bluuebunny/crossref_metadata_2025 huggingface dataset:
Human induced pluripotent stem cells (hiPSCs) in schizophrenia: Modelling the disease and the treatment response
Authors: Marcatili M. , Marsoner F. , D’Agostino A. , Scarone S. , Conti L.
Published: June 2017

Response to drug treatment is under the sophisticated control of complex signalling pathways and gene regulatory networks. Indeed, drug-induced modulation of dysregulated gene expression and altered synaptic plasticity are critical steps for the successful treatment of neuropsychiatric disorders. Among the antipsychotic drugs, clozapine (CLZ) is widely considered to be the most effective medication for the treatment of schizophrenia. However, due to its high risk for severe side effects, CLZ use is currently restricted to patients who do not respond to other antipsychotics. Nonetheless, up to 20% of patients are considered nonresponders to CLZ treatment. The mechanism of action underlying CLZ's exceptional clinical efficacy in SCZ is not fully understood. In this context, in vitro molecular and functional assessment of patient-derived glutamatergic and GABAergic neurons’ properties are mandatory to reveal the mechanisms underlying CLZ responsiveness and might mirror the clinical response. Here, we will describe the generation of hiPSCs from SCZ patients, classified based on their response to conventional treatments, to CLZ or total resistance to every treatment. These patient-specific hiPSCs have been converted into enriched cortical glutamatergic neurons and parvalbumin-positive GABAergic interneurons populations that are under inspection to reveal phenotypic and molecular/pharmacological aspects correlating with patient-specific responsivity pattern to CLZ treatment. These results might help to unveil the molecular basis of treatment response profiles that can be exploited to predict response to antipsychotic drugs and that might help to develop personalized treatments, more individually tailored and less hazardous.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Pre-morbid personality trait and cognitive function impact on schizophrenia course and social maladaptation
Authors: Samburskis D.
Published: June 2017

Background

Certain personality traits are found in persons with high risk for schizophrenia onset and therefore it could be used as diagnostic marker.

Objectives

To analyze correlations between personality traits and cognitive functions on schizophrenia onset and its course and social adaptation.

Methods

This was a retrospective cohort study conducted in Riga center of psychiatry and narcology, Latvia. Study consisted of two parts. In the first part, data on first presentation schizophrenia patients hospitalized in 2006 was collected from medical records. Patients without completed MMPI, Schulte table; visual memory and 10 words recall tests were excluded from study group. The Second part of the study consisted of participant interviews that were held in early 2016 acquiring demographic data and each participant completed a Sheehan disability scale (SDS). Microsoft Excel 2016 and SPSSv22 were used for data operation.

Results

Study group consisted of 11 males and 20 females (35.5%/64.5%). Mean age of participants was 37 years (IQR = 48–33), but mean age at onset of first schizophrenia symptoms was 27 years (IQR = 37–21). 68% (n = 21) of participants had schizoid personality traits as per MMPI and they had higher results on all SDS subscales. There was a negative correlation between the SDS score in the first section with the occupational level in 2006 (P = 0.065) and 2016 (P = 0.040) and marital status in 2016 (P = 0.040) in those with psychopathy scale.

Conclusion

The hypothesis that schizoid personality traits are a leading factor in the onset of schizophrenia, have not been proven. Schizophrenia patients with psychopathic personality traits are likely to have better social adaptation.

Disclosure of interest

The author has not supplied his/her declaration of competing interest.
Sexual minorities: The terminology
Authors: Cochat Costa Rodrigues M.C. , Leite F. , Queirós M.
Published: June 2017

Introduction

The term “sexual minority” includes a variety of gender and sexual identities and expressions that differ from cultural norms. Usually, sexual minorities are comprised of lesbian, gay, bisexual and transgender individuals.

Objectives/aims

Definition of the correct terminology for sexual orientation, sexual behaviors, gender identity, gender expression and gender dysphoria.

Methods

Literature review concerning researched articles published in Pubmed/Medline as well as related bibliography.

Results

Human sexuality is a broad concept that embodies interaction among anatomy, hormones, physiology, psychology, interpersonal relationships and sociocultural influences.

Healthcare providers can support sexual minorities by normalizing sexuality throughout childhood, early identification of gender or sexual orientation nonconformity and associated psychosocial and health concerns, helping parents support their child, assisting with decisions about disclosure and providing educational resources to the community.

Conclusions

This work focuses on providing more awareness about this topic and reducing stigma associated with sexual minorities.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Motivation of sexual relationship with animal–Study of a multinational group of 345 zoophiles
Authors: Sendler D. , Lew-Starowicz M.
Published: June 2017

Introduction

We explore relationship-seeking behaviour of zoophiles (zoos), using Francoeur's (1991) definition of sexual orientation (as consisting of affection orientation, sexual fantasy orientation, and erotic orientation).

Objectives

This study intends to be the largest in recent decades’ comprehensive analysis of self-identified zoophiles, living on all five continents. It describes similarities and differences between normative sexual orientations (hetero- and homo-) and zoophilic sexuality, using Francoeur's (1991) framework.

