bluuebunny/crossref_metadata_2025 huggingface dataset:
Validation of the Arabic Version of the Oxford Happiness Inventory Among Undergraduates in Kuwait
Authors: Alansari B. , AlAli T.
Published: June 2017

Introduction

The Oxford Happiness Inventory (OHI) 29-Item, each involving the selection of four options that are different for each item. Although there is an Arabic version, it is not identical to the original version in terms of the number of items and response.

Objectives

to evaluate the psychometric properties of the Arabic adaptation OHI and its factorial structure in undergraduate sample.

Methods

The participants were 720 first year undergraduate Kuwaitis: 360 males mean age = 20.38 ± 1.60 and 360 females; mean age = 19.71 ± 1.39 (t = 5.87, P < 0.001). The Arabic version of OHI (Argyle, Martin, & Crossland) was administered to participants. The internal consistency reliability, factor structure, and convergent validity of the OHI with Life Orientation Test (LOT-R, Adult Hope Scale (AHS), Satisfaction With Life Scale (SWLS) were assessed as well as divergent validity of the OHI with Beck Depression Inventory-II (BDI-II)

Results

Internal consistency was satisfactory for the OHI (Cronbach's alpha = 0.87) for males and (Cronbach's alpha = 0.86) for females. The results revealed no significant gender differences on happiness (F = 1.77, P > 05). Principal component analyses (PCA) showed that a seven-component solution explains %50.50 of the total variance for males and 51.47% for females. The OHI positively correlates with the following variables: SWLS (r = .52), LOT-R (r = 0.56) AHS (r = .48) while the OHI correlates negatively with BDI-II (r = -54).

Conclusions

Findings confirm that the OHI provides satisfactory validation, and thus it can be recommended as a measure of happiness among Arab samples.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Effectiveness of Psychoanalysis and Long-term Psychodynamic Psychotherapy 10 Years After Start of Treatment
Authors: Lindfors O. , Knekt P. , Lehtonen J. , Virtala E.
Published: June 2017

Introduction

The evidence of potentially greater long-term benefits of psychoanalysis (PA) in comparison to long-term psychodynamic psychotherapy (LPP) is scarce.

Aims

This study aimed to compare the effectiveness of PA and LPP on different aspects of functioning and wellbeing during a 10-year follow-up from the beginning of the treatments.

Methods

Altogether 169 patients were included in the study: 41 patients self-selected for PA and 128 patients assigned to LPP in the Helsinki Psychotherapy Study. The eligible patients were 20–45 years of age and had a long-standing anxiety or mood disorder causing work dysfunction. Potential confounding factors were assessed at baseline and acknowledged in analyzing outcomes in personality (LPO, IIP-64, DSQ, SASB) and social functioning (SAS-SR, SOC, Perceived competence, LSS), psychiatric diagnoses (DSM-IV), symptoms (SCL-90, HDRS, HARS), work ability (SAS-work, WAI, PPF, GAF, work status), and remission, including the use of additional psychiatric treatment, measured 5 to 14 times during the 10-year follow-up.

Results

From the 5-year to the 7-year follow-up personality and social functioning improved significantly more in the PA than in the LPP group. In the domain of psychiatric symptoms and work ability practically no differences were found beyond the 5-year follow-up and at the final 10-year measurement, when psychiatric and work status was relatively good in both treatment groups.

Conclusions

PA may give additional benefits especially when personality-related long-term aims are essential and less intensive treatments are not considered to be sufficient.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Effectiveness of Treatment of Young Psychotic Patients on Psychotherapeutic Inpatient Unit
Authors: Restek-Petrovic B. , Bogovic A. , Majda G. , Nina M. , Igor F.
Published: June 2017

Introduction

The psychotherapeutic unit for psychotic patients in Psychiatric hospital Sveti Ivan, Zagreb, Croatia provides psychotherapeutic and psychosocial treatment for mostly young psychotic patients. Psychotherapeutic program has basically psychodynamic frame and patients participate in small and medium groups. Also, they participate in workshops based on cognitive behavioral principles (anti-stigma, self-concept, emotion, relationships, goals, stress), psycho-education, therapeutic community, work and occupational therapy, recreational therapy.

Aim

The aim of this study was to determine effectiveness of this comprehensive program during hospitalization of individuals with first psychotic episode on psychotherapeutic ward. We evaluated the possible changes during treatment in attitudes towards drugs, in quality of life, insight and self-esteem.

Methods

Participants were 37 individuals with first psychotic episode, average age: 25.1. They fulfilled: Drug attitude inventory (DAI-10), The World Health Organization Quality of Life (WHOQOL), Insight scale and Rosenberg's Self-Esteem Scale at the beginning of treatment and at discharge from the hospital.

Results

Results show tendency of more positive attitude towards drugs at discharge, as well as tendency of better self-esteem, statistically significant more satisfaction with physical health (P = 0.004), psychological health (P = 0.004) and with environment (P = 0.001), and statistically significant better quality of life (P = 0.000). There was no significant difference in insight.

