bluuebunny/crossref_metadata_2025 huggingface dataset:
Transformation of social networking sites’ usage patterns – a threat to health?
Authors: Szczegielniak A.R. , Palka K. , Krysta K.
Published: May 2016

Introduction

Internet as a vast global network, consisting of commercial, educational, informational and communicational facilities, has a huge impact on human behavior. Designed simultaneously by the needs of users and technical capacity, has become an addictive medium thanks to low cost of usage and broad availability. Social networking sites (SNSs) have a special place in the cyberspace. Due to the wide range of services, additionally differing on latitude, age and other variables, SNSs’ impact on a life of an average user is difficult to assess.

Aim

The study assess the changes between 2013 and 2015 in usage patterns and impact of the social networking sites on users with focus on possibility of dependence development and emphasis on gender differences.

Materials and methods

Anonymous questionnaire, available on-line, was prepared solely for the purpose of the study. Questions were related to the types and frequency of specific activities undertaken by the private profiles of users and based on pilot study conducted in January 2013.

Results

The first stage (March–April 2013) consisted of 1248 respondents, the second stage (August–September 2015) gathered 1112 respondents. Research showed changes in age of users, type of information looked for and tools used to browse SNSs.

Conclusions

Private profiles are no longer used only for communication or personal expression; it is a new way of getting to know what is happening and sharing voices of communities. As a tool of making money, which is more and more visible, SNSs interfere with previous patterns of portals’ usage.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Decrease of velocity and acceleration of fast eye movement after the administration of methadone
Authors: Walecki P. , Gorzelanczyk E. , Feit J. , Kunc M.
Published: May 2016

Aims

The goal of this study is to assess the differences in peak and medium velocity, peak and medium acceleration of eyeball movements after the administration of methadone.

Materials and methods

Twenty-eight opioid addicts were examined. Patients admitted oculomotor impaired were excluded.

In this study, we made use of the Saccadometer Advanced (Advanced Clinical Instrumentation, Cambridge, UK), allowing the measurement of eye position with the time resolution of 1 msec (1000 Hz). The eye movement measurement is automated and synchronised with stimuli presentation. Before and after the administration of methadone two saccadic tests were carried out: Prosaccades Test (PT) and Antisaccades Test (AT).

Results

The average of peak and medium velocity and the average of peak and medium acceleration of eyeball movements in the test AT were lower than in the PT test. After administration of a single dose of methadone the peak and medium velocity, peak and medium acceleration decreased in both tests (PT and AT). After administration of methadone prolonged the duration of saccades, and prolonged the duration of rising and falling slope of saccades.

Conclusion

It was found that methadone (μ-opioid receptor agonist) is associated with change of velocity and acceleration of eyeball movements.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Adversities in childhood and their impact on mental health across the life course
Authors: Pollak S.
Published: May 2016

How is the brain shaped and refined by children's early social and emotional experiences? In this colloquium, I will focus on the development of children who have endured environments marked by toxic levels of stress early in their development. These children are known to be at increased risk for a variety of health, academic, and social problems. Some of these problems appear immediately, but others may not manifest themselves until much later in development. I will highlight ways in which we can address central issues in human development by studying the quality and timing of children's social experiences. To do so, I will describe recent research involving children who have experienced child abuse and neglect, children raised in poverty, children raised in institutional settings, children who have endured traumatic life experiences, and typically developing children. Through these studies, I will highlight new insights about the developmental processes underlying children's sensitivity to their social environments as a way to understand the emergence of both adaptive and maladaptive human emotional behavior. Defining and specifying ways in which the environment creates long-term effects on brain and behavior holds tremendous promise for improving the health and well-being of children.

Disclosure of interest

The author has not supplied his declaration of competing interest.
Do bipolar II and bipolar I disorder have different genotypes and why do we observe unipolar depression converting to bipolar II and then bipolar I?
Authors: Agius M. , Fawcett M. , Zaman R.
Published: May 2016

We review the recent literature in order to establish the importance of a spectrum for bipolar affective disorder, and that unipolar depression, bipolar II and bipolar I are discrete entities that may however evolve in sequence. We discuss clinical, genetic and neurobiological data which illustrate the differences between bipolar I and bipolar II. To fit the data we suggest a series of multiple mood disorder genotypes, some of which evolve into other conditions on the bipolar spectrum. Thence, we discuss the nature of the bipolar spectrum and demonstrate how this concept can be used as the basis of a staging model for bipolar disorder.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Discontinuation of antipsychotic therapy in severe mania: A six months follow-up study
Authors: Brioschi S. , Delmonte D. , De Santis C. , Franchini L. , Colombo C.
Published: May 2016

Introduction

Independently of the drug choice, antimaniac treatment has to be continued at least until full remission. Most guidelines recommend continuation therapy for 6–12 months but controlled studies are lacking.

Objectives

A six months follow-up study on a sample of 57 inpatients affected by mania at Mood Disorder Unit.

