bluuebunny/crossref_metadata_2025 huggingface dataset:
Suffering of the Spouses of Narcissistic Perverts: About Two Cases
Authors: Ben Saadi S. , Moula O. , Zerriaa O. , Chebli S. , Ghachem R.
Published: June 2017

Introduction

The narcissistic perversion is a psychoanalytical term resulting from the association of 2 Freudian notions: perversion and narcissism. The concept of narcissistic pervert has no clinical validity. The companions of the narcissistic perverts undergo moral suffering, often unknown by their entourage.

Objectives

We suggest studying the trajectory of life of two wives of narcissistic perverts.

Aims

Emphasize the peculiarities of the narcissistic perverse personality.

Methods

We are going to postpone 2 clinical cases of spouses of narcissistic perverts.

Results

Case 1: Mrs. A., 60-year-old, divorced once. Mother of a girl. She met her current husband during the marriage of her daughter. At the beginning of their common life, Mr. M. was loving and in the small care with his wife. After three months of the marriage, Mrs. A. reported the change of character of her husband who became aggressive, decreasing her and taking her away from her family. He seized all her goods. She is actually getting a divorce.

Case 2: Mrs. R., 27-year-old, married Mr. C. after 9 months of knowledge. At the beginning of their marriage, they had a good agreement. Forced to stay at home to take care only of domestic spots, she reported a real-life experience of neglect and emotional carelessness, she felt belittled and isolated. At present engaged in a divorce procedure after been physically assaulted threatened with death.

Both women consulted for depression.

Conclusion

The narcissistic perversion is a personality problem which affects as well the person involved but especially his entourage. When you are in connection with a narcissistic pervert, even after leaving him, you never recover from it.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Shame and Guilt in Mental Disorders - Diagnostics and Treatment
Authors: Madeira L.
Published: June 2017

Guilt and shame are important human emotions, which have been studied by several different disciplines. Seminal and recent inputs in Psychology (particularly Psychoanalysis) and Psychiatry are briefly reviewed including cross-cultural considerations and developmental psychology studies on these emotions. Yet this keynote focuses in the phenomenology and epistemology of guilt and shame as complex emotions. This includes considering that guilt is experienced in two moments (decompressed into a moment of negligence and another of guilt) while shame only in one moment (prolonged in a “frozen now”). All the inputs have suggested an operationalization of epistemic and phenomenic differences considering their context, formal object, particular object and action tendency. Lastly it refers to the relation of these experiences with psychopathology and nosology concerning their adaptive and maladaptive nature, their relation with empathy as well as their presence in several disorders such as anxious, depressive and obsessive compulsive sorts.

Disclosure of interest

The author has not supplied his declaration of competing interest.
Personality Traits of Participants of Local Armed Conflicts in the Remote Post-combat Period
Authors: Epanchintseva E. , Kazennyh T.V. , Rudnitsky V.A. , Ivanova A.A.
Published: June 2017

Introduction

The problem of the psycho-injuring influence of military operations and accidents on mentality of the person is relevant and significant that is connected with existence of emergency situations, local wars and the international conflicts.

Material and methods

We examined group of patients of participants of local armed conflicts (69 people) in the remote post-combat period (not less than 15 years). Most examined persons were older than 40 years (92%). Duration of stay in conditions of military operations made 6–7 months in 42.0%, 12 months and more – in 43.0%; 15.0% participated in official journeys. Clinical, clinical-physiological, experimental-psychological examination was carried out.

Results

During experimental-psychological examination reorganization of the pre-morbid personality which was expressed in increase in its structure of specific weight of pathocharacterological disorders both as a result of acuteness of qualities of character inherent in patients, and emergence of new forms of personal reaction was revealed. In communication sharpness, maximalism of judgments, rough behavior was typical in combatants. In some cases, we observed existence of permanent mood disorders in the form of a combination of intense affects of melancholy and rage. Behavioural disturbances were expressed to rough demonstration of affect of anger and rage as a proneness to conflict, with jamming on negatively colored experiences, tendency to destructive actions up to criminal acts, abuse of alcohol took place. In some patients, the desire to return back to a situation of military operations was revealed. In the circle of the family, they showed hostility, aggression, and intolerance.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Borderline Personality Programme in a Rural Area: The Value of a Therapy
Authors: Marin Olalla M. , Perez Ramirez B. , Vidal Lopez A.M. , Martinez Martinez B. , Maldonado Lozano R.
Published: June 2017

Introduction

An increased incidence of personality disorders (TP) in general, and borderline personality (BP) is currently a significant health problem because of the complexity of the clinic, the difficulty for early diagnosis, often unsatisfactory response to available treatments and the lack of clear proposals on multidisciplinary therapeutic interventions. In more serious cases, people with TP generate a high level of self and family suffering, as well as a high care burden that does not have a proportional impact on the quality of life of those affected and their families.

Aim

Establish a stable functional organization of professional and organizational resources of the Mental Health Unit of the North of Almeria that ensuring comprehensive care for people with borderline personality disorder and their families.