Conclusion

During psychotherapeutic treatment of individuals with first psychotic episode, positive changes were observed. So, our findings indicate importance of implementing such a comprehensive program in treatment.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Relationship Between Self-reported and Clinician-rated Psychopathology in Youth Psychiatric Outpatients
Authors: Silva Ribeiro J. , Morais S. , Oliveira P. , Mendes E. , Botelho A. , Godinho H. , Vale L. , Bessa A. , Renca P. , Santos V. , Madeira N.
Published: June 2017

Introduction

Psychopathology rating scales have been widely used. Studies evaluating the congruence between self and observer-reported ratings show inconsistent results.

Objectives or aims

Determine whether there was consistency between psychopathology as assessed by patients and clinicians’ assessment in outpatients observed in the Young Adult Unit of our Psychiatry Department (Coimbra Hospital and University Centre-Portugal).

Methods

Socio-demographic characterization was undertaken with young adult outpatients observed during nineteen months (1st January 2015–31st July 2016). Brief Symptom Inventory–53 items (BSI-53) and Brief Psychiatric Rating Scale (BPRS) were applied at the first clinical evaluation. Spearman correlation coefficient between General Severity Index (GSI) of BSI-53 and BPRS total score was calculated.

Results

During the mentioned interval 255 outpatients were observed: 64.3% females and 35.7% males; aged between 17 and 39 years old (average: 20.56; median: 20). Fifty percent were diagnosed with neurotic, stress-related and somatoform disorders (ICD-10 F40-48) and 14.1% with mood disorders (ICD-10 F30-39). BPRS and BSI-53 rating scales were administered to 55 patients: 72.5% females and 27.5% males; average age 21.2. A statistical significant correlation was found between BPRS total and GSI score.

Conclusions

Several factors can determine the accuracy of psychopathology self-assessment, including diagnosis and severity of illness. In fact, studies show strong correlation between self and observer assessment of depressive and anxious psychopathology, but no correlation in psychotic psychopathological dimensions. Therefore, the correlation found in this population can be explained by the fact that the majority of patients were diagnosed with neurotic, stress-related and somatoform and mood disorders.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Estradiol Production Suppressed by Prolactin in at-risk Mental State and First Episode Psychosis Female Patients? Preliminary Results
Authors: Ittig S. , Studerus E. , Heitz U. , Menghini-Müller S. , Egloff L. , Beck K. , Leanza L. , Andreou C. , Riecher-Rössler A.
Published: June 2017

Introduction

Clinical, epidemiological and basic research studies have confirmed that estradiol can have protective effects in schizophrenic psychoses. At the same time many patients with schizophrenic psychoses – even antipsychotic naïve at-risk mental state (ARMS) patients show hyperprolactinemia and gonadal dysfunction with estrogen deficiency in women and possibly testosterone deficiency in men.

Aim

To investigate the relation between the stress hormone prolactin and the sex hormones estradiol in women and testosterone in men in emerging psychosis.

Methods

Forty-seven antipsychotic-naïve ARMS (38 men and 9 women) and 17 antipsychotic-naive first episode psychosis (FEP) (14 men and 3 women) patients were recruited via the Basel Früherkennung von Psychosen (FePsy) study. Blood was taken under standardized conditions between 8 and 10 am after an overnight fast and 30 minutes of rest. We performed a linear regression model to evaluate the association between prolactin and sex hormones including age and current antidepressant use as covariates.

Results

In women, estradiol was negatively associated with prolactin (β = −1.28, P = 0.01) whereas in men there was a positive association of testosterone with prolactin (β = 0.52, P = 0.031).

Conclusion

The often observed estrogen deficiency in women with psychosis could therefore be explained by the stress hormone prolactin suppressing the gonadal axis already in very early untreated stages of the emerging disease.

In ARMS or FEP men prolactin does not seem to influence the gonadal axis in the same way as in women.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Association Between Prolactin Gene Polymorphism (–1149 G/T) and Hyperprolactinemia in Anti-psychotic Treated Patients with Schizophrenia
Authors: Ivanova S. , Osmanova D. , Boiko A. , Pozhidaev I. , Fedorenko O. , Kornetova E. , Semke A. , Bokhan N. , Wilffert B. , Loonen A.
Published: June 2017

Hyperprolactinemia (HPRL) is a classical side effect of anti-psychotic drugs. Extrapituitary prolactin (PRL) production is regulated by an alternative promoter, which contains the functional single nucleotide polymorphism – 1149 G/T (rs134,1239) in prolactin gene. We examined whether this polymorphism is associated with hyperprolactinemia in patients with schizophrenia. The experimental group comprised 443 patients with schizophrenia. The control group comprised 126 healthy persons. The PRL concentration was measured in serum using the AccuBind ELISA Microwells kit. The functional polymorphism – 1149 G/T (rs134,1239) of the PRL gene was genotyped using the The MassARRAY® system. Genotype and allele frequencies were compared using χ2 test. A total of 227 patients suffered from HPRL (98 males/129 females) according to the criteria of hyperprolactinemia. The frequency of genotypes and alleles in patients with schizophrenia did not differ from those in control subjects. A comparison between patients with schizophrenia with and without hyperprolactinemia revealed that the frequency of G allele in patients with hyperprolactinemia is significantly higher than in patients without hyperprolactinemia (χ2 = 7.25; P = 0.007; OR = 1.44 [1.10–1.89]). Accordingly, the genotype GG was found to be more often in patients with hyperprolactinemia than without it (χ2 = 9.49; P = 0.009). A significant association of the polymorphic variant rs134,1239 with the development of hyperprolactinemia in patients with schizophrenia treated with anti-psychotic drugs was revealed. Therefore, the serum concentration of prolactin in anti-psychotic treatment patients with schizophrenia may also give an indication of the activity of gene regulating extrapituitary prolactin expression.

