bluuebunny/crossref_metadata_2025 huggingface dataset:
Mechanisms of callose deposition in rice regulated by exogenous abscisic acid and its involvement in rice resistance to Nilaparvata lugens Stål (Hemiptera: Delphacidae)
Authors: Liu Jinglan , Du Haitao , Ding Xu , Zhou Yaodong , Xie Pengfei , Wu Jincai
Published: June 2017

BACKGROUND

Callose is a plant cell wall polysaccharide controlled by β‐1,3‐glucanase and synthase. Abscisic acid (ABA) is an important plant hormone. Exogenous ABA promotes rice resistance to pests. Whether exogenous ABA could reduce the decline in rice yield after brown planthopper (Nilaparvata lugens Stål; BPH) feeding is an important question, however, the mechanisms behind rice resistance induced by ABA remain obscure.

RESULTS

Electronic penetration graph (EPG) recording indicated a significant increase in rice resistance to BPH, and the number of BPH eggs decreased significantly upon application of exogenous ABA. As the concentration of ABA increased, the reduction in rice yield decreased significantly after BPH feeding. Further studies showed that β‐1,3‐glucanase activity was significantly lower, but synthase activity was higher after ABA treatment than in controls.

CONCLUSIONS

Our results demonstrated that exogenous ABA suppressed β‐1,3‐glucanase and induced synthase activity, and promoted callose deposition. This is an important defense mechanism that prevents BPH from ingesting phloem sap. These studies provide support for an insect‐resistance mechanism after ABA treatment and provide a reference for the integrated management of other piercing–sucking pests. © 2017 Society of Chemical Industry
Increased efficacy and extended shelf life of spinosad formulated in phagostimulant granules against Spodoptera frugiperda
Authors: Tamez‐Guerra Patricia , Tamayo‐Mejía Fernando , Gomez‐Flores Ricardo , Rodríguez‐Padilla Cristina , Damas Gabriela , Tamez‐Guerra Reyes S , Ek‐Ramos Maria J , Williams Trevor
Published: June 2017

BACKGROUND

Spinosad is recommended for control of Spodoptera frugiperda (J.E. Smith) larvae; its application with phagostimulants may reduce the quantity of active ingredient required for effective pest control. Spinosad (Tracer®) was formulated in maize flour matrix granules and three field tests compared 10–100 ppm a.i. granules (equivalent to 0.24–2.4 g a.i. ha–1) with Tracer as an aqueous spray (200 ppm a.i.; 60 g a.i. ha–1), and the recommended application rates of Bacillus thuringiensis, a chemical and an untreated controls were performed.

RESULTS

The 100 ppm spinosad granules resulted in similar S. frugiperda mortality compared with the chemical treatments in all three field trials, and resulted in a significantly higher maize grain yield compared with unformulated and control treatments (4141 vs. 2857 and 2407 kg ha–1, respectively) that was similar to the chemical treatment (3778 kg ha–1). Bioassays of granules stored at room and cold temperatures showed that after 5 years, ∼ 70% of the original activity remained (OAR) of spinosad when formulated as granules. Nevertheless, after 9 years, efficacy was reduced (26.2% and 48.5% OAR) at both room (25 °C) and refrigerated temperatures (4 °C).

CONCLUSION

Spinosad, in the granular phagostimulant formulations evaluated in this study, had advantages measured as high efficacy and long shelf life. © 2017 Society of Chemical Industry
Baricitinib: a new oral treatment for rheumatoid arthritis
Authors: Chaplin Steve
Published: June 2017

Baricitinib (Olumiant) is a new oral janus kinase inhibitor licensed for the second‐line treatment of moderate to severe active rheumatoid arthritis. This article summarises its efficacy, side‐effects and place in therapy.
Processes leading to deep convection and sensitivity to sea‐state representation during HyMeX IOP8 heavy precipitation event
Authors: Bouin M.‐N. , Redelsperger J.‐L. , Lebeaupin Brossier C.
Published: June 2017

During the first observation period of the HyMeX programme, the Mediterranean coasts of Spain were impacted by several heavy precipitating events (HPEs). The most damaging one occurred during IOP 8 resulting in cumulative rainfall amounts over 180 mm in the area of Murcia–Valencia. Numerical simulations using a high‐resolution atmospheric model provide a very realistic representation of the mesoscale convective systems (MCSs) at the origin of this HPE and of the associated low‐level conditions, consisting in two cold sectors surrounding a warm sector. This study provides a detailed analysis of the mechanisms of deep convection initiation and maintenance between 1200 UTC 28 September and 0000 UTC 29 September 2012. On the coastal mountainous area, the conditionally unstable inflow feeding the MCS is uplifted by the relief whereas at sea, a strong low‐level convergence plays the same role. At the coast, cold pools are generated and strengthened by a strong low‐level jet (LLJ) carrying cold dense air parcels from the Gulf of Lion and by evaporation and cooling under the precipitating systems. These cold pools play a key role in triggering the deep convection, either by directly uplifting the air masses or by deflecting the inflow horizontally. They largely control the localisation and distribution of the heavy precipitation at sea near Valencia. A weak barrier wind over the cold pools and a secondary cyclonic circulation result in a bending of the convergence line at sea, in agreement with radar observations.

