bluuebunny/crossref_metadata_2025 huggingface dataset:
Attitudes toward psychiatry and psychiatric patients in medical students: Can real-world experiences reduce stigma?
Authors: Pascucci M. , Stella E. , La Montagna M. , De Angelis A. , Parente P. , Di Nunzio V. , Ventriglio A. , Bellomo A. , Janiri L. , Pozzi G.
Published: May 2016

Introduction

Stigma towards psychiatry and mental illness significantly worsens the quality of life of psychiatric patients. Negative prejudices in medical students make it difficult for future doctors to send patients to mental health services and promote an increased risk of premature death.

Aims

Our aim is to assess stigma towards mental illness and psychiatry in medical students, and to study the influence of real-world experiences, such as having visited a psychiatric ward, having personally met a psychiatric patient or having friends and/or family members who suffer from a mental illness.

Methods

One hundred and thirteen Italian medical students completed the following tests:

– Attitudes Towards Psychiatry (ATP-30);

– Community Attitudes Towards Mental Ill (CAMI);

– Perceived Discrimination Devaluation Scale (PDD);

– Baron-Cohen's Empathy Quotient (EQ).

Results

Having visited a psychiatric ward correlates with a better attitude towards psychiatry (P = 0.008), rather than towards the mentally ill. Having personally known someone with mental disorders correlates with less stigmatizing scores in CAMI: total score (P = 0.002), authoritarianism (P < 0.001), benevolence (P = 0.047) and social restriction (P = 0.001). Similar results emerged in those who have close relationships with a psychiatric patient. There is no statistical significance as to empathy.

Conclusions

The students who have visited a psychiatric ward have a less stigmatizing vision of psychiatry, while having personally known psychiatric patients favors a less stigmatizing attitude towards them. Those who have not had this experience, have a more hostile and intolerant vision of mental illness, and consider psychiatric patients as inferior subjects that require coercive attitudes and that would be better to avoid because socially dangerous.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Oxidative DNA damage is associated with antidepressant use, not depression or anxiety disorders
Authors: Black C. , Bot M. , Scheffer P. , Penninx B.
Published: May 2016

Introduction

Oxidative stress has been implicated in the pathophysiology of depression and anxiety disorders and may be influenced by antidepressant use.

Objectives

This study investigated the association of oxidative stress, measured by plasma levels of F2-isoprostanes and 8-hydroxy-2′-deoxyguanosine (8-OHdG), reflecting oxidative lipid and DNA damage respectively, with major depressive disorder (MDD), generalized anxiety disorder, social phobia, panic disorder, agoraphobia and antidepressant use in a large cohort.

Methods

Data was derived from the Netherlands Study of Depression and Anxiety including patients with current (n = 1641) or remitted (n = 610) MDD and/or anxiety disorder(s) (of which n = 709 antidepressant users) and 633 controls. Diagnoses were established with the Composite Interview Diagnostic Instrument. Plasma 8-OHdG and F2-isoprostanes were measured using UHPLC-MS/MS. ANCOVA was performed adjusting for sampling, sociodemographic, health and lifestyle variables.

Results

F2-isoprostanes did not differ between controls and patients, or by antidepressant use. Patients (current or remitted) using antidepressants had lower 8-OHdG (adjusted mean 38.3 pmol/L) compared to patients (current or remitted) without antidepressants (44.7 pmol/L) and controls (44.9 pmol/L, P < 0.001; Cohen's d 0.26). Findings for 8-OHdG were similar over all disorders and all antidepressant types (SSRIs, TCAs, SNRIs; P < 0.001).

Conclusion

Contrary to previous findings this large-scale study did not find increased oxidative stress measured by F2-isoprostanes or 8-OHdG in MDD or anxiety disorders. 8-OHdG levels were lower in antidepressant users, which suggests antidepressants may have antioxidant properties.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Portuguese version of the Disgust Propensity and Sensitivity Scale-Revised: Preliminary data
Authors: Ferreira J. , Soares S. , Bem-Haja P. , Alho L. , Rocha M. , Madeira N. , Silva C.
Published: May 2016

Introduction

Disgust propensity (DP) and disgust sensitivity (DS) contribute to individual differences in the experience of disgust. Studies have shown that DP and DS are predictive of some anxiety (e.g., spider phobia and blood-injection-injury phobia) and obsessive-compulsive and related disorders.

Aim

The aim of this study was to develop and validate a Portuguese version of the Disgust Propensity and Sensitivity Scale-Revised (DPSS-R; van Overveld= et al., 2006) for use in Portuguese-speaking populations.

Method

Two hundred and six participants (162 females), with ages between 18 and 47 (M = 25.92; SD = 8.75), filled in the DPSS-R, which was first translated and adapted into Portuguese language by individuals highly proficient in English and then back-translated by a bilingual with no prior knowledge of the scale. Finally, the DPSS-R was subjected to a think-aloud procedure.

Results

The results showed good internal consistency (Cronbach's alfa = .833) for a DPSS-R. The two subscales displayed an adequate internal consistency (DPCronbach'salfa = .776; DSCronbach'salfa = .790). Test-retest analysis documented good intraclass correlation coefficient for the two subscales (ICCPropensity = .889; ICC Sensitivity = .900). We also confirmed the bifactorial structure using a confirmatory factor analysis, since we obtained appropriate values in all goodness of fit indices (χ2df = 1,906; CFI = .94; PCFI = .736; GFI = .93; PGFI = .607; RMSEA = .067).