The study was supported by the Russian Science Foundation, Grant 14-35-00023.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Relationships Between Smoking, Psychopathology and Medication Outside Effects in Schizophrenia
Authors: Ghanmi L. , Zitoun K. , Zouari L. , Maalej M.
Published: June 2017

Aim

To determine the relationship between smoking status and clinical characteristics of schizophrenic patients.

Methods

It was a cross-sectional study. One hundred and seventy-five schizophrenic outpatients were assessed by the Positive And Negative Syndrome Scale (PANSS), the Global Assessment of Functioning Scale (GAF), the scale of measurement of abnormal involuntary movements (AIMS) and by the rating scale akathisia caused by a drug Thomas Barnes. Current smokers (n = 85) were compared to non-smokers (n = 90) on clinical variables.

Results

The mean number of cigarettes was 15 cig/day. In our sample, current smokers account for half of the patients and were exclusively men. Smokers were significantly more single patients (76.5 vs. 58.9, P = 0.01). There were no significant differences between smokers and non-smokers regarding clinical variables, including age of onset of the disease, the duration of the disease, the severity of positive and negative symptoms, and GAF scores. Smoking was significantly associated with more frequent prescription of conventional neuroleptics (98.8 vs. 92%, P = 0.03) and poorer adherence to treatment (77 vs. 62.2%, P = 0.02). There were no significant differences between the 2 groups regarding the average doses of neuroleptics, the presence of extrapyramidal signs, scores on the AIMS score and akathisia.

Conclusion

Smoking is common in patients suffering from schizophrenia. Smoking status should be considered in the assessment of neuroleptic treatment in schizophrenia.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Medical Comorbidity in Schizophrenia
Authors: Pestana Santos A. , Amílcar Teixeira J.
Published: June 2017

People with schizophrenia have higher prevalence of physical disease and its lifespan is shortened when compared with general population. On average, they die 10 to 25 years earlier than general population.

Aim

The authors aim to identify the main comorbidities in people with schizophrenia and define strategies to prevent it.

Methods

Literature review on Medline database.

Results

People with schizophrenia have higher risk to have hepatitis, cardiovascular diseases, diabetes, overweight, sexual dysfunction and obstetric complications. This high vulnerability is associated with higher rates of preventable risk factors, such as smoking, alcohol consumption, use of street drugs, poor dietary habits and lack of exercise. Moreover, some antipsychotic medications used to treat schizophrenia have been associated with higher incidence of physical disease. At last, there are risk factors attributable to patients and healthcare services. Psychiatrists are often not trained in detection and treatment of physical disease. Despite this, there are several attitudes that can reduce the associated morbidity and mortality in people with schizophrenia, such as improving access to healthcare services, integrated healthcare interventions to enable early diagnosis and promotion of healthy habits.

Conclusions

Diagnosis and management of morbidity in people with schizophrenia are more difficult because obstacles related to the patient, the illness, the medical attitudes and the structure of the healthcare services. Regardless these difficulties, the increased frequency of physical disease in people with schizophrenia must be valued due to improved detection and treatment of medical disease will have significant benefits for their psychosocial function and overall quality of life.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Investigation of Food Addiction and Impulsivity Relations Biological Rhythms Differences and Insomnia in University Students
Authors: Kandeger A. , Selvi Y.
Published: June 2017

Objective

Increasing prevalence of obesity in the world and increasing role of processed foods in daily life has led to become the focal point of food addiction. This study aims to investigation of food addiction and impulsivity relations biological rhythms differences and insomnia in university students.

Method

One thousand and five hundred students planned to participate who studies in Konya Selcuk University central campus. Participants were to fill out the test during their classes under physician supervision. The volunteers completed a package of psychological instruments including the Morningness–Eveningness Questionnaire, Yale Food Addiction Scale, Insomnia Severity Index, and Barratt Impulsiveness Scale administered by two investigators in their classrooms.

Results

In total, 1323 forms were suitable for statistical analysis. The mean age was 20.83, mean BMI was 22.02. Food addiction prevalence was 18.2%. Our study showed that association between the eveningness type and food addiction (P < 0.045). Also, the eveningness type and insomnia were in positive correlation in impulsivity (P < 0.001).

Conclusion

This study has explored the association between eveningness type of biological rhythms, food addiction, insomnia and impulsivity.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Impulsivity as a Risk Factor for Suicidality in Depressed Patients
Authors: Hambrich M. , Nemes B. , Soare R. , Cozman D.
Published: June 2017

Introduction

Suicide behavior is an important and preventable cause of injury, disability and death in the world, and, at the same time, a major economic and social burden for modern societies. The majority of suicide attempts and completions are associated with psychiatric disorders, especially major depressive episode. Impulsivity has been associated with suicidality in major depressive disorder patients.