A sensitivity study to a more realistic representation of the sea state in the air–sea exchanges shows that the LLJ is decelerated by the increased sea‐surface roughness, resulting in cold pools extending further at sea and shifting the precipitation patterns 50 km offshore.
Sediment‐associated organic matter sources and sediment oxygen demand in a Special Area of Conservation (SAC): A case study of the River Axe, UK
Authors: Collins A. L. , Zhang Y. , McMillan S. , Dixon E. R. , Stringfellow A. , Bateman S. , Sear D. A.
Published: June 2017

Oxygen demand in river substrates providing important habitats for the early life stages of aquatic ecology, including lithophilous fish, can arise due to the oxidation of sediment‐associated organic matter. Oxygen depletion associated with this component of river biogeochemical cycling, will, in part, depend on the sources of such material. A reconnaissance survey was therefore undertaken to assess the relative contributions from bed sediment‐associated organic matter sources potentially impacting on the River Axe Special Area of Conservation (SAC), in SW England. Source fingerprinting, including Monte Carlo uncertainty analysis, suggested that the relative frequency‐weighted average median source contributions ranged between 19% (uncertainty range 0–82%) and 64% (uncertainty range 0–99%) for farmyard manures or slurries, 4% (uncertainty range 0–49%) and 35% (uncertainty range 0–100%) for damaged road verges, 2% (uncertainty range 0–100%) and 68% (uncertainty range 0–100%) for decaying instream vegetation, and 2% (full uncertainty range 0–15%) and 6% (uncertainty range 0–48%) for human septic waste. A reconnaissance survey of sediment oxygen demand (SOD) along the channel designated as a SAC yielded a mean SOD5 of 4 mg O2 g−1 dry sediment and a corresponding SOD20 of 7 mg O2 g−1 dry sediment, compared with respective ranges of 1–15 and 2–30 mg O2 g−1 dry sediment, measured by the authors for a range of river types across the UK. The findings of the reconnaissance survey were used in an agency (SW region) catchment appraisal exercise for informing targeted management to help protect the SAC.
Some remaining challenges regarding multiple endpoints in clinical trials
Authors: Snapinn Steven
Published: June 2017

Despite recent advance in methods for handling multiple endpoints in clinical trials, some challenges remain. This paper discusses some of these challenges, including confusion surrounding the terminology used to describe the multiple endpoints, the justification for simultaneously testing for non‐inferiority and superiority in a non‐inferiority trial, lack of agreement on the situations under which multiple objectives do or do not lead to the need for a multiplicity correction, and choice of the most appropriate multiple comparisons procedure. In addition, this paper will discuss the position of the recent FDA draft guidance, Multiple Endpoints in Clinical Trials, on these issues. Copyright © 2017 John Wiley & Sons, Ltd.
Differential Treatment Response to Insulin Intensification Therapy: A Post Hoc Analysis of a Randomized Trial Comparing Premixed and Basal-Bolus Insulin Regimens
Authors: Shi Li Xin , Li Peng Fei , Hou Jia Ning
Published: June 2017

Introduction

Identification of subgroups of patients that may benefit most from certain treatment is important because individual treatment response varies due to multiple contributing factors. The present study used the subgroup identification based on the differential effect search (SIDES) algorithm to identify subgroups with different treatment responses to insulin intensification therapies.

Methods

This was a post hoc analysis of a 24-week, multicenter, open-label, randomized, parallel study comparing prandial premixed therapy (PPT) to basal-bolus therapy (BBT). Patients with type 2 diabetes mellitus were randomized to PPT (insulin lispro mix 50/50 thrice daily with meals) or BBT (glargine at bedtime plus mealtime insulin lispro) insulin intensification therapies. The SIDES algorithm was used to identify the subgroups from at-goal patients [glycated hemoglobin (HbA1c) <7.0% (53.0 mmol/mol) at the end of 24 weeks; n = 182] who could have benefitted from insulin intensification therapies.

Results

Baseline characteristics of overall at-goal patients were comparable between PPT and BBT groups. The SIDES algorithm identified patients with race other than Caucasian (i.e., African–American, Asian, and Hispanic) and baseline fasting blood glucose (FBG) <8.89 mmol/L as a subgroup that could respond better to PPT relative to BBT than the overall at-goal patient population. In this identified subgroup population, the HbA1c mean (standard deviation) changes from baseline to endpoint in PPT and BBT groups were −2.27 (0.88)% versus −2.05 (0.75)%; p = 0.40, respectively; while in the overall at-goal patients, the HbA1c changes were −2.17 (0.79)% versus −2.34 (1.00)%; p = 0.19, respectively.