Conclusion

DPSS-R obtained good psychometric properties and may therefore be proposed as a valid instrument to assess DS and DP in the Portuguese population. This instrument may provide an important contribute to study the development and maintenance of psychopathology associated with disgust.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Dysfunctional meta-cognitive beliefs across psychopathology: A meta-analytic review
Authors: Sun X. , So S.H.W. , Zhu C. , Leung P.W.L.
Published: May 2016

Introduction

It is assumed that dysfunctional meta-cognitive beliefs about one's thoughts increase problematic appraisals and coping behaviors, which further contribute to the development of mental disorders (Wells and Matthews, 1994; Wells, 2000). Although this research interest originated around generalized anxiety disorder (GAD), recent studies have begun to examine similar meta-cognitive processes in other disorders. The majority of studies using Meta-cognitions Questionnaire (MCQ; Cartwright-Hatton & Wells, 1997) and its variants to assess meta-cognitive beliefs.

Objectives

We conducted a meta-analysis to integrate empirical findings on group differences in meta-cognitive beliefs between healthy individuals and patients with various psychiatric disorders.

Methods

We followed the PRISMA guideline (Liberati et al., 2009). A systematic literature search was conducted. We included studies that involved a diagnosed psychiatric group and healthy controls (aged 18 or above), reported group comparisons of metacognition, and were published during the period of 1990–27 August 2015. Effect sizes were computed.

Results

A final set of 43 studies was included. Large combined effect sizes were found on each subdomain of the MCQ, indicating increased levels of dysfunctional meta-cognitive beliefs in patients. Subgroup analyses were carried out based on psychiatric diagnosis (i.e. psychosis, n = 10; GAD, n = 7; obsessive-compulsive disorder, OCD, n = 15; anorexia nervosa, n = 5). All patient groups were more dysfunctional on each subtype of meta-cognitive beliefs than controls. Effect size of U/D was particularly large for GAD, and that of CSC was particularly large for OCD.

Conclusions

Dysfunctional meta-cognitive beliefs are evident across several psychiatric disorders, with specific types of beliefs being more marked in certain diagnoses.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Characteristics and treatment patterns of children and adolescents with attention-deficit/hyperactivity disorder in real-world practice settings
Authors: Joseph A. , Davis K. , Fridman M. , Gustafsson P. , Quintero J. , Sikirica V. , Banaschewski T.
Published: May 2016

Objective

To document patient characteristics and treatment patterns in a real-world population diagnosed with attention-deficit/hyperactivity disorder (ADHD).

Methods

This was a retrospective chart review of children/adolescents (6–17 years) diagnosed with ADHD in the UK, Germany and Netherlands who initiated stimulant monotherapy (SM), non-stimulant (atomoxetine) monotherapy (NSM) or polypharmacy (SM/NSM ± SM/NSM or other psychotropics) on/after 1-1-2012. To facilitate descriptive comparisons, cohort quotas were imposed: ∼50% SM; ∼25% NSM; ∼25% polypharmacy. Index date was first SM, NSM or polypharmacy treatment on/after 1-1-2012. Patients were required to have ≥ 6 months’ pre-index (baseline) history and ≥ 12 months’ post-index follow-up. Analyses were descriptive.

Results

In total, 497 patients were included (mean [SD] age: 10.8 [2.9] years; 77% male); 65% (SM), 63% (NSM) and 83% (polypharmacy) had at least marked baseline ADHD severity based on Clinical Global Impressions scale (P < 0.05 SM/NSM vs polypharmacy). Ninety percent (SM), 75% (NSM) and 73% (polypharmacy) were pharmacotherapy naïve at index (all P < 0.10); 61% (SM), 65% (NSM) and 72% (polypharmacy) received previous behavioural therapy. In SM patients, methylphenidate was predominant (most frequent brands: Concerta® [29%], Medikinet® [28%]); in polypharmacy patients, methylphenidate plus atomoxetine (22%) or other psychotropic (19%) was most common. Index therapy switch was common, particularly in polypharmacy patients (25%) (P < 0.05 vs SM [14%] and NSM [13%]). Switches were precipitated by poor response in 75% of cases overall.

Conclusions

Polypharmacy patients generally presented a more complicated history (including higher ADHD severity) and treatment pathway versus monotherapy patients. Index therapy switches were commonplace and more frequent in polypharmacy patients, often due to poor response.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Characterization of agomelatine-induced liver injury, incidence and risk factors: A pooled analysis of 7605 treated patients
Authors: Perlemuter G. , Cacoub P. , Valla D. , Guyader D. , Saba B. , Batailler C. , Moore K.
Published: May 2016

Introduction/objective

The hepatic safety of agomelatine was assessed in 49 phase II and III studies. The aim was to analyze the characteristics of patients who developed an increase in transaminases whilst taking agomelatine.