Methods

The program was structured:

– elemental: BP census, individual sessions with optional nurse reference;

– advanced individual: BP census, individual sessions, Nurse reference;

– advanced individual and group: BP census, Individual sessions, Nurse reference and Therapeutic Group Hospital Mental Health Day weekly applying dialectical behaviour therapy.

Results

The census of patients with borderline personality disorder was established in 30 people, 20 of them participating in two editions of therapeutic group. Fifty weekly sessions were carried out continuously, except holiday periods. A multidisciplinary team (nurse and two psychiatrists) were involved. The results indicate that there was an improvement in the quality of life of patients. It had been reduced hospitalisations, emergency assistance, and more than 60% of them got a job after that.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Working With Anxiety and Depression from a Buddhism Framework
Authors: Allen A.
Published: June 2017

Buddhism as a spiritual discipline is concerned with freedom from suffering, conceptualizing suffering as originating in false views about the nature of self and reality. Buddhist psychology conceptualizes emotions and mental habits as being wholesome or unwholesome based on the tendency of these habits to promote or hinder the quest for enlightenment, and contains a rich diversity of methods to transform unwholesome emotional tendencies. Many of these emotions, such as anger, fear, and despair, are commonly dealt with in clinical or therapy settings. Buddhist ideas about the genesis and cessation of suffering can be used as an overarching model to organize a diversity of therapeutic techniques, bridge different therapy models, and select particular techniques at particular times in the treatment of emotional disorders. Learning objectives: after this session, participants will be able to use the Buddhist Yogacara model of mind and karma as a model of how negative emotions are transformed. After this session, participants will be able to describe indirect methods (evoking wholesome feelings) in order to transform negative emotional tendencies and how this overlaps with current therapy models such as supportive and compassion-focused therapy. After the session, participants will be able to conceptualize how Buddhist “direct methods” of mindful awareness and contemplating right view overlaps with methods used in cognitive behavioural therapy, marital therapy, or acceptance and commitment therapy. Self-assessment questions: according to Buddhist psychology, what is the primary cause of negative emotions? Broadly speaking, what are 3 types of techniques for transforming emotional habits?

Disclosure of interest

The author has not supplied his/her declaration of competing interest.
The Time Perception in Contemporary
Authors: Burgese D.F. , Bassitt D.P. , Ceron-Litvoc D. , Liberali G.B.
Published: June 2017

With the advent of new technologies, the man begins to experience a significant change in the perception of the other, time and space. The acceleration of time promoted by new technology does not allow the exercise of affection for the consolidation of ties, relations take narcissists hues seeking immediate gratification and the other is understood as a continuation of the self, the pursuit of pleasure. It is the acceleration of time, again, which leads man to present the need for immediate, always looking for the new – not new – in an attempt to fill an inner space that is emptied. The retention of concepts and pre-stressing of temporality are liquefied, become fleeting. We learn to live in the world and the relationship with the other in a frivolous and superficial way. The psychic structure, facing new phenomena experienced, loses temporalize capacity and expand its spatiality, it becomes pathological. Post-modern inability to retain the past, to analyze the information received and reflect, is one of the responsible for the mental illness of today's society. From a temporality range of proper functioning, the relationship processes with you and your peers will have the necessary support to become viable and healthy.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Leonardo da Vinci: A Neuropsychological Enigma or an Aberration?
Authors: Kumar S.
Published: June 2017

Introduction

It has been universally regarded that Leonardo da Vinci was one of the all-time geniuses in terms of his contribution to art and sciences. A number of theories have been proposed to explain his genius that range from neurological, psychological uniqueness, and enhanced functional intelligence.

Aim

The primary aim is to explore these theories in detail and register their pros and cons alongside contextualizing their credibility and weightage against the extant evidence in science.

Method

A detailed literature search has been undertaken to identify variety of models and theories either:

– dealing with neurological, psychological or neuro-philosophical explanations;

– have been proposed by psychiatrist or psychologist and neurologists pertaining to Leonardo's brain or mind;

– theories around occult and religion have been excluded.

Discussion

The results are synthesized and presented in a tabular form. The discussion expand son the various theories and the relevance of Leonardo da Vinci to the merging unified field of neurology, psychology, technology and philosophy (consciousness studies).

Disclosure of interest

The author has not supplied his/her declaration of competing interest.
Alexithymia in War Veterans with Post-traumatic Stress Disorder
Authors: Becirovic E. , Avdibegovic E. , Softic R. , Mirkovic-Hajdukov M. , Becirovic A.
Published: June 2017

Introduction

Alexithymia consider a cluster of cognitive and affective characteristics that include: inability of recognizing and describing emotions, difficulties in distinguishing feelings and physical sensations during emotional arousal, narrowed capacity for imagination and externally oriented cognitive style. Several studies links alexithymia with increased risk for physical and mental damage. Symptoms of alexithymia are documented in persons who develop PTSD in response to different types of traumatic events.

Objectives

To examine alexithymia in war veterans.