Conclusions

The preliminary results showed that the subgroup of patients with race other than Caucasian and FBG <8.89 mmol/L may respond better to premixed intensification therapy. This result provides some preliminary information for further investigation in prospective studies.

Funding

Eli Lilly and Company.

Clinical Trial Registration

Clinicaltrials.gov ID number: NCT00110370.
The interplay of parental monitoring and socioeconomic status in predicting minor delinquency between and within adolescents
Authors: Rekker Roderik , Keijsers Loes , Branje Susan , Koot Hans , Meeus Wim
Published: June 2017

This six‐wave multi‐informant longitudinal study on Dutch adolescents (N = 824; age 12–18) examined the interplay of socioeconomic status with parental monitoring in predicting minor delinquency. Fixed‐effects negative binomial regression analyses revealed that this interplay is different within adolescents across time than between adolescents. Between individuals, parental solicitation and control were not significantly associated with delinquency after controlling for SES: Adolescents whose parents exercised more monitoring did not offend less than others. Within individuals, higher levels of parental control were unexpectedly associated with more delinquency, but this relation was dependent on SES: Low‐SES adolescents, but not high‐SES adolescents, offended more during periods in which their parents exercised more control than during other periods with less control. In contrast to earlier work, this finding suggests that monitoring could be least effective when needed most. Low‐SES parents might not use monitoring effectively and become overcontrolling when their child goes astray.
The Cost of Non-treatment
Authors: Knapp M.
Published: June 2017

There are large treatment gaps in relation to schizophrenia across all European countries, either because the illness is not recognised or because the response from treatment and care services is inadequate - not evidence-based. This could be because of resource or other constraints. The consequence can be very damaging indeed for individuals with schizophrenia, their families and for the wider society. In this talk I will set out the economic consequences of not identifying or responding appropriately to schizophrenia. Evidence will be drawn from a number of studies, but will be channelled to show new findings in relation to both England and Czech Republic. These figures add to the argument for earlier and better treatment, to benefit everybody including public and private budgets.

Disclosure of interest

The author has not supplied his declaration of competing interest.
Guidelines for Managing ADHD and Substance Use Disorders
Authors: Matthys F.
Published: June 2017

Guideline for managing ADHD and substance use disorders (SUD)

Frieda Matthys, MD, PhD.

Background

Despite the high prevalence of ADHD in adults with SUD and the availability of an approved guideline, under diagnosis and inadequate treatment still persist. This comorbidity associates with reduced treatment effectiveness, making successful treatment in adults with ADHD and SUD a challenge.

Methods

The guideline of 2010 for recognizing and treating adult ADHD in patients with SUD is updated in 2016, in cooperation with caregivers, of the addiction centers in Belgium and based on research literature and clinical experience. The english translation is discussed by an international group of clinicians and experts to result in a consensus statement via ICASA (International Collaboration on ADHD and Substance Abuse).

Results

This consensus presents a useful guide for the diagnosis and treatment of ADHD and SUD. Due to the lack of scientific evidence on some of the topics, the guide is a combination of evidence based and practice based recommendations.

Conclusion

The management of ADHD in patients with SUD remains a challenge. Diagnosis is complicated by SUD symptoms and by the skepticism associated with the recognition of ADHD in adults. The treatment is hampered by high relapse rates and reduced effectiveness of the currently available pharmacotherapies. Combining psycho-and pharmacotherapy in an integrated treatment that covers both ADHD and SUD, may help to keep these patients in treatment.

A Dutch manual for the integrated treatment of ADHD and SUD is being developed.

Disclosure of interest

Honorarium Lilly.

Advisory board Johnson&Johnson.
Permutations and Computational Power: A Molecular Cascade Analysis to Approach Big Data in Psychiatry
Authors: Drago A.
Published: June 2017

In the last few years, we conducted a number of molecular pathway analyses on the genetic samples provided by the NIMH. The molecular pathway approach accounts for the polygenic nature of the most part of psychiatric disorders. Nevertheless, the limits of this approach including the limited knowledge about the function of the genes, the fact that longer genes have higher probability to harbour variations significantly associated with the phenotype under analysis and the false positive associations for single variations, demand statistical control and bio-statistical knowledge. Permutations are a methodology to control for false positive associations, but their implementation requires that a number of criteria are taken into account: 1) the same number of genes and the same number of variations of the index pathway must be simulated in order to limit the bias of selecting significantly longer or shorter genes; 2) a sufficient number of permutated pathways is created (10E5 to 10E6 depending on computational resources) which demands higher computational power; 3) the correct statistical thresholds are identified and discussed; 4) some pathways might be over-represented and the source of information must be constantly updated. The tools for running a molecular pathway analysis (R Foundation for Statistical Computing, 2013) when interacting with a supercluster PC and the international bioinformatic datasets (Embase, NIMH and others), together with the critical steps of bioinformatics scripting (bash language) are described and discussed.

