bluuebunny/crossref_metadata_2025 huggingface dataset:
Increased prevalence of toxoplasma gondii seropositivity in patients with treatment-resistant schizophrenia
Authors: Sagud M. , Vlatkovic S. , Svob Strac D. , Sviben M. , Zivkovic M. , Vilibic M. , Vuksan-Cusa B. , Mihaljevic-Peles A. , Pivac N.
Published: June 2017

Introduction

Previous studies suggested that patients with schizophrenia had an increased prevalence of antibodies against toxoplasma gondii (TG) and that those seropositive patients had higher symptom severity. However, there is no data on the relationship between treatment-resistant schizophrenia (TRS) and TG seroprevalence.

Objectives

To determine the association between TRS and TG seropositivity, and to further investigate the relationship between TG seropositivity and different clinical features of schizophrenia.

Methods

In this cross-sectional study, we included 210 male inpatients with schizophrenia. TG seropositivity was determined by ELFA assay. Treatment-resistance was defined as a failure of at least 2 adequate anti-psychotic trials. Data were analyzed using χ2 test or Mann–Whitney test.

Results

The rate of TG seropositivity in the entire sample was 52.3%, whereas 47.6% of patients met the definition for treatment-resistance. Seropositive patients had twice the rate of treatment–resistance compared to seronegative patients (63.6% vs. 30.0%, P < 0.0001). Moreover, in the seropositive group, the patients were older (47.6 ± 12.2 vs. 39.81 ± 12.01 years, P < 0.0001), had higher number of previous hospitalizations (13.9 ± 11.7 vs. 9.6 ± 8.5, P = 0.0073), and increased Calgary depression scale for schizophrenia (CDSS) total score (7.8 ± 4.5 vs. 6.3 ± 3.8, P = 0.012). There were no differences between the groups in the age of disease onset, smoking, positive and negative syndrome scale (PANSS) total, positive and negative scores, and the life-time history of suicide attempts.

Conclusions

Our results support the hypothesis that TG seropositivity might contribute to treatment-resistance in schizophrenia, at least in male patients.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
From polipharmacy to monotheraphy a case about schizoaffective disorder
Authors: Salonia S.F. , Asensio Pascual P.E. , Pérez Molina B. , García Herrero A.M. , Martinez Tomás M.D.C. , Martinez Martinez J. , Maroto Hernández Á.A. , Gea Jimenez A.M. , Sanchís Lledó F.J. , de Lugarnuevo M. Infante Sánchez
Published: June 2017

The aim of the present poster is to describe an initial complex case of schizoaffective disorder with other clinical adverse conditions (metabolic disorders) in a young adult male, which gradually went into a positive treatment way from polipharmacy to monoteraphy. His psychiatric history started when he was 25-year-old, he was diagnosed of heroine dependence, hypercholesterolemia and hypertrigliceridemia. In 2000 he had a suicide attempt in a context of depressive mood and delusions. He needed a psychiatric hospitalization for the first time in his life and he received anti-psychotics for the first time too. Drug abuse was detected in that hospitalization (cannabis and alcohol). In 2001 was diagnosed of paranoid schizophrenia. In 2007 the diagnosis was modified to schizoaffective disorder and also was detected high blood pressure, Diabetes Mellitus II and overweight. From 2007 to the present he passed from a scheme treatment composed by four or more psychotropic drugs to monotherapy (only one psychotropic drug, an anti-psychotic), he stayed clinically stable and all his metabolic parameters remained equal or improved.

Disclosure of interest

Janssen-Cilag research study.
Is there a “critical age” for first use of marijuana? Analysis of cannabis induced experiences by age at first use in a large internet-based sample
Authors: Sami M. , Bhattacharyya S.
Published: June 2017

Introduction

Increased psychotomimetic response to cannabis is demonstrated in psychosis-prone individuals. Early use of cannabis has poorer prognostic outcomes. However, as yet no cut-off age for early use has been established.

Aims and objectives

To determine, if age at first use affects later cannabis experiences and to determine if a “critical age” of first use exists for psychotomimetic cannabis experiences.

Methods

The cannabis experiences questionnaire (CEQ) (EUGEI version) was administered to a large internet-based non-clinical sample. Regression analysis was conducted of age at first use against CEQ scores controlling for gender, age frequency of use and duration of use. To determine cut-off age: independent ‘t’ tests (parametric) and Mann–Whitney-U tests (non-parametric) were used to determine significance of differences in CEQ scores at cut-off ages from 12-25.

Results

We obtained data for 1115 participants. Younger age at first use was significantly associated with increased psychotomimetic experiences (adjusted P < 0.001). All cannabis experiences were increased in in those commencing at younger age at every cut off age from 17 to 22 (P < 0.001) with maximal difference at 22. Psychotic experiences significantly varied from age of first use of 19 to 22 with maximal difference at cut-off ages 20, 21 and 22 (P < 0.001). Pleasurable experiences were significantly reduced in those commencing later at every cut-off age from age of use 17 to 22 (P < 0.001) with maximal difference between groups at age 20.

