bluuebunny/crossref_metadata_2025 huggingface dataset:
The effect of the reductions in social interactions due to the economic crisis on the subjective well-being of non-insurance health care seekers in Greece
Authors: Lyrakos G. , Grigoriadou M. , Zacharis T. , Grigoraki M. , Menti D. , Tsioumas N. , Georgiadis A. , Spyropoulos I. , Spinaris V.
Published: May 2016

Background

Social interactions have an important effect on the subjective well-being of individuals. However, in periods of financial crisis these interactions are reduced, affecting thus the mental health of the individuals as well.

Aim

To investigate the effect of the reduction in social interactions, as a result of the economic crisis, on the subjective well-being of non-insurance health care seekers in Greece.

Method

Two hundred and sixty-six individuals participated in this study, 90 (35.6%) males and 163 (64.4%) females, with a mean age of 47. Analysis of data was conducted with Anova, using the SPSS software.

Results

The findings showed that reductions in social interactions, caused by the financial crisis, led to significant reductions in the subjective well-being of individuals as well (F(1.259) = 13.276, P < 0.001 for social activities and F(1,258) = 14.531, P < 0.001 for peer socialization). More specifically, individuals whose social interactions were greatly affected by the financial crisis reported significantly lower subjective well-being than individuals who reported a medium effect (M = −2.952, SD = .764, P < 0.001). Furthermore, individuals who reported that the economic crisis had a great effect on their peer socialization reported significantly lower subjective well-being compared to both those who reported a medium (M = −1.868, SD = .658, P < 0.015) or low (M = −2.77, SD = .809, P < 0.001) effect of the crisis.

Conclusion

The results of this research showed that the financial crisis reduced the well-being of affected individuals through reductions in their social interactions. Further research is needed to investigate appropriate interventions to reduce the negative impact that the financial crisis has on the well-being of affected individuals.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Decreased interhemispheric functional coordination underlying the cognitive impairment in late-onset depression
Authors: Hou Z. , Jiang W. , Yue Y. , Yin Y. , Zhang Y. , Sui Y. , Yuan Y.
Published: May 2016

Background

The intuitive association between cognitive dysfunction in late onset depression (LOD) and the aberrant functional activity in the brain's default-mode network (DMN) has prompted interest in exploring the role of the DMN in LOD. The altered pattern of resting state voxel-mirrored homotopic connectivity (VMHC) in cognitive processes is not yet well understood in LOD.

Methods

The study was designed to examine the implicit coupling between the alteration of interhemispheric functional coordination and cognitive impairment in LOD. Thirty-one LOD patients and 37 matched healthy controls (HC) underwent neuropsychological tests and functional magnetic resonance imaging (fMRI) in this study.

Results

Compared to HC group, attenuated VMHC in superior frontal gyrus, superior temporal gyrus, posterior cerebellar lobe, postcentral and precentral gyrus was observed in LOD. Neuro-behavioral relevancy approach revealed that the imbalanced interhemispheric functional coordination in bilateral cerebellum was positively correlated with the performance of trail making test in LOD (r = 0.367, P = 0.040).

Conclusion

Altered linkage pattern of intrinsic homotopic connectivity and cognition was firstly investigated in LOD, and it would provide a novel clue to reveal the neural substrates underlying the cognitive dysfunction in LOD.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Gamma band dysfunction in patients with schizophrenia during a Sternberg Task: A wavelet analysis
Authors: Marasco D.D. , Di Lorenzo G. , Petito A. , Altamura M. , Francavilla G. , Inverso L. , Bellomo A.
Published: May 2016

Background

Increasing body of evidence suggest that patients with schizophrenia (SCZ) present dysfunction of the gamma band oscillations (GBO) during cognitive tasks. The current study aimed to explore the GBO activity in SCZ during a Sternberg task.

Materials and methods

Twenty-eight chronic stabilized SCZ and 18 healthy controls (HC), were recruited. Ongoing EEG was recorded during the execution of the Sternberg task. Continuous EEG data were band-pass filtered (1–100 Hz) and corrected for eye blink and muscle artefacts by ICA. For each subject, the event-related-spectral-perturbation (ERSP) and the inter-trial-coherence (ITC) were computed at the Pz channel only for those stimulus-locked segments containing correct responses. GBO wavelet analysis was performed with two different increasing cycle ranges (3 to 5.8 and 12 to 22.6; frequency range: 30–90 Hz), to obtain the best information about temporal and frequency dynamics. Student's t test (with multiple comparisons FDR correction) was used to compare the groups.

Results

During the manteinance phase (4000 to 4600 ms after the stimulus onset), SCZ presented a significant increase, respect to HC, in low GBO activity (range: 30-50 Hz;). In the other phases of the Sternberg task (encoding, probe presentation and response periods), no significant difference in GBO was observed between SCZ and HC.