Aim

The current study aims to evaluate impulsivity in major depressive disorder patients with a history of suicide attempts as compared to major depressive disorder patients without a history of suicide attempts.

Methods

One hundred and twelve patients with major depressive disorder, aged 51.91 ± 10.72 (70% females) were included through convenient sampling procedure from the patient population of the 3rd Psychiatry Clinic of the Cluj County Emergency Hospital. Impulsivity was assessed through Barratt Impulsiveness Scale (BIS-11).

Results

In total, 27.8% of the patients had a history of suicide attempts. Significant differences between the two groups were obtained only for the Perseverance subscale of the BIS-11. (12.7 ± 1.8 vs. 7.13 ± 2.1, P = 0.005–Mann Whitney U-test).

Conclusions

Perseverance might be a discriminating element between patients that eventually commit a suicide attempt and those that do not.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Working Hours of United Kingdom Psychiatric Trainees: Findings From the BoSS Study
Authors: Beezhold J.N. , Beezhold K. , Lydall G. , Malik A. , Podlesek A. , Jovanovic N.
Published: June 2017

Introduction

The international burnout syndrome study (BoSS) examined burnout in psychiatry trainees and associated factors. Long working hours were significantly associated with burnout.

Aims

A high rate of severe burnout in UK psychiatric trainees (38%) was found in the BoSS study. This paper looks at the working hours of UK trainees.

Methods

Data collected during the BoSS study included information related to working hours, looking in particular at the working time directive rules. A total of 3964 UK psychiatric trainees were invited to take part, of which 1187 (30%) responded, and 811 (20%) provided complete responses for working hours questions.

Results

The mean age was 33 years, with 49.1% males and equal gender distribution of participants and non-participants. The mean hours of contracted work per week were 42.7 (42.2–43.2) for men, versus 41.1 (40.4–42.0) for women. Actual hours worked were significantly higher at 46.2 (45.0–47.4) for men and 46.0 (44.9–47.1) for women. Forty-six percent of trainees breached one or more working time directive (WTD) safety limits.

Conclusion

Actual hours worked among psychiatric trainees in the United Kingdom are about 10% higher than contracted hours. Female trainees also work more uncontracted hours than male trainees. This is significant when considering the association between hours of work and burnout, and also adds to the perception that women have to work harder for the same recognition as men. Forty-six percent of trainees breached WTD limits.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
How Satisfied are Patients with Interprofessional Teams? Meta-analysis of a Pilot Study
Authors: Lazzari C. , Masiello I.
Published: June 2017

Introduction

A doctor–patient encounter is a dyadic interaction between two people, one needing help and the other providing it. However, the encounter between an interprofessional team and a patient is changing this picture.

Objectives

To measure how patient satisfaction changes when patients are treated by an interprofessional team.

Aims

Ecological momentary assessment (EMA) directly evaluates patient satisfaction when patients interact with interprofessional teams. This research is a before-and-after study of undergraduate health care students undergoing interprofessional education. Answers to questions on a 5-point Likert scale (from “Totally satisfied” to “Totally unsatisfied”) were uploaded online on a survey platform linked to a dedicated app.

Methods

Twenty-nine undergraduate students before, and eight after, interprofessional training reported their evaluation of patient satisfaction with interprofessional teams. Meta-analysis used Tau2, Cochrane's Q and I2.

Results

Meta-analysis showed a homogeneity in the answers before and after IPE training (P = 0.4) and variability of only I2 = 39%, with t2 = .006, and Q (4 df) = 4.0. To a certain degree, the study showed a drop before and after in students who report their patients being “moderately satisfied” (from 20.7% to 0%), with C.I. 95% = 4.702 (0.238–92.713) (Fig. 1).

Conclusions

This study requires further inquiry on why a moderate level of patient satisfaction declines when patients are treated by an interprofessional team.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Can Patients Differentiate When They Receive Integrated Care by Interprofessional Teams? Meta-analysis of a Pilot Study
Authors: Lazzari C. , Italo M.
Published: June 2017

Introduction

A patient's quality of care and satisfaction depends greatly on the perception of being treated and attended to by an integrated team of professionals.

Objectives

To make students mindful of a patient's perception of being treated by a blended interprofessional team when undergraduate students in training perform as a team in the patient's care.

Aims

To assess if patients under the care of interprofessional teams perceive, they are being treated by an integrated team.

Methods

Twenty-three undergraduate students undergoing a seven-day period of interprofessional training interviewed their common patients after each day of practice. Responses were given on a “yes-no-do not know” scale to the following question: “a team of students from different professions has just treated and cared for you. Do you think they have acted like a well-coordinated team?” Results were obtained by meta-analysis.

Results

In 60.9% of cases (Tau2 = 0.042; Q (2df) = 12.663; Het. P-value = 0.002; I2 = 84.206%) (Fig. 1), patients perceived they were treated by a well-coordinated interprofessional team; however, this perception was not affected by the days of training by the same IPE team.

Conclusions

Results suggest that other interpersonal factors might be involved in team-to-patient interactions that are barely affected by interprofessional training.

Disclosure of interest

The authors have not supplied their declaration of competing interest.