Conclusions

Later onset of use is associated with reduced cannabis experiences till the early 1920s. This may have public health implications.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Tracking referrals to early intervention in psychosis team: An audit
Authors: Sharma J.
Published: June 2017

Aims

To monitor if the early intervention services (EIS) in Sandwell meet the standard of assessing all patients referred to the team within the set target. To monitor factors that affects the outcome including the source of referral, whether the patients, are known to another team, and the demographic features of the patient.

Background

Providing timely, appropriate and coordinated care for patients presenting with a first episode of psychosis has been a focus for EIS teams to improve outcomes, experiences and in reducing costs. In April 2016, new target times of 5–10 days for referral-to-assessment and 14 days for referral-to-treatment were introduced by the government.

Method

All the referrals that were made since 01/04/2016 were followed up. A comparison was made with the referral-to-assessment and referral-to-treatment target for referrals made before the 01/04/16.

Results

There has been an increase in referrals. Preliminary evidence gathered suggests that there has been a marked improvement in the referral-to-assessment pathway and referral-to-management pathway. Patients referred to the EIS are offered an earlier assessment. Majority of the referrals made are however not appropriate to receive care from the EIS, and are not taken on by the team. All the patients that are accepted by the team are offered a NICE treatment package. Most of the referrals that come from other EIS teams or wards, are accepted by the team, at least for an extended assessment. Referrals from Children services are usually at the point when they are due to turn 18, for a second opinion.

Disclosure of interest

The author has not supplied his/her declaration of competing interest.
Parkinson's disease and psychosis: Report of a case
Authors: Barea M. Valverde , Osuna A. España , Moreno F. Cartas
Published: June 2017

Introduction

Jealous delusional ideation appears in 7-14% of cases of Parkinson's disease. Treatment with dopaminomimetics drugs is a significant risk factor for psychosis. However, the most likely etiology of psychosis in these patients is a loss of central cholinergic function associated with age since described psychosis even before the introduction of the L-Dopamine. Cognitive impairment and sleep disorders are predictors of development of psychosis.

Objective

Present a clinical case of psychosis in Parkinson's disease and its treatment.

Method

Reason for consultation. Patient diagnosed with Parkinson's disease with behavioral disorder and delusional.

Current illness

The patient after antiparkinsonian medication has increased suspicion, self-referentiality, delusional jealousy ideation to her husband, delusional interpretations regarding somatic symptoms, insomnia and behavioral disorders with aggression.

Family background

Mother with Alzheimer's.

Personal history

No contact with mental health.

Psychopathological examination

Conscious, repetitive language, dysphoric mood with delusions of prejudice and jealousy.

Mixed insomnia.

Diagnosis

Psychosis in Parkinson's disease.

Treatment

Quetiapine 300 mg/day. Carbidopa 25 mg/L-dopa 100 mg: 1-0-1. On subsequent visits quetiapine was suspended and replaced by clozapine 200 mg/day.

Results

The treatment of psychosis was effective with the use of quetiapine and subsequently clozapine with good tolerance and effectiveness. He also said lower antiparkinsonian medication.

Conclusions

Psychotic symptoms are the most common psychiatric clinic in Parkinson's disease. Often not enough antiparkinsonian dopaminomimetics reduced to control psychotic symptoms and use of antipsychotics is required. The use of antipsychotics in Parkinson's disease should be careful for the likely increase in motor clinical and increased mortality. The most useful, are especially quetiapine and clozapine atypical antipsychotics.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Serum testosterone level and its relation to aggressive behavior in schizophrenia
Authors: Zholob M. , Godinova S. , Zelman M.
Published: June 2017

This work is presenting partial preliminary outcomes of our study focused on evaluating the levels of testosterone in psychotic patients and its relationship to aggressive behavior.

Our study group included 10 male patients (from planned 20), with history of aggressive behavior at baseline and 24 male patients (from planned 40), without history of aggressive behavior. Non-aggressive patients were considered as control group. All included patients were hospitalized in psychiatric hospital Hronovce with diagnose of psychotic disorder. Levels of testosterone were measured by laboratory evaluation. Aggressive behavior was assessed by HCR scale, which was linked with every TSH evaluation. The level of testosterone was measured in all subjects at the baseline and in the group of aggressive patients was realized next measurement after 14 days of hospitalization.

According to our preliminary findings, the average level of TSH in our whole study group was 478.66 ng/dl (range from 158.06 to 767.81). The control group showed average value of TSH 486,84 ng/dl (range from 158.06 to 767.81). The group of patients with history of aggressive behavior showed average value of TSH 459.04 ng/dl (range from 191.81 to 638.02) and after 14 days of cure the levels were of average value 452.55 ng/dl (range from 253.53 to 657.92).

These preliminary findings don’t show significant intergroup differences, but there are some clear casuistic declines in TSH. After collecting the envisaged group of patients we plan to correlate values of testosterone level with the score of HCR, intergroup comparison and detailed analysis (including demography, pharmacology).