Conclusions

These findings are in line with the evidence that GBO dysfunction in SCZ is present during selective phases of the working memory task. Future studies have to clarify the role of GBO dysfunction on the cognitive performance and the clinical utility of selective GBO modulation during cognitive rehabilitation.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
3-dimensional evaluation of lateral ventricle volumes of schizophrenia patients and investigation of the subgroups
Authors: Nazli I. Polat , Atlamaz M. , Ozalay O. , Deger F. , Kitis O. , Gonul A.S.
Published: May 2016

Introduction

The thought of greater loss of brain tissue in Deficit Syndrome (DS) i.e. subgroup of schizophrenia with enduring primary negative symptoms defined by Carpenter et al.; this has not been verified by recent studies.

Objective

Accumulated researches suggest that enlargement in Lateral Ventricles (LV) is related with current negative symptoms and poor prognosis. However, this has not been validated in DS.

Aims

Our aim is to study the association between the enduring negative symptoms and LV changes schizophrenia. We included both deficit and non-deficit patients for comparison with controls.

Methods

Forty-five patients (18 DS, 27 non-DS) and 37 healthy controls were recruited, evaluated for positive and negative symptoms, depression and extrapyramidal symptoms. Structural magnetic resonance imaging was performed. LV was assessed by MANCOVA (gender, age total brain volume as confounding factors) in 3-dimensional (3D) shape analyses. Correlations between clinical and imaging data were analyzed by Pearson correlation coefficient; P > 0.05 being significant.

Results

LV of patients was found to be greater than controls, especially in regions adjacent to parietal and temporal regions but no significant difference between subgroups was detected. Enlargement in right LV by corpus callosum adjacency was found in DS. There was no correlation between negative symptoms and LV volume.

Conclusions

The idea of greater amount of LV enlargement in patients with predominant negative symptoms could not be observed in 3D analyses. New pathophysiological theories are needed for the explanation of negative symptoms, loss of functioning and poor prognosis rather than only commenting about tissue decrease/loss.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Schizophrenia and dementia. Morphological and spectroscopic findings. Baseline data
Authors: San Román Uría A. , Monforte Porto J.Á. , Santirso Abuelbar L. , Chaviano Grajera J. , Martín Pérez M.Á. , Alcalá Dueñas J.A. , Cuéllar Leal V.A.
Published: May 2016

Introduction

Spectroscopy is a diagnostic method using MRI, to analysis tissue in vivo noninvasively. There are several studies with magnetic resonance spectroscopy (MRS) in patients with psychiatric disorders, especially schizophrenia and Alzheimer's type dementia, in their different developmental stage. Sometimes spectroscopy may allow brain metabolic changes to be observed before the onset of alterations in brain parenchyma. We do not know any documented case of spectroscopy performed on a psychiatry-targeted manner on our hospital. It is a noninvasive technique without added cost to the MRI and is available in our hospital. It seems interesting for us to combine two specialties like radiology and psychiatry in the field of a neuroimaging Project.

Objectives and aims

Our goal is try to establish a radiological anatomical correlate to brain molecular levels. It's a transverse and longitudinal prospective observational study in which subjects will be submitted to various psychiatric assessments by conducting a radiological examination that is the MRI and MRS to determine the regional metabolic pattern in the subjects explored.

Methods

Informed consent to all patients, aged more than 18 years, selected according inclusion/exclusion criteria that meet ethical principles. Patients are selected within the public health network of Sacyl Health Care System, Zamora Hospital, Spain.

Expected results and conclusions

Schizophrenia increased creatinine, choline and glutamate. NAA decrease in untreated patients and increased the same in patients with treatment Alzheimer: < increased NAA (N-acetyl aspartate) and increased MI (myo-inositol), their relationship has a high negative predictive value, ie if it is negative (the peaks are not increased) is discarded Alzheimer's disease. Early Dx/screening? Treatment?

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Psychiatric comorbidities in patients with brain tumors after radiotherapy – An intermediate report
Authors: Bran M. , Ladea M. , Stanculescu D. , Purnichi T.
Published: May 2016

Introduction

Primary or secondary CNS tumors are among the most difficult to manage forms of cancer. Treatment of these tumors remains a challenge in oncology and the success rates for treatment of brain tumors are much lower than in extracerebral localizations. Because most chemotherapeutic agents do not cross the blood-brain barrier effectively and surgery is sometimes only palliative, radiotherapy remains the main method of treatment of these lesions. Both localized and generalized brain radiotherapy have numerous psychiatric complications.

Objectives

The objective of the study was to assess the psychiatric comorbidities in patients with brain tumors receiving radiotherapy.

Aims

This is an intermediate report of a larger study that assesses comorbidities in patients with brain tumors after radiotherapy.

Methods

Twenty-five patients with different localization brain tumors were included in this observational study before receiving radiotherapy. All patients were assessed using Hospital Anxiety and Depression Scale (HADS) for anxiety and depressive symptoms, Montreal Cognitive Assessment (MOCA) for cognitive impairment and Quality of Life Enjoyment and Satisfaction Questionnaire–Short Form (Q-LES-Q-SF) at inclusion and after 3 months from finishing the radiotherapy sessions.

Results

Twenty-two patients completed the study. Nine patients received antidepressant treatment (sertraline, tianeptine) during the study for depressive symptoms or anxiety. Patients receiving antidepressants showed better scores on HADS, MOCA and Q-LES-Q-SF scales.

