bluuebunny/crossref_metadata_2025 huggingface dataset:
Stress management versus cognitive restructuring: A randomized clinical study on traumatized refugees
Authors: Ekstrøm M. , Carlsson J. , Sonne C. , Mortensen E.L.
Published: May 2016

Background and aim

There is a lack of evidence regarding which kind of psychotherapy that is the most effective when treating traumatized refugees. Studies on the effect of psychotherapy among other patient groups with PTSD suggest a good effect using cognitive behavioural therapy (CBT). The competence center for transcultural psychiatry (CTP) has specialized in the treatment of traumatized refugees. The objectives were to study the effect of CBT with a focus on either stress management or cognitive restructuring in a clinical sample of traumatized refugees with PTSD and to identify predictors for the treatment effect.

Methods

All patients (n = 143) referred to CTP from June 2011–March 2012 and fulfilling the inclusion criteria were offered to participate in the study. Participants were offered combined treatment with a psychiatrist (psycho-education and psychopharmacological treatment when needed) and a psychologist (CBT). The duration of the treatment was 6–7 months. The participants were randomized to either CBT with a focus on stress management or cbt with focus on cognitive restructuring. The primary outcome was PTSD measured by the Harvard Trauma Questionnaire.

Results

The results are presently being analyzed and will be presented at the congress.

Conclusions

Both research results and the clinical experience at CTP suggest, that cognitive restructuring is not always a useful tool and that stress reducing techniques could be more useful. This hypothesis was tested in the present study.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
The treatment of traumatised refugees with sertraline versus venlafaxine in combination with psychotherapy – a randomised clinical study
Authors: Ekstrøm M. , Sonne C. , Carlsson J. , Bech P. , Elklit A.
Published: May 2016

Background and aim

Today we lack sufficient evidence to conclude which type of treatment approach that is most efficient when it comes to trauma-affected refugees. That is a problem for both patients and doctors as well as for society. Also there is a lack of studies, which examine the relation between psychosocial resources and treatment efficiency, in order to find reliable predictors of treatment outcome. This study therefore aims to produce new evidence within this field in order to optimise treatment for trauma-affected refugees with complex PTSD.

Methods

The study included 207 patients referred to Competence Centre for Transcultural Psychiatry between April 2012 and September 2013. Patients were randomised into one of the two treatment groups: a sertraline group (n = 109) or a venlafaxine group (n = 98). Patients in both groups received the same manual based cognitive behavioural therapy, specially adapted to this group of patients. The trial endpoints were PTSD-and depression symptoms and social functioning, all measured on validated ratings scales. Furthermore the study examined the relation between expected outcome of treatment from a range of predictors and the relation to the treatment results for the individual patient.

Results

Data are presently being analysed and results will be ready for the conference.

Conclusion

The study is among the largest randomised studies ever conducted on pharmacological treatment among traumatised refugees. It is expected to bring forward new knowledge about clinical evaluation and medical treatment of traumatised refugees.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Stigma towards psychiatric disorders in a sample of depressed females in two different communities
Authors: Elsheikh M. , Haltenhof H. , Bahary M.H.
Published: May 2016

Introduction

Stigma and discrimination experienced by persons suffering from mental illness, unlike other medical conditions, recognized as a barrier in countries rich and poor, and in countries with well-developed mental health services and those with limited services. It was hypothesized that depression may affect patients’ attitude towards mental illness “public stigma” as well as self-stigmatization and that there will be a difference between Egyptians and Germans.

Aims

This study sets out to identify and compare public–and self-stigma among depressed women in two different communities.

Objectives

To test findings from transcultural comparative study of two patient groups of depressed women from two different communities. Participants were 50 adult females diagnosed with depression from Egypt and Germany.

Method

Participants completed after clinical interviewing and diagnosis with depression two questionnaires: the inventory of attitude towards mental illness (Shokeer, 2002) and the explanatory model interview catalogue EMIC (Weis et al., 2001).

Results

Analysis indicates that positive attitudes towards mental illness were more for the German respondents than for the Egyptians. There were significant differences between the two groups in the causal attributions of mental illness. Psychotherapy was widely accepted in the two groups as a helpful method for treatment of mental illness.

Conclusion

It was concluded that the traditional beliefs affect the understanding of illness causality and that the subjective experience of depression may affect attitude towards mental illness and mentally ill people. The effect of the social desirability is discussed.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Impact of language fluency level on patients’ pathway and clinical outcome of the Japanese psychiatric service
Authors: Yuasa A. , Nagasawa S. , Yu A.
Published: May 2016

