bluuebunny/crossref_metadata_2025 huggingface dataset:
New designer benzodiazepines use in Barcelona
Authors: Pérez González S. , De Dios Felis M. , Monteagudo Gimeno E. , Sanagustín Bosqued D. , Trabsa Biskri A. , Grifell Guàrdia M. , Galindo Guarín L. , Quintana Mathe P. , Torrens Melich M.
Published: June 2017

Introduction

New designer benzodiazepines such as phenazepam, etizolam, diclazepam, clonazolam and flubromazolam have appeared in the recreational drug market due to that they provide an attractive alternative to prescription-only benzodiazepines as they are readily available over the Internet.

Objective

To describe the presence of new designer benzodiazepines in samples delivered to energy control since 2010 to 2016 in Barcelona.

Methods

From 2010 to 2016, 24,551 samples were delivered to energy control. Among this samples 43 (0.175%) were analysed as benzodiazepines. They were analyzed by energy control, a Spanish harm reduction NGO that offers the possibility of analyzing the substances that users report. Analysis was done by gas chromatography-mass spectrometry.

Results

From the 43 samples analyzed as benzodiazepines, 1 (2.32%) was delivered in 2010, none in 2011, 2 (4.65%) in 2012, 2 (4.65%) in 2013, 1 (2.32%) in 2014, 15 (34.88%) in 2015 and 21 (48.83%) in 2016.

Discussion

The data shows that new designer benzodiazepines use is increasing in Barcelona, especially in the last two years. Abuse an addiction to these drugs may be a new public health problem in Barcelona. Unknown side effects may appear due to lack of information about pharmacokinetic profile of these drugs.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Nootropics: Emergents drugs associated with new clinical challenges
Authors: Saiz Garcia H. , Montes Reula L. , Portilla Fernandez A. , Pereira Sanchez V. , Olmo Lopez N. , Mancha Heredero E. , Rosero Enriquez A.S. , Martinez Parreño M.E.
Published: June 2017

Introduction

The “nootropic” or simplified as a “smart drug”, is a common term that will tag along with the compound responsible for the enhancement of mental performance. Certain individuals with a history of mental or substance use disorders might be particularly vulnerable to its adverse effects.

Methodology

A review was conducted aiming to clarify the mechanisms associated of how these drugs increase mental functions including memory, motivation, concentration, and attention; and which kind of individuals are at risk of developing adverse effects when taking these drugs. The literature search was conducted in PubMed data reviewing articles dating between 2015 and 2016.

Results

– Glutaminergic Signalling, Cholinergic System, Amyloid Precursor Protein and Secondary Messenger may be related to the cognitive enhancement achieved by Nootropics. Others, like insulin and angiotensin receptor may involved too.

– Some of them, like Ginkgo biloba, seem to have neuroprotective effects observed in human and animal models, acting as antioxidant and antiapoptotic, also inducing inhibition effects against caspase-3 activation and amyloid-aggregation toward Alzheimer's disease.

– Synthetic nootropics, a lab created compound such as piracetam, especially in people with history of drug abuse, may be associated with psychiatric exacerbations of some patients.

Conclusions

Young adults all over Europe, especially university students, are starting to use nootropic drugs to improve their academic results. Some of them seem to have beneficial effects over mental health but others are sometimes related with sudden and unexplained exacerbations in stable psychiatric patients. It is important to early identify symptoms and to treat them properly.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Readiness to change, insight and motivation in hospitalized alcohol-dependent patients in three countries
Authors: Slepecky M. , Stanislav V. , Kotianova A. , Kotian M. , Ryniak J. , Betkovka Korpala B. , Zatkova M. , Popelkova M. , Prasko J. , Latalova K.
Published: June 2017

Introduction

Alcohol dependence is a serious problem in Central Europe and the treatment effect depends on level of patient's motivation. The theory of change assumes that therapeutic approaches should be adapted to the motivation stage.

Objectives

To examine the state of readiness to change at the beginning and the end of inpatient 6-week and 12-week therapeutic program in Slovakia, Poland, and Czechia.

Aim

To compare readiness to change with insight and motivation. To find out, whether patients change during the therapeutic program and how this change leads to advances in treatment.

Methods

A total of 380 inpatients were examined using Alcohol Use Disorders Identification Test (AUDIT), the Stages of Change Readiness and Treatment Eagerness Scale (SOCRATES), Readiness to Change Questionnaire (RCQ), and Demographic Questionnaire.

Results

Measured by AUDIT, single patients declared higher severity of alcohol dependence than married or divorced patients. A majority of patients were at the stage of action (68.5%) or preparation (26.3%) according to RCQ at the beginning of the treatment. Readiness to change was higher at the end of both programs in terms of taking steps in married patients and in terms of Decreasing of Ambivalence in single patients. The results of the 6-week program appear to be slightly better than 12-week treatment.