Conclusions

Antidepressant use in patients receiving radiotherapy for brain tumors could be neuroprotective and could improve quality of life.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
The fibromyalgia patients would present higher levels of magnification that controls pain: A pilot study
Authors: Cabas-Hoyos K. , Muñoz-Salgado J.L. , Cadavid-Perez I. , De Hoyos L. , Gonzalez-Gamero G. , Luna-Martinez L. , Perez-Solano I. , Quintero-Soto L. , Roman F.
Published: May 2016

Catastrophism is a variable of great importance in the study of pain. Catastrophism refers to a negative and exaggerated compared to the experience of pain, both real and anticipated mental perception (Sullivan, Bishop and Pivik, 1995; Sullivan et al., 2001). The current study to compare the levels of catastrophism in patients with and without fibromialgia. This study is cross-cutting and comparative. Twenty participants (M: 47.20; SD: 12.11) distributed as the following way:

– group 1: patients with fibromyalgia previously diagnosed through the American College of Rheumatology criteria (n = 10);

– group 2: Clinical depression, defined according to the DSM-5 (n = 5);

– group 3: healthy patients (n = 5) paired by age with the group of Fibromyalgia.

The PCS, a self-administered, was used to measure Catastrophism. Responses were summed to yield three different subscales: Rumination, Magnification and Helplessness. This instrument is validated in both experimental and clinical population (Van Damme, Crombez, Bijttebier, Gouber and Van Houdenhove, 2002; Edwards et al., 2006). A comparison among the three groups was established using one-way factor ANOVA. The results point out that patients with fibromyalgia have higher levels of magnification controls with depression and healthy group (P < 0.05). In contrast, although the average level of Catastrophism total presented a greater tendency in fibromyalgia patients no statistically significant differences were found. This is discussed in relation to the literature, a higher level of magnification to explain pain and maintaining the chronicity of the disease. It is important to consider the component catastrophism to have a multidimensional view of pain.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Exploring the factorial structure of the revised Fibromyalgia Impact Questionnaire (FIQR) in a Portuguese sample of fibromyalgia patients
Authors: Pinto A.M. , Costa C. , Pereira A.T. , Marques M. , Pereira da Silva J.A. , Macedo A.
Published: May 2016

Introduction

The Revised-Fibromyalgia Impact Questionnaire (FIQR), composed by 21 items, is one of the most used tools to measure the impact of fibromyalgia both in clinical and research settings. Although it has demonstrated good psychometric properties (Bennet et al., 2009; Costa et al., 2015), little is known about its factorial structure.

Objective/Aims

To explore FIQR's factorial structure and examine its association with several psychological constructs.

Methods

Hundred and three women with fibromyalgia (mean age 47.32 ± 10.63) filled in the Portuguese validated versions of the FIQR, Perceived Stress Scale, Perseverative Thinking Questionnaire, Beck Depression Inventory-II and Profile of Mood States. A principal components analysis with varimax rotation was carried out. The number of factors to extract was based on Cattel's scree plot and eigenvalues’ magnitude. The associations between FIQR dimensions and psychological constructs were examined via Pearson correlations and multiple linear regressions.

Results

Three factors were extracted [F1/Function = Items 1–9, α = 0.92; F2/Symptoms = Items 12, 16–21, α = 0.83; F3/Impact = Items 10, 11, 13–15, α = 0.83] explaining 58.57% of the variance. FIQR symptoms were the best and, nearly in all analyses, the only significant predictor.

Conclusions

The factorial structure of the Portuguese version of FIQR partially overlaps with the proposed theoretical domains (Bennet et al., 2009). Similarly to Luciano et al.’s study (2013), factorial analysis also evidenced the multidimensionality of some items. Fibromyalgia symptoms seem to play the most deleterious effect, being associated with poor mental health indicators. Future studies are needed to confirm the factorial structure found, due to sample size, items subjectivity and study's exploratory nature.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Family skills training in dialectical behaviour therapy: The experience of the significant others
Authors: Ekdahl S. , Idvall E. , Perseius K.I.
Published: May 2016

Introduction

Borderline personality disorder (BPD) is a severe psychiatric health problem with reputation of being difficult to deal with and to treat. Significant others (SOs) of patients with BPD show higher levels of psychological distress compared with the general population. Strengthening the coping strategies of SOs plays an important role in the recovery of the patient. Support and education for SOs is important, both for SOs themselves and for the patients recovery.

Objectives

Research around support and education for SOs is of great importance not only for SOs and patients, but also for psychiatric staff, in order to offer help and support, for the whole family.

Aim

The aim was to describe significant others’ experiences of dialectical behaviour therapy-family skills training (DBT-FST), their life situation before and after DBT-FST, and measurement of their levels of anxiety and depressive symptoms.

Methods

The study had a descriptive mixed method design. Data were collected with free text questionnaires (n = 44), group interviews (n = 53) and the HAD scale (n = 52) and analysed by qualitative content analysis and descriptive and inferential statistics.