Language fluency often impacts on patients’ behaviors. It might affect their pathways, how they find an available psychiatric clinic, and the clinical outcomes, if they continue their treatments. Multicultural services deficiency is serious concern in Japanese psychiatric fields. According to the Ministry of Health, Labor and Welfare in 2014, more than two million of foreign visitors live in Japan, however, the psychiatric institutions providing multilingual services are rare and inadequate comparing the situation in Europe. The research sets the objective of analyzing the status quo in a multi-language providing psychiatric clinic, how the pathways and outcomes of language diffluent patients differ from these of the local patients. It further aims to find the significance of foreign patients, and strives the improvement of language services for non-native patients in Japanese mental health cares. The research utilized and quantitatively analyzed the retrospective research data among 900 Japanese patients and 902 non-Japanese patients, who have visited a psychiatric clinic located in Tokyo. The analysis revealed that the significant proportion of foreign patients relied on their acquaintances as their pathways, and that the lower their language levels were, the higher proportion they had this path. For the outcomes, the lower their language levels were, the higher continuity status they had. Our research suggested that two of the common ways to find a psychiatric service when local patients suffer from psychopathological maladjustments are researching Homepages and neighboring clinics, however, the foreigners with limited language abilities tended to follow the different pathways and outcome patterns.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
A study of mood status in children with type I diabetes mellitus: Relationship with parental stress and metabolic control
Authors: Abdelhameed M. , Ali B.
Published: May 2016

Introduction

It has been widely recognized that DM can result in psychological, social and physical problems. Parents of children with DM are likely to be highly distressed.

Objective

The study of the relationship between mood status of children with type I DM and some factors that might be implicated in its determination.

Aims

To evaluate the presence and degree of depression in a sample of children with type I diabetes and how much it might be affected by their metabolic control and the level of their parents’ stress.

Methods

Ninety-three children were diagnosed with DM type I. They were clinically interviewed and examined. They went through Childhood Depression Rating Scale (CDI), Family Attitudes Questionnaire and HbA1c% assessment. An age and sex matched control group was taken.

Results

The age range of diabetic children was 7–18 and two thirds of them were females. Thirty-five patients (37.6%) were depressed according to CDI results. Diabetic children had significantly higher CDI total score and total parenting stress index (PSI) compared to the control group. CDI total score was positively and significantly correlated with indicators of poor diabetes control (frequency of DKA and HbA1C%) and with duration of diabetic illness. CDI total score was also positively and significantly correlated with PSI score.

Conclusions

Depression was highly present in this sample of diabetic children. The degree of their mood impairment was positively correlated with duration of diabetic illness, indicators of poor metabolic control of DM and to the level of their parents’ stress.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Seasonal affective disorder associate with common chronic diseases and symptoms in a population-based study
Authors: Basnet S. , Merikanto I. , Lahti T. , Partonen T.
Published: May 2016

Background

Seasonal affective disorder (SAD) is a recurrent mood disorder with 22%–42% of the patients experiencing symptoms even after 5–11 years after diagnosis, and 33%–44% developing non-seasonal symptoms. The purpose of this study was to assess how seasonality is associated with some of the most common non-communicable diseases in the general Finnish population.

Methods

The global seasonality score (GSS) and the experiences of problems due to the seasonal variations from FINNRISK 2012 dataset were used to measure the seasonality in 4689 Finns aged 25–74 years living in five geographical regions in Finland, and assess their association with common non-communicable diseases (NCDs). The regression models and odds ratios were adopted to analyze the associations adjusted for covariates.

Results

The prevalence of SAD in the Finnish general population is 21%. Seventy percent of the participants had seasonal variations in sleep duration, social activity, mood and energy level, while 40% had seasonal variations is weight and appetite. Angina pectoris and depression were significantly associated with seasonality, including seasonal variations in sleep duration, mood, weight, appetite, social activity and energy level. Depression was significantly associated with the increased odds for experiencing a problem due to the seasonal variations (OR = 4.851, P < 0.0001) and SAD symptoms (OR = 4.075, P < 0.0001), and with the GSS (P < 0.0001).

Conclusion

Our data suggest that seasonality is associated with depression and angina pectoris. The co-occurrence of the seasonal variations in mood and behavior with common NCDs warrants the need for future research to have insights into the etiology and potentially shared pathways and mechanisms of action.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Acceptance and commitment therapy (ACT) predictive factors of return to work after depression
Authors: Darbeda S. , Seznec J.C.
Published: May 2016

Introduction

Prolonged sick leaves are a major risk to quit the world of work and depression is the leading cause of disability in France. New therapies from the third wave of CBT as the Commitment and Acceptance Therapy (ACT) may be interesting to promote the return to work (RTW).

Objectives

To assess predictive factors of return to work after depression.

Methods

This is a descriptive, prospective and multicentric study. The recruitment of investigating doctors was conducted by the publication of an advertisement in a French journal of occupational medicine. Each investigator recruited patients during reinstatement medical examination after a prolonged sick leave for depressive syndrome. Sociodemographic, occupational, medical and psychological factors (particularly in connection with the ACT) was assessed at baseline and 3 months later.

Results

Thirty-one patients were initially included in the study, but 2 were lost to follow up at 3 months and 29 were analyzed. Twenty three patients RTW at 3 months. Those who RTW were less anxious (P = 0.023), less depressed (P = 0.021), had a better impression of improvement (P = 0.0066) and had a lower score of experiential avoidance (P = 0.0025).

