substance use psychiatric disorders (non-SUD) and any substance use disorder admitted in a dual diagnosis unit.

Material and methods

Data on demographic, family, and clinical factors were gathered among subjects admitted to our dual diagnosis unit along three years, all of them meeting DSM-IV criteria of any non-substance related Axis I or II disorder and comorbid substance use disorder (SUD). Statistical analysis was performed by using SPSS program.

Results

We show results of 748 patients (437 of EARLY group and 311 of LATE group). Predominantly male (73,53%) with a mean age of 39,60 ± 9,7 years. Most prevalent non-SUD psychiatric disorders were psychotic disorder (39,97%) and personality disorder (39,30%). In our sample, most common substances of abuse were Alcohol (45,05%) and Cocaine (30,35%). EARLY patients had an earlier first contact all substances as well as an earlier age of problematic consumption of cocaine, alcohol, opioids and nicotine; they also had major prevalence of opioid SUD, sedatives SUD and amphetamines SUD (see Tables 1, 2 and 3).

Conclusions

Patients who began earlier their consumptions of alcohol had major prevalence of opioid, sedatives and amphetamine use. They also had earlier consumptions of other substances and earlier problematic consumptions of cocaine, alcohol, opioids and nicotine, what probably means greater severity of drug addiction in the long run.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Nalmefene as an intermittent treatment for alcohol abuse triggering cocaine and sex consumption
Authors: Morera-Fumero A. , Diaz-Mesa E.
Published: May 2016

Nalmefene modulates the motivational system by blocking the opioids receptors. Nalmefene indication is the alcohol consumption reduction in alcoho dependent patients. We describe the case of a patient with weekend alcohol abuse that was followed by cocaine use and sex. After being treated with nalmefene, the patient decreased alcohol consumption and did not engage cocaine use and sex. The patient is a 36-year-old man with a previous history of cocaine, cannabis and alcohol abuse. After detoxification the patient became a weekend drinker. Two months later he started complaining that after drinking he needed to consume cocaine and this led him to having sex with prostitutes. These behaviours had a serious impact on his finances that lead him to asking for help. Nalmefene, 18 mg at dinner before going out, was prescribed. Taking one pill of nalmefene “allowed me to drink several shots without feeling a need to continue drinking and, most importantly, I didn’t feel the need to consume cocaine and have sex”. In an attempt to ascertain if what had happened the previous weekend was “psychological” the patient went out without taking nalmefene. The pattern of alcohol use, control loss, and consumption of cocaine and sex repeated itself. During the following two months, the patient took nalmefene during dinner before going out every weekend and the results were the same as when he first took the treatment.

Conclusion

Nalmefene may be helpful in the treatment of several other addictions by blocking the positive reinforcements of the drugs.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
A case of share psychotic disorder induced by mephedrone
Authors: Baena R.A. , Lázaro Y. , Rodriguez J. , Olivares L. , Matas A. , Niell L.
Published: May 2016

Introduction

Share psychotic disorder “folie à deux” is a rare condition characterized by the transmission of delusional aspects from a patient to another linked by a close relationship. We report the case of two Spanish men who have experienced a combined delusional episode induced by mephedrone.

Objectives

Describe a case of share psychotic disorder induced by mephedrone. Make a review on scientific literature about the use of mephedrone (little is known about the psychiatric consequences of the use of these compounds). The patients had no psychiatric history.

Aims

Show the danger of these novel drugs that are often bought as apparently safe and legal.

Conclusions

Share psychotic disorder was first introduced by Lasegue and Falret who hypothesized that transmission of psychiatric disturbance from one person to another was possible under certain circumstances. The correlation of symptoms with the intake of these substances is supposed in the light of a negative psychiatric history and no other concomitant medical treatments. An important number of case reports documented deaths related to the ingestion of mephedrone. Another problem is that these substances are not detected by standard blood and urine test so that the diagnosis of intoxication is often delayed.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Quetiapine XR reduce impulsivity and dissociation in a sample of alcoholic patients
Authors: Godio M. , Preve M. , Suardi N.E. , Bolla E. , Colombo R.A. , Traber R.
Published: May 2016

Introduction

Alcohol dependence (AD) is a major public health problem. Currently, three drugs for the treatment of AD have been approved: acamprosate, disulfiram and oral naltrexone. Quetiapine XR is an atypical antipsychotic has been shown to be a promising medication for the treatment of alcoholism [1,2]. The aim of our study is evaluate quetiapine efficacy on impulsivity in a sample of alcoholic patients.