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Methylation of the HPA axis related genes in men with hypersexual disorder
Authors: Jokinen J.
Published: June 2017

Introduction

Hypersexual disorder (HD) defined as non-paraphilic sexual desire disorder with components of impulsivity, compulsivity and behavioral addiction, was proposed as a diagnosis in the DSM-5. Recent research shows some overlapping features between HD and substance use disorder including common neurotransmitter systems and dysregulated hypothalamic-pituitary-adrenal (HPA) axis function. We have reported that HD was significantly associated to DST non-suppression and higher plasma DST-ACTH levels indicating HPA axis dysregulation in male patients with HD.

In this cohort, comprising 54 male patients diagnosed with HD and 33 healthy male volunteers, we aimed to identify HPA-axis coupled CpG-sites, in which modifications of the epigenetic profile are associated with hypersexuality.

Methods

We performed multiple linear regression models of methylation M-values to a categorical variable of hypersexuality in 87 male subjects, adjusting for depression, DST non-suppression status, CTQ total score, and plasma levels of TNF-alpha and IL-6.

Results

Seventy-six individual CpG sites were tested, and four of these were nominally significant (P < 0.05), associated with the genes CRH, CRHR2 and NR3C1. Cg23409074–located 48 bp upstream of the TSS of the CRH gene–was significantly hypomethylated in hypersexual patients after corrections were made for multiple testing using the FDR-method. Methylation levels of cg23409074 were positively correlated with gene expression of the CRH gene in an independent cohort of 11 healthy male subjects. CRH is an important integrator of neuroendocrine stress responses in the brain, modulating behavior and the autonomic nervous system; our results show epigenetic changes in CRH gene related to hypersexual disorder in men.

Disclosure of interest

The author has not supplied his/her declaration of competing interest.
The under-diagnosed green-eyed monster: Otello syndrome and how to manage it
Authors: Latecki B.
Published: June 2017

Otello syndrome derives its name from Shakespeare's drama (character) and, clinically, describes a person with delusions of the partner's infidelity. A variety of other psychopathology may present: obsessive-compulsive features, alcohol dependency, voyeurism, sadism, possessiveness and domineering, hyper-sexuality, paranoid attitude, abuse of different nature, violent behaviour, including, occasionally, homicide. Yet, in the author's opinion, the syndrome, unless it presents itself as obviously absurd, is frequently missed.

Management is rather difficult and does not always result in recovery but, if not treated with neuroleptics, it would render any other means of treatment useless. The condition could pose a diagnostic challenge. Moreover, it also poses an ethical dilemma whether to warn the spouse of the psychotic condition of the partner, the poor prognosis and possible implications of its existence. Moreover, the long-term partners of such patients frequently present with the symptoms of dependency, submissiveness or even masochism.

The paper discusses the abovementioned issues, including the likely psychodynamics, biological background, historical and social elements and possible effective management.

Disclosure of interest

The author has not supplied his/her declaration of competing interest.
Sexual dysfunction in obese women
Authors: Sellami R. , Moalla M. , Affes L. , Feki I. , Mnif F. , Abid M. , Masmoudi J.
Published: June 2017

Introduction

The increasing prevalence of obesity represents a major public health problem, with can effect on physical and emotional well-being and psychosocial function. Somatic and psychological dysfunctions, such as infertility, osteoarthritis, social disabilities caused by stigmatization, sleeping problems or apnea, are also known to follow obesity. Sexual dysfunction (SD) may also be related to obesity, but is rarely mentioned, and may cause concern for the affected individual and partner, constituting a great problem.

Objectives

The aim of this study was to identify the frequency of SD among obese women.

Methods

Our study concerned 42 obese married women consulting in endocrinology department. Obesity was defined by body mass index (BMI) ≥30. All participants assessed a sociodemographic data and the “Female Sexual Function Index” (FSFI). FSFI is a 19-item multidimensional self-reporting measure that quantifies six domains of female sexual dysfunction (FSD), including desire, arousal, lubrication, orgasm, satisfaction, and pain. Score ≤26 indicate the presence of FSD.

Results

The mean age was 33.6 years (20 → 47 years). The mean total score of FSFI was 22.5 (3.2 → 32.6). The percentage of SD among obese women was 68.2%. FSFI score was correlated to ancient obesity (P = 0.026; r = 0.347) and waist circumference (P = 0.007; r = 0.412). High socio-economic level was correlated to desire and satisfaction (P = 0.021 and P = 0.048 respectively). Women with high educational level have better blurbification (P = 0.005). FSFI score was not correlated to BMI or obesity class.

Conclusion

Almost two-thirds of obese women have sexual dysfunctions. Women with ancient obesity and higher waist circumference seemed to have better sexual functions.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Evaluation of dynamics of neurocognitive indicators and pathological craving in patients with dependence on synthetic cannabinoids during use of microwave resonance therapy
Authors: Bokhan N. , Abolonin A.F. , Belokrylov I.I.
Published: June 2017

Background

There is no unequivocal estimation of influence of synthetic cannabinoids on health of the users, their influence on neurocognitive functions and their correction with use of microwave resonance therapy (MRT).