Conclusions

The ACT, through its action on the reduction of experiential avoidance, and the definitions of new life values could allow a faster RTW after a sick leave for depressive syndrome.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Acute administration of reboxetine reduces alcohol self-administration but, after a subchronic treatment with this drug, alcohol self-administration is enhanced
Authors: Alen F. , Marban Castro T. , Ballesta-Garcia A.J. , Anton Valades M. , Ramirez-Lopez M.T. , Vazquez M. , Blanco N. , Ouco D. , Jaimez-Alameda M. , Gomez de Heras R. , Serrano A. , Gorriti M.A. , Suarez J. , Rodriguez de Fonseca F.
Published: May 2016

Introduction

Comorbidity between alcoholism and depression has long been acknowledged, and the possibility that similar brain mechanisms, involving both serotonergic (5-HT) and noradrenergic systems (NE), underlie both pathologies has been suggested. Thus, inhibitors of NE and 5HT uptake have been proposed for the treatment of alcoholism, as they have shown to reduce alcohol intake in various animal models. However, most of the studies mentioned were carried out acutely and there is a lack of knowledge of the possible long-term effects. Clinical studies report an overall low efficacy of antidepressant treatment on alcohol consumption, or even a worsened prognosis. In addition, several cases of alcohol dependence following antidepressant treatment have been reported in the literature.

Objectives

We aimed at comparing the acute and chronic effects of the treatment with the antidepressant drug reboxetine on alcohol consumption.

Methods

We used a rat model of alcohol self-administration, and two different schedules of reboxetine administration (acute and chronic).

Results

Our results confirm the acute suppressant effects of reboxetine on alcohol consumption but indicate that, when this drug is administered chronically in a period of abstinence from alcohol, it can significantly increase the rate of alcohol self-administration.

Conclusions

These results are important for the understanding of the clinical reports describing cases of increased alcohol consumption after antidepressant treatment, and suggest that much more research is needed to fully understand the long term effects of antidepressants, which remain the most widely prescribed class of drugs.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Neurocognitive impairments in euthymic patients with bipolar disorder type II
Authors: Ilhan R.S. , Senturk-Cankorur V.
Published: May 2016

Introduction

Most of the studies have indicated that there have been neurocognitive impairments especially in the domains of executive functions, attention, verbal and working memory among euthymic patients with bipolar disorder type I (BD-I). However, there has been limited research investigating neurocognitive functioning in euthymic patients with BD- II.

Objectives/aims

Aim of this study was to investigate neurocognitive functions in euthymic BD-II patients. Our hypothesis was that euthymic BD-II patients would have neurocognitive impairments in the domains of executive functions, attention, verbal and working memory.

Methods

Euthymic BD-II patients (n = 37) and healthy controls (HC) (n = 35) were compared in terms of their neurocognitive functioning in the domains of executive functions assesed by the number of perseverative errors, non-perseverative errors and category completed on the Wisconsin Cart Sorting Test (WCST); working memory assessed by Auditory Consonant Trigrams (ACT); immediate verbal memory assessed by the Logical Memory subscale of the Wechsler Memory Scale I (WMS I) and attention assesed by Stroop Colour-Word Interference Test (SCWIT). Euthymic state was confirmed by the low scores both on Hamilton Depression Rating Scale, Young Mania Rating Scale.

Results

Significant differences were found between two groups in terms of WCST non-perseverative errors (Z = 3.8, P < 0.01) and category completed subtests (Z = 3.8, P < 0.01), ACT (t = 2.97, P < 0.01) WMSI (Z = 2.4, P = 0.01), SCWIT (t = 3.52, P < 0.01) performances.

Conclusions

Our study indicated that euthymic BD-II patients had poorer performance on the domains of executive functions, attention, working memory and verbal memory than the HC group. But future studies with large samples are needed to support our results.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
The importance of art therapy in the integrative treatment of recurrent depressive disorder – case study
Authors: Pavlovic Stojkovic J. , Milosavljevic M. , Vukovic M. , Vidic L. , Lecic Tosevski D.
Published: May 2016