Aims

To determine whether alexithymia is significantly more present in war veterans with PTSD.

Methods

Cross-sectional study of 205 war veterans tested by Harvard Trauma Questionnaire and by Toronto Alexithymia Scale (TAS-20).

Results

Out of 205 war veterans 89 (43.4%) of them have alexithymia. Significantly more veterans with PTSD (78 or 75%) than without PTSD (11 or 10.9%) has alexithymia (Chi2 = 88.955, P < 0.001) was found a statistically significant difference between the two groups in the total score of alexithymia (t-test = −10.676, P < 0.001) statistically significant difference was found in all three domains of alexithymia.

Conclusions

Alexithymia is significantly often in war veterans with than without PTSD.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Residual Sleep Disturbance in Tunisian Military Patients with Post-traumatic Stress Disorder
Authors: Belhadj H. , Krir W. , Elkefi H. , Oumaya A.
Published: June 2017

Introduction

Sleep disorders such as nightmares and insomnia are among the most frequently reported symptoms in patients with post-traumatic stress disorder (PTSD).

Objective

To assess the prevalence of residual sleep disorders in military personnel with PTSD.

Methods

A cross-sectional study was conducted and included 25 military consultants meeting the criteria of DSM-5 for PTSD. Sleep disorders were assessed using the insomnia severity index (ISI).

Results

The mean score of the ISI was 14. Fourteen percent of the participants (n = 21) reported difficulty falling asleep. All patients reported difficulties staying asleep. Nightmares were reported by 48% of the sample (n = 12). All patients were under hydroxyzine at dosages ranging from 25 to 50 mg per day. More than half of the sample (n = 18) was under a combination of benzodiazepine and hydroxyzine. Seventy-one percent of patients (n = 15) considered that their sleep difficulties significantly disrupted their daily lives.

Conclusion

Insomnia is one of the most frequent and persistent symptoms in PTSD patients. These sleep disorders can impede remission and may be due in part to co-morbid depression.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Post-traumatic Stress and Subthreshold Autism Spectrum Among Divers of the Italian Navy Employed in Search and Rescue Activities
Authors: Carmassi C. , Isabella P. , Bertelloni C.A. , Corsi M. , Massimetti G. , Conversano C. , Dell’Osso L.
Published: June 2017

Introduction

Rescue emergency personnel is at high risk to develop PTSD due to possible extreme and repetitive exposition to “cruel details of traumatic events”.

Objective

This study aimed to explore posttraumatic stress and subthreshold autism symptomatology and their impact on social and working functioning level among sub mariner of Italian Navy, who were employed in the Costa Concordia and Genova tower rescue operation.

Methods

Eighty-five subjects were enrolled and investigated by the following instruments: Trauma and Loss Spectrum Self-Report (TALS-SR), Adult Autism Subthreshold Spectrum (AdAS Spectrum) and Work and Social Adjustment Scale (WSAS).

Results

The response rate was about 50%. Ninety-five percent of the subjects were employed in recovering corpses and 80% reported at least one rescue operation in the last three years. Full and partial DSM-5 PTSD rates were 8% and 27.5%, respectively. A strong correlation emerged between several TALS-SR and ADAS domain. Furthermore, TALS-SR domain scores were related to WSAS domain.

Conclusion

This data showed rescue personnel to be at risk for post-traumatic stress spectrum and related work and social impairment. Further studies are needed to better investigate possible risk and resilience factors associated to PTSD.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Deaths and Symbolic Use of Language: Semiotics and Thanatological Reading of the Film Nell
Authors: Färber S. , Färber M.
Published: June 2017

Introduction

Psychiatric disorders may become more severe when the subject is exposed to a hostile environment. Symptoms of mental malaise are expressed by the senses, including speech and language.

Methods

The method is used of semiotic analysis and thanatological movie.

Objective

To investigate the limit and death as a trigger of a singular mode of use of the spoken language. The problem presented in this paper is the linguistic system created by Nell.

Results

Partial results show that spoken language in this particular cut, becomes an instrument for dealing with the losses accumulated throughout his life. The life of isolation, restrictions on maternal vocalization, her mother's death and mourning acted as an inhibitor of language.

Conclusion

The spoken language works like kaleidoscope of interactions of the individual with their group, with the medium in which it is inserted, with the set of beliefs that nourishes and with the world that she wants there, even if only in your intimate venue. Thus, demonstrating the sociolinguistic approach inalienable role in speech performance.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Augmentation Effects of Eye Movement Desensitization and Reprocessing (EMDR) Intervention in Pharmacotherapy-resistant PTSD
Authors: Park J.E. , Kim D. , Bae H. , Kim W.H. , Roh D. , Kim W.
Published: June 2017

Aim

Both trauma-focused cognitive behaviour therapy and antidepressant medication are regarded as the first line treatments for post-traumatic stress disorder (PTSD). However, little is known about sequential or combined efficacy of these two different treatment options. This prospective study examined the add-on efficacy of eye movement desensitization and reprocessing (EMDR) therapy among adult civilians with PTSD who continued to be symptomatic after antidepressant treatment.