Conclusions

The intention and motivation to treatment changed during therapy. Marital status may increase the active component for readiness to change, while passive component (decreasing the ambivalence) is observed in single patients. Duration of the program does not seem to be crucial for readiness to change.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
This paper discusses the relationship between alcohol consumption and suicidal behavior in Belarus
Authors: Davidouski S. , Razvodovsky Y.
Published: June 2017

Introduction

Suicide is one of the main causes of premature mortality in Belarus. It is well recognized that drinking is among the major risk factors that are associated with suicidal behavior.

Aims

This study was design to extend our understanding the relationship between alcohol and suicidal behavior.

Methods

Risk factors for suicidal behavior (completed suicide and parasuicide) among residents of Minsk city and Gomel city were studied.

Results

Among the residents of Minsk the maximum suicides risk was in the age of 46–60 years, and parasuicide at age 20–39 years. The ratio of men to women - 4:1; they were often BAC-positive (from 38.8% in 2015 to 42% in 2008). Among parasuicides sex ratio of about 1:1; 30% of men aged 20–39 years, were BAC-positive. Studies in the city of Gomel, has shown maximum number of parasuicides in the ages of 18–29 years (39.3% in women and 30.7% men). Among parasuicides the majority of men (57.8%) and a significant proportion of women (34.2%) were BAC-positive. Maximum number of those attempted suicide and dependent on alcohol were among men ages 30–39 years (66.15%) and 50–59 years (65.22%), among women in the age 30–39 years (45.45%).

Conclusions

Acute alcohol intoxication is characteristic of young people who commit parasuicide. Chronic alcohol intoxication is a risk factor in middle-aged persons who commit suicide. Prolonged use of alcohol contributes to the development of comorbid mental disorders, during the crisis of middle age is manifested as an increased risk of suicides.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Sociodemographic and clinical profile in elderly suicide victims: 34 autopsy case studies
Authors: Ellouze S. , Baati I. , Ben Amar W. , Trigui D. , Abbes W. , Maatoug S. , Masmoudi J.
Published: June 2017

Introduction

The elderly suicide is a major public health problem that is gaining more and more ground, given the aging population problem. This has rarely been the subject of forensic studies in Tunisia.

Objectives

To identify the sociodemographic and clinical characteristics of elderly suicide victims over 60 years and to determine what factors might increase suicide risk in this population.

Methods

We conducted a retrospective study on suicide victims aged 60 and over, autopsied in forensic medicine department of the Habib Bourguiba university hospital in Sfax (Tunisia), on a 10-year period (January 2006–December 2015).

Results

We identified 34 cases with an average age of 66 years. The sex ratio was 2.77. Suicide victims were alone in 38.2% of cases. They were inactive professionally in 32.4% of cases. Almost half of them (44.1%) had a psychiatric history, 40% of depressed pace, 26.7% of bipolar disorder and 13.3% of schizophrenia.

Three main factors were identified as precipitating the passage to suicidal act: family conflicts (26.5%), financial difficulties (11.8%) and loss of autonomy (5.9%).

Suicide methods were hanging (50%), immolation and drug intoxication (11.8%), hit by train and poisoning (8.8%), jumping from height (5.9%) and drowning (2.9%). In 55.8% of cases, suicide took place at home.

Conclusion

Elderly suicide seems to be a huge but largely preventable public health problem. Its prevention is essentially based on the identification of risk situations and the detection and treatment of depression: major suicide risk factor in this population.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Bridgend “Bebo Internet Suicide Cult” and ritual violence in Wales
Authors: Kurz R.
Published: June 2017

Introduction

In a small South Wales town 17 teenagers seemingly committed suicide through hanging in 2008 triggering national media coverage. In the same region, several “Satanist” offenders were successfully prosecuted since.

Objectives

This paper raises awareness of this “suicide epidemic” and its possible links to ritual violence ideologies.

Aims

The research explores how “mind control” through secret societies can lead to suicide and murder.

Methods

The research was prompted by client disclosures of a crime series that lead to a false “delusional” diagnosis. Review of the sparse literature and media coverage was used to ascertain themes.

Results

Colin Batley, a self-styled Satanist high priest, was sentenced for child sexual abuse alongside 4 others. His son Damien had died through aspiration when filming himself in a “sexual stimulation game”.

Ian Watkins, disgraced singer of “The Lost Prophets”, was sentenced for abusing two babies provided by two “super-fan” mums. Peaches Geldorf tweeted their names, got a tattoo of O.T.O, a Satanist “kinky sex” group and was found dead a year later.

Albert and Carole Hickman were sentenced for sexually abusing an 11-year-old including “sucking blood”.

Matthew Williams cannibalised his victim before being killed with a police taser.

Conclusions

“Hanging” and “Over-dosing” could be the result of suicide or of “being suicided”. The abuse crimes of all three Satanists convicted in the last 15 years in UK courts occurred in South Wales. Associated violent death in the vicinity of the cases and authority irregularities suggest the operation of an “Organised ritualised crime abuse network” posing challenges for psychiatry.