Fig. 1

Meta-analysis of patient's perception of being treated by a coordinated team.
Effect of Adenotonsillectomy on Attention-deficit/hyperactivity Disorder Symptoms, Sleep Disturbance Symptoms, and Quality of Life of Children with Adenotonsillar Hypertrophy and Sleep-disordered Breathing
Authors: Türkoglu S. , Somuk B.T. , Sapmaz E. , Goktas G. , Bilgic A.
Published: June 2017

Objectives

To date, limited data has been available regarding the impact of adenotonsillectomy (AT) on the psychosocial well-being of chronic adenotonsillar hypertrophy (CAH) subjects.

Aims

In the present study, we examined the impacts of AT on attention-deficit/hyperactivity disorder symptoms (ADHD) and sleep disturbance symptoms and quality of life of children with chronic adenotonsillar hypertrophy.

Methods

Parents of children with CAH filled in Conners Parent Rating Scale-Revised Short (CPRS-RS), children's sleep habits questionnaire (CSHQ), and the pediatric quality of life inventory, parent versions (PedsQL-P) before and six months after AT.

Results

A total of 64 children were included the study (mean age: 6.8 ± 2.4 years; 50% boys). Mean ADHD Index (11.98 ± 6.94 versus 10.35 ± 6.44) (before AT versus after AT) and oppositional scores (6.73 ± 3.72 versus 5.87 ± 3.52) improved statistically significantly after AT (P < 0.05). All of the CSHQ subdomain scores, except sleep duration, significantly reduced after AT (P < 0.05). Regarding to quality of life, both PedsQL-P physical health (64.20 ± 19.81 versus 69.84 ± 18.63) and psychosocial health subdomain scores (67.83 ± 12.89 versus 75.57 ± 13.16), and PedsQL-P total score (66.57 ± 12.94 versus 73.58 ± 12.46) of the patients were significantly higher six months after AT (P < 0.001).

Conclusions

It is necessary for child and adolescent psychiatrists to query the symptoms of CAH to identify children with chronic adenotonsillar hypertrophy who suffer from ADHD symptoms, oppositionality, and sleep disturbance. To carry out AT seems to be beneficial for coexisting ADHD and sleep disorder symptoms and quality of life in these children.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Startle Habituation Depends on Selective Attention in Schizophrenia Patients and Cannabis Users
Authors: Wehmann E. , Kedzior K.K. , Martin-Iverson M.
Published: June 2017

Introduction

Schizophrenia is associated with cannabis use and deficits in selective attention.

Objectives/aims

This study investigated these relationships using habituation of the startle reflex in schizophrenia patients relative to cannabis users during selective attentional tasks.

Methods

Participants included 12 healthy controls (CON), 16 healthy cannabis users in the last 12 months (THC), and eight schizophrenia patients (SCZ). Auditory startle reflex was recorded from orbicularis oculi muscle while participants were attending to (Attend Task) or ignoring (Ignore Task) 100 dB startling pulses. Startle habituation was measured as the absolute reduction in startle magnitude on block 2 (last nine trials) vs. block 1 (first nine trials) on each attentional task and in each group.

Results

All three groups were matched on demographics, alcohol, and caffeine consumption. ANCOVA with two within-subject factors (attention and habituation with 2 levels each), one between-subject factor (group with 3 levels), and one covariate (nicotine use which was higher in SCZ vs. CON or THC) showed a significant startle habituation with moderate to large effect sizes in all three groups on the Ignore Task (Cohen's d = 0.67 in CON, d = 0.59 in THC, d = 0.90 in SCZ) but not on the Attend Task. Attentional modulation of the startle reflex occurred only in CON (d = 1.33) and THC (d = 1.17), but not in SCZ.

Conclusion

Auditory startle habituation depends on selective attention but is not affected by schizophrenia or cannabis use. Deficient attentional modulation of the startle reflex suggests that a more severe deficit in selective attention occurs in schizophrenia relative to cannabis use.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Personality traits and tobacco smoking among male alcoholics with secondary depression
Authors: Mandic-Gajic G. , Dolic M. , Eror A. , Spiric Z.
Published: June 2017

Introduction

After alcohol withdrawal, secondary depression may persists and might be a risk factor for relapse among primary alcoholics.

Objectives

The differences between male alcoholics with secondary depression (D) and without depression (wD) regarding the personality dimensions and tobacco smoking were explored.

Aims

The aim was to investigate risk factors for secondary depression.

Methods

One hundred male primary alcoholics were recruited during inpatient treatment, and 86 completed the study. The assessment of depression by Hamilton Depression Rating Scale - HAMD (Hamilton, 1960), the pattern of cigarette use and personality dimensions assessment by Eysenck personality questionnaire – EPQ (Eysenck & Eysenck, 1975) were performed for all participants on admission. After four weeks according HDRS cut off score, they were divided into D group (n = 43) and wD (n = 43) group. The differences between groups were tested by Student t-test and Pearson's correlation test was applied.