Method

A retrospective pooled analysis of changes in serum transaminase in 7605 patients treated with agomelatine (25 mg or 50 mg/day) from 49 completed studies was undertaken. A significant increase in serum transaminase was defined as > 3-fold the upper limit of normal (> 3 ULN). Final causality was determined in a case-by-case review by five academic experts.

Results

Transaminase increased to > 3 ULN in 1.3% and 2.5% of patients treated with 25 mg and 50 mg of agomelatine respectively, compared to 0.5% for placebo. The onset of increased transaminases occurred at < 12 weeks in 64% of patients. The median time to recovery (to ≤ 2ULN) was 14 days following treatment withdrawal. Liver function tests recovered in 36.1% patients despite the continuation of agomelatine, suggesting the presence of a liver adaptive mechanism. Patients with elevated transaminases at baseline, secondary to obesity and fatty liver disease (NAFLD), had an equally increased risk of developing further elevations of transaminases with agomelatine and placebo. This reflects the widespread fluctuations of serum transaminases in patients with NAFLD.

Conclusions

The overall incidence of abnormal transaminases was low and dose dependent. No specific population was identified regarding potential risk factors. Withdrawal of agomelatine led to rapid recovery, and some patients exhibited an adaptive phenomenon. The liver profile of agomelatine seems safe when serum transaminases are monitored.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
ECT-treatment in Western Norway; first data from the Regional register of neurostimulation treatment
Authors: Kessler U. , Schoeyen H.
Published: May 2016

Introduction

Electroconvulsive therapy (ECT) is one of the most polarizing treatments in medicine. Although the treatment effect is well documented in clinical studies, there is a lack of data regarding patients treated in an ordinary clinical setting. In 2013, we established a regional register of neurostimulation treatment in Western Norway.

Objectives

To describe the use of ECT at the Haukeland university hospital in Bergen.

Methods

Patients treated with ECT between June 2013 and June 2015 were included in the register.

Results

One hundred and forty-seven patients received ECT during the 2 years period. The mean age was 58.4 years (22–91 years), 67% were female. Half of the patients (49.7%) had been treated with ECT previously. Indication for treatment was depression in 137 patients (93.2%), of which 29 (19.7%) were moderately, and 69 patients (46.9%) severely depressed, and additional 37 patients (25.2%) presented with severe depression with psychotic features. All but two patients were treated with right unilateral electrode placement, with a mean of 9.7 (3–22) treatments.

The mean MADRS before treatment was 34.2 (4–56) and after treatment 11.9 (0–39). One hundred and ten patients (74.8%) responded to treatment; of which 89 (60.5%) remitted (response defined as a 50% or greater decrease from MADRS baseline score, remission defined as MADRS ≤ 12). Twenty patients (13%) continued with continuation or maintenance ECT after the index series.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Shifting focus approach: An alternative to classical CBT therapy for relapse prevention among opioid detoxified patients
Authors: Rady A. , Moukoukheya T. , Shawky E.
Published: May 2016

Aim

Most current psychotherapeutic approaches are self-focused in terms of focusing attention on how one thinks, feels, behaves or maintains, in one way or another, a pathological chain reactions. The aim of current is to challenge such focus by shifting the focus of attention to serving others rather than analyzing one's self.

Method

Sixty patients were recruited after heroin detoxification, all have been subject to psycho-education about addictive behavior, craving process and risks of relapse. Half of them (group A; n = 30) were subject to weekly basis classical CBT group sessions while the other half (group B; n = 30) were subject to shifting focus approach where they were encouraged to serve on voluntary nonprofit basis at Alexandria university hospitals with weekly group support sessions to share experiences and encourage action. Patients in both arms were followed for 3 months and evaluated in terms of abstinence rate and quality of life.

Results

Both groups were balanced in terms of age, marital status, age of onset of abuse, number of previous detoxification, criminal record and score of the Quality of Life Scale QLS at base line before psychotherapy. After 3 months, no difference as regards abstinence rate between both arms (X2 = 1.763; P = 0.288), also no difference between both groups as regards change in QLS score after 3 months (t = 0.039; P = 0.969).

Conclusion

Shifting focus approach shows no difference in terms of abstinence or quality of life improvement compared to classical CBT in non inferiority study.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Adaptation and validation of the Korean Version of the Bipolar Depression Rating Scale (K-BDRS)
Authors: Bahk W.M. , Kim M.D. , Jung Y.E. , Woo Y.S. , Lee J. , Min K.J. , Chung S.K. , Kwon Y.J. , Jon D.I. , Lee K.H. , Kim H.C. , Yoon B.H.
Published: May 2016

Objectives

The Bipolar Depression Rating Scale (BDRS) is a scale for assessment of the clinical characteristics of bipolar depression. The primary aims of this study were to describe the development of the Korean version of the BDRS (K-BDRS) and to establish more firmly its psychometric properties in terms of reliability and validity.

Methods

The study included 141 patients (62 male and 79 female) who had been diagnosed with bipolar disorder, were currently experiencing symptoms of depression, and were interviewed using the K-BDRS. Other measures included the Montgomery and Asberg Depression Scale (MADRS), the 17-item Hamilton Depression Scale (HAMD), and the Young Mania Rating Scale (YMRS). Additionally, the internal consistency, concurrent validity, inter-rater reliability, and test-retest reliability of the K-BDRS were evaluated.