Aims

To evaluate a timeframe for the discontinuation of the antipsychotic therapy.

Methods

Fifty-seven bipolar inpatients affected by a manic episode according to DSM-5 criteria. Patients treated according to our pharmacological protocol with a mood stabilizer (lithium or valproate) and an antipsychotic (haloperidol or risperidone). Course of illness assessed with Young Mania Rating Scale (YMRS) scored at week 0, 1, 2, 4, 8, 24. Remission defined as YMRS < 12.

Results

Twenty men (35.09%) and 37 women (64.91%); mean age 43.18 ± 12.71 years. Mean YMRS basal score 38.55 ± 8.08. At 4th week, remission rate was 54.39% (31 patients); at 8th week was 80.70% (46 patients). At 8th week, 39/57 patients (68.42%) discontinued the antipsychotic. Relapse rate after 6 months was 26.32% (12 depressed, 3 manic). Multiple regression, t-test and Chi2 analysis were performed: older patients (P = 0.01) and with higher number of episodes (P = 0.04) tend to relapse earlier. Neither severity of the episode (P = 0.3), nor delusional symptoms (P = 0.6) nor discontinuation of the antipsychotic (P = 0.3) correlate with relapse time.

Conclusions

Our experience suggests that an early discontinuation of antipsychotics, usually 4–8 weeks after remission, does not worsen the short-term course of illness. This approach could minimize the risk of side effects. Evidence is lacking about the duration of this therapy, long-term studies are still necessary.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Association between suicide attempts and insight among patients with bipolar disorders
Authors: Cardoso A. , Aguiar P. , Byrne M. , Xavier M.
Published: May 2016

Introduction

Insight is an important factor associated with non-compliance and poor outcome. Poor level of insight has been described as a characteristic in patients with acute bipolar disorder with more unawareness in social consequences. In contrast, awareness of having a mental disorder, of its symptoms, of its consequences, and/or of the need for treatment is associated with a number of positive prognostic indicators. Insight is also linked, however, to depression and suicidal ideation in bipolar disorder.

Objectives

(1) Assess the illness perception. (2) Assess the impact of insight in suicidal tendencies.

Aims

Contribute to development measures to improve the insight in bipolar disorders.

Methods

In this cross sectional study we use a convenience sample of patients with bipolar disorder attending in the mental health departments of three general hospitals in Lisbon great area. We have applied clinical and socio-demographic questionnaire and additional measures to assess symptom severity, treatment adherence and illness perception.

Results

A samples was composed by 64 patients with bipolar disorder (mean age = 38.7; SD ± 10.1). A total of 48.4% patients (n = 31) had made a suicide attempted and 23.4% (n = 15) of this patient done 5 or more attempted suicide. We found a significant correlation with symptoms and insight (rs = 0.56; P < 0.01).

Conclusion

Mental health professionals often utilize insight as an indicator of prognosis, because of its association with treatment adherence. The findings of the current study suggest that having intact or good insight may be an indicator for suicidal ideation among patients with bipolar disorders. A brief psychoeducational approach could potentially be effective. We recommend a combined approach to Improve clinical insight in bipolar disorder.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
The emotional intelligence in severe mental disorders: A comparative study in schizophrenia and bipolar disorder
Authors: Chapela E. , Félix-Alcántara M. , Quintero J. , Morales I. , Gómez-Arnau J. , Correas J.
Published: May 2016

Introduction

Severe mental disorders have deficits in different aspects of social cognition, which seem to be more pronounced in patients with schizophrenia compared to those with bipolar disorder. Emotional intelligence, defined as the ability to process, understand and manage emotions, is one of the main components of the sociocognition. Both in schizophrenia and bipolar disorder have been described changes in emotional intelligence, but only few studies compare both disorders.

Objectives

The objective of this research is to increase knowledge about the differences between schizophrenia and bipolar disorder.

Aims

To compare emotional intelligence in patients with schizophrenia versus bipolar patients.

Methods

Seventy-five adult patients with schizophrenia and bipolar disorder were evaluate.

The assessment protocol consisted of a questionnaire on socio-demographic and clinical-care data, and a battery of assessment scales (BPRS, PANSS, SCID-I-RV, YMRS, HDRS, CGI-S, EEAG, MSCEIT). Among the assessment tools of emotional intelligence, we select MSCEIT as the most validated.

Statistical analysis was performed using SPSS 23 version. After the descriptive analysis of the data, we compare the results of the scales.

Results

Both disorders show a deterioration of emotional intelligence compared to the general population. There were no statistically significant differences in the comparison of emotional intelligence between schizophrenia and bipolar disorder.