Disclosure of interest

The author has not supplied his/her declaration of competing interest.
Learning by doing, learning by seeing: Does observation of clinical simulation still count?
Authors: Fernando M. , Barry T. , Chester L. , Bhat M.
Published: June 2017

Introduction

Role-playing scenarios are widely used in psychiatry education, both as a means of assessment and for teaching various clinical skills. But can you get as much from them by learning vicariously as an observer? Fourth-year medical students from Queen Mary University of London were invited to a psychiatry practice OSCE (objective structured clinical examination), shortly before end of year exams. We created 96 places, approximately 40% of the year, but to maximize numbers students also rotated through the six-station OSCE circuit in pairs. For each scenario students alternated either undertaking the OSCE task or observing.

Objectives and methods

We sought to identify if there was a significant difference in student experience depending on whether they were the ‘candidate’ or ‘observer’. Students were asked to rate their learning experience in each station on a five-point Likert scale and this was analyzed using an ordinal logistic regression model.

Results

While students rated their experiences as ‘observers’ marginally lower than that of ‘candidates’, we found no statistically significant difference (OR = 0.629, P = 0.093). Practice OSCEs took place over six half-days with different facilitators and role-players, but we identified no interaction from these factors. For one station on depression, we found a statistically significant interaction in which ‘candidates’ rather than ‘observers’ rated better experiences (P = 0.032).

Conclusions

Observation by learners is frequently used within simulated clinical scenarios and may have a number of potential advantages. However, while unable to examine the direct impact on knowledge or skills, we found no significant difference in student-reported experiences between ‘candidate’ and ‘observer’ positions.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
EMDR training's for Bosnia and Herzegovina mental health workers resulted with seven European accredited EMDR psychotherapists and one European accredited EMDR consultant
Authors: Hasanovic M. , Morgan S. , Oakley S. , Richman S. , Šabanović Š. , Habibović S. , Pajević I.
Published: June 2017

Introduction

Bosnia-Herzegovina (BH) citizens, affected by 1992–1995 war, developed serious mental health posttraumatic consequences. Their needs for EMDR (eye movement desensitisation and reprocessing) treatment increased. The Humanitarian Assistance Programmes UK & Ireland (HAP) work in partnership with mental health professionals in Bosnia-Herzegovina (BH) from 2010.

Objectives

We aim to build a body of qualified and experienced professionals who can establish and sustain their own EMDR training.

Method

Authors described educational process considering the history of idea and its realization through training levels and process of supervision which was provided from the Humanitarian Assistance Program (HAP) of UK &Ireland with non profit, humanitarian approach in sharing skills of EMDR to mental health therapists in BH.

Results

The trainers from HAP UK & Ireland completed five EMDR trainings in BH (two in Tuzla and three in Sarajevo) for 100 recruited trainees from different BH health institutions from different cities and entities in BH. To be accredited EMDR therapists all trainees are obliged to practice EMDR therapy with clients under the supervision process of HAP UK&Ireland supervisors. Supervision is organized via Skype Internet technology. Up today seven trainees completed their supervision successfully and became European Accredited EMDR Psychotherapists, one of them became European Accredited EMDR Consultant.

Conclusion

Five training of Bosnia-Herzegovina mental health workers to effectively use EMDR with enthusiastic help of EMDR trainers from HAP UK&Ireland resulted with seven European accredited EMDR psychotherapists, and one of them became European accredited EMDR consultant. This will increase psychotherapy capacities in postwar BH.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Doctor–patient communication issues for international medical graduates and medical graduates of foreign origin in Ireland
Authors: Maddock C. , Kelly F.
Published: June 2017

Introduction

The proportion of international medical graduates (IMGs) in Ireland has increased from 13.4% in 2000 to over 33% in 2010. Many of their countries of origin have different cultures, expectations of the doctor–patient relationship and communication styles than Ireland. These differences can adversely impact on the quality of care provided by IMGs. There is a lack of research on the impact of cultural differences on communication in the Irish context.

Methods

Semi-structured interviews were conducted with 16 IMGs in Drogheda Department of Psychiatry. Transcripts were analysed using nVivo10, a specialised computer programme for conducting qualitative analysis and analysed thematically.

Results

General themes emerged relating to IMG experience of cultural differences in medicine and psychiatry and cultural differences in communication. IMGs did not find their proficiency in English to be a barrier to communication but did find accents, culture-specific sayings and non-verbal cues to be challenging. Differences in doctors’ status relative to patients and different expectations of the doctor–patient relationship were challenging and, at times, frustrating and annoying. It was generally recognised that training in cross-cultural communication skills would be beneficial to new IMGs although a small minority recognised no such issues. Significant differences in attitude to patient confidentiality in Ireland versus the country of origin were identified.

Conclusions

Consideration should be given to providing specific cross-cultural communication skills training for all IMGs training in Ireland focusing not just on verbal and non-verbal communication but also differences in the doctor–patient relationship, patient and relative expectations and medical confidentiality requirements.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Evaluation of capacity to love, depression, and anxiety in women according to their relationship status
Authors: Busch I. , Kapusta N.D.
Published: June 2017

Introduction

Associations between psychiatric disorders and relationship status as well as the impact of psychiatric symptoms on the quality of romantic relationships have already been demonstrated but the association between psychiatric symptoms and the capacity to maintain romantic relationships has been rarely examined.