Method

Adult patients with PTSD at a specialized trauma clinic who received treatment doses of antidepressants for more than 12 weeks were recruited; definition of symptomatic PTSD was a total score > 40 on the Clinician-administered PTSD Scale (CAPS). The CAPS and the global improvement from Clinical Global Impression (CGI) were rated prior to EMDR, after termination and six months follow-up.

Results

A total of 15 patients underwent an average of six sessions of EMDR and 7 (47%) of 15 no longer met the criteria for PTSD and 10 (67%) were given status of very much or much improved. The CAPS scores and significantly decreased after EMDR therapy (paired t = 7.38, df = 14, P < 0.0001).

Conclusion

These results indicate that EMDR or trauma-focused CBT can be successfully added to those who failed to improve after initial pharmacotherapy for PTSD. Further studies are needed to explore the best sequence or components of therapies in the treatment of PTSD.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Psychiatric Risk Assessment Scale (PRAS)
Authors: Shoka A. , Lazzari C.
Published: June 2017

Introduction

The aim of psychiatry is the prediction of risks.

Objectives

Creation of the Psychiatric Risk Assessment Scale (PRAS) (Table 1).

Aims

To assess psychiatric inpatients for risk to self and others.

Methods

The PRAS comprises 20 risk items that rate five probabilities of occurrence: 0% (nil), 25% (low), 50% (moderate), 75% (high) and 100% (severe). Cut-off score indicates “moderate” risk = 50. The mathematical formulas for the risks are as follows:

– severity of risk (SR) = average for the whole table multiplied by %;

– number of significant risk events (NSRE) = count of risks scored from 50% to 100% divided by 20 (items);

– probability of occurrence of risks (POR = NSRE%);

– range probability of death (RPD) = range score of (overdose + suicide + reckless activities)%.

Two raters assessed independently n = 8 patients. Kappa inter-rater statistic was used by dichotomous results (above-below cut-off score).

Results

Inter-rater Kappa = 0.60 indicates a moderate inter-rater agreement. In the sample, only 2 patients scored above the cut-off score of 50, indicating a level of moderate-to-severe risk. For the other patients, the average SR = 36%, indicating low-to-moderate risk.

Conclusions

PRAS is constantly used to assess the likelihood that the care provided to patients admitted to hospital is sufficient or whether major remedial action is required.

Table 1

Disclosure of interest

The authors have not supplied their declaration of competing interest.
The impact of emotional acknowledgement and self-esteem on resilience to family dysfunction
Authors: Fontaine C. , Connor C. , Channa S. , Palmer C. , Birchwood M.
Published: June 2017

Introduction

Family dysfunction can test the resilience of adolescents, specifically those from single parent families and those attending schools in more socio-economically challenged areas.

Objectives

To determine what factors are associated with resilience for those from single parent families or attend schools in more socio-economically challenged areas.

Aims

To examine the role of emotional regulation and self-esteem as putative resilience factors in the context of single parents status and socioeconomic disadvantage.

Methods

Secondary school pupils from single and dual parent families aged 13 to 15 answered questionnaires at three time points on: emotional regulation, self-esteem, depression and anxiety. A total of 434 pupils took part at time 1, 574 at time 2, and 467 at time 3. The secondary schools were categorised into more and less disadvantaged schools.

Results

Positive self-esteem [F(1.205) = 54.568, P = 0.000; F(1.157) = 35.582, P = 0.000] and emotional regulation [F(1.205) = 46.925, P = 0.000; F(1.157) = 16.583, P = 0.000] were both associated with resilience against depression in adolescents from single parent families. Positive self-esteem [F(1,75) = 102.629, P = 0.000; F(1.355) = 60.555, P = 0.000] and emotional regulation [F(1.60) = 34.813, P = 0.000; F(1.73) = 36.891, P = 0.000] were both associated with resilience against depression in adolescents attending more socio-economically challenged areas.

Conclusions

This research suggests that adolescent resilience against depression may be promoted by improving self-esteem and emotional regulation. Therefore, future interventions could focus on boosting these resilience factors. Further resilience research could include emotional regulation and self-esteem as protective factors for resilience in adolescent mental health. As these variables have been identified, they can help find more pieces to the complex puzzle of resilience.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Promotion of mental health literacy and mental well-being in a Portuguese unemployed population sample: Effectiveness assessment of a capacity building community-based intersectoral intervention
Authors: Heitor dos Santos M.J. , Moreira S. , Dinis A. , Virgolino A. , Carreiras J. , Rosa R. , Ambrósio S. , Lopes E. , Fernandes T. , Santos O.
Published: June 2017

Introduction

Economic crises have consequences on labor market, with impacts on mental health (MH) and psychological well-being (PWB). We describe the effectiveness of an intervention among unemployed, performed within EEA Grants Healthy Employment project.

Objectives

Evaluate the effectiveness of an intervention for MH literacy, PWB and resilience among unemployed.

Aims

MH and PWB promotion, common mental disorders prevention and inequalities reduction linked to unemployment.