Conclusion

Schizophrenia and bipolar disorder have deficits in emotional intelligence, while it is difficult to show differences between them. These changes in emotional intelligence are part of a set of cognitive, social and non-social skills, which are altered in these severe mental disorders.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Treatment of bipolar patients in manic phase: A comparison between asenapine and aripiprazole
Authors: Girardi L. , Gili S. , Gambaro E. , Di Tullio E. , Gattoni E. , Grossini E. , Farruggio S. , Mora L. , Gramaglia C. , Zeppegno P.
Published: May 2016

Introduction

Agitation is the most evident symptom in an acute manic episode. It can be defined as excessive motor or verbal activity that can degenerate into aggressive behaviour. Both aripiprazole and asenapine are indicated for the treatment of agitation in patients with manic episode.

Aims

To retrospectively evaluate the acute effects of drug therapy on psychomotor agitation rated with the PANSS-EC, the change in manic symptoms through the YMRS, the QoL with the SF-36v2 and the cardiometabolic effects of the new oral APS.

Methods

We administered the following tests to 13 patients with DBI at T0 (baseline), T1 (after 1 week), T2 (after 4 weeks), T3 (after 12 weeks) and T4 (after 24 weeks): PANSS-EC, YMRS, SF-36v2, CGI-BD, CGI-S, HAM-D, BPRS. We also considered weight, height, BMI, ECG and complete blood count.

Results

Patients recruitment and statistical analyses are still in progress. Our preliminary results suggest that there is not a marked difference between the two drugs. We highlighted that there has been a noticeable decrease in results at PANSS as well as at YMRS from T0 to T4 and patients showed an improvement in QoL. Only one patient treated with asenapine showed an increase in the results of HAM-D.

Conclusions

Results suggest the efficacy of the two new APS but further recruitment and data collection are needed to better understand their impact on agitation and QoL, including the metabolic profile, with the aim to help clinicians to make a more accurate choice of drug for each specific patient.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Association between the 5-HTTLPR genotype and childhood impulsivity in subjects with bipolar II disorder
Authors: Kim E.J.
Published: May 2016

Objective

It has been suggested that the features of childhood ADHD are significantly associated with adult mood disorders. Some genetic factors may be common to both ADHD and mood disorders underlie the association between these two phenotypes. The present study aimed to determine whether a genetic role may be played by the serotonin transporter-linked polymorphic region (5-HTTLPR) in the childhood ADHD features of adult patients with mood disorders.

Methods

The present study included 232 patients with MDD, 154 patients with BPD, and 1288 normal controls. Childhood ADHD features were assessed with the Korean version of the Wender Utah Rating Scale. The total score and the scores of three factors (impulsivity, inattention, mood instability) from the WURS-K were analyzed to determine whether they were associated with the 5-HTTLPR genotype.

Results

In the BPD II group, the 5-HTTLPR genotype was significantly associated with the total score (P = 0.029) and the impulsivity factor (P = 0.004) on the WURS-K. However, the inattention and mood instability factors were not associated with the 5-HTTLPR genotype, and the MDD and normal control groups did not exhibit any significant associations between the WURS-K scores and the 5-HTTLPR genotype.

Conclusion

The present findings suggest that the 5-HTTLPR genotype may play a role in the impulsivity component of childhood ADHD in patients with BPD II. Because of a small sample size and a single candidate gene, further studies investigating other candidate genes using a larger sample are warranted to more conclusively determine any common genetic links.

Disclosure of interest

The author has not supplied his declaration of competing interest.
The late-onset bipolar disease: A case report
Authors: Lopes A. , Sales P.
Published: May 2016

The prevalence of bipolar disorder after 65 years is 0.1 to 0.4%. Mania represents 4.6% to 18.5% of all psychiatric admissions in geriatrics in the USA. It has some specificity in terms of clinical presentation, evolution, prognosis and treatment.

We report the case of a patient who presented a first manic episode after 65 years. E.H, AP, 67 years old, single, without personal and familial psychiatric history, addressed to psychiatric emergencies for psychomotor agitation and euphoric mood. He presented two months ago a manic access with almost total insomnia, euphoria, psychomotor agitation and delusions of grandeur. The balance sheet reveals no incorrections (blood count, thyroid balance, serology: TPHA, VDRL, hepatitis B and C, HIV). The cerebral CT was normal. The patient has been received a quetiapine 200 mg/day, olanxapine 10 mg/day and valproate 1000 mg/day. The evolution after three weeks was favorable.

The late-onset bipolar disorder is characterized by: a less intense euphoria, replaced by anger and irritability, a more elements of persecution, disinhibiting and impulsivity. Respecting to that, this case is an exception. The most common confounding symptoms and behavioral disorders. A higher frequency of neurological diseases is noted in elderly subjects with a bipolar disorder and, so, a neuropsychiatric rigorous evaluation is fundamental to exclude the possibility of an organic pathology for the manic access. The prescription of psychotropic drugs in the elderly must be under monitoring.