Aim

To investigate anxiety, depressive symptoms and capacity to love (CTL) in single women (sw) and those in a relationship (rw).

Methods

Two hundred healthy adult females (100 sw, 100 rw; mean age 27.8 ± 8.1 yrs and 27.3 ± 8.1 yrs, respectively) completed the PHQ-4 and the CTL-Inventory. Differences in anxiety and depressive symptoms and CTL between both groups were assessed by independent-samples t-tests. Moreover, correlations between CTL, anxiety and depressive symptoms in each group were investigated.

Results

Sw showed a significantly higher level of depressive symptoms (meansw ± SDsw 1.5 9 ± 1.66, meanrw ± SDrw 1.07 ± 1.37, P = 0.016) and a significantly lower CTL (meansw ± SDsw 126.81 ± 12.60; meanrw ± SDrw 137.13 ± 11.26, P ≤ 0.001) than rw but no differences occurred for anxiety symptoms.

Among sw, CTL negatively correlated with depressive (r = −0.37, P < 0.001) and anxiety symptoms (r = −0.44, P < 0.001) whereas in rw, a negative correlation occurred only between CTL and depressive symptoms (r = −0.43, P < 0.001).

Conclusion

Our results suggest that single women, compared to women in a relationship, show a lower CTL and suffer more from depressive symptoms.

Furthermore, a lower CTL is associated with more anxiety and depressive symptoms, thus suggesting that future therapeutic approaches to depression and anxiety should also take into account relationship conflicts and CTL. As a crucial personality trait, CTL might be an important moderator of coping with common psychiatric symptoms.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
The psychological effects of abuse and battering on wives and partners: Case study in the Philippines
Authors: Lu S.F.
Published: June 2017

Introduction

In the country, the most prevalent form of violence against women is physical abuse/maltreatment or wife/partner battering based on both records of the Philippine national police, and the women in especially difficult circumstances.

Objectives

This study looked into the psychological effects of abuse and battering on wives-partners.

Aims

This paper will also give a description on how battered wives acquire a learned helplessness behavior due to uncontrollable events or situations.

Methods

The methods used were structured interview method and case method, and interview with a psychiatrist in the hospital where the three cases had consultations.

Results

Wife battering refers to violent acts such as psychological, sexual or physical assault by an assailant against his partner with the intent of controlling by inducing fear and pain. It is a common incident being violated under RA 9262. Three cases were studied. One was stabbed 12 times by her live in “matador” partner who works in a slaughter house. The second case was about a partner who was forced to do sexual favors for her husband that were animalistic and perverted. On the third case, while married, she noticed that the man was also sexually perverted. He also raped their daughter.

Conclusion

All three cases also manifested depression in various forms with varying symptoms. Case A was diagnosed with post-traumatic stress disorder (evaluation made by the psychiatrist). Case A manifested symptoms of depression, panic of being attacked again by assailant who is at large.

Disclosure of interest

The author has not supplied his/her declaration of competing interest.
Impact of emotional intelligence on level of academic achievement in a sample of Saudi female medical student
Authors: Soliman E. , Fayed A. , Mussaed E. Al , Alawad H. , Elradi D.
Published: June 2017

Background

Emotional intelligence (EI) assessment has become an effective technique in exploring individual competencies. In the medical educational, there is a growing evidence for relation between academic achievement and emotional intelligence.

Objective

To examine relation between academic achievement and emotional intelligence among medical students.

Method

A cross-sectional study of 189 female university students using paper-based Bar-On Emotional Quotient Inventory: Youth Version was conducted. BarOn EQ-i:YV consists of 7 sub-scores which estimate various domains of emotional intelligence along with general mood. The academic achievement was assessed via self-reported Grade Point Average (GPA).

Result

The average Intrapersonal score of participating students was 14.9 ± 3.4 and Interpersonal was 41.7 ± 4.9. The students scored 32.0 ± 5.0 in stress management scale and 31.9 ± 4 in adaptability. The lowest score achieved in the Emotional Inelegance scale was 32.5 whereas the top score was 71.3. The average general mood was 47.1 ± 6.4 and the positive impression ranged between 6 and 23 (17.3 ± 2.8). Positive week correlations were defined between the GPA and self-efficacy (r = 0.13) and Adaptability (r = 0.08) though these correlations were statistically insignificant (P > 0.05). Linear regression model showed that domains of Bar-On scale could explain up to 33% of changes in GPA (R2 = 0.33) with significant effect of self-efficacy, adaptability and general mood scores (P < 0.05).

Conclusion

Medical students showed high level of emotional intelligence which positively affect their academic achievement. Therefore, improving the emotional intelligence domains can help students improving their academic achievement.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Dissociation and Therapy of Depressive and Anxiety Disorders with or Without Personality Disorders
Authors: Prasko J. , Grambal A. , Sigmundova Z. , Kasalova P. , Kamaradova D. , Vrbova K. , Ociskova M. , Holubova M. , Latalova K. , Zatkova M. , Slepecky M. , Kotianova A.
Published: June 2017

Objective

Goal of the study was to analyze the impact of dissociation on the treatment of the patients with anxiety/neurotic spectrum and depressive disorders, and with or without personality disorders.

