bluuebunny/crossref_metadata_2025 huggingface dataset:
Influence of 5-HTR2C Polymorphisms on Metabolic Syndromes in Thai Schizophrenia Patients
Authors: Puangpetch A. , Na Nakorn C. , Unaharassamee W. , Sukasem C.
Published: June 2017

Introduction

Metabolic syndrome is a significant problem in the schizophrenia patients. Previous research demonstrated that single nucleotide polymorphisms in the serotonin 2C receptor (5HTR2C) genes are associated with metabolic syndrome related to schizophrenia patients taking atypical anti-psychotic drugs. This study aimed to investigate whether the effect of 3 SNPs in 5HTR2C gene on the presence of the metabolic syndrome in Thai schizophrenia patients.

Method

We conducted a cross-sectional study and 154 patients were recruited. The schizophrenia patients were identified from a diagnostic and statistical manual of mental disorders, 4th edition, (DSM-IV) and criterion and determined the metabolic syndrome according to the 2005 international diabetes federation (IDF) Asia criteria. Patients were genotyped for the 5HTR2C rs51,8147, rs126,881,02, rs128,367,71 polymorphisms.

Results

The preliminary analysis from 154 patients showed the metabolic syndrome prevalence was 38.73%, with 46.50% in male and 53.48% in female patients. The results showed that the patients who have heterozygous and homozygous variant on 5HTR2C gene (rs518,147 and rs126,881,02) showed a significant difference in the presence of metabolic syndrome when compare with patients who carry homozygous wild type (P = 0.007), especially in male patients (P = 0.002). The association between 5HTR2C polymorphisms and metabolic syndrome was found in male patients but not found in female patients.

Conclusion

These findings suggest that 5HTR2C genotypes are associated with the metabolic syndrome in patients taking atypical anti-psychotics. However, the metabolic syndrome results from the multigenetic effects. The further studies should focus on the other genes, which were involved in metabolic syndrome.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Introduction to Mindfulness: A Pilot Exploratory Study Among Memory Clinic Attendees
Authors: Dolan C. , Bruce I. , Lawlor B.A.
Published: June 2017

Background

Evidence from the literature suggests that group mindfulness interventions result in improved quality of life, less depressive symptoms and improved subjective sleep quality among patients with memory problems [1].

Objectives

To design and pilot a brief mindfulness intervention for Memory Clinic attendees.

Aims

To develop a non-pharmacological low-resource intervention for Memory Clinic attendees.

Methods

An introduction to mindfulness pack, designed by author CD, includes a booklet introducing the concept of mindfulness, instructions for meditation exercises with an accompanying CD. Memory clinic attendees diagnosed with subjective memory complaints or mild cognitive impairment were invited to take part. Participants completed standardised questionnaires pre- and post-intervention, which examined subjective memory, depression and anxiety symptoms, subjective sleep quality, worry and mindfulness levels. Qualitative information was also gathered.

Results

Of twenty-four participants (66.6% female, mean age 60.8 years), 14 (58.3%) completed the 6-week study. There was no statistical difference in anxiety and depressive symptoms, quality of life, sleep quality and worry levels pre- and post-intervention among participants. However, 100% of participants found the mindfulness intervention beneficial, with 64.3% (n = 9) reporting a subjective improvement in both memory and concentration.

Conclusions

In this small pilot study, a brief self-guided mindfulness intervention was found to be acceptable to a heterogenous group of Memory Clinic attendees.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Economic Recession and Mental Health Distress: Does Age Matter?
Authors: Frasquilho D. , Cardoso G. , Ana A. , Silva M. , Caldas-de-Almeida J.M.
Published: June 2017

Introduction

The association between economic crises and mental health problems can be attributed to a number of factors. Among these, age seems to be an important determinant.

Objectives

The aim of this study was to assess whether mental health of the Portuguese population following the onset of the 2008 recession, differs by age groups.

Methods

A follow-up study (2015) on the population aged 18 to > 65 years old, using the National Mental Health Survey (n = 911). The age-group prevalence of mental health distress assessed by the ten-item Kessler's Psychological Distress Scale (K10) was calculated using Chi2 statistics and mental distress as a categorical variable (P < 0.05).

Results

Mean mental distress score differed significantly according to age group, χ2(3) = 10.684, P < = 0.05. The results showed that the older groups (50–64 and 65 = years old) were more frequently under mental distress (17–19%) compared to younger people (18–49 = years old), which were less likely to report being distressed (8–12%).