Disclosure of interest
The authors have not supplied their declaration of competing interest.
First episode of bipolar depression and suicide attempt after bariatric surgery in a 45-year-old woman
Authors: Muniz Magalhaes E. , Gois Campos R. , Sarin L.M. , Del Porto J.A.
Published: May 2016

Introduction

Weight loss positively influences mental health but findings are mixed in patients undergoing bariatric surgery. The permanent changes in body image, diet-related stress, and unmet expectations could increase mental health problems such as major depression and self-harm behaviors. Mixed symptoms during major depressive episode were often misdiagnosed as agitated depression, and should be regarded as a risk factor for suicide and rapid cycling course of illness.

Method

Single case report.

Results

A 45-year-old woman, initially diagnosed as a unipolar depressive episode after bariatric surgery, did not show improvement after SSRI treatment. She had no history of previous episode but her temperament was described as hyperthymic. Antidepressant worsened irritability, racing/crowded thoughts, heightened anxiety and aggressive impulses, mood instability, impaired concentration, insomnia and she had a suicide attempt (antidepressant overdose). After mood stabilizer and atypical antipsychotic, symptoms fully remitted and she is stable in the last year.

Conclusion

Self-harm emergencies after bariatric surgery are higher than before surgery. Intentional overdose is considered the most common self-harm mechanism. Psychiatric follow-up after bariatric surgery and early recognition of bipolar depression with mixed features as a distinct condition among the variety of depressive syndromes is essential to reduce the risk of self-harm behaviors and improve treatment outcomes. Premorbid temperamental features, especially hyperthymic and cyclothymic temperaments, are often responsible for such mixed depressive presentations.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
C-reactive protein levels are related to suicidality in euthymic patients with bipolar disorder
Authors: Pantovic Stefanovic M. , Dunjic-Kostic B. , Lackovic M. , Damjanovic A. , Jovanovic A. , Totic-Poznanovic S. , Ivkovic M.
Published: May 2016

Introduction

Immune alterations are believed to be an important part in etiopathogenesis of affective disorders. However, it is not clear if the altered immune mediators are related to distinct disorders or particular psychopathology.

Aims

The aim of our study was to explore the differences in C-reactive protein levels (CRP) between euthymic BD patients and healthy controls, as well as to explore the relationship between CRP and lifetime presented psychopathology within BD.

Methods

The study group consisted of 83 patients diagnosed with BD, compared to the healthy control group (n = 73) and matched according to age, gender, and body mass index (BMI). Lifetime psychopathology has been assessed according to predominant polarity as well as previous history of suicide attempts and psychotic episodes.

Results

The CRP levels were significantly higher in BD patients when compared to healthy controls. After covarying for confounders, we observed that CRP levels, in euthymic BD patients, were related to number of previous suicide attempts, but not other indicators of lifetime psychopathology.

Conclusions

BD patients per se, and particularly those with more suicide attempts, are more likely to present with proinflammatory state, even when in remission. Previous history of suicide attempts could bear specifically vulnerable endophenotype within BD. Systemic, longitudinal monitoring of the course of illness, and potential inflammatory mediators that underlie its systemic nature is warranted.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Psychotic mixed state in bipolar I disorder due to neurosyphilis: Case report and literature review
Authors: Preve M. , Godio M. , Suardi N.E. , Traber R. , Colombo R.A.
Published: May 2016

Introduction

The presence of mixed features in bipolar disorder (BD) has been associated with a worse clinical course and high rates of comorbidities including anxiety, personality, alcohol and substance use disorders and head trauma or other neurological problems [1]. A recent study reports the connection of neurosyphilis and mania [2]. The aim of our study is to evaluate an inpatient with a psychotic mixed state due to a medical condition (neurosyphilis).

Method

An inpatient with psychotic mixed state in BD was assessed with: SCID-P, HRSD, YMRS, and a complete internistical examination, blood test exams, urinanalysis, electrocardiogram and ecocardiogram, as well as a first level brain imagin (CT and/or MRI). We conducted a systematic review of the literature (PubMed, Embase, PsychInfo), using the terms “bipolar disorder”, “neurosyphilis” AND “mixed state”.

Results

A comprehensive diagnostic and laboratory screening was unremarkable except for a positive venereal disease research laboratory (VDRL). Treatment for syphilis was started and we used olanzapine to control the psychiatric symptoms.

Discussion and conclusion

The estimated annual incidence of non-HIV STIs (sexually transmitted infections) has increased by nearly 50% during the period 1995–2008 [3]. Our case report underly, like Barbosa et al., the need to evaluate neurosyphilis as a potential cause of behavioural and psychiatric symptoms that simulate a psychotic mixed state of bipolar disorder. Olanzapine control and improve the psychiatric symptomatology in neurosyphilis. Methodological limitations, clinical implications and suggestions for future research directions are considered.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
First episode of bipolar depression after systemic lupus erythematosus in a 51-year-old woman
Authors: Tardelli V. , von Nielander L. , Sarin L. , Del Porto J.A.
Published: May 2016

Introduction

Systemic lupus erythematosus (SLE) is a multisystem disease with a broad spectrum of clinical features and neuropsychiatric manifestations that occur in up to 60% of patients. Disease activity and treatment with corticosteroids may contribute to this higher risk. It is also known that 36% of patients with SLE and comorbid Bipolar Disorder (BD) have had their psychiatric onset after they had been diagnosed with SLE.