Methods

The sample consisted of inpatients who met the ICD-10 criteria for the Depressive disorder, Panic disorder, GAD, Mixed anxiety-depressive disorder, Agoraphobia, Social phobia, OCD, PTSD, Adjustment disorders, dissociative/conversion disorders, Somatoform disorder or other anxiety/neurotic spectrum disorder. The participants completed Beck Depression Inventory, Beck Anxiety Inventory, subjective version of clinical global impression-severity, Sheehan Patient-Related Anxiety Scale, and Dissociative Experience Scale, at the start and the end of the therapeutic program.

Results

The total of 840 patients with anxiety or depressive spectrum disorders, who were resistant to pharmacological treatment in outpatients basis and were referred for hospitalization for the six-week complex therapeutic program, were enrolled in this study. Six hundred and six of them were statistically analyzed. The patients’ mean ratings on all measurements were significantly reduced during the treatment. The patients without comorbid personality disorder improved significantly more than patients with comorbid personality disorder in the reduction of depressive symptoms. However, there were no significant differences in change of anxiety levels and severity of the disorder between the patients with and without personality disorders. The higher degree of dissociation at the beginning of the treatment predicted minor improvement. The higher therapeutic change was connected to the greater reduction of the dissociation level.

Conclusions

Dissociation presents an important factor influencing treatment effectiveness in the treatment-resistant patients with anxiety/depression with or without personality disorders.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Improving and Assessing Public Beliefs, Knowledge and Attitudes Towards Bipolar Disorder in Pakistan
Authors: Zaidi S.
Published: June 2017

Background

Studies have shown that beliefs, attitudes and knowledge towards bipolar disorder are influenced by country-specific social and cultural factors. Our study aims to improve and assess public beliefs, knowledge and attitude towards bipolar disorder in Pakistan.

Methods

We targeted 500 population. A questionnaire was organized into four sections in order to investigate knowledge about bipolar disorder, attitudes and beliefs, treatment options and fighting stigma and help seeking attitudes.

Results

Of the 500 participants, 28% people were aware of exact definition of bipolar disorder. A widespread belief (85%) was that people suffering from bipolar disorder should avoid talking and telling about their illness. According to 50% respondents people experiencing bipolar disorder “are dangerous to others”, 68% population viewed it as a result of black magic. Sixty-five per cent thought that the best way to recover from bipolar disorder consisted in seeking help from Psychiatrist. Twenty per cent thought to take help from religious people and shrines. Most of people seemed convinced that drugs are addictive (70%) and may cause serious side effects (80%).

Conclusions

Mental health illness including bipolar disorder can be improved by the positive influence of education, employment availability, respect, social support, rehabilitative services, justice and equity. Lack of education, stigmatization, and cultural norms are the leading barriers towards.

Disclosure of interest

The author has not supplied his/her declaration of competing interest.
Gender Difference Among Admitted Patients with Bipolar Disorder in a Psychiatric Service During a Three-year Period
Authors: Fernandes M. , Mota D. , Olivera A. , Ribeiro J. , Silva S. , Santos V. , Madeira N. , Celsa P. , Santos Z.
Published: June 2017

Introduction

Gender differences in bipolar disorder are becoming apparent, but have been less studied compared with major depression. The presentation, clinical features, course and evolution of bipolar disorder differ between men and women. Research data on these differences will help determine whether gender is important in influencing illness variables.

Objectives

Determine whether men and women with bipolar disorder have statistical significant differences in socio-demographic and clinical data.

Methods

Charts of all patients with a diagnosis of bipolar disorder admitted in the Coimbra Hospital and Universitary Center over a three-year period (between 2013 and 2015) were reviewed to gather data on socio-demographic, clinical and psychopathological variables to assess differences across genders. Statistical analysis of data with “SPSS21”.

Results

During a three-year period, 189 patients were admitted with bipolar disorder, the majority were female patients, with ages between 21 and 84 years old. The authors will analyse if there is any statistical significant difference between gender in the rate of bipolar I or II diagnoses, age at onset, symptom presentation, delay in diagnoses, number of depressive, or manic episodes, hospitalisations, involuntarily admissions, number of suicide attempts, co-morbidity rates, negative life events, family history and treatment options. Sociodemograpic characteristics will also be analysed.

Conclusion

Gender differences in bipolar disorder is a controversial issue in the literature. The importance of gender on the course and outcome in bipolar disorder has been widely acknowledged. The limited data suggest that the prevalence is similar between sexes but that the course of illness may be different.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Cognitive Function in Older Euthymic Bipolar Patients
Authors: Hajbi K. , Baati I. , Ellouze S. , Mkaouar S. , Abida I. , Masmoudi J.
Published: June 2017

Objectives

To assess cognitive function in older euthymic bipolar patients. To investigate the relationship between cognitive disorders and clinical features in this population.

