bluuebunny/crossref_metadata_2025 huggingface dataset:
Identifying the relationship between marital adjustment and, sex roles and burnout rather than dependence features of the patient in wives of the patients with AUD
Authors: Kokurcan A. , Nazan K. , İlhan İ.Ö.
Published: June 2017

Objective

To identify the relationship between marital adjustment and, sex roles and burnout rather than dependence features of the patient in wives of the patients with AUD.

Method

The study sample consisted of 33 wives of AUD patients (according to DSM-IV-TR criteria) who were applied to a University Hospital Alcohol Dependence Clinic to leave alcohol use. Sociodemographic questionnaire, Marital Adjustment Scale (MAS), Maslach Burnout Inventory (MBI), Bem Sex Role Inventory-Short Form (BSRI) and, Beck Depression Inventory (BDI) were applied to the wives of ADD patients.

Results

Mean MAS score was under cut-off score (29.63 ± 10.33) and it shows that marital adjustment is lower in wives of ADD patients. It was shown that marriages longer than ten years, and higher emotional exhaustion scores were associated with lower marital adjustment in our study. Masculinity scores were higher in wives who perceived their income status higher. In contrast to previous studies, which examined marital adjustment, masculinity role was found to be associated with higher marital adjustment in our study.

Discussion

Emotional exhaustion and depression are common in spouses of the patients with ADD in our study. There may be a distortion in expected roles of the spouses which cause a disequilibrium on the family relationship. Lower income status, having increased number of children was associated with severe depression in wives which found to reduce marital adjustment scores. Finally, most of the wives of ADD patients will need psychotherapeutic treatments during addiction period. So incorporating spouses into treatment of ADD patients is a necessity to improve marital adjustment and burnout.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Absent substance use disorder and survival of extraordinarily high blood alcohol concentration
Authors: Gahr M. , Graf H. , Malejko K.
Published: June 2017

Introduction

Intoxications with alcohol are very frequent in clinical psychiatry and may lead to death depending on (maximum) blood alcohol concentration (BAC) and accompanying factors as liver function, tolerance, comedication, etc. Death may occur due to ethanol-induced respiratory depression and/or aspiration of gastric content (due to an impaired gag reflex); thus, securing of the airway and ventilation are occasionally necessary.

Objectives/aims

To illustrate the broad range of clinical outcomes of alcohol intoxications and their adequate therapy.

Methods

We present the case of a 58-year female patient with depression who demonstrated a very high BAC of 8.68 g/L (representing the highest survived BAC in literature) due to ingestion of large amounts of alcohol with suicidal intent.

Results

Intubation and ventilation were lifesaving and the patient did not develop any physical or mental consequential damage. As the patient had not regularly used alcohol or any other psychotropic agent tolerance could be ruled out.

Conclusions

This case emphasizes the necessity of rapid securing of the airway in patients with alcohol intoxication and respiratory depression and, furthermore, illustrates the large inter-individual differences regarding ethanol susceptibility.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Comparative examination of the differences between cannabis psychosis and methamphetamine psychosis in a psychological state
Authors: Oda A.
Published: June 2017

Background

With the rapid and intensive spread of marihuana abuse among youth, Japanese society is focusing on law enforcement against drug abusers. In 2016, a mass killing allegedly committed by a marihuana abuser was reported in Japan.

Objectives

To consider that common recognition of the diverse process and potential risks of cannabis psychosis should be shared among psychiatrists.

Aims

Elicit differences between cannabis psychosis and methamphetamine psychosis, and determine whether specific guidelines for treatment of cannabis psychosis are required.

Method

Intensive retrospective review of distinctive methamphetamine and cannabis psychosis through case studies in our hospital.

Result

Major symptoms of methamphetamine psychosis include auditory hallucination and paranoia, however recovery is achieved soon after undertaking treatment. In cannabis psychosis, distinctive features are megalomania and by a pseud-enlightenment experience of supernatural existence, abusers stick to an unrealistic self-estimate of omnipotent, which leads them to refuse the fading away of this feeling and repeat abuse.

Conclusion

Psychological substances have strong suggestibility so abusers’ symptoms are easily modified by their mental state. Involvement of syndicate or perception of illegality reflects abusers’ drastic symptoms, but after dehospitalisation, recurrences are relatively fewer. Cannabis, however, grows wild and is admitted legally in some countries, so abusers lack awareness of guilt by mistaken perception of omnipotence and unrealistic optimism. Due to addiction and depersonalization, they rather enjoy gaining contact with supernatural power and fall into social withdrawal and are implicated to social problems. Considering the difficulty of rehabilitating and returning abusers to the community, we should not disregard the risks of cannabis abuse.