Methods

A five modules intervention (life-work balance; impact of unemployment on PWB and MH; stigma; depression and anxiety; health promotion) distributed by 20 hours was developed based on literature reviews and a Delphi panel. It was delivered to unemployees from two public employment centers (PECs). Inclusion criteria: 18–65 years old; registration in PEC for less than a year; minimum of nine years of formal education. Control groups from the same PECs received the care-as-usual. Measures of psychological WB, MH self-reported symptoms, life satisfaction, resilience and mental health literacy were collected through an online survey before and one week after intervention.

Results

Overall, 87 unemployed participated, 48% allocated to the intervention group (IG); 56% women (21–64 years old), average education was 15 years. Mixed measures ANOVA showed that the interaction between time and group was significant for PWB and MH literacy measures. The IG showed better self-reported PWB and improved MH literacy after intervention, compared to controls. No significant interactions were found for MH symptoms, life satisfaction and resilience.

Conclusions

This study shows the contribution of short-term community-based interventions in increasing MH literacy and PWB among unemployed.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Bridging the gap between clinical practice and research: The association for research in psychiatry
Authors: Mattei G. , Bursi S. , Bursi R. , Colantoni A.
Published: June 2017

Clinical practice and research are frequently seen as two worlds apart, in psychiatry as in the vast majority of medical specialties. In order to bridge the gap between them, economic founds and grants are required, not always easy to obtain. In this contribution we report the birth of the Association for Research in Psychiatry (ARPSY) and its main activities. ARPSY was born in May 2016 thanks to a research prize assigned to dr. Giorgio Mattei by the eight Rotary Clubs of the Province of Modena, Italy (Rotary Club Modena, Mirandola, Carpi, Sassuolo, Vignola Castelfranco Bazzano, Frignano, Modena L.A. Muratori, Castelvetro di Modena Terra dei Rangoni, that altogether make up the so-called “Ghirlandina Group”). Aim of the association is to promote mental health among students and trainees, mental health professionals, patients and their families, and among the general population by means of fund raising, in order to finance research projects, clinical interventions and educational activities.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Correlations between medical students’ specialty choice and different attitudes towards mental illness
Authors: Pascucci M. , Stella E. , La Montagna M. , Di Sabatino D. , Nicastro R. , Grandinetti P. , Testa R. , Parente P. , Janiri L. , Pozzi G. , Ventriglio A. , Bellomo A.
Published: June 2017

Introduction

Discrimination and stigmatization cause an important burden for people suffering from psychiatric disorders. The medical doctors, those who should be important reference points for psychiatric patients, are instead one of the categories that contribute to their stigmatization.

Objectives

It is extremely important to study and to know the attitudes of undergraduate medical students towards psychiatric disorders, since these individuals will be involved in the care of these patients throughout their careers.

Aims

The present study analyzes the attitudes of a group of Italian medical students towards mental illness, highlighting the differences between the students who would choose surgical specialties from those who prefer medical ones.

Methods

A total of 339 medical students of different medical schools, in Rome and Foggia (Italy), completed a cross-sectional survey. The Italian version of community attitude towards the mentally Ill test (CAMI) was used to evaluate the students’ attitudes.

Results

The students that would choose medical specialties reported less stigmatizing responses in 11 CAMI items (including five items with P < 0.01), in benevolence and community mental health ideology subscales (P = 0.003) and in the total score (P = 0.003).

Conclusions

It is evident that the students that prefer the surgical specialties have more stigmatizing attitudes towards psychiatric patients. Negative feedbacks on Psychiatry from non-psychiatrist colleagues may have a fundamental role in stigmatizing mental disorders.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Inflammatory markers in mild cognitive impairment and anxiety disorders in middle-aged subjects with metabolic syndrome
Authors: Piotrovskaya V. , Neznanov N.
Published: June 2017

Anxiety disorders are increasingly being associated with metabolic and cardiovascular burden, in contrast with depression; the role of inflammation in anxiety has sparsely been discussed. A number of reports of elevated inflammatory markers in mild cognitive impairment (MCI) suggest that inflammation may be a potential early marker of the pathological cascade associated with dementia. The aim of this study was to evaluate a possible association between peripheral blood concentrations of inflammatory factors in patients with MCI and mental processes such as, cognitive impairment and anxiety in obesity.

Methods and results

The data collected from 271 patients with MetS according IDF criteria, (aged 30–60 years) have been analyzed. Lifetime diagnoses of depression (D), anxiety (A) was self-reported. Current D and A were confirmed by psychodiagnostic interview according to the criteria of ICD-10. All patients passed through: MMSE test, Wechsler memory scale, symbol coding and category Fluency test, scales HADS, HAM-A. Inflammatory markers included CRP, IL-6, IL-1 and TNF-α. Subjects were divided into group A–with D and/or A (139) and group B–without affective disorders (132). Using Mann–Whitney test significant connection between presence of MCI and high levels of inflammation is associated with simultaneous presence affective disorders. High correlations in subjects with A/D were between IL-6, IL-1 and MCI. In-group B, there was no significant correlations between inflammatory markers and MCI.