An integrative treatment of patients with affective disorders during hospitalisation also includes art therapy. Art therapy, as a form of expressive therapy, uses the creative process to encourage communication, expression of feelings and offers the space for mutual mirroring. This paper presents a patient who has been treated for approximately five years under the diagnosis of a recurrent depressive disorder (F33) and mixed personality disorder (F61). The patient has been experiencing unrecognised and untreated problems of the depression spectrum since 1993, when he took part in the Yugoslav war. The main issue was the somatic symptoms (headaches, nausea etc). Another major problem during his psychiatric treatment and an additional cause of unsatisfactory therapeutic effect was his inability to verbalise his feelings. In the course of art therapy, when the patient was given a topic “How I see myself in five years”, he drew a man who appeared to be sleeping and explained that he could not see himself in five years’ time, since he would not be alive at the time and that he could not see a way out of the current situation. With the help of a supportive group, for the first time since the beginning of his treatment, he spoke about his thoughts and feelings of hopelessness, sorrow, alienation and loneliness. This enabled new insight into the patient's depression. This clinical example shows how art therapy and reaction of the group, which was supportive and highly associative, can turn the non-verbal into verbal and non-communication into communication.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Somatic Symptoms As Measured By Ssi-26 (somatic Symptom Inventory) Correlate With Social And Physical Functioning (sf36) In Depressed Patients. The Relative Contribution Of Anhedonia
Authors: Pérez Morenilla A.L. , Salazar A. , Failde I. , Mico J.A.
Published: May 2016

According to the DSM5, Somatic Symptom Disorder (SSD) is characterized by somatic symptoms that are either very distressing or result in significant disruption of functioning. These criteria are significantly different compared with previous editions of DSM. For example, the DSM-IV diagnosis of somatization disorder required a specific number of complaints from among four symptom groups, however the SSD criteria no longer have such a requirement. Nevertheless somatic symptoms must be significantly distressing or disruptive to daily life. Very few studies have focussed on the influence of suffering anhedonia on the perception of somatic symptoms and how this impact on Health Related Quality of Life (HRQoL), particularly physical functioning. We studied the relative impact of somatic symptoms on the social and physical functioning in depressed patients. Moreover we have explored the influence of anhedonia as measured by the Snaith-Hamilton Anhedonia Pleasure Scale (SHAPS). We analysed the correlations between the scores of the 8 dimensions of the SF-36, the SSI-26 and the SHAPS questionnaires. The results show a significant correlation between SSI-26 score and physical functioning (r = –0.565; P < 0.001), role physical (r = –0.551; P < 0.001), bodily pain (r = –0.659; P < 0.001), general health (r = –0.534; P < 0.001), vitality (r = –0.481; P = 0.001), social functioning (r = –0.302; P = 0.044) and mental health (r = –0.461; P = 0.001). Additionally, SHAPS score correlates with vitality (r = –0.371; P = 0.012), social functioning (r = –0.574; P < 0.001) and mental health (r = –0.445; P = 0.002). The results demonstrated that both somatic symptoms and level of anhedonia negatively correlate with HRQoL, suggesting a potential relationship between level of anhedonia and some somatic symptoms. This could impact on the diagnosis and treatment of depressed patients with somatic symptoms and anhedonia.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
A Comparison Of The Improving In Major Depressive Symptoms As Reported By Romanian Physicians And Patients In a Prospective, Multicenter, Observational Study
Authors: Purnichi T. , Marinescu V. , Ladea M. , Eda M.C. , Marinescu I. , Pirlog M. , Pavel I. , Mihalcea D. , Paraschiv G. , Tudose C.
Published: May 2016

Introduction

Depression leads to substantial suffering for the patients, their families and becomes an economic burden for system [1,2]. Patients and clinicians tend to rate the remission differently [3].

Objectives and methods

We investigate if clinicians and patients rate different the treatment response. This study assed the evolution of major depressive episode (MDE) in patients treated with Agomelatine, in Romania. It was designed as a multicentre, observational study that included 1213 adult patients evaluated in 75 sites in 2014. The design included 3 visits (baseline (V1); visit at 2/3 weeks (V2); visit 6/8 weeks (V3)). The scales used were: MADRS, SHAPS, CGI-I, CGI-S, PGI-I, PGI-S.

Results

The MDE improvement was significant (P < 0.001) for all aspects evaluated. At baseline, more clinicians vs. patients considered the moderately or markedly ill as best descriptors of the state. The difference between the two assessments was even higher for V2 and V3. During V2 clinicians reported “minimally improvement” while patients reported “much improvement” in higher percentage. During V3, both, clinicians and patients reported a “very much improved” clinical status. Of the patients 42.60% reported at V3 “normal”, not at all ill’ in comparison to 34.81% of clinicians who reported the same (P < 0.001).

Conclusions

This could mean that patients are not aware of the severity of their disease. This data could be interpreted in the way that patients are more prone to rate higher the improvements as response to treatment and the clinicians to rate as response a more than 50% decrease of symptomatology.

References not available.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Rumination And Primary Care Depression
Authors: Riihimäki K. , Vuorilehto M. , Jylhä P. , Isometsä E.
Published: May 2016

Introduction

Response styles theory postulates that rumination is a central factor in occurrence, severity and maintaining of depression. High neuroticism has been associated with tendency to ruminate.

Objective

To evaluate the relationships between rumination, neuroticism and depression in a naturalistic prospective cohort of primary care patients with depressive disorders with life-chart methodology.

Aims

We hypothesized, that rumination would correlate with severity and duration of depression and with concurrent anxiety, gender and neuroticism.