Disclosure of interest

The author has not supplied his/her declaration of competing interest.
25c-nbome: Case report and literature review
Authors: Preve M. , Casigliani S. , Tognola L. , Traber R. , Colombo R.A.
Published: June 2017

Introduction

Novel psychoactive drugs (NPS) have rapidly increase in the last years in the drug market as a recreational use. A new group of toxic phenethylamine derivates named NBOMe of 2 C class present have emerged recently, are frequently bought using the internet and have similar effects to other hallucinogenic drugs; however, they may pose larger risks, due to the limited knowledge about them, their relatively low price and availability via the internet. The purpose of this report is to review the clinical evidence for the potential of abuse of NBOMe compounds. We propose a case report and literature review.

Method

We conducted a systematic review of the literature with the principal database (PubMed, Enbase, PsychInfo) and we present a case report.

Results

The effects of 25C-NBOMe is characterized by hallucination, violent agitation, rhabdomyolysis and kydney injury.

Discussion and conclusion

Effects from 25C-NBOMe in our case report were similar to previous individual case reports in literature. The clinical features were also similar to effects from other analogues in the class (25I-NBOMe, 25B-NBOMe). In our case, violent agitation (signs of serotonergic stimulation), rhabdomyolysis and kidney injury were observed. Further research is warranted to replicate our clinical and qualitative observations and, in general, quantitative studies in large samples followed up over time are needed. Methodological limitations, clinical implications and suggestions for future research directions are considered.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Paramethoxymethamphetamine (Mitsubishi turbo) abuse: Case report and literature review
Authors: Preve M. , Suardi N.E. , Godio M. , Traber R. , Colombo R.A.
Published: June 2017

Introduction

Paramethoxymethamphetamine and paramethoxyamphetamine (PMMA and PMA) are two so-called designer amphetamines, which appear from time to time on the illegal narcotics market in many countries. They are frequently sold as ecstasy or amphetamine, often mixed with amphetamine or methamphetamine [1, 2]. Paramethoxyamphetamine (PMA) is a hallucinogenic synthetic substituted amphetamine with capable of development of dependence [3]. The purpose of this report is to review the clinical evidence for the potential of abuse of paramethoxyamphetamine. We propouse a case report and literature review.

Method

We conducted a systematic review of the literature with the principal database (PubMed, Enbase, PsychInfo) and we present a case report.

Results

The effects of paramethoxyamphetamine is characterized at the beginning with symptoms like euphoria, derealizzation, psychomotor activation, feeling in tune with surroundings and in love for friends, who come to visual and auditory illusions and hallucinations, paranoid delusion, and violent agitation.

Discussion and conclusion

The use of these recreational drugs is especially common among young people participating in rave parties. Occasionally paramethoxymethamphetamine (PMMA) or paramethoxyamphetamine (PMA) are found in street drugs offered as ecstasy. Further research is warranted to replicate our clinical and qualitative observations and, in general, quantitative studies in large samples followed up over time are needed. Methodological limitations, clinical implications and suggestions for future research directions are considered.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Screening for alcohol use disorder, in mentally healthy military personnel
Authors: Rantis K. , Gougoulias K.
Published: June 2017

Introduction

AUD, with a prevalence of 7.5% in Europe, is a common disorder among general population. Reports show higher incidence in military personnel.

Purpose

To detect possible AUD in mentally healthy military personnel, and estimate the need for a more regular screening.

Methods

Using the AUDIT questionnaire, we assessed personnel (n = 248) visiting our outpatient department, from January to June 2016, diagnosed as having “no major psychopathology”, by gender, age, marital status, rank and education. The results were processed using the SPSS Mann–Whitney-U and Kruskal Wallis tests.

Results

We tested n = 215 men and n = 33 women, most aged over 35, married, n = 97 officers and n = 151 NCOs (non-commissioned officers), of medium or higher education; 59.7%, scored very low (0–2), n = 11 had a borderline score of 6–7, 6 scored > 8, with one scoring 16, all men and NCOs. Women had very low scores (72.7% P = 0.009). Older personnel concentrated on lower scores, while the younger (18–24) have higher odds of AUD (12.6% scored 6+). Married personnel scored lower (P < 0.001). No significant correlation between AUDIT scores and education (P = 0.705), however, lower education personnel seem to concentrate on very low scores (82.6%).