Conclusion

There is link between affective disorders and levels of inflammatory markers. Increased levels of IL-6 and IL-1 provoke co-morbidity of MCI and depression or anxiety.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Hoarding disorders: Two different clinical presentations
Authors: Samico A. , Mota D. , Venâncio Â. , Ribeiro L.
Published: June 2017

Introduction

Hoarding disorders (HD) have increasingly become a public health hazard. It usually emerges during two broad life periods: in early age-of-onset is usually associated with obsessive-compulsive disorder (OCD); in the elderly, it can be due to psychiatric and organic disorders, unrelated to OCD.

Objectives

Our objective is to increase medical awareness and to highlight that both young and elderly people may suffer from this condition.

Aims

The aim of this presentation is to address HD and its different presentations.

Methods

Presentation of two clinical cases of HD and pathology revision.

Results

A 30-year-old woman was hoarding litter, food and several items in a systematic way, become aggressive when her family tried to clean the house and was admitted several times in a psychiatric facility for cleanliness of her house. She had a history of depressive symptoms and severe OCD, with obsessive thoughts and several verification behaviors. A 78-year-old woman, with history of cerebral vascular disease, was self-neglected, living in a filthy home, with hoarding of litter and many worthless objects in a disorganized way, become aggressive after her relatives try to enter her house and refused to get help of any kind. Later on, she was admitted in a psychiatric facility and diagnosed with vascular dementia.

Conclusions

Timely diagnosis and proper management of these two variations of HD will allow more advanced studies in this matter and more effective pharmacological and psychotherapeutic treatments. These clinical cases reinforce the importance of practical guidelines for appropriate approach of these patients with complex and multidimensional needs.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Fathers’ personality dispositions and conduct-disordered children's perception of their fathers
Authors: Singh C.
Published: June 2017

Introduction

Individual's personality profile is one of the major determinants of one's behavior. Thus, poor personality disposition of fathers and the child's perception of father have been reported to be powerful predictors of subsequent delinquency and criminal offences. The externalizers resemble the dimensions of conduct disorder as prescribed in diagnostic statistical manual IV. The essential feature is their repetitive behavioral pattern wherein the basic right of others or major age appropriate societal norms are violated.

Objective

This study finds out the relationship between the fathers’ personality-disposition, having male children with conduct disorder (CDC, n = 30, experimental group), dysthymic disorder (DDC, n = 30, control group), and normal (NC, n = 30, control group), by applying the new five factor inventory, and children's perception of their fathers on the parent–child relationship scale.

Method

The children were matched on age, sex, socio-economic status and other relevant variables. The CD and DD were selected on the DSM-IV criteria for the diagnosis of conduct disorder and dysthymic disorder. The fathers of each group of children were administered the aforesaid questionnaires.

Result

The CDF showed only significantly poor agreeableness compared to the NF. The CDC's perceived their fathers most negatively compared to the DDC and NC. The CDF's conscientiousness was significantly correlated to a number of variables of the children's perception of them as observed on the PCRS.

Conclusion

The CDF showed lower agreeableness than the NF. The CDC perceived their fathers most negatively, hence, setting the model for the child to observe and learn socially inappropriate behavior.

Disclosure of interest

The author has not supplied his/her declaration of competing interest.
Films and fiction leading to onset of psycho-phenomenology: Case reports from a tertiary mental health center, India
Authors: Soman S. , Parameshwaran J. , KP J.
Published: June 2017

Mind is influenced by socio-cultural religious belief systems, experiences and attributions in the development of psychophenomenology. Film viewing is a common entertainment among young adults.

Objectives

Influence of repetitive watching of films of fiction and horror genres on onset phenomenology in young adults.

Method

Two case reports on onset of psychotic features and mixed anxiety depressive phenomenology were seen in two patients aged 16 and 20 years respectively and based on the fantastic imagination created by films. The 28-year-old female patient diagnosed with schizoaffective disorder had onset at 16 years of age and the course of phenomenology was influenced by the fiction movie ‘Jumanji’ with partial response to medications over 10 years. The depressive and anxiety symptoms of less than 6 months duration of a 20-year-old male patient was influenced by film ‘Hannibal’ and responded to antidepressant and cognitive behavior therapy.

Conclusions

Horror and fiction films can influence the thinking patterns and attribution styles of a young adult by stimulating fantasy thinking which if unrestrained can lead to phenomenology. Viewing films compulsively, obsessive ruminations on horror and fictional themes can lead to onset of psychopathology of both psychosis and neurotic spectrum. Further research on neurobiological, psychological correlates is needed. Parental guidance and restricted viewing of horror genre films with avoidance of repeated stimulatory viewing of same genre movies in children, adolescents, young adults and vulnerable individuals is required.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Chlorpromazine-induced lupus with circulating anticoagulant. A case report
Authors: Abbes W. , Imen B. , Hanene A. , Mouna S. , Kamilia K. , Zouheir B. , Jawaher M.
Published: June 2017

The drug-induced lupus erythematosus (DILE) is an autoimmune disorder caused by chronic use of certain drugs, including chlorpromazine. Chlorpromazine-induced lupus associated to circulating anticoagulant antibodies (CAC) would be even less frequent. Our observation is an illustration of this association.