Method

A sample of alcoholic patients (n = 40) was assessed at the entrance and 2 months with: SCID-P, Brief-Temps, BIS-11, GSR, BPRS, SCI-DER, and CGI. The medium dosage of quetiapine is 300 mg.

Results

Using the last observation carried forward, the mean total BIS score decreased from 60.8 at baseline to 40.2 at the final visit (P = .03). More pronounced improvement was observed in motor impulsiveness (P < .03) and attentional impulsiveness (P < .05) compared with non-planning impulsiveness (P = .09). We observed an improvement in SCI-DER total score (P = .02), in particular in derealization (P = .03) and autopsychic depersonalization (P = .04). A mean weight gain of 4.8 kg was observed. There is not significant different related to the different affective temperament.

Discussion and conclusion

Analyses revealed a significant effect of Quetiapine XR in improving impulsivity and dissociation, in particular motor and attentional impulsiveness, derealization and autopsychic depersonalization. Moreover, an improvement of dissociative symptoms is probably connected with the blockade of postsynaptic 5-HT1A receptors [3]. Methodological limitations, clinical implications and suggestions for future research directions are considered.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Alcohol and dual disorder. Paliperidone palmitate effectiveness
Authors: Raposo M.R. , Ivanov V. , Martínez I. , González A.L. , Piqueras M.D. , Busaileh A. , Murcia J.B. , Manzur P. , Belmar A. , Bello I. , Bravo S. , Gil A. , Rodríguez A.
Published: May 2016

Introduction

Alcohol use is a common behavior in most people in our society. A first episode of alcoholism can be fully recovered through specialized treatment and other protective factors and need not become a relapse later.

Objectives

Whether there are differences in alcohol use after 1, 3 and 6 months after the administration of paliperidone palmitate extended-release injectable suspension in a sample of patients.

Material and methods

This is a descriptive study that analyzed the differences observed with respect to alcohol use after administration of paliperidone palmitate in a sample of 98 patients attending in a Mental Health Centre, in the Unit for drug dependency to present pathology dual.

Results

The percentage of alcohol use at baseline is 56.1% of the total sample.

One month after treatment with paliperidone palmitate the percentage of use is reduced to 31.6%. At 3 months of treatment the reduction is more significant assuming only the 6.1% of the total sample. Finally after 6 months of treatment the percentage of patients maintaining alcohol use is 4.1%, which represents a 52% reduction compared to the initial rate of use.

Conclusions

The data reflect a 92% reduction in alcohol use after 6 months of the administration of paliperidone palmitate.

We can say that paliperidone palmitate is effective in reducing alcohol use in patients with dual diagnosis.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Dual diagnosis patients at first admission in an acute psychiatric ward. Trend over a decade
Authors: Rossi A. , Lombardi A. , Gramaglia C. , Cavanna M. , Bert F. , Siliquini R. , Zeppegno P.
Published: May 2016

Introduction

Dual diagnosis (DD) is the coexistence of a Psychiatric Disorder (PD), and Substance Use Disorder (SUD). The increase of DD observed in recent years has caused serious problems to both public and private services organization.

Aims

Our aim is to assess the prevalence and features (including clinical and sociodemographic ones) of DD over a decade, comparing the period 2003–2004 and 2013–2014.

Methods

We performed a retrospective study retrieving the medical records of DD patients at their first admission to the Psychiatry Ward AOU “Maggiore della Carità”, Novara, Italy. Sociodemographic and clinical features were recorded. The two groups of patients (2003–2004 vs. 2013–2014) were compared.

Results

In both periods DD patients are usually Italian male, aged 19–40, single. They have usually attended middle school, live with parents, have two or more brothers and/or sisters but no kids. DD patients in 2003–2004 and 2013–2014 showed differences as far as employment and diagnosis are concerned. The first were more frequently employed than the latter: moreover the 2003–2004 patients were more frequently diagnosed with a personality disorder while the 2013–2014 patients had mixed diagnoses. We have found differences in the possible predictors of substance abuse in the two periods, as well.

Conclusions

The identification of changes in the prevalence of first admission DD patients and their clinical and sociodemographic features may help to highlight an evolving pattern of substance use and to identify possible risk factors which may be the target of prevention and treatment approaches.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Before and after nalmefene, a case report
Authors: Salgado N. , Benavente S. , Macías B. , Sanchez C.
Published: May 2016

Introduction

Clinical and social improvement after treatment with nalmefene in an alcoholic 41-year-old male, with history of dependence during 20 years.