Conclusions

Female gender, age, marriage, and rank may have a positive effect on alcohol use. Lower educated personnel possibly drink less due to their more physical duties. The fact that 17 diagnosed as mentally healthy personnel had a score implying borderline to problematic alcohol use, could underline the need for a more regular screening for alcohol use disorder in the armed forces.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Suicide prevention program in the argentine federal penitentiary service
Authors: Jemar G.N. , Barros D. , Cisneros C. , Salech M. , Gizzi V.
Published: June 2017

Suicide configures failure in the mental health care of persons deprived of their liberty in terms of detection of risk factors, prevention, specific planning in terms of addressing thoughts of death or autolytic planning, trends, impulses and moods. The factors that unite in this catastrophe are multiple and depend not only on mental health care, but also on the circumstances that led to the deprivation of liberty, the family and the care of social continence and the intimate relationship of the person with its existence. Also, security personnel who take care of people in confinement contexts have a preponderant role in suicide preference. Structuring the personality distorted, immature or insufficient, circumstances that lead to vulnerability and threaten the preservation of life in the context of constant stress and loneliness. The transdisciplinary work experience provides us with constant review and dynamic concepts and practices to predict, diagnose and prevent risky behaviors prone to the symptoms of self-injury or self-harm of patients. In this sense, we propose interdisciplinary interviews of entry, registry for the detection of risk factors, specific treatment in patients at risk. The transdisciplinary confluence is a tool to be implemented to quantify the results and propose to reduce the incidence of suicide in people in a confinement context.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Suicides and road traffic deaths in Russia: A comparative analysis of trends
Authors: Razvodovsky Y.
Published: June 2017

Introduction

It has long been recognized that there are difficulties in obtaining valid mortality rates for suicides. The evidence indicated that suicides are sometimes misclassified and “hidden” as accidental. Suicide by motor vehicle crash is a recognized phenomenon, leading to under-reporting of the actual number of suicides and inaccuracies in the suicides mortality statistics. Road traffic accident mortality and the suicides rates in Russia are both among the highest in the world. This phenomenon has attracted much attention in recent years, but remains poorly understood.

Aims

The present study aims to test the hypothesis of the close aggregate level link between road traffic accident mortality and the suicides rates in Russia.

Methods

Trends in sex-specific road traffic accident mortality and the suicides rates from 1956 to 2015 were analyzed employing a distributed lags analysis in order to assess bivariate relationship between the two time series.

Results

The graphical evidence suggests that the trends in both road traffic accident mortality and the suicides for male and female seem to follow each other across the time series. The results of analysis indicate the presence of a statistically significant association between the two time series for male at lag zero. This association for female was also positive, but statistically non-significant.

Conclusions

This study indirectly supports the hypothesis that many of road traffic accident deaths in Russia are likely to have been suicides. Alternatively, common confounding variables, including binge drinking and psychosocial distress, may explain positive aggregate-level association between the two time series.

Disclosure of interest

The author has not supplied his/her declaration of competing interest.
Suicidal ideation expressed in online video diaries: New form of sharing intention to die
Authors: Sendler D.
Published: June 2017

Introduction

Suicide risk is increasing among all population groups, and no effective prevention method has been established due to high variability of risk factors.

Objectives

To (1) determine risk factors in people, who video-streamed unsuccessful suicide attempt, and (2) assess whether screening video blog websites is an effective suicide prevention.

Methods

Participants (n = 24, 14 M and 10F, age range = 19 to 53) with past history of suicidal attempts were recruited online to participate in encrypted video qualitative interview. Three scales assessed suicidal tendencies and Internet addiction: Columbia–suicide severity rating (C-SSRS), suicide assessment five-step evaluation and triage (SAFE-T), validated Internet addiction scale of own design. Reported data are mixed quantitative and qualitative measures.

Results

Participants were stratified into two age categories (students vs. working professionals), and all were determined to be addicted to Internet. Each group engaged in minimum 15 suicides ideation-related postings, prior to attempting suicide. Young participants typically posted impulsive, quick massages capturing distress caused by peers and family conflicts; seeking short-time recognition was evidenced by eliciting more “likes” and “comments” for each post. Working professionals posted less, but each video was lengthier and messages were emotional, usually ending in tearful summary of life events leading up to suicidal thoughts. While students expressed anger with “the system” as motivation to die, working professionals had financial problems and trouble forming long-lasting friendships.

Conclusion

People of all age groups increasingly document intention to die via blog video posts. These messages can be captured by prevention professionals who can reach out to troubled students and working adults.

Disclosure of interest

The author has not supplied his/her declaration of competing interest.
Designing an instrument to assess the competence of cognitive analytic therapists in training
Authors: Gimeno E. , Chiclana C.
Published: June 2017

Introduction

Since its origins, cognitive analytic therapy (CAT) has become a focused and more effective alternative that can be approached from the first line of action by mental health teams. However, since CAT incorporates in its intervention aspects of other currents, it is possible that its limits and specificity may have blurred. Furthermore, therapists in training use to report difficulties related to this. For that reason, assessing the competence of CAT therapists in training becomes so important, as it promote the reflection of the therapist in its training and provides professionals necessary skills to ensure a better quality care for their patients.