Results

The results show that life before DBT-FST was a struggle. DBT-FST gave hope for the future and provided strategies, helpful in daily life. For the subgroup without symptoms of anxiety and depression before DBT-FST, anxiety increased significantly. For the subgroup with symptoms of anxiety and depression the symptoms decreased significantly. This indicates, despite increased anxiety for one group, that DBT-FST is a beneficial intervention and most beneficial for those with the highest anxiety and depressive symptoms.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Mutual influence between mood disorders and personality disorders
Authors: Khemakhem R. , Homri W. , Karoui D. , Mezghani M. , Mouelhi L. , Bram N. , Ben Romdhane I. , Labbane R.
Published: May 2016

Introduction

Several studies have explored the vulnerability to mood disorders that constitute some personality traits.

Aims

To study the potential relationship between mood disorders and personality disorders.

Objective

We hypothesized that personality disorders can be related to severe mood disorders.

Methods

This was a retrospective study including the period from January 2000 till September 2015 and related to patients in whom the diagnosis of mood disorder and personality one were retained according to the criteria of the DSM-IV TR while the sociodemographic and clinical were collected by a pre-established railing.

Results

We included 28 patients (15 ♂, 13 ♀). The average age was 38 years. Eighteen (64.3%) patients (7 ♂, 11 ♀) are unemployed. Fifteen patients (10 ♂, 5 ♀) were schooled until secondary level. Seventeen patients (60.7%) were married. The bipolar I disorder (BD I) was most frequently founded (50%), followed by the major depressive disorder in 25% (n = 7) then by the bipolar II disorder in 21.4% (n = 6). A case of dysthymia was also noted. Half of the personality disorders were the borderline type, followed by the histrionic type in 28.6% (n = 8) then by the antisocial in 17.9% (n = 5) and finally one patient presented a paranoiac personality. The antisocial personality was significantly associated with the BD I (P = 0.011) and half of the patients with a pathological personality, presented a depressive symptomatology.

Conclusion

The personality disruption is a factor of severity of the thymic disorders. Consequences on the management of patients and their response to treatments remain available.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Glucocorticoid-based therapeutic options for PTSD
Authors: Ouanes S.
Published: May 2016

Introduction

PTSD has been associated with HPA axis alterations, mainly consisting of reduced cortisol levels, elevated CRH and enhanced glucocorticoid receptor responsiveness. These findings led to the emergence of glucocorticoid-based therapeutic options for PTSD.

Objective

To outline the different glucocorticoid-based interventions for PTSD either for prophylactic or for curative treatment.

Methods

A systematic review was performed. The Medline database was searched using the following keywords: ‘PTSD’, ‘treatment’, ‘Glucocorticoids’, ‘hydrocortisone’.

Results

Glucocorticoid-based therapeutic for PTSD comprise preventive and curative interventions. Preventive interventions mainly consist of administering one single bolus of hydrocortisone shortly following the exposure to a traumatic event. Evidence comes from six published trials, all positive. Curative interventions include: prescribing hydrocortisone over short periods of time to treat PTSD symptoms, using Glucocorticoids to augment psychotherapy (in particular exposure therapy) for PTSD and using Mifepristone, a glucocorticoid receptor antagonist. Moreover, novel glucocorticoid receptor modulators are currently being developed and tested on animal models as a potential curative treatment for PTSD.

Conclusions

Use of hydrocortisone in preventing PTSD might be tempting, as is the use of hydrocortisone or Glucocorticoid receptors antagonists/modulators in treating PTSD. Yet, it should be emphasized that these interventions are not mainstream yet. They rather reflect a revolutionary new direction.

Disclosure of interest

The author has not supplied his/her declaration of competing interest.
Risk factors for post-traumatic stress disorder – an epidemiological study
Authors: Pejuskovic B. , Lecic-Tosevski D.
Published: May 2016

Introduction

Exposure to a traumatic event is necessary but not sufficient condition for development of posttraumatic stress disorder (PTSD). This is evident from the fact that many people who experience traumatic stressors do not develop this disorder. PTSD is a multicausal phenomenon and a final end point of the combination of a number of potential causes.

Objectives

To examine the different factors as potential risk factors for developing PTSD in general adult population.

Methods

The sample consisted of 640 subjects, randomly chosen in five regions of the country. The assessment has been carried out by MINI-5, Life Stressor Checklist-Revised, Brief Symptom Inventory, and Manchester Short Assessment of Quality of Life scale.

Results

Older age, low education and lower monthly income can predict current PTSD, as well as decreased quality of life, psychiatric comorbidity and higher personal distress.

Conclusions

The risk and resilience factors contribute to the development/protection of developing PTSD, which is important for prevention and treatment of this disorder.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Differences in attitudes towards mental illness and psychiatry among medical students, before and after the academic course of psychiatry
Authors: Pascucci M. , La Montagna M. , Stella E. , De Angelis A. , Parente P. , Di Nunzio V. , Ventriglio A. , Janiri L. , Pozzi G. , Bellomo A.
Published: May 2016

Background

Stigma towards mental illness and psychiatry have a major impact on psychiatric patients’ quality of life; in particular, prejudicial beliefs make it more difficult for future doctors to send patients to mental health services, leading to a delay of necessary care.