Conclusions

Age seems to be an important determinant of distress levels during the economic crisis in Portugal. Older adults reported to be more distressed compared to younger individuals. There are several hypotheses for a differential expression of psychological distress between age groups such as working status and retirement, which can express differential access to coping resources under such contextual negative pressure of economic recession. Further research on age groups is thus needed to better understand how recession generates adverse effects on mental well-being.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
The Effect of Apolipoprotein E ɛ4 (APOE E4) on Visuospatial Working Memory in Healthy Elders and Amnestic Mild Cognitive Impairment Patients: An Event-related Potentials Study
Authors: Gu L.
Published: June 2017

Introduction

Previous studies provided inconsistent evidences for the effect of apolipoprotein E ɛ4 (APOE ɛ4) status on the visuospatial working memory (VSWM). Our study was the first investigation with event-related potential (ERP) to explore the effect of APOE ɛ4 on VSWM in healthy elders and aMCI patients.

Objective

The aim was to investigate the effect of APOE ɛ4 on VSWM with event-related potential (ERP) study in healthy elders and aMCI patients.

Methods

Thirty-nine aMCI patients (27 APOE ɛ4 non-carriers and 12 APOE ɛ4 carriers) and 43 their matched control (25 APOE ɛ4 non-carriers and 18 APOE ɛ4 carriers) performed an N-back task, a VSWM paradigm that manipulated the number of items to be stored in memory.

Results

Our study detected reduced accuracy and delayed mean correct response time in aMCI patients than healthy elders. P300 was elicited by VSWM and its amplitude was lower in aMCI patients at the central-parietal and parietal electrodes than healthy controls. In healthy elders, P300 amplitude declined prior to task performance change in APOE ɛ4 carriers than non-carriers. Regarding aMCI patients, P300 amplitude result revealed exacerbated VSWM deficits in APOE ɛ4 carriers than APOE ɛ4 non-carriers. Additionally, standardized low-resolution brain electromagnetic tomography analysis (s-LORETA) result showed enhanced brain activation in right parahippocampal gyrus during P300 time range in APOE ɛ4 carriers than non-carriers in aMCI patients (Fig. 1, Tables 1 and 2).

Conclusions

It demonstrated that P300 amplitude might serve as a biomarker for recognizing aMCI patients and contribute to early detection of worse VSWM in APOE ɛ4 carriers than non-carriers.

Disclosure of interest

The author has not supplied his/her declaration of competing interest.
Charles Bonnet Syndrome (CBS): Successful Treatment of Visual Hallucinations Due to Vision Loss with Agomelatine in Three Cases
Authors: Hsu H.C. , Huang Y.S. , Fan W.X. , Chen T.C.
Published: June 2017

Background

CBS becomes more prevalent as the population ages. CBS is characterized by the triad of impairment of vision, complex visual hallucinations with insight, mentally normal people. Although visual hallucinations in the elderly are often associated with dementia with Lewy body, Alzheimer's disease and delirium, they are excluded from the diagnosis of typical CBS. Here, we describe three typical CBS patients whose visual hallucinations developed after bilateral severe visual impairment due to diabetic retinopathy. The effectiveness of agomelatine adds to evidence implicating serotonergic and melatoninergic pathways in the pathogenesis of visual hallucinations.

Case report

The average age of these three patients (2 males and 1 female) is 71. Except for the visual hallucinations, all patients showed no psychiatric symptoms or cognitive decline or neurological focal signs. They were frequently upset by the fact of hallucinating, fearing that they are losing their minds. They lived in fear of impending insanity, guilty feeling, unhappy mood, insomnia. The frequency of visual hallucinations stopped with agomelatine 25 mg/day for 3 weeks in these cases.

Discussion

To our knowledge, this is the first report describing the effectiveness of agomelatine in treating typical CBS patients and indicates that agomelatine is an safer option for the treatment of CBS, especially in the elderly, diabetic population. Therapeutic options for CBS still remain poor and of uncertain benefit for the individual patient. CBS has a high prevalence rate (0.4%–30%) among the visually impaired. Clinicians must ask elderly people with visual impairment whether they have hallucinations. Firm reassurance that the syndrome is not related to mental illness is a major relief to an elderly person burdened already with failing vision.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
White matter hyperintensities as a new predictor of driving cessation in the elderly
Authors: Lim K.Y. , Son S.J. , Jang M. , Hong C.H.
Published: June 2017

Background/aims

Motor, perceptual, and cognitive functions affect driving competence. White matter hyperintensities (WMH) changes on brain MRI are associated structural brain changes along with cognitive and motor performance. The aim of this study was to investigate the association between WMH and driving ability in the elderly.

Methods

Participants (n = 540) were drawn from a nationwide, multicenter, hospital-based, longitudinal cohort study. Each participant underwent clinical evaluations, neuropsychological tests, and interview for caregiver including driving capacity, which was categorized as ‘now driving’, and ‘driving cessation (driving before, not now)’. A total 540 participants were divided into three groups (389 mild, 116 moderate, and 35 severe) depending on the degree of WMH. The same evaluations of them were followed after each year. The statistical analyses were performed using χ2 test, an analysis of variance (ANOVA), structured equation model (SEM), and generalized estimating equation (GEE).