Method

Single case report.

Results

A 51-year-old woman received a diagnosis of SLE 24 months before the beginning of depressive symptoms. After her diagnosis of SLE, seven years ago, she had three suicide attempts, being diagnosed with major depressive disorder. From them on, she had crises characterized by well-defined periods of 7 to 10 days with sadness, reduced need for sleep, social isolation, irritability, anger outbursts, impulsivity, racing thoughts and suicidal ideation. After treatment with mood stabilizers (quetiapine 300 mg/day and lithium 600 mg/day), she had a substantial reduction of symptoms intensity and frequency.

Conclusion

The link between immune dysregulation, autoimmunity and bipolar disorder may be closer than previously thought. Even if the autoimmune disease is not directly etiologically related to the psychiatric presentation, its detection is important due to the high morbidity and mortality, considering the current understanding that Bipolar Disease is strongly related with inflammation in central nervous system.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Psychological experiences reported by offsprings of mothers with bipolar disorder: A clinical-qualitative study in a Brazilian university outpatient service
Authors: Campos L.K.S. , Santos A. , Garcia C. , Turato E.R.
Published: May 2016

Introduction

Children of patients with bipolar disorder are at increased risk of developing psychopathology and psychosocial difficulties.

Objectives

To understand the emotional experiences of adult children of mothers with bipolar disorder.

Method

Qualitative study, using in-depth semi-directed interviews with open-ended questions, sample closed by saturation information criteria, content analysis, discussion under psychodynamic concepts.

Results

From interviewees’ reports, it can be seen that offspring's experiences emotional vulnerability, such as directions given by early exposure to self injurious behaviour, psychiatric hospitalizations, routine absences from home and consequent perception of helplessness, especially in periods of the mother's crisis. The findings suggest that for the children the insecurity to assume the precociously inverted responsibility regarding the need of care to mother seems to experience by them as an entrapment to the care of the mother, for the effort they make to keep them alive, with an emotional burden due to both impaired childhood and adolescent.

Conclusion

It was analyzed the assumption that the evolution of reactive psychological stages regarding the mother affected by a mental illness marked by bipolarity manifestations, alternating with phases of the normality of psychic manifestations, would follow the evolution of the oscillating psychological stages of his/her own mother, which minimizes often both the disease and the treatment during the phases of remission of manifestations.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Fecundity and bipolar spectrum disorder
Authors: Vieira J. , Salta M. , Barata B. , Nogueira J. , Sousa R. , Costa R. , Madruga L. , Mendes R. , Mendes S. , Ribeiro B. , Ribeiro R. , Gamito A.
Published: May 2016

Introduction

Fertility and fecundity are usually considered signs of social and emotional well-being. Bipolar disorder (BD) is a prevalent psychiatric disease that influences the individual's life style and behaviours. Some studies have addressed the issue of fecundity among women with bipolar disorder but few have focused on determining the differences between disease subtypes, which is expected, taking into account the studied differences in demographic measures.

Objectives

To examine the fecundity of a population of women with bipolar disorder.

Aim

The aim of this study is to compare the fecundity among women diagnosed with subtypes I to IV of BD, according to Akiskal's bipolar spectrum disorder classification.

Methods

A total of 108 female outpatients were divided into four groups. We analyzed number of offspring and demographic features between patients with different subtypes of BD using multivariate analyses.

Results

Our results showed a significantly higher average number of children for BD IV patients when compared with BD I patients. Although not reaching statistical significance, BD I patients had less offspring than BD II and BD III patients. BD I patients had lower marriage rates compared to the other groups.

Conclusions

Our results suggest that the subtype of bipolar disorder influences fecundity and behaviours, as is expressed by the lower number of marriages seen in BD I patients. We found that fecundity is significantly impaired among BD I patients, which may imply that female with more severe disorders are less likely to become parents. Fecundity is higher among BD IV patients, which makes a way to speculate about the adaptive role of hyperthimic temperamental traits.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Mental health care to children and adolescents
Authors: Alonso Díaz R. , Cortázar Alonso E. , Guillén Rodrigo H. , Remesal Cobreros R. , Fuentes Márquez S.
Published: May 2016

Unit Mental Health Day Hospital Child and youthful, is a device of tertiary health care, integrated into the UGC Mental Health, led to intensive treatment of children and young people in the province of Huelva, with severe mental illness and who need specialized medical care.

To first access to this unit, the person should be referred for specialized Pediatrics; by your psychiatrist or psychologist benchmark for mental health teams; or from the Hospitalization Unit, as it is a third-level device.