Results

The Cronbach's α-coefficient for the K-BDRS was 0.866, the K-BDRS exhibited strong correlations with the HAMD (r = 0.788) and MADRS (r = 0.877), and the mixed symptoms score of the K-BDRS was significantly correlated with the YMRS (r = 0.611). An exploratory factor analysis revealed three factors that corresponded to psychological depressive symptoms, somatic depressive symptoms, and mixed symptoms.

Conclusions

The present findings suggest that the K-BDRS has good psychometric properties and is a valid and reliable tool for assessing depressive symptoms in patients with bipolar disorder.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
The association between childhood trauma and empathy in patients with stable schizophrenia
Authors: Arous A. , Trabelsi R. , Mrizak J. , Aissa A. , Ben Ammar H. , El Hechmi Z.
Published: May 2016

Introduction

Empathy, which refers to the ability to understand and share the thoughts and feelings of others, has emerged as an important topic in the field of social neuroscience. It is one of the most understudied dimensions of social cognition in schizophrenia (SCZ).

Objectives

To investigate the relationship between cognitive and affective empathy and CT in SCZ.

Methods

Fifty-eight outpatients with stable SCZ completed the Childhood Trauma Questionnaire retrospectively assessing five types of childhood trauma (emotional, physical and sexual abuse, and emotional and physical neglect). They also completed the Questionnaire of Cognitive and Affective Empathy (QCAE) comprising five subscales intended to assess cognitive and affective components of empathy.

Results

Patients with a history of sexual abuse better emotion contagion scores (P = 0.048) which means that develop more easily self-oriented emotional state matching the affective states of others. Patients with a history of emotional neglect or/and in denial of CT had higher scores in perspective taking score (P = 0.017). Perspective taking assesses the extent to which respondents can take another's perspective or see things from another's point-of-view.

Conclusions

Investigating psychosocial mechanisms, specifically the role of CT, underlying the development of empathic capacities is important since empathy can represent a treatment-target.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Metacognitive training vs psycho-educational group, results from a clinical trial in patients with psychosis of recent onset
Authors: Barrigon M.L. ,   S.M.S.G.
Published: May 2016

Aim

To assess the efficacy of Metacognitive Training (MCT) in symptoms and metacognitive variables in people with a recent onset of psychosis.

Method

A multicenter, randomized and controlled clinical trial was performed. One hundred and twenty-six patients were randomized to MCT or a psycho-educational intervention. Patients with a recent onset of psychosis were recruited from 9 centers of Spain. The treatment consisted in 8 weekly sessions in both groups. Patients were assessed at baseline, post-treatment, and 6 months of follow-up. Symptoms were assessed by the PANSS. Metacognition was assessed by a battery of questionnaires of cognitive biases and social cognition: BCIS, IPSAQ, TCI, Hinting task and Emotional Recognition Test.

Results

PANSS positive symptoms significant declined between baseline and post-treatment in psycho-educational (P = 0.04) and MCT group (P = 0.01), while general PANSS and total PANSS were significant between baseline and post-treatment in the MCT group only (P = 0.008; P = 0.005). Across time, the MCT group was superior to psycho-educational on the BCIS total and self-certainty subscale (P = 0.042). Regarding irrational beliefs, the intolerance to frustration subscale declined more strongly in the MCT in relation to psycho-educational group (P = 0.016). ToM, Personalizing Bias and JTC improved more strongly in the MCT group compared to psycho-educational group (P < 0.001–0.032). Most results remained significant at the follow-up.

Conclusions

MCT could be an effective psychological intervention for people with a recent onset of psychosis in order to improve symptoms, insight, tolerance to frustration and personalizing bias.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Virtual reality insights into schizophrenic patients’ way to interpret an Avatar's help
Authors: Brunet-Gouet E. , Oker A. , Berrada-Baby Z. , Courgeon M. , Urbach M. , Bazin N. , Martin J.C. , Amorim M.A. , Roux P. , Passerieux C.
Published: May 2016

With regards to the neurocognitive deficits and cognitive bias of schizophrenic disorders, it may be hypothesized that these patients suffer a deficit in recognizing helping intentions in others. To investigate help recognition, new technologies allowing to control an interaction with virtual affective agents were used with an adaptation of a previously described card-guessing paradigm (project COMPARSE ANR-11-EMCO-0007). We investigated whether the same game proposed successively by two virtual agents asking either empathetic (i.e. on the subject's feelings) or non-empathetic (i.e. on technical aspects of the game) questions to the participant would elicit different interpretations on their intentions. Dependent variables consisted of monetary allocation to the virtual agent, of questionnaires assessing the agent's help, interest, attention, etc. A group of 20 individuals with schizophrenia and one of 20 healthy controls, matched on gender, with comparable age, estimated verbal-IQ and educational level were recruited. The healthy subjects’ ratings of the virtual agent's behavior demonstrated that they interpreted empathetic questioning as helping and rewarded it positively with an increased monetary allocation. Schizophrenic patients had a qualitatively reduced perception of the differences between the two agents. Only the rating concerning the “interest/attention” of the agent toward them exhibited medium effect size when contrasting conditions. Hypothetically, schizophrenic patients take into account the fact they are the object of another's attention, but may fail to infer the intentional meaning and to provide an increased monetary allocation.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Low erythrocyte glutathione peroxidase activity in schizophrenic patients is mediated by gender, the number of episodes, disease duration and drug treatment
Authors: Djordjevic V. , Knezevic M.
Published: May 2016

Introduction

Inconsistent data showed that erythrocyte glutathione peroxidase (GPx) activity in schizophrenics is altered.