Objective

To evaluate dynamics of pathological craving and neurocognitive functions in patients with dependence on synthetic cannabinoids during use of MRT.

Materials and methods

Thirty-two patients (main group with dependence on synthetic cannabinoids with MRT) and 38 patients (control group with medication and without MRT) were examined. Craving was evaluated with “Drug Craving Scale”; efficiency with CGI. For evaluation of psychophysiological functions we used methods: “number square”, ‘balance-tranquility’, “verbal memory”, “linear visual estimation”, “exclusion of the word”.

Results and discussion

After therapy, stopping of symptoms of pathological craving was observed in the main group as 29.6% as more than in control group, improvement according to CGI as 37.1% as more than in control one. The evaluation of neurocognitive indicators was conducted. Attention: in the main group improved by 11 ± 1.3 points; in control one by 7 ± 3.1 points. Level of activation: in the main group decreased by 16 ± 2.9 points; in control one by 9 ± 3.5 points. Memory in the main group improved by 3 ± 0.21; in control one by 2 ± 0.3 points. Perception: in the main group improved by 1.5 ± 0.2; in control one by 0.8 ± 0.12 points. Thought: in the main group improved by 14.0 ± 1.6; in control one by 6.4 ± 1.1 points. Thus, it was shown that during use of MRT both perception and processing of information, improve in complicated conditions, reduction of pathological craving accelerates.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Exercise addiction: Links, risks and challenges faced
Authors: Lichtenstein M. , Hinze C.J. , Emborg B. , Thomsen F. , Hemmingsen S.D.
Published: June 2017

Introduction

Exercise addiction is a condition described by a craving for physical training resulting in excessive exercise behaviour and withdrawal symptoms. It has not been accepted as a mental disorder and further research is needed to examine the pathology of the condition.

Objectives

Exercise addiction is suggested to have links to other mental disorders and risks in terms of negative consequences such as injuries. Treatment for exercise addiction faces several challenges as the condition is associated with ambivalence, and studies based on controlled interventions are missing.

Aims

The aim of this study was to examine and interpret the existing research on links, risks and challenges faced in treatment interventions.

Methods

A literature review was conducted in the databases PubMed, PsycINFO and Scopus with the terms: “exercise addiction, excessive exercise” and/or “comorbidity, eating disorder, depression, anxiety, personality, pain, injury, illness, social isolation, stress, intervention, treatment”.

Results

Exercise addiction seems to be associated with eating disorder pathology, obsessive-compulsive behaviour and personality traits characterized by perfectionism, narcissism and neuroticism. Overload injuries (e.g. stress fractures) and impaired interpersonal relations are reported. In a treatment context, low compliance is described as a challenge. Thus, motivational interviewing is recommended, and also cognitive behavioural therapy is suggested for treatment. None of these interventions have yet been scientifically evaluated in addicted exercisers.

Conclusion

This review concludes that exercise addiction has links to psychopathology and increases the risk of injuries. More research is needed to estimate the level of psychosocial and physiological distress in these athletes. Controlled treatment interventions have to be conducted.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Prescription opioid abuse, addiction and psychopathology in a pain clinic
Authors: Lazcano A.I. López , Ortega L. , Fauli A. , Busquets C. , Lligoña A.
Published: June 2017

Introduction

There has been an escalation of therapeutic use and abuse of opioids. Aberrant drug related behaviors (ADRB) have prevalence between 2.8% and 62.2% in chronic pain patients treated with opioids and dependence is estimated around 3.27%.

Objectives

To estimate the prevalence of dependence, ADRB, risk of opioid abuse, and co-occurring disorders in patients with chronic pain in our environment.

Methods

A total of 115 (n = 115) patients attending our pain clinic were screened to evaluate the risk of opioid abuse and presence of dependence including a clinical interview, hamilton depression scale (HAD), opioid risk tool (ORT), diagnostic criteria for substance abuse and dependence (DSM IV-TR) and a checklist of ADRB.

Results

Among the patients, 78.26% were taking opioids, aberrant opioid related behaviors were detected in 20% and 8.9% met criteria for abuse or dependence; 11.3% had high risk and 20% moderate risk of opioid abuse (ORT). The most prevalent substance use disorders were sedative (11.3%) and alcohol (5.2%). There was a significant difference in means (t = -3.20 P < 0.005) in ORT scores between patients with current opiod dependence (x = 7.70 [s.d. = 3.07]) and without it (x = 2.88 [s.d = 3.58]); 30.4% had anxiety, 20% depression and 3.5% adjustment disorders; 57.5% and 48.3% had a score > 10 on anxiety and depression respectively on the HAD.