Method

A qualitative observational study of user activity (n = 958) on discussion forums, combined with brief demographic survey. Data were analyzed according to principles of grounded theory. Next, surveys of own design (demographic, discreet + open ended questions) were received by n = 350 participants. Presented data show aggregate conclusions from mixed methods qualitative and quantitative analysis.

Results

Trend analysis yielded four main discussions among zoophiles – worldview, personal space, sex life, and online space. Within worldview category, zoos overwhelmingly discuss bad press (55%), as well as social (41%) and legal (22%) ostracism. In personal space, the primary concern is coming at easy with own sexuality (>60%) and forming lasting relationship with either human, animal, or both partners simultaneously. In terms of sex life, zoos are concerned with improving sex play (>40%) and figuring out legality of sexual encounters with animals (22%). Concerning online space, the biggest concern here is networking (40%) and meeting other zoos for dating (15%).

Conclusions

Modern zoophiles have a wide array of personal, social, legal, and sex life challenges that can be approximated using qualitative studies.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Evaluation of insomnia management in the elderly by general practitioners
Authors: Turki M. , Aloulou J. , Halouani N. , Ennaoui R. , Amami O.
Published: June 2017

Introduction

Insomnia is the most common sleep disorder in the elderly. Its management must take into account the physiological changes associated with age, a higher frequency of comorbidities and polypharmacy.

Aim

To evaluate the management of insomnia in the elderly patients by general practitioners and to compare it with international recommendations.

Methods

We conducted a cross-sectional and descriptive study among general practitioners in Sfax over a period of two months (January and February 2016). We proposed to these doctors to participate in our study by sending to them a questionnaire in their emails, which they fill anonymously.

Results

A total of 32 doctors responded to the questionnaire. Among them, 62.5% reported that they often or very often receive elderly consulting for insomnia. Before prescribing hypnotic drugs, 65.6% of practitioners reported that they often advise lifestyle and dietary rules. The most prescribed hypnotic classes were: benzodiazepines (BZD) 59.37%; antihistamines 59.37% and homeopathic treatments 56.25%. In the last prescription, the treatment period exceeded 30 days in 18.75%. As for the prescription of BZD, molecules with long half-life were used in 37.48% of cases, and the dosage was identical to adult in 34.4% of cases.

Conclusion

The prescription of hypnotic treatment in the elderly meets a logical approach to care, after an accurate diagnosis, taking into account psychiatric and somatic comorbidities, the precautions and contraindications. In this context, we have identified several shortcomings in the management of insomnia in the elderly in general practice. A multiplication of training on this subject is needed.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Psychometric evaluation of the Slovenian translation of the Circumstances, Motivation and Readiness Scales
Authors: Delic M. , Kajdiz K. , Pregelj P.
Published: June 2017

Introduction

According to the available data, treatment motivation and readiness are closely linked to retention. There are instruments for measuring the stages of motivation and readiness, and predicting treatment retention and outcome.

Aim

This study describes psychometric properties, while focusing on the reliability of the Slovenian version of the Circumstances, Motivation and Readiness (CMR) scales.

Methods

We included 109 male and female patients with opioid addiction at the Centre for Treatment of Drug Addiction, Ljubljana. The CMR was translated into Slovenian by using the “forward-backward” procedure by our team and its author. Data analysis addressed psychometric properties of the CMR. Internal consistency was examined by applying exploratory and confirmatory factor analysis, while reliability was examined with Cronbach's coefficient alpha.

Results

Cronbach alpha coefficients of reliability were calculated for each of the three CMR subscales and for the total score. The total alpha was 0.842. Alpha for Motivation was 0.860, for Circumstances 0.372 and for Readiness 0.818. Exploratory factor analysis extracted a 3-factor solution with 56% explained total variance. The factors do not provide an exact match with the dimensions C, M and R.

Conclusion

On the basis of these results we can conclude that the Slovenian translation of the CMR is a valid instrument for evaluating patients’ motivation and readiness for treatment.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Alcoholic hallucinosis after chronic alcohol abuse: A case report
Authors: Fernandez Miranda J.J. , Frías Ortiz D.F. , Maria Francina F.C. , Rossi P. , Shaban Rodríguez O.W. Muquebil Ali Al
Published: June 2017

Introduction

Alcoholic hallucinosis is a rare complication of chronic alcohol abuse and a prevalence of 0.6–0.7% in alcoholics has been reported.