Aim

The aim of this study was to evaluate whether some of the demographic, clinical and therapeutic factors had any significant impact on erythrocyte GPx activity in patients with schizophrenia.

Methods

This study included 68 schizophrenic patients and 59 healthy individuals. GPx activity was tested related to patient age, gender, heredity, the onset of the disease, the duration of the disease, the number of episodes, PANSS scores and drug treatment. GPx activity was determined in erythrocyte hemolysates by Ransel commercially available test.

Results

Erythrocyte GPx activity was significantly lower in patients with schizophrenia than in controls. Male patients had significantly lower GPx activity in comparison with those in female ones. Heredity negative patients showed significantly lower enzyme activity compared to control values. Significantly lower GPx activity was obtained independently of the onset of the disease. The patient group having more than one psychotic episode also showed significantly lower GPx activity compared to the control group. The disease duration of more than 1 year caused a significant decrease in enzyme activity. There was a significant difference in GPx activity between patients with different PANSS scores. In patients treated with second generation antipsychotics and in those treated with both first and second generation antipsychotics, GPx activity was significantly lower than in controls.

Conclusion

This study shows that the low erythrocyte GPx activity in schizophrenics depends on patient gender, the number of episodes, disease duration and drug treatment.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Inflammatory and metabolic biomarkers of psychopathological dimensions of schizophrenia
Authors: Gonzalez-Blanco L. , García-Portilla M.P. , Garcia-Alvarez L. , Iglesias C. , Saiz P. , Coto A. , Bobes J.
Published: May 2016

Introduction

The concept of schizophrenia as a systemic disease includes, not only psychosis, but an increase in somatic comorbidity and cardiovascular risk [1]. Furthermore, it is known the implication of inflammation in the pathogenesis of schizophrenia [2].

Objectives

To determinate potential inflammatory/metabolic biomarkers of schizophrenia's dimensions.

Methods

Sample: 36 outpatients with schizophrenia for less than 11 years, under stable maintenance treatment (mean age [32.25], males [63.9%]) and their 36 matched controls (age [32.53 ± 6.63]; males [72.2%]).

Evaluation

PANSS, Clinical Assessment Interview for Negative Symptoms(CAINS), Calgary Scale(CDS), CGI, Personal and Social Performance Scale(PSP). Biomarkers: C-reactive protein (CRP), homocysteine, glucose, insulin, HOMA-IR (insulin resistance), cholesterol, HDL, LDL, triglycerides.

Results

Biomarkers differences between groups are shown in Table 1. Table 2 shows the correlations found after controlling for Body Mass Index [patients(28.61 ± 5.69);controls(24.64 ± 3.80);p = 0.001] and Smoking [patients(52.8%-yes);controls(5.6%-yes);p = 0.000].

Conclusions

1. CRP, a potential inflammatory biomarker in schizophrenia, is related to depression severity. Homocysteine, representing an oxidative stress, is related to positive, negative, cognitive and depressive symptoms severity, and worse functioning. 2. Patients with schizophrenia have lower HDL–related to negative and cognitive symptoms severity and worse functioning–and insulin resistance – related to worse cognition –.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Clinical and functional response to paliperidone palmitate in early schizophrenia–A retrospective observational study in newly diagnosed patients treated over a 12-month period
Authors: Hargarter L. , Bergmans P. , Cherubin P. , Schreiner A.
Published: May 2016

Introduction

Data on clinical outcomes with long-acting antipsychotic treatment in young, newly diagnosed patients with schizophrenia is sparse.

Objectives

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

Methods

International, multicenter, retrospective, observational study. Outcomes presented: baseline (BL) characteristics and demographics, clinically relevant improvements in disease severity (ie ≥ 20% decrease in PANSS or BPRS total score or CGI-S Change ≥ −2 or CGI-C ≥ 3, with no score showing worsening) and clinically relevant functional improvement (i.e. change in PSP total score ≥ +7 points or change in GAF total score ≥ +20 points, with no score showing worsening) from BL to last-observation-carried-forward endpoint (LOCF-EP) within 12-month documentation period, mean mode PP dose and adverse drug reactions.

Results

Eighty-four patients analyzed: 69% male, mean age at initiation of PP was 24.1 (SD2.7) years, mean BL weight was 78.7 (SD16.0) kg and 80.0 (SD14.7) kg at LOCF-EP, with a mean change of 1.2 (SD3.9) kg; mean time from first psychotic episode to initiation of PP was 5.5 (SD3.3) months. At LOCF-EP 86.6% achieved a clinically relevant improvement (71/84, Kaplan-Meier median time from initiation of PP: 52.4 days). 63.4% achieved a clinically relevant functional improvement (52/84, Kaplan-Meier median time from initiation of PP: 53.1 days). PP mean mode maintenance dose was 96.4 (SD19.8) mg. ADRs reported in ≥ 5% of patients were weight increase 9.1% and hyperprolactinemia 5.7%.