Aims

Our aim is to evaluate the stigma towards mental illness and psychiatry, in a sample of Italian medical students. We studied the differences between the first-year students who have not attended the academic course in psychiatry, compared to the senior students who have attended the psychiatric lectures.

Methods

We tested 113 medical students, using the following questionnaires:

– Attitudes Towards Psychiatry (ATP 30);

– Community Attitudes Towards Mental Ill (CAMI);

– Perceived Discrimination Devaluation Scale (PDD), to assess the discrimination towards mental illness perceived in society;

– Baron-Cohen's Empathy Quotient (EQ), to measure empathy.

Results

Among the 113 students, 46 have already attended the academic course of psychiatry and CAMI scores were less stigmatizing as total score (P = 0.014) and in authoritarianism subscale (P = 0.049), social restriction (P = 0.022) and ideology of mental health in the community (P = 0.017). However, there were no statistically significant differences in empathy, perceived discrimination in the society and stigmatization of psychiatry.

Conclusions

The 67 students who have not attended the academic course of psychiatry are more stigmatizing, considering psychiatric patients as inferior people that require coercive attitudes, socially dangerous and that should be treated faraway from the community. Studying psychiatry is therefore useful to reduce, in the future doctors, these prejudices toward mentally ill patients.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Immunomodulatory role of paliperidone in the poly(I:C) model of schizophrenia
Authors: MacDowell K. , Munarriz-Cuezva E. , Martín-Hernández D. , Sayd A. , García-Bueno B. , Meana J.
Published: May 2016

Introduction

Alterations on the innate inflammatory response may underlie the pathophysiology of psychiatric diseases, but the mechanisms implicated remain elusive. Current antipsychotics modulate pro/anti-inflammatory pathways, but the specific mechanisms involved remain elusive. One attractive possibility is the regulation of the intracellular signalling pathways of the innate immune receptors Toll-like 3 (TLR3), which triggers antiviral and inflammatory responses.

Aims

To elucidate the regulatory role of paliperidone on maternal immune activation (MIA) induced alterations on TLR3 pathway and on the two emerging endogenous antiinflammatory/antioxidant mechanisms NRF2/antioxidant enzymes pathway and the cytokine milieu regulating M1/M2 polarization in microglia.

Methods

Pregnant mice were treated with the synthetic Toll-like Receptor 3 (TLR3) agonist Poly(I:C) in gestational day 9 and chronically treated with paliperidone (0,05 mg/kg i.p.) in adult offspring. Animals were sacrificed one day after treatment and behavioral test. Inflammation oxidative stress-related mediators were analysed at mRNA and protein level in prefrontal cortex samples. In addition, behavioral test t-maze was conducted.

Results

Paliperidone prevented TLR3 pathway activation and the subsequent MIA-induced neuroinflammatory response. Also, paliperidone induced an increment in the activity and protein expression of nuclear NRF2, as well as increased mRNA levels of the antioxidant enzymes HO1, SOD and catalase in the MIA model. Otherwise, paliperidone increases the antiinflammatory cytokines levels TGFβ and IL-10 in favour of a M2 microglia profile and increased the levels of the M2 cellular markers ArgI and FOLR2.

Conclusions

The modulation of neuroinflammation and enhancement of endogenous antioxidant/anti-inflammatory pathways by current and new antipsychotics could represent an interesting therapeutic strategy for the future.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Hospital admissions and direct costs: A comparative study between paliperidone palmitate and oral antipsychotics
Authors: Soler Iborte A. , Galiano Rus S. , Ruíz Sánchez J.A.
Published: May 2016

Introduction

The total costs of schizophrenia increased to 2576 million Euros in 2013 in Spain, or 2.7% of the annual cost of health services. The hospitalizations, along with other intermediate resources, such as Day Hospital, etc., significantly contribute to the increase of economic burden. In Spain, the average hospital stay of schizophrenic patients is 18.24 days, totalling to an average cost of 6,753 Euros/patient (370.23 Euros/patient/day).

Material and methods

The sample selected included patients from both sexes, aged between 18 and 65 years old, with diagnostic criteria of schizophrenia (according to DSM-IV and ICD-10), admitted in the Mental Health Hospital Unit (MHHU), Úbeda between 2012 and 2013, with registered visits of at least 2 outpatient visits or 1 hospitalization related to the schizophrenia diagnosis (n = 48).

Results

After the start of treatment with the injectable antipsychotic drug of prolonged duration, the number of patients that required hospitalization for any psychiatric motive went from 24 patients (49.7%) to 11 patients (22.4%; P < 0.001). The patients who started treatment with PAP during hospitalization had an average stay of 15.7 days, as compared to 18.24 days of average hospital stay due to schizophrenia in Spain. The direct costs of hospitalization stays due to psychiatric reasons decreased from 162,071.88 Euros to 74,282.95 Euros (P < 0.001).