Conclusions

A systematic screening of risk of opioid abuse and of dependence as well as psychotherapy to treat comorbid psychopathology should be part of the treatment protocol.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Is methylone a new public health threat in Spain?
Authors: Monteagudo E. , de Dios M. , Trabsa A. , Grifell M. , Galindo L. , Quintana P. , Palma A. , Ventura M. , Sanagustín D. , Pérez S. , Torrens M.
Published: June 2017

Introduction

Due to the continuous search for new, legal, less expensive, and more powerful highs by drug users, the synthesis of novel cathinone derivatives has become a fruitful industry, leading to a fast emergence of new alternative substances every year. Methylone (3,4-methylenedioxy-N-methylcathinone) is one of the substances that rapidly emerged as the main ingredient of “bath salts”, becoming readily accessible on the Internet. This fact has raised concerns about its potential harmfulness.

Objectives

The aim of the present study is to analyze the presence of methylone in samples delivered to energy control from 2014 to 2015 in Spain.

Methods

A total of 8324 samples were assessed from June 2014 to May 2015. Only those samples acquired as methylone were studied. They were analyzed by energy control, a Spanish harm reduction NGO that offers the possibility of analyzing the substances that users report. Analysis was done by gas chromatography-mass spectrometry.

Results

Ten users reported to have acquired methylone (0.12%). The most used source for acquiring it was the Internet (60%). Other sources included a friend or relative (10%), home-delivered (10%) or undetermined (20%). There was no peak of consume as 50% were acquired in 2014 and 50% in 2015.

Discussion

According to the results, the presence of methylone in our samples is extremely low. Therefore, despite the fact that methylone monitorization is ought to be carried out, this substance is not expected to be an emerging issue concerning Public Health and no further clinical research should be done.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Identifying and Supporting Children of Mentally Ill Parents within Adult Mental Health Services
Authors: Reedtz C.
Published: June 2017

Background

Studies have shown that implementing a change of practice in adult mental health care to identify and support children of mentally ill parents is challenging, even though the risk of transgenerational transmission of socioemotional problems and psychopathology has been thoroughly demonstrated the last decade.

Aims

The current presentation describes the existing practice of identifying and supporting children of mentally ill parents within adult mental health services. The study was conducted after Norwegian health legislation had been changed to make these tasks mandatory. The effort included implementation of two interventions; Family Assessment, an intervention for practitioners to increase identification of patients who are also parents and their children, and child talks, an intervention designed to provide support for parents and children within the participating hospital.

Method

The sample included mental health professionals in a large university hospital in Northern Norway, who responded to a web-based survey on the routines of the services, attitudes within the workforce capacity, worker's knowledge on the impact of parental mental illness on children, knowledge on legislation concerning children of patients, and demographic variables. Register data from the Electronic Patient Journals (EPJ) was analyzed to assess whether or not the self-reported routines match the reality in the clinic.

Discussion

The prospects of clinical change will be discussed in general, as well as to which extent the two implemented interventions have contributed to changes in the clinical practice, workforce knowledge and attitudes in the participating hospital.

Disclosure of interest

The author has not supplied his declaration of competing interest.
Toward the Development of New Strategies to Assess the Needs of Children and Adolescents with Severely Mentally Ill Parents
Authors: Abel K.
Published: June 2017

Up to 10% of mothers and 5% of fathers in Europe have mental illness. Family, educational and social lives of children and adolescents with parental with mental illness (CAPRI) are disrupted by deprivation & repeated hospitalization. This is an urgent political & public health concern: The European Union's CAMHEE report recommends better information on CAPRI risks and resilience and to enable interventions to target the highest risk. This is important because although large numbers of children are in the riskset, most remain resilient. Research needs to support delivery of the CAMHEE initiative by understanding who is at risk and how we can target them early before their life trajectories are fatally disrupted.

To do this, we aim to create groundbreaking cross- national datasets providing robust data on CAPRI prevalence & life trajectories needed to plan future services.

But epidemiology alone cannot expose how risk creates effects at the individual level. We need to know which CAPRI to target with potentially expensive, time-consuming specialist services

Powerful neuroscience techniques such as functional near infrared spectroscopy are now available with which we can link epidemiological risk to elucidate effects of exposure within individual infant brain. This unique interdisciplinary approach yokes robust epidemiological evidence to cutting-edge optical imaging that can be undertaken in very young infants.

This allows us to target developments in clinical interventions for CAPRI to those in greatest need and potentially to those most vulnerable with the future aim to identify early biomarkers of abnormality for targeting intervention in CAPRI.

Disclosure of interest

The author declares that he has no competing interest.
Clinical diagnostic criteria of modern spice addiction
Authors: Sosin I. , Chuev Y. , Misko G. , Goncharova O.
Published: June 2017

Introduction

Populations of spice addicts in Ukraine demonstrate distinct tendency for steady spreading, and transitory psychotic episodes, overdosing and fatal cases are being registered in consequence of smoking. “Spice” are synthetic analogues of tetrahydrocannabinol.

Aims and objectives

To develop an average personified clinical portrait of spice addict for more specified therapy.

Method

Twelve patients who consumed spices systematically for 1–2 years were observed. Methods of examination: clinical psychopathological, psychological testing, clinical laboratory.