Conclusions

Treatment with once-monthly PP was well tolerated and associated with clinically relevant improvements in disease severity and functioning in young, newly diagnosed schizophrenia patients.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Cognitive function in early psychosis patients from a low-income country
Authors: Husain M.O. , Chaudhry I.B. , Kiran T. , Thomasson R. , Mehmood N. , Husain N.
Published: May 2016

Background

Cognitive impairments are well established findings in schizophrenia and are associated with significant impairment of social functioning. Episodic memory, working memory and executive function test scores are typically 1 standard deviation below healthy controls. There are reports suggesting the presence of neurocognitive deficits prior to illness onset, opening the possibility of using cognitive profiles as disease markers. Interest in exploring cognitive functioning in early stages schizophrenia has continued to grow, as earlier treatments could possibly lead to improved outcomes.

Methods

This is a cross-sectional assessment of cognitive profiles in patients with early psychosis. A total of 51 patients suffering from psychosis in the age group of 18–65 years were recruited and matched with 51 healthy controls. A wide range of neurocognitive domains were assessed using standardised neuropsychological tests.

Results

There was evidence of statistically significant impairments in cognitive functioning across a broad range of cognitive domains in early-psychosis patients, as compared to healthy controls. More pronounced deficits were seen in executive function tests.

Conclusions

To our knowledge, this is the first study to report cognitive deficits across a range of domains in patients with first episode psychosis from a low-income country. This study found deficits across multiple domains, including language, memory, attention, executive function, and visuospatial function in patients with early psychosis. Evidence of neuropsychological deficits in the early course of the disease may highlight crucial therapeutic windows for both pharmacological treatments and cognitive rehabilitation. This may improve functional outcomes in this patient group in the longer term.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Serum hormone levels and cognitive functioning in male schizophrenia patients
Authors: Krysta K. , Bratek A. , Koźmin-Burzyńska A. , Krupka-Matuszczyk I.
Published: May 2016

Background

Hormones deregulation is a common feature in schizophrenia. Among the hormones that gained increased interest are sex hormones, thyroid hormones and prolactin. However, the question whether there is an impact of the hormonal disturbances on cognitive functioning of schizophrenia patients is rarely addressed.

Objective

To assess the relationship between serum levels of hormones and cognitive abilities in male schizophrenic patients.

Subjects and methods

In the index group, there were 15 schizophrenia male patients, mean age 36. The control group was formed by 15 healthy volunteers, mean age 36. In the two groups, serum hormones levels were measured and neuropsychological tests were performed. Analysed hormones included thyroid-stimulating hormone (TSH), luteinizing hormone (LH), follicle-stimulating hormone (FSH), estradiol, testosterone, progesterone and prolactin. Cognitive abilities were measured with the following tests: Trail Making Test (TMT) Part A and B, Semantic Category Fluency (SCF), Initial Letter Fluency (ILF) and Stroop Task Part 1 and 2.

Results

The levels of FSH, LH and testosterone were lower in the index group than in the control group (3.01 mIU/mL vs 5.90 mIU/mL; 3.83 mIU/mL vs 5.28 mIU/mL; 2.76 ng/mL vs 4.69 ng/mL; accordingly) while the level of prolactin was higher in the index group (620 uIU/mL vs 118 uIU/mL). Patients performed worse that controls in all neuropsychological tests. The differences in scores of TMT Part B, ILF and Stroop Task Part 2 were found to be statistically signiﬁcant.

Conclusions

There was no signiﬁcant relationship between serum level of analysed hormones and performance on cognitive tasks.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Effectiveness of Brief Individual Cognitive Behavioral Therapy for auditory hallucinations in a sample of Egyptian patients with schizophrenia
Authors: Nagui Rizk D. , Salama H. , Molokhiya T. , Kassem L.
Published: May 2016

Background

Auditory hallucination is one of the most common symptoms in schizophrenia. The frequency of the auditory hallucinations and ensuing distress make the individual believe that these voices are not able to be controlled and to be coped with.

Aim

Testing the effectiveness of brief cognitive behavioral therapy for psychosis (CBTp) for auditory hallucinations, using it in modifying the beliefs about the voices and improving symptom severity and overall functioning.

Methods

Forty participants with schizophrenia were randomized into intervention and control groups. Intervention group were 20 patients who received 8 individual sessions of CBTp plus Treatment As Usual (TAU) over 8 weeks and the control group were the other 20 patients who received TAU only. The Positive and Negative Syndrome Scale (PANSS), the Arabic version of Beliefs About Voices Questionnaire (BAVQ) and the General Assessment of Functioning scale (GAF) were assessed at baseline and at the end of the study.

Results

Intervention group showed a statistically significant increase in GAF (P = 0.012), a statistically significant reduction regarding the Positive (P < 0.001), Negative (P = 0.008), General (P < 00.001) and total (P ≤ 00.001) sub-scales of PANSS. Regarding BAVQ, Intervention group showed a statistically significant reduction in Malevolence (P = 0.008), Engagement (P = 0.001); and showed a statistically significant increase in Resistance (P = 0.049) compared to control.