Aim and objectives

The aim of this study was to design an instrument to identify the main training problems in CAT therapists which allows therapist's competence evaluation.

Methods

For this purpose, a specific tool to detect the main problems in the implementation of the psychotherapy by self-report was administered and evaluated by two therapists in training during its clinical practice.

Results

The main implementation problems detected had to do with collusions and the temporary adjustment of the sessions. The therapists reported a high satisfaction with the instrument, which was valued as useful to be aware of the problems in CAT training and with clearly explained contents.

Conclusions

The tool has been shown to be useful to assess therapist's competence and to take awareness of collusions allowing the therapist to avoid them.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Differential Neural Correlates of Dimensions of Negative Symptoms in Schizophrenia During Social-emotional Appraisal and Effects of Treatment
Authors: Aleman A.
Published: June 2017

Factor analyses of large datasets have established two dimensions of negative symptoms: expressive deficits and a motivation. This distinction is of relevance as the dimensions differ in their cognitive and clinical correlates (e.g. with regard to functional outcome). Using functional MRI, we examined the neural correlates of the two negative symptom dimensions with brain activation during social-emotional evaluation. Patients with schizophrenia (n = 38) and healthy controls (n = 20) performed the Wall of Faces task during fMRI, which measures emotional ambiguity in a social context by presenting an array of faces with varying degrees of consistency in emotional expressions. More specifically, appraisal of facial expressions under uncertainty. We found severity of expressive deficits to be negatively correlated with activation in thalamic, prefrontal, precentral, parietal and temporal brain areas during emotional ambiguity (appraisal of facial expressions in an equivocal versus an unequivocal condition). No association was found for a motivation with these neural correlates, in contrast to a previous fMRI study in which we found a motivation to be associated with neural correlates of executive (planning) performance. We also evaluated the effects of medication and neurostimulation (rTMS treatment over the lateral prefrontal cortex) on activation during the social–emotional ambiguity task. The medication comparison concerned an RCT of aripiprazole versus risperidone. Compared to risperidone, aripiprazole showed differential involvement of frontotemporal and frontostriatal circuits in social-emotional ambiguity. We conclude that deconstruction of negative symptoms into more homogeneous components and investigating underlying neurocognitive mechanisms can potentially shed more light on their nature and may ultimately yield clues for targeted treatment.

Disclosure of interest

AA received speaker fees from Lundbeck.
Flow experiences improve mindfulness of educational emotions during interprofessional training. Meta-analysis of a pilot study
Authors: Lazzari C. , Masiello I.
Published: June 2017

Introduction

Csikszentmihalyi defines “flow experience” as the state of mind students experience when the average skills and challenges while learning are above their own average.

Objectives

Delle Fave, Massimi, & Bassi optimal experiences are used to assess students’ flow experience during interprofessional education (IPE).

Aims

To use the emotions comprising the Milan school eight-channel model [“afraid, concerned, bored, relaxed, in control, excited, happy (‘flow’), and glad”] to assess flow experiences of undergraduate health care students during interprofessional training.

Methods

Twenty-seven undergraduate health care students undergoing IPE training recoded their flow emotions during discussion of a clinical case in ward rounds, patient care in interprofessional teams, self-reflective practice at the end of each day of training and supervision of teachers. Statistical evaluation using meta-analysis with Tau squared (t2), Cochrane's Q and I2 provided the results (Table 1).

Results

As reported in Table 1, interactions with teachers (I2 = 60.98%), patient care (I2 = 58.87%) and discussion of clinical cases (I2 = 63.31%) reported higher variability, significant at P < 0.05. The most frequent emotions were “relaxed” (> 66%) and “in control” (> 66%) but not “flow” (> 20%).

Conclusions

Results show that challenges were below the skills possessed, which can slow down the learning process.

Table 1

Results for flow experiences in interprofessional education.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
The Patient is Suicidal: What Should I Do as a Clinician?
Authors: Carli V.
Published: June 2017