Results

In a SEM, greater baseline degree of WMH was directly associated with driving cessation regardless of cognitive and motor dysfunction (β = –0.110, P < 0.001). In GEE models controlling for age, sex, education, cognitive, and motor dysfunction, the more severe changes of the degree of WMH was associated with the faster change from ‘now driving’ state to ‘driving cessation’ state over time in the elderly (β = –0.508, P < 0.001).

Conclusion

In both cross-sectional and longitudinal aspects, the degree of WMH might be one of the predictive factors for driving cessation in the elderly, reflecting both motor and cognitive functions or independently.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
The Effectiveness and Long-term Prognosis of the Intravenous Course of Cerebrolysin in Patients with the Amnestic MCI
Authors: Ponomareva E.
Published: June 2017

Early diagnosis and treatment in the predementia stage of Alzheimer's disease, i.e. in amnestic MCI (aMCI) may improve patient quality of life and promote slowing of conversion to dementia. The purpose of the study was to analyze the effectiveness and long-term prognosis of the course of cerebrolysin therapy in aMCI patients. Twenty elderly aMCI patients were included in the study and treated with a 20-day course of therapy with daily intravenous infusions of 30 mL cerebrolysin. Cognitive functions were assessed by the battery of neuropsychological scales and tests: MMSE, MoCA-test, МDRS, the Boston naming test, the Clock Drawing Test, Frontal Assessment Battery, the test “10 words”, the Digit Repetition Test. The level of the auto-antibodies to a short peptide fragment of the neurotrophins P75 receptor has been investigated by ELISA in the patient blood serum 3 times per 6 months (0, 10 and 26 weeks). Analysis of the data showed a statistically significant improvement in psychometric tests at the therapy end and also at 10 and 26 weeks of the study. Long-term therapeutic effect (5 months) proved to be significantly correlating with the following parameters: patient's age older than 70 years, basic indices of the MoCA-test and the test “memory” of the dementia Matisse scale. The decline serum level of autoantibodies to the fragment 155–164 receptor of neurotrophins P75 also provided to be an indicator of the long-term effectiveness of the therapy. These results could determine those aMCI patients who could have positive long-term therapeutic effect following cerebrolysin treatment.

Disclosure of interest

The author has not supplied his/her declaration of competing interest.
What Predicts Adjustment to Aging Among Lesbian, Gay and Bisexual Older Adults?
Authors: Von Humboldt S. , Leal I. , Carneiro F.
Published: June 2017

Introduction

Intervention programs that highlight predictors of adjustment to aging (AtA) for minority older lesbian, gay and bisexual (LGB) populations are scarce.

Objective

The aim of this preliminary study is to build a structural model to explore whether socio-demographic, health and lifestyle-related variables, are correlates of AtA in a group of LGB older adults.

Methods

The sample comprised 287 LGB older adults aged 75 years old and older. Convenience sampling was used to gather questionnaire data. Measures encompassed the adjustment to aging scale, the satisfaction with life scale, demographics and lifestyle and health-related characteristics. Structural equation modeling was used to explore a structural model of the self-reported AtA, comprising all the above variables.

Results

The structural model indicated the following significant correlates: perceived health (β = 0.456; P < 0.001), leisure (β = 0.378; P < 0.001), income (β = 0.302; P < 0.001), education (β = 0.299; P = 0.009), spirituality (β = 0.189; p <0 .001), sex (β = 0.156; P < 0.001), physical activity (β = 0.142; P < 0.001), satisfaction with life (β = 0.126; P < 0.001), and marital status (β = 0.114; P = 0.008). The variables explain respectively 76.4% of the variability of AtA.

Conclusions

These outcomes suggest that policy making and community interventions with LGB older adults may benefit of including variables, such as, perceived health, leisure and income, as these were pointed out as significant for this group of older adults for promoting adjustment to aging in late adulthood.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Neural Patterns in Ecological Momentary Assessment of Social Stressors
Authors: Courtet P. , Olié E. , Husky M. , Swendsen J.
Published: June 2017

Background

Suicidal behaviors result from a complex interaction between social stressors and individual vulnerability. Ecological Momentary Assessment (EMA) provides the opportunity to investigate the relationship between social stressors in daily life and the occurrence of negative thoughts leading to suicidal ideation. fMRI showed that a neural network supports the sensitivity to social stressors in suicide attempters.

Objective

A joint fMRI/EMA study investigated whether individual differences in brain reactivity to scanner-based social rejection was related to social rejection during real-world social interactions.

Method

Sixty women were included: euthymic women with a history of depression with or without suicidal behavior and healthy controls. The Cyberball Game was used as a social exclusion paradigm. Following the fMRI, subjects used EMA for seven days, providing data on environmental, contextual and emotional factors.

Results

In the fMRI study, in comparison to patients without any history of suicide attempt and healthy controls, suicide attempters showed decreased activation in the posterior cingulate cortex, insula and superior temporal gyrus during the exclusion vs. inclusion condition. In the EMA study, social stressors were specific predictors of suicidal ideation in suicide attempters. We will examine here if individuals who show greater activity in specific brain regions during scanner-based social rejection reported a greater social distress during their daily social interactions.

Conclusions

this study used a combined technique to assess whether neural reactivity to experimental social rejection in the scanner is related to real-world social experience, and if it may help to understand the sensitivity to social stress in suicidal behavior.

Disclosure of interest

The authors declare that they have no competing interest.
Difference in cognitive emotional regulation strategies used by mothers with conflict and barrier personal meaning of child's illness
Authors: Pervichko E. , Dovbysh D.
Published: June 2017

Introduction

A number of studies have noted a high level of symptoms of depression and anxiety in mothers bringing up children with burn injury. The emergence of such symptoms show high importance of child's disease situation to mother and suggests the formation of a special personal meaning of child's illness for mother (conflict or barrier). The aim of this study is to describe specific patterns of mothers responding on the situation of the child burn injuries : special cognitive emotion regulation strategies and personal meaning of illness.

Methods

Clinical interview to assess personal meaning of illness, State Trait Anxiety Inventor, Cognitive Emotion Regulation Questionnaire.

Participants

Twenty-eight mothers (aged between 22 to 43 years), children received burn 5-7 days ago ; 2 mothers (aged between 24 to 37 years), children had burns over a year ago.

Results

We found a strong correlation between using certain strategies of cognitive emotion regulation and different personal meaning of child's illness : mothers with a conflict meaning characterized by using of « Rumination » and « Self-Blame » strategies ; mothers with barrier meaning – « Refocus on planning ». This connection is maintained throughout the child's illness and does not depend on medical specialties. A number of strategies of cognitive emotion regulation are used by all mothers at different stages of the child's illness, regardless of the mother's personal meaning of illness : immediately after injury the most popular strategies are “Catastrophizing” and « Self-Blame » ; in the long-term rehabilitation – « Putting into perspective » is the most common one.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
MicroRNA Profiling in Postmortem Brain and Plasma Exosomes: Biomarker Perspective of Suicidality
Authors: Dwivedi Y.
Published: June 2017

Introduction

Suicide is a leading cause of death. Although research on the biological aspects of suicide is accumulating, there is no testable biomarker to assess suicidality. miRNAs, small non-coding RNAs, have been implicated in synaptic plasticity, genetic susceptibility to stress and coping to stress response. Because of the presence of microRNAs in circulating body fluids, miRNAs can not only be used as regulators of disease pathologies but also in prognosis and treatment response.

Objectives

Whether miRNAs can be used as biomarker for suicidality.

Aims

To examine miRNA expression in brain of suicide victims and in plasma exosomes of suicidal individuals.

Methods

microRNA expression was studied in prefrontal cortex of depressed suicide subjects and healthy normal controls. Role of microRNAs in synaptic plasticity was studied by examining total and synaptonerosomes. microRNA expression was also studied in plasma exosomes of depressed non-suicide and depressed suicide subjects and healthy normal controls.

Results

We found a global down–regulation of miRNAs in depressed subjects (21 miRNAs significantly down-regulated). Many of them were synaptically enriched and encoded at nearby chromosomal loci, shared motifs within the 5’-seeds, and shared putative mRNA targets. In addition, we found a dramatic reorganization of microRNAs in a coordinated and cohesive fashion in depressed subjects. We also detected changes in miRNAs in plasma exosomes of depressed suicide subjects that corresponded to microRNA changes in prefrontal cortex.

Conclusion

Our study provides critical evidence that microRNAs play a major role in suicide pathophysiology and that these microRNAs can be reliably used as peripheral biomarker.

Disclosure of interest

The author declares that he has no competing interest.
No effect of cognitive performance on post-intervention improvement in emotion recognition
Authors: Bozikas V.P. , Tsotsi S. , Dardagani A. , Dandi E. , Nazlidou E.I. , Garyfallos G.
Published: June 2017

Deficits in emotion perception in patients with first episode of psychosis have been reported by many researchers. Till now, training programs have focused mainly in patients with schizophrenia and not in first psychotic episode (FEP) patients. We used a new intervention for facial affect recognition in a group of 35 FEP patients (26 male). The emotion recognition intervention included coloured pictures of individuals expressing six basic emotions (happiness, sadness, anger, disgust, surprise, fear) and a neutral emotion. The patients were trained to detect changes in facial features, according to the emotion displayed. A comprehensive battery of neuropsychological tests was also administered, measuring attention, memory, working memory, visuospatial ability and executive function by using specific tests of the Cambridge Neuropsychological Test Automated Battery (CANTAB). We tried to explore whether cognitive performance can explain the difference noted between the original assessment of emotion recognition and the post-intervention assessment. According to our data, overall cognitive performance did not correlate with post-intervention change in emotion recognition. Specific cognitive domains did not correlate with this change, either. According the above mentioned results, no significant correlation between neuropsychological performance and post-intervention improvement in emotion recognition was noted. This finding may suggest that interventions for emotion recognition may target specific processes that underlie emotion perception and their effect can be independent of general cognitive function.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Research and practice for ultra-high risk for psychosis: A national survey of early intervention in psychosis services in England
Authors: Stain H. , Mawn L. , Common S. , Pilton M. , Andrew T.
Published: June 2017

Objectives

Evidence from meta-analyses of randomised clinical trials shows interventions for young people at ultra-high risk (UHR) of developing psychosis are effective both clinically and economically. While research evidence has begun to be integrated into clinical guidelines, there is a lack of research on the implementation of these guidelines. This paper examines service provision for UHR individuals in accordance with current clinical guidelines within the National Health Service (NHS) in England.

Method

A self-report online survey was completed by clinical leaders of Early Intervention in Psychosis (EIP) teams (n = 50) within the NHS across the UK.

Results

Of the 50 EIP teams responding (from 30 NHS Trusts), 53% reported inclusion of the UHR group in their service mandate, with age range predominantly 14–5 years (81%) and service provided for at least 12 months (53%). Provision of services according to NICE clinical guidelines showed 50% of services offered cognitive behavioural therapy (CBT) for psychosis, and 42% offered family intervention. Contrary to guidelines, 50% of services offered antipsychotic medication. Around half of services provided training in assessment by CAARMS, psycho-education, CBT for psychosis, family work and treatment for anxiety and depression.

Conclusions

Despite clear evidence for the benefit of early intervention in this population, current provision for UHR within EIP services in England does not match clinical guidelines. While some argue this is due to a lack of allocated funding, it is important to note the similar variable adherence to clinical guidelines in the treatment of people with established schizophrenia.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Auditory verbal hallucinations in first episode psychosis – an fMRI symptom capture study
Authors: Dunne T. , Mallikarjun P. , Broome M. , Farmah B. , Heinze K. , Reniers R. , Wood S. , Oyebode F. , Upthegrove R.
Published: June 2017

Introduction

Neurobiological models of auditory verbal hallucination (AVH) have been advanced by symptom capture functional magnetic resonance imaging (fMRI), where participants self-report hallucinations during scanning. To date, regions implicated are those involved with language, memory and emotion. However, previous studies focus on chronic schizophrenia, thus are limited by factors, such as medication use and illness duration. Studies also lack detailed phenomenological descriptions of AVHs. This study investigated the neural correlates of AVHs in patients with first episode psychosis (FEP) using symptom capture fMRI with a rich description of AVHs. We hypothesised that intrusive AVHs would be associated with dysfunctional salience network activity.

Methods

Sixteen FEP patients with frequent AVH completed four psychometrically validated tools to provide an objective measure of the nature of their AVHs. They then underwent fMRI symptom capture, utilising general linear models analysis to compare activity during AVH to the resting brain.

Results

Symptom capture of AVH was achieved in nine patients who reported intrusive, malevolent and uncontrollable AVHs. Significant activity in the right insula and superior temporal gyrus (cluster size 141 mm3), and the left parahippocampal and lingual gyri (cluster size 121 mm3), P < 0.05 FDR corrected, were recorded during the experience of AVHs.

Conclusions

These results suggest salience network dysfunction (in the right insula) together with memory and language processing area activation in intrusive, malevolent AVHs in FEP. This finding concurs with others from chronic schizophrenia, suggesting these processes are intrinsic to psychosis itself and not related to length of illness or prolonged exposure to antipsychotic medication.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Diagnostic Stability in First Psychotic Episode after 5 years follow-up
Authors: Mota-Oliveira M. , Peixoto M.J. , Ferraz I. , Pereira E. , Guedes R. , Norton A. , Silveira C.
Published: June 2017

Introduction

The diagnosis of psychosis is based on the presence or absence of characteristic symptoms. The presence of such symptoms varies during the course and treatment, raising the question of diagnostic stability after a first psychotic episode.

Aims and objectives

The aim of this study is to evaluate the diagnostic stability after a first psychotic episode in the long term (five years after the first inpatient admission).

Methodology

A retrospective study that included patients with first psychotic episode between 2007 and 2011 admitted to the inpatient unit of the psychiatry and mental health clinic of São João hospital center, Oporto, Portugal and re-evaluation of the diagnosis after five years.

Results

We included 60 patients with a first psychosis episode, 22 of which were drop-outs after five years. Of the 38 patients evaluated, it was possible to see that after 5 years 68.4% (n = 26) maintained the same diagnosis during follow-up. In particular, the diagnosis of schizophrenia was kept in 83.3% of patients after 5 years (n = 15, 18 patients with the diagnosis of schizophrenia after first admission). Diagnosis of acute and transient psychotic disorder and psychosis not otherwise specified were the least stable diagnosis after 5 years.

Conclusions

The diagnosis after a first psychotic episode has important therapeutic and prognostic implications. The presence of characteristic symptomatology, with periods of partial or total remission between subsequent episodes emphasizes the need for regular monitoring, since this group of patients appears to be more vulnerable to changes in diagnosis over time.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Role of Co-occurring Alcohol and Substances Abuse on QTc Interval Prolongation Among Psychiatric Patients: A Cross-sectional National Survey
Authors: Corbo M. , Acciavatti T. , Fiori F. , Santacroce R. , Aguglia A. , Bartoli F. , Calò S. , Ribolsi M. , Barone Y. , Pinna F. , Stilo M. , Staffa P. , Caroleo M. , Ruberto S. , Signorelli M.S. , Suraniti F. , Quattrone D. , Reggianini C. , Carra E. , Gazzoletti E. , Campese O. , Castellazzi M. , Ostuzzi G. , Bighelli I. , Nosè M. , Barbui C. , Martinotti G.
Published: June 2017

Introduction

QTc interval prolongation is considered a risk factor for fatal polymorphic ventricular tachycardia, which can result in sudden cardiac death. Most psychotropic drugs have a dose-dependent potential to prolong the QTc interval. However, other factors require appropriate consideration, including: age; gender; other medications; electrolyte abnormalities; severe comorbid conditions, such as co-occurring alcohol or substances abuse/dependence.

Objectives

The objective was to study the potential mediating roles of alcohol/substances abuse on QTc prolongation.

Aims

The Italian research group STAR Network, in collaboration with the Young Italian Psychiatrists Association, aimed to evaluate the frequency of QTc interval prolongation in a sample of patients under treatment with psychotropic drugs through a cross-sectional national survey.

Methods

A sample of 2411 unselected patients were enrolled after performing an ECG during the recruitment period. Sociodemographic and clinical characteristics were collected from medical records. Collected data underwent statistical analysis.

Results

A total of 11.2% of patients reported alcohol abuse, and only 8.9% psychotropic substances. According to the threshold, less than 20% of patients had a borderline value of QTc, and 1% a pathological value. Patients with co-occurring alcohol misuse and drug abuse were more likely to have longer QTc interval.

Conclusions

The present study describes the frequency of QTc prolongation in real-world clinical practice. Before prescribing a psychotropic drug, the physician should carefully assess its risks and benefits to avoid this type of adverse reaction, particularly when additional risk factors are present. The potential role of alcohol and substances on QTc length could be particularly useful in emergency settings.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Resilience and Psychological Correlates in a Group of Patients Affected by Dual Diagnosis
Authors: Delicato C. , Gattoni E. , Di Marco S. , Vecchi C. , Venesia A. , Zeppegno P. , Gramaglia C.
Published: June 2017

Introduction

Although several authors found a strong association between childhood trauma and substance abuse disorder, many other suggest that specific personological aspects and resilience may contribute to the development of this disease.

Objectives

To compare the characteristics of psychiatric patients with and without dual diagnosis assessing differences in psychological correlates, such as resilience, coping strategies, self-esteem, temperament, character traits and childhood trauma.

Methods

From November 2015 to May 2016, we recruited all patients aged between 18 to 65 years referred to the Psychiatry Ward of “Maggiore della Carità” Hospital in Novara, Italy. Diagnosis of psychiatric disorder was made according to DSM-5 diagnostic criteria. Exclusion criteria were: inability to express a valid inform consent, a personality disorder or mental retardation diagnosis. We administered to each patient: Resilience Scale for Adult (RSA), Brief Cope, Rosenberg Self-esteem Scale (RSES), Childhood Trauma Questionnaire (CTQ), Temperament and Character Inventory (TCI). Patients were subdivided for the analysis into two groups: dual diagnosis and no dual diagnosis (or single diagnosis) group.

Results

Data show that dual-diagnosis patients (n = 40) had lower global levels of resilience (RSA) and cooperativeness (TCI). Higher novelty seeking and reward dependence traits (TCI) were found as well. Moreover, the lower Cope-Avoidance (Brief Cope) was statistically different among patients with dual diagnosis compared to single diagnosis ones.

Conclusions

Identified differences between these two groups could suggest targets to manage during the treatments in order to optimise dual diagnosis patients’ outcomes.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Substance-induced Psychotic Disorders in an Emergency Department
Authors: Fernandez-Quintana A. , Novo-Ponte A. , Quiroga-Fernandez C. , Garcia-Mahia M.D.C.
Published: June 2017

Introduction

Substance abuse has been correlated with psychotic disorders albeit more accurate details on causality remain to be assessed. Furthermore, the prevalence and prognosis of substance-induced psychotic disorders have not been clearly established.

Method

Retrospective study performed in 124 patients assessed in an Emergency Department (ED) due to psychotic symptoms over a 6-month period. Medical records were reviewed to obtain clinical and socio-demographic variables.

Objectives

(1) To analyse substance abuse patterns among ED psychotic patients; (2) to estimate the prevalence of substance-induced psychotic disorders in ED; (3) to underpin the socio-demographic and clinical variables associated.

Results

Personal history of substance abuse: THC 31.5%, alcohol 29%, cocaine 18.5%, benzodiazepines 18.5%, opiates 6.5%, MDMA 4%, amphetamines 3.2%, hallucinogens 2.4%. Accumulated time interval of substance abuse prior to psychotic onset: 0–5 years 15% (3.9% developed psychosis during the first year of cannabis use), 5–10 years 9.2%, more than 10 years 20.8%. Urine testing for drug misuse undertaken in 80.6% of cases: positives 53%, negatives 47%. Among positive urine test results: THC 16.5%, benzodiazepines 16.5%, cocaine 6.1%, opiates 5.1%, alcohol 0.9%, amphetamines 0.8%, hallucinogens 0.8%. Substance-induced psychotic disorder (F19.15) was diagnosed among 20.4% of patients. This diagnosis was 1.5 times more prevalent among males. Forty-eight percent of patients were single, 36% married, 12% divorced, 4% widowers. Habitat: 68% urban, 34% rural. Highest prevalence group 36 – 50 year olds.

Conclusions

Both substance abuse and substance-induced psychotic disorders are highly prevalent in our sample. Their socio-demographic and clinical profile is similar to that found in schizophrenia. Further refinements of these findings are warranted.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Childhood Traumatic Experiences and Coping Strategies: Correlations With Quality of Life
Authors: Serafini G. , Conigliaro C. , Pittaluga F. , Pompili M. , Girardi P. , Amore M.
Published: June 2017

Introduction

Individuals with a history of childhood traumatic experiences may exert maladaptive coping strategies and impaired adult quality of life.

Objectives

The present study explored the association between childhood traumatic experiences, coping strategies, and quality of life.

Aims

We aimed to evaluate whether childhood traumatic experiences or specific coping strategies may significantly predict quality of life.

Methods

This is a cross-sectional study including 276 patients (19.9% men, 81.1% women; mean age: 48.1 years, SD: 16.9), of which most with major affective disorders, who were recruited at the psychiatric unit of the university of Genoa (Italy). All participants were assessed using the Childhood Trauma Questionnaire (CTQ), Coping Orientation to Problems Experienced (Cope), and Short Form 12 Health Survey version 2 (SF-12).

Results

Subjects with a history of emotional abuse were more likely to have an earlier age of onset of their psychiatric conditions, an earlier age of their first treatment/hospitalization, higher recurrent episodes and days of hospitalization, longer illness duration and non-psychiatric treatments at intake when compared with those who did not present any history of abuse. Based on regression analyses, only positive reinterpretation and growth, focus on and venting of emotions, and substance abuse, but not childhood traumatic experiences, resulted positive predictors of physical quality of life. Moreover, focus on and venting of emotions was able to predict mental quality of life.

Conclusions

While traumatic experiences did not predict quality of life, specific coping strategies were significant predictors of quality of life. Further studies are requested to test these preliminary results.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
An Embodied Approach to Understand Behavioural Characteristics in Subjects with Autism Spectrum Disorders
Authors: Kékes Szabó M.
Published: June 2017

There are three main areas of impairment in autism: social interaction, communication and repetitive-stereotyped behaviors. While over a long time orthodox cognitive psychology tried to explain the background of these symptoms, nowadays embodiment theories also seem to be useful tools to grasp the real nature of the disease and get a coherent picture about it. The significance of body states, the perceiver's experiences, dynamic interaction between the organism and its environment, and the emergent nature of the connected processes have increased. This study focused on the autistic children's cognitive development and aimed to explore several aspects of it. Accordingly, the sensory-perceptual processes and the participating children's object use were investigated. The main research methods were questionnaires that were filled in by the parents, participant observation via object play and eye-movement analysis during static and dynamic stimuli. The results confirmed different behavioral patterns by children with autism. Thus, for example, hyper-/hyposensitivity, a reduced rate of creative/pretend activities and a lower level of the preference of social effects could be explored in the autistic group more often than it was found in the case of individuals with typical development. In this way, more aspects of the disease could be clearly interpreted using an embodied approach to the behavioural characteristics, although further studies are required to explore these phenomena in a wider range.

Disclosure of interest

The author has not supplied his/her declaration of competing interest.
The Effects of High Exposure to Smartphone from Ages 3 to 5 Years on Children's Behaviors
Authors: Kim S.J. , Cho S.M. , Lim K.Y.
Published: June 2017

Introduction

Smartphones are becoming widely popular and the number of users is significantly increasing, reaching over 65% in South Korea in 2013 and the children begin to use a smartphone at earlier age. Earlier and higher exposure of multimedia is known to have negative effects on children's physical and mental status.

Objectives

The aim of the present study was to examine young children's exposure to smartphone and identify the effects of high exposure of smartphone on children's behaviors among Korean children from ages 3–5 years.

Methods

In 2014–2015, the parents of 400 children aged 3–5 years (207 boys and 193 girls) were surveyed using a questionnaire on the use of smartphone, children's behaviors, temperaments, social and language development at 3 community-based children's mental health centers.

Results

Many children used televisions (95.5%), computers (37.3%) or tablet PC (36.2%), and smartphones (84.6%). Most (74.2%) started using mobile medias before age 2. Parents gave children devices like smartphones to keep them calm (60.8%), when being busy doing something (52.2%), and at playtime (34.3%). The children's age at first smartphone use and the frequency were not associated with children's behaviors and temperaments. Higher use group (> 2 h/d) show more somatic symptoms (OR 8.97, P < .001), more attention problem(OR 4.43, P < .001), more aggressive symptoms (OR 1.30, P < .001) and more withdrawal symptoms(OR 1.22, P < .001) than lower use group.

Conclusions

Young children in Korean urban communities had almost universal exposure to mobile devices, especially smartphone. Early and severe exposure of smartphone by young children aged 3–5 years is highly associated with children's behaviour problems like both internalising and externalising problems.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Evaluation of Stress and Support to Parents of Children with Developmental Disabilities–Our Experience
Authors: Kostić J. , Milosavljević L. , Stanković M.
Published: June 2017

Introduction

Stress is an integral part of parenting. The stress of parenting is especially increased at parents of children with developmental disabilities, which can have negative effects on the health of the parents, the relationship with the child and total parental behavior. The objective of this work is to assess the level of stress of parenting among parents of children with developmental disabilities. Parents were involved in workshops support within a regional project. The workshops were conducted twice a month, in the duration of two hours, during the one-year period. The workshops were led by experts in various fields, and work with parents was psycho-educational and supportive. The assessment was made using the questionnaire Parenting Stress Index-Short Form, within the two time frames, at the beginning of the project and after 12 months. The results showed that nearly two-thirds of parents of children with disabilities were under clinically significant stress at the beginning of the service. By retesting after twelve months, it was found that parental stress decreased, and the decrease is particularly evident in the parental competence experience. Although stress is reduced to some extent by the way the parent is experiencing emotional exchange with the child, its level still remains high.

Conclusion

Our experience shows that supportive workshops, which we participated in significantly, but insufficiently contributed to the stress reduction among parents. This paper discusses other possible interventions, which would specifically be aimed at developing strategies for reductions of clinically high level of parental stress.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Korean Public Knowledge and Perceptions about Treatment of Attention-deficit Hyperactivity Disorder
Authors: Shon I. , Nam B.
Published: June 2017

Objective

The aim of this study was to examine (1) public knowledge and perceptions about attention-deficit hyperactivity disorder (ADHD) and (2) factors influencing the public's decisions to adhere to ADHD pharmacotherapy.

Methods

In this study, 396 participants responded to the Internet survey regarding their experiences, beliefs and treatment preferences about ADHD.

Results

Two hundred and fifty-two respondents (63.6%) were reluctant to pharmacological treatment of ADHD. The respondents chose the functional impairment of the brain as the main cause of ADHD were favorable to pharmacological treatment and scored significantly high on the ADHD Knowledge Questionnaire. On the other hand, the respondents who regarded ADHD as an overly active personality rather than a disease were skeptical to pharmacotherapy and scored significantly low. The respondents who were acquainted with someone who had been diagnosed with ADHD perceived themselves relatively well informed about ADHD. However, the subjective perception of the degree of knowledge of ADHD was not correlated with the objective score of the ADHD Knowledge Questionnaire.

Conclusion

The Korean public is not well informed about ADHD and its treatments. Culturally appropriate psychoeducational strategies based on the media and the Internet are needed. Providing biomedical conceptualization of ADHD to the public may aid with treatment decisions and promote adherence to pharmacological treatment.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
The Improvement of Mental Health Competences and Skills on a Brazilian Federal University
Authors: Soria D. , Cabrial J.D. , Marinho B.C. , Romeiro N. , Mendes A. , Mello R. , Vernaglia T.V.C.
Published: June 2017

Background

The extension project “UNIRIO is madness: the improvement of mental health competences and skills.” work since 2015 with “Ponto de Cultura Loucura Suburbana” on the promotion of mental health and culture style in Brazil. The project work on the development of psychosocial rehabilitation for psychiatric patients, their families and the community.

Aims

Participate on the production and execution on the artistic/therapeutic workshop that demystify the social stigmatizing vision about psychiatric patients.

Methods

The activities developed are: administrative actions; institutional strengthening for social inclusion initiative through work; and the Carnival Block organization.

Results

This study work on constituting a social inclusion initiative through workshop that generate employment, e.g.: sale material production, financial management, material replacement. Although we do all the preparative to the Carnival Block–“Loucura Suburbana”.

Conclusion

The relationship with the psychiatric patients shows that social inclusion through carnival workshop practice is the primary means for the identity of people suffering from mental disorders and contribute to reduce community social stigma.

Disclosure of interest

The authors have not supplied their declaration of competing interest.