We report the case of Mrs. H., 33-year-old, without medical or surgical history, who has been followed in psychiatry since the age of 20 for bipolar disorder type 1. This patient was initially stabilized by an association of fluphenazine, sodium valproate and levomepromazine. The introduction of chlorpromazine in June 2015 induced a leuconeutropenia, which was corrected after stopping this drug. During subsequent decompensations, rechallenge with chlorpromazine and administration of other phenothiazines (levomepromazine, fluphenazine) or atypical anti-psychotics (olanzapine, risperidone, aripiprazole) induced a leuconeutropenia reversible after drug withdrawal. Within the etiological investigation of this leuconeutropenia, physical examination was normal; inflammatory tests (erythrocyte sedimentation rate, serum protein electrophoresis) and serology for hepatitis B and C and HIV were negative; antinuclear antibodies (ANA) titre was positive (1: 160) with a negative antibodies screen; rheumatoid factor and complement levels were normal. Activated partial thromboplastin time (APTT) was prolonged (47/29 s) and not corrected by addition of normal plasma. Lupus anticoagulant antibodies were positive. ANA became negative six months after cessation of implicated drugs. Thus, the diagnosis of “chlorpromazine-induced lupus with CAC” was retained. The pathophysiological mechanism of this association remains a subject of discussion. This induced autoimmunity, involving several anti-psychotics, is a real therapeutic challenge in our patient's case.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Diagnostic Procedures for Prediction of Psychosis - Achievements and Challenges
Authors: Raballo A.
Published: June 2017

Individualized prognostic predictions in people at clinical high risk are crucial to tailor suitable interventions and personalized prevention. Furthermore, in recent years, the synergy between fast-pace technical sophistication in neuroscience (e.g. neuroimaging and neurophysiological) and novel bio-statistical tools (e.g. machine learning algorithms) has accelerated the development of more inclusive predictive models and magnified the potential for such individualized risk stratification enriching classical psychopathological tools. However, the clinical translation of such research insights is still circumscribed and, despite incremental optimization of assessment tools, increasingly accepted criteria to characterize at risk mental states and tumultuous advance in the field, the prediction of psychosis at such individual level remains a not fully accomplished target.

Disclosure of interest

The author has not supplied his declaration of competing interest.
Comparison of efficacy between risperidone and aripiprazole in combination with sodium valproate in patients with acute manic or mixed episodes
Authors: Amanat N. , Nazeri Astane A. , Dieji B. , Rezaie O. , Biglarian A.
Published: June 2017

Today, despite of the improvement in the psychological therapeutic approach, mania still remains as a challenging problem for health system. The aim of this study is comparison efficacy of risperidone and aripiprazole in combination with sodium valproate in bipolar patients with acute manic or mixed episodes who hospitalized in Razi psychiatric hospital in Tehran. This study was conducted as a double blind randomized clinical trial in two groups of bipolar disorder patients with manic or mixed episodes (18–65 age). Patients randomly set in two groups who received valproate with aripiprazole or risperidone. Clinical response was assessed with young mania rating scale (YMRS) and weight gain at 3 and 6 weeks. Data was analyzed with Chi2 test, paired t-test and analysis of covariance and repeated measurement. Evaluation of treatment response after 3 and 6 weeks (50% reduction in Young's scale) in both groups did not show any significant difference between the two therapeutic combinations. The combination of sodium valproate and risperidone showed higher weight gain in comparison with the combination of valproate and aripiprazole at the end of week 6 (P < 0.001). The mentioned combination in bipolar I disorder with manic or mixed episode has similar therapeutic effect, so that both of them are effective and usable. There was no difference in their efficacy, and both treatments can be used. Due to the less weight gain, the combination of valproate and aripiprazole in patients who prone to weight gain, this approach is recommended as more safe and effective therapy.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Bupropion induced hyponatremia: A review of literature
Authors: Arts M. , Petrykiv S. , Fennema J. , De Jonge L.
Published: June 2017

Introduction

For over 20 years, bupropion has been used as an antidepressant by inhibiting the norepinephrine-dopamine reuptake. Hyponatremia is a relatively rare condition that has been associated with the use of antidepressants including selective serotonin reuptake inhibitors (SSRIs), serotonin norepinephrine reuptake inhibitors (SNRIs), and tricyclic antidepressants (TCAs). However, a few case studies have reported that bupropion was associated with hyponatremia.

Objectives and aims

To review available literature on bupropion-induced hyponatremia and its possible underlying mechanisms.

Methods

Case studies are presented and discussed followed by a literature review.