Suicidal behaviour is the most common psychiatric emergency. A large proportion of suicidal behaviour can be prevented, particularly in cases associated with mental disorders. Early recognition of suicidality and reliable evaluation of suicide risk are crucial for the clinical prevention of suicide. Evaluation of suicidal risk involves assessment of suicidal intent, previous suicide attempts, underlying psychiatric disorders, the patients’ personality, the social network, and suicide in the family or among acquaintances as well as other well-known risk factors. Suicide risk assessment should take place on several levels and relate to the patient, the family and social network but also to the availability of treatment, rehabilitation and prevention resources in the community. As suicide risk fluctuates within a short period of time, it is important to repeat the suicide risk assessment over time in an emphatic and not mechanistic way. The suicidal person may mislead both family members and hospital staff, giving a false sense of independence and of being able to manage without the help of others. Although extreme ambivalence to living or dying is often strongly expressed by the suicidal individual, it is not seldom missed by others. If observed in the diagnostic and treatment process, dialogue and reflection on such ambivalence can be used to motivate the patient for treatment and to prevent suicide. If ambivalence and suicidal communications go undiscovered, the treatment process and the life of the patient can be endangered. Today, several measurement tools of suicide risk exist, including psychometric and biological measurements. Some of these tools have been extensively studied and measures of their sensitivity and specificity have been estimated. This allows for the formulation of an approximate probability that a suicidal event might happen in the future. However, the low precision of the predictions make these tools insufficient from the clinical perspective and they contribute very little information that is not already gained in a standard clinical interview. Psychiatrists and other mental health professionals have always longed for reliable and precise tools to predict suicidal behavior, which could support their clinical practice, allow them to concentrate resources on patients that really need them, and backup their clinical judgement, in case of eventual legal problems. In order to be useful, however, the approximate probability that a suicidal event might happen in the future is not sufficient to significantly change clinical routines and practices. These should rely on the available evidence base and always consider the safety of the patient as paramount.

Disclosure of interest

The author declares that he has no competing interest.
Psychological and psychiatric consequences of violence against Women
Authors: Kachaeva M. , Shport S.
Published: June 2017

Introduction

Domestic violence against women has increasingly been recognized nationally and internationally as a serious problem. Violence against women is a troubling phenomenon in Russia. Meanwhile domestic abuse against women often results in long-term mental health problems.

Objectives

The main aim of the study was to find out the psychological and psychiatric consequences of violence against women and to determine the origins of crimes committed by abused females.

Materials and methods

A cohort of 18 females was examined by forensic psychiatrists. All women had committed crimes of violence (murders, attempted murders). Details of background, psychiatric and offending history were extracted. Each item was assessed with the help of descriptive statistics.

Results

A research has been carried out on the basis of psychiatric and forensic psychiatric assessment of two groups of women who had a long history of violence by their husbands or partners. Clinical assessment has revealed depression, anxiety, low self-esteem, post-traumatic stress disorder, drug abuse. All women underwent forensic psychiatric assessment as they had committed serious crimes of violence. The research has revealed two types of homicides. Women of the first subgroup displayed pathological altruistic motivation of their children. Women of the second subgroup had committed homicides of their husbands and partners whose violence towards women escalated in severity.

Conclusion

The research shows the necessity of domestic violence prevention by legal provisions and multidisciplinary research with participation of psychiatrists, psychologists, sociologists, human rights advocates and feminist societies.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Fear Crush: Effect of an Interventional Program for Elementary School Children with Performance Anxiety
Authors: Benevides J. , Barreto Carvalho C. , Salvador M.D.C. , Macedo A.F.
Published: June 2017

The prevalence of mental disorders in Portugal is 23%. Of these, anxiety disorders are most prevalent. Given these data, the development and implementation of remediate programs in general takes urgent character, especially in the younger population, where it is estimated that one in every five children suffer from some mental disorder. Given the lack of intervention programs in performance anxiety, we propose the development and implementation of a group program for elementary school children, targeting both the improvement and possible recovery of this condition as a means of reducing school failure in these children. In this program the following aspects will be addressed: the study and regulation of emotions; perceptions of self-efficacy; and therapeutic strategies based on third generation of cognitive behavior therapy–acceptance and commitment therapy. As a non-randomized controlled study, this project involves the development, implementation and validation of the intervention program. To this end, an assessment protocol will be administered to both control and experimental groups. This latter protocol will be administered at three different times: before and after implementation of the program and as a follow-up evaluation 6 months later. This program aims to promote emotional regulation in children with performance anxiety and, concurrently, to improve chances for their possible recovery as well as the reduction of significant school failure rates among Azorean children. The implementation of this therapeutic group intervention program with elementary school children may also prevent later interventions in other health and educational settings.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
From Telepsychiatry to eMental Health–Experiences and Prospects in Europe
Authors: Mucic D.
Published: June 2017

What started with telepsychiatry (videoconference) has been turned into e-Mental Health (eMH) due to rapid development of IT technology, decreased prices and increased user experiences. Access to mental health care is one of the identified problems within EU mental health services. Increased migration into and within EU cause the increased demands for clinicians with selected skills. Telepsychiatry is the oldest and most common eMH application. The first international telepsychiatry collaboration established between Sweden and Denmark back in 2006 was a success. This model might be used as collaboration prototype while speaking about current refugee crisis in Europe and treatment of mentally ill migrants. The experiences from this pioneer international transcultural telepsychiatry service in combination with various eMH applications may be used as an inspiration for conducting of larger international eMH service capable to provide mental health care toward diversity of patient populations underserved on their mother tongue within EU.

eMH applications could improve quality of care and access to mental health care in rural, remote and under-served as well as in metropolitan areas all around EU.