Case report

A 54-year-old Indian immigrant in Barcelona was referred for psychiatric evaluation in April 2016 by due of his behavioral alterations. Evaluation revealed that he was apparently asymptomatic when he come to Spain, 18 years ago. He had been consuming alcohol since 1974 and gradually the frequency and quantity increased to 600 mL of rum daily by 1996. He complained of hearing voices of family members, being irritable even when he was alone and in catatonic phases. He was found to be gloomy, reclusive, not sleeping and talking to oneself. He used to have sleep disturbances; irritability and tremors when temporarily stopped alcohol consumption. He presented a clinical abstinence syndrome, with pharmacological resistance to benzodiazepine perfusion: it was necessary to use dexmedetomidine an Alpha2-agonist with sedative and analgesic properties. After 12 days of medical treatment on UCI, he recovered from abstinence syndrome and was transferred to psychiatry ward. Blood analysis showed raised aspartate amino transferase and alanine amino transferase. Computed tomography and magnetic resonance imaging brain revealed bilateral lateral ventricle enlargement with narrowing of lower end of Aqueduct of Sylvius. He was treated with oral paliperidone. The dose was gradually increased to 18 mg/day and he responded quickly. In the follow-up, he was abstinent from alcohol, compliant with treatment and free from all kinds of hallucinations after medication adherence and psychotherapy.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Addictive behaviors among psychiatric outpatients
Authors: Ghanmi L. , Zitoun K. , Hachaichi I. , Hamrouni S. , Salem O. , Zouari L. , Maalej M.
Published: June 2017

Introduction

Little is known about the epidemiology of smoking and substance use disorders (SUD) among psychiatric outpatients in south of Tunisia.

Objective

Examine the prevalence of smoking and SUD among adult psychiatric outpatients at the regional hospital of Gabes.

Method

A survey was conducted to assess the extent of alcohol abuse, drug abuse and smoking among adult psychiatric outpatients (n = 115), with different psychiatric diagnoses (DSM−5), aged over 18 years, following the psychiatric department of the regional hospital of Gabes. Data collection was done through a semi-structured interview with the patient and a family member + review of medical records. SUD was defined as an abuse or dependence to alcohol or drug.

Results

Smokers account for 29.6% of the patients. Smoking was significantly higher in male patients (97.1% vs. 43.2%, P < 10−3). Compared to nonsmokers, smokers patients had significantly more the diagnosis of schizophrenia (64.7% vs. 35.3%, P = 0.004), a higher level of education (52.9% vs. 32.1%, P = 0.03), a higher rate of alcohol (14.7% vs. 1.2%, P = 0.008) and drug use disorders (8.8% vs. 0%, P = 0.02), and a higher rate of relapses (3.5 vs. 2, P = 0.004). Alcohol use was noted in 6% of patients and cannabis in 4%. Patients with a SUD had significantly more the diagnosis of schizophrenia (100% vs. 36.2%, P = 0.05), a higher rate of smoking (100% vs. 27.7%, P = 0.02). Financial situation, education, marital status and age of onset of the disease were not associated with SUD.

Conclusion

Addictive behaviors are prevalent among psychiatric outpatients. This has implications in treatment and management of these patients.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Role of Psychiatrists in Memory Clinics
Authors: Verhey F.
Published: June 2017

Memory clinics (MCs) are multidisciplinary teams involved with early diagnosis and treatment of people with dementia. In this presentation, we will discuss several trends of the role of psychiatrists over the last twenty years, on the basis of five questionnaires that were sent to MCs every 5 years in the Netherlands.

MCs have developed in Europe using a range of service models but providing similar functions, which include assessment, information, treatment monitoring, education, training and research. MCs may vary among each other, and across countries. Psychiatrists used to play a coordinating role in most MCs, but there is now a tendency that MCs are more frequently led by other specialists, notably neurologists. In 1998 in the Netherlands, only a small minority of the MCs had a structural cooperation with local service providers, but 10 years later, most of them were collaborating with other regional care organizations. In most cases, the collaborating partner was a community mental health team or a long-term care facility.

Disclosure of interest

The author has not supplied his declaration of competing interest.
Elevated neutrophil lymphocyte ratio in patients with substance use disorders
Authors: Ozkan N. , Sonmez M.B. , Tas Durmus P. , Gorgulu Y. , Kose Cınar R. , Vardar M.E.
Published: June 2017

Introduction

Disturbances in inflammatory processes may play a role in the pathophysiology of psychiatric disorders. The neutrophil lymphocyte ratio (NLR) and C-reactive protein (CRP) are indicators of the systemic inflammatory response.

Objectives

The current study was prepared based on the assumption that dysregulated immune function and elevated inflammation markers may be seen in substance use disorders.

Aims

Our aim was to investigate whether NLR and CRP are higher in patients diagnosed with substance use disorders than in healthy subjects.

Methods

The participants in the study included 115 male inpatients diagnosed with alcohol (n = 41), heroin (n = 46), or synthetic cannabinoid (n = 28) dependence according to the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV-TR), and 32 healthy male volunteers. We used NLR and CRP as measures of systemic inflammation. Blood samples were taken on the next morning of admission for detoxification. Addiction severity was assessed using the Addiction Profile Index (API).