Results

Hyponatremia has been reported with the use of many antidepressants, however, studies on bupropion induced hyponatremia has been limited. In literature only four case reports have been presented. Typically, this condition is only seen in frail or elderly patients. Possible mechanism is that bupropion may cause hyponatremia by the noradrenergic stimulation of vasopressin release.

Conclusion

Clinicians should be aware of increased risk of hyponatremia associated with antidepressants, including bupropion. Especially in the elderly, clinical symptoms of hyponatremia can be misinterpreted and may lead to a life-threatening condition.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
SSRIs and QT interval prolongation management. A review
Authors: Ballesteros A. , Saiz H. , Rosero Á.S. , Portilla A. , Montes L. , Elorza R.
Published: June 2017

Introduction

In 2011, the FDA issued an alert recommending not to prescribe citalopram high doses, due to QT prolongation risk. We explored the clinical background of QT interval prolongation related to serotonin selective reuptake inhibitors (SSRI) use and the clinical implications of safety issues.

Methodology

A review was conducted to clarify the mechanisms associated with the occurrence of TdP when using SSRI and investigating therapeutic measures to avoid/minimize these effects. The literature search was conducted in PubMed data reviewing articles between 2001 and 2016.

Results

(1) Related to risk factors/intraclass differences: risk factors are increase in QTc interval ≥60 ms from the pretreatment value, advanced age, female sex, acute myocardial infarction and electrolytic abnormalities among others. Citalopram appears more likely than others to induce this phenomenon but its importance is under current debate. (2) Related to dose: drug-induced QTc interval prolongation and TdP was associated to citalopram in doses > 40 mg/day. However, psychotropic drug-induced sudden cardiac death may be an outlier in the absence of identified risk factors for QTc interval prolongation and TdP. (3) Related to poly-pharmacy/management: there is an additive effect when using SSRI and antipsychotics (EKG control is recommended in those cases). Cross-sectional studies showed that SSRI use was not associated with QT interval prolongation. This could be explained by the EKG intra-intersubject variability.

Conclusions

There is little evidence that drug-associated QTc interval prolongation by itself is sufficient to predict TdP. Future research needs to improve its precision to better understand the factors that facilitate/attenuate that progression. Clarifying this may lead to a safer SSRI use.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Prolactin levels in patients with severe mental disorders: Are we doing well? An observational study of Seville area population
Authors: Blanco Ramón P. , Suarez de Venegas N. Gomez-Coronado , Martinez I.
Published: June 2017

Introduction

It is well known that hyperprolactinemia increases the risk of hypogonadism, osteoporosis and cardiovascular diseases. Atypical anti-psychotics are directly related with its development. Despite its importance, pharmacological hyperprolactinemia it is not considered and treated by psychiatrists as much as expected. Nowadays, long-acting aripiprazole is one of the main treatments that barely increase the prolactin (PRL) levels.

Objectives

To determine the number of cases in which PRL levels are detected. To quantify the reduction of PRL levels with patients treated with long-acting aripiprazole.

Methods

Observational, descriptive study, from February 2015 to July 2016, of 52 patients treated with anti-psychotics, in two Sevillian community mental health centers.

Results

In 56% of cases, PRL level was measured at least one time: in 77% of cases with prescription of long-acting aripiprazole, PRL levels are reduced.

Conclusion

First step to reduce the impact of hyperprolactinemia in patients is to determine the PRL levels in a systematic way being this practice a must to be considered. In the study carried out and described in this abstract, reduction of PRL levels in target populations using long-acting aripiprazole is observed.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Tobacco and anti-psychotics side effects
Authors: González González I. , Hernández Dorta A.
Published: June 2017

Introduction

It's known that, patients with schizophrenia smoke more tobacco than general population, and that tobacco is a potent inducer of cythocrome P450 isoenzyme 1A2 (CYP 1A2). In addition, clozapine and quetiapine, drugs frequently used in the treatment of schizophrenia, are CYP1A2 substrates. So, tobacco smoking may reduce blood levels of clozapine and quetiapine.

Objective

To revisit the influence of changes in tobacco consumption in clozapine and quetiapine side effects.

Methods

Case report.

Results

A 48-year-old male diagnosed of schizophrenia following DSM IV-TR criteria. He required five hospital admissions from 2008 to 2013 because of psychotic episodes. Since 2013, he was asymptomathic receiving clozapine, 600 mg/day, and quetiapine, 1200 mg/day. Recently, he came to the emergency service due to sudden extreme sedation, thinking impairment, sialorrhea, and walking disability. The patient denied treatment abuse and his family confirmed this statement. When asked about toxics he referred progressive tobacco reduction in the last 3 months (from 60 to 20 cigarettes/day). Bearing in mind the relationship between clozapine and quetiapine metabolism and tobacco, treatment was slowly reduced until the doses of clozapine 500 mg/day and quetiapine 400 mg/day. One week after admission, side effects disappeared, psychotic symptoms were not detected, and the patient was discharged.

Conclusions

Inquiring about changes in tobacco consumption may be useful when anti-psychotics side effects appear suddenly without an alternative explanation.

Disclosure of interest

The authors have not supplied their declaration of competing interest.