Disclosure of interest

The author declares that he has no competing interest.
E-Mental Health in Health Care Systems–a Global Perspective
Authors: Wise J.
Published: June 2017

eMental Health is the use of information technology (ICT) to support and improve mental health; it includes online resources, social media and smartphone applications, as well as videotelephony.

It used to be the new frontier, ungoverned but time has led to a maturity such that the novel is now commonplace and what was once Tomorrow's World is here today. From the experience of the networked Scandinavian countries, to the populations that novel techniques are reaching out to; QR codes in the UK, teens in Australia; from determining levels of Internet Addiction in Poland, to the use of that medium to treat anxiety disorders.

An innovation from Law Enforcement has massive implications for patients recording consultations. Other experiments with risk management led to the failure of ‘Radar’, but paved the way for social care providers to develop safer systems that can care for large populations with few therapists.

It is this use of Artificial Intelligence that may be the most challenging. Over 90 companies are developing the use of AI in diagnostics and related fields, with 14 US and Canadian hospitals involved with IBM's Watson. Will Drs become unnecessary? However the most innovative aspect of ICT in medicine is in research whether to greatly accelerate the process, or to ensure that educational tools genuinely answer patients’ questions.

eHealth is an expanding field, that holds new promise, and opens question about who we are, what is our role, who do we care for and how; that today, ‘No man is an Island’, everyone should be connected.

Disclosure of interest

The author declares that he has no competing interest.
Co-morbid Obsessive-compulsive Disorder and Bipolar Disorder in Highly Endogamous Population: Which Came First?
Authors: Bener A.
Published: June 2017

The aim of this study was to determine the prevalence of co-morbidity with obsessive-compulsive disorder (OCD) among bipolar disorder (BD) patients in order to assess the impact of OCD on the socio-demographic and clinical features of patients in a highly endogamous population. A cohort study was carried out on 396 patients enrolled between November 2011 to October 2013. We employed the WHO Composite International Diagnostic Interview (WHO-CIDI) and Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition-IV/Clinical Version for diagnoses, the Yale-Brown Obsessive Compulsive Scale Symptom Checklist for scoring OCD. Patients were grouped in BD patients with OCD (BD-OCD) and BD patients without OCD.

Groups were compared for socio-demographic and clinical variables. There were no significant differences for age, gender, BMI, and marital status, between BD patients with and without OCD. We found significant differences in level of education (P = 0.022), occupation status (P = 0.025), household income, (P = 0.049), cigarette smoking (P = 0.038), sheesha smoking (P = 0.007), and prevalence of consanguinity (P = 0.036) among these groups. Number of hospitalizations and Young Mania Rating Scale score were not different among BD patients with or without OCD whereas there were significant differences in Hamilton-Depression score, Clinical Global Impression-BD Score, duration of illnesses, and Global Assessment of Functioning (GAF). Also specific phobia, somatization, depression, mania, any mood disorder, oppositional defiant disorder, ADHD and personality disorder were more common in BD than OCD–BD group. This study confirms that BD-OCD is a common co-morbidity, largely under-recognized in clinical practice, which may significantly change BD presentation and outcome.

Disclosure of interest

The author has not supplied his/her declaration of competing interest.
Benzodiazepines Intake at Youth–Experience from Adolescent Consultation at Centro Hospitalar Lisboa Norte
Authors: Almeida C. , Paulino S. , Croca M. , Santos N.
Published: June 2017

Introduction

The increasing intake of psychotropic medication by children and adolescents is a reality that worries many mental health professionals. Recently, european school survey project on alcohol and other drugs showed that tranquillizers and sedatives were mainly consumed by Portuguese youth, without medical prescription, bringing this topic to medical and health stakeholders’ attention.

Objectives

Characterize benzodiazepine prescription in the youth population followed in a psychiatric consultation at centro hospitalar Lisboa Norte psychiatric department.

Aims

Discuss Portuguese trends in mental health among youths.

Methods

Analysis of 127 adolescents, seen for the first time from January to December of 2015, using Microsoft office excel.

Results

Our sample is comprised by adolescents from 12 to 20 years old, 81 female and 46 male. Only 16% of the adolescents were medicated with benzodiazepines, although low neuroleptic doses were often required, and 30% carried out psychotherapy. Sixty-five per cent of the diagnosis corresponds to anxiety, depressive and impulse control disorders.