Results

The difference between the groups with respect to NLR was statistically significant (P = 0.014). Patients diagnosed with alcohol, heroin or synthetic cannabinoid dependence had similar NLR. Patients with alcohol or synthetic cannabinoid dependence had significantly higher NLR than healthy controls (P = 0.001 and P = 0.029, respectively). Patients with heroin dependence trended towards statistically significantly higher NLR compared to healthy controls (P = 0.067). CRP levels did not differ significantly between the patient and control groups. NLR and CRP were not significantly correlated with API scores.

Conclusions

Our findings suggest that NLR is elevated in patients with substance use disorders in comparison to healthy controls.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
The prevalence of psychiatric comorbidities and relapses in males treated for alcohol dependence syndrome – Prospective study from tertiary de-addiction care unit in Kerala, India
Authors: Soman S. , Vr A.
Published: June 2017

Kerala has high percapita consumption of alcohol among the other Indian states.

Objectives

Prevalence of psychiatric comorbidities in alcohol dependence syndrome and association of severity of alcohol dependence, personality dimensions, motivation and short delay relapses.

Methods

A prospective study in 91 male alcoholic patients for 2 months.

Results

Two groups not relapsed (NR = 48) and Relapsed (R = 43) were comparable in age, SADQ severity score, average units of alcohol consumption and years of alcohol use. Average consumption was 17 units/day (500 mL spirits), age of onset before 25 years 87%, mean age 40 and severe alcohol dependence was in 57% of study population. Co-morbid nicotine use was 80.2% and in equal numbers in the relapsers and non-relapsers group.

Conclusions

Bipolar disorder was the most prevalent (19.8%) in the study population. About 53.8% had alcohol dependence as the primary diagnosis with no associated psychiatric comorbidities. Anxiety disorders (12%) and personality disorders (19.7%) were found more in the relapsers group. Anxiety symptoms seemed to be a risk factor for relapsing compared to other comorbidities in bivariate analysis (Pearson Chi2 5.998, P = 0.014). Psychoticism among relapsers were high (Pearson Chi2 4.901, P value 0.027, OR: 3.782, 95% CI: 1.103–12.958). Co-morbidities were not statistically significant in multivariate (Pearson Chi2 1.765, P = 0.184, OR: 1.755, 95% CI: 0.763–4.037). Severity of alcohol dependence in relapsers was not significant (Pearson Chi2 0.650, P = 0.722). Motivation levels of 62.8% of relapsers were low, 32.6% medium and only 4.7% reported high motivation (Pearson Chi2 11.846, P = 0.003). Poor motivation proved to be a risk factor for future relapse (P = 0.008, 95% CI: 1.266–4.648, SE.332).

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Central nervous system grey matter decreases in volume in smokers impacting cognitive abilities: A systematic review
Authors: Vnukova M. , Ptacek R. , Raboch J. , Stefano G.
Published: June 2017

Background

Even though cigarette smoking is a leading cause of preventable mortality, worldwide tobacco is consumed by approximately 22% of population. Smoking is also one of the risk factors for cardiovascular disease and it impacts our brain processing as well as being one of the recognised risk factors for Alzheimer's disease. The tobacco toxins may cause these disorders, e.g., nicotine at high levels, which are inhaled, resulting in preclinical brain changes. Researchers suggest that there are differences in brain volume between smokers and non-smokers. This review examines these differences on the brain grey matter volume (GMV).

Material/methods

In March/April 2015: MedLine, Embasse and PsycInfo were searched using terms: “grey matter”, “voxel based”, “smoking” and “cigarette”.

Results

Studies found brain GMV decreases in smokers compared to non-smokers. Furthermore, gender specific differences were found, while thalamus and cerebellum was affected in both genders decrease in olfactory gyrus was found only in male smokers. Age group differences were also found and these may suggest pre-existing abnormalities that lead to nicotine dependence in younger individuals. Only one study found positive correlation between number of pack-years and GMV.

Conclusion

Smoking decreases the volume of grey matter in most brain areas. This decrease may be responsible for the cognitive impairment and difficulties with emotional regulation in smokers compared with non-smokers.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Socio-demographic, clinical and therapeutic features of patients treated for schizoaffective disorder using cannabis
Authors: Walid B. , Marrag I. , Ellouze F. , Nasr M.
Published: June 2017

Introduction

Psychotic disorders were formerly associated with cannabis use. It could accelerate the course of the illness and thus, constitutes a severity factor in terms of prognosis.

Objectives

To define the socio-demographic, clinical and therapeutic profiles of patients suffering from schizoaffective disorder (ASD) and who are consuming cannabis.

Methods

A retrospective study of 16 patients diagnosed with ASD, who were hospitalized at the psychiatric department of Tahar Sfar Mahdia's hospital, and whose toxicology test results during the hospitalization came back positive for tetrahydrocannabinol.

Results

Sixteen patients were gathered, all male, the average age was 26 years. The average age of first hospitalization was 25 years, 41.9% were unemployed; 76.3% of our sample were single. Three quarters of patients were hospitalized without consent. The average hospital stay was 30.33 days. Our patients had required during their stay an average dosage of antipsychotic, equivalent to chlorpromazine, of 752.42 ± 342.79 mg. The average scores of psychometric scales were: BPRS = 55.72 ± 14.11, SAPS = 41.5 ± 14.80 and 42.11 ± 18.88.