Disclosure of interest

The author has not supplied his declaration of competing interest.
Core Competencies for Health Professionals in Global Health
Authors: Dias M. Casanova , Ryland H.
Published: June 2017

Introduction

The world is becoming increasingly globalised and this has a major impact on the delivery of healthcare. Issues such as conflict, migration, climate change and technological advances all contribute to this. But are we equipped to deal with the challenges of Global Health?

Objectives

To discuss the core competencies that health professionals should have in Global Health.

Methods

The UK's Global Health Curriculum Group (GHCG), a group of healthcare professionals, was commissioned by the Academy of Medical Royal Colleges to lead a consultation on global health competencies. The consultation took the form of a modified Policy Delphi which involved an online survey and face-to-face and telephone interviews over three rounds. Over 250 stakeholders participated, including doctors, other health professionals, policymakers and members of the public from all continents of the world.

Results

This study demonstrated broad agreement that global health competence is essential for postgraduate doctors and other health professionals. It identified five core competencies, relevant to the UK and applicable to other parts of the world: (1) diversity, human rights and ethics; (2) environmental, social and economic determinants of health; (3) global epidemiology; (4) global health governance; and (5) health systems and health professionals.

Conclusions

This framework of five core competencies aims to equip psychiatrists and other doctors with the skills, knowledge and attitudes necessary to practice in a globalised world.

In the workshop we will harness the international nature of the delegates attending the congress to enable a lively debate about the meaning of global mental health and the skills psychiatrists need.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Auditory Cortex Characteristics in Early Onset Psychosis and its Associations with Auditory Hallucinations: A Structural MRI Study
Authors: Smelror R.E. , Lonning V. , Mørch-Johnsen L. , Nerland S. , Gurholt T. , Agartz I.
Published: June 2017

Introduction

Smaller auditory cortex volume in schizophrenia patients with auditory hallucinations (AH) may be a result of reduced cortical surface area and/or cortical thickness. A neuro–imaging study from our group demonstrated that adult schizophrenia spectrum patients with AH had significantly thinner cortex in the left side Heschl's gyrus (HG), compared to patients without AH, and healthy controls (HC).

Objectives

This study aims to investigate if adolescents with early-onset psychosis (EOP) and AH demonstrate thinner cortices in HG, as found in Mørch-Johnsen et al. in 2016, compared to EOP patients without AH, and HC.

Methods

EOP patients (schizophrenia spectrum, psychotic disorder not otherwise specified) (n = 29) underwent MRI. Mean volume, cortical thickness and surface area in auditory cortex regions (HG, superior temporal gyrus [STG]) were compared between patients with AH (n = 20) and without AH (n = 9), measured with item P3 from the Positive And Negative Syndrome Scale (PANSS), and 48 HC.

Results

Preliminary results show no significant differences between patients with and without AH and HC in mean volume, cortical thickness, or surface area in HG or STG. There were no significant side differences across hemispheres for these structures.

Conclusions

AH in EOP were not related to smaller volume, thinner cortex or reduced surface area in auditory cortex regions. To overcome the limitation of having a relatively small sample size, the sample will be expanded with other EOP cohorts. Investigations into HG structure variation in relation to AH in EOP will also be conducted.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Forensic care in Germany
Authors: Dressing H. , Salize H.J.
Published: June 2017

Although the idea that offenders suffering from a mental disorder must primarily be considered as ill and should therefore be exempted from punishment is of considerable antiquity legal frameworks and key concepts, which are applied in this field, differ widely in European Union member States. The respective legal regulations and epidemiological data of Germany will be presented.

In German penal law the question of the guilt of an offender is of central significance. Legal regulations on the placement and treatment of mentally ill offenders in a forensic psychiatric hospital are subsumed under the section “Measures on improvement and safety”. Section 63 of the German penal law provides for the temporally unlimited commitment to a forensic- psychiatric hospital.

In accordance with section 64 of the German penal law addicted offenders can be committed to a detoxification center for a period of up to two years. The available epidemiological data show a clear increase in the admissions to forensic psychiatric hospitals and to detoxification centers since beginnings of the 1990s. Recently the German parliament passed a new law. The aim of the new law is to strengthen patients’ rights and to diminish the number of forensic patients.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Psychiatric Training in Perinatal Mental Health Across European Countries
Authors: Casanova Dias M. , Sonmez E. , Baessler F. , Kanellopoulos A. , Naughton S. , Pinto Da Costa M. , Ryland H. , De Picker L.
Published: June 2017

Introduction

The aim of postgraduate psychiatric training is to prepare psychiatrists to practice independently. The quality of care provided will depend on the training they received. Pregnancy and childbirth (usually called the perinatal period) are a high-risk period for many women with psychiatric problems. An illness episode at that time can have a devastating effect on women and the whole family, including the child's development.

Objectives

To understand how perinatal mental health training is organized within Europe and how it fits in the training curricula.

Methods

The European Federation of Psychiatric Trainees conducts an annual survey of all member country organizations. We have asked respondents if they received training in perinatal psychiatry, whether that was optional or mandatory and what was its duration. Where training in perinatal psychiatry was not available we asked if they felt it should be.