Case report

Our patient had been abusing alcohol for almost 20 years with short breaks of abstinence (one month). Before treatment he made a consumption of 105 g of alcohol per day. Serological examination showed hepatic alterations (GGT 2115, ALT 229) and a low amount of platelets (61,000). He also had no other relevant medical history and other possible clinical diagnoses were excluded. After a week detoxification program and alcohol consumption cessation during one month, the analytical values drastically changed: ALT 35, GGT 275, platelets 222,000.

Discussion

Nalmefene is an opioid system modulator with antagonist activity at the μ and δ receptors and partial agonist activity at the κ receptor. Nalmefene as-needed has been shown to reduce the total amount of alcohol consumption and number of heavy drinking days and to improve liver function. The aim of this treatment is centered in decreasing consumption rather than achieving a total abstinence.

Conclusions

Against other pharmacologic approaches such as disulfiram an acamprosate, the options that allow acute consumption help patients in controlling drinking rampage and make them realize they will be able to afford alcohol cessation.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Gender differences in the use of prohibited substances in prison
Authors: Sanz Garcia O. , Ibañez M.P. , Muro A.
Published: May 2016

Objectives

The aim of this study is to evaluate the use of both legal and illegal substances, and see the difference in consumption patterns that occur in both men and women.

Methods

Surveys have been conducted on consumer habits in the past year among 84 inmates (60 women and 24 men) at the prison Brians 1, interrogating both the consumption of illegal drugs and consumer recreational drugs and routes of administration. Data were analyzed using SPSS program.

Results

A total of 57.1% had used illegal drugs. The most frequent was cannabis, with 54.8% (62.5% men and 51.7% women), followed by heroin, with 23.8% (29.2% in men and 21.7% in women) and cocaine, with 14.3% (20.8% in men and 11.7% women).

Use of legal drugs was 45.2% (50% in men and 43.3% women). In this case, the greatest differences were obtained in the use of bupropion (26.7% women versus 0% men), new generation anticonvulsants such as gabapentin and pregabalin (31.7% women and 12.5% men) and the use of intranasal route of administration (31.7% women versus 0% for men). At the other extreme we find more abuse benzodiazepines abuse in men (45.8 versus 20% in women) and sedative antipsychotics (37.5% vs. 8.3%)

Conclusions

Although there is a serious problem with the misuse of legal psychotropic drugs by inmates in prisons, there is still greater consumption of illegal substances.

Men's consumption pattern is more “traditional” (predominance of illegal substances and “classical” legal substances orally).

Women's consumption pattern is more experimental at both the use of new psychoactive drugs and the use of alternative routes of administration.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Hereditary influence in alcohol dependence
Authors: Teixeira J. , Pereira G. , Mota T. , Cabral Fernandes J.
Published: May 2016

Introduction

Alcohol dependence is one of the psychiatric disorders for which hereditary influence is strongest. In fact, the importance of genetic factors in transmission of vulnerability to alcohol dependence was first described in literature many years ago by psychiatrists who dedicate to its study. That vulnerability may be explained by an epigenetic model in which biological hereditary factors associate with environmental factors to cause alcohol dependence.

Objectives

Study the influence of genetic factors on alcohol dependence.

Methods

During 4 consecutive months a sample of alcoholic patients was collected from the Alcohol Treatment Unit of CHPL (inpatients and outpatients). Biographic data, patient's psychiatric diagnosis and family history of alcohol dependence or of dependence of other drugs were recorded.

Results

Initial sample included 122 patients. After exclusion of patients who were also hospitalized in that period, the final sample included 102 patients (26% female), with a mean age of 48 years old. Main patients’ diagnosis was alcohol dependence but most of them (52%) presented psychiatric comorbidity. Most patients (55%) had family history of alcohol dependence or dependence of other substances, 26% did not have and 19% did not know. For 61% of patients, the father and/or mother were the affected relative. Most patients (61%) who had a family history of alcohol dependence or dependence of other substances had 2 or more affected relatives.