Conclusion

Currently, it is recognized that prolonged use of cannabis is an exogenous risk factor. The association between cannabis and schizoaffective disorder may amend the treatment modalities. It requires, thereby, an integrated and simultaneous treatment of schizophrenia and addictive behavior.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Disorganization and Social Cognition: Data from the Italian Network of Research on Psychoses
Authors: Rocca P.
Published: June 2017

Social cognition (SC) refers broadly to the domains of cognitive functions that are employed in socially relevant situations. These disturbances have been found to be strongly related to disorganized and negative symptoms in schizophrenia. Each of the disorganization symptoms suggests a diminishment or absence of organization. There seems to be a loss of the ability to be directed toward or committed to a particular focal topic or goal. Such conditions are likely to impact patients’ drives or motivations to initiate goal-directed activities that could yield pleasurable opportunities. Moreover, it has been suggested that disorganized symptoms are an integral link in cognitive pathways, with connections between cognitive processes weakening as disorganized symptoms increase. Thus, it seems that when disorganized symptoms are present, people with schizophrenia are no longer able to effectively utilize the neurocognitive abilities necessary for performing social cognitive or metacognitive tasks. It is also in line with models of disorganization in schizophrenia (Bleuler, 1911) that a “loosening of associations”—similar to current conceptualizations of disorganized symptoms—is at the core of these cognitive disruptions. Previous research has linked disorganization to cognition (neurocognition and SC) and cognition to social functioning, although in separate studies. The present study was conducted to explore a model, where disorganization predicted social functioning both directly both through indirect effects on other determinants (neurocognition, SC and negative symptoms) in a large, and well-characterized sample of patients with schizophrenia recruited in the context of a multi-center study of the Italian Network for Research on Psychoses (NIRP).

Disclosure of interest

The author declares that he has no competing interest.
Characteristics of suicide attempters with a high lethality means
Authors: Lee C.T. , Lee S.Y. , Lee K.U. , Lee H.K. , Kweon Y.S.
Published: June 2017

Introduction

Suicide attempts with higher lethality increase the likelihood of suicide completion. Accumulating knowledge on risk factors contributing to higher suicide lethality may help clinicians to allocate their limited resources to more endangered people.

Objectives

To explore the factors associated with higher lethality in suicide attempts.

Methods

All suicide attempters, who visited the emergency department of Uijeongbu St. Mary's hospital from January 2014 to December 2015, were reviewed retrospectively. We compared between the high vs. the low lethality group, of which had been recorded based on clinical judgment using t-test or Chi2/Fisher's exact test with two-sided P-value of 0.05.

Results

Among the 753 suicide attempters, the assessed lethality was recorded in 736 cases. Low and highly lethal attempters were 426 (57.9%) and 310 (42.1%), respectively. For demographic variables, the high lethality attempters were significantly more likely to be older (48.3 vs. 44.78; P = 0.009), unemployed (61.0% vs. 56.5%; P = 0.042, without religion (90.9% vs. 84.9%; P = 0.017). For clinical variables, the high lethality attempters were significantly more likely have hopelessness (67.7% vs. 58.2%; P = 0.013) and a history of schizophrenia (4.5% vs. 1.4%; P = 0.023, while they did display any difference for mood disorders. The low lethality suicide attempts were more frequent in patients with comorbid personality disorders (9.2% vs. 4.9%; P = 0.031).

Conclusions

These results are in line with literatures reporting higher suicide risk in people, who are old, unemployed, not having a religion, psychotic and hopeless. These may have been moderated by committing a higher lethal means of suicide at least in part and warrants additional investigations.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Suicides in the Kyrgyz Republic: Discrepancies in different types of official statistics
Authors: Molchanova E. , Galako T.
Published: June 2017

In order to develop the “prevention of suicides” component of the state program on mental health protection of the Kyrgyz Republic population for 2017–2030 years, a suicide situation in the country over the past 10 years was investigated. During collecting, processing and statistical analysis of data from different sources, a significant discrepancy was revealed between them.

According to the national statistics committee (NSC), in 2015 the level of prevalence of suicide was 6.93% per 100,000 of population, whereas, according to the information from the republican medical information center it was 4.82%. Over the last 10 years in the Kyrgyz Republic, a level of suicidal behavior among children, teenagers and young adults has still been rather high and 22.63% of suicide attempts were committed by persons aged between 18 and 22 years. A significant difference was revealed in the indexes of suicides among these age categories provided by NSC and the ministry of Inner affairs.

Due to religious and national traditions, suicide is a very sensitive topic in Kyrgyzstan. In a lot of cases, death from suicide is not registered or is disguised as accidents and other causes of death, so the figures may be considered reliable.