Results

Data will be presented from the 35 countries that responded in the 2016 survey. Six countries reported that training in perinatal mental health is available. But it is mandatory in only one, with the others offering a mix of theoretical and practical optional training. Of the 29 countries that do not offer perinatal psychiatry training, the majority reported it should be offered and mandatory.

Conclusion

There is a gap in the expectations of psychiatrists treating women in pregnancy and after birth, and a widespread lack of training for them to be able to do so effectively.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Trauma and Migration in First Episode Psychosis
Authors: Tosato S. , Bonetto C. , Tarricone I. , Ruggeri M. , Tomassi S. , Morgan C. , Eugei G.
Published: June 2017

Introduction

Researches show that the period of migration, or the migration process itself, may confer an increased risk for psychosis. Some studies have addressed whether the high rates of psychosis found in migrants could be due to higher genetic or environmental risk factors. Facing severe or chronic stress such as trauma, social isolation, low socio-economic status, late-life social adversity may result in long term, sometimes permanent, alterations of the biological stress response system, leading to the onset of psychosis.

Objectives

This study aims to examine, in a large sample of first episode psychosis patients, whether negative social experiences like stressful life events and difficulties, trauma and isolation have significantly higher frequencies in migrants with respect to natives.

Methods

The present study is conducted within the framework of the EUGEI (European Network of National Schizophrenia Networks Studying Gene Environment Interactions) study, a Europe-wide incidence and case–control study of psychosis conducted in 12 centers chosen to include areas with large first and subsequent generation migrant populations.

Data about age, gender, migration history, trauma, life events, ethnicity, social class and family history of mental disorders have been collected.

Results

Preliminary data on the relationship between trauma and migration in first episode psychosis will be presented.

Conclusions

Since migration is an important stressful life event, and difficulties in integration in host countries may remain chronic, it is important to identify in each context the most vulnerable minority groups in order to implement targeted prevention interventions.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Migration History and the Onset of Psychotic Disorders
Authors: Tarricone I. , Lastrina O. , Tosato S. , Di Forti M. , Murray R.M. , Domenico B. , Morgan C.
Published: June 2017

Introduction

Research has established that there are high rates of first episode psychosis (FEP) in immigrant populations. These findings could indicate that socio-environmental risk factors, such as individual social class, social capital, early trauma, life events, neighborhood deprivation could be relevant in explaining the differences in incidence rates observed between migrants and natives, following the socio-developmental model of Morgan et al. (2010). Some preliminary results also indicate that migration history itself versus ethnicity could implicate higher risk of the onset of psychotic disorders.

Aims

To present preliminary findings from the EUGEI European Network of National Schizophrenia Networks Studying Gene Environment Interactions study.

Methods

Population based FEP incidence/case control study. Comparison of the incidence rate of FEP and of the distribution of several risk factors (e.g. substance abuse, neighborhood deprivation, urbanicity and trauma) in natives and migrants in different countries across Europe.

Results

Preliminary results of the EUGEI study will be discussed in comparison with previous evidences.

Conclusion

The EUGEI study allows a deeper understanding of the excess of FEP found among migrants in Europe.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
The Evolution of Negative Symptom Constructs
Authors: Mucci A. , Galderisi S.
Published: June 2017

Introduction

Negative symptoms represent a separate dimension of schizophrenia psychopathology, distinct from positive symptoms, disorganization and cognitive impairment. It is increasingly acknowledged that negative symptoms are associated with poor functional outcome and represent an unmet need in schizophrenia treatment. Improvement in definition of their phenomenology, assessment instruments and experimental models are needed in order to improve schizophrenia prognosis.

Aims

The presentation will review key aspects of the evolution of negative symptom constructs. In particular, findings concerning phenomenology, clinical assessment, association with functional outcome and brain imaging correlates will be presented.

Methods

We searched PubMed for English full-text publications with the keywords

Schizophrenia AND “negative symptoms”/“primary negative symptoms”/“deficit schizophrenia”/“persistent negative symptoms”/“affective flattening”/alogia/“expressive deficit”/apathy/asociality/“social withdrawal”/anhedonia/“anticipatory anhedonia”/avolition/neuroimaging.

Results

The distinction between secondary negative symptoms (i.e., those due to identifiable factors, such as drug effects, psychotic symptoms or depression), and primary or persistent negative symptoms (i.e., those etiologically related to the core pathophysiology of schizophrenia) is grounded on solid research evidence and might have major implications for both treatment development and clinical care. The evidence that negative symptoms cluster in motivation- and expressive-related domains is founded on large consensus and empirical evidence and will foster pathophysiological modeling. The motivation-related domain is a stronger predictor of functional outcome than the expressive one.

Conclusions

An improved definition and assessment of negative symptoms needs to translate in large-scale studies to advance knowledge. In the short-term, the improved identification of treatable causes of secondary negative symptoms can translate into better care for people with schizophrenia.