Methods

We conducted a cross-sectional study during the period from August to November 2015. It included 34 stable bipolar outpatients, aged at least 65 years. We used the Montreal Cognitive Assessment (MoCA) to screen for cognitive disorders. Our patients were clinically euthymic, as checked by the Hamilton depression scale and the Young mania scale.

Results

The sex ratio was 1. The mean age of our patients was 68.2 years. Most of them were married (82.4%), unemployed (55.8%), living in urban area (82.4%), had low educational level (58.8%) and low income (64.7%).

The majority was bipolar type 1 (67.6%). The most recent episode was manic in 55.9% of cases, including psychotic features in 50% of cases. Subsyndromal affective symptoms were noted between episodes in 23.5% of them. The average MoCA score was 23.6. Cognitive disorders were found in 61.5% of patients, who showed impairments across all cognitive domains. The most frequent deficits were found in attention (100%) and executive functions (85.3%).

Cognitive dysfunction correlated to psychotic features during the last episode (P = 0.005), subsyndromal affective symptoms between episodes (P = 0.13), high number of mood episodes (P = 0.007) and hospitalisations (P = 0.014).

Conclusion

Our study confirmed that cognitive dysfunction was frequent in older bipolar patients in Tunisia. Preventing mood episodes, screening for addictive and somatic comorbidities, as well as cognitive rehabilitation, are suitable strategies for improving cognitive functioning among these patients.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Assessing Discomfort and Avoidance of Social Situations Due to Weight and Physical Appearance in Adolescents: An Exploratory Factor Analysis of a New Measure
Authors: Cunha M. , Costa A.R. , Palmeira L. , Couto M. , Galhardo A.
Published: June 2017

Introduction

In adolescence experiencing weight and physical appearance concerns is common. These body and weigh-related preoccupations are associated with anxiety and may lead adolescents to avoid social situations where their body image is exposed.

Aim

The present study aimed to conduct an exploratory factor analysis and explore the psychometric properties of a new measure of social situations discomfort and avoidance due to weight or physical appearance (DASSWPA) in a sample of adolescents.

Methods

The sample comprised 357 adolescents aged between 12 and 18-years-old, 195 males and 162 females, with a mean age of 14.69 (SD = 1.68). Participants completed a set of self-reported questionnaires concerning anxiety, stress and depression symptoms (DASS-21), bullying experiences (BIVES-A) and body image related shame feelings (BISS).

Results

The DASSWPA is comprised of two separate scales: one regarding discomfort/anxiety and another one related to avoidance of social situations. Results suggested that both scales presented a similar two-factor structure. Both scales revealed good psychometric properties, including high internal consistency (α = 0.91) and an excellent temporal stability. Moreover, DASSWPA showed significant and positive associations with body image related shame feelings, victimization experiences, and anxiety, stress and depressions symptoms. Gender differences were also found, with girls presenting significantly higher levels in the anxiety/discomfort scale than boys.

Conclusion

The DASSWPA proved to be a reliable and stable measure to assess anxiety and avoidance of social situations due to one's physical appearance and weight in adolescents.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Smoking, Preparing the Patient with a Severe Mental Disorder for Change
Authors: Chauca Chauca G.M. , Jaén Moreno M.J. , Osuna Carmona M.I. , Alcalá Partera J.A. , Rico del Viejo A.B. , Sarramea Crespo F.
Published: June 2017

Introduction

Smoking is a serious health problem for people with mental illness like the bipolar disorder patients. The developmental of motivational tools such as brief intervention it is necessary in the context of community care.

Objectives

Evaluating the change in motivational stage after brief intervention and evaluating the clinical and smoking factors in relation with this.

Methods

Two hundred and twenty patients diagnosed with bipolar disorder (according DSM-5 criteria) that were in the euthymic phase (defined as less than 7 points in YMRS and 10 points in HDRS) and attended the community care centers of three provinces of Andalusia (Spain). Patients who consumed in the last month qualified for the level of motivation for change (measured by URICA scale).

Results

After brief intervention the 29.3% of the smoking patients change in their motivational stage. The results of the multivariate analysis showed three factors in relation with dificultar the progression of the evolution of motivation to change. The high punctuation in Hamilton anxiety scale (OR = 0.53; IC95%, P = 0.002), the high puntuation in the Fageström scale (OR = 0.56, IC95%, P = 0.01), and have high autoperception of the capacity of change (OR = 0.52; IC95%, P = 0.002).

Conclusions

The anxiety (measure with Hamilton anxiety scale) plus factors in relation with smoking, like the puntuation in Fagestrom scale and the autoperception of the capacity of change decrease the possibilities to change.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Dual diagnosis: On the Way to an Integrated Treatment Model?
Authors: Ezquiaga I. , González Vega Z. , Rossi P. , Fonseca F. , Tamarit C. , Castillo C. , Castro I. , Torrens M.
Published: June 2017

Introduction

Substance use disorders (SUD) with psychiatric co-morbidity (dual diagnosis) represent a challenge for both mental health and addiction networks. Dual patients present greater disorder severity and worse prognosis than those with SUD or psychiatric disorders alone. There is a lack of consensus regarding which treatment model (sequential, parallel or integrated) is the most appropriate for them. Despite integrated treatment is seen as the model of excellence, it is a standard difficult to achieve.