Thus, despite the relative standardization of suicides accounting by the separate departments, the further work is needed for coordination and harmonization of the data collection, as well as for development and implementation of inter-agency action plan to prevent suicides at the national level, taking into account the regional, cultural and ethnic characteristics.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Temperament and character traits among suicidal patients during depressive episode of bipolar disorder
Authors: Petek Eric A. , Eric I. , Dodig-Curkovic K. , Kralik K. , Filakovic P.
Published: June 2017

Introduction

Both suicide and mood disorders represent current and future global burden on public health system. Bipolar disorder (BD), part of a diagnostic group of mood disorders, is characterized by manic, depressive and mixed episodes with life-expectancy much shorter than in general population. Patients with BD have 30 times higher suicide rate than the general population and 25–50% of these patients attempts suicide. About 15% of patients who attempted suicide eventually end their lives with completed suicide.

Aim

The aim of our research was to distinguish personality features among bipolar patients with current depressive episode (BD-D) who attempted suicide.

Materials and methods

The research was conducted among patients with depressive episode of BD (according to diagnostic criteria of ICD–10) who attempted suicide and had been admitted for hospital psychiatric treatment. For assessment of personality, we used the Temperament and Character Inventory (TCI, Cloninger R.) upon admittance. Our sample consisted of 31 (n = 31) patient who met the above mentioned criteria. All patients given their written informed consent. The statistical analysis was performed using SPSS 17.0.

Results

In our sample, we found, higher scores on harm-avoidance (HA), significantly higher scores on novelty seeking (NS) with significantly lower scores on persistence (P), self-directedness (SD) and cooperativeness (C) scales of the TCI. The Mann–Whitney-U test was used to compare samples.

Conclusion

In our sample, suicide attempts are associated with temperament and character dimensions. These results confirmed our initial hypotheses on existence of specific personality features among that group of suicidal patients with BD–D.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Implementation of the national register of suicide attempts as a preliminary strategy for the prevention of suicides in Poland
Authors: Gmitrowicz A. , Szmajda R. , Baran A. , Makowska I. , Kropiwnicki P.
Published: June 2017

Studies show that suicide attempts are a major independent predictor of suicide. Only in some countries of the world, there are national registers of these behaviors. Poland is among the countries where suicide prevention is at the stage of implementation of these strategies. One is the initial diagnosis of the prevalence of suicidal behavior (SB) in selected populations. The aim of the study was to assess the prevalence of SB in Poland on the basis of available databases, including data such as age, sex and mental disorders and the analysis of differentiation of selected indicators of SB.

Material and methods

We analyzed available registers of completed suicides (CS) and suicide attempts (SA), carried out under reporting of the central statistical office (CSO, in the general population, based on death certificates), Police Headquarters (PH, the number of reported SB in the country) and the Institute of Psychiatry and Neurology in Warsaw (IPiN, the number of SB in all psychiatric institutions) and the department of adolescent psychiatry in Łódź (SB among hospitalized youth).

Results and conclusions

Reported data on dissemination of SB in Poland are incomplete, which may affect the reliability of the assessment of the effectiveness of implemented strategies for the prevention of suicides. The aim should be to create a central register of SB, which will not only gather a well-defined data but also monitor how it is obtained.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
A case report highlights the neglect problem of pregnancy denial
Authors: Di Giacomo E. , Calabria M. , Colmegna F. , Pucci B. , Clerici M.
Published: June 2017

Pregnancy denial was observed in a patient after her second delivery. Contrary to the first pregnancy, she denied weight gain, body changes and baby movements. She reported using a contraceptive pill throughout the entire pregnancy. After a short home delivery without assistance, she was admitted to obstetrical department and referred for psychiatric evaluation. Mrs. T. accepted psychiatric follow-up appointments and was followed up for 6 months. She was initially assessed using the SCID II Interview, beck anxiety and depression interview, WHOQOL (WHO quality of life), and childhood trauma questionnaire. She denied pregnancy concealment and during the period of assessment and follow-up there was no evidence of intimate partner violence. Her female newborn was healthy without consequences of oestrogen/progesteron absorption (hypoplastic left heart syndrome, gastroschisis, hypospadias or congenital urinary trait anomalies) in one year follow up. The patient was discharged after 6 months of clinical outpatient follow-up. This case stresses and emphasizes the health and risk outcomes for both mother and child linked to an underestimated but serious phenomenon such as the denial of pregnancy.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Review of Risk Prediction Approaches for Bipolar Episodes in the Perinatal Period
Authors: Casanova Dias M. , Jones I. , Di Florio A. , Jones L. , Craddock N.
Published: June 2017

Introduction

The perinatal period is a high-risk period for the development of illness episodes in women with bipolar disorder. Relapse rates vary between 9 and 75% depending on the study. The overall risk of a severe episode is approximately 20%. The impact on women, the relationships with their babies and their families can be devastating. In the UK costs to society are £8.1 billion per year-cohort of births. The advice currently given to women is based of general risk rates. Women's needs of information for decision-making in the perinatal period are not being met.

Objectives

To review the risk prediction approaches used for women with bipolar disorder in the perinatal period.