Disclosure of interest

AM received honoraria or advisory board/consulting fees from the following companies: Janssen Pharmaceuticals, Otsuka, Pfizer and Pierre Fabre.

SG received honoraria or advisory board/consulting fees from the following companies: Lundbeck, Janssen Pharmaceuticals, Hoffman-La Roche, Angelini-Acraf, Otsuka, Pierre Fabre and Gedeon-Richter.
Helping Abused Children from Various Minorities in the Greek Context
Authors: Kanellopoulos A. , Dionysopoulou K. , Antoniou X. , Marini E. , Nikolaidis G.
Published: June 2017

Introduction

Children's abuse and neglect is widely studied as a major risk factor for emotional and behavioural disorders, various somatic and psychiatric problems during adulthood.

Objective

Mental health is fundamental to health. Mental illnesses are real, disabling conditions affecting all populations regardless of race or ethnicity but disparities in mental health services exist for racial and ethnic minorities, and thus, mental illnesses exact a greater toll on their overall health and productivity.

Aim

The most important aim when working with ethnic minorities is to better understand the roles of culture, race and ethnicity, and overcome obstacles that would keep anyone with mental health problems from seeking or receiving effective treatment.

Methods

The Day Centre “The House of the Child” is a community unit which provides customized clinical mental health services for therapeutic treatment and psychosocial rehabilitation of children victims of abuse, neglect or domestic violence. The Day Centre was founded by the non-profit voluntary organization “THE SMILE OF THE CHILD”. The services are based on the bio-psycho-social model approach and treatment, which aim at early detection, and treatment of possible mental disorders and the overall psychosocial rehabilitation of victims of abuse/neglect and the support of their carers.

Results

By identifying the many barriers to quality care faced by racial and ethnic minorities, the Day Center provides mental health services also to children who come from minority populations.

Conclusions

Different case studies highlight challenges and various levels of difficulties in this specific scheme of cooperation aiming to open an interesting dialogue on the topic.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Evidence-based Medicine - A Critical Review
Authors: Gaebe W.
Published: June 2017

Evidence-based medicine is a method to establish best practice recommendations based on graded recommendations for diagnostic and therapeutic issues in health care. In mental healthcare, evidence-based medicine has shown that the therapeutic procedures are efficient and can help to not only ameliorate the symptoms of mental disorders, but also to improve the quality of life of those affected by mental disorders. Evidence-based medicine is not, however, cookbook medicine. While evidence is mostly generated in larger group trials and should be applicable to the majority of cases, aspects of the personal situation, social support systems and legal boundaries all affect mental healthcare and may modulate the interpretation of the findings of evidence-based medicine. A human-based psychiatry will therefore need to use the methods of evidence-based medicine as a basis for diagnostic and therapeutic recommendations, but will also need to extend into the acknowledgements of personal accounts, traditions and the cultural framework, in which mental healthcare is provided. This presentation will highlight some of the issues associated with the questions of the roles of evidence-based medicine in mental healthcare, and in a human-based approach towards mental healthcare.

Disclosure of interest

Unterstützung bei Symposien/Symposia Support.

Janssen-Cilag GmbH, Neuss.

Aristo Pharma GmbH, Berlin.

Lilly Deutschland GmbH, Bad Homburg.

Servier Deutschland GmbH, München.

Fakultätsmitglied/Faculty Member.

Lundbeck International Neuroscience Foundation (LINF), Dänemark.
Psychosis and Schizencephaly – A Case Report and Systematic Review
Authors: Gunturu S. , Schmalz L. , Zebelian J. , Gonzalez L. , Drazinic C. , Korenis P.
Published: June 2017

Psychotic symptoms have been reported in association with a wide array of brain abnormalities. Few published reports have examined the association between schizencephaly and psychiatric illness. Originally defined by Wilmarth and later by Yakolev and Wadsworth – Schizencephaly is an uncommon congenital disorder of cerebral cortical development, defined as a grey matter-lined cleft extending from the pial surface to the ventricle. The nosology is based on neuroradiologic findings and confirmed by neuropathology when available. The Clinical presentation and neurodevelopmental outcomes of the disorder vary and are usually related to the extent/areas of the brain involved. In this article we review the medical literature around Schizencephaly paying particular attention to the pathophysiology, etiology and diagnosis of such patients. We then present a case of Schizencephaly and first episode psychosis in a 16-year-old adolescent who was admitted to our inpatient psychiatric service. Lastly, we present the findings of a systematic review from PubMed whereby we summarize 10 cases of Schizencephaly with associated psychiatric symptoms.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Glutamatergic Synaptic Plasticity in the Periaqueductal Gray Governs Fear-induced Depression-like Behavior in Rats
Authors: Ho Y.C. , Hsieh M.C. , Lai C.Y. , Peng H.Y.
Published: June 2017

Introduction

Major depressive disorder affecting more than 110 million people worldwide every year is a heterogeneous illness influenced by a variety of factors, including repeated stressful factors. Despite widely research during the past several decades, the pathophysiology and neurobiological mechanisms of depressive disorders remain unclear. Ventrolateral periaqueductal gray (vlPAG), a midbrain nucleus, has been considered as an important part of the circuitry that involves in stress-induced depression-like behaviors. Dysregulation of glutamatergic neurotransmission in depressed patients suggests that glutamate-mediated excitatory system is critical involved in the depressive disorders.