Results

Main spice addiction diagnostic criteria were: Spice smoking, obsessive and uncontrolled anosognosic desire and craving to test on themselves effects of their action, pathognomonic tolerance increase, specific post-intoxication consequences. After the first smoke inspiration heavy intoxication with euphoria and loss of surrounding real perception, sexual disinhibition and craving to repeat smoking manifested after the first smoke inspiration. Then, spice smoking became subjectively pleasant, caused condition of intoxication with increased mood, fussiness, was accompanied with feeling of hunger, thirst, and hoarse voice. In the patients rather quickly (for 2–3 weeks) twice reduced duration of intoxication state from 40 to 20 minutes, loss of situation and quantitative control over smoking was observed. Clinical specifics of addiction for spices smoking is rather quick (from 5 to 10 trials) formation of psychic equivalent of addiction, extremely intensive and emotionally saturated craving for smoking, quick rise of tolerance with loss of situational and quantitative control over smoking.

Conclusions

Definite rules in the development and formation of spice dependence is necessary to be considered while developing programs for therapy and prevention in clinical narcology.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
ASD, SUD and gender
Authors: Van Wijngaarden-Cremers P.J.M.
Published: June 2017

Introduction

Autism and substance use disorder (SUD) is not the co-morbidity that is commonly considered. Yet these conditions have more commonalities than one would suspect.

Objective

We will consider the evidence for co-morbidity between ASD and Addiction (Substance Use Disorders (SUD) and explore the influence of gender.

Method

A pilot study of 80 admissions to an adult ASD unit will be presented.

Results

The co-morbidity ASD and SUD in this study was very high (65% of the inpatients). There were no gender differences in prevalence in total but addiction to medication (32% in woman vs. none in man) and eating disorders (24% in women vs. 9% in man) was far more common in women whereas addiction to drugs (13% in man vs. none in women) was far more common in man.

Conclusions

There are clear indications that a possible co-morbidity of substance abuse disorder should be considered in cases of individuals with autism spectrum disorders. There are no gender differences in prevalence of co-morbidity ASD and SUD in total but addiction to medication and eating disorders seems to be much more common in women whereas addiction to drugs probably more common in man.

Disclosure of interest

The author has not supplied his/her declaration of competing interest.
Impact of nonideaton states on youth suicide attempts
Authors: Copelan R.
Published: June 2017

Background

Youth nonideation suicidality (NIS), distinct from impulsive deliberate-self harm (DSH), is a potential consequence of adjustment disorder (AD) or selective serotonin reuptake inhibitor (SSRI) adverse reaction. It is characterized by the absence of transient or enduring ideation. A new measure was constructed to evaluate the impact of NIS on attempt rates.

Methods

Youth 8 to 24-years-old were recruited in this case control study. Entry criteria included DSH (n = 50), AD (n = 91), and SSRI (n = 29) emergent events with overt or suspected NIS, worsening of existing or new onset suicidality, or abrupt mental status or behavioral change. Exclusion criteria included sensorimotor deficit or primary depressive disorder. Ratings from the new measure utilized dichotomous as well as outcome scores, and compared to ratings from other validated scales, after controlling for depression and other matched factors.

Results

High risk AD and SSRI groups presented with abrupt onset, high lethality attempt, intense motor restlessness, great intra-psychic distress, and irresistable suicidality. AD symptoms overlapped with SSRI presentations. Eighty-one percent of the AD sample reported no ideation; however, 96% made an attempt. For the SSRI group, 52% reported no ideation; however, 95% made an attempt. Sensitivity 80.3%, specificity 98.1%. Internal consistency 0.75 to 0.92. Test-retest scores 0.78 to 0.98, and neurodiagnostic correlations 0.70 to 0.98. Some scores correlated significantly with the “gold standard” Barnes Akathisia Rating Scale.

Conclusion

NIS is associated with alarmingly high rates of youth suicide attempt. The new neuropsychological measure demonstrates practical screening value in unobvious NIS proposed to represent a heretofore unrecognized neural mechanism.

Disclosure of interest

The author has not supplied his/her declaration of competing interest.
Resilience and attempted suicide in depressed patients
Authors: Gattoni E. , Gramaglia C. , Marangon D. , Feggi A. , Delicato C. , Di Marco S. , Venesia A. , Zeppegno P.
Published: June 2017

Introduction

Among the patients, 6.6% with past-year major depressive disorders attempt suicide in their life. Resilience (the ability to respond positively to adversity) and coping strategies (the ability to manage living stresses) may be protective factors against suicide ideation and behavior. A study conducted on 100 abstinent substance dependent patients suggested that suicide attempters had significantly lower resilience scale scores. Other authors demonstrated that intrinsic religiosity, resilience, quality of life were associated with previous suicide attempts in depressed patients.

Aim

To examine the correlation among resilience, coping strategies and sociodemographic and clinical characteristics in depressed patients.