When a patient was diagnosed with eating behavior disorder (TCA) is derived, an initial consultation with the child and parents, a first psychiatric evaluation, also by nutritional and Endocrinology Nursing is performed. After evaluation of these professionals, you can take the decision to begin an intensive outpatient treatment in which the patient would have frequent consultations with the psychiatrist, the nurse and endocrine.

They may also decide inpatient hospitalization and this could be partial, to be held in the Day Hospital; or all, if the patient is under 14 years and hospitalization for psychiatric criteria indicated; the patient would enter Pediatrics. If he is over 14 years old, would join Hospitalization Unit.

In Child and Adolescent Hospitalization Unit of Huelva patient it is included in a specific program for TCA where a psychiatric, endocrine, educational approach in the classroom is done. Coordination meetings with education, social services and early care centers that are also in contact with that child are also conducted.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
The RDoC roadmap to explore neurocognitive difficulties of youths with severely dysregulated mood: Current findings and prospects
Authors: Benarous X.
Published: May 2016

The Research Domain Criteria (RDoC) has been developed as a multilevel approach to study neurocognitive impairments in psychiatry. Considering the high prevalence and the functional impairment associated with disruptive mood dysregulation disorders (DMMD) in youths, a better understanding of the neurobiological mechanisms underlying such emotional difficulties could help guide therapeutics.

So far, three key difficulties in the socio-emotional neurocognitive process have been documented in youths with DMDD:

– a deficit in the recognition of facial emotions has been found (systems for social process/social communication construct). Functional imagery has shown that such impairment is associated with a hypoactivity of limbic neural structures, especially the amygdala. Such findings are in line with those found in adults with depressive episodes;

– poor flexibility during cognitive tasks (cognitive systems/cognitive effortful control construct). In particular, these youths score poorly in neuropsychological tasks associated with response reversal paradigm measuring the capacity to change cognitive strategy when the rules of the game change implicitly. These results partly explain the difficulties facing DMDD youths in a frustrating context;

– higher level of emotional arousal. Such youths would present specific impairments in the initial stages of attention; reflected by lower N1 event-related potential amplitude during Posner affective tasks.

Ongoing studies are being conducted to explore other RDoC domains such as abnormalities in circadian rhythms; in metacognition and perspective-taking tasks; and in the non-facial communication process (such as prosody or postural expressions). A computational model of interactive behaviors is a promising field to study difficulties of DMDD youths in regulating moods during social interaction.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Childhood adversities and emergency room visits
Authors: Samsó B. , Alba L. , Chavarria V. , Sanchez B. , Pardo M.
Published: May 2016

Introduction

Institutionalized children and adolescents who reside in foster centres are a subgroup of population that use mental health resources. This group of population has an increased risk of physical and psychopathology health problems. That translates into a greater number of emergency visits. This is the same perception presented by different professionals.

Objectives

The aim of the study is to analyse visits to emergency child and adolescent psychiatry service from a pediatric hospital. Also ask for a point of view of the professionals about it.

Methods

We select all the patients attended the emergency psychiatry child and adolescent care that were institutionalized. The sample was collected for 4 months in a pediatric hospital.

Results

n = 66 (51.5% male; mean age 14.09 ± 1.95 years old), 31.8% was the first time at the emergency room, 31.8% had consulted between 2–4 times and 36.4% over 4 times. The main reason for consultation was aggressiveness (66.7%). The three main discharge diagnoses were conduct disorder (50%), adjustment disorder (25.7%) and TDAH (7.5%) The 45.5% had a history of drug use and the 24.2% of self-harm. Asking professionals 80% responded perception of increased emergency consultations and the 90% think inadequate value between 50–70% of queries.

Conclusions

The boys institutionalized perform a high use of paediatric and psychiatric emergencies. There are a significant number of re-consultations. Professionals have the perception that their emergency visits are increasing. Since patients are at high risk of suffering mental disorders and high use of emergency would be interesting to develop specific protocols for emergency care for these groups.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Relationship between coping and anxiety in young university population
Authors: Cabas-Hoyos K. , German-Ayala N. , Nadia E.D.L. , Loreina M.B. , Alicia U.U.
Published: May 2016

In Latin American countries the University Entrance occurs before 17 years of age, in adolescence. The literature proposes some tasks of this stage as the search for identity and definition of the plan of life (Casullo et Fernández-Liporace, 2001). This stage is characterized by changes that may lead to stress (Frydenberg et Lewis, 1991) and strategies and styles should be deployed to deal with situations surpluses. The aim of this paper is to explore the relationship between coping styles and anxiety in young university students.

The total sample consisted of n = 216 university students (53.2% female, n = 115, 46.8% male, n = 101; between 16 and 18 years of age: m = 17.32, SD = 0.70). The subjects answered the ACS (Frydenberg, 1997) which assesses coping styles in young people and the AMAS-E (Reynolds, 2007) assessing anxiety. The design was corelational, the data were analyzed using SPSS 21.0 statistical program.