Conclusions

Brief cognitive behavioral therapy for auditory hallucinations can improve severity of schizophrenia, increase the level of functioning and improve the beliefs about the voices.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
The effect of a 16-week walking program on biomarkers, physical fitness, health related quality of life and self-perceptions of adults with schizophrenia
Authors: Oliveira E. , Uba-Chupel M. , Sousa D. , Rocha C. , Teixeira A. , Ferreira P.
Published: May 2016

Introduction

People with schizophrenia exhibit low levels of physical activity, which have impact on physical and mental health as well as overall quality of life (QOL). Mental and physical benefits of exercise are known, although the mechanisms through which physical exercise improves schizophrenia symptoms are not fully understood.

Objectives

To assess the effect of a 16-week exercise program (EP) on the expression of BDNF and S100B biomarkers, physical fitness, health related quality of life and self-perceptions of adults with schizophrenia.

Methods

Thirty-five patients with schizophrenia (PwSZ) were divided in three groups Institutionalized Patients (n = 11); Psychosocial Rehabilitation (n = 13); and Control Group (n = 11). The EP consisted of one-hour walking session three times a week during 16 weeks. All participants were assessed before and after EP using the six minutes walking test, a psychological tests battery including MOS Short Form 36, Rosenberg Self-Esteem Scale, Physical Self-Perception Profile, Satisfaction with Life Scale as well as the BDNF and S100B measurements using serum analysis.

Results

No significant statistical differences were found both for BDNF and S100B levels as a result of exercise. Additionally, no significant statistical differences were found for Physical Self-concept and Global Self-esteem changes as a result of the walking program (WP). However, PwSZ showed significant statistical differences on the satisfaction with life (P < 0.05) and on the perceived health related QOL (P < 0.05) in all groups participating in the EP.

Conclusion

In spite of the limited impact of the WP in PwSZ, this group may obtain positive outcomes of the exercise participation based on a more positive attitude towards life.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Electroconvulsive therapy in schizophrenia – where do we stand?
Authors: Silva J. , Mota J. , Azevedo P.
Published: May 2016

Introduction

Electroconvulsive therapy is currently used in the management of severe depression, long-term mania and catatonia. Regarding schizophrenia-related psychosis ECT is also an option, but the indication is restrictive to severe cases, drug intolerance or resistant ones. Lack of evidence of cost-effectiveness compared to clozapine, and side effects of ECT techniques before 2003, influenced NICE guidance to not recommend ECT in schizophrenia, but modern ECT machines and procedures are subsequent to 2003. ECT is often performed when clozapine fails to respond in monotherapy or if there is intolerance to antipsychotic side effects. ECT in combination with clozapine seems to have significant results allowing the patients to achieve rapid control of psychotic symptoms with fewer side effects, comparing with antipsychotics-association strategies.

Objectives

To summarized the latest literature about this field and to present recent data from the Electrovulsivetherapy Unit, in Hospital de Magalhães Lemos, Portugal.

Aim

To explore and critically review the controversies of electroconvulsive therapy in the management of drug-resistant schizophrenia.

Methods

Retrospective data of an Electroconvulsive Therapy Unit during 2006–2015 was review.

Results

198 ECT treatments in schizophrenic patients were performed in our unit, during 2006–2007, in a total of 647 ECT (30,6%). In 2014–2015, 945 schizophrenic patients received ECT treatment, in a total of 2149 performed ECT (43,9%).

Conclusions

Although guidelines are crucial for the uniform practice of medicine, sometimes is important to be critical about them. The use of ECT in schizophrenia is safe and effective and further research is needed to continue to support this treatment.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Symptoms of schizophrenia and suicidal behaviour
Authors: Sisek-Šprem M. , Herceg M. , Jukić V.
Published: May 2016

Introduction

Risk prediction for suicide in schizophrenia is known to be complex. Illness-related risk factors are important predictors, with number of prior suicide attempts, depressive symptoms, active hallucinations and delusions.

Aims

To analyze the impact of clinical features of schizophrenia on suicidal behaviour and analyze relationship between violence and suicidality.

Methods

We compared a group of 28 suicidal, 32 hetero-aggressive and 60 non-aggressive male patients with schizophrenia. The severity of the psychopathology was assessed using PANSS, hetero-aggressiveness using OAS and suicidality using C-SSRS and InterSePT scales.

Results

Suicidality is in positive correlation with the presence of depression (r = 0.485, P < 0.001) and imperative hallucinations (r = 0.391, P < 0.001) but in negative correlation with total PANSS score (r = –0.297, P < 0.001), impulsiveness (r = –0,237, P < 0.001) and hetero-aggressive behaviour (r = –0.551, P < 0.001). Previous attempt was found in 53% suicidal patients (P = 0.047). Heteroaggressiveness is in positive correlation with total PANSS (r = 0.43, P < 0.001) and impulsive behaviour (r = 0.57, P < 0.001). This study supports the contention that high impulsivity in schizophrenia patients is significant in the etiology of violent but not suicidal behaviour.