Conclusion

Although trends in Portuguese youth mental health seem to be encouraging, as highlighted by local reports, European Union Joint Action on Mental Health and Well-Being recommends community and school active roles in primary and secondary prevention. Our experience shows that benzodiazepines’ use is rarely necessary and symptoms as anxiety, impulsivity and insomnia decreased with other strategies. Coping strategies must be discussed with the adolescents, in formal psychotherapy or in a supportive and containing therapeutic relationship, as well as discussed in family interventions. Community initiatives promotion and increased mental health care services accessibility should be priorities.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Developing Joint Approaches to Transition Strategy Between Child and Adolescent Psychiatrists and Adult Psychiatrists in the UK
Authors: Jacobs B.
Published: June 2017

Transition for young people from Child and Adolescent Mental Health Services (CAMHS) to Adult Mental Health Services often creates considerable disquiet for young people and their families in the United Kingdom. There are examples of good services. However, this is a longstanding problem. Professionals know what to do but solutions have been difficult to implement. There is no single solution because services differ across the country. The question becomes how to understand the difficulties of establishing good transition services. What needs to change to achieve this? This presentation will try to address some of these issues.

Disclosure of interest

The author declares that he has no competing interest.
Regulation Disorders of Sensory Processing–Understanding the Complexities of Child-parents Relationship
Authors: Baptista B. , Aguiar A. , Melo S. , Araujo M.
Published: June 2017

Introduction

Many authors have agreed on the clinical importance of sensory regulation for a child's cognitive, affective and social development. Sensory regulation abilities are fundamental for an efficient modulation of internal states and the development of appropriately graded responses to the constantly changing sensory experiences. Sensory modulation deficit is an essential feature of regulation disorders of sensory processing (RDSP), that is characterized by difficulties in regulating emotions, behaviors and motor abilities, in response to sensory stimulation and lead to impairment in functioning. We also know that, through daily interactions and early relationship (child's attachment), parents play a crucial role on child's regulation in terms of their emotional and physical availability and how they interpret and respond to child needs.

Objective

The authors will present a clinical case of a two-year child who has been diagnosed with RDSP, highlighting the main features, types (hypersensitive; hyposensitive/under-responsive; sensory-stimulation seeking/impulsive) and challenges of this disturb.

Aims

Explore the association between sensory regulation difficulties, RDSP and child attachment.

Methods

Systematic literature review.

Results

Recent studies showed the high prevalence of sensory regulation difficulties (33–76%) and insecure attachment (80%) in children with psychiatric disorders. Results also revealed that children with greater sensory impairment were significantly more likely to show elevated scores of insecurity (avoidance and dependence) to their caregiver.

Conclusions

This work underscores the caregiver's role as a facilitator of child integration and response to sensory stimuli and its importance on the development of behavioral and emotional disorders. This can help early diagnosis and better treatment who prevent future psychiatric conditions.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Efficacy of the “Cooperative Assessment” Diagnostic Procedure to Early Improve Acute Symptoms in a Sample of Adolescents with Anxiety and Mood Disorders
Authors: Biagiarelli M. , Curto M. , Andraos M.P. , Aprile V. , Pelaccia S. , Listanti G. , Trabucchi G. , Moscati F.M. , Pazzelli F. , Caccia F. , Pezzotti M. , Mazzei A. , Caltagirone S. , Girardi P. , Pompili M. , Ferracuti S. , Sarlatto C.
Published: June 2017

Introduction

Anxiety and mood disorders are common in adolescence and predict poor mental health outcomes and low quality of life in adulthood. Although early intervention seems to be critical, dropouts in the early stages of treatment are frequent and associated with low insight and severe symptoms. Therefore, a diagnostic assessment phase aimed to increase insight and early reduce symptoms appears to be essential in adolescents.

Objectives

The objective of this study is to demonstrate that the diagnostic method Cooperative Assessment is able to early reduce symptoms in adolescents with anxiety and mood disorders.

Methods

A sample of 88 patients, aged 14–19 years were included. All were recruited at the first visit and evaluated with the Cooperative Assessment. This manualized procedure was created from principles of collaborative and therapeutic assessment and aim to involve the patient in a co-developed diagnosis thorough the collaborative use of test results. Patients were evaluated before (T0), in the middle (T1) and after (T2) the assessment using CGI, GAF, HAM-A, HAM-D and MRS scales.

Results

Eighty-eight adolescents, 56.8% females, diagnosed with anxiety (47.7%) and mood disorders (52.3%) completed the protocol. HAM-A, HAM-D, MRS, CGI and GAF significantly improved at T1 and T2 with respect to T0 (T0: HAM-A 17.31 ± 8.22; HAM-D 16.97 ± 8.37; MRS5.78 ± 6.17; GAF 59.3 ± 11.06; CGI 3.63 ± 1.35; T2: HAM-A 11.41 ± 6.82; HAM-D 11.1 ± 6.91; MRS3.82 ± 3.87; GAF 67.5 ± 10.76; CGI 3.03 ± 1.26; P < 0.001; Wilcoxon signed-rank test for repeated measures).