Results and discussion

As used style Troubleshooting reduces test anxiety, the tendency of these two variables is negative (P = 0.01). Implement the style Relating to others it will decrease test anxiety, the tendency of both variables is negative and statistically significant (P > 0.05). Stress in young people increases as gets underway unproductive type (P = 0.00). The results are consistent with the literature that suggests that late adolescents in academic challenges cause such hardship (Marote et Martínez, 2001).

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Hoarding disorder and obsessive-compulsive disorder
Authors: De la Torre Brasas F. , Duque Domínguez A. , Echeverría Hernández N. , Lázaro Redondo M.D.M. , García Montero C. , Otalora Navarro M. , Martín Díaz L. , Más Villaseñor A.
Published: May 2016

Introduction

Hoarding disorder is described in the DSM-5 as a new clinical entity whose essential characteristic is the persistent difficulty discarding or parting with possessions, regardless of their actual value, arguing reasons of utility, aesthetics, attachment or strong fear of losing Information.

Objectives

We present the case of an 11-year-old male patient brought to the Health Mental office when his mother found in the school bag debris that he had collected from the garbage, and useless objects in a bedroom drawer. The patient recognizes the nonsense of his behaviour but is unable to get rid of these objects but he allows his mother to do it. He had lowered school performance and showed irritable, shy and solitary, difficulties to sleep and cried often without apparent reason. They also noted since six months before, strange movements with the neck and eyes.

Methods

After ruling out, underlying organic pathology, we started treatment with sertraline 50 mg, aripiprazole 2.5 mg and cognitive behavioural therapy, with complete disappearance of symptoms including the movement disorder.

Results

Obsessive compulsive disorder 300.3 (F42); Hoarding disorder 300.3 (F42); Provisional Tic disorder 307.21 (F95.0).

Conclusions

Hoarding behaviour of strange objects is very unusual in Hoarding Disorder but more common in the Obsessive-Compulsive Disorder. In this case report, we consider the possibility of both disorders.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
From ADHD to psychosis… executive functions and time
Authors: Isabel C.D.M.
Published: May 2016

Introduction

Cognitive impairment is present from the early stages of psychotic disorders. Alterations are found mainly in areas of attention, memory work and executive functions. During adolescence, ADHD patients often suffer from secondary disorders to lack of efficient procurement processes information by the poor development of executive functions.

Objective

Evaluation of a patient whose diagnosis of ADD evolve to acute psychotic episode.

Method

Review by clinical and psychometric tests developments in executive functions disorders.

Results

Twelve years old patient who comes to the hospital since 2012, was initially diagnosed with literacy difficulties and low academic performance, after MFF-20 speaks of Learning Disabilities. It presents lack of motivation, apathy, difficulty in scheduling and organization and adherence to schedules, so they diagnosed ADD. It is given treatment with methylphenidate and atomoxetine, presenting erratic path.

After a year without treatment and the presence of a major stressful life event, at 17, has a first episode, consisting in mutiste attitude, phenomena of self-referenciality, experiences of control, enforcement and dissemination of ideas and auditory hallucination imperative type.

Conclusions

The presence of emocional dysregulation and alterations in the executive functions atribuyen to ADD, in this case, were premorbid symtomatology of a first psychotic episode. The presence of positive symptoms allows to clarify the diagnosis.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Delayed memory in ADHD children
Authors: Lvova O.
Published: May 2016

Introduction

It is known that children with ADHD have deficit in cognitive abilities. However there are different opinions about the nature of this deficit. It is necessary to conduct researchers for revealing specific profile of impairments in different cognitive domains in ADHD children to better understanding the nature of this disorder.

Aims

The aim of this research was to examine the hypothesis that children with ADHD have a specific deficit in memory – weakness in delayed memory.

Methods

The experimental group included 15 Russian-speaking children with ADHD at age 7–8 years. The control group included 15 typically developing children. The children from experimental and control group were matched for IQ, gender and age. Children from both groups were assessed with NEPSY using memory for names subtest. This subtest is designed to assess the ability to learn the names of children in immediate and delayed conditions. Two-way ANOVA was used to reveal group differences in reproducing the names in two conditions.

Results

We have not revealed significant differences between children from experimental and control group in the reproducing the names in immediate condition.

However, the interaction of condition type and group was significant (P ≤ 0.05). ADHD children were less successful in reproducing the names in delayed condition.

Conclusions

In view of the obtained results, it can be assumed that children with ADHD have specific deficit in memory domain – weakness in delayed memory. It is necessary to confirm this result using different memory tasks.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
A bizarre love
Authors: Noval Canga C. , Hernández Antón R. , Cepedello Pérez S. , Gómez Sánchez S. , Rodríguez Andrés L. , Gallardo Borge L. , Medina Ojeda G. , Alonso Sánchez A. , Álvarez Astorga A. , Portilla Fernández A.
Published: May 2016

Introduction

Adoption constitutes a discontinuity in child care trajectory, that falls into a separation and a lost of reference figures, and therefore, the need to set up new attachment figures into a suitable familiar atmosphere.