Aims

To understand the existing risk prediction models and approaches used for prognosis of the risk of recurrence of bipolar disorder for women in the perinatal period.

Methods

Systematic literature search of public medical electronic databases and grey literature on risk prediction for bipolar episodes in the perinatal period.

Results

We will present the existing models and approaches used for risk prediction of illness episodes in the perinatal period.

Conclusions

Awareness of existing risk prediction models for recurrence of bipolar disorder in the perinatal period will allow better informed risk-benefit analysis of treatment and management options.

This person-centred approach will help women and clinicians in their decision-making at this crucial high-risk period.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Organizational Skills Training for Children with ADHD
Authors: Bikic A. , Sukhodolsky D. , Dalsgaard S.
Published: June 2017

Introduction

In addition to problems with inattention and hyperactivity, children with ADHD show poor organizational skills required for managing time and materials in academic projects. Poor organizational skills are associated with academic underachievement as well as psychosocial, occupational and economic difficulties. Behavioral approaches for ADHD are effective in reducing hyperactivity symptoms and behavioral problems, but the effects on academic functioning have been modest. An increasing emphasis on treatment of organizational skills has emerged in recent years, as difficulties with time management and organization of materials tend to persist and increase with age despite medication and behavioral treatments.

Objectives

The primary objective is to investigate whether organizational skills training has a positive effect on organizational skills. The secondary and exploratory objectives are to investigate the effect on ADHD symptoms, adaptive functioning, academic performance and cognitive functions with a 24 weeks follow up.

Aims

Our goal is to provide cost-effective group-based treatment for children with ADHD and their parents. This will be the first randomized and controlled trial of organizational skills in Denmark.

Methods

Participants are included in two sites in Southern Denmark and will be randomized to Organizational skills training or treatment as usual. Organizational skills training will be provided in a group format for children and parents over 10 weeks.

Perspectives Given the strong association between organizational skills and functional outcome, it is very important to address organizational skills in children and adolescents with ADHD as organizational skills deficits hinder the academic performance of even gifted students with ADHD and increase with age.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
The Duration of Undiagnosed Bipolar Disorder: Impact of Substance use Disorders co-morbidity
Authors: Ben Mustapha S. , Homri W. , Jouini L. , Labbane R.
Published: June 2017

Aims

Study the impact of substance use disorders (SUD) co-morbidity on the duration of undiagnosed bipolar disorder (DUBP).

Methods

Case-control study during a period of six months from July 2015 to December 2015. One hundred euthymic patients with BD (type I, II or unspecified) were recruited in the department of psychiatry C Razi Hospital, during their follow-up. Two groups were individualized by the presence or not of a SUD co-morbidity. In our study DUBP was defined as the period between the first symptoms and the beginning of treatment by a mood stabilizer.

Results

The beginning of addictive behaviour preceded the installation of bipolar disease in 32% of cases. Installation of bipolar disorder preceded the installation of addictive behaviour in 12% of cases. The beginning of addictive behaviour was concomitant with the installation of bipolar disease in 6% of cases. The average DUBP in the full sample was 4.80 years with a standard deviation of 8.04 and extremes ranging from 0.08 to 37.5.

The average DUBP in patients with SUD co-morbidity was 5.91 years with a standard deviation of 8.16 and extremes ranging from 0.08 to 35, and 3.68 years with a standard deviation of 7.84 and extremes ranging from 0.08 to 37.5 in patients without SUD co-morbidity.

Conclusions

According to studies over two thirds of patients with bipolar disorder received misdiagnoses before diagnosis of BD, and among the factors involved can report the presence of SUD co-morbidity. Hence, we should detect BD among patients with SUD.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Psychiatry's and Psychiatrists’ Contract with Society
Authors: Janse van Rensburg B.
Published: June 2017

Introduction

The World Psychiatric Association (WPA) is a world-wide association of national psychiatric associations, aiming to increase knowledge and skills necessary for work in the field of mental health and care of the mentally ill. It was suggested that Psychiatry's relationship with society should be seen as a contract [1]. This implicit understanding usually specifies the scope, principles, quality and outcome of this agreement. It also implies a series of reciprocal rights and duties, privileges and obligations, as well as expectations from both sides.

Aim

To investigate the extent of existing social contracting of WPA Member Associations (MAs) and WPA structures regarding:

– communities they serve;

– general public;

– medical institutions;

– other practitioner groups in the multidisciplinary team;

– administrations, managers and funders.

Objectives

Include to describe the current scope of psychiatric practice across WPA regions and the content of existing social contracts.

Methods

A mixed–methods, explorative, descriptive, theory generating inquiry, with different phases, including a systematic review of literature and WPA documentation, electronic questionnaires to MAs and focus group discussions with WPA ZS chairs/representatives.

Results

MA profiles and progress indicators were identified and summarised. A transcription of group discussions was made, while pertaining documents, questionnaires and in depth/focus group interview content was analysed.

Conclusions

This presentation will report on progress with this study to date.