Methods

In the Vantaa Primary Care Depression Study, a stratified random sample of 1119 adult patients was screened for depression using the Prime-MD. Depressive and comorbid psychiatric disorders were diagnosed using SCID-I/P and SCID-II. Of the 137 patients with depressive disorders, 82% completed the five-year follow-up with a graphic life chart. Neuroticism was measured with the Eysenck Personality Inventory (EPI-Q). Response styles were investigated at five years using the Response Styles Questionnaire (RSQ-43).

Results

Rumination correlated significantly with Hamilton Depression Rating Scale (r = 0.54), Beck Depression Inventory (r = 0.61), Beck Anxiety Inventory (r = 0.50), Beck Hopelessness Scale (r = 0.51) and Neuroticism (r = 0.58). Rumination correlated also with proportion of follow-up time spent depressed (r = 0.38). In multivariate regression, high rumination was significantly predicted by current depressive symptoms and neuroticism, but not by anxiety symptoms or preceding duration of depressive episodes.

Conclusions

Rumination correlated with current severity of depression, but the association with preceding episode duration remained uncertain. The association between neuroticism and rumination was strong. The findings are consistent with rumination as a state-related phenomenon, which is also strongly intertwined with traits predisposing to depression.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Plasma Concentrations Of Endocannabinoids And Congeners In a Primary Care Sample Of Depressed Patients: Influence Of Biological Variables, Severity And Antidepressant Medication
Authors: Romero-Sanchiz P. , Nogueira-Arjona R. , Mayoral-Cleríes F. , Rivas-Guerrero F. , Araos-Gómez P. , Pedraz-Fernández M. , Serrano-Criado A. , Pavón-Morón F.J. , De la Torre-Fornell R. , Pastor-Bosch A. , Rodríguez de Fonseca F.
Published: May 2016

Introduction

Endocannabinoid system has been highlighted as one of the most relevant research topics by neurobiologists, pharmacists, basic scientists and clinicians. The association between endocannabinoids and its congeners and mood disorders is relatively recent. However, evidence from both clinical and preclinical studies is increasing and many researchers point out endocannabinoid system and particularly endocannabinoids and congeners as promising pharmacological targets.

Aims and objectives

The main objective of this study is to compare the plasma concentrations of endocannabinoids and congeners between a sample of patients with depression and a sample of control subjects, and the influence of variables such as age, body mass index, gender, severity of symptoms, and antidepressant medication.

Method

Plasma concentrations of endocannabinoids and congeners will be analyzed in 69 patients with depression from primary care and 47 controls using mass spectrometry analysis.

Results

Statistically significant differences in 2-arachidonoylglycerol and monoacylglycerols were found between both samples. Somatic symptoms of depression seems to be more related to these compounds that to cognitive-affective symptoms. In addition, differences between mildly and moderately depressed patients were found in concentrations of AEA, LEA, DGLEA and POEA. Patients with antidepressant medication showed higher levels of 2-AG, DGLEA and OEA.

Conclusions

The results of this study provide evidence supporting the hypothesis that in depression there is a dysregulation of the inflammatory signaling and, consequently the immune system. The results of this study could also support the realization of translational research to better understand the mechanisms of this widely distributed system.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
A Novel, Very Short Questionnaire As a Screening Tool For Depression
Authors: Pękala K. , Sobow T.
Published: May 2016

Introduction

Self-assessment tools are frequently used as screening tools for depression. However, they are usually long and time-consuming.

Aim of the study

To assess specificity, sensitivity and overall accuracy of a novel, very short, 5 questions tool.

Subjects and methods

The questionnaire consists of 3 phenomenological (based on main symptoms of depression) and 2 questions to assess functional impact of the symptoms. One hundred and ninety patients diagnosed clinically as having major depression (according to ICD-10 criteria and with the help of MINI tool) filled the questionnaire in twice, during episode and remission.

Results

At least two (out of three possible) “yes” answers to phenomenological questions and both two “yes” functional answers yielded 100% specificity (no person in remission). At least one “yes” answer to phenomenological questions and both “yes” answers to functional question yielded 82.8% specificity, 83.7% sensitivity and 83,3% overall accuracy. These results varied insignificantly in subgroups with different depression severity.

Conclusion

A short, 5-question questionnaire may be used as a screening tool for depression. Specificity, sensitivity and overall accuracy are above 80% largely independently of depression severity.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Ethnicity And Depression Among Maritime University Students In Canada
Authors: Steenbeek A. , Langille D. , Wilson K. , Muir A.
Published: May 2016

Introduction

Depression is among the most common mental illnesses in Canada. Although many factors contribute to depression, stress is among the most commonly reported. Studies suggest that marginalized groups often experience high levels of stress.

Objective

To examine associations between ethnicity and depressive symptoms among university students.

Aim

To identify if ethnic groups, particularly Aboriginal students, are at greater risk of depression.