Objectives

This case is a review of how a child adoption process, that can be something positive at first, can also produce many problems in the future, added to dificulties in order to regulate stressing situations and also solving problems.

Methods

The clinical case consists in a 25-year-old woman, who suffers from anxiety and self-injure behaviour. She has a diagnosis of non-specified personality disorder with limit characteristics. The patient was adopted a few months after her birth. At the moment she's living with her adoptive father, her adoptive mother passed away when she was 4. At the age of 21, the patient meets her biological mother and since that moment she spends most of the weekends with her. After a few medical appointments, she admits that she has allowed sexual relationships with her biological mother since six months ago.

Results

It's important to appreciate the value of familiar atmosphere, and in addition, the attachment between child and his parental figures. The quality of the attachment is going to have influence in emotional regulation.

Conclusions

Children who have suffered neglect from their biological parents and have been adopted develop attachment behaviours characterized by negative experiences. In spite of being in a good familiar environment, they feel vulnerable and insecure. Early and appropriate attachment experiences can improve relationships between children and their new family.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Brain development in attention deficit hyperactivity disorder: A neuroimaging perspective review
Authors: Pereira V. , de Castro-Manglano P. , Soutullo Esperon C.
Published: May 2016

Introduction

Attention deficit hyperactivity disorder (ADHD) is a challenge in child and adolescent psychiatry. In the recent decades many studies with longitudinal designs have used neuroimaging with ADHD patients, suggesting its neurodevelopmental origin.

Objectives

Study the findings of neuroimaging (MRI, fMRI, DTI, PET) techniques on ADHD patients from a longitudinal point of view, looking also for the potential influence of treatments and other predictors (i.e. genetics).

Aims

To provide a global perspective of all the recent findings on ADHD patients with the neuroimaging technics, focusing on longitudinal measurements of the changes in brain development.

Methods

We conducted a review of the literature in the databases Pubmed and ScienceDirect (terms ADHD, neuroimaging, MRI, fMRI, DTI, PET, functional connectivity, metilphenidate and cortical thickness). We focused on studies using neuroimaging techniques with ADHD patients, looking at their populations, methodologies and results.

Results

The studies found abnormalities in the structure of grey matter, activity and brain connectivity in many neural networks, with particular involvement of the fronto-parietal and Default Mode Network. There is also convergent evidence for white matter pathology and disrupted anatomical connectivity in ADHD. In addition, dysfunctional connectivity during rest and during cognitive tasks has been demonstrated.

Conclusions

This evidence describe ADHD as a brain development disorder, with delays and disruptions in the global development of the central nervous system that compromises grey and white matters, most evident in the prefrontal cortex, parietal and posterior cingulate cortices, as well as basal ganglia, damaging activity and structural and functional connectivity of various brain networks, especially the fronto-striato-parietal and default mode network.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Clinical manifestations in patients with acute and transient psychosis
Authors: López Díaz Á. , Soler Iborte A. , Galiano Rus S. , Fernández González J.L. , Aznarte López J.I.
Published: May 2016

Introduction

The term, acute and transient psychosis, is comprehended as a heterogeneous group of disorders, which share, as a common feature, the abrupt and brief deployment of typical psychotic behaviour, either polymorph, delusional, or schizophreniform. This diversity of symptoms may also be present in other psychotic disorders, for which, some authors question its reliability.

Objetive

To analyse the clinical manifestations present in acute and transient psychotic disorders (ATPD), and determine the differences between its different subcategories.

Method

Retrospective chart review study of adult patients admitted in our psychiatric unit between 2011 and 2015, with a mean diagnosis of ATPD at hospital discharge. Diagnostic criteria was according to the International Classification of Diseases (ICD-10). Symptoms were divided under operative procedures, as set out in psychopatologic descriptions. For methodological reasons, statistical analysis was conducted between polymorphic features group (PM) and nonpolymorphic group (NPM). Chi-squared test and Fisher's exact test (as appropriate) were performed, using MedCalc software.

Results

Thirty-nine patients met the inclusion criteria. Acute polymorphic psychotic disorder with and without symptoms of schizophrenia (39%), acute schizophrenia-like psychotic disorder (20%), acute predominantly delusional psychotic disorder (23%), other and NOS (18%). There were statistically significant differences between PM and NPM groups in emotional turmoil (>PM, P = 0.0006), grossly disorganized or abnormal motor behaviour (>PM, P = 0.0038), and type of onset (sudden >PM, P = 0.0145).

Conclusion

Currently, the same concept encompasses two categories (PM and NPM) to be differentiated. The ATPD construct is under review, due its long-term instability.

Disclosure of interest

The authors have not supplied their declaration of competing interest.