Results

The personality traits showed difference between D and wD alcoholics’ subgroups for neuroticism 15.07 ± 4.89 vs. 10.37 ± 4.40 (P < 0.01) and for extraversion 11.74 ± 5.05 vs. 14.30 ± 4.24 (P < 0.05) respectively. The positive correlation between the mean HDRS score and neuroticism (r = 0.487, P < 0.001), without significant correlation between other EPQ dimensions and depression was recorded. The D group started smoking earlier, but without differences of cigarettes daily.

Conclusions

The group of alcoholics with depression started smoking earlier. They were characterized by higher neuroticism and lower extraversion on admission, which could predict persistent secondary depression. Screening on personality traits among alcoholics on admission could improve prevention of secondary depression after alcohol withdrawal.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Impact of anxiety-depressive symptoms on outpatients’ quality of life: Preliminary results from an Italian observational study
Authors: Tassi S. , Rioli G. , Mattei G. , Ferrari S. , Galeazzi G.M.
Published: June 2017

Introduction

Several studies have shown an association between the Short-Form 36 (SF36) scores and anxiety-depressive symptoms, suggesting that depression in particular could reduce Quality of Life (QoL) to the same, and even greater, extent than chronic non-communicable diseases, such as diabetes and hypertension.

Aims

To explore the relationship among QoL and anxiety, depressive and anxiety-depressive symptoms in an outpatient sample.

Methods

Cross-sectional study. Inclusion criteria: outpatients aged ≥40 years, without history for cancer, attending colonoscopy after positive faecal occult blood test. Collected data: blood pressure, blood glucose, lipid profile. Psychometric test: Hospital Anxiety and Depression Scale (HADS). QoL was assessed with SF36. Statistics performed with STATA13.

Results

54 patients enrolled (27 females). Sixteen patients (30.2%) were positive for anxiety symptoms, ten (18.9%) for depressive symptoms and five (9.4%) for anxiety-depressive symptoms. The perceived QoL was precarious in twelve subjects (22.2%): eight (15.9%) had low score (≤ 42) at “Mental Component Summary” (MCS) subscale, three (5.7%) at the “Mental Health” item and one patient (1.9%) at the “Vitality” one. At the multiple regression analysis, depressive (OR = 28.63; P = 0.01) and anxiety-depressive symptoms (OR = 11.16; P = 0.02) were associated with MCS.

Conclusions

The association emerging from the present study between depressive/anxiety symptoms and the MCS component of SF36 is consistent with available literature. Study design and small sample size do not allow to generalize results, that need further studies to be confirmed.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Differences in care intensity held by a consultation-liaison service in a general hospital among patients suffering from different somatic illnesses
Authors: Valdes-Stauber J. , Bachthaler S.
Published: June 2017

Background

There are differences in psychiatric comorbidity and perceived diagnosing and psychological supporting needs depending on professionals, units, programs, awareness, and diagnoses.

Objectives

This investigation explores possible differences in psychiatric comorbidity, in care intensity and in care priorities by a psychiatric-psychosomatic consultation-liaison service among main physical disease groups.

Methods

Three-year survey (n = 1,862 individuals) about all elective referrals from 16 different units in a middle-sized general hospital with 520 beds and 34,000 treated patients per annum. Five clinical and six care variables have been selected from the collected data by means of basic documentation of CLS. Chi-square-tests and ANOVA including Scheffé post-hoc test as well as multivariate regression analyses with robust regression coefficients were performed.

Results

The sample consisting of 55% women is on average 61 years old, 79% showing current and 35% psychiatric comorbidity prior to hospitalisations. Average GAF amounted to 67.2 (SD = 20.5) and ECOG to 1.22 (SD = 1.38). Psychosomatic disorders (F4) amounted to 38%, mood disorders (F3) to 19% and mental organic disorders (F0) to 11% of psychiatric disorders. Each patient received on average 2.11 (SD = 2.63) contacts and 105 minutes (SD = 144) of treatment time, 59% psychopharmacological and 32% psychotherapeutic interventions. Men and older people receive less, but comorbid patients independently of age and gender more intensive psychological support. There are hardly differences according to physical diseases.

Discussion

Cancer patients show less psychiatric comorbidity, but more psychotherapeutic interventions. Patients suffering from psychiatric comorbidity received more intensive care and more post-discharge recommendations. Patients treated because of chronic pain received much more interventions and treatment time.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Duration of untreated illness and outcome of obsessive-compulsive disorder: A naturalistic follow-up study
Authors: Prisco V. , Perris F. , Iannaccone T. , Fabrazzo M. , Catapano F.
Published: June 2017

Duration of untreated illness (DUI) is a predictor of outcome in psychotic and affective disorders. Data available on DUI and its relationship with outcome in obsessive-compulsive disorder (OCD) suggest an association between longer DUI and poorer treatment response. The present study investigated socio-demographic and clinical predictors of DUI and its association with long-term outcome in OCD patients. Eighty-three OCD outpatients were treated with serotonin reuptake inhibitors (SRIs) and prospectively followed-up for 3 years. Baseline information was collected on demographic and clinical characteristics using standard assessments. Each patient was assessed through the structured clinical interview for DSM-IV axis I disorders (SCID-I), the structured clinical interview for DSM-IV axis II personality disorders (SCID-II), the Yale-Brown obsessive–compulsive scale (Y-BOCS) and the 17-item Hamilton rating scale for depression (HDRS). The DUI was explored by interviewing patients, family caregivers and clinicians. OCD subjects had a mean DUI of 7.3 (5.8) years. A younger age at onset and a greater severity of OCD symptoms at baseline were associated with a longer DUI. The DUI of patients with a “good outcome” was shorter than that of patients with a “poor outcome”. Logistic regression analysis revealed indeed a possible association between longer DUI and “poor outcome”. In the logistic multivariable model, the association of DUI with treatment outcome held true whilst controlling for socio-demographic and clinical variables.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Depressive disorder: Particularities of theory of mind
Authors: Rivis I.A. , Cristea I.E. , Giurgi-Oncu C. , Ienciu M. , Bredicean C.
Published: June 2017