Methods

Online survey data were collected from students attending eight universities in the Canadian Maritime Provinces (n = 10,180). Depressive symptoms were assessed using the 12-item version of the Center for Epidemiological Studies Depression Scale. Ethnicity was organized into five groups: Caucasian only, Aboriginal only, Aboriginals with other ethnicities, Mixed Ethnicity (not including Aboriginal), and Other (single ethnicity not including Aboriginal or Caucasian). Unadjusted and adjusted logistic regression models were used to assess associations between ethnicity and elevated depressive symptoms. Adjusted models accounted for demographic, socioeconomic, and behavioural characteristics.

Results

In adjusted analyses for men, Mixed (OR: 2.01; 95% CI: 1.12–3.63) and Other ethnic students (OR: 1.47; 95% CI: 1.11–1.96) were more likely to have elevated depressive symptoms than Caucasians. There were no differences between those who were Aboriginal and those who were Caucasian. In unadjusted and adjusted analyses for women, depressive symptoms in ethnic groups (including Aboriginals) were not significantly different from Caucasians.

Conclusion

Among male university students in the Maritime, ethnicity (other than being Aboriginal) was associated with depressive symptoms in comparison to Caucasians, after adjusting for covariates. However, among women, ethnicity was not significantly associated with depressive symptoms.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
First bipolar episode and functionality: Relation with depressive symptoms and inflammation levels
Authors: Martinez-cengotitabengoa M. , Bermudez-ampudia C. , Lopez M.P. , Garcia-alocen A. , Gonzalez-ortega I. , Zorrilla I. , Gonzalez-pinto A.
Published: May 2016

Introduction

It is important to make an early and effective intervention from the first bipolar episode. The presence of depressive symptoms in the course of a manic episode could influence negatively the evolution and the prognosis of the patient. Inflammation and oxidative stress are also related with functionality.

Objectives

To explore the relationship between depressive symptoms during a first episode of mania, inflammatory parameters and patient functionality during the follow-up.

Method

We included in the study 92 are patients with a first manic episode and 92 matched healthy controls. We compared 13 inflammatory/oxidative stress parameters measured at baseline (TFNα, IL6, PGE2, MCP1, TBARS, NO2, SOD, CAT, GSHTOT, GSSG, GSHfree, GPx, TAS) between both groups. Between patients, 46 presented pure mania (PM) (no depressive symptoms) and 46 mixed mania (MM) (with depressive symptoms). We explored the influence of inflammatory factors in functionality, exploring differences between PM and MM. To measure patients’ general functioning one year after illness onset, we used the Functional Assessment Short Test (FAST).

Results

We found significant differences in TFNα, MCP1 and TBARS (higher in patients) and in SOD, GSHtot, GSSG, GSHfree, GPx and TAS levels (lower in patients). Only In MM group, there was a significant influence of SOD and GSHfree in FAST scores suggesting that a higher antioxidant levels at baseline the patient functionality improves one year after.

Conclusions

Some parameters of oxidative stress at baseline are related with patient's functionality one year after the first episode of mania, but only when mania debuts with depressive symptons simultaneously.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
The Co-occurrence Of Eating Disorders And Psychosis
Authors: Alves Pereira C. , Silva J.R. , Cajão R. , Lourenço J.P. , Casanova T.
Published: May 2016

Introduction

Several reviews have reported the incidence of schizophrenia in patients with eating disorders (ED) to be between 3–10% and the incidence of transient psychotic episodes to be 10–15%. On the other hand, anorexia nervosa appears to affect 1 to 4% of schizophrenia patients. Reports of psychosis and ED occurring in the same patient have led to various views as to the nature of the relationship between the two.

Objective

Analysis of the literature illustrated by different clinical cases in which appears to be a relationship between ED and psychosis.

Aims

Critical reflection about the hypothesis that could underlie the comorbidity of psychotic illness and ED.

Methods

Non-systematic review of a literature search using the keywords: eating disorders; psychosis; comorbidity.

Results

There is no consistent sequence in the co-occurrence of the two conditions – ED sometimes precede and sometimes follows the onset of psychosis. ED patients can develop psychotic symptoms, most frequently transient in the course of the disorder, while others are subsequently diagnosed with a chronic psychotic disorder. On the other hand, patients with a primary psychotic illness can develop an eating disorder. The connection between the two, however, remains speculative, considering the hypothesis that ED and psychosis can be entirely separate disorders that can, by chance, occur in the same person.

Conclusions

The area of comorbidity and overlapping symptoms in psychiatry requires more deep research. Despite evidence from case series, the comorbidity between ED and psychosis is poorly understood, and firm conclusions cannot be drawn from this analysis.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Recognition Of Emotional Prosody In Anorexia Nervosa
Authors: Dondaine T. , Douailler-Gautier B. , Guillery M. , Robert G. , Millet B. , Guillaume S. , Drapier D.
Published: May 2016

Deficits in emotional processes are often observed by clinicians in anorexia nervosa and may have an impact on social functioning. Recognition of emotion was mostly investigated using visual stimuli as faces of emotional scenes. Only one study (Kucharska-Pietura et al., 2004) demonstrated impairments in emotional prosody using positive and negative valenced stimuli. However, this study did not provide a highlight for the identification of emotional bias (for example, to recognize an intense fear in a friendly voice). The aim of this study is to better understand the recognition of emotional prosody in anorexia nervosa using a wide range of positive, negative and neutral stimuli (Belin et al., 2008).