Conclusion

In the order to diminish the level of suicide among patients with schizophrenia we must be aware of the importance of depressive symptoms, imperative hallucinations and previous attempts. This study supports the contention that high impulsivity in schizophrenia patients is significant in the etiology of violence but not suicidal behaviour.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Second-generation antipsychotics and the metabolic syndrome in drug-naive adolescents
Authors: Sjo C. , Bilenberg N.
Published: May 2016

Introduction

Poor physical health and shorter life expectancy often follows from mental illness. If the disorder starts in childhood/adolescence, the risk of this outcome is even higher. Second generation antipsychotics (SGAs) are suspected to increase cardiovascular risk factors through the development of the metabolic syndrome.

Objective

We investigated all the aspects of the metabolic syndrome in drug-naive youth, over a period of 12 months of treatment with SGAs.

Aims

This study examines drug-naive youth in their first year of treatment with SGAs, and the possible development of markers of the metabolic syndrome, in a naturalistic setting. We also look at aspects of the patient's disease and environment that may predict which patients are the most at risk for these metabolic derangements.

Methods

Thirty-five drug-naive adolescents were recruited after their contact with the Psychosis Team at Department of Child and Adolescent Psychiatry in Odense, Denmark. Measurements were taken at different times over the course of their first year of treatment. The markers included, among others: body mass index, waist circumference, blood pressure, fasting blood glucose, as well as high density, low density and total cholesterol. Factors of the patients’ lifestyle and development were recorded as well.

Results

The results will be presented at the EPA March 2016 in Madrid.

Conclusions

This is, to our knowledge, the first study to include all of the aforementioned aspects in drug-naive adolescents over a 12-month period. Because of this, it may provide us with a unique insight into how, and in which patients, these metabolic changes develop.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Depression in the active phase of paranoid schizophrenia in relation to age of onset and sex
Authors: Skokou M. , Gourzis P.
Published: May 2016

Introduction

Depression is often observed in schizophrenia, in all phases of the disorder. Age of illness onset and sex have been found to correlate with depressive symptomatology in many but not all studies.

Aims

In the present work the relation between depressive symptoms and age of onset and sex was investigated, in a sample of patients with paranoid schizophrenia.

Methods

Eighty-eight (88) patients with paranoid schizophrenia according to DSM-IV-TR criteria were examined, 21 of which became ill at ≥35 years of age (late onset), whereas 60 had age of onset < 30 years (young onset). During the active phase the Calgary Depression Scale for Schizophrenia (CDSS) was applied. Comparisons were performed by using the two-tailed Wilcoxon rank-sum and Chi-squared tests.

Results

The percentage of patients with depression (CDSS > 6) in the whole sample was 27.2%. There was a trend for higher scores in early awakening in late onset patients (P = 0.060). In men, there was a trend for heavier depression in late onset patients, and higher scores in early awakening (P = 0.082, 0.019, respectively). In young onset patients, there was a trend for heavier symptomatology in women compared with men, and heavier pathological guilt (P = 0.073, 0.007, respectively), whereas in late onset patients, there was a trend for heavier self depreciation in men (P = 0.072).

Conclusions

Although the frequency of depression does not seem to be influenced by age of onset or sex, more subtle differences are found in the severity of certain depressive symptoms, in relation to these factors, possibly warranting further investigation.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Sleep disorders among adolescents in Nigeria: The development of an assessment instrument (Sleep Disorders in Nigeria Questionnaire [SDINQ])
Authors: Igbokwe D. , Ola B.A. , Odebunmi A. , Gesinde M.A. , Alao A. , Agbu J. , Ndom R.J.E. , Adeusi S.O. , Adekeye O.A. , Agoha B.C.E.
Published: May 2016

Introduction

Nigerian adolescents report various sleep disorders metaphorically based on the local/native description of such disorders. Hence, it is sometimes difficult for clinicians without a good grasp of the nuance in their description to understand their presentation.

Aim

To develop a culturally relevant (Nigerian) instrument for assessing sleep disorders.

Methods

One thousand two hundred and twenty-seven Nigerian Secondary School adolescents (634 males and 593 females) between 12–19 years with mean age of 15.20 (SD = 1.5) were administered a 44 item instrument developed following the DSM (V), American Association of Sleep Medicine's International Classification of Sleep Disorders (ICSD, 2005) criteria, and case reports of sleep disorders. The data was subjected to a Principal Component Analysis using Varimax rotation.

Result

Ten factors instead of the original eleven factors suggested by the authors emerged in the analysis and on closer examination and in juxtaposition with cultural nuances, it was found the ten factors were in line with what is generally reported by adolescents. Sleep walking disorders and sleep related movement disorders loaded in one factor labelled sleep movement disorders, while items representing non restorative sleep experiences, sleep talking, sleep paralysis, sleep apnea, circadian rhythm sleep disorder, narcolepsy, insomnia, sleep terror disorder and nightmare disorder loaded on their individual factors. The SDINQ showed a Cronbach Alpha of .916 and a good correlation with subscales of the School Sleep Habits Survey (SSHS).

Conclusions

The SDINQ has been found to be a valid and reliable instrument for assessing the presence of sleep disorders among adolescents in Nigeria.

Disclosure of interest

The authors have not supplied their declaration of competing interest.