Methods

From December 1st 2014 to December 31st 2015 we recruited inpatients and outpatients aged > 18 years with a diagnosis of depression (current or past). At baseline, patients were assessed with Montgomery Asberg Depression Rating Scale, Resilience Scale for Adult and Brief-COping with problems experienced; sociodemographic and clinical characteristics were gathered. Follow-up was conducted after 1 year in order to assess the possible presence of further depressive episodes and suicide attempts. Analysis was performed with SPSS.

Results and discussion

Data collection are still ongoing; results and implications will be discussed. We expect to find higher attempted suicide rates in patients with lower resilience and less coping strategies.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Suicide in depressed patients: Identifying a clinical risk profile
Authors: Sarzetto A. , Delmonte D. , Seghi F. , Brioschi S. , Locatelli C. , Barbini B. , Colombo C.
Published: June 2017

Introduction

Suicides that occur during psychiatric hospitalization are tragic events causing immense distress to relatives, peers, and physicians. Suicide risk is particularly high in patients with mood disorders.

Objectives

To identify a clinical risk profile which can be predictive of suicide in patients undergoing a major depressive episode, hospitalized and within three months after discharge.

Methods

We are going to include consecutively admitted depressed patients in San Raffaele Turro hospital (Milan), with a diagnosis of major depressive disorder or bipolar disorder, for a longitudinal prospective study. Demographical and clinical characteristics will be assessed. Barratt impulsiveness scale, aggression questionnaire, Hamilton psychiatric rating scale for depression, scale for suicide ideation, Columbia suicide severity rating scale will be administered to evaluate, respectively, traits of impulsiveness and aggression, severity of psychopathology and suicidal ideation. A follow-up program has been established to evaluate suicidal ideation one month and three months after discharge.

Results

Considering suicide rates in other psychiatric wards, we retrospectively analyzed in our mood disorder unit the inpatient suicide rate of the last 3 years. In this period, we admitted 1794 patients. The suicide rate has been cumulatively of 0.17% (4 patients): 0.16% in 2014, 0.16% in 2015, and 0.19% in 2016. In the same period, outpatient suicide rate has been of 0.39%; 57.14% of outpatient suicides happened within three months after discharge.

Conclusions

Hospitalization and discharge are critical circumstances for psychiatric patients. Evaluation of risk factors will contribute to explain our ward suicide rate and hopefully to reduce it in the future.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
The confrontation of those who remain: Qualitative reports of relatives about 3 cases of suicide in a small city in the Northeast Brazil
Authors: Sena R.M.C. , Izidoro J. , Silva D.A.R. , Turato E.R.
Published: June 2017

Introduction

Suicide is serious public health problem. In Brazil, suicides are more frequent in countryside and small cities.

Objective

To understand how informants have confronted emotionally the suicide at home by listening to viewpoints reported by such relatives of the deceased.

Method

Qualitative, exploratory design, conducted in a basic health unit area, in “Pau dos Ferros”, a city with 30,000 inhabitants, State of Rio Grande do Norte (RN), Brazil. Sample constructed by technique of “snowball”, in which the health team presented us the first family, whose member informed about the following; and this, the third one. Data collection through semi-directed interviews with open-ended questions in depth, and submitted to thematic analysis.

Results

Individuals from relatives who had family bond with the suicidal people were interviewed. From analysis of transcribed interviews, three categories emerged:

– “she has never demonstrated” – possible non-perception of potential suicidal behavior by the family;

– “I got crazy” – feelings of relatives facing a hard scene of suicide and determined cultural questionings;

– “we have no professional support in following days” – absence of psychosocial support and healthcare problems.

Conclusions

Possible mood oscillations from suicidal persons were masked by opposite emotional reactions of themselves, and/or oscillations were denied by the observers. Suicide scene seems to have provoked feelings of helplessness and guilt for relatives in not being able to avoid the dramatic act. Feelings of discomfort occurred facing curiosity from many persons who would raise uncomfortable assumptions about suicidal motivations. Family members complained about lack of more effective psychosocial care.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Why a multidisciplinary workforce needs a multidisciplinary education team: Our experiences of providing integrated training in a community and mental health service
Authors: Chester L. , Barry T. , Fernando M. , Bhat M.
Published: June 2017

Introduction

North East London NHS Foundation Trust (NELFT) provides an extensive range of integrated community and mental health services for people living in London serving a population of 1.5 million people. With an annual budget of £325 million NELFT is one of the largest community service providers in the United Kingdom (UK). NELFT is responsible for the education and training of the entire workforce and in August 2016, it employed a nurse fellow to work with the medical education fellows so it could focus on multidisciplinary team (MDT) teaching.

Objectives

(1) Providing MDT teaching by delivered by a MDT medical education team.

(2) Improving the training experience of all trainees, nurses and allied health professionals in NELFT.

(3) Improving physical health knowledge for mental health staff.

(4) Improving mental health knowledge of physical health staff.

Methods

Two psychiatrists and one nurse manager worked together on joint projects to deliver the MDT teaching. Teaching sessions where at least one psychiatrist and nurse manager delivered teaching on serious incidents affecting patient care, identification and management of sepsis in community settings and empathy training using an old age simulation suit.