In order to test emotion recognition biases in emotional prosody, we exposed 15 patients with anorexia nervosa and 15 healthy controls (HCs) to emotional vocal tasks asking them to rate emotional intensity on visual analog scales. In addition, we assessed clinical symptomatology and cognitive functioning for all participants.

We showed that patients with anorexia nervosa provided higher intensity ratings on the non-target scales (e.g., surprise scale for fear stimuli) than HCs for sadness, fear and neutral voices. Furthermore, with the exception of neutral vocal stimuli, they provided the same intensity ratings on the target scales as the HCs.

These findings suggested a bias in the processing of emotional prosody and may impact the social functioning of patients with anorexia nervosa. The bias may result from a sensorial deficit or a high-order cognitive dysfunction and have to be investigated in future studies.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Men With Anorexia: a Descriptive Study Of The Characteristics Of Male Patients In An Intensive Psychotherapy Day Hospital For Eating Disorders During 2015 In Madrid
Authors: Espinosa Benavides A. , García Calvo C. , Unzeta Conde B. , Vilariño Besteiro M.P. , Pérez Franco C.
Published: May 2016

Objective

To describe the main characteristics of male patients suffering from anorexia in a specialized unit for eating disorders management.

Introduction

As a result of a more prevalent diagnosis of eating disorders in women (including anorexia among others), male patients characteristics have been less described in current literature.

Methodology

The authors retrospectively reviewed the clinical history of all male patients attending our unit of Eating Disorders in a period of one year (2015). The recorded characteristics were analyzed and classified as demographic, clinical and biographical. Finally a bibliographic review was also performed and correlated with our results.

Conclusion

During our review (currently being performed) we have found that, even if in much less numbers than in women, the characteristics of male patients suffering anorexia have recognizable patterns and for instance can be used for the better understanding of this pathology in this population.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
The Effect Of Atipical Antipsychotic Medications In Anorexia Nervosa
Authors: Barchiesi M. , Martellini M. , Oriani M.G. , Nardi B.
Published: May 2016

Introduction

Anorexia nervosa (AN) is severe and debilitating psychiatric illness characterized by destructive weight loss behaviour, refusal to maintain body weight at or above minimal normal weight for age and height, intense fear of weight gain and disturbance in experience of body shape and weight.

Objectives

The purpose of this review is to investigate the state of art concerning the use of atypical antipsychotics (SGA) in the treatment of anorexia nervosa, comparing the efficacy and tolerability in female patients not selected by age.

Methods

A Medline enquiry of published articles from 2005 to October 2015 was performed using the following Keywords: “anorexia nervosa; pharmacological treatment; atypical antipsychotics; olanzapine; risperidone; paliperidone; aripiprazole; quetiapine”. Reviews and RCT were also analyzed.

Results

No strong evidence of beneficial effects was found in using SGA in adults. The majority of studies focused on olanzapine, which seems to have, in some studies, only positive effect on body mass index, eating disorder symptoms and functional impairment. Risperidone doesn’t seem to have effect on body mass index. Olanzapine and risperidone increase the mean fasting glucose and insulin levels. In a recent study the main finding is represented by the positive effects of the adjunct of aripiprazole to antidepressants on eating-related obsessive-compulsive symptomatology.

Conclusions

In conclusion, in our review we observed that research in treatment with SGA of AN is still far away from finding univocal conclusions.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
A peripheral composite proteomic and gene expression biomarker related to diagnosis and affective state in rapid cycling bipolar disorder
Authors: Munkholm K. , Vinberg M. , Kessing L.V.
Published: May 2016

Introduction

Management of bipolar disorder is limited by absence of laboratory test. While alterations related to multiple biological pathways have been found in bipolar disorder, findings have not translated into clinically applicable biomarkers. We previously found promise for a combined gene expression biomarker. The combination of gene expression and proteomic biomarkers could have potential as a meaningful clinical test.

Objectives

To identify a composite biomarker based on multiple potential peripheral biomarkers related to neuroplasticity, inflammation and oxidative stress, both on a proteomic and gene expression level.

Aims

To test the ability of a composite biomarker to discriminate between bipolar disorder patients and healthy control subjects and between affective states in bipolar disorder patients.

Methods

mRNA expression of a set of 19 candidate genes and protein levels of immune markers and neurotrophic factors were measured in peripheral blood mononuclear cells and combined with urinary levels of oxidized nucleosides of 37 rapid cycling bipolar disorder patients in different affective states (depression, mania and euthymia) during a 6–12-month period and in 40 age- and gender-matched healthy control subjects. A composite measure was constructed in the first half of the sample and independently validated in the second half of the sample. The composite measure was evaluated using ROC curves and by calculating sensitivity and specificity.