Conclusions

Most patients with alcohol dependence have family history of alcohol dependence or dependence of other substances, usually in more than 1 relative, which must be taken in account during treatment.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Alexithymia in a sample of alcohol-dependent patients: Clinical correlations and cognitive patterns
Authors: Vecchiotti R. , Orsolini L. , Panichi M. , Marconi M. , Valchera A.
Published: May 2016

Introduction

Alexithymia represents a personality construct, characterized by an inability in identifying and verbally describing own and others’ emotions. According to the recent research on emotional dysregulation and the alexithymic construct, it has been described a positive correlation between alcoholism and alexithymia. The present study aims to evaluate the presence of alexithymia in a sample of alcohol dependant patients and, therefore, analyze how the presence of these alexithymic traits may influence/interact with a range of cognitive processes such as the anger rumination, metacognitive capabilities and dissociative experiences.

Methods

A sample of 40 alcohol dependant inpatients affected with alcohol dependence and alcohol-related issues were recruited, evaluated and compared with a sample of 40 healthy controls. A clinical evaluation and a complete clinical and psychological assessment were carried out in order to investigate alcohol-related clinical patterns, alexithymia construct, anxiety and depression symptomatology and cognitive pattern.

Results

Subjects with alcohol addiction show higher total scores in all tests except the scale that evaluates anxiety, compared to healthy controls. Finally, a factorial ANOVA analysis demonstrated that alcoholism seems to be determined by the lack of emotional recognition from which derives a dissociative state, which consequently generates a depressive rumination.

Conclusions

According to the recent literature, the present study identifies a significant proportion of alexithymic patients within the sample of subjects affected by alcohol-related disorders. Other clinical variables (i.e. depression, pathological anxiety-related worry, anger rumination, dissociation and metacognitive capabilities) mirror a specific cognitive pattern in the sample of alcoholics rather than the healthy group.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Effects of BF-HRV of opioid-dependent persons with pathological gambling
Authors: Gorzelanczyk E. , Feit J. , Pasgreta K. , Laskowska E. , Walecki P.
Published: May 2016

Introduction

It is necessary to search for and to carry out effective treatments for chemical dependency – including behavioral addictions. One of the methods used in various disorders is a biofeedback HRV (BF-HRV). The aim of the study is to examine the impact of BF-HRV on people addicted behaviorally to gambling and chemically dependent patients on opioids.

Material and methods

Twenty-four opioid addicts were examined. We used emWave (HeartMath) with a heart rhythm monitor to learn stress reduction and emotional management skills. For a detailed analysis of the HRV data was used Kubios 2.0 software (Biosignal Analysis and Medical Imaging Group).

Results

The average value of the three components of HRV, i.e. low (LF), medium (MF) and high (HF) frequencies of spectral energy FFT recorded during six consecutive sessions of BF-HRV were the following: 1st session LF 63%; MF: 17%; HF: 19%. Changing parameters in the next sessions: 2nd session LF −9.27%, MF: +0.50%, HF: +6.19%; 3rd session LF −11.11%, MF: +1.00%, HF: −10.07%; 4th session LF −14.27%, MF: −4.17%, HF: +18.77%; 5th session LF −15.02%, MF: −2.04%, HF: +17.07%; 5th session LF −15.02%, MF: −2.04%, HF: +17.07%; 6th session LF −20.86%, MF: −4.04%, HF: +24.90.

Conclusions

After the BF-HRV training decrease low and medium frequencies (LF-MF) and increase high frequency (HF). Recent studies suggest that LF-HRV is an index of cardiac sympathetic control and the LF/HF ratio is an index of sympathovagal balance.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Low vitamin D, and bone mineral density with depressive symptoms burden in menopausal and post-menopause women
Authors: Bener A.
Published: May 2016

Objective

The objective of current study was conducted to determine whether low vitamin D level and BMD are associated with depressive symptoms as burden in Arab women during the menopausal and post-menopausal period.

Design and setting

A cross-sectional descriptive study.

Subjects

A multi-stage sampling design was used and a representative sample of 1436 women aged 45–65 years were included.

Methods

Bone mineral densitometry measurements [BMD] (g/m2) was assessed at the BMD unit using. Data on body mass index (BMI), clinical biochemistry variables including serum 25-hydroxyvitamin D were collected. The Beck Depression Inventory (BDI) was administered for depression purposes.