Introduction

“Theory of mind” represents the cognitive ability to attribute mental states as belonging to others and it's essential in any social interaction.

Objectives

Our objective was to evaluate the capacity of emotion recognition in patients with recurrent depressive disorder.

Aims

This study aimed to determine if theory of mind is influenced by psychotic features and the type of emotions distinguished.

Methods

We analyzed a sample of 45 patients with a diagnosis of recurrent depressive disorder (WHO ICD10) that was divided to include 23 patients with at least one episode with psychotic symptoms, while the rest had no history of psychotic symptoms. The “Reading the mind in the eyes” test was applied in an outpatient setting, in remission. The data has been processed in SPSS.

Results

The study found that 72.72% of patients without psychotic symptoms have a low capacity of emotion attribution, while 27.72% demonstrated a normal capacity (P = 0.00252). The majority with a history of psychotic depression (82.60%) showed a low capacity of emotion recognition, while 17.39% had normal abilities (P = 0). None of the patients showed a high capacity of emotion recognition. There was a significant difference in the frequency of negative emotions recognition by all patients (77.77%), while only a few managed to detect positive emotions (22.22%), regardless of psychotic symptom history.

Conclusions

In itself, a history of recurrent depressive disorder is directly related to a reduced ability to correctly attribute emotions. Moreover, these patients are more likely to detect negative emotions rather than positive ones.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Usage of selective serotonin-noradrenalin reuptake inhibitors in treatment of depressive disorders
Authors: Uzbekov M. , Maximova N.
Published: June 2017

Objectives

Relevance of current investigation is conditioned by the high prevalence of depression in population and tendency of increased rate of relapses.

Aim

To study efficacy of selective serotonin-noradrenalin reuptake inhibitor–milnacipran in treatment of depressive disorders.

Methods

There were investigated 22 patients. Patient's state was defined as depressive episode (F32.1) and recurrent depressive disorder (F33.1). Mean age–33 years, duration of disease–from 2 weeks to 18 years, duration of current depressive episode–5.3 months. Mean point according to HAM-D scale before treatment was 24.0. Patients were investigated in dynamics of antidepressant therapy (milnacipran–50–150 mg/daily) for 4–5 weeks.

Results

Efficacy of treatment with milnacipran was 82% (18 responders, 4 nonresponders). In responder's group decrease of depressive symptoms was started after 1 week of treatment and practical reduction of all these symptoms was observed after 4–5 weeks of therapy (points of HAM-D scale–0.81). Patients of this group receive milnacipran as supportive therapy at least for 3 months after signing out of clinic. During 1 year after signing out of clinic, there were no signs of aggravation of patient's state. 2 patients independently discontinue to take the medicine; there were aggravation of state and they were hospitalized in psychiatric clinic.

Conclusion

Milnacipran is effective in treatment of depressive disorders, ensured effective reduction of depressive symptoms. Its therapeutic effect is realized rather quickly. Milnacipran can be recommended as antidepressant of choice for prophylaxis of depressive disorders.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Mental illness is an inevitable consequence of the singular diversity of human beings
Authors: Schwartz M. , Moskalewicz M. , Schwartz E. , Wiggins O.
Published: June 2017

Nowadays, cosmopolitan populations increasingly applaud the broad physical, ethnic, racial, and cultural diversity of human beings. So long as we behave within sanctioned norms. This presentation will focus upon the above paradox: In contrast to delighting in physical, ethnic and cultural expressions of human diversity, present-day cosmopolitan societies increasingly call for conformity in behavioral and experiential realms. For example, at meetings such as this, we can freely express and celebrate racial, ethnic, and culturally differences, but we must communicate–within remarkably narrow ranges–cordiality, spontaneity, agreeableness, respectful disagreement and tact. And if we cannot?? We propose that the phenomenon of mental illness arises as a consequence of the phenomenon of human diversity coming up against constraints and limitations in mental and behavioral realms. This presentation will focus upon evolutionary, genetic, biological, anthropological, historical and cultural aspects of the primary role that human diversity plays in mental illness. We will discuss the adaptive origins and strengths associated with the extraordinary diversity of humans (and our pets/domestic animals) as well accompanying vulnerabilities. For example, diversity of skin pigmentation has enabled humans to extend across the globe. A consequence however, is enhanced vulnerability to skin cancer for some with fair skin and vitamin D deficiency for others with dark skin. Psychological diversities can be viewed analogously. The thesis that mental illness is an inevitable consequence of the singular diversity of humanity will be exemplified by disorders such as ADHD, melancholia, schizophrenia and sociopathy.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Collaborative care for treating common mental disorders in the community. Developing a clinical pathway for early intervention in Southeast Tuscany
Authors: Lussetti M. , De Lilla R.
Published: June 2017

Introduction

Common mental disorders (CMD) have a 12-month prevalence over 7% in the Italian population. Only 16,9% of people are treated by the health services, despite the high cost in disability and loss of productivity.