Results

Statistical analysis is ongoing. Results will be presented at the congress.

Conclusions

A peripheral composite biomarker based on multiple biological pathways on both proteomic and gene expression levels may have potential as a clinically applicable biomarker.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Eating Disorders: How Can It Be Detected?
Authors: Silvia C.F. , Cano Ruiz P. , Gómez Peinado A.
Published: May 2016

Introduction

Disorders of eating behavior can affect all people regardless of socioeconomic or cultural situation. More common in females (90-95%), has its peak incidence in adolescence. These are processes that can subtly start and go unnoticed at first.

Objective

To analyze the clinical, epidemiological, diagnostic approach of the disorder, evolution and treatment of disordered eating behavior.

Methods

Review of the subject and recent articles on eating behavior disorders in Psychiatric guides and magazines.

Results

The eating behavior disorders arise as a result of three factors: predisposing, precipitating and perpetuating. We must take into account the genetics and family history, dissatisfaction with body weight resulting in a restriction of diet and multi-disciplinary consequences of this disorder (physical, psychological and social) as perpetuating factors. We consider the coexistence of comorbidity between disordered eating behavior and personality disorders, mood disorders (depression) and disorders of impulse control.

Conclusions

Eating behavior disorders represent a major health problem that threatens the patient's life. Very important are the rapid detection of the same and the establishment of treatment. Treatment should be multidisciplinary with the patient and family, providing information on the approach to the patient, taking into account the lack of awareness of disease that often exists in patients.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Early Identification of Language and Behavioral Deficits for Psycho-educational Intervention as a Public Policy
Authors: Varanda C. , Mendes E.C. , Campina N. , Aulicino M.D.G. , Nascimento R.D.C.G. , Grilo K.R. , Marczak C.M. , Diogo E.C. , Mello F. , Corrêa R.C. , Fernandes F.D.M.
Published: May 2016

The impact of educational public policies in developing countries such as Brazil is determinant in the improvement of socioeconomic outcomes as well as in the increase of individual's well-being.

This research aimed to study the effects of early detection and intervention in language and behavioral difficulties among 3–4-year-old preschoolers in Brazil. It was designed as a pretest–posttest model with a total of 178 subjects, 90 girls and 88 boys, divided in control (n = 94) and experimental groups (n = 84), with average age of 3.7 y. Children were evaluated in receptive and expressive vocabulary, central auditory processing and behavior. Subjects of the experimental group were engaged in intervention for three months for the development and refinement of language and behavior through activities developed in software used in tablets and orientation provided to their parents and teachers by a professional team composed by speech therapists, psychologists and psycho-pedagogues. The subjects improved their performance in all tests. There was a significant difference in the performance of behavioral and language tests in posttest, indicating that improvement was due to the intervention proposed. This research was supported by the Foundation for Research Support of the State of São Paulo (FAPESP) and Maria Cecilia Souto Vidigal Foundation (FMCSV) whose agreement aims to develop and support projects with potential application in society. These results are meant to guide the design of a project, which will allow the early identification of communication disorders and behavioral difficulties and the development of continuing education actions for the teachers.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Preventing Self-harm and Reducing Suicidal Ideation Through an Expedited Regular Supportive Psychotherapy and assertive Case Management – Protocol for a Three-arm Partial Randomised Controlled Trial
Authors: agyapong V. , Behre T. , Juhas M. , Greenshaw a.
Published: May 2016

aim

To conduct a three-arm partial randomised controlled trail to evaluate the effectiveness of expedited regular supportive psychotherapy and assertive case management for patients presenting with suicidal ideation or self-harm to the emergency department (ED).

Hypothesis

we expect expedited regular supportive psychotherapy plus assertive case management will reduce the suicidality and/or suicidal behaviour in patients by at least 20% at 4 weeks compared to patients receiving only assertive case management or routine care and these differences will be sustained at 6 months.

Methods

This will be a longitudinal, prospective, three-arm controlled single-rater-blinded partial randomized clinical trial with a recruitment period of 12 months and an observation period of 6 months for each participant. Patients in the intervention group will receive regular face-to-face or over the phone brief supportive psychotherapy during weekdays following presentation to the ED with suicidal ideation or self-harm until patients are actively enrolled in regular community mental health services with active case management by the therapist. Patients in the control and the assertive outreach arms will each receive the usual follow-up services offered routinely to regular patients and assertive outreach patients respectively who present to the ED with suicidal ideation or self-harm.

Results

Recruitment will commence in February 2016 and we expect the results of the study to be available by September 2017.

Conclusion

If our hypothesis is proved correct, our intervention will be a new model for caring for patients with self-harm and suicidal ideation and is expected to reduce suicide rates.

Disclosure of interest

The authors have not supplied their declaration of competing interest.