Results

Of the 1436 women living in urban and rural areas, 1106 women agreed to participate (77.0%). There were statistically significance differences between menopausal stages with regards to ethnicity, education level, systolic and diastolic blood pressure, parity, sheesha smoking and depressive symptoms. Overall, 30.4% of women were affected with osteopenia/osteoporosis in menopause and postmenopausal (24.4% vs. 35.7%; P = 0.0442). Osteopenia in menopause and postmenopausal (18.7% vs. 29.3%; P = 0.030) and osteoporosis (9.9% vs. 15.9%; P = 0.049) were significantly higher in post-menopausal women than in pre-menopausal women (P = 0.046). Similarly, vitamin D deficiency was more prevalent among postmenopausal women than menopausal women. The study revealed that vitamin D level, hemoglobin level, serum iron fasting plasma glucose, calcium, triglycerides, HDL cholesterol, LDL cholesterol, alkaline phosphate and magnesium were considerably lower in postmenopausal compared to menopause women (P < 0.001).

Conclusion

The study confirmed strong association between vitamin D level and BMD in Arab women during the menopausal and post-menopausal period.

Disclosure of interest

The author has not supplied his declaration of competing interest.
A research on anxiety disorder prevalence and severity among vestibuler migraine and migraine patients
Authors: Kutay Yüksel Ö. , Akdal G. , Alkın T. , Dönmez Balcı B.
Published: May 2016

In this research, anxiety, depression symptoms and severity were compared between healthy controls (HC), vestibuler migraine (VM) and migraine patients without history of vertigo (MO).

Method

Thirty-five definite vestibuler migraine patients (according to Neuhauser criteria), 35 MO patients and 32 healthy controls were included. All patients were evaluated for their lifetime psychiatric disorders with Structured Clinical Interview for DSM–IV/Clinical version (SCID-I/CV). All three groups evaluated by:

– Hamilton Anxiety Rating Scale (HARS);

– State-Trait Anxiety Inventory (STAI), (STAI-X1) and the other trait anxiety STAI-X2);

– Beck depression inventory (BDI);

– Lifetime Panic Agoraphobic Spectrum Scale (PAS-SR);

– Penn State Worry Questionnaire (PENN);

– Separation Anxiety Symptoms Inventory (SASI);

– Adult Separation Anxiety Questionnaire (ASA).

Psychiatric diagnosis history (SCID-I); comparison of VM and MO did not indicate a significant difference (P < 0.05). VM and MO patients were significantly different than HC in terms of anxiety symptoms in “HAM-A, PENN, ASA, PAS-SR and PAS-SR subscales (P < 0.05)”. VM was significantly different than MO patients in BDE and PAS-SR (overall; separation anxiety, agoraphobia, reassurance seeking) (P < 0.05). The longer the history of migraine the higher was the anxiety points in both in VM and MO patients (P < 0.05). Headache and vertigo severity in VM patients were significantly correlated with the elevated anxiety and depression points (P < 0.05).

Conclusion

VM and MO patients significantly different in anxiety and mood disorder when compared with healthy controls. Our findings showed that VM patients were more vulnerable to psychiatric disorders. For that reason, multidisciplinary approach for the treatment of VM may facilitate the treatment process.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
The Balkan region preferences for the treatment of anxiety disorders
Authors: Latas M. , Bonevski D. , Andromahi Naumovska A.
Published: May 2016

The most countries from West Balkan region do not have the official guidelines for the treatment of patients with anxiety disorders (AD).

We have done the survey on preferences of treatment of patients with AD. We have collected data from sample of 221 psychiatrists from Croatia (41 psychiatrists), Macedonia (81 psychiatrists) and Serbia (99 psychiatrists). They give as information about their preferences for treating patients with AD.

The results indicate that the vast majority of psychiatrists report that almost all patients with AD receive benzodiazepines prior to first psychiatric visit. The majority of psychiatrist would opt for SSRI/SNRI antidepressants (91–97%) as the monotherapy or in combination with benzodiazepines (53–59%) or in combination with cognitive-behavior (25–35%) or psychodynamic psychotherapy (12–16%).

The most indicative difference between psychiatrists from different countries is result about the use of pregabalin – almost half of Serbian subsample would opt for pregabalin, but only a quarter of Croatian subsample and no psychiatrist from Macedonian subsample would choose pregabalin. Also, much more Macedonian and Serbian psychiatrist would opt for CBT treatment, but, in contrast, much more Croatian psychiatrist would opt for psychodynamic psychotherapy versus CBT. There is the dissimilarity between preferences for patients’ treatment and preferences for psychiatrists himself/herself treatment:

– more than half of the sample would opt for benzodiazepines in their patients but only the third of the sample would prefer benzodiazepines for himself/herself treatment;

– more psychiatrists would prefer to receive psychotherapy treatment than they would prefer to give it to their patients.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Mental health and drug
Authors: Alonso Díaz R. , Cortázar Alonso E. , Guillén Rodrigo H.
Published: May 2016

Introduction

Bipolar disorder (BD) is often associated with various comorbidities. It is substance use disorders (SUD) one of the most frequent comorbidities.