Objectives

To improve access to low-intensity CBT (LI-CBT) treatments in primary care.

Aims

To organize a clinical pathway in which general practitioners (GPs) identify the early signs of CMD and promote a collaborative care with a team of mental health practitioners (MHPs).

Methods

A small team of MHPs outlined and implemented, in collaboration with a group of 9 GPs, a clinical pathway to treat CMD in stepped care. Guided self-help was the first and main intervention. Group and individual CBT were offered–when needed–as a second and third step. If the user opted for drug treatment, a psychiatrist conducted one or two sections of consultation to the GP. The MHP team was fully integrated within the community mental health center (CMHC). PHQ-9 and GAD-7 were rated at each appointment.

Results

With a mean of 5,3 appointments, 90 persons were treated in 1 year. 68% reached recovery (both PHQ-9 and GAD-7 < 10), a result in line with the best performing English Clinical commissioning groups in the IAPT project.

Conclusions

A small multi-professional team of MHP can build with GPs a simple clinical pathway able to reach high standards of care with relatively small resources offering LI-CBT integrated with drug treatment and high intensity care.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Apathy in depression: An arterial spin labeling study
Authors: Conan C. , Batail J.M. , Corouge I. , Palaric J. , Robert G. , Drapier D.
Published: June 2017

Introduction

Apathy is usually defined as a lack of goal-directed behavior. Although it is observed in about 30% of depressed patients, neurovascular mechanisms underpinning apathy remain little-known.

Objectives

The main objective of this study was to compare the cerebral perfusion of apathetic depressed patients with non-apathetic depressed patients by arterial spin labeling (ASL), a quantitative and non-invasive perfusion magnetic resonance imaging (MRI) technique. The secondary objectives were to study their clinical profile and their correlation with cerebral perfusion data.

Methods

This study was conducted from a cohort of depressed patients in Rennes, France. Eighty-three depressed patients were included, of whom 22 were apathetic (AES≥42), 61 non-apathetic (AES < 42). Everyone got a clinical evaluation with scale screenings, especially for apathy (AES), anxiety (STAI) and anhedonia (SHAPS) as well as a cerebral MRI, including a pseudo-continuous ASL sequence.

Results

Apathetic depressed patients were significantly less anxious and less anhedonic. Apathetic perfused better than non-apathetic in the inferior frontal gyrus (P = 0.022). We found a significant positive relationship between apathy and perfusion of the left frontal inferior gyrus (P = 0.05, r = 0.21). State-anxiety was positively correlated with perfusion of the cingulate cortex, the insula and the left amygdala. Anhedonia was positively correlated with the perfusion of the ventromedial prefrontal cortex, the cingulate cortex and the insula.

Conclusions

We have shown that the clinical and perfusional profiles of apathetic depressed and non-apathetic differ. This study suggests the existence of two distinct neurobiological networks for depressed patients; one involving motivational networks for apathetic patients, and another one involving emotional networks for more anhedonic patients.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
The squeezing snake, a psychiatric presentation of epilepsy: A case report
Authors: Mangas M. , Bravo L. , Martins Y. , Matos Pires A.
Published: June 2017

Introduction

Epilepsy is considered a complex neurological disorder with a great variety of clinical presentations that can resemble psychiatric disorders.

Objectives

Disclose an unusual clinical case with psychiatric symptoms as the presentation of epilepsy.

Methods

Psychiatric assessments and retrospective review of the clinical file and literature research.

Results

A 40-years-old Romanian woman presented to the psychiatry outpatient service with a history of persistent depressive mood and disturbed sleep for the past 3 years, complaining of a feeling that she described as “a snake squeezing around her body, starting in her left leg and spreading to the rest of her body up to the neck” associated with a sense of pins and needles, occurring during night time. She attended general practice, neurosurgery and psychiatry appointments. Her medical history included “gastritis” and lower left leg fracture and a pituitary microadenoma revealed in brain CT-scan. Blood work, including endocrine tests and brain-MRI were normal. Her symptoms initially led to diagnosis of: anxiety, somatization, Ekbom syndrome and depression. She was treated with antidepressives, antipsychotics and anxiolytics, without response. After careful reconstruction of the clinical history and further analyses of her complaints, the diagnosis of focal sensory jacksonian seizure was made. Levetiracetam introduction led to symptomatic remission.

Conclusion

Epilepsy includes a variety of neuropsychiatric symptoms. This case illustrates that epileptic patients may experience non-convulsive seizures that might be mistaken as primary psychiatric disorders. Neurologists and psychiatrists must be aware of this varied presentation while obtaining the medical history in order to investigate and manage this patient effectively.

Disclosure of interest

The authors have not supplied their declaration of competing interest.