Conclusions

This observational study shows us that the treatment with PAP reduced the average length of the hospital stay, and resulted in a decreased percentage of re-admissions as compared to oral treatments for schizophrenia. These data led to savings of more than 50% of the direct costs of hospitalization.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Long-term electrical stimulation of bed nucleus of stria terminalis for obsessive-compulsive disorder
Authors: Raymaekers S. , Kristof V. , Bervoets C. , Gabriëls L. , Luyten L. , Demyttenaere K. , Nuttin B.
Published: May 2016

Introduction

We previously reported that deep brain stimulation (DBS) in the anterior limb of the internal capsule/bed nucleus of the stria terminalis (IC/BST) is effective in reducing symptoms in severe treatment-resistant obsessive-compulsive disorder patients.

Objective

To examine the long-term evolution of obsessive compulsive disorder (OCD) symptoms in 24 patients treated with chronic electrical stimulation in IC/BST.

Aims

We aimed to examine the evolution of the Yale-Brown Obsessive Compulsive Scale (Y-BOCS) and to determine if a number of predictors assessed before surgery are significantly related to this evolution.

Methods

We used a linear mixed model to investigate the evolution of the Y-BOCS in 24 patients. Data was collected in a naturalistic manner. Seven hundred measurements, taken during a total of 1836 follow-up months, are included in this analysis.

Results

Our analysis showed a long-term, sustained effect of electrical stimulation in the IC/BST. After a fast initial decline of OCD symptoms, these symptoms stay relatively stable. In addition, results show a strong ON/OFF effect of stimulation (e.g., due to battery depletion). Beside the ON/OFF effect of stimulation, the surgery itself has no additional effect on OCD symptoms. The Beck Depression Inventory (BDI) at baseline was the only predictor significantly related to the evolution of the Y-BOCS. A higher BDI at baseline seemed to be related to a smaller decrease of the Y-BOCS over time.

Conclusion

Electrical stimulation in the IC/BST has a fast and sustained effect on OCD symptoms.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Digging out insights and behavioral correlates of false and true femininity in borderline personality disorder patients attending four-step integrative model group psychotherapy
Authors: Abdelhameed M. , Mahfouz R. , Kamal A. , Taha M.
Published: May 2016

Introduction

The four-step integrative model of psychotherapy is concerned with individual's needs, wants, rights and decisions in that order. It may carry a promise for deep and changing vision for patients with borderline personality disorder (BPD).

Objectives

The study of the illuminating and changing effect of dealing with BPD patients in view of their needs, wants, rights and decisions.

Aims

To evaluate the effect of group work through the hierarchy of the four-step integrative model with BPD patients and to help them explore false and true elements of their femininity.

Methods

Forty-three female patients (age range: 19-37) diagnosed according to DSM-IV diagnostic criteria for BPD were enrolled in a dynamic psychotherapy group. Their progress was evaluated using Borderline evaluation of severity over time (BEST) and they wrote down detailed comments about their experience quarterly.

Results

Results of regular attendants for 2 years were included (35 = 81.4%). The results of BEST showed a significant reduction of BPD severity at the end of 1 and 2 years. During psychotherapy sessions and within their quarterly comments, patients expressed their change in terms of moving from a state of cunning, manipulation, aggression, arrogance, envy and rejection (as stemming from their false femininity) into wisdom, confrontation, patience, pride, healthy competition and containment respectively (as stemming from their true femininity).

Conclusions

Patients with BPD may gain a better insight and genuine change as they realize what is false and what is true about their femininity in the context of attending four-step integrative model group psychotherapy.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Properties of a coding system for traumatic memories
Authors: Fernández-Lansac V. , Soberón C. , Crespo M. , Gómez-Gutiérrez M.
Published: May 2016

Introduction

Narrative studies have focused on the language used by the individuals to describe stressful or traumatic experiences. Hence, linguistic procedures have been applied aiming to obtain information about autobiographical memories and trauma processing. However, there is a general lack of agreement about how to measure narrative aspects. Software programs for this purpose are limited, since they don’t capture the language context, and systems based on judge's rates are not free of subjective biases.

Objectives

This study presents a coding system developed to analyze several language categories related to traumatic memories and psychological processes. Structural aspects (e.g., coherence) and content dimensions of traumatic narratives (e.g., emotional or cognitive processes) are measured. Each narrative aspect is coded by raters using both dichotomous (presence/absence) and numerical values (Likert scale).

Aims

To propose a structured coding system for traumatic narratives that considers the language context and maximizes consensus among different raters.

Methods

Traumatic narratives from 50 traumatized women and stressful narratives from 50 non-traumatized women have been evaluated according the system developed. Three blind raters coded each narrative.

Results

Inter-rater reliability data are provided for the different narrative categories. The agreement between raters is discussed for both structural and content language domains.

Conclusions

The analysis of the inter-rater reliability allows exploring subjective biases in assessing different structural and content language dimensions. This study advances in the development of a procedure to analyze autobiographical narratives in a valid and reliable way, with a special focus on traumatic and other unpleasant memories.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
How do social cognition dimensions relate to DSM-5 dimensions of psychosis?
Authors: Arous A. , Mrizak J. , Trabelsi R. , Aissa A. , Ben Ammar H. , El Hechmi Z.
Published: May 2016

Introduction

Existing research shows that individuals with schizophrenia (SCZ) show substantial deficits in social cognitive domains, including facial emotion recognition (FER), empathy, and Theory of Mind (ToM). Their exact relationship with the different dimensions included in the “Clinician- Rated Dimensions of Psychosis Symptom Severity” of the 5th edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) remains unexplored.