Disclosure of interest

The author has not supplied his/her declaration of competing interest.
Targeting Kynurenine Pathway in Olfactory Bulbectomised Mice: Inflammatory and Neurodegerative Pathway of Depression
Authors: Bansal Y. , Kuhad A. , Singh R. , Saroj P.
Published: June 2017

Aims and objectives

The aim of study was to evaluate the pharmacotherapeutic efficacy of NDGA in experimental paradigm of depression i.e. olfactory bulbectomy (OB) specifically targeting kynurenine pathway.

Materials and method

Depression like behaviours was induced in OB mice and evaluated by assessment of various behavioural (olfactory deficit test, forced swim test, splash test, open field test, sucrose preference test), biochemical (catalase, reduced glutathione, SOD, nitrite, MAO-A, MDA, corticosterone), inflammatory cytokines (TNF- α, IL-1β, IL-6, IFN-γ) levels and alterations in delta sleep was recorded using EEG. Kynurenine pathway metabolites were determined in plasma and brain using HPLC method. After 14 days post-surgery, olfactory bulbectomized (OBX) mice were administered nordihydroguaiaretic acid (5 mg/kg, 10 mg/kg and 25 mg/kg) daily i.p.

Results

We have developed a new HPLC method for simultaneous estimation of monoamines and kynurenine pathway metabolites in plasma and brain samples of mice. Chronic treatment with nordihydroguaiaretic acid significantly restored all behavioural, biochemical and neurochemical alterations in OBX mice and increase in quinolinic acid and decrease in kynurenic acid point out the neurodegeneration hypothesis of depression.

Conclusion

Nordihydroguaiaretic acid showed potent neuropharmacotherapeutic effect in OBX mice by virtue of its strong anti-oxidant, anti-inflammatory, anti-stress and by restoring quinolinic acid levels.
A Person-centered Approach to Burnout-depression Overlap
Authors: Lichtenthäler A. , Bianchi R.
Published: June 2017

Introduction

Burnout has widely infiltrated the popular culture and has been extensively studied in both psychiatry and psychology. However, there are currently no consensual or binding diagnostic criteria for burnout. A major obstacle to the elevation of burnout to the status of nosological category is the overlap of burnout with depression.

Objectives

We examined whether burnout and depressive symptoms can be distinguished from each other using a person-centered approach.

Methods

A total of 1759 French schoolteachers took part in the present study (77% female; mean age: 41; mean length of employment: 15). Burnout symptoms were assessed with the Shirom-Melamed Burnout Measure (14 items) and depressive symptoms with a dedicated module of the Patient Health Questionnaire (9 items). Data were primarily processed using two-step cluster analysis. Correlation analysis and analysis of variance (ANOVA) were additionally carried out.

Results

Considered as continuous variables, burnout and depression were found to be closely intertwined (r = 0.81; disattenuated correlation: 0.91). Our cluster analysis revealed four different participant profiles, identifiable as “minimal burnout-depression” (n = 542; 31%), “low burnout-depression” (n = 566; 32%), “medium burnout-depression” (n = 412; 23%), and “high burnout-depression” (n = 239; 14%). Burnout and depression played equivalently important roles in cluster construction. Our ANOVA confirmed that the four clusters differed from each other in terms of burnout and depressive symptoms.

Conclusions

Our findings are consistent with the view that the burnout syndrome is depressive in nature. A diagnostic category dedicated to burnout may therefore not be needed.
Early Prediction of Non-response to Anti-depressive Treatment with an Easy-to-use Electrophysiological Index Dynamics
Authors: Yariv S. , Shahaf G. , Bloch B. , Reshef A. , Bloch Y.
Published: June 2017

Introduction

The evaluation of response to pharmacological treatment in MDD requires 6–8 weeks. Therefore, the ability to predict response, and especially lack of response to treatment, as early as possible after treatment onset or change, is of major significance. Many studies demonstrated significant results regarding the ability to use EEG and ERP markers. However, these markers are derived from long EEG/ERP samples, often from multiple channels, which render them impractical for frequent sampling.

Methods

We developed a new electrophysiological attention-related marker from a single channel (2 electrodes) and 1 minute samples. This work presents an initial evaluation of the ability to harness this marker, for early differentiation between responders and non-responders to anti-depressive treatment, in 26 patients with various levels of depression and heterogeneous treatment interventions and 10 healthy controls. Subjects who initiated treatment for depression were followed clinically through their Hamilton depression scores as well as their EEG activity twice a week for a period of 8 weeks. Any acceptable anti-depressive treatment been included. The improvement in Hamilton scores at the end of 8 weeks used to discriminate responders and non-responders.

Results

Within two weeks, we could differentiate between non-responders and responders to anti-depressive treatment, with absolute discrimination between subjects with moderate to severe depression, and with 0.71 sensitivity and 0.96 specificity within the whole depressed subjects.

Conclusions

This is a proof of concept for an easy to use, cheap and quick marker for the lack of respond to anti-depressive treatment within two weeks of anti-depressive treatment.