The ECA study (Epidemiologic Catchment Area) observed a prevalence over the life of the 56, 1% for any TUS in the total sample of patients with bipolar disorder. In subjects with bipolar I disorder prevalence was 60.7%, and those of type II 48.1.

In the OMS study conducted in America, Europe and Asia, the results confirm the high rates of disorders in patients diagnosed with bipolar disorder regardless of the country of study.

Case

This is a male, 32, who came first to the Provincial Drug Addiction Service of Huelva in 2009 for cocaine, cannabis and alcohol.

In his personal history, he relates a convulsive episode at 14 years and one manic episode associated with consumption of cocaine in 2002 which began to be treated by a team of Mental Health and Provincial Center for Addictions.

He entered twice in a therapeutic community in 2009 for treatment for their disorder dependence on cocaine, alcohol and cannabis.

It has required admission to the Unit Hospitalization twice in 2012, with the discharge diagnosis of manic episode secondary to drug consumption.

Conclusions

Most epidemiological studies in recent decades note the high prevalence of comorbidity BD + SUD.

BD-SUD comorbidity is particularly complex because each disorder affects the evolution of the other and they are frequently multiple comorbidities. In addition, it implies a worse clinical and functional outcome as well as poorer therapeutic response.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Case study: Bipolar disease in treatment with asenapine
Authors: Alvarez Montoya A.M. , Diago Labrador C. , Ruano Hernandez T.
Published: May 2016

Objectives

Analysis of the treatment alternatives for patients diagnosed with a bipolar disorder of torpid evolution. Revision of the possible adverse effects of lithium and its impact on the adherence to treatment.

Methods

We revise the clinical evolution of a patient diagnosed with Bipolar disorder type I, with the following characteristics: at least two maniac episodes per year, consumption of toxic substances and high sensibility to antipsychotics and euthymics.

Results

We will describe the case of a 23-years-old patient diagnosed with bipolar disorder type I. During the course of the illness, benign intracranial hypertension is diagnosed and the treatment with lithium must be stopped. We replace lithium treatment by Asenapine monotherapy. The evolution of the patient was very positive. Taking account of the adverse effects of lithium and reducing them can facilitate the adherence to treatment and also benefit early remission and less deterioration in each episode.

Conclusions

It is fundamental to promote a comprehensive approach to each patient, including psychotherapy, psychoeducation as well as appropriate medication. The knowledge of the described effects helps us to determinate the appropriate medication for each patient.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Manic episode associated with interferon alpha therapy: A case report
Authors: González L. , Gomis C. , Rodriguez V. , Gomez C. , tercelan E. , Ortigosa C. , Anibarro M. , Garcia L.
Published: May 2016

Interferon alpha is a cytokine with antiviral and antineoplastic action, which is commonly used for treatment of Hepatitis C and B, malignant melanoma, Kaposi's sarcoma, kidney cancer and certain hematologic diseases. It is well-known some of its neuropsychiatric symptoms such as depressive symptoms, cognitive impairment, chronic fatigue, dysphoria and anxiety, but there are also other less common like mania, psychotic symptoms and suicide risk that have been reported. These symptoms interfere in the quality of life very significantly, which at the end can affect treatment adherence.

We report a case of a 33-year-old man who was taken to the emergency department by his family referring nervousness, irritability, verbose, and insomnia during the last 5 days. The patient had not psychiatric history. He was diagnosed with a malignant melanoma stage III A a year ago which required to start interferon alpha treatment.

Patient and family tell that symptoms began after forgetting last interferon dose. In the psychopathology exploration, we could observe mood lability, delusion ideas of prosecution, which includes his entire family and autorreferentiality. In the emergency room the blood test, urine drug test and CT were normal.

During the admission, and in collaboration with the Oncology service, it was agreed the reintroduction and maintenance of interferon combined with olanzapine up to 30 mg/day and clonazepam up to 6 mg/day, which resulted in the resolution of symptoms in two weeks.

Disclosure of interest

The authors have not supplied their declaration of competing interest.