Conclusions

Cooperative assessment is able to early improve symptoms in adolescents with mood and anxiety disorders.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Medication Effects on EEG Biomarkers in Attention-deficit/Hyperactivity Disorder
Authors: Cebi M. , İsiten N. , Metin B. , Sütçübaşı B. , Tarhan N.
Published: June 2017

EEG biomarkers have become increasingly used to aid in diagnosis of ADHD. Despite several studies suggesting that EEG theta/beta ratio may help discriminating ADHD from other disorders, the effect of medications on theta/beta ratio is not known. Forty-three children with ADHD that were evaluated with quantitative EEG before and after methylphenidate were included in the study. Theta/beta ratio, theta and beta powers for whole brain, central and frontal areas were calculated. Theta/beta power decreased significantly after treatment; however this change was largely due to an increase in beta power, rather than a fall in theta power. The results suggest that beta power is sensitive to medication effects, while theta power remains as a trait biomarker unaffected by medication status. The value of EEG biomarkers for monitoring neuropsychological performance and clinical status should be explored by future studies.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Psychosis in adolescence: A prognosis or a diagnosis? Integrated treatment with psychodynamic peer support
Authors: Ciampa L. , Gucci F.
Published: June 2017

Introduction

Our work comprises an integrated intervention strategy for the treatment of psychotic manifestations and functioning in adolescents which, following the theories of Laufer and Chan, questions the usefulness of the diagnosis ‘psychotic’ during adolescence. We apply an “open light treatment” (IPOLT), which includes psychodynamically oriented peer-support.

Objectives

To build a new form of therapeutic alliance with peer-support based on shared real life experiences enabling adolescents to reintegrate within their environment and re-establish cognitive functioning which has become disorganised, aiding a gradual return of the cohesion of ego and self and in some cases, cessation of psychotic symptoms.

Methodology

An observational study of one year on a group of ten adolescents aged 17 to 20 in institutional and private settings with psychotic manifestations and functioning. The group were tested at the start and end of the study using WAIS-IV and MMPI-A.

Results

The adolescents recruited showed a faster recovery of the cohesive processes of their fragmented ego as well as a quicker resumption of social relations. Our model provided an organising function and a flexible yet secure ‘container’ (Bion, 1988) for the young people's psychic structure. The tests showed a demonstrable improvement in their verbal comprehension, visual-spazial reasoning, fluid reasoning, working memory and processing speed.

Conclusions

Psychotic manifestations occurring in adolescence may decrease with an immediate integrated and rehabilitative intervention, without need of an institutional psychiatric setting. In conclusion, we find that “psychosis” in adolescence is a prognosis and not a diagnosis.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Improvement of Autism Symptoms After Comprehensive Intensive Early Interventions in a Clinical Setting
Authors: Haglund N. , Dahlgren S. , Råstam M. , Gustafsson P. , Källén K.
Published: June 2017

Introduction

The last two decades increase in early detection and diagnosing children with autism spectrum disorders (ASD) has challenged child and youth habilitation centers to offer the best and most appropriate treatment and support.

Objectives and aims

To evaluate an ongoing Comprehensive Intensive Early Intervention (CIEI) program for children with ASD based on principles of behaviour learning and developmental science, implemented in the child's natural setting.

Method

The change in autism symptoms among children participating in CIEI (intervention group, n = 67) was compared with children who received traditional habilitation services only (comparison group, n = 27). Symptom changes were measured as evaluation-ADOS-R-scores, total-, severity-, and module-adjusted-scores (ADOS-MAS), minus the corresponding baseline-scores, divided by the time between baseline and evaluation, and estimated using ANOVA adjusting for confounders. The ADOS-MAS were developed to allow improved communicative functions to be counted in the overall symptom improvement.

Results

Children in both study groups improved their autism symptoms as measured with the ADOS-MAS, and the improvement was statistically significantly larger among children without any developmental delay (P < .001). When adjustments were made for developmental delay, there was a statistically significant larger improvement of ADOS-MAS among children in the intervention group than in the comparison group (P = 0.047). Similar results were found for ADOS-R-total and ADOS-severity scores (P = 0.023 and P = 0.060. respectively).

Conclusion

The results of the current study indicate that the CIEI program significantly improve social and communicative skills among children with autism, and that children with developmental delay could benefit to a similar degree as other children.

Disclosure of interest

The authors have not supplied their declaration of competing interest.