Objectives

It is still unclear that whether vlPAG involves in fear condition-elicited depression-like behavior.

Aims

We investigated the synaptic transmission in the vlPAG to examine whether vlPAG participates in fear-induced depression-like behavior in rats.

Methods

Depression-like behaviors, in the rats, were induced by learned helplessness procedure. The synaptic transmission was conducted by whole-cell patch-clamp recording in the rat brain slices containing periaqueductal gray.

Results

Rats receiving learned helplessness procedure displayed high failure rate in the escapable foot-shock test compared to control group. Both amplitude and frequency of miniature excitatory postsynaptic currents were significant reduced compared to control group, suggesting reduced presynaptic glutamate release and postsynaptic responses were involved in the learned helplessness procedure-induced depression behavior in rats.

Conclusions

Reduced glutamatergic transmission in the vlPAG contributes to learned helplessness procedure-induced depression-like behavior in rats through pre – and post-synaptic mechanisms.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Plastic Surgery Treatment of Post-bariatric Patients Cannot Remain “brainless”
Authors: Pavan C. , Vindigni V. , Vallesi A.
Published: June 2017

Introduction

The aim of this study was to investigate the presence of executive difficulties due to a lack of the management of cognitive conflict, inhibition, and cognitive flexibility in this group of patients. If executive difficulties are at the basis of uncontrolled alimentary behavior, these will be present also after a dramatic weight loss and could led to a poor compliance of the patient after plastic surgery procedures.

Materials and methods

We enrolled 21 consecutive post-bariatric patients. This clinical population was compared with a control group (n = 21) from the general population sharing the same clinical and demographic features. Psychiatric evaluation was performed. Executive difficulties were investigated through electroencephalography using the stroop task, sustained attention to response task, and task switching tests.

Results

The patient group reported more frequently psychiatric disorders than control group. Patients had higher prevalence of lifetime major depression (58.3% vs. 14.3%), of lifetime panic disorder (36.1% vs. 4.8%) and generalized anxiety disorder (16.75% vs. 0%). Finally, patients were more frequently affected by body dismorphic disorder (chi2 = 8.867, P = .003). Electroencephalography confirmed the presence of executive difficulties sustained by a lack of the control of cognitive conflict and cognitive flexibility, and a difficulty of the inhibitory control in the patient group.

Conclusion

Electroencephalography confirmed for the first time the high prevalence of psychological/psychiatric problems in post-bariatric patients. Patients showing high values of executive difficulties will need a psychological/psychiatric support to sustain a positive outcome after post-bariatric plastic surgery.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Knowledge Takes up Space, a Family Affair
Authors: Garcia Ayala L. , Gomez Revuelta M. , Martin Requena C. , Juncal Ruiz M. , Olivares O. Porta , Garcia de Acilu E. Saez de Adana , Itoiz A. Aranzabal , Hernandez B. Gonzalez , Laborde Zufiaurre M. , Lopez Peña M.P. , Nuñez Morales N. , Zubia Martin M. , Gonzalez-Pinto Arrillaga A.M.
Published: June 2017

Introduction

Previous research suggests that hoarding aggregates in families and is associated with health, safety risks and family problems. Hoarding symptoms appear to be more common among first-degree relatives of people who hoard. A predominance of shared hoarding disorder has been observed among female relatives.

Objectives

We present an atypical case report describing hoarding symptoms among first-degree male relatives who present two different subtypes of hoarding disorder.

Materials and methods

We report the case of a 38 years old male patient, attended for the first time by the mental health services at the age of 22, and being diagnosed of severe OCD at that moment. In the home visit paid by the social services, an excessive object hoarding was observed, including the presence of over 40,000 books.

Moreover, they found a 38 years old man looking severely deteriorated; when they ask him about it, the patient's father admits to having been isolated in the house for almost 14 years. Hoarding history was gathered, through the acquisition of various objects by the patient's father, dating back to over 30 years ago.

Discussion

The harmonic coexistence for over a decade between two patients affected with a hoarding disorder with two different clinical setting subtypes was only made possible by the complementary nature of their symptoms.

Conclusion

The hoarding disorders amongst more than one person living under the same roof are uncommon, can present themselves in both genders and can exhibit different symptoms.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
About a case suicide attempt as a trigger of remission in obsessive and compulsive disorder
Authors: Garcés J.M. Got. , Lopez R. García , Segovia A. Porras , Negro J.E. Muñoz , Jiménez J. García , Rojas L. Gutierrez
Published: June 2017

Introduction

This is the case of a 73 year old woman with a late onset, severe and refractory obsessive-compulsive disorder who experimented a sudden remission after a frustrated suicide attempt.