Objectives

To investigate the relationship between different social cognition dimensions and the dimensions of psychosis included in the DSM-5.

Methods

Fifty-eight outpatients with stable SCZ completed the Intention-Inferencing Task (IIT), a non-verbal ToM task and the Questionnaire of Cognitive and Affective Empathy (QCAE). They also completed a newly developed and validated FER task constructed from photographs of the face of a famous Tunisian actress and evaluating the ability to correctly identify Ekman's six basic facial emotions. The clinician-rated dimensions of psychosis symptom severity was used to evaluate 8 dimensions of psychosis.

Results

The patients presenting higher cognitive empathy capacities had less present abnormal psychomotor behaviour scores (P = 0.05). Higher levels of affective empathy were correlated to lower present delusions score (P = 0.037). Better scores in the IIT were correlated to less present negative scores (P = 0.013) and less impaired cognition scores (P = 0.009). FER task score didn’t correlated with any clinical dimension.

Conclusions

Our results suggest the existence of specific relationships between social cognition dimensions and psychosis dimensions. Further studies are needed to confirm these relationships.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Evaluation of reproductive hormones relations with response to treatment in male patients with first episode psychosis
Authors: Ates A. , Oner I. , Basoglu C. , Algul A. , Tutuncu R. , Balibey H. , Ipcioglu O.
Published: May 2016

Objectives

Data regarding schizophrenia treatment has been increasing whereas the information about predictors of treatment response is limited. In this study, our aim is to investigate the serum levels of reproductive hormones as a biological predictor in terms.

Methods

Thirty-three hospitalized male patients in GATA Haydarpasa Training Hospital with the diagnosis of first episode psychosis were included into the study. The study was prospective and naturalistic in design. The clinical course was recorded by means of Positive and Negative Symptom Scale (PANSS) in pretreatment period, 2nd and 6th weeks of the study. Prolactin, FSH, LH, estrogen, testesterone and oxytocin serum levels were also measured at the same dates.

Results

Treatment response was assessed as unresponsive when PANSSttl scores were lower than 25%, partial response when PANSSttl scores were between 25%-40% changes, and response when PANSSttl scores were higher than 40%. Patients were grouped according to those cut-off points. There was a significant positive correlation between oxytocin, FSH serum levels and positive symptoms (ρ = 0.437, P = 0.011; r = 0.385, P = 0.027). There was also significant negative correlation between testesterone serum levels and negative and total psychopathology scores (r = −0.352, P = 0.044; r = −0.429, P = 0.013). It was seen that pretreatment testerone levels had a significant biological marker on predicting remission when the serum levels were lower than 460,91 ng/dL.

Conclusions

This study shows that hypothalamo-hypophysial-gonadal axis hormones and reproductive hormones, especially testesterone, may be an important biological marker of treatment response prediction in first episode psychosis.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Clinical experience with aripiprazole long-acting injection
Authors: Calvo Rivera M.P. , Girela Serrano B. , Porras Segovia A. , Gutiérrez Rojas L.
Published: May 2016

Introduction

Aripiprazole long-acting injection is the latest long-acting injectable (LAI) antipsychotic medication released in the market which requires a monthly injection.

Objectives

The aim of our study is to present our experience in the use of Aripiprazole long-acting injection as maintenance therapy in patients with schizophrenia and other psychotic disorders.

Methodology

Our sample consists of 20 patients who started treatment with long acting aripiprazole during the last 6 months of its release. Validated scales for collecting information on sociodemographic, clinical evaluation (CGI scale), quality of life (health questionnaire SF-36) and function (Sheehan Disability Inventory and social relationship scale SBS) were used.

Results

The health condition of the patients was generally good and 68% reported feeling better than during the last year. Social functioning was adequate (level 1 or 2) in about 70% of the patients. Social, employment and family's disability was mild in 57% of cases, the average stress’ perception was 23% and the average social support perception was 72%. Regarding the clinical evaluation, in comparison to the initiation of the treatment 18% of the patients were slightly better, 45% moderately better and 36% much better.

Conclusion

A remarkable clinical improvement was observed, maintaining good health, with an acceptable level of functionality. This study shows that the incorporation of long-acting Aripiprazole to the treatment of our sample has been a significant improvement in overall functioning of the patient.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Early schizophrenia patients treated with once-monthly paliperidone palmitate over a 12-month period - a retrospective observational study
Authors: Hargarter L. , Bergmans P. , Cherubin P. , Schreiner A.
Published: May 2016

Introduction

Little is known about patient characteristics and rehospitalization in newly diagnosed patients with schizophrenia treated with long-acting antipsychotics.

Objectives

To retrospectively explore hospitalizations, drug utilization and clinical outcomes from medical records of young, newly diagnosed schizophrenia patients during the first 12 months of treatment with once-monthly paliperidone palmitate (PP).

Methods

International, multicenter, retrospective, observational study. Outcomes presented are patient characteristics, reason for PP initiation and hospitalization data.