Results

Multiple teaching sessions were delivered to MDTs within the Trust. Staffs were receptive to learning in MDTs rather than traditional splits according to professions. Due to the success of this teaching and the reputation of the medical education team, neighboring Trusts have expressed an interest in working in partnership with the team to further enhance teaching and learning in acute and community settings.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Women with hysterical manifestations: Menopause, gender and mental health
Authors: Bokhan N. , Lukiyanova E.V.
Published: June 2017

Introduction

Aging and menopause as a medico-social determinant of female gender influence on mental health. Female gender in the period of menopause is associated with the end of fertility that affects adaptation to changed conditions, decreases intellectual and physical possibilities, narrows role positions, leads to non-psychotic mental disorders (NPMD).

Objective

To identify influence of the age, menopause, female sex, sociodemographic parameters on hysterical symptoms in structure of NPMD.

Material

In the borderline states department, 93 female patients with hysterical manifestations in structure of NPMD were treated.

Methods

Psychopathological, clinical-dynamic, clinical-catamnestic, psychometric, psychological and statistical.

Results

In 100%, the hysterical symptoms in the puberty leveled at reproductive age, intensified in climax: 72.04% - pre-menopause (P < 0.05), meno-, postmenopause - 13.98% each. Sociodemographic characteristics (marital status, social status, place of living, education, family composition, family relations) were not interrelated with frequency of hysterical manifestations in the structure of NPMD (P > 0.05). There were more married (68.82%) than divorced (15.05%), widowed (10.75%), single (5.38%); more working (70.97%) than pensioners (22.58%), unemployed (6.45%); more living with husband (51.61%) than with husband and children (17.21%), living alone (15.05%), with adult children (16.13%); more townswomen (80.65%) than villagers (19.35%); education more often secondary (51.61%), high (45.16%) than elementary (3.23%); disharmonic family relations more often (70.97%) than harmonic (13.98%), indifferent (15.05%).

Conclusions

Age, menopause, female sex are reliably (P < 0.05) connected with intensification of hysterical symptoms in the structure of NPMD in difference from sociodemographic parameters not associated with frequency of hysterical manifestations.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Marital separation among some poor Bangladeshi women: Analysis of some cases
Authors: Hasan N.
Published: June 2017

Objective

This paper intends to show the challenges faced by poor Bangladeshi Muslim women from lower socioeconomic status, in case of divorce or separation in marriage. Participants will also learn how they earn for their living and how they raise their children if any. This paper will also present the obligations of marriage in Islam, which may reduce the hazards in their life.

Method

Some women were interviewed from lower socioeconomic status from slum area of Dhaka. Researcher took their consent before interview had started. They were asked about their age, educational status, duration of marriage, type of work they do for livelihood, whether they get any maintenance money from the husbands in case of separation, expenses for raising children if any, any criticize from the friends and relatives, etc. The answers were noted carefully.

Results

After critical analysis of the interview it was revealed that they were leading their lives on their own, most of them were not aware of their rights relating to marriage in Islam. Two of the women had to pay dowry. Some of them were addicted to tobacco leaf taken with betel nut and PAN, a special form of leaf.

Conclusions

In conclusion, it can be said that these women lead their lives with courage. They need to be educated about their marriage rights in Islam and legal help. At a time, men should be educated about the marriage rights of the wives and the evil effects of dowry in the society.

Disclosure of interest

The author has not supplied his/her declaration of competing interest.
Diagnosing and Treating Suicidal Adolescents
Authors: Balazs J.
Published: June 2017

Suicide is the second leading cause of death in Europe among 15–29 year olds. Adolescence is a sensitive period during development with several age specific factors, which can increase suicidal risk.

As it is in all cases, the first step of the diagnostic procedure of suicidal adolescents is creating an appropriate environment for the evaluation and rapport building.

More than 90% of suicidal adolescents has ongoing and usually untreated psychiatric disorder/s and about three-quarters of them has at least one subthreshold diagnosis. Potential common risk factors of adolescence suicide include both internalizing and externalizing disorders, such as major depressive episode, substance use and conduct disorder. The comorbidity of psychiatric disorders–both subthreshold and threshold - has been associated with increased risk for suicide. The careful assessment of subthreshold and full psychiatric disorders of suicidal adolescent is important in suicide prevention and the treatment of suicidal adolescents. The diagnostic procedure includes both clinical assessment and using validated (semi) structured diagnostic interviews. Rating scales can provide information on the severity of the patient's symptoms. Next to the assessment of the symptoms it is important to take the history and to get know about adolescents’ possible life events. Clinicians should carefully screen potential suicidal behavior itself, which includes both clinical assessment and validated interviews and tests.Complex treatment of suicidal adolescents can include, if it is necessary hospitalization due to the management of acute suicide risk and the appropriate treatment of subthreshold and threshold psychiatric disorders with the consideration of possible life events.

Disclosure of interest

This work was supported by OTKA K108336 grant.

Judit Balázs was supported by the János Bolyai Research Scholarship of the Hungarian Academy of Sciences.