Objectives/Aims

To describe the presence of dual diagnosis and treatment model received in a sample recruited from a drug abuse community center in Barcelona (CAS Barceloneta).

Methods

Cross-sectional descriptive analysis of an outpatient center for SUD clinical sample regarding psychiatric co-morbidity (DSM-IV-TR criteria), social-demographic characteristics and treatment model received.

Results

In the moment of this study, a total of 574 SUD patients are attended at CAS Barceloneta. Of them, 300 (52%) present a dual diagnosis, 64% men, mean age = 48 (SD = 11.29). Thirteen percent (n = 40) of dual patients have psychotic disorder (PsyD) diagnosis and their SUD comorbidities are: alcohol-UD (12.5%, n = 5), cocaine-UD (7.5%, n = 3), cannabis-UD (15%, n = 6), opioids-UD (17.5%, n = 7) and multiple SUD (47.5%, n = 19). Half of dual patients with PsyD (n = 20) are attended in parallel in community mental health centers.

Conclusions

Our results suggest there is an important percentage of SUD patients that present psychiatric co-morbidity treated in drug abuse community centers. Parallel treatment is mainly for PsyD patients and sometimes they get lost in the gaps. We would need to develop specific dual programs to give these patients an integrated assistance.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
The impact of Cannabis in Schizophrenia: Pafip Three-year Longitudinal Study on Outcome and Functionality After a First Episode of Psychosis
Authors: Gomez Revuelta M. , Juncal Ruiz M. , Porta Olivares O. , Fernández Rodríguez M. , Abejas Díez D. , Sánchez Blanco L. , Landera Rodríguez R. , Medina Blanco R. , Crespo Facorro B. , Río Hortega I. Madrazo Del , Gutierrez Martin R.
Published: June 2017

Introduction

The association between cannabis and psychosis makes crucial the intervention on cannabis use disorder at first episodes of psychosis (FEP), especially among young population. In this group of patients, the harmful potential of cannabis is more evident by its influence on neurodevelopment. However, the nature of the association cannabis-psychosis is not clearly described. It seems to represent a mediating factor for an increased risk of psychosis in healthy and high-risk populations, determining an earlier age of onset and worsening long term outcome.

Objectives

To assess the impact of cannabis in terms of functional and clinical prognosis in patients recruited after a FEP.

Material and methods

PAFIP is an early intervention program for early stages of psychosis. One hundred and sixty-three were included, followed-up at regular intervals of six months for three years with administration of clinical and functional scales (BPRS, SAPS, SANS, CDRS, GAF and Drake). Patients were divided into three groups: (1) those non-users neither before the onset nor during follow-up (nn) PEP, (2) consumers before the FEP and during follow-up (ss) and (3) consumers before the FEP that gave up consumption during follow-up (sn).

Results

No statistically significant differences were observed in terms of functionality at three-year follow-up endpoint but a trend to a better-preserved functionality in the sn group. The sn group presented lower scores in scales for positive symptoms with respect to the comparison groups.

Conclusions

The interruption in cannabis use may have a beneficial effect on short-term clinical prognosis and functionality on long term.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Dual Diagnosis and Medical Co-morbidity: Data from a Specialized Brief Psychiatric In-patient Unit
Authors: Gomez Revuelta M. , Juncal Ruiz M. , Porta Olivares O. , Sanchez Blanco L. , Abejas Diez D. , Santayana Jenaro G. Pardo de , Landera Rodriguez R. , Nuñez Morales N.I. , Garcia Ayala L.
Published: June 2017

Introduction

Previous research on the prevalence of medical disorders among adults with dual diagnosis (DD) has been inconclusive.

Objectives

The purpose of this study was to assess dual diagnosis and medical co-morbidity at the Brief Psychiatric Inpatient Unit of Marqués de Valdecilla Hospital, Santander in the period from January 2014 until March 2015.

Methods

Ninety-three patients were admitted at our hospital from December 2014 until March 2015. The simple was analyzed retrospectively. Sixty-two of the patients (66.7%) met criteria for Dual Diagnosis. We collected socio-demographic variables, drug abuse, mental pathology, and treatment received.

Results

The mean age of the sample was 42.95 years (± 14 DS) with a male:female ratio of 1.8:1 (no significant differences by gender). Hypertension was more prevalent among patients without dual pathology (22.5%). Patients with dual diagnosis presented hypertension less likely (6.5%) (P < 0.005). This can be explained by the fact that patients without dual diagnosis had a higher mean age (47 years) than patients with dual diagnosis (42 years). We did not found statistically significant differences between both groups respect to diabetes mellitus, vascular brain disease, HIV and dyslipidemia.