Results

Eighty-four patients were analyzed: mean age (years) at first psychotic episode was 23.8 (SD2.6), 23.9 (SD2.6) at first antipsychotic treatment and 24.1 (SD2.7, range 19-29) at PP initiation. Time between first antipsychotic treatment and PP initiation was 4.8 (SD: 3.4, range: 0-12) months. At PP initiation, 42.9% of patients were in hospital, primarily for the management of the first episode/relapse (97.2%). Reason for PP initiation was: LAT favored over oral treatment for relapse prevention (56%), partial/non adherence with previous oral medication (20.0%), convenience (15.5%) or limited access to health care systems (2.4%). Mean time (days) between admission and initiation of PP, and between initiation of PP and discharge from hospital was 28.8 (SD23.0) and 23.2 (SD24.5), respectively. 96.4% of patients were not hospitalized during the 12-month PP treatment period. 3/84 patients (3.6%) had a single hospitalization of 15.7 (SD: 8.1) days for management of episode/relapse.

Conclusions

In this young, newly diagnosed schizophrenia population, the number of hospitalizations following PP initiation was low. Main reason to initiate PP was clinicians favoring LAT over oral antipsychotic treatment for relapse prevention or due to partial/non adherence with previous oral treatment.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Reaction time, processing speed and sustained attention in patients with schizophrenia: Impact on functioning
Authors: Orozco A. , Vicens M. , Ruiz A. , Brañas A. , Lahera G.
Published: May 2016

Introduction

Some studies have related processing speed with functionality. A more discriminative analysis of different components of this neuropsychological construct is needed.

Objectives/Aims

To measure the performance of a group of patients with schizophrenia in reaction time, processing velocity and sustained attention. To compare the impact on functioning of these three measures.

Methods

Ninety-eight outpatients between 18 and 65 years diagnosed with schizophrenia, based on the DSM-V, with a 3-month period of clinical stability, were recruited. Sociodemografic and clinical data were collected: PANSS scale, Akathisia Simpson-Angus Brief Scale, State-Trait Anxiety Inventory (STAI) and Global Functioning Scale (GAF). The following variables were measured: reaction time (SUPERLAB PRO), processing speed (TMT-A, subtest of symbol coding BACS, verbal fluency) and sustained attention (Continuous Performance Test).

Results

Functionality of patients was correlated to Elective Reaction Time (the subject must react to different types of stimuli and to choose between several possible answers) [P = −0.205; P = 0.047], but NOT with Simple Reaction Time [P = 0.109; P = 0.293)]. Functionality was significantly correlated to Symbols Coding (P = 0.328; P = 0.001), and a trend was observed regarding semantic fluency (P = 0.190; P = 0.06) and the TMT-A (P = −0.179; P = 0.08). In CPT, Correct Detection was correlated with GAF score (P = 0.380; P = 0.000) but not omission errors. The model of lineal regression shows a differential impact of every measure in global functioning.

Conclusions

Reaction time, processing speed and sustained attention are different variables and each of them have impact on functioning in schizophrenia.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Comparative study of the side-effect profile between clozapine and non-clozapine patients
Authors: Ramos Perdigues S. , Mane Santacana A. , Salgado Serrano P. , Jove Badia E. , Valiente Torrelles X. , Ortiz Sanz L. , Dinamarca F. , Fortuny Olive J.R. , Perez Sola V.
Published: May 2016

Introduction

For resistant schizophrenia, the only approved treatment is clozapine. However, clozapine is underused, mainly due to its wide range of side-effects. Secondary effects differ amongst antipsychotics (Leucht et al., 2009). Despite that there is no good evidence that combined antipsychotics offer any advantage over the use of a single antipsychotic, combination increases the frequency of adverse events (Maudsley guidelines).

Objectives

To compare the side-effect profile between clozapine and non-clozapinepatients.

Aims

To provide evidence that clozapine patients do not show a worse side-effects profile.

Methods

We cross-sectionally analysed all patients from a Spanish long-term mental care facility (n = 139). Schizophrenic/schizoaffective patients were selected (n = 118) and their treatment was assessed, 31 patients used clozapine. We paired clozapine and non-clozapine patients by sex and age and assessed antipsychotic side effects and possible confounder variables.

Results

Our sample was 27 clozapine patients and 29 non-clozapine patients. 67,9% were male with a mean age of 51.3 (SD 9.6) years. For continuous variables: age, BMI, waist/hip, cholesterol, TG, glucose, prolactin, heart-rate, blood pressure, sleeping hours, the only statistical differences found were lower heart-rate (P = 0.001) in clozapine group and higher salivation subscale of SAS (P = 0.002) in clozapine group. For discrete variables: monotherapy, obesity, overweight, metabolic syndrome or possible confounders as propranolol, laxative, diet, antiglycemiant or insulin, fibrates or statins, antihypertensive or anticholinergic, no statistical differences were found.

Conclusions

We did not find differences in cardiometabolic parameters, which are the main barrier to prescribing clozapine, probably due to the concomitant use of other drugs in both groups.

Disclosure of interest

The authors have not supplied their declaration of competing interest.