Objective

Our target is to make a reflection about the relation between traumatic closeness to own death and neurosis spontaneous remission.

Method

Patient has been interviewed and her medical record studied.

Results

Patient's psychiatric history shows major depressive disorder, recurrent (ICD 10 CM-F33). Patient is a housewife with primary education. In her psychobiography distinguish a conflictive relationship which probably acted as a trigger for obsessive-compulsive symptoms. These symptoms include obsessive thoughts of contamination, ritual hand washing and avoid contact with others people. In the course of the last 10 years, since the OCD (ICD 10 CM-F42.2) diagnose, the patient has been through a wide therapeutic arsenal, from cognitive-behavioural psychotherapeutic interventions to psychopharmacological treatment, resulting with limited effectiveness. The last treatment was fluoxetine 200 mg (0–0–1) and pregabalin 300 mg (1–0–1). Subsequently, the patient underwent a failed suicide attempt by hanging. After physical recovery, all OCD symptoms had subsided.

Conclusions

Traditionally, literature and philosophy considered catharsis as a purifying experience, and Breuer and Freud introduced this concept in modern psychology as a therapeutic method. More recent authors as Yalom have correlated the closeness to death as a stress factor with radical change in life's perspective and attitude. Although current research presents contradicting data about healing effectiveness through a catharsis processes, this case exposes a clear example of positive outcomes in this assumption.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Neuroleptic-induced Parkinsonism in Patient with Obsessive Compulsive Disorder: A Case Report
Authors: Nunes J. , Brigadeiro D. , Andrade J. , Costa A. Pissarra da
Published: June 2017

Obsessive-compulsive disorder (OCD) is a neuropsychiatric disorder characterized by either obsessions (recurrent unwanted thoughts, images or impulses) or compulsions (repetitive behaviors often performed to relieve anxiety or distress). In some cases, it is considered antipsychotic enhancement. However, in high doses, it can exacerbate OCD symptoms and cause extrapyramidal effects such as neuroleptic-induced Parkinsonism.

Here, the authors present a clinic case of a single male patient with 50 years old, in which with the age of 42, started with a obsessive-compulsive framework about the developed task at the work place (production of fabric) followed by several verifications of the assembled pieces, which interfered with his work performance. This patient was admitted to the psychiatric hospital due to the deterioration of the symptoms with obsessive ideas of HIV contamination resulting in rigid cleaning rituals. He was medicated with several OCD medications including Clozapine 50 mg.

In the following years and complaining of insomnia, the clozapine dose was increased by the patient reaching the dose of 200 mg. In 2016 he started secondary Parkinsonism framework to antipsychotics, characterized by akinesia, facial hypomimia, stiff, coarse tremor and stooped posture. Therapeutic setting was made with a reduction of clozapine at doses of 50 mg occurring fading of extrapyramidal symptoms and decrease the symptoms of OCD.

The authors intend with this presented case to highlight the importance of surveillance of patients receiving antipsychotics for OCD to avoid worsening of symptoms and the development of extrapyramidal effects, which deeply contribute to the decrease of quality life of these patients.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Visual Hallucinations in Elderly People: Early Dementia, Psychosis or Charles Bonnet Syndrome? Review and Case Report
Authors: García Moreno M. , De Cos Milas A. , Poza Cano B. , Beatobe Carreño L.
Published: June 2017

Introduction

Charles Bonnet Syndrome (CBS) is an uncommon disease that involves visual hallucinations in visually impaired individuals, in absence of cognitive impairment or psychiatric illness, although some authors propose CBS as an early maker of dementia.

Objectives

Show the importance of differential diagnosis in individuals with presence of visual hallucinations, with distinction of CBS from others psychiatric or organic disorders such as hypnogogic and hypnopompic hallucinations, epileptic phenomenon, Parkinson disease, dementia, delirum tremens or late-onset psychosis.

Methods

Literature review about visual hallucinations in people with psychiatric illness, dementia or in absence of these status, followed by a case report of a patient who met criteria for CBS.

Results

Eighty one-years-old female with no previous psychiatric illness, experience suddenly visual hallucinations (animals, insects) with secondary anxiety, fear and insomnia as well as disruptive behaviour (throw lye to kill the animals) and delusional interpretations of the hallucinations considering them as a divine proof. Clinical exam, neuroimaging tests and SPECT confirmed just a minimal cognitive impairment nor suggestive of dementia. She had personal history of cataracts and macular degeneration, with no other medical condition. Olanzapine was prescribed but it was withdrew because of adverse effects. Later, haloperidol was introduced with well tolerance and symptom's recovery ad integrum.

Conclusions

Charles Bonnet syndrome is a rare condition that may sometimes be the beginning of a dementia. Medical evaluation and complementary tests help differential diagnosis in order to reject others psychiatric/somatic disorders. Neuroleptic and anti-epileptic treatment should be useful to control symptoms.

Disclosure of interest

The authors have not supplied their declaration of competing interest.