Conclusions

Hypertension was less likely to appear among patients with dual pathology admitted to an ultra brief psychiatry unit. This could be explained for an earlier mean age at admission among these patients.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Rewarding Network Mechanism of Left Orbito-frontal Cortex Transcranial Magnetic Stimulation in Depression
Authors: Dai Q. , Xuntao Y. , Zhengzhi F.
Published: June 2017

Objective

The difficulties in the clinical antidepressant treatment lead to the pursuing of more effective methods such as transcranial magnetic stimulation (TMS). Mixed findings from DLPFC targeted TMS result in the exploration of optimal stimulation location. Disturbed function of obitofrontal cortex (OFC) has been indicated in depression, which is involving in the remission of depression. However, whether it could be a more specific treating target is not tested. Simultaneously, disturbed reward network (RN) has been confirmed in depression, however, whether this could be improved by TMS treatment remains unclear.

Methods

Fourteen patients with major depressive disorder (MDD) were allocated in a four-week course of OFC targeted TMS. Motivated by the literature, before and after the treatment, the function connectivity of RN with the seed of ventral striatum was conducted. The results were also compared with the data from 33 healthy controls.

Results

The OFC targeted TMS improved the clinical depression significantly and enhanced the function connectivity within the RN effectively. Specifically, lower baseline dorsolateral striatum connectivity predicted strong therapeutic effect of TMS on depression, while lower baseline insula connectivity predicted weak therapeutic effect on depression.

Conclusions

The findings offer the first experimental evidence of the therapeutic effect of OFC targeted TMS on clinical depression, enhanced function connectivity within RN might be the potential neural mechanism (Fig. 1). Lower dorsolateral striatum connection might be a reliable neural biomarker of strong responding for TMS treatment, which helps to identify the patients who will be cured by TMS most effectively.
The Subjective Perception of Time as a Factor of the Course of Depressive Disorders
Authors: Fedchenko V. , Panko T. , Kalenska G.
Published: June 2017

Introduction

Personal peculiarities of the individual are the separate significant factor of formation and course of depression that has a predictive value.

Objectives

Investigation of an emotionally significant attitude of patients to their past, present, future and also depending on the severity of depressive symptoms.

Methodology

Forty patients with depressive episodes (F 32.0. F 32.1, F 32.2) and 35 persons without mental disorders were examined. An integrated approach was applied using the method of “Semantic time differential”.

Results

Correlation analysis showed that in mild depression patients experienced their present condition changed, it is associated with emotional assessment of the past (r = −0.441) and extrapolated their experiences for the future–feeling doubt about their implementation in the future, including its activity (r = −0.484) and size (r = −0.523). In an moderate degree of depression patients in the present acutely realized that they had depression and from the point of view of this condition perceived their past and future–feeling a structureness and size of the past (r = 0.500) and worrying about the emotional background, structureness and activity of the future (r = −0.500. r = −0.756 and r = −0.500. respectively). In severe depression patients did not associate their condition with the past, realized the presence of depression in the present, and did not expected to improve their emotional conditions in the future (r = −0.432).

Conclusions

The data can be used to assess the dynamics of patient's conditions with depressive episodes as well as to develop an adequate psychotherapy.
Quetiapine XR as Add-on to Antidepressants in Treatment-resistant Late-life Major Depression
Authors: Vasiliu O. , Vasile D. , Vasiliu D.G. , Andreea Filareta A. , Vasile F.
Published: June 2017

Objective

To assess the efficacy and tolerability of quetiapine as add-on to antidepressant agents in treatment-resistant late-life major depression.

Methods

A group of 15 patients, 8 male and 7 female, mean age 68.2, evaluated in our department for clinical symptoms that made possible a DSM 5 diagnosis of major depressive disorder, were initiated on quetiapine XR, flexible daily dose 50–300 mg QD. All patients were on treatment with an antidepressant–either a selective serotonin reuptake inhibitor (SSRI) (n = 10), or venlafaxine (n = 5)–for at least 6 weeks and presented no improvement during current treatment administered at therapeutic doses. Patients were assessed using Montgomery Asberg Depression Rating Scale (MADRS), Clinical Global Impression–Severity (CGI-S), Global Assessment of Functioning (GAF), and Columbia Suicide Severity Rating Scale (C-SSRS) every 4 weeks for 3 months.

Results

After 12 weeks, patients had a mean improvement in MADRS score of 45.7 ± 2.3%, with a final mean MADRS score of 13.5 (P < 0.01). No variations were registered depending on the specific SSRI or venlafaxine concomitant treatment. Quetiapine XR mean daily dose administered during the study was 125 mg. C-SSRS didn’t registered significant variations in suicidal ideation or behavior throughout the trial. Overall GAF score increased with 22.1 points, and CGI-S decreased with a mean of 1.5 points at week 12 (P < 0.01). Tolerability of add-on quetiapine was very good, no serious adverse event being reported.

Conclusions

Quetiapine was efficient and well tolerated in late-life resistant major depression, as add-on to SSRIs or venlafaxine, during